Browsing by Author "Kirimi, E"

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Asymmetrical Nonscalp Aplasia Cutis Congenita: a Case Report
(Wiley, 2004) Atik, B; Tan, O; Bayram, I; Tuncer, O; Kirimi, E
Aplasia cutis congenita or congenital absence of the skin is a rare and serious congenital disease; its etiopathogenesis remains unclear. In this condition, localized or widespread areas of skin are absent at birth. A newborn suffering from an unusual aplasia cutis congenita located asymmetrically on the nonscalp, without blistering, was presented. This patient was completely healed with conservative treatment.
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 Thanatophoric Dysplasia Type I Associated With Mandibular Clefting
(Medecine Et Hygiene, 2004) Tuncer, O; Çaksen, H; Kirimi, E; Kayan, M; Atas, B; Odabas, D
Childhood Amoebiasis
(Royal Soc Medicine Press Ltd, 2002) Cesur, Y; Çaksen, H; Özkaya, E; Kirimi, E; Yilmaz, H; Akçay, G; Odabas, D
Chloral Hydrate Intoxication in a Newborn Infant
(Elsevier Science inc, 2002) Kirimi, E; Çaksen, H; Cesur, Y; Odabas, D; Ozkaya, E; Ceylan, N
Clinical Value of Color Doppler Ultrasonography Measurements of Full-Term Newborns With Perinatal Asphyxia and Hypoxic Ischemic Encephalopathy in the First 12 Hours of Life and Long-Term Prognosis
(Tohoku Univ Medical Press, 2002) Kirimi, E; Tuncer, O; Atas, B; Sakarya, ME; Ceylan, A
The cerebral blood flow velocities (CBFV) of infants with perinatal asphyxia and hypoxic ischemic encephalopathy (HIE) in the first 12 hours of their lives have been the chief focus of our concern in this study. Cerebral ischemia which can develop in the earlier hours of HIE, and the detection and diagnosis of this condition with color Doppler ultrasonography (cD-USG) will be put into discussion. Twenty-three full-term newborn infants who had perinatal asphyxia and HIE together with a control group constituting twenty full-term newborn infants who produced no problems, were included in our study, All of the infants underwent cD-USG in the postpartum period of the first 12 hours (mean 8.4 hours). Measurements being based upon peak systolic velocity (PSV), end diastolic velocity (EDV) and Pouecelout's resistive index (RI) in anterior and middle cerebral arteries were conducted. The infants, having been discharged from the unit they were followed up for mean 9.8 months in the outpatient clinic. PSV and EDV counts in the postpartum first 12 hours of 23 infants who were detected to have HIE were found to be significantly lower compared to the control group, whereas RI counts were found to be significantly higher (p < 0.05). The counts obtained from the right and left cerebral arteries of the infants with HIE were found to be corraleted with each others. The neonates in the patient group were observed to have gone through this prognosis: Three of them died, three of them had cerebral palsy, one of them had infantile spasms, and three of them had developmental retardation. When we compared the CBFV of the 10 neonates who had poor prognosis, retrospectively with the other 13 neonates who had good prognosis, PSV and EDV were found to be significantly lower and RI significantly higher (p < 0.05). In the light of the data we have obtained, cD-USCT can be considered to be a highly practical device in evaluating CBVF of the infants with HIE. A skillful detection of the decrease in cerebral blood flow which can develop in the postasphyxial first 12 hours and the prospective treatments being based upon this approach would contribute to the diagnosis, treatment and. prognosis of such cases. - Doppler; neonatal; cerebral blood flow velocities (C) 2002 Tohoku University Medical Press.
