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1.
Clin Lab ; 69(1)2023 Jan 01.
Article in English | MEDLINE | ID: mdl-36649519

ABSTRACT

BACKGROUND: Levels of zonulin, a surrogate marker of intestinal permeability, are elevated in various disorders including insulin resistance, obesity, celiac disease, and inflammatory bowel disease. We aimed to elucidate the association of zonulin levels and metabolic syndrome (MS) in renal transplant recipients. METHODS: Seventy-nine renal transplant recipients were enrolled. Diagnosis of MS was established employing the Adult Treatment Panel III (ATP III) criteria. Serum zonulin level was determined using the double antibody sandwich ELISA method. RESULTS: MS was encountered in 37 (41.6%) of the 79 patients. Serum zonulin level was significantly higher in patients with MS compared to those without MS (p < 0.001). Serum zonulin level correlated with presence of MS (r: 739, p < 0.001), abdominal obesity (r: 514, p < 0.001), fasting glucose level (r: 361, p: 0.001), presence of fasting glucose/diabetes criterion of MS (r: 316, p: 0.005), presence of low HDL criterion of MS (r: 266, p: 0.018), and BMI (r: 527, p < 0.001). CONCLUSIONS: A Zonulin-mediated increase in intestinal permeability may play a role in the pathogenesis of metabolic syndrome. We propose that zonulin may be a suitable surrogate marker of MS in renal transplant recipients.


Subject(s)
Kidney Transplantation , Metabolic Syndrome , Adult , Humans , Metabolic Syndrome/diagnosis , Kidney Transplantation/adverse effects , Obesity , Haptoglobins , Glucose , Biomarkers , Permeability
2.
Arch Med Sci ; 14(4): 781-787, 2018 Jun.
Article in English | MEDLINE | ID: mdl-30002695

ABSTRACT

INTRODUCTION: The aim of the current study was to examine the difference between patients detected with nonalcoholic fatty liver disease (NAFLD) and healthy subjects in terms of serum angiopoietin-like protein (ANGPTL) 2 and ANGPTL6 levels and to evaluate the correlation between ANGPTL2 and ANGPTL6 levels and liver enzyme levels, fasting glucose, lipid levels, and steatosis degree on ultrasonography (USG). MATERIAL AND METHODS: A total of 159 participants were included in the study. The participants were divided into 3 groups depending on the steatosis degree on USG and serum alanine aminotransferase (ALT) levels: the NAFLD group with increased ALT, the NAFLD group with normal ALT, and the healthy control group. The groups were compared in terms of biochemical and ultrasonographic findings, insulin resistance, metabolic syndrome (MetS), and anthropometric parameters. RESULTS: There was no significant difference between NAFLD patients and healthy subjects with respect to serum ANGPTL2 and ANGPTL6 levels (p > 0.05). ANGPTL2 levels did not correlate with serum, biochemical, or ultrasonographic findings, or anthropometric parameters (p > 0.05). A positive correlation was found between serum ANGPTL6 levels and fasting blood glucose, ALT, alkaline phosphatase, γ-glutamyl transpeptidase, fasting insulin, and HOMA-IR levels. CONCLUSIONS: While our findings suggest no relationship between serum ANGPTL2 and ANGPTL6 levels and NAFLD, ANGPTL6 levels may be related to metabolic and biochemical parameters. The effects of ANGPTL2 and ANGPTL6 in the pathogenesis of NAFLD should be investigated further.

