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The gastrointestinal tract is the predominant site of appearance of extranodal non-Hodgkin lymphomas. The most frequent endoscopic finding of mantle cell lymphoma is multiple lymphomatous polyposis, which is a very rare entity. Multiple lymphomatous polyposis is characterized by multiple polypoid lesions involving long segments of the gastrointestinal tract and it accounts for 2% of primary gastrointestinal tract lymphomas. A 68-year-old patient was admitted to our clinic with intermittent diarrhea, weight loss, hematochezia and fatigue. Multiple lymphomatous polyposis was detected on the endoscopic evaluations. Gastrointestinal mantle cell lymphoma was confirmed with histopathological and immunohistochemical studies on biopsy specimens from colon, small intestine and stomach. The patient was successfully treated by combination chemotherapy.

Background and Aims: In this study, we investigated whether reticulated platelets (RP) would be useful markers in the evaluation of ulcerative colitis (UC) activity and also aimed to gain indirect information about the platelet kinetics., Materials and Methods: Complete blood count, C-reactive protein, erythrocyte sedimentation rate, and proportion of RP were measured in 16 active, 21 inactive UC patients, and 20 healthy blood donors. UC activity was assessed by Truelove-Witts criteria., Results: Mean platelet count was increased in patients with active compared to inactive UC (p=0.008) or healthy donors (p=0.000). Mean platelet volume (MPV) was significantly decreased in patients with active compared to inactive (p=0.015) and healthy donors (p=0.001). RP values was significantly decreased in active and inactive UC groups compared to healthy donors (p=0.000, p=0.000, respectively), while there was no significant difference between active and inactive UC patients (p=0.980). Significant negative correlation between platelet count and MPV in patients with active UC (r=-0.542, p=0.030) was observed., Conclusions: RP values is reduced in active and inactive UC patients compared to healthy donors. To our knowledge, this is the first study about proportion of RP with UC in literature. However, the role of low RP values have not been determined clinically. Further studies are needed to evaluate the role of platelet abnormalities and changes in megakaryopoiesis caused by inflammatory state on low MPV and RP values during the course of UC.

Background and Aim: The postinfectious irritable bowel syndrome (PI-IBS) frequently follows bacterial infections. Since people suffering from PI-IBS and Trichinella spiralis-infected mice develop similar findings, this animal model has been successfully used for PI-IBS studies; however, IBS has never been studied in humans after trichinellosis. The aim of this study was to evaluate the IBS symptoms in people who had acquired trichinellosis., Patients and Methods: A large outbreak of trichinellosis caused by Trichinella britovi occurred in Izmir, Turkey, in 2003-2004. The diagnosis of trichinellosis was confirmed by serology and muscle biopsy. After clinical and laboratory evaluations, 72 patients (38 women, 34 men, mean age 33.2 +/- 10.4 yr) with trichinellosis without preexisting IBS were enrolled in the study. Noninfected people (N=27) were used as control group. A questionnaire was developed to assess symptoms of IBS and alarm symptoms. The first interview was done face-to-face. After 2, 4, and 6 months of the first interview, the questionnaire was readministered to the patients without any information on the occurrence of a previous trichinellosis syndrome, while it was applied after a year only to the patients who had suffered IBS symptoms according to at least one of the previous interviews., Results: According to Rome II criteria, PI-IBS developed in 10 of 72 (13.9%) people with confirmed trichinellosis, who had no preexisting IBS. The rate of PI-IBS was 13.9% and 13.9% at the 4th and 6th months, respectively. The symptoms of PI-IBS persisted in five of them up to 1 yr. People without trichinellosis did not develop any IBS symptoms., Conclusions: This is the first report of the development of PI-IBS after T. britovi. Consequently, IBS can be considered as a secondary syndrome induced by trichinellosis.

Surface antigen mutations of hepatitis B virus (HBV) may lead to immune escape and cause failure of immunization. In this report, the development of a chronic HBV infection in a vaccinated renal transplant recipient with pre-existing anti-HBs antibody is documented. The sequencing data showed that the HBV strain carried five amino acid substitutions in the major hydrophilic region of the S protein, one (sS143L) located at the "a" determinant. A commercial HBsAg assay failed to detect the mutant antigen.

Anesthesiology management of endoscopic retrograde cholangiopancreatography (ERCP) in the twenty-first week of pregnancy of a woman patient is reported. The patient gave birth to a healthy male baby at 40 weeks of gestation.

