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Biomedical subjects

F C Tanyel

Publications and source records attributed to F C Tanyel.

At least 19 recordsLinked to original sources
PubMed1997

Colonic volvulus: a rare presentation of Hirschsprung's disease.

Although rare, patients with Hirschsprung's disease (HD) may be admitted with colonic volvulus. Among 302 patients with HD two patients were admitted with colonic volvulus (0.66%). Involved segments were cecum and sigmoid colon. During the same period, 11 patients including those with HD were diagnosed with colonic volvulus. An aganglionic segment below sigmoid colon, and a freely mobile mesosigmoid seem to be the cause of sigmoid volvulus. However, extension of aganglionosis above the sigmoid colon in addition to anatomic tendency seems to result in volvulus of proximal segments. Because HD has been associated with colonic volvulus, children who present with colonic volvulus should be suspect for underlying HD.

Cecal Diseases↗
PubMed1997

Appendiceal perforation: a potentially lethal initial mode of presentation of Hirschsprung's disease.

In Hacettepe University Children's Hospital, between 1976 and 1993 two patients among 302 with Hirschsprung's disease were diagnosed with appendiceal perforation (AP) at initial admission. Both patients were less than 2 months of age. One of them was a boy with total colonic aganglionosis and the latter a girl with long-segment disease. In both cases the site of AP was the base, and periappendicitis without mucosal involvement was detected. The present cases and review of the literature suggest that longer aganglionic segment carries a higher risk of AP.

Appendectomy↗
PubMed1997

Obstructive jaundice resulting from adenocarcinoma of the ampulla of Vater in an 11-year-old boy.

Adenocarcinoma of ampulla of Vater causing obstructive jaundice in an 11-year-old boy is reported. He first underwent pylorus-preserving duodenectomy, which later necessitated classical Whipple operation because of the microscopical evidence of the disease beyond surgical margins. This child is the youngest case of adenocarcinoma of ampulla of Vater in the English-language literature.

Adenocarcinoma↗
PubMed1997

Expression of beta-1 integrins in ganglionic and aganglionic segments of patients with Hirschsprung's disease.

An immunocytochemical study was performed to assess the role of beta-1 integrins in the pathogenesis of Hirschsprung's disease. Fresh tissue samples from both aganglionic and ganglionic segments of five patients who were undergoing surgery for Hirschsprung's disease were obtained. Samples were rapidly frozen in liquid nitrogen. Sections were cut and stained using anti alpha-1, 2, 3, 4, 5, 6 and beta-1 monoclonals according to the indirect immunoperoxidase method. The evaluation did not reveal any significant change of pattern in the distribution of beta-1 integrins in the non-neural elements of both aganglionic and ganglionic segments of colon, such as the epithelium, muscularis mucosa, muscularis externa, connective tissues and blood vessels. Nerve fibres in both aganglionic and ganglionic segments strongly expressed the alpha-6 chain of very late activation antigen which led to their increase in the aganglionic segment. In addition to revealing the increase, alpha-6 monoclonals also had in situ positive control due to their presence in non-neural elements. Hence, immunostaining of the suction biopsies with anti alpha-6 monoclonals may be employed as a new and simple method in the diagnosis of Hirschsprung's disease. On the other hand, beta-1 integrins do not seem to play a role in the defective migration of ganglion cells occurring in Hirschsprung's disease.

Antigens, CD↗
PubMed1997

Neuronal intestinal and fibromuscular arterial dysplasias associated with intraluminal mucosal web.

A two-year-old boy presenting with the signs and symptoms of partial intestinal obstruction caused by a mucosal web in the ileum is presented. Histopathological evaluation following resection and primary anastomosis revealed neuronal intestinal dysplasia associated with fibromuscular arterial dysplasia limited to the segment proximal to the web and normal findings in the distal part. These findings and a brief review of the literature support the hypothesis that neuronal and fibromuscular dysplasias may develop on the basis of congenital obstructive lesions of the bowel.

Arteries↗
PubMed1997

Is fetal thoracic compression really the underlying mechanism of lung hypoplasia in oligohydramnios? An experimental study in a rabbit model.

