Oğuz Ateş | Ankara University (original) (raw)
Papers by Oğuz Ateş
Journal of Pediatric Surgery, 2010
In "single conventional port" intracorporeal laparoscopic appendectomy, the appendix is suspended... more In "single conventional port" intracorporeal laparoscopic appendectomy, the appendix is suspended with a transabdominal SLING suture, which replaces the second working instrument (grasper). Thus, the second port is not required. We had modified the SLING suture to SWING suture and renamed our technique as Single Port Incisionless-Intracorporeal Conventional Equipment-Endoscopic Surgery. We herein present our experience with appendectomy conducted by the Single Port Incisionless-Intracorporeal Conventional Equipment-Endoscopic Surgery using the homemade grasper: the SWING suture.
Digestive Diseases and Sciences, 2005
Although there are many studies evaluating the effect of elevated gastric pressure in total wrap ... more Although there are many studies evaluating the effect of elevated gastric pressure in total wrap and partial anterior and posterior wrap fundoplications, there are no ex vivo manometric studies evaluating the contribution of elevated gastric pressure to prevention of gastroesophageal reflux (GER) in Collis and uncut Collis procedures without fundoplication. An experimental study has been designed to determine the contribution of elevated intragastric pressure in the absence of in vivo anatomic and functional factors to the prevention of GER in Collis and uncut Collis without fundoplication procedures. The study was conducted on adult male New Zealand rabbits' esophagus and stomachs. The stomachs were divided into four groups: total wrap fundoplication group, partial wrap anterior fundoplication group, Collis without fundoplication group, and uncut Collis without fundoplication group. The minimum intragastric pressure (MIP) causing GER of each stomach before and after the procedure were measured with a two-way catheter introduced through the pylorus. The MIP values causing GER of the total wrap and partial anterior wrap fundoplication groups were found to be significantly higher compared with the basal intragastric pressures (P < 0.01). The MIP values causing GER of the Collis and uncut Collis without fundoplication groups were not significantly different compared with basal intragastric pressures (P > 0.05). The elevated gastric pressure is found to be insufficient to prevent GER in Collis and uncut Collis without fundoplication procedures. The efficacy of these procedures in preventing GER seems to be related to the anatomic and functional factors affecting in vivo circumstances.
Journal of Pediatric Surgery, 2006
The laparoscopic approach to giant ovarian cysts in pediatric population may be difficult regardi... more The laparoscopic approach to giant ovarian cysts in pediatric population may be difficult regarding the risk of cyst rupture and limited working space. We herein report a 16-year-old adolescent girl that presented with a giant ovarian cyst. To reduce the limitations of the laparoscopy, we performed laparoscopy after draining the cyst under ultrasonographic guidance. Under local anesthesia, a nephrostomy catheter was placed into the cyst by the Seldinger technique. During laparoscopy, abdominal cavity was explored by the scope and then the nephrostomy catheter was removed. Laparoscopic procedure was completed easily. No pre-and postoperative complications were encountered and the patient was discharged on the second postoperative day. The pathologic examination of the cyst revealed as follicular cyst. Laparoscopic excision of giant ovarian cysts after ultrasound-guided drainage seems to be safe and applicable treatment modality in children. D
Digestive Diseases and Sciences, 2002
While the effects of transient intestinal ischemia on mucosa have been well investigated, less is... more While the effects of transient intestinal ischemia on mucosa have been well investigated, less is known about its effect on motor function. An experimental study was designed to investigate the effects of ischemia–reperfusion (I/R) on intestinal motility and intestinal muscular microcirculation. Wistar albino rats were divided into four groups: (1) baseline, (2) sham operation, (3) I/R, and (4) I/R with allopurinol pretreatment. Ischemia was induced by clamping the superior mesenteric artery (SMA) for 10 min. Gastroanal transit time (GATT) was measured with serial x-rays after instillation of barium sulfate to the stomach. Intestinal muscular microcirculation was evaluated by determining the number of carbon-perfused intestinal muscular microvessels (CPIMM). I/R prolonged GATT and decreased CPIMM significantly (P < 0.01). Pretreatment with allopurinol prevented prolongation of GATT and returned the number of CPIMM to the level of sham treatment (P < 0.01). In conclusion, reperfusion after 10 min of SMA ischemia alters intestinal motility. The no-reflow phenomenon plays an important role in this alteration of motility. Administration of allopurinol before reperfusion preserves intestinal motility by preventing the occurrence of no-reflow phenomenon.
