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    Evaluation of paraoxonase, malondialdehyde, and lipoprotein levels in patients with asymptomatic cholelithiasis
    (Wolters Kluwer Medknow Publications, 2014) Atamer, Aytac; Kurdas-Ovunc, Ayse O.; Yesil, Atakan; Atamer, Yildiz
    Background/Aim: To compare lipoprotein and malondialdehyde levels and paraoxonase-1 activity between subjects with asymptomatic cholelithiasis and controls. Patients and Methods: Eighty subjects with asymptomatic cholelithiasis (55 women, 25 men, mean age: 51, SD 14 years) and 40 control subjects without cholelithiasis (25 women, 25 men, mean age: 51, SD 12 years) were enrolled to the study. Serum paraoxonase activity, lipoproteins, and malondialdehyde were measured. Results: In the cholelithiasis group, serum total cholesterol, low-density lipoprotein cholesterol, and malondialdehyde were significantly higher and high-density lipoprotein cholesterol (HDL-C) and paraoxonase-1 were significantly lower than the controls. In cholelithiasis patients with serum glucose level > 100 mg/dL, body mass index, serum total cholesterol, triglyceride (TG), and malondialdehyde levels were significantly higher than cholelithiasis patients with serum glucose level < 100 mg/dL. Paraoxonase-1 activity was significantly lower in patients with serum glucose level > 100 mg/dL. In cholelithiasis patients with TG > 150 mg/dL, mean age, body mass index, glucose, total cholesterol, and malondialdehyde were significantly higher than in cholelithiasis patients with TG < 150 mg/dL. In cholelithiasis subgroup with TG > 150 mg/dL, HDL-C level and paraoxonase-1 activity were lower than in the cholelithiasis subgroup with TG < 150 mg/dL. All of the above comparisons were statistically significant (P < 0.05). Conclusions: Patients with asymptomatic cholelithiasis have evidence of increased lipid peroxidation and decreased antioxidant capacity. Patients with asymptomatic cholelithiasis with components of the metabolic syndrome have more lipid peroxidation and less antioxidant capacity than patients with asymptomatic cholelithiasis but without the components of the metabolic syndrome.
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    Not only type 2 diabetes but also prediabetes is associated with portal inflammation and fibrosis in patients with non-alcoholic fatty liver disease
    (Elsevier Science Inc, 2014) Yilmaz, Yusuf; Senates, Ebubekir; Yesil, Atakan; Ergelen, Rabia; Colak, Yasar
    Aims: Growing evidence suggests that not only type 2 diabetes (T2D) but also prediabetes (PD) is common in patients with non-alcoholic fatty liver disease (NAFLD). However, few data exist on how PD impacts the histological characteristics of NAFLD patients. In this exploratory study, we sought to investigate the associations of PD and T2D with the severity of the histological features in patients with NAFLD. Methods: The population consisted of 280 patients with biopsy-proven NAFLD. The associations of PD and T2D with the severity of histological features of NAFLD were analyzed using multiple logistic (or ordinal logistic) regression models after adjustment for confounding factors. Results: PD and T2D was noted in 102 (36.4%) and 92 (32.8%) of patients, respectively. Of the 92 patients with T2D, ten (10.9%) were diagnosed de novo after the OGTT. PD and T2D were significantly associated with more severe portal inflammation (P < 0.01); the adjusted odds ratios (ORs) of PD and T2D for having a higher grade of portal inflammation were 1.8 [95% CI, 1.1, 3.2] and 2.6 [95% CI, 1.3, 5.8]), respectively. A similar relationship was observed for liver fibrosis (P < 0.001); specifically, the adjusted ORs of PD and T2D for having a higher grade of hepatic fibrosis were 2.4[95% CI, 1.3, 3.7] and 3.8 [95% CI, 1.9, 6.1]), respectively. Conclusion: Not only T2D but also PD is independently associated with portal inflammation and fibrosis in NAFLD patients. PD may be useful as a clinical indicator of patients who are likely to have already more severe histological findings. (C) 2014 Elsevier Inc. All rights reserved.
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    Re-Evalluation of Cases with Gastroenteropancreatic Neuroendocrine Tumors between 2004 and 2012 according to 2010 Criteria
    (H G E Update Medical Publishing S A, 2013) Ozkara, Selvinaz; Aker, Fugen; Yesil, Atakan; Senates, Ebubekir; Canbey, Ceren; Yitik, Ali; Gonen, Can
    Background/Aims: We re-evaluated the clinical, histopathological and immunohistochemical features of neuroendocrine tumors (NETs) diagnosed in our pathology laboratory between 2004 and 2012 and re-classified them according to the WHO-2000 and WHO-2010 criteria. Methodology: The study included NET samples of 106 patients having gastroenteropancreatic and hepatobiliary tumors. The histopathological findings were re-assessed. The cases were re-appraised based on the WHO-2000 and WHO-2010 criteria. The association between survival and Ki-67 index was analysed. Results: The most frequent localization was the stomach, The average tumor size was 3.0 +/- 4.1 cm. Differentiation was poor in 17 cases (16.0%). Lymphovascular invasion was detected in 16.1% (n=17) and necrosis was identified in 15.1% (n=16). The average number of Ki-67 was 9.1 +/- 19.9. Ki-67 measurements were significantly higher in patients who died compared to those who survived (p <0.01). In ROC analysis, the cut-off point for Ki-67 was 5. Conclusions: Our study is a single-center study comprising patients from Turkey for a period of 8 years. We found that the most frequent localization is the stomach. This ratio is associated with common use of endoscopy in our center. The specimens were re-evaluated according to the WHO-2000 and WHO-2010 classification systems the data and terminology have been updated.
