Browsing by Author "Üner, A"

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Anhidrotic Ectodermal Dysplasia in a Child With a Fever of Unknown Origin
(Japanese dermatolgical Assoc, 2001) Üner, A; Çaksen, H; Odabas, D
Bilateral Galactocele in a Male Infant
(Freund Publishing House Ltd, 2001) Cesur, Y; Çaksen, H; Demirtas, I; Kösem, M; Üner, A; Özer, R
A galactocele is a rare benign breast lesion usually occurring in females during or following lactation. These lesions are a rare cause of breast enlargement in infants and children. In this article we present a 10 month-old boy who was admitted with a two-month history of bilateral progressive breast enlargement, and diagnosed as having galactocele. Our purpose was to emphasize the importance of galactocele as a benign condition in the differential diagnosis of gynecomastia in childhood.
A Case of Allgrove (Triple A) Syndrome Associated With Renal Ectopia
(Medecine Et Hygiene, 2002) Çaksen, H; Cesur, Y; Kirimi, E; Üner, A; Arslan, S; Çelebi, V; Odabas, D
Allgrove syndrome (triple A syndrome) is an autosomal recessive disorder characterized by adrenocorticotropin hormone-resistant adrenal insufficiency, achalasia and alacrima. Aside from the classic features of the syndrome, several abnormalities including mainly neurological abnormalities have been reported in the syndrome. Herein, we presented a case of Allgrove syndrome associated with left renal ectopia. To the best of our knowledge renal abnormality in Allgrove syndrome has not been reported in the literature until now. We think that ectopic kidney diagnosed in our patient is coincidental because the incidence of renal ectopia is high, approximately I in 900 in population.
A Case of Melkersson-Rosenthal Syndrome Associated Withehlers-Danlos Syndrome
(Medecine Et Hygiene, 2002) Çaksen, H; Cesur, Y; Tombul, T; Üner, A; Kirmi, E; Tuncer, O; Odabas, D
Melkersson-Rosenthal syndrome (MRS) is characterized by the triad of recurrent facial palsy, lingua plicata, and facial edema. Herein, we report a case of MRS associated with Ehlers-Danlos syndrome due to rare presentation. To the best of our knowledge only one case of MRS associated with Ehlers-Danlos syndrome has been reported in the literature until now.
Comparison of Lytic Cocktail, Chloral Hydrate and Midazolam for Pediatric Sedation
(Oxford Univ Press, 2001) Çaksen, H; Üner, A; Cesur, Y; Abuhandan, M; Çelebi, V; Sar, S
Cranial Computed Tomography in Purulent Meningitis of Childhood
(informa Healthcare, 2004) Tuncer, U; Çaksen, H; Arslan, S; Atas, B; Üner, A; Öner, AF; Odabas, D
The cranial computed tomography (CT),findings of 48 children with purulent meningitis were examined, prospectively, to determine the importance of cranial CT findings on the prognosis of childhood meningitis, in a developing country. The age of children ranged from 2 months to 13 years. Of 48 patients, 29 (60.5%) survived without sequelae, 13 (27%) survived with sequelae, and six (12.5%) died. Cranial CT was normal in 21 (43%) patients of 48 children with meningitis at admission. Abnormal CT findings were detected in 10, H, and 6 children in the groups of survived without sequelae, survived with sequelae, and deaths, respectively, at admission (p < .05) We found that CT scan results were correlated with neurological signs (p < .05). At least one or more cranial CTs were was re-taken in children in whom the first CT revealed abnormal findings; we did not find a statistically significant difference for the follow-up CT findings between the groups (p > .05). Hydrocephalus and subdural effusion were the commonest abnormal CT findings. In conclusion, our findings showed that cranial CT may safely be used to detect intracranial complications of meningitis in childhood and the ratio of sequelae and death were more common in children with abnormal cranial CT than those of normal cranial CT findings. Additionally, there was a positive correlation between CT scan results and neurological signs.
Deadly Nightshade (Atropa Belladonna) Intoxication
(Arnold, Hodder Headline Plc, 2003) Çaksen, H; Odabas, D; Akbayram, S; Cesur, Y; Arslan, S; Üner, A; Öner, AF
Deadly nightshade (Atropa belladonna) intoxication has been infrequently reported in both children and adults in the literature. In this article, the clinical and laboratory findings of 49 children with acute deadly nightshade intoxication are reviewed. Our purpose was to enlighten the findings of deadly nightshade intoxication in childhood. The most common observed symptoms and signs were meaningless speech, tachycardia, mydriasis, and flushing. None of the children required mechanical ventilation or died in our series. The patients were categorized into two groups, mild/moderate and severe intoxication. Children with and without encephalopathy were accepted as severe and mild/moderate intoxication, respectively. While 43 children were placed in the group of mild/moderate intoxication, six were in severe intoxication group. We found that meaningless speech, lethargy, and coma were more common, but tachycardia was less common in the severe intoxication group (children with encephalopathy) (P < 0.05). In the treatment, neostigmine was used in all children because of no available physostigmine in our country. In conclusion, our findings showed that the initial signs and symptoms of acute deadly nightshade intoxication might be severe in some children, but no permanent sequel and death were seen in children. We also showed that meaningless speech, lethargy, coma, and absence of tachycardia were ominous signs in deadly nightshade intoxication in childhood. Lastly, we suggest that neostigmine may be used in cases of deadly nightshade intoxication if physostigmine cannot be available.
