Browsing by Author "Yilmaz, Ö"
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Item Evaluation of voiding dysfunctions in children with chronic functional constipationKasirga, E; Akil, I; Yilmaz, Ö; Polat, M; Gözmen, S; Egemen, AThere are controversial results about the role of dysfunctional bowel emptying in disorders of the urinary tract like urinary tract infection (UTI), vesicoureteral reflux (VUR) and enuresis. Constipation may cause UTI, enuresis and VUR due to the uninhibited bladder contraction. The aim of this study was to investigate the frequency of nocturnal enuresis, UTI and instability symptoms in chronic functional constipation (CFC). This study included 38 children with CFC and 31 children as the control group. Detailed past and present history of UTIs or symptoms pointing to this diagnosis, enuresis, encopresis, urgency and urge incontinence was obtained from both groups as well as the family history of UTI. Urinalysis, urine culture and stool parasite analysis as well as abdominal ultrasonography were performed on both groups. Age range of the children with CFC was 6-192 months (mean +/- standard deviation (SD) 63.5 +/- 51 months); that of the control group was 4-180 months (mean +/- SD 82 +/- 46.2 months). Frequency of UTI and urgency was significantly higher in the CFC group. However, frequencies of urge incontinence, nocturnal enuresis, and genitourinary abnormalities were not different between the two groups. In conclusion, risk of UTI and urgency is increased in CFC, but that of other voiding dysfunctions like urge incontinence do not change significantly. Therefore, we suggest that UTI and urgency should be questioned in children with CFC and vice versa.Item The Effect of Flexible Bronchoscopy on Anxiety in ChildrenTürkeli, A; Yilmaz, Ö; Topçu, I; Yüksel, HOBJECTIVES: Flexible bronchoscopy (FB) is a semi-invasive diagnostic tool that allows direct visualization of the airways. The use for diagnostic and therapeutic purposes in children is incrasing with the developments in modern anesthesia. Irrespective of the type of the invasive diagnostic procedure, these interventions are known to cause anxiety in patients. The aim of our study was to evaluate the anxiety and depression status in children hospitalized for bronchoscopy and to investigate the effects of FB. MATERIAL AND METHODS: Thirty children hospitalized for FB and 30 controls, aged 7 to 16 years, were enrolled in this study. Anxiety was evaluated with the Hospital anxiety and depression scale (HADS) besides other parameters recorded. RESULTS: The mean HADS anxiety scores in the patient and control groups were respectively 10.1 (3.5) and 2.7 (1.3) (p=0.001). The mean HADS depression scores were respectively 8.8 (3.7) and 2.2 (1.1) (p=0.001). Among the patients, 50% had anxiety and 53.3% had findings while none in the control group showed signs of anxiety and depression. A positive correlation was found between the age and, anxiety and depression scores in patients' groups (respectively r(1) = 0.257; p=0.05 and r(2) = 0.288; p=0.02). CONCLUSION: Anxiety was demonstrated in nearly half of the children hospitalized for bronchoscopy. It has been observed that behavioral and physical problems may be encountered in approximately 40-60% of children who feel generalized anxiety before anesthesia, during the preoperative, postoperative period, and subsequent periods. These results suggest that the detection of children with increased anxiety and indicate the individual requirements can be assisted pharmacological and psychological supports.Item Improvement in sleep quality with allergen-spesific immunotherapy in patients with allergic rhinitisBayrak Degirmenci, P; Kirmaz, C; Deveci, A; Yüksel, H; Yilmaz, ÖObjective: In the medical literature, it has been shown that quality of life and sleep quality are impaired due to allergic rhinitis and are improved with treatment. In this study, we aimed to determine the change in sleep quality of patients with allergic rhinitis using allergen-specific immunotherapy. Materials and Methods: Seventy-four patients diagnosed with allergic rhinitis according to the clinical evaluation and skin prick test findings in Celal Bayar University Allergy-Immunology Outpatient Department were enrolled in our study. Sleep quality was evaluated with Pittsburgh Sleep Quality Index (PSQI) just before specific immunotherapy was initiated and at the