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    Relationship Between Neutrophil Gelatinase-Associated Lipocalin (NGAL) Levels and Inflammatory Bowel Disease Type and Activity
    (Springer, 2013) Yesil, Atakan; Gonen, Can; Senates, Ebubekir; Paker, Nurcan; Gokden, Yasemin; Kochan, Koray; Erdem, Emrullah Duzgun
    Background and Aim Neutrophil gelatinase associated lipocalin (NGAL) is a recently identified molecule, which is bacteriostatic, has tissue destructive effects and is proinflammatory with chemoattractant molecule binding properties. Our aim was to investigate the relationship between serum NGAL levels and the type and level of disease activity of IBD. Methods A total of 92 patients [43 with Crohn's disease (CD) and 49 with ulcerative colitis (UC)], and 30 age-and sex-matched healthy controls (HC) were included in this study. Serum NGAL levels were measured using ELISA. Results Serum NGAL levels were elevated in the IBD group [median 171, range (57-312) ng/mL] compared to the HC group [107 (45-234) ng/mL] (p < 0.0001) and were elevated in UC patients [188 (74-312) ng/mL] compared to CD patients [168 (57-279) ng/mL] (p = 0.006). When NGAL levels were further analysed based on localization of the CD and UC, the levels in ulcerative pancolitis [233 (144-312) ng/mL] were significantly higher (p = 0.004) than the left-sided colitis [156 (103-309) ng/mL]. Similarly, NGAL levels were significantly higher in colonic CD [207 (125-249) ng/mL] than ileal CD [114 (78-210) ng/mL], and also in ileocolonic CD [198 (57-279) ng/mL] than ileal CD (p = 0.033). When CD and UC groups were further categorized as active and inactive according to clinical and endoscopic activity indices, serum NGAL concentrations did not differ between inquiescent versus active stages. When a cut-off level of 129 ng/mL was used to distinguish IBD from HC, a sensitivity of 76.1 % and a specificity of 60.9 % was reached. Conclusions The serum NGAL levels in the IBD group was significantly higher than the HC group. Serum NGAL levels were higher in more extensive colonic involvement.
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    RELATIONSHIP BETWEEN SERUM LIPIDS AND COLON POLYPS: A PILOT STUDY
    (Carbone Editore, 2014) Kayatas, Kadr; Kaya, Ozhan; Senates, Ebubekr; Yesil, Atakan; Senates, Banu Erkalma; Yesil, Ezgi Ersoy; Belen, Erdal
    Background/Aim: The relationship between dyslipidemia and various malignancies is still unclear. We therefore investigated the possible relationship between atherogenic dyslipidaemia and colon polyps and assessed the predictive role of dyslipidaemia in the development of colorectal cancer. Methods: The study involved patients evaluated at the Gastroenterology Clinic of HaydarpasaNumune Training and Research Hospital between October 2, 2011, and November 16, 2012. Data were collected from 74 patients with colon polyps (advanced and low-grade dysplasia [LGD]) and 57 healthy control subjects. Results: Triglyceride (p=0.001) and high-density lipoprotein (HDL)-cholesterol (p<0.01) concentrations were significantly higher in patients with advanced dysplasia (AD) than in the control group. Triglyceride (p=0.001) and HDL-cholesterol (p<0.01) concentrations were also significantly higher in patients with LGD than in the control group. Triglyceride and HDL-cholesterol concentrations, however, were similar in the AD and LGD groups. Conclusions: Atherogenic dyslipidaenzia is significantly associated with adenoma, suggesting that it could be involved in adenoma development. Atherogenic dyslipidaemia should not be ignored in colorectal cancer prevention programs.
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    SYNBIOTIC THERAPY INCREASES ERADICATION RATE IN HELICOBACTER PYLORI ERADICATION
    (Carbone Editore, 2013) Sahin, Onder; Yesil, Atakan; Senates, Ebubekir; Akdogan, Mehmet Fatih; Konur, Sevki; Erdem, Emrullah; Dal, Mehmet Sinan
    Background: Probiotics are used in combinations of H. pylori eradication regimens with variable results. Many strains tested had shown positive effects on side effect profiles. However, a clear effect on eradication rate is studied thoroughly. We aimed to investigate the beneficial effect of a synbiotic combination in clarithromycin-based triple eradication therapy. Methods: Ninety-two patients who were infected with H. pylori (confirmed via endoscopic biopsy) were randomized into two groups: those undergoing standard triple treatment (control group (rabeprozol plus amoksisilin plus clarithromycin bid) n=49) and those receiving symbiotic (triple plus symbiotic bid group n=43). The symbiotic product contained lactobacillus, bifidobacterium and enterococcus. The 13C-breath test was performed at least 6 weeks after completing both therapy regimens. Results: In the synbiotic group, 3 of the patients complained of metallic taste (7.0%). 1 complained of diarrhea (23%), 3 had nausea (7.0%), 2 had gas (4.7%), 3 experienced vomiting (7.0%) and 1 had constipation (23%). In the control group, 3 of the patients experienced a metallic taste (63%), 7 had diarrhea (14.6%), 5 had nausea (10.4%), 3 had intestinal bloating (63%), 3 experienced vomiting (63%) and I had constipation (2.1%). There was no significant difference between the two groups. However, side effect intensity and eradication rates were significant different between the groups (p<0.05). The eradication rate in the synbiotic group was 88.4%, while it was 68.8% in the control group (p<0.05). Conclusion: The addition of synbiotic to triple therapy decreases the rate of antibiotic-related side effects. It also increases H. pylori eradication rates in clarithromycin-based triple therapy.