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Soyer, Tutku/0000-0003-1505-6042 WOS: 000350825200009 PubMed: 25746698 Purpose: To investigate the effects of enteral hormones on pyloric muscle in order to clarify the etiopathogenesis of hypertrophic pyloric stenosis (HPS). Methods: Forty-two newborn Wistar-Albino rats were included. No intervention was done in the control group (CG, n = 6). In the sham group (SG, n = 6) 1 ml saline (0.9% NaCl solution), in the Nw-nitro-L-arginine methyl ester hydrochloride (L-NAME) group (LNG, n = 6) 100 mg/kg/d L-NAME, in the somatostatin group (STG, n = 6) 7 mcg/kg/d ST, in the cholecystokinin group (CCKG, n = 6) 3 mcg/kg/d CCK, in the substance P group (SPG, n = 6) 5 ml/kg/d SP, and in the prostaglandin-E1 group (PGE1G, n = 6) a cumulative dose of 360 mcg/kg PGE1 was given intraperitoneally for 14 days. On the 21st day, histopathological examination and muscle thickness measurements were done. Results were evaluated statistically. Results: Total and circular pyloric muscle thicknesses were significantly increased in the LNG compared to the CG and SG (p < 0.05). Circular pyloric muscle thickness was not increased in the STG, CCKG and SPG compared to the CG and SG (p > 0.05). In the PGE1G, muscle thickness was significantly decreased in the pylorus and increased in the antrum compared to the CG and SG (p < 0.05). Conclusion: Nitric oxide synthase (NOS) inhibition with L-NAME seems to be a causative factor in HPS by increasing pyloric muscle thickness. PGE predominantly affects antral gastric muscle and has no profound effect on pyloric muscle. (C) 2015 Elsevier Inc. All rights reserved. Kirikkale University Scientific Research CouncilKirikkale University [2013/61] This study was supported by Kirikkale University Scientific Research Council (2013/61). Special thanks go to Mrs. Corrine Can for her kind contribution to the English revision of the manuscript.

KISA, Ucler/0000-0002-8131-6810; Soyer, Tutku/0000-0003-1505-6042 WOS: 000429301400046 PubMed: 28693848 Purpose: To investigate the effects of penile tourniquet (PT) application on bacterial adhesion to urothelium. Methods: Fifty-six ratswere allocated into control group (CG), shamgroup (SG), PT group (PTG). No intervention was applied in CG. A 5mm-length urethral repair was performed in SG and PTG. In PTG, a 10-min duration of PT was applied during the procedure and the tissue oxygenation monitor was used to adjust the same degree of ischemia in all subjects. Sampleswere examined for wound healing parameters and tissue levels of inflammatory markers, eNOS, e-selectin, and ICAM-1antibodies. The adhesion of Escherichia coli to urotheliumwas investigated with in vitro adhesion assay. Results: Inflammation was higher and wound healing was worse in SG than CG and in PTG in comparison to CG and SG (p < 0.05). The endothelial damage, as shown by eNOS expression, was significantly higher in PTG compared to CG and SG (p < 0.05). The staining with ICAM-1 and e-selectin antibodies, showing increased inflammatory response to bacterial adhesion, was significantly higher in PTG compared to CG and SG (p < 0.05). In vitro urethral cell proliferation was achieved only in CG and SG revealing significantly increased adhesion in SG compared to CG (p < 0.05). The PT application caused endothelial corruption and prevented cell proliferation in cell culture. Conclusion: The PT application does not improve wound healing and increases bacterial adhesion molecules in penile tissue. The in vitro assays showed that PT causes severe endothelial damage and inhibits endothelial cell proliferation. (c) 2017 Elsevier Inc. All rights reserved. Kirikkale University Scientific Research CouncilKirikkale University [2014/82] This study was supported by Kirikkale University Scientific Research Council (2014/82).

