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Özen, Mehmet Ali

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Mehmet Ali

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Özen

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Özen, Mehmet Ali

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2016 - 2019112020 - 20226

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    Two-year old girl with glial choristoma presented in a thyroglossal duct cyst
    (Turkish J Pediatrics, 2020) Peker, Önder; Eroğlu, Egemen; N/A; N/A; Şal, Oğuzhan; Özen, Mehmet Ali; Undergraduate Student; Faculty Member; School of Medicine; School of Medicine; Koç University Hospital; 341966; 293404
    Background: Neuroglial choristomas are rare entities that are composed of differentiated neuroectodermal cells presenting where they do not belong. Case: Here in this paper, we represent a two-year old patient with a very rare presentation of neuroglial choristoma which manifested itself within a thyroglossal duct cyst. In this paper we will also discuss pathogenesis, clinical manifestation, differential diagnosis and management of the neuroglial choristomas. Conclusion: In conclusion we believe this unique case may aid in understanding the pathophysiology, differential diagnosis, and management of this rare congenital anomaly.
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    Safe and effective technique in newborn tongue-tie: Frenotomy
    (Logos Medical Publishing, 2019) N/A; N/A; Özen, Mehmet Ali; Eroğlu, Egemen; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 293404; 214688
    Objective: In this study, we aimed to present the surgical technique and results of the the technique we used in patients diagnosed with tongue-tie in newborn period. Method: Between 2015 and 2019, the records of infants who underwent frenotomy in the Koç University Hospital Pediatric Surgery Clinic during the newborn period due to tongue-tie were examined retrospectively. The infants were evaluated in terms of clinical presentation, surgical indication technique, and outcomes. Results: During the four-year period, a total of 41 babies had undergone frenotomy for tongue-tie. The presenting complaints in decreasing frequency were the inability to take out tongue, difficulty in sucking the mother's breast, need for bottle-feeding, inability to maintain breastfeeding, need to support the baby's head from behind during the breastfeeding and having nipple pain. During the follow-up period, bleeding, hematoma, or infection was not observed in patients. None of the patients required re-intervention during follow-up. In 41 patients, there was a significant improvement in the sucking problem. In addition, nipple pain of 9 out of 11 mothers during breastfeeding resolved. Conclusion: Tongue-tie problem can be resolved in a safe, successful and easy way with the use of the frenotomy technique in infants with tongue-tie detected during physical examination who can not be breastfed even though they can be bottle-fed.
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    Evaluation of circumcision in terms of parental feedback and medical outcomes
    (Logos Medical Publishing, 2019) N/A; N/A; Özen, Mehmet Ali; Eroğlu, Egemen; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 293404; 214688
    Objective: The prevalence of circumcision is virtually 100% in Turkey. The purpose of this study is to investigate the parental feedbacks and the medical outcomes of circumcision in a large cohort study. Method: A questionnaire was designed to investigate parental opinions after circumcision of their children, and to document medical considerations. The questionnaire forms consisted of a total of 14 questions. Results: Questionnaire survey results of a total of 1000 children were enrolled. As for parents underlying causes of circumcision were as follows; 1) pressure imposed by tradition, and social environment (n=606), 2) religious belief (n=132), 3) medical problems (n=125), 4) hygienic consideration (n=88). Statistically, the satisfaction rate of the parents who preferred the newborn circumcision was significantly higher. 