Browsing by Author "Emre, S"
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Item Comparison of the Protective Effects of Prostaglandin Analogues in the Ischemia and Reperfusion Model of Rabbit EyesEmre, S; Gul, M; Ates, B; Esrefoglu, M; Koc, B; Erdogan, A; Yesilada, EThis study was planned to investigate the neuroprotective potentials of three commercially available prostaglandin analogues (PGA), in the ischemia and reperfusion model (I/R). Thirty New Zealand rabbits were divided into 5 groups and except for the control group (non-ischemic, non-treated), 0.9% NaCl, bimatoprost, latanoprost, or travoprost were applied to both eyes of animals of the respective groups for 1 week. At the end of treatment, ischemia was induced in both eyes of the 4 treatment groups by anterior chamber irrigation of the animals for 60 min. Following 24 h reperfusion, the animals were sacrified. Enucleated eyes and retinal tissues were investigated by light microscopy, electron microscopy, immunohistochemicstry for retinal histopathology, intracellular and apoptotic cells and by retinal morphometry. Vitreous samples were biochemically investigated for probable role of reactive oxygen species, by measuring xanthine oxidase (XO) activity. Analysis of morphometric measurements and vitreous XO activity revealed significant differences between the PGA-treated groups and the NaCl-treated group (P<0.05). Similarly, apoptotic cell counts in different retinal layers showed that PGA-treated groups had fewer apoptotic cells in all retinal layers than the NaCl-treated ischemic group (P<0.05). PGA may have high protective potential for different retinal layers and cells. Biochemical analysis of vitreous showed that all PGAs decreased vitreous XO activity significantly compared to the NaCl-treated group (P<0.05). However we could not find any statistically significant differences among the analogues. PGAs may reduce the injury induced by I/R, through the inhibition of XO activity, and it seems that their effects are elicited through numerous pathways.Item Ciliary body cysts in neurofibromatosis: A new coexistence?Emre, S; Palamar, M; Ulusoy, MO; Gençoglan, GNeurofibromatosis 1 (NF1) is an autosomal dominant, multisystem disorder that also effects the eye. Herein, we aimed to investigate the posterior iris surface and ciliary body morphology of NF1 patients by ultrasonic biomicroscopy (UB). Nine consecutive unrelated subjects with NF1, and as a control group 25 healthy subjects, were included in the study. All patients underwent ophthalmic examination including visual acuity testing, slit-lamp biomicroscopy, tonometry, gonioscopy (Schaffer classification), and dilated ophthalmoscopy, UB. Mean age was 35.1 +/- 16.2 (range, 11-57) and 34.5 +/- 15.6 (range, 9-60) for NF1 and control groups respectively ( > 0.05). Lisch nodules were present in 16 of 18 eyes (88.8%) in NF1 group. Fundoscopic examination of the control group and 15 eyes of NF1 (83.3%) patients was normal, whereas hypoplastic and tilted optic nerve were present in three eyes, and temporally-located bone-spicule-like lesions was present in one eye of the NF1 group. UB revealed ciliary body cyst in 77.7% (14/18) of the eyes among NF1 group, and 8% (4/50) among control group ( < 0.05). The mean size of the cysts were 520 +/- 191 mu (range, 220-860 mu) and 495 +/- 231 mu (range, 300-830 mu) at NF1 and control groups, respectively. Gonioscopic evaluation revealed that 55% of the NF1 patients have an unoccludable anterior chamber angle (Grade 3 or 4), 45% occludable angle (Grade 1 or 2), and 78% irregular pigment patches. However, occludable angle rate was just 4% in the control group, and none of the patients had irregular pigment patches. The coexistence of ciliary body cysts and NF1, and the effect of these cysts in the eye should be enlightened with further studies.Item New Treatment Alternatives in the Management of Non-infectious intraocular inflammations: Biologic AgentsEmre, S; Tutkun, ITConventional immunosuppressive agents have been traditionally used for the treatment of noninfectious uveitis. Recent developments in genetic engineering have made it possible to synthesize proteins that target specific molecules playing role in the inflammatory response. These agents are generally in protein structure and are named biologic agents. While there is limited experience with biologics in the field of ophthalmology, they are commonly used in other disciplines such as rheumatology and dermatology. Although considerable data have accumulated in the uveitis literature