Browsing by Author "Dülger, A.C."

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A Case of Fibrolamellar Hepatocellular Carcinoma Presented With Elevated Serum Vitamın B12 Levels
(TIP ARASTIRMALARI DERNEGI, 2011) Dülger, A.C.; Atmaca, M.; Aytemiz, E.; Altindal, E.; Akdeniz, H.
Fibrolamellar carcinoma of the liver is a variant of hepatocellular carcinoma. It is relatively common in young people and has equal gender distribution. The disease presents as abdominal pain, weight loss and malaise. In several reports of fibrolamellar liver tumors, high cobalamin level has been demonstrated in the human's serum. Therefore, serum cobalamin has been found as a good tumour marker for fibrolamellar hepatocellular carcinoma. Elevated production or decreased elimination of haptocorrin may play an important role for this phenomen. For early fibrolamellar carcinoma, surgical resection, when feasible, is the gold standart for the treatment. In advanced stage of the disease; single-modality treatments (recombinant interferon α-2b or sorafenib) can be tried. Herein, we report a case of metastatic fibrolamellar hepatocellular carcinoma that was presented with high vitamin B12 levels and continued subcutaneous recombinant interferon α-2b thrice-weekly.
Case Report: Hookworm Infection in a Patient With Severe Anemia
(2009) Yilmaz, H.; Taş Cengiz, Z.; Ciçek, M.; Dülger, A.C.
In this study, a patient who was hospitalized with a severe anemia in the Internal Medicine Clinic of the Health Research and Application Hospital of Yüzüncü Yil University for one week is presented. The patient had fatigue, paleness and dizziness for one month and approximately 12 kg weight lost for four mounts previous to admission.. Severe iron deficiency anemia was diagnosed in the patient by laboratory analyses. Because there were no hematologic factors associated with severe anemia, the stool examination was also performed. In the Parasitology Laboratory, stool microscopy of the patient revealed numerous ova of hookworm. General condition of the patient well improved with anti-parasitic and anti-anemia treatment. It was concluded that patients with iron deficiency anemia diagnosed in health centers should be also examined for the intestinal parasitic diseases encountered rarely, and physicians should consider non-endemic parasitic diseases in their provinces.
Colon Cancer and Midkine
(Springer Netherlands, 2012) Kemik, O.; Kemik, A.S.; Dülger, A.C.
Midkine, a heparin-binding growth factor, promotes the growth, survival, and migration of various cell populations, and it is over-expressed in many malignant human tumors. Midkine expression is generally increased in colon carcinomas compared to normal colon tissue. Additionally, colon adenomas with medium-to severe-dysplasia exhibit increased midkine expression. Therefore, midkine is expressed during the early stages of colon carcinogenesis and is likely to be involved in the oncogenic process, presumably by promoting tumor cell growth and survival. In the advanced tumor stages, midkine is expected to contribute to tumor progression by promoting tumor angiogenesis. A truncated form of midkine mRNA, which lacks the sequence encoding the N-terminal domain, is expressed in colon cancers in a cancer-specific manner. Detection of this sequence might help to detect micro metastases. Furthermore, the truncated midkine mRNA appears to contribute to colon carcinogenesis because a genetic variant favoring its formation is more frequently found in patients with colon carcinoma compared to unaffected controls. Finally, midkine inhibitors are expected to be valuable in colon cancer treatment; antisense oligo-DNA has been proven to suppress cancer growth in experimental systems. © 2012 Springer Science+Business Media Dordrecht. All rights reserved.
Cystoisospora Sp. Infection Determined in Immunosuppressed and Immunocompetent Children: Three Cases Report
(2016) Taş Cengiz, Z.; Yılmaz, H.; Çiçek, M.; Beyhan, Y.E.; Dülger, A.C.
The aim of this study was to present three cystoisosporiasis cases diagnosed in pediatric patients of the Yuzuncu Yil University Medical Faculty. In the study, stool samples of the patients were evaluated by native-Lugol and modified acid-fast staining methods in the Parasitology Laboratory. The first case was a 4-year-old male child diagnosed with acute lymphoblastic leukemia (ALL). It was reported that the patient had abdominal pain, and permanent bloody and mucous diarrhea (8-10 times a day) was present for almost 1 week after the beginning of ALL treatment. The second case was a 10-year-old boy diagnosed with depression. The patient was brought to our hospital by his parents with complaints of abdominal pain, diarrhea, lack of appetite, weight loss, and fatigue persisting since 1 month in addition to headache, fear, sleeplessness, and waking up with cry. The third case was a 13-year-old boy who complained of abdominal pain, diarrhea (rare occasions), lack of appetite, and headache for 2 months. These patients had not traveled abroad. The cases were treated successfully with co-trimoxazole. Our results suggest that all patient groups with diarrhea and abdominal pain should also be considered in cystoisosporiasis.
Epidemiology of the Hepatitis C Infection in Van's Region
(2013) Gültepe, B.; Dülger, A.C.; Aytemiz, E.
