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Öğe Comparison of routine laboratory tests in acute appendicitis and intussusception in childhood(2019) Gurunluoglu, Kubilay; Tasci, Aytac; Gozukara Bag, Harika; Demircan, MehmetAim: Acute appendicitis and idiopathic intussusception are two major causes of acute abdomen in childhood. In this study, we investigated the clinical, laboratory and radiological findings of these two surgical emergencies during the first presentation. Material and Methods: In this study, we retrospectively reviewed the records of pediatric patients with acute appendicitis and idiopathic intussusception between 2015-2018. Patients were identified according to inclusion criteria. Results: Physical examination findings were positive in all patients with acute appendicitis and idiopathic intussusception. White Blood Cell (WBC) [15.55] and C-Reaktif Protein (CRP) [3.75] were high in the laboratory test in patients with acute appendicitis. In patients with idiopathic intussusception, lactate dehydrogenase (LDH) [302] and CRP [0.6] were high and Ultrasound findings were positive. In addition, WBC [10,1 (5,07)] was normal in patients with idiopathic intussusception. Conclusion: While WBC, CRP, physical examination is valuable in the diagnosis of acute appendicitis, physical examination, CRP, LDH and USG are valuable in the diagnosis of intussusception. In an Idiopathic intussusception patient, WBC may be normal at first admission.Öğe The Effects of Different Burn Dressings on Length of Telomere and Expression of Telomerase in Children With Thermal Burns(Oxford Univ Press, 2019) Gurunluoglu, Kubilay; Demircan, Mehmet; Koc, Ahmet; Kocbiyik, Alper; Tasci, Aytac; Durmus, Kubra; Gurunluoglu, SemraBackground: Burns are a common traumatic injury triggered by local tissue damage and a systemic response. In this study, we evaluated the effects of different burn dressings on telomere kinetics in children with thermal burn injury. Methods: Sixty children with thermal burn were included in this prospective study. The burn area of the patients included 20 to 50% total body surface area. Three different dressings (hydrofiber with silver [HFAg], poylactic membrane [PLM], and silver sulfadiazine [SSD]) and control groups were created. Telomere length in nucleated blood cells and telomerase expression in the skin tissue were evaluated in control and burn groups. Results: In the whole burn groups, telomere length in blood cells increased. The length of telomeres increased the most in the SSD group. The PLM group is the treatment that increases the number of squamous cell counts in the basal layer and telomerase expression in the skin. In HFAg and SSD groups, the expression of telomerase in the skin is decreased. In the HFAg group, the basal layer in the skin was also reduced in squamous cells. Conclusion: In all burn groups, the telomere length of nucleated cells in the blood was higher than in the control group. SSD dressing along with autografting is the treatment method that maximizes telomere length in blood cells. The PLM has the most increased telomerase expression in the skin of burned patients. The PLM application increases the number of cells on both burned and normal skin.Öğe Effects of high-voltage electrical burns and other burns on levels of serum oxidative stress and telomerase in children(2018) Gurunluoglu, Kubilay; Demircan, Mehmet; Tasci, Aytac; Uremia, Muhammed Mehdi; Turkoz, Yusuf; Bag, Harika GozukaraIntroduction: Electrical burns cause significant morbidity and mortality worldwide. Here we measured changes in levels of serum oxidative stress and telomerase in children suffering from high-voltage electrical burn (HVEB) injuries and other burns and the significance of these parameters in terms of amputation. Materials and methods: After obtaining approval from our ethics committee for this prospective study, we formed three groups: a group of 18 children with HVEBs, a group of 18 children with thermal burns, and a control group. All children were 1-16 years of age. The HVEB group was divided into HVEB-WA (without amputation) and HVEB-A (with amputation) subgroups. Serum malondialdehyde (MDA) level, total antioxidant capacity (TAC), total oxidant capacity (TOC), glutathione (GSH) level, and telomerase level were measured and compared among the groups. Results: The patients differed in terms of demographics. The healing time of the HVEB group was longer than that of the thermal burn group, and the oxidative stress indicators of the HVEB group remained higher for longer. The mean oxidative stress indices in the HVEB-A group were higher than those in the HVEB-WA group and remained elevated for longer. Conclusion: HVEBs are more destructive than thermal burns; damage may progress over time, and healing takes longer. Healing can be followed biochemically by measuring levels of oxidative stress indicators. Indications for amputation, if not initially obvious, can be predicted by evaluating these indicators, affording therapeutic advantages. (C) 2018 Elsevier Ltd and ISBI. All rights reserved.