26 results on '"TUNÇ, Bilge"'
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2. A novel finding in MNGIE (Mitochondrial Neurogastrointestinal Encephalomyopathy): hypergonadotropic hypogonadism
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Kalkan, İsmail Hakkι, Tayfur, Öykü, Öztaş, Erkin, Beyazit, Yavuz, Yildiz, Hakan, and Tunç, Bilge
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- 2012
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3. Doktorlar için bir klinik zorluk: Abdominal tüberküloz 24 olgunun derlemesi
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ERGÜN, Meltem, TUNÇ, Bilge, ÜLKER, Aysel, and ŞAŞMAZ, Nurgül
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Gastrointestinal tuberculosis,abdominal tuberculosis,intestinal tuberculosis ,Gastrointestinal tüberküloz,abdominal tüberküloz,intestinal tüberküloz - Abstract
Background and Aims:Abdominal tuberculosis is still seen in immunocom-petent adults in developing countries. The accurate diagnosis of abdominal tuberculosis requires a high index of suspicion and combination of diagnos-tic modalities in clinic practice and is time-consuming. Materials and Met-hods: The records of 24 patients (10 females, mean age: 40 years, range: 21-68 years) diagnosed with abdominal tuberculosis between January 2000 and December 2011 were analyzed retrospectively. Patients' characteristics, labo-ratory investigations, and radiological, endoscopic and surgical findings we-re evaluated. Follow-up information was obtained by telephone contact and scheduled visits. Results: 24 patients were enrolled in the study. The most frequent symptoms were abdominal pain (n=19, 79%), fever (n=20, 83%), ascites (n=8, 33%), diarrhea (n=10, 42%), and weight loss (n=16, 66%). Su-bacute/acute intestinal obstruction was found in 5 cases. Past history of treat-ment for tuberculosis and family history of tuberculosis were present in 4 (16%) and 5 (21%) patients, respectively. The basis of diagnosis of abdomi-nal tuberculosis were histopathology obtained by endoscopic/colonoscopic biopsies in 8 (33%), ultrasound/computed tomography-guided biopsies in 5 (21%), laparoscopic/surgical interventions in 7 (29%), and ascites examinati-ons in 2 (8%) patients. Microbiological tests were positive in only 4 (17%) patients. The predominant site of involvement by abdominal tuberculosis was intestinal in 12 (50%), peritoneal in 8 (33%), and solid viscera/nodal in 4 (16%) cases. Conclusions: Abdominal tuberculosis is a complex disease with non-specific symptomatology. Combination of a high index of clinical suspi-cion and use of multiple adjuvant diagnostic tools is required to make the correct diagnosis., Amaç:Abdominal tüberküloz halen gelişmekte olan ülkelerde immun yetmezliği olmayan bireylerde görülebilen bir hastalıktır. Kesin tanı öncelikle bu hastalıktan şüphelenilerek ve farklı tanı metotlarını bir arada kullanarak mümkündür ve uzun zaman alabilir. Gereç ve Yöntem: Ocak 2000 ile Aralık 2011 tarihleri arasında kliniğimizde abdominal tüberküloz tanısı konulan 24 hastanın kayıtları retrospektif olarak analiz edildi. Demografik özellikler, laboratuar kayıtları, radyolojik, endoskopik ve cerrahi bulgular değerlendirildi. Takipler hastalara randevu verilerek veya telefonla yapılan görüşmelerle sağlandı. Bulgular: Toplam 24 hasta çalışmaya dahil edildi (10 bayan, ortalama yaş: 40, dağılım: 2168). Hastaların en sık klinik semptomu ateş (20, %83), karın ağrısı (19, %79), iştahsızlık (17, % 71), kilo kaybı (16,%66), gece terlemesi (12,%50), ishal (10,%42), asit (8, %33) olarak saptandı. Subakut/akut intestinal obstrüksiyon olguların 5'inde (%21) saptandı. Hastaların 4'ünde (%16) geçirilmiş pulmoner tüberküloz hikâyesi, 5'inde (%21) ailede tüberküloz hikâyesi mevcuttu. Hastaların 12'sinde (%50) intestinal tutulum saptanırken, 8'inde (%30) peritoneal ve 4'ünde nodal tutulum saptandı. ‹ntestinal tutulum gösteren hastaların 9'unda (%75) ileoçekal bölgede lezyon saptandı. Abdominal tüberküloz tanısı 8 (33%) hastada endoskopik/ kolonoskopik biopsilerin histopatolojik incelemesiyle, 5 (21%) hastada abdominal ultrason/tomografi rehberliğinde yapılan biyopsilerle, 7 (29%) hastada laparoskopik/cerrahi girişimle, 2 (8%) hastada da asit incelemeleri ile kondu. Mikrobiolojik incelemelerde pozitişik sadece 4 (17%) hastada saptandı. Sonuç: Abdominal tüberküloz spesifik olmayan semptomatolojisi ile karmaşık bir hastalıktır. Tanısını koymak için öncelikle şüphelenmek ve bir çok tanı metotlarını bir arada kullanmak gerekir.
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- 2015
4. An intestinal tuberculosis case diagnosed by bone marrow biopsy
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ERGÜN, Meltem, AYDOĞ, Gülden, BAŞARANOĞLU, Metin, ÜLKER, Aysel, TUNÇ, Bilge, ÖKTEN, Sarper, and ŞAŞMAZ, Nurgül
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Gastrointestinal tuberculosis,abdominal tuberculosis,intestinal tuberculosis ,Gastrointestinal tüberküloz,abdominal tüberküloz,intestinal tüberküloz - Abstract
İntestinal tüberküloz gelişmekte olan ülkelerde halen görülmekte olan ve vakaların yaklaşık 1/3'ünde pulmoner tüberkülozun eşlik ettiği bir hastalıktır. Özellikle pulmoner tüberkülozu olmayan vakalarda tanı koymak güçtür. Spesifik olmayan semptomatolojisi, Crohn hastalığıyla karışabilen yönleri ve tanı; koymaya yönelik testlerin farklı sensitivite ve spesifiteleri nedenleriyle tanı öncelikle bu hastalıktan şüphelenmek ve multiple diagnostik metodları bir arada kullanarak konulabilir. Burada sunduğumuz 30 yaşında diare, karın ağrısı, kilo kaybı şikayetleri ile başvuran anemi, hipoalbüminemisi saptanan ve kolonoskopik incelemede ileoçakal valv ve ileum ülserleri bulunan bayan hastada öncelikle Crohn hastalığı düşünülerek tedavi verilmiş ancak klinik yanıtsızlık nedeniyle yapılan uzun araştırmalar sonunda intestinal tüberküloz tanısı konulabilmiştir., Intestinal tuberculosis is still seen in developing countries, and approximately one-third of the cases are accompanied by pulmonary tuberculosis. Because of the non-specific symptomatology, similar findings to Crohn's disease and different sensitivity and specificity rates of diagnostic tests, a high index of suspicion and combination of multiple diagnostic modalities are required to diagnose intestinal tuberculosis. A 30-year-old woman was admitted to our hospital with a two-year history of diarrhea, abdominal pain and weight loss. Laboratory tests showed anemia and hypoalbuminemia, and ulcers were found in the ileum and ileocecal valve on colonoscopic examination. Crohn's disease was diagnosed, but there was no clinical remission with mesalazine and steroid treatment. Intestinal tuberculosis was diagnosed after an extended work-up period.
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- 2015
5. Enterovesical fistula in Crohn's disease causing a view similar to bladder tumor
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BİLGE, Zülfükar, TUNÇ, Bilge, TORUN, Serkan, YILDIZ, Hakan, SUNA, Nurettin, ÖZİN, Yasemin Özderin, and ŞAŞMAZ, Nurgül
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Crohn's disease,bladder tumor,enterovesical fistula ,digestive system diseases ,Crohn hastalığı,mesane tümörü,enterovezikal fistül - Abstract
Crohn's disease is of unknown origin and may involve the gastrointestinal tract from the mouth to the anus. The course of this disease may be inflammatory or cause stricturing or fistulas. The majority of fistulas in Crohn's disease are in the perianal region. Rarely, fistulas in Crohn's disease can be enterovesical, which may cause urinary tract infection, pneumaturia and fecaluria. It can sometimes lead to bladder inflammatory masses. Especially in patients with a history of rheumatic disease, such as ankylosing spondylitis, and in the presence of findings suggestive of enterovesical fistula, such as fecaluria and pneumaturia, Crohn's disease should be considered, Crohn hastalığı ağızdan perianal bölgeye kadar tüm gastrointestinal sistemi tutabilen, etyolojisi tam olarak bilinmeyen bir hastalıktır. Hastalı k obstrüktif stenozan ya da fistülizan şekilde seyredebilir. Crohn hastalığı nda görülen fistüllerin büyük çoğunluğu perianal bölgede olur. Enterovezikal fistüller Crohn hastalığında daha nadir görülür. Tekrarlayan üriner sistem enfeksiyonlarına, pnömatüri ve fekalüri gibi şikayetlere yol açarlar. Bazen de mesanede inşamatuvar kitlelere yol açabilirler. Özellikle ankilozan spondilit gibi romatolojik bir hastalık öyküsü olan hastalarda enterovezikal fistülü çağrıştıran pnömatüri ve fekalüri gibi şikayetlerin de varlığında Crohn hastalığı mutlaka göz önünde bulundurulmalı dır.
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- 2015
6. A rare case of Crohn's disease with involvement of the vulva
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TUNÇ, Bilge, BİLGE, Zülfükar, TAŞKIRAN, İsmail, YÜKSEL, Mahmut, AYDINLI, Onur, and KAYAÇETİN, Ertuğrul
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integumentary system ,Crohn's disease,vulva ,skin and connective tissue diseases ,Crohn hastalığı,vulva - Abstract
Crohn's disease can involve any part of the gastrointestinal tract, and is a disease that causes transmural inflammation in the areas of involvement. The disease can also have frequent extraintestinal manifestations. The most common skin lesions in patients are erythema nodosum and pyoderma gangrenosum. There are relatively few reported cases in the literature of Crohn's disease with vulvar involvement. In the case of vulvar involvement in Crohn's disease, a greater number of articles and large case series are needed to understand treatment options and the course of the lesions, Crohn hastalığı gastrointestinal sistemin herhangi bir bölümünü tutabilen ve tutulan bölgelerde transmural inflamasyona yol açabilen bir hastalıktır. Hastalık aynı zamanda sık görülen ekstraintestinal tutulumlarla da gidebilir. Hastalarda en sık görülen deri tutulumu eritema nodozum ve pyoderma gangrenosum şeklindedir. Literatürde vulvar tutulumu olan Crohn hastalığı ile ilgili bildirilen vaka sayısı oldukça azdır. Crohn hastalığında vulvar tutulumun olması durumunda lezyonun seyri ve tedavi seçeneklerini anlamak için daha fazla sayıda bildiriye veya geniş vaka serilerine ihtiyaç vardır.
