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International Journal of Ophthalmology(English edition) 2024年第7期17卷 1267-1272页

作者： Selim Doganay Mehmet Omer Kiristioglu Derya Doganay Elif Kacmaz Department of Ophthalmology Bursa Uludag University School of MedicineBursa 16059Turkey Department of Ophthalmology University of Health Sciences Bursa Yuksek Ihtisas Training and Research HospitalBursa 16310Turkey

AIM:To investigate changes in choroidal thickness and vascularity in keratoconus patients treated with corneal ***:This study evaluated 28 eyes of 22 patients with keratoconus who underwent corneal *** choroidal thicknesses were evaluated on enhanced depth imaging optical coherence tomography at the preoperative and postoperative 3d,1,and *** thickness in the four cardinal quadrants and the fovea were *** choroidal vascularity index was also ***:There was no significant difference in central choroidal thickness between the preoperative and postoperative 3d,1mo(P>0.05).There was a significant increase in the 3mo(P=0.034)and a significant decrease in the horizontal choroidal vascularity index on the postoperative 3d(P=0.014),there was no statistically significant change in vertical axes and other visits in horizontal sections(P>0.05).CONCLUSION:This study sheds light on choroidal changes in postoperative corneal crosslinking for *** it suggests the procedure’s relative safety for submacular choroid,more extensive research is necessary to confirm these findings and their clinical significance.

关键词： keratoconus corneal crosslinking choroidal vascularity index enhanced depth imaging optical coherence tomography

Effect of interferon and ribavirin combined with amantadine in interferon and ribavirin non-responder patients with chronic hepatitis C (genotype 1)

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World Journal of Gastroenterology 2005年第4期11卷 580-583页

作者： Dilek Oguz Bahattin Cicek Levent Filik Bulent Odemis Mesut Kilic Engin Altintas Neslihan Zengin Emin Altiparmak turkiye yuksek ihtisas hospital Gastroenterology Clinic Mersin University Department of Gastroenterology turkiye yuksek ihtisas hospital Department of Pathology turkiye yuksek ihtisas hospital Gastroenterology Clinic

AIM: To evaluate the efficacy of amantadine plus interferonalpha and ribavirin in non-responder patients with chronic hepatitis ***: Twenty-six non-responder patients received the regimen of IFN-α-2a at a dose of 6 million units three times a week, 1 000-1 200 mg of ribavirin daily, and 200 mg of amantadine daily in divided doses over 48 wk. After the end of treatment, at the 72nd wk, a sustained viral response rate was ***: An early (after 12 wk of therapy) response was seen in 34.6% (9/26) of patients. Response rate at the 24th wk was 42.3% (11/26). End of treatment response (ETR) was 53.8% (14/26). Sustained viral response (SVR) was 42.3% (11/26). There was a statistically significant difference between 0 and 12 wk (P = 0.04), 0 and 24 wk (P = 0.01), 0 and 48 wk (P = 0.00), and 0 and 72 wk (P = 0.001). No patient had severe adverse effects during the ***: Combination regimen of interferon-α,ribavirin and amantadine can enhance sustained viral response on IFN-α and ribavirin non-responder patients with HCV. Triple therapy with amantadine should be evaluated in further studies.

关键词： Chronic hepatitis C IFN-α-2a Ribavirin

Interesting rendezvous location in a liver transplantation patient with anastomosis stricture

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World Journal of Gastroenterology 2014年第42期20卷 15916-15919页

作者： Bulent Odemis Erkin Oztas Mehmet Yurdakul Serkan Torun Nuredtin Suna Ertugrul Kayacetin Department of Gastroenterology Yuksek Ihtisas Education and Research Hospital Department of Radiology Yuksek Ihtisas Education and Research Hospital

An endoscopic or radiologic percutaneous approach may be an initial minimally invasive method for treating biliary strictures after living donor liver transplantation; however, cannulation of biliary strictures is sometimes difficult due to the presence of a sharp or twisted angle within the stricture or a complete stricture. When an angulated or twisted biliary stricture interrupts passage of a guidewire over the stricture, it is difficult to replace the percutaneous biliary drainage catheter with inside stents by endoscopic retrograde cholangiopancreatography. The rendezvous technique can be used to overcome this difficulty. In addition to the classical rendezvous method, in cases with complete transection of the common bile duct a modified technique involving the insertion of a snare into the subhepatic space has been successfully performed. Herein, we report a modified rendezvous technique in the duodenal bulb as an extraordinary location for a patient with duct-to-duct anastomotic complete stricture after liver transplantation.

关键词： Liver transplantation Anastomosis stricture Endoscopic radiologic rendezvous Duodenal bulb

Transcutaneous cervical esophagus ultrasound in adults: Relation with ambulatory 24-h pH-monitoring and esophageal manometry

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World Journal of Gastroenterology 2007年第39期13卷 5245-5252页

作者： Sabite Kacar Selma Uysal Sedef Kuran Ulku Dagli Yasemin Ozin Erdem Karabulut Nurgul Sasmaz Gastroenterology Department Turkiye Yuksek Ihtisas Hospital Turkey Radiology Department Ankara Training and Research Hospital Turkey Biostatistics Department Hacettepe University Turkey

AIM: To determine the gastroesophageal refl uxate in the cervical esophagus (CE) and measure transcutaneous cervical esophageal ultrasound (TCEUS) f indings [anterior wall thickness (WT) of CE, esophageal luminal diameter (ELD), esophageal diameter (ED)]; to compare TCEUS findings in the patient subgroups divided according to 24-h esophageal pH monitoring and manometry; and to investigate possible cut-off values according to the TCEUS f indings as a predictor of gastroesophageal refl ux (GER). METHODS: In 45/500 patients, refl uxate was visualized in TCEUS. 38/45 patients underwent esophagogastroduo denoscopy (EGD), 24-h pH monitoring and manometry. RESULTS: The 38 patients were grouped according to 24-h pH monitoring as follows: Group A: GER-positive (n = 20) [Includes Group B: isolated proximal refl ux (PR) (n = 6), Group C: isolated distal reflux (DR) (n = 6), and Group D: both PR/DR (n = 8)]; Group E: no refl ux (n = 13); and Group F: hypersensitive esophagus (HSE) (n = 5). Groups B + D indicated total PR patients (n = 14), Groups E + F refl ux-negatives with HSE (n = 18), and Groups A + F refl ux-positives with HSE (n = 25). When the 38 patients were grouped according to manometry fi ndings, 24 had normal esophageal manometry; 7 had hypotensive and 2 had hypertensive lower esophageal sphincter (LES); and 5 had ineffective esophageal motility disorder (IEM). The ELD measurement was greater in group A + F than group E (P = 0.023, 5.0 ± 1.3 vs 3.9 ± 1.4 mm). In 27/38 patients, there was at least one pathologic acid refl ux and/or pathologic manometry fi nding. The cut-off value for ELD of 4.83 mm had 79% sensitivity and 61% specificity in predicting the PRbetween Groups B + D and E (AUC = 0.775, P = 0.015). CONCLUSION: Visualizing refluxate in TCEUS was useful as a pre-diagnostic tool for estimating GER or manometric pathology in 71.1% of adults in our study, but it was not diagnostic for CE WT.

关键词： Ambulatory 24-h pH monitoring Cervical esophageal ultrasound Gastroesophageal reflux Esophageal manometry Esophageal refluxate

Brain metastasis of hepatocellular carcinoma:A case report and review of the literature

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World Journal of Gastroenterology 2004年第11期10卷 1688-1689页

作者： Bilge Tunc Levent Filik Irsel Tezer-Filik Burhan Sahin turkiye yuksek ihtisas hospital Gastroenterology ClinicAnkara 06520Turkey Hacettepe University Department of NeurologyAnkara 06520Turkey

Hepatocellular carcinoma (HCC) is one of the most frequent malignancies in the world. It is more common in far eastern countries and relatively rare in the United States and western European countries where at autopsy it accounts for only 1-2% of malignant rumors, The disease is usually manifested in the the 6^th and 7^th decade of life. HCC is one of the highly malignant neoplasms, Extrahepatic metastases are seen in 64% of patients with HCC. The lungs, regional lymph nodes, kidney, bone marrow and adrenals are common sites of HCC metastasis^[1-3], But, metastasis to brain and skull is extremely rare. Table I shows some of the reported cases of HCC with brain metastasis. These case reports reaffirms the complex and multidisciplinary care of these patients^[4-5].

关键词： Brain Neoplasms Carcinoma, Hepatocellular Humans Liver Neoplasms Male Middle Aged Tomography, X-Ray Computed

Etiology and portal vein thrombosis in Budd-Chiari syndrome

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World Journal of Gastroenterology 2008年第18期14卷 2858-2862页

作者： Oguz Uskudar Meral Akdogan Nurgul Sasmaz Sevinc Yilmaz Muharrem Tola Burhan Sahin turkiye yuksek htisas hospital clinics of gastroenterology Ankara 06010 Turkey turkiye yuksek htisas hospital hematology unit Ankara 06010 Turkey turkiye yuksek htisas hospital clinics of radiology Ankara 06010 Turkey

