Fatal encephalitis associated with novel influenza A (H1N1) virus infection in a child

A 4-year-old girl presented with fever, coughing, and vomiting; followed by unconsciousness. Magnetic resonance imaging showed hyperintense changes in the thalami bilaterally, brain stem, cerebellum, and subcortical cortex. Novel influenza A (H1N1) virus was identified by polymerase chain reaction in patient’s nasopharyngeal swab specimen. We reported a rare case of clinically severe, novel influenza A-associated encephalitis. Novel influenza A should be considered in the differential diagnosis in patients with seizures and mental status changes, especially during an influenza outbreak

Çocuk çağı akut lenfoblastik lösemisinde antiapoptotik proteinlerden aven mRNA ekspresyonu

TEZ5017Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2004.Kaynakça (s. 41-45) var.x, 44 s. ; 30 cm.

Çocukluk çağı akut lenfoblastik lösemilerinde herpes grubu virüs enfeksiyonları

TEZ1301Tez (uzmanlık) -- Çukurova Üniversitesi, Adana, 1993.Kaynakça (s. 85-95) var.95 s. ; rnk. res. ; 30 cm.

Brucellosis case with thrombocytopenia

Brusellozisde hematolojk komplikasyonlar görülür ve bunlardan biri de trombositopenidir. Biz burada hepatomegali, splenomegali, lenfadenopati, periferik yaymada dev trombositler ve kemik iliği incelemesinde megakaryositer seride artış olan trombositopeni ile seyreden bir Brusella olgusu sunduk.Heametologic complications of brucellosis is seen and thromboyctopenia is the one. Here, we report a brucellosis one with trombocytopenia who had hepatosplenomegaly, lympadenopaty and peripheral blood smear contained giant platelets, examination of bone marrow showed elevating numbers of megakaryocytes

The Prognostic Significance of Serum Tumor Necrosis Factor (TNF)-Related Apoptosis-Inducing Ligand (TRAIL) in Childhood Acute Leukemias

