Biomedical subjects

E Eroğlu

Publications and source records attributed to E Eroğlu.

14 recordsLinked to original sources

PubMed2005

Cervical spinal cord stimulation increases cerebral cortical blood flow in an experimental cerebral vasospasm model.

BACKGROUND: Cerebral microcirculatory changes during cerebral vasospasm after aneurysmal subarachnoid haemorrhage (SAH) are still controversial and uncertain. The aim of our study is to demonstrate that spinal cord stimulation (SCS) augments cerebral cortical microcirculatory blood flow in an experimental cerebral vasospasm model by using Laser Doppler Flowmetry (LDF). METHOD: The experiments were carried out on 24 New Zealand rabbits. Three experimental groups were designed. In group 1, Cerebral cortical blood flow (CCoBF) was evaluated by LDF in 8 rabbits. In group 2, Intracisternal saline injection and cervical epidural electrode placement without SCS were performed in 8 animals before LDF. In group 3, LDF was performed before and after SCS on the 4th day of SAH in 8 rabbits. CCoBF parameters obtained from LDF data were compared. FINDINGS: The occurrence of vasospasm after SAH was demonstrated with significant changes in LDF values. In all SAH animals, SCS resulted in significant increase (approximately 30%) in CCoBF. This increase was observed to continue even after the cessation of the stimulation. CONCLUSIONS: These results indicate that SCS improves cortical ischemia due to vasospasm after induced SAH. The cervical SCS may constitute a new therapeutic modality in treating disturbed CCoBF due to vasospasm.

Animals↗

PubMed2005

The anticarcinogenic effect of propolis in human lymphocytes culture.

The in vitro anticarcinogenic potential of propolis in human lymphocytes was investigated. Blood samples were obtained from ten healthy males, non-smoking volunteers, which were incubated and exposed to increasing concentrations of propolis (0.01, 0.05, 0.1, 0.2, 0.5, 0.7 and 1.0 ml). The mean micronucleus rates were 1.47 +/- 0.38 - 4.02 +/- 0.64. Mitotic index rates were between 19.45 +/- 2.22 and 0.28 +/- 0.33. The differences between the control and exposed cells were statistically significant (p < or = 0.05). We conclude that exposure to different concentrations of propolis cannot produce a carcinogenic effect in peripheral human lymphocytes in vitro. However, increasing micronucleus (MN) rates showed that propolis could have a carcinogenic effect in high concentrations. Also chemical analysis of propolis sample was evaluated by GC/MS. Propolis sample mainly contains flavonoids, fatty and aromatic acids and their esters.

Adult↗

PubMed2004

Feminizing surgical management of intersex patients.

The study's objective was to evaluate the results of surgical modalities for children with ambiguous genitalia. The records of 55 patients who were reared as females between 1985 and 2001 were reviewed regarding diagnosis, age at surgery, operative procedures, and outcome. The mean age at surgery was 3.5 years, and the follow-up period averaged 4.1 years with a range of 2 months-17 years. The types of reconstructive surgical techniques were clitorovaginoplasty in 29, staging clitoral surgery and vaginoplasty in seven, clitoroplasty in five, total urogenital mobilization (TUM) in three, vaginal bowel substitution in two, clitoridectomy in one, and gonadectomy in six, and two are waiting for vaginal substitution surgery after gonadectomy. The main complications were vaginal stenosis in four patients. All of the TUM patients had good appearances of their urethral orifice and vagina, all of them were continent, and none of them had urinary tract infections. With our limited experience with the TUM procedure, we feel that it is possible to obtain a better cosmetic and functional result with an easier technique. Among the 10 patients of postpubertal age, none of them had had sexual experience. Eight of the postpubertal patients asked questions about their reproductive status. Patients with an intersex disorder should be informed about their problems, especially about their reproductivity.

Age Factors↗

PubMed2004

Changes in the threshold voltage and alterations of smooth-muscle physiology after bladder outlet obstruction.