Introduction: Mutations of hepatitis B virus (HBV) polymerase, especially occurring at the highly conserved YMDD region, are related to resistance to lamivudine. Although these mutations are frequently secondary to lamivudine use, they can also occur naturally. The aim of the present study was to determine the prevalence of YMDD variants that exist naturally in patients who are inactive HBV carriers., Methods: Seventy-one adult inactive HBV carriers were studied. All of the patients were confirmed to have maintained normal alanine aminotransferase (ALT) values for one or more years by monitoring serum ALT levels at 3-monthly intervals. None of the patients received interferon or antiviral agents. YMDD variants were analyzed by the HBV Drug Resistance Line Probe assay (Inno-Lipa HBV-DR)., Results: YMDD variants were detected in 13 (18.3%) of the 71 anti-HBe positive inactive HBV carriers. Of the 13 patients, 10 (76.9%) also had accompanying L180M mutation. The combination of wild type and YMDD variant HBV was present in 11 of 13 patients. In two patients, only YIDD and/or YVDD variants plus L180M were detected without the presence of wild YMDD motif., Conclusion: Naturally occurring YMDD motif variants were detected at a high rate in a group of lamivudine-untreated inactive HBV carriers.

Background: The clinical course of patients with inflammatory bowel disease (IBD) is frequently complicated by thromboembolic events and may involve the arterial and venous systems. Although not uniformly documented, several studies document substantial alterations in markers of coagulation and fibrinolysis in patients with IBD., Methods: 45 patients with IBD (31 UC,14 CD) were included in the study. Age and sex matched 16 volunteers were used as a control group. TAFI antigen was determined using an ELISA kit VisuLiseTM for quantitative measurement., Results: Inflammatory parameters such as white blood cell, platelet levels, erythrocyte sedimentation rate, C-reactive protein were found to be significantly higher in active disease group compared to inactive patients. Coagulation parameters of prothrombin time, activated partial thromboplastin time and d-dimer levels showed no significant difference between active and inactive IBD. Fibrinogen levels were significantly higher in clinically active IBD patients. Plasma TAFI levels demonstrated no significant difference between active and control, inactive and control as well as active and inactive groups. We observed no significant changes in levels of β-TG and PF-4 between active and inactive disease group., Conclusions: We studied plasma TAFI levels in IBD. In conclusion, plasma TAFI levels does not appear to represent to be a marker of activation in IBD in contrast to literature. So further studies covering more patients with different clinic and disease activity status might improve the perspective on this issue.

Background: In this study, we have aimed to show the possible relation between atrophic gastritis and premature atherosclerosis via hyperhomocysteinemia., Materials and Methods: Thirty-four patients with atrophic gastritis were enrolled to the study. The control group consisted of 35 patients with non-atrophic gastritis. Classical cardiovascular disease risk factors did not significantly differ between atrophic gastritis and control subjects. The presence and degree of atrophic gastritis were assessed histologically and Helicobacter pylori infection was determined by both histologic and serologic methods. Body mass index was measured by standard technique blood fasting glucose, serum creatinine, total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, vitamin B12, folic acid, and homocysteine levels were measured by biochemical methods. Carotid intima-media thickness was measured by B-mode ultrasonography to examine the premature atherosclerosis., Results: Plasma vitamin B12 levels were significantly lower (p = .00) and homocysteine levels were significantly higher (p = .01) in the atrophic gastritis group. There was no statistically significant difference in plasma folic acid levels between the two groups (p = .728). Carotid intima-media thickness was higher in the atrophic gastritis group than in the control group (0.516 mm versus 0.465 mm), but this difference did not show any statistical significance (p = .062)., Conclusion: Our results showed that atrophic gastritis may cause hyperhomocysteinemia, which is an independent risk factor for atherosclerosis and cardiovascular diseases. However, when compared with controls, carotid intima-media thickness of the atrophic gastritis patients was found to be higher but did not reach statistically significant levels.

We report a patient with protein C and protein S deficiency and factor V Leiden mutation presenting with splenic vein thrombosis and with a web between the hepatic venous confluence and vena cava inferior. These two findings were thought to be due to the hypercoagulable state of the patient. Interestingly, there was no need for invasive procedures as the inferior accessory hepatic vein was patent. Hepatic venous flow was being maintained by the inferior accessory hepatic vein or a dominant collateral vein.

