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Öğe Brucellosis in the etiology of febrile neutropenia: Case report(Taylor & Francis Ltd, 2002) Sari, R; Buyukberber, N; Sevinc, A; Bayindir, Y; Buyukberber, SBrucellosis is one of the leading diseases in the differential diagnosis of fever of unknown origin in some parts of the world. It can lead to treatment failure because of slow growth in blood cultures and late appearance of signs and symptoms in patients with febrile neutropenia who were unresponsive to empirical antibiotic treatment. During the last year in our oncology unit adjuvant chemotherapy was given to 3 patients with breast (n=l) and stomach cancer (n=2) and febrile neutropenia was seen after the first course of chemotherapy (cyclophosphamide, methotrexate, 5-fluorouracil, etoposide, Adriamycin, and cisplatin) in all 3 patients. Cefepime and amikacin were commenced but the fever continued. Prior to antifungal treatment, the patients were re-evaluated because of the history of unpasteurized milk ingestion without overt signs and symptoms. Serum agglutination tests of brucellosis were performed and were 1:640 in two patients and 1:320 in the third. Brucella melitensis was identified only in one case although multiple blood cultures were taken from all 3 patients. Empiric antibiotic treatment was stopped and streptomycin 1 g/day (10 days), doxycycline 200 mg/day (28 days), trimethoprim 320 mg and sulfamethoxazole 1600 mg/day (28 days) were given. Although neutropenia continued, fever subsided in 3 days. Due to high incidence of brucellosis in some geographic areas, especially in the Middle East, brucellosis should be kept in mind in the differential diagnosis of febrile neutropenia.Öğe Cancer antigen 125: Tumor or serosal marker in case of ascites?(Amer Medical Assoc, 2001) Sevinc, A; Sari, R; Buyukberber, S[Abstract Not Available]Öğe The efficacy of acetazolamide on visual functions in a patient with choroid metastasis of breast carcinoma(Medicom International, 2001) Sari, R; Camci, C; Kutlu, R; Totan, Y; Sevinc, A; Buyukberber, SBreast carcinoma is the most frequent cancer in women and is the second leading cause of death. Choroid metastasis of breast carcinoma can be found either at presentation or in remission. It is frequently encountered in disseminated breast cancer with multiple organ metastasis. It has been proposed that the oedema-reducing effect of acetazolamide is due to stimulated ion and fluid removal from the retina to the choroid. A 40-year-old female patient on adjuvant chemotherapy for breast cancer was found to have an isolated choroid metastasis. Clinical and radiological remission was achieved after orbital radiotherapy, chemotherapy and acetazolamide treatment. In this case report, we emphasise the possible beneficial effect of acetazolamide in patients with choroid metastasis.Öğe Elevated serum CA-125 levels in hemodialysis patients with peritoneal, pleural, or pericardial fluids(Academic Press Inc, 2000) Sevinc, A; Buyukberber, S; Sari, R; Kiroglu, Y; Turk, HM; Ates, MObjective. Serum CA-125, an ovarian tumor marker, is used especially in the follow-up of ovarian cancer for monitoring the efficacy of therapy and for early detection of recurrence. A number of benign gynecologic as well as benign and malignant nongynecologic conditions are associated with elevated serum CA-125 levels. Malignant and nonmalignant serosal fluids were also found to be associated with high serum levels of CA-125, suggesting that the presence of fluid in the serosal cavities may stimulate its release. Methods. We performed a clinical study in 39 patients (21 females, 18 males) on chronic hemodialysis who were divided into two groups based on the presence of fluid in the serosal cavities (peritoneum, pleura, or pericardium) without clinical and radiologic evidence of neoplasia. There were 26 patients (16 females, 10 males) aged 50.11 +/- 13.86 years (range, 20-76 years) in the serosal fluid-negative group (group 1) and 13 patients (8 females, 5 males) aged 45.30 +/- 18.84 