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Öğe A Fifteen-Year Analysis of Rare Isolated Fallopian Tube Torsions in Adolescent Children: A Case Series(Mdpi, 2019) Guney, Cengiz; Coskun, AbuzerIsolated tubal torsions presenting to the emergency department are a very rare cause of pediatric acute abdominal pain. Since making the diagnosis early is of importance in terms of affecting tubal damage and fertility, we aimed to evaluate cases of isolated tubal torsions in light of the literature. This study included 10 patients under 18 years of age who presented to the emergency department with abdominal pain between January 2003 and December 2018. The mean age was 14.5 +/- 1.43 years (range: 12-17 years). The demographic characteristics, surgical findings and techniques, and concomitant pathology results of these patients were retrospectively evaluated. The reason for presenting to the emergency department for the 10 patients included in the study was abdominal pain. The mean duration of hospital admission with pain was 4.97 days. The onset of pain was less than 24 h in seven patients (70%) and more than 24 h in three patients (30%). Of the patients, nine (90%) had tenderness in the lower abdominal quadrant, five (5%) had defense, and three (30%) had rebound. Nausea, vomiting and leukocytosis were present in 50% of the cases. Right and left tubal involvement of the cases was equal. Seven (70%) of the isolated tubal torsions were accompanied by paraovarian cysts. Eight patients (80%) underwent open surgery and two (20%) underwent laparoscopic intervention. Detorsion was performed on five (50%) patients and salpingectomy was performed on five (50%) patients. Isolated tubal torsion should be considered in children presenting with acute abdominal pain in early adolescence. Early diagnosis is important for the preservation of fertility.Öğe An Adolescent Girl with an Abdominal Mass(MOSBY-ELSEVIER, 2014) Alaygut, Demet; Sezer, Ferhat; Guney, Cengiz; Kilic, Suar Caki; Solak, Orhan…Öğe Alterations in spontaneous contractions of rat ileum and jejunum after peritonitis(ELSEVIER SCIENCE BV, 2008) Koyluogu, Gokhan; Bageivan, Ihsan; Karadas, Baris; Guney, Cengiz; Durmus, Nedim; Altun, Ahmet; Kaya, TijenThe aim of this study was to investigate the effects of peritonitis on spontaneous contractions of ileum and jejunum smooth muscles isolated from rats. Peritonitis was induced by cecal ligation and puncture in 8 rats. Another group of 8 rats underwent a sham operation and acted as controls. Twenty-four hours after the operation, the rats were killed, and their ileum and jejunum smooth muscles were excised and placed in circular muscle direction in a 10 ml organ bath. Changes in the amplitude and frequency of spontaneous contractions were analyzed before and after the addition of different antagonists. Peritonitis induced the decrease in the amplitude and frequency of spontaneous contractions in ileum and jejunum smooth muscles. In control groups, both ileum and jejunum, the amplitude and frequency of spontaneous contractions were significantly elevated in the presence of N-G-nitro-L-arginine (L-NNA) and indomethacin. In peritonitis groups, both ileum and jejunum, the amplitude and frequency of spontaneous contractions were significantly enhanced in the presence Of L-NNA, aminoguanidine, indomethacin and celecoxib compared to control values. In conclusion, peritonitis induces the decrease in the amplitude and frequency of spontaneous contractions of ileum and jejunum that can be attributed to the rise of nitric oxide synthase and cyclooxygenase isoforms levels. (c) 2007 Elsevier B.V All rights reserved.Öğe Amyand's hernia in the children: A single center experience(MOSBY-ELSEVIER, 2010) Cankorkmaz, Levent; Ozer, Hatice; Guney, Cengiz; Atalar, Mehmet H.; Arslan, Mehmet S.; Koyluoglu, GokhanBackground. The presence of a vermiform appendix in an inguinal hernial sac is termed Amyand's hernia. It may present as a tender inguinal or inguinoscrotal swelling, and it is often misdiagnosed as an incarcerated or strangulated hernia. Methods. Between 1998 and 2006, we have managed 564 patients with acute appendicitis, 1, 090 patients with inguinal hernia, 33 patients with incarcerated. inguinal hernia, and 12 patients with Amyand's hernia on our pediatric surgery service. A retrospective analysis of clinical data of these patients with Amyand's hernia was performed. Results. All patients with Amyand's hernia were boys with a median. age of 40 days (range, 15 days-14 months). One patient's condition was diagnosed pre-operatively. All of them, therefore, underwent emergency operation with a presumptive diagnosis of either incarcerated or strangulated inguinal hernia. Operative findings included 2 normal appendices, 6 inflamed appendices, and 4 appendices with external signs of serosal inflamation of uncertain significance in the inguinal hernial sac. Two patients with a normal appendix had hernia repair without an appendectomy. The other 10 patients with an abnormal appendix underwent an emergency open appendectomy with repair of the inguinal hernia. None of the patients developed recurrent hernia. The median postoperative follow-up period was 2.5 years. Conclusion. In pediatric patients with Amyand's hernia, the inflammatory status of the appendix can be used to determine the type of hernia repair and the operative approach. Incidental appendectomy in the case of a normal appendix is not favored by us. Treatment includes appendectomy (via the hernia sac) and hernia repair in children with an inflamed appendix. (Surgery 2010;147:140-3.)