Browsing by Author "Genç, A"
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Item Three-dimensional evaluation of pelvic posture in adolescents with and without a history of low back painÖzyürek, S; Genç, A; Kul Karaali, H; Algun, ZCBackground/aim: This study aimed to evaluate the three-dimensional (3D) profile of pelvic posture and postural displacements of the pelvis in adolescents with and without a history of low back pain (LBP). Materials and methods: Thirty-two adolescents participated in this study. Participants were asked if they had ever suffered LBP at some point in their lives. Participants were divided into two groups: with a history of LBP (LBP group) and without a history of LBP (control group). For 3D evaluation of pelvic posture, the PosturePrint system was used. Three digital photographs were obtained in an upright stance (anteroposterior, left-right lateral) and analyzed. Postural displacements of the pelvis were calculated as rotations in degrees and translations in millimeters. The posture index, which is the total postural displacements score, was recorded. Results: Overall, 40.6% of the participants reported a history of LBP, while 59.4% of the participants did not. Although the 3D profile of pelvic posture, postural displacements of pelvis, and posture index score were similar between groups, the majority of participants in both groups had altered pelvic and total body posture. Conclusion: The findings suggest that adolescents with LBP have a profile of pelvic posture similar to those of healthy adolescents without a history of LBP.Item Polytetrafluoroethylene bars in stabilizing the reconstructed sternum for pectus excavatum operations in childrenGenç, A; Mutaf, ONine children with severe pectus excavatum deformity were operated on in the Department of Pediatric Surgery, Thoracic Unit, Ege University Faculty of Medicine, Izmir, Turkey. There were four boys and five girls, and the mean age at operation was 6.3 years. A modified Ravitch technique was performed by using two polytetrafluoroethylene bars placed retrosternally for fixation and stabilization of the reconstituted anterior chest wall. The bars were removed 6 months after the operation. Results were satisfactory in all cases, with no surgical complications.Item CAN URINARY BIOMARKERS SUCCEED DIAGNOSTIC VALUE OF RENAL SCINTIGRAPHY IN PATIENTS WITH URETEROPELVIC JUNCTION DISRUPTION?Gürer, DE; Yilmaz, Ö; Ertan, P; Eser, E; Taneli, F; Aras, F; Oran, A; Genç, A; Günsar, C; Sencan, A; Gürer, E; Taneli, CItem Esophageal motility changes in acute and late periods of caustic esophageal burns and their relation to prognosis in childrenGenç, A; Mutaf, OBackground/Purpose: Esophageal burns as a result of accidental swallowing of caustic material are seen frequently in children. Severe motor function disorders of the esophagus after caustic burns are already reported covering the late periods. The aim of this study was to detect, follow, and report the clinical results of esophageal motility changes in acute as well as the late periods of caustic esophageal insult and its relation with prognosis in children. Methods: Esophageal motility was studied in 20 children aged 1.5 to 11 years (mean, 3.8). In the study group, motility of the esophagus was investigated on the fifth day of the burn (after decrease of the edema) and repeated at the end of the third month. To standardize the results, the amplitude and the duration of the pressure waves were recorded at 3 cm above the lower esophageal sphincter (LES), and the velocity in the distal esophagus was calculated. Then the mean values of amplitude, duration, and velocity of 15 swallows were obtained for each patient. Results: At the end of the fifth day, peristaltic response of the esophagus to swallowing was followed in 13 patients. Seven patients were able to swallow water, but no peristaltic response was detected. Therefore, the subjects were divided into 2 groups as motility (+) and motility (-), and each were compared with the control group separately. The amplitude of the pressure wave in the motility (-) group was significantly low when compared with the control group. All the subjects in this group had NaOH burns, and development of severe strictures was detected at the endoscopic examinations after 3 weeks. In motility (+) group, no pathologies were detected except significant decrease in the velocity of the peristaltic wave. Eleven of the subjects in this group had acid burns, and 2 had NaOH burns, and, at the follow-up