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Öğe Assessment of psychiatric diagnosis, alexithymia, temperament and character of patients with irritable bowel syndrome(2007) Taymur I.; Erberk-Özen N.; Boratav C.; Güliter S.Objective: It is well documented that there is a strong relationship with Irritable Bowel Syndrome (IBS) and stress. Indeed IBS is a psychosomatic disease of gastrointestinal system. In this study it is aimed to determine the anxiety and alexithymia levels and their association with temperament, and personality in both patient and healthy control groups. Method: Thirty-four patients with IBS according to Roma II Diagnostic Criteria and 32 healthy volunteers were included in the study. Patients with IBS and the healthy subjects were evaluated by DSM-IV diagnostic criteria, Temperament and Character Inventory (TCI), State and Trait Anxiety Inventory-II (STAI-II) and Toronto Alexithymia Scale-26 (TAS-26) have been applied. Results: Mean age of patients with IBS was 36.41±8.5 and average period of the illness was 6.65±5.8 years. 76.5% of IBS patients had at least one DSM-IV diagnoses. In IBS patient group, mean STAI-II score were significantly higher than the control group (p=0.001 and p=0.007, respectively). Among TCI subscales harm avoidance (HA) and self-transcendence (ST) mean score were significantly higher in IBS patient group than healthy controls (p=0.023 and p=0.039, respectively). The result of backward condition logistic regression analysis of total HA and total ST points in the sixth step were found to be a significant predictors of IBS's existence (in the sixth step it was found that 2 log likelihood: 80.615 and R 2=0.181). Conclusion: With respect to these psychiatric disorders or temperamental and characteristic properties they can have a role in occurrence and exacerbation of IBS.Öğe Can lansoprazole, amoxicillin, and clarithromycin combination still be used as a first-line therapy for eradication of helicobacter pylori?(2005) Güliter S.; Keleş H.; Özkurt Z.N.; Cengiz D.U.; Kolukisa E.Background/aims: To determine H. pylori eradication rate with lansoprazole-amoxicillin-clarithromycin treatment regimen, which is the most frequently used as first-line therapy, in the Kirikkale region. Methods: One hundred and five patients (44 male, 61 female) with H. pylori infection were included in the study. Patients were divided into two groups based on the endoscopic findings: non-ulcer dyspepsia (n=84, 31 male, 53 female) and acute gastric or duodenal ulcer (n=21, 13 male, 8 female) groups. The diagnosis of H. pylori infection was confirmed if both the urease test and histological examination, which were performed on endoscopic biopsies, were positive. Lansoprazole 30 mg, amoxicillin 1 g, and clarithromycin 500 mg were given twice daily for 14 days to all patients. Endoscopic biopsies were repeated for the evaluation of eradication three months after the treatment. Results: Ninety-six patients completed the study. Eradication rates were found to be 45.8% (44 of 96) in all patients, 42.1% (32 of 76 patients) in the non-ulcer dyspepsia group and 60% (12 of 20 patients) in the gastric or duodenal ulcer group for per protocol analysis, and the difference between non-ulcer dyspepsia and gastric or duodenal ulcer groups was not statistically significant (p=0.208). Conclusions: Lansoprazole-amoxicillin-clarithromycin treatment regimen, the most frequently preferred regimen in H. pylori eradication, is ineffective in our region. The low eradication rates observed with lansoprazole-amoxicillin-clarithromycin, at least in our region, bring into question its use as a first-line therapy. The use of alternative treatment protocols or antibiotic susceptibility test before the treatment may be helpful in achieving successful eradication with first-line therapy.Öğe Diffuse plane xanthomatosis in a patient with Budd-Chiari syndrome and monoclonal gammopathy(2009) Koçak M.; Keleş H.; Yakaryilmaz F.; Bozdoğan Ö.; Güliter S.Diffuse plane xanthomas are characterized by the presence of yellowish plaques on the eyelids, neck, upper trunk, buttocks, and flexural folds. Histology shows foamy histiocytes in the dermis. Approximately half of the cases are associated with lymphoproliferative disorders. Budd-Chiari syndrome is an uncommon condition induced by thrombotic or nonthrombotic obstruction of hepatic venous outflow. We present a case of diffuse plane xanthoma in a 62-year-old man who developed normolipemic plane xanthomas coinciding with Budd-Chiari syndrome and monoclonal gammopathy. We review the English-language literature regarding the rare association of xanthomas and Budd-Chiari syndrome.