Cengiz Acikel

Gulhane Military Medical Academy, Engüri, Ankara, Turkey

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Publications (124)166.47 Total impact

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    ABSTRACT: Background Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in childhood, affecting the joints and lasting at least 6 weeks, with the age of disease onset under 16 years. The classification of the childhood chronic arthritis hasn't been solved. Objectives We aimed that analysing the demographics, clinical and laboratory features, disease status, and subtype distributions of JIA according to the International League of Associations for Rheumatology (ILAR) criteria in Turkey. Methods Between March 2010 and February 2014 with this cross-sectional study, consecutive patients seen with JIA in selected 5 major centres. All patients were classified according to the ILAR criteria. Related to the disease status assessment we evaluate acute phase reactants, physician-patient-parent global assessment of overall disease activity (PGA)(21circle VAS), pain scale (10cm VAS), disease status, and Juvenile Arthritis Damage Index (JADI). We checked the correlations between physician-patient-parent global assessment (PGA) of overall disease activity, and disease status scores. Results In this study, 208 (58.1%) females and 150 (41.9%) males were evaluated (Female/Male:1.39). The mean age of patients was 11.15±4.47 years. The distributions of JIA patients according to onset of disease were as follows: systemic 50 (13.9%), oligoarticular extended 35 (9.4%), oligoarticular persistent 104 (29%), rheumatoid factor (RF) positive polyarthritis 5 (1.2%), RF negative polyarthritis 89 (24.9%), enthesitis-related 51 (13.8%), psoriatic 15 (3.8%), unclassified group 9 (2.6%). The frequency of uveitis was 21 (15.1%) among all of the oligoarticular patients and 12 (5.5%) among in the other group. ANA was positive mainly among the oligoarticular onset patients. 16 patients also had FMF. Among systemic JIA patients, the frequency of macrophage activation syndrome was 24% (n=12). Related to the disease status of the subtypes of JIA revealed that while the RF positive polyarthritis was found to have the highest, and the unclassified group has the lowest activity score via using Articular JADI. The RF (-) polyarthritis was found to has the highest, and the unclassified group has the lowest activity score according to the Extra-articular JADI. Based on the last week's parent-patient-pain score, while the unclassified group has the highest, the psoriatic arthritis has the lowest activity score. Assessment of the disease status by the PGA was resulted the fact that there was statistically significant positive correlation between parent-patient (r=0.770), moderate positive correlation between physician-parent (r=0.456) and physician-patient (r=0.512). There was also statistically positive correlation between the patient and parent pain score (r=0.857). Conclusions We assessed the main clinical and laboratory features, and the disease activity status of the Turkish patients with childhood chronic arthritis. We evaluated the diagnoses and the subtype distributions according to ILAR classification. Disclosure of Interest None declared
    Annals of the Rheumatic Diseases 06/2015; 74(Suppl 2):1225.3-1226. DOI:10.1136/annrheumdis-2015-eular.1570 · 10.38 Impact Factor
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    ABSTRACT: Vascularized composite allografts can undergo immune-mediated rejection, and skin biopsies are needed for monitoring of the transplant. However it is an invasive method, and requires processing time and pathological assessment. The purpose of this study is to use a new noninvasive monitoring method of the reflectance confocal microscopy (RCM) to determine severity of the allograft rejection on rats. Five groin flap allotransplantation were performed between 10 male Sprague-Dawley rats. Immunosuppressive therapy with cyclosporine A was given to the recipients during 10 days after surgery and was ended at the 10th postoperative days to allow acute transplant rejection. Following cessation of CsA, concomitant RCM evaluation and skin biopsy was performed every other day from each animal until total rejection of the allograft. Complete rejection of the allograft took nearly about 10 days and 4 or 5 RCM evaluation and skin biopsy was performed from each rat during this period. A total of 17 specimens were evaluated. A scoring system was developed based on the RCM findings. Skin biopsies were evaluated according to the Banff 2007 working classification criteria. RCM evaluation revealed epidermal irregularity and collagen destruction, however mild perivascular inflammation and degeneration of the basal epidermal layer were observed in early and late rejection period respectively with histopathologic evaluation. High correlation was found between the RCM scores and histopathologic grading. The RCM may be the useful tool to reduce the need for skin biopsy for monitoring of the skin containing vascularized composite allograft. © 2015 Wiley Periodicals, Inc. Microsurgery, 2015. © 2015 Wiley Periodicals, Inc.
    Microsurgery 05/2015; DOI:10.1002/micr.22419 · 2.42 Impact Factor
  • Metin Sencimen · Isil Saygun · Aydin Gulses · Vehbi Bal · Cengiz H. Acikel · Ayhan Kubar ·
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    ABSTRACT: Objectives The aim of this study was to investigate the mandibular third molar pericoronitis flora by using real-time polymerase chain reaction (PCR).Materials and methodsThe quantitative values of Aggregatibacter actinomycetemcomitans (Aa), Campylobacter rectus (Cr), Fusobacterium nucleatum (Fn), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi) and Tannerella forsythia (Tf) were evaluated in comparison with the healthy third molar flora by using real time PCR.ResultsAa, Cr, Pg, and Pi were not statistically significant but numerically higher than the pericoronitis group. In contrast to samples from control subjects, statistically significant higher numbers of Tf were detected in samples from pericoronitis patients. The study revealed the strong relation between risk of pericoronitis and the presence of Tf. Individuals who have Tf in their samples present with an almost eight times relative risk of pericoronitis as the individuals with an absence of Tf in their samples.Conclusion Tf plays an important role in the development of clinical symptoms related to pericoronitis.
    05/2014; 64(4). DOI:10.1111/idj.12109
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    G. Ozbek · H.C. Gul · A. Karakas · C. Artuk · C. Acikel · L. Gorenek · O. Coskun ·

