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Use of entecavir in hepatitis B virus reactivation of a patient with non-Hodgkin's lymphoma

Gozdas H.T. | Arpaci E.

Article | 2015 | World Journal of Gastroenterology21 ( 35 ) , pp.10251 - 10252

We read with interest the case report by Liu et al and the correspondence by Tuna et al regarding this case. Liu et al described hepatitis B virus (HBV) reactivation in a patient with non-Hodgkin's lymphoma after withdrawal of lamivudine prophylaxis. When HBV reactivation was observed three months after lamivudine withdrawal, entecavir 0.5 mg daily was started. HBV DNA level was moderately elevated (104 copies/mL) at that time. So, we could not understand why a potent antiviral like entecavir was required for this case. In addition to this, entecavir must be used at a dose of 1 mg in patients with prior prophylactic treatment with l . . .amivudine. As stated by Tuna et al duration of lamivudine prophylaxis in this case might be insufficient and HBV reactivation might have occured for this reason. So, we suppose that resolution of HBV reactivation might also be achieved with lamivudine instead of entecavir in this case. © The Author(s) 2015 Daha fazlası Daha az

Pancreatic hyperechogenicity on endoscopic ultrasound examination

Ustundag Y. | Ceylan G. | Hekimoglu K.

Article | 2011 | World Journal of Gastroenterology17 ( 15 ) , pp.2061 - 2062

There is an ongoing discussion on how to diagnose a hyperechogenic pancreas and what is the clinical significance of diffusely hyperechogenic pancreas. Computerized tomography and magnetic resonance imaging are the more appropriate methods to diagnose pancreatic hyper-echogenicity when compared with transcutaneous or endoscopic ultrasound examination. More importantly, pancreatic hyperechogenicity may not be a certain indicator of pancreatic fat infltration. Even if it is true, we do not know the clinical significances of pancreatic fat accumulation. Some suggested that excess fat in the pancreas is associated with chronic pancreati . . .tis. However, several histologi-cal studies on human alcoholic chronic pancreatitis did not prove the presence of fatty pancreas in such cases. Thus, except for aging, it is very rare to have truly steatotic pancreas in the absence of certain human diseases. © 2011 Baishideng. All rights reserved Daha fazlası Daha az

Spontaneous rupture of a hepatic hydatid cyst into the peritoneum causing only mild abdominal pain: A case report

Karakaya K.

Article | 2007 | World Journal of Gastroenterology13 ( 5 ) , pp.806 - 808

Hydatid disease is an endemic disease in certain areas of the world. It is located mostly in the liver. Spontaneous rupture of the hydatid cyst into the peritoneum is a rare condition, which is accompanied by serious morbidity and mortality generally. We present herein a case with a spontaneous rupture of a hepatic hidatid disease into the peritoneum without any serious symptoms. A 15-year-old boy was admitted to the emergency room with a mild abdominal pain lasting for a day. Physical examination revealed only mild abdominal tenderness. There was no history of trauma or complaints related to hydatid diseases. Ultrasonography showed . . . a large amount of free fluid and a cystic lesion with irregular borders in the liver. He was operated on. Postoperative albendazol therapy was given for 2 mo. No recurrence or secondary hydatidosis was seen on CT investigation in the 3rd, 6th and 12th mo following surgery. © 2007 The WJG Press. All rights reserved Daha fazlası Daha az

Effects of Helicobacter pylori infection on gastric epithelial cell kinetics in patients with chronic renal failure

Aydemir S. | Ozdemir B.H. | Gur G. | Dogan I. | Yilmaz U. | Boyacioglu S.

