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Öğe Clinico-epidemiological study of caustic substance ingestion accidents in children in anatolia: The DROOL score as a new prognostic tool(Acta Medical Belgica, 2012) Uygun, İbrahim; Aydoğdu, Bahattin; Okur, Mehmet Hanifi; Arayıcı, Yılmaz; Çelik, Yusuf; Öztürk, HülyaBackground : To examine the clinico-epidemiological details of paediatric caustic substance ingestion (CSI) accidents in Turkey. To present the new DROOL Score (DS), which the authors developed based on the severity and duration of initial signs and symptoms (ISSs) to predict oesophageal stricture (OS) without endoscopy, and to present our management protocol based on immediate feeding, early detection, and oesophageal balloon dilatation (OBD) of OS with no barium study. Methods : We prospectively reviewed the records of 202 children admitted with a history of CSI within 48 hours. Patient, parent, caustic substance, and accident characteristics were noted in detail. Patients were fed as soon as they could swallow saliva. Diagnoses of OS were made earlier via timely endoscopy (mean, 10-14 days after CSI) for patients with persistent dysphagia and OBD was started earlier. ISSs and DSs were analyzed. OS treatment results were compared between early (10-14 days) and late (>= 21 days) dilatation patients who were referred for OBD by other hospitals. Results : In total, 144 (71%) incidents occurred within the parents' home and 44 (22%) occurred at another individual's home. The caustic substances were frequently sold in non-original containers (68.8%). Most patients' parents had low incomes and were poorly educated. Ninety-six children had no ISSs, whereas 106 patients had ISSs. Seventeen symptomatic patients had persistent dysphagia after 10-14 days. Timely endoscopy was performed within 10-14 days for these patients only, and OS was diagnosed and successfully treated. DSs were significantly lower in patients with OS than those without (p < 0.001). A DS <= 4 was a significant predictor of OS (100% sensitivity, 96% specificity, 85% positive and 100% negative predictive values). Results were significantly more satisfactory in early (n = 17) than in late (n = 6) dilatation patients. Conclusions : Paediatric CSI accidents might decrease if caustic substances were sold in the original child-proof containers. OS can be highly predicted by a simple DS instead of endoscopic grading, and can be diagnosed earlier (10-14 days) via endoscopy only in patients with persistent dysphagia, instead of a late barium study (>= 21 days). OBD can then also be started earlier in these patients.Öğe Çocuklarda konjenital musküler tortikollis: Geç başvuran 12 olgunun analizi(2008) Öztürk, Hayrettin; Okur, Mehmet Hanifi; Öztürk, Hülya; Çiğdem, Murat Kemal; Duran, Hatun; Önen, Abdurrahman; Dokucu, Ali İhsanAmaç: Bu çalışmadaki amacımız geç başvuran konjenital musküler tortikollis (KMT)’li hastalarımızın klinik, tanı ve tedavi özelliklerini analiz etmek ve literatür ile karşılaştırmaktır. Yöntem: Retrospektif olarak hastalarımız yaş, cinsiyet, klinik bulgular, yüzde ikincil biçim değişiklikleri, şişliğin yerleşimi, tanı yöntemleri, ek anomaliler, cerrahi girişimde karşılaşılan bulgular, sağaltım amacıyla uygulanan cerrahi girişimler açısından değerlendirildi. Bulgular: Hastalarımızın (5 erkek, 7 kız) yaş ortalaması 6,7 (1,5-12 yaş) yıl idi. Lezyonların çoğunluğu solda (%58) görüldü. Olgularımızın ikisi küçük yaş grubundaydı. İki olguda (%17) boyunda kitle palpe edilebildi. Olguların çoğunluğunda boyun hareketlerinde kısıtlılık (%83) en sık bulgu idi. Serimizdeki hastaların tümü cerrahi girişimle tedavi edildi ve ayrıca fizik-tedavi egzersizleri de uygulandı. Sonuç: Bu çalışmada, geç başvuran KMT’li çocuklarımızın çoğunluğunda cerrahi tedavi ve konservatif tedavi ile boyun hareketleri ve boyun eğriliğinde belirgin bir düzelme oldu.Öğe Damak yarığı olgularının tedavisinde Glubran 2’nin kullanımı(2008) Öztürk, Hülya; Öztürk, Hayrettin; Duran, Hatun; Okur, Mehmet HanifiAmaç: Yarık damak ve dudak insanlardaki en sık konjenital kraniyofasyal anomalidir. Palatoplastinin gecikmiş komplikasyonu fistül gelişimi ve midfasiyal büyüme geriliğidir. Bu çalışmada fistül gelişiminin engellenmesinde doku yapıştırıcılarının kullanımının etkinliğinin araştırılması amaçlanmıştır. Gereç ve yöntem: Ocak 1995 ile Mayıs 2005 tarihleri arasında kliniğimizde opere edilen 39 hasta yaş, cinsiyet, yarık damağın tipi, operasyon tekniği, doku yapıştırıcısı kullanımı ve komplikasyon gelişimi bakımından karşılaştırıldı. Bulgular:Yarık damaklı 39 hastanın 24’üne palatoplasti, 15 hastayada palatoplastiye ek olarak doku yapıştırıcısı Glubran 2 uygulandı. Yalnızca palatoplasti yapılan 24 hastanın 7’sinde (%29.1) fistül gelişti. Ancak palatoplastiye ek olarak Glubran 2 kullanılan 15 hastanın 1’inde (%6.6) fistül gelişti Sonuç: Yarık damaklı hastalarımızın tedavisindeki bu olumlu sonuçlarında klinik tecrübelerimizdeki gelişmelere ek olarak doku yapıştırıcısı Glubran 2’nin etkili olduğu söylenebilir.