Tümör nekroze edici faktör(TNF) ilişkili apopitoz indükleyici protein (TRAIL) TNF süper ailesinin bir üyesidir. TRAIL pek çok organda ekprese edilen, hücre yüzeyinde yer alan transmembran bir proteindir. C-domainin (hücre dışında yer alan)ayrılması sonucunda serumda bulunan formunun oluşmasına izin verir.TRAIL, reseptörlerinden TRAIL reseptör 1 (TRAIL-R1) ve TRAIL reseptör 2 (TRAIL-R2)' ye bağlanarak apopitozu indükler bununla birlikte apopitoz sinyali TRAIL reseptör 3 (TRAIL-R3) ve TRAIL reseptör 4 (TRAIL-R4) ile bağlanması sonucunda indüklenemez. Apopitotik yolak bozuklukları ve lösemi gelişimi arasındaki ilişkiyi araştıran pek çok çalışma yapılmıştır.Çalışmamızda akut lösemi hastalarında ilk tanı anında serum TRAIL miktarını tespit etmek istedik. Serum TRAIL'ın akut lösemi hastalarında hasta sağkalımı ve klinik parametrelerle ilişkisini incelemeyi amaçladık. Materyal ve Metod: Bu çalışma Ekim 2009- Temmuz 2010 tarihleri arasında Çukurova Üniversitesi Tıp Fakültesi Çocuk Hematoloji ve Çocuk Onkoloji Bilim Dalına başvuran hastalarda yapıldı. Çalışmaya 9 ay-12 yaş 8ay yaş dağılımında yeni tanı almış 23 akut lenfoblastik lösemili (ALL) hasta ile, 9 gün-19 yaş dağılımında yeni tanı almış 14 akut miyeloblastik lösemili (AML) hasta dahil edildi. Sağlıklı, kan hastalığı olmayan, lösemi grubuna benzer yaş ve cinsiyetteki 21 çocuk, kontrol grubu olarak seçildi. Serum TRAIL düzeyleri Elisa yöntemi ile araştırıldı. Bulgular: Akut lösemi tanılı hastalar ile kontrol grubu karşılaştırıldığında akut lösemi hastalarında ortalama serum TRAIL düzeyi sağlıklı kontrollerden düşük tespit edildi (p=0,002). ALL'li yüksek risk grubundaki (HRG) hastalarda, TRAIL düzeyi kontrol grubuna göre düşük tespit edildi (p=0,008). Common akut lenfoblastik lösemi antijeni (CALLA )(-) B ALL grubunda TRAIL düzeyi kontrol grubuna göre düşük tespit edildi (p=0,004). Lösemi tanısı alan ve eksitus olan hastalarla yaşayan hastalar kıyaslandığında TRAIL düzeyi eksitus olan grupta düşük tespit edildi (p=0,004). Sonuç: Serum TRAIL lösemi hastalarında lökomogenezde rol oynayabilir. Hastalarımızda tespit edilen düşük serum TRAIL düzeyleri azalmış TRAIL aracılıklı apopitoza ve lökomogeneze neden olmuş olabilir. Akut lösemi patogenezinde serum TRAIL'ın rol aldığını önermek için eş zamanlı bakılmış TRAIL aracılıklı apopitotik aktivitenin ölçülmesi gereklidir.Düşük serum TRAIL düzeyi kötü prognozu gösteren bir belirteç olarak kullanılabilir. Daha kapsamlı sonuçlar elde etmek için daha çok sayıda vaka ile yapılmış prospektif çalışmalara ihtiyaç vardırTumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) is a TNF superfamily member. TRAIL is transmembrane protein expressed on cell surfaces and has a broad expression pattern in a variety of organs. Cleavage of its C-terminal part (extracellular domain) allows for a soluble form of TRAIL.TRAIL induces apoptosis with its receptors TRAIL-receptor 1 (TRAIL-R1), TRAIL-receptor 2 (TRAIL-R2) however apoptosis can not be induced by receptors TRAIL-receptor 3 (TRAIL-R3) and TRAIL-receptor 4 (TRAIL-R4). There are many trials to search the correlation between leukemia and apoptotic pathway disorders. In this study we determined the seum levels of TRAIL in acute childhood leukemias at first diagnose. We aimed to determine the relation between the levels of serum TRAIL and patient's survey, clinical parameters. Material and Methods: The study was performed in patients admitted to Pediatric Hematology and Pediatric Oncology Department of Çukurova University Medical Faculty between October 2009 and July 2010. Twenty-three cases with new diagnosis acute lymphoblastic leukemia (ALL) at the age disturbition 9-months-12-year and 8-months and fourteen cases with new diagnosis acute myeloblastic leukemia (AML) at the age disturbition of 9 days-18 years are included in this study. Twenty-one healty children with no blood disease with similar sex and age with leukemia group was chosen as the control group. Serum TRAIL levels were determined by using ELISA method. Results: The comparison of the average values of the TRAIL levels in acute leukemia patients and control group have shown that patients with leukemia have low serum TRAIL levels (p=0.002). In patients with high-risk-grade (HRG) of ALL compared with control group have shown low serum TRAIL levels in HRG of ALL (p=0.008). In patients with common acute lymphoblastic leukemia antigen(CALLA)(- ) B ALL compared with control group have shown low serum TRAIL levels in CALLA(-) B ALL (p=0.004). Children with acute leukemias (ALL, AML) who died during treatment compared with survived group have shown low levels of serum TRAIL in expired patients (p=0.004). Conclusion: As a result, serum TRAIL might play a role in leukomegenesis. The low levels of serum TRAIL detected in our patients may be associated with leukomogenezis and impaired TRAIL-mediated apoptosis. To suggest soluble TRAIL's role in acute leukemias detection of TRAIL-mediated apoptosis is needed. The low serum TRAIL may be used as a sign of bad prognosis. For more comphrensive results prospective studies with greaater number of patients are neede

