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Cömert HSY, Güney D, Durakbaşa ÇU, Dökümcü Z, Soyer T, Fırıncı B, Çiftçi İ, Öztan MO, Demirel BD, Parlak A, Göllü G, Karaman A, Akkoyun İ, Gül C, İlhan H, Oral A, Özcan R, Özen Ö, Kıyan G, Erdem AO, Özaydın S, Uzunlu O, Yıldız A, Erginel B, Ertürk N, Bilici S, Samsum H, Özen MA, Özçakır E, Aydın E, Mert M, Topbaş M. The effect of postoperative ventilation strategies on postoperative complications and outcomes in patients with esophageal atresia: Results from the Turkish Esophageal Atresia Registry. Pediatr Pulmonol 2023; 58:763-771. [PMID: 36398363 DOI: 10.1002/ppul.26251] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 07/22/2022] [Revised: 11/07/2022] [Accepted: 11/13/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Postoperative ventilatory strategies in patients with esophageal atresia (EA) and tracheoesophageal fistula (TEF) may have an impact on early postoperative complications. Our national Esophageal Atresia Registry was evaluated to define a possible relationship between the type and duration of respiratory support on postoperative complications and outcome. STUDY DESIGN Among the data registered by 31 centers between 2015 and 2021, patients with esophago-esophageal anastomosis (EEA)/tracheoesophageal fistula (TEF) were divided into two groups; invasive ventilatory support (IV) and noninvasive ventilatory support and/or oxygen support (NIV-OS). The demographic findings, gestational age, type of atresia, associated anomalies, and genetic malformations were evaluated. We compared the type of repair, gap length, chest tube insertion, follow-up times, tensioned anastomosis, postoperative complications, esophageal dilatations, respiratory problems requiring treatment after the operation, and mortality rates. RESULTS Among 650 registered patients, 502 patients with EEA/TEF repair included the study. Four hundred and seventy of patients require IV and 32 of them had NIV-OS treatment. The IV group had lower mean birth weights and higher incidence of respiratory problems when compared to NIV-OS group. Also, NIV-OS group had significantly higher incidence of associated anomalies than IV groups. The rates of postoperative complications and mortality were not different between the IV and NIV-OS groups. CONCLUSION We demonstrated that patients who required invasive ventilation had a higher incidence of low birth weight and respiratory morbidity. We found no relation between mode of postoperative ventilation and surgical complications. Randomized controlled trials and clinical guidelines are needed to define the best type of ventilation strategy in children with EA/TEF.
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Affiliation(s)
| | - Doğuş Güney
- Department of Pediatric Surgery, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Çiğdem Ulukaya Durakbaşa
- Department of Pediatric Surgery, Faculty of Medicine, Istanbul Medeniyet University, İstanbul, Turkey
| | - Zafer Dökümcü
- Department of Pediatric Surgery, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Tutku Soyer
- Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Binali Fırıncı
- Department of Pediatric Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - İlhan Çiftçi
- Department of Pediatric Surgery, Faculty of Medicine, Selçuk University, Konya, Turkey
| | - Mustafa Onur Öztan
- Department of Pediatric Surgery, Faculty of Medicine, Izmir Katip Celebi University, İzmir, Turkey
| | - Berat Dilek Demirel
- Department of Pediatric Surgery, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Ayşe Parlak
- Department of Pediatric Surgery, Faculty of Medicine, Uludağ University, Bursa, Turkey
| | - Gülnur Göllü
- Department of Pediatric Surgery, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Ayşe Karaman
- Department of Pediatric Surgery, Dr Sami Ulus Maternity and Children Health and Research Application Center, Ankara, Turkey
| | - İbrahim Akkoyun
- Department of Pediatric Surgery Konya, Konya Education and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - Cengiz Gül
- Department of Pediatric Surgery, Zeynep Kamil Maternity and Children Health and Research Application Center, University of Health Sciences Turkey, İstanbul, Turkey
| | - Hüseyin İlhan
- Department of Pediatric Surgery, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Akgün Oral
- Department of Pediatric Surgery, Dr. Behcet Uz Education and Research Hospital, Izmir, Turkey
| | - Rahşan Özcan
- Department of Pediatric Surgery, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Önder Özen
- Department of Pediatric Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Gürsu Kıyan
- Department of Pediatric Surgery, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Ali Onur Erdem
- Department of Pediatric Surgery, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey
| | - Seyithan Özaydın
- Department of Pediatric Surgery, Başakşehir Çam and Sakura City Hospital, University of Health Sciences Turkey, İstanbul, Turkey
| | - Osman Uzunlu
- Department of Pediatric Surgery, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Abdullah Yıldız
- Department of Pediatric Surgery, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - Başak Erginel
- Department of Pediatric Surgery, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Nazile Ertürk
- Department of Pediatric Surgery, Faculty of Medicine, Muğla Sıtkı Kocaman University, Muğla, Turkey
| | - Salim Bilici
- Department of Pediatric Surgery, Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Turkey
| | - Hakan Samsum
- Department of Pediatric Surgery, Private Antakya Academy Hospital, Hatay, Turkey
| | - Mehmet Ali Özen
- Department of Pediatric Surgery, School of Medicine, Koç University, Istanbul, Turkey
| | - Esra Özçakır
- University of Health Sciences Bursa Yuksek Ihtisas Training And Research Hospital, Bursa, Turkey
| | - Emrah Aydın
- Department of Pediatric Surgery, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
| | - Mehmet Mert
- University of Health Sciences Van Training And Research Hospital, Van, Turkey
| | - Murat Topbaş
- Department of Public Health, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
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Albez FS, Araz Ö, Yılmazel Uçar E, Alper F, Karaman A, Sağlam L, Akgün M. Long-term follow-up of young denim sandblasters in Turkey. Occup Med (Lond) 2022; 72:403-410. [PMID: 35762845 DOI: 10.1093/occmed/kqac043] [Citation(s) in RCA: 1] [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] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Denim sandblasting-induced silicosis is a recently identified occupational disease. AIMS In this study, we aimed to evaluate pulmonary and radiological changes in the long-term follow-up of former denim sandblasters. METHODS Ninety former denim sandblasters were followed from 2007 to 2018. Chest X-rays were evaluated according to the International Labour Organization (ILO) classification. Baseline and final data were compared. Silicosis prevalence, radiological progression and pulmonary dysfunction were evaluated. RESULTS All of the sandblasters were men. Their mean age was 34 ± 5 years, mean follow-up time was 9 ± 2 years (mean time since initial exposure: 17 ± 2 years) and mean duration of exposure was 34 ± 25 months. Rates of radiological progression and decline in pulmonary during follow-up were 63% and 39%, respectively. During follow-up, all patients were diagnosed with silicosis. All workers who were ILO category 0 at baseline (n = 26, 29%) progressed to higher categories. The number of patients in Category 2 doubled and the number of patients in Category 3 increased by 2.5-fold. Eleven patients developed new large opacities and the number of patients with category C opacity increased from 4 to 13. Exposure time was an independent determinant of radiological progression (OR: 1.0, P = 0.036) and decline in pulmonary function (OR: 1.3, P = 0.019). CONCLUSION The prevalence of silicosis in denim sandblasters increases steadily even after exposure is discontinued. Radiological progression was observed in a higher proportion of workers than a decline in lung function. Duration of exposure was the major determinant of disease progression in our study.
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Affiliation(s)
- F S Albez
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Erzurum, Turkey
| | - Ö Araz
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Erzurum, Turkey
| | - E Yılmazel Uçar
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Erzurum, Turkey
| | - F Alper
- Department of Radiology, Atatürk University School of Medicine, Erzurum, Turkey
| | - A Karaman
- Department of Radiology, Atatürk University School of Medicine, Erzurum, Turkey
| | - L Sağlam
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Erzurum, Turkey
| | - M Akgün
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Erzurum, Turkey
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Anayurt M, Karaman A, Balcı Ö, Özgüner İF, Karaman İ. The effects of hesperidin on stricture formation in corrosive esophageal burns: an experimental study. Esophagus 2022; 19:189-196. [PMID: 34312811 DOI: 10.1007/s10388-021-00861-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 02/18/2021] [Accepted: 07/06/2021] [Indexed: 02/03/2023]
Abstract
AIM/BACKGROUND Esophageal strictures in children that develop as a result of accidental ingestion of corrosive substances remain an important health problem. The purpose of this study is to determine the effects of Hesperidin, an effective bioflavonoid in the proliferative and exudative phase of inflammation, on the stricture formation in corrosive esophageal burns. METHODS Experimental esophageal burns in rats were created using a modified Gehanno and Guedon model with 20% NaOH. Rats were divided into 5 groups. In the Sham group, the distal esophagus was prepared and cannulated according to the model, but no NaOH was administrated. The esophageal burn was created with NaOH in the other groups. The burned groups were divided into two groups as untreated (T14, T21) and treated with 100 mg/kg/day Hesperidin (H14, H21) intraperitoneally, and these groups were divided into two according to their sacrification periods (14 and 21 days). Inflammation, fibrosis, and necrosis were graded by histopathological evaluation in all groups. The efficacy of treatment was evaluated using the weight of rats, stenosis index, and histopathological parameters. RESULTS Histopathologic damage scores such as inflammation, necrosis, and fibrosis were lower in the H14 and H21 groups and higher in the T14 and T21 groups. And also stenosis index was found higher in T14 and T21 groups (p < 0.05), while it was similar to the Sham group in H14 and H21 groups. No statistically significant difference was found between the H14 and H21 groups in terms of stenosis index. When weights of the rats at the beginning and end of the experiment were compared, weights of the H14 and H21 groups and the Sham group were similar. There was a significant decrease in the weight of the rats in the T14 and T21 groups (p < 0.001). CONCLUSIONS This study is the first to use Hesperidin in preventing esophageal damage in an esophageal caustic burn model. It was shown that Hesperidin was effective in reducing macroscopic and microscopic histopathologic damage in the corrosive esophageal burn model, preventing the stricture formation, and has positive effects on nutrition in rats with an esophageal burn.