    International Journal of Infectious Diseases 04/2014; 21:402. DOI:10.1016/j.ijid.2014.03.1250 · 1.86 Impact Factor
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    ABSTRACT: Background Although genetic factors known to play crucial role in the pathogenesis of ankylosing spondylitis (AS), little is known about the molecular mechanisms that are responsible. In that context, endoplasmic reticulum aminopeptidase 1 (ERAP1) gene has been suggested as the most important factor in genetic susceptibility, with the exception of HLA-B27. Objectives To investigate the role of ERAP1 in the pathogenesis of AS and its relationship with clinical findings. Methods We included 150 consecutive AS patients who were fulfilling the Modified New York classification criteria and 150 blood donors as healthy control. DNA isolation from the participants’ blood samples was performed automatically by the BioRobot® EZ1 station and we investigated the presence of ERAP1 gene single nucleotide polymorphisms (SNPs) (rs30187, rs27044, rs26653, rs27037, rs2287987, rs10050860, rs17482078, rs7711564, rs27980, rs27529) by using the method of competitive allele-specific PCR. We also determined the subgroups of HLA-B27 by PCR-Sequence Specific Primer (SSP). The differences between genotype and allele frequencies were compared by Pearson Chi-square test. Results The mean age of patients and controls were 34.6 and 29.4 years, respectively. In the patient group, the rate of HLA-B27 positivity was 66.7%, while this was 4.7% in the control group. We detected rs26653 SNP C/C homozygotes in 36 patients (24.0%) and 21 controls (14.0%). The frequency distribution of rs26653 SNP C/C homozygous genotype between the groups was found to be statistically significant (p=0.015). We identified that the frequency of rs26653 SNP’s risky C allele was higher in the patient group (50.0%) than the control group (38.3%) (OR 1.609, %95 CI 1.163-2.226, p=0.004). The contribution of rs26653 SNP’s risky C allele to the total AS genetic risk was calculated as 23.4%. The differences between genotype and allele frequency distribution of other SNPs were not statistically significant. Conclusions In our study, only rs26653 SNP, out of 10 ERAP1 gene SNPs, which were suggested as genetic susceptibility factors in AS at previous studies, was found to be associated with the risk of genetic predisposition in our AS group. The contribution of rs26653 SNP to the total AS genetic risk in the present study was found as 23.4% and it was compatible with the literature (26%). Since there was no relation between HLA-B27 positivity and rs26653 SNP, the contribution of both factor to the pathogenesis of AS seems to be independent from each other. Disclosure of Interest None Declared
    Annals of the Rheumatic Diseases 01/2014; 72(Suppl 3):A283-A283. DOI:10.1136/annrheumdis-2013-eular.879 · 10.38 Impact Factor
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    ABSTRACT: Background Childhood systemic vasculitis are a group of rare diseases with multi-organ involvement and potentially devastating consequences. The biomedical perspective does not take into account a patient’s own psychological perspective. Patients’ subjective experiences may represent the key domains of illness that differ from clinicians’ views. Objectives The aim of the study is to develop an multidimensional assessment instrument named “Juvenile Vasculitis Multidimensional Assessment Report” (JVAMAR) to measure all these domains. In this study it will be presented the data of “Qualitative Interviews”, one of the steps of item generation in JVAMAR. Methods Twelve children with vasculitis and their mother were enrolled to this study. Data were collected using both a demographic data form and a semi-structured interview form. Study was made on individual patient interview by face-to-face manner. Results Data analysis by grounded theory revealed four categories. These categories were (1) physical impact of disease, (2) emotional impact of disease, (3) social impact of disease and (4) complaints about treatment protocols. In the physical impact category, severe pain, hypersensitivity to cold, restriction in movement, weakness, fatigue, frequently upper respiratory tract infections, anorexia and hypertension were the prominent features. As emotional impact, the most common features were thought of death, pessimism, hopelessness, weak adaptation of social environment relevant to patients age, increased mother dependency, anxiety about treatment and future life, dissatisfaction about body image according to medical therapy and emotional hypersensitivity. In the social impact category, the patients reported that difficulty to access to health services, economic problems, decrease in academic performance, absenteeism to school, increased religious behavior and thoughts, conceal the sickness from friends. In the complaints about treatment protocols category, many patients reported improved health status after treatment but fear about having a chronic disease although the drug use regularly, they complained from life time drug use and frequency of daily drug doses. Conclusions Children with vasculitis imply that they experience several difficulties regarding physical, emotional and social aspects and treatment protocols. There is a need to develop a multidimensional instrument to measure important domains of the illness such as quality of life, the burden of disease in vasculitis, defined as the impact of permanent damage on the patient and its assessment. Disclosure of Interest None Declared
    Annals of the Rheumatic Diseases 01/2014; 71(Suppl 3):738-738. DOI:10.1136/annrheumdis-2012-eular.2438 · 10.38 Impact Factor
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    Pediatric Rheumatology 12/2013; 11(Suppl 2):P185. DOI:10.1186/1546-0096-11-S2-P185 · 1.61 Impact Factor
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    Pediatric Rheumatology 12/2013; 11(Suppl 2):P200. DOI:10.1186/1546-0096-11-S2-P200 · 1.61 Impact Factor
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    K Fidanci · A Kilic · M Gulgun · C Acikel · G Basbozkurt · E Demirkaya · F Gok ·

