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Öğe Benign fibroblastic polyp of the colon: A case report(Turkish Soc Gastroenterology, 2009) Doganavsargil, Basak; Serin, Gurdeniz; Akyildiz, Murat; Ertan, Yesim; Tuncyurek, MugeThere are a fair number of polyps in the gastrointestinal tract, which cannot be classified under a certain category. We report herein a 50-year-old man with a 6-mm sigmoidal polyp; he had been operated previously for rectal carcinoma. The polyp was characterized by benign-appearing spindle cells in the lamina propria leading to a wide separation and disorganization of the colonic crypts, accompanied by focal erosion and restricted areas suspicious for inflammatory fibroid polyp. The histologic features were found consistent with the disease spectrum of "benign fibroblastic polyp of the colon" defined by Eslanzi-Varzaneh et al. The case is presented with a review of the literature and differential diagnostic considerations.Öğe Benign fibroblastic polyp of the colon: A case report(Turkish Soc Gastroenterology, 2009) Doganavsargil, Basak; Serin, Gurdeniz; Akyildiz, Murat; Ertan, Yesim; Tuncyurek, MugeThere are a fair number of polyps in the gastrointestinal tract, which cannot be classified under a certain category. We report herein a 50-year-old man with a 6-mm sigmoidal polyp; he had been operated previously for rectal carcinoma. The polyp was characterized by benign-appearing spindle cells in the lamina propria leading to a wide separation and disorganization of the colonic crypts, accompanied by focal erosion and restricted areas suspicious for inflammatory fibroid polyp. The histologic features were found consistent with the disease spectrum of "benign fibroblastic polyp of the colon" defined by Eslanzi-Varzaneh et al. The case is presented with a review of the literature and differential diagnostic considerations.Öğe Celiac disease associated with B-cell lymphoma(Aves, 2010) Oruc, Nevin; Ozutemiz, Omer; Tekin, Fatih; Sezak, Murat; Tuncyurek, Muge; Krasinskas, Alyssa M.; Tombuloglu, MuratCeliac disease is a gluten-induced enteropathy controlled by gluten restriction. Celiac disease is occasionally associated with T-cell lymphoma. We report a case with celiac disease who presented with duodenal ulcer-like symptoms and endoscopic findings. The persistent symptoms despite a strict diet led to the suspicion of an associated malignancy. Intensive evaluation revealed a case with celiac disease associated with B-cell lymphoma. Although B-cell lymphoma is rare, it should be kept in mind especially in female patients with persistent symptoms and refractory celiac disease.Öğe Comparison of 1-and 2-week pantoprazole-based triple therapies in clarithromycin-sensitive and resistant cases(Elsevier Science Bv, 2007) Aydin, Ahmet; Onder, Goktug; Akarca, Ulus; Tekin, Fatih; Tuncyurek, Muge; Ilter, TankutBackground: The objectives of this prospective study were: (i) to compare the efficacy of 1-week with 2-week pantoprazole-based triple therapy and (ii) to evaluate the impact of clarithromycin resistance on Helicobacter pylori (H. pylori) eradication rates. Methods: Eighty dyspeptic patients were randomly allocated to two groups. The first group (PAC-1, n = 40) received pantoprazole 40 mg, amoxicillin 1000 mg, and clarithromycin 500 mg twice a day for one week, and the second group (PAC-2, n = 40) received the same regimen for two weeks. Endoscopy was repeated one month after the end of the treatment. Results: DNA extraction for clarithromycin resistance could not be performed in seven cases. Five cases were lost to follow-up. Clarithromycin resistance was found to be 44.1% (15/34) in the PAC-1 group and 58.8% (20/34) in the PAC-2 group (p > 0.05). Eradication was achieved in 16 (PP: 47.1%, ITT: 44.4%) and 25 (PP:73.5%, ITT: 67.6%) patients in the PAC-1 and PAC-2 groups, respectively (p > 0.05). H. pylori was eradicated in 4 of 15 (PP: 26.7%, ITT: 26.7%) clarithromycin-resistant patients in the PAC-1 group and in 12 of 20 (PP: 60%, ITT: 60%) clarithromycin-resistant patients in the PAC-2 group (p > 0.05). Among the clarithromycin-sensitive ones, eradication was achieved in 12 of 19 (PP: 63.2%, ITT: 57.1%) patients in the PAC-1 group and in 13 of 14 (PP: 92.8%, ITT: 76.5%) patients in the PAC-2 group (p > 0.05). Conclusion: Although the 2-week regimen of pantoprazole-based triple therapy was effective for H. pylori eradication in clarithromycin-sensitive cases, highly effective H pylori eradication protocols are needed for clarithromycin-resistant ones. (C) 2007 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.