Browsing by Author "Yuksel, H"

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    Prevalence of parasitic infections in children with allergic diseases and its relation with severity parameters
    Girgin, K; Yilmaz, O; Horasan, GD; Sogut, A; Kilimcioglu, A; Balcyoglu, C; Asar, K; Yuksel, H
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    Alterations in cross-epithelial barrier integrity and inhalant allergen sensitivity in children
    Yilmaz, O; Simsek, Y; Inan, S; Buga, O; Eskiizmirli, G; Pinar, E; Kanik, E; Yuksel, H
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    Effect of Subcutaneous Immunotherapy on The Natural Course of Allergic Diseases in Pediatric Patients: A Real-Life Cohort
    Yilmaz, O; Yasar, A; Simsek, Y; Alpdogan, S; Kunay, B; Yuksel, H
    Aim: 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.
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    Influence of VEGF and TNF antagonism on zonula occludens proteins in an experimental asthma model
    Yuksel, H; Yilmaz, O; Karaman, M; Firinci, F; Turkeli, A; Kanik, ET; Inan, S
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    Regulatory-T, T-Helper 1, and T-Helper 2 Cell Differentiation in Nasal Mucosa of Allergic Rhinitis with Olive Pollen Sensitivity
    Sogut, A; Yilmaz, O; Kirmaz, C; Ozbilgin, K; Onur, E; Celik, O; Pinar, E; Vatansever, S; Dinc, G; Yuksel, H
    Background: 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, Basel
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    Changes in epithelial barrier components E-cadherin, Beta-catenin, EGR with steroid treatment in murine model of asthma
    Yuksel, H; Yilmaz, O; Karaman, M; Firinci, F; Turkeli, A; Kanik, ET; Inan, S
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    Epithelial Barrier Dysfunction Related To Neutrophilic Inflammation In Non-Cystic Fibrosis Bronchiectasis
    Yilmaz, O; Simsek, Y; Aslan, C; Kanik, ET; Ulman, C; Yildiz, R; Ozdogru, E; Yuksel, H
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    TESTING THE PSYCHOMETRIC PROPERTIES OF THE TURKISH VERSION OF THE KINDL-R GENERIC HRQOL MEASURE FOR CHILDREN
    Eser, E; Yuksel, H; Baydur, H; Erhart, M; Saatli, G; Ozyurt, BC; Ravens-Sieberer, U
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    Effects of glucan treatment on the Th1/Th2 balance in patients with allergic rhinitis: a double-blind placebo-controlled study
    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-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.
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    Increased expression of angiogenic markers in patients with seasonal allergic rhinitis
    Kirmaz, C; Ozbilgin, K; Yuksel, H; Bayrak, P; Unlu, H; Giray, G; Kiliccioglu, B
    Background. Increased vascularity due to neo-angiogenesis is an essential part of airway remodelling. Vascular endothelial growth factor (VEGF), CD34 and von Willebrand's factor (FvW) are known angiogenic markers. Angiogenesis and airway remodelling has been documented in asthma but not in allergic rhinitis. Objective We aimed to investigate the presence of increased angiogenesis and its relation to angiogenic molecules, namely VEGF, CD34 and FvW, in endothelial cells of nasal mucosa in patients with seasonal allergic rhinitis (SAR), using three different immunohistochemical analysis methods, namely HSCORE, microvessel density (MVD) and vascular surface density (VSD). The findings in allergic rhinitis were compared with the findings in nasal septal deviation (NSD), which is not associated with increased angiogenesis. Methods. Twenty patients with symptomatic SAR, who were not under treatment, were enrolled in the study. Ten patients with NSD, who needed surgical therapy, served as the control group. Demographic characteristics did not differ between the two groups. Inferior turbinate biopsy was obtained from SAR patients and control patients, under local anaesthesia and during surgery respectively. All biopsies were evaluated for angiogenesis on the basis of VEGF, CD34 and FvW by two blinded histologists using three immumohistochemical analysis methods (HSCORE, MVD and VSD). Results. HSCORE, estimated on the basis of each staining technique, showed statistically significant differences among the two groups (p=0.002; p=0.045; p=0.016, respectively). Anti-CD34 and anti-VEGF showed higher MVD values in SAR when compared to the controls (p=0.038; p=0,009, respectively). No statistically significant difference was found in Anti-FvW-based MVD between SAR patients and controls (p=0.071). The measurements of VSD for FvW and VEGF from nasal biopsy specimens displayed a statistically significant difference between the two groups (p=0.004; p=0.0001, respectively). However, measurement of VSD for CD-34 was not significantly different between the groups (p=0.086). On the other hand, morphometric data obtained by all three methods did not correlated. Conclusion. There are a few studies that have investigated the essential role of angiogenesis in the pathogenesis of allergic rhinitis. We conclude that, increased angiogenesis may be as prominent in patients with allergic rhinitis as in patients with non-allergic nasal pathologies and may play an important role in the remodelling of nasal mucosa of subjects with SAR.
