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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 Simple suture for perforated peptic ulcer followed by helicobacter pylori eradication in children(Pakistan Journal of Medical Sciences, 1969) Yıldız, Turan; İlçe, Huri Tilla; Özcan, Canan Ceran; İlçe, ZekeriyaObjective: Peptic ulcer disease in children is rare. Therefore, the diagnosis can be missed until complications such as perforation or hemorrhage occur. Few reports have investigated the procedures and outcomes of children who have undergone operations for perforated duodenal ulcers. We report our experience with the modified Graham technique for perforated duodenal ulcers in nine children and review the literature. Methods: The records of patients operated on for a perforated duodenal ulcer in the last 8 years in two pediatric surgery centers were evaluated retrospectively. Patient demographics, symptoms, time to admission to hospital, operative findings, and postoperative clinical course were evaluated. Results: Nine children (mean age 13.2 years, range 6–170 years) were included. All patients were admitted in the first six hours after their abdominal pain started. In three patients, there was free air on plain x-rays, while the x-rays were normal in six. All perforations were located on the anterior surface of the first part of the duodenum and repaired with primary suturing and Graham patch omentoplasty. The recovery was uneventful in all patients. In five patients, urea breath tests were performed postoperatively for Helicobacter Pylori, and the results were positive. All patients underwent triple therapy with lansoprazole, amoxicillin, and clarithromycin. The mean follow-up time was 58 (range 3–94) months. Conclusions: Peptic ulcer perforation should be suspected in children who have acute abdominal pain and peritoneal signs, especially when their suffering is intense. The simple patch repair and postoperative triple therapy for Helicobacter Pylori are safe and satisfactory for treating peptic ulcer perforation in children.Öğe Effect of bilirubin in ischemia reperfusion injury on rat small intestine(Journal of Pediatric Surgery, 2001) Özcan, Canan Ceran; Sönmez, Kaan; Türkyılmaz, zafer; Demiroğulları, Billur; Dursun, AyşePurpose: The aim of this study was to determine the effects of bilirubin in experimental small intestinal ischemia/reperfusion (I/R) injury in rats. Methods: Thirty rats were divided into 5 groups (n 5 6). In group S, saline and in group B, bilirubin, 20 mg/kg were infused via the jugular vein without an additional procedure. In groups S-IR, saline, B1-IR and B2-IR, 10 and 20 mg/kg/h of bilirubin were infused for 2 hours, respectively. In these groups, an I/R procedure was done after infusions by occluding the superior mesenteric artery for 45 minutes followed by 1 hour of reperfusion. After reperfusion, the small intestines were resected for histopathologic and malondialdehyde (MDA) assessments. Mucosal lesions were scored between 0 and 5. Malondialdehyde levels and histopathologic grades were analyzed statistically.Öğe Femoral hernia repair with mesh plug in children(Journal of Pediatric Surgery, 2002) Özcan, Canan Ceran; Köylüoğlu, Gökhan; Sönmez, KaanPurpose: Femoral hernias (FH) are rarely seen in children, so there is no consensus on the age and sex distribution or the optimum method of repair. Recently, repair of the femoral hernias with mesh-plug has gained wide popularity in adults. The authors used this method in 4 children with FH and discuss its utilization in children. Methods: Four consecutive children with femoral hernia were treated using mesh-plug. Patients’ characteristics and operative technique was described. Results: Plugging femoral defect with a mesh-plug was applied successfully in children. No complications were seen after a follow-up period for 2 years (range, 8 to 30 months). Conclusion: Repair of femoral hernias with mesh-plug is performed easily and successfully in children. J Pediatr Surg 37:1456-1458. Copyright 2002, Elsevier Science (USA). All rights reserved.