The effects of amlodipine on the biochemical and histopathological changes in the rabbit ileum subjected to ischemia-reperfusion.

OBJECTIVE: The aim of this study was to determine the potential, protective effects of amlodipine in an experimental, ischemia-reperfusion (I/R) model in the rabbit small intestine. MATERIALS AND METHODS: The rabbits were divided into four groups: sham-operated, amlodipine (10 mg/kg) + sham-operated, I/R, and I/R + amlodipine (10 mg/kg) groups. An intestinal I/R model was applied to the rabbits. The superior mesenteric artery was occluded for 1 h with an atraumatic vascular clamp and then was reperfused for 2 h. Animals in the amlodipine and I/R + amlodipine groups received the amlodipine by oral gavage. At the end of the 2-h-reperfusion period, the animals were sacrificed. RESULTS: Pretreatment with amlodipine significantly increased SOD activity and GSH levels to values close to those found in the serum from the I/R group. Rabbits in the I/R group showed high levels of serum MDA. Amlodipine pretreatment significantly reduced the serum MDA levels compared to the I/R group, although the MDA levels in the I/R + amlodipine group were still higher than in the sham-operated group. The I/R damage was ameliorated by amlodipine pretreatment, as evidenced by histopathological analysis. CONCLUSION: The present study is the first to report an attenuation of I/R-induced intestinal injury by the systemic administration of amlodipine.

[The disguised face of blast injuries: shock waves]. / Patlama yaralanmalarinin gizli yüzü: Sok dalgalari.

BACKGROUND: The increase in terrorist attacks has brought a profound and new knowledge of blast injuries. In order to improve our knowledge regarding the mechanisms of blast injuries, we analyzed the effects of shock waves. METHODS: 100 g TNT and 1000 g C4 were detonated and recorded by high-speed camera. Blast wind, shock wave and shrapnel speeds were calculated, and final condition of the target was examined. RESULTS: A flash ball appeared first followed by the shock wave. Finally, blast wind occurred and shrapnel was distributed. The macroscopic structure of targets was not affected by the shock wave but was affected by shrapnel and blast wind. Shock waves created a transparent ballistic gel inside the target mat by changing its microscopic structure. The speed of the shock wave was 6482-7194 m/sn and shrapnel speed was 1420-1752 m/sn. CONCLUSION: Shock waves especially affect the air-filled organs and cause lung injury, acute respiratory distress syndrome, and intestinal and eardrum perforation. Blast wind destroys targets due to its high speed and high density. The main cause of mortality is shrapnel injury. The high temperature created by the explosion causes thermal injuries. Being informed of the mechanisms of blast injuries will assist in providing better treatment. Additionally, consideration of all mechanisms of blast injuries will facilitate lower mortality and morbidity rates.

A new method for hepatic resection and hemostasis: absorbable plaque and suture.

OBJECTIVE: Blunt and penetrating hepatic injuries are conditions that are frequently encountered in emergency surgeries, and they involve high mortality morbidity. In the handling of such injuries, methods ranging from the application of simple cauterization and suturing for hemostasis to hepatic lobectomies, which might involve the removal of the greater part of the organ, have been defined. Due to the organ's fragility and susceptibility to bleeding, elective hepatic resections necessitate both surgical experience and technological equipment. Therefore, the demand still exists for an affordable and easy-to-use-method that could be applied by all centers. MATERIALS AND METHODS: To meet this demand, we have developed a method of hemorrhage control via sutures supported by absorbable plaques that provide effective compression and prevent the suture from cutting the tissue during the application of the sutures in the treatment of such fragile organs as the liver. In our method, we have achieved hemostasis by bilaterally compressing the tissue through strong ties after placing, on the part of the tissue on which the sutures are applied, absorbable and flexible plaques that prevent the suture from cutting the tissue during the application of a polyglactin suture to the solid organ. To prevent dislocation of the plaques, we have fastened the sutures by reeving them through the holes made in the plaques. RESULTS: We have demonstrated the success and the practicality of our method by applying it on four pigs; we experimentally inflicted hepatic injuries on two pigs, and we performed resection on the other two pigs. The hepatic hemorrhages we developed in both of the animals were successfully restrained by the use of our method. On the other hand, two resections were performed on the right and left lobes of the other two animals. There were no hemorrhages during the surgery, and the procedure took 45 minutes in total. No postoperative complications occurred. While the liver function test values were high on the seventh day, due to the operation, they were observed to be normal on the thirtieth day. After the laparotomies, performed six months later, we observed that the plaques as well as the sutures were absorbed and that the injured tissues were completely healed. Additionally, it was observed during the pathological examination that the tissues beneath the area of application were healed through fibrosis and that the liver had no other pathologies. CONCLUSIONS: In conclusion, we believe that the method can be safely used in hepatic resections or traumatic hemorrhages in the proper locations.

A novel laparoscopic suction device for applying precise aspiration during laparoscopic surgery: sponge-tip suction tube.

Aspiration of the intra-abdominal fluid and debris is usually needed during different stages of the operation. This is necessary to protect the intra-abdominal space from contamination and/or to remove blood or tissue fluids occurring during the operation. It is also essential for obtaining a clean surgical area. Aspiration of the intra-abdominal fluid is relatively more difficult in laparoscopic surgery because of the suctioning of the omentum and intestine with the aspirator. In this paper, we report on a new suction device (sponge tip suction tube; STST), which allows the surgeon easier suctioning of intra-abdominal fluid. STST has an additional sponge tip and air channel, which prevents the device from suctioning intra-abdominal organs, such as the intestine and omentum. We tested the efficacy of STST in a simulated intra-abdominal space, such as a large transparent plastic bag with fresh sheep intestine-omentum and with 2000 cc of physiologic saline solution and 14 mm Hg of air pressure. Whereas the suctioning of all the fluid was difficult and time consuming when the conventional suction unit was used, all of the saline solution was easily and quickly suctioned when STST was used. In conclusion, STST provides a safe, fast, and complete fluid extraction.

[Comparison of soft tissue and bone injuries caused by handgun or rifle bullets: an experimental study]. / Tabanca ve piyade tüfegi mermileri ile olusturulan yumusak doku ve kemik yaralanmalarinin karsilastirilmasi: deneysel çalisma.

OBJECTIVES: The aim of this study was to investigate the factors that influence the severity of soft tissue and bone injuries occurring in gunshot traumas and to compare the effects of handgun and rifle bullets on these injuries. METHODS: Sixteen tissue simulants which were made of transparent gel candle blocks and calibrated to muscle tissue were targetted by pistol (9 mm parabellum) or military rifle (G-3) bullets. Half of the blocks contained fresh calf humerus bone. The effects of the bullets in tissue simulants were monitored by using high velocity cameras capable of taking 1,000 views per second. RESULTS: On a millisecond time scale, handgun bullets produced a small-sized temporary cavity while rifle bullets produced a wide temporary cavity in isolated soft tissue simulants. It was shown that the differences in the size of temporary cavities resulting from the blast effect correlated highly with the severity of injury occurring in soft tissues. In samples at which calf humerus bone was targetted, we observed that fragmentation and cavity effects correlated highly with the velocity of the bullet and determined the severity of injury. CONCLUSION: Experimental demonstration of differences in the size and severity of injuries caused by handgun or rifle bullets may have significant implications in the planning of treatment.