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T Aktuğ

Publications and source records attributed to T Aktuğ.

At least 19 recordsLinked to original sources
PubMed2001

The effect of amnio-allantoic fluid pH on the intestines: an experimental study in the chick embryo gastroschisis model.

BACKGROUND/PURPOSE: Prolonged exposure to amniotic fluid causes the intestinal changes such as serosal edema, thickening, fibrous coating, and adhesions in gastroschisis. The effect of amnio-allantoic fluid (AAF) pH on intestines was evaluated using a chick embryo gastroschisis model. METHODS: Seventy fertile eggs were divided into 5 groups: preliminary study (PS, n = 20), AAF control (AAC, n = 10), just gastroschisis (JG, n = 10), gastroschisis pretreated with placebo (GPP, n = 15), and gastroschisis pretreated with sodium bicarbonate (GPS, n = 15). The PS group was also divided into 2 subgroups to determine the biochemical differences between the amniotic and the allantoic fluid. Gastroschisis was created surgically at the 14th day of incubation. In GPS group, 8.4% NaHCO(3) solution (0.1 mL/100 mg/d) was instilled into the AAF for 4 days. RESULTS: A significant decrease in intestinal damage was observed both macroscopically and microscopically in the group GPS compared with the JG and GPP groups. CONCLUSIONS: Pretreatment with alkalization of AAF prevented intestinal damage because of gastroschisis. Alkalization could be a simple alternative for pretreatment with amniotic fluid exchange for human fetuses with gastroschisis.

Alkalies↗
PubMed2001

Experimentally prefabricated bladder.

PURPOSE: Long life expectancy after augmentation cystoplasty increases the importance of late complications of augmentation cystoplasty. Many complications are related to the mucosa of the intestinal flap used for augmentation cystoplasty. We compared a new prefabricated enterocystoplasty flap with the classic techniques of enterocystoplasty using seromuscular flaps. For prefabrication the seromuscular flap was partially grafted with uro-epithelium before augmentation cystoplasty. MATERIALS AND METHODS: The study consisted of 4 groups. In the first 2 groups seromuscular flaps were used for augmentation cystoplasty with different sides of the flap inside the bladder. The muscular and serosal surfaces were prefabricated in groups 3 and 4, respectively. Prefabricated seromuscular flaps were used for augmentation cystoplasty after remaining in situ for 2 weeks. RESULTS: While mean augmented bladder capacity in groups 1, 2 and 4 was 18 to 20 ml. after 8 weeks, capacity in the prefabricated seromuscular enterocystoplasty group was 50 ml. Histopathological examination showed severe fibrosis in all except the prefabricated seromuscular enterocystoplasty group. CONCLUSIONS: Prefabrication allows the avoidance of the complications caused by intestinal mucosa in the reservoir and results in good capacity when the raw surface of the seromuscular flap is partially grafted with uro-epithelium before use.

Animals↗
PubMed2000

The effects of intraamniotic human neonatal urine and meconium on the intestines of the chick embryo with gastroschisis.

BACKGROUND/PURPOSE: Urinary waste products in the amniotic fluid has been implicated as a cause of intestinal damage (ID) in gastroschisis based on the fact that fetus urinates physiologically into the amniotic cavity. However, experimental and clinical data suggest that intrauterine defecation is a physiological event, thus gastrointestinal waste products also may be responsible for ID in gastroschisis. An experimental study was performed to investigate the effects of intraamniotic human neonatal urine and diluted meconium on the intestines of chick embryo with gastroschisis. METHODS: Five-day-old fertilized chick eggs (Gallus domesticus) were used. Gastroschisis was created through amniotic cavity without opening the allantoic cavity. Sterile urine and meconium were obtained from newborn humans, and 1% meconium suspension was prepared. The eggs were divided in to 3 groups. In the first group, gastroschisis was created, and amniotic fluid was reinstilled without changing its composition (control group). Equal amounts of amniotic fluid and urine mixture was instilled into the amniotic cavity in second group (urine group) and 1% meconium suspension was instilled in similar fashion in the third group after creation of gastroschisis (meconium group). RESULTS: Histopathologic features of the intestines of the urine group did not differ from the intestines of the control group. The meconium group's bowel showed serosal thickening, inflammation, focal fibrin, and collagen deposits. Histopathologic changes of intestines induced by intraamniotic diluted meconium are consistent with the ones described for human gastroschisis specimens. CONCLUSION: Gastrointestinal waste products seem responsible for the ID in gastroschisis rather than urinary waste products.

