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Öğe Association of vesicoureteral reflux and renal scarring in urinary tract infections(SOC ARGENTINA PEDIATRIA, 2018) Yilmaz, Isa; Peru, Harun; Yilmaz, Fatma H.; Sekmenli, Tamer; Ciftci, Ilhan; Kara, FatihIntroduction. The aim was to investigate the relationship between vesicoureteral reflux (VUR) and renal damage in non-febrile, febrile for the first time and recurrent urinary tract infection (UTI) patients. The secondary aim was to determine whether C-reactive protein (CRP) in febrile UTIs could be a predictor of renal scarring. Population and methods. This prospective study included non-febrile, febrile for the first time and recurrent pediatric UTI cases. The routine lab analyses comprised a complete blood count, urea, creatinine, fully automated urinalysis, urine culture and CRP analyses. All the participants were examined using urine ultrasonography subsequent to their UTI diagnosis, voiding cystourethrography (VCUG) after six weeks and Tc-99m dimercaptosuccinic acid (DMSA) static renal scintigraphy after six months. Results. There were included 47 children with non-febrile UTIs, 48 with fist febrile UTIs and 61 with recurrent UTIs. A statistically significant difference was found among the groups in terms of VUR and renal scarring (p = 0.001 and p = 0.011, respectively). A statistically significant difference was also found in terms of renal scarring between patients with and without VUR (p = 0.001). Moreover, a statistically significant difference was also present in relation to renal scarring (p<0.05)in patients with five-fold lower or higher CRP values than the accepted cut-off value (5mg/dl). Conclusion. The ratio of renal scars detected was found to be parallel to the VUR frequency. The higher the VUR grade, the more renal damage was found. A positive correlation between elevated CRP and renal scarring was determined, indicating the presence of scarring during the diagnosis of pyelonephritis.Öğe Çocuklarda anesteziye engel bir durum nedeniyle planlanan operasyonu ertelemenin maliyete etkisi(2013) Sekmenli, Tamer; Salman, Ahmet BediAmaç: Bu çalışmada elektif cerrahi girişimlerin ertelenme sebepleri ve getirdiği ek mali yükün önemini araştırmayı amaçladık. Yöntemler: Olgular, yaklaşık 2 yıllık süre içerisinde Atatürk Üniversitesi Tıp Fakültesi Çocuk Cerrahisi Poliklini- ğinde muayene olan ve elektif cerrahi gerektiren, tanı esnasında anestezi almasına engel görülmeyen ve operasyon için randevu verilmiş olgular arasından seçildi. Randevu günü anesteziye engel çeşitli nedenlerle operasyonu ertelenip, verilen ikinci randevu gününde opere olan 100 olgu çalışma grubuna dâhil edildi. Kontrol grubu, randevu günü yatırılıp, hemen ameliyat edilen 50 olgudan oluşturuldu. Bulgular: Operasyonu ertelemeli olarak gerçekleştirilen olguların % 41i Erzurum ili ve ilçelerinden, % 59u çevre illerden müracaat etmekteydi. Kontrol grubunda randevu gününde opere edilenlerin % 80i Erzurum ili ve ilçelerinden, % 20si dışarıdan gelen olgulardan oluşmaktaydı. Bu verilere göre çevre illerden müracaat edenlerde ertelenme oranı daha yüksekti. Operasyonun ertelenme yüzdesinin 2-4 yaş aralığında istatistiksel olarak anlamlı oranda arttığı gözlendi. Olgu başına ortalama gider çalış- ma grubumuzda 227 TL, kontrol grubunda 70 TL olarak kaydedildi. Sonuç: Üst solunum yolu enfeksiyonu, yoğun kış şartlarının yaşandığı Doğu Anadolu Bölgesinde özellikle çevre illerden müracaat eden olgularda sık karşılaşılan önemli bir erteleme sebebidir. Elektif cerrahi gerektiren olguların, yaşadıkları il merkezlerinde ameliyat edilmelerinin ya da bu amaçla yönlendirilecek olguların rutin muayene ve tetkiklerinin bulundukları yerleşim birimlerinde yapılarak anesteziye uygun olanların sevk edilmesinin aile bütçesi ve ülkemiz ekonomisi üzerine olumlu etkileri olabileceği sonucuna vardık.