Article | 2005 | World Journal of Gastroenterology11 ( 45 ) , pp.7183 - 7187

Aim: To evaluate the effects of Helicobacter pylori infection on gastric epithelial cell kinetics in patients with chronic renal failure (CRF). Methods: Forty-four patients were enrolled in this study and divided into four groups with respect to their Helicobacter pylori (H pylori) and CRF status. Groups were labeled as follows: 1a: normal renal function, H pylori negative (n = 12), 1b: normal renal function, H pylori positive (n = 11), 2a: CRF, H pylori negative (n = 10), 2b: CRF, H pylori positive (n = 11). Upper gastrointestinal endoscopy was done in all the patients involved in the study. During endoscopical investigation, antra . . .l biopsy specimens were taken from each patient. In order to evaluate the cell apoptosis and proliferation in gastric epithelial cells, Bax and proliferating cell nuclear antigen (PCNA) labeling indexes (LI) were assessed with immunohistochemical staining method. Results: For groups 1a, 1b, 2a, and 2b, mean Bax LI was identified as 34.4±13.7, 44.1±16.5, 46.3±20.5, 60.7±13.8, respectively and mean PCNA LI was identified as 36.2±17.2, 53.6±25.6, 59.5±25.6, 67.2±22, respectively. When the one-way ANOVA test was applied, statistically significant differences were detected between the groups for both Bax LI (P = 0.004 Daha fazlası Daha az

Appendiceal mucocele: Case reports and review of current literature

Karakaya K. | Barut F. | Emre A.U. | Ucan H.B. | Cakmak G.K. | Irkorucu O. | Tascilar O.

Article | 2008 | World Journal of Gastroenterology14 ( 14 ) , pp.2280 - 2283

The mucocele of the appendix is an uncommon disorder which is often asymptomatic but sometimes causes acute appendicitis-like symptoms. Sometimes, patients with mucocele can present with confusing symptoms. Preoperative suspicion and diagnosis of appendiceal mucocele are important. Ultrasonography and camputed tomography are useful tools for the diagnosis of appendiceal mucocele. It may be also recognised by colonoscopy as a smooth submucosal lesion of the cecum. Optimal management of the mucocele could be achieved through accurate preoperative diagnosis. Preoperative diagnosis is a major component for minimizing intra-operative and . . . post-operative complications. We herein report five cases and discuss the diagnostic methods and surgical treatment. © 2008 WJG. All rights reserved Daha fazlası Daha az

Effect of oophorectomy and exogenous estrogen replacement on liver injury in experimental obstructive jaundice

Uçan H.B. | Kaplan M. | Salman B. | Yilmaz U. | Menteş B.B. | Aybay C.

Article | 2008 | World Journal of Gastroenterology14 ( 18 ) , pp.2818 - 2824

Aim: To investigate the role of estrogen on liver injury in an experimental obstructive jaundice model. Methods: Three groups of female rats were constituted; group 1 was oophorectomized and given E2 (n 14), group 2 was oophorectomized and given placebo (n 14), and group 3 was sham operated (n = 14). Fourteen days following constitution of bile duct ligation, all groups were compared in terms of serum tests, histopathologic parameters, and tissue levels of IFN-? and IL-6. Results: The parameters representing both the injury and/or the reactive response and healing were more pronounced in groups 1 and 2 (? 2 = 17.2, ?2 = 10.20; ?2 = . . .12.4, P < 0.05). In the sham operated or E2 administered groups significantly lower tissue levels of IFN-? and higher IL-6 levels Were found. In contrast, high IFN-? and low IL-6 tissue levels were found in the oophorectomized and placebo group (P < 0.001). Kupffer cell alterations were observed to be more pronounced in the groups 1 and 3 (?2 = 6.13, P < 0.05). Conclusion: Our study indicates that E2 impaired liver functions, accelerated both the liver damage and healing. In the conditions of bile duct obstruction, estrogen significantly changed the cytokine milieu in the liver. © 2008 WJG. All rights reserved Daha fazlası Daha az

Analysis of risk factors associated with complications of colonic stenting for malignant obstruction

Dindar G. | Ustundag Y. | Karakan T.

Article | 2014 | World Journal of Gastroenterology ( 27 ) , pp.9215 - 9216

Self expanding metalic stent (SEMS) application can cause serious problems up to one third of the patients and some studies reported negative effect of SEMSs on survival in patients with malignancy. The SEMS type especially the rigid one like Wall-stent rather than more flexible type Ultraflex was also reported to have bad impact on the risk of perforation we believe that stent based management protocol for patients with non-perforating left sided obstructing colorectal cancer is a complex method that needs qualified medical and technical team. © 2014 Baishideng Publishing Group Inc. All rights reserved.

