Deniz Koc - Academia.edu (original) (raw)
Papers by Deniz Koc
Turkiye Klinikleri Tip Bilimleri Dergisi, 2005
Amaç: Çalışmamızda, endoskopik tetkikleri sonucu kronik aktif gastrit veya duodenal ülser tanısı ... more Amaç: Çalışmamızda, endoskopik tetkikleri sonucu kronik aktif gastrit veya duodenal ülser tanısı alan hastalarda mukoza altında yer alan lenfoid doku “Mucosa Associated Lymphoid Tissue (MALT)” prevalansını tespit etmek, Helicobacter pylori (Hp) yoğunluğu ve klinik tanılarla MALT ilişkisini araştırmak amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya, Haziran-Kasım 1999 tarihleri arasında Taksim Eğitim ve Araştırma Hastanesi’nde üst gastrointestinal sistem endoskopisi yapılarak duodenal ülser veya kronik aktif gastrit tanısı konulan ve mide mukoza biyopsilerinde Hp tespit edilen 77 hasta alındı. Hp eradikasyon tedavisi ya da antibiyotik tedavisi almış olanlar, mide cerrahisi geçirmiş olanlar, sistemik hastalığı ya da malignitesi olanlar çalışma dışı bırakıldı. Antrum ve korpustan alınan 3’er adet biyopsi materyali hemotoksilen eozin ve modifiye Giemsa ile boyanarak 2 patolog tarafından incelendi.
Journal of Surgery and Medicine, 2021
How to cite: Koç DÖ, Gökden Y. Retrospective analysis of the use of 22-gauge and 25-gauge needles... more How to cite: Koç DÖ, Gökden Y. Retrospective analysis of the use of 22-gauge and 25-gauge needles for EUS-guided fine needle aspiration of solid lesions.
Appendectomy and tonsillectomy remain controversial environmental factors in the etiology of infl... more Appendectomy and tonsillectomy remain controversial environmental factors in the etiology of inflammatory bowel disease (IBD). In this study, we aimed to investigate the frequency of tonsillectomy and appendectomy in patients with IBD. In addition, the effects of tonsillectomy and appendectomy on age of IBD diagnosis, site of intestinal involvement, and medical treatments were investigated. Methods: A total of 131 IBD patients and 76 healthy controls (HCs) were included in this study. All of these patients included in this study were asked if they had undergone an appendectomy or tonsillectomy and their age at the time of the surgery. The age of diagnosis of IBD, medical treatment, disease location, and perianal involvement characteristics of the patients collected from the hospital records were evaluated. Results: Of 90 patients with ulcerative colitis (UC), 2 patients underwent appendectomy after the age of 20 and after the diagnosis of UC. Compared with HCs, appendectomy and the age during operation were not associated with the incidence of UC. Moreover, 8 of 41 patients with Crohn's disease (CD) had undergone appendectomy. Of these, 6 patients had undergone surgery before the age of 20 and before the diagnosis of CD. Compared with HCs, appendectomy and the operative age were significantly associated with the incidence of CD. No significant relationship was observed between the groups in terms of tonsillectomy. Conclusion: Appendectomy was associated with an increased risk of developing CD; however, no effect was observed on the risk of developing UC. Moreover, tonsillectomy was not associated with an increased risk of incidence of both CD and UC.
Background and Aims: Gastroesophageal reflux disease and obesity are increasingly important healt... more Background and Aims: Gastroesophageal reflux disease and obesity are increasingly important health problems. The literature on the relationship between gastroesophageal reflux disease and obesity is conflicting. The most objective method of defining gastroesophageal reflux disease is 24-hour esophageal pH monitoring, which has a high specificity. We planned this retrospective study to investigate if there is a relationship between body mass index (BMI) and pH monitoring data in patients with gastroesophageal reflux disease. Materials and Methods: Data of 207 patients who underwent 24-hour esophageal pH monitoring were analyzed. The demographic characteristics and pH monitoring records were evaluated. The correlation between body mass index and 24-hour esophageal pH monitoring parameters was investigated. The World Health Organization categories of body mass index were used to group the patients. The esophageal 24-hour pH monitoring parameters were compared between body mass index gr...
Cureus, 2021
Background and objective Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy... more Background and objective Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disease. G-proteincoupled bile acid receptor 1 (TGR5) agonists might be beneficial in ICP treatment. In this study, we aimed to investigate the relationship of serum TGR5 levels with ICP and associated itching. Methods Sixty-three pregnant women diagnosed with ICP based on a serum bile acid level of >10 µmol/L (patient group) and 47 healthy pregnant women as a control group were included in the study. In the patient group, ursodeoxycholic acid (UDCA) therapy was given at a dose of 15 mg/kg from the time of diagnosis until the termination of pregnancy. Serum transaminase levels were measured at the beginning and within 15 days after the onset of treatment, and the dose was increased in patients who were unresponsive to treatment. Results Bile acid level was found to be between 10-39 µmol/L in 61.9% of the ICP patients, and it was ≥40 µmol/L in 38.1% of the patients. The majority of the patients responded well to the treatment with UDCA. The mean TGR5 level was significantly higher in the patient group compared to the control group (0.98 ±0.95 ng/mL vs. 0.74 ±0.23 ng/mL, p=0.032). In the patient group, TGR5 level showed negative correlations with age and red cell distribution width and a positive correlation with lactate dehydrogenase level and lymphocyte count. Conclusions Based on our findings, it can be suggested that TGR5 may have a role in the pathogenesis but has no impact on the prognosis of the condition.
