Background: Acute pancreatitis (AP) is a life-threatening disease. We aimed to explore the progno... more Background: Acute pancreatitis (AP) is a life-threatening disease. We aimed to explore the prognostic relevance of renal function based on estimated glomerular filtration rate (eGFR).Methods: A prospective registry of AP patients was established by the Hungarian Pancreatic Study Group. Data of 1,224 consecutive patients were collected between 2012 and 2017. Patients were divided into 3 groups according to their eGFR measured within 24 h of hospitalization: normal renal function: >90 mL/min, mild to moderate renal functional impairment: 30–90 mL/min and severe renal dysfunction: <30 mL/min. Associations of eGFR with outcome (survival, length of hospitalization, AP severity, blood glucose), inflammatory markers (erythrocyte sedimentation rate, white blood cell count), anemia and organ failure (heart, kidney, liver) were analyzed.Results: Death, longer hospitalization and severe AP, but not the cause of AP, were significantly associated with lower eGFR. The inflammatory markers (...
Background/aims: Inflammatory bowel disease patients are at an increased risk for Clostridium dif... more Background/aims: Inflammatory bowel disease patients are at an increased risk for Clostridium difficile infection because of frequent hospitalizations and usage of immunosuppressive/immunomodulator drugs as well as antibiotics. The frequency of Clostridium difficile infection increases in parallel with the increase in disease activity. We aimed to evaluate the frequency of Clostridium difficile toxin A/B in patients with mildly and moderately active inflammatory bowel disease because a search on PubMed revealed a scarcity of literature knowledge in this regard. Methods: One hundred inflammatory bowel disease patients (48 females, 52 males) with mild and moderate activity were consecutively enrolled in the study; none of the patients had a history of hospitalization and/or antibiotic usage for the last three months. A stool sample was investigated for Clostridium difficile toxin A/B with enzyme immunoassay method by a microbiologist who was blinded to the study. Additionally, samples...
Background and aim: Malignancies can cause noncirrhotic portal hypertension by affecting the hepa... more Background and aim: Malignancies can cause noncirrhotic portal hypertension by affecting the hepatoportal vascular (right, left and middle hepatic veins and portal vein) system with metastasis, thrombosis, viscosity changes and vasculitis. The aim of this study was to assess the coincidence of hepatoportal vein thrombosis and malignancies in patients with noncirrhotic portal hypertension. Material and methods: Patients admitted to our clinic between 1995-2000 with noncirrhotic portal hypertension who had malignancy and hepatoportal vein thrombosis were assessed retrospectively. Results: Sixty-four percent (n:28) of patients with noncirrhotic portal hypertension were K [n:18, mean:36.8, median:33, range:20-71], 36% were E [n:10, mean:46.8, median:37, range:14-76]. Fifty-seven percent of noncirrhotic portal hypertension patients had hepatoportal vein thrombosis [n:16, 8 E (mean:37, medium: 48, range:23-65), 8 K (mean:31, medium:35, range:23-65)]. Onethird of thromboses were located in...
Background and aims: In the Endoscopy Unit of Haydarpasa Numune Education and Research Hospital, ... more Background and aims: In the Endoscopy Unit of Haydarpasa Numune Education and Research Hospital, the endoscopic results of 240 patients who were diagnosed with upper gastrointestinal bleeding were evaluated between February 1, 2007 and May 1, 2008. Materials and methods: These results were compared with results in the same unit obtained over a 15-month period between 1992 and 1993. Results: Of the 240 patients who were evaluated by endoscopy between February 1, 2007 and May 1, 2008, 169 were male, 71 were female, and the median age was 57 (14- 86); 40% were over 60 years old. Of the patients evaluated 15 years ago, the median age was 47.5 (12-84) and 37% were over 60 years old. In the 2008 results, 36.2% of the patients had active bleeding. These patients were endoscopically treated with: injection (82.7%), argon plasma coagulation (12.6%) or heater probe (4.6%). However, in 1993, the ratio of active bleeding was 26%, and these patients were treated by injection only. The most commo...
