murat kekilli - Academia.edu (original) (raw)

Papers by murat kekilli

Research paper thumbnail of An Unusual Presentation of Celiac Disease: Vertigo

Celiac disease (CD), intolerance to gluten, is characterized by the autoimmune inflammation of th... more Celiac disease (CD), intolerance to gluten, is characterized by the autoimmune inflammation of the small intestine in genetically susceptible individuals. Herein, we will report a case of a patient diagnosed with CD during investigations performed for recurrent vertigo attacks. Clinicians should be aware that CD may also present with vertigo, and especially in patients with recurrent and prolonged vertigo attacks, CD should also be ruled out.

Research paper thumbnail of Endoscopic retrograde cholangiopancreatography-oriented surgery for accomplished treatment of Mirizzi syndrome: a single-center experience

European Journal of Gastroenterology & Hepatology, Feb 27, 2023

Research paper thumbnail of Retrospective Evaluation of Endoscopic Treatment Outcomes in Biliary Leak After Hepatobiliary Surgery: Single Center Experience

Ankara Üniversitesi tıp fakültesi mecmuası, Dec 1, 2018

Biliary leak, after the hepatobiliary tract injuries, is a serious complication and can lead to m... more Biliary leak, after the hepatobiliary tract injuries, is a serious complication and can lead to morbidity and prolonged hospitalization. Endoscopic management has proved to be an effective treatment for the biliary leak. However, the most appropriate endoscopic intervention is still controversial and the long-term follow-up data of patients are limited. The aim of this study is to identify the efficacy of endoscopic treatment methods, to determine the biliary drainage devices and their duration period and to investigate the outcome of treatment in patients with biliary leak after hepatobiliary surgery. Materials and Methods: The Endoscopic Retrograde Cholangiopancreatography (ERCP) procedures were held in Gastroenterology Endoscopy Unit between January 2016 and January 2017 and retrospectively evaluated. Patients were compared with the demographic characteristics, endoscopic treatment method (only sphincterotomy, stent insertion only, sphincterotomy+ stent insertion), biliary stent implantations, how many times ERCP was done, the time of healing bile leak and ERCP related complication. Results: A total of 1037 consecutive patients who underwent ERCP were scanned retrospective. 22 patients with bile leak fulfilled the criteria of study. In 20 patients with bile leakage associated with cholecystectomy, the leak was closed at the 6th week after ERCP procedure + biliary stent. In one of every 2 patients who developed biliary leakage secondary to cyst hydatid operation, the leakage was still persisted 6 weeks later. Therefore, plastic stents were inserted into the biliary system of those patients with two ERCP procedures by the three month intervals and bile leak continued

Research paper thumbnail of Local ocular surface parameters in patients with systemic celiac disease

Eye, Mar 17, 2017

Purpose This was a collaborative study from the Ophthalmology and Gastroenterology departments of... more Purpose This was a collaborative study from the Ophthalmology and Gastroenterology departments of a tertiary care hospital, designed to investigate the local ocular surface parameters in patients with celiac disease (CD). Methods Fifty-six eyes of 28 patients with CD and 58 eyes of 29 healthy adult subjects serving as controls were evaluated. The Schirmer test, tear-film break-up time, and conjunctival impression cytology were performed in addition to a complete ophthalmological examination. Impression cytology specimens of each group were graded and scored in the range 0-3. Results The 28 patients with CD consisted of 24 females (86%) and 4 males (14%). The mean age was 34.4 ± 11.3 years (22-55 years). Tear-film break-up time and Schirmer test results were significantly lower in the study group than in the controls (Po0.05). Also, there was a significant difference between the groups for impression cytology grading scores (P = 0.001). Conclusions The CD group showed a marked preponderance of females with an F/ M ratio of six females per male, as reported in the literature. Tear-film functions and conjunctival surface epithelial morphology were significantly altered in patients with CD.

Research paper thumbnail of The relationship between extended D-dimer elevations and hereditary thrombophilia in COVID-19 patients

Journal of Medicine and Palliative Care

Aim: To compare the D-Dimer levels in patients with mild COVID-19 disease with and without heredi... more Aim: To compare the D-Dimer levels in patients with mild COVID-19 disease with and without hereditary thrombophilia. Material and Method: Factor V Leiden (G1691A) mutation, methylene tetrahydrofolate gene mutation (C677T, A1298C), and PAI-1 (4G-5G) and FXIII (V34L) gene mutations were examined in all patients included in the study for various reasons such as recurrent miscarriage and venous embolism. Patients with any mutation were included in the hereditary thrombophilia group, while patients without mutations were included in the control group. D-dimer levels of the patients were also analyzed for the second time at least 25 days after admission. All included patients had received previously at least two doses of the BioNTech-Pfizer or CoronaVac vaccines. Results: A total of 158 patients, 46 (29.1%) male and 112 (70.9%) female, were included in the study. The mean age of the patients included in the study was 39.08 ± 9.09 years. A total of 121 patients, 33 (27.3%) men and 88 (72.7...