Öğe The efficacy of ultrasonography in hemodynamically stable children with blunt abdominal trauma a prospective comparison with computed tomography(European Journal of Radiology, 2004) Taş, Fikret; Özcan, Canan Ceran; Atalar, Mehmet H.; Bulut, Sema; Selbeş, Bilge; Işık, A. OktayPurpose: In this prospective study we aimed to investigate the diagnostic value of ultrasonography (US) in hemodynamically stable children after blunt abdominal trauma (BAT) using computed tomography (CT) as the gold standard. Materials and methods: Between 1997 and 2001, 96 children with BAT were evaluated prospectively. CT was performed first, followed by US. US and CT examinations were independently evaluated by two radiologists for free fluid and organ injury. The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of US were assessed regarding CT as the gold standard. Results: Overall 128 organ injuries were determined in 96 patients with CT; however, 20 (15.6%) of them could not be seen with US. Free intraabdominal fluid (FIF) was seen in 82 of 96 patients by CT (85.4%) and eight of them (9.7%) could not be seen by US. We found that sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of the US for free intra-abdominal fluid were 90.2, 100, 100, 63.6 and 91.7%, respectively. Conclusions: US for BAT in children is highly accurate and specific. It is highly sensitive in detecting liver, spleen and kidney injuries whereas its sensitivity is moderate for the detection of gastrointestinal tract (GIT) and pancreatic injuries. © 2003 Published by Elsevier Ireland Ltd.Öğe Ceftriaxone associated biliary pseudolithiasis in paediatric surgical patients(International Journal of Antimicrobial Agents, 2005) Özcan, Canan Ceran; Öztoprak, İbrahim; Cankorkmaz, Levent; Gümüş, Cesur; Yıldız, Turan; Köylüoğlu, GökhanIt is well known that ceftriaxone leads to pseudolithiasis in some patients. Clinical and experimental studies also suggest that situations causing gallbladder dysfunction, such as fasting, may have a role for the development of pseudolithiasis. In this study, we prospectively evaluated the incidence and clinical importance of pseudolithiasis in paediatric surgical patients receiving ceftriaxone treatment, who often had to fast in the post-operative period. Fifty children who were given ceftriaxone were evaluated by serial abdominal sonograms. Of those, 13 (26%) developed biliary pathology. Comparison of the patients with or without pseudolithiasis revealed no significant difference with respect to age, sex, duration of the treatment and starvation variables. After cessation of the treatment, pseudolithiasis resolved spontaneously within a short period. The incidence of pseudolithiasis is not affected by fasting. © 2004 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.Öğe Early enteral feeding in newborn surgical patients(Nutrition 21 (2005) 142–146, 2005) Ekingen, Gülşen; Özcan, Canan Ceran; Güvenç, Haluk; Tuzlacı, Ayşe; Karaman, HayrunnisaObjective: We report the results of a multicenter prospective trial of early enteral trophic feeding in a group of 56 neonates who required abdominal surgery for a variety of congenital anomalies. Methods: In this clinical study, 33 neonates were fed in the early postoperative period (early enteral nutrition [EEN] group), and the remaining 23 (control [C] group) were fasted until resolution of postoperative ileus. Patients in the EEN group (Kocaeli feeding protocol) received 3 to 5 mL of breast milk every hour through a nasogastric feeding tube, starting a mean of 12 h (8 to 20 h) after surgery. The nasogastric tube was clamped for 40 min after each infusion and then opened for drainage. Groups were further divided into two subgroups according to whether an intestinal anastomosis or laparotomy was performed. The change in daily gastric drainage, time to first stool, day of toleration to full oral feeding, and length of hospital stay were compared. Blood bilirubin levels, white blood cell count, and C-reactive protein levels were monitored. Results: The time to first stool and day of toleration to full oral feeding occurred significantly sooner, whereas nasogastric tube drainage duration and hospital stay were significantly shorter in the EEN-anastomosis group than in the C-anastomosis group. Time to first stool occurred significantly sooner in the EEN-laparotomy group than in the C-laparotomy group, although other parameters did not differ. Neither anastomotic leakage nor dehiscence was observed in any group. There were two cases of wound infection and two of exitus among patients in the C group. Conclusion: Postoperative, early intragastric, small-volume breast milk feeding is well tolerated by newborns. It is a reliable and feasible approach in neonates even in the presence of an intestinal anastomosis after abdominal surgery. © 2005 Elsevier Inc. All rights reserved.