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- 2015
7. Left paraduodenal hernia: Multidetector computerized tomography findings
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ACU, Ruşen, ÖKTEN, Sarper, KÜÇÜKAY, Fahrettin, TUNÇ, Bilge, KALKAN, İsmail Hakkı, and ÖLÇER, Tülay
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İnternal herni,paraduodenal herni,karın ağrısı,bilgisayarlı tomografi ,Internal hernia,Paraduodenal hernia,abdominal pain,computerized tomography - Abstract
Paraduodenal herniler, internal abdominal herniasyonun en sık rastlanan tipi olup vakaların yaklaşık %50'sini oluşturur. Sol paraduodenal herni, sağa göre 3 kat daha fazla izlenir. Preoperatif dönemde nadiren tanınmakla birlikte semptomatik dönemde yapılan abdominal görüntüleme sayesinde tanıya gidilebilir. Bulantı, kusma ve karın ağrısı şikayetleri ile hastanemize başvuran ve yapılan abdominal bilgisayarlı tomografi incelemesi sonrasında sol paraduodenal herni saptanan olguyu bildiriyoruz., Paraduodenal herniae are the most common internal herniae, accounting for 50% of the cases. Leftsided herniae are three times more common than rightsided paraduodenal herniae. Diagnosis is rarely made preoperatively but abdominal imaging helps to detect symptomatic cases early on. We report a case of left-sided paraduodenal hernia presented with nausea, vomiting and abdominal pain, diagnosed after abdominal computerized tomography.
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- 2015
8. The predictive value of Beta-2 Microglobulin levels to determine activity of inflammatory bowel disease
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TUNÇ, Bilge, KILIÇ, Z.mesut Yalın, AKTAŞ, Semra, PARLAK, Erkan, ÜLKER, Aysel, and BALCI, Mustafa
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Crohn hastalığı,ülseratif kolit,β-2 mikroglobulin ,Crohn disease,ulcerative colitis,β-2 microglobulin ,digestive system diseases - Abstract
Background and aims: Serum β-2 microglobulin levels increase in all chronic inflammatory and autoimmune diseases. This incease is linked to the severity and extant of inflammation. The aim of our study was to evaluate value of serum β-2 microglobulin levels to determine Crohn disease activity. Material and methods: A total of 116 subjects (46 ulcerative colitis, 25 Crohn's disease, 55 Healthy controls) were included in the study. Ulcerative colitis and Crohn's disease patients were divided into three groups according to disease activity: Active, partial remission, complete remission. Chron's disease subjects were classified according to their treatment response as: responsive (complete or+ partial remission) and unresponsive (active). Subjects were divided into three groups according to the extent of disease: Distal, Left and Pancolitis for ulcerative colitis; ileitis, ileocolitis and colitis for Crohn's disease. All groups were compared for the mean Serum β-2 Microglobulin levels. Results: In both Crohn's disease and ulceratice colitis groups mean β-2 microglobulin levels were significantly higher than healthy (control) group (p, Giriş ve amaç: Serum β-2 Mikroglobulin düzeyleri tüm inflamatuvar ve otoimmun hastalıklarda artar. Bu artış inflamasyonun şiddeti ve yaygınlığı ile ilişkilidir. Çalışmamızın amacı, kronik inflamatuvar hastalıklardan olan Crohn hastalığının aktivitesini belirlemekte serum β- 2 Mikroglobulin düzeylerinin değerinin incelemektir. Gereç ve yöntem: Toplam 117 olgu (46 ülseratif kolitis, 25 Crohn hastalığı, 55 sağlıklı- K) çalışma kapsamına alınmıştır. Ülseratif kolit ve Crohn hastaları hastalık aktivitesine göre 3 gruba ayrılmışlardır: Aktif, kısmi remisyon, komplet remisyon. Crohn hastalığı olguları tedaviye yanıtları açısından: yanıtlı (komplet + kısmi remisyon) ve yanıtsız (aktif) olarak gruplandırıldılar. Hastalığın yayılımına göre ülseratif kolit olguları: distal, sol, pankolit; Crohn hastalığı olguları: ileit, ileokolit, kolit gruplarına ayrıldılar. Tüm bu gruplar β-2 mikroglobulin düzeylerine göre karşılaştırıldılar. Bulgular: Crohn hastalığı ve ülseratif kolit gruplarının ikisinde de ortalama serum β-2 Mikroglobulin düzeyleri sağlıklı (kontrol) gruptan belirgin olarak yüksekti (p0,05). Tedaviye yanıt açısından Crohn hastalarında yanıtsız grubun β-2 mikroglobulin düzeyleri yanıtlı grubunkinden istatistiksel olarak anlamlı derecede yüksekti (p0,05). Sonuç: Crohn hastalığında inflamasyonda hücresel immunitenin rolü fazladır. Bu nedenle serum β-2 mikroglobulin düzeyleri daha yüksek bulunur ve aktivite parametresi olarak kullanılabilir.