The purpose of this study was to determine the resultant changes in the bladder function after partial bladder outlet obstruction (BOO), with particular emphasis on the threshold voltage and on the role of NO. A total of 12 adult rabbits were used in the study. New Zealand-type rabbits were subjected to no intervention and 3 weeks duration of a partial outlet obstruction. They underwent an in vivo cystometric evaluation before and after the BOO, histological studies, bladder-strip stimulation studies using acetylcholine, electrical field stimulation, and relaxation studies using NO donor nitroprusside. Statistical significance was determined by two-way ANOVA for multiple variations and Student's t-test. Histology sections demonstrated smooth-muscle hypertrophy, hyperemia of the vessels in the wall and widely set mononuclear cell infiltration in the rabbits with partial BOO. Cystometry showed markedly decreased bladder capacities, and decrease of compliance from 4.3 +/- 1.8 to 1.6 +/- 0.3 in the obstructed group. Tissue bath studies demonstrated no meaningful change with cholinergic stimulation, increased contractility in response to electrical field stimulation, and increased threshold voltage values from 57.5 to 93.3 compared to controls. Nitroprusside did not induce relaxation of the neostigmine and acetylcholine-precontracted bladder in all animals. Hypertrophy was observed due to adaptation of the detrusor against the obstruction. During this adaptation period, bladder capacity decreases and the elasticity disappears, thus causing higher pressures with lesser volumes. In other words, compliance decreases. The neurogenic damage can be shown with increasing values of threshold voltage, and higher voltages are needed to start a contraction. Nitroprusside has no inhibitory effect on smooth-muscle tone in the rabbit bladder.

Acetylcholine↗

PubMed2004

Evolving experience in the management of pleural empyema.

The objective of this study was to determine treatment strategies for children admitted with pleural empyema. We reviewed the medical records of 93 consecutive patients with pleural empyema who presented in the last three years. Mean age was 3.8 years (range 3.5 months to 14 years) and the male to female ratio was 52 : 41. The left side was involved in 51 (54.8 %) cases and there was only one case with bilateral effusion. After the chest X-ray and analysis of pus obtained by thoracocentesis, the initial treatment modality was chest tube drainage in 81 (87 %) patients. Children required chest tube drainage for an average of 11.9 +/- 4.8 days. Out of the 81 children, 6 needed thoracotomy due to organized pleural fluid and another 4, who developed loculated pleural effusions, were treated with intrapleural urokinase (UK) administration. Twelve children, who had a delayed presentation with organized loculated pleural fluid and pleural thickening, underwent decortication and one, who was found to have a foreign body, found during surgery, needed an upper lobe resection. Medical management with adequate chest tube drainage and appropriate antibiotics has resulted in full resolution in the majority of patients with empyema. In cases of loculated pleural effusions identified at the early stages of the chest tube drainage, intrapleural UK administration was found to be a safe and efficient treatment modality. Thoracotomy should be reserved for late and organized empyema cases.

Adolescent↗

PubMed2004

The effect of replacement fluids and normovolaemic haemodilution on the survival of dorsal skin flaps in rats.

The objective of this study is to investigate the effect of normovolaemic haemodilution (anaemia), haemoglobin level and replacement fluids on the survival of local flaps in rats. Fifty male Wistar rats were divided into four study groups and one control group (10 rats for each). In the study groups, 20% or 30% of blood was withdrawn and replaced by either Gelofusine or saline (0.9%). Single 1.5 cm x 3 cm cranially based dorsal random skin flaps consisting of skin and panniculus carnosus were elevated in all rats. No difference was determined between the control and 20% exsanguinated groups regarding flap survival area. There was a statistically significant difference between the flap survival areas of 20% exsanguinated groups and 30% exsanguinated groups. If the blood loss exceeds 30% of total volume and/or haemoglobin (Hb) level is lower than 10.72 g/dL, the risk of flap necrosis increases significantly.

Anemia↗

PubMed2003

Management of esophagogastric corrosive injuries in children.

