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Öğe Buccal midazolam for treatment of prolonged seizures in children(Elsevier Science Bv, 2003) Kutlu, NO; Dogrul, M; Yakinci, C; Soylu, HMidazolam is a relatively new anticonvulsive agent in the benzodiazepine group. It has a short onset of duration and is practical for use, providing several alternatives such as intravenous, intramuscular, and intranasal routes. The buccal route could be an alternative choice for seizure control in an emergency setting. However, no sufficient reports are available on buccal midazolam administration. The present study was designated to examine the efficacy of buccal midazolam in children at different ages with seizures of more than 5 min duration. Nineteen previously unreported children, aged from 1 month to 15 years, were treated with a 0.3 mg/kg dose of buccal midazolam; 13 had prolonged seizures, and six had status epilepticus, with a duration of 5-45 min (mean 22 min). Sixteen of 19 seizures (84.2%) stopped within 10 min of buccal midazolam being given. The drug efficacy in patients with status epilepticus was 50%. However, all patients with convulsions shorter than 30 min showed a perfect response (100%). Convulsion episodes stopped within 3.89 +/- 2.22 min (median time 3 min). Seizure duration was correlated with cessation of seizure (r = 0.76, P < 0.001). No clinically important side effects were seen in any patient. On the basis of this experience, we concluded that a 0.3 mg/kg dose of buccal administration of midazolam might offer an effective treatment in all ages of children. (C) 2002 Elsevier Science B.V. All rights reserved.Öğe A child with dehydration and severe hypernatraemia(Springer-Verlag, 2000) Soylu, H; Kutlu, NO; Sönmezgöz, E; Ertas, K[Abstract Not Available]Öğe Dissection of bilateral internal carotid arteries and occlusion of both vertebral arteries in a child patient(Pergamon-Elsevier Science Ltd, 2002) Kutlu, NO; Saraç, K; Yakinci, C[Abstract Not Available]Öğe The effect of caffeic acid phenethyl ester on ischemia-reperfusion injury in comparison with ?-tocopherol in rat kidneys(Springer-Verlag, 2001) Irmak, MK; Koltuksuz, U; Kutlu, NO; Yagmurca, M; Özyurt, H; Karaman, A; Akyol, ÖOxygen-derived free radicals have been implicated in the pathogenesis of renal injury after ischemia-reperfusion. Caffeic acid phenethyl ester (CAPE), an active component of propolis extract, exhibits antioxidant and anti-inflammatory properties. To determine whether CAPE offers any advantage over alpha -tocopherol, we compared their effects on an in vivo model of renal ischemia-reperfusion injury in rats. CAFE at 10 mu mol/kg or alpha -tocopherol at 10 mg/kg was administered intraperitoneally before reperfusion. Acute administration of CAFE suppressed ischemia-reperfusion induced renal lipid peroxidation and tissue injury more than alpha -tocopherol. CAFE may therefore offer a therapeutic advantage in acute injury settings.Öğe Effect of water extract of Turkish propolis on tuberculosis infection in guinea-pigs(Academic Press Ltd- Elsevier Science Ltd, 2004) Yildirim, Z; Hacievliyagil, S; Kutlu, NO; Aydin, NE; Kurkcuoglu, M; Iraz, M; Durmaz, RMycobacterium tuberculosis (H37Rv)-infected guinea-pig model was used to investigate the effect of water extract of propolis (WEP). After subcutaneous inoculation of tubercle bacilli, each animal received oral WEP (n = 9), isoniazid (n = 5) or saline (n = 6) as placebo and were sacrificed 30 days later. Formation of necrosis was less prominent in the group treated with WEP, but was not statistically significant (P > 0.05). The granuloma formation in the same group was more prominent than the placebo and isoniazid groups; however, this finding failed to reach statistical significance by the Kruskal-Wallis test (P > 0.05). These findings suggest that Turkish WEP may have a limited effect on the development of tuberculosis infection in this guinea-pig model. (C) 2003 Elsevier Ltd. All rights reserved.Öğe The effects of androstenediol and dehydroepiandrosterone on the immune response to BCG at puberty(Oxford Univ Press, 2003) Kutlu, NO; Akinci, A; Sönmezgöz, E; Temel, I; Evliyaoglu, EIn order to assess the effects of age-related changes of serum dehydroepiandrosterone sulphate (DHEAS) and androstenediol (AED) concentrations on BCG vaccination throughout the puberty period, we matched 41 prepubertal (mean age 8.63+/-1.36 years, range 8-14 years) and 43 pubertal (mean age 13.8+/-1.31 years, range 10-16 years) schoolchildren who were PPD negative and free of disease or medication known to affect immune function. The tuberculin test was performed 8 weeks after vaccination and tuberculin response and hormone levels were compared between prepubertal and pubertal subjects. We found a higher tuberculin response in the pubertal