end of the first year of treatment with specific immunotherapy. Results: Frequency of having healthy sleep increased significantly after specific immunotherapy in the patients (p<0.001). A significant correlation was detected between the changes in symptom score and PSQI when evaluated with Spearman correlation analysis (p= 0.01). Improvement was demonstrated in subjective sleep quality, sleep latency, sleep duration, sleep efficacy, factors influencing sleep, use of hypnotics, and daytime somnolence parameters of the PSQI with a decrease in symptom score. Conclusion: In our study, chronic sleep disorder disappeared and improvement in sleep quality was detected in most patients during the second evaluation one year after initiation of specific immunotherapy. Sleep quality increased as the symptom score decreased. These findings demonstrated improvement in the patients' sleep quality with improvement in symptoms following specific immunotherapy treatment. These data should be supported with longer specific immunotherapy therapy in patients with allergic rhinitis.Item The Key Cell of the Mucosal Immunity: M CellSimsek, Y; Yilmaz, Ö; Yüksel, HM cells are immune cells located in the mucosal epithelium. They constitute the initial step of mucosal as well as systemic immune response by presenting antigens to the mucosa-associated lymphoid tissue located under the mucosa. Structural and functional characteristics of M cells which are different from their neighboring epithelial cells show that their primary function is antigen presentation. Furthermore, they are used as an entrance gate to the host tissue by many pathogens. These characteristics make M cells the target for oral, nasal vaccine and intestinal drug applications. The role of M cells in the antigen sampling makes these cells important for oral immunotherapy applications, too. With the advancement in M cell cultures and increasing understanding of M cells would make M cell-mediated differences in the treatment and applications.Item Effectiveness of magnetic resonance angiography in the evaluation of lung perfusion in constrictive bronchiolitis obliteransYilmaz, Ö; Savas, R; Sogut, A; Özkol, M; Yüksel, HChildhood constrictive bronchiolitis obliterans (CBO) is characterized clinically by the persistence of obstructive respiratory symptoms following a prolonged episode of lower respiratory viral infection. The diagnosis depends on the clinical, radiological and laboratory findings. Perfusion defects on scintigraphy may predict the severity. This report describes a 2-year-old girl who presented with a 15-day history of respiratory distress despite treatment. Auscultation of the lungs revealed prolonged expiration and bilateral crepitant rales. CXR revealed bilateral paracardiac infiltration. She improved with a treatment regimen of bronchodilators, systemic steroids and antibiotherapy; however, rales were detected again 10 days after discharge. HRCT of the lung revealed an oligaemic-mosaic pattern, more prominent in the left lung. The diagnosis of CBO was made on the basis of these clinical and radiological findings. Perfusion was normal in the right lung but diffusely decreased in the left lung on perfusion scintigraphy by Tc99m-MAA. Magnetic resonance (MR) angiography source images of the lungs revealed significant but not diffuse perfusion defects in the left lung, in contrast to radionuclide scintigraphy. There were areas of low perfusion in the right lung, which were not evident in radionuclide scintigraphy. The use of source images of MRI angiography of the lungs may be more sensitive and specific for the detection of perfusion defects in patients with CBO and may assist in determining the prognosis.Item CAN URINARY BIOMARKERS SUCCEED DIAGNOSTIC VALUE OF RENAL SCINTIGRAPHY IN PATIENTS WITH URETEROPELVIC JUNCTION DISRUPTION?Gürer, DE; Yilmaz, Ö; Ertan, P; Eser, E; Taneli, F; Aras, F; Oran, A; Genç, A; Günsar, C; Sencan, A; Gürer, E; Taneli, CItem Effects of allergen specific immunotherapy on functions of Th and Treg cells in patients with seasonal allergic rhinitisKirmaz, C; Kirgiz, O; Degirmenci, P; Yilmaz, Ö; Vatansever, S; Ozbilgin, K; Onur, E; Celik, O; Sogut, A; Ay, G; Yuksel, HItem Attention deficit and hyperactivity symptoms in children with monosymptomatic nocturnal enuresisErtan, P; Gönülal, D; Sögüt, A; Yilmaz, Ö; Bozgül, A; Dinç, G; Aydemir, Ö; Yüksel, HAim: Monosymptomatic