Öğe Familial Mediterranean fever and ankylosing spondylitis: A case report(2005) Güliter S.; Özkurt Z.N.; Keleş I.; Keleş H.; Aydin G.Familial Mediterranean fever (FMF) is an inherited disease characterized by recurrent attacks of fever and accompanying peritonitis, pleuritis, arthritis or erysipelas-like skin disease. The relationship between FMF and spondyloarthropathy (SpA) remains controversial. We described a particular case of 36-yr-old male patient with FMF and ankylosing spondylitis with negative HLA-B27. This case had late-onset FMF in spite of homozygote M694V mutation and his typical acute attacks of FMF began many years after the initiation of complaints related to sacroiliitis. There is no general consensus on whether the association of FMF and SpA is only an occasional coincidence or they are clinically and pathologically linked two conditions. Further studies with larger series are required to clarify the relationship between FMF and SpA.Öğe Role of macrophage microaggregation in the diagnosis of inflammatory colitis(Journal of Clinical and Analytical Medicine, 2014) Altunoglu A.; Tuncer C.; Erten S.; Kalkanci A.; Tunc B.; Uzum N.; Güliter S.Aim: Recent studies have advocated that the presence of macrophage microaggregations (MMA) may be a criterion in the diagnosis of Crohn's colitis (CC). In our study we aimed to investigate the role of MMA to differenti-ate ulcerative colitis (UC) and (CC). Material and Method: We analyzed the role of MMA in 29 patients with UC, 26 patients with CC and 22 healthy subjects without diagnosis of inflammatory bowel disease. For all subjects, esophagogastroduodenoscopy was performed. Biopsies were taken from non-lesion regions of stomach and duodenum. Biopsy materials underwent immunohistochemical staining for the microscopic investigation of the presence of MMA. Also, determination of Perinuclear Anti-Neutropil Cytoplasmic Antibodies (pANCA) and Anti-Saccharomyces Cerevisiae Antibodies (ASCA) (Immunoglobulin G and A) was done with ELISA in serum samples. In patient and control groups, presence of Helicobacter pylori (H. pylori) positivity was histopathologically evaluated. Results: MMA was higher in patients with both CC and UC compared with control groups (46.2%, 41.3%, and 9.1% respec-tively). There was statistically significant difference between patient groups and the control group in terms of MMA but there was no difference between CC and UC groups (p=0.007). No statistically significant difference was ob-tained between the groups in terms of ASCA and p-ANCA. H.pylori positivity was determined in 41.3% of MMA patients with CC, in 75% of patients with UC, and in 50% of healthy subjects. There was no significant difference between the three groups (p=0.344). Discussion: MMA positivity increases in patients with both CC and UC. In patients with inflammatory colitis, H. pylori existence, pANCA and ASCA positivity was similar to healthy subjects.Öğe Superior mesenteric artery syndrome: CT and ultrasonography findings(2005) Ünal B.; Aktaş A.; Kemal G.; Bilgili Y.; Güliter S.; Daphan Ç.; Aydinuraz K.Purpose: The purpose of the study was to describe-computed tomography (CT) and ultrasonography findings in superior mesenteric artery syndrome (SMAS). Materials and methods: The study was performed on 89 CT examinations. Ultrasonography was performed on 32 and barium study was performed an four of these subjects. Group A consisted of cases with one or more of the following complaints: postprandial epigastric pain, weight loss and vomiting. Group B consisted of the remaining cases. Cases who had all of the above-mentioned clinical findings and duodenal dilatation, to-and-fro barium movement and SMA indentation in barium study were diagnosed as having SMAS. Body mass index (BMI, kg/m2) was calculated. The distance between SMA and aorta, at the location where the duodenum passes from, was measured on CT and ultrasonography. The angle between SMA and aorta was measured on ultrasonography images. Group and gender differences were analyzed with t-test, the relationship between clinical and CT findings was analyzed with Mann Whitney U test and the relations between BMI-CT and CT-ultrasonography measurements were analyzed with Pearson coefficients. Results: Of 13 cases in Group A, 3 were diagnosed as SMAS. Eight of the cases showed gastric and/or duodenal dilatation. In 6 cases, antrum had an abnormally high location at portal hilus. In Group A, the SMA-aorta distance was 6.6 ± 1.5 mm and the SMA-aorta angle was 18.7 ± 10.7°. In Group B, these values were 16.0 ± 5.6 mm and 50.9 ± 25.4°, respectively (p<0.001). Cut-off values between SMAS and Group B were 8 mm (100% sensitivity and specificity), and 22° (42.8% sensitivity, 100% specificity). CT and ultrasonography measurements (p<0.001) and SMA-aorta distance and BMI (p=0.004) were significantly correlated. The SMA-aorta distance was significantly shorter in females (p=0.036). Conclusion: Gastric and/or duodenal dilatation and a diminished SMA-aorta distance have a significant correlation with clinical symptoms of SMAS that include postprandial pain, vomiting and weight loss. © Turkish Society of Radiology 2005.
