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The effects of ozone on the acute phase of intestinal ischemia-reperfusion injury in rats
(2020) Günal, Yasemin Dere; Türer, Özlem Boybeyi; Atasoy, Pınar; Kısa, Üçler; Aslan, Mustafa Kemal
BACKGROUND: In this study, we aimed to examine the therapeutic effects of ozone on the acute phase of intestinal ischemia-reperfusion (I/R) injury in rats to resemble clinical practice. METHODS: Eighteen Wistar albino rats were assigned to control (CG, n=6), sham (SG, n=6) and ozone groups (OG, n=6). A midline laparotomy was performed and a superior mesenteric artery (SMA) in the SG and OG was occluded with a 0/0 catgut suture, but in the CG, the incision was closed without any intervention. Tissue oxygenation was monitored with a tissue oxygenation monitor to achieve the same grade during intestinal ischemia. The incision was closed and, in the OG, ozone/oxygen mixture (0.7 mg/kg) was injected intraperitoneally, 20 minutes before reperfusion. Surgical incision was reopened and reperfusion was achieved after 60 minutes of ischemia in the SG and OG. After 60 minutes of reperfusion, 2 cm small intestine segment was sampled for histopathological assessment of the intestinal mucosal damage (Chiu score) and biochemical assessment of oxidative stress markers (nitric oxide: NO, malondialdehyde: MDA, superoxide dismutase: SOD) in all groups. RESULTS: The Chiu scores of the SG and OG were statistically increased than that of the CG (p=0.002; and p=0.002, respectively). Chiu score in the OG was higher compared to that in the SG, but not statistically significant (p=0.175). MDA levels were statistically higher in the SG and OG than that of the CG (p=0.004; and p=0.010, respectively). However, the difference between the SG and OG was not statistically significant (p=0.522). SOD and NO levels were not significantly different between groups (p=0.451 and p=0.056, respectively). CONCLUSION: Contrary to the literature, single-dose ozone therapy did not reduce the oxidative stress or improve the ischemic damage in intestinal I/R injury in rats. Further evaluation with different doses in different time periods is needed for potential clinical use.
Laparotomi yapılan hastalarda brid ileus risk faktörleri ve tedavi yaklaşımlarının değerlendirilmesi
(2017) Ertürk, Ahmet; Karaman, İbrahim; Karaman, Ayşe; Yılmaz, Engin; Afşarlar, Çağatay Evrim; Erdoğan, Derya; Çavuşoğlu, Yusuf Hakan
Amaç: Postoperatif yapışıklıklar intestinal obstrüksüyona yol açması, reoperasyon durumlarında abdominal eksplorasyonu zorlaştırması, organ yaralanmalarına sebep olması nedeniyle hem hasta hem de hekimler için önemli bir klinik durumdur. Bu çalışmada brid ileus gelişimine etki eden faktörlerin saptanması ve brid ileusdaki tedavi sonuçlarının değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem: 2005-2010 yılları arasında çeşitli nedenlerle laparotomi yapılan hastalar brid ileus gelişimi açısından retrospektif olarak değerlendirildi. Bulgular: Bu çalışmaya laparotomi yapılan 3271 hasta dahil edildi. Apandisit en sık laparotomi endikasyonuydu (%66). 152 hastada (%4,6) postoperatif brid ileus geliştiği tespit edildi. Bunların %88'inin postoperatif ilk 6 ayda, %99'unun da ilk 3 yıl içinde geliştiği görüldü. Yaş ve cinsiyet ile brid ileus gelişimi arasında ilişki yoktu. Vakaların %23'ü kirli vasıfta ameliyatlardı. Temiz, temiz kontamine ameliyatlardan sonra brid ileus gelişme oranı %3,4 iken, kontamine ve kirli ameliyatlardan sonra bu oran %10,9 olarak bulundu. Batın içerisine dren yerleştirilmesinin brid ileus gelişimini etkilemediği saptandı. Ameliyat süresi uzadıkça postoperatif brid ileus gelişme oranının arttığı tespit edildi. Ayrıca ameliyatta Meckel divertikülü gibi ek patolojiler araştırılan hastalarda brid ileus gelişme oranının 3 kat arttırdığı görüldü.Brid ileus gelişen hastaların %61'i nonoperatif-konservatif yollarla tedavi edilirken %39'unda cerrahi girişim gerektiği tespit edildi. Sonuçlar: Çalışmamızda batın içinde uygulanan ek girişimlerin, operasyon süresinin uzun olmasının ve intraperitoneal kontaminasyonun brid ileus gelişimini artırdığı gösterilmiştir. Bu konulara dikkat edilmesinin brid ileus gelişimini azaltabileceği düşünülmüştür. Çocuk yaş grubunda uygun vakalarda konservatif tedavi ile daha yüksek oranlarda başarı sağlanabileceği kanısına varılmıştır