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- 2015
9. Benign özofagus darlıklarının etyolojisine göre Savary-Gilliard buji dilatasyonunun etkinliği
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ALTINTAŞ, Engin, TUNÇ, Bilge, KAÇAR, Sabite, SEZGİN, Orhan, PARLAK, Erkan, ALTIPARMAK, Emin, SARITAŞ, Ülkü, and ŞAHİN, Burhan
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Benign esophageal strictures,bougie dilation,endoscopic therapy ,Benign özofagus darlığı,buji dilatasyonu,endoskopik tedavi - Abstract
Background and aims: Bougie dilatation is effective treatment for benign esophageal strictures, and should be utilized as primary therapy for most strictures. We aimed to evaluate the effectiveness of Savary- Gilliard bougie dilators according to the etiology of benign esophageal strictures such as peptic anastomotic, and postradiotherapy. Materials and methods: Between May 1995 and March 1999, 21 patients were followed in the "Therapeutic Endoscopy Group" and underwent a total of 97 dilatation sessions. The anastomotic group was composed of nine patients (8M, IF) (mean 64 years, range 16-68), the peptic group of eight patients (5M, 3F) (mean 39.2 years, range 15-65), and the postradiotherapy group of four patients (1M,3F) (mean 62.5 years, range 51-76). Dilation of 15mm was considered successful. Periodic dilation index was estimated by rating total dilation number to follow up time (months). Results: There was no difference between these group with respect to age, sex, localization, symptoms recurrence frequency, total dilatation number and dilatation number per month. When the anastomotic group (6/9, 66.7%) was compared with the peptic group (5/8, 62.5%), the success of the Savary-Gilliard bougie dilators was significantly different (p=0.04). Conclusion: In view of the varied etiology of benign esophageal strictures, esophageal dilation should be chosen as first therapy., Giriş ve amaç: Buji dilatasyon tedavisi benign özofagus darlıkları için etkin ve birçok darlık için birinci basamak tedavidir. Bu çalışmanın amacı benign özofagus darlıklarının etyolojilerine göre Savary-Gilliard buji dilatasyonunun etkinliğini araştırmaktır. Gereç ve yöntem: Mayıs 95-Mart 99 yılları arasında Terapötik Endoskopi Grubu'nda takip edilen ve toplam 97 seans dilatasyon uygulanan 21 hastanın sonuçlarını değerlendirdik. Bu hastaların 9'u (8E,1K) cerrahi sonrası darlık (ort. 64 yaş, erim 16-68 yaş), 8'i (5E,3K) peptik darlık (ort.39.2 yaş,erim 15-65 yaş), 4'ü (1E,3K) radyoterapi sonrası darlık (ort.62.5 yaş,erim 51-76 yaş) şeklindeydi. Ondört mm'ye kadar dilatasyonu yeterli olarak kabul ettik. Periyodik dilatasyon indeksini; dilatasyon sayısını takip edilen süreye (ay olarak) oranlayarak hesapladık. Bulgular: Gruplar arasında yaş, cinsiyet, lokalizasyon, semptomların tekrarlama sıklığı, toplam dilatasyon sayısı ve periyodik dilatasyon indeksi açısından fark yoktu. Yalnızca dilatasyon tedavisinin başarısı açısından cerrahi sonrası darlıkla peptik darlık arasında istatistiki olarak anlamlı bir fark saptandı (p=0.04). Sonuç: Benign özofagus darlıklarının tedavisinde etyolojisine bakılmaksızın disfajinin sağaltımı asıl amaçtır. Her ne kadar peptik darlıklar güç dilate edilseler de seçilecek ilk tedavi dilatasyon olmalıdır.
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- 2015
10. Tek merkeze ait hepatosellüler karsinom verileri; retrospektif çalışma
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ARHAN, Mehmet, AKDOĞAN, Meral, İBİŞ, Mehmet, KILIÇ, Z. Mesut Yalın, KAÇAR, Sabite, TUNÇ, Bilge, and ŞAŞMAZ, Nurgül
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Hepatocellular carcinoma,etiology,alpha-fetoprotein ,Hepatosellüler karsinom,etiyoloji,alfa-fetoprotein - Abstract
Background and Aims: There is a lack of information about hepatocellular carcinoma in Turkey. Therefore, we aimed to present the data regarding the tumor characteristics and records of patients followed for hepatocellular carcinoma in a specific time period. Materials and Methods: We retrospectively reviewed the records of our patients diagnosed as hepatocellular carcinoma between 2000 and 2006. Results: There were 98 patients (12.2% F, 87.8% M). The mean age of the patients was 60.6±9.6 years. HBV (+) patients were significantly younger than HCV (+) patients. Alcohol abuse was the etiological factor in 5.1% of the patients, and no etiologic cause could be identified in 5.1% of the patients. The distribution of the patients with cirrhosis was as follows: Child A, 33.3% of patients; Child B, 39.5% of patients; and Child C, 27.2% of patients. Portal vein thrombosis was found in 8.2% of the patients. Serum alpha-fetoprotein levels were as follows: >200 ng/ml in 30.6%, 5 cm in 26.5% of the patients. Nodules were localized in the right lobe in 56.2% and left lobe in 17.3%, and were bilateral in 26.5% of the patients. 59.2% of the patients were treated with alcohol ablation and 11.2% with chemoembolization. 4.1% of the patients received surgical therapy. 21.4% of the patients received symptomatic therapy, 2% systematic chemotherapy and 2% underwent liver transplantation. Conclusions: Hepatocellular carcinoma is usually seen in older male patients. Viral etiology, especially HBV, remains the most important etiological factor in our country., Giriş ve Amaç: Hepatosellüler karsinomla ilgili ülkemize ait veriler oldukça azdır. Bu nedenle, belirli zaman diliminde kliniğimizde hepatosellüler karsinom tanısı ile takip edilen hastalara ve tümöre ait tanımlayıcı verileri sunmayı amaçladık. Gereç ve Yöntem: Kliniğimizde 2000–2006 yılları arasında hepatosellüler karsinom tanısı alan hastalara ait kayıtlar tarandı. Bulgular: Hepatosellüler karsinomlu 98 hastanın %12,2’si kadın ve %87,8’i erkekti. Hastaların yaş ortalaması 60,6±9,6 yıldı. HBV pozitif hastalar HCV pozitif hastalara göre anlamlı olarak daha gençti. Hastaların %84,7’sinde karaciğer sirozu vardı. Vakaların %63,3’ünde HBV, %22,5’inde HCV, %5,1’inde alkol kullanımı vardı ve %5,1’inde kronik karaciğer hastalığı etiyolojisi bulunamadı. Sirotik olguların %33,3’ü Child A, %39,5’i Child B ve %27,2’si Child C idi. Hastaların %8,2’de portal ven trombozu tespit edildi. Serum alfa-fetoprotein düzeyi olguların %30,6’da > 200 ng/ml, %41,8’de < 20 ng/ml ve %27,6’da 20–200 ng/ml arasında bulundu. Hastaların %54,1’de tek lezyon, %42,8’de ≥2 lezyon ve %3’de diffüz tip tespit edildi. Hastalarımızın %26,5’de < 3 cm, %42,9’da 3-5 cm ve %26,5’de > 5 cm büyüklüğünde lezyon tespit edildi. Lezyonlar hastaların %56,1’de sağ lobda, %17,3’de sol lobda ve %26,5’de her iki lobda saptandı. Hastaların %59,2’ne alkol ablasyon, %11,2’ne kemoembolizasyon, %4,1’ne cerrahi rezeksiyon uygulandı. Hastalarımızın %21,4’üne semptomatik tedavi, %2’sine sistemik kemoterapi ve %2’sine karaciğer transplantasyonu yapıldı. Sonuç: Hepatosellüler karsinom ileri yaşlarda özellikle erkeklerde sık görülür ve hepatosellüler karsinom için ülkemizde halen viral etiyoloji, özellikle HBV en önemli risk faktörüdür.
