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Öğe Anti-oxidant status in relation to lipoproteins, leptin and pro-inflammatory cytokines in children with steroid-sensitive nephrotic syndrome(Blackwell Publishing Asia, 2004) Ece, A; Atamer, Y; Gürkan, F; Bilici, M; Koçyigit, YBackground: Reactive oxygen species and cytokines are reported to play a role in the proteinuria of nephrotic syndrome. The aim of this study was to investigate indirect evidence of oxidant activity together with leptin, lipoproteins and pro-inflammatory cytokines in children with steroid-sensitive nephrotic syndrome. Methods: A total of 40 children with steroid-sensitive nephrotic syndrome (20 with newly onset or relapse comprised group I and 20 in remission while receiving steroids comprised group II) and 20 sex and age matched healthy control children were included. The following indirect parameters of oxidant activity were determined: serum malondialdehyde, erythrocyte superoxide dismutase, catalase and whole-blood-reduced glutathione. Serum leptin, lipids and lipoproteins were also determined. Results: Similar glutathione, increased malondialdehyde levels and decreased superoxide dismutase and catalase activity were observed in group I patients compared with controls. There was no significant difference in these variables between group I and group II (P > 0.05). Tumour necrosis factor-alpha and interleukin-6 concentrations were similar in patients and controls. Concentrations of interleukin-1beta and interleukin-8 were higher in the active phase of nephrotics compared with controls (P < 0.05). Significant positive correlations were found between malondialdehyde and interleukin-1beta, interleukin-6, leptin and lipoprotein (a) (P < 0.05). There were significant negative correlations between anti-oxidants and leptin, lipoprotein (a) and several cytokines (P < 0.05). Conclusions: Changes in the concentrations of malondialdehyde, superoxide dismutase, catalase and glutathione are compatible with increased amounts of oxidation in steroid-sensitive nephrotic syndrome. Leptin and pro-inflammatory cytokines may be related to excessive protein permeability in nephrotic syndrome.Öğe Cardiac troponin-1 as a marker of myocardial dysfunction in children with septic shock(E M H Swiss Medical Publishers Ltd, 2004) Gurkan, F; Alkaya, A; Ece, A; Haspolat, K; Boşnak, Mehmet; Bilici, M; Kervancioglu, MObjectives: Cardiac depression is well known in severe sepsis and septic shock. Our aim was to investigate the incidence of myocardial ischaemia as shown by cardiac troponin I (cTnI) levels in patients with septic shock and to evaluate the correlation with myocardial dysfunction measured by echocardiography. Methods: The study was performed in the paediatric intensive care unit in Dicle University Hospital, Turkey, between January 2001 and December 2002. Patients in septic shock, with a mean age of 6.4 +/- 2.8 months, were simultaneously submitted to a two-dimensional echocardiograin and biochemical investigation on admission. Results: The mean serum cTnI level of the patients was 3.1 +/- 2.6 ng/ml (0.01-9.80 ng/ml) and the mean LVEF value was calculated as 48% +/- 11%. 21 patients (75%) had a cTnI level greater than or equal to0.6 ng/ml, and 15 patients (54%) had a LVEF <0.5. For cTnI levels greater than or equal to0.6 ng/ml, sensitivity and specificity were 9 3.3% and 46.2%, and positive and negative predictive values were 66.7% and 85.7% respectively. For cTnI values greater than or equal to2.0 ng/ml, sensitivity and specificity were 86.7% and 76.9%, and positive and negative predictive values were 81.3% and 83.3%, respectively. There was a statistically significant relationship between LV dysfunction and cTnI positivity (r(2) = 0. 3 16, p = 0.002). No significant difference was found for the cTnI levels greater than or equal to0.6 ng/ml between non-survivors and survivors (p >0.05). Conclusion: Myocardial ischaemia and cell injury seem to be common in patients with septic shock and correlate with left ventricular dysfunction. Measurement of cTnI may be an easy and practical tool for monitoring cardiac damage in critically ill septic patients.