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Öğe Acquired Glanzmann thrombastenia due to immune thrombocitopenic purpura(2006) Altintaş A.; Ayyildiz O.; Söker M.; Müftüoğlu E.Glanzmann thrombastenia is a rare otosomal ressesive disease which has normal platelet count and morphology, and impairment of platelet aggregation. There is qualitative or quantitative abnormality in GPIIb-IIIa proteins that have a function of receptor to fibrinogen and Von-Willebrand Factor. Mucocutenous hemorrhage, epistaxis, gingival hemorrhage, and hemorrhage were seen especially in young age. The disease may occur rarely as an acquired. Autoantibodies developed in the course of some disease such as Non-hodgkin's lymphoma, Hodgkin disease, multiple myeloma, in patients who are taking immunusuppressive drugs, and particularly in immune thrombocytopenic purpura. We report here, a patient 42 years-old female, who is diagnosed as Acquired Glanzmann thrombastenia due to immune thrombocytopenia.Öğe Assessment of thyroid function in children aged 1-13 years with beta-thalassemia major(Brieflands, 2011) Pirinççioğlu A.G.; Deniz T.; Gökalp D.; Beyazit N.; Haspolat K.; Söker M.Objective: Hypothyroidism usually appears in the second decade of life and is thought to be associated with iron overload in patients with thalassemia major. This study aimed to evaluate thyroid dysfunctions in patients with beta-thalassemia major and to see if they appear in the earlier period of life. Methods: Thyroid function and iron load status were evaluated in 90 children with a mean age of 7.17±3.78 years with beta-thalassemia major by measuring serum free thyroxin (FT4), serum free triiodothyronine (FT3), total thyroxin (T3), serum total triiodothyronine (T4), thyroid-stimulating hormone (TSH) and ferritin levels from serum of patients admitted to the Pediatric Department, Faculty of Medicine University of Dicle between March 2005 and July 2009. A control group formed from an age-sex matched healthy children with a mean age of 6.98±3.66 years was also included. A standard thyrotropin releasing hormone test was applied to 3 patients who had high TSH levels and were classified as subclinical primer hypothyroidism. The study was designed according to the Declaration of Helsinki and informed consent was obtained from the parents of all participants. Findings: All thyroid parameters in patients were in the normal ranges compared with the controls except three of them which had high TSH levels. Serum ferritin level (2703±1649 ng/mL) in patients was significantly higher than in controls (81.5±15.5 ng/mL). Conclusion: The work implies that hypothyroidism could be even seen in the first decade of life in patients with beta-thalassemia major in spite of improved hematological cares. © 2011 by Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, All rights reserved.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 The contribution to success of various methods of treatment of temporomandibular joint ankylosis (a statistical study containing 24 cases)(2005) Tanrikulu R.; Erol B.; Görgün B.; Söker M.Temporomandibular joint (TMJ) ankylosis is an important joint disorder which, in addition to emerging through trauma, can also arise as a result of local and systemic infections. TMJ ankylosis which develops in childhood in particular has its own characteristics. Despite the existence of different views on the treatment of TMJ ankylosis, various techniques have been defined, and three basic techniques are currently employed: gap arthroplasty, interpositional arthroplasty and joint reconstruction. Our study is intended as a statistical inquiry into the contribution to the operation success of the three different methods of treatment. Moreover, the effect on treatment outcome of unilateral or bilateral ankylosis is also statistically evaluated. In our study, eight cases were treated with gap arthroplasty, nine with interpositional arthroplasty and seven with joint reconstruction performed by costochondral graft. As a result of our statistical evaluation, it was determined that the effect of interpositional arthroplasty on post-operative maximal interincisal mouth opening was greater than that observed with the other methods.