Ragip Ortac

The Effectiveness of Sucralfate Against Stricture Formation in Experimental Corrosive Esophageal Burns

PurposeIn this study, the effectiveness of sucralfate against stricture formation in experimental corrosive esophageal burn is reported.MethodsSixty-four Swiss albino adult male rats were divided into three groups, group A (control; n, 7), group B (esophageal burn induced but not treated; n, 25), and group C (esophageal burn induced and treated with sucralfate, n, 32). Groups B and C were further subdivided into subgroups for evaluation on days 2, 7, and 28. A standard esophageal burn was performed by the method of Gehanno, using 50% NaOH. Oral sucralfate treatment was given to group C at a dosage of 50 mg/100 g twice daily. The rats were then killed after 2, 7, or 28 days. Levels of tissue hydroxyproline were measured in excised abdominal esophageal segments, and a histopathological evaluation was performed with hematoxylin–eosin and Masson’s trichrome staining.ResultsThe tissue hydroxyproline levels were significantly lower in group C than in group B (P = 0.017). There was a significant difference in the stenosis index between groups B and C (P = 0.016). When compared with group B, the collagen deposition in the submucosa and tunica muscularis was significantly lower in group C (P = 0.02).ConclusionSucralfate has an inhibitory effect on stricture formation in experimental corrosive burns and can be used in the treatment of corrosive esophageal burns to enhance mucosal healing and suppress stricture formation.

Becker's naevus and segmental naevus depigmentosus: An example of twin spotting?

A 12‐year‐old girl presented with a 1‐year history of a Beckers naevus involving the right posterior thigh and gluteal area. In addition, three hypopigmented macules of naevus depigmentosus distributed in a segmental pattern on the medial aspect of the right posterior thigh had been present since birth. We suggest that their unusual coexistence in close proximity may represent an example of twin spotting.

Simple testicular cyst: A rare cause of scrotal swelling in infancy

A simple testicular cyst is a rare cause of scrotal swelling in infancy. Only 10 cases have been reported in children less than two years of age in the English literature. Pathogenesis of the lesion is unclear. Preoperative diagnosis is possible using ultrasonography (US). Testis‐sparing surgery with simple enucleation of the cyst has a favorable outcome. We report two patients with a simple testicular cyst, who were 9 and 8 months of age. The first case was referred with a presumptive diagnosis of hydrocele, and the second infant was admitted with a history of testicular swelling. Ultrasonography provided accurate preoperative diagnosis in both of the cases. The patients were successfully treated with testis‐sparing surgery with outstanding long‐term results. This unusual lesion of infancy should be considered in the differential diagnosis of a scrotal mass.

Tissue Expression of MLH1, PMS2, MSH2, and MSH6 Proteins and Prognostic Value of Microsatellite Instability in Wilms Tumor: Experience of 45 Cases

Background: Although the importance of microsatellite instability (MSI) and mismatch repair genes (MMR) is strongly established in colorectal cancer seen in the Lynch syndrome, its significance has not been fully established in Wilms tumor (WT). The aim of this study was to determine the prognostic value of MSI and MMR proteins in WT. Methods: This study included 45 pediatric cases with nephroblastoma. Protein expression was analyzed by immunohistochemistry of archival tissue sections. Real-time PCR melting analysis and fluorescence capillary electrophoresis (FCE) were performed to evaluate the MSI markers BAT25, BAT26, NR21, NR24, MONO27, penta D, and penta C in DNA extracted from tumor and normal tissues. Results: Lower levels of MSI were observed in six cases (13.3%). There were no statistically significant correlations between MSI and some clinical prognostic factors such as stage of the tumors, and survival rates. Nineteen tumors (42.2%) showed loss of protein expression of MLH1, PMS2, MSH2, or MSH6. MMR protein defects were correlated with size (P = .021), and stage (P = .019) of the tumor, and survival rates (P < .01). Similarly MSI was also correlated with the size of the tumor (P = .046). Conclusions: This study showed that a small proportion of WT might be associated with the presence of MSI, as is the case with defects of DNA mismatch repair genes in the pathogenesis of WT. However, there was no concordance with the frequency of tissue expression of MMR proteins and MSI. These findings suggest that MMR genes may play an important role in the development of WT via different pathways.

Ureteral fibroepithelial polyps in children

Fibroepithelial polyps of the ureter presenting as pelviureteric junction (PUJ) obstruction in two boys are reported. These neoplasms are uncommon, especially in children. Surgical excision of the PUJ with the polyp and dismembered pyeloplasty was performed in each case. Postoperative recoveries were uneventful.

Intrascrotal paratesticular rhabdomyoma: a case report.

tracheostomy placement, or with total airway occlusion and resultant cardiopulmonary failure. It is our hope that this article will heighten the awareness of physicians and other healthcare givers who deal with pediatric burn victims both inside and outside the hospital to the dangers inherent to hot liquid aspiration presenting as part of a scald injury in the toddler age group, a possibility that must be kept in mind at all times when treating any young child presenting with perioral or facial scald injuries. Any toddler presenting with scald burn injuries of the face and especially of the perioral area should be suspected of having aspirated hot liquid and of developing resultant laryngeal edema. Until this is ruled out, these children should be closely monitored, and under no circumstances should they be sent for further treatment unaccompanied by a physician or paramedic capable of performing endotracheal intubation with the onset of the slightest signs of airway compromise.

