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Öğe An Adult Choledochocele Case Presented with Acute Pancreatitis: Treatment by Endoscopic Sphincterotomy and Cyst Unroofing(Korean Soc Gastrointestinal Endoscopy, 2015) Bestas, Remzi; Ekin, Nazim; Ucmak, Feyzullah; Kaya, Muhsin[Abstract Not Available]Öğe Aşırı yükselmiş ve uzun süreli devam eden hiperbilirubineminin nadir sebebi: Weil hastalığı(2016) Kaya, Muhsin; Tuncel, Elif Tuğba; Kaçmaz, HüseyinLeptospirozis vakalarının büyük çoğunluğunda grip benzeri hafif klinik tablo görülürken, %10'u sarılık ve böbrek yetmezliği bulgularının olduğu ve Weil hastalığı olarak adlandırılan klinik formda görülür. Çalış- mamızda Weil hastalığı tanısı konulan, yaş ortalaması 36.2±1.7 olan beş erkek hasta sunulmuştur. Tüm hastalarda ateş, yaygın kas ağrısı, karın ağrısı, sarılık, konjunktivalarda kızarıklık ve şişlik, üç vakada ka- şıntı ve yaygın cilt döküntüleri mevcuttu. Biyokimya tetkiklerinde tüm vakalarda bilirubin ve kreatin kinaz seviyesinde belirgin artma ve normal protrombin düzeyi ile beraber aspartat amino transferaz, alanin amino transferaz, alkalen fosfataz ve gama glutamil transferaz seviyesinde hafif artma; dört vakada kreatin seviyesinde belirgin artma saptandı. Tam kan sayımında tüm vakalarda trombositopeni ve lökositoz vardı. Weil hastalığı tanısı mikroskobik aglutinasyon testi ile doğrulandı. Tüm hastalara yatışının ilk gününden itibaren geniş spektrumlu antibiyotik tedavisi başlandı. Akut böbrek yetmezliği olan üç hastamız hemodiyaliz tedavisine alındı. Tüm hastalara tedavinin ilk gününden karaciğer fonksiyon testlerinin normale dönmesine kadar ursodeoksikolik asit tedavisi verildi. Hastalardan biri yatışının birinci gününde akciğer içi kanama nedeniyle vefat etti. Geriye kalan dört hastanın diğer klinik ve laboratuvar bulguları erken düzelirken, serum bilirubin düzeyleri ortalama 99.2±7.4 gün sonra normale döndü. Sonuç olarak, akut enfeksiyon belirtileriyle başlayan ve uzun süreli devam eden sarılık olgularının ayırıcı tanısında Weil hastalığı da düşünülmelidir.Öğe Brucellosis Induced Ascites, Cholestasis and Elevated Serum CA 125 Level: Case Report(Ortadogu Ad Pres & Publ Co, 2012) Kaya, Muhsin; Bestas, Remzi; Cangul, Mehmet Sadik; Kaya, BesirGastrointestinal complications of brucellosis are randomly reported, ascites and cholestasis being particularly rare. A 25-year-old female patient with a history of fever, weakness, jaundice, nausea and sweating was admitted to our clinic. The physical examination revealed a temperature of 39.3 degrees C, hepatosplenomegaly and moderate free ascites in the abdomen. Initial laboratory investigation revealed mild anemia, biochemical findings of cholestasis, hypoalbuminemia, elevated serum CA 125 level, increased lymphocyte count in ascidic fluid and low (0.9 g) serum-ascites albumin gradient. After comprehensive evaluation, Brucella melitensis induced ascites, intrahepatic cholestasis and elevated serum CA 125 level were detected. We observed complete clinical and laboratory improvement at the end of anti-brucellosis treatment.Öğe Clinical presentation and management of fasciola hepatica infection: Single-center experience(Baishideng Publishing Group, 2011) Kaya, Muhsin; Beştaş, Remzi; Çetin, SedatAIM: To identify the characteristic clinical, laboratory and radiological findings and response to treatment in patients with fascioliasis. METHODS: Patients who were diagnosed with Fasciola hepatica infection were included in this prospective study. Initial clinical, laboratory and radiological findings were recorded. All patients were followed until a complete response was achieved or for 6 mo after treatment