Giris ve Amac: Turkiye’de Helikobakter pilori prevalansi yaklasik %80’dir. Proton pompa inhibitor... more Giris ve Amac: Turkiye’de Helikobakter pilori prevalansi yaklasik %80’dir. Proton pompa inhibitoru, amoksisilin ve klaritromisinden olusan standard uclu tedavi rejimi ile eradikasyon orani zamanla azalmaktadir. Eradikasyon oranini arttirmak amaci ile bu rejimlere probiyotikler ve cesitli vitaminler eklenmistir. Bu calismanin amaci 7 gunluk standard uclu tedaviye 14 gun sure ile C ve E vitamini eklenmesinin Helikobakter pilori eradikasyon oranini arttirip arttirmayacagini arastirmaktir. Gerec ve Yontem: Bu calismaya 53 Helikobakter pilori pozitif nonulser dispepsili hasta dahil edildi. Tum hastalar 7 gunluk lansoprazol 30 mg BID, amoksisilin 1000 mg BID ve klaritromisin 500 mg BID ile birlikte 14 gunluk vitamin C 500 mg BID ve vitamin E 200 IU BID aldi. Eradikasyon oranlari intention-to-treat ve per-protocol analizleri ile hesaplandi. Bulgular: Elli hasta calismayi tamamladi. Helikobakter pilori eradikasyonu intention-to-treat analizde 53 hastanin 31’inde (58,5%), per-protocol analiz...
This study aimed to investigate whether AI via a deep learning algorithm using endoscopic ultraso... more This study aimed to investigate whether AI via a deep learning algorithm using endoscopic ultrasonography (EUS) images could predict the malignant potential of gastric gastrointestinal stromal tumors (GISTs). A series of patients who underwent EUS before surgical resection for gastric GISTs were included. A total of 685 images of GISTs from 55 retrospectively included patients were used as the training data set for the AI system. Convolutional neural networks were constructed to build a deep learning model. After applying the synthetic minority oversampling technique, 70% of the generated images were used for AI training and 30% were used to test AI diagnoses. Next, validation was performed using 153 EUS images of 15 patients with GISTs. In addition, conventional EUS features of 55 patients in the training cohort were evaluated to predict the malignant potential of GISTs and mitotic index. The overall sensitivity, specificity, and accuracy of the AI system for predicting malignancy risk were 83%, 94%, and 82% in the training dataset, and 75%, 73%, and 66% in the validation cohort, respectively. When patients were divided into low-risk and high-risk groups, sensitivity, specificity, and accuracy increased to 99% in the training dataset and 99.7%, 99.7%, and 99.6%, respectively, in the validation cohort. No conventional EUS features were found to be associated with either malignant potential or mitotic index (P > 0.05). AI via a deep learning algorithm using EUS images could predict the malignant potential of gastric GISTs with high accuracy.
European Journal of Gastroenterology & Hepatology, 2019
Background Hypertriglyceridemia (HTG)-induced acute pancreatitis (AP) leads to higher morbidity a... more Background Hypertriglyceridemia (HTG)-induced acute pancreatitis (AP) leads to higher morbidity and mortality compared with other etiologies. The role of plasma exchange (PE) in this context is still not well established. We aimed to assess the clinical outcomes of patients with HTG-induced AP who underwent PE and compare it with those who did not. Patients and methods We retrospectively evaluated the data of patients who were admitted with HTG-induced AP between January 2013 and May 2018. The endpoint of the study was to assess the clinical outcomes, which included complication rates, mortality, and pancreatitis recurrence rate. Results Overall, 41 patients were included in the final analysis. Of these, 12 (29.2%) underwent PE. Patients undergoing PE had more severe pancreatitis on the basis of the Japanese Severity Score [10 (83.3%) vs. 14 (48.3%), P=0.03, respectively). Although mortality was higher in patients who underwent PE [three (25.0%) vs. zero, P<0.01, respectively], there was no difference in terms of complications and recurrence rates. Over a median 21 months of follow-up, 11 (26.8%) patients had recurrent AP. Conclusion Although PE effectively reduced plasma triglyceride levels, there was no decrease in mortality or recurrences.