Erkek yalancı hermafrodit olguların yetiştirildikleri cinsiyetle ilişkili biyopsikososyal değişkenler
(2007) Uslu, Runa; Öztop, Didem; Özcan, Özlem; Yılmaz, Savaş; Berberoğlu, Merih; Adıyaman, Pelin; Çakmak, Murat
Amaç: Kuşkulu eşeysel yapıya sahip çocuklarda yetiştirilme tutumlarının cinsel kimlik gelişimi üzerine etkisi konusunda günümüzde farklı görüşler bulunmaktadır. Bu çalışmada erkek yalancı hermafroditizmi olan olguların ana babaları tarafından yetiştirildikleri cinsiyetle ilişkili etmenlerin araştırılması amaçlanmıştır. Yöntem: Çocuk psikiyatrisi polikliniğine cinsel kimlik gelişiminin değerlendirilmesi amacı ile gönderilen, 6 ay-14 yaşlar arasında, 28?i kız, 28?i erkek olarak yetiştirilmekte olan 56 erkek yalancı hermafroditizm olgusu çalışmaya alınmıştır. Olguların demografik ve biyolojik bilgileri dosya kayıtlarından elde edilmiştir. Ana babalara ve çocuklara Öykü Alma Görüşmesi, çocuklara Cinsel Kimlik Ölçeği, İnsan Resmi Çizme Testi, zeka ve gelişim değerlendirmeleri uygulanmıştır. Çocuklar serbest oyunda gözlemlenmişlerdir. Değişkenler, çocukların yetiştirildikleri cinsiyet bakımından karşılaştırılmışlardır. Bulgular: Erkek yetiştirilen çocukların daha küçük yaşta tanı için getirildikleri, daha çok geniş ailelerden geldikleri ve Prader skorlarının daha yüksek olduğu saptanmıştır. Çocuklar yetiştirildikleri cinsiyete uygun cinsiyet rollerini benimsemiş görünmekle birlikte, İnsan Resmi Çizme Testi ve Cinsel Kimlik Ölçeği?nde tüm erkek çocukların yetiştirildikleri cinsiyeti benimsedikleri, öte yandan bazı kızların erkek cinsiyetine uygun bulgular verdikleri görülmüştür. Sonuç: Yetiştirilme cinsiyeti ile sorunun fark edildiği ve tanının konduğu yaşlar arasındaki ilişkiler, ülkemizde sorunun doğumda fark edilmesini ve erken dönemde tanıyı, cinsiyet tayinini ve tedaviyi sağlayacak önlemlerin alınmasının önemine işaret etmektedir.
Hirschsprung Hastalığında Transanal Endorektal Pull-through ve Martin-modifiye Duhamel Ameliyatlarının Sonuçlarının Karşılaştırılması
(2019) Günal, Yasemin Dere; Aslan, Mustafa Kemal; Karaman, Ayşe; Karaman, İbrahim; Erdoğan, Derya; Çavuşoğlu, Yusuf Hakan
Amaç: Hirschsprung hastalığı (HH) tanısıyla transanal endorektal pull-through (TEPT) ve Martin-modifiye Duhamel ameliyatları yapılmış olan hastalarımızın sonuçlarının karşılaştırması. Gereç ve Yöntem: Kliniğimizde 2002-2007 yılları arasında HH nedeniyle TEPT (grup 1, n=24), transanal yolla başlanıp laparotomi gerektiren endorektal pull-through (grup 2, n=12) ve Martin modifiye Duhamel (grup 3, n=17) uygulanan 53 hasta değerlendirildi. Bu hasta grupları yaş, cinsiyet, aganglionik segment uzunluğu, intraoperatif detaylar, postoperatif erken dönem komplikasyonlar ve uzun dönem fonksiyonel sonuçlar açısından değerlendirildi ve karşılaştırıldı. Bulgular: Çalışmamızda grup 1 hastaların ortalama ameliyat yaşı, ameliyat süresi, oral beslenmeye başlama zamanı, ilk gaita çıkarma zamanı ve hastanede kalış süresi grup 2 ve grup 3 hastalarla karşılaştırıldığında anlamlı olarak az veya kısa bulundu (p<0,001). Ameliyat sırasında kan transfüzyonu ihtiyacı yüzde olarak grup 1 hastalarda daha az olmasına rağmen aradaki bu fark istatistiksel olarak anlamlı bulunmadı (p>0,05). Serimizde postoperatif enterokolit oranı grup 3’te yüzde olarak daha yüksek bulunmasına rağmen aralarındaki bu fark anlamlı bulunmadı (p>0,05). Her üç düzeltici tekniğin uzun dönem fonksiyonel sonuçları (kontinans, fekal soiling, kabızlık) değerlendirilip karşılaştırıldığında aralarında anlamlı bir fark bulunmadı (p>0,05). Sonuç: TEPT tekniği kolay uygulanabilen güvenli bir tekniktir. Özellikle erken dönemde tanı konmuş, enterokolit öyküsü olmayan, henüz bağırsak dilatasyonu gelişmemiş, rektosigmoid tutulumlu HH’lerde TEPT ilk tercih olabilir
Human tissue transglutaminase antibody screening by immunochromatographic line immunoassay for early diagnosis of celiac disease in Turkish children
(2008) Demirçeken, Fulya G.; Kansu, Aydan; Kuloğlu, Zarife; Girgin, Nurten; Güriz, Haluk; Ensari, Arzu
