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    Acoustic radiation force impulse (ARFI) elastography for detection of renal damage in children
    (Springer, 2015) Goya, Cemil; Hamidi, Cihad; Ece, Aydin; Okur, Mehmet Hanifi; Tasdemir, Bekir; Cetincakmak, Mehmet Guli; Hattapoglu, Salih
    Acoustic radiation force impulse (ARFI) imaging is a promising method for noninvasive evaluation of the renal parenchyma. To investigate the contribution of ARFI quantitative US elastography for the detection of renal damage in kidneys with and without vesicoureteral reflux (VUR). One hundred seventy-six kidneys of 88 children (46 male, 42 female) who had been referred for voiding cystourethrography and 20 healthy controls were prospectively investigated. Patients were assessed according to severity of renal damage on dimercaptosuccinic acid (DMSA) scintigraphy. Ninety-eight age- and gender-matched healthy children constituted the control group. Quantitative shear wave velocity (SWV) measurements were performed in the upper and lower poles and in the interpolar region of each kidney. DMSA scintigraphy was performed in 62 children (124 kidneys). Comparisons of SWV values of kidneys with and without renal damage and/or VUR were done. Significantly higher SWV values were found in non-damaged kidneys. Severely damaged kidneys had the lowest SWV values (P < 0.001). High-grade (grade V-IV) refluxing kidneys had the lowest SWV values, while non-refluxing kidneys had the highest values (P < 0.05). Significant negative correlations were found between the mean quantitative US elastography values and DMSA scarring score (r = -0.788, P < 0.001) and VUR grade (r = -0.634, P < 0.001). SWV values of the control kidneys were significantly higher than those of damaged kidneys (P < 0.05). Our findings suggest decreasing SWV of renal units with increasing grades of vesicoureteric reflux, increasing DMSA-assessed renal damage and decreasing DMSA-assessed differential function.
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    Antioxidant enzyme activities, lipid peroxidation, and total antioxidant status in children with Henoch-Schonlein purpura
    (Springer, 2008) Ece, Aydin; Kelekci, Selvi; Kocamaz, Halil; Hekimoglu, Askin; Balik, Hasan; Yolbas, Ilyas; Erel, Ozcan
    The aim of this study was to assess the role of oxidative stress in the pathogenesis of Henoch-Schonlein purpura (HSP) vasculitis. The activities of catalase (CAT), arylesterase (ARYL), and paraoxonase (PON) as antioxidant enzymes and serum malondialdehyde (MDA) level as an indicator of lipid peroxidation, together with total antioxidant status (TAS), were measured in 29 children with HSP (mean age 9.3 +/- 2.7 years), both at the onset of the disease and at the remission period and in matched controls. Active-stage HSP had significantly higher MDA level (15.5 +/- 7.3 vs 7.8 +/- 3.9 nmol/l, respectively, P<0.001) and lower TAS (524 +/- 122 vs 699 +/- 122 mu mol Trolox Equiv/1, P< 0.001), PON (97 +/- 47 vs 136 +/- 95 U/1, P=0.042), ARYL (158 +/- 39 vs 212 +/- 52 U/1, P<0.001), and CAT (50 +/- 27 vs 69 +/- 20 U/1, P=0.002) activities compared with the control subjects. Although CAT (P>0.05) and PON (P>0.05) activities were found to be similar between active and remission stages of HSP, the active stage of the disease had significantly lower ARYL (P=0.011) and TAS (P=0.006) and higher MDA (P<0.001) values compared with remission period. Significant positive correlations were found between CAT and MDA (r=0.433, P=0.019) and between CAT and C-reactive protein (r=0.386, P=0.035) in the active stage of HSP. No significant differences were detected in oxidant/antioxidant parameters between patients with or without renal, gastrointestinal, or joint involvement (P>0.05). Increased oxidative stress and lipid peroxidation may play important roles in the pathogenesis of HSP vasculitis. Antioxidant therapeutic interventions in longlasting vasculitis and risk of atherosclerosis secondary to increased oxidant stress remain to be investigated.
