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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 < 0.001).CONCLUSION Baseline liver 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

Tata-box-binding protein-associated factor 15 as a new potential marker in gastrointestinal tumors

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World Journal of Gastroenterology 2024年第28期30卷 3367-3372页

作者： Gulsum ozlem Elpek Department of Pathology Akdeniz University Medical SchoolAntalya 07070Türkiye

In this editorial,the roles of tata-box-binding protein-associated factor 15(TAF15)in oncogenesis,tumor behavior,and as a therapeutic target in cancers in the context of gastrointestinal(GI)tumors are discussed concerning the publication by Guo et ***15 is a member of the FET protein family with a comprehensive range of cellular ***,evidence has shown that TAF15 is involved in many diseases,including ***15 contributes to carcinogenesis and tumor behavior in many ***,its relationship with the mitogen-activated protein kinases(MAPK)signaling pathway makes TAF15 a new target for ***,the fact that there is few studies investigating the expression of TAF15 constitutes a potential limitation in GI system,the association of TAF15 expression with aggressive tumor behavior and,similar to other organ tumors,the influence of TAF15 on the MAPK signaling pathway emphasize that this protein could serve as a new molecular biomarker to predict tumor behavior and target therapeutic intervention in GI *** conclusion,more studies should be performed to better understand the prognostic and therapeutic role of TAF15 in GI tumors,especially in tumors resistant to therapy.

关键词： Gastrointestinal cancer Tata-box-binding protein-associated factor 15 Cell proliferation Cell migration Prognosis

Is sarcopenia effective on survival in patients with metastatic gastric cancer?

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 1861-1868页

作者： ozlem Dogan Hayriye Sahinli Yakup Duzkopru Tuba Akdag Abdulkadir Kocanoglu Department of Medical Oncology Adıyaman University Training and Research HospitalAdiyaman 02100Turkey Department of Medical Oncology Ankara Etlik City HospitalAnkara 06170Turkey Department of Radiology University of Health SciencesDiskapi Yildirim Beyazit Training and Research HospitalAnkara 06000Turkey Department of Medical Oncology Ankara Ataturk Sanatoryum Training and Research HospitalAnkara 06170Turkey

BACKGROUND Sarcopenia is a progressively diminishing state characterized by the reduction of muscle mass and density,which is frequently observed in malignancies of solid *** To assess how sarcopenia affects the overall survival of individuals who have been diagnosed with metastatic gastric *** The study retrospectively included individuals who had been diagnosed with metastatic gastric cancer between January 2008 and December *** was identified through the calculation of the average Hounsfield units(HUAC)using computed tomography(CT)images taken at the time of diagnosis in *** A total of 118 patients with metastatic gastric cancer were *** was detected in 29 patients(24.6%).The median survival of all patients was 8(1-43)*** median survival of patients with sarcopenia was 2 mo,while it was 10 mo for those without sarcopenia(P<0.001).A significant relationship was found between sarcopenia and *** Sarcopenia has been observed to impact survival outcomes in various types of solid tumor *** patients can be identified in a short time,easily and inexpensively,by HUAC measurements from CT images used for diagnosis,and survival could be promoted with nutritional support.

关键词： Hounsfield units Sarcopenia Gastric cancer Survival Psoas muscle mass Muscle density

Assessment of the potential interactions between favipiravir and radiocontrast agents

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World Journal of Radiology 2024年第5期16卷 128-135页

作者： Sonay Aydin ozlem Celik Aydin Mesut Furkan Yazar Huseyin Aydemir Mecit Kantarci Sureyya Barun Department of Radiology Erzincan Binali Yıldırım UniversityFaculty of MedicineErzincan 24100Türkiye Department of Pharmacology Gazi UniversityFaculty of MedicineErzincan 24100Türkiye Department of Radiology Bilecik Education and Reseach HospitalBilecik 11230Türkiye Department of Radiology Atatürk UniversityFaculty of MedicineErzurum 25030Türkiye

