I. Haluk Gokcora

Preventive effect of pentoxifylline on renal scarring in rat model of pyelonephritis

OBJECTIVES To evaluate the efficiency of pentoxifylline (PTX), a methyl xanthine derivative, in preventing renal scar formation after the induction of pyelonephritis in an experimental rat model with delayed antimicrobial therapy. METHODS An inoculum of 1 x 10(9) colony-forming units/0.1 mL of the K-12 strain of Escherichia coli, which has both type 1 and P pili, was injected directly into both renal parenchyma of Wistar rats (n = 40). Group 1 (control) received isotonic saline instead of bacterial solution (n = 10). Four equal groups were then formed: group 2 was not treated and group 3 was treated only with ciprofloxacin for 5 days, starting 3 days after bacterial inoculation; in group 4, 50 mg/kg of PTX, and in group 5, PTX (50 mg/kg) and ciprofloxacin (15 mg/kg) together were administered intraperitoneally for 5 days, starting 3 days after bacterial inoculation. Six weeks after bacterial inoculation, all the rats were killed, and both kidneys were examined histopathologically for renal scarring. RESULTS Delayed treatment with antibiotics had no effect on scarring compared with the untreated controls. However, the addition of PTX to the delayed antibiotic therapy significantly inhibited renal scarring compared with the untreated or antibiotic-only groups (P <0.05). CONCLUSIONS These results suggest that PTX is effective in preventing renal scar formation in pyelonephritis when the initiation of antimicrobial treatment is delayed in this rat model of pyelonephritis.

The effect of electromagnetic field on undescended testis after orchiopexy

Undescended testis is a common problem leading to infertility. After orchiopexy some studies support the necessity of hormonal therapy. Electromagnetic field stimulation on living tissues increase cell proliferation, protein and DNA synthesis.Sixteen prepubertal rats was objected to the fixation of left testes to the anterior abdominal wall for 30 days, right testes were removed. Another group of sixteen rats objected only to the right orchiectomy and a manipulation simulating study group without fixation. After orchiopexy, animals were divided into two groups. Both groups had eight rats. Electromagnetic field (EMF) stimulation group had the stimulation for two hours every day for ten days, while the second group did not. The sham group also divided into two groups. The first one applied EMF and name as Group CEM, the second one was sham. Weight of removed testes were measured and fixed in 10% formaldehyde for histopathological evaluation. At the creating of undescended testis and right orchiectomies a blood sample was obtained for testosterone level of prepubertal rats. After finishing EMF stimulation the rats were mated with females for 17 days. After fertility study a blood sample was obtained for testosterone assay and body weight were measured and fixed in formaline for histopathologic evaluation. All the rats were killed with overdose ether anesthesia and number of fetuses were recorded. Histopathological evaluation was based on Johnsen criteria and seminiferous tubule diameter measurements.We conclude that EMF stimulation resulted in Leydig cell proliferation, increase in testosterone level, testis weight, but decrease in germ cell population.

An exceptional complication following appendectomy: Acute inguinal and scrotal suppuration

Inguinal and scrotal suppuration following appendectomy is a rare event, occurring mostly when a patent processus vaginalis is present. Herein we report a small series of children operated for appendicitis and presented with acute inguinal and scrotal symptoms postoperatively. Although acute scrotum is commonly attributed to torsion of testis or its appendage, epididymo-orchitis and incarcerated hernia, following appendicitis scrotal and/or inguinal abscess should be considered.

A children's disease of rarity: "scrotal lymphangioma circumscriptum".

A 13-year-old boy with a long-standing history of multiple translucent vesicles covering his left hemiscrotal skin, which occasionally bled and oozed serosanguinous fluid, is presented. Histopathologic examination revealed lymphangioma circumscriptum, following surgical excision. The critical points in diagnosis and treatment of this unusual entity are as follows: Lymphangioma circumscriptum need always be kept in mind when vesicular skin lesions are associated with lymphedema. Chance of recurrence is lowered by excising not only the affected skin but also all the subcutaneous tissue, down to the deep fascia.

Tracheobronchial Rupture due to Blunt Chest Trauma : Report of a Case

Tracheobronchial injuries following blunt chest trauma are uncommon in children. The involvement of both the trachea and right main bronchus separately is highly unusual. We herein report the case of a 13-year-old boy who presented with both a tracheal and right main bronchial rupture following blunt chest trauma. While the tracheal laceration required a tracheotomy, a delayed repair of right main bronchial disruption was performed with a complete preservation of the right lung. The features of this uncommon entity are discussed, with special emphasis on early diagnosis and surgical management.

Distal hypospadias repair: Comparison of two different techniques

The cosmetic results and the morbidity of Mathieu and Barcat techniques are presented and compared in a series of 52 children aged between five months to 19 years during January 1991 to May 2001. All patients treated with the Mathieu procedure had negligible glandular hypospadias at some level. The neomeatus was slit-like or elliptic in majority of the cases. The horizontal bucket handle deformity was eliminated which remains as a meatal problem of the original Mathieu procedure. Four patients had fistula, which was closed by surgery whereas another three had mild stricture formation. Cosmetic and functional results were excellent with the Barcat balanic groove technique. There was no fistula formation, only two had meatal stricture which responded to dilatations.The Barcat technique allows anatomically superior glans reconstruction resulting in a vertical and slit like neomeatus in distal hypospadias repair with a low complication rate.

Penile agenesis and congenital hypertrophic pyloric stenosis: An association or a random coexistence?

A neonate with penile agenesis and congenital hypertrophic pyloric stenosis is presented. The patterns of associated anomalies with penile agenesis, and those of congenital hypertrophic pyloric stenosis are discussed.