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- 2015
11. Endoskopik yöntemle tedavi edilen bir duodenal duplikasyon kisti olgusu
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KALKAN, İsmail Hakkı, TUNÇ, Bilge, DİŞİBEYAZ, Selçuk, ÖZTAŞ, Erkin, PARLAK, Erkan, and ŞAŞMAZ, Nurgül
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Duodenal duplikasyon kisti,iğne uçlu sfinkterotom,snare polipektomi ,Duplication cyst of the duodenum,needle knife sphincterotome,snare polypectomy - Abstract
Nineteen years old female patient presented with a history of intermittant ab-dominal pain. Her abdominal ultrasonography and CT revealed a 3 cm du-odenal duplication cyst located between second and third parts of the duode-num. Endoscopic needle knife sphincterotome and snare polypectomy met-hods performed succesfully at two different sessions for this rare disease., Ondokuz yaflnda genç bayan hasta tekrarlayan karn a¤rs flikayeti ile bafl-vurdu. Abdominal ultrasonografi ve tomografi tetkikleri sonucunda duode-num 2. ve 3. ksmlar arasnda 3 cm'lik bir duplikasyon kisti tespit edildi. Bu nadir hastalık için iki ayrı seansta endoskopik sfinkterotomi ve snare polipektomi yöntemleri başarı ile uygulandı
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- 2015
12. İnflamatuvar barsak hastalıkları aktivitesi ile serum neopterin düzeyi arasındaki ilişki
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ERTUĞRUL, İbrahim, YOLCU, Ömer Faruk, CESUR, Salih, DAĞLI, Ülkü, BAŞAR, Ömer, YÜKSEL, İlhami, ÇAKAL, Başak, ÖZİN, Yasemin Ö., İBİŞ, Mehmet, ATASEVEN, Hilmi, TUNÇ, Bilge, ÜLKER, Aysel, and ŞAŞMAZ, Nurgül
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Neopterin,inflammatory bowel diseases,Crohn's disease,ulcerative colitis ,Neopterin,inflamatuvar barsak hastalığı,crohn hastalığı,ülseratif kolit - Abstract
Background/aims: The etiology of inflammatory bowel diseases, chronic intestinal diseases characterized by remissions and activation periods, is still unknown. Identification of the active period is important because it guides the therapy and point outs the prognosis. To date, there is still a lack of agreement on determining the active state. Neopterin is produced in monocytes/macrophages primarily upon stimulation with interferon-gamma. It is a marker associated with cell-mediated immunity. The aim of this study was to investigate the role of serum neopterin levels in Crohn's disease and ulcerative colitis disease activity. Materials and methods: Sixty-one patients with ulcerative colitis (21 female, 40 male) and 27 patients with Crohn's disease (9 female, 18 male) who were followed up at Türkiye Yüksek İhtisas Hospital were enrolled into the study. Fiftytwo healthy controls (22 female, 30 male) were also enrolled. Neopterin is measured by enzyme-linked immunosorbent assay. Serum levels >10 nmol/L are regarded as elevated. Patients with malignancy and systemic infectious diseases were not included in the study. For statistical analysis, one-way ANOVA, Pearson correlation analysis test, Fisher's exact test, Mann-Whitney U test and Student's test were used. Significance was established at p
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- 2015
13. Kişisel gözlemimiz ve literatürden derlenmiş bilgiler ışığında tam netleşmemiş bir klinik antite olarak kolesterolozis
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ÖZBAĞI, Tuna, ÇAKAR, Kenan Sami, MALKOÇ, Gültekin, and TUNÇ, Bilge
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Kolesterolozis,safra kesesi ,Cholesterolosis,gallbladder - Abstract
Background/aim: Cholesterolosis of the human gallbladder has long been considered as a histomorphological entity. Although its etiology has not been fully understood, recognition of cholesterolosis by the pathologist is easy. Recently it has been questioned whether it is a clinical as well as a histomorphological entity, and it has been reported that it could cause symptoms. Materials and methods: In the Pathology Department of SSK Gazi Hospital, we examined 118 cholecystectomy specimens of patients who were operated because of chronic cholecystitis and/or cholelithiasis and reviewed the histopathologic diagnoses regarding the existence of cholesterolosis. Results: We found cholesterolosis in 21 cases (11.6%) of 118 cholecystectomy specimens. All cases were female and ages ranged between 37 and 75 (median: 60). Eleven cases (5.8%) had cholesterolosis with chronic calculous cholecystitis and 8 cases (4.3%) had cholesterolosis with cholelithiasis. Remarkably, we found 2 cases (1.5%) in whose specimens cholesterolosis was the only histopathological finding. Conclusion: In the literature it has also been emphasized that cholesterolosis might cause clinical symptoms and that it should be suspected in patients with symptoms suggestive of biliary disease and with no abnormality on cholecystography or ultrasonography. When cholesterolosis is detected, an appropriate curative approach (clinical following symptomatic supportive treatment, and even cholecystectomy in patients with biliary colic episodes) would prevent the patient's suffering from being symptomatic., Giriş ve amaç: Etyolojisi net olarak aydınlatılamamakla birlikte histopatolojik açıdan kolayca teşhis edilerek daha ziyade histomorfolojik bir antite olarak yaklaşılan safra kesesi kolesterolozisinin klinik açıdan da sorgulanmaya başlandığı görülmekte, semptomlara neden olabileceği bildirilmektedir. Kolesterolozise kolesistektomi spesmenlerinin %10- 25'inde rastlandığı belirtilmektedir. Gereç ve yöntem: SSK Gazi Hastanesi (TCDD Ankara Hastanesi) Patoloji departmanına gönderilen ve 1995-2004 yılları arasında klinikoultrasonografik olarak kolelityazis ve/veya kronik kolesistit tanısıyla opere edilen 118 olgunun kolesistektomi spesmenlerindeki histopatolojik özellikler ve tanı raporları kolesterolozis varlığı yönünden incelenmiştir. Bulgular: 118 olgudan 21'inde (% 11,6) kolesterolozis varlığı saptanmıştır. Kolesterolozisli olguların hepsi kadın hasta olup yaşları 37-75 arasında değişmektedir. Ortalama yaş 56,4'tür (median: 60). 11 olguda (% 5,8) kolesterolozis ve kronik taşlı kolesistit; 8 olguda (% 4,3) kolesterolozis ve kolelityazis birlikteliği gözlenmiş, ilginç olarak 2 olguda (% 1,5) ise histopatolojik olarak yalnı z kolesterolozis tanısı verildiği dikkati çekmiştir. Sonuç: Literatürde de kolesterolozisin nadiren klinik semptomlara neden olabileceği, kolesistografik ve ultrasonografik olarak anomali tespit edilemeyen biliyer sistem rahatsızlığı düşünülen hastalarda kolesterolozis olasılığının düşünülmesi gerektiği vurgulanmaktadır. Kolesterolozis saptanması durumunda, gözlenen semptomlara göre klinik takip veya konservatif destek tedavisi gerekliliği, biliyer kolik episodlarının gözlendiği pür kolesterolozis olgularında ise kolesistektomi uygulanabileceği belirtilmektedir.