group when compared with the prepubertal ones. The pubertal children had 79.1 per cent tuberculin positivity compared with 46.4 per cent of prepubertal children (p<0.05). Diameters of induration of the tuberculin test among prepubertal students vs. pubertal students were 9.5+/-3.8 mm and 11.9+/-3.7 mm, respectively (p<0.005). Pubertal stage, testis volume, and pubic stage were also found to have significant effects on tuberculin test results. No difference was observed between both sexes with regard to responses of the tuberculin test in either the prepubertal or the pubertal group (p>0.05). DHEAS and AED levels in the tuberculin-positive subjects were found to be significantly higher than tuberculin-negative ones (p=0.040 and p=0.046, respectively). Among both these hormones, only AED levels were correlated with tuberculin test responses. These results suggest that AED may play a role in the immunity to BCG vaccination and further immunological investigations are warranted to provide support for this idea.Öğe Hypochlorous acid for accidental vincristine overdose: A preliminary experimental study(Inst Exp Pathol Oncol Radiobiol, 2003) Ozgen, U; Stout, M; Turkoz, Y; Ozugurlu, F; Kutlu, NO; Soylu, H; Koltuksuz, UAim: to investigate the potential efficacy of in vivo treatment of accidental vincristine (VCR) overdose using hypochlorous acid (HOCl). Methods: 24 New Zealand rabbits were divided into 4 groups as control, HOCl-treated, VCR + treated and HOCl + VCR-treated, and their clinical and laboratory indexes were examined. Results: there were no clinical and laboratory abnormalities observed in control and HOCl group subjects. All rabbits died after quadriplegia and respiratory insufficiency in VCR and HOCl + VCR groups. Bone marrow suppression was more pronounced and onset of the neurotoxicity was early in VCR group compared to HOCl + VCR group subjects. Serum half-life of VCR was lower in HOCl + VCR group animals suggesting a contribution of HOCl in eliminating VCR resulting in the observed clinical and laboratory differences in these two groups. Conclusion: although further research is necessary, our results indicate a potential role for HOCl in the treatment of accidental VCR overdose.Öğe Hypomelanosis of Ito with trisomy 13 mosaicism [46, XY, der (13;13) (q10;q10),+13/46,XY](Turkish J Pediatrics, 2002) Yakinci, C; Kutlu, NO; Alp, MN; Senol, M; Durmaz, Y; Budak, TThe term hypomelanosis of Ito (HI) has been used as a diagnosis for individuals with swirly hypopigmentation or depigmentation distributed along the lines of Blaschko. HI should be appropriately evaluated for a possible association with chromosomal or genetic mosaicism or chimerism. We report a six-month-old severely motor and mental retarded boy with these typical cutaneous lesions associated with extracutaneous features, including facial dysmorphism, polydactyly, and inguinal. hernia. The cytogenetic examination of lymphocytes kdemonstrated a mosaicism of 46, XY, der (13;13) (q10;q10), +13/46, XY. This is the first case reported in the literature showing an association between phylloid pigmentary pattern of hypomelanosis of Ito and trisomy 13 mosaicism.Öğe Infantile-onset megalencephalic leucoencephalopathy in two siblings(Blackwell Science Asia, 2000) Soylu, H; Yüksel, A; Kutlu, NO; Aydinli, M; Seven, M; Mocan, HInfantile-onset megalencephalic. leucoencephalopathy (IML) is a recently recognized autosomal recessive white matter disorder. Unlike other megalencephalic leucoencephalopathies, in patients with IML a mild clinical course, a slowly progressive delay in motor development and mild mental deterioration are typical. We report on two affected siblings who have typical clinical and radiological findings of IML. Cranial magnetic resonance imaging showed involvement of the capsula externa, extrema and interna, nucleus dentatus, cnrs cerebri, periventricular and subcortical white matter. In addition, bilateral cystic changes were determined predominantly in the temporal lobes. There were no clear biochemical or metabolic disturbances. In the present paper, we discuss the clinical and neuroimaging findings of IML.Öğe Intranasal midazolam for prolonged convulsive seizures(Elsevier Science Bv, 2000) Kutlu, NO; Yakinci, C; Dogrul, M; Durmaz, YIn order to determine the efficiency of intranasal midazolam in prolonged convulsive episodes, we conducted a prospective study in children with various types of seizures. Nine patients (six buys, three girls; age range 6 months to 9 years) with prolonged convulsions lasting more than 10 min were treated with intranasal midazolam, 0.3 mg/kg. The success rate was 100% with only one case requiring a second dose. Estimated duration of seizures was 12-30 min (mean 18.6) while mean time elapsed until cessation of seizures was 139.6 s (range 60-480). No significant adverse effects were noted except fur one patient who had seizures secondary to serious CNS infection and respiratory depression after intranasal midazolam. (C) 2000 Elsevier Science B.V. All rights reserved.