Erol Basuguy

Congenital-infantile fibrosarcoma of the ileocecal region: the first case presentation.

Infantile fibrosarcoma is a very rare soft tissue tumor that originates most commonly in the body and extremities. We present a neonate with an infantile fibrosarcoma that originated in the ileocecal region and was detected incidentally without symptoms. This is the first case of fibrosarcoma reported in the ileocecal region.

A new experimental rat model of pancreatitis using Ecballium elaterium

BACKGROUND We originally aimed to determine the beneficial effects of Ecballium Elaterium (EE) on acute pancreatitis; however, we observed negative effects of EE on the pancreas. Thus, we used EE in rats to generate a new model of pancreatitis, which we compared with other established pancreatitis models. METHODS A total of 32 Wistar albino rats were used. Rats were divided into 4 groups, each of which contained 8 rats. Group 1 (Control), Group 2 (L-Arginine (LA), Group 3 (LA + EE), Group 4 (EE): Twenty-four hours after that serum parameters were analyzed in the collected blood. Blood samples were transported on mice to the Biochemistry Laboratory following cardiac puncture. The levels of amylase, interleukin (IL)-6, interleukin (IL) 1-β (IL-1β), malondialdhyde (MDA), tumor necrosis factor (TNF)-α, total antioxidant status (TAS), and total oxidant status (TOS) were analyzed. Histopathological analysis: The pancreas and lung tissue samples obtained from the rats. Edema, inflammation, vacuolization, and necrosis of the pancreas were assessed using a scoring system ranging from 0 to 4. Edema, hemorrhage and inflammation of the lung tissue were evaluated using a scoring system ranging from 0 to 3. RESULTS Histopathological analysis revealed that edema, inflammation, necrosis, and hemorrhage were significantly higher in the LA + EE group than in the control group. Moreover, necrosis was higher in the rats that received LA and EE compared to the rats that received only LA or EE. Increases in inflammatory mediator levels, including IL-6, IL-1β, TNF-α, MDA, and TOS, were observed in all groups as compared to the control group. Moreover, lower TAS levels were detected in all groups but the control group. The increase in IL-1β and TNF-α levels and the decrease in TAS were statistically significant in all groups (P < 0.05). CONCLUSIONS EE may be used to create a successful acute pancreatitis (AP) model, resulting in edema, necrosis, hemorrhage, and inflammation of the pancreas. The major advantage of this model is that it does not require laparotomy, and can be implemented with only an intraperitoneal injection (IP). Moreover, EE may be combined with other agents, such as LA, to create severe pancreatitis. Further molecular studies are warranted to determine the underlying effects of EE on the pancreas.

Protective Effect of Cordycepin on Experimental Testicular Ischemia/Reperfusion Injury in Rats

ABSTRACT Objective: To investigate the role of cordycepin in testicular ischemia/reperfusion injury in rats. Materials and methods: Forty Wistar albino rats were randomly divided into four groups, as follows: group one, control (C); group two, torsion and ischemia (I); group three: detorsion with ischemia–reperfusion (IR); and group four, detorsion/cordycepin. The rats were then analyzed macromorphologically and histopathologically, and blood tests were performed. Specifically, the total oxidant status (TOS) and total antioxidant status (TAS) were determined, and malondialdehyde (MDA), tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-1β levels were analyzed. In addition, pyknotic nuclei, spermatozoa, edema, and hemorrhage were assessed. Results: When the IR and cordycepin groups were compared with the other groups, there was a statistically significant decrease in TNF-α and MDA levels (p < 0.05). Increased TAS levels were observed in the cordycepin group compared with the control group. TOS levels were significantly increased in the I and IR groups, but decreased in the cordycepin group (p < 0.05). Similar effects were observed in tissue biochemistry analysis. Histopathological evaluations revealed that the spermatozoa count was decreased in the I and IR groups. However, there was an increase in the cordycepin group, as well as a statistically significant difference between the IR and cordycepin groups (p < 0.01). Finally, edema and inflammation were increased in the I and IR groups, but decreased in the cordycepin group. Conclusions: Histological and biochemical findings revealed that cordycepin protected against IR-induced testicular injury.

Effects of Ecballium Elaterium on Proinflammatory Cytokines in a Rat Model of Sepsis.

