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Öğe Adrenomedullin and nitric oxide in children with detrusor instability(Springer Verlag, 2003) Balat A.; Sarica K.; Çekmen M.; Yürekli M.; Ya?ci F.; Erba?ci A.Detrusor instability (DI) and detrusor-external sphincter dyssynergia lead to poor bladder emptying and high bladder pressure. Recent results indicate that nitric oxide (NO) is an important transmitter or messenger molecule in autonomic neurotransmission. Adrenomedullin (AM) is a potent vasodilator and natriuretic peptide, originally purified from human pheochromocytoma. Since NO and AM have vasodilatory effects on smooth muscles, we considered them to be of interest in children with DI. We determined the tissue levels of NO and AM in 14 children with DI, and compared these with 6 children with normal bladder activity. Bladder biopsy total nitrite levels (nmol/g tissue) were decreased in children with DI (10.69±0.91 vs. 12.83±0.98, P<0.01). However, AM levels (pmol/g tissue) were increased in the same patients (48.84±3.52 vs. 28.79±1.53, P<0.001). According to our results, decreased NO production probably has a role in the pathophysiology of DI, although increased AM appears to be compensatory. NO may provide a therapeutic target in clinical situations related to DI. However, the functional significance of AM and NO in bladder smooth muscle remains to be determined by further detailed studies.Öğe Eosinophilic fasciitis - Progression to linear scleroderma. A Case Report(1999) Balat A.; Akinci A.; Turgut M.; Mizrak B.; Aydin A.Eoslnophilic fasciitis is a rare disease in children. Although changes similar to linear scleroderma have been reported, the outcome is usually good. In this report, a 10-year-old boy who developed eosinophilic fasciitis without a good response to steroids is presented. He progressed to linear scleroderma within months. Our case reinforces the hypothesis that eosinophilic fasciitis may be an early manifestation or a variant of localized scleroderma similar to the other cases in the literature.Öğe Interpupillary index: A new parameter for hypo-hypertelorism(Churchill Livingstone, 2001) Evereklioglu C.; Doganay S.; Er H.; Tercan M.; Gunduz A.; Balat A.; Borazan M.Aim: To establish a new clinical index to evaluate the presence of hypo-hypertelorism with greater accuracy. Material and Methods: After screening a wide range of population, 310 elementary school children (185 boys, 125 girls) aged 7-15 years were included in this study. For this cross-sectional study, a millimetre ruler was used. The anatomical interpupillary distance was measured by a modified Viktorin's method. In addition, inner and outer intercanthal distances were obtained. The data were analyzed by Student's t-test for two independent samples using SPSS for Windows. There were children with clinical hypertelorism (n = 92, group 1), children with large fronto-occipital circumference (FOC) (n = 101, group 2), and age- and sex-matched normal controls (n = 117, group 3). Due to variations in FOC among healthy subjects, we introduced a new practical concept for evaluation of interpupillary distance, namely the interpupillary index, the simple product obtained by dividing the interpupillary distance by the FOC, multiplied by 100. Results: The overall idiopathic benign macrocephalic children (group 2) had significantly (p < 0.001) larger interpupillary distances (6.13 ± 0.36 cm) and FOCs (56.99 ± 1.46 cm) than those of normal controls (5.70 ± 0.26 cm and 52.82 ± 1.22 cm, respectively). But, the difference between the combined product of interpupillary distance and FOC, the interpupillary index, was not significant (10.76 ± 0.50 and 10.79 ± 0.35, respectively) (p > 0.05). On the other hand, the children with hypertelorism had significantly (p < 0.001) larger interpupillary distances (6.47 ± 0.29 cm) and FOCs (54.90 ± 2.18 cm) when compared with the controls. In addition, the interpupillary index was significantly (p < 0.001) higher (11.80 ± 0.45) than both macrocephalic children (10.76 ± 0.50) and controls (10.79 ± 0.35). Intercanthal distances and intercanthal index of hyperteloric children were also significantly (p < 0.001) larger than both macrocephalic children and controls. Conclusion: This new index offers a new concept for more accurate evaluation of the presence of ocular hypo-hypertelorism. © 2001 European Association for Cranio-Maxillofacial Surgery.Öğe Sarcoma botryoides of the uterine endocervix: Long-term results of conservative surgery(1996) Balat O.; Balat A.; Verschraegen C.; Tornos C.; Edwards C.L.Sarcoma botryoides, a variant of embryonal rhabdomyosarcoma, is the most common neoplasm of the lower genital tract in girls under 16 years of age. This neoplasm more frequently has a vaginal location in patients younger than 4 years, whereas a cervical location has its peak incidence in the second decade. Although the recommended therapy has been radical surgery alone or combined with other modalities, the use of neoadjuvant chemotherapy has changed the surgical approach to one employing a less radical procedure such as a simple hysterectomy or local excision. We present the case of a 12-year-old girl diagnosed with an embryonal rhabdomyosarcoma of the endocervix who received vincristine-Adriamycin-cyclophosphamide combination chemotherapy followed by a simple hysterectomy. The patient exhibits no evidence of disease 8 years after the initial diagnosis.
