The role of hepcidin and its related genes (BMP6, GDF-15, and HJV) in rats exposed to ischemia and reperfusion

Background/aim: To determine the roles of hepcidin and its related genes in a renal ischemia/reperfusion model. Materials and methods: A total of 20 Wistar albino rats were equally divided into 2 groups: Group I was the control group and Group II was the ischemia and reperfusion (I/R) group (60 min of ischemia + 48 h of reperfusion). I/R was performed on the left kidneys of these rats and then the I/R-treated kidneys were removed. The levels of serum biochemical markers were evaluated after renal I/R. The expression levels of hepcidin-linked genes [growth differentiation factor 15 (GDF-15), bone morphogenetic protein 6 (BMP6), and hemojuvelin (HJV)] were also measured by RT-PCR technique. In addition, the tissues were evaluated histopathologically. Results: No significant association was found between renal dysfunction and I/R when compared to biochemical parameters (P > 0.05). However, differences in platelet values were statistically significant (P < 0.05). Expression levels of GDF-15, BMP6, and HJV genes increased, but this increase was not statistically significant. In addition, histopathological evaluation was performed using hematoxylin and eosin stain. This showed a significant relationship between the control group and I/R group for ischemic and nonischemic kidney scoring. Conclusion: Hepcidin and BMP6, HJV, and GDF-15 should be taken into account when investigating the process of I/R.Background/aim: To determine the roles of hepcidin and its related genes in a renal ischemia/reperfusion model. Materials and methods: A total of 20 Wistar albino rats were equally divided into 2 groups: Group I was the control group and Group II was the ischemia and reperfusion (I/R) group (60 min of ischemia + 48 h of reperfusion). I/R was performed on the left kidneys of these rats and then the I/R-treated kidneys were removed. The levels of serum biochemical markers were evaluated after renal I/R. The expression levels of hepcidin-linked genes [growth differentiation factor 15 (GDF-15), bone morphogenetic protein 6 (BMP6), and hemojuvelin (HJV)] were also measured by RT-PCR technique. In addition, the tissues were evaluated histopathologically. Results: No significant association was found between renal dysfunction and I/R when compared to biochemical parameters (P > 0.05). However, differences in platelet values were statistically significant (P < 0.05). Expression levels of GDF-15, BMP6, and HJV genes increased, but this increase was not statistically significant. In addition, histopathological evaluation was performed using hematoxylin and eosin stain. This showed a significant relationship between the control group and I/R group for ischemic and nonischemic kidney scoring. Conclusion: Hepcidin and BMP6, HJV, and GDF-15 should be taken into account when investigating the process of I/R

Laparoscopy-Assisted Percutaneous Cholangiography in Biliary Atresia Diagnosis: Comparison with Open Technique

Introduction. Biliary atresia is a surgical cause of prolonged jaundice, which needs to be diagnosed with cholangiography that has traditionally been performed via laparotomy. Laparoscopic assistance has lately been introduced to avoid unnecessary laparotomy. We aim to evaluate the benefits of the laparoscopy-assisted cholangiography and compare it to the traditional procedure via laparotomy. Patients and Method. The medical records of the cases who had undergone cholangiography for prolonged jaundice between 2007 and 2014 were analyzed. The patients were grouped according to cholangiography technique (laparotomy/laparoscopy). The laparoscopy and laparotomy groups with patent bile ducts were focused and compared in terms of operation duration, postoperative initiation time of enteral feeding, and full enteral feeding achievement time. Results. Sixty-one infants with prolonged jaundice were evaluated between 2007 and 2014. Among the patients with patent bile ducts, operation duration, postoperative enteral feeding initiation time, and the time to achieve full enteral feeding were shorter in laparoscopy group. Conclusion. Laparoscopic cholangiography is safe and less time-consuming compared to laparotomy, with less postoperative burden. As early age of operation is a very important prognostic factor, laparoscopic evaluation should be an early option in work-up of the infants with prolonged jaundice with direct hyperbilirubinemia, for diagnosis/exclusion of biliary atresia

Çocukluk çağında tiroidin cerrahi sorunları

TEZ909Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 1991.Kaynakça (s. 52-57) var.57 s. ; 30 cm.

