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    Anthropometric growth study of auricle of healthy preterm and term newborns
    (Elsevier Ireland Ltd, 2006) Kalcioglu, MT; Toplu, Y; Ozturan, O; Yakinci, C
    Objective: Auricular abnormalities are important for early diagnosis of the birth defects in the prematures and newborns. Auricular antropometric studies in healthy premature and mature population depend on their gestational age are limited and insufficient. The aims of this study were to reveal antropometric growth and dynamics of the auricle in the healthy newborns from the 28th to the 42nd gestation weeks. Materials and methods: A total of 600 newborns were evaluated in 40 groups. Each group comprising 20 preterm or term newborns according to their sexes and gestational weeks. Six surface dimensions were performed directly from the right ears of the subjects: the length from the superaurale to subaurale, the width from the tragus to helix, the width from the tragus to antihelix, the conchal depth, the distance from the helix to mastoid at superaural level and the distance from the helix to mastoid at tragal level. The frequency of the prominent ear deformity and lobule attachment were also noted. Results: The results of auricular antropometric measurements of healthy preterm and term newborns in different gestational weeks were to determined. No statistical differences of auricular length were found between mate and female infants. The incidence of the prominent ear deformity and attached lobule was 8.16 and 27.4%, respectively. Conclusions: Normal anthropometric features for healthy newborns on the basis of gestational age are very important for the diagnosis of a variety of congenital malformations or syndromes. In this study, antropometric measurements of the auricle in the healthy preterm and term newborns on the basis of gestational age in our region were noted. Similar anthropometric studies in the preterm and term newborns at different geographic and various socioeconomic areas should be performed to constitute normative data in the literature. (c) 2005 Elsevier Ireland Ltd. All rights reserved.
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    Anthropometric growth study of normal human auricle
    (Elsevier Sci Ireland Ltd, 2003) Kalcioglu, MT; Miman, MC; Toplu, Y; Yakinci, C; Ozturan, O
    Objective: The aim of this study was to reveal the anthropometric growth of auricula from birth to the age of 18 years and to bring out the dynamics of ear growth. Material and methods: A total of 1552 children in 50 groups were evaluated. Six surface measurements were performed directly on the right auricle of the subjects: the length from the superaurale to subaurale, the width from the tragus to helix, the width from the tragus to antihelix, the concha[ depth, the height from the helix to mastoid at superauraler level, and the height from the helix to mastoid at tragal level. The frequency of prominent ear deformity and the degree of attachment of the lobule were also noted. Results: Vertical auricular growth was complete in girls at the age of 11 and in boys at the age of 12, whereas the auricular width from the tragus to helix, the height from the helix to mastoid at superauraler level and the height from the helix to mastoid at tragal level were found almost complete at the age of 6. The auricular width from the tragus to antihelix attained its full size at 6 months for girls and 12 months for boys. The conchal. depth was found almost complete at the age of 5 in both sexes. The incidence of prominent ear deformity and attached lobule was 9.8 and 26.5%, respectively. Conclusions: Different ear growth pattern and maturation size from previously published reports are obtained in different populations. There is still need for future studies comparing populations with different social and ethnic background to interpret common knowledge about the size of the ear. This study gives dimensional information and the growth pattern of the auricle, and therefore may reveal important implications for the adequate timing of the surgical treatment of auricular deformity. (C) 2003 Elsevier Ireland Ltd. All rights reserved.
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    Autonomic nervous system function in childhood migraine
    (Blackwell Science Asia, 1999) Yakinci, C; Mungen, B; Er, H; Durmaz, Y; Karabiber, H
    Background: Although the pathogenesis of migraine is controversial, autonomic nervous system (ANS) dysfunction has been reported in patients with adult migraine in recent years. The present study was planned to investigate ANS function in childhood migraine. Methods: The migraine and control groups consisted of 25 migraineur and 30 healthy children, respectively. Orthostatic test, sustained handgrip, Valsalva ratio, 30/15 ratio and heart rate responses to deep breathing were used as non-invasive ANS function tests in both groups. Results: In the orthostatic test, systolic (SBP) and diastolic blood pressures (DBP) were higher in the upright than the supine position in the migraine group, but were higher in the supine than upright position in the control group. In the sustained handgrip test, the mean difference in SEP was higher in the migraine than the control group (P = 0.0278), but there was no significant difference in DBP between migraine and control groups (P = 0.107). The Valsalva ratio was higher in the migraine than the control group (P = 0.0002), as was the 30/15 ratio (P = 0.0108). Heart rate responses to deep breathing were not different between the migraine and control groups (P = 0.749). Conclusions: Our results demonstrate ANS dysfunction, with hyperactivity of both the sympathetic and parasympathetic nervous system, in children with migraine.
