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Gürünlüoğlu S, Ceran C, Gürünlüoğlu K, Koçbiyik A, Gül M, Yıldız T, Bağ HG, Gül S, Taşçi A, Bayrakçi E, Akpinar N, Çin ES, Ateş H, Demircan M. Glial Cell Line-Derived Neurotrophic Factor, S-100 Protein and Synaptophysin Expression in Biliary Atresia Gallbladder Tissue. Pediatr Gastroenterol Hepatol Nutr 2021; 24:173-186. [PMID: 33833973 PMCID: PMC8007845 DOI: 10.5223/pghn.2021.24.2.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/09/2020] [Accepted: 10/20/2020] [Indexed: 11/14/2022] Open
Abstract
PURPOSE Biliary atresia (BA) is a disease that manifests as jaundice after birth and leads to progressive destruction of the ductal system in the liver. The aim of this study was to investigate histopathological changes and immunohistochemically examine the expression of glial cell line-derived neurotrophic factor (GDNF), synaptophysin, and S-100 protein in the gallbladder of BA patients. METHODS The study included a BA group of 29 patients and a control group of 41 children with cholecystectomy. Gallbladder tissue removed during surgery was obtained and examined immunohistochemically and histopathologically. Tissue samples of both groups were immunohistochemically assessed in terms of GDNF, S-100 protein, and synaptophysin expression. Expression was classified as present or absent. Inflammatory activity assessment with hematoxylin and eosin staining and fibrosis assessment with Masson's trichrome staining were performed for tissue sample sections of both groups. RESULTS Ganglion cells were not present in gallbladder tissue samples of the BA group. Immunohistochemically, GDNF, synaptophysin, and S-100 expression was not detected in the BA group. Histopathological examination revealed more frequent fibrosis and slightly higher inflammatory activity in the BA than in the control group. CONCLUSION We speculate that GDNF expression will no longer continue in this region, when the damage caused by inflammation of the extrahepatic bile ducts reaches a critical threshold. The study's findings may represent a missing link in the chain of events forming the etiology of BA and may be helpful in its diagnosis.
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Affiliation(s)
- Semra Gürünlüoğlu
- Department of Pathology Malatya Education and Research Hospital, Pathology Laboratory, Malatya, Turkey
| | - Canan Ceran
- Department of Pediatric Surgery, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Kubilay Gürünlüoğlu
- Department of Pediatric Surgery, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Alper Koçbiyik
- Department of Pathology, Istanbul Bakırköy Dr Sadi Konuk Education and Research Hospital, Pathology Laboratory, Istanbul, Turkey
| | - Mehmet Gül
- Department of Histology and Embryology, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Turan Yıldız
- Department of Pediatric Surgery, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Harika Gözükara Bağ
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Semir Gül
- Department of Histology and Embryology, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Aytaç Taşçi
- Department of Pediatric Surgery, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Ercan Bayrakçi
- Department of Pediatric Surgery, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Necmettin Akpinar
- Department of Pediatric Surgery, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Ecem Serbest Çin
- Department of Pediatric Surgery, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Hasan Ateş
- Department of Pediatric Surgery, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Mehmet Demircan
- Department of Pediatric Surgery, Faculty of Medicine, İnönü University, Malatya, Turkey
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Gürünlüoğlu K, Ceran C, Yıldırım İO, Kutlu R, Saraç K, Yıldız T, Bayrakçı E, Taşçı A, Arslan AK, Demircan M. Use of angiographic embolization in trauma-induced pediatric abdominal solid organ injuries. ULUS TRAVMA ACIL CER 2019; 25:238-246. [PMID: 31135937 DOI: 10.5505/tjtes.2018.00056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Knowledge of the utility of angiographic embolization (AE) in pediatric cases of blunt abdominal solid organ trauma injuries is limited. The current study is an examination of AE as an effective and reliable method to control bleeding in patients with persistent bleeding due to blunt trauma-induced abdominal solid organ injury. METHODS This was a retrospective examination of patients <17 years of age who had experienced blunt abdominal solid organ injury and who presented at a single institution within 4 years. A statistical analysis of the data was performed. RESULTS The mean length of intensive care unit stay was 4 days for those who underwent embolization (n=11), and the mean length of hospital stay was 12 days. The average pre-AE blood loss, as measured by the decrease in hematocrit (%) from admission to embolization, was -7.33+-5.3% (p<0.001). The average post-AE blood loss, as measured by the change in hematocrit 72 hours post AE, was 2+-0.97% (p>0.05). All of the patients were discharged with a full recovery. CONCLUSION AE was a safe and effective method to control solid organ hemorrhage in pediatric patients with blunt abdominal injuries.
