A Celik

Dokuz Eylul University, Ismir, İzmir, Turkey

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Publications (73)102.68 Total impact

  • Z Cavdar · S Ozbal · A Celik · Bu Ergur · E Guneli · C Ural · T Camsari · Ga Guner
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    ABSTRACT: Matrix metalloproteinases (MMPs) are enzymes that are responsible for degradation of extracellular matrix (ECM); they are involved in the pathogenesis of ischemia-re-perfusion (I-R) injury. We investigated the possible preventive effect of alpha-lipoic acid (LA) in a renal I-R injury model in rats by assessing its reducing effect on the expression and activation of MMP-2 and MMP-9 induced by I-R. Rats were assigned to four groups: control, sham-operated, I-R (saline, i.p.) and I-R+ LA (100 mg/kg, i.p.). After a right nephrectomy, I-R was induced by clamping the left renal pedicle for 1 h, followed by 6 h re-perfusion. In the sham group, a right nephrectomy was performed and left renal pedicles were dissected without clamping and the entire left kidney was excised after 6 h. LA pretreatment was started 30 min prior to induction of ischemia. Injury to tubules was evaluated using light and electron microscopy. The expressions of MMP-2 and MMP-9 were determined by immunohistochemistry and their activities were analyzed by gelatin zymography. Serum creatinine was measured using a quantitative kit based on the Jaffe colorimetric technique. Malondialdehyde (MDA) and glutathione (GSH) were analyzed using high performance liquid chromatography. Tissue inhibitor of metalloproteinase (TIMP)-2 and TIMP-1 were assessed using enzyme-linked immunosorbent assay (ELISA). I-R caused tubular dilatation and brush border loss. LA decreased both renal dysfunction and abnormal levels of MDA and GSH during I-R. Moreover, LA decreased significantly both MMP-2 and MMP-9 expressions and activations during I-R. TIMP-1 and TIMP-2 levels were increased significantly by LA administration. LA modulated increased MMP-2 and MMP-9 activities and decreased TIMP-1 and TIMP-2 levels during renal I-R.
    No preview · Article · Oct 2013 · Biotechnic & Histochemistry
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    ABSTRACT: Background Renal transplantation is the best renal replacement therapy because it significantly improves patient survival. The developments in transplantation and increasing number of patients with end-stage renal disease (ESRD) have unmasked long-term complications secondary to immunosuppressive drugs and chronic renal failure.Methods and ResultsEighty-six renal transplant recipients with grafts that have functioned more than 15 years were included in the study. This cross-sectional retrospective analysis of demographic, clinical, and laboratory findings was conducted in 3 Turkish transplantation centers. The mean age was 30.4 ± 10.2 years at the time of the transplantation. The mean time between the transplantation and the study was 19.1 ± 3.6 years. At the time of the study, mean creatinine level was 1.52 ± 0.60 mg/dL, 70.09% of the patients displayed glomerular filtration rates <60 mL/min/1.73 m2. Urinary protein excretion was 0.57 ± 0.65 g/d. Hypertension and hyperlipidemia were the most common comorbid diseases. Twelve patients had diabetes and 9 cardiovascular disease. Seventeen patients had been diagnosed with skin and 5 with non-skin cancer.Conclusions As the number of recipients with long-term functioning grafts increases, long-term complications become evident, particularly chronic renal failure. Survivors should be evaluated regularly and treated early for risk factors and complications to improve long-term graft and patient survival.
    Full-text · Article · Apr 2013 · Transplantation Proceedings
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    ABSTRACT: Aim: To evaluate the relation between cortical and medullary peritubular capillaries (PTCs) and scarring. Th ere are presently no studies about medullary PTCs in renal allograft biopsies. Materials and methods: Nonprotocol allograft biopsies were evaluated and 41 with adequate medullary and cortical tissues were selected. Vascular structures were counted separately at the medulla and cortex on anti-CD34 stained sections. Other histopathological and clinical fi ndings were retrieved from the patient fi les. Results: A weak but positive correlation was found between the number of cortical vascular structures (nVC) and medullary vascular structures (nVM). Th e nVC and nVM were decreased in cases with increased renal scarring; however, this was not statistically signifi cant. A moderate negative correlation was found between nVC and blood creatinine (Cr) at the time of biopsy (P = 0.045, r = –0.32), but not between nVM and Cr. A moderate negative correlation was detected between both nVC and nVM and the most recent Cr (P = 0.01, r = –0.54 and P = 0.03, r = –0.51). Conclusion: nVC might be a valuable prognostic marker, as described previously. Th e relation between the latest Cr and nVM suggests that nVM might also be of value, a novel fi nding requiring further investigation. Th e weak correlation between nVC and nVM, which is described here for the fi rst time, may point to unequal responses of the cortex and medulla to injurious factors.
