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Öğe A comparative study between adolescent and adult patients with pilonidal sinus disease(2021) Katı, Ömer; Kandur, Yaşar; Kaya, Murat; Güler, Ahmet Gökhan; Dalkıran, TahirObjectives: The main targets of the treatment modalities for pilonidal sinus are to prevent recurrences, and to increase the quality of life. It is unknown whether there is a different treatment trend in pediatric patients as compared with adults. In this study, we aimed to evaluate the surgical methods in pediatric and adult patients with pilonidal sinus. Material and Method: This retrospective study was conducted at the Departments of Pediatric Surgery and General Surgery Department of Necip Fazıl City Hospital, Kahramanmaraş from 2013 to 2017. A total of 66 pediatric patients and 68 adult patients were enrolled in this study. Results: The number of pediatric patients was significantly higher than adults in mean of flap closure (21 (31.8%) vs 2 (2.9%), p?0.01). However, primary closure was the most preferred method both in pediatric and adult patients, 45 (68.2%) pediatric patients and 63 (92.6%) adults. During a postoperative follow-up period of 1 month, 10 (15.2 %) pediatric patients and 12 (17.6%) adult patients developed wound infections (p=0.21). There was no significant difference between pediatric and adult patients with respect to mean recurrence rate (pediatric= 8 (%12.1) vs adult =9 (%13.2) (p=0.527)). Conclusion: We believe that pediatric surgeons should increase their interest in treatment options of PS disease since its prevalence increases in pediatric age group especially in adolescents in recent years. Besides, there was a female prepondarance in pediatric patiens.Öğe Apendektomi yapılan çocuklarda peritoneal sıvı kültürü elde edilecek olguların seçimi(2007) Soyer, Tutku; Türkmen, Feyza; Akman, Hülya; Kaya, Murat; Hançerlioğulları, Öymen; Cesur, Özkan; Çakmak, MuratAmaç: Apendektomi sırasında elde edilen peritoneal sıvı kültürlerinin (PSK) postoperatif takibe olan katkısı tartışmalıdır. Apendektomi yapılan çocuklarda PSK alınacak olguların seçimini belirlemek üzere prospektif bir çalışma planlanmıştır. Gereç ve Yöntem: Son bir yılda kliniğimizde apendektomi yapılan hastalar; yaş, cinsiyet, karın ağrısı süresi, akyuvar sayısı, peritoneal sıvı kültürü ve antibiyogramlan ile postoperatif komplikasyonlar açısından prospektif olarak incelenmiştir. Yaş, cinsiyet, karın ağrısı süresi, akyuvar sayısı ve olguların akut-perfore apendisit olması ile PSK sonuçları karşılaştınlmıştır. Tüm hastalar operasyon sonrası erken (l.ve 3. ay) ve geç (9 aydan sonra) komplikasyonlar açısından takip edilmiştir. Bulgular: Çalışmaya dahil edilen 33 hastanın yaş ortalaması 10 (5-15) yıl olup, kız erkek oranı 111.1'dir. Olguların % 63.6'sı akut (n:21), % 36.4'üperfore (n:12) apendisitdir. PSK'da üreme olmayan ve olan olgularda karın ağrısı süresinin ortancası sırasıyla 1 (1-1,24) gün ve 5 (3-10) gün olup, akyuvar sayısı ortancaları ise 13.350 (12.225-18.200) /mm3 ve 15.600 (15.400-27.800) /mm3'dür. Pozitif PSK olguları ile yanlız perfore apendisit .olguları ve karın ağrısı süresi ile ilişkilidir (p0.05, Mann Whitney-U testi). Perfore apendisit olgularında (n:7), akut apendisitlere (n:0) oranla pozitif PSK daha sıktır. (p0.05, ki-kare testi). Antibiyogramlara göre 3 hastada antibiyotik değişlikliği yapılmıştır. Akut apendisit grubunda postoperatif komplikasyona rastlanmazken, perfore apendisit olan hastaların 4'ünde (% 33.3) yara enfeksiyonu, 2'sinde adezif intestinal tıkanıklık (% 16.7) ve birinde (% 8.3) enterokutanöz fistül tespit edilmiştir. Sonuç: PSK perfore apendisit nedeniyle ameliyat edilen ve başvuru anında karın ağrısı 3 günden uzun süren hastalarda, postoperatif antibiyotik sağaltımını yönlendirmek amacıyla yapılabilir.