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Relationship between the pathogenesis of sarcoidosis and hepatitis C

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World Journal of Gastroenterology 2007年第12期13卷 1883-1884页

作者： Sevtap sipahi Demirkok Division of Lung Diseases Department of Internal Medicine Cerrahpasa Medical School Istanbul Turkey

TO THE EDITORI read the article by Kim et al with great interest. This is a rare case of systemic sarcoidosis in a patient with chronic hepatitis C without treatment for neither sarcoidosis nor hepatitis C. In this case, spontaneous resolution of sarcoidosis was noted while hepatitis activities were aggravating. The authors suggest that this relationship mentioned above was not a fortuitous coincidence and these two diseases share a common pathogenesis due to the fact that interferon-induced immune activation is an important mechanism of viral replication suppression in chronic hepatitis C, hepatitis activities may be suppressed when chronic hepatitis C is combined with active sarcoidosis.

关键词： Sarcoidosis Hepatitis C Tmmunopathogenesis

Helminths as an alternative therapy for intestinal diseases

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World Journal of Gastroenterology 2017年第33期23卷 6009-6015页

作者： Aytan Miranda sipahi Daniel Machado Baptista LIM 07-Laboratory of Experimental Clinical Gastroenterology Department of Gastroenterology and HepatologyClínicas Hospital of University of Sao Paulo-HCFMUSP andSchool of Medicine at the University of Sao Paulo

Animal models and clinical studies have shown that helminth infections exert immunomodulatory activity,altering intestinal permeability and providing a potential beneficial action on autoimmune and inflammatory disorders in human beings,such as inflammatory bowel disease(IBD) and celiac disease. This is consistent with the theory that intestinal microbiota is responsible for shaping human immunological responses. With the arrival of the immunobiologic era and the use of antibodies,we propose a distinctive pathway for treating patients with IBD and celiac disease. We have some evidence about the safety and tolerability of helminth use,but evidence about their impact on disease activity is lacking. Using worms to treat diseases could be a possible way to lower treatment costs,since the era of immunobiologic agents is responsible for a significant rise in expenses. Some questions remain to be investigated regarding the use of helminths in intestinal disease,such as the importance of the specific species of helminths used,appropriate dosing regimens,optimal timing of treatment,the role of host genetics,diet,environment,and the elucidation of the exact mechanisms of action. One promising approach is the use of helminth-derived anti-inflammatory molecules as drugs. Yet there are still many challenges with this method,especially with regard to safety. Studies on intestinal permeability point to Strongyloides stercoralis as a useful nematode for these purposes.

关键词： Helminths Strongyloidiasis Immunology Inflammation Inflammatory bowel diseases Intestinal diseases Intestinal permeability Celiac disease

Petrogenesis of the late Cretaceous Turnagol intrusion in the eastern Pontides:Implications for magma genesis in the arc setting

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Geoscience Frontiers 2013年第4期4卷 423-438页

作者： Abdullah Kaygusuz Ferkan sipahi Nurdane Ilbeyli Mehmet Arslan Bin Chen Emre Aydincakir Department of Geological Engineering.Gumushane University Department of Geological Engineering Akdeniz University Department of Geological Engineering.Karadeniz Technical University Department of Geological Engineering.Peking University

A series of Cretaceous plutons is present in the eastern Pontides of northeastern Turkey. The Turnag61 intrusion is the least studied and, thus, the least understood plutons in the orogen. This intrusion consists of hornblende-biotite granodiorites emplaced at 78 Ma based on LA-ICP-MS U-Pb zircon dating. It is of sub- alkaline affinity, belongs to the medium- to high-K calc-alkaline series, and displays features typical of I- type granites. The rocks of the intrusion are enriched in large-ion lithophile elements and light rare earth- elements with negative Eu anomalies （EuJEu＊ = 0.69-0.82）, but are deficient in high-field-strength elements. They have a small range of （87Sr/S6Sr）i （0.7060 0.7063）, ENd （-2.6 to 3.1）, and 6180 （＋8.1 to ＋9.1） values. Their Pb isotopic ratios are 206pb/204pb = 18.63-18.65, ＇207Tpb/204pb = 15.62-15.63, and 208pb/204pb 38.53-38.55. The fractionation of plagioclase, hornblende, and Fe-Ti oxides had key functions in the evolution of the Turnag61 intrusion. The crystallization temperatures of the melts ranged from 758 to 885 ℃ as determined by zircon and apatite saturation thermometry. All these characteristics, combined with the low values of K20/Na20 and （Na20 ＋ K20）/（FeOt ＋ MgO ＋ TiO2）, as well as the high values of （CaO ＋ FeOt ＋ MgO ＋ TiO2）, suggest an origin by dehydration melting from a metabasaltic lower crustal source.