    Preview · Article · Aug 2012 · Turkish Journal of Medical Sciences
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    ABSTRACT: We assessed the risk factors and causes of death in patients with familial Mediterranean fever (FMF) in an era when colchicine is the standard therapy for all patients.This study included all FMF patients who had presented to any of the internal medicine, rheumatology, or nephrology clinics at Dokuz Eylul University Hospital between 1992 and 2009. Of the 650 patients with FMF identified, 587 (90.3%) had either a face-to-face (n = 380) or telephone (n = 193) interview, or were confirmed as deceased. A structured questionnaire was used to obtain socioeconomic and demographic data, presenting and cumulative clinical features, and disease severity scores.During the follow-up period mortality was analyzed by calculating age- and sex-standardized mortality ratio (SMR) according to the mortality statistics of the Turkish population. Factors predictive of mortality were evaluated using Kaplan-Meier and Cox proportional hazard models. Sixty-three (9.7%) patients whose initial demographic and major clinical characteristics were similar to the rest of the group could not be contacted during the study period.Most (94.2%) patients were on colchicine at the time of the study. Thirty-seven (6.3%) patients had biopsy-verified amyloidosis, and 44 (7.5%) had renal disease. During a median follow-up of 6 years, 14 patients (9 women) died, and amyloidosis and its related complications were the leading causes of death in 7 patients. Univariate analysis revealed that increasing age, coronary heart disease, hypertension, renal disease, and amyloidosis were associated with mortality. However, Cox regression analysis showed amyloidosis as the only significant predictor of mortality (p < 0.001). The overall patient survival rate was not significantly different from the age- and sex-matched Turkish general population (SMR, 1.48; 95% confidence interval, 0.817-2.49).Our findings suggest that although the survival of FMF patients in the colchicine era is comparable to that of the general population, renal involvement still predicts mortality.
    No preview · Article · Apr 2012 · Medicine
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    ABSTRACT: Cytomegalovirus (CMV) infection is common in solid organ transplant recipients and accounts for the majority of graft compromise. Major risk factors include primary exposure to CMV infection at the time of transplantation and the use of antilymphocyte agents such as OKT3 (the monoclonal antibody muromonab-CD3) and antithymocyte globulin. It most often develops during the first 6 months after transplantation. Although current prophylactic strategies and antiviral agents have led to decreased occurrence of CMV disease in early posttransplant period, the incidence of late-onset CMV disease ranges from 2% to 7% even in the patients receiving prophylaxis with oral ganciclovir. The most common presentation of CMV disease in transplant patients is CMV pneumonitis followed by gastrointestinal disease. Hemorrhagic cystitis is a common complication following hematopoietic stem cell transplantation. The condition is usually due to cyclophosphamide-based myeloablative regimens and infectious agents. Even in these settings, CMV-induced cases occur only sporadically. Ureteritis and hemorrhagic cystitis due to CMV infection after kidney transplantation is reported very rarely on a case basis in the literature so far. We report here a case of late-onset CMV-induced hemorrhagic cystitis and ureteritis presenting with painful macroscopic hematuria and ureteral obstruction after 4 years of renal transplantation. The diagnosis is pathologically confirmed by the demonstration of immunohistochemical staining specific for CMV in a resected ureteral section. We draw attention to this very particular presentation of CMV hemorrhagic cystitis with ureteral obstruction in order to emphasize atypical presentation of tissue-invasive CMV disease far beyond the timetable for posttransplant CMV infection.