About half of the world population is infected with Helicobacter pylori (H. pylori), a bacterium ... more About half of the world population is infected with Helicobacter pylori (H. pylori), a bacterium associated with gastric cancer and considered to be a risk factor for pancreatic ductal adenocarcinoma. Whether the bacterium is associated with intraductal papillary mucinous neoplasm, believed to be a precursor of pancreatic ductal adenocarcinoma, is unknown. The aim of this study was to investigate the presence of H. pylori DNA in tissue sections of intraductal papillary mucinous neoplasm. The presence of H. pylori DNA was tested in a retrospective controlled study of formalin-fixed, paraffin-embedded pancreatic tissues from 24 patients who underwent surgery for intraductal papillary mucinous neoplasm. Histologically normal tissues surrounding neoplasms were used as control. H. pylori DNA was evaluated after deparaffinization, DNA extraction, and purification, and results were evaluated statistically. Samples were collected from 13 males and 11 females with mean age 59 years (range 44-77), and consisted of 19 cases of main-duct and three cases of branched-duct intraductal papillary mucinous neoplasm. Two patients were diagnosed with pancreatic cancer and main-duct intraductal papillary mucinous neoplasm. H. pylori DNA was not detected either in intraductal papillary mucinous neoplasm tissue, or in surrounding normal tissue. Although H. pylori has been implicated in pancreatic ductal adenocarcinoma, it may not play a key role in the development of intraductal papillary mucinous neoplasm.
Zeitschrift Fur Die Welt Der Turken Journal of World of Turks, Dec 15, 2012
Bu calismada, Turk madencilik sektorunde onemli bir yere sahip olan krom madenciliginin mevcut du... more Bu calismada, Turk madencilik sektorunde onemli bir yere sahip olan krom madenciliginin mevcut durumunun stratejik yonetim bakis acisiyla analize tabi tutulmasi ve rekabet ustunlugu saglayabilecek ozelliklerinin belirlenmesi, mevcut sorunlarinin tanimlamasi amaclanmis ve bunun icin nitel bir yontem izlenmistir. Bu dogrultuda, konu ile ilgili literatur taramasi yapilarak betimsel yontem benimsenmistir. Calismanin baslangicinda stratejik yonetim yaklasimi ve ozellikleri incelenmis, sonrasinda rekabet ve rekabetcilik konusu ele alinmistir. Rekabetcilik baglaminda degerlendirme yapilirken stratejik yonetimde bu anlamda cok tercih edilen yontemlerden birisi olan swot analizi tekniginden yararlanilmistir. Analize gecmeden once krom madenciligi sektoru hakkinda genel bir bilgi verilmis daha sonra bu sektorun swot analizi yapilmistir. Calismanin sonuc bolumunde ise onceden yapilan degerlendirmeler ve yapilan analizler dogrultusunda krom madenciligi ile ilgili stratejik anlamda bir degerlendirme yapilarak cesitli onerilerde bulunulmustur. In this study, Chrome mining which has an important place in the Turkish mining industry, analyzed and determined features that can provide a competitive advantage, and also aimed to identifing the existing problems.In this study qualititive study has done.In this context, literature review was done and descriptive method is used.The first section reviews recent discussions about strategic management approach and its features. The second section includes competetion and competitiveness.In the context, swot analysis technique, the most preferred method, was utilized for assesing the competetion.And then, swot analysis is done chrome mining lastly, strategic evaluation is done in the context of assesments and analysis for chrome mining and various suppestions have been made about the strategic sense.
