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    Adrenomedullin and nitrite levels in children with minimal change nephrotic syndrome
    (Springer-Verlag, 2000) Balat, A; Çekmen, M; Yürekli, M; Gülcan, H; Kutlu, O; Türköz, Y; Yologlu, S
    Nitric oxide (NO) serves many functions within the kidney, and recent evidence suggests that NO contributes to glomerular injury. Adrenomedullin (AM) is a novel hypotensive peptide originally isolated from human pheochromocytoma. Recent studies showed that plasma AM concentrations correlated with the extent of proteinuria. We have examined the possible role of these two agents by studying plasma and urinary total nitrite (NO-(2) + NO-(3)) and AM levels in children with minimal change nephrotic syndrome (MCNS). In comparison with healthy controls, children with MCNS had increased urinary nitrite excretion (mu mol/mg urinary creatinine), irrespective of whether the disease was in relapse or remission (3.2+/-0.2 in relapse, n=13; 1.9+/-0.3 in remission, n=12; 1.0+/-0.2 in controls, n=10, P<0.05). Plasma nitrite levels (mol/l) were high in relapse compared with controls (53.2+/-8.7 vs 32+/-4.0, P<0.05). Plasma AM levels (pmol/ml) were decreased in relapse (27.6+/-1.4 in relapse, 43.3+/-1.2 in remission, 41.5+/-1.6 in controls, P<0.05). Urinary AM levels (pmol/mg urinary creatinine) were significantly higher in relapse than in remission and in controls (156+/-43 in relapse, 56+/-18 in remission, 36+/-16 in controls, P<0.05). Our data indicate that NO may play a role in mediating the clinical manifestations of MCNS in children. However, changes in AM levels may be the result of heavy proteinuria.
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    Multivoxel magnetic resonance spectroscopy in a rhizomelic chondrodysplasia punctata case
    (Sage Publications Inc, 2005) Sigirci, A; Alkan, A; Kutlu, R; Gülcan, H
    A case of a 5-day-old newborn with rhizomelic chondrodysplasia punctata was investigated with multivoxel magnetic resonance spectroscopy, including chemical shift imaging maps, which disclosed a decrease in the choline peak and the choline signal intensity, respectively, in the right cerebral hemisphere. This is the second report of multivoxel magnetic resonance spectroscopy examination of the brain associated with rhizomelic chondrodysplasia punctata in the literature. Multivoxel magnetic resonance spectroscopy with chemical shift imaging maps has the advantage of obtaining more information in a short period of time, which shortens the duration of anesthesia and its associated risks and complications. We suggest that future efforts be directed to evaluating such patients with multivoxel magnetic resonance spectroscopy instead of single-voxel magnetic resonance spectroscopy.
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    Renal interlobar artery parameters with duplex Doppler sonography and correlations with age, plasma renin, and aldosterone levels in healthy children
    (Amer Roentgen Ray Soc, 2006) Sigirci, A; Hallaç, T; Akyncy, A; Temel, S; Gülcan, H; Aslan, M; Koçer, M
    OBJECTIVE. The objectives of this study were to compare and make correlations between age and Doppler parameters of the interlobar arteries, including synchronously obtained plasma renin and aldosterone levels and to obtain new normative data regarding acceleration time in healthy children from neonates to 16 years. SUBJECTS AND METHODS. One hundred sixty-nine healthy children (72 girls and 97 boys) were classified into four groups: group 1 (< 1 year; n = 34), group 2 (range, 1-6 years; n = 48), group 3 (range, 6-12 years; n = 50), and group 4 (range, 12-16 years; n = 37). Blood samples from the renin and aldosterone were collected in the morning after bed rest and fasting. The resistive index (RI), pulsatility index (PI), and the acceleration time of the renal interlobar arteries with duplex Doppler sonography, including both kidney longitudinal lengths with gray-scale sonography, were evaluated. One-way analysis of variance with the least significant difference post-hoc test and Pearson's correlation test were used to compare the differences between groups and to make correlations, respectively. An independent-sample t test was used to evaluate the differences between all parameters based on sex and to compare the left and right kidney longitudinal lengths in each group. RESULTS. The RI, PI, and acceleration time were statistically significant in between-group comparisons. Only in group 4 was acceleration time not statistically significant compared with groups 2 and 3. Plasma renin levels were significantly higher in group 1 compared with groups 2 (p < 0.03) and 4 (p < 0.0001); in group 2 compared with group 4 (p < 0.05); and in group 3 compared with group 4 (p < 0.01). The plasma aldosterone levels were significantly higher only in group 1 compared with groups 2 (p < 0.001), 3 (p < 0.008), and 4 (p < 0.0001). The RI correlated linearly with the PI, plasma renin levels, and aldosterone levels and correlated inversely with acceleration time. Age had a negative correlation with the RI, PI, plasma renin levels, and aldosterone levels and correlated positively with acceleration time. There were no statistically significant differences between all parameters based on sex and no significant difference found between the right and left kidney longitudinal lengths in each group. CONCLUSION. The RI in children up to 54 months old is higher than in adults. Therefore, the adult mean renal RI criterion of 0.70 should be applicable to children 54 months old and older. We showed that the age dependency of the RI was directly related to that of plasma renin and aldosterone levels in healthy children in whom Doppler parameters and blood analysis were evaluated synchronously.