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Affiliation(s)
- Meryem Anayurt
- Department of Pediatric Surgery, University of Health Sciences Turkey, Dr Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Beştepeler Mah, Alparslan Türkeş Cad. No: 27, 06560, Beştepe/Ankara, Turkey
| | - Ayşe Karaman
- Department of Pediatric Surgery, University of Health Sciences Turkey, Dr Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Beştepeler Mah, Alparslan Türkeş Cad. No: 27, 06560, Beştepe/Ankara, Turkey
| | - Özlem Balcı
- Department of Pediatric Surgery, University of Health Sciences Turkey, Dr Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Beştepeler Mah, Alparslan Türkeş Cad. No: 27, 06560, Beştepe/Ankara, Turkey.
| | - İsmet Faruk Özgüner
- Department of Pediatric Surgery, University of Health Sciences Turkey, Dr Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Beştepeler Mah, Alparslan Türkeş Cad. No: 27, 06560, Beştepe/Ankara, Turkey
| | - İbrahim Karaman
- Department of Pediatric Surgery, University of Health Sciences Turkey, Dr Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Beştepeler Mah, Alparslan Türkeş Cad. No: 27, 06560, Beştepe/Ankara, Turkey
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Ergün E, Yağız B, Alper Kara Y, Nur Abay A, Balcı Ö, Eryılmaz S, Faruk Özgüner İ, Karaman A, Karaman İ. Comparison of laparoscopic percutaneous internal ring suturing method and open inguinal hernia repair in children under 3 months of age. Turk J Surg 2021; 37:215-221. [DOI: 10.47717/turkjsurg.2021.5157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/12/2021] [Indexed: 12/29/2022]
Abstract
Objective: Laparoscopic inguinal hernia repair in younger infants has not been completely accepted worldwide. The aim of this study was to evaluate the safety and feasiblity of laparoscopic percutaneous internal ring suturing method in children aged younger than 3 months and compare the recurrence and complication rates with open repair; which may still be mentioned as the gold standard procedure.
Material and Methods: A total of 387 children underwent inguinal hernia repair in the clinic between 2016 and 2019. One hundred and forty of them were under 3 months old and divided into two groups; children who underwent laparoscopic percutaneous internal ring suturing (Group 1) and open surgery (Group 2). Selection of the surgical method was regardless of weight, sex or any patient characteristics other than surgeon’s choice. Operation durations, complications and recurrences were compared between the two groups.
Results: A total of 140 patients underwent surgery due to inguinal hernia. Group 1 included 85 and Group 2 included 55 children. There were two recurrences in each group (p> 0.05). Operative durations were shorter in Group 1 for both; unilateral and bilateral repairs (< 0.0001). There were no intraoperative complications in any group. There was one major postoperative complication in Group 2: iatrogenic undescended testis, and none was observed in Group 1. In the laparoscopic group, 47% of the children who were diagnosed to have unilateral hernia were revealed to have bilateral inguinal hernias (n= 31).
Conclusion: Laparoscopic percutaneous internal ring suturing method seems favourable in terms of operative time. It also has the advantage of detecting contralateral patent processus vaginalis or asymptomatic contralateral inguinal hernia.
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Oztan MO, Soyer T, Oztorun CI, Firinci B, Durakbaşa ÇU, Dokumcu Z, Gollu G, Akkoyun I, Demirel D, Karaman A, Ciftci I, Ilhan H, Parlak A, Ozden O, Cömert HSY, Oral A, Tekant G, Kiyan G, Erginel B, Guvenc U, Erdem AO, Erturk N, Yildiz A. Outcome of Very Low and Low Birth Weight Infants with Esophageal Atresia: Results of the Turkish Esophageal Atresia Registry. Eur J Pediatr Surg 2021; 31:226-235. [PMID: 32629496 DOI: 10.1055/s-0040-1713663] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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] [Indexed: 01/21/2023]
Abstract
INTRODUCTION The data of the Turkish Esophageal Atresia Registry (TEAR) was evaluated to define the outcome of very low birth weight (VLBW) and low BW (LWB) infants with esophageal atresia (EA). MATERIALS AND METHODS The data registered by 24 centers between 2014 and 2018 were evaluated for demographic features, prenatal findings, associated anomalies, surgical treatment, and outcome. Patients were enrolled in three groups according to their BWs (VLBW <1,500 g), LWB = 1,500-2,500 g), and normal BW (NBW; >2,500 g). RESULTS Among the 389 cases, there were 37 patients (9.5%) in the VLBW group, 165 patients (42.4%) in the LBW group, and 187 patients (48.1%) in the NBW group. Prenatal diagnosis rates were similar among the three groups (29.7, 34.5, and 24.6%, respectively). The standard primary anastomosis was achieved at a significantly higher rate in NWB cases than in the other groups (p < 0.05). In patients with tracheoesophageal fistula (TEF), patients of the NBW group had significantly higher rates of full oral feedings, when compared with VLBW and LBW cases (p < 0.05). At the end of the first year, when we evaluate all patients, the number of cases with fistula recanalization and esophageal anastomotic strictures (AS) requiring esophageal dilatation was similar among the groups. The weight and height measurements at 6 months and 1 year of age of the survivors were similar in all the groups. The overall mortality rate was significantly higher in the VLBW and LBW groups, when compared with the NBW patients, even in patients with tension-free anastomosis (p < 0.05). The incidence of the associated anomalies was 90.6% in cases with mortality, which was significantly higher than in survivors (59.6%; p < 0.05). According to Spitz's classification, the survival rate was 87.1% in class I, 55.3% in class II, and 16.7% in class III. The most common causes of mortality were associated with cardiovascular diseases, pneumonia, and sepsis. CONCLUSION The national data of TEAR demonstrates that the developmental and feeding parameters are better in NBW patients. Although VLBW patients have higher risk of developing fistula canalization than the LBW and NBW groups, long-term complications, such as anastomotic strictures, weight, and height values, after 1 year are similar in both groups. According to our results, associated anomalies and LBWs are still significant risk factors for mortality in cases with EA.
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Affiliation(s)
- Mustafa O Oztan
- Department of Pediatric Surgery, Izmir Katip Celebi University, Izmir, Turkey
| | - Tutku Soyer
- Department of Pediatric Surgery, Hacettepe University, Ankara, Turkey
| | - Can I Oztorun
- Department of Pediatric Surgery, Ankara Yildirim Beyazit Universitesi, Ankara, Turkey
| | - Binali Firinci
- Department of Pediatric Surgery, Ataturk University, Erzurum, Turkey
| | - Çiğdem U Durakbaşa
- Department of Pediatric Surgery, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Zafer Dokumcu
- Department of Pediatric Surgery, Ege University, Izmir, Turkey
| | - Gulnur Gollu
- Department of Pediatric Surgery, Ankara University, Ankara, Turkey
| | - Ibrahim Akkoyun
- Department of Pediatric Surgery, Konya Education and Research Hospital, Konya, Turkey
| | - Dilek Demirel
- Department of Pediatric Surgery, Ondokuz Mayıs University, Samsun, Turkey
| | - Ayşe Karaman
- Department of Pediatric Surgery, Dr. Sami Ulus Maternity and Children Health and Research Application Center, University of Health Sciences, Ankara, Turkey
| | - Ilhan Ciftci
- Department of Pediatric Surgery, Selçuk University, Konya, Turkey
| | - Huseyin Ilhan
- Department of Pediatric Surgery, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Ayse Parlak
- Department of Pediatric Surgery, Uludag University, Bursa, Turkey
| | - Onder Ozden
- Department of Pediatric Surgery, Cukurova University, Adana, Turkey
| | - Hatice S Y Cömert
- Department of Pediatric Surgery, Karadeniz Technical University, Trabzon, Turkey
| | - Akgun Oral
- Department of Pediatric Surgery, Dr. Behcet Uz Education and Research Hospital, Izmir, Turkey
| | - Gonca Tekant
- Department of Pediatric Surgery, Istanbul University-Cerrahpasa, Istanbul, Istanbul, Turkey
| | - Gursu Kiyan
- Department of Pediatric Surgery, Marmara University, Istanbul, Turkey
| | - Başak Erginel
- Department of Pediatric Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Unal Guvenc
- Department of Pediatric Surgery, Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey
| | - Ali Onur Erdem
- Department of Pediatric Surgery, Adnan Menderes University, Aydin, Turkey
| | - Nazile Erturk
- Department of Pediatric Surgery, Mugla Sitki Kocman University Ringgold standard institution, Mugla, Turkey
| | - Abdullah Yildiz
- Department of Pediatric Surgery, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
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Kara YA, Yağız B, Balcı Ö, Karaman A, Özgüner İF, Karaman İ. Comparison of Open Repair and Laparoscopic Percutaneous Internal Ring Suturing Method in Repairing Inguinal Hernia in Children. Cureus 2021; 13:e14262. [PMID: 33959445 PMCID: PMC8093124 DOI: 10.7759/cureus.14262] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Introduction An inguinal indirect hernia is one of the most frequent surgical conditions in children. In this study the experience with laparoscopic percutaneous internal ring suturing (PIRS) and open inguinal hernia surgery and their relations evaluated. Methods All children over 90 days of age and without having prior inguinal region surgery with a diagnosis of indirect inguinal hernia underwent surgical repair with open or laparoscopic PIRS technique. Patients' gender, age at surgery, inguinal hernias side, surgery duration, recurrence, complications, and follow-ups were collected. Results A total of 488 inguinal hernias of 405 patients were repaired. The diagnoses were unilateral inguinal hernia in 360 (88.9%) and it was bilateral in 33 (8.1%) patients. The operative technique was laparoscopic PIRS for 227 and open inguinal hernia surgery for 178 patients. In the PIRS group, a contralateral hernia was found in 48 of 205 children (23.4%). The surgery times were 23.3 (PIRS) and 33.7 (open) min for unilateral and 28 (PIRS) and 53.1 (open) min on average for bilateral inguinal hernia surgery. Mean follow-up was 30.4 months for PIRS and 24.4 months for open technique. Recurrence was observed in seven (3%) patients in PIRS and one (0.5%) in the open group and postoperative complications in three (1.3%) in PIRS and four (2.2%) in the open group. Conclusion PIRS method has the advantage to evaluate contralateral hernia at the same session, minimal scar related to surgery, and preserve the spermatic cord from manipulation. PIRS is an alternative feasible method and easy to perform to repair the inguinal hernia with/without communicating hydrocele in children.