Amaç: Çölyak hastalığı tüm dünyada yaygın sıklıkta görülmektedir. Türkiye?de dünya ile karşılaştırılabilecek epidemiyolojik veriler sınırlı sayıdadır. Bu ön hazırlayıcı çalışmanın amacı, Türk çocuklarında çölyak hastalığı sıklığını 1000 olguda yeni, kolay ve görsel tek adımda yapılabilen bir immünolojik tarama yöntemiyle belirlemektir. Yöntem: Bu prospektif çalı şma, Ankara Üniversitesi Tıp Fakültesi Çocuk Polikliniğine başvuran, sağlıklı görünen veya çölyak hastalığı dışında bir rahatsı zlığı olan, 2-18 yaş arası 1000 çocuk ve ergenden bilgilendirilmiş onam formu ile gönüllü olarak alınan serum örneklerinde yapıldı. Serumlar insan doku transglutaminazına ve gliadine karşı oluşmuş IgA sınıfı antikorlar için hızlı, görsel immünokromatografik çölyak hastalığı çizgisel immun yöntemiyle çalışıldı. Tarama testi sonuçları pozitif olan serumlar ikinci basamak doğrulama aşaması için ELISA yöntemi ile insan doku transglutaminazına karşı oluşmuş endomisyal antikor IgA ve antigliadin antikorlar IgA/IgG için ayrıca test edildiler. Anti doku transglutaminaz ve/veya endomisyal antikor pozitif olan bütün çocuklara ince barsak biyopsisi önerildi. Bulgular: 1000 olgunun 10?unda (%1) insan doku transglutaminazına karşı pozitif antikor tarama sonucu saptandı. Bütün doku transglutaminaz antikoru pozitif örnekler ELISA yöntemiyle endomisyal antikor çalışıldığında uyumlu görüldüler. Takiben yapılan ince barsak biyopsisinde de biri hariç dokuz olguda çölyak hastalığı tanısı doğrulandı. Biyopsi ile kanıtlanmış çölyak hastalığı prevalansı 1/111 (%0,9) olarak saptandı. Sonuçlar: Çölyak hastalığı için anti-doku transglutaminaz antikorlarının kolay görsel bir yöntemle belirlenmesi ELISA yöntemi kadar güvenilirdir. Yapması ve yorumlaması kolay bu testin, ucuz ve hızlı bir tarama yöntemi olarak geniş toplum tabanlı çalışmalarda uygulanabileceği düşünüldü. Bu ön çalışmada Türk çocukları örnek grubunda saptanan çölyak hastalığı sıklığı (1:111 veya %0.9) Avrupa, Orta Doğu ülkeleri ve ABD verileri ile benzer bulundu.
Kırıkkale ilinde 7-15 yaş grubu çocuklarda arteryel kan basıncı değerlendirilmesi
(2015) Şanlı, Cihat; Alpcan, Ayşegül
Amaç: Çalışmamız Kırıkkale ilinde ilköğretim çağındaki çocuklarda arteryel kan basıncı ortalamalarının saptanması ve cinsiyet, boy, vücut ağırlığı, vücut kitle indeksi (BMI), yüzey alanı ile ilişkili olup olmadığının değerlendirilmesi amacıyla yapıldı. Gereç ve Yöntemler: İl merkezinde değişik sosyoekonomik ve kültürel özellikler taşıyan dört ayrı okuldan 7-15 yaş grubunda toplam 905 öğrenci (451 erkek (%49), 454 kız (%51)) grup örnekleme yöntemi ile araştırmaya dahil edildi. Her çocuğun arteriyel kan basınçları üçer kez ölçülüp, son ikisinin ortalaması çocuğun kan basıncı olarak kaydedildi, genel fizik incelemesi ve antropometrik ölçümleri yapıldı. Her yaş grubunda sistolik ve diyastolik kan basıncı için 50., 75., 90., 95. persantil değerleri belirlendi. ABD Second Task Force Grubu değerlerine göre sistolik ve diyastolik arteryel kan basıncı değerleri 95. persentil üzerinde olanlar hipertansif olarak kabul edildi. Bulgular: Buna göre 40 çocukta (%4,4) sistolik hipertansiyon (12 erkek, 28 kız), 28 çocukta (%3,1) diyastolik hipertansiyon (6 erkek, 22 kız), 15 (%1,6) çocukta ise hem sistolik hem de diyastolik hipertansiyon (4 erkek, 11 kız) saptandı. Sosyoekonomik düzeyi yüksek okullarda sistolik hipertansiyon oranı %1,8, diyastolik hipertansiyon oranı %1,2, sosyoekonomik düzeyi düşük okullarda sistolik hipertansiyon oranı %2,5, diyastolik hipertansiyon oranı %1,8 bulunmuştur. Okulların sosyoekonomik durumuna göre, yaş ve cinse bağlı olarak sistolik kan basıncı değerleri arasında anlamlı bir ilişki bulunurken (p=0,031), diyastolik kan basıncı arasında anlamlı bir ilişki (p= 0,086) saptanamamıştır. Sonuç: Her iki cinsiyette de hem sistolik hem de diyastolik arteryel kan basıncı değerleri ile çocuğun yaş, boy, vücut ağırlığı, vücut kitle indeksi, yüzey alanı değerleri arasında Pearson Korelasyon Testi ile pozitif ilişki saptanırken, cinsiyet ile anlamlı bir ilişki olmadığı görülmüştür
How should trichobezoar be treated in children?