    No preview · Article · Jan 2012 · Renal Failure
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    ABSTRACT: Renal transplant recipients should be considered at high risk for development of Mycobacterium tuberculosis infection (tuberculosis, TB). TB is relatively more frequent among transplant recipients than general population, depending on its epidemicity in the geographic region. Clinical manifestations in this group of patients may be atypical and deserve aggressive investigations for diagnosis. Tuberculin skin test has several limitations regarding diagnosis in chronic renal failure patients. In this retrospective study, we aimed to explore the prevalence and clinical manifestations of TB in renal transplant patients. We retrospectively analyzed the data for TB prevalence, clinical presentations, and patient and graft survivals of total 320 pediatric and adult renal transplant recipients in our center between 1992 and 2010. The prevalence of TB was 2.8%. Five patients received kidney from living-donor related and four from cadaveric donors. Cadaveric-donor patients received antithymocyte globulin for induction, and four patients received pulse steroid for acute rejection. The median duration of time between transplantation and TB was 21 (1-150) months, and between induction/pulse therapy and infection was 5 (1-100) months. The immunosuppressive protocols included prednisolone and cyclosporine/rapamycin with or without mycophenolate mofetil/azathioprine. The major symptoms were fever (77%), cough (66%), and abdominal pain (22%). Extrapulmonary TB with intestinal (2/9), pericardial (1/9), lymph node (1/9), and cerebral (1/9) involvements developed in five patients. One patient had both pulmonary and testicular involvements. All patients received quartet of anti-TB therapy for a median duration of 9 months. One patient died at the second month of therapy because of dissemination of TB, and one patient returned to hemodialysis because of chronic allograft nephropathy. The prevalence of TB was 2.8% in our renal transplant patients. The quartet of anti-TB treatment including rifampicin resulted in success in a majority of patients.
    No preview · Article · Sep 2011 · Renal Failure
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    ABSTRACT: In this retrospective study, 83 patients were accepted. Mammalian target of rapamycin (mTOR) group consisting of 37 patients were converted from calcineurin inhibitors (CNI), and the control group included 46 patients (initially CNI-receiving patients). As a control-match of each mTOR inhibitor patient, the succeeding patient with transplantation who continued CNI therapy was chosen. All patients received CNI, MMF, and prednisolone as an immunosuppressive therapy initially. In comparison of two groups, there was no significant difference between sex, donor organ source, donor organ ischemia time, or mismatches. However, mean age between groups was significantly different (mTOR group: 48.3 ± 12, CNI group: 38.6 ± 11, p < 0.001). Decision of conversion to mTOR inhibitors in 30 patients was made by biopsy. The reasons for conversion were determined as CNI nephrotoxicity in 15 patients, chronic allograft nephropathy in 15 patients, malignancy in 6 patients, and renal artery stenosis in 1 patient. Basal glomerular filtration rates (GFRs) were markedly lower in mTOR group than in CNI group (38.8 mL/min vs. 72.7 mL/min). At the end of 48-month follow-ups, GFR increased from 38 mL/min to 54 mL/min in mTOR group; however, it decreased to 53 mL/min from 72 mL/min in CNI group. There was no difference left between the two groups in GFR after 4-year follow-up. Hyperlipidemia was higher in mTOR group. Acute rejection rates were similar. Cytomegalovirus (CMV) disease was more prevalent in CNI group. Graft failure developed due to secondary reasons, causing mortality in both groups. We suggest that conversion to mTOR inhibitors maintains and improves graft functions well.
    No preview · Article · Sep 2011 · Renal Failure
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    ABSTRACT: This study evaluates the effect of enteric-coated mycophenolate sodium (EC-MPS) on patient and graft survivals, the incidence of rejection episodes, and graft function among de novo and maintenance renal transplant recipients. This open label, multicenter, prospective, post-marketing observational study of 470 renal transplantation patients at 23 centers in Turkey includes 331 de novo patients whose mean age was 29.6 ± 13.2 years and 139 maintenance patients of 34.0 ± 13.0 years. The latter subjects had EC-MPS substituted for mycophenolate mofetil or added to the immunosuppressive therapy. Patients were followed for 12 months to evaluate graft function and treatment failure. The most common primary disease requiring transplantation was glomerulonephritis (24.3%). De novo and maintenance groups were similar in terms of overall rejection rates and acute rejection incidence whereas chronic rejection was evident only among the latter cohort (P < 0.001). Time to an acute rejection episode was significantly longer among maintenance rather than de novo patients (220.8 versus 18.7 months; P = 0.015). Overall, 12 and 36 month survival rates were 91.6 ± 1.3% and 86.9% ± 0.3% among subjects experiencing acute rejection versus 99.7 ± 0.2% and 50.3% for those displaying chronic rejection. Among maintenance group no deterioration of renal function was observed after conversion from mycophenolate mofetil to EC-MPS. The incidences of leukopenia, new-onset anemia, or liver dysfunction were similar between de novo and maintenance patients. Gastrointestinal discomfort was more prevalent among the maintenance group, reaching a significant level at the fourth visit (P < 0.05). EC-MPS dose reduction was required in only 16.7% of patients at visit, it was more frequent among the de novo group (17.9 versus 13.8%). EC-MPS was an effective adjunctive therapy for de novo as well as maintenance renal transplant recipients in the Turkish population due to a relatively low incidence of dose reductions necessitated by adverse events as well as with an increased likelihood of long-term graft survival.
