[Show abstract][Hide abstract] ABSTRACT: Objective Determination of human epidermal growth factor receptor-2 status in advanced gastric cancer is important in clinical decision
making. In the trastuzumab for GC trial, trastuzumab-based therapy demonstrated a significant overall survival benefit in
patients with human epidermal growth factor receptor-2-positive advanced gastric cancer. Human epidermal growth factor receptor-2
discordance in gastric cancer primary and its metastases has been long debated. The aim of the study was to evaluate the rate
of human epidermal growth factor receptor-2 discordance and its effect on treatment decisions in advanced gastric cancer.
Full-text · Article · Mar 2015 · Japanese Journal of Clinical Oncology
[Show abstract][Hide abstract] ABSTRACT: Collagenous sprue is a clinicopathological entity with an unknown etiology. Its clinical features include progressive malabsorption, diarrhea, weight loss, unresponsiveness to treatment, and high mortality rates. The age interval of collagenous sprue is quite broad and ranges between 2 and 85 years. As far as to our knowledge, the presented case is the first reported case in infancy.
No preview · Article · Dec 2014 · Fetal and Pediatric Pathology
[Show abstract][Hide abstract] ABSTRACT: Our aim is to assess the relationship between interleukin 1β (IL-1 β), (-511,-31 alleles), interleukin 1RN (IL-RN), Helicobacter pylori (HP) status and gastroesophageal reflux disease (GERD) diagnosed by pH monitoring in the Turkish population.
A Total of 100 consecutive patients with GERD were enrolled in the study. Genotypes of IL-1β (-511,-31), IL-1RN gene polymorphisms and HP status of the patients were analyzed.
While thirty-two patients were diagnosed as esophagitis with varying severity the remaining patients had no esophagitis. Seventy six participants were positive for HP and the remaining patients were negative. The difference between erosive and non-erosive groups was statistically significant when we compared IL-1β (-511) but no difference regarding IL-1β (-31) and IL-1RN variations. We also analyzed T/T, C/T and C/C alleles and the difference was significant statistically in T/T allele between patients with and without erosive GERD 1 (3.1%) vs. 12 (17.9%), respectively with a p value <0.05. But C/C, C/T alleles of (-511), (-31) and IL-1RN polymorphisms were not statistically significant between the groups.
IL-1β genetic polymorphisms may take part in the pathophysiology of gastroesophageal reflux disease.
No preview · Article · Dec 2014 · The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology
[Show abstract][Hide abstract] ABSTRACT: Aim: Recent studies have advocated that the presence of macrophage microaggregations (MMA) may be a criterion in the diagnosis of Crohn's colitis (CC). In our study we aimed to investigate the role of MMA to differenti-ate ulcerative colitis (UC) and (CC). Material and Method: We analyzed the role of MMA in 29 patients with UC, 26 patients with CC and 22 healthy subjects without diagnosis of inflammatory bowel disease. For all subjects, esophagogastroduodenoscopy was performed. Biopsies were taken from non-lesion regions of stomach and duodenum. Biopsy materials underwent immunohistochemical staining for the microscopic investigation of the presence of MMA. Also, determination of Perinuclear Anti-Neutropil Cytoplasmic Antibodies (pANCA) and Anti-Saccharomyces Cerevisiae Antibodies (ASCA) (Immunoglobulin G and A) was done with ELISA in serum samples. In patient and control groups, presence of Helicobacter pylori (H. pylori) positivity was histopathologically evaluated. Results: MMA was higher in patients with both CC and UC compared with control groups (46.2%, 41.3%, and 9.1% respec-tively). There was statistically significant difference between patient groups and the control group in terms of MMA but there was no difference between CC and UC groups (p=0.007). No statistically significant difference was ob-tained between the groups in terms of ASCA and p-ANCA. H.pylori positivity was determined in 41.3% of MMA patients with CC, in 75% of patients with UC, and in 50% of healthy subjects. There was no significant difference between the three groups (p=0.344). Discussion: MMA positivity increases in patients with both CC and UC. In patients with inflammatory colitis, H. pylori existence, pANCA and ASCA positivity was similar to healthy subjects.
[Show abstract][Hide abstract] ABSTRACT: Background/aims:
Grading and staging are important in gastroenteropancreatic neuroendocrine tumors for directing treatment. In this study, we evaluated the histopathological parameters of gastroenteropancreatic neuroendocrine tumors and statistically analyzed the correlations of these parameters between the World Health Organization (WHO) 2000 and 2010 classifications.