Öğe Characteristics of pediatric urolithiasis in south-east Anatolia(Blackwell Science Asia, 2000) Ece, A; Özdemir, E; Gürkan, F; Dokucu, AI; Akdeniz, OBackground: Urolithiasis is endemic in Turkey and characteristics of urolithiasis vary in different regions of the world. The aim of the present study was to evaluate the etiological and clinical characteristics and course of pediatric urolithiasis in south-east Turkey. Methods: The study population consisted of 81 children (52 girls) with urolithiasis at a mean age of 6.2 +/- 4.2 years who were followed up for 1-32 months. Results: Metabolic disorders, anatomical defects and infection stones were found to be the etiological factor in 34.6, 29.6 and 22.2% of patients, respectively, while 13.6% of patients were considered idiopathic. Of all patients, 28.4% were admitted with acute renal failure (ARF) and 72.8% had urinary tract infection. Recurrence was seen in 19.8% of patients at presentation. The localization of the stone was found to be in the upper urinary tract, the lower urinary tract or both in 65.4, 14.8% and 17.3% of patients, respectively. Patients with multiple and bilateral stones had a higher risk for ARF than the others. The risk for chronic renal failure was significantly higher in children with multiple, bilateral or recurrent stones and with ARF at presentation. Conclusions: Early diagnosis and management of renal stones and urinary tract infections is necessary to prevent the development of ARF or chronic renal failure and to improve the quality of a patient's life.Öğe Clinical review of tuberculous peritonitis in 39 patients in Diyarbakir, Turkey(Wiley, 2005) Tanrikulu, AC; Aldemir, M; Gurkan, F; Suner, A; Dagli, CE; Ece, AAbdominal tuberculosis (TB) is a rare manifestation, which can be overlooked on long-lasting and non-specific findings unless a high index of suspicion is maintained. The purpose of the present study was to investigate the diagnostic features of 39 patients hospitalized with tuberculous peritonitis (TBP) in Dicle University Hospital, Turkey between January 1994 and August 2003. Twenty-two patients were male; patient age ranged between 1 and 59 years (mean: 16.2 +/- 14.4 years). There were 21 patients (54%) under 15 years of age. Thirteen children had a history of familial TB and seven adults had prior history of TB. Six (29%) of 21 pediatric cases had bacille Calmette-Guerin (BCG) scars and results of 5-tuberculin units (TU) tuberculin test were positive in seven children (18%). Of all cases, the most common presenting findings were abdominal pain (95%), ascites (92%) and abdominal distention (82%). Five of the patients had accompanying pulmonary TB, and six patients (15%) had intestinal TB who were admitted to emergency service with acute abdomen, of whom three (8%) had perforation and three (8%) had ileus. Histopathologically 20 cases (51%) were proven on abdominal ultrasonography, and computed tomography revealed most commonly ascites and thickening of peritoneum. No microbiologic evidence was obtained except three positive culture results for Mycobacterium tuberculosis. As a result, TBP should be considered for diagnosis, in patients with non-specific symptoms of abdominal pain, wasting, fever, loss of appetite, abdominal distension and even symptoms of acute abdomen, because early diagnosis and effective treatment will decrease morbidity and mortality. (C) 2005 Blackwell Publishing Asia Pty Ltd.Öğe Distinguishing features of Salmonella and viral hepatitis(Lippincott Williams & Wilkins, 2000) Gürkan, F; Derman, O; Yaramis, A; Ece, A[Abstract Not Available]Öğe Ectodermal dysplasia: Retrospective study of fifteen cases(Elsevier Science Inc, 2006) Yavuz, I; Baskan, M; Ulku, R; Dulgergil, TC; Dari, O; Ece, A; Yavuz, YThe aim of this article is to review possible cranio-maxillofacial deformative consequences associated with hypohidrotic ectodermal dysplasia and embryonic malformations, which include dental ageneses, and describe the oral habilitation. Hypohidrotic ectodermal dysplasia patients had a clinical examination and underwent radiographic and Steiner's analyses and a respiratory capability test before assessment and treatment. Fifteen patients (eight males and seven females, aged 5-45 years) had tooth ageneses (from hypodontia to anodontia) associated with cutaneous dyshydrosis and hair and nail dystrophy. Most patients had sparse or absent hair, a short face with an unusual facial concavity, a maxillary retrusion and a relative mandibular protrusion. Dentists must conduct a comprehensive and multidisciplinary approach to these patients in order to improve their dental, masticatory, growth and orthognathic conditions. (c) 2006 IMSS. Published by Elsevier Inc.