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Biomedical subjects

G Karagüzel

Publications and source records attributed to G Karagüzel.

14 recordsLinked to original sources

An uncommon association relating to cloacal maldevelopment: bladder agenesis, anorectal atresia, and absence of vulva, vagina, and uterus.

The authors report on a newborn girl with complex urogenital and hindgut abnormalities. Urogenital anomalies consisted of absence of vulva and vagina, uterine and urethral atresias, bladder agenesis with ectopic ureteric opening, and bilateral pelvic ectopic kidneys. In addition, the baby had anorectal atresia without fistula as a hindgut anomaly. Herein, clinical evaluation and embryological review are made to explain the concomitant occurrence of these rare malformations.

Abnormalities, Multiple

A gastroschisis-like abdominal wall defect in the left hypochondrium. Case report and literature review.

Congenital abdominal wall defects are exceedingly rare on the left side. The presented patient had an upper abdominal wall defect located just lateral to the left rectus muscle. Additionally, upper parts of the abdominal flat muscles were defective on that side. Because no report was found in the literature about the defect described here, both its terminological and embryological backgrounds are discussed.

Abdominal Muscles

Acute bronchodilatory effect of salmeterol on methacholine-induced bronchoconstriction in childhood asthma.

A review of the literature highlights the need for research, particularly on the acute bronchodilatory effect of salmeterol on bronchoconstriction in the pediatric age group. The present study attempted to evaluate the acute bronchodilatory effect of salmeterol on methacholine-induced bronchoconstriction in childhood asthma and to compare it with the effect of salbutamol. Forty-four asymptomatic children with mild-to-moderate asthma (23 boys and 21 girls; aged 7-17 years) were studied. At the beginning, the baseline forced expiratory volume in 1 s (FEV1) was measured, and the methacholine challenge was performed by doubling the dose to determine PC20 (provocative concentration of inhaled methacholine required to reduce FEV1 by 20%). At the same time, the transcutaneous arterial oxygen saturation (SaO2) was also measured. Each subject inhaled a single dose of 25 micrograms salmeterol (n: 23, group I) or 100 micrograms salbutamol (n: 21, group II) following the SaO2 measurement. The same measurements (FEV1, SaO2) were repeated 5 and 20 min after the inhalation. After inhalation of salmeterol or salbutamol, the differences between the values of FEV1 and SaO2 after 5 and 20 min were insignificant in both group I and group II (P > 0.05), although there was a significant improvement in both FEV1 and SaO2 after 5 and 20 min (P < 0.005). From these findings it was concluded that salmeterol can be considered as effective as salbutamol on methacholine-induced bronchoconstriction.

Adolescent

Short-term effects of budesonide, nedocromil sodium and salmeterol on bronchial hyperresponsiveness in childhood asthma.

BACKGROUND: The effects of budesonide, nedocromil sodium and salmeterol on bronchial hyperresponsiveness were determined over a period of 3 weeks. METHODS: Forty-three asymptomatic children (22 male, 21 female, aged 7-17 years) with mild-to-moderate asthma were evaluated. The study was placebo-controlled and double-blind. At the beginning the forced expiratory volume in 1 second (FEV1) was measured and a methacholine challenge was performed to determine PC20 (provocative concentration of inhaled methacholine required to reduce FEV1 by 20%). The patients in group I (n = 12), group II (n = 10), group III (n = 11), and group IV (n = 10) inhaled 200 micrograms of budesonide, 2 mg of nedocromil sodium, 25 micrograms of salmeterol and a placebo, respectively, twice a day over the period of 3 weeks. Then the methacholine PC20 values of all patients were measured again and the results were compared statistically with their previous values. RESULTS: The statistical data revealed that the methacholine doses in PC20 before and after treatment were different in group I (P < 0.01). However, these differences were not statistically significant in the other groups (P > 0.05). CONCLUSIONS: The short term usage of budesonide decreases bronchial hyperresponsiveness, but nedocromil sodium and salmeterol in the given dises do not affect bronchial hyperresponsiveness.

Adolescent

Acute physiopathological and histopathological effects of fetal distress on the fetal stomach: an experimental study.

Although effects of stress on the stomach have been extensively investigated in children and adults, our knowledge about effects of fetal distress (FD) on the fetal stomach is quite limited. Therefore, an experimental study was planned to evaluate the effects of FD on fetal gastric physiology and histology. In this study, a model of FD was created by way of intermittent maternal aortic occlusion in pregnant rabbits. In total, 21 fetuses of 6 pregnant rabbits were available for surgical and laboratory procedures. Laboratory examinations showed that (1) fetal gastric acid secretion was 4.24 +/- 2.68 muEq/h in the control group and 18.08 +/- 6.34 muEq/h in the distress group (p < 0.01) and (2) fetal gastric PGE2 level was 16.59 +/- 6.15 mg/g wet weight in the control group and 9.86 +/- 3.46 mg/g wet weight in the distress group (p < 0.05). Histopathologically, there were mild hemorrhagic and errosive changes in the distressed fetuses, but not in control fetuses. These findings support that FD adversely affects fetal gastric physiology through two mechanisms consisting of increased gastric acid secretion and decreased fetal gastric protection in rabbits. Consequently, gastric injury should be noted as a potential problem among hypoxia-associated abnormalities encountered in the distressed fetus.

