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Tartar T, Akdeniz I, Onalan E, Bakal U, Sarac M, Genc E, Kaymaz T, Kazez A. Investigation of VGLL3 and sub-target genes in the aetiology of paediatric acute appendicitis: a prospective case-control study. Pediatr Surg Int 2023; 39:169. [PMID: 37029824 DOI: 10.1007/s00383-023-05462-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/03/2023] [Indexed: 04/09/2023]
Abstract
PURPOSE Vestigial like family member 3 (VGLL3) and its sub-target genes show considerable transcriptomic overlap in terms of several autoimmune and inflammatory diseases. Herein, we investigated the role of VGLL3 rs13074432 polymorphism and its sub-target genes in the aetiology of acute appendicitis (AA). METHODS In this prospective case-control study, we included 250 patients (age, 0-18 years) who underwent appendectomy with the diagnosis of AA (patient group; blood and appendix tissue samples) and 200 healthy children (control group; only blood samples) without appendectomy. ELISA method was used for protein-level detection of VGLL3 and sub-target genes expression change in obtained tissue samples, and real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used for mRNA level detection. Genotyping analyses were performed on DNA samples isolated from blood using TaqMan SNP genotyping test. RESULTS The frequency of TT variant genotype (p < 0.001) and T allele (p = 0.002) showed a significant decrease in the patient group compared with the control group. No significant correlation was observed between the expression of VGLL3 in the appendiceal tissue and patient clinical and demographic data (p > 0.050). CONCLUSION This study revealed that the VGLL3 gene and its sub-target genes are associated with AA aetiology.
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Affiliation(s)
- Tugay Tartar
- Department of Pediatric Surgery, Firat University Faculty of Medicine, 23119, Elazig, Turkey.
| | - Ibrahim Akdeniz
- Department of Pediatric Surgery, Fethi Sekin City Hospital, 23280, Elazig, Turkey
| | - Ebru Onalan
- Department of Medical Biology and Genetics, Firat University Faculty of Medicine, 23119, Elazig, Turkey
| | - Unal Bakal
- Department of Pediatric Surgery, Firat University Faculty of Medicine, 23119, Elazig, Turkey
| | - Mehmet Sarac
- Department of Pediatric Surgery, Adiyaman University Faculty of Medicine, 02200, Elazig, Turkey
| | - Ercan Genc
- Department of Pediatric Surgery, Firat University Faculty of Medicine, 23119, Elazig, Turkey
| | - Tugce Kaymaz
- Department of Medical Biology and Genetics, Firat University Faculty of Medicine, 23119, Elazig, Turkey
| | - Ahmet Kazez
- Department of Pediatric Surgery, Firat University Faculty of Medicine, 23119, Elazig, Turkey
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Bakal U, Sarac M, Tartar T, Aydin M, Kara A, Gurgoze MK, Kazez A. Peritoneal dialysis in children: Infectious and mechanical complications: Experience of a tertiary hospital in Elazığ, Turkey. Niger J Clin Pract 2022; 25:1227-1232. [DOI: 10.4103/njcp.njcp_1529_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Saraç M, Bakal U, Tartar T, Aydin S, Kuloğlu T, Akdeniz I, Yardim M, Yilmaz M, Kazez A. A new biomarker (RENALASE) for the diagnosis of blunt renal trauma in an experimental study. J Pediatr Urol 2021; 17:762.e1-762.e10. [PMID: 34583902 DOI: 10.1016/j.jpurol.2021.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 07/26/2021] [Accepted: 09/10/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Kidneys are the most frequently injured organ in the genitourinary system, but there is no specific biological marker for this trauma. Renalase may be a descriptive biomarker of the pathology that causes renal ischemia, nephrotoxicity, and acute renal failure. OBJECTIVE This study investigated the role of serum and urine levels of renalase for the diagnosis of renal injury in rats with experimentally induced blunt renal trauma. STUDY DESIGN Thirty 3-month-old Sprague-Dawley adult male rats were divided into five groups (n = 6) as follows: control (Group 1), sham (Group 2), right nephrectomy (Group 3), left renal trauma (Group 4), and right nephrectomy plus left renal trauma (Group 5). Serum samples were acquired 3, 24 and 48 h post-trauma, and urine samples were acquired between 0-24 and 24-48 h post-trauma. Changes in serum and urine levels of renalase, dopamine, epinephrine, metanephrine, normetanephrine, urea, and creatinine were assessed after blunt renal trauma. RESULTS No significant changes in serum levels of these compounds were observed at 3 h post-trauma in Groups 1 and 2 or in urine collected sequentially at 0-24 and 24-48 h. By contrast, levels of renalase, dopamine, metanephrine, and normetanephrine in serum increased during hour 3 in Groups 4 and 5. Moreover, increases in urine levels of renalase, dopamine, epinephrine, metanephrine, and normetanephrine were observed at hours 0-24 in Groups 4 and 5. DISCUSSION A definitive diagnosis of traumatic renal injury in children is made with contrast-enhanced computed tomography. However, the scan results in high doses of radiation exposure to children. Here, we report for the first time that renalase levels may be useful as a biomarker for the diagnosis of renal injury due to blunt renal trauma. CONCLUSION Renalase may be a simple, effective, and noninvasive biomarker that indicates traumatic renal injury. It could be used as an adjunct for evaluation, particularly for isolated traumatic renal injury in cases where access to computed tomography is not straightforward.
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Affiliation(s)
- Mehmet Saraç
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, 23119, Turkey.
| | - Unal Bakal
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, 23119, Turkey.
| | - Tugay Tartar
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, 23119, Turkey.
| | - Süleyman Aydin
- Department of Medical Biochemistry (Firat Hormones Research Group), School of Medicine, Firat University, Elazig, 23119, Turkey.
| | - Tuncay Kuloğlu
- Department of Histology and Embryology, Firat University School of Medicine, Elazig, 23119, Turkey.
| | - Ibrahim Akdeniz
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, 23119, Turkey.
| | - Meltem Yardim
- Department of Medical Biochemistry, Yerköy State Hospital, Yozgat, 66900, Turkey.
| | - Mustafa Yilmaz
- Department of Emergency Medicine, Firat University Faculty of Medicine, Elazig, 23200, Turkey.
| | - Ahmet Kazez
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, 23119, Turkey.
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Saraç M, Canpolat Ş, Önalan Etem E, Tektemur A, Tartar T, Bakal U, Kazez A. The role of sonic hedgehog homologue signal pathway in hypospadias aetiology. J Pediatr Urol 2021; 17:630.e1-630.e7. [PMID: 34275739 DOI: 10.1016/j.jpurol.2021.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Hypospadias is one of the most common congenital anomalies of the male genitalia. Sonic hedgehog homologue (SHH) signalling pathway is believed to be involved in the development of the male genital system. OBJECTIVE In this clinical prospective study, the role of the SHH pathway in hypospadias aetiology was investigated. STUDY DESIGN In this study, 200 healthy children (boys without hypospadias, control group), 118 patients (boys with distal hypospadias) and 82 patients (boys with proximal hypospadias) of age 0-16 years were included. The expression of the genes suppressor of fused protein (SUFU), SHH, protein patched homologue (PTCH; PTCH1 and PTCH2), glioma-associated oncogene homologue (GLI; GLI1, GLI2, GLI3 and GLI4), smoothened, frizzled-class receptor (SMO) and serine/threonine-protein kinase 36 (STK36) that are involved in SHH pathway were investigated. Furthermore, polymorphism analyses of GLI2, SHH and PTCH1 genes were performed. The history of hypospadias in the first and second-degree relatives of the patients in boys with distal hypospadias and boys with proximal hypospadias was inquired. RESULTS Ten patients in the boys with distal hypospadias and twenty patients in the boys with proximal hypospadias had a history of hypospadias in first or second-degree relatives (p < 0.05). There was a significant decrease in mRNA expressions of SHH and PTCH1 genes in boys with proximal hypospadias compared to boys without hypospadias (p < 0.05). Besides, a significant decrease in mRNA fold-change of GLI2 gene was detected in boys with both distal hypospadias and proximal hypospadias compared to boys without hypospadias (p < 0.05). In contrast, there was no significant difference in the mRNA fold-changes of PTCH2, SUFU, GLI1, GLI3, GLI4, SMO and STK36 genes among the groups. Moreover, there were no significant differences in the frequencies of variant genotypes and alleles rs735557, rs12711538 and rs4848632 (GLI2 gene), rs104894049 (SHH gene) and rs41313327 (PTCH1 gene) (p > 0.05). DISCUSSION SHH expression is required for the growth and differentiation of the genital bulge. Developmental defects in the external genital organs were demonstrated in mice with SHH deletion. It has been demonstrated that SHH mainly plays a role in the formation of sinusoid morphology of the penis. In the present study, although SHH and PTCH gene expressions were found to be decreased only in the penile tissues of proximal hypospadias, GLI2 gene expression was decreased in penile tissues of boys with both distal hypospadias and boys with proximal hypospadias. CONCLUSION Genes involved in the SHH pathway might play a role in the aetiology of hypospadias. Furthermore, there is a correlation between molecular defects in this pathway and severity of hypospadias.
