Browsing by Author "Cesur, Y"

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An Analysis of Seven Infants With Brachmann-De Lange Syndrome, of Whom Two Identical Twin Sisters
(Medecine Et Hygiene, 2001) Çaksen, H; Kurtoglu, S; Cesur, Y; Öztürk, A
An analysis of seven Infants with Brachmann-de Lange syndrome, of whom two identical twin sisters: Brachmann-de Lange syndrome (BDLS) is characterized by typical facial features, intrauterine growth retardation, short stature, microbrachycephaly, hirsutism and limb anomalies. Here, we reviewed the findings of seven infants with BDLS, of whom two were identical twin sisters of normal parents. All of the infants' parents were normal, and no consanguinity between the parents was noted although the ratio of consanguineous marriages is very high (21.1%) in Turkey. It is well known that most cases of BDLS are sporadic, some cases of this disorder are inherited in an autosomal dominant trait. Our findings suggested that familial cases of BDLS were infrequent, and vast majority of cases appeared to be sporadic and the occurrence of the syndrome in the identical twin sisters of normal parents was also thought a heterogeneity in this condition, overlapping with other conditions and syndromes as mentioned by Fryns et al. (6).
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.
Childhood Amoebiasis
(Royal Soc Medicine Press Ltd, 2002) Cesur, Y; Çaksen, H; Özkaya, E; Kirimi, E; Yilmaz, H; Akçay, G; Odabas, D
Childhood Brucellosis Is Still a Severe Problem in the Eastern Region of Turkey
(Sage Publications inc, 2002) Çaksen, H; Arslan, S; Öner, AF; Cesur, Y; Ceylan, A; Atas, B; Abuhandan, M
Chloral Hydrate Intoxication in a Newborn Infant
(Elsevier Science inc, 2002) Kirimi, E; Çaksen, H; Cesur, Y; Odabas, D; Ozkaya, E; Ceylan, N
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
Cutaneous Anthrax in Eastern Turkey
(Excerpta Medica inc, 2001) Çaksen, H; Arabaci, F; Abuhandan, M; Tuncer, O; Cesur, Y
Anthrax, caused by the spore-forming bacterium Bacillus anthracis, is rarely seen in industrial nations but is common in developing countries. Cutaneous anthrax (CA), the most common form of the disease, accounts for 95% of cases and usually develops on exposed sites. This study reviews the clinical and laboratory findings of 21 patients diagnosed with CA during 2 separate epidemics in the Van region of Turkey. All patients had a history of direct contact with infected cattle. The patients, aged 1.5 to 64 years, included 13 females and 8 mates. Of the patients, 9 were 15 years or younger. Skin lesions were localized on the hands and fingers in 15 patients, on the face in 3 patients, on the face and finger in 1 patient, on the chest and-finger in 1 patient, and on the eyelid in 1 patient. Gram-positive bacillus were noted on Gram-stains of material obtained from skin lesions in 2 patients. All but one patient was successfully treated with penicillin; the unresponsive patient was treated with cefuroxime and required plastic reconstructive surgery because of a skin defect on the eyelid.
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.
Dural Arteriovenous Malformation: a Rare Cause of Epilepsy in Childhood
(Neurol Soc india, 2001) Caksen, H; Unal, O; Tombul, T; Cesur, Y; Abuhandan, M
A 3 year and 6 month old girl with epilepsy associated with dural arteriovenous malformation (DAVM), diagnosed on the MRI, is presented to emphasise the importance of DAVM in the aetiology of childhood epilepsy.
Evaluation of Thyroid and Parathyroid Functions in Children Receiving Long-Term Carbamazepine Therapy
(Taylor & Francis Ltd, 2003) Çaksen, H; Dülger, H; Cesur, Y; Atas, B; Tuncer, O; Odabas, D
We studied serum calcium, phosphorus, alkaline phosphatase (ALP), thyroid hormones (total thyroxine [TT4], free thyroxine [FT4], thyroid-stimulating hormone [TSH]), parathyroid hormone (PH), and osteocalcine levels in children with epilepsy who had been receiving long-term carbamazepine (CBZ) therapy to determine whether there was any effect of CBZ therapy on these hormones. The study included 18 patients with epilepsy receiving CBZ and 16 healthy age-matched controls. The age ranged from 4-18 years (11.26 +/- 3.59 years) and 4.5-17 years (11.16 +/- 3.13 years) in the study and control group, respectively. The duration of CBZ use was between 10 months-5 years (3.12 +/- 1.09 years). When comparing the results we did not find any significant difference in serum calcium, phosphorus, ALP, osteocalcine and TSH and PH levels between the groups (p > .05). However, serum TT4 and FT4 levels were found to be significantly lower in the study group than those of control group (p < .05). However, we observed no clinical signs of hypothyroidism in all subjects. To these findings we suggest that serum thyroid hormone levels should be monitored in children receiving long-term CBZ therapy.
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.