Öğe Effects of high-voltage electrical burns and other burns on levels of serum oxidative stress and telomerase in children(Elsevier Sci Ltd, 2018) Gurunluoglu, Kubilay; Demircan, Mehmet; Tasci, Aytac; Uremia, Muhammed Mehdi; Turkoz, Yusuf; Bag, Harika GozukaraIntroduction: Electrical burns cause significant morbidity and mortality worldwide. Here we measured changes in levels of serum oxidative stress and telomerase in children suffering from high-voltage electrical burn (HVEB) injuries and other burns and the significance of these parameters in terms of amputation. Materials and methods: After obtaining approval from our ethics committee for this prospective study, we formed three groups: a group of 18 children with HVEBs, a group of 18 children with thermal burns, and a control group. All children were 1-16 years of age. The HVEB group was divided into HVEB-WA (without amputation) and HVEB-A (with amputation) subgroups. Serum malondialdehyde (MDA) level, total antioxidant capacity (TAC), total oxidant capacity (TOC), glutathione (GSH) level, and telomerase level were measured and compared among the groups. Results: The patients differed in terms of demographics. The healing time of the HVEB group was longer than that of the thermal burn group, and the oxidative stress indicators of the HVEB group remained higher for longer. The mean oxidative stress indices in the HVEB-A group were higher than those in the HVEB-WA group and remained elevated for longer. Conclusion: HVEBs are more destructive than thermal burns; damage may progress over time, and healing takes longer. Healing can be followed biochemically by measuring levels of oxidative stress indicators. Indications for amputation, if not initially obvious, can be predicted by evaluating these indicators, affording therapeutic advantages. (C) 2018 Elsevier Ltd and ISBI. All rights reserved.Öğe The effects of hydrostatic reduction and operative manual reduction on the success of intussusception reduction(2018) Gurunluoglu, Kubilay; Tasci, Aytac; Gozukara Bag, Harika; Sigirci, Ahmet; Demircan, MehmetAim: Intussusception is the most common cause of bowel obstruction in children aged 3 months to 6 years. Ultrasonically guided Hydrostatic reduction (UGHR) and operative manual reduction (OMR) are among the treatment methods. The aim of this study is to compare the effects of UGHR and OMR techniques on successful reduction in children with intussusception. Material and Methods: This study was performed retrospectively between January 2015 and May 2018. The data of intussusception child patients were reviewed. A total of 63 patients’ records were reached. A total of 31 UGHR procedures and 32 OMR procedures were recorded. Demographic data, recurrence, reduction success of UGHR and OMR patients were calculated and evaluated statistically. Results: No significant difference was found in terms of demographic information. There was no recurrence in both groups. While rate of successful reduction of patient with UGHR is 77.4%, OMR’s success is 87.5%. There was no statistically significant difference in terms of reduction success. It was determined that what was important in the reduction success was the first application time. Conclusions: When we evaluated our results, we found that the factor affecting the reduction success in a patient with intussusception was not the method of reduction. We found that the most important factor affecting reduction success was the time between onset of symptoms and initiation of reduction. If this is less than 24 hours, we have found that the reduction success is very good.