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    Assessment of epicardial adipose tissue thickness and the mean platelet volume in children with familial Mediterranean fever
    (Bmc, 2015) Uluca, Unal; Demir, Fikri; Ece, Aydin; Sen, Velat; Gunes, Ali; Aktar, Fesih; Tan, Ilhan
    Background: Familial Mediterranean fever (FMF) is an inflammatory disease, which is suggested to be associated with increased risk of atherosclerosis. Epicardial adipose tissue (EAT) thickness and the mean platelet volume (MPV) are parameters used in prediction of atherosclerotic risk in various conditions. These parameters were evaluated in children with FMF and compared with healthy controls. Methods: Forty-five patients with FMF and 54 age-and gender-matched healthy controls were assessed. Duration of symptoms, age at diagnosis, duration of delay in diagnosis, frequency and duration of FMF attacks, disease severity scores, response to colchicine therapy, MEditerraneanFeVer (MEFV) gene mutations, and MPV values were recorded. EAT thicknesses were measured by echocardiography. Results: Epicardial adipose tissue thicknesses of the children with FMF were found to be significantly greater than that of controls (5.1 +/- 1.4 vs. 4.5 +/- 0.9 mm, p = 0.036). FMF patients had significantly higher MPV values compared with the controls (7.8 +/- 1.1 vs. 7.3 +/- 1.4 fl, p = 0.044). Age at diagnosis, duration of delay in diagnosis, and MPV values were found to be correlated with EAT thickness in the patient group (r = 0.49, p = 0.001 for the former parameters and r = 0.32, p = 0.04 for MPV). Conclusion: Epicardial adipose tissue thickness and MPV values seem to be increased in children with FMF. These findings may indicate an increased risk of atherosclerosis in FMF patients.
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    Clinical and Demographic Features of Children Diagnosed with Cystic Fibrosis after Sweat Test Screening for Failure to Thrive, Chronic Diarrhea or Recurrent Pulmonary Infections
    (Galenos Yayincilik, 2013) Konca, Capan; Gunes, Ali; Sen, Velat; Yel, Servet; Yolbas, Ilyas; Ece, Aydin; Gurkan, Mehmet Fuat
    Introduction: The aim of this study was to investigate the incidence of cystic fibrosis (CF) in patients with recurrent pulmonary infection, chronic diarrhea and failure to thrive having no specific diagnosis and also to investigate the demographic features, and clinic and laboratory findings of such patients. Materials and Methods: The diagnosis of CF has been established through measuring the sweat conductivity in children presenting with one or more characteristic phenotypic features of CF. A chloride concentration lower than 59 mmol/l was interpreted as negative; 60-79 as borderline and over 80 as positive. A borderline sweat test result supported with genetic mutation, nasal potential difference or elastase activity was diagnosed as atypical CF. Results: A total of 356 patients fulfilled the study criteria. Twenty (5.6%) patients were diagnosed as CF. The mean age of the patients was 19.3 +/- 18.1 months and 234 (65.7%) of them were boys. Of the patients suffered from recurrent pulmonary infection, chronic diarrhea and failure to thrive; 15.5%, 10.1%, and 7% were diagnosed as CF, respectively. Major presenting complaints were fever, respiratory tract diseases, failure to thrive, and chronic diarrhea in patients with CF. A total of 430 sweat tests were applied to 356 patients and 20 of the 33 patients with a test resulting over 60 mmol/L were diagnosed as CF. Conclusions: CF should be considered for the differential diagnosis of the patients presented with chronic diarrhea, recurrent pulmonary infection, and failure to thrive. While the incidence of CF in white people is approximately 1 in 3000 individuals, we found a higher rate of 5.6% in our study group.
