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Öğe Absence of Anca in Behçet's Syndrome with Large Vessel Involvement(Thieme Medical Publishers, Inc., 2001) Tunç, Recep; Özbakır, Fatma; Çağlayan, Aygül; Altıparmak, M. Rıza; Yargan, Pelin; Fresko, İzzet; Yazıcı, HasanThe aim of this study was to examine the prevalence of anti-neutrophil cytoplasmic antibodies (ANCA) in patients with Behcet's syndrome (BS) with large vessel involvement. The sera of 48 consecutive patients with BS with large vessel involvement, seven patients with Wegener granulomatosis (WG), and 10 healthy staff were studied for the presence of the cytoplasmic (c) and perinuclear (p) pattern of ANCA by indirect immunofluoresance (IIF). The sera were also examined for antibodies against proteinase 3 (anti-PR3) and myeloperoxidase (anti-MPO) by enzyme-linked immunosorbent assay (ELISA). None of the sera from the patients with BS and healthy controls had detectable ANCAs, while all positive control sera from patients with WG showed ANCA positivity in some form. This study confirms that there are no detectable ANCAs in patients with BS with large vessel involvement by IIF and ELISA tests.Öğe Allogeneik Kök Hücre Nakli Sonrası Gelişen Parvovirüs B19'un Neden Olduğu Geçici Aplastik Kriz Olgusu(2002) Kurtoğlu, Erdal; Tunç, RecepAmaç: Akut human parvovirus (HPV) B19 enfeksiyonunun ülkemizdeki sıklığının % 7-30'larda olduğu ve bu enfeksiyonun bazı hastalarda geçici aplastik krize neden olduğunun bilinmesine rağmen konu ile ilgili yerli çalışmalar azdır. Olgu sunumu: Bu makalede, allogeneik kök hücre nakli sonrasında gelişen HPV-B19 enfeksiyonuna bağlı anemi ve trombositopeni olgusu bildirildi. Hemolitik anemili veya immünsüpressif hastalarda gelişen alışılmışın dışındaki sitopeni durumlarında HPV-B19 enfeksiyonunun hatırlanması hızla tanı koyulmasında yararlı olacaktır. İmmunokompetent hastada geçici aplastik atak kendi kendini sınırlayan bir enfeksiyondur. Sadece kan transfüzyonu ve destek tedavisi genellikle yeterlidir. İmmünsuprese hastada ortaya çıkan persistan HPV-B19 enfeksiyonunda immünsupresif tedavinin kesilmesi, bu yapılamıyor ise intravenöz immünglobulin (İVİG) uygulaması önerilmektedir. Hastamızda kan transfüzyonu gereksinimi olmamış ve İVİG uygulamasına yanıt alınmıştır. Sonuç: Akut HPV-B19 enfeksiyonuna bağlı geçici aplastik kriz, immünsupresif kişilerde sık olmasına rağmen ülkemizde bildirilen ilk olgu olması nedeni ile sunulmuştur.Öğe Bone and Calcium Metabolism in Subclinical Autoimmune Hyperthyroidism and Hypothyroidism(Japan Endocrine Society, 2003) Kısakol, Gürcan; Kaya, Ahmet; Gönen, Sait; Tunç, RecepBone turnover is reported to increase in favour of resorption in overt hyperthyroidism and the rate of resorption is associated with the levels of thyroid hormones. Hypothyroidism, on the other hand, was shown to cause no disturbance of calcium kinetics and found to associate lower trabecular resorption surfaces and increased bone cortical thickness. Similar studies are very rare in subclinical thyroid disorders and consequently we aimed to examine calcium and bone metabolism in subclinical thyroid disorders. Thirteen patients with subclinical hyperthyroidism secondary to untreated Graves' disease, 20 patients with subclinical hypothyroidism and 10 healthy subjects participated in this survey. Briefly calcium, phosphorus, and creatinine (Cre), urinary deoxypyridinoline (U-DPD) and serum osteocalcin (OC) were measured as biochemical markers for calcium metabolism. Concerning serum Ca and phosphorus levels, there were no differences between three of the groups, but urinary Ca excretion was higher in subclinical hyperthyroid patients compared to control and hypothyroid subjects. Hypothyroid patients had similar U-DPD levels with control subjects (p = 0.218). Serum OC and U-DPD were higher in subclinical hyperthyroid compared to control subjects (p<0.001 and p<0.001 respectively). We demonstrated a higher bone turnover and greater calcium excretion in subclinical hyperthyroid patients. Additionally, we found that subclinical hypothyroidism is not associated with disturbed calcium metabolism. As persistent increase in bone turnover is responsible for accelerated bone loss, patients with Graves' disease may have increased risk for osteoporosis.