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Affiliation(s)
- Mehmet Saraç
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, 23119, Turkey.
| | - Şenay Canpolat
- Ministry of Health University, Ankara Dr. Sami Ulus Obstetrics, Child Health and Diseases Training and Research Hospital, Elazig, 23119, Turkey.
| | - Ebru Önalan Etem
- Department of Medical Biology, Firat University School of Medicine, 23119, Elazig, Turkey.
| | - Ahmet Tektemur
- Department of Medical Biology, Firat University School of Medicine, 23119, Elazig, Turkey.
| | - Tugay Tartar
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, 23119, Turkey.
| | - Unal Bakal
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, 23119, Turkey.
| | - Ahmet Kazez
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, 23119, Turkey.
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Tartar T, Saraç M, Bakal Ü, Onur MR, Kazez A. A rare cause of inguinal abscess: perforated appendicitis due to foreign body in Amyand`s hernia. Turk J Pediatr 2021; 62:889-892. [PMID: 33108097 DOI: 10.24953/turkjped.2020.05.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Amyand`s hernia is rarely noted in children, and appendicitis caused by a foreign body in Amyand`s hernia is even rarer. CASE A 2-year-old girl presented with recurrent conglomerate lymph node enlargements and an abscess in the right groin existing for one year despite medical treatment. Direct radiography revealed a foreign body in the right inguinal region. Computed tomography showed a foreign body and soft tissue inflammation in the inguinal canal. Laparotomy was performed, and Amyand`s hernia was diagnosed. A foreign body was found in the lumen of the appendix vermiformis causing perforated appendicitis. This case is presented because of its rarity and unusual clinical presentation. CONCLUSION Amyand`s hernia should be considered in paediatric cases with the history of recurrent inguinal abscesses.
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Affiliation(s)
- Tugay Tartar
- Department of Pediatric Surgery, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Mehmet Saraç
- Department of Pediatric Surgery, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Ünal Bakal
- Department of Pediatric Surgery, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Mehmet Ruhi Onur
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ahmet Kazez
- Department of Pediatric Surgery, Fırat University Faculty of Medicine, Elazığ, Turkey
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Kazez A. Trauma in children. Turk Arch Pediatr 2021. [DOI: 10.4274/turkpedars.45.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Saraç M, Tartar T, Bakal Ü, Aydın M, Akdeniz İ, Kazez A. Intestinal Atresia: Twenty Years of Experience at a Reference Hospital. Istanbul Med J 2021. [DOI: 10.4274/imj.galenos.2020.98957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Abstract
Objectives The relationship hydatid cyst (HC) is a parasitic disease that is endemic worldwide. Aims To study the clinical findings and laboratory results of patients with hydatid disease. Materials and Methods Total number of patients (n = 78) who underwent surgery for HC disease from 2000 to 2017 were retrospectively evaluated. The patients' demographic characteristics, reasons for admission into hospital, lesion location and size, laboratory results, and complications were recorded. Results Of the HCs, 59% and 26.9% were located in the liver and lungs, respectively. The rate of multiple organ involvement was 10.3%. A total of 16 (20.5%) cases had ruptured HCs (7 livers, 7 lungs, 1 spleen, and 1 omentum). There was no significant difference in the rate of eosinophilia between patients with and without cyst rupture (P = 0.9). Indirect hemagglutination (IHA) tests yielded negative results in 38.9% of the patients; among them, 32.1% had ruptured HCs. A negative IHA test result was significantly associated with rupture (P = 0.046). No significant difference between rupture and cyst size or location was found. Conclusions HC rupture was not correlated with cyst size. The sensitivity of serological tests and the blood eosinophil count was low, even in cases of ruptured HCs. The recurrence rate can be reduced by open surgery and medical treatments.
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Affiliation(s)
- T Tartar
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
| | - U Bakal
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
| | - M Sarac
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
| | - A Kazez
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
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Bakal Ü, Saraç M, Tartar T, Poyraz AK, Kazez A. Duplex Kidney with a Segmental Solitary Cystic Dysplasia and Ureteric Atresia: A Rare Case. Istanbul Med J 2020. [DOI: 10.4274/imj.galenos.2020.29795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Bakal Ü, Saraç M, Tartar T, Atılgan R, Kuloğlu T, Dağlı AF, Kazez A. Efficacy of Sclerotherapic Agents in the Treatment of Simple Ovarian Cysts Created by Experimental Rat Model. Istanbul Med J 2020. [DOI: 10.4274/imj.galenos.2020.52296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Tartar T, Sağmak-Tartar A, Saraç M, Bakal Ü, Akbulut A, Kazez A. Does microbial resistance profile change in community-based intra-abdominal infections? Evaluation of the culture results of patients with appendicitis. Turk J Pediatr 2019; 60:520-526. [PMID: 30968625 DOI: 10.24953/turkjped.2018.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Tartar T, Sağmak-Tartar A, Saraç M, Bakal Ü, Akbulut A, Kazez A. Does microbial resistance profile change in community-based intra-abdominal infections? Evaluation of the culture results of patients with appendicitis. Turk J Pediatr 2018; 60: 520-526. Most common origin of intra-abdominal infections in children is appendicitis. Microorganisms responsible for community-based and hospital-acquired intra-abdominal infections vary. The aim of this study was to evaluate microbial culture outcomes and antibiotic susceptibilities of these microorganisms in samples obtained intraoperatively from pediatric patients with appendicitis, and to define the infectious microorganisms responsible for the community-based intra-abdominal infections in our region, and their antibiotic susceptibilities. This study included 231 patients between 0 and 16 years of age, operated on due to appendicitis between 2014 and 2017. Appendicular tissues were sampled intraoperatively. Antibiogram was studied in case of reproduction in tissue culture. Forms included information on the age and gender of the patients, intra-abdominal event, bacterial growth in microbial culture and antibiogram, antibiotic switch during follow-up, duration of the treatment, complications and outcomes were recorded. No microbial growth was observed following inoculation of the samples obtained from appendiceal tissue of 24.7% patients, whereas growth was positive in 75.3%. Gram negative bacteria were isolated in 94.3% of the patients, whereas gram positive bacteria was isolated in 5.7%. Polymicrobial growth was observed in 2.2% of the patients. E. coli in 79.9%, P. aeruginosa in 5.2%, Enterobacter cloacae in 3.4%, Coagulase-negative staphylococci in 3.4%, Klebsiella spp. in 1.7%, Citrobacter spp. in 1.7%, Enterococcus spp. in 1.7%, Comamonas testosteroni in 1.2% of patients produced. ESBL positivity is present in 51 (36.7%) of 139 E. coli strains reproducing in appendiceal tissue culture. ESBL was positivity detected in one of the reproduced 3 Klebsiella spp. strains. In E. coli, ciprofloxacin resistance as 20.86%, ampicillin-sulbactam resistance as 83.45%, and co-trimoxazole resistance as 41% were found. Our study clearly demonstrates that the resistance profile varies in community-based intra-abdominal infections. Empirical treatment protocols should be revised in especially the patients admitted with septic presentation and where the source control is not possible.
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Affiliation(s)
- Tugay Tartar
- Departments of Pediatric Surgery, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Ayşe Sağmak-Tartar
- Infectious Diseases and Clinical Microbiology, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Mehmet Saraç
- Departments of Pediatric Surgery, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Ünal Bakal
- Departments of Pediatric Surgery, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Ayhan Akbulut
- Infectious Diseases and Clinical Microbiology, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Ahmet Kazez
- Departments of Pediatric Surgery, Fırat University Faculty of Medicine, Elazığ, Turkey
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Abstract
Aim Bochdalek hernias, which brought after the neonatal period, are also late-defined cases. In this study, we aimed to present the clinical characteristics of patients with late-presentation Bochdalek hernias who underwent surgery in a reference hospital and our experience regarding their diagnosis. Material and Methods Patients with late-presentation Bochdalek hernia who underwent surgery in our clinic between 2001 and 2016 were analyzed retrospectively in terms of the causes of the delay in diagnosis, symptoms, and radiologic and surgical results. Results A total of seven patients with late-presentation Bochdalek hernia underwent surgery, four males and three females. The median age was 48 months. Of the 43 patients who underwent surgery for Bochdalek hernia during the same period, 7 (16.27%) presented to hospital late. In all late-presentation Bochdalek hernia cases, the defect was on the left side. Two patients had hernia sacs, and two patients had ectopic intrathoracic left kidneys. Six of the patients presented with gastrointestinal system symptoms, and one with respiratory system symptoms. The median time between the onset of symptoms and diagnosis was 60 days. The maternal age of four patients was ≥30 years. The gestational age and birth weights of the patients were normal. In physical examination, there was a scaphoid abdomen and an increased chest anterior-posterior diameter. In chest radiographs of all patients, the appearance was consistent with intestinal gas in the left hemithorax. The transverse length of the defect in the diaphragm (median value: 5 cm) in the patients with late-presentation Bochdalek hernia was longer than that (median value: 3 cm) of patients who were diagnosed early (p=0.02). The difference was statistically significant. All patients survived, were followed up for an average of 3 years, and no relapse was observed during the follow-up period. Conclusion Bochdalek hernia can be diagnosed after the neonatal period. Contrary to cases diagnosed in the neonatal period, gastrointestinal system symptoms are at the forefront in these cases, and these patients have good prognosis. Congenital diaphragmatic hernia should be considered in the differential diagnosis in patients with gastrointestinal system symptoms such as recurrent nausea and vomiting.