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    Clinical and Laboratory Characteristics and Follow Up Results of 121 Children with Juvenile Idiopathic Arthritis
    (Modestum Ltd, 2013) Ece, Aydin; Sen, Velat; Yel, Servet; Gunes, Ali; Uluca, Unal; Tan, Ilhan; Karabel, Duran
    This study aimed to investigate the clinical and laboratory features of children with juvenile idiopathic arthritis (JIA) that followed up at Dicle University Hospital Department of Pediatrics. Totally, 121 (64 male, 57 female) children with the mean age of 10.0 +/- 4.1 (range, 1.5-1.8) years were included. The mean disease onset age was 7.9 +/- 3.8 (range, 0.8-15.4) years and the mean follow up period was 2.1 +/- 1.9 years. The percentages of JIA subtypes were as follows: Oligoarticular JIA 67 (55.4%), polyarticular 45 (37.2%), enthesitis related arthritis 5 (4.1%) and systemic JIA 4 (3.3%). The most common complaints were arthralgia (91.7%), fever (57.0%), fatigue (38.8%) and malaise (34.7%) and the most frequently involved joints were knee (74.4%), ankle (57.9) and wrist (48.8%). Complete remission were achieved in 28 (23.1%) and partial remission in 56 (46.3%), however 27 (21.3%) cases not responded to treatment satisfactorily. Significant risk factors for poor response to treatment with logistic regression were found as delay in treatment >= 6 months (Odds ratio, OR: 11.1; p=0.006), existence of thrombocytosis (OR: 7.5; p=0.009) and early disease onset (age<5 years) (OR: 18.1; p=0.004). In conclusion, JIA is a heterogeneous childhood disease with varied clinical manifestations. Early onset disease, delay in treatment and existence of thrombocytosis were the risk factors for an unfavorable outcome.
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    Clinical, radiological and laboratory findings in 185 children with tuberculous meningitis at a single centre and relationship with the stage of the disease
    (Biomed Central Ltd, 2015) Gunes, Ali; Uluca, Unal; Aktar, Fesih; Konca, Capan; Sen, Velat; Ece, Aydin; Hosoglu, Salih
    Background: A delay in the diagnosis and treatment of tuberculosis meningitis (TBM) may lead to increased mortality and morbidity. The aim of this study was to describe the clinical, radiological and laboratory findings of TBM on a cohort of 185 pediatric patients at a single centre over a 10 year period and to investigate relationship between the stage of the disease. Methods: The hospital records of 185 TBM children that presented to the Pediatric Clinics of Dicle University Hospital were retrospectively evaluated. The age, gender, family history of tuberculosis, result of Mantoux skin test, status of BCG vaccination, stage of TBM at hospitalization, and clinical, laboratory and radiological features were recorded. Clinical staging of TBM was defined as follows: Stage I, no focal neurological findings and Glasgow Coma Scale (GCS) score 15; Stage II, GCS 15 presenting with focal neurological deficit or all the patients with GCS 10-14; Stage III, all the patients with GCS < 10. Relationships between results and stages of TBM were investigated. Results: The mean age of the patients was 53.5 +/- 44.9 months (4 months-18 years). 121 (65.4 %) of the patients were male and 64 (34.6 %) female. Family history of tuberculosis was defined in 62 (33.5 %) patients. Forty five (24.3 %) children had BCG vaccination scar. Mantoux skin test was interpreted as positive in 35 (18.9 %) patients. Sixty-eight (36.8 %) children were at stage I TBM, 57 (30.8 %) at stage II and 60 (32.4 %) were at stage III on admission. Mean duration of hospitalization was 23.9 +/- 14.1 days. Totally, 90 patients (48.6 %) had abnormal chest X-ray findings (parenchymal infiltration in 46 (24.9 %), mediastinal lymphadenopathy in 36 (19.5 %), miliary opacities in 25 (13.5 %), pleural effusion in 2 (1.1 %), and atelectasis in 2 (1.1 %) patients). One hundred sixty seven (90.3 %) patients had hydrocephalus in cranial computerized tomography. There were 24 (13.0 %) patients with positive culture for Mycobacterium tuberculosis and 3 (1.6 %) patients with positive acid-fast bacilli in cerebrospinal fluid. Overall mortality rate was 24 (13.0 %). Among the findings; patients at Stage III had less frequent positive chest X-ray abnormality, miliary opacities and BCG vaccination scar when compared with patients at Stage I and II (p = 0,005; p = 0,007, p = 0.020, respectively). Conclusions: Children with TBM and positive chest X-ray findings at hospital admission were more frequently diagnosed at Stage I, and BCG vaccination might be protective from the Stage III of the disease.
