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Mutaf C, Ocak B, Inal A, Hazar L, Gokyigit B. Treatment of Infantile Esotropia - Comparison Between Botulinum Toxin A and Bilateral Medial Rectus Recession. Beyoglu Eye J 2024; 9:20-25. [PMID: 38504960 PMCID: PMC10944856 DOI: 10.14744/bej.2024.90958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/22/2024] [Accepted: 02/05/2024] [Indexed: 03/21/2024]
Abstract
Objectives The objective of the study is to evaluate the examination findings, treatment methods, and follow-up results of children diagnosed with infantile esotropia (IE) and to compare botulinum toxin A (BTA) and bilateral medial rectus (MR) recession surgery. Methods We retrospectively reviewed the medical records of patients who were diagnosed with IE. The age of the patient and the angle of deviation were taken into account to determine the treatment. Patients who underwent bilateral MR recession surgery and BTA injection were analyzed and the BTA and surgical groups were compared. Successful correction was defined as orthotropia and a deviation of up to 10 prism diopters (PD) after one surgical procedure or 1-3 botulinum injections. Results Two hundred and forty-six patients with esotropia were included in the study. Twelve were followed up with refractive correction only. BTA injection was administered to 110 patients, while 124 patients underwent bilateral MR recession. The age of the patients ranged from three to 39 months. Patients were followed for at least 6 months, with a mean follow-up of 24.3 months in the BTA group and 21.7 months in the surgical group (p=0.23). The mean pre-treatment angle deviation was 38.9 PD in the BTA group and 40.1 PD in the surgical group (p=0.62). The success rate for patients with more than 30 PD of deviation was 72% in the surgical group compared to 36% in the BTA group (p<0.001). No statistically significant difference in success rate was observed in patients with deviations <30 PD (surgery 62%, BTA 55%, p=0.26). Conclusion Surgical treatment of IE was more successful than BTA injection in patients with large angle deviations (>30 PD). BTA injection can be considered as an alternative to surgery in cases of small to moderate angle deviations (<30 PD).
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Affiliation(s)
- Cagri Mutaf
- Department of Ophthalmology, Harran University Faculty of Medicine, Sanlıurfa, Turkiye
| | - Bulut Ocak
- Department of Ophthalmology, Dunya Eye Hospital, Istanbul, Turkiye
| | - Asli Inal
- Department of Ophthalmology, Beyoglu Eye Training and Research Hospital, Istanbul, Turkiye
| | - Leyla Hazar
- Department of Ophthalmology, Dicle University Faculty of Medicine, Diyarbakir, Turkiye
| | - Birsen Gokyigit
- Department of Ophthalmology, Yeni Yuzyil University, Istanbul, Turkiye
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Ocak OB, Inal A, Aygit ED, Celik S, Yurttaser Ocak S, Gurez C, Basgil Pasaoglu I, Gokyigit B. Comparison of different tendon transposition techniques for the treatment of monocular elevation deficiency type 2. J AAPOS 2020; 24:8.e1-8.e4. [PMID: 31901510 DOI: 10.1016/j.jaapos.2019.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 09/08/2019] [Accepted: 09/23/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE To compare results of three different tendon transposition techniques (Knapp procedure and two modified techniques) for the treatment of type 2 monocular elevation deficiency (MED) patients. METHODS The medical records of patients with MED type 2 operated on at a single institution from 2000 to 2016 were reviewed retrospectively. Patients were divided into three vertical transposition groups: (1) full tendon width, (2) augmented surgery; and (3) partial tendon width. Surgical success was defined as no severe limitation of upgaze, hypotropia of <6Δ, and no hypertropia in primary position. Pre- and postoperative vertical deviations in the primary position and limitations in elevation levels were compared. RESULTS A total of 39 patients were included. The pre- and postoperative deviations in the full-tendon group were 22.50Δ ± 4.17Δ and 3.50Δ ± 1.27Δ, respectively; in the augmented surgery group, 23.75Δ ± 4.78Δ and 1.75Δ ± 1.14Δ; and in the partial-tendon group, 20.50Δ ± 3.98Δ and 4.12Δ ± 2.78Δ. Corrected vertical deviations were 19Δ, 23Δ, and 16Δ, respectively. The pre- and postoperative limitation of elevations were -2.80 and -0.80 in the full-tendon group, -3.20 and -0.90 in the augmented surgery group, and -2.37 and -1.12 in the partial-tendon group. The pre- and postoperative vertical deviation improvements and limitations of elevation were statistically significant (P < 0.05) in all groups. Success was achieved in 29 patients (74%). CONCLUSIONS In this study cohort, all three procedures were reasonably effective in improving vertical deviations and limitation of elevation.
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Affiliation(s)
- Osman Bulut Ocak
- University of Health Sciences, Beyoğlu Eye Research and Training Hospital, İstanbul, Turkey.
| | - Asli Inal
- University of Health Sciences, Beyoğlu Eye Research and Training Hospital, İstanbul, Turkey
| | - Ebru Demet Aygit
- University of Health Sciences, Beyoğlu Eye Research and Training Hospital, İstanbul, Turkey
| | - Selcen Celik
- University of Health Sciences, Beyoğlu Eye Research and Training Hospital, İstanbul, Turkey
| | - Serap Yurttaser Ocak
- University of Health Sciences, Okmeydani Research and Training Hospital, İstanbul, Turkey
| | - Ceren Gurez
- University of Health Sciences, Beyoğlu Eye Research and Training Hospital, İstanbul, Turkey
| | - Isil Basgil Pasaoglu
- University of Health Sciences, Beyoğlu Eye Research and Training Hospital, İstanbul, Turkey
| | - Birsen Gokyigit
- University of Health Sciences, Beyoğlu Eye Research and Training Hospital, İstanbul, Turkey
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Ocak OB, Inal A, Tülü Aygün B, Kırmacı Kabakci A, Kemer Atik B, Yurttaser Ocak S, Gökyiğit B. Refraction under general anesthesia in children, using cycloplegic refraction only as a reference. Strabismus 2020; 28:73-78. [PMID: 31985321 DOI: 10.1080/09273972.2020.1714669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To compare the measurements of cycloplegic refraction and refraction (R1-1) under general anesthesia (GA) when using the same portable auto-refractometer (ARF) in pediatric patients. METHODS 36Thirty-six to 60-month-old patients who underwent refraction measurements using a portable ARF (Retinomax® K plus 3, Righton, Japan), who did not receive prior cycloplegics under this GA and who had cycloplegic refraction using 1% cyclopentolate and the same Retinomax® device < 3 months prior this GA, between 2015 and 2018, were included in this study. The agreement (Bland-Altman analysis) and correlation (Pearson correlation) between the mean values of the measurements were analyzed. RESULTS Two-hundred-twenty-two right eyes of 222 patients (114 male and 108 female) were included in this study. The mean age was 45.04 ± 11.24 months. The mean spherical refractions (R1-1, R2-1) under GA and cycloplegic refraction were 1.08 ± 3.50 diopter (D) (-8.00 to +8.00) and 2.58 ± 3.28 D (-6.50 to +9.25), respectively. A strong positive correlation was detected between the two measurements (r = 0.95). When comparing measurements, the mean measurement under GA was -1.49 D (95% confidence interval: lower limit, -3.63; upper limit, +0.63) more myopic than the mean cycloplegic refraction (R1-1) value (Bland-Altman analysis test). The differences between the measurements were within ± 1 D in 92 eyes (41.44%) and within ± 2 D in 180 eyes (81.01%). No significant difference was detected when comparing the cylindrical refractive error values (p > .05). CONCLUSION Refractive measurements under GA were more myopic than cycloplegic refraction (R1-1) measurements. It is important to consider that complete cycloplegia is not achieved under GA.
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Affiliation(s)
- Osman Bulut Ocak
- Beyoglu Eye Training and Research Hospital, University of Health Sciences , Istanbul
| | - Asli Inal
- Beyoglu Eye Training and Research Hospital, University of Health Sciences , Istanbul
| | - Beril Tülü Aygün
- Beyoglu Eye Training and Research Hospital, University of Health Sciences , Istanbul
| | - Aslı Kırmacı Kabakci
- Okmeydanı Training and Research Hospital, University of Health Sciences , Istanbul
| | - Burcu Kemer Atik
- Gaziosmanpaşa Taksim Training and Research Hospital, University of Health Sciences , Istanbul
| | - Serap Yurttaser Ocak
- Okmeydanı Training and Research Hospital, University of Health Sciences , Istanbul
| | - Birsen Gökyiğit
- Beyoglu Eye Training and Research Hospital, University of Health Sciences , Istanbul
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Inal A, Gokyigit B, Ocak OB, Aygit ED, Celik S. Vertical rectus muscle union combined with lateral rectus plication for complete abducens nerve palsy. Int Ophthalmol 2019; 40:423-429. [PMID: 31646412 DOI: 10.1007/s10792-019-01200-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 10/19/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study was to report our postoperative results concerning the vertical rectus (VR) muscle union combined with lateral rectus (LR) plication for the treatment of large-angle esotropia (ET) in complete abducens nerve palsy. METHODS Medical records from 36 patients who had undergone the VR union procedure for ET treatment due to sixth-nerve palsy between July 2014 and July 2018 at Beyoglu Eye Research and Training Hospital were reviewed. One week before surgery, all patients underwent a 4-IU botulinum toxin A (btx) injection into the ipsilateral medial rectus (MR). All patients then underwent a VR muscle union procedure. A non-absorbable suture was inserted through the lateral muscular margin of each VR muscle at approximately 1/5 the width from the edge at 10 mm distance from the VR insertion. Both sutures were then tied to each other above the LR. Plication of the LR muscle using a non-absorbable suture was performed in all cases. RESULTS The study population consisted of 14 (38.9%) females and 22 (61.1%) males. The mean age was 36.31 ± 19.16 years. The mean preoperative deviation angle in primary gaze into distance was 47.77 ± 18.48 prism diopter (PD). The mean deviation angle 1 year after surgery was - 1.0 ± 6.62 PD. Abduction improved from - 4.27 ± 0.46 to - 1.88 ± 0.96. CONCLUSION The VR muscle union in combination with LR plication appears to be an effective treatment procedure for complete abducens nerve palsy patients.