Research paper thumbnail of Social stigmatization in Turkish patients with chronic hepatitis B and C

Gastroenterología y Hepatología (English Edition)

Research paper thumbnail of The effect of lactose intolerance on plasma glucose levels and related biochemical parameters

Journal of Health Sciences and Medicine

Aim: To determine the effect of lactose intolerance on serum glucose levels and related biochemic... more Aim: To determine the effect of lactose intolerance on serum glucose levels and related biochemical parameters in the adult population who refrain from consuming milk and milk products. Material and Method: This retrospective, observational study was conducted in a tertiary care hospital between January 2016 and December 2019 with 296 participants. Plasma glucose, calcium, 25-hydroxyvitamin D3, folate, vitamin B12, thyroid-stimulating hormone (TSH), and ferritin levels were controlled. Patients with positive lactose intolerance test results were accepted as the study group and negative results were accepted as the control group, and data of two groups were compared. Results: Of the total 296 participants 212 (71.7%) were found to have lactose intolerance and 84 (28.3%) were found to be normal. In the lactose intolerant group, blood glucose levels were significantly lower than the control group (5.14±0.53 mmol/L versus 5.47±0.54 mmol/L, p

Research paper thumbnail of Monocyte/HDL Ratio in Non-Alcoholic Hepatic Steatosis

Arquivos De Gastroenterologia, Dec 16, 2021

Non-alcoholic hepatic steatosis (NAS) is characterized by excess fat accumulation in hepatocytes,... more Non-alcoholic hepatic steatosis (NAS) is characterized by excess fat accumulation in hepatocytes, causing portal and lobular inflammation and hepatocyte injury. We aimed to evaluate the alterations in monocyte count to high-density lipoprotein cholesterol ratio (MHR) in patients with grade 2 or 3 fatty liver disease and the association of this marker with liver function tests and insulin resistance. In this retrospective analysis; patients diagnosed and followed for the grade 2 or 3 fatty liver disease were included in the patient group and the patients who had undergone abdominal ultrasound for any reason and who were not having any fatty liver disease were included in the control group. Totally 409 cases were included in the study. Among participants, 201 were in the control group, and 208 were in the NAS group (111 were having grade 2 and 97 were having grade 3 steatosis). The monocyte/HDL ratio was significantly higher in the NAS group compared with the healthy controls (P=0.001). There was a significant positive correlation between the monocyte/HDL ratio and age (r=0.109; P=0.028), ALT (r=0.123, P=0.014) and HOMA-IR (r=0.325, P=0.001) values. In conclusion, the monocyte to high-density lipoprotein ratio significantly increases in fatty liver disease and correlates with insulin resistance. Since it was suggested as a prognostic marker in atherosclerotic diseases, elevated MHR values in fatty liver disease should be evaluated cautiously.

Research paper thumbnail of Gastroenterolog Gözüyle Kolanjioselüler Karsinom

Turkiye Klinikleri Medical Oncology - Special Topics, 2021

Research paper thumbnail of Vaka: Ampulla Vateri Kanserli Hastada Multidisipliner Yaklaşım

Turkiye Klinikleri Medical Oncology - Special Topics, 2021

Research paper thumbnail of Thyroid Nodules Colon Polyps And Gallbladder Polyps In Acromegaly Patients

Eastern Journal Of Medicine, 2022

Research paper thumbnail of Otoimmün hepatit tanılı hastada azatioprin tedavisi sonrası gelişen Kaposi sarkomu

Akademik Gastroenteroloji Dergisi, 2021

Kaposi sarkomu, insan herpes virüsü-8 ile ilişkili mezenkimal bir neoplazmdır. Genellikle birinci... more Kaposi sarkomu, insan herpes virüsü-8 ile ilişkili mezenkimal bir neoplazmdır. Genellikle birincil veya ikincil immün yetmezliği olan hastalarda bulunur. Azatioprin gibi immünomodülatör ilaçlar otoimmün hepatit hastalığında etkilidir, ancak bunların kullanımı toksisite endişeleri nedeniyle sınırlıdır. Burada, otoimmün hepatit hastalığı için azatioprin tedavisi alan ve sonrasında Kaposi sarkomu gelişen, insan immün yetmezlik virüsü negatif bir olguyu sunuyoruz.

Research paper thumbnail of Is emergency endoscopic retrograde cholangiopancreatography safe in COVID-19 pandemic?