Öğe EVALUATION OF THE SLEEP QUALITY IN PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER(CARBONE EDITORE, 2015) Küçük, Adem; Albayrak, İlknur; Bağçacı, Sinan; Karpuz, Savaş; Küçükşen, Sami; Tunç, RecepBackground: Familial Mediterranean Fever (FMF) is a hereditary autoimmune disorder characterised by acute attacks of fever and serosal inflammation. This study aimed to investigate sleep quality in patients with familial Mediterranean fever (FMF). Methods The study involved 86 patients. The patients were enrolled in the study during an attack-free period. The sleep quality of all the patients. was evaluated by the Pittsburgh Sleep Quality Index (PSQ1). Results: The PSQ1 total score was 6.5 +/- 4 and the prevalence of poor sleepers was 50% (43/86) according the PSQ1 total score in this study. Women with a higher number of attacks per year and patients resistant to the colchicine treatment had a. poorer sleep quality (p<0.05)., Conclusions: This study underlines the need to assess and manage sleep problems in patients with FMF. Poor sleep quality cause other symptoms of the disease to aggravate. So, the physician must also assess the sleep quality when questioning the routine complaints Of the patients with FMF.Öğe Prevalence of Behcet's Disease in Istanbul, Turkey(Wiley-Blackwell, 2003) Azizlerli, Gülsevim; Köse, Afet Akdağ; Sarıca, Rıfkiye; Gül, Ahmet; Tutkun, İlknur Tuğal; Kulaç, Mustafa; Tunç, Recep; Urgancıoğlu, Meri; Dişçi, RianBackground The prevalence of Behcet's disease (BID) is much higher in countries along the ancient Silk Route, extending from Japan to Mediterranean countries including Turkey, than in northern Europe and the USA. Three previous epidemiologic surveys have been carried out in different regions of Turkey. Patients and methods This study investigated the cross-sectional prevalence of BID in individuals aged > 12 years in Istanbul, Turkey, in two stages. The first stage aimed to identify individuals with recurrent oral ulcers (ROUs) by visiting them in their homes, and the second stage aimed to further examine those with ROUs for the presence of other BID-related manifestations under hospital conditions. The sample size was determined to be 24,000 with an expected BID prevalence rate of 1/1000 and a sampling error of 4/10,000, with a 95% confidence interval (CI) of 6-14/10,000. The number of individuals to be screened in each district was determined in proportion to the population of all districts in Istanbul. Results The standard questionnaire was applied to a total of 23,986 individuals at their homes. A history of ROU was recorded in 2289 individuals (9.5%), and a previous diagnosis of BID was recorded in 47. The diagnosis of ROU was confirmed in 700, and the diagnosis of BID was established in 101 according to the International Study Group criteria. The prevalence rate of BID was estimated as 42/10,000 (95% Cl, 34-51/10,000) in Istanbul, Turkey. Conclusions This survey conducted in Istanbul, the largest cosmopolitan city in Turkey with immigrants from all over the country, has a larger sample size than other previous studies, and therefore the reported prevalence rate of BID has a more acceptable confidence interval. This study aids in the estimation of the prevalence of BID in Turkey, and supports previous findings that Turkey has the highest prevalence rate of the disease in the world.Öğe Sistemik Lupus Eritematosis ve Crohn Hastalığı Birlikteliği(2007) Kayaçetin, Ertuğrul; Tunç, RecepCrohn Hastalığı ve Sistemik Lupus Eritematosis kronik inflamatuar ve multisistemik hastalıklardır. Gastrointestinal sistem bulguları başta olmak üzere, bazı radyolojik, klinik ve laboratuar bulguları birbiriyle örtüşebilir. Her iki hastalığın birlikteliği oldukça nadirdir, 42 yaşında Sistemik Lupus Eritematosis ve Diabetes Mellitus nedeniyle takip edilirken son 6 yıldır Crohn hastalığı tanısı da alan bir vakayı takdim ettik.