BACKGROUND In cases of coronavirus disease 2019(COVID-19),favipiravir is commonly included to the therapy *** interactions between favipiravir and other COVID-19 therapy drugs are frequently ***,no research on possible drug interactions between Favipiravir and radiocontrast agents,which have become almost crucial in diagnostic processes while not being part of the treatment,has been *** To determine potential medication interactions between Favipiravir and radiocontrast *** The study comprised patients who were taking Favipiravir for COVID-19 therapy and underwent a contrast-enhanced computed tomography(CT)or magnetic resonance imaging(MRI)test while taking the *** computerized patient files of the cases included in the study,as well as the pharmacovigilance forms in the designated hospital,were evaluated for this *** The study included the evaluation of data from 1046 *** study sample's mean age was 47.23±9.48 *** mean age of cases with drug interactions was statistically significant greater than that of cases with no drug interactions(P=0.003).When evaluated with logistic regression analysis,a 1-year raises in age increases the risk of developing drug interactions by 1.63 times(P=0.023).There was no statistically significant difference in the occurrence of medication interactions between the sexes(P=0.090).Possible medication interactions were discovered in 42 cases(4%).CONCLUSION The findings of this study revealed that the most notable findings as a result of the combined use of contrast agents and favipiravir were increased creatinine and transaminase values,as well as an increase in the frequency of nausea and *** majority of drug interactions discovered were modest enough that they were not reflected in the *** interactions become more common as people get older.

关键词： Favipiravir Iohexol Gadoxetic acid Meglumine gadoterate Drug interactions

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

Prognostic significance of tumor budding,desmoplastic reaction,and lymphocytic infiltration in patients with gastric adenocarcinoma

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World Journal of Gastrointestinal Pathophysiology 2024年第1期15卷 9-25页

作者： Aysen Yavuz Kubra Simsek Anil Alpsoy Busra Altunay Elif Ocak Gedik Betul Unal Cumhur Ibrahim Bassorgun Ali Murat Tatli Gulsum ozlem Elpek Department of Pathology Akdeniz University Medical SchoolAntalya 07070Türkiye Department of Medical Oncology Akdeniz University Medical SchoolAntalya 07070Türkiye

BACKGROUND Recent studies have shown that the tumor microenvironment significantly influences the behavior of solid *** this context,Accumulated data suggests that pathological evaluation of tumor budding(TB),desmoplastic reaction(DR),and tumor-infiltrating lymphocytes(TILs)may be crucial in determining tumor behavior in the gastrointestinal *** gastric adenocarcinoma(GAC),although some results suggest that TB and TILs may be effective in determining the course of the disease,the data do not ***,very few studies have investigated the relationship between DR and *** present,the associations between tumor TB,DR and TILs in GAC patients have not been *** To establish the relationships between TB,DR,and TILs in patients with GAC and to assess their influence on *** Our study group comprised 130 patients diagnosed with *** definition of TB was established based on the International TB Consensus *** DR was categorized into three groups according to the level of tumor stroma *** assessment of TILs was conducted using a semiquantitative approach,employing a cutoff value of 5%.The statistical analysis of the whole group and 100 patients with an intestinal subtype of GAC was performed using SPSS version *** A significant correlation between peritumoral budding(PTB)and intratumoral budding(ITB)was noted(r=0.943).Tumors with high PTBs and ITBs had a greater incidence of immature DRs and low TILs(P<0.01).PTB and ITB were associated with histological subtype,lymph node metastasis(LNM),and stage(P<0.01).ITB,PTB,LNM,DR,and stage were significant risk factors associated with poor *** multivariate Cox regression analysis identified ITB,PTB,and LNM as independent prognostic variables(P<0.05).In intestinal-type adenocarcinomas,a positive correlation between PTB and ITB was noted(r=0.972).While univariate analysis revealed that LNM,stage,PTB,ITB,and DR were strong parameters for pred

关键词： Gastric cancer Tumor budding Desmoplastic stroma Tumor-infiltrating lymphocytes Prognosis

Mixed neuroendocrine–nonneuroendocrine neoplasms of the gastrointestinal system:An update

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World Journal of Gastroenterology 2022年第8期28卷 794-810页

作者： Gulsum ozlem Elpek Pathology Akdeniz University Medical SchoolAntalya 07070Turkey