Öğe Daunorubicin induced blue-gray hyperpigmentation: A case report(2005) Ayyildiz O.; Şit D.; Söker M.; Kadiro?lu A.K.; Yeşilba?dan A.H.Daunorubicin is used widely in the treatment of acute myeloblastic leukemia (AML). Daunorubicin has some toxicity which limit the usage of drug. Blue-gray pigmentation is an uncommon side effect of daunorubicin. It is one of the side effect which might disturb patient for a long time cosmetically. We report here a hyperpigmentation case with acute myelomonocytic leukemia who is still on the treatment.Öğe The effects of pomegranate and carvacrol on methotrexate-induced bone marrow toxicity in rats(The Canadian Society for Clinical Investigation, 2014) Şen V.; Bozkurt M.; Söker S.; Ece A.; Güneş A.; Uluca Ü.; Söker M.Purpose: The aim of this study was to evaluate the effects 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 methotrexate induced oxidative bone marrow damage. Use of these antioxidants, in combination with chemotherapeutics, may help to reduce some adverse effects of methotrexate. © 2014 CIM.Öğe Evans syndrome: A case report(2009) Taşkesen M.; Okur N.; Okur N.; Söker M.Evans syndrome is rare and characterized with autoimmun thrombocytopenia and hemolytic anemia. Etiology is unknown. The patients may apply with different clinical findings. Seven years old boy was refered for fever, abdominal pain and epistaxis. In physical examination pallor and hepatosplenomegaly were detected. In laboratory anemia, thrombocytopenia, insufficient of thrombocytes and hemolysis in periferic blood smear, high lactic dehydrogenase, low haptoglobulin, increased reticu-locyte count were found and Direct Coombs test were positive. Hypercellularity, increased erytroid series and megacar-yocytes were determined in bone marrow examination. Erythrocyte suspension and intravenous immunglobulin were used for treatment. In 12 days follow-up hemoglobine level and platelet count were in normal limits and patient was discharged succesfully. The patient had no symptoms and normal laboratory findings two months later. The aim of this case report is evaluation of clinical and laboratory features of Evans syndrome.Öğe Inhibitors in hemophilia A and B in Southeast of Turkey(2006) Altintaş A.; Ayyildiz O.; Çil T.; Söker M.; Müftüoğlu E.Hemophilia A and B are inherited, X chromosome linked coagulation disorders that characterized by clinical signs and symptoms seen in males. The most important treatment related complication was viral infection in the past years, but this problem is overcoming by developing of modern factors concentrate which are available in the market, nowadays. However, developing inhibitor against concentrated factors that used is the most important problem, as in western countries. In this study, we aimed to evaluate the inhibitor developing rate in 73 hemophiliac pediatric and adult patients who have treated and followed up in Dicle University hematology polyclinics in Southeastern Anatolia. 62 (85%) of cases were hemophilia A and 11 (15%) were hemophilia B. Of hemophilia A patients 41 (66.2%) had severe and 17 (27.4%) had moderate disease. The same rates were 7 (63.6%) and 3 (27.3%) in hemophilia B patients, respectively. Only one patient (2.4%) with severe hemophilia A had high titrate of inhibitor positivity (17 BU/ml). Inhibitor was present in any of hemophilia B patients. This rate was lower than previously reported data from community of Turkey. We proposed that the most important cause of this low frequency of inhibitor is using fresh frosen plasma in treatment of those patients with bleeding.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 Quantitative analysis of t(8,21) and inv(16) via RT-PCR in patients with acute myeloid leukemia(2005) Ayyildiz O.; Kalkanli S.; Batun S.; Işikdo?an A.; Söker M.; Yurt M.; Müftüo?lu E.It has been showed that there is a relation between chromosomal abnormality and prognosis in acute myeloid leukemia (AML). There are many chromosomal abnormalities in AML patients and it is known that t(8;21) and inv(16) are good prognostic abnormalities. Recently the treatment has been planned according to these abnormalities. We investigated t(8,21) and inv(16) abnormalities by quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) in 19 patients with AML. Morever conventional cytogenetic method was applied for all patients. Of whom 9 were men and 10 women. Age of avarage was 19 to 58 years. FAB morphologic classification follows as; 5 AML-M1, 8 AML-M2, 5 AML-M4, 1 AML-M5. Complete remission was obtained in eighteen patients with first induction regimen, whereas in one patient after second induction. t(8;21) has been found in 1 patient with cytogenetic method and confirmed with RT-PCR. In this study, we aim to search t(8;21) and inv(16) abnormalities in AML cases.