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Affiliation(s)
- Yusuf A Kara
- Pediatric Surgery, Dr. Sami Ulus Health Research and Training Center, Ankara, TUR
| | - Beytullah Yağız
- Pediatric Surgery, Dr. Sami Ulus Health Research and Training Center, Ankara, TUR
| | - Özlem Balcı
- Pediatric Surgery, Dr. Sami Ulus Health Research and Training Center, Ankara, TUR
| | - Ayşe Karaman
- Pediatric Surgery, Dr. Sami Ulus Health Research and Training Center, Ankara, TUR
| | - İsmet F Özgüner
- Pediatric Surgery, Dr. Sami Ulus Health Research and Training Center, Ankara, TUR
| | - İbrahim Karaman
- Pediatric Surgery, Dr. Sami Ulus Health Research and Training Center, Ankara, TUR
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Çankaya BY, Polat G, Tezcan A, Yalçın A, Sade R, Pirimoğlu RB, Karaman A, Kızıloğlu HA, Alper F, Akgün M. Evaluation of lung densitometric and volumetric changes in silicosis patients using three-dimensional software for multidetector CT and the relationship with profusion scores. Clin Radiol 2021; 76:393.e19-393.e24. [PMID: 33509607 DOI: 10.1016/j.crad.2020.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 12/24/2020] [Indexed: 11/25/2022]
Abstract
AIM To evaluate the density and volume changes in the lungs of silicosis patients and their relationship with the disease severity classification of the International Labor Organization (ILO). MATERIALS AND METHODS The multidetector computed tomography (CT) images of 44 patients diagnosed with silicosis and 32 controls that underwent thoracic CT due to trauma were evaluated. Patients with silicosis were divided into three categories according to the ILO classification. Data related to the total lung volume, total lung mean density, lung opacity score, percentage of lung high opacity, and mean density in the lower and upper lobes were obtained using three-dimensional (3D) software. RESULTS There was no significant difference between the total lung mean densities of the silicosis and control groups (p=0.213); however, a significant difference was observed between the two groups in terms of the total lung volume (p<0.0001). According to the ILO classification, there was a significant difference between the disease severity categories in relation to the percentage of lung high opacity (p=0.000005). A strong correlation was detected between disease severity and high opacity percentage (p<0.0001, r=0.804). According to the ILO classification, there was also a significant difference between disease severity categories in terms of the lung opacity score (p=0.000144), as well as a moderate correlation between disease severity and opacity score (p<0.0001, r=0.580). CONCLUSION Total lung volume is a CT finding that shows variation in exposure to crystalline silica. The percentage of high opacity determined using multidetector CT is an effective parameter in evaluating disease severity.
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Affiliation(s)
- B Y Çankaya
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey.
| | - G Polat
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - A Tezcan
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - A Yalçın
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - R Sade
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - R B Pirimoğlu
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - A Karaman
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - H A Kızıloğlu
- Ömer Halisdemir Training and Research Hospital, Niğde, Turkey
| | - F Alper
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - M Akgün
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
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Yağız B, Hancıoğlu S, Balcı Ö, Demirel BD, Karaman A, Bıçakcı Ü, Özgüner İF, Karaman İ. Management of perinatal testicular torsion: experience of two tertiary centers. Pediatr Surg Int 2020; 36:959-963. [PMID: 32405765 DOI: 10.1007/s00383-020-04666-4] [Citation(s) in RCA: 2] [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] [Accepted: 04/29/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Perinatal testicular torsion is a rare condition in which testicular salvage rates are significantly low and management is controversial. We retrospectively evaluated our patients and aimed to go through our management approach. METHODS The newborn patients who underwent surgery for testicular torsion in two tertiary referral centers between 2000 and 2019 are enrolled. Radiological and clinical findings are retrospectively evaluated. RESULTS Thirty-two newborns are enrolled in the study. All of the cases were unilateral and 30 ended up with immediate orchidectomy while 2 received orchidopexy but both underwent atrophy on follow-up. No bilateral torsion is demonstrated neither in 16 patients with bilateral exploration nor in the follow up of the rest 16 with unilateral exploration. Intravaginal torsion was encountered in five patients (16%). No morbidity or mortality related to anesthesia is documented. No malignancy is encountered in any of the patients. CONCLUSION Although ipsilateral testicular salvage rates are low, urgent bilateral exploration in a multidisciplinary center seems reasonable to give a chance to the ipsilateral testis and to avoid the rare but catastrophic bilateral torsion, after discussing with the family.
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Affiliation(s)
- Beytullah Yağız
- Divison of Pediatric Urology, Department of Pediatric Surgery, Ondokuz Mayıs University School of Medicine, Ondokuz Mayıs Üniversitesi Kurupelit Kampüsü, 55200, Atakum, Samsun, Turkey.
| | - Sertaç Hancıoğlu
- Department of Pediatric Surgery, Ondokuz Mayıs University School of Medicine, Ondokuz Mayıs Üniversitesi Kurupelit Kampüsü, 55200, Atakum, Samsun, Turkey
| | - Özlem Balcı
- Department of Pediatric Surgery, Dr Sami Ulus Gynecology, Obstetrics and Child Health and Diseases Training and Research Hospital, Beştepeler Mah, Alparslan Türkeş Cad. No: 27, 06560, Beştepe, Ankara, Turkey
| | - Berat Dilek Demirel
- Department of Pediatric Surgery, Ondokuz Mayıs University School of Medicine, Ondokuz Mayıs Üniversitesi Kurupelit Kampüsü, 55200, Atakum, Samsun, Turkey
| | - Ayşe Karaman
- Department of Pediatric Surgery, Dr Sami Ulus Gynecology, Obstetrics and Child Health and Diseases Training and Research Hospital, University of Health Sciences, Beştepeler Mah, Alparslan Türkeş Cad. No: 27, 06560, Beştepe, Ankara, Turkey
| | - Ünal Bıçakcı
- Department of Pediatric Surgery, Ondokuz Mayıs University School of Medicine, Ondokuz Mayıs Üniversitesi Kurupelit Kampüsü, 55200, Atakum, Samsun, Turkey
| | - İsmet Faruk Özgüner
- Department of Pediatric Surgery, Dr Sami Ulus Gynecology, Obstetrics and Child Health and Diseases Training and Research Hospital, University of Health Sciences, Beştepeler Mah, Alparslan Türkeş Cad. No: 27, 06560, Beştepe, Ankara, Turkey
| | - İbrahim Karaman
- Department of Pediatric Surgery, Dr Sami Ulus Gynecology, Obstetrics and Child Health and Diseases Training and Research Hospital, University of Health Sciences, Beştepeler Mah, Alparslan Türkeş Cad. No: 27, 06560, Beştepe, Ankara, Turkey
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9
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Kaman A, Tanır G, Çakmakçı E, Demir P, Öz FN, Teke TA, Metin Ö, Gayretli-Aydın ZG, Karaman A. Characteristics, diagnosis, and treatment modality of pediatric patients with cystic echinococcosis: a single centre experience. Turk J Pediatr 2020; 61:704-713. [PMID: 32105002 DOI: 10.24953/turkjped.2019.05.009] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Kaman A, Tanır G, Çakmakçı E, Demir P, Öz FN, Aydın Teke T, Metin Ö, Gayretli Aydın ZG, Karaman A. Characteristics, diagnosis, and treatment modality of pediatric patients with cystic echinococcosis: a single centre experience. Turk J Pediatr 2019; 61: 704-713. Cystic echinococcosis (CE) is among the most common zoonotic infections worldwide. Studies about CE are limited in childhood. The aim of this study was to evaluate clinical, radiological and laboratory characteristics of childhood CE at a tertiary care pediatric hospital. Medical records of children with CE were analyzed between January 2005 and January 2015. A total of 130 patients with a median age of 10.4 years (IQR= 7.2-years-13.2 years) were evaluated. The anatomic locations of cysts were as follows; liver (76.9%), lung (36.9%), spleen (6.2%), pelvic region (3.8%) and kidney (2.3%). The most common symptoms were abdominal pain and cough in the patients with liver cysts and lung cysts, respectively. The indirect hemagglutination (IHA) test positivity was 58%. Elevated serum total immunoglobulin E levels were detected in 59% of the patients. Fourty-four patients with liver CE, 33 patients with lung CE were treated surgically and 23 patients with liver CE were treated with percutaneous aspiration, injection and re-aspiration (PAIR) along with medical treatment. The recurrence was observed in five patients with liver CE. It was demonstrated that CE mainly involves liver but lung cysts are more frequently symptomatic and prone to be complicated than liver cysts in children. IHA test positivity together with abdominal ultrasonography are useful to diagnose liver CE but thorax CT is usually needed to diagnose lung CE. Liver cysts that are sized greater than 5 cm are more frequently treated with PAIR or surgery but smaller liver cysts can be treated medically.