Öğe An interesting journey of a grass inflorescence from broncho to dorsum: case report(Turkish Assoc Tuberculosis & Thorax, 2010) Cankorkmaz, Levent; Koyluoglu, Gokhan; Atalar, Mehmet H.; Guney, Cengiz; Arslan, Mehmet S.An interesting journey of a grass inflorescence from broncho to dorsum: case report A 15-years-old male was presented with hyperemic and painful right flank mass. His medical history was consisted of a treatment for pneumonia and hemoptysia in the other hospital five months ago. Diagnostic X-rays was showed consolidation in the posterobasal segment of right pulmoner lobe and abscess in the paravertebral muscle extending from L4-5 level. The patient was discharged after antibiotic treatment. At the second hospitalization, a grass inflorescence was discharged from the fistula. When the patient was reevaluated his history was consisted of the aspiration of a grass inflorescence eight months ago. To our knowledge, this patient represents the first case of penetration by a grass inflorescence migrated out of the lomber region.Öğe ATPase inhibition by omeprazole reveals role of heat shock proteins on testicular torsion(Wiley, 2021) Guney, Cengiz; Coskun, Kubra Acikalin; Tutar, YusufTesticular torsion leads ischaemic injury and generates reactive oxygen species. Reactive oxygen species triggers lipid peroxidation, protein degradation and DNA damage. These biochemical processes trigger tissue damage. Heat shock proteins (HSPs) are important in spermatogenesis, and this work elucidates role of HSPs at the testicular torsion-detorsion process. A proton-pump inhibitor, omeprazole, tested to reveal the drug's curative effect since HSP functions through ATP hydrolysis. Thirty-two male Wistar Albino rats were divided into four groups: sham, control, omeprazole and serum physiologic groups. Right testis was torsed, while left ones remained untorsed. Protein peroxidation, DNA damage and lipid hydroperoxide levels as well as HSP expression were measured. Further, the effects were visualised with histopathologic imaging. HSP expression increases at the torsed right testis compared to the contralateral testis. Although HSP70 and HSP90 help antioxidant enzymes to keep their native structure, their anti-apoptotic properties accelerate the tissue damage. Omeprazole a proton-pump inhibitor employed to impair electron transfer chain and to inhibit HSP ATPase function. Omeprazole effectively inhibits HSPs and alleviates lipid peroxidation and DNA damage levels both at molecular and at tissue level, and the drug has profound curative effect on testicular torsion recovery.Öğe Can Fetuin-A, CRP, and WBC Levels Be Predictive Values in the Diagnosis of Acute Appendicitis in Children with Abdominal Pain?(Mdpi, 2019) Guney, Cengiz; Coskun, AbuzerBackground: Acute appendicitis (AA) is the most common cause of emergency surgery. Therefore, perforation is common. Early diagnosis and new markers are needed. The aim of this study was to investigate the effects of plasma Fetuin-A (FA) levels in patients with an acute abdomen (AB). Material and Method: This prospective study included 107 patients younger than 16 years of age who were admitted to the emergency department for abdominal pain between January and December 2018. The patients who presented abdominal pain were divided into two groups as AA and other causes (OC) of AB. Patients with acute appendicitis; intraperitoneal, retrocolic/retrocecal, and appendicitis were divided into three groups. Additionally, the AA group was divided into two groups as perforated appendicitis and non-perforated appendicitis. Serum FA levels of the patients were evaluated in the emergency department. Results: In the AA group, C-reactive protein (CRP) and white blood cell (WBC) levels were higher, and FA levels were significantly lower than in the AB group. Intraperitoneal localization was 95.2% and perforation was frequent. When significant values in the univariate regression analysis for acute abdomen and perforation were compared in the multivariate regression analysis, CRP, WBC, and FA levels were found to be prognostic. Furthermore, decreased FA levels were associated with AA, while too greatly decreased FA levels were associated with the risk of perforation. Conclusion: Current diagnosis can be made by history, physical examination, laboratory, and imaging methods in appendicitis cases. While trying to diagnose AA in children, the FA, CRP, and WBC levels may be predictive values to identify risk factors.