Background: Acute pancreatitis (AP) is a life-threatening disease. We aimed to explore the progno... more Background: Acute pancreatitis (AP) is a life-threatening disease. We aimed to explore the prognostic relevance of renal function based on estimated glomerular filtration rate (eGFR).Methods: A prospective registry of AP patients was established by the Hungarian Pancreatic Study Group. Data of 1,224 consecutive patients were collected between 2012 and 2017. Patients were divided into 3 groups according to their eGFR measured within 24 h of hospitalization: normal renal function: >90 mL/min, mild to moderate renal functional impairment: 30–90 mL/min and severe renal dysfunction: <30 mL/min. Associations of eGFR with outcome (survival, length of hospitalization, AP severity, blood glucose), inflammatory markers (erythrocyte sedimentation rate, white blood cell count), anemia and organ failure (heart, kidney, liver) were analyzed.Results: Death, longer hospitalization and severe AP, but not the cause of AP, were significantly associated with lower eGFR. The inflammatory markers (...
Background/aims: Inflammatory bowel disease patients are at an increased risk for Clostridium dif... more Background/aims: Inflammatory bowel disease patients are at an increased risk for Clostridium difficile infection because of frequent hospitalizations and usage of immunosuppressive/immunomodulator drugs as well as antibiotics. The frequency of Clostridium difficile infection increases in parallel with the increase in disease activity. We aimed to evaluate the frequency of Clostridium difficile toxin A/B in patients with mildly and moderately active inflammatory bowel disease because a search on PubMed revealed a scarcity of literature knowledge in this regard. Methods: One hundred inflammatory bowel disease patients (48 females, 52 males) with mild and moderate activity were consecutively enrolled in the study; none of the patients had a history of hospitalization and/or antibiotic usage for the last three months. A stool sample was investigated for Clostridium difficile toxin A/B with enzyme immunoassay method by a microbiologist who was blinded to the study. Additionally, samples...
Background and aim: Malignancies can cause noncirrhotic portal hypertension by affecting the hepa... more Background and aim: Malignancies can cause noncirrhotic portal hypertension by affecting the hepatoportal vascular (right, left and middle hepatic veins and portal vein) system with metastasis, thrombosis, viscosity changes and vasculitis. The aim of this study was to assess the coincidence of hepatoportal vein thrombosis and malignancies in patients with noncirrhotic portal hypertension. Material and methods: Patients admitted to our clinic between 1995-2000 with noncirrhotic portal hypertension who had malignancy and hepatoportal vein thrombosis were assessed retrospectively. Results: Sixty-four percent (n:28) of patients with noncirrhotic portal hypertension were K [n:18, mean:36.8, median:33, range:20-71], 36% were E [n:10, mean:46.8, median:37, range:14-76]. Fifty-seven percent of noncirrhotic portal hypertension patients had hepatoportal vein thrombosis [n:16, 8 E (mean:37, medium: 48, range:23-65), 8 K (mean:31, medium:35, range:23-65)]. Onethird of thromboses were located in...
Background and aims: In the Endoscopy Unit of Haydarpasa Numune Education and Research Hospital, ... more Background and aims: In the Endoscopy Unit of Haydarpasa Numune Education and Research Hospital, the endoscopic results of 240 patients who were diagnosed with upper gastrointestinal bleeding were evaluated between February 1, 2007 and May 1, 2008. Materials and methods: These results were compared with results in the same unit obtained over a 15-month period between 1992 and 1993. Results: Of the 240 patients who were evaluated by endoscopy between February 1, 2007 and May 1, 2008, 169 were male, 71 were female, and the median age was 57 (14- 86); 40% were over 60 years old. Of the patients evaluated 15 years ago, the median age was 47.5 (12-84) and 37% were over 60 years old. In the 2008 results, 36.2% of the patients had active bleeding. These patients were endoscopically treated with: injection (82.7%), argon plasma coagulation (12.6%) or heater probe (4.6%). However, in 1993, the ratio of active bleeding was 26%, and these patients were treated by injection only. The most commo...