years (range, 17-73 years) in the serosal fluid-positive group (group 2). The control group consisted of 52 healthy volunteers (30 females, 22 males) aged 44.19 +/- 12.59 years (range, 19-68 years). Results. Significantly elevated serum CA-125 levels were found in hemodialysis patients with serosal fluid (P < 0.05) when compared with both the hemodialysis patients without serosal fluid and the control group. There was no statistically significant difference between the control group and the patients without serosal fluids (P > 0.05). Conclusion. Although CA-125 can be considered a reliable tumor marker in patients undergoing hemodialysis, it should be interpreted with caution in patients with serosal fluids. (C) 2000 Academic Press.Öğe Elevated serum CA-125 levels in patients with nephrotic syndrome-induced ascites(Int Inst Anticancer Research, 2000) Sevinc, A; Buyukberber, S; Sari, R; Turk, HM; Ates, MCA-125 is a sensitive, but not a specific, tumour marker especially used in the diagnosis and follow-up of ovarian cancer. Because of the elevated levels of CA-125 encountered during the etiological investigation of nephrotic syndrome (NS) a clinical study was designed to investigate the probable relationship between elevated CA-125 levels in patients with NS, with and without ascites. Twenty-four patients with NS due to non-tumoural pathologies, aged 24 to 56 (15 females and 9 males), were investigated We detected elevated levels of serum CA-125 (275.92 +/- 154.71 U/mL) in 14 (70%) NS patients with ascites (p<0.05). In the other 10 NS patients without ascites (Group 2) and in the control group, consisting of 52 age and sex-marched healthy volunteers, the serum CA-125 levels were found to be 13.60 +/- 5.12 U/mL and 8.50 +/- 5.02 U/mL, respectively (p>0.05). There was no statistically significant difference between the control group and the patients without serosal fluids (p>0.05). We concluded that serum CA-125 levels were elevated in NS patients with ultrasonographically detected ascites in the absence of an ovarian tumour or other diseases known to increase the levels of CA-125.Öğe Elevated serum CA-125 levels: Hepatitis or ascites?(Academic Press Inc, 2000) Sevinc, A; Buyukberber, S; Sari, R[Abstract Not Available]Öğe The evaluation of suspected infectious episodes in patients with hematological diseases.(W B Saunders Co, 1996) Aydogdu, I; Buyukberber, S; Duygulu, C; Tayfun, E; Yucesoy, M[Abstract Not Available]Öğe Follicular thyroid cancer presenting initially with soft tissue metastasis(Oxford Univ Press, 2000) Sevinc, A; Buyukberber, S; Sari, R; Baysal, T; Mizrak, BFollicular thyroid cancer rarely manifests itself as a distant metastatic lesion. We report a case of an otherwise asymptomatic 58-year-old woman with follicular thyroid cancer who initially presented with a soft tissue mass on the right scapular region, An incisional biopsy specimen of soft tissue metastasis showed thyroid follicular neoplasm. Upon this diagnosis, the thyroid gland was re-evaluated by ultrasound, which demonstrated a solitary, hypoechoic nodule in the right lobe, Ultrasonography guided fine-needle aspiration biopsy of the thyroid nodule confirmed follicular neoplasm and the diagnosis of metastatic follicular thyroid cancer was established. The patient refused any type of treatment and left hospital against medical advice. 2.5 years later the patient was admitted to the hospital with giant, sarcoma-like multiple soft tissue masses. On this admission, the serum thyroglobulin level was extremely elevated (3500 ng/ml) and she only accepted to receive chemotherapy, Epirubicin and cyclophosphamide were administered, She received three courses of chemotherapy and is alive with a stable disease after 3 months of follow-up, This case of follicular thyroid cancer is reported because of its uncommon initial presentation with soft tissue metastasis which spread to multiple areas as giant soft tissue masses during follow-up.