Journal of Pediatric Surgery, 2007
Background/Purpose: Intestinal damage (ID) is closely related to morbidity and mortality in gastr... more Background/Purpose: Intestinal damage (ID) is closely related to morbidity and mortality in gastroschisis. This study was performed to determine the intraamniotic substances that may correlate ID and also to verify their time course levels that would be useful for determining when ID starts in gastroschisis. Methods: In this study, 13-day-old fertilized chick eggs were used. The amnioallantoic membrane was perforated to create amnioallantoic cavity in all embryos. Gastroschisis was created in gastroschisis group to simulate human gastroschisis. Amnioallantoic fluid samples were collected from the embryos on the 13th to 19th gestational days, and the intestines of each group were harvested for evaluation. Amnioallantoic levels of interleukin-8, ferritin, alkaline phosphatase, and amylase were measured. Serosal thickness of the intestines in each group was evaluated. Results: Increasing amnioallantoic fluid levels of interleukin-8, alkaline phosphatase, and amylase were found in both groups. In contrast to control group, ferritin levels, as a sign of inflammation, were found increased only in gastroschisis group. Histopathologic examination of intestines in the gastroschisis group showed a significant increase in the serosal thickness especially after the 16th day. Conclusion: Increases in amnioallantoic fluid levels of ferritin show promise as a marker for determining ID encountered in gastroschisis but warrant further investigation.
Journal of Pediatric Urology, 2008
... to the laboratory in Krebs-# S04-5 (PP) ROSUVASTATIN PREVENTS NO-REFLOW Gu lce HAKGU DER, Erd... more ... to the laboratory in Krebs-# S04-5 (PP) ROSUVASTATIN PREVENTS NO-REFLOW Gu lce HAKGU DER, Erdal KARAKAYA, Oguz Dokuz ... of this study is to investigate the effect ON HUMAN SPERMATIC VEIN AND Ibrahim YILDIRIM, Melik SEYREK*, Seref TURKEY - * Gulhane ...
European Journal of Pediatric Surgery, 2007
When studying intestinal blood flow (IBF) using radiolabeled erythrocytes in the rabbit intestina... more When studying intestinal blood flow (IBF) using radiolabeled erythrocytes in the rabbit intestinal volvulus model, we also evaluated whether a pulse oxymeter (POX) could be used for the measurement of intestinal blood flow. IBF was measured with radiolabeled erythrocytes and POX in the rabbit intestinal volvulus model. The study was performed on 3 groups: 1) baseline, 2) volvulus, 3) volvulus plus devolvulus. The POX and scintigraphic measurements were in correlation and showed that IBF stopped for 6 hours following volvulus. IBF was significantly decreased in the volvulus plus devolvulus group compared to the baseline group (p < 0.01). IBF measured with POX correlated with scintigraphic measurements. POX is useful for the measurement of IBF and thus may be a cheap and reliable alternative to other intestinal blood flow measurement methods.
Journal of Pediatric Surgery, 2003
Background/Purpose: Acquisition of clinical skills in medical education requires repeated practic... more Background/Purpose: Acquisition of clinical skills in medical education requires repeated practice. Current medical education mandates simulator-based clinical skills training programs. The details of our simulator-based clinical skills training on inguino-scrotal disorders (ISD) of the childhood, and the feedbacks obtained from the trainees are reported Methods: From 1999 to 2001, simulator-based skill training on ISD is given to second-and fourth-year students (n ϭ 207 and n ϭ 128, respectively) and to primary health care physicians during postgraduate continuing medical education program (n ϭ 80). Feedback forms filled out by each participant after the training were evaluated.
