Biomedical subjects

Oğuzhan Ozdemir

Publications and source records attributed to Oğuzhan Ozdemir.

6 recordsLinked to original sources

PubMed2006

The effects of increased intraabdominal pressure on testicular blood flow, oxidative stress markers, and morphology.

BACKGROUND: This study was carried out to evaluate the effects of increased intraabdominal pressure (IAP) on testicular blood flow (TBF), oxidative stress markers, and morphology. METHODS: Twenty-four Sprague-Dawley rats weighing 300 to 350 g were allocated randomly into 3 groups consisting of 8 animals each: A, gasless (control); B, 10 mm Hg IAP with CO(2) pneumoperitoneum for 60 minutes; and C, 20 mm Hg IAP with CO(2) pneumoperitoneum for 60 minutes. Testicular blood flow was studied using the Doppler technique. In the 10 and 20 mm Hg IAP groups, time points of TBF measurements were defined as follows: TBF(baseline), 10 minutes before insufflation; TBF(10min), 10 minutes after pneumoperitoneum; TBF(50min), 50 minutes after pneumoperitoneum; and TBF(reperfusion), 10 minutes after pneumoperitoneum deflation. To evaluate the changes in oxidative stress, we assayed the malondialdehyde (MDA) levels of testicular tissues. A 4-level grading scale was used to quantify histologic injury. RESULTS: For both testes of each rat, TBF(10min), TBF(50min), and TBF(reperfusion) values of each group were separately evaluated according to their TBF(baseline) value percentages. The results revealed no significant differences for each time point of TBF measurements between the right and left testes in any group. Pneumoperitoneum caused a significant decrease in TBF at the 10th and 50th minutes of pneumoperitoneum, both in the 10 and 20 mm Hg IAP groups, compared with their baseline values. TBF(reperfusion) values in both groups were also lower than their baseline values. We determined that mean TBF(10min) and TBF(50min) values decreased significantly in the 20 mm Hg IAP group compared with the 10 mm Hg IAP group, despite there being no significant difference in their mean TBF(reperfusion) values. Mean MDA levels were significantly increased in both the 10 and 20 mm Hg IAP groups compared with those of the control group for the right and left testes. However, there was no significant difference between the mean MDA levels in these first 2 groups. The histologic injury score was significantly increased in both the 10 and 20 mm Hg IAP groups compared with the control group; however, there was no difference in the scores between these first 2 groups. CONCLUSIONS: We demonstrated in an animal model that abdominal deflation after IAP of 10 and 20 mm Hg for 60 minutes causes testicular hypoperfusion, free radical production, and subsequent testicular damage.

Abdomen↗

PubMed2005

Bloody nipple discharge in children: possible etiologies and selection of appropriate therapy.

An understanding of underlying causes of bloody nipple discharge (BND) is necessary to be able to advise treatment guidelines of this rare symptom in the pediatric age group. Of 11 patients with 14 breasts that had BND, data regarding age, sex, side and duration of BND, physical examination findings, laboratory values, culture reports, ultrasonography (US) findings, treatment approach, histopathologic details, and outcomes were obtained, and also, literature was reviewed. The patients were between 3 months and 12 years of age. There were six males and five females. The BND was located in the right breast in six patients, in the left in two, and it was bilateral in three. On physical examinations, seven patients had palpable cystic nodules located at the areolar area and three had a diffuse breast enlargement without skin findings. Laboratory investigations showed normal hormone levels in all patients. At US examinations, seven breasts had cystic lesions, three had hypoechoic tissue in the subareolar region, and others had normal US findings. In a girl with positive culture for Staphylococcus aureus, BND resolved after oral antibiotics. Two cases resolved spontaneously, with 6 months and 4 months follow-up periods, respectively. Surgical intervention was performed for the remaining eight patients, and mean time to operation after onset of symptoms was 10 months (range = 1-34 months). Histopathologic findings showed that the underlying cause of BND was duct ectasia in five breasts, gynecomastia in three, and fibrocystic change in two. Their follow-up periods ranged between 3 months and 6 years, and no recurrences were observed. Classification of breasts with BND for selecting appropriate therapy on the basis of results of careful physical examination, with an US evaluation in selected cases, is effective, and prevents unnecessary investigations.

Algorithms↗

PubMed2005

Pneumatoceles in postpneumonic empyema: an algorithmic approach.