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Affiliation(s)
- Kubilay Gürünlüoğlu
- Department of Pediatric Surgery, İnönü University Faculty of Medicine, Turgut Özal Medical Center, Malatya-Turkey
| | - Canan Ceran
- Department of Pediatric Surgery, İnönü University Faculty of Medicine, Turgut Özal Medical Center, Malatya-Turkey
| | - İsmail Okan Yıldırım
- Department of Radiolgy, İnönü University Faculty of Medicine Turgut Özal Medical Center, Malatya-Turkey
| | - Ramazan Kutlu
- Department of Radiolgy, İnönü University Faculty of Medicine Turgut Özal Medical Center, Malatya-Turkey
| | - Kaya Saraç
- Department of Radiolgy, İnönü University Faculty of Medicine Turgut Özal Medical Center, Malatya-Turkey
| | - Turan Yıldız
- Department of Pediatric Surgery, İnönü University Faculty of Medicine, Turgut Özal Medical Center, Malatya-Turkey
| | - Ercan Bayrakçı
- Department of Pediatric Surgery, İnönü University Faculty of Medicine, Turgut Özal Medical Center, Malatya-Turkey
| | - Aytaç Taşçı
- Department of Pediatric Surgery, İnönü University Faculty of Medicine, Turgut Özal Medical Center, Malatya-Turkey
| | - Ahmet Kadir Arslan
- Department of Biostatistics and Medical Informatic, İnönü University Faculty of Medicine, Malatya-Turkey
| | - Mehmet Demircan
- Department of Pediatric Surgery, İnönü University Faculty of Medicine, Turgut Özal Medical Center, Malatya-Turkey
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Ozcan H, Ceran C. Epididymo-orchitis caused by Behcet s disease: An unusual cause of acute scrotum. j-pucr 2019. [DOI: 10.14534/j-pucr.2019351743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Ceran C, Demirseren M, Aksam E, Cicek C, Demiralp C. Lateral malleolar region defects with exposed implants: proximally based peroneus brevis muscle flap. J Wound Care 2015; 24:372-7. [DOI: 10.12968/jowc.2015.24.8.372] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- C. Ceran
- Ataturk Training and Research Hospital, Department of Plastic Reconstructive and Aesthetic Surgery, Ankara, Turkey
| | - M.E. Demirseren
- Ataturk Training and Research Hospital, Department of Plastic Reconstructive and Aesthetic Surgery, Ankara, Turkey
| | - E. Aksam
- Akhisar State Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, Manisa, Turkey
| | - C. Cicek
- Ataturk Training and Research Hospital, Department of Plastic Reconstructive and Aesthetic Surgery, Ankara, Turkey
| | - C.O. Demiralp
- Ataturk Training and Research Hospital, Department of Plastic Reconstructive and Aesthetic Surgery, Ankara, Turkey
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Yildiz T, Ilce HT, Ceran C, Ilce Z. Simple patch closure for perforated peptic ulcer in children followed by helicobacter pylori eradication. Pak J Med Sci 2014; 30:493-6. [PMID: 24948965 PMCID: PMC4048492 DOI: 10.12669/pjms.303.4705] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 12/27/2013] [Accepted: 03/05/2014] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE Peptic ulcer disease in children is rare. Therefore, the diagnosis can be missed until complications such as perforation or hemorrhage occur. Few reports have investigated the procedures and outcomes of children who have undergone operations for perforated duodenal ulcers. We report our experience with the modified Graham technique for perforated duodenal ulcers in nine children and review the literature. Methods : The records of patients operated on for a perforated duodenal ulcer in the last 8 years in two pediatric surgery centers were evaluated retrospectively. Patient demographics, symptoms, time to admission to hospital, operative findings, and postoperative clinical course were evaluated. Results : Nine children (mean age 13.2 years, range 6-170 years) were included. All patients were admitted in the first six hours after their abdominal pain started. In three patients, there was free air on plain x-rays, while the x-rays were normal in six. All perforations were located on the anterior surface of the first part of the duodenum and repaired with primary suturing and Graham patch omentoplasty. The recovery was uneventful in all patients. In five patients, urea breath tests were performed postoperatively for Helicobacter Pylori, and the results were positive. All patients underwent triple therapy with lansoprazole, amoxicillin, and clarithromycin. The mean follow-up time was 58 (range 3-94) months. Conclusions : Peptic ulcer perforation should be suspected in children who have acute abdominal pain and peritoneal signs, especially when their suffering is intense. The simple patch repair and postoperative triple therapy for Helicobacter Pylori are safe and satisfactory for treating peptic ulcer perforation in children.