66 The children had minor problems at first postoperative week (n=66), scab over the glans (n=8), edema and ecchymosis (n=11), adhesions (N=47), and upward deviated urination (n= 5). Buried penis developed after 34 newborn circumcisions and 16 of them resolved after 3±0.5 years. Thirty out of 33 cases of UTI resolved after circumcision. Conclusion: Tradition is the main reason for circumcision. Newborn period and after 6 years of age were the most common circumcision ages. However, parents were apparently happier when their children were circumcised in the newborn period. From the parents' perspectives newborn period was seen as the best time for circumcision. Meatal stenosis (web), after circumcision developed only after newborn circumcision and its incidence is lower than reported in the literature. / Amaç: Sünnet prevalansı Türkiye’de neredeyse %100’dür. Bu çalışmanın amacı, geniş bir kohort çalışmada ebeveyn geri bildirimlerini ve sünnetin tıbbi sonuçlarını araştırmaktır.Yöntem: Çocuklarının sünnetinden sonra ebeveyn görüşlerini araştırmak ve tıbbi düşünceleri belgelemek için bir anket tasarlanmıştır. Anket formu toplam 14 sorudan oluşmaktadır.Bulgular: Toplam 1.000 çocuğun anketi kaydedildi. Ebeveynler için altta yatan sünnet nedenleri; 1) gelenek-sosyal baskı (n=606), 2) dini inanç (n=132), 3) tıbbi sorunlar (n=125), 4) hijyenik düşünce (n=88) olarak belirlendi. İstatistiksel olarak, yenidoğan sünnetini tercih eden ebeveynlerin memnuniyet oranı anlamlı derecede yüksekti. Sünnet sonrası birinci hafta kontrolünde 66 çocuğun küçük sorunları vardı; 8 çocuğun glans üzerinde kabuklanması, 11’inin ödem ve ekimozu, 47’sinin ise yapışıklığı mevcuttu. Beş çocukta yukarı yönlü idrar akımı mevcuttu. Gömülü penis 34 yenidoğan sünneti sonrasında gelişti ve 3±0,5 yıl sonra gömülü penislerden 16’sı düzeldi. İYE sünnet sonrası 33’ten 3’e düşürüldü.Sonuç: Gelenek, sünnetin temel nedenidir. Yenidoğan dönemi ve 6 yaş sonrası en sık görülen sünnet yaşlarıydı. Bununla birlikte, ebeveynler, çocukları yenidoğan döneminde sünnet edildiğinde daha mutluydular. Bu dönem ebeveynlerin gözünde sünnet için en uygun zaman olarak görülmektedir. Sünnet sonrası meatal darlık (ağ), yalnızca yenidoğan sünneti sonrasında gelişti ve görülme sıklığı literatürde bildirilenden düşüktür.
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    Is there a unique symptom in lower urinary tract dysfunction in children?
    (Wiley, 2021) N/A; N/A; Özen, Mehmet Ali; Taşdemir, Mehmet; Aygün, Murat Serhat; Necef, Işıl; Aydın, Emrah; Bilge, İlmay; Eroğlu, Egemen; Faculty Member; Faculty Member; Teaching Faculty; Faculty Member; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 293404; 175867; 291692; N/A; 32059; 198907; 214688
    Objectives Lower urinary tract symptoms (LUTS), particularly urgency, incontinence and intermittency are common in children and it is suggested that the specific symptoms may be used for definite diagnosis for LUT dysfunction (LUTD). This study was performed to investigate the relationship between each LUTD and its associated symptoms, using uroflowmetry/electromyography (UF/EMG) as a diagnostic tool. Methods Each patient was categorized into one of four LUT conditions which were overactive bladder (OAB), dysfunctional voiding (DV), underactive bladder and primary bladder neck dysfunction (PBND), according to UF/EMG results. Patients' complaints and findings were documented by using voiding dysfunction symptom score, bladder diary, urine analysis and ultrasonography. In addition, a detailed history of bowel habits (including use of Rome III criteria) was obtained. Results There were 189 children of which 106 were female. The OAB was the largest group including 91 patients, followed by the DV group which had 61 patients. The symptoms specific to any LUTD group were constipation and hesitancy (P < .05). Hesitancy was present in 89.4% with PBND and constipation was present in 78.6% of patients with DV. None of other symptoms were able to differentiate any LUTD group from the other. Conclusions While certain symptoms are often presumed by clinicians to imply specific diagnoses, the main outcome of this study is that there is a generally weak correlation between the specificity of symptoms and LUTD. Symptoms-based approach may lead to misdiagnosis in LUTD. Thus, it may be essential to focus on the underlying pathologies and UF/EMG test may help this.
