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Öğe Effects of vitamin E treatment on peroxisome proliferator-activated receptor-alpha expression and insulin resistance in patients with non-alcoholic steatohepatitis: results of a pilot study(Wiley, 2007) Yakaryilmaz, F.; Guliter, S.; Savaş, B.; Erdem, O.; Ersoy, R.; Erden, E.; Özenirler, S.Background: Insulin resistance (IR) is commonly associated with non-alcoholic steatohepatitis (NASH). Peroxisome proliferator-activated receptor-alpha (PPAR-alpha) may also play a role in the pathogenesis of NASH. A pivotal role in NASH pathogenesis depends on the hypothesis of increased oxidative stress. The aim of our study was to evaluate the effects of supplemental oral vitamin E, a potent antioxidant, on liver functions, PPAR-alpha expression and IR in patients with NASH. Methods: Nine patients with biopsy-proven NASH were given oral vitamin E 800 mg daily for 24 weeks. Liver functions, lipid parameters, IR index with homeostatic metabolic assessment and liver histology and PPAR-alpha staining index in biopsy specimens were detected before and after the treatment. Results: Seven patients (78%) had IR initially. After 6 months of therapy in nine patients, fasting insulin improved (P = 0.01), but serum cholesterol, triglyceride, fasting blood glucose levels and body mass index remained unchanged. Aspartate aminotransferase and alanine aminotransferase levels decreased (P = 0.01 and P = 0.01, respectively). IR index with homeostatic metabolic assessment resistance improved (P = 0.01), but PPAR-alpha staining index did not change (P = 0.37). Although the histological grade of steatosis decreased (P = 0.01), necroinflammation and fibrosis remained unchanged. In seven patients with IR, however, necroinflammation and PPAR-alpha staining index were improved (P = 0.04 and P = 0.02). Conclusion: Vitamin E treatment, in addition to its previously shown beneficial effect by suppressing oxidative stress, may also achieve improvement by reducing IR and PPAR-alpha expression in NASH.Öğe Evaluation of gallbladder volume and motility in non-insulin-dependent diabetes mellitus patients using real-time ultrasonography(Lippincott Williams & Wilkins, 2003) Guliter, S.; Yilmaz, S.; Karakan, T.Aims: The prevalence of cholelithiasis is 2 to 3 times higher in patients with diabetes mellitus than in the normal population, especially in a group of patients with non-insulin-dependent diabetes mellitus (NIDDM). We investigated the pathogenesis of this increased prevalence by ultrasonography with a brief comparison of demographic features. Materials and Methods: The study group was consisted of NIDDM patients (41 males and 47 females, mean age 53.5 +/- 11 years), and the control group included healthy volunteers (33 males and 34 females, mean age 50.3 +/- 18 years). All patients were investigated after 12 hours of fasting and 30 minutes after a standard test meal. Pre-meal and post-meal gallbladder volumes were used for calculation of the ejection fraction of the gallbladder and fasting gallbladder volume. Results: In the study group, there was no correlation between the fasting gallbladder volume and age, parity, and body mass index. However, fasting gallbladder volume and duration of diabetes mellitus showed significant correlation (r = 0.212, P < 0.05). The mean ejection fraction of gallbladders in the study group was 48.48%, whereas that of the control group was 56.32%. There was a significant reduction of ejection fraction in the study group (P = 0.003). Conclusion: Our study indicated that there were an increased fasting gallbladder volume and impaired ejection fraction in NIDDM patients. This may be the initiator of bile stasis in the gallbladder and subsequent cholesterol crystal and stone formation.Öğe Frequencies of serum antibodies to Helicobacter pylori CagA and VacA in a Turkish population with various gastroduodenal diseases(Blackwell Publishing, 2006) Sezikli, M.; Guliter, S.; Apan, T. Z.; Aksoy, A.; Keleş, H.; Özkurt, Z. N.Infection with Helicobacter pylori (H. pylori) strains secreting cytotoxin-associated gene A (CagA) and vacuolating cytotoxin A (VacA) proteins is associated with more severe gastroduodenal pathologies. However, this association varies among geographical regions and ethnic groups. We investigated the frequencies of antibodies to CagA and VacA proteins in 131 H. pylori-infected dyspeptic patients [40 duodenal ulcer (DU), 19 gastric ulcer (GU), 28 gastric cancer (GC), and 44 non-ulcer dyspepsia (NUD)] across 30 H. pylori-infected and endoscopically normal asymptomatic subjects (AS). Anti-CagA and anti-VacA antibodies were detected by Western blotting. The positivity rates of anti-CagA and anti-VacA antibodies were higher in patients with DU (92.5 and 75%), GU (89.5 and 84.2%) and GC (96.4 and 85.7%) than patients with NUD (70.5 and 50%) and AS (50 and 23.3%) (p < 0.05). CagA(+)VacA(+) phenotype was more frequent in patients with DU, GU and GC than patients with NUD and AS (75, 84.2, 85.7 vs. 47.7 and 20%, respectively) (p < 0.01). Our results showed that there is a significantly positive association between the presence of anti-CagA and anti-VacA antibodies and DU, GU and GC in our region.Öğe Helicobacter pylori in allergic inflammation - Fact or fiction?(Elsevier Doyma Sl, 2008) Baccioglu, A.; Kalpaklioglu, F.; Guliter, S.; Yakaryilmaz, F.Background: Although it has been hypothised that infections may play a preventive role in allergic diseases, the role of Helicobacter pylori (H. pylori) is not clear. In this study we aimed to determine the association between H. pylori infection and allergic inflammation. Methods: H. pylori infection was assessed in gastric mucosa tissue by microscopy. Skin prick tests (SPT) were performed with a battery of common inhalant and certain food allergens. Serum samples were tested for total immunglobulin E (T.IgE). Predictive factors for H. pylori infection and atopy were examined by a questionnaire. Results: A total of 90 subjects suffering dyspeptic symptoms were enrolled into the study. SPT positivity was similar between H. pylori (+) and H. pylori (-) subjects. Among the possible factors examined: age; gender; educational status; pet at home; BMI, family size; number of children and siblings; monthly income; drinking water source; smoking; and serum T.IgE levels were not related with H. pylori infection. However, perennial allergic symptoms were significantly higher in the H. pylon (-) group, seasonal allergic symptoms were related with an increased risk for H. pylori infection. Conclusions: In this sample group from a developing country H. pylori infection was not shown to be associated with atopic diseases. Therefore, the eradication of H. pylori may not be assumed to have an effect on allergic inflammation.Öğe Ischaemic Colitis during Haemodialysis(Univ West Indies Faculty Medical Sciences, 2016) Sapmaz, F.; Kalkan, I. H.; Guliter, S.Ischaemic colitis results from a chronic or acute drop in the blood supply to the bowel and accounts for 6-18% of the causes of acute lower gastrointestinal bleeding. Diabetes mellitus, hypotension, advanced age, aortic surgery and peripheral vascular disease have also been suggested to be predisposing factors for ischaemic colitis (1). In this report, we present a case of ischaemic colitis in haemodialysis with a good response to conservative treatment.