关键词： Turnagl intrusion Late Cretaceous Sr-Nd-Pb-O isotope U-Pb zircon dating Eastern Pontides Turkey

Coronary artery bypass graft surgery in a patient with ureterosigmoidostomy

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World Journal of Clinical Cases 2014年第9期2卷 466-468页

作者： Ismail Haberal Deniz Ozsoy Ege sipahi murat Mert Department of Cardiovasculary Surgery Cardiology Institute Istanbul University

A 75-year-old male patient had stable angina pectoris After coronary angiography we decided to perform a coronary artery bypass graft surgery. Twenty years ago the patient underwent radical cystectomy and bilateral ureterosigmoidostomy because of bladder cancer After that, his micturition was via the rectum. We did not experience that before. As is known, monitoring of urine output is very important after cardiac surgery The patient was consulted with an urologist for how to monitor urine output in him. Transrectal catheterization was recommended for our follow-up, but before the catheterization bowel cleansing is necessary. Four-vessel on-pump coronary artery bypass graft surgery was performed without any problem. Peroperative urine volume and arterial blood gas results were normal. Urine output is a sensitive variable reflecting the patient's effective blood volume and tissue perfusion. Urinary catheterization is a standard for all cardiac surgeries and it allows the patients' urine to drain freely from the bladder for collection. Monitoring of urine output in patients with ureterosigmoidostomy is impossible by standard urinary catheterization method. In this casewe performed transrectal catheterization for Urine flow follow-up. Urine flow follow-up is essential after the open-heart surgery and it can be measured in different ways, as in our case.

关键词： Open heart surgery Urine output followup Catheterization Ureterosigmoidostomy Coronary artery bypass graft

Ophthalmologic manifestations of celiac disease

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International Journal of Ophthalmology(English edition) 2016年第1期9卷 159-162页

作者： Thiago Goncalves dos Santos Martins Ana Luiza Fontes de Azevedo Costa Maria Kiyoko Oyamada Paulo Schor Aytan Miranda sipahi Department of Ophthalmology Federal University of SgoPaulo Sao Paulo 04023-062 Brazil Department of Ophthalmology University of Sao Paulo Sao Paulo 04023-062 Brazil Departmem of Gastroenterology Clinicas Hospital of University of Sao Paulo and the Laboratory of Experimental Clinical Gastroenterology School of Medicine at the University ofSao Paulo LIM 07 Sao Paulo 04023-062 Brazil

Celiac disease is an autoimmune disorder that affects the small intestine of genetically predisposed *** manifestations are within the extra-intestinal manifestations,and can be divided into those of autoimmune disorders or those due to absorptive *** article reviewed the ophthalmologic manifestation of celiac *** symptoms are rare,but should be investigated in patients with celiac disease and taken into consideration as the first systemic manifestation.

关键词： ophthalmology celiac disease review

Titanium dioxide induced inflammation in the small intestine

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World Journal of Gastroenterology 2012年第34期18卷 4729-4735页

作者： Carolina Maciel Nogueira Walter Mendes de Azevedo Maria Lucia Zaidan Dagli Sérgio Hiroshi Toma AndréZonetti de Arruda Leite Maria Laura Lordello Iêda Nishitokukado Carmen Lúcia Ortiz-Agostinho Maria IrmaSeixas Duarte Marcelo Alves Ferreira Aytan Miranda sipahi Department of Gastroenterology Laboratory of Clinical and Experimental Gastroen-terologySchool of MedicineUniversity of So PauloCerqueira César01246-900 So PauloBrazil Department of Fundamental Chemistry Federal University of PernambucoCidade Universitária50670-901 RecifeBrazil Department of Pathology Veterinary Medicine SchoolUniversity of So PauloCidade Universitária05508-270 So PauloBrazil Laboratory of Supramolecular Chemistry and Nanotechnology Chemistry InstituteUniversity of So PauloCidade Universitária05513-970 So PauloBrazil Laboratory of Transmissible Disease Medicine SchoolUniversity of So PauloCerqueira César01246-900 So PauloBrazil Laboratory of Cellular Biology Medicine SchoolUniversity of So PauloCerqueira César01246-900 So PauloBrazil

