MCBÜ Açıkerişim Sistemi :: Browsing by Author "Tanriverdi, HI"

Browsing by Author "Tanriverdi, HI"

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Effects of Hesperidin and Diosmin on Necrotizing Enterocolitis: An
Senel, U; Tanriverdi, HI; Tanriverdi, S; Sapmaz, HI; Akbas, A; Gevrek, F; Uysal, M; Tas, U
Background: Necrotizing enterocolitis (NEC) is a serious intestinal illness in newborns.Objectives: We aimed to investigate the potential protective effects of hesperidin (Hsd) and diosmin on NEC.Methods: Thirty newborn rats were divided into 3 groups: the control group (n = 10), the NEC group (n = 10), and the treatment group (n = 10). The treatment group was given 100 mg/kg of the flavonoid by oral gavage twice daily. On day 5 of the study, animals were sacrificed under anesthesia. After laparotomy, the tissue samples were obtained from the stomach, cecum, and ileum. NEC scoring was performed histopathologically. Apoptotic changes were evaluated by TUNEL (terminal deoxynucleotidyl transferase-mediated biotin-deoxyuridine triphosphate nick-end labeling) staining. Furthermore, levels of oxidants and antioxidants were determined by biochemical analyzes of the tissues.Results: Glutathione peroxidase (GSH-Px) activity and malondialdehyde (MDA) levels were significantly higher in the NEC group than in the control group in all gastrointestinal tract regions examined. Similar to the control group, GSH-Px and MDA were found to be low only in the cecum in the group treated with flavonoids. NEC damage score and apoptotic index in all 3 regions examined were significantly higher in the NEC group than in the control and treatment groups. The apoptotic index values in the treatment group were similar in the stomach and cecum, and the NEC damage score was similar to those in the control group only in the cecum.Conclusions: Hsd and diosmin treatment significantly reduces the severity of NEC-induced damage and apoptotic cell death, espe-cially in the cecum.
Protective effect of famotidine on ischemia-reperfusion injury following testicular torsion in rats
Tanriverdi, HI; Senel, U; Gevrek, F; Akbas, A
Introduction In testicular torsion, testicular blood flow is impaired, resulting in ischemic changes. Torsion must be corrected urgently with surgical treatment. Detorsioning and restoration of blood supply to the testis cause reperfusion injury. Objective In this experimental study, we aimed to investigate the effect of famotidine on ischemia-reperfusion injury in a rat model of testicular torsion. Study design The rats were randomly divided into three groups; Group I (control, no torsion) (n = 8), Group II (torsion + detorsion) (n = 8), Group III (torsion + detorsion + famotidine) (n = 8). Levels of oxidative stress markers, such as malondialdehyde (MDA) and nitric oxide (NO), and antioxidants, such as superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), were measured for biochemical analysis. Testicular tissues were assessed by Johnsen Scoring for spermatogenic evaluation. Tissues were also examined with TUNEL staining to determine the extent of apoptosis. Results Average MDA level was higher in Group II than Groups I and III. The difference was only significant between Group I and II (p = 0.03). Average NO level was significantly higher in Group II than Groups I and III (p = 0.03; p = 0.04; respectively). Conversely, average SOD level was lower in Group II than Groups I and III. The difference was only significant between Group II and III (p < 0.001). Average GSH-Px level was lower in Group II than Groups I and III, but the differences were not significant (p = 0.37; p = 0.35; respectively). The average Johnsen score in Group II was significantly lower than the scores in Groups I and III (p < 0.001; p < 0.001; respectively). The apoptotic index of Group II was significantly higher than those of Groups I and III (p < 0.001; p < 0.001; respectively). Discussion Famotidine prevented increases in oxidative stress markers and reductions of antioxidants during ischemia-reperfusion injury in our study. Spermatogenesis was less affected and DNA injury was reduced in rats treated with famotidine. The antioxidant characteristics of famotidine and its protective effects have been shown in our study. Conclusion Famotidine may prevent oxidative tissue injury during ischemia-reperfusion. [GRAPHICS]