ABSTRACT Objective: Ecballium elaterium (EE) is a plant from Cucurbitaceae family. Its anti-inflammatory role in sepsis is not well understood. We investigated the effects of EE on serum levels of proinflammatory cytokines and further explored the mechanisms underlying histological changes in liver and ileum following EE administration in a polymicrobial sepsis model. Methods: Thirty rats were divided into three groups of 10 rats each. Rats were subjected to sham laparotomy plus normal saline administration (control group, CG), laparotomy with cecal ligation and puncture (CLP) (sepsis group, SG), and laparotomy with CLP plus 2.5 mg/kg EE administration (experimental group, EG). Twenty-four hours after laparotomy, animals underwent cardiac puncture, and blood was collected for interleukin 1 (IL-1), interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-α) assessment. Whole sections of liver and ileum tissues were collected for histologic examination. Results: The serum level of IL-6 was significantly lower in EG as compared to SG. Although IL-6 levels were shown a statistically significant (p < 0.0001) decline to near control values, no significant changes were observed in serum levels of IL-1 and TNF-α after EE treatment. Histologic examination revealed statistically significant reduction in collagen formation (p = 0.001) on serosal surface of ileum and hepatic venous congestion (p = 0.040) in EG as compared to SG. Conclusion: EE might play a protective role in sepsis prevention and treatment by decreasing IL-6 production and reducing liver damage and may influence bacterial translocation by reinforcing intestinal barrier function.

Type II A2 duplication of urethra in an 8-month-old male child: A case report

Urethral duplication is a rare congenital anomaly, usually found with multiple anatomical variants. In this article was presented a case of urethral duplication in an 8-month-old male child. The malformation was characterized by the presence of continent hypospadic and normal apical urethra. Retrograde urethrogram through both urethral tracts simultaneously revealed the malformation as Effmann Type II A-2. The accessory ventral urethra was excised without complication.

Bilateral renal agenesis, a severe anomaly in a premature infant with VACTERL association: A case report

We report on a preterm male (birth weight 1,100 g) with bilateral renal agenesis, a lethal malformation. Additionally, the child suffered from an atrial septal defect, ventricular septal defect, right aortic arch anomaly, a high type of anal atresia, vertebral anomalies, limbs defects (VACTERL association). The infant during first day of life was treated with an emergency sigmoid ostomy and peritoneal dialysis because of increasing abdominal dilatation and high urea and creatinine levels in blood. Important congenital anomalies associated with VACTERL association and prematurity are very serious causes of mortality in the early period.

The Outcome of Percutaneous Nephrolithotomy Using Intravenous Catheter for Obtaining Percutaneous Access as a Treatment for Renal Stone Disease in Children: A Pilot Study

PURPOSE Using percutaneous nephrolithotomy (PNL), it is easy to reach stones in various parts of the kidney via a single access tract. In the current study, we set out to demonstrate that the intravenous catheter is a safe way to gain renal access, and that PNL is safe in children. MATERIALS AND METHODS We retrospectively reviewed the medical records of patients who underwent PNL as a treatment for renal stone disease at our center between September 2013 and December 2014. There were no specific exclusion criteria. We used 14 gauge intravenous catheter for renal access in all cases. RESULTS Eleven of the 32 patients (34.4%) were female and 21 (65.6%) were male. The mean ± SD patient age was 4.7 ± 3.71 years (9 months-16 years). Six patients (18.7%) were infants less than 1 year of age. Fifteen of the stones (46.8%) were located in the right kidney, and 17 of the stones (53.1%) were located in the left kidney. The average stone size was 13.9 ± 4.8 mm (range, 12-28). The average duration of operation was 69.7 ± 10.4 minutes (range, 50-110), and the average duration of fluoroscopy was 2.21 ± 1.06 minutes (range, 1-6). There were complications in 5 of the cases (15.6%). CONCLUSION The access and dilatation stages are quite important. We propose that the intravenous catheter is a safe and inexpensive tool for renal access in PNL in pediatric age group patients.