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Affiliation(s)
- Ayşe Kaman
- Departments of Pediatric Infectious Diseases, Dr. Sami Ulus Maternity and Children's Training and Research Hospital
| | - Gönül Tanır
- Departments of Pediatric Infectious Diseases, Dr. Sami Ulus Maternity and Children's Training and Research Hospital
| | - Emin Çakmakçı
- Departments of Radiology, Dr. Sami Ulus Maternity and Children's Training and Research Hospital
| | - Pervin Demir
- Department of Biostatistics, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - Fatma Nur Öz
- Departments of Pediatric Infectious Diseases, Dr. Sami Ulus Maternity and Children's Training and Research Hospital
| | - Türkan Aydın Teke
- Departments of Pediatric Infectious Diseases, Dr. Sami Ulus Maternity and Children's Training and Research Hospital
| | - Özge Metin
- Departments of Pediatric Infectious Diseases, Dr. Sami Ulus Maternity and Children's Training and Research Hospital
| | - Zeynep Gökçe Gayretli-Aydın
- Departments of Pediatric Infectious Diseases, Dr. Sami Ulus Maternity and Children's Training and Research Hospital
| | - Ayşe Karaman
- Departments of Pediatric Surgery, Dr. Sami Ulus Maternity and Children's Training and Research Hospital
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Balcı Ö, Karaman İ, Karaman A. A Huge Anterior Urethral Diverticulum After Circumcision in a Child: An Unusual Complication of Disposable Plastic Circumcision Device. jus 2019. [DOI: 10.4274/jus.galenos.2019.2623] [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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11
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Kerget B, Araz O, Yilmazel Ucar E, Karaman A, Calik M, Alper F, Akgun M. Female workers' silicosis diagnosis delayed due to gender bias. Occup Med (Lond) 2019; 69:219-222. [PMID: 30869783 DOI: 10.1093/occmed/kqz019] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
After excluding alternative explanations, a silicosis diagnosis is based on the combination of appropriate silica exposure history and compatible clinical, radiological and occasionally pathological findings. Not taking appropriate occupational history by a physician may cause a misdiagnosis or underdiagnosis of silicosis. Herein, we present a female worker in a small-scale sandblasting factory who worked as a controller. Her silicosis diagnosis was established 10 years after her first symptoms, and she underwent invasive procedures due to a lack of inquiry about her occupational history. Gender bias may be one of the reasons that her occupational history was not taken.
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Affiliation(s)
- B Kerget
- Department of Pulmonary Diseases, School of Medicine, Atatürk University, Erzurum, Turkey.,Health Science University, Erzurum, Turkey
| | - O Araz
- Department of Pulmonary Diseases, School of Medicine, Atatürk University, Erzurum, Turkey
| | - E Yilmazel Ucar
- Department of Pulmonary Diseases, School of Medicine, Atatürk University, Erzurum, Turkey
| | - A Karaman
- Department of Radiology, School of Medicine, Atatürk University, Erzurum, Turkey
| | - M Calik
- Department of Pathology, School of Medicine, Firat University, Elazig, Turkey
| | - F Alper
- Department of Radiology, School of Medicine, Atatürk University, Erzurum, Turkey
| | - M Akgun
- Department of Pulmonary Diseases, School of Medicine, Atatürk University, Erzurum, Turkey
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12
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Şahin NM, Bayramoğlu E, Çetinkaya S, Erdeve ŞŞ, Karaman A, Akdoğan MP, Aycan Z. Vaginal bleeding and a giant ovarian cyst in an infant with 21-hydroxylase deficiency. J Pediatr Endocrinol Metab 2018; 31:229-233. [PMID: 29252197 DOI: 10.1515/jpem-2017-0235] [Citation(s) in RCA: 3] [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: 06/14/2017] [Accepted: 10/25/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Increased adrenal androgen hormones in congenital adrenal hyperplasia (CAH) can rarely cause giant ovarian cysts in the neonatal period. Although the exact mechanism of the development of ovarian cysts is unknown, it is thought that increased androgen levels stimulate folicle development by increasing follicle stimulating hormone (FSH) levels. CASE PRESENTATION A 16-day-old newborn with ambiguous genitalia was presented to our clinic. Laboratory test results were as follows: sodium: 126 mEq/L, potassium: 5.4 mEq/L, renin: 132 pg/mL, adrenocorticotropic hormone (ACTH): 207 pg/mL, cortisole: 7.8 μg/dL, basal 17OH progesterone: 21 ng/mL, androstenedione: 5.1 ng/mL, testosterone: 1188 ng/dL and dehydroepiandrosterone sulfate (DHEAS)>1500 μg/dL. Karyotype analysis resulted in 46,XX. A homozygous mutation of R356W was detected in the CYP21A2 gene. The classical severe form of salt wasting 21 hydroxylase deficiency was diagnosed and treatment was started with hydrocortisone and fludrocortisone. Good metabolic control was ensured by monthly visits but the baby presented with vaginal bleeding as soiling at 4 months. The cystic lesion which extended to the epigastric area from the pelvis in the midline abdomen, had a size of 90×80×60 mm and medially, thin ovarian parenchyma was detected in ultrasonography. CONCLUSIONS The findings in our patient suggest that a decline in adrenal androgens after glucocorticoid treatment resulted in an increase in gonadotropin levels and the giant cyst is developed by activation of gonadotropin cascade and increased gonadotropin receptors, instead of androgens.
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Affiliation(s)
- Nursel Muratoğlu Şahin
- Clinic of Pediatric Endocrinology, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey
| | - Elvan Bayramoğlu
- Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Pediatric Endocrinology Clinic, Altındağ/Ankara, 06020, Turkey, Phone: +90 03123056513, Fax: +90 03123170353
| | - Semra Çetinkaya
- Clinic of Pediatric Endocrinology, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey
| | - Şenay Şavaş Erdeve
- Clinic of Pediatric Endocrinology, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey
| | - Ayşe Karaman
- Clinic of Pediatric Surgery, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey
| | - Melek Pala Akdoğan
- Clinic of Radiology, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey
| | - Zehra Aycan
- Clinic of Pediatric Endocrinology, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey
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Abstract
Ardıçlı B, Karaman A, Özyazıcı A, Zenciroğlu A, Okumuş N. Isolated thoracoschisis: Case report. Turk J Pediatr 2017; 59: 217-220. Thoracoschisis is a rare congenital anomaly that refers to a congenital fissure of the chest wall. It is frequently accompanied with other congenital defects of the limbs and the abdominal wall as part of the limb-body wall complex, which is exencephaly/encephalocele and facial clefts, thoracoschisis and/or abdominoschisis and limb defects. Isolated thoracoschisis is a rare entity. We present a case of isolated thoracoschisis. A 24-week gestational age boy presented with a 3 cm chest wall defect in the left lateral 10th intercostal space and intestines herniating through the defect. There was no history of maternal drug use during pregnancy. Birth weight was 500 g. He underwent surgery. The intestines were reduced via the thoracic wall defect.
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Affiliation(s)
- Burak Ardıçlı
- Department of Pediatric Surgery, Dr. Sami Ulus Maternity and Children's Training and Research Hospital, Ankara, Turkey
| | - Ayşe Karaman
- Department of Pediatric Surgery, Dr. Sami Ulus Maternity and Children's Training and Research Hospital, Ankara, Turkey
| | - Ahmet Özyazıcı
- Division of Neonatology, Department of Pediatrics, Dr. Sami Ulus Maternity and Children's Training and Research Hospital, Ankara, Turkey
| | - Ayşegül Zenciroğlu
- Division of Neonatology, Department of Pediatrics, Dr. Sami Ulus Maternity and Children's Training and Research Hospital, Ankara, Turkey
| | - Nurullah Okumuş
- Division of Neonatology, Department of Pediatrics, Dr. Sami Ulus Maternity and Children's Training and Research Hospital, Ankara, Turkey
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Atıcı A, Yılmaz E, Karaman A, Apaydın S, Afşarlar ÇE. Tuba-ovarian auto-amputation caused by ovarian teratoma in an adolescent girl. Turk J Pediatr 2017; 59:90-92. [PMID: 29168372 DOI: 10.24953/turkjped.2017.01.017] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Atıcı A, Yılmaz E, Karaman A, Apaydın S, Afşarlar ÇE. Tuba-ovarian auto-amputation caused by ovarian teratoma in an adolescent girl. Turk J Pediatr 2017; 59: 90-92. Ovarian auto-amputation is an extremely rare condition commonly encountered in the perinatal period. Spontaneous or secondary torsion of the ovary caused by an ovarian lesion may result in infarction and subsequent auto-amputation of the ovary. This paper demonstrates a case that underwent laparoscopic appendectomy with an incidental calcified auto-amputated right ovary. A 16-year-old adolescent girl was admitted to our department with a history of one-day abdominal pain. Physical examination of the patient revealed abdominal tenderness and rigidity on right lower quadrant. Her white blood cell count was 11x103/mL, and C-reactive protein was 69 mg/L. The patient underwent a laparoscopic appendectomy with a provisional diagnosis of acute appendicitis, and further exploration revealed a 2x2 cm white ovoid mass floating freely in the pelvis. The left ovary was clearly identified in its usual localization, but the right tuba was blindly ending without any fimbria or ovary. Postoperative course of the patient was uneventful, and she was discharged on postoperative day 2. The histopathological examination revealed a necrotic calcified ovarian teratoma. Auto-amputated ovary is a rare occasion mostly encountered during perinatal period, and it may be unilateral or bilateral. An auto-amputated ovarian mass may rarely be a teratoma although the most common cause of auto-amputation during perinatal and adolescent period is ovarian torsion due to an ovarian cyst.
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Affiliation(s)
- Ahmet Atıcı
- Department of Pediatric Surgery, Dr.Sami Ulus Maternity, Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Engin Yılmaz
- Department of Pediatric Surgery, Dr.Sami Ulus Maternity, Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Ayşe Karaman
- Department of Pediatric Surgery, Dr.Sami Ulus Maternity, Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Sema Apaydın
- Department of Pathology, Dr.Sami Ulus Maternity, Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Çağatay Evrim Afşarlar
- Department of Pediatric Surgery, Dr.Sami Ulus Maternity, Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
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Karaman İ, Karaman A, Çınar HG, Ertürk A, Erdoğan D, Özgüner İF. Is color Doppler a reliable method for the diagnosis of malrotation? J Med Ultrason (2001) 2017; 45:59-64. [DOI: 10.1007/s10396-017-0794-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 05/02/2017] [Indexed: 12/11/2022]
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Doğan NN, Dilli D, Fettah Dinlen N, Erdoğan D, Koyuncu E, Zenciroğlu A, Karaman A, Okumuş N. Congenital Chylothorax in a Newborn with Down Syndrome. Haseki 2017. [DOI: 10.4274/haseki.3011] [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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17
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Karaman İ, Koç O, Karaman A, Erdoğan D, Çavuşoğlu YH, Afşarlar ÇE, Yilmaz E, Ertürk A, Balci Ö, Özgüner IF. Evaluation of 968 children with corrosive substance ingestion. Indian J Crit Care Med 2016; 19:714-8. [PMID: 26813230 PMCID: PMC4711203 DOI: 10.4103/0972-5229.171377] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background and Aims: The aim of the study was to evaluate the etiology, treatment, and prognosis in children who had presented at our clinic with corrosive substance ingestion and comparison of our results with the literature. Materials and Methods: The patients were put on nil by mouth and broad-spectrum antibiotics were administered. Oral fluids were started for patients whose intraoral lesions resolved and who could swallow their saliva. Steroids were not given, a nasogastric catheter was not placed, and early endoscopy was not used. Results: A total of 968 children presented at our clinic for corrosive substance ingestion during the 22-year period. The stricture development rate was 13.5%. Alkali substance ingestion caused a stricture development rate of 23%. A total of 54 patients required 1–52 sessions (mean 15 ±12) of dilatation. Conclusion: We do not perform early endoscopy, administer steroids, or place a nasogastric catheter at our clinic for patients who had ingested a corrosive substance. This approach has provided results similar to other series. We feel that determining the burn with early esophagoscopy when factors that prevent or decrease the development of corrosive strictures will be very important.
