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Biomedical subjects

A Kazez

Publications and source records attributed to A Kazez.

18 recordsLinked to original sources

Does a fibrin-collagen patch support early anastomotic healing in the colon? An experimental study.

BACKGROUND: The aim of this study was to evaluate the effect of absorbable fibrin-collagen patch (FCP) during early colonic anastomotic healing in rats. METHODS: Prepubertal Wistar albino rats were randomly divided into 6 groups of 6 rats each. Colon was transected and then anastomosed with sutures (Group A), sutures+FCP (TachoComb; Nycomed, Austria) (Group AT) or only FCP (Group T). Rats were sacrificed either 3 or 7 days after the anastomosis. Anastomoses were evaluated for perianastomotic adhesion formation, bursting pressures and histological features. RESULTS: Perianastomotic adhesion formation was significant in Groups AT and T. Bursting pressures were in higher group AT than in Group A on postoperative day 3 and lower on day 7 (p < 0.05). Histological examinations revealed an increase in inflammatory cells in Group T on day 3 and decreased wound healing in Group AT when compared to Group A on day 7 (p < 0.05). CONCLUSIONS: In the early period of anastomotic healing, FCP supports anastomotic integrity. However, it also causes an inflammatory reaction which may increase the time necessary for healing process. Thus, the use of this biomaterial should be preferred in only selective clinical cases with a careful follow-up.

Anastomosis, Surgical↗

An unusual presentation of patent urachus: report of a case.

Congenital umbilical disorders are frequently seen in the pediatric population and are mostly classified as retained umbilical cord structures or failure of umbilical ring closure. Vitelline duct anomalies, urachal anomalies and umbilical herniations comprise the main group of these congenital problems. Here we report a new presentation of vesicoumbilical patency in a 20-day-old male baby. A brief review of the literature concerning the classification of patent urachus to explain the possible mechanism of the anomaly is given.

Hernia, Umbilical↗

Sacrococcygeal heart: a very rare differentiation in teratoma.

A mature teratoma was identified in a two-month-old girl who was operated for a sacrococcygeal mass. The cystic components of the mass were accidentally opened during surgery, and a solid, rudimentary organ resembling a heart emerged. It had a vascular pedicle and a pulsation like cardiac activity different from the infant's heart rate. The mass was totally excised together with the coccyx, and in histological examinations, it was diagnosed as a mature teratoma and a rudimentary heart. To the best of our knowledge, the case presented in this report is only the second case of a cardiac development in a teratoma in the literature. In the light of data obtained about this case and related literature, we consider that fetus-in-fetu and teratoma may not be irrelevant entities, and that they possibly have the same developmental malformation. We also suggest that such an intermediate case is a combination of fetus-in-fetu and teratoma.

Bone Neoplasms↗

Detection of bacterial translocation during intestinal distension in rats using the polymerase chain reaction.

To investigate whether distension causes bacterial translocation (BT), a rat model reported earlier by us was used and to detect the presence of bacterial DNA in blood by polymerase chain reaction (PCR) assay, the most sensitive detection method to date. In 4 groups of 4-week-old Wistar-albino rats a total of 15 animals each were included. In the 1st group (distension+gavage), 1010 Escherichia coli colonies were given via gavage and distension was carried out by rectal air inoculation. In the 2nd group (gavage), animals were inoculated with E. coli and no distension was induced. The 3rd group (distension) were only distended and no bacteria were inoculated. The control group were neither distended nor inoculated with E. coli. Blood samples were collected 3 h after manipulations and both blood cultures and PCR assays were performed. According to the PCR results BT was evident in 80% of group 1, 20% of group 2, and 33% of group 3 animals. BT was not determined in the control group. Significantly low percentages of positivity were observed in blood cultures in all groups (P < 0.05). These results confirm reports that BT occurs in the presence of distension and that PCR is a superior way of determining BT. Thus, it would be advisable to utilize PCR technology in cases where the possibility of distension exists, as early intervention might be useful before any severe clinical pathology (sepsis, multiple-organ-system failure) becomes evident.

