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Öğe Erythrocyte and plasma superoxide dismutase activities in acute appendicitis(1998) Koltuksuz U.; Uz E.; Gursoy H.; Demircan M.; Aydinc M.; Mutus M.; Cetin S.Although the role of oxygen free radicals in many inflammatory diseases has been well known, it has not been thoroughly investigated in the inflammatory diseases, of the abdomen. In order to investigate the possible role of oxygen free radicals in the mechanism of progression following the onset of inflammation, blood samples from 18 patients diagnosed as acute appendicitis and 10 healthy children as controls were collected. After plasma and erythrocytes of the blood samples were separated, superoxide dismutase (SOD) activities were measured in these compartments. Additionally, the patients with appendicitis were divided into perforated (n=8), and nonperforated (n=10) subgroups, according to intraoperative examination findings and histopathological classification. SOD activities were compared statistically between these two groups, and the control group. A significant difference in SOD activity between perforated and nonperforated appendicitis in both plasma and erythrocyte was observed (plasma: 4.2±1.7 and 2.0±0.7 U/ml, p<0.05; erythrocyte: 1690.7±799.6 and 1104.2±225.1 U/grHb, p<0.05). The difference between the nonperforated group and control group was not significant, whereas there was a significant difference between the perforated and control groups (plasma: 4.2±1.7 and 2.6±0.9 U/ml, p<0.05; erythrocyte: 1690.7±799.6 and 1148.8±152.2 U/grHb, p<0.05). According to these results, we may speculate that free oxygen radicals released from polymorphonuclear leucocytes following an inflammatory condition may play an important role in the progression of acute appendicitis with the contribution of some other possible factors.Öğe Injuries of large vessels in high stage neuroblastoma surgery. A case report(1999) Koltuksuz U.; Gürsoy M.H.; Aydinç M.; Özgen Ü.; Ege E.; Mutus M.Complete resection of the primary lesion in stage III neuroblastoma improves survival. Neuroblastoma has a tendency towards surrounding and infiltrating the large vessels, leading to injuries during tumor resection. We operated on a stage Ill neuroblastoma, which resulted in the right and left common iliac artery and vein damage. The right common iliac artery and, veins were repaired by end to end anastomosis. There was a long gap between the two ends of the left common iliac artery and it was repaired using a mesenteric vein (marginal vein of the colon) graft. Digital subtraction angiography performed 6 months after the operation did not reveal any stenosis or aneurysmatic changes in the anastomoses. We conclude that short segments of large vessels may be sacrificed during the resection of neuroblastomas invading the vessel wall, and the resulting defects may be repaired by end to end anastomosis, or even by substituting mesenteric vein grafts, for the purpose of total or near total removal.Öğe Intraoperative laparoscopy by a flexible scope: is it reliable in contralateral childhood hernias?(1997) Gursoy M.H.; Gurel M.; Koltuksuz U.; Uguralp S.; Aydinc M.BACKGROUND AND OBJECTIVES: Negative contralateral groin exploration for childhood hernias raises the question of whether contralateral groin exploration is necessary or not. To find out whether a contralateral processus vaginalis was patent, we performed laparoscopy with a flexible scope. METHODS: After carbon dioxide insufflation, a flexible laparoscope was inserted through the opened hernia sac and the contralateral processus vaginalis orifice was examined. We considered a patent processus vaginalis as a potential hernia. The study involved 20 children: 16 boys and 4 girls. The symptomatic side was explored in a conventional manner and laparoscopy was performed through the opened hernia sac. RESULTS: A contralateral processus vaginalis was found in 6 children: 4 boys and 2 girls. These results were confirmed by exploring the opposite groin. We did not explore if the laparoscopic examination was within normal limits. There was one false-positive result in a female patient. CONCLUSIONS: Intraoperative non-puncture laparoscopy utilizing a flexible laparoscope through the hernia opening is an uncomplicated, reliable and precise method for identifying a patent contralateral processus vaginalis. It may represent a satisfactory alternative to routine bilateral inguinal exploration. Also, use of the flexible laparoscope may be more beneficial than use of a rigid laparoscope passed through the umbilicus or hernia sac.Öğe Repair of abdominal wall defects with fasciocutaneous flaps. Experimental study(1997) Koltuksuz U.; Tuncer R.; Okur H.; Keskin E.; Zorludemir U.; Olcay I.Purpose: The ideal treatment of omphalocele and gastroschisis is primary full-thickness closure of the abdominal wall defect. Several surgical techniques have been described to overcome the problems, however, no definitive solution has been found so far. We have investigated whether the abdominal wall defects can be primarily repaired by using abdominal fasciocutaneous flaps. Methods: Ten rats weighing 280-320 gm, were devided into two groups (i.e. experimental and control). A full thickness excision was done on the lateral abdominal wall bilaterally to reduce the intraabdominal volume by 78% on all of them. In the experimental group, the defect was closed by using a fasciocutaneous flap which consisted of the skin and anterior sheet of the rectus muscle. Primary abdominal closure was performed in the control group. Results: Following the procedures, 95.5% increase in the intraabdominal volume was achieved in the experimental group (p < 0.01). On the postoperative 17-19th days in both groups abdominal volume of the rats were found to be increased. No herniation, diastasis nor evisceration was observed in the experimental group when the intraabdominal pressure was increased up to 40 cm H2O with saline injection. It was also recorded that inferior vena cava pressure was correlated with intraabdominal pressure. Conclusion: It is concluded that abdominal wall defects could be repaired by using fasciocutaneous rectus flaps.Öğe The treatment of ureteroureteral reflux in incomplete ureteral duplication: Ureteropyclostomy(1999) Koltuksuz U.The incomplete ureteral duplication where the ureters join to form a single stem at a variable distance above the bladder may cause ureteroureteral reflux. We report a case of incomplete ureteral duplication in which we performed ureteropyelostomy since it caused intractable urinary tract infection. Follow up at two years showed adequate urinary drainage and no urinary infection.
