Mevlut Kurt

Age-based computer-aided diagnosis approach for pancreatic cancer on endoscopic ultrasound images.

Aim: The aim was to develop a high-performance computer-aided diagnosis (CAD) system with image processing and pattern recognition in diagnosing pancreatic cancer by using endosonography images. Materials and Methods: On the images, regions of interest (ROI) of three groups of patients (<40, 40-60 and >60) were extracted by experts; features were obtained from images using three different techniques and were trained separately for each age group with an Artificial Neural Network (ANN) to diagnose cancer. The study was conducted on endosonography images of 202 patients with pancreatic cancer and 130 noncancer patients. Results: 122 features were identified from the 332 endosonography images obtained in the study, and the 20 most appropriate features were selected by using the relief method. Images classified under three age groups (in years; <40, 40-60 and >60) were tested via 200 random tests and the following ratios were obtained in the classification: accuracy: 92%, 88.5%, and 91.7%, respectively; sensitivity: 87.5%, 85.7%, and 93.3%, respectively; and specificity: 94.1%, 91.7%, and 88.9%, respectively. When all the age groups were assessed together, the following values were obtained: accuracy: 87.5%, sensitivity: 83.3%, and specificity: 93.3%. Conclusions: It was observed that the CAD system developed in the study performed better in diagnosing pancreatic cancer images based on classification by patient age compared to diagnosis without classification. Therefore, it is imperative to take patient age into consideration to ensure higher performance.

The Syk Inhibitor Fostamatinib Decreases the Severity of Colonic Mucosal Damage in a Rodent Model of Colitis

BACKGROUND AND AIMS Inflammatory bowel disease is a chronic inflammatory disease of the gastrointestinal system. In some cases, current medications used for inflammatory bowel disease may not be enough for remission, creating a need for more potent and reliable medications. There is no study showing the efficacy of fostamatinib, with proven effects on some inflammatory diseases, on ulcerative colitis. In our study we planned to research the efficacy of fostamatinib, a spleen tyrosine kinase inhibitor, on acetic acid-induced colitis. METHODS The study included 28 male Sprague-Dawley rats, randomly divided into control group, fostamatinib group, colitis group and fostamatinib + colitis group, each containing seven rats. Colitis induction was performed with 4% acetic acid. Colonic inflammation was assessed with disease activity index, macroscopic and histological damage scores, colonic myeloperoxidase, malondialdehyde and superoxide dismutase activity, and tumour necrosis factor alpha [TNFα], CD3, Syk, and phospho-Syk expression. RESULTS There was a significant difference between the colitis and control groups in terms of all parameters. The disease activity index, macroscopic and microscopic damage scores, immunohistochemical TNFα, CD3, Syk, and phospho-Syk expression, and tissue myeloperoxidase activity were found to be significantly lower in the colitis + fostamatinib group compared with the colitis group. There was no significant difference between the two groups in terms of myeloperoxidase and malondialdehyde activity. CONCLUSIONS Fostamatinib reduced the inflammatory damage in the experimental colitis. This effect may be due to suppression of TNFα, T-lymphocytes, and neutrophils in colonic mucosa via suppression of Syk. Fostamatinib may be an appropriate treatment alternative for ulcerative colitis. Further clinical studies are required to support this.

The efficacy of tyrosine kinase inhibitor dasatinib on colonic mucosal damage in murine model of colitis

BACKGROUND AND OBJECTIVE Ulcerative colitis is an inflammatory condition of the colon in the gastrointestinal system. Currently, the most potent medications used for ulcerative colitis produce no response in 20-30% of cases. There is a need for more efficient and reliable medications. Tyrosine kinase inhibitors have shown efficacy in some inflammatory diseases. Although dasatinib, a tyrosine kinase inhibitor, suppresses proinflammatory cytokines in colonic tissue, there are a few cases of hemorrhagic colitis with dasatinib. There is no study investigating the effect of dasatinib on experimental colitis. We aimed to investigate the effect of dasatinib in a colitis model induced with acetic acid in our study. METHODS In the study, 24 male Sprague-Dawley rats randomly distributed into 4 groups of 6 rats each as control, dasatinib, colitis and dasatinib+colitis groups. For colitis induction, 4% acetic acid was used. Sacrificing of the rats was performed on the seventh day. Disease activity, morphologic and histological injury, superoxide dismutase, myeloperoxidase and malondialdehyde activity, TNFα and CD3 expression were assessed in colonic tissue. RESULTS Apart from malondialdehyde, significant difference in all parameters between the control and colitis groups was determined. Difference between the colitis and colitis+dasatinib groups was not significant in only weight loss and biochemical parameters. Though dasatinib does not fully resolve the changes in colitis, there was significant regression. CONCLUSIONS Dasatinib decreased the inflammation in a rodent model of colitis. It may be provide this effect by the suppression of TNFα. Dasatinib may be one of the treatment options for ulcerative colitis.

Non-invasive fibrosis tests are correlated with necroinflammatory actvity of liver in patients with chronic hepatitis B.

BACKGROUND The gold standarda method used for assessing necroinflammatory activity and fibrosis in the liver is a liver biopsy which has many disadvantages. Therefore, many investigators have been trying to develop non-invasive tests for predicting liver fibrosis score (LFS) of these patients. The aim of this study is to describe the relationship between certain non-invasive fibrosis markers with LFS and histological activity index (HAI) detected histopathologically by liver biopsy in chronic hepatitis B patients. MATERIALS AND METHODS A total of 54 patients who had undergone a liver biopsy with the diagnosis of chronic HBV infection were included in the study. Ishak scoring was used for the evaluation of liver fibrosis, and a modified Knodell HAI was used for demonstration of necroinflammation. In this study, non-invasive fibrosis tests were calculated as described in previous studies. RESULTS Histological acitivity index was positively correlated with age, age/platelet index, cirrhosis discriminant score (CDS), AST/platelet ratio index (APRI), AST/platelet/GGT/AFP index (APGA), fibro-quotient (Fibro-Q), Goteburg University Cirrhosis Index (Guci), and Platelet/Age/Phosphatase/AFP/AST index (PAPAS). When divided into two groups according to HAI, Guci and APGA were found significantly different both in >4 and >4 HAI groups than the other group. In ROC analysis performed for LFS; PAPAS, APGA, FFI and APRI were the markers having the highest AUC levels, and in ROC analysis performed for HAI; Guci, APRI and APGA were the markers with the highest AUC levels. CONCLUSIONS APRI, APGA and GUCI tests may be helpful in prediction of necroinflammