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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 The effect of sustained and local administration of epidermal growth factor on improving bilateral testicular tissue after torsion(Springer, 2004) Uguralp, S; Karabulut, AB; Mizrak, B; Kaymaz, F; Kiziltay, A; Hasirci, NEpidermal growth factor (EGF) modulates Leydig cell proliferation, steroidogenesis, spermiogenesis, and Sertoli cell activity. It plays an important role in repairing ischemia-reperfusion injury in different tissues. The aim of this study was to evaluate the effects of sustained and local administration of EGF on improving bilateral testicular tissue after torsion. A total of 57 Wistar albino rats were used. For the EGF transport system, 1x2 cm gelatin films containing 2 mug EGF were used. Torsion was created by rotating the right testis 720degrees in a clockwise direction for 4 h in all groups except the control group. Then, in the torsion group, bilateral orchiectomy was performed. After returning the torsioned ipsilateral testes to their normal state, the bilateral testes were wrapped by 1x2 cm unloaded gelatin films in the gelatin (G7 and G21) groups and, by 2 mug EGF loaded gelatin films in the EGF 7 and EGF 21 groups. The testes were removed on the seventh and 21st days, respectively, for biochemical and histological examination. Histologically, Johnsen's spermatogenesis criteria and mean seminiferous tubule diameter (MSTD) measurements were used. The EGF7 group did not show significant loss of Sertoli cells, while in the G7 group the number of these cells decreased. The ipsilateral ischemic testis of the EGF21 group showed Leydig cell hyperplasia, and the contralateral non-ischemic testes in this group were similar to the control group. In the G21 group, the bilateral testes showed Sertoli cell only syndrome in some sections, and most of the cells were undergoing apoptosis. The mean spermatogenesis scores and MSTD in the EGF7 and EGF21 groups were higher than in the G7 and G21 groups (P<0.05). Malondialdehyde levels were significantly lower in the EGF groups than in the G groups (P<0.05). Glutathione peroxidase (GSH-Px) levels in the G21 group were significantly higher than in the EGF21 group. Our study shows that local and sustained EGF release after testicular torsion improves bilateral testicular injury. EGF administration may be a new treatment choice for bilaterally injured testis after detorsion without removing the twisted testis.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 Effects of pentoxifylline and vitamin E on the bilateral ovary after experimental ovarian ischemia(Georg Thieme Verlag Kg, 2005) Uguralp, S; Karabulut, AB; Mizrak, BPentoxifylline (PTX) and vitamin E inhibit the release of superoxide and hydroxyl radicals, and PTX improves capillary flow and tissue oxygenation. This experimental study was designed to determine the effects of PTX and vitamin E in the ovary after unilateral ovarian ischemia reperfusion (I-R) in albino Wistar rats. A vascular clamp was placed on the left ovary for 4 hours in all groups except for the control group. Following this, in the ischemia (1) group bilateral ovariectomy was performed. Saline, PTX, vitamin E, and PTX plus vitamin E were infused 30 min before reperfusion in the reperfusion (R), pentoxifylline (P), vitamin E (E), and pentoxifylline plus vitamin E (PE) groups, respectively. After 4 hours of reperfusion, the ovaries were removed for biochemical and histologic examination. MDA levels of bilateral ovaries in the PE group were significantly lower than in the E group (p < 0.0033). NO levels of bilateral ovaries in the PE group were significantly lower than in the P and E groups (p < 0.0033). Massive hemorrhage was determined in the ipsilateral ovaries of the R group. Hemorrhage was minimal or moderate in the ipsilateral ovaries of other groups. The contralateral ovaries showed congestion in different degrees. The contralateral ovaries of the group PE and the bilateral ovaries of the control group showed no pathological changes. PTX and vitamin E given together seems to be more effective in reducing I-R injury in ovarian tissue compared to administration of PTX, or vitamin E alone. However, further studies are required to evaluate the effective dose and duration of PTX and vitamin E on bilateral ovaries.Öğe Interferon alpha reduces the development of experimental necrotizing enterocolitis (vol 25, pg 204, 2004)(Academic Press Ltd Elsevier Science Ltd, 2005) Uguralp, S[Abstract Not Available]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 Intraoperative laparoscopy by a flexible scope: Is a a good alternative to routine bilateral exploration in childhood hernias?(Monduzzi Editore, 1997) Gursoy, MH; Gurel, M; Koltuksuz, U; Uguralp, S; Aydinc, MNegative contralateral explorations go on raising the question on whether the contralateral exploration is still necessary or not. To iind out whether the contralateral processus vaginalis was patent or not, we performed intraoperative non-puncture laparoscopy by a flexible scope. We inserted the flexible scope through the open hernia sac and tried to see the opening of the contralateral processus vaginalis. The study involved a total of 20 children, 16 boys and 4 girls. The symptomatic side was explored and laparoscopy was performed through the opened hernial sac. We found a contralateral processus vaginalis in 6 children, 4 boys and 2 girls, by flexible scopy. We confirmed the results by exploring the opposite groin. There was 1 false-positive result in a girl. Intraoperative non-puncture laparoscopy by a flexible scope through the hernial opening is an uncomplicated, reliable and precise method. it may represent a very satisfactory alternative to routine bilateral inguinal exploration and also by its enhanced mobility, it may be much more beneficial than the recently developed technique of scoping children with a rigid laparoscope.