nocturnal enuresis in children may cause psychological and behavioral problems. The aim of this study was to assess symptoms of attention deficit and hyperactivity in children with monosymptomatic nocturnal enuresis. Material and Method Fifty-seven children (23 male, 34 female) with monosymptomatic nocturnal enuresis and 57 healthy controls (25 male, 32 female) aged 6 to 12 years participated in the study. Conners' Parent Rating Scale-48 (CPRS), a 48-item multiple-choice questionnaire, was completed by the mothers to identify the attention deficit and hyperactivity symptoms in children. Results: Mean age of the children with enuresis was 8.54 +/- 2.18 years and that of the control group 9.12 +/- 2.13 years. Attention deficit score in the enuretic group was significantly higher than that in the control group (p=0.02). Hyperactivity scores were not significantly different between the groups (p=0.36). Bedwetting frequencies were not different between enuretic children with and without attention deficit or hyperactivity symptoms (p=0.06). Conclusions: Psychological and behavioral assessment may be indicated in children with monosymptomatic nocturnal enuresis since the results of this study demonstrate increased attention deficit symptomatology. (Turk Arch Ped 2010; 45: 37-40)Item Significant Changes in Trans-Epithelial Barrier Proteins of Adenoid Tissue with Atopic Status in ChildrenYilmaz, Ö; Simsek, Y; Inan, S; Buga, Ö; Eskiizmir, G; Pinar, E; Kanik, E; Yüksel, HOBJECTIVES: Adenoid tissue is important in local immune response and epithelial barrier dysfunction of this tissue may contribute to allergies. The aim of this study was to evaluate the relationship between the status of cross-epithelial barrier elements in adenoid tissue lymphoepithelium and inhalant allergen sensitization. MATERIALS AND METHODS: Children aged 5-15 years, who underwent adenotonsillectomy, participated in this study. All subjects underwent skin prick testing with environmental inhalant allergens. Occludin, ZO1, e-cadherin, beta-catenin, desmoglein, desmoplakin, and connexon-43 were stained immunohistodiemically in the adenoid tissues obtained and scored by H-score. RESULTS: We enrolled 76 children, 14 among whom were sensitized to environmental allergens. Among the zonula occludens proteins, median H-scores for occludin, claudin, and ZO-1 were significantly lower in the atopic compared to the nonatopic group respectively (p<0.001). Similarly, median H-scores for e-cadherin and beta catenin proteins of the zonula adherens were significantly lower in the atopic group (p<0.001). Both desmoglein and desmoplakin H-scores were significantly lower in the atopic group [60 (50-100) vs 280 (260-300), p<0.001 and 105 (87.5-120) vs 280 (67.25-300), p<0.001 respectively]. Moreover, connexin-43 protein of the gap junction was significantly lower in the atopic group (p<0.001). CONCLUSION: Adenoid tissue, which is the initial point of contact of inhalant allergens demonstrates epithelial barrier junctional protein, changes in children with inhalant allergen sensitization without clinical allergic disease symptoms. Therefore, it may be concluded that epithelial barrier function plays an important role in the development of allergen sensitization versus tolerance.Item Symptoms of the olive pollen allergyKirmaz, C; Yuksel, H; Bayrak, P; Yilmaz, ÖBackground: Olive (Olea europaea; O.e.) pollen is a major cause of seasonal respiratory allergy. The O.e. pollination season lasts two months from the beginning of May till the end of June. It was expected that patients with allergic disease from O.e. sensitization were symptomatic only during this period. However, during the last few years, we have observed that the clinical symptoms appear not only during the O.e. pollination season but also during the rest of the year. Objective: The aim of this study was to observe and document symptoms of respiratory allergic diseases in the O.e. sensitized patients during the O.e. pollination season and after it. Methods: One hundred and twenty-seven patients with respiratory allergic disease were enrolled in the study. Allergenic sensitizations were shown by SPT. Finally, patients were split into two groups as monosensitized with O.e. (n=19) and polysensitized (n=108). Patients were assessed by using scores of respiratory allergic disease symptoms and percentage of peak expiratory flow rate values (PEFR %) (only