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Öğe Blood levels of leukotrienes (LTC4, D-4, E-4, B-4) and synthesis of leukotriene B-4 by peripheral leukocytes in children with acute A and B hepatitis(Turkish J Pediatrics, 1999) Kasirga, E; Coker, I; Aydogdu, S; Yagci, RV; Taneli, B; Gousseinov, ALeukotrienes (LTs) are cell-membrane derived lipid inflammatory mediators, synthesized and eliminated by the liver. LTs have effects on liver cells in some pathological conditions. In this study, we measured plasma endogenous and liberated leukotriene (LT) concentration in peripheral blood leukocytes stimulated in vitro by the calcium ionophore (CaA23187) and platelet-activating factor (PAF). Production of LTs was measured in type A (n=37) and type B (n=10) acute hepatitis patients and control subjects (n=10). LTs levels were measured by high performance liquid chromatography (HPLC) and radioimmunoassay (RIA). The concentration of LTB4 measured in plasma and stimulated peripheral blood leukocyte supernatants of children with hepatitis A infection was found to be statistically elevated and in positive correlation with serum alanine aminotransferase (ALT) levels. In plasma samples of hepatitis B patients, LTC, and LTE, were measured in significantly elevated concentrations. These results suggest that LTB4 may be a critical mediator of hepatitis A virus-induced hepatocellular injury.Öğe Current therapeutic approaches in childhood chronic hepatitis B infection(Elsevier Science Bv, 2003) Dikici, B; Ozgenec, F; Kalayci, A; Targan, S; Ozkan, T; Selimoglu, A; Doganci, T; Kansu, A; Tosun, S; Arslan, N; Kasirga, E; Bosnak, M; Ece, A; Buyukgebiz, B; Aydogdu, S; Girgin, N; Yagci, RVÖğe Current therapeutic approaches in childhood chronic hepatitis B infection(Elsevier Science Bv, 2003) Dikici, B; Ozgenec, F; Kalayci, A; Targan, S; Ozkan, T; Selimoglu, A; Doganci, T; Kansu, A; Tosun, S; Arslan, N; Kasirga, E; Bosnak, M; Ece, A; Buyukgebiz, B; Aydogdu, S; Girgin, N; Yagci, RVÖğe Current therapeutic approaches in childhood chronic hepatitis B infection: A multicenter study(Blackwell Publishing Asia, 2004) Dikici, B; Ozgenc, F; Kalayci, AG; Targan, S; Ozkan, T; Selimoglu, A; Doganci, T; Kansu, A; Tosun, S; Arslan, N; Kasirga, E; Bosnak, M; Haspolat, K; Buyukgebiz, B; Aydogdu, S; Girgin, N; Yagci, RVBackground and Aim: The aim of the present study was to compare the therapeutic efficacy of three different regimens in childhood chronic hepatitis B (CHB) infection. Methods: A total of 182 children with CHB infection were prospectively allocated to three random groups. Sixty-two patients in the first group received high-dose interferon (IFN)-alpha 2b (10 MU/m(2)) thrice/weekly alone for 6 months. In the second (n = 60) and third groups (n = 60), IFN-alpha was used for 6 months (5 MU/m(2)) thrice/weekly in combination with lamivudine (LAM) (4 mg/kg, maximum 100 mg/day) for 12 months. Lamivudine was started simultaneously with IFN in the second group, while it was started 2 months prior to IFN injections in the third group. Results: The initial mean alanine aminotransferase (ALT) values for the first, second and third groups were 109 +/- 93 IU/L, 101 +/- 64 IU/L and 92 +/- 42 IU/L, respectively (P > 0.05). At the end of the therapy, ALT values decreased to 82 +/- 111 IU/L, 38 +/- 41 IU/L and 29 +/- 16 IU/L in groups 1, 2 and 3, respectively. The mean ALT value of the first group was significantly different to the second and third groups (P = 0.046 and P = 0.002, respectively) at the end of the therapy and these differences were found to be sustained after 18 months. However, results in the second and third groups were similar (P > 0.05). There were no significant differences in HBeAg clearance and anti-HBe seroconversion at the initial stage, 12 months and 18 months between the three groups (P > 0.05). Hepatitis B virus (HBV) DNA clearance in the first group was different from the second and third groups, while the second and third groups had similar HBV DNA clearance ratios at 12 and 18 months. No significant difference was found in the complete response (normalization of ALT, clearance of HBV DNA and seroconversion of anti HBe) ratios of all groups (at 12 months: 28.8, 45.5, 35.8% and at 18 months 33.3, 49 and 34% in groups 1, 2 and 3, respectively, P > 0.05). Conclusions: Although the ALT normalization and HBV DNA clearance ratios of IFN plus LAM combination groups were better than the high-dose IFN-alpha monotherapy group, no significant difference was found in the complete response ratios of all three groups. (C) 2004 Blackwell Publishing Asia Pty Ltd.