regarding the use of biologic agents, including mainly interferon, infliximab, and adalimumab, their use for this indication is still off-label. Moreover, there are certain precautions that have to be taken into account, as well as important safety issues associated with their use. The purpose of this paper is to present an updated comprehensive review of biologic agents that may be used for the treatment of refractory uveitis.Item Risk Factors of Peroperative Suprachoroidal HaemorrhageKayikiçoglu, OR; Emre, S; Demiray, B; Baser, E; Kurt, E; Ilker, SSPurpose: The aim of this study is to evaluate peroperative risk factors of patients who had suprachoroidal haemorrhage during different types of intraocular surgeries. Material and Method: We retrospectively evaluated general risk factors of five patients who had suprachoroidal haemorrhage. For that purpose, we reviewed the preoperative systemic and ophthalmologic recordings, performed procedures, and complications during and after the surgery from patients' files. Results: Suprachoroidal haemorrhage developed during cataract surgery with phacoemulsification in three cases, in a combined glaucoma and cataract surgery in one, and pars plana vitrectomy in one case. As surgical risk factor, one case had posterior capsular rupture, one hypermature cataract and one previous retinal detachment surgery. In the case with age-related macular degeneration and intravitreal heamorrhage, suprachoroidal haemorrhage arose during pars plana vitrectomy. Only the patient who underwent combined mini-nuc and trabeculectomy procedure had expulsive haemorrhage. As systemic risk factors all the patients were elderly, systemic hypertension, pain during the surgery, anxiety related to panic atac and prostate hypertrophy were other detected risk factors. Discussion: According to our clinical experiences, detected risk factors in our patients were in concordance with literature data. In addition to this, despite the smaller incision size trend in ophthalmic surgery, suprachoroidal haemorrhage is still an important potential complication, particularly in patients who had previous ocular surgeries or who had associated ophthalmologic or systemic risk factors.Item Corneal Hysteresis, Corneal Resistance Factor, and Intraocular Pressure Measurement in Patients with Scleroderma Using the Reichert Ocular Response AnalyzerEmre, S; Kayikçioglu, Ö; Ates, H; Çinar, E; Inceoglu, N; Yargucu, F; Pirildar, T; Oksel, FPurpose: The Reichert ocular response analyzer (ORA) measures corneal biomechanical properties in vivo by monitoring and analyzing the corneal behavior when its structure is submitted to a force induced by an air jet. This study was designed to examine corneal biomechanical properties and intraocular pressure in patients with systemic sclerosis (SSc) and to compare with control eyes. Patients and Methods: ORA measurements were performed on the right eyes of 29 patients with SSc (group 1) and 29 healthy people who served as the control group (group 2). Corneal hysteresis, conical resistance factor (CRF), and intraocular pressure [Goldmann correlated (IOPg) and conical compensated] were recorded with ORA. Results: Mean age of patients with SSc and control groups were 51.7 +/- 11.1 and 50.3 +/- 10.8 years, respectively. Mean (+/- SD) of the corneal hysteresis and CRF readings were 9.8 +/- 1.7 versus 9.5 +/- 1.2 mm Hg (P>0.05) and 10.0 +/- 1.5 versus 9.2 +/- 1.4 mm Hg (P<0.05), in groups 1 and 2, respectively. Mean (+/- SD) of the IOPg and intraocular pressure corneal-compensated recordings were 15.9 +/- 2.5 versus 14.1 +/- 2.4 mm Hg (P<0.05) and 16.9 +/- 3.2 versus 15.6 +/- 2.9 mm Hg (P>0.05), in groups 1 and 2, respectively. Statistical analysis revealed significant differences for CRF and IOPg between the study groups. Conclusions: The mean CRF and IOPg values of patients with SSc were higher when compared with normal controls. According to the results of our study, one can conclude that corneal biomechanical properties would be changed in patients with SSc and this can be determined by CRF.Item Investigation of human papillomavirus and Epstein-Barr virus DNAs in pterygium tissueOtlu, B; Emre, S; Turkcuoglu, P; Doganay, S; Durmaz, RPURPOSE. Recent studies postulated the presence of a probable relationship between pterygium and neoplasia. This study aimed to investigate the role of two oncogenic viruses, human papillomavirus (HPV) and Epstein-Barr virus (EBV), in the development of conjunctival pterygia. METHODS. Polymerase chain reaction was used to identify the presence of