Evisceration of the small intestine through the anus is an extremely rare event in children. We report a 2-year-old boy who sustained transanal small bowel evisceration associated with bilateral diaphragmatic rupture, left diaphragmatic herniation, and spinal cord injury without radiographic abnormality which happened after crushing by motor vehicle. We reviewed children with transanal small bowel evisceration and discussed etiological differences between children and adult. We also discussed the basic principles of management and follow up in these patients.
The transforming growth factor β (TGF-β) is thought to have important roles in several stages of folliculogenesis. Vitamin D is effective in cell proliferation, differentition and on estrogen biosynthesis. The aim of the present study was to determine the respective role of 1,25-dihydroxyvitamin D3 on expression of TGF-β1 in developing rat ovaries. 24 (one-mounth-old n = 12 and adult n = 12) female Wistar rats were enrolled in this study. All animals were divided into 4 groups. Group I and II that consist of one-month-old (n = 6) and adult rats (n = 6) respectively served as control groups. Intramuscular vitamin D3 ( 0,05 μgr/kg/every other day) was injected for 8 weeks to group III and IV which consist of one-mounth-old and adult rats respectively. After last injection, ovaries of animals were removed and processed for immunohistochemistry assay. No remarkable differences in staining intensity and localization for TGF-β1 were observed in group I and group III. TGF immunostaining was also predominantly found in oocytes. In granulosa cells, TGF-β1 immunoreactivity was negative. TGF-β1 immunostaining were observed both in nuclei and cytoplasm of granulosa cells in group II. But in group IV granulosa cells and oocytes were negative for TGF-β1. We found that vitamin D administration resulted in a decrease in TGF-β1 levels in the adult rats, but, TGF-β1 expression did not significantly decrease in the newborn rats. However, in multiple linear regression analysis, TGF-β1 expressions were independently associated with vitamin D administration. It is observed that Vitamin D attenuated TGF-β1 expression. The results of this study suggest that vitamin D may play role in folliculogenesis via TGF-β1.
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