European Journal of Gastroenterology & Hepatology, 2020

guideline for coeliac disease and other gluten-related disorders. United Eur Gastroenterol J 2019... more guideline for coeliac disease and other gluten-related disorders. United Eur Gastroenterol J 2019; 7:583–613. 3 Celiac Disease Foundation. Celiac Disease and COVID-19. 2020; https:// celiac.org/celiac-disease-and-covid-19/. [Accessed June 19, 2020] 4 Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020. doi: 10.1001/jama.2020.2648. 5 Centers for Disease Control and Prevention. Hand Hygiene Recommendations. 2020; https://www.cdc.gov/coronavirus/2019nCoV/index.html. [Accessed June 19, 2020]

Research paper thumbnail of Endoscopic Treatment of Chronic Pancreatitis – An Alternative to Surgery?

Digestive Surgery, 1996

Treatment of chronic pancreatitis has traditionally been relegated to medical or surgical therapy... more Treatment of chronic pancreatitis has traditionally been relegated to medical or surgical therapy. Aim : This article attempts to place pancreatic endotherapy into the perspective of

Research paper thumbnail of Successful treatment of life-threatening small bowel bleeding in patient with granulomatosis with polyangiitis : sequential clamping with intraoperative endoscopic guidance

PubMed, Oct 24, 2018

Gastrointestinal bleeding after kidney transplantation is a complication that can occur from immu... more Gastrointestinal bleeding after kidney transplantation is a complication that can occur from immunosuppressant use. We present a case of refractory small bowel bleeding treated successfully with thalidomide after multiple failed attempts of conventional treatment. A 65-year-old male patient with diabetic nephropathy underwent living donor kidney transplantation. The surgery was uneventful, however, he developed immunosuppressantinduced melena with unstable vital signs 11 days later. There were a total of 4 bleeding episodes until the 90th postoperative day, and he received a total of 290 units of red blood cell transfusion during this period. Endoscopic clipping, transarterial embolization, and 2 surgical interventions failed to stop the bleeding. A trial of thalidomide 100 mg per day finally stopped the bleeding and the patient was discharged on the 110th postoperative day with a functioning renal graft. This case shows that thalidomide can be a safe option to treat immunosuppressant-induced refractory gastrointestinal bleeding in the setting of kidney transplantation. Additionally, this is the first case that reports the survival of a renal graft after more than 3000 mL of transfusion.

Research paper thumbnail of Servikal özofagustaki heterotopik gastrik mukozanın endoskopik sıklığı; bir referans merkez çalışması

Akademik Gastroenteroloji Dergisi, Dec 1, 2009

İnlet patch olarak bilinen üst özofagusta heterotopik gastrik mukoza (HGM), ilk olarak 1805 yılın... more İnlet patch olarak bilinen üst özofagusta heterotopik gastrik mukoza (HGM), ilk olarak 1805 yılında Schmit tarafından postmortem muayene esnasında tanımlanmıştır (1). HGM genellikle proksimal özofagusun ilk 3 cm'sinde üst özofagus sfinkter altında, lateral veya posterior duvarda yer alır. Makroskopik olarak, koyu pembe ve kadifemsi bir görünümdedir. Boyutu 2-3 mm'den 4 cm'ye kadar değişmektedir (2). Normal mukozadan keskin sınırlar ile ayrılan; tek bir parça ve/veya multipl parçalar halinde olabileceği gibi, özofagusu sirküler olarak çepeçevre sarabilmektedir (3). HGM'nın histopatolojik görünümü oldukça karakteristik olup antral yada fundik tip hücrelerden oluşur (2). HGM asemptomatik benign bir lezyon olup genellikle tesadüfi olarak saptanır. (4). HGM'nın hidroklorik asid sekrete edebilme özelliğinden dolayı servikal özofagusta özofageal spazm, web, kronik peptik özofajit, striktür, ülserasyon, kanama, perforasyon, extra özofageal fistül, özofagogastroduodenal fistül ve adenokarsinoma yol açabileceği gösterilmiştir (5). HGM'nin orijini tartışılsa da çoğunluğun kabul ettiği özofageal epitelizasyonun eksik kalması sonrasında gelişen konjenital bir anomali olduğudur (4). Diğer bir teori ise, mikst teori olup re

Research paper thumbnail of Relationship between helicobacter pylori infection and pityriasis versicolor: can helicobacter pylori infection be a new etiologic factor for pityriasis versicolor?