Successful outcomes in laparoscopic pyeloplasty using knotless self-anchoring barbed suture in children
Yilmaz, O; Tanriverdi, HI; Cayirli, H; Ertan, P; Sencan, A; Genc, A; Taneli, C
Introduction Laparoscopic pyeloplasty for ureteropelvic junction obstruction in children has gained increasing importance over the last decade. Intracorporeal knot tying still remains a technical challenge for the surgeon. Self-anchoring suture incorporates a new concept for tissue approximation and reduces intracorporeal knot tying problems. There are very few reports on self-anchoring knotless suture and its application for laparoscopic pyeloplasty in children. We present our results of a series of consecutive children undergoing laparoscopic pyeloplasty with knotless barbed sutures. Material and method We prospectively evaluate 15 consecutive patients who underwent laparoscopic pyeloplasty with knotless barbed sutures (VLoc (TM), Covidien) for ureteropelvic anastomosis. The decision of the operation was given by pediatric nephrology-urology-radiologic imaging diagnostic team, and all patients were operated by a single surgeon. Pyeloplasty was performed without pelvic reduction, and the anastomosis was made by barbed sutures using running fashion. Results The mean age of the patients were 5.39 (3 months-17 years). Two cases had undergone a right-sided pyeloplasty, and thirteen had undergone a left-sided pyeloplasty. The duration of the operative procedure was 60-110 min. Neither intraoperative nor postoperative complication was encountered in any of the cases. Patients were followed by ultrasonographic evaluation. The anteroposterior diameter (AP) diameter of renal pelvis and hydronephrosis grade Society for Fetal Urology (SFU) are significantly different when compared with pre-operative and postoperative period (p = 0.001 and p = 0.001, respectively). Owing to the renal parenchymal thickness change by age pre-operative and postoperative thickness comparison is adjusted by age, because age is considered as a covariate (confounder variable). We observed statistically significant (p = 0.003) difference in parenchymal thickness in all cases. Follow-up periods of the 15 consecutive pediatric pyeloplasty cases were 6-54 months. Conclusion In the present study, successful outcome of the laparoscopic pyeloplasty using barbed suture was shown for the first time in children in literature. We believe that successful outcome of laparoscopic pyeloplasty could be achieved by eliminating knots and less manipulation on the wound edge also minimizes tissue injury during the procedure.
The Pediatric Tracheostomy Practice During COVID-19 Pandemic at a PICU
Zengin, N; Bal, A; Cankorur, OO; Tanriverdi, HI
Introduction: To evaluate pediatric tracheostomies performed at a tertiary care pediatric intensive care unit (PICU) before and after the Coronavirus disease-2019 (COVID-19) pandemic. Methods: A total of 57 pediatric tracheostomy patients performed at a tertiary care PICU were included. Prognostic scores including pediatric risk of mortality 2, pediatric index of mortality 2 and pediatric logistic organ dysfunction scores, the family education process and time to home discharge were evaluated according to time of tracheostomy (pre-pandemic vs. after pandemic) and responsible surgeon (pediatric surgeon vs. otolaryngologist). MedCalc (R) Statistical Software version 19.7.2 (MedCalc Software Ltd, Ostend, Belgium; https: //www.medcalc.org; 2021) was used for statistical analysis. Results: A non-significant tendency for higher rate of pediatric surgery-based tracheostomies was noted after the pandemic (76.0 vs. 24.0%, p=0.134). No significant difference was noted between tracheostomies performed before vs. after the COVID-19 pandemic and those performed by otolaryngologists vs. pediatric surgeons in terms of prognostic scores and time to home discharge. Conclusion: Our findings emphasize the maintenance of high quality patient care for pediatric tracheostomy patients in accordance with standardized tracheostomy protocols and policies during the pandemic period with no significant difference between tracheostomies performed before and after the COVID-19 pandemic and those performed by pediatric surgeons vs. otolaryngologists in terms of prognostic scores and time to home discharge.
