Background: Peroxisome proliferator-activated receptor gamma (PPARγ) is a ligand dependent transcription factor involved in various processes, including carcinogenesis. We aimed to investigate any possible association of the PPARγ Pro12Ala (rs1801282) polymorphism with risk of developing gastric cancer (GC). Patients and Methods: A hospital based case control study was designed covering 50 patients with GC and 120 healthy controls. The frequencies of PPARγ Pro12Ala (rs1801282) were determined using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. Results: The Ala12 allele of the PPARγ Pro12Ala G gene was associated with a 1.95 fold increased risk of GC development (p: 0.022; 95% CI: 1.58-2.40). Subgroup analyses showed that the same allele was also associated with metastasis (p: 0.000; OR:4.09; 95%CI:2.273-7.368) and differentiation (p: 0.004; OR:1.95; 95%CI:1.335-2.875) in patients with GC. Conclusion: This study suggests that the PPARγ Pro12Ala G (Ala12) allele might be associated with development, differentiation and metastatic process of GC in the Turkish population. Further studies conducted in larger study groups and in different ethnic populations will be needed to clarify the exact role of the PPARγ Pro12Ala polymorphism in GC.
Objecti ve:In this study, we co mpared the results of patients who underwent laparoscopic and open ventral and incisional hern ia repair in our clin ic during last four years. Materials and Methods:The data of 76 patients who underwent surgery for ventral and incisional hernia between January 2012 and January 2016 in our clinic were analyzed retrospectively. The patients who underwent surgery for other types of abdominal wall hern ias (such as inguinal, femoral, Sp iegelian etc.) and patients who underwent primary repair without use of mesh were excluded. Forty-three patients (n: 43, 56,5%) whose operation was completed laparoscopically were defined as group1 and 33 patients (n:33, %43,5) who were operated using mesh with onlay technique were defined as group2. The cases were evaluated in terms of demographic data, body mass index (BMI), repair p rocedures, operation time, duration of hospital stay and postoperative complications. Results: In 44 patients, operation was initiated laparoscopically and in 43 were completed laparoscopically, whereas 33 patients were operated by open surgical technique. There was no significant difference in demographic data between these two groups. In the laparoscopic group, the operation time was significantly higher than the open group. However, the duration of hospital stay was significantly shorter. When the general comp lication rates during and after the surgery were co mpared, it was found that group 2 had significantly mo re comp lications. When the factors affecting recurrence
INTRODUCTIONAcute pancreatitis progresses on an instable course that has exacerbations and remissions. The mortality rate is between 2.1% and 7.8%. Development of necrosis increases mortality in pancreatitis. In patients with necrosis, the mortality rate increases up to 25% (1, 2). Contrast-enhanced computed tomography (CT) is the most important imaging technique to determine the severity of pancreatitis. However, recent studies suggest that the contrast agent for CT aggravates pancreatitis and provokes organ failure. In addition, the inability to administer contrast to patients with renal dysfunction and contrast allergy causes the disease to be assessed insufficiently (3).Limitations of CT have canalized clinicians to consider different imaging studies. It is believed that diffusion-weighted magnetic resonance imaging (DW MRI) may be compared to and may even replace CT. The severity of acute biliary pancreatitis was evaluated with contrast-enhanced CT and it was compared with DW MRI. MATERIAL AND METHODS PatientsThe patients diagnosed with acute biliary pancreatitis in the Department of General Surgery of İstanbul University by the School of Medicine using DW MRI and MRCP when cholestasis enzyme levels or bilirubin levels were elevated at the time of initial diagnosis were taken for a CT scan within 8 h. The results of two imaging techniques were compared. None of the patients had imaging contraindications such