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Öğe Abdominal pain, nausea, vomiting, and ascites in a 14-year-old girl with systemic lupus erythematosus: Answers(Springer, 2019) Elmas, Ahmet Taner; Tabel, YilmazYilmaz; Selimoglu, Ayse; Kenc, Senay; Kutlu, Ramazan[Abstract Not Available]Öğe Abdominal pain, nausea, vomiting, and ascites in a 14-year-old girl with systemic lupus erythematosus: Questions(Springer, 2019) Elmas, Ahmet Taner; Tabel, Yilmaz; Selimoglu, Ayse; Kenc, Senay; Kutlu, Ramazan[Abstract Not Available]Öğe Aortic aneurysm(Galenos Yayincilik, 2007) Karakurt, Cemsit; Kocak, Guelendam; Selimoglu, Ayse; Ozen, Metehan[Abstract Not Available]Öğe Clinical and Imaging Findings in Childhood Posterior Reversible Encephalopathy Syndrome(Iranian Child Neurology Soc, 2018) Gungor, Serdal; Kilic, Betul; Tabel, Yilmaz; Selimoglu, Ayse; Ozgen, Unsal; Yilmaz, Sezai; Sigirci, AhmetObjective Posterior reversible encephalopathy syndrome (PRES) is characterized by typical radiologic findings in the posterior regions of the cerebral hemispheres and cerebellum. The symptoms include headache, nausea, vomiting, visual disturbances, focal neurologic deficits, and seizures. The aim of this study is to evaluate the clinical and radiological features of PRES in children and to emphasize the recognition of atypical features. Materials & Methods We retrospectively examined 23 children with PRES from Mar 2010-Apr 2015 in Inonu University Turgut Ozal Medical Center in Turkey. We compared the clinical features and cranial MRI findings between underlying diseases of PRES. Results The most common precipitating factors were hypertension (78.2%) and medications, namely immunosuppressive and antineoplastic agents (60.8%). Manifestations included mental changes (100%), seizures (95.6%), headache (60.8%), and visual disturbances (21.7%) of mean 3.6 (range 1-10) days' duration. Cranial magnetic resonance imaging (MRI) showed bilateral occipital lesions in all patients, associated in 82.6% with less typical distribution of lesions in frontal, temporal or parietal lobes, cerebellum, corpus callosum, basal ganglia, thalamus, and brain stem. Frontal involvement was predominant, observed in 56.5% of patients. Clinical recovery was followed by radiologic resolution in all patients. Conclusion PRES is often unsuspected by the clinician, thus radiologists may be the first to suggest this diagnosis on an MRI obtained for seizures or encephalopathy. Atypical MRI finding is seen quite often. Rapid diagnosis and treatment are required to avoid a devastating outcome.Öğe Determination of risk factors affecting mortality in patients with gastrointestinal perforation after pediatric liver transplantation(Wiley, 2019) Barut, Bora; Akbulut, Sami; Kutluturk, Koray; Koc, Cemalettin; Ozgor, Dincer; Aydin, Cemalettin; Selimoglu, AyseGastrointestinal perforation (GIP) is one of the most serious complications occurring after liver transplantation (LT), especially in pediatric patients. This study aimed to determine the risk factors affecting mortality in pediatric patients with GIP after LT. GIP developed in 37 (10%) of 370 pediatric patients who underwent LT at our institute. Patients were divided into two groups: alive (n = 22) or dead (n = 15), and both groups were compared in terms of demographic and clinical parameters using univariate analysis. There was no statistically significant difference between groups in either demographic or clinical parameters, except for perforation site (P = 0.001) and median follow-up (P = 0.001). Stomas arose in 17 (45.9%) patients: 76% of patients with stomas and 45% of those without survived (P = 0.052). Kaplan-Meier analysis indicated that patients with stomas had a significantly higher overall survival (P = 0.029) and that patients with duodenal and colonic perforation had a significantly lower overall survival. Multivariate analysis showed that re-perforation was an independent risk factor for mortality (P = 0.035; OR: 17.674; 95% CI for OR: 1.233-253.32). Although there are many options for management of GIP, including primary repair, resection plus anastomosis, and resection plus end or loop ostomy, gastrointestinal diversion is still the best option.