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Introduction: This study aimed to evaluate the changes made by the pandemic in pediatric appendicitis, the Alvarado score and the contribution of ultrasonography to the diagnosis. Methods: This study was conducted on patients who underwent surgery for appendicitis to compare the COVID-19 pandemic period versus the same period the year before. Data regarding demographics, age, the time between symptom onset and admission to hospital, laboratory, ultrasonography and pathology results and Alvarado score were considered. Results: A total of 211 patients were operated on for appendicitis, 132 patients in the control group and 79 patients in the COVID-19 group. No significant differences between the groups in terms of age, gender and the distribution of appendicitis severity were found. The median time between the onset of symptoms and admission to the hospital was 2.72 days during the COVID-19 pandemic period and there was a significant difference between the two groups(p=0.043). Alvarado score and ultrasonography were evaluated together, in the control group sensitivity 98.4%, specificity 87.5%, PPV 96.9% and NPV 93.3%; if in the COVID-19 group were 94.5%, 88.8%, 97.2% and 80%, respectively. Conclusions: This study has shown that the evaluation of the Alvarado score and ultrasonography together, increases both sensitivity and specificity for the diagnosis of childhood appendicitis. That's why the combination of these tests becomes more important in special situations such as the COVID-19 period.

Resumen Antecedentes La dehiscencia glandular (DG) es una de las principales complicaciones que se producen tras la cirugia de hipospadias. Existe un numero limitado de publicaciones sobre la DG en la literatura. Objetivo Esta revision tiene como objetivo revelar los factores que afectan la DG mediante una revision bibliografica. Adquisicion de la evidencia Se realizo una busqueda literaria de articulos relacionados en la base de datos utilizando el termino de busqueda dehiscencia del glande sin establecer limite temporal ni ningun otro limite. Se incluyeron en este estudio todos los articulos relacionados con la dehiscencia del glande tras la cirugia de hipospadias. Tras recopilar la informacion de los textos completos, se incluyeron 71 articulos en esta revision sistematica. Se obtuvieron los siguientes datos para la realizacion del estudio: la localizacion del meato hipospadico, el tipo de cirugia, y otros datos clinicos que se consideraron factores de riesgo de la DG. Se utilizo la prueba de X2 para comprobar las diferencias entre los distintos parametros, considerando un valor p Resultados Tras evaluar los 71 articulos que cumplian los criterios de inclusion, en esta revision se detectaron 309 casos (3,48%) de DG tras 8.858 reparaciones de hipospadias. Las tasas de DG fueron significativamente altas en el caso de las reparaciones de hipospadias proximales (5%), las reparaciones en dos tiempos quirurgicos (5%) y las reintervenciones (8,75%) (p = 0,002, 0,022 y 0,004, respectivamente). El ancho del glande de Conclusiones El aumento de la tasa de DG se asocia a cirugias de hipospadias proximales, cirugias previas fallidas (cripple) y reparacion por etapas, al ancho de glande

Tracheomalacia (TM) is a disease that causes the airway obstruction of the tracheal lumen as a result of the structural disorder of the tracheal cartilage. We present a 4-month-old patient who developed ventilator depended TM after repair of esophageal atresia with tracheoesophageal fistula. Aortopexy and intraoperative flexible bronchoscopy were first performed via partial sternotomy in Turkey for this patient. He was weaned from ventilatory support and extubated at the first and discharged at the 8th post-operative day. Partial sternotomy is performed in the supine position, thus it allows for intraoperative flexible bronchoscopy permitting to check for the adequacy of the aortopexy.

We describe in situ skin graft tubularisation over the urethral catheter. This tehnique allows preparation of a urethral tube on a fixed line and suture the wound sides comfortably while preventing the movement of the graft.

