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    Caudal anesthesia for minor subumbilical pediatric surgery: a comparison of levobupivacaine alone and levobupivacaine plus sufentanil
    (ELSEVIER SCIENCE INC, 2008) Erol, Atilla; Tavlan, Aybars; Tuncer, Sema; Topal, Ahmet; Yurtcu, Mueslim; Reisli, Ruhiye; Otelcioglu, Seref
    Study Objectives: To compare the postoperative analgesic efficacy and duration of analgesia after caudal levobupivacaine 0.20% with and without the addition of sufentanil 0.5 mu g kg(-1). Design: Prospective, randomized study. Setting: University teaching hospital. Patients: 40 ASA physical Status I pediatric Patients, aged one to 7 years, who were scheduled for elective minor subumbilical surgery. Interventions: Patients were divided into two groups to receive either a single caudal injection of one mL kg(-1) levobupivacaine 0.20% (Group L) or levobupivacaine 0.20% plus sufentanil 0.5 mu g kg(-1) (Group LS). Measurements: Analgesia (Children and Infants Postoperative Pain Scale score), motor block (Motor Blockade Scoring), and side effects were assessed at predetermined time points during the first 24 postoperative hours. Main Results: The Children and Infants Postoperative Pain Scale scoring at the first hour was significantly lower in Group LS than in Group L. No significant differences were found between the two groups for Pain scores at two, three, 4, 5 6 9 12, and 24 hours. Degree of motor block was comparable between the two groups. Conclusion: The effect of adding sufentanil to caudal levobupivacaine on postoperative pain scores is brief after elective minor subumbilical surgery in children. (C) 2008 Elsevier Inc. All rights reserved.
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    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, Engin
    Background/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.
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    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, Engin
    Purpose: 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.
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    A rare presentation of true hermaphroditism: an abnormal inguinoscrotal mass
    (MAGHIRA & MAAS PUBLICATIONS, 2007) Yurtcu, Mueslim; Aydogdu, Bahattin; Avunduk, Mustafa Cihat; Gunel, Engin
    This 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.