AIM: To research the etiology, portal vein thrombosis and other features of Budd-Chiari syndrome (BCS) patients prospectively. METHODS: A total of 75 patients (40 female, 35 male) who were diagnosed between January 2002 and July 2004 as having BCS were studied prospectively. Findings from on physical examination, ultrasonography, duplex ultrasonography and venography were analyzed. Hemogram and blood chemistry were studied at the time of diagnosis and on each hospital visit. Bone marrow examination and immune phenotyping were performed by a hematologist when necessary. Protein C, S, antithrombin Ⅲ, activated protein C resistance, and anticardiolipin antibodies, antinuclear antibodies, and anti ds-DNA were studied twice. The presence of ascite, esophageal varices, and portal thrombosis were evaluated at admission and on every visit. RESULTS: At least one etiological factor was determined in 54 (72%) of the patients. The etiology could not be defined in 21 (28%) patients. One etiological factor was found in 39, 2 factors in 14 and 3 factors in 1 patient. The most common cause was the web (16%), the second was Hydatid disease (11%), the third was Behcet’s disease (9%). Portal vein thrombosis was present in 11 patients and at least one etiology was identified in 9 of them (82%). CONCLUSION: Behcet’s disease and hydatid disease are more prominent etiological factors in Turkey than in other countries. Patients with web have an excellent response to treatment without signs of portal veinthrombosis while patients having thrombofilic factors more than one are prone to develop portal vein thrombosis with worse clinical outcome.

关键词： Budd-Chiari syndrome Etiology Web Behcet's disease Portal thrombosis

Analysis of 24 patients with Achenbach’s syndrome

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World Journal of Clinical Cases 2019年第10期7卷 1103-1110页

作者： Fatih Ada Ferit Kasimzade Department of Cardiovascular Surgery Sivas Cumhuriyet University School of MedicineSivas 58140Turkey Department of Cardiovascular Surgery Turkiye Yuksek Ihtisas Training and Research HospitalAnkara 06100Turkey

BACKGROUND Achenbach’s syndrome is a rare condition,and the etiology is *** is most commonly seen in the volar plate of the hand distal interphalangeal *** diagnosed with Achenbach’s syndrome in cardiovascular surgery clinic were retrospectively compared with the *** To investigate the symptoms,findings,sociodemographic conditions,and laboratory data of patients diagnosed with Achenbach’s *** The study is a retrospective review of 24 patients diagnosed with Achenbach’s syndrome at Afyonkarahisar State hospital between March 2015 and November 2016,at Sivas Numune hospital between November 2016 and November 2017,and at Cumhuriyet University Cardiovascular Surgery Department between November 2017 and November *** the study,demographic characteristics of the patients,signs and symptoms of the disease,and laboratory data were analyzed *** The cohort consisted of 83.33%female patients and 16.67%male *** disease was most commonly located in the index finger of the right *** of the patients complained of bruising and *** pathologic findings were present in the laboratory *** to these results,it can be concluded that Achenbach syndrome is most commonly seen in the right index finger of middle-aged female *** Further research is needed to clarify Achenbach’s syndrome and to develop a diagnosis and treatment *** the awareness of this syndrome increases,large amounts of data will be *** to current knowledge,Achenbach’s syndrome is not among the known causes of mortality or ***,it is unknown whether it is seen in brain or other vital organs.

关键词： Achenbach’s syndrome Blue thumb Digital hematoma Digital hemorrhage Hand Pulse oximeter

Manometric findings in patients with isolated distal gastroesophageal reflux

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World Journal of Gastroenterology 2009年第43期15卷 5461-5464页

作者： Yasemin Ozin Ulku Dagli Sedef Kuran Burhan Sahin Gastroenterology Department Turkey Yuksek Ihtisas Training and Research HospitalKizilay Sokak06040 SihhiyeAnkara Turkey

