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Öğe 4-YEAR-OLD CASE WAS ADMITTED TO HOSPITAL WITH DELIRIUM CAUSED BY DEHYDRATION AND METABOLIC ACIDOSIS(2023) Özcan, Eda Gül; Kaymaz, Nazan; Aylanç, Hakan; Şehitoğlu, M.Hilal; Kurtuluş, ŞenayDelirium, a potentially reversible, acute-onset organic brain syndrome, is a behavioral manifestation of acute brain dysfunction associated with underlying medical conditions. It presents as marked and inconsistent mental changes characterized by dysregulated states of focus and cognition. It can be caused by several different causes, including infections, drugs, toxins, metabolic disorders, and a number of other medical conditions. This case report presents a 4-year-old girl with short bowel syndrome, who developed hyperactive delirium due to acute metabolic acidosis.Öğe Can a frenuloplasty performed during circumcision lead to meatal stenosis?(Logos Medical Publishing, 2024) Kurtuluş, ŞenayObjectives: In this study, we aimed to investigate the role of frenuloplasty in developing meatal stenosis (MS) in boys who underwent frenuloplasty and those whose frenulum was preserved. Patients and methods: Between June 2022 and July 2023, medical data of a total of 308 male patients who were circumcised using a guillotine or squeezing technique with an Alisklamp were retrospectively analyzed. The patients were divided into two groups based on whether frenuloplasty was performed during circumcision. Group 1 (frenuloplasty with circumcision, n=153 [mean age: 62.6±39.0 months; range, 2 to 132 months]) and Group 2 (frenulum preserved, n=155 [mean age: 6.7±3.9 months; range, 2 to 22 months]) were both evaluated for the development of complications, including MS after circumcision. Results: Wound infection was observed in one patient in Group 1 and post-circumcision bleeding and secondary phimosis were observed in two patients in Group 2. When the parents were questioned about the urination habits of their children in the outpatient clinic follow-ups, there were no complaints of decreased urine thickness, prolonged urination, or difficulty in starting to urinate. In the outpatient follow-up at one week, one month, and six months, the external urethral meatus was evaluated as normal. In the external genital examinations performed at one week, one month, and six months after circumcision, the external urethral meatus was evaluated as normal in all patients. Conclusion: Meatal stenosis is not a common complication of circumcision, and frenuloplasty is not a risk factor for developing MS.Öğe Evaluation of Smooth Muscle Myosin Heavy Chain Isoform Expressions in a Buried Penis(W B Saunders Co-Elsevier Inc, 2024) Kurtuluş, Şenay; Süzen, Alev; Sılan, Fatma; Öztopuz, Rahime ÖzlemBackground: A buried penis (BP) is rare in which the penile body is retracted into the prepubic adipose tissue. This research focuses on differences in smooth muscle myosin heavy chain (SMMHC) isoform expressions in the dartos fascia. Methods: A total of 82 children, 41 of whom had BPs, who applied for circumcision between May and November 2021, were included in the study. The cases were divided into four groups aged >= 6 years (NP6, n = 18) and aged <= 3 years (NP3, n = 17) with normal penile appearance, aged >= 6 years (BP6, n = 23) and aged <= 3 years (BP,n = 24) with a BP. SMMHC isoforms mRNA gene expression analyses were performed by quantitative PCR technique in dartos fascia obtained from foreskin removed by circumcision. Results: Compared to the NP3 group, the SM1 mRNA expressed in the BP6 group was statistically significantly higher (p < 0.005). SM2 mRNA levels expressed in dartos fascia were considerably higher in NP6 and NP3 groups compared to BP6 and BP3 groups (p < 0.001). The SM2/SM1 ratio was 0.85 in the BP6 group and 1.46 in the NP6 group, which was statistically significant (p = 0.006) and increased from 0.87 in the BP3 group to 2.21 in the NP3 group (p < 0.001). Conclusion: In a buried penis, there is a difference in the expression of SMMHC isoforms. SM1 is highly expressed, while SM2 decreases, increasing the SM2/SM1 ratio. This causes increased contractility in the smooth muscle, leading to retraction of the penile body. The dartos fascia surrounding it resembles aberrant muscle tissue in boys with a BP. Level of Evidence: Level III. Type of Study: Case-control study.Öğe Familial Mediterranean Fever Present with Gastrointestinal Manifestations of Henoch Schonlein Purpura(2021) Şehitoğlu, M.Hilal; Güzel, Yusuf; Kaymaz, Nazan; Kırmızıtaş, Ezgi; Kurtuluş, ŞenayHenoch Schönlein Purpura is the most common small vessel vasculitis in childhood which is characterized with non-thrombocytopenic purpuric skin rash, arthritis, abdominal pain and renal disease. Palpable purpura usually occurs as the first clinical finding. However, gastrointestinal symptoms can rarely appear before the rash and may cause delays in diagnosis. Here, we present a case of Henoch Schönlein Purpura who underwent appendectomy with the diagnosis of acute abdomen and developed skin involvement in clinical follow-up. Another important point of our case is; In the genetic analysis performed in our patient with Henoch Schönlein purpura attack, Familial Mediterranean Fever was diagnosed with heterozygous mutation M694V and V726A . Since Henoch Schönlein Purpura is more common in Familial Mediterranean Fever patients; Familial Mediterranean Fever findings should be questioned in patients with Henoch Schönlein Purpura and gene mutation analysis should be performed if Familial Mediterranean Fever findings are specified.Öğe Torsion of juvenile granulosa cell ovarian tumor(Elsevier Inc., 2022) Kurtuluş, Şenay; Demir, Bülent; Aylanç, NilüferJuvenile granulosa cell tumor (JGCT), which is one of the sex cord-stromal tumors of the ovary, is a rare malignancy of childhood. Juvenile type is a rare form that accounts for 5% of granulosa cell tumors. Isosexual precocious puberty is the most common presentation in prepubertal girls with juvenile granulosa cell tumors. Less frequently, they present with the complaint of a mass in the abdomen. We present an 8-year-old girl with a juvenile granulosa cell tumor who presented with sudden onset of abdominal pain and enlargement of the abdomen. She underwent exploratory laparotomy with right salpingo-oophorectomy and a complete mass resection was performed. Pathologic staging of the mass, which was diagnosed as juvenile granulosa cell tumor of the ovary, was determined as pT1c3, and our patient received four cycles of chemotherapy.
