Hacer Ergin

Prevalence of tonsillar hypertrophy and associated oropharyngeal symptoms in primary school children in Denizli, Turkey

OBJECTIVE The purpose of this study is to investigate the prevalence of tonsillar hypertrophy and associated oropharyngeal symptoms in primary school children. METHODS The study was performed in two primary schools which were chosen randomly in Denizli. Size of the tonsils was evaluated and scored on a five-point scale and weights of children were measured. The mothers or primary caregivers of children were asked to fill a questionnaire that included questions concerning the associated symptoms of tonsillar hypertrophy. The interrelations between tonsillar hypertrophy and other studied items were examined by chi(2) tests. RESULTS The study population consisted of 1211 (636 boys, 575 girls) primary school children between 6 and 13 years old (mean 9.3+/-2 years). Prevalence of tonsillar hypertrophy in school children was found as (133) 11% in the school children. There were a statistically significant association between tonsillar hypertrophy and history of frequently having tonsillitis, habitual snoring, observed apnea, oral breathing during sleep and difficulty eating. CONCLUSION The prevalence of tonsillar hypertrophy was found to be 11% in school children in Denizli, Turkey. Primary school children with tonsillar hypertrophy have signs and symptoms of frequent upper airway infections and upper airway obstruction so they need further evaluation for associated oropharyngeal symptoms of tonsillar hypertrophy.

Electrophysiological assessment of the brain function in term SGA infants.

Small for gestational age (SGA) infants are defined as babies having a birth weight below the 10th percentile for gestational age. A great number of studies have shown that children with SGA have an increased risk of impaired neurodevelopment. Electroencephalography (EEG) is an excellent method for measuring brain maturation in newborns. In this study, the effect of SGA on the maturation of cerebrocortical electrographic activity was investigated by the EEG and also analyzed with power spectral analysis. Serial EEGs were performed in 40 term SGAs, and 20 term appropriate for gestational age (AGA) infants in 1st week, 1st and 3rd month. Power spectral analysis was performed quantitatively in five channels (Fp1-C3, C3-O1, Fp2-C4, C4-O2, and Cz-C4 channels). Amplitude levels of the SGA group were significantly lower than the AGA group in all records. Delta frequency was the major frequency component in the groups. Delta frequency activities in the midline vertex region were decreased in the AGA group with increasing postconceptual age while the activities of the SGA group were increased. Contrarily, beta frequency activities in the midline vertex region were increased in the AGA group with increasing postconceptual age while these activities of the SGA group were decreased. Theta frequency activities in the fronto-central regions were lower in the SGA group. In terms of the vertex, k-complex, and sleep spindle, there was no difference between the two groups. We conclude that cerebrocortical electrophysiological maturation has been delayed in term SGA infants during the first three months of postnatal life.

Protective effects of clarithromycin in rats with hypoxia/reoxygenation-induced intestinal injury.

BACKGROUND This study was designed to determine the role of oxidative stress, nitric oxide (NO), and glutathione-related antioxidant enzymes in rat pups with hypoxia/reoxygenation (H/R)-induced bowel injury and to evaluate the potential benefits of prophylactic clarithromycin. METHODS One-day-old Wistar albino rat pups (N = 21) were randomly divided into 3 groups: group I (control), group II (exposed to H/R), and group III (clarithromycin + H/R). Clarithromycin was administered (40 mg/kg) subcutaneously to group III for 3 days. On the fourth day, all rats except controls were exposed to H/R and were killed at 6 hours after H/R. Histopathologic injury scores (HIS), malonyldialdehyde, glutathione (GSH), glutathione-peroxidase (GSH-Px) activities, and NO levels were measured on intestinal samples. RESULTS Whereas there was no difference for malonyldialdehyde levels among groups, HIS and NO levels were higher in group II than groups I and III (P < .05). However, GSH and GSH-Px activities were lower in group II than groups I and III (P < .05). Clarithromycin significantly increased GSH and GSH-Px activities and reduced HIS and NO levels in group III. CONCLUSION This study showed that oxidative stress and NO contributed to the pathogenesis of H/R-induced bowel injury and that clarithromycin had a protective effect on bowel injury owing to anti-inflammatory and antioxidant effects.

A Prenatally Detected Case of Congenital Hepatoblastoma

Hepatoblastoma is a rare tumor of childhood and its incidence in the first year of life is about one in a million. Forty-two congenital hepatoblastoma cases were reported so far. Among 42 congenital hepatoblastoma patients, only seven cases have been detected in the prenatal period. Here we report a rare case diagnosed before birth and confirmed by postmortem autopsy.

