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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 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 Long-term effects of orchiopexy and orchiectomy on the testes of rats with testicular torsion(Elsevier Sci Ltd, 2022) Tasci, Aytac; Uguralp, Sema; Akatli, Ayse Nur; Arslan, Ahmet Kadir; Karabulut, Aysun BayIntroduction Ischemia/reperfusion injury occurs after testicular torsion, levels of free oxygen radicals and inflammatory cytokines are increased in both the torsional and contralateral testis, leading to testicular injury. Objective The present study investigated whether orchiopexy or orchiectomy after testicular torsion was superior in terms of fertility potential in the long term. Study design Following 720 degrees, 4 h left testicular torsion, orchiectomy or orchiopexy was performed on 84 rats, which were then sacrificed and evaluated for testicular function at day 1, at 3 months and 6 months (n = 14 per group). An additional 14 rats were in the control group. Results Follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone levels were significantly lower in the orchiopexy group than the orchiectomy and control groups after 3 months. However, there were no significant differences in hormone parameters among the three groups after 6 months. The hormone levels, Johnsen score, seminiferous tubule diameter, and inducible nitric oxide synthase (iNOS) expression at 3 and 6 months were not significantly different between the orchiectomy group and controls. Histopathological analyses at 3 and 6 months indicated significant decreases in Johnsen score and seminiferous tubule diameter in the ipsilateral testis in the orchiopexy group. At 3 months, the level of iNOS expression in the contralateral testis was significantly lower in the orchiopexy group than in other groups. At 6 months, however, it was not significantly different between the orchiopexy and control groups. There were no significant differences in iNOS expression at 3 or 6 months in the orchiectomy group compared to controls. Discussion The ipsilateral testis in the orchiopexy group began to atrophy at 3 months, and the degree of atrophy became more evident at 6 months. The level of iNOS expression was low in the bilateral testis at 3 months in the orchiopexy group, and sperm in the contralateral testis were not yet functionally healthy. The level of iNOS expression in the ipsilateral testis decreased further at 6 months in the orchiopexy group, while that in the contralateral testis returned to the normal level. Conclusion Testicular functions were restored faster after orchiectomy compared to orchiopexy following testicular torsion. However, follow-up of the rats for 6 months demonstrated that orchiopexy or orchiectomy procedures conducted on the testicular torsion had no effect on future fertility potential after 4 h of torsion.Öğe Solitary Bone Cyst Like Areas in Myositis Ossificans: A Breast Mass in a Child(Taylor & Francis Inc, 2021) Akatli, Ayse Nur; Uguralp, Sema; Alan, Saadet; Tasci, Aytac; Yildirim, GokhanBackground: Myositis ossificans is an extraosseous, benign tumor-like condition characterized by prominent heterotopic ossification. Cystic degeneration in myositis ossificans is an uncommon entity. Case report: A 13-year-old girl presented with a large and painful breast lump. Physical examination revealed a mobile, hard mass, clinically resembling a fibroadenoma. The mass was excised and diagnosed as myositis ossificans with central bone cyst like changes. Conclusion: Our case represents the first myositis ossificans case with central bone cyst like changes in a child.Öğe Wandering spleen torsion resulted as intestinal obstruction(2020) Tasci, Aytac; Yildiz, TuranWandering spleen is a very rare condition with an estimated incidence of 0.2%. Clinical presentation of wandering spleen can vary from asymptomatic to an abdominal emergency. In this report, we present a two-year-old girl with acute intestinal obstruction due to the torsion of wandering spleen. We successfully performed the splenopexy procedure in a 2-year-old patient who came with an acute intestinal obstructionÖğe 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 day