Amniotic Fluid↗
PubMed2000

Sacrococcygeal extraspinal ependymomas: the role of coccygectomy.

BACKGROUND: Ependymomas, the common glial tumors of the spinal cord, occur occasionally outside the central nervous system and are called exstraspinal ependymomas (EEP). EEPs are found primarily in sacrococcygeal region during childhood. The pathogenesis and the treatment of the sacrococcygeal (SC) ependymomas are still controversial. Therefore, we present our case with metaanalysis of other case reports to determine the optimal treatment modality for SC EEPs. METHODS: A metaanalysis of case reports of SC EEPs, including the current case, was conducted. Also all available case reports of EEPs, without age limit, were analyzed to determine the distribution of EEPs localization. RESULTS: EEPs usually are found in teratoma localizations such as the SC area, ovary, paraovarian structures, and medastinum. The distribution of EEPs localization differs with age. Local recurrence rate of EEPs after coccyx excision is zero, however, it increases to 71% when the coccyx was left behind. CONCLUSION: The identical clinical characteristics of the SC teratomas and EEPs imply that the SC EEPs may be monophasic teratomas as their ovarian counterparts are named. Coccyx excision is an important part of the surgical treatment of these tumors, with an apparent decrease in the recurrence rate.

Adolescent↗
PubMed2000

Bilateral asynchronous perinatal testicular torsion: a case report.

Bilateral perinatal testicular torsion (PTT) is an extremely rare condition. A baby boy at the postnatal 28th hour presented with right scrotal erythema and swelling, and left hydrocele were detected. There were no systemic symptoms. Right hydrocele had been detected during prenatal ultrasonography at the 34th week of gestation. Emergency technetium Tc 99m pertechnetate scintigraphy showed hypoperfusion in both sides suggesting testicular torsion. The patient underwent surgery immediately. Right necrotic testis was removed, left testis was judged as viable, and thus was treated with detorsion. Bilateral PTT in the neonate is a true emergency because of the risk of anorchia. Controversy still exists regarding the treatment of unilateral PTT. Some investigators suggest delayed operation regarding the anesthetic risk imposed on the neonate and the reality that operative salvage of the prenatally torsed testicle is a remote possibility. However, although asynchronous bilateral PTT is rare, the patient with unilateral PTT is at risk of contralateral testicular torsion in the waiting period of delayed operation. Therefore, the authors recommend early surgical intervention.

Humans↗
PubMed2000

Amniotic fluid exchange for the prevention of neural tissue damage in myelomeningocele: an alternative minimally invasive method to open in utero surgery.

OBJECTIVE: Experimental studies have shown that neural tissue damage in myelomeningocele (MMC) is acquired, resulting from exposure of neural tissue to amniotic fluid (AF). Similar to neural tissue damage in MMC, in gastroschisis, intestines exposed to AF are damaged. In gastroschisis, intestinal damage can be prevented by changing the composition of the AF with partial AF exchanges. An experimental study was performed to investigate whether the neural tissue damage in MMC can be prevented by AF exchange. METHODS: Thirteen-day-old fertilized chick eggs were used. In group 1, the amnio-allantoic membrane was opened to create a common cavity, and MMC was created (MMC-only group). In group 2, after creation of MMC, amnio-allantoic fluid exchange was performed (MMC-plus-exchange group). Chicks were extirpated for histopathologic examination 5 days later. RESULTS: While edema, focal calcification, fibrosis, capillary cell proliferation and scattered mononuclear cells were observed in the MMC-only group, histopathologic changes were mild in the exchange group. The number of neuron-specific enolase stainings (+) neural cell count was significantly higher in the exchange group compared to the MMC-only group (p < 0.01). CONCLUSION: Exposure of MMC to AF causes structural neural tissue damage that can be prevented by AF exchange. AF exchange is minimally invasive compared to open in utero surgery for the closure of MMC. By AF exchange, neural tissue damage that occurs during the gestational period may be prevented.