No Effect of Long-Term Valproate Therapy on Thyroid and Parathyroid Functions in Children
(Taylor & Francis Ltd, 2002) Çaksen, H; Dülger, H; Cesur, Y; Odabas, D; Tuncer, O; Atas, B
In this study, we studied serum calcium, phosphorus, alkaline phosphatase, thyroid hormones (total thyroxine, free thyroxine, thyroid-stimulating hormone), parathyroid hormone, and osteocalcine levels in children with epilepsy who had been receiving long-term valproate (VPA) therapy in order to determine whether there was any effect of VPA therapy on these hormones. The study included 31 patients with epilepsy receiving VPA and 22 healthy age-matched controls. The age ranged from 15 months to 16 years and 18 months to 17 years in the study and control group, respectively. The duration of VPA use was between 12 months and 5 years (1.93 +/- 1.90 years). When comparing the results, we did not find any significant difference in any of the parameters, including serum calcium, phosphorus, alkaline phosphatase, osteocalcine, and thyroid and parathyroid hormone levels, between the study and control group. We suggest that VPA can safely be used with regard to thyroid and parathyroid dysfunction in childhood epilepsy.
Pro-Inflammatory Cytokines in Turkish Children With Protein-Energy Malnutrition
(Carfax Publishing, 2002) Dülger, H; Arik, M; Sekeroglu, MR; Tarakçioglu, M; Noyan, T; Cesur, Y; Balahoroglu, R
BACKGROUND: Protein-energy malnutrition (PEM) results from food insufficiency as well as from poor social and economic conditions. Development of PEM is due to insufficient nutrition. Children with PEM lose their resistance to infections because of a disordered immune system. It has been reported that the changes occurring in mediators referred to as cytokines; in the immune system may be indicators of the disorders associated with PEM. Aims: To determine the concentrations of pro-inflammatory cytokines in children with PEM, and to find out whether there was an association with the clinical presentation of PEM. Methods: The levels of serum total protein, albumin, tumour necrosis factor-a, and interleukin-6 were measured in 25 patients with PEM and in 18 healthy children as a control group. PEM was divided into two groups as kwashiorkor and marasmus. The kwashiorkor group consisted of 15 children and the marasinus group consisted of 10 children. Results: Levels of serum total protein and albumin of the kwashiorkor group were significantly lower than both the marasmus group and controls (p < 0.05). In view of tumour necrosis factor-a levels, there was no difference between groups (P > 0.05). While levels of interleukin-6 in both the marasmus group and the kwashiorkor group were significantly higher compared with controls (p < 0.05), there was no significant difference between the groups of marasmus and kwashiorkor (p > 0.05). Conclusions: It was observed that the inflammatory response had increased in children with malnutrition.
Right Thalamic Hemorrhage Resulting From High-Voltage Electrical Injury
(Elsevier Science Bv, 2004) Çaksen, H; Yuca, SA; Demirtas, I; Odabas, D; Cesur, Y; Demirok, A
A 12-year-old boy was admitted with electrical burn and loss of consciousness. On physical examination his general condition was poor. Extensive burn areas, second and third degree, were present on his face, scalp, bilateral auricles, right cervical region, shoulders, right axilla, upper region of the thorax, and proximal region of the upper extremities. The total burned surface area was about 25%. Pupils were isocoric, but response to light was bilateral poor. He was stuporous and responsive only to pain. Deep tendon reflexes were exaggerated and plantar responses were bilateral extensor. Bilateral decorticate rigidity was noted. Computerized tomography of brain revealed brain edema and right thalamic hemorrhage. Magnetic resonance imaging of brain, examined 25 days after admission, revealed fight thalamic hemorrhage and mild right subdural effusion. He was discharged form hospital 40 days after admission. However, spastic quadriplegia and severe mental retardation remained as sequela. On the 4th month of follow-up, no improvement was noted in his neurological examination. On the 9th month of follow-up, his clinical condition was better, but bilateral electric cataract was diagnosed. Both eyes were operated on and intraocular lenses were implanted with good results. Now he is 16th month of follow-up: neurological examination revealed only mild hemiparesis on the left side and mild articulation disorder. His school performance was moderate and intelligence quotient was 71. Magnetic resonance imaging of brain showed markedly improvement of the hemorrhage. To our best knowledge thalamic hemorrhage resulting from high-voltage electrical injury has not previously been reported in the literature. (C) 2003 Elsevier B.V. All rights reserved.
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.
Use of Interferon Alpha-2b and Prednisolone in the Treatment of Severe Intractable Diarrhea in a Child With Systemic Mastocytosis
(Blackwell Publishing Asia, 2003) Çaksen, H; Odabas, D; Öner, AF; Cesur, Y; Arslan, S; Akbayram, S; Erol, M
Use of Sulfasalizine in the Treatment of Post Amebic Rectocolitis
(Elsevier Science inc, 2002) Kirimi, E; Çaksen, H; Cesur, Y; Ceylan, A; Demirtas, I; Yilmaz, H; Odabas, D
Very High Serum Aldesterone Level in an Infant Who Expired
(Elsevier Science inc, 2003) Çaksen, H; Cesur, Y; Akgün, C; Odabas, D