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    Comparison of two techniques in achieving planned correction angles in femoral subtrochanteric derotation osteotomy
    (Lippincott Williams & Wilkins, 2012) Turker, Mehmet; Cirpar, Meric; Cetik, Ozgur; Senyucel, Cagri; Tekdemir, Ibrahim; Yalcinozan, Mehmet
    Increased femoral anteversion in cerebral palsy alters biomechanics of gait. Femoral subtrochanteric derotational osteotomies are increasingly performed to improve gait in cerebral palsy. The amount of angular correction can be determined and planned preoperatively but, accuracy in achieving planned angular correction has not been tested experimentally before. The aim of this study was to evaluate the accuracy of the two techniques in achieving planned angular correction. Sixteen dry femora were used in this study. Specimens in both groups were derotated to achieve a desired amount of correction with two different techniques, consecutively. In technique one, the cross section of the femur was assumed to be circular and the desired amount of angular correction was calculated and expressed in terms of surface distance by a geometric formula (surface distance = 2 x pi x radius of femur). In both groups, derotations were made based on this surface distance calculation. Consecutively the same specimens were derotated by pins and guide technique. Femoral anteversion of specimens were measured before and after derotation by computerized tomography. There was a statistically significant differance in planned and achieved correction angles (P = 0.038) in both subgroups derotated by the surface distance technique. When the two techniques were compared, there was significant difference (P = 0.050) between high magnitude correction subgroups (subgroups 2 vs. 4). In conclusion, the results of this study highlighted the difficulty in achieving accurate derotation angles. Derotations based on guide-pins technique yielded more accurate results than derotations based on surface distance technique. In addition, surface diameter technique was not suitable when higher degrees of derotations are needed. In achieving a planned derotation angle two techniques are described for accuracy. Both the techniques have potential pitfalls resulting in malrotations. Surgeons must be aware of these obstacles and try to avoid them. J Pediatr Orthop B 21: 215-219 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
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    Myofibroblastoma of Breast in a Male Infant
    (Taylor & Francis Inc, 2012) Soyer, Tutku; Ayva, Sebnem; Senyucel, Mine F.; Senyucel, Cagri; Aslan, Mustafa K.; Cakmak, Murat
    Breast masses are very rare in infants and premature telarche due to excessive endogen or exogenous estrogens is the most common presentation during infancy. Myofibroblastoma is a stromal tumor of the breast, occurring especially in elder males. This breast mass has a close relationship between androgen receptors and has not been reported in infants previously. A 10-month old male baby with a left breast mass, which is diagnosed as myofibroblastoma, is discussed to evaluate the clinical features and treatment modalities of breast myofibroblastomas in children.
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    Right middle lobe atelectasis in children with asthma and prognostic factors
    (Japanese Society Allergology, 2016) Soyer, Ozge; Ozen, Cinar; Cavkaytar, Ozlem; Senyucel, Cagri; Dallar, Yildiz
    Background: Although right middle lobe (RML)-atelectasis of the lungs is a common complication of asthma, the relevant data is limited. The aim of this study is to define the characteristics of RML atelectasis in asthma during childhood. Methods: Children with asthma who had recently developed RML atelectasis were included; anti-inflammatory medications, clarithromycin, and inhaled salbutamol were prescribed, chest-physiotherapy (starting on the sixth day) was applied. Patients were reevaluated on the sixth, fourteenth, thirtieth, and ninetieth days, chest X-rays were taken if the atelectasis had not resolved at the time of the previous visit. Results: Twenty-seven patients (6.8 (4.8-8.3) years, 48.1% male) with RML atelectasis were included. Symptoms started 15 (7-30) days before admission. The thickness of the atelectasis was 11.8 +/- 5.8 mm; FEV1% was 75.9 +/- 14.2 and Childhood Asthma Control Test scores were 11.8 +/- 5.6 at the time of admission. The atelectasis had been resolved by the sixth (n = 3), fourteenth (n = 9), thirtieth (n = 10), and ninetieth days (n = 3). The treatment response of the patients whose atelectasis resolved in fourteen days was better on the sixth-day (atelectasis thickness: 4.7 +/- 1.7 vs. 11.9 +/- 7.3 mm, p = 0.021) compared to those whose atelectasis resolved later. Nearly half (54.5%) of the patients whose atelectasis had resolved by fourteen days were using controller medications at the time of admission. However, only two patients (13.3%) were on controller treatment in the latter group (p = 0.032). Regression analysis didn't reveal any prognostic factors for the early resolution of atelectasis. Conclusions: Early diagnosis and treatment of RML atelectasis prevents complications. Patients who had early resolution of atelectasis had already been on anti-inflammatory medications, and responded better to aggressive treatment within the first week. Copyright (C) 2015, Japanese Society of Allergology. Production and hosting by Elsevier B.V.