Congenital Cytomegalovirus Infection Associated With Anomalies of the Left Foot
(Medecine Et Hygiene, 2005) Ceylan, A; Tuncer, O; Akbayram, S; Çaksen, H; Dogan, M; Gülmehmed, F; Kirimi, E
The Effects of Prednisolone and Serum Malondialdehyde Levels in Puppies With Experimentally Induced Meconium Aspiration Syndrome
(Sage Publications Ltd, 2003) Kirimi, E; Tuncer, O; Kösem, M; Ceylan, E; Tas, A; Tasal, I; Caksen, H
The aim of this study was to investigate the effect of different doses of prednisolone in puppies experimentally induced with meconium aspiration syndrome (MAS). Meconium was collected from human babies in the first day of life and was released into the trachea of 11 newborn puppies to induce MAS. Puppies were treated with 2 mg/kg prednisolone (standard dose), 30 mg/kg prednisolone (megadose) or 0.9% saline, all administered intravenously. The study ended 20 h after meconium aspiration and the lungs were then scored for histopathology. Animals not treated with prednisolone deteriorated after 8 h while respiration rate, oxygenation, pH and partial pressure of carbon dioxide values were better in the prednisolone-treated groups. Histopathology scores were better in the treatment groups compared with the control group, with megadose giving the best result. At the end of the study, serum malondialdehyde levels were significantly higher in the megadose prednisolone group compared with the other two groups. In conclusion, we determined that prednisolone reduced physiological and histological changes in puppies with MAS and that a 30 mg/kg dose was more effective than 2 mg/kg.
Four Children With Colchicine Poisoning
(Arnold, Hodder Headline Plc, 2004) Atas, B; Çaksen, H; Tuncer, O; Kirimi, E; Akgün, C; Odabas, D
Colchicine poisoning is a rare event. It is characterized by multiorgan involvement and by poor prognosis associated with overdose. In this article we present four children with colchicine poisoning to emphasize that colchicine poisoning has a large spectrum in childhood. The children's ages ranged between 1 year and 3.5 years. The ingested dosage of colchicine was between 0.37 and 1.72 mg/kg. Most of the findings of colchicine poisoning such as gastrointestinal symptoms, hepatotoxicity, cardiotoxicity, bone marrow suppression, hypocalcaemia and hair loss were diagnosed in our patients. Two children receiving 0.37 mgukg and 1 mg/kg colchicine and admitted 13 and 19 hours after poisoning, respectively, died. Our findings suggest that in addition to amounts of the drug, mortality was also related to the duration between drug ingestion and admission to hospital.
A Girl With a Giant Bladder Stone
(Elsevier Science inc, 2004) Atas, B; Caksen, H; Arslan, S; Akbayram, S; Kirimi, E; Tuncer, O; Kayan, M
Hyperkalemia Most Likely Associated With Massive Cephalhematoma in a Newborn Infant Who Was Treated With Urgent Peritoneal Dialysis: Case Report
(Elsevier Science inc, 2003) Kirimi, E; Tuncer, O; Atlas, B; Arslan, S
Cephalhematomas rarely lead to serious complications such as infection, osteomyelitis and skull fractures. However, we present a newborn infant with hyperkalemia in the context of a serious complication believed to be caused by hemolysis of a large cephalhematoma. The patient was treated with urgent peritoneal dialysis and discharged with a successful outcome. In conclusion, neonates with massive cephalhematoma should be closely examined in terms of bilirubin counts as well as electrolyte counts. (C) 2003 Elsevier Science Inc.
Myoglobinuric Renal Failure - Response
(Elsevier Science inc, 2004) Kirimi, E; Tuncer, O; Atas, B; Arslan, S; Ataş, B.; Arslan, S.
Pfapa Syndrome Mimicking Familial Mediterranean Fever
(Elsevier Science inc, 2003) Atas, B; Çaksen, H; Arslan, S; Tuncer, O; Kirimi, E; Odabas, D
The PFAPA (Periodic Fever, Aphthous stomatitis, Pharyngitis, Adenitidis) syndrome is characterized by periodic fever, adenitis, pharyngitis, and aphthous stomatitis. Herein, we present a Turkish child with PFAPA syndrome mimicking familial Mediterranean fever because of a rare presentation. A 9-year-old boy was admitted with recurrent fever, aphthous stomatitis, sore throat, headache, and general body pains, lasting 2 to 3 days since 3.5 years of age. He was completely symptom-free between the attacks. He was diagnosed as having familial Mediterranean fever according to the clinical findings when he was 6 years of age and Colchicum tablet was administrated. Despite colchicines therapy for 8 months, his attacks did not subside; therefore, the drug was discontinued. He had high fever, a painful cervical lymphadenopathy, aphthous stomatitis, and tonsillo-pharyngitis. The patient was then diagnosed as having PFAPA syndrome: He was given a single dose of prednisolone (0.35 mg/kg/dose). His complaints dramatically and completely disappeared 3 h after administration of the drug. During the 8(th) month of follow-up, a similar febrile attack lasting only 1 day was noted and it was controlled with a single dose of prednisolone (0.5 mg/kg/day). At this writing the patient is in the 12(th) month of follow-up, and there have,been no symptoms after the second attack. In conclusion, our patient shows that PFAPA syndrome can be confused with familial Mediterranean fever. We also would like to emphasize that the typical PFAPA syndrome can be easily diagnosed by detailed history-taking and physical findings. 2003 Elsevier Inc.
