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Recent developments and innovations in gastric cancer

World Journal of Gastroenterology 2016年第17期22卷 4307-4320页

作者： Mehmet Mihmanli enver Ilhan Ufuk Oguz Idiz Ali Alemdar Uygar Demir Department of General Surgery Sisli Etfal Training and Research Hospital Department of General Surgery Izmir Bozkaya Training and Research Hospital Department of General Surgery Okmeydani Training and Research Hospital

Gastric cancer has an important place in the worldwide incidence of cancer and cancer-related deaths. It can metastasize to the lymph nodes in the early stages, and lymph node metastasis is an important prognostic factor. Surgery is a very important part of gastric cancer treatment. A D2 lymphadenectomy is the standard surgical treatment for c T1N+ and T2-T4 cancers, which are potentially curable. Recently, the TNM classification system was reorganized, and the margins for gastrectomy and lymphadenectomy were revised. Endoscopic, laparoscopic and robotic treatments of gastric cancer have progressed rapidly with development of surgical instruments and techniques, especially in Eastern countries. Different endoscopic resection techniques have been identified, and these can be divided into two main categories: endoscopic mucosal resection and endoscopic submucosal dissection. Minimally invasive surgery has been reported to be safe and effective for early gastric cancer, and it can be successfully applied to advanced gastric cancer with increasing experience. Cytoreductive surgery and hypertherm?c intraper?toneal chemotherapy were developed as a combined treatment modality from the results of experimental and clinical studies. Also, hyperthermia increases the antitumor activity and penetration of chemotherapeutics. Trastuzumab which is a monoclonal antibody interacts with human epidermal growth factor(HER) 2 and is related to gastric carcinoma. The anti-tumor mechanism of trastuzumab is not clearly known, but mechanisms such as interruption of the HER2-mediated cell signaling pathways and cell cycle progression have been reported previously. H. pylori is involved in 90% of all gastric malignancies and Japanese guidelines strongly recommend that all H. pylori infections should be eradicated regardless of the associated disease. In this review, we present innovations discussed in recent studies.

关键词： Gastric Cancer Endoscopic mucosal resection Endoscopic submucosal resection Minimally invasive surge

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Heart Valve Lesions Due to the Formation of a Beta-Hemolytic Streptococ Role of Adhesion Molecules

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Surgical Science 2013年第8期4卷 371-376页

作者： Semsi Altaner Turhan Kurum Muzaffer Demir Burhan Turgut Turan Ege enver Duran Hematology Department School of Medicine Trakya University Edirne Turkey Pathology Department School of Medicine Baskent University Istanbul Turkey School of Medicine Namik Kemal University Tekirdag Turkey School of Medicine Trakya University Edirne Turkey TEM Hospital Istanbul Turkey

Objectives: A rise in the levels of adhesion molecules such as VCAM-1, ICAM-1and E-selectin in valve disease patients has been reported lately. In our study, by detecting the presence of adhesion molecule expression in the valve endothelium we will try to show the level of adhesion molecules in peripheral blood leucocytes. Materials and Methods: Valve samples were obtained from patients having undergone aortic and mitral valve replacement due to symptomatic aortic stenosis/aortic insufficiency and/or mitral stenosis/mitral insufficiency. The clinical preoperative diagnosis was made using two-dimensional echocardiography and Doppler echocardiography. Rheumatic valves were in group B (n = 20). Group A (n = 8) constituted the control group. Immunohistochemical staining was performed using CD4, CD8, CD54/ICAM-1, and CD106/VCAM-1. Flow cytometric analysis was performed. The Kolmogorov-Smirnov test and Fisher’s exact test were used for the comparison of categorical variables. Results: Group A (non-rheumatic) patients were found to be older than group B (rheumatic) patients (59.8 ± 11.4 years vs. 45.3 ± 11.8 years, p = 0.008). In group B VCAM-1 level was higher than that of group A (296.6 ± 21.2 vs. 258.5 ± 42.1, p = 0.004). CD11b monocyte in group B was higher than in group A (98.8 ± 0.5 vs. 92.9 ± 9.7, p = 0.003). CD11b granulocyte was higher in group B than in group A (99.96 ± 0.05 vs. 93.79 ± 13.26, p = 0.33). Significant differences were not determined in the other parameters. Conclusion: The fact that increases in serum VCAM-1 and CD-11b only occurred in patients with rheumatic valvular disease in our study suggests that inflammation in patients with the same hemodynamic disorder is higher in rheumatic valvular disease than in the ones with non-rheumatic valvular disease.

