Browsing by Author "Yilmaz, O"
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Item Omalizumab in patients with severe persistent asthma in real life setting in Manisa, TurkeyHavlucu, Y; Yorgancioglu, A; Kurhan, F; Özdemir, L; Coskun, S; Goktalay, T; Yilmaz, O; Celik, PItem Effect of Subcutaneous Immunotherapy on The Natural Course of Allergic Diseases in Pediatric Patients: A Real-Life CohortYilmaz, O; Yasar, A; Simsek, Y; Alpdogan, S; Kunay, B; Yuksel, HAim: Specific allergen immunotherapy (SIT) is the only disease-modifying therapy for allergic diseases. We aimed to examine the effect of subcutaneous specific allergen immunotherapy (SCIT) applications on the prognosis of asthma and allergic rhinitis in pediatric cases in real-life settings. Methods: The study was designed as a retrospective cohort study. Patients with asthma and/or allergic rhinitis aged between 5 and 18 years old were enrolled between 2010 and 2015. The groups who received SCIT and who did not receive were compared in terms of disease severity parameters in follow-up recorded in their files. Results: A total of 298 cases, among which 140 received subcutaneous specific allergen immunotherapy. The frequency of asthma, allergic rhinitis, and co-morbidity was similar between the two groups. In the first year of the follow-up, asthma symptoms severity was not significant between the two groups; however, both asthma and allergic rhinitis symptoms were significantly lower in the SCIT patients at the end of the third year of follow-up. While the follow-up rate for three years or more was 62% in the group that received subcutaneous specific allergen immunotherapy, it was 38% in the group that did not receive. Conclusion: These results showed that SIT is an effective treatment modality in real-life settings with low side effects in pediatric patients with uncontrolled asthma and allergic rhinitis despite medical treatment.Item Influence of VEGF and TNF antagonism on zonula occludens proteins in an experimental asthma modelYuksel, H; Yilmaz, O; Karaman, M; Firinci, F; Turkeli, A; Kanik, ET; Inan, SItem Regulatory-T, T-Helper 1, and T-Helper 2 Cell Differentiation in Nasal Mucosa of Allergic Rhinitis with Olive Pollen SensitivitySogut, A; Yilmaz, O; Kirmaz, C; Ozbilgin, K; Onur, E; Celik, O; Pinar, E; Vatansever, S; Dinc, G; Yuksel, HBackground: Allergic rhinitis (AR) is a disease in which T-helper (Th)2 response is predominant and its pathogenic mechanism is still poorly understood. Aim: To evaluate the possible role of Th1, Th2 and regulatory-T (Treg) cells in the pathogenesis of AR. Methods: This case-control study enrolled 41 patients with seasonal AR (10-62 years old), sensitive to olive pollens, and 15 healthy controls (18-60 years old). Nasal biopsy was performed and specimens of nasal lavage fluid were obtained from all participants. The levels of interleukin (IL)-4, IL-10, interferon (IFN)-gamma and transforming growth factor-beta (TGF-beta) were measured in nasal lavage fluid specimens. The expression of FOXP3, GATA-3 and T-bet was measured by immunohistochemical methods in the nasal biopsy specimens. Results: The levels of IFN-gamma in the group with AR were significantly lower than those in the control group (p = 0.008). The levels of IL-4, IL-10 and TGF-beta did not differ between the two groups. The expression of FOXP3 and T-bet in patients with AR was significantly lower than that in the control group (both p = 0.001). Expression of GATA-3 in the nasal mucosa was similar between the groups (p = 0.2). The ratios of T-bet/GATA-3 and FOXP3/GATA-3 in the AR group were significantly lower than those in the control group (p = 0.001). Conclusion: Insufficient Treg and Th1 cells may be associated with the allergic inflammation that may be attributed to the Th2 immune response in patients suffering from AR who are sensitive to olive pollen. Copyright (C) 2011 S. Karger AG, BaselItem Changes in epithelial barrier components E-cadherin, Beta-catenin, EGR with steroid treatment in murine model of asthmaYuksel, H; Yilmaz, O; Karaman, M; Firinci, F; Turkeli, A; Kanik, ET; Inan, SItem Epithelial Barrier Dysfunction Related To Neutrophilic Inflammation In Non-Cystic Fibrosis BronchiectasisYilmaz, O; Simsek, Y; Aslan, C; Kanik, ET; Ulman, C; Yildiz, R; Ozdogru, E; Yuksel, HItem The role of dendritic cell in nasal mucosal response in comorbidity of allergic rhinitis and asthmaYilmaz, O; Onur, E; Kirmaz, C; Ergin, S; Yuksel, HItem Effects of glucan treatment on the Th1/Th2 balance in patients with allergic rhinitis: a double-blind placebo-controlled studyKirmaz, C; Bayrak, P; Yilmaz, O; Yuksel, HBackground. Allergic rhinitis (AR) is a disease characterized by IgE-mediated, allergic