Objective: Recently, proton pump inhibitor (PPI)-based triple therapy has been recommended as a first line treatment in the eradication of Helicobacter pylori. The aim of this open, multicentre trial was to investigate the efficacy, safety, tolerability and the ulcer healing rate of a triple regimen consisting of pantoprazole 40 mg, clarithromycin 500 mg and amoxicillin 1000 mg twice daily for 7 days, in the eradication of H. pylori in patients with duodenal ulcer in Turkey., Research Design and Methods: H. pylori infection was assessed by histological examination and rapid urease test at baseline and 4 weeks after the completion of the therapy. Seventy-seven patients were enrolled, 5 were excluded due to various reasons and 72 completed the entire course of the trial., Results: H. pylori eradication was confirmed in 49 of these patients; the eradication rate was 68% by per-protocol analysis and 63.6% by intention-to-treat analysis. The ulcers were completely healed in 61 patients (85%) at the second endoscopic examination. Drug compliance was excellent (97.3%) and there were no serious adverse events., Conclusion: Pantoprazole-based 1-week triple therapy was well tolerated and the ulcer healing rate was high (85%). Relatively low H. pylori eradication rates may be attributed to rising antibiotic resistance over recent years. A large scale, comparative study with other PPI-based regimens is warranted based on the results of this open study with the pantoprazole-based regimen.

The surface of naturally hydrophobic mineral pyrophyllite was modified to hydrophilic by treatment with prehydrolyzed N-(2-aminoethyl)-3-aminopropyltrimethoxysilane (APEO) coupling agent to prepare a novel and effective adsorbent for the removal of 4-nitrophenol (4-NP) from aqueous solutions. XRD, FTIR, and SEM analyses were used to characterize the surface modification. It was found that after the grafting procedure, heat treatment at 110 degrees C results in condensation reaction between the OH groups of the APEO molecule and the hydroxyl groups and/or oxygen atoms on the pyrophyllite surface and the adsorption of 4-NP by APEO-modified pyrophyllite involves interactions between dissociated 4-NP molecules and protonated amine groups of APEO molecules attached to the mineral surface. Adsorption equilibrium data for 4-NP adsorption on APEO-treated and untreated pyrophyllite were most satisfactorily fitted using the Freundlich adsorption isotherm and adsorption capacity was found to be 0.268 mg/g for modified pyrophyllite whereas it was only 0.105 mg/g for untreated pyrophyllite., (Copyright 2004 Elsevier Inc.)

We investigated the systemic effect of intraperitoneal low-molecular-weight heparin (LMWH) in continuous ambulatory peritoneal dialysis (CAPD) patients by measuring plasma total tissue factor pathway inhibitor (TFPI) levels, regarding the fact that the levels of plasma TFPI increases 2- to 4-fold after subcutaneous and intravenous administration of unfractioned heparin or LMWH. Eleven men and 6 women who had been on CAPD for 32 +/- 26 months and 15 healthy controls were included in the study. After administration of intraperitoneal enoksiparin in dialysate, plasma samples were obtained 4 h later. TFPI levels were significantly higher in CAPD patients (207.8 +/- 55 ng/ml) compared to the healthy subjects (72.5 +/- 29 ng/ml) (p < 0.0001). Both TFPI levels (225.9 +/- 47 vs. 207.8 +/- 55 ng/ml) (p < 0.54) and plasma factor Xa (anti-FXa assay) (0.097 +/- 0.14 vs. 0.093 +/- 0.16 U/ml) (p < 0.54) levels did not show any statistical difference before and after intraperitoneal administration of LMWH. By these findings we might suggest that intraperitoneal LMWH does not have any systemic effect., (Copyright 2002 S. Karger AG, Basel)

This report presents a hepatitis B surface antigen positive case presenting with acute hepatitis and with findings of low serum alanine aminotransferase in contrast to very high levels of aspartate aminotransferase. A 64 year-old female patient was admitted to our hospital with fatigue and jaundice. Hepatitis B surface antigen was positive. During follow up, aspartate aminotransferase levels remained very high, while alanine aminotransferase levels continued to be extremely low. Additionally, all of the patients five daughters had low alanine aminotransferase levels. The clinical importance of alanine aminotransferase deficiency is still unclear.

Tissue factor pathway inhibitor (TFPI) is a Kunitz-type proteinase inhibitor that has a crucial role in haemostasis and is primarily synthesized in the vascular endothelium. We investigated plasma total TFPI, antiphospholipid antibodies, and some other coagulation and fibrinolytic system parameters in 30 patients with Behçet's disease and 15 controls by the enzyme-linked immunosorbent assay method. TFPI levels were significantly higher in the Behçet's group (119 +/- 57.5 ng/ml) compared with the control group (74.8 +/- 31.5) (P < 0.009). We also noted a statistical significance in TFPI levels between patients with active disease (n:16) (139 +/- 55) and patients without activation (n:14) (96 +/- 53) (P < 0.03), whereas inactive patients lacked any significance when compared with the control group (P < 0.29). Other parameters disclosed no statistical significance between patients and control group except for elevated fibrinogen and plasminogen activator inhibitor-1 levels in the patient group (P < 0.003). Increased levels of TFPI may reflect a defensive mechanism like in other diseases characterized by thrombotic tendency and represent a parameter of disease activity., (Copyright 2001 Wiley-Liss, Inc.)