Helicobacter pylori infection in hemodialysis patients: Susceptibility to amoxicillin and clarithromycin

Aydemir S. | Boyacioglu S. | Gur G. | Demirbilek M. | Can F.K. | Korkmaz M. | Yilmaz U.

Article | 2005 | World Journal of Gastroenterology11 ( 6 ) , pp.842 - 845

Aim: To evaluate susceptibility of Helicobacter pylori to amoxicillin and clarithromycin in end-stage renal disease (ESRD) patients and non-uremic controls. Methods: The subjects with dyspeptic complaints were 33 ESRD patients and 46 age- and sex-matched non-uremic controls who exhibited H pylori on antral biopsy specimens. The two groups were age and sex matched. The H pylori strains' pattern of susceptibility to amoxicillin and clarithromycin was investigated with the agar dilution technique. Results: None of the H pylori strains from either group showed resistance to amoxicillin with the agar dilution method. Twelve (36.4%) of th . . .e ESRD group strains and 7 (15.2%) of the control group strains showed resistance to clarithromycin, and this difference was statistically significant ( Daha fazlası Daha az

Plasmapheresis and corticosteroid treatment for persistent jaundice after successful drainage of common bile duct stones by endoscopic retrograde cholangiography

Saritas U. | Aydin B. | Ustundag Y.

Article | 2007 | World Journal of Gastroenterology13 ( 30 ) , pp.4152 - 4153

Prolonged cholestasis is a very rare complication of endoscopic retrograde cholangiography (ERC). Only few cases with this complication are reported in the English literature. We report persisting cholestatic jaundice in a 73-year old man after successful therapeutic ERC for choledocholithiasis. Serologic tests for viral and autoimmune hepatitis were all negative. A second-look ERC was normal also. He denied any medication except for prophylaxis given intravenous 1 g ceftriaxon prior to the ERC procedure. After an unsuccessful trial with ursodeoxycholic acid and cholestyramine for 2 wk, this case was efficiently treated with cortico . . .steroids and plasmapheresis. His cholestatic enzymes became normal and intense pruritis quickly resolved after this treatment which lasted during his follow-up period. We discussed the possible mechanisms and treatment alternatives of intrahepatic cholestasis associated with the ERC procedure. © 2007 WJG. All rights reserved Daha fazlası Daha az

Pretreatment with adenosine and adenosine A1 receptor agonist protects againts intestinal ischemia-reperfusion injury in rat

Özaçmak, Veysel Haktan | Sayan, Hale

Article | 2007 | World Journal of Gastroenterology13 ( 4 ) , pp.538 - 547

Aim: To examine the effects of adenosine and A1 receptor activation on reperfusion-induced small intestinal injury. Methods: Rats were randomized into groups with sham operation, ischemia and reperfusion, and systemic treatments with either adenosine or 2-chloro-N6-cyclopentyladenosine, A1 receptor agonist or 8-cyclopentyl-1,3-dipropylxanthine, A1 receptor antagonist, plus adenosine before ischemia. Following reperfusion, contractions of ileum segments in response to KCI, carbachol and substance P were recorded. Tissue myeloperoxidase, malondialdehyde, and reduced glutathione levels were measured. Results: Ischemia significantly dec . . .reased both contraction and reduced glutathione level which were ameliorated by adenosine and agonist administration. Treatment also decreased neutrophil infiltration and membrane lipid peroxidation. Beneficial effects of adenosine were abolished by pretreatment with A1 receptor antagonist. Conclusion: The data suggest that adenosine and Al receptor stimulation attenuate ischemic intestinal injury via decreasing oxidative stress, lowering neutrophil infiltration, and increasing reduced glutathione content. © 2007 The WJG Press. All rights reserved Daha fazlası Daha az

Cholangiocarcinoma: A compact review of the literature

Ustundag Y. | Bayraktar Y.