Journal of Pediatric Surgery, 2006
Background/Purpose: Contact with amniotic fluid causes intestinal damage in gastroschisis, and in... more Background/Purpose: Contact with amniotic fluid causes intestinal damage in gastroschisis, and intraamniotic meconium has been shown to be responsible. Meconium has been shown to contain a significant amount of IL-8, which may be the responsible cytokine for harmful effects of meconium. Neonatal urine contains high amount of urinary trypsin inhibitor (UTI) compared with adult human urine. Urinary trypsin inhibitor has been shown to exert inhibitory effects on IL-8. Therefore, far from being destructive, presence of fetal urine in the amniotic fluid might be beneficial because human urine contains UTI. An experimental study has been performed to investigate whether presence of intraamniotic human urine (consequently UTI) besides meconium is beneficial on intestines of chick embryo with gastroschisis. Methods: Five-day-old fertilized chick eggs were used. Gastroschisis was created through amniotic cavity without opening the allantoic cavity. Sterile urine and meconium were obtained from newborn humans. Study was conducted in 2 stages. In the first stage, gastroschisis was created, and meconium suspensions at minimal harmful meconium concentration were prepared using natural and denatured human neonatal urine and instilled into the amniotic cavity. In the second stage of study, various concentrations of UTI plus meconium suspension at minimal harmful meconium concentration was instilled into the amniotic cavity. Results: Serosal thickening, inflammation, and focal fibrin deposits were observed in intestines of the groups with meconium and meconium in denatured urine. Histopathologic features of intestines of the group with meconium in natural urine did not differ from the intestines of the control group. Histopathologic examination of intestines of groups with meconium and meconium plus 50 U/mL UTI showed serosal thickening, inflammation, focal fibrin, and collagen deposits. Histopathologic features of intestines of the groups with 1:400 intraamniotic meconium plus 100 and 200 U/mL UTI did not differ from the intestines of control group. Conclusion: Urinary trypsin inhibitor 100 U/mL prevented the intestinal damage via inhibiting IL-8, which is contained by 1:400 concentration of meconium. Therefore, besides the existence of threshold 0022-3468/$ -see front matter D
European Journal of Pediatric Surgery, 2006
International Urology and Nephrology, 2010
Recently, anti-inflammatory and tissue protective effects of statins have been shown independent ... more Recently, anti-inflammatory and tissue protective effects of statins have been shown independent from its anti-hyperlipidemic effect. It has been shown that one of the statins, rosuvastatin, may reduce ischemia/reperfusion (I/R)-induced tissue injury in the brain, intestines, and heart. We planned an experimental study to evaluate the effect of rosuvastatin on I/R injury encountered after the detorsion of the testicular torsion. Rats were divided into three groups. In group 1, testis basal blood flow (basal value) was measured with LASER Doppler flowmeter (LDF). Testis was relocated into the scrotum without torsion. Two and 3 h after the basal measurement, testis was brought out from the same incision, and the second (second value) and third (third value) testicular blood flow measurements were done, respectively. In group 2, after the measurement of basal value testicular torsion was created. Second and third value measurements were obtained with LDF at the end of the 2 h of testicular torsion just before the detorsion and 1 h after detorsion. In group 3, same procedures in torsion/detorsion group were repeated in this group, but 10 mg/kg rosuvastatin was injected intraperitoneally 30 min before detorsion. Second values in groups 2 and 3 were significantly lower than group 1. Third values were significantly low in group 2 compared to groups 1 and 3. Regarding the third measurement, there was no significant difference between the groups 1 and 3. Tissue injury is closely related with condition of microvascular perfusion after I/R. Rosuvastatin can protect tissue perfusion in the experimental testicular torsion model.
Pediatric Pulmonology, 2006
Tracheal mucosal damage has been reported in autopsy specimens of cases with proximal esophageal ... more Tracheal mucosal damage has been reported in autopsy specimens of cases with proximal esophageal atresia and distal tracheoesophageal fistula (EA-TEF) (Gross classification type C). Such changes have not been reported for isolated EA (Gross classification type A). Our hypothesis is that passage of amniotic fluid (AF) through fistula via larynx and trachea may damage tracheal mucosa. An experimental study was conducted to investigate this hypothesis in the Adriamycin-induced EA-TEF model. In the first stage of the study, we tested whether the fetuses with EA-TEF associated with pyloric atresia cannot swallow AF whereas the fetuses EA-TEF without intestinal atresia can swallow AF. Carbon solution was injected into the AF for this purpose. In the second stage of study, at the 21st day of their gestation, fetuses were extirpated and dissected under microscope. In both stages, fetuses were divided into four groups as control, fetuses without tracheoesophageal abnormalities, fetuses with EA-TEF only, fetuses with pyloric atresia associated with EA-TEF. Lungs and tracheas of the all fetuses were removed for histopathological examination. While carbon particles were present in the trachea, stomachs of the fetuses without tracheoesophageal anomalies, with EA-TEF only and control fetuses, carbon particles were absent in both trachea and stomachs of the fetuses with pyloric atresia associated with EA-TEF. Histopatological examination of the tracheal mucosa showed damage throughout the trachea in the fetuses with EA-TEF only group. Tracheal mucosa was found to be normal in other groups. Bronchial mucosa and lung tissues were found to be normal in all groups. Amniotic fluid swallowed through the TEF causes histopathological changes in the tracheal mucosa of the fetuses with EA-TEF only group. These findings may also contribute to the development of new fetal treatment modalities. Pediatr Pulmonol. 2006, 41:1049–1052. © 2006 Wiley-Liss, Inc.
