Zekai Tahir Burak Maternity Hospital

Ankara, Turkey

Zekai Tahir Burak Maternity Hospital

Ankara, Turkey

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Akawi N.A.,United Arab Emirates University | Canpolat F.E.,Zekai Tahir Burak Maternity Hospital | White S.M.,Murdoch Childrens Research Institute | White S.M.,University of Melbourne | And 7 more authors.
Human Mutation | Year: 2013

We have recently shown that the hemorrhagic destruction of the brain, subependymal, calcification, and congenital cataracts is caused by biallelic mutations in the gene encoding junctional adhesion molecule 3 (JAM3) protein. Affected members from three new families underwent detailed clinical examination including imaging of the brain. Affected individuals presented with a distinctive phenotype comprising hemorrhagic destruction of the brain, subependymal calcification, and congenital cataracts. All patients had a catastrophic clinical course resulting in death. Sequencing the coding exons of JAM3 revealed three novel homozygous mutations: c.2T>G (p.M1R), c.346G>A (p.E116K), and c.656G>A (p.C219Y). The p.M1R mutation affects the start codon and therefore is predicted to impair protein synthesis. Cellular studies showed that the p.C219Y mutation resulted in a significant retention of the mutated protein in the endoplasmic reticulum, suggesting a trafficking defect. The p.E116K mutant traffics normally to the plasma membrane as the wild-type and may have lost its function due to the lack of interaction with an interacting partner. Our data further support the importance of JAM3 in the development and function of the vascular system and the brain. © 2012 Wiley Periodicals, Inc.


Ark M.,Gazi University | Ozdemir A.,Gazi University | Polat B.,Zekai Tahir Burak Maternity Hospital
Apoptosis | Year: 2010

Ouabain, a specific Na+/K+-ATPase inhibitor, has recently been identified as a mammalian hormone. Its elevated concentrations in human plasma have also been associated with pathogenesis of several diseases. Recent studies have shown that ouabain induces aponecrotic cell death in a cell-type- and dose-dependent manner. However, the exact mechanism of ouabain-induced cell death is not fully understood. The Rho GTPase effectors Rho kinases-1 and -2 (Rock-1 and Rock-2) which play central roles in the organization of the actin cytoskeleton, involve in several models of apoptosis. In this study, we investigated the possible involvement of Rocks in ouabain-induced human umbilical vein endothelial cell (HUVEC) apoptosis. Ouabain treatment resulted in loss of cell-cell and cell-substratum adhesion and apoptotic blebbing. Pretreatment of cells with Y-27632, a specific Rock inhibitor, resulted in the inhibition of cell-to-cell detachment and formation of membrane blebs. However, Y-27632 did not prevent ouabain-induced cell-substratum detachment. Instead, treatment with Y-27632 actually accelerated this process. Ouabain treatment induced cleavage of Rock-1 and Rock-2, which was prevented by caspase-3 and caspase-2 specific inhibitors z-DEVD-fmk and z-VDVAD-fmk, respectively. Ouabain-induced Rock-2 cleavage generated a fragment of approximately 140 kDa corresponding to the consensus sequence of caspase-2 on the carboxy terminus of Rock-2. Although it has been previously shown that Rock-2 was cleaved by caspase-2, we have identified here a novel cleavage site and fragment of Rock-2. Our data indicate that ouabain induces both Rock-1 and Rock-2 cleavage via caspase-dependent mechanisms and provide evidence that Rocks are involved in ouabain-induced cell-to-cell detachment and apoptosis. © 2010 Springer Science+Business Media, LLC.


