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Öğe CD7 positive acute myeloblastic leukemia exhibiting pleural and pericardial involvement as an initial manifestation(2001) Söker M.; Ayyildiz O.; Devecioglu C.; Haspolat K.A 12-year-old girl was admitted to our hospital because of cardiac tamponade and pleural effusion. Her pericardial and pleural fluid contained myeloblasts and a diagnosis of acute myeloblastic leukemia was made from the findings of a bone marrow smear. She was classified as M4 acute myeloblastic leukemia according to French-American-British classification. The surface marker analysis of the blasts was positive for CD7, CD33, CD14, CD34 and HLA-DR. Leukemic pericardial effusion with cardiac tamponade and pleural involvement is very rare as an initial manifestation of acute myeloblastic leukemia. We report a case with a diagnosis of CD7+ acute myeloblastic leukemia presenting initially with pericardial effusion complicated with cardiac tamponade and pleural involvement as an unusual presentation.Öğe Clinical and echocardiographic evaluation in children with cardiomyopathy(1996) Elevli M.; Kilinc M.; Gunbey S.; Devecioglu C.; Tas M.A.Thirty cases diagnosed cardiomyopathy by echocardiography were evaluated with clinical and laboratory findings. The patients were aged between 2.5 months and 13 years. There was history of consanguinity in of 26 cases with myocarditis and cardiomyopathy. The left ventricular apical thrombus was in two patients with myocarditis and cardiomyopathy. Dyspne, cough, cyanosis weakness and fever were the most often encountered clinical symptoms of patients with idiopathic and dilated myocarditis and cardiomyopathy. The left ventricular apical thrombus was observed in two patients with myocarditis dilated cardiomyopathy. The mean left atrial dimension was 127.04 23.88 % of the predicted normal mean value in patients with myocarditis and dilated cardiomyopathy. In patients with myocarditis and dilated cardiomyopathy left ventricular end-diastolic and right ventricular end-diastolic dimensions were considerably in excess of expected normal upper limits in children with the same body weight (119.58 18.67 % and 136.85 25.89 % respectively. The ejection fraction and fractional shortening were significantly lower than the normal value in all the patients with myocarditis and dilated cardiomyopathy (ejection fraction: 34.21 8.34 %, fractional shortening: 15.99 4.99 % respectively). In cases with hypertrophic cardiomyopathy the mean fractional shortening values were 75.5 22.45 % and 48.92 4.21 %. M-mode and two-dimensional echocardiographic study are valuable diagnostic methods in the diagnosis of myocarditis and dilated and hypertropathy. Color Doppler echocardiographic study is also available by the measurement of flow velocities an the determination of valvular insufficiencies.Öğe Henna induced acute hemolysis in a G6PD-Deficient patient: A case report(2000) Soker M.; Devecioglu C.; Haspolat K.; Dikicl B.; Dogru O.Lawsone is a chemical present in henna, the crushed leaves of which are used worldwide as a cosmetic agent to stain hair, skin and nails. Vitro observations showed that lawsone was capable of causing oxidative hemolysis in a close dependent manner in rats. In the literature, acute hemolysis after henna dye application over the human body is rare except in infancy. A Glucose-6-Phosphate Dehydrogenase (G6PD) enzyme deficient patient with acute hemolysis after exposure to henna is presented.Öğe Microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure associated with acute brucellosis(2001) Söker M.; Devecioglu C.; Yaramis A.; Ipek S.; Özbek M.N.; Tüzün H.Microangiopathic hemolytic anemia and severe thrombocytopenia are rare in childhood brucellosis: there are few reported cases. We report our experience with a 9-year-old boy with brucella infection presenting at the onset as a microangiopathic hemolytic anemia, severe thrombocytopenia and acute renal failure with coexisting gastrointestinal bleeding and gross hematuria. Peripheral blood smear examination showed hemolytic anemia, thrombocytopenia, and leukopenia. Bone marrow aspiration specimen revealed hypercellularity, histiocytic proliferation, and hemophagocytosis of the typical features associated with Brucella infection. Results of agglutination tests for Brucella in CSF and serum were positive. The patient recovered completely after appropriate antimicrobial therapy (consisting of rifampin, doxycycline, gentamicin) and fresh-frozen plasma, platelet transfusion, and rehydration therapy. We suggest that brucellosis must be investigated when hemolytic uremic syndrome (HUS) like disease exists with no known etiology, especially in endemic countries.Öğe An outbreak due to multidrug-resistant Klebsiella pneumoniae in Neonatal Intensive Care Unit(1997) Hosoglu S.; Ayaz C.; Devecioglu C.; Boşnak Mehmet; Geyik M.F.An outbreak of neonatal septicemia due to Klebsiella pneumonias have been detected in Neonatal Care Unit, Dicle University Hospital, between the period of October 1996-March 1997. Septicemia was diagnosed in 105 cases by clinical features and routine laboratory findings but only 68 (64.8%) of them were included to the study by at least one blood culture positivity. Cultivation of the blood samples was performed in PEDS Plus/F Medium BACTEC 9240 system. The beta lactamase production and the antibiotic susceptibilities were tested on Sceptor panel and MIC Identification panel respectively, and all the 30 K. pneumoniae strains were found beta lactamase positive and multidrug resistant. K. pneumoniae (44.1%) was followed by coagulase-negative Staphylococci (22%) and Enterobacter spp. (11.8%) those isolated from blood cultures. As the identical strain of K. pneumoniae was isolated from the environmental cultures of nursery in Obstetrics Department as well, it is concluded that the source of the infection was the environment. The majority of K. pneumoniae strains showed high sensitivity to ciprofloxacin (100%) and imipenem (96.6%) but they were resistant to ceftazidime, tobramicin, mezlocillin, ticarcillin, cefazolin, gentamycin and ampicillin. After an education programme given to the personnel, only one case was detected in March 1997.