Öğe The effects of total parenteral nutrition on telomerase expression in rabbit(2018) Gurunluoglu, Kubilay; Bayrakci, Ercan; Gokce, Hasan; Kocbiyik, Alper; Taskapan, Cagatay; Tasci, Aytac; Aksungur, Zeynep; Arslan, Ahmet Kadir; Demircan, MehmetAbstract Aim: Total parenteral nutrition (TPN) is a technique which is use to give vitally mandatory substances in to the venous compartments whenever the gastrointestinal system cannot be used by the patients. Telomerase catalyzes DNA synthesis, which is necessary to maintain telomere length and stabilize the genome to allow continued cell proliferation. In this study, we explored the effects of TPN administration on telomerase reverse transcriptase (TERT) expression in various tissue and serum telomerase level. Material and Methods: In this study a number of 42 same-aged albino, equal number of male and female, new zealand rabbits were use, divided in to three groups. Group 1 rabbits received TPN for 10 days via a central venous catheter. Group 2 received 50 mL/ kg/day physiological saline via a central venous catheter. Group 3 served as the control group. The rabbits were sacrificed after 10 days, and serum telomerase levels were measured by enzyme-linked immunosorbent assay. TERT expression in gonadal, liver, jejunum, and skin tissues were determined immunohistochemically. Blood samples were obtained before and after TPN and saline administration in the TPN and serum saline groups, respectively, and at the end of the experiment in the control group. Results: Telomerase expression in liver, gonads and serum level of TPN group was significantly higher than control and serum saline groups. Conclusion: TPN may be a positive effect in liver and gonadal telomer kinetic. However, we think that TPN increases DNA damage throughout the body.Öğe The Effects of Two Different Burn Dressings on Serum Oxidative Stress Indicators in Children with Partial Burn(Oxford Univ Press, 2019) Gurunluoglu, Kubilay; Demircan, Mehmet; Tasci, Aytac; Uremis, Muhammed Mehdi; Turkoz, Yusuf; Bag, Harika Gozukara; Akinci, AysehanIn this study, we evaluated and compared the effect of treatment with a hydrofiber dressing with silver (HFAg) and a polylactic membrane (PLM) on systemic oxidative stress in systemic inflammatory reaction in thermal burn injuries in children. A prospective randomized and matched pairing study of 20 to 50% of TBSA was performed from children equal to both sexes affected by thermal injuries. The control group was included in normal children of both sexes. Serum malondialdehyde (MDA), total antioxidant capacity (TAC), total oxidant capacity (TOC), and glutathione (GSH) levels were analyzed and the results were analyzed statistically. In this study, it was found that PLM treatment increased TAC and GSH levels in burn patients significantly more than the other group. With the use of PLM, TOC decreased to normal level from day 3. In the HFAg group, TAC and GSH levels began to increase on the seventh day. On the first day of the burn, the TOC level started to increase. This increase continued on days 7 and 14. The TOC level began to fall on the 21st day. The increase in TAC was higher in the PLM group. In the PLM group, TOC fell faster. As a result, we think that different burn dressings can have different systemic effects. We can speculate that PLM has an antioxidant effect in the burn tissue due to high lactate content. Therefore, PLM may have decreased serum oxidative stress indicators more effectively than HFAg.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 Global gene expression profiling in congenital diaphragmatic hernia (CDH) patients(Springer Heidelberg, 2022) Gurunluoglu, Kubilay; Dundar, Muhammed; Unver, Turgay; Akpinar, Necmettin; Gokce, Ismail Kursad; Gurunluoglu, Semra; Demircan, MehmetCongenital diaphragmatic hernia (CDH) is an anomaly characterized by a defect in the diaphragm, leading to the passage of intra-abdominal organs into the thoracic cavity. Herein, the presented work analyzes the global gene expression profiles in nine CDH and one healthy newborn. All of the patients had left posterolateral (Bochdalek) diaphragmatic hernia, operated via an abdominal approach, and stomach and bowels in the thorax cavity. Some patients also had additional anomalies. A total of 560 differentially regulated genes were measured. Among them, 11 genes showed significant changes in expression associated with lung tissue, vascular structure development, and vitamin A metabolism, which are typical ontologies related to CDH etiology. Among them, SLC25A24 and RAB3IL1 are involved in angiogenesis, HIF1A and FOXC2-AS1 are related with the alveolus, MAGI2-AS3 is associated with the diaphragm, LHX4 and DHH are linked with the lung, and BRINP1, FZD9, WNT4, and BLOC1S1-RDH5 are involved in retinol. Besides, the expression levels of some previously claimed genes with CDH etiology also showed diverse expression patterns in different patients. All these indicated that CDH is a complex, multigenic anomaly, requiring holistic approaches for its elucidation.