Hepatitis C virus (HCV) is an enveloped positive-strand RNA virus of the genus hepacivirus in the family of Flaviviridae. HCV causes chronic infection in more than 80% of cases. It is responsible for more than 50% of liver transplantation among adults in the developed countries. Approximately 200 million people are infected with HCV entire of the world. Africa and many parts of Asia are the major endemic areas for HCV infection. Although HCV is one of the most common cause of chronic liver disease in middle-east, its epidemiology remains unclear around the Lake Van region. Therefore, we assessed the prevalence of HCV infection in individuals who live in rural areas of eastern part of Turkey. We retrospectively analyzed 1062 (405 male, 657 female) patients who admitted to Gastroenterology clinic of Yuzuncu Yil University Faculty of Medicine between January-October in 2011. Patients with prior HCV infection and with acute HCV infection were excluded. Presence of HCV infection was assessed by the routine ELISA method. Anti-HCV antibodies were screened by ELISA method using ADVIA Centaur ® XP Immunoassay System (Siemens, Ireland). Samples with positive HCV RNA real-time PCR was used as the correction method. Isolation reaction processes were analyzed by QIAGEN (Düsseldorf, Germany) brand in the QIAsymphony SP/AS instrument. Real Time PCR analysis was studied by Rotor Gene Q instrument and Artus HCV Virus-1 QS-RGQ kits (QIAGEN, Düsseldorf, Germany). All data was recorded on SPSS and was analyzed by simple statistical methods. The mean age was 46.1±17.9 years in males and was 42.5±17 years in females. 3 men and 6 women had anti-HCV antibody. Total Anti-HCV seropositivity was 0.8%. Interestingly, HCV infection is not a serious health problem in eastern part of Turkey. It may be due to low prevalence of intravenous drug users and homosexuals as well as to strict traditional rules. Further analyses may be required to establish this phenomenon particularly in eastern part of Turkey which is located on the main crossroad of the world narcotic trade.
Evaluation of Patients With Idiopathic Portal Hypertension: Could Tissue Transglutaminase Antibodies Predict the Celiac Disease
(Yuzuncu Yil Universitesi Tip Fakultesi, 2016) Gören, F.; Dülger, A.C.
Idiopathic portal hypertension (IPH) traditionally has been described as a diagnosis of exclusion in patients who have presinusoidal portal hypertension. Gut- derived serologic markers in IPH are an increasing focus of attention, but there are only a few published studies on serological markers of celiac disease in patients with IPH and the results are contradictory. Furthermore, the role of tissue transglutaminase (TTG) antibodies have not been identified yet. This study determined what proportion of IPH patients had a seropositivity of TTG antibodies and evaluated the role of TTG antibodies in IPH. Demographics and clinical data, TTG antibodies, hematologic and biochemical parameters and radiologic studies were retrospectively reviewed in all IPH patients attending our hospital. 10 clinically and biopsy-proven IPH patients (8 women and 2 men) were identified, all of them were diagnosed between 2009 and 2011. IgA and G antibodies to tissue transglutaminase were evaluated in all patients. 5 patients had a positive TTG IgA, 3 patients had a positive TTG IgG and 2 of them had negative autoantibodies. No patient was IgA deficient. 6 patients were eligible for duoenal biopsy and none of them had biopsy-proven celiac disease (CD). Conclusions: Although the data are limited, this study suggests that seropositivity for TTG antibodies could be positive in IPH. But there was no relation between positive serologic results and CD. © 2016, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Gastrıc İntestınal Metaplasıa And Covıd 19 İnfectıon
(Yuzuncu Yil Universitesi Tip Fakultesi, 2020) Aydın, M.; Dülger, A.C.; Özer, S.; Dirik, Y.; Keskin, S.; Demir, C.
Gastric intestinal metaplasia (GIM) is defined as immigration of enteric or colonic mucosa within gastric lining.Gastric intestinal metaplasia (GIM) is a premalign condition seen in gastric lining. It is prevalent in Asia and may lead to gastric carcinoma at a rate of 1% annually. COVID 19, which has been a global issue since late 2019, causes mostly respiratory symptoms; however, some patients may present with gastrointestinal symptoms including diarrhea, vomiting (5%) and abdominal pain (3.8%).We tried in this text to handle any possible association between COVID 19 infection and GIM. In this retrospective study we included 39 COVID 19 patients and 180 age-matched control subjects to compare rate of intestinal metaplasia. All statistical analyses were performed with SAS software (SAS Institute, Cary, N.C.). The clinical and radiological characteristics of patients were compared using Student's t-test. Intestinal metaplasia was found in 11 (28%) of 39 patients while in 7 (3,9%) of 181 controls, which meant a statistical significance (p<0,05). Of the 181 subjects, atrophy was found in 39 (21%) whereas it was noted in 9 (23%) of 39 patients, which yielded no statistical significance (p>0,05). We found that GIM is a premalignant condition that can lead to COVID 19 infection. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Infestation of the Human Digestive System With Beetle Larvae (Coleoptera: Cantharidae): a Case Report
(2014) Yılmaz, H.; Taş Cengiz, Z.; Dülger, A.C.; Ekici, P.