Kilic, Birim Gunay/0000-0002-4566-2564; Bahadir, Gulnur Gollu/0000-0001-8163-2226; Sertcelik, Mehmet/0000-0001-7031-3318; Soyer, Tutku/0000-0003-1505-6042 WOS: 000352140500009 PubMed: 25840059 Background/aim: Children with attention-deficit/hyperactivity disorder (AD/HD) have risk taking behavior and are more prone to sustaining injury. It is aimed to evaluate the cognitive and behavioral characteristics of children with caustic ingestion. Patients and methods: Ninety two children with a history of nonsuicidal caustic ingestion (CI, n = 46) and healthy subjects (HS, n = 46) admitted to pediatric surgery department were enrolled into the study. Patients in groups were evaluated for age, sex, number of siblings and educational status of the parents. Before filling the questionnaires, the children were undergone flexible endoscopy and treated accordingly. Conners Parents Rating Scale-revised long form (CPRS-R:L), validated for Turkish Children, was used to evaluate the cognitive and behavioral characteristics of children. Parents rate their child's behavior with a four-point Likert scale. Subscales of CPRS-R: L including cognitive problems/inattention (CG/I), hyperactivity (H), attention deficit hyperactivity disorder index (AD/HD-I), Conners' Global Index-discomfort-impulsivity (CGI-DI), DSM-IV-symptom subscale-inattention (DSMIV, SS-I), DSM-IV-symptom subscale-hyperactivity-impulsivity (DSM-IV, SS-HI), DSMIV-symptom subscale-total score (DSM-IV SS-T) were used to determine the severity of the AD/HD symptom. Demographic features and cognitive/behavioral characteristics of children with caustic ingestion were compared with healthy subjects. Results: The median age of the patients was 4 (2-14 years) in both CI and HS groups. Female male ratio was 13:33 in CI and 12:34 in HS. Sixty seven percent of patients were preschool children (younger than 5 years of age) in both CI and HS groups. There was no difference between groups for number of siblings (p > 0.05). Parents of HS group had higher educational status than parents in CI (p < 0.05). When subscale scores of CPRS-R: L compared between CI and HS groups, CI group had higher CGI-DI scores than HS (p < 0.05). Children younger than five years of age had higher scores of H, emotional instability and total CG/I in CI than HS group (p < 0.05). Conclusion: Children with caustic ingestion had impulsiveness behavior when compared to healthy children. In addition to impulsivity, hyperactivity can be also assessed as a risk factor for caustic ingestion in children younger than 5 years of age. We suggest that association between AD/HD behavior and risk of sustaining injuries was also confirmed for caustic ingestion in children. (C) 2015 Elsevier Inc. All rights reserved.

KISA, Ucler/0000-0002-8131-6810; Soyer, Tutku/0000-0003-1505-6042 WOS: 000308810400027 PubMed: 22974614 Aim: The current accepted management of ovarian torsion is ovary-sparing surgery. Ozone therapy is used to reduce ischemia/reperfusion (I/R) injury in several situations. An experimental study was designed to evaluate effect of ozone application in ovarian I/R injury. Materials and methods: Three groups (n = 6) and 18 rats were included in the study. After anesthesia, right ovaries were fixed and removed at the end of 2 hours in sham group (SG). In torsion group (TG), right ovaries underwent 720 torsion in a counterclockwise direction. Ovaries were removed after 2 hours torsion and 2 hours reperfusion. In ozone group (OG), torsion was created by the same technique, and 95% oxygen plus 5% ozone gas mixture was given intraperitoneally (25 mu g/mL, 0.5 mg/kg) 10 minutes before reperfusion. After 2 hours reperfusion, ovaries were removed. Histopathologic examination of ovarian and periovarian sections was performed for the presence of congestion (C), hemorrhage, interstitial edema (IE), and polymorphonuclear neutrophilic infiltrations. Tissue samples were analyzed for malondialdehyde, nitric oxide (NO), and total sulphidryl (t-SH) values. Results were compared between 3 groups. Results: At histopathologic examination, the TG have elevation in terms of ovarian C, polymorphonuclear neutrophilic infiltration, and periovarian IE when compared with SG (P < ,05). In OG, ovarian C and periovarian IE were reduced according to TG, whereas the increase was observed only in ovarian C compared with SG (P < .05). At biochemical evaluation of oxidative stress markers in SG and TG, there was no difference between them (P < .05). Malondialdehyde levels were significantly lower in OG than TG, whereas NO and t-SH values were higher (P < .05). Malondialdehyde levels were decreased in OG compared with SG (P < .05). However, no difference was observed in NO and t-SH levels (P > .05). Conclusion: Intraperitoneal application of ozone creates a positive impact on histologic and biochemical markers on I/R injury owing to ovarian torsion. The ozone application can be developed to support efforts to protect ovary in ovarian torsion. (C) 2012 Elsevier Inc. All rights reserved. Kirikkale University Scientific Research CouncilKirikkale University This study was presented in the 29th National Congress of Turkish Pediatric Surgeons, in 2011, Istanbul, Turkey, and supported by Kirikkale University Scientific Research Council.