3.
Euroasian J Hepatogastroenterol ; 7(2): 158-162, 2017.
Article in English | MEDLINE | ID: mdl-29201800

ABSTRACT

AIM: To compare the effects of propofol/remifentanil and meperidine/midazolam on postprocedure cognitive function. MATERIALS AND METHODS: A total of 100 American Society of Anesthesiologists (ASA) score I to III patients undergoing elective colonoscopy were taken into the study and divided into two groups. Exclusion criteria were patient refusal, mini mental test (MMT) <26, The Amsterdam Preoperative Anxiety and Information Scale (APAIS) >10, advanced cardiopulmonary or psychiatric disease, chronic alcohol abuse, morbid obesity, and known allergy to study drugs. In group MM, 2 mg midazolam and 20 mg meperidine was given intravenously and additional 1 to 2 mg midazolam and 20 mg meperidine (with a maximum total of 5 mg midazolam and 50 mg meperidine) was given when bispectral index (BIS) was >80. In group RP, 100 µg/kg/minute propofol infusion and 1 µg/kg remifentanil bolus was administered and additional 0.5 µg/kg remifentanil bolus was given when BIS was >80. Observer's Assessment of Alertness/Sedation scale (OAA/S) and Facial Pain Score (FPS) values were recorded. Cognitive function was measured by Trieger Dot Test (TDT) and Digit Symbol Substitution Test (DSST). RESULTS: The study was concluded with 100 patients. Heart rate was slower and BIS values were lower in group RP throughout the procedure. Blood pressure was lower in group RP without clinical significance. There was no difference concerning recovery time and visual analog scores (VASs). In group MM, TDT scores were higher and DSST scores were lower. Satisfaction was higher in group RP. CONCLUSION: Propofol/remifentanil combination is better than meperidine/midazolam combination concerning cognitive function in sedation for colonoscopy. CLINICAL SIGNIFICANCE: The addition of BIS monitorization to evaluate the depth of sedation and the negative effects of midazolam meperidine combination on postprocedural cognitive function.How to cite this article: Ekmekci P, Erkan G, Yilmaz H, Kazbek BK, Koksoy UC, Doganay G, Tüzüner F. Effect of Different Sedation Regimes on Cognitive Functions in Colonoscopy. Euroasian J Hepato-Gastroenterol 2017;7(2):158-162.

4.
Turk J Gastroenterol ; 28(6): 453-459, 2017 Nov.
Article in English | MEDLINE | ID: mdl-28928100

ABSTRACT

BACKGROUND/AIMS: To assess the effect of propofol supplemented with alfentanil or fentanyl on cognitive functions for sedation during elective colonoscopy. MATERIALS AND METHODS: Patients (n=150, 18-65 years old, American Society of Anesthesiologists risk group I-III) scheduled undergo elective colonoscopy were included. They were randomized into three groups using the closed envelope methodpropofol-alfentanil (Group A), propofol-fentanyl (Group F), and propofol only (Group P).Group A patients were given an alfentanil (10 mcg/kg)-supplemented propofol bolus infusion and 5 mcg/kg alfentanil when necessary. Group F patients were given fentanyl (1 mcg/kg)-supplemented propofol and 0.5 mcg/kg fentanyl when necessary. Group P patients were given 1 mg/kg propofol and 0.5 mg/kg propofol when necessary. Vital signs, depth of sedation, recovery parameters, and patient and endoscopist satisfaction were recorded. Trieger dot test (TDT) and Digit Symbol Substitution Test (DSST) were performed post procedure. RESULTS: Demographic data were similar among all patients in the groups. Bispectral index values were lower in Group P (p<0.001). DSST scores were higher in Group A (p=0.004). TDT scores and Facial Pain Scale scores were higher in Group P (p<0.005). Apnea incidence (p=0.009) and Observer's Assessment of Alertness/Sedation Scale scores (p=0.002) were also higher in Group P. Patient satisfaction and endoscopist satisfaction were similar among all patients. CONCLUSIONS: Compared with propofol-alfentanil and propofol-fentanyl, propofol alone is associated with an increased incidence of apnea, drug consumption, and reported pain. Propofol-alfentanil has a less negative effect on cognitive functions than propofol alone or propofol-fentanyl.


Subject(s)
Alfentanil/adverse effects , Cognition/drug effects , Conscious Sedation/adverse effects , Fentanyl/adverse effects , Hypnotics and Sedatives/adverse effects , Propofol/adverse effects , Adolescent , Adult , Aged , Alfentanil/administration & dosage , Cognitive Dysfunction/chemically induced , Colonoscopy , Conscious Sedation/methods , Drug Therapy, Combination , Female , Fentanyl/administration & dosage , Humans , Hypnotics and Sedatives/administration & dosage , Male , Middle Aged , Propofol/administration & dosage , Treatment Outcome , Young Adult
5.
J Clin Lab Anal ; 31(5)2017 Sep.
Article in English | MEDLINE | ID: mdl-27925300