Schwannoma Localized Retroperitoneally in a 14-Year-Old Boy
Cayirli, H; Tanriverdi, HI; Ozguven, AA; Gunsar, C; Ersoy, B; Kandiloglu, AR
Schwannomas usually occur in adults being between the second and fifth decades, and such neoplasms are extremely rare in a pediatric population. In addition, they are not normally found in the retroperitoneal region. Here, we present a pediatric case of a retroperitoneal schwannoma in an adrenal location where the tumor was not able to be preoperatively differentiated from other benign ormalign adrenal gland tumors. In our opinion, this tumor can be included in the differential diagnosis of a nonfunctioning retroperitoneal adrenal mass in children.
Intraoperative evaluation of testicular vascularization and perfusion in rat testicles with indocyanine green (ICG)/near-infrared (NIR) fluorescent imaging after torsion-detorsion and reperfusion
Sencan, A; Tanriverdi, HI; Simsek, FB; Usta, IB; Üçöz, M; Özbilgin, K
Introduction The aim of this study was to evaluate testicular perfusion and vascularization with intraoperative ICG/NIR imaging in a testicular ischemia-reperfusion model and to investigate the effects of ICG on testicular tissue. Materials and methods 24 male rats were divided into four groups. In the ICG group, only ICG was given and images of the testicles were recorded with NIR camera. In the torsion group, the testicles were left in torsion for 4 h. ICG/NIR images were obtained after torsion and detorsion. In the reperfusion group, ICG/NIR images of the testicles were obtained at the 4(th) hour of reperfusion. After the procedures, testicles were collected and evaluated with histological, immunohistochemical examination and qRT-PCR. Results There was no histologically negative effect of ICG on testicular tissue. There was no testicular perfusion in the torsion group, but perfusion started after detorsion. At the 4th hour of reperfusion, testicular perfusion continued. TNF-a, IL-6, MCP-1 and caspase-3 immunoreactivity were found to be at low levels in the control and ICG groups, while high in the torsion and reperfusion groups (p < 0.05). In qRT-PCR, TNF-a, IL-6, MCP-1 and caspase-3 expressions were lower in the control and ICG groups, but higher in the torsion and reperfusion groups. Conclusion There was no histologically negative effect of ICG on testicles. The ICG/NIR imaging technique seems to be a feasible method in testicular torsion and may contribute to the surgeon in the intraoperative management of testicular torsion. In testicles that started to be perfused after detorsion, perfusion still continued at the 4th hour of reperfusion. Our next goal is to test whether testicles showing ICG fluorescence in during reperfusion maintain their viability for long term.
Could increased expression of aquaporin-1 be an etiological cause in childhood noncommunicating hydroceles that do not regress spontaneously?
Tanriverdi, HI; Gunsar, C; Nese, N; Yilmaz, Ö; Sencan, A
Background Aquaporins are membrane water channel proteins that are expressed in the epithelium and endothe-lium. Their primary function is to control the flow of water in the membranes of the cells. Objective In this study, we investigated whether there is increased expression of aquaporin-1 in the tunica vaginalis of hydrocele patients in childhood that do not regress spontaneously an whether it has an ef-fect on the etiology of hydrocele. Study design Boys who were diagnosed with hydrocele and scheduled for surgery were included and formed the hydrocele group. Boys in the same age range who underwent surgery for inguinal hernia or unde-scended testicles were included as a control group. Aquaporin-1 expression was evaluated by immuno-histochemical examination of capillaries in tissue samples taken from the tunica vaginalis during the operation. Aquaporin-1-positive vessels were coun-ted by selecting 5 unrelated areas with the highest vascular density, and the average number of vessels was calculated for each case. Results A total of 48 male patients were included in the study. Of these, 27 constituted the hydrocele group (mean age 3.51 +/- 2.59 years), and 21 constituted the control group (inguinal hernia, n = 17; unde-scended testicle, n = 4) (mean age 3.95 +/- 3.80 years). The mean ages of both groups were statisti-cally similar (p = 0.32). The mean numbers of aquaporin-1-positive vessels at the capillaries in the tunica vaginalis of the patients were 20.74 +/- 7.10 in hydrocele group and 17.23 +/- 4.07 in the control group. The expression of aquaporin-1 in the hydro-cele group was significantly higher (p = 0.037). Discussion It was shown that aquaporin-1 expression was higher in adult cases with hydrocele. Also an increase in aquaporin-1 expression was detected in tunica vag-inalis of children with hydrocele in our study. Conclusion It was thought that aquaporin-1 overexpression may play a role in non-communicating hydroceles in children.