for asthmatic patients) during the O.e. pollination season and after it. Results: Of the patients with O.e. monosensitization, 13 had allergic rhinitis (AR) only while six had allergic asthma (AA) additionally. AR alone and accompanied by AA was present in 84 and 24 polysensitized patients respectively. Eleven patients with O.e. sensitization (57.9 %) and 86 patients with polysensitization (79.6 %) had AR symptoms throughout the year irrespective of the O.e. pollination season. Similarly, three of the O.e. monosensitized and ten of the polysensitized patients with AA had asthmatic symptoms during the O.e. pollination season and also after it. Conclusions: In the patient group sensitive to O.e. along with other pollen extracts, it was possible to observe symptoms outside the pollination season. However, patients with O.e. monosensitization also had symptoms to a great extent outside the season.Item Does having an asthmatic sibling affect the quality of life in children?Yilmaz, Ö; Türkeli, A; Karaca, Ö; Yüksel, HChronic illness in a family member leads to deterioration of quality of life in other members of that family. We aimed to investigate the influence of having an asthmatic sibling on a child's quality of life (QoL). We enrolled 2-12 year aged healthy children with an asthmatic sibling in the study group and healthy children with a healthy sibling in the control group of this cross-sectional study. Sociodemographic characteristics of children and disease severity characteristics of asthmatic siblings were recorded. All parents filled in Turkish generic PedsQLTM short form appropriate for the child's age group. Study and control groups had 114 children each. Total PedsQLTM scores were not significantly different in any of the age groups (p=0.23, p=0.13, p=0.11 respectively). Emotional PedsQLTM sub-scores in children with an asthmatic sibling were significantly worse (83.0 +/- 16.5 vs 91.6 +/- 10.9 in the 2-4 year age group, 72.0 +/- 17.8 vs 92.2 +/- 11.6 in the 5-7 year age group, 73.7 +/- 24.1 vs 88.7 +/- 14.8 in the 8-12 year age group respectively, p=0.002 for all). Similarly, psychosocial sub-score was significantly lower in the 2-4 and 5-7-year-olds but not the 8-12 year old groups (p=0.01, p=0.01, p=0.08 respectively). In conclusion, healthy children with asthmatic siblings have significantly lower emotional QoL and this needs to investigated for other chronic diseases in further research.Item Frequency and characteristics of mongolian spots among Turkish children in Aegean regionEgemen, A; Ikizoglu, T; Ergör, S; Asar, GM; Yilmaz, ÖMongolian spots, which are benign congenital lesions observed in the first years of life, can cause distress for parents due to aberrant localization as well as unexpected number and size. Therefore, efficient differential diagnosis is necessary. The aim of this study was to determine the frequency and characteristics of mongolian spots in 1-12-month-old children in a west Anatolian city and to evaluate parental approach to these lesions. The study included 924 children who presented to Ege University Hospital Healthy Child Outpatient Department between January and August 2003. A questionnaire was applied to the families while all children were examined scrupulously for the presence of mongolian spots. The frequency of these lesions in the study population was determined to be 26%; this rate was 20% and 31% in boys and girls, respectively. No lesion was detected in blond-haired children; however, it was detected in 47% of brunettes. Most common localizations were lumbosacral, gluteal, and back, though knee, scalp and feet were also encountered. Upon questioning, most parents stated it was a birth mark; however, 10% accepted to consult a doctor about the issue. In conclusion, identifying mongolian spots and informing parents are essential to strengthen the family-doctor relationship.Item Infecting Glial Cells with Antimony Resistant Leishmania tropica: A New ex-vivo ModelZorbozan, O; Harman, M; Evren, V; Erdogan, MA; Kilavuz, A; Tunali, V; Çavus, I; Yilmaz, Ö; Özbilgin, A; Turgay, NLeishmaniasis is a vector-borne zoonotic disease that shows different clinical features like cutaneous, mucocutaneous, visceral and viscerotropic forms. The protocols used in the treatment of leishmaniasis are toxic and have many limitations during administration. One of the limitations of treatment is the resistance against the