- Published
- 2015
14. Comparison of demographic and clinical characteristics of patients with early vs. adult vs. late onset ulcerative colitis
- Author
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Kalkan, İsmail Hakkı, primary, Dağli, Ülkü, additional, Öztaş, Erkin, additional, Tunç, Bilge, additional, and Ülker, Aysel, additional
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- 2013
- Full Text
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15. Efficacy and Safety of Azathioprine Therapy in Turkish Patients with Inflammatory Bowel Disease: A Retrospective Long Term Follow Up Study
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ÖNAL, İbrahim Koral, primary, ARHAN, Mehmet, additional, ÖZİN, Yasemin, additional, TAŞ, Adnan, additional, SEZER, Semih, additional, TUNÇ, Bilge, additional, and ÜLKER, Aysel, additional
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- 2011
- Full Text
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16. The role of red cell distribution width as a marker in inflammatory bowel disease
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ARHAN, MEHMET, primary, ÖNAL, İBRAHİM KORAL, primary, TAŞ, ADNAN, primary, KURT, MEVLÜT, primary, KALKAN, İSMAİL HAKKI, primary, ÖZİN, YASEMİN, primary, TUNÇ, BİLGE, primary, and ÜLKER, AYSEL, primary
- Published
- 2011
- Full Text
- View/download PDF
17. Conscious sedation during endoscopic retrograde cholangiopancreatography: midazolam or midazolam plus meperidine?
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Yüksel, Osman, primary, Parlak, Erkan, additional, Köklü, Seyfettin, additional, Ertugrul, İbrahim, additional, Tunç, Bilge, additional, and Şahin, Burhan, additional
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- 2007
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18. Serous Cystadenoma of the Pancreas Presenting as a Third Primary Neoplasm
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Köksal, Aydın Şeref, primary, Ülker, Aysel, additional, Asıl, Mehmet, additional, Tunç, Bilge, additional, Kemal, Arda, additional, Şavkılıoğlu, Metin, additional, Özoğul, Yusuf, additional, and Turhan, Nesrin, additional
- Published
- 2003
- Full Text
- View/download PDF
19. Colonic tuberculosis or Crohn's disease ? An important differential diagnosis.
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Arhan, Mehmet, Köksal, Aydın Şeref, Özin, Yasemin, Yalın Kılıç, Z. Mesut, Tunç, Bilge, and Ülker, Aysel
- Published
- 2013
20. Serous Cystadenoma of the Pancreas Presenting as a Third Primary Neoplasm
- Author
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Şeref Köksal, Aydın, Ülker, Aysel, Asıl, Mehmet, Tunç, Bilge, Kemal, Arda, Şavkılıoğlu, Metin, Özoğul, Yusuf, and Turhan, Nesrin
- Abstract
Serous cystadenomas are the most common cystic neoplasms of the pancreas. They may occur solely or coexist with other neoplasms. A 10 cm mass involving the body of the pancreas was observed in the computed tomography of a 61-year-old man with a previous history of bladder and prostate carcinoma. Ultrasonography and computed tomography of the mass demonstrated multiple small cysts associated with a central calcified scar. A distal pancreatectomy was performed. Pathological examination confirmed the diagnosis of serous microcystic adenoma. This is the first report of a serous cystadenoma of the pancreas with two metachronous neoplasms. This feature should be kept in mind during the diagnosis and evaluation of patients with serous cystadenoma.
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- 2003
- Full Text
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21. Clinical course and predictors of total colectomy in ulcerative colitis; a referral center experience from Turkey.