    Pediatric Rheumatology 12/2013; 11(Suppl 2):P217. DOI:10.1186/1546-0096-11-S2-P217 · 1.61 Impact Factor
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    Pediatric Rheumatology 12/2013; 11(Suppl 2):P203-P203. DOI:10.1186/1546-0096-11-S2-P203 · 1.61 Impact Factor
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    Pediatric Rheumatology 12/2013; 11(Suppl 2):P318. DOI:10.1186/1546-0096-11-S2-P318 · 1.61 Impact Factor
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    Pediatric Rheumatology 11/2013; 11(Suppl 1):A81-A81. DOI:10.1186/1546-0096-11-S1-A81 · 1.61 Impact Factor
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    E Demirkaya · C Acikel · A Tufan · A Kucuk · A Berdeli · A Gul · AM Onat · A Delibas · A Duzova · A Dinc · [...] · S Emre · S Senel · S Erten · S Yavuz · S Kalman · T Kasifoglu · U Kalyoncu · Y Tabel · Z Ekinci · S Ozen ·

    Pediatric Rheumatology 11/2013; 11(Suppl 1):A78-A78. DOI:10.1186/1546-0096-11-S1-A78 · 1.61 Impact Factor
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    Pediatric Rheumatology 11/2013; 11(Suppl 1):A163. DOI:10.1186/1546-0096-11-S1-A163 · 1.61 Impact Factor
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    K Fidanci · M Gulgun · A Kilic · C Acikel · E Demirkaya · S Ozen · F Gok ·

    Pediatric Rheumatology 11/2013; 11(Suppl 1):A43. DOI:10.1186/1546-0096-11-S1-A43 · 1.61 Impact Factor
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    K Fidanci · A Kilic · M Gulgun · C Acikel · G Basbozkurt · E Demirkaya · F Gok ·