HPV and EBV in 30 primary and 10 recurrent pterygia samples. Twenty conjunctival samples obtained from patients undergoing cataract surgeries were used as the control group. Patient groups had similar sex, race, and age distribution to eliminate bias. For exploration of HPV in groups, two different PCR methods (in-house PCR with two different primer sets and one real-time PCR method) were studied. The presence of EBV was shown by real-time PCR method. RESULTS. HPV was identified in none of the pterygia and control group patients. However, EBV was detected in 3 out of 30 (10%) primary pterygia patients and in none of the recurrent pterygia and control patients. CONCLUSIONS. Up to now, HPV has been blamed as the major viral pathogen in the etiopathogenesis of pterygium. The current results suggest that EBV may also be involved in the pathogenesis of pterygium, but further larger studies with larger cohorts are required to confirm this hypothesis. (Eur J Ophthalmol 2009; 19: 175-9)Item Propolis Prevents the Effects of Chronic Alcohol Intake on Ocular TissuesEmre, S; Yilmaz, Z; Öztürk, F; Emre, MHAim: This study is designed to investigate the protective effects of propolis in ocular tissues against chronic alcohol exposure. Material and Method: Wistar albino rats were used in this study. Rats were divided into 4 groups, and each group was fed a special liquid diet which contained an equal amount of calories. The control group was fed the liquid special diet without alcohol and propolis. We added propolis (150 mg/kg) to the diet of the second group. The diet of the third group contained alcohol, the concentration of which was increased progressively. The fourth group was fed a diet including propolis and alcohol. To counterbalance caloric intake, we decreased the amount of glucose in the special liquid diet for groups 3 and 4. At the end of 30 days, the animals were sacrificed and samples were kept at -80 degrees C until evaluation. Specimens were investigated by light microscopy for morphology and morphometry. Results: In the histological investigation of ocular tissues, alcohol caused an increase in thickness of the cornea and corneal epithelium compared to the control group (p < 0.05). This incremental tendency was significantly reduced by propolis, and values were very close to those of the control group (p > 0.05). Alcohol did not cause any significant alteration of rat retinal thickness. Conclusion: This study showed that propolis is highly effective against corneal edema secondary to chronic alcohol intake. Copyright (C) 2009 S. Karger AG, BaselItem Psoriatic uveitis responding to adalimumab therapyErmertcan, AT; Emre, S; Öztürk, F; Gençoglan, G; Gündüz, KItem Expression of Nitric Oxide Synthase in Primary and Recurrent PterygiumEmre, S; Vatansever, SH; Türköz, E; Kayikçioglu, ÖRPurpose: The aim of this study was to investigate the expression of different nitric oxide synthases (NOSs) in primary and recurrent pterygia and to investigate the probable role of any nitric oxide synthase on pterygium recurrence. Materials and Method: Specimens of 40 primary pterygia and 10 recurrent pterygia excised during pterygium surgery were included in the study. Also, 15 normal conjunctiva of medial limbus obtained from patients free of pterygia and removed during other ophthalmologic surgeries formed the control group. Specimens were stained with hematoxylin and eosin for general histological and morphologic evaluation. The distribution of n-NOS, e-NOS and i-NOS were analyzed using indirect immunoperoxidase staining. Results: Histological evaluation of specimens revealed that the epithelium in primary and recurrent pterygia groups was thicker compared to that in the control group. Immunohistochemical analysis revealed that in both primary pterygium and control groups, immunoreactivity was positive for all NOSs in both epithelium and connective tissue. For recurrent pterygium group, NOS immunoreactivity could be detected moderately for n-NOS in the epithelium and weakly for e-NOS in both epithelium and connective tissue. However, in recurrent pterygium samples, i-NOS immunoreactivity was lacking in both epithelium and connective tissue. Discussion: These data are the first to demonstrate that NOS expression may differ between primary and recurrent pterygia. Meanwhile, continuous expression of n-NOS with suppression of i-NOS and e-NOS may be an important step in the recurrence process of pterygia.Item A Patient with Cystinosis Presenting Like Bartter Syndrome and Review of LiteratureErtan, P; Evrengul, H; Ozen, S; Emre, SBackground: Nephropathic cystinosis is an autosomal recessively inherited metabolic disorder presenting with metabolic acidosis, Fanconi syndrome and renal failure. Case Presentation: We present a 6-year-old girl with severe growth failure, hyponatremia and hypokalemia. Her parents were 4th degree relatives. Two relatives were diagnosed as end stage renal failure. She also had persistant hypokalemic hypochloremic metabolic alkalosis. Her renal function was normal at presentation. She was thought to have Bartter syndrome with supporting findings of elevated levels of renin and aldosterone with normal blood pressure, and hyperplasia of juxtaglomerular apparatus. Her metabolic alkalosis did not resolve despite supportive treatment. At 6th month of follow-up proteinuria, glucosuria and deterioration of renal function developed. Diagnosis of cystinosis was made with slit lamp examination and leukocyte cystine levels. At 12th month of follow-up her metabolic alkalosis has converted to metabolic acidosis. Conclusion: In children presenting with persistant metabolic alkalosis, with family history of renal failure, and parental consanguinity, cystinosis should always be kept in mind as this disease is an important cause of end stage renal failure which may have features mimmicking Bartter syndrome.Item The Effect of Intravitreal Bevacizumab on Apoptosis of Rat Retina CellsKayikçioglu, Ö; Vatansever, S; Topçu, I; Aydemir, I; Bilecenoglu, T; Kahvecioglu, F; Emre, SPurpose: To investigate the apoptotic effects of intravitreal bevacizumab on rat retinal cells. Material and Method: Thirty-six male adult Swiss albino rats were randomly divided into two groups. The first group was applied 0.25 mg bevacizumab in 0.01 ml saline, and the second group received the same amount of saline intravitreally. Each group was divided into 3 subgroups. The animals were sacrificed and their globes were enucleated at the 3rd, 24th, and 72nd hours of the experiment. Enucleated eyes were preserved for histological analysis, immunohistochemical analysis of caspase-3, caspase-8, caspase-9, Fas/Fas L, VEGF and VEGF receptors (Flt-1, Flk-1), and TUNEL staining. Results: Histological evaluation showed no sign of retinal toxicity in both groups. In TUNEL staining, TUNEL(+) cells were detected in all subgroups, but the number of positive cells was relatively lower in bevacizumab treatment group that reached statistically significant level at 24 and 72 hours of treatment (p<0.001). Immunohistochemical analysis revealed that in saline-treated subgroups, immunoreactivity was more pronounced for all apoptosis-inducing proteins compared to bevacizumab-treated group. Also immunoreactivity of VEGF was prominent in saline treated group. For VEGF receptors, staining was only positive for Flt-1 at the 3rd hour in the control group. Discussion: Bevacizumab did not have apoptosis-inducing potential compared to saline solution in short term, which was documented with TUNEL and immunohistochemical staining.Item Corneal biochemical features of patients with vernal keratoconjunctivitisEmre, S; Baser, E; Öztürk, B; Zorlu, S; Uzun, Ö; Gülhan, CVernal keratoconjunctivitis (VKC) is a chronic, bilateral, seasonally exacerbated, allergic inflammation of the ocular surface, involving bulbar and a or tarsal conjunctiva and cornea. The ocular response analyzer (ORA) measures corneal biomechanical properties in vivo by monitoring and analyzing the corneal behavior when its structure is submitted to a force induced by an air jet. This study was designed to examine corneal biomechanical properties and intraocular pressure in patients with VKC, and to compare with control eyes. ORA measurements were performed on the both eyes of 26 patients with VKC (group I) and 14 healthy children who served as the control group (group II). Corneal hysteresis (CH), corneal resistance factor (CRF) and intraocular pressure [Goldmann correlated (IOPg) and corneal compensated (IOPcc)] were recorded with ORA. Mean age of patients with VKC and control groups were 11.3 +/- 5.8 and 10.6 +/- 1.9 years for groups I and II respectively. Mean (+/- SD) of the CH and CRF readings were 10.1 +/- 1.6 versus 10.5 +/- 1.6 (p > 0.05) and 9.5 +/- 1.7 versus 10.8 +/- 1.7 mmHg (p < 0.05), in groups I and II respectively. Mean (+/- SD) of the IOPg and IOPcc recordings were 13.3 +/- 3.4 versus 16.6 +/- 3.6 mmHg (p < 0.05) and 14.3 +/- 3.4 versus 16.9 +/- 3.7 mmHg (p > 0.05) in groups I and II respectively. Statistical analysis revealed significant differences for CRF and IOPg between