The effect of laparoscopic and open surgery on oxidative DNA damage and IL-37 in children with acute appendicitis.

BACKGROUND: Although laparoscopic appendectomy (LA) is considered to be minimally invasive compared with open appendectomy (OA), there are few studies showing this in terms of cytokines and oxidative stress markers. AIM: LA and OA techniques have been compared in terms of different conditions such as operation time and complication rate. Here, we compared how oxidative DNA damage and some cytokines levels change in relation to LA and OA. METHOD: This study was performed in children diagnosed with acute appendicitis in our hospital. The study was conducted on 30 children with acute appendicitis in each group. Oxidative DNA damage and malondialdehyde levels were determined by high-performance liquid chromatography, and interleukin-1ß, interleukin-37, ischaemia-modified albumin and total thiol levels were determined by enzyme-linked immunosorbent assays. RESULTS: There was a dramatic decrease in ischaemia-modified albumin (IMA) levels after LA. However, there were no statistically significant differences in pre- and postoperative IMA levels in the OA group. Oxidative DNA damage and malondialdehyde levels were low significantly according to preoperative levels after the LA and OA. Total thiol levels were high in children who underwent LA while they were low after OA. In addition, postoperative interleukin-1ß levels were low in both groups. Furthermore, IL-37 levels postoperatively were low in the LA group, while there was no significant change in the OA group. CONCLUSION: LA had a more positive effect on oxidative DNA damage, IL-1ß and IL-37 than the OA. In addition, surgical stress was reduced with LA.

The effects of CoQ10 supplement on matrix metalloproteinases, oxidative DNA damage and pro-inflammatory cytokines in testicular ischaemia/reperfusion injury in rats.

We aimed to study the effect of coenzyme Q10 on pro-inflammatory cytokine, matrix metalloproteinase, oxidative DNA damage, caspase 3 and caspase 8 in ischaemia/reperfusion injury led to by testicular torsion/detorsion. Our research is a controlled experimental animal research using rats. This study was conducted with fifty-six adult male Albino Wistar rats. Interleucine-1ß, 2, 6, 10, tumour necrosis factor-α, matrix metalloproteinase-2, 3, 9, 13, tissue inhibitor matrix metalloproteinase-1, 2, malondialdehyde and leucocyte 8-hydroxy-2-deoxy guanosine/106 deoxyguanosine was detected in serum and tissue samples. In addition, immunohistochemical analysis of caspase 2 and caspase 8 was performed. In testicular I/R injury, especially 24 hr after detorsion, oxidative damage pro-inflammatory cytokines and matrix metalloproteinases were increased. At the coenzyme Q10 group, a meaningful decrease was observed in these parameters. In addition, a decrease in the expression of caspase3 and caspase 8 was viewed in coenzyme Q10-treated groups. The coenzyme Q10 has beneficial effects on oxidative damage, pro-inflammatory cytokine levels, remodelling of extracellular matrix and apoptosis in testicular I/R injury.

Why is the rate of perforated appendicitis higher in girls in eastern Turkey, unlike the literature?

AIM: Appendicitis is the most common cause of surgical abdominal pain in children. The incidence of appendicitis is higher in boys than girls. Delay in diagnosis may result in perforation of the appendix. Aim of this study is, to examine the terms of gender distribution of perforated appendicitis cases in eastern Turkey. MATERIAL AND METHODS: Patients who underwent appendectomy in our clinic between the years of 2017-2018 were classified according to histopathology results as acute appendicitis and perforated appendicitis. Two groups was evaluated in term of; the age, gender, and length of hospital stay. RESULTS: Of the patients included in the study, 168 were male and 99 were female. The incidence of perforated appendicitis was higher in girls (%59), (p=0,001) and acute appendicitis was higher in boys (%63), (p=0,001). The mean age was 11.44±3.50 years in acute appendicitis and 9.22±4.26 years in perforated appendicitis. In perforated appendicitis, the mean length of hospital stay (6,73 day) was longer than acute appendicitis (2,59 day) (p=0,001). In addition, the mean length of hospital stay (8,13 day) for girls with perforated appendicitis was statistically significantly longer than boys (6,03 day), (p=0,001). CONCLUSION: While diagnosing appendicitis in the east of Turkey; living environment of the child, education level of the family, socioeconomic status and cultural structure of the society must be considered. It should not be forgotten that the rate of perforated appendicitis in girls is higher than boys in this region.