discontinuation. RESULTS: Fasciola hepatica infection was diagnosed in 30 patients (24 females; mean age: 42.6 years) between January 2008 and February 2011. Twenty-two (73%) patients had hepatic phase fascioliasis, 5 patients had biliary phase, and 3 patients had biliary phase associated with acute pancreatitis. Of the 8 patients with biliary phase fascioliasis, 2 patients displayed features that overlapped with both hepatic and biliary phase. Abdominal pain and right upper abdominal tenderness were the most prominent signs and symptoms in all patients. Eosinophilia was the most prominent laboratory abnormality in both patients with hepatic and biliary phase (100% and 50%, respectively respectively). Multiple nodular lesions like micro-abscesses on abdominal computerized tomography were the main radiological findings in patients with hepatic phase. Small linear filling defects in the distal choledochus were the main endoscopic retrograde cholangiopancreatography (ERCP) findings in patients with biliary phase. Patients with hepatic phase were treated with triclabendazole alone, and patients with biliary phase were treated with triclabendazole and had live Fasciola hepatica extracted from the bile ducts during ERCP. CONCLUSION: Fasciola hepatica infection should be considered in the differential diagnosis of patients with hepatic or biliary disease and/or acute pancreatitis associated with eosinophilia.Öğe Clinical remission after strict gluten-free diet in a patient with celiac disease, advanced cryptogenic cirrhosis and splenic atrophy(Turkish Soc Gastroenterology, 2012) Kaya, Muhsin; Bestas, Remzi; Cetin, Sedat; Buyukbayram, Huseyin[Abstract Not Available]Öğe Differentiation of Tuberculous Peritonitis from Peritonitis Carcinomatosa without Surgical Intervention(Medknow Publications & Media Pvt Ltd, 2011) Kaya, Muhsin; Kaplan, Mehmet A.; Isikdogan, Abdurrahman; Celik, YusufBackground/Aim: Ascites of tuberculous peritonitis (TBP) is an exudative type and may well be misdiagnosed as carcinomatous peritonitis, especially in the elderly. The aim of this study was to identify independent predictors that can differentiate TBP from peritonitis carcinomatosa without surgical intervention. Patients and Methods: This prospective cohort study was performed on 75 subjects in the following groups: TBP (n=27) (TBP group), ovarian cancer complicated with ascites (n=24) (Ov Ca group), and gastric cancer complicated with ascites (n=24) (Ga Ca group). The frequency of clinical symptoms, laboratory parameters, and serum tumor markers levels were compared. Results: In univariate analysis; fever, night sweats, and abdominal pain were significantly more frequent in the TBP group compared to those in the Ov Ca group (P < 0.001, P < 0.001, and P = 0.035, respectively) and the Ga Ca group (P < 0.001, P < 0.001, and P = 0.015, respectively). Serum CA 19-9 and carcino embryonic antigen (CEA) levels were significantly lower in the TBP and Ov Ca group compared to the Ga Ca group (P < 0.001 and P < 0.001, respectively). Elevated serum CA 125 level was found in all patients with TBP and Ov Ca and in 86.6% of patients with Ga Ca. In the multivariate analysis, presence of fever (P < 0.001), night sweats (P < 0.001), age under 40 years (P = 0.008), and normal serum CA 19-9 level (P = 0.044) were independent predictor of diagnosis of TBP. Conclusion: The presence of fever, elevated serum CA 125 level, normal serum CA 19-9, and CEA associated with lymphocyte predominant benign ascites may establish the diagnosis of TBP.