Öğe Magnetic compression gastrostomy in the rat(Springer, 2012) Uygun, İbrahim; Okur, Mehmet Hanifi; Çimen, Hasan; Keleş, Ayşenur; Yalçın, Özben; Öztürk, HayrettinMagnetic compression anastomosis is used for gastrointestinal, biliary, and urinary anastomoses. We have developed a simple magnetic compression gastrostomy technique in rats. Animals were randomized into two groups (n = 12 each): magnetic gastrostomy (MG) and surgical gastrostomy (SG) (control). In the MG group, a magnetic insertion catheter was coupled with the first magnetic ball and introduced transorally into the stomach. A second magnetic ball was placed subcutaneously into the left upper quadrant. The two magnetic balls (4 mm) were strongly coupled together. On postoperative day (PD) 20 (MG group) and PD10 (SG group), rats were killed, gastrostomies were evaluated macroscopically and histopathologically, and mechanical burst testing was performed. Two animals died due to suspected leaks. Macroscopic evaluation indicated no gastrostomy canal in one rat in each group. Mild adhesion was observed in two rats in the MG group. Moderate adhesion was observed in all rats in the SG group. No significant differences were observed in burst pressure between the two groups (means: MG group, 143 mmHg, n = 9; SG group, 159 mmHg, n = 8). Magnetic compression gastrostomy can be performed easily in rats, and may be developed in future as a simple alternative to some gastrostomy procedures in humans.Öğe Magnetic compression ostomy as new cystostomy technique in the rat : magnacystostomy(Elsevier Science Inc, 2012) Uygun, İbrahim; Okur, Mehmet Hanifi; Çimen, Hasan; Keleş, Ayşenur; Yalçın, Özben; Öztürk, HayrettinOBJECTIVE To report the first creation of magnetic compression cystostomy (magnacystostomy) using an easy and simple new technique in rats. Magnetic compression anastomoses (magnamosis) have been previously described for gastrointestinal, biliary, urinary, and vascular anastomoses. METHODS Female rats were randomized into 2 groups (n = 10 each): a magnetic cystostomy group and a formal surgical cystostomy group as the control group. In the magnetic cystostomy group, a very small cylindrical magnet was inserted into the bladder. The external magnetic ball was placed subcutaneously into the suprapubic region, and the 2 magnets were coupled together strongly. On postoperative day 20 in the magnetic cystostomy group and day 10 in the surgical cystostomy group, the rats were killed, and the cystostomies were evaluated macroscopically, histopathologically, and by mechanical burst testing. RESULTS In the surgical cystostomy group, 3 rats died. In the remaining rats, no evidence of complications was observed. However, mild adhesion in 1 rat in the magnetic cystostomy group and moderate adhesions in all the rats in the surgical cystostomy group were observed. No significant difference was found in burst pressure between the 2 groups (mean 162 mm Hg in the magnetic cystostomy group [n = 6] and 185 mm Hg in the surgical cystostomy [n = 5] group). However, the procedure time between the magnetic cystostomy group (7.70 +/- 1.64 minutes) and surgical cystostomy group (18.50 +/- 2.01 minutes) was significantly different (P < .001). CONCLUSION Magnacystostomy is easy and safe in the rat model and could be useful for some suprapubic cystostomy procedures in humans. UROLOGY 79: 738-742, 2012. (C) 2012 Elsevier Inc.Öğe Peripherally inserted central catheters in the neonatal period(Acta Cirurgica Brasileira, 2011) Uygun, İbrahim; Okur, Mehmet Hanifi; Otcu, Selçuk; Öztürk, HayrettinPURPOSE: Peripherally inserted central catheters (PICC) have been extensively used in neonates. However, insertion of these thinnest catheters is a very delicate procedure associated with a high failure rate. In our Neonatal Surgical Intensive Care Unit, we developed a very easy new PICC insertion and evaluated the neonates treated with PICCs which were inserted by using our technique as well as catheter features such as success rate, number of insertion attempts, reason for removal and complications. METHODS: Information was retrospectively collected on all 40 PICCs inserted at Kutahya Evliya Celebi Goverment Hospital and Dicle University Hospital during a 6-years period from September 2004 to September 2010. RESULTS: A total of 40 PICCs were inserted in 37 patients (26, 70% males, 11, 30% females) by using new technique. The median age of patients was 8.3 days (range 1 to 66 days) and the median weight of patients was 2365 g (range 600 to 5000 g). The vein most commonly accessed was long saphenous vein (85%). The length of PICCs in the body was 19.6 cm (range 5 cm to 30 cm). The tip was located in a central vein in all patients. Surgical abdomen was the most common cause for PICC insertion (38%). Duration of catheterization was 7.7 +/- 5.6 days (1-F 5.5 days, 2-F 8.6 days). Almost all of the PICCs were inserted successfully (40/42, success rate 95%) and in the first venipucture (36/42, 86%). Completion of therapy and removed after death were achieved with 87% of PICCs. Three minor complications were noted. Minor bleeding in the insertion site which was stopped via compression occurred in two neonates. Major complication was not seen. No deaths were directly attributed to PICCs use. CONCLUSION: The new insertion technique of the neonatal peripherally inserted central catheters may be one of the easiest and safest techniques, in comparison to previous techniques reported in the literature.
