Browsing by Author "Genç A."
Now showing 1 - 20 of 38
Results Per Page
Sort Options
Item Askin tumors in children: A report of four cases(Hippokrates Verlag GmbH, 1998) Taneli C.; Genç A.; Erikçi V.; Yüce G.; Batik E.Primary malignant tumors of the chest are rare in the pediatric age group. Askin tumor belongs to the peripheral primitive neuroectodermal tumor family, and typically involves the periosteum, soft tissue and extrapulmonary tissue of the thoracic wall. We report our ten years experience with four cases of this rare tumor.Item Long-term follow-up and evaluation of autoaugmentation cystoplasty (detrusorotomy) in an animal model(1999) Taneli C.; Genç A.Objective: To evaluate long-term follow-up of an autoaugmentation (detrusorotomy) technique, in puppies. Patients and methods: In 10 mongrel puppies, bladder capacities were reduced to nearly half their original volume by 10 per cent formalin instillations. In 7 puppies, the muscular coat of the bladder was split open widely down to the mucosal layer, from the bladder neck anteriorly, to the trigone posteriorly while the mucosa was kept exposed and intact. Three puppies were kept as controls. Results: Mean post- instillation bladder capacity was 15.40 ml. One week after detrusorotomy the bladder capacity averaged up to 20.00 ml; 3 weeks later up to 20.43 ml; and 3 months later up to 34.28 ml and were well up to 3 months. However, at the termination of an additional 9-month period, the bladders of 4 of the remaining five dogs were seen to decrease in volume except the one with an accidental omental adherence to the exposed mucosa which kept the detrusorotomy intact. Conclusion: Post-detrusorotomy volume could be retained if a graft, e.g. omentum, gut segment, amniotic membrane or lyophilized dura is inserted at the time of intervention, in-between the split musculature to line the exposed mucosa externally and to prevent re-adhesion of the muscular edges.Item Esophageal reconstruction in the treatment of caustic esophageal strictures in children; [Çocukluk çaǧi kostik özofagus darliklarinin tedavisinde özofagus rekonstrüksiyonlari](2001) Genç A.; Ural Z.; Güçlü C.; Şen T.; Yilmaz M.; Mutaf O.Aim: The incidence of esophageal strictures in children due to caustic ingestion shows a descending trend but still keeps its importance. In severe cases, who are resistant to medical treatment, several surgical interventions are proposed in repair of the constricted esophagus. The aim in the present study is to summarize the experiences in the technical approach. Method: In 1277 patients who were admitted to Pediatric Surgery Department of Faculty of Medicine of Ege University between the years 1975-1999 only 123 underwent corrective surgical treatment of the esophagus. Results of the different surgical approaches, complications, relations of the complications with the treatment applied, treatment applied for complications and morbidity were retrospectively reviewed. Results: In a total of 102 cases coloesophagoplasty was applied, in 10. through right thoracic retrohilar path and in 92 by retrosternal colon interposition. In 2 cases (2 %) necrosis was seen whole transplant and in 3 cases only at the cervical end of the transplant. When cases were evaluated according to the application of anastomosis in the first or second sequences, anastomosal stricture was seen in 6 of 12 cases (50 %) in the former, but in only 8 of 80 cases (10 %) in the latter. It was clearly seen that correction in the second sequence leads to less strictures. Grafts were widened and elongated in 7 of 10 cases with right thoracic retrohilar colon interposition, however in cases whom the transplants were placed retrosternally the graft widening and elongation were of lesser problem. To three cases jejunoesophagoplasty applied and in one case terminal necrosis and in 2 cases total necrosis were seen. In the remaining 18 cases in the present series, the intra thoracic esophageal stricture resection and end to end anastomosis were applied, Total overall mortality rate was 3.25 % (4 of 123). Conclusion: In the surgical treatment of esophageal strictures, if possible, a stricture resection and primary anastomosis should be undertaken. Otherwise a coloesophagoplasty with left colon through retrosternal path in two sequence seems more appropriate and has good outcome with low complication rate.Item Analysis of meatal location in 300 boys(2001) Genç A.; Taneli C.; Öksel F.; Balkan C.; Bilgi Y.The high incidence of anterior hypospadias and the consideration of some of the parents that this location is a normal variation and the resistance to the surgical treatment led us to investigate the normal meatal location in boys. The location of external meatus was analyzed