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Affiliation(s)
- Asli Inal
- Strabismus Department, Beyoglu Eye Research and Training Hospital, University of Health Sciences, Bereketzade Mahallesi, Bereketzade Cami Sk. 2/4, 34437, Beyoğlu, İstanbul, Turkey.
| | - Birsen Gokyigit
- Strabismus Department, Beyoglu Eye Research and Training Hospital, University of Health Sciences, Bereketzade Mahallesi, Bereketzade Cami Sk. 2/4, 34437, Beyoğlu, İstanbul, Turkey
| | - Osman Bulut Ocak
- Strabismus Department, Beyoglu Eye Research and Training Hospital, University of Health Sciences, Bereketzade Mahallesi, Bereketzade Cami Sk. 2/4, 34437, Beyoğlu, İstanbul, Turkey
| | - Ebru Demet Aygit
- Strabismus Department, Beyoglu Eye Research and Training Hospital, University of Health Sciences, Bereketzade Mahallesi, Bereketzade Cami Sk. 2/4, 34437, Beyoğlu, İstanbul, Turkey
| | - Selcen Celik
- Strabismus Department, Beyoglu Eye Research and Training Hospital, University of Health Sciences, Bereketzade Mahallesi, Bereketzade Cami Sk. 2/4, 34437, Beyoğlu, İstanbul, Turkey
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Pasaoglu I, Satana B, Altan C, Artunay O, Basarir B, Onmez FE, Inal A. Lamina cribrosa surface position in idiopathic intracranial hypertension with swept-source optical coherence tomography. Indian J Ophthalmol 2019; 67:1085-1088. [PMID: 31238417 PMCID: PMC6611274 DOI: 10.4103/ijo.ijo_1736_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose: The purpose of this study is to compare the thickness and depth measurements of the lamina cribrosa (LC) obtained using a swept-source optical coherence tomography (SS-OCT) device in idiopathic intracranial hypertension (IIH) patients and healthy subjects. Methods: This retrospective, cross-sectional observational study included 16 eyes with IIH and 20 control eyes. The LC measurements with serial horizontal B scans of the optic nerve head were obtained using SS-OCT (Topcon 3D DRI OCT Triton). The anterior lamina surface (ALS) depth, posterior lamina surface (PLS) depth, and LC thickness measurements were evaluated. Results: In patients with IIH, the mean ALS depth was 225.00 ± 58.57 μm and the mean PLS depth was 449.75 ± 63.50 μm. In the IIH control group, the corresponding values were 359.40 ± 105.38 and 570.10 ± 99.41 μm (P < 0.05). The difference in LC thickness between the IIH and control subjects was not statistically significant. Conclusion: LC can be evaluated using an SS-OCT device. LC was displaced anteriorly in patients with IIH compared with normal controls. The assessment of LC level with SS-OCT in IIH cases is a valuable and reproducible adjunctive imaging method in terms of diagnosis and follow-up.
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Affiliation(s)
- Isil Pasaoglu
- Department of Neuro-Ophthalmology, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - Banu Satana
- Department of Neuro-Ophthalmology, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - Cigdem Altan
- Department of Neuro-Ophthalmology, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - Ozgur Artunay
- Department of Neuro-Ophthalmology, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - Berna Basarir
- Department of Neuro-Ophthalmology, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - Funda E Onmez
- Department of Neuro-Ophthalmology, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - Asli Inal
- Department of Neuro-Ophthalmology, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
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Inal A, Yilmaz I, Ocak OB, Aygit ED, Celik S, Pasaoglu I, Yilmaz BS, Gokyigit B. Optical Coherence Tomography Angiography: Are There Any Changes in Measurements After Strabismus Surgery? J Pediatr Ophthalmol Strabismus 2019; 56:95-100. [PMID: 30889263 DOI: 10.3928/01913913-20190128-01] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 11/26/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the possible hemodynamic changes following strabismus surgery via optical coherence tomography angiography. METHODS Thirty-two eyes of 16 patients who underwent strabismus surgery in one eye were included in the study. Fellow eyes were used as a control group. The vessel densities of the superficial and deep capillary plexus and superficial and deep foveal avascular zones were measured preoperatively and 3 months postoperatively. RESULTS The mean superficial and deep foveal avascular zones measurements were 0.84 ± 0.09 and 0.76 ± 1.13 mm2, respectively. The mean vessel density of the superficial capillary plexus was 1.23 ± 0.12 and 11.13 ± 1.04 mm2 preoperatively in the 1- and 3-mm zones, respectively, whereas the mean vessel density of the deep capillary plexus was 1.13 ± 0.16 and 10.11 ± 1.28 mm2 preoperatively. Postoperatively, the mean superficial and deep foveal avascular zones changed to 0.20 ± 0.13 and 0.23 ± 0.12 mm2, respectively. Postoperatively, the mean vessel density of the superficial capillary plexus changed to 1.47 ± 0.11 and 12.75 ± 1.10 mm2, and the mean vessel density of the deep capillary plexus changed to 1.56 ± 0.12 and 13.91 ± 1.35 mm2 in 1- and 3-mm zones, respectively. There was a statistically significant increase in vessel density measurements of the superficial and deep capillary plexus, and a statistically significant decrease in measurements of the superficial and deep foveal avascular zone postoperatively (P < .05). In the fellow eyes, there was no statistically significant change in any of the measurements (P > .05). CONCLUSIONS Following strabismus surgery, vessel density of the fovea may increase and the foveal avascular zone may decrease according to optical coherence tomography angiography measurements. [J Pediatr Ophthalmol Strabismus. 2019;56(2):95-100.].
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Ocak OB, Inal A, Aygit ED, Celik S, Ocak SY, Karabulut GO, Gokyigit B. Surgical Management in Type 1 Monocular Elevation Deficiency. J Pediatr Ophthalmol Strabismus 2018; 55:369-374. [PMID: 30074607 DOI: 10.3928/01913913-20180620-04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 04/20/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the outcome of surgical treatment in patients with type 1 monocular elevation deficiency. METHODS Patients who were diagnosed as having type 1 monocular elevation deficiency by forced duction test and exaggerated traction test between 2000 and 2016 were retrospectively reviewed. Epidemiologic and clinical features of the patients were noted. The efficacy of ipsilateral inferior rectus recession to vertical misalignments and limitation of elevation were evaluated. The clinical features of the patients who did not achieve surgical success after inferior rectus recession were determined. The surgical and functional results of contralateral superior rectus recession were evaluated for patients who had residual hypotropia under inferior rectus recession. RESULTS Thirty-nine patients were included in the study. Preoperatively, vertical deviations were 20.53 ± 4.50 prism diopters (PD) for near and 22.21 ± 5.12 PD for distance. After inferior rectus recession, the amount of vertical deviation corrected was 15 ± 1.14 PD for near and 17.01 ± 2.00 PD for distance. Ten (25.64%) patients did not achieve surgical success (> 6 PD residual hypotropia). Nine patients (preoperative inferior rectus recession measurements = 28.77 ± 7.25 PD for near and 27 ± 7.44 PD for distance) underwent contralateral superior rectus recession as a second surgery. After contralateral superior rectus recession, 7 of 9 (77.78%) patients achieved surgical success. The limitation of elevation significantly improved after both surgeries (Wilcoxon test, P < .05). No diplopia or other complications after surgeries were reported. CONCLUSIONS Inferior rectus recession is the first surgical option for patients with type 1 monocular elevation deficiency. Contralateral superior rectus recession is an effective alternative surgical treatment for residual hypotropia after ipsilateral inferior rectus recession. [J Pediatr Ophthalmol Strabismus. 2018;55(6):369-374.].
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Inal A, Ocak OB, Aygit ED, Celik S, Ozturk Karabulut G, Inal B, Taskapili M, Gokyigit B. Medial Rectus Bridge Faden Operations in Accommodative and Partially Accommodative Esotropia With Convergence Excess. J Pediatr Ophthalmol Strabismus 2017; 54:369-374. [PMID: 28991347 DOI: 10.3928/01913913-20170801-03] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 05/08/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the results of the bilateral bridge Faden operation on the medial rectus muscles with and without recession in the treatment of accommodative and partially accommodative esotropia with convergence excess. METHODS A retrospective analysis was performed on the medical records of 103 patients who underwent the bridge Faden operation on both medial rectus muscles, with or without recession, for the treatment of accommodative and partially accommodative esotropia with convergence excess. Preoperative and postoperative near and distance deviations and near-distance disparities were evaluated. RESULTS The study population consisted of 38 (37%) girls and 65 (63%) boys. The mean age was 9.32 ± 5.83 years (range: 1 to 18 years) and the mean follow-up period was 14.49 ± 2.78 months. Fifty-one patients underwent the bridge Faden operation on both medial rectus muscles with recession (recession group) and 52 patients underwent the bridge Faden operation on both medial rectus muscles without recession (no recession group). The mean preoperative amount of esotropia at near was 43.51 ± 7.00 and 24.24 ± 3.56 prism diopters (PD) for the recession and no recession groups, respectively. The mean preoperative amount of esotropia at distance was 26.63 ± 6.86 and 9.22 ± 2.09 PD for both groups, respectively. The mean preoperative near-distance disparity was 17.14 ± 3.00 and 14.05 ± 4.14 PD for both groups, respectively. In both groups, there was a statistically significant difference in the near and distance deviations and the near-distance disparity between preoperative and postoperative values (P < .05). Postoperatively, there was no significant difference between 1 month, 6 months, and 1 year and between 6 months and 1 year (P > .05). CONCLUSIONS The bridge Faden operation on both medial rectus muscles either with or without recession was a successful surgical procedure in patients with accommodative and partially accommodative esotropia. During the follow-up period, the success rates did not decrease. [J Pediatr Ophthalmol Strabismus. 2017;54(6):369-374.].
