-
-
-
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND: The aims of this study were to determine the frequency of delayed gastric emptying in children and adolescents with Type 1 diabetes mellitus (T1DM); and to investigate the relationship between gastric emptying rate and other contributing factors, such as serum HbA1c levels, duration of diabetes and micro-albuminuria, in these patients. SUBJECTS AND METHODS: This was a clinical trial evaluating the rate of gastric emptying of solid meals in 33 children and adolescents with T1DM and in 26 healthy peers, by radionuclide method. Three consecutive overnight urine collections were used to calculate albumin excretion rate (AER). RESULTS: There was no significant difference in the gastric half-emptying time (GE t1/2) (151.66 ±154.46 min vs. 109.76 ± 60.52 min, P=0.885) and the frequency of delayed gastric emptying (36.4% vs. 30.8%, P=0.433) between patients and controls. There was a moderately positive correlation with the GE t1/2 and duration of diabetes in the patients (r=0.380, P=0.029). The GE t1/2 did not correlate with the microalbumin levels in the patients. In these patients, the Body Mass Index Standard Deviation Scores (BMISDS) were significantly lower than in patients with normal gastric emptying (-0.13±0.87 vs. 0.7±1.23, P=0.044). CONCLUSION: Progression of delayed gastric emptying is more likely to be related to a longer duration of diabetes rather than glycemic control in children and adolescents with T1DM. Patients with delayed gastric emptying are thinner compared to patients with a normal rate of gastric emptying; they may also be asymptomatic. SIGNIFICANT FINDING(S) OF THE STUDY: Type 1 diabetic children with delayed gastric emptying are frequently asymptomatic and thin. There were no correlations between delayed gastric emptying and borderline micro-albuminuria and metabolic control. This study adds that the rate of gastric emptying can be investigated in thin children with T1DM with long disease duration, although they may be asymptomatic.
Journal of Diabetes 03/2013;
-
[show abstract]
[hide abstract]
ABSTRACT: The aim of this study was to evaluate serum levels of leptin, ghrelin, and adiponectin in obese and non-obese children with asthma and in healthy non-asthmatic children, and analyze their relationships with clinical outcomes.
This study enrolled 40 obese and 51 non-obese children with asthma and 20 healthy children. Body mass index and serum leptin, ghrelin, and adiponectin levels were determined in all children. Asthma symptom scores and lung function test results were recorded for subjects with asthma.
Serum leptin levels (11.8±7.9, 5.3±6.8, and 2.1±2.4 ng/mL in the obese asthmatic, non-obese asthmatic, and control groups, respectively) and adiponectin levels (12,586.2±3,724.1; 18,089.3±6,452.3; and 20,297.5±3,680.7 ng/mL, respectively) differed significantly among the groups (P<0.001 for all). Mean ghrelin levels were 196.1±96.8 and 311.9±352.8 pg/mL in the obese and non-obese asthmatic groups, respectively, and 348.8±146.4 pg/mL in the control group (P=0.001). The asthma symptom score was significantly higher in the obese children with asthma than in the non-obese children with asthma (P<0.001). Leptin and adiponectin levels were correlated with the asthma symptom score in non-obese children with asthma (r=0.34 and r=-0.62, respectively).
Obesity leads to more severe asthma symptoms in children. Moreover, leptin, adiponectin, and ghrelin may play important roles in the inflammatory pathogenesis of asthma and obesity co-morbidity.
Allergy, asthma & immunology research 03/2012; 4(2):98-103. · 1.91 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The aim of our study was to assess the relationship of beliefs about medications questionnaire (BMQ) scores of asthmatic children presenting to the emergency department and their parents with asthma severity parameters.
Eighty children with asthma presenting to the emergency department with acute asthma findings and their mothers were enrolled in the study. BMQ was applied to all parents and children older than 7 years of age. Asthma severity clinical score was recorded.
The mean age of children (39 males, 41 females) was 49.1 ± 42.8 months. Parent necessity and concerns scores were significantly correlated with their counterparts in children (r = 0.74 and r = 0.60, respectively). Difference between necessity and concerns scores was correlated between parents and children (r = 0.60, p = .002). Child's necessity score was significantly correlated with respiratory severity score (r = -0.43, p = .036).
BMQ necessity and concerns scores of asthmatic children in the emergency department and their parents are correlated with asthma severity. Although not assessed in this study, this result may be attributed to the relationship of necessity and concerns with drug adherence. Therefore, increasing the knowledge about asthma medications in asthmatic children and their parents may contribute to asthma control and decrease their emergency visits with acute asthma findings.
Journal of Asthma 02/2012; 49(3):282-7. · 1.52 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Allergic rhinitis (AR) is a disease in which T-helper (Th)2 response is predominant and its pathogenic mechanism is still poorly understood.
To evaluate the possible role of Th1, Th2 and regulatory-T (Treg) cells in the pathogenesis of AR.
This case-control study enrolled 41 patients with seasonal AR (10-62 years old), sensitive to olive pollens, and 15 healthy controls (18-60 years old). Nasal biopsy was performed and specimens of nasal lavage fluid were obtained from all participants. The levels of interleukin (IL)-4, IL-10, interferon (IFN)-γ and transforming growth factor-β (TGF-β) were measured in nasal lavage fluid specimens. The expression of FOXP3, GATA-3 and T-bet was measured by immunohistochemical methods in the nasal biopsy specimens.
The levels of IFN-γ in the group with AR were significantly lower than those in the control group (p = 0.008). The levels of IL-4, IL-10 and TGF-β did not differ between the two groups. The expression of FOXP3 and T-bet in patients with AR was significantly lower than that in the control group (both p = 0.001). Expression of GATA-3 in the nasal mucosa was similar between the groups (p = 0.2). The ratios of T-bet/GATA-3 and FOXP3/GATA-3 in the AR group were significantly lower than those in the control group (p = 0.001).
Insufficient Treg and Th1 cells may be associated with the allergic inflammation that may be attributed to the Th2 immune response in patients suffering from AR who are sensitive to olive pollen.
International Archives of Allergy and Immunology 11/2011; 157(4):349-53. · 2.40 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To evaluate genetic variations of innate immune system such as mannose binding lectin (MBL), Toll like receptor 4 (TLR4), CD14, LY96 (MD2) and Uroplakin 1B (UPK1B) genes in children with recurrent urinary tract infection (UTI).
The study included 30 children with recurrent UTI and 30 healthy controls. Blood was drawn and analysed for genetic polymorphisms of MBL, TLR4 and CD14 genes by the PCR-RFLP method. Direct DNA sequencing analysis was performed for LY96 and UPK 1B gene mutation in 10 children from UTI group and 5 children from control group.
TLR4 gene Thr399Ile polymorphism was not observed in any child. Genotype distribution and allele frequency of Asp299Gly polymorphism was similar in both groups (p = 0.55). Codon 54 polymorphism of the MBL gene was similar in UTI and control groups (p = 0.49). -159 CC/CT/TT genotypes of CD14 gene was similar between the two groups (p = 0.14). UPK1B and LY96 gene DNA sequence analysis was similar in UTI and control groups.
This study is the first study in which different parts of the innate immune system were evaluated in UTI etiopathogenesis in Turkish children. The results did not point out a significant role of any of the genes evaluated in this study.
The Indian Journal of Pediatrics 03/2011; 78(10):1229-33. · 0.52 Impact Factor
-
Cengiz Kirmaz,
Ozlem Ozenturk Kirgiz,
Papatya Bayrak, Ozge Yilmaz,
Seda Vatansever,
Kemal Ozbilgin,
Ece Onur,
Onur Celik,
Ayhan Sogut,
Gungor Ay,
Hasan Yuksel
[show abstract]
[hide abstract]
ABSTRACT: Seasonal allergic rhinitis (SAR) is characterized by a helper T (Th)2 cell-mediated immune response at the target site. There is a relative Th1 and/or regulatory T (Treg) cell insufficiency in patients with SAR. It has been demonstrated that there is a change in the balance between these cells after allergen-specific immunotherapy (SIT), which is a curative treatment modality for this disease. However, there are few studies that evaluate the number and function of these cells in the inflammatory area after SIT treatment.