ABSTRACT

BACKGROUND: Liver biopsy is recommended in the majority of patients with chronic viral hepatitis for fibrosis evaluation. Because of the potential risks of liver biopsy, many studies related to non-invasive biomarkers of hepatic fibrosis have been performed. We aimed to assess the diagnostic value of serum biglycan as a non-invasive fibrosis marker in chronic hepatitis B patients. METHODS: This study included 120 patients with biopsy-proven hepatitis B patients and 60 healthy controls. Fibrosis stage and necroinflammatory activity were assessed in liver biopsy specimens. Biglycan level was measured using an ELISA assay. RESULTS: Serum biglycan levels of chronic hepatitis B patients were found to be significantly higher than those of healthy controls (337.3±363.0 pg/mL vs 189.1±61.9 pg/mL, respectively, P<.001). There was a statistically significant positive correlation between serum biglycan level and fibrosis stage (P=.004; r=.213). Besides, a statistically significant positive correlation was found between serum biglycan level and necroinflammatory activity (P<.001; r=.271). The AUROC of BGN levels was 0.702 for fibrosis stage, differentiating patients from healthy controls with statistical significance (P<.001). The AUROC of BGN levels was 0.632 for necroinflammatory activity score, differentiating patients from healthy controls with statistical significance (P=.004). CONCLUSIONS: Serum biglycan might be used as a non-invasive marker of liver fibrosis. Further studies are needed to evaluate the usefulness of this marker.


Subject(s)
Biglycan/blood , Biomarkers/blood , Hepatitis B, Chronic/blood , Liver Cirrhosis/blood , Adult , Biopsy , Female , Hepatitis B, Chronic/diagnosis , Hepatitis B, Chronic/epidemiology , Humans , Liver Cirrhosis/diagnosis , Liver Cirrhosis/epidemiology , Male , Middle Aged , Prospective Studies , ROC Curve
6.
Clin Res Hepatol Gastroenterol ; 39(6): 692-8, 2015 Dec.
Article in English | MEDLINE | ID: mdl-25887687

ABSTRACT

BACKGROUND: We aimed to evaluate the hepatic immunoreactivity of angiotensin-converting enzyme 2 (ACE2) in non-alcoholic steatohepatitis (NASH) patients, elucidate its association with the clinicopathological characteristics and also determine its role in fibrosis progression. METHODS: The consecutive biopsy proven NASH patients were subdivided into two groups according to their fibrosis score. Fibrotic stages<3 in mild fibrosis group and fibrotic stages ≥ 3 in advanced fibrosis depending on the presence of bridging fibrosis. Liver biopsy specimens were immunohistochemically stained for ACE2 immunoreactivity. Demographics and clinical properties were compared between the groups. Univariate and multivariate analysis were also performed to evaluate the independent predicting factors for the presence of advanced liver fibrosis caused by NASH. RESULTS: One hundred and eight patients were enrolled in the study. Out of this, ninety-four patients representing 87% were classified as mild fibrosis group, whilst fourteen representing 13% were in advanced fibrosis group. We compared high hepatic immunoreactivity of ACE2 between mild and advanced fibrosis groups and found a statistically significant difference 65.9% vs 28.5%, respectively and P=0.008. Hepatic ACE2 immunoreactivity was inversely correlated with the fibrosis score (r: -0.337; P<0.001). The significant variables in the univariate analysis were then evaluated in multivariate logistic regression analysis and hepatic ACE2 immunoreactivity was an independent predicting factor of liver fibrosis [odds ratio (OR): 0.194; 95% confidence interval (CI): 0.082-0.897, P=0.036]. CONCLUSION: Hepatic immunoreactivity of ACE2 was inversely correlated with the liver fibrosis among biopsy proven NASH patients and it was also an independent predicting factor of advanced fibrosis.


Subject(s)
Liver Cirrhosis/etiology , Non-alcoholic Fatty Liver Disease/complications , Peptidyl-Dipeptidase A/immunology , Adult , Aged , Angiotensin-Converting Enzyme 2 , Female , Humans , Liver Cirrhosis/immunology , Male , Middle Aged , Retrospective Studies , Young Adult
8.
J Dig Dis ; 15(3): 131-6, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24528633