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Affiliation(s)
- Turan Yildiz
- Turan Yildiz, Department of Pediatric Surgery, Sakarya University Medical Schools, Sakarya, Turkey
| | - Huri Tilla Ilce
- Huri Tilla Ilce, Department of Nucleer Medicine, Sakarya University Medical Schools, Sakarya, Turkey
| | - Canan Ceran
- Canan Ceran, Department of Pediatric Surgery,Inonu University Medical Schools, Malatya, Turkey
| | - Zekeriya Ilce
- Zekeriya Ilce,Department of Pediatric Surgery, Sakarya University Medical Schools, Sakarya, Turkey
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Abstract
OBJECTIVES In addition to its roles in the stimulation of growth hormone secretion and the regulation of appetite and metabolism, ghrelin exerts immunomodulatory, anti-inflammatory and antioxidant actions in several organ systems. In this study, we investigated the effects of ghrelin on the healing of experimental colonic anastomoses. METHODS Wistar rats were randomly divided into two groups (n = 10 in each). A segment of colon was excised, and an end-to-end anastomosis was performed in the distal colon. The Ghrelin Group received 10 ng/kg/day IP ghrelin for seven days postoperatively, whereas the Control Group received an identical volume of saline. On the seventh postoperative day, the anastomotic bursting pressures and hydroxyproline levels were measured, and adhesion formation around the anastomoses was examined. Histopathological analyses were performed to evaluate inflammatory cell infiltration, fibroblast infiltration, collagen density and neovascularization. RESULTS In the Ghrelin Group, the bursting pressure and hydroxyproline levels were significantly higher than in the Control Group. The adhesion formation scores were lower in the Ghrelin Group than in the Control Group. Although the inflammatory cell infiltration was diminished in the Ghrelin Group, the degrees of fibroblast infiltration, collagen density and neovascularization were not significantly different between the groups. CONCLUSION Our results indicate that ghrelin improves the healing of colonic anastomoses in rats.
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Affiliation(s)
- Canan Ceran
- Department of Pediatric Surgery, Inönü University Medical School, Malatya, Turkey.
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Uğuralp S, Ceran C, Demircan M. Congenital distal esophageal obstruction caused by intraluminal mucosal web. Turk J Pediatr 2012; 54:317-319. [PMID: 23094548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Here, we report a case with intraluminal membrane (web) located in the lower esophagus causing complete obstruction. Esophagogram revealed complete obstruction near the esophagogastric junction. Surgical excision of the esophageal membrane was performed. To our knowledge, only a few cases with membranous esophageal atresia have been reported. It must be remembered in neonates who cannot tolerate feeding.