Öğe Çocuklarda ileusun nadir nedeni: Mezenter kisti torsiyonu(2015) Sekmenli, Tamer; Çiftçi, İlhan; Çelik, Zehra EsinMezenter kisti abdominal kitlelerin nadir nedenlerinden biridir. Karakteristik klinik bulgu vermemesi ve radyolojik görün - tüleme yöntemlerinin spesifk olmaması nedeniyle tanı koymak güçtür. Genellikle komplike olmamış olgularda abdominal distansiyonla kendini gösterir. 1.5 yaşında erkek hasta 2 gün öncesinde başlayan karın ağrısı safralı kusma şikayetlerinin devam etmesi üzerine tedavi için kliniğimize yatırıldı. Fizik muayenede abdominal distansyonu olan hastanın, ayakta direkt karın grafde multipl, keskin hava sıvı seviyeleri olup, distalde gaz yoktu. Hasta operasyona alındı. 10x10cm çapında büyük bir mezenter kist torsi - yonu nedeniyle mevcut kliniğin oluştuğu görüldü, komşuluğundaki meckel divertiküyle birlikte bu mesafedeki iskemik ans çıkarıldı ve ileal segment uç uca anastomoz yapıldı. Postop 4. günde beslenen hastanın 6. gün sorunsuz taburcusu edildi. Komplike olmamış mezenter kistlerini ultrasonda bağırsaklardan ayırt etmek oldukça zordur. Karın şişkinliği ile gelen ve olası karın içi sıvı artışı nedenleri saptanmayan hastalarda mezenter kistini ayırıcı tanıda düşünmek gerekir. Görüntüle - mede ultrason ve tomograf katkı sağlar. Ek anomali olabileceği unutulmamalıdır. Cerrahi eksizyon tedavi için yeterlidir.Öğe Çocuklarda özofagus yabancı cisimleri(2015) Sekmenli, Tamer; Çiftci, İlhan; Öncel, Murat; Sunam, Güven SadiSelçuk Üniversitesi Tıp Fakültesi Çocuk Cerrahisi ve Göğüs Cerrahisi Kliniklerince Ocak 2013 ile Ocak 2014 tarihleri arasında çocuk hastalarda özofagus'a yabancı cisim tanısıyla yatmış ve tedavi olmuş olguların retrospektif değerlendirilmesi amaçlandı. Gereç ve yöntem: Selçuk Üniversitesi Tıp Fakültesi Çocuk Cerrahisi ve Göğüs Cerrahisi Kliniklerince Ocak 2013 ile Ocak 2014 tarihleri arasında çocuk hastalarda özofagusda yabancı cisim tanısıyla yatmış ve tedavi olmuş olgular retrospektif değerlendirildi. Bulgular: Hastanemizde son 1 yıl içinde toplam 13 hasta, endoskopik olarak özofagusda yabancı cisim nedeniyle tedavi edildi. Ortalama yaş 4.8 yaş (6ay-12yaş) idi. Birinci darlıkda yabancı cisim 10 hastada olup 6'sında (%60) bulunan cisim paraydı. 2. darlık'da 2 olguda bu gıda artığı olup, bu iki olgunun birinde opere özofagus atrezi darlığı nedeniyle gıda artığı vardı, diğerinde ise koraziv madde içimi sonrası oluşan darlığa sekonder gıda artığı vardı. Sonuç: Özofagus yabancı cisimlerinin erken tanısı, tedavisi ciddi ve hayatı tehdit edebilecek komplikasyonlardan dolayı çok önemlidir. Yabancı cisimlerden para en sık görülümekte olup, özofagustaki yabancı cisim disk pil ise, erken dönemde çıkarılmalıdır. Çünkü ciddi yanık ve perforasyon yapabilirÖğe A Comparison of Holmium YAG Laser and Electrokinetic Lithotripter in Pediatric Ureteral Stone Treatment(KOWSAR CORP, 2017) Gunduz, Metin; Ciftci, Ilhan; Sekmenli, Tamer; Elmaci, Ahmet Midhat; Peru, HarunBackground: We evaluated endoscopic treatment of ureter stones with a holmium: yttrium-aluminum-garnet laser (Ho: YAG) lithotripter and an electrokinetic lithotripter (EKL) in children. Methods: Patients with ureteral stones, admitted to the pediatric surgery department of our hospital between November 2011 and January 2015, were evaluated retrospectively. Demographic data, initial symptoms, age, sex, stone size, preoperative renal pelvis diameter, use of a jj stent, and complications were recorded. We used a 4.5 Fr semirigid ureterorenoscope with a Ho: YAG lithotripter and an EKL to treat ureteral stones. Results: In patients treated with Ho: YAG lithotripter, a total of 17 ureteroscopic procedures were performed on seven female and six male children having a mean age of 7.62 +/- 4.46 years. Seven of these patients had right, five had left, and one had bilateral ureteral stones, with a mean diameter of 8.96 +/- 3.52 mm. Preoperative pelvis renalis diameter was 16.22 +/- 11.45 mm. A jj stent was used in all patients. Abdominal pain, hematuria, nausea-vomiting, and pollakiuria were the initial symptoms with complications such as hematuria, ureteral damage, infection, and spontaneous jj stent removal. In three cases, fragmentation was not successful and we needed a second session. In the EKL group, a total of 18 ureteroscopic procedures were performed on ten female and six male children with a meanage of 6.81 +/- 3.67 years. Six of these patients had right, eight had left and two had bilateral ureteral stones, with a mean diameter of 8.26 +/- 2.83 mm. Mean preoperative pelvis renalis diameter was 10.18 +/- 2.66 mm. No jj stent was used in these patients. Initial symptoms were abdominal pain, hematuria, nausea-vomiting, vomiting, dysuria, and pain in the costovertebral region, while hematuria was also among the postoperative complication. In two cases, fragmentation was not successful and an extra session was needed. Conclusions: Either of Ho: YAG lithotripter or EKL are effective and can be successfully used in ureteroscopic management of pediatric ureterolithiasis. The complication rate was slightly lower when an EKL was used.Öğe Comparison of the Radiologic and Clinical Findings of Adolescents With Breast Complaints(LIPPINCOTT WILLIAMS & WILKINS, 2018) Sekmenli, Tamer; Koksal, Hande; Gunduz, Metin; Bostanci, Hasan; Ciftci, Ilhan; Koksal, YavuzIntroduction:The American College of Radiology's Breast Imaging Reporting and Data System (BI-RADS) was developed to guide imaging-based surgical treatment in patients with breast cancer. Studies confirming the BI-RADS did not include adolescents. To evaluate the validity of this classification system in adolescents, we aim to investigate the relationship between the BI-RADS and pathology findings in adolescents. Methods:The medical data of 67 female adolescent patients, aged 12 to 18, referred to our clinic for breast-related complaints between 2013 and 2016 were reviewed retrospectively for demographic data and the results of radiologic and surgical pathologies. Results:The main underlying reasons for the visit at the clinic were fullness, tenderness, pain, and palpable masses. Of the 67 patients, 46 were enrolled in the study. After breast ultrasonography, patients whose complaints had diminished were subtracted from the follow-up. The mean age of the patients was 16 years (12 to 18y). The mean mass diameter size was 3.69 cm (0.9 to 15 cm), and the mean clinical follow-up was 65.3 days (11 to 1095 d). All the patients who were surgically intervened had benign pathology. Of the 21 surgically intervened patients with BI-RADS levels of >= 3, most had fibroadenomas. Conclusions:The BI-RADS classification-based treatment algorithm may not be valid in adolescents. In the present study, all patients with lesions with BI-RADS >= 3 levels had revealed benign pathologies. The BI-RADS classification may show an increased risk. However, to determine the need for a biopsy in adolescents, there is a need for larger-scale pediatric and adolescent studies using the BI-RADS classification.