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Affiliation(s)
- İbrahim Karaman
- Department of Pediatric Surgery, Dr. Sami Ulus Children's Hospital, Ankara, Turkey
| | - Orhan Koç
- Department of Pediatric Surgery, Dr. Sami Ulus Children's Hospital, Ankara, Turkey
| | - Ayşe Karaman
- Department of Pediatric Surgery, Dr. Sami Ulus Children's Hospital, Ankara, Turkey
| | - Derya Erdoğan
- Department of Pediatric Surgery, Dr. Sami Ulus Children's Hospital, Ankara, Turkey
| | | | | | - Engin Yilmaz
- Department of Pediatric Surgery, Dr. Sami Ulus Children's Hospital, Ankara, Turkey
| | - Ahmet Ertürk
- Department of Pediatric Surgery, Dr. Sami Ulus Children's Hospital, Ankara, Turkey
| | - Özlem Balci
- Department of Pediatric Surgery, Dr. Sami Ulus Children's Hospital, Ankara, Turkey
| | - Ismet Faruk Özgüner
- Department of Pediatric Surgery, Dr. Sami Ulus Children's Hospital, Ankara, Turkey
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Keskin M, Savaş-Erdeve Ş, Kurnaz E, Çetinkaya S, Karaman A, Apaydın S, Aycan Z. Gonadoblastoma in a patient with 46, XY complete gonadal dysgenesis. Turk J Pediatr 2016. [PMID: 28621097 DOI: 10.24953/turkjped.2016.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
46, XY complete gonadal dysgenesis (Swyer syndrome) is a rare cause of 46, XY sexual development disorder. The patient presented to our clinic with absence of breast development and lack of periods at the age of 17 years. Her history and familial history involved no relevant conditions. She had Tanner stage 1 thelarche, and Tanner stage 2 pubic hair development with no axillary hair development. External genital structure appearance was consistent with female phenotype and the patient had no palpable gonad. The patient diagnosed as 46, XY complete gonadal dysgenesis after evaluation of laboratory analyses, radiological methods and karyotype. The Sexual Orientation and Gender Identity Committee concluded that gonadectomy should be performed. Histopathologic analysis demonstrated gonadoblastoma. Gonad structures should be sought laparoscopically and once diagnosed, streak gonads should be removed prophylactically in patients with 46, XY complete gonadal dysgenesis.
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Affiliation(s)
| | - Şenay Savaş-Erdeve
- Departments of Pediatric Endocrinology, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey
| | - Erdal Kurnaz
- Departments of Pediatric Endocrinology, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey
| | - Semra Çetinkaya
- Departments of Pediatric Endocrinology, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey
| | - Ayşe Karaman
- Departments of Pediatric Surgery, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey
| | - Sema Apaydın
- Departments of Pathology, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey
| | - Zehra Aycan
- Departments of Pediatric Endocrinology, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey
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Savaş-Erdeve Ş, Aycan Z, Keskin M, Çetinkaya S, Karaman A, Apaydın S, Çakmakçı E. Complete androgen insensitivity syndrome associated with bilateral sertoli cell adenomas and unilateral paratesticular leiomyoma: A case report. Turk J Pediatr 2016; 58:654-657. [PMID: 29090880 DOI: 10.24953/turkjped.2016.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
Complete androgen insensitivity syndrome (CAIS) disorder of sex development due to mutations that cause function loss in androgen receptors in 46, XY individuals. The risk of malignancy in CAIS is 5-10% until the age of 25 years. A 17-year-old patient raised as a female presented to our clinic complaining of amenorrhea. She had a history of surgery for inguinal hernia at the age of 2 years. The patient's niece of the same age had been diagnosed with CAIS at our department and gonadectomy had been performed six months ago. She had four other nieces with the same diagnosis. Her external genital appeared phenotypically female. On physical examination, breast development was Tanner stage 5 and pubic hair Tanner stage 2 with scarce axillary hair. The gonad was palpated in the left inguinal region. Chromosome analysis revealed 46, XY and sex determining region Y (SRY) was positive. The patient was diagnosed as CAIS with laboratory and radiology results. The Sexual Orientation and Gender Identity Committee decided on gonadectomy. Histopathological evaluation of the gonad revealed bilateral Sertoli cell tumor and right paratesticular leiomyoma.
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Affiliation(s)
- Şenay Savaş-Erdeve
- Clinic of Pediatric Endocrinology, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey
| | - Zehra Aycan
- Clinic of Pediatric Endocrinology, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey
| | - Melikşah Keskin
- Clinic of Pediatric Endocrinology, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey
| | - Semra Çetinkaya
- Clinic of Pediatric Endocrinology, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey
| | - Ayşe Karaman
- Clinic of Pediatric Surgery, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey
| | - Sema Apaydın
- Clinic of Pathology, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey
| | - Emin Çakmakçı
- Clinic of Radiology, Dr. Sami Ulus Obstetrics and Gynecol and Pediatrics Training and Research Hospital, Ankara, Turkey
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Yilmaz E, Hizli F, Afşarlar ÇE, Demirtaş C, Apaydin S, Karaman İ, Karaman A. Early diagnosis of testicular torsion in rats by measuring plasma d-dimer levels: comparative study with epididymitis. J Pediatr Surg 2015; 50:651-4. [PMID: 25840081 DOI: 10.1016/j.jpedsurg.2014.05.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 03/17/2014] [Revised: 05/11/2014] [Accepted: 05/19/2014] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the differential diagnosis of testicular torsion and acute epididymo-orchitis by measuring the acute increase in plasma d-dimer levels in an experimental rat model. METHODS Thirty male Wistar rats were randomly divided into 5 groups, 1--sham operated group (acute term; 4 hours), 2--early torsion group (acute term; 4 hours), 3--late torsion group (long-term; 72 hours), 4--control of epididymitis group (vehicle injected; 0.1 ml physiologic saline injected into the left ductus deferens) (long term; 72 hours), 5--epididymitis group (0.1 ml Escherichia coli injected into the left ductus deferens), (n=6 for each group). RESULTS Serum d-dimer levels were significantly higher compared with the sham operated group with early torsion (p=0.002). This elevation remained mildly in the late torsion group compared with the control group (p<0.001), but there was no difference between 4 and 72 hours of the testis torsions (p=0.794). On the other hand, d-dimer levels were significantly higher in the torsion groups compared to the epididymitis group (p=0.042). CONCLUSIONS The present study demonstrated that testicular damage that occurs following testicular torsion shows a higher increase in d-dimer levels than epididymitis, suggesting that d-dimer level can be used as a diagnostic marker of testicular torsion.
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Affiliation(s)
- Engin Yilmaz
- Department of Pediatric Surgery, Sami Ulus Women's Health and Children Training and Research Hospital, Ankara, Turkey
| | - Fatih Hizli
- Department of Urology, Oncology Training and Research Hospital, Ankara, Turkey.
| | - Çağatay Evrim Afşarlar
- Department of Pediatric Surgery, Sami Ulus Women's Health and Children Training and Research Hospital, Ankara, Turkey
| | - Canan Demirtaş
- Department of Biochemistry, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Sema Apaydin
- Department of Pathology, Sami Ulus Women's Health and Children Training and Research Hospital, Ankara, Turkey
| | - İbrahim Karaman
- Department of Pediatric Surgery, Sami Ulus Women's Health and Children Training and Research Hospital, Ankara, Turkey
| | - Ayşe Karaman
- Department of Pediatric Surgery, Sami Ulus Women's Health and Children Training and Research Hospital, Ankara, Turkey
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Karaman A, Aydin H, Geçkinli B, Göksu K. The deletion 22q13 syndrome: a new case. Genet Couns 2015; 26:53-60. [PMID: 26043508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The deletion 22q13.3 syndrome (Phelan-McDermid syndrome) is a chromosome microdeletion syndrome characterized by neonatal hypotonia, global developmental delay, normal to accelerated growth, absent to severely delayed speech, and minor dysmorphic features. Common physical traits include long eye lashes, large or unusual ears, relatively large hands, dysplastic toenails, full brow, dolicocephaly, full cheeks, bulbous nose, and pointed chin. Behavior is autisticlike with decreased perception of pain and habitual chewing or mouthing. The loss of 22q13.3 can result from simple deletion, translocation, ring chromosome formation and less common structural changes affecting the long arm of chromosome 22, specifically the region containing the SHANK3 gene. The present case was referred at the age of 8 months because of delayed psychomotor development, hypotonia and autistic features. Clinical examination showed a small forehead, long eyelashes, epicanthal folds and lowset ears, large and broad hands and feet with short terminal phalanges. He had no eye contact and could not sit without support.