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Kalkan İH, Dağlı Ü, Kekilli M, Öztaş E, Tunç B, and Ülker A
- Subjects
- Adolescent, Adult, Age of Onset, Aged, Aged, 80 and over, Chronic Disease, Colitis, Ulcerative drug therapy, Colitis, Ulcerative pathology, Disease Progression, Female, Follow-Up Studies, Humans, Male, Medical Records statistics & numerical data, Middle Aged, Multivariate Analysis, Retrospective Studies, Severity of Illness Index, Steroids therapeutic use, Tertiary Care Centers, Turkey, Young Adult, Colectomy statistics & numerical data, Colitis, Ulcerative surgery
- Abstract
Background/aims: We aimed to describe the clinical course of Ulcerative colitis (UC) and the factors that predict the need for total colectomy in Turkish patients with severe UC receiving regular follow up., Materials and Methods: We analyzed the demographic and clinical characteristics of 612 patients with UC receiving regular follow up between 1994 and 2010 in a tertiary referral center in Ankara., Results: Men accounted for 58% of patients (M:F ratio, 1.4:1), and the mean age at diagnosis was 37.9 years. Of these, 32% had distal colitis and 8.8% had further extension, and 39 patients (6.4%) had chronic active disease. Steroid dependency and steroid resistance rates were 7.5% and 17.2%, respectively. In multivariate analysis, steroid dependency (p=0.04), steroid resistance (p=0.002), further extension (p<0.001), presence of extensive disease (p=0.006), and chronic active disease (p<0.001) were independent predictors of the need for total colectomy. Patients with chronic active disease had lower total colectomy free survival (p<0.001)., Conclusion: The predictors of total colectomy were comparable with those previously reported in the literature. However, we identified further extension in disease localization to predict the need for total colectomy.
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- 2015
- Full Text
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22. Characterization of de novo colonic stricture due to Crohn's disease.
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Başaranoğlu M, Sayılır A, Yüksel M, Yıldız H, Suvak B, Turhan N, Tunç B, and Özin Y
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- Adult, Cecum diagnostic imaging, Colon diagnostic imaging, Colonic Diseases etiology, Constriction, Pathologic diagnostic imaging, Constriction, Pathologic etiology, Constriction, Pathologic pathology, Crohn Disease drug therapy, Endoscopy, Gastrointestinal, Female, Humans, Male, Middle Aged, Radiography, Rectum diagnostic imaging, Retrospective Studies, Young Adult, Colonic Diseases diagnostic imaging, Colonic Diseases pathology, Crohn Disease complications
- Abstract
Background/aims: The development of colonic stenosis is a rare complication of Crohn's disease (CD) without a surgical anastomosis history. So, the management and long-term follow-up results of colonic stricture due to CD have not been clearly defined. In this study, we aimed to characterize de novo colonic stricture due to CD., Materials and Methods: We evaluated 702 patients with CD to investigate colonic stricture. Colonic stricture was considered to exist when passage of a standard colonoscope was not possible and was diagnosed radiologically and endoscopically in this study., Results: Of the 702 patients, 14 had colonic stricture according to the definition above. Of the 14, 8 were male. The interval between diagnosis of disease and recognition of the stricture varied from 0 to 13 years. Localization of the strictures differed from the rectum to cecum. Of the 14, 3 patients had more than 1 stricture. Pathological examination of the stricture(s) did not show dysplasia or malignancy initially or during the follow-up., Conclusion: De novo colonic stricture due to CD is a rare condition according to the presented study's results. Distribution of the stricture(s) varied from the rectum to cecum without increased colonic cancer risk. We observed the antifibrotic role of thiopurines and biologic agents in this study.
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- 2014
- Full Text
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23. Antineutrophil cytoplasmic autoantibodies and anti-Saccharomyces cerevisiae antibodies in inflammatory bowel diseases.
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Kiliç ZM, Tunç B, Ayaz S, Filik L, Aktaş S, Parlak E, and Ulker A
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- Adolescent, Adult, Aged, Case-Control Studies, Colitis, Ulcerative complications, Colitis, Ulcerative diagnosis, Crohn Disease complications, Crohn Disease diagnosis, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Turkey, Antibodies, Antineutrophil Cytoplasmic blood, Antibodies, Fungal blood, Colitis, Ulcerative blood, Crohn Disease blood, Saccharomyces cerevisiae immunology
- Abstract
Background/aims: Perinuclear antineutrophil cytoplasmic autoantibody is a marker for ulcerative colitis, and anti-Saccharomyces cerevisiae antibody is known to be associated with Crohn's disease. The purpose of this study was to search the value of detecting perinuclear antineutrophil cytoplasmic autoantibody and anti-Saccharomyces cerevisiae antibody for the diagnosis of Turkish inflammatory bowel disease patients., Methods: Serum samples were obtained from 80 patients with ulcerative colitis, 61 patients with Crohn's disease and 40 healthy controls. Determination of both anti-Saccharomyces cerevisiae antibody and antineutrophil cytoplasmic autoantibody was performed with the standardized enzyme-linked immunosorbent assay., Results: In cases with ulcerative colitis, 65% tested seropositive for antineutrophil cytoplasmic autoantibody, whereas the controls showed 2.5% positivity. In cases with Crohn's disease, 63.9% tested seropositive for anti-Saccharomyces cerevisiae antibody, whereas the controls showed 2.5% seropositivity. The combination of a positive anti-Saccharomyces cerevisiae antibody test and a negative antineutrophil cytoplasmic autoantibody yielded a sensitivity and specificity of 32.0% and 97.5%, respectively. The combination of a positive perinuclear antineutrophil cytoplasmic autoantibody and a negative anti-Saccharomyces cerevisiae antibody test yielded a sensitivity and specificity of 44.2% and 97.5%, respectively., Conclusions: Both serologic tests may aid in the differential diagnosis of inflammatory bowel disease.