Amniotic Fluid↗
PubMed1998

An experimental study investigating the effects of intraperitoneal human neonatal urine and meconium on rat intestines.

Urinary waste products (UWP) in the amniotic fluid have been held responsible for the intestinal damage (ID) in gastroschisis, based on the fact that the fetus urinates physiologically into the amniotic cavity. However, experimental and clinical evidence suggests that intrauterine defecation is a physiological event; thus gastrointestinal waste products (GWP) may also be responsible for ID in gastroschisis. An experimental study was performed to investigate the effects of intraperitoneal human neonatal urine and diluted meconium on rat intestines. Adult Wistar albino rats were used. Sterile urine and meconium were obtained from newborn humans and 5% meconium suspension was prepared. Histopathological features of the intestines of the rats injected with urine did not differ from the intestines of the untreated rats. The bowel in rats injected with a meconium suspension showed serosal thickening, inflammation, focal fibrin and collagen deposits. Histopathological changes in intestines induced by intraperitoneal diluted meconium were consistent with those described for human gastroschisis specimens. We conclude that GWP, rather than UWP, seems to be responsible for the ID in gastroschisis.

Animals↗
PubMed1998

Laparoscopic appendectomy in children performed using single endoscopic GIA stapler for both mesoappendix and base of appendix.

BACKGROUND/PURPOSE: Similar to open appendectomy (OA), most of the methods described for laparoscopic appendectomy (LA) require two steps: (1) dissection and division of mesoappendix and (2) excision of appendix. Dissection of mesoappendix requires more skill and experience during LA. In single endoscopic GIA stapler laparoscopic appendectomy technique (SESLAT), both mesoappendix and base of appendix may be divided in one step with the application of a single endoscopic GIA stapler. METHODS: LA was attempted in 18 patients who had acute appendicitis and was successfully performed in 16 patients. RESULTS: In two patients, the operation was converted to OA. The authors did not need conversion to OA because of complication resulting from the use of the stapler. CONCLUSIONS: SESLAT is a quick, easy, and versatile method for LA in children that obviates dissection of mesoappendix and related complications. Thus, it enables LA to be performed by inexperienced beginners.

Adolescent↗
PubMed1998

A case of split notochord syndrome: presence of dorsal enteric diverticulum adjacent to the dorsal enteric fistula.

Like umblical enteric remnants (eg, umblical sinus and omphalomesenteric fistula), enteric remnants can be seen on the dorsal aspect of the body (dorsal enteric sinus, dorsal enteric fistula IDEF], dorsal enteric diverticulum) in conjunction with complete cleft of the vertebral column. Complete cleft of the vertebral column associated with gastrointestinal tract and central nervous system anomalies is known as "split notochord syndrome" (SNS). The authors present an unreported variant of SNS having dorsal enteric diverticulum adjacent to the DEF. The patient died 17 days after surgical repair.

Abnormalities, Multiple↗
PubMed1998

A case of mediastinal cystic hygroma whose only symptom was hoarseness.

Hoarseness caused by mediastinal cystic hygroma has not been reported before. The authors report a case of mediastinal cystic hygroma in which the patient's only symptom was hoarseness. A 6-year-old girl had hoarseness. Physical examination findings were normal except for indirect laryngoscopy, which showed unilateral vocal cord paralysis. The chest radiograph showed an opacification 3 cm wide in the left side of the superior mediastinum. Through a median sternotomy, a large multicystic mass was resected. During resection, left laryngeal recurrent nerve was seen to be intact, and its integrity was preserved. Six months later the left vocal cord was moving to a limited extent. A chest radiograph should be considered in a case of hoarseness caused by a peripheral nerve lesion to detect a mediastinal mass without any cervical component.

