K Sönmez

Gazi University, Ankara, Ankara, Turkey

Are you K Sönmez?

Claim your profile

Publications (55)63.35 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction Short bowel syndrome (SBS) is a clinical condition resulting from the loss of absorptive surface area following resection of 50% or more small bowel. Morphological and functional changes called "intestinal adaptation" occur in the residual intestine. Melatonin exists in the gastrointestinal tract and has effect on mitotic activity. Therefore, we hypothesized that melatonin may have beneficial effects on intestinal adaptation.Materials and Methods A total of 32 male Wistar albino male rats were divided into four groups. In group I (sham-S), small bowel was transected and reanastomosed. In group II (SBS-control), 75% small bowel resection and anastomosis were performed. In group III (SBS-vehicle), after 75% small bowel resection and anastomosis, 2 mL of 5% ethanol in saline was given intraperitoneally once a day. In group IV (SBS-melatonin), after 75% small bowel resection and anastomosis, 300 µg/kg melatonin was given intraperitoneally once a day. After 15 days, small bowels were removed and divided into two segments as jejunum and ileum. Each segment was weight and measured. Histological examination was performed in all samples. Bowel and mucosal weights and DNA/protein ratio were calculated. Apoptotic cells were also identified.Results The bowel length measurements were statistically longer in group IV. Mucosal and bowel weights were the highest in group IV. The villus height, crypt depth, and the number of mitotic figures were the highest in the jejunum of group IV. Melatonin also gave rise to a significant increase in DNA/protein ratios in group IV.Conclusion According to this study, melatonin significantly enhanced intestinal adaptation.
    European Journal of Pediatric Surgery 04/2013; · 0.84 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Vascular access device fragment embolization is a relatively rare but potentially serious complication. The purpose of this study was to report our experience with endovascular retrieval of embolized vascular access device fragments by interventional radiological means. Ten patients with a vascular access device fragment embolism were treated between 2004 and 2010. Attempted retrieval from the vascular bed was performed for five port catheter fragments, two temporary catheter fragments and three guide wires. The demographic data, underlying disease of the patients, type of inserted catheters, interval between implantation and discovery of embolism, interval between discovery of embolization and retrieval and localization and length of the embolized fragments were identified from the patient charts. In nine of the ten patients (90%), radiologic intervention retrieval of the embolized vascular access device fragments was successful. The reasons for intravascular fragment embolism consisted of rupture at the connection site of the chamber or the external hub and the intravascular catheter (n=4), pinchoff syndrome (n=3), operator inexperience (n=3). Embolized catheter fragments or guide wires were retrieved under fluoroscopy by a gooseneck snare. The postprocedural course was uneventful. The radiological retrieval of embolized vascular access device fragments is the preferred method, and it has a high success rate. Considering the potential for devastating complications, patients should be referred to interventional radiology, and the embolized catheters should be retrieved using interventional endovascular techniques.
    Diagnostic and interventional radiology (Ankara, Turkey) 02/2011; 18(1):87-91. · 1.03 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The management of giant omphalocele (GO) presents a major challenge to pediatric surgeons. Current treatment modalities may result in wound infection, fascial separation, and abdominal domain loss. We report a GO infant who required a delayed closure and was managed using sterile incision drape and polypropylene mesh. A 3080 g full-term female infant was born with a GO. The skin was dissected from the fascia circumferentially without opening the amniotic sac and the peritoneum. Subsequently, two polypropylene meshes of 10 x 10 cm in diameter were sutured to each other. Inner surface of the mesh silo was covered with sterile incision drape. This texture was sutured to the fascial margin. Then, the skin was sutured to the mesh and the silo was closed from the side and above. On the 4th day the reduction was started using thick sutures without anesthesia. This procedure was repeated on every 3rd day. When it came closer to the skin margins, constriction was performed using right angle clamps, each time placed 2 cm proximally to the previous sutures in a circular manner. Silo was removed easily and the skin, subcutaneous layers, and fascia were then approximated on the 42nd day. The postoperative course was uneventful and the infant was well with left inguinal hernia repaired in the 3rd month. The method we used can be performed at bedside and without the application of anesthesia, but should be tried on more patients to determine its effect.