Immunoglobulin Subgroups in Children With Febrile Seizures
(Blackwell Science Asia, 2001) Çaksen, H; Öner, AF; Arslan, S; Kan, MC; Cesur, Y; Üner, A
Background: The aim of the present study was to determine whether or not there was a role for immunoglobulin (Ig) or IgG subgroups in the pathogenesis of febrile seizures (FS). Methods: Serum levels of IgA, total IgG, IgM, IgE, IgG1, IgG2, IgG3 and IgG4 were measured in 34 children with FS and in 37 healthy children used as a control group. Both patients and controls were divided into two groups according to age (group I, 6-24 months; group II, 25-72 months). Results: Compared with controls, mean IgG4 levels in patients were found to be decreased in both groups I and II (group I: 95+/-14 vs 57+/-5, respectively, P=0.01; group II: 178.5+/-38.5 vs 65.1+/-24.5, respectively, P <0.01), while mean IgG2 levels were found to be decreased only in group II patients (170+/-16 vs 103+/-22; P <0.05). Conclusions: The results of the present study suggest that Ig subclass deficiencies may be responsible for the infections connected with FS or that they may be related to the pathogenesis of FS in some children.
Nasopharyngeal Rhabdomyosarcoma in a Patient With Hypohidrotic Ectodermal Dysplasia Syndrome
(Elsevier Sci Ltd, 2002) Çankaya, H; Kösem, M; Kiris, M; Üner, A; Metin, A
Hypohidrotic ectodermal dysplasia (Christ-Siemens-Touraine syndrome) is characterized by partial or complete absence of sweat glands, hypotrichosis, hypodontia, prominent frontal ridges and chin, saddle nose, sunken cheeks, thick, everted lips, large ears and sparse hair. While association of other ectodermal dysplasia syndromes with tumors such a non-Hodgkin's lymphoma, hamartoma, keratoakanthoma, Merkel-cell cancer, squamous-cell carcinoma, syringofibroadenomatosis has been reported, association of hypohidrotic ectodermal dysplasia and a tumor has not been reported. In a five-year-old male patient admitted with nasal obstruction and nasal mass complaints, we have reported firstly an association of hypohidrotic ectodermal dysplasia and nasopharyngeal. rhabdomyosarcoma. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
Platelet Functions in Patients With Protein-Energy Malnutrition
(Lippincott Williams & Wilkins, 2001) Üner, A; Çaliskan, Ü; Öner, AF; Koç, H; Kasap, AF
Protein-energy malnutrition (PEM) has been known to cause several organ damages or dysfunctions. In this study, using optic method, platelet aggregation (PA) analyses were performed in patients with PEM. Adenosine diphosphate (ADP)- and collagen-induced PA were significantly decreased in the patients with PEM. The low values reached normal when the patients caught up the optimal growing curve for their age. PA with ristocetin and epinephrine were not significantly altered in the patients. Conversely, mean platelet count was increased at the beginning compared to those of after therapy and to the control. These results indicate that some platelet functions (ADP- and collagen-induced platelet aggregations), as well as other body functions, have been decreased in PEM.
Prognostic Factors in Children With Purulent Meningitis in Turkey
(Okayama Univ Med School, 2003) Kirimi, E; Tuncer, O; Arslan, S; Atas, B; Çaksen, H; Üner, A; Odabas, D
In this study the clinical and laboratory findings of 48 children with purulent meningitis were examined, prospectively, to determine the prognostic factors in childhood meningitis in a developing country. Patients were examined for the following variables: history of antibiotic use; period between onset of symptoms and hospital admission; age at presentation; sex; fever; convulsion; level of consciousness; malnutrition; anemia; leukocyte and thrombocyte counts; erythrocyte sedimentation rate; serum C-reactive protein (CRP) level; and cerebrospinal fluid (CSF) including white blood cell count; glucose, protein, and CRP concentrations; antibiotic treatment; neurological sequelae; and fatality rate during the hospital stay. Most of these parameters were re-evaluated in all patients 36-48 h after admission. Patients were divided into 3 groups: surviving without sequelae, surviving with sequelae, and not surviving (deceased). A total of 48 children, 19 girls (39.5%) and 29 boys (60.5%), aged 2 months to 13 years, were included in the study. Of the 48 patients, 29 (60.5%) survived without sequelae, 13 (27%) survived with sequelae and 6 (12.5%) died. In a comparison among groups, we found that absence of anemia, low (< 1,000) CSF white blood cell (WBC) count, and high CRP level at admission were the indicative of poor prognosis. Thirty-six to 48 h after admission, the presence of fever, depressed level of consciousness, high (> 1,000) CSF WBC count, and low CRP level were also poor prognostic factors. In addition, we observed that mortality rate was lower in the penicillin G+ chloramphenicol group than in the ampicillin-sulbactam + cefotaxime group (P < 0.05). The mean period between onset of symptoms and hospital admission was longer in the surviving with sequelae and in the not surviving groups than in the surviving without sequelae group (P < 0.05).