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Affiliation(s)
- Sema Uğuralp
- Department of Pediatric Surgery, Inönü University Faculty of Medicine, Turgut Ozal Medical Center (TOMC), Malatya, Turkey
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Ceran C, Pampal A, Goktas O, Pampal HK, Olmez E. Commonly used intravenous anesthetics decrease bladder contractility: An in vitro study of the effects of propofol, ketamine, and midazolam on the rat bladder. Indian J Urol 2011; 26:364-8. [PMID: 21116355 PMCID: PMC2978435 DOI: 10.4103/0970-1591.70570] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Aim: This study was designed to test the hypothesis that propofol, ketamine, and midazolam could alter the contractile activity of detrusor smooth muscle. Materials and Methods: Four detrusor muscle strips isolated from each rat bladder (n = 12) were placed in 4 tissue baths containing Krebs-Henseleit solution. The carbachol (10
−8to 10−4mol/L)-induced contractile responses as well as 5, 10, 20, 30, 40, 50 Hz electrical field stimulation (EFS)-evoked contractile responses of the detrusor muscles were recorded using isometric contraction measurements. After obtaining basal responses, the in vitro effects of propofol, ketamine, midazolam (10−5 to 10−3 mol/L), and saline on the contractile responses of the detrusor muscle strips were recorded and evaluated. Results: All the 3 drugs reduced the carbachol-induced and/or EFS-evoked contractile responses of rat detrusor smooth muscles in different degrees. Midazolam (10−4 to 10−3 mol/L) caused a significant decrease in the contractile responses elicited by either EFS or carbachol (P=0.000−0.013). Propofol (10−3mol/L) caused a decrease only in EFS-evoked contractile responses (P=0.001−0.004) and ketamine (10−3mol/L) caused a decrease only in carbachol-induced contractile responses (P=0.001−0.034). Conclusion: We evaluated the effects of the 3 different intravenous anesthetics on detrusor contractile responses in vitro and found that there are possible interactions between anesthetic agents and detrusor contractile activity. The depressant effects of midazolam on the contractile activity were found to be more significant than ketamine and propofol. Despite the necessity of further studies, it could be a piece of wise advice to clinicians to keep the probable alterations due to intravenous anesthetics in mind, while evaluating the results of urodynamic studies in children under sedation.
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Affiliation(s)
- Canan Ceran
- Department of Pediatric Surgery, Inonu University, Malatya
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Demircan M, Aksoy T, Ceran C, Kafkasli A. Tracheal agenesis and esophageal atresia with proximal and distal bronchoesophageal fistulas. J Pediatr Surg 2008; 43:e1-3. [PMID: 18675618 DOI: 10.1016/j.jpedsurg.2008.04.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2008] [Revised: 04/03/2008] [Accepted: 04/09/2008] [Indexed: 10/21/2022]
Abstract
Tracheal agenesis (TA) is an extremely rare, typically fatal congenital tracheal malformation. Lack of prenatal symptoms and emergent presentation usually lead to a failure to arrive at the correct diagnosis and manage the airway properly before the onset of irreversible cerebral anoxia. Esophageal atresia (EA) encompasses a group of congenital anomalies comprising an interruption of the continuity of the esophagus with or without a persistent communication with the trachea. In 86% of cases, there is a distal tracheoesophageal fistula (TEF); in 7%, there is no fistulous connection, whereas in 4%, there is a TEF without atresia. We report the case of an infant born with TA and EA with proximal and distal bronchoesophageal fistulas. During 3 consecutive antenatal ultrasound examinations, there had been polyhydramniosis, difficulty visualizing the stomach, and dilatation of proximal esophagus, leading to a presumptive diagnosis of EA. The clinical presentation, embryology, classification, and surgical management are discussed.