Öğe Ectopic fascioliasis mimicking a colon tumor(Baishideng Publishing Group Inc, 2007) Makay, Ozer; Gurcu, Baris; Caliskan, Cemil; Nart, Deniz; Tuncyurek, Muge; Korkut, MustafaFasciola hepatica, a leaf shaped trematode that is common in cattle, sheep and goats, is acquired by eating raw water plants like watercress or drinking water infected with the encysted form of the parasite. The varied clinical presentations of fascioliasis still make a high index of suspicion mandatory. Besides having a wide spectrum of hepatobiliary symptoms like obstructive jaundice, cholangitis and liver cirrhosis, the parasitic infection also has extrabiliary manifestations. Until recently, extrahepatic fascioliasis has been reported in the subcutaneous tissue, brain, lungs, epididymis, inguinal lymph nodes, stomach and the cecum. In this report, a strange manifestation of the fasciola infection in a site other than the liver, a colonic fascioliasis, is presented. (C) 2007 The WJG Press. All rights reserved.Öğe The efficacy of ranitidine bismuth citrate, amoxicillin and doxycycline or tetracycline regimens as a first line treatment for Helicobacter pylori eradication(Elsevier Science Bv, 2009) Akyildiz, Murat; Akay, Sinan; Musoglu, Ahmet; Tuncyurek, Muge; Aydin, AhmetBackground: The eradication rates of Helicobacter pylori (H. pylori) clearly decreased with standard PPI-based triple therapies. Aim: To assess the efficacy of two different triple therapies consisting of ranitidine bismuth citrate-amoxicillin-doxycycline and ranitidine bismuth citrate-amoxicillin-tetracycline combinations as a first line treatment option. Methods: One hundred and fifteen consecutive dyspeptic patients in whom H. pylori infection was diagnosed for the first time were enrolled in this study. The patients were randomized into two groups. Group I (n=57) was assigned to receive a 14-day triple therapy consisting of ranitidine bismuth citrate 400 mg (b.i.d), amoxicillin I g (b.i.d) and doxycycline 100 mg (b.i.d). Group 2 (n=58) was assigned to receive a 14-day triple therapy consisting of ranitidine bismuth citrate 400 mg (b.i.d), amoxicillin I g (b.i.d) and tetracycline 500 mg (q.i.d). Results: The eradication was achieved in 45.7% (21/46) and 40.8% (20/49) of the patients in group I and group 2, according to per protocol analysis. The intention-to-treat eradication rates were 36.8% (21/57) and 34.5% (20/58) in group I and group 2, respectively. Conclusions: Two-week therapy with neither ranitidine bismuth citrate-amoxicillin-doxycycline nor ranitidine bismuth citrate-amoxicillin-tetracycline is adequately effective for H. pylori eradication as a first line therapy, (C) 2008 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.Öğe Flow cytometric DNA analysis of gastrointestinal stromal tumors(Springer, 2007) Cobanoglu, Umit; Tekelioglu, Yavuz; Ozoran, Yavuz; Ensari, Arzu; Dursun, Ayse; Doran, Figen; Gedikoglu, Gokhan; Dogusoy, Gulen; Pak, Isin; Tuncyurek, Muge; Sagol, Ozgul; Kapran, YersuÖğe I-131 uptake in malignant fibrous histiocytoma(Lippincott Williams & Wilkins, 2007) Acar, Ebru; Akgun, Aysegul; Kocacelebi, Kenan; Kumanlioglu, Kamil; Tuncyurek, MugeÖğe Intestinal Behcet's disease: A case report(Springer, 2007) Doganavsargil, Basak; Keser, Gokhan; Kandiloglu, Gulsen; Caliskan, Cemil; Tuncyurek, Muge; Doganavsargil, EkerÖğe Is it possible to diagnose infectious oesophagitis without seeing the causative organism? A histopathological study(Aves, 2014) Demir, Derya; Doganavsargil, Basak; Sarsik, Banu; Sezak, Murat; Tuncyurek, MugeBackground/Aims: We investigated the utility of using histological changes to diagnose infectious oesophagitis when causative organisms cannot be seen. Materials and Methods: Sixty-seven endoscopic biopsy specimens (51 Candida, 9 herpes simplex virus, 4 tuberculosis, and 3 cytomegalovirus oesophagitis) collected from 2000-2010 that matched the investigative criteria were included in the study. Cases were re-evaluated for histological changes observed in oesophagitis, and the findings were statistically compared using nonparametric tests. Results: Thirty-nine cases occurred in male patients, and 28 occurred in female patients; the mean age of the patients was 51 +/- 20.1 years (range, 5-94 years). All cases showed lymphocytic and neutrophilic infiltration; while 27 (40.3%) showed eosinophilic infiltration. The density of