in 300 boys. The meatal location was classified as type A (anterior third/tip of the glans) type B (middle third) and type C (posterior third/glandular hypospadias). Of the 300 boys taken into study, in 282 (94%) meatus was located at the tip of the glans in 14 patients (4.6%) on the middle third, 'type B' and in 2 patients (0.6%) on the posterior third, 'type C'. The present study clearly demonstrated that the true location of urethral meatus should be at the tip of the glans. Type B is an acceptable location, which requires no operation and is seen in a very small percentage. Type C is a true glandular hypospadias and should certainly be corrected by glanuloplasty and meatal advancement. We are of the opinion that after surgery for anterior hypospadias meatal position presenting elsewhere than at the tip of the glans should not be considered a successful intervention.Item Polytetrafluoroethylene bars in stabilizing the reconstructed sternum for pectus excavatum operations in children(Lippincott Williams and Wilkins, 2002) Genç A.; Mutaf O.Nine 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 Evaluation of the location of the anus by a modified technique in the neonate(2002) Genç A.; Taneli C.; Tansuǧ N.; Kasirga E.; Yilmaz D.; Küçükoǧlu T.; Onaǧ A.Purpose: 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. © 2002 Elsevier Science Ltd. All rights reserved.Item Congenital midline cervical cleft: A rare embryo pathogenic disorder(2002) Genç A.; Taneli C.; Arslan O.A.; Daǧlar Z.; Mir E.Congenital midline cervical cleft (CMCC) is a rare disorder of the ventral neck. The cleft consists of an epithelium-covered, longitudinal central depression with a protuberance at the cervical end. The adjacent skin is tethered by scar tissue forming a depression, which ends in a blind sinus at the caudal end. Although a variety of embryological mechanisms are proposed, its etiology is obscure. Up to the present time, fewer than 50 cases have been reported in the English literature. CMCC can be seen in association with several midline anomalies related to the branchial arches, including median cleft of the lower lip and mandible, and hypoplasia or absence of other midline neck structures. We present a 36-day-old boy with CMCC to illustrate its clinical presentation and the result at 24 months postoperatively. © Springer-Verlag 2002.Item Histopathological evaluation of the urethra after the Snodgrass operation: An experimental study in rabbits(2002) Genç A.; Taneli C.; Günşar C.; Türkdoǧan P.; Yilmaz O.; Arslan O.A.; Mir E.Objective: 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 1 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 MURCS association and rectovestibular fistula: Case report of a patient treated with one-stage posterior sagittal anorectoplasty and sigmoid loop vaginoplasty(W.B. Saunders, 2003) Günşar C.; Genç A.; Şencan A.; Daǧlar Z.; Alparslan O.; Mir E.MURCS association is rare, first described by Duncan in 1979, including nonrandom association of Mullerian duct aplasia or hypoplasia (MU), renal agenesis or ectopy (R), and cervicothoracic somite dysplasia. A 5-year-old girl was admitted to the clinic with a complaint of anteriorly located anus. Physical and radiologic examination of the patient found MURCS association with anorectal malformation (ARM) of rectovestibular-type fistula. She had multiple vertebral anomalies, left renal agenesis, vaginal and uterine agenesia, with a normal female 46,XX karyotype. Posterior sagittal anorectoplasty (PSARP) and sigmoid loop vaginal reconstruction was performed as a one-stage operation for the treatment of vaginal agenesis and ARM, There were no complications in the postoperative period. This combined one-stage operation can be used easily in the treatment of some components of the MURCS association such as vaginal agenesis and ARM as an associated anomaly. Copyright 2003, Elsevier Science (USA). All rights reserved.Item Urethral meatal dilatation using topical EMLA cream for anaesthesia [3](Blackwell Publishing Ltd., 2003) Genç A.; Tekin I.; Taneli F.; Arslan O.A.; Taneli C.; Mir E.