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Inal A, Ocak OB, Aygit ED, Yilmaz I, Inal B, Taskapili M, Gokyigit B. Comparison of visual acuity measurements via three different methods in preschool children: Lea symbols, crowded Lea symbols, Snellen E chart. Int Ophthalmol 2017. [PMID: 28639088 DOI: 10.1007/s10792-017-0596-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of this study was to compare three different methods to measure visual acuity (VA) in healthy and amblyopic preschool children: a Snellen E chart (SE), a single Lea symbols (SLS), and a crowded Lea symbols (CLS). METHODS Seventy-eight eyes of 54 patients (28 females, 26 males) were included in this cross-sectional, comparative study. The control group consisted of 30 healthy cases, and the amblyopic group consisted of 24 patients with amblyopia. Best-corrected VA (BCVA) measurements with SLS, CLS, and SE were compared in control eyes (CE), amblyopic eyes (AE), and fellow eyes (FE) separately. RESULTS The mean age of the cohort was 5.7 ± 0.7 years (range 5-7 years). The mean refractive error was +1.02 ± 0.36 D (diopter, spherical equivalent) in CE, +5.59 ± 2.45 D in AE, and +3.96 ± 2.38 D in FE. The median BCVA (logMAR) was (in order of SLS, CLS, and SE) 0.00 [interquartile range (IQR) 0.10], 0.10 (IQR 0.10), 0.00 (IQR 0.10) in CE, 0.25 (IQR 0.33), 0.35 (IQR 0.30), 0.25 (IQR 0.38) in AE, and 0.10 (IQR 0.08), 0.10 (IQR 0.00), 0.10 (IQR 0.10) in FE. There was no statistically significant difference between the three methods in terms of the CE or FE (p > 0.05). In contrast, there was a statistically significant difference in AE (p < 0.05). The mean VA measurement with SLS was higher compared with CLS in AE. A positive and strong correlation between the three charts was found in all of the groups (p < 0.001). CONCLUSION We found SLS, CLS, and SE to be consistent: all three methods can be used to obtain measurements of VA in healthy and amblyopic preschool children.
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Affiliation(s)
- Asli Inal
- University of Health Sciences Prof. Dr. N. Reşat Belger Beyoglu Eye Research and Training Hospital, Istanbul, Turkey.
| | - Osman Bulut Ocak
- University of Health Sciences Prof. Dr. N. Reşat Belger Beyoglu Eye Research and Training Hospital, Istanbul, Turkey
| | - Ebru Demet Aygit
- University of Health Sciences Prof. Dr. N. Reşat Belger Beyoglu Eye Research and Training Hospital, Istanbul, Turkey
| | - Ihsan Yilmaz
- University of Health Sciences Prof. Dr. N. Reşat Belger Beyoglu Eye Research and Training Hospital, Istanbul, Turkey
| | - Berkay Inal
- University of Health Sciences Okmeydanı Research and Training Hospital, Istanbul, Turkey
| | - Muhittin Taskapili
- University of Health Sciences Prof. Dr. N. Reşat Belger Beyoglu Eye Research and Training Hospital, Istanbul, Turkey
| | - Birsen Gokyigit
- University of Health Sciences Prof. Dr. N. Reşat Belger Beyoglu Eye Research and Training Hospital, Istanbul, Turkey
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Aygit ED, Kocamaz M, Inal A, Fazil K, Ocak OB, Akar S, Gokyigit B. Management of Duane retraction syndrome with prismatic glasses. Clin Ophthalmol 2017; 11:697-700. [PMID: 28442887 PMCID: PMC5396923 DOI: 10.2147/opth.s124183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To report the results of using prismatic glasses for Duane retraction syndrome (DRS). METHODS Data were obtained from the records of patients who were evaluated during the year 2000 in the Strabismus Unit of the Beyoglu Eye Training and Research Hospital. The average follow-up was 12.2±17.7 months. In all cases, 2 main variables were evaluated: horizontal deviation in the primary position and face turn. Prismatic glasses were provided to patients according to the degree of shift in the primary position. RESULTS The mean age of patients was 11.2 years. An analysis was performed on the data collected from 12 cases; 7 patients were females (58.3%) and 5 were males (41.7%), with 11 (91.7%) cases being of type I DRS. All 12 patients had abnormal head posture (face turn) and an angle of mean deviation equaling 10 PD (prism dioptri). CONCLUSION Treatment was individualized on a case-by-case basis. Prismatic glasses are useful for eliminating abnormal head posture and ocular misalignment in selected cases.
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Affiliation(s)
- Ebru Demet Aygit
- Strabismus Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - Murat Kocamaz
- Strabismus Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - Asli Inal
- Strabismus Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - Korhan Fazil
- Strabismus Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - Osman Bulut Ocak
- Strabismus Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - Serpil Akar
- Ophthalmology Department, Medicine Faculty, Baskent University, Istanbul, Turkey
| | - Birsen Gokyigit
- Strabismus Department, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
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Ertas SK, Inal A, Keklik M, Ozkul Y, Akalin H, Canoz I, Kontas O, Baran M, Civgin S, Kaynar L, Eser B, Cetin M. PP-015 IMPACT ON PROGNOSIS OF K-RAS MUTATION AND C-MYC OVEREXPRESSION AT DIFFUSE LARGE B-CELL LYMPHOMAS. Leuk Res 2014. [DOI: 10.1016/s0145-2126(14)70069-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Keskin D, Keskin G, Inal A, Ozışık L. Serum angiostatin levels in patients with Behçet's disease: does angiogenesis play a role in the pathogenesis of Behçet's disease? Acta Clin Belg 2014; 69:246-50. [PMID: 25012748 DOI: 10.1179/2295333714y.0000000030] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Angiogenesis plays an important role in the pathogenesis of inflammatory diseases, but the possible role of angiogenesis in Behçet's disease (BD) has not yet been studied. The aim of this study was to determine angiostatin levels in patients with BD and the role of angiogenesis in the pathogenesis of the disease. Thirty-seven patients with BD (mean age: 28·6±5·4 years, mean disease duration: 9·3±3·7 years) and 18 healthy controls were enrolled to the study. Twenty-four patients were in active and 13 patients were in inactive stage of the disease. The mean serum angiostatin level of patients with BD was 113·9±53·2 and 60·7±20·1 ng/ml in healthy controls. The mean serum angiostatin level was 142·7±43·1 ng/ml in active and 86·9±15·5 ng/ml in inactive patients with BD. Serum angiostatin levels were significantly high in patients with BD compared with healthy controls (P<0·001) and it was significantly high in active patients compared with inactive patients with BD (P<0·001). In inactive patients with BD, serum angiostatin concentrations were found to be higher compared with healthy controls (P<0·01). In active BD patients, the mean serum angiostatin level was correlated with the deep vein thrombosis (r = 0·482, P = 0·05), uveitis (r = 0·582, P = 0·01), and arthritis (r = 0·492, P = 0·05). According to these results; elevated serum angiostatin levels in patients with BD suggest the possible role of angiogenesis in the pathogenesis of the disease and its high levels in inactive Behçet's patients is related with the continuous activation of the disease even in the subclinical period.
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13
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Geredeli C, Artac M, Yildirim S, Dede I, Inal A, Guler T, Boruban M, Zamani A, Bozcuk H, Demirkazik A. P0146 The prognostic role of XRCC1, ERCC1, ERCC2, and TP53 single nucleotide polymorphisms in resected non-small-cell lung cancer. Eur J Cancer 2014. [DOI: 10.1016/j.ejca.2014.03.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Gunay Y, Inal A, Yener N, Sinanoglu O, Selvi O, Bircan HY. A novel mechanism of anti-T-lymphocyte globulin mediated by fractalkine in renal ischemia-reperfusion injury in rats. Transplant Proc 2014; 45:2461-8. [PMID: 23953563 DOI: 10.1016/j.transproceed.2013.02.118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 01/18/2013] [Accepted: 02/16/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Ischemia-reperfusion injury (IRI) is among the main challenges in kidney transplantation. It causes delayed graft function and graft loss in long-term follow-up studies. Anti-T lymphocyte globulin (ATG), a common induction immunosuppressive, has been used in kidney transplantation to prevent rejection. Fractalkine (FKN) is among the main chemokines involved in IRI. This study was designed to identify the relationship between ATG and FKN after warm ischemia in rat kidneys. METHODS Rats were divided into three groups: Control, IRI+normal saline(NS) and IRI+ATG. After IRI was initiated, rats received a dose of ATG or NS during surgery as well as two more doses at 24 and 48 hours after surgery. All rats were humanely killed at 72 hours. RESULTS The concentration of FKN as well as dendritic cells (DC) and macrophages were lower in both peripheral blood and the injured kidney among ATG-treated versus control rats. Additionally cell necrosis, cytoplasmic vacuolization, cast formation, and tubular dilatation were improved among ATG-treated rats. Serum creatinine levels were lower in rats that received ATG. CONCLUSION ATG depleted the concentration of FKN, which inhibits migrations of DCs and macrophages into the kidney, and reduces IRI-related pathology.
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Affiliation(s)
- Y Gunay
- Florence Nightingale Hospital, Liver Transplanation center, Istanbul, Turkey.
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15
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Bircan HY, Inal A, Ozcelik U, Koc B, Demirag A, Moray G, Kemik O. LigaSure® versus clamp tie technique for thyroid surgery; decreased operative time versus increased inflammatory effect: a prospective randomized study. Eur Rev Med Pharmacol Sci 2014; 18:1997-2005. [PMID: 25027338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The aim of this study was to compare the LigaSure® Small Jaw Instrument (LSJI) with the conventional clamp-and-tie (CT) technique in thyroid surgery regarding complication rates (hematoma, hypocalcemia and recurrent nerve palsy), the duration of the operative procedure, and systemic and local inflammatory effects. PATIENTS AND METHODS Fifty-four consecutive patients were randomized prospectively into two groups, a Conventional Clamp-Tie (CT) group and a LigaSure® Vessel Sealing System (LVSS) Group. Pre- and postoperative blood plasma samples were taken to measure the tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), calcium, parathormon, CRP levels and WBC, as well as the lymphocyte subset (CD3, CD4, CD8, CD16/56, CD19) counts. The drain fluid samples were collected after the removal of the drains to measure the levels of IL-6 and TNF-α. RESULTS Both groups showed significant changes regarding peripheral blood CD3+, CD4+, and CD8+ T cell levels (p < 0.05). In the LVSS group, the level of CD16+56+ NK cells showed a significant decrease compared with the CT group (p < 0.05). The IL-6 and TNF-α levels in the drainage fluid were significantly higher in the LVSS group. CONCLUSIONS We demonstrated that LSJI can decrease operative time. Although the systemic inflammatory effect of LSJI remains inconclusive, the local inflammatory effect was significant, which could cause early and late postoperative problems.
