Person: ERTEM ŞAHİNOĞLU, DENİZ
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ERTEM ŞAHİNOĞLU
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DENİZ
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Publication Metadata only Blue rubber bleb nevus syndrome(AMER ACAD PEDIATRICS, 2001) ERTEM ŞAHİNOĞLU, DENİZ; Ertem, D; Acar, Y; Kotiloglu, E; Yucelten, D; Pehlivanoglu, EBlue rubber bleb nevus syndrome is a rare disorder characterized by distinctive cutaneous and gastrointestinal venous malformations that usually cause massive or occult gastrointestinal hemorrhage and iron deficiency anemia secondary to the bleeding episodes. It is even a rare cause of gastrointestinal hemorrhage during childhood. We describe a 6-year-old boy who had multiple venous malformations all over his body. He also suffered from several episodes of melena, chronic anemia, and growth retardation. The endoscopic examination of the gastrointestinal tract revealed multiple bluish-black sessile and polypoid venous malformations in various sizes. It was possible to remove the largest venous malformations causing massive bleeding during colonoscopy.Publication Open Access Mucus sialylation determines intestinal host-commensal homeostasis(2022-03-31) ÖZEN, AHMET OĞUZHAN; BARIŞ, SAFA; ERTEM ŞAHİNOĞLU, DENİZ; Yao Y., Kim G., Shafer S., Chen Z., Kubo S., Ji Y., Luo J., Yang W., Perner S. P., Kanellopoulou C., et al.Intestinal mucus forms the first line of defense against bacterial invasion while providing nutrition to support microbial symbiosis. How the host controls mucus barrier integrity and commensalism is unclear. We show that terminal sialylation of glycans on intestinal mucus by ST6GALNAC1 (ST6), the dominant sialyltransferase specifically expressed in goblet cells and induced by microbial pathogen-associated molecular patterns, is essential for mucus integrity and protecting against excessive bacterial proteolytic degradation. Glycoproteomic profiling and biochemical analysis of ST6 mutations identified in patients show that decreased sialylation causes defective mucus proteins and congenital inflammatory bowel disease (IBD). Mice harboring a patient ST6 mutation have compromised mucus barriers, dysbiosis, and susceptibility to intestinal inflammation. Based on our understanding of the ST6 regulatory network, we show that treatment with sialylated mucin or a Foxo3 inhibitor can ameliorate IBD.Publication Metadata only Autoimmune complications associated with hepatitis A virus infection in children(LIPPINCOTT WILLIAMS & WILKINS, 2001) ERTEM ŞAHİNOĞLU, DENİZ; Ertem, D; Acar, Y; Pehlivanoglu, EHepatitis A virus infection is usually a self-limited disease during childhood. Autoimmune manifestations are rarely reported among patients. We describe two children with acute hepatitis A infection who developed immune thrombocytopenia and hepatic venous thrombosis during the course of acute infection. Antiphospholipid antibodies were increased in both of them during the thrombocytopenic and thrombotic complications and decreased during the resolution of these events.Publication Metadata only Does endoscopic appearance of esophagus always suffice the diagnosis of esophagitis in patients presenting with otolaryngologic symptoms?(BLACKWELL PUBLISHING INC, 2005) ERTEM ŞAHİNOĞLU, DENİZ; Cam, S; Ertem, D; Pehlivanoglu, EPublication Open Access Phenotypic pattern of early versus later-onset pediatric inflammatory bowel disease in a eurasian country(2022-10-01) ERTEM ŞAHİNOĞLU, DENİZ; Akkelle B. S., Ertem D., Volkan B., Tutar E.Objectives: It is not clear whether the characteristics of pediatric inflammatory bowel disease (IBD) differ between Eastern and Western countries. The aim of this study was to analyze the characteristics of PIBD in Turkey, according to the age at diagnosis. Methods: The data of 176 children with IBD who were followed in our center were analyzed. Patients were divided into early (EO-IBD, onset at 2 to <10 years) and later-onset (LO-IBD, 10 to <= 17 years) IBD according to the age at diagnosis. Patients\" data with ulcerative colitis (UC) and Crohn\"s disease (CD) were compared. Results: Of 176 patients, 47 (26.7%) were diagnosed with EO-IBD. Patients with early-onset ulcerative colitis (EO-UC) had the highest rate of family history of IBD (17.6%). Pancolitis was the most common form of UC regardless of the age at onset. The rate of moderate-severe disease