inflammation of the nasal mucosa. T helper (Th) 2 cells play an important role in the development of IgE-mediated diseases such as AR, with local overproduction of Th2 cytokines (IL-4, IL-5 and IL-13) at the site of allergic inflammation. Th1 cytokines (IL-12 and IFN-gamma) are known to suppress this Th2 immune response, aiding the treatment of these diseases. beta-1,3-1,6-glucan (Glucan) is an immunomodulator stimulating particularly the antitumor response. An efficient antitumor stimulation can be achieved through a Th1-mediated immune response. Objective. The aim of this study was to investigate the effects of Glucan on the immunopathogenic processes in the microenvironment to determine if it reverses the Th2-mediated immune response in AR to Th1-mediated response. Methods. 24 Olea europea mono-sensitized patients with AR were randomized into Glucan and placebo groups. The Glucan group consisted of 12 patients who received Glucan treatment for 12 weeks, while the placebo group of 12 patients received placebo during the same period. A nasal provocation test (NPT) with Olea europea was performed at the beginning and end of treatment, and nasal lavage followed the positive NPT. IL-4, IL-5, IFN-gamma and IL-12 levels and the eosinophil count (%) were measured in nasal lavage fluid (NLF) samples. Simultaneously, peripheral blood eosinophil % values were measured. Results. After treatment, IL-4 and IL-5 levels in NLF from the Glucan group were found to have decreased significantly (p = 0.027, p = 0.04; respectively), while IL-12 levels were found to have significantly increased (p = 0.008). However, IFN-gamma levels had not changed. On the other hand, none of the cytokine levels had changed significantly in the placebo group following treatment. Moreover, the percentage of eosinophils in the NLF was found to have decreased significantly after treatment in the Glucan group (p = 0.01), while that of the placebo group did not change. Peripheral blood percentage eosinophil levels had not changed significantly in any group. Conclusion. Th2-originated IL-4 and IL-5 levels responsible for the allergic inflammatory response in the microenvironment of patients with AR, are decreased with Glucan while levels of Th1-originated IL-12 are increased. Moreover, eosinophils, which are important effector cells of the inflammatory response, are decreased in the microenvironment. As a result, Glucan may have a role as an adjunct to standard treatment in patients with AR.Item Validity and reliability of asthma quality of life questionnaire in a sample of Turkish adult asthmatic patientsAlpaydin, AO; Yorgancioglu, A; Yilmaz, O; Bora, M; Göktalay, T; Çelik, P; Yüksel, HWe aimed to investigate the validity and reliability and of Asthma Quality of Life Questionnaire (AQLQ) in Turkish adult asthmatic patients. New or previously diagnosed [according to Global Initative for Asthma (GINA) 2008] symptomatic 118 consecutive stable asthmatic patients between 18 and 55 years old were included. Asthma severity was determined and Turkish adaptation of the AQLQ was administered. Lara asthma symptom scales (LASS), pulmonary function tests, Turkish adaptation of Medical Outcomes Survey Short Form-36 (SF-36) were evaluated. All assessments were done twice at recruitment and after 10 weeks. During this period patients were allowed to make modifications on their medication when necessary. Among the recruited 118 patients 95 were female and 14 were lost in the follow-up. Sixty-two percentages of the patients had mild and 38% moderate asthma. The internal consistency of AQLQ was high (Cronbach's alpha 0.81-0.87) and item-total score correlations were ranging from 0.75-0.89. The cross-sectional and longitudinal correlations between AQLQ total and domain scores and SF36 domain scores were in a range of little or fair degree (r= 0.241-0.626, p<0.005). Total AQLQ scores were observed significantly different according to disease severity and LASS both in the first (p<0.001, both) and 10 weeks follow-up visits (p=0.006, p<0.001 respectively). A statistical significant change was observed in AQLQ symptom score as in total LASS changed ( p<0.001, both) in the follow-up. Our results demonstrated that Turkish version of AQLQ is feasible, reliable, valid and sensitive to changes in adult asthmatics.Item Effects of low-dose propofol vs ketamine on emergence cough in children undergoing flexible bronchoscopy with sevoflurane-remifentanil anesthesia: a randomized, double-blind, placebo-controlled trialOzturk, T; Acikel, A; Yilmaz, O; Topçu, I; Çevikkalp, E; Yuksel, HStudy Objective: To determine the effects of low-dose ketamine and propofol on cough during emergence and the recovery period when