PubMed: 17161170 Hypothyroidism is a serious endocrine disorder emerging from deficient production of thyroid hormone (thyroid gland agenesis or dysgenesis, or inborn metabolic defects of thyroid hormone production) or a defect in thyroid hormonal receptor activity. Prevention of iodine organification by means of using iodine-containing drugs or solutions is a protective mechanism for the body and is known as the Wolff-Chaikoff effect. This effect blocks thyroid hormone generation and is often transient, with thyroid hormone synthesis recovering in a few days or weeks. We present a neonate with transient thyroid dysfunction resulting from topical exposure to iodine-containing antiseptic solution. Our aim was to increase awareness that the use of antiseptic iodine solutions in neonates may result in transient hypothyroidism through the Wolff-Chaikoff effect and should be considered after the use of iodine-containing solutions or drugs. © 2006 Elsevier Inc. All rights reserved.

KISA, Ucler/0000-0002-8131-6810 WOS: 000343140200006 PubMed: 25280648 Aim: Intestinal ischemia/reperfusion (I/R) injury is a serious clinical condition. Colchicine and low-dose methotrexate have anti-inflammatory features. An experimental model was conducted to investigate the effect of colchicine and methotrexate on intestinal I/R injury. Methods: Twenty-four rats were included. Only laparotomy was done in control group (CG, n = 6). In experimental groups, superior mesenteric artery was occluded. After 1 h ischemia, reperfusion (1 h) was started by de-occlusion. 30 min before reperfusion, saline in sham group (SG,n: 6), colchicine (1 mg/kg) in colchicine group (CNG, n: 6), andmethotrexate (0.1 mg/kg) in methotrexate group (MTXG, n: 6) were infused intraperitoneally. Small intestines were harvested for evaluation of intestinal mucosal injury (Chiu score) and oxidative stress markers (nitric oxide: NO, malondialdehyde: MDA, superoxide dismutase: SOD). Results: Biochemically, MDA levels were significantly low in CG compared to SG, CNG, and MTXG (p < 0.05). NO levels were significantly low and SOD levels were significantly high in CG compared to MTXG (p < 0.05). Histopathologically, Chiu score was significantly low in CG compared to SG, CNG, and MTXG (p < 0.05), and significantly high in MTXG compared to SG and CNG (p b 0.05). Conclusion: The present experimental model caused I/R injury in rat intestines. Contrary to literature, it was found that methotrexate worsens and colchicine does not attenuate intestinal I/R injury. (C) 2014 Elsevier Inc. All rights reserved.

Bayram, Cem/0000-0001-8717-4668; Soyer, Tutku/0000-0003-1505-6042 WOS: 000327938200031 PubMed: 24314201 Aim: Platelet rich fibrin (PRF) is an autologous source of growth factors and promotes wound healing. An experimental study was performed to evaluate the effect of PRF on growth factor levels in urethral repair. Materials and Methods: Eighteen Wistar albino rats were included in the study. Rats were allocated in three groups (n:6): control (CG), sham (SG), and PRF (PRFG). In SG, a 5 mm vertical incision was performed in the penile urethra and repaired with 10/0 Vicryl (R) under a microscope. In PRFG, during the urethral repair as described in SG, 1 cc of blood was sampled from each rat and centrifuged for 10 minutes at 2400 rpm. PRF obtained from the centrifugation was placed on the repair site during closure. Penile urethras were sampled 24 hours after PRF application in PRFG and after urethral repair in SG. Transforming growth factor beta receptor (TGF-beta-R-CD105), vascular endothelial growth factor (VEGF) and its receptor (VEGF-R), as well as endothelial growth factor receptor (EGFR), were evaluated in subepithelia of the penile skin and urethra. Groups were compared for growth factor levels and growth factor receptor expression with the Kruskal Wallis test. Results: TGF-beta-R levels were significantly decreased in SG when compared to CG (p < 0.05). In PRFG, TGF-beta-R was increased in both subepithelia of penile skin and urethra with respect to SG (p < 0.05). When VEGF levels and its receptor expression were compared between SG and PRFG, VEGF levels were found to be increased in penile skin subepithelium, whereas VEGF-R expressions were decreased in urethral subepithelia in PRFG (p < 0.05). There was no difference between groups for EGFR levels (p > 0.05). Conclusion: Use of PRF after urethral repair increases TGF-beta-R and VEGF expressions in urethral tissue. PRF can be considered as an alternative measure to improve the success of urethral repair. (C) 2013 Elsevier Inc. All rights reserved. Kirikkale University Scientific CouncilKirikkale University This study is presented in 30th Congress of Turkish Pediatric Surgeons, in 2012, Ankara, Turkey and supported by Kirikkale University Scientific Council. Special thanks to Serkan Sahinoglu, MD for his kind contribution to review the English of the manuscript.

