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Ozguner I.F.,Dr Sami Ulus Maternity And Childrens Training And Research Hospital | Kizilgun M.,Ankara Childrens Hematology and Oncology Training and Research Hospital | Karaman A.,Dr Sami Ulus Maternity And Childrens Training And Research Hospital | Cavusoglu Y.H.,Dr Sami Ulus Maternity And Childrens Training And Research Hospital | And 4 more authors.
European Journal of Pediatric Surgery | Year: 2014

Background/Purpose The aim of the study is to evaluate the diagnostic value of interleukin-6 (IL-6) level and neutrophil cluster of differentiation 64 (CD64) expression in diagnosis of acute appendicitis (AA). Methods A prospective controlled trail was performed. Children who were hospitalized with a diagnosis of right lower quadrant pain were our cohort. Serum samples for white blood cell, C-reactive protein (CRP), leukocyte CD64 expression, and IL-6 were obtained from the patients just after their admission. Operation was performed if appendicitis seemed probable, others were observed actively. Patients who had noncomplicated appendicitis were Group 1, patients who had complicated appendicitis were Group 2, and patients who had discharged after observation without operation with a diagnosis of nonspecific abdominal pain and had negative appendectomy without another surgical disease were Group 3. Results In this study, 49 patients were enrolled. CRP and CD64 levels were found higher in Group 2. IL-6 levels were found to be lower in Group 3 than Groups 1 and 2. Conclusions There was a difference between Group 2 and the other groups about CD64 levels. The CRP level and expression of leukocyte CD64 level did not effectively predict the diagnosis of noncomplicated appendicitis, but it predicted well the patients with complicated appendicitis. However, IL-6 levels are statistically significantly different between Group 3 and Groups 1 and 2. According to this result, IL-6 levels predicted well the patient with appendicitis. Applying additional diagnostic methods such as IL-6 levels seems to be helpful in reducing the numbers of false-positive diagnosis of AA. © 2014 Georg Thieme Verlag KG Stuttgart · New York.

Dundar Y.,Ministry of Health | Akcan F.A.,Ankara Childrens Hematology and Oncology Training and Research Hospital | Dilli A.,Dskap Yldrm Beyazt Training and Research Hospital | Tatar E.,Dskap Yldrm Beyazt Training and Research Hospital | And 2 more authors.
Journal of International Advanced Otology | Year: 2015

OBJECTIVE: To analyze the effectiveness of diffusion-weighted magnetic resonance imaging (DW-MRI) in the evaluation of recurrent cholesteatomas. MATERIALS and METHODS: Twenty-three patients undergoing second-look surgery were included in our study. There were 14 men and 9 women with ages ranging from 10 to 50. All patients underwent DW-MRI prior to second-look surgery. All magnetic resonance imaging (MRI) examinations were performed with a 1.5-T MRI unit using a standard 8-channel neurovascular coil. DW-MRI and apparent diffusion coefficient maps were included in the examination. Cholesteatoma was diagnosed on the DW-MRI as a marked hyperintense signal in comparison with brain tissue. All cases were classified as positive or negative. RESULTS: The sensitivity and specificity of DW-MRI were 86% and 87%, respectively. The positive predictive value of DW-MRI was 92%, while the negative predictive value was 77%. CONCLUSION: The DW-MRI technique is an important and effective technique in the evaluation of residual cholesteatoma. It can be an alternative method to second-look surgery, which can spare patients repeat operations. © The Mediterranean Society of Otology and Audiology.

Ari M.E.,Ankara Childrens Hematology and Oncology Training and Research Hospital | Erdogan I.,Baskent University | Varan B.,Baskent University | Ozkan M.,Baskent University
Turkish Journal of Thoracic and Cardiovascular Surgery | Year: 2015

Williams syndrome is a genetic disorder caused by multiple gene deletions on chromosome 7. The majority of the cases is sporadic and has typical facial appearance, cardiac anomalies and mental retardation. Cardiovascular anomalies are present in about 80% of the cases, most frequently supravalvular aortic stenosis and pulmonary arterial stenosis. In this article, we report two pediatric cases with a rapidly progressive form of aortic coarctation, each of whom required two surgeries and two percutaneous balloon dilatations within the first five months of life.