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Affiliation(s)
- Tugay Tartar
- Department of Pediatric Surgery, Fırat University School of Medicine, Elazığ, Turkey
| | - Mehmet Saraç
- Department of Pediatric Surgery, Fırat University School of Medicine, Elazığ, Turkey
| | - Ünal Bakal
- Department of Pediatric Surgery, Fırat University School of Medicine, Elazığ, Turkey
| | - Ahmet Kazez
- Department of Pediatric Surgery, Fırat University School of Medicine, Elazığ, Turkey
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Abstract
BACKGROUND/AIMS Littre hernia (LH) is difficult to distinguish from other hernias until complications arise. In this research, we present the details of diagnosis, treatment, and frequency of LH cases with differentiated clinical properties. MATERIALS AND METHODS Littre hernia prevalence, clinical properties, and treatment details of cases diagnosed as incarceration/strangulation (I/S) of hernias between December 1996 and December 2017 were retrospectively investigated. RESULTS Incarceration/strangulation was detected in 403 out of 3758 hernias within 21 years. Four cases were detected as LH (0.09%) in 403 I/S patients. Partly reduced 2 cases were treated by resection/anastomosis with the abdominal approach. CONCLUSION The possibility of LH in strangulated or partly reduced hernias should be considered. The abdominal approach may be necessary in nonreducible hernia with possible LH patients.
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Affiliation(s)
- Ünal Bakal
- Department of Pediatric Surgery, Fırat University School of Medicine, Elazığ, Turkey
| | - Tugay Tartar
- Department of Pediatric Surgery, Fırat University School of Medicine, Elazığ, Turkey
| | - Mehmet Saraç
- Department of Pediatric Surgery, Fırat University School of Medicine, Elazığ, Turkey
| | - Ahmet Kazez
- Department of Pediatric Surgery, Fırat University School of Medicine, Elazığ, Turkey
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Bakal U, Onur MR, Sarac M, Tartar T, Kontas O, Kazez A. Burned-Out Tumor of the Undescended Testis: A Rare Cause of Intra-Abdominal Mass in Childhood. Istanbul Med J 2018. [DOI: 10.5152/imj.2018.33254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Sarac M, Bakal U, Tartar T, Canpolat S, Kazez A. Is stent type used in snodgrass method a factor in fistula formation? Niger J Clin Pract 2018; 21:1198-1202. [PMID: 30156207 DOI: 10.4103/njcp.njcp_317_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Context Snodgrass method (tubularized incised plate urethroplasty [TIPU]) is a widely used technique for hypospadias repair. Aim It was aimed to compare the outcome of hypospadias repair with stenting using feeding tube compare with those with Foley catheter. Subjects and Methods The demographic characteristics of the 123 patients who underwent hypospadias repair with Snodgrass method, the success of the applied method, and the factors affecting fistula complication were evaluated retrospectively. Patients were divided into two groups: those operated before January 2010 (Group A) and those who were operated after (Group B). In Group A patients, urethroplasty was performed using silicone Foley catheters, in which balloon of these catheters was filled by saline at appropriate size. In Group B, urethroplasty was performed using feeding catheter. Results Group A and Group B consisted of 32 and 91 patients, respectively. Fistula developed in 10 (31.3%) and 4 (4.39%) patients in Group A and Group B, respectively. There was a statistically significant difference between the two groups in terms of the development of fistula complication (P = 0.0002). Conclusion The use of a feeding catheter in TIPU could be a more advantageous than using a Foley catheter.
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Affiliation(s)
- M Sarac
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
| | - U Bakal
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
| | - T Tartar
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
| | - S Canpolat
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
| | - A Kazez
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
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Tartar T, Sarac M, Bakal U, Canpolat S, Kazez A. Transverse Testicular Ectopia: Two Case Reports. Istanbul Med J 2018. [DOI: 10.5152/imj.2018.88557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Sarac M, Bakal U, Tartar T, Canpolat S, Kara A, Kazez A. Bochdalek hernia and intrathoracic ectopic kidney: Presentation of two case reports and review of the literature. Niger J Clin Pract 2018; 21:681-686. [PMID: 29735873 DOI: 10.4103/njcp.njcp_217_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Bochdalek hernia is a congenital abnormality with high morbidity and mortality characterized by passage of the abdominal organs into the thoracic cavity through a diaphragmatic defect. Intrathoracic location of abdominal organs such as kidneys is very rare, with a reported incidence of only 0.25% in the literature. Herein, we present two cases of Bochdalek hernia with a herniation of intra-abdominal organ such as kidney that was treated in our clinic and compare this rare case with those in the literature. In both cases, the functionally normal kidneys were left in situ during diaphragmatic repair. No complications were observed during the postoperative period, and 10- and 1-year follow-ups. In cases with Bochdalek hernia associated with an intrathoracic ectopic kidney, the functionally normal ectopic kidneys were left in situ during repair of the diaphragmatic defect without complications.
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Affiliation(s)
- M Sarac
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
| | - U Bakal
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
| | - T Tartar
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
| | - S Canpolat
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
| | - A Kara
- Department of Pediatric Nephrology, Firat University School of Medicine, Elazig, Turkey
| | - A Kazez
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
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Sarac M, Bakal U, Kuloglu T, Tartar T, Aydin S, Yardim M, Artas G, Kazez A. Effects of Carnosine and Vitamin E on Nucleobindin 2 (NUCB2)/nesfatin-1, Ghrelin, Adropin, and Irisin in Experimentally Induced Ovarian Torsion. Ann Clin Lab Sci 2018; 48:345-354. [PMID: 29970439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Delay in the diagnosis of ovarian torsion leads to serious histopathological changes and many problems, including infertility. Various agents have been investigated to minimize detorsion-associated potential injury. This study was performed to study the effects of carnosine and vitamin E on tissue and serum expression of Nucleobindin 2 (NUCB2)/nesfatin-1, ghrelin, adropin, and irisin to determine whether they have protective effects in cases of ovarian torsion. MATERIAL AND METHOD Seventy-eight rats were allocated evenly into 13 groups. All rats, excluding those in the control and sham groups and Groups (G) III, IV, and V, were subjected to ovarian torsion for 12 hours. The groups were designated as follows: G-I (control), G-II (sham), G-III (vitamin E), G-IV (carnosine), G-V (carnosine + vitamin E), G-VI (torsion), G-VII (torsion + detorsion), G-VIII (torsion + vitamin E), G-IX (torsion + carnosine), G-X (torsion + carnosine + vitamin E), G-XI (torsion + detorsion + vitamin E), G-XII (torsion + detorsion + carnosine), and G-XIII (torsion + detorsion + carnosine + vitamin E). Serum levels of NUCB2/nesfatin-1, ghrelin, adropin, and irisin were measured by ELISA. Immunohistochemical methods were used to measure the expression of these hormones in ovarian tissue. RESULTS The levels of NUCB2/nesfatin-1 immunoreactivity were increased in G-VII, G-XI, and G-XII (p<0.05). The immunoreactivity of ghrelin was significantly decreased in G-VI, G-IX, G-XI, and G-XII. However, adropin immunoreactivity did not differ significantly between the groups (p>0.05). The level of irisin immunoreactivity was decreased in G-VI, G-VII, and G-VIII (p<0.05). The serum levels of NUCB2/nesfatin-1, ghrelin, adropin, and irisin paralleled the tissue immunohistochemical results. CONCLUSION Carnosine and vitamin E protected the ovaries from ischemia-reperfusion injury in ovarian torsion. These antioxidants, especially carnosine, may be useful for the treatment of ovarian torsion.
