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Öğe Bir İnfantta Saptanan Servikal Subkutan Yerleşimli Kartilajinöz Koristoma(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2007) Karaman, Abdurrahman; Ceran, Canan; Uğuralp, Sema; Gürses, İclal; Demircan, MehmetKartilajinöz koristoma çocuklarda oldukça nadir görülen bir patolojidir. Kitlenin total çıkarılması en seçkin tedavi yöntemdir. Bu çalışmada boyun lateral yerleşimli bir kartilajinöz koristoma olgusu sunulmuştur.Öğe Cervical subcutaneous cartilaginous choristoma in an infant(2007) Karaman, Abdurrahman; Ceran, Canan; Uğuralp, Sema; Gürses, İclal; Demircan, MehmetAbstract: Kartilajinöz koristoma çocuklarda oldukça nadir görülen bir patolojidir. Kitlenin total çıkarılması en seçkin tedavi yöntemdir. Bu çalışmada boyun lateral yerleşimli bir kartilajinöz koristoma olgusu sunulmuşturÖğe Commonly used intravenous anesthetics decrease bladder contractility: An in vitro study of the effects of propofol, ketamine, and midazolam on the rat bladder(Medknow Publications & Media Pvt Ltd, 2010) Ceran, Canan; Pampal, Arzu; Goktas, Ozgur; Pampal, H. Kutluk; Olmez, ErcumentAim: 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 (10-8 to 10-4 mol/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 (10-3 mol/L) caused a decrease only in EFS-evoked contractile responses (P= 0.001-0.004) and ketamine (10-3 mol/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.Öğe Congenital distal esophageal obstruction caused by intraluminal mucosal web(Turkish J Pediatrics, 2012) Uguralp, Sema; Ceran, Canan; Demircan, MehmetUguralp S, Ceran C, Demircan M. Congenital distal esophageal obstruction caused by intraluminal mucosal web. Mirk J Pediatr 2012; 54: 317-319. 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.Öğe The effects of ghrelin on colonic anastomosis healing in rats(Hospital Clinicas, Univ Sao Paulo, 2013) Ceran, Canan; Aksoy, Rauf Tugrul; Gulbahar, Ozlem; Ozturk, FigenOBJECTIVES: 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.Öğe Epididymo-orchitis caused by Behcet’s disease: An unusual cause of acute scrotum(2019) Özcan, Hamdi; Ceran, CananAbstract: Behçet’s disease (BD) is a rare systemic inflammatory disorder of the blood vessels and tissues. It is rarely seen in children. The clinical course of the disease in children is similar to that of the adults by symptoms such as recurrent oral ulcers, genital ulcers and ocular inflammation. Additionally, urological manifestations rarely seen in BD. Here we present two children with BD and epididymoorchitis confusing with testicular torsion. Since BD is rarely observed in children, it is very difficult to diagnose the patients with epididymo-orchitis. Treatment for the testicular torsion is immediate surgical therapy to prevent the testicular necrosis. On the other hand epididymo-orchitis caused by BD should be treated medically. Unnecessary surgery on BD patient can affect morbidity negatively. We aimed to take attention to this rare condition to prevent the patients from unnecessary operation.Öğe Glial Cell Line-Derived Neurotrophic Factor, S-100 Protein and Synaptophysin Expression in Biliary Atresia Gallbladder Tissue(Korean Soc Pediatric Gastroenterology & Nutrition, 2021) Gurunluoglu, Semra; Ceran, Canan; Gurunluoglu, Kubilay; Kocbiyik, Alper; Gul, Mehmet; Yildiz, Turan; Bag, Harika GozukaraPurpose: 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.Öğe İnce Barsak İskemi Reperfüzyonunda Reperfüzyon Süresinin Biyokimyasal Değişiklikler ve Anastomoz İyileşmesine Etkisi(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2006) Ekingen, Gülsen; Ceran, Canan; Demirtola, Arzu; Demiroğulları, Billur; Sancak, Banu; Poyraz, Aylar; Sönmez, Kaan; Basaklar, A.Can; Kale, NuriBu çalışmada ince barsak dokusunda iskemi sonrası değişen reperfüzyon süresinin, biyokimyasal değişiklikler ve anastomoz iyileşmesine olan etkilerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Geçici barsak iskemisi oluşturulan 36 adet Wistar-Albino rat altı gruba ayrıldı: Kontrol grubu (sadece laparatomi), grup I (40 dk. iskemiyi takiben 20 dk. reperfüzyon), grup II (40 dk. iskemiyi takiben 24 sa. reperfüzyon), kontrol-A (ince barsak anastomozu), grup I-A (40 dk. iskemi, 20 dk. reperfüzyon ve