Öğe Effect of paralysis of the abdominal wall muscles by botulinum A toxin to intraabdominal pressure: an experimental study(W B Saunders Co-Elsevier Inc, 2006) Çakmak, Murat; Cağlayan, Fatma; Somuncu, Salih; Leventoğlu, Alev; Ulusoy, Sevgi; Akman, Hülya; Kaya, MuratPurpose: To show the effect of botulinum A toxin-induced paralysis of abdominal muscles oil intraabdominal pressure. Material and Methods: Fifteen Sprague-Dawley rats were divided into 2 groups. An abdominal skin incision was done, and 2 catheters were placed for the pressure monitoring and saline infusion. Saline Solution was given to the abdomen until reaching to a pressure level of 9 cm H2O and 6 min Hg in pressure device, and the amounts of injected saline were recorded. Then intraabdominal saline was drained. Two milliliters (5 U/mL) botulinum A toxin was applied to the abdominal muscles in group 2. Saline was injected at the same points in same amounts in group 1. After 3 days, catheters were placed, and the saline volumes needed to obtain the same pressure levels were recorded for each rat. Spontaneous motor unit potential (MUP), single MUP analysis and interference patterns of the muscles, respiratory rates, and vascular pressure measurements were recorded before and after botulinum toxin (Botox) injections. Results: Mean intraabdominal saline volumes in the first and third days were 63.8 and 64.4 mL in group 1 and 67.6 and 80.6 mL in group 2, respectively. Mean MUP amplitude and duration of the rectus muscles in group 2 (17.1 mu V and 1.47 milliseconds) were significantly lower than those of group I (187 mu V and 4.9 milliseconds) in the third day. There were no pathological changes in respiratory rates and pressure measurements before and after Botox injections. Conclusion: This pilot experimental study showed that local injection of botulinum A toxin causes paralysis in abdominal wall muscles, increases the intraabdominal volume, and decreases the pressure, and this application may be used as ail adjunct in abdominal Wall Closure in selective cases. (c) 2006 Elsevier Inc. All rights reserved.Öğe Effect of Penile Tourniquet on Growth Factors in Rat Penile Tissue(Georg Thieme Verlag Kg, 2009) Kaya, Murat; Soyer, Tutku; Ayva, Şebnem; Çakmak, MuratAim: This study aimed to evaluate the effect of penile tourniquet application on growth factors in rat penile tissues. Materials and Methods: Forty Wistar male rats were included in the study. Rats were divided into 4 groups. After anesthetization, perimeatal penile skin and the corpus cavernosum were sampled in the control group (CG). A Mathieu-like flap was designed without a penile tourniquet (PT) to serve as a sham group (SG). In the PT groups, a Mathieu-like flap was created and a 5 mm diameter rubber circular band was applied at the base of the penis. The PT was applied for 10 min in the PT-10 group and for 30 min in the PT-30 group. Penile tissue was sampled 24 h after PT application in the SG and PT groups. Tissues obtained were examined in three sections: the subepithelial vascular plexus (SVP), the corpus cavernosum (CC) and the smooth muscle-like mesenchymal cells in the corpus cavernosum (MC). Acute inflammation was evaluated with hematoxylin-eosin staining. The effect of PT on vascular endothelial growth factor (VEGF), VEGF receptor (VEGFR) and transforming growth factor 0 receptor (TGF beta-R) levels was evaluated. Results: Higher grades of acute inflammation were encountered in the PT-10 and PT-30 groups compared to the CG and SG (p<0.005). However, mean grades of acute inflammation did not show a statistical difference between the PT-10 and PT-30 groups (p>0.05). When the levels of growth factors were compared between the CG and PT-10 group, the PT-10 group showed increased levels of VEGF and TGF beta-R. In the PT-30 group, both VEGF and VEGFR levels were found to be decreased. When acute inflammation grades of tissues were correlated with VEGF and TGF beta-R, higher acute inflammation grades correlated with decreased VEGF and increased TGF beta-R levels (Spearman's correlation, p<0.005). Although alterations in VEGF and TGF beta-R levels were detected in the SVP and CC of penile tissues, altered VEGFR levels were only detected in the MC sections. Conclusion: PT caused higher grades of acute inflammation which correlated with decreased VEGF levels and increased TGF beta-R levels. Decreased VEGF levels after PT may alter the angiogenesis phase of wound healing and cause poor angiogenesis in penile skin flaps. Increased levels of TGF beta-R can be considered as an acute inflammatory response to PT. These results confirmed that prolonged PT application may result in altered growth factors in penile tissue and may reduce the success rate of repair.