Coexistence of Anal Atresia, Anophthalmia and Intestinal Neuronal Dysplasia Type-A in a Newborn.

We report a patient with anal atresia, anophthalmia and intestinal neuronal dysplasia type A.

Mesenchymal stem cell therapy in necrotizing enterocolitis: a rat study.

We evaluated the potential therapeutic use of exogenous human bone marrow-derived mesenchymal stem cells (hBM-MSCs) in an experimental rat model of necrotizing enterocolitis (NEC). Thirty-six newborn Sprague-Dawley rats were randomly divided into three groups: NEC, NEC + hBM-MSC, and a control (control and control + hBM-MSC). NEC was induced by enteral formula feeding, exposure to hypoxia-hyperoxia, and cold stress. After NEC was induced, iron-labeled hBM-MSCs were administered by intraperitoneal injection. All pups were killed on the fourth day following injection, and the terminal ileum was excised for a histopathological and immunohistochemical evaluation. The pups in the NEC + hBM-MSC group showed significant weight gains and improvements in their clinical sickness scores (p < 0.01). Bowel damage severity observed in the histopathological evaluation was significantly lower in the NEC + hBM-MSC group than that in the NEC group (p = 0.012). The number of MSCs homing to the bowel was significantly higher in the NEC + hBM-MSC group than that in the control + hBM-MSC group. In conclusion, this is the first study that has evaluated the effectiveness of hBM-MSCs in a neonatal rat NEC model. MSCs reduced histopathological damage significantly.

C5a, a complement activation product, is a useful marker in predicting the severity of necrotizing enterocolitis.

Necrotizing enterocolitis (NEC) is the most common neonatal gastrointestinal emergency, predominantly affecting low-birth weight, premature infants. Early clinical signs of NEC are nonspecific and the laboratory findings are not fully reliable. Its severe morbidities and rapid progression require the application of new biomarkers for early diagnosis and intervention. The complement activation product, C5a (anaphylatoxin) has been reported to be a contributing factor leading to mesenteric ischemia/reperfusion injury which is a predisposing factor in the pathogenesis of NEC. Therefore, our aim was to evaluate the efficacy of serial C5a measurements in the diagnosis and follow-up of NEC. Preterm infants, whose gestational age and weight matched each other, were grouped as controls (n = 23) and NEC (n = 22). Serum levels of C5a, serum amyloid-A (SAA), C-reactive protein (CRP), and interleukin-6 (IL-6) levels were measured on the third day of life for the control group and on the day of diagnosis (1st day), 3rd and 7th days of the NEC group. C5a, SSA, CRP, and IL-6 levels were significantly higher in the NEC patients compared to the control group (P < 0.05) in the follow-up. Additionally, serum levels of C5a were found to be more accurate than the other parameters for the prediction of death and requirement for surgery at the time of diagnosis (P < 0.05). In conclusion, C5a may be useful as a new marker for both diagnosis and follow-up of infants with NEC in combination with clinical and radiographical findings.

The protective effect of erythropoietin infusion on testicular torsion/detorsion: an experimental study.

INTRODUCTION: The aim of the present study was to evaluate the effects of erythropoietin (EPO) on the histopathology of testes after unilateral testicular torsion and detorsion. MATERIALS AND METHODS: Twenty-five male Sprague-Dawley rats weighing 120 g were used in this study. The rats were randomly divided into three groups, a sham group consisting of five rats and the other two groups consisting of ten rats. In group 1 (sham group), right orchiectomy with no additional intervention was performed. In group 2 (T/D group), torsion was created by rotating the testis 720 degrees in a clockwise direction for 4 h. After a 4-h torsion period, the right testis was detorted and replaced into the scrotum for 4 h. After the torsion, 0.5 cc 0.9% NaCl solution was injected once and three times in a week (total 12 doses). In group 3 (T/D + erythropoietin; EPO group), the same surgical procedure was done as in group 1, but EPO 1,000 IU/kg was injected just before the detorsion and three times in a week. At the end of each procedure, bilateral orchiectomies were performed for the histopathological examinations in all groups. RESULTS: We examined the testes weight, vascularization of the region between the seminiferous tubules, percentage of necrotic seminipherous tubules, and maturation of spermatogenesis in terms of necrosis, sertoli cells, maturation arrest of spermatogenesis, hypospermatogenesis, and normal spermatogenesis of torsioned testis tissues with and without EPO treatment. Extremely significant differences in testicular weight were observed in group 1 compared to groups 2 and 3 (P < 0.001). CONCLUSION: Administration of EPO significantly influenced the rescue of testicular function by preserving the intact seminiferous tubular morphology, lowering the percentage of necrotic seminipherous tubules, and significantly reducing histological damage (P < 0.05).

Urethrocutaneous fistula: a case report.

BACKGROUND: A 16-year-old boy with penilurethra anomaly was admitted to our clinic. This is a case description of a hypospadiac congenital urethrocutaneous fistula of the anterior urethra. METHODS/RESULTS: After the chordee was corrected by removing dysgenetic tissue in urethral plate, urethral defect was repaired with tranverse preputial island flap. CONCLUSIONS: Congenital urethrocutaneous fistula is rare. Thirty-two cases of urethrocutaneous fistula have been reported previously. Embryological events that cause anterior urethrocutaneous fistula are unclear. We reported a case with hypospadiac congenital urethrocutaneous fistula of the anterior urethra treated with tranverse preputial island flap.