Öğe Disfaji Lusoria; Vaka Raporu ve Literatür Derlemesi(2024) Karabulut, Ümit; Yolaçan, Ramazan; Ece, Çiğdem Budak; Öncül, Fatma Yılmaz; Kaya, MuhsinDisfaji lusoria, özofagusa vasküler basıya bağlı olarak oluşan disfajiyi tanımlamak için kullanılır. Bu anomalinin varlığı genellikle asemptomatiktir ve büyük çoğunluğu tesadüfen görüntüleme veya otopsi sırasında keşfedilir. Hastaların yaklaşık %20-40’ında disfaji, öksürük ve göğüs ağrısı gibi semp- tomlar görülebilir. Disfaji lusoria tanısında kullanılan en iyi yöntem, başlangıçta bir baryumlu özofagus grafisi ve ardından BT veya MRI taramasıdır. Disfaji lusoria hastalarının yönetimi semptomların şiddetine bağlı değişir. Bu yazıda, yutma güçlüğü olan, disfaji lusoria tanısı konulan bir olgu sunuyoruz.Öğe Ectopic opening of common bile duct into duodenal bulb and gastric antrum and its importance(Academy of Medical Sciences of I.R. Iran, 2022) Karabulut, Ümit; Üzel, Ali; Yolaçan, Ramazan; Uçmak, Feyzullah; Kaya, MuhsinBackground: Ectopic opening of the common bile duct (CBD) is extremely rare, and its importance has not been adequately defined. The aim of our study is to present the characteristics of patients with this abnormality. Methods: This retrospective study was conducted in a tertiary center in Dicle University Hospital, Diyarbakır, Turkey, between October 2008 and December 2020. We present clinical, laboratory, endoscopic and cholangiographic features as well as the success rate of therapeutic interventions of consecutive patients with this abnormality undergoing endoscopic retrograde cholangiopancreatography (ERCP). Results: Ectopic opening of the CBD was identified in 29 (21 men; mean age 62) out of 3872 (0.74%) patients. There was a history of cholecystectomy in 14 (48%) and recurrent acute cholangitis in 20 (69%) patients. We found peptic ulcer in 13 (45%) and duodenal deformity associated with apical stenosis in 21 (72%) patients. Opening site was seen as abnormal in all patients, and it opened into the antrum in 2 (6.8%) and into the first part of the duodenum in 27 (93%) patients. Copious amount of bile and/ or bile sediment in the stomach were seen in all patients. We observed dilatation in both intrahepatic and extrahepatic bile ducts together with tapered narrowing and a hook-shaped distal end of CBD in all patients. There was bile stone in 26 (89%) and sludge in 3 (10%) patients. Sphincterotomy was not performed in any patients because there was not enough incision distance. Balloon dilatation was performed for extraction of stone and sludge in all patients. Complete stone extraction was achieved in only 7 out of 26 (27%) patients. Conclusion: Ectopic opening of CBD is usually associated with gastroduodenal and bile ducts disease. Endoscopic treatment is unsatisfactory in most patients with this abnormality.Öğe Evaluation of demographic, clinic and treatment features of patients and a cross-sectional survey of cyclosporiasis in patients with diarrhea in Southeastern Turkey(Academic Journals, 2012) Cicek, Mutalip; Palanci, Yilmaz; Ceylan, Ali; Ozekinci, Tuncer; Kaya, MuhsinIn this research, we aimed at reporting the results of a cross-sectional epidemiological scanning performed on an outbreak of cyclosporiasis, occurring in a family and patients' socio-demographic epidemiological, clinical, diagnostic and therapeutic features, after detecting Cyclospora oocysts on stool sample of a person admitted to gastroenterology polyclinic. Scanning was performed in the neighborhood of the patient. The investigation group consisted of 75 individuals with diarrheal occurring from neighbor and family of patients. A questionnaire was performed for information on epicrisis of diarrheal persons and the samples were collected in stool containers. The samples were