Materials and methods:
A total of 77 cases diagnosed as neuroendocrine tumors were included in the study. Cases were classified according to the WHO 2000 and WHO 2010 classification systems, and the differences and correlations between the two systems were discussed.
Among the 50 cases that were diagnosed as well-differentiated neuroendocrine tumor according to WHO 2000, 45 were found to be Grade 1 and 5 were found to be Grade 2 according to the WHO 2010 classification. Among the 8 cases with well-differentiated neuroendocrine carcinoma according to WHO 2000; 5 and 3 were Grade 1 and Grade 2, respectively, according to the WHO 2010 classification. All of the 19 cases with poorly differentiated neuroendocrine carcinoma according to WHO 2000 were found to be Grade 3 according to the WHO 2010 classification. No differences were found between the classifications in the poorly differentiated group with a full correlation between the two classifications.
Although WHO 2000 seems to be a better classification to predict prognosis, since it is based on various parameters, such as depth of invasion, angiolymphatic invasion, and presence of metastasis, it was concluded that there was no difference between the WHO 2000 and WHO 2010 classification, which is based on only the number of mitoses and Ki-67 proliferation index.
Preview · Article · Feb 2014 · The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology
[Show abstract][Hide abstract] ABSTRACT: Objectives: Ulcerative colitis (UC) is an inflammatory disease of the colonic mucosa with involvement from distal to proximal and characterized by neutrophil infiltration. There is no golden standart for the current state of therapy of the patients with UC. The aim of this study is to evaluate the possible effects of colchicine against acetic acid (AA)-induced colitis in rats. Methods: Fifty three rats were divided into six groups. Rats with AA-induced colitis were treated by intraperitoneal or oral administration of colchicine (80 mcg/kg/day) on treated group. Other four groups formed as colitis control groups and sham groups. Superoxide dismutase (SOD), myeloperoxidase (MPO), lipid peroxidation end products (MDA, FOX) were evaluated from the tissue extracts of colon. Results: The macroscopic and microscopic colitis scores were found to be significantly increased on AA-induced colitis compared to the sham groups (p < 0.0001). However, there were no significant differences between oral or intraperitoneal treated groups and their control groups for those scores. Oral colchicine therapy was associated with decreased SOD (p < 0.0001) and MPO (p=0.001), but increased FOX (p=0.013) levels. Conclusions: Colchicine could be beneficial to control the inflammation in treatment of UC. However, in our study, there was not any protective effect to antioxidant activity neither inhibition on lipid peroxidation end products were observed.
No preview · Article · Jan 2014 · Türk Biyokimya Dergisi / Turkish Journal of Biochemistry
[Show abstract][Hide abstract] ABSTRACT: The establishment of postnatal mother-infant bonding is important for a healthy mother-infant relationship. Our research was designed to detect the reliability of the Turkish-language versions of the Brockington Postpartum Bonding Questionnaire (PPBQ) and the Taylor Mother-to-Infant Bonding Scale (MIBS) in mothers at the second month postpartum. 189 mothers were enrolled in the study. Following adaptation of the scales to create Turkish versions, their reliability and validity were analyzed. The Edinburgh Postnatal Depression scale (EPDS) was used for comparison. There was a positive correlation between the EPDS and the PPBQ, and between the EPDS and the MIBS. Cronbach's alpha for the EPDS was 0.78, for the PPBQ 0.75, and for the MIBS 0.61. These findings suggest that the Turkish versions of both scales are reliable in mothers at the second month postpartum.
No preview · Article · Jan 2014 · Cocuk Sagligi ve Hastaliklari Dergisi
[Show abstract][Hide abstract] ABSTRACT: Background/aims:
The risk of gastric cancer is increased in patients with intestinal metaplasia. Cyclooxygenase-2 activity is crucial for gastric cancer cell survival and proliferation. We aimed to assess cyclooxygenase-2 expression in patients with intestinal metaplasia or chronic active gastritis and in patients with or without a family history of gastric cancer, i.e. a first-degree relative with gastric cancer.
Materials and methods:
One hundred and six patients with histologically proven intestinal metaplasia, chronic active gastritis or normal gastric mucosa were included. Immunohistochemical staining was performed using the immunoperoxidase method.