Öğe Effect of Copper Staining in Wilson Disease: A Liver Explant Study(Baskent Univ, 2017) Karadag, Nese; Tolan, Kerem; Samdanci, Emine; Selimoglu, Ayse; Akpolat, Nusret; Yilmaz, SezaiObjectives: Wilson disease is a rare genetic disease with clinical and histopathologic differential diagnostic challenges. In this study, we evaluated the histo pathologic findings of explanted livers in Wilson disease, with special emphasis on copper histochemistry. Materials and Methods: Our study group was recruited by reviewing archived histopathology reports and the liver transplant clinic patient records retrospectively for patients who had liver transplant for Wilson disease between January 2010 and June 2015, at Turgut Ozal Medical Center. Archival slides were reevaluated. When needed, relevant clinical and laboratory data were obtained from patient medical records. Results: During the selected period, there were 33 patients fitting the study criteria (22 male, 11 female, mean age of 22 +/- 11 y). All patients had mild to moderate septal inflammation. We found that 29 patients (88%) showed glycogenated hepatocyte nuclei and 27 patients (79%) showed nuclear pleomorphism. Other histopathologic findings were cholestasis (48%) and macrovesicular steatosis (39%). There was no special finding in hilar regions except for 2 patients who had recanalized portal vein thrombosis. In terms of copper histochemistry, 2 copper stains, Timm silver sulfide and rhodanine, were performed in all cases, with orcein staining only done for 25 of the cases. Positivity rates for these copper stains were 85%, 82%, and 36%. Periodic acid-Schiff-diastase-and periodic acid-Schiff-positive granules were detected in 7 of 33 patients (21%). Iron deposition was seen in 12 patients (focal and/or minimal in 11, more than focal in 1). There was no dysplasia or malignancy in any of the patients. Conclusions. On routine hematoxylin and eosinstained slides, detection of glycogenated hepatocyte nuclei and the finding of the nuclear pleomorphism should alert the pathologist for the possibility of Wilson disease, especially with cryptogenic liver disease. Timm stain is a more convenient histo chemical stain in revealing copper deposition in liver.Öğe Evaluation of arterial hypertension by ambulatory blood pressure monitoring in pediatric liver transplant recipients(Lippincott Williams & Wilkins, 2022) Arikanoglu, Emrullah; Tabel, Yilmaz; Selimoglu, AyseObjective Many cardiovascular complications, including hypertension, are seen in pediatric liver transplantation. The purpose of this study was to analyze the frequency of arterial hypertension of pediatric liver transplant recipients and also to determine the related risk factors. Methods Thirty-six pediatric liver transplant recipients aged 8-17 years were prospectively studied by manual and ambulatory blood pressure measurement (ABPM) technique. Results The mean age of patients was 12.42 +/- 2.74 years and the mean ABPM measurement time after transplantation was 2 years (3 months-5.9 years). Only one (2.7%) patient was detected as hypertensive by casual measurement, but 17 (47.2%) patients were found to be hypertensive when measured through ABPM. Of children that were found to be hypertensive as a result of ABPM, 64.7% were observed to have a nondipper pattern. Considering the time passed after the transplantation, patients were found to be more hypertensive in the first 2 years posttransplant although it was not found statistically significant. Conclusions In this study, it has been shown that it is possible to diagnose hypertension at an earlier period of transplantation using ABPM in pediatric liver transplant patients. ABPM is needed to detect masked hypertension that may develop following liver transplantation.Öğe Intracerebral Hemorrhage Related With Penicillium Species Following Deceased-Donor Liver Transplant(Baskent Univ, 2021) Yonder, Huseyin; Akbulut, Sami; Kocaaslan, Huseyin; Ince, Volkan; Karadag, Nese; Demirtas, Gokhan; Selimoglu, AyseEarly or late posttransplant opportunistic infections are among the leading complications after liver transplant. The source of early posttransplant opportunistic infections is usually the patient, the implantation of an infected graft, contamination during a surgical procedure, or invasive interventions performed at the intensive care unit. A 10-year-old male patient with Wilson disease (Pediatric End-Stage Liver Disease Score of 42, Child-Pugh score of 12, total bilirubin 40 