as metallic implant or claustrophobia for DW MRI. The patients' questionnaire included history of hepatic or biliary operations, hepatotoxic drug use, chronic alcohol use, hepatitis B or C carrier status, and suspicion of periam- Objective: The aim of this study was to compare contrast-enhanced computed tomography with diffusion-weighted magnetic resonance imaging in the evaluation of patients with acute biliary pancreatitis. Material and Methods:Fifty-three patients diagnosed with acute biliary pancreatitis, between February 2012 and July 2015, were evaluated using diffusion-weighted magnetic resonance imaging and magnetic resonance cholangiopancreatography to explain the elevation of cholestasis enzymes and bilirubin levels at İstanbul University. Contrast-enhanced computed tomography imaging was applied within 8 h following first evaluation. Demographic data, severity of pancreatitis, pancreatic apparent diffusion coefficient, and computed tomography severity index were compared. The significance of the results was evaluated using Statistical Package for the Social Sciences 21.0 program. Results:Median age was 53.39 (22-90) years in these 53 patients (26 were males and 27 were females). The mean Ranson criterion was 0.96 (0-4) and mean hospitalization duration was 16.02 (3-100) days. Twenty-eight patients were evaluated to have mild acute pancreatitis, whereas 16 were moderately severe and nine were severe based on the Revised Atlanta Classification. Mild pancreatitis score was 0.89, moderately severe pancreatitis score was 3.50, and severe pancreatitis score was 5.78 using the Balthazar score. Eleva...
Background Familial Mediterranean fever (FMF) is a clinical diagnosis and depends mainly on disease history of recurrent attacks of serositis. A history of recurrent arthritis with erythema over the involved joint (red arthritis) is considered an important feature of FMF and used as a tool in the clinic to distinguish it from other rheumatologic conditions. Objectives The aim of this study is to determine whether history of erythema over the joint would predict FMF compared to diseased controls. Methods We surveyed patients with FMF (n=100; M, F), gout (n=16), ankylosing spondylitis (AS) (n=55), inflammatory bowel disease (IBD), (n=51) rheumatoid arthritis (RA) (n=70), Behçet’s syndrome (BS) (n=50) and systemic lupus erythematosus (SLE) (n=50) followed in our rheumatology outpatient clinics. Only those who had joint involvement were analyzed. We used a 20-item questionnaire that sought details of joint involvement. All patients were shown a picture of erythema over the joint to confirm if they had experienced a similar condition. Results Demographic features and the number of patients with a history of erythema over the joint in each group are given in the Table. Erythema over the joint predicted a diagnosis of FMF compared to overall controls which included BS, SLE, RA, AS,IBD and gout with an odds ratio of 2.5 (95% CI 1.3-4.7) (p=0.002). When the odds ratio was calculated for each control group, erythema over the joint discriminated FMF from AS OR=3.2 (95% CI 1.2-9.0) (p=0.04) and RA OR=4.9 (95% CI 2.3-10.8) (p=0.001). If history of red arthritis with an onset before the age of 20 is considered, an OR of 22.8 (95% CI 8.8-61) is obtained, giving a sensitivity of 79.4% and a specificity of 85.4% for the diagnosis of FMF Table 1. Demographic characteristics and erythema over the joint frequency among the study groups Erythema over the joint,Erythema over the joint with an onset n (%)before the age of 20 FMF (n=57/100)37 (64.9)31 (54.3) 31/37 (83.7) RA (n=70/70)19 (27.14)3 (4.2) 3/19 (15.7) BD (n=23/50)13 (56.5)4 (17.3) 4/13 (30.7) SLE (n=25/50)13 (52)0 Gout (n=16/16)12 (75)0 AS (n=22/55)8 (36.3)1 (4.5) 1/8 (12.5) IBD (n=5/51)3 (60)0 Conclusions History of erythema over the joint (red arthritis) may discriminate FMF arthritis from certain arthritidies. The sensitivity and specificity improves significantly if age of onset of red arthritis is taken into consideration. This observation should be improved by including a control group consisting of other periodic fever syndromes. Disclosure of Interest None Declared
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