Öğe Global gene expression profiling in congenital diaphragmatic hernia (CDH) patients (vol 22, pg 359, 2022)(Springer Heidelberg, 2022) Gurunluoglu, Kubilay; Dundar, Muhammed; Unver, Turgay; Akpinar, Necmettin; Gokce, Ismail Kursad; Gurunluoglu, Semra; Demircan, Mehmet[Abstract Not Available]Öğe Histopathological and ultra-structural investigation of the damaging effects of hypoinsulinemia, hyper glycaemia and oxidative stress caused by parenteral nutrition combined with fasting on the small intestine of rabbits(Elsevier, 2023) Gurunluoglu, Semra; Gul, Mehmet; Gurunluoglu, Kubilay; Kocbiyik, Alper; Gul, Semir; Bag, Harika Gozukara; Uremis, Muhammed MehdiBackground and study aims: Parenteral nutrition (PN) is a life-saving practice when the use of the gastrointestinal tract is not appropriate. Despite its great benefits, however, PN may cause several complications. In this study, we conducted histopathological and ultra-structural examinations of the effect of PN combined with starvation on the small intestines of rabbits.Materials and methods: Rabbits were divided into four groups. A fasting + PN group was left completely unfed and received all its daily required energy by PN through an intravenous central catheter. An oral feeding + PN group received half the necessary daily calories by oral feeding and the other half through PN. A semi-starvation group received only half the necessary daily calories by oral feeding and no PN. The fourth group, serving as a control, was supplied with its entire daily energy requirements through oral feeding. After 10 days, the rabbits were euthanized. Blood and small intestine tissue samples were collected from all groups. Blood samples were bio-chemically analysed, and tissue samples were examined by light and transmission electron microscopy.Results: The fasting + PN group exhibited lower insulin levels, higher glucose levels, and increased systemic oxidative stress than the other groups. Ultra-structural and histopathological examinations revealed a significant increase in apoptotic activity in this group's small intestines and a significant decrease in villus length and crypt depth. Severe damage to the intracellular organelles and nuclei of enterocytes was also observed.Conclusion: PN combined with starvation appears to cause apoptosis in the small intestine due to oxidative stress and hyperglycaemia with hypoinsulinemia, with destructive effects on small intestine tissue. Adding enteral nutrition to PN may reduce these destructive effects.Öğe Impact of COVID-19 pandemic on pediatric appendicitis hospital admission time and length of hospital stay(Turkish Assoc Trauma Emergency Surgery, 2022) Tasci, Aytac; Gurunluoglu, Kubilay; Yildiz, Turan; Arslan, Ahmet Kadir; Akpinar, Necmettin; Cin, Ecem Serbest; Demircan, MehmetBACKGROUND: Appendicitis is one of the most common surgical emergencies among children. In this retrospective clinical study, we attempted to determine the effects of the COVID-19 pandemic period on hospital admission time and length of hospital stay (LOS) in pediatric appendicitis cases. METHODS: We retrospectively compared pediatric appendectomies from the date of the first reported COVID-19 case to June 1, 2020, which is considered as the start of the normalization process, with pre-pandemic pediatric appendectomies of the same number of days in terms of age, gender, hospital admission time, LOS, parental educational level, laboratory values, and histopathological findings. RESULTS: There was an average increase of 2 days in the time from the onset of symptoms to hospital admission in pediatric appendicitis patients in the COVID-19 period (p=0.001). Furthermore, C-reactive protein value was statistically significantly higher in the COVID-19 period (p=0.018). Given the LOS, it was calculated as an average of 5 days in the pre-pandemic period and 4 days in the COVID-19 period, and this difference was statistically insignificant (p=0.273). There was no significant difference between the groups in terms of histopathological findings (p=0.176). The parental educational level had no effect on the admission time. CONCLUSION: The hospital admission time of pediatric appendicitis patients is significantly prolonged in the COVID-19 pandemic, but this prolongation had no histopathological effect. During the pandemic, the recovery of patients who required urgent treatment during the stay-at-home period was also negatively affected. Notwithstanding, we are of the opinion that the absence of an increase in the LOS may be due to the willingness of both families and physicians to keep the LOS as short as possible. Despite the increase in hospital admission time in pediatric appendicitis during the Covid 19 pandemic process, the lack of increase in the rate of complicated appendicitis may be an indicator of the importance of other factors in the development of complicated appendicitis.