Pulmonary Endarteritis and Subsequent Embolization To the Lung as a Complication of a Patent Ductus Arteriosus -: a Case Report
(Westminster Publ inc, 2004) Bilge, M; Üner, A; Özeren, A; Aydin, M; Demirel, F; Ermis, B; Özkökeli, M
The authors describe a case of pulmonary endarteritis and subsequent embolization to the lungs as a complication of a patent ductus arteriosus (PDA). Although 2-dimensional echocardiography has been shown to be of great value in the diagnosis of patients with infective endocarditis, echocardiographic detection of vegetation within the pulmonary artery and subsequent embolization to the lung is extremely rare and, to our knowledge, has been previously reported only in a few cases. In brief, our case not only shows the importance of echocardiography in making this rare diagnosis but also emphasizes the role of echocardiography as an effective means of following up such a case.
Report of Two Turkish Infants With Norman-Roberts Syndrome
(Medecine Et Hygiene, 2004) Çaksen, H; Tuncer, O; Kirimi, E; Fryns, JP; Üner, A; Ünal, Ö; Odabas, D
Lissencephaly or agyria refers to a rare disorder that is characterized by the absence of cerebral convolutions and a poorly formed sylvian fissure, giving the appearance of a 3-4 months old fetal brain. At present more than 25 dysmorphology syndromes with lissencephaly or other disorders of neuronal migration have been described. In 1976, Norman et al. reported on two patients with lissencephaly type I and short, sloping forehead, an atypical phenotype for Miller-Dieker syndrome, a more common lissencephaly syndrome. In this article, we report two Turkish female infants whose abnormal findings were consistent with Norman-Roberts syndrome because of their very rare presentation. Both patients had typical cranio-facial abnormalities and abnormal magnetic resonance imaging findings, but no deletion in 17p13.3 for Miller-Dieker syndrome. In addition to the typical findings of Norman-Roberts syndrome, case 1 had atrial septal defect, corpus callosum agenesis, intracranial widespread calcification and case 2 had bilateral macular cherry-red spot, persistent foramen ovale, increased blood level of C6 hexanoylcarnitine, cavum septum pellucidum vergae anomaly and cerebellar atrophy. In conclusion, we would like to emphasize that Norman-Roberts syndrome should also be considered in infants with lissencephaly. A detailed physical examination, chromosomal and fluorescence in situ hybridization (FISH) analysis to exclude a deletion in 17p13.3 should be performed for the definite diagnosis of the syndrome.
Severe Peripheral Polyneuropathy in a Child With Infective Endocarditis Caused by Staphylococcus Aueus
(Acta Medica Belgica, 2004) Çaksen, H; Üner, A; Arslan, S; Anlar, Ö; Odabas, D; Tosun, N; Akgün, C
Although central nervous system complications such as stroke, encephalopathy and meningitis are commonly described in Staphylococcus aureus endocarditis, peripheral nervous system involvement is rarely reported in the literature. In this article we report on a 13-year-old boy with infective endocarditis caused by Staphylococcus aureus in whom severe polyneuropathy developed during hospitalization. To the best of our knowledge this is the first child case with infective endocarditis associated with peripheral polyneuropathy in the literature.
Silent Stroke in a Case of Β-Thalassemia Major Associated With Chronic Renal Failure and Diabetes Mellitus
(B C decker inc, 2003) Çaksen, H; Odabas, D; Akbayram, S; Öner, AF; Arslan, S; Cesur, Y; Üner, A
Severe anemia, growth retardation, diabetes mellitus, cardiac disorders, and, infrequently, stroke are well-known complications of thalassemia major. We report a girl, age 7 years, 2 months, with beta-thalassemia major associated with chronic renal failure, diabetes mellitus, and cardiomyopathy in whom a silent stroke was noted during follow-up. She was diagnosed with thalassemia major at age 6 months, chronic renal failure at age 3 years, 3 months, and diabetes mellitus and cardiomyopathy at age 7 years. Although cranial computed tomography was found to be normal at the age of 3 years, 3 months, magnetic resonance imaging showed cerebral infarct in the right frontal region at 7 years, 2 months. A thrombophilic panel revealed increased factor VIII and decreased protein C concentrations. She died from disseminated intravascular coagulation at age 7 years, 9 months. We did not record any clinical findings of stroke during her follow-up. We think that diabetes mellitus, dilated cardiomyopathy, and increased factor VIII and decreased protein C concentrations led to the occurrence of cerebral infarct. In conclusion, we emphasize that children with thalassemia major should be monitored closely for stroke. We also suggest that stroke can show a silent progression in severely affected children, as in our case.