KISA, Ucler/0000-0002-8131-6810; Soyer, Tutku/0000-0003-1505-6042 WOS: 000311222500027 PubMed: 23163997 Aim: The omentum plays a crucial role in abdominal defense mechanism by adhering to sites of inflammation and absorbing bacteria and debris from the peritoneal cavity. An experimental study was conducted to evaluate the inflammatory response of omentum in different abdominal events with omental P-/E-selectin levels and histopathologic findings. Materials and methods: Thirty Wistar rats were placed into 5 groups (n = 6), including a control group (CG), sham group (SG), bladder perforation (BP) group, splenic laceration (SL) group, and cecal ligation and puncture (CLP) group. Omental samples were obtained in CG after median laparotomy. In accordance with described models, BP, SL, and CLP were performed in experimental groups. Twenty-four hours after the first laparotomy, localization of the omental pad was noted, and omental samples were obtained for biochemical analysis of levels and histopathologic findings (no. of vessels in sections, polymorphic nuclear leukocytes [PMLs], lymphocytes). The mean P-/E-selectin levels and histopathologic findings of inflammation were compared between groups. Results: Although omentum was adhered to the cecum in all subjects after CLP, similar findings were not detected in other groups. P-selectin and E-selectin levels and number of PML were significantly increased in the CLP group when compared with other groups (P < .05). The number of vessels in sections was significantly increased in CLP group when compared with SG and BP groups (P < .05), and the BP group had a decreased number of vessels than CG (P < .05). The number of PML was significantly increased in SG and SL and BP groups with respect to CG (P < .05). Conclusion: Among different experimental intraabdominal catastrophes, only CLP caused an inflammatory response and increased levels of adhesion molecules in the omentum. These findings suggest that the nature of the inflammation is the main determining factor for the omental function in intraabdominal events. (c) 2012 Elsevier Inc. All rights reserved.

Soyer, Tutku/0000-0003-1505-6042 WOS: 000296869100020 PubMed: 22075343 Aim: Neonates undergoing surgery may receive phototherapy (PT) for the treatment of hyperbilirubinemia. Although the effects of PT on neonatal structures are well documented, the effect of PT on wound healing has not been previously evaluated. An experimental study was performed to evaluate the effect of PT on growth factor levels responsible for wound healing in neonatal rat skin. Materials and Methods: Eighteen Wistar newborn rats (7 +/- 2 g) were included in the study. Rats were randomized into 3 groups: control (CG), PT, and sham (SG) (n = 6). Both groups had 1-cm median dorsal skin incision. In CG, 1 x 1 cm of dorsal skin was sampled including the incised skin. The PT group received 5 banks of blue light (wave density, 30-40 mu w/cm(2) per nanometer; exposure distance, 45 cm). Phototherapy was started 24 hours after birth and exposed during light period (mean duration, 21 hours to 15 minutes perpendicular to 2 hour to 1.5 minutes). Sham group consisted of animals that received a bank of white light with same exposure distance and a total duration of 26 hours to 18 minutes +/- 3 hours to 9.1 minutes. After exposure, 1 x 1 cm dorsal skin samples were obtained from both PT and SG groups, including the median incision. The effect of PT was evaluated with the expressions of vascular endothelial growth factor (VEGF), its receptor (VEGF receptor), and transforming growth factor beta (TGF-beta) in endothelial vessels and fibroblasts of neonatal skin samples. Results: There was no significant difference between groups in VEGF receptor and transforming growth factor beta expressions. The VEGF levels in endothelial vessels were significantly decreased in PT and SG when compared with CG (P < .05). Conclusion: Vascular endothelial growth factor is a mediator of angiogenesis and may decrease in neonatal rat skin after light exposure. It can be suggested that decreased levels of VEGF after PT application may alter angiogenesis and also may adversely affect the healing features of neonatal skin. (C) 2011 Elsevier Inc. All rights reserved.