Journal of Academic Research in Medicine, 2020
Objective: We aimed to determine whether red cell distribution width (RDW) is useful in evaluatin... more Objective: We aimed to determine whether red cell distribution width (RDW) is useful in evaluating the activity and remission periods of inflammatory bowel disease (IBD). Methods: One hundred thirty-two IBD patients, consisting of 98 ulcerative colitis (UC) patients and 34 Crohn's patients, were included in this retrospective study. Serum C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), leukocyte and platelet counts and hemoglobin (Hb) concentrations were evaluated separately during disease activity and remission periods. Disease activity for UC and Crohn's disease was determined by Mayo score and Crohn's Disease Activity Index (CDAI), respectively. Results: The median age (interquartile range) was 37.5 (29-50) and the duration of the disease was 29.4±44.3 months in the patients included in the study. RDW, ESR, CRP values, leukocyte and thrombocyte counts were significantly active periods compared to remission periods (p<0.01), while Hb concentration was significantly lower (p<0.001). ESR, CRP, and platelet levels were significantly associated with Mayo score in UC patients and CDAI severity in Crohn's patients (p<0.05). No association was observed between RDW and disease severity according to IBD activity scores. RDW, ESR, Amaç: İnflamatuar barsak hastalığının (IBH) aktivite ve remisyon dönemlerinin değerlendirilmesinde, kırmızı hücre dağılım genişliğinin (RDW) faydalı olup olmadığını belirlemeyi amaçladık. Yöntemler: Bu retrospektif çalışmaya 98 ülseratif kolit (ÜK) ve 34 Crohn hastasından oluşan 132 İBH hastası dahil edildi. Hastaların serum C-reaktif protein (CRP) seviyesi, eritrosit sedimentasyon hızı (ESR), lökosit ve trombosit sayıları ve hemoglobin (Hb) konsantrasyonları, hastalık aktivite ve remisyon dönemlerinde ayrı ayrı değerlendirildi. ÜK ve Crohn hastalığı için hastalık aktivitesi sırasıyla Mayo skoru ve Crohn Hastalığı Aktivite İndeksi (CDAİ) ile belirlendi. Bulgular: Çalışmaya dahil edilen hastalarda medyan yaş (çeyrekler arası aralık) 37,5 (29-50), hastalık süresi 29,4±44,3 ay olarak saptanmıştır. Hastaların RDW, ESR, CRP değerleri, lökosit ve trombosit sayıları remisyon dönemleri ile karşılaştırıldığında, aktif dönemlerinde anlamlı olarak yüksekken (p<0,01), Hb konsantrasyonu anlamlı düşüktü (p<0,001). ÜK hastalarında Mayo skoru ve Crohn hastalarında CDAİ şiddeti ile ESR, CRP ve trombosit seviyeleri arasındaki ilişki anlamlıydı (p<0,05). RDW ile İBH aktivite skorlarına göre hastalık şiddeti arasında ilişki gözlenmedi. Anemisi olan ÜK (%36,7) ve Crohn (%41,2) hastalarının aktif dönemlerinde RDW, ESR, CRP değerleri ve trombosit sayıları, anemisi olmayanlara göre anlamlı olarak yüksek bulunmuştur (p<0,01). Sonuç: RDW, İBH hastalarında aktivitenin ve remisyonun bir göstergesi olarak kullanılabilir. RDW, hastalık aktivitesinin takibinde, nüksü öngörmede ve tedavi takibinde kolay ve ucuz bir araç olarak yararlı bir ek belirteç olabilir.
Pteridines, 2020
Chronic Hepatitis B virus (HBV) is still one of the major reasons for liver related mortality and... more Chronic Hepatitis B virus (HBV) is still one of the major reasons for liver related mortality and morbidity all around the world. This study aimed to investigate the possible relationship between the immune system activation and presence, as well as progression, of hepatitis B infection by monitoring the tryptophan degradation and serum neopterin levels in patients with HBV. 110 patients with HBV and 23 healthy subjects were included in the study. The patients had significantly higher neopterin levels and increased kynurenine to tryptophan ratios, which were most probably due to enhanced indoleamine 2,3-dioxygenase (IDO) activity compared to healthy control. A strong positive correlation was found between neopterin levels and IDO activity in patient group. Neopterin levels and IDO activity were markedly increased in patients with histological activity index (HAI) ≥4 compared to HAI<4, and a significant correlation was found between neopterin and HAI. Moreover, there was a signifi...
Journal of Surgery and Medicine, 2020
Journal of Gastrointestinal & Digestive System, 2017
Goals: To present retrospective data on esophagogastroduodenoscopy (EGD) findings of patients who... more Goals: To present retrospective data on esophagogastroduodenoscopy (EGD) findings of patients who were admitted to a training and research hospital due to upper gastrointestinal system problems. Background: EGD is an interventional method used for diagnosing diseases of the esophagus, stomach, and duodenum. EGD is essential in the diagnosis of various benign and malign upper gastrointestinal diseases, as well as for therapy or disease follow-up. Study: This study evaluated retrospective data of 5014 patients with upper gastrointestinal problems who were admitted to General Surgery and Family Medicine Departments and Emergency Service of Taksim Training and Research Hospital and were referred for EGD in the Endoscopy Department between the years 2002 and 2009. Results: Among 5014 patients, EGD could be performed in 4950 (2820 females) with a mean age of 47.7 ± 16.2 years (range, 31.5-63.9 years). The number of patients undergoing EGD was higher in 2007 and 2008 than the other years. The most common diagnosis was gastric diseases (92.1%). Only 3.3% of all patients had normal EGD findings. Gastritis, hiatal insufficiency, and duodenitis were the most common diseases in the study population (84.3%, 24.4%, and 10.6% respectively). Esophageal, gastric, and duodenal diseases were most commonly observed in the years 2007 and 2008 in the whole study population. Conclusion: Our study revealed that gastric diseases were the most commonly observed diseases in the patients undergoing EGD. Endoscopy is a safe and reliable procedure that is essential for the diagnosis, treatment and follow-up of upper gastrointestinal diseases.
Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, 2019
Amaç: Otoimmun hepatit karaciğerde histopatolojik olarak periportal hepatitle giden serumda hiper... more Amaç: Otoimmun hepatit karaciğerde histopatolojik olarak periportal hepatitle giden serumda hipergammaglobulinemi ve otoantikor pozitifliğinin eşlik ettiği karaciğer inflamasyonudur. Anti-oksidan ve anti-fibrotik özelliklere sahip olan vitamin E’nin inflamasyonu ve karaciğer fibrozisi baskılamada etkili olduğunu bidiren çalışmalar yayınlanmıştır. Bu çalışmanın amacı, otoimmün karaciğer hastalığı tespit edilmiş ve fibrozis oluşumu karaciğer biyopsi örnekleri ile belirlenmiş olgularda vitamin E düzeyini tespit etmek ve vitamin E düzeyleri ile fibrozis arasındaki ilişkiyi ortaya koymaktır.Gereç ve Yöntem: Yaşları 19-75 arasında olan 63 vaka kontrollü prospektif metot ile incelendi. Karaciğer fibrozis dereceleri histopatoloji ile belirlenmiş olan 33 otoimmün hepatit hastası ve karaciğer hastalığı olmayan karaciğer biyopsisi yapılmamış 30 sağlıklı bireyin serumları toplandı ve bu serumlarda vitamin E düzeyleri ticari bir vitamin E ELISA kiti ile tespit edildi.Bulgular: Bu çalışma, 27 kad...
The Turkish Journal of Gastroenterology, 2018
Background/Aims: Glycoprotein 2 (GP2), the major autoantigen of Crohn's disease (CD)-specific pan... more Background/Aims: Glycoprotein 2 (GP2), the major autoantigen of Crohn's disease (CD)-specific pancreatic autoantibodies, is reportedly correlated with several characteristics of CD. We investigated this serological marker in Turkish patients with CD and assessed its utility in combination with anti-Saccharomyces cerevisiae antibodies (ASCAs) for differential diagnosis of CD. Materials and Methods: A total of 60 patients with CD, 62 patients with ulcerative colitis (UC), and 46 healthy controls with a definite diagnosis who were similar in age and sex were enrolled in the study conducted from November 2011 to October 2012. ASCA and anti-GP2 levels were measured using commercially available kits. Results: Anti-GP2 IgA and IgG levels were higher in patients with CD (25%) than in those with UC (5%) and controls (2%). The seroprevalence of anti-GP2 IgA was markedly higher than that of IgG in patients with CD in contrast to previous studies. The specificity and positive predictive value of seropositivity for both ASCA and anti-GP2 were 100%. ASCA IgA seropositivity was correlated with a complicated disease course and a history of surgery. There was no correlation between anti-GP2 seropositivity and disease location, disease behavior, or a history of surgery. Conclusion: The combination of ASCA and anti-GP2 may enable differentiation of CD from UC. As ASCA seropositivity is associated with a more complicated disease course, patients seropositive for ASCA at the initial diagnosis should undergo more intense therapy.
Journal of Gastrointestinal & Digestive System, 2017
Aim: To evaluate patient characteristics by reviewing colonoscopy procedures performed within an ... more Aim: To evaluate patient characteristics by reviewing colonoscopy procedures performed within an 8-year period in the endoscopy centre of a training and research hospital. Methods: Colonoscopy procedures that were performed for various indications between 2002 and 2009 in the endoscopy unit of our hospital were retrospectively evaluated. Of 3035 colonoscopy procedures, 2831 were included in the analysis. In addition to demographic characteristics of the patients, presence and localization of colorectal masses, presence of inflammatory bowel disease, frequency of presence of hemorrhoids, diverticula, polyps, and other diseases, as well as complications were recorded. Results: The mean age of the patients (male, 50.5%) was 54.36 ± 15.05 years (range, 16-93 years). While a pathological finding was determined in 1512 (53.4%) colonoscopy procedures, 1319 (46.6%) colonoscopy procedures were reported as normal. Concerning complications during examinations, perforation was encountered in two patients and major bleeding was not determined in any of the patients. The most common diagnoses were polyps (15.9%) and hemorrhoids (15.9%), followed by colorectal mass (12.9%), diverticula (6.8%), and inflammatory bowel disease (5.6%). Conclusion: The fact that colorectal masses ranked third among the colonoscopic diagnoses suggested that cancer screening programs should be handled nationally.
Turkiye Klinikleri Journal of Medical Sciences, 2005
Amaç: Çalışmamızda, endoskopik tetkikleri sonucu kronik aktif gastrit veya duodenal ülser tanısı ... more Amaç: Çalışmamızda, endoskopik tetkikleri sonucu kronik aktif gastrit veya duodenal ülser tanısı alan hastalarda mukoza altında yer alan lenfoid doku “Mucosa Associated Lymphoid Tissue (MALT)” prevalansını tespit etmek, Helicobacter pylori (Hp) yoğunluğu ve klinik tanılarla MALT ilişkisini araştırmak amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya, Haziran-Kasım 1999 tarihleri arasında Taksim Eğitim ve Araştırma Hastanesi’nde üst gastrointestinal sistem endoskopisi yapılarak duodenal ülser veya kronik aktif gastrit tanısı konulan ve mide mukoza biyopsilerinde Hp tespit edilen 77 hasta alındı. Hp eradikasyon tedavisi ya da antibiyotik tedavisi almış olanlar, mide cerrahisi geçirmiş olanlar, sistemik hastalığı ya da malignitesi olanlar çalışma dışı bırakıldı. Antrum ve korpustan alınan 3’er adet biyopsi materyali hemotoksilen eozin ve modifiye Giemsa ile boyanarak 2 patolog tarafından incelendi.