(2019) Gülerman, Fulya; Güven, Burcu; Demir, Sabri; Özmen, İsmail
[Özet Yok]
Evaluation of intraabdominal hypertension and genitofemoral nerve motor conduction
(2016) Türer, Özlem Boybeyi; İnal, Elem; Günal, Yasemin Dere; Aslan, Mustafa Kemal; Aydın, Gülümser; Soyer, Tutku
Background/aim: The aim of this study was to electrophysiologically evaluate the effect of increased intraabdominal pressure (IAP) on genitofemoral nerve (GFN) motor conduction. Materials and methods: Seven Wistar albino rats were included. After anesthetization, latency and duration of GFN conduction was recorded with a needle-probe at rest. IAP was increased to 15 mmHg by insufflating atmospheric air with a percutaneous intraperitoneal needle. At 30 min of IAP, GFN motor conduction was recorded. Abdominal pressure was then increased to 20 mmHg. At 60 min, GFN motor conduction was recorded again. The consecutive recordings of latency and duration of GFN conduction (rest, 30 min, 60 min) were evaluated statistically. Results: There was a significant difference between latencies at rest (1.90 ± 0.22 ms), at 30 min (2.3 ± 0.36 ms), and at 60 min (2.74 ± 0.57 ms) (Friedman test, P = 0.001). The latency was significantly increased at 60 min compared to rest (post hoc Tukey test, P = 0.003). No similar difference was detected between the recordings at 30 and 60 min. The duration of GFN motor conduction showed no difference between consecutive recordings (P = 0.067). Conclusion: Both increased and prolonged IAP causes prolonged latency of GFN conduction, probably due to a compression effect on GFN. Neuropraxial consequences of increased IAP are thought to be related to the compression effect of peripheral nerves.
Oxidative and histopathological effects of the application of electrosurgical devices to the penile tissue of rats
(ELSEVIER SCI LTD, 2020) Günal, Yasemin Dere; Boybeyi, Özlem; Atasoy, Pınar; Kısa, Üçler; Aslan, Mustafa Kemal; Bakar, Bülent; Soyer, Tutku
Introduction This study was performed to evaluate the oxidative and histopathological changes that occur following the application of electrosurgical devices (monopolar or bipolar cautery) to penile tissue. Material and methods Eighteen Wistar albino male rats were randomly distributed into three groups. In the control group (CG, n = 6), all penile tissues were sampled without any additional process following the administration of anesthesia. In the monopolar cautery group (MPG, n = 6), a 15-W cauterization process lasting 5 s was performed on an approximately 2 mm(2) area of the ventral side of the penile shaft, 0.5 cm proximal to the edge of the glans in the midline. Bipolar cautery was practiced in the third group (BPG, n = 6) using the same techniques outlined in the previous statement. Penile tissues consisted of the cautery application area, the edge of the glans, and dorsal side of the penis and were sampled after 90 min; then, histopathological evaluation and biochemical examination involving malondialdehyde (MDA), nitric oxide (NO), and superoxide dismutase (SOD) measurements were performed. Results and discussion Histopathologically, the MPG and BPG demonstrated increased inflammation, fibrosis, and epithelial loss in the urethra in the areas to which cautery was applied as compared to the CG (P < 0.05). The vascular structures of the corpus cavernosa were significantly decreased in the cautery application area of both the MPG and the BPG as compared to the CG (P < 0.05). In the Masson's trichrome stained samples, significant collagen deposition was observed in the cautery application area both in the MPG and the BPG as compared to the CG (P < 0.05). However, S-100 staining was decreased in these groups as compared to the CG (P < 0.05). S-100 staining was also decreased in the MPG as compared to the BPG on the edge of the glans (P < 0.05). Biochemically, MDA values were significantly increased in the MPG as compared to the CG and the BPG (P < 0.05). Conclusion Monopolar and bipolar cautery both did cause oxidative changes and triggered inflammatory, vascular, and peripheral nerve alterations in the cautery application area while bipolar cautery did not cause any distant effects.