examined with native-lugol, sedimentation and modified acid fast staining methods. The stools were cultured in Salmonella-Shigella agar medium to investigate their bacteriological properties. The different vegetables from the mobile market place (peddler) founded in the neighborhood and water samples from house were collected to detect the infection source. Parasitosis (single or mix parasite) were encountered in 20 out of 75 persons in the examined samples (26.6%) and C. oocysts were detected in 13 out of 75 persons (17.3%). Out of the total number of patients having cyclosporiasis, none has immunodeficiency and chronic diseases. All cases were determined in the month of July. Oocysts were detected in six different families. Bacteria were not cultivated in stool cultures and occult blood was negative. The agent was not encountered in green vegetables, though water samples were examined to detect infection resource. Examination of the samples for Cyclospora was not neglected in diarrhea individuals; as such an examination was performed for the source of transmission of the infection. Cyclospora may generate family infection in individuals and if detected in one individual of a family, all the family individuals were examined for this infection.Öğe F-18-FDG PET/BT’de kolanjiosellüler kanseri taklit eden Fasciola hepatica vakası(2018) Kaya, Muhsin; Tuncel, Elif Tuğba; Ebik, Berat; Yalçın, Kendal; Kaçmaz, Hüseyin; Komek, Halil; Uçmak, Feyzullahİnsan fasioliazisi, Fasciola hepatica ve Fasciola gigantica’nın neden olduğu, dünya genelinde nadir görülen zoonotik bir hastalıktır. Genellikle çiftlik hayvanlarını etkileyen bir trematod olup insan rastlantısal ara konakçıdır. Spesifik olmayan semptom ve bulgularının birçok hepatobiliyer hastalıkta izlenebilmesi nedeniyle fasioliazisin tanı ve tedavisi gecikebilmektedir. Elli üç yaşında kadın hasta 18-Florodeoksi-glukoz pozitron emisyon bilgisaya-ralı tomo-grafi incelemesinde ekstrahepatik safra yollarında yüksek florode-oksi-glukoz tutulumu nedeniyle kliniğimize başvurdu. Hastada son 3 aydır süren karın ağrısı, kaşıntı ve halsizlik yakınmaları mevcuttu. Kolanjiyosellü-ler kanseri taklit eden ve serolojik olarak tanısı konan biliyer fasioliazisli bu vakayı sunacağız.Öğe Gebelik sırasında gelişen hipertrigliseridemiye bağlı akut pankreatit tedavisinde heparin ve insulin faydalı mıdır?(2010) Beştaş, Ramzi; Çetin, Sedat; Kaya, MuhsinGebeliğin komplikasyonu olarak gelişen akut pankreatit nadir olup, daha önce yüksek mortaliteyle seyrettiği bildirilmiştir. Dördüncü gebeliklerinde konjenital hipertirigliseridemiye bağlı akut pankreatit gelişen iki vaka sunulmuştur. Vakalardan biri klasik tedaviye ilaveten düşük lipitli diyet ve diğeri de klasik tedaviye ilaveten düşük lipitli diyet, glukoz-insulin ve düşük molekül ağırlıklı heparinle tedavi edildi. Her iki hasta da klinik ve laboratuvar tam düzelmeyle hastaneden taburcu edildi.Öğe General Characteristics of Our Patients Diagnosed with Autoimmune Hepatitis: Single Center Experience(Veysi AKPOLAT, 2024) Yolacan, Ramazan; Yıldırım, Cihat; Kaya, MuhsinObjective:Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease characterized by elevated liver enzymes and serum immunoglobulin levels, often accompanied by high titers of autoantibodies, typical histopathological findings, and a diagnosis established upon the exclusion of other liver diseases. The etiology of AIH is not fully understood. Our aim was to investigate the general characteristics of our AIH patients, the treatments administered, and the responses to these treatments, and to compare these with the data available in the literature. Materials and Methods:Between 