activity in later-onset UC (62.5%) was higher than in EO-UC (37.5%). A higher rate of extraintestinal manifestations was observed in EO-IBD patients, particularly in EO-UC (38.2%) than in LO-IBD patients. Patients with early-onset CD (EO-CD) had predominantly colonic involvement and nonstricturing, nonpenetrating disease behavior. The rate of perianal disease in patients with later-onset CD (LO-CD) (64.5%) was noticeably higher than those with EO-CD (23%). Conclusions: Our results suggest that patients with EO-UC represented a distinct phenotype with a mild disease activity, high rate of extraintestinal symptoms, and a high proportion of family history. The analysis of our IBD cohort also demonstrated remarkably high rate of perianal disease, particularly in patients with LO-CD.Publication Open Access Reactive oxygen species and chemokines: Are they elevated in the esophageal mucosa of children with gastroesophageal reflux disease?(W J G PRESS, 2008) ÇELİKEL, ÇİĞDEM; Tutar, Engin; Ertem, Deniz; Unluguzel, Goksenin; Tanrikulu, Sevda; Haklar, Goncagul; Celikel, Cigdem; Ademoglu, Evin; Pehlivanoglu, EnderAIM: To determine the role of inflammatory cytokines and reactive oxygen species (ROS) in childhood reflux esophagitis. METHODS: A total of 59 subjects who had complaints suggesting GERD underwent esophagogastroduoden oscopy. Endoscopic and histopathologic diagnosis of reflux esophagitis was established by Savary-Miller and Vandenplas grading systems, respectively. Esophageal biopsy specimens were taken from the esophagus 20% proximal above the esophagogastric junction for conventional histopathological examination and the measurements of ROS and cytokine levels. ROS were measured by chemiluminescence, whereas IL-8 and MCP-1 levels were determined with quantitative immunometric ELISA on esophageal tissue. Esophageal tissue ROS, IL-8 and MCP-1 levels were compared among groups with and without endoscopic/histopathologic esophagitis. RESULTS: Of 59 patients 28 (47.5%) had normal esophagus whereas 31 (52.5%) had endoscopic esophagitis. In histopathological evaluation, almost 73% of the cases had mild and 6.8% had moderate degree of esophagitis. When ROS and chemokine levels were compared among groups with and without endoscopic esophagitis, statistical difference could not be found between patients with and without esophagitis. Although the levels of ROS, IL-8 and MCP-1 were found to be higher in the group with histopathological reflux esophagitis, this difference was not statistically significant. CONCLUSION: These results suggest that the grade of esophagitis is usually mild or moderate during childhood and factors apart from ROS, IL-8 and MCP-1 may be involved in the pathogenesis of reflux esophagitis in children. (C) 2008 The WJG Press. All rights reserved.Publication Open Access Homozygous IL37 mutation associated with infantile inflammatory bowel disease(NATL ACAD SCIENCES, 2021-03-09) ÖZEN, AHMET OĞUZHAN; Zhang, Zinan Z.; Zhang, Yu; He, Tingyan; Sweeney, Colin L.; Baris, Safa; Karakoc-Aydiner, Elif; Yao, Yikun; Ertem, Deniz; Matthews, Helen F.; Gonzaga-Jauregui, Claudia; Malech, Harry L.; Su, Helen C.; Ozen, Ahmet; Smith, Kenneth G. C.; Lenardo, Michael J.Interleukin (IL)-37, an antiinflammatory IL-1 family cytokine, is a key suppressor of innate immunity. IL-37 signaling requires the heterodimeric IL-18R1 and IL-1R8 receptor, which is abundantly expressed in the gastrointestinal tract. Here we report a 4-mo-old male from a consanguineous family with a homozygous loss-of-function IL37 mutation. The patient presented with persistent diarrhea and was found to have infantile inflammatory bowel disease (I-IBD). Patient cells showed increased intracellular IL-37 expression and increased proinflammatory cytokine production. In cell lines, mutant IL-37 was not stably expressed or properly secreted and was thus unable to functionally suppress proinflammatory cytokine expression. Furthermore, induced pluripotent stem cell-derived macrophages from the patient revealed an activated macrophage phenotype, which is more prone to lipopolysaccharide and IL-1 beta stimulation, resulting in hyperinflammatory tumor necrosis factor production. Insights from this patient will not only shed light on monogenic contributions of I-IBD but may also reveal the significance of the IL-18 and IL-37 axis in colonic homeostasis.Publication Metadata only Thromboembolic complications