There has been an increase in the number of patients admitted to our hospital with caustic esophageal injuries during the last five years. The aim of this study was to analyze the complications and results of the treatment of corrosive esophagogastric injury. Between 1990 and 2000, 120 caustic ingestion accidents were admitted to our unit. The mean age was 4 years, with a 2 : 1 male to female ratio. The average time between the caustic ingestion and admission to hospital was 14.9 days. The ingested substances were alkali in 80.9 % and acid in 19.1 % of the cases. Stenosis of the esophagus developed in 31 (25.8 %) and gastric outlet obstruction (GOO) in 6 (5 %) patients. Management of the esophageal stricture consisted of dilatation in 28 patients. Three children underwent colonic interposition without a dilatation attempt. Six children were lost to follow-up; 4 patients were successfully treated; 13 patients were still in the dilatation program at the time of writing with 6 improving and 2 patients waiting for interposition surgery; 4 patients underwent colonic interposition and 1 patient underwent resection of the stenotic part of the esophagus. Among the patients in the dilation program, we observed 4 esophageal perforations. Three of them were treated medically and further dilatations were carried out, while one was managed by colonic interposition. The treatment modalities for GOO cases consisted of pyloroplasty in 3, Billroth I in 2 and balloon dilation of the pylorus in 1 child. Although balloon dilatation of the esophagus carries the risk of perforation, it should be the first line of treatment in suitable cases. GOO cases may require surgical therapy following a detailed endoscopic evaluation.

Acids↗

PubMed2002

Urodynamic findings of posterior urethral valve patients.

The most frequently observed cause of obstructed bladder in children is the posterior urethral valve (PUV). In this report, we analysed the urodynamic findings of 26 patients whose valves were fulgurated 12.6 months previously (range: 2 days - 8 years,after the fulguration). The mean age of the patients at the time of the procedure was 4.5 years (range: 2 months -13 years). Bladder capacity was decreased in 15, increased in 6, and normal in 5 patients; hypo-compliance was observed in 13, hyper-compliance was observed in 4, and normo-compliance was observed in 9 children. Generally, hypo-compliance and decreased bladder capacity was more frequent in patients younger than 4 years of age. There were 10 patients with instable detrusor contractions(IDC) and high residual urine was present in 8 patients. Eight patients developed chronic renal failure and 6 of these patients had high residual urine. All the patients who required bladder augmentation during follow-up were the ones treated after 2.5 years of age; 4 of these 5 patients had hypo-compliance and low bladder capacity on urodynamic studies. In conclusion, all patients with PUV had pathological urodynamic findings that could change with age, and early relief of the infravesical obstruction could have an improving effect on bladder function. Urodynamic investigations may help us to design the proper treatment according to the bladder function.

Adolescent↗

PubMed2001

Corrosive injury-induced gastric outlet obstruction: a changing spectrum of agents and treatment.

METHODS: During the last 5 years, 61 children were admitted to the authors' hospital because of corrosive substance ingestion, and among them 6 patients were seen with gastric outlet obstruction. Two of them had ingested acid substances, and the other 4 had ingested alkali corrosives. The mean age was 2.9 years (range, 1.5 to 3). Their common complaint was postprandial vomiting, which had begun 3 weeks after the event (range, 1 week to 10 weeks). Endoscopic evaluation and barium contrast radiographies were performed at admission. Four patients had a pyloric stricture, 1 had an antral stricture, and another had an antropyloric stricture. Balloon dilatation of the pylorus (in 1 patient), pyloroplasty (in 3 patients), and Billroth I procedures (in 2 patients) were performed. The mean follow-up period was 22 months (range, 6 weeks to 48 months). One patient, who had undergone a Billroth I procedure, underwent reoperation because of intestinal obstruction 3 months later. On follow-up they are all free of symptoms. CONCLUSIONS: The treatment of gastric outlet obstruction caused by corrosive ingestion should be treated surgically. Although endoscopic and radiologic evaluation helps to determine the time and necessity, once the diagnosis is confirmed, early definitive surgical intervention should be performed, and the type of the surgery depends mostly on the findings of the surgeon at laparotomy. Endoscopic balloon dilatation of the pylorus maybe attempted in suitable cases. Special care should be given to prevent children from accidental corrosive ingestion.