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Affiliation(s)
- H Y Bircan
- Department of Surgery, Baskent University, Faculty of Medicine, Istanbul Research Hospital, Istanbul, Turkey. ozgurkemik @hotmail.com
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16
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Kucukoner M, Arpaci E, Isikdogan A, Bilici M, Uncu D, Cetin B, Dane F, Inanc M, Ekinci AS, Inal A, Cayir K, Yetisyigit T, Ozdemir N, Kaplan MA, Aksoy S, Alkıs N, Tekin SB, Eroglu C, Turhal S, Buyukberber S. Prognostic analysis of patients with operable gastric cancer and tolerability to adjuvant radio-chemo-therapy. Neoplasma 2013; 60:19-25. [PMID: 23067212 DOI: 10.4149/neo_2013_003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The aim of this study is to evaluate the tolerability and toxicity of adjuvant chemoradiotherapy (CRT) and to analyze the prognosis in patients with operable gastric cancer. The retrospective analysis included 723 patients with operable gastric cancer; stage IB-IV (M0), received adjuvant CRT from 8 Medical Centers in Turkey between 2003 and 2010. The patients' age, sex, tumor localization, Lauren classification, grade and stage of the disease, type of dissection, the toxicity and tolerability status and survival rate were analyzed. All patients were divided into two groups as tolerable group to adjuvant CRT and intolerable group to adjuvant CRT .Among the patient, 73.9% had stage III-IVM0 disease; 61.0% had the intestinal type of gastric cancer, 51.1% had the distal type, and 61.4% had undergone D2 dissections. The number of patients who completed the entire course of the adjuvant CRT was 545 (75.4%).The median follow-up period was 20.8 months (range: 1.5-107 months). Overall Survival (OS) rates were 80% and 52%, while the relapse free survival (RFS) rates were 75% and 48% at 1 and 3 years, respectively.In the univariate analysis of the groups based on the the age defined as <65 or ≥ 65 (p=0.16 / p=0.003), Lauren classification (p=0.004 / p<0.001), localization of tumor (p=0.02 / p=0.04), tumor grade (p=0.06 / p=0.003), disease stage (p<0.001 / p<0.001), type of dissection (p=0.445 / p=0.043), presence or absence of toxicity (p=0.062 / p=0.077) and tolerability of the therapy (p=0.002 / p=0.001). In the cox regression analysis, tumor stage (Hazard Ratio (HR): 0.332; 95% confidence interval (CI): 0.195-0.566; p<0.001), and tolerability (HR: 0.516; 95% CI: 0.305-0.872; p=0.014), were found to be related with the OS. Tumor stage (HR: 0.318; 95% CI: 0.190-0.533; p=<0.001) and tolerability (HR: 0.604; 95% CI: 0.367-0.995; p=0.048) were observed to be statistically significant in terms of the RFS.We have observed that whether a patient can or cannot tolerate adjuvant CRT due to its toxicity is an independent prognostic factor besides the known prognostic factors like tumor stage and Lauren classification. We are of the opinion that the treatment of patients who cannot tolerate adjuvant CRT should be replaced with less toxic adjuvant therapies.
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Affiliation(s)
- M Kucukoner
- Dicle University, Medical Oncology Department, Diyarbakir, Turkey.
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17
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Bulent Akinci M, Algin E, Inal A, Odabas H, Berk V, Coskun U, Uyeturk U, Isikdogan A, Aksoy S, Civelek B, Sevinc A, Buyukberber S. Sequential adjuvant docetaxel and anthracycline chemotherapy for node positive breast cancers: a retrospective study. J BUON 2013; 18:314-320. [PMID: 23818340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE Anthracyclines and taxanes are the most active agents in the adjuvant treatment of breast cancer (BC). They can be used simultaneously or sequentially. The optimal schedule and duration for their administration is unknown. We analyzed the efficacy of sequential adjuvant anthracycline and docetaxel administration in node positive BC patients. METHODS Node positive BC patients (N=539) from 6 medical oncology centers in Turkey who received sequential adjuvant anthracycline-based regimens and taxane chemotherapy were included in this study between 2006 - 2010. One-hundred and thirty-eight (25%) patients received 3 cycles of anthracycline-based chemotherapy followed by 3 cycles of docetaxel (3+3) and 401 (75%) patients received 4 cycles of anthracycline-based chemotherapy followed by 4 cycles of docetaxel (4+4). Prognostic factors analyzed were estrogen receptor (ER), progesterone receptor (PR), HER2, tumor grade, and nodal status in relation to disease free survival (DFS) and HER2 status in relation to overall survival (OS). RESULTS The patient median age was 48 years (range 18-79). Most common grade 3-4 toxicities were neutropenia, mucositis and arthralgia. No treatment-related toxic deaths were seen. With a median follow up of 26 months (range 1-115) 61 (11.3%) recurrences and 11 (2%) deaths were registered. Three-year DFS was 81% and OS 96% for all patients. There was no statistically significant difference between 3+3 and 4+4 groups in terms of survival (3-year DFS 88% and 79% [p=0.28] and OS 97% and 95% [p=0.60), respectively). CONCLUSION Sequential chemotherapy with 4+4 cycles of anthracycline and docetaxel every 3 weeks is an acceptable regimen for adjuvant treatment of node positive BC patients. Duration of chemotherapy should be planned depending on prognostic factors. In this study there was no difference between 3+3 and 4+4 groups in DFS and OS despite the presence of good prognostic factors in the 3+3 group.
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Affiliation(s)
- M Bulent Akinci
- Ankara Numune Educational Hospital Department of Medical Oncology, Ankara, Turkey
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Inal A, Akman T, Yaman S, Demir Ozturk S, Geredeli C, Bilici M, Inanc M, Harputoglu H, Demirci U, Balakan O, Yesil Cinkir H, Alici S, Uysal Sonmez O, Goksel G, Gokoz Dogu G, Umit Unal O, Tamozlu T, Buyukberber S, Melih Boruban C, Isikdogan A. Endocrine therapy alone vs. chemotherapy plus endocrine therapies for the treatment of elderly patients with endocrine-responsive and node positive breast cancer: a retrospective analysis of a multicenter study (Anatolian Society of Medical Oncology). J BUON 2013; 18:64-69. [PMID: 23613390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE The extra benefit of adding chemotherapy to effective endocrine therapy (ET) has not been clearly or consistently identified in patients older than 70 years with estrogen receptor (ER) positive and node positive breast cancer. The aim of this study was to evaluate the efficacy of adjuvant ET vs. chemotherapy plus endocrine therapies (Chemo/ET) in such patients. METHODS In this retrospective multicenter study 191 patients ≥ 70 years with operated hormone receptor breast cancer, who were administered adjuvant ET or Chemo/ET were assessed. RESULTS The median patient follow-up time was 29.0 months (range 1-252). Therefore disease free survival (DFS) and overall survival (OS) analysis was limited, due to the rather short median follow-up, and only 30-month cumulative percentages are reported herein. The 30-month DFS rates were 50.0% in the ET arm and 49.0% in the Chemo/ET arm (p=0.79). The 30-month OS rates were 86% in the ET arm and 96.0% in the Chemo/ET arm (p=0.08). Cox proportional hazard model showed that only surgery was independent prognostic factor for survival (p=0.047), while tumor size showed a strong trend for statistical significance (p=0.051). CONCLUSION The addition of chemotherapy to endocrine therapy in older patients has no significant impact on DFS and OS.
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Affiliation(s)
- A Inal
- Dicle University, Department of Medical Oncology, Diyarbakir, Turkey.
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19
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Inal A, Kucukoner M, Kaplan MA, Urakci Z, Karakus A, Komek H, Dostbil Z, Isikdogan A. Prognostic value of fluorine-18 fluorodeoxyglucose positron emission tomography in patients with advanced non-small cell lung cancer: single center experience. J BUON 2012; 17:724-728. [PMID: 23335532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE The purpose of this retrospective single-center study was to evaluate the prognostic implication on overall survival (OS) of the F-18 FDG PET scan in locally advanced or metastatic non small cell lung cancer (NSCLC) patients. METHODS We retrospectively reviewed 120 locally advanced or metastatic NSCLC patients (December 2004-November 2011) treated/followed at the Dicle University, School of Medicine, Department of Medical Oncology. SUVmax and other potential prognostic variables (n=18) were chosen for analysis. Univariate and multivariate analyses were conducted to identify prognostic factors for OS. RESULTS Among 18 variables of univariate analysis, 6 were identified to bear prognostic significance: sex (p=0.01), performance status (PS) (p =0.03), stage (p=0.04), bone metastases (p=0.002), serum albumin (p=0.01) and blood glucose level (p=0.03). Multivariate analysis showed that PS, bone metastases and serum albumin level were independent prognostic factors for OS (p=0.01, p=0.004, p=0.003, respectively). CONCLUSION PS, serum albumin levels and bone metastases were independent prognostic factors, while FDG uptake of the primary lesion was not associated with prognosis of OS in locally advanced or metastatic NSCLC patients.
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Affiliation(s)
- A Inal
- Department of Medical Oncology, Dicle University, Diyarbakir, Turkey.
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Kaplan M, Inal A, Kucukoner M, Urakci Z, Ekici F, Firat U, Isikdogan A. Cranial Magnetic Resonance Imaging (MRI) in the Staging of HER2-Positive Breast Cancer Patients. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32952-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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21
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Inal A, Kaplan MA, Kucukoner M, Isikdogan A. Docetaxel and Cisplatin Plus Fluorouracil compared with Modified Docetaxel, Cisplatin, and 5-Fluorouracil as first-line therapy for advanced gastric cancer: a retrospective analysis of single institution. Neoplasma 2012; 59:233-6. [PMID: 22248282 DOI: 10.4149/neo_2012_030] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Gastric cancer is the second most common among cancer-related deaths in the world. Systemic chemotherapy for patients with gastric cancer has limited impact on overall survival. We performed a retrospective analysis of the efficacy and side effects of Docetaxel and Cisplatin Plus Fluorouracil (DCF) versus Modified-Dose Docetaxel, Cisplatin, and 5-Fluorouracil (mDCF) in the metastatic gastric cancer with first-line chemotherapy treated patients. Retrospectively were reviewed 107 locally advanced or metastatic gastric cancer patients who were treated DCF or mDCF as first-line treatment from June 2007 to August 2011 in Dicle University Hospital, Department of Medical Oncology.The DCF protocol included 75 mg/m2 docetaxel and cisplatin on day 1 and 750 mg/m2/day 5-FU infusion for 5 days, repeated every 3 weeks. The mDCF protocol included 60 mg/m² docetaxel and cisplatin on day 1 and 600 mg/m² 5-Fluorouracil continuous infusion per day on days 1-5, every 3 weeks.Patients were treated using DCF arm 85 (M: 56, F: 29), the mDCF arm 22 (M: 13, F: 9) After treatment toxicities were: Grade III-IV neutropenia (48.2% vs 13.6% p=0.003), anemia (21.2% vs 4.5% p=0.06), nausea (44.7% vs 13.6% p=0.008) and vomiting (31.8% vs 4.5%, p=0.01) was higher in the DCF arm. Other toxicities profile was similar in both groups (p>0.05). The rate of response was similar in both arm. Among patients with the DCF and mDCF arm rate complete response (10.3% vs 6.7%, p>0.05), partial response (35.3% vs 40.0%, p>0.05), stable disease (32.4% vs 33.3%, p>0.05), progressive disease (22.1% vs 20.0%, p>0.05) and overall response (45.6% vs 46.7%, p>0.05) did not have a statistically difference (p>0.05). Progression-free survival (PFS) and overall survival (OS) were more favorable in the DCF arm than mDCF arm, but the difference was not significant statistically (9.9 vs 8.6, 7.4 vs 6.5 p>0.05)In conclusion, the response rate, median PFS and median OS are similar in both arms, while the mDCF regimen are more favorable than the DCF for toxicity profile regimen in advanced gastric cancer patients who were undergoing first-line palliative treatment. Therefore, a prospective and larger clinical trials are needed.