European Journal of Pediatric Surgery, 2002
European Journal of Radiology Extra, 2006
We present a case of jejunal haematoma just distal to the origin of treitz ligament. The magnetic... more We present a case of jejunal haematoma just distal to the origin of treitz ligament. The magnetic resonance imaging (MRI) appearances of this entity have not been widely reported. MR imaging was used for differential diagnosis between the intestinal mass and haematoma because of the unreliable history and unclear sonography findings. MRI clearly demonstrated jejunal haematoma and obstructed intestinal lumen.
Journal of Pediatric Surgery, 2006
Background/Purpose: Portosystemic shunt operations are indicated in patients with extrahepatic po... more Background/Purpose: Portosystemic shunt operations are indicated in patients with extrahepatic portal hypertension owing to portal vein thrombosis (EPH-PVT) suffering from recurrent variceal bleeding despite endoscopic sclerotherapy. Mesenterico left portal bypass procedure (MLPB) is an alternative procedure to the portosystemic shunt operations in patients with EPH-PVT. MLPB operation reestablishes hepatopetal portal blood flow. We herein present our experience with MLPB in children with EPH-PVT. Methods: Six patients were treated for EPH-PVT with recurrent bleeding despite endoscopic sclerotherapy (2 boys and 4 girls) in our unit. All patients were evaluated preoperatively with complete blood count, portal duplex system Doppler ultrasonography, magnetic resonance angiography, and upper gastrointestinal (GI) endoscopy. MLPB operation was performed as described by de Ville de Goyet. During the postoperative period, patients were evaluated with complete blood count, portal duplex system Doppler ultrasonography, upper GI endoscopy, and magnetic resonance angiography. Results: Six patients were assessed to be candidates for MLPB procedure and were operated to perform the MLPB procedure. Left portal veins were found to be patent during the operation in 4 patients, and the MLPB procedure was performed. Internal jugular vein was used in 3 patients and enlarged inferior mesenteric vein in 1 patient. Left portal veins of the remaining 2 patients were found to be obliterated; therefore, mesocaval shunt was performed. The postoperative course of the patients was uneventful except for 1 patient. During the following period, the leukocyte and the platelet counts were significantly increased in 3 of the 4 patients after the MLPB procedure. Upper GI bleeding occurred in the early postoperative period in 1 patient with MLPB procedure because of prepyloric ulcer that was successfully treated by endoscopic sclerotherapy. Internal jugular vein graft thrombosis was detected on the 10th postoperative day. This patient underwent a second laparotomy, the distal half of the graft was found to be sclerosed and narrowed that the graft was revised with a synthetic allograft. Conclusions: Based on a review of the literature, the MLPB functions well in patients with portal hypertension caused by portal vein thrombosis and appears to have a physiologic advance over shunts 0022-3468/$ -see front matter D
Journal of Pediatric Surgery, 2007
Background/Purpose: Laparoscopic appendectomy (LA) is becoming popular for the treatment of acute... more Background/Purpose: Laparoscopic appendectomy (LA) is becoming popular for the treatment of acute and perforated appendicitis. Since it was first described, LA has been modified various times. We present the results of a new technique of LA conducted through a single port without exteriorizing the appendix to perform the operation. Materials and Methods: Single-port LA was attempted in 38 patients (23 boys, 15 girls). Under general anesthesia, an 11-mm port with two 5-mm working channels or an 11-mm port through which a 10-mm scope (08) with a parallel eyepiece and a 6-mm working channel was inserted through the umbilicus. The appendix was grasped and dissected from the surrounding tissues with a single dissector or grasper. With a percutaneously inserted suture from the right lower quadrant into the peritoneal cavity, the appendix was pulled toward the abdominal wall after passing the suture through the mesoappendix. After mesenteric dissection with hook cautery, the base of the appendix was ligated with 2-0 polyglactin with a fisherman knot. The appendix was withdrawn into the trocar and extracted from the abdomen together with the trocar. Results: Laparoscopic appendectomy was completed in 35 patients through a single port. A second port insertion was required in 3 patients. No peroperative and postoperative complications were encountered. Average duration of the procedure was 38 F 5.6 minutes. Conclusion: This unique method further improves the minimal invasiveness of LA because a single port is used. Single-port intracorporeal appendectomy procedure is a safe, highly minimal invasive procedure with excellent cosmetic results. D
Journal of Pediatric Surgery, 2003
Farmaco, 2002
In this study, a new series of 4-(3-coumarinyl)-3-cyclohexyl-4-thiazoline-2-one benzylidene hydra... more In this study, a new series of 4-(3-coumarinyl)-3-cyclohexyl-4-thiazoline-2-one benzylidene hydrazones (3a-p) were synthesized. Structures of the title compounds were determined by analytical and spectral methods. 3a-p were evaluated for antituberculosis activity against Mycobacterium tuberculosis H37Rv.