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Affiliation(s)
- Mehmet Sarac
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
| | - Unal Bakal
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
| | - Tuncay Kuloglu
- Department of Histology and Embryology, Firat University School of Medicine, Elazig, Turkey
| | - Tugay Tartar
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
| | - Suleyman Aydin
- Department of Medical Biochemistry (Firat Hormones Research Group), School of Medicine, Firat University, Elazig, Turkey
| | - Meltem Yardim
- Department of Medical Biochemistry (Firat Hormones Research Group), School of Medicine, Firat University, Elazig, Turkey
| | - Gokhan Artas
- Department of Pathology, Firat University School of Medicine, Elazig, Turkey
| | - Ahmet Kazez
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
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Sarac M, Bakal U, Tartar T, Kuloglu T, Yardim M, Artas G, Aydin S, Kazez A. Ghrelin and NUCB2/Nesfatin-1 expression in unilateral testicular torsion-induced rats with and without N-acetylcysteine. ACTA ACUST UNITED AC 2017; 63:40-45. [PMID: 28838338 DOI: 10.14715/cmb/2017.63.7.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 05/15/2017] [Accepted: 05/16/2017] [Indexed: 11/18/2022]
Abstract
Testicular torsion (TT) is a common urological problem in the field of pediatric surgery. The degree and duration of torsion determines the degree of testicular damage; however, its effects on the expression of octanoylated ghrelin and nucleobindin 2 (NUCB2) /nesfatin-1 synthetized from testicular tissue remain unclear. We explored the effects of experimentally induced unilateral TT on serum and contralateral testicular tissue ghrelin and NUCB2/nesfatin-1 levels, and determined whether N-acetyl cysteine (NAS) treatment had any effects on their expression. A total of 42 Wistar Albino strain rats were divided into 7 groups: Group (G) I control, GII sham, GIII 12-hour torsion, GIV 12-hour torsion + detorsion + 100 mg/kg NAS, GV 24-hour torsion, GVI 24-hour torsion + detorsion + 100 mg/kg NAS, and GVII 100 mg/kg NAS. Octanoylated ghrelin and NUCB2/nesfatin-1 concentrations were evaluated in serum using the ELISA method and in testicular tissue with immunohistochemical methods. Immunoreactivity of octanoylated ghrelin significantly increased in GI compared to GIII, GV, and GVI (p<0.05). NUCB2/nesfatin-1 immunoreactivity increased in GV and GVIII relative to GI (p<0.05). In the 12-hour torsion group, a significant decrease in octanoylated ghrelin levels with NAS treatment was observed; however, in the 24-hour torsion group, a significant decrease was not observed. In the 12-hour torsion + NAS treatment group, a significant change was not observed in NUCB2/nesfatin-1 expression. Following 24-hour torsion, an increase in NUCB2/nesfatin-1 levels was observed, and NAS treatment did not reverse this increase. It was determined that increases in the expression of octanoylated ghrelin and NUCB2/nesfatin-1, the latter of which was a result of TT, reflect damage in this tissue. Importantly, NAS treatment could prevent this damage. Thus, there may be a clinical application for the combined use of NAS and octanoylated ghrelin in preventing TT-related infertility.
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Affiliation(s)
- M Sarac
- Department of Pediatric Surgery, Medical School, Firat University, 23119 Elazig, Turkey
| | - U Bakal
- Department of Pediatric Surgery, Medical School, Firat University, 23119 Elazig, Turkey
| | - T Tartar
- Department of Pediatric Surgery, Medical School, Firat University, 23119 Elazig, Turkey
| | - T Kuloglu
- Department of Histology and Embryology, Firat University School of Medicine, 23119, Elazig, Turkey
| | - M Yardim
- Department of Medical Biochemistry (Firat Hormones Research Group), School of Medicine, Firat University, Elazig, 23119, Elazig, Turkey
| | - G Artas
- Department of Pathology, Firat University School of Medicine, Elazig, Turkey
| | - S Aydin
- Department of Medical Biochemistry (Firat Hormones Research Group), School of Medicine, Firat University, Elazig, 23119, Elazig, Turkey
| | - A Kazez
- Department of Pediatric Surgery, Medical School, Firat University, 23119 Elazig, Turkey
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Tartar T, Sarac M, Bakal U, Canpolat S, Kazez A. Juvenile Granulosa Cell Tumor of the Testis in a Newborn with Swelling in the Scrotum: A Rare Case and Literature Review. Erciyes Med J 2017. [DOI: 10.5152/etd.2017.17016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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21
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Saraç M, Bahcecioglu IH, Tartar T, Bakal U, Kazez A. Endoscopic treatment of a pediatric case of choledochocele associated with choledocholithiasis. Journal of Pediatric Surgery Case Reports 2017. [DOI: 10.1016/j.epsc.2017.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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22
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Karakus SC, Ozokutan BH, Bakal U, Ceylan H, Sarac M, Kul S, Kazez A. Delayed diagnosis: An important prognostic factor for oesophageal atresia in developing countries. J Paediatr Child Health 2016; 52:1090-1094. [PMID: 27701787 DOI: 10.1111/jpc.13354] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 06/05/2016] [Accepted: 06/07/2016] [Indexed: 01/28/2023]
Abstract
AIM The aim of this study is to analyse the effect of delayed diagnosis on mortality rates, and evaluate the role of delayed diagnosis as a new prognostic factor in patients with oesophageal atresia (OA), especially in developing countries. METHODS The records of 80 consecutive patients with OA (2008-2013) were reviewed. Patients were divided into two groups according to the time of diagnosis. As we demonstrated the effect of delayed diagnosis on mortality, we decided to develop a new classification that will be utilised to predict the prognosis of OA. The discrimination ability of the new prognostic classification was compared with those of the Waterston, Montreal and Spitz classifications using the area under the curve. RESULTS The parameters of the new prognostic classification were birth weight less than 2000 g, the presence of major cardiac/life-threatening anomalies and delay in diagnosis. Class I consisted of patients with none or one of these parameters. Class II consisted of patients with two or three of these parameters. The area under the curve of the new classification was better than those of the other classifications in determining the prognosis of patients with OA. CONCLUSIONS Delayed diagnosis of OA significantly led to morbidity and mortality. Although delayed diagnosis is not a characteristic of newborn or a marker of severity for OA and is a health care system issue in developing countries, we here point out that it is a prognostic factor in its own right. Our new classification has a superior discriminatory ability compared to the above-mentioned classifications.
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Affiliation(s)
- Suleyman Cuneyt Karakus
- Department of Pediatric Surgery, Faculty of Medicine, University of Gaziantep, Gaziantep, Turkey
| | - Bulent Hayri Ozokutan
- Department of Pediatric Surgery, Faculty of Medicine, University of Gaziantep, Gaziantep, Turkey
| | - Unal Bakal
- Department of Pediatric Surgery, Faculty of Medicine, University of Firat, Elazig, Turkey
| | - Haluk Ceylan
- Department of Pediatric Surgery, Faculty of Medicine, University of Gaziantep, Gaziantep, Turkey
| | - Mehmet Sarac
- Department of Pediatric Surgery, Faculty of Medicine, University of Firat, Elazig, Turkey
| | - Seval Kul
- Department of Medical Statistics, Faculty of Medicine, University of Gaziantep, Gaziantep, Turkey
| | - Ahmet Kazez
- Department of Pediatric Surgery, Faculty of Medicine, University of Firat, Elazig, Turkey
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Saraç M, Önalan E, Bakal Ü, Tartar T, Aydın M, Orman A, Tektemur A, Taşkın E, Erol FS, Kazez A. Magnesium-permeable TRPM6 polymorphisms in patients with meningomyelocele. Springerplus 2016; 5:1703. [PMID: 27757375 PMCID: PMC5047867 DOI: 10.1186/s40064-016-3395-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 09/26/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND To evaluate whether there is an association between single nucleotide polymorphisms in magnesium-permeable TRPM6 ion channel and development of meningomyelocele (MMC). Therefore, we examined a total of 150 children with MMC, along with age- and gender-matched controls. DNA collected from whole blood was analyzed for the presence of two polymorphisms, rs2274924 (A > G; K1579E; Leu1579Glu) and rs3750425 (G > A; Val1393Ile), in TRPM6. Serum Mg2+ and calcium levels were also examined. RESULTS A statistically significant difference in the distribution of rs2274924 genotypes (p = 0.049) was observed between the groups. Decreases in the AA genotype, and increases in the AG heterozygous genotype were also detected in the study group. The distribution of polymorphisms in the rs3750425 genotype and alleles was not statistically different between groups. Serum Mg2+ levels were lower in the GG genotype of rs3750425 compared with the GA and AA genotypes (p = 0.003). CONCLUSIONS A statistically significant difference in rs3750425 genotypes was observed between the patients with MMC and the controls, which corresponded to lower serum Mg2+ concentrations in these patients. Taken together, these results suggest that genetic variations in the Mg2+-permeable TRPM6 ion channel may play a role in the etiopathogenesis of MMC during embryonic development.
