The effect of amnio-allantoic fluid pH on the intestines: an experimental study in the chick embryo gastroschisis model.

BACKGROUND/PURPOSE: Prolonged exposure to amniotic fluid causes the intestinal changes such as serosal edema, thickening, fibrous coating, and adhesions in gastroschisis. The effect of amnio-allantoic fluid (AAF) pH on intestines was evaluated using a chick embryo gastroschisis model. METHODS: Seventy fertile eggs were divided into 5 groups: preliminary study (PS, n = 20), AAF control (AAC, n = 10), just gastroschisis (JG, n = 10), gastroschisis pretreated with placebo (GPP, n = 15), and gastroschisis pretreated with sodium bicarbonate (GPS, n = 15). The PS group was also divided into 2 subgroups to determine the biochemical differences between the amniotic and the allantoic fluid. Gastroschisis was created surgically at the 14th day of incubation. In GPS group, 8.4% NaHCO(3) solution (0.1 mL/100 mg/d) was instilled into the AAF for 4 days. RESULTS: A significant decrease in intestinal damage was observed both macroscopically and microscopically in the group GPS compared with the JG and GPP groups. CONCLUSIONS: Pretreatment with alkalization of AAF prevented intestinal damage because of gastroschisis. Alkalization could be a simple alternative for pretreatment with amniotic fluid exchange for human fetuses with gastroschisis.

The effect of corticosteroids and pentoxifylline in caustic esophageal burns. A prospective trial in rats.

BACKGROUND: Caustic Esophageal Burns (CEB) usually results in scatritial tissue and stricture formation. Management requires preventing the massive inflammatory process that ensues in its early phase and decreasing bacterial complications. METHODS: An animal model was created to investigate the effect of corticosteroids and pentoxifylline in CEB using 52 male Wistar rats. The injury was produced using an indwelling esophageal catheter through which 3N of 12% sodium hydroxide was infused. The rats were grouped as control, CEB, CEB and ceftazidime (CEB-C, 100 mg/kg/day im. bid. 10 days), CEB and ceftazidime plus dexamethasone (CEB-CD, 0.1 mg/kg/day im. bid. 4 weeks) and CEB and ceftazidime plus pentoxifylline (CEB-CP, 50 mg/kg/day im. tid. 4 weeks). The groups were evaluated making use of esophagograms, hydroxyproline (OH-P) contents and histologic examination of the specimens 28 days after injury. RESULTS: No significant statistical differences were observed among the dexamethasone (CEB-CD), pentoxifylline (CEB-CP), antibiotics (CEB-C) and the untreated CEB groups.

Neonatal hypertrophic pyloric stenosis: congenital or infantile?

Hypertrophic pyloric stenosis (HPS) is very rare during the newborn period. Here we present a fullterm male neonate with abundant hematemesis 12 hours after birth which interrupted oral feeding. Bleeding subsided within three days after conservative measures, and oral feeding was restarted but not tolerated. The vomiting was effortless and nonbilious. An upper gastrointestinal series revealed gastric dilatation and partial obstruction of the gastric outlet. HPS was found by laparotomy on the fourth day and Fredet-Ramstedt pyloromyotomy relieved the gastric emptying. This is one of the few cases of HPS present at birth, which was diagnosed and surgically treated early, and we suggest a congenital etiology in previously reported cases of HPS. Hypertrophic pyloric stenosis (HPS) is a common cause of pediatric surgery. Usually young infants are involved; HPS is extremely rare in neonates and infants older than 6 months. Vomiting typically begins between the 3rd and 6th week of life, although some infants may have mild symptoms like regurgitation from birth.

Blood flow determination in contralateral ovary with 133 Xe in unilateral ovarian torsion (experimental study in rabbits).

Clinical and experimental studies have shown that, in unilateral testicular torsion, some structural and hormonal changes may occur in the contralateral testis. The present study was designed to determine the effect of unilateral ovarian torsion on the blood flow in the contralateral ovary using #133Xe. Basal blood flow of the bilateral ovaries was determined in 40 prepubertal, female New Zealand rabbits. Right ovaries were then torsioned 720 degrees in all groups with the exception of the control group, where only laparotomy was performed. Bilateral ovarian blood flows were measured in the first group one hour after torsion, in the second group 8 hours after torsion, in the third group 24 hours after torsion and at the same times after laparotomy in the control group. Basal and post torsional blood flow measurements were analyzed. Contralateral ovarian blood flow was reduced after unilateral torsion in all of the groups. In the control group, there were no changes in these criteria.