Öğe Evaluation of genitofemoral nerve motor conduction in inguinoscrotal pathologies(W B Saunders Co-Elsevier Inc, 2008) Soyer, Tutku; Tosun, Aliye; Aydin, Gueluemser; Kaya, Murat; Arslan, Ayse; Orkun, Sevim; Cakmak, MuratAim: Inguinoscrotal pathologies are commonly seen in childhood. The genitofemoral nerve (GFN) is responsible for sensitive innervations of scrotal region and the motor innervations of cremasteric muscle. GFN also innervates the afferent and efferent pathways of cremasteric reflex. A prospective study was performed to evaluate the possible relation between inguinoscrotal pathologies and GFN motor functions. Methods: Patients with inguinal hernia, hydrocele, undescended or retractile testicles, aged between 2-12 years were enrolled in the study. Bilateral latency and duration of GFN motor conductions (GFNMC) were obtained electrophysiologically by Surface electrodes. GFNMC recordings of non-pathological sides were assessed as control group. Latency and duration of each group were compared with control group (Mann-Whitney U test). P values lower than .05 were considered significant. Results: Seventy-three electrophysiologic evaluations were investigated in inguinal hernia (n:18), hydrocele (n:9). undescended testicle (n: 14), retractile testicle (n: 12) and control (n:20) groups. There was no age difference between groups and controls. Latency was significantly prolonged in inguinal hernia group when compared with control group (P = .028). Although the latencies were shortened in Undescended testicle group, no significant difference detected (P > .05). Conclusion: Prolonged latencies in inguinal hernia may be a result of nerve trap caused by hernia sac. GFN motor functions showed no causative role in other inguinoscrotal pathologies. It can be also suggested that clinical features of other inguinoscrotal pathologies were not affected by GFN motor functions. Electrophysiological studies in Younger age groups with large number of patients are needed to support our suggestions. (C) 2008 Elsevier Inc. All rights reserved.Öğe Idiopathic benign bilateral testicular enlargement in a pubertal boy: a case report and review of literature(W B Saunders Co, 2005) Somuncu, Salih; Çakmak, Murat; Çağlayan, Fatma; Akman, Hülya; Ulusoy, Sevgi; Kaya, MuratWe present a case of 12-year-old boy with idiopathic benign bilateral testicular enlargement. We eliminated precocious puberty, juvenile hypothyroidism, adrenal rest tumors, X-linked mental retardation, and bilateral testicular neoplasms. The clinical and laboratory features and differential diagnosis of benign bilateral testicular enlargement are discussed. (c) 2005 Elsevier Inc. All rights reserved.Öğe Ischemia-reperfusion injury of rabbit ovary and protective effect of trapidil: an experimental study(Springer, 2008) Somuncu, Salih; Cakmak, Murat; Dikmen, Gunnur; Akman, Huelya; Kaya, MuratWe aimed to detect the protective effect of trapidil in ischemia-reperfusion (IR) injury due to ovarian torsion and detorsion. Thirty-two pubertal New Zealand albino rabbits were used. Adnexal torsion was created by rotating the left adnexa including the tubal and ovarian vessels in a 360 clockwise direction. Adnexal detorsion was done by untwisting the adnexa. In the IR group, left oopherectomy was performed after 3 h of adnexal torsion and 3 h of adnexal detorsion. In the study group, a 3-h adnexal torsion was performed and trapidil was administered intraperitoneally as a single dose of 40 mg/kg, 1 h before detorsion. The left oopherectomy was performed after a 3-h adnexal detorsion. In the sham group, sham operation was performed followed by left oopherectomy. In the control group, normal ovarian tissue was evaluated. Catalase, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and malondialdehyde (MDA) levels of ovarian tissue were determined for each group. The values of SOD and GSH-Px activities in the IR group were significantly decreased (P < 0.05). In addition, the MDA level was significantly higher in the IR group (P < 0.01). The trapidil-administered group showed significant increase in the levels of GSH-Px (P < 0.05), catalase (P < 0.05), SOD (P < 0.05), and decreased MDA levels (P < 0.05) compared to those in the IR group. The study has shown that trapidil treatment prevents ischemia induced oxidative damage in the ovarian tissues of rabbits.