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Affiliation(s)
- A Inal
- Dicle University, Department of Medical Oncology, Diyarbakir, Turkey.
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Inal A, Kaplan MA, Kucukoner M, Karakus A, Isikdogan A. Prognostic factors in elderly patients with advanced non-small cell lung cancer treated with first-line cisplatin-based chemotherapy: a retrospective analysis of single institution. J BUON 2012; 17:533-536. [PMID: 23033295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE Non-small cell lung cancer (NSCLC) makes up 80-85% of all lung cancers cases. Lung cancer in older individuals is frequently undertreated. Patients eligible for cisplatin- based chemotherapy should be selected carefully. The aim of this retrospective single-center study was to evaluate prognostic factors for overall survival (OS) in elderly (≥65 years) patients with advanced NSCLC who received first-line cisplatin-based chemotherapy. METHODS We retrospectively reviewed 110 elderly patients with locally advanced or metastatic NSCLC who had been administered cisplatin-based first-line chemotherapy between December 2004 and November 2011. Seventeen potential prognostic variables were chosen for analysis. Univariate and multivariate analyses were conducted to identify prognostic factors associated with OS. RESULTS Among the 17 variables of univariate analysis, 4 were identified to have prognostic significance for OS: comorbidities (p<0.001), Eastern Cooperative Oncology Group (ECOG) performance status (PS) (p=0.02), first-line chemotherapy cycles (p<0.001) and serum albumin level (p=0.04). Multivariate analysis showed that only ECOG PS (p=0.01) was independent prognostic factor for OS. CONCLUSION PS was important prognostic factor in elderly patients with advanced NSCLC. The findings of this study may facilitate pretreatment prediction of OS and therefore can be used for selecting the most appropriate treatment for elderly patients.
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Affiliation(s)
- A Inal
- Department of Medical Oncology, Dicle University, Diyarbakir, Turkey.
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Zincircioglu SB, Kaplan MA, Isikdogan A, Cil T, Karadayi B, Dirier A, Kucukoner M, Inal A, Yildiz I, Aggil F, Donmez O, Urakci Z, Pekkolay Z, Firat U. Contribution of low-molecular weight heparin addition to concomitant chemoradiotherapy in the treatment of glioblastoma multiforme. J BUON 2012; 17:124-127. [PMID: 22517705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE Glioblastoma multiforme (GBM) is the most common brain tumor in adults and has a very aggressive course. Median survival is as short as 2 years with standard treatment (chemoradiotherapy followed by adjuvant temozolomide). The purpose of this study was to determine the contribution of low molecular weight heparin (LMWH) addition to concomitant chemoradiotherapy in the treatment of GBM. METHODS All patients with newly diagnosed GBM between March 2004-May 2009 were evaluated. After surgical intervention (total, subtotal resection or only biopsy) all of them were treated with concomitant chemoradiotherapy (2 Gy daily, 5 days a week, 30 fractions, total tumor dose 60 Gy; and 75 mg/m² temozolomide, 7 days a week), followed by adjuvant temozolomide (6 cycles, 150-200 mg/m², 5 days every 28 days), with or without LMWH (4000 IU/day, 7 days a week, concomitant with radiotherapy) because of risk of thrombosis. The primary endpoint was the determination of progression-free survival (PFS) and overall survival (OS); secondary endpoints were 1- and 2-year OS survival. RESULTS 30 patients (13 patients in the group non receiving LMWH (LMWH-) and 17 patients in the group receiving LMWH (LMWH+)) were included in the study. Median age was 54 years (range 24-75). Median PFS was 57 and 38 weeks in LMWH+ and LMWH- groups, respectively (p=0.068). Median OS was 69 and 44 weeks (p=0.095), 1-year OS survival 84.6 and 41.2% (p=0.016), and 2-year OS survival 38.5 and 5.9% in LMWH+ and LMWH-, respectively (p=0.061). No significant difference was noted between the two groups for grade 3-4 toxicity (p>0.05). CONCLUSION Better PFS, OS and 2-year OS survival were obtained in present study with the addition of LMWH to concomitant chemoradiation for GBM but without statistical significance. One-year OS survival was statistically significant favoring the LMWH group. The addition of LMWH did not increase temozolomide toxicity.
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Affiliation(s)
- S B Zincircioglu
- Department of Radiation Oncology, Dicle University, Diyarbakir, Turkey
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Inal A, Kos FT, Algin E, Yildiz R, Berk V, Tugba Unek I, Colak D, Colak D, Kucukoner M, Tamer Elkiran E, Helvaci K, Geredeli C, Dane F, Balakan O, Ali Kaplan M, Gok Durnali A, Harputoglu H, Goksel G, Ozdemir N, Buyukberber S, Gumus M, Ozkan M, Benekli M, Isikdogan A. Prognostic factors in patients with advanced pancreatic cancer treated with gemcitabine alone or gemcitabine plus cisplatin: retrospective analysis of a multicenter study. J BUON 2012; 17:102-105. [PMID: 22517701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE The majority of patients with pancreatic cancer present with advanced disease. Systemic chemotherapy for patients with pancreatic cancer has limited impact on overall survival (OS). Patients eligible for chemotherapy should be selected carefully. The aim of this study was to analyse prognostic factors for OS in advanced pancreatic cancer patients treated with first-line palliative chemotherapy with gemcitabine alone or gemcitabine plus cisplatin. METHODS We retrospectively reviewed 343 locally advanced or metastatic pancreatic cancer patients who were treated with gemcitabine or gemcitabine plus cisplatin as first-line chemotherapy between December 2000 and June 2011. Fifteen potential prognostic variables were chosen for analysis. Univariate and multivariate analyses were conducted to identify prognostic factors associated with OS. Univariate and multivariate statistical methods were used to determine prognostic factors. RESULTS Among the 15 variables of univariate analysis, 6 were identified to have prognostic significance: stage (p<0.001), cholestasis (p=0.02), weight loss, prior pancreatectomy, serum CEA level (p<0.001) and serum CA19-9 level (p>0.001). In addition, age, chemotherapy and liver metastasis were of borderline significance (p=0.06). Multivariate analysis (Cox proportional hazard model) included the 6 significant prognostic factors of univariate analysis and showed that stage was independent prognostic factor for OS, as were weight loss, and serum CEA level. CONCLUSION Stage, weight loss, and serum CEA level were identified as important prognostic factors for OS in advanced pancreatic cancer patients. These findings may also facilitate pretreatment prediction of OS and can be used for selecting patients for treatment.
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Affiliation(s)
- A Inal
- Dicle University, Department of Medical Oncology, Diyarbakir, Turkey.
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25
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Kaplan MA, Inal A, Kucukoner M, Urakci Z, Isikdogan A. P4-17-08: Is Cranial Magnetic Resonance Imaging (MRI) Necessary for Staging of Asymptomatic HER2−Positive Breast Cancer Patients? Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p4-17-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Breast cancer one of the most common tumors of the adults. Approximately 20% to 25% of all breast cancers are HER2−positive. It can be assumed that up to 30% of HER2−positive metastatic breast cancer (MBC) patients may experience brain metastasis during the course of their disease. The aim of this study to investigate that whether cranial MR is necessary for staging in asymptomatic HER2−positive breast cancer patients.
Material and metods: HER2−positive breast cancer patients without symptoms of brain metastasis included in the study. Cranial MRI was added to the staging procedures. Subgroup analysis was performed to determine risk factors for developing brain metastasis.
Results: Seventy five patients included in the study. Of whom, 71 were women (94.7%). Median age was 42.5 (22-76). Ten of the 75 patients (13.3%) had brain metastasis. The distribution rate of brain metastasis according to breast cancer stage at diagnosis was: 0% for stage I, 9.1% for stage 2, 4.3% for stage 3 and 28.6% for stage 4 (p=0.027). There was no association between presence of brain metastasis and the site of metastasis, estrogen and progesterone receptor positivity, grade, histological subgroup, menopausal status and gender.
Discussion: Brain metastasis is an important problem for breast cancer patients. Treatment strategies may vary in the presence of brain metastasis. In our study we found brain metastasis nearly one quarter of patients with metastatic HER2−positive breast cancer. Cranial MRI imaging can be performed routinely in patient with metastatic HER2−positive breast cancer patients.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-17-08.
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Affiliation(s)
- MA Kaplan
- 1Dicle University, Diyarbakir, Turkey
| | - A Inal
- 1Dicle University, Diyarbakir, Turkey
| | | | - Z Urakci
- 1Dicle University, Diyarbakir, Turkey
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Sekerel BE, Soyer OU, Keskin O, Uzuner N, Yazicioglu M, Kiliç M, Artaç H, Ozmen S, Can D, Zeyrek D, Cokugras H, Canitez Y, Aydogan M, Kuyucu S, Inal A, Gurkan F, Orhan F, Yilmaz O, Boz AB, Tahan F, Cevit O. The reliability and validity of Turkish version of Childhood Asthma Control Test. Qual Life Res 2011; 21:685-90. [PMID: 21792732 DOI: 10.1007/s11136-011-9970-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2011] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The reliability and validity of Turkish version of Childhood Asthma Control Test (C-ACT). PURPOSE The management of asthma is an important as well as difficult issue of physician's daily practice particularly in busy clinical settings. C-ACT was created to identify asthma control levels in children aged 4-11 years. Our aim was to evaluate the reliability, validity and responsiveness of C-ACT in a Turkish sample of children with asthma. METHOD In this multicenter study, 368 children were enrolled. C-ACT was completed every month by parents and patients who were evaluated in 3 visits within 2 month intervals. At each visit, physicians interpret the control level and decided for the treatment step as established in GINA guidelines. RESULTS The internal consistency reliability of the Turkish version of C-ACT (C-ACT1 to C-ACT5) was found to be 0.82, 0.83, 0.82, 0.82 and 0.80, respectively (reliability statistics, Cronbach's alpha). Test-retest reliability was 0.71. There was significant correlation between C-ACT and physician's assessment of asthma control at visit 1 (r = 0.65, P < 0.001). CONCLUSIONS Turkish version of C-ACT is an accurate and reliable tool to evaluate asthma control in children aged 4-11 years. Its widespread use may facilitate appropriate assessment of asthma control and may lead to decrease the number of uncontrolled patients.
