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Biomedical subjects

Y Yavuz

Publications and source records attributed to Y Yavuz.

15 recordsLinked to original sources

Hemodynamic and tissue blood flow responses to long-term pneumoperitoneum and hypercapnia in the pig.

BACKGROUND: Increased peritoneal blood flow may influence the ability of cancer cells to adhere to and survive on the peritoneal surface during and after laparoscopic cancer surgery. Carbon dioxide (CO2) pneumoperitoneum is associated with a marked blood flow increase in the peritoneum. However, it is not clear whether the vasodilatory effect in the peritoneum is related to a local or systemic effect of CO2. METHODS: In this study, 21 pigs were exposed to pneumoperitoneum produced with either CO2 (n = 7) or helium (He) (n = 7) insufflation at 10 mmHg for 4 h, or to two consecutive levels of hypercapnia (7 and 11 kPa) (n = 7) produced by the addition of CO2 to the inhalational gas mixture. Tissue blood flow measurements were performed using the colored microsphere technique. RESULTS: Blood flow in peritoneal tissue increased during CO2, but not He, pneumoperitoneum, whereas it did not change at any level of hypercapnia alone. There was no change in blood flow in most organs at the partial pressure of CO2 (PaCO2) level of 7 kPa. However, at a PaCO2 of 11 kPa, blood flow was increased in the central nervous system, myocardium, and some gastrointestinal organs. The blood flow decreased markedly in all striated muscular tissues during both levels of hypercapnia. CONCLUSION: The effect of CO2 on peritoneal blood flow during laparoscopic surgery is a local effect, and not attributable to central hemodynamic effects of CO2 pneumoperitoneum or high systemic levels of CO2.

Animals↗

Ergonomic design criteria for a novel laparoscopic tool handle with tactile feedback.

Laparoscopic surgery has many ergonomic disadvantages often not considered in the design of instruments. The poorly designed surgical tools produce inconveniences in both functional and cognitive aspects; including tactile sensation and visual-motor space coordination. The aim of this article is to find out how laparoscopic handle design can be improved by combining classical ergonomic guidelines with tactile feedback related to handle design. The article briefly discusses how the human hand and hand-held tools are used to perform tasks. An ergonomic handle for laparoscopic grasping, with a built-in tactile sensation display, is presented. Our review of laparoscopic instruments reveals important aspects for handle design. It is concluded that there is a need for greater awareness of ergonomic guidelines for users' sensory requirements when designing and manufacturing laparoscopic instruments.

Equipment Design↗

Development of a total colonoscopy rat model with endoscopic submucosal injection of the cecal wall.

BACKGROUND: Experimental models of colorectal tumor require either laparotomy for induction or anastomosis following resection. The long murine cecum avoids the need for an anastomosis, making the cecum the preferred site for induction. This study aimed to evaluate total colonoscopy with submucosal injection of cecal wall (TCWI) in rats in terms of failure rate (FR), complication rate (CR), and reproducibility (R). METHODS: A bolus of bowel prep was given. Anesthesia was injected intraperitoneally. A video fiberscope (5.9 mm outer diameter, 180/90 degrees up/down bending, 100/100 degrees right/left bending, 103 cm working length, 120 degrees view field, and 2.0 mm channel) allowed for irrigation and suction. Saline 1 ml was injected in the cecal wall through a 4-mm-long, 23-gauge needle placed on a 3-mm wire, resulting in a blister. FR was a failure to reach and inject the cecum. Rats were allowed to recover. CR was measured at necropsy. R was assessed by comparing TCWI time, FR, and CR for three investigators. Sample size of 120 (type I error, 0.05; power, 80%) was based on a pilot study. Data are presented as median (range). RESULTS: A total of two of 122 rats (1.6%) died after prep or anesthesia. Bowel prep resulted in 99.1% evacuation of solid feces. A total of 120 male Sprague-Dawley retired breeders weighing 592 g (range, 349-780) underwent TCWI. Scope depth was 28 cm (range, 20-36). Irrigating fluid was 290 ml (range, 100-600). TCWI time was 7 min (range, 4-28). FR was 4%. In three failed cases, the scope reached the ascending colon. CR was 2%. There were two perforations in the ascending colon. All three operators had similar TCWI time (p = 0.673), FR (p > 0.1), and CR (p > 0.1). A total of 98.3% of rats survived to planned sacrifice. At 48-h necropsy, the injection site was macroscopically identified in 118 rats. CONCLUSIONS: A safe and reproducible TCWI rat model has been achieved, which may provide a valuable tool in the future for studies of solid colorectal tumors.

