Gülbin Ünsal

The Role of Serum Cytokines in the Pathogenesis of Hepatic Osteodystrophy in Male Cirrhotic Patients

Objective. In this study, we aimed to investigate the possible role of serum cytokines in the development of hepatic osteodystrophy. Matherial and Methods. 44 consecutive male cirrhotic patients (17 alcoholic, 20 hepatitis B, 7 hepatitis C), 15 age- and sex-matched chronic alcoholics without liver disease, and 17 age- and sex-matched healthy controls were included in the study during one year period. Bone mineral density was measured by dual X-ray absorptiometry in the lumbar vertebrate and femoral neck. Serum interleukin levels were measured by ELISA method. Results. Although osteopenia frequency between our cirrhotic patients was 20%, there was no difference in T-scores among the controls and other groups. Serum interleukin-1, interleukin-8, and tumor necrosis factor-alpha levels were not different between all groups. Serum interleukin-2 and interleukin-6 levels were higher in the cirrhotics than controls (P < 0.001). However, there were no significant difference between osteopenic and nonosteopenic cirrhotics. Conclusion. According to the results of the study in this small population of 44 male cirrhotic patients, frequency of hepatic osteopenia is small and serum interleukins 1, 2, 6, 8, and tumor necrosis factor-alpha may not play a role in the pathogenesis of hepatic osteodystrophy. Further studies in which large number of patients involved are necessary in this field.

Investigation of IL23R, JAK2, and STAT3 gene polymorphisms and gene-gene interactions in Crohn's disease and ulcerative colitis in a Turkish population.

BACKGROUND/AIMS Inflammatory bowel diseases are chronic, relapsing, inflammatory conditions. They have a genetic backround resulting in patient susceptibility. The aim of our study is to investigate the involvement of IL23R, JAK2, and STAT3 polymorphisms in inflammatory bowel diseases in a Turkish population. MATERIALS AND METHODS Polymorphisms in IL23R (rs11209026), JAK2 (rs10758669), and STAT3 (rs3816769, rs2293152, rs744166, rs957970, rs8074524) were genotyped in 69 Crohns disease patients, 157 ulcerative colitis patients, and 89 healthy controls. RESULTS The presence of (C) in rs10758669, (T) and (TT) in rs957970, and (TT) in rs744166 were found to increase the susceptibility to Crohns disease (p=0.049, p=0.016, p=0.010, p=0.035, respectively), while rs2293152 (GC), rs744166 (CT), and rs957970 (CT) provide protection against Crohns disease (p=0.007, p=0.043, p=0.043, respectively). While rs2293152 (GC) was protective, rs2293152 (CC) increased the susceptibility to ulcerative colitis (p=0.009, p=0.001). All the polymorphisms were associated with age-at-diagnosis, except rs11209026. Furthermore, rs2293152 was associated with an extension in ulcerative colitis, while rs10758669, rs3816769, rs744166, rs2293152, and rs957970 were associated with the subphenotype in Crohns disease. The presence of rs10758669 (AC) was protective against perianal Crohns disease (p=0.016). Additionally, rs10758669 and rs2293152 in Crohns disease and rs8074524, rs3816769, and rs10758669 in ulcerative colitis were associated with the requirement of immunsuppression. Finally, rs8074524 and rs10758669 in Crohns disease and rs11209026 in ulcerative colitis were associated with disease-related operation. CONCLUSION This is the first study of the single marker association of IL23R, JAK2, and STAT3 polymorphisms with ulcerative colitis and Crohns disease in a Turkish population. It was demonstrated that these polymorphisms may be effective in the etiology of inflammatory bowel disease in this Turkish population.

Kronik Hepatit B ve C’li Hastalarda Karaciğer Hastalığın Farklı Evrelerinde Yaşam Kalitesinin Değerlendirilmesi

Amac : Kronik hastaliklarda, hastalarin buyuk cogunlugu hastaligin getirdigi agri, yorgunluk ve depresif semptomlarla birlikte sosyal yasamlarinda kisitliliklar, fiziksel aktivitelerini gerceklestirmede guclukler yasamaktadir. Buna bagli yasam kalitesi etkilenmektedir. Kronik hepatitli hastalarda, hastaliginin erken evrelerinde hicbir semptom bulunmazken, ileri evrede siroza bagli komplikasyonlar yasam kalitesini belirgin sekilde bozabilir. Calismamizda farkli evrelerdeki kronik hepatit B (KHB) ve C (KHC)’li hastalarda yasam kalitesinin karsilastirilmasi planlanmistir. Gerec-Yontem : Hastaligin farkli evrelerindeki toplam 175 kronik hepatit (129 KHB ve 46 KHC) hastasi ve 20 saglikli gonullu calismaya alindi. Hastalara SF-36 yasam kalite indeksi anketi uygulandi. Bulgular: Her iki hastalik icin de SF-36’nin internal uyumlulugu yuksekti (Cronbach α KHB ve KHC icin:0.95, kontrol icin:0.90). KHB’de evre arttikca fiziksel ve sosyal fonksiyonlarda daha cok kisitlanma, canlilik ve enerjide daha fazla azalma ve sagliginin daha cok kotulesecegine inanma izlenmektedir. Genel olarak fiziksel ve mental saglik ile genel yasam kalitesi evre arttikca anlamli derecede azalmaktadir. KHC’de ise evre arttikca sadece fiziksel sagligin bozulmasindan dolayi iste ve gunluk etkinliklerde daha fazla kisitlama olmaktadir. Univaryant regresyon analizinde, tani ve hastalik evresinin yaninda yasadigi cevre, egitim seviyesi, sigara ve medeni durum yasam kalitesine etki eden faktorler olarak tespit edildi. Sonuc: KHC ve KHB’de, hastalik suresinin uzun olmasi, beraberinde komplikasyonlarin gelismesi ve psikolojik morbidite ile ozellikle KHC’de ve siroz hastalarinda tedavilerin yan etkileri hastalarda yasam kalitesini ciddi oranda dusurmektedir. Yasam kalitesinin arttirilmasi icin tedavi opsiyonlarinin hastaya gore olusturulmasi ve yasam kalitesini etkileyen diger faktorlerin saptanip en aza indirilmesi gerekmektedir. Anahtar Kelimeler: Kronik hepatit B; Kronik hepatit C; Yasam kalitesi

Helikobakter Pilori únfeksiyonu ve Benign Gastroduodenal Hastal×klar, Trakya Bölgesi Verileri

Results: Overall, the rapid urease test was positive in 52.8% of cases. Helicobacter pylori was positive in 65% of the bulbar ulcer, 61% of the erosive bulbitis, 60.2% of the gastric ulcer and, 48.4% of the gastritis patients. (p<0.001). H. pylori positivity was 52% in Trakya born patients, 56.3% in immigrants from Anatolia and 48.7% in immigrants from Europe (p=0.02). H. pylori positivity frequencies in women and men were 52.2% and 53.2%, respectively (p=0.52). Urease test positivity was significantly more frequent in patients 30-60 years of age compared to the groups younger than 30 or older than 60.