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Yayın Acute intravascular hemolysis due to ABO incompatible platelet transfusion(Karger, 2003) Öztürk, Ahmet; Sayan, Özkan; Atasoyu, E. M.Acute Intravascular Hemolysis due to ABO-Incompatible Platelet TransfusionYayın Albumin, hemoglobin, body mass index, cognitive and functional performance in elderly persons living in nursing homes(Elsevier, 2010) Önem, Yalçın; Terekeci, Murat Hakan; Küçükardalı, Yaşar; Şahan, Burak; Solmazgül, Emrullah; Şenol, Mehmet Güney; Nalbant, Selim; Sayan, Özkan; Top, Cihan; Öktenli, ÇağatayThe aim of this study is to produce the relation between cognitive and functional performance and some biochemical parameters in elderly population. So, we searched for the correlation between the activities of daily living (ADL), mini-mental state examination (MMSE) and body weight, age, hemoglobin, albumin, serum sodium level of 180 elderly people in five nursing homes. Face-to-face interviews and questionnaires were applied to evaluate ADL. To evaluate the cognitive function we used the MMSE. The average age of 180 people contacted was 71.5+/-5.1 (+/-S.D.), ranging 65-91 years; 112 of them were women (62.2%), 68 were men (37.8%). Of these elderly people, 25% had no medically diagnosed illnesses, whereas 17 of them (9.4%) were bedridden. There was a positive correlation between ADL and hemoglobin, albumin, body weight, cognitive function parameters and a negative one with age and serum sodium. There was a positive correlation between cognitive functions and hemoglobin, body weight, ADL and a negative one with serum sodium. Hemoglobin concentrations indicating anemia were observed in 30% of subjects, 3.9% of them had hyponatremia and 26.7% displayed a hypernatremia. There was a positive correlation between cognitive and physical function scores and hemoglobin, albumin levels in elderly patients. These results suggest that restoration of hemoglobin and albumin levels could improve cognitive and physical functional status in the elderly population.Yayın Blood oxidative stres biomarkers in patients with Familial Mediterranean Fever (FMF)(Thieme Publishing Group, 2010) Çelik, Serkan; Öktenli, Çağatay; Terekeci, Murat Hakan; İpçioğlu, Osman; Sanisoğlu, Yavuz S.; Sayan, Özkan; Yeşilova, Zeki; Yıldız, Oğuzhan; Tunca, Yusuf; Nalbant, SelimInterest in the relationship between oxidative stress and inflammation has increased in recent years. Familial Mediterranean fever (FMF) represents a suitable autoinflammatory disease model for investigation of this relationship. We aimed to determine blood oxidative stress biomarkers in patients with FMF in both acute attacks and in attack-free periods, and to evaluate its associations with pyrine mutations and C-reactive protein (CRP) levels. The mean levels of CRP and serum lipid hydroperoxide were higher and serum superoxide dismutase and catalase activities were lower in patients with FMF than in healthy volunteers. Serum lipid hydroperoxide levels were higher and antioxidants were lower in FMF patients during an acute attack than in the attack-free period. Serum lipid hydroperoxide levels were significantly higher, and antioxidants were significantly lower in patients with the M694V homozygous mutations than the other genotypes. Our data imply that higher serum lipid hydroperoxide and lower antioxidant enzyme activities in FMF may indicate inflammation-related 'oxidative stress'. Our findings also raise interesting questions on oxidative stress and its associations with pyrine mutations in FMF and awaits further investigations.Yayın The diagnosis of non Hodgkin lymphoma in an epidermodysplasia verruciformis patient(2009) Karagöz, Bülent; Erikçi, Alev Akyol; Karabudak, Özlem; Bilgi, Oğuz; Sayan, Özkan; Küçükkodaci, Zafer; Türken, Orhan; Kandemir, Emin Gökhan; Öztürk, Ahmet KutluEpidermodysplasia verruciformis is a rare, multifactorial disorder. The disease has genetic and immunologic components. Many