Browsing by Author "Yilmaz O."
Now showing 1 - 20 of 120
Results Per Page
Sort Options
Item Histopathological evaluation of the urethra after the Snodgrass operation: An experimental study in rabbits(2002) Genç A.; Taneli C.; Günşar C.; Türkdoǧan P.; Yilmaz O.; Arslan O.A.; Mir E.Objective: To investigate the histopathological outcome of the incised urethral plate after tubularized incised-plate urethroplasty (the Snodgrass procedure to repair hypospadias) in a hypospadiac rabbit model, as it can produce meatal and neourethral strictures, and healing with scarring. Materials and methods: The study comprised 10 male New Zealand White rabbits (2.2-2.4 kg); under general anaesthesia the ventral urethra was completely excised 1 cm from the meatus proximally and a model of hypospadias formed. A full-thickness incision was then made in the distal dorsal urethra and the two sides of the incision marked by Indian ink tattooing. After placing a feeding tube (5 F) as a urethral catheter, both urethral wings were sutured ventrally by a 7/0 polydioxanone running suture, and the penile skin approximated by 5/0 chromic catgut. At 21 days and 3 months after surgery the penises were harvested. assessed histopathologically, and compared with those from control untreated rabbits of the same age and weight. Results: In the study group the incised area of the dorsal urethra was re-epithelialized; the regional tissue and vascularity were normal. Conclusion: In this rabbit model the dorsal urethral incisions healed with no scar tissue: only the ventral suture lines had minimal fibrosis and inflammatory reaction.Item Serum tumor growth factor-β1 levels in patients with cirrhosis, chronic hepatitis B and chronic hepatitis C(2004) Kirmaz C.; Terzioǧlu E.; Topalak O.; Bayrak P.; Yilmaz O.; Ersoz G.; Sebik F.Chronic liver disease and cirrhosis are two of the most important health problems according to current gastroenterology literature. Based on the recent developments in the field of immunology, advanced follow-up and treatment modalities have been introduced for these disorders. Immune defence against viral infections depends on effective cellular immune responses derived mainly from Th1-related cytokines. Th2 type immune responses can inhibit efficient immune function by secretion of several cytokines such as IL-10, TGF-β1. In this particular study, we determined the serum levels of TGF-β1, which plays a role in immune suppression and induction of tissue fibrosis. We evaluated the role of TGF-β1 in the pathogenesis of chronic liver disease and cirrhosis. Fourteen chronic hepatitis B (CHB), 12 chronic hepatitis C (CHC) patients and 21 cirrhotic patients were enrolled in the study. The control group consisted of ten healthy people. Serum TGF-β1 levels were higher in both cirrhosis and CHC group when compared to those in CHB and control groups (P < 0.05). Although serum TGF-β1 levels in the cirrhosis group were higher than that in the CHC group, the difference was not statistically significant. In conclusion, elevated TGF-β1 levels in patients with CHC and cirrhosis may have a role in the pathogenesis and chronicity of these diseases.Item Biochemical analysis of urethral collagen content after tubularized incised plate urethroplasty: An experimental study in rabbits(Springer Verlag, 2004) Taneli F.; Ulman C.; Genc A.; Yilmaz O.; Taneli C.The aim of the present study was the biochemical analysis of tissue hydroxyproline levels in incised urethral plates in order to show the total collagen content after the Snodgrass operation in the hypospadiac rabbit model. The study comprised 21 male New Zealand rabbits, (2.2-2.4 kg). The animals were randomly allocated to three groups each containing seven rabbits as follows: group 1, the ventral urethra was completely excised and a model of hypospadias formed. A full-thickness incision was made on the distal dorsal urethra, a feeding tube was placed as an urethral catheter and both urethral wings were sutured ventrally. Group 2, inserting an iris knife into the urethra, the ventral wall was incised mimicking an urethrotome. Group 3 consisted of normal control rabbits to determine the basal tissue hydroxyproline level. A slight increase in the hydroxyproline level was observed in the ventral part of the urethral tissue compared to the dorsal part in both groups 1 and 2; however, these differences were not significant. After the Snodgrass operation in the