Öğe Determination of melatonin deprivation impact on sepsis with acute phase reactants(ACADEMIC PRESS INC ELSEVIER SCIENCE, 2020) Akbulut, Hatice Feyza; Vatansev, Hüsamettin; Sekmenli, TamerBackground: The aim of the present study is to determine the association of melatonin hormone level on CRP, Total Antioxidant Status, Leukocyte, Procalcitonin, and Malondialdehyde, all acute phase reactants in the dark and light cycle of rats with sepsis model. Materials and methods: In this study, 54 rats were divided into three groups. Whereas the first and third groups had a 12 h dark-light cycle, the second group was exposed to light for 24 h at 21 degrees C-22 degrees C for 10 d without any water and food restrictions. In the second and third groups, sepsis model was formed by cecal ligation and puncture (CLP) method at the end of 10th day, and blood samples were taken at the end of the 10th day. C-reactive protein, Malondialdehyde, Procalcitonin in the blood samples were analyzed by ELISA, and the levels of Total Antioxidant Status and leukocyte were determined by colorimetric method in the subsequent 12 and 24 h. Results: CRP values increased in the second group rats, which were kept continuously under light and had undergone CLP, from 288.8 mg/L to 584.0 mg/L at the end of the 12 h and the end of the 24 h, approximately, two times. In rats, which were kept under 12 h of light, 12 h of darkness, and applied CLP (group 3), these values increased from 416.9 to 619.1; an increase of 1.5 times. When assessed for MDA, it was determined that the differences between Group 2 and Group 3 were more prominent between 0 h and 12 h. While the MDA values in group 2 increased from 16.53 nmol/mL at the 12 h to 17.66 nmol/mL at the 24 h. However, MDA values did not yield statistically significant changes in the third group. Changes in the in PCT values were similar to the MDA values obtained. Increase coefficient of the PCT values between 0 h and 12 h in the second group 2 was 1.26; however, in the third group, it was negligible. Conclusions: An increase in the oxidative stress was observed in the rats that underwent CLP and melatonin deprivation via continuous 24 h light exposure for 10 d. Accordingly, deprivation of light is considered to be effective in sepsis treatment due to the increase in melatonin levels in intensive care unit patients. (C) 2019 Elsevier Inc. All rights reserved.Öğe Do JJ Stents Increase the Effectiveness of Extracorporeal Shock Wave Lithotripsy for Pediatric Renal Stones?(KARGER, 2017) Gunduz, Metin; Sekmenli, Tamer; Ciftci, Ilhan; Elmaci, Ahmet MidhatPurpose: We aimed to evaluate the effects of preoperative urinary catheterization in nephrolithiasis treatment with extracorporeal shock wave lithotripsy (SWL). Methods: Patients admitted to the Department of Pediatric Surgery for renal stones between June 2012 and June 2014 were evaluated retrospectively. Patients were divided into 2 groups based on JJ stent placements. Group 1 did not receive JJ stents, while group 2 did. The recorded demographic data for each group included age, gender, stone size, location, sessions, and complications. The Elmed Complit ESWL system was used with 11-13 kV, and 1,000-1,200 shots in patients 2-4 years of age, and 11-14 kV, and 1,000-1,500 shots for patients over 4 years. Results: In group 1, 18 sessions of SWL were performed on 8 female and 2 male children with a mean age of 4.5 (range 2-12) years and stone diameter of 9 (range 7-15) mm. The locations of the renal stones were in the upper pole in 1 patient, 7 in the lower pole, and 2 in the pelvis renalis. Postoperatively, 1 patient had hematuria, 2 had dysuria, and one had a stone in the external urethral meatus. Eighty percent of patients were stone free; there were no fragmentations in 2 patients, and 1 patient discontinued treatment. In group 2, 15 SWL sessions were performed on 5 female and 5 male children aged 4 (range 3-5) and the stone diameter was 9 (range 7-16) mm. The locations of the renal stones were in the upper pole in 6 patients, in the lower pole in 3 patients, and in the ureteropelvic junction in one patient. JJ stents were placed in all patients preoperatively. Postoperatively, 3 patients had hematuria and one had dysuria. At the end of the study, all of the patients were stone free. Statistically, there were no differences in age, gender, stone size, location, and the number of sessions. Conclusions: Our results indicate that SWL without preoperative ureteral stenting is an effective and safe procedure that can be carried out in the pediatric population. Preoperative JJ stenting is unnecessary in patients, especially in those with smaller stone diameters. (C) 2016 S. Karger AG, BaselÖğe Duodenal atresia and hirschsprung disease in a patient with down syndrome(2011) Sekmenli, Tamer; Koplay, Mustafa; Alabalık, Ulaş; Kıvrak, Ali SamiDown sendromu olan iki günlük yenidoğan kız hasta kusma şikayeti ile hastanemize başvurdu. Fizik muayenede Down sendromu’nun tipik fiziksel görünümü dışında özellik yoktu. Abdominal radyografide, duodenal obstrüksiyon için karakteristik olan çift kabarcık işareti izlendi ve hasta duodenal atrezi ön tanısı ile ameliyat edildi. Ancak operasyon sırasında, Hirschsprung hastalığından şüphelenildi, kesin tanısı rektal biyopsi ile doğrulandı. Bu çalışmada, biz Down sendromlu bir hastada Hirschsprung hastalığı ile birlikte olan duodenal atrezi olgusunu tanımladık. Radyolog ve çocuk cerrahları doğru tanı ve tedavi için bu durumu göz önünde bulundurmalıdır.Öğe The effect of the trendelenburg position on the internal jugular vein's cross-sectional area in overweight and obese children(E-CENTURY PUBLISHING CORP, 2016) Sekmenli, Tamer; Nayman, Alaaddin; Onal, Ozkan; AriYuca, Sevil; Apiliogullari, Seza; Ciftci, Ilhan; Celik, Jale BengiBackground: The Trendelenburg position is a common technique used during internal jugular vein (IJV) cannulation in pediatric patients. There has been some speculation as to the correlation between Trendelenburg positioning and increases in the cross-sectional area (CSA) of the IJV in obese child patients. In the present study, we use ultrasound (US) measurements to assess and determine the predictivity of Trendelenburg positioning on the CSA of the right IJV in obese child patients. Methods: The researchers of this studyenrolled 30 cases from the American Society of Anesthesiologists (ASA) II of patients under the age of 18 who underwent ultrasonographic examination between December 2013 and March 2015. US images of the right IJV of each patient were obtained in a transverse orientation at the cricoid level. The CSAs of the right IJVs were measured undert wo different conditions applied in a random orderin a sealed envelope: State 0, in which the table was flat (no tilt) and the patient lay in the supine position; and State T, in which the operating table wastilted 20 degrees to the Trendelenburg position. Results: The change in the CSA of the IJV from the supine to the Trendelenburg position (0.99 cm(2) vs 0.96 cm(2)) was not significant. In contrast, the CSA of the right IJV decreased in 14 of the 30 patients (9 of the 14 were female). Conclusions: The Trendelenburg position does not cause the mean CSA of the right IJV in obese child patients to increase; in fact, the position causes the CSA in some patients to decrease. The researchers of this study do not support the use of the Trendelenburg position for IJV cannulation in obese child patients.Öğe The effects of melatonin and colchicine on ischemia-reperfusion injury in experimental rat testicular torsion model(W B SAUNDERS CO-ELSEVIER INC, 2017) Sekmenli, Tamer; Gündüz, Metin; Öztürk, Bahadır; Karabağlı, Pınar; Çiftçi, İlhan; Tekin, Gülsüm; Yılmaz, MustafaPurpose: The aim of the present study is to investigate the efficiency of colchicine and melatonin in an experimental rat testicular torsion model in the light of histological and biochemical data. Methods: A total of 34 Wistar albino male rats were randomly divided into 5 groups as: Group C (control, n= 6), Group S (sham; underwent only left scrotal exploration, n= 7), Group TD (torsion and detorsion; 6 h of ischemia and 7 days of reperfusion, n= 7), Group TD/M (TD + Melatonin; 6 h of ischemia and 7 days of reperfusion and 7 days of 17 mg/kg intraperitoneal melatonin per day, n = 7), group TD/Col (TD + Colchicine; 6 h of ischemia and 7 days of reperfusion and 7 days of 1 mg/kg oral colchicine per day, n = 7). Histopathologic evaluation of seminiferous tubule deterioration was performed by Johnsen's scoring system. Total antioxidant status (TAS), total oxidant status (TOS), IL-6, TNF alpha levels were analyzed in each group. Results: The histopathologic scores, total antioxidant status (TAS), total oxidant status (TOS), IL-6, TNF alpha levels in groups C and TD/Col were significantly lower than groups TD and TD/M (P < .001). Conclusion: Our study results revealed that colchicine reduced testicular ischemia-reperfusion injury in experimental rat testis torsion model. Although detorsion of testis is crucial for the preserving the testicular viability, antioxidant and anti-inflammatory treatment modalities like colchicine might help to reduce ischemia-reperfusion injury in detorsed testis. (C) 2017 Elsevier Inc. All rights reserved.Öğe Esophageal Stricture in a Child With Habit of Acidic Drinks(LIPPINCOTT WILLIAMS & WILKINS, 2017) Erdur, Omer; Sekmenli, Tamer; Ciftci, Ilhan; Ozturk, KayhanA 12-year-old boy with Down syndrome referred Dysphagia was especially with solid foods and had a 12-month history. When he was 7, he had started to drink Coke and from that time he had a Coke drinking habit. Every day he was drinking more than 2 L Coke and was eating meals in small amounts. Investigations of the patient revealed esophageal stricture related to acidic drink habit and gastro-oesephageal reflux. The patient was treated with recurrent bouginage, antireflux medication, and nutrional support. The patient became symptom free from 13 months and gained weight. The clinicians should take the nutrition habits into consideration when evaluating the esophageal stricture patients.Öğe Giant Ovarian Mucinous Cystadenoma in Premenarchal Girl(2016) Sekmenli, Tamer; Ciftci, IlhanOvarian cysts are an extremely common gynecological problem in adolescent. Ovarian Mucinous cystadenoma are rare in children. A 14-year-old presented with a history of increasing abdominal distension and pain for approximately six months. An adnexal mass measuring 24x18x13 cm was detected by abdominal ultrasonography and computed tomography. She underwent laparotomy and after surgical removal. Histopathology findings showed that the tumor was diagnosed as a mucinous cystadenoma (MCA) of the ovary. Epithelial tumors should not be forgotten in the differential diagnosis. We present a case of giant MCA of the right ovary in a 14-year-old pubertal girl and a review of the supporting literature.