Clinical and Laboratory Characteristics of Hyperprolactinemia in Children and Adolescents: National Survey
(Galenos Yayincilik, 2019) Eren, Erdal; Ergur, Ayca Torel; Isguven, Sukriye Pinar; Bitkin, Eda Celebi; Berberoglu, Merih; Siklar, Zeynep; Tarim, Omer
Objective: We aimed to report the characteristics at admission, diagnosis, treatment, and follow-up of cases of pediatric hyperprolactinemia in a large multicenter study. Methods: We reviewed the records of 233 hyperprolactinemic patients, under 18 years of age, who were followed by different centers. The patients were divided as having microadenomas, macroadenomas, drug-induced hyperprolactinemia and idiopathic hyperprolactinemia. Complaints of the patients, their mode of treatment (medication and/or surgery) and outcomes were evaluated in detail. Results: The mean age of the patients with hyperprolactinemia was 14.5 years, and 88.4% were females. In terms of etiology, microadenomas were observed in 32.6 %, macroadenomas in 27 %, idiopathic hyperprolactinemia in 22.7% and drug-induced hyperprolactinemia in 6.4 %. Other causes of hyperprolactinemia were defined in 11.3%. Common complaints in females (n = 206) were sorted into menstrual irregularities, headaches, galactorrhea, primary or secondary amenorrhea and weight gain, whereas headache, gynecomastia, short stature and blurred vision were common in males (n = 27). Median prolactin levels were 93.15 ng/mL, 241.8 ng/ml, 74.5 ng/mL, 93.2 ng/mL, and 69 ng/mL for microadenomas, macroadenomas, idiopathic hyperprolactinemia, drug-induced hyperprolactinemia, and other causes of hyperprolactinemia, respectively. Of 172 patients with hyperprolactinemia, 77.3 % were treated with cabergoline and 13.4 % with bromocriptine. 20.1 % of the patients with pituitary adenomas underwent pituitary surgery. Conclusion: We present the largest cohort of children and adolescents with hyperprolactinemia in the literature to date. Hyperprolactinemia is more common in females and cabergoline is highly effective and practical to use in adolescents, due to its biweekly dosing. Indications for surgery in pediatric cases need to be revised.
Comparison of Treatment Regimens in Management of Severe Hypercalcemia Due to Vitamin D Intoxication in Children
(Galenos Yayincilik, 2019) Demir, Korcan; Doneray, Hakan; Kara, Cengiz; Atay, Zeynep; Cetinkaya, Semra; Cayir, Atilla; Ozkan, Behzat
Objective: No large study has been conducted to date to compare the effectiveness of prednisolone, alendronate and pamidronate as first-line treatment in children with hypercalcemia due to vitamin D intoxication. The aim was to perform a multicenter, retrospective study assessing clinical characteristics and treatment results. Methods: A standard questionnaire was uploaded to an online national database system to collect data on children with hypercalcemia (serum calcium level > 10.5 mg/dL) due to vitamin D intoxication [serum 25-hydroxyvitamin D (25(OH)D) level > 150 ng/mL] who were treated in pediatric endocrinology clinics. Results: Seventy-four children [median (range) age 1.06 (0.65-1.60) years, 45 males (61 %) from II centers] were included. High-dose vitamin D intake was evident in 77% of the cases. At diagnosis, serum calcium, phosphorus, alkaline phosphatase, 25(OH)D and parathyroid hormone concentrations were 15 +/- 3.2 mg/dl., 5.2 +/- 1.2 mg/dL, 268 +/- 132 IU/L, 322 (236-454) ng/ml, and 5.5 (3-10.5) pg/mL, respectively. Calcium levels showed moderate correlation with 25(OH)D levels (r(s) = 0.402, p <0.001). Patients were designated into five groups according to the initial specific treatment regimens (hydration-only, prednisolone, alendronate, pamidronate, and combination). Need for another type of specific drug treatment was higher in children who initially received prednisolone (p <0.000). Recurrence rate of hypercalcemia was significantly lower in children who were treated with pamidronate (p=0.02). Conclusion: Prednisolone is less effective in the treatment of children with severe hypercalcaemia secondary to vitamin D intoxication and timely implementation of other treatment regimens should be considered.
Dexmedetomidine as an Alternative Anesthetic Agent for Flap Surgery: An Intravital Evaluation in the Cremaster Muscle Flap
(Lippincott Williams & Wilkins, 2019) Gencay, Isin; Boybeyi, Ozlem; Unlu, Gulhan; Yazici, Ilker; Aydin, Gulcin; Buyukkocak, Unase
Introduction: Flap surgery is one of the most commonly used techniques of reconstructive surgery for effective repair of damaged tissue. Optimal anesthetic technique and anesthetic agent plays an important role in flap perfusion. This study aimed to evaluate the effects of dexmedetomidine infusion on the microcirculation in the cremaster muscle flap by direct in vivo monitoring. Materials and Methods: We randomly divided 9 Wistar albino rats into 3 groups. The rats in the control group underwent the surgical procedure (isolation of the cremaster muscle) alone; the rats in the experimental groups 1 and 2 received an infusion of dexmedetomidine (10 and 30 min) after the surgical procedure. Results: The means of vessel diameters, number of functional capillaries, and movements of leukocytes in all groups were evaluated using intravital microscopic examination. The diameters of the arterioles and venules of the cremaster muscle significantly increased in the dexmedetomidine groups. The number of functional capillaries was higher in the dexmedetomidine groups than in the control group. No difference was observed in the movements of leukocytes between the control and experimental groups. Dexmedetomidine significantly increased the diameters of the arterioles and venules of the cremaster flap and the number of functional capillaries. Conclusion: On the basis of the effects of dexmedetomidine on microcirculation, we suggest that dexmedetomidine continue to be used as an anesthetic agent, and may be considered also for reconstructive procedures, particularly flap surgery.