Compression of the fetal thorax by the uterine wall is one of the theories proposed to explain the mechanism of lung hypoplasia in association with oligohydramnios. However, the reduction in the intrathoracic space and the evidence of compression on the fetal thorax have not been demonstrated in detail. Therefore an experimental study was planned to determine the effects of oligohydramnios on available intrathoracic space and lung volume in the rabbit fetus. Amniotic fluid was shunted into the peritoneal cavity between 23 and 31 days of gestation. Intrathoracic space and lung volumes (TV and LV), and lung and body weight (LW and BW) values were measured in our study and control fetuses at term. Lung weight/body weight, lung volume/thorax volume, thorax volume/body weight ratios were calculated and the values of the fetuses with shunting and controls were compared. The difference between TV/BW ratios was not significant. LW/BW and LV/TV ratios were significantly reduced in experimental fetuses compared to the controls. Chronic drainage of amniotic fluid into the peritoneal cavity resulted in reduced LW/BW and LV/TV ratio, but did not effect TV/BW ratio. The low LV/TV ratio in the fetuses with shunting despite similar TV/BW ratio suggested that the diaphragm had been elevated. This is also an explanation for the observation of reduced chest circumference and chest circumference/abdominal circumference ratio in prolonged premature rupture of the membranes in vivo. The developing fetal lungs would undergo not only transthoracic but also trans-abdomino-diaphragmatic compression. However, it is unlikely in the tubular shaped rabbit uterus. In oligohydramnios amniotic fluid dynamics or physical characteristics with its contents should be disturbed. A previous experimental study with herniation of the amniotic sac causing lung hypoplasia through reduced intraamniotic pressure without oligohydramnios also questioned the role of fetal compression. Although fetal lung development was significantly impaired, the thoracic cage was not affected by amniono-peritoneal shunting. Therefore, we suggest that lung hypoplasia resulted from another mechanism rather than thoracic compression.

Amniotic Fluid↗
PubMed1997

Spontaneous rupture of choledochal cyst: an unusual cause of acute abdomen in children.

Rupture is one of the rare complications of choledochal cysts. The cause of rupture is unknown in many cases and is considered to be spontaneous. Two patients admitted to the hospital with acute abdominal picture were initially thought to have postoperative abscess and appendicitis. However, the presence of bilelike fluid suggested a bile tract pathology, and evaluation showed rupture choledochal cysts. Although spontaneous rupture of a choledochal cyst is a rare complication, and can sometimes be the initial manifestation of a choledochal cyst, it should be considered in the presence of bilelike fluid and differentiated from spontaneous perforation of the bile tract. In spontaneous rupture of choledochal cyst, cystectomy, cholecystectomy, and Roux-Y hepaticoportoenterostomy is the treatment of choice.

Abdomen, Acute↗
PubMed1996

In utero defecation by the normal fetus: a radionuclide study in the rabbit.

An experimental study was performed to investigate the excretion function of the liver, gastrointestinal motility, and in utero defecation by radionuclide techniques in 24 New Zealand white rabbit fetuses at 25 days' gestation (fullterm, 31 to 32 days). 0.1 mL of technetium 99m (99mTc)-HIDA (a derivative of iminodiacetic acid) containing 1 mCi of radioactivity was injected into the gluteus muscle of each fetus which had been exposed through the uterus. After replacing the fetus and uterus into the abdomen, and beginning 1 hour after injection, a live fetus was killed each hour for 24 hours Tissue samples from the lung heart, stomach, kidney, bladder, liver, meconium in the proximal, mid and distal bowel, and amniotic fluid were taken. The radioactivity of each sample was determined by a gamma counter and the percentage uptake per gram of tissue was calculated. The very low radioactivity levels detected in the stomach, kidneys, and bladder indicated the in vivo stability of 99mTc-HIDA 99mTc-HIDA is predominantly trapped by the liver via systemic circulation and is excreted into the gastrointestinal tract through which it passes into the amniotic fluid. Demonstrated passage of excreted 99mTc-HIDA through the fetal liver and into the gastrointestinal tract and amniotic fluid strongly suggests that fetal defecation is a physiological event.