Öğe Urethral polyps in children A review of the literature and report of two cases(International Journal of Urology, 2006) Demircan, Mehmet; Özcan, Canan Ceran; Karaman, Abdullah; Uğuralp, Sema; Mızrak, BülentAbstract A solitary polyp of the urethra is a rare benign fibroepithelial growth and has often been described in boys. Its occurrencein girls is exceptional. In the present paper, two children with solitary polyps of the urethra are presented and discussed. The firstcase was an 18-month-old boy with a posterior urethral polyp arising from the posterior urethra and extending to the bladder. Itwas excised by cystostomy because of an unsuccessful endoscopic removal attempt. The second case was a 2-year-old girl withan interlabial mass arising from the posterior wall of urethra and protruding from the external urethral meatus. It was excisedtransurethrally.Öğe Traumatic rupture of a pulmonary hydatid cyst a case report(Ulus Travma Acil Cerrahi Derg, 2006) Şahin, Ekber; Kaptaoğlu, Melih; Aydın, Nadir; Özcan, Canan CeranWe present a case of traumatic hydropneumothorax due to hydatid cyst rupture in a 10 year-old girl. The patient was suspected to have a bronchial rupture because of prolonged massive air leak and she underwent cystotomy via right posterolateral thoracotomy. The patient was readmitted with dyspnea and chest X-ray revealed a lung collapse 13 months postoperatively. Lung collapse was treated by using a Heimlich valve. Pulmonary hydatid cyst can be asymptomatic for a long time unless a complication occurs. Because of the high incidence of hydatid disease in our country, this condition should be considered in cases with hydropneumothorax. The use of a Heimlich valve may be a good choice in the management of persistent air leak and may reduce the need for surgery.Öğe Do antıbıotıcs contrıbute to postoperatıve ıleus contractıle responses of ıleum smooth muscle ın guınea pıgs to long term parenteral ceftrıaxone and ampıcıllın(ANZ Journal of Surgery, 2006) Özcan, Canan Ceran; Karadaş, Barış; Kaya, Tijen; Arpacık, Mehmet; Bağcıvan, İhsan; Saraç, BülentBackground: Antibiotics may impair small bowel smooth muscle contractility and contribute to postoperative ileus. The aim ofthis study was to compare the contractile responses of ileum smooth muscle to different agonists in guinea pigs treated withceftriaxone (Rocephin; F. Hoffman–La Roche, Kaiseraugst, Switzerland) or ampicillin (Ampisina; Mustafa Nevzat_Ilacx SanayiiASx, Istanbul, Turkey).Methods: Twenty-four adult guinea pigs were randomly divided into three groups. Whereas eight of these received ceftriaxonesodium (100 mg/kg per day, i.m.) for 10 days, another eight guinea pigs received ampicillin (50 mg/kg per day, i.m.) for 10 days andthe remaining eight served as the control group receiving 1 mL distilled water during 10 days as placebo. By the end of 10 days, theanimals were killed and their ilea were excised. Ileum segments were placed in an organ bath; concentration–response relationship forcarbachol and histamine were obtained by adding the reagent cumulatively to the bath.Results: pD2values being the same, maximum contractile responses (Emax) to carbachol and histamine were significantly reducedin the ceftriaxone sodium group compared with the control group. No significant differences in Emaxand pD2values to carbachol andhistamine were observed between the ampicillin group and the control group.Conclusion: These data indicate that whereas ceftriaxone may impair small bowel smooth muscle contractility, ampicillin does not.There are implications for the long-term use of parenteral antibiotics in the postoperative period.