endoscopic examination after 3 weeks, only one acid burn patient had a slight stricture. Motility measurements conducted at the end of the third month showed that the initial motility (-) group had no changes. No peristaltic response was detected after swallowing, and amplitude of the pressure wave measured at the distal esophagus was significantly lower than the controls. However, in the motility (+) group, decrease in the velocity of the peristaltic wave had disappeared, and there were no differences when compared with the control group. Conclusion: It is suggested that the manometric studies of the esophagus give important data about the severity of the initial esophageal injury and have an important role in determining the prognosis. Copyright 2002, Elsevier Science (USA). All rights reserved.Item The frequency and associated factors of low back pain among a younger population in TurkeyÇakmak, A; Yücel, B; Özyalçin, SN; Bayraktar, B; Ural, HI; Duruöz, MT; Genç, AStudy Design. Open design cross-sectional questionnaire. Objectives. The aims of this study are to determine the frequency of low back pains in the younger population and the factors that have an influence on this frequency. Summary of Background Data. Low back pain is one of the most important social problems that causes injuries in the younger population. Low back pain frequency is around 30% among adolescents, and 88% of those with low back pain experiences in adolescence have low back pain in later years. Therefore, identifying and, if possible, preventing the associated factors in adolescence and young adulthood is essential for the solution of this social problem. Methods. A total of 1,552 students from a total of 8,000 who had come from all parts of Turkey for university registration accepted to participate in the study and were given a questionnaire about low back pain experiences, disability, and possible associated factors. Results. Low back pain frequency was found to be 40.9%. This rate increases with age. Abandonment of moderate level physical activity and traumas such as slipping on ice and falling down the stairs were identified as associated factors. Conclusions. Regular physical activity and the prevention of falls might be ways for decreasing the frequency of low back pain experiences among the youth and significantly influencing the frequency of low back pain in adult population.Item Recyclability of CsPbBr3 quantum dot glass nanocomposites for their long-standing use in white LEDsVahedigharehchopogh, N; Erol, E; Kibrisli, O; Genç, A; Ersundu, MÇ; Ersundu, AEThe embedding of CsPbBr3 perovskite quantum dots (PQDs) in an inorganic glass matrix not only protects them against chemical, thermal, and photodegradation but also provides an effective strategy to isolate toxic elements such as Pb from the environment for a long period of time. Herein, the recyclability of glass is another important feature that contributes to environmental sustainability. Hence, effective and efficient recycling technologies are needed for the widespread use of PQD glass nanocomposites (GNCs) in many commercial applications. However, studies on the recyclability of CsPbBr3 PQD GNCs have not been conducted so far. Therefore, in this work, we investigate the structural, thermal, optical, and photoluminescence properties of recycled CsPbBr3 PQD GNCs to assess their suitability as long-standing and reusable luminescent materials. For this purpose, the recyclability of GNCs is checked by three repeated melt-quenching and subsequent heat-treatment processes. Although the color emission properties of GNCs under the same heat-treatment conditions show a slight variation after each recycling step, PQD GNCs almost retain their PLQY even after the last recycling step. Ultimately, a prototype white light-emitting diode is constructed by coupling recycled PQD GNCs and a commercial red phosphor on top of a blue LED chip showing high-performance with CIE color coordinates of x = 0.3228, y = 0.3470 and a CCT value of 5920 K. The findings of this work reveal that the recyclability of PQD GNCs holds great promise for a more sustainable technology.Item Turkish adaptation of Parkinson fatigue scale and investigating its psychometric propertiesÇilga, G; Genç, A; Çolakoglu, BD; Kahraman, TParkinson's disease (PD) is one of the most common chronic degenerative diseases of the nervous system. In PD, nonmotor symptoms are seen as frequently as motor symptoms. Fatigue can occur in all stages of PD and leads to significant