Accidental ingestion of foreign bodies is a common situation in infants and children. Although coins are frequently swallowed by children, the introduction of electronic devices into our lives as a result of technological advances and the increase in battery use in toys have led to an increase in battery swallowing cases. Ingestion of button batteries is a more urgent situation than other foreign body ingestion, as it may cause complications such as perforation, trachea-esophageal fistula, large vein fistulization, esophageal stricture, vocal cord paralysis or spondylodiscitis. With this case report, we wanted to present an interesting case in which a 10-month-old boy who swallowed a 15 mm diameter button battery and developed esophageal perforation at the tracheal carina level after being pushed into the stomach whose perforation healed spontaneously with a conservative approach with chest tube, total parenteral nutrition and gastrostomy., Bebek ve çocuklarda kaza sonucu yabancı cisim yutulması sık karşılaşılan bir durumdur. Çocuklarda sıklıkla madeni para yutulmakla birlikte günümüzde teknolojik ilerlemeler sonucu hayatımıza elektronik cihazların girmesi ve oyuncaklarda pil kullanımın artması pil yutma vakalarında artışa sebep olmuştur. Yassı pillerin yutulması diğer yabancı cisim yutulmalarına göre perforasyon, trakea-özofagus fistül, büyük damara fistülizasyon, özofagus darlığı, vokal kord felci veya spondilodiskit gibi komplikasyonlara neden olabileceğinden daha acil bir durumdur. Biz de bu vaka sunumuyla 15 mm çapında yassı pil yutan ve mideye itilme sonrası trakeal karina seviyesinde özofagus perforasyonu gelişen 10 aylık erkek çocukta göğüs tüpü, total parenteral nutrisyon ve gastrostomi tedavisinden oluşan konservatif yaklaşımla perforasyonun kendiliğinden iyileştiği ilginç vakayı sunmak istedik.

OBJECTİVE: Classical transverse, verticalabdominal or thoracoabdominal incisions inpediatric patients are frequently used to removelarge abdominal tumors such as hepatoblastomaand neuroblastoma. We present our initial experienceson our patients who was operated by modifiedMakuuchi incision.MATERİALS AND METHODS: We used this incisionin 6 cases with large abdominal tumors (1 hepatoblastomaand 5 neuroblastoma and/or ganglioneuroma)between January 2019 and August 2020.RESULTS: These patients had previously receivedchemotherapy according to appropiate protocol. Theexposure of surgical field was perfect with this incisionand dissection of the tumors was easily performed.Complete removal of large abdominal tumors was successfullyachieved in the patients although the masseshave close proximity and adhesions with importantstructures and organs. There was serous collection in2 patients and it resolved spontaneously. No wound infection, hernia or wound dehiscence was observedduring a mean follow-up of 9.6 months (ranged from3 to18 months).CONCLUSİON: According to our preliminary experiences,the Modified Makuuchi incision provides a niceexposure for removal of large abdominal tumors to thesurgeons and is well tolerated by children.Las incisiones clásicastransversa, abdominal vertical o toracoabdominal enpacientes pediátricos son utilizadas frecuentementeen la escisión de tumores abdominales de gran tamañocomo el hepatoblastoma y el neuroblastoma.Presentamos nuestra experiencia inicial en pacientesoperados usando la incision de Makuuchi modificada.MATERIALES Y MÉTODOS: Usamos esta incision en6 casos con tumores abdominales de gran tamaño (1hepatoblastoma y 5 neuroblastomas y/o ganglioneuroma)entre Enero 2019 y Agosto 2020.Los pacientes recibieron quimioterapianeoadyuvante según protocolo. La exposicióndel campo quirúrgico, así como la disección del tumor,fue perfecta con esta incisión. Se logró remover la totalidadde los tumores con éxito a pesar de su proximidady adherencias a órganos vecinos. Dos pacientespresentaron colecciónes serosas que se resolvieronespontáneamente. No se observaron infecciones de herida, hernias o dehiscencia de heridas durante elperíodo de seguimiento con una media de 9.6 meses(rango de 3-18 meses).Según nuestra experiencia preliminar,la incisión de Makuuchi modificada ofrece alcirujano una buena exposición del campo quirúrgicopara la extirpación de tumores abdominales de grantamaño, además de ser bien tolerada por los niños.