Animals

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

Surgical management of the pancreatic pseudocyst in children: a long-term evaluation.

Pseudocyst of the pancreas is an uncommon disorder in children. During the period of 1977 to 1990, the authors reviewed the records of 10 consecutive patients with pancreatic pseudocyst (PP) who were surgically treated in our institution. In 8 patients, the surgical procedure that was used was transgastric cystogastrostomy, and in 1 patient it was total excision of the pseudocyst. The remaining 1 patient underwent external drainage. After an average follow-up of previous operation except the 1 patient who was treated with external drainage. Biochemical tests, abdominal ultrasonographies, and barium meals were also normal in 9 patients. The analysis of the results indicates that despite new percutaneous therapeutic modalities, it is still an internal drainage through transgastric cystogastrostomy that should be favored in treatment of PP in children.

Child

Subsequent biological effects of chemical sympathectomy in rats undergoing unilateral testicular torsion.

The effects of chemical sympathectomy on contralateral testicular histology, fertility and fecundity following unilateral testicular torsion were evaluated in rats. Four groups, placebo plus sham operation, 6-OH-dopamine plus sham operation, placebo plus torsion, and 6-OH-dopamine plus torsion, were established. When the placebo plus sham operation and placebo plus torsion groups were compared, it was found that contralateral testicular damage following unilateral testicular torsion occurred with significantly decreased values for mean seminiferous tubular diameter (MSTD), mean testicular biopsy score (MTBS) and fertility. The relatively normal values for MSTD, MTBS and fertility in the 6-OH-dopamine plus sham operation and 6-OH-dopamine plus torsion groups indicate the preventive role of chemical sympathectomy on contralateral testicular damage. Since chemical sympathectomy prevents contralateral histologic deterioration and preserves fertility in unilateral testicular torsion, the decreased blood flow in the reflex-activating sympathetic system may play a role in contralateral testicular damage.

Animals

Is ipsilateral testis mandatory for contralateral testicular deterioration encountered following spermatic cord torsion?

Although deteriorating effects of unilateral spermatic cord torsion are generally accepted, the mechanism remains controversial. An experimental study was performed to evaluate the necessity of testicular and spermatogenetic material for contralateral testicular deterioration following unilateral spermatic cord torsion in rats. The animals were allocated to four groups: control, spermatic cord torsion, subepididymal orchiectomy, and spermatic cord torsion 14 days after subepididymal orchiectomy. The testes were removed on the 14th days and mean seminiferous tubular diameters and mean testicular biopsy scores were determined. Although contralateral testicular deterioration was more pronounced in the presence of testicular tissue, the absence of testicular tissue and/or spermatogenetic material did not prevent its occurrence. This is highly suggestive that autoimmune mechanism does not play a role in contralateral testicular damage following unilateral spermatic cord torsion.

Animals

The preventive role of chemical sympathectomy on contralateral testicular hypoxic parameters encountered during unilateral testicular torsion.

OBJECTIVE: To evaluate the effect of chemical sympathectomy on lactic acid and hypoxanthine concentrations in both testes during unilateral testicular torsion in a rat experimental model. MATERIALS AND METHODS: Four groups, comprising 10 rats each, were studied. Group I was the control group, Group II rats received a placebo and underwent unilateral testicular torsion, Groups III and IV received guanethidine monosulphate and 6-OH-dopamine hydrobromide respectively, and underwent unilateral testicular torsion. The levels of lactic acid and hypoxanthine in both testes were measured. RESULTS: In rats in Group II the levels of lactic acid and hypoxanthine in both testes were significantly elevated when compared to the control group. In the groups of rats that had undergone chemical sympathectomy, the levels of lactic acid and hypoxanthine were significantly decreased in the contralateral testes compared to rats in Groups I and II. CONCLUSION: Chemical sympathectomy prevents the elevation of lactic acid and hypoxanthine levels in the contralateral testis of rats with unilateral testicular torsion. Therefore, we conclude that contralateral testicular damage during unilateral testicular torsion may result through a reflex activating sympathetic system.

Animals

Persistent diffuse peritonitis in children.

In adults, persistent diffuse peritonitis (PDP) having a special microbiologic spectrum is now defined as a distinct intraabdominal infection because of its aggressive clinical course. Considering also other types of peritonitis, this study was performed to determine characteristics of childhood PDP in regard to clinical picture, microbiologic features, treatment and outcome. Classification of 175 patients with peritonitis showed that nine patients had primary peritonitis and 121, 37 and eight patients had secondary peritonitis, PDP, and intraabdominal abscess, respectively. Rates of host defense affecting disease, extra-appendicular origin, and mortality were markedly higher in the PDP group. However, polymicrobic and anaerobic infection rates were lower in the PDP group than those of the secondary peritonitis group. While 26 of 37 patients with PDP underwent surgical intervention, the remaining 11 patients were managed by conservative measures. In the PDP group, mortality was 18 percent for conservatively and 23 percent for surgically treated patients. Being of young age, presence of an accompanying disease and fungal growth increased the mortality. The results indicate that PDP is a distinct type of peritonitis in children as well as in adults. In addition, accurate identification of these patients may prevent some unnecessary operations and improve survival by the choice of more conservative treatment plans.

Adolescent