Congenital mesoblastic nephroma ( A case report )

Mezoblastik nefroma infantların en yaygın benign renal neoplazisidir. Ancak rutin patolojik materyal içinde oldukça seyrek rastlanır. En sık yenidoğan periyodunda veya erken infant döneminde görülür. Yaşamın ilk 3 ayında görülen tüm renal tümörlerin %90'ını oluşturur. Tümör genellikle abdominal bir kitle olarak tespit edilir. Total eksizyon veya nefrektomi tedavi için yeterlidir. Sunulan olgu doğduğunda karnın sağ tarafında şişlik farkedilen 36 günlük erkek bebektir. BT ve USG'de böbrek üst polde 5x6 cm boyutunda kitle saptanmıştır. Hastaya sağ nefrektomi ve sağ sürrenalektomi uygulanmıştır. Olgumuz literatür bilgileri ışığında tartışılmıştır.Although mesoblastic nephroma is the most common benign renal neoplasia of infancy, accounting for more than 90% of all renal tumors seen in the first 3 months of life; it is rarely encountered in routine pathologic materials. Tumor is usually detected as an abdominal mass. Total excision or nephrectomy is curative. Our case is a 36 days old male infant. A mass was noticed in right abdominal region at birth. The computed tomography and ultrasonography showed a 5x6 cm. mass in the upper pole of kidney. Right nephrectomy and adrenalectomy was perfomed. The case is discussed in the view of the literature

A rare anomaly-aplasia cutis congenita: A report of three patients

Aplaziya kütis konjenita (AKK) cildin lokalize veya geniş alanlar şeklinde yokluğu ile karakterize ender bir anomalidir. En sıklıkla skalpta görülmesine karşın, tek veya multipl lezyonlar şeklinde vücudun herhangi bir yerinde bulunabilir. Hastalığa diğer konjenital malformasyonlar eşlik edebilir. Küçük defektler kendiliğinden iyileşebilirken, büyük lezyonlar cerrahi onarıma gerek duyar. Anabilim Dalımızda AKK'lı üç hasta tedavi edildi. Lezyonları karın cildinde olan ilk iki hasta (Hasta 1 ve 2) üçüz eşleri olup, üçüzlerin üçüncüsü 12 haftalık fetüs papiraseus şeklindeydi. Skalpta simetrik cilt defektine sahip son hastada (Hasta 3) ek olarak omfalosel, sakral dermal sinüs, mikroftalmi, polidaktili, bilateral intraabdominal testis, düşük kulaklar, sağ pektoral kas anomalisi ve üreteral atrezili sol multikistik displastik böbrek vardı. Bu ender anomaliye sahip üç hasta sunuldu ve tartışıldı.Aplasia cutis congenita (ACC) is a rare disease characterized by localized or widespread areas of absent skin at birth. Although the scalp is the most common site, ACC may present with single or multipl lesions in any region of the body. It is at times associated with other congenital malformations. Small defects may recover spontaneously but large lesions require operative coverage. Three patients with ACC were treated at our Department. The first two patients with ACC of the abdomen (Patient 1 and 2) were triplets and whose birth had been accompanied by the delivery of a dead 12 week old fetus papyraceus. Patient 3 with simetrical ACC of the scalp had other congenital malformations: omphalocele, sacral dermal sinus, microphthalmia, polydactyly, bilateral cryptorchidism, low - set ears, left multicystic displastic kidney with ureteral atresia, abnormality of right pectoral muscle. Three cases of this rare entity are presented and discussed

First Identified Case in Literature: Association of Achalasia and Celiac Diseases

WOS: 000376566600033Celiac disease has been shown to cause problems related to gastrointestinal system motility such as reduction of the esophageal sphincter pressure and prolongation of gastric emptying time. Achalasia disease is a motor disorder that is characaterized by the absence of esophageal peristalsis and by incomplete relaxation of the lower esophageal sphincter. Association of achalasia and celiac diseases has not been reported yet. Our patient with growth and developmental retardation had vomiting effects which lasted for 3 years. Celiac disease was diagnosed serologically and histopathologically in our patient; we determined achalasia disease with esophagoscopic examination, upper gastrointestinal system contrast study, and esophageal manometer. Esophageal balloon dilatation was applied. This case is presented because of the interesting association between celiac disease and achalasia disease

Cash vs. net working capital as strategic tools for the long-term relation between bank credits and liquidity: Inequalities in Turkey

12th International Strategic Management Conference (ISMC) -- OCT 28-30, 2016 -- Antalya, TURKEYCash and net working capital are among corporate liquidity indicators which are generally compared with the short-term bank credits. The study reveals both the short and the long-term bank credits and their reflections on the cash, working capital and the short-term liabilities of the businesses in the long-run. The bank credits as a financing resource of the real sector (nonfinancial) businesses in Turkey with their effects on cash and net working capital are assessed in order to make comparisons on the total data of the businesses selected from all of the sectors for the case of Turkey in the long-run (1996-2014) in the study. The study endorses the strategic relation between bank credit usage and liquidity levels of the businesses so as to improve timely accessibility and creditability. In the findings, we confirm that cash-cash equivalents and net working capital have impacts on the level of bank credits in the long-term. Finally, the study endorses the strategic relation of bank credit and liquidity by inequalities. (C) 2016 The Authors. Published by Elsevier Ltd.Int Strateg Management & Managers Asso

