Browsing by Author "Yentur, EA"

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    Neurotoxicity of chronic epidural somatostatin administration in rabbits
    Tekin, I; Mirzai, H; Yentur, EA; Ates, U; Baka, M; Yurtseven, M
    The central administration of somatostatin (SMS) in humans became a subject of controversy on the issue of potential neurotoxicity on the spinal cord. The study was aimed at the assessment of the neurodegenerative effects of chronic epidural SMS administration in rabbits. Rabbits were randomly assigned to two groups: the SMS and the control group. The SMS group received 100 mug SMS and the control group received isotonic saline by epidural catheter for 15 consecutive days. Then, laminectomy was performed and the spinal cord was removed. Light and electron microscopic examinations were performed. In the control group, a mild dural inflammatory response and in the SMS group, loss of Nissl bodies at the pericarion, chromatolysis and shrinking at nucleus membranes were observed in all animals at different degrees in light microscopy. In electron microscopy, mitochondrial swellings, irregularities in both nucleus and cell membrane, splitting at myelin lamellae, degeneration at myelin sheath and shrinking of axolemma were found in the SMS group. Our results showed the neurotoxic effects of chronic administration of SMS in rabbits both in light and electron microscopy even in a quite low doses. However, there were no significant clinical findings for the neurological effects during long term follow up.
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    Repeated epidural injections of ketamine with preservative benzethonium chloride produce evidence for neurotoxicity in rabbits
    Yentur, EA; Mirzai, IT; Mirzai, H; Ates, U; Baka, M; Yurtseven, M
    Background and objectives: In this study, we investigated whether repeated doses of 1% ketamine with preservative benzethonium chloride, administered into the epidural space of the rabbit, caused direct neurotoxicity. Methods: Twelve rabbits were randomly assigned to two groups (ketamine and control). After the animals were anesthetized, lumbar epidural catheters were placed for repeated epidural drug delivery. The ketamine group received 1% ketamine with preservative benzethonium chloride (0.5 ml) and the control group received isotonic saline (0.5 ml) once a day for 14 consecutive days. The day after the last injection, the animals were reanaesthetized, the left and right ventricles were cannulated and perfused with 2% glutaraldehyde, 1% formaldehyde mixture, in 0.1 mol/l phosphate buffer. Then, laminectomy was performed. A five centimetre segment of the spinal cord was removed and examined by light and electron microscopy to observe possible histological changes. Microscopic examinations were performed by coding each animal by a neuro-histologist who was blinded as to the source of each specimen. Results: Ketamine-treated rabbits showed significant histological changes at light and electron microscopy findings compared with the control group (p < 0.05). Conclusions: These changes suggested a neurotoxic effect of ketamine with preservative benzethonium chloride following chronic epidural administration.
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    Seizures, metabolic acidosis and coma resulting from acute isoniazid intoxication
    Topcu, I; Yentur, EA; Kefi, A; Ekici, NZ; Sakarya, M
    Isoniazid is an anti-tuberculosis drug, used commonly for treatment and prophylaxis of tuberculosis. Acute isoniazid intoxication is characterized by a clinical triad consisting of metabolic acidosis resistant to treatment with sodium bicarbonate, seizures which may be fatal and refractory to standard anticonvulsant therapy, and coma. Treatment requires admission to the intensive care unit for ventilatory support, management of seizures and metabolic acidosis. Pyridoxine, in a dose equivalent to the amount of isoniazid ingested, is the only effective antidote. We report the successful treatment of two isoniazid intoxication cases: the case of a child developing an accidental acute isoniazid intoxication and an adult case of isoniazid intoxication with the intent of suicide.
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    The effect of epidural and general anesthesia on newborn rectal temperature at elective cesarean section
    Yentur, EA; Topcu, I; Ekici, Z; Ozturk, T; Keles, GT; Civi, M
    Both epidural and general anesthesia can impair thermoregulatory mechanisms during surgery. However, there is lack of information about the effects of different methods of anesthesia on newborn temperature. The purpose of this study was to determine whether there are differences in newborn rectal temperature related to type of anesthesia. Sixty-three pregnant women were randomly assigned to receive general or epidural anesthesia. Maternal core temperature was measured three times with a rectal probe just before anesthesia, at the beginning of surgery and at delivery. In addition, umbilical vein blood was sampled for pH. The rectal temperatures of the babies were recorded immediately after delivery, and Apgar scores were determined 1, 5, and 10 min after birth. The duration of anesthesia and the volume of intravenous fluid given during the procedure (833 +/- 144 vs 420 +/- 215 mL) were significantly higher in the epidural group than in the general anesthesia group (P < 0.0001). Maternal rectal temperatures were not different in both groups at all measurements. In contrast, newborn rectal temperatures were lower in the epidural anesthesia group than in the general anesthesia group (37.4 +/- 0.3 vs 37.6 +/- 0.3 degrees C; P < 0.05) immediately after birth. Furthermore, the umbilical vein pH value (7.31 +/- 0.05 vs 7.33 +/- 0.01; P < 0.05) and Apgar scores at the 1st-min measurement (8.0 +/- 0.9 vs 8.5 +/- 0.7; P < 0.05) were lower in the epidural anesthesia group than in the general anesthesia group. Since epidural anesthesia requires more iv fluid infusion and a longer time for cesarean section, it involves a risk of a mild temperature reduction for the baby which, however, did not reach the limits of hypothermia.
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    Is skin disinfection with 10% povidone iodine sufficient to prevent epidural needle and catheter contamination?
    Yentur, EA; Luleci, N; Topcu, I; Degerli, K; Surucuoglu, S
    Background and Objectives: Epidural space infection is a potential complication of epidural catheter placement. in this study, we investigated the incidence of epidural needle and catheter contamination after skin surface disinfection with 10% povidone-iodine (PI). Methods: Sixty seven patients having surgery under epidural anesthesia were enrolled in this prospective study. After preparation with 10% PI, skin swab cultures were taken from the site of catheter insertion. Epidural needles were cultured immediately after epidural catheters were placed. Catheters were removed at 48 hours and 2 to 3 cm of the distal tips were cultured as well. Results: Fifty-six skin swabs, 52 epidural needles, and 48 catheters were cultured. Although only 3.5% (2) colonization was observed on skin surface cultures, 34.6% (18) of the epidural needles and 45.8% (22) of the catheters were colonized. No systemic or local infection was observed. Conclusion: Our results suggest that despite skin surface disinfection with PI, there is still significant risk for contamination of needles and catheters during epidural catheterization.