    Full-text · Article · Apr 2011 · Transplantation Proceedings
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    ABSTRACT: AIM: Renal replacement therapy (RRT) prolongs survival in patients with end-stage-renal-disease (ESRD). We compared patient survival, number and duration of hospitalization in patients treated with RRT in this study. MATERIAL and METHODS: Two hundred and eighty seven patients (87 hemodialysis (HD), 97 peritoneal dialysis (PD), 103 renal transplant (RT) patients) were enrolled in this study. Patients' data were collected retrospectively from hospital records. RESULTS: HD patients were older and had more comorbid diseases compared to PD and RT patients. Mortality rates were not different between the modalitites. The number and duration of hospitalization episodes were significantly lower in the PD group than that of the other two groups. Survival rates of HD patients were 84%, 55% and 30% for the 1 st, 5 th and 10 th years, respectively while these rates were 93%, 81% and 59% for PD and 95%, 81% and 77% for RT patients. CONCLUSION: PD and RT patients were younger than HD patients and had less comorbid diseases. As a result, the number and duration of hospitalization episodes were significantly lower in the PD group when compared to the others. Survival rates in the RT group were better than that of the HD and PD groups.
    Full-text · Article · Jan 2011 · Turkish Nephrology
  • D Yilmaz · M Akin · Y Ay · C Balkan · A Celik · O Ergün · K Kavakli
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    ABSTRACT:   Haemophiliacs and their families consider that circumcision is a very important step to become a member of society and it is a social obligation for men in Turkey. Although bleeding risk is high, almost all haemophiliacs would like to be circumcised in Turkish society. The aim of this study was to evaluate our experience in circumcision of haemophilia patients and define efficacy, safety and complication rates of our protocol, called 'Izmir protocol'. In this study, we retrospectively reviewed medical records of 50 patients with haemophilia who underwent circumcision at our hospital according to Izmir protocol between 1996 and 2009. Oral tranexamic acid and fibrin glue were used in all children. One hour before the operation, first dose of factor concentrate was given. After reaching a plasma factor level of around 90-100%, the prepuce was incised circumferentially and excised using Gomco clamp or open technique under general anaesthesia. Intermittent injections of factor concentrate were given every 12 for 48 h. While the first two doses were given at higher amount to achieve or continue plasma factor level at 90-100%, in the last three doses, the aim was to maintain the plasma factor level at 50-60%. Forty-eight hours after the circumcision, patients were discharged. Three patients (6%) showed bleeding complication and all were resolved easily. All had at least one excuse from the protocol (Lower doses of factor concentrates was used in 2, tranexamic acid was not used in 2). Izmir protocol is safe, cheap and easy to carry out.