Biliary Atresia Splenic Malformation Syndrome: A Single Center Experience

Introduction: The cause of biliary atresia (BA) is not understood exactly as well as biliary atresia splenic malformation (BASM) syndrome. BA is destructive biliary fibrosis; the etiology may be multifactorial. Association of cytomegalovirus (CMV) and BA have been shown in many reports but CMV and BASM have not been mentioned in the literature. So we aimed to report BASM experiences, an association of CMV infection and need of duodenoduodenostomy if preduodenal portal vein exists. Materials and Methods: The data were collected retrospectively from Cukurova University which is one of the largest tertiary hospitals in Turkey between 2005-2017. The patients of sex, age, blood chemistry counts, TORCH infections blood parameters, BA types, operational findings and mortality were noted. Results: In total, 59 BA patients were diagnosed between 2005- 2017. Seven of them were classified as BASM. The median age of them was 60 days (45-90 days). Three of them were girl and 4 of them were male in gender. The main complaint of whole patients was jaundice. The jaundice of 6 patients began since birth. One of them began at 20 days-age. Median total / direct blood bilirubin levels were 9.6 / 5.4 mg/dl. Median values of liver function tests; ALT, AST and GGT were 77 IU/L, 201 IU/L and 607 IU/L respectively. Five of the patients showed positive results for anti-CMV immunoglobulin M. All had positive anti-CMV Ig G and anti-toxoplasmosis Ig G. Evaluation of the types of BA revealed that one patient had type 2, while all others had type 3. Four of BASM patients had polysplenia and one had asplenia. Five of them had a preduodenal portal vein. All of them had midgut malrotation. One had inferior vena cava interruption. One had hepatic artery anomaly which was originated from SMA. The median time of follow-up was 4 years (1-5 years). All of them are alive and 1 required liver transplantation. Conclusion: BASM should be kept in mind by the surgeon for the requirement of additional surgical procedures such as Ladd procedure, duodenoduodenostomy with Kasai Porto-enterostomy. Duodenoduodenostomy may be performed when the existence of preduodenal portal vein. Further research is recommended for CMV infection and BASM

Yenidoğan Yoğun Bakım Ünitesindeki Bebeklerin Nekrotize Enterokolit Risk Faktörlerinin Karşılaştırılması

Amaç: Nekrotize enterokolit prematüre bebeklerde rastlanan en önemli problemlerden biridir. Yenidoğan bakım ünitesindeki bebeklerin %1-5'inde görülmekte olup gebelik yaşı ve doğum ağırlığı ile ters orantılıdır. Materyal ve Metod: Bu çalışmada Çukurova Üniversitesi Yenidoğan Bakım Ünitesinde 1 Ocak 2001- 31 Ocak 2004 yılları arasında nekrotize enterokolit tanısı konan 31 bebek ile aynı gebelik yaşı ve doğum ağırlığına sahip kontrol grubu karşılaştırmalı olarak değerlendirilmiştir. Bulgular: Bu dönemdeki nekrotize enterokolit görülme sıklığı 1,4 (31/ 2214 kabul edilen hasta) olarak belirlenmiştir. Ortalama gebelik yaşı 30,5±3,2 hafta , Ortalama doğum ağırlığı 1331±384 gramken %71'i 32 gebelik haftasından erken ve %67,7'si 1500 gr'ın altında idi. NEC semptomlarının saptanama süresi ortalama 11,2±10 gündür. Bebeklerin 26'sı (%83,9) nekrotize enterokolit belirtileri ortaya çıktığında düzenli olarak besleniyorlardı. beslenme sırasında NEC'e rastlanmıştır. Walsh ve Kliegman sınıflandırmasına göre; bebeklerin 19'u 1. Evrede (17'si 1a, ikisi 1b), Üçü 2a evresinde, dokuzu üçüncü evrede (Yedisi 3b) sınıflandırılmıştır. Kan kültürünün 7 (%22.6) bebekte pozitif çıktığı ve bunların beşinde gram negatif mikroorganizmalar olduğu tespit edilmiştir. Bebeklerin onbirinde (%35.5) ölüm gerçekleştiği, 12'sininde taburcu olduğu saptanmıştır. Hipoksi, respiratuar distres sendromu, intraventrikuler kanama ve umbilikal katater uygulaması nekrotize enterokolitteki önemli risk faktörleridir. Trombositopeni, lökopeni, ve C-reaktif proteinindeki artış nekrotize enterokolitli grupta oldukça yükselmiştir. Emzirme kontrol grubunda oldukça yüksektir. Sonuç: Nekrotize enterokolit yenidoğan bakım ünitelerinde en sık hastalık ve ölüme yolaçan nedenlerden biridir. Az miktarlarda erken emzirme, sütün yavaşça miktarının artırılması, antenatal steroidler ve hijyen kurallarının önemsenmesiyle bu hastalığın gelişiminin önüne geçilebilir.Purpose: Necrotizing enterocolitis is one of the important problems of premature infants. The incidence is about 1-5% in infants followed in neonatal care units and inversely related to gestational age and birth weight. Materials and Methods: In this study, 31 infants with necrotizing enterocolitis and 31 infants with similar gestational age and birth weight as control group hospitalized in Cukurova University Neonatal Care Unit between 1 January 200131 January 2004 were evaluated. Results: The incidence of necrotizing enterocolitis in this period was 1.4 (31/2214 admission). Mean gestational age was 30.5 ± 3.2 weeks , mean birth weight was 1331 ± 384 grams while 71% was younger than 32 gestational weeks and 67.7% was under 1500 grams. The signs of NEC were detected at a mean of 11.2 ± 10. days. Twenty-six (83.9%) were being fed at the time of the necrotizing enterocolitis signs appeared. According to the Walsh and Kliegman classification, 19 (61.3%) infants were in stage 1 (17 were 1a, 2 were 1b); 3 (9.6%) infants were in stage 2a, 9 (%29.1) infants were in stage 3 (7 were in 3b). Blood culture was positive in 7 (%22.6) infants with predominance of gram negative microorganisms (5 infants). Eleven (%35.5) infants were exitus, 12 were discharged. Hypoxia, respiratory distress syndrome, intraventricular hemorrhage and umbilical catheterization were significant risk factors in necrotizing enterocolitis . Thrombocytopenia, leucopenia and high C-reactive protein levels were significantly high in necrotizing enterocolitis group. Breast feeding is significantly high in control group. Conclusion: Necrotizing enterocolitis, is a leading cause of morbidity and mortality in neonatal intensive care units. Early breast feeding with small amounts, increasing amount of milk slowly, antenatal steroids, caring hygiene rules can prevent the development of it