Öğe Leukoencephalopathy with a mild clinical course: a case report(Pergamon-Elsevier Science Ltd, 1999) Yakinci, C; Soylu, H; Kutlu, NO; Sener, RNInfantile-onset leukoencephalopathy of van der Knaap type is manifested by initially normal or near normal neurological findings despite infantile-onset megalencephaly and magnetic resonance imaging evidence of severe white matter affection. Until this entity was recently described, these cases were usually presented under the heading of atypical variants of Alexander disease. To date 63 individuals have been reported in English literature. We report a four-year-old boy presented in the first months of life with progressive megalencephaly. delay in walking, clumsiness, convulsions and magnetic resonance imaging evidence of diffuse swelling of white matter, cystic cavitations in frontal, temporal and parietal lobes. (C) 1999 Elsevier Science Ltd. All rights reserved.Öğe Malignant melanoma of the soft parts showing calciphylaxis(Taylor & Francis Inc, 2003) Kutlu, NO; Aydin, NE; Aslan, M; Bulut, T; Özgen, ÜCalciphylaxis is a poorly understood and highly morbid syndrome of vascular calcification and skin necrosis. Hypercalcemia, hyperphosphatemia, and secondary hyperparathyroidism are the factors implicated in the pathogenesis of calciphylaxis, which is generally identified in patients with hyperparathyroidism secondary to end-stage renal disease. It has also been observed in primary hyperparathyroidism, end-stage liver disease, and rheumatoid arthritis, in the absence of renal disease. There are few case reports of calciphylaxis occurring in hypercalcemia of malignancy. An unusual case is reported of calciphylaxis associated with malignant melanoma of the soft parts in the absence of renal or parathyroid disease. This is the first reported case of this soft tissue sarcoma showing calciphylactic changes.Öğe Morgagni hernia(Wiley-Liss, 2000) Soylu, H; Koltuksuz, U; Kutlu, NO; Sarihan, H; Sen, Y; Üstün, N; Baki, AMorgagni hernia (MH) is the least common type of congenital diaphragmatic hernias. Although its course is often asymptomatic, it may be associated with various respiratory and gastrointestinal symptoms. We describe 7 children with MH during a 5-year period in three pediatric centers in Turkey. All children had acute or chronic respiratory symptoms; cough was the most frequent. The diagnosis was made by posterior-anterior (PA) and lateral chest X-rays. The PA chest X-rays showed a homogenous mass in 2 and a gas-filled cystic image in 3 children in the right cardiophrenic angle. A retrocardiac homogeneous density in one child, and bilateral consolidation in lower lung areas in another child were also seen. All lateral chest X-rays showed gas-filled bower loops above the diaphragm. The diagnosis was confirmed by barium-contrast radiograph. Four patients had five additional anomalies, i.e., ventricular septal defect, right inguinal hernia, congenital hip dislocation, pectus carinatum, and obstruction of the uretero-pelvic junction. All of the hernias were repaired by an abdominal approach. There were no complications or recurrences during follow-up. In conclusion, MH should be considered in the differential diagnosis of cases of long-standing respiratory symptoms and/or when an unexplained radiological image, especially on the right cardiophrenic area, is present. (C) 2000 Wiley-Liss, Inc.Öğe Potential salvage therapy for accidental intrathecal vincristine administration(Karger, 2000) Özgen, Ü; Soylu, H; Önal, SÇ; Mizrak, B; Türköz, Y; Kutlu, NO; Koçak, ABackground: Accidental intrathecal vincristine (VCR) administration results in severe neurotoxicity, usually fatal in outcome. No specific therapy for initrathecal VCR toxicity has been reported so far. In our recent report, complete in vitro degradation of VCR by hypochlorous acid (HOCl) was demonstrated. Methods: In this comparative study, we examined the in vivo effectivity of HOCl in the cerebrospinal fluid of 24 New Zealand rabbits following intracisternal VCR administration. Results: There were no significant clinical or histopathologic abnormalities in the control and HOCl groups; however, multiple necrotic foci on histopathological examination of brain sections in the VCR group were determined. There were significantly lower numbers of necrotic foci in brain sections of rabbits which received HOCl administration than those without therapy. Conclusion: Our results indicate that HOCl may reduce VCR neurotoxicity. Copyright (C) 2000 S. Karger AG, Basel.