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Öğe Anaesthesia and the acute phase protein response in children undergoing circumcision(Hindawi Ltd, 2005) Büyükkoçak, Ünase; Çağlayan, Fatma; Çağlayan, Osman; Basar, Murat; Çakmak, Murat; Batislam, Ertan; Ulusoy, SevgiConcentrations of acute phase proteins (CRP: C-reactive protein, albumin) change during surgery. We investigated the acute phase response to circumcision and the effects of anaesthesia on this response. The children were divided into four groups; group 1 (intratracheal general anaesthesia, n = 40), group 2 (general anaesthesia with mask, n = 20), group 3 (ketamine, n = 20), group 4 (local anaesthesia, n = 35). Blood samples were obtained, 24 hours before circumcision, after premedication, and 24 hours after circumcision. CRP and albumin before circumcision were comparable for all groups. There was no increase in CRP, and albumin remained steady throughout the study. No difference was observed among the groups, and related to anaesthesia. No responsiveness may be explained with the size of injured tissue or anatomical and histological type of preputium.Öğe The effect of indwelling catheter on OH-proline in the urethral wound: An experimental study(2006) Somuncu, Salih; Çağlayan, Osman; Çakmak, Murat; Çağlayan, Fatma; Ulusoy, SevgiObjective: To investigate the effect of catheterization on urethral wound healing by measuring OH-proline. Methods: Eighteen male New Zealand albino rabbits were divided equally into three groups. In the control group, urethral tissue samples were taken from the ventral penile surface. In group II, the ventral penile surface was incised and primarily repaired by 6/0 polydioxanone. In group III, the incised urethra was repaired by 6/0 polydioxanone and a urethral catheter was inserted. Tissue samples were taken on the 20th postoperative day in groups II and III. Tissue OH-proline levels were measured by the method of Bergman and Loxley. The Kruskal-Wallis statistical test was used for evaluation. Results: OH-proline values as ?g/mg dry tissue were 16.43 ± 2.68 in the control group, 14.47 ± 1.82 in group II and 14.63 ± 0.63 in group III. There was no significant difference between the three groups (P > 0.05). Conclusion: Use of a urethral catheter does not appear to have a direct effect on collagen synthesis in wound healing. © 2005 Journal of Pediatric Urology Company.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 Embryologic preputial sinus remnant mimicking urethral duplication(2006) Somuncu, Salih; Çağlayan, Fatma; Çakmak, Murat; Ulusoy, SevgiUrethral duplications are rare congenital anomalies. Approximately 200 cases of urethral duplications have been reported in literature. We present a seven-year-old-boy with an embryologic preputial sinus remnant which was mimicking urethral duplication. The clinical presentations and embryology of the urethral duplication and preputial sinus are discussed.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 Investigation of OH-proline contents of hernia sacs in children and comparison with adults(Georg Thieme Verlag Kg, 2005) Çağlayan, Fatma; Çağlayan, Osman; Çakmak, Murat; Saygun, Oral; Somuncu, Salih; Ulusoy, Sevgi; Akman, HPurpose: One of the factors suggested to be causative in hernia formation is defective collagen metabolism. In this study, we investigated whether there is any relationship between the collagen contents of indirect hernial sacs and certain demographic and anatomic parameters. Methods: Hernial sac hydroxyproline levels were measured in 100 pediatric and 23 adult indirect inguinal hernia cases as indicators of collagen concentrations. Hydroxyproline levels were compared between boys and girls, right and left sided hernias, unilateral and bilateral cases, children and adults. Whether there was any relationship between patient age and hydroxyproline level was also investigated. Results: No difference was found between males and females (p > 0.05), right and left sided