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Öğe Angiographic findings and endovascular interventional procedures in 41 patients with Takayasu's arteritis(B M J Publishing Group, 2004) Aksu, K; Keser, G; Memis, A; Inal, V; Parildar, M; Doganavsargil, EÖğe Angiographic findings and endovascular interventional procedures in 41 patients with Takayasu's arteritis(B M J Publishing Group, 2004) Aksu, K; Keser, G; Memis, A; Inal, V; Parildar, M; Doganavsargil, EÖğe Anticardiolipin antibodies in acute rheumatic fever and chronic rheumatic heart disease: Is there a significant association?(Clinical & Exper Rheumatology, 1996) Narin, N; Kutukculer, N; Narin, F; Keser, G; Doganavsargil, EObjective. The incidence and significance of IgG and IgM anticardiolipin in antibodies (aCLa) in patients with acute rheumatic fever (ARF), chronic rheumatic heart disease (CRHD) and streptococcal pharyngitis have been investigated in order to determine whether these antibodies play an important role in the pathogenesis and if they are markers that can be used to confirm disease activity. Methods. An enzyme-linked immunosorbent assay was used to measure the IgG and IgM aCLa levels. aCLa levels of patients were considered positive if they were gr-eater than 3.0 standard deviations above the mean for healthy children. Results. No significant difference in aCLa levels was found between patients with rheumatic fever or streptococcal pharyngitis and healthy controls, and aCLa concentrations did not correlate with the acute phase reactant levels. Conclusions. aCLa in patients with ARF and CRHD do not appear to be markers of disease activity, and our data suggest that aCLa do not play nit important role in the pathogenesis of rheumatic fever.Öğe A case of Behcet's disease with pulmonary arterial aneurysm and secondary amyloidosis(Oxford Univ Press, 2002) Aksu, K; Kocanaogullari, H; Keser, G; Inal, V; Kabasakal, Y; Oksel, F; Gumusdis, G; Doganavsargil, EÖğe Endothelial functions in Behcet's disease(Springer Heidelberg, 2006) Kayikcioglu, M; Aksu, K; Hasdemir, C; Keser, G; Turgan, N; Kultursay, H; Doganavsargil, EBehcet's disease (BD) is a systemic vasculitis, capable of involving all types of vessels. Endothelial dysfunction (ED) has been previously documented in BD. The aim of the study was to see whether ED was more prominent in Behcet's patients with vascular involvement (VI) than in those without. The study population consisted of 65 patients with BD, 27 of whom had VI, and 30 healthy controls. High-resolution ultrasound was used to measure endothelium-dependent vasodilatation (EDVD) of brachial artery. Overall, regardless of VI, EDVD was significantly impaired in patients with BD compared with controls (11.4 +/- 6.3 vs 20.4 +/- 9.1%,P=0.001); however, EDVD was similar in BD patients with and without VI (9.7 +/- 6.3% vs 12.6 +/- 6.1%, P=0.07). Patients with BD had significantly-higher plasma homocysteine levels than controls (13 +/- 6 mu mol/L vs 9 +/- 3 mu mol/L, P=0.001). Plasma homocysteine levels were significantly higher in the subgroup with VI than in those without (15 +/- 7 mu mol/L vs 12 +/- 4 mu mol/L, P=0.03); however, we found no positive/significant correlation between plasma homocysteine levels and EDVD. ED is a constant feature of BD, regardless of VI. Etiology of ED in BD is probably multifactorial, including high homocysteine levels. As both ED and elevated homocysteine levels may represent an early atherosclerotic process, a more structured approach to risk factor assessment is needed in BD.Öğe Erectile dysfunction in Behcet's disease without neurological involvement: two case reports(Oxford Univ Press, 2000) Aksu, K; Keser, G; Gunaydin, G; Ozbek, SS; Colakoglu, Z; Gumusdis, G; Doganavsargil, EÖğe Focal myositis(Springer Verlag, 1998) Kocanaogullari, H; Ozdemir, E; Keser, G; Tuncbay, T; Gumusdis, G; Doganavsargil, EÖğe Hyperhomocysteinaemia in Behcet's disease(Oxford Univ Press, 2001) Aksu, K; Turgan, N; Oksel, F; Keser, G; Ozmen, D; Kitapcioglu, G; Gumusdis, G; Bayindir, O; Doganavsargil, EObjective. Arterial and venous thrombosis are among the clinical features of Behcet's disease (BD), the pathogenesis of which is not completely understood. In this study, we