Journal of Pediatric Surgery, 2010
In "single conventional port" intracorporeal laparoscopic appendectomy, the appendix is suspended... more In "single conventional port" intracorporeal laparoscopic appendectomy, the appendix is suspended with a transabdominal SLING suture, which replaces the second working instrument (grasper). Thus, the second port is not required. We had modified the SLING suture to SWING suture and renamed our technique as Single Port Incisionless-Intracorporeal Conventional Equipment-Endoscopic Surgery. We herein present our experience with appendectomy conducted by the Single Port Incisionless-Intracorporeal Conventional Equipment-Endoscopic Surgery using the homemade grasper: the SWING suture.
Digestive Diseases and Sciences, 2005
Although there are many studies evaluating the effect of elevated gastric pressure in total wrap ... more Although there are many studies evaluating the effect of elevated gastric pressure in total wrap and partial anterior and posterior wrap fundoplications, there are no ex vivo manometric studies evaluating the contribution of elevated gastric pressure to prevention of gastroesophageal reflux (GER) in Collis and uncut Collis procedures without fundoplication. An experimental study has been designed to determine the contribution of elevated intragastric pressure in the absence of in vivo anatomic and functional factors to the prevention of GER in Collis and uncut Collis without fundoplication procedures. The study was conducted on adult male New Zealand rabbits' esophagus and stomachs. The stomachs were divided into four groups: total wrap fundoplication group, partial wrap anterior fundoplication group, Collis without fundoplication group, and uncut Collis without fundoplication group. The minimum intragastric pressure (MIP) causing GER of each stomach before and after the procedure were measured with a two-way catheter introduced through the pylorus. The MIP values causing GER of the total wrap and partial anterior wrap fundoplication groups were found to be significantly higher compared with the basal intragastric pressures (P < 0.01). The MIP values causing GER of the Collis and uncut Collis without fundoplication groups were not significantly different compared with basal intragastric pressures (P > 0.05). The elevated gastric pressure is found to be insufficient to prevent GER in Collis and uncut Collis without fundoplication procedures. The efficacy of these procedures in preventing GER seems to be related to the anatomic and functional factors affecting in vivo circumstances.
Journal of Pediatric Surgery, 2006
The laparoscopic approach to giant ovarian cysts in pediatric population may be difficult regardi... more The laparoscopic approach to giant ovarian cysts in pediatric population may be difficult regarding the risk of cyst rupture and limited working space. We herein report a 16-year-old adolescent girl that presented with a giant ovarian cyst. To reduce the limitations of the laparoscopy, we performed laparoscopy after draining the cyst under ultrasonographic guidance. Under local anesthesia, a nephrostomy catheter was placed into the cyst by the Seldinger technique. During laparoscopy, abdominal cavity was explored by the scope and then the nephrostomy catheter was removed. Laparoscopic procedure was completed easily. No pre-and postoperative complications were encountered and the patient was discharged on the second postoperative day. The pathologic examination of the cyst revealed as follicular cyst. Laparoscopic excision of giant ovarian cysts after ultrasound-guided drainage seems to be safe and applicable treatment modality in children. D
Digestive Diseases and Sciences, 2002
While the effects of transient intestinal ischemia on mucosa have been well investigated, less is... more While the effects of transient intestinal ischemia on mucosa have been well investigated, less is known about its effect on motor function. An experimental study was designed to investigate the effects of ischemia–reperfusion (I/R) on intestinal motility and intestinal muscular microcirculation. Wistar albino rats were divided into four groups: (1) baseline, (2) sham operation, (3) I/R, and (4) I/R with allopurinol pretreatment. Ischemia was induced by clamping the superior mesenteric artery (SMA) for 10 min. Gastroanal transit time (GATT) was measured with serial x-rays after instillation of barium sulfate to the stomach. Intestinal muscular microcirculation was evaluated by determining the number of carbon-perfused intestinal muscular microvessels (CPIMM). I/R prolonged GATT and decreased CPIMM significantly (P < 0.01). Pretreatment with allopurinol prevented prolongation of GATT and returned the number of CPIMM to the level of sham treatment (P < 0.01). In conclusion, reperfusion after 10 min of SMA ischemia alters intestinal motility. The no-reflow phenomenon plays an important role in this alteration of motility. Administration of allopurinol before reperfusion preserves intestinal motility by preventing the occurrence of no-reflow phenomenon.