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    Autonomic nervous system functions in childhood essential hypertension
    (Blackwell Science, 1996) Yakinci, C; Mungen, B; Tayfun, M; Gunduz, M; Karabiber, H
    The etiopathology of essential hypertension (EH) is still controversial, different pathologic mechanisms have been estimated as a cause of EH. One of these mechanisms is autonomic nervous system dysfunction (ANSD). Although there are different studies showing ANSD in adult EH, limited studies on ANSD in childhood EH are present. The present study was planned to investigate the role of ANSD in childhood EH. The study group (SG) consisted of 24 children with EH and the control group (CG) was 24 healthy children. Non-invasive autonomic nervous system function tests: the orthostatic test, Valsalva ratio, 30/15 ratio and heart rate responses to deep breathing were performed on members of both groups. The mean differences in systolic blood pressure between supine resting and standing positions in the study and control groups were significant (z = -2.577, P = 0.0051). The mean differences in diastolic blood pressure between supine resting and standing positions in SG and CG were found to be statistically meaningful (z = -2.722, P = 0.0033). The mean differences in heart rate variation during hyperventilation in SG and CG were significant (z = -2.54, P = 0.0055). The mean differences in the Valsalva ratio between SG and CG were not statistically meaningful (z = 1.52, P = 0.0643). The mean differences in the 30/15 ratio in SG and CG were not found to be significant (z = -1.455, P = 0.0735). In the light of these results, both sympathetic and parasympathetic autonomic nervous system dysfunction in childhood essential hypertension were found.
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    Autonomic nervous system functions in children with nocturnal enuresis
    (Elsevier Science Bv, 1997) Yakinci, C; Mungen, B; Durmaz, Y; Balbay, D; Karabiber, H
    Nocturnal enuresis is involuntary urination during night sleep, The pathogenesis of nocturnal enuresis is controversial. Developmental delay, genetic factors, stress and psychological factors, and sleep abnormalities are considered to be the etiologic factors. Various urodynamic studies showed bladder hyperactivity in enuretic children. Since the cause of vesical hyperactivity is not clear, we investigated the possible role of autonomic nervous system dysfunction in these children. The study groups consisted of 41 enuretic (25 boys and 16 girls) and 30 healthy children (18 boys and 12 girls). Four non-invasive autonomic nervous system function tests (orthostatic test, Valsalva ratio, 30:15 ratio, heart rate responses to deep breathing) were carried out in both groups. The differences between the enuretic and control groups were statistically significant in the Valsalva and 30:15 ratios (P < 0.0005 and P < 0.005, respectively). The results of these two tests demonstrated parasympathetic nervous system hyperactivity. No abnormality of the sympathetic nervous system was found. We suggest that the parasympathetic nervous system hyperactivity shown in our study may be a cause of vesical hyperactivity in enuretic children. (C) 1997 Elsevier Science B.V.
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    Autonomic nervous system functions in obese children
    (Elsevier Science Bv, 2000) Yakinci, C; Mungen, B; Karabiber, H; Tayfun, M; Evereklioglu, C
    Childhood obesity is a complex syndrome, probably due to the multiplicity of contributing factors, contradictory literature information about etiology, prognosis, prevention and treatment. In the recent reports, autonomic nervous system (ANS) dysfunction has been documented in adult obesity. Autonomic nervous system functions in obese children are not clear. This study was planned to investigate autonomic nervous system function in childhood (7-13 years of age) obesity. Study and control groups consisted of 33 simple obese (23 boys and ten girls, mean age 9.5 +/- 1.4 years) and 30 healthy children (18 boys and 12 girls, mean age 10.1 +/- 1.8 years), respectively. Four non-invasive autonomic nervous system function tests (Orthostatic test, Valsalva ratio, 30/15 ratio, Heart rate responses to deep breathing) and general ophthalmic examination were performed on both groups. The difference between the obese and control groups was found statistically significant in Valsalva ratio, 30/15 ratio and Heart rate responses to deep breathing (P < 0.025), and insignificant in Orthostatic test (P > 0.05). Ophthalmic examinations were normal. The result of these tests suggested normal activity of sympathetic, and hypoactivity of parasympathetic nervous system, implying parasympathetic nervous system dysfunction as a risk factor or associated finding in childhood obesity. (C) 2000 Elsevier Science B.V. All rights reserved.