Turkish Journal of Medical Sciences, Jun 23, 2020

Introduction Helicobacter pylori is a bacterium in the gastric and duodenal mucosa that causes dy... more Introduction Helicobacter pylori is a bacterium in the gastric and duodenal mucosa that causes dyspeptic symptoms and gastric cancer [1]. H. pylori has been found to be related to certain dermatological diseases such as chronic spontaneous urticaria, atopic dermatitis, lichen planus, and vitiligo [2,3]. Pityriasis versicolor (PV) also known as tinea versicolor is a chronic, benign, and asymptomatic infection caused by Malassezia spp. [4]. Hereditary factors, hyperhidrosis, seborrhoea, and the chemical constitution of sebum may play an important role in the aetiology of PV [5]. H. pylori-induced systemic inflammation has been shown to play a role in the pathogenesis of skin diseases such as chronic urticaria, and atopic dermatitis leading to dysregulation of cytotoxic and other cell-mediated mechanisms in the skin microenvironment [6]. This immune dysregulation in the skin microenvironment could provide the basis for the formation of pityriasis versicolor (PV) in patients with H. pylori infection. The aim of this research was to investigate the relationship of H. pylori with skin diseases in patients with PV. 2. Materials and methods 2.1. Study population This was a prospective study performed in the

Research paper thumbnail of Over-expression of angiotensin-converting enzyme (CD 143) on leukemic blasts as a clue for the activated local bone marrow RAS in AML

Leukemia & Lymphoma, 2006

Local bone marrow renin-angiotensin system (RAS) is an autocrine-paracrine system affecting hemat... more Local bone marrow renin-angiotensin system (RAS) is an autocrine-paracrine system affecting hematopoiesis. Angiotensin II type 1a (AT1a) receptors are present on the CD34+ hematopoietic stem cells. Angiotensin II stimulates the proliferation of bone marrow and umbilical cord blood hematopoietic progenitors. There are preliminary data that local RAS might also be involved in leukemogenesis. ACE hyper-function may lead to the acceleration of negative hematopoietic regulator peptide, AcSDKP, metabolism, which in turn lowers its level in the bone marrow micro-environment, finally removing the anti-proliferative effect of AcSDKP on the hematopoietic cells and blasts. Renin expression could have a role on the leukemia development and angiotensin may act as an autocrine growth factor for acute myeloid leukemia (AML) cells. The aim of this study is to search ACE (CD 143) surface antigen by flow-cytometric analyses on the leukemic blast cells taken from the bone marrow of the patients with AML. Bone marrow aspiration materials and peripheral blood samples were obtained from 11 patients with AML (eight males, three females; aged 46 (range 26-67) years) and six patients with non-malignant hematological disorders (four males, two females; aged 56 (range 22-71) years). ACE (CD 143) surface antigen was shown to be over-expressed in leukemic myeloid blast cells. ACE is positively correlated with bone marrow blast count. Elucidation of the pathological activity of the local RAS-mediated regulation of the leukemogenesis is both pathobiologically and clinically important, since the angiotensin peptides represent a molecular target in the disease management.

Research paper thumbnail of Over-Expression of the Local Bone Marrow Renin-Angiotensin System in Acute Myeloid Leukemia

Blood, Nov 16, 2005

Local bone marrow renin-angiotensin system (RAS) is an autocrine-paracrine system affecting hemat... more Local bone marrow renin-angiotensin system (RAS) is an autocrine-paracrine system affecting hematopoiesis. Angiotensin II stimulates the proliferation of bone marrow and umbilical cord blood hematopoietic progenitors. Angiotensin-converting enzyme (ACE) hyperfunction may lead to the acceleration of negative hematopoietic regulator peptide, AcSDKP, metabolism, which in turn lowers its level in the bone marrow microenvironment, finally removing the antiproliferative effect of AcSDKP on the hematopoietic cells and blasts. The aim of this study is therefore to search those major RAS components simultaneously in the leukemic blast cells taken from the bone marrow of patients with acute myeloid leukemia (AML). Bone marrow aspiration materials were obtained from 10 patients with AML (8 males, 2 females; median age 48.5 years) and 8 patients with nonmalignant hematological disorders (6 males, 2 females; median age 45 years). EDTA-treated bone marrow samples were stored at -70 degrees C until analysis. Total RNA was extracted from 200-microl bone marrow samples by High Pure RNA Isolation Kit. The medians of expression ratios of AML patient samples have been found 0.736 (IQR 1.359), 0.540 (IQR 0.725), and 0.075 (IQR 0.002) for ACE, ANG and REN genes, respectively. All three gene expressions were found to be significantly higher in the bone marrow samples of AML patients. In this study, the expression of the mRNAs of the major RAS components-namely ACE, renin and angiotensinogen-in human bone marrow samples were quantified by reverse transcription-polymerase chain reaction (RT-PCR) to confirm the presence of the local bone marrow RAS. Elucidation of the pathological activity of the local RAS-mediated regulation of the leukemogenesis is both pathobiologically and clinically important, since the angiotensin peptides represent a molecular target in the disease management.