[No abstract available]Item Foreign body extraction with endoscopy assisted tracheotomy: Case report; [Endoskopi yardimiyla trakeotomi ile yabanci cisim çikarilmasi: Olgu sunumu](2003) Günşar C.; Genç A.; Şencan A.; Taneli C.; Mir E.The authors present a rare case of foreign body aspiration treated with a recently defined technique. Endoscopy assisted tracheotomy was used for the removal of a broken plastic pen top from a child and the surgical methods used in the treatment of tracheobronchial foreign body aspiration are discussed.Item Does high-pressure carbon dioxide insufflation facilitate mucosal dissection in transanal endorectal pull-through? A rabbit model(2003) Genç A.; Taneli C.; Türkdoǧan P.; Yilmaz Ö.; Arslan O.A.; Mir E.The 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.Item The effect of circumcision status on periurethral and glanular bacterial flora(2004) Günşar C.; Kurutepe S.; Alparslan O.; Yilmaz Ö.; Daǧlar Z.; Şencan A.; Genç A.; Taneli C.; Mir E.Introduction: 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 © 2004 S. Karger AG, Basel.Item Testis-fixation in prepubertal rats: Fibrin glue versus transparenchymal sutures reduces testicular damage(2004) Şencan A.; Genç A.; Günşar C.; Daǧlar Z.; Yilmaz Ö.; Ulukuş Ç.; Özer E.; Taneli C.; Mir E.Experimental studies have shown that different suture materials used in testis fixation cause some degree of inflammation in the testis. This study was planned to compare the histological changes that were caused by fibrin glue which is a tissue sealant and by silk and polypropylene for transparenchymal testis fixation. 28 prepubertal rats were divided into 4 groups. Testis was fixed to the tunica vaginalis by fibrin glue in group 1, by silk in group 2 and by polypropylene in group 3. Group 4 was planned as a control. Testicular inflammation and seminiferous tubular diameter were evaluated for histological changes. The least inflammation was observed in the fibrin glue group, while the most inflammation occurred in the silk group. Seminiferous tubular diameter was 241.55 ± 45.90 in the fibrin glue group, 151.90 ± 8.34 in the silk group and 161.36 ± 9.96 in the polypropylene group. In conclusion, fibrin glue, when used for testis fixation, causes less inflammation and less destruction of seminiferous tubular diameter compared with silk and polypropylene.Item Modification of meatal advancement and glanuloplasty for correction of distal hypospadias(2004) Taneli C.; Genç A.; Günsar C.; Sencan A.; Arslan O.A.; Daglar Z.; Mir E.Objective: 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 Intrascrotal paratesticular lymphangioma; [Skrotum içi testis dişi lenfanjiom](2004) Günşar C.; Şencan A.; Demir M.A.; Genç A.; Küçükoǧlu T.; Taneli C.; Mir E.We present a case of cystic scratal lymphangioma who showed three different clinical presentations in fourty days. At his first admission, he had a soft, painless, transilluminating, scrotal mass which progressed to an acute scrotum like disease after inadequate excision. Following total excision of the mass, he had a local celhditis attack on the scrotal skin. His lesions healed without any sequela. For histopathological differential diagnosis we performed some immunohisiochcmical dyeing methods in addition to the classical hematoxylene-eosine stained sections. Scrotal lymphangioma should be kepi in mind for the differential diagnosis of inguinoscrotal lesions and with adequate, surgical interventions, the recurrences could be prevented.Item Effect of alarm treatment on bladder storage capacities in monosymptomatic nocturnal enuresis(2004) Taneli C.; Ertan P.; Taneli F.; Genç A.; Günsar C.; Sencan A.; Mir E.; Onag A.Objective: 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 The frequency and associated factors of low back pain among a younger population in Turkey(2004) Çakmak A.; Yücel B.; Özyalçin S.N.; Bayraktar B.; Ural H.I.; Duruöz M.T.; Genç A.Study 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 The effect of spermatic vessel ligation on testicular nitric oxide levels and germ cell-specific apoptosis in rat testis(Elsevier GmbH, 2005) Taneli F.; Vatansever S.; Ulman C.; Yilmaz O.; Giray G.; Genç A.; Taneli C.Management 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 h (group 2) and 24 h (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 24 h 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. © 2004 Elsevier GmbH. All rights reserved.Item CHARGE association: Case report; [CHARGE birlikteliǧi: Olgu sunumu](2005) Yilmaz Ö.; Arslan O.A.; Genç A.; Kücükoǧlu T.; Günşar C.; Şencan A.; Mir E.; Taneli C.CHARGE association is a combination of a number of related birth defects and acronyme of the first letter of each defect. A 5-year-old male admitted to our hospital with complaint of passing urine through a stenotic hypospadic meatus. Physical examination showed that his weight was 10-20th percentiles and his height was 10-20th percentiles. He had a left sided bad ear. Ophthalmologic examination revealed microphthalmia, iris coloboma, choroid coloboma and lens coloboma of both eyes. External genital examination revealed a coronal hypospadias and a ventral chordee. His mental development was found 3.5 years in social, 4 years in motor skills. An urethroplasty was performed by the Snodgrass technique. Four of the 7 components of the CHARGE association were present in present case.