2010-2020, data from 62 patients diagnosed with AIH at our clinic were retrospectively reviewed. The study investigated the general characteristics at the time of diagnosis, laboratory values, autoantibody levels, the presence of additional autoimmune diseases, liver histology, treatment status and responses, as well as average follow-up and survival times. Results:Of the patients, 57 (91.9%) were female, with a female to male ratio of 11:1, and the average age of all patients was 34.76±14.9 years. The average follow-up duration was 34.7±23.4 months, the average survival time was 105 months, and the 5-year survival rate was determined to be 92%. At the time of diagnosis, a more than tenfold increase in aminotransferase levels and acute hepatitis were statistically significantly higher in females (p<0.05). While there was a statistically significant relationship between the average time to remission and aminotransferase levels (p<0.05), no significant relationship was found between the development of relapse (p>0.05). A statistically significant conversion was observed between patients with definite and probable diagnoses before and after treatment (p<0.05). Conclusion:AIH should always be considered in patients with acute and chronic liver disease, hypergammaglobulinemia, and especially those with other autoimmune diseases, as AIH presents with various clinical, laboratory, and histological features. It is important to remember that AIH responds well to treatment and patients can be maintained in remission for extended periods with appropriate therapy.Öğe Güneydoğu Anadolu Bölgesindeki üçüncü basamak gastroenteroloji kliniğinin toksik hepatit deneyimi(Dicle Üniversitesi Tıp Fakültesi, 2018) Uçmak, Feyzullah; Tuncel, Elif Tuğba; Kaçmaz, Hüseyin; Ebik, Berat; Kaya, MuhsinAmaç: Toksik hepatit birçok ilaç ve bitkisel ürünün alınmasıyla ortaya çıkan klinik tablodur. Çok sayıda ilaç değişik mekanizmalarla toksik hepatite neden olmaktadır. Hastalığın görülme sıklığı ve sebepleri bölgesel farklılıklar gösterebilmektedir. Çalışmadaki amacımız kliniğimize başvuran toksik hepatitli olguların demografik, klinik ve laboratuar özelliklerini sunmaktır. Yöntemler: Ağustos 2014-Haziran 2016 tarihleri arasında kliniğimize anormal karaciğer fonksiyon testleri nedeniyle yatırılan, klinik ve laboratuar değerlendirme sonrası TH tanısı konulan hastalar alındı. Hastaların demografik özellikleri, toksik hepatitin muhtemel etiyolojisi, klinik özellikleri, biyokimya ve tam kan değerleri, klinik seyirleri kaydedildi. Bulgular: Çalışmaya yaş ortalaması 41.4±16.8 olan 56 (34 kadın) hasta alındı. Hastaların 31 (%55.6)’inde ilaçlar, 11 (%20.4)’inde bitkisel maddeler, 6 (%9,3)’ında narkotik madde ve 8 (%14,8)’inde bitkisel madde, ilaç ve narkotik kullanımına bağlı toksik hepatit geliştiği saptandı. İlaçlar içinde en çok antibiyotik (birinci sırada amoksisilin+ klavulanik asit) ve non-steroid anti inflamatuvar ilaç (birinci sırada diklofenak sodyum) kullanımı hikayesi saptandı. Bitkisel madde kullanımı olan hastalarda en sık meryem otu, lavanta çayı ve atom çayı kullanım hikayesi mevcuttu. Narkotik madde olarak en sık ekstazi (5 hasta) kullanımı saptandı. Otuz yaş altı (RR:1.545, p<0.001) ve erkek cinsiyet (RR:11.0, p=0.013) narkotik madde kullanımı için risk faktörü olarak saptandı. Sonuç: Bölgemizde ilaç ve bitkisel madde kullanımına bağlı gelişen TH anormal karaciğer fonksiyon testlerinin önemli bir sebebi olarak dikkate alınmalıdır. Özellikle genç erkeklerde narkotik kullanımı toksik hepatit etiyolojisinde önemli yer tutmaktadır.