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Endoscopic submucosal dissection for premalignant lesions and noninvasive early gastrointestinal cancers

World Journal of Gastroenterology 2011年第13期17卷 1701-1709页

作者： Sadettin Hulagu omer senturk Cem Aygun Orhan Kocaman Altay Celebi Tolga Konduk Deniz Koc Goktug Sirin Ugur Korkmaz Ali Erkan Duman Neslihan Bozkurt Gokhan Dindar Tan Attila Yesim Gurbuz Orhan TarcinDivision of Gastroenterology Derince State Hospital Kocaeli 41900 Turkey Cem Kalayci Division of Gastroenterology Kocaeli University Medical School Kocaeli 41000 Turkey Division of Gastroenterology American HospitalIstanbul 34365 Turkey Department of Pathology Kocaeli UniversityMedical School Kocaeli 41000 Turkey Division of Gastroenterology Marmara University School of Medicine Altunizade Istanbul 34662 Turkey

AIM: To investigate the indication, feasibility, safety, and clinical utility of endoscopic submucosal dissection (ESD) in the management of various gastrointestinal pathologies. METHODS: The medical records of 60 consecutive patients (34 female, 26 male) who underwent ESD at the gastroenterology department of Kocaeli University from 2006-2010 were examined. Patients selected for ESDhad premalignant lesions or non-invasive early cancers of the gastrointestinal tract and had endoscopic and histological diagnoses. Early cancers were considered to be confined to the submucosa, with no lymph node involvement by means of computed tomography and endosonography. RESULTS: Sixty ESD procedures were performed. The indications were epithelial lesions (n = 39) (33/39 adenoma with high grade dysplasia, 6/39 adenoma with low grade dysplasia), neuroendocrine tumor (n = 7), cancer (n = 7) (5/7 early colorectal cancer, 2/7 early gastric cancer), granular cell tumor (n = 3), gastrointestinal stromal tumor (n = 2), and leiomyoma (n = 2). En bloc and piecemeal resection rates were 91.6% (55/60) and 8.3% (5/60), respectively. Complete and incomplete resection rates were 96.6% (58/60) and 3.3% (2/60), respectively. Complications were major bleeding [n = 3 (5%)] and perforations [n = 5 (8.3%)] (4 colon, 1 stomach). Two patients with colonic perforations and two patients with submucosal lymphatic and microvasculature invasion (1 gastric carcinoid tumor, 1 colonic adenocarcinoma) were referred to surgery. During a mean follow-up of 12 mo, 1 patient with adenoma with high grade dysplasia underwent a second ESD procedure to resect a local recurrence. CONCLUSION: ESD is a feasible and safe method for treatment of premalignant lesions and early malignant gastrointestinal epithelial and subepithelial lesions. Successful en bloc and complete resection of lesions yield high cure rates with low recurrence.

关键词： Endoscopic submucosal dissection Premalignant gastrointestinal lesion Noninvasive early gastrointestinal cancer Neuroendocrine tumor Gastrointestinal stromal tumor

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N-acetylcysteine attenuates alcohol-induced oxidative stress in the rat

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World Journal of Gastroenterology 2003年第1期9卷 125-128页

作者： Resat Ozaras Veysel Tahan Seval Aydin Hafize Uzun Safiye Kaya Hakan senturk Department of Infectious Diseases and Clinical Microbiology University of IstanbulIstanbulTurkey Department of Internal Medicine University of IstanbulIstanbulTurkey Department of Biochemistry University of IstanbulIstanbulTurkey