protocols in practice. There is also a need to define new treatment options especially for resistant patients. Ex-vivo models using primary cell cultures may be a good source for evaluating new drug options in patients with antimony resistance, in addition to in-vitro and in-vivo studies. In this study, it was aimed to define a new ex-vivo culture model to evaluate treatment options in patients with cutaneous leishmaniasis who did not respond to treatment. In our experimental model of ex-vivo infection, Leishmania tropica promastigotes isolated from a case previously diagnosed with cutaneous leishmaniasis were used. The primary astroglial cell culture used for the ex-vivo model was prepared from 2-3 days old neonatal Sprague Dawley rat brains under sterile conditions by the modification McCarthy's method. The astroglia cells, which reached sufficient density, were infected with antimony resistant L.tropica promastigotes. After 24 hours of incubation, the supernatant on the cells were collected, the cell culture plate was dried at room temperature, then fixed with methyl alcohol and stained with Giemsa to search for L.tropica amastigotes. Amastigotes were intensely observed in glia cells in primary cell cultures infected with L.tropica promastigotes. No promastigotes were seen on Giemsa stained preparations of the precipitates prepared from the bottom sediment after the centrifugation of the liquid medium removed from the infected plates. In this study, promastigotes from a cutaneous leishmaniasis patient unable to respond to pentavalent antimony therapy were shown to infect rat glia cells and converted to amastigote form. This amastigote glial cell model, as far as we know, is the first model in the literature produced by L.tropica. The occurrence of L.tropica amastigote forms in glia cells may be indicative of the ability of Leishmania species to infect the central nervous system. The central nervous system may be an area for the Leishmania amastigotes to escape from the immune system in cases of leishmaniasis without a treatment response. Our study is important because it is the first study to show the infection of glia cells with L.tropica amastigotes.Item Change in quality of life, anxiety and depressive symptoms with asthma severity in childrenYilmaz, Ö; Sögüt, A; Kader, S; Taskin, O; Yüksel, HObjective: The aim of this study was to evaluate the change in anxiety-depression symptoms with the change in asthma related symptom score and quality of life in children. Materials and Methods: Thirty five children with asthma aged 6 to 16 years were enrolled in this cohort. Symptom scores were recorded and all children filled in Pediatric Asthma Quality of Life Questionnaire (PAQLQ), Hospital Anxiety Depression Scale (HADS) and Center for Epidemiologic Studies Depression Scale (CES-D). They were called in again four months later to evaluate for change in all parameters. Results: When initial presentation and follow-up values were compared, significant decrease in symptom score, number of exacerbations and number of emergency visits was detected (p< 0.001, p= 0.001 and p= 0.004 respectively). Similarly, HADS anxiety and depression scores as well as CES-D score improved significantly at follow-up when compared to the initial presentation (p< 0.001, p= 0.001 and p< 0.001 respectively). Change in symptom score was significantly correlated with changes in CES-D score as well as PAQLQ symptom, emotion and total scores (r= 0.39 p= 0.04, r= -0.57 p< 0.001, r= -0.66 p< 0.001, r= -0.66 p< 0.001 respectively). Change in PAQLQ total score demonstrated significant negative correlation with the change in HADS anxiety score (r= -0.42, p= 0.02). Conclusion: Improvement in asthma symptoms and QoL is associated with improvement in depression-anxiety symptoms.Item Anti-VEGF treatment suppresses remodeling factors and restores epithelial barrier function through the E-cadherin/β-catenin signaling axis in experimental asthma modelsTürkeli, A; Yilmaz, Ö; Karaman, M; Kanik, ET; Firinci, F; Inan, S; Yüksel, HBesides maintaining a physical barrier with adherens junctional (AJ) and tight junctional proteins, airway epithelial cells have important roles in modulating the inflammatory processes of allergic asthma. E-cadherin and beta-catenin are the key AJ proteins that are involved in airway remodeling. Various mediators such as transforming growth factor-beta (TGF-beta), epidermal