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    The contribution of nitric oxide on the relaxation effects of diethylstilbestrol
    (Saudi Med J, 2008) Hekimoglu, Askin; Celik, Fatma; Tas, Taskin; Ece, Aydin; Kavak, Vatan
    Objectives: To evaluate the contribution of nitric oxide (NO) on the relaxation effects of diethylstilbestrol on rat uterus. Methods: Uterine rings from 8 nonpregnant Wistar Albino rats (300-350g) in the pro-estrous phase were suspended in an organ bath and electrical field stimulation applied for recording isometric tension. The influence of NO on contractile responses of rat uterine rings was investigated. The effects of NO precursor L-arginine (10(-7)-10(-4)M) concentration and NO synthase inhibitor L-nitro-arginine-methyl ester (10(-7)-10(-4)M) concentration and a combination of them on contractile responses were studied in the presence and absence of diethylstilbestrol (2x10(-4)M) concentration. The study was carried out at the Department of Pharmacology Laboratory, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. Results: Totally, 30 samples were investigated (n=6 for each group, 5 groups). Diethylstilbestrol inhibited contractile responses 64.2 +/- 4.5% (n=6, p<0.05). Contractile responses decreased in the presence of Larginine (n=6, p<0.05) and this inhibition was abolished in the presence of L-nitro-arginine-methyl ester (n=6, p<0.05). The inhibition on contractile responses to diethylstilbestrol was potentiated in the presence of Larginine under similar conditions (n=6, p<0.05). The contractile responses to electrical field stimulation in the presence of diethylstilbestrol were not affected by L-nitro-arginine-methyl ester (n=6, p>0.05). Conclusions: These data provide evidence that NO may potentiate the inhibitory effects of diethylstilbestrol by different mechanisms on the electrically induced contractions of the non-pregnant rat uterus.
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    Correlation of mean platelet volume, neutrophil-to-lymphocyte ratio, and disease activity in children with juvenile idiopathic arthritis
    (E-Century Publishing Corp, 2015) Gunes, Ali; Ece, Aydin; Sen, Velat; Uluca, Unal; Aktar, Fesih; Tan, Ilhan; Yel, Servet
    Juvenile idiopathic arthritis (JIA) is a chronic inflammatory arthritis characterized by periods of remission and relapse. Mean platelet volume (MPV) is an indicator of systemic inflammation. In the present study, we aimed to determine the association between mean platelet volume (MPV), neutrophil/lymphocyte ratio (NLR), platelet distribution width (PDW) and clinical measures of diseases activity in children with JIA. The study included 115 patients with JIA (64 with active disease and 51 with inactive disease) and 64 age-gender matched healthy control subjects. Routine laboratory methods were used to measure white blood cell count (WBC), platelet count (PLT), neutrophil count, lymphocyte count, hemoglobin (Hb), MPV, PDW, NLR, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) in all subjects of both the patient and control groups. Active disease was associated with significantly increased MPV (8.23 +/- 1.16 fl) compared with inactive disease (7.00 +/- 1. 08 fl) and control subjects (6.77 +/- 1.08 fl) P<0.001, P<0.001, P=NS, respectively). NLR was significantly higher in patients with active (2.11 +/- 1.19) and inactive (2.03 +/- 1.51) disease relative to the control subjects (1.33 +/- 0.66) (P<0.001, P=0.017, respectively). Mean PDW was significantly higher in patients with active disease (17.84 +/- 1.06) compared with the control group (17.19 +/- 0.93) (P=0.01). Our results suggest that MPV may be a useful marker of disease activity in patients with JIA. Regular treatment may decrease platelet activation in JIA patients. However, NLR was not a predictive marker of disease activity in patients with JIA.
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    Cutaneous Anthrax of the Eyelid
    (Iranian Soc Ophthalmology, 2010) Sahin, Alparslan; Caca, Ihsan; Ece, Aydin; Ari, Seyhmus; Sen, Velat
    Purpose: Cutaneous anthrax of the eyelid is a rare condition in clinical practice, but should be considered in the differential diagnosis of preseptal and orbital cellulitis. Here we report a case of palpebral anthrax. Case report: A 5-year-old girl with anthrax infection of the right upper eyelid is presented. Her eyelid showed an edematous, necrotic, and partially bullous lesion. Following complete healing of the eyelid lesion, mild cicatricial ectropion resulted. Conclusion: Anthrax is a rare disease that is not well known by ophthalmologists. Clinicians should be aware of the complications and the management of palpebral anthrax.