Öğe Interferon-? treatment as a possible cause of relapse in a child with precursor B acute lymphoblastic leukemia(Lippincott Williams & Wilkins, 2001) Söker, M; Dikici, Bünyamin; Devecioglu, C; Ece, A; Haspolat, K[Abstract Not Available]Öğe Juvenile delinquency in a developing country: A province example in Turkey(Pergamon-Elsevier Science Ltd, 2005) Ozen, S; Ece, A; Oto, R; Tirasci, Y; Goren, SThe aim of this study was to determine offence behavior, socio-demographic characteristics and some features of the juvenile offenders' families in a selected region, and compare with developed countries. A total of 165 juvenile offenders were included. Information was obtained by individually interviewing all children. Of a total of 165 juveniles, 162 (98%) were boys. The most frequently committed crimes were theft (52%) and wounding (20%). Of these juveniles, 33% were 14 years old when they committed offence, 21% had a history of an offence behavior, 14.5% had an offender sibling, 36% had smoking habits, 21% had a history of running away from home, and 28% had a history of internal migration. Mild psychiatric disorders were detected in 9 (5.4%) and 51% of them were not student at the time of offence behavior. Most of the families were crowded and had rather low economical and educational levels. Some features such as low income and low family educational levels, insufficient parental control, crowded family, migration, repetition of offences, and cigarette smoking were found to be risk factors for offensive behavior. These risk factors can be taken into consideration for the prevention of future crimes. (c) 2005 Elsevier Inc. All rights reserved.Öğe Oxidative stress, inflammation and early cardiovascular damage in children with chronic renal failure(Springer, 2006) Ece, A; Gürkan, F; Kervancioglu, M; Kocamaz, H; Günes, A; Atamer, Y; Selek, SThe relationship between inflammation, oxidant stress and cardiovascular damage in children with chronic renal failure (CRF) has not previously been investigated. The aim of this study was to investigate markers of oxidative stress, inflammation and early cardiovascular abnormalities. Therefore, erythrocyte superoxide dismutase (SOD) and catalase (CAT) activities; blood glutathione (GSH) and serum malondialdehyde (MDA) levels; C-reactive protein (CRP) and proinflammatory cytokines (IL-6, TNF-alpha,); and left ventricular masses (LVM) and intima media thicknesses (IMT) were measured in children with CRF. A total of 29 children with CRF (19 nondialysis, 10 peritoneal dialysis) were included. The control group consisted of 25 healthy subjects. CRF children had significantly increased IL-6, TNF-alpha, CRP and MDA concentrations and decreased SOD, CAT and GSH levels compared with controls (P < 0.05). Nondialysis and peritoneal dialysis subgroups had similar oxidative stress and inflammation biomarkers (P > 0.05). Erythrocyte CAT was positively correlated with CRP, TNF-alpha, and IL2-R in the study group. Positive correlations were found between cytokine concentrations, CRP and urea/creatinine levels. Significantly increased LVM and IMT values were found in CRF children (P < 0.05). In conclusion, increased oxidant stress and inflammation together with early cardiovascular damage were found in CRF children. Further studies with more patients are needed to verify these results.Öğe Paraoxonase, anti-oxidant response and oxidative stress in children with chronic renal failure(Springer, 2006) Ece, A; Atamer, Y; Gürkan, F; Davutoglu, M; Bilici, M; Tutanç, M; Günes, AIncreased oxidative stress is believed to contribute to an increased risk of cardiovascular disease in uraemia. In children with chronic renal failure (CRF), an anti-oxidant enzyme, paraoxonase (PON), that inhibits oxidation of LDL-cholesterol, has not been previously investigated. In this study we aimed to investigate PON activity, total anti-oxidant response (TAR), total peroxide (TPX), oxidative stress index (OSI) and some pro-oxidant cytokines in 29 children with CRF [mean age 10.2 +/- 3.5 years; 19 pre-dialysis, ten on continuous ambulatory peritoneal dialysis (CAPD)] and in 25 control subjects. Children with CRF had lower PON and TAR and higher TPX and OSI values than did controls (P<0.05). Except for lower TAR and serum albumin levels of the CAPD subgroup (P<0.05), other parameters were similar in non-dialysis and CAPD patients (P>0.05). Patients had significant positive correlation between TAR and serum albumin (P<0.05). Serum urea had significant positive correlation with TPX and OSI (P<0.05). Increased oxidative stress and decreased anti-oxidants measured by serum PON activity and TAR were found in children with CRF. We can hypothesize, on the basis of statistical correlations, that low levels of serum albumin and high levels of uraemic metabolites might be responsible for increased oxidative stress in children with CRF. Further studies with larger sample sizes are needed to verify these results.