Öğe Impaction of the polylactic membrane or hydrofiber with silver dressings on the interleukin-6, tumor necrosis factor-?, transforming growth factor-?3 levels in the blood and tissues of pediatric patients with burns(Turkish Assoc Trauma Emergency Surgery, 2021) Demircan, Mehmet; Gurunluoglu, Kubilay; Bag, Harika Gozde Gozukara; Kocbiyik, Alper; Gul, Mehmet; Uremis, Nuray; Gul, SemirBACKGROUND: We aimed to evaluate the effects of two different burn dressings, hydrofiber with a silver (HFAg) and polylactic membrane (PLM), on altering the levels of important biomarkers Interleukin-6 (IL-6), Tumor necrosis factor-alpha (TNF-alpha), Transforming growth factor-beta(3) (TGF-beta(3)) in blood and burnt tissue in children with second-degree burns. METHODS: Children between the ages of one to 16 years, with 25-50% second-degree partial-thickness burns of the total body surface area were included in this study. Patients in the PLM group were dressed with PLM in a typical way according to the manual. The HFAg group was dressed with HFAg and a sterile cover. During and at the end of the 21-day treatment, blood and skin tissue samples were taken from the two burn and control groups. IL-6, TNF-alpha, and TGF-beta beta(3) levels were evaluated in blood and tissue samples from all groups, and the results were analyzed statistically. RESULTS: In the PLM group, IL-6 and TNF-alpha levels decreased early days in both serum and tissue samples to reach normal ranges compared with the HFAg group. In the PLM group, TGF-beta(3) levels were elevated than in other groups for two weeks. CONCLUSION: In this study, we found that PLM controls inflammation earlier in both systemic and burn tissue. We also found that PLM increased the level of TGF-beta(3), which may be associated with the prevention of the development of hypertrophic scar in the burn wound, in the blood and burn tissue during this study.Öğe Investigation of the cardiotoxic effects of parenteral nutrition in rabbits(W B Saunders Co-Elsevier Inc, 2020) Gurunluoglu, Kubilay; Gul, Mehmet; Kocbiyik, Alper; Koc, Ahmet; Uremis, Nuray; Gurunluoglu, Semra; Bag, Harika GozukaraIntroduction: Parenteral nutrition (PN) is used for the intravenous delivery of nutrients to patients who cannot take food orally. However, it is not clear whether PN also negatively impacts cardiac tissue. The present empirical study investigated the cardiac effects of PN in rabbits. Methods: The effects of PN were examined in three groups of rabbits: animals in the PN + fasting group (n = 14) had been fully fasted before receiving a full PN dose via an intravenous central catheter; the PN + oral feeding group (n = 14) received half of the daily calorie requirement as a half dose of PN via an intravenous central catheter; the third group consisted of controls (n = 14) with full enteral feeding and full enteral fluid intake with no PN and no central venous catheter. Al the end of the 10-day study period, the rabbits were subjected to echocardiographic examination and euthanized. Blood and tissue samples were obtained from all groups. DNA was isolated from nucleated blood cells. Tissue samples were examined by both light and electron microscopy, relative telomere length was determined from DNA, and blood samples were analyzed biochemically. Results: At the end of the study, there were no statistically significant differences in weight change between the three groups. Echocardiography revealed minimally impaired diastolic function in the PN + fasting group compared to the other groups. Biochemical and histopathological analyses, relative telomere length determination, and electron micrographs showed significant cardiac damage in the PN + fasting group but not in the PN + oral feeding group or the control group. The blood biochemical analyses showed hyperglycemia and a low insulin level in the PN + fasting group but not in the other two groups. Conclusions: A combination of PN and fasting may damage the cardiac muscle cells of rabbits via a mechanism involving hyperglycemia and oxidative stress. Additional enteral feeding may protect against the destructive effects of PN on cardiac tissue. (C) 2019 Elsevier Inc. All rights reserved.