AMAÇ: Apandisit çocuklardaki en sik cerrahi karin agrisi nedenidir. Erkek çocuklarda sikligi kiz çocuklarindan daha yüksektir. Tanidaki gecikmeler apandiksin perforasyonu ile sonuçlanabilir. Bu çalismada amaç, Türkiye'nin dogusundaki perfore apandisit olgularinin cinsiyet açisindan dagilimini irdelemektir. GEREÇ VE YÖNTEMLER: 2017­2018 yillari arasinda klinigimizde apandektomi yapilan hastalar histopatoloji sonuçlarina göre akut apandisit ve perfore apandisit olarak iki gruba ayrildi. Bu iki grupta hastalarin yasi, cinsiyeti ve hastanede yatis süresi arasindaki iliski degerlendirildi. BULGULAR: Çalismaya alinan hastalarin 168'i erkek, 99'u kiz idi. Erkek çocuklarda akut (%63), kiz çocuklarda ise perfore apandisit (%59) sikligi daha yüksek bulundu, (p=0,001 ve p=0,001). Akut olgularda ortalama yas 11,44±3,50 yil iken, perfore apandisitlerde 9,22±4,26 yil olarak saptandi. Perfore apandisitlerde hastanede ortalama yatis süresi (6,73 gün), akut apandisitlerden (2,59 gün) daha yüksekti, (p=0,001). Ayrica perfore apandisit tanili kiz çocuklarin ortalama yatis süresi (8,13 gün) de erkek çocuklara (6,03 gün) nazaran istatiksel olarak anlamli bir sekilde yüksek bulundu, (p=0,001). ÇIKARIMLAR: Türkiye'nin dogusunda apandisit tanisi konulurken çocugun yasadigi ortam, sosyoekonomik durumu, ailenin egitim düzeyi ve yasadigi toplumun kültürel yapisi göz önüne alinmalidir. Bu bölgedeki kiz çocuklarda perfore apandisit oraninin erkek çocuklara nazaran daha yüksek oldugu unutulmamalidir.

Oxidative DNA Damage and NOX4 Levels in Children with Undescended Testes.

BACKGROUND: Undescended testis (UDT) is a common urological disorder. Patients with UDT have a risk of malignancy and infertility. The development of these conditions may be due to oxidative stress mediated by reactive oxygen species. The aim of this study was to investigate the relationship between these parameters by detecting oxidative DNA damage (8-hydroxy 2 deoxyguanosine/106 deoxyguanosine), ischemia-modified albumin (IMA), malondialdehyde (MDA), and nicotinamide adenine dinucleotide phosphate oxidase 4 (NOX4) levels in children with UDT and healthy control group. MATERIALS AND METHODS: The blood samples were obtained from 30 patients with UDT and 40 healthy male subjects. The levels of oxidative DNA damage were detected by high-pressure liquid chromatography method. We used commercially available kits that use enzyme-linked immunosorbent assay method to measure IMA, MDA, and NOX4 levels. RESULTS: The levels of MDA, IMA, NOX4, and oxidative DNA damage in children with UDT were statistically significantly higher than control group. In addition, we found that the levels of NOX4, IMA, and oxidative DNA damage after 12 months of age was significantly higher than before 12 months of age. CONCLUSION: We identified increased lipid peroxidation, oxidative DNA damage, IMA, and NOX4 levels in children with UDT. Delay in the treatment of UDT may cause oxidative damage. That is why, according to us the antioxidant treatment may be beneficial in children with UDT.

A new enema for treatment of intussusception with hydrostatic reduction: Olive oil.

OBJECTIVES: Intussusception is routinely treated using ultrasound-guided hydrostatic reduction (USGHR) with normal saline in our paediatric surgery department. With this study, olive oil was added to normal saline in ultrasound-guided reduction of intussusception. MATERIALS AND METHODS: Forty patients who were diagnosed and treated for intussusception in Van Yuzuncu Yil University Faculty of Medicine Pediatric Surgery Department from March 2017 to May 2017 were included in the study. During this retrospective study, randomly chosen 20 patients that treated with USGHR using normal saline were marked as Group 1. Moreover, 20 patients that treated with USGHR using a mixture of olive oil and saline (10% olive oil 90% normal saline) were marked as Group 2. Patients' age, gender, symptoms, treatment techniques, complications and hospitalisation periods were retrospectively noted. RESULTS: Forty patients were included in the study. In Group 1, 14 patients were treated in the first session, 4 patients were treated in the second session and 2 patients required laparotomy. Mean reduction time in this group was 15 min mean fluid volume used in each reduction was 80 ml/kg and mean hospitalisation period was 38 h. In Group 2, 19 patients were treated in the first session, and only 1 patient required a second session. Mean reduction time was 12 min, used fluid volume was 58 ml/kg for each reduction and hospitalisation period was 24 h. CONCLUSION: The average volume of fluid used for reduction, average reduction time, numbers of recurrent reductions and hospitalisation were less when a mixture of olive oil and normal saline were used in comparison with when normal saline was used alone to reduction the intussusception under ultrasound guidance. Using olive oil mixed with normal saline as a new enema fluid is likely to increase the success rate of ultrasound-guided reduction of intussusception.