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Affiliation(s)
- Mehmet Saraç
- Department of Pediatric Surgery, Firat University Medical Faculty, 23119 Elazig, Turkey
| | - Ebru Önalan
- Department of Medical Biology, Firat University Medical Faculty, Elazig, Turkey
| | - Ünal Bakal
- Department of Pediatric Surgery, Firat University Medical Faculty, 23119 Elazig, Turkey
| | - Tugay Tartar
- Department of Pediatric Surgery, Firat University Medical Faculty, 23119 Elazig, Turkey
| | - Mustafa Aydın
- Department of Neonatology, Firat University Medical Faculty, Elazig, Turkey
| | - Ayşen Orman
- Department of Neonatology, Firat University Medical Faculty, Elazig, Turkey
| | - Ahmet Tektemur
- Department of Medical Biology, Firat University Medical Faculty, Elazig, Turkey
| | - Erdal Taşkın
- Department of Neonatology, Firat University Medical Faculty, Elazig, Turkey
| | - Fatih Serhat Erol
- Department of Neurosurgery, Firat University Medical Faculty, Elazig, Turkey
| | - Ahmet Kazez
- Department of Pediatric Surgery, Firat University Medical Faculty, 23119 Elazig, Turkey
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Bakal U, Aydin S, Sarac M, Kuloglu T, Kalayci M, Artas G, Yardim M, Kazez A. Serum, Saliva, and Urine Irisin with and Without Acute Appendicitis and Abdominal Pain. Biochem Insights 2016; 9:11-7. [PMID: 27330302 PMCID: PMC4910648 DOI: 10.4137/bci.s39671] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 05/08/2016] [Accepted: 05/19/2016] [Indexed: 11/05/2022]
Abstract
A 112-amino-acid protein irisin (IRI) is widely expressed in many organs, but we currently do not know whether appendix tissue and blood cells express it. If appendix tissue and neutrophil cells express IRI, measuring its concentration in biological fluids might be helpful in the diagnosis of acute appendicitis (AA), since neutrophil cells are the currently gold-standard laboratory parameters for the diagnosis of AA. Therefore, the purpose of this study was to investigate the suitability of enzyme-linked immunosorbent assay-based measurements of the proposed myokine IRI for the discrimination of patients with AA from those with acute abdominal pain (AP) and healthy controls. Moreover, immunoreactivity to IRI was investigated in appendix tissues and blood cells. Samples were collected on admission (T1), 24 hours (T2), and 72 hours (T3) postoperatively from patients with suspected AA and from patients with AP corresponding to T1–T3, whereas control subject blood was once corresponding to T1. IRI was measured in serum, saliva, and urine by using enzyme-linked immunosorbent assay, whereas in appendix tissue and blood cells, IRI was detected by immunohistohcemistry. Appendix tissue and blood cells (except for erythrocytes) are new sources of IRI. Basal saliva, urine, and serum levels were higher in children with AA compared with postoperative levels (T2) that start to decline after surgery. This is in line with the finding that IRI levels are higher in children with AA when compared with those with AP or control subject levels, most likely due to a large infiltration of neutrophil cells in AA that release its IRI into body fluids. Measurement of IRI in children with AA parallels the increase or decrease in the neutrophil count. This new finding shows that the measurement of IRI and neutrophil count can together improve the diagnosis of AA, and it can distinguish it from AP. IRI can be a candidate marker for the diagnosis of AA and offers an additional parameter to neutrophil count. The promising receiving operating curve results indicate the following sensitivities and specificities, respectively, for IRI: serum 90% and 55%, saliva 90% and 60%, and urine 90% and 50%. Serum neutrophil count gave a sensitivity of 90% and a specificity of 90%. This promising result now needs to be confirmed in a larger group of patients.
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Affiliation(s)
- Unal Bakal
- Department of Pediatric Surgery, School of Medicine, Firat University, Elazig, Turkey
| | - Suleyman Aydin
- Department of Medical Biochemistry (Firat Hormones Research Group), School of Medicine, Firat University, Elazig, Turkey
| | - Mehmet Sarac
- Department of Pediatric Surgery, School of Medicine, Firat University, Elazig, Turkey
| | - Tuncay Kuloglu
- Department of Histology and Embryology, School of Medicine, Firat University, Elazig, Turkey
| | - Mehmet Kalayci
- Deparment of Laboratory Medical Biochemistry, Elazig Education and Research Hospital, Elazig, Turkey
| | - Gokhan Artas
- Department of Pathology, School of Medicine, Firat University, Elazig, Turkey
| | - Meltem Yardim
- Department of Medical Biochemistry (Firat Hormones Research Group), School of Medicine, Firat University, Elazig, Turkey
| | - Ahmet Kazez
- Department of Pediatric Surgery, School of Medicine, Firat University, Elazig, Turkey
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Bakal U, Sarac M, Aydin M, Tartar T, Kazez A. Recent changes in the features of hypertrophic pyloric stenosis. Pediatr Int 2016; 58:369-71. [PMID: 26615824 DOI: 10.1111/ped.12860] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Revised: 08/27/2015] [Accepted: 09/29/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hypertrophic pyloric stenosis (HPS) is a rare cause of non-bilious vomiting in young infants; the condition requires surgical management. Diagnosis is based on clinical, laboratory, and radiological findings. In the present study, we evaluate recent changes in the features of HPS. METHOD We retrospectively reviewed the demographic, clinical, and laboratory data on 56 HPS patients who underwent pyloromyotomy between 1996 and 2015. Patients were divided into two groups according to date of operation (group 1, 1996-2006; group 2, 2007-2015). RESULTS Group 1 consisted of 30 patients and group 2, 26. The age at diagnosis was longer in group 2 (43.3 ± 13.1 days) than group 1 (37.4 ± 17.7 days). All diagnoses were confirmed on ultrasonography. Pyloromyotomy was performed on all 56 patients (48 boys, 8 girls). Significant between-group differences were evident in terms of age at onset of vomiting; rate of dehydration; development of palpable olive-shaped abdominal mass; serum urea and creatinine; acid-base status; and air distribution pattern on abdominal radiography (all P < 0.05). CONCLUSION The frequency of olive-shaped abdominal mass evident on physical examination decreased significantly over time, and was lower than published values. Early diagnosis triggers timely support and surgical intervention, and may thus prevent development of the classical clinical and laboratory findings of late-stage HPS. The remarkable recent advances in ultrasonography and techniques allow HPS to be diagnosed earlier than formerly.
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Affiliation(s)
- Unal Bakal
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
| | - Mehmet Sarac
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
| | - Mustafa Aydin
- Department of Neonatology, Firat University School of Medicine, Elazig, Turkey
| | - Tugay Tartar
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
| | - Ahmet Kazez
- Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey
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Bakal U, Ersoz F, Eker I, Sarac M, Aydin M, Kazez A. Long-Term Prognosis of Patients with Esophageal Atresia and/or Tracheoesophageal Fistula. Indian J Pediatr 2016; 83:401-4. [PMID: 26558918 DOI: 10.1007/s12098-015-1930-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 10/16/2015] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To investigate long-term prognosis of infants with esophageal atresia (EA) and/or tracheoesophageal fistula (TEF). METHODS The data of patients with EA were investigated from their medical files. For the neurodevelopmental evaluation, they were requested to come for a return visit to authors' polyclinic. Intellectual development was assessed by Ankara Developmental Screening Inventory (ADSI) (for 0-6 age) and Wechsler Intelligence Scale for Children-Revised (WISC-R) (for 6-16 age). RESULTS Of the 57 patients, 50 had EA+ distal TEF (87.7 %), six had isolated EA (10.5 %) and one had isolated TEF (1.8 %). Of the total patients, 18 cases (31 %) died and remaining 39 cases (69 %) survived. In the surviving cases, the most common long-term complication was dysphagia (n = 37, 94.8 %). Intellectual levels of the 24 patients assessed by ADSI were normal and of the remaining 15 cases evaluated by WISC-R ranged between 95 and 110 points. CONCLUSIONS The long-term complications and hospital visits are common in surviving cases of EA; however, they have normal cognitive functions and physical developmental characteristics.