The Turkish Journal of Gastroenterology, 2013
ABSTRACT
Southern Medical Journal, 2006
A case of an inflammatory pseudotumor of the spleen is presented. A 43-year-old woman was hospita... more A case of an inflammatory pseudotumor of the spleen is presented. A 43-year-old woman was hospitalized for a detailed examination due to pancytopenia, which was diagnosed during an examination related to left upper quadrant abdominal pain. Physical examination revealed a 2 to 3 cm splenomegaly. Reticulocyte count was 4% and erythrocyte sedimentation rate was 55 mm/h. No other important findings were noted, except for an evident increase in myeloid series and megakaryocytes (more evident in erythroid series) on bone marrow aspiration and biopsy. Computed tomography (CT) scan revealed splenomegaly and a centrally located hypodense lesion with a 92 X 86 mm axial diameter in the spleen. With a hematologic malignancy prediagnosis, a splenectomy was performed on the patient because of pancytopenia and splenomegaly. An intrasplenic, centrally located, well-limited, capsulated lesion (9.5 x 11 x 10 cm in diameter) was discovered on macroscopic examination of the material. A cellular infiltration area was seen on microscopic examination. The spleen capsule was mildly fibrotically thickened. The lesion that separated from the spleen tissue consisted of diffusely proliferated fusiform fibroblasts, heterogenous inflammatory cells consisting mainly of plasma cells, lymphocytes, sparse neutrophils and vascular elements. No granuloma or multinuclear giant cells were detected. Pancytopenia improved on follow-up. The patient followed up for two years, is now healthy and has no complaints.
bakirkoytip.org
Akut miyokard infarktüsü geçiren nondiyabetik hastalarda glikoz-insülin-potasyum tedavisinin etki... more Akut miyokard infarktüsü geçiren nondiyabetik hastalarda glikoz-insülin-potasyum tedavisinin etkinli¤i Amaç: Çal›flmam›zda akut miyokard infarktüsü (AM‹) geçiren nondiyabetik hastalarda standart tedavilere ek olarak verdi¤imiz glikoz-insülin-potasyum (G‹K) tedavisinin etkinli¤i araflt›r›ld›. Gereç ve Yöntem: Çal›flmam›za Taksim E¤itim ve Araflt›rma Hastanesi Koroner Yo¤un Bak›m Ünitesi'nde Ocak 2005-Haziran 2005 tarihleri aras›nda AM‹ tan›s› ile takip edilen nondiyabetik 29 hasta al›nd›. Standart tedavilere ek olarak hastalar›n 14'üne G‹K solüsyonu verildi, 15'ine ise verilmedi. ‹ki grup aras›nda kardiyak enzim yükselme h›z› bak›m›ndan fark olup olmad›¤› araflt›r›ld›. Diyabetes mellitus tan›s›, anamnezinde antidiyabetik ilaç kullanmas› veya açl›k kan flekerinin iki kez 126 ve üzerinde olmas› veya tokluk kan flekerinin 200'ün üzerinde ve diyabete ait semptomlar›n olmas› ile konuldu. Miyokard infarktüsü tan›s› klinik de¤erlendirme, elektrokardiyografi ve kardiak enzim yüksekli¤i ile konuldu. Baflvuruda 6, 12 ve 24. saatte kreatin fosfokinaz (CPK), CPK-MB, myoglobin, Troponin I ile C-reaktif protein (CRP) düzeylerine bak›ld›. Lipid profili incelendi. Bulgular: Gruplar aras›nda yafl, vücut a¤›rl›¤›, boy, baflvuru saati ve lipid profili aç›s›ndan fark yoktu. Baflvuru, 6 ve 12. saat CRP düzeyleri iki grup aras›nda istatistiksel aç›ndan anlaml› fark oluflturmazken 24. saat de¤eri G‹K verilen grupta 22.56±12.95 mg/dL iken verilmeyen grupta 78.92±69.4 mg/dL olup p 0.013 bulundu. Dunn's Çoklu Karfl›laflt›rma Testi'ni kullanarak yapt›¤›m›z de¤erlendirmede G‹K verilen grupta Troponin I'n›n 0 ile 6. ve 12. saat de¤erleri aras›nda istatistiksel olarak anlaml› bir fark olmas›na karfl›n (p<0.05 ve p<0.001) G‹K verilmeyen grupta bu fark yoktu (p>0.05). Gelifl ve 24. saat de¤erlerine bak›ld›¤›nda ise her iki grupta da p<0.05 bulundu. Sonuç: G‹K verdi¤imiz grupta miyokardiyal hasar belirteçlerinin bir k›sm›nda düflme oldu¤unu belirledi¤imiz çal›flmam›zda G‹K solüsyonunun diyabetik hastalar kadar nondiyabetik hastalarda da yararl› olabilece¤i kan›s›na vard›k.
Pteridines, 2020
In Coronavirus disease 2019 (COVID-19), it is important to evaluate disease activity and investig... more In Coronavirus disease 2019 (COVID-19), it is important to evaluate disease activity and investigate possible biomarkers. Therefore, in this study, we investigated the relationship between disease activity and serum levels of possible immune activation marker neopterin in patients with COVID-19. The study enrolled 45 patients (23 females, 51.1%) treated for COVID-19. The patients were divided into two groups according to their clinical presentation: those who recovered quickly (Group 1) and those who worsened progressively (Group 2). The neopterin and C-reactive protein levels were high in all patients on admission. In Group 1, neopterin concentrations and serum neopterin/creatinine ratios were significantly higher on admission compared to Day 14 of the disease, whereas in Group 2, levels were significantly higher at Day 14 of the disease than on admission. Neopterin levels at admission were significantly higher in Group 1. The serum neopterin concentrations at admission were marked...
Beyoglu Eye Journal, 2020
which could be a life-threatening disorder. This is a report of a case diagnosed with a rare and ... more which could be a life-threatening disorder. This is a report of a case diagnosed with a rare and potentially fatal disease, chronic intestinal pseudo-obstruction (CIPO), following detection of a vitamin A deficiency in an ophthalmological examination and referral to a gastroenterology clinic.