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).
Report of Three Children With Leptospirosis in Rural Area of the East of Turkey
(Tohoku Univ Medical Press, 2003) Kurtoglu, MG; Tuncer, O; Bozkurt, H; Çaksen, H; Berktas, M; Ceylan, E; Kirimi, E
Leptospirosis is a systemic infection usually producing fever with hepatorenal involvement, meningoencephalitis, and hemorrhage. In this article, we present three children between 10 and 13 years of age with leptospirosis. The purpose of this paper is to emphasize that leptospirosis is a problem in our country with farmers/cattle and that leptospirosis should be considered in certain ill children. The main symptoms were headache, fever, fatigue, abdominal pain and unconsciousness. Two patients had hepatic and renal involvement. The other had hepatic, pulmonary and probably pericardial. involvement. In all children spirochetes were demonstrated in blood and urine smears by dark-field microscopy and they were also isolated from urine and blood cultures by using Flecher medium. All patients were treated with penicillin; however, one subsequently required additional antibiotics due to Klebsiella pneumoniae septicemia. While one patient was discharged in a good health, the others were taken to their home by parents without completing treatment. In conclusion, we would like to emphasize that leptospirosis is still a public health problem in our region (Eastern Turkey) in where the majority of population are farmers and raise domestic animals such as cattle in rural areas. Additionally, leptospirosis should be considered in children admitted with headache, unconsciousness, fever and abdominal pain. (C) 2003 Tohoku University Medical Press.
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.
A Review of 35 Cases of Asymmetric Crying Facies
(Medecine Et Hygiene, 2004) Çaksen, H; Odabas, D; Tuncer, O; Kirimi, E; Tombul, T; Ikbal, M; Yuca, SA
A review of 35 cases of asymmetric crying facies: Congenital asymmetric crying facies (ACF) is caused by congenital hypoplasia or agenesis of the depressor anguli oris muscle (DAOM) on one side of the mouth. It is well known that this anomaly is frequently associated with cardiovascular, head and neck, musculoskeletal, respiratory. gastrointestinal, central nervous system, and genitourinary anomalies. In this article we report 35 ACF patients (28 children and 7 adults) and found additional abnormalities in 16 of them (i.e. 45%). The abnormalities were cerebral and cerebellar atrophy, mega-cisterna magna, mental motor retardation, convulsions, corpus callosum dysgenesis, cranial bone defect, dermoid cyst, spina bifida occulta, hypertelorism, micrognatia, retrognatia, hemangioma on the lower lip, short frenulum, cleft palate, low-set cars, preauricular tag, mild facial hypoplasia, sternal cleft, congenital heart defect, renal hypoplasia, vesicoureteral reflux, hypertrophic osteoarthropathy, congenital joint contractures, congenital hip dislocation, polydactyly, and umbilical and inguinal hernia. Besides these, one infant was born to a diabetic mother, and had atrial septal defect and the four other children had 4p deletion, Klinefelter syndrome, isolated CD4 deficiency and Treacher-Collins like facial appearance, respectively. Although many of these abnormalities were reported in association with ACF, cerebellar atrophy, sternal cleft, cranial bone defect, infant of diabetic mother, 4p deletion, Klinefelter syndrome, isolated CD4 deficiency and Treacher, Coll ins like facial appearance were not previously published.
Short Rib-Polydactyly Syndrome Type I Associated With a Single Umbilical Artery
(Medecine Et Hygiene, 2004) Tuncer, O; Çaksen, H; Kirimi, E; Kösem, M; Oral, H; Atas, B; Odabas, D
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