in children with Crohn's disease(LIPPINCOTT WILLIAMS & WILKINS, 1999) ERTEM ŞAHİNOĞLU, DENİZ; Ertem, D; Ozguven, E; Acar, Y; Alper, G; Pehlivanoglu, EPublication Metadata only Gastric histopathology, iron status and iron deficiency anemia in children with Helicobacter pylori infection(LIPPINCOTT WILLIAMS & WILKINS, 2004) ERTEM ŞAHİNOĞLU, DENİZ; Baysoy, G; Ertem, D; Ademoglu, E; Kotiloglu, E; Keskin, S; Pehlivanoglu, EObjectives: Helicobacter pylori has been established as a major cause of gastritis and peptic ulcer disease in adults and children. H. pylori infection may also have a role in the development of some extragastrointestinal diseases, including iron deficiency anemia. The aim of this study is to investigate H. pylori-related changes in gastric physiology and histology and the relationship of these changes to iron deficiency anemia in children. Methods: Fifty-two patients with gastrointestinal complaints were studied. Hematologic parameters, 3-day vitamin C and iron consumption, serum gastrin levels, and gastric juice ascorbic acid levels were compared in patients with and without H. pylori infection. Dietary intake of vitamin C and iron, serum gastrin, gastric juice ascorbic acid content, and gastric histology were compared in patients with H. pylori infection and anemia and in patients with H pylori infection and no anemia. The CagA status of the H. pylori organisms was evaluated. Results: Twenty-eight of 52 patients had H. pylori. Thirty-one patients had iron deficiency anemia. H. pylori infection was associated with low serum iron levels. H. pylori gastritis was associated with a decrease in the gastric juice ascorbic acid level. Infection with CagA-positive strains was associated with a greater decrease in gastric juice ascorbic acid than infection with CagA-negative strains. However, the gastric juice ascorbic acid levels of patients with H. pylori and anemia were not different from those of non-anemic patients with H. pylori. Among patients with H. pylori infection, pangastritis was twice as common in those with anemia than in those without anemia. Conclusions: H. pylori infection was associated with a decrease in gastric juice ascorbic acid concentration, and this effect was more pronounced in patients with the CagA-positive strain. Pangastritis was more common in patients whose H. pylori.infection was accompanied by anemia.Publication Open Access Korozif-kostik madde maruziyeti nedeniyle başvuran çocuklarda endoskopik bulguların değerlendirilmesi: Retrospektif araştırma(2023-03-01) ŞAHİN AKKELLE, BİLGE; KARAOĞLU, SALİH; TUTAR, ENGİN; ERTEM ŞAHİNOĞLU, DENİZ; ŞAHİN AKKELLE B., Volkan B., Dursun C., Korkmaz B., KARAOĞLU S., TUTAR E., ERTEM ŞAHİNOĞLU D.Objective: Accidental caustic ingestions cause damagecomplications in the gastrointestinal tract. In our study, the characteristics of children who underwent endoscopy due to caustic ingestions were evaluated. Material and Methods: The demographic, clinic, endoscopic data of symptomatic children who underwent endoscopy due to caustic ingestions between 2016-2021 were reviewed. According to Zargar classification, patients with normal or mild findings on endoscopy were defined as Group 1; those with moderate/severe findings on endoscopy were defined as Group 2. The data of the two groups were compared. Results: The mean age of 284 patients included in our study was 42±41 months, and 58.4% of them were male. The most frequently exposed caustic agents were household cleaning chemicals (87.3%). Most of the caustic agents exposed were alkaline (78.9%) and 64.3% were in granule form. Esophageal corrosive damage compatible with at least Grade 2a was found in 26.1% of the patients. Complaints of drooling, dysphagia were more frequent in Group 2 compared to Group 1 (p<0.05). There was a statistically significant difference between the groups in terms of the chemical properties of exposed agents. In the follow-up, esophageal stenosis was detected in 2.8% of the patients and pyloric stenosis was detected in 1 patient. Conclusion: The results of our study showed that drooling and dysphagia symptoms are important in predicting esophageal damage in caustic ingestions, but oropharyngeal examination findings may be misleading. Preventive medicine approaches, inspections and sanctions for corrosive chemicals that are produced, sold, stored improperly are important in preventing these accidents.