Öğe The Role of FLT3-ITD and CCAAT-Enhancer-Binding Protein ? Mutations on Prognosis of Acute Lymphoblastic Leukaemia in Turkish Patients(University of the West Indies, 2022) Uluca U.; Söker M.; Ayyıldız M.O.; Yurt M.; Şen V.; Yel S.; Güneş A.Background: Acute lymphoblastic leukaemia (ALL) is the most common malignancy in childhood. Although some prognostic factors have been defined to date, the estimation of prognosis is currently not perfect. Previous studies had shown an association of FLT3 with poor prognosis and CCAAT-enhancer-binding protein ? (CEBPA) mutation with the development of acute myeloid leukaemia (AML). Here, we aimed to evaluate the prognostic value of FLT3-ITD and CEBPA mutations in ALL. Methods: Sixty-one patients with ALL were included in the study. The patients were divided into three risk groups according to BFM risk classification. All of the patients were examined for FLT3-ITD mutations and 45 of them for CEBPA mutations. Mutation positive and negative patients were compared in terms of their risk groups, translocations and cell lineage. The clinical courses of the patients were appraised. Results: FLT3-ITD mutation was detected in 3 of the 61 patients, and CEBPA mutations were detected in 11 of the 45 patients. The incidence of established prognostic indicators including BFM risk classification, t(9; 22); BCR-ABL, t(1; 19); E2A-PBX1, t(12; 21); TEL-AML1, t(4; 11); MLL-AF4 were similar between FLT3-ITD and CEBPA positive and negative patients. A patient with an FLT3-ITD mutation was very susceptible to pancytopenia after maintenance treatment and two other patients with FLT3-ITD mutations were more prone to febrile neutropenia. Conclusion: Our results suggested that CEBPA or FLT3-ITD mutations might not be related to ALL prognosis in the sampled Turkish patients. However, FLT3-ITD mutation might have an influence on the response of bone marrow to chemotherapy. © West Indian Medical Journal 2022. This is an article published in open access under a Creative Commons Attribution International licence (CC BY). For more information, please visit https://creativecommons.org/licenses/by/4.0/deed.en_USÖğe Successful treatment of Wilms' tumor with intracaval extension by preoperative chemotherapy: Report of two cases(2000) Dokucu A.I.; Öztürk H.; Söker M.; Alan S.; Bükte Y.; Özçelik C.; Zincircio?lu B.Two patients presenting with advanced Wilms' tumor extending to inferior vena cava anal right atrium, were successfully treated with chemotherapy and surgery. The first case presented with a right renal mass and intraatrial tumor extension. The original mass regressed 28 % in volume while the thrombus remained at the vena cava as it was before chemotherapy. Surgery was performed via laparotomy and sternotomy. The second case presented with bilateral Wilms' tumor and intracaval extension up to the right atrium. In this case, both renal masses and intracaval thrombus well regressed (up to 80 %) with chemotherapy. Surgical excision of the both masses and removal of intracaval thrombus were performed via laparotomy. The results obtained with preoperative chemotherapy as in these two patients mediates strongly against difficult surgery being undertaken as primary treatment for such patients.Öğe An unusual diagnosis in a child presenting with hypercalcemia: Acute lymphoblastic leukemia(Gulhane Askeri Tip Akademisi, 2010) Taşkesen M.; Okur N.; Söker M.; Taş M.A.Hypercalcemia is a rare complication of acute lymphoblastic leukemia in childhood. We report a 4-year-old boy who presented with hypercalcemia and was diagnosed to have acute leukemia. The laboratory tests for main causes of hypercalcemia (Hyperparathyroidism, hypervitaminosis A and D, hyperthyroidism) were within normal limits. Hypercalcemia was treated with intravenous isotonic sodium chloride solution, furosemide and corticosteroids. In repeat laboratory tests performed on day 4 of admission, a normal complete blood cell count was found, but peripheral blood smear examination at this time revealed atypical lymphocytes. A bone marrow aspiration was performed, and 80% lymphoblasts were determined. The diagnosis of acute leukemia cannot be excluded in a patient with hypercalcemia and normal complete blood cell count and peripheral blood smear examination results. Repeat laboratory and detailed peripheral blood smear examinations are necessary to make a correct diagnosis in such cases. © Gülhane Askeri Ti{dotless}p Akademisi 2010.