Aydos, Tolga Resat/0000-0002-1832-9336; Soyer, Tutku/0000-0003-1505-6042 WOS: 000270065100014 PubMed: 19735814 Background/Purpose: It has been suggested that whole gut irrigation (WGI), which is a preparation method for large bowel surgery or colonoscopy, increases gastrointestinal motility by creating a gastrocolic reflex. An experimental study was performed to evaluate the effect of different WGI solutions on gastrointestinal smooth muscle activity. Materials and Methods: Thirty Wistar albino rats weighing 200 to 250 g were enrolled in the study. After anesthetization with thiopental sodium (50 mg/kg), proximal ileum, terminal ileum, and colon segments were removed via median laparotomy to obtain a control group. Four different groups (n = 6) were designated as having WGI with saline solution (SS), lactated Ringer's solution (RL), polyethylene glycol (PEG), and dibasic sodium phosphate (DNP). Bowel cleaning was performed by infusing solutions at a rate of 2 mL/min via gastric tube, until the stool was cleared. After completing the bowel cleaning, 2 cm of tissues were removed and suspended in Tyrode solution in an isolated organ bath with a resting tension of I g, to obtain carbachol and potassium chloride (KCl) responses. Results: The mean bowel cleaning times were 87.5 +/- 9.35, 81.6 +/- 9.83, 86.6 +/- 11.6, and 85.0 +/- 0.0 minutes in SS, RL, PEG, and DNP groups, respectively. The total amounts of solutions needed for cleaning were 156.67 +/- 21.6, 195.0 +/- 20.0, 197.5 +/- 32.8, and 70.0 +/- 0.0 mL, respectively. Although there was no difference in cleaning time between the groups, the amount of solution required was significantly less in the DNP group (P = .02). In the proximal ileum segments, though there was no difference in carbachol responses between groups, KCl responses were significantly increased in the RL group (P < .05). When we evaluated the terminal ileum responses, carbachol responses were significantly increased in RL and PEG groups (P = .011) and decreased in the DNP group (P = .049). The KCl responses were also significantly increased in the R-L group with respect to the other groups (P < .05). Colon segments showed no difference in contractile responses with respect to different WGI solutions (P >.05, analysis of variance, post hoc Dunn's test). Conclusion: The different WGI solutions demonstrated no significant differences in colon contractions. The increased contractile responses in the proximal and terminal ileum segments after WGI with RL may be related to the electrolyte composition of RL. Although the lower amount of DNP solution required to achieve bowel cleaning seems to be an advantage, the decreased ileal contractions can be assessed as a disadvantage of DNP irrigations. (c) 2009 Elsevier Inc. All rights reserved. Turkish Association of Pediatric Surgeons This study was recognized with the "Professor Akgun Hicsonmez, Best Scientific Research Project" award by the Turkish Association of Pediatric Surgeons in the 26th National Congress of Pediatric Surgery, June 16-18, 2008, Istanbul, Turkey.

WOS: 000237015800053 PubMed: 16567201 Purpose: To show the effect of botulinum A toxin-induced paralysis of abdominal muscles oil intraabdominal pressure. Material and Methods: Fifteen Sprague-Dawley rats were divided into 2 groups. An abdominal skin incision was done, and 2 catheters were placed for the pressure monitoring and saline infusion. Saline Solution was given to the abdomen until reaching to a pressure level of 9 cm H2O and 6 min Hg in pressure device, and the amounts of injected saline were recorded. Then intraabdominal saline was drained. Two milliliters (5 U/mL) botulinum A toxin was applied to the abdominal muscles in group 2. Saline was injected at the same points in same amounts in group 1. After 3 days, catheters were placed, and the saline volumes needed to obtain the same pressure levels were recorded for each rat. Spontaneous motor unit potential (MUP), single MUP analysis and interference patterns of the muscles, respiratory rates, and vascular pressure measurements were recorded before and after botulinum toxin (Botox) injections. Results: Mean intraabdominal saline volumes in the first and third days were 63.8 and 64.4 mL in group 1 and 67.6 and 80.6 mL in group 2, respectively. Mean MUP amplitude and duration of the rectus muscles in group 2 (17.1 mu V and 1.47 milliseconds) were significantly lower than those of group I (187 mu V and 4.9 milliseconds) in the third day. There were no pathological changes in respiratory rates and pressure measurements before and after Botox injections. Conclusion: This pilot experimental study showed that local injection of botulinum A toxin causes paralysis in abdominal wall muscles, increases the intraabdominal volume, and decreases the pressure, and this application may be used as ail adjunct in abdominal Wall Closure in selective cases. (c) 2006 Elsevier Inc. All rights reserved.