关键词： Rheumatic Fever Chronic Valve Disease Cell Adhesion Molecules

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New parameter in diagnosis of acute appendicitis:Platelet distribution width

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World Journal of Gastroenterology 2015年第6期21卷 1821-1826页

作者： Bulent Dinc Alten Oskay Selcan enver Dinc Bilge Bas Sabri Tekin Department of General Surgery Ataturk State Hospital Department of Emergency Denizli State Hospital Department of Emergency Isparta State Hospital Department of Gastroenterology Ataturk State Hospital Department of Surgery Medical Park Hospitals

AIM:To investigate the diagnostic accuracy of the mean platelet volume and platelet distribution width in acute ***:This retrospective,case-controlled study compared 295 patients with acute appendicitis(Group?Ⅰ),100 patients with other intra-abdominal infections(GroupⅡ),and 100 healthy individuals(GroupⅢ)between January 2012 and January *** age,gender,and white blood cell count,neutrophil percentage,mean platelet volume,and platelet distribution width values from blood samples were compared among the *** analyses were performed using SPSS for Windows 21.0 *** addition,the sensitivity,specificity,positive and negative predictive values and likelihood ratios,and diagnostic accuracy were ***:The mean ages of patients were 29.9±12.0years for Group?Ⅰ,31.5±14.0 years for GroupⅡ,and30.4±13.0 years for GroupⅢ.Demographic features such as age and gender were not significantly different among the *** blood cell count,neutrophil percentage and platelet distribution width were significantly higher in Group?Ⅰ?compared to groupsⅡandⅢ(P<0.05).Diagnostically,the sensitivity,specificity and diagnostic accuracy were 73.1%,94.0%,and 78%for white blood cell count,70.0%,96.0%,and 76.0%for neutrophil percentage,29.5%,49.0%,and 34.0%for mean platelet volume,and 97.1%,93.0%,and 96.0%for platelet distribution width,*** highest diagnostic accuracy detected was for platelet distribution width between Group?Ⅰ?and GroupⅢ(P<0.01).CONCLUSION:Platelet distribution width analysis can be used for diagnosis of acute appendicitis without requiring additional tests,thus reducing the cost and loss of time.

关键词： Appendicitis Diagnosis Platelet function test Plat

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Erythrocyte Membrane Protein Band 3 Predicts Interferon Ribavirin-Induced Anemia

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Open Journal of Regenerative Medicine 2019年第2期8卷 5-16页

作者： Engin Altintas Serap Yalin Orhan Sezgin enver Ucbilek Anil Tombak Arzu Kanik Department of Gastroenterology Faculty of Medicine University of Mersin Mersin Turkey Faculty of Pharmacy University of Mersin Mersin Turkey Department of Biostatistics Faculty of Medicine University of Mersin Mersin Turkey

Aim & Background: It was proposed that the differences in erythrocyte membrane protein contents—especially band 4—take a role in the serious anemia related to interferon plus ribavirin (I/R). The aim of this study is to evaluate whether the erythrocyte membrane protein contents predict anemia related to I/R or not. Methods: 180 mcg interferon α 2a once a week and weight adjusted ribavirin daily were given for 48 weeks to fifty patients with chronic hepatitis C. It was diagnosed as anemia when haemoglobin concentration was Results: Anemia developed in 17 patients (34%). The levels of erythrocyte membrane proteins were as;spectrin: 20.468 ± 2.5902, ankyrin: 4.576 ± 1.2706, B3: 19.240 ± 2.8358, B4.1: 5.628 ± 1.8832, and B4.2: 5.848 ± 1.8030. When the relation between the development of anemia and erythrocyte membrane proteins was investigated, a relation was only found at B3 which was not statistically significant (p = 0.058). When ROC analysis was performed, 95% CI p = 0.035 for B3 (0.517 - 0.792) was found. In patients whose B3 level was below 17.7%, the sensitivity of anemia development risk was calculated as 64.7% and the specificity thereof was calculated as 66.7%. Erythrocyte membrane protein contents by gender were only different at B3 (p = 0.042). Anemia developed in 17 patients (34%). 14 of these patients were of female and 3 were of male gender;the gender played a significant role in terms of anemia (p = 0.003). Conclusions: Erythrocyte membrane protein B3 is not only useful in predicting the patient under the risk of developing anemia, but also it may be useful in preventing it and it may explain why women inclined to anemia.