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Affiliation(s)
- Unal Bakal
- Department of Pediatric Surgery, Firat University School of Medicine, 23119, Elazig, Turkey.
| | - Fikret Ersoz
- Department of Pediatric Surgery, Firat University School of Medicine, 23119, Elazig, Turkey
| | - Irem Eker
- Department of Psychology, Elazığ Mental Health Hospital, Elazig, Turkey
| | - Mehmet Sarac
- Department of Pediatric Surgery, Firat University School of Medicine, 23119, Elazig, Turkey
| | - Mustafa Aydin
- Department of Pediatrics-Neonatology, Firat University School of Medicine, Elazig, Turkey
| | - Ahmet Kazez
- Department of Pediatric Surgery, Firat University School of Medicine, 23119, Elazig, Turkey
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Bakal U, Saraç M, Ciftci H, Tartar T, Kocdemir E, Aydin S, Kazez A. Neutrophil gelatinase-associated lipocal in protein levels as an acute appendicitis biomarker in children. Springerplus 2016; 5:193. [PMID: 27026889 PMCID: PMC4769236 DOI: 10.1186/s40064-016-1853-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 02/15/2016] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Appendicitis is very commonly encountered in emergency clinics. There is an urgent need for early and accurate predictive biomarkers of appendicitis in order to save lives, because currently-available biomarkers are imprecise and their delayed response impairs the ability of emergency doctors and pediatric surgeons to provide timely and potentially effective therapies. This study was performed to determine whether changes in the blood levels of neutrophil gelatinase-associated lipocalin (NGAL) can help to diagnose acute appendicitis in children and distinguish acute appendicitis from abdominal pain. METHODS Sixty children were enrolled and divided into three groups, with 20 patients per group: Group 1 (patients with appendicitis), Group 2 (patients with abdominal pain) and Group 3 (control). Blood NGAL levels were determined by ELISA. RESULTS The basal average serum NGAL levels were 8.2 ng/ml for Group 1, 3.9 ng/ml for Group 2, and 3.3 ng/ml for Group 3. Twenty-four and 72 h after surgery the levels were 5.1 and 2.8 ng/ml, respectively, in Group 1, 2.9 and 2.8 ng/ml in Group 2, and 2.6, 2.7 ng/ml in Group 3. Setting the cut-off point to 7 generated an area under the receiving operating curve (ROC) curve at 95 % confidence interval with 77.3 % sensitivity and 97.4 % specificity. CONCLUSION These data indicate a significant difference in NGAL values between basal and postoperative measurements in appendicitis patients (p < 0.05). The ROC curve results showed that NGAL is a promising novel biomarker for the differential diagnosis of acute appendicitis from abdominal pain.
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Affiliation(s)
- Unal Bakal
- Department of Pediatric Surgery, School of Medicine, Firat University, 23119 Elazig, Turkey
| | - Mehmet Saraç
- Department of Pediatric Surgery, School of Medicine, Firat University, 23119 Elazig, Turkey
| | - Harun Ciftci
- Department of Medical Biochemistry, Ahievran University, 4000 Kirsehir, Turkey
| | - Tugay Tartar
- Department of Pediatric Surgery, School of Medicine, Firat University, 23119 Elazig, Turkey
| | | | - Suleyman Aydin
- Department of Medical Biochemistry and Clinical Biochemistry (Firat Hormones Research Groups), School of Medicine, Firat University, 23119 Elazig, Turkey
| | - Ahmet Kazez
- Department of Pediatric Surgery, School of Medicine, Firat University, 23119 Elazig, Turkey
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Abstract
CONTEXT Bladder perforations in children occur due to several different reasons. AIM In this clinical series study, we focused on bladder perforations due to the pelvic injury, and our aim also was to create awareness for a rare type of bladder injuries. SETTING AND DESIGN This was a retrospective study of the patients who were treated in our clinic for bladder perforation between 2006 and 2011. SUBJECTS AND METHODS We reviewed the documents of childhood bladder perforations, and demographic and clinical characteristics of the patients were obtained. No statistical analyses were used because of the limited number of cases. RESULTS There were ten patients who suffered from bladder perforation in 5-year period; 5 were male, and 5 were female. The mean age of the patients was 4.35 years. Four patients (40%) experienced iatrogenic perforation and six patients (60%) experienced perforation due to the accident. Common symptoms were hematuria, abdominal tenderness, and inability to urinate. Three patients were diagnosed via emergency laparotomy, without any radiological examinations performed before surgery. Four patients suffered from the intraperitoneal perforation, three patients suffered from extraperitoneal injury and three of them both of intraperitoneal and extraperitoneal injuries. Mean recovery time for patients was 15 days. One patient developed a urinary tract infection and one newborn died due to accompanying morbidities. Nine patients were discharged from the hospital. CONCLUSION If the patients had a pelvic injury, surgeons must pay attention for the bladder perforation. Isolated bladder perforations are rare, and they are generally associated with iatrogenic injuries. Clinicians should pay attention to findings such as anuria, inability to insert a urinary catheter, and free fluid in the abdomen in order to diagnose the bladder perforation in newborns. Novice surgeons should pay more attention to avoid causing iatrogenic bladder perforation during inguinal hernia repair.
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Affiliation(s)
- U Bakal
- Department of Pediatric Surgery, Firat University Medical Faculty, Elazig, Turkey
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Aydin S, Kuloglu T, Ozercan MR, Albayrak S, Aydin S, Bakal U, Yilmaz M, Kalayci M, Yardim M, Sarac M, Kazez A, Kocdor H, Kanat B, Ozercan İH, Gonen M, Bilgen M, Balgetir F. Irisin immunohistochemistry in gastrointestinal system cancers. Biotech Histochem 2016; 91:242-50. [PMID: 26963139 DOI: 10.3109/10520295.2015.1136988] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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Bakal U, Aydin M, Orman A, Taskin E, Kazez A. A Non-Surgical Condition of Neonatal Pneumoperitoneum: Retroperitoneal Free Air Secondary to Massive Tension Pneumothorax. J Med Cases 2016. [DOI: 10.14740/jmc2371w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Bakal U, Simsek S, Kazez A. Surgical and Molecular Evaluation of Pediatric Hydatid Cyst Cases in Eastern Turkey. Korean J Parasitol 2015; 53:785-8. [PMID: 26797450 PMCID: PMC4725236 DOI: 10.3347/kjp.2015.53.6.785] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 08/21/2015] [Accepted: 10/06/2015] [Indexed: 11/23/2022]
Abstract
Cystic echinococcosis (CE) caused by Echinococcus granulosus is a major public health problem worldwide, including Turkey. The aim of the current study was to identify the strains and to estimate the potential risk factors of E. granulosus in operated pediatric cases in eastern Turkey. Ten pediatric patients (7 boys and 3 girls) living in rural areas, with ages ranging from 3 to 15 years old and various clinical histories, were included in this study. Eight patients had only liver hydatid cyst, while 1 patient had liver and lung hydatid cyst and the other liver, lung, and spleen, together. There were 2 ruptured liver cysts. After surgery, during follow-up, no increase was observed in hemagglutination levels, there were no mortalities, and there was no evidence of recurrence at 2 years post operation in all patients. Molecular analysis was performed on hydatid cyst samples obtained from the 10 pediatric cases. According to mt-12S rRNA PCR results, all cases were found to be G1/G3 cluster of E. granulosus sensu stricto.
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Affiliation(s)
- Unal Bakal
- Department of Pediatric Surgery, Faculty of Medicine, University of Firat, Elazığ, Turkey
| | - Sami Simsek
- Department of Parasitology, Faculty of Veterinary Medicine, University of Firat, Elazığ, Turkey
| | - Ahmet Kazez
- Department of Pediatric Surgery, Faculty of Medicine, University of Firat, Elazığ, Turkey
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Bakal U, Sarac M, Tartar T, Cigsar EB, Kazez A. Twenty years of experience with perineal injury in children. Eur J Trauma Emerg Surg 2015; 42:599-603. [DOI: 10.1007/s00068-015-0576-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 09/19/2015] [Indexed: 11/24/2022]
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Abstract
Bilateral epididymal cysts are rare in childhood. Clinically they may present as acute scrotum and should be differentiated from other pathologies. Here in, we report bilateral epididymal cysts in a 14-year-old boy. He was admitted to emergency department with symptoms of acute left scrotum. There was no history of trauma or infection. Blood analyses, including testis tumor markers were unremarkable. Bilateral epididymal cysts were diagnosed on ultrasonography evaluation. Medical treatment did not stop his scrotal pain. During scrotal exploration, there was no evidence of testicular torsion or any other pathology. An excision of cyst was performed. Histopathologically, the cyst wall was lined by columnar epithelia. As a result of these findings, a pathological diagnosis of epididymal cyst was made. The synchronized evaluation of clinical and ultrasonography findings with an appropriate histopathological evaluation can usually diagnose this rare pathology.
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Çakin H, Kaplan M, Öztürk S, Kazez A. Intrathoracic migration of ventriculoperitoneal shunt through the Morgagni's hernia in case with Down syndrome: a rare shunt complication. Neurol India 2013; 61:552-3. [PMID: 24262475 DOI: 10.4103/0028-3886.121952] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Hakan Çakin
- Department of Neurosurgery, Firat University, Elazig, Turkiye
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Abstract
Congenital diaphragmatic hernia (CDH, Bochdalek type) is rarely seen in both members of identical twins. Herein, we report a 37 weeks’ twins with CDH along with a brief review of the literature. Both the neonates survived.