A rare cause of acute abdominal pain in children: Isolated tubal torsion; a case series
(Kare Publ, 2017) Gunal, Yasemin Dere; Bahadir, Gokhan Berktug; Boybeyi, Ozlem; Cil, Aylin Pelin; Aslan, Mustafa Kemal
Isolated tubal torsion -a rare cause of acute abdomen in children-is usually difficult to diagnose because of non-specific findings. Surgical salphingectomy is required in delayed diagnosis in most cases. Three sexual inactive adolescents diagnosed in isolated tubal torsion (ITT) were discussed for its diagnostic features and surgical management. Laboratory tests and radiological studies including ultrasonography (US), color doppler ultrasound were performed in all patients after evaluation for acute lower abdominal pain in emergency department and they underwent surgical intervention with laparotomy (n:2) and laparoscopy (n:1). One of the patients in this study had salpingectomy. Detorsion of the fallopian tube and cyst excision were performed in the remaining two patients who also had paratubal cysts. There was no recurrence in these patients during the follow-up for 3 and 2 years. The isolated tubal torsion should be kept in mind and early surgical management is essential in order to preserve fallopian tube because of its importance in fertility. Copyright (C) 2016 The Emergency Medicine Association of Turkey. Production and hosting by Elsevier B.V. on behalf of the Owner. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
The effects of dexmedetomidine on renal injury induced by intra-abdominal hypertension in rats
(Allied Acad, 2016) Yaman, Ferda; Boybeyi, Ozlem; Kose, Emine Arzu; Balci, Mahi; Kisa, Ucler; Apan, Alpaslan
Introduction: Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are potentially life-threatening conditions in critically ill patients. Laparascopic surgery is the gold standard and has been widely performed for many procedures since its inception in the early 1980s. Pneumoperitoneum is essential for laparascopic surgery. Dexmedetomidine is a potent and highly selective alpha-2 adrenoceptor agonist with sympatholytic, sedative, amnestic and analgesic properties without respiratory depression. There is increasing evidence of its organ protective effects against ischemic and hypoxic injury, including neuroprotection, cardioprotection and renoprotection. The aim of this experimental study was to investigate the effects of the a-2 adrenoceptor agonist, dexmedetomidine on IAH induced by renal injury. Materials and methods: A total of 24 male Wistar-albino rats were randomly separated into 4 groups as the control group (CG, n=6), sham group (SG, n=6), low-dose group (DXLD, n=6) and high-dose group (DXHD, n=6). In CG, no intervention was made. IAH was obtained by insufflating atmospheric air with percutaneous intraperitoneal needle using a manual insufflator of manometer up to 15 mmHg. At the 60th min, in SG, 1.5 ml/100 gr/hr saline was infused. In DXLD, 0.5 mu g/kg/hr, and in DXHD, 1 mu g/kg/hr dexmedetomidine (Precedex, 100 mu g/ml; Abbott, Istanbul, Turkey) was infused intravenously. At the 90th min, a midline incision was made and the left kidney was harvested by median laparatomy for the measurement of tissue nitric oxide (NO), malondialdehyde (MDA) level and histopathological examination for proximal tubule injury by light microscopy. Results: No significant difference was determined between the groups either biochemically or histopathologically (p>0.05). Conclusion: Dexmedetomidine may not provide renoprotective effects within the clinical infusion doses of 0.5 mu g/kg/hr, and 1 mu g/kg/hr.
Endoscopic balloon dilatation of benign esophageal strictures in childhood: a 15-year experience
(Wiley-Blackwell, 2016) Cakmak, M.; Boybeyi, O.; Gollu, G.; Kucuk, G.; Bingol-Kologlu, M.; Yagmurlu, A.; Dindar, H.
