Aydemir, Selim | Tekin, Solak Nilgün | Aktunç, Erol | Numanoğlu, Gamze | Üstündağ, Yücel
Article | 2004 | Turkish Journal of Gastroenterology15 ( 3 ) , pp.192 - 195
Amaç: Celiac hastalığı ince barsakların glutene intoleransı sonucu oluşan bir hastalıktır. Epidemiolojik çalışmalarda prevalansı hakkında çok farklı veriler vardı. Hastalarda genellikle çok geniş spektrumda semptom ve bulgulara neden olabildiğinden celiac hastalığı tanısının konulması zor olabilmektedir. Hastalığın erken evrede yakalanması önemlidir. Çünkü bu hastalarda barsak lenfoması gelişme riski artmıştır. Celiac hastalığı olan hastalarda rekürren aftoz stomatit prevalansındaki yükseklik nedeniyle rekürren aftoz stomatitli hastaların celiac hastalığı yönünden araştırılması asemptomatik celiac hastalığı olan hastaların tanı alma . . .sını sağlayabilir. Bu çalışma rekürren aftoz stomatit nedeniyle başvuran olgularda celiac hastalığı prevalansını saptamak için planlanmıştır. Yöntem: Çalışma gurubu olarak rekürren aftoz stomatit öyküsü olan, kontrol grubu olarak ise rekürren aftoz stomatit öyküsü olmayan olgular alındı. Tüm olgularda anti gliadin IgG, antigliadin IgA ve anti endomisium antikorları bakıldı. Ayrıca endoskopi yapılarak duodenum distal kesiminden biyopsiler alındı. Bulgular: Rekürren aftoz stomatit öyküsü olan 41 olgunun ikisinde patolojik inceleme ile doğrulanan celiac hastalığı bulundu (%4.8). Celiac hastalığı saptanan bu iki olgunun her ikisinde de anti gliadin IgA ve endomisium antikorları pozitif bulundu. Anti gliadin IgG antikoru ise olguların birinde pozitifti. Kontrol grubundaki 49 olgunun hiçbirinde celiac hastalığı saptanmadı. Sonuç: Rekürren aftoz stomatit olgularında celiac hastalığı açısında ileri incelenmeler yapılmalıdır. Endoskopinin invaziv ve daha pahalı olması nedeniyle rekürren aftoz stomatitli olgularda celiac hastalığı ı araştırmak için öncelikli olarak serolojik tetkikler yapılmalı, seroljik markır pozitif olan olgularda endoskopik olarak duodenum ikinci kesiminden biyopsiler alınmalıdır. Background/aims: Celiac disease is a condition related to the small intestine’s intolerance to gluten. In epidemiologic studies the prevalence is highly variable. The diagnosis can be difficult due to the wide spectrum of signs and symptoms. As the risk for intestinal lymphoma is higher in these patients, early diagnosis has its privileges. The higher prevalence of recurrent aphthous stomatitis in celiac disease led us to investigate the celiac disease prevalence in patients with recurrent aphthous stomatitis, which might assist in diagnosis of asymptomatic celiac disease patients. The aim of this study was to determine the prevalence of celiac disease in patients presenting with recurrent aphthous stomatitis. Methods: The study group consisted of patients having a history of recurrent aphthous stomatitis. The control group included patients not having aphthous stomatitis. Antibodies to gliadin IgG and IgA and antibodies to endomysium were determined from the serum samples of all patients. Biopsies were obtained from the distal part of the duodenum. Results: Biopsies of two patients (4.8%) out of 41 belonging to the study group were diagnosed as celiac disease. In serum samples of both, antibodies to gliadin IgA and antibodies to endomysium were found to be positive. Antibodies to gliadin IgG antibody were positive in only one of these two patients. None of the 49 patients in the control group was diagnosed as celiac disease. Conclusion: Further evaluation of recurrent aphthous stomatitis patients for celiac disease must be performed. As the endoscopic procedures are invasive and costly, evaluation of recurrent aphthous stomatitis patients for celiac disease must include serologic markers at the beginning. If any positivity is determined in markers, then endoscopic procedures including biopsies of the duodenum must be considered as the second-step intervention Daha fazlası Daha az
Aydemir, Selim | Bayraktaroğlu, Taner | Üstündağ, Yücel | Borazan, Ali | Sekirmez, Nedret | Aktunç, Erol | Numanoğlu, Gamze
Article | 2004 | Akademik Gastroenteroloji Dergisi3 ( 3 ) , pp.129 - 133
