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    Doble Outlet Right Ventricle with Discordant Atrioventricular Connections in a Newborn: Case Report and Brief Overview of the Literature
    (DERMAN MEDICAL PUBL, 2016) Sert, Ahmet; Aypar, Ebru; Gokmen, Zeynel; Oc, Mehmet; Odabas, Dursun
    Double outlet right ventricle is a rare cardiac malformation of all congenital cardiac defects. It is a heterogeneous group of abnormal ventriculoarterial connections. Both great arteries (pulmonary artery and aorta) arise primarily from the morphological right ventricle. Double outlet right ventricle with discordant atrioventricular connections have been reported rarely in the literature. We report a newborn with double outlet right ventricle with discordant atrioventricular connections arid hypoplastic pulmonary arteries. We reported a rare complex cardiac malformation diagnosed by echocardiography. Segmental approach and sequential analysis of cardiac segments by echocardiography are the clue for diagnosis of complex cardiac ma formations
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    Double Outlet Right Ventricle with Discordant Atrioventricular Connections in a Newborn:Case Report and Brief Overview of the Literature
    (2016) Sert, Ahmet; Aypar, Ebru; Gökmen, Zeynel; Öç, Mehmet; Odabaş, Dursun
    Çift çıkışlı sağ ventrikül bütün doğumsal kalp defektlerinin nadir bir kardiyak malformasyondur. Anormal ventriküloarteryal bağlantıların heterojen bir grubudur. Her iki büyük arter (pulmoner arter ve aorta) esas olarak morfolojik sağ ventrikülden çıkmaktadır. Diskordan atriyoventriküler bağlantılı çift çıkışlı sağ ventrikül ve hipoplazik pulmoner arterleri olan bir yenidoğanı sunmaktayız. Ekokardiyografi ile tanı konulan nadir karmaşık bir kardiyak malformasyonu bildirdik. Ekokardiyografi ile segmental yaklaşım ve kardiyak segmentlerin ardışık analizi karmaşık kardiyak malformasyonların tanısında ipucudur.
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    A Girl With Metopic Synostosis and Trisomy 13 Mosaicism: Case Report and Review of the Literature
    (WILEY-BLACKWELL, 2011) Aypar, Ebru; Yildirim, M. Selman; Sert, Ahmet; Ciftci, Ilhan; Odabas, Dursun
    Trisomy 13, or Patau syndrome is a rare chromosomal disorder characterized by a triad of cleft lip and palate, postaxial polydactyly and microcephaly. Complete, partial, or mosaic forms of the disorder can occur. Mosaic trisomy 13 is very rare, it occurs in only 5% of all patients with trisomy 13 phenotype. Metopic synostosis (MS) is premature fusion of the metopic suture, which is part of the frontal suture. It results in a V-shaped abnormality at the front of the skull. MS may occur in a syndromic or nonsyndromic form. We report on a 24-day-old girl with hypotonia, MS, trigonocephaly, capillary hemangioma, hypotelorism, upward slanting palpebral fissures, epicanthal folds, small nose with anteverted nares, high palate, ankyloglossia, long philtrum, low-set ears, short neck, postaxial polydactyly of both hands and feet and congenital heart defect. Cytogenetic analysis demonstrated trisomy 13 mosaicism; 46, XX[58]/47,XX,+13[42]. Although MS has been previously reported in complete and partial forms of trisomy 13, it has not been reported in mosaic form of trisomy 13. Our report supports the evidence that trisomy 13 causes MS. It also emphasizes the need for cytogenetic investigations in patients presenting with MS and multiple congenital anomalies for providing accurate diagnosis, genetic counseling, and prenatal diagnosis. (C) 2011 Wiley-Liss, Inc.
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    P-Wave Dispersion in Children With Acute Rheumatic Fever
    (SPRINGER, 2012) Kocaoglu, Celebi; Sert, Ahmet; Aypar, Ebru; Oran, Bulent; Odabas, Dursun; Arslan, Derya; Akin, Fatih
    As a new and simple electrocardiographic marker, P-wave dispersion is reported to be associated with inhomogeneous and discontinuous propagation of sinus impulses. The current study aimed to investigate P-wave dispersion in children with acute rheumatic fever. The study population consisted of 47 children with acute rheumatic fever (29 patients with carditis and 18 patients without carditis) and 31 healthy control subjects. Maximum and minimum P-wave durations were measured from the 12-lead surface electrocardiogram. The P-wave dispersion was calculated as the difference between maximum and minimum P-wave durations. The maximum P-wave duration and the P-wave dispersion of the patients with and without carditis were significantly greater than those of the control subjects. The P-wave dispersion of the patients with carditis was significantly greater than that of the patients without carditis. In conclusion, the P-wave dispersion was higher in the children with acute rheumatic fever than in the healthy control subjects.
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    Serum Asymmetric Dimethylarginine Levels in Patients with Acute Rheumatic Fever
    (GEORG THIEME VERLAG KG, 2015) Sert, Ahmet; Cimen, Derya; Arslan, Derya; Aypar, Ebru; Vatansev, Husamettin; Kaya, Fatma; Kilicaslan, Cengizhan
    Asymmetric dimethylarginine (ADMA) is an analogue of L-arginine, a naturally occurring product of metabolism found in human circulation. It is an endogenous inhibitor of nitric oxide production. Acute rheumatic fever (ARF) is a delayed immunologically mediated autoimmune sequel of throat infection by group A beta-hemolytic streptococci. As serum ADMA levels have not previously been assessed in patients with ARF, we aimed to investigate ADMA levels in patients with ARF during the acute stage and after anti-inflammatory treatment and compared results with healthy control subjects. The study population consisted of 34 children with ARF (30 patients with carditis and 4 patients without carditis) and 31 healthy control subjects. Erythrocyte sedimentation rate and C-reactive protein values were significantly higher and serum ADMA values were lower, but not statistically significant in patients with ARF during the acute stage when compared with controls. Serum C-reactive protein and erythrocyte sedimentation rate values were significantly decreased in patients with ARF after the treatment when compared with baseline and ADMA levels were increased after the treatment compared with baseline, but this change was not statistically significant. Our study has demonstrated that resolution of acute inflammation in patients with ARF may lead to a mild increase in serum concentration of ADMA. Comprehensive prospective and observational studies are required to confirm our findings and to assess potential interactions between ARF and ADMA levels.
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    Takayasu arteritis in a 4-year-old girl: case report and brief overview of the pediatric literature
    (TURKISH J PEDIATRICS, 2012) Aypar, Ebru; Celebi-Tayfur, Asli; Keser, Melike; Odabas, Dursun; Ozaltin, Fatih; Paksoy, Yahya; Ozen, Seza
    Takayasu arteritis (TA) is a large vessel vasculitis that involves the aorta, its major branches and pulmonary arteries. Diagnosis of TA during childhood remains challenging due to the non-specific symptoms. We report a fouryear- old girl presenting with fever, fatigue, weight loss, and elbow pain who was later diagnosed as childhood TA. On admission, she had fever, hypertension, decreased pulses, bruits, hepatosplenomegaly, and increased erythrocyte sedimentation rate and C-reactive protein level. Computed tomography angiography showed luminal narrowing and wall thickening in ascending aorta, brachiocephalic, left common carotid and left vertebral arteries and descending aorta. Oral corticosteroid (prednisone, 2 mg/kg/day) was instituted, later followed by oral methotrexate (12.5 mg/m(2)/week). TA is rare in children; however, childhood TA must be considered in children who present with non-specific systemic symptoms, hypertension and increased acute phase reactants.