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Biomedical subjects

A O Ciftci

Publications and source records attributed to A O Ciftci.

At least 55 records · Page 3Linked to original sources
PubMed1998

Inflammatory pseudotumor causing intestinal obstruction: diagnostic and therapeutic aspects.

The authors report an unusual presentation of inflammatory pseudotumor (IPT) that caused intestinal obstruction in a 9-year-old boy, and discuss the clinicopathologic features of this rare entity with emphasis on diagnosis and treatment. There are no specific presumptive clinical and laboratory findings, including tumor markers and imaging techniques, that distinguish mesenteric IPT from other abdominal mass lesions. The most important diagnostic aid is to bear this entity in mind when a child presents with intestinal obstruction associated with an abdominal mass. Radical unnecessary surgical procedures or potentially harmful therapy should be avoided, and appropriate treatment is achieved by total excision of the lesion in most of the cases.

Abdominal Neoplasms↗
PubMed1998

Female breast masses during childhood: a 25-year review.

Thirty females were treated at our unit with the diagnosis of breast mass between 1970 and 1995. Twenty-seven girls had surgical intervention; for fibroadenoma (n = 14), cystosarcoma phylloides (n = 5), fibrocystic disease (n = 4), intraductal papilloma (n = 2), metastatic carcinoma (n = 1) and fat necrosis (n = 1), while three patients with fibroadenoma were managed nonoperatively. Surgical complications included a nipple slough and hematoma requiring surgical drainage in two patients after the excision of giant fibroadenomas. Our experience revealed that most of the breast masses can be handled operatively through a circumareolar incision without any major complications. Protection of the developing breast bud, nipple and areola is as important as the appropriate excision of the lesion. A detailed physical examination accompanied with ultrasound scan is sufficient for the correct diagnosis in most cases. Female adolescents presenting with fibroadenoma, fibrocystic disease and cystosarcoma phylloides should undergo surgery after a reasonable observation period of 3-4 menstrual cycles. Excision of discrete, undiagnosed breast masses is warranted. This is indicated first to define the pathology and rule out the rare malignancy, second to obviate enlargement and asymmetry, and third to allay the apprehension of the child and family.

Adolescent↗
PubMed1997

Granulocytic sarcoma of the scapula: an unusual presentation of acute myeloblastic leukemia.

The unusual presentation of acute myeloblastic leukemia as a scapular granulocytic sarcoma in an infant without systemic manifestations is reported for the first time. Granulocytic sarcoma as a presentation of leukemia should be considered in the differential diagnosis of scapular masses during childhood. Surgery is limited to obtain sufficient tissue for histopathologic diagnosis.

Biopsy↗
PubMed1997

Bilateral multiple adrenal pseudocysts associated with incomplete Beckwith-Wiedemann Syndrome.

A newborn with an incomplete form of Beckwith-Wiedemann Syndrome associated with bilateral multiple adrenal pseudocysts is presented for the first time. A high index of suspicion and detailed diagnostic studies are required in the differential diagnosis of benign and malignant cystic lesions of the adrenal gland in the newborn. Exploratory laparotomy is warranted in selected cases.

Adrenal Gland Diseases↗
PubMed1997

Acute blunt traumatic abdominal hernia.

A rare childhood case of acute blunt traumatic abdominal hernia in which the colon and jejunal loops herniated into a large subcutaneous pocket in front of the sternum is presented. Considerations in diagnosis and management are discussed. Emergency laparotomy is indicated after confirmation of the diagnosis by radiologic modalities. Thorough abdominal exploration is warranted to rule out associated injuries. Reduction of the herniated bowel into the abdomen, debridment of the nonviable tissue, and primary tension-free closure of the defect is the appropriate treatment.

Accidents, Traffic↗
PubMed1997

Epigastric cleft: a previously unreported entity.

A newborn who is believed to have an anterior midline abdominal wall fusion defect located in the epigastric region is presented, with a proposal of new nomenclature as "epigastric cleft."

Abdominal Muscles↗
PubMed1997

Histological evidence of decreased contralateral testicular blood flow during ipsilateral testicular torsion.