Giriş ve amaç: Standart üçlü tedavi ile Helicobacter pylori (H. pylori) eradikasyonu sağlanmayan olgularda ikinci tedavi ile eradikasyon daha zordur. H. pylori eradikasyon başarısızlıklarında uygulanacak tedavi kombinasyonları kesin belirlenmemiştir. Bu çalışmada lansoprazol, amoksisilin ve klaritromisin (LAK) ile yapılan standart üçlü tedavi ile H. pylori eradikasyonu sağlanamayan olgularda lansoprazol, ranitidin bizmut sitrat, tetrasiklin ve metronidazolden (LBTM) oluşan dörtlü tedavinin etkinliğini araştırdık. Gereç ve yöntem: Peptik ülser hastalığı veya nonülser dispepsi nedeniyle standart üçlü LAK tedavisi verilen ve H. pylori . . .eradikasyonu sağlanamayan toplam 36 olgu çalışmaya alındı. Bu olgulara lansoprazol (2x30 mg), ranitidin bizmut sitrat (2x400 mg), tetrasiklin (4x500 mg) ve metronidazolden (3x500 mg) oluşan dörtlü tedavi 14 gün verildi. Tedavinin bitiminden iki ay sonra endoskopik biyopsi ile H. pylori eradikasyonu değerlendirildi. Bulgular: Olgulardan beşi tedavi bitiminde kontrole gelmediğinden çalışma dışı bırakıldı. Dörtlü tedavi ile H. pylori eradikasyon oranı çalışmaya alınan tüm olgular değerlendirildiğinde %58.3, çalışma sonunda kontrole gelen olgular değerlendirildiğinde ise %67.7 saptandı. Sonuç: Bölgemizde standart LAK tedavisi ile H. pylori eradikasyonu sağlanamayan olgularda LBMT dörtlü tedavi kombinasyonunun başarı oranını oldukça düşük bulduk. Bu durumun ülkemizdeki metronidazol direncinin yüksek seviyelerde olması ile açıklanabileceğini düşünmekteyiz. Ülkemizde farklı bölgelerde H. pylorinin antibiyotik direnç durumunu ve tedavi başarısızlığı sebeplerini değerlendiren araştırmalara ihtiyaç vardır. Background/aim: Successful eradication of Helicobacter pylori (H. pylori) infection after failure of standard triple therapy is difficult. There are no guidelines on second-line therapies for H. pylori eradication failures. In the present study we investigated the efficacy of a 14-day quadruple regimen combining lansoprazole, ranitidine bismuth citrate (RBC), tetracycline and metronidazole as rescue treatment for Helicobacter pylori infection after failure of standard triple therapy combining lansoprazole, amoxicillin, clarithromycin (LAC). Materials and methods: A prospective study was designed consisting 36 patients infected with H. pylori and diagnosed with peptic ulcer or non-ulcer dyspepsia in whom triple therapy with LAC had failed. The patients were treated with quadruple therapy including lansoprazole, 30 mg twice daily, RBC, 400 mg twice daily, tetracycline, 500 mg four times daily, and metronidazole, 500 mg three times daily, for 14 days. Two months after completion of therapy, endoscopic biopsy evaluation was performed to confirm eradication. Results: Five cases who did not attend to the appointment were excluded from the study. With quadruple therapy, the H. pylori eradication rates were 58.3% by intention-to-treat analysis and 67.7% by per protocol analysis. Conclusion: The success rate of quadruple therapy with LBTM was found to be low in patients in whom standard triple therapy had failed in western Blacksea region. This finding may be explained by higher rates of metronidasole resistance in our country. We conclude that further studies about the drug resistance rates and explanation of reasons for treatment failure must be carried out Daha fazlası Daha az
Kolsal, Ebru | Tekin, İshak Özel | Pişkin, Etem | Aydemir, Cumhur | Akyüz, Mehmet | Çabuk, Hasan | Eldes, Nilüfer | Numanoğlu, Kemal Varın
Article | 2009 | Journal of Clinical Apheresis24 ( 1 ) , pp.21 - 24
Tricyclic antidepressant poisoning is one of the most common causes of serious intoxication. Here, we report a 2-year-old girl with severe amitriptyline (70 mg/kg) intoxication. She was in comatose, had generalized tonic clonic seizure, ventricular tachycardia, and wide QRS complexes. Although she did not respond to classical therapies, very good clinical response to plasmapheresis was obtained and she developed no complications. Thus, plasmapheresis may be an effective treatment modality in poisoning with drugs, which bind to plasma proteins with high affinity. © 2009 Wiley-Liss, Inc.