We aimed to investigate the distribution of Th1, Th2 and Treg cells in nasal biopsies and lavage fluid (NLF) specimens from patients with SAR, before and after SIT.
Twenty-four, symptomatic SAR patients sensitized to Olea europeae, were enrolled in the study prior to treatment. Fifteen, non-allergic subjects with nasal septum deviation, who needed surgical treatment, served as the control group. NLF and inferior turbinate biopsies were obtained from both groups during the pollen season. Conventional, subcutaneous SIT with Olea europeae extract was initiated in patients with SAR. One year after the first biopsy, biopsies and NLF specimens were again obtained for reevaluation. All biopsies were evaluated for Th1, Th2 and Treg cell counts by means of their transcription factors (T-bet, GATA-3 and FoxP3) using an immunohistochemical analysis method. Additionally, all NLF specimens were evaluated for the functions of these cells, by means of their specific cytokines, using an ELISA method.
When the basal status of those patients with SAR was evaluated based on transcription factors, prior to treatment, Th1 and Treg cells were found to be fewer than in non-allergic controls (p=0.001 for both T-bet and FoxP3). It was demonstrated that numbers of GATA-3-carrying cells, which are a marker for Th2, were not significantly different between the groups (p=0.276), but evaluation of the Th1/Th2 ratio revealed a relative Th2 dominance in patients with SAR prior to treatment. When evaluated on the basis of cytokine levels, it was observed that Th1-originated IFN-γ was lower in patients with SAR compared to the control group, both before and after treatment (p=0.012 for both comparisons), Th2-originated IL-4 levels were not significantly different between the groups either before or after treatment (p=0.649, p=0.855; respectively). Th2- and Treg cell-originated IL-10 levels were higher in patients with SAR before treatment (p=0.033), but this difference was not statistically signifant following treatment compared with controls (p=0.174). Treg cell-originated TGF-β levels were slightly lower in patients with SAR compared to the controls, although the difference was not statistically significant (p=0.178, p=0.296; respectively). None of the above mentioned cytokine levels changed significantly as a result of SIT.
The results of our study indicate that although clinical findings improve after one year of SIT, this duration may not be sufficient to detect changes in cytokine patterns and transcription factors. Further studies that evaluate outcome over a longer duration of treatment would provide valuable information.
European cytokine network. 03/2011; 22(1):15-23.
-
[show abstract]
[hide abstract]
ABSTRACT: The aim of this study was to investigate the influence of exercise training on oxidative stress and markers of lung inflammation in children with asthma.
Thirty children aged 8-13 years diagnosed with asthma were enrolled in the study as well as 13 healthy children. One group received only pharmacological treatment and the other group was also enrolled in an exercise programme. Venous blood and 24-hour urine samples were obtained from the children enrolled in the study at the beginning and end of the study. Leukotriene E4 and creatinine levels were measured in the urine and matrix metallopeptidase (MMP-9), endothelin-1(ET-1), malnodialdehyde (MDA), IgE and specific IgE levels were measured in blood samples.
Leukotriene E4, MDA and MMP9 levels decreased significantly with treatment in both groups (p < 0.001). However, ET-1 levels decreased significant only in the exercise group (26.5 ± 3.6 vs 21.3 ± 2.4 pg/ml respectively, p = 0.001). Moreover, ET-1 levels were found to be significantly lower in the exercise group compared to the only pharmacotherapy group (24.2 ± 3.1 vs 21.3 ± 2.4 pg/ml, p=0.007).