disabilities. The aim of this study was to investigate the psychometric properties of the Turkish version of Parkinson fatigue scale (PFS). Ninety-six patients with idiopathic PD were included in this study with a cross-sectional and test-retest design. Structural validity, internal consistency and test-retest reliability of PFS were analyzed. For convergent validity, fatigue severity scale and modified fatigue impact scale were used. Internal consistency was determined by the Cronbach's alpha coefficient. For test-retest reliability, PFS was repeated after a 7-14-day period. Significant strong correlations were found between the PFS and the fatigue severity scale (r(s)=0.844) and the modified fatigue impact scale (r(s)=0.764), which indicate a high convergent validity. The Cronbach's alpha coefficient, which indicates the internal consistency of the scale, was calculated as 0.947. The test-retest reliability was found to be high (intraclass correlation coefficient=0.928). This study suggests that the Turkish version of PFS is valid and reliable. PFS is suitable for use by researchers and healthcare professionals to assess fatigue in Turkish-speaking patients with PD.Item Effect of alarm treatment on bladder storage capacities in monosymptomatic nocturnal enuresisTaneli, C; Ertan, P; Taneli, F; Genç, A; Günsar, C; Sencan, A; Mir, E; Onag, AObjective: Despite a great number of studies, very little is known about the mechanism of action of enuresis alarm systems. Nevertheless, as a result of this treatment many children are able firstly to wake up before urination occurs and then, in time, to sleep through the night without voiding. The aim of this study was to investigate the effect of enuresis alarms on bladder storage capacities. Material and Methods: A total of 28 children aged >7 years who were not polyuric but who voided once every night, slept alone in their own bedroom and who were willing, along with their family members, to cooperate were recruited. Patients were asked to record their urine output using a frequency/volume chart for two consecutive days. After these records and the results of physical and laboratory examinations were taken into consideration, treatment was instituted with the bell-and-pad ( alarm) system for a period of 12 weeks. At the end of this period, patients were asked to complete another frequency/volume chart. Results: The pre- and post-treatment maximum functional bladder capacity was 178.35 +/- 87.86 ml and 243.03 +/- 102.84 ml, respectively and the pre- and post-treatment mean day-time bladder capacity was 111.11 +/- 45.87 and 148.445 +/- 7.68 ml. Both of these differences were statistically significant (p < 0.0001 and < 0.0001, respectively). The maximum nocturnal bladder capacity was found to be increased from 177.85 +/- 84.95 to 255.25 +/- 124.52 ml after treatment (p < 0.0001). Conclusion: Treatment with the alarm system for a period of 12 weeks was seen to be associated with a significant increase in bladder storage capacities ( maximum nocturnal bladder capacity, maximum functional bladder capacity and mean day-time bladder capacity).Item Early postoperative small bowel obstruction is a different clinical entity than postoperative adynamic ileusSencan, A; Sencan, A; Taneli, C; Günsar, C; Genç, A; Ayhan, S; Mir, EEarly postoperative small bowel obstruction is a rare clinical entity different from postoperative adynamic ileus. The cases were presented to emphasize the differences between early postoperative small bowel obstruction and postoperative adynamic ileus. In this study, a 14-year-old patient who developed early postoperative (post op. 2. Day) small bowel obstruction after appendectomy was presented. Re-laparotomy was performed on the 7th postoperative day. It was observed that early postoperative small bowel obstruction was due to adhesions which caused significant intestinal loss. Ileostomy was performed and the patient was discharged from hospital uneventfully on the 25th postoperative day after stoma closure. Since symptoms, and signs of early postoperative small bowel obstruction can be confused with those of postoperative adynamic ileus, long term conservative follow-up may result in significant intestinal loss. For this reason, it is important not to delay the re-laparotomy decisionItem Urethral meatal dilatation using topical EMLA cream for anaesthesiaGenç, A; Tekin, I; Arslan, OA; Taneli, C; Mir, EItem Evaluation of the location of the anus by a modified technique in the