patients have impaired cell-mediated immunity. Although squamous cell cancers may develop in EV patients, the association with other hematological or solid malignancies and EV is reported in a few studies. In this report, a case of EV with primary mediastinal large B-cell lymphoma is presented. A 20-year-old man with a five years history of red-brown macular lesions was admitted to our hospital. The skin biopsy revealed epidermodysplasia verruciformis. Persistent cough started during the hospitalization. On the chest X-ray, mediastinal enlargement was determined. Thoracic computed tomography demonstrated a mediastinal mass of 6 cm in diameter. Diffuse, large B-cell lymphoma was diagnosed. The chemotherapy (R-CHOP regiment) and involved field radiotherapy were administered. Complete response was achieved after the combined treatment modality. He is lymphoma-free for 18 months follow-up. Epidermodysplasia verruciformis is frequently seen in immunosuppressive patients and many accompany infections with type human papilloma virus subtypes such as 5 and 8. These human papilloma virus subtypes that have oncogenic properties may trigger lymphomagenesis. In addition, lymphomas are seen more frequently in immunosuppressive patients than healthy persons. We conclude that there may be a predisposition to lymphoma development in epidermodysplasia verruciformis patients.Yayın The diagnosis of non-hodgkin’s lymphoma in epidermodysplasia verruciformis patient(Turkish Society of Hematology, 2005) Karagöz, Bülent; Akyol Erikçi, Alev; Karabudak, Özlem; Bilgi, Oğuz; Sayan, Özkan; Kandemir, E. Gökhan; Öztürk, AhmetEpidermodysplasia verruciformis (EV) is a rare, multifactorial disorder. This disease contains genetic and immunologic components and accompanies infection with some specific Human Papilloma Virus (HPV) types. The patients may develop multiple in situ and/or invasive squamous cell carcinomas. The most of the patients have impaired cell-mediated immunity. Although EV accompanies frequently skin cancer and extracutanous squamous cell carcinoma, the association between EV and other cancers is not described. In this report, a case of EV with primary mediastinal large B cell lymphoma is presented. A 20-year-old man was seen in our outpatient clinic. He had red-brown macular lesions in sun exposed areas as face and neck for five years duration. EV was diagnosed by histopathologic examination of skin biopsy. One month later, he started to cough. The histological diagnosis of mediastinal mass measuring 6 cm in diameter was diffuse large Bcell lymphoma. B symptoms were absent. He was diagnosed to have stage IAX disease. R-CHOP chemotherapy (Rituximab plus CHOP) and involved field radiotherapy were administered. We have been following this case for 6 months and complete remission is achieved. EV accompanies infection with specific HPV types and is seen in immunosuppressive patients. Some of EV-specific HPVs, particularly HPV 5 and 8 have oncogenic properties. These may have also lymphogenic effect. Moreover the lymphomas are seen frequently in immunosuppressive patients. We conclude that EV may be a predisposition for lymphoma.Yayın Does leptin play a role in idiopathic thrombocytopenic purpura(Turkish Society of Hematology, 2005) Akyol Erikçi, Alev; Sayan, Özkan; Çağlayan, Sinan; Öztürk, Ahmet; Narin, YavuzBackground:Idiopathic thrombocytopenic purpura (ITP) is an immune disorder characterized by accelerated platelet destruction. Aim: We wanted to evaluate serum leptin levels in ITP, in order to determine the role of leptin on the pathogenesis of ITP.Methods: Twenty-three untreated patients with chronic ITP were compared with 15 healthy people of similar age, sex and body mass index (BMI). Serum leptin levels were measured by immunoradiometric assay (IRMA). Results:We found that the mean serum leptin levels in patients with ITP (26.71 +/- 17.69 ng/mL) were significantly (P < 0.001) higher than that in healthy control