Browsing by Author "Yüceyar, H"
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Item Histological and clinical predictive value of determination of tissue CagA status by PCR in Helicobacter pylori infected patients;: Results of the large population based study in western TurkeySaruç, M; Demir, MA; Küçükmetin, N; Kandiloglu, AR; Akarca, US; Yüceyar, HBackground/Aims: Early experimental and epidemiological studies have suggested that the presence of cagA gene was a virulence factor for Helicobacter pylori. We aimed to investigate the clinical significance of tissue CagA status in Helicobacter pylori infected patients and to assess its association with histological changes in gastric mucosa. Methodology: Three hundred and forty-five patients with Helicobacter pylori infection established by both urease test and histological examination were included in the study. The symptoms of the patients were recorded according to the Glasgow dyspepsia scale. Biopsies (cardia, corpus, angulus and antrum) were evaluated histologically according to the Sidney system. The cagA status was determined by polymerase chain reaction method from an antral biopsy. Polymerase chain reaction studies were performed by Wizard genomic DNA purification system (promega). We also determined the serum levels of tumor necrosis factor-alpha, and gastrin. They were all prescribed lansoprazole (30mg b.i.d.), clarithromycin (500mg b.i.d.), and amoxycillin (1g b.i.d.) for a week. At the 8th week a second endoscopy was performed and further biopsy specimens were obtained from the same sites. Mann-Whitney U and chi(2) tests were used for statistical analyses. Results: Two hundred and thirty-five patients (68.1%) were infected with cagA-positive strains of Helicobacter pylori and the other 110 patients (31.8%) were infected with cagA-negative strains. We compared the parameters and measurements studied in this trial between the patients infected with cagA-positive and negative Helicobacter pylori strains. Helicobacter pylori density was greater in the cagA-positive group by 1.9 0.9 than in the cagA-negative group by 1.2 +/- 0.7 (P=0.01). Helicobacterpylori activity and chronic inflammation also were significantly higher in the cagA-positive group with the values of 1.4 +/- 0.8 and 2.1 +/- 1.1 than in the cagA-negative group with 0.7 +/- 0.2 and 1.3 +/- 0.5, respectively (P=0.001, P=0.002). The presence of atrophy and lymphoid aggregate was not different between the two groups (P>0.05). However intestinal metaplasia was shown to be significantly frequent in patients infected with cagA-positive Helicobacter pylori strains (0.001). Serum tumor necrosis factor-a and gastrin levels which were accepted as the markers of inflammation in Helicobacter pylori infection were increased in the cagA-positive group compared with the cagA-negative group. Serum tumor necrosis factor-alpha level was 11.3 +/- 7.0pg/mL in the cagA-positive group and 4.9+/-2.7pg/mL in the cagA-negative group (P=0.001). Gastrin level also showed a significant difference between two groups by 66.8+/-31.1pg/mL and 37.2+/-19.2pg/mL, respectively, in the cagA-positive and negative groups (P=0.001). The virulent strains seem to cause peptic ulcer more frequently. Peptic ulcer was determined in 17% of patients in the cagA-positive group but this ratio was 9% in the cagA-negative group (P=0.608). Although, all these differences of the degree of inflammation, clinical spectrum and biochemical parameters were seen, interestingly there was no significant difference in the severity of the symptoms of the patients in both groups according to Glasgow dyspepsia severity score (P=0.20). Conclusions: Our results confirm that cagA-positive strains of Helicobacter pylori cause greater histological changes. However this virulence is not associated with more severe symptoms. The histological changes can be predictable by determining the tissue cagA status.Item Correlation Among Standard Endoscopy, Narrow Band Imaging, and Histopathological Findings in the Diagnosis of Nonerosive Reflux DiseaseKasap, E; Zeybel, M; Asik, G; Ayhan, S; Yüceyar, HBackground and Aims: Gastroesophageal reflux disease (GERD) is caused by the reflux of gastric contents into the esophagus. Narrow band imaging (NBI) facilitates mucosal surface evaluation and may improve the endoscopic diagnosis of GERD. The diagnosis of GERD is based on the combination of clinical symptoms, endoscopic findings, and histological changes. In this