Öğe Gluten-free diet improves iron-deficiency anaemia in patients with coeliac disease(I C D D R B-Centre Health Population Research, 2000) Sari, R; Yildirim, B; Sevinc, A; Buyukberber, STwo cases of newly-diagnosed asymptomatic coeliac disease with 3 years of unexplained severe iron-deficiency anaemia are presented. Oral iron supplementation had no effect on their serum iron levels and, therefore, had no influence on their anaemia. Upper gastrointestinal endoscopy confirmed normal macroscopic findings, Duodenal biopsies revealed subtotal villous atrophy of the mucosa of the small intestine. A strict gluten-free diet led to an increase in serum iron, resolution of anaemia, and restitution of normal mucosal morphology, Thus, severe iron-deficiency anaemia associated with asymptomatic coeliac disease is responsible to gluten-free diet.Öğe Hemodynamic changes in the early phase of artificially created arteriovenous fistula: Color Doppler ultrasonographic findings(Amer Inst Ultrasound Medicine, 1997) Mahmutyazicioglu, K; Kesenci, M; Fitoz, S; Buyukberber, S; Sencan, O; Erden, IThe objective of this study was to evaluate hemodynamic variables in arteriovenous fistulas by color Doppler ultrasonography. This study involved 28 patients with chronic renal failure who were sent to surgery clinic for creation of an arteriovenous fistula of the Brescia-Cimino type. Patients were evaluated preoperatively and on the first and seventh days postoperatively by a color Doppler ultrasound machine with a 7.5 MHz linear probe. The distal radial artery was examined preoperatively and the fistula itself postoperatively. Changes in the fistula size and the velocity, volume, and resistive index of the distal radial artery were recorded. Postoperatively the radial artery diameter, systolic flow rates, and volume flow had increased significantly, especially on the first day, in comparison to preoperative values. Resistive index values has deceased significantly at both the first and the seventh days postoperatively. Color Doppler ultrasonography is a very effective method in the evaluation of hemodynamics of arteriovenous fistulas in hemodialysis patients. It will allow an understanding of the pathology in nonfunctioning fistulas or of the cause of complications that develop secondarily.Öğe Heparin-induced exfoliative dermatitis in a patient on haemodialysis(Adis International Ltd, 1999) Sevinc, A; Pekdemir, H; Harputluoglu, M; Sari, R; Buyukberber, S; Senol, M[Abstract Not Available]Öğe Metastatic bone marrow tumours: a report of six cases and review of the literature(Vsp Bv, 2001) Sari, R; Aydogdu, I; Ozen, S; Sevinc, A; Buyukberber, SBone marrow aspirations and biopsies are now employed in the investigation of many disorders in haematology, oncology, and internal medicine. In this paper, clinical, laboratory, and pathological findings are presented of patients with bone marrow metastases of solid tumours (n = 6). Anemia was detected in four cases (66.6%), thrombocytopenia in five cases (83.3%), leukopenia in three cases (50%), diffuse bone pain in four cases (66.6%), elevated serum alkaline phosphatase levels in four cases (66.6%), and hypercalcaemia in two cases (33.3%). In conclusion, bone marrow aspiration and biopsy examinations are effective, practical, and cheap in detecting solid tumour metastasis to bone marrow in a selected group of patients.Öğe Non-invasive imaging methods before fine-needle aspiration in the diagnosis of cervical masses(Wiley, 2002) Camci, C; Sari, R; Buyukberber, S; Kutlu, R; Sevinc, A; Çokkeser, YA carotid body tumour is a vascular tumour usually located at or around the bifurcation of the carotid artery and originating from the tunica adventitia. Carotid body tumours, which are generally non-functional and asymptomatic, grow slowly, which is why diagnosis can be delayed. Because of the vascular structures, fine-needle aspiration biopsy may be dangerous and impractical. Efficient and reliable methods of diagnosis, such as colour Doppler ultrasound, magnetic resonance imaging, computerised tomography and arteriography, can be useful. We report on a 58-year-old woman with diarrhoea, flushing and a cervical, hard, non-tender, fixed mass. An unsuccessful diagnostic fine-needle aspiration biopsy was performed after palpation of the cervical mass. A carotid body tumour was finally diagnosed. We concluded that non-invasive imaging methods should be evaluated before fine-needle aspiration in cervical masses. It should also be kept in mind that asymptomatic cervical masses may be related to non-local symptoms.