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Karaman A, Aydin H, Göksu K. Concomitant omphalocele, anencephaly and arthrogryposis associated with trisomy 18. Genet Couns 2015; 26:77-79. [PMID: 26043511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
MESH Headings
- Abnormalities, Multiple/diagnostic imaging
- Abnormalities, Multiple/genetics
- Abortion, Induced
- Adult
- Anencephaly/diagnostic imaging
- Anencephaly/genetics
- Arthrogryposis/diagnostic imaging
- Arthrogryposis/genetics
- Chromosomes, Human, Pair 18/diagnostic imaging
- Chromosomes, Human, Pair 18/genetics
- Female
- Hernia, Umbilical/diagnostic imaging
- Hernia, Umbilical/genetics
- Humans
- Pregnancy
- Trisomy/genetics
- Trisomy 18 Syndrome
- Ultrasonography, Prenatal
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Aydin BH, Arisoy R, Simsek H, Erdogdu E, Geckinli B, Karaman A, Demirci O. CO-OCCURRENCE OF NEURAL TUBE DEFECT, THORACAL DEFECT AND OMPHALOCELE: A RARE CASE AND REVIEW OF THE LITERATURE. Genet Couns 2015; 26:253-257. [PMID: 26349198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Demirci O, Yavuz T, Arisoy R, Pekin O, Acar H, Aydin H, Cetinkaya A, Karaman A, Erdoğdu E, Kumru P. AGENESIS OF THE DUCTUS VENOSUS--A CASE WITH NOONAN SYNDROME. Genet Couns 2015; 26:373-376. [PMID: 26625673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Geckinli BB, Aydin H, Karaman A, Delil K, Simsek H, Gokmeydan E, Turkdogan D. CLINICAL REPORT OF A PATIENT WITH DE NOVO TRISOMY 12q23.1q24.33. Genet Couns 2015; 26:393-400. [PMID: 26852509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We report a patient with a rare de novo duplication of 12q23.1-12q24.33 region with a 32.7 Mb gain, having similar features seen in previously reported isolated cases of duplications of the 12q23q24 region, such as growth retardation, neuromotor retardation, corpus callosum agenesis, dysmorphic features such as, hypertelorism, epicanthus, flat nasal bridge, low-set small ears, down-turned corners of the mouth, micrognathia, cryptorchidism and limb anomalies such as pes plano valgus, prominent heels and overriding toes. Our patient has Noonan-like features, such as short stature, short neck, epicanthal folds, ptosis of eyelids, hypertelorism, pectus excavatum, widely spaced nipples and cryptorchidism. Duplication of PTPN11 gene has been postulated as a mechanism for the Noonan syndrome. Phenotypic features and the genes involved in this region are important to further delineate the 12q23q24 phenotype.
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Atıcı A, Karaman A, Zenciroğlu A, Karaman I, Afşarlar CE, Yılmaz E, Okumuş N, Cavuşoğlu YH, Ozgüner IF, Erdoğan D. Factors affecting mortality in stage 3b necrotizing enterocolitis. Turk J Pediatr 2014; 56:133-137. [PMID: 24911845] [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: 06/03/2023]
Abstract
This study aimed to determine the factors that may affect the development of mortality in patients with stage 3b necrotizing enterocolitis (NEC). Between January 2005 and December 2012, patients with the diagnosis of stage 3b NEC who were surgically treated were enrolled in the study. Gestational age, birth weight, presence of hypoxemia history, major congenital heart diseases, enteral feeding, age at perforation, drainage type, operation, and laboratory findings were considered regarding their possible relationship with mortality. Thirty-one patients were enrolled in this study. Following treatment, 15 patients died, while 16 patients recovered and were discharged. Feeding type, high levels of prothrombin time (PT), activated partial thromboplastin time (aPTT), creatinine, and low platelet count, as well as need of inotropic support were associated with mortality. When the cut-off point of platelet level for mortality development in stage 3b NEC was calculated by receiver operating characteristic (ROC) curve, the cut-off point for thrombocyte level was found to be 110,000/µL, with 93.3% sensitivity and 87.5% specificity. Despite the innovations in newborn intensive care, the mortality rate of stage 3b NEC remains very high. Breastfeeding has a significantly positive impact on the survival of patients with NEC. Thrombocytopenia is the most important risk factor of mortality in stage 3b NEC.
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Affiliation(s)
- Ahmet Atıcı
- Department of Pediatric Surgery, Dr. Sami Ulus Maternity, Children's Health and Diseases, Research and Training Hospital, Ankara, Turkey
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Aydin H, Yanik S, Tug E, Ahsen H, Geckinli B, Senol S, Karaman A, Yilmaz F, Boran C. Craniorachischisis, gastroschisis, and a branchial sinus defect: a case report. Genet Couns 2014; 25:237-240. [PMID: 25059025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Geckinli BB, Aydin H, Karaman A. A patient with duplication (7)(p15.3p22.3) and deletion (7)(p22.3pter) characterized by array-CGH. Genet Couns 2014; 25:405-412. [PMID: 25804019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We report a patient with neurodevelopmental delay, hypotonia, congenital cardiac anomaly and dysmorphic features such as macrocephaly, a large anterior fontanel, prominent forehead, short neck, downslanted and short palpebral fissures, hypertelorism, wide nasal bridge, straight, thin nose with asymmetric narrow inverted nostrils, micrognathia, low-set dysplastic ears. 7p15.3-p22.3 duplication and a 7p22.3-pter deletion were characterized by array-CGH analysed after karyotyping and FISH studies. The patient's distinctive features are consistent with the phenotypic features of 7p duplication. The genes involved in these regions are discussed for their possible relation to our patient's phenotype.
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Afşarlar ÇE, Peltek-Kendirci HN, Erdoğan D, Özgüner İF, Çavuşoğlu YH, Karaman A, Çetinkaya S. The first case of Bruck syndrome associated with gastroschisis. Turk J Pediatr 2013; 55:651-654. [PMID: 24577988] [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: 06/03/2023]
Abstract
Bruck syndrome is an extremely rare disorder featuring the unusual combination of skeletal changes resembling osteogenesis imperfecta with congenital contractures of large joints. Although the genotypic and phenotypic features of Bruck syndrome are heterogeneous, we report a baby girl having gastroschisis complicated with jejunal perforation in addition to bone fractures and joint contractures, which supported the diagnosis of Bruck syndrome. After surgical procedures for gastroschisis, the fractures were treated with splints, and cyclic pamidronate treatment was started. On postoperative day 30, the patient was discharged without any complications. She is now seven months of age, gaining weight and has had no additional fractures with the ongoing pamidronate treatment. Although prematurity and low birth weight are common in gastroschisis, musculoskeletal anomalies have not been reported until now, and thus the case is unique. Additionally, cyclic pamidronate administration is a good treatment choice for bone fragility in Bruck syndrome to reduce the number of fractures, and it may be beneficial for the subsequent clinical deterioration of the patients.
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Affiliation(s)
- Çağatay Evrim Afşarlar
- Departments of Dr. Sami Ulus Maternity, Children's Health and Diseases, Training and Research Hospital, Ankara, Turkey.
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Yilmaz İ, Karaman A, Vardi N, Cetin A, Erdemli E. Effects of organic apricot on liver regeneration after partial hepatectomy in rats. Transplant Proc 2013; 45:2455-60. [PMID: 23953562 DOI: 10.1016/j.transproceed.2013.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 03/05/2013] [Accepted: 04/23/2013] [Indexed: 02/09/2023]
Abstract
BACKGROUND The present study investigated the effects of (sun-dried organic apricot/SDOA) supplementation in chow on liver regeneration after partial hepatectomy/(PH) in rats. METHOD In this study, 28 female rats were randomized into four groups. On the 7th day of the study, group 1 underwent laparoscopic intervention while a PH was performed on the other three cohorts. On day 28, all rats were humanely killed. Blood and liver tissue samples were subjected to biochemical determinations, histological examinations, and measurement of tissue oxidative stress enzyme activity. RESULTS Serum levels of alanine transaminase (ALT), alkaline phosphatase (ALP), and liver tissue glutathione (GSH) activities were affected by PH and/or SDOA consumption (P < .05). Moderately staining cell counts in group 4 were significantly different from the other three groups (P < .05). However, no significant differences were detected among all groups in regard to aspartate aminotransferase (AST) serum levels or liver tissue superoxide dismutase (SOD), malondialdehyde (MDA), catalase (CAT) or glutathione peroxidase (GSHpx) activities (P < .05). CONCLUSION The 5% SDOA supplementation over a 21-day feeding period showed a beneficial effect on liver regeneration in rats, as reflects by Ki-67 finding although there was no change in ALT or ALP or in liver tissue GSH activity.
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Affiliation(s)
- İ Yilmaz
- Department of Pharmacology, İnonu University, Malatya/Turkey.
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Afşarlar CE, Yılmaz E, Karaman A, Karaman I, Ozgüner IF, Erdoğan D, Cavuşoğlu YH, Maden HA. Treatment of adolescent pilonidal disease with a new modification to the Limberg flap: symmetrically rotated rhomboid excision and lateralization of the Limberg flap technique. J Pediatr Surg 2013; 48:1744-9. [PMID: 23932616 DOI: 10.1016/j.jpedsurg.2013.01.029] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [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: 07/26/2012] [Revised: 01/19/2013] [Accepted: 01/21/2013] [Indexed: 01/15/2023]
Abstract
BACKGROUND/PURPOSE Pilonidal disease is a common and frustrating problem among adolescents due to its high recurrence rate. The rhomboid excision and Limberg flap techniques promise successful results, but the lower part of the incision left on the intergluteal sulcus is prone to recurrences. Consequently, we have developed a new modification to this technique and have designed a descriptive prospective study to evaluate its efficiency. METHODS We conducted this prospective study between March 2011 and March 2012. All of the patients who were operated on for sacrococcygeal pilonidal disease were included in this study. The surgical procedure primarily consisted of symmetrically rotated (clockwise) rhomboid excision and lateralization of the Limberg flap in order to keep the inferior corner of the suture line apart from the intergluteal sulcus. RESULTS A total of 15 adolescents (8 boys and 7 girls) were included in the study group. Of the patients, 47% were normal, 13% were overweight, and 40% were obese. Five patients were operated on under general anesthesia, and 10 were operated on under spinal anesthesia. The length of the flap margins ranged from 2.5 to 7 cm (median=4 cm). The median duration of hospitalization was 5 days, and the median duration of suction drainage was 4 days. The median postoperative follow-up period was 4 months (ranging from 1 to 12 months), and we did not encounter any wound infection or recurrent disease during this period. Only one patient had wound hematoma as a result of drain breakdown and was treated with wound care without any additional complications. CONCLUSION Although the number of patients in this study was small and the follow-up period was short, we obtained satisfactory results without any recurrence by performing a symmetrically rotated rhomboid excision and lateralized Limberg flap procedure.