lymphocytes and eosinophils were 8.43 +/- 6 and 1.07 +/- 1.62 per high power field, respectively, and these rates were higher in tuberculosis oesophagitis cases. Lamina propria infiltration was present in herpes simplex virus and Candida oesophagitis. Dense neutrophilic infiltration (>50/high power field) was noted in herpes simplex virus oesophagitis. Candida colonization was observed in 82% of cases with eosinophilic infiltration, and 80% of cases with erosion. Ulceration was present in all tuberculosis oesophagitis cases (p<0.001). Basal cell hyperplasia, papillary elongation, and dilated intercellular spaces were seen in all cases except for 2 Candida oesophagitis cases. Lamina propria fibrosis was especially noted in cytomegalovirus oesophagitis cases. Conclusion: It is not possible to distinguish infectious oesophagitis from other subtypes, especially reflux oesophagitis, if the causative organism is not detected. Clinicopathological correlation and control with repeat targeted biopsies are essential for diagnosis.Öğe The Modified Sequential Treatment Regimen Containing Levofloxacin for Helicobacter pylori Eradication in Turkey(Wiley, 2009) Aydin, Ahmet; Oruc, Nevin; Turan, Ilker; Ozutemiz, Omer; Tuncyurek, Muge; Musoglu, AhmetBackground: Eradication rates of Helicobacter pylori have declined to unacceptable levels in recent years. New and effective treatment options are warranted both as a first and second line treatment. Aim: To test an effectiveness of modified sequential therapy with levofloxacin for H. pylori eradication in Turkey. Material and Methods: Helicobacter pylori infected dyspeptic patients were included to the study. Subjects were treated with modified sequential therapy consisting of rabeprazole 20 mg b.i.d. and amoxicillin 1 g b.i.d., for 7 days followed by rabeprazole 20 mg b.i.d, levofloxacin 500 mg q.d. and metronidazole 500 mg b.i.d for the remaining 7 days. Results: Sixty-three treatment naive patients and 37 previous treatment failures were enrolled to the study (59 F, 41 M, age: 21-80 years). There was five drop out. Helicobacter pylori eradication was achieved in 80 patients, intention-to-treat (ITT): 80% (95% CI: 71-87%) and per-protocol (PP): 84.2% (95% CI: 75-91%), totally. In treatment naive patients ITT and PP eradication rates were 82.5% (95% CI: 71-91%), and 86.7% (95% CI: 75-94%), respectively. As a second line treatment eradication was successful in ITT 75.7%.(95% CI: 59-88%), and PP 80% (95% CI: 63-92%). Mild side effects were reported by 8 patients (8.4%). Conclusions: Sequential therapy using "rabeprazole and amoxicillin 7 days followed by rabeprazole, metronidazole and levofloxacin for 7 days" is a new regimen with acceptable eradication rates in naive patients in Turkey. Further modifications in the dose or duration of this new sequential therapy might increase its effectiveness as both first and second line treatment.Öğe The Modified Sequential Treatment Regimen Containing Levofloxacin for Helicobacter pylori Eradication in Turkey(Wiley, 2009) Aydin, Ahmet; Oruc, Nevin; Turan, Ilker; Ozutemiz, Omer; Tuncyurek, Muge; Musoglu, AhmetBackground: Eradication rates of Helicobacter pylori have declined to unacceptable levels in recent years. New and effective treatment options are warranted both as a first and second line treatment. Aim: To test an effectiveness of modified sequential therapy with levofloxacin for H. pylori eradication in Turkey. Material and Methods: Helicobacter pylori infected dyspeptic patients were included to the study. Subjects were treated with modified sequential therapy consisting of rabeprazole 20 mg b.i.d. and amoxicillin 1 g b.i.d., for 7 days followed by rabeprazole 20 mg b.i.d, levofloxacin 500 mg q.d. and metronidazole 500 mg b.i.d for the remaining 7 days. Results: Sixty-three treatment naive patients and 37 previous treatment failures were enrolled to the study (59 F, 41 M, age: 21-80 years). There was five drop out. Helicobacter pylori eradication was achieved in 80 patients, intention-to-treat (ITT): 80% (95% CI: 71-87%) and per-protocol (PP): 84.2% (95% CI: 75-91%), totally. In treatment naive patients ITT and PP eradication rates were 82.5% (95% CI: 71-91%), and 86.7% (95% CI: 75-94%), respectively. As a second line treatment eradication was successful in ITT 75.7%.