Didem Baskın Embleton

Laryngeal Fracture due to Blunt Trauma Presenting with Pneumothorax and Pneumomediastinum

Aim: Injuries due to traffic accidents are frequent in childhood, and they have high mortality and morbidity. Laryngeal injury due to a traffic accident is a rare pathology and might be missed if not suspected. Here we present a laryngeal fracture in a child after a blunt chest trauma during a traffic accident that presented with pneumomediastinum and pneumothorax. Case: A 14-year-old girl was referred for pneumomediastinum. Her physical examination was normal except subcutaneous emphysema, edema and tenderness in the cervical area, hoarseness, facial and extremity abrasions and ecchymoses. Chest tomography revealed pneumothorax and pneumomediastinum, and cranial tomography revealed maxillofacial fractures. Upper airway damage was suspected, flexible endoscopy revealed right vocal cord paralysis and cervical tomography revealed thyroid cartilage fracture. The fracture was repaired and tracheotomy was performed. She was discharged on postoperative day 6. Facial fractures were repaired in another center. Tracheotomy was removed on postoperative day 20. Her hoarseness, although decreased, still persists. Conclusion: Pneumomediastinum is a rare result of a laryngeal fracture and if not suspected, the fracture can easily be missed. It should be kept in mind after blunt cervical trauma with pneumomediastinum and/or pneumothorax. Direct endoscopy and cervical tomography may be necessary for the differential diagnosis.

Benign Cystic Mesothelioma in a Child: Case Report and Review of the Literature.

BACKGROUND Benign cystic mesothelioma (BCM) is a rare tumor with benign characteristic. There are only 8 child cases reported in the English literature. In this report, we present this rare entity a brief review of the literature. CASE REPORT A two year-old boy presenting with abdominal swelling was hospitalized. Physical examination revealed a mass filling the abdomen. Laboratory findings were not specific. Abdominal computerized tomography showed a 15×13×11 cm cystic mass extending from the bladder to the liver with no solid components and no infiltration to adjacent organs. Operation revealed a cystic mass filled with yellow-green serous fluid which was attached to the right lobe of the liver with a 1 cm thick peduncle. Total excision of the mass was performed by clamping and cutting the narrow attachment. Recovery was uneventful. Pathology revealed multiple cysts lined with mesothelial cells. No recurrence was seen after 5 years of follow-up. CONCLUSION BCM should be kept in mind as a rare cause of the abdominal mass in children, as it may lead to confusion in preoperative diagnosis. Although rare, patients should be followed throughout life because of the risk of recurrence and malignant degeneration.

A practical offer for hypospadias dressing: Allevyn®

INTRODUCTION An ideal hypospadias dressing material must be cheap and non-allergenic. It also must be easily and quickly applied, non-adherent to the incision, effectively absorb the leakages of the wound, pressurise the flaps and grafts effectively, without damaging the blood circulation, protect against infections, and must be easily and painlessly removable. We use a product that is produced for healing chronic wounds and burns, Allevyn Adhesive® , as a wound dressing after hypospadias surgery and circumcision. MATERIALS AND METHODS We included 61 hypospadias and 85 circumcision cases operated in our clinic between November 2007 and August 2010, for the study. Allevyn Adhesive® dressing was used in all the cases. For approximately every 10 patients a sheet sized 22.5 x 22.5 cm was used. RESULTS We did not meet any difficulty in application and removal of the dressings and the dressing could be performed easily even by inexperienced health personnel. The cost of the application is about

A comparison of preoperative and postoperative testicular volume and blood flow in patients with inguinal hernia, hydrocele, and cord cyst: A prospective cohort study

5 for each case. We did not encounter any complications with regard to the dressing during the follow-up. CONCLUSION We did not encounter any of the complications with Allevyn Adhesive® that were seen with the use of traditional dressing products, such as, problems with removal of the dressing, development of maceration secondary to inadequate absorption of leakages from the wound, cohesions of the wound lips, and infections and necrosis of the flaps and grafts, secondary to erroneous locations of the dressings. There was no additional therapeutical cost due to the use of this product. For these reasons we thought that Allevyn Adhesive® is a good alternative for the dressing of hypospadias and circumcision.

The Protective Effects of Alpha-Lipoic Acid and Coenzyme Q10 Combination on Ovarian Ischemia-Reperfusion Injury: An Experimental Study

Objective: To evaluate the effect of inguinal operations performed with a modified Ferguson technique upon testicular volume and blood flow. Methods: This study involved 23 children receiving surgery for inguinal hernia, hydrocele, and cord cyst. This was a prospective study performed between April 2016 and June 2016 in a medical faculty pediatric surgery unit. The color Doppler ultrasound (CDUS) was used to assess testicular volume and blood flow before and after a modified Ferguson technique surgery. The pre- and post operative testicular volume and blood flow were compared with the contralateral testes. SPSS software was used to statistically analyze the data arising; the Mann-Whitney U test and Friedman test were used to compare samples, and P<0.05 was accepted as statistically significant. Results: Preoperative and postoperative testicular volumes were not statistically different when compared to contralateral testes. In patients with right sided inguinal pathology, testicular blood flow on the right side was significantly lower than that on the left side (P=0.023). The testicular blood flow was not statistically different compared with the contralateral testes during the first week evaluation and first month evaluation. The blood flow, probably reduced due to the pressure caused by inguinal pathology, was normalized through surgery. Conclusions: The modified Ferguson technique do not change the testes volume and blood flow.