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    The effect of malnutrition on kidney size in children
    (Springer, 2007) Ece, Aydin; Gozu, Ayfer; Bukte, Yasar; Tutanc, Murat; Kocamaz, Halil
    Malnutrition is a widespread disorder in children, and ultrasonography is the method of choice to estimate kidney dimensions. Previously, kidney sizes had been studied in healthy newborns and in pediatric patients; however, kidney sizes were not investigated sufficiently in malnourished children. The study group consisted of 74 children with energy malnutrition (marasmus), and the control group consisted of 47 healthy children. Kidney sizes were mesaured by the same radiologist using ultrasonography. The mean age of the marasmic group was 29.6 +/- 14.0 months. Malnourished children had significantly lower kidney length and renal volume but higher relative kidney volume (cm(3)/body weight) compared with controls (P < 0.05). The mean length and volume of left kidney were higher than those of right kidney in both marasmic and control groups (P < 0.05). The strongest positive correlations were found between body height and kidney length, depth and volume in marasmic group. Regression analysis revealed that height and age of marasmic children had a significant effect on kidney volume; however, only body height had an effect on kidney length. In conclusion, malnourished children had smaller kidney sizes, and body height was the main determinant of their kidney length and volume. The potential long-term detrimental consequences of poor renal growth in malnutrition need to be investigated.
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    The Effects of Pomegranate and Carvacrol on Methotrexate-Induced Bone Marrow Toxicity in Rats
    (Canadian Soc Clinical Investigation, 2014) Sen, Velat; Bozkuri, Mehtap; Soker, Sevda; Ece, Aydin; Gunes, Ali; Uluca, Unal; Soker, Murat
    Purpose: The aim of this study was to evaluate the e ff ects of pomegranate (PMG) extract and carvacrol (CARV) on methotrexate (MTX)- induced oxidative stress and bone marrow toxicity. Methods: Wistar albino rats (32 rats) were divided into four groups (n=8): Group 1 was control; Group 2 was given a single intraperitoneal injection of methotrexate (20 mg/kg); Group 3 was treated with carvacrol (73 mg/kg i.p.) one day before MTX (20 mg/kg i.p.) injection; and, Group 4 received a single dose of MTX (20 mg/kg i.p) while PMG was administered orally for seven days at 225 mg/kg. After animals were euthanized, blood samples were taken to evaluate hematological parameters and oxidative stress. In addition, the femur was cropped and bone marrow was extracted for examination. Results: White blood cell count, hemoglobin, hematocrit and platelet count were found to be decreased in the MTX group, but these changes were prevented in the groups that received CARV and PMG. Furthermore, decreased bone marrow cellularity was found in the groups treated with MTX, whereas the PMG and CARV groups had cellularity similar to controls. Strikingly, oxidative stress increased in the MTX group, but was ultimately decreased in the rats that received the antioxidants PMG and CARV. Conclusion: Carvacrol and PMG were found to be protective against methotrexateinduced oxidative bone marrow damage. Use of these antioxidants, in combination with chemotherapeutics, may help to reduce some adverse effects of methotrexate.