the study groups. The mean CRF and IOPg values of patients with VKC were lower than those of controls. According to the results of our study, one can conclude that corneal biomechanical property, CRF, could be different in VKC patients compared to normals.Item Comparison of Induced Astigmatism After Trabeculectomy and Deep Sclerectomy+Trabeculectomy Surgeries with Vector AnalysisKayikçioglu, ÖR; Emre, S; Mayali, H; Baser, EFPurpose: The aim of this study is to compare the changes in surgically induced astigmatism with time among two different glaucoma surgery techniques that have been used in cases of progressive glaucomatous optic nerve damage. Material and Method: The study group was composed of eyes which have been operated on with classical trabeculectomy (group 1) or deep sclerectomy+trabeculectomy (group 2). Each group consisted of 13 eyes of 12 patients. All eyes were examined preoperatively and postoperatively at 1. week, 1., 3. and 6. month. At these examinations, except intraocular pressure (IOP), corneal power was recorded with keratometer and corneal topographer. The magnitude of absolute astigmatism, and induced astigmatism were determined by vector analysis at each visit and were statistically compared between the study groups. Results: The mean (+/-SD) age of the patients was 56.2+/-24.0 and 52.5+/-24.3 in group 1 and 2, respectively. Preoperatively, IOP were 30.77+/-10.30 and 27.54+/-11.28 mmHg, and at 6 month of surgery decreased to 12.38+/-4.13 and 12.08+/-5.73 mmHg in groups 1 and 2, respectively. At all postoperative visits, a significant decrease in IOP was observed compared to the preoperative measurements (p< 0.05). Postoperatively at 1. week of surgery, the mean induced astigmatism values were 1.50+/-2.16 and 2.60+/-2.65D in group 1, and 1.66+/-1.32 and 2.01+/-1.95D in group 2, with keratometer and corneal topographer, respectively. The difference between the groups was not significant (p>0.05). At following visits, surgically induced astigmatism decreased in both groups with both methods and the difference never reached significant levels with time. Discussion: Glaucoma surgeries, particularly in the early period, are likely to be the reason for the changes in the corneal power. It seems that the addition of deep sclerectomy to trabeculectomy does not cause any significant change in surgically induced astigmatism.Item Isokinetic evaluation of knee extensor/flexor muscle strength in Behcet's patientsDurmus, B; Emre, S; Sahin, N; Karincaoglu, Y; Dogan, E; Baysal, O; Ersoy, Y; Altay, ZBackground: Behcet's disease (BD) is an idiopathic, multisystemic, progressive disease. The purpose of this study is to compare the knee flexor and extensor isokinetic muscle strengths of Behcet's patients with that of healthy subjects. Methods: Twenty-five (13 male and 12 female) patients with BD and 25 (15 male and 10 female) healthy individuals were included in the study Velocities of 90 degrees/sec, 120 degrees/sec, and 150 degrees/sec were used for the isokinetic muscle strength testing. Patients with active inflammatory knee arthritis were excluded. Peak torque (Nm) and peak torque adjusted to body weight (%) were taken into consideration for comparison between study groups. Results: Compared to healthy controls, there was a statistically significant decrease in both the bilateral knee extensor and flexor muscle isokinetic peak torques (Nm) as well as the peak torques adjusted to body weight (%) at velocities of 90 degrees/sec, 120 degrees/sec and 150 degrees/sec in patients with BD (p < 0.05). However, there was no significant difference in the agonist-antagonist ratio of the isokinetic peak torques of knee muscles between the two groups. Conclusion: In light of these findings, we have concluded that both knee flexor and extensor isokinetic muscle strengths are lower in BD. We therefore recommend careful monitoring of patients with BD in temis of muscle strength.Item Genetic screening in adolescents with steroid-resistant nephrotic syndromeLipska-Zietkiewicz, BS; Iatropoulos, P; Maranta, R; Caridi, G; Ozaltin, F; Anarat, A; Balat, A; Gellermann, J; Trautmann, A; Erdogan, O; Saeed, B; Emre, S; Bogdanovic, R; Azocar, M; Balasz-Chmielewska, I; Benetti, E; Caliskan, S; Mir, S; Melk, A; Ertan, P; Baskin, E; Jardim, H; Davitaia, T; Wasilewska, A; Drozdz, D; Szczepanska, M; Jankauskiene, A; Higuita, LMS; Ardissino, G; Ozkaya, O; Kuzma-Mroczkowska, E; Soylemezoglu, O; Ranchin, B; Medynska, A; Tkaczyk, M; Peco-Antic, A; Akil, I; Jarmolinski, T; Firszt-Adamczyk, A; Dusek, J; Simonetti, GD; Gok, F; Gheissari, A; Emma, F; Krmar, RT; Fischbach, M; Printza, N; Simkova, E; Mele, C; Ghiggeri, GM; Schaefer, FGenetic