ince barsak anastomozu), grup II-A (40 dk. İskemi, 24 sa. Reperfüzyon ve ince barsak anastomozu). Kontrol grubu, grup I ve II de reperfüzyon süresi bitince histopatolojik ve biyokimyasal değerlendirmeler için ince barsak doku örnekleri alındı. Kontrol grubu, grup I ve grup II de dokuda Myeloperoksidaz ve Süperoksit Dismutaz enzim düzeyleri ölçüldü. Kontrol-A grubu, grup I-A ve II-A da ise ince barsak anastomozu oluşturuldu. Anastomoz iyileşmesi, 4. gün patlama basıncı ve kollojen kontenti ölçülerek değerlendirildi. Bulgular: İnce barsak dokusunda myeloperoksidaz ve süperoksit dismutaz enzim düzeylerinin reperfüzyonun erken evrelerinde artarken 24. saatte azaldığı (p<0,05) saptandı. Geç dönemde yapılan anastomozlarda patlama basınçları ve hidroksiprolin kontentinin erken dönemdekine kıyasla daha düşük olduğu saptandı (p<0,05). Sonuç: İskemi/Reperfüzyon hasarı geç dönemde ince barsak anastomozlarının güvenilirliğini azaltmaktadır. İnce barsak anastomozları yapılırken bu durumun göz önünde bulundurulması gerekir.Öğe Kolon Perforasyonu ve Ventrikülo-Peritoneal Şantın Anüsten Protrüzyonu: İki Olgu(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2006) Ceran, Canan; Karadağ, Özen; Gürünlüoğlu, Kubilay; Önal, ÇağatayHidrosefalik çocukların tedavisinde beyin omurilik sıvısı akımını düzeltmek için en sık uygulanan yöntem ventrikülo-peritoneal şant vasıtasıyla beyin omurilik sıvısının periton içine akıtılmasıdır. Basit ama komplikasyon oranı yüksek bir yöntem olan ventrikülo-peritoneal şant uygulaması sonrası şant kateterinin anüsten çıktığı iki olguyu sunarak; bu komplikasyonun muhtemel oluş mekanizmalarını ve tedavisini tartışmayı amaçladık.Öğe Simple patch closure for perforated peptic ulcer in children followed by Helicobacter pylori eradication(Professional Medical Publications, 2014) Yildiz, Turan; Iice, Huri Tilla; Ceran, Canan; Ilce, ZekeriyaObjective: 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 Pylon, 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.Öğe Tracheal agenesis and esophageal atresia with proximal and distal bronchoesophageal fistulas(W B Saunders Co-Elsevier Inc, 2008) Demircan, Mehmet; Aksoy, Tugrul; Ceran, Canan; Kafkasli, AyseTracheal 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 die 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. (C) 2008 Elsevier Inc. All rights reserved.Öğe Use of angiographic embolization in trauma-induced pediatric abdominal solid organ injuries(Turkish Assoc Trauma Emergency Surgery, 2019) Gurunluoglu, Kubilay; Ceran, Canan; Yildirim, Ismail Okan; Kutlu, Ramazan; Sarac, Kaya; Yildiz, Turan; Bayrakci, ErcanBACKGROUND: 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.Öğe Whole exome sequencing analysis for mutations in isolated type III biliary atresia patients(Termedia Publishing House Ltd, 2020) Gurunluoglu, Kubilay; Koc, Ahmet; Durmus, Kubra; Bag, Harika Gozukara; Ceran, Canan; Gurunluoglu, Semra; Yildiz, TuranAim of the study: Biliary atresia is an idiopathic, destructive disease that affects both extrahepatic and intrahepatic bile ducts with severe inflammation and manifests as progressive jaundice within the first few months of life. In this study, we aimed to investigate the significance of genetic mutations in the onset of biliary atresia disease. Material and methods: With the approval of the ethics committee and parental consent, blood was taken from patients to obtain their DNA, and the study commenced. In this prospective study, we examined the DNA of 10 patients with no disease other than biliary atresia, and an exome sequence analysis was performed with the new-generation DNA sequencing method. The genetic structure of biliary atresia disease was examined by statistical analysis of the mutations, which were determined according to the reference DNA sequencing. Results: In the exome sequence analysis, the number of mutations detected among the patients changed significantly; the lowest number was 12,591, and the maximum was 19,863. By examining these mutations, we identified the mutated genes that were common to all patients. Conclusions: In this study, the highest mutation rates were detected in the PRIM2 and MAP2K3 genes. These genes have not previously been associated with biliary atresia.