Child↗
PubMed1998

Amnio-allantoic fluid exchange for prevention of intestinal damage in gastroschisis II: Effects of exchange performed by using two different solutions.

The prevention of intestinal damage in gastroschisis was reported after amnio-allantoic fluid (AAF) exchange using serum saline. However it is not clear why AAF exchange prevents intestinal damage. Are some harmful chemicals withdrawn from AAF by exchange or sodium content of AAF is merely increased? A study was planned to find the end results of AAF exchange performed by using two different solutions in the chicken embryo gastroschisis model. After creation of gastroschisis, three groups were studied. In the first group AAF exchange was not performed. In the second group AAF exchange was performed using 0.075% NaCl solution (physiologic saline for chicken). In the third group AAF exchange was performed using 0.054% NaCl plus 1% dextrose solution. Exchange with two different solutions prevented cellular infiltration and fibrous peel formation in intestines which are observed in the non-treatment group. In the third group, intestinal edema was an additional pathologic finding. This study shows that in gastroschisis, the intestines outside the abdominal cavity are very sensitive to the quality of the fluid in which they are bathed. The intestinal damage resembling that encountered in human gastroschisis can be prevented by removing the harmful chemicals from AAF by exchange.

Allantois↗
PubMed1998

Amnio-allantoic fluid exchange for the prevention of intestinal damage in gastroschisis. III: Determination of the waste products removed by exchange.

Experimental amnio-allantoic fluid (AAF) exchange has been shown to prevent intestinal damage in the chicken embryo gastroschisis model. AAF contains both urinary and gastrointestinal waste products (UWP and GIWP). An experimental study was performed to find the waste products responsible for this intestinal damage. Gastroschisis was created in 20 chick embryos. Half were treated with AAF exchange, the other half were not treated. AAF samples were obtained for biochemical determination of urea nitrogen and creatinine as UWP, bile acids and bilirubin as GIWP at the end of the incubation. Intestines were evaluated by light microscopy. While GIWP (Bile salts and bilirubin) were significantly removed from AAF by exchange, the levels of UWP (urea nitrogen and creatinine) were unaffected. Intestinal wall thickness was less in the exchange group compared to the untreated group. The unchanged levels of UWP after AAF exchange may be attributed to their relatively rapid production compared to GIWP. Dilution of GIWPs by AAF exchange results in prevention of the intestinal damage in gastroschisis.

Allantois↗
PubMed1998

Colonic atresia associated with Hirschsprung's disease: it is not a diagnostic challenge.

Colonic atresia Hirschsprung's disease association (CAHDA) is usually diagnosed after several failures of intestinal anastomoses. Having previously reported one of the cases of CAHDA, we established the diagnosis in a patient before attempting intestinal anastomosis for stoma closure. We herein report the first patient with CAHDA in the literature diagnosed before a therapeutic challenge. We recommend a biopsy of the distal colonic segment either during initial laparotomy or before attempting intestinal anastomosis for closure of colostomy to prevent therapeutic challenge in the patients with colonic atresia.

Biopsy↗
PubMed1998

Pretreatment of gastroschisis with transabdominal amniotic fluid exchange.

BACKGROUND: Intestinal thickening in gastroschisis results from prolonged exposure to amniotic fluid (AF). Experimental AF exchange has been shown to prevent intestinal thickening in gastroschisis. CASE: A 25-year-old primigravida was referred at 24 weeks' gestation with a prenatal diagnosis of gastroschisis. Transabdominal AF exchange was performed at 29 weeks. This pretreatment did not cause any complications and prevented intestinal thickening in our patient. Thus, we were able to perform primary fascial closure with an intra-abdominal pressure less than 5 mmHg. We began feeding the infant on the 5th day and discharged her on the 8th day. CONCLUSION: Evidence obtained from this initial case seems promising for the further application of the AF exchange for prevention of intestinal thickening in gastroschisis.

Abdominal Muscles↗