The importance of clinical approach in aggravated sexual abuse: Case report
Karabag, G; Tanriverdi, HI; Yavuz, MS; Genç, A; Akin, U; Saraç, S
The 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.
Providing a Fossa Navicularis in Reconstruction of Hypospadias Reply
Taneli, C; Tanriverdi, HI; Genc, A; Sencan, A; Gunsar, C; Yilmaz, O
Primary closure of superior partial sternal cleft in a 2-month-old girl: case report
Tanriverdi, HI; Doganeroglu, F; Genç, A; Yilmaz, Ö
Background: 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.
The Effect of Tunica Albuginea Incision on Testicular Tissue After Detorsion in the Experimental Model of Testicular Torsion
Gultekin, A; Tanriverdi, HI; Inan, S; Yilmaz, O; Gunsar, C; Sencan, A
Purpose: Testis torsion is a surgical emergency, and sometimes we cannot sufficiently prevent injury even surgical detorsion of the testis is performed in the appropriate time period due to some reasons such as tissue edema. In this experimental study, we investigated the effect of tunica albuginea incision (TAI) on testicular torsion-detorsion model (TDM). Materials and Methods: Twenty four male rats were used. The rats were randomly divided into three groups. In Group I, testicular torsion (TT) of 720 was created. After 4 hours of torsion period, the testis was detorsioned. Then three longitudinal incisions were made on tunica albuginea of the testis. In Group II, torsion and detorsion was created by the same way as in Group I, but TAI was not added to the procedure. Group III was Sham group. At the end of the first week, rats in the experimental groups were sacrificed and the testes were harvested for histological, immunohistological examinations and for the assessment of apoptotic activity. Results: In Group I, the procedures led to partial improvement in color of the testes. Modified Johnsen Scores in Groups I, II and III were detected as 7.8, 4.3 and 9.6 respectively (P = .001). In Group I, immunoreactivity of anti-APAF-1 was moderate in 7 rats, and strong in 1 rat. Immunoreactivity of anti-cytochrome C and anti-caspase 3 were moderate in 6 rats, and strong in 2 rats. Immunoreactivity of anti-caspase 8 and 9 were moderate in 5 rats, and strong in 3 rats. The differences of immunoreactivity between the groups were statistically significant. TUNEL percentages were detected as 40, 62% in Group I, 60% in Group II and 11,75% in Group III respectively (P = .001). Conclusion: As a result, multiple incisions made on tunica albuginea after detorsion in the TDM in rats, decrease the amount of ischemia- reperfusion injury. This effect might be related with the decrease in testicular edema and free oxygen radicals together with increase in tissue perfusion. Moreover, the decreased apoptotic activity seems to play a role in the decrease in inflammatory response and preservation of tissue parenchyma consequently.