Protective effects of Ginkgo biloba extract in rats with hypoxia/reoxygenation-induced intestinal injury.

BACKGROUND The purpose of this study is to investigate the protective effects of Ginkgo biloba extract (EGb 761) in rat pups with hypoxia/reoxygenation (H/R)-induced bowel injury. METHODS One-day-old Wistar albino rat pups (n = 21) were randomly divided into 3 groups: group 1 (control, untreated and not exposed to H/R, n = 7), group 2 (untreated but exposed to H/R, n = 7), and group 3 (EGb 761 + H/R, n = 7). Ginkgo biloba extract was administered (100 mg/kg per day, subcutaneously) to group 3 for 3 days. On the fourth day, all animals except controls were exposed to H/R and were killed 6 hours after H/R. Histopathologic injury scores (HIS), malondialdehyde, glutathione (GSH), GSH-peroxidase (Px) activities, and nitric oxide (NO) levels were measured on intestinal samples. RESULTS Although the control group had normal HIS, group 2 had grade 3 HIS. In contrast, group 3 had minimal HIS, and these results were significantly better than those of group 2 (P < .001). Malondialdehyde and NO levels of group 3 were significantly lower than those of group 2 (P < .01). Glutathione and GSH-Px activities of group 1 were higher than those of groups 2 and 3 (P < .05). However, there were no significant differences for GSH and GSH-Px activities between groups 2 and 3. CONCLUSIONS This study showed that hypoxia and NO contributed to the pathogenesis of H/R-induced intestinal injury and that prophylactically administered EGb 761 had a protective effect on bowel injury.

Calcinosis Cutis in a Newborn with Transient Pseudohypoparathyroidism

Pseudohypoparathyroidism (PHP) is a heterogenous group of disorders characterized by hypocalcemia with hyperphosphatemia, increased serum concentration of parathyroid hormone (PTH), and insensitivity to the biological activity of PTH. Calcinosis cutis, the cutaneous deposition of calcium salts in the dermis, is a rare clinical symptom in infancy. The deposition of calcium in the skin may be classified as dystrophic, metastatic, idiopathic, and iatrogenic. Although a few infants with PHP and calcinosis cutis have been reported, to the authors’ knowledge, the combination of neonatal transient PHP and calcinosis cutis associated with calcium treatment has not been previously reported. The authors report a newborn boy with transient PHP presenting with early hypocalcemia, hyperphosphatemia, increased PTH levels, and calcinosis cutis after intravenous treatment of calcium gluconate.

The role of UGT1A1 promoter polymorphism and exon-1 mutations in neonatal jaundice

Abstract Objective: In the present study, we investigated the effects of promoter polymorphism and an exon-1 mutation (G71R) in the UGT1A1 gene in neonates with unexplained hyperbilirubinemia and direct Coombs-negative [DC(–)] ABO incompatibility. Methods: Two-hundred term neonates in their first week of life and without additional icterogenic factors were included in the study. Neonates with a serum total bilirubin (STB) level ≥17 mg/dL constituted the hyperbilirubinemia group (n = 100), while the control group comprised healthy neonates with a STB level <12.9 mg/dL (n = 100). The cases were further subdivided into unexplained hyperbilirubinemia (n = 50), ABO(+) hyperbilirubinemia (n = 50), ABO(–) control (n = 50), and ABO(+) control (n = 50) groups on the basis of the presence or absence of DC(–) ABO incompatibility. DNA was isolated from peripheral blood and amplified by PCR, and UGT1A1 gene promoter and exon-1 were sequenced to verify sequence alterations. Results: The frequency of TA6/6, TA6/7, TA7/7, and GGA/GGA, GGA/AGA, AGA/AGA genotypes was found to be 63.5%, 21%, 15.5%, and 91.5%, 8%, 0.5%, respectively. While both heterozygous and homozygous TA7 polymorphism increased risk of hyperbilirubinemia in the ABO(+) hyperbilirubinemia group (heterozygous OR 16.76, 95% CI:3.52-79.70, p < 0.0001; homozygous OR 6.81, 95% CI:1.98-23:42, p = 0.002), only heterozygous TA7 polymorphism increased jaundice risk (OR 5.08 95% CI:76-14.65, p = 0.003) in unexplained hyperbilirubinemia. But, the coexistence of G71R mutation and promoter polymorphism or G71R mutation and DC(–) ABO incompatibility did not increase the severity of hyperbilirubinemia (p > 0.05). Conclusions: UGT1A1 gene promoter polymorphism and G71R mutation are possible risk factors for Turkish neonates with DC(–) ABO incompatibility and unexplained hyperbilirubinemia.