neonateGenç, A; Taneli, C; Tansug, N; Kasirga, E; Yilmaz, D; Küçükoglu, T; Onag, APurpose: The aim of the current study was to bring to notice the anterior displacement of the anus and to recommend the measurement of anal position index in the neonate by a modified method. Methods: Sixty newborns (34 girls and 26 boys) were taken into study, and the anal position index (API), which is the ratio of anus-fourchette (scrotum) distance to coccyx fourchette (scrotum) distance, was measured. To obtain the measurement, a transparent adhesive tape was placed along the midline on the long axis, covering the anus. The upper and lower tips and the center of the anal circle was marked and measured using a caliber. Results: API was found as 0.46 (SD +/- 0.08) and 0.53 (SD +/- 0.05) in female and male neonates, respectively. Because an index of 0.34 in girls and 0.46 in boys are considered abnormal, the 3 female babies in the study group with API indices of 0.18, 0.28, and 0.33 were subjected to further examination. The abnormality was seen not to be rare in the Aegean region. Conclusions: An abnormal index alone cannot be the sole cause of constipation mentioned in the literature and therefore not an indication for operation, Anal position index in the neonates could be measured more accurately by the current modified method. If an anterior location of the anus is found early in infancy the baby should undergo follow-up accordingly. J Pediatr Surg 37:80-82. Copyright, (C) 2002 by W B. Saunders Company.Item The effect of spermatic vessel ligation on testicular nitric oxide levels and germ cell-specific apoptosis in rat testisTaneli, F; Vatansever, S; Ulman, C; Yilmaz, Ö; Giray, G; Genç, A; Taneli, CManagement of high testis may vary but the most popular method in surgical treatment is the Fowler-Stephens maneuver. The aim of the present study was to investigate the effects of spermatic vessel ligation on testicular nitric oxide (NO) levels, expression of inducible nitric oxide synthase (iNOS), and endothelial nitric oxide synthase (eNOS) and germ cell-specific apoptosis in both ipsilateral. and contralateral. testes in rats. Twenty-eight animals were randomly allocated into four groups (n = 7 each). The spermatic vessels were ligated as a simulation of the Fowler-Stephens maneuver. The groups of animals were sacrificed at 2 h (group 1), 4 In (group 2) and 24h (group 3) after ligation, respectively. Sham-operated animals served as controls (group 4). Biochemical. assessment of testicular NO levels was performed by the Griess method. iNOS and eNOS expression and apoptosis were studied in ipsilateral. and contralateral, testes. Testicular NO levels at 24h after the simulated Fowler-Stephens maneuver were found to be significantly increased in both ipsilateral. and contralateral testes when compared with the sham-operated group. eNOS expression was clearly increased in ipsilateral testes, whereas. moderate expression was detected in the contralateral seminiferous tubules at 24 h after ligation. Mild focal iNOS immunostaining was also observed in seminiferous tubules of the ipsilateral. testis at 24 h after the simulated Fowler-Stephens maneuver. Apoptosis was dramatically increased in ipsilateral. testes; however, it was only detected in single cells in the contralateral. side at 24 h after ligation. In conclusion, the simulated Fowler-Stephens maneuver induces testicular nitric oxide synthesis and germ cell-specific apoptosis in the ipsilateral testis. These results suggest that high levels of NO induce apoptosis and may impair spermatogenesis thus explaining the unsuccessful outcome of the Fowler-Stephens maneuver. (c) 2004 Elsevier GmbH. All rights reserved.Item Modification of meatal advancement and glanuloplasty for correction of distal hypospadiasTaneli, C; Genç, A; Günsar, C; Sencan, A; Arslan, OA; Daglar, Z; Mir, EObjective: The meatal advancement and glanuloplasty (MAGPI) technique is still successfully used for the repair of distal hypospadias. The technique has been modified considerably since it was first described in 1981. The primary drawbacks of the procedure are the complications of meatal regression and meatal stenosis. The aim of this study was to present a modification of MAGPI for correction of distal hypospadias. Material and Methods: Ten cases with distal hypospadias were operated on using our modified MAGPI procedure. The modification involves excision of a pull-out, tag-shaped piece of glanular tissue through the vertical incision in the meatoplasty section of the