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Biomedical subjects

I Kiriştioğlu

Publications and source records attributed to I Kiriştioğlu.

15 recordsLinked to original sources

Quantitation of defecation function using radionuclide artificial stool in children with chronic constipation.

We aimed to investigate the value of scintigraphically determined evacuation fraction (EVF) as an objective follow-up criterion in medically treated children with chronic constipation, and to evaluate the relation between patients' symptoms and rectal emptying rate. Thirty children (m: 22, f: 8, mean age: 8.9 +/- 0.9 year) suffering from chronic constipation were assessed by scintigraphic evacuation study. All patients underwent anal manometric and scintigraphic examinations before their therapy was started. During 3 months, they received conventional laxative treatment for constipation, and scintigraphic studies were repeated in 20 of 30 patients. Scintigraphic examinations consisted of instillation of artificial stool into the rectum up to the volume impending rectal evacuation, and acquisition of pre- and post-evacuation images. EVF values were then calculated from the images using a fixed region of interest. All of the patients had high resting anal canal pressure (75 +/- 12 mmHg) and had positive rectoanal inhibitory reflex. In 14/20 patients (70%) who benefited from therapy, mean EVF changed from 43.6% to 62.2% (p < 0.001), while decreasing in 6120 who did not benefit. The volume arousing rectal evacuation was significantly lower at the second scintigraphic study (261 +/- 98 ml) than the first study (354 +/- 138 ml) (p < 0.05). As a conclusion: 1) EVF was low in chronically constipated children, 2) it was improved after conventional laxative treatment and, 3) radionuclide EVF determination may be a useful method for follow-up.

Adolescent↗

Jugular phlebectasia.

A patient, 5 years of age, presented with a swelling on the right side of the neck. Ultrasonography and computed tomography confirmed a diagnosis of phlebectasia of the right internal jugular vein (IJV). The patient underwent operation and the dilated IJV was excised. Dilatation of the IJV with a Valsalva maneuver suggested a mechanical obstruction in the neck or mediastinum. However, the exact cause is still unknown. Finally, we found the patient to have a thinning of the wall but no other associated abnormality.

Child, Preschool↗

Aicardi syndrome associated with palatal hemangioma.

An 1-day-old female newborn who had typical clinical features of Aicardi syndrome, such as agenesis of the corpus callosum, ocular abnormalities and infantile spasm associated with a palatal hemangioma is reported. The intraoral mass, which occluded incompletely the oropharynx and right side of the nasopharynx, was partially excised under general anesthesia. This is the first reported patient with Aicardi syndrome with palatal hemangioma, according to the med-line search.

Abnormalities, Multiple↗

Ruptured spleen due to blunt trauma in children: analysis of blood transfusion requirements.

Selective non-operative management of splenic injury in children is generally considered to be safe, and the majority of those with isolated injuries do not require blood transfusion. Eighty-four children were treated for blunt splenic trauma from 1988 to 1997 in the Department of Paediatric Surgery, The Medical Faculty of Uludag University, Bursa, Turkey. Management involved non-operative care in 56 cases (66.7%), splenectomy in 20 (23.8%) and splenorraphy in eight (9.5%) cases. There were no later complications related to splenic injury. The overall mortality was 9.5% (8/84) and the factors effecting mortality were additional intra-abdominal and/or other system injuries. Twenty-two children were not transfused during non-operative treatment. In our study, only 57.1% of the children in the non-operative group received blood transfusions. Some of the patients in this group received only small amounts of blood and probably would have recovered without it. It is concluded that, based on a very strict protocol in conservative management, the total amount of transfused blood could be reduced in children with splenic injuries due to blunt abdominal trauma.

Adolescent↗

Giant omphalocele filled by a duplication cyst.

Ileal duplication cysts within a giant omphalocele are very rare. Only a few cases have been reported in the English literature (4). We report one case of giant omphalocele, which included a huge ileal duplication cyst, detected by prenatal US, and diagnosed at surgery after birth. This case illustrates the diagnostic and therapeutic problems occurring during pregnancy and the neonatal period.

Cysts↗

Sigmoidoscopy in minor lower gastrointestinal bleeding.

The role of sigmoidoscopic examination in the diagnosis, evaluation, and treatment of minor lower gastrointestinal bleeding was investigated. A hundred patients with minor rectal bleeding were examined by rigid sigmoidoscopy under general anaesthesia between January 1989 and July 1996. Patients who had bleeding secondary to infections, anal fissure, or haemorrhoids were excluded from study. Patients were reviewed retrospectively according to their diagnosis and endoscopic and histopathological findings. Twenty nine of these patients were girls and 71 boys; their ages ranged between 8 month and 14 years (mean 7.2 years). Endoscopic pathological findings were established in 60 patients; 32 had rectal polyps, 16 non-specific proctitis, four solitary rectal ulcers, three internal haemorrhoids, two ulcerative colitis, two Hirschsprung's enterocolitis, and one haemangioma. It is concluded that sigmoidoscopic examination should be performed for the diagnosis, prognosis, and choice of treatment in patients with minor rectal bleeding and the diagnosis should be confirmed histopathologically.