Öğe Efficacy of interferon-alpha 2b treatment in children with chronic hepatitis B who have previously undergone therapy for cancer(Wiley, 2000) Kasirga, E; Isenlik, S; Aksoylar, S; Yaprak, I; Kansoy, S; Yuce, GBackground: The aim of the present study was to evaluate the efficacy of treatment with recombinant interferon (IFN)-alpha 2b in 12 children with chronic hepatitis B who had previously undergone therapy for cancer. Methods: Nine children had acute leukemias and the other three children had solid tumors. The mean (+/-SD) age of the children was 8.4 +/- 3.8 years (range 4-16 years). All cases were hepatitis B virus (HBV)-DNA positive and 11 were hepatitis B e antigen (HBeAg) positive. One was anti-HBe positive (mutant strain). Four cases were anti-delta IgG positive. Liver biopsy revealed chronic hepatitis B in 11 patients and cirrhosis in one patient. Interferon-alpha 2b was given at a dose of 5 MU/m(2) three times a week, subcutaneously, for 12 months. Results: Elimination of serum HBV-DNA was obtained in three cases, but a further three patients demonstrated a marked decrease in HBV-DNA levels after therapy. Three of 11 patients seroconverted from HBeAg to anti-HBe. Alanine aminotransferase (ALT) levels returned to normal in three of nine cases in whom the ALT levels were high before treatment. At the end of therapy, the mean histologic activity index score was significantly diminished (P = 0.0039). Conclusions: In conclusion, a 12 month course of IFN-alpha 2b induces some beneficial effects on virologic, biochemical and histologic indices in children with chronic hepatitis B who have previously undergone therapy for cancer.Öğe Four siblings with achalasia, alacrimia and neurological abnormalities in a consanguineous family(Munksgaard Int Publ Ltd, 1996) Kasirga, E; Özkınay, F; Tutuncuoglu, S; Aydogdu, S; Colakoglu, Z; Musoglu, A; Yagci, A; Taneli, B; Yagci, RVFour siblings with achalasia, alacrimia and other problems involving the autonomic nervous system involvements are reported. Achalasia and alacrimia were present in all of them. Their parents are first cousins and have four other healthy children. Electrophysiological tests showed that autonomic dysfunction has progressed with age. Blood cortisol levels were normal in all four affected children. Depending on these findings of our cases and previous reports, we conclude that triple-A syndrome and achalasia, alacrimia with or without neurological abnormalities could be variable manifestations of the same autosomal recessive gene defect.Öğe Frequency of gastroesophageal reflux disease in nonatopic children with asthma-like airway disease(W B Saunders Co Ltd, 2006) Yuksel, H; Yilmaz, O; Kirmaz, C; Aydogdu, S; Kasirga, EGastroesophageal reflux disease (GERD) is commonly associated with asthma; however, frequency in nonatopic children with asthmatic symptoms is unknown. The aim of this study was to determine the frequency of gastroesophageal reflux (GER) in nonatopic children with asthma-like airway disease that recur despite conventional asthma treatment and to evaluate the clinical response to lansoprazole treatment. Twent-five nonatopic children aged between 1 and 16 years who have asthma-like airway disease and 25 healthy children were included in the study. All cases underwent 24h pH monitoring with dual. sensor catheters. Additionally, acid suppressor treatment was administered to patients diagnosed as having GERD and clinical response was evaluated. Major symptoms encountered in the patient group included wheezing and cough (88%, and 32%, respectively). Reflux episodes were more common in distal esophagus during the prone position (reflux index (RI) of 11.5 +/- 10.3 vs. 16.2 +/- 9.4 during supine vs. prone). ALL distal esophageal parameters were significantly higher in the patient group except number of reflux episodes lasting longer than 5 min (RI of 13.3 +/- 13.1 vs. 3.9 +/- 2.9 in the patient vs. control groups, respectively). There was a significant improvement in symptoms and requirement for medication with treatment (number of systems decreased from 2.3 +/- 0.6 to 0.4 +/- 0.6, P = 0.00). In conclusion, GERD is significantly more common in nonatopic children with asthma-Like airway disease compared to the controls and clinical improvement is significant after acid suppressor treatment. Thus, we suggest that children followed-up with the diagnosis of nonatopic asthma with recurrent exacerbations despite adequate asthma treatment have a high frequency of GER and that Lansoprazole treatment may be considered early in management. (c) 2005 Elsevier Ltd. All rights reserved.Öğe Increased gastric juice leukotriene B-4, C-4 and E-4 concentrations in children with Helicobacter pylori colonization(Turkish J Pediatrics, 1999) Kasirga, E; Coker, I; Aydogdu, S; Yagci, RV; Taneli, B; Gousseinov, ADuring recent years, the role of inflammatory lipid mediators in the pathophysiology of Helicobacter pylori (H. pylori) infections has been investigated in several studies. The concentrations of leukotrienes (LTs) in gastric juice from Fl. pylori positive (n = 13) and negative (n = 18) children with recurrent abdominal pain were studies in order to determine whether these lipid inflammatory mediators are involved in local and systemic biological actions. Gastric juice samples and biopsy specimens of mucosa were obtained endoscopically from 31 patients with recurrent abdominal pain for assessment of LTs and histopathological examination. In this study, all children with recurrent abdominal pain were investigated by rapid urease test and histological assessment for H. pylori colonization. Leukotriene levels were measured by high performance liquid chromatography (HPLC) and raioimmunoassay (RIA) In gastric juice samples. Gastric juice LTB4, LTC4, and LT4 levels were significantly higher in patients with H. pylori colonization than in children without H. pylori colonization. These results indicate that increased gastric content of proinflammatory mediators (LTB4, LTC4, and LT4) may be related to the pathogenesis of H. pylori-associated gastritis.