mg/dL, platelet count 55 000/mL, hemoglobin level 6.3 g/dL, albumin level 1.7 g/dL, urinary copper level 4305 mu g/24 h) was closely monitored in the pediatric intensive care unit of our liver transplantation center for care of a worsened general status. A deceased- donor liver transplant was performed using a right lobe liver graft (ex vivo split) obtained through the national organ sharing network. The patient developed rightward deviation of eyes and altered consciousness after the procedure and underwent cranial magnetic resonance imaging and computerized tomography examinations. The cranial magnetic resonance image, taken on the third postoperative day, revealed lesions consistent with embolic infarction, and the computed tomography scan, taken on the eighth day, showed intracerebral hemorrhage. Decompressive craniotomy, which included hematoma drainage and catheter placement, was performed. Culture and histopathologic examinations of the hematoma material revealed a Penicillium species of fungi. However, the patient died before a definitive diagnosis was made. The aim of this report is to raise awareness on early posttransplant opportunistic infections of the central nervous system presenting with intracranial hemorrhage following liver transplant.Öğe Management of Hepatotoxicity Induced by the Use of Olanzapine(Mary Ann Liebert, Inc, 2017) Donmez, Yunus Emre; Ozcan, Ozlem; Soylu, Nusret; Sarioglu, Fatma Kartal; Selimoglu, AyseNumerous drugs cause hepatotoxicity clinically or biologically. Neuropsychiatric drugs constitute 16% of these drugs. The occurrence of hepatotoxicity induced by the use of olanzapine is expressed by the researchers. In such cases, generally the dose of olanzapine is reduced or the drug is completely discontinued and the treatment of the patient fails. The aim of this study is to report the case for whom elevated liver enzymes were observed but the process was managed without changing treatment dose and drug and to discuss this case with literature information. The present study has characteristics of being the first in the literature concerning management of the process.Öğe Prevalence of Celiac Disease in a Sample of Turkish Children With Epilepsy(Elsevier Science Inc, 2010) Ertekin, Vildan; Selimoglu, Ayse; Tan, Hueseyin; Konak, Murat[Abstract Not Available]Öğe Rare Causes of Recurrent Acute Liver Failure In Children: Infantile Liver Failure Syndromes(Georg Thieme Verlag Kg, 2023) Cakir, Murat; Issi, Fatma; Guven, Burcu; Yakici, Nalan; Karaguzel, Gulay; Selimoglu, Ayse[Abstract Not Available]Öğe The Role of Living Donor Liver Transplantation for Acute Liver Failure(Wiley-Blackwell, 2011) Ates, Mustafa; Dirican, Abuzer; Isik, Burak; Ara, Cengiz; Ince, Volkan; Selimoglu, Ayse; Kayaalp, Cuneyt[Abstract Not Available]Öğe Strain and strain rate echocardiography in children with Wilson's disease(Clinics Cardive Publ Pty Ltd, 2016) Karakurt, Cemsit; Celik, Serkan; Selimoglu, Ayse; Varol, Ilknur; Karabiber, Hamza; Yologlu, SaimObjective: This study aimed to evaluate strain and strain rate echocardiography in children with Wilson's disease to detect early cardiac dysfunction. Methods: In this study, 21 patients with Wilson's disease and a control group of 20 age-and gender-matched healthy children were included. All the patients and the control group were evaluated with two-dimensional (2D) and colour-coded conventional transthoracic echocardiography by the same paediatric cardiologist using the same echocardiography machine (Vivid E9, GE Healthcare, Norway) in standard precordial positions, according to the American Society of Echocardiography recommendations 2D strain and strain rate echocardiography were performed after the ECG probes of the echocardiography machine were adjusted for ECG monitoring. Longitudinal, transverse and radial strain, and strain rate were assessed from six basal and six mid-ventricular segments of the left ventricle, as recommended by the American Society of Echocardiography. Results: Left ventricular wall thickness, systolic and diastolic diameters, left ventricular diameters normalised to body surface area, end-systolic and end-diastolic volumes, cardiac output and cardiac index values were within normal limits and statistically similar in the patient and control groups (p > 0.05). Global strain and strain rate: the patient group had a