investigated whether hyperhomocysteinaemia, being a well known risk factor for thrombosis, is also a contributive risk factor for the arterial and venous thrombosis of ED. Method's. Eighty-four patients fulfilling the criteria of the International Study Group for Behcet's Disease (54 males, 30 females, mean age 36 +/- 9 yr) were enrolled. All the patients were carefully screened for a history of venous thrombosis and were separated into two groups with respect to thrombosis history. Thirty-six healthy individuals (23 males, 13 females), matched for age and sex with the ED group, were included as a negative control group. Patients were excluded if they had any condition that might affect plasma homocysteine concentration. As methotrexate (MTX) causes hyperhomocysteinaemia, we also included 29 rheumatoid arthritis patients (five males, 24 females) receiving MTX weekly. Fasting plasma homocysteine concentrations were measured by high-performance liquid chromatography. The data were analysed with the chi (2) test and Student's T-test. Results. The highest homocysteine concentrations were found in the MTX group (17.5 +/- 5.3 mu mol/l). Mean plasma homocysteine concentrations in ED patients were significantly higher than in the healthy controls (11.5 +/- 5.3 vs 8.8 +/- 3.1 mu mol/l, P < 0.001). Among ED patients with a history of thrombosis, 20 of 31 (64%) had hyperhomocysteinaemia, and this was significantly higher than in those without thrombosis (9%). On the other hand, there was no significant difference between patients with non-thrombotic ED and healthy controls (P > 0.05). In patients with thrombosis, we found no correlation between the duration of the postthrombotic period and homocysteine concentration. Among all the variables investigated, only hyperhomocysteinaemia was found to be related to thrombosis. Conclusion. Hyperhomocysteinaemia may be assumed to be an independent risk factor for venous thrombosis in ED. Unlike the factor V Leiden mutation, hyperhomocysteinaemia is a correctable risk factor. This finding might lead to new avenues in the prophylaxis of thrombosis in ED.Öğe Hypothalamus-hypophysis-thyroid axis, triidothyronine and antithyroid antibodies in patients with primary and secondary Sjogren's syndrome(Springer-Verlag, 2001) Ozgen, AG; Keser, G; Erdem, N; Aksu, K; Gumusdis, G; Kabalak, T; Doganavsargil, EIt has been well established that, antithyroglobulin antibodies (ATG) and anti-microsomal antibodies (AMC) may be present in various thyroid disorders and other systemic autoimmune diseases, including Sjogren's syndrome (SS). However, presence of circulating autoantibodies to thyroid hormones, i.e. both to triiodothyronine (T3) and tetraiodothyronine (T4), has not been studied extensively in SS. Autoantibodies to T3 and T4 are very important, because serum T3 and T4 levels may be detected spuriously higher or lower, due to the presence of these autoantibodies. Their presence should be suspected when measured serum thyroid hormone levels are not consistent with clinical status of the patient. SS is a slowly progressive, inflammatory autoimmune disease, affecting primarily the exocrine glands. Thyroid gland, being a target in some autoimmune diseases, is well known to be affected in SS as well. Keeping this possibility in mind, we investigated T3 autoantibody levels and thyroid gland involvement in patients with SS. Twenty-six SS patients (F/M:22/4) with a mean age of 46,6 years, were recruited in this study. Twelve of them we-re accepted as primary SS (pSS), while others had secondary SS (sSS) (7 with rheumatoid arthritis (RA), 3 with systemic lupus erythematosus (SLE), 3 with progressive systemic sclerosis (PSS) and 1 with sarcoidosis). Thyroid function tests, including T3, T4, fT3, fT4, TSH, ATG, AMC, T3 antibody measurements, thyroid scintigraphy, thyroid ultrasonography and TRH stimulation tests were performed in all patients. We compared our results with those of the twenty healthy normal controls. Serum ATG and/or AMC were detected in three patients with pSS (25%) and no patients with sSS. No significant difference could be shown in the other parameters, including T3 autoantibodies and thyroid function tests. TRH stimulation test was also normal, showing that the hypothalamus-hypophysis-thyroid axis was not affected in patients both with pSS and sSS. In conclusion, we found that T3 autoantibody levels in pSS, were not significantly higher than sSS and normal controls.