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    Congenital prepubic sinus
    (Bmj Publishing Group, 2016) N/A; N/A; N/A; Eroğlu, Egemen; Özen, Mehmet Ali; Gündoğdu, Gökhan; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; 214688; 293404; N/A
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    Manual separation, topical vaseline and estrogen in labial adhesions
    (Logos Medical Publishing, 2019) N/A; N/A; Özen, Mehmet Ali; Aydın, Emrah; Eroğlu, Egemen; Shabsog, Mohammed Kamal Yahya; Oğuzkurt, Nigar Pelin; Faculty Member; Faculty Member; Faculty Member; Undergraduate Student; Doctor; School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; N/A; N/A; N/A; Koç University Hospital; 293404; 32059; 214688; N/A; N/A
    Objective: Although labial adhesions are frequently seen in childhood, debates are continuing about its pathophysiology and management. Despite topical estrogen is the most preferred treatment option, there are different opinions about its efficacy and side effects. Herein, we aimed to compare the effectiveness of combined treatments and manual separation and their long-term recurrence rates. Method: All primary cases diagnosed with complete labial adhesion between 2014 and 2019 and followed up for at least 6 months were analyzed per age, admission complaints, recurrence and side effects. Study groups were determined as; MS (Group 1); MS and pure vaseline (Group 2); MS and topical estrogen (Group 3). Results: Ninety-eight patients with median age of 2.6 years (range 4 to 108 months) who met the study criteria were included in the study. While itching, erythema, post-void dripping and urinary infection were the most common symptoms at presentation, 28.5% of the patients were diagnosed during routine examination and 17.3% of the cases diagnosed by the families as closed vagina. Group 1 had 30 (30.61%), Group 2, 39 (39.80%) and Group 3 29 (29.60%) patients. The recurrence rates were 23.3%, 2.5%, and 6.8%, respectively. Side effects were seen only in MS and topical estrogen-treated group (4 children). Conclusion: Treatment with MS and pure vaseline has a lower recurrence rate without any side effects compared to the other two groups. It can be preferred safely in the treatment of complete labial adhesions.  / GİRİŞ ve AMAÇ: Labial adezyon çocukluk çağında sık görülmesine rağmen, patofizyolojisi ve yönetimi hakkında tartışmalar mevcuttur. En sık tercih edilen tedavi seçeneği topikal östrojen olmakla beraber etkinliği ve yan etkileri hakkında farklı görüşler mevcuttur. Bu çalışmada manuel separasyon (MS) ile kombine yapılan tedavilerin etkinliğini ve uzun süredeki nüks oranlarını karşılaştırmayı amaçladık. YÖNTEM ve GEREÇLER: 2014 ve 2019 yılları arasında tam labial adezyon tanısı alan ve en az 6 ay süre ile takip edilen tüm birincil vakalar yaş, başvuru yakınması, nüks ve yan etkiler bakımından analiz edildi. Çalışma grupları; MS (Grup 1); MS ve saf vazelin (Grup 2); MS ve topikal östrojen (Grup 3), olarak belirlendi. BULGULAR: Kriterleri karşılayan 98 hasta çalışmaya dahil edildi. Hastaların ortanca yaşı 2,6 yıldı ( 4-108 ay). Grup 1 de 30 (%30,6), grup 2 de 39 (%39,8) ve grup 3 de 29 (%29,6) hasta mevcuttu. Kaşıntı, kızarıklık, işeme sonrası damlama, üriner enfeksiyon en sık başvuru semptomları iken, hastaların %28,5 inde tanı semptom olmadan rutin muayene esnasında, %17,3 ünde ise aileler tarafından tespit edilen vajen kapalılığı sonrasında konulmuştu. Nüks oranları grup 1 de %23,3, grup 2 de %2,5 ve grup 3 de ise %6,8 olarak tespit edildi. Sadece MS ve topikal östrojen uygulanan grupta, 4 çocukta yan etki görülmüştü. TARTIŞMA ve SONUÇ: MS ve saf vazelin tedavisi, diğer iki gruba göre herhangi bir yan etkisi olmadan daha düşük nüks oranına sahiptir. Bu sebeplerden dolayı labial adezyonların tedavisinde bu uygulamanın güvenle tercih edilebileceğini düşünmekteyiz.
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    Reevaluation of recurrence mechanisms after Nissen fundoplication
    (Logos Medical Publishing, 2019) Uzuner, Selçuk; Gökçe, Selim; Tekin, Mehmet; Gündoğdu, Gökhan; N/A; Özen, Mehmet Ali; Eroğlu, Egemen; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 293404; 214688
    Objective: Nissen fundoplication is the most frequently performed surgery for the gastroesophageal reflux disease (GERD), however recurrence is frequent in neurologically impaired patients. Anatomic deformation of the fundoplication wrap is the classically defined presentation. The putative risk factors exist in most of cases and but they are unable to define the pathology of failure. We aimed to analyze failure mechanisms after fundoplication. Method: Children with GERD who had undergone fundoplication between January 2011 and February 2014 were included in the study. Ongoing reflux symptoms after surgery were considered as recurrence of gastroesophageal reflux disease (rGERD). Correlation between development of disease recurrence and gender, age, failure to thrive, neurological status, hiatus hernia, scoliosis, surgical methods, gastrostomy and oropharyngeal symptoms was investigated. Variables were studied by logistic regression analysis. P<0.05 was considered statistically significant. Results: Sixty-seven children (male 40, female 27) were included in the study. Mean age of the patients was 57.10±52.22 months and follow up time was 19.64±7.75 months. Reflux recurrence was detected in 16 (23.8%) children. In barium contrast studies, fundoplication wrap was deformed in only one (6.2%) patient. In endoscopic examination loose wrap adherence (n=7) and intermittent wrap relaxation (n=3) activities were observed as the etiologic mechanisms of recurrence that were correlated with severe swallowing dysfunction and gagging, respectively. Conclusion: We assume that despite an anatomically intact fundoplication, persistent lower esophageal sphincter relaxations and loose wrap configurations might be the etiologic factors for recurrence in some of neurologically impaired patients. Also the relationship of these fundoplication findings with some oropharyngeal symptoms implies a complex failure mechanism. Oropharyngeal symptoms might be helpful in prediction of the development of risk preoperatively.