Verruca Vulgaris or wart is a common skin disease caused by human papillomavirus (HPV) infection. Warts are usually located on fingers, hands, elbows and feet. Anogenital region is an uncommon location for warts. Three children with large perianal warts were treated by holmium: Yttrium Aliminum Garnet (Ho-YAG) laser. No recurrences or significant complications were seen in 2 years of follow up period. Ho-YAG Laser was successfully applied in the treatment of pediatric perianal warts. It is a safe and effective method.

Summary Introduction Penile tourniquet (Pt) application aims to work in a bloodless field in penile surgery. When the tourniquet is released, reperfusion injury occurs with the resumption of blood flow. Molecular hydrogen can easily attach to biomembranes and enter cytosol, mitochondria and other organelles of the cell and convert the formed OH- to H₂O to prevent cell and tissue damage. Aim We investigated the effects of hydrogen rich saline solution (HRSS) on penile Mathieu type flap tissue with Pt application in rats. Study design Thirty-six Wistar-albino male rats were randomly divided into six groups. No operations were performed in the Sham group. Ventral penile Mathieu type flap was prepared and Pt was applied to the root of the penis with a plastic band in other groups. Pt was applied 10 and 30 min in the PT1⁰ and PT³⁰ groups. HRSS was injected intraperitoneally (ip) 5 ml/kg just before Pt was released in the HRSS1⁰ and HRSS³⁰ groups. In the HRSSB group, HRSS was injected 1 h before 10 min of Pt application. At the 4th hour of experiments the rats were sacrificed and tissue samples were taken for biochemical and histopathological studies. Tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), myeloperoxidase (MPO), malondialdehyde (MDA) and glutathione (GSH) levels were determined in the penile tissue. The results were analyzed with one-way ANOVA and Pearson's Chi-Squared test. Results Tissue MDA, MPO, IL-6 and TNF-α values were significantly lower in all HRSS groups compared to PT1⁰ and PT³⁰ groups. Tissue GSH levels of HRSS groups were higher compared to PT groups. Histopathologically, inflammation was found to be higher in PT groups compared to HRSS groups. Interestingly, in the HRSSB group with HRSS administration prior to Pt, the damage was less in grade, but not statistically different than the other HRSS groups (p > 0.05). Discussion In previous studies, damage in histopathological examinations after Pt could only be demonstrated long after tourniquet applications such as 24 h and with longer duration of Pt such as 30 min. Structural changes in different Pt application times could be demonstrated at 60 min by electron microscopy and 48 h by light microscopy. In this study, the histopathological effect of Pt application could be demonstrated at the 4th hour after release and HRSS was observed to reduce the damage histopathologically as well as biochemically with its anti-inflammatory and antioxidant effects. It was observed that administration of HRSS either before or following Pt did not cause an alteration statistically. Conclusion HRSS reduces tissue oxidative stress and inflammation on the flap tissue and has a protective effect in Pt applied to the hypospadias model created with a penile flap. Summary Table . Penil tissue Glutathione (GSH) (ng/mg protein), malondialdehyde (MDA) (nmol/mg protein), myeloperoxidase (MPO) (ng/mg protein), interleukin 6 (IL-6) (pg/mg protein) and tumor necrosis factor-α (TNF-α)levels (pg/mg protein)) for all groups. GSH MDA MPO IL-6 TNF-α Sham 1370,51 ± 751,47 0,51 ± 0,14 7,94 ± 3,07 79,45 ± 5,1 440,76 ± 268,46 PT1⁰ 625,25 ± 240,98 1,67 ± 0,44 7,63 ± 1,24 140,19 ± 98, 26 701,39 ± 132,41 PT30 545,86 ± 246,31 1,74 ± 0,29 8,77 ± 1,13 364,01 ± 388,47 552,6 ± 375,92 HRSS1⁰ 773,95 ± 161,41 0,37 ± 0,22 3,12 ± 1,17 97,98 ± 17,97 426,76 ± 287,8 HRSS30 767,24 ± 319,41 0,39 ± 0,18 3,73 ± 1,91 78,68 ± 1,72 461,93 ± 262,13 HRSSB 883,59 ± 471,57 0,57 ± 0,36 3,46 ± 1,34 86,56 ± 20,92 502,89 ± 247,93 p value 0,028 0,001 0,001 0,035 0,030