Animals↗

Effect of interleukin-10 on pancreatic damage caused by organophosphate poisoning.

Organophosphate poisoning is a common cause of severe morbidity and mortality in emergency departments. Acute pancreatitis is a frequently reported consequence of organophosphate poisoning, but preventing this potentially severe complication has not been the subject of much research. We tested whether interleukin-10, a cytoprotective agent, could prevent or diminish pathological signs of acute pancreatitis caused by organophosphate poisoning. Thirty rats were divided into three equal groups. Group 1 did not receive any agent during the experiment. Group 2 received 0.8 g/kg fenthion intraperitoneally, followed by 6 ml/kg intraperitoneal normal saline 30 min and 3 h later. Group 3 received 0.8 g/kg fenthion intraperitoneally, followed by 2 microg/kg of interleukin-10 intraperitoneally 30 min and 3 h later. All rats underwent laparotomy and thoracotomy while still under anesthesia at 6 h, and tissue samples were obtained from the pancreas. After blood samples were taken by cardiac puncture, the animals were sacrificed. Organophosphate poisoning resulted in significant elevations of serum amylase and glucose. Interleukin-10 significantly reduced pancreatic damage as determined by pathologic scoring, but not by enzyme elevations. Interleukin-10 should be considered for larger studies in other animal models to confirm its ability to decrease pancreatic damage after organophosphate poisoning treatment with interleukin-10.

Acute Disease↗

Image-guided laparoscopic surgery. Review and current status.

The main drawback with laparoscopic surgery is that the surgeon is unable to palpate vessels, tumours and organs during surgery. Further-more, the laparoscope only provides a surface view of organs. There is a need for more advanced visualizations techniques that can enhance the display presented to the surgeon so that important information below the surface of the organs is included when planning the procedure as well as for guidance and control during treatment. In this paper, we present a review of the literature and the state of art within image-guided laparoscopic surgery. We describe our own experience using a prototype navigation system for advanced visualizations and guidance during laparoscopic procedures in the retroperitoneum. Furthermore, we show sample images from the Future Operating Room for laparoscopic surgery in Trondheim, where this technology is being further developed and tested in clinical studies. Our system is based on three-dimensional navigation technology, i.e. preoperatively acquired magnetic resonance or computed tomography data used in combination with tracked instruments, allowing the surgeon to interactively control the display of images prior to and during surgery with normal use of the instruments. In summary, we believe that abdominal image navigation using tracked instruments and advanced visualizations has a large potential for improving future laparoscopic surgery, especially in cases where vessels and anatomical relations beyond surfaces is difficult to identify using only a laparoscope. The technology helps the surgeon to better understand the anatomy and locate blood vessels. Accordingly, we believe that this new technology could increase safety and make it easier for the surgeon to perform successful laparoscopic surgery.

Diagnostic Imaging↗

Effect of carbon dioxide pneumoperitoneum on tissue blood flow in the peritoneum, rectus abdominis, and diaphragm muscles.

BACKGROUND: Changes in local blood flow may play a role in the pathogenesis of port-site metastasis. This study aimed to investigate the effect of pneumoperitoneum induced by carbon dioxide (CO2) on the blood flow in the peritoneum and abdominal wall muscle layers, which are target structures for this phenomenon. METHODS: The study was performed on domestic farm swine of both genders weighing 20 to 25 kg. Intraabdominal pressures (IAP) of 0, 5, and 10 mmHg were produced by either CO2 ( n = 9) or helium (He) ( n = 6) insufflations. The colored microsphere technique was used to measure blood flow distributions in the parietal peritoneum, rectus abdominis, and diaphragm muscles. RESULTS: Insufflation of CO2 was associated with a threefold increase in blood flow of the parietal peritoneum at both 5 and 10 mmHg IAP ( p < 0.001 for both pressure levels). In contrast, insufflation of He caused a significant decrease in blood flow in the parietal peritoneum at both 5 and 10 mmHg ( p < 0.05). In the rectus abdominis and diaphragm muscles, blood flow remained unchanged after insufflation of CO2 at both 5 and 10 mmHg IAP. However, after insufflation of He, there was a substantial decrease in blood flow both in the rectus abdominis and diaphragm muscles at both 5 mmHg ( p < 0.01 and p < 0.05, respectively) and 10 mmHg ( p < 0.001 and p < 0.01, respectively). CONCLUSIONS: Despite high intraabdominal pressure, tissues surrounding the abdominal cavity, particularly the peritoneum, respond to insufflation of CO2 with increased blood flow, which may favor the growth of tumor cells.