volunteers (6.54 +/- 4.36 ng/mL). Serum leptin levels in patients with ITP were inversely related (P < 0.001) to the platelet counts. Conclusion: We conclude that these findings suggest that leptin might be an independent factor in the pathogenesis of ITP.Yayın High frequency of MEFV gene mutations in patients with myeloid neoplasm(SpringerLink., 2010) Öktenli, Çağatay; Sayan, Özkan; Çelik, Serkan; Erikçi, A. Alev; Tunca, Yusuf; Terekeci, Murat Hakan; Erkuvan Umur, Elçin; Sanisoğlu, Yavuz S.; Torun, Deniz; Tangı, Fatih; Şahan, Burak; Nalbant, SelimWe aimed to investigate the rate of MEFV, the gene mutated in familial Mediterranean fever, mutations in patients with myeloid neoplasm and to determine if known mutations of MEFV cause a tendency for myeloid neoplasms. The frequency of the five most common MEFV gene mutations (M694V, M680I, V726A, E148Q and M694I) was determined in 26 patients with myeloid neoplasm. We identified 1 homozygous (E148Q/E148Q), 1 compound heterozygous (M694V/E148Q) and 5 heterozygous MEFV gene mutations; none had their own and/or family history compatible with familial Mediterranean fever. The mean overall mutation rate was 0.269. We found a high frequency of carriers in patients with myelodysplastic syndrome (66.6%), polycythemia vera (33.3%) and acute myeloid leukemia (28.6%). However, there was no MEFV gene mutation in patients with chronic myeloid leukemia. In conclusion, this study reports for the first time a possibly high prevalence of MEFV gene mutations in patients with myeloid neoplasm, especially myelodysplastic syndrome, polycythemia vera and acute myeloid leukemia. Our findings could open new perspectives for MEFV gene mutations in myeloid neoplasms and its association with tumor promotion. Further research is needed to determine the actual role of MEFV gene mutations in these malignancies.Yayın Increased asymmetric dimethylarginine levels in young men with familial Mediterranean fever (FMF): is it early evidence of interaction between inflammation and endothelial dysfunction in FMF?(The Journal of Rheumatology Publishing Co. Ltd., 2008) Terekeci, Murat Hakan; Öktenli, Çağatay; Özgürtaş, Taner; Nalbant, Selim; Top, Cihan; Çelik, Serkan; Tapan, Serkan; Küçükardalı, Yaşar; Sanisoğlu, Yavuz S.; Solmazgül, Emrullah; Şahan, Burak; Sayan, ÖzkanObjective: Unlike in many other chronic inflammatory rheumatic diseases, studies investigating endothelial dysfunction and atherosclerosis in familial Mediterranean fever (FMF) are limited, and the results are controversial. Asymmetric dimethylarginine (ADMA) is considered an indicator for endothelial dysfunction and a sensitive marker for cardiovascular risk. There have been no reports on serum ADMA levels in patients with FMF. Methods: We aimed (1) to determine serum ADMA concentrations in 38 young male patients with FMF and 23 age- and body mass index-matched healthy volunteers; (2) to evaluate its correlations with MEFV mutations, C-reactive protein (CRP) levels, and lipid profile; and (3) to compare effects of colchicine on circulating ADMA concentrations. Results: In patients with FMF, ADMA and CRP levels were higher than in healthy controls. The mean levels of ADMA and CRP were higher during acute attacks than in attack-free periods. Patients taking colchicine had lower serum ADMA levels than non-colchicine users. There was a positive strong correlation between ADMA and CRP in patients with FMF. Stepwise linear regression analysis in patients with FMF revealed that age and CRP levels were independently associated with serum ADMA levels. Conclusion: Our data imply that higher serum ADMA levels in FMF may indicate inflammation-related "endothelial dysfunction." It seems likely that regular use of colchicine is effective in preventing the development of and reversing not only amyloidosis but also endothelial dysfunction in patients with FMF.Yayın Increased circulating asymmetric dimethylarginine (ADMA) levels in active stage of