Öğe Primary intestinal lymphangiectasia(Lippincott Williams & Wilkins, 2001) Uguralp, S; Mutus, M; Kutlu, O; Çetin, S; Baysal, T; Mizrak, B[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.Öğe Resveratrol may reduce apoptosis of rat testicular germ cells after experimental testicular torsion(Georg Thieme Verlag Kg, 2005) Uguralp, S; Usta, U; Mizrak, BThe aim of the study is to evaluate the effects of resveratrol on apoptosis of testicular germ cells after experimental testicular torsion. Thirty Wistar albino rats were divided into 3 groups. Torsions were created by rotating the right testis 720 degrees in a clockwise direction for 4 h in all groups except the control group (group 1). They were then repaired by counter-rotation and replaced into the scrotum. In group 2, saline was infused 30 min before detorsion. In group 3, 30 mg/kg resveratrol was infused 30 min before detorsion. In groups 2 and 3, the bilateral testes were removed to determine germ cell apoptosis after 20 h of detorsion. The number of apoptotic cells was evaluated using the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling (TUNEL) technique and caspase 3. Mean apoptotic score of ipsilateral testes in group 3 was lower than that of group 2 (p < 0.05). Mean apoptotic score of the contralateral testes in group 3 was not different from that of group 2 (p > 0.05). The present study demonstrates that intraperitoneal administration of resveratrol in rats may decrease germ cell apoptosis in the ipsilateral testes.Öğe Resveratrol reduces ischemia reperfusion injury after experimental testicular torsion(Georg Thieme Verlag Kg, 2005) Uguralp, S; Mizrak, B; Karabulut, ABThe aim of the study was to evaluate the effects of resveratrol on testicular ischemia reperfusion injury. Forty Wistar albino rats were divided into 4 groups. Torsions (ischemia) were created by rotating the right testis 720° in a clockwise direction for 4 hours in all groups except the control group. In the torsion group after 4 hours' ischemia bilateral orchiectomy was performed. In the detorsion group, saline was injected by an intraperitoneal route, 30 min before detorsion (reperfusion). In the resveratrol group, 30 mg/kg resveratrol was injected by an intraperitoneal route, 30 min before detorsion. In the detorsion and resveratrol groups, the bilateral testes were removed after 20 hours of detorsion. In all groups, the tissue levels of malondialdehyde (MDA) and glutathione (GSH) and histological changes were determined. In rats treated with resveratrol, MDA levels (138 ± 25 nmol/mg protein) were significantly decreased compared with torsion (426 ± 178 nmol/mg protein) and detorsion (370 ± 76 nmol/mg protein) groups (p < 0.05). GSH levels (6.54 ± 0.8 ? mol/g wet tissue) were significantly increased compared with torsion (4.61 ± 0.4 ? mol/g wet tissue) and detorsion groups (5.24 ± 0.9 ? mol/g wet tissue) (p < 0.05). The mean testicular tissue injury score in the resveratrol group was significantly lower than in torsion and detorsion groups (p < 0.05). The present study demonstrates that intraperitoneal administration of resveratrol in rats may protect testis against injury associated with reperfusion.Öğe The use of silver nitrate for chemical de-epithelialization and urothelialization of intestine in a rabbit model of augmentation cystoplasty(Springer, 2003) Demirbilek, S; Uguralp, S; Gürbüz, N; Sezgin, N; Kirimlioglu, HUrinary tract reconstruction using bowel segments can result in complications such as electrolyte abnormalities, infections, stones and cancer. Intestinal mucosa is the primary site responsible for these complications. De-epithelialization of the mucosa and subsequent urothelialization might alleviate these problems. We recently reported our success in de-epithelialization and subsequent uroepithelialization of intestinal segments using 10 g/100 ml AgNO3 solution in a rat model of augmentation. In this study, chemical de-epithelialization of a colonic segment was attempted using 10 g/100 ml AgNO3 solution in a rabbit model of augmentation. Sigmoid cystoplasty was performed in 20 male New Zealand rabbits using a 6 cm patch of sigmoid colon. There were two groups, including one group of five rabbits (control, group 1) that underwent augmentation alone, while another group (15 rabbits, treatment group or group 2) was treated with 10g/100 ml AgNO3 solution before augmentation. Control rabbits were killed at the week 8 of experimentation. Treatment rabbits were killed at 2-, 4-, 6- and 8-week intervals. Immediately before augmentation and at the end of the 8 week experimental period each rabbit underwent cystometry. De-epithelialization of the bowel epithelium without urothelialization was apparent in the treatment rabbits killed at 2 and 4 weeks. Histological analysis revealed almost complete urothelialization of the augmented sections treated with 10 g/100 ml AgNO3 solution at the end of the 6 and 8 week of experimental periods. The preoperative and postoperative bladder capacities increased substantially in all groups. There was no obvious histologic difference in the amount of collagen present in the augmented tissues in any of the experimental groups. The present study confirmed that the treatment of intestinal segments with 10g/100 ml AgNO3 solution led to chemical de-epithelialization and urothelialization of the augmented segments. This procedure could, theoretically, have applications to human surgery.