    World Journal of Pediatrics 08/2010; 6(3):274-7. · 1.08 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Endoscopic treatment of vesicoureteral reflux (VUR) by subureteral injection of biocompatible polymers is an established treatment option for reflux. Dextranomer/hyaluronic acid copolymer(Dx/HA) has gained wide popularity for treating VUR. We decided to investigate the antibacterial activity of Dx/HA and its interaction with antibiotics in in-vitro conditions. Materials and Methods: Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Proteus mirabilis suspensions were inoculated into Mueller-Hinton agar media and 30 micro liter of Dx/HA was inoculated in 5 mm diameter pits and the plates were incubated at 37 degree C for 24 hours. At the end of the incubation period, inhibition zones around the discs were measured. Expansion of the inhibition zones towards the pits which contained Dx/HA was considered as synergism. Dx/HA was inoculated into pits made in Mueller-Hinton agar medium without antibiotic discs but containing suspensions of bacteria. These media were incubated under the same circumstances and same measurements were done. All experimental procedures were performed twice. Increase in bacterial zone diameters for >= 5 mm was inoculated was regarded as significant for each agent. Results: Dx/HA caused no difference in bacterial growth either with or without antibiotic discs as determined by inhibition zones in the culture media. Conclusion : Dx/HA will not contribute to UTI if it is used for the treatment of VUR in cases either with or without infection.
    International Medical Journal Malaysia. 01/2010;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Blind-ending bifid ureter is an extremely rare congenital anomaly. The authors report on a 13-year-old boy who presented with a previous diagnosis of right duplicated ureter and who had undergone a bilateral ureteroneocystostomy for vesicoureteral reflux in another clinic. The revision showed right blind-ending bifid ureter. The embryology, clinic and treatment of this anomaly is discussed.
    Acta chirurgica Belgica 01/2010; 110(1):109-11. · 0.36 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A newborn female infant delivered after a normal pregnancy was found to have a large sacrococcygeal mass. Imaging and laboratory studies suggested this was a sacrococcygeal teratoma. On the 16th day of age, the tumor was completely removed. Histopathologic examination of the tumor showed malignant Triton tumor (MTT). Thus, we describe a female newborn without a family history of neurofibromatosis with an MTT that mimics a sacrococcygeal teratoma. To our knowledge, this is the first report of a sacrococcygeal MTT detected in a neonate.
    Journal of Pediatric Surgery 11/2009; 44(11):e5-8. · 1.38 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Gastric volvulus (GV) occurs when the stomach abnormally rotates around one of its axes and is a rare upper gastrointestinal obstruction. We present an unusual case of intrathoracic GV associated with delayed manifestation of congenital diaphragmatic hernia. A 16-month-old female infant presented with a history of projectile non-bilious vomiting for 2 days and mild hematemesis for the last day. Physical examination showed epigastric fullness and pain with abdominal palpation. Complaints of the patient disappeared on the 2nd day after hospital admission. On the 6th day non-bilious vomiting started again and an epigastric mass was palpable. Contrast study of the stomach after oral barium administration showed the mesenteroaxial volvulus of the stomach. At laparotomy, the association of non-necrotic intrathoracic GV with intrathoracic spleen was confirmed. Moreover, the diaphragm presented a giant posterolateral hernia of the left dome. Diaphragmatic repair was performed in addition to gastropexy and splenopexy. The postoperative course was uneventful and the child was discharged on the 5th post-operative day. On follow up after one month, clinical examination and plain abdominal X-ray were normal. GV is a clinical emergency which can be life-threatening for children. Upper gastrointestinal study and CT scan with contrast meal are helpful in the diagnosis of the lesion. We emphasize prompt surgical therapy to avoid gastric necrosis.