Behçet’s Syndrome(Thieme Publishing Group, 2009) Terekeci, Murat Hakan; Nalbant, Selim; Özgürtaş, Taner; Çelik, Serkan; Tapan, Serkan; Sanisoğlu, Yavuz S.; Şahan, Burak; Sayan, Özkan; Küçükardalı, Yaşar; Top, Cihan; Öktenli, ÇağatayThere is little evidence in the literature about circulating asymmetric dimethylarginine (ADMA) levels in Behçet's syndrome (BS). The aim of the present study was 1. to measure the levels of ADMA in male patients with BS, 2. to compare ADMA levels with healthy volunteers, and 3. to evaluate whether there is any difference between patients both with / without thrombosis and in active / inactive stage. In patients with BS, CRP levels were higher than controls. The mean ADMA and C-reactive protein (CRP) levels were significantly higher in active stage patients and patients with thrombosis than in patients during the inactive stage and without thrombosis. In conclusion, we did not find any significant difference in ADMA levels between patients with BS and healthy controls. Serum ADMA concentrations, however,Yayın Long term evaluation of adult onset Still’s disease in a hematology department(Turkish Society of Hematology, 2005) Erikçi, Alev; Sayan, Özkan; Kaplan, Mustafa; Öztürk, AhmetAdult onset Still`s disease (AOSD) is a rare disorder. We report a rare case of a 21 - year old male with AOSD. He was admitted to hospital with 31.000 WBC/mm3, fever and muscle weakness. He was referred to our clinic with a preliminary diagnosis of acute leukemia. Peripheral blood examination and bone marrow aspiration biopsies were performed. A detailed investigation was performed and finally he was diagnosed to be AOSD. Corticosteroid therapy of 60 mg total divided in two doses was started, his fever dropped to normal levels in the very first day, his leucocytosis and clinical symptoms resumed within a week. AOSD should be kept in mind in a hyperleucocytosis case with fever which cannot be explained otherwise.Yayın Mean Platelet Volume (MPV) in Intensive Care Unit (ICU) Patients: Is it a useful parameter in assessing prediction for mortality?(International Research Journals, 2010) Küçükardalı, Yaşar; Önem, Yalçın; Terekeci, Murat Hakan; Tangı, Fatih; Şahan, Burak; Erikçi, A. Alev; Sayan, Özkan; Nalbant, Selim; Öktenli, ÇağatayThe aim of the study is to investigate MPV (mean platelet volume) showing platelet reactivity if it is associated with the severity of the critical illness or mortality in ICU patients. Study group (130 patients) was formed from survivor group (68 patients) and non-survivor group (62 patients). Platelet counts and MPV values were compared between two groups in the first five days of hospitalization. MPV correlation was studied with APACHE II score, age, haemoglobin level, duration in the ICU and as an independent risk factor in mortality. Mean age and APACHE scores were significantly higher in non-survivor group compared to survivor group (p<0.05). There was no significant difference between two groups according to MPV and platelet counts in first five days of hospitalization. There was a unique positive correlation between MPV and APACHE score (r: 0.34, p< 0.05). Only age was independent risk factor in mortality. In our study, we found positive correlation between severity of critical illness and MPV. However, there was no relation between MPV and mortality in heterogenic critical patients. Subgroup analysis of patients in ICU might be useful in assessing prediction for mortality.Yayın Prognostic value of mean platelet volume in patients with upper gastrointestinal bleeding(SpringerLink, 2008) Nalbant, Selim; Çağıltay, Eylem; Terekeci, Murat Hakan; Kaplan, Mustafa; Şahan, Burak; Sayan, Özkan; Öktenli, ÇağatayThis study included patients with upper gastrointestinal hemorrhage who were treated in intensive care unit of GATA Haydarpasa Training Hospital, Division of Internal Medicine during 1 year. Medical and demographic data of the patients were recorded. These patients were