study we aimed to show the differences between standard white light endoscopy and the NBI technique in squamo-columnar junction evaluation. We also evaluated the patients with NERD, as determined by standard white light endoscopy, using the NBI technique and histopathological mucosa examination (inflammation or normal mucosa). Methods: A total of 60 subjects were recruited prospectively: 40 with nonerosive reflux disease (NERD) and 20 with erosive reflux disease (ERD). Patients were subjected to esophagogastroduodenoscopy and, in all of them, two biopsies were taken 2 cm above the esophagogastric junction. Results: NBI was more sensitive than standard white light endoscopy in distinguishing normal endoscopic findings. Histopathological findings were more prevalent than the mucosal changes diagnosed by the standard white light endoscopy and NBI. Conclusion: NBI is more sensitive than white light endoscopy in detecting inflammation in NERD patients. However, histopathological evaluation is the most sensitive, therefore taking a biopsy will remain useful.Item Treatment of inflammatory bowel disease by leukocytapheresisGerçeker, E; Yüceyar, H; Kasap, E; Demirci, U; Ekti, BC; Aydogdu, I; Miskioglu, MStudies about leukocytapheresis have emerged with the need of search for alternatives to conventional treatment in inflammatory bowel diseases (IBD). Leukocytapheresis is a novel non-pharmacologic approach for active ulcerative colitis (UC) and Crohn's disease (CD), in which leukocytes are mechanically removed from the circulatory system. Patients with active IBD treated with leukocytapheresis using a Cellsorba E column between 2012 and 2015, were enrolled in Turkey. In our experience, the results of leukocytapheresis therapy in 6 patients with CD and 20 patients with active UC were overviewed. Leukocytapheresis (10 sessions for remission induction therapy, 6 sessions for maintenance therapy) was applied to the patients with their concomitant medications. Intensive leukocytapheresis (>= 4 leukocytapheresis sessions within the first 2 weeks) was used in 30% patients with active severe UC. The overall clinical remission rate in patients with UC was 80%, and the mucosal healing rate was 65%. Patients were followed for an average of 24 months. It was observed that clinical remission has continued in 65% of patients with UC. Mild relapse was observed in 3 patients with UC during follow up period. In 5 patients with CD significant clinical remission was achieved except only one patient. Surgical needs were disappeared in 3 patients with obstructive type Crohn's disease, Adverse events were seen in only 4.3% of 416 sessions. Any concomitant medications did not increase the incidence of adverse events. Our results indicate that leukocytapheresis is efficacious in improving remission rates with excellent tolerability and safety in patients with IBD. (C) 2017 Elsevier Ltd. All rights reserved.Item Schizophrenia and gastroesophageal reflux symptomsKasap, E; Ayer, A; Bozoglan, H; Ozen, C; Eslek, I; Yüceyar, HBackground: Psychological factors and psychiatric disorders play a role in a variety of gastrointestinal illnesses, including esophageal diseases. Aim: The aim of the present study was to evaluate the frequency of gastroesophageal reflux disease symptoms in patients with schizophrenia in Turkey. Patients and Methods: Ninety-eight patients with schizophrenia and one hundred control individuals were enrolled in the study, which was undertaken at the Manisa State Hospital for Mental Health and Neurological Disorders and Celal Bayar University Gastroenterology Department. Case and control subjects alike underwent 30-45 min oral interviews conducted by a designated study coordinator (E.K.). The coordinator gathered information about demographic characteristics, social habits, and a large variety of symptoms suggestive of reflux disease or other gastrointestinal conditions. Results: In terms of reflux symptoms, cough was the only significant association in schizophrenic patients than controls. Heartburn and regurgitation were more frequent in schizophrenic patients who smoked than in controls who were smokers. However, the prevalence of reflux symptoms in cigarette smokers versus nonsmoker patients with schizophrenia was similar. Heartburn and/or regurgitation occurred more frequently in patients with schizophrenic than controls with alcohol use. Conclusions: Psychiatric disorders might indirectly affect esophageal physiology