    No preview · Article · Nov 2010 · Haemophilia
  • S Tiryaki · O Ergun · A Celik · I Ulman · A Avanoglu
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    ABSTRACT: Fecal incontinence (FI) is a devastating problem for children. The failure of optimal medical treatment may require further interventions such as appendicocutaneostomy. We report on a patients' perspective of the success of a Malone procedure for FI. The records of 32 patients who had undergone ACE procedure in the past 9 years were reviewed. Patients and families were contacted, and telephone inquiries were conducted to assess the overall success of the operation. The questionnaire covered the concerns of patients/families about the stoma, functional results and changes in the patients' quality of life (QOL). The indications for ACE stomas were meningomyelocele in 17 patients, anorectal malformation in 8, Hirschsprung/NID in 3, spinal tumor in 3 and traumatic spinal injury in one. 7 laparoscopic and 25 conventional operations were performed. The vermiform appendix was used in 27 of the patients and a cecal flap was used in 5. The most frequent complication was stenosis of the stoma orifice observed in 14 patients. 8 patients responded to dilatations while 6 patients required minor surgical revision. There were 2 perforations during catheterization, and they required surgical repair of the conduit. 5 patients had mild leakage from the stoma; all 5 were open ACE procedures, and required revision. 25 patients could be reached by phone. 5 of these children stopped using the stoma due to previous perforation in 2 patients and stricture in 1. The remaining 2 stopped using their stomas because "they did not like the idea of it". 16 patients are completely clean. 3 patients have occasional soiling. Only one patient was not satisfied with using the ACE stoma and stated that it did not sufficiently improve her condition. 8 patients complained about the duration of the enema (longer than 1 h); however, 5 of them refuse to use the stoma every day. All patients but one perceived a significant improvement in their QOL. Mean QOL scores before and after the procedure were 5.8 (2-9) and 11.5 (5-14), respectively. ACE stomas provide a satisfactory improvement in patients' quality of life. Stoma-related complications are not uncommon. The most common problems are strictures, followed by stoma leakage.
    No preview · Article · Oct 2010 · European Journal of Pediatric Surgery
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    ABSTRACT: Renal expression of matrix metalloproteinases (MMP) and tissue inhibitors of MMP (TIMP) contribute to the development of tubulointerstitial fibrosis characteristic of progressive forms of primary glomerulonephritis (GN). The aim of this study was to investigate the therapeutic effect of MMP inhibitor, doxycycline, administration in an experimental rat model of immune-complex nephritis (ICN). Methods: The induction of immune-complex glomerulonephritis was carried out by the administration of an i.v. dose of 2 mg bovine serum albumin (BSA) daily for 28 days after 8 weeks of s.c. immunization with 1 mg of BSA in complete Freund's adjuvant. Doxycycline (30 mg/kg) was given daily (in groups 2 and 4) by gavage for 28 days. Animals treated with doxycycline showed significant reduction in glomerular area and cell proliferation than non-treated controls. Glomerular deposition of immunoglobulin (Ig)G and C3 was less intense in treated rats than non-treated controls. Although not statistically significant, interstitial inflammation was less intense in treated rats than non-treated controls. Glomerular expression of MMP-9 by immunoflourescence was significantly inhibited in the treated group. In addition pro-MMP-2 on gelatin zymography was importantly suppressed by doxycycline in ICN. Doxycycline, in addition to its antibiotic property, may, following further investigation, provide a possible survival benefit in proliferative glomerulonephritis.
    No preview · Article · Aug 2010 · Nephrology
  • O Ergun · R Tatlisu · M Pehlivan · A Celik
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    ABSTRACT: This study reports on the preliminary results of external neuromyogenic electrostimulation (ENS) for the treatment of anorectal continence problems. A total of seventeen patients with anorectal malformations (n=11), Hirschsprung's disease (n=5) or pelvi-perineal trauma (n=1) were included in the study. All patients were evaluated using clinical, radiological, and manometric methods prior to ENS. The Holschneider Continence Scale and the Quality of Life (QOL) Score were used for clinical assessment. The ENS stimulator is a two-channel ambulatory device providing a pulse current. ENS was performed by parents in a home setting twice daily for 6 weeks using skin electrodes attached to the sides of the anus. Three of the 11 preset programs were used (lack of sensitivity, pelvic floor work out and building up endurance). Clinical and manometric variables were reevaluated following completion of the 6-week program. Mean age was 9.7 years (range 5-22 years). The Holschneider Continence Score increased from a mean value of 5.3+/-3.2 to 12.4+/-1.7 (p=0.002) and mean QOL scores increased from 5.6+/-2.3 to 11.6+/-1.8 (p=0.01) following ENS. Mean anal canal resting pressures prior to ENS were 20.3+/-6 cmH (2)O and increased to 28.7+/-14.1 cmH (2)O after 6 weeks (p>0.05). Maximum voluntary squeeze pressures before and after ENS were 56.1+/-16.7 cmH (2)O and 100.7+/-16.9 cmH (2)O respectively (p=0.001). Preliminary results for ENS have shown that patients achieved higher maximum voluntary squeeze pressures, and showed a marked improvement in their continence and QOL scores. Given the advantage of ambulatory use in a home setting, the ENS seems promising in terms of achieving improved anorectal continence in selected patients.
