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Öğe Clinical value of late DMSA scan in predicting vesicoureteral reflux in children with febrile urinary tract infection(2020) Caglar, Ozgur; Nalcacioglu, Hulya; Yel, Sibel; Celik, Binnaz; Bastug, FundaAim: To assess the usefulness of late dimercaptosuccinic acid (DMSA) renal scans in revealing high-grade vesicoureteral reflux (VUR). Material and Methods: Between July 2015 and December 2016, medical records of 112 patients who were admitted with febrile urinary tract infections (fUTIs) were retrospectively reviewed. The demographic information of the patients, and follow-up imaging [ultrasonography (USG), DMSA renal scans, and voiding cystourethrography] data were reviewed.Results: Of the 112 patients, 82 patients (73.2%) were female, 30 were male (26.8%), and the mean age was 7.04 ± 3.94 years. Recurrent fUTIs were detected in 65 patients (58%). Of the patients, 68 (60.7%) had abnormal urinary system USG, and 74 (66.1%) had abnormal DMSA renal scans. Vesicoureteral reflux (VUR) was detected in 63 patients (56.3%). VUR was present in 49 (66.2%) of 74 patients with scarring in DMSA and detected in 14 (38.8%) of 38 patients with normal DMSA scans. Significant agreement (kappa: 0.274 / p=0.003) was found between DMSA and VUR results. The sensitivity, specificity and positive predictive values of late DMSA renal scan to predict VUR were 77.8 %, 49 % and 63.2% respectively.Conclusion: Abnormal late DMSA scans carry a higher sensitivity and positive predictive value for predicting high-grade VUR in children with recurrent fUTIs. Late DMSA imaging seems a useful option in screening for high-grade VUR in children when the acute interventions are limited.Öğe Current considerations and criticism for childhood abdominal tuberculosis with our seven cases experiences(2020) Caglar, Ozgur; Sinmaz, Kutlug; Ozcatal, Mustafa; Firinci, Binali; Celik, Taylan; Muhafiz Ozsu, Huriye Gozde; Yilmaz, Semsi GulizAim: Childhood abdominal tuberculosis is frequently diagnosed as an acute abdomen and operate in veiny. Milky way, like appearance on X-ray/computerized tomography get, should be thanked for tuberculosis. Direct microscopic and consecutive histopathologic examination of endoscopic aspiration material is to be the first approach of such patients. Materials and Methods: We retrospectively examined primary abdominal tuberculosis owned seven cases diagnosed with clinical, radiological, microbiological, and evenly histopathological methods in five years duration. All of them examined with laparotomy to direct visualization, lymph node biopsy, culture material, appendectomy, and clean of pathologic materials. Antituberculous treatment was begun following surgery.Results: Historical examination knowledge as that one of the patient’s mother treated for active tuberculosis, the others have abdominal lymphadenitis. Mesenteric lymphadenomegaly and peritoneal fluid collection detected all patients; but appendicolitis (n=1) and mesenteric inflammation (n=1) diagnosed additional pathologies by ultrasonography and computed tomography. None of them have thoracic involvement. The peritoneal culture was positive in one patient. Lymph node biopsy proved caseification necrosis. Specific whitish tubercles and lymph nodes observed during surgery of six patients. Histopathological diagnosis was tuberculosis of all patients. All patients completely healed with surgery plus anti-tuberculosis therapy without complications. Conclusion: Effective radiological, microbiological, and histopathological examinations are essential for current diagnosis for abdominal tuberculosis, although it is very rare. Laparotomy/laparoscopy should be done for urgent, complicated, and undiagnosed cases for early treatment to reduce of morbidity, mortality, and complications.