Mikro RNA and Cancer

MikroRNA'lar, genom üzerinde protein kodlayan intron veya ekzon bölgeleri ve protein kodlamayan bölgelerdeki RNA genlerinden transkripsiyonu sağlanan, fakat proteine translasyonu gerçekleşmeyen, fonksiyonel RNA molekülleridir. MikroRNA’lar protein translasyonunun inhibisyonuna ve/veya mRNA'nın yıkımına neden olur. Yapılan çoğu çalışmada bu küçük moleküllerin hematopoezde farklılaşma, çoğalma ve apopitoz gibi çok önemli hücresel olaylarda kritik öneme sahip olduğunu göstermiştir. Malign hastalıklardaki rolü giderek daha fazla araştırmanın konusu olmaktadır. MikroRNA’lar bir ya da birden fazla hedef geni baskılayarak hücrenin gelişim, farklılaşma, çoğalma, ölümü gibi farklı olaylarda rol oynarlar. miRNA genlerinin %50'sinden fazlası kanser ile ilişkilendirilmiş genom üerinde bulunur. Yapılan çok sayıda deneysel çalışma; miRNA'ların yeni bir onkogen veya tümör baskılayıcı gen sınıfı oluşturabileceğini göstermiştir. Normal ve patolojik dokular arasında farklı seviyede ifade edilen miRNA'lar tespit edilerek, insan kanserlerinde tanı ve tedavide etkili olabilecek yeni miRNA'lar belirlenebilecektir.Mikro-RNAs are functional, non-protein coding RNA molecules and their transcriptions provided by intron or exon regions of the genome and non-protein coding regions of RNA genes. Mikro-RNAs inhibit translation of protein and / or cause destruction of mRNA. Most of studies have demonstrated that many of these small molecules have critical importance in many important cellular events such as hematopoiesis, differentiation, proliferation and apoptosis. The role of mikro-RNAs in malign diseases have become the subject of research increasingly. Mikro-RNAs play a role in different events such as cell growth, differentiation, proliferation and death by suppressing one or more target gene. More than 50% of miRNA genes are located on the genome which has associated with cancer. A large number of experimental studies show that miRNAs may have generate a new class of oncogenes or tumor suppressor gene. MiRNAs are thought to be identified at a different level of expression in normal and pathological tissues can be determined between the miRNAs that are effective diagnosis and treatment of human cancers

Kala-azar in childhood

Kala-azar (Visceral Leishmaniasis;, sıklıkta Leishmania (L) donovani, L. infantum ve L. chagasi tarafından oluşturulan, tedavi edilmediğinde ölümle sonuçlanan protozoal bîr hastalıktır. Bu yazıda, Çukurova Üniversitesi Tıp Fakültesi Balcalı Hastanesi Çocuk Enfeksiyon Hastalıktan Servisinde son 3 yılda izlenen 14 Kala-azar'lı olgu retrospektif olarak incelenerek, hastalığın klinik, laboratuvar ve tedavi özellikleri literatürün ışığında gözden geçirilmiştir. Olgularda en sık görülen başvuru yakınmalarının karın sisliği (%85.7), ateş (%78.6) ve iştahsızlık (%57.1) olduğu ve olguların tümünde anemi ve hepatosplenomegali bulunduğu saptanmıştır. 13 olguda (%92.8) kemik iliğinde, 1 olguda (%7.2) karaciğer biopsi örneğinde amastigotların saptanması ile tanı konulduğu, 10 olguda (%71.4) tek basına meglumin antimonate tedavisi ile şifa sağlandığı görülmüştür. Hastalığın bulasıcılığını kolaylaştıran koşulların yaygın olarak bulunduğu bölgemizde, ateş, karın şişliği, iştahsızlık gibi yakınmalar ile gelen olguların Kala-azar yönünüden değerlendirilmesi ve hastalığın yayılımının engellenmesi için bölgede etkin önlemlerin alınması gerektiği düşünülmüştür.Kala-azar (Visceral leishmaniasis) which is frequently caused by Leishmania (L) donovani, L.infantum and Lchagasi, is a protozoal disease. Visceral dissemination may result in fatal complications, if the disease is not treated. In this retrospective study, we evaluated the clinical and laboratory findings and the treatment modalities of 14 patients with Kala-azar who had been followed up in the Department of Pédiatrie Infectious Disease during the last three years. At the beginning of the disease, the most frequent complaints were abdominal distention (85.7%), fever (78.6%) and anorexia (57.1%). The most prominent findings were marked anemia and hepato splenomegaly. The diagnosis had been confirmed by demonstrating the amastigotes in bone marrow aspiration in 13 patients (92.8%) and by liver biopsy in 1 patient (7.2%). Ten patients (71.4%) were treated with meglumin antimony successfully. We concluded that, since the Çukurova region is an endemic area for Kala-azar and factors leading to transmission are very common, children who present with fever, abdominal distention and anorexia should be evaluated for Kala-azar, and effective preventive measures need to be taken against this infection in this region

