Burhan Beger

Megacystis-microcolon-intestinal hypoperistalsis syndrome: a case report.

Megacystis Microcolon Intestinal Hypoperistalsis Syndrom (MMIHS) is a quite rare congenital and fatal disease which was firstly defined by Berdon and his colleagues. It appears through a widely enlarged bladder and microcolon and its cause is unknown (Berdon et al., 1976; Carmelo et al., 2005; Makhija et al., 1999; Loening-Baucke and Kimura 1999; Redman et al., 1984; Hsu et al., 2003; Yigit et al., 1996; Srikanth et al., 1993). The disease is found in females three or four times more than in males (Srikanth et al., 1993; Sen et al., 1993; Hirato et al., 2003). Most of the cases die within the early months of their lives (Yigit et al., 1996; Srikanth et al., 1993; Sen et al., 1993; Hirato et al., 2003). We present the case of a female newborn with antenatal ultrasound revealing intestinal mass and bilateral hydroureteronephrosis. The case was admitted for intestinal obstruction after birth.

Morphometric properties of the levator scapulae, rhomboid major, and rhomboid minor in human fetuses

PurposeThe main objective of this study is to showcase the growth dynamics of levator scapulae, rhomboid major, and rhomboid minor algebraically, to help plan surgeries on newborns and young infants.MethodsTwenty-five formalin-fixed fetuses (11 male–14 female) with a mean gestational age of 21.80 ± 2.61 (range 18–27) weeks present in the inventory of Mersin University Faculty of Medicine Anatomy Department were dissected. Surface area of levator scapulae, rhomboid major, and rhomboid minor was calculated using digital image analysis software; width and length parameters were measured using digital calipers.ResultsNeither sex nor side significant differences were observed in relation with the numerical data of levator scapulae, rhomboid major, and rhomboid minor (p > 0.05). Algebraic parameters such as surface area, width and length were detected to exhibit a linear growth from 18th to 27th week. Linear functions for levator scapulae, rhomboid major and rhomboid minor surface areas were obtained as y = − 136.871 + 10.598 × age (weeks), y = − 480.567 + 33.147 × age (weeks) and y = − 128.090 + 8.843 × age (weeks), respectively.ConclusionThe results and data of this study can potentially be beneficial in planning of surgeries for many infancy diseases such as trapezius paralysis, obstetrical brachial plexus palsy, Sprengel’s disease, or winged scapula. Linear functions calculated in this study are expected to provide a better understanding of the growth dynamics of levator scapulae, rhomboid major, and rhomboid minor in fetal term and more precise estimation of muscle sizes.

Ovarian Torsion in the Normal Ovary: A Diagnostic Challenge in Postmenarchal Adolescent Girls in the Emergency Department

Background Ovarian torsion can be seen in the otherwise-normal ovary and is a challenging issue in the emergency department. The aims were (1) to evaluate and compare the surgically verified ovarian torsion cases in otherwise-normal ovaries and ovaries including a mass or cyst and (2) to investigate whether the normal-appearing ovaries on ultrasound examination affected the diagnosis of ovarian torsion or not. Material/Methods A retrospective cohort study design was used. The medical records of all postmenarchal adolescent girls with surgically verified ovarian torsion treated in a university hospital from 2010 to 2016 were reviewed. Results Twenty-nine post-menarchal girls were identified. The subjects were divided into two groups. Eight girls (group 1) had ovarian torsion in a normal ovary, and twenty-one girls (group 2) had ovarian torsion including a mass or cyst. The median ages of group 1 and 2 were 13 and 14 years, respectively. Abdominal pain was the main presenting symptom for all cases in both groups. Doppler flow studies were abnormal in 6/9 (66.6%) in group 1 and 12/21 (57.1%) in group 2. The time from first admission to the operation was statistically longer in group 1 than in group 2 (34.5±24.3 hours vs. 19.5±9.2 hours, respectively; p=0.001). The longitudinal axis of uterine size was significantly shorter in group 1 than in group 2 (34.3±2.9 mm vs. 47.6±4.5 mm, respectively; p=0.001). Conclusions Ovarian torsion in adolescent girls can be seen within the otherwise-normal ovary. The normal-appearing ovaries on ultrasound in the emergency department may lead to delay in the diagnosis of ovarian torsion in adolescent girls.

Morphometric properties of the tensor fascia lata muscle in human fetuses

BACKGROUND In neonatal and early childhood surgeries such as meningomyelocele repairs, closing deep wounds and oncological treatment, tensor fasciae lata (TFL) flaps are used. However, there are not enough data about structural properties of TFL in foetuses, which can be considered as the closest to neonates in terms of sampling. This studys main objective is to gather data about morphological structures of TFL in human foetuses to be used in newborn surgery. MATERIALS AND METHODS Fifty formalin-fixed foetuses (24 male, 26 female) with gestational age ranging from 18 to 30 weeks (mean 22.94 ± 3.23 weeks) were included in the study. TFL samples were obtained by bilateral dissection and then surface area, width and length parameters were recorded. Digital callipers were used for length and width measurements whereas surface area was calculated using digital image analysis software. RESULTS No statistically significant differences were found in terms of numerical value of parameters between sides and sexes (p > 0.05). Linear functions for TFL surface area, width, anterior and posterior margin lengths were calculated as y = -225.652 + 14.417 × age (weeks), y = -5.571 + 0.595 × age (weeks), y = -4.276 + 0.909 × age (weeks), and y = -4.468 + 0.779 × age (weeks), respectively. CONCLUSIONS Linear functions for TFL surface area, width and lengths can be used in designing TFL flap dimensions in newborn surgery. In addition, using those described linear functions can also be beneficial in prediction of TFL flap dimensions in autopsy studies.