Journal of Pediatric Surgery, 2007
Background/Purpose: Intestinal damage (ID) is closely related to morbidity and mortality in gastr... more Background/Purpose: Intestinal damage (ID) is closely related to morbidity and mortality in gastroschisis. This study was performed to determine the intraamniotic substances that may correlate ID and also to verify their time course levels that would be useful for determining when ID starts in gastroschisis. Methods: In this study, 13-day-old fertilized chick eggs were used. The amnioallantoic membrane was perforated to create amnioallantoic cavity in all embryos. Gastroschisis was created in gastroschisis group to simulate human gastroschisis. Amnioallantoic fluid samples were collected from the embryos on the 13th to 19th gestational days, and the intestines of each group were harvested for evaluation. Amnioallantoic levels of interleukin-8, ferritin, alkaline phosphatase, and amylase were measured. Serosal thickness of the intestines in each group was evaluated. Results: Increasing amnioallantoic fluid levels of interleukin-8, alkaline phosphatase, and amylase were found in both groups. In contrast to control group, ferritin levels, as a sign of inflammation, were found increased only in gastroschisis group. Histopathologic examination of intestines in the gastroschisis group showed a significant increase in the serosal thickness especially after the 16th day. Conclusion: Increases in amnioallantoic fluid levels of ferritin show promise as a marker for determining ID encountered in gastroschisis but warrant further investigation.
Journal of Pediatric Urology, 2008
... to the laboratory in Krebs-# S04-5 (PP) ROSUVASTATIN PREVENTS NO-REFLOW Gu lce HAKGU DER, Erd... more ... to the laboratory in Krebs-# S04-5 (PP) ROSUVASTATIN PREVENTS NO-REFLOW Gu lce HAKGU DER, Erdal KARAKAYA, Oguz Dokuz ... of this study is to investigate the effect ON HUMAN SPERMATIC VEIN AND Ibrahim YILDIRIM, Melik SEYREK*, Seref TURKEY - * Gulhane ...
European Journal of Pediatric Surgery, 2007
When studying intestinal blood flow (IBF) using radiolabeled erythrocytes in the rabbit intestina... more When studying intestinal blood flow (IBF) using radiolabeled erythrocytes in the rabbit intestinal volvulus model, we also evaluated whether a pulse oxymeter (POX) could be used for the measurement of intestinal blood flow. IBF was measured with radiolabeled erythrocytes and POX in the rabbit intestinal volvulus model. The study was performed on 3 groups: 1) baseline, 2) volvulus, 3) volvulus plus devolvulus. The POX and scintigraphic measurements were in correlation and showed that IBF stopped for 6 hours following volvulus. IBF was significantly decreased in the volvulus plus devolvulus group compared to the baseline group (p < 0.01). IBF measured with POX correlated with scintigraphic measurements. POX is useful for the measurement of IBF and thus may be a cheap and reliable alternative to other intestinal blood flow measurement methods.
Journal of Pediatric Surgery, 2003
Background/Purpose: Acquisition of clinical skills in medical education requires repeated practic... more Background/Purpose: Acquisition of clinical skills in medical education requires repeated practice. Current medical education mandates simulator-based clinical skills training programs. The details of our simulator-based clinical skills training on inguino-scrotal disorders (ISD) of the childhood, and the feedbacks obtained from the trainees are reported Methods: From 1999 to 2001, simulator-based skill training on ISD is given to second-and fourth-year students (n ϭ 207 and n ϭ 128, respectively) and to primary health care physicians during postgraduate continuing medical education program (n ϭ 80). Feedback forms filled out by each participant after the training were evaluated.