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Erdoğan D, Karaman I, Aslan MK, Karaman A, Cavuşoğlu YH. Analysis of 3,776 pediatric inguinal hernia and hydrocele cases in a tertiary center. J Pediatr Surg 2013; 48:1767-72. [PMID: 23932620 DOI: 10.1016/j.jpedsurg.2012.09.048] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [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: 07/24/2012] [Revised: 09/28/2012] [Accepted: 09/28/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND/PURPOSE This study describes the pediatric inguinal hernia and hydrocele experience of a tertiary care training hospital. METHODS A total of 3776 patients who had been operated between January 2005 and June 2009 for inguinal hernia, cord hydrocele, and hydrocele were included. The surgeries and patient follow-up were performed by 6 pediatric surgery specialists and 8 pediatric surgery residents. RESULTS The patient age varied from 6 days to 17 years. There were 2959 (78.4%) males and 817 (21.6%) females (ratio: 3.6:1). The hernia was on the right in 2306 (61.1%) patients, on the left in 1111 (29.4%) patients, and bilateral in 359 (9.5%) patients. Age at presentation was younger in males (p<.001). Contralateral hernia repair was required later on during follow-up in 2% of the patients. Postoperative complications developed in 1.2% of the patients. Reoperation was needed because of wound infection in 0.6%, recurrence in 0.4%, hematoma in 0.1%, testicular atrophy in 1 patient, and acquired undescended testis in 1 patient. CONCLUSIONS The age of first hernia symptoms was younger in males compared to females and in premature babies compared to term babies (p<.05). The recurrent hernia rate was higher in infancy. The complication rate was higher in hernia surgery in the newborn period and in cases of incarcerated hernia compared to the overall rate (p<.05). There was no indication for contralateral routine exploration.
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Affiliation(s)
- Derya Erdoğan
- Dr Sami Ulus Maternity and Children's Research and Training Hospital - Pediatric Surgery Department, Ankara, Turkey.
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Yilmaz E, Afşarlar CE, Karaman I, Özgüner IF, Karaman A, Hızli F. Congenital hemiscrotal agenesis: report of a rare entity. J Pediatr Urol 2013; 9:e76-7. [PMID: 23044375 DOI: 10.1016/j.jpurol.2012.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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: 02/28/2012] [Accepted: 09/13/2012] [Indexed: 02/07/2023]
Abstract
Congenital scrotal agenesis is the rarest anomaly of scrotal development disorder and is characterized by the absence of scrotal rugae in the perineum between the penis and anus. We report here a case of hemiscrotal agenesis in a 2-year-old boy. To the best of our knowledge, our patient is the second reported case of hemiscrotal agenesis in the English literature.
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Affiliation(s)
- Engin Yilmaz
- Bakirköy Dr. Sadi Konuk Training and Research Hospital, Department of Pediatric Surgery, İstanbul, Turkey
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Binici DN, Karaman A, Coşkun M, Oğlu AU, Uçar F. Genomic damage in patients with type-2 diabetes mellitus. Genet Couns 2013; 24:149-156. [PMID: 24032284] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
DNA damage seems to play a role in the pathogenesis of type-2 diabetes mellitus (DM2) and its complications. Several in vitro assays have been used to measure the DNA damage. In the present study, we aimed to investigate the frequency of sister chromatid exchange (SCE) and micronuclei (MN) in DM2 patients compared with healthy controls. SCE and MN tests were carried out with the blood-cell cultures from 50 DM2 patients and 30 healthy, age- and sex-matched control subjects. The mean age of the DM2 patients was 58.12 +/- 13.39 years, with a mean duration of the diabetes of 5.40 +/- 4.32 years. The mean level of HbAlc of the DM2 patients was 8.93 +/- 2.56. Patients with DM2 showed a higher frequency of SCE compared with controls (7.11 +/- 1.14 and 4.96 +/- 0.92, p < 0.001). Furthermore, the SCE frequency was positively correlated with the plasma HbA1c level (p < 0.05), but there was no significant correlation between the duration of diabetes and SCE. On the other hand, our result showed a MN frequency significant increase in DM2 patients (3.45 +/- 1.01 per 1000 cells) relative to that of the control group (1.79 +/- 0.67 per 1000 cells) (p < 0.001), but there was no significant correlation between the duration of diabetes, HbA1c and MN. In conclusion, these results suggest that DM2 is a condition with genomic instability characterized by an increased level of SCE and MN. Hyperglycemia-induced oxidative stress may be the underlying factor of the increased SCE and MN frequency.
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Affiliation(s)
- D N Binici
- Department of Internal Medicine, Erzurum Training and Research Hospital, Erzurum, Turkey
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Aydin H, Arisoy R, Geckinli B, Erdogdu E, Karaman A, Gokmeydan E, Pekin O, Tugrul S, Yorganci C. Tetrasomy 12p presenting with long appendix: a prenatal case. Genet Couns 2013; 24:439-440. [PMID: 24551989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Affiliation(s)
- Ayşe Karaman
- Department of Pediatric Surgery; Dr. Sami Ulus Children's Hospital; Ankara; Turkey
| | - Çağatay E Afşarlar
- Department of Pediatric Surgery; Dr. Sami Ulus Children's Hospital; Ankara; Turkey
| | - Nilüfer Arda
- Department of Pathology; Dr. Sami Ulus Children's Hospital; Ankara; Turkey
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Erdoğan D, Azılı MN, Çavuşoğlu YH, Tuncer İS, Karaman İ, Karaman A, Özgüner İF. 11-year experience with gastroschisis: factors affecting mortality and morbidity. Iran J Pediatr 2012; 22:339-43. [PMID: 23399980 PMCID: PMC3564089] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Revised: 01/12/2012] [Accepted: 02/11/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study was the evaluation of patients treated with a diagnosis of gastroschisis and to establish the factors which affected the morbidity and mortality. METHODS Twenty-nine patients, managed for gastroschisis during 2000-2010 were reviewed retrospectively. Patients were analysed in respect to gestational age, birth weight, associated anomalies, type of delivery, operative procedures, postoperative complications, total parenteral nutrition (TPN) related complications. The factors affecting mortality and morbidity were determined. FINDINGS Associated abnormalities were present in 24% of the patients. Eleven patients underwent elective reduction in the incubator (Bianchi procedure) without anesthesia. Eight patients had delayed reduction with silo and ten patients had primary closure. Although the type of delivery had an effect on morbidity but not mortality, gestational age, birth weight, and the operative procedure performed had no effect on morbidity or mortality. Duration until tolerance of oral intake, and of TPN and hospitalization were found to be statistically significantly shorter in the group of babies delivered by cesarean section. CONCLUSION In our study the most important cause of mortality was the abdominal compartment syndrome and multi-organ failure in the early years. Long hospitalization periods and sepsis were the main causes of mortality in recent years.
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Affiliation(s)
- Derya Erdoğan
- Corresponding Author:Address: Hosdere caddesi, 71/8, Yukarı Ayrancı 06540, Ankara, Turkey. E-mail:
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Karaman A, Bayram F, Gundogan K, Ozsan M, Karaman H, Kelestimur F. Prevalence of diabetes mellitus and glucose metabolism disorders in the first degree relatives of type 2 diabetic patients. ACTA ACUST UNITED AC 2012; 113:361-7. [PMID: 22693973 DOI: 10.4149/bll_2012_082] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND OBJECTIVES We designed this study to observe the DM prevalence, insulin resistance, beta cell reserve and the interaction of these parameters in the first degree relatives of Type 2 diabetic patients in Turkish population. METHODS 125 subjects were included in the study. 25 subjects without the first degree diabetic relatives were selected as the control group; they were matched by age, BMI, socio-economical, cultural and environmental factors. (OGTT), (IVGTT), (GST), and (ITT), were performed on all subjects and controls. RESULTS 12 (9.6 %) DM and 23 (18. 4 %) impaired glucose tolerance (IGT) cases of 125 subjects were diagnosed according to OGTT results. The mean BMI of diabetic subjects was significantly higher than of controls and subjects with normal glucose tolerance (p<0.05). When compared to the control group, the mean AUCinsulin levels were significantly lower in diabetic subjects (p<0.05). To observe the correlation between HOMAIR and KITT values, a statistically significant correlation was found (p<0.05, r: 0.222). There was a deficiency in the C-peptide response to glucagon stimulation in diabetic relatives (p<0.05, F: 4.59 One Way ANOVA). CONCLUSION We demonstrated that the first degree relatives of Type 2 diabetic patients constitute a high risk group for DM, IGT and insulin resistance by using four different tests in Turkish population.The significant finding(s) of the study: We demonstrated a high prevalence of glucose metabolism disorders in the relatives of type 2 diabetic patients.This study adds our knowledge; insulin resistance and decreased beta cell reserve occur before diabetes mellitus begin in relatives (Tab. 5, Ref. 42).
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Affiliation(s)
- A Karaman
- Erciyes University, Department of Internal Medicine, Kayseri, Turkey.
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Karaman I, Karaman A, Boduroğlu EC, Erdoğan D, Tanır G. Invasive Aspergillus infection localized to the gastric wall: report of a case. Surg Today 2012; 43:682-4. [PMID: 22864935 PMCID: PMC7101927 DOI: 10.1007/s00595-012-0255-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 02/02/2012] [Indexed: 11/30/2022]
Abstract
Invasive aspergillosis is most commonly seen in patients with immune disorders and usually in the lung. Local invasive aspergillosis of the gastrointestinal system is quite rare. A 13-year-old female without immune deficiency presented with acute abdomen due to full-thickness necrosis of the gastric fundus. The necrotic gastric wall was excised and the stomach repaired. The pathology revealed a gastric ulcer with invading Aspergillus hyphae and spores. Aspergillosis is an opportunistic infection and its spores cannot survive in the normal gastric mucosa. The Aspergillus spores in this case probably grew on a background of gastric ulcer and caused wall necrosis and that the surgical treatment possibly provided a cure because it remained localized to the gastric wall.