rabbit model, no significant differences were observed in the hydroxyproline levels of the dorsal and ventral parts of the urethra or between these and of the controls. Further studies are required in order to determine the mechanism underlying urethral healing through normal re-epithelization without excess collagen deposition after incised urethral plate urethroplasty.Item Effect of adhesion barrier (Interceed TC7) on two-stage orchidopexy operation(2004) Genc A.; Taneli F.; Yilmaz O.; Turkdogan P.; Arslan O.A.; Sencan A.; Taneli C.Objective: In two-stage orchidopexy, adhesions formed after the first stage usually cause difficulty during the second operation and may even lead to injury to the testis itself or to the spermatic cord. We investigated whether the use of adhesion-preventing barriers in the abdominal or pelvic region during surgery could lessen adhesions formed during two-stage orchidopexy and thus ease dissection. Material and Methods: The study subjects comprised 21 male, albino, 30-day-old Wistar rats that were divided into three equal groups. In Group 1, the right testes were enveloped in adhesion barriers after dissection and sutured to the inguinal canal. In Group 2, the right testes were sutured to the inguinal canal without the barriers. In Group 3 (sham-operated group), all testes were dissected but no suturing was performed. Rats were sacrificed after 21 days and the ipsilateral testes were harvested. Results: Dissection of barrier-enveloped testes was relatively easy; however, no significant (p < 0.535) difference was seen in adhesion scores between Groups 1 and 2. Total tissue collagen was estimated by means of the hydroxyproline content. Tissue hydroxyproline levels were 16.04 ± 8.58, 13.20 ± 6.34 and 14.71 ± 5.51 μg/mg wet tissue in Groups 1-3, respectively and these differences were not significant. The histopathologic evaluation revealed significant differences only in the thickness of the tunica albuginea in Groups 1 and 2 (110.0 ± 30.0 vs 77.1 ± 21.3 μm, respectively; p < 0.038). Conclusion: The adhesion scores and the biochemical and histopathological examinations showed that an adhesion barrier is not beneficial in two-stage orchidopexy.Item The effect of spermatic vessel ligation on testicular nitric oxide levels and germ cell-specific apoptosis in rat testis(Elsevier GmbH, 2005) Taneli F.; Vatansever S.; Ulman C.; Yilmaz O.; Giray G.; Genç A.; Taneli C.Management of high testis may vary but the most popular method in surgical treatment is the Fowler-Stephens maneuver. The aim of the present study was to investigate the effects of spermatic vessel ligation on testicular nitric oxide (NO) levels, expression of inducible nitric oxide synthase (iNOS), and endothelial nitric oxide synthase (eNOS) and germ cell-specific apoptosis in both ipsilateral and contralateral testes in rats. Twenty-eight animals were randomly allocated into four groups (n=7 each). The spermatic vessels were ligated as a simulation of the Fowler-Stephens maneuver. The groups of animals were sacrificed at 2 h (group 1), 4 h (group 2) and 24 h (group 3) after ligation, respectively. Sham-operated animals served as controls (group 4). Biochemical assessment of testicular NO levels was performed by the Griess method. iNOS and eNOS expression and apoptosis were studied in ipsilateral and contralateral testes. Testicular NO levels at 24 h after the simulated Fowler-Stephens maneuver were found to be significantly increased in both ipsilateral and contralateral testes when compared with the sham-operated group. eNOS expression was clearly increased in ipsilateral testes, whereas moderate expression was detected in the contralateral seminiferous tubules at 24 h after ligation. Mild focal iNOS immunostaining was also observed in seminiferous tubules of the ipsilateral testis at 24 h after the simulated Fowler-Stephens maneuver. Apoptosis was dramatically increased in ipsilateral testes; however, it was only detected in single cells in the contralateral side at 24 h after ligation. In conclusion, the simulated Fowler-Stephens maneuver induces testicular nitric oxide synthesis and germ cell-specific apoptosis in the ipsilateral testis. These results suggest that high levels of NO induce apoptosis and may impair spermatogenesis thus explaining the unsuccessful outcome of the Fowler-Stephens maneuver. © 2004 Elsevier GmbH. All rights reserved.Item Effects of glucan treatment on the Th1/Th2 balance in patients with allergic rhinitis: A double-blind placebo-controlled study(2005) Kirmaz C.; Bayrak P.; Yilmaz O.; Yuksel H.Background. 