growth factor (EGF), fibroblast growth factor (FGF), platelet derived growth factor (PDGF), insulin-like growth factor (IGF), tumor necrosis factor-alpha (TNF-alpha) and angiogenic factors, such as vascular endothelial growth factor (VEGF), are released by the airway epithelium in allergic asthma. The signaling pathways activated by these growth factors trigger epithelial-mesenchymal transition (EMT), which contributes to fibrosis and subsequent downregulation of E-cadherin. The present study used a mouse asthma model to investigate the effects of anti-VEGF, anti-TNF and corticosteroid therapies on growth factor and E-cadherin/beta-catenin expression. The study used 38 male BALB/c mice, divided into 5 groups. A chronic mouse asthma model was created by treating 4 of the groups with inhaled and intraperitoneal ovalbumin (n= 8 per group). Saline, anti-TNF-alpha (etanercept), anti-VEGF (bevacizumab) or a corticosteroid (dexamethasone) were applied to each group by intraperitoneal injection. No medication was administered to the control group (n=6). Immunohistochemistry for E-cadherin, beta-catenin and growth factors was performed on lung tissues and protein expression levels assessed using H-scores. Statistically significant differences were observed in E-cadherin, beta-catenin, EGF, FG, and PFGF (P<0.001 for all) as well as the IGF H-scores between the five groups (P<0.005). Only anti-VEGF treatment caused E-cadherin and beta-catenin levels to increase to the level of non-asthmatic control groups (P>0.005). All treatment groups had reduced TGF-beta, PDGF and FGF H-scores in comparison with the untreated asthma group (P=0.001). The EGF and IGF levels were not significantly different between the untreated asthmatic and non-asthmatic controls. The results suggested that anti-VEGF and TNF-alpha inhibition treatments are effective in decreasing growth factors, in a similar manner to conventional corticosteroid treatments. Anti-VEGF and TNF inhibition therapy may be an effective treatment for remodeling in asthma while offering an alternative therapeutic option to steroid protective agents. The data suggested that anti-VEGF treatment offered greater restoration of the epithelial barrier than both anti-TNF-alpha and corticosteroid treatment.Item Testis fixation in prepubertal ratsSencan, A; Cenç, A; Günsar, C; Daglar, Z; Yilmaz, Ö; Ulukus, Ç; Özer, E; Taneli, C; Mir, EExperimental studies have shown that different suture materials used in testis fixation cause some degree of inflammation in the testis. This study was planned to compare the histological changes that were caused by fibrin glue which is a tissue sealant and by silk and polypropylene for transparenchymal testis fixation. 28 prepubertal rats were divided into 4 groups. Testis was fixed to the tunica vaginalis by fibrin glue in group 1, by silk in group 2 and by polypropylene in group 3. Group 4 was planned as a control. Testicular inflammation and seminiferous tubular diameter were evaluated for histological changes. The least inflammation was observed in the fibrin glue group, while the most inflammation occurred in the silk group. Seminiferous tubular diameter was 241.55 +/- 45.90 in the fibrin glue group, 151.90 +/- 8.34 in the silk group and 161.36 +/- 9.96 in the polypropylene group. In conclusion, fibrin glue, when used for testis fixation, causes less inflammation and less destruction of seminiferous tubular diameter compared with silk and polypropylene.Item Cord blood Interleukin-13 and IFN-Gamma levels As Biomarkers of Ever-Wheezing in the First Year of LifeYilmaz, Ö; Yasar, A; Ay, P; Polat, AC; Cingöz, FO; Alkin, T; Taneli, F; Hasdemir, S; Basbay, YS; Yüksel, HItem Awareness and intervention approaches related to smoking addiction among child and adolescent psychiatristsErten, T; Sapmaz, SY; Güleç, AG; Hesapçioglu, ST; Kandemir, H; Yilmaz, Ö; Yüksel, HAim: To determine the attitudes of child and adolescent psychiatrists working in different institutions throughout Turkey towards smoking addiction and intervention steps. Material and Methods: An information form assessing physicians' 5As approach was established considering the studies included in the literature, and this form was applied to physicians working in the area of child psychiatry by way of e-mail and phone. Results: Although most physicians (52.5%) asked about smoking status, which is included in the first step