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Öğe Alloimmune Hemolytic-Anemia After Renal-Transplantation(Oxford Univ Press United Kingdom, 1995) Ok, E; Akcicek, F; Coker, A; Tombuloglu, M; Toz, H; Tokat, Y; Cirit, M; Tobu, M; Onder, G; Basci, AÖğe Basiliximab significantly reduces acute rejection in renal transplant patients given triple therapy with azathioprine(Elsevier Science Inc, 2001) Ponticelli, C; Yussim, A; Cambi, V; Legendre, C; Rizzo, G; Salvadori, M; Kahn, D; Kashi, SH; Salmela, K; Fricke, L; Garcia-Martinez, J; Lechler, R; Heemann, U; Monteon, F; Ortuno, J; Amenabar, JJ; Arias, M; Nicholson, ML; Sperschneider, H; Abendroth, D; Gracida, C; Lao, M; Sever, MS; Lameire, N; Sanchez-Fructuoso, A; Basci, A; Segoloni, G; Connolly, J; Altieri, P; Akoh, J; Prestele, H; Girault, DÖğe Blood pressure control achieved by strict salt restriction and ultrafiltration is associated with better patient survival in peritoneal dialysis: 11 years experience(Oxford Univ Press, 2005) Asci, G; Ozkahya, M; Duman, S; Ok, E; Basci, AÖğe Blood transfusion in the erythropoietin ERA: Is it still an issue?(Oxford Univ Press, 2005) Ponce, P; Basci, A; Cesare, S; Di Benedetto, A; Marcelli, D; Richards, NÖğe Blood transfusions during haemodialysis: Evaluation on the level of aderence to guideline recommendations(Oxford Univ Press, 2005) Richards, N; Basci, A; Cesare, S; Di Benedetto, A; Marcelli, D; Ponce, PÖğe By reducing TGF beta 1, octreotide lessens the peritoneal derangements induced by a high glucose solution(Wichtig Editore, 2001) Gunal, AI; Duman, S; Sen, S; Unsal, A; Terzioglu, E; Akcicek, F; Basci, ABackground. Chronic peritoneal dialysis may eventually result in peritoneal fibrosis, which progressively reduces dialytic efficacy. Although the pathogenesis has not been elucidated, it has been proposed that transforming growth factor beta-1 (TGF beta1) plays a central role in the onset of peritoneal fibrosis. Methods. Rats were divided into three groups and given saline, hypertonic peritoneal dialysis solution alone, a hypertonic peritoneal dialysis solution plus octreotide intraperitoneally. After four weeks, a one-hour peritoneal equilibration test was done. Dialysate-to-plasma urea ratio, glucose reabsorption, ultrafiltration volume and levels of dialysate protein, TGF beta1 and cancer antigen 125 (CA 125) were determined. The peritoneal membrane was examined histologically by light microscopy. Results. Compared to the saline group, peritoneal function tests (ultrafiltration volume 6 (5-7) vs 0.0 ml, dialysate-to-plasma urea ratio 0.51 vs 0.76, glucose reabsorption 0.54 vs 0.40 and morphology (thickness 4.5 vs 75.5 mum) were dramatically deranged in hypertonic peritoneal dialysis solution-treated rats, which also had a higher level of TGF beta1 and undetectable CA 125. In contrast, in hypertonic peritoneal dialysis solution plus octreotide rats' peritoneal function was protected (ultrafiltration volume 3 mL, dialysate-to-plasma urea 0.60, glucose reabsorption 0.51) but peritoneal thickening (37.7 mum) was not so markedly reduced although the production of TGF beta1 was significantly inhibited. Conclusion. These data show that by inhibiting the production of TGF beta1, octreotide can preserve peritoneal function and remodeling of the mesothelial cell. Although the production of TGF beta1 was significantly inhibited, peritoneal thickening cannot be completely prevented.