screening paradigms for congenital and infantile nephrotic syndrome are well established; however, screening in adolescents has received only minor attention. To help rectify this, we analyzed an unselected adolescent cohort of the international PodoNet registry to develop a rational screening approach based on 227 patients with nonsyndromic steroid-resistant nephrotic syndrome aged 10-20 years. Of these, 21% had a positive family history. Autosomal dominant cases were screened for WT1, TRPC6, ACTN4, and INF2 mutations. All other patients had the NPHS2 gene screened, and WT1 was tested in sporadic cases. In addition, 40 sporadic cases had the entire coding region of INF2 tested. Of the autosomal recessive and the sporadic cases, 13 and 6%, respectively, were found to have podocin-associated nephrotic syndrome, and 56% of them were compound heterozygous for the nonneutral p.R229Q polymorphism. Four percent of the sporadic and 10% of the autosomal dominant cases had a mutation in WT1. Pathogenic INF2 mutations were found in 20% of the dominant but none of the sporadic cases. In a large cohort of adolescents including both familial and sporadic disease, NPHS2 mutations explained about 7% and WT1 4% of cases, whereas INF2 proved relevant only in autosomal dominant familial disease. Thus, screening of the entire coding sequence of NPHS2 and exons 8-9 of WT1 appears to be the most rational and cost-effective screening approach in sporadic juvenile steroid-resistant nephrotic syndrome.Item Effects of nutritional vitamin D supplementation on markers of bone and mineral metabolism in children with chronic kidney diseaseLerch, C; Shroff, R; Wan, M; Rees, L; Aitkenhead, H; Bulut, IK; Thurn, D; Bayazit, AK; Niemirska, A; Canpolat, N; Duzova, A; Azukaitis, K; Yilmaz, E; Yalcinkaya, F; Harambat, J; Kiyak, A; Alpay, H; Habbig, S; Zaloszyc, A; Soylemezoglu, O; Candan, C; Rosales, A; Melk, A; Querfeld, U; Leifheit-Nestler, M; Sander, A; Schaefer, F; Haffner, D; Cortina, G; Arbeiter, K; Dusek, J; Harambat, J; Ranchin, B; Fischbach, M; Zalosczyk, A; Querfeld, U; Habbig, S; Galiano, M; Büscher, R; Gimpel, C; Kemper, M; Melk, A; Thurn, D; Schaefer, F; Doyon, A; Wühl, E; Pohl, M; Wygoda, S; Jeck, N; Kranz, B; Wigger, M; Montini, G; Lugani, F; Testa, S; Vidal, E; Matteucci, C; Picca, S; Jankauskiene, A; Azukaitis, K; Zurowska, A; Drodz, D; Tkaczyk, M; Urasinski, T; Litwin, M; Niemirska, A; Szczepanska, M; Texeira, A; Peco-Antic, A; Bucher, B; Laube, G; Anarat, A; Bayazit, AK; Yalcinkaya, F; Basin, E; Cakar, N; Soylemezoglu, O; Duzova, A; Bilginer, Y; Erdogan, H; Donmez, O; Balat, A; Kiyak, A; Caliskan, S; Canpolat, N; Candan, C; Civilibal, M; Emre, S; Alpay, H; Ozcelik, G; Mir, S; Sözeri, B; Yavascan, O; Tabel, Y; Ertan, P; Yilmaz, E; Shroff, R; Prytula, A; Bachetta, J; Haffner, D; Klaus, G; Gessner, M; Schmitt, CP; Stabouli, S; Reusz, G; Verrina, E; Groothoff, J; Tondel, C; Gamero, MA; Petrosyan, E; Bakkaloglu, SA; Dursun, I; Shroff, RBackground. We investigated the effects of nutritional vitamin D supplementation on markers of bone and mineral metabolism, i.e. serum levels of fibroblast growth factor 23 (FGF23), Klotho, bone alkaline phosphatase (BAP) and sclerostin, in two cohorts with chronic kidney disease (CKD). Methods. In all, 80 vitamin D-deficient children were selected: 40 with mild to moderate CKD from the ERGO study, a randomized trial of ergocalciferol supplementation [ estimated glomerular filtration rate (eGFR) 55 mL/min/1.73 m(2)], and 40 with advanced CKD from the observational Cardiovascular Comorbidity in Children with Chronic Kidney Disease (4C) study (eGFR 24 mL/min/1.73 m2). In each study, vitamin D supplementation was started in 20 children and 20 matched children not receiving vitamin D served as controls. Measures were taken at baseline and after a median period of 8 months. Age- and gender-related standard deviation scores (SDSs) were calculated. Results. Before vitamin D supplementation, children in the ERGO study had normal FGF23 (median 0.31 SDS) and BAP (-0.10 SDS) but decreased Klotho and sclerostin (-0.77 and -1.04 SDS, respectively), whereas 4C patients had increased FGF23 (3.87 SDS), BAP (0.78 SDS) and sclerostin (0.76 SDS) but normal Klotho (-0.27 SDS) levels. Vitamin D supplementation further increased FGF23 in 4C but not in ERGO patients. Serum Klotho and sclerostin normalized with vitamin D supplementation in ERGO but remained unchanged in 4C patients. BAP