Animals↗

The role of melatonin in prevention of intestinal ischemia-reperfusion injury in rats.

BACKGROUND/PURPOSE: The aim of this study was to determine the effect of melatonin, a hormone that is known as an antioxidant, on the prevention of tissue damage during mesenteric ischemia/reperfusion (I/R). METHODS: A total of 40 young Wistar-albino rats were divided equally into 4 groups with varied treatment. Group 1 was control (sham), group 2 was I/R, group 3 was I/R plus melatonin (10 mg/kg) and group 4 was I/R plus melatonin (20 mg/kg). I/R was realized as follows: after laparatomy, a microvascular atraumatic clip was placed across the superior mesenteric artery (SMA) under general anaesthesia, and it was removed after ischemia for 30 minutes. The first dose of melatonin was applied intraperitoneally at the start of reperfusion. The second and third doses were applied intramuscularly on the first and second day. Only SMA dissection under general anaesthesia was carried out in the control group rats. On the third day of the study all the rats were killed, and their bowels were removed. Malondialdehyde (MDA) levels were assayed as an index of lipid peroxidation reflecting free radical reaction in the intestine. Histopathologic analysis was made using light microscopy in a blind fashion. RESULTS: The levels of tissue MDA were found to be significantly lower in groups 3 and 4 compared with group 2 (P < .05). The MDA levels of group 4 did not differ significantly from that of the control group (P > .05). The histopathologic results were consistent with the MDA levels. CONCLUSION: These results suggest that melatonin has a strong antioxidant effect in preventing intestinal I/R damage, and that this effect is exerted in a dose-dependent manner.

Animals↗

Protective effect of melatonin on antioxidative system in experimental ischemia-reperfusion of rat small intestine.

AIMS: Effect of exogenously administered melatonin (N-acetyl 5-methoxytryptamine) on antioxidant systems in experimental Ischemia-Reperfusion (I-R) of rat gastrointestinal system (GIS) was examined. METHODS: A total of 40 rats were divided into 4 groups: Group 1 (Sham), Group 2 (I-R), Group 3 (I-R + 10 mg/kg melatonin) and Group 4 (I-R + 20 mg/kg melatonin). Activity levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were determined in small intestines. RESULTS: There was a significant (p<0.05) reduction in GSH-Px levels in Group 2 (64.16+/-7.02 U/mg protein) compared to Group 1 (80.15+/-9.32 U/mg protein). We observed a meaningful increase in GSH-Px levels in melatonin applied groups (Group 3: 75.94+/-9.83 U/mg protein, Group 4: 78.55+/-9.11 U/mg protein) compared to Group 2. Correspondingly, SOD activity levels were significantly reduced (p<0.001) in Group 2 (24.14+/-4.35 U/mg protein) compared to controls (52.91+/-6.13 U/mg protein). A stronger effect (p<0.001) of melatonin was observed on SOD levels compared to GSH-Px levels in both doses (Group 3: 38.96+/-6.39 U/mg protein, Group 4: 43.07+/-7.76 U/mg protein). Levels of selenium were reduced significantly in Group 2 (1.11+/-0.31 microg/g tissue) compared to Group 1 (2.01+/-0.19 microg/g tissue). Melatonin application in Group 3 (1.13+/-0.28 microg/g tissue) and Group 4 (1.89+/-0.48 microg/g tissue) caused an increase in selenium levels. There was a strong correlation between increases in selenium and GSH-Px levels in Group 4 (r:0.651 p<0.01). CONCLUSIONS: Melatonin seems to exert its antioxidant effect in GIS tract by stimulating SOD and GSH-Px. Selenium also seems to have an antioxidant contribution on protecting rat gastrointestinal tract I-R injury.

Animals↗

Migration of the abdominal catheter of a ventriculoperitoneal shunt into the scrotum--case report.

