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Öğe Effects of fasting and preoperative feeding in children(W J G PRESS, 2009) Yurtcu, Muslim; Gunel, Engin; Sahin, Tahir Kemal; Sivrikaya, AbdullahAIM: To investigate whether children should undergo surgery without a long period of fasting after feeding. METHODS: Eighty children with inguinoscrotal disorders (aged 1-10 years) were studied prospectively. They were divided into eight groups that each contained 10 children who were fed normal liquid food (NLF) and a high-calorie diet (HCD) 2, 3, 4 and 5 h before surgery, in two doses at 6-h intervals. NLF was given to four groups and HCD to the other four. In all groups, glucose, prealbumin and cortisol levels in the blood were measured twice: just after oral feeding and just before the operation. After the establishment of adequate anesthesia, gastric residue liquid was measured with a syringe. RESULTS: Blood glucose levels in all patients fed NLF and HCD were high, except in patients in, the HCD-4 group. There was no significant difference in the blood prealbumin levels. There was a significant increase in the blood cortisol levels in the NLF-2 (14.4 +/- 5.7), HCD-2 (13.2 +/- 6.0), NLF-3 (10.9 +/- 6.4), and HCD-5 (6.8 +/- 5.7) groups (P < 0.05). CONCLUSION: The stress of surgery may be tolerated by children when they are fed up to 2 h before elective surgery. (C) 2009 The WJG Press and Baishideng. All rights reserved.Öğe Hepatoblastoma in a child with neurofibromatosis type I(WILEY-BLACKWELL, 2007) Ucar, Canan; Caliskan, Umran; Toy, Hatice; Gunel, EnginA major hallmark of NF1 is the development of benign tumors, including peripheral neurofibromas, plexiform neurofibromas, gliomas of the optic tract, other low grade gliomas, and pheochromocytomas. Hepatoblastoma have not been previously reported in patients with neurofibromatosis type 1. We present a case of a 9-month-old boy diagnosed with both hepatoblastoma and neurofibromatosis type 1. Hepatoblastoma occurs in association with several well-described cancer predisposition syndromes, including familial adenomatous polyposis, Beckwith-Wiedemann syndrome, Li-Fraumeni syndrome, trisomy 18, and glycogen storage disease type 1. This paper describes a case of hepatoblastoma diagnosed in association with neurofibromatosis type 1.Öğe Investigation of histopathologic changes in the ureter walls in experimental congenital obstructive uropathy(W B SAUNDERS CO-ELSEVIER INC, 2008) Guerbuezer, Nilifer; Yurtcu, Mueslim; Findik, Siddika; Avunduk, Mustafa Cihat; Gunel, EnginBackground/Purpose: The aim of this study is to determine the histopathologic changes in the ureter wall in experimental urinary bladder hypoplasia and agenesis. Methods: Timed pregnant rats were randomly divided and received intraperitoneal Adriamycin (ADR) at 2 mg/kg on gestational days (GD) 6 to 9 (ADR group) and saline at 2 mL/kg on GD 6 to 9 (SF group). The control (C) group did not receive any medication in their pregnancy. Fetuses were harvested near term on GD 21 and dissected under a dissecting microscope and examined for urinary system abnormalities. Results: Diameter of ureter lumen was significantly increased, but wall thickness, tunica muscularis, and epithelial thickness of the ureter were decreased in the ADR group as compared with the C and SF groups. Conclusions: Diameter of the ureter lumen was increased, but wall thickness, tunica muscularis, and uroepithelium of the ureter were decreased in the ADR group in the intrauterine period. The diameter of the ureter lumen and wall thickness Of ureter (tunica muscularis of ureter and uroepithelium) were increased following obstructive uropathy after the birth. (C) 2008 Elsevier Inc. All rights reserved.Öğe Investigation of histopathologic changes in the ureter walls in vesicoureteral reflux(W B SAUNDERS CO-ELSEVIER INC, 2009) Yurtcu, Mueslim; Gurbuzer, Nilifer; Findik, Siddika; Avunduk, Mustafa Cihat; Gunel, EnginPurpose: This study aimed to determine the histopathologic changes in ureteral walls (UWs) in children with vesicoureteral reflux (VUR). Methods: Twenty ureteral specimens taken from children were divided into 2 groups, refluxing (R) and control (C) groups, each containing 10 specimens. Wall thickness of the ureter, tunica muscularis of the ureter, mucosal thickness of the ureter (uroepithelium), collagen thickness of the ureter, mucosal change, and inflammation were evaluated in resected distal UWs in children with VUR. Results: The mean wall thickness of the ureter, mean tunica muscularis of the ureter, and mean uroepithelium values of the UWs in the R group were not significantly lower compared to those in the C group. Collagen thickness values in the R group were significantly lower than those in the C group. Conclusions: Our data suggest that wall thickness (tunica muscularis and uroepithelium) was not significantly decreased, but collagen thickness of the ureter was decreased in the UWs of children with VUR. (C) 2009 Elsevier Inc. All rights reserved.Öğe Mesenchymal hamartoma of the liver mimicking hepatoblastoma(LIPPINCOTT WILLIAMS & WILKINS, 2008) Unal, Ekrem; Koksal, Yavuz; Akcoren, Zuhal; Tavli, Lema; Gunel, Engin; Kerimoglu, UlkuMesenchymal hamartoma of the liver is a cystic benign liver mass occurring in children. Diagnostic confusion with hepatoblastoma may arise when a-feto-protein (AFP) level is elevated. We report an extremely rare case of mesenchymal hamartoma in an 11-month-old boy. Serum AFP was elevated and fine-needle aspiration biopsy suggested the lesion as hepatoblastoma, so he received preoperative chemotherapy. At the end of the preoperative chemotherapy, the tumor size and AFP level decreased. A right hepatectomy was performed. The pathologic examination of the specimen revealed mesenchymal hamartoma. Mesenchymal hamartoma of the liver with increased serum AFP levels may mimic hepatoblastoma if a cytological examination samples only the hepatocellular component of mesenchymal hamartoma. According to our knowledge, this is the first case of the mesenchymal hamartoma of the liver, which showed reduction in serum levels of AFP and involution of the tumor size by preoperative chemotherapy.Öğe A rare presentation of true hermaphroditism: an abnormal inguinoscrotal mass(MAGHIRA & MAAS PUBLICATIONS, 2007) Yurtcu, Mueslim; Aydogdu, Bahattin; Avunduk, Mustafa Cihat; Gunel, EnginThis study examined the differential diagnosis of inguinoscrotal masses and true hermaphroditism as well as incarcerated inguinal hernia in the differentia! diagnosis of abnormal inguinoscrotal masses. Inguinoscrotal masses are a rare presentation of true hermaphroditism. A child with an inguinoscrotal mass of the right groin and penoscrotal hypospadias was diagnosed. Our case suggested that abnormal inguinoscrotal masses occur in true hermaphroditism as well as incarcerated inguinal hernia. These congenital anomalies should be considered in the differential diagnosis of inguinoscrotal masses of the groin.