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-γ) are known to suppress this Th2 immune response, aiding the treatment of these diseases. β-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-γ 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-γ 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 Evaluation of histologic changes in the urinary tract of hypercalciuric rats(2006) Akil I.; Kavukçu S.; Inan S.; Yilmaz O.; Atilla P.; Işlekel H.; Neşe N.; Müftüoǧlu S.Idiopathic hypercalciuria (IH) has been speculated to have a predisposing role in the development of urinary tract infection (UTI), due to the uroepithelial cell damage it leads to. In this study, we aimed to investigate the effects of hypercalciuria on the bladder, ureters, and kidneys in rats with experimentally induced hypercalciuria. Normocalcemic hypercalciuria was induced by furosemide (60 mg/100 mL of drinking water) administration to 16-week-old male Wistar Albino rats for 14 days. Calciuria (calcium/creatinine ratio, mg/mg, Ca/Cr) increased from 0.07±0.01 at the beginning of administration to 0.41±0.1 on day 14 (p=0.000). The Ca/Cr ratio was 0.14±0.06 at the beginning of the study and 0.25±0.06 on day 14 in the control group rats (p=0.002 vs. the hypercalciuric group rats on day 14). Bladder, ureter, and kidney specimens of the rats, dissected on the 14th day, were fixed in 10% formalin and 2.5% gluteraldehyde solutions for light and electron microscopic examination, respectively. Histopathological and ultrastructural examination of the hypercalciuric rats revealed proliferation and apical cytoplasmic vacuole formation in transitional epithelial cells, mitotic activity in the intermediate cell line, vasodilatation, edema, and separation of collagen fibers in the bladder and ureter specimens. Light microscopic examination of the kidney specimens revealed a lot of erythrocyte in the glomerular capillary lumen, while electron microscopy revealed vacuolization of proximal and distal tubules, tubular degeneration, interstitial edema, and vasodilatation. In this study, hypercalciuria was observed to have adverse effects on the cell architecture of the uroepithelium and disruption of the epithelial barrier of the bladder and ureters and all kidney structures, especially on the proximal epithelial cells. © IPNA 2006.Item Interaction of two public health problems in Turkish schoolchildren: Nutritional deficiencies and goitre(2006) Ersoy B.; Günes H.S.; Gunay T.; Yilmaz O.; Kasirga E.; Egemen A.Objective: The aim of the present study was to determine the interaction of and association between frequency of goitre detected by palpation, nutritional status evaluated by anthropometric indices and socio-economic status in school-aged children. Subjects: One thousand and eighteen prepubertal and pubertal children (aged 6-14 years) attending primary schools in an urban area were included in this study. Design and setting: All subjects were evaluated for the presence of goitre and nutritional status. Thyroid size was assessed using the World Health Organization's (WHO) palpation system (1960). Severity of protein-energy malnutrition (PEM) was based on WHO criteria. Children were grouped into four categories of socio-economic status. Results: Eight per cent of children were detected to have goitre by palpation. Body mass index and weight-for-height were significantly lower in children who had palpable goitre than in children who did not have goitre (P < 0.05). Frequencies of having palpable goitre and being stunted and underweight were especially higher in children with very low socio-economic status (P = 0.016, 0.01 and 0.01, respectively). Frequency of being stunted, underweight and wasted in children with palpable goitre did not change significantly according to socio-economic status (P > 0.05). In logistic regression analyses, the most important factor in detection of palpable goitre was socio-economic status (B = 0.517, P = 0.004). Fathers' education and occupation were found to be most significant (P = 0.031 and 0.020, respectively). Conclusion: Children detected to have palpable goitre were thinner. However, nutritional disorders were not more frequent among children with palpable goitre compared with children without goitre. Goitre and nutritional