Clues to the diagnosis of biliary atresia in neonatal cholestasis

Background/Aims: The purpose of this study was to identify important clues in differentiating biliary atresia (BA) from causes of neonatal cholestasis other than BA (non-BA) and establishing the reliability of current tests.Materials and Methods: Thirty-four patients with BA and 27 patients with non-BA cholestasis being monitored at the Çukurova University Medical Faculty, the Pediatric Gastroenterology Department and the Pediatric Surgery Department between 2009 and 2015 were retrospectively assessed. Results: Cases of early onset jaundice, acholic stool, gamma-glutamyl transferase (GGT) elevation, and absent or small gallbladder on ultrasonography (USG) were greater in the BA group, while the levels of consanguinity and splenomegaly were higher in the non-BA group. The highest positive predictive value and specificity was determined for a GGT level greater than 197 in addition to absent or small gallbladder on USG and acholic stool in the BA group. Moreover, the presence of acholic stool (97%) exhibited the highest sensitivity and accuracy in the diagnosis of BA.Conclusion: Pale stool, GGT elevation, and absent or small gallbladder on USG are the most reliable tests for diagnosing BA. We recommend that intraoperative cholangiography should be performed without waiting for further test results when a neonate or infant presents with acholic stool, high GGT values, and absent or small gallbladder on abdominal USGBackground/Aims: The purpose of this study was to identify important clues in differentiating biliary atresia (BA) from causes of neonatal cholestasis other than BA (non-BA) and establishing the reliability of current tests.Materials and Methods: Thirty-four patients with BA and 27 patients with non-BA cholestasis being monitored at the Çukurova University Medical Faculty, the Pediatric Gastroenterology Department and the Pediatric Surgery Department between 2009 and 2015 were retrospectively assessed. Results: Cases of early onset jaundice, acholic stool, gamma-glutamyl transferase (GGT) elevation, and absent or small gallbladder on ultrasonography (USG) were greater in the BA group, while the levels of consanguinity and splenomegaly were higher in the non-BA group. The highest positive predictive value and specificity was determined for a GGT level greater than 197 in addition to absent or small gallbladder on USG and acholic stool in the BA group. Moreover, the presence of acholic stool (97%) exhibited the highest sensitivity and accuracy in the diagnosis of BA.Conclusion: Pale stool, GGT elevation, and absent or small gallbladder on USG are the most reliable tests for diagnosing BA. We recommend that intraoperative cholangiography should be performed without waiting for further test results when a neonate or infant presents with acholic stool, high GGT values, and absent or small gallbladder on abdominal US