    No preview · Article · Jul 2010 · European Journal of Pediatric Surgery
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    ABSTRACT: The prevalence of thyroid cancer in renal transplant population has not been widely studied, and there is no consensus on the management of thyroid cancer in transplant patients. The aim of this study was to evaluate changes in thyroid hormone levels and investigate the incidence of the thyroid cancer after renal transplantation. From October 1989 to April 2007, 122 renal allograft recipients that were being followed underwent thyroid ultrasonography to determine nodules together with thyroid hormone levels. Ultrasound-guided fine-needle aspiration biopsy (FNAB) was performed to the nodules > 10 mm or those with 8-10 mm diameter but with calcifications. One hundred and eight patients (88.5%) had normal thyroid function. None of the patients had overt hypothyroidism, 2 had subclinical hypothyroidism, 10 subclinical thyrotoxicosis, and 2 low T3 syndrome. Mean thyroid volume was 14.2 +/- 7.2 ml. In all, 91.8% was diagnosed with goiter (n = 112). Seventy-two thyroid nodules were detected in 49 kidney allograft recipients (single nodule in 30, multiple in 19 patients). Eighty-four biopsy samples were reported as benign (n = 21, 87.5%), 8 as suspicious (n = 2, 8.3%), and 4 as inadequate (n = 1, 4.1%). After surgery, one of the patients (0.8%) with suspicious FNAB was reported as papillary thyroid carcinoma. Because of the high incidence of thyroid dysfunction in transplant patients, screening of thyroid function should be a part of follow-up. Our results suggest that although frequency of nodules is increased in kidney transplant patients, prevalence of thyroid cancer is slightly, but not significantly, higher than that of the normal population.
    No preview · Article · Mar 2010 · Renal Failure
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    ABSTRACT: The aim of this study is to assess the influence of darbepoetin on the development of peritoneal fibrosis in rats induced by chlorhexidine gluconate (0.1%) and ethanol (15%) and to determine the effect on peritoneal tissue levels of MMP-2 and TIMP-2, possible important factors in progression of peritoneal fibrosis. Twenty-four female Wistar albino rats were divided into three groups. The first group (CH group) received 3 ml/200g daily intraperitoneal injections of chlorhexidine gluconate (0.1%) and ethanol (15%) dissolved in saline to induce chemical peritonitis; group 2 (ESA group) received 3 ml/200g daily injections of chlorhexidine gluconate (0.1%) and ethanol (15%) dissolved in saline and also darbepoetin 12.5 microgr/ per kilogram/ day subcutaneously on the first and seventh days; group 3 (Control group) received intraperitoneal 0.9% saline (3 ml/200g/d) through the right lower quadrant by 21 gauge needle. The study duration was fourteen days. On the fifteenth day rats were sacrificed, parietal peritoneum samples were obtained from the left anterior abdominal wall. Pathological samples were examined using Hematoxyline & Eosin (HE) stains. The thickness, vasculpathy, and inflammation were determined by light microscopy. MMP-2 and TIMP-2 were studied immunohistochemically by monoclonal antibody staining. The activity of MMP-2 on peritoneal tissue was studied by gelatin zymography and TIMP-2 protein level was analysed by ELISA, biochemically. The decrease in thickness of parietal peritoneum in group ESA was statistically significant when compared to CH group (p<0.05). Inflammation scores, and vascularization score surfaces were not statistically different between these groups (p>0.05). Immunohistochemically, darbepoetin was shown to decrease MMP-2 expression on parietal peritoneum in CH group (p<0.05), but had no effect on TIMP-2 (p>0.05). Biochemically the ratio of active MMP-2 to proMMP-2 was more significantly increased in the ESA group than in the CH group (p<0.001), however, TIMP- 2 levels in both groups were decreased compared to the control group (p<0.05). Darbepoetin histopathologically reduced peritoneal fibrosis induced by chlorhexidine gluconate. We can suggest that Darbepoetin does not cause peritoneal fibrosis and may prevent peritoneal fibrosis in rats possibly related to an effect on MMP-2 expression. Further research regarding the utility and dosage should be considered.