关键词： Anemia Erythrocyte Membrane Protein Interferon Ribavirin

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Preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: What can be done?

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World Journal of Gastroenterology 2015年第4期21卷 1069-1080页

作者： Goran Hauser Marko Milosevic Davor Stimac enver Zerem Predrag Jovanovi? Ivana Blazevic Department of Internal Medicine Division of GastroenterologyClinical Hospital Centre Rijeka51000 RijekaCroatia Department of Anaesthesiology Clinical Hospital Centre Rijeka51000 RijekaCroatia Department of Gastroenterology University Clinical Center TuzlaTrnovac bb75000 TuzlaBosnia and Herzegovina Center for Emergency Medicine Clinical Hospital Centre Rijeka51000 RijekaCroatia

Post-endoscopic retrograde cholangiopancreatographypancreatitis(PEP) is the most common complication of endoscopic retrograde cholangiopancreatography. The incidence of post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis varies substantially and is reported around 1%-10%, although there are some reports with an incidence of around 30%. Usually, PEP is a mild or moderate pancreatitis, but in some instances it can be severe and fatal. Generally, it is defined as the onset of new pancreatictype abdominal pain severe enough to require hospital admission or prolonged hospital stay with levels of serum amylase two to three times greater than normal, occurring 24 h after ERCP. Several methods have been adopted for preventing pancreatitis, such as pharmacological or endoscopic approaches. Regarding medical prevention, only non-steroidal anti-inflammatory drugs, namely diclofenac sodium and indomethacin, are recommended, but there are some other drugs which have some potential benefits in reducing the incidence of post-ERCP pancreatitis. Endoscopic preventive measures include cannulation(wire guided) and pancreatic stenting, while the adoption of the early pre-cut technique is still arguable. This review will attempt to present and discuss different ways of preventing post-ERCP pancreatitis.

关键词： Endoscopic retrograde cholangiopancreatography Pos

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Microbiological Contamination of Fresh Chicken Meat in the Retail Stores

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Food and Nutrition Sciences 2021年第1期12卷 64-72页

作者： Karahmet enver Isaković Senita Operta Sabina Hamidović Saud Toroman Almir Đulančić Nermina Muhamedagić Samir Faculty of Agriculture and Food Sciences University of Sarajevo Sarajevo Bosnia and Herzegovina

The aim of this study was to assess the hygienic properties of swabs taken from the arm and coat of workers, work surfaces, refrigerated display cases, trays and packaging materials. As well as the safe properties of samples of fresh chicken meat (wing, drumstick, chest) and chicken internal organs (heart and liver) from two butcheries. One of the goals was to determine whether education on hygienic conditions was carried out, influenced the hygienic condition of swabs and safety samples of fresh chicken meat offal. The results of the analysis showed that on the first day of sampling, the largest number of aerobic mesophilic bacteria were found in the swabs of the arm (butcher A-8.15 × 102 CFU/ml), butcher (B-17.88 × 102 CFU/ml) and the smallest in the packaging material (0.03 × 102 CFU/ml). Comparing the results of the first and thirtieth sampling day was a visible decrease in the number of aerobic mesophilic

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Minimally invasive treatment of pancreatic pseudocysts

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World Journal of Gastroenterology 2015年第22期21卷 6850-6860页

作者： enver Zerem Goran Hauser Svjetlana Loga-Zec Suad Kunosi Predrag Jovanovi Dino Crnki Department of Gastroenterology University Clinical Center Tuzla Department of Medical Sciences The Academy of Sciences and Arts of Bosnia and Herzegovina Department of Internal Medicine Division of Gastroenterology Clinical Hospital Centre Rijeka Institute of Pharmacology Medical FacultyUniversity of Sarajevo Department of Physics Faculty of Natural Sciences and Mathematics University of Tuzla Faculty of Pharmacology University of Tuzla

