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Öğe Accessory spleen presenting as mass in the left upper abdomen(College Physicians & Surgeons Pakistan, 2008) Yağmur, Yusuf; Öztürk, HayrettinAn enlarged accessory spleen, 10 x 8 x 6 cm in diameter, adjoining the spleen appearing as a mass on CT and ultrasonography is reported herein. Accessory spleen is an ectopic mass of healthy splenic tissue separate from the main body of the spleen. It should be considered the differential diagnosis of an enlarged mass in the left upper quadrant.Öğe Continuous infusion of small-volume fluid resuscitation in the treatment of combined uncontrolled hemorrhagic shock and Head Injury(College Physicians & Surgeons Pakistan, 2007) Öztürk, Hayrettin; Yağmur, Yusuf; Taş, Aşkın; Topçu, Soykan; Orak, MuratObjective: To determine-the effect of continuous limited fluid resuscitation on the hemodynamic response and survival in rats in a model of uncontrolled hemorrhage shock due to Massive Splenic Injury (MSI) and Head Injury (HI). Design: An experimental study. Place and Duration of Study: Dicle University Animal Research Laboratory, Turkey, between January and February 2005. Subjects and Methods: Seventy Sprague-Dawley rats were used in this study. Group 1 rats (n=10) was sham-operated. In group 2 (n=10), only Massive Splenic Injury (MSI) was performed and untreated. In group 3 (n=10), only head injury (HI) was performed and untreated. In group 4 (n=10), HI and MSI were performed and were untreated. In group 5 (n=10), HI and MSI were performed and 15 minutes later treated with 7.5% NaCl. In group 6 (n=10), HI and MSI were performed, and rats were treated with Ringer's Lactate (RL) solution. In group 7 (n=10), HI and MSI were performed, rats were treated with 0.9% NaCl. In groups 2,4,5,6 and 7 midline incision was reopened and splenectomy was performed at 45 minutes. Results: In group 4 rats, Mean Arterial Pressure (MAP) was decreased from 104 +/- 6.1 mmHg to 75 +/- 19.5 mmHg at 15 minutes; heart rate decreased from 357 +/- 24.9 beats/min to 321 +/- 62.1 beats/min and hematocrit decreased from 46 +/- 1.3% to 43 +/- 2.5% (p<0.01). Similar early changes in MAP, heart rate and hematocrit were observed in groups 5, 6, and 7, at 15 minutes. At 45,60 and 120 minutes, in fluid resuscitated rats (group 5,6,7) MAP, heart rate and hematocrit values were measured higher than group 2 and 4 (p<0.01 for all). At 120 min. in group 6, hematocrit was higher than group 4, 5 and 7, in group 6, total blood loss after splenectomy was calculated at 20 +/- 2.4% of blood volume and was the best value compared to other fluid resuscitated group 5 and 7 (28% and 27% of blood volume) (p<0.01). Mortality was lower in all fluid resuscitated groups when compared to group 3 and 4 (p<0.05). The median survival time was again higher in fluid resuscitated groups. Conclusion: Continuous infusion of 7.5% NaCl, RL and 0.9% NaCl following uncontrolled hemorrhagic shock with massive splenic injury and combined head injury resulted in better survival and RL did not increase abdominal bleeding before splenectomy was performed.Öğe Distal ileal perforation secondary to ingested foreign bodies(Coll Physicians & Surgeons Pakistan, 2009) Yağmur, Yusuf; Öztürk, Hayrettin; Öztürk, HülyaA 22-year-old man was admitted with abdominal pain, nausea and vomiting secondary to ingestion of multiple foreign bodies. He was found to be in increasing distress with an increase in abdominal pain and distention and no passage of foreign bodies. Patient underwent a laparotomy. Foreign bodies removed from perforated distal ileum included 8 big size (10 cm) plastic clothes pegs, a 10 cm pencil, couple of stones, a 10 cm wood nail, nail scissors and a small size battery. In case of foreign body ingestion, especially in mentally-ill patients, the patient should be carefully examined because of the potential risk of obstruction and bowel perforation, more so, if the foreign body is a battery which can puncture causing corrosive injury as well.