Research paper thumbnail of A rare cause of submucosal lesions in the cardiac region of the stomach

Research paper thumbnail of An Unusual Presentation of Celiac Disease: Vertigo

Celiac disease (CD), intolerance to gluten, is characterized by the autoimmune inflammation of th... more Celiac disease (CD), intolerance to gluten, is characterized by the autoimmune inflammation of the small intestine in genetically susceptible individuals. Herein, we will report a case of a patient diagnosed with CD during investigations performed for recurrent vertigo attacks. Clinicians should be aware that CD may also present with vertigo, and especially in patients with recurrent and prolonged vertigo attacks, CD should also be ruled out.

Research paper thumbnail of Endoscopic retrograde cholangiopancreatography-oriented surgery for accomplished treatment of Mirizzi syndrome: a single-center experience

European Journal of Gastroenterology & Hepatology, Feb 27, 2023

Research paper thumbnail of Retrospective Evaluation of Endoscopic Treatment Outcomes in Biliary Leak After Hepatobiliary Surgery: Single Center Experience

Ankara Üniversitesi tıp fakültesi mecmuası, Dec 1, 2018

Biliary leak, after the hepatobiliary tract injuries, is a serious complication and can lead to m... more Biliary leak, after the hepatobiliary tract injuries, is a serious complication and can lead to morbidity and prolonged hospitalization. Endoscopic management has proved to be an effective treatment for the biliary leak. However, the most appropriate endoscopic intervention is still controversial and the long-term follow-up data of patients are limited. The aim of this study is to identify the efficacy of endoscopic treatment methods, to determine the biliary drainage devices and their duration period and to investigate the outcome of treatment in patients with biliary leak after hepatobiliary surgery. Materials and Methods: The Endoscopic Retrograde Cholangiopancreatography (ERCP) procedures were held in Gastroenterology Endoscopy Unit between January 2016 and January 2017 and retrospectively evaluated. Patients were compared with the demographic characteristics, endoscopic treatment method (only sphincterotomy, stent insertion only, sphincterotomy+ stent insertion), biliary stent implantations, how many times ERCP was done, the time of healing bile leak and ERCP related complication. Results: A total of 1037 consecutive patients who underwent ERCP were scanned retrospective. 22 patients with bile leak fulfilled the criteria of study. In 20 patients with bile leakage associated with cholecystectomy, the leak was closed at the 6th week after ERCP procedure + biliary stent. In one of every 2 patients who developed biliary leakage secondary to cyst hydatid operation, the leakage was still persisted 6 weeks later. Therefore, plastic stents were inserted into the biliary system of those patients with two ERCP procedures by the three month intervals and bile leak continued

Research paper thumbnail of Local ocular surface parameters in patients with systemic celiac disease

Eye, Mar 17, 2017

Purpose This was a collaborative study from the Ophthalmology and Gastroenterology departments of... more Purpose This was a collaborative study from the Ophthalmology and Gastroenterology departments of a tertiary care hospital, designed to investigate the local ocular surface parameters in patients with celiac disease (CD). Methods Fifty-six eyes of 28 patients with CD and 58 eyes of 29 healthy adult subjects serving as controls were evaluated. The Schirmer test, tear-film break-up time, and conjunctival impression cytology were performed in addition to a complete ophthalmological examination. Impression cytology specimens of each group were graded and scored in the range 0-3. Results The 28 patients with CD consisted of 24 females (86%) and 4 males (14%). The mean age was 34.4 ± 11.3 years (22-55 years). Tear-film break-up time and Schirmer test results were significantly lower in the study group than in the controls (Po0.05). Also, there was a significant difference between the groups for impression cytology grading scores (P = 0.001). Conclusions The CD group showed a marked preponderance of females with an F/ M ratio of six females per male, as reported in the literature. Tear-film functions and conjunctival surface epithelial morphology were significantly altered in patients with CD.

Research paper thumbnail of The relationship between extended D-dimer elevations and hereditary thrombophilia in COVID-19 patients

Journal of Medicine and Palliative Care

Aim: To compare the D-Dimer levels in patients with mild COVID-19 disease with and without heredi... more Aim: To compare the D-Dimer levels in patients with mild COVID-19 disease with and without hereditary thrombophilia. Material and Method: Factor V Leiden (G1691A) mutation, methylene tetrahydrofolate gene mutation (C677T, A1298C), and PAI-1 (4G-5G) and FXIII (V34L) gene mutations were examined in all patients included in the study for various reasons such as recurrent miscarriage and venous embolism. Patients with any mutation were included in the hereditary thrombophilia group, while patients without mutations were included in the control group. D-dimer levels of the patients were also analyzed for the second time at least 25 days after admission. All included patients had received previously at least two doses of the BioNTech-Pfizer or CoronaVac vaccines. Results: A total of 158 patients, 46 (29.1%) male and 112 (70.9%) female, were included in the study. The mean age of the patients included in the study was 39.08 ± 9.09 years. A total of 121 patients, 33 (27.3%) men and 88 (72.7...

