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Biomedical subjects

K Yorganci

Publications and source records attributed to K Yorganci.

11 recordsLinked to original sources
PubMed2002

In vitro evaluation of the antibacterial activity of three different central venous catheters against gram-positive bacteria.

The aim of this study was to evaluate the activity of three different catheters against Staphylococcus aureus ATCC 29213 and the slime-producing Staphylococcus epidermidis ATCC 35984 (RP62A). Three central venous catheters were evaluated: one impregnated with silver sulfadiazine-chlorhexidine, one to which minocycline/rifampin is bonded and a novel one into which silver, platinum and carbon are incorporated. A nonantiseptic catheter was used as the control catheter. One-centimeter trisected pieces of catheter were immersed in phosphate-buffered saline (0.01 mol/l) with 0.25% dextrose and incubated. On days 1, 3, 7, 14 and 21, a 1 ml standardized inoculum was added for 30 min and then replaced with phosphate-buffered saline with 0.25% dextrose. One-third of the samples were immediately sonicated and plated to determine bacterial adherence. The remaining segments were incubated for 4 and 24 h to determine the persistence of bacterial adherence. Bacterial adherence to the catheters impregnated with silver sulfadiazine-chlorhexidine was reduced 91-98% for the first 7 days. Adherence of Staphylococcus aureus to catheters into which silver, platinum and carbon are incorporated was reduced 70% on day 1 and 35% on day 3. Adherence to minocycline/rifampin-bonded catheters was quite variable. There was an 85.6-99.8% reduction in the persistence of bacterial adherence to the three catheters compared to controls. Bacteriostatic and bactericidal studies indicated that the effluents from the catheters impregnated with silver sulfadiazine-chlorhexidine were bactericidal, while effluents from the minocycline/rifampin-bonded catheters were bacteriostatic. The antibacterial activity of the effluents from catheters impregnated with silver sulfadiazine-chlorhexidine dissipated by day 7, while the activity of effluents from the minocycline/rifampin-bonded catheters continued to show activity at day 21. No measurable antibacterial activity was detected in the effluents of the catheters into which silver, platinum and carbon are incorporated. These data suggest that catheters coated with antibiotic/antibacterial agents and the novel catheters that incorporate antiseptic agents have different activities against initial bacterial adherence. All of them, however, effectively prevent bacterial colonization by gram-positive bacteria.

Anti-Bacterial Agents↗
PubMed2001

Effects of aminoguanidine and N(omega)-nitro-L-arginine methyl ester on vascular hyporeactivity induced by endotoxaemia.

OBJECTIVE: To investigate the effects of endotoxaemia on the reactivity of the aortic bed in rats, and to compare the effects of the nitric oxide (NO) synthase inhibitors aminoguanidine and N(omega)-nitro-L-arginine methyl ester (L-NAME), on endotoxaemia-induced changes in vascular reactivity. DESIGN: Randomised experiment. SETTING: University laboratory, Turkey. SUBJECTS: 54 Wistar rats. INTERVENTIONS: Rats were divided into control (n = 24) and endotoxaemia (n = 30) groups and were treated with an intraperitoneal injection of saline (control) and lipopolysaccharide (20 mg/kg), respectively. Subgroups of control and endotoxaemic rats were given either aminoguanidine or L-NAME by the same route. MAIN OUTCOME MEASURES: Contractile responses to phenylephrine and relaxation responses to acetylcholine 4 hours after treatment. RESULTS: Incubation with aminoguanidine and L-NAME potentiated the phenylephrine-induced contractile response and inhibited acetylcholine-induced relaxation in aortic rings in the control group. The vascular responses to phenylephrine and acetylcholine were less pronounced in the endotoxaemia group, and in vitro incubation with aminoguanidine and L-NAME partially restored the contraction induced by phenylephrine but did not affect the impaired response to acetylcholine. Aminoguanidine given in vivo prevented the impairment of vascular responses to both phenylephrine and acetylcholine whereas L-NAME gave no such protection. CONCLUSION: Aminoguanidine acted similarly to L-NAME when incubated with the tissues in vitro, and did not show selectivity to inducible compared with constitutive isoforms of NO synthase. The finding that aminoguanidine but not L-NAME, prevented the endotoxin-induced impairment of vascular reactivity when administrated in vivo, therefore, suggested a role other than inhibition of NO synthase.