administered at emergence in children undergoing fiberoptic bronchoscopy for bronchoalveolar lavage (FOBL) with sevoflurane-remifentanil anesthesia. Design: Randomized, double-blind, placebo-controlled trial. Setting: Operating room, postoperative recovery area. Patients: Sixty-eight children aged 1 to 8 years old undergoing elective diagnostic FOBL. Interventions: After discontinuation of anesthetics at the end of FOBL, patients were randomly divided into 3 groups: in group K, children were administered 0.5 mg/kg of ketamine; in group P, 0.5 mg/kg of propofol; and in group C, 0.1 mL/kg of normal saline. Measurements: Anesthesia time, procedure time, emergence time, and recovery time were recorded. Coughing and delirium scores were recorded as the patient fully emerged from anesthesia (time 0) and 5, 10, 15, and 20 minutes later. Main Results: The percentage of children with moderate or severe cough during emergence was similar in all groups. Mean delirium scores at emergence (TO) were significantly lower in group K than those in group P and in group C (P = .0001 and P = .02). Mean delirium score at 5 minutes in group K (6 [5-10]) was significantly lower than that of group C (P = .02) and similar to that of group P. The recovery time of group K was significantly longer than that of group C and group P (P = .01 and P = .03, respectively). Conclusions: Ketamine or propofol given at the end of sevoflurane-remifentanil general anesthesia in children undergoing FOBL did not decrease cough more than normal saline during the emergence period. Ketamine and propofol, compared to normal saline, had a beneficial effect on decreasing the incidence of emergence delirium. Ketamine lengthened recovery time. (C) 2016 Elsevier Inc. All rights reserved.Item Frequency of gastroesophageal reflux disease in nonatopic children with asthma-like airway diseaseYüksel, H; Yilmaz, O; Kirmaz, C; Aydogdu, S; Kasirga, EGastroesophageal reflux disease (GERD) is commonly associated with asthma; however, frequency in nonatopic children with asthmatic symptoms is unknown. The aim of this study was to determine the frequency of gastroesophageal reflux (GER) in nonatopic children with asthma-like airway disease that recur despite conventional asthma treatment and to evaluate the clinical response to lansoprazole treatment. Twent-five nonatopic children aged between 1 and 16 years who have asthma-like airway disease and 25 healthy children were included in the study. All cases underwent 24h pH monitoring with dual. sensor catheters. Additionally, acid suppressor treatment was administered to patients diagnosed as having GERD and clinical response was evaluated. Major symptoms encountered in the patient group included wheezing and cough (88%, and 32%, respectively). Reflux episodes were more common in distal esophagus during the prone position (reflux index (RI) of 11.5 +/- 10.3 vs. 16.2 +/- 9.4 during supine vs. prone). ALL distal esophageal parameters were significantly higher in the patient group except number of reflux episodes lasting longer than 5 min (RI of 13.3 +/- 13.1 vs. 3.9 +/- 2.9 in the patient vs. control groups, respectively). There was a significant improvement in symptoms and requirement for medication with treatment (number of systems decreased from 2.3 +/- 0.6 to 0.4 +/- 0.6, P = 0.00). In conclusion, GERD is significantly more common in nonatopic children with asthma-Like airway disease compared to the controls and clinical improvement is significant after acid suppressor treatment. Thus, we suggest that children followed-up with the diagnosis of nonatopic asthma with recurrent exacerbations despite adequate asthma treatment have a high frequency of GER and that Lansoprazole treatment may be considered early in management. (c) 2005 Elsevier Ltd. All rights reserved.Item Influence of oral intake of Saccharomyces boulardii on Escherichia coli in enteric floraAkil, I; Yilmaz, O; Kurutepe, S; Degerli, K; Kavukcu, SEnteric flora constitutes 95% of the cells in the human body. It has been shown that the bacterial content of this flora is affected by diet and changes in nutrition. Considering that urinary tract infections (UTI) are mostly due to ascending infections from the gut flora, the importance of the elements of this flora and their characteristics becomes more evident. The aim of this study was to evaluate the influence of oral Saccharomyces boulardii (S. boulardii) intake on the number of Escherichia coli (E. coli) colonies in the colon. This study was carried out with 14 boys and 10 girls (total of 24 children) aged between 36 and 192 months (mean: 104.3 +/- 45.1 months). A commercial capsule or powder containing 5 billion colony-forming units (cfu) of S. boulardii