AIM： To analyze manometric abnormalities in patients with isolated distal reflux and compare these findings in patients with erosive and non-erosive disease, METHODS： Five hundred and fifty patients who presented to the outpatient clinic of turkiye yuksek ihtisas hospital with gastroesophageal reflux disease-like symptoms were enrolled, Each individual was evaluated with esophageal manometry, 24-h ambulatory pH monitoring, and upper gastrointestinal endoscopy, Manometric findings for the patients with isolated distal reflux were compared to findings in controls who were free of reflux disorders or hypersensitive esophagus, Findings for isolated distal reflux patients with and without erosive reflux disease were also compared, RESULTS： Of the 550 subjects enrolled, 97 （17.6%, mean age 48 years） had isolated distal reflux and i00 had no abnormalities on ambulatory pH monitoring （control group, mean age 45 years）. There were no significant differences between the isolated distal reflux group and control group with respect to age, body mass index, and esophageal body contraction amplitude （EBCA）. Mean lower esophageal sphincter pressure was significantly higher in the control group （12.7 ± 10.3 mmHg vs 9.6 ± 7.4 mmHg, P = 0.01）. Fifty-five （56.7%） of the 97 patients with isolated distal reflux had erosive reflux disease. There were no statistical differences between the erosive reflux disease and non-erosive reflux disease subgroups with respect to mean EBCA, lower esophageal sphincter pressure, or DeMeester ***, 13% of patients with gastroesophageal reflux disease had distal wave amplitudes ≤ 30 mmHg, whereas none of the patients with non-erosive reflux disease had distal wave amplitudes in this low category. CONCLUSION： Patients with erosive and non-erosive disease present with similar manometric abnormalities. The only striking difference is the observation of very low EBCA exclusively in patients with erosive disease.

关键词： Esophageal motility disorders Isolated distal reflux Gastroesophageal reflux disease Manometry Esophagitis

The relation between differential leukocyte count, neutrophil to lymphocyte ratio and the presence and severity of coronary artery disease

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Open Journal of Internal Medicine 2012年第3期2卷 163-169页

作者： Hatice Selcuk Lale Dinc Mehmet Timur Selcuk Orhan Maden Ahmet Temizhan Cardiology Department Turkiye Yuksek Ihtisas Hospital Ankara Turkey

Objectives: Total leukocyte count, a marker of inflammation has long been reported to be related with coronary artery disease (CAD). Recently, differenttial leukocyte count and elevated neutrophil to lymphocyte ratio (N/L) has been shown to indicate an increased long-term risk of mortality in patients with stable CAD, myocardial infarction and undergoing cardiovascular surgery. Thses studies offer incremental prognostic value to total leukocyte count. We sought to determine the relationship between the leukocyte subtypes and N/L ratio and the presence and extent of CAD. Study design: The study consisted of 107 patients [70 (65.4%) men, 37 (34.6%) women, mean age 59.5 ± 10.6 years] referred to coronary angiography with suspected CAD. The subjects were classified into two groups according to the presence of significant CAD and the extent of CAD was determined by the Gensini method. Results: The lymphocyte count was found to be lower (2031 ± 741 cells/μL vs 2392 ± 611 cells/μL, p: 0.010) and the N/L ratio was found to be higher in patients with CAD (2.86 ± 1.57 vs 2.04 ± 1.01, p p: 0.005]. Conclusion: Our findings reveal that N/L ratio, a simple marker which can be derived from a routine complete blood count test was significantly and independently related to presence and severity of coronary atherosclerosis.

关键词： Leukocyte Neutrophil Lymphocyte Coronary Artery Disease Lymphocyte Ratio

Comparison of Fractional Flow Reserve-Guided Revascularization Strategies in Isolated Proximal Left Anterior Descending Coronary Artery Disease

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Open Journal of Internal Medicine 2018年第3期8卷 167-176页

作者： Mehmet Timur Selcuk Enis Grbovic Orhan Maden Hatice Selcuk Murat Gül Kevser Gülcihan Balci Mustafa Mücahit Balci Cardiology Turkiye Yuksek Ihtisas Research and Education Hospital Ankara Turkey

The data about FFR-guided revascularization in isolated proximal LAD disease are limited and studies comparing long-term outcomes of FFR-guided PCI versus FFR-guided CABG in single-vessel proximal LAD disease are lacking. We aimed to assess the 4-year long-term safety and effectiveness of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) and FFR-guided coronary artery bypass graft surgery (CABG) for the treatment of proximal left anterior descending (LAD) lesions. The study included 129 patients with functionally significant (FFR ≤ 0.80) isolated proximal LAD stenosis (PCI, 88 patients vs. CABG, 41). Clinical endpoints were assessed by Kaplan-Meier method and compared by the log-rank test. At a mean follow-up time of 47 ± 12 months, a higher incidence of myocardial infarction in the PCI group (PCI: 32% vs. CABG: 15%;p = 0.003) and a higher incidence of stroke in the CABG group (CABG: 3 (7%) vs. PCI 0 (0%);p = 0.031) were observed. However, there were no significant differences in the primary composite endpoint, death and target vessel revascularization between PCI and CABG groups. The PCI and CABG in isolated proximal LAD lesions yielded similar long-term outcomes regarding the primary composite clinical endpoints. However, stroke was more frequent in the CABG group than in the PCI group.

关键词： Coronary Artery Bypass Grafting Fractional Flow Reserve Percutaneous Coronary Intervention