hernias (p > 0.05) or unilateral and bilateral cases (p > 0.05). Hydroxyproline levels of adults were found to be significantly higher than those of children (p = 0.000). There was also a positive correlation between age and hydroxyproline levels of boys (r = 0.285, p = 0.023). Conclusion: Although a relationship between direct inguinal hernia and collagen structure has been shown by some investigators, we were unable to point to any significant findings which would indicate such a relationship in indirect inguinal hernia cases. Further studies on hydroxyproline levels in peritoneal samples will be necessary to understand the role of peritoneal hydroxyproline levels in hernia formation.Öğe Testicular epidermoid cyst and organ preserving surgery(Medknow Publications and Media Pvt. Ltd, 2006) Somuncu, Salih; Cakmak, Murat; Atasoy, Pınar; Akman, Hülya; Ulusoy, SevgiEpidermoid cyst is a rare and non-teratomatous, benign tumour of the testis. Testis-sparing surgery is recommended as surgical treatment. We present a 9-year-old-boy with testicular epidermoid cyst. The embryology, histogenesis and treatment of epidermoid cyst of testis, are discussed.Öğe Testis torsiyonunda N-asetil sisteinin kullanımı ile serbest oksijen radikallerinin zararlı etkilerinin önlenmesi(Kırıkkale Üniversitesi, 2005) Ulusoy, Sevgi; Çakmak, MuratÖZET Ulusoy S, Testis Torsiyonunda N-Asetil Sistein Kullanımı İle Serbest Oksijen Radikallerinin Zararlı Etkilerinin Önlenmesi. Kırıkkale Üniversitesi Tıp Fakültesi Çocuk Cerrahisi Anabilim Dalı, Uzmanlık Tezi, Kırıkkale 2005. Testis torsiyong, çocukluk çağında ve erişkinlerde karşılaşılan acil ürolojik bir problemdir. Deneysel testis torsiyonu ilgili yapılan birçok çalışmada iskemi reperfüzyon hasarı biyokimyasal ve patolojik olarak gösterilmiş ve değişik ilaçların bu hasarı önlemede ki etkinliği araştırılmıştır. N- acetylcysteine (NAC), içerdiği protein bağlayan labil disülfid bağlarının sayesinde, fonksiyonel olan disülfid gruplarının korunmasını sağlar ve transportunu kolaylaştırır. Glutatyon redüktaz aktivitesini, sülfidril gruplarının transferi ile artırarak, glutatyon sentezini destekler, glutatyon prekürsörü olarak hareket eder. Bu çalışmada, testis torsiyonu ve detorsiyonu sonrası oluşan iskemi-reperfüzyon hasarının önlenmesinde NAC'in etkisinin araştırılması amaçlanmıştır. Bu amaçla 36 adet albino Wistar erkek rat, sham ve kontrol grubunda 8'er, iskemi-NAC (I NAC) ve iskemi-reperfüzyon-NAC (IRNAC) grubunda 10'ar adet olmak üzere dört gruba ayrıldı. Kontrol grubunda sol testis midskrotal insizyondan çıkarılıp saat yönünde 720° rotasyon oluşturulup 2 saatlik torsiyon, 4 saatlik detorsiyon sağlandı. INAC grubunda kontrol grubundaki işlemin yanı sıra torsiyonun 1. saatinde 150mg/kg'dan NAC intraperitoneal olarak uygulandı. IRNAC grubunda ise INAC grubundaki işlemlere ek olarak detorsiyonu takiben 150 mg/kg'dan intraperitoneal NAC verildi. 4 saatlik detorsiyon sonrasında orşiektomi yapıldı.. Her bir testis dokusunda biyokimyasal olarak gram protein başına malondialdehit (MDA), nitrik oksit (NO) ve total sülfidril (T-SH) değerlerine bakıldı ve dokular seminifer tubul yapıları ve spermatid sayıları açısından histopatolojik olarak değerlendirildi. Doku T-SH değerlerinde INAC ve IRNAC gruplarında artma bulundu. NO düzeylerinde INAC ve IRNAC gruplarında kontrol grubundan belirgin düzeyde bir artma mevcutken, MDA düzeylerindeVI istatistiksel açıdan bir fark yoktu. Histopatolojik olarak ise, INAC ve IRNAC gruplarında kontrol grubuyla karşılaştırıldığında, seminifer tubul yapılarının korunduğu ancak spermatid sayılarında bir azalma olduğu görüldü. Sonuç olarak, NAC'in testiküler torsiyon detorsiyon sonrası oluşan iskemi reperfüzyon hasarının önlenmesinde etkili olduğu biyokimyasal ve histopatolojik olarak gösterilmiştir. NAC, kolay bulunabilirliği ve uygulama kolaylığı açısından testiküler torsiyon sonrasında ve detorsiyon sırasında kullanılabilir. Anahtar Kelimeler: Testis torsiyonu, iskemi reperfüzyon, N-asetilsistein.