Hoşnuter, Mübin | Babucçu, Orhan | Kargı, Eksal | Numanoğlu, Gamze | Koca, Rafet | Babucçu, Berfu
Article | 2004 | European Journal of Plastic Surgery27 ( 5 ) , pp.246 - 248
Cylindroma is a rare tumor which originates from skin appendages and occurs predominantly on the scalp and face. It is considered to be benign, but malignant transformation has been reported. It has two distinct clinical presentations, solitary and multiple. A review of the literature revealed that the majority of malignant cylindromas occur among multiple type cylindromas. Only 36 malignant cylindromas have been reported, and only 9 were of the solitary type. A case with a solitary type of cylindroma exhibiting malignant transformation of the scalp is presented. © Springer-Verlag 2004.
Gün, Banu Doğan | Numanoğlu, Gamze | Özdamar, Şükrü Oğuz
Article | 2006 | Acta Obstetricia et Gynecologica Scandinavica85 ( 4 ) , pp.402 - 406
Background. To determine whether adequate trophoblastic migration and maternal placental perfusion occurs in cases of early pregnancy loss, we compared vessels in elective abortion decidua with those in spontaneous abortion decidua. Methods. Elective abortion decidua at 5-11 weeks ( n =40) were compared with spontaneous abortion decidua at 5-12 weeks ( n =25). Also normal late secretory endometrial biopsy specimens ( n =10) were examined. The cross-sections of veins and arteries were counted in 25 elective and 15 spontaneous abortion materials. The number of the veins that contain trophoblastic fragments and the number of the spiral . . . arteries converted by trophoblasts were determined. Statistical significance by Mann-Whitney U and Spearman's correlation test was p Daha fazlası Daha az
Sayin, Meral Y. | Kaya, Bektas | Bakkal, Bekir Hakan | Altundag, Kadri | Altundag, Muzaffer B.