Öğe Tracheal agenesis and esophageal atresia with proximal and distal bronchoesophageal fistulas(Journal of Pediatric Surgery, 2008) Demircan, Mehmet; Aksoy, Tuğrul; Özcan, Canan Ceran; Kafkaslı, AyşeAbstract Tracheal agenesis (TA) is an extremely rare, typically fatal congenital tracheal malformation. Lack of prenatal symptoms and emergent presentation usually lead to a failure to arrive at the correct diagnosis and manage the airway properly before the onset of irreversible cerebral anoxia. Esophageal atresia (EA) encompasses a group of congenital anomalies comprising an interruption of the continuity of the esophagus with or without a persistent communication with the trachea. In 86% of cases, there is a distal tracheoesophageal fistula (TEF); in 7%, there is no fistulous connection, whereas in 4%, there is a TEF without atresia. We report the case of an infant born with TA and EA with proximal and distal bronchoesophageal fistulas. During 3 consecutive antenatal ultrasound examinations, there had been polyhydramniosis, difficulty visualizing the stomach, and dilatation of proximal esophagus, leading to a presumptive diagnosis of EA. The clinical presentation, embryology, classification, and surgical management are discussed.Öğe Commonly used intravenous anesthetics decrease bladder contractility An in vitro study of the effects of propofol ketamine and midazolam on the rat bladder(Indian Journal of Urology, 2010) Özcan, Canan Ceran; Pampal, Arzu; Özgür, Göktaş; Pampal, Hasan Kutluk; Ölmez, ErcümentAim : This study was designed to test the hypothesis that propofol, ketamine, and midazolam could alter the contractile activity of detrusor smooth muscle. Materials and Methods : Four detrusor muscle strips isolated from each rat bladder (n = 12) were placed in 4 tissue baths containing Krebs-Henseleit solution. The carbachol (10 -8 to 10 -4 mol/L)-induced contractile responses as well as 5, 10, 20, 30, 40, 50 Hz electrical field stimulation (EFS)-evoked contractile responses of the detrusor muscles were recorded using isometric contraction measurements. After obtaining basal responses, the in vitro effects of propofol, ketamine, midazolam (10−5 to 10−3 mol/L), and saline on the contractile responses of the detrusor muscle strips were recorded and evaluated. Results : All the 3 drugs reduced the carbachol-induced and/or EFS-evoked contractile responses of rat detrusor smooth muscles in different degrees. Midazolam (10−4 to 10−3 mol/L) caused a significant decrease in the contractile responses elicited by either EFS or carbachol (P=0.000-0.013). Propofol (10−3 mol/L) caused a decrease only in EFS-evoked contractile responses (P=0.001-0.004) and ketamine (10−3 mol/L) caused a decrease only in carbachol-induced contractile responses (P=0.001-0.034). Conclusion : We evaluated the effects of the 3 different intravenous anesthetics on detrusor contractile responses in vitro and found that there are possible interactions between anesthetic agents and detrusor contractile activity. The depressant effects of midazolam on the contractile activity were found to be more significant than ketamine and propofol. Despite the necessity of further studies, it could be a piece of wise advice to clinicians to keep the probable alterations due to intravenous anesthetics in mind, while evaluating the results of urodynamic studies in children under sedation.Öğe Small bowel perforation afterdrawing a blood sample in the femoral artery a case report(Ulus Travma AcilCerrahi Dergisi, 2010) Ara, Cengiz; Çoban, Sacid; Işık, Burak; Özcan, Canan Ceran; Yılmaz, SezaiSmall bowel perforation is a rare complication of femoral artery access in cases of femoral hernia. A 48-yearold woman was admitted to the intensive care unit due to pulmonary insufficiency. After a routine femoral arterial blood gas analysis, severe abdominal pain and nausea began. She underwent emergency laparotomy due to acute abdomen. Laparotomy revealed small bowel perforation. Segmental resection and end-to-end anastomosis were performed. The femoral canal was closed using plaque mesh. Special attention is needed during femoral artery access to avoid accidental small bowel perforation. As seen in this case, a careful examination should be done in cases of femoral hernia.