A 3-day-old male neonate presented with migration of the ventriculoperitoneal (VP) shunt tip through the patent processus vaginalis resulting in scrotal hydrocele. The association of myelomeningocele with hydrocephalus may have been a predisposing factor in this rare complication. Development of scrotal swelling or hydrocele in a child with VP shunt should be recognized as a possible shunt complication.

Catheters, Indwelling↗

A model of hypoxia-induced necrotizing enterocolitis: the role of distension.

BACKGROUND/PURPOSE: This study was performed to investigate additional effects of intestinal distension in the damage to the gut caused by hypoxia-reperfusion. METHODS: Five groups each consisting of ten 1-day-old Wistar albino rat pups were studied; Group 1, hypoxia-reoxygenation; Group 2, hypoxia-reoxygenation and distension; Group 3, distension and hypoxia-reoxygenation; Group 4, distension; and Group 5, control. Hypoxia was induced by placing the rat pups in a 100% carbon dioxide chamber for 5 minutes. After the hypoxia, the pups were exposed to 100% oxygen for reoxygenation for 5 minutes. The intestinal distension was carried out with a fine 21-gauge SILASTIC cannula via rectal route. The rats were killed on the third day, and all the intestine were harvested from duodenum to sigmoid colon. Malondialdehyde (MDA) levels were determined as an index of lipid peroxidation related to free radical reaction in the intestine. The histopathologic investigation was carried out by light microscopy in a blinded fashion. RESULTS: The MDA levels of Group 3 animals were significantly higher than those in Group 1, 4, and the control group (P < .05). The MDA level of Group 2 did not differ significantly from that of the Group 3 (P > .05). All MDA levels of the study groups also were significantly higher than the control group (P < .05). CONCLUSION: The results demonstrated that intestinal distension increased the damaging effects of hypoxia-reoxygenation in the gut.

3,4-Methylenedioxyamphetamine↗

Mesenteric, omental, and retroperitoneal cysts in children.

OBJECTIVE: To report our experience in the management of mesenteric, omental, and retroperitoneal cysts. DESIGN: Retrospective study. SETTING: University department of paediatric surgery, Turkey. SUBJECTS: 10 children with mesenteric, omental, and retroperitoneal cysts. INTERVENTIONS: Laparotomy in all cases. MAIN OUTCOME MEASURES: Mode of presentation, imaging techniques, surgical intervention, histological examination, morbidity, and recurrence. RESULTS: The main presenting symptoms were abdominal distension and pain. A palpable abdominal mass was detected in 4 patients. Preoperative ultrasonography was done in 8 patients and showed a cystic mass in 7. All patients underwent laparotomy-6 as emergencies because of acute abdominal findings. The cysts were located in the small bowel mesentery in 6, in the retroperitoneum in 2, and in the omentum and the mesosigmoid in another 2. Operations included complete excision of the cyst in 5 and complete excision with intestinal resection in the other 5. There was only one recurrence of a retroperitoneal cyst that needed a second operation. CONCLUSION: Early recognition and appropriate treatment of these cysts are associated with a good prognosis, but long term follow-up is advisable because of the possibility of recurrence.

Child↗

Congenital alacrima in a patient with G (Opitz Frias) syndrome.

Congenital alacrima is an autosomal dominant disorder showing markedly deficient lacrimation and punctate corneal epithelial erosions. The G (Opitz-Frias) syndrome is also an autosomal dominant disorder characterised by hypertelorism, hypospadias, stridor, and dysphagia. Here we report a 5-year-old boy with the G syndrome presenting congenital alacrima.

Abnormalities, Multiple↗

The effect of vitamin E on ipsilateral and contralateral testis following unilateral testicular torsion in rats.