levels were unchanged in all patients. In the total cohort, significant effects of vitamin D supplementation were noted for Klotho at eGFR 40-70 mL/min/1.73 m(2). Conclusions. Vitamin D supplementation normalized Klotho and sclerostin in children with mild to moderate CKD but further increased FGF23 in advanced CKD.Item Low levels of urinary epidermal growth factor predict chronic kidney disease progression in childrenAzukaitis, K; Ju, WJ; Kirchner, M; Nair, V; Smith, M; Fang, ZY; Thurn-Valsassina, D; Bayazit, A; Niemirska, A; Canpolat, N; Bulut, IK; Yalcinkaya, F; Paripovic, D; Harambat, J; Cakar, N; Alpay, H; Lugani, F; Mencarelli, F; Civilibal, M; Erdogan, H; Gellermann, J; Vidal, E; Tabel, Y; Gimpel, C; Ertan, P; Yavascan, O; Melk, A; Querfeld, U; Wühl, E; Kretzler, M; Schaefer, F; Arbeiter, K; Rosales, A; Dusek, J; Zaloszyc, A; Liebau, M; Weber, L; Muschiol, E; Büscher, R; Oh, J; Thurn-Valassina, D; Haffner, D; John, U; Wygoda, S; Jeck, N; Wigger, M; Testa, S; Murer, L; Matteucci, C; Jankauskiene, A; Drozdz, D; Zurowska, A; Zaniew, M; Litwin, M; Nimierska, A; Teixeira, A; Peco-Antic, A; Laube, G; Anarat, A; Duzova, A; Bilginer, Y; Caliskan, S; Mir, S; Sozeri, B; Kranz, B; Dorn, B; Baskin, E; Soylemezoglu, O; Emre, S; Candan, C; Kiyak, A; Ozcelik, G; Shroff, R; Rachin, B; Szczepanska, M; Donmez, O; Balat, A; Aksu, N; Yilmaz, E; Anarat, A; Bakkaloglu, A; Ozaltin, F; Peco-Antic, A; Sallay, P; Drozdz, D; Bonzel, KE; Wingen, AM; Urowska, AZ; Balasz, I; Trivelli, A; Perfumo, F; Müller-Wiefel, DE; Möller, K; Offner, G; Enke, B; Hadtstein, C; Mehls, O; Emre, S; Caliskan, S; Mir, S; Wygoda, S; Hohbach-Hohenfellner, K; Jeck, N; Klaus, G; Ardissino, G; Testa, S; Montini, G; Charbit, M; Niaudet, P; Afonso, AC; Fernandes-Teixeira, A; Dusek, J; Matteucci, C; Picca, S; Wigger, M; Berg, UB; Celsi, G; Fischbach, M; Terzic, J; Fydryk, J; Urasinski, T; Coppo, R; Peruzzi, L; Grenda, R; Neuhaus, TJUrinary epidermal growth factor (uEGF) has recently been identified as a promising biomarker of chronic kidney disease (CKD) progression in adults with glomerular disease. Low levels of uEGF predict CKD progression and appear to reflect the extent of tubulointerstitial damage. We investigated the relevance of uEGF in pediatric CKD. We performed a post hoc analysis of the Cardiovascular Comorbidity in Children with CKD (4C) study, which prospectively follows children aged 6-17 years with baseline estimated glomerular filtration rate (eGFR) of 10-60 ml/min/1.73 m(2). uEGF levels were measured in archived urine collected within 6 months of enrollment. Congenital abnormalities of the kidney and urinary tract were the most common cause of CKD, with glomerular diseases accounting for <10% of cases. Median eGFR at baseline was 28 ml/min/1.73 m(2), and 288 of 623 participants (46.3%) reached the composite endpoint of CKD progression (50% eGFR loss, eGFR < 10 ml/min/1.73 m(2), or initiation of renal replacement therapy). In a Cox proportional hazards model, higher uEGF/Cr was associated with a decreased risk of CKD progression (HR 0.76; 95% CI 0.69-0.84) independent of age, sex, baseline eGFR, primary kidney disease, proteinuria, and systolic blood pressure. The addition of uEGF/Cr to a model containing these variables resulted in a significant improvement in C-statistics, indicating better prediction of the 1-, 2- and 3-year risk of CKD progression. External validation in a prospective cohort of 222 children with CKD demonstrated comparable results. Thus, uEGF may be a useful biomarker to predict CKD progression in children with CKD.Item Investigation of hematologic findings related to brucellosis in Anatolian regionÇelik, M; Arslan, Y; Topcu, E; Sahinoglu, MS; Altindag, D; Gürbüz, E; Atalay, E; Demircan, SK; Emre, S; Kirik, Y; Atasoy, PY; Özer, D; Ipek, D; Dogan, E; Atli, SB; Kusçu, EG; Alkan, S; Çiçek, Y; Yüksekkaya, E; Aldemir,Ö; Sahin, A; Ürkmez, EY; Al, SÖ; Boran, R; Mizrakçi, SO; Demiray, EKD; Ceylan, MR; Erdogdu, H; Tekin, SObjectives: To investigate the prevalence of hematologic findings and the relationship between hemogram parameters and brucellosis stages in patients. Methods: This multi-center study included patients older than 16 years of age who were followed up with a diagnosis of brucellosis. Patients' results, including white blood cell, hemoglobin, neutrophil, lymphocyte, monocyte, mean platelet volume, platelet and eosinophil counts were analyzed at the initial diagnosis. Results: In this study 51.3% of the patients diagnosed with brucellosis were male. The age median was 45 years for female and 41 