OBJECTIVE: To evaluate contralateral testicular blood flow by histological examination of arterioles during ipsilateral testicular torsion. MATERIALS AND METHODS: The study comprised two groups of 20 male albino rats (weight 250-270 g). The control group underwent a sham operation, while in the second group the left testes were twisted clockwise by 720 degrees. All rats underwent bilateral orchidectomy 24 h after the initial intervention. Three slides for each testis (n = 240) were evaluated randomly while unaware of treatment to determine the total number of arterioles, the percentage of collapsed and open arterioles, the diameter of open arterioles and the presence or absence of blood cells in the lumen. Differences were assessed using t-tests for paired and independent samples. RESULTS: Very few arterioles were collapsed in both testes of the control group and in the ipsilateral testes of the torsion group, but half the arterioles in the contralateral testes of the torsion group were collapsed. The difference between the contralateral testes of the two groups and between the ipsilateral and contralateral testes in the torsion group were significant. The diameter of uncollapsed arterioles did not differ significantly among either testes of the control and torsion groups and either testes in each group. Both testes in the torsion group had significantly more arterioles containing blood cells than those in the control group. The difference between the testes in the torsion group was also significant, but was not in the control group. CONCLUSION: There was histological evidence of decreased blood flow in the contralateral testis during unilateral testicular torsion; contralateral testicular damage during unilateral testicular torsion may result from hypoxia caused by decreased blood flow.

Animals↗
PubMed1997

Neuronal intestinal and fibromuscular arterial dysplasias associated with intraluminal mucosal web.

A two-year-old boy presenting with the signs and symptoms of partial intestinal obstruction caused by a mucosal web in the ileum is presented. Histopathological evaluation following resection and primary anastomosis revealed neuronal intestinal dysplasia associated with fibromuscular arterial dysplasia limited to the segment proximal to the web and normal findings in the distal part. These findings and a brief review of the literature support the hypothesis that neuronal and fibromuscular dysplasias may develop on the basis of congenital obstructive lesions of the bowel.

Arteries↗
PubMed1997

Comparative trial of four antibiotic combinations for perforated appendicitis in children.

OBJECTIVE: To compare the therapeutic efficacy of four antibiotic regimens: penicillin, tobramycin, and clindamycin; penicillin, tobramycin, and ornidazole; piperacillin alone; and ceftriaxone and ornidazole in the treatment of children operated on for perforated appendicitis. DESIGN: Prospective randomised study. SETTING: Teaching hospital, Turkey. SUBJECTS: 200 patients aged between 1 and 16 years treated from December 1991 to December 1995 who were randomly assigned to one of four groups each consisting of 50 patients. INTERVENTIONS: Preoperative antibiotics given intravenously, peritoneal drainage by Penrose drains without irrigation, appendicectomy with the inversion of the stump by a purse string, taking peritoneal swabs, and primary skin closure. MAIN OUTCOME MEASURES: Comparability of the groups, duration of fever, leucocytosis, antibiotic treatment, stay in hospital, nasogastric intubation, and drainage, as well as results of cultures and complications. RESULTS: There were no significant differences between the groups for any variable studied. The predominant bacterial species were Escherichia coli, Klebsiella spp, Pseudomonas spp, Fusobacteria, and Peptostreptococci which were appropriately covered by all the antibiotic regimens. Fourteen patients had complications including wound infections (n = 10), prolonged ileus (n = 2) and intra-abdominal abscess (n = 2) all of which were treated conservatively. There was no mortality and no major complications. All regimens had the same clinical and bacteriological efficacy. CONCLUSION: There is no gold standard for antimicrobial chemotherapy in perforated appendicitis. Different antibiotic combinations or a single broad spectrum antibiotic, which include both aerobic and anaerobic coverage, can safely be used in children with perforated appendicitis.

Adolescent↗
PubMed1996

Megacystis microcolon intestinal hypoperistalsis syndrome: evidence of a primary myocellular defect of contractile fiber synthesis.

Two infant boys with megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS) are reported. Presenting with neonatal intestinal obstruction, they underwent laparotomies that showed megacystis, microcolon, and aperistaltic shortened small bowel without any mechanical obstruction. Patient 1 gradually improved and is developing normally at home, on a normal diet without genitourinary or gastrointestinal complaints (now 11 years old). Patient 2, who underwent vesicoamniotic drainage antenatally, never developed adequate gastrointestinal or genitourinary function in spite of appropriate diversion and pharmacologic support. He showed progressive deterioration and died at the age of 7 months. Detailed histo-immuno- and ultrastructural pathology assessment, although confirming results in the existing literature in some aspects, showed previously unreported neuronal dysplastic changes associated with increased laminin and fibronectin. Although patient 1 showed ultrastructural features of vacuolar degeneration of smooth muscle as reported in the literature, patient 2 showed ultrastructural and histochemical evidence of excessive smooth muscle cell glycogen storage with severely reduced contractile fibres displaced to the extreme periphery of the cells, suggesting a fundamental defect of glycogen-energy utilization. A deficiency of fiber synthesis as the alternative primary defect is discussed. In both cases, a two-step genetic defect may explain the variability in clinical outcome and pathological findings.

Abnormalities, Multiple↗
PubMed1996

In utero defecation by the normal fetus: a radionuclide study in the rabbit.