original operation. By means of this excision, burying of the meatus into the glans was eased without inducing extra mobilization of the glans wings. As less glans tissue was left at the dorsal urethra the urethral meatus could be replaced in the center of the glans and better anatomic reconstruction could be attained. Results: After 1-3 years of follow-up, all the operated cases showed functionally and cosmetically satisfactory results. The cosmetic appearance achieved with our modified technique was better than that obtained with the classical MAGPI procedure. Conclusions: Using our MAGPI modification, the urethra was localized deeper in the glans and an elliptical (slit-like), wide meatus was obtained. the cosmetic appearance of which was more acceptable than that achieved with classical MAGPI.Item Histopathological evaluation of the urethra after the Snodgrass operationGenç, A; Taneli, C; Günsar, C; Türkdogan, P; Yilmaz, Ö; Arslan, OA; Mir, EObjective To investigate the histopathological outcome of the incised urethral plate after tubularized incised-plate urethroplasty (the Snodgrass procedure to repair hypospadias) in a hypospadiac rabbit model, as it can produce meatal and neourethral strictures, and healing with scarring. Materials and methods The study comprised 10 male New Zealand White rabbits (2.2-2.4 kg); under general anaesthesia the ventral urethra was completely excised I cm from the meatus proximally and a model of hypospadias formed. A full-thickness incision was then made in the distal dorsal urethra and the two sides of the incision marked by Indian ink tattooing. After placing a feeding tube (5 F) as a urethral catheter, both urethral wings were sutured ventrally by a 7/0 polydioxanone running suture, and the penile skin approximated by 5/0 chromic catgut. At 21 days and 3 months after surgery the penises were harvested, assessed histopathologically. and compared with those from control untreated rabbits of the same age and weight. Results In the study group the incised area of the dorsal urethra was re-epithelialized; the regional tissue and vascularity were normal. Conclusion In this rabbit model the dorsal urethral incisions healed with no scar tissue; only the ventral suture lines had minimal fibrosis and inflammatory reaction.Item The effect of circumcision status on periurethral and glanular bacterial floraGünsar, C; Kurutepe, S; Alparslan, O; Yulmaz, Ö; Daglar, Z; Sencan, A; Genç, A; Taneli, C; Mir, EIntroduction: Circumcision is a historical operation which is still performed for different purposes. The aim of this study is to investigate the changes in periurethral and glanular sulcus flora due to circumcision to determine the role of circumcision on urinary tract infections (UTIs). Patients and Methods: Fifty patients who were circumcised for social-religious reasons between January 2000 and January 2001 were evaluated in this prospective study. Two swabs were taken from the periurethral and glanular sulcus regions both just before circumcision and 4 weeks after, and the bacteria cultured were recorded. Results: We isolated pathogenic bacteria in the periurethral region of 32 (64%) patients (enterococci in 14 cases; Escherichia coli in 12 cases) before circumcision, and this number decreased to 5 (10%) after circumcision. Similarly, pathogenic bacteria were cultured from the glanular sulcus swabs of 33 (68%) patients (enterococci in 14 cases; E. coli in 10 cases), as well as coagulase-negative staphylococci in another 15 patients before circumcision. Following circumcision, we detected pathogenic bacteria in the glanular cultures of only 4 cases, whereas 40 children had non-pathogenic skin flora. Only 1 of 5 children with history of UTIs (n = 1) and retractable phimosis (n = 4) had periurethral pathogenic bacteria (Proteus spp.) in the post-circumcision period. The differences between pre- and post-circumcision values of the pathogenic bacterial colonizations were statistically significant in both groups sampled (p < 0.05). Conclusion: Non-circumcised patients have similar pathogenic bacterial colonizations in the periurethral and the inner preputial regions, although they have no phimosis. The origin of periurethral flora should be the deeper preputial regions. The flora greatly changed with skin commensals after circumcision. Circumcision might be beneficial from this point of view. Copyright (C) 2004 S. Karger AG, Basel.Item Early renal parenchymal histological changes in an experimental model of vesico-ureteral reflux