Öğe Self ınflicted urethrovesical foreign bodies in children(Case Reports in Urology, 2012) Uğuralp, Sema; Özcan, Canan CeranWe present two cases of self-inflicted urethrovesical foreign body in children. Case 1 was a 6-year-old girl admitted with a history of self-introduction of a pin. The X-ray revealed the pin as 3.5 cm in length and in the bladder. The foreign body was removed endoscopically. Case 2 was a 13-year-old boy with a self-introduced packing needle, 13 cmin length, partially in the urethra. The end and the tip of the needle passed through the urethra to the surrounding tissues. Foreign body removed via a little skin incision with endoscopic guidance. Foreign bodies are rarely found in the lower urinary tract of children. Definitive treatment is usually the endoscopic removal; however, sometimes surgical intervention may require.Öğe Congenital distal esophageal obstruction caused by intraluminal mucosalweb(Turk J Pediatr., 2012) Uğuralp, Sema; Özcan, Canan Ceran; Demircan, MehmetHere, we report a case with intraluminal membrane (web) located in the lower esophagus causing complete obstruction. Esophagogram revealed complete obstruction near the esophagogastric junction. Surgical excision of the esophageal membrane was performed. To our knowledge, only a few cases with membranous esophageal atresia have been reported. It must be remembered in neonates who cannot tolerate feeding.Öğe The effects of ghrelin on colonic anastomosis healing in rats(Clinics, 2013) Özcan, Canan Ceran; Aksoy, Rauf Tuğrul; Gülbahar, Özlem; Öztürk, FigenOBJECTIVES: In addition to its roles in the stimulation of growth hormone secretion and the regulation of appetite and metabolism, ghrelin exerts immunomodulatory, anti-inflammatory and antioxidant actions in several organ systems. In this study, we investigated the effects of ghrelin on the healing of experimental colonic anastomoses. METHODS: Wistar rats were randomly divided into two groups (n = 10 in each). A segment of colon was excised, and an end-to-end anastomosis was performed in the distal colon. The Ghrelin Group received 10 ng/kg/day IP ghrelin for seven days postoperatively, whereas the Control Group received an identical volume of saline. On the seventh postoperative day, the anastomotic bursting pressures and hydroxyproline levels were measured, and adhesion formation around the anastomoses was examined. Histopathological analyses were performed to evaluate inflammatory cell infiltration, fibroblast infiltration, collagen density and neovascularization. RESULTS: In the Ghrelin Group, the bursting pressure and hydroxyproline levels were significantly higher than in the Control Group. The adhesion formation scores were lower in the Ghrelin Group than in the Control Group. Although the inflammatory cell infiltration was diminished in the Ghrelin Group, the degrees of fibroblast infiltration, collagen density and neovascularization were not significantly different between the groups. CONCLUSION: Our results indicate that ghrelin improves the healing of colonic anastomoses in rats.Öğe Pericardial flap aortopexy an easy and safe technique in the treatment of tracheomalacia(J Cardiovasc Surg (Torino). 2002 Apr;43(2):295-7., 2016) Köylüoğlu, Gökhan; Günay, İlhan; Özcan, Canan Ceran; Berkan, ÖcalA 5-month-old boy who had been operated for esophageal atresia and tracheoesophageal fistula was presented with recurrent life-threatening apneic spells, expiratory stridor and difficulty in feeding. Diagnosis of tracheomalacia was confirmed by bronchoscopy and pericardial flap aortopexy was performed. Pericardial flap aortopexy is a relatively simple procedure with minimal risk to the aorta. Minimal dissection is required and there are no sutures placed in the aortic wall, thus avoiding the risk of tears.