Öğe Citric-Acid In Calcium Effervescent Tablets May Favor Aluminum Intoxication(Karger, 1991) Mees, Ejd; Basci, AÖğe Clinicopathological features of hepatitis C virus infection in dialysis and renal transplantation(Wichtig Editore, 2002) Toz, H; Ok, E; Yilmaz, F; Akarca, US; Erensoy, S; Zeytinoglu, A; Ozkahya, M; Karasu, Z; Yuce, G; Basci, ABackground: Liver biopsy (LB) gives an accurate picture of the severity of hepatitis C virus (HCV) infection in end-stage renal disease. The aim of this study was to find out whether clinical and histopathological course of HCV infection in renal transplant (RT) patients (pts) is different from dialysis (Dx) pts. Methods: Forty Dx and 46 RT pts underwent LB. Clinical and biochemical data were retrospectively collected from medical charts. ALT level above the upper limit was described as elevated. LB was done regardless of the ALT level. LB specimens were examined using a semiquantitative scoring system locally modified from Scheuer. Histological activity (grade) and fibrosis (stage) were scored separately. Results: ALT was elevated in 65% of Dx pts. At the time of LB 30% of Dx pts had elevated ALT and 95% were viremic. Normal/minimal inflammation was detected in 25% of LBs, chronic hepatitis in 72.5%, cirrhosis in 2.5%. Stage and grade were respectively 1.08 +/- 1.02 and 4.30 +/- 2.98. Normal/minimal inflammation was detected in 9% of the 46 RT pts, chronic hepatitis in 84%, cirrhosis in 7%. Stage and grade were respectively 1.74 +/- 1.1 and 5.39 +/- 2.21. Although there was no significant difference in the histological grade between Dx and RT pts, histological stage was significantly higher in RT pts than Dx. The frequency of cirrhosis, hepatitis and normal inflammation was similar in the two groups. Conclusion: Histopathological liver injury due to HCV infection seems to be more severe in RT than Dx pts but this does not seem to be clear at the clinical and biochemical level. Sequential histopathological assessment and longer follow-up will be required to clarify this issue.Öğe Clinicopathological features of rapidly progressive hepatitis C virus infection in HCV antibody negative renal transplant recipients(Oxford Univ Press, 1998) Ok, E; Unsal, A; Celik, A; Zeytinoglu, A; Ersoz, G; Tokat, Y; Erensoy, S; Akarca, US; Basci, A; Yuce, GBackground. Hepatitis C virus (HCV) infection acquired during dialysis treatment generally shows a relatively benign course after renal transplantation (RTx). However, less is known about the course of HCV infection acquired during or after RTx. Methods. Clinical and histopathological assessment of 15 renal transplant recipients who acquired HCV infection during or after RTx. Results. Alanine aminotransferase levels rose for the first time 1-19 weeks after RTx. HCV RNA was found positive in all patients, but anti-HCV became positive in only nine of them. During a mean follow-up of 21 +/- 12 months, jaundice appeared in 12 patients while ascites and/or hepatic encephalopathy occurred in six. Azathioprine was stopped in all patients. Cyclosporin was also stopped in four patients and in two of them prednisolone was also interrupted for a period of 3-7 weeks. Following this, ascites, hepatic encephalopathy and biochemical disturbances improved, while no deterioration was seen in graft function. Nine of the 15 patients had undergone two consecutive liver biopsies (LB). The first LB revealed cirrhosis in three and chronic hepatitis in six patients; the second LB showed cirrhosis in seven patients. The histological activity index (Knodell's score) progressed from 11.8 +/- 3.5 to 13.8 +/- 3.8. Conclusions. The results suggest that HCV infection acquired during or after RTx may run an unusual and rapidly progressive clinical and histopathological course at least in some of these patients. Decrease or withdrawal of immunosuppressive drugs may improve early hepatic failure without detrimental effect on graft function during that period.