and the role of apoptosisSencan, A; Vatansever, S; Yilmaz, Ö; Genç, A; Serter, S; Gümüser, G; Kurutepe, S; Pekindil, G; Günsar, C; Mir, EObjectives. To observe early renal parenchymal cellular changes in an experimental model of vesico-ureteral reflux (VUR) and to show whether the apoptotic pathway plays a role in these cellular changes. Material and methods. Fourteen New Zealand breed rabbits were used and were divided into two equal groups (control and experimental groups). Urine samples were obtained in a sterile manner and cultured. In the study group, reflux was created in the right kidneys surgically. Renal scintigraphy and voiding cystourethrography (VCUG) were performed in both groups on Day 17. The kidneys were examined in terms of histology, apoptotic activity and caspase activity. Results. No growth was observed in urine cultures in either group. VUR was manifested in only two rabbits in the experimental group on VCUG. On renal scintigraphy, no renal scarring was observed in either of the groups and renal uptake values were in the normal range. There was a greater increase in collagen in the right kidneys in the experimental group than in the control group and apoptotic activity was significantly increased in the study group: 0% in the control group, 10.8%0.7% in the experimental group (p0.001). Caspase-6 activity was strongly positive and caspase-8 and -9 activities were moderately positive in the right kidneys of the experimental group. Caspase-6 activity was moderately positive, and caspase-8 and -9 activities were weakly positive in the contralateral kidneys of the experimental group. Caspase activities in the control group were negative (p0.001). Conclusions. In this experimental model of VUR, apoptotic activity was initiated via the caspase-8 and -9 pathway and collagen tissue increased in the renal parenchyma where reflux occurred. The balance of apoptotic activity may play a key role in the occurrence of reflux nephropathy.Item The importance of clinical approach in aggravated sexual abuse: Case reportKarabag, G; Tanriverdi, HI; Yavuz, MS; Genç, A; Akin, U; Saraç, SThe reported rate of sex crimes, some of the most severe acts of violence that can be perpetrated against an individual, is increasing across all societies, regardless of gender or age of the victim. Sexual abuse has been defined, in part, as the involvement of a child in sexual activity for which they are incapable of giving consent, that they cannot fully comprehend, or for which they are developmentally immature. Molestation of the anorectal region is frequently encountered when the victim of sexual abuse is a male child.Tenderness around the anus, ecchymosis, and detachment in the anal sphincter and rectum mucosa may be observed in the acute examination of children who have been subjected to aggravated sexual abuse; however, injuries related to the anus or the rectum may also occur as a result of an accident. An 11-year-old male patient was referred from another health center with a report of being at risk of death. The injury that was said to be the result of accidentally sitting on a knife.An examination in the lithotomy position revealed perianal ecchymosis, a superficial laceration at 1 and 6 o'clock, and a deep laceration at 7 o'clock. Based upon a suspicion of sexual abuse, anal and rectal swab specimens were obtained.The pediatric surgery department performed a primary repair of the lacerations.The microscopic examination of the swab specimens revealed cells showing sperm morphology, and therefore the appropriate forensic statements were made and the swab specimens were sent to the judicial authority for genetic analysis. This report emphasizes the importance of the awareness of physicians regarding the prompt collection and submission of potentially evidential biological samples in a case of suspected sexual abuse though it may be presented as an accident.Item The effect of obesity on testicular function by insulin-like factor 3, inhibin B, and leptin concentrations in obese adolescents according to pubertal stagesTaneli, F; Ersoy, B; Özhan, B; Çalkan, M; Yilmaz, Ö; Dinç, G; Genç, A; Taneli, CObjectives: The aim of the present study is to investigate the effect of obesity on testicular function by evaluating reproductive hormones, inhibinB, insulin-like 3(INSL3), and leptin, in obese and non-obese adolescents according to pubertal Tanner stages. Design and methods: Eighty adolescent boys were grouped (n = 20) as; Group1 : obese-Tanner2, Group2: non-obese-Tanner2, Group3: obese-Tanner4, Group4: non-obese-Tanner4. Serum INSL3, luteinizing hormone, follicle-stimulating hormone, total testosterone, free testosterone, estradiol, sex hormone binding globulin, inhibin B and leptin levels were assessed in all groups. Results: INSL3 levels were significantly lower in obese adolescents compared to non-obese boys (p = 0.003, Tanner2) and (p = 0.031, Tanner4). There was a negative correlation between INSL3 and leptin (r = -0.468, p = 0.001). The negative correlation between INSL3 and BMISDS indicates that pubertal obesity leads to Leydig cell impairment. Conclusions: This study demonstrated for the first time in the literature that obesity effects testicular Leydig cell function starting from Tanner stage 2. (C) 2010 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.Item Primary closure of superior partial sternal cleft in a 2-month-old girl: case reportTanriverdi, HI; Doganeroglu, F; Genç, A; Yilmaz, ÖBackground: Sternal cleft is a quite rare malformation. It is seen 1 out of 100,000 live births and makes up less than 1% of all chest wall deformities, seen more often among females. The deformity can be partial or complete. Partial deformities can be superior or inferior. It is generally diagnosed at birth when paradoxical respiratory movements are seen. Patients are often asymptomatic when they are born and generally other abnormalities accompany. As sternal clefts can be repaired primarily at early ages, they are repaired using autologous or synthetic grafts in the following years. We present a 2-month-old girl with superior partial sternal cleft repaired primary and accompanying hemangiomas in this case report. Case presentation: A girl who was born in another center and had a sternal cleft, who did not have any problems in the early period, was admitted to our hospital with respiratory distress at the age of 43 days. The patient was monitored with mechanical ventilator support, and there were hemangiomas around his left ear and lips. There were paradoxical respiratory movements in front of the heart, in the upper midline of the chest. Three-dimensional computed tomography showed that the upper part of the sternum did not develop, and there were hypoplasic sternal bars on both sides. It was evaluated as superior partial sternal cleft, and surgery was planned. In the operation, the sternal bars were released from the pericardium and pleura. The periosteum in the medial of both sternal bars was then released and connected in the midline, in front of the pericardium. Conclusion: Although neonates with a sternal cleft are asymptomatic at birth, respiratory symptoms may develop in later periods. In addition, because the structures are more flexible in the neonatal period, the primary repair of the cleft is easier and the risk of cardiac compression is lower. In our case, sternal bars could be approached primary, and no chondral grafts, patches, or steel wires were required.Item Does high-pressure carbon dioxide insufflation facilitate mucosal dissection in transanal endorectal pull-through?: A rabbit modelGenç, A; Taneli, C; Türkdogan, P; Yilmaz, Ö; Arslan, OA; Mir, EThe aim of the present study was to investigate whether high-pressure carbon dioxide insufflation facilitates mucosal dissection in the transanal endorectal pull-through (TEPT) operation performed in Hirschsprung's disease in a rabbit model. In the study, ten New Zealand rabbits were used. In six of the rabbits, CO2 under 50 mmHg pressure was insufflated into the submucosal area through a 25-gauge scalp needle inserted 0.3 cm over the dentate line. Two of the rabbits were taken for histopathological examination. In four rabbits, the TEPT operation was performed and in another four the operation was performed without CO2 insufflation. Histopathological examination in the CO2-insufflated group of rabbits showed that at transversal incisions mucosa was seen to be separated circumferentially from submucosa by high pressure CO2 and at longitudinal incision the separation was seen to be complete along the anal canal. It was noted that mucosal dissection was rapid, non-bloody and without induced mucosal tears or perforation; however, in the non-insufflated group the operation was time-consuming, bloody and more difficult to perform and needed meticulous care. In the present study, it was seen that submucosal high pressure CO2 insufflation in rabbits facilitates mucosal dissection in the TEPT operation and is easy to perform, time-saving and highly economical.