Giris ve Amac: Turkiye’de Helikobakter pilori prevalansi yaklasik %80’dir. Proton pompa inhibitor... more Giris ve Amac: Turkiye’de Helikobakter pilori prevalansi yaklasik %80’dir. Proton pompa inhibitoru, amoksisilin ve klaritromisinden olusan standard uclu tedavi rejimi ile eradikasyon orani zamanla azalmaktadir. Eradikasyon oranini arttirmak amaci ile bu rejimlere probiyotikler ve cesitli vitaminler eklenmistir. Bu calismanin amaci 7 gunluk standard uclu tedaviye 14 gun sure ile C ve E vitamini eklenmesinin Helikobakter pilori eradikasyon oranini arttirip arttirmayacagini arastirmaktir. Gerec ve Yontem: Bu calismaya 53 Helikobakter pilori pozitif nonulser dispepsili hasta dahil edildi. Tum hastalar 7 gunluk lansoprazol 30 mg BID, amoksisilin 1000 mg BID ve klaritromisin 500 mg BID ile birlikte 14 gunluk vitamin C 500 mg BID ve vitamin E 200 IU BID aldi. Eradikasyon oranlari intention-to-treat ve per-protocol analizleri ile hesaplandi. Bulgular: Elli hasta calismayi tamamladi. Helikobakter pilori eradikasyonu intention-to-treat analizde 53 hastanin 31’inde (58,5%), per-protocol analiz...
This study aimed to investigate whether AI via a deep learning algorithm using endoscopic ultraso... more This study aimed to investigate whether AI via a deep learning algorithm using endoscopic ultrasonography (EUS) images could predict the malignant potential of gastric gastrointestinal stromal tumors (GISTs). A series of patients who underwent EUS before surgical resection for gastric GISTs were included. A total of 685 images of GISTs from 55 retrospectively included patients were used as the training data set for the AI system. Convolutional neural networks were constructed to build a deep learning model. After applying the synthetic minority oversampling technique, 70% of the generated images were used for AI training and 30% were used to test AI diagnoses. Next, validation was performed using 153 EUS images of 15 patients with GISTs. In addition, conventional EUS features of 55 patients in the training cohort were evaluated to predict the malignant potential of GISTs and mitotic index. The overall sensitivity, specificity, and accuracy of the AI system for predicting malignancy risk were 83%, 94%, and 82% in the training dataset, and 75%, 73%, and 66% in the validation cohort, respectively. When patients were divided into low-risk and high-risk groups, sensitivity, specificity, and accuracy increased to 99% in the training dataset and 99.7%, 99.7%, and 99.6%, respectively, in the validation cohort. No conventional EUS features were found to be associated with either malignant potential or mitotic index (P > 0.05). AI via a deep learning algorithm using EUS images could predict the malignant potential of gastric GISTs with high accuracy.
European Journal of Gastroenterology & Hepatology, 2019
Background Hypertriglyceridemia (HTG)-induced acute pancreatitis (AP) leads to higher morbidity a... more Background Hypertriglyceridemia (HTG)-induced acute pancreatitis (AP) leads to higher morbidity and mortality compared with other etiologies. The role of plasma exchange (PE) in this context is still not well established. We aimed to assess the clinical outcomes of patients with HTG-induced AP who underwent PE and compare it with those who did not. Patients and methods We retrospectively evaluated the data of patients who were admitted with HTG-induced AP between January 2013 and May 2018. The endpoint of the study was to assess the clinical outcomes, which included complication rates, mortality, and pancreatitis recurrence rate. Results Overall, 41 patients were included in the final analysis. Of these, 12 (29.2%) underwent PE. Patients undergoing PE had more severe pancreatitis on the basis of the Japanese Severity Score [10 (83.3%) vs. 14 (48.3%), P=0.03, respectively). Although mortality was higher in patients who underwent PE [three (25.0%) vs. zero, P<0.01, respectively], there was no difference in terms of complications and recurrence rates. Over a median 21 months of follow-up, 11 (26.8%) patients had recurrent AP. Conclusion Although PE effectively reduced plasma triglyceride levels, there was no decrease in mortality or recurrences.