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Affiliation(s)
- Mehmet Demircan
- Department of Pediatric Surgery, Inonu University, Medical School, 44315 Malatya, Turkey
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Ceran C, Karadas B, Kaya T, Arpacik M, Bagcivan I, Sarac B. DO ANTIBIOTICS CONTRIBUTE TO POSTOPERATIVE ILEUS? CONTRACTILE RESPONSES OF ILEUM SMOOTH MUSCLE IN GUINEA PIGS TO LONG-TERM PARENTERAL CEFTRIAXONE AND AMPICILLIN. ANZ J Surg 2006; 76:1023-6. [PMID: 17054555 DOI: 10.1111/j.1445-2197.2006.03922.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Antibiotics may impair small bowel smooth muscle contractility and contribute to postoperative ileus. The aim of this study was to compare the contractile responses of ileum smooth muscle to different agonists in guinea pigs treated with ceftriaxone (Rocephin; F. Hoffman-La Roche, Kaiseraugst, Switzerland) or ampicillin (Ampisina; Mustafa Nevzat Ilaç Sanayii AS, Istanbul, Turkey). METHODS Twenty-four adult guinea pigs were randomly divided into three groups. Whereas eight of these received ceftriaxone sodium (100 mg/kg per day, i.m.) for 10 days, another eight guinea pigs received ampicillin (50 mg/kg per day, i.m.) for 10 days and the remaining eight served as the control group receiving 1 mL distilled water during 10 days as placebo. By the end of 10 days, the animals were killed and their ilea were excised. Ileum segments were placed in an organ bath; concentration-response relationship for carbachol and histamine were obtained by adding the reagent cumulatively to the bath. RESULTS pD(2) values being the same, maximum contractile responses (E(max)) to carbachol and histamine were significantly reduced in the ceftriaxone sodium group compared with the control group. No significant differences in E(max) and pD(2) values to carbachol and histamine were observed between the ampicillin group and the control group. CONCLUSION These data indicate that whereas ceftriaxone may impair small bowel smooth muscle contractility, ampicillin does not. There are implications for the long-term use of parenteral antibiotics in the postoperative period.
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Affiliation(s)
- Canan Ceran
- Departments of Pediatric Surgery and Department of Pharmacology, Cumhuriyet University School of Medicine, Sivas, Turkey.
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Abstract
A solitary polyp of the urethra is a rare benign fibroepithelial growth and has often been described in boys. Its occurrence in girls is exceptional. In the present paper, two children with solitary polyps of the urethra are presented and discussed. The first case was an 18-month-old boy with a posterior urethral polyp arising from the posterior urethra and extending to the bladder. It was excised by cystostomy because of an unsuccessful endoscopic removal attempt. The second case was a 2-year-old girl with an interlabial mass arising from the posterior wall of urethra and protruding from the external urethral meatus. It was excised transurethrally.
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Affiliation(s)
- Mehmet Demircan
- Department of Pediatric Surgery, Inonu University, Faculty of Medicine, Malatya, Turkey.
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Sahin E, Kaptanoğlu M, Nadir A, Ceran C. [Traumatic rupture of a pulmonary hydatid cyst: a case report]. ULUS TRAVMA ACIL CER 2006; 12:71-5. [PMID: 16456754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
We present a case of traumatic hydropneumothorax due to hydatid cyst rupture in a 10 year-old girl. The patient was suspected to have a bronchial rupture because of prolonged massive air leak and she underwent cystotomy via right posterolateral thoracotomy. The patient was readmitted with dyspnea and chest X-ray revealed a lung collapse 13 months postoperatively. Lung collapse was treated by using a Heimlich valve. Pulmonary hydatid cyst can be asymptomatic for a long time unless a complication occurs. Because of the high incidence of hydatid disease in our country, this condition should be considered in cases with hydropneumothorax. The use of a Heimlich valve may be a good choice in the management of persistent air leak and may reduce the need for surgery.
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Affiliation(s)
- Ekber Sahin
- Department of Thoracic Surgery, Medicine Faculty of Cumhuriyet University, Sivas, Turkey.
