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Practical points that gastrointestinal fellows should know in management of COVID-19

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World Journal of Clinical Cases 2022年第16期10卷 5133-5145页

作者： Tevhide Sahin cem simsek Hatice Yasemin Balaban Department of Gastroenterology Hacettepe UniversityFaculty of MedicineAnkara 06100Turkey

Pandemics obligate providers to transform their clinical *** extensive effort has been put to find out feasible approaches for gastrointestinal diseases and also to manage coronavirus disease 2019(COVID-19)related gastrointestinal ***,hepatitis,and pancreatitis can be seen in the COVID-19 *** procedures increase the risk of contamination for medical staff and patients despite precautions,therefore indications should be tailored to balance risks vs ***,whether the immunosupression in inflammatory bowel diseases,liver transplantation,and autoimmune liver diseases increases COVID-19 related risks and how to modify immunosupression are topics of ongoing *** review aims to provide most up to date practical approaches that a gastrointestinal fellow should be aware on the problems and management of gastrointestinal and hepatobiliary diseases during the COVID-19 pandemic.

关键词： COVID-19 Gastrointestinal diseases Practical points Endoscopy Gastrointestinal fellows

Comprehensive clinicopathologic characteristics of intraabdominal neurogenic tumors:Single institution experience

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World Journal of Clinical Cases 2021年第10期9卷 2218-2227页

作者： cem simsek Meral Uner Feride Ozkara Orkun Akman Aytekin Akyol Taylan Kav Cenk Sokmensuer Gokhan Gedikoglu Department of Gastroenterology Hacettepe UniversityAnkara 06230Turkey Department of Pathology Hacettepe UniversityAnkara 06230Turkey Department of Internal Medicine Hacettepe UniversityAnkara 06230Turkey Department of Pathology Yozgat City HospitalYozgat 66100Turkey

BACKGROUND Neurogenic tumors are rare but represent an important consideration in the differential diagnosis of abdominal mesenchymal *** on their incidence,pathological features and clinical characteristics are *** To advance the overall knowledge on the histologic,immunohistochemical,clinical and radiologic characteristics of neurogenic tumors through this case *** An established database of a nationwide tertiary referral center,covering a 15-year period(2005 and 2020),was retrospectively *** of neurogenic tumor cases were confirmed by two experts following review of the macroscopic,histological and immunohistochemical records along with findings from analysis of archived tissue sections for each included *** microarrays were constructed for cases lacking necessary immunohistochemical *** data and follow-up information were collected from the hospital records and the patients themselves,when *** The study included 19 cases of intraabdominal neurogenic tumors,representing 12 women and 7 men, between 18 and 86 years of age (median: 51 years). Finalconfirmed diagnoses were 12 schwannomas, 2 diffuse submucosal neurofibromatoses,2 ganglioneuromas, 2 malignant peripheral sheath nerve tumors,and 1 mucosal Schwann cell hamartoma. Sizes of the tumors were variable, with amedian diameter of 4 cm;the two largest (> 10 cm) were schwannomas. Themajority of cases were asymptomatic at presentation, but the most frequentsymptom was abdominal pain. Gastrointestinal tract lesions were detected withendoscopy and extra-luminal lesions were detected with cross-sectional *** cases were S100-positive and CD117-negative;most cases were negative fordesmin, epithelial membrane antigen, smooth muscle actin and CD34. In all but 5cases, the Ki67 proliferation index was ≤ 1%.CONCLUSION Re-evaluation of 19 cases of abdominal neurogenic tumors demonstrated considerablevariability in clinicopathologic ch

关键词： Neurogenic tumors Mesenchymal tumors Schwannoma Neurofibroma Malignant peripheral sheath tumor Intraabdominal

Machine learning in endoscopic ultrasonography and the pancreas:The new frontier?

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Artificial Intelligence in Gastroenterology 2022年第2期3卷 54-65页

作者： cem simsek Linda S Lee Department of Gastroenterology Hepatology and EndoscopyDepartment of MedicineBrigham and Women's HospitalHarvard Medical SchoolBostonMA 02215United States Division of Gastroenterology Hepatology and EndoscopyDepartment of MedicineBrigham and Women's HospitalHarvard Medical SchoolBostonMA 02115United States

Pancreatic diseases have a substantial burden on society which is predicted to increase further over the next *** ultrasonography(EUS)remains the best available diagnostic method to assess the pancreas,however,there remains room for *** intelligence(AI)approaches have been adopted to assess pancreatic diseases for over a decade,but this methodology has recently reached a new era with the innovative machine learning algorithms which can process,recognize,and label endosonographic *** review provides a targeted summary of AI in EUS for pancreatic *** studies cover a wide spectrum of pancreatic diseases from pancreatic cystic lesions to pancreatic masses and diagnosis of pancreatic cancer,chronic pancreatitis,and autoimmune *** these,AI models seemed highly successful,although the results should be evaluated carefully as the tasks,datasets and models were greatly *** addition to use in diagnostics,AI was also tested as a procedural real-time assistant for EUS-guided biopsy as well as recognition of standard pancreatic stations and labeling anatomical landmarks during routine *** thus far have suggested that the adoption of AI in pancreatic EUS is highly promising and further opportunities should be explored in the field.