Waardenburg syndrome with extended aganglionosis: report of 3 new cases

PURPOSE The Waardenburg-Shah syndrome is an autosomal recessive disease with varied penetration where Hirschsprungs disease and the Waardenburg syndrome are seen together. Although the length of the involved intestinal segment varies in this syndrome, most patients had total colonic aganglionosis with or without small bowel involvement. We present in this study 2 siblings and one first-degree relative for a total of 3 male patients with Waardenburg syndrome and total colonic aganglionosis with or without small bowel involvement, together with their clinical characteristics and treatment methods. PATIENTS The patients who presented with intestinal obstruction findings within the first 48 hours after birth were operated on with 2 patients under elective conditions and 1 as an emergency. The ganglionic segment lengths were 6, 8, and 20 cm, respectively. Aganglionic enterostomy was performed, and the Ziegler operation was used for these patients. The enterostomies started to function on the third postoperative week, and they started to gain weight. However, all died because of sepsis on the 5th to 12th month. CONCLUSION Waardenburg-Shah syndrome patients have a higher incidence of total colonic aganglionosis with or without small bowel involvement. The Ziegler operation may be used in patients with inadequate ganglionic bowel length to gain some time for the child to grow and to decrease total parenteral nutrition complications.

Nutritional status of children with chronic hepatitis B in a population with low socioeconomic status.

Objective Chronic infections and liver diseases may lead to malnutrition. However, growth failure is rarely reported in chronic hepatitis B. We aimed to establish the nutritional status of children with chronic hepatitis B and the relation between anthropometric data and laboratory findings in a population with low socioeconomic status. Methods Anthropometrical and laboratory findings were noted from the hospital records. Cases with and without malnutrition were compared with regard to sex, age, histological activity (HAI) scores, aspartate aminotransferase, alanine aminotransferase, &ggr;-glutamyl transpeptidase, protein, albumin, and hepatitis B virus (HBV) DNA levels. Results Eighty children, of which 36 (45%) were girls, with a mean age of 11.5±3.2 years were enrolled in the study. Malnutrition was found in 39 (49%). Acute malnutrition (24 out of 39, 61.5%) was the most common form. There was no difference of age or sex between children with and without malnutrition. Age of diagnosis was higher and duration of follow-up was shorter in cases with malnutrition (P = 0.051 and P = 0.016, respectively). In children with malnutrition, aspartate aminotransferase levels were significantly higher but other laboratory results were not different. Malnutrition rate was not different between groups that did and did not receive treatment or that did and did not respond to treatment. Anthropometrical data and malnutrition rate was similar in children with high and low HAI scores. Conclusion As features suggesting severe liver disease like high alanine aminotransferase values, HAI scores, or HBV DNA levels were not different in children with and without malnutrition, it may be proposed that chronic HBV infection does not have an effect on nutritional status.

Investigation of iron’s neurotoxicity during cerebral maturation in the neonatal rat model of haemolysis

INTRODUCTION Haemolytic disease of newborns due to rhesus and AB0 incompatibility is encountered frequently in neonatal clinics and may lead to severe haemolysis. In this study, it is suggested that important amounts of iron released with haemolysis may have a toxic effect on the brain parenchymal tissue, and the severity of the toxic effect can be correlated with the maturation of the brain barrier systems. To demonstrate the accumulation and the neuro-toxic effects of free iron (Fe) in the brain an experimental haemolysis model with various maturation phases was performed. MATERIAL AND METHODS The study was composed of 48 Wistar rats with the following ages: five days old (Group A), 10 days old (Group B), and 19 days old (Group C). Each group was divided into three experimental subgroups and three control groups. Experimental groups were treated with intraperitoneal 75 mg/kg/day phenyl hydrazine hydrochloride for haemolysis. RESULTS We demonstrated that the blood brain barrier (BBB) is permeable in five-day-old newborn rats and is mature in 10- and 19-day-old rats. Iron staining and neuronal damage were detected in group A and group B rats. No damage was detected in the brain tissue of group C animals. The presence of iron staining and neuronal damage in group B with mature BBB may suggest the existence of other incomplete barrier systems different from BBB that lead to iron accumulation in the brain. CONCLUSIONS Blood brain barrier has a partial role in Fe transport, and the alternative barrier systems may also be involved. It could be supposed that after maturation of all barrier systems, excessive Fe penetration to the brain cannot occur. Our findings showed that the toxic amounts of iron may penetrate into the brain parenchyma of newborns despite the BBB preservation and cause neuronal damage in newborns, but the mature brain is not affected by the same magnitude blood levels.

Acquired Port-Wine Stain in a Pediatric Patient

Background: Acquired port-wine stains (PWSs) are vascular lesions that are identical to congenital PWSs morphologically and histopathologically. Objective: Because acquired PWSs are rarely seen in adult and pediatric patients, we present a 9-year-old boy with an acquired PWS on his left forearm. Conclusion: None of the proposed etiologies, such as trauma, chronic sun exposure, or hormonal medication, was applicable to our patient, and a literature review showed us that acquired PWSs give a faster and better response to pulsed dye laser therapy than congenital lesions do.