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Ekingen G, Ceran C, Guvenc BH, Tuzlaci A, Kahraman H. Early enteral feeding in newborn surgical patients. Nutrition 2005; 21:142-6. [PMID: 15723741 DOI: 10.1016/j.nut.2004.10.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2004] [Revised: 02/19/2004] [Accepted: 05/17/2004] [Indexed: 01/18/2023]
Abstract
OBJECTIVE We report the results of a multicenter prospective trial of early enteral trophic feeding in a group of 56 neonates who required abdominal surgery for a variety of congenital anomalies. METHODS In this clinical study, 33 neonates were fed in the early postoperative period (early enteral nutrition [EEN] group), and the remaining 23 (control [C] group) were fasted until resolution of postoperative ileus. Patients in the EEN group (Kocaeli feeding protocol) received 3 to 5 mL of breast milk every hour through a nasogastric feeding tube, starting a mean of 12 h (8 to 20 h) after surgery. The nasogastric tube was clamped for 40 min after each infusion and then opened for drainage. Groups were further divided into two subgroups according to whether an intestinal anastomosis or laparotomy was performed. The change in daily gastric drainage, time to first stool, day of toleration to full oral feeding, and length of hospital stay were compared. Blood bilirubin levels, white blood cell count, and C-reactive protein levels were monitored. RESULTS The time to first stool and day of toleration to full oral feeding occurred significantly sooner, whereas nasogastric tube drainage duration and hospital stay were significantly shorter in the EEN-anastomosis group than in the C-anastomosis group. Time to first stool occurred significantly sooner in the EEN-laparotomy group than in the C-laparotomy group, although other parameters did not differ. Neither anastomotic leakage nor dehiscence was observed in any group. There were two cases of wound infection and two of exitus among patients in the C group. CONCLUSION Postoperative, early intragastric, small-volume breast milk feeding is well tolerated by newborns. It is a reliable and feasible approach in neonates even in the presence of an intestinal anastomosis after abdominal surgery.
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Affiliation(s)
- Gülşen Ekingen
- Department of Pediatric Surgery, Kocaeli University Medical School, Kocaeli, Turkey
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Taş F, Ceran C, Atalar MH, Bulut S, Selbeş B, Işik AO. The efficacy of ultrasonography in hemodynamically stable children with blunt abdominal trauma: a prospective comparison with computed tomography. Eur J Radiol 2005; 51:91-6. [PMID: 15186891 DOI: 10.1016/s0720-048x(03)00145-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2003] [Revised: 05/09/2003] [Accepted: 05/12/2003] [Indexed: 12/26/2022]
Abstract
PURPOSE In this prospective study we aimed to investigate the diagnostic value of ultrasonography (US) in hemodynamically stable children after blunt abdominal trauma (BAT) using computed tomography (CT) as the gold standard. MATERIALS AND METHODS Between 1997 and 2001, 96 children with BAT were evaluated prospectively. CT was performed first, followed by US. US and CT examinations were independently evaluated by two radiologists for free fluid and organ injury. The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of US were assessed regarding CT as the gold standard. RESULTS Overall 128 organ injuries were determined in 96 patients with CT; however, 20 (15.6%) of them could not be seen with US. Free intraabdominal fluid (FIF) was seen in 82 of 96 patients by CT (85.4%) and eight of them (9.7%) could not be seen by US. We found that sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of the US for free intra-abdominal fluid were 90.2, 100, 100, 63.6 and 91.7%, respectively. CONCLUSIONS US for BAT in children is highly accurate and specific. It is highly sensitive in detecting liver, spleen and kidney injuries whereas its sensitivity is moderate for the detection of gastrointestinal tract (GIT) and pancreatic injuries.
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Affiliation(s)
- Fikret Taş
- Department of Radiology, Faculty of Medicine, Cumhuriyet University, 58140 Sivas, Turkey.
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Ceran C, Oztoprak I, Cankorkmaz L, Gumuş C, Yildiz T, Koyluoglu G. Ceftriaxone-associated biliary pseudolithiasis in paediatric surgical patients. Int J Antimicrob Agents 2005; 25:256-9. [PMID: 15737522 DOI: 10.1016/j.ijantimicag.2004.10.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2004] [Accepted: 10/25/2004] [Indexed: 10/25/2022]
Abstract
It is well known that ceftriaxone leads to pseudolithiasis in some patients. Clinical and experimental studies also suggest that situations causing gallbladder dysfunction, such as fasting, may have a role for the development of pseudolithiasis. In this study, we prospectively evaluated the incidence and clinical importance of pseudolithiasis in paediatric surgical patients receiving ceftriaxone treatment, who often had to fast in the post-operative period. Fifty children who were given ceftriaxone were evaluated by serial abdominal sonograms. Of those, 13 (26%) developed biliary pathology. Comparison of the patients with or without pseudolithiasis revealed no significant difference with respect to age, sex, duration of the treatment and starvation variables. After cessation of the treatment, pseudolithiasis resolved spontaneously within a short period. The incidence of pseudolithiasis is not affected by fasting.