Surgicel is a hemostatic agent that consists of oxidized regenerated cellulose and used in surgical procedures as an aid to bleeding control. It is left in the operation site for hemostasis, could cause an operation by mimicking the recurrence of tumor, as in our patient.A 3-year-old boy was operated by us at the age of 40 days and 2.5 years, respectively, due to pelvic neuroblastoma. He was re-operated for mimicking recurrence or residue tumor secondary to the prior placement of Surgicel within the peritoneal cavity.Re-laparotomy was performed and the mass approximately 2.8 × 2×1 cm in size in front of the right ureter and iliac vessels and behind the bladder was removed by blunt and sharp dissection without damaging these organs. While gelatinous content was evacuated from this mass, there was no apparent tumor appearance. Pathology report was reported as fibrotic tissue characterized by foreign body and foreign body giant cells. The postoperative period was uneventful and he was discharged on the 2nd postoperative day.In the light of our case, the use of hemostatic agents should be kept to a minimum and should not be left in the body unless it is difficult. Thus, unnecessary examination or recurrent surgery can be avoided.

Surgery for pilonidal disease (PD) often is followed by an unpleasant postoperative course that restricts school and social activities. We performed a retrospective medical record review to evaluate the outcome of the Gips procedure on 19 adolescents with PD. We recorded each patient's age at surgery, surgical history, symptoms, duration of operation and hospital stay, time to return to activity, wound healing time, and recurrence. Our review demonstrated that the Gips procedure is an easy-to-use technique in adolescents with PD and had a high success rate. Furthermore, it is less restrictive on school and social activities than traditional surgical therapies.

We aim to relate our practice during the COVID-19 pandemic between March 17 and May 17, 2020 in our pediatric surgery department.

Aim We investigated the effects of hydrogen-rich saline solution (HRSS) on intestinal anastomosis performed after intestinal ischemia reperfusion injury (IRI). Materials and methods Thirty Wistar albino female rats were randomly divided into five groups. Only laparotomy was performed in the Sham group. In the other four groups, an intestinal IRI was performed for 45 min by clamping the superior mesenteric artery. After intestinal IRI, anastomosis was performed by cutting the intestine from the proximal 15 cm of the ileocecal valve at the first and 24th hours. HRSS was given intraperitoneally 5 ml/kg before reperfusion and for four more days in the HRSS1 and HRSS24groups, while no treatment was given to the I/R1 and I/R24 groups. After 5 days, all groups underwent relaparotomy. The anastomotic bursting pressures were measured in all groups, except the Sham group. The tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6), myeloperoxidase (MPO) and malondialdehyde (MDA) levels were measured in the tissues taken from the anastomosis line. The tissue sections were evaluated histopathologically and the apoptosis index was determined by applying the TUNEL method. The results were analyzed one-way analysis of variance (ANOVA) and Pearson's chi-squared test. Results Although the MPO, MDA, IL-6 and TNF-α tissue values were not statistically significant among the groups, the degree of tissue damage and apoptosis levels were lower and the anastomotic bursting pressures values were higher in the HRSS1 and HRSS24 groups compared to the I/R1 and I/R24 groups. Conclusion HRSS is effective in reducing the intestinal damage caused by an IRI: HRSS has the potential to reduce the detrimental effects of intestinal anastomosis performed after an intestinal IRI.