Öğe Prevalence of febrile convulsion in 3637 children of primary school age in the province of Malatya, Turkey(Oxford Univ Press, 2000) Yakinci, C; Kutlu, NO; Durmaz, Y; Karabiber, H; Egri, M[Abstract Not Available]Öğe Protective role of ?-tocopherol and caffeic acid phenethyl ester on ischemia-reperfusion injury via nitric oxide and myeloperoxidase in rat kidneys(Elsevier, 2004) Gurel, A; Armutcu, F; Sahin, S; Sogut, S; Ozyurt, H; Gulec, M; Kutlu, NOBackground: The aim of this study was to determine the acute effects of antioxidant caffeic acid phenethyl ester (CAPE) and alpha-tocopherol (vitamin E) on nitric oxide (NO) production, neutrophil infiltration, and antioxidant enzyme activities on an in vivo model of renal ischemia-reperfusion injury. Methods: Rats were divided into five equal groups each consisting six rats: sham operation, ischemia, ischemia-reperfusion (I/R), I/R plus CAPE, and I/R plus vitamin E groups. CAPE or vitamin E was administered intraperitoneally before reperfusion. After experimental procedure, rats were sacrificed and both ipsilateral and contralateral kidneys were removed and prepared for NO concentrations, myeloperoxidase (MPO), catalase (CAT) and superoxide dismutase (SOD) activities. Results: Acute administration of vitamin E decreased NO concentrations in both ipsilateral and contralateral renal tissues compared to I/R group. SOD activity was increased in I/R and I/R + CAPE groups compared to sham operation group. The most prominent results were encountered in MPO activities, which did not change in contralateral kidneys in both ischemia and I/R groups. There was a significant decrease in ipsilateral MPO activity in ischemia group and a significant increase in I/R group compared to sham operation group. Pretreatment with intraperitoneal CAPE significantly diminished the tissue MPO activity indicating the prevention of the neutrophil sequestration into the kidney. Conclusion: There is a role for CAPE in attenuation in renal damage after I/R injury of the kidney, in part at least by inhibition of neutrophil sequestration. (C) 2003 Elsevier B.V. All rights reserved.Öğe Prune-belly syndrome and pulmonary hypoplasia(Blackwell Science Asia, 2001) Soylu, H; Kutlu, NO; Sönmezgöz, E; Bükte, Y; Özgen, Ü; Akinci, A[Abstract Not Available]Öğe Severe epistaxis in brucellosis-induced isolated thrombocytopenia: A report of two cases(Blackwell Science Ltd, 2000) Sevinc, A; Kutlu, NO; Kuku, I; Ozgen, U; Aydogdu, I; Soylu, HBrucellosis can present initially with its haematological findings including anaemia, leukopenia, and thrombocytopenia and may mimic primary haematological diseases. We present two patients with complaints of severe epistaxis and isolated thrombocytopenia which was initially diagnosed as idiopathic thrombocytopenic purpura but which was finally attributed to brucellosis. Their platelet count reverted to normal within 2-3 weeks of initiating antibrucellosis treatment with recovery from the disease.Öğe Urinary excretion of deoxypyridinoline in 24-hour and first-void samples in healthy Turkish children(Pergamon-Elsevier Science Ltd, 2000) Soylu, H; Aras, S; Kutlu, NO; Egri, M; Sahin, KObjectives: Collagen cross-links are formed during the maturation process of bone matrix. They have been considered as valuable markers in some metabolic, endocrinologic, and neoplastic bone disorders. As an advantage, it can be measured in urine as well as in serum samples. However, the excretion characteristics remains controversial. Design and methods: We investigated urinary free deoxypyridinoline (f-Dpd) excretion in first-void urine samples and in 24-hour collections in healthy Turkish children. We also evaluated the possible correlations and gender-related differences in Dpd excretion between these sampling methods. Both urine samples of 62 subjects (aged from 31 to 120 months) were analyzed by Immulite chemiluminescent technique. Results: There were no remarkable differences in f-Dpd excretion between first-void and 24-hour urine samples, although f-Dpd values of the first-void samples were slightly higher (Dpd: creatinine, mean +/- SD, 20.5 +/-; 5.8 nmol/mmol vs. 19.6 +/- 5.6 nmol/mmol, respectively, p > 0.05), A strong linear correlation was found between 24-hour and first-void urine f-Dpd excretions (r = 0.77, p < 0.05). In addition, f-Dpd showed no gender-related differences between boys and girls in either 24-hour or first-void urine samples (p > 0.05). Conclusions: Because of difficulties in long-time urine collection in infants and young children, f-Dpd assessment in first-void single urine samples is an easy, safe, and non-invasive method. Copyright (C) 2000 The Canadian Society of Clinical Chemists.Öğe Urinary free deoxypyridinoline assessment in recognition of rickets(Oxford Univ Press, 2001) Soylu, H; Aras, S; Kutlu, NO; Egri, M; Sazak, S[Abstract Not Available]