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Affiliation(s)
- B E Sekerel
- Faculty of Medicine, Pediatric Allergy and Asthma Unit, Hacettepe University, 06100, Ankara, Turkey.
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Inal A, Isikdogan A, Kos T, Algin E, Gumus M, Dikilitas M, Elkiran ET, Helvaci K, Geredeli C, Dane F, Balakan O, Gok Durnali A, Harputluoglu H, Goksel G, Ozdemir N, Buyukberber S, Yildiz R, Kaplan MA, Ozkan M, Uncu D. Gemcitabine alone versus gemcitabine plus cisplatin for the treatment of patients with locally advanced and/or metastatic pancreatic adenocarcinoma: A retrospective analysis of multicenter study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kucukoner M, Isikdogan A, Bilici M, Tekin SB, Uncu D, Cetin B, Dane F, Inanc M, Kaplan MA, Cayir K, Buyukberber S, Ozdemir N, Turhal NS, Ozkan M, Inal A, Aksoy S, Benekli M. Adjuvant chemoradiotherapy in 450 patients with gastric cancer: The multicenter retrospective study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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29
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Kaplan MA, Isikdogan A, Gumus M, Yalçintas Arslan Ü, Geredeli C, Ozdemir N, Koca D, Dane F, Suner A, Elkiran ET, Kucukoner M, Seker M, Helvaci K, Guler T, Uncu D, Inal A, Yildiz R. Childhood, adolescents, and young adults (age 25 and younger) colorectal cancer: A multicenter study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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30
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Kaplan MA, Isikdogan A, Zincircioglu SB, Poyraz T, Cil T, Kucukoner M, Inal A, Yildiz I, Batun S, Kalkanli S. Vascular endothelial growth factor (VEGF) level in differantial diagnosis of malignant and benign effusion. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e21114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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31
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Isikdogan A, Kaplan MA, Zincircioglu SB, Cit M, Cil T, Karadayi B, Dirier A, Kucukoner M, Inal A, Yildiz I. Concurrent chemoradiotherapy with or without low molecular weigth heparin (LWMH) in the treatment of locally advanced non-small cell lung cancer (NSCLC). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e17526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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32
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Seyrek M, Vural IM, Tunca YM, Aydin C, Ulku C, Demirkaya K, Inal A, Yildiz O. The vasodilatory effect of a synthetic polymer-based root canal material on thoracic aorta. Int Endod J 2010; 43:590-9. [DOI: 10.1111/j.1365-2591.2010.01732.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sekerel B, Keskin O, Uzuner N, Yazicioglu M, Kilic M, Artac H, Ozmen S, Can D, Zeyrek D, Cokugras H, Soyer O, Sapan N, Aydogan M, Kuyucu S, Inal A, Gurkan F, Orhan F, Yilmaz O, Bingol Boz A, Tahan F, Cevit O. The Utility of Childhood Asthma Control Test and its Relationship with Control Measures and with the Decisions Made by Asthma Specialist. J Allergy Clin Immunol 2010. [DOI: 10.1016/j.jaci.2009.12.537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kendirli SG, Yilmaz M, Bayram I, Altintas DU, Inal A, Karakoc G. Potential association between allergic diseases and pertussis infection in schoolchildren: results of two cross-sectional studies seven years apart. Allergol Immunopathol (Madr) 2009; 37:21-5. [PMID: 19268057 DOI: 10.1016/s0301-0546(09)70247-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND In this study, we aimed to investigate the relationship between pertussis infections and allergic diseases in two cross-sectional questionnaire-based surveys carried out in 1997 and 2004. We also measured serum level of antibody to B. pertussis. MATERIAL AND METHODS Two cross-sectional, questionnaire-based surveys were carried out in 1997 (n = 3164) and 2004 (n = 3728). 361 cases and 465 controls were recruited from both surveys. The skin tests were performed using standardised extracts. The level of pertussis specific IgG was measured in 136 allergic and 168 non-allergic children. RESULTS We found that allergic diseases prevalence was significantly higher in the children suffering from pertussis infections (22.3 % fi rst and 8.8 % second survey) compared to children who did not suffer from pertussis infections (6.6 % fi rst and 4.5 % second survey) (p = 0.001 and p = 0.035, respectively). Asthma prevalence was also significantly higher in children suffering from pertussis infection (37.6 % fi rst and 26.2 % second survey) compared to children who did not suffer from pertussis (7.4 % fi rst and 5.0 % second survey) (p = 0.001 and p = 0.001, respectively). However, the mean serum levels of anti-pertussis IgG were similar in allergic and non-allergic groups (p > 0.05). CONCLUSION Although pertussis antibody levels in atopic and non-atopic children were similar to each other, pertussis infection still seemed to have a significant effect on the development of atopic diseases.
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MESH Headings
- Adolescent
- Asthma/epidemiology
- Asthma/etiology
- Child
- Cross-Sectional Studies
- Dermatitis, Atopic/epidemiology
- Dermatitis, Atopic/etiology
- Female
- Humans
- Hypersensitivity/epidemiology
- Hypersensitivity/etiology
- Hypersensitivity/immunology
- Immunoglobulin G/blood
- Immunoglobulin G/immunology
- Male
- Prevalence
- Rhinitis, Allergic, Perennial/epidemiology
- Rhinitis, Allergic, Perennial/etiology
- Rhinitis, Allergic, Seasonal/epidemiology
- Rhinitis, Allergic, Seasonal/etiology
- Skin Tests
- Surveys and Questionnaires
- Time Factors
- Turkey/epidemiology
- Whooping Cough/complications
- Whooping Cough/epidemiology
- Whooping Cough/immunology
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Affiliation(s)
- S G Kendirli
- Cukurova University Faculty of Medicine, Division of Pediatric Allergy and Immunology, Adana, Turkey
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Inal A, Kendirli SG, Yilmaz M, Altintas DU, Karakoc GB, Erdogan S. Indices of lower airway inflammation in children monosensitized to house dust mite after nasal allergen challenge. Allergy 2008; 63:1345-51. [PMID: 18782114 DOI: 10.1111/j.1398-9995.2008.01694.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND There are few available data assessing the united airway disease and its systemic aspects in children. With this study, we aimed to investigate the inflammation markers of upper and lower airways before and after nasal allergen challenge in mite sensitive children with different clinical expression of the allergic disease. METHODS Four study groups were formed: rhinitis only, without bronchial hyper-responsiveness (R, n = 10), rhinitis with asthma (R + A, n = 22), atopic asymptomatics (AA, n = 8) and nonallergic healthy controls (C, n = 10). Blood eosinophils, nasal and sputum eosinophils, sputum eosinophil cationic protein (ECP) and cys-LTs, and serum ECP levels were measured before and 24 h after nasal allergen challenge. RESULTS The groups were comparable in terms of age and gender. Cumulative symptom scores recorded during and 1 h after nasal challenge were not significantly different between patients with R, R + A and AA groups. At T(24), the children belonging to R, R + A and AA showed significant increases in nasal eosinophils (P < 0.01, P < 0.001, and P = 0.01, respectively), sputum eosinophils (P = 0.01, P < 0.001, and P < 0.05, respectively) and blood eosinophils (P < 0.01, P < 0.001, and P < 0.05, respectively). Similarly, increases in sputum ECP (P < 0.01, P < 0.001, and P = 0.07, respectively) and sputum cys-LT levels (P = 0.07, P < 0.001, and P < 0.05, respectively) were detected in children belonging to these three groups at T(24). Sputum eosinophils significantly correlated with blood eosinophils (r = 0.54, P < 0.001) and sputum ECP (r = 0.58, P < 0.001) at T(24). CONCLUSIONS This study showed that nasal allergen challenge increased markers of eosinophilic inflammation in both upper and lower airways of children monosensitized to mites, even before the onset of clinical symptoms.
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MESH Headings
- Adolescent
- Animals
- Antigens, Dermatophagoides/administration & dosage
- Antigens, Dermatophagoides/blood
- Antigens, Dermatophagoides/immunology
- Asthma/diagnosis
- Asthma/immunology
- Asthma/pathology
- Bronchial Hyperreactivity/diagnosis
- Bronchial Hyperreactivity/immunology
- Bronchial Hyperreactivity/pathology
- Child
- Dermatophagoides pteronyssinus/immunology
- Eosinophils/pathology
- Female
- Humans
- Hypersensitivity, Immediate/diagnosis
- Hypersensitivity, Immediate/immunology
- Hypersensitivity, Immediate/pathology
- Leukotrienes/metabolism
- Male
- Nasal Provocation Tests
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/immunology
- Rhinitis, Allergic, Seasonal/pathology
- Skin Tests
- Sputum/immunology
- Sputum/metabolism
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Affiliation(s)
- A Inal
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, University of Cukurova, Adana, Turkey
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Annagür A, Kendirli SG, Yilmaz M, Altintas DU, Inal A. Is there any relationship between asthma and asthma attack in children and atypical bacterial infections; Chlamydia pneumoniae, Mycoplasma pneumoniae and Helicobacter pylori. J Trop Pediatr 2007; 53:313-8. [PMID: 17535826 DOI: 10.1093/tropej/fmm040] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
UNLABELLED Asthma is a chronic inflammatory airway disease characterized by variable airway obstruction and bronchial hyperresponsiveness. There are many factors affecting the development and severity of childhood asthma such as genetic predisposition, atopy, environmental factors, obesity, diet, socioeconomic status, and infectious triggers. In the present study we aimed to investigate the frequency of Mycdoplasma pneumoniae, Chlamydia pneumoniae, and Helicobacter pylori infections in asthmatic children. We investigated also whether there is a relationship between these agents and asthma attacks. MATERIAL AND METHODS Seventy-nine asthmatic children (46 males, aged 5-15 years) were included in study. The study group was divided into two groups: group 1 consisted of 37 children with asthma attacks and group 2 consisted of 42 children with stable asthma. As a control group we studied 36 healthy children. Pulmonary function tests, skin prick tests for common allergens were performed; serum total IgE, phadiatop, specific IgM and IgG antibody levels (ELISA) for M. pneumoniae, C. pneumoniae and H. pylori were measured in all patients. RESULTS Mycoplasma IgM and Chlamidia IgM were positive in 8.1% (3 patients) and 18.9% (7 patients) of group 1 patients, respectively. There was a statistically significant difference for Mycoplasma IgM (p = 0.031) and Chlamidia IgM (p = 0.03) between group1 and other two groups. We have not found significant difference for M. pneumoniae IgG, C. pneumoniae IgG and H. pylori IgM and IgG among groups. CONCLUSION M. Pneumoniae and C. Pneumoniae may play a role in development of asthma exacerbations in childhood. We could not find a relationship between H. Pylori and asthma.
