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Adrenomedullin in cirrhotic and non-cirrhotic portal hypertension

World Journal of Gastroenterology 2003年第10期9卷 2325-2327页

作者： V Tahan E Avsar C Karaca E Uslu f Eren S Aydin H Uzun HO Hamzaoglu f besisik C Kalayci A Okten N Tozun Gastroenterology Institute Marmara University Gastroenterology Department Medical faculty Istanbul University Biochemistry Department Cerrahpasa Medical FacultyIstanbul University

AIM:Adrenomedullin (ADM) is a potent vasodilator peptide. ADM and nitric oxide (NO) are produced in vascular endothelial *** ADM level has been linked to hyperdynamic circulation and arterial vasodilatation in cirrhotic portal hypertension (CPH).The role of ADM in non-cirrhotic portal hypertension (NCPH) is unknown,plasma ADM levels were studied in patients with NCPH,compensated and decompensated cirrhosis in order to determine its contribution to portal hypertension (PH) in these groups. METHODS:There were 4 groups of *** 1 consisted of 27 patients (f/M:12/15) with NCPH due to portal and/or splenic vein thrombosis (mean age:41±12 years),group 2 consisted of 14 patients (f/M:6/8) with compensated (Child-Pugh A) cirrhosis (mean age:46±4), group 3 consisted of 16 patients (f/M:6/10) with decompensated (Child-Pugh C) cirrhosis (mean age:47±12). fourteen healthy subjects (f/M:6/8) (mean age:44±8) were used as controls in Group *** level was measured by *** was determined as nitrite/nitrate level by chemoluminescence. RESULTS:ADM level in Group 1 (236±61.4 pg/mL) was significantly higher than that in group 2 (108.4±28.3 pg/mL) and group 4 (84.1±31.5 pg/mL) (both Pficantly higher than that in group 2 (19.8±2.8 μmol/L) and group 4 (16.9±1.6 μmol/L) but was lower than that in Group 3 (39±3.6 μmol/L) (for all three Pf cirrhosis,and were significantly higher than those in patients with NCPH. Portal hypertension plays an important role in the increase of ADM and *** damage in cirrhosis may contribute to the increase in these paramete

关键词： Adult Comparative Study female Humans Hypertension, Portal Liver Cirrhosis Male Middle Aged Nitrates Nitric Oxide Nitrites Peptides Vasodilation

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Intrahepatic and peripheral T-cell responses in genotype 1b hepatitis C virus-infected patients with persistently normal and elevated aminotransferase levels

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World Journal of Gastroenterology 2005年第45期11卷 7188-7191页

作者： filiz Akyüz Nuray Polat Sabahattin Kaymakoglu Nevzat Aksoy Kadir Demir fatih besisik Selim Badur Yilmaz Cakaloglu Atilla (O|¨)kten Department of Gastroenterohepatology Department of Microbiology

AIM： To evaluate whether the cytokine responses in liver and serum differ in chronic hepatitis C patients with normal and high alanine aminotransferase （ALT） levels. METHODS： Thirty-three （16 with normal ALT level as group 1 and 17 with elevated ALT level as group 2） patients infected with genotype lb hepatitis C virus （HCV） were examined. Liver infiltrating lymphomononuclear cells （LILMCs） were isolated from liver biopsy by collagenase type 1 and stimulated with phytohemagglutinin and interleukin 2 （IL-2）. IL-10, IL-12, interferon gamma （IfN-γ） and tumor necrosis factor alpha （TNf-α were determined in serum and LILMCs by ELISA. RESULTS： Serum cytokine levels were similar in both groups （P〉0.05）. Stimulated IfN-γ and TNf-α levels in LILMCs were increased in both groups. IL-12 and IL-10 levels stimulated with IL-2 were higher in group 1 than in group 2 （P = 0.023）. Histological activity index （HAI） and stage had a negative correlation with TNf-α and IfN-γ levels in group 2. CONCLUSION： Increased T-helper type 2 （Th2） cytokine response may regress inflammatory and biochemical activity. Progression of histological abnormalities in persons with elevated ALT probably depends on insufficient Th2 cytokine response, which does not balance Th1 cytokine response.

关键词： Liver cytokines HCV, ALT

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Risk factors associated with progression to intestinal complications of Crohn disease

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Chinese Medical Journal 2019年第20期132卷 2423-2429页

作者： Yusuf Kayar Bulent Baran Asli Cifcibasi Ormeci filiz Akyuz Kadir Demir fatih besisik Sabahattin Kaymakoglu Department of Gastroenterology Van Education and Research HospitalVan 65100Turkey Department of Gastroenterology Koc UniversityIstanbul 34100Turkey Department of Gastroenterology Istanbul UniversityIstanbul 34065Turkey

Background:Crohn disease is a chronic bowel disease that causes serious complications. Prevalence of Crohn disease is increasing. Studies have shown that the behavior of the disease is not stable and severe complications secondary to behavior change over time have been shown. In this study, we aimed to evaluate the prognostic risk factors associated with phenotypic change in Crohn disease in a Turkish patient ***:Patients followed up from March 1986 to August 2011 were evaluated for demographic and clinical characteristics to determine possible risk factors and initial clinical phenotype of the disease based on the Montreal classification. The cumulative probabilities of developing stricturing or penetrating intestinal complications were estimated using the Kaplan-Meier analysis. Univariate and multivariate Cox-proportional hazard models were used to assess associations between baseline clinical characteristics and intestinal ***:Three hundred and thirty patients (mean age, 30.6 ± 11.1 years;148 female) were included in the study. Mean follow-up duration was 7.4 ± 5.3 years (range: 1.0-25.0 years). At baseline 273 patients had inflammatory-type disease, 57 patients experienced stricturing/penetrating intestinal complications before or at the time of diagnosis. The cumulative probability of developing complicated disease was 37.4% at 5 years, 54.3% at 10 years, 78.8% at 25 years. Independent predictors associated with progression to intestinal complications were current smoking, perianal disease, extra-intestinal manifestations, and location of ***:Location of disease is the most powerful indicator for the development of stenosis and penetrating complications in inflammatory-type disease. Patients with ileal involvement should be considered for more aggressive immunosuppressive therapy.