Öğe Systemic onset juvenile rheumatoid arthritis presenting with absence of B lymphocytes(SPRINGER, 2007) Artaç, Hasibe; Alp, Hayrullah; Keleş, Sevgi; Reisli, İsmail; Tunç, RecepJuvenile rheumatoid arthritis (JRA) is a complex disease involving the interactions of several cell populations with different mediators. Herein, we report a five-year-old girl with systemic-onset JRA. At admission, peripheral blood flowcytometric analysis showed the percentages of CD19(+)and CD20(+) stop B cells were < 1%. These values returned to normal on the tenth day of steroid treatment. This is the first report of JRA presented with absence of B lymphocytes in the literature and suggested that lymphocytes subset analysis could change with treatment in patients with JRA. Different clinical signs and symptoms reflecting aspects of JRA are critical for the etiology of the disease and to identify new strategies for treatment.Öğe Target Organ Associations in Turkish Patients With Behçet's Disease: A Cross Sectional Study by Exploratory Factor Analysis(2002) Tunç, Recep; Keyman, Erkani; Melikoğlu, Melike; Fresko, Izzet; Yazıcı, HasanObjective. To look for target organ associations in Turkish patients with Behçet's disease (BD). Methods. We studied target organ associations in 272 consecutive patients with BD. The occurrence of any of the clinical manifestations related to BD within the previous 3 months was sought by history questionnaire completed by a rheumatologist and by physical examination. Factor analysis was used to analyze the data. Results. Four factors were identified by factor analysis of variables oral and genital ulcers, erythema nodosum, papulopustular skin lesions, uveitis, superficial and deep vein thrombosis, joint, arterial, neurological, and gastrointestinal involvement; the 4 identified factors explained 69% of the original information of the matrix. There was an association between oral ulcers, genital ulcers, and erythema nodosum (Factor 1); and between superficial and deep vein thrombosis (Factor 2). Uveitis was identified as a distinct feature, and was negatively associated with erythema nodosum (Factor 3) only among the females. There was also an association between papulopustular skin lesions and joint involvement (Factor 4). Factors 2 and 3 had higher scores in males (p = 0.001 and p = 0.009, respectively) versus females. Conclusion. We studied clinical features of BD in Turkish patients. The 4 factors we identified by factor analysis differ from a previous study from Israel, probably due to different methodologies used in the 2 studies. One factor described in our study, the association between papulopustular lesions and arthritis, supports findings of our recent study. A recognized association between superficial and deep vein thrombosis was also confirmed.Öğe Türkiye'deki Mezuniyet Öncesi Tıp Eğitiminde Bazı Temel Tıp Kavramlarının Öğrenilmesi: Çok Merkezli, Kesitsel Bir Çalışma(2002) Tunç, Recep; Kurtoğlu, Erdal; Çağlayan, Aygül; Kısakol, Gürcan; Kaya, AhmetÇalışmamızın amacı, ülkemizdeki Tıp Fakültesi son sınıf öğrencilerinin mezuniyet öncesi dönemde öğrenmeleri gereken, çoğunluğu Dahili Tıp Bilimleri ile ilgili, iç hastalıkları temel kavramlarından bazılarının son durumunu kesitsel olarak değerlendirmektir. Çoğunluğu Dahili Tıp Bilimleri ile ilgili 10 açık-uçlu sorudan oluşan anket formu hazırlanmıştır. Çalışmaya altı farklı Tıp Fakültesinden 176 gönüllü son sınıf öğrencisi katılmıştır. Anket formları öğretim üyelerinin gözetiminde ve mesai saatleri içinde öğrenciler tarafından doldurulmuştur. Doğru yanıt oranları tıp fakülteleri ve cinsiyete göre yüzde olarak saptanmış ve kız ve erkek öğrencilerin doğru yanıt oranları ki-kare testi ile karşılaştırılmıştır. Öğrencilerin, soruların %95'ini yanıtladıkları görülmüştür. Doğru yanıtlama oranı %31 olup, bu oran üniversiteler arasında %22-47 arasında değişmektedir. Bir soru dışında, sorulara verilen doğru yanıtlar yönünden cinsler arasında fark yoktu. Bu çalışmanın sonuçları, ülkemizdeki mezuniyet öncesi tıp eğitimi esnasında öğrenilmesi gereken bazı temel tıp kavramlarının öğrenilmesi yada öğretilmesinde yetersizlikler olabileceğini düşündürtmektedir.