Turkiye Klinikleri Tip Bilimleri Dergisi, 2005
Amaç: Çalışmamızda, endoskopik tetkikleri sonucu kronik aktif gastrit veya duodenal ülser tanısı ... more Amaç: Çalışmamızda, endoskopik tetkikleri sonucu kronik aktif gastrit veya duodenal ülser tanısı alan hastalarda mukoza altında yer alan lenfoid doku “Mucosa Associated Lymphoid Tissue (MALT)” prevalansını tespit etmek, Helicobacter pylori (Hp) yoğunluğu ve klinik tanılarla MALT ilişkisini araştırmak amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya, Haziran-Kasım 1999 tarihleri arasında Taksim Eğitim ve Araştırma Hastanesi’nde üst gastrointestinal sistem endoskopisi yapılarak duodenal ülser veya kronik aktif gastrit tanısı konulan ve mide mukoza biyopsilerinde Hp tespit edilen 77 hasta alındı. Hp eradikasyon tedavisi ya da antibiyotik tedavisi almış olanlar, mide cerrahisi geçirmiş olanlar, sistemik hastalığı ya da malignitesi olanlar çalışma dışı bırakıldı. Antrum ve korpustan alınan 3’er adet biyopsi materyali hemotoksilen eozin ve modifiye Giemsa ile boyanarak 2 patolog tarafından incelendi.
Journal of Surgery and Medicine, 2021
How to cite: Koç DÖ, Gökden Y. Retrospective analysis of the use of 22-gauge and 25-gauge needles... more How to cite: Koç DÖ, Gökden Y. Retrospective analysis of the use of 22-gauge and 25-gauge needles for EUS-guided fine needle aspiration of solid lesions.
Appendectomy and tonsillectomy remain controversial environmental factors in the etiology of infl... more Appendectomy and tonsillectomy remain controversial environmental factors in the etiology of inflammatory bowel disease (IBD). In this study, we aimed to investigate the frequency of tonsillectomy and appendectomy in patients with IBD. In addition, the effects of tonsillectomy and appendectomy on age of IBD diagnosis, site of intestinal involvement, and medical treatments were investigated. Methods: A total of 131 IBD patients and 76 healthy controls (HCs) were included in this study. All of these patients included in this study were asked if they had undergone an appendectomy or tonsillectomy and their age at the time of the surgery. The age of diagnosis of IBD, medical treatment, disease location, and perianal involvement characteristics of the patients collected from the hospital records were evaluated. Results: Of 90 patients with ulcerative colitis (UC), 2 patients underwent appendectomy after the age of 20 and after the diagnosis of UC. Compared with HCs, appendectomy and the age during operation were not associated with the incidence of UC. Moreover, 8 of 41 patients with Crohn's disease (CD) had undergone appendectomy. Of these, 6 patients had undergone surgery before the age of 20 and before the diagnosis of CD. Compared with HCs, appendectomy and the operative age were significantly associated with the incidence of CD. No significant relationship was observed between the groups in terms of tonsillectomy. Conclusion: Appendectomy was associated with an increased risk of developing CD; however, no effect was observed on the risk of developing UC. Moreover, tonsillectomy was not associated with an increased risk of incidence of both CD and UC.
Background and Aims: Gastroesophageal reflux disease and obesity are increasingly important healt... more Background and Aims: Gastroesophageal reflux disease and obesity are increasingly important health problems. The literature on the relationship between gastroesophageal reflux disease and obesity is conflicting. The most objective method of defining gastroesophageal reflux disease is 24-hour esophageal pH monitoring, which has a high specificity. We planned this retrospective study to investigate if there is a relationship between body mass index (BMI) and pH monitoring data in patients with gastroesophageal reflux disease. Materials and Methods: Data of 207 patients who underwent 24-hour esophageal pH monitoring were analyzed. The demographic characteristics and pH monitoring records were evaluated. The correlation between body mass index and 24-hour esophageal pH monitoring parameters was investigated. The World Health Organization categories of body mass index were used to group the patients. The esophageal 24-hour pH monitoring parameters were compared between body mass index gr...
Cureus, 2021
Background and objective Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy... more Background and objective Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disease. G-proteincoupled bile acid receptor 1 (TGR5) agonists might be beneficial in ICP treatment. In this study, we aimed to investigate the relationship of serum TGR5 levels with ICP and associated itching. Methods Sixty-three pregnant women diagnosed with ICP based on a serum bile acid level of >10 µmol/L (patient group) and 47 healthy pregnant women as a control group were included in the study. In the patient group, ursodeoxycholic acid (UDCA) therapy was given at a dose of 15 mg/kg from the time of diagnosis until the termination of pregnancy. Serum transaminase levels were measured at the beginning and within 15 days after the onset of treatment, and the dose was increased in patients who were unresponsive to treatment. Results Bile acid level was found to be between 10-39 µmol/L in 61.9% of the ICP patients, and it was ≥40 µmol/L in 38.1% of the patients. The majority of the patients responded well to the treatment with UDCA. The mean TGR5 level was significantly higher in the patient group compared to the control group (0.98 ±0.95 ng/mL vs. 0.74 ±0.23 ng/mL, p=0.032). In the patient group, TGR5 level showed negative correlations with age and red cell distribution width and a positive correlation with lactate dehydrogenase level and lymphocyte count. Conclusions Based on our findings, it can be suggested that TGR5 may have a role in the pathogenesis but has no impact on the prognosis of the condition.