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    Buccal midazolam for treatment of prolonged seizures in children
    (Elsevier Science Bv, 2003) Kutlu, NO; Dogrul, M; Yakinci, C; Soylu, H
    Midazolam 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.
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    Cavernous hemangioma in a child presenting with hemichorea
    (B C Decker Inc, 2001) Yakinci, C; Durmaz, Y; Korkut, M; Aladag, A; Önal, C; Aydinli, M
    The case of a 9-year-old boy with hemichorea due to cavernous hemangioma in the left caudate nucleus is presented. To our knowledge, only two children have been reported with hemichorea associated with cavernous hemangioma. Hemichorea in our patient responded to pimozide, a neuroleptic that blocks central nervous system dopaminergic receptors.
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    Cervical hematomyelia
    (Karger, 2002) Önal, Ç; Yakinci, C; Kocak, A; Erguvan, R; Tekiner, A; Kutlu, R; Özcan, C
    Spinal cord injury with or without trauma has been reported in the perinatal period. The prognosis depends primarily on diagnosis of the level, extent and nature of the lesion, established by correlations between clinical, imaging and electrophysiological data. A 25-day-old boy with normal birth weight delivered at term by cesarean section was transferred to Inonu University Turgut Ozal Medical Center because of respiratory distress and brachial diplegia. A suspicious medullary lesion on cervical computerized tomography was confirmed as an intramedullary lesion extending from C3 to D1 on magnetic resonance imaging (MRI). Emergent surgery consisting of exposure of the lesion site and interlaminar direct puncture of the lesion under fluoroscopy revealed that the pathology was an intramedullary hematoma. The partial evacuation of the lesion with direct puncture, the patient's neurological improvement and close follow-up of the patient with ultrasonography, electrophysiology and MRI are discussed in the light of recent literature. Copyright (C) 2002 S. Karger AG, Basel.
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    Concentration of total serum IgE in parasitized children and the effects of the antiparasitic therapy on IgE levels
    (Oxford Univ Press, 1998) Durmaz, B; Yakinci, C; Köroglu, M; Rafiq, M; Durmaz, R
    [Abstract Not Available]
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    Delayed myelination in a rhizomelic chondrodysplasia punctata case: MR spectroscopy findings
    (Elsevier Science Inc, 2003) Alkan, A; Kutlu, R; Yakinci, C; Sigirci, A; Aslan, M; Sarac, K
    Rhizomelic chondrodysplasia punctata is a member of genetic peroxisomal disorders. Delayed myelination, which is probably related to the inadequacy of plasmalogens biosynthesis, is an important feature of this disorder. Direct assessment of neuropathologic aspects of RCDP syndrome such as neuronal degeneration and delayed myelination is possible with MR spectroscopy. In this report, MR spectroscopy findings (decreased Cho/Cr and increased Ins-Gly/Cr ratios and increased levels of mobile lipids) of a rhizomelic chondrodysplasia punctata case supporting delayed myelination are presented. This is the second report of MR spectroscopy examination of the specific brain metabolic changes associated with rhizomelic chondrodysplasia punctata. (C) 2003 Elsevier Science Inc. All rights reserved.
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    Diagnosis of tuberculosis
    (Oxford Univ Press, 1998) Sönmez, E; Yakinci, C; Aladag, M; Evliyaoglu, E; Yologlu, S; Köksal, N
    In recent years, several articles have been published about BCG tests in the diagnosis of tuberculosis, particularly in children. The test is reportedly more sensitive and more specific than tuberculin test (PPD), We evaluated the results of simultaneous application of PPD and BCG test in order to assess its efficacy in adults and adolescents with tuberculosis (tbc), We applied BCG test and PPD concurrently in 35 healthy controls and 41 tuberculosis cases presented to Research Hospital, Inonu University and Malatya Tuberculosis Dispensary with clinical and radiological findings, The subjects also had sputum examined for presence of acid-fast bacilli (AFB) by direct microscopy, culture on Lowenstein Jensen medium and by polymerase chain reaction (PCR). We conclude that ECG test is more sensitive and more specific than PPD in diagnosis of tuberculosis in adults and adolescents.