The study aims to evaluate the effectiveness and safety of endoscopic balloon dilatation (EBD) in childhood benign esophageal strictures. The medical records of 38 patients who underwent EBD from 1999 to 2013 were retrospectively reviewed. Demographic features, diagnoses, features of strictures, frequency and number of EBD, complications, outcome, and recurrence data were recorded. Median age was 1.5 years (0-14), and female/male ratio was 17/21 (n = 38). Primary diagnoses were corrosive esophageal stricture (n = 19) and esophageal atresia (n = 19). The length of strictures were less than 5cm in 78.9% (n = 30). No complication was seen in 86.8% (n = 33). Perforation was seen in 10.5% (n = 4), and recurrent fistula was seen in 2.7% (n = 1). Total treatment lasted for 1 year (1-11). Dysphagia was relieved in 60.5% (n = 23). Recurrence was seen in 31.6% (n = 12). Treatment effectiveness was higher, and complication rates were lower in strictures shorter than 5cm compared with longer ones (70% vs. 25%, P < 0.05, and 3.4% vs. 37.5%, P < 0.05). Although there was no statistical difference, treatment effectiveness rates were lower and complication and recurrence rates were higher in corrosive strictures compared with anastomotic ones (P > 0.05). EBD is a safe and efficient treatment choice in esophageal strictures, especially in strictures shorter than 5cm and anastomotic strictures.
Accidental ingestion of a pen in an adolescent girl
(Edizioni Minerva Medica, 2016) Sapmaz, Ferdane; Aslan, Mustafa Kemal; Guenal, Yasemin Dere; Boybeyi, Oezlem; Kalkan, Ismail Hakki; Guliter, Sefa
Foreign body ingestion is a common problem in pediatric population with a peak incidence between 6 months and 6 years. adolescents, however, are more likely to swallow or insert foreign bodies intentionally as a risk-taking behavior, a bid for attention, or under the influence of drugs or alcohol. in this paper we report the case of an adolescent girl who accidentally ingested a pen, which was successfully removed with endoscopy.
The effect of extracorporeal shock wave lithotripsy on distribution of interstitial cells of Cajal in rabbit renal pelvis and proximal ureter
(Tubitak Scientific & Technical Research Council Turkey, 2015) Boybeyi, Ozlem; Fedakar Senyucel, Mine; Ayva, Ebru Sebnem; Soyer, Tutku; Aslan, Mustafa Kemal; Basar, Mehmet Murad; Cakmak, Ahmet Murat
Background/aim: An experimental study was performed to evaluate the effect of extracorporeal shock wave lithotripsy (ESWL) on the distribution of interstitial cells of Cajal (ICC) in rabbit renal pelvis and proximal ureter. Materials and methods: Six New Zealand rabbits were included. Right kidneys were exposed to a total of 3000 shock waves (14 kV) by using an electrohydraulic-type ESWL device. Right sides were allocated as the ESWL group (EG, n = 6) and left sides as the control group (CG, n = 6). Tissues were harvested on day 7. Tissues were examined histopathologically for the presence of edema, inflammation, congestion, hemorrhage, fibrosis, and vascularization. Mast cell tryptase and CD117 (c-kit) staining was performed for ICC distribution. Results: Although increased tissue edema in renal pelvises and increased inflammation in ureters were observed in EG, no statistical difference was detected between groups (P > 0.05). In CG, positive CD117 staining was detected in 2 renal pelvises and ureters. None of the EG samples showed CD117 staining and no statistical difference was detected between groups (P > 0.05). Conclusion: Rabbit does not appear to be a good model for investigating ICCs. ESWL may cause histopathological alterations in the renal pelvis and ureter. Since it has not been statistically proven, reduced contractility of the ureter after ESWL may not be attributed to altered distribution of ICCs in the renal pelvis and ureter.
Investigation of the effects of enteral hormones on the pyloric muscle in newborn rats
(W B Saunders Co-Elsevier Inc, 2015) Boybeyi, Ozlem; Soyer, Tutku; Atasoy, Pinar; Gunal, Yasemin Dere; Aslan, Mustafa Kemal
Purpose: To investigate the effects of enteral hormones on pyloric muscle in order to clarify the etiopathogenesis of hypertrophic pyloric stenosis (HPS). Methods: Forty-two newborn Wistar-Albino rats were included. No intervention was done in the control group (CG, n = 6). In the sham group (SG, n = 6) 1 ml saline (0.9% NaCl solution), in the Nw-nitro-L-arginine methyl ester hydrochloride (L-NAME) group (LNG, n = 6) 100 mg/kg/d L-NAME, in the somatostatin group (STG, n = 6) 7 mcg/kg/d ST, in the cholecystokinin group (CCKG, n = 6) 3 mcg/kg/d CCK, in the substance P group (SPG, n = 6) 5 ml/kg/d SP, and in the prostaglandin-E1 group (PGE1G, n = 6) a cumulative dose of 360 mcg/kg PGE1 was given intraperitoneally for 14 days. On the 21st day, histopathological examination and muscle thickness measurements were done. Results were evaluated statistically. Results: Total and circular pyloric muscle thicknesses were significantly increased in the LNG compared to the CG and SG (p < 0.05). Circular pyloric muscle thickness was not increased in the STG, CCKG and SPG compared to the CG and SG (p > 0.05). In the PGE1G, muscle thickness was significantly decreased in the pylorus and increased in the antrum compared to the CG and SG (p < 0.05). Conclusion: Nitric oxide synthase (NOS) inhibition with L-NAME seems to be a causative factor in HPS by increasing pyloric muscle thickness. PGE predominantly affects antral gastric muscle and has no profound effect on pyloric muscle. (C) 2015 Elsevier Inc. All rights reserved.