An experimental study was conducted to investigate the role of lipid peroxidation in ipsilateral and contralateral testicular reperfusion injury following unilateral testicular torsion (TT) and the effect of vitamin E in the management of this injury. Fifty adult male Sprague-Dawley rats were divided into five equal groups. Bilateral orchiectomy was performed immediately in group 1, and 3 h after unilateral TT in group 2. In group 3, both testes were harvested 3 h after a sham operation. In groups 4 and 5, unilateral TT, detorsion after 3 h and bilateral orchiectomy after 6 h were performed. Vitamin E was given before detorsion in group 4 and after detorsion in group 5. The levels of malondialdehyde (MDA) were measured as an index of lipid peroxidation in all testes. There were no significant differences between right and left testes within groups or between right or left testicular MDA values in different groups. The results suggest that lipid peroxidation does not play an important role in ipsilateral and contralateral testicular injury following unilateral TT and that vitamin E given before or after detorsion of testes is not useful in preventing testicular reperfusion injury.

Animals↗

Genitourinary tract injuries in girls.

OBJECTIVE: To evaluate lower genitourinary tract injuries in girls and to propose guidelines for the investigation and initial management of this unusual injury. PATIENTS AND METHODS: The hospital records of 38 girls (aged 2-13 years) treated in our institution because of lower genitourinary (LG) tract injury between 1988 and 1995 were reviewed retrospectively. Urethral ruptures were detected in six patients, but the most frequent injuries were to the vulva (63%) and vagina (53%). There were pelvic fractures in eight patients and femoral fractures in a further five. Eight patients had concomitant anorectal lacerations. Vaginal and perineal lacerations were repaired primarily and a temporary urethral catheter was placed for a mean of 3 days. Partial urethral disruptions were repaired primarily over a stenting catheter in three patients. In one case, vaginal laceration and proximal complete rupture of the urethra was managed through a transvaginal approach with end-to-end urethral anastomosis over a stenting catheter. There was a complete rupture of the distal urethra and avulsion of the external meatus in two cases and these patients were managed by urethral advancement and meatoplasty. RESULTS: Perineal physical signs did not reflect the severity of the lesions and cystovaginoscopy allowed localization of lacerations in some cases. Primary repair was possible in all cases. Three patients (8%) had wound infection after surgery. One patient had temporary urinary incontinence which was managed conservatively and one patient had faecal incontinence which needed secondary surgery. CONCLUSION: All female paediatric patients with suspected LG tract injury should undergo examination under anaesthesia to determine the degree of injury or possible concomitant injury to the urethra, bladder or rectum. Primary repair of these injuries is recommended.

Accidental Falls↗

Hypoxia-induced necrotizing enterocolitis in the immature rat: the role of lipid peroxidation and management by vitamin E.

The authors developed an experimental model of necrotizing enterocolitis (NEC) by hypoxia-reoxygenation, and determined the content of malondialdehyde levels as an index of lipid peroxidation, related with a free-radical reaction in the gastrointestinal tract of newborn rats. They also investigated the role of vitamin E, an antioxidant, in this free-radical injury. The study was performed on 1-day-old rats. The 30 rat pups were divided into three groups. Hypoxia was induced by placing the pups in a 100% carbon dioxide chamber for 5 minutes. The pups were reoxygenated with 100% oxygen for 5 minutes. Group 1 (n = 10) was subjected to hypoxia-reoxygenation and killed 3 days after hypoxia. Group 2 (n = 10) was subjected to hypoxia-reoxygenation and treated with vitamin E (30 IU/kg/d intraperitoneally) for the next 3 days, and killed. Group 3 (n = 10) rats served as controls. The histopathology of the intestinal lesions in group 1 animals was characteristic of ischemic injury and ranged from superficial epithelial damage with villous shortening to transmural necrosis. In the vitamin E-treated animals these lesions were milder. The malondialdehyde levels of group 1 were significantly higher than those of the other two groups (P < .001). This study shows that oxidant-mediated lipid peroxidation injury plays a central role in mediating hypoxia-induced intestinal necrosis and suggests that vitamin E may play a therapeutic role in NEC.

Animals↗

Swenson's operation for neonatal Hirschsprung's disease.