AIM:To investigate the effects of titanium dioxide (TiO2) nanoparticles (NPTiO 2 ) and microparticles (MPTiO 2 ) on the inflammatory response in the small intestine of mice. METHODS: Bl 57/6 male mice received distilled water suspensions containing TiO 2 (100 mg/kg body weight) as NPTiO 2 (66 nm), or MPTiO 2 (260 nm) by gavage for 10 d, once a day; the control group received only distilled water. At the end of the treatment the duodenum, jejunum and ileum were extracted for assessment of cytokines, inflammatory cells and titanium content. The cytokines interleukin (IL)-1b, IL-4, IL-6, IL-8, IL-10, IL-12, IL-13, IL-17, IL-23, tumor necrosis factor-α (TNF-α), intracellular interferon-γ (IFN-γ) and transforming growth factor-β (TGF-β) were evaluated by enzyme-linked immunosorbent assay in segments of jejunum and ileum (mucosa and underlying muscular tissue). CD4 + and CD8 + T cells, natural killer cells, and dendritic cells were evaluated in duodenum, jejunum and ileum samples fixed in 10% formalin by immuno-histochemistry. The titanium content was determined by inductively coupled plasma atomic emission spectrometry. RESULTS: We found increased levels of T CD4 + cells (cells/mm 2 ) in duodenum:NP 1240 ± 139.4, MP 1070 ± 154.7 vs 458 ± 50.39 (P < 0.01); jejunum:NP 908.4 ± 130.3, MP 813.8 ± 103.8 vs 526.6 ± 61.43 (P < 0.05); and ileum:NP 818.60 ± 123.0, MP 640.1 ± 32.75 vs 466.9 ± 22.4 (P < 0.05). In comparison to the control group, the groups receiving TiO 2 showed a statistically significant increase in the levels of the inflammatory cytokines IL-12, IL-4, IL-23, TNF-α, IFN-γ and TGF-β. The cytokine production was more pronounced in the ileum (mean ± SE):IL-12: NP 33.98 ± 11.76, MP 74.11 ± 25.65 vs 19.06 ± 3.92 (P < 0.05); IL-4: NP 17.36 ± 9.96, MP 22.94 ± 7.47 vs 2.19 ± 0.65 (P < 0.05); IL-23: NP 157.20 ± 75.80, MP 134.50 ± 38.31 vs 22.34 ± 5.81 (P < 0.05); TNFα: NP 3.71 ± 1.33, MP 5.44 ± 1.67 vs 0.99± 019 (P < 0.05); IFNγ: NP 15.85 ± 9.99, MP 34.08 ± 11.44 vs 2.81 ±

关键词： Titanium dioxide Microparticles Nanopar-tides Immune response Small intestine Mice

Inter- and intraobserver agreement in computed tomography enterography in inflammatory bowel disease

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World Journal of Gastroenterology 2016年第45期22卷 10002-10008页

作者： Natally Horvat Camila Carlos Tavares Adriana Ribas Andrade Julia Campos Sim?es Cabral Hilton Muniz Le?o Filho Angela Hissae Motoyama Caiado Serli Kiyomi Nakao Ueda André Zonetti de Arruda Leite Aytan Miranda sipahi Manoel de Souza Rocha Radiology Department Hospital das Clínicas da Faculdade de Medicina da Universidade de S?o Paulo Gastroenterology Department Lim 07 Hospital da Clínicas da Faculdade de Medicina da Universidade de S?o Paulo