Öğe The Hepatic Phase of Fascioliasis Complicated with Liver Bleeding: Presentation of Three Cases(Iranian Scientific Society Medical Entomology, 2024) Ucmak, Feyzullah; Kaya, MuhsinBleeding is a very rare complication of Fasciola species ( F. hepatica or F. gigantica ) infection. We present here three cases of subcapsular liver bleeding caused by the hepatic phase of Fasciola spp. infection in patients, two of whom were women, aged 22, 66, and 84 years in Diyarbakir Province, southeastern Turkey. They had symptoms of right upper quadrant pain (n = 3), nausea (n = 1), and vomiting (n = 2) for periods ranging from 6 hours to 15 days. All patients with clinical presentations ranging from moderate abdominal pain to hypovolemic shock and ischemic hepatitis were improved with supportive treatment without the need for surgery. They showed complete clinical and laboratory recovery after triclabendazole administration in their follow-up. In conclusion, Fasciola spp . infection should be considered in the etiology of bleeding from liver disease.Öğe Hepatotoxicity case due to interferon beta-1a use(2023) Yolaçan, Ramazan; Kaya, Bekir; Üzel, Ali; Karabulut, Ümit; Uçmak, Feyzullah; Kaya, MuhsinInterferon ?-1a is an immunomodulatory drug widely used in the treatment of multiple sclerosis. Liver dysfunction is a common side effect of this drug and usually develops within the first 6 months of starting interferon therapy. Here, we present our case who developed hepatotoxicity secondary to interferon ?-1a treatment.Öğe Immune mechanisms and the role of oxidative stress in intrahepatic cholestasis of pregnancy(Termedia Publishing House Ltd, 2014) Ozler, Ali; Ucmak, Derya; Evsen, Mehmet Siddik; Kaplan, Ibrahim; Elbey, Bilal; Arica, Mustafa; Kaya, MuhsinIntroduction: The purpose of this study was to investigate levels of inflammatory cytokines such as interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha) and neopterin and oxidative stress status in patients with intrahepatic cholestasis of pregnancy (ICP) as well as their potential role in the pathophysiology. Material and methods: Thirty patients with ICP (Group 1) and 30 healthy pregnant women (Group 2) were included in this prospective case-control study. Levels of IL-6, TNF-alpha and neopterin were determined in both of the groups. Total anti-oxidant status (TAS) and total oxidative stress (TOS) levels were determined by means of a fully automated Erel method. Oxidative stress index (OSI) was calculated as the ratio of TOS to TAS. Results: There was no significant difference between the groups in IL-6 and TNF-alpha levels (p = = 0.105 and p = 0.722, respectively). The mean neopterin level was significantly higher in Group 1 compared to Group 2 (2.34 +/- 0.77 and 1.57 +/- 0.38, respectively, p = 0.001). In addition, TAS, TOS and OSI levels were significantly higher in Group I (p = 0.004, p = 0.001 and p = 0.001, respectively) compared to Group 2. Discussion: Intrahepatic cholestasis of pregnancy is an inflammatory disorder in which maternal immune reaction may play a role. Interleukin 6 and TNF-alpha, which are some of the markers of humoral reaction, act as an indicator of abnormal reaction rather than acute-phase reaction in ICP. Further clinical trials and supportive placental findings are needed on the role of cytokines in cellular and humoral immune reactions during the symptomatic period and delivery to better understand the role of immune mechanisms in the aetiology of ICP.