Glanular dehiscence (GD) is one of the main complications after hypospadias surgery. There is a limited number of publications regarding GD in the literature.The aim of this work is to reveal the factors that affect GD after a literature review.A literature search for relevant articles was performed in database using the search term glans dehiscence without setting date range limit or any other limits. All articles related to GD after hypospadias surgery were included in this study. After collecting the information from full text articles, 71 articles were included in this systematic review. In these studies, localization of hypospadic meatus, type of surgery, and other clinical data which were thought to behave as risk factors for GD were obtained. Chi-Square test was used to evaluate the differences between the parameters, where p 0.05 was taken as statistically significant.After evaluating the 71 articles that met the inclusion criteria, 309 cases (3.48%) of GD after 8858 hypospadias repairs were obtained in this review. GD rates were found significantly high for proximal hypospadias (5%), two-stage hypospadia repairs (5%) and re-do hypospadias repair (8.75%) (p = 0.002, 0.022, and 0.004, respectively). Glans width14 mm, urethral plate (UP) width7 mm, hypospadias surgeries performed before 6 months of age and after puberty, and caudal block anesthesia increased the rate of GD.The rate of GD increases after proximal, cripple and staged hypospadias surgeries, a glans width15 mm and UP width8 mm, postpubertal surgeries, and caudal anesthesia use during surgery.

Background Uroterocele causes atony and stagnation in the ureter, thus predisposing the patient to stone formation. Multiple calculi in uroteroceles are common in adults but very rare in children. Case presentation We describe the case of a 3-year-old boy who presented with hematuria and was found to have multiple ureteral and ureterocele stones. The diagnosis was made during endoscopic lithotripsy. A holmium/yttrium–aluminum–garnet (Ho–YAG) laser was used to excise the uroterocele and for lithotripsy. Conclusions In appropriate cases, minimally invasive techniques, for example, Ho–YAG laser lithotripsy and ureterocele excision may be preferred.

Purpose: To evaluate the clinical data and treatment outcomes of 3 different methods for redo hypospadias surgery. Patients and Methods: We retrospectively reviewed the data of 39 patients with redo hypospadias surgery between January 2010 and April 2019 at our clinic. A ventral preputial onlay flap, a preputial tubular flap, and a full thickness skin tubular graft were used in redo hypospadias surgery. We evaluated these methods regarding age, number, and type of previous repairs, catheter time, chordee, length of the urethral defect, operation time, complications, and follow-up results. T tests and Fisher’s exact tests were used to compare differences between groups. Results: The mean operation age of the patients was 5.23 years. Sixteen patients had a single, 21 had 2, and 2 patients had 3 previous repairs. The position of the urethral meatus was perineal in 2, penoscrotal in 6, mid penile in 21, and distal penile in 10 patients. The initial repairs comprised 19 tubularized incised plates (TIP), 12 Mathieu procedures, 5 tubularized preputial flaps, 2 full thickness skin tubular grafts, and 1 onlay island flap repair. Eight full thickness skin tubular grafts, 18 onlay preputial island flaps, and 13 preputial tubular flaps were used for redo surgery. The success rate was 79.1%. Eight wound infections, 6 glans dehiscences, 13 fistulas, 12 meatal stenoses, and 5 urethral diverticulas were seen in the patients. The rates of these complications, Cystofix requirement, and reoperation were higher in the skin tubular graft group but this was not statistically significant (p > 0.05). One patient with graft contracture required a redo skin graft urethroplasty. The mean follow-up duration was18 months. Conclusion: Preputial tissue should be preferred in the presence of redo hypospadias surgery. In the absence of preputial tissue other tissues such as oral or buccal mucosa should be preferred instead of skin grafts.

Although surgical operation is a commonly preferred method in lymphangiomas (LAs), there is a risk of vascular or nerve injury especially in macrocystic LA. Therefore, sclerotherapy would be more appropriate as the first treatment. The authors wanted to share the excellent results of intralesional bleomycin treatment in 3 patients with cervical macrocystic LA.