Öğe İnvajinasyon nedeniyle opere olan Henoch-Schönlein purpuralı bir olgu sunumu(2014) Sekmenli, Tamer; Akbulut, Hikmet; Emiroğlu, Halil HaldunHenoch-Schönlein purpurası karın ağrısı, kusma, melena, artralji, purpurik döküntü ve hematüri ile seyreden; çocukluk çağında en sık görülen, küçük damar vasküliti ile karakterize bir hastalıktır. İlkbahar ve sonbahar aylarında daha sık görülen bu hastalığın tanısı klinik verilerle konulur ancak nadiren tanı için biyopsi gerekebilir. Hastalığın akut dönemde seyrini gastrointestinal tutulum belirler- ken kronik dönemde böbrek tutulumu belirler. Hastalık çoğu kez kendini sınırlasa da invajinasyon gibi operasyona neden olabilecek durumlara da yol açabilir. Bu olgu; Henoch-Schönlein purpurası tanısı alan hastalarda gelişebilecek, çoğu zaman cerrahi gerektiren bir bulgu olan invajinasyona dikkat çekmek amacıyla yazılmıştırÖğe İstemli kilo verme sonrasında gelişen süperior mezenterik arter (Wilkie) sendromu: Nadir bir olgu sunumu(2016) Sekmenli, Tamer; Gündüz, Metin; Hidayetoğlu, Semiha; Emiroğlu, Halil HaldunWilkie sendromu akkiz bir hastalık olup, ergenlerde hızlı büyüme ve istemli diyet girişimleri sonucunda retroperitoneal yağ yastığını azaltarak, süperior mezenterik arter sendromunu tetikleyebilir. Biz öncelikle istemli kilo kaybı sonrasında gelişen, istemsiz kusma ve kilo kaybı semptomlarıyla gelen 15 yaşında kız hastamızın, kliniğini ve tedavi sürecini literatür bilgileri eşliğinde sunmayı amaçladık.Öğe Little negligence leading to irreparable harm: Thinner burns(2017) Arslan, Kemal; Atay, Arif; Sekmenli, Tamer; Gunduz, Metin; Dogru, Osman; Ciftci, IlhanThe aim of the present study is to evaluate the epidemiology and outcome of paint thinner induced burn injuries at a local burn center. A retrospective analysis of 55 patient paint thinner thermal burn cases was conducted. Relevant patients’ data such as age, sex, etiologic factors, burn extent and localization, employed methods of treatment, hospitalization period, and results were evaluated in retrospect from patients’ records. 50 male and five female patients with a mean age of 26,78 years participated in the presented study. Kindling fire with paint thinner was the most frequent etiologic factor. Total body surface burn area was 22,5 % . The mean hospitalization period of the survivors was 24 days. Early excision and split-thickness sking grafting was applied in 22 patients. The remaining 26 patients were treated with topical agents. Total mortality was only 7 (12.7%). These patients had paint thinner induced burned body surfaces of 60 % with accompanying inhalation injuries. Paint thinner may cause catastrophic thermal injuries even with terminal outcomes and should therefore never used to kindle a fireÖğe Massive hemorrhage: a late complication of replacement percutaneous endoscopic gastrostomy: case report(SOC ARGENTINA PEDIATRIA, 2018) Sekmenli, Tamer; Gunduz, Metin; Akbulut, Hikmet; Emiroglu, H. Haldun; Koplay, Mustafa; Ciftci, IlhanPercutaneous endoscopic gastrostomy (PEG) is used as an alternative to enteral/nasoenteral feeding in situations where long-term oral feeding is ineffective or not tolerated. It is mostly preferred in patients with neurological conditions and also to support nutrition in patients with congenital heart diseases, cystic fibrosis, inflammatory bowel disease, and various oropharyngeal diseases. Although it is easily applicable compared to many invasive procedures, it has complications ranging from wound infection to death. PEG requires experienced medical personnel, appropriate prophylactic antibiotics and exhaustive information to the patients or their families about the procedure and subsequent care. We present a rare but important complication during the replacement of the gastrostomy tube subsequent to the "cut and push" method. The bumper portions, which should move to the distal end of the stomach, moved upwards to the proximal esophagus, caused a deep ulcer in the esophageal mucosa and a massive hemorrhage.