Browsing by Author "Akinci, G"

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    Miller Fisher syndrome
    Akinci, G; Polat, M; Tosun, A; Serdaroglu, G; Gökben, S; Tekgül, H
    Miller Fisher syndrome is characterized by the acute onset of ophthalmoplegia, ataxia, and areflexia. Anti-GQ1b antibodies are useful markers for the differential diagnosis of Miller Fisher syndrome. We describe the case of a seven-year-old male who presented with a four-day history of diplopia and ophthalmoplegia following a febrile flu-like illness with sore throat. On examination he was found to have ataxia, areflexia and ophthalmoplegia, and a diagnosis of Miller Fisher syndrome was made after the exclusion of other conditions and concomitant with electrophysiological findings on electromyography. Although this disorder has a rare incidence, it should still be considered in the differential diagnosis in our country.
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    Evaluation of markers of inflammation, insulin resistance and endothelial dysfunction in children at risk for overweight
    Akinci, G; Akinci, B; Coskun, S; Bayindir, P; Hekimsoy, Z; Özmen, B
    OBJECTIVE: Childhood obesity is associated with impaired endothelial function, insulin resistance and inflammation. Being at risk for overweight has been defined as having a body mass index (BMI) between the 85(th) and 94(th) percentile for age and sex. In this study, we looked for features linked to cardiovascular, risk in children who are at risk for overweight. DESIGN: Twenty-one children who were at risk for overweight (study group) and 20 children with a BMI between the 25(th)-74(th) percentiles (controls) were studied. Fasting blood levels of glucose, insulin, total cholesterol, HDL cholesterol, triglycerides, uric acid, fibrinogen and high sensitive C-reactive protein (CRP) were assessed in both groups. LDL-cholesterol, HOMA-IR and QUICKI indices were calculated. Flow-Mediated Vasodilatation (FMD) was determined for the evaluation of endothelial function. RESULTS: Increased HOMA-IR was observed in children who were at risk for overweight. Waist circumference was the main predictor of insulin resistance in these children. Higher levels of CRP were found in the study group compared to controls, while plasma fibrinogen died not differ in the two groups. The children who were at risk for overweight had lower FMD values and slightly elevated lipids compared to controls; however, these differences were not statistically significant. CONCLUSION: Insulin resistance and inflammation indices were higher in children who were at risk for overweight as has been shown for obese children. The data suggest that appropriate treatment strategies for weight control are essential not only for obese children but also for those at risk for overweight.
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    Atherosclerosis risk factors in children of parents with the metabolic syndrome
    Akinci, G; Coskun, S; Akinci, B; Hekimsoy, Z; Bayindir, P; Onur, E; Ozmen, B
    Background: Metabolic syndrome is a constellation of disorders that produces a high risk of atherosclerosis. Endothelial dysfunction is the key event in atherosclerosis and already present even in the childhood. The aim of the present study is to investigate inflammatory and radiological signs of atherosclerosis in children who have parents with the metabolic syndrome. Design and methods: Fifty children of parents with the metabolic syndrome and 38 age- and sex-matched controls were studied. Anthropometric measurements, blood pressure assessment, echocardiography, flow-mediated vasodilatation (FMD) which is a non-invasive test for the evaluation of endothelial function and fasting blood measurements including blood glucose, insulin, total cholesterol, HDL cholesterol, triglyceride, hsCRP and soluble CD40 ligand were performed. Results: Serum sCD40L and hsCRP levels were significantly higher in the study group compared to the controls. FMD values did not differ between the study and control groups. Increased serum sCD40L levels were positively correlated with body mass index, waist hip ratio, LDL/HDL cholesterol ratio, and the number of metabolic syndrome components in parents, whereas showed negative correlation with the serum HDL cholesterol levels. High hsCRP levels were positively correlated with body mass index and the number of metabolic syndrome components. Multiple regression analysis demonstrated that the number of metabolic syndrome components in parents presented as being a significant predictor of the serum sCD40L and hsCRP levels of their children. Conclusion: Our results suggest that children of patients with metabolic syndrome have higher values of the serum markers of inflammation, which may be associated with increased risk for development of cardiovascular disease. (C) 2007 Elsevier Ireland Ltd. All rights reserved.