Cognitive and behavioral characteristics of children with caustic ingestion
(W B Saunders Co-Elsevier Inc, 2015) Cakmak, Murat; Gollu, Gulnur; Boybeyi, Ozlem; Kucuk, Gonul; Sertcelik, Mehmet; Gunal, Yasemin Dere; Kilic, Birim Gunay
Background/aim: Children with attention-deficit/hyperactivity disorder (AD/HD) have risk taking behavior and are more prone to sustaining injury. It is aimed to evaluate the cognitive and behavioral characteristics of children with caustic ingestion. Patients and methods: Ninety two children with a history of nonsuicidal caustic ingestion (CI, n = 46) and healthy subjects (HS, n = 46) admitted to pediatric surgery department were enrolled into the study. Patients in groups were evaluated for age, sex, number of siblings and educational status of the parents. Before filling the questionnaires, the children were undergone flexible endoscopy and treated accordingly. Conners Parents Rating Scale-revised long form (CPRS-R:L), validated for Turkish Children, was used to evaluate the cognitive and behavioral characteristics of children. Parents rate their child's behavior with a four-point Likert scale. Subscales of CPRS-R: L including cognitive problems/inattention (CG/I), hyperactivity (H), attention deficit hyperactivity disorder index (AD/HD-I), Conners' Global Index-discomfort-impulsivity (CGI-DI), DSM-IV-symptom subscale-inattention (DSMIV, SS-I), DSM-IV-symptom subscale-hyperactivity-impulsivity (DSM-IV, SS-HI), DSMIV-symptom subscale-total score (DSM-IV SS-T) were used to determine the severity of the AD/HD symptom. Demographic features and cognitive/behavioral characteristics of children with caustic ingestion were compared with healthy subjects. Results: The median age of the patients was 4 (2-14 years) in both CI and HS groups. Female male ratio was 13:33 in CI and 12:34 in HS. Sixty seven percent of patients were preschool children (younger than 5 years of age) in both CI and HS groups. There was no difference between groups for number of siblings (p > 0.05). Parents of HS group had higher educational status than parents in CI (p < 0.05). When subscale scores of CPRS-R: L compared between CI and HS groups, CI group had higher CGI-DI scores than HS (p < 0.05). Children younger than five years of age had higher scores of H, emotional instability and total CG/I in CI than HS group (p < 0.05). Conclusion: Children with caustic ingestion had impulsiveness behavior when compared to healthy children. In addition to impulsivity, hyperactivity can be also assessed as a risk factor for caustic ingestion in children younger than 5 years of age. We suggest that association between AD/HD behavior and risk of sustaining injuries was also confirmed for caustic ingestion in children. (C) 2015 Elsevier Inc. All rights reserved.
Selective inhibition of nitric oxide synthase causes increased muscle thickness in rat esophagus
(W B Saunders Co-Elsevier Inc, 2015) Soyer, Tutku; Boybeyi, Ozlem; Atasoy, Pinar
Aim: Achalasia is a primary motor dysfunction of esophagus which can be created experimentally by nitric oxide synthase (NOS) inhibition. Although several theories have been suggested, mechanism of increased esophageal muscle thickness in achalasia is still unclear. An experimental study was performed to evaluate the esophageal muscle thickness after selective inhibition of NOS in rats. Materials and methods: Wistar albino rats (n = 18) weighing 150-200 g of both sexes were included in the study. After anesthetization with ketamine hydrochloride, esophageal body and distal esophagus were sampled in control group (CG, n = 6). In sham group (SG, n = 6), intraperitoneal saline (1 ml) injection was performed for 21 days. L-NAME (L-nitroarginin metyl ester, selective inhibitor of NOS) group (LNAMEG, n = 6) received 100 mg/kg/d L-NAME intraperitoneally for 21 days. The esophageal body and distal esophagus were removed for histopathological analysis in each group. All samples were evaluated for total and circular muscle thickness with hemotoxylene-eosine (HE) staining. Results: None of the samples showed pathologic finding in esophageal mucosa. There was no difference between CG and SG for total and circular muscle thickness in esophageal body and distal esophagus. LNAMEG had higher median levels of both total and circular muscle thickness than CG and SG in esophageal body (P < 0.05). However, in distal esophageal segments, only total muscle thickness was statistically higher in LNAMEG than CG and SG (P < 0.05). Conclusion: Selective inhibition of NOS causes increased total smooth muscle thickness in esophageal body and distal esophagus. However, this effect could not detected in circular muscle in the distal esophagus. We suggest that NOS inhbition not only increases esophageal peristalsis but also causes muscle hypertrophy in esophagus. (C) 2015 Elsevier Inc. All rights reserved.

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