Burns, Chemical↗

PubMed2001

Experience with laparoscopy in nonpalpable testis.

AIM: The aim of this study was to investigate the feasibility and benefits of diagnosis and interventional laparoscopy in those paediatric patients with nonpalpable testes (NPT). PATIENTS AND METHODS: Between 1992 and 1999, 75 patients with NPT (mean age 3 years, range 6 months to 14 years) were treated. 86 testes were evaluated. RESULTS: According to the laparoscopic findings 4 groups of testes were identified: Vanishing testis (n = 32), low abdominal testis (< 2 cm to the internal ring) (n = 26), high abdominal testis (> 2 cm to the internal ring) (n = 24) and intersex patients (n = 4). Of the first group, 19 testes (one bilateral) had blind-ending spermatic cord and vessels and if an atrophic testicular tissue was identified, it was removed laparoscopically. For those with spermatic cord and vessels beyond the internal ring (13 testes), atrophic testes were removed through a high scrotal incision. 19 testes of the second group had a laparoscopy-assisted orchidopexy. In the same group a laparoscopic orchidopexy was performed on 7 testes. 24 testes in the 3rd group had a Fowler-Stephens (FS) stage 1 and 18 testes had a laparotomy performed for FS stage 2 procedure (laparotomy and orchidopexy) after 6 months. At laparotomy there was no evidence of testicular atrophy in all but one testis, which was removed and the FS stage 2 procedure was completed in 17 testes. The follow-up period was between 6 months and 4 years, and two more testicular atrophies were noted after FS stage 2. The results were satisfactory in 15 out of 18 testes (83%). In the intersex group, the patient with testicular feminization underwent laparoscopic orchiectomy. The other patient with bilateral nonpalpable testis was identified as having an uterus and two intraabdominally located gonads on laparoscopy and gonadal biopsies were obtained for diagnosis. Histology demonstrated bilateral ovotestes, confirming the diagnosis of a true hermaphrodite. CONCLUSION: We are of the opinion that laparoscopy decreases the number of laparotomies in NPT, allows a single-stage procedure in low abdominal testis, and facilitates clip ligation of the testicular artery in high abdominal testis. Laparoscopy also provides diagnostic and therapeutic options for vanishing testis and intersex patients.

Adolescent↗

PubMed2001

Catheterisable continent urinary diversion (Mitrofanoff principle)--clinical experience and psychological aspects.

48 Mitrofanoff principles (MTR) were performed on 46 patients (male : female ratio, 30 : 16) with a mean age of 9.1 years (range 2.5 to 24 years). The primary diagnoses were neurogenic bladder in 11, infravesical obstruction in 7 and bladder exstrophy-epispadias complex in 28 patients. The most common type of conduit was appendix (38 cases); other conduits were constructed from the ileum (seven) and ileocaecum (one). In two cases with bladder substitution the uterine tube and tubularised bladder stump were used as perineal MTR. 33 of the 46 children underwent augmentation cystoplasty in conjunction with the MTR procedure. The Malone procedure for antegrade colonic enema (ACE) was performed at the same stage with MTR in eight cases. To achieve continence, bladder neck reconstruction was performed in 32 patients and the bladder neck was closed in four patients during the same operation and MTR procedure. The mean follow-up period was 28.7 months (range one month to 57 months). To assess the psychological aspects of the MTR procedure, the Rosenberg Self-Esteem Scales were completed by 12 children older than eight years of age. Nine patients had problems with the MTR (19.5 %). Three appendiceal MTR had strictures at the skin level, 2 of which needed minor surgical revisions. A mucocele formation at the skin level of an appendix was removed successfully. We did not observe any complaints among the other appendiceal conduits. All the tapered ileum conduits were difficult to catheterise, and 1 of them had a leakage from the stoma. None of the three transversely tubularised ileum MTRs had problems with catheterisation or leakage. A stricture of the conduit from the uterine tube was observed. 36 of the 42 patients are now continent, giving a ratio of 86 %. The results of the Rosenberg Self-Esteem Scales revealed that there was an increase in the percentage of patients with high self-esteem, and a decrease in depressive feelings after the MTR procedure. We conclude that the MTR procedure provides excellent continence, offers good prospects of a socially acceptable life with increased self-esteem, and the appendix seems to be the ideal organ for continent urinary diversion, with the transverse tubularised ileal tube as a second choice.