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    The role of calcitonin gene-related peptide (CGRP) and cremaster muscle in the etiology of undescended testis
    (Logos Medical Publishing, 2020) Mutuş, Hüseyin Murat; Zemheri, Ebru Itir; Okur, Hamit; Durakbaşa, Çiǧdem Ulukaya; N/A; Özen, Mehmet Ali; Faculty Member; School of Medicine; 293404
    Objective: Although different theories have been proposed about the descending mechanism of the testis and the causes of undescended testis (UDT), its etiopathogenesis hasn't been clearly explained. One of the most popular theories is the hypothesis that includes the genitofemoral nerve, CGRP and cremaster muscle (CM), which are mostly based on animal experiments. The adaptability of this hypothesis to human is controversial. In this study, we aimed to evaluate the possible role of CGRP in UDT by analyzing the CGRP receptor in the CM of children with and without UDT. Method: This clinical prospective study included 15 boys with UDT, 15 girls with inguinal hernia (IH) and 15 boys with IH. CM samples were taken during the operations. The CGRP receptors were demonstrated using the CGRP antibody. Results: No statistically significant difference was found between the groups in terms of age distribution. While CGRP receptor was detected in each boy group, it wasn't detected in the girl group. In the UDT group, there was a higher rate of receptors than the children with normal testis (64.7% and 35.3%, respectively), statistical difference between the groups was within the limit of significance (p=0.05). Conclusion: CGRP receptors in the CM weren't found in girls but only in boys, suggesting that CGRP may play a role in testicular descent. However, the fact that both the UDT and the descended testis group consisted of patients with and without receptors, restricted making a clear conclusion about this matter. We think that combined studies, including the effects of androgens and gubernaculum together with CM and CGRP are needed
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    Anal fissure: is it a complication of constipation?
    (Pamukkale Üniversitesi Tıp Fakültesi, 2020) N/A; N/A; Özen, Mehmet Ali; Eroğlu, Egemen; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 293404; 214688
    Purpose: Although there are various theories about the etiology of anal fissure, there is no general consensus. One of the most popular theories is the development of anal fissure after anal canal trauma secondary to constipation. In this study, we aimed to investigate the initial concomitant constipation in patients diagnosed with anal fissure. Materials and methods: Patients diagnosed with acute anal fissure were evaluated according to age, presenting symptoms, anorectal examination findings and anatomic localizations of the fissures. Functional constipation accompanying anal fissure was evaluated by applying the Roma IV criteria and the diagnosis was made in this way. Results: The most common presenting symptom was rectal bleeding. While the presence of blood in the butt-cleaned napkins was found in 69.6% of the cases, the presence of blood on the stool was found in 20.6% of the cases. Constipation was found in 8.8% of the patients according to Roma IV criteria. In the physical examination, anal fissure was detected in the anterior wall in 10.7%, lateral wall in 8.8%, and in the posterior wall in 72.5% of the patients. Conclusion: In this study, constipation rate in children with anal fissure was not higher than the rate of constipation in healthy children in the current literature. These results suggest that constipation and hard stool theory may be insufficient in explaining the etiology of anal fissure in children. Therefore, other theories such as high basal internal sphincter pressure and related ischemia should be kept in mind. / Amaç: Anal fissürün etiyolojisi hakkında çeşitli teoriler olmasına rağmen genel bir fikir birliği bulunmamaktadır. En popüler teorilerden bir tanesi kabızlık ve sert gaytaya sekonder anal kanal travması ve buna bağlı mukozal yırtılma ile