Öğe Comparison of the Effects of Enalapril and Theophylline on Polycythemia After Renal-Transplantation(Williams & Wilkins, 1995) Ok, E; Akcicek, F; Toz, H; Kursat, S; Tobu, M; Basci, A; Mees, EjdPosttransplant erythrocytosis (PTE) is a potentially serious complication for which (apart from phlebotomy) two alternative treatments have been proposed: theophylline (Theo) and angiotensin-converting enzyme inhibitors. We investigated 28 patients with PTE, who were assigned to 3 matched groups. Group 1 (10 patients) received 10 mg of Enalapril (Ena)/day. After 2 months, mean hematocrit (Ht) had dropped from 0.57 (range 0.52-0.62) to 0.45 (0.34-0.49), Ena was stopped and, after a period of 3.8+/-0.3 months, Ht had risen again to baseline values (0.56, range 0.52-0.61) in 8 of them, These 8 patients were then given 5 mg/day Ena. Ht decreased more slowly, and after 3 months reached a mean of 0.49 (0.44-0.54). Group 2 (9 patients) received 600 mg/day Thee in 2 doses. After 2 months, Ht had decreased from 0.56 (0.52-0.61) to 0.52 (0.46-0.63), but in 5 patients, Ht remained above 0.51. After I month discontinuation of treatment, PTE persisted in 7 patients. These patients were given 10 mg/day Ena, whereupon Ht decreased from 0.55 (0.52-0.64) to 0.46 (0.40-0.53) after 2 months and to 0.41 (0.33-0.47) after 3 months. Group 3 did not receive medical treatment, After 3 months, PTE persisted in 8 out of the 9 patients and remained unchanged during the following 3 months. Mean values for Ht were: baseline, 0.55 (0.52-0.58); after 3 months, 0.56 (0.53-0.59); and after 6 months, 0.55 (0.52-0.60). We conclude that Ena is superior to Theo in the treatment of PTE, There were no resistant patients, but individual sensitivity differs, Its effect is dose dependent, reversible, and reproducible, Excessive Ht decrease may occur; thus, doses should be titrated individually.Öğe Cryptosporidiosis and blastocystosis in renal transplant recipients(Karger, 1997) Ok, UZ; Cirit, M; Uner, A; Ok, E; Akcicek, F; Basci, A; Ozcel, MASome intestinal parasitic infections are frequently seen in renal transplant recipients. Parasites such as Cryptosporidium spp. and Blastocystis hominis are often asymptomatic or responsible for limited infections in normals, but may cause prolonged and heavy infections with gastrointestinal complaints, mainly diarrhea, in immunocompromised patients. Such infections can often not be detected by routine diagnostic procedures, but special concentration and staining methods are needed. We investigated 115 fecal specimens from 69 renal transplant recipients and 42 fecal specimens from 42 control cases. Of the 69 recipients, 27 (39.1%) had B. hominis and 13 (18.8%) had Cryptosporidium spp. in at least one fecal specimen. Prevalence of symptomatic Cryptosporidium infections was significantly higher in the renal transplant recipients, when compared with the control group (p < 0.05). Special parasitological procedures must be performed in immunocompromised patients with chronic gastrointestinal complaints. Disappearance of symptoms after antiparasitic drugs in some of 16 symptomatic patients are described, suggesting that these infections are more pathogenic in transplant recipients.Öğe Diuretic Effect of Frusemide In Patients With Nephrotic Syndrome - Is It Potentiated By Intravenous Albumin(British Med Journal Publ Group, 1995) Akcicek, F; Yalniz, T; Basci, A; Ok, E; Mees, EjdÖğe Diuretic Effects of Intravenous Furosemide (F), Albumin (A) and the Combination (F+A) In Massive Edema Due To Nephrotic Syndrome (Ns)(Blackwell Science Publ Inc Cambridge, 1995) Acicek, F; Basci, A; Ozbasli, C; Yalniz, Mt; Coker, C; Zirek, O; Tanyilmaz, A; Mees, EjdÖğe Effect of elevated calcium levels on segmental tubular sodium reabsorption in normal man(Karger, 1996) Yalniz, MT; Ozbasli, CF; Akcicek, F; Basci, A; Yelden, K; Coker, I; Mees, EJDThe aim of