Öğe Ultra-structural and histopathological features of liver biopsy taken during laparotomy to confirm the diagnosis of biliary atresia(Wolters Kluwer Medknow Publications, 2022) Gurunluoglu, Semra; Gul, Mehmet; Zararsiz, Gokmen; Akpinar, Necmettin; Varol, Fatma, I; Demircan, Mehmet; Gurunluoglu, KubilayBackground: Neonatal cholestasis is caused by a group of diseases that cause jaundice, which can be encountered in the neonatal period. Biliary atresia (BA) and idiopathic neonatal hepatitis (INH) are among neonatal cholestasis diseases. Aims: The aim of this study was to perform histopathological and ultra-structural examinations of liver biopsy tissue samples from BA and INH patients with liver biopsies taken during laparotomy to confirm the diagnosis of biliary atresia. Settings and Design: A total of patients undergoing Kasai surgery before the age of 60 days were included in an early group (n = 7), whereas patients undergoing surgery after the age of 60 days were included in a late group (n = 11). The control group (n = 11) included INH patients. Materials and Methods: For histopathological examinations, liver tissue samples obtained intra-operatively were subjected to routine histopathological procedures after being stained with caspase-3 and cytokeratin-7 antibodies. Ultra-structural evaluations were also performed. Statistical analysis used: For comparisons between the groups, a one-way analysis of variance (ANOVA) test and the Mann-Whitney U test were used for continuous variables. Results: Histopathological findings reflected the specific liver pathologic findings seen in biliary atresia. Although there was no significant difference between the BA groups, these parameters were not detected in the control group. The histopathological evaluations revealed no significant differences in the findings of liver parenchyma damage between the early, late, and control groups. Electron microscopic examinations showed that the patients in the late group had more severe signs of intra-cellular damage to the liver. Conclusions: Although the histopathological examination revealed no significant differences in liver damage between the three groups, in ultra-structural evaluation, intra-cellular damage was found to be less in groups with better prognosis. Electron microscopy evaluations of intra-cellular damage may be more useful in this respect.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 When is free air a sign of complication on abdominal plain radiography after laparotomy in pediatric patients?(2018) Gurunluoglu, Kubilay; Tasci, Aytac; Gozukara Bag, Harika; Demircan, Mehmet; Sigirci, AhmetAim: Postoperative free air in the abdomen may not be harmful for the patient, it may be innocent, but it may also be an important indicator or marker of an operation-related complication. In this study we aimed to find out retrospectively when post-operative free air in the abdomen disappears in pediatric patients undergone laparotomy. Material and Methods: From January 2009 to April 2018, records of all pediatric patients under 17 years of age undergoing laparotomy were reviewed. The data of 1570 patients who underwent laparotomy were obtained. Among these patients, 101 patients who complained of vomiting on the first postoperative day were identified. On the first postoperative day, 101 patients with vomiting complaints were found to have abdominal plain radiographs (APR). Among these patients, those who were re-operated were identified. Both groups were statistically analyzed in terms of the disappearance time of free air and demographic information in the APR film. Results: The free air in the group of re-laparotomy continued to be seen for a longer time. We found that free air was lost in APR in 28.7% of patients in 1 day, 60.3% in 2 days, 7.9% in 3 days and 2.9% in 4 days. Conclusion: In our study, we found that free air continued to be seen in APR for 2 days after laparotomy in children. We claim that surgical intervention should be considered as a primary consideration if free air is present in the APR after 3rd postoperative dayÖğe 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.
