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Öğe Aluminum in total parenteral nutrition solutions produces portal inflammation in rats(Lippincott Williams & Wilkins, 1998) Demircan, M; Ergun, O; Coker, C; Yilmaz, F; Avanoglu, S; Ozok, GBackground: Aluminum contaminates parenteral nutrition solutions and accumulates in bone and Liver of patients receiving total parenteral nutrition therapy. Although previous reports have shown that parenteral administration of aluminum in pharmacologic doses to rats results in the production of elevated total serum bile acid concentrations alone or in combination with decreased bile flow, they have failed to demonstrate any abnormalities in the histologic appearance of liver tissue. The effects of aluminum in total parenteral nutrition and of aluminum chloride on total serum bile acid concentrations, aluminum contents of the liver, and histopathologic changes in the liver were studied in rats. Methods: The aluminum concentrations in the aluminum chloride solution and total parenteral nutrition formula were equal (300 mu g/l). They were given intraperitoneally as follows: control group, 0.9% saline for 14 days, T-7 group, total parenteral nutrition for 7 days: A(7) group, aluminum chloride for 7 days; A(14) group, aluminum chloride for 14 days; T(7)A(7) group, total parenteral nutrition for 7 days and aluminum chloride for the next 7 days; and T7O7 group, total parenteral nutrition for 7 days and 0.9% saline for the ne,ut 7 days. Volumes of 0.9% saline, aluminum chloride, and total parenteral nutrition given to rats were equal. During the experiment, mts were maintained on rat chow and water ad libitum. Serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, alkaline phosphatase, and bile acid concentrations and aluminum content of the liver were measured. The liver was evaluated histopathologically by light microscope, and a morphologic portal inflammation index was calculated. Results: Portal inflammation was present in all groups except the control group. The morphologic portal inflammation correlated with hepatic aluminum accumulation in all groups and was the highest in the T(7)A(7) group. Levels of serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, and alkaline phosphatase did not correlate with the histopathologic findings, but serum bile acid concentrations correlated with morphologic portal inflammation and hepatic aluminum accumulation in all groups. Hepatic aluminum accumulation also correlated with the duration of exposure to total parenteral nutrition and aluminum chloride concentration. Conclusion: Aluminum in contaminating doses, not in pharmacologic doses, accumulates in the liver and can produce hepatobiliary dysfunction characterized by portal inflammation detectable in histologic examination of liver tissue.Öğe Bardet-Biedl syndrome associated with vaginal atresia(Turkish J Pediatrics, 2003) Uguralp, S; Demircan, M; Çetin, S; Sigirci, AThis is a case report of Bardet-Biedl syndrome associated with vaginal atresia diagnosed in a 15-year-old girl. She had mild mental retardation; obesity; nistagmus, retinitis pigmentosa and optic atrophy in both eyes; accessory digit on the left hand; polydactyly in lower extremities; a mobile, painful, nonfixed mass of 6 cm in diameter in the pelvic region; a palpable cystic mass in front of the rectal wall; and no vaginal opening. Secondary sex characteristics were determined. The vaginal atresia was distinguished from vaginal agenesis by the presence of proximal vagina in radiological examination.Öğe Determination of serum bile acids routinely may prevent delay in diagnosis of total parenteral nutrition-induced cholestasis(W B Saunders Co, 1999) Demircan, M; Ergun, O; Avanoglu, S; Yilmaz, F; Ozok, GBackground/Porpose: Early diagnosis of development of cholestasis is a current major problem for patients receiving total parenteral nutrition (TPN). Conventional tests for hepatic function such as serum transaminases and alkaline phosphatase do not often reflect simultaneously histopathologic changes of the liver. The aim of this study is to find out the relationships between conventional hepatic function tests, total serum bile acid concentrations (TSBA), and the histopathologic changes in the liver during TPN administration in rats. Methods: Forty Albino rats were divided into four experimental groups, each consisting of 10 rats, as follows: control group (C), 0.9% saline for 14 days; T-7 group, TPN for 7 days; T-14 group, TPN for 14 days; T7O7 group, TPN for 7 days and then 0.9% saline for the next 7 days. All solutions were administered by infusion through intraperitoneal catheter in two equal doses. During the experiment, rats also maintained on rat chow and water ad libitum. Levels of serum glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, alkaline phosphatase, and TSBA were