Öğe Paraoxonase, total antioxidant response, and peroxide levels in children with steroid-sensitive nephrotic syndrome(Springer, 2005) Ece, A; Atamer, Y; Gürkan, F; Davutoglu, M; Koçyigit, Y; Tutanç, MReactive oxygen species (ROS) are reported to play a role in inducing the proteinuria of nephrotic syndrome (NS). This study investigated paraoxonase (PON), total antioxidant response (TAR), and oxidant total peroxide together with serum proteins and lipoproteins in children with steroid-sensitive NS. The study included 40 children with steroid-sensitive NS (21 with acute-period NS in group I, 19 nonproteinuric while receiving steroids in group II) and 22 sex- and age-matched formerly nephrotic children in remission weaned from steroids (group III). The following parameters were determined: total peroxide, oxidative stress index (OSI), PON and TAR. Serum proteins and lipoproteins were also determined. Patients in the active phase of NS had significantly lower PON and TAR levels and higher OSI and total peroxide values than those in full remission; no differences were found in PON, TAR, or OSI values of groups I and II. Significant correlations were found between PON, TAR, and total peroxide. Serum total protein had a significantly positive correlation with PON and negative correlation with total peroxide in acute-period NS patients. Our results demonstrate greater oxidative stress and decreased antioxidants in the active phase of steroid-sensitive NS and while patients receive steroids than during full remission. Low-dose alternate-day steroids do not seem to decrease oxidative stress even while proteinuria ceases. Despite some conflicting data increased oxidation and/or decreased antioxidant response may be related to the pathogenesis of steroid-sensitive NS.Öğe Polymorphisms of the angiotensin converting enzyme and angiotensin II type 1 receptor genes and renal scarring in non-uropathic children with recurrent urinary tract infection(Blackwell Publishing, 2005) Ece, A; Tekes, S; Gürkan, F; Bilici, M; Budak, TAim: The aim of this study was to investigate whether the angiotensin converting enzyme (ACE) and angiotensin II type 1 receptor (A1166C) gene polymorphisms were associated with the renal scar formation secondary to recurrent urinary tract infection in children without uropathy. Methods: The polymorphisms were investigated by polymerase chain reaction in 97 children (81 females, 16 males; age, 2.5-13 years) with recurrent urinary tract infection and 100 healthy controls as a single centre study. Children with vesicoureteral reflux, bladder dysfunction and other uropathies were excluded. The dimercaptosuccinic acid (DMSA) scan performed at least 3 months after a proven urinary tract infection and the result of the last DMSA was taken into consideration. Results: Renal scarring was found in 30 patients (30.9%) using DMSA scan. The number of urinary tract infection attacks was significantly higher in patients with renal scarring compared with children without scarring (P < 0.05). The follow-up period and male/female ratio of patients with or without renal scarring was similar (P > 0.05). Age at the first urinary tract infection was lower in the group with scarring. The ACE insertion/deletion genotype distribution and D allele frequency were similar between patients and controls (P > 0.05), and in patients with renal scarring and those without renal scarring. Also, the angiotensin II type 1 receptor gene polymorphism was not associated with renal parenchymal damage (P > 0.05). Conclusion: The results indicated that the ACE insertion/deletion and angiotensin II type 1 receptor gene polymorphisms were not independent risk factors for renal scar formation in recurrent urinary tract infection of paediatric patients without uropathy.Öğe Relationship among serum selenium levels, lipid peroxidation, and acute bronchiolitis in infancy(Humana Press Inc, 2004) Gurkan, F; Atamer, Y; Ece, A; Kocyigit, Y; Tuzun, H; Mete, MThirty-four infants with acute bronchiolitis and 25 age-matched healthy controls were enrolled to investigate the possible relationship between serum malondialdehyde (MDA) and selenium (Se) levels and the occurrence and severity of acute bronchiolitis in children. Serum samples were taken for serum Se and MDA measurements, and the clinical score was assessed at admission. Blood was taken again from the children with bronchiolitis at 2 mo after discharge from the hospital. Mean serum MDA levels were significantly higher in patients with acute bronchiolitis than at the postbronchiolitis stage and the controls (4.2+/-2.5 nmol/L, 1.4+/-0.8 nmol/L, and 0.7+/-0.2 nmol/L, respectively [p<0.001]). Infants with bronchiolitis had lower mean serum Se levels at the acute stage than