Ender Aritürk

Risk factors influencing inadvertent hypothermia in infants and neonates during anesthesia

Background : The factors affecting the thermal status in neonates and infants undergoing general anesthesia are not yet investigated in detail. We evaluated the factors leading to intraoperative hypothermia in 60 neonates and infants.

A rare cause of chronic rectal bleeding in children; solitary rectal ulcer: case report.

Alt gastrointestinal kanamaya neden olan soliter rektal ulser, cocuklarda oldukca nadir gorulur. Nadir gorulmesi, ozgun olmayan bulgularla ortaya cikmasi, bu konuda yeterli deneyimin olmamasi ve cesitli rektal hastaliklari taklit etmesi, bazi cocuk hastalarda yanlis veya gecikmis taniya neden olabilmektedir. Burada, belirtilerin baslangicindan 2 yil sonra tanisi konan, yuksek lifli diyet, laksatif, tuvalet egitimi ve sukralfat lavman tedavisine iyi yanit veren soliter rektal ulserli 10 yasindaki bir olgu sunuldu.

Pilor atrezisi ve epidermolizis bülloza birlikteliği: İki olgu sunumu ve literatür derlemesi

The coexistence of pyloric atresia (PA) and epidermolysis bullosa (EB) is a rare but well-known surgical emergency in neonates. PA/EB is described by the association of atresia of the pylorus and bullous lesions on the skin. Ninety one cases have been reported in the literature to date. We present two new cases and evaluate the association of PA/ EB, its etiopathogenesis and the clinical properties. Case 1: A three-day-old female presented with nonbilious vomiting and bullous lesions 2-3 cm in diameter on the extremities. Abdominal X-ray showed a single air-fluid level in the left upper quadrant. At laparotomy, we found PA and performed a pyloro-pylorostomy. The patient died due to sepsis complication of EB two months after surgery. Case 2: A two-day-old male presented with severe dermal bullous lesions on the trunk, neck and extremities. His stomach was dilated and there was no gas distally. We found PA and performed gastroduodenostomy. Initially, he tolerated the feeding well, but he died due to severe sepsis on the postoperative 23rd day. Almost all neonates born with the PA/EB result in a fatal outcome in the first few years. The complications related to EB are usually the cause of death. Even after successful repair of PA, skin lesions lead to death due to infection.

Effects of splenohepatopexy and omentopexy in experimentally induced infrahepatic portal hypertension in rats

The purpose of this study was to determine whether splenohepatopexy (SHP) or omental transposition (OP) could reverse the portal hypertension (PH) induced by portal vein ligation (PVL). Fifty-eight Wistar rats divided into four groups: in group A (22 rats) PH was produced by calibrated PVL. In group B (8 rats), SHP was performed. Group C animals (13 rats) underwent SHP and PVL. In group D (15 rats) both PVL and OP were done. In all of the rats, the portal pressures (PP) were measured before and after the production of PVL. For SHP, small areas on the spleen and liver capsula were stripped off, and these two areas were placed together. In group D, an omentum patch was tied on the prepared liver surface. Twelve weeks after surgery, the PP were measured again and portal angiography was done. The liver, omentum and spleen were histopathologically examined. In all of the groups, the PP after PVL were significantly higher than before PVL. Twelve weeks after surgery, the PP of SHP and OP groups were significantly lower than those with PVL alone. Angiographic study showed many collaterals between transposed tissue and liver. Histopathologically, the collaterals of animals with SHP or OP were found to be well developed to allow sufficient flow for PP reduction. Both SHP and OP may reverse the increased PP in PVL model of PH. In the future; these methods may be alternative techniques for PP reduction in human beings as well.

Vesico-diverticular fistula : an unusual presentation of Meckel's diverticulum

A vesico-diverticular fistula in a 4-year-old child is described. Histologically, the diverticulum showed normal mucosal epithelium without ectopic mucosa. The literature is reviewed and possible explanations of fistula formation are discussed.

A Case Report: Thoracoscopic Diagnosis Of Right-Sided Traumatic Diaphragmatic Rupture

The diagnosis of traumatic diaphragmatic rupture is relatively easy on the left side, but is frequently difficult on the right, partly because the herniated organ is usually the liver. A right-sided diaphragmatic rupture due to gun shot injury in a 13 year-old boy, diagno¬sed by thoracoscopy, is reported. Torakoabdominal travmali hastalarda diafragma rupturu tanisi sol tarafta daha kolaydir. Sag diafragmatik ruptur teshisi, diafragma altindaki karacigerin diger organlarin toraks icine fitiklasmasini engellenmesi nedeniyle, zordur. Atesli silah yaralanmasi ile gelen 13 yasindaki bir erkek hastada sag diafragma rupturu, suphe uzerine yapilan torakoskopi ile konulmustur.