ÇOCUKLUK ÇAĞI ARAÇ DIŞI TRAFİK KAZALARININ EPİDEMİYOLOJİSİ

Objective. This study aims to evaluate whether alpha-lipoic acid and/or coenzyme Q10 can protect the prepubertal ovarian tissue from ischemia-reperfusion injury in an experimental rat model of ovarian torsion. Materials and Methods. Forty-two female preadolescent Wistar-Albino rats were divided into 6 equal groups randomly. The sham group had laparotomy without torsion; the other groups had torsion/detorsion procedure. After undergoing torsion, group 2 received saline, group 3 received olive oil, group 4 received alpha-lipoic acid, group 5 received coenzyme Q10, and group 6 received both alpha-lipoic acid and coenzyme Q10 orally. The oxidant-antioxidant statuses of these groups were compared using biochemical measurement of oxidized/reduced glutathione, glutathione peroxidase and malondialdehyde, pathological evaluation of damage and apoptosis within the ovarian tissue, and immunohistochemical assessment of nitric oxide synthase. Results. The left ovaries of the alpha-lipoic acid + coenzyme Q10 group had significantly lower apoptosis scores and significantly higher nitric oxide synthase content than the left ovaries of the control groups. The alpha-lipoic acid + coenzyme Q10 group had significantly higher glutathione peroxidase levels and serum malondialdehyde concentrations than the sham group. Conclusions. The combination of alpha-lipoic acid and coenzyme Q10 has beneficial effects on oxidative stress induced by ischemia-reperfusion injury related to ovarian torsion.

The Reason for the Rare Scrotal Mass in the Newborn: Antenatal Intravaginal Torsion of the Testis

AMAC: Cocukluk yas grubunda arac disi trafik kazalarina ait epidemiyolojik verilerin incelenmesi ve bu kazalari onlemeye yonelik olarak cesitli risk faktorlerinin belirlenmesi. GEREC VE YONTEM: Bir universite acil servisine basvuran bes yillik trafik kazasi kayitlari icinden 0-18 yas grubuna ait arac disi trafik kazalari (ADTK) retrospektif olarak incelendi. Kaza kodlari, yas, cinsiyet, kazanin sehir icinde veya sehir disinda olmasi, saati, gun, ay, kaza sirasinda aile birlikteligi, yaralanan organ sistemleri, hastaneye yatis olup olmadigi, yatan hastalarin yatis sureleri ve sonuc kaydedildi. Elde edilen veriler uygun istatistiksel yontemler kullanilarak degerlendirildiler. BULGULAR: Toplam 272 kayit incelendi. Cinsiyetlere gore dagilim 178 erkek (%65,4), 94 kiz (%34,6) seklindedir. Aylara gore dagilima bakildiginda %22,8 ile Eylul ayi kazalarin en cok gerceklestigi ay, %2,9 ile Ocak ve Şubat aylari kazalarin en az gerceklestigi aylar olarak tespit edilmistir. Verilere gore %16,5 ile Sali gunu kazalarin en cok gerceklestigi gun iken, %10,7 ile Cumartesi kazalarin en az gerceklestigi gun olmustur. En sik kaza gorulen saatler 08:00-15:59 (138 cocuk, %50.7) ve 16:00-23:59 saatleri (119 cocuk, %43.8) arasidir. Kazalarin %63.6’sinin sehir icinde oldugu, %51.7’sinin cocuk ailesiyle birlikte degilken gerceklestigi ogrenildi. Toplam 12 hastada kaza sonrasi epilepsi, ensefalopati, serebral palsi, isitme kaybi, spastik hemipleji, fasiyal sinir bozuklugu, fleksiyon kisitliligi seklinde kalici sakatliklarin olustugu, 6 hastanin (%2,2) da kaybedildigi tespit edilmistir. SONUC: Ozellikle erkek cocuklari Eylul ayinda, sehir icinde, mesai saatlerinde daha fazla kazaya maruz kalmistir. Kazalarin artis nedenlerinin ve onleme yollarinin saptanabilmesi icin ek calismalar gerekmektedir

Evlerdeki Gizli Tehlike; Turşu Kur İçmeye Bağlı Özofagus Korozyonu

©Copyright 2017 by the Association of Urological Surgery / Journal of Urological Surgery published by Galenos Publishing House. Correspondence: Ahmet Ali Tuncer MD, Afyon Kocatepe University Faculty of Medicine, Department of Pediatric Surgery, Afyonkarahisar, Turkiye Phone: +90 505 948 93 71 E-mail: drtaali@yahoo.com Received: 08.02.2017 Accepted: 06.03.2017 Intravaginal testicular torsion is a very rare pathology in the neonatal period. However, it is seen most commonly torsion type in puberty. In this article, we presented a male patient with a scrotal hyperemia and an abnormal mass in the testis. According to the ultrasonographic examination, a patient had an antenatal intravaginal testicular torsion and no testicular blood flow was observed. This article was written to draw attention to the importance of neonatal examination and to remind us of testicular torsion which is a rare pathology in newborns with scrotal colour change or the presence of an abnormal mass.

External genital injuries in childhood: obey the rules and detect the unseen

Esophageal burns due to caustic substance ingestion are frequently observed in developing countries. In this report a 4-year-old girl is presented with esophageal burn due to the inges