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    Efficacy of vitamin E in children with immunotolerant-phase chronic hepatitis B infection
    (Wiley, 2007) Dikici, Bünyamin; Dagli, Abdullah; Ucmak, Hasan; Bilici, Meki; Ece, Aydin
    Background: The purpose of the present paper was to investigate the efficacy of vitamin E in children with immunotolerant-phase chronic hepatitis B virus (CHB) infection. Methods: Fifty-eight immunotolerant children were prospectively and randomly recruited into two groups. Group 1 (study group) included 30 patients who received vitamin E at a dose of 100 mg/day throughout 3 months; group 2 (control group) contained 28 patients who did not receive any medication. Comparison of serological, virologic, and biochemical response ratios were done at the end of the therapy and after 6 months of vitamin E discontinuation. Results: Mean alanine transaminase (ALT) values in group 1 at the beginning of the therapy, 3 months after the therapy initiation and 6 months after discontinuation were 30.4 +/- 7.3 IU/L, 31.3 +/- 7.8 IU/L and 32.1 +/- 8.5 IU/L, respectively. The mean hepatitis B virus (HBV)-DNA load of group 1 at onset, and at the third and ninth months of the treatment were 3106 +/- 718 pg/mL, 3530 +/- 137 pg/mL and 3364 +/- 1246 pg/mL, respectively. These changes in both ALT and HBV-DNA values did not reach significant levels (P > 0.05). In group 2, mean ALT values at the beginning of therapy, and at the third and ninth months were 28.0 +/- 1.8 IU/L, 34.6 +/- 8.1 IU/L, and 34.1 +/- 7.0 IU/L, respectively (P > 0.05), and mean viral load of HBV-DNA was 4227 +/- 1435 pg/mL, 3368 +/- 2673 pg/mL, and 3018 +/- 2814 pg/mL, respectively (P > 0.05). There was no statistically significant difference between group 1 and group 2 at the third and ninth months in the mean ALT values and viral load of HBV-DNA (P > 0.05). Hepatitis B s antigen and hepatitis B e antigen clearance or hepatitis B s antibody and hepatitis B e antibody seroconversion were not observed in either group. Conclusion: As a first study investigating the effect of vitamin E in children with immunotolerant CHB infection, no beneficial effect could be demonstrated. Different immunomodulator protocols should be considered for future investigations.
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    Evaluation of the Mean Platelet Volume in Children with Juvenile Idiopathic Arthritis
    (Modestum Ltd, 2014) Sen, Velat; Ece, Aydin; Uluca, Unal; Gunes, Ali; Tan, Ilhan; Tuncel, Tuba; Aktar, Fesih
    Juvenile idiopathic arthritis (JIA) is the most common chronic inflammatory arthritis in children. Mean platelet volume (MPV) is an indicator of platelet size and has been investigated as an inflammation marker in several diseases. This study was designed to investigate the MPV values in patients with JIA and healthy subjects, and determine the correlation between MPV, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). The hospital records of a total of 40 children with JIA, diagnosed using the International League of Associations for Rheumatology (ILAR) criteria, and 40 healthy controls were enrolled into the study. White blood cell count (WBC), platelet count, CRP, ESR, and MPV levels were retrospectively recorded. Children with JIA had significantly higher MPV values (8.28 +/- 1.12 fL) compared to the control group (7.53 +/- 1.07 fL) (p=0.003). Significant correlations were found between MPV, ESR, and CRP in the JIA group (r=0.676, p<0.001 and r=0.430, p<0.006). In addition, a negative correlation was found between platelet count and MPV (r=-0.818, p<0.001) in JIA patients. There was no significant difference in WBC values between the patient and the control groups (p>0.05). Our results suggest that MPV levels may be a useful marker of inflammation and prognostic factor for atherosclerosis risk in pediatric JIA patients.
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    High frequency of E148Q sequence variation in children with familial Mediterranean fever in southeast Turkey
    (Soc Argentina Pediatria, 2015) Uluca, Unal; Ece, Aydin; Sen, Velat; Coskun, Salih; Gunes, Ali; Yel, Servet; Tan, Ilhan
    Objective: The aim of this study was to investigate the spectrum of Mediterranean fever (MEFV) gene mutations and genotype-phenotype correlation in children with familial Mediterranean fever (FMF) in southeast Turkey. Methods: A total of 507 children (274 females) with FMF and MEFV gene mutation(s) were included. A 15-year retrospective evaluation was conducted; parameters analyzed were: age, sex, age at symptoms onset, age at FMF diagnosis, delay between symptoms onset and diagnosis, FMF attack symptoms, and response to colchicine. Disease severity scores were calculated and MEFV mutation analysis was performed via real-time PCR for the 6 most frequent mutations. Children with comorbid diseases or tested negative for MEFV gene mutations were excluded to provide homogeneity. Results: A family history of FMF was found in 60.2% (n=305) of patients. The most common symptoms reported for FMF attacks were abdominal pain (98.0%), fever (93.9%) and arthralgia (47.3%); 75.0% of patients (n= 380) were heterozygous, 14.2% were homozygous (n= 72) and 10.8% were compound heterozygous (n= 55). The following MEFV gene mutation alleles were identified: E148Q (40.1%), M694V (25.9%), V726A (15.8%), R761H (7.4%), M680I (6.8%), and P369S (4.1%). The M694V subgroup had the lowest mean age of disease onset and the highest mean disease severity score, whereas the E148Q group had later mean disease onset and the lowest mean disease severity score (p<0.05). Conclusion: The highest E148Q mutation frequency and milder disease in the course of FMF in our study population may be due to geographic and ethnic background dissimilarities of southeast Turkey.