Hirschsprung Disease: Duhamel-Martin Experiences

Hirschsprung Hastalığı (HH), kolonun myenterik ve submukozal sinir pleksuslarında parasempatik ganglion hücrelerinin yokluğu sonucunda etkilenen segmentteki barsakta peristaltik aktivitenin olmaması ile karakterize bir hastalıktır (1-3). HH 5000 doğumda bir görülür ve erkek çocuklarda daha sıktır. Belirtileri yenidoğan ile çocuk yaş grubunda değişkenlik göstermekle birlikte kabızlık ve abdominal distansiyon en sık bulgulardır. HH olan yenidoğanların %90‘ında hayatın ilk 24 saatinde mekonyum çıkışı izlenmeyebilir. Fizik muayenede rektal tuşe ile fışkırır tarzda gaita çıkışı tipiktir (1,4,5). ÖZET

Quantitative assessment of the growth dynamics of the teres major in human fetuses

PurposeThe main objective of the study was to examine the use of teres major (TM) as a flap in the pediatric surgeries from an anatomical perspective by: (1) revealing the growth dynamics of the developing TM; (2) assessing the possible interconnecting structures between TM and latissimus dorsi (LD); (3) exposing the innervation patterns of TM in human fetuses.MethodsStudy was conducted on 50 fetuses (26 females and 24 males), on a mean gestational age of 22.86 ± 3.21 (range 18–30) weeks. All the measurements were collected with a digital caliper and a digital image analysis software. Additionally, structural relations between TM and LD were examined in detail and further classified.ResultsNo significant difference of side and sex was detected on TM measurements (p > 0.05). Linear functions for the surface area, width, length of the superior and inferior margins of TM were detected as follows: y = − 257.142 + 18.334 × age (weeks), y = − 5.497 + 0.545 × age (weeks), y = − 1.621 + 1.068 × age (weeks), and y = − 2.147 + 1.284 × age (weeks), respectively. As classified in five types, a number of 33 muscular or tendinous connections between TM and LD were detected. Musculo-tendinous slips from TM to triceps brachii (TB) were evident in four sides. Innervation of TM was observed to be providing by the lower subscapular nerve in all the cases.ConclusionFirst, linear functions, representing the developing fetal morphometry obtained by our study can be adapted for estimating the morphometric of this muscle in early childhood. Besides, acknowledging the diverse appointments of TM with the surrounding muscles such as LD and TB may facilitate the prevention of neurovascular structures and the application of surgical procedures during tendon transfers. In brief, our findings are highly potent to bring the attention of pediatric surgeons.

Ganglioneuroma in a child with chronic constipation and abdominal pain

Background: Ganglioneuromas are rare, benign, slow-growing tumors arising from the neural crest. They are most commonly in posterior mediastinum, retroperitoneum, adrenal medulla and neck. They are very rare in presacral region. Case Report: A 15 year old girl presented with abdominal pain and chronic constipation. A mass was seen between the uterus and sacrococcygeal bone in abdominal CT. It is resected totally and evaluated as ganglioneuroma. Conclusion: Presacral ganglioneuroma is a benign tumor which is rarely encountered. Patients might present with abdominal pain and constipation complaints as seen in our patient. Therefore, imaging methods should certainly be used for patients with chronic constipation which is resistance to treatment.

Prevalence, demographic characteristics and associated risk factors of malnutrition among 0-5 aged children: a cross-sectional study from Van, eastern Turkey

Malnutrition in childhood is a dramatic indicator of poor socio-economical status worldwide. To recognize and reveal the socio-demographic features is crucial, especially for developing countries. Our aim was to investigate the prevalence and association with sociodemographic variables of malnutrition in 0-5 years old children in Van, Turkey. A total of 702 children are included in this cross-sectional study. Demographic features of subject including age, gender, family characteristics and other data were obtained. Nutritional assessment was done using anthropometric indices including weight-for-age, height-for-age, weight-for-height, head circumference and body mass index-for-age. Multivariate logistic regressions were carried out to assess malnutrition-associated factors. Prevalence of underweight, stunting and wasting were 19.7, 17.7 and 16.2%, respectively. Socio-demographic variables that statistical significantly in association with malnutrition were low monthly family income, educational level and employment status of father, parental consanguinity, number of pregnancies, regular intake of vitamin D and history of prematurity. The prevalence of children with head circumference-z score ≤2SD and body mass index-for-age ≤2SD were 9.8 and 16.3%, respectively. Multivariate analysis detected following risk factors for these indices; low monthly family income, history of prematurity, unemployed father and the period between pregnancies (1-2 years). We found that prevalence of malnutrition in the city of Van, was still higher than more developed regions of Turkey. The associated risk factors of malnutrition should be specifically interpreted by health professionals and also by government authorities that are responsible for making practical politics of public health.