Öğe The importance of acoustic radiation force impulse (ARFI) elastography in the diagnosis and clinical course of acute pancreatitis(Aves Yayıncılık, 2018) Kaya, Muhsin; Değirmenci, Mehmet Serdar; Göya, Cemil; Tuncel, Elif Tuğba; Uçmak, Feyzullah; Kaplan, Mehmet AliBackground/Aims: Acute pancreatitis (AP) is characterized by acute inflammation of the pancreas and it has a highly variable clinical course. The aim of our study was to evaluate the value of acoustic radiation force impulse (ARFI) elastography in the diagnosis and clinical course of AP. Materials and Methods: Consecutive patients with a diagnosis of AP (patients group) and healthy subject (control group) were prospectively enrolled to the study. Demographic features and clinical, laboratory, and radiological data were recorded. Virtual Touch Tissue Quantification (VTQ) was used to implement ARFI elastography. The tissue elasticity is proportional to the square of the wave velocity (SWV). Results: A total of 108 patients (age, 57±1.8 y) and 79 healthy subjects (age, 53.6±1.81 y) were included in the study. There were 100 (92.5%) edematous and 8 (7.4%) necrotizing AP. The mean SWV was significantly higher in the patient group than in the control group (2.43±0.08 vs. 1.27±0.025 m/s, p<0.001). There was not significant difference between patient and control group regarding age and gender. SWV cutoff value of 1.63 m/s was associated with 100% sensitivity and 98% specificity for the diagnosis of AP. There was not significant difference between patients with and without complications and patients with edematous and necrotizing AP regarding mean SWV value. There was also not significant correlation between mean SWV value and age, mean length of hospital stay, and mean amylase level. Conclusion: ARFI elastography may be a feasible method for the diagnosis of AP, but it has no value for the prediction of clinical course of AP.Öğe Incidence and Characteristics of Colon Polyps in Southeast Anatolian Region: A 5-Year Evaluation(2016) Uçmak, Feyzullah; Büyükbayram, Hüseyin; Kaya, Muhsin; Ekin, Nazım; Tuncer, Elif TuğbaAmaç: Alt gastrointestinal sistemin en sık saptanan patolojilerinden biri poliplerdir. Kolonoskopik polipektomi, bu lezyonların tedavisinin yanısıra histolopatolojik özelliklerinin ortaya konmasına da imkan sunmaktadır. Bu çalışmanın amacı kliniğimizde uygulanan polipektomi sonuçlarını değerlendirmektir. Yöntem: Dicle Üniversitesi Tıp Fakültesi Endoskopi Ünitesi'nin arşivi taranarak; Ocak 2010 ile Aralık 2014 tarihleri arasında kolonoskopi raporları retrospektif olarak incelendi. Kolonoskopik polipektomi yapılmış olan 470 hastanın demografik, kolonoskopik ve histopatolojik verileri kaydedildi.Bulgular: Beş yıllık süre içerisinde (Ocak 2010 ile Aralık 2014 arasında) toplam 3514 hastaya kolonoskopi yapılmış ve 470 hastada polip veya polipler saptanmıştır (%13,3). Hastaların yaş ortalaması 56,9±16,0 yıl ve 270'i (%61,7) erkekti. Polip boyutları 2-40 mm arasında (ortalama 6,24±5,0 mm) olan 980 polipektomi işlemi yapılmıştı. Hastaların %31,3'ünde birden fazla lokalizasyonda polip saptandı ve en sık yerleşim yeri rektumdu (%44,9). Histopatolojik olarak polipler adenomatöz (%53,6), hiperplastik (%31,7), kanser (%6,6), displazik (%5,1) ve diğer patolojiler (%3) olarak tanımlanmıştı. Histopatolojik olarak malignite riski ile 20 mm'den büyük çaplı polip, saplı polip ve birden fazla lokalizasyonda polip bulunması arasında korelasyon saptandı (sırasıyla p<0,001, p<0,001 ve p=0,011). Histopatolojik olarak displazi riski ile poliplerin sağ kolon yerleşimi arasında da korelasyon saptandı (p=0,033).Sonuç: Kolonoskopi yapılan hastalarımızın önemli bir kısmında polip saptanmıştır. Bu polipler arasında en sık rastlanan grup malignite potansiyeline sahip olan adenomatöz poliplerdir.