ABSTRACT

OBJECTIVE: To investigate the correlation between advanced oxidation protein products (AOPP) levels and biochemical and histopathological findings in patients with nonalcoholic steatohepatitis (NASH). METHODS: Sixty biopsy-proven NASH patients and 60 individuals with ultrasonographically healthy liver (the control group) were included in the study. AOPP levels were determined in all the participants and liver histopathological examination based on liver biopsy was performed in NASH patients. The NASH activity score (NAS), hepatosteatosis, liver inflammation and fibrosis were evaluated. RESULTS: Serum AOPP level was significantly higher in the NASH group than that in the control group (461.8 ± 201.9 µmol/L vs 191.7 ± 152.5 µmol/L, P < 0.001). The receiver operating characteristic (ROC) curve revealed a sensitivity of 73.3% and a specificity of 88.3% for the diagnosis of NASH with an AOPP cut-off value of 332 µmol/L (the area under ROC curve 0.88, 95% confidence interval 0.82-0.94, P < 0.01). AOPP levels were positively correlated with NAS (r = 0.27, P = 0.035), fibrosis (r = 0.27, P = 0.037) and inflammation (r = 0.34, P = 0.008), but not the grade of steatosis (r = 0.02, P = 0.83) or ballooning (r = 0.02, P = 0.55). CONCLUSIONS: AOPP levels are significantly higher in patients with NASH than in those with ultrasonographically healthy liver. AOPP levels are positively correlated with biochemical and histopathological findings (NAS, liver inflammation and fibrosis), indicating that AOPP may play a role in the development of liver fibrosis and inflammation and may predict liver histopathology in NASH.


Subject(s)
Advanced Oxidation Protein Products/blood , Fatty Liver/blood , Adult , Biomarkers/blood , Biopsy , Case-Control Studies , Fatty Liver/diagnosis , Fatty Liver/diagnostic imaging , Fatty Liver/pathology , Female , Humans , Liver/diagnostic imaging , Liver/pathology , Male , Middle Aged , Non-alcoholic Fatty Liver Disease , Sensitivity and Specificity , Severity of Illness Index , Ultrasonography
9.
Turk J Gastroenterol ; 25 Suppl 1: 63-8, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25910371

ABSTRACT

BACKGROUND/AIMS: Nonalcoholic fatty liver disease is related to obesity, metabolic syndrome, and insulin resistance. Nonalcoholic fatty liver disease and metabolic syndrome may also be encountered in non-obese, non-diabetic individuals, and there are no published data about the prevalence of these conditions in non-obese, non-diabetic Turkish subjects. We aimed to determine the difference between non-obese, non-diabetic nonalcoholic fatty liver disease patients and healthy controls in terms of insulin resistance and metabolic syndrome in Turkish subjects. MATERIALS AND METHODS: Non-obese, non-diabetic individuals (n=219) were enrolled. The cohort was divided into two groups according to presence of steatosis in ultrasonography: nonalcoholic fatty liver disease group (n=143) and healthy control group (n=76). Insulin resistance and metabolic syndrome were analyzed and compared between the two groups. RESULTS: The prevalences of metabolic syndrome (32.2% vs. 5.3%, respectively; p<0.001) and insulin resistance (46.2% vs. 9.2%, respectively; p<0.001) were significantly higher in the nonalcoholic fatty liver disease group. According to multiple logistic regression analysis, age (odds ratio 1.534; p=0.0032), insulin resistance (odds ratio 1.074; p<0.001), and serum ALT levels (odds ratio 1.102; p<0.001) were independently associated with nonalcoholic fatty liver disease. CONCLUSION: Insulin resistance and metabolic syndrome are not rare in non-obese, non-diabetic Turkish subjects with nonalcoholic fatty liver disease. Ultrasonographically detected fatty liver was independently associated with insulin resistance, irrespective of the presence of metabolic syndrome.


Subject(s)
Insulin Resistance , Metabolic Syndrome/blood , Metabolic Syndrome/epidemiology , Non-alcoholic Fatty Liver Disease/blood , Non-alcoholic Fatty Liver Disease/epidemiology , Adult , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Blood Glucose/metabolism , Body Mass Index , Female , Humans , Hypertension/epidemiology , Insulin/blood , Male , Middle Aged , Non-alcoholic Fatty Liver Disease/diagnostic imaging , Pilot Projects , Prevalence , Triglycerides/blood , Turkey/epidemiology , Ultrasonography , Waist Circumference , Waist-Hip Ratio , Young Adult , gamma-Glutamyltransferase/blood
10.
Pathol Res Pract ; 209(11): 727-30, 2013 Nov.
Article in English | MEDLINE | ID: mdl-24054032