Öğe In Sjogren's syndrome gastroesophageal reflux disease is not related with disturbances on gastric myoelectrical activity(B M J Publishing Group, 2003) Turk, T; Celebi, A; Bor, S; Keser, G; Kabasakal, Y; Doganavsargil, EÖğe In Sjogren's syndrome gastroesophageal reflux disease is not related with disturbances on gastric myoelectrical activity(B M J Publishing Group, 2003) Turk, T; Celebi, A; Bor, S; Keser, G; Kabasakal, Y; Doganavsargil, EÖğe Increased excretions of glycosaminoglycans and heparan sulfate in lupus nephritis and rheumatoid arthritis(Springer-Verlag, 2003) Bicer, I; Aksu, K; Parildar, Z; Tanyalcin, T; Doganavsargil, E; Kutay, FZUrinary glycosaminoglycans (GAG) and heparan sulfate (HS) are considered to be markers of early renal involvement. This study was undertaken to demonstrate their excretion patterns in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) with and without arthritis. Serum creatinine and urinary GAG, HS, microalbumin, and creatinine measurements were made in 51 biopsy-proven lupus nephritis (LN) cases, 12 RA patients, and 21 healthy controls. Urinary GAG and HS levels were higher in the LN and RA groups than in controls. Heparan sulfate excretions and SLE disease activity index (SLEDAI) scores were no different between SLE patients with classes 1 and 2 (group A) and those with classes 3, 4, and 5 (group B) renal involvement. However, GAG and microalbumin excretions were significantly high in the latter. There were no differences in GAG and HS excretions between normoalbuminuric, microalbuminuric, and macroproteinuric SLE patients or between those with and without arthritis. In conclusion, urinary GAG and HS, being unrelated to the presence of arthritis, are independent markers of LN. Extrarenal causes or subclinical renal involvement may be responsible in RA due to their increased excretion in these patients.Öğe Increased excretions of glycosaminoglycans and heparan sulfate in lupus nephritis and rheumatoid arthritis(Springer-Verlag, 2003) Bicer, I; Aksu, K; Parildar, Z; Tanyalcin, T; Doganavsargil, E; Kutay, FZUrinary glycosaminoglycans (GAG) and heparan sulfate (HS) are considered to be markers of early renal involvement. This study was undertaken to demonstrate their excretion patterns in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) with and without arthritis. Serum creatinine and urinary GAG, HS, microalbumin, and creatinine measurements were made in 51 biopsy-proven lupus nephritis (LN) cases, 12 RA patients, and 21 healthy controls. Urinary GAG and HS levels were higher in the LN and RA groups than in controls. Heparan sulfate excretions and SLE disease activity index (SLEDAI) scores were no different between SLE patients with classes 1 and 2 (group A) and those with classes 3, 4, and 5 (group B) renal involvement. However, GAG and microalbumin excretions were significantly high in the latter. There were no differences in GAG and HS excretions between normoalbuminuric, microalbuminuric, and macroproteinuric SLE patients or between those with and without arthritis. In conclusion, urinary GAG and HS, being unrelated to the presence of arthritis, are independent markers of LN. Extrarenal causes or subclinical renal involvement may be responsible in RA due to their increased excretion in these patients.Öğe Increased thickness of the carotid artery intima-media assessed by ultrasonography in Behcet's disease(Clinical & Exper Rheumatology, 2005) Keser, G; Aksu, K; Tamsel, S; Ozmen, M; Kitapcioglu, G; Kabaroglu, C; Killi, R; Bayindir, O; Doganavsargil, EObjective. Behcet's disease (BD), is a unique systemic vasculitis, which affects almost all types and sizes of blood vessels. Carotid intima-media thickness (IMT) is an endothelial cell dysfunction (ECD) parameter which may also be associated with atherosclerosis. We aimed to search carotid IMT and plaque formation in BD, using high-resolution B-mode Doppler ultrasonography (USG). Methods. We studied 114 BD patients (M/F: 68146; mean