Öğe Penil turnike uygulamasının yara iyileşmesine etkisinin penil cilt ve dokudaki VEGF/TGF-beta düzeyleriyle değerlendirilmesi(Kırıkkale Üniversitesi, 2008) Kaya, Murat; Soyer, TutkuHipospadias onarımı çocuk yaş grubunda sık uygulanan bir ürolojik operasyondur. Bu operasyonlar sırasında kanamayı azaltmak ve ereksiyon testi yapmak için penis köküne turnike uygulanmaktadır. Penil turnike süresince dokuda oluşan iskemi ve turnike sonrası sağlanan reperfüzyonun oluşturabileceği doku hasarı birçok biyokimyasal, farmakolojik ve histopatolojik çalışmayla irdelenmiştir. Ancak, penil turnikenin yara iyileşmesine olan etkisi araştırılmamıştır. Penil turnikenin neden olduğu iskemik değişikliklerin penil cilt ve kavernöz dokulardaki yara iyileşme faktörlerine etkisi değerlendirmek amacıyla deneysel bir çalışma yapılmıştır. Çalışmaya 10'ar denekten oluşan dört grup dahil edilmiştir. İlk gruba Mathiu tipi insizyon ve 10 dakikalık turnike uygulamasından 24 saat sonra penektomi işlemi yapılmıştır (PT 10G). Aynı tipte insizyon sonrası 30 dakikalık turnike uygulanmış ve aynı sürede penektomi yapılarak PT 30G grubu elde edilmiştir. Turnike uygulaması yapılmadan Mathiu tipi insizyon yapıldıktan 24 saat sonra penektomi işlemi yapılarak sham grubu oluşturulmuştur (SG). Ayrıca kontrol grubunda turnike uygulaması ve insizyon işlemleri yapılmadan penektomi işlemi yapılmıştır (KG). Penil dokularda H&E ile akut inflamasyon değerlendirilmiştir. Immünhistokimyasal incelemede; subepitelyal vasküler ağ (SVA), korpus kavernozum (KK) ve KK içinde düz kas yapısına benzer mezenkimal hücrelerde (MH) Vasküler endotelyal büyüme faktörü (VEGF), Vasküler endotelyal büyüme faktörü reseptörü (VEGFR) ve transforming büyüme faktörü beta reseptör (CD 105) düzeyleri incelenmiştir. Gruplarda elde edilen sonuçlar SPSS 15.0 ile karşılaştırılmıştır. Gruplar arası akut inflamasyon evreleri değerlendirildiğinde PT 10G ve PT 30G arasındaki fark istatistiksel0 olarak anlamlı değildir (p >0.05). Ancak, diğer gruplar arasında belirgin fark bulunmaktadır. KG ile PT 10G arasında yalnız VEGFR'leri bakımından fark yoktur. PT 10G'de VEGF düzeyleri kontrol gruba göre azalmış ancak CD 105 düzeyleri ise artmıştır. Aynı faktör düzeyleri ile gruplardaki akut inflamasyon evreleri karşılaştırıldığında akut inflamasyonda artma ile VEGF arasında ters korelasyon (rs: - 0.345 ve rs: - 0.409) ve CD 105 ile doğru korelasyon (rs: 0.324 ve rs: 0.504) saptanmıştır (Spearman korelasyonu, p <0.005). Sonuç olarak, Penil turnike uygulaması penis dokusunda süre ile artan oranda akut inflamatuvar yanıta neden olmaktadır. Penil turnikenin penis dokularında CD 105 düzeyini arttırdığı, buna karşın VEGF düzeylerini azalttığı izlenmiştir. Turnike sonrası ortaya çıkan CD 105 artışı penil turnikenin yara iyileşmesine katkısından çok, akut inflamasyona oluşan bir yanıt olarak değerlendirebilir. VEGF düzeylerinin turnike sonrası azalması penil turnikenin yara iyileşmesindeki anjiogenezis safhasını olumsuz etkileyebileceğini düşündürmektedir.Öğe The Pimpled Gold Nanosphere: A Superior Candidate for Plasmonic Photothermal Therapy(DOVE MEDICAL PRESS LTD, 2020) Nasseri, Behzad; Turk, Mustafa; Kosemehmetoglu, Kemal; Kaya, Murat; Piskin, Erhan; Rabiee, Navid; Webster, Thomas J.Background: The development of highly efficient nanoparticles to convert light to heat for anti-cancer applications is quite a challenging field of research. Methods: In this study, we synthesized unique pimpled gold nanospheres (PGNSs) for plasmonic photothermal therapy (PPTT). The light-to-heat conversion capability of PGNSs and PPTT damage at the cellular level were investigated using a tissue phantom model. The ability of PGNSs to induce robust cellular damage was studied during cytotoxicity tests on colorectal adenocarcinoma (DLD-1) and fibroblast cell lines. Further, a numerical model of plasmonic (COMSOL Multiphysics) properties was used with the PPTT experimental assays. Results: A low cytotoxic effect of thiolated polyethylene glycol (SH-PEG400-SH-) was observed which improved the biocompatibility of PGNSs to maintain 89.4% cell viability during cytometry assays (in terms of fibroblast cells for 24 hrs at a concentration of 300 mu g/mL). The heat generated from the nanoparticle-mediated phantom models resulted in Delta T=30 degrees C, Delta T=23.1 degrees C and Delta T=21 degrees C for the PGNSs, AuNRs, and AuNPs, respectively (at a 300 mu g/mL concentration and for 325 sec). For the in vitro assays of PPTT on cancer cells, the PGNS group induced a 68.78% lethality (apoptosis) on DLD-1 cells. Fluorescence microscopy results showed the destruction of cell membranes and nuclei for the PPTT group. Experiments further revealed a penetration depth of sufficient PPTT damage in a physical tumor model after hematoxylin and eosin (H&E) staining through pathological studies (at depths of 2, 3 and 4 cm). Severe structural damages were observed in the tissue model through an 808-nm laser exposed to the PGNSs. Conclusion: Collectively, such results show much promise for the use of the present PGNSs and photothermal therapy for numerous anti-cancer applications.