Cyclooxygenase-2 expression was detected in 23.1% of normal gastric mucosa, 70.6% of chronic active gastritis, and 90.5% of intestinal metaplasia patients. Cyclooxygenase-2 expression was significantly higher in intestinal metaplasia than in chronic active gastritis (p=0.018). Cyclooxygenase-2 expression was significantly more severe in the intestinal metaplasia group when compared to the chronic active gastritis group (p=0.017). Severe cyclooxygenase-2 expression (>60% of cells) was more frequent in the intestinal metaplasia group. Cyclooxygenase-2 expression was higher in the Helicobacter pylori-positive group when compared to the Helicobacter pylori-negative group (80.3% vs 57.1%, respectively; p=0.012). Cyclooxygenase-2 expression did not significantly differ according to presence of a first-degree relative with gastric cancer.
Patients with intestinal metaplasia demonstrated increased presence and severity of cyclooxygenase-2 expression. Our findings suggest that cyclooxygenase-2 plays an important role in the stepwise process that eventually leads to gastric cancer. There was no statistically significant difference between the patients with and without a first-degree relative with a history of gastric cancer in terms of cyclooxygenase-2 expression.
No preview · Article · Oct 2012 · The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology
[Show abstract][Hide abstract] ABSTRACT: Background and aim Lead, mercury and cadmium are widely exposed environmental pollutants throughout the world. In this study, we aimed to investigate the level of exposure to lead(Pb), mercury(Hg) and cadmium(Cd) during intrauterine life.
Methods We included 123 mother-infant pairs between December 2006 and January 2007. Umbilical cord blood collected immediately after delivery while breast milk and newborn hair samples collected between 3–10th postpartum days. All the specimens analyzed by Inductively Coupled Plasma Mass Spectrometry.
Results Cord blood samples Pb was present in 99.2%(the mean 1.66±1.6µg/dl) while Hg in only 1.7% and Cd in 19.8%(ranged 0–6.71µg/L). Cord blood Pb was higher than ≥2µg/dl in 29% of the samples. Pb, Hg and Cd were detectable in all the newborn hair samples. Among breast milk samples 83.2% had detectable lead levels(mean 14.5±12.1µg/L). Presence of Hg and Cd in breast milk samples were 53.3% and 9% respectively. Cord blood lead levels were significantly higher when maternal age >35 years. Breast milk Cd levels were significantly higher in women who were residing close to the major city waste site. Cord blood Cd levels were significantly higher in women consuming more than two fish weekly. Maternal exposure to environmental tobacco smoking(ETS) resulted increased newborn hair Pb and Cd levels.
Conclusion Intrauterine heavy metal exposure is an important concern for pediatricians. Most samples had detectable levels for Pb, Hg, Cd indicating long term maternal exposure and considerable number exceeds the present accepted safety levels at cord and breast milk samples. Preventing ETS, limiting fish consumption and improved living conditions for pregnant women may decrease exposure levels.
Preview · Article · Oct 2012 · Archives of Disease in Childhood
[Show abstract][Hide abstract] ABSTRACT: The primary aim is to compare individuals with intestinal metaplasia (IM), chronic active gastritis (CAG), and normal gastric mucosa (NGM) in terms of apoptosis, proliferation, and Bcl-2 expression. The secondary aim is to determine whether these parameters are different between patients with and without gastric cancer in first-degree relatives. We enrolled 106 patients whose histopathological results were consistent with IM (n: 42), CAG (n: 51), or NGM (n: 13). Antral biopsies were immunohistochemically stained for Bcl-2 and Ki-67 expression. Apoptosis was detected using TUNEL assay. While no significant difference was determined between three groups with regard to apoptosis and Bcl-2 expression (p>0.05), Ki-67 expression was significantly higher in the IM group when compared with the CAG and NGM groups (29.90±22.87 vs. 18.18±16.22 vs. 18.54±20, respectively; p=0.012). Helicobacter pylori was determined to increase apoptosis (49.3% vs. 25.7%, p<0.05), nevertheless, it had no significant effect on proliferation and Bcl-2 expression. Bcl-2 and Ki-67 expression and apoptosis were not different among patients with and without a history of gastric cancer in first degree relatives. Although intestinal metaplasia cases demonstrate an increase in proliferation, no elevation is observed in apoptosis. This can be an important factor in the progression to gastric cancer.