(95% CI: 59-88%), and PP 80% (95% CI: 63-92%). Mild side effects were reported by 8 patients (8.4%). Conclusions: Sequential therapy using "rabeprazole and amoxicillin 7 days followed by rabeprazole, metronidazole and levofloxacin for 7 days" is a new regimen with acceptable eradication rates in naive patients in Turkey. Further modifications in the dose or duration of this new sequential therapy might increase its effectiveness as both first and second line treatment.Öğe The ongoing debate in thyroid surgery: Should frozen section analysis be omitted?(Japan Endocrine Soc, 2007) Makay, Ozer; Icoz, Gokhan; Gurcu, Baris; Ertan, Yesim; Tuncyurek, Muge; Akyildiz, Mahir; Yetkin, EnisControversies concerning the role of frozen section (FS) have been a matter of debate. The aim of this study was to identify the role of FS analysis in intraoperative decision making and analyze the effect of the cost in detecting thyroid malignancies in Turkey. Out of 214 consecutive patients who had been operated on for thyroid cancer between January 1996 and August 2004, 178 patients were evaluated retrospectively. All 178 patients were subjected to FS. Intraoperative FS correctly identified the pathology as malignant in 58.4% of patients. A true-positive FS result changed the surgical strategy in 30 (27.6%) cases False negative FS lesions were defined histologically as papillary microcarcinoma in 54%, follicular variant of papillary cancer in 18% and follicular cancer in 8% of cases. The sensitivities of FNAB and intraoperative FS in thyroid cancer patients were 22.5% and 58.4%, respectively. False negative FS results increased the cost for each informative FS from (sic)25 to (sic)42.7. Despite limitations, results of this Study reject the idea that the role of FS is becoming limited. We recommend routine frozen section in the operative assessment of thyroid nodules. Omitting FS may be suggested only in cases with a FNAB revealing malignancy.Öğe p21 and p27 immunoexpression in gastric well differentiated endocrine tumors (ECL-cell carcinoids)(W J G Press, 2006) Doganavsargil, Basak; Sarsik, Banu; Kirdok, Fatma Secil; Musoglu, Ahmet; Tuncyurek, MugeAIM: To investigate the expression of cyclin-dependent kinase inhibitors p21 and p27 in gastric well differentiated endocrine tumors (GWDET) (ECL-cell carcinoids). METHODS: The expressions of p21 and p27 were examined immunhistochemically in endoscopic biopsy specimens from 16 patients matching the diagnostic criteria of GWDET Percentage of positive nuclear staining either weak or strong was noted. The association of immunoexpressions with age, gender, tumor localization, multifocality and accompanying chronic atrophic gastritis, neuroendocrine cell hyperplasia (NEH), neuroendocrine dysplasia (NED), intestinal metaplasia (IM), Ki-67 proliferation index and clinical outcome were also evaluated. RESULTS: All cases expressed p27 with a mean expression score of 43.6%, while 31.3% of the cases showed any p21 expression. p21 and p27 immunoexpressions were significantly correlated with each other (P < 0.01), and the p21-expressing group had higher p27 expression scores (68% vs 22%). p21 and p27 expressions were lower in women, in non-atrophic mucosa and cases whose tumors were located somewhere other than fundus without submucosal extension. On contrary, p21 and p27 expressions were higher in males and the patients with submucosal extension and atrophic gastritis. Cases presenting lower p27 scores had solitary tumors showing neither NEH-NED nor IM. Despite, cases with lower p21 expression presented multifocal tumors accompanied by NEH-NED. However, no correlation of p21 and p27 expressions was found with age and Ki-67 expression. CONCLUSION: p27 is widely expressed in GWDETs; while p21 expression is sparse and observed in two thirds of the cases. Loss of p21 and p27 expressions may be correlated with different carcinoid tumor subtypes; however, more studies are needed to assess the role of these prospective markers in gastrointestinal endocrine tumors. (c) 2006 The WJG Press. All rights reserved.