Oral health status in children with acute lymphoblastic leukemia and lymphoma

We evaluated the oral health status of 85 acute lymphoblastic leukemia (ALL)/lymphoma pediatric patients who received remission-induction and maintenance chemotherapy and 85 age and sex-matched healthy children with the criteria of World Health Organization (WHO) and to determine the prevalence and distribution of dental problems in order to constitute preventive dentistry precautions in this study. The gingival tissues were scored with Community Index of Periodontal Treatment Necessity (CPITN) and dmf-t and DMF-T indices were used for caries evaluation. In the study group, malocclusion was found in 24 patients (28.2%). CPITN was scored as follows in the study group; 11% of the patients had healthy gingiva (Grade 0), the presence of plaque (Grade I) 79% of the patients, the presence of calculus (Grade II) 10% of patients were observed. Nevertheless, mucositis was found with various grades in 9 patients who received chemotherapy. Decayed teeth were found in the 76 patients and in 45 healthy children. 91.7% of patients and 52.9% of children needed dental treatment were determined. The DMF-T and dmf-t scores showed that ALL/lymphoma patients had more decayed and needed more dental treatment, missing or filled teeth both in their deciduous (<0.001) and permanent (<0.05) dentition when compared to systemically healthy children.We evaluated the oral health status of 85 acute lymphoblastic leukemia (ALL)/lymphoma pediatric patients who received remission-induction and maintenance chemotherapy and 85 age and sex-matched healthy children with the criteria of World Health Organization (WHO) and to determine the prevalence and distribution of dental problems in order to constitute preventive dentistry precautions in this study. The gingival tissues were scored with Community Index of Periodontal Treatment Necessity (CPITN) and dmf-t and DMF-T indices were used for caries evaluation. In the study group, malocclusion was found in 24 patients (28.2%). CPITN was scored as follows in the study group; 11% of the patients had healthy gingiva (Grade 0), the presence of plaque (Grade I) 79% of the patients, the presence of calculus (Grade II) 10% of patients were observed. Nevertheless, mucositis was found with various grades in 9 patients who received chemotherapy. Decayed teeth were found in the 76 patients and in 45 healthy children. 91.7% of patients and 52.9% of children needed dental treatment were determined. The DMF-T and dmf-t scores showed that ALL/lymphoma patients had more decayed and needed more dental treatment, missing or filled teeth both in their deciduous (<0.001) and permanent (<0.05) dentition when compared to systemically healthy children

Cataract Formation due to use of Deferiprone in a Patient with Thalassemia Major

Talasemiler; otozomal resesif kalıtım gösteren, hemoglobin zincirlerinden birinin veya bir kaçının hasarlı sentezi sonucu ortaya çıkan hipokrom mikroster anemi ile karakterize heterojen bir grup hastalıktır. Hastaların sık transfüzyona maruz kalması sonucunda aşırı demir birikimine bağlı yaşamı tehdit eden önemli klinik bulgular ortaya çıkar. Talasemili hastalarda hastalığın kendisine ya da kullanılan şelatör tedavisine bağlı olarak oküler değişikliklere çok sık olmasa da rastlanmaktadır. Bu değişiklikler genellikle katarakt, optik nöropati, retinal pigment epitelinde (RPE) dejenerasyon, RPE mottling, retinal venous tortuosity, vitreoretinal hemorrhages and obliteration of iris patern şeklindedir. İlk defa demir bağlayıcı şelatör olarak kullanılmaya başlanan deferoxamin optik nöropati ve retinal toksisite gibi iyi bilinen komplikasyonlara sahiptir. Ancak deferoxaminin yerini alan ve yakın dönemde sık kullanılan deferipronun oküler toksisitesi ile ilgili literatürde daha önce bildirilmiş az sayıda bilgi vardır. Bu olgu deferipron kullanımına bağlı gelişen katarakt oluşumuna dikkat çekmek amacıyla bildirilmiştir.Thalassemias are a heterogeneous group of autosomal recessive diseases characterized by hypochromic microcytic anemia and occur as a result of defective synthesis of one or more hemoglobin chains. In patients, life-threatening clinical manifestations may occur because of severe iron overload due to frequent blood transfusions. Ocular changes in patients with thalassemia are to be encountered depending on the disease itself or chelator used in the treatment, but not very often. These changes are usually cataracts, optic neuropathy, retinal pigment epithelium (RPE) degeneration, RPE mottling, retinal venous tortuosity, vitreoretinal hemorrhages and obliteration of the iris pattern. Desferrioxamine that is used as the first iron-binding chelating has well-known complications such as optic neuropathy and retinal toxicity. However, Deferiprone that used more common recently has replaced the Desferrioxamine but, there is very little information in the literature about the ocular toxicity of deferiprone. In this case report, we have reported a patient with deferiprone-induced cataract formation in order to draw attention to a little-known complication of the drug