Cordycepin prevents postoperative formation of intra-abdominal adhesion in a rat model: An experimental study

BACKGROUND The aim of the present study was to investigate whether cordycepin prevented adhesion formation in a rat model. METHODS Rats were randomly assigned to 3 groups of 10 rats. CONTROL GROUP The absence of adhesion was confirmed via laparotomy. Adhesion group: The cecum was removed from the abdomen and scraped with a dry gauze bandage until petechial hemorrhagic foci developed. Cordycepin group: The same surgical procedure was performed as in the adhesion group, and 10 mg/kg cordycepin was administered intraperitoneally. After 15 days, the rats were sacrificed humanely via cardiac blood withdrawal under anesthesia. The rats were then analyzed morphologically and histopathologically, and hydroxyproline (OH-p) and malondialdehyde (MDA) levels were measured. RESULTS Macroscopic analysis revealed significantly less adhesion in the cordycepin group than in the adhesion group (p<0.01). Furthermore, significant histopathological improvement was also evident in the cordycepin group compared to the adhesion group (p<0.05). The levels of OH-p and MDA in blood and tissue were higher in the adhesion group than in the control group, and lower in the cordycepin group than the adhesion group. Interestingly, MDA level was significantly lower (blood: p<0.05; tissue: p<0.01) in the cordycepin group than in the adhesion group, whereas only tissue OH-p was significantly lower in the cordycepin group compared with the adhesion group (p<0.05). One rat in both adhesion group and cordycepin group died postoperatively. CONCLUSION Results indicated that cordycepin effectively reduced adhesion in a rat abrasion model. Thus, this agent may be valuable to prevent postoperative adhesion.

Analysis of Risk Factors for Appendicitis in Children: A Multicenter Epidemiological Study