Öğe Protective effects of trapidil in ischemia-reperfusion injury due to testicular torsion and detorsion: An experimental study(Blackwell Publishing, 2006) Somuncu, Salih; Çakmak, Murat; Erdoğan, Sibel; Cağlayan, Osman; Akman, Hülya; Kaya, MuratObjective: We aimed to detect the preventive effects of trapidil in ischemia reperfusion (IR) injury due to testicular torsion and detorsion. Methods: Forty prepubertal albino rats were used. In the IR group, torsion was created by rotating the left testis over 2 h, and detorsion was done by untwisting the testis. Bilateral orchiectomies were performed after 4 h. In study group, 2-h torsion was performed and trapidil was administered as a single dose I h before detorsion. Bilateral orchiectomies were performed after 4 h. In the sham group, a sham operation was done. In the sham plus trapidil group, a sham operation was done and trapidil was administered as a single dose. Testicular tissue malondialdehyde (MDA), nitric oxide (NO) and total sulfhydryl (T-SH) levels were determined for each group. The grades of interstitial injury were determined in histopathologic examination. Results: The NO and MDA levels in the IR group were significantly higher than the study, sham and sham plus trapidil groups in the left testis (P < 0.05 P < 0.001 and P < 0.001, respectively). A statistical difference was not found among Study, sham and sham plus trapidil groups in the left testis in NO and MDA levels (P > 0.05). The T-SH level in the study group was significantly higher than in the IR. sham and sham plus trapidil groups in left testis P < 0.05). In the IR group (left testis), grade I interstitial injury was 30% (3/10), grade 2 injury was 60% (6/10) and grade 3 injury was 10% (1/10). In the study group (left testis), grade I interstitial injury was 30% (3/10) and there was no injury in 70% (7/10). Conclusion: Trapidil decreased free oxygen radical formation in testicular torsion and detorsion, and attenuated histopathological damage in the ipsilateral twisted testis.Öğe Trapidil, an inhibitor for phosphodiesterase and platelet-derived-growth factor, ameliorates corrosive esophageal burn in rats(Tohoku Univ Medical Press, 2005) Somuncu, Salih; Çakmak, Murat; Erdoğan, Sibel; Çağlayan, Osman; Akman, Hülya; Kaya, MuratCorrosive esophageal burn is a common health problem in the pediatric age group and causes serious esophageal injuries. The medical treatment In acute phase of corrosive esophageal injury is of particular importance for prevention of esophageal stricture. We therefore aimed to investigate the possible beneficial effect of trapidil (triazolopyrimidine), an inhibitor for phosphodiesterase and platelet-derived-growth-factor, during acute phase of esophageal corrosive injury. Wistar albino rats were randomly allocated to untreated, treated, and sham-operated groups (n = 10 for each group). Corrosive esophageal burn was generated with 10% NaOH solution. The rats were left untreated (untreated group) or treated with trapidil as a single dose of 40 mg/kg intraperitoneally after one hour of the injury (treated group). Abdominal esophageal segment was isolated and tied in sham-control group. The studied esophageal segment was removed from each animal after 24 hours. Malondialdehyde (MDA) and nitric oxide (NO) levels were measured in the esophageal tissues. The ulcer depth was graded by histopathologic examination. MDA and NO levels were significantly higher in the untreated group than in the treated group. Namely, trapidil treatment significantly decreased MDA and NO levels in the injured tissues, the levels of which are similar to those in the tissues of control animals. The grades of ulcer depth were significantly improved in the treated group. These results indicate that the reactive oxygen radicals increase in the early phase of corrosive esophagitis and cause tissue damage. We suggest that trapidil treatment may be useful in acute phase of corrosive esophageal injury.