PURPOSE: The aim of the study was to determine the natural course and select appropriate therapy for pneumatocele (PC) in children with postpneumonic empyema. MATERIALS AND METHODS: Records of 134 children treated for postpneumonic empyema between October 1997 and June 2003 were reviewed retrospectively, and 58 (43%) of them were found to have PC. Their chest x-rays and computed tomography scans as well as patient profiles were evaluated to assess the size, location, course, and complications. Clinical course, treatment indications, and results were also reviewed. RESULTS: The patients were aged from 14 months to 15 years (mean 3.8 years). There were 36 boys and 22 girls. The PC was located on the right hemithorax in 34 patients and on the left in 24. Staphylococcus aureus was the most common isolated infective agent. Of the 58 children, 37 (63.7%) showed complete resolution with improvement of the infection within 2 months. Thirteen PCs had evidences of gradual decrease in size without any indication for invasive approaches, and they resolved completely, with a mean time of 6.1 (ranging from 1-13) months. One tension PC, 3 large PCs (>50% of hemithorax), 1 case with bad tolerance to follow-up, and 2 persistent PCs had no reduction in size on follow-up; a total of 7 patients underwent image-guided catheter drainage procedure, and 5 of them resolved completely. In the last 2 cases, surgical excision was required because of persistent cystic cavity caused by thickened PC wall. One patient whose PC had not been decreasing in size developed findings of severe lung abscess with thickened wall and directly underwent surgery. In none of these patients recurrences or complaints related to PC were noted on their control visits. CONCLUSION: Most of these PCs are simple PC and show spontaneous resolution with improvement of the infection within the first 2 months. However, some decrease gradually by time, and close follow-up should be continued in case of complicated PC. Persistent features of chest infection, more than 50% involvement of hemithorax and severe atelectasis, development of broncopleural fistulae (tension PC), and bad tolerance to follow-up remind complicated PC, and they are indications of image-guided catheter drainage procedure. Its failure occurs in PC with thickened wall that does not collapse, as was in our cases with persistent PC and severe infected PC, and thus, this is an indication for surgical excision.

Adolescent↗

PubMed2005

Congenital paraesophageal hiatal hernia: pitfalls in the diagnosis and treatment.

PURPOSE: The aim of this study was to analyze pitfalls in the diagnosis and treatment of congenital paraesophageal hiatal hernia (PEHH). METHODS: Between 1992 and 2004, the records of 5 infants with PEHH were retrospectively reviewed for age, sex, presenting symptoms, radiological studies, operative findings and approaches, and outcomes. RESULTS: All cases (3 male, 2 female) had right-sided hernias. They had clinical features of recurrent chest infections and intermittent vomiting that were present since birth in 3. Three presented acutely ill with findings of respiratory distress and vomiting. Three were referred with misdiagnoses of reflux disease, thoracic mass, and bronchopneumonia. On the chest x-rays of 3 cases, there were paracardiac opacities suggesting a mass lesion. According to the upper gastrointestinal series and/or computed tomography findings, 4 cases had a combination of sliding and paraesophageal hernia, and the remainder one had pure rolling hiatus hernia. Three had obstruction owing to organoaxial volvulus and required an emergency operation. All cases had a large hernia orifice. Four had gastroesophageal junction (GEJ) displaced into the thorax, and in 3, the stomach was found to be twisted, and transverse colon with omentum was also in the thorax in 2. In the remainder, the GEJ was in its normal position with herniated stomach. None of the cases had normal gastrosplenic and gastrocolic ligaments. Surgical repair included resection of the sac, closure of the hiatal defect, and Thal procedure. Two had intestinal malrotation, with right ovarian torsion and ventricular septal defect, respectively. Postoperative ventilation was required in one who later died. At a mean follow-up of 2 years, the other 4 had no symptoms related to the disease, and no evidence of recurrence or reflux was noted on control upper gastrointestinal series. CONCLUSION: Congenital PEHH may be difficult to diagnose. It is frequently complicated and associated with morbidity and even mortality. If the defect is large and associated with displacement of GEJ into the thorax, adding an antireflux procedure to the repair is appropriate.

Diagnosis, Differential↗

PubMed2005

Nonoperative treatment of traumatic pancreatic duct disruption in children with an endoscopically placed stent.

The presence of ductal injury is the main determinant of consequence and a cause of significant mortality and morbidity in children with blunt pancreatic trauma. Proper treatment must be initiated on the basis of accurate anatomic diagnosis of the type and location of the injury. Computed tomography is an insufficient method for the diagnosis of the type and location of pancreatic ductal injury. Endoscopic retrograde pancreatography (ERP) is a reliable technique for determining the status of the pancreatic duct in children and may allow for definitive treatment of ductal injury by stenting in selected patients. There is only one study of 2 cases reporting therapeutic ERP with ductal stenting in children after blunt trauma. In this report, we present an 11-year-old child with pancreatic ductal injury who was diagnosed and treated endoscopically by stent placement, during ERP. The patient improved steadily and was discharged uneventfully. Endoscopic retrograde pancreatography may be a very useful diagnostic and treatment tool in the management of main ductal disruptions.

Abdominal Injuries↗

PubMed2004

Two cases of pyometrocolpos due to distal vaginal atresia.

Children with pyometrocolpos due to distal vaginal atresia may present as acutely ill, with severe obstructive uropathy and septicemia. In such patients the clinical course is markedly improved by urgent drainage of the infected cystic mass, and a temporary drainage procedure is required to allow local findings of infection to subside before definitive surgery. We present two children with pyometrocolpos with the above-mentioned clinical course, in whom percutaneous drainage with computed tomography-guided catheter placement through the lower abdominal wall was performed because of the high risks of complex drainage procedures and general anesthesia. This drainage did result in dramatically improved clinical status, and findings of local inflammation resolved within 4-6 weeks, which facilitated a later successful definitive surgical procedure.

Abscess↗