followed for 3 months after being discharged from the intensive care unit. Of the 50 patients in the study, 18 were female (36%), 32 were male (64%). The mean age was 47±2 years, and the ages ranged between 17 and 89 years. We did not find any statistically significant results in our evaluation of the relationship between the mean platelet volume and the number of transfusions, endoscopic findings, and prognosis after 3 months of follow-up. This is a preview of subscription content, log in to check access.Yayın The relapse of non-hodgkin’s lymphoma presented with large renal mass and pulmonary multiple nodules mimicking renal cell carcinoma.(Turkish Society of Hematology, 2005) Karagöz, Bülent; Sayan, Özkan; Bilgi, Oğuz; Akyol Erikçi, Alev; Kandemir, E. Gökhan; Öztürk, AhmetPrimary renal involvement of non-Hodgkin lymphomas is rare, secondary involvement is not common. In case of renal mass, other causes should also be considered. There are some cases reporting an association of renal cell carcinoma with lymphoma in literature. We report a case of relapsed non Hodgkin lymphoma with pulmonary nodular involvement. A 32-year-old woman was admitted in oncology department anterior mediastinal mass and vena cava superior syndrome. Tru-cut biopsy revealed primary mediastinal diffuse large B cell lymphoma. She received six cycles of CHOP chemotherapy regimen followed by involved field radiotherapy. The complete response was achieved. After six months, she complained abdominal pain. The computed tomography demonstrated a mass with 8 cm in diameter and multiple nodules in lung parenchyma. This picture mimicked renal cell carcinoma with pulmonary metastasis. The association between renal cell carcinoma and lymphomas was reported. Although renal involvement of non Hodgkin lymphoma is seen as %50 in autopsy series, antemortem diagnosis is uncommon. Moreover after treatment of lymphoma, risk of renal cancer is elevated. However biopsy was applied from renal mass and established relapse of diffuse large B cell lymphoma. The probability of extranodal relapse of thymic lymphoma should be kept in mind.Yayın Relationship between anaemia and cognitive functions in elderly people(Elsevier, 2010) Terekeci, Hakan Murat; Küçükardalı, Yaşar; Önem, Yalçın; Erikçi Akyol, Alev; Küçükardalı, Betül; Şahan, Burak; Sayan, Özkan; Çelik, Serkan; Güleç, Mahir; Sanisoğlu, Yavuz S.; Nalbant, Selim; Top, Cihan; Öktenli, ÇağatayBackground The primary goal of the present study was to investigate the effects of anaemia on the cognitive functions and daily living activities in elderly people. Methods This sectional study was performed using 180 elderly people. Face-to-face interviews and questionnaires were conducted to evaluate daily activities. To evaluate cognitive functions we used the Folstein's Mini-Mental State Examination (MMSE). Results The mean age of the anaemic group and the nonanaemic group were 76.0 ± 11.7 and 72.5 ± 15.2 years, respectively. The average haemoglobin level among the anaemic population was 10.4 g/dL compared with 13.6 g/dL among the nonanaemic population; a statistically significant difference. There was more impairment in functional status (Katz ADL) (6.8 ± 4.3 vs 9.3 ± 3.7) and cognition (MMSE) (17.9 ± 6.4 vs 21.7 ± 6.7) in anaemic than nonanaemic groups, respectively. Albumin and body mass index were lower and the percentage of two or more comorbidities was higher in anaemic group compared to the nonanaemic group, which was a statistically significant variation. The anaemic group was more dependent in terms of bathing, dressing, toileting and transferring. Conclusion In the elderly anaemic group, the dependency for daily activities that require physical effort was higher compared to the nonanaemic group. The MMSE score in the elderly anaemic group was lower than subjects who had normal haemoglobin levels. We conclude that anaemia may impair cognitive functions and some daily living activities in the elderly.
