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    Do antibiotics contribute to postoperative ileus? Contractile responses of ileum smooth muscle in guinea pigs to long-term parenteral ceftriaxone and ampicillin
    (BLACKWELL PUBLISHING, 2006) Ceran, Canan; Karadas, Baris; Kaya, Tijen; Arpacik, Mehmet; Bagcivan, Ihsan; Sarac, Buelent
    Background: Antibiotics may impair small bowel smooth muscle contractility and contribute to postoperative ileus. The aim of this study was to compare the contractile responses of ileum smooth muscle to different agonists in guinea pigs treated with ceftriaxone (Rocephin; F. Hoffman-La Roche, Kaiseraugst, Switzerland) or ampicillin (Ampisina; Mustafa Nevzat Ilac Sanayii AS, Istanbul, Turkey). Methods: Twenty-four adult guinea pigs were randomly divided into three groups. Whereas eight of these received ceftriaxone sodium (100 mg/kg per day, i.m.) for 10 days, another eight guinea pigs received ampicillin (50 mg/kg per day, i.m.) for 10 days and the remaining eight served as the control group receiving 1 mL distilled water during 10 days as placebo. By the end of 10 days, the animals were killed and their ilea were excised. Ileum segments were placed in an organ bath; concentration-response relationship for carbachol and histamine were obtained by adding the reagent cumulatively to the bath. Results: pD(2) values being the same, maximum contractile responses (E-max) to carbachol and histamine were significantly reduced in the ceftriaxone sodium group compared with the control group. No significant differences in E-max and pD(2) values to carbachol and histamine were observed between the ampicillin group and the control group. Conclusion: These data indicate that whereas ceftriaxone may impair small bowel smooth muscle contractility, ampicillin does not. There are implications for the long-term use of parenteral antibiotics in the postoperative period.
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    Inflammatuar markers in the diagnosis of acute appendicitis
    (2002) Köylüo?lu, Gökhan; Arpacik, Mehmet; Arici, Sema; Ceran, Canan; Kivanç, Fügen
    Aim: To analyze the preoperative white blood cell count (WBC), C-reactive protein (CRP) concentration, fraction of neutrophil granulocytes (neutrophil count), and erythrocyte sedimentation rate (ESR), of the patients who were operated on for a clinical suspicion of acute appendicitis and who were separated into five groups with different findings at histopathologic examination. Method: 110 patients, who were operated on for suspected acute appendicitis in the last two years were evaluated prospectively. Blood was collected preoperatively from the patients for the measurement of serum CRP, WBC, ESR and neutrophil count. The histopathology of appendices were grouped into normal, grade 1, 2, 3 and 4 appendicitis. The relationship between inflammatory markers and histopathologic findings were examined. Results: In 10 (9%) of the 110 patients operated on, normal histopathologic findings were confirmed, in 13 (11.8 %) appendix was grade 1 (minor inflammation), in 29 (26.4%) appendix was grade 2 (inflammed), in 47 (42.8 %) appendix was grade 3 gangrenous and in 11 (10%) appendix was grade 4 (peforated). WBC was not amarker of increasing appendiceal inflammation. CRP increased markedly after appendiceal inflammation and increased gradually with histopathologic findings. Neutrophil count and ESR increased significantly after appendiceal inflammation but did not increase parallel to histopathologic findings. Conclusion: CRP level is an early marker of appendiceal inflammation and moreover repeated controls of the CRP concentrations may improve the accuracy of the diagnosing acute appendicitis.
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    Traumatic rupture of a pulmonary hydatid cyst: A case report
    (2006) Şahin, Ekber; Kaptano?lu, Melih; Nadir, Aydin; Ceran, Canan
    We present a case of traumatic hydropneumothorax due to hydatid cyst rupture in a 10 year-old girl. The patient was suspected to have a bronchial rupture because of prolonged massive air leak and she underwent cystotomy via right posterolateral thoracotomy. The patient was readmitted with dyspnea and chest X-ray revealed a lung collapse 13 months postoperatively. Lung collapse was treated by using a Heimlich valve. Pulmonary hydatid cyst can be asymptomatic for a long time unless a complication occurs. Because of the high incidence of hydatid disease in our country, this condition should be considered in cases with hydropneumothorax. The use of a Heimlich valve may be a good choice in the management of persistent air leak and may reduce the need for surgery.