The study aims to evaluate the effectiveness and safety of endoscopic balloon dilatation (EBD) in childhood benign esophageal strictures. The medical records of 38 patients who underwent EBD from 1999 to 2013 were retrospectively reviewed. Demographic features, diagnoses, features of strictures, frequency and number of EBD, complications, outcome, and recurrence data were recorded. Median age was 1.5 years (0-14), and female/male ratio was 17/21 (n = 38). Primary diagnoses were corrosive esophageal stricture (n = 19) and esophageal atresia (n = 19). The length of strictures were less than 5 cm in 78.9% (n = 30). No complication was seen in 86.8% (n = 33). Perforation was seen in 10.5% (n = 4), and recurrent fistula was seen in 2.7% (n = 1). Total treatment lasted for 1 year (1-11). Dysphagia was relieved in 60.5% (n = 23). Recurrence was seen in 31.6% (n = 12). Treatment effectiveness was higher, and complication rates were lower in strictures shorter than 5 cm compared with longer ones (70% vs. 25%, P < 0.05, and 3.4% vs. 37.5%, P < 0.05). Although there was no statistical difference, treatment effectiveness rates were lower and complication and recurrence rates were higher in corrosive strictures compared with anastomotic ones (P > 0.05). EBD is a safe and efficient treatment choice in esophageal strictures, especially in strictures shorter than 5 cm and anastomotic strictures.

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An 11-year-old morbidly obese boy was diagnosed with pancreatic pseudocyst. Following fine needle aspiration, the cyst recurred in 1-month follow-up. Therefore, endoscopic drainage and cystoduodenostomy was performed following endosonography. Control ultrasonography (USG) revealed a completely shrunken cyst. During the 3 years of follow-up, the patient was asymptomatic with no evidence of cyst on computerized tomography scans. Endoscopic drainage and cystoduodenostomy is a minimally invasive, effective, and safe approach in the management of pancreatic pseudocysts in children.

Background/Aim. The aim of the present study was to find out if there is an increase in the expression of pro-apoptotic Bax and reduction in expression of anti-apoptotic Blc-2A1 in newborn intestines with necrotizing enterocolitis (NEC). Material and Methods. We compared 8 consecutive newborn patients undergoing bowel resection for NEC with 8 neonates undergoing intestinal resection for ileal atresia. Histopathological evaluation of tissue injury and apoptosis was performed by using light microscopic examination and TUNEL method. The mRNA level of apoptotic (CASP3, CASP6, CASP7, Bax, BIRC2) and anti-apoptotic genes were evaluated by PCR array method. Protein expression was assessed by immunohistochemistry. Results. Tissue injury scores and mean apoptosis scores were significantly higher in NEC group when compared with control group (p <0.01). Expression of pro-apoptotic genes were significantly increased in NEC group when compared with control group (p <0.01). Expression of anti-apoptotic Bcl-2A1 gene was significantly decreased in NEC group, (p <0.01). Protein expression of Bax and CASP3 was significantly increased in NEC group, (p <0.01). Conclusion. Our data in human newborns suggest that alteration of the balance between pro-apoptotic Bax expression and antiapoptotic Bcl-2A1 expression in the site of injury is a possible mechanism in the pathogenesis of NEC. Keywords: apoptosis, gene expression, necrotizing enterocolitis, newborn.http://dx.doi.org/10. 5546/aap.2016.eng.243 INTRODUCTION N e c r o t i z i n g e n t e r o c o l i t i s ( N E C ) i s a complicated, multi-factorial condition of newborns and premature infants which causes significant mortality and morbidity in this population. NEC is characterized by intestinal epithelial cell apoptosis, necrosis, haemorrhage, i n c o m p l e t e e n t e r o c y t e m i g r a t i o n , a n d proliferation that results in persistent gut barrier failure which leads to loss of epithelial integrity, invasion of the intestine by bacteria followed by an acute, hyper-reactive inflammatory reaction and consecutive bowel necrosis. 1,2The balance between cell proliferation and cell loss is necessary for the maintenance of intestinal epithelial homeostasis.3,4 The majority of cell loss in the normal intestine occurs by apoptosis.3 The balance of pro-apoptotic and anti-apoptotic proteins is crucial for cell survival.3 Bcl-2 family is a significant class of molecules that control enterocyte apoptosis.3 Bcl-2A1 is an antiapoptotic protein which inhibits the cytochrome c release from the mitochondria and reverses the effects of the pro-apoptotic protein Bax.3 It has been showed that an exaggerated epithelial apoptosis in gut leads to severe NEC injury. 2,3,5 In a rat model of NEC, it has been shown that expression of apoptotic genes increased whereas expression of anti-apoptotic genes decreased. Furthermore, prevention and reducing apoptosis in experimental settings have been suggested to reduce NEC incidence.5-7 Therefore, we aimed to find out if there is an increas...