Animals↗

Diagnostic value of serum cystatin C for evaluation of hepatorenal syndrome.

BACKGROUND: The evaluation of renal function in patients with decompensated cirrhosis is important for prognosis, dosage assessment of potentially nephrotoxic drugs and recognition of changes in glomerular filtration rate (GFR) to decide paracentesis and diuretic therapy. Patients with many different disorders of hepatic function can present with various abnormalities of renal function in the absence of other known causes of renal failure which has been called hepatorenal syndrome (HRS). Some reports have pointed out that serum creatinine levels frequently failed to rise above normal levels even when glomerular filtration rate (GFR) is very low in cirrhotic patients with hepatorenal syndrome. The aim of this study was to determine if estimation of serum cystatin C could replace creatinine clearance in routine GFR determinations for patients with cirrhosis. METHODS: Serum cystatin C, creatinine clearance (Clcr), and 99mTc-DTPA clearance were determined in 26 patients with cirrhosis. According to Child-Pugh's classification, 21 patients were in group C and 5 were in Group B. RESULTS: Pearson correlation analyses showed that correlation between serum cystatin C and 99mTc-DTPA clearance was r=-0.522, p=0.006, between serum creatinine and 99mTc-DTPA was r=-0.373, p=0.06. The results of our study demonstrated that neither serum creatinine nor creatinine clearance (Clcr) were good indicators of hepatorenal syndrome because the mean value for Clcr was found to be higher than Tc-DTPA clearance, and there was no correlation between these two parameters (r=0.059). Additionally, the mean value of serum creatinine was found to be within the normal range, whereas the mean DTPA clearance level was lower than normal range. CONCLUSIONS: This finding could be explained by the fact that cirrhotic patients with poor nutrition may have decreased protein intake, low muscle mass and lack of converting capacity of creatine to creatinine. Thus, we suggest that serum cystatin C assay, which has good analytical performance, could replace or at least be added to creatinine measurement for GFR assessment in patients with cirrhosis.

Adult↗

Effect of increased intraabdominal pressure on cardiac output and tissue blood flow assessed by color-labeled microspheres in the pig.

BACKGROUND: Studies of the hemodynamic effects associated with the pneumoperitoneum have had controversial results. We set out to investigate the effect of increased intraabdominal pressure (IAP) on cardiac output and tissue blood flow in various intraabdominal and extraabdominal organs using the color-labeled microsphere (CLM) technique. METHODS: IAP was induced by CO2 insufflation in anesthetized pigs; 0, 5, and 10 mmHg was used in the low-pressure group and 0, 15, and 24 mmHg in the high-pressure group. Tissue blood flow (ml.min-1.g-1) and cardiac output (CO) (ml/min) were determined by the CLM technique. RESULTS: CO decreased at IAP > or = 15 mmHg. Arterial PaCO2 and hydrogen ion concentration increased in response to all levels of IAP. Arterial PaO2, oxygen saturation, and bicarbonate ion concentration remained unchanged. Low IAP did not influence tissue blood flows in most of the organs. However, in the spleen, pancreas, esophagus, and gastric mucosal specimens, tissue blood flow was significantly decreased at 24 mmHg. CONCLUSION: The level of IAP used in current practice (10-12 mmHg) appears to be safe with regard to hemodynamic variables and tissues blood flow; however, higher levels may induce a decrease in cardiac output and tissue blood flow.