age 38.15 +/- 9.44 years; disease duration 121 +/- 79 months), being followed tip by Ege University; Rheumatology Department. A e and sex-matched, 77 healthy, controls, and as the disease control group 46 non-matched SLE patients were also included. Exclusion criteria for all the study participants were, hypertension, hyperlipidemia, diabetes mellitus, obesity and history of cardiovascular or cerebrovascular disease. Comparison of the three groups were made by ANOVA and for post-hoc confirmation, Bonferoni test was used. Results. The carotid IMT in BD (mean +/- SD, 0.55 +/- 0.14 min) was significantly higher than in healthy controls (0.48 +/- 0.09 min) (p = 0.004), but signficantly lower than in SLE (0.66 +/- 0.24 mm) (p = 0.001). Likewise, plaque frequency in BD (5/114) was significantly higher than in health), controls (0/77), but significantly lower than in SLE (8146) (p < 0.001). Conclusion. Despite significantly higher carotid IMT and plaque frequency in BD compared with healthy controls, these parameters in BD were not as marked as in SLE. Less severe carotid artery abnormalities in BD, may partially explain why cardiovascular morbidity and mortality do not seem to be increased in BD, unlike in SLE.Öğe Manometric assessment of esophageal motility in patients with primary Sjorgren's syndrome(Springer Heidelberg, 2005) Turk, T; Pirildar, T; Tunc, E; Bor, S; Doganavsargil, EObjective: The aim of this study was to assess the esophageal motility by manometry in patients with primary Sjogren's syndrome. Methods: Esophageal manometry was carried out in 40 patients with primary Sjogren's syndrome (SS), 15 with rheumatoid arthritis (RA), 15 with RA and secondary SS, and 21 healthy volunteers. Results: We found that the mean lower esophageal sphincter (LES) pressures measured by station pull-through and rapid pull-through techniques were significantly higher in primary SS patients than with healthy controls and RA patients with or without SS (P < 0.05). Our study did not show any major differences when comparing the three patient groups (P > 0.05). However, peristaltic contraction velocity was lower and peristaltic contraction duration significantly higher at the middle and lower thirds of the esophagus in primary SS patients than in healthy controls (P < 0.05). Conclusion: The results of our study support the view that various esophageal motility disorders can be found in patients with primary SS which could be related to an increase in LES pressure. We also found no correlation of the esophageal abnormalities with other factors studied, suggesting that the cause of dysphagia is multifactorial in nature.Öğe Multicentric reticulohistiocytosis(Royal Belg Rheumatol Soc, 1996) Kocanaogullari, H; Ozsan, H; Oksel, F; Ozturk, G; Kandiloglu, G; Ustun, EE; Doganavsargil, EWe describe a 42-year-old man with a five-year history of arthritis mutilans-like destructive joint changes and with a one-year history of nodules on the fingers, ears, oral mucosa, pharynx, larynx, vocal cords, some being ulcerated and haemorrhagic. He was diagnosed as having rheumatoid arthritis; however, biopsies from the nodules an the oral mucosa and ear revealed multicentric reticulohistiocytosis, The large nodule over the olecranon process, simulating a rheumatoid nodule but diagnosed as multicentric reticulohistiocytosis with biopsy; ulcerated and haemorrhagic nodules on the oral mucosa; and rapidly progressive joint destructions make our case interesting.Öğe Nasal staphylococcus aureus carriage in Behcet's disease(B M J Publishing Group, 2003) Erdogan, M; Keser, G; Tunger, A; Aydemir, S; Oksel, F; Inal, V; Aksu, K; Kabasakal, Y; Gumusdis, G; Doganavsargil, EÖğe Nasal staphylococcus aureus carriage in Behcet's disease(B M J Publishing Group, 2003) Erdogan, M; Keser, G; Tunger, A; Aydemir, S; Oksel, F; Inal, V; Aksu, K; Kabasakal, Y; Gumusdis, G; Doganavsargil, EÖğe Nasal Staphylococcus aureus carriage is not increased in Behcet's disease(Springer, 2005) Keser, G; Erdogan, M; Aydemir, S; Karatas, T; Aksu, K; Tunger, A; Doganavsargil, EÖğe Osteonecrosis in systemic lupus erythematosus patients(B M J Publishing Group, 2003) Pirildar, T; Ozmen, M; Turk, T; Keser, G; Oksel, F; Doganavsargil, E