deficiencies were more common in children with lower socio-economic status but the frequency of nutritional disorders in children with palpable goitre did not change according to socio-economic status. © The Authors 2006.Item Frequency of gastroesophageal reflux disease in nonatopic children with asthma-like airway disease(2006) Yüksel H.; Yilmaz O.; Kirmaz C.; Aydogdu S.; Kasirga E.Gastroesophageal 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 24 h 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. © 2005 Elsevier Ltd. All rights reserved.Item Long-term effect of pentoxifylline and NG-nitro-L-arginine methyl ester on testicular function in spermatic artery ligation(2006) Yilmaz O.; Genc A.; Taneli F.; Demireli P.; Kocakoc I.D.; Sencan A.; Gunsar C.; Mir E.; Taneli C.Objective. To investigate long-term testicular function in pentoxifylline- and NG-nitro-L-arginine methyl ester (L-NAME)-treated rats prior to spermatic artery ligation by assessing serum inhibin B concentration, a reliable endocrine marker of spermatogenesis. Material and methods. Forty prepubertal rats were randomly divided into four equal groups. Right orchiectomy was performed in all rats. Intraperitoneal pentoxifylline and L-NAME were administered to Groups 1 and 2, respectively. Rats in Group 3 did not receive any medication. The spermatic arteries of the left testes were ligated in all groups with the exception of the sham controls (Group 4). One month postoperatively, a histopathologic evaluation was performed and serum inhibin B concentrations were assessed in all groups. Results. There were no statistically significant differences in testis size or serum inhibin B concentration between Groups 1, 2 and 3. However, the testes were significantly smaller (p1=0.01, p2=0.01, p3 =0.01) and serum inhibin B levels were significantly decreased (p1=0.01, p2 =0.01, p3 =0.01) when Groups 1-3 were compared with Group 4. Histopathological evaluations revealed necrosis and calcification in all specimens with the exception of the sham-operated group. Conclusions. The long-term outcomes of spermatic artery ligation were poor and testicular atrophy developed in rat testes in all study groups. Testicular atrophy could not be reversed by preoperative administration of pentoxifylline and L-NAME. © 2006 Taylor & Francis.Item Influence of oral intake of Saccharomyces boulardii on Escherichia coli in enteric flora(2006) Akil I.; Yilmaz O.; Kurutepe S.; Degerli K.; Kavukcu S.Enteric 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. © IPNA 2006.Item Evaluation of sleep quality and anxiety-depression parameters in asthmatic children and their mothers(2007) Yuksel H.; Sogut A.; Yilmaz O.; Demet M.; Ergin D.; Kirmaz C.Background: 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 Sleep Quality Index (PSQI) was administered to both the children and their mothers while 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 sleep quality and anxiety-depression status. © 2007 Elsevier Ltd. All rights reserved.Item Pulmonary hemosiderosis with normocomplementemic urticarial vasculitis in a child(PI-ME Tipografia Editrice S.r.l., 2007) Yuksel H.; Yilmaz O.; Savas R.; Kirmaz C.; Sogut A.; Özalp S.Pulmonary hemosiderosis is rarely associated with urticarial vaculitis especially if normocomplementemic. An eigth year old girl presented with relapsing and remitting chronic and persistent urticarial lesions, conjunctival injection, recurrent cough and hemoptysis. Respiratory findings started at seven years of age. Physical examination revealed diffuse skin lesions mainly settled on the extremites, nonpurulent conjunctival injection, rare ronchi and fine crackles in bilateral lower zones of the lungs. Biopsy of the urticaria like skin lesions demonstrated leukocytoclastic vasculitis. Rheumatological markers were negative. Levels of complement fractions 3 and 4 were normal. Chest x-ray demonstrated diffuse alveolar infiltrative images. High Resolution Computed Tomography of the chest revealed diffuse ground-glass appearance, increased interstitial density. Diagnostic flexible fiberoptic bronchoscopy was performed and bronchoalveolar lavage fluid revealed hemosiderin laden alveolar macrophages. She was started on systemic corticosteroid treatment. During follow up, pulmonary symptoms disappeared, however skin lesions and conjunctival symptoms persisted and exacerbated four times in two years. CT of lungs after two