Positive influences of exercise training in children with asthma may be mediated by decrease in ET-1 levels.
Allergologia et Immunopathologia 02/2011; 40(1):20-4. · 1.04 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The pathogenesis of asthma involves both airway inflammation and an oxidant/antioxidant imbalance. It is demonstrated in asthmatic adults that exercise programmes improve lung function, a mechanism yet to be elucidated. The purpose of this study was to investigate the possible beneficial effects of physical exercise on antioxidant status in asthmatic children which may lead to ameliorated lung function.
The study enrolled thirteen control and thirty asthmatic children. The asthmatic group was subdivided into two: the first group receiving only pharmacological treatment (n=15) and the second receiving pharmacological treatment with exercise programme (n=15) for 8 weeks. Blood samples were drawn from the subjects before and after treatment periods. As oxidant stress markers blood levels of malondialdehyde (MDA) and total nitric oxide (NO), and as antioxidant status, glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) enzyme activities were assessed.
Before any treatment was initiated, MDA and NO levels in the asthmatic group were significantly higher than the controls (3.40±0.96 nmol/ml vs 2.46±0.58 nmol/ml, and 12.53±2.10 vs 9.40±1.39 micromol/L, respectively). Both SOD (p=0.0001) and GSH-Px (p=0.023) activities were significantly lower in the asthmatic group. Pharmacological treatment and exercise programme together significantly improved lung performance and decreased the levels of oxidant stress markers, in concordance with a significantly increase in antioxidant enzyme activity measures when compared to the pharmacological treatment.
Structured exercise programme in asthmatic children resulted in better lung function, which may be attributed to its effect on antioxidant status.
Allergologia et Immunopathologia 01/2011; 39(2):90-5. · 1.04 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We aimed to investigate the validity and reliability and of "Asthma Quality of Life Questionnaire (AQLQ)" in Turkish adult asthmatic patients. New or previously diagnosed [according to Global Initiative for Asthma (GINA) 2008] symptomatic 118 consecutive stable asthmatic patients between 18 and 55 years old were included. Asthma severity was determined and Turkish adaptation of the AQLQ was administered. Lara asthma symptom scales (LASS), pulmonary function tests, Turkish adaptation of Medical Outcomes Survey Short Form-36 (SF-36) were evaluated. All assessments were done twice at recruitment and after 10 weeks. During this period patients were allowed to make modifications on their medication when necessary. Among the recruited 118 patients 95 were female and 14 were lost in the follow-up. Sixty-two percentages of the patients had mild and 38% moderate asthma. The internal consistency of AQLQ was high (Cronbach's alpha 0.81-0.87) and item-total score correlations were ranging from 0.75-0.89. The cross-sectional and longitudinal correlations between AQLQ total and domain scores and SF36 domain scores were in a range of little or fair degree (r= 0.241-0.626, p< 0.005). Total AQLQ scores were observed significantly different according to disease severity and LASS both in the first (p< 0.001, both) and 10 weeks follow-up visits (p= 0.006, p< 0.001 respectively). A statistical significant change was observed in AQLQ symptom score as in total LASS changed (p< 0.001, both) in the follow-up. Our results demonstrated that Turkish version of AQLQ is feasible, reliable, valid and sensitive to changes in adult asthmatics.
Tuberkuloz ve toraks 01/2011; 59(4):321-7.