A pancreatic pseudocyst(PPC) is typically a complication of acute and chronic pancreatitis, trauma or pancreatic duct obstruction. The diagnosis of PPC can be made if an acute fluid collection persists for 4 to 6 wk and is enveloped by a distinct *** PPCs regress spontaneously and require no treatment, whereas some may persist and progress until complications occur. The decision whether to treat a patient who has a PPC, as well as when and with what treatment modalities, is a difficult one. PPCs can be treated with a variety of methods: percutaneous catheter drainage(PCD), endoscopic transpapillary or transmural drainage, laparoscopic surgery, or open pseudocystoenterostomy. The recent trend in the management of symptomatic PPC has moved toward less invasive approaches such as endoscopic- and image-guided PCD. The endoscopic approach is suitable because most PPCs lie adjacent to the stomach. The major advantage of the endoscopic approach is that it creates a permanent pseudocysto-gastric track with no spillage of pancreatic enzymes. However, given the drainage problems, the monitoring, catheter manipulation and the analysis of cystic content are very difficult or impossible to perform endoscopically, unlike in the PCD approach. Several conditions must be met to achieve the complete obliteration of the cyst *** duct anatomy is an important factor in the prognosis of the treatment outcome, and the recovery of disrupted pancreatic ducts is the main prognostic factor for successful treatment of PPC, regardless of the treatment method used. In this article, we review and evaluate the minimally invasive approaches in the management of PPCs.

关键词： Complications Pseudocyst Treatment Drainage Outcomes

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Polymorphisms in methylenetetrahydrofolate reductase gene: Their impact on liver steatosis and fibrosis of chronic hepatitis c patients

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Open Journal of Gastroenterology 2014年第2期4卷 73-80页

作者： Engin Altintas Zuhal Mert Altintas Orhan Sezgin enver Ucbilek Erdinc Nayir Mehmet Emin Erdal Ayse Polat Gulhan Orekeci Department of Biostatistics Faculty of Medicine University of Mersin Mersin Turkey Department of Medical Biology and Genetic Faculty of Medicine University of Mersin Mersin Turkey Department of Pathology Faculty of Medicine University of Mersin Mersin Turkey Gastroenterology Department Faculty of Medicine University of Mersin Mersin Turkey

Aim & Background: The mechanism of steatosis in Hepatitis C virus infection is multifactorial;therefore, it is complex and unclear. The aim of this study was to investigate the effects of methylentetrahydrofolate reductase (MTHFR) gene polymorphisms on the course of chronic hepatitis C virus infection and the development of steatosis due to hepatitis C virus. Methods: This study included 109 patients with chronic hepatitis C virus infection. Necroinflammatory activity, degrees of fibrosis and steatosis and MTHFR gene polymorphisms were investigated. Polymerase chain reaction-restriction fragment length polymorphism was used to determine MTHFR C677T and A1298C polymorphisms. Results: Fibrosis was correlated with age (r = 0.336, p = 0.002), platelet (r = ?0.448, p < 0.0001), ALT (r = 0.241, p = 0.026), AST (r = 0.361) and GGT (r = 0.224, p = 0.039). Steatosis was only correlated with fibrosis. MTHFR C677T and A1298C polymorphisms did not have a significant effect on the degree of steatosis (p = 0.857, p = 0.202 respectively). There was a relation between MTHFR C677T and the degree of fibrosis but not A1298C (p = 0.014, p = 0.187 respectively). Conclusion: We found that MTHFR C677T polymorphism contributed to the development of fibrosis in patients with chronic hepatitis C virus infection.