Objective: At the present times uterus transplantation is an alternative therapy for women with untreatable uterine-based infertility factors. Before transplantation, the donor organ must stored in some solutions, but they may not adequate for protection. In this study, we investigated the potential protective effects of acetyl L-carnitine, added into histidine-tryptophanketoglutarate (HTK) solution, on rat uterus. Methods: We divided 24 female Wistar Albino rats into four groups (n=6). Their uterine tissues were stored into four different solutions at different periods at 4oC ; Group 1 HTK, 4 hours; Group 2. HTK + acetyl L- carnitine, 4 hours, Group 3. HTK, 24 hours; Group 4. HTK + acetyl L- carnitine, 24 hours. Then tissues from uterus were used for histological and biochemical examination. Results: In the study the number of TUNEL positive cells in group 4 was lower than group 3. Biochemically evaluated TBARS and NOS levels were highest in group 3 however CAT level was highest in group 2. Conclusion: In conclusion, addition of acetyl L-carnitine to HTK solution reversed the histological alterations after 24 hours cold storage on rat uterus.Amac: Uriner sistem tas hastaliginin endourolojik tedavisinde ki gelismeler birincil secenek tedavi yontemleriyle ilgili tartismalara yol acmistir. Bu calismamizda, bobrek alt pol tasi olan hastalara klinigimizde uygulanan Ekstrakorporeal Şok dalga litotripsi (ESWL) tedavisinin sonuclari incelenmistir.Yontemler: Ocak- Temmuz 2013 tarihleri arasinda kontrastsiz bilgisayarli tomografi (BT) sonucuyla teshis edilip klinigimizde ESWL uygulanan 271 bobrek tasi hastasinin kayitlari retrospektif olarak incelendi. Tedavi oncesi ya da sonrasi izlemlerde kontrastsiz BT filmleri olmayan ve ESWL tedavisi tamamlanmayan hastalar calisma disi birakilmistir. 52 hasta, ESWL basarisina gore iki gruba ayrilmistir. ESWL basarisi, tasin buyuklugu, tasin yogunlugu ve tasin cilde olan uzakligi; kontrastsiz BT kayitlarinin incelenmesi ile saglanmistir.Bulgular: Calismamiz, 28 (%54) erkek ve 24 (%46) bayan hastadan olusmaktadir. Ortalama yas 46±12,3 (2173) idi. ESWL tedavisi alan ve calismaya dahil edilen 52 hastanin 24’u (%46,2) tedaviden fayda gormustur, 28’i (%53,8) tedaviden fayda gormemistir. Ortalama tas boyutu 9.8 mm (6-17 mm), ortalama tas-cilt mesafesi 93 mm idi, ortalama tas yogunlugu 845 HU idi. Tartisma: ESWL tedavisi bobrek alt pol taslarinda hala non-invaziv ve basarili bir yontemdir. ESWL basarisi degerlendirilirken secilen goruntuleme yontemi onemlidir ve abdominal BT’nin kullanimi dogru degerlendirme saglar. Minimal invaziv tedavi yontemlerinin yuksek basari oranlari umut vericidir ve gelecekteki tedavi yontemlerinin degisimine neden olabilirObjective: The aim of this study was to provide information on utilization of home health care services provided by government and determine health status of children and young people who received this medical care. Methods: Data for 576 patients who were followed and recorded by the health staff of the Ministry of Health between 2010 and 2015 were used in this study. Of these patients 234 (40.63 %) were female and 342 (59.37%) were male. The patients were divided into three age groups: 0-6 years of age: 93(16.15%), 7–14 years of age:219 (38.02%), and 15–22 years of age: 264 (45.83%). Results: There was no significant difference in gender between the age groups (χ2=1.077, p>0.05). In 2015, there was an increase in the prevalence of home care services across all age groups (χ2=38.734, p<0.01). Diyarbakir Children Hospital was more efficient than other hospitals (χ2=42.230, p<0.01) in providing this medical care. The most common diseases seen among these young patients were central nervous system diseases, neurodevelopmental diseases, and acquired brain injuries. In addition, epilepsy, SSPE, and cerebral palsy were also widely prevalent among this group of children and youth. The prevalence of cerebral palsy was larger in the 0–6 and 15–22 age groups (χ2=6.491, p<0.05). A prevalence of central nervous system diseases was seen most in the 0–6 age group (χ2=11.937, p<0.01). Apart from these, there were no other significance diseases observed by gender or age groups. Conclusion: After favorable adjustments to public home care services, an increase was seen in the utilization of services in recent years. As disabled patients need health care in their homes, this service has to be a primary goal for governments in order to provide them with a higher quality of life.Objectives: Papillary thyroid cancer (PTC) is the most common endocrine malignancy and the most common genetic anomaly with PTC is the BRAF V600E mutation. This mutation is linked to many clinical and pathological features and may have a diagnostic and therapeutic role especially in the era of targeted therapy. The aim of this study is to review the prevalence of BRAF V600E mutation in PTC, its distribution according to the histological subtype and geographic area and its association with the age of patients, gender, subtype and recurrence of tumors. Methods: The Pubmed database was searched to look for articles about BRAF mutation in PTC. Outcomes of interest included prevalence, age, gender, country, subtype and recurrence. Results: The prevalence of BRAF V600E mutation in PTC was 47%, with noticeably higher prevalence in the eastern countries. The prevalence of BRAF V600E was also higher in the tall and classic subtypes and could be associated with worse prognosis and higher risk of recurrence. Conclusions: The BRAF mutation, which is more prevalent in the eastern countries, is determined to be an important molecular marker for PTC.Objectives: In our study, the assessment of age, gender, incidence and seasonal differences in the regions related to appendicitis were investigated. Methods: 676 patients that received an operation following a diagnosis of appendicitis in 3 hospitals from 3 different regions of Turkey occurring at different dates were examined retrospectively after being categorized by region. The differences among groups were compared to each. Results: The mean age of male (63%) (n = 426) and female (37%) (n = 250) patients (total = 676) was 10.8 years (range, 1–18 years). The percentage of female patients in the The Black Sea Region (BR) group was significantly higher (48%) than that in the other two groups (%33 for SR, 30% for MR) (P = 0.001). The frequency of appendicitis was higher (36%) in the spring and winter (25%) than that during summer or fall. The number of cases increased the most in the BR group in spring (47%) (P < 0.001). When the types of appendicitis in the different age groups were compared with season, acute appendicitis (P < 0.02) was more frequently (93%) seen in the child-adolesan (CA) group in the spring; however, perfore apandicitis (45%) was greater in the Infant-Preschool (IPS) group (P < 0.02). Acute appendicitis comprised 55% and perforated appendicitis comprised 45% of cases in the IPS group, whereas acute appendicitis comprised 78% and perforated appendicitis comprised 22% in the CA group. Conclusion: According to the results of our study, appendicitis was most frequently seen in the spring and winter seasons and more frequent in boys between the ages of 10-13 years. As age decreases, the frequency of perforated appendicitis increases. Appendicitis is affected by environmental factors. Reducing the incidence of appendicitis may be possible by establishing regional and specific studies related to this subject and the etiologies of the disease.

Acute abdomen caused by spontaneous perforation of the urinary bladder in childhood: Report of one case

Spontaneous urinary bladder rupture in children is a very rare clinical occurrence that can be life threatening if left untreated. Patients usually present with symptoms of peritonitis and the correct diagnosis is usually made at surgery. Here, we present a case of spontaneous bladder perforation that was operated with a diagnosis of acute abdomen. No etiological factor for bladder perforation was found, and after the operation, the patient experienced no further problems.