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    Kidney growth and renal functions under the growth hormone replacement therapy in children
    (Informa Healthcare, 2014) Ece, Aydin; Cetinkaya, Semra; Eksioglu, Secil; Senel, Saliha; Ozkasap, Serdar; Ginis, Tayfur; Sen, Velat
    Objective: The aim of this study was to investigate the kidney growth and renal functions in children receiving recombinant human growth hormone (rhGH) treatment. Materials and methods: A total of 37 children who received rhGH for 1.5 years before the study was started and 48 healthy controls were included at first evaluation. Hormone levels were determined and kidney sizes were measured by ultrasound. Kidney functions were assessed by serum creatinine and estimated glomerular filtration rate (eGFR). After 3 years of first evaluation, 23 patients were re-assessed. Results: Kidney sizes were found to be lower in rhGH received children compared with controls at first evaluation (p<0.05). Significant positive correlations were found between anthropometric measurements and kidney length and kidney volume (p<0.05). Height was the most significant predictor of kidney volume in rhGH received children (p<0.001). After 3-years of follow-up significantly increases were found in kidney length and volume compared with the first measurements (p<0.05). Increase percentage of body height was similar to increasing percent of kidney length and liver long axis (14.2%, 11.7.1% and 7.7%, respectively, p>0.05). Although no abnormal renal function test results were found at first and second evaluations; rhGH received children had significantly lower eGFR, at first evaluation, compared with controls; however, renal functions significantly increased after 3 years of follow-up (p<0.05). Conclusions: In conclusion, effect rhGH treatment on kidney growth is parallel to growth in body height and other visceral organs. A 3-years rhGH treatment resulted in significant increases in renal functions.
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    Mean platelet volume as an indicator of disease activity in juvenile SLE
    (Springer London Ltd, 2014) Yavuz, Sevgi; Ece, Aydin
    The aim of the study was to assess mean platelet volume (MPV) in children with systemic lupus erythematosus (SLE) at the active and inactive stages. Twenty children with SLE and 30 age- and gender-matched controls were enrolled. Demographic data, SLE disease activity index (SLEDAI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), MPV, complement 3 (C3), complement 4 (C4), urine protein (Up), and urine creatinine (Ucr) values upon reactivation and remission phases were recorded. MPV was statistically higher in patients than in controls and significantly increased in active phase compared to inactive phase (p = 0.001). A MPV level of 8.4 fL was determined as predictive cutoff value of activation of SLE (sensitivity 75 %, specificity 90 %). MPV was positively correlated with SLEDAI (p = 0.01, r = 0.55), ESR (p = 0.01, r = 0.45), CRP (p = 0.04, r = 0.24), and Up/Ucr (p = 0.01, r = 0.45) and negatively correlated with C3 (p = 0.02, r = -0.36), albumin (p = 0.01, r = -0.63), and Hb (p = 0.01, r = -0.48). There was not any significant association between MPV and the histological classification of lupus nephritis (p = 0.65). MPV might be used as an early indicator of reactivation in children with SLE. MPV seemed to be more accurate than ESR, CRP, and C3 for monitoring the disease activity in SLE.