was administered once a day for 5 days. The number of E. coli and yeast colonies was measured in the stool samples of the study group before and after the use of this drug. Before treatment, the mean number of E. coli colonies in g/ml stool was 384,625 +/- 445,744. This number decreased significantly to 6,283 +/- 20,283 after treatment (p=0.00). S. boulardii was not detected in stool before treatment and the number of colonies increased to 11,047 +/- 26,754 in g/ml stool. S. boulardii may be effective in reducing the number of E. coli colonies in stool. The influence of this finding on clinical practice such as prevention of UTI needs to be clarified by further studies.Item Prognostic value of initial antithrombin levels in neonatal sepsisErsoy, B; Nehir, H; Altinoz, S; Yilmaz, O; Dundar, PE; Aydogan, AObjectives: We determined whether initial antithrombin (AT) levels help in diagnosis and prognosis of neonatal sepsis. Methods: Sepsis was diagnosed according to clinical and laboratory findings and positive culture results it? 34 of the 54 newborns who presented to the hospital with suspected sepsis. Between AT levels and hematological parameters (fibrinogen levels, prothrombin time (PT), activated partial thromboplastin time (alpha PTT) and liver function tests), these were correlated each other and with outcome of the babies. Results: Initial AT and fibrinogen levels were significantly lower in newborns with sepsis compared to control (P < 0.05). Initial AT levels ivere lower in the ones who developed disseminated intravascular coagulation (DIC) compared to those without DIC (P < 0.05). Initial AT levels ivere significantly lower in newborns who died as compared to survivors (P < 0.05). Sensitivity of AT was highest at 15 mg/dL for prognosis in neonatal sepsis (sensitivity:92.3%, specificity: 61.9%, positive predictive value : 61.9%, negative predictive value: 61.9%). Conclusion: Lower initial AT levels in neonatal sepsis are associated with a severe disease and increased mortality. It may be useful in predicting clinical outcome in neonatal sepsis.Item Epithelial Barrier Dysfunction and Innate Immune System Interaction in Allergic ResponseYuksel, H; Tayanc, E; Yilmaz, O; Yasar, A; Inan, SItem Assessment of the efficacy of absorbable adhesion barriers on dissection in esophagus operationsYilmaz, O; Genc, A; Taneli, F; Demireli, P; Deliaga, H; Taneli, CObjective: During childhood, recent repeated operations for esophagus are normally conducted if long gap esophageal atresia exists. During multistaged extrathoracic esophageal elongation procedure, the dissection of the esophagus poses severe problems due to adhesion. However, Gore-Tex membrane may simplify esophagus dissection. The most popular adhesion barriers used today are sodium hyaluronate, (Seprafilm(R); Genzyme Corp., Cambridge, MA) and oxidized regenerated cellulose (Interceed(R); Johnson Et Johnson Medical Inc., New Brunswick, NJ). The purpose of this study is to investigate the efficacy of adhesion barriers on esophagus dissection. Methods: In the study, 21 Wistar albino adult male rats were worked on. The rats were randomly divided into three groups, each including seven rats. About 1 cm-segment of the esophagus, located just behind the trachea, was dissected from the surrounding tissues through blunt dissection. Rats in group 1 were wrapped with Seprafilm(R), and in group 2 with Interceed(R). But the rats in group 3 underwent only esophagus dissection. Three weeks later, during esophagus dissection, adhesion scoring was performed and esophagus was divided into two parts: one for the assessment of hydroxyproline level, and the other for histological examination. Results: When the adhesion scores of the three groups were compared, there was not a significant difference between the groups (p = 0.75). In terms of tissue hydroxyproline levels, mean scores of hydroxyproline revealed no significant difference between the three groups (p = 0.19). When the histopathological results were examined, esophagus looked normal and no connective tissues were seen around esophagus. Conclusion: Seprafilm(R) and Interceed(R) had no effect on esophagus dissection. Although Seprafilm(R) had the best mean score, this was statistically insignificant. Gore-Tex might play a better role than Interceed(R) in preventing adhesion formation; however, it is still not certain whether adhesion barrier should be used in such organs as esophagus having no serosa. Published by Elsevier Ireland Ltd.Item Evaluation of sleep quality and anxiety-depression parameters in asthmatic children and their mothersYuksel, H; Sogut, A; Yilmaz, O; Demet, M; Ergin, D; Kirmaz, CBackground: Having a child with a chronic disease