AIM To evaluate intra- and interobserver agreement in imaging features in inflammatory bowel disease and comparison with fecal calprotectin(FC) *** Our institutional computed tomography enterography(CTE) database was retrospectively queried to identify patients who underwent CTE from January 2014 to June 2015. Patient inclusion criteria were confirmed inflammatory bowel disease(IBD) and FC collected 1 pattern, or normal); and signs of active disease(present or absent). In 42 of 44 patients evaluated, routine CTE reports were made by one of the readers who reevaluated the CTEs ≥ 6 mo later, to determine the intraobserver agreement. FC was considered a sign of disease activity when it was higher than 250 μg/*** Forty-four patients with IBD(38 with Crohn's disease and 6 with ulcerative colitis) were included. There was a moderate interobserver agreement regarding localization of IBD(k = 0.540), type of disease(k = 0.410) and the presence of active signs in CTE(k = 0.419). There was almost perfect intraobserver agreement regarding localization, type and signs of active disease in IBD. The k values were 0.902, 0.937 and 0.830, respectively. After a consensus between both radiologists regarding inflammatory activity in CTE, we found that 24(85.7%) of 28 patients who were classified with active disease had elevated FC, and six(37.5%) of 16 patients without inflammatory activity in CTE had elevated FC(P = 0.003). The correlation between elevated FC and the presence of active disease in CTE was significant(k = 0.495, P = 0.001).CONCLUSION We found almost perfect intraobserver and moderate interobserve

关键词： Crohn’s disease Ulcerative colitis Computed tomography Fecal calprotectin Inflammatory bowel disease activity

Prevalence of celiac disease in an urban area of Brazil with predominantly European ancestry

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World Journal of Gastroenterology 2006年第40期12卷 6546-6550页

作者： Maria Angélica G Pereira Carmen L Ortiz-Agostinho Iêda Nishitokukado Maria N Sato Adérson OMC Damio Marília L Alencar Clarice P Abrantes-Lemos Eduardo LR Canado Thales de Brito Sérgio O Ioshii Sandra BM Valarini Aytan M sipahi Department of Gastroenterology Medical Investigation Laboratories (LIM 07) University of So Paulo School of Medicine So Paulo SP Brazil Medical Investigation Laboratories (LIM 56) University of So Paulo School of Medicine So Paulo SP Brazil Institute of Tropical Medicine (LIM 06) University of So Paulo School of Medicine So Paulo SP Brazil Department of Histopathology Federal University of Paraná Brazil Department of Internal Medicine Catholic University of Paraná Brazil

AIM： To determine the prevalence of celiac disease in a group of volunteer blood donors at a blood bank in the city of Curitiba, Brazil through detection of the serum marker immunoglobulin A （IgA） antitransglutaminase antibody. METHODS： Blood samples collected from 2086 healthy subjects at the Paraná State Center for Hematology and Hemotherapy in Curitiba were submitted to ELISA testing for the IgA antitransglutaminase antibody. Positive samples received IgA antiendomysium antibody test through indirect immunofluorescence using human umbilical cord as substrate. Subsequently, patients who were positive on both tests underwent small bowel （distal duodenum） biopsy. RESULTS： Six subjects, four males and two females, tested positive for the two serum markers. Five of the six were submitted to intestinal biopsy （one declined the procedure）. Biopsy results revealed changes in the distal duodenum mucosa （three classified as Marsh mb lesions and two as Marsh Ⅱ lesions）. Most donors diagnosed having celiac disease presented multiple symptoms （gastrointestinal tract complaints）. One donor reported having a family history of celiac disease （in a niece）. CONCLUSION： Among apparently healthy blood donors,the prevalence of biopsy-confirmed celiac disease was approximately 1：417, similar to that seen in European countries.

关键词： Celiac disease Epidemiology Malabsorption Prevalence Small bowel disease

Causes of failure in acute respiratory distress syndrome modeling and treatment in animal research and new approaches

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World Journal of Respirology 2015年第2期5卷 65-68页

作者： Emine Yilmaz sipahi Department of Medical Pharmacology Faculty of MedicineBulent Ecevit University

Acute respiratory distress syndrome(ARDS) is a major cause of morbidity, death and cost in intensive careunits. Despite intensive research, pharmacotherapy has not passed the experimental stage and mortality rates are still high. Animal models provide a bridge between patients and the laboratory bench. Different animal models have been developed in order to mimic human ARDS, but they have limitations. The purpose of this review was to summarize the properties of the most commonly used experimental animal models mimicking the causes and pathology of human ARDS, the limitations of ARDS models, treatment failure and new therapeutic approaches.

关键词： Acute respiratory distress syndrome Lung injury Animal models Model limitations