years of treatment revealed rare patchy areas of ground glass appearance in bilateral lower lobes and right upper lobe as well as a few of milimetric pleural nodules. This patient is still followed up under low dose steroids and pulmonary findings regressed but low grade inflammation due to vasculitis is thought to continue as supported by the persistence of tomographic findings in the lungs despite the absence of any symptoms. This case demonstrates association of urticarial vasculitis and pulmonary hemosiderosis in the setting of normocomplementemia.Item Improvement in symptoms of psoriasis in a child after treatment with grass pollen specific allergen immunotherapy(Dermatologia Pediatrica, 2007) Sogut A.; Yilmaz O.; Yuksel H.Psoriasis is a chronic inflammatory disease of skin in which Th1 lymphocytes have a central role. Similar to all inflammatory diseases, additional inflammation may lead to the exacerbation of manifestations. Allergic asthma is the chronic eosinophilic inflammatory disease of the bronchial mucosa in which Th2 lymphocyte activity predominates. A nine year old boy who had been under conventional topical treatment for psoriasis without improvement for three months, presented to the outpatient department with recurrent cough, dyspnea and wheezing of one year duration. The physical examination revealed white plaques on extensor surfaces of elbows and knees as well as prolonged expirium and wheezing. Positive allergen skin prick test against "olea europea" and "fraxinus excelsior" pollens were observed. Inhaled steroids and allergen specific immunotherapy were initiated with the diagnosis of allergic asthma. Psoriatic findings regressed without requirement for an additional topical treatment during follow up along with asthma findings. As a conclusion, inflammatory stress of allergic asthma may aggravate psoriasis and treatment with allergen specific immunotherapy may help decrease findings of psoriasis.Item Increased expression of tissue vascular endothelial growth factor and foetal liver kinase-1 receptor in seasonal allergic rhinitis and relevance to asthma component(2007) Yuksel H.; Kose C.; Yilmaz O.; Ozbilgin K.; Degirmenci P.B.; Pinar E.; Kirmaz C.Background: There is a difference in the extent of remodelling in allergic rhinitis (AR) and asthma. This may be attributed to the difference in local tissue response to these mediators. Objectives: The aim of this study was to compare vascular endothelial growth factor (VEGF) and its receptor foetal liver kinase (Flk)-1 expression between seasonal AR patients with or without asthma and non-allergic controls as well as that between AR patients with and without asthma. Methods: Thirteen subjects with seasonal AR and six non-allergic controls were included in the study. Allergic sensitization was demonstrated by a skin prick test. Inferior turbinate thiny biopsies were obtained from both groups. Monoclonal mouse antibodies were used to demonstrate VEGF and Flk-1. Nasal mucosal endothelial cells' staining intensity was graded semi-quantitatively and the histochemical score (HSCORE) was calculated. In all samples, VEGF- and Flk-1-labelled vessels were counted for the assessment of vascular surface density (VSD). Results: The mean HSCORE for VEGF and anti-VEGF-based VSD were significantly higher in the patient group (P=0.001 and 0.002, respectively). The mean HSCORE for Flk-1 and anti-Flk-1-based VSD in the patient group were significantly higher than those in the control group (P=0.016 and 0.028, respectively). Differences between the mean HSCORE for VEGF and anti-VEGF-based VSD in patients with pure AR and AR and asthma were insignificant (P=0.16 and 0.39, respectively). The mean HSCORE for Flk-1 and anti-Flk-1-based VSD in patients with pure AR were significantly lower than those in patients with AR and asthma (P=0.004 and 0.018, respectively). Conclusion: Angiogenic factor VEGF and its receptor Flk-1 is increased in AR. A similar increase in VEGF in AR with and without asthma despite a higher Flk-1 in AR patients with asthma may be a possible explanation for the presence of angiogenesis in the airway wall in patients with asthma but not in those with pure AR. © 2007 Blackwell Publishing Ltd.Item A pediatric case of pyomyositis presenting with septic pulmonary emboli(2007) Yuksel H.; Yilmaz O.; Orguc S.; Yercan H.S.; Aydogan D.Pyomyositis is a suppurative infection of skeletal muscle most commonly caused