No preview · Article · Feb 2012 · Pathology - Research and Practice
[Show abstract][Hide abstract] ABSTRACT: Hemophagocytic lymphohistiocytosis (HLH) may develop secondary to infections, malignancies, immune deficiency syndromes, and rheumatologic and metabolic disorders. Associations between HLH and inborn errors of metabolism, including lysinuric protein intolerance, multiple sulfatase deficiency, galactosemia, Gaucher disease, Pearson syndrome, and galactosialidosis, have previously been reported in the literature. In this report the authors present 3 children with disorders of propionate metabolism--1 with methylmalonic acidemia and 2 with propionic acidemia--who developed secondary HLH during their metabolic attacks. All patients fulfilled the 5 HLH criteria of the Histiocyte Society. Familial HLH was ruled out by molecular analysis. Plasma exchange was performed for 2 of them. Unfortunately 1 died of multiorgan failure despite intensive therapy. This is the first report of such an association.
Full-text · Article · Feb 2012 · Pediatric Hematology and Oncology
[Show abstract][Hide abstract] ABSTRACT: Primary systemic carnitine deficiency (SCD) is an autosomal recessive disorder caused by defective cellular carnitine transport. Patients usually present with predominant metabolic or cardiac manifestations. SCD is caused by mutations in the organic cation/carnitine transporter OCTN2 (SLC22A5) gene. Mutation analysis of SLC22A5 gene was carried out in eight Turkish patients from six families. Six patients presented with signs and symptoms of heart failure, cardiomyopathy, and low plasma carnitine levels, five of them with concurrent anemia. A patient with dilated cardiomyopathy had also facial dysmorphia, microcephaly, and developmental delay. Tandem MS analyses in siblings of the patients revealed two more cases with low plasma carnitine levels. SCD diagnosis was confirmed in these two cases by mutation screening. These two cases were asymptomatic but echocardiography revealed left ventricular dilatation in one of them. Carnitine treatment was started before the systemic signs and symptoms developed in these patients. Mean value of serum carnitine levels of the patients was 2.63±1.92μmol/L at the time of diagnosis. After 1year of treatment, carnitine values increased to 16.62±5.11 (p<0.001) and all responded to carnitine supplementation clinically. Mutation screening of the OCTN2 gene study in the patients revealed two novel (p.G411V, p.G152R), and four previously identified mutations (p.R254X, p.R282X, p.R289X, p.T337Pfs12X). Early recognition and carnitine supplementation can be lifesaving in this inborn error of fatty acid oxidation.
[Show abstract][Hide abstract] ABSTRACT: Acrodermatitis enteropathica (AE) is a rare autosomal recessive disorder of zinc deficiency due to an abnormal intestinal zinc transporter. It is characterized by the triad of acral dermatitis, alopecia, and diarrhoea. Once AE is correctly diagnosed, patients are treated with orally administered zinc sulphate. In some patients, relapses occur during adolescence, despite the regular treatment. Here, we discuss the clinical and molecular features of a 13-year-old adolescent girl with acrodermatitis enteropathica who was resistant to high-dose zinc sulphate therapy. We successfully treated the patient with zinc gluconate and vitamin C, and we detected a novel homozygous c.541_551dup (p.Leu186fsX38) mutation in the exon 3 of her SLC39A4 gene.
[Show abstract][Hide abstract] ABSTRACT: Near infrared spectroscopy measures tissue oxygenation even when there is complete cessation of blood flow. We evaluated near infrared spectroscopy to diagnose testicular torsion and blindly compared its accuracy with that of Doppler ultrasound. We also compared it by immunohistochemical evaluation of hypoxia and cell viability.
Rats were randomized to 4 groups, including group 1-720-degree unilateral torsion, group 2-360-degree unilateral torsion, group 4-sham operation and group 4-720-degree unilateral torsion followed by surgical torsion reduction at minute 180. Near infrared spectroscopy and Doppler ultrasound were done blindly at minutes 0, 5, 30, 60, 180 and 400. All torsed and contralateral testicles were excised for pathological examination using hypoxia inducible factor-α for hypoxia and the TUNEL test for apoptosis. We compared all groups with the contralateral testis and the sham operated group.
All blinded, near infrared spectroscopy measurements correctly identified the torsed testis after minute 5. Median oxygen saturation in groups 1 and 2 was significantly different compared to that in the sham operated group after minute 5. In group 4 near infrared spectroscopy detected detorsion with the loss of a significant oxygen saturation difference between the affected and the contralateral testicle after detorsion. At minute 400 median oxygen saturation in group 4 was not statistically different compared to that in the sham operated group (p = 0.09) but it was significantly different compared to that in groups 1 and 2 (p <0.001). In each torsed testis oxygen saturation was at least 18.75% lower than in the contralateral testis. In groups 1 and 2 hypoxia inducible factor-α staining in torsed testicles was significantly greater than that in the contralateral organ and the sham operated group. In group 4 hypoxia inducible factor-α staining after detorsion was significantly decreased compared to that in groups 1 and 2. There was no significant difference in the apoptotic index between the experimental and the contralateral testis or the sham operated group.