Animals↗

A comparative experimental study evaluating the performance of surgical robots aesop and endosista.

The aim of this study was to experimentally assess and compare the accuracy of the surgical robots Aesop and Endosista as camera holders for use in laparoscopic surgery. The performance of these two robotic systems was examined for linear (upwards, downwards, diagonal), complex, and "in and out" movements using laparoscopic training boxes. Standard distances and tests were used for each system, and the time required to achieve each task was measured. The majority of the linear movements of the verbal and preprogrammed modes of Aesop were quicker than those of Endosista. Diagonal movements were significantly faster with the preprogrammed-mode Aesop. Complex or three-dimensional movements were also significantly faster with both modes of Aesop than with Endosista. Under the experimental conditions, Aesop, particularly in the preprogrammed mode, is quicker and more accurate than Endosista.

Evaluation Studies as Topic↗

The effect of antioxidant therapy on colonic inflammation in the rat.

Under normal physiological conditions, chemical and antioxidant defenses protect tissues from the damaging effects of reactive oxygen metabolites (ROM). It has been proposed that ROMs are involved in the development of tissue injury in many inflammatory diseases and also in patients with colitis. In the present study we aimed to investigate the effects of antioxidant therapy on the extent of colonic inflammation and ROM levels in the injured tissues in a trinitrobenzene sulfonic acid-induced colitis model in the rat. Sprague-Dawley rats were pretreated with the antioxidants superoxide dismutase (30,000 U/kg s.c.) or catalase (400,000 U/kg s.c.) prior to induction of colitis and they were decapitated 24 h (acute group) or 6 days (chronic group) after the induction of colitis (each group consists of eight to ten rats). Pretreatment with the antioxidants reduced the macroscopic damage score significantly in both acute and chronic groups compared with untreated colitis groups, whereas they reduced the microscopic damage score and colonic wet weight only in the chronic group. The chemiluminescence assay - a technique to assess the presence of reactive oxygen species in the tissues - values of the groups pretreated with the antioxidants showed a tendency to decrease compared with the untreated colitis group, but they were not statistically significant. Based on these findings, pretreatment with the antioxidants superoxide dismutase or catalase has beneficial effects on the extent of colonic inflammation, particularly in the chronic period, and this may support the importance of antioxidant therapy to reduce the severity of inflammatory bowel disease in humans.

Animals↗

Comparison of infertility rates in communities from boron-rich and boron-poor territories.

As a part of a large-scale work aimed at studying the health effects of boron (B) in residents of a country with the world's largest supply, developmental effects of B are presented. Spontaneous abortions, stillbirths, and congenital malformations in addition to early infant mortality were questioned in the field by home visits. Although the number of families so far ascertained is rather small, the rates related to spontaneous abortions and stillbirths from high B exposure vs low B exposure subpopulations revealed no differences of significance, providing no evidence that B affects human development adversely.

Abortion, Spontaneous↗

Electroadsorption of acilan blau dye from textile effluents by using activated carbon-perlite mixtures.

The feasibility of the removal of dye stuffs from textile effluents by electroadsorption has been investigated. An activated carbon-perlite mixture with a ratio of 8:1 for bipolarity has been used as the adsorbent. Conventional adsorption experiments have also been conducted for comparison. A bipolar trickle reactor has been used in the electroadsorption experiments. The model wastewater has been prepared by using acilan blau dye. Initial dye concentration, bed height between the electrodes, applied potential, flowrate, and the supporting electrolyte concentration have been examined as the parameters affecting the removal efficiency. A local textile plant effluent has been treated in the optimum values of these parameters obtained from the experimental studies. Adsorption kinetics and the amount of adsorbent required to reach the maximum removal efficiency have also been investigated and mass-transfer coefficients have been calculated for adsorption and electroadsorption. The results showed that a removal efficiency of up to 100% can be achieved with energy consumption values of 1.58 kWh/m3 of wastewater treated. However, energy consumption decreases to 0.09 kWh/m3 if an exit dye concentration of 4.65 mg/L is accepted. It can be concluded from this work that this method combines all of the advantages of the activated-carbon adsorption and electrolytic methods for the removal of dyes from wastewater.

Adsorption↗