by Staphylococcus aureus. It is mainly encountered in children and immunocompromised. Eight year old previously healthy girl presented with confusion, fever and swelling of the right knee two days after a trauma. Abdominal ultrasonography and computerized tomography taken upon development of hematemesis revealed no pathology in the abdomen, but potential bleeding sites in lung sections. Thorax CT images were interpreted in favor of septic pulmonary emboli due to the presence of peripheral nodular consolidation areas with central cavitation, mostly pathchy in medial areas. S. aureus was isolated in the blood culture. At the end of third week of hospitalization, gadolinium enhanced contrast MRI of right extremity was taken to evaluate right extremity swelling and revealed abcess formation as expected in the clinical progress of pyomyositis. Pyomyositis and septic pulmonary emboli are a rare association. This case demonstrates that the high index of suspicion in pediatric cases with muscle findings and septic pulmonary findings and early institution of therapy may improve the prognosis. © 2007 Elsevier Masson SAS. All rights reserved.Item Prognostic value of initial antithrombin levels in neonatal sepsis(2007) Ersoy B.; Nehir H.; Altinoz S.; Yilmaz O.; Dundar P.E.; Aydogan A.Objectives: 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 in 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 (aPTT) 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 were lower in the ones who developed disseminated intravascular coagulation (DIC) compared to those without DIC (P <0.05). Initial AT levels were 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 The frequency of wheezing phenotypes and risk factors for persistence in aegean region of Turkey(2007) Yuksel H.; Sakar A.; Dinç G.; Yilmaz O.; Gozmen S.; Yorgancioglu A.; Ozcan C.The aim of the study was to determine the prevalence of wheezing and evaluate the risk factors for its persistence in children. Survey data was collected on 725 children aged 17 years or below. The mean age was 8.94 ± 5.16 years; 22.1% of them were reported to have had a wheezing episode at any point in their lives. A wheezing episode was reported in 18.1% of children 3 years of age or younger and persisted in 51% of these subjects; 69.6% of ever wheezers had late onset wheezing. Persistence was significantly common in males. Perinatal disease, lack of breast feeding, and low income were significant risk factors for persistence. In summary, breast feeding, perinatal disease, and income status may be significant risk factors influencing wheezing peristence and consequent asthma. Copyright © 2007 Informa Healthcare.Item A case of primary pulmonary tuberculosis presenting as foreign body aspiration(IOS Press, 2007) Ikizoǧlu T.; Yilmaz O.; Özkol M.; Söǧüt A.; Yüksel H.An 18-month-old child was hospitalized with presumptive diagnosis of foreign body aspiration. Chest radiography revealed atelectasis in the right lower lobe. Foreign body was not seen at rigid bronchoscopy. Tuberculin skin test was 11 mm with one scar of Bacillus Calmette-Guerin vaccine. Computerized tomography of thorax revealed conglomerating lymphadenopathy in the right hilus and calcified lymphadenopathy as well as pneumonic consolidation of the right lower lobe. Tuberculosis was diagnosed based on his tuberculin skin test and thorax computerized tomography. This case is presented to emphasize that tuberculosis should be included to the differential diagnosis of children that present with signs and symptoms of foreign body aspiration and atelectasis. © 2007 IOS Press. All rights reserved.Item Assessment of the efficacy of absorbable adhesion barriers on dissection in esophagus operations(2007) Yilmaz O.; Genc A.; Taneli F.; Demireli P.; Deliaga H.; Taneli C.Objective: 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®; Genzyme Corp., Cambridge, MA) and oxidized regenerated cellulose (Interceed®; Johnson&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®, and in group 2 with Interceed®. 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® and Interceed® had no effect on esophagus dissection. Although Seprafilm® had the best mean score, this was statistically insignificant. Gore-Tex might play a better role than Interceed® in preventing adhesion formation; however, it is still not certain whether adhesion barrier should be used in such organs as esophagus having no serosa.