Journal of Academic Research in Medicine, 2020
Objective: We aimed to determine whether red cell distribution width (RDW) is useful in evaluatin... more Objective: We aimed to determine whether red cell distribution width (RDW) is useful in evaluating the activity and remission periods of inflammatory bowel disease (IBD). Methods: One hundred thirty-two IBD patients, consisting of 98 ulcerative colitis (UC) patients and 34 Crohn's patients, were included in this retrospective study. Serum C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), leukocyte and platelet counts and hemoglobin (Hb) concentrations were evaluated separately during disease activity and remission periods. Disease activity for UC and Crohn's disease was determined by Mayo score and Crohn's Disease Activity Index (CDAI), respectively. Results: The median age (interquartile range) was 37.5 (29-50) and the duration of the disease was 29.4±44.3 months in the patients included in the study. RDW, ESR, CRP values, leukocyte and thrombocyte counts were significantly active periods compared to remission periods (p<0.01), while Hb concentration was significantly lower (p<0.001). ESR, CRP, and platelet levels were significantly associated with Mayo score in UC patients and CDAI severity in Crohn's patients (p<0.05). No association was observed between RDW and disease severity according to IBD activity scores. RDW, ESR, Amaç: İnflamatuar barsak hastalığının (IBH) aktivite ve remisyon dönemlerinin değerlendirilmesinde, kırmızı hücre dağılım genişliğinin (RDW) faydalı olup olmadığını belirlemeyi amaçladık. Yöntemler: Bu retrospektif çalışmaya 98 ülseratif kolit (ÜK) ve 34 Crohn hastasından oluşan 132 İBH hastası dahil edildi. Hastaların serum C-reaktif protein (CRP) seviyesi, eritrosit sedimentasyon hızı (ESR), lökosit ve trombosit sayıları ve hemoglobin (Hb) konsantrasyonları, hastalık aktivite ve remisyon dönemlerinde ayrı ayrı değerlendirildi. ÜK ve Crohn hastalığı için hastalık aktivitesi sırasıyla Mayo skoru ve Crohn Hastalığı Aktivite İndeksi (CDAİ) ile belirlendi. Bulgular: Çalışmaya dahil edilen hastalarda medyan yaş (çeyrekler arası aralık) 37,5 (29-50), hastalık süresi 29,4±44,3 ay olarak saptanmıştır. Hastaların RDW, ESR, CRP değerleri, lökosit ve trombosit sayıları remisyon dönemleri ile karşılaştırıldığında, aktif dönemlerinde anlamlı olarak yüksekken (p<0,01), Hb konsantrasyonu anlamlı düşüktü (p<0,001). ÜK hastalarında Mayo skoru ve Crohn hastalarında CDAİ şiddeti ile ESR, CRP ve trombosit seviyeleri arasındaki ilişki anlamlıydı (p<0,05). RDW ile İBH aktivite skorlarına göre hastalık şiddeti arasında ilişki gözlenmedi. Anemisi olan ÜK (%36,7) ve Crohn (%41,2) hastalarının aktif dönemlerinde RDW, ESR, CRP değerleri ve trombosit sayıları, anemisi olmayanlara göre anlamlı olarak yüksek bulunmuştur (p<0,01). Sonuç: RDW, İBH hastalarında aktivitenin ve remisyonun bir göstergesi olarak kullanılabilir. RDW, hastalık aktivitesinin takibinde, nüksü öngörmede ve tedavi takibinde kolay ve ucuz bir araç olarak yararlı bir ek belirteç olabilir.
Pteridines, 2020
Chronic Hepatitis B virus (HBV) is still one of the major reasons for liver related mortality and... more Chronic Hepatitis B virus (HBV) is still one of the major reasons for liver related mortality and morbidity all around the world. This study aimed to investigate the possible relationship between the immune system activation and presence, as well as progression, of hepatitis B infection by monitoring the tryptophan degradation and serum neopterin levels in patients with HBV. 110 patients with HBV and 23 healthy subjects were included in the study. The patients had significantly higher neopterin levels and increased kynurenine to tryptophan ratios, which were most probably due to enhanced indoleamine 2,3-dioxygenase (IDO) activity compared to healthy control. A strong positive correlation was found between neopterin levels and IDO activity in patient group. Neopterin levels and IDO activity were markedly increased in patients with histological activity index (HAI) ≥4 compared to HAI<4, and a significant correlation was found between neopterin and HAI. Moreover, there was a signifi...
Journal of Surgery and Medicine, 2020
Journal of Gastrointestinal & Digestive System, 2017
Goals: To present retrospective data on esophagogastroduodenoscopy (EGD) findings of patients who... more Goals: To present retrospective data on esophagogastroduodenoscopy (EGD) findings of patients who were admitted to a training and research hospital due to upper gastrointestinal system problems. Background: EGD is an interventional method used for diagnosing diseases of the esophagus, stomach, and duodenum. EGD is essential in the diagnosis of various benign and malign upper gastrointestinal diseases, as well as for therapy or disease follow-up. Study: This study evaluated retrospective data of 5014 patients with upper gastrointestinal problems who were admitted to General Surgery and Family Medicine Departments and Emergency Service of Taksim Training and Research Hospital and were referred for EGD in the Endoscopy Department between the years 2002 and 2009. Results: Among 5014 patients, EGD could be performed in 4950 (2820 females) with a mean age of 47.7 ± 16.2 years (range, 31.5-63.9 years). The number of patients undergoing EGD was higher in 2007 and 2008 than the other years. The most common diagnosis was gastric diseases (92.1%). Only 3.3% of all patients had normal EGD findings. Gastritis, hiatal insufficiency, and duodenitis were the most common diseases in the study population (84.3%, 24.4%, and 10.6% respectively). Esophageal, gastric, and duodenal diseases were most commonly observed in the years 2007 and 2008 in the whole study population. Conclusion: Our study revealed that gastric diseases were the most commonly observed diseases in the patients undergoing EGD. Endoscopy is a safe and reliable procedure that is essential for the diagnosis, treatment and follow-up of upper gastrointestinal diseases.
Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, 2019
Amaç: Otoimmun hepatit karaciğerde histopatolojik olarak periportal hepatitle giden serumda hiper... more Amaç: Otoimmun hepatit karaciğerde histopatolojik olarak periportal hepatitle giden serumda hipergammaglobulinemi ve otoantikor pozitifliğinin eşlik ettiği karaciğer inflamasyonudur. Anti-oksidan ve anti-fibrotik özelliklere sahip olan vitamin E’nin inflamasyonu ve karaciğer fibrozisi baskılamada etkili olduğunu bidiren çalışmalar yayınlanmıştır. Bu çalışmanın amacı, otoimmün karaciğer hastalığı tespit edilmiş ve fibrozis oluşumu karaciğer biyopsi örnekleri ile belirlenmiş olgularda vitamin E düzeyini tespit etmek ve vitamin E düzeyleri ile fibrozis arasındaki ilişkiyi ortaya koymaktır.Gereç ve Yöntem: Yaşları 19-75 arasında olan 63 vaka kontrollü prospektif metot ile incelendi. Karaciğer fibrozis dereceleri histopatoloji ile belirlenmiş olan 33 otoimmün hepatit hastası ve karaciğer hastalığı olmayan karaciğer biyopsisi yapılmamış 30 sağlıklı bireyin serumları toplandı ve bu serumlarda vitamin E düzeyleri ticari bir vitamin E ELISA kiti ile tespit edildi.Bulgular: Bu çalışma, 27 kad...
The Turkish Journal of Gastroenterology, 2018
Background/Aims: Glycoprotein 2 (GP2), the major autoantigen of Crohn's disease (CD)-specific pan... more Background/Aims: Glycoprotein 2 (GP2), the major autoantigen of Crohn's disease (CD)-specific pancreatic autoantibodies, is reportedly correlated with several characteristics of CD. We investigated this serological marker in Turkish patients with CD and assessed its utility in combination with anti-Saccharomyces cerevisiae antibodies (ASCAs) for differential diagnosis of CD. Materials and Methods: A total of 60 patients with CD, 62 patients with ulcerative colitis (UC), and 46 healthy controls with a definite diagnosis who were similar in age and sex were enrolled in the study conducted from November 2011 to October 2012. ASCA and anti-GP2 levels were measured using commercially available kits. Results: Anti-GP2 IgA and IgG levels were higher in patients with CD (25%) than in those with UC (5%) and controls (2%). The seroprevalence of anti-GP2 IgA was markedly higher than that of IgG in patients with CD in contrast to previous studies. The specificity and positive predictive value of seropositivity for both ASCA and anti-GP2 were 100%. ASCA IgA seropositivity was correlated with a complicated disease course and a history of surgery. There was no correlation between anti-GP2 seropositivity and disease location, disease behavior, or a history of surgery. Conclusion: The combination of ASCA and anti-GP2 may enable differentiation of CD from UC. As ASCA seropositivity is associated with a more complicated disease course, patients seropositive for ASCA at the initial diagnosis should undergo more intense therapy.
Journal of Gastrointestinal & Digestive System, 2017
Aim: To evaluate patient characteristics by reviewing colonoscopy procedures performed within an ... more Aim: To evaluate patient characteristics by reviewing colonoscopy procedures performed within an 8-year period in the endoscopy centre of a training and research hospital. Methods: Colonoscopy procedures that were performed for various indications between 2002 and 2009 in the endoscopy unit of our hospital were retrospectively evaluated. Of 3035 colonoscopy procedures, 2831 were included in the analysis. In addition to demographic characteristics of the patients, presence and localization of colorectal masses, presence of inflammatory bowel disease, frequency of presence of hemorrhoids, diverticula, polyps, and other diseases, as well as complications were recorded. Results: The mean age of the patients (male, 50.5%) was 54.36 ± 15.05 years (range, 16-93 years). While a pathological finding was determined in 1512 (53.4%) colonoscopy procedures, 1319 (46.6%) colonoscopy procedures were reported as normal. Concerning complications during examinations, perforation was encountered in two patients and major bleeding was not determined in any of the patients. The most common diagnoses were polyps (15.9%) and hemorrhoids (15.9%), followed by colorectal mass (12.9%), diverticula (6.8%), and inflammatory bowel disease (5.6%). Conclusion: The fact that colorectal masses ranked third among the colonoscopic diagnoses suggested that cancer screening programs should be handled nationally.
Turkiye Klinikleri Journal of Medical Sciences, 2005
Amaç: Çalışmamızda, endoskopik tetkikleri sonucu kronik aktif gastrit veya duodenal ülser tanısı ... more Amaç: Çalışmamızda, endoskopik tetkikleri sonucu kronik aktif gastrit veya duodenal ülser tanısı alan hastalarda mukoza altında yer alan lenfoid doku “Mucosa Associated Lymphoid Tissue (MALT)” prevalansını tespit etmek, Helicobacter pylori (Hp) yoğunluğu ve klinik tanılarla MALT ilişkisini araştırmak amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya, Haziran-Kasım 1999 tarihleri arasında Taksim Eğitim ve Araştırma Hastanesi’nde üst gastrointestinal sistem endoskopisi yapılarak duodenal ülser veya kronik aktif gastrit tanısı konulan ve mide mukoza biyopsilerinde Hp tespit edilen 77 hasta alındı. Hp eradikasyon tedavisi ya da antibiyotik tedavisi almış olanlar, mide cerrahisi geçirmiş olanlar, sistemik hastalığı ya da malignitesi olanlar çalışma dışı bırakıldı. Antrum ve korpustan alınan 3’er adet biyopsi materyali hemotoksilen eozin ve modifiye Giemsa ile boyanarak 2 patolog tarafından incelendi.