Journal of Pediatric Surgery, 2006
Background/Purpose: Contact with amniotic fluid causes intestinal damage in gastroschisis, and in... more Background/Purpose: Contact with amniotic fluid causes intestinal damage in gastroschisis, and intraamniotic meconium has been shown to be responsible. Meconium has been shown to contain a significant amount of IL-8, which may be the responsible cytokine for harmful effects of meconium. Neonatal urine contains high amount of urinary trypsin inhibitor (UTI) compared with adult human urine. Urinary trypsin inhibitor has been shown to exert inhibitory effects on IL-8. Therefore, far from being destructive, presence of fetal urine in the amniotic fluid might be beneficial because human urine contains UTI. An experimental study has been performed to investigate whether presence of intraamniotic human urine (consequently UTI) besides meconium is beneficial on intestines of chick embryo with gastroschisis. Methods: Five-day-old fertilized chick eggs were used. Gastroschisis was created through amniotic cavity without opening the allantoic cavity. Sterile urine and meconium were obtained from newborn humans. Study was conducted in 2 stages. In the first stage, gastroschisis was created, and meconium suspensions at minimal harmful meconium concentration were prepared using natural and denatured human neonatal urine and instilled into the amniotic cavity. In the second stage of study, various concentrations of UTI plus meconium suspension at minimal harmful meconium concentration was instilled into the amniotic cavity. Results: Serosal thickening, inflammation, and focal fibrin deposits were observed in intestines of the groups with meconium and meconium in denatured urine. Histopathologic features of intestines of the group with meconium in natural urine did not differ from the intestines of the control group. Histopathologic examination of intestines of groups with meconium and meconium plus 50 U/mL UTI showed serosal thickening, inflammation, focal fibrin, and collagen deposits. Histopathologic features of intestines of the groups with 1:400 intraamniotic meconium plus 100 and 200 U/mL UTI did not differ from the intestines of control group. Conclusion: Urinary trypsin inhibitor 100 U/mL prevented the intestinal damage via inhibiting IL-8, which is contained by 1:400 concentration of meconium. Therefore, besides the existence of threshold 0022-3468/$ -see front matter D
European Journal of Pediatric Surgery, 2006
International Urology and Nephrology, 2010
Recently, anti-inflammatory and tissue protective effects of statins have been shown independent ... more Recently, anti-inflammatory and tissue protective effects of statins have been shown independent from its anti-hyperlipidemic effect. It has been shown that one of the statins, rosuvastatin, may reduce ischemia/reperfusion (I/R)-induced tissue injury in the brain, intestines, and heart. We planned an experimental study to evaluate the effect of rosuvastatin on I/R injury encountered after the detorsion of the testicular torsion. Rats were divided into three groups. In group 1, testis basal blood flow (basal value) was measured with LASER Doppler flowmeter (LDF). Testis was relocated into the scrotum without torsion. Two and 3 h after the basal measurement, testis was brought out from the same incision, and the second (second value) and third (third value) testicular blood flow measurements were done, respectively. In group 2, after the measurement of basal value testicular torsion was created. Second and third value measurements were obtained with LDF at the end of the 2 h of testicular torsion just before the detorsion and 1 h after detorsion. In group 3, same procedures in torsion/detorsion group were repeated in this group, but 10 mg/kg rosuvastatin was injected intraperitoneally 30 min before detorsion. Second values in groups 2 and 3 were significantly lower than group 1. Third values were significantly low in group 2 compared to groups 1 and 3. Regarding the third measurement, there was no significant difference between the groups 1 and 3. Tissue injury is closely related with condition of microvascular perfusion after I/R. Rosuvastatin can protect tissue perfusion in the experimental testicular torsion model.
Pediatric Pulmonology, 2006
Tracheal mucosal damage has been reported in autopsy specimens of cases with proximal esophageal ... more Tracheal mucosal damage has been reported in autopsy specimens of cases with proximal esophageal atresia and distal tracheoesophageal fistula (EA-TEF) (Gross classification type C). Such changes have not been reported for isolated EA (Gross classification type A). Our hypothesis is that passage of amniotic fluid (AF) through fistula via larynx and trachea may damage tracheal mucosa. An experimental study was conducted to investigate this hypothesis in the Adriamycin-induced EA-TEF model. In the first stage of the study, we tested whether the fetuses with EA-TEF associated with pyloric atresia cannot swallow AF whereas the fetuses EA-TEF without intestinal atresia can swallow AF. Carbon solution was injected into the AF for this purpose. In the second stage of study, at the 21st day of their gestation, fetuses were extirpated and dissected under microscope. In both stages, fetuses were divided into four groups as control, fetuses without tracheoesophageal abnormalities, fetuses with EA-TEF only, fetuses with pyloric atresia associated with EA-TEF. Lungs and tracheas of the all fetuses were removed for histopathological examination. While carbon particles were present in the trachea, stomachs of the fetuses without tracheoesophageal anomalies, with EA-TEF only and control fetuses, carbon particles were absent in both trachea and stomachs of the fetuses with pyloric atresia associated with EA-TEF. Histopatological examination of the tracheal mucosa showed damage throughout the trachea in the fetuses with EA-TEF only group. Tracheal mucosa was found to be normal in other groups. Bronchial mucosa and lung tissues were found to be normal in all groups. Amniotic fluid swallowed through the TEF causes histopathological changes in the tracheal mucosa of the fetuses with EA-TEF only group. These findings may also contribute to the development of new fetal treatment modalities. Pediatr Pulmonol. 2006, 41:1049–1052. © 2006 Wiley-Liss, Inc.