Article | 2007 | MEDICAL ONCOLOGY24 ( 4 ) , pp.379 - 383
In this prospective study, we investigated the effects of hypofractionated radiotherapy for patients with high-grade gliomas. About 31 patients with glioblastoma multiforme or anaplastic astrocytoma were studied between October 2003 and December 2004. Hypofractionated radiotherapy (3 Gy/fraction/day) was delivered to a total dose of 45 Gy in 15 fractions in 10 patients (32%) who had total excision before radiotherapy and to a total dose of 54 Gy in 18 fractions in 21 patients (68%) who had subtotal excision or biopsy alone. Sex, age, type of surgery, tumor grade, Karnofsky performance status, time between surgery and initiation of r . . .adiotherapy, and total radiotherapy dose were analyzed as potential prognostic factors for survival using the univariate log-rank method. The median follow-up was 15 months (4-16 months). A total of 15 patients (48%) died of their illness; 16 patients (52%) were still alive at the last follow-up. The median survival time was 8 months. Actuarial 1-year overall survival was 40%. Type of surgery, timing of radiotherapy after surgery, and initial Karnofsky performance status were significant prognostic factors for survival. No grade 3-4 acute or late neurotoxicity was observed. The tolerance of patients to hypofractionated RT was not different from that for con- ventional radiotherapy. This treatment schedule can be used for patients with high-grade gliomas. Future investigations are needed to determine the optimal fractionation for high-grade gliomas Daha fazlası Daha az
Gültekin, Fatma Ayça | Bakkal, Bekir Hakan | Sümer, Demet | Köktürk, Füruzan | Bektaş, Sibel
Article | 2013 | Balkan Medical Journal30 ( 4 ) , pp.369 - 374
Background: Acute radiation proctitis is a common complication of pelvic radiation and management of acute radiation proctitis is under evaluation. The beneficial effects of ozonated olive oil (OzOO) have already been shown in the treatment of chronic wounds. Thus, this study was designed to evaluate the therapeutic effects of topical OzOO on acute radiation proctitis. Aims: To evaluate the therapeutic effects of topical OzOO on acute radiation proctitis. Study Design: Animal experimentation. Methods: Rats were divided into three groups: control; irradiation+saline (1 mL); and irradiation +OzOO (1 mL). A single fraction of 17.5 Gy w . . .as delivered to each rat. The OzOO was administered rectally each day after irradiation. Each rat was observed daily for signs of proctitis. Irradiated rats were euthanised on days 5 and 10. The mucosal changes were evaluated macroscopically and pathologically. Results: According to the clinical findings, five rats in the irradiation+saline group showed Grade 4 symptoms on the 10th day. Macroscopic finding scores on the 10th day in the irradiation+saline and irradiation+OzOO groups were statistically significantly different. On pathological examination, radiationinduced mucosal damage was the most prominent 10 days after irradiation in saline-treated rats. On the 10th day, the irradiation+OzOO group showed mild inflammation and slight crypt change, which corresponded to Grade 1 pathological findings. Conclusion: OzOO attenuates macroscopic and pathological findings of acute radiation proctitis in rats. Background: Acute radiation proctitis is a common complication of pelvic radiation and management of acute radiation proctitis is under evaluation. The beneficial effects of ozonated olive oil (OzOO) have already been shown in the treatment of chronic wounds. Thus, this study was designed to evaluate the therapeutic effects of topical OzOO on acute radiation proctitis. Aims: To evaluate the therapeutic effects of topical OzOO on acute radiation proctitis. Study Design: Animal experimentation. Methods: Rats were divided into three groups: control; irradiation+saline (1 mL); and irradiation +OzOO (1 mL). A single fraction of 17.5 Gy was delivered to each rat. The OzOO was administered rectally each day after irradiation. Each rat was observed daily for signs of proctitis. Irradiated rats were euthanised on days 5 and 10. The mucosal changes were evaluated macroscopically and pathologically. Results: According to the clinical findings, five rats in the irradiation+saline group showed Grade 4 symptoms on the 10th day. Macroscopic finding scores on the 10th day in the irradiation+saline and irradiation+OzOO groups were statistically significantly different. On pathological examination, radiationinduced mucosal damage was the most prominent 10 days after irradiation in saline-treated rats. On the 10th day, the irradiation+OzOO group showed mild inflammation and slight crypt change, which corresponded to Grade 1 pathological findings. Conclusion: OzOO attenuates macroscopic and pathological findings of acute radiation proctitis in rats Daha fazlası Daha az