Aydemir O.,Zekai Tahir Burak Maternity and Teaching Hospital | Aydemir O.,Zekai Tahir Burak Maternity Hospital | Sarikabadayi Y.U.,Zekai Tahir Burak Maternity and Teaching Hospital | Aydemir C.,Zekai Tahir Burak Maternity and Teaching Hospital | And 6 more authors.
Eye | Year: 2011

AimTo analyze relative weight gain by 2-week intervals up to 6 weeks after birth in order to predict the development of retinopathy of prematurity (ROP) requiring treatment among very low birth weight (BW) infants.MethodsA prospective study including infants with BW 1500 ≤ g born in a single tertiary intensive care unit over 1-year period was conducted. Body weight measurements were recorded weekly and relative weight gains (g/kg/day) were calculated. The main outcome was development of ROP requiring treatment.ResultsMean BW and gestational age (GA) of the whole cohort were 1165 ± 223 g and 29.3 ± 2.3 weeks, respectively. Relative weight gain at 2 weeks and 4 weeks postnatal age were significantly lower in infants with severe ROP (P0.041 and P0.017, respectively). Relative weight gain at 6 weeks was not different between groups. Infants with severe ROP gained 6.7 ±4 g/kg/day in the first 4 weeks of life, compared with 9.34.5 g/kg/day for those with mild or no ROP. After adjusted for BW and GA in logistic regression poor relative weight gain in the first 4 weeks was found to be related to severe ROP (P0.015). When all the other risk factors significant for severe ROP were included in the logistic regression poor weight gain did not arise as an independent risk factor.ConclusionPoor postnatal weight gain in the first 4 weeks of life is the end result of several comorbidities rather than being an independent risk factor. Poor weight gain can be an additional predictor of severe ROP in very low BW infants. © 2011 Macmillan Publishers Limited All rights reserved.


Sarikabadayi Y.U.,Zekai Tahir Burak Maternity Hospital | Aydemir O.,Zekai Tahir Burak Maternity Hospital | Ozen Z.T.,Zekai Tahir Burak Maternity Hospital | Aydemir C.,Zekai Tahir Burak Maternity Hospital | And 5 more authors.
Ophthalmic Epidemiology | Year: 2011

Purpose: We aimed to determine applicable guidelines for screening of retinopathy of prematurity (ROP), and evaluate the contribution of risk factors for severe ROP. Methods: A prospective cohort study of neonates with a gestational age (GA) < 34 weeks or birth weight < 2000g who were admitted to the Neonatal Intensive Care Unit (NICU) of a tertiary level hospital was conducted. The study group was classified into three groups according to eye examination findings as no ROP, mild ROP and severe ROP. Results: Of the 700 neonates screened, the frequencies of ROP for any stage and severe ROP were 32.7% and 3.1%, respectively. Laser photocoagulation was needed in 9.6% of neonates with ROP. None of the neonates with a GA ≥ 31 weeks required treatment. Any ROP was detected in 199 (53.6%) of the babies < 32 weeks (n=371), 22 (5.9%) of whom were treated with laser photocoagulation. Independent risk factors for severe ROP in babies < 32 weeks GA were birth weight, duration of mechanical ventilation and patent ductus arteriosus (PDA). Conclusion: This is the largest prospective cohort study including infants younger than 34 weeks GA from Turkey. Our data which belongs to the last 1-year period shows lower incidence of severe ROP when compared to previous reports from Turkey. According to our data, screening babies smaller than 32 weeks GA or 1500g birth weight seems reasonable. In the presence of long duration of mechanical ventilation and PDA, screening should be intensified. © 2011 Informa Healthcare USA, Inc.


Ozkan O.,Akdeniz University | Erman Akar M.,Akdeniz University | Dogan N.U.,Zekai Tahir Burak Maternity Hospital
Annals of Plastic Surgery | Year: 2011

Vaginal ageneses are by no means rare anomalies. Complete Mullerian agenesis is the most common reason for vaginal agenesis requiring reconstruction. Patients usually present with pain, hematocolpos, or hematometra in puberty, and later with amenorrhea and dyspareunia. Detailed information is given here regarding etiologies, timing of surgery, and current treatment options for vaginal agenesis. Outcomes and short- and long-term complications of recent treatment options are also discussed. Copyright © 2011 by Lippincott Williams & Wilkins.