Öğe Simple suture for perforated peptic ulcer followed by helicobacter pylori eradication in children(Pakistan Journal of Medical Sciences, 2014) Yıldız, Turan; Tilla İlçe, Huri; Ceran Özcan, Canan; İlçe, ZekeriyaObjective: Peptic ulcer disease in children is rare. Therefore, the diagnosis can be missed until complications such as perforation or hemorrhage occur. Few reports have investigated the procedures and outcomes of children who have undergone operations for perforated duodenal ulcers. We report our experience with the modified Graham technique for perforated duodenal ulcers in nine children and review the literature. Methods: The records of patients operated on for a perforated duodenal ulcer in the last 8 years in two pediatric surgery centers were evaluated retrospectively. Patient demographics, symptoms, time to admission to hospital, operative findings, and postoperative clinical course were evaluated. Results: Nine children (mean age 13.2 years, range 6–170 years) were included. All patients were admitted in the first six hours after their abdominal pain started. In three patients, there was free air on plain x-rays, while the x-rays were normal in six. All perforations were located on the anterior surface of the first part of the duodenum and repaired with primary suturing and Graham patch omentoplasty. The recovery was uneventful in all patients. In five patients, urea breath tests were performed postoperatively for Helicobacter Pylori, and the results were positive. All patients underwent triple therapy with lansoprazole, amoxicillin, and clarithromycin. The mean follow-up time was 58 (range 3–94) months. Conclusions: Peptic ulcer perforation should be suspected in children who have acute abdominal pain and peritoneal signs, especially when their suffering is intense. The simple patch repair and postoperative triple therapy for Helicobacter Pylori are safe and satisfactory for treating peptic ulcer perforation in children.Öğe Effect of bilirubin in ischemia reperfusion injury on rat small intestine(Journal of Pediatric Surgery, 2001) Ceran Özcan, Canan; Sönmez, Kaan; Türkyılmaz, Zafer; Demiroğulları, Billur; Dursun, Ayşe; Düzgün, Ersel; Başaklar, Abdullah Can; Kale, NuriPurpose: The aim of this study was to determine the effects of bilirubin in experimental small intestinal ischemia/reperfusion (I/R) injury in rats. Methods: Thirty rats were divided into 5 groups (n 5 6). In group S, saline and in group B, bilirubin, 20 mg/kg were infused via the jugular vein without an additional procedure. In groups S-IR, saline, B1-IR and B2-IR, 10 and 20 mg/kg/h of bilirubin were infused for 2 hours, respectively. In these groups, an I/R procedure was done after infusions by occluding the superior mesenteric artery for 45 minutes followed by 1 hour of reperfusion. After reperfusion, the small intestines were resected for histopathologic and malondialdehyde (MDA) assessments. Mucosal lesions were scored between 0 and 5. Malondialdehyde levels and histopathologic grades were analyzed statistically. Results: Mucosal injury was severe in S-IR (grade 4 to 5), mild in B1-IR (grade 0 to 3) and none in B2-IR group (grade 0). Grades of group S-IR were higher than those of B1-IR and B2-IR statistically (P ,.05). Tissue MDA levels of the S-IR group were significantly higher than those of B1-IR and B2-IR groups (U 5 36, P , .05). Bilirubin levels correlated inversely with MDA levels (r 5 20.94). Conclusions: Bilirubin effectively prevents intestinal I/R injury in rat. This observation is consistent with the hypotheses regarding bilirubin as an antioxidant, having a role in the body defense.Öğe Femoral hernia repair with mesh plug in children(Journal of Pediatric Surgery, 2002) Ceran Özcan, Canan; Köylüoğlu, Gökhan; Sönmez, KaanPurpose: Femoral hernias (FH) are rarely seen in children, so there is no consensus on the age and sex distribution or the optimum method of repair. Recently, repair of the femoral hernias with mesh-plug has gained wide popularity in adults. The authors used this method in 4 children with FH and discuss its utilization in children. Methods: Four consecutive children with femoral hernia were treated using mesh-plug. Patients’ characteristics and operative technique was described. Results: Plugging femoral defect with a mesh-plug was applied successfully in children. No complications were seen after a follow-up period for 2 years (range, 8 to 30 months). Conclusion: Repair of femoral hernias with mesh-plug is performed easily and successfully in children. J Pediatr Surg 37:1456-1458. Copyright 2002, Elsevier Science (USA). All rights reserved.