    World Journal of Pediatrics 09/2009; 5(3):226-8. · 1.08 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Although the incidence of caustic ingestion is declining, the management of caustic esophageal strictures remains a challenge. Although many agents have been tried experimentally to treat strictures, few have gained clinical application. The aim of this study was to investigate the influence of mitomycin C (MMC), which inhibits fibroblastic proliferation in treating delayed caustic esophageal strictures. Forty-two rats were allocated into 3 groups. Caustic esophageal burns were created as described by Gehanno. Group A was instilled only with saline. Group B was injured with 10% NaOH and left untreated. Group C was injured and received topical MMC at 0.04% concentration in the fourth week. At 56 days, stenosis index (SI), collagen deposition, and hydroxyproline content (HP) were determined in distal esophageal segments. Statistical analyses were performed. The mean SI in group B was significantly higher than others (SI: 1.15 +/- 0.37 d/lum, P < .05). Collagen accumulation was highest in group B, followed by groups C and A, respectively. Collagen deposition in group C was statistically lower than group B (P < .018). The mean HP in group B was statistically higher than others (5.07 +/- 1.30 microg/mg tissue, P < .05), and similar between groups A and C (1.20 +/- 0.20, 1.91+/- 0.79, respectively, P = .73). In the current study, MMC treatment ameliorated caustic esophageal stricture as reflected in the significantly lower SI. We conclude that MMC application is effective in the treatment of caustic esophageal strictures.
    Surgery 02/2009; 145(2):219-25. · 3.37 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In this study we aimed to investigate the effects of different suture materials on wound healing and infection in subcutaneous closure techniques. Twenty-nine rats were randomly allocated to 5 groups. All subjects received 2-cm vertical dermal and subdermal incisions on their backs under sterile and proper surgical conditions. The subdermal cuts were then closed with vicryl (polyglycolic acid), biosyn (monofilament glycomer), prolene (polypropylene) and tissue adhesive (2-octylcyanoacrylate). After 10 days, all sutured areas were examined for seroma, haematoma formation and cosmetic outcome. The incisional lines were excised with 1-cm-wide skin strips and tissue hydroxyproline levels were determined. The specimens obtained were evaluated for the presence of giant cells, mononuclear cells, fibrosis and neutrophils. No differences in tissue hydroxyproline levels were found between any of the suture materials used. Fibrotic process and inflammatory cell infiltration were more prominent in the biosyn and prolene groups than in other groups. Foreign body giant cells were observed in the biosyn group. Vicryl and tissue adhesive should be preferred in subcutaneous closure techniques.
    B-ENT 01/2009; 5(3):149-52. · 0.08 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Isolated premature thelarche is a common disorder characterized by breast development, usually younger than 2 years, with no other signs of puberty. Although it is usually associated with adrenal or ovarian disorders, hypothyroidism, and use of exogenous hormones or drugs, it may also be associated with long-term use of herbal medicine. Thus, long-term use of preparations such as Foeniculum vulgare, which is used to eliminate gas and regulate intestinal function in children, may cause premature thelarche, and thus, the use of such preparations should be limited.
    Journal of Pediatric Surgery 12/2008; 43(11):2109-11. · 1.38 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Ureteral injuries represent less than 1% of all traumatic genitourinary injuries. The rarity of traumatic ureteral injury is at least in part because the ureters are relatively well protected in the retroperitoneum. Ureteral injuries after blunt trauma are not common, and bilateral disruption of the ureteropelvic junction (UPJ) has only been previously reported in just one child. This is the first documented case of operative ureteral repair of bilateral complete UPJ disruption with double J ureteral stents in a child.
    Journal of Pediatric Surgery 11/2008; 43(10):e35-7. · 1.38 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Castleman disease is a rare lymphoproliferative disorder of unclear etiology. It usually presents as localized enlarged lymph nodes in children. Surgical excision is curative in localized form. Clinical findings of malabsorption are rarely reported in the literature. Herein, we describe a 14-year-old girl who presented with anemia, failure to thrive, osteoporosis, zinc, and vitamin deficiency. She was diagnosed as localized mesenteric mixed type of Castleman disease. Her clinical findings improved after surgical excision of the mass.