    Pediatric Rheumatology 11/2013; 11(Suppl 1):A42. DOI:10.1186/1546-0096-11-S1-A42 · 1.61 Impact Factor
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    Pediatric Rheumatology 11/2013; 11(Suppl 1):A80. DOI:10.1186/1546-0096-11-S1-A80 · 1.61 Impact Factor
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    ABSTRACT: Background and aim: Familial Mediterranean fever (FMF) is an autoinflammatory disease caused by mutations of the MEFV gene. We analyse the impact of ethnic, environmental and genetic factors on the severity of disease presentation in a large international registry. Methods: Demographic, genetic and clinical data from validated paediatric FMF patients enrolled in the Eurofever registry were analysed. Three subgroups were considered: (i) patients living in the eastern Mediterranean countries; (ii) patients with an eastern Mediterranean ancestry living in western Europe; (iii) Caucasian patients living in western European countries. A score for disease severity at presentation was elaborated. Results: Since November 2009, 346 FMF paediatric patients were enrolled in the Eurofever registry. The genetic and demographic features (ethnicity, age of onset, age at diagnosis) were similar among eastern Mediterranean patients whether they lived in their countries or western European countries. European patients had a lower frequency of the high penetrance M694V mutation and a significant delay of diagnosis (p<0.002). Patients living in eastern Mediterranean countries had a higher frequency of fever episodes/year and more frequent arthritis, pericarditis, chest pain, abdominal pain and vomiting compared to the other two groups. Multivariate analysis showed that the variables independently associated with severity of disease presentation were country of residence, presence of M694V mutation and positive family history. Conclusions: Eastern Mediterranean FMF patients have a milder disease phenotype once they migrate to Europe, reflecting the effect of environment on the expression of a monogenic disease.
    Annals of the rheumatic diseases 03/2013; 73(4). DOI:10.1136/annrheumdis-2012-202708 · 10.38 Impact Factor
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    ABSTRACT: We designed one-and-a-half-barrel vascularized free fibular flap which is a further modification of the double-barrel technique, and we tried to overcome the discrepancy between mandible and fibula flap. We used this flap in case of a segmental mandibular defect that occurred as a result of a giant cell reparative granuloma excision. This new modification eliminated volume insufficiency of the classical technique and volume excess of the double-barrel technique.A segmental mandibular defect that occurred as a result of giant cell reparative granuloma excision was reconstructed using one-and-a-half-barrel vascularized free fibular flap. The size discrepancy between mandible and free fibula flap is a well-known problem, and this new modification of free fibular flap eliminated volume insufficiency or excess problems of the other techniques.
    The Journal of craniofacial surgery 03/2013; 24(2):e167-9. DOI:10.1097/SCS.0b013e31827c840f · 0.68 Impact Factor
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    ABSTRACT: Objectives: The residual alveolar bone height at the implant recipient site plays a key role in determination of the risk of sinus membrane perforation during crestal sinus elevation. In this study, we aimed to determine the correlation between residual ridge height and perforation limit of sinus membrane and to examine the safety range for the sinus membrane continuity in crestal sinus elevation. Formalin-fixed cadavers were used for the experiment to observe outcomes. Method and materials: Crestal sinus elevations were performed on 14 preserved human cadavers' heads. Residual ridge heights were measured using a bone caliper. The physiodispenser was preset to 30 Ncm and sinus floors were elevated by a concave sinus screw with diameter of 4 mm until sinus membrane perforation occurred. The perforations were identified either as Class I or Class II and the portion of the concave sinus screw in the sinus was measured each time using a ruler. Spearman's correlation coefficient was calculated to show the relation between the residual ridge heights and the membrane elevations at the time of perforation of the sinus membranes. Results: In general, the perforation limit of sinus membrane after elevation was higher with greater residual ridge height. A statistically significant correlation was found between residual ridge heights and perforations of the sinus membrane (r = 0.620, P < .001). Conclusion: Although it is not always possible to extrapolate results from cadavers to an in vitro clinical setting, it could be considered to have clinical significance. Our findings suggest that higher subsinusoidal elevation may be achieved when the residual ridge bone height increases. The conclusions of this study should be verified with studies of more rigorous design.
    Quintessence international (Berlin, Germany: 1985) 02/2013; 44(9). DOI:10.3290/j.qi.a29185 · 0.73 Impact Factor

Publication Stats

1k Citations
166.47 Total Impact Points


  • 1998-2015
    • Gulhane Military Medical Academy
      • • Department of Plastic and Reconstructive Surgery
      • • Gülhane Military Medical Academy
      • • Department of Public Health
      Engüri, Ankara, Turkey
  • 2013
    • Hacettepe University
      • Department of Pediatrics
      Ankara, Ankara, Turkey
  • 2011-2013
    • Acibadem Üniversitesi
      İstanbul, Istanbul, Turkey
  • 2001-2011
    • Istanbul Surgery Hospital
      İstanbul, Istanbul, Turkey
  • 2005
    • The Jikei University School of Medicine
      • Department of Plastic and Reconstructive Surgery
      Tokyo, Tokyo-to, Japan
  • 2004-2005
    • University of Texas Southwestern Medical Center
      • Department of Plastic Surgery
      Dallas, Texas, United States
  • 2003
    • Istanbul Training and Research Hospital
      İstanbul, Istanbul, Turkey