Ischemia-modified albumin in preterm infants born to mothers with pre-eclampsia

Pre‐eclampsia (PE) carries an increased risk for maternal and/or fetal mortality or serious morbidity. PE is associated with ischemia and increased oxidative stress in the placenta, which may lead to modification of plasma albumin to ischemia‐modified albumin (IMA). The aim of this study was to investigate IMA and hematological parameters in mothers and in premature infants in normal and in pre‐eclamptic pregnancies.

Caffeine prevents bilirubin-induced cytotoxicity in cultured newborn rat astrocytes

Abstract Objective: Unconjugated bilirubin (UCB) may cause neurotoxicity in preterm neonates due to immaturity of UGT1A1 leading to bilirubin accumulation in the brain. Caffeine used in the treatment of apnea of prematurity was reported to decrease mechanical ventilation requirement, the frequencies of bronchopulmonary dysplasia, patent ductus arteriosus, cerebral palsy and neurodevelopmental disorders in very low birth weight infants. However, the effect of caffeine on hyperbilirubinemia was not yet clarified. Methods: We used astrocyte cell cultures obtained from 2-day-old Wistar albino rats via modified Cole and de Vellis method. UCB concentration toxic to 50% of astrocytes, and caffeine concentration increasing cell viability 100% were used in experiments. While no medication was applied to the control group, UCB (50 μM) and caffeine (100 μM) were applied to the bilirubin and caffeine groups for 24 h. Prophylactic and therapeutic caffeine groups were treated with caffeine 4 h before and after UCB exposure. The effects of caffeine were investigated in rat astrocytes exposed to UCB in terms of cell viability, apoptosis, antioxidant defense, proinflammatory cytokines, and Toll-like receptor (TLR)s. Results: Compared to the control group, UCB increased apoptosis, malondialdehyde (MDA), tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6, total nitrate/nitrite, and TLR4 levels, and decreased cell viability, catalase (CAT), glutathione peroxidase (GPx), superoxide dismutase (SOD) activities, glutathione, and TLR9 levels (for all p < .001). Conversely, prophylactic and therapeutic caffeine improved the detrimental effects of UCB. Conclusions: Caffeine seems encouraging for the prevention and treatment of bilirubin neurotoxicity in rats by means of its antiapoptotic, antioxidant, anti-inflammatory, anti-nitrosative, and anti-TLR-4 properties.

P389 Atypical prune-belly syndrome presented with isolated fetal ascite

Introduction Prune-Belly syndrome (PBS) is characterised by abdominal wall absence/hypoplasia, urinary system anomalies, and bilateral undescended testicle triad. The incidence is one in 30,000–50,000 live births, and 95% of the cases are male. Herein, we introduced a preterm infant with atypical PBS presented with fetal urinary ascite, abdominal wall defect, and bilateral undescended testicle. Case A male twin premature neonate was born 2800 gr (10–50p) at 34 weeks gestation by caesarean section due to preterm labour and fetal distress. His Apgar score is 6 and 8 at postnatal 1st and 5th minute. His parents were non-consanguineous. It was learned the presence of fetal ascite at 21st gestational age. On physical examination, abdominal distension due to fluid, bilateral undescended testicle were detected; abdominal muscles could not be palpated; eye examination and hearing test were normal. The abdominal ultrasonography (US) of the patient showed diffuse ascites, hypoplasia of the abdominal wall muscles, and bilateral testes in the inguinal canal. On his abdominal magnetic resonance imaging, ascites was detected. Transfontanel US, portal vein doppler US and voiding cystourethrography were normal. Echocardiography revealed patent ductus arteriosus, ventricular and atrial septal defect. Pericardial effusion was not observed. There were no anomalies of extremities and vertebra on his radiograms. The patient’s karyotype (male, 46, XY), routine biochemical evaluation, ferritin levels, viral serologies (TORCH, parvovirus B19) and metabolic scans were normal. While urea and creatinine levels were 19 mg/dl and 0.49 mg/dl in the serum, their levels were 23 mg/dl, and 0,55 mg/dl in the ascite fluid evacuated by paracentesis so, ascite fluid was considered urinary ascite in this case. The patient was discharged at 21 days of age. Conclusion Fetal urinary ascite may be seen even if there is no coexisting urinary anomaly in the cases with PBS.