Öğe Variable sonographic spectrum of parathyroid adenoma with a novel ultrasound finding: dual concentric echo sign(Soc Romana Ultrasonografe Medicina Biologie-Srumb, 2015) Acar, Turker; Ozbek, Suha Sureyya; Ertan, Yesim; Kavukcu, Gulgun; Tuncyurek, Muge; Icoz, Recep Gokhan; Akyildiz, Mehmet Mahir; Makay, Ozer; Acar, SevalAims: To review the detailed gray-scale and Doppler ultrasonography features of histologically proven parathyroid adenomas (PAs) evaluated with high-end ultrasonography devices and to present a novel ultrasonography finding called the dual concentric echo sign in PA with histopathologic correlation which was encountered during detailed analysis. Material and methods: Fifty-six PAs with histopathological result were enrolled. The longest dimension, shape, distance to skin surface, internal echo and Doppler US features obtained with high-end US devices were evaluated. Results: PAs had variable range of shape including oval, irregular, fusiform, lobulated, crescent-shaped, and nodular configuration. In nine patients the lesions were shown to have cystic components and calcifications were seen in four cases. Dual concentric echo sign was detected in 18% PAs. Histological reevaluation of this subgroup demonstrated significantly increased edema (p<0.01), and ectatic vessels (p=0.02) in the central part of the lesion compared to the rest of the PAs. Conclusions: The results of the study led to the conclusion that PAs have variable gray-scale and Doppler findings. Typical sonographic features like ovoid shape, homogeneously hypoechoic pattern may not be present in all PAs. Dual concentric echo sign which is a novel sonographic pattern may be suggestive of a PA.Öğe Variable sonographic spectrum of parathyroid adenoma with a novel ultrasound finding: dual concentric echo sign(Soc Romana Ultrasonografe Medicina Biologie-Srumb, 2015) Acar, Turker; Ozbek, Suha Sureyya; Ertan, Yesim; Kavukcu, Gulgun; Tuncyurek, Muge; Icoz, Recep Gokhan; Akyildiz, Mehmet Mahir; Makay, Ozer; Acar, SevalAims: To review the detailed gray-scale and Doppler ultrasonography features of histologically proven parathyroid adenomas (PAs) evaluated with high-end ultrasonography devices and to present a novel ultrasonography finding called the dual concentric echo sign in PA with histopathologic correlation which was encountered during detailed analysis. Material and methods: Fifty-six PAs with histopathological result were enrolled. The longest dimension, shape, distance to skin surface, internal echo and Doppler US features obtained with high-end US devices were evaluated. Results: PAs had variable range of shape including oval, irregular, fusiform, lobulated, crescent-shaped, and nodular configuration. In nine patients the lesions were shown to have cystic components and calcifications were seen in four cases. Dual concentric echo sign was detected in 18% PAs. Histological reevaluation of this subgroup demonstrated significantly increased edema (p<0.01), and ectatic vessels (p=0.02) in the central part of the lesion compared to the rest of the PAs. Conclusions: The results of the study led to the conclusion that PAs have variable gray-scale and Doppler findings. Typical sonographic features like ovoid shape, homogeneously hypoechoic pattern may not be present in all PAs. Dual concentric echo sign which is a novel sonographic pattern may be suggestive of a PA.Öğe Variable sonographic spectrum of parathyroid adenoma with a novel ultrasound finding: dual concentric echo sign(Soc Romana Ultrasonografe Medicina Biologie-Srumb, 2015) Acar, Turker; Ozbek, Suha Sureyya; Ertan, Yesim; Kavukcu, Gulgun; Tuncyurek, Muge; Icoz, Recep Gokhan; Akyildiz, Mehmet Mahir; Makay, Ozer; Acar, SevalAims: To review the detailed gray-scale and Doppler ultrasonography features of histologically proven parathyroid adenomas (PAs) evaluated with high-end ultrasonography devices and to present a novel ultrasonography finding called the dual concentric echo sign in PA with histopathologic correlation which was encountered during detailed analysis. Material and methods: Fifty-six PAs with histopathological result were enrolled. The longest dimension, shape, distance to skin surface, internal echo and Doppler US features obtained with high-end US devices were evaluated. Results: PAs had variable range of shape including oval, irregular, fusiform, lobulated, crescent-shaped, and nodular configuration. In nine patients the lesions were shown to have cystic components and calcifications were seen in four cases. Dual concentric echo sign was detected in 18% PAs. Histological reevaluation of this subgroup demonstrated significantly increased edema (p<0.01), and ectatic vessels (p=0.02) in the central part of the lesion compared to the rest of the PAs. Conclusions: The results of the study led to the conclusion that PAs have variable gray-scale and Doppler findings. Typical sonographic features like ovoid shape, homogeneously hypoechoic pattern may not be present in all PAs. Dual concentric echo sign which is a novel sonographic pattern may be suggestive of a PA.