Öğe A child with an unusual complication of Crimean-Congo hemorrhagic fever: Hemorrhagic pleural effusion(MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2016) Sahin, Irfan Oguz; Guven, Ahmet Sami; Kaya, Ali; Guney, Cengiz; Cevit, Omer; Arslan, Mesut…Öğe Megacystis Microcolon Intestinal Hypoperistalsis Syndrome in Which a Different De Novo Actg2 Mutation was Detected: A Case Report(TAYLOR & FRANCIS INC, 2018) Korgali, Elif Unver; Yavuz, Amine; Simsek, Cemile Ece Caglar; Guney, Cengiz; Kurtulgan, Hande Kucuk; Baser, Burak; Atalar, Mehmet Haydar; Ozer, Hatice; Egilmez, Hatice ReyhanIntroduction: Megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS) is characterized by bladder distension without urinary tract obstruction, decreased or absent intestinal peristalsis and microcolon. Although the definitive cause remains unknown, changes in the ACTG2 gene are thought to be responsible for the intestinal and bladder hypoperistalsis. Case report. This female newborn with MMIHS had a c.532C > A /p.Arg178Ser heterozygous de novo mutation detected in the ACTG2 gene. Normal immature ganglion cells, normal calretinin punctate positivity, maintence of smooth muscle actin immunoreactivity, and decreased numbers of interstitial cells of Cajal(ICCs) were detected. Conclusion: This previously unreported c.532C >A /p.Arg178Ser heterozygous de novo mutation in the ACTG2 gene may lead to a severe form of MMIHS.Öğe Our childhood cases with intussusception and pneumatic reduction(TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2010) Cankorkmaz, Levent; Koyluoglu, Goekhan; Arslan, Mehmet Serif; Guney, CengizBACKGROUND Intussusception is defined as telescopic insertion of the terminal ileum in to the colon after the cecum and colon. The aim of this study was to present our experience in pneumatic reduction of intussusception. METHODS In our study, 118 intussusception cases treated between 1996 and 2008 were analyzed. Age, gender, admission time, diagnostic/treatment methods, types of intussusception including leading point, and postoperative complications were evaluated. RESULTS Of these patients, 76 (64%) were male and 42 (36%) were female. Mean age was 25 +/- 34 months (3-180 months). The most common clinical presentations were vomiting, abdominal pain/irritable crying and bloody stools. Intussusceptions were ileocolic in 109 (92.3%) patients, ileoileal in 7 (6%) patients, and colocolic in 2 (1.7%) patients. No mortality was noted. Fifty-three patients (45%) were treated by non-operative reduction whereas the remainder were treated surgically. Among 65 patients operated, 13 leading points were detected. Pneumatic reduction success rate was 86%. Age significantly reduced the pneumatic reduction success rate; however, the duration between the beginning of symptoms and hospital admission and bloody stool were not effective. CONCLUSION Intussusception can be treated by non-operative methods when diagnosed early. Our results suggest that pneumatic reduction of intussusception in the pediatric population should be considered as a first choice.Öğe Splenic rupture presenting with marked scrotal ecchymosis in a 2-day-old newborn(Taylor & Francis Ltd, 2022) Tunc, Gaffari; Guney, Cengiz; Aygunes, UtkuSplenic rupture is a rare and severe condition in neonates. The signs and symptoms are vague and non-specific and are often not recognised before the onset of hypovolaemic shock or death. A 2-day-old infant presented with scrotal ecchymosis, and ultrasonography detected haemorrhage in the scrotal, right inguinal and adrenal regions. Computed tomography demonstrated a peri-splenic haematoma. Haemoglobin (Hb) was 2.79 g/dL and, despite repeated transfusions, the Hb level could not be sustained. Exploratory laparotomy detected a large haematoma in the splenic region, and, because of the uncontrolled haemorrhage, splenectomy was required.Öğe The Effect of Lactate Level on Early Mortality and Late Wound Healing in Children with Thoracoabdominal Trauma with Fluid Treatment Before Hospital(Mre Press, 2020) Guney, Cengiz; Coskun, AbuzerBackground: In this study, we aimed to evaluate the effect of serum lactate levels on early mortality and late wound healing in patients with childhood thoracoabdominal trauma, pre-hospital fluid replacement in patients admitted to the emergency department. Methods: This study included 479 patients under the age of 18 who applied to the emergency room for thoracoabdominal trauma between January 2014 and December 2018. Of these, 278(58%) were male, with a mean age of 8.34 years (range, 1-16 years). Demographic characteristics, fluid resuscitation, and serum lactate levels, trauma pattern, and mortality results of these patients were evaluated retrospectively. Results: 474 (98.9%) of the cases were blunt and 5 (1.1%) were penetrating trauma. 