An experimental study was performed to investigate the excretion function of the liver, gastrointestinal motility, and in utero defecation by radionuclide techniques in 24 New Zealand white rabbit fetuses at 25 days' gestation (fullterm, 31 to 32 days). 0.1 mL of technetium 99m (99mTc)-HIDA (a derivative of iminodiacetic acid) containing 1 mCi of radioactivity was injected into the gluteus muscle of each fetus which had been exposed through the uterus. After replacing the fetus and uterus into the abdomen, and beginning 1 hour after injection, a live fetus was killed each hour for 24 hours Tissue samples from the lung heart, stomach, kidney, bladder, liver, meconium in the proximal, mid and distal bowel, and amniotic fluid were taken. The radioactivity of each sample was determined by a gamma counter and the percentage uptake per gram of tissue was calculated. The very low radioactivity levels detected in the stomach, kidneys, and bladder indicated the in vivo stability of 99mTc-HIDA 99mTc-HIDA is predominantly trapped by the liver via systemic circulation and is excreted into the gastrointestinal tract through which it passes into the amniotic fluid. Demonstrated passage of excreted 99mTc-HIDA through the fetal liver and into the gastrointestinal tract and amniotic fluid strongly suggests that fetal defecation is a physiological event.

Amniotic Fluid↗
PubMed1996

Gastric lymphoma causing gastric outlet obstruction.

An unusual presentation of abdominal lymphoma causing gastric outlet obstruction is reported. Gastric lymphoma should be considered in the differential diagnosis of gastric outlet obstruction during childhood. The possibility of gastric malignancy should not be excluded only on the basis of the patient's age. Complete resection of the tumor, with postoperative radiation and/or chemotherapy is the best method of treatment for high-grade lymphomas.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

Diaphragmatic rupture after plication: etiopathogenesis with review of the literature.

We present an infant who developed diaphragmatic rupture and secondary hernia following a successful diaphragmatic plication performed for congenital diaphragmatic eventration. The rupture occurred through the normal looking diaphragmatic tissue with an intact plication suture line, which has not been reported before. The possible etiologic factors of this secondary hernia are discussed with a brief review of the literature.

Diaphragmatic Eventration↗
PubMed1996

Appendicitis after blunt abdominal trauma: cause or coincidence?

The association of appendicitis and blunt abdominal trauma (BAT) is an exceptionally rare occurrence with a few case reports in the literature. The main question whether this association is a result of causative or coincidental relationship has not been evaluated among children. A retrospective clinical study was performed to clarify the pathogenesis, incidence, clinical characteristics and outcome of appendicitis diagnosed in children during the hospitalization period following blunt abdominal trauma (BAT). The records of 554 patients with BAT who were admitted to our unit between 1979 and 1993 inclusive were reviewed. Five patients (0.90%), 3 males and 2 females, with a mean age of 9.4 +/- 1.4 were found to have appendicitis. None of these patients had any signs or symptoms related to appendicitis prior to BAT. Bruising and rupture of the mesoappendix were noted in 3 patients while edema and hematoma of appendix and terminal ileum were found in two. Full recovery was achieved in all patients following appendicectomy. Our incidence of 0.90% is statistically significantly higher than the highest incidence rate of appendicitis stated in the literature during childhood (t-test for population proportion, t = 2.892; p < 0.05). We emphasise the possibility of a causative relationship between appendicitis and BAT depending on the clinical characteristics, operative findings, statistically significant high incidence rate and literature review.

Abdominal Injuries↗
PubMed1995

Adhesive small bowel obstruction caused by familial Mediterranean fever: the incidence and outcome.

Familial Mediterranean fever (FMF) is a disease characterized by recurring and self-limiting attacks of febrile serosal inflammation involving the peritoneal, synovial, and pleural membranes. Peritonitis is the most common clinical picture of FMF, and repeated acute abdominal episodes may result in formation of peritoneal adhesions that may cause adhesive small bowel obstruction (ASBO) requiring surgical intervention. This subject has neither been clarified nor thoroughly evaluated in the literature. The records of 355 pediatric patients diagnosed to have FMF were reviewed in order to clarify the incidence and outcome of ASBO without prior laparotomy during the course of FMF. The incidence rate has been found as 3% with no mortality. This figure shows ASBO to be the most frequent complication of FMF. Therefore this life-threatening surgical emergency should be kept in mind in the differential diagnosis of acute abdominal attacks during the course of FMF.

Child↗
PubMed1995

Malacoplakia involving the surgical wound in a 4 year old.

Malacoplakia is a specific chronic inflammatory disease. In the English-language literature, there are a few reports of gastrointestinal malacoplakia occurring in childhood. The authors present the first case of gastrointestinal malacoplakia involving a surgical wound and preventing healing, with persistent drainage; the patient was a 4-year-old boy. The clinicopathologic features of this rare entity are discussed, with emphasis on diagnosis and treatment.

Child, Preschool↗