after 2 mo (31.7+/-28.9 mug/L versus 68.4+/-26.4 mug/L, p<0.05, respectively); both of which were significantly lower than the control group measurements (145.0+/-21.9 mug/L) (p<0.001). There was a negative correlation between serum MDA and Se levels in the patient group (r=-0.85, p<0.001). The age of the patient, child's immunization status, parental smoking habit, and family crowding index were not correlated with serum Se, MDA levels, or clinical score at admission. In conclusion, increased MDA levels and impaired Se status demonstrate the presence of possible relationship of these parameters with pathogenesis of acute bronchiolitis, and antioxidant supplementation with Se might be thought to supply a beneficial effect against bronchiolitis.Öğe Serum leptin levels in asthmatic children treated with an inhaled corticosteroid(Amer Coll Allergy Asthma Immunology, 2004) Gurkan, F; Atamer, Y; Ece, A; Kocyigit, Y; Tuzun, H; Mete, NBackground: Recent observations suggest the presence of an interaction between leptin and the inflammatory system; however, there is no adequate knowledge about the role of leptin in atopic states such as asthma. Objectives: To evaluate the potential role of leptin in relation to bronchial asthma and inhaled corticosteroid therapy. Methods: Twenty-three children with mild-to-moderate, newly diagnosed asthma enrolled in this 2-period trial. The control group consisted of 20 age- and sex-matched children. Serum leptin levels were measured in patients at initiation and after 4 weeks of budesonide treatment and were compared with control group measurements. Results: Asthmatic children had higher mean +/- SD serum leptin levels at admission (19.3 +/- 5.1 ng/mL) than after budesonide treatment (10.6 +/- 1.6 ng/mL) and vs control group measurements (9.8 +/- 1.6 ng/mL) (P < .001). There was a significant correlation between serum leptin levels before and after budesonide treatment (r = 0.68; P = .007). Mean +/- SD body mass indices in patients and controls were 16.7 +/- 2.1 and 16.9 +/- 2.6 kg/m(2), respectively. Serum leptin levels did not correlate with body mass indices before budesonide treatment in the study group (r = -0.13; P = .65) but correlated well after budesonide treatment (r = 0.58; P = .009) and in the control group (r = 0.65; P = .008). Conclusions: The role of leptin elevation in children with asthma might be a regulatory mechanism rather than being etiologic, but a question may be raised whether it is possible that leptin may contribute to poor patient outcomes. Further research, both basic and clinical, is essential to explain the exact mechanism.Öğe Serum lipid and lipoprotein profile in children with iron deficiency anemia(Blackwell Science Asia, 1999) Ece, A; Yigitoglu, MR; Vurgun, N; Güven, H; Iscan, ABackground: A close association has been found between serum lipoprotein abnormalities and the risk of atherosclerosis. In adults, high stored body iron, high serum iron concentrations and low iron binding capacity were found to be risk factors for coronary heart disease. Iron-deficient diets have caused contradictory lipid changes in rats. This report investigates the relationships between iron deficiency, macronutrient intake and the serum lipid and lipoprotein profiles in children with iron deficiency anemia (IDA). Methods and Results: Fifty-six children with IDA, aged 3.0 +/- 1.3 years and 60 healthy age- and sex-matched controls were evaluated. The mean total cholesterol (TC) and low density lipoprotein cholesterol (LDLC), lipoprotein (a) levels and LDL-C/high density lipoprotein cholesterol (HDL-C) and TC/HDL-C ratios of the IDA group were significantly lower than those of controls. While there were no differences in triglycerides and apolipoprotein B (apoB) values between patients and controls, apolipoprotein A-1 (apoA-1) and HDL-C levels were higher in the IDA group. Dietary energy carbohydrates, total fat and protein intakes of the IDA group were lower than those of controls. After oral iron supplementation, the lipoprotein profile of patients with IDA became similar to controls. In the multivariate analysis, while energy was taken as a covariate, there was no difference in the lipid profile of patients and controls. Conclusions: Patients with IDA are also deficient in macronutrients. The low atherogenic serum lipid profile of IDA is not a direct result of iron deficiency itself but related to decreased energy and protein intakes.Öğe Which combination should be preferred in the management of children with chronic hepatitis B infection?(Lippincott Williams & Wilkins, 2005) Dikici, Bünyamin; Ece, A; Boşnak, Mehmet[Abstract Not Available]