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    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]
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    Early- and late-state subacute sclerosing panencephalitis: Chemical shift imaging and single-voxel MR spectroscopy
    (Amer Soc Neuroradiology, 2003) Alkan, A; Sarac, K; Kutlu, R; Yakinci, C; Sigirci, A; Aslan, M; Baysal, T
    BACKGROUND AND PURPOSE: Subacute sclerosing panencephalitis (SSPE) is a rare, progressive, inflammatory neurodegenerative disease. Our aim was to determine the metabolic abnormalities of brain in early- and late-stage SSPE by using MR spectroscopy and to assess areas of involvement in the early stages when MR imaging findings were normal. METHODS: Children with stage II (n = 3) or III (n = 3) SSPE and 10 healthy, age-matched children underwent MR imaging, multivoxel MR spectroscopy, and short-echo single-voxel MR spectroscopy (SVS). Areas of involvement in the brain were determined with chemical shift imaging. For SVS, 2 x 2 x 2-cm voxels were placed in the frontal subcortical white matter (FSWM) and parieto-occipital white matter (POWM). N-acetylaspartate (NAA)/creatine (Cr), choline (Cho)/Cr, myo-inositol (Ins)/Cr, and NAA/Cho ratios were calculated. RESULTS: Comparisons of NAA/Cr, Cho/Cr, Ins/Cr and NAA/Cho ratios between patients and control subjects showed significant differences in FSWM and POWM (P <.0l). In patients with SSPE, NAA/Cr ratios in POWM were significantly less than those in FSWM (P <.0l). NAA/Cr ratios in patients with stage II SSPE and those in the control group were not significantly different; this may reflect the absence of neuronal loss. Decreased NAA/Cr, increased Cho/Cr and Ins/Cr ratios, and increased lactate and lipid peaks were found in patients with stage III SSPE. CONCLUSION: MR spectroscopy showed findings suggestive of inflammation in stage II and findings of demyelination, gliosis, cellular necrosis, and anaerobic metabolism in stage III. MR spectroscopy could be a promising technique for early diagnosis and treatment planning in cases of SSPE.
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    Ectopic thymic tissue: A cause of emphysema in infants
    (Elsevier Science Inc, 1999) Baysal, T; Kutlu, R; Kutlu, O; Yakinci, C; Karaman, I
    Ectopic thymic tissue can present a diagnostic dilemma when it is located in the posterior mediastinum. The diagnosis can be made by awareness of it and bq use of computed tomography (CT) and magnetic resonance imaging (MRI). Rarely, ectopic thymus are reported to cause airway obstruction. In infants ectopic thymic tissue should also be considered in the differential diagnosis of secondary pneumonias and emphysema especially located in the upper lung zones. (C) Elsevier Science Inc., 1999.
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    Effect of long-term therapy with sodium valproate on nail and serum trace element status in epileptic children
    (Humana Press Inc, 2004) Armutcu, F; Ozerol, E; Gurel, A; Kanter, M; Vural, H; Yakinci, C; Akyol, O
    Antiepileptic drugs could cause changes in the trace element status of the body. Valproic acid (VPA) is a very effective anticonvulsant agent widely used in the management of various forms of epilepsy. Nail trace element content is a reliable index of trace element nutritional status of the body. To determine whether some of the side effects of antiepileptic drugs could be the result of zinc (Zn) depletion within tissues, Zn concentrations as well as copper (Cu) concentrations in nail and serum in 59 children having various types of epilepsy receiving valproate and 31 controls were assessed. Although serum Zn level in epileptic patients was found to be decreased, there was no difference in nail samples when compared to controls. There was a statistically significant increase in nail Cu level in epileptic patients when compared to controls. On the other hand, serum Cu levels were not different between the groups. Although none of our patients showed any symptoms of Cu elevation and Zn depletion, we should pay attention to potential body trace element changes in patients with epilepsy under VPA treatment. In conclusion, our results indicate that serum trace metal homeostasis might be affected by VPA therapy, but not by the convulsive disorder itself.
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    The effect of long-term therapy with sodium valproate on oxidant/antioxidant status in epileptic children
    (Wiley, 2003) Ozerol, E; Aslan, M; Cakmak, EA; Gulec, M; Yakinci, C; Akyol, O
    Antiepileptic drugs may cause the changes in the oxidant/antioxidant status of the body. Reactive oxygen species have been suggested to be an important factor in the pathogenesis of various diseases as well as drug interactions and/or adverse effects. The aim of this study, therefore, is to investigate the status of major antioxidant enzyme activities as well as the end products of lipid peroxidation in erythrocyte and plasma from epileptic children after therapy with sodium valproate (VPA). Superoxide dismutase (SOD), catalase (CAT) activities and malondialdehyde (MDA) levels in erythrocyte and plasma were analyzed in 41 epileptic patients under long-term antiepileptic therapy with VPA and 32 healthy controls. Erythrocyte SOD activity was found to be increased (p=0.024) whereas erythrocyte CAT activity decreased (p=0.016) in patients with epilepsy under VPA treatment compared to the controls. MDA levels in erythrocyte were found to be markedly decreased in epileptic children compared to controls (p<0.001). In conclusion, decreased CAT activity seems to be compensated with increased SOD activity in erythrocytes protecting erythrocyte membranes from lipid peroxidation in patients with epilepsy under VPA treatment.