Aim/Background Although many agents have been tested as treatment options for caustic esophageal burn (CEB), none have successfully suppressed the formation of strictures. Thus,the purpose of this study was to determine the efficacy of Contractubex® gel (10% onion extract, 50 U/gr heparin, and 1% allantoin) in stricture preventing after CEB. Methods In this study, 24 Wistar-albino rats were divided into 4 groups. CEB was initiated with an instillation of 1 mL of 10% NaOH solution into the an isolated esophageal segment for 3 min. Group C (control) was uninjured and untreated. In Group CEB, was initiated but no treatment was given. In Groups CTX1 and CTX2, the animals received 100 and 200 mg/kg/d, respectively, of Contractubex® for 4 weeks via gavage after CEB was initiated. The stenosis indices (SI), histopathologic damage scores, tissue hydroxyproline (HP) levels, and weights of the rats were taken before the experiment and 4 weeks after the experiment. Results The Mean SI levels, HP levels, and histopathologic damage scores were statistically lower in Groups CTX1 and CTX2 when compared with Group CEB (p 0,05); the efficacy of the treatment was not dose-dependent. Conclusion For the first time, Contractubex® was used for its antifibrotic, antioxidant, anti-inflammatory, and wound healing effects to treat caustic esophageal burn in rats. It was effective in reducing stricture formation by decreasing the HP levels and histopathologic damage as well as preventing stenosis and weight gain in the treatment groups.

Aim: The aim of the present study is to investigate the neuroprotective effects of l-Arginine (l-arg) in the seven-day-old rat hypoxia-ischemia model. Materials and methods: L-Arginine (n = 10) or saline (n = 8) was administered intraperitoneally to seven-day-old rats before hypoxia-ischemia. In addition, 18 seven-day-old rats were given l-Arginine (n = 10) or saline (n = 8) after hypoxic-ischemic insult. Neuronal apoptosis was investigated by terminal dUDP-biotin nick end-labeling (TUNEL) following three days of recovery. The ratios of right side numerical density to the sum of right and left sides' numerical densities (right apoptosis index) were calculated for every brain region in rats receiving l-arginine and they were compared with the vehicle groups. Results: Right side apoptosis indexes of the hippocampus (mean +/- SD; 35.0 +/- 16.1) and striatum (41.9 +/- 16.0) were significantly decreased in the l-Arginine post-treatment groups when compared to vehicles (61.0 +/- 17.0 and 62.4 +/- 27.0 respectively) (p < 0.05). There was no significant difference in the right apoptosis indexes of the cortex between l-Arginine post-treated group and the vehicle group. There were also no significant differences between the right side apoptosis indexes of the l-Arginine pretreatment groups and those of the vehicle group in any of the three regions (p > 0.05). Conclusions: It is concluded that neuronal apoptosis due to hypoxic-ischemic injury may likely to be reduced by post-treatment of l-Arginine in the neonatal rat model and l-Arginine provides a new possibility for neuroprotective strategies based on NO production.

Aims: Ureteropelvic junction obstruction (UPJO) may originate from extrinsic or intrinsic causes in children. The aim of this study is to present preoperative and postoperative data of our patients operated for UPJO. Methods: A total of 64 patients who underwent open pyeloplasty were investigated retrospectively. They were evaluated in terms of demographically, clinics, hydronephrosis, differential renal functions (DRFs), half-time tracer clearance (½TC), and histopathologic results. Patients’ numerical results were stated as mean ± standard deviation (SD). Results: Male gender was more prevalent ( n = 47, 73.4%) and mean age at surgery was 46.87 months. UPJO was located at the left side in 56.3% ( n = 36), and at the right side in 39.1% ( n = 25) of patients. It was bilateral in 4.7% ( n = 3). Hydronephrosis was found antenatally in 68.8% ( n = 44) of patients. The mean preoperative DRF was 49.7% (21–78%) and mean postoperative DRF was 49.2% (20–56%). Mean renal scintigraphic t1/2 was >20 min for all patients. The mean AP diameter was 21.58 mm (10–62 mm). Muscular hypertrophy was the most common pathological finding, mean length of excised segment was 10.26 mm (3–40 mm). Crossing vessel (CV) was detected in 17.18% ( n = 11). The CV was statistically associated with increased age of operation, left side, and female gender. Statistically significant hydronephrosis was found in non-CV patients. Re-operation was required in seven patients (7.8%). Conclusions: Intrinsic pathologies are more seen in the etiology of UPJO patients with antenatal diagnosis and this group needs operation at an earlier age. However, CV is found more commonly in patients who are diagnosed and operated at older ages.