Öğe Occult parathyroid carcinoma in a patient with papillary thyroid carcinoma and Hashimoto's thyroiditis(Editrice Kurtis S R L, 2001) Savli, H; Sevinc, A; Sari, R; Ozen, S; Buyukberber, S; Ertas, EA 47-year-old female patient with a previous history of right thyroid lobectomy was admitted to the hospital because of a 3 cm nodule in the thyroid gland. Hormonal evaluation showed subclinical hypothyroidism with serum levels of thyroid stimulating hormone slightly elevated to 4.4 mug/dl (normal: 0.4-4 mug/dl). Thyroid ultrasound showed diffuse irregularity of the gland and the presence of a solitary nodule (30x18 mm in diameter) localized in the left lobe. A fine needle aspiration biopsy was performed. Cytological analysis revealed papillary thyroid carcinoma and Hashimoto's thyroiditis. Total thyroidectomy was performed. During the operation, two of the parathyroid glands were detected to be hyperplastic. Histopathological examination of the thyroid and parathyroid glands revealed Hashimoto's thyroiditis with papillary thyroid carcinoma and synchronous carcinoma of the parathyroid gland. To our knowledge, this association of occult parathyroid carcinoma in a patient with papillary thyroid carcinoma and Hashimoto's thyroiditis has not been reported in the literature. Given the high prevalence of autoimmune diseases in elderly women, a random occurrence of this triad represents the most likely explanation. (C) 2001, Editrice Kurtis.Öğe Plasma lipid peroxidation products and antioxidant enzyme activities in patients with type 2 diabetes mellitus(Springer-Verlag Italia Srl, 2002) Turk, HM; Sevinc, A; Camci, C; Cigli, A; Buyukberber, S; Savli, H; Bayraktar, NDiabetes is associated with a significant increase in thiobarbituric acid reactive substances (TBARS) which are considered as an index of endogenous lipid peroxidation. The human body has a complex antioxidant defense system that prevents the initiation of free radical chain reactions. We measured plasma TBARS levels, superoxide dismutase (SOD) and catalase (CAT) activities and compared their relation to the metabolic control of diabetes and diabetic microangiopathy. Sixty-four patients (19 men), aged 52.35 +/- 9.31 years with type 2 diabetes mellitus were included in the study. Thirty-six healthy subjects (12 men), aged 51.02 +/- 7.01 years formed the control group. TBARS levels and SOD activity were elevated in the diabetic group when compared with the control group (p<0.001 and p<0.00001, respectively). However CAT activity was significantly decreased in the diabetic group when compared with the control group (p<0.00001). Patients with diabetic nephropathy and retinopathy. but not neuropathy, had elevated TBARS levels but there was no statistically significant difference when compared with diabetic patients without microangiopathy (p>0.05). There was a positive correlation between plasma TBARS levels and SOD activity (r=0.770, p=0.0001) and a negative correlation between plasma TBARS levels and CAT activity (r=-0.482, p=0.0001). There was also a negative correlation between SOD and CAT activities (r=-0.609, p=0.0001). We found significantly elevated TBARS levels in diabetic patients. We did not observe any correlation between TBARS levels and blood glucose and HbA(1c) levels. Elevated TBARS levels and SOD activity and decreased CAT activity may be due to a compensation mechanism of the body.