Treatment algorithm in 960 pediatric burn cases: A review of etiology and epidemiology.

OBJECTIVE: Burn injuries are one of the most significant threats to life in both undeveloped and developing countries. In this study, we evaluate the demographic characteristics and treatment methods in pediatric burn cases admitted to our clinic. METHODS: A total of 960 patients aged 0-16 years old who were referred to our center with burn injuries between 2015 and 2016 were analyzed in terms of sex, age, etiology, epidemiology, burn percentage, the degree of burn, hospitalization duration, morbidity-mortality, and treatment methods. RESULTS: In the present study, 512 male and 448 female patients were included. Burns were seen mostly among the patients aged 2-4, and the majority of them were extremity burns. The mean hospitalization duration was 10±6.7 days, and the most common source of burn injury was from hot liquids. CONCLUSION: Burn injuries are a pediatric emergency that needs to be emphasized to reduce occurrences due to the long hospitalization period, the unfavorable mortality and morbidity rates, and increased treatment costs. It is possible to obtain more positive results by way of a standard and easily applicable treatment algorithm in cases of burn injury.

Histopathological Diagnostic Dilemma in Retrorectal Developmental Cysts: Report of a Case and Review of the Literature.

Retrorectal developmental cysts are lesions that are classified according to their histopathological characteristics and origins. The major types are epidermoid cyst, dermoid cyst, rectal duplication cyst, rectal cystic hamartoma and teratoma. These cysts grow slowly and the majority of cases are asymptomatic. Total excision is required and histopathological examination should be carefully performed for retrorectal localized developmental cysts, since the cystic lesions may show malignant transformation. Here, a 3-year-old male patient with retrorectal mass, which was histopathologically compatible with tailgut cyst, is presented and the differential diagnosis of retrorectal developmental cysts is discussed.

Ischemia-modified albumin and other inflammatory markers in the diagnosis of appendicitis in children.

BACKGROUND: The aim of the present study was to determine relationship of ischemia-modified albumin (IMA) level, C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), white blood cell (WBC) count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) to appendicitis in children. METHODS: Study included total of 63 patients who presented at hospital between May 2015 and November 2015. Of these, 30 were cases of appendicitis, and 33 were healthy control subjects. The groups were statistically similar in age and gender. RESULTS: Receiver operating characteristic curve was evaluated for IMA, CRP, ESR, WBC, MPV, NLR, and PLR values in patients with appendicitis, and IMA was determined to have highest area under the curve value (0.991), followed by NLR (0.946), CRP (0.808), PLR (0.779), ESR (0.767), WBC (0.749), and MPV (0.583). CONCLUSION: Use of NLR, PLR, IMA, and ESR values may be helpful in diagnosis of appendicitis, in addition to WBC and CRP values, lower right quadrant abdominal pain, and ultrasonography signs commonly used.

Parasitic infestation in appendicitis. A retrospective analysis of 660 patients and brief literature review.

OBJECTIVES: To investigate the incidence of parasitic infestations and inflammation accompanying parasitosis in a series of appendectomy cases.  Methods: Six-hundred-sixty  patients who had undergone appendectomy in Bingöl State Hospital, Bingol, Turkey with the preliminary diagnosis of appendicitis between January 2012 and February 2015 were included in this retrospective study. They were retrospectively evaluated in terms of age, gender and pathological findings. Cases diagnosed with parasitic infestations were re-evaluated histopathologically for inflammatory response.  Results: The mean age was 19.6 years, and the male/female ratio was 1.8. When evaluated in terms of histopathological diagnoses, 573 (86.8%) were diagnosed as acute appendicitis, and parasitic infestation was identified in 12 (1.8%). Among cases with parasitic infestation, Enterobius vermicularis was identified in 9 (75%) and Taenia in 3 (25%) cases. Of cases with Enterobius vermicularis, 4 (44.4%) had lymphoid hyperplasia, 1 (11.1%) had normal-structured appendix vermiformis, and 4 (44.4%) had findings of acute appendicitis. All cases with taeniasis had an inflammatory response: acute appendicitis was identified in 2 (66%) and acute gangrenous appendicitis in 1 (33%) of them.  Conclusion: Parasitic infestations are among the probable causes in appendicitis etiology and should be kept in mind during differential diagnosis. However, whether every parasitic infestation leads to appendiceal inflammatory response is controversial.