AIM: There is increasing evidence that alcohol-induced liverdamage may be associated with increased oxidative *** aimed to investigate free-radical scavenger effect of n-acetylcysteine in rats intragastrically fed with ***: Twenty-four rats divided into three groups werefed with ethanol (6 g/kg/day, Group 1), ethanol and n-acetylcysteine (1 g/kg, Group 2), or isocaloric dextrose(control group, Group 3) for 4 weeks. Then animals weresacrificed under ether anesthesia, intracardiac blood andliver tissues were obtained. Measurements were performedboth in serum and in homogenized liver *** (MDA) level was measured by TBARSmethod. Glutathione peroxidase (GSH-Px) and superoxidedismutase (SOD) levels were studied by commercial ***-Wallis test was used for statistical ***: ALT and AST in Group 1 (154 U/Land 302 U/L,respectively) were higher than those in Group 2 (94 U/L and155 U/L) and Group 3 (99 U/L and 168 U/L) (P＝0.001 forboth). Serum and tissue levels of MDA in Group 1 (1.84 nmol/mL and 96 nmol/100 mg-protein) were higher than Group 2(0.91 nmol/mL and 64 nmol/100 mg-protein) and Group 3(0.94 nmol/mL and 49 nmol/100 mg-protein) (P＜0.001 forboth). On the other hand, serum GSH-Px level in Group 1(8.21 U/g-Hb) was lower than Group 2 (16 U/g-Hb) andGroup 3 (16 U/g-Hb) (P＜0.001). Serum and liver tissue levelsof SOD in Group 1 (11 U/mL and 26 U/100 mg-protein)were lower than Group 2 (18 U/mL and 60 U/100 mg-protein)and Group 3 (20 U/mL and 60 U/100 mg-protein) (P＜0.001for both).CONCLUSION: This study demonstrated that ethanol-induced liver damage is associated with oxidative stress,and co-administration of n-acetylcysteine attenuates thisdamage effectively in rat model.

关键词： Oxidative Stress Acetylcysteine Animals Erythrocytes Ethanol dosage Free Radical Scavengers Glutathione Glutathione Peroxidase Lipid Peroxidation Liver Male Rats Rats, Wistar Research Support, Non-U.S. Gov't Superoxide Dismutase Thiobarbituric Acid Reactive Substances

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N-acetylcysteine attenuates alcohol-induced oxidative stess in rats

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World Journal of Gastroenterology 2003年第4期9卷 791-794页

AIM:To investigate free-radical scavenger effect of n- acetylcysteine in rats intragastrically fed with ethanol. METHODS:Twenty-four rats divided into three groups were fed with ethanol (6 g/kg/day,Group 1),ethanol and n- acetylcysteine (1 g/kg,Group 2),or isocaloric dextrose (control group,Group 3) for 4 *** animals were sacrificed under ether anesthesia,and intracardiac blood and liver tissues were *** were made in both serum and homogenized liver tissues. Malondialdehyde (MDA) level was measured by TBARS *** peroxidase (GSH-Px) and superoxide dismutase (SOD) levels were studied by commercial kits. Kruskal-Wallis test was used for statistical analysis. RESULTS:ALT and AST in Group 1 (154 U/L and 302 U/L, respectively) were higher than those in Group 2 (94 U/L and 155 U/L) and Group 3 (99 U/L and 168 U/L) (P=0.001 for both).Serum and tissue levels of MDA in Group 1 (1.84 nmol/mL and 96 nmol/100 mg-protein) were higher than that in Group 2 (0.91 nmol/mL and 64 nmol/100 mg protein) and Group 3 (0.94 nmol/ml and 49 nmol/100 mg-protein) (P<0.001 for both).On the other hand,serum GSH-Px level in Group 1 (8.21 U/g Hb) was lower than that in Group 2 (16 U/g Hb) and Group 3 (16 U/g-Hb) (P<0.001).Serum and liver tissue levels of SOD in Group 1 (11 U/mL and 26 U/100 rag-protein) were lower than that in Group 2 (18 U/ mL and 60 U/100 mg protein) and Group 3 (20 U/mL and 60 U/100 rag-protein) (P<0.001 for both). CONCLUSION:Ethanol-induced liver damage was associated with oxidative stress,and co-administration of n-acetylolsteine attenuates this damage effectively in rat model.