Yenidoğanda Soğuk Buhar Uygulamasının Boğaz Florası Üzerine Etkisi

It is essentially important to perform the ventilatory management to hospitalized or opera¬ted newborns. However, the cold steam inhalation is acceptable in some of the newborn units and not acceptable in some others. In our study, we designed two groups included the newborns without steam therapy in the first group (n: 12) and the second group with steam therapy (n: 40) in order to evaluate the effects of cold steam inhalation on throat flora of the newborns. The pathological microorganisms were identified 40% in the first group and 38.5% in the second. Here, in this study, we did not determinate any signifi¬cant difference between two groups Yenidogan doneminde hospitalize edilen ya da operasyon uygulanan hastalara verilecek solunum destegi son derece onemlidir. Ancak yenidogan doneminde soguk buhar uygula¬masi bazi merkezlerde kullanilirken bazi merkezlerde ise bu uygulamadan kacinilmaktadir. Bu nedenle calismamizda, buhar tatbik edilen ve edilmeyen olarak iki grup olusturuldu ve 52 yenidoganda soguk buharin bogaz florasi uzerine etkileri incelen¬di. Yenidoganlardan soguk buhar uygulamasinin oncesinde ve sonrasinda bogaz kulturleri alinarak floradaki degisiklikler saptandi. Birinci grupta patolojik ureme %40 iken, ikinci grupta bu oran %38.5 olmustur. Her iki grup arasinda ureyen mikroorganiz¬malarin turu acisindan da belirgin fark gozlenmemistir. Calismamizda, yenidogan doneminde soguk buhar uygulamasinin bogaz florasi uzerine belirgin etkisinin olmadigi sonucu ortaya cikmistir

Cycle loading tissue expansion of rat jejunum

Cycle loading was applied to 40 Sprague-Dawley rat jejunums to increase their diameters using a balloon catheter filled with saline over a 30-min period, with each load lasting 3 min at 1-min intervals. The dilations were performed using 0.2 ml saline in group I, 0.4 ml saline in group II, 0.6 ml saline in group III, and no dilation in the control group. The percentage increments of increase in external jejunal diameter were 10.52 in group I, 48.38 in group II, and 68.08 in group III. Histologic changes were reversible in groups I and II and irreversible in group III. It is suggested that cycle-loading tissue expansion could be used as an alternative method for the treatment of intestinal atresias to correct discrepancies in the caliber of gastrointestinal lunens.

Çocuklarda Trakeobronşial Yabancı Cisim Aspirasyonu

TRACHEOBRONCHIAL FOREIGN BODIES ASPIRATION IN CHILDREN %/ From January 1992 to March 1994, 58 cases were observed and treated because of trac-heobronchial foreign bodies aspiration. These cases were evaluated retrospectively with the review of the literature. The yougest one was at 7 months old ant the oldest one was at 16 years old. All of the foreign bodies were removed with rigit bronchoscope except two which removed by open thoracotomy. In our cases the most of the foreign bodies were the needles which use to close the head wraps by the muslim women (38%). These findings were found very interesting and not correlated with the literature. Klinigimizde Ocak 1992-Mart 1994 tarihleri arasinda trakeobronsial yabanci cisim aspirasyonu nedeniyle takip ve tedavi edilen 58 olgu literatur esliginde retrospektif olarak degerlendirildi. En kucugu 7 aylik ve en buyugu 16 yasinda olan olgularimizdan ikisinde yabanci cisim torakotomi ile cikartilirken, digerlerinin tumu rijit bronkoskop ile cikartildi. Olgularimizda yabanci cisim aspirasyonunun en sik 12-16 yas grubunda olmasi (%34.5) ve en sik aspire edilen yabanci cismin teseddur ignesi olusu (%38) dikkat cekicidir ve bu ozellikleri ile literaturle uyum gostermemektedir.

Sensory nerve endings in the anal canal: increasing patterns with age

Eleven fetuses and 9 newborns were examined for sensory innervation of the anorectal area. The specimens were obtained immediately after death and were stained by the modified Gross silver impregnation method and examined with a light microscope. The perianal skin and rectal mucosa did not differ in either group. The anal canals of the fetuses had numerous thin, singly- and doubly-branched nerve endings with 1.0 to 1.5 μm axonal diameters. Paccinian-type lamellated corpuscles were few and contained 3–5 fibroblastic lamellae and had a diameter of 70–100 μm. The newborn group had more prominent subepithelial free nerve endings with 2.0 to 2.5-μm axonal diameters, mostly myelinated and with numerous Paccinian corpuscles with 8–10 lamellae and diameters of 100–150 μm. Globular endings were fewer and smaller in the fetal group. Muscle spindles were seen embedded in the external sphincter muscle bundles of both groups. We conclude that this pattern of sensory nerve endings indicates a time-dependent developmental process in the human anal canal.