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Affiliation(s)
- Ibrahim Karaman
- Department of Pediatric Surgery, Dr. Sami Ulus Children's Hospital, Babür Cad., No: 44, Altındağ, 06080 Ankara, Turkey.
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Tos T, Karaman A, Aksoy A, Tukun A. Structural chromosomal abnormalities in patients with mental retardation and/or multiple congenital anomalies: a new series of 24 patients. Genet Couns 2012; 23:289-296. [PMID: 22876589] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Chromosomal abnormalities are a major cause of mental retardation and/or multiple congenital anomalies (MCA/MR). Screening for these chromosomal imbalances has mainly been done by standard karyotyping. The objective of this study was to report standard chromosome analysis and FISH screening of a series of 24 patients with MCA/MR. Structural chromosomal abnormalities were detected in 24 alterations and included 5 deletions, 2 duplications, 6 unbalanced translocations, 3 inversions, 2 insertions, 3 derivative chromosomes, 2 marker chromosomes and 1 isochromosome. We confirm that a high percentage of MCA/MR cases hitherto considered idiopathic is caused by chromosomal imbalances. We conclude that patients with MCA/MR should be routinely karyotyped.
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Affiliation(s)
- T Tos
- Department of Medical Genetics, Dr. Sami Ulus Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
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Abstract
A 7.5-year-old boy was admitted to our department with left undescended testis. On surgical exploration, the vas deferens and epididymis were normal in appearance in its route to the scrotum, but no obvious testis or testis-like structure was identified. Exploration was extended to the abdominal cavity via the processus vaginalis, and the testis was found near the sigmoid colon without any connection to the vas deferens and epididymis. The testis was freed from surrounding structures preserving the testicular vasculature, and an orchidopexy was performed. In cases of nonpalpable testis with the vas deferens and epididymis reaching to the scrotum, an intra-abdominal testis owing to a nonunion phenomenon must be considered, and extended exploration should be performed.
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Affiliation(s)
- Ayşe Karaman
- Department of Pediatric Surgery, Dr Sami Ulus Children's Hospital, Ankara, Turkey.
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Karaman I, Karaman A, Erdoğan D, Cavuşoğlu YH, Ozgüner IF. The first male with thoracoschisis: case report and review of the literature. J Pediatr Surg 2011; 46:2181-3. [PMID: 22075354 DOI: 10.1016/j.jpedsurg.2011.08.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [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: 05/28/2011] [Revised: 08/22/2011] [Accepted: 08/22/2011] [Indexed: 10/15/2022]
Abstract
A male infant presented at birth with intestine and liver herniated through a defect 3 cm below the left nipple on the anterior thoracic wall. Riedel lobe, attached to the left liver lobe, and the transverse colon were seen protruding through the defect at the region of the left eighth intercostal space at surgery. A fibrous band extending from the lower defect border to the bladder was present. The hernia content was reduced inside the abdomen and the fibrous band, and Riedel lobe and necrotic-appearing omentum were excised. Thoracoschisis is a very rare congenital anomaly with only 4 cases reported. This is the first isolated thoracoschisis case without an accompanying diaphragmatic hernia.
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Affiliation(s)
- Ibrahim Karaman
- Department of Pediatric Surgery, Dr Sami Ulus Children's Hospital, 06080 Altındağ/Ankara/Turkey.
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Abstract
This study reports a 1-year-old boy with unilateral partial duplication of vas deferens, diagnosed during surgery for undescended testis. Pediatric surgeons need to be aware of this kind of anomaly in order to avoid injury to this vital structure.
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Affiliation(s)
- Ayşe Karaman
- Department of Pediatric Surgery, Dr. Sami Ulus Children's Hospital, Ankara, Turkey
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Abstract
Fetus in fetu is a rare condition that has been defined as the presence of one of the twins in the body of the other. It is most frequently located in retroperitoneal area; however, it has been reported in other locations as well. This report presents two cases of "fetus in fetu" cases: one located in the retroperitoneal area and the other in the sacrococcygeal area.
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Affiliation(s)
- Ibrahim Karaman
- Department of Pediatric Surgery, Dr. Sami Ulus Children's Hospital, Ankara, Turkey
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Tos T, Karaman A, Gül D. A boy with Weyers-like ulnar ray/oligodactyly reduction limb defects and split hand malformation: case report. Genet Couns 2011; 22:245-248. [PMID: 22029164] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Weyers ulnar ray/oligodactyly syndrome is characterized by variable ulnar, radial, or fibular ray limb reductions, single central incisor, and renal, splenic or cardiac anomalies. Split hand/split foot malformation is a central reduction defect of the hands and feet, and may occur either as an isolated malformation or as a part of syndrome. We describe a patient with Weyers-like ulnar ray/oligodactyly reduction limb defects and split hand malformation.
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Affiliation(s)
- T Tos
- Department of Medical Genetics, Dr. Sami Ulus Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
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Karaman A, Kahveci H. Klippel-Feil syndrome and Dandy-Walker malformation. Genet Couns 2011; 22:411-415. [PMID: 22303802] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The Klippel-Feil deformity is a complex of osseous and visceral anomalies, which include low hairline, platybasia, fused cervical vertebrae with a short neck, and deafness. Associated central nervous system abnormalities include occipital cephalocele, Chiari I malformation, syrinx, microcephaly, and hydrocephalus. Herein, we report a case with Klippel-Feil syndrome and Dandy-Walker malformation.
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Affiliation(s)
- A Karaman
- Erzurum Nenehatun Obstetrics and Gynecology Hospital, Department of Medical Genetics, Erzurum, Turkey.
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Karaman A, Kahveci H. Unusual acrofacial dysostosis with severe limb defects: a new syndrome. Genet Couns 2011; 22:249-253. [PMID: 22029165] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The acrofacial dysostoses are a heterogeneous group of disorders characterised by defects in craniofacial and limb development. The hallmarks include downward slanting palpebral fissures, malar hypoplasia, and retrognathia combined with variable limb malformations. We report the patient, a 5-day-old-boy with craniofacial dysmorphic features and upper and lower limb defects respectively.
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Affiliation(s)
- A Karaman
- Department of Medical Genetics, Erzurum Nenehatun Obstetrics and Gynecology Hospital, Erzurum, Turkey.
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Tos T, Karaman A, Aycan Z, Tükün A. A rare case of monosomy 18p: translocation between chromosomes 18 and 21. Genet Couns 2011; 22:227-231. [PMID: 21848017] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A rare case of monosomy 18p with molecular cytogenetic characterization of 18;21 whole arm translocation is presented. An 8-year-old gril with mental deficiency and growth deficiency was the child of a 45-year-old healthy mother and 50-year-old nonconsanguineous father with unremarkable prenatal history. She had a round face, flat nasal bridge, micrognathia and hypotonia. Cytogenetic studies revealed de novo 45,XX,del(18)t(18;21) karyotype, which was confirmed by fluorescence in situ hybridization (FISH).
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Affiliation(s)
- T Tos
- Department of Medical Genetics, Dr. Sami Ulus Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
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Abstract
Foreign body ingestion is a condition more common in the pediatric population than in adults. In adults, although foreign body ingestion can be well tolerated, approximately 10-20% of patients require endoscopic intervention. Delayed diagnosis and unremoved foreign bodies can cause serious and fatal complications including perforation, fistula and gastrointestinal bleeding. Here we report a patient with bleeding duodenal ulcer thought to be initiated by a large foreign body.
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Affiliation(s)
- A Karaman
- Department of Gastroenterology, Erciyes University Faculty of Medicine, Kayseri, Turkey
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Karaman A, Ramadan SU, Karaman I, Gökharman D, Erdoğan D, Kacar M, Cavuşoğlu YH, Koşar U. Diagnosis and follow-up in constipated children: should we use ultrasound? J Pediatr Surg 2010; 45:1849-55. [PMID: 20850631 DOI: 10.1016/j.jpedsurg.2010.05.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [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: 12/07/2009] [Revised: 04/19/2010] [Accepted: 05/04/2010] [Indexed: 11/29/2022]
Abstract
PURPOSE We investigated the efficacy of ultrasound in determining megarectum and fecal load and the response to treatment in constipation and tried to specify objective criteria in this study. METHODS A total of 66 cases were queried and divided into 2 groups as constipated (n = 35; mean age, 6.8 ± 2.9 years) and control (n = 31; mean age, 8.4 ± 3.8 years) according to Rome III criteria. After the clinical evaluation, pelvic ultrasonography (US) was performed by 2 separate radiologists. The bladder capacity and the transverse rectal diameter were measured with a full bladder. Then the rectal diameter and rectal anterior wall thickness were measured, and the presence of fecal load in the rectum and sigmoid colon was recorded with an empty bladder. The examination and ultrasound were repeated after treatment for a month in these patients. RESULTS Comparison of the US measurements of the 2 radiologists performing the US tests did not show any interobserver difference (r = 0.981; P < .001). We therefore believe our results are objective and reproducible. We found a positive correlation between the rectal diameters and the age, height, weight, and bladder capacity. The posturination mean rectal diameter was thicker in the constipated group (3.02 ± 1.04 cm) than in the control group (1.98 ± 0.64 cm) (P < .001). The cutoff point of rectal diameter for a diagnosis of constipation was determined as 2.44 cm (71% sensitive; 76% specific; area under curve, 0.825; P < .001). The rectal anterior wall thickness and fecal load were higher in the constipated patients (P < .001). There was a significant decrease in the constipation score and fecal load after treatment for a month (P < .001), but the rectal diameter had not reached normal limits yet despite the decrease (2.71 ± 0.77 cm) (P > .05). CONCLUSION The use of US helps in making a correct diagnosis and in the follow-up with objective criteria and also convinces the patient and the family that the treatment needs to be continued.
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Affiliation(s)
- Ayşe Karaman
- Department of Pediatric Surgery, Dr Sami Ulus Children's Hospital, 06080 Ankara, Turkey.
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