Background The effectiveness of nonoperative treatment of esophageal perforation (EP) in children with octreotide is highlighted. Methods Records of nine patients (seven boys and two girls with an average age of 5.83 ± 5.35 years) with EP were reviewed. Results EP developed in six patients during dilation of esophageal stenosis (five of six caused by caustic burns). In the other three patients, EP developed after nasogastric placement, after endotracheal intubation, and during endoscopy for foreign body. The symptoms consisted of dyspnea in four patients, tachypnea in seven patients, fever in six patients, chest pain in two patients, and abdominal pain in one patient. Two patients had pneumomediastinum, four patients had pleural effusion, one patient had subcutaneous emphysema, four patients had pneumothorax, and two patients had severe sepsis. Eight of the perforations resolved spontaneously. Therapy included cessation of oral feedings, implementation of proper antibiosis, parenteral and/or enteral nutrition by gastrostomy, and drainage of pleural effusions or mediastinal abscesses if required. Though not recommended by literature, octreotide was administered to these patients. Only one patient was operated in another clinic and was lost during follow-up. The length of hospitalization stay had a median of 11 ± 6.59 days, ranging between 5 and 28 days. If the patient who was operated and did not receive octreotide therapy is excluded, the median hospitalization was only 8 days (5 to 12 days). All patients in our series (except patient 8) survived and still have their native esophagus. Conclusion The initiation of octreotide treatment in the early period after diagnosis of EP without surgical intervention leads to early improvement in children.

Background The present study aimed to investigate the effects of hydrogen rich saline solution (HRSS) in a rat model of ovarian ischemia–reperfusion injury. Methods Thirty-six female Wistar-albino rats were grouped randomly, into six groups of six rats. The groups were classified as: sham (S), hydrogen (H), torsion (T), torsion/detorsion (TD), hydrogen-torsion (HT), and hydrogen-torsion/detorsion (HTD). Bilateral adnexal torsion was performed for 3h in all torsion groups. HRSS was given 5ml/kg in hydrogen groups intraperitoneally. Malondialdehyde (MDA) and glutathione- S -transferase (GST) levels were measured in both the plasma and tissue samples. Tissue sections were evaluated histopathologically, and the apoptotic index was detected by TUNEL assay. The results were analyzed by Kruskal–Wallis and Pearson chi-square tests using computer software, SPSS Version 20.0 for Windows. Results The MDA levels were higher and GST levels were lower in the torsion and detorsion groups when compared to other groups, but the differences were insignificant ( P >0.05). The MDA levels were lower and GST levels were higher in the HT and HTD groups compared with the T and TD groups ( P >0.05). Follicular injury, edema, vascular congestion, loss of cohesion and apoptotic index were higher in the torsion groups but decreased in the groups that received HRSS. Conclusions According to histopathological and biochemical examinations, HRSS is effective in attenuating ischemia–reperfusion induced ovary injury.

