Arif Yilmaz

Usefulness of serum pepsinogen levels as a screening test for atrophic gastritis and gastric cancer.

OBJECTIVE The purpose of our study was to research the applicability of measuring serum pepsinogen I (PG I) and PG I/pepsinogen II (PG II) ratios as screening tests for atrophic gastritis, which is the most important predisposition for stomach cancer. MATERIALS AND METHODS We measured serum pepsinogen levels in non-specific gastritis, atrophic gastritis and gastric cancer using a radioimmunoassay method. We included in this study 30 healthy control, 30 nonspecific gastritis, 30 atrophic gastritis and 50 gastric cancer cases. RESULTS The serum PG I level was statistically higher in the control group and in the patient group with chronic nonspecific gastritis compared to the patient groups with chronic atrophic gastritis and stomach cancer (p<0.05). The best cutoff values for diagnosing stomach cancer using serum PG I and PG I / PG II ratios were found to be <25 ng/ml for PG I and <3.0 for PG I / PG II. The same cut-off values were also most effective for the patients with atrophic gastritis. CONCLUSIONS Serum pepsinogen screening was shown to be a practical predictor of stomach cancer and atrophic gastritis, the most important predisposing lesion for stomach cancer. Although the diagnosis of stomach cancers localized in the pylorus and cardia via this method is difficult, we believe that the detection of early-stage cancers that develop following chronic atrophic gastritis in particular will be possible, and therefore the morbidity and mortality of stomach cancer will be decreased.

Plasma homocysteine levels in patients with esophageal cancer

SuleymanDemirel Universitesi TIP FAKULTESI DERGISI: 2007 Haziran; 14(2) Plasma homocysteine levels in patients with esophageal cancer Omer Yilmaz*, Atila Turkyilmaz**, Kerim Cayir*, Atilla Eroglu**, Nurettin Karaoglanoglu**, Arif Yilmaz* *Departments of Gastroenterology, Faculty of Medicine, Ataturk University, Erzurum, Turkey **Departments of Thoracic Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey Ozet Ozofagus kanserli hastalarda plazma homosistein duzeyleri Amac: Kanser tum dunyada en onemli saglik problemlerinden birini olusturmaktadir. Olume neden olan hastaliklar arasinda kalp hastaliklarindan sonra ikinci sirayi almaktadir. Tumor belirtecleri kanserlerin tanisinda ve tedaviye cevabin degerlendirilmesinde kullanilmasina ragmen henuz herhangi bir kanser turu icin ozgul bir belirtec bulunamamistir. Hiperhomosisteinemi bir cok hastalikla iliskili bulunmustur. Yapilan degisik calismalarda bazi kanser turlerinde de artis tespit edilmistir. Bu calismada ozofagus kanserli hastalarda homosistein duzeyleri ve diger tumor belirtecleri arasindaki iliski arastirildi. Methods: Bu calismaya 2003 0cak ve 2004 Temmuz tarihleri arasinda hastanemizde endoskopik biopsilerle histopatolojik tanisi konmus toplam 40 ozofagus kanserli hasta grubu ile 40 saglikli kisiden olusan kontrol grubu alindi. Tumor belirteclerinden Homosistein, CEA ve CA19-9 duzeyleri ozefagus kanserli hastalar ile saglikli kontrol grubu olmak uzere iki grup uzerinde calisildi. Veriler istatistiksel olarak karsilastirilarak ozofagus kanserli olgularda homosistein seviyesinin onemi arastirildi. Bulgular: Kontrol grubu ile kiyaslandiginda ozofagus kanserli hastalarda plazma homosistein (hcy) duzeyleri anlamli derecede yuksek bulundu (p<0.05). Yine ayni vakalarda calisilan tumor belirteclerinde gozlenen artis kontrol grubu ile kiyaslandiginda istatistiksel acidan anlamli degildi. Bununla birlikte ozofagus kanserli hasta grubunda hcy duzeyleri ile tumor belirteclerinin duzeyleri arasinda herhangi bir korelasyon yoktu. Sonuclar: Plazma homosistein duzeyleri ozofagus kanserlerinde artmaktadir ve tumor belirteci olarak kullanilabilecegini dusunuyoruz. Ancak daha genis kapsamli calismalara ihtiyac vardir. Anahtar kelimeler: Homosistein (hcy), GIS maligniteleri, tumor belirtecleri. Abstract Objectives: Cancer accounts for one of the most important health problems in the whole world. Among fatal diseases, it is ranked second following cardiovascular diseases. Though tumor markers are used in the diagnosis of cancers and response to treatment, yet no marker specific to a type of cancer has been found. Hyperhomocysteinemia has been found to be related to several diseases. In various studies conducted, increments in plasma homocysteine have been observed in some cancer types. In this study, the relationship between homocysteine levels and other tumor markers in esophagus cancer patients was investigated. Methods: A total of 40 patients with esophagus cancer, diagnosed histopathologically with endoscopic biopsies in our clinic, and 40 healthy subjects enrolled in this study. The levels of tumor markers homocysteine, CEA and CA19-9 were investigated in the two groups, namely the esophagus cancer patients and healthy controls. The significance of homocysteine levels in esophagus cancer patients was studied via statistical comparison of the data. Results: As compared with the controls, the plasma homocysteine levels were significantly higher in esophagus cancer patients (p<0.05). The increments observed in other tumor markers studied in the same cases were not statistically significant when compared with the controls. However, no correlation was found between the homocysteine and other tumor marker levels in the esophagus cancer patients. Conclusion: Plasma homocysteine levels increase in esophageal cancers and thus it may possibly be used as a tumor marker. However, further large-scale studies are required for this hypothesis. Key words: Homocysteine, esophageal carcinoma, tumor markers

The Effect of Atrial Pressure Changes and Cardiac Nerves on Plasma Atrial Natriuretic Peptide Levels

The authors researched the association between plasma atrial natriuretic peptide (ANP) levels and atrial pressure changes and cardiac nerves in 14 dogs. The dogs were divided into two groups, each group containing 7 dogs. In the second group, cardiac denervation was performed. Left atrial pressure was in creased by creating partial mitral obstruction in both groups. In the second stage, after atrial pressures were decreased to previous values, the dogs were bled. Eventually, atrial pressures were decreased below the normal value. Plasma ANP levels and right and left atrial pressures were determined in all stages. It was concluded that ANP was released from the atria by a direct effect of stretching of the atrial wall and that there was no specific effect of cardiac nerves on ANP release.