in the 5As approach used in smoking cessation, it was observed that they implemented further steps of the 5As with gradually decreasing rates in our study. Only 15% of the physicians performed follow-up in smoking cessation treatment. Conclusion: Physicians who work with pediatric and adolescent patients in Turkey have low levels of awareness about smoking addiction and they do not feel competent. Considering that tobacco and related addictions are gradually increasing in children and adolescents, physicians must receive training in the area of smoking cessation methods and start practicing these methods. It was thought that organizing smoking cessation training for physicians would contribute positively to the treatment of patients.Item Effects of Vitamin D Levels on Asthma Control and Severity in ChildrenTurkeli, A; Ayaz, O; Uncu, A; Özhan, B; Kavaz Tufan, A; Bas, VN; Yilmaz, Ö; Yüksel, HObjective: The prevalence rates of asthma and vitamin D deficiency have been increasing in parallel, leading to significant morbidity. This study aimed to compare the vitamin D levels in the children with asthma and in healthy controls and to assess the relationship between vitamin D levels and asthma clinical parameters and control. Materials and Methods: 115 children with asthma and 115 controls who presented to the Pediatric Immunology and Allergy outpatient clinic between December 2014 and February 2015 were enrolled in the study. Vitamin D levels were measured. Levels = 20 ng/ml were considered adequate and those lower than 20 ng/ml as deficient. Asthma control was classified according to the Global Initiative for Asthma guidelines (GINA) and Childhood asthma control test (C-ACT). Results: Serum vitamin D levels were 17.27 (5.77) ng/ml in the asthma group and 22.78 (10.64) ng/ml in the control group, indicating statistical significance (p= 0.001). When the asthma patients were divided into groups according to vitamin D level, 72.2% were deficient while 27.8% had adequate levels. The number of asthma exacerbations, number of emergency service visits and the number of hospitalizations within the last year were higher in the deficient group, compared to the adequate group (p < 0.001, p 0.001 and p < 0.002, respectively). Uncontrolled asthma rates were higher in the deficient group, compared to the adequate group (p < 0.01). Serum vitamin D levels were correlated with the ACT score (r= 0.204, p= 0.03). Conclusion: The rate of vitamin D deficiency was higher in asthmatic children compared to the controls. We also showed that increased asthma severity and reduced asthma control were associated with vitamin D deficiency. There was a positive correlation between serum vitamin D levels and asthma control.Item Clinical significance of lung perfusion defects in children with post-infectious bronchiolitis obliteransYüksel, H; Yilmaz, Ö; Ürk, V; Yüksel, D; Göktan, C; Savas, R; Sayit, EClinical significance of segmental lung perfusion defects in children with bronchiolitis obliterans (BO), have not been reported before. The aim of this study was to evaluate clinical significance of lung perfusion defects in children with BO and to reveal its impact on follow up. The study included 38 children aged 9 to 60 months (17.8 +/- 13.4 months) with BO. Diagnosis was based on persistent respiratory findings beyond six weeks and oligemic-mosaic pattern in lung high resolution computerized tomography. Chest X-ray, 24 hour esophageal pH monitoring, sweat chloride test, immunoglobulin levels and respiratory viral screening were carried out in all. Lung perfusion scintigraphy was carried out at least three months after the first clinical sign of BO. Perfusion defects were scored. Scintigraphy demonstrated perfusion defects in 24 (63.2%) patients but was normal in 14 (36.8%). Number of segments having perfusion defects was 2.9 +/- 2.6. Mean number of exacerbations and days of hospitalization during the first year of follow up were 4.7 +/- 4.4 and 26.9 +/- 29.8 respectively. It was detected that number of perfusion defects correlated significantly with the number of exacerbations and duration of hospitalization (r= 0.66 and p= 0.00). In conclusion, number and extent of segments with perfusion defects in lungs of children with BO are correlated with clinical severity. Therefore, evaluation of lung perfusion status may aid in clinical determination of disease severity and its follow-up.