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Affiliation(s)
- Ali Annagür
- Department of Pediatric Allergy and Immunology, Faculty of Medicine, University of Cukurova, Adana, Turkey.
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Inal A, Gunes A, Zhang F, Cakmak I. Peanut/maize intercropping induced changes in rhizosphere and nutrient concentrations in shoots. Plant Physiol Biochem 2007; 45:350-6. [PMID: 17467283 DOI: 10.1016/j.plaphy.2007.03.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
A greenhouse study was conducted to investigate the rhizosphere effects on iron (Fe), phosphorus (P), nitrogen (N), potassium (K), calcium (Ca), zinc (Zn), and manganese (Mn) nutrition in peanut plants (Arachis hypogaea L.) by intercropping them with maize (Zea mays L.). In addition, we studied the release of phytosiderophores and the ferric reductase activity of roots, pH and acid phosphatases in the rhizosphere and bulk soil, and the secretion of acid phosphatases in roots. Our results revealed that shoot yields of peanut and maize plants were decreased by intercropping the plants, as compared to monocultured plants. Growing peanut plants in a mixture with maize, enhanced the shoot concentrations of Fe and Zn nearly 2.5-fold in peanut, while the Mn concentrations of peanut were little affected by intercropping. In the case of maize, the shoot concentrations of Fe, Zn and Mn were not significantly affected by intercropping with peanut. Intercropping also improved the shoot K concentration of peanut and maize, while it negatively affected the Ca concentration. In the intercropping of peanut/maize, the acid phosphatase activity of the rhizosphere and bulk soil and root secreted acid phosphatases were significantly higher than that of monocultured peanut and maize. In accordance, the shoot P concentrations of peanut and maize plants were much higher when they were intercropped with peanut or maize, respectively. The rhizosphere and bulk soil pH values were not clearly affected by different cropping systems. When compared to their monoculture treatments, the secretion of phytosiderophore from roots and the root ferric reducing capacity of the roots were either not affected or increased by 2-fold by the intercropping, respectively. The results indicate the importance of intercropping systems as a promising management practice to alleviate Fe deficiency stress. Intercropping also contributes to better nutrition of plants with Zn, P and K, most probably by affecting biological and chemical process in the rhizosphere.
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Affiliation(s)
- A Inal
- Ankara University, Faculty of Agriculture, Department of Soil Science and Plant Nutrition, 06110 Ankara, Turkey
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Kurtaran B, Aksu H, Tasova Y, Saltoglu N, Inal A, Candevir A, Seydaoglu G. P1495 One-year follow-up of adefovir dipivoxil treatment in chronic hepatitis B patients. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71334-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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39
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Inal A, Altintas DU, Yilmaz M, Karakoc GB, Kendirli SG, Sertdemir Y. Prevention of new sensitizations by specific immunotherapy in children with rhinitis and/or asthma monosensitized to house dust mite. J Investig Allergol Clin Immunol 2007; 17:85-91. [PMID: 17460946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Previous studies have suggested that single-allergen-specific immunotherapy (SIT) may prevent sensitization to other airborne allergens in monosensitized children. We aimed to assess the prevention of new sensitizations in monosensitized children treated with single-allergen SIT injections in comparison with monosensitized patients given appropriate pharmacologic treatment for their disease. METHODS A total of 147 children with rhinitis and/or asthma monosensitized to house dust mite were studied; 45 patients underwent SIT with adsorbed extracts and 40 patients underwent SIT with aqueous extracts for 5 years. The control group was comprised of 62 patients given only pharmacologic treatment for at least 5 years. Skin prick tests, medication scores for rhinitis and asthma, and atopy scores according to skin prick tests were evaluated at the beginning and after 5 years of treatment. RESULTS All groups were comparable in terms of age, sex, and disease characteristics. At the end of 5 years, 64 out of 85 (75.3%) in the SIT group showed no new sensitization, compared to 29 out of 62 children (46.7%) in the control group (P = .002). There were no differences between the SIT subgroups with regard to onset of new sensitization (P = .605). The patients developing new sensitizations had higher atopy scores (P = .002) and medication scores for both rhinitis (P = .008) and asthma (P = .013) in comparison to patients not developing new sensitizations after 5 years of SIT. CONCLUSION According to our data, SIT has the potential to prevent the onset of new sensitizations in children with rhinitis and/or asthma monosensitized to house dust mite.
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Affiliation(s)
- A Inal
- Division of Pediatric Allergy and Immunology, Faculty of Medicine, Cukurova University, Adana, Turkey.
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Inal A, Altintaş DU, Güvenmez HK, Yilmaz M, Kendirli SG. Life-threatening facial edema due to pine caterpillar mimicking an allergic event. Allergol Immunopathol (Madr) 2006; 34:171-3. [PMID: 16854350 DOI: 10.1157/13091043] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Approximately 150 species of Lepidoptera have been described as causing damage to human skin. One of these species is the pine processionary caterpillar, which is responsible for dermatitis, contact urticaria, ocular lesions and rarely respiratory signs and anaphylactic reactions through IgE-mediated or non-IgE-mediated mechanisms. We report a pediatric case of severe orofacial edema mimicking an allergic reaction after ingestion of a pine processionary caterpillar; urgent airway intubation was required. CASE REPORT A 15-month-old boy was sleeping under a pine tree when his mother noted a pine caterpillar on his tongue. Because of rapidly developing facial swelling and respiratory distress, the infant was first taken to a local hospital where he received intravenous dexamethasone and pheniramine hydrogen maleate. On arrival at our emergency department, diffuse swelling and edema involving the tongue, perioral, nasal and perimandibular regions, and neck was noted, requiring urgent orotracheal intubation. There were no findings of anaphylaxis. The results of skin prick tests and specific IgE to common aero- and food allergens were negative. A skin prick test with extract of pine caterpillar was also negative. Prednisolone and pheniramine hydrogen maleate were administered for 7 days. The child gradually improved and was successfully extubated 4 days later. CONCLUSION Although oral contact with a pine processionary caterpillar in the form of ingestion is rare, it may cause significant local reaction and airway compromise mimicking an allergic event. In this situation, early intubation to maintain airway patency is a life-saving measure.
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Affiliation(s)
- A Inal
- Cukurova University Faculty of Medicine, Division of Pediatric Allergy and Immunology, Adana, Turkey.
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Inal A, Bayraktar S, Inal B, Bayraktar Z, Yilmaz OF. Intraocular pressure control after clear corneal phacoemulsification in eyes with previous trabeculectomy: a controlled study. ACTA ACUST UNITED AC 2005; 83:554-60. [PMID: 16187992 DOI: 10.1111/j.1600-0420.2005.00497.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare intraocular pressure (IOP) control in eyes with or without clear corneal phacoemulsification following trabeculectomy. METHODS The study group included 30 eyes that underwent uneventful clear corneal phacoemulsification and foldable intraocular lens implantation following trabeculectomy without antimetabolites. Thirty eyes that had undergone filtering surgery without cataract extraction were selected as controls. Case and control groups were matched with respect to age, gender, IOP, number of glaucoma medications, glaucoma type (primary open-angle glaucoma/pseudoexfoliative glaucoma), trabeculectomy time and follow-up. Comparisons between the study and control groups (intergroup) and within the same group at different time-points (intragroup) were performed for IOP, glaucoma medications and bleb morphology. Success rates were investigated by Kaplan-Meier survival analysis and the factors influencing final success by logistic regression. RESULTS Intraocular pressure (p = 0.04) and glaucoma medications (p = 0.001) increased during an average follow-up of 26.1 +/- 9.9 months in both groups. Intragroup differences became statistically significant after the 6-month visit, but intergroup differences remained insignificant. Bleb height decreased significantly following phacoemulsification in the study group (p = 0.017). Success rates decreased with time in both groups, with no intergroup difference (p = 0.46). The final success rate was negatively correlated with IOP and number of glaucoma medications used at the study entry, while there was a positive correlation between the baseline and final success rates. CONCLUSION Trabeculectomy success decreased in a time-dependent manner in eyes with and without subsequent phacoemulsification. Uncomplicated clear corneal phacoemulsification was not found to have any additional unfavorable influence on IOP control in eyes with filtering blebs.
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Affiliation(s)
- Asli Inal
- Beyoğlu Eye Education and Research Hospital, Istanbul, Turkey
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Musabak U, Sengul A, Oktenli C, Pay S, Yesilova Z, Kenar L, Sanisoglu SY, Inal A, Tuzun A, Erdil A, Bagci S. Does immune activation continue during an attack-free period in familial Mediterranean fever? Clin Exp Immunol 2005; 138:526-33. [PMID: 15544632 PMCID: PMC1809227 DOI: 10.1111/j.1365-2249.2004.02632.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Although some information is available regarding immune activation in familial Mediterranean fever (FMF), little is known about either peripheral blood T cell activation marker expression or the T cell proliferative response to phytohaemagglutinin (PHA). In the present study, we aimed to investigate the percentages of peripheral blood lymphocyte subsets, T cell expression of cellular activation markers (CD25, CD69, HLA-DR), the T cell response to PHA and serum levels of soluble interleukin-2 receptor (sIL-2R) and interleukin (IL)-10 in patients with FMF. Forty patients with FMF were enrolled into the study. Control groups were sex- and age-matched and consisted of 20 healthy blood donors and 15 patients with inactive Behcet's disease. The patients with FMF in an attack period had higher levels of sIL-2R than those in an attack-free period, and also in comparison with both control groups. The levels of sIL-2R were also found to be higher in patients with FMF in an attack-free period than those in both control groups. The mean levels of IL-10 were found to be lower in patients with FMF in an attack-free period than those in an attack period and were also lower than those in the healthy controls. In an acute attack period, the absolute counts of CD3+HLA-DR+, CD4+CD69+, CD8+CD25+ and CD8+CD69+ T cells in peripheral blood samples were also higher than those in both control groups. Both the percentages and absolute counts of CD4+CD69+ T cells in peripheral blood samples of patients with FMF in an attack-free period were slightly but significantly higher than those in the healthy controls. In conclusion, our study indicates that the T cell system is abnormally activated in patients with FMF in both the attack and attack-free period and that decreased IL-10 levels may create a tendency to perpetuate subclinical immune activation in the attack-free period.