Aydemir C.,Zekai Tahir Burak Maternity Hospital | Dilli D.,Zekai Tahir Burak Maternity Hospital | Uras N.,Zekai Tahir Burak Maternity Hospital | Ulu H.O.,Zekai Tahir Burak Maternity Hospital | And 3 more authors.
Journal of Pediatric Surgery | Year: 2011

Background: Oxidative stress has been implicated in the pathogenesis of necrotizing enterocolitis (NEC). In this study, we compared the global oxidant/antioxidant status by measuring total antioxidant capacity (TAC), total oxidant status (TOS), and oxidative stress index (OSI) in preterm infants with NEC and with control preterms. Methods: Forty-one preterm neonates with NEC (stage 1 [group 1; n = 23] and stages 2 and 3 [group 2; n = 18]) and age-matched 36 healthy preterm controls (group 3) were included in this study. Blood samples were obtained both at the time of NEC diagnosis and 72 hours after for the evaluation of TAC and TOS. Serum levels of TAC, TOS, and OSI in patients with NEC were compared with controls. Results: Demographic characteristics were comparable in all 3 groups. Preterm neonates in group 2 (with stages 2 and 3 NEC) had the highest TOS levels and OSI (P <.001 vs both groups 1 and 3). There was no difference in TAC levels among the groups (P =.26). Conclusions: Our findings demonstrated that although TAC levels were similar in all 3 groups, oxidant stress mechanisms were activated in preterm neonates with definite NEC (stages 2 and 3 NEC). Premature neonates with increased levels of TOS and OSI were associated with severity of NEC. © 2011 Elsevier Inc. All rights reserved.


Aydemir C.,Zekai Tahir Burak Maternity Hospital | Oguz S.S.,Zekai Tahir Burak Maternity Hospital | Dizdar E.A.,Zekai Tahir Burak Maternity Hospital | Akar M.,Zekai Tahir Burak Maternity Hospital | And 4 more authors.
Archives of Disease in Childhood: Fetal and Neonatal Edition | Year: 2011

Background: Invasive fungal infections are a major cause of morbidity and mortality in preterm infants. The authors conducted the first prospective, randomised controlled trial of nystatin compared with fluconazole for the prevention of fungal colonisation and invasive fungal infection in very low birth weight (VLBW) neonates. Methods: During a 12-month period, all VLBW neonates were assigned randomly to receive nystatin (1 ml suspension, 100 000 U/ml, every 8 h), fluconazole (3 mg/kg body weight, every third day) or placebo from birth until day 30 of life (day 45 for neonates weighing <1000 g at birth). The authors performed weekly surveillance cultures and systemic fungal susceptibility testing. Results: During the study period, 278 infants (fluconazole group, n=93; nystatin group, n=94; control group, n=91) weighing <1500 g at birth were admitted. There were no differences in birth weight, gestation, gender or risk factors for fungal infection among the groups. Fungal colonisation occurred in 11.7% of the nystatin group and 10.8% of the fluconazole group, as compared with 42.9% of the control group. The incidence of invasive fungal infection was 4.3% in the nystatin group and 3.2% in the fluconazole group, as compared with 16.5% in the control group. There were no differences in fungal colonisation and invasive fungal infection between the nystatin and fluconazole groups. Conclusions: Prophylactic nystatin and fluconazole reduce the incidence of colonisation and invasive fungal infection in VLBW neonates. The authors believe that nystatin is an alternative to fluconazole, because nystatin is safe, inexpensive, well tolerated and effective.


Dogan N.U.,Zekai Tahir Burak Maternity Hospital | Salman M.C.,Hacettepe University | Yuce K.,Hacettepe University
Archives of Gynecology and Obstetrics | Year: 2011