measured. Liver was evaluated histopathologically by light microscope and then Morphological Cholestasis Index (MCI) was calculated. Results: Cholestasis was present in all experimental groups except control. Levels of transaminases and alkaline phosphatase were not correlated with the histopathologic changes (P > .05), but TSBA concentrations were correlated with MCI in all groups (P < .01). TSBA concentrations and MCI in all groups also were correlated with the duration of exposure with TPN (P < .01). Conclusions: Measurement of TSBA seems to be more sensitive in early diagnosis of TPN-induced cholestasis. Therefore, periodical determination of TSBA during TPN administration can be done routinely. Copyright (C) 1999 by W.B. Saunders Company.Öğe The effects of acetylsalicylic acid, interferon-?, and vitamin E on prevention of parenteral nutrition-associate cholestasis(Lippincott Williams & Wilkins, 1999) Demircan, M; Uguralp, S; Mutus, M; Gurer, EI; Atik, E; Turhan, F; Gursoy, MHBackground: Cholestasis is one of the major complications of parenteral nutrition. The purpose of this experimental study was to detect the effects of acetylsalicylic acid (ASA), vitamin E (Vit E), and interferon-alpha (IFN-alpha) on prevention of parenteral nutrition-associated cholestasis. Methods: Ten experimental groups, each consisting of 10 4-week-old Wistar albino rats, were formed: control 10- and 20-day groups (C-10 and C-20), parenteral nutrition-only 10- and 20-day groups (T-10 and T-20), ASA-supplemented parenteral nutrition 10- and 20-day groups (TA(10) and TA(20)), Vit E-supplemented parenteral nutrition 10- and 20-day groups (TE10 and TE20), and IFN-alpha-supplemented 10- and 20-day groups (TF10 and TF20). Acetylsalicylic acid, Vit E, and IFN-alpha were administered in the parenteral nutrition solution through an intraperitoneal route. At the end of the study, serum total bile acids, serum aspartate and alanine aminotransferases, and alkaline phosphatase were measured biochemically. In addition, the histopathologic findings of cholestasis were evaluated by using a morphologic portal inflammation index. Results: Although the difference in the serum levels of transferases and alkaline phosphatase was not significant among all groups (p > 0.05), it was significant in total bile acid levels (p 0.05). There was also a significant correlation between the histopathologic changes of the liver and serum total bile acid concentrations (p < 0.05). Portal inflammation in varying degrees was seen in all experimental groups, but not in the control groups. Serum total bile acid concentrations in parenteral nutrition groups receiving ASA were significantly lower than those in the parenteral nutrition-only group (p < 0.01). Although Vit E-supplemented parenteral nutrition was effective in preventing the development of cholestasis in the 10-day group (p < 0.05), it was not effective in the 20-day group when compared with incidence of cholestasis in the parenteral nutrition-only group (p > 0.05). Conversely, IFN-alpha-supplemented parenteral nutrition had no effect on cholestasis in the 10-day group (p > 0.05) but lowered cholestasis in the 20-day group when compared with incidence the parenteral nutrition-only group (p < 0.05). Conclusion: Our results indicate that acetylsalicylic acid may be beneficial in preventing, and alpha-interferon in treating, parenteral nutrition-associated cholestasis.Öğe The effects of orchiopexy on serum anti-Mullerian hormone levels in unilateral cryptorchid infants(Springer, 2006) Demircan, M; Akinci, A; Mutus, MBackground/Purpose: In males, serum anti-Mullerian hormone (AMH) reflects Sertoli cell function and provides an estimate of seminiferous tubular integrity. It has been suggested that comparison of AMH levels before and after surgery could be useful to determine effectiveness of the treatment. In this study, we determined the serum AMH levels in infants with unilateral cryptorchidism before and after orchiopexy procedure and compared these data with the AMH values in age-matched controls. Methods: The study population was 20 cryptorchid children with unilateral palpable testes who underwent orchiopexy as a cryptorchid group, and 20 healthy children who underwent circumcision as a control group. All children are 12 months of age. Serum AMH levels were measured at just before surgery (at 12 month old) and 6 months after surgery (at 18 month old). Results and Conclusions: All undescended testes were found to be normal in size and in the superficial inguinal pouch or subcutaneous region of the groin at surgery. With regard to the preoperative serum AMH levels, there was a significant difference between the cryptorchid and the control groups (40.04 +/- 4.97 ng/ml versus 53.46 +/- 7.51 ng/ml) (P < 0.05). Similarly, the postoperative serum AMH levels were lower in cryptorchid children than in controls (39.27 +/- 4.58 ng/ml versus 52.79 +/- 6.27 ng/ml) (P < 0.05). In cryptorchid children, serum AMH levels measured at 6 months after orchiopexy were similar with preoperative basal levels (40.04 +/- 4.97 ng/ml versus 39.27 +/- 4.58 ng/ml) (P > 0.05). AMH levels in children with unilateral palpable undescended testes remain unchanged 6 months after orchiopexy performed at 1 year of age. This is the first report in literature regarding the effect of orchiopexy on the serum AMH levels.