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Biomedical subjects

F C Tanyel

Publications and source records attributed to F C Tanyel.

At least 109 records · Page 6Linked to original sources

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↗

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↗

Obstructive jaundice resulting from adenocarcinoma of the ampulla of Vater in an 11-year-old boy.

Adenocarcinoma of ampulla of Vater causing obstructive jaundice in an 11-year-old boy is reported. He first underwent pylorus-preserving duodenectomy, which later necessitated classical Whipple operation because of the microscopical evidence of the disease beyond surgical margins. This child is the youngest case of adenocarcinoma of ampulla of Vater in the English-language literature.

Adenocarcinoma↗

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↗

Expression of beta-1 integrins in ganglionic and aganglionic segments of patients with Hirschsprung's disease.

An immunocytochemical study was performed to assess the role of beta-1 integrins in the pathogenesis of Hirschsprung's disease. Fresh tissue samples from both aganglionic and ganglionic segments of five patients who were undergoing surgery for Hirschsprung's disease were obtained. Samples were rapidly frozen in liquid nitrogen. Sections were cut and stained using anti alpha-1, 2, 3, 4, 5, 6 and beta-1 monoclonals according to the indirect immunoperoxidase method. The evaluation did not reveal any significant change of pattern in the distribution of beta-1 integrins in the non-neural elements of both aganglionic and ganglionic segments of colon, such as the epithelium, muscularis mucosa, muscularis externa, connective tissues and blood vessels. Nerve fibres in both aganglionic and ganglionic segments strongly expressed the alpha-6 chain of very late activation antigen which led to their increase in the aganglionic segment. In addition to revealing the increase, alpha-6 monoclonals also had in situ positive control due to their presence in non-neural elements. Hence, immunostaining of the suction biopsies with anti alpha-6 monoclonals may be employed as a new and simple method in the diagnosis of Hirschsprung's disease. On the other hand, beta-1 integrins do not seem to play a role in the defective migration of ganglion cells occurring in Hirschsprung's disease.

Antigens, CD↗

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↗

Is fetal thoracic compression really the underlying mechanism of lung hypoplasia in oligohydramnios? An experimental study in a rabbit model.

Compression of the fetal thorax by the uterine wall is one of the theories proposed to explain the mechanism of lung hypoplasia in association with oligohydramnios. However, the reduction in the intrathoracic space and the evidence of compression on the fetal thorax have not been demonstrated in detail. Therefore an experimental study was planned to determine the effects of oligohydramnios on available intrathoracic space and lung volume in the rabbit fetus. Amniotic fluid was shunted into the peritoneal cavity between 23 and 31 days of gestation. Intrathoracic space and lung volumes (TV and LV), and lung and body weight (LW and BW) values were measured in our study and control fetuses at term. Lung weight/body weight, lung volume/thorax volume, thorax volume/body weight ratios were calculated and the values of the fetuses with shunting and controls were compared. The difference between TV/BW ratios was not significant. LW/BW and LV/TV ratios were significantly reduced in experimental fetuses compared to the controls. Chronic drainage of amniotic fluid into the peritoneal cavity resulted in reduced LW/BW and LV/TV ratio, but did not effect TV/BW ratio. The low LV/TV ratio in the fetuses with shunting despite similar TV/BW ratio suggested that the diaphragm had been elevated. This is also an explanation for the observation of reduced chest circumference and chest circumference/abdominal circumference ratio in prolonged premature rupture of the membranes in vivo. The developing fetal lungs would undergo not only transthoracic but also trans-abdomino-diaphragmatic compression. However, it is unlikely in the tubular shaped rabbit uterus. In oligohydramnios amniotic fluid dynamics or physical characteristics with its contents should be disturbed. A previous experimental study with herniation of the amniotic sac causing lung hypoplasia through reduced intraamniotic pressure without oligohydramnios also questioned the role of fetal compression. Although fetal lung development was significantly impaired, the thoracic cage was not affected by amniono-peritoneal shunting. Therefore, we suggest that lung hypoplasia resulted from another mechanism rather than thoracic compression.

Amniotic Fluid↗

Urolithiasis in patients with Hirschsprung's disease.

Although patients with Hirschsprung's disease (HD) carry some factors that increase the risk of urolithiasis this fact seems to be underestimated. Among 302 patients with HD, four patients (1.32%) with urolithiasis were encountered. Since factors increasing the risk of urolithiasis such as urinary tract infection, constipation, vesicoureteral reflux, enteric resections and malabsorption may be encountered during the course of HD, an increased risk of urolithiasis in these patients should be expected.

Bacteriuria↗

Hirschsprung-associated congenital anomalies.

Between 1976-1993, 302 patients were diagnosed to have Hirschsprung's disease (HD) in Hacettepe University Children's Hospital. All patients have been searched for the occurrence of associated anomalies and other parameters including 1) sex, 2) gestational age, 3) birth weight, 4) length of aganglionic segment, 5) familial occurrence, 6) consanguinity. Forty-nine of 302 patients were proved to have 83 associated congenital anomalies together with HD. Distribution of anomalies was as follows; central nervous system and special senses 28.92%, genitourinary system 26.51%, skeletal 24.09%, gastrointestinal 12.05%, cardiovascular 8.43%. In eleven patients more than one anomaly involving different systems were detected; only one of these patients was female and six of them have shown short segment disease. Down's syndrome was present in 5 patients. Female: male ratio was 1:4.2 for the whole series and 1:6 for the patients with Hirschsprung associated congenital anomalies (HACA). In the HACA group the percentage increased in favor of long-segment and extensive aganglionosis without statistical significance (p>0.05). The majority of patients were term babies and their birth weights were between 2500g < 3500g. Consanguinity was present in 36 families. No affected parents were detected but two sisters and four brothers were proved to have HD. Three pairs of twins, one of which was monozygotic, and all showing discordance were detected. There was no difference between HACA group and HD without HACA in terms of sex, birth weight, length of aganglionic segment and consanguinity. Although HD seemed to be genetically heterogeneous HACA did not have a genetically different origin from that of HD.

Abnormalities, Multiple↗

Spontaneous rupture of choledochal cyst: an unusual cause of acute abdomen in children.

Rupture is one of the rare complications of choledochal cysts. The cause of rupture is unknown in many cases and is considered to be spontaneous. Two patients admitted to the hospital with acute abdominal picture were initially thought to have postoperative abscess and appendicitis. However, the presence of bilelike fluid suggested a bile tract pathology, and evaluation showed rupture choledochal cysts. Although spontaneous rupture of a choledochal cyst is a rare complication, and can sometimes be the initial manifestation of a choledochal cyst, it should be considered in the presence of bilelike fluid and differentiated from spontaneous perforation of the bile tract. In spontaneous rupture of choledochal cyst, cystectomy, cholecystectomy, and Roux-Y hepaticoportoenterostomy is the treatment of choice.

Abdomen, Acute↗

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↗

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↗

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↗