Unconsciously caustic ingestion is one of the most common causes of serious esophageal strictures in children. The aim of this study is to determine the efficiency of polaprezinc in preventing stricture formation after corrosive esophageal burns (CEB); this was the first time it has been used to treat experimental CEB in rats. Twenty-four rats were divided into four groups, three of which received CEB by the instillation of 1 mL of 10% NaOH solution into their isolated esophageal segments for three minutes. Group C (control) was uninjured and untreated. Group B (esophageal burn) received CEB but were left untreated. Groups PT1 and PT2 had CEB and received 100 mg/kg/day and 200 mg/kg/day, respectively, of intraperitoneal polaprezinc treatment (PT) for the first two weeks, then oral PT for another two weeks. We assessed the treatment's efficiency of the treatment after the fourth week by evaluating the stenosis index (SI) and the histopathological damage score, determining tissue hydroxyproline content (HP), and measuring the weight of the rats before and after the experiment. Mean SI was statistically lower in the groups PT1 and PT2 when compared with Group B (p = 0.006, 0.004, respectively). HP levels were highest in Group B, but it was insignificant (P > 0.05). In terms of histopathological damage score, treatment groups demonstrated less collagen deposition, mucosal, and submucosal damage than both Group B (p = 0.01) and Group C (p = 0.02). Group PT1 and Group PT2 (P > 0.05) showed similar results, indicating the treatment's effectiveness was independent of dosage. Outside of Group C, weight gain was detected only in Group PT2, though it was statistically insignificant. In Group PT1, weight loss was lower than in Group B. Polaprezinc, with its antifibrotic, antioxidant, anti-inflammatory, wound-healing and antiapoptotic effects, was efficient in reducing stricture formation by decreasing HP levels and histopathologic damage, preventing stenosis, and weight gain in higher dosages in the treatment group.

Background: In this study, it was aimed to determine the effects of alfuzosin on experimentally generated unilateral partial ureteropelvic junction obstruction (UPO) in rats.Materials and methods: Thirty Long-Evans rats were randomly allocated into five groups. In control group (C), nothing was performed; in group Sham (S) only laparotomy was done; in Alfuzosin group (A) only alfuzosin was administered for two weeks (10mg/kg/day p.o.) without any surgery; in UPO group, unilateral UP junction obstruction was produced; and in the Group UPT (ureteropelvic obstruction+treatment), alfuzosin was administered for two weeks (10mg/kg/day p.o.) in addition to UPO production. Renal pelvic anteroposterior diameters were determined with ultrasonography (USG) and renal arterial resistivity indexes by color Doppler USG. Urine was collected both at the beginning and at the end of the experiment for 24h in all the groups and at the end of the experiment, blood samples were obtained. Blood and urine electrolytes and TGF-1, urine density, urine (2) microglobulin levels were determined. Renal tissue samples harvested from all of the rats were histopathologically evaluated. Results were determined using one-way ANOVA t-test; p

Objective Data on the prevalence of patent processus vaginalis (PPV) and hernia in patients with cryptorchidism are controversial. While some pediatric surgeons do not dissect the processus vaginalis (PV), most prefer to do so to prevent hernia formation and to achieve an effective orchiopexy outcome. This study was performed to evaluate the importance of dissection and high ligation of the PV during treatment of undescended testis (UT). Methods The clinical findings and surgical procedures of 55 patients with UT were retrospectively investigated. Results The mean patient age was 2.5 (range 1.0–12.0) years. Non-palpable testis (NPT) was located on the right and left side in 39 and 16 patients, respectively. Ultrasonography revealed no testis in 10 patients and an atrophic testis in 7 patients. Seven patients had a parent with an inguinal hernia, and the silk sign or a PPV was detected during inguinoscrotal examination in 22 patients. Undescended testis repair was performed by an inguinal approach in all patients. The inguinal canal was opened in all patients; 42 patients had a wider-than-normal internal ring (>2.5 cm), and the posterior wall of the inguinal canal was consequently weakened. Two-stage orchiopexy was performed in 2 patients, and 15 underwent the Prentiss maneuver. In the remaining patients, the dissection was easily done, and the orchiopexy was performed without any difficulty. Scrotal edema and wound infection occurred in five and two patients, respectively. One patient presented with an atrophic testis, and three had recurrent UT. Inguinal hernia was not observed in any of the patients during the study period, and all procedures were performed on an outpatient basis. Conclusion High ligation of the PV is an effective method for successful orchiopexy and prevention of inguinal hernia in patients with NPT and UT.