Öğe Modified Hinderer's Technique for Serious Proximal Hypospadias with Ventral Curvature: Outcomes and Our Experience(UROL & NEPHROL RES CTR-UNRC, 2019) Ciftci, Ilhan; Gunduz, Metin; Sekmenli, TamerPurpose: Hypospadias is a congenital anomaly that includes deficient ventral structure of the penis. Proximal hypospadias cases make up 20% of all hypospadias cases. The choice of operative technique for hypospadias repair depends on the severity, and it is influenced by the surgeon's experience and perception of where priorities should lie. Several other factors interact to determine the type of repair, such as meatal site, presence of chordee, availability of the prepuce, and quality of the urethral plate and in addition surgeon's experience affects the type of repair. Materials and Methods: The treatment records of 42 penoscrotal and perineal hypospadias cases that were treated in our clinic from 1998 to 2017 were reviewed retrospectively. Cases with penoscrotal and perineal meatus were included in the study at the beginning of the urethroplasty. All cases had surgical intervention via Hinderer's technique. Results: Acceptable cosmetic results were obtained in 37 (85%) patients with an objective scoring system (HOSE) for evaluating the results of hypospadias surgery score. The mean score after surgery was 14.8. Fistula and wound breakdown occurred in 7 out of the 42 cases. Conclusion: In conclusion, the modified Hinderer's technique is a safe and reliable technique for both proximal and perineal hypospadias. Low complication rates and application in a single surgical session increase the comfort of both the patient and the surgeon.Öğe Multiple Intestinal Perforation and Necrosis due to Magnet Ingestion(AVES, 2016) Sekmenli, Tamer; Ciftci, IlhanAmong the few foreign bodies swallowed, multiple magnets are very rare. Ingestion of Multiple Magnets may lead to a number of dire complications. The present case report is about the ingestion of multiple singing magnets by 4-year-old child leading to intestinal segmental necrosis and perforations.Öğe Primer retroperitoneal tümörlerde klinik deneyimlerimiz(2018) Sekmenli, Tamer; Çiftçi, İlhan; Köse, Doğan; Köksal, Yavuz; Sekmenli, NevinAMAÇ: Bu çalışmada Selçuk Üniversitesi Tıp Fakültesi2011-2013 tarihleri arasında Çocuk Onkoloji AnabilimDalı’nda takipli ve Çocuk Cerrahisi Kliniğince opere edilentoplam 22 retroperitoneal tümörlü hastanın kayıtlarıretrospektif olarak değerlendirildi.GEREÇ VE YÖNTEM: Retroperitoneal tümör nedeniyle2011-2013 arasında cerrahi girişim yapılan olgulargeriye dönük olarak incelendi. Primer retroperitonealtümörü kontrol altına alınan, başka uzak organ metastazıolmayan cerrahi tedavi uygulanan olgular çalışmayadahil edildi. Yaş, cinsiyet, primer tanı anında tümör evresi,cerrahi tedavi yöntemi, patolojik tanı ve takip açısındanolguların dosyaları retrospektif olarak değerlendirildi.BULGULAR: Olgularımızın 9’u (%40) erkek, 13’ü (%60)kadındı. Ortalama yaş erkeklerde 71 ay (3-132), kadınlarda37 ay (6-204) idi. Histopatolojik olarak olguların 15(%68)’i nöroblastom, 4’ü (%18.5) Wilms tümörü, 1’i(%4.5) embriyonal rabdomyosarkom, 1’i (%4.5) berrakhücreli sarkom, 1’i (%4.5) malign sinir kılıfı tümörü olarakdeğerlendirildi. Tanı anında olguların 8’i (%36) evre I, 7’si(%32) Evre III, 7’si (%32) evre IV safhasındaydı.SONUÇ: Olgularımızın %68’i nöroblastom olup,tanı anında hastaların %64’ü evre III ve evre IV idi.Anatomik lokalizasyonları nedeniyle ileri evrelere kadarsessiz tümörler olan retroperitoneal tümörlerin çoğunöroblastomdur ve genellikle ileri evrelerde tanı alırlar.