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    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 trial
    Ozturk, T; Acikel, A; Yilmaz, O; Topçu, I; Çevikkalp, E; Yuksel, H
    Study 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.
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    Is pulmonary arterial pressure affected by allergic rhinitis with nasal obstruction?
    Bayrak, P; Kirmaz, C; Sekuri, C; Yuksel, H
    Obstructive pathologies of the pulmonary tract may cause various levels of hypoxia. To compensate for the hypoxia, pulmonary arterial pressure and pulmonary arterial flow may increase. We investigated 35 patients with seasonal allergic rhinitis (AR) whether hypoxia caused by AR with a high level of obstruction in the airways may lead to an increased pulmonary arterial pressure. An echocardiographical evaluation was made following the determination of the symptomatic and non-symptomatic symptom scores. We found a positive correlation between the symptom scores both in the symptomatic and non-symptomatic periods, nasal obstruction scores and the mean pulmonary arterial pressures during these periods. Further studies with more cases are needed in order to determine the cardiac effects of hypoxia in AR, mainly pulmonary arterial hypertension.
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    Short-term effects of montelukast in stable patients with moderate to severe COPD
    Celik, P; Sakar, A; Havlucu, Y; Yuksel, H; Turkdogan, P; Yorgancioglu, A
    This study aims to investigate the possibility of additional value of leukotriene receptor antagonist (LTA) on dyspnea score, arterial blood gases (ABG), pulmonary function tests (PFTs), and quality of life (St. George QoL) in chronic obstructive pulmonary disease (COPD) patients. In this randomized, prospective, single-blind, and controlled study, 117 non-reversible COPD patients defined by global initiative for chronic obstructive lung disease (GOLD) criteria were randomized to receive ipratropium bromide, formoterol and montelukast (n:58, montelukast group) or ipratropium bromide and formoterol (n:59, control group) after a 2-week run-in period. There was no significant demographic difference between the two groups (P > 0.05). Baseline ABG, PFT, visual analoque scores r(VAS), and QoL scores were obtained and at first month and second month, PFT, VAS, and QoL scores were repeated and ABG was obtained at second month and the values were compared with baseline values. As the result of the comparision, there was significant increase in vital capacity, FVC, FEV1, VAS, and PaO2 parameters (P < 0.05), and a significant decrease in the QoL scores (P < 0.05) in the montelukast group. These parameters did not show any difference in the control group (P > 0.05). Sputum samples that could be obtained in 24 of the COPD patients were evaluated and in the montelukast group, there was a decrease in neutrophitic activity after treatment (n:13) (P <= 0.059). These results suggest that LTA that is used additionally in routine treatment protocol can produce additive improvement on PFr, dyspnea score and especially QoL in patients with stable COPD and for these reasons, LTA may be taken into account when there is need for an additional anti-inflammatory treatment in COPD patients. (c) 2004 Elsevier Ltd. All rights reserved.
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    Effects of allergen specific immunotherapy on functions of Th and Treg cells in patients with seasonal allergic rhinitis
    Kirmaz, C; Kirgiz, O; Degirmenci, P; Yilmaz, Ö; Vatansever, S; Ozbilgin, K; Onur, E; Celik, O; Sogut, A; Ay, G; Yuksel, H
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    Epithelial Barrier Dysfunction and Innate Immune System Interaction in Allergic Response
    Yuksel, H; Tayanc, E; Yilmaz, O; Yasar, A; Inan, S
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    Evaluation of sleep quality and anxiety-depression parameters in asthmatic children and their mothers
    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 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.
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    Evaluation Of Vascular And Inflammatory Parameters In Differential Diagnosis Of Transient Tachypnea Of Newbron And Neonatal Pneumonia
    Yilmaz, O; Kahraman, BA; Bilgili, G; Simsek, Y; Guvenc, Y; Cosar, H; Toksoz, R; Yuksel, H