through increased consumption of alcohol and nicotine.Item Lung involvement in inflammatory bowel diseasesSarioglu, N; Türkel, N; Sakar, A; Çelik, P; Saruç, M; Demir, MA; Göktan, C; Kirmaz, C; Yüceyar, H; Yorgancioglu, AItem Does Helicobacter pylori eradication improve the symptoms of globus hystericus?Kasap, E; Ayhan, S; Yüceyar, HBackground/aims: Globus hystericus is a feeling of a tension in the throat, irrelevant of swallowing, persisting for at least 12 weeks. Since the cause of glob us hystericus is not fully described, a controversy exists about the treatment options. We aimed in this study to determine the symptoms of gastroesophageal reflux disease, the upper gastrointestinal endoscopic findings, prevalence of Helicobacter pylori, and the post-treatment symptoms (symptoms of gastroesophageal reflux disease and/or Helicobacter pylori) in patients with a diagnosis of globus hystericus. Materials and Methods: In this study, we retrostectively evaluated the medical records of 123 patients who, after the initial diagnosis of globus sensation (globus hystericus), underwent endoscopic examination in the Department of Gastroenterology and Endoscopy at Celal Bayar University Medical School, and thereafter, were given Helicobacter pylori eradication therapy and were followed in the Gastroenterology outpatient clinic, between January 2009 and August 2010. Results: Helicobacter pylori was positive in seventy-five (60%) of the 123 patients. Heartburn, regurgitation, and inlet patch in the upper esophagus were significantly more frequent in Helicobacter pylori (+) patients than in Helicobacter pylori () patients with globus hystericus. Normal endoscopy findings were significantly more common in Helicobacter pylori (-) patients than in Helicobacter pylori (+) patients with globus hystericus. Of patients with eradicated Helicobacter pylori, 27 (50%) reported that globus symptoms had disappeared, while 12 (17.3%) of them had not observed any regression of the symptoms. Improvement of symptoms had a positive correlation with Helicobacter pylori eradication (p=0,001). Conclusions: Helicobacter pylori prevalence among cases with globus sensation is similar to that in the general population. However, Helicobacter pylori eradication was found to decrease the symptoms of globus.Item Does Helicobacter pylori treatment improve the symptoms of globus hystericus?Kasap, E; Ayhan, S; Yüceyar, HBackground/aims: Globus hystericus is a feeling of tension in the throat, irrelevant of swallowing, persisting for at least 12 weeks. Since the cause of glob us hystericus is not fully described, the treatment is controversial. We aimed in this study to determine the symptoms of gastroesophageal reflux disease, upper gastrointestinal endoscopic findings, prevalence of Helicobacter pylori, and post-treatment symptoms (symptoms of gastroesophageal reflux and/or Helicobacter pylori) in patients with a diagnosis of globus hystericus. Materials and Methods: One hundred twenty three patients were recruited from the archives of the Department of Gastroenterology and Endoscopy at Celal Bayar University Medical School between January 2009 and August 2010. Results: Helicobacter pylori was positive in 75 (60%) of 123 patients with globus hystericus. Helicobacter pylori (+) patients had significantly more heartburn, regurgitation, and inlet patch in upper esophagus than Helicobacter pylori (-) patients. Significantly more Helicobacter pylori (-) patients had normal endoscopy findings when compared to Helicobacter pylori (+) patients. While 27 (50%) of Helicobacter pylori-eradicated patients had regressing globus symptoms, 12 (17.3%) of them did not have any regression in globus symptoms. Improvement in symptoms showed a positive correlation with Helicobacter pylori eradication (p=0.001). Conclusions: Helicobacter pylori rate among cases with glob us sensation was similar to values in the general population. Helicobacter pylori eradication was found to decrease glob us symptoms.Item Reliability and validity of Turkish form of SCOFF Eating Disorders ScaleAydemir, Ö; Köksal, B; Yalin Sapmaz, S; Yüceyar, HObjective: There is no useful scale both in daily routine psychiatry practice and field trials in Turkish. The aim of the study is to perform the reliability and validity study of SCOFF Eating Disorders Scale. Methods: The study sample is consisted of female students of Grade 5 of Celal Bayar University, School of Medicine. For the study, 62 volunteers