    No preview · Article · May 2009 · European Journal of Inflammation
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    ABSTRACT: Objective: We aimed to evaluate sexual functions and the factors that affect changes in sexual functions in male patients undergoing renal transplantation due to endstage renal disease. Materials and methods: The study included 46 male patients (mean age 43.0±8.5 years) who were followedup after renal transplantation. Data on demographic characteristics, clinical examination, renal transplantation, and sexual functions were collected. Erectile functions were assessed using the International Index of Erectile Function questionnaire (IIEF). Changes in libido and erection quality after transplantation were also questioned. Results: The mean duration of hemodialysis before transplantation was 16.7±2.9 months and the mean time elapsed after transplantation was 58.3±9.6 months. Twenty-eight patients (60.9%) underwent living-related donor transplantation. Self-reported rates of erectile dysfunction (ED) and premature ejaculation were 34.8% and 54.4%, respectively. The mean IIEF score was 24.4±5.8. The IIEF score showed ED in 47.8% of the patients. Duration of hemodialysis differed significantly between patients with and without ED (19.9±5.5 months vs. 13.8±2.6 months; p<0.05). The frequency of ED did not differ significantly between recipients from living donors and cadaveric donors (42.9% vs. 55.6%; p>0.05). After transplantation, 8.7% of patients reported decreased libido and 17.4% reported increased libido. The corresponding figures for erection quality were 13.0% and 26.1%. While the mean ages of patients reporting changes in libido did not differ significantly, those reporting improved erection quality were significantly younger (p<0.05). Conclusion: Sexual functions show improvement after renal transplantation. Prolonged duration of hemodialysis before transplantation is associated with increased risk for ED.
    Full-text · Article · Mar 2009 · Turk Uroloji Dergisi
  • B Akinci · A Celik · F Saygili · S Yesil
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    ABSTRACT: Gitelman's syndrome is an autosomal recessive disorder caused by various mutations of the thiazide- sensitive sodium chloride cotransporter gene. Hypokalaemia, metabolic alkalosis, hypomagnesemia, and hypocalciuria are major clinical features of the syndrome. The onset of the disease is in early adulthood with a mild muscle weakness complaint or incidentally diagnosed hypokalaemia by blood test. However, it has a significant impact on quality of life of patients. Rarely, patients with Gitelman's syndrome may present with hypokalaemic paralysis. Profound hypokalaemia is uncommon in Gitelman's syndrome. Here we report a case of Gitelman's syndrome, who presented with hypokalaemic paralysis and extreme hypokalaemia. To the best of our knowledge, after a Medline search, this is the most severe hypokalaemia described in a patient with Gitelman's syndrome.
    No preview · Article · Feb 2009 · Experimental and Clinical Endocrinology & Diabetes
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    ABSTRACT: Takayasu arteritis is a chronic inflammatory disease that affects mainly the aorta, main branches of aorta, and pulmonary arteries with unknown etiology. Disease affecting solely the renal arteries is rare. We will present a case that had hypertension, hypokalemia, and metabolic alkalosis where the etiology was type 2 Takayasu arteritis, affecting renal arteries.
    Full-text · Article · Feb 2009 · Renal Failure
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    ABSTRACT: Erdheim–Chester disease (ECD) is a rare, non-Langerhans cell histiocytic disorder of unknown cause characterized by heterogeneous systemic manifestations. The histiocytic infiltration can affect bones, orbits, heart, kidneys, lungs, mediastinum, liver, spleen and central nervous system. Corticosteroids are the first-line treatment. The 3-year survival rate for patients with ECD is approximately 50%. We report the case of a 31 year old male ECD patient that have pulmonary fibrosis, bone involvement and diabetes insipidus. He was treated with systemic and inhaled corticosteroids and has remained stable for 53 months after this rare type of treatment.
    Full-text · Article · Dec 2008 · Respiratory Medicine CME

  • No preview · Article · Jul 2008 · Transplantation

Publication Stats

430 Citations
102.68 Total Impact Points

Institutions

  • 1995-2013
    • Dokuz Eylul University
      • • Department of Internal Medicine
      • • Faculty of Medicine
      • • Biyokimya
      Ismir, İzmir, Turkey
  • 1996-2010
    • Ege University
      • • Department of Pediatric Surgery
      • • Department of Urology
      Ismir, İzmir, Turkey