may cause anxiety and depression and impair the sleep quality in the mothers. The aim of this study was to evaluate sleep quality in asthmatic children and their mothers as well as the status of anxiety-depression in the mothers. Methods: Study group consisted of 75 asthmatic children aged between 7 and 16 years (mean +/- SD 8.4 +/- 2.9) and the control group consisted of 46 healthy children aged between 7 and 15 years (mean +/- SD 9.1 +/- 3.6). Pittsburgh Steep Quality Index (PSQI) was administered to both the children and their mothers white Hospital Anxiety and Depression Scale (HADS) was administered only to the mothers. Results: Total PSQI score of the mothers in the asthmatic group was significantly correlated with asthma severity of the children (r = 0.49, p = 0.00). There was a significant correlation between asthma symptom score and sleep disturbing factors subscore in children with asthma (r = 0.34, p = 0.01). Moreover, anxiety and depression subscores of the mothers in the asthma group were significantly higher (p = 0.02). Conclusion: Asthma may be associated with altered sleep quality in children and their mothers. Similarly, mothers of children with asthma may have disorder of anxiety and depression. Therefore, children with and their mothers need to be assessed for the requirement of support regarding steep quality and anxiety-depression status. (C) 2007 Elsevier Ltd. All rights reserved.Item Sonic hedgehog, TBX18, and TSHZ3 proteins involved in pyeloureteral motility development are overexpressed in ureteropelvic junction obstruction An immunohistochemical, histopathological, and clinical comparative studyYilmaz, O; Nese, N; Dalgic, M; Kesici, GP; Genc, A; Taneli, C; Gunsar, C; Sencan, A; Cayirli, H; Isisag, AObjectives: To compare pathological samples obtained from cases that underwent surgery for ureteropelvic junction (UPJ) obstruction with samples obtained during autopsies of subjects. Methods: Retrospectively, 42 patients who had undergone surgery due to UPJ obstruction (group 1) were included in the study. Histopathological and immunohistochemical features for sonic hedgehog (SHH), TBX18, and TSHZ3 of UPJ were evaluated and findings were compared with 20 autopsy cases (group 2). Results: In group 1, the scores were statistically significantly higher in terms of cytoplasmic SHH, nuclear TBX18, cytoplasmic and nuclear TSHZ3 staining. Statistically, no correlation was found between age and the staining scores belonging to these 3 antibodies in group 1 and group 2. Intense inflammation was found to be related with nuclear staining for TBX18. Conclusion: Gene product expressions of SHH, TBX18 and TSHZ3 are statistically higher in patients with UPJ obstruction, when compared with control group. The explanation may be the reactivation of the processes, which had shown their effects in the embryological period, due to the chronic inflammation and long-term micro-trauma created by the disease.Item Evaluation Of Vascular And Inflammatory Parameters In Differential Diagnosis Of Transient Tachypnea Of Newbron And Neonatal PneumoniaYilmaz, O; Kahraman, BA; Bilgili, G; Simsek, Y; Guvenc, Y; Cosar, H; Toksoz, R; Yuksel, HItem LAPAROSCOPIC TRANSPERITONEAL DISMEMBERED PYELOPLASTY BY UTILIZING V-LOC BARBED SUTUREYilmaz, O; Taneli, C; Ertan, P; Gurer, E; Genc, AItem Serum levels of spexin are increased in the third trimester pregnancy with gestational diabetes mellitusAkbas, M; Koyuncu, FM; Mete, TO; Taneli, F; Ozdemir, H; Yilmaz, OSpexin is a peptide that is involved in energy homeostasis and its expression is influenced by altered glucose metabolism. Gestational diabetes mellitus (GDM) is associated with increased insulin resistance (IR) and pregnancy is a progressive insulin resistant state. We hypothesized that spexin may have an effect on the pathophysiology of GDM which further could help to identify the disease. The aim of this study was to investigate spexin levels in the third trimester pregnancies with GDM and healthy controls. Thirty-nine women with GDM and 39 healthy singleton pregnancies were enrolled in this case-control study. Serum spexin concentrations were measured and correlated to biochemical and clinical parameters. Serum spexin levels were significantly higher in women with GDM (3686.25 +/- 348.37 vs. 3472.33 +/- 293.93 pg/ml, p=.004). Spexin levels did not differ significantly according to treatment modality. Moreover, spexin levels were significantly positively correlated with homeostasis model assessment of IR (HOMA-IR). Spexin levels were significantly higher in women with GDM and closely related to HOMA-IR in the third trimester pregnancy. This may help to better clarify the pathophysiological role of spexin in GDM.