Gocun P.U.,Gazi University | Karakus E.,Ankara Childrens Hematology and Oncology Training and Research Hospital | Bulutay P.,Gazi University | Akturk M.,Gazi University | And 2 more authors.
Cancer Cytopathology | Year: 2014

BACKGROUND: The Bethesda System for Reporting Thyroid Cytopathology (BSRTC) provides uniform diagnostic terminology for communication between pathologists and clinicians. Each diagnostic category is associated with a specific risk of malignancy and a recommendation for its management. The indeterminate diagnostic categories of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) present a major challenge for both pathologists and clinicians. We report our institution's 3 years' experience with the AUS/FLUS category and follow-up of these patients. METHODS: A retrospective analysis was conducted for all thyroid fine-needle aspirations (FNAs) between July 2010 and July 2013. During this period, 9242 nodules from 4916 patients were reported according to the BSRTC guidelines. We adopted the AUS terminology in our practice to refer to both AUS, and FLUS. RESULTS: Of the 4916 patients, 347 (7%) were diagnosed as AUS. The malignancy risk for patients who underwent surgical resection after initial diagnosis of AUS was 22.8%, whereas that for patients who underwent a second FNA and surgical resection was 36%. When we included patients with second FNA and without surgery, the malignancy risk was 15.7%. CONCLUSIONS: The malignancy risk for AUS reported in the present study is consistent with those reported previously and is higher than those anticipated according to the Bethesda System. This supports that a multimodal approach (clinical, radiologic, and cytopathologic) is necessary for the management of thyroid nodules diagnosed as AUS. Therefore, we suggest that the recommendation for repeat FNA following an initial diagnosis of AUS should be based on a multimodal approach for each particular patient. © 2014 American Cancer Society.

Elmaogullari S.,Ankara Childrens Hematology and Oncology Training and Research Hospital | Tepe D.,Ankara Childrens Hematology and Oncology Training and Research Hospital | Ucakturk S.A.,Ankara Childrens Hematology and Oncology Training and Research Hospital | Kara F.K.,Ankara Childrens Hematology and Oncology Training and Research Hospital | Demirel F.,Yildirim Beyazit University
JCRPE Journal of Clinical Research in Pediatric Endocrinology | Year: 2015

Objective: Childhood-onset obesity is associated with increased mortality and morbidity related to cardiovascular diseases (CVD) during adulthood. Dyslipidemia has a fundamental role in the pathogenesis of CVD. This study aimed to evaluate the prevalence of dyslipidemia and related factors among obese children and adolescents. Methods: Obese patients aged between 2 and 18 years were included in the study. Serum concentrations of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), fasting glucose levels, insulin, thyroid-stimulating hormone (TSH), free thyroxine (fT4), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and liver ultrasound findings were evaluated retrospectively. Results: Among 823 obese patients, 353 (42.9%) met the dyslipidemia criteria: 21.7% had hypertriglyceridemia, 19.7% had low levels of HDL-C, 18.6% had hypercholesterolemia, and 13.7% had high levels of LDL-C. Older age and/or high body mass index (BMI) were related to increased prevalence of dyslipidemia. Hepatosteatosis was more common among dyslipidemic patients. The frequency of insulin resistance (IR) and of higher levels of ALT and TSH were also detected in dyslipidemic patients. Patients with both dyslipidemia and grade 2-3 hepatosteatosis had higher levels of ALT, AST and TSH and lower levels of fT4. Conclusion: Prevalence of dyslipidemia is high in obese children, and hypertriglyceridemia is in the foreground. Higher levels of IR and more apparent abnormal liver function test results are observed in the context of dyslipidemia and hepatosteatosis coexistence. Metabolic and hormonal alterations related with thyroid functions may also be associated with dyslipidemia and hepatosteatosis in obese patients. © Journal of Clinical Research in Pediatric Endocrinology, Published by Galenos Publishing.

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