225 (47%) of the trauma cases were less than one meter falling, 162 (33.8%) were over one meter falling from the high, and 87 (18.2%) were car accidents inside and outside. Mortality was found most common in falling from height cases, which were related to prolonged hospitalization and high lactate level (p < 0.05). Wound healing times of patients undergoing pre-hospital fluid resuscitation and wound healing times of patients without pre-hospital fluid resuscitation were compared. Multivariate regression analysis, lactate level, and wound healing time were found to be predictive of the values found to be significant in the univariate regression analysis with fluid resuscitation and mortality (p < 0.05). Conclusion: Most thoracoabdominal traumas can be treated with conservative methods. Pre-hospital fluid treatment in severe trauma cases may lead to decreased lactate levels, reduced mortality, and shortened wound healing time.Öğe The Relation Between Angiotensin Converting Enzyme Gene Polymorphism and Renal Scarring with Vesicoureteral Reflux(Aves, 2010) Dumlupmar, Yusuf; Cankorkmaz, Levent; Koyluoglu, Gokhan; Ozdemir, Ozturk; Guney, CengizObjectives: Vesicoureteral reflux (VUR) is the retrograde flow of urine from the bladder to the ureter. With its pivotal role in the Renin-Angiotensin-Aldosteron System, Angiotensin Converting Enzyme(ACE) is an exopeptidase that has an effect in many direct or indirect physiological and metabolic events. The aim of this study was to investigate whether the ACE gene I/D polymorphism is a risk factor for reflux nephropathy in children with VUR. Patients and Methods: The study included 53 (29 girls, 24 boys) patients with VUR and sixty healthy children constituted the control group. ACE genotypes were determined as II, ID, and DD using the polymerase chain reaction. Technetium-m99-dimercaptosuccinic acid scanning was performed for all patients. The association among the groups was analyzed using chi-square test. Results: There was no difference between the groups with and without reflux nephropathy regarding age at diagnosis of VUR, associated urological abnormalities, frequency of urinary tract infection episodes and the occurrence of bilateral or unilateral VUR. The ACE I/D genotype distribution were similar between the patient and the control groups and in patients with reflux nephropathy and those without reflux nephropathy. Conclusion: ACE gene I/D polymorphism is an independent prognostic indicator of reflux nephropathy inpatients with VUR.Öğe Twins abused by their father(GALENOS YAYINCILIK, 2011) Butun, Celal; Beyaztas, Fatma Yucel; Oral, Resmiye; Guney, Cengiz; Buyukkayhan, Derya; Sato, YutakaChild abuse and neglect is an important public health problem that recurs unless it is recognized early and protection measures are implemented timely. Multidisciplinary collaboration of related professionals is of paramount importance in assessing and managing cases of child abuse and neglect. The father of the twins presented in this paper, who was employed in odd jobs as the sole bread-winner of his family of five and abused his wife also physically abused his twin children under one year of age. Although the physicians reported these children to law enforcement, the family concealed the abuse and neither the physicians nor the law enforcement reported this family to child protective services. As a consequence, a picture of recurrence of abuse with a cumulative negative medico-social outcome was observed. Since the mother declined to testify on the father abusing his children during the court proceedings, the father returned to the family after a brief incarceration. Child protective measures were established only after the forensic medicine physician interfered with the proceedings on a voluntary basis. This presentation aimed at reviewing the risk factors related to abuse and associated findings and assessment steps of abuse. In addition, these cases confirmed that every child abuse case that is missed by physicians and mismanaged legally or from child protection perspective has the potential to lead to severe, chronic abuse. Therefore, it is important that the family, law, medicine, and social services should collaborate in diagnosis and management of these cases. (Turk Arch Ped 2011; 46: 346-50)Öğe An unusual cause of abdominal ascites and acute kidney injury: Answers(SPRINGER, 2014) Alaygut, Demet; Guney, Cengiz; Oflaz, Mehmet Burhan; Guven, Ahmet Sami; Aygunes, Utku; Cevit, Omer…Öğe An unusual cause of abdominal ascites and acute kidney injury: Questions(SPRINGER, 2014) Alaygut, Demet; Guney, Cengiz; Oflaz, Mehmet Burhan; Guven, Ahmet Sami; Aygunes, Utku; Cevit, Omer…