-
[show abstract]
[hide abstract]
ABSTRACT: Since most of in utero bone mass accretion occurs during the third trimester and postnatal need for bone nutrients is increased, preterm infants have an increased risk of low bone mass. Early identification of the risk is of crucial importance. Quantitative ultrasound, which is a relatively inexpensive, portable, noninvasive, and radiation-free method, gives information about bone density, cortical thickness, elasticity and microarchitecture. The aim of this study was to obtain quantitative ultrasound measurements of tibial speed of sound of preterm and term infants and to assess clinical factors associated with these measurements during the first year of life. Seventy-eight preterm and 48 term infants were enrolled in this study. Measurements were made on the 10th day of life in both groups, and were repeated on the 2nd, 6th and 12th months for preterm infants and on the 12th month for the term infants. Speed of sound on preterm infants was significantly decreased on the 2nd month but significantly increased on the 12th month (P=0.00). Comparing speed of sound of term and preterm infants, 10th day measurements were significantly different (P=0.00), but there was not any significant difference between the 12th month values (P=0.26). There was not any relation between biochemical parameters and speed of sound. The technique has potential clinical value for assessment of bone status. Further studies with long term follow up are needed to evaluate the value of quantitative ultrasound with other bone markers to predict the risk of fracture.
European journal of radiology 04/2010; 79(3):428-31. · 2.65 Impact Factor
-
Hasan Yuksel,
Demet Can,
Ismail Reisli,
Nevin Uzuner,
Fazil Orhan,
Omer Cevit,
Fulya Tahan,
Yakup Canitez,
Semanur Kuyucu,
Aysen Bingol Boz,
Ahmet Akcay, Ozge Yilmaz
[show abstract]
[hide abstract]
ABSTRACT: Childhood atopic dermatitis (AD) is classically accepted as initial finding of atopic march; however, nonatopic cases do not follow this course. The aim of this study was to determine the characteristics and prognosis of AD in childhood in Turkey.
The study included 531 children with AD that presented to pediatric allergy departments in 11 different regions of Turkey. Age at diagnosis, total serum and inhalant-specific immunoglobulin E (IgE) levels and allergen skin prick test results were recorded retrospectively. Clinical characteristics like additional allergic diseases at presentation or during follow-up were recorded as well as duration of follow-up.
Mean age at diagnosis was 37.8 +/- 36.2 months. Mean IgE level was 318.3 +/- 677.8 IU/ml (median 100 IU/ml). Skin prick tests yielded positive results in 47% of children. At presentation, 31.6% of children reported additional allergic disease, while 11.7% developed allergic disease during follow-up. Among all, 46.6% had additional allergic disease at any point. IgE levels were significantly higher in children with additional allergic diseases (p = 0.001). Allergen skin prick test positivity and family history of allergic diseases increased the risk of additional allergic diseases significantly (OR = 3.90, 95% CI = 2.3-6.6 and OR = 1.89, 95% CI = 1.3-2.8, respectively).
Allergic sensitization is not present in all cases of AD. Coexistence of additional allergic diseases is not as high as expected but more common in children who have been demonstrated to have atopic sensitization with high IgE levels and allergen skin prick test positivity.
International Archives of Allergy and Immunology 03/2010; 152(4):362-7. · 2.40 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Sleep-disordered breathing is an important public health problem in adolescents. The aim of this study was to investigate the prevalence and risk factors of habitual snoring and symptoms of sleep-disordered breathing in adolescents.
A cross-sectional study was conducted with children from primary schools and high schools that the ages ranged from 12 to 17 years. Data were collected by physical examination and questionnaires filled in by parents regarding sleep habits and possible risk factors of snoring. According to answers, children were classified into three groups: non-snorers, occasional snorers, and habitual snorers.
The response rate was 79.2%; 1030 of 1300 questionnaires were fully completed and analyzed. The prevalence of habitual snoring was 4.0%. Habitual snorers had significantly more nighttime symptoms including observed apneas, difficulty breathing, restless sleep and mouth breathing during sleep compared to occasional and non-snorers. Prevalence of habitual snoring was increased in children who had had tonsillar hypertrophy, allergic rhinitis, and maternal smoking.
We found the prevalence of habitual snoring to be 4.0% in adolescents from the province of Manisa, Turkey which is low compared to previous studies. Habitual snoring is an important problem in adolescents and habitual snorers had significantly more nighttime symptoms of sleep-disordered breathing compared to non-snorers.