Öğe Increased anti-Echinococcus granulosus antibody positivity in Fasciola hepatica infection(Aves, 2012) Kaya, Muhsin; Bestas, Remzi; Girgin, Sadullah; Cicek, Muttalip; Kaplan, Mehmet AliBackground/aims: Parasitic helminths express some antigen, which often accounts for serological cross-reactions. The aim of this study was to determine the prevalence of anti- Echinococcus granulosus antibody in patients with Fasciola hepatica infection using indirect immunofluorescence assay. Materials and Methods: The study population consisted of the following groups: Fasciola hepatica group (n=22), hydatid disease group (n=22) and healthy control group (n=24). Indirect immunofluorescence assay for Echinococcus granulosus was performed in all groups. Results: Indirect immunofluorescence assay was positive in all patients with hydatid disease, in 13 of 22 (59%) patients with fascioliasis and in 2 of 24 (8%) healthy subjects. The positivity rate of indirect immunofluorescence assay was significantly higher in the hydatid disease group compared to the fascioliasis group (p<0.001) and compared to the control group (p<0.001), and it was significantly higher in the fascioliasis group compared to the control group (p=0.001). Antibody titer was 11100 in 7 patients, 11320 in 12 patients and 111000 in 3 patients with hydatid disease. Indirect immunofluorescence assay was positive in 10 of 15 patients with hepatic phase and in 3 of 7 patients with biliary phase of fascioliasis. The antibody titer was 11100 in 6 and 11320 in 7 patients with fascioliasis. The antibody titer was 11100 in both healthy subjects. Conclusions: Indirect immunofluorescence assay for Echinococcus granulosus may be positive in a majority of patients with Fasciola hepatica infection and in some healthy subjects.Öğe Increased bone mineral density in patients with non-alcoholic steatohepatitis(Baishideng Publishing Group Inc, 2013) Kaya, Muhsin; Isik, Devran; Bestas, Remzi; Evliyaoglu, Osman; Akpolat, Veysi; Buyukbayram, Huseyin; Kaplan, Mehmet AliAIM: To determine the relationship between non-alcoholic steatohepatitis (NASH) and bone mineral density (BMD). METHODS: A total of 38 patients (25 males) with a diagnosis of histologically proven NASH and 42 healthy controls (24 males) were enrolled in the study. Demographic features, clinical findings, complete blood count and routine biochemical analysis, as well as adrenal, thyroid and gonadal functions, were recorded. Additionally, intact parathormone, 25-OH-vitamin-D3, tumor necrosis factor-alpha, interleukin-6, interleukin-1, in-sulin-like growth factor-1 and insulin-like growth factor binding protein-3 levels were measured in both groups. Furthermore, lumbar spine and femoral neck BMD of both groups were measured by the dual-energy X-ray absorptiometry (DXA) method. RESULTS: The mean age was 41 +/- 12 years in the NASH group and 43 +/- 11 years in the control group. Among demographic features, waist circumference was significantly larger in the NASH group compared to the control group (P < 0.019). Among laboratory parameters, serum triglyceride (P < 0.008), alanine transaminase (P < 0.0001), aspartate transaminase (P < 0.001), alkaline phosphatase (P < 0.016), gamma glutamyl transferase (P < 0.0001), ferritin (P < 0.001) and 25-OH-vitamin-D3 levels (P < 0.0001) were significantly higher in the NASH group compared to the control group. Lumbar BMD was significantly higher in the NASH group compared to the control group (1.057 +/- 0.119 g/cm(2) vs 0.941 +/- 0.133 g/cm(2); P < 0.001, respectively). In the NASH group, there was no significant relationship between BMD and fibrosis stage in liver biopsy. CONCLUSION: NASH increases BMD and may be related to an elevated serum 25-OH-vitamin D3 level. (C) 2013 Baishideng Publishing Group Co., Limited. All rights reserved.
