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    An alternative way to cover ventral penile skin defect in Mathieu technique
    (Hippokrates Verlag Gmbh, 2000) Koltuksuz, U; Gürsoy, MH; Aydinç, M; Mutus, M; Çetin, S; Karaman, A
    Mathieu technique is used satisfactorily in distal penile hypospadias without chordee or with minimal chordee. After using this technique, a large defect may sometimes appear on the ventral surface of the penis. To cover the defect, a few techniques, including preputial island flap, Byar's flap and Ombredanne-Nesbit's flap, are used. We describe a new flap to cover the defect more cosmetically. Twenty-four patients ranging in age from one year to 14 years (median age 6.5 years) were operated on. In the patients for whom the defect could not be covered primarily, a longitudinal incision was made along the midline through the penile shaft skin from penile radix up to the border of preputial skin. The relaxed penile skin, which was incised on the dorsal surface, could be approached and sutured easily on the ventral surface without stretching. The new defect that developed on the dorsal surface was closed with the prepuce matching the defect. Nine patients, two with chordee and seven without chordee, underwent this technique. The cosmetic and functional results were excellent in all patients and none of the patient's parents complained about the cosmetic aspect. Only one fistula complication, which healed spontaneously, developed on the 20th postoperative day. Considering these results, we may conclude that excellent cosmetic results can be accomplished by the use of this flap technique.
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    Caffeic acid phenethyl ester prevents intestinal reperfusion injury in rats
    (W B Saunders Co-Elsevier Inc, 1999) Koltuksuz, U; Özen, S; Uz, E; Aydinç, M; Karaman, A; Gültek, A; Akyol, Ö
    Background/Purpose: Ischemia-reperfusion injury is encountered frequently in conditions that diminish intestinal blood flow. Caffeic acid phenethyl ester (CAPE), which is a specific component of the honeybee hive product propolis, exhibits potential antioxidant: properties. This experimental study was designed to determine the effect of CAFE on ischemia-reperfusion injury in rat intestine. Methods: Fifty rats were divided into 5 groups: sham (SH), saline ischemia (SI), saline reperfusion (SR), CARE ischemia (CI), and CARE reperfusion (CR). Either CAFE, 10 mu mol/kg, or saline was administered intraperitoneally 30 minutes before ischemia. Intestinal ischemia for 30 minutes and reperfusion for 60 minutes were applied. Ileum specimens were obtained to determine the tissue levels of malondialdehyde, superoxide dismutase, catalase, and histological changes. Results Malondialdehyde levels in the CR group did not increase after reperfusion when compared with the CI group. However, statistically significant differences were observed between the SR and SI groups. Additional mucosal injury in the CR group when compared with the CI group was not observed. Whereas, there was a statistically significant increase in mucosal injury in the SR group. Reperfusion did not cause further injuries through both biochemical and histological parameters in the CR group. Conclusions: Results of this study showed that prophylactic administration of CAFE in ischemic condition prevents reperfusion injuries by eliminating oxygen radicals and inhibiting polymorphonuclear leukocyte infiltration. CARE may be useful in combating the diseases of oxidative stress. J Pediatr Surg 34:1458-1462. Copyright (C) 1999 by W.B. Saunders Company.
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    Injuries of large vessels in high stage neuroblastoma surgery -: A case report
    (Edizioni Minerva Medica, 1999) Koltuksuz, U; Gürsoy, MH; Aydinç, M; Özgen, Ü; Ege, E; Mutus, M
    Complete resection of the primary lesion in stage III neuroblastoma improves survival. Neuroblastoma has a tendency towards surrounding and infiltrating the large vessels, leading to injuries during tumor resection. We operated on a stage III neuroblastoma, which resulted in the right and left common iliac artery and vein damage, The right common iliac artery and, veins were repaired by end to end anastomosis, There was a long gap between the two ends of the left common iliac artery and it was repaired using a mesenteric vein (marginal vein of the colon) graft. Digital subtraction angiography performed 6 months after the operation did not reveal any stenosis or aneurysmatic changes in the anastomoses. We conclude that short segments of large vessels may be sacrificed during the resection of neuroblastomas invading the vessel wall, and the resulting defects may be repaired by end to end anastomosis, or even by substituting mesenteric vein grafts, for the pur pose of total or near total removal.