关键词： Artificial intelligence Pancreas Endoscopic ultrasonography Pancreatic cancer Autoimmune pancreatitis Pancreatic cystic lesions

Hepatocellular Carcinoma and the Role of Liver Transplantation:A Review

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Journal of Clinical and Translational Hepatology 2021年第5期9卷 738-748页

作者： Haris Muhammad Aniqa Tehreem Peng-Sheng Ting Merve Gurakar Sean Young Li cem simsek Saleh A.Alqahtani Amy K.Kim Ruhail Kohli Ahmet Gurakar Department of Internal Medicine Greater Baltimore Medical CenterMDUSA Department of Internal Medicine Sinai HospitalBaltimoreMDUSA Division of Gastroenterology and Hepatology Johns Hopkins University School of MedicineBaltimoreMDUSA Department of Medicine Osler Residency ProgramJohns Hopkins University School of MedicineBaltimoreMDUSA Duke University DurhamNCUSA

Hepatocellular carcinoma(HCC)is one of the leading causes of cancer deaths worldwide and liver transplantation(LT)is the only potentially curative *** the years,Milan criteria has been used for patient *** is ongoing research in this field with introduction of new biomarkers for HCC that can help guide future ***,newer therapies for downstaging of the tumor are being implemented to prevent dropout from the transplant *** addition,combination therapies for better outcome are under ***,the concept of living-donor LT and possible use of hepatitis C virus-positive donors has been implemented as an attempt to expand the organ ***,there is a conflict of opinion between different centers regarding its efficacy and data is *** aim of this review article is to outline the various selection criteria for LT,discuss the outcomes of LT in HCC patients,and explore future directions of LT for ***,a comprehensive PubMed/MEDLINE review was *** expand our search,references of the retrieved articles were also screened for additional *** selecting the studies,the authors independently reviewed them to identify the relevant *** careful evaluation 120 studies relevant to out topic are cited in the *** tables and two figures are also *** conclusion LT for HCC has evolved over the *** the introduction of several expanded criteria beyond Milan,the introduction of bridging therapies,such as transcatheter arterial chemoembolization and radiofrequency ablation,and the approval of newer systemic therapies,it is evident that there will be more LT recipients in the *** is promising to see ongoing trials and the continuous evolution of *** studies are needed to guide the development of a pre-LT criteria that can ensure low HCC recurrence risk and is not overly stringent,clarify the role of LDLT,and determine the optimal bridgin

关键词： Hepatocellular carcinoma Liver transplantation Model for endstage liver disease Trans-arterial radioembolization Locoregional therapies

Recurrence of hepatocellular carcinoma following deceased donor liver transplantation:case series

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Hepatoma Research 2020年第3期6卷 31-40页

作者： cem simsek Amy Kim Michelle Ma Nilay Danis Merve Gurakar Andrew M.Cameron Benjamin Philosophe Jacqueline Garonzik-Wang Shane Ottmann Ahmet Gurakar Behnam Saberi Johns Hopkins University School of Medicine Division of Gastroenterology and Hepatology-Transplant HepatologyBaltimoreMD 21205USA Johns Hopkins University Bloomberg School of Public Health BaltimoreMD 21205USA Johns Hopkins University School of Medicine Division of Transplant SurgeryBaltimoreMD 21205USA

Aim:We aimed to study the clinical and pathological characteristics of liver transplant recipients with hepatocellular carcinoma ***:We reviewed the data for 26 patients who had tumor recurrence after deceased donor liver transplant for hepatocellular carcinoma at the Johns Hopkins Hospital from January 2005 to December ***:In total,88%of recipients were *** mean age was 59 *** explant,poor differentiation was detected in 43%,while 73%had microvascular ***,62%were diagnosed to be outside of Milan *** of these,15%met the criteria for ***(77%)patients had pre-transplant alpha fetoprotein levels≥20 ng/*** 54%of patients,the location of hepatocellular carcinoma(HCC)recurrence was extrahepatic,followed by intrahepatic in 31%and both intra-and extrahepatic in 15%.The post-transplant tumor recurrence was diagnosed at a mean of 427 days(range 34-1502).Fifty percent of HCC recurrences were diagnosed within one year following liver ***(77%)patients received treatment for their recurrent HCC:external radiation(n=10),surgical resections(n=8;brain 4,spine 2,bone 1,and Whipple surgery 1),sorafenib(n=7),locoregional therapy(n=5).Overall,24 out of 26(92%)recipients died within four years after the ***:HCC recurrence after liver transplant is *** than fifty percent of HCC recurrences following liver transplant are *** better recipient selection for liver transplant,the curative options are limited in recurrent cases and associated with extremely poor outcomes.

关键词： Hepatocellular carcinoma liver transplant liver resection locoregional therapy