Effectiveness of nonsurgical antibiotic treatment in the experimental appendicitis model in rats
Demirtürk, HC; Tanriverdi, HI; Taneli, F; Ayhan, S; Günsar, C
Background: In this study, we aimed to demonstrate efficacy and laboratory follow-up criteria of nonsurgical antibiotic treatment in uncomplicated acute appendicitis. We established an experimental appendicitis model in rats, and antibiotic treatment was evaluated by biochemical and immunohistochemical changes. Materials and method: In the study, 28 rats were divided into 4 groups. Group 1 constituted the group of sham; group 2 was the control group that appendicitis model was created and did not receive any treatment. Group 3 was created as an appendicitis model and was given regular antibiotic treatment. In group 4, appendicitis model was created, and appendectomy was performed on the 2nd day. Blood samples were taken from the rats on the 0, 2nd, and 7th days in all groups. Rats in groups 1, 2, and 3 underwent appendectomy with laparotomy under anesthesia on the 7th day. Serum C-reactive protein (CRP), procalcitonin, and leukocyte levels were measured for biochemical analysis. In immunohistochemical evaluation, inflammation severity of the tissue samples taken from appendices was evaluated. Also, tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) levels of tissue samples were evaluated. Results: A statistically significant difference in CRP values was observed between groups 1 and 2 on the 7th day (p = 0.046), between groups 1 and 4 on 0 and 2nd days (p = 0.004, p = 0.004), between groups 2 and 3 on 0, 2nd, and 7th days (p = 0.018, 0.013, 0.025), between groups 2 and 4 on 0, 2nd, and 7th days (p = 0.002, p = 0.002, p = 0.009), and between groups 3 and 4 on 0 and 2nd days (p = 0.013, p = 0.025). There was a significant difference in procalcitonin values between groups 1 and 3 on the 7th day (p = 0.032) and between groups 1 and 4 on day 0 (p = 0.019). A significant difference was also observed in TNF-alpha and IL-6 inflammation between groups 2 and 3 (p = 0.031, p = 0.018) and between groups 2 and 4 (p = 0.031,p = 0.01). Conclusion: Acute uncomplicated and early appendicitis may be treated with antibiotics. According to our results, CRP levels are useful as follow-up criterion in experimental appendicitis model. Clinical studies on the assessment of CRP levels in the course of nonsurgical treatment in the patients with acute appendicitis will reveal out the effectiveness of this marker.
Myointimoma of the glans penis
Tanriverdi, HI; Yilmaz, O; Nese, N; Taneli, C; Genc, A
Tubularized Reconstructed Plate Urethroplasty: An Alternative Technique for Distal Hypospadias Repair
Taneli, C; Tanriverdi, HI; Genc, A; Sencan, A; Gunsar, C; Yilmaz, O
OBJECTIVE To report current results of a new surgical technique, tubularized reconstructed plate urethroplasty (TRPU) in distal hypospadias repair which allows the tubularization of urethral plate without incision or grafting. METHODS This study is a prospective single surgeon series. Between January 2019 and March 2020, total of 158 patients underwent hypospadias repair, and 29 selected patients had TRPU procedure. Demographic data, duration of follow-up, complications were recorded. A vertical incision is made starting from halfway up the glans. This incision creates a diamond like defect which enables wedge removal of a segment of spongiosum tissue from the base of urethral plate extending to the hypospadiac meatus. Vertical incision is closed horizontally. The urethral plate is stretched and loos ened from the base and re-secured into its bed using quilting stitches. Reconstructed urethral plate ensures the required width to allow the formation of neourethra of adequate circumference, followed by a formal glansplasty. RESULTS Preoperative glans width was 13.4 +/- 0.9 mm, urethral plate width was 6.1 +/- 0.9 mm. Mean post operative follow-up period was 13.6 months. All patients had successful functional outcome and cosmetically satisfying appearance. None of the patients required meatal calibration. The total complication rate was 3.4%. CONCLUSION Native urethral plate itself is used as a natural flap to increase the surface area of the urethral plate in this new perspective of urethroplasty method. We believe that TRPU procedure provides an alternative approach for the formation of neourethra and it is a successful and relatively simple procedure with low complication rates, good cosmetic results and promising successful functional short-term outcome. (c) 2020 Elsevier Inc.

Browsing by Author "Tanriverdi, HI"

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