Research paper thumbnail of Social stigmatization in Turkish patients with chronic hepatitis B and C

Gastroenterología y Hepatología (English Edition)

Research paper thumbnail of The effect of lactose intolerance on plasma glucose levels and related biochemical parameters

Journal of Health Sciences and Medicine

Aim: To determine the effect of lactose intolerance on serum glucose levels and related biochemic... more Aim: To determine the effect of lactose intolerance on serum glucose levels and related biochemical parameters in the adult population who refrain from consuming milk and milk products. Material and Method: This retrospective, observational study was conducted in a tertiary care hospital between January 2016 and December 2019 with 296 participants. Plasma glucose, calcium, 25-hydroxyvitamin D3, folate, vitamin B12, thyroid-stimulating hormone (TSH), and ferritin levels were controlled. Patients with positive lactose intolerance test results were accepted as the study group and negative results were accepted as the control group, and data of two groups were compared. Results: Of the total 296 participants 212 (71.7%) were found to have lactose intolerance and 84 (28.3%) were found to be normal. In the lactose intolerant group, blood glucose levels were significantly lower than the control group (5.14±0.53 mmol/L versus 5.47±0.54 mmol/L, p

Research paper thumbnail of Monocyte/HDL Ratio in Non-Alcoholic Hepatic Steatosis

Arquivos De Gastroenterologia, Dec 16, 2021

Non-alcoholic hepatic steatosis (NAS) is characterized by excess fat accumulation in hepatocytes,... more Non-alcoholic hepatic steatosis (NAS) is characterized by excess fat accumulation in hepatocytes, causing portal and lobular inflammation and hepatocyte injury. We aimed to evaluate the alterations in monocyte count to high-density lipoprotein cholesterol ratio (MHR) in patients with grade 2 or 3 fatty liver disease and the association of this marker with liver function tests and insulin resistance. In this retrospective analysis; patients diagnosed and followed for the grade 2 or 3 fatty liver disease were included in the patient group and the patients who had undergone abdominal ultrasound for any reason and who were not having any fatty liver disease were included in the control group. Totally 409 cases were included in the study. Among participants, 201 were in the control group, and 208 were in the NAS group (111 were having grade 2 and 97 were having grade 3 steatosis). The monocyte/HDL ratio was significantly higher in the NAS group compared with the healthy controls (P=0.001). There was a significant positive correlation between the monocyte/HDL ratio and age (r=0.109; P=0.028), ALT (r=0.123, P=0.014) and HOMA-IR (r=0.325, P=0.001) values. In conclusion, the monocyte to high-density lipoprotein ratio significantly increases in fatty liver disease and correlates with insulin resistance. Since it was suggested as a prognostic marker in atherosclerotic diseases, elevated MHR values in fatty liver disease should be evaluated cautiously.

Research paper thumbnail of Gastroenterolog Gözüyle Kolanjioselüler Karsinom

Turkiye Klinikleri Medical Oncology - Special Topics, 2021

Research paper thumbnail of Vaka: Ampulla Vateri Kanserli Hastada Multidisipliner Yaklaşım

Turkiye Klinikleri Medical Oncology - Special Topics, 2021

Research paper thumbnail of Thyroid Nodules Colon Polyps And Gallbladder Polyps In Acromegaly Patients

Eastern Journal Of Medicine, 2022

Research paper thumbnail of Otoimmün hepatit tanılı hastada azatioprin tedavisi sonrası gelişen Kaposi sarkomu

Akademik Gastroenteroloji Dergisi, 2021

Kaposi sarkomu, insan herpes virüsü-8 ile ilişkili mezenkimal bir neoplazmdır. Genellikle birinci... more Kaposi sarkomu, insan herpes virüsü-8 ile ilişkili mezenkimal bir neoplazmdır. Genellikle birincil veya ikincil immün yetmezliği olan hastalarda bulunur. Azatioprin gibi immünomodülatör ilaçlar otoimmün hepatit hastalığında etkilidir, ancak bunların kullanımı toksisite endişeleri nedeniyle sınırlıdır. Burada, otoimmün hepatit hastalığı için azatioprin tedavisi alan ve sonrasında Kaposi sarkomu gelişen, insan immün yetmezlik virüsü negatif bir olguyu sunuyoruz.

Research paper thumbnail of Is emergency endoscopic retrograde cholangiopancreatography safe in COVID-19 pandemic?