Adolescent↗

Morphological and physiological findings of fetal adrenal grafts in rats who underwent bilateral staged adrenalectomy.

Earlier studies have shown successful transplantation of fetal grafts into the greater omentum of rats. This report evaluates the effects of fetal adrenal glands in adult rats, who underwent bilateral staged adrenalectomy. At first we carried out a preliminary study to investigate the outcome of bilateral adrenalectomy: There were three groups each consisting of 10 rats. In Group 1 we performed bilateral adrenalectomy, and all rats died postoperatively within 8 hours. In Group 2 the rats underwent sham procedure, and only one rat died. Group 3 was for control and all rats survived. After the preliminary study we constructed a 4th group (Tx group) with 20 rats. We performed a left adrenalectomy and immediately transplanted fetal adrenal glands into the greater omentum (stage 1). All animals survived the operation. After 6 weeks we did a second laparotomy and excised the right adrenal gland (stage 2). All of rats from Group 4 compared to Group 1 did not die postoperatively within 8 hours. 6 rats survived staged bilateral adrenalectomy with fetal grafts. Histologic investigation of fetal grafts revealed well developed cortex containing all three layers, but we could not find any medullary cells. In view of these findings we speculate that the fetal adrenal grafts have functioned in this model.

Adrenal Cortex↗

Surgical correction of muscular torticollis in older children with Peter G. Jones technique.

In the Department of Pediatric Surgery, Uludağ University Medical Faculty in Bursa, during the last 11 years, the Peter G. Jones technique for the surgical correction of muscular torticollis in older children has been introduced. Twenty children between 4 and 13 years of age were treated for muscular torticollis. They were followed up from 3 months to 10 years after surgery. All patients had a middle-third open transection of the sternocleidomastoid muscle. Preoperative and postoperative assessment by a rigid scoring system showed that all patients improved in terms of function as well as cosmesis. Children younger than 10 years showed the most improvement, with 90% excellent and good results. Late middle-third open transection of the sternomastoid in muscular torticollis may give acceptable results.

Adolescent↗

Fluconazole treatment of neonates and infants with severe fungal infections.

A total of 24 neonates and infants, aged from 2 days to 10 months, received treatment with intravenous fluconazole for microbiologically documented or presumed fungal infection. The mean fluconazole dosage was 6 mg/kg/day (range 2-16 mg/kg/day) and the mean duration of therapy was 25 days (range 5-72 days). Efficacy was evaluated in neonates with proven fungal infections, as documented by the presence of pathogen at baseline. A positive clinical response was achieved in 23 of the 24 clinically evaluable patients (96%); eradication of the fungal organism was also achieved in 23 of the 24 evaluable patients (96%). Adverse events occurred in two patients (8%) but therapy was not discontinued in either patient. The present results confirm the efficacy and safety of fluconazole in the treatment of neonates and infants with severe fungal infections.

Antifungal Agents↗

The effects of a fluoroquinolone on the growth and development of infants.

Growth and development were monitored for up to 42 months in nine neonates to whom ciprofloxacin, a fluoroquinolone, was given in the neonatal period at a dosage of 20 mg/kg/day. Ciprofloxacin was used only as a ¿life-saving' therapy in cases of sepsis produced by bacterial agents resistant to other antibiotics. Two other groups of nine neonates, matched by birth weight and gestational age, were studied as controls: one group with sepsis, which was effectively treated with cefotaxime and a group of healthy neonates. No statistically significant differences in growth and development between the groups were found during follow-up for 42 months. No osteoarticular problems or joint deformities were observed in the ciprofloxacin group. Ciprofloxacin appears to provide a therapeutic option as a ¿life-saving' therapy for newborns with sepsis produced by multiply resistant organisms.

Anti-Infective Agents↗

Solitary rectal ulcer syndrome in children.

The solitary rectal ulcer syndrome (SRUS) is an unusual disorder in childhood. Although well recognized in adult literature, the pediatric experience with this condition is limited, so SRUS often goes unrecognized or misdiagnosed. There are very few pediatric case reports in the English literature. This report describes four patients who presented with rectal bleeding, constipation, mucous discharge, and lower abdominal pain, with a diagnosis of SRUS. The diagnosis was made by rectoscopy, defecogram, anorectal manometry and histopathological evaluation. In two patients, defecogram showed a rectocele with both, the sphincter failed to relax to voluntary squeeze pressure on anorectal manometric examination. The histopathological finding in all patients was fibrous obliteration of the lamina propria with disorientation of muscle fibers. All of the patients responded well to conservative therapy, which included defecation training, laxatives, sulfasalazine, and application of rectal sucralfate enema, and remained asymptomatic on the follow-up. Although rare in the pediatric population, SRUS should be relatively easy to recognize in the child with rectal bleeding, after elimination of other causes. If suspected, the diagnosis of SRUS may be made at endoscopy and confirmed by rectal biopsy.

Anti-Ulcer Agents↗