关键词： Fibrosis Hepatitis C Gene Polymorphism Methylenetetrahydrofolate Reductase Steatosis

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Evaluation of leukocyte esterase and nitrite strip tests to detect spontaneous bacterial peritonitis in cirrhotic patients

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World Journal of Gastroenterology 2007年第45期13卷 6027-6030页

作者： Serkan Torun enver Dolar Yusuf Yilmaz Murat Keskin Murat Kiyici Melda Sinirtas Emre Sarandol Selim Gurel Selim Giray Nak Macit Gulten Uludag University Medical School Department of Internal Medicine Bursa 16059 Turkey Uludag University Medical School Department of Gastroenterology Bursa 16059 Turkey Uludag University Medical School Department of Microbiology and Infectious Diseases Bursa 16059 Turkey Uludag University Medical School Departmentof Biochemistry Bursa 16059 Turkey

AIM: To investigate the diagnostic eff icacy of leukocyte esterase and nitrite reagent strips for bedside diagnosis of spontaneous bacterial peritonitis (SBP). METHODS: A total of 63 consecutive patients with cirrhotic ascites (38 male, 25 female) tested between April 2005 and July 2006 were included in the study. Bedside reagent strip testing was performed on ascitic ? uid and the results compared to manual cell counting and ascitic fluid culture. SBP was defined as having a polymorphonuclear ascites count of ≥ 250/mm3. RESULTS: Fifteen samples showed SBP. The sensitivity, specificity, positive and negative predictive values of the leukocyte esterase reagent strips were; 93%, 100%, 100%, and 98%, respectively. The sensitivity, specifi city, positive and negative predictive value of the nitrite reagent strips were 13%, 93%, 40%, and 77%, respectively. The combination of leukocyte esterase and nitrite reagents strips did not yield statistically signif icant effects on diagnostic accuracy. CONCLUSION: Leukocyte esterase reagent strips may provide a rapid, bedside diagnostic test for SBP.

关键词：白细胞酯酶亚硝酸盐腹膜炎

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Soluble forms of extracellular cytokeratin 18 may differentiate simple steatosis from nonalcoholic steatohepatitis

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World Journal of Gastroenterology 2007年第6期13卷 837-844页

作者： Yusuf Yilmaz enver Dolar Engin Ulukaya Semra Akgoz Murat Keskin Murat Kiyici Sibel Aker Arzu Yilmaztepe Selim Gurel Macit Gulten Selim Giray Nak Uludag University Medical School Department of Internal Medicine Bursa Turkey Uludag University Medical School Department of Gastroenterology Bursa Turkey Uludag University Medical School Department of Biochemistry Bursa Turkey Uludag University Medical School Department of Statistics Bursa Turkey Uludag University Medical School Department of Pathology Bursa Turkey

AIM: To investigate whether serum levels of two soluble forms of extracellular cytokeratin 18 (M30-antigen and M65-antigen) may differentiate nonalcoholic steatohepatitis (NASH) from simple steatosis in patients with nonalcoholic fatty liver disease (NAFLD). METHODS: A total of 83 patients with suspected NAFLD and 49 healthy volunteers were investigated. Patients with suspected NAFLD were classified according to their liver histology into four groups: definitive NASH (n = 45), borderline NASH (n = 24), simple fatty liver (n = 9), and normal tissue (n = 5). Serum levels of caspase-3 generated cytokeratin-18 fragments (M30-antigen) and total cytokeratin-18 (M65-antigen) were determined by ELISA. RESULTS: Levels of M30-antigen and M65-antigen were significantly higher in patients with definitive NASH compared to the other groups. An abnormal value (> 121.60 IU/L) of M30-antigen yielded a 60.0% sensitivity and a 97.4% specificity for the diagnosis of NASH. Sensitivity and specificity of an abnormal M65-antigen level (> 243.82 IU/L) for the diagnosis of NASH were 68.9% and 81.6%, respectively. Among patients with NAFLD, M30-antigen and M65-antigen levels distinguished between advanced fibrosis and early-stage fibrosis with a sensitivity of 64.7% and 70.6%, and a specificity of 77.3% and 71.2%, respectively. CONCLUSION: Serum levels of M30-antigen and M65-antigen may be of clinical usefulness to identify patients with NASH. Further studies are mandatory to better assess the role of these apoptonecrotic biomarkers in NAFLD pathophysiology.

关键词：单纯肝脂肪变性非酒精性脂肪肝鉴别可溶性细胞角蛋白18 M30抗原 M65抗原

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