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    Assessment and statistical evaluation of suction characteristics obtained via filter paper technique on zeolite-bentonite mixtures
    Durukan, S; Akinci, G
    Filter paper technique (FPT) is known to measure both matric and total suctions in a wide measurement range. However, it has many individual errors due to the uncertainty of calibration curve and sensitivity of the measurements to the temperature and relative humidity variations. Besides, the ASTM procedure for FPT does not specify any sample preparation and repetition for experiments. In this regard, this study covers the reliability of suction measurements using the FPT and its application on zeolite-bentonite mixtures (ZBMs), which were proposed for use of liner material in the literature. A calibration curve for Whatman No. 42 filter paper was constructed and compared to the other calibration curves given in the literature. Due to large scatter of calibration curves, total suction measurement is found to be inconvenient for suction values under 1000 kPa. An improvement in sample preparation and necessary minimum numbers of tests are also suggested. When preparing the test specimen, the compacted sample is recommended not to be cut but to be compacted separately as upper and lower parts where the contact filter paper to be placed in between in order to obtain good contact area to measure the matric suction accurately. The necessary minimum numbers of tests for +/- 10% accuracy band in a confidence level of 95% for ASTM procedure on ZBMs are suggested. Repetitions were found to vary depending on the suction type and bentonite content. Repetitions of six and eight times are recommended for 10% ZBMs for matric and total suction measurements, respectively. Similarly, for 20% ZBMs the repetitions of six and ten times are found for matric and total suction measurements, respectively. In addition, the influence of index properties and compaction states on suction was also investigated. Matric suction values decrease from dry of optimum water content to the wet of optimum water content and approach to zero for higher water contents. The suction values are found to increase with decreasing water contents where the dry density and the void ratio were constant. On the other hand, for a given water content, matric suction values are found to be increasing with increasing dry densities, while the void ratio was decreasing being more evident at relatively higher saturation degrees.
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    A subset of patients with acquired partial lipodystrophy developing severe metabolic abnormalities
    Saydam, BO; Sonmez, M; Simsir, IY; Erturk, MS; Kulaksizoglu, M; Arkan, T; Hekimsoy, Z; Cavdar, U; Akinci, G; Demir, T; Altay, CT; Mihci, E; Secil, M; Akinci, B
    Purpose/Aim of the study: Acquired partial lipodystrophy (APL) is a rare disease characterized by selective loss of adipose tissue. In this study, we aimed to present a subset of patients with APL, who developed severe metabolic abnormalities, from our national lipodystrophy registry. Materials and Methods: Severe metabolic abnormalities were defined as: poorly controlled diabetes (HbA1c above 7% despite treatment with insulin more than 1 unit/kg/day combined with oral antidiabetics), severe hypertriglyceridemia (triglycerides above 500 mg/dL despite treatment with lipid-lowering drugs), episodes of acute pancreatitis, or severe hepatic involvement (biopsy-proven non-alcoholic steatohepatitis (NASH)). Results: Among 140 patients with all forms of lipodystrophy (28 with APL), we identified 6 APL patients with severe metabolic abnormalities. The geometric mean for age was 37 years (range: 27-50 years; 4 females and 2 males). Five patients had poorly controlled diabetes despite treatment with high-dose insulin combined with oral antidiabetics. Severe hypertriglyceridemia developed in five patients, of those three experienced episodes of acute pancreatitis. Although all six patients had hepatic steatosis at various levels on imaging studies, NASH was proven in two patients on liver biopsy. Our data suggested that APL patients with severe metabolic abnormalities had a more advanced fat loss and longer disease duration. Conclusions: We suggest that these patients represent a potential subgroup of APL who may benefit from metreleptin or investigational therapies as standard treatment strategies fail to achieve a good metabolic control.