ABSTRACT

Estrogens exert a protective effect against hepatic steatosis and fibrosis. Loss of estrogen receptor-alpha (ER-α) in the liver is associated with hepatic steatosis and inflammation in animal models. We conducted a study in order to investigate the presence and extent of ER-α expression in HCV infection, and its relationship with histological and biochemical findings. Ninety biopsy-proven chronic hepatitis C (CHC) patients were enrolled in the study. Liver biopsy specimens were immunohistochemically stained for ER-α expression. Nuclear ER-α expression percentage was calculated. ER-α was positive in 69 of the patients (76%). ER-α positive and negative groups were not significantly different in terms of age, gender, necroinflammatory activity, fibrosis, steatosis, serum levels of AST, ALT, ALP, GGT, and bilirubin. ER-α expression percentage was not correlated with fibrosis, steatosis, necroinflammatory activity and biochemical findings. Although estrogens are known to be protective against fibrosis and steatosis in animal models, we did not find any significant correlation between ER-α expression and histopathological and biochemical findings in CHC patients. These findings should be verified in further large scale studies.


Subject(s)
Estrogen Receptor alpha/analysis , Hepatitis C, Chronic/metabolism , Liver/chemistry , Adult , Aged , Biomarkers/blood , Biopsy , Female , Hepatitis C, Chronic/blood , Hepatitis C, Chronic/pathology , Humans , Immunohistochemistry , Liver/pathology , Male , Middle Aged
11.
Hepatogastroenterology ; 60(125): 1095-100, 2013.
Article in English | MEDLINE | ID: mdl-23803374

ABSTRACT

BACKGROUND/AIMS: Simple, reproducible and non-invasive tests that can be used to determine the severity of non-alcoholic steatohepatitis (NASH) are needed. Liver-type fatty acid binding protein (L-FABP) plays a key role in the fatty acid metabolism of the liver. We aimed to determine whether serum L-FABP levels in patients with NASH were different from those in healthy controls, and if so, whether this was associated with the degree of fibrosis, steatosis and inflammatory activity. METHODOLOGY: Forty-seven patients with histologically confirmed NASH and 41 healthy controls were included in the study. Serum L-FABP levels were measured in all participants. RESULTS: Mean L-FABP levels were significantly higher in patients with NASH compared to the control group (2703.19±1603.47 vs. 1684.58±860.19, p<0.001). Serum L-FABP levels showed a significant positive correlation with NAS score (p=0.03, r=0.312), the degree of fibrosis (p=0.02, r=0.324) and inflammation (p=0.03, r=0.312), BMI (p=0.05, r=0.303), serum ALT (p=0.01, r=0.28), AST (p=0.04, r=0.315), and triglyceride levels (p=0.03, r=0.328). CONCLUSIONS: Serum L-FABP levels are elevated in NASH and this elevation is positively correlated with the degree of fibrosis and inflammation. L-FABP levels may aid as a non-invasive marker in determining the severity of fibrosis and inflammation in patients with NASH.


Subject(s)
Fatty Acid-Binding Proteins/blood , Fatty Liver/blood , Fatty Liver/pathology , Liver/pathology , Adult , Aged , Female , Humans , Male , Middle Aged , Non-alcoholic Fatty Liver Disease , Severity of Illness Index
12.
Pathol Res Pract ; 209(7): 429-32, 2013 Jul.
Article in English | MEDLINE | ID: mdl-23707549

ABSTRACT

Loss of estrogen receptor-alpha (ER-α) in the liver is associated with hepatic steatosis and inflammation. We conducted a study in order to investigate the presence and extent of ER-α expression in NASH, and its relationship with histological findings. Fifty-four patients with histologically confirmed NASH, 12 patients with simple steatosis (SS), and 6 patients with normal liver tissue (NLT) were included. NASH activity score and fibrosis score were calculated according to biopsy findings. Liver biopsy specimens were immunohistochemically stained for ER-α expression. Nuclear ER-α expression percentage (staining index) was calculated. Mean staining index was significantly different across the NASH, SS, and NLT groups (6.3±9.9 vs. 22.1±26.4 vs. 44.2±24.8, respectively, p<0.001 for all comparisons). Staining index was significantly higher in women than in men (19.4±22.2 vs. 7.9±15.3, respectively, p=0.003). Staining index negatively correlated with serum ALT (r=-0.240; p=0.04), fasting plasma glucose (r=-0.261; p=0.027), and fibrosis score (r=-0.312; p=0.011). As a conclusion, hepatic nuclear ER-α expression percentage (staining index) is lower in patients with NASH when compared to SS and NLT groups. Staining index is negatively correlated with serum ALT levels, plasma glucose, and fibrosis score. Further studies are required to clarify the significance of ER-α expression in NASH.