anal fissürün geliştiğidir. Bu çalışmada anal fissür tanısı konulan hastalarda başlangıçta eşlik eden kabızlığı araştırmayı ve anal fissür ile kabızlık arasındaki olası ilişkiyi değerlendirmeyi amaçladık. Gereç ve yöntem: Akut anal fissür tanısı konulan hastalar başvuru yaşları, yakınmaları, anorektal muayene özellikleri, fissür veya fissürlerin anatomik lokalizasyonları bakımlarından değerlendirildi. Anal fissüre eşlik eden fonksiyonel kabızlık Roma IV kriterleri uygulanarak değerlendirildi ve tanı bu şekilde konuldu. Bulgular: En sık başvuru yakınması rektal kanamaydı. Popo temizliği yapılan mendil veya peçetede kan görülmesi olguların %69,6’sında mevcut iken gayta üzerinde kan görülmesi olguların %20,6’sında bulunmaktaydı. Roma IV kriterlerine göre hastaların %8,8’inde kabızlık saptandı. Yapılan fizik muayenede anal fissür, hastaların %10,7’sinde anterior duvarda, %8,8’inde lateral duvarda, %72,5’inde ise posterior duvarda tespit edildi. Sonuç: Bu çalışmada tespit edilen anal fissüre eşlik eden kabızlık oranı mevcut literatürde sağlıklı çocuklarda tespit edilen kabızlık oranlarından daha yüksek değildi. Bu sonuçlar çocuklarda anal fissür etiyolojisini açıklamada kabızlık ve sert gayta teorisinin yetersiz kalabileceğini düşündürmüştür. Bu nedenle anal fissür etiyolojisinde yüksek bazal internal sfinkter basıncı ve buna bağlı iskemi gibi diğer teorileri akılda tutmak gerekir.
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    The effectiveness of skin anchoring technique for the treatment of isolated buried penis
    (Türkiye Klinikleri, 2020) N/A; Aydın, Emrah; Özen, Mehmet Ali; Oğuzkurt, Nigar Pelin; Eroğlu, Egemen; Faculty Member; Faculty Member; Doctor; Faculty Member; School of Medicine; School of Medicine; N/A; School of Medicine; Koç University Hospital; 32059; 293404; N/A; N/A
    Objective: Buried penis has long been a problem not only for its causes but also for diversity in the techniques of surgical correction sometimes with unsatisfactory outcomes. The aim of the current study is to evaluate the effectiveness of a simple skin anchoring technique. Material and Methods: Buried penis repair patients between 2016 and 2018 were analyzed and those are younger than 1 year old, have accompanying congenital anomalies and a body mass index over 25 were excluded. The technique involves a complete degloving of penile shaft skin followed by two fixation sutures (5/0 polydioxanone) at 5 and 7 directions between Buck’s fascia at the penile base and the skin dermis at the base of the degloved penis and trimming the redundant prepuce per the skin length with resultant circumcision. Results: There were 12 patients whose mean age was 4.67±2.84 years and the mean follow up was 15.83±7.84 months. One (8.3%) patient had dissatisfaction who was lost to follow up but reached out by phone. Rest of the patients had satisfactory cosmetic outcomes. Conclusions: When treating patients with an isolated buried penis; degloving and skin anchoring technique is a simple and functionally and cosmetically satisfactory surgical technique. / Amaç: Gömülü penis sadece meydana getiren sebepler nedeni ile değil aynı zamanda çok farklı tedavi yöntemlerine rağmen başarısız sonuçlar nedeni ile de güncel bir problemdir. Çalışmanın amacı izole gömülü penis cerrahisinde cilt sabitleme tekniğinin sonuçlarını bildirmektir. Gereç ve Yöntemler: Çalışmada 2016-2018 yılları arasında gömülü penis nedeni ile opere edilen yaşı birden büyük, eşlik eden anomalisi olmayan ve vücut kitle indeksi 25’in altında olan olgular irdelendi. Penis tam deglovingi takiben penis kökünde Buck fasyası ile dermis arasına saat 5 ve 7 yönlerinde iki adet fiksasyon dikişi ile sabitlendi ve sünnet yapıldı. Bulgular: Çalışmaya dahil edilen 12 hastanın yaş ortalaması 4,67±2,84 yıl ve ortalama takip süresi 15,83±7,84 aydı. Estetik memnuniyetsizlik nedeni ile takipten çıkan 1 (8,3%) olgu dışında bütün hastalar sorunsuzdu. Sonuç: İzole gömülü penis cerrahisinde uygun hasta grubunda cilt asma tekniği basit ve işlevsel ve kozmetik olarak tatminkar bir cerrahi tekniktir.