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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

Treatment of Crohn's disease and familial Mediterranean fever by leukopheresis:Single shot for two targets

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World Journal of Gastroenterology 2015年第13期21卷 4078-4081页

作者： Mahmut Yuksel Fatih Saygili Orhan Coskun Nuretdin Suna Mustafa Kaplan Ufuk Baris Kuzu Zeki Mesut Yalin Kilic Yasemin Ozderin Ozin Ertugrul Kayacetin Department of Gastroenterology Turkiye Yuksek Ihtisas Training and Education HospitalAnkara 06230Turkey

Coexistence of Crohn's disease(CD) and familial Mediterranean fever(FMF) is a rare condition and knowledge about this clinical situation is limited with a few case reports in the literature. The treatment of both diseases depends on their individual therapies. However, it is very hard to deal with this coexistence when CD is refractory to standard therapies. Ongoing activity of CD triggers the clinical attacks of FMF and the symptoms like abdominal pain interfere with both disease presentations which can cause problems about diagnostic and therapeutic approach. The main therapeutic agent for FMF is colchicine and diarrhea is the most common side effect of this drug. This side effect also causes problems about management of these diseases when both of them are clinically active. Here we report probably the first case in the literature with coexisting CD and FMF who was successfully treated by leukopheresis since he was refractory to conventional therapies for CD.

关键词： Crohn’s disease Familial Mediterranean fever Leuko

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

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

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

The impact of macular surgery in different grades of epiretinal membrane

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International Journal of Ophthalmology(English edition) 2017年第12期10卷 1877-1882页

作者： Cosar Batman Mehmet Citirik yuksek ihtisas university Koru HospitalAnkara 06520Turkey university of Health Science Ankara Ulucanlar Eye Education and Research HospitalAnkara 06230Turkey

AIM：To assess the impact of macular surgery on the functional and anatomic outcomes of the patients in different grades of epiretinal membrane（ERM）.METHODS：Seventy-one eyes of 71 patients who underwent 23-gauge transconjunctival sutureless pars plana vitrectomy for primary isolated ERM were evaluated in this ***：There were 38 females（53.5%） and 33 males（46.5%）.The average age of the patients was 68.1 y（range 42-89 y）.Mean follow up period was 14 mo（range 6-26 mo）.The cases were divided into two subgroups of cellophane maculopathy（CM） and macular pucker（MP）.An improvement was observed in the postoperative best-corrected visual acuity（BCVA）,as well as a decrement in central foveal thickness（CFT） in both groups（both of these being statistically significant;P=0.001）.In comparison between two groups,it was found that there was a significant improvement on BCVA and CFT in CM group than MP group（P=0.01）.Furthermore,the postoperative fundus findings regarding RPE alterations and macular edema were significantly higher in MP group when compared to the CM group（P=0.01）.CONCLUSION：ERM and internal limiting membrane peeling surgery can lead to a significant reduction of CFT and visual improvements in idiopathic ERM.A long-term ERM persistence will cause unrecoverable retinal damage and visual loss.

关键词： cellophane maculopathy epiretinal membrane intemal limiting membrane peeling macular pucker membranepeeling vitrectomy

Detecting early changes in choroidal vascularity and thickness using optical coherence tomography in patients with corneal crosslinking for keratoconus

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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

Predictive value of C-reactive protein/albumin ratio in acute pancreatitis

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Hepatobiliary & Pancreatic Diseases International 2017年第4期16卷 424-430页

作者： Mustafa Kaplan Ihsan Ates Muhammed Yener Akpinar Mahmut Yuksel Ufuk Baris Kuzu Sabite Kacar Orhan Coskun Ertugrul Kayacetin Department of Gastroenterology Turkey Yuksek Ihtisas Training and Research HospitalAnkara 06100Turkey Department of Internal Medicine Ankara Numune Training and Research HospitalAnkara 06100Turkey

BACKGROUND:Serum C-reactive protein(CRP) increases and albumin decreases in patients with inflammation and ***,their role in patients with acute pancreatitis is not *** present study was to investigate the predictive significance of the CRP/albumin ratio for the prognosis and mortality in acute pancreatitis ***:This study was performed retrospectively with 192 acute pancreatitis patients between January 2002 and June *** scores,Atlanta classification and CRP/albumin ratios of the patients were ***:The CRP/albumin ratio was higher in deceased patients compared to *** CRP/albumin ratio was positively correlated with Ranson score and Atlanta classification in particular and with important prognostic markers such as hospitalization time,CRP and erythrocyte sedimentation *** addition to the CRP/albumin ratio,necrotizing pancreatitis type,moderately severe and severe Atlanta classification,and total Ranson score were independent risk factors of *** was found that an increase of 1 unit in the CRP/albumin ratio resulted in an increase of 1.52 times in mortality risk.A prediction value about CRP/albumin ratio >16.28 was found to be a significant marker in predicting mortality with 92.1% sensitivity and 58.0% *** was seen that Ranson and Atlanta classification were higher in patients with CRP/albumin ratio >16.28 compared with those with CRP/albumin ratio ≤*** with CRP/albumin ratio >16.28 had a 19.3 times higher chance of ***:The CRP/albumin ratio is a novel but promising,easy-to-measure,repeatable,non-invasive inflammationbased prognostic score in acute pancreatitis.

关键词： Atlanta classification C-reactive protein Glasgow prognostic score Ranson score acute pancreatitis

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