Subject(s)
Estrogen Receptor alpha/analysis , Fatty Liver/metabolism , Liver/chemistry , Adult , Alanine Transaminase/blood , Biomarkers/blood , Biopsy , Blood Glucose/analysis , Case-Control Studies , Cell Nucleus/chemistry , Chi-Square Distribution , Down-Regulation , Fasting/blood , Fatty Liver/pathology , Female , Humans , Immunohistochemistry , Liver/pathology , Liver Cirrhosis/metabolism , Liver Cirrhosis/pathology , Male , Middle Aged , Non-alcoholic Fatty Liver Disease , Predictive Value of Tests , Severity of Illness Index
14.
Turk J Gastroenterol ; 23(5): 478-84, 2012.
Article in English | MEDLINE | ID: mdl-23161322

ABSTRACT

BACKGROUND/AIMS: The risk of gastric cancer is increased in patients with intestinal metaplasia. Cyclooxygenase-2 activity is crucial for gastric cancer cell survival and proliferation. We aimed to assess cyclooxygenase-2 expression in patients with intestinal metaplasia or chronic active gastritis and in patients with or without a family history of gastric cancer, i.e. a first-degree relative with gastric cancer. MATERIALS AND METHODS: One hundred and six patients with histologically proven intestinal metaplasia, chronic active gastritis or normal gastric mucosa were included. Immunohistochemical staining was performed using the immunoperoxidase method. RESULTS: Cyclooxygenase-2 expression was detected in 23.1% of normal gastric mucosa, 70.6% of chronic active gastritis, and 90.5% of intestinal metaplasia patients. Cyclooxygenase-2 expression was significantly higher in intestinal metaplasia than in chronic active gastritis (p=0.018). Cyclooxygenase-2 expression was significantly more severe in the intestinal metaplasia group when compared to the chronic active gastritis group (p=0.017). Severe cyclooxygenase-2 expression (>60% of cells) was more frequent in the intestinal metaplasia group. Cyclooxygenase-2 expression was higher in the Helicobacter pylori-positive group when compared to the Helicobacter pylori-negative group (80.3% vs 57.1%, respectively; p=0.012). Cyclooxygenase-2 expression did not significantly differ according to presence of a first-degree relative with gastric cancer. CONCLUSIONS: Patients with intestinal metaplasia demonstrated increased presence and severity of cyclooxygenase-2 expression. Our findings suggest that cyclooxygenase-2 plays an important role in the stepwise process that eventually leads to gastric cancer. There was no statistically significant difference between the patients with and without a first-degree relative with a history of gastric cancer in terms of cyclooxygenase-2 expression.


Subject(s)
Cyclooxygenase 2/biosynthesis , Gastric Mucosa/metabolism , Gastritis/enzymology , Immunohistochemistry/methods , Precancerous Conditions/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Biopsy , Chronic Disease , Endoscopy, Gastrointestinal , Female , Gastric Mucosa/pathology , Gastritis/pathology , Humans , Male , Metaplasia , Middle Aged , Precancerous Conditions/enzymology , Prognosis , Risk Factors , Severity of Illness Index , Young Adult
15.
Kulak Burun Bogaz Ihtis Derg ; 22(1): 6-11, 2012.
Article in English | MEDLINE | ID: mdl-22339562

