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Hamamci M.,Ankara University | Karaahmet F.,Ankara University | Akinci H.,Ankara University | Kilincalp S.,Ankara University | And 3 more authors.
Acta Gastro-Enterologica Belgica | Year: 2015

HCC is the most common type of primary liver tumor. The Practice Guideline, AASLD, for HCC recommended surveillance of HBV carriers at high risk of HCC with US every 6-12 months. Laboratory surveillance option is the measurement of serum α-fetoprotein level which has long been used for the diagnosis of HCC. But, increased serum levels of α-fetoprotein are also seen in acute hepatitis, cirrhosis, and malignancies include yolk sac carcinoma, neuroblastoma, hepatoblastoma, gastric and lung carcinoma. Because of elevation α-fetoprotein in these malignancies, liver mass with an elevated α-fetoprotein does not directly indicate HCC. For these reason, clinicians evaluating patient with liver mass and HBV-related cirrhosis should be vigilant for other case of α-fetoprotein elevation. © 2015, Universa Press. All rights reserved. Source


Basar O.,Dskap Yldrm Beyazt Educational and Research Hospital | Akbal E.,Ankara Educational and Research Hospital | Koklu S.,Ankara Educational and Research Hospital | Kocak E.,Ankara Educational and Research Hospital | And 5 more authors.
Scandinavian Journal of Clinical and Laboratory Investigation | Year: 2012

Background and aims. Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver pathology worldwide and is strongly associated with obesity and insulin-resistance and food intake. Nesfatin-1 is a new peptide that controls appetite and food intake. The objective of this research was to examine the serum concentrations of nesfatin-1 in NAFLD. Material and methods. Thirty NAFLD patients who had elevated liver enzymes and 40 age-and sex-matched healthy subjects were included in this study. NAFLD was diagnosed and graded with the findings of liver ultrasound scan. Nesfatin-1 concentrations were measured using an ELISA method and the relationship between nesfatin-1 and metabolic parameters were investigated. The subjects were divided into two groups according to their body mass index (≥30 and <30) and nesfatin-1 concentrations were examined between both groups. Results. Serum nesfatin-1 concentrations in NAFLD patients were lower than healthy controls (0.26±0.14 ng/ml, 0.38±0.18 ng/ml, respectively, and p 0.008). We found a negative correlation between nesfatin-1 and fasting glucose and body mass index. In obese subjects, serum nesfatin-1 concentrations were significantly lower when compared with non-obese subjects (0.26±0.12 ng/ml, 0.37±0.19 ng/ml, respectively; p 0.014). In addition, we showed that nesfatin-1 concentrations in subjects with insulin resistance were significantly lower in comparison with insulin-sensitive ones (0.27±0.17 ng/ml, 0.38±0.17 ng/ml, respectively; p 0.015). Conclusion. Our study has shown that nesfatin-1 concentrations were reduced in NAFLD. The results of this study indicate that nesfatin-1 may have a significant role in NAFLD. © 2012 Informa Healthcare. Source


Karaahmet F.,Dskap Yldrm Beyazt Educational and Research Hospital | Klncalp S.,Dskap Yldrm Beyazt Educational and Research Hospital | Coskun Y.,Dskap Yldrm Beyazt Educational and Research Hospital | Hamamci M.,Dskap Yldrm Beyazt Educational and Research Hospital | And 7 more authors.
Wiener Klinische Wochenschrift | Year: 2015

Summary: Background: Dieulafoy’s lesion (DL) is a relatively uncommon medical condition characterized by a large tortuous arteriole in the submucosa of any part of gastrointestinal (GI) tract wall that bleeds via erosion likely caused in the submucosal surface by protrusion of the pulsatile arteriole. Compared with other endoscopic hemostatic techniques, clipping alone for DL is limited. Summary: Aims: The aim of the present case series study is to identify common clinical and endoscopic features, rates of occurrence, to review the outcome of endoscopic management of upper GI tract DL, and to illustrate the use and the efficiency of endoclips in maintaining the GI bleeding due to DL. Summary: Patients and methods: This case series was conducted at Department of Gastroenterology, Dıskapı Yıldırım Beyazıt Educational and Research Hospital. The patients who were admitted to the emergency department of Dıskapı Yıldırım Beyazıt Educational and Research Hospital underwent gastrointestinal system (GIS) endoscopy between 2008 and 2013 and were assessed retrospectively. Five cases of GI bleeding related to DL were given endoscopic treatment with hemoclip application. Clinical data, endoscopic findings, and the effects of the therapy were evaluated. Summary: Results: The median number of endoscopic hemoclips application in first endoscopy was 4 (2–9). Rebleeding developed in all patients who had hemoclips applied. Re-endoscopy was performed in three of these patients, which controlled the bleeding. Two patients were transferred to surgery. Summary: Conclusions: Combination of endoscopic injection and mechanical therapies seems a suitable method for maintaining upper GIS bleeding due to DL. Also, further studies are needed to better define the best endoscopic approach for the treatment of DL. © 2015 Springer-Verlag Wien Source


