Yakup Ergül

Effect of vitamin C on oxidative liver injury due to isoniazid in rats

Background:  The aim of the present study was to investigate the effect of different doses of vitamin C on oxidative liver injury due to isoniazid (INH) in rats.

Systemic lupus erythematosus due to Epstein–Barr virus or Epstein–Barr virus infection provocating acute exacerbation of systemic lupus erythematosus?

Systemic lupus erythematosus (SLE) is a rheumatologic disease characterized by an inflammatory destruction of the target organ systems of the body in an unknown way by autoantibodies formed against self-antigens. Infectious agents like Epstein–Barr virus (EBV), cytomegalovirus and parvovirus B19 may have a role in the occurrence or the exacerbation of the SLE. In this report, the clinical follow-up of a 14-year-old girl diagnosed with SLE following an EBV infection with bicytopenia, lymphadenomegaly and hepatomegaly is discussed. This case could support the role of viral infections in the etiology of SLE.

Permanent cardiac pacing in a 2.5 month-old infant with severe cyanotic breath-holding spells and prolonged asystole.

We report the case of a 2.5 month-old infant with cyanotic breath-holding spells, loss of consciousness and seizures. Prolonged asystole up to 70 s despite cardiopulmonary resuscitation was documented by 24 hour Holter monitoring. An epicardial pacemaker was implanted followed by no further loss of consciousness and seizures during spells in a six month follow-up period.

Evaluation of Permanent or Transient Complete Heart Block after Open Heart Surgery for Congenital Heart Disease.

The features of pediatric patients with postoperative transient and permanent complete atrioventricular (AV) block (CAVB) were compared.

Transcatheter closure of a fistula between the right pulmonary artery and left atrium using the Amplatzer septal occluder

A congenital fistula between the right pulmonary artery (RPA) and left atrium (LA) is a rare condition that results in central cyanosis. An 11-year-old boy was admitted with exertional dyspnea and easy fatigability. He had severe cyanosis of the lips and limbs with clubbing of the fingers. Systemic oxygen saturation was 70%. There was no abnormal finding on electrocardiography, chest radiography, and echocardiography. Agitated saline injection showed early appearance of contrast bubbles in the LA. A pulmonary arteriovenous fistula was suspected and diagnostic cardiac catheterization was performed. Angiography demonstrated a large fistula between the proximal RPA and LA. The narrowest part of the fistula was 13.8 mm in balloon sizing. A 14-mm Amplatzer septal occluder was deployed at the narrowest site; however, the device migrated to the LA and then to the aortic arch. The device was removed and was successfully reimplanted to the fistula. After the procedure, arterial oxygen saturation increased from 70% to 96% and control angiography demonstrated complete occlusion of the fistula. The patient was symptom-free on follow-up evaluations at 6, 12, and 18 months, with a mean oxygen saturation of 96%. This case represents the first pediatric patient in whom a septal occluder was used.

Evaluation rhythm problems in unexplained syncope etiology with implantable loop recorder

Syncope is a frequent complaint in children and adolescents and may be a significant sign of serious pathology. Although patient history, family history, and physical examination are sufficient to reach a diagnosis in most cases of syncope, the cause of syncope still cannot be determined after initial investigation in one‐third to half of all patients. The aim of this study was to evaluate the diagnostic yield of implantable loop recorder (ILR) in children with unexplained syncope.

Electrocardiographic and electrophysiologic effects of dexmedetomidine on children.

Dexmedetomidine (DEX) is a highly selective alpha‐2‐adrenergic agonist approved for short‐term sedation and monitored anesthesia care in adults. Its effects on the electrocardiography and cardiac conduction tissue are not well described in the literature. Therefore, we aimed to characterize the electrocardiographic and electrophysiologic effects of DEX in children.

Evaluation of non‐surgical causes of cardiac tamponade in children at a cardiac surgery center

The aim of this study was to examine the causes of cardiac tamponade in children undergoing percutaneous pericardiocentesis.

Does early hyperbaric oxygen therapy prevent extremity necrosis in Nicolau syndrome

Nicolau syndrome (embolia cutis medicamentosa or livedo-like dermatitis) was first defined in 1925 after the use of intramuscular bismuth salts for treatment of syphilis. It has been associated with administration of many other drugs, such as non-steroidal anti-inflammatory drugs, corticosteroids, local anesthetics, long acting penicillin and a-interferon. The most commonly identified triggers of Nicolau syndrome (NS) in children are antibiotics. NS is characterized by sudden onset of painful swelling, followed by livedoid erythema, circumscribed hemorrhagic patches and, ultimately, necrosis of the skin, subcutaneous fat and, occasionally, muscular tissue. In certain cases, the necrosis can be extensive; it may be accompanied by rectal hemorrhage, neurologic complications, compartment syndrome, acute renal failure and transient or permanent ischemia of the ipsilateral limb that may even require amputation. Furthermore, NS can be fatal in children. Treatment consists of medical (heparin, pentoxifylline) and surgical (excision, grafting, etc.) therapy, depending on the timing of the diagnosis. In this report, we present a case of NS developed after an injection of benzathine penicillin, in which we used early hyperbaric oxygen (HBO) therapy in addition to heparin and pentoxifylline.

Evaluation of coronary artery abnormalities in Williams syndrome patients using myocardial perfusion scintigraphy and CT angiography

BACKGROUND Sudden death risk in Williams syndrome (WS) patients has been shown to be 25-100 times higher than in the general population. This study aims to detect coronary artery anomalies and myocardial perfusion defects in WS patients using noninvasive diagnostic methods. METHODS This study features 38 patients diagnosed with WS. In addition to physical examination, electrocardiography, and echocardiography, computed tomography (CT) angiography and rest/dipyridamole stress technetium-99m sestamibi ((99m)Tc-sestamibi) single photon emission computed tomography (SPECT) myocardial perfusion scintigraphy (MPS) were performed. RESULTS Twenty-one (55%) patients were male; 17 (45%) were female. The average patient age was 12 ± 5 years (2.5-26 years); the average follow-up period was 7.2 ± 4.2 years (6 months-18 years). Cardiovascular abnormalities were found in 89% of patients, the most common one being supravalvar aortic stenosis (SVAS). CT angiography revealed coronary anomalies in 10 (26%) patients, the most common ones being ectasia of the left main coronary artery and proximal right coronary artery as well as myocardial bridging. SVAS was present in 80% of patients with coronary artery anomalies. (99m)Tc-sestamibi SPECT MPS revealed findings possibly consistent with myocardial ischemia in 29% of patients, and ischemia in 7 out of 10 patients (70%) with coronary anomalies shown on CT angiography (p = 0.03). CONCLUSIONS Coronary artery abnormalities are relatively common in WS patients and are often accompanied by SVAS. CT angiography and dipyridamole (99m)Tc-sestamibi SPECT MPS seem to be less invasive methods of detecting coronary artery anomalies and myocardial perfusion defects in WS patients.