ABSTRACT

OBJECTIVES: This study aims to investigate the possible correlations between the heterotopic gastric mucosa (HGM) islets in the cervical esophagus and laryngopharyngeal reflux (LPR). PATIENTS AND METHODS: Between May 2010 and April 2011, 45 patients (36 females, 9 males; mean age 39.8±14.1 years; range 18 to 72 years) who had reflux symptom index (RSI) >10 and reflux finding score (RFS) >7 were included. The study group consisted of 21 patients who were diagnosed with HGM islets in the cervical esophagus, while control group consisted of 24 patients without any HGM islets assessed by upper gastrointestinal system endoscopy. Esophagus manometric examination and dual-channel 24-hour pH monitoring were performed on all patients. RESULTS: Pretreatment mean RSI and RFS were 25.6±3.5 and 15.1±3.4 in group 1, while it was found to be 21.1±4.4 and 11.9±2.6 in group 2 (p=0.001, p=0.001). A total of 29.7% of patients who underwent pH monitoring had distal reflux, whereas 43.2% of them had proximal reflux. In group 1, distal reflux was observed in 15.4% and proximal reflux was found in 54% of the patients, while distal reflux was observed in 38% and proximal reflux was found in 38% of the patients in group 2 (p=0.152; p=0.27). Fourteen patients diagnosed with HGM had antral- and seven patients had fundal-type epithelium. CONCLUSION: Our study results suggest that HGM islets may be considered as an etiological factor in the patients with severe LPR with isolated proximal reflux based on the 24-hour pH monitoring.


Subject(s)
Choristoma/physiopathology , Esophageal Diseases/physiopathology , Esophageal Sphincter, Upper , Gastric Mucosa , Laryngopharyngeal Reflux/physiopathology , Adolescent , Adult , Aged , Choristoma/complications , Esophageal Diseases/complications , Esophageal pH Monitoring , Female , Humans , Laryngopharyngeal Reflux/etiology , Male , Middle Aged , Monitoring, Physiologic , Severity of Illness Index , Young Adult
16.
Pathol Res Pract ; 208(2): 89-93, 2012 Feb 15.
Article in English | MEDLINE | ID: mdl-22277792

ABSTRACT

The primary aim is to compare individuals with intestinal metaplasia (IM), chronic active gastritis (CAG), and normal gastric mucosa (NGM) in terms of apoptosis, proliferation, and Bcl-2 expression. The secondary aim is to determine whether these parameters are different between patients with and without gastric cancer in first-degree relatives. We enrolled 106 patients whose histopathological results were consistent with IM (n: 42), CAG (n: 51), or NGM (n: 13). Antral biopsies were immunohistochemically stained for Bcl-2 and Ki-67 expression. Apoptosis was detected using TUNEL assay. While no significant difference was determined between three groups with regard to apoptosis and Bcl-2 expression (p>0.05), Ki-67 expression was significantly higher in the IM group when compared with the CAG and NGM groups (29.90±22.87 vs. 18.18±16.22 vs. 18.54±20, respectively; p=0.012). Helicobacter pylori was determined to increase apoptosis (49.3% vs. 25.7%, p<0.05), nevertheless, it had no significant effect on proliferation and Bcl-2 expression. Bcl-2 and Ki-67 expression and apoptosis were not different among patients with and without a history of gastric cancer in first degree relatives. Although intestinal metaplasia cases demonstrate an increase in proliferation, no elevation is observed in apoptosis. This can be an important factor in the progression to gastric cancer.


Subject(s)
Apoptosis , Cell Proliferation , Gastric Mucosa , Gastritis , Ki-67 Antigen/analysis , Precancerous Conditions , Proto-Oncogene Proteins c-bcl-2/analysis , Stomach Neoplasms , Adolescent , Adult , Aged , Aged, 80 and over , Analysis of Variance , Biopsy , Case-Control Studies , Chi-Square Distribution , Chronic Disease , Disease Progression , Female , Gastric Mucosa/chemistry , Gastric Mucosa/microbiology , Gastric Mucosa/pathology , Gastritis/metabolism , Gastritis/microbiology , Gastritis/pathology , Helicobacter pylori/isolation & purification , Heredity , Humans , Immunohistochemistry , In Situ Nick-End Labeling , Male , Metaplasia , Middle Aged , Pedigree , Precancerous Conditions/chemistry , Precancerous Conditions/microbiology , Precancerous Conditions/pathology , Stomach Neoplasms/chemistry , Stomach Neoplasms/genetics , Stomach Neoplasms/microbiology , Stomach Neoplasms/pathology , Turkey , Young Adult
17.
Turk J Gastroenterol ; 23(6): 773-5, 2012.
Article in English | MEDLINE | ID: mdl-23864453