Akman, Tulay | Tanrıverdı, Ozgur | Ozturk, Mehmet A. | Petekkaya, Ibrahim | Bakkal, Bekir Hakan | Sonmez, Ozlem U. | Avcı, Nilufer
Article | 2014 | Uluslararası Hematoloji-Onkoloji Dergisi24 ( 3 ) , pp.195 - 201
Günümüzde onkoloji alanında her geçen gün deneysel ve klinik araştırmaların sonucu olarak yeni bir gelişme olmaktadır. Kişi başına düşen yayın sayısına bakıldığında, Türkiye diğer gelişmiş Avrupa ülkelerinden epeyce geride yer almaktadır. Örneğin tüm dünyada kanser alanında yapılmış olan yayınların sayısı 2,134,964 iken, Türkiye’dekilerin sayısının toplamı 15.576’dır ve toplam yayın sayısı nüfus oranları ile karşılaştırıldığında diğer gelişmiş Avrupa ülkelerine göre epeyce geride kalmaktadır. Türkiye’de klinik çalışmaların önündeki en önemli engellerin finansal sorunlar, çalışma şartlarının zorlukları, iş yoğunluğu nedeniyle zaman k . . .ısıtlılığı, deneyimli-eğitimli insan gücü eksikliği, bilimsel çalışmanın tüm aşamalarında yardımcı olacak bir ekibin eksikliği, proje hazırlama ve etik kurul izin sürecinde yaşanan sıkıntılar, motivasyon eksikliği olduğu düşünülebilir. Biz genç onkologlar olarak bu yazımızda; dünya genelinde ülkemizin bilimsel ve klinik araştırmalardaki yerini, bilimsel araştırmaların yapılamamasının nedenlerini, ülkemizde yapılmakta olan yayınların çeşit ve kalitesini, bizim ülkemize ait varolan ger- çekleri ve bunlara yönelik getirilebilecek çözüm önerilerini tartışmayı amaçladık. There is a new improvement in oncology nearly in every day as a result of preclinical or clinical. As the number of publication per capita, Turkey is far behind the other developed European countries. For example, the number of publications in oncology field is 2.134.964 in the world, it is 15.576 in our country. The most important obstacles for clinical trials in Turkey may be listed as financial problems, difficulties of working conditions, time limitation due to work intensity, inadequate experienced/trained man-power, absence of assistance team at all steps of a scientific trial, difficulties faced during project planning and ethics committee submissions, and lack of motivation. In this article, we, as young oncologists, aimed to discuss the place of Turkey in areas of scientific and clinical trials in the world; underlying causes for inadequate number, type and quality of national studies and possible solution proposals in our countr Daha fazlası Daha az
Bilir C. | Engin H. | Bakkal, Bekir Hakan | Ilikhan S.U. | Malkoç D.
Article | 2013 | Medicinski Glasnik10 ( 2 ) , pp.298 - 303
Aim To analyze the results of chemotherapy applied at the Bülent Ecevit University School of Medicine, Department of Medical Oncology, to elderly patients with metastatic gastric cancer (GC). Methods The study retrospectively investigated hospital records including pathological reports, imaging records, chemotherapy regimens, response and toxicity profile. All patients received systemic chemotherapy for pathologically proven metastatic GC at the Bülent Ecevit University School of Medicine, Department of Medical Oncology. Results From 2005 to 2012, 23 metastatic GC patients older than 70 years were treated with systemic chemotherapy . . .as a first-line therapy. As the first-line chemotherapy, 17 (74%) patients received polychemotherapy and the remaining six (26%) patients received monotherapy. Overall, 113 cycles were administered. The median progression free survival (PFS) for the first-line chemotherapy was 6 months (95% CI, 0-16) and the median overall survival (OS) was 14 months (95% CI, 3-30). Multivariate analysis revealed that decreased OS was significantly associated with poor Eastern Cooperative Oncology Group (ECOG) performance status (p=0.045), elevated carcinoembryonic antigen (CEA) levels at the diagnosis time (p = 0.040) and decreased number of chemotherapy cycles (p=0.019) with R-Sq (adj) = 41, 6%. One patient had a complete response with docetaxel, cisplatin and fluorouracil combined (DCF) regimen and had 12 months of disease free survival (DFS). Conclusion This is the first study investigating the outcomes of chemotherapy in Turkish elderly metastatic GC patients. Docetaxel, cisplatin and fluorouracil combination were the most common regimen, which is a tolerable and effective choice in elderly patients who had good performance status Daha fazlası Daha az
Bakkal, Bekir Hakan | Vural T. | Elmas O. | Yildiz O. | Kokturk F.