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Affiliation(s)
- Mustafa T Gurbaz
- Department of Pediatric Surgery, Fιrat University, Elazig, Turkey
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Abstract
Report of incidentally detected sewing needles on plain abdominal radiographs in two patients without any prior history of ingestion or of being pierced: one in the liver and the other in the peritoneum encased by omentum. These case reports point out a rare mode of entry of needles into the abdominal cavity by penetration from outside.
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Affiliation(s)
- Unal Bakal
- Department of Pediatric Surgery, Fırat University Faculty of Medicine, Elazig, Turkey
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Bakal U, Kazez A, Akyol M, Kocakoc E, Simsek S. A portable ultrasound based screening study on the prevalence and risk factors of cystic echinococcosis in primary school children in East Turkey. Acta Trop 2012; 123:91-5. [PMID: 22531011 DOI: 10.1016/j.actatropica.2012.03.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 03/26/2012] [Accepted: 03/28/2012] [Indexed: 10/28/2022]
Abstract
The tapeworm Echinococcus granulosus constitutes a major public health concern, since its larval stage causes cystic echinococcosis (CE) which is a life-threatening zoonotic disease in many parts of the world. The purpose of the present study was to perform a screening study in order to investigate the prevalence and risk factors of CE using a portable ultrasound (US) in a representative sample of 2500 primary school children aged 7-14 in East Turkey, where CE is known to be endemic. The students were scanned by portable US while standing, with special attention to the liver, spleen, pancreas, and kidneys. The US scan was followed by a physical examination. In addition, a questionnaire was distributed to all students for completion with the assistance of their teachers regarding their demographic and social characteristics as well as their hygienic habits possibly related to CE. Students found positive were subjected to serologic examination. The US based prevalence was 0.2%. Organ involvement was 0.12% for liver and 0.08% for kidney. The response rate of the questionnaire survey was 93%. The risk factors found to be significant (P<0.05) for CE infection were hand washing and family relative with CE. The results of this study indicate that CE infection is an important public health problem in East Turkey requiring appropriate control measures.
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Abstract
Cystic abdominal masses in children are not an infrequently encountered condition of childhood. These lesions usually present with large size and mimick each other with similar presenting symptoms. Imaging examinations have an important role to determine the type of the cystic abdominal masses, which is crucial for management of patients and presurgical planning. In this pictorial essay, we summarized the imaging features of common cystic abdominal masses of children, including cystic lesions arising from liver, biliary ducts, kidney, pancreas, bowel, ovary, mesentery, and miscellaneous tissues.
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Affiliation(s)
- Mehmet Ruhi Onur
- Department of Radiology, Firat University Faculty of Medicine, Elazig, Turkey.
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Hanbeyoğlu A, Kazez A, Ustündağ B, Akpolat N. Determination of urinary N-acetyl-ß-D glucosaminidase (NAG) levels in experimental blunt renal trauma. ULUS TRAVMA ACIL CER 2012; 17:475-81. [PMID: 22289997 DOI: 10.5505/tjtes.2011.57973] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND We evaluated the applicability of urinary N-acetyl-beta-D glucosaminidase (NAG) levels in the diagnosis and follow-up in blunt kidney injury. METHODS Twenty Sprague-Dawley rats were studied. In the Sham group, left kidney exploration was made. In the Trauma group, after left kidney exploration, a 20 g weight was dropped onto the kidneys. Urine was collected for analysis with strip and determination of urinary NAG and creatinine (Cr) levels at baseline and 0-6, 12-24, 24-36 and 36-48 postoperative hours. Mann-Whitney U and Kruskal-Wallis tests were used. RESULTS Macroscopic examinations of traumatized kidneys revealed grade II and III injury, and histopathological examinations showed relevant changes. Macroscopic hematuria was observed in all traumatized rats. Urinary NAG/Cr levels in the Trauma group were found to be significantly higher than their base levels at 0-6, 12-24, 24-36, and 36-48 hours. In the Sham group, only the level of NAG/Cr at 0-6 hours was significantly higher. The increase in NAG/Cr levels at 0-6 hours was significantly higher in the Trauma group than in the Sham group. CONCLUSION After isolated blunt renal trauma, urinary NAG levels increase in the early stage. However, more detailed clinical studies are needed to develop NAG levels as a criterion in the follow-up of blunt renal trauma.
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Affiliation(s)
- Alpaslan Hanbeyoğlu
- Department of Pediatric Surgery, Fırat University Faculty of Medicine, Elazığ, Turkey
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Onur MR, Simsek BC, Kazez A. Sclerosing stromal tumor of the ovary: ultrasound elastography and MRI findings on preoperative diagnosis. J Med Ultrason (2001) 2011; 38:217-20. [PMID: 27278587 DOI: 10.1007/s10396-011-0311-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 05/04/2011] [Indexed: 11/27/2022]
Abstract
Sclerosing stromal tumor (SST) is a benign stromal tumor of the ovary. Preoperative diagnosis of this benign tumor mainly depends on imaging findings. Dynamic computed tomography (CT) and magnetic resonance imaging (MRI) show typical contrast enhancement of SST with peripheral enhancement in the early phase and centripetal progression in the delayed phases. We present the imaging findings of ultrasonography, ultrasound elastography, and dynamic MRI in the diagnosis of SST. Abdominal ultrasound elastography is a novel technique that depicts the stromal structure of SSTs by comparing the elasticity of the tumor and the myometrium using quantitative strain values.
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Affiliation(s)
- Mehmet Ruhi Onur
- Department of Radiology, University of Firat Faculty of Medicine, Firat Universitesi Hastanesi Rektorluk Kampusu, 23119, Elazig, Turkey.
| | | | - Ahmet Kazez
- Department of Pediatric Surgery, University of Firat Faculty of Medicine, Elazig, Turkey
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Kaplan M, Akgun B, Kazez A, Ucler N, Cobanoglu B. Posterior approach for sacrococcygeal posterior meningocele with anterior large mature cystic teratoma. ACTA ACUST UNITED AC 2010; 71:221-3. [PMID: 20464651 DOI: 10.1055/s-0029-1243194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M Kaplan
- Firat University, Neurosurgery, Elazig, Turkey
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Özel SK, Emir H, Dervişoğlu S, Akpolat N, Şenel B, Kazez A, Söylet Y, Çetin G, Danişmend N, Büyükünal SNC. The roles of extracellular matrix proteins, apoptosis and c-kit positive cells in the pathogenesis of ureteropelvic junction obstruction. J Pediatr Urol 2010; 6:125-9. [PMID: 19716769 DOI: 10.1016/j.jpurol.2009.07.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2009] [Accepted: 07/23/2009] [Indexed: 01/12/2023]
Abstract
AIM To investigate histopathological changes in ureteropelvic junction obstruction (UPJO) from an etiological perspective. PATIENTS AND METHODS Medical records of patients with UPJO were reviewed and pathological specimens collected. Nephrectomy materials from forensic autopsies were taken as controls. Specimens were assessed with light microscopy. Fibronectin, type 4 collagen, laminin, Bax and Bcl-2 expression for apoptosis, together with interstitial cells of Cajal determination with c-kit were determined immunohistochemically. Staining scores were evaluated semiquantitatively. Results were evaluated using Mann-Whitney U-test. RESULTS Control group comprised 14 children (median age, 3.5 years; 6 months-17 years). Study group comprised 22 children with UPJO (median age, 9 months; 1 month-10 years). Light microscopy revealed non-specific inflammation, epithelial proliferation and atrophy with fibrosis in the smooth muscle of the UPJ in all patients. Fibronectin, type 4 collagen and laminin were found to be significantly increased in UPJO at the intrafascicular space of smooth muscle and the matrix of stroma. Bcl-2 expression was increased in UPJO. c-Kit was unable to stain interstitial cells of Cajal, but staining for mast cells was significant. CONCLUSIONS High expression of fibronectin, laminin and type 4 collagen may indicate a relation to the pathogenesis of UPJO. Defective kidney morphogenesis, during branching and tubulogenesis of ureteric bud, may be responsible for this congenital pathology.
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Affiliation(s)
- S K Özel
- Fırat University Faculty of Medicine, Department of Pediatric Surgery, Elazığ, Turkey.