ABSTRACT

The aging population has resulted in an increasing need for long-term enteral nutrition of patients with a wide range of disabling conditions. Percutaneous endoscopic gastrostomy is one of the applicable methods for long-term enteral nutrition support. The buried bumper syndrome is a rarely encountered but grave complication of percutaneous endoscopic gastrostomy. Various internal and external methods have been described for the removal of the buried bumper. Removing the percutaneous endoscopic gastrostomy tube by external traction without an abdominal incision can resolve this problem efficiently, especially in cases in whom retrieval-type percutaneous endoscopic gastrostomy tubes have been used. We report a case of buried bumper syndrome as a late complication of percutaneous endoscopic gastrostomy placement. We removed the buried bumper with external traction and placed a new percutaneous endoscopic gastrostomy tube in a different site because of the peristomal infection.


Subject(s)
Device Removal , Enteral Nutrition/adverse effects , Enteral Nutrition/instrumentation , Foreign-Body Migration/etiology , Gastrostomy/adverse effects , Gastrostomy/instrumentation , Aged , Female , Foreign-Body Migration/therapy , Humans , Ischemia/etiology , Ischemia/therapy , Syndrome
18.
ISRN Gastroenterol ; 2011: 481980, 2011.
Article in English | MEDLINE | ID: mdl-21991512

ABSTRACT

A 24-year-old pregnant patient was referred to us because of pain and tenderness in the right upper quadrant. Her liver enzymes and bilirubin levels were elevated; an abdominal ultrasound examination revealed gallstones within the gallbladder. Diagnosis of biliary pancreatitis was established based on elevated amylase levels. Oral intake was withheld; intravenous antibiotic therapy and total parenteral nutrition were administered. An endoscopic sphincterotomy without the use of fluoroscopy was performed. Abdominal pain and elevated serum amylase levels subsided after this procedure. In our case, biliary pancreatitis, which developed during pregnancy, responded well to the endoscopic sphincterotomy, and this procedure obviated the need for surgical intervention and prevented the recurrence of pancreatitis.

19.
Case Rep Med ; 2011: 685273, 2011.
Article in English | MEDLINE | ID: mdl-21912555

ABSTRACT

Lymphomas are solid tumors that arise from lymphoid tissue and present themselves as Hodgkin's or non-Hodgkin's lymphoma. Particularly gastrointestinal lymphomas can be clinically confused with other gastrointestinal tumors as well as with diffuse and inflammatory bowel disease. Early diagnosis and treatment bear vital importance in the management of lymphomas due to their high proliferation rates. In this report, we are presenting a case which initially displayed clinical and radiological signs of Crohn's disease, but was eventually diagnosed as Burkitt's lymphoma by laparotomy, and also we aim to underscore the importance of differential diagnosis.

20.
J Thyroid Res ; 2011: 654304, 2011.
Article in English | MEDLINE | ID: mdl-21860776

ABSTRACT

Background. Subclinical hypothyroidism (SH) predominantly affects women. The necessity of treatment in SH is controversial. Objective. We aimed to investigate the response of diastolic dysfunction to thyroid hormone replacement therapy (THRT) in women. Methods and Results. Twenty-two female subjects with SH and 20 euthyroid female controls were enrolled. Baseline and follow-up biochemical, hormonal, and echocardiographic evaluations were performed. Repeat echocardiograms were performed three months after the achievement of a euthyroid status with THRT. Mean baseline myocardial performance index (MPI) was 0.27 ± 0.08 in the SH group, and 0.22 ± 0.06 in the control group (P = 0.03). MPI did not change significantly after THRT. Pulsed-wave Doppler findings were not different among the groups. However, tissue Doppler-derived mitral annular E' velocities were significantly lower in the SH group. A moderate but significant improvement was observed in E' velocities after THRT (13.2 ± 3.87 versus 14.53 ± 2.75, P = 0.04). We also observed left ventricular concentric remodeling in SH patients which was reversible with THRT. Conclusions. Tissue Doppler echocardiography may be a useful tool for monitoring the response of diastolic dysfunction to thyroid hormone replacement therapy in patients with SH. Our findings suggest that THRT may reverse diastolic dysfunction in women with SH.

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