Adolescent↗

PubMed2000

The relation between human leukocyte antigen (HLA) distribution and intestinal obstruction and adhesions in childhood: preliminary report.

To investigate the association between the human leukocyte antigen (HLA) system and adhesions causing intestinal obstruction in childhood in order to determine whether HLA profiles can be used to identify and screen individuals at risk for intestinal adhesions, clinical and laboratory evaluations were done in a total of 42 (F:M = 27:15) patients. The mean age was 6.11 +/- 3.2 years (0.6-13 years). The patients were tested for HLA phenotype in two groups; the HLA phenotype distribution and relative risk (RR) for adhesions were determined. The study patients were children operated upon due to acute abdominal emergencies. Group 1 included patients who needed readmission after the surgery due to intestinal obstruction (n = 19), group 2 patients had no readmission for any reason following surgery (n = 23). Of the 19 patients in group 1, 9 were treated only medically and 10 needed surgical intervention. Among the patients in whom medical treatment was initiated (n = 14), 5 needed surgery during follow-up. There was an increased RR for certain HLA subtypes (A24 [9], HLA11, DR11 [5], B22) in patients presenting with intestinal obstruction due to adhesions. Among these, A24 (9) and DR11 (5) were statistically significant (P < 0.05) compared with the control group. Several possible mechanisms could link the HLA system with disease, especially those in which the immune response is suspected to be involved, but the questions of how the inflammatory response is initiated and the role of proinflammatory cytokines remain unclear. Future research developments are likely to focus on increased understanding of the molecular biology of the major histocompatibility complex and its biological function in the immune response and adhesion formation and intestinal obstruction. It is possible that HLA profiles can be used to identify individuals at risk for intestinal adhesions in the future.

Abdomen, Acute↗

PubMed2000

Esophageal replacement using the colon: a 15-year review.

Colonic interposition is a treatment option in childhood when esophageal replacement (ER) is necessary. We reviewed 18 children who underwent ER by colon between 1984 and 1999. There were 5 with esophageal atresia and 13 with corrosive esophagitis; 15 had long-term follow-up (mean 38 months). Three procedures were performed by the Waterston technique and 12 by the retrosternal technique. ER was completed in a single stage in all but 1 patient. Pyloroplasty or antireflux surgery were not done routinely during colonic interposition. As early complications, we observed 11 cervical leaks and 2 pulmonary problems. As late complications, there were 4 redundancies, 3 gastrocolic refluxes, 2 cervical anastomotic stenoses, and 1 each intestinal obstruction due to adhesions, cologastric stricture, cosmetic deformity of the thorax, and bulging of the neck. Six patients with complications required secondary surgery. There were 4 deaths, 2 of them unrelated to the surgery. Cervical leakage, which was the most commonly observed problem, healed well. We believe the colon is still one of the best substitutes for the esophagus and that there is no need to perform a routine pyloroplasty or antireflux procedure as an adjunct to the primary surgery.

Caustics↗

PubMed1996

Reducing seroma formation with fibrin glue in an animal mastectomy model.

Mastectomy is a frequently performed surgical procedure which has some important complications that may prolong hospital stay. Seroma formation after mastectomies and axillary dissection has an incidence of 5.8-53%. A new technique for preventing seroma formation was studied in an animal mastectomy model. Radical mastectomy was performed in guinea pigs. A control group of 20 animals had no further procedure post-mastectomy other than drying the wound with sterile gauze. In the other group fibrin glue was topically applied to prevent seroma formation to the operative field. Ten days after the operation, necropsy was performed and fluid collections were drained with an 18-gauge needle. The results were statistically analysed with a Two-sample rank-sum test. A significant difference existed between Groups I and II (P < 0.00005). It is concluded that fibrin glue can be used to prevent seroma formation after mastectomies.

Animals↗