Amniotic Fluid↗
PubMed1996

Gastric lymphoma causing gastric outlet obstruction.

An unusual presentation of abdominal lymphoma causing gastric outlet obstruction is reported. Gastric lymphoma should be considered in the differential diagnosis of gastric outlet obstruction during childhood. The possibility of gastric malignancy should not be excluded only on the basis of the patient's age. Complete resection of the tumor, with postoperative radiation and/or chemotherapy is the best method of treatment for high-grade lymphomas.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

The effects of chemical sympathectomy on contralateral testicular histology, fertility and fecundity in unilateral abdominal testes.

OBJECTIVE: To evaluate the effects of abdominal testis on ipsilateral and contralateral testicular histology, fertility and fecundity in rats which were chemically sympathectomized neonatally. MATERIALS AND METHODS: The study comprised 60 male albino rats, 30 receiving a placebo and 30 a chemical sympathectomic agent neonatally. When 21 days old, the two groups of 30 rats were each divided into three groups and underwent a control operation or abdominal fixation of one or both testes. After they were 8 weeks old, each male rat was housed with two fertile female rats for 25 days, after which their testes were harvested. Females were observed for an additional 25 days and any pregnancies and the number of offspring were recorded. Mean seminiferous tubular diameters and mean testicular biopsy scores were determined for each testis. RESULTS: Although fertility and fecundity rates and mean testicular biopsy scores were not significantly different, chemical sympathectomy prevented the decrease in mean seminiferous tubular diameters which occurred in the contralateral testis. CONCLUSION: Chemical sympathectomy protected contralateral testicular histology to some degree. Therefore, the sympathetic system may play a role in contralateral testicular deterioration.

Animals↗
PubMed1996

Is there any predictive characteristic for malignancy in thyroid enlargements during childhood?

Although thyroid surgery is mainly based on the malignancy risk, determination of cases with thyroid malignancy among the patients with enlarged thyroid is a controversial issue in children. To find out whether thyroid enlargements have any predictive clinical or laboratory characteristic for thyroid malignancy, a retrospective clinical study was scheduled. A total of 137 patients who had undergone surgery for thyroid enlargement in a 15-year period were evaluated. The series was composed of 90 (65.7%) cases with uninodular goiter, 40 (29.2%) cases with multinodular goiter and seven (5.1%) cases with diffuse goiter. Histopathologic examination showed nine (6.6%) patients with differentiated thyroid carcinoma. All the remaining patients had benign thyroid enlargements. Analysis of results showed no ideal or near-ideal predictive one for thyroid malignancies among clinical or laboratory characteristics consisting of age, sex, presumptive symptoms, previous irradiation, type of nodularity, nodule localization and size, lymphadenopathy, thyroid function tests, ultrasonography and thyroid scan. No characteristic studied had a simultaneous high level of positive and negative predictive value. Only two physical characteristics including nodule size less than 2.5 cm in diameter and lymphadenopathy had simultaneous high levels of sensitivity and specificity above 50%. Therefore new guidelines with higher predictivity should be sought for surgical evaluation of the childhood thyroid enlargements. Fine-needle aspiration biopsy that is extensively used in adults may also be an alternative approach despite some restrictive aspects in children.

Adenocarcinoma, Follicular↗
PubMed1996

Diaphragmatic rupture after plication: etiopathogenesis with review of the literature.

We present an infant who developed diaphragmatic rupture and secondary hernia following a successful diaphragmatic plication performed for congenital diaphragmatic eventration. The rupture occurred through the normal looking diaphragmatic tissue with an intact plication suture line, which has not been reported before. The possible etiologic factors of this secondary hernia are discussed with a brief review of the literature.

Diaphragmatic Eventration↗
PubMed1996

Aneurysmatic arteriovenous fistula complicating splenic injury.

A child with a posttraumatic aneurysmatic arteriovenous (AV) fistula located in the spleen is presented. The fact that the increased use of more conservative diagnostic and therapeutic approaches in splenic injuries might lead to underestimation of some uncommon complications is discussed.

Adolescent↗