Mixed neuroendocrine-nonneuroendocrine neoplasms(Mi NENs)of the digestive tract are a rare heterogeneous group of tumors that present many challenges in terms of diagnosis and *** the years,the diagnostic criteria,classification,and clinical behavior of these tumors have been the subjects of ongoing debate,and the various changes in their nomenclature have strengthened the challenges associated with Mi *** review is performed to provide an understanding of the key factors involved in the evolution of the designation of these tumors as Mi NEN,highlight the current diagnostic criteria,summarize the latest data on pathogenesis and provide information on available ***,this work seeks to increase the awareness about these rare neoplasms by presenting the clinicopathological features and prognostic factors that play important roles in their behavior and discussing their different regions of origin in the gastrointestinal system(GIS).Currently,the Mi NEN category also includes tumors in the GIS with a nonneuroendocrine component and epithelial tumors other than adenocarcinoma,depending on the organ of *** is based on the presence of both morphological components in more than 30%of the ***,this value needs to be reconfirmed with further studies and may be a limiting factor in the diagnosis of Mi NEN by ***,available clinicopathological data suggest that the inclusion of amphicrine tumors in the definition of Mi NEN is not supportive and warrants further *** diagnosis of these tumors is not solely based on immunohistochemical *** are not hybrid tumors and both components can act independently;thus,careful grading of each component separately is *** addition to parameters such as the metastatic state of the tumor at the time of diagnosis and the feasibility of surgical resection,the aggressive potential of both components has paramount importance in the choice of treatment.R

关键词： Mixed neuroendocrine–nonneuroendocrine neoplasms Mixed adeno neuroendocrine carcinoma Gastrointestinal system Liver Pancreas Gallbladder

Epidemiology and etiology of chemical ocular injury:A brief review

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World Journal of Clinical Cases 2023年第6期11卷 1245-1251页

作者： Zeynep Akgun ozlem Barut Selver Department of Ophthalmology Ege University Faculty of MedicineIzmir 35100Turkey

Chemical ocular injury is one of the common ophthalmologic emergencies that can cause vision loss and serious *** all protective measures,it continues to be a serious public health problem,especially in young male *** it is known that injuries occur most frequently in the workplace and in young male patients,there is a variable frequency and distribution in different regions around the *** addition,with the coronavirus disease 2019 pandemic,there are changing trends in ocular chemical *** review aims to specify an update on the epidemiological and etiological features of ocular chemical injuries.

关键词： Chemical ocular injury Alkaline Acid COVID-19 Epidemiology Etiology

Role of natural products and intestinal flora on type 2 diabetes mellitus treatment

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World Journal of Clinical Cases 2023年第1期11卷 65-72页

作者： ozlem Celik Aydin Sonay Aydın Sureyya Barun Department of Medical Pharmacology Erzincan Mengücek Gazi Training and Research HospitalErzincan 24100Turkey Department of Radiology Erzincan Binali Yıldırım UniversityMengücek Gazi Training and Research HospitalErzincan 24100Turkey Department of Medical Pharmacology Gazi University Faculty of MedicineAnkara 06500Turkey

Diabetes mellitus(DM)is a complicated,globally expanding disease that is influenced by hereditary and environmental *** in modern society’s food choices,physical inactivity,and obesity are significant factors in the development of type 2 DM(T2DM).The association between changes in intestinal flora and numerous disorders,including obesity,diabetes,and cardiovascular diseases,has been studied in recent *** purpose of this review is to analyze the mechanisms underlying the alteration of the diabetic patients’intestinal flora,as well as their therapeutic *** included is a summary of the antidiabetic benefits of natural compounds demonstrated by *** short-chain fatty acids theory,the bile acid theory,and the endotoxin theory are all potential methods by which intestinal flora contributes to the establishment and progression of *** to an intestinal flora imbalance,abnormalities in shortchain fatty acids and secondary bile acids have been found in diabetic ***,metabolic endotoxemia with altering flora induces a systemic inflammatory response by stimulating the immune system via bacterial *** agenda for diabetes treatment includes the use of short-chain fatty acids,probiotics,prebiotics in the diet,fecal bacteria transplantation,and *** studies have proven the antidiabetic benefits of numerous bioactive substances,including Flavonoids,Alkaloids,Saponin,and ***,further research is required to contribute to the treatment of diabetes.

关键词： Diabetes mellitus Intestinal flora Natural products Endotoxemia Bioactive compounds Probiotics