Objectives: To assess human papilloma viruses (HPV) DNA test for detection of recurrences in cervical intraepithelial neoplasia (CIN) patients after loop electrosurgical excision procedure (LEEP). Also effect of LEEP on the clearance of HPV infection was evaluated for CIN 1 lesions. Methods: HPV DNA positive 37 patients (25 CIN 2-3 and 12 CIN 1 cases proven by colposcopic biopsies) were treated with LEEP and followed prospectively with HPV DNA and cytology at third and sixth months. Results: There were 11 patients with abnormal cytologic results in third month and 4 in sixth month. HPV DNA positivity rate declined in CIN 1 group between third and sixth month but this did not reach to statistical significance (44 vs. 36%, P = 0.41). There were 3 treatment failures out of 37 patients (8.1%). All these three patients had CIN 3 at the beginning and two of them had positive HPV DNA in two controls. There were no recurrence/treatment failure for CIN 1 patients. Regarding 37 patients, decrease in cytologic abnormality incidence between third and sixth-month control was statistically significant (29.7 vs. 10.9%, P = 0.03). All four patients with cytologic abnormality at the sixth month had HPV persistence. Cytologic abnormality was more prevelant in HPV persistent women (P = 0.01) and also there was no cytologic abnormality in case of HPV DNA negativity. Conclusion: LEEP does not seem to decrease HPV DNA incidence for CIN 1 at least for 6 months. But HPV DNA used in addition to cytology might help to detect recurrences. © Springer-Verlag 2010.


Aydemir C.,Zekai Tahir Burak Maternity Hospital | Dilli D.,Zekai Tahir Burak Maternity Hospital | Oguz S.S.,Zekai Tahir Burak Maternity Hospital | Ulu H.O.,Zekai Tahir Burak Maternity Hospital | And 3 more authors.
Early Human Development | Year: 2011

Background/Aim: Intestinal fatty acid binding protein (I-FABP) is found within cells at the tip of the intestinal villi, an area commonly injured in necrotizing enterocolitis (NEC). In this study, we aimed to investigate the value of serum I-FABP in early diagnosis and predicting severity of NEC. Methods: This prospective study was conducted between April 2009 and November 2009. The preterm infants with suspected NEC were included in the study. These infants were divided into two groups according to their final diagnoses; Group 1: Stage 1 NEC and Group 2: Stages 2-3 NEC (Group 2a: Stage 2 NEC, Group 2b: Stage 3 NEC). Healthy preterms were assigned to control group (Group 3). Serial blood samples were obtained from the patients at symptom onset, 24. h and 72. h later. One blood sample was taken from the controls. Serum I-FABP levels were compared among the groups. Results: Initial serum I-FABP concentrations were 324.0 ± 165.8 pg/ml, 764.7 ± 465.1. pg/ml, and 360.2 ± 439.5. pg/ml in Group 1, Group 2a, and Group 2b, respectively, and all were significantly higher than those of the control group (76.9 ± 115.9 pg/ml) (p< 0.001). The serum I-FABP levels gradually decreased from the onset of the disease to 72nd hour in Group 1 and Group 2a (p=0.001). In Group 2b I-FABP concentrations slightly decreased at 24th hour of the disease and increased thereafter, but the difference was not significant (p = 0.06). Conclusion: Serial measurements of I-FABP levels may be a useful marker for early diagnosis and prediction of disease severity in NEC. © 2011 Elsevier Ltd.


Aydemir C.,Zekai Tahir Burak Maternity Hospital | Onay H.,Ege University | Oguz S.S.,Zekai Tahir Burak Maternity Hospital | Ozdemir T.R.,Ege University | And 3 more authors.
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2011

Objective.Preterm neonates are susceptible to infection due to a combination of sub-optimal immunity and increased exposure to invasive organisms. Invasive fungal infections are associated with significant morbidity and mortality among preterm infants cared for in the neonatal intensive care unit (NICU). Mannose-binding lectin (MBL) is a component of the innate immune system, which may be especially important in the neonatal setting. The objective of this study was to investigate the presence of any association between MBL gene polymorphism and nosocomial invasive fungal infection in preterm neonates. Methods.Codon 54 (B allele) polymorphism in exon 1 of the MBL gene was investigated in 31 patients diagnosed as nosocomial invasive fungal infection and 30 control preterm neonates. Results.AB genotype was determined in 26% and 30% of patient and control groups, respectively, and the difference was not statistically significant. AA genotype was determined in 74% of the patient group and in 67% of the control group, and the difference was not statistically significant. B allele frequency was not different significantly in the patient group (13%) compared to the control group (18%). Conclusions.In our study, no relationship was found between MBL codon 54 gene polymorphism and the risk of nosocomial invasive fungal infection in preterm neonates in NICU. © 2011 Informa UK, Ltd.

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