Near infrared spectroscopy is as effective but quicker than Doppler ultrasound for detecting testicular torsion without a radiologist. Near infrared spectroscopy accurately reveals oxygen saturation, which is more vital than blood flow, on which Doppler ultrasound focuses.
Full-text · Article · Dec 2011 · The Journal of urology
[Show abstract][Hide abstract] ABSTRACT: This study was designed to determine the level of survivin expression and its clinical significance as a prognostic factor in gastrointestinal stromal sarcoma (GIST). Twenty patients (12 males and 8 females) ranging in age from 25 to 72, with a median age of 53 were evaluated. Failure of TKI treatment was higher in the survivin-positive group (p=0.06). The rate of metastasis was significantly higher in the survivin positive group vs. the negative group (80% vs. 30%, p=0.18). The median overall survival (OS) time was 114 (range 29-199)months, and the median disease-free survival (DFS) time was 88 (range 40-135) months. The median progression-free survival (PFS) time was 40 (range 24-55) months. Further, a comparison of patients with survivin positive versus negative tumors, revealed no significant difference for OS, DFS, and PFS (p=0.45, p=0.19, p=0.55, respectively), number of mitoses in 50 HPF (p=0.14), and tumor size (p=0.94). In conclusion, survivin was highly expressed in GISTs, although we found no correlation between survivin expression and PFS, DFS and OS, survivin may be a predictive marker in GISTs for disease progression. We believe that additional studies are warranted to determine the clinical significance of survivin expression as a prognostic or predictive marker in patients with GIST.
Full-text · Article · Dec 2011 · International immunopharmacology
[Show abstract][Hide abstract] ABSTRACT: Tyrosinemia type I (OMIM 276700) is a rare, autosomal recessive disorder caused by a deficiency in the fumarylacetoacetate hydrolase (FAH) enzyme. This study examined the spectrum of FAH gene mutation in 32 patients with tyrosinemia type I. In addition, clinical and biochemical findings were evaluated to establish a genotype–phenotype relationship in the patients. Mutation screening was performed using a 50K custom-designed resequencing microarray chip (TR_06_01r520489, Affymetrix) and sequencing analysis. Of the 12 different mutations found, 6 are categorized as novel. Three of the mutations-IVS6-1G>A, D233V, and IVS3-3C>G-are the most common in Turkish patients, comprising 25%, 17.1%, and 12.5% of mutant alleles, respectively.
Clinical evaluations suggest that the spectrum of symptoms observed in the patients with very early and early disease were of the more nonspecific form, whereas the patients with late-presenting disease had more of the distinctive form over the course of the disease. This study adds support to the notion that the D233V mutation is specific to the Turkish population.
[Show abstract][Hide abstract] ABSTRACT: Backgroud and aims: To analyse infantile (birth characteristics, feeding type) and environmental (maternal smoking, nutrition and psychological status, mother-child bonding, family structure, support to mother, familial atopy) risk factors for infantile colic and to follow up infants with respect to physical growth, sleeping status up to 8 months of age in a nested case-control study.Methods: 660 mothers who delivered at Dr. Zekai Tahir Burak Maternity Hospital, were enrolled within postpartum 3-72 hours. Infants with insolablepersistant crying and subsequent four infants with no crying episodes were invited to Hacettepe University Ihsan Dogramaci Children's Hospital at postpartum 30-45 days by phone. At postpartum 40-55 days, infants were examined; 47 infants were diagnosed as colic cases and 142 as noncolic. When the infants were 7-8 month old, another interview was done.Results: Colic group had higher percentages of less educated (≤8 years) and smoking mothers, extended family, families with domestic violence than noncolic group. Colic group had significantly higher rates of “impaired bonding” in Postpartum Bonding Questionaire, higher scores of Edinburg Postpartum Depression Scale, higher scores for hostility subscales of Brief Symptom Inventory and more irregular sleep pattern than noncolic group. At 7-8 months, colic group was shorter than noncolic group.Conclusion: Colic was associated with some perinatal factors (maternal education, smoking habits, cheese consumption, hostility scores and domestic violence) and having infantile colic had negatively affected sleeping pattern and height of infant.