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Affiliation(s)
- Canan Ceran
- Department of Pediatric Surgery, Medical School of Cumhuriyet University, Sivas, Turkey.
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Arpacik M, Ceran C, Kaya T, Karadas B, Sarac B, Koyluoğlu G. Effects of ceftriaxone sodium on in vitro gallbladder contractility in guinea pigs1. J Surg Res 2004; 122:157-61. [PMID: 15555612 DOI: 10.1016/j.jss.2004.05.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2003] [Indexed: 10/26/2022]
Abstract
BACKGROUND/PURPOSE It has been reported that ceftriaxone may induce the formation of gallstones. Changes of gallbladder motility may play a role in this phenomenon. The present study was designed to analyze the gallbladder contractility of ceftriaxone sodium-treated guinea pigs in response to different agonists. MATERIALS AND METHODS Twenty adult guinea pigs were randomly divided into two groups. Ten guinea pigs were treated with ceftriaxone sodium (100 mg/kg/day) for 10 days, whereas the remaining 10 served as the control group, receiving 1 ml of distilled water during 10 days as placebo. By the end of the experimental period the animals were sacrificed and the gallbladders were removed. The responses to KCl, papaverine, sodium nitroprusside, carbachol, and histamine on gallbladder strips from control and experimental groups were recorded and analyzed. RESULTS There was no significant difference between the responsiveness to KCl, papaverine, and sodium nitroprusside on tissues isolated from experimental and control groups. Comparison of the two groups revealed that the maximum responses (E(max)) to carbachol and histamine were significantly reduced in the experimental group, without any change in the pD(2) values. CONCLUSION These data indicate that, after ceftriaxone sodium therapy, the decreased maximum contractile response to carbachol and histamine may contribute to the formation of gallstones.
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Affiliation(s)
- Mehmet Arpacik
- Department of Pediatric Surgery, Cumhuriyet University School of Medicine, Sivas, Turkey
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Kaya TT, Koyluoglu G, Karadas B, Yildiz T, Bagcivan I, Ceran C, Gökgöz S. Effect of peritonitis on gallbladder smooth muscle contractility in guinea pigs. J Surg Res 2004; 120:219-24. [PMID: 15234216 DOI: 10.1016/j.jss.2003.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2003] [Indexed: 11/24/2022]
Abstract
BACKGROUND The mechanisms involved in the impaired gallbladder contractile response in peritonitis are unknown. The aim of this study was to determine the effect of peritonitis on the contraction and relaxation responses to different agonists in gallbladder smooth muscle in guinea pig. MATERIALS AND METHODS Peritonitis was induced by cecal ligation and puncture (CLP) in 10 guinea pigs. Another group of 10 guinea pigs underwent a sham operation and acted as controls. Twenty-four hours after the operation, the guinea pigs were killed, and gallbladder strips were placed in organ bath. The contraction responses to KCl, carbachol, and histamine, and relaxation responses to cyclooxygenase inhibitors (indomethacin, nimesulide, and DFU) on KCl-induced contractions were recorded. RESULTS There was no significant difference between the contractile responsiveness to KCl, but maximum contractile responses (E(max)) to carbachol and histamine were significantly reduced. Indomethacin, nimesulide, and DFU concentration dependently inhibited on KCl-induced contractions of gallbladder smooth muscle. E(max) values of indomethacin, nimesulide, and DFU were significantly reduced in the peritonitis group compared with controls (P < 0.05). The inhibitor effects of nimesulide and DFU were considerably similar, but inhibitor effect of indomethacin was significantly less than that measured for nimesulide and DFU in both control and peritonitis groups (P < 0.05). CONCLUSIONS The contraction responses to carbachol and histamine and relaxation responses to COX inhibitors on gallbladder smooth muscle are significantly decreased by peritonitis. Although the mechanism of the decrease in contraction and relaxation responses in CLP-induced peritonitis is completely unknown, we speculate that impaired smooth muscle responses may be related to an alteration in the regulation of receptor/postreceptor excitation-response coupling and/or through changes on Ca(2+) influx.