Öğe Interferon-alpha reduces the development of experimental necrotizing enterocolitis(Academic Press Ltd- Elsevier Science Ltd, 2004) Uguralp, S; Mizrak, B; Karabulut, AB; Gürbüz, N; Demircan, MCytokines had important role in the pathogenesis of necrotizing enterocolitis (NEC). The aim of this study is to investigate if IFN-alpha has a prophylaxic, effect on experimental NEC development in newborn rat pups. Twenty eight Wistar Albino newborn rat pups were divided into three groups. Control group rats were breast-fed, NEC group and interferon (IFN) group rat pups were hand-fed with premature newborn formula. IFN-alpha was administered subcutaneously at a dose of 50,000 IU/rat/day in IFN group. NEC was induced experimentally by cold stress twice a day in IFN and NEC groups. On the fourth day, the rats were killed, and all the intestine were removed to determine the tissue level of malonaldehyde (MDA) and histologic changes. The microscopic lesions in the NEC group rats were virtually the same as those seen in neonatal NEC, with severe separation of submucosa and/or lamina propria, loss of villi and in some cases necrosis to extention the muscularis. In contrast, in the rats treated with IFN, lesions were moderate separation of submucosa and/or lamina propria, edema in submucosal and muscular layers. Intestinal injury score and MDA levels in NEC group were significantly higher than in the IFN group (P < 0.05). In conclusion it was suggested that IFN-a was effective in reducing the severity of NEC in rat pups. (C) 2004 Elsevier Ltd. All rights reserved.Öğe Pilomatricoma in children: A prospective study(Wiley, 1997) Demircan, M; Balik, EPilomatricoma is a skin appendage tumor that frequently involves the skin of the head, neck, and upper extremities in young children. In this prospective study, we present and discuss the characteristics of our patients with pilomatricoma. During the years 1984 to 1994, 15 children (9 girls and 6 boys) with pilomatricoma were admitted to our service. Their ages ranged from 3 to 13 years (mean age 9 years). All of the lesions of these patients were excised totally. On histopathologic examination, calcification was found in all of the specimens, No invasion or malignancy was observed by light microscopy, All patients have been followed up periodically by the same surgeons. Interestingly, we found two familial occurrences and four multiple occurrences. Although our series was too small for accurate statistical evaluation, multiple and familial occurrences of pilomatricoma (26.7% and 13.3%, respectively) were higher than in previously reported series.Öğe Plasma D-Lactate level: A useful marker to distinguish a perforated appendix from acute simple appendicitis(Taylor & Francis Inc, 2004) Demircan, M[Abstract Not Available]Öğe Regional anesthesia is a good alternative to general anesthesia in pediatric surgery: Experience in 1,554 children(W B Saunders Co, 2002) Uguralp, S; Mutus, M; Koroglu, A; Gurbuz, N; Koltuksuz, U; Demircan, MBackground/Purpose: Although caudal and spinal blocks are modern and safe techniques, in many centers children still are operated on under general anesthesia (GA), or the blocks are used for postoperative analgesia after GA in infraumbilical operations. The authors aimed to document the results and the complications of 1,554 regional anesthesia cases, thereby assessing their validity. Methods: The analysis of 1,459 caudal and 95 spinal blocks cases collected until January 2001 in children from newborn to 12 years of age are documented retrospectively. The types of anesthesia analyzed in the study were caudal block (CB) only, CB plus GA, GA plus CB, GA plus spinal block, and spinal block only. Results: There were 1,338 caudal and 95 spinal block cases that clinically were satisfactory. Because the duration of CB produce a CB occurred in 82 cases (5.57%). There were 257 of 1,338 patients operated on under GA and supported by caudal block for postoperative analgesia. Conclusions: Caudal anesthesia seems to be an inexpensive, simple, and effective technique not only as a supplement for postoperative analgesia, but also as a single method of anesthesia. and the authors recommend its use in a wider setting of clinical entities in infraumbilical surgical procedures of children. Copyright 2002 Elsevier Science (USA). All rights reserved.