International journal of pediatric otorhinolaryngology 10/2009; 73(12):1769-73. · 0.85 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Children with allergic rhinitis (AR) are reported to have disturbed sleep and daytime fatigue due to nasal obstruction.
To evaluate sleep impairment in children with AR using actigraphic evaluation.
Fourteen children aged 7 to 16 years with grass pollen-sensitized seasonal AR were enrolled. They completed the Total 4-Symptom Score (T4SS) scoring system for AR symptom score and the Pittsburgh Sleep Quality Index (PSQI) questionnaire for sleep quality, and they underwent actigraphy for 3 days in the pretreatment period. After topical corticosteroid and antihistaminic treatment for 8 weeks, actigraphy, the T4SS, and the PSQI were repeated. Fourteen healthy children aged 8 to 16 years underwent actigraphy and completed the PSQI questionnaire as controls.
There were no significant age or sex differences between the AR and control groups. Pretreatment PSQI and actigraphy scores were worse in the AR group vs the control group. After treatment, sleep quality improved, and there were no differences in actigraphy and PSQI scores between the 2 groups. Before treatment, the T4SS was significantly correlated with the sleep efficiency, daytime napping episodes, and total nap duration variables of actigraphy (r = -0.53, P = .004; r = 0.43, P = .02; and r = 0.39, P = .04, respectively). The T4SS was correlated with the total PSQI score (r = 0.67, P < .001).
Sleep can be compromised in children with AR. There is a significant correlation of clinical symptom score with the actigraphic and PSQI variables. Therefore, actigraphy may be used as an objective tool to evaluate sleep disturbance in children with AR.
Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology 10/2009; 103(4):290-4. · 2.83 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Efficacy of bronchodilator treatment in children with asthma depends on the proper use of inhalation devices. The aim of this study was to compare the efficacy of inhaled bronchodilator treatment with a spacer and a nebulizer in children with acute asthma findings.
Fifty-eight children with acute asthma findings who received ambulatory inhaled bronchodilator treatment with a nebulizer and 39 with a spacer were enrolled in the study. Duration of asthma, inhaled steroid treatment and the number of exacerbations during the previous year were recorded. Duration of current acute symptoms, exacerbation severity score and duration of respiratory findings after initiation of treatment were also recorded.
Children in both groups were similar in age (76.5 +/- 30.3 months using a nebulizer vs 83.1 +/- 25.1 in spacer group, p = 0.26). Duration after diagnosis of asthma, initiation of inhaled steroid treatment and exacerbation symptoms were similar between groups (p = 0.15, 0.76 and 0.93, respectively). Exacerbation severity score in the nebulizer group was not significantly different from the spacer group (2.6 +/- 0.7 vs 2.8 +/- 0.7 respectively, p = 0.19). Number of exacerbations in the previous year was not different (2.0 +/- 1.2 in the nebulizer group vs 1.6 +/- 0.9 in the spacer group, p = 0.08). Duration of acute asthma findings after initiation of inhaled bronchodilator treatment was similar between the two groups (6.5 +/- 2.9 vs 7.2 +/- 4.6 p = 0.34).
Nebulizers and spacers have similar influence on the duration of acute asthma findings in children when used in ambulatory home bronchodilator treatment.
Journal of Asthma 04/2009; 46(2):191-3. · 1.52 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Iron-deficiency anemia due to iron malabsorption and duodenal nodular lymphoid hyperplasia (NLH) has been described in children with Giardia intestinalis infection. Also, symptomatic iron-deficiency anemia is rarely encountered in male adolescents. A 14-year-old boy underwent esophagogastroduodenoscopy for investigation of symptomatic iron-deficiency anemia (hemoglobin 5.8 g/dL, mean corpuscular volume 65.3 fL, serum ferritin < 1.5 ng/mL). He had a sufficient diet for iron and recurrent bouts of diarrhea without melena. At upper endoscopy, duodenal mucosa was diffusely nodular. Histopathologic evaluation of biopsy samples from the duodenum revealed infection with Giardia intestinalis. His anemia improved with metronidazole and iron treatment.