    Journal of Pediatric Hematology/Oncology 09/2008; 30(8):618-20. · 0.97 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Many factors and mechanisms have been proposed as causes for intussusception (IN); however, the etiology remains unclear. Inflammatory mediators such as tumor necrosis factor (TNF) and interleukin-6 (IL-6), which are elevated during infectious diseases, can significantly affect gastrointestinal motility. Motility changes caused by these agents might contribute to the development of IN. The aim of this experimental study was to determine the preventive effects of indomethacin on lipopolysaccharide (LPS)-induced IN in mice and to investigate the role of TNF and IL-6 on intussusception. Seventy-eight mice were divided into five groups. In the Control group (n=6), no procedure was done. In the Sham group (n=6), 1 ml saline, in the Indomethacin group (n=6), 10 mg/kg of indomethacin, in the LPS group (n=30), 12 mg/kg of LPS was administered intraperitoneally (IP). In the Treatment group (n=30), 10 mg/kg of indomethacin was administered IP following 12 mg/kg of LPS. All animals were laparotomized 6 hours following IP injections. The existence of IN was noted and blood specimens were obtained. TNFalpha and IL-6 plasma level measurements were performed by standard ELISA for mice. The results were compared using the Mann-Whitney U test and one-way ANOVA test. A value of p<0.05 was considered significant. Five mice (1 in the control, 2 in the LPS, 2 in the Treatment group) were excluded from the study. IN was observed in 6 (20%) mice in the LPS group, whereas it was not found in any mice in the Treatment group. Mean TNFalpha and IL-6 levels were statistically higher in the LPS group (394.72+/-403.79; 195.18+/-218.37 pg/ml, respectively) compared to all other groups, including the Treatment group (p<0.05 for each comparison). Within the LPS group of mice, the levels were higher in animals with IN compared to the mice without IN. Increased TNFalpha and IL-6 levels induced by LPS correlated well with the occurrence of IN, and a decrease in these levels via cyclooxygenase (COX) inhibition by indomethacin prevented IN from forming in this experimental model.
    European Journal of Pediatric Surgery 04/2008; 18(2):103-6. · 0.84 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Enterocutaneous fistula (EF) in newborns and prematures is a well-recognized complication after necrotizing enterocolitis and other abdominal surgical procedures. Conservative management consists of bowel rest, antibiotics, wound care, and the administration of drugs that either reduce gastrointestinal motility or secretions. Octreotide decreases gastrointestinal secretions, inhibits or blocks the effects of gastrointestinal hormones, diminishes gut motility and thus reduces the flow through the fistula. We used octreotide and were able to report successful spontaneous closure of a fistula in our 2 neonatal patients, one a premature neonate with necrotizing enterocolitis (NEC) and the other with meconium peritonitis.
    European Journal of Pediatric Surgery 03/2008; 18(1):56-8. · 0.84 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This aim of this study was to define the characteristics of the patients who underwent surgery for ankyloglossia. The patients (n = 127) with ankyloglossia underwent surgery between 1987 and 2005. The patients were evaluated for age, gender, complaints, grade, and operative procedures. This study did not cover postoperative evaluation of the procedure. The ages of the children ranged from 20 days to 7 years, and 84% of them were under 1 year of age. Seventy-two percent were boys; 28% were girls. The most common complaint of the parents of infants under one year of age was breast-feeding (35/84). When the tongue movements of the patients were examined, 57 patients (of whom 18 were over one year of age) had limited tongue mobility. The mean frenulum length of the patients was grade 1 in 72 patients and grade 2 in 55 patients. Ankyloglossia was corrected by frenotomy. Three patients had bleeding from their frenotomy site which resolved with local pressure. General anaesthesia was preferred for 77 patients, and there was a need for suturing in 20 patients. The correction of ankyloglossia at an early age reduces the risk of latent complications. In addition, the early correction will mitigate the feeding- and speech-related concerns of parents and doctors alike.
    B-ENT 02/2008; 4(2):81-5. · 0.08 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A giant paraesophageal hiatal hernia with preduodenal portal vein, nonrotating gut, intrathoracic spleen, and left inferior vena cava has not been reported to date. This set of complex anomalies can have significant clinical implications. Awareness of these anomalies is essential to avoid further complications.