Article | 2014 | Journal of Cancer Research and Therapeutics10 ( 3 ) , pp.558 - 562
Aims: The aim of this study was to evaluate and compare the effect of radiotherapy on testicles with different treatment positions and plans for rectal cancer patients. Settings and Design: Mono-institutional prospective study. Patients and Methods: Three different plans; supine 4-fields (s4f), prone 4-fields (p4f), and prone 3-fields (p3f) of 15 male patients with rectal carcinoma receiving 45 Gy pelvic radiotherapy were evaluated. Testicular doses in each plan were calculated. Since the localizations of the primary tumor may affect testicular dose, boost doses were not taken into account. Statistical Analysis Used: Kruskal Wallis . . .test, Pearson and Spearman correlation analysis. Results: Median cumulative testicular doses of s4f, p4f, and p3f plans were 19.8, 69.3, and 100.8 cGy, respectively (P = 0.013). Median V0.5 (Volume receiving more than 0.5 Gy) and V1 (Volume receiving more than 1 Gy) for testicles were also significantly lower in s4f plans (3%, 60.7%, and 78.1% for V0.5 and 0.3%, 35.8%, and 52.3% for V1 in s4f, p4f, and p3f, respectively) (P = 0.001). The median distances between lower edge of fields and testicles in s4f, p4f, and p3f plans were 65 mm, 29 mm, and 29 mm, respectively (P < 0.01). Median bladder doses were significantly lower in p3f plans (P = 0.002). Conclusions: S4f external beam radiotherapy for rectal carcinoma allows better testicular dose than p3f and p4f. The probably reason was the increase of distance between lower edge of the field and testicles Daha fazlası Daha az
Sayin M. | Bakkal, Bekir Hakan
Article | 2011 | Tumori97 ( 1 ) , pp.123 - 125
Herpes zoster is an infectious disease caused by varicella-zoster virus that may occur sporadically at any age. We report on two patients with herpes zoster who received chemotherapy for breast cancer. Both patients were immunocompromised and received filgrastimtherapy for themanagement of neutropenia. Zoster occurred during filgrastim therapy but the symptoms were alleviated rapidly in the course of therapy. We conclude that granulocyte colony-stimulating factor therapy helped symptom alleviation and accelerated the recovery fromherpes zoster in our chemotherapy-treated patients. Free full text available at www.tumorionline.it.
Karabey M.S. | Yirmibeşoğlu Erkal E. | Yolcu A. | Bakkal, Bekir Hakan | Ay Ö. | Aksu M.G. | Sarper E.B.
Article | 2017 | Turkish Journal of Medical Sciences47 ( 2 ) , pp.412 - 416
Background/aim: This study presents the joint experience of three centers in the treatment of patients with biliary tract tumors with radiation therapy (RT). Materials and methods: The records of 27 patients were retrospectively reviewed. All of the patients who had undergone surgical resection received postoperative adjuvant RT, whereas all of the patients who had not undergone a surgical resection received RT with palliative intent. Twenty patients with adequate performance status were treated with RT and chemotherapy, while the remaining seven patients were treated with RT alone. Results: Follow-up ranged from 1 to 44 months. Loc . . .al control was not achieved in 10 out of 11 patients who had received RT with palliative intent. Systemic failure was observed in eight patients at 5 to 16 months. Fifteen patients died due to disease-related causes at 1 to 22 months. At 2 years, overall survival was 33% and disease-free survival was 19%. A surgical resection with curative intent predicted improved local failure-free survival and improved disease-free survival. Conclusion: Since local recurrence is still the leading cause of failure following postoperative RT and the outcome following palliative RT is far from satisfactory, the indications, the target volume, and the doses for RT should be reconsidered. © TÜBİTAK Daha fazlası Daha az