Pediatric Hematology and Oncology 02/2009; 26(1):57-61. · 0.89 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Childhood constrictive bronchiolitis obliterans (CBO) is characterized clinically by the persistence of obstructive respiratory symptoms following a prolonged episode of lower respiratory viral infection. The diagnosis depends on the clinical, radiological and laboratory findings. Perfusion defects on scintigraphy may predict the severity. This report describes a 2-year-old girl who presented with a 15-day history of respiratory distress despite treatment. Auscultation of the lungs revealed prolonged expiration and bilateral crepitant rales. CXR revealed bilateral paracardiac infiltration. She improved with a treatment regimen of bronchodilators, systemic steroids and antibiotherapy; however, rales were detected again 10 days after discharge. HRCT of the lung revealed an oligaemic-mosaic pattern, more prominent in the left lung. The diagnosis of CBO was made on the basis of these clinical and radiological findings. Perfusion was normal in the right lung but diffusely decreased in the left lung on perfusion scintigraphy by Tc99m-MAA. Magnetic resonance (MR) angiography source images of the lungs revealed significant but not diffuse perfusion defects in the left lung, in contrast to radionuclide scintigraphy. There were areas of low perfusion in the right lung, which were not evident in radionuclide scintigraphy. The use of source images of MRI angiography of the lungs may be more sensitive and specific for the detection of perfusion defects in patients with CBO and may assist in determining the prognosis.
Respirology 01/2009; 14(2):295-8. · 2.42 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Clinical significance of segmental lung perfusion defects in children with bronchiolitis obliterans (BO), have not been reported before. The aim of this study was to evaluate clinical significance of lung perfusion defects in children with BO and to reveal its impact on follow up. The study included 38 children aged 9 to 60 months (17.8 + or - 13.4 months) with BO. Diagnosis was based on persistent respiratory findings beyond six weeks and oligemic-mosaic pattern in lung high resolution computerized tomography. Chest X-ray, 24 hour esophageal pH monitoring, sweat chloride test, immunoglobulin levels and respiratory viral screening were carried out in all. Lung perfusion scintigraphy was carried out at least three months after the first clinical sign of BO. Perfusion defects were scored. Scintigraphy demonstrated perfusion defects in 24 (63.2%) patients but was normal in 14 (36.8%). Number of segments having perfusion defects was 2.9 + or - 2.6. Mean number of exacerbations and days of hospitalization during the first year of follow up were 4.7 + or - 4.4 and 26.9 + or - 29.8 respectively. It was detected that number of perfusion defects correlated significantly with the number of exacerbations and duration of hospitalization (r= 0.66 and p= 0.00). In conclusion, number and extent of segments with perfusion defects in lungs of children with BO are correlated with clinical severity. Therefore, evaluation of lung perfusion status may aid in clinical determination of disease severity and its follow-up.
Tuberkuloz ve toraks 01/2009; 57(4):376-82.
-
[show abstract]
[hide abstract]
ABSTRACT: The aim of this study was to determine influence of prenatal granulocyte-macrophage colony-stimulating factor (GM-CSF) administration on lung growth, maturation, and vascular endothelial growth factor (VEGF) expression. Twenty Wistar rats received sterile saline (1 mL) or recombinant human GM-CSF (50 micro g/kg) on day 16 of pregnancy. Rats were sacrificed on days 18 and 20 of gestation. H-score for VEGF was calculated immunohistochemically. Alveolar VEGF expression on days 18 and 20 of gestation was significantly higher in the GM-CSF group (P < .01). Increase in VEGF with prenatal GM-CSF administration indicates that GM-CSF may stimulate lung growth and maturation and may be protective against lung disease due to prematurity.
Experimental Lung Research 12/2008; 34(9):550-8. · 1.22 Impact Factor