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    The MEFV mutations and their clinical correlations in children with familial Mediterranean fever in southeast Turkey
    (Springer Heidelberg, 2014) Ece, Aydin; Cakmak, Erdal; Uluca, Unal; Kelekci, Selvi; Yolbas, Ilyas; Gunes, Ali; Yel, Servet
    The aim of this study was to determine the Mediterranean fever (MEFV) gene mutations and their clinical correlations in children with familial Mediterranean fever (FMF) in southeast Turkey. Clinical and laboratory characteristics of 147 (65 males, 82 females) consecutive children with FMF having a positive MEFV gene mutation were prospectively investigated. Patients with negative MEFV gene mutations or atypical FMF presentations and those from other regions of the country were excluded. Clinical manifestations and disease severity scores were recorded. The six most frequent MEFV mutations including M694V, V726A, R726H, P369S, E148Q and P369S were investigated by a reverse hybridization test method. The median age of study group was 9.0 years, median age at diagnosis was 7.8 years, median age at disease onset was 5.0 years, and median follow-up duration was 4.0 years. A positive family history of FMF and parent-to-offspring transmission was found in 58.5 and 42.2 % of families, respectively. The frequencies of independent alleles, with decreasing order, were E148Q (30.7 %), M694V (26.0 %), R761H (13.5 %), V726A (13.0 %), P369S (10.5 %) and M680I (6.3 %) in FMF patients. The M694V subgroup had higher mean disease severity score and longer attack duration compared with E148Q and other mutations subgroups (p < 0.05). Two patients with amyloidosis had the M694V homozygote genotype. In conclusion contrast to other regions and many other ethnicities of the world, the most frequent MEFV gene mutation was E148Q in southeast Turkey. The M694V mutation frequency was lower, and disease severity was relatively mild in FMF children of this region.
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    Myocardial infarction in an 11-year-old child with systemic lupus erythematosus
    (Turkish Soc Cardiology, 2016) Bilici, Meki; Demir, Fikri; Ture, Mehmet; Akin, Alper; Cil, Habip; Ece, Aydin; Polat, Nihat
    [Abstract Not Available]
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    Neutrophil activation, protein oxidation and ceruloplasmin levels in children with Henoch-Schonlein purpura
    (Springer, 2007) Ece, Aydin; Kelekci, Selvi; Hekimoglu, Askin; Kocamaz, Halil; Balik, Hasan; Yolbas, Ilyas; Erel, Ozcan
    The aim of this study was to investigate the role of neutrophil activation, protein oxidation and ceruloplasmin (CLP) in the pathogenesis of Henoch-Schonlein purpura (HSP), which has not been investigated previously. Serum activities of myeloperoxidase (MPO) and arylesterase (ARYL) and levels of free thiol groups, CLP and total oxidant status (TOS) were measured in 29 children with HSP at the onset of the disease and during remission in comparison with 30 healthy subjects. Patients at active stage had significantly higher MPO activity (391 +/- 277 vs. 155 +/- 154 U/l, P<0.001), higher CLP (832 +/- 120 vs. 682 +/- 114 mg/dl, P<0.001) and TOS values (20.7 +/- 11.8 vs. 7.5 +/- 2.8 mu mol H2O2/l, P<0.001) than the controls, respectively. Patients had significantly lower ARYL activity (158x10(3) +/- 3x10(3) vs. 187x10(3) +/- 4 46x10(3) U/l, P<0.001) and lower free thiol levels (234 +/- 48 vs. 279 +/- 26 mu mol/l, P<0.001) than the controls, respectively. Significantly positive correlations were found between TOS and MPO (r=0.437, P=0.018) and TOS and CLP (r=0.409, P=0.028) at disease onset, whereas a negative correlation was found between MPO and thiol (r=-0.597, P=0.001) during remission. In conclusion, protein oxidation and neutrophil activation may play important roles in the pathogenesis of HSP. Further research is required to understand the potential linkage between oxidant stress and complications and to develop therapeutic strategies in HSP.
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    Nutcracker syndrome complicating with renal abscess
    (Pakistan Medical Assoc, 2016) Yavuz, Sevgi; Ece, Aydin; Corapli, Mahmut; Ilter, Cigdem; Guven, Rufat
    The nutcracker syndrome refers to compression of left renal vein between the superior mesenteric artery and aorta. Renal abscess consists of purulent and necrotic material localised to the renal parenchyma. These two entities are extremely rare and their coincidence has not previously been described in literature. Here, we report a case of a 10-year-old girl who developed left renal abscess probably due to nutcracker syndrome.