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Biomedical subjects

S Demirbilek

Publications and source records attributed to S Demirbilek.

23 records · Page 2Linked to original sources

One-stage hypospadias repair with stent or suprapubic diversion: which is better?

PURPOSE: The authors report on 105 consecutive patients who underwent one-stage hypospadias repair based on use of suprapubic diversion or transurethral drainage with stenting. METHODS: The surgical procedures included 52 metal-based flap urethroplasty (Mathieu) for coronal, subcoronal, and distal shaft hypospadias; 32 transverse island pedicle graft (Duckett) for mid and proximal shaft hypospadias; 21 transverse island pedicle (Duckett) plus rolled midline tube (Thierchs) for penoscrotal and scrotal hypospadias. To accomplish urinary drainage, suprapubic diversion (cystofix) was used in 28 of 52 Mathieu operations, in 17 of 32 Duckett operations, and in 11 of 21 transverse island pedicle graft plus rolled midline tube operations. In the rest of the cases, transurethral drainage with stenting was used. RESULTS: All children had excellent cosmetic and functional outcomes. But the rates of complications such as fistula and meatal stenosis were significantly different between the groups in which suprapubic tube or urethral stent was used. In 56 of the 105 patients in whom suprapubic diversion was used, four (7.14%) had fistulas and three (5.35%) had meatal stenosis, in contrast to a fistula rate of 14.28% and meatal stenosis rate of 12.24% in patients that urethral stent is used for urinary drainage. CONCLUSION: The authors believe that the use of suprapubic diversion is advantageous for the outcome of one-stage hypospadias repair in relation to fistula occurrence and meatal stenosis.

Adolescent↗

Seromuscular gastrocystoplasty in rats.

Long-term results of seromuscular gastrocystoplasty have not been reported in the literature. In the presented study, a seromuscular gastrocystoplasty technique in rats and related biochemical, physiological, and histopathologic results are discussed. Fifty rats were grouped as follows: control and sham (group A), animals with gastrocystoplasty (group B), and animals with seromuscular gastrocystoplasty (group C). Urine pH, blood pH, and bicarbonate levels, bladder capacity, and end filling pressures were evaluated in all groups. After gastrocystoplasty and seromuscular gastrocystoplasty both group B and C showed a statistically significant increase in bladder capacity. Aciduria developed in 22% of rats in group B. In group A and C aciduria was not noted. No statistically significant difference was observed in blood pH, bicarbonate levels, and end-filling pressure measurements in each group of rats. Significant histopathologic changes of bladder occurred in the gastrocystoplasty group. In the 13 bladders examined histologically in group B, 2 had a papilloma on the mucosal surface of the transplanted gastric patch. The bladder mucosa adjacent to the transplanted gastric patch had pronounced hyperplastic and squamous metaplastic changes. In the 15 bladders examined histologically in group C none had a papilloma on the gastric segments. Squamous metaplasia in the bladder mucosa adjacent to the transplanted gastric patch was noted only in 2 rats of this group. Two rats also had bladder calculi in the lumen. Possible etiologies and differences of gastrocystoplasty and seromuscular gastrocystoplasty related pathological changes between two groups are discussed.

Animals↗

A case of a mediastinal neurenteric cyst demonstrated by prenatal ultrasound.

We report the case of a posterior large mediastinal neurenteric cyst demonstrated by prenatal ultrasound (US). Postnatal chest radiography and CT studies demonstrated a posterior, large cystic mediastinal mass associated with vertebral abnormalities including scoliosis, hemivertebrae and anterior spina bifida. Because postnatally respiratory distress developed and rapidly progressed, an emergency operation was performed 12 hours after delivery. The cyst was excised via right posterolateral thoracotomy. Postoperatively, respiratory distress regressed. This is the third reported case of a neurenteric cyst demonstrated by prenatal ultrasound.

Cesarean Section↗

Effects of estradiol and progesterone on the synthesis of collagen in corrosive esophageal burns in rats.

The effects of sex hormones on the synthesis of collagen were investigated in rats with alkali-induced corrosive esophageal burns. In 75 rats, a standard esophageal burn was produced as described by Gehanno. The animals were then grouped as follows: controls (group A), animals with pure esophageal burns (group B), and animals with esophageal burns treated with estradiol and progesterone (group C). All animals were killed on the 28th day of the experiment. Hydroxyproline levels were determined, and histopathologic evaluation was performed for each group. The hydroxyproline levels were significantly lower in the rats treated with estradiol and progesterone. Histopathologically, collagen deposition in the submucosa and tunica muscularis was lower in the estradiol/progesterone group than in the group with pure esophageal burns. Based on the results, the authors believe that estradiol and progesterone inhibited new collagen synthesis, and therefore, alkali-induced esophageal stricture formation.

Animals↗