OBJECTIVE: To describe our experience with Swenson's operation for Hirschsprung's disease done during the neonatal period. DESIGN: Retrospective study. SETTING: University department of paediatric surgery. SUBJECTS: 10 Neonates with Hirschsprung's disease. INTERVENTIONS: Rectosigmoidectomy and pull through (Swenson's operation), with covering transverse colostomy. MAIN OUTCOME MEASURES: Mortality, morbidity, and continence. RESULTS: The median age at definitive operation was 25 days (range 15-35). There was one late death three weeks after discharge from hospital of respiratory and cardiac failure. Two patients presented with caecal perforation and two with intestinal obstruction; in all four Hirschsprung's disease was diagnosed on frozen section, a transverse colostomy was done, and the Swenson's operation was done electively. The other six were diagnosed by barium enema examination and biopsy, and underwent total bowel irrigation followed by Swenson's operation and transverse colostomy. The colostomies were closed three to four weeks later. There were no postoperative complications. All nine surviving patients were continent (3-4 stools/day), at a mean (SD) follow up of 21 (5) months. CONCLUSION: With the current high standards of anaesthesia and neonatal intensive care, and an experienced surgeon, Swenson's operation for neonatal Hirschsprung's disease is safe and the procedure of choice for this condition.

Anal Canal↗

Preoperative sonographic diagnosis of sliding appendiceal inguinal hernia.

Rarely, the appendix forms the sliding component of an inguinal hernia. We report the case of a 2-month-old boy who was preoperatively diagnosed with sliding appendiceal inguinal hernia by sonographic examination. To our knowledge, this is the first report in the literature of the preoperative sonographic diagnosis of a sliding appendiceal inguinal hernia.

Appendix↗

Ectopic adrenal tissue in the inguinal region in children.

Adrenal rests are common in children and are most often found as bright yellow, retroperitoneal nodules from the diaphragm to the pelvis. They are usually incidental findings during surgery. In a 12-month period, 268 children, 18 days to 15 years (mean 3.2 years) of age, underwent 304 operations for common inguinoscrotal disorders at the Department of Pediatric Surgery, Erciyes University Medical School. There were 252 males and 16 females, (M/F 15.7:1). Ectopic adrenal tissue was found in nine males (3%). This report concerns the incidence and structure of aberrant adrenal tissue found in children during inguinoscrotal operations, including its embryology, histology, and clinical implications.

Adolescent↗

Prune-belly syndrome associated with extra-abdominal abnormalities in a 7-year-old boy.

Prune-belly syndrome (PBS) is an association of abdominal wall deficiency, genitourinary anomalies, and in males, cryptorchidism. Other congenital anomalies are associated with PBS, particularly musculoskeletal deformities and gastrointestinal tract anomalies. In this report, a seven-year-old boy with PBS had mega cisterna magna variant, microcornea, aortic stenosis with bicuspid aortic valves, cholelithiasis, and Hirschsprung's disease. Coexistence of these abnormalities with PBS supports the concept of PBS being caused by an early disturbance of not only mesodermal development but also of the other germ layers. There was maternal ingestion of drugs in the 1st month of gestation. All cases with PBS should be evaluated thoroughly for extra-abdominal abnormalities resulting from disturbances of ectodermal and endodermal development. Even though disturbances related to ectodermal and endodermal development may be asymptomatic, early diagnosis of the disturbances may help in preventing possible future problems.

Abnormalities, Drug-Induced↗

Virginal hypertrophy. Case report.

A 13-year-old girl with virginal hypertrophy (bilateral extensive juvenile hypertrophy) of the breasts is presented. Her breasts began to grow rapidly after puberty and reached an enormous size within a year. On examination, both breasts were greatly enlarged. Routine blood chemistry and the endocrinological investigations were normal. The computerized tomography scan of the sella was unremarkable. A bilateral reduction mammaplasty was performed, and histological analysis of the breast tissue revealed the diagnosis of virginal hypertrophy. After four months her breasts began to grow again, and a second mammaplasty was performed. After this operation, tamoxifen citrate was given to prevent recurrence for four months, and during the follow-up period of 20 months, no recurrence was noted.

Adolescent↗