Öğe Intestinal ischemia, bacterial translocation, and oxygen free-radical production in abdominal compartment syndrome(Wroclaw Medical Univ, 2009) Yağmur, Yusuf; Öztürk, Hayrettin; Güloğlu, Cafer; Geyik, Mehmet Faruk; Öztürk, Hülya; Mete, FatihObjectives. The aim of this experimental study was to evaluate the consequences of increased intra-abdominal pressure on the small bowel and whether this pressure creates intestinal ischemia leading to oxygen free-radical production and bacterial translocation. Material and Methods. Twenty Sprague-Dawley rats weighing 275-300 g were used. Group 1 rats (n = 10) were subjected to 20-mm Hg pneumoperitoneum pressure for 60 minutes. In group 2 rats (n = 10, controls) the intra-abdominal pressure was not increased. In all rats the following parameters were investigated: mean arterial pressure after carotid catheterization, histopathological examination of the intestinal mucosa evaluated with a scoring system, malondialdehyde production in the liver and small bowel, and bacterial translocation towards the mesenteric lymph nodes, liver, and spleen 24 hours after pneumoperitoneum deflation. Results. The mean arterial pressure exhibited no alterations. Histological analysis mainly showed extensive epithelial separations from the lamina propria down the sides of the villi and ulceration at the villus tips in the rats with increased intra-abdominal pressure. Bacterial translocation occurred to the mesenteric lymph nodes, spleen, and liver after 60 minutes of increased intra-abdominal pressure of 20 mm Hg (p < 0.05). Malondialdehyde increased in the liver and small bowel mucosa (p < 0.05 for both). Conclusions. Increased intra-abdominal pressure in rats leads to intestinal ischemia and mild histological changes in the small bowel and to oxygen free-radical production and bacterial translocation (Adv Clin Exp Med 2009, 18, 2, 115-120).Öğe The prognostic importance of serum IL-1 beta, IL-6, IL-8 and TNF-alpha levels compared to trauma scoring systems for early mortality in children with blunt trauma(Springer Verlag, 2008) Öztürk, Hayrettin; Yağmur, Yusuf; Öztürk, HülyaThe purpose of the present study was to determine whether a correlation exits between the main trauma scoring systems and the activation of inflammatory cells and mediators such as interleukin-(IL-) 1 beta, IL-6, IL-8 and tumor necrosis factor alpha (TNF-alpha) after trauma, and moreover to assess if any of these can be used to predict the outcome in patients under care at a trauma center. Forty-seven children (37 boys, 10 girls) presenting with blunt trauma, were evaluated by an analysis of the relationship between overall mortality and potential risk factors. Admission data, including serum IL-1 beta, IL-6, IL-8, TNF-alpha, pediatric trauma score (PTS), and injury severity score (ISS), were collected and analyzed. In descriptive statistics for independent variables, some prognostic factors such as IL-8 (P = 0.04), and ISS (P = 0.004) were significant in their relationship to mortality. In the univariate statistical analysis some other risk factors such as IL-8 (P = 0.004), > 20 TNF-alpha (P = 0.04), and ISS (P = 0.007) were significant in their relationship to mortality. The relative risk of developing mortality was higher than two for each of the following risk factors: > 10 ages, > 25 IL-6, 10-20 TNF-alpha, > 20 TNF-alpha, PTS <= 8, and ISS > 15. There was a positive correlation between IL-8 (r = 0.31, P = 0.33), ISS (r = 0.31, P = 0.0001), and mortality. There was also a correlation with ISS and IL-8 (r = 0.32, P = 0.02). ISS, and the serum IL-8 level are the most important determinants of clinical outcome in critically injured patients. A correlation exits between IL-8 and mortality and between ISS and IL-8.