years for male. A total of 55.1% of the patients had acute brucellosis, 28.2% had subacute, 7.4% had chronic and 9% had relapse. The most common hematologic findings in brucellosis patients were anemia (25.9%), monocytosis (15.9%), eosinopenia (10.3%), and leukocytosis (7.1%). Pancytopenia occurred in 0.8% of patients and was more prominent in the acute phase. The acute brucellosis group had lower white blood cell, hemoglobin, neutrophil, eosinophil, and platelet counts and mean platelet volume, and higher monocyte counts compared to subacute and chronic subgroups. Conclusion: It was noteworthy that in addition to anemia and monocytosis, eosinopenia was third most prominent laboratory findings in the study. Pancytopenia and thrombocytopenia rates were low.Item Analysis of factors influencing target PASI responses and side effects of methotrexate monotherapy in plaque psoriasis: a multicenter study of 1521 patientsErduran, F; Emre, S; Hayran, Y; Adisen, E; Polat, AK; Üstüner, P; Öztürkcan, S; Öztürk, P; Ermertcan, AT; Selçuk, LB; Aksu, EK; Akbas, A; Kalkan, G; Demirseren, D; Kartal, SP; Topkarci, Z; Kilic, A; Yaldiz, M; Aytekin, S; Hizli, P; Gharehdaghi, S; Borlu, M; Isik, L; Botsali, BR; Solak, EO; Albayrak, H; Gönülal, M; Balci, DD; Polat, M; Daye, M; Ataseven, A; Yildiz, S; Özer, I; Zorlu, O; Dogan, S; Erdemir, VA; Dikicier, BSMethotrexate (MTX) is commonly used as first-line systemic treatment agent in psoriasis. We aimed to evaluate the clinical characteristics and treatment responses of patients with psoriasis undergoing MTX monotherapy. Data from adult patients with plaque psoriasis who received MTX monotherapy for at least 3 months between April 2012 and April 2022 were retrospectively evaluated in 19 tertiary care centers. Our study included 722 female and 799 male patients, a total of 1521 participants. The average age of the patients was 44.3 +/- 15.5 years. Mode of treatment was oral in 20.4% of patients while in 79.4% it was subcutaneous. The median treatment duration was 8 months (IQR = 5-15). The median weekly dose was 15 mg (IQR = 11-15). 1448 (95.2%) patients were taking folic acid supplementation. At week 12, 16.3% of the patients achieved PASI (Psoriasis Area and Severity Index) 90 response while at week 24, 37.3% achieved it. Logistic regression analysis for week 12 identified the following independent factors affecting PASI 90 achievement positively: median weekly MTX dose <= 15 mg (P = 0.011), subcutaneous administration (P = 0.005), no prior systemic treatment (< 0.001) and folic acid use (0.021). In logistic regression analysis for week 24; median weekly MTX dose <= 15 mg (P = 0.001), baseline PASI >= 10 (P < 0.001), no prior systemic treatment (P < 0.004), folic acid use (P = 0.001) and absence of comorbidities (P = 0.009) were determined as independent factors affecting the achievement of PASI 90. Adverse effects were observed in 38.8% of the patients, with nausea/vomiting (23.9%) and transaminase elevation (13%) being the most common. The most common reasons for interruptions (15.3%) and discontinuations (27.1%) of the treatment were patient related individual factors. The use of MTX as the first systemic treatment agent, at doses <= 15 mg/week and concurrent folic acid application are positive predictive factors for achieving the target PASI response both at weeks 12 and 24. In our study, which is one of the most comprehensive studies on MTX treatment in psoriasis, we observed that MTX is an effective and safe treatment option.Item Conducting polymers with benzothiadiazole and benzoselenadiazole units for biosensor applicationsEmre, FB; Ekiz, F; Balan, A; Emre, S; Timur, S; Toppare, LPoly(4,7-di(2,3)-dihydrothienol[3,4-b][1,4]dioxin-5-yl-benzo[1,2,5]thiadiazole) (PBDT) and poly(4,7-di(2,3)-dihydrothienol[3,4-b][1,4]dioxin-5-yl-2,1,3-benzoselenadiazole) (PESeE) were electrochemically deposited on graphite electrodes and used as immobilization matrices for biosensing studies. After electrochemical deposition of the polymeric matrices, glucose oxidase (GOx) was immobilized on the modified electrodes as the model enzyme. In the biosensing studies, the decrease in oxygen level as a result of enzymatic reaction was monitored at -0.7 V vs Ag/AgCl (3.0 M KCl) and correlated with substrate concentration. The biosensor was characterized in terms of several parameters such as operational and storage stabilities, kinetic parameters (K-m and I-max) and surface morphologies. The biosensor was tested on real human blood serum samples. (C) 2011 Elsevier B.V. All rights reserved.