Unusual presentation of infantile hemangioendothelioma.

Infantile hemangioendothelioma is a rare benign hepatic tumor arising from mesenchymal tissue. Most of the cases present with congestive heart failure and asymptomatic abdominal mass were before 6 months of age. We described a patient with projectile vomiting, which is quite an unusual presentation. Following surgical resection, neither recurrence nor symptoms were seen in 2 years of follow-up.

Ectomesenchymoma: case report and review of the literature.

Ectomesenchymoma (EMCH) is a rare tumor that may arise in the brain or soft tissue. This tumor type is defined as a form including ectodermal components represented by neuroblasts or ganglion cells and differentiated mesenchymal structures of various types. The mesenchymal component is most often a rhabdomyosarcoma, but liposarcoma, malignant fibrous histiocytoma, leiomyosarcoma, chondrosarcoma, malignant schwannoma, and osseous elements have also been recorded. We report a case of an abdominal malignant ectomesenchymoma, containing three components, schwannoma, embryonal rhabdomyosarcoma, and ganglion cells, in a four-month-old infant. We also review 43 previously reported cases.

Effects of erythropoietin and pentoxifylline on the oxidant and antioxidant systems in the experimental short bowel syndrome.

In this study, we investigated the effects of erythropoietin (Epo), and pentoxifylline (Ptx) on the oxidant and antioxidant systems in the experimental short bowel syndrome. Spraque-Dawley rats were divided into four groups and all animals underwent 75% small bowel resection. Group E was treated with 500 IU kg(- 1) Epo subcutaneously (s.c.), group P with 50 mg kg(- 1) day(- 1) s.c. Ptx and group E+P with 500 IU kg(- 1) s.c. Epo plus 50 mg kg(- 1) day(- 1) s.c. Ptx for a period of 28 days. In group C, which is the control group, no drug treatment was given. At the end of 28 days the experimented rats were killed and ileum samples excised for biochemical and histopathological testing. Malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels were determined in ileum homogenates. When compared to group C, the MDA and GSH-Px levels were significantly decreased (p < 0.05), but SOD activity was not changed (p > 0.05) in groups P and E+P, whereas both MDA and SOD and also GSH-Px activities were not changed significantly in group E (p > 0.05). The average villous length, crypt depth, muscular thickness and mucosal length were measured in all groups. The average crypt depth and mucosal length were statistically higher in the group P than group C (p < 0.001, p < 0.01, respectively). In addition, the crypt depth was statistically higher in both E and E+P groups as compared to group C (p < 0.001, p < 0.01, respectively). Therefore, our study indicates that Ptx may be more effective than Epo in reducing lipid peroxidation. Moreover, we considered that Ptx may give this protective effect by inhibiting the free oxygen radicals to a greater extent than developing the antioxidant capacity.

Conservative surgical treatment of pulmonary hydatid disease in children: an analysis of 35 cases.

PURPOSE: Hydatid cyst disease is a major health problem for people who live in endemic countries such as Turkey. The definitive cure for pulmonary hydatidosis is still surgical. This study evaluates our experience of treating pulmonary hydatidosis, focusing on the conservative surgical management of children with this disease. METHODS: We retrospectively analyzed 35 children ranging in age from 3 to 13 years old, treated for pulmonary hydatidosis during a recent 4-year period. RESULTS: The 35 patients had a collective total of 48 cysts. Twenty-seven patients had a single cyst, 7 had unilateral multiple cysts, and 1 had bilateral multiple cysts. Six patients had multiple coexisting liver cysts. The 33 pulmonary cysts were intact and uncomplicated. Of the total 48 cysts, 34 were larger than 5 cm in diameter. Fever, cough, and dyspnea were the most common symptoms and chest radiography gave a correct diagnosis in 96.4% of the patients. Conservative surgical treatment was carried out in 33 of the 35 children (94%). There were few postoperative complications, and no mortality or recurrence in this series. CONCLUSIONS: Parenchyma-saving surgical procedures such as cystotomy and capitonnage are the preferred methods of treatment for pulmonary hydatid disease in childhood. These simple procedures are safe, reliable, and successful. Combined medical treatment can be given but not as an alternative to surgery. Simultaneous surgical procedures for coexisting liver cysts may be preferred because of the lower morbidity rates and hospitalization. Ultrasound or computed tomography scanning should be done to detect coexisting liver cysts in every patient with pulmonary hydatid disease.

A patient with an unusual complication of sliding inguinal hernia: Stercoral appendiceal fistula.

An unusual case of sliding inguinal hernia complicated by stercoral appendicular fistula as a result of acute appendicitis was reported in a 3-month-old boy. A diagnosis was made using barium enema. Elective appendectomy and narrowing of the internal ring using a purse-string suture were carried out safely via a right transverse infraumblical incision. Postoperative follow-up was uneventful.