The hydatid cyst (HC) is an endemic parasitic disease worldwide. Although the HC can locate in every part of a body, it rarely occurs over the abdominal wall. A 12-year-old female patient was brought to Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey in 2017. She had been suffering from abdominal pain for one week. A lump was determined underneath her skin in the suprapubic region. It was swollen, tense and movable. A cystic mass filling the midline was found in the radiological bladder superior. It was an anechoic cyst causing ondulation on the muscles of the anterior abdominal wall. The sizes of the mass were measured approximately as 9x7 cm (mesentery cyst?). The cystic mass was occurred in the urachal area of the anterior abdominal wall, not in the abdomen. After the cyst was emptied with applying mini median incision below the umbilicus, we saw the germinative membrane inside the cyst. Diagnosis of the HC was confirmed with the pathologic evaluation. For the differential diagnosis of a pure cystic mass, which can locate in every part of a body, diagnosis of the HC should be considered.
Purpose: Vestigial like family member 3(VGLL3) and its sub-target genes have been determined to have significant transcriptomic overlap many autoimmune and inflammatory diseases. In this study, we investigated the role of VGLL3 rs13074432 polymorphism and its sub-target genes in the etiology of acute appendicitis (AA). Methods: 250 patients aged 0-18 years, who underwent appendectomy with the diagnosis of AA (patient group; blood and appendix tissue samples), and 200 healthy children (control group; only blood samples) without appendectomy were included in the prospective case-control study. ELISA method was used for protein level detection of VGLL3 and sub-target genes expression change in obtained tissue samples, and Real-Time Quantitative Reverse Transcription polymerase chain reaction (qRT-PCR) was used for mRNA level detection. Genotyping analyses were performed on DNA samples isolated from blood using TaqMan SNP genotyping test. Results: The frequency of TT variant genotype (p=0.000) and T allele (p=0.002) decreased statistically in the patient group compared to the control. No significant correlation was observed between the expression of VGLL3 in the appendiceal tissue and the clinical and demographic data of the patient (p>0.05). Conclusion: This study revealed that the VGLL3 gene and its sub-target genes are associated with the etiology of AA.
ÖZAmaç: Bu çalışmada, Bochdalek hernisi nedeniyle cerrahi uygulanan yenidoğanların mortalitesi üzerine etkili olan faktörlerin ortaya konulması amaçlanmıştır. Gereç ve Yöntem: 2001-2016 yılları arasında cerrahi tedavi uygulanan 36 Bochdalek hernili olgunun dosyaları geriye dönük olarak incelendi. Bulgular: Hastalardan ikisi ikiz, yaş, ortalama doğum ağırlığı 3000±503 g, ortanca cerrahi yaşı 4 (1-10) gün ve mekanik ventilatörde kalma süresi ise 8,5 (2-60) gündü. Serimizde mortalite oranı %25 idi. Gebelik yaşı ≤ 36 hafta olan hastalardaki mortalite oranı (%50) gebelik yaşı > 36 hafta olan hastalardaki mortalite oranından (%17,8) belirgin olarak daha yüksekti (p=0,046). Yenidoğan yoğun bakım ünitesinde izlenen olgulardaki mortalite oranı (%47,1) çocuk cerrahisi yoğun bakım ünitesinde izlenen olguların mortalite oranına (%5,2) göre anlamlı derecede daha yüksekti (p=0,005). Mortalite oranları sırasıyla prenatal tanı konulan olgularda %43, beşinci dk. Apgar skoru ≤5 olan olgularda %30, beşinci dk. Apgar skoru >5 olan olgularda %11 ve pulmoner hipertansiyonu olan olgularda ise %62,9'du. Sağ Bochdalek hernili hiçbir olgu kaybedilmemişti. Eksitus olan hastaların %77,7'sinde majör konjenital kardiyak anomaliler vardı. Eksitus olan olgularda pulmoner vazodilatör ajanların ve yüksek frekanslı mekanik ventilasyon modunun daha fazla kullanıldığı görüldü. Sonuç: Bochdalek hernili olgular %25 oranında mortaliteye sahiptirler. Pulmoner hipertansiyon, prematürite ve düşük doğum ağırlığı mortaliteyi etkileyen faktörlerdir. ABSTRACT Objective: In this study, it was aimed to investigate the factors affecting the mortality of newborn infants who underwent surgery due to Bochdalek hernia. Material and Methods: The files of 36 cases with Bochdalek hernia who underwent surgery between 2001 and 2016 were retrospectively reviewed. Results: Two of the patients were twins. The male to female ratio was 19/17. Median gestational age of the patients was 36 (32-38) weeks, maternal age 29 (16-41) years, mean birth weight 3000±503 g, median age at surgery 4 (1-10) days and duration of mechanical ventilation was 8.5 (2-60) days. The mortality rate in our series was 25%. The mortality rate (50%) in patients with gestational age ≤36 weeks was significantly higher than the mortality rate (17.8%) in patients with gestational age >36 weeks (p=0.046). The mortality rate (47.1%) of the patients followed up in the neonatal intensive care unit was significantly higher than the mortality rate (5.2% )those monitored in the intensive care unit of the pediatric surgery department (p=0.005). Mortality rates were 43% in cases with prenatal diagnosis, 30% in cases with 5th min. Apgar scores of ≤5 and 11% in cases with 5th min. Apgar scores of >5, and 62.9% in cases with pulmonary hypertension. None of the right Bochdalek hernia cases died. Major congenital cardiac anomalies were present in 77.7% of exited patients. Pulmonary vasodilator agents and high frequency mechanical ventilation mode were more commonly used in exited cases. Conclusion: The cases with Boch...
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