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Affiliation(s)
- Tijen Temiz Kaya
- Department of Pharmacology, Faculty of Medicine, Cumhuriyet University, 58030 Sivas, Turkey
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Abstract
PURPOSE Femoral hernias (FH) are rarely seen in children, so there is no consensus on the age and sex distribution or the optimum method of repair. Recently, repair of the femoral hernias with mesh-plug has gained wide popularity in adults. The authors used this method in 4 children with FH and discuss its utilization in children. METHODS Four consecutive children with femoral hernia were treated using mesh-plug. Patients' characteristics and operative technique was described. RESULTS Plugging femoral defect with a mesh-plug was applied successfully in children. No complications were seen after a follow-up period for 2 years (range, 8 to 30 months). CONCLUSION Repair of femoral hernias with mesh-plug is performed easily and successfully in children.
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Affiliation(s)
- Canan Ceran
- Department of Pediatric Surgery, Cumhuriyet University School of Medicine, Sivas, Turkey
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Köylüoğlu G, Günay I, Ceran C, Berkan O. Pericardial flap aortopexy: an easy and safe technique in the treatment of tracheomalacia. J Cardiovasc Surg (Torino) 2002; 43:295-7. [PMID: 11887074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
A 5-month-old boy who had been operated for esophageal atresia and tracheoesophageal fistula was presented with recurrent life-threatening apneic spells, expiratory stridor and difficulty in feeding. Diagnosis of tracheomalacia was confirmed by bronchoscopy and pericardial flap aortopexy was performed. Pericardial flap aortopexy is a relatively simple procedure with minimal risk to the aorta. Minimal dissection is required and there are no sutures placed in the aortic wall, thus avoiding the risk of tears.
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Affiliation(s)
- G Köylüoğlu
- Department of Pediatric Surgery, Cumhuriyet University, Faculty of Medicine, Sivas, Turkey.
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Ceran C, Sönmez K, Türkyllmaz Z, Demirogullarl B, Dursun A, Düzgün E, Başaklar AC, Kale N. Effect of bilirubin in ischemia/reperfusion injury on rat small intestine. J Pediatr Surg 2001; 36:1764-7. [PMID: 11733902 DOI: 10.1053/jpsu.2001.28816] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE The aim of this study was to determine the effects of bilirubin in experimental small intestinal ischemia/reperfusion (I/R) injury in rats. METHODS Thirty rats were divided into 5 groups (n = 6). In group S, saline and in group B, bilirubin, 20 mg/kg were infused via the jugular vein without an additional procedure. In groups S-IR, saline, B(1)-IR and B(2)-IR, 10 and 20 mg/kg/h of bilirubin were infused for 2 hours, respectively. In these groups, an I/R procedure was done after infusions by occluding the superior mesenteric artery for 45 minutes followed by 1 hour of reperfusion. After reperfusion, the small intestines were resected for histopathologic and malondialdehyde (MDA) assessments. Mucosal lesions were scored between 0 and 5. Malondialdehyde levels and histopathologic grades were analyzed statistically. RESULTS Mucosal injury was severe in S-IR (grade 4 to 5), mild in B(1)-IR (grade 0 to 3) and none in B(2)-IR group (grade 0). Grades of group S-IR were higher than those of B(1)-IR and B(2)-IR statistically (P <.05). Tissue MDA levels of the S-IR group were significantly higher than those of B(1)-IR and B(2)-IR groups (U = 36, P <.05). Bilirubin levels correlated inversely with MDA levels (r = -0.94). CONCLUSIONS Bilirubin effectively prevents intestinal I/R injury in rat. This observation is consistent with the hypotheses regarding bilirubin as an antioxidant, having a role in the body defense. J Pediatr Surg 36:1764-1767.
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Affiliation(s)
- C Ceran
- Pediatric Surgery Department of Gazi Univercity Medical School, Ankara, Turkey
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