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- 2004
24. Esophageal variceal ligation for acute variceal bleeding: results of three years' follow-up.
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Altintaş E, Sezgin O, Kaçar S, Tunç B, Parlak E, Altiparmak E, and Saritaş U
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- Adult, Esophageal and Gastric Varices complications, Esophageal and Gastric Varices diagnosis, Esophagoscopy methods, Female, Follow-Up Studies, Gastrointestinal Hemorrhage complications, Gastrointestinal Hemorrhage diagnosis, Humans, Ligation methods, Liver Cirrhosis complications, Male, Middle Aged, Probability, Retrospective Studies, Risk Assessment, Severity of Illness Index, Time Factors, Treatment Outcome, Esophageal and Gastric Varices therapy, Gastrointestinal Hemorrhage therapy, Hemostasis, Endoscopic methods, Liver Cirrhosis diagnosis
- Abstract
Background/aims: Endoscopic variceal ligation is widely accepted as the optimum endoscopic treatment for esophageal variceal hemorrhage. However, the rebleeding course and long-term outcome of patients with esophageal variceal hemorrhage after ligation have been poorly defined. Therefore, we conducted a long-term follow-up study to delineate the outcome of ligation., Methods: Twenty-one liver cirrhotic patients with endoscopically proven esophageal variceal hemorrhage were treated by endoscopic variceal ligation. These patients received regular follow-up and detailed clinical assessment of at least 24 months., Results: Twenty-one eligible patients were followed up for a mean of 44.45 months (range 33.5-64 months). The mean number of sessions required to obtain eradication was 3.57+/-1.99 (range 1-8). Esophageal varices could be obliterated within 11.57+/-6.8 weeks (range 3-30). The percentage of variceal recurrence during follow-up was 57.14% (12/21) after endoscopic variceal ligation. Recurrence were observed in a mean of 34 months (median 29 months). Rebleeding from esophageal varices appeared in four patients (19.04%). The appearance rates of portal hypertensive gastropathy and fundal gastric varices after varice obliteration were found to be 45.45% (5/11) and 25% (3/12), respectively., Conclusions: Based on the results of long-term follow-up of endoscopic variceal ligation, although the percentage of variceal recurrence was high, endoscopic ligation achieved variceal obliteration faster and in fewer treatment sessions. Furthermore, endoscopic variceal ligation had a lower rate of rebleeding and of development of fundal gastric varices, but high portal hypertensive gastropathy.
- Published
- 2004
25. Pattern of gastrointestinal and psychosomatic symptoms across the menstrual cycle in women with inflammatory bowel disease.
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Parlak E, Dağli U, Alkim C, Dişibeyaz S, Tunç B, Ulker A, and Sahin B
- Subjects
- Abdominal Pain, Adult, Anxiety, Appetite, Colitis, Ulcerative complications, Colitis, Ulcerative physiopathology, Colitis, Ulcerative psychology, Constipation, Crohn Disease complications, Crohn Disease physiopathology, Crohn Disease psychology, Defecation, Diarrhea, Female, Flatulence, Headache, Humans, Irritable Bowel Syndrome complications, Irritable Bowel Syndrome physiopathology, Irritable Bowel Syndrome psychology, Irritable Mood, Nausea, Prospective Studies, Psychomotor Agitation, Severity of Illness Index, Sleep Initiation and Maintenance Disorders complications, Vomiting, Colitis, Ulcerative diagnosis, Crohn Disease diagnosis, Irritable Bowel Syndrome diagnosis, Menstrual Cycle
- Abstract
Background/aims: The purpose of this study was to determine the frequency of defecation, gastrointestinal (GI) and non-GI symptoms among women with ulcerative colitis (UC) (n=38) and Crohn's disease (CD) (n=21), and to compare the results with those from healthy women (n=38) across the menstrual cycle., Methods: Women were followed for three menstrual cycles with a symptom diary consisting of frequency of defecation, and GI and non-GI symptoms. One point was allowed for each symptom in the same phases of three cycles, and total scores for GI and non-GI symptoms were obtained., Results: Frequency of defecation was found to be higher during menstruation in controls and in remitting UC and CD. GI symptom scores were higher in all three phases in patients with CD. These decreased in the postmenstrual phase in controls, and in patients with UC and remitting CD. In all three cycles, non-GI symptom scores were higher in patients with CD. These symptoms decreased during the postmenstrual period in all three groups. The activation of UC and CD did not affect the non-GI symptom score in the same menstrual cycle. Patients on mesalamine had less GI and non-GI complaints than those on sulfasalazine in all phases. There was no correlation between GI and non-GI symptom scores during all menstrual phases., Conclusion: Cyclic pattern present in healthy women persisted in patients with UC and CD. Disease activity and the drug used may modify the severity of the symptoms.
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- 2003
26. The course of colonic disease in ulcerative colitis patients with primary sclerosing cholangitis.
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Parlak E, Ulker A, Alkim C, Ozderin Y, Dişibeyaz S, Tunç B, and Dağli U
- Abstract
Background/aims: Although there are many studies reporting that colonic dysplasia and cancer develop more frequently in ulcerative colitis patients with ulcerative colitis with primary sclerosing cholangitis, there are insufficient data on the course of the colonic disease. In this study, the course of the colonic disease in ulcerative colitis patients with primary sclerosing cholangitis was investigated., Methods: Data obtained from ten patients with total colitis and accompanying primary sclerosing cholangitis (three females, seven males, mean age: 44.5+/-10.0 years) were compared with data obtained from 64 patients with pancolitis but without primary sclerosing cholangitis (27 females, 37 males; mean age: 42.3+/-17.1 years)., Results: The follow-up period was 6.4+/-6.2 years in patients without primary sclerosing cholangitis, 12.7+/-6.2 years in total and 5.1+/-4.0 years (after development of the condition) in patients with primary sclerosing cholangitis (p<0.01). The number of disease attacks (3.7 attacks/yr vs. 0.5 attacks/yr), duration of the active disease (12.9+/-8.0 months vs. 0,3+/-1.0 months), the number of patients in whom corticosteroids were used (47 patients vs. one patient), the number of patients hospitalized (50 patients vs. one patient) and duration of hospitalization (1.2+/-0.8 months vs. 0,1+/-03 months) were higher in patients with than without primary sclerosing cholangitis (after development of the condition) (p<0.001). There was no significant difference in data obtained from patients with and without primary sclerosing cholangitis before development of the disease., Conclusions: Colonic disease subsides when primary sclerosing cholangitis develops. The higher frequency of colonic dysplasia and cancer seen in patients with primary sclerosing cholangitis can be explained by the fact that most of them have a longer duration of total colitis and fewer need total colectomy. Even though it does not seem to cause clinical problems, the colonic disease should not be ignored in these patients.
- Published
- 2002
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