关键词： complications involvement progression

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Current state and clinical outcome in Turkish patients with hepatocellular carcinoma

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World Journal of Hepatology 2018年第1期10卷 51-61页

作者： Omer Ekinci Bulent Baran Asli Cifcibasi Ormeci Ozlem Mutluay Soyer Suut Gokturk Sami Evirgen Arzu Poyanli Mine Gulluoglu filiz Akyuz Cetin Karaca Kadir Demir fatih besisik Sabahattin Kaymakoglu Department of Gastroenterohepatology Istanbul Faculty of Medicine Istanbul University Department of Internal Medicine Istanbul Faculty of Medicine Istanbul University Department of Gastroenterology Ko? University Hospital Department of Radiology Istanbul Faculty of Medicine Istanbul University Department of Pathology Istanbul Faculty of Medicine Istanbul University

AIM To investigate clinical, etiological, and prognostic features in patients with hepatocellular *** Patients with hepatocellular carcinoma who were followed-up from 2001 to 2011 were included in the study. The diagnosis was established by histopathological and/or radiological criteria. We retrospectively reviewed clinical and laboratory data, etiology of primary liver disease, imaging characteristics and treatments. ChildPugh and Barcelona Clinic Liver Cancer stage was determined at initial diagnosis. Kaplan-Meier survival analysis was done to find out treatment effect on survival. Risk factors for vascular invasion and overall survival were investigated by multivariate Cox regression analyses. RESULTS five hundred and forty-five patients with hepatocellular carcinoma were included in the study. Viral hepatitis was prevalent and 68 patients either had normal liver or were non-cirrhotic. Overall median survival was 16(13-19) mo. Presence of extrahepatic metastasis was associated with larger tumor size(OR = 3.19, 95%CI: 1.14-10.6). Independent predictor variables of vascular invasion were AfP(OR = 2.95, 95%CI: 1.38-6.31), total tumor diameter(OR = 3.14, 95%CI: 1.01-9.77), and hepatitis B infection( OR = 5.37, 95 % CI : 1.23-23.39). Liver functional reserve, tumor size/extension, AfP level and primary treatment modality were independent predictors of overall survival. Transarterial chemoembolization(HR = 0.38, 95%CI: 0.28-0.51) and radioembolization(HR = 0.36, 95%CI: 0.18-0.74) provided a comparable survival benefit in the real life setting. Surgical treatments as resection and transplantation were found to be associated with the best survival compared with loco-regional treatments(log-rank, P function, oncologic features including AfP level and primary treatment modality determines overall survival in patients with hepatocellular carcinoma.

关键词： Hepatocellular carcinoma Cirrhosis Alfafetoprotein Prognosis Treatment Survival

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What is the impact of capsule endoscopy in the long term period?

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World Journal of Gastrointestinal Endoscopy 2016年第7期8卷 344-348页

作者： Asli Ormeci filiz Akyuz Bulent Baran Suut Gokturk Tugrul Ormeci Binnur Pinarbasi Ozlem Mutluay Soyer Sami Evirgen Umit Akyuz Cetin Karaca Kadir Demir Sabahattin Kaymakoglu fatih besisik Division of Gastroenterohepatology Department of Internal Medicine Istanbul Faculty of Medicine Istanbul University Department of Radiology Medipol University Department of Gastroenterology Yeditepe Univer-sity

AIM: To assess the clinical impact of capsule endoscopy(CE) in the long-term follow-up period in patients with obscure gastrointestinal bleeding(OGIB). METHODS: One hundred and forty-one patients who applied CE for OGIB between 2009 and 2012 were retrospectively analyzed, and this cohort was then questioned prospectively. Demographic data of the patients were determined via the presence of comorbid diseases, use of non-steroidal anti-inflammatory drugs anticoagulant-antiaggregant agents, previous diagnostic tests for bleeding episodes, CE findings, laboratory tests and ***: CE was performed on 141 patients becauseof OGIB. The capsule was retained in the upper gastrointestinal(GI) system in two of the patients, thus video monitoring was not achieved. There were 139 patients [62% male, median age: 72 years(range: 13-93 years) and a median follow-up duration: 32 mo(range: 6-82 mo)]. The overall diagnostic yield of CE was 84.9%. Rebleeding was determined in 40.3%(56/139) of the patients. The rebleeding rates of patients with positive and negative capsule results at the end of the follow-up were 46.6%(55/118) and 4.8%(1/21), respectively. In the multivariate analysis, usage of NSAIDs, anticoagulant-antiaggregant therapies(OR = 5.8; 95%CI: 1.86-18.27) and vascular ectasia(OR = 6.02; 95%CI: 2.568-14.146) in CE were detected as independent predictors of rebleeding. In the univariate analysis, advanced age, comorbidity, and overt bleeding were detected as predictors of ***: CE is a reliable method in the diagnosis of obscure GI bleeding. Negative CE correlated with a significantly lower rebleeding risk in the long-term follow-up period.

关键词： Capsule endoscopy Small bowel Obscure gastrointestinal bleeding Rebleeding

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