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Öğe Global gene expression profiling in congenital diaphragmatic hernia (CDH) patients(Springer Heidelberg, 2022) Gurunluoglu, Kubilay; Dundar, Muhammed; Unver, Turgay; Akpinar, Necmettin; Gokce, Ismail Kursad; Gurunluoglu, Semra; Demircan, MehmetCongenital diaphragmatic hernia (CDH) is an anomaly characterized by a defect in the diaphragm, leading to the passage of intra-abdominal organs into the thoracic cavity. Herein, the presented work analyzes the global gene expression profiles in nine CDH and one healthy newborn. All of the patients had left posterolateral (Bochdalek) diaphragmatic hernia, operated via an abdominal approach, and stomach and bowels in the thorax cavity. Some patients also had additional anomalies. A total of 560 differentially regulated genes were measured. Among them, 11 genes showed significant changes in expression associated with lung tissue, vascular structure development, and vitamin A metabolism, which are typical ontologies related to CDH etiology. Among them, SLC25A24 and RAB3IL1 are involved in angiogenesis, HIF1A and FOXC2-AS1 are related with the alveolus, MAGI2-AS3 is associated with the diaphragm, LHX4 and DHH are linked with the lung, and BRINP1, FZD9, WNT4, and BLOC1S1-RDH5 are involved in retinol. Besides, the expression levels of some previously claimed genes with CDH etiology also showed diverse expression patterns in different patients. All these indicated that CDH is a complex, multigenic anomaly, requiring holistic approaches for its elucidation.Öğe Global gene expression profiling in congenital diaphragmatic hernia (CDH) patients (vol 22, pg 359, 2022)(Springer Heidelberg, 2022) Gurunluoglu, Kubilay; Dundar, Muhammed; Unver, Turgay; Akpinar, Necmettin; Gokce, Ismail Kursad; Gurunluoglu, Semra; Demircan, Mehmet[Abstract Not Available]Öğe Impact of COVID-19 pandemic on pediatric appendicitis hospital admission time and length of hospital stay(Turkish Assoc Trauma Emergency Surgery, 2022) Tasci, Aytac; Gurunluoglu, Kubilay; Yildiz, Turan; Arslan, Ahmet Kadir; Akpinar, Necmettin; Cin, Ecem Serbest; Demircan, MehmetBACKGROUND: Appendicitis is one of the most common surgical emergencies among children. In this retrospective clinical study, we attempted to determine the effects of the COVID-19 pandemic period on hospital admission time and length of hospital stay (LOS) in pediatric appendicitis cases. METHODS: We retrospectively compared pediatric appendectomies from the date of the first reported COVID-19 case to June 1, 2020, which is considered as the start of the normalization process, with pre-pandemic pediatric appendectomies of the same number of days in terms of age, gender, hospital admission time, LOS, parental educational level, laboratory values, and histopathological findings. RESULTS: There was an average increase of 2 days in the time from the onset of symptoms to hospital admission in pediatric appendicitis patients in the COVID-19 period (p=0.001). Furthermore, C-reactive protein value was statistically significantly higher in the COVID-19 period (p=0.018). Given the LOS, it was calculated as an average of 5 days in the pre-pandemic period and 4 days in the COVID-19 period, and this difference was statistically insignificant (p=0.273). There was no significant difference between the groups in terms of histopathological findings (p=0.176). The parental educational level had no effect on the admission time. CONCLUSION: The hospital admission time of pediatric appendicitis patients is significantly prolonged in the COVID-19 pandemic, but this prolongation had no histopathological effect. During the pandemic, the recovery of patients who required urgent treatment during the stay-at-home period was also negatively affected. Notwithstanding, we are of the opinion that the absence of an increase in the LOS may be due to the willingness of both families and physicians to keep the LOS as short as possible. Despite the increase in hospital admission time in pediatric appendicitis during the Covid 19 pandemic process, the lack of increase in the rate of complicated appendicitis may be an indicator of the importance of other factors in the development of complicated appendicitis.Öğe Ultra-structural and histopathological features of liver biopsy taken during laparotomy to confirm the diagnosis of biliary atresia(Wolters Kluwer Medknow Publications, 2022) Gurunluoglu, Semra; Gul, Mehmet; Zararsiz, Gokmen; Akpinar, Necmettin; Varol, Fatma, I; Demircan, Mehmet; Gurunluoglu, KubilayBackground: Neonatal cholestasis is caused by a group of diseases that cause jaundice, which can be encountered in the neonatal period. Biliary atresia (BA) and idiopathic neonatal hepatitis (INH) are among neonatal cholestasis diseases. Aims: The aim of this study was to perform histopathological and ultra-structural examinations of liver biopsy tissue samples from BA and INH patients with liver biopsies taken during laparotomy to confirm the diagnosis of biliary atresia. Settings and Design: A total of patients undergoing Kasai surgery before the age of 60 days were included in an early group (n = 7), whereas patients undergoing surgery after the age of 60 days were included in a late group (n = 11). The control group (n = 11) included INH patients. Materials and Methods: For histopathological examinations, liver tissue samples obtained intra-operatively were subjected to routine histopathological procedures after being stained with caspase-3 and cytokeratin-7 antibodies. Ultra-structural evaluations were also performed. Statistical analysis used: For comparisons between the groups, a one-way analysis of variance (ANOVA) test and the Mann-Whitney U test were used for continuous variables. Results: Histopathological findings reflected the specific liver pathologic findings seen in biliary atresia. Although there was no significant difference between the BA groups, these parameters were not detected in the control group. The histopathological evaluations revealed no significant differences in the findings of liver parenchyma damage between the early, late, and control groups. Electron microscopic examinations showed that the patients in the late group had more severe signs of intra-cellular damage to the liver. Conclusions: Although the histopathological examination revealed no significant differences in liver damage between the three groups, in ultra-structural evaluation, intra-cellular damage was found to be less in groups with better prognosis. Electron microscopy evaluations of intra-cellular damage may be more useful in this respect.