European Journal of Gastroenterology & Hepatology, 2020

guideline for coeliac disease and other gluten-related disorders. United Eur Gastroenterol J 2019... more guideline for coeliac disease and other gluten-related disorders. United Eur Gastroenterol J 2019; 7:583–613. 3 Celiac Disease Foundation. Celiac Disease and COVID-19. 2020; https:// celiac.org/celiac-disease-and-covid-19/. [Accessed June 19, 2020] 4 Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020. doi: 10.1001/jama.2020.2648. 5 Centers for Disease Control and Prevention. Hand Hygiene Recommendations. 2020; https://www.cdc.gov/coronavirus/2019nCoV/index.html. [Accessed June 19, 2020]

Research paper thumbnail of Endoscopic Treatment of Chronic Pancreatitis – An Alternative to Surgery?

Digestive Surgery, 1996

Treatment of chronic pancreatitis has traditionally been relegated to medical or surgical therapy... more Treatment of chronic pancreatitis has traditionally been relegated to medical or surgical therapy. Aim : This article attempts to place pancreatic endotherapy into the perspective of

Research paper thumbnail of Successful treatment of life-threatening small bowel bleeding in patient with granulomatosis with polyangiitis : sequential clamping with intraoperative endoscopic guidance

PubMed, Oct 24, 2018

Gastrointestinal bleeding after kidney transplantation is a complication that can occur from immu... more Gastrointestinal bleeding after kidney transplantation is a complication that can occur from immunosuppressant use. We present a case of refractory small bowel bleeding treated successfully with thalidomide after multiple failed attempts of conventional treatment. A 65-year-old male patient with diabetic nephropathy underwent living donor kidney transplantation. The surgery was uneventful, however, he developed immunosuppressantinduced melena with unstable vital signs 11 days later. There were a total of 4 bleeding episodes until the 90th postoperative day, and he received a total of 290 units of red blood cell transfusion during this period. Endoscopic clipping, transarterial embolization, and 2 surgical interventions failed to stop the bleeding. A trial of thalidomide 100 mg per day finally stopped the bleeding and the patient was discharged on the 110th postoperative day with a functioning renal graft. This case shows that thalidomide can be a safe option to treat immunosuppressant-induced refractory gastrointestinal bleeding in the setting of kidney transplantation. Additionally, this is the first case that reports the survival of a renal graft after more than 3000 mL of transfusion.

Research paper thumbnail of Servikal özofagustaki heterotopik gastrik mukozanın endoskopik sıklığı; bir referans merkez çalışması

Akademik Gastroenteroloji Dergisi, Dec 1, 2009

İnlet patch olarak bilinen üst özofagusta heterotopik gastrik mukoza (HGM), ilk olarak 1805 yılın... more İnlet patch olarak bilinen üst özofagusta heterotopik gastrik mukoza (HGM), ilk olarak 1805 yılında Schmit tarafından postmortem muayene esnasında tanımlanmıştır (1). HGM genellikle proksimal özofagusun ilk 3 cm'sinde üst özofagus sfinkter altında, lateral veya posterior duvarda yer alır. Makroskopik olarak, koyu pembe ve kadifemsi bir görünümdedir. Boyutu 2-3 mm'den 4 cm'ye kadar değişmektedir (2). Normal mukozadan keskin sınırlar ile ayrılan; tek bir parça ve/veya multipl parçalar halinde olabileceği gibi, özofagusu sirküler olarak çepeçevre sarabilmektedir (3). HGM'nın histopatolojik görünümü oldukça karakteristik olup antral yada fundik tip hücrelerden oluşur (2). HGM asemptomatik benign bir lezyon olup genellikle tesadüfi olarak saptanır. (4). HGM'nın hidroklorik asid sekrete edebilme özelliğinden dolayı servikal özofagusta özofageal spazm, web, kronik peptik özofajit, striktür, ülserasyon, kanama, perforasyon, extra özofageal fistül, özofagogastroduodenal fistül ve adenokarsinoma yol açabileceği gösterilmiştir (5). HGM'nin orijini tartışılsa da çoğunluğun kabul ettiği özofageal epitelizasyonun eksik kalması sonrasında gelişen konjenital bir anomali olduğudur (4). Diğer bir teori ise, mikst teori olup re

Research paper thumbnail of Relationship between helicobacter pylori infection and pityriasis versicolor: can helicobacter pylori infection be a new etiologic factor for pityriasis versicolor?