    Journal of Pediatric Surgery 01/2008; 42(12):e23-5. · 1.38 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Foreign body ingestion is a common problem in children. Safety pin ingestion is common in Turkey. We describe a new method of removal for safety pins in our 2 cases. A 9-month-old girl and a 6-month-old boy had each ingested a safety pin. Abdominal X-rays detected the safety pins in their stomachs. At the end of 3 months, the foreign bodies still remained in their stomachs and laparotomy was indicated. This technique consists of a limited midline upper laparotomy with vertical incision. Without the utilisation of a gastrotomy, an orogastric tube was inserted into the stomach and the open end of the safety pin was pinned to the tube from outside the stomach. The orogastric tube was gently pulled out to remove the safety pin. This method provides shorter hospitalisation time and fewer complications.
    Annals of the Academy of Medicine, Singapore 04/2007; 36(3):206-7. · 1.36 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study is to determine the effect of melatonin on intestinal anastomosis in the presence of peritonitis. 32 Wistar albino rats were randomized into four groups (n = 8): A (sham), B (control), C (melatonin 5 mg/kg), and D (melatonin 10 mg/kg). In group A, only cecal dissection was carried out. In the other groups, cecal ligation and puncture (CLP) followed cecal dissection in order to induce bacterial peritonitis. 24 h after the previous operation, cecal resection and ileocolic anastomosis were performed in the rats of all groups. In group C (5 mg/kg) and group D (10 mg/kg), melatonin was injected for 5 consecutive days starting after CLP. At the 48th hour of the CLP procedure, blood was drawn via the tail vein for tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) analysis, and on the 4th day of the experiment relaparotomy was carried out for bursting pressure (BP) measurements. The intestinal tissue containing the anastomotic line was then snap-frozen in liquid nitrogen and stored at -80 degrees C for determination of tissue levels of malondialdehyde (MDA) and glutathione (GSH). The tissue MDA level, blood TNF-alpha and IL-6 levels of group B were significantly higher than in the other groups, whereas the BP results and GSH levels of group B were found to be significantly lower than in the other groups. The results of groups C and D are statistically different from those of group B. When we compared the results of groups C and D, we found significantly higher results in terms of BP and GSH levels in group D and also significantly lower results in terms of MDA, blood TNF-alpha and IL-6 levels in group D. The findings of this experiment suggest that melatonin has a dose-independent positive effect on wound healing of colonic anastomosis.
    European Surgical Research 02/2007; 39(2):122-7. · 0.75 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Hydatid cysts (HCs) of the liver are a major problem in the areas to which they are endemic. Approximately 15% of hepatic cysts have been shown to communicate with the biliary system. In 2 cases in which patients were undergoing HC surgery, the cystic fluid appeared to be clear, but after the germinative membranes were removed, a connection with the biliary system could be seen. This observation suggests that the decision to inject a scolicidal or sclerosing agent during surgery should be evaluated carefully, as should the use of percutaneous HC treatment. Otherwise, conditions associated with serious morbidity, such as sclerosing cholangitis, may occur.
    Advances in Therapy 01/2007; 24(2):291-5. · 2.44 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Recently, the thoracic approach has been suggested in the surgical treatment of Morgagni hernias with some reported advantages over abdominal surgery. This manuscript reports the authors' experience with childhood Morgagni hernias repaired via laparotomy. Records of five cases of Morgagni hernias were evaluated with respect to age, presentation, operative data, complications, and outcome. The average age of four male and one female patients was 34 months (range 6 months to 8 years). Predominant presenting symptoms were related to the respiratory system. The diagnoses were made by posterior-anterior and lateral chest X-rays and confirmed by barium enema contrast radiographs. Associated anomalies were detected in three cases. All cases were managed by abdominal approach through upper midline incisions reducing the herniated viscera (transverse colon in all and including omentum in one patient) and excising the hernia sac which was present in all patients. The postoperative period was uneventful in this series and no recurrence was detected in an average of four years of follow-up. The transabdominal approach is appropriate in the surgical correction of paediatric Morgagni hernias.
    The West Indian medical journal 11/2006; 55(5):319-22. · 0.32 Impact Factor

Publication Stats

296 Citations
63.35 Total Impact Points

Institutions

  • 1995–2011
    • Gazi University
      • • Department of Radiology
      • • Faculty of Medicine
      • • Department of Pediatric Surgery
      Ankara, Ankara, Turkey
  • 2002
    • Ankara University
      • Department of Pediatric Surgery
      Ankara, Ankara, Turkey