the present study was to assess the effect of calcium infusion on segmental tubular reabsorption in humans using lithium clearance, along with creatinine and free water clearances during maximal water diuresis. In 8 healthy volunteers, a 20-min 5 mg/kg calcium infusion that increased serum calcium levels from 2.27 +/- 0.07 to 2.87 +/- 0.07 mmol/l (p < 0.01) was followed by a 60-min 3 mg/kg infusion for maintenance. During the experimental period, blood pressure did not change. Maximal urine flow increased from 15.6 +/- 2.4 to 20.8 +/- 2.8 ml/min (p < 0.01), while clearance of sodium increased from 1.5 +/- 0.4 to 3.7 +/- 0.9 ml/min (p < 0.001). Lithium clearance showed an increase of 7.4 ml/min, pointing to a suppression of proximal reabsorption. Free water clearance also increased from 11.5 +/- 3.7 to 14.4 +/- 3.9 ml/min, indicating an increase in TALH reabsorption which was attributed to increased sodium and water reaching this segment. Time control studies showed no significant changes in the parameters measured except for potassium excretion. Potassium excretion during calcium infusion was somewhat lower than during the control studies. The data support the view that an increase in serum calcium concentration leads to a decrease in proximal tubular reabsorption as indicated by lithium clearance while a decrease in reabsorption in the collecting duct could well add to the diuretic properties of calcium.Öğe Effect of recombinant human erythropoietin treatment on echocardiographic parameters of chronic haemodialysis patients(W B Saunders Co Ltd, 2001) Sagcan, A; Onen, F; Terzioglu, E; Basci, AÖğe Effectiveness of pulse cyclophosphamide plus oral steroid therapy in idiopathic membranoproliferative glomerulonephritis(Oxford Univ Press, 1997) Toz, H; Ok, E; Unsal, A; Asci, G; Basdemir, G; Basci, AÖğe The efficiency of fractionated parenteral iron treatment in CAPD patients(Peritoneal Dialysis Publications, 1997) Akcicek, F; Ozkahya, M; Cirit, M; Ok, E; Unsal, A; Toz, H; Celik, A; Atabay, G; Basci, A; Khanna, RSome chronic renal failure patients respond poorly to recombinant human erythropoietin (rHuEPO). In continuous ambulatory peritoneal dialysis (CAPD) patients, such a poor response may indicate inadequate dialysis or low body iron stores. To correct iron deficiency, once-a-week intravenous iron supplementation is recommended. However, hemodialysis patients receive iron supplements three times a week. This study was designed to compare the efficacy of iron supplementation between once-weekly and twice-weekly regimens. In both groups, rHuEPO doses were similar. Seventeen CAPD patients were studied. All had hemoglobin levels less than 10 g/dL. Ten patients were given 50 mg intravenous iron twice weekly until a total iron dose of 600 mg was achieved (stage I). The patients were crossed over to receive another 600 mg iron (stage II). Hematocrit increased significantly in patients receiving twice-a-week iron supplementation (+3.8% and 6%) commentation (+1.3% and 1.4%) during stages I and II. The ferritin levels were not different between the groups. In conclusion, rHuEPO is more effective when administered with intravenous iron.Öğe Enalapril Treatment In Posttransplant Erythrocytosis (Pe)(Blackwell Science Publ Inc Cambridge, 1995) Ok, E; Akcicek, F; Coker, A; Karaca, E; Basak, K; Akalin, E; Basci, A; Yararbas, OÖğe Excellent control of blood pressure ambulatory measured for 48-hours in hemodialysis patients(Oxford Univ Press, 2005) Toz, H; Ozkahya, M; Asci, G; Duman, S; Ok, E; Basci, AÖğe Feasibility of the implementation of the EBPG guideline on dialysis adequacy in the largest private dialysis network in Turkey(Oxford Univ Press, 2005) Basci, A; Sever, MS; Tombul, Z; Kirchgessner, J; Marcelli, D