Turkish Journal of Medical Sciences, Jun 23, 2020

Introduction Helicobacter pylori is a bacterium in the gastric and duodenal mucosa that causes dy... more Introduction Helicobacter pylori is a bacterium in the gastric and duodenal mucosa that causes dyspeptic symptoms and gastric cancer [1]. H. pylori has been found to be related to certain dermatological diseases such as chronic spontaneous urticaria, atopic dermatitis, lichen planus, and vitiligo [2,3]. Pityriasis versicolor (PV) also known as tinea versicolor is a chronic, benign, and asymptomatic infection caused by Malassezia spp. [4]. Hereditary factors, hyperhidrosis, seborrhoea, and the chemical constitution of sebum may play an important role in the aetiology of PV [5]. H. pylori-induced systemic inflammation has been shown to play a role in the pathogenesis of skin diseases such as chronic urticaria, and atopic dermatitis leading to dysregulation of cytotoxic and other cell-mediated mechanisms in the skin microenvironment [6]. This immune dysregulation in the skin microenvironment could provide the basis for the formation of pityriasis versicolor (PV) in patients with H. pylori infection. The aim of this research was to investigate the relationship of H. pylori with skin diseases in patients with PV. 2. Materials and methods 2.1. Study population This was a prospective study performed in the

Research paper thumbnail of Over-expression of angiotensin-converting enzyme (CD 143) on leukemic blasts as a clue for the activated local bone marrow RAS in AML

Leukemia & Lymphoma, 2006

Local bone marrow renin-angiotensin system (RAS) is an autocrine-paracrine system affecting hemat... more Local bone marrow renin-angiotensin system (RAS) is an autocrine-paracrine system affecting hematopoiesis. Angiotensin II type 1a (AT1a) receptors are present on the CD34+ hematopoietic stem cells. Angiotensin II stimulates the proliferation of bone marrow and umbilical cord blood hematopoietic progenitors. There are preliminary data that local RAS might also be involved in leukemogenesis. ACE hyper-function may lead to the acceleration of negative hematopoietic regulator peptide, AcSDKP, metabolism, which in turn lowers its level in the bone marrow micro-environment, finally removing the anti-proliferative effect of AcSDKP on the hematopoietic cells and blasts. Renin expression could have a role on the leukemia development and angiotensin may act as an autocrine growth factor for acute myeloid leukemia (AML) cells. The aim of this study is to search ACE (CD 143) surface antigen by flow-cytometric analyses on the leukemic blast cells taken from the bone marrow of the patients with AML. Bone marrow aspiration materials and peripheral blood samples were obtained from 11 patients with AML (eight males, three females; aged 46 (range 26-67) years) and six patients with non-malignant hematological disorders (four males, two females; aged 56 (range 22-71) years). ACE (CD 143) surface antigen was shown to be over-expressed in leukemic myeloid blast cells. ACE is positively correlated with bone marrow blast count. Elucidation of the pathological activity of the local RAS-mediated regulation of the leukemogenesis is both pathobiologically and clinically important, since the angiotensin peptides represent a molecular target in the disease management.

Research paper thumbnail of Over-Expression of the Local Bone Marrow Renin-Angiotensin System in Acute Myeloid Leukemia

Blood, Nov 16, 2005

Local bone marrow renin-angiotensin system (RAS) is an autocrine-paracrine system affecting hemat... more Local bone marrow renin-angiotensin system (RAS) is an autocrine-paracrine system affecting hematopoiesis. Angiotensin II stimulates the proliferation of bone marrow and umbilical cord blood hematopoietic progenitors. Angiotensin-converting enzyme (ACE) hyperfunction may lead to the acceleration of negative hematopoietic regulator peptide, AcSDKP, metabolism, which in turn lowers its level in the bone marrow microenvironment, finally removing the antiproliferative effect of AcSDKP on the hematopoietic cells and blasts. The aim of this study is therefore to search those major RAS components simultaneously in the leukemic blast cells taken from the bone marrow of patients with acute myeloid leukemia (AML). Bone marrow aspiration materials were obtained from 10 patients with AML (8 males, 2 females; median age 48.5 years) and 8 patients with nonmalignant hematological disorders (6 males, 2 females; median age 45 years). EDTA-treated bone marrow samples were stored at -70 degrees C until analysis. Total RNA was extracted from 200-microl bone marrow samples by High Pure RNA Isolation Kit. The medians of expression ratios of AML patient samples have been found 0.736 (IQR 1.359), 0.540 (IQR 0.725), and 0.075 (IQR 0.002) for ACE, ANG and REN genes, respectively. All three gene expressions were found to be significantly higher in the bone marrow samples of AML patients. In this study, the expression of the mRNAs of the major RAS components-namely ACE, renin and angiotensinogen-in human bone marrow samples were quantified by reverse transcription-polymerase chain reaction (RT-PCR) to confirm the presence of the local bone marrow RAS. Elucidation of the pathological activity of the local RAS-mediated regulation of the leukemogenesis is both pathobiologically and clinically important, since the angiotensin peptides represent a molecular target in the disease management.

Research paper thumbnail of A rare cause of submucosal lesions in the cardiac region of the stomach