Öğe Potential for cytokine and product manipulation to improve the results of autologous stem cell transplantation for rheumatoid arthritis(J Rheumatol Publ Co, 2001) Talmadge, JE; Singh, R; Ino, K; Ageitos, A; Buyukberber, SThe eradication of autoreactive T cells by high dose therapy and stein cell transplantation and the resultant alterations in the immunologic network, thymic reeducation, and peripheral tolerance provide treatment mechanisms for autoimmune and inflammatory diseases. One outcome of autologous stein cell transplantation is a significant decrease in the CD4:CD8 ratio due to a loss in CD4+ cells and a depression in T cell function. Mechanistically, the loss of T cell function is associated with an increased frequency of circulating monocytes, their expression of Fas ligand (FasL). and it high frequency of apoptotic CD4+ T cells. This suggests that activated Fas+ CD4+ lymphocytes interact with FasL+ monocytes, resulting in apoptosis, preferential deletion of CD4+ T cells, an inversion in the CD4:CD8 ratio, and depressed T cell function. These observations suggest the potential for immune regulation using stem cell manipulation or posttransplant cytokine administration its therapeutic strategies for autoimmune/inflammatory diseases.Öğe Protein C, protein S and antithrombin III levels in nephrotic syndrome.(W B Saunders Co, 1996) Buyukberber, S; Aydogdu, I; Buyukberber, NM; Bektas, A; Idilman, R; Karatan, O; Uysal, A[Abstract Not Available]Öğe Pure red cell aplasia concurrent with monoclonal gammopathy (case report).(W B Saunders Co, 1996) Aydogdu, I; Duygulu, C; Buyukberber, S; Tayfun, E; Yucesoy, M[Abstract Not Available]Öğe The relation between plasma endothelin-1 levels and metabolic control, risk factors, treatment modalities, and diabetic microangiopathy in patients with Type 2 diabetes mellitus(Elsevier Science Inc, 2001) Ak, G; Buyukberber, S; Sevinc, A; Turk, HM; Ates, M; Sari, R; Savli, HWe evaluated the possible relation between plasma endothelin-1 (ET-I) levels and metabolic control, risk factors, treatment modalities, and diabetic microangiopathy, including nephropathy, neuropathy, and retinopathy in patients with Type 2 diabetes and healthy control group. Sixty-eight (39 females and 29 males) patients with Type 2 diabetes and 14 (6 females and 8 males) healthy subjects were included in the study. Plasma ET-I levels were found to be 10.46 +/- 1.24 pmol/l in the diabetic group, whereas 7.97 +/- 0.41 pmol/l in the control group, which was statistically significant (P < .01). We also found elevated plasma ET-I levels in patients with the least one microvascular complication when compared with the uncomplicated diabetes group (P=.02). Moreover, plasma ET-1 levels of the uncomplicated group was higher than the control group (P < .05). Plasma ET-1 levels were significantly elevated in hypertensive diabetics than normotensive diabetics (t=2.58, P=.012). It wets also found to be elevated in diabetic patients with diabetes duration of more than 10 years when compared with patients less than 10 years ( P=.02). These findings can be interpreted as the increased damage of microvascular complications in the disease process that may lead to elevated ET-I levels. Mean plasma ET-I levels in diabetic patients with a family history of diabetes was found to be higher than patients with no family history of diabetes. Genetical and environmental factors may have an effect on ET-1 level. We also studied the correlations of plasma ET-I levels on age, sex, fasting blood glucose levels, treatment modalities HbAlc, hyperlipidemia, C-peptide, Body Mass Index, and smoking, but did not find any statistically significant difference. In conclusion, plasma ET-1 levels are well correlated with microangiopathy, hypertension, increased disease duration, and family history of diabetes, but poorly correlated with metabolic control, treatment modalities, age, sex, hyperlipidemia, obesity, and smoking. (C) 2001 Elsevier Science Inc. All rights reserved.Öğe Relationship between plasma adrenomedullin levels and metabolic control, risk factors, and diabetic microangiopathy in patients with type 2 diabetes(Amer Diabetes Assoc, 2000) Turk, HM; Buyukberber, S; Sevinc, A; Ak, G; Ates, M; Sari, R; Savli, H[Abstract Not Available]