Review | 2008 | World Journal of Gastroenterology14 ( 42 ) , pp.6458 - 6466

Cholangiocarcinoma (CC) is a devastating cancer arising from biliary epithelia. Unfortunately, the incidence of this disease is increasing in Western countries. These tumors progress insidiously, and liver failure, biliary sepsis, malnutrition and cancer cachexia are general modes of death associated with this disease. To date, no established therapy for advanced disease has been established or validated. However, our knowledge in tumor biology is increasing dramatically and new drugs are under investigation for treatment of this notorious tumor. In clinical practice, there are better diagnostic tools in use to facilitate an earlier . . . diagnosis of CC, at least in those patients with known risk factors. CC is resectable for cure in only a small percentage of patients. Preoperative staging for vascular and biliary extension of CC is very important in this tumor. Laparoscopy and recently endosonography seem to protect against unnecessary laparotomies in these patients. During the last 15 years, aggressive surgical approaches, including combined liver resections and vascular reconstructive surgical expertise, have improved survival in patients with CC. Surgery is contraindicated in CC cases having primary sclerosing cholangitis (PSC). Although CC was previously considered a contraindication to liver transplantation, new cautious protocols, including neo-adjuvant chemoradiation therapies and staging procedures before the transplantation, have made it possible to achieve long-term survival after liver transplantation in this disease. New ablative therapies with photodynamic therapy, intraductal high-intensity ultrasonography and chemotherapy-impregnated plastic biliary endoprosthesis are important steps in the palliative management of extrahepatic CCs. Radiofrequency and chemo-embolization methods are also applicable for intra-hepatic CCs as palliative modes of treatment. We need more prospective randomized controlled trials to evaluate the role of the new emerging therapies for CC patients. © 2008 The WJG Press. All rights reserved Daha fazlası Daha az

Assessment of the correlation between serum prolidase and alpha-fetoprotein levels in patients with hepatocellular carcinoma

Ilikhan S.U. | Bilici M. | Sahin H. | Akca A.S.D. | Can M. | Oz I.I. | Guven B.

Article | 2015 | World Journal of Gastroenterology21 ( 22 ) , pp.6999 - 7007

AIM: To determine the predictive value of increased prolidase activity that reflects increased collagen turnover in patients with hepatocellular carcinoma (HCC). METHODS: Sixty-eight patients with HCC (mean age of 69.1 ± 10.1), 31 cirrhosis patients (mean age of 59.3 ± 6.3) and 33 healthy volunteers (mean age of 51.4 ± 12.6) were enrolled in this study. Univariate and multivariate analysis were used to evaluate the association of serum ?-fetoprotein (AFP) values with HCC clinicopathological features, such as tumor size, number and presence of vascular and macrovascular invasion. The patients with HCC were divided into groups accordi . . .ng to tumor size, number and presence of vascular invasion (diameters; ? 3 cm, 3-5 cm and ? 5 cm, number; 1, 2 and ? 3, macrovascular invasion; yes/no). Barcelona-clinic liver cancer (BCLC) criteria were used to stage HCC patients. Serum samples for measurement of prolidase and alphafetoprotein levels were kept at-80 °C until use. Prolidase levels were measured spectrophotometrically and AFP concentrations were determined by a chemiluminescence immunometric commercial diagnostic assay. RESULTS: In patients with HCC, prolidase and AFP values were evaluated according to tumor size, number, presence of macrovascular invasion and BCLC staging classification. Prolidase values were significantly higher in patients with HCC compared with controls (P < 0.001). Prolidase levels were significantly associated with tumor size and number (P < 0.001, P = 0.002, respectively). Prolidase levels also differed in patients in terms of BCLC staging classification (P < 0.001). Furthermore the prolidase levels in HCC patients showed a significant difference compared with patients with cirrhosis (P < 0.001). In HCC patients grouped according to tumor size, number and BCLC staging classification, AFP values differed separately (P = 0.032, P = 0.038, P = 0.015, respectively). In patients with HCC, there was a significant correlation (r = 0.616; P < 0.001) between prolidase and AFP values in terms of tumor size, number and BCLC staging classification, whereas the presence of macrovascular invasion did not show a positive association with serum prolidase and AFP levels. CONCLUSION: Considering the levels of both serum prolidase and AFP could contribute to the early diagnosing of hepatocellular carcinoma. © 2015 Baishideng Publishing Group Inc. All rights reserved Daha fazlası Daha az

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