Burkitt's lymphoma in Turkish children: clinical, viral [EBV] and molecular studies.

Eighty-one Turkish children with Burkitt's lymphoma (BL) were observed during a period of 24 years (1968-1992). The diagnosis was established histologically according to WHO criteria. BL represented 48.5% of NHL in this series. The median age of patients was 5 years with a sex (M/F) ratio of 2.3/1. The most common primary site of tumor involvement at initial presentation was the abdomen (70.4%), which was followed by facial tumors, in particular the jaw and orbit (45.7%). The majority of the patients (84.0%) were in advanced stages (C and D) at initial diagnosis. Facial tumors observed in Turkish children with BL were more similar to African Burkitt's lymphoma than American or European cases. High titers of antibodies against VCA and EA of EBV were also observed in 32 recent cases of BL. Preliminary molecular and immunologic studies revealed EBV-DNA (type I) and T cell deficiency. The clinical presentation, median age, and association with EBV revealed that BL appears to be inbetween African and non-African types in Turkish children. This will be further elucidated in the future by direct examination of tumor cells for EBV and investigation of the molecular characteristics in these cases.

A bronchopleurocutaneous fistula caused by an unusual foreign body aspiration simulating acute abdomen.

A 12-year-old boy was admitted to hospital for abdominal pain, vomiting and fever. On physical examination he had râles on the lower right hemithorax without any respiratory complaints. Chest X-ray revealed a condensation in the right lower chest. Abdominal findings were secondary to lobar pneumonia. Treatment of pneumonia with antibiotics showed no improvement over 2 days. On bronchoscopy no foreign body was seen, but pus was aspirated. Two days later a mass appeared on the right hemithorax and fistulized. An organic foreign body, Hordeum murinum, with 3-5 ml of pus was observed. Chest X-ray taken at the day of fistulization showed no pneumothorax or subcutaneous emphysema. Less than 11 cases of pneumocutaneous fistulas secondary to aspiration of grasses have been reported in literature. Why an ear of Hordeum murinum can migrate only in a forward direction and why a pneumothorax had not developed is discussed.

Histologic and ultrastructural changes in the contralateral ovary in unilateral ovarian torsion: an experimental study in rabbits.

This study was planned to investigate the extent of cellular damage of the contralateral ovary in unilateral ovarian torsion and to determine possible changes histopathologically by light and ultrastructurally by electron microscopy. Unilateral ovarian torsion was performed in 21 prepubertal, female New Zealand rabbits. One, 8 and 24 hours after the torsion, contralateral ovaries were biopsied. The control group consisted of rabbits without any torsion. Contralateral cellular damage was demonstrated after unilateral torsion. Oocytic nuclei, mitochondria, lysosomes and ovarian stromal cells were also affected when evaluated ultrastructurally.

Influence of unilateral ovarian torsion to the contralateral ovary.

An experimental study was planned to show the suppression of contralateral ovary in unilateral ovarian torsions. In the study, 55 New Zealand female rabbits were used. Basal and stimulation 17 beta estradiol values were measured and unilateral torsion in 20 rabbits, bilateral torsion in ten rabbits and bilateral oophorectomy in five rabbits were performed. Eight, 16, 24 hours after the procedure, 17 beta estradiol levels were measured again and the second stimulation values maintained. The control group consisted of 20 rabbits. Values were analyzed statistically and the results were significant.

Human amniotic membrane as an intestinal patch for neomucosal growth in the rabbit model.

This experiment was carried out as a preliminary study, an attempt to grow new intestinal mucosa on human amniotic membrane in the terminal ileum in 37 rabbits. After ketamin sulfate anesthesia at laparatomy, 5-cm ileal defects were patched with human amniotic membrane (5 x 2 cm). These patched intestines were investigated on the first postoperative day and the 2nd, 5th, 10th, and 20th weeks corresponding to 4, 5, 5, 10, and 10 rabbits, respectively. Only three rabbits died in the early postoperative period. There was no evidence of intestinal obstruction or dilatation with barium meal. Microscopically, the neomucosa consisted of a thin layer of columnar epithelial cells at 2 weeks with more maturity of the villi and less irregularity and branching by 20 weeks. All patches were covered with neomucosa commencing at 2 weeks and covering the whole patch area by 20 weeks. This technique's advantages are the large size and the ease of the availability of the human amniotic membrane for neonates at risk without jeopardizing the neonates tissues. It is hoped that this method might be considered when neonatal material is scarce.