statistically significant lower peak A longitudinal velocity of the left basal point and peak E longitudinal velocity of the left basal (VAbasR) point, and higher global peak A longitudinal/ circumferential strain rate (GSRa) compared to the corresponding values of the control group (p < 0.05). Radial strain and strain rate: end-systolic rotation [ROT (ES)] was statistically significantly lower in the patient group (p < 0.05). Longitudinal strain and strain rate: end-systolic longitudinal strain [SLSC (ES)] and positive peak transverse strain (STSR peak P) were statistically significantly lower in the patient group (p < 0.05). Segmental analysis showed that rotational strain measurement of the anterior and lateral segments of the patient group were statistically significantly lower than the corresponding values of the control group (p < 0.05). Segmental analysis showed statistically significantly lower values of end-systolic longitudinal strain [STSR (ES)] of the basal lateral (p < 0.05) and end-systolic longitudinal strain [SLSC (ES)] of the basal septal segment (p < 0.05) in the patient group. End-systolic longitudinal strain [SLSC (ES)] and positive peak transverse strain (STSR peak P) were statistically significantly lower in the patient group (p < 0.05). Segmental analysis showed statistically significantly lower values of end-systolic longitudinal strain [SLSC (ES)] of the mid-anterior and basal anterior segments (p < 0.05), end-systolic longitudinal strain [STSR (ES)] measurements of the posterior and mid-posterior segments, end-systolic longitudinal displacement [LDC (ES)] of the basal posterior, mid-posterior and mid-antero-septal segments in the patient group. Conclusion: Cardiac arrhythmias, cardiomyopathy and sudden cardiac death are rare complications but may be seen in children with Wilson's disease due to copper accumulation in the heart tissue. Strain and strain rate echocardiography is a relatively new and useful echocardiographic technique to evaluate cardiac function and cardiac deformation abnormalities. Our study showed that despite normal systolic function, patients with Wilson's disease showed diastolic dysfunction and regional deformation abnormalities, especially rotational strain and strain rate abnormalities.Öğe Subclinical diastolic dysfunction in children with Wilson's disease assessed by tissue Doppler echocardiography: a possible early predictor of cardiac involvement(Taylor & Francis Ltd, 2013) Elkiran, Ozlem; Karakurt, Cemsit; Selimoglu, Ayse; Karabiber, Hamza; Kocak, Gulendam; Celik, Serkan F.; Colak, CemilBackground The aim of this study was to evaluate the left ventricular systolic and diastolic functions and cardiac rhythm problems for the early detection of myocardial dysfunction in children with Wilson's disease. Methods We compared patients who had Wilson's disease (n=22) with age- and sex-matched healthy control subjects (n=21). The diagnosis of Wilson's disease was based on clinical symptoms and laboratory tests (serum ceruloplasmin, urinary and hepatic copper concentrations). Standard echocardiographic examination, as well as pulsed-wave Doppler, tissue Doppler echocardiography examinations of all patients were performed. 24-hour ECG Holter monitoring was also performed in all subjects. Results All patients were asymptomatic on cardiological examination and had sinus rhythm on electrocardiography. Left ventricular ejection fraction, fractional shortening, wall thickness and left ventricular mass were similar in both groups. In comparison to healthy subjects, children with Wilson's disease had significantly lower mitral E velocity, mitral E/A ratio (P=0.046, P=0.021, respectively) and longer isovolumetric relaxation time values (P=0.015) as estimated by pulsed wave Doppler echocardiography. Wilson patients had longer isovolumetric relaxation time (IVRT) values estimated by tissue Doppler echocardiography (P=0.006) compared to the controls. On 24-hour ECG Holter monitoring, none of the Wilson patients showed life-threatening cardiac arrhythmia. Conclusion Our study showed results that might be consistent with subclinical diastolic dysfunction in cardiologically asymptomatic Wilson's disease children which probably represents an early stage of cardiac involvement. Therefore it may be useful to monitor these signs in the follow-up of the patients.