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Kazez A, Ozel SK, Bakal U, Sarac M. Abdominotransanal approach to pouch colon associated with rectal atresia. J Pediatr Surg 2009; 44:E19-21. [PMID: 19524712 DOI: 10.1016/j.jpedsurg.2009.02.058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2009] [Revised: 02/11/2009] [Accepted: 02/28/2009] [Indexed: 11/19/2022]
Abstract
Pouch colon anomaly and high anorectal malformation are well-defined rare anomalies. The association of pouch colon anomaly with rectal atresia has previously been defined in only one case. In this study, a 2-day-old baby is presented with pouch colon anomaly without fistula and with rectal atresia. As a second case in the literature, this pathologic condition has been treated through the abdominotransanal route by using a single-stage endorectal coloanal pull-through. Being uncommon and having an important therapeutic approach, this case has been evaluated as worth presenting.
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Affiliation(s)
- Ahmet Kazez
- Department of Pediatric Surgery, Firat University, Faculty of Medicine, Elazig, Turkey.
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Kaplan M, Ozel SK, Dönmez O, Kazez A. Treatment approaches for abdominal migration of peritoneal catheter of ventriculoperitoneal shunt. Turk Neurosurg 2007; 17:158-162. [PMID: 17935037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Migration of peritoneal catheter into the abdominal cavity is rare. We have discussed and presented the treatment options in two cases with accompanying literature. Abdominal migration of peritoneal catheter appears as a result of shunt fracture and disconnection. The complaints on presentation in the abdominal cavity migration of peritoneal catheter are due to shunt dysfunction and peritoneal irritation. The peritoneal catheter with abdominal migration should be removed in cases where abdominal symptoms are present. This procedure may be easily performed laparoscopically with a single mini incision. In some cases, the catheter may cause adhesions to the intra-abdominal organs. Forcefully pulled catheters may result in organ injuries. One should therefore switch to laparotomy in these cases.
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Affiliation(s)
- Metin Kaplan
- Firat University School of Medicine, Neurosurgery, Elaziğ, Turkey.
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Abstract
BACKGROUND/PURPOSE Recent reports have focused on detorsion after ovarian torsion in the literature. The aim of the study was to investigate late term changes in both ovaries after delayed detorsion following ovarian torsion in rats. MATERIALS Female, prepubertal, Wistar albino rats were divided into four groups (n = 6/group). The left ovaries were used for the study and the right ovaries were kept as the control. The groups were constituted as follows: Group 1: left ovarian fixation, bilateral oophorectomy 48 hours later; Group 2: left ovarian torsion and fixation, bilateral oophorectomy 48 hours later; Group 3: detorsion 48 hours after torsion and bilateral oophorectomy after another 48 hours; Group 4: detorsion 48 hours after torsion and bilateral oophorectomy after 21 days. The total injury score (TIS) was compiled histologically in a double-blind fashion. Congestion, edema, bleeding and polymorphonuclear lymphocyte infiltration were assessed for TIS. RESULTS The TIS was found to be 8 points in Group 1; 38 in Group 2; 28 in Group 3 and 12 in Group 4, respectively. The TIS was based on results from the left ovaries in Group 1, whereas 31 points were attributable to the left ovaries and 7 to the right ovaries in Group 2. In Groups 3 and 4, TIS points were the same in both study and control ovaries. The difference between the left ovaries of Groups 1 and 2 and the left ovaries of Groups 2 and 4 was statistically significant (p < 0.05). CONCLUSION Viable ovarian tissue can be detected even after 48 hours of torsion, which is a relatively long period of ischemia. Tissue injury decreases significantly after detorsion during late recovery. In view of previous case reports in the literature and the present findings, detorsion is recommended in children with ovarian torsion regardless of the ischemic period and/or macroscopic appearance.
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Affiliation(s)
- A Kazez
- Department of Pediatric Surgery, Firat University, Faculty of Medicine, Elaziğ, Turkey.
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Ozel SK, Kazez A, Akpolat N. Presence of ectopic adrenocortical tissues in inguinoscrotal region suggests an association with undescended testis. Pediatr Surg Int 2007; 23:171-5. [PMID: 17066272 DOI: 10.1007/s00383-006-1826-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2006] [Indexed: 11/30/2022]
Abstract
Ectopic adrenocortical tissues (EAT) are rare pathologies in children. They are frequently encountered in the inguinal region incidentally during surgical procedures but they are also classically known to be located from diaphragm to pelvis. EAT were investigated during inguinal procedures including inguinal hernia, hydrocele, hydrocele of cord and undescended testis (UDT) in 1,069 patients, 159 girls, 910 boys, from April 1997 until April 2006. All these nodules were confirmed to be adrenocortical tissues after histopathological examinations. Statistical analysis was done with Fisher's exact test. EAT were noted on the plexus pampiniformis external to processus vaginalis of 22 male patients (1.73%) during inguinal explorations. This figure was 1.63% for inguinal explorations of inguinal hernia, hydrocele and hydrocele of cord and 5.1% for UDT. This difference was statistically significant (P<0.0001). There were no EAT detected during inguinal exploration of female patients. EAT are uncommon pathologies seen during inguinoscrotal explorations. Incidence of EAT is significantly increased with UDT. This increase may be explained with the embryological events that take place during adrenal and gonadal development. The relatively low observation of EAT in girls may be due to the localization of gonads and association of EAT with gonadal position. Adrenal rests in inguinal region may suggest an association with descent of gonads.
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Affiliation(s)
- S Kerem Ozel
- Pediatric Surgery, Firat University Faculty of Medicine, Elazig, Turkey.
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Okur H, Küçükaydn M, Ozokutan BH, Muhtaroğlu S, Kazez A, Turan C. Relationship Between Release of β-Endorphin, Cortisol, and Trauma Severity in Children With Blunt Torso and Extremity Trauma. ACTA ACUST UNITED AC 2007; 62:320-4; discussion 324. [PMID: 17297320 DOI: 10.1097/01.ta.0000222714.91463.a3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the levels of beta-endorphin and cortisol in children with multiple injuries and to determine whether there is any difference between and compare the severity of trauma and beta-endorphin and cortisol release as calculated using Pediatric Trauma Score (PTS). METHODS During a 10-month period, 80 children with multiple injuries admitted to a University Hospital's Pediatric Surgery Department were studied. Blood samples were obtained immediately at admission and a PTS of each patient was calculated. The correlation between PTS and hormonal values were searched. The children were classified into two groups according to their PTS. Group 1 had PTS >8 and group 2 had PTS < or =8. The two groups were also compared with respect to their beta-endorphin and cortisol values. RESULTS There was a linear correlation between beta-endorphin and cortisol values and the injury severity. The levels were higher in the patients with more severe injuries. There were 60 patients in group 1 and 20 patients in group 2. Their ages were 9.2 +/- 4.1 and 9.7 +/- 4.2 years, respectively (p > 0.05). The mean PTS for group 1 patients was 11 +/- 0.8 and for group 2 patients was 7.4 +/- 1.2 (p < 0.001). The mean plasma beta-endorphin concentrations were 124.4 +/- 114.4 pg/mL in group 1 patients and 261.6 +/- 231.2 pg/mL in group 2 (p < 0.001). The respective plasma cortisol concentrations in the two groups were 22.5 +/- 10.3 microg/dL and 30.8 +/- 17.2 microg/dL (p < 0.05), respectively. CONCLUSIONS The results of this study show that the plasma beta-endorphin and cortisol levels are elevated in children after blunt trauma and the degree of elevation is related to the injury severity.
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Affiliation(s)
- Hamit Okur
- Department of Paediatric Surgery, Erciyes University School of Medicine, Kayseri, Turkey.
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Kaplan M, Ozel SK, Akgun B, Kazez A, Kaplan S. Hepatic pseudocyst as a result of ventriculoperitoneal shunts: case report and review of the literature. Pediatr Neurosurg 2007; 43:501-3. [PMID: 17992040 DOI: 10.1159/000108795] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2006] [Accepted: 10/01/2006] [Indexed: 11/19/2022]
Abstract
Hepatic pseudocyst formation is a rare intra-abdominal complication of ventriculoperitoneal shunts. The presence of an intracranial tumor and a history of central nervous system infection are major risk factors for the development of this complication. Hepatic pseudocysts secondary to ventriculoperitoneal shunts can be classified as intra- and extra-axially growing cysts. On abdominal computed tomography images, extra-axially growing pseudocysts are typically surrounded by a fine annulus that shows continuity to hepatic parenchyma. For treatment of extra-axially growing hepatic pseudocysts, surgical unroofing of the cyst and repositioning of the catheter is an effective method if there is no shunt infection and/or dysfunction.
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Affiliation(s)
- Metin Kaplan
- Department of Neurosurgery, Firat University, Elazig, Turkey.
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Kocakoc E, Kazez A, Dagli AF, Koc M. Postcircumcision granuloma: a rare cause of a penile mass in a boy. J Ultrasound Med 2006; 25:1611-3. [PMID: 17121960 DOI: 10.7863/jum.2006.25.12.1611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- Ercan Kocakoc
- Department of Radiology, Faculty of Medicine, Firat University, 23119 Elazig, Turkey.
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