This study was conducted to report the digestive system infestation caused by the larvae of Coleoptera in a female pediatric patient. She was admitted to our hospital with the complaints of emergence of insect larvae from her vomit and feces, abdominal pain, inguinal pain, lack of appetite, hair loss, excessive cleaning behavior, extreme irritability, and distractibility. The larvae observed typically had the morphology of the larvae of insects related to the Cantharidae family in the Coleoptera order. For treatment, a single dose of albendazole (400 mg) was used. Consequently, in the present case, it was seen that the larvae of Coleoptera incidentally taken orally could continue to live for a period in the digestive tract of people, without losing vitality, and the larvae caused a variety of symptoms due to both their toxic agents and the possible irritation they caused.
A Nasopharyngeal Human Infestation Caused by Linguatula Serrata Nymphs in Van Province: a Case Report
(2011) Yilmaz, H.; Cengiz, Z.T.; Ciçek, M.; Dülger, A.C.
The reason for the presentation of this case is that Linguatula serrata, a parasite rarely encountered in humans, was found in a patient in Van province. The patient, who was 26 years old, lived in Erciş a town in Van province, East Turkey. She was admitted to the Outpatient Clinic of Infectious Diseases of Erciş Government Hospital with a complaint of coughing a few worms about 4 cm long from the oral cavity, and also sore throat, partial voice loss and vomiting. The polyclinic doctor suspected that the worm was a parasite but he could not make a diagnosis, and the patient was referred to Health Research and Training Hospital, Yüzüncü Yil University. The parasite was examined in the Parasitology Laboratory and it was observed that this parasite was the nymph of L. serrata whose mouth was surrounded with four hooks and had approximately 90 body segments with small hooks. No medical treatment was given to the patient except that gargling with saline solution was recommended. As a result, we think that physicians should consider L. serrata infestation in patients applying to health foundations with complaints such as pharyngitis accompanied by pharyngeal pain, coughing, sneezing and vomiting.
Serum Level of Soluble Vascular Adhesion Molecule 1 in Patients With Rectal Cancer
(TIP ARASTIRMALARI DERNEGI, 2011) Kemik, O.; Kemik, A.S.; Hasirci, I.; Adaş, M.; Purisa, S.; Dülger, A.C.; Tüzün, S.
Aim: Vascular adhesion molecule 1 (VCAM-1) plays an important role in solid tumor enlargement and/or metastases. This study evaluated the clinical significance of measuring serum levels of soluble VCAM-1 in rectal cancer and aimed to clarify the biologic significance of its local expression. Method: Serum was collected from 90 patients with rectal cancer and 40 healthy volunteers. Cancer tissue was collected from 84 patients. The level of soluble VCAM-1 in serum and cancer tissue was measured enzyme linked immunosorbent assay.Result: The mean soluble VCAM-1 level in patients was significantly higher than that in control subjects. Elevated serum soluble VCAM-1 was significantly associated with clinicopathologic paramaters such as tumor size, lymph node metastasis, distant metastasis, and poor prognosis. The prognosis for stage 2 patients positive for soluble VCAM-1 level was comparable to that for stage 3 patients. In addition, the serum level of soluble VCAM-1 level was not found correlation with the cancer tissue level. Conclusion: The preoperative level of soluble VCAM-1 level reflected disease progression and was a sensitive biomarker for rectal cancer.
Transforming Growth Factor Beta-1 in Human Colorectal Cancer Patients
(TIP ARASTIRMALARI DERNEGI, 2011) Kemik, O.; Kemik, A.S.; Purisa, S.; Hasirci, I.; Dülger, A.C.; Adaş, M.; Tüzün, S.
Aim: Colorectal cancer patients are treated with surgery and sometimes radiotherapy and chemotherapy. Transforming growth factor beta-1 (TGF-β1) acts both as an inhibitor of tumor growth and as a promoter of tumor progression. The aim of this study was to determine the levels of TGF-β1 in plasma in colorectal cancer patients and relate these to the effect of clinicopathological variables. Method: One hundred patients scheduled for colorectal cancer surgery were included. Blood samples were taken during surgery and later assayed with enzyme linked immunsorbent assay for total TGF-β1 and active TGF-β1. Result: Total and active TGF-β1 was higher in tumor samples compared to controls (p<0.001).Total TGF-β1 was higher in patients with metastases compared to patients without. Active TGF-β1 levels were not found statistically different in patients with metastases. Conclusion: Higher levels of total TGF-β1 in plasma at surgery may be indicate of distant metastases, Measurement of total TGF-β1 in colorectal cancer patients may be of clinical use in the future.