The Turkish Journal of Gastroenterology, 2013
ABSTRACT
Southern Medical Journal, 2006
A case of an inflammatory pseudotumor of the spleen is presented. A 43-year-old woman was hospita... more A case of an inflammatory pseudotumor of the spleen is presented. A 43-year-old woman was hospitalized for a detailed examination due to pancytopenia, which was diagnosed during an examination related to left upper quadrant abdominal pain. Physical examination revealed a 2 to 3 cm splenomegaly. Reticulocyte count was 4% and erythrocyte sedimentation rate was 55 mm/h. No other important findings were noted, except for an evident increase in myeloid series and megakaryocytes (more evident in erythroid series) on bone marrow aspiration and biopsy. Computed tomography (CT) scan revealed splenomegaly and a centrally located hypodense lesion with a 92 X 86 mm axial diameter in the spleen. With a hematologic malignancy prediagnosis, a splenectomy was performed on the patient because of pancytopenia and splenomegaly. An intrasplenic, centrally located, well-limited, capsulated lesion (9.5 x 11 x 10 cm in diameter) was discovered on macroscopic examination of the material. A cellular infiltration area was seen on microscopic examination. The spleen capsule was mildly fibrotically thickened. The lesion that separated from the spleen tissue consisted of diffusely proliferated fusiform fibroblasts, heterogenous inflammatory cells consisting mainly of plasma cells, lymphocytes, sparse neutrophils and vascular elements. No granuloma or multinuclear giant cells were detected. Pancytopenia improved on follow-up. The patient followed up for two years, is now healthy and has no complaints.
bakirkoytip.org
Akut miyokard infarktüsü geçiren nondiyabetik hastalarda glikoz-insülin-potasyum tedavisinin etki... more Akut miyokard infarktüsü geçiren nondiyabetik hastalarda glikoz-insülin-potasyum tedavisinin etkinli¤i Amaç: Çal›flmam›zda akut miyokard infarktüsü (AM‹) geçiren nondiyabetik hastalarda standart tedavilere ek olarak verdi¤imiz glikoz-insülin-potasyum (G‹K) tedavisinin etkinli¤i araflt›r›ld›. Gereç ve Yöntem: Çal›flmam›za Taksim E¤itim ve Araflt›rma Hastanesi Koroner Yo¤un Bak›m Ünitesi'nde Ocak 2005-Haziran 2005 tarihleri aras›nda AM‹ tan›s› ile takip edilen nondiyabetik 29 hasta al›nd›. Standart tedavilere ek olarak hastalar›n 14'üne G‹K solüsyonu verildi, 15'ine ise verilmedi. ‹ki grup aras›nda kardiyak enzim yükselme h›z› bak›m›ndan fark olup olmad›¤› araflt›r›ld›. Diyabetes mellitus tan›s›, anamnezinde antidiyabetik ilaç kullanmas› veya açl›k kan flekerinin iki kez 126 ve üzerinde olmas› veya tokluk kan flekerinin 200'ün üzerinde ve diyabete ait semptomlar›n olmas› ile konuldu. Miyokard infarktüsü tan›s› klinik de¤erlendirme, elektrokardiyografi ve kardiak enzim yüksekli¤i ile konuldu. Baflvuruda 6, 12 ve 24. saatte kreatin fosfokinaz (CPK), CPK-MB, myoglobin, Troponin I ile C-reaktif protein (CRP) düzeylerine bak›ld›. Lipid profili incelendi. Bulgular: Gruplar aras›nda yafl, vücut a¤›rl›¤›, boy, baflvuru saati ve lipid profili aç›s›ndan fark yoktu. Baflvuru, 6 ve 12. saat CRP düzeyleri iki grup aras›nda istatistiksel aç›ndan anlaml› fark oluflturmazken 24. saat de¤eri G‹K verilen grupta 22.56±12.95 mg/dL iken verilmeyen grupta 78.92±69.4 mg/dL olup p 0.013 bulundu. Dunn's Çoklu Karfl›laflt›rma Testi'ni kullanarak yapt›¤›m›z de¤erlendirmede G‹K verilen grupta Troponin I'n›n 0 ile 6. ve 12. saat de¤erleri aras›nda istatistiksel olarak anlaml› bir fark olmas›na karfl›n (p<0.05 ve p<0.001) G‹K verilmeyen grupta bu fark yoktu (p>0.05). Gelifl ve 24. saat de¤erlerine bak›ld›¤›nda ise her iki grupta da p<0.05 bulundu. Sonuç: G‹K verdi¤imiz grupta miyokardiyal hasar belirteçlerinin bir k›sm›nda düflme oldu¤unu belirledi¤imiz çal›flmam›zda G‹K solüsyonunun diyabetik hastalar kadar nondiyabetik hastalarda da yararl› olabilece¤i kan›s›na vard›k.
Pteridines, 2020
In Coronavirus disease 2019 (COVID-19), it is important to evaluate disease activity and investig... more In Coronavirus disease 2019 (COVID-19), it is important to evaluate disease activity and investigate possible biomarkers. Therefore, in this study, we investigated the relationship between disease activity and serum levels of possible immune activation marker neopterin in patients with COVID-19. The study enrolled 45 patients (23 females, 51.1%) treated for COVID-19. The patients were divided into two groups according to their clinical presentation: those who recovered quickly (Group 1) and those who worsened progressively (Group 2). The neopterin and C-reactive protein levels were high in all patients on admission. In Group 1, neopterin concentrations and serum neopterin/creatinine ratios were significantly higher on admission compared to Day 14 of the disease, whereas in Group 2, levels were significantly higher at Day 14 of the disease than on admission. Neopterin levels at admission were significantly higher in Group 1. The serum neopterin concentrations at admission were marked...
Beyoglu Eye Journal, 2020
which could be a life-threatening disorder. This is a report of a case diagnosed with a rare and ... more which could be a life-threatening disorder. This is a report of a case diagnosed with a rare and potentially fatal disease, chronic intestinal pseudo-obstruction (CIPO), following detection of a vitamin A deficiency in an ophthalmological examination and referral to a gastroenterology clinic.