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    Effects of valproate and carbamazepine on serum levels of homocysteine, vitamin B12, and folic acid
    (Elsevier Science Bv, 2003) Karabiber, H; Sommezgoz, E; Ozerol, E; Yakinci, C; Otlu, B; Yologlu, S
    Homocysteine (HMC) is a sulfur containing amino acid, which plays a role in methionine metabolism. Folic acid (FA) and vitamin B12 (B12) are essential for remethylization of HMC to methionine. HMC level increases in the deficiency of these vitamins. Hyperhomocysteinemia causes vascular endothelial damage, which causes atherosclerosis. The aim of this study is to investigate the effect of valproate (VA) and carbamazepine (CBZ) on the serum levels of HMC, B12, and FA. Thirty-six children receiving CBZ and 30 children receiving VA for epilepsy for the last 1-year period and 29 healthy children as control were the population of this study. After 6 h of fasting serum HMC, B12, and FA levels were measured and results were compared statistically. Mean values of HMC, FA, and B12 levels in control group were 9.2 +/- 2.7 mumol/l, 9.0 +/- 2.0 ng/ml, and 342 +/- 162 pg/ml, in VA group 14.0 +/- 6.8 mumol/l, 7.3 +/- 2.9 ng/ml, and 368 +/- 159 pg/ml, in CBZ group 16.0 +/- 13.1 mumol/l, 7.5 +/- 3.3 ng/ml, and 285 +/- 158 pg/ml, respectively. Serum HMC levels were higher in VA and CBZ groups than control group (P < 0.01 and P < 0.05, respectively). Serum FA levels were lower in VA and CBZ groups compared to control group (P < 0.05). Serum levels of B12 were not different between VA and control groups (P > 0.05). In CBZ group serum B 12 levels were lower than control group (P < 0.05). FA may be added to the treatment protocol (if the patients take only CBZ, then B 12 should also be added) for patients taking these antiepileptic drugs to decrease the degenerative effect of VA and CBZ on vascular endothelium. (C) 2002 Elsevier Science B.V. All rights reserved.
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    Giant axonal neuropathy: MRS findings
    (Sage Publications Inc, 2003) Alkan, A; Kutlu, R; Sigirci, A; Baysal, T; Altinok, T; Yakinci, C
    Giant axonal neuropathy (GAN) is a rare genetic disease of childhood involving the central and peripheral nervous systems. Axonal loss with several giant axons filled with neurofilaments is the main histopathological feature of peripheral nerve biopsies in this disease. Routine neuroimaging studies reveal diffuse hyperintensities in cerebral and cerebellar white matter. In this case report, the authors present the brain magnetic resonance spectroscopic features (normal N-acetylaspartate/creatine and increased choline/creatine and myoinositol/creatine ratios), which might indicate the absence of neuroaxonal loss and the presence of significant demyelination and glial proliferation in white matter, of an 11-year-old boy diagnosed with GAN.
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    Glutaric aciduria type I diagnosed after poliovirus immunization: Magnetic resonance findings
    (Elsevier Science Inc, 2002) Alkan, A; Baysal, T; Yakinci, C; Sigirci, A; Kutlu, R
    Glutaric aciduria type I is an uncommon inborn error of metabolism. It is a serious disease, often with a fatal outcome. Magnetic resonance imaging findings and the clinical course of monozygotic twin females with glutaric aciduria type I who were admitted with acute encephalopathic crisis symptoms 3 days after immunization for poliovirus are presented in this report. Magnetic resonance imaging findings revealed hyper-intensity in the putamen, head of the left caudate nucleus, and globus pallidus, periventricular white matter (on T-2-weighted images), arachnoid cysts in bilateral temporal regions, and enlargement of the sylvian fissures. Glutaric aciduria type I should be included in the differential diagnosis of patients with acute encephalopathic crisis occurring shortly after poliovirus immunization. Typical magnetic resonance findings guide urinary organic acid analysis in these patients. (C) 2002 by Elsevier Science Inc. All rights reserved.