were invited and 50 individuals who fulfilled all the study instruments constituted the study sample. All the study volunteers were female and the mean age was found to be 22.31 +/- 1.68. For concurrent validity, Eating Attitude Test was applied. Results: The forward and back translation of the SCOFF Eating Disoders Scale was performed, and linguistic equivalence was obtained with the scale prepared. In internal consistency, the Cronbach's alpha coefficient was found to be 0.74 and item-total correlation coefficients were between 0.21-0.55. In the exploratory factor analysis, one dimension was observed and all the items were represented. The confirmatory factor analysis confirmed the one-dimension structure. In the correlation analysis with Eating Attitude Test, the coefficient was found to be r=0.52. Conclusion: It is suggested that the Turkish form of SCOFF Eating Disorders Scale can be used reliably and validly in order to screen eating disorders.Item The association of dehydroepiandrosterone, obesity, waist-hip ratio and insulin resistance with fatty liver in postmenopausal women -: A hyperinsulinemic euglycemic insulin clamp studySaruç, M; Yüceyar, H; Ayhan, S; Türkel, N; Tuzcuoglu, I; Can, MBackground/Aims: The relationship between insulin resistance and the occurrence of fatty acid has been documented. Recently DHEA (dehydroepiandrosterone) was shown to have a protective effect against development of fatty liver in rats. We aimed to investigate the association of nonalcoholic fatty liver and serum levels of DHEA, obesity, fat distribution and insulin resistance and to evaluate the effect of DHEA on fatty liver, obesity and insulin resistance. Methodology: Thirteen postmenopausal women with nonalcoholic fatty liver and 14 postmenopausal women with normal liver histology were included into the study. Body mass index, waist-hip ratio, serum DHEA, DHEAS, triglyceride, cholesterol levels and insulin resistance were determined. Fatty liver was determined by ultrasound and established by Ever biopsy and histology. Hyperinsulinemic euglycemic clamp studies were performed. Results: The subjects in both groups were age matched (P > 0.05). Body mass index showed obesity in patients with fatty liver but not in control group (p = 0.01). Central obesity was present in women with fatty liver (p = 0.039). As expected, insulin resistance was significantly present in patients with fatty liver (p = 0.001). DHEA and DHEAS levels of women with fatty liver were greater than those of control group (p(1) = 0.001 and p(2) = 0.0001, respectively). DHEA and DHEAS were positively correlated with both body mass index and waist-hip ratio. However, glucose disposal rate was inversely and significantly correlated with DHEA and DHEAS levels. Conclusions: These data do not support the hypothesis that DHEA or DHEAS protect postmenopausal women against fatty liver, diabetes and obesity. Indeed, DHEA and DHEAS may be the cause of fatty liver, obesity (especially abdominal obesity) and diabetes in estrogen-deficient women.Item Overexpressions of RHOA, CSNK1A1, DVL2, FZD8, and LRP5 genes enhance gastric cancer development in the presence of Helicobacter pyloriDemirci, U; Orenay-Boyacioglu, S; Kasap, E; Gerçeker, E; Bilgiç, F; Yüceyar, H; Yildirim, H; Baykan, AR; Ellidokuz, EB; Korkmaz, MBackground and study aims: Intestinal metaplasia (IM), and Helicobacter pylori (HP) infection can be shown as risk factors in the development of gastric cancer (GC). WNT signaling pathway plays a critical role in carcinogenesis. However, the literature studies are limited on the significance of this pathway for the transition from IM to GC. Patients and methods: We aimed to investigate the importance of the genes of WNT signaling pathways diagnostic and prognostic markers in the presence and absence of HP in conversion from IM to GC. 104 patients, (GC group n = 35, IM group n = 45, control group n = 25) were included in this case-control study. Expression of genes in WNT signalling were searched in study groups with qRT-PCR array and qRT-PCR method. Data were analysed using PCR array data analysis software. Results: Statistically significant overexpression of RHOA, CSNK1A1, DVL2, FZD8 and LRP5 genes was detected in the GC and IM groups compared to the control group (p < 0.05). Statistically significant overexpression of RHOA, CSNK1A1, DVL2, FZD8 and LRP5 genes was observed in patients with metastatic GC compared to patients with GC without metastasis (p < 0.05). It was found that the RHOA, CSNK1A1, DVL2, FZD8 and LRP5 genes were statistically significantly over-expressed in diffuse GC patients compared to non-diffuse GC patients (p < 0.05). Statistically significant overexpression of RHOA, CSNK1A1, DVL2, FZD8 and LRP5 genes was detected in HP positive IM patients compared to HP negative IM patients (p < 0.05). Conclusion: Overexpression of RHOA, CSNK1A1, DVL2, FZD8 and LRP5 genes in IM may suggest that these genes are important markers in the development of IM and inflammation with HP. In addition, these genes are linked to tumor burden in the GC group. Consequently, we can conclude that these genes are poor prognosis biomarkers for GC and have the potential to be used as markers for future treatment monitoring.Item Potential role of chromatin remodeling factor genes in atrophic gastritis/gastric cancer riskBilgiç, F; Gerçeker, E; Boyacioglu, SÖ; Kasap, E; Demirci, U; Yildinm, H; Baykan, AR; Yüceyar, HBackground/Aims: Atrophic gastritis (AG), intestinal metaplasia (IM), and Helicobacter pylori (HP) are the risk factors for the development of gastric cancer (GC). Chromatin remodeling is one of the epigenetic mechanisms involved in the carcinogenesis of GC. The purpose of this study was to investigate the expression profiles of defined chromatin remodeling genes in gastric mucosal samples and their values as gastric carcinogenesis biomarkers. Materials and Methods: In total, 95 patients were included in the study. Patients were divided into 3 groups as: GC group (n=34), AG group (n=36), and control group (n=25). AG group was further divided into subgroups based on the presence of HP and IM in gastric mucosa. Chromatin remodeling gene expressions were analyzed using real-time PCR (RT-PCR) array in all groups. Data were evaluated using the RT-gPCR primer assay data analysis software. Results: EED, CBX3, and MTA1 were more overexpressed, whereas ARID1A ING5, and CBX7 were more underexpressed in the AG and GC groups compared with the controls. No significant differences were observed between the AG and GC groups concerning the expression of these 6 genes, although the fold change levels of these genes in the GC group were well above than in the AG group. EEO, CBX3, and MTA1 were significantly more overexpressed in HP- and IM-positive AG subgroup compared with the HP- or IM-negative AG subgroup. Conclusion: In conclusion, our results provide an evidence of epigenetic alterations in AG. Expressions of EED, CBX3, MTA1, ARID1A, ING5, and CBX7 may be considered as promising markers to be used in GC screening for patients with AG.Item The association between insulin resistance and hepatic fibrosis in patients with chronic hepatitis C: An observational, multicenter study in TurkeyDökmeci, A; Üstündag, Y; Hulagu, S; Tuncer, I; Akdogan, M; Demirsoy, H; Köklü, S; Güzelbulut, F; Dogan, I; Demir, A; Akarsu, M; Yüceyar, H; Özdogan, OC; Özdener, F; Erdogan, SBackground/Aims: To evaluate the association between insulin resistance and hepatic fibrosis in patients with chronic hepatitis C. Materials and Methods: A total of 104 chronic hepatitis C patients were included in this non-interventional, open-label, observational, multicenter, cross-sectional study conducted at 20 gastroenterology clinics in Turkey. The primary end point was the correlation between stage of hepatic fibrosis and insulin resistance evaluated via the homeostasis model of assessment-insulin resistance index. Confounders of hepatic fibrosis and insulin resistance were the secondary end points. Results: The mean age of patients was 52.8 years; 65.4% were female. Type 2 diabetes was present in 6.8% and insulin resistance noted in 38.0% of patients. Further, 45.7% of the patients had mild (A0/A1) and the remaining had moderate/severe (A2/A3) hepatic necroinflammatory activity. Patient distribution according to Metavir fibrosis stage was as follows: F0/F1 (57.0%); F2 (6.5%); F3 (23.7%); and F4 (12.9%). A univariate analysis revealed significant positive correlations between Metavir fibrosis stage and insulin resistance (r=0.297; p=0.007). Logistic regression analysis showed that significant predictors of insulin resistance were high alanine transaminase levels (odds ratio, 0.97; 95% confidence interval, 0.944-0.997) and liver fibrosis stage (odds ratio, 0.114; 95% confidence interval, 0.021-0.607). Conclusion: Our findings revealed significant associations between insulin resistance and hepatic fibrosis.