Kilincalp S.,Dskap Yldrm Beyazt Educational and Research Hospital | Coban S.,Dskap Yldrm Beyazt Educational and Research Hospital | Akinci H.,Dskap Yldrm Beyazt Educational and Research Hospital | Hamamc M.,Dskap Yldrm Beyazt Educational and Research Hospital | And 7 more authors.
European Journal of Cancer Prevention | Year: 2015

Colorectal cancer (CRC) is the third most common cause of cancer-related death in Europe. The aim of the present study was to elucidate the efficiency of the neutrophil/lymphocyte ratio (NLR), the platelet/lymphocyte ratio (PLR), and the mean platelet volume (MPV) as tools for the preoperative diagnosis of CRC and their usefulness in the follow-up of CRC. A total of 144 CRC patients, as diagnosed by colonoscopy, and 143 age-matched and sex-matched healthy participants were included in the study. Medical records were used to compare preoperative and postoperative data including hemoglobin levels, platelet counts, MPV, NLR, and PLR. NLR, PLR, and MPV were significantly higher in CRC patients preoperatively, compared with healthy participants. Receiver-operating characteristic curve analysis suggested 2.02 as the cutoff value for NLR [area under the curve (AUC): 0.921, sensitivity: 86%, specificity: 84%], 135 as the cutoff value for PLR, (AUC: 0.853, sensitivity: 70%, specificity: 90%) and 8.25 fl as the cutoff value for MPV (AUC: 0.717, sensitivity: 54%, specificity: 76%). Subgroup analysis showed that NLR, PLR, and MPV levels were also significantly higher in nonanemic CRC patients compared with the control group, which is of great theoretical and clinical value for the early detection of CRC. Surgical tumor resection resulted in a significant decrease in NLR, PLR, and MPV. Our results suggest that NLR, PLR, and MPV may be used as easily available additional biomarkers for CRC in screening the general population, as well as in postoperative follow-up. © 2015 Wolters Kluwer Health, Inc. All rights reserved. Source


Simsek Z.,Dskap Yldrm Beyazt Educational and Research Hospital | Tuncer N.C.,Gazi University | Alagozlu H.,Cumhuriyet University | Karaahmet F.,Dskap Yldrm Beyazt Educational and Research Hospital | And 2 more authors.
Turkish Journal of Medical Sciences | Year: 2015

Background/aim: Irritable bowel syndrome (IBS) is a gastrointestinal condition characterized by chronic abdominal pain, discomfort, bloating, and alteration of bowel habits in the absence of any organic cause. This trial investigated the presence of microscopic colitis (MC) and associated factors related to MC in patients diagnosed with IBS. Materials and methods: The study group (group I) consisted of 91 consecutive patients diagnosed with IBS based on the Rome III Criteria for whom colonoscopic examination was requested. The control group (group II) had 41 patients diagnosed with IBS considered as eligible for colonoscopic investigation due to specific conditions, and for whom colonoscopic examination was recommended for screening purposes due to a familial history of colon cancer. Clinical data, endoscopic findings, and the effects of the therapy were evaluated. Results: In the diarrhea-predominant IBS group, nine patients (9.89%) were diagnosed with microscopic colitis, seven with lymphocytic colitis (7.69%), and two with collagenous colitis (CC) (2.19%). None of the patients in group II were found to have MC (P = 0.007). There were no diagnoses of MC in the constipation-predominant and mixed type IBS groups. Conclusion: Clinicians should keep MC in mind for patients presenting with diarrhea-predominant IBS symptoms. © TÜBİTAK Source

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