About half of the world population is infected with Helicobacter pylori (H. pylori), a bacterium ... more About half of the world population is infected with Helicobacter pylori (H. pylori), a bacterium associated with gastric cancer and considered to be a risk factor for pancreatic ductal adenocarcinoma. Whether the bacterium is associated with intraductal papillary mucinous neoplasm, believed to be a precursor of pancreatic ductal adenocarcinoma, is unknown. The aim of this study was to investigate the presence of H. pylori DNA in tissue sections of intraductal papillary mucinous neoplasm. The presence of H. pylori DNA was tested in a retrospective controlled study of formalin-fixed, paraffin-embedded pancreatic tissues from 24 patients who underwent surgery for intraductal papillary mucinous neoplasm. Histologically normal tissues surrounding neoplasms were used as control. H. pylori DNA was evaluated after deparaffinization, DNA extraction, and purification, and results were evaluated statistically. Samples were collected from 13 males and 11 females with mean age 59 years (range 44-77), and consisted of 19 cases of main-duct and three cases of branched-duct intraductal papillary mucinous neoplasm. Two patients were diagnosed with pancreatic cancer and main-duct intraductal papillary mucinous neoplasm. H. pylori DNA was not detected either in intraductal papillary mucinous neoplasm tissue, or in surrounding normal tissue. Although H. pylori has been implicated in pancreatic ductal adenocarcinoma, it may not play a key role in the development of intraductal papillary mucinous neoplasm.
Zeitschrift Fur Die Welt Der Turken Journal of World of Turks, Dec 15, 2012
Bu calismada, Turk madencilik sektorunde onemli bir yere sahip olan krom madenciliginin mevcut du... more Bu calismada, Turk madencilik sektorunde onemli bir yere sahip olan krom madenciliginin mevcut durumunun stratejik yonetim bakis acisiyla analize tabi tutulmasi ve rekabet ustunlugu saglayabilecek ozelliklerinin belirlenmesi, mevcut sorunlarinin tanimlamasi amaclanmis ve bunun icin nitel bir yontem izlenmistir. Bu dogrultuda, konu ile ilgili literatur taramasi yapilarak betimsel yontem benimsenmistir. Calismanin baslangicinda stratejik yonetim yaklasimi ve ozellikleri incelenmis, sonrasinda rekabet ve rekabetcilik konusu ele alinmistir. Rekabetcilik baglaminda degerlendirme yapilirken stratejik yonetimde bu anlamda cok tercih edilen yontemlerden birisi olan swot analizi tekniginden yararlanilmistir. Analize gecmeden once krom madenciligi sektoru hakkinda genel bir bilgi verilmis daha sonra bu sektorun swot analizi yapilmistir. Calismanin sonuc bolumunde ise onceden yapilan degerlendirmeler ve yapilan analizler dogrultusunda krom madenciligi ile ilgili stratejik anlamda bir degerlendirme yapilarak cesitli onerilerde bulunulmustur. In this study, Chrome mining which has an important place in the Turkish mining industry, analyzed and determined features that can provide a competitive advantage, and also aimed to identifing the existing problems.In this study qualititive study has done.In this context, literature review was done and descriptive method is used.The first section reviews recent discussions about strategic management approach and its features. The second section includes competetion and competitiveness.In the context, swot analysis technique, the most preferred method, was utilized for assesing the competetion.And then, swot analysis is done chrome mining lastly, strategic evaluation is done in the context of assesments and analysis for chrome mining and various suppestions have been made about the strategic sense.
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