European Journal of Pediatric Surgery, 2002
European Journal of Radiology Extra, 2006
We present a case of jejunal haematoma just distal to the origin of treitz ligament. The magnetic... more We present a case of jejunal haematoma just distal to the origin of treitz ligament. The magnetic resonance imaging (MRI) appearances of this entity have not been widely reported. MR imaging was used for differential diagnosis between the intestinal mass and haematoma because of the unreliable history and unclear sonography findings. MRI clearly demonstrated jejunal haematoma and obstructed intestinal lumen.
Journal of Pediatric Surgery, 2006
Background/Purpose: Portosystemic shunt operations are indicated in patients with extrahepatic po... more Background/Purpose: Portosystemic shunt operations are indicated in patients with extrahepatic portal hypertension owing to portal vein thrombosis (EPH-PVT) suffering from recurrent variceal bleeding despite endoscopic sclerotherapy. Mesenterico left portal bypass procedure (MLPB) is an alternative procedure to the portosystemic shunt operations in patients with EPH-PVT. MLPB operation reestablishes hepatopetal portal blood flow. We herein present our experience with MLPB in children with EPH-PVT. Methods: Six patients were treated for EPH-PVT with recurrent bleeding despite endoscopic sclerotherapy (2 boys and 4 girls) in our unit. All patients were evaluated preoperatively with complete blood count, portal duplex system Doppler ultrasonography, magnetic resonance angiography, and upper gastrointestinal (GI) endoscopy. MLPB operation was performed as described by de Ville de Goyet. During the postoperative period, patients were evaluated with complete blood count, portal duplex system Doppler ultrasonography, upper GI endoscopy, and magnetic resonance angiography. Results: Six patients were assessed to be candidates for MLPB procedure and were operated to perform the MLPB procedure. Left portal veins were found to be patent during the operation in 4 patients, and the MLPB procedure was performed. Internal jugular vein was used in 3 patients and enlarged inferior mesenteric vein in 1 patient. Left portal veins of the remaining 2 patients were found to be obliterated; therefore, mesocaval shunt was performed. The postoperative course of the patients was uneventful except for 1 patient. During the following period, the leukocyte and the platelet counts were significantly increased in 3 of the 4 patients after the MLPB procedure. Upper GI bleeding occurred in the early postoperative period in 1 patient with MLPB procedure because of prepyloric ulcer that was successfully treated by endoscopic sclerotherapy. Internal jugular vein graft thrombosis was detected on the 10th postoperative day. This patient underwent a second laparotomy, the distal half of the graft was found to be sclerosed and narrowed that the graft was revised with a synthetic allograft. Conclusions: Based on a review of the literature, the MLPB functions well in patients with portal hypertension caused by portal vein thrombosis and appears to have a physiologic advance over shunts 0022-3468/$ -see front matter D
Journal of Pediatric Surgery, 2007
Background/Purpose: Laparoscopic appendectomy (LA) is becoming popular for the treatment of acute... more Background/Purpose: Laparoscopic appendectomy (LA) is becoming popular for the treatment of acute and perforated appendicitis. Since it was first described, LA has been modified various times. We present the results of a new technique of LA conducted through a single port without exteriorizing the appendix to perform the operation. Materials and Methods: Single-port LA was attempted in 38 patients (23 boys, 15 girls). Under general anesthesia, an 11-mm port with two 5-mm working channels or an 11-mm port through which a 10-mm scope (08) with a parallel eyepiece and a 6-mm working channel was inserted through the umbilicus. The appendix was grasped and dissected from the surrounding tissues with a single dissector or grasper. With a percutaneously inserted suture from the right lower quadrant into the peritoneal cavity, the appendix was pulled toward the abdominal wall after passing the suture through the mesoappendix. After mesenteric dissection with hook cautery, the base of the appendix was ligated with 2-0 polyglactin with a fisherman knot. The appendix was withdrawn into the trocar and extracted from the abdomen together with the trocar. Results: Laparoscopic appendectomy was completed in 35 patients through a single port. A second port insertion was required in 3 patients. No peroperative and postoperative complications were encountered. Average duration of the procedure was 38 F 5.6 minutes. Conclusion: This unique method further improves the minimal invasiveness of LA because a single port is used. Single-port intracorporeal appendectomy procedure is a safe, highly minimal invasive procedure with excellent cosmetic results. D
Journal of Pediatric Surgery, 2003
Farmaco, 2002
In this study, a new series of 4-(3-coumarinyl)-3-cyclohexyl-4-thiazoline-2-one benzylidene hydra... more In this study, a new series of 4-(3-coumarinyl)-3-cyclohexyl-4-thiazoline-2-one benzylidene hydrazones (3a-p) were synthesized. Structures of the title compounds were determined by analytical and spectral methods. 3a-p were evaluated for antituberculosis activity against Mycobacterium tuberculosis H37Rv.