关键词： Acetylcysteine Alanine Transaminase Animals Aspartate Aminotransferases Ethanol inhibitors Glutathione Glutathione Peroxidase Liver Male Malondialdehyde Oxidative Stress Rats Rats, Wistar Research Support, Non-U.S. Gov't Superoxide Dismutase

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Significant cohort of non-alcoholic fatty liver disease with portal vein thrombosis in transplant waiting list

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World Journal of Hepatology 2016年第7期8卷 376-384页

作者： Metin Basaranoglu Sonia M Najjar Ali Ebag Demirbag Hakan senturk Division of Gastro-enterology Department of Internal Medicine Bezmialem Vakif University Faculty of Medicine Division of Gastroenterology Türkiye- Yüksek Ihtisas Hospital Department of Physiology and Pharmacology Center for Diabetes and Endocrine Research (Ce DER) University of Toledo College of Medicine and Life Sciences Division of Gastrointestinal Surgery Türkiye Yüksek Ihtisas Hospital

AIM: To characterize non-alcoholic fatty liver disease(NAFLD) presentation with esophageal varices. METHODS: We carried out a retrospective cohort study on 258 patients with esophageal varices at a single tertiary referral center. These patients underwent diagnosis of several liver diseases, including: NAFLDassociated cirrhosis, hepatitis B, hepatitis C, Wilson disease, autoimune liver diseases, and others. RESULTS: Of the 258 patients, 39% of patients exhibited esophageal varices due to NAFLD-associated cirrhosis. Of the 38(14.7%) patients developed hepatocellular carcinoma during follow-up, 52% were due to hepatitis B, 26% due to hepatitis C and 13.2% due to NAFLD. Of the 258 patients, 50.0% with NAFLD, 33.3% with hepatitis B, 26.3% with hepatitis C, and 58.3% with other diseases were alive at the end of the 5-year period with a significant difference according to the Kaplan-Meier log Rank test(P = 0.040). Portal vein thrombosis was detected in 47.5% of patients with NAFLD, in 29% of patients with hepatitis B, in 17% of patients with hepatitis C, and in 62% of patients with other related diseases(P < 0.0001). CONCLUSION: Our study showed a proportionally greater elevation in liver transplant candidacy in patients with NAFLD and portal vein thrombosis. Older patients were more prone to developing cirrhosis, hepatocellular carcinoma and a high mortality rate. However, younger patients exhibited more portal vein thrombosis and gastric varices.

关键词： Hepatocellular carcinoma Non-alcoholic fatty liver disease Portal vein thrombosis Esophageal varices

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Familial chylomicronemia syndrome related chronic pancreatitis: a single-center study

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Hepatobiliary & Pancreatic Diseases International 2014年第2期13卷 209-214页

作者： Gurhan Sisman Yusuf Erzin Ibrahim Hatemi Erkan Caglar Salih Boga Vikesh Singh Hakan senturk Division of Gastroenterology Istanbul University Cerrahpasa Medical Faculty Division of Gastroenterology i li Etfal Education and Research Hospital Division of Gastroenterology Johns Hopkins Hospital Division of Gastroenterology Bezmialem School of Medicine

BACKGROUND: Hypertriglyceridemia induces acute recurrent pancreatitis, but its role in the etiology of chronic pancreatitis(CP) is controversial. This study aimed to evaluate the clinical laboratory and radiological findings of 7 patients with CP due to type 1 hyperlipidemia compared to CP patients with other or undefined etiological ***: We retrospectively analyzed the clinical, laboratory and radiological findings of 7 CP patients with type 1 hyper lipidemia compared to CP patients without hypertriglyceridemia These 7 patients had multiple episodes of acute pancreatitis and had features of CP on abdominal CT, endoscopic retrograde cholangiopancreatography and/or endoscopic ***: All CP patients were classified into two groups: a group with type 1 hyperlipidemia (n=7) and a group with other etiologies (n=58). The mean triglyceride level was 2323±894mg/dL in the first group. Age at the diagnosis of CP in the first group was significantly younger than that in the second group(16.5±5.9 vs 48.3±13.5, P<0.001). The number of episodes of acute pancreatitis in the first group was significantly higher than that in the second group (15.0±6.8 vs 4.0±4.6, P=0.011)The number of splenic vein thrombosis in the first group was significantly higher than that in the second group (4/7 vs 9/58P=0.025). Logistic regression analysis found that younger age was an independent predictor of CP due to hypertriglyceridemia(r=0.418, P=0.000).CONCLUSIONS: Type 1 hyperlipidemia appears to be an etiological factor even for a minority of patients with CP. It manifests at a younger age, and the course of the disease might be severe.

关键词： chronic pancreatitis hyperlipidemia treatment

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