Acetylcholine↗
PubMed2001

Laparoscopic double cholecystectomy.

Gallbladder anomalies, although rarely seen, can be a challenge to the surgeon. There are many cases in the literature in which double gallbladder has been missed at the first operation. A case in which accessory gallbladder was suspected, confirmed at the operation, and managed successfully by laparoscopic cholecystectomy is described. The lack of specific symptoms and findings and the inaccuracy of imaging methods may cause missed diagnoses. The laparoscopic surgeon should always be aware of this abnormality.

Cholecystectomy, Laparoscopic↗
PubMed2000

Effect of local and remote ischemia-reperfusion injury on healing of colonic anastomoses.

BACKGROUND: Although the effect of locally applied ischemia-reperfusion (I-R) injury on gastrointestinal anastomoses has been studied, to our knowledge there is no previous study that investigates the effect of remote I-R injury on gastrointestinal anastomotic healing. The aim of this study was to investigate and compare the effects of local I-R injury and remote I-R injury on the healing of colonic anastomoses. METHODS: Anastomosis of the right colon was performed in 30 rats that were divided into 5 groups. Group 1 was the control group. In Group 2, I-R was applied to the colonic segment containing the anastomosis. Unilateral lower extremity I-R, unilateral renal I-R, and segmental small intestinal I-R was applied to the rats in Groups 3, 4, and 5, respectively, at the same time as colonic anastomosis. On the fourth postoperative day, animals were killed and bursting pressure and tissue hydroxyproline concentration of the anastomoses were analyzed and compared. RESULTS: The mean bursting pressure values were: 143 mm Hg in Group 1, 40.8 mm Hg in Group 2, 82.8 mm Hg in Group 3, 46.1 mm Hg in Group 4, and 52.3 mm Hg in Group 5 (P <.0001; 1-way analysis of variance). Mean tissue hydroxyproline concentration values were: 5.3 microg/mg in Group 1, 1.6 microg/mg in Group 2, 2.2 microg/mg in Group 3, 1.3 microg/mg in Group 4, and 1.5 microg/mg in Group 5 (P <. 0001, 1-way analysis of variance). Bursting pressure and tissue hydroxyproline concentration values had a good correlation r = 0.86, P <.001, Pearson correlation analysis). CONCLUSIONS: This study showed that I-R injury is a systemic phenomenon, and remote organ I-R can significantly delay anastomotic healing. This has to be kept in mind when constructing an intestinal anastomosis in the presence of local or remote I-R injury.

Anastomosis, Surgical↗
PubMed2000

Detrimental effects of nitric oxide on mesenteric circulation during endotoxaemia and its reversal by aminoguanidine.

OBJECTIVE: To investigate the effect of endotoxaemia on rat mesenteric vascular bed and plasma nitrite concentrations, the possible beneficial effect of aminoguanidine (the selective inducible nitric oxide synthase inhibitor) compared with N(G)-nitro-L-arginine methyl ester (L-NAME) (non-selective nitric oxide synthase inhibitor). DESIGN: Randomised experiment. SETTING: University surgical research laboratory, Turkey. SUBJECTS: 75 Wistar rats. INTERVENTIONS: Rats were divided into control (n = 30) and endotoxaemia (n = 42) groups. Endotoxaemia was produced by intraperitoneal injection of lipopolysaccharide 20 mg/kg. Subgroups were given either aminoguanidine or L-NAME. MAIN OUTCOME MEASURES: After 4 hours, isolated perfused mesenteric preparations were obtained and pressor responses to phenylephrine and vasodilatation responses to acetylcholine were evaluated, and plasma nitrite concentrations measured. RESULTS: Pressor response to phenylephrine did not alter but vasodilatation in response to acetylcholine was significantly reduced during endotoxaemia. Pretreatment with aminoguanidine prevented the impairment of the response to acetylcholine. However, L-NAME was ineffective. In the control group, aminoguanidine and L-NAME did not alter the vascular reactivity. The baseline plasma nitrite concentrations in the control group were increased 5-fold during endotoxaemia. This increase was significantly reduced with aminoguanidine but not with L-NAME. CONCLUSION: The protection achieved by aminoguanidine but not L-NAME suggested that nitric oxide produced by inducible nitric oxide synthase had a role in the impairment of endothelial response during endotoxaemia, and confirmed the importance of selective inducible nitric oxide synthase inhibition to achieve beneficial effects in endotoxaemia.

Acetylcholine↗
PubMed2000

An experimental study of the adhesive potential of different meshes.

OBJECTIVE: To assess the adhesive potential and incidence of incisional hernia with three meshes. DESIGN: Open experimental study. SETTING: Surgical Research Laboratory, Turkey. ANIMALS: 75 Wistar albino rats INTERVENTIONS: Abdominal walls were excised, and defects closed primarily or with polyglactin 910, polypropylene, or dura mater. Adhesions were graded and hydroxyproline concentrations measured on days 14 and 180. On day 180, the incidence of incisional hernia, and the grades of inflammation and fibrosis were also recorded. RESULTS: The polyglactin 910 group had a higher adhesion grading than the control and dura mater groups on day 14, whereas the polypropylene group had higher adhesion grading than controls. Both polypropylene and polyglactin 910 groups had significantly higher concentration of hydroxyproline than the control and dura mater groups. On day 180, the polypropylene group had a higher adhesion grading than the controls. There were no differences in hydroxyproline concentrations, incidence of hernias, or grading of fibrosis levels among the groups. CONCLUSION: Polyglactin 910 induced more fibrotic adhesions in the early postoperative period whereas polypropylene did in both the early and late postoperative periods.

Abdomen↗
PubMedDate not supplied

Missed malignancies during laparoscopic cholecystectomy.

BACKGROUND/AIMS: Laparoscopic cholecystectomy is now the treatment of choice for symptomatic gallstone diseases. However, besides its great benefits, perhaps the most disappointing complication of this operation is missed malignancies. In this study, patients who had missed malignancies that were diagnosed shortly after laparoscopic cholecystectomy were studied. We aim to find out the cause of missed and delayed diagnosis. METHODOLOGY: Between 1991 and June 1997, 9 patients undergoing laparoscopic cholecystectomy, which had been performed elsewhere 2-9 months earlier, and having had missed malignancy were included in this study. A diagnostic survey was collected from the medical records, questionnaires, and a semiological analysis. All laboratory data and physical findings, before and after laparoscopic cholecystectomy, were recorded. Follow-up data were obtained through a telephone questionnaire. RESULTS: Of these 9 patients, 6 had colorectal carcinoma and 3 had pancreas carcinoma. All patients complained of recent atypical pain at the time of laparoscopic cholecystectomy, except for 1 patient who had no symptomatic regression. CONCLUSIONS: It is necessary to make a careful semiological, physical and laboratory analysis of patients with cholelithiasis before especially laparoscopic cholecystectomy. Elderly patients, atypical biliary pain and associated symptoms must draw attention to the possibility malignancy.

Abdominal Pain↗
PubMedDate not supplied

Perforation of acute calculous Meckel's diverticulitis: a rare cause of acute abdomen in elderly.

Complications of the Meckel's diverticula are well-known and defined. However, acute inflammation and perforation secondary to a calculus is a rare clinical presentation. A case of acute calculous Meckel's diverticulitis with perforation in a 58-year old man is presented and possible pathological conditions are discussed. Location of the perforation, apical microscopic focal ulcers, and ischaemic changes in the diverticulum remind the pathogenesis comparable to that of acute calculous cholecystitis. This case report with major complications related to Meckel's diverticulum strengthens the concept of prophylactic resection of Meckel's diverticulum in adults, incidentally discovered at laparotomy.

Abdomen, Acute↗