Öğe Enigmatic role of vagal network as a construction worker on thyroid gland creation by inspiration from neurohistology studies(2020) Ozmen, Sevilay; Caglar, OzgurAim: Thyroid functions regulate higher brain centers and olfactory informations are wireless universal stimulators for thyroid hardware and software development by way of vagal complex management. We wonder if thyroid architecture and functions are regulated by vagal nerve.Material and Methods: The animals were divided to three groups according to their T4 hormone levels which 1.89±0.10 µg/dl values was accepted as normal (G0; n=12); 2.13±0.19 µg/dl values was accepted as hyperfunctioned (GI; n=7) and 1.61±0.09 µg/dl values was accepted as hypofunctioned (GII; n=5). All of the thyroid glands, thyroidal branches of vagal nerves and brainstem section at the level of motor nucleus of vagal nerves sections were stained with haematoxylin-eosin, GFAP and tunnel dye for histological examination. All microscopical Stereological evaluations were done to understand how vagal morphology effects thyroid tissue architectures and T4 levels. All of the thyroid glands, thyroidal branches of vagal nerves and vagal motor nucleus evaluated stereologically to recognise whether some histomorphological variations thyroid follicles and volumes per cubic centimeter compared with thyroid hormone levels statistically.Results: The mean neuron density of vagal nucleus (NDVN), axon density of thyroidal branches of vagal nerves (TBVN), TFV, and T4 levels were measured as G0;GI and GII consequtively: (312±91)x106/mm3, 19.543±2.321/mm2, 1.89±0.10 µg/dl and (296±72)x106µm3/cm3 in G0; (387±93)x106/mm3, 22.576±2.864/mm2, 2.13±0.19 µg/dl and (331±65)x106µm3/cm3 in GI and (245±56)x106/mm3, 12.432±1.234mm2, 2.13±0.19 µg/dl and (231±45)x106µm3/cm3 in GII. Conclusion: It seems that decrased hormone levels due to ineffective/unadequate thyroid gland development results from inadequately developing vagal complex architecture.Öğe Important interaction between urethral taste bud-like structures and Onuf's nucleus following spinal subarachnoid hemorrhage: A hypothesis for the mechanism of dysorgasmia(Elsevier Espana Slu, 2022) Caglar, Ozgur; Aydin, Mehmet Dumlu; Aydin, Nazan; Ahiskalioglu, Ali; Kanat, Ayhan; Aslan, Remzi; Onder, ArifBackground: We previously postulated that orgasmic sensation may occur through recently discovered genital taste bud-like structures. The interaction between the pudendal nerve and Onuf's nucleus may be important for developing orgasmic information. The study aims to investigate whether ischemic damage to Onuf's nucleus-pudendal network following spinal subarachnoid hemorrhage (SAH) causes taste bud degeneration or not. Methods: The study was conducted on 22 fertile male rabbits who were divided into three groups: control (GI; n = 5), SHAM (GII; n = 5) and study (GIII; n = 12). Isotonic solution, .7 cm(3), for the SHAM, and .7 cm(3) homologous blood was injected into spinal subarachnoid spaces at S2 level of the study group. Two weeks later, Onuf's nucleus, pudendal ganglia and the taste bud-like structures of the penile urethra were examined histopathologically. Degenerated neuron densities of Onuf's nucleus, pudendal ganglia and atrophic taste bud-like structures were estimated per mm(3) and the results analyzed statistically. Results: The mean degenerated neuron densities of taste bud-like structures, Onuf's nucleusand pudendal ganglia were estimated as 2 +/- 1/mm(3), 5 +/- 1/mm(3), 6 +/- 2/mm(3) in GI; 12 +/- 4/mm(3), 35 +/- 9/mm(3), 188 +/- 31/mm(3), in GII and 41 +/- 8/mm(3), 215 +/- 37/mm(3), 1321 +/- 78/mm(3), in GIII. Spinal SAH induced neurodegeneration in Onuf's nucleus, pudendal ganglia and taste budatrophy was significantly different between GI/GII (p <.005); GII/GIII (p <.0005) and GI/GIII(p<.0001). Conclusion: Ischemic neuronal degenerations of Onuf's nucleus and pudendal ganglia following spinal SAH lead to genital taste bud-like structure atrophy. This mechanism may be responsible for sexual anhedonia and sterility in cases with spinal cord injury, which has not been documented so far. More studies are needed. (C) 2020 Asociacion Espanola de Andrologia, Medicina Sexual y Reproductiva. Published by Elsevier Espana, S.L.U. All rights reserved.