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Affiliation(s)
- U Musabak
- Department of Immunology, Gülhane School of Medicine, Ankara, Turkey
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Baykal Y, Saglam K, Yilmaz MI, Taslipinar A, Akinci SB, Inal A. Serum sIL-2r, IL-6, IL-10 and TNF-alpha level in familial Mediterranean fever patients. Clin Rheumatol 2003; 22:99-101. [PMID: 12740672 DOI: 10.1007/s10067-002-0682-1] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In this study we investigated cytokine levels in patients with familial Mediterranean fever (FMF). Twenty patients and 20 healthy controls were included. Ten patients had acute attacks of FMF, whereas the other 10 were in the silent period. Patients with the acute exacerbation of FMF had higher soluble interleukin-2 receptor (sIL-2r), interleukin-6 (IL-6), tumour necrosis factor-alpha, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and fibrinogen levels than those in the silent period ( P<0.001) and controls ( P<0.001). In patients with acute attacks of FMF, interleukin-10 (IL-10) levels were not significantly different from those in the other patients or the controls ( P>0.05). In FMF patients IL-6, TNF-alpha, sIL-2r, ESR, CRP and fibrinogen levels increased with the acute-phase reaction, especially in the attack period. On the other hand, anti-inflammatory cytokine IL-10 levels did not increase as much as did the inflammatory cytokines. The balance between the cytokines may help us to understand the pathophysiology of FMF and to develop therapies. We conclude that the levels of the acute-phase reactants and the cytokines could be useful for diagnosis of acute exacerbations, follow-up and treatment. However, the cost of cytokine measurement analyses seems disadvantageous at present.
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Affiliation(s)
- Y Baykal
- Department of Internal Medicine,Gulhane School of Medicine, Hacettepe University, Etlik-Ankara 06018, Turkey
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Musabak U, Bolu E, Ozata M, Oktenli C, Sengul A, Inal A, Yesilova Z, Kilciler G, Ozdemir IC, Kocar IH. Gonadotropin treatment restores in vitro interleukin-1beta and tumour necrosis factor-alpha production by stimulated peripheral blood mononuclear cells from patients with idiopathic hypogonadotropic hypogonadism. Clin Exp Immunol 2003; 132:265-70. [PMID: 12699415 PMCID: PMC1808705 DOI: 10.1046/j.1365-2249.2003.02141.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
In the present study, we aimed to investigate the effects of testosterone deficiency and gonadotropin therapy on the in vitro production of tumour necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta) by peripheral blood mononuclear cells (PBMCs) from patients with idiopathic hypogonadotropic hypogonadism (IHH) in order to elucidate the modulatory role of androgen in cytokine production. Fifteen male patients with untreated IHH and 15 age-matched healthy male subjects were enrolled in the study. Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), free testosterone (FT), sex hormone binding globulin (SHBG), prolactin, and IL-2 and IL-4 levels were also measured. In unstimulated cultures, IL-1beta and TNF-alpha secretion were not significantly different between patient and control groups. However, after stimulation with lipopolysaccharide (LPS), secretion of IL-1beta and TNF-alpha was significantly higher in cultures from untreated patients with IHH than in control subjects. Mean FSH, LH and FT levels were significantly lower, whereas SHBG, IL-2 and IL-4 levels were significantly higher in patients with IHH compared than in controls. In patients with IHH, FT negatively affected the serum levels of IL-4 and in vitro secretion of IL-1beta and TNF-alpha. In addition, IL-2 and IL-4 affected the in vitro secretion of IL-1beta in a positive manner. Gonadotropin therapy decreased both TNF-alpha and IL-1beta in PBMCs from patients with IHH. The levels of serum IL-2 and IL-4 were also decreased by therapy. In conclusion, in the present study, gonadotropin treatment restored the in vitro production of IL-1beta and TNF-alpha by PBMCs from patients with IHH, suggesting that androgen modulates proinflammatory cytokine production, at least directly through its effects on PBMCs. It seems probable that this effect plays an important role in the immunosuppressive action of androgens.
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Affiliation(s)
- U Musabak
- Department of Immunology, Gülhane School of Medicine, Ankara, Turkey
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Yetiser S, Inal A, Taser M, Ozkaptan Y. Otolaryngological aspects of relapsing polychondritis: course and outcome. Rev Laryngol Otol Rhinol (Bord) 2002; 122:195-200. [PMID: 11799863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Relapsing Polychondritis (RP) is a rare disorder characterised by episodic inflammation of the cartilaginous structures. Differential diagnosis of this pathology is a challenging enigma since it appears only intermittently and none of the clinical features are pathognomonic, although most of the patients are usually referred to an ENT physician initially. The natural history of the disease is unpredictable. Initiating effective treatment sooner considerably reduces the rate of mortality. Patients with RP should be seen on a regular basis even if the patient is non-symptomatic. This study reports a retrospective analysis of the otolaryngological manifestations of 7 patients with RP as well as their long-term progress and reviews the symptomatology, histopathology, immunology and management.
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Affiliation(s)
- S Yetiser
- Gulhane Medical School, Dept of ORL & HNS, Etlik 06018, Ankara, Turkey.
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Abstract
Familial Mediterranean fever (FMF) is an autosomal recessive disease. Although the possibility of multiple immunologic mechanisms have been studied, the actual mechanism is still unresolved. Forty-one patients with FMF (24 males and 17 females with a mean age and disease duration of 17.8 +/- 4.1 and 4.7 +/- 2.3 years, respectively) and 14 healthy controls (10 males and 4 females with a mean age 23.2 +/- 5.1) were involved in the study. A phagotest was studied in both the patients and control groups with a FACScalibur Flow. All patients were in the acute stages of the disease and had not undergone colchicine treatment for 2 months. The percentage blood phagocytic activity of both granulocytes and monocytes were 84.23 +/- 8.76 and 67.28 +/- 10.15 in the patient group and 94.68 +/- 3.24 and 76.23 +/- 5.7 in the control group, respectively. There was no statistically significant difference in the percentage of phagocytic activity of the granulocytes and monocytes between the FMF patients and healthy controls (p > 0.05 and p > 0.05, respectively).
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Affiliation(s)
- G Keskin
- Department of Clinical Immunology and Rheumatology, SSK Ankara Ihtisas Hospital, Turkey.
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Abstract
Immunosuppression following thermal injury has been noted in recent years. Both cellular and humoral immune systems have been reported to be affected. The present study aimed to compare the quantitative differences between cutaneous and electrical burn patients in respect to the partition and levels of lymphocyte populations. From March 1997 through February 1998, 15 patients with major thermal injury or high voltage electrical injury were included in this clinical prospective study. Blood samples were collected at three and seven days postburn. The evaluation of lymphocyte populations of patients was performed by SimulTest IMK plus. T cell and B cell populations, activated T cells, natural killer and helper T cell levels were all suppressed in both groups. Suppressor T cell levels were elevated in electrical burn group at both three and seven days. Therefore, CD 4/CD 8 ratios were more suppressed in electrical burn group. In conclusion, lymphocyte populations in electrical burn patients and also contributing factors which play important roles in the development of sepsis in both group need to be investigated further.
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Affiliation(s)
- M Deveci
- Department of Plastic and Reconstructive Surgery and Burn Centre, Gülhane Military Medical Academny, Ankara, Turkey.
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Keskin G, Tokgöz G, Düzgün N, Duman M, Kinikli G, Olmez U, Aydintug AO, Turgay M, Inal A. Systemic lupus erythematosus in Turkish men. Clin Exp Rheumatol 2000; 18:114-5. [PMID: 10728461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Keskin G, Inal A, Ali Sari R, Sengül A, Sahin M, Turgay M, Kinikli G. Serum IFN-gamma and IL-10 levels before and after specific immunotherapy in patients with allergic rhinitis. Allergol Immunopathol (Madr) 1999; 27:261-4. [PMID: 10568876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Although a detailed explanation of the mechanism of immunotherapy is not known, several immunologic explanation have been proposed. It's said that T cell-cytokine profile changed with allergen immunotherapy. In our study we evaluated IFN-* and IL-10 levels before and after immunotherapy in patients with allergic rhinitis. Twenty patients (mean age; 27.3 +/- 4.84), 8 male, 12 female with allergic rhinitis, mean duration of disease was 5.55 +/- 1.23 years and 13 healthy controls, 5 male, 8 female (mean age: 28.38 +/- 5.61) were enrolled in the study. Immunotherapy was performed for grass pollen allergen extract to patients with allergic rhinitis for 31.5 +/- 4.98 months. Serum IL-10 and IFN-* levels were evaluated with ELISA. Serum IL-10 levels were significantly high before and after immunotherapy compared to controls. There was no difference in IFN-* levels before and after SIT compared to controls. According to this study, in patients with allergic rhinitis after immunotherapy serum IL-10 levels are decreased but IFN-* no change.
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Affiliation(s)
- G Keskin
- SSKAnkara Ihtisas Hospital Clinic Immunology and Rheumatology Department, Ankara, Türkiye
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Hacibektaşoğlu A, Barut A, Inal A. [Relationship of histocompatibility groups to chronic HBV infections]. MIKROBIYOL BUL 1993; 27:241-8. [PMID: 8361414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
HLA-A, B, C and DR locus specificities studied in 168 patients (71 Chronic active Hepatitis, 97 Chronic Persistent Hepatitis) serologically and histopathologically proven Chronic Hepatitis B Virus infection. There were 113 men and 55 women with a mean age of 23.2 (21-52) years. Hundred and seventy four healthy subjects (107 men, 67 women) included in control group with a mean age of 26.4 (20-54) years. The frequency of HLA A3 (p < 0.01), HLA A11 (p < 0.01), HLA B35 (p < 0.05) and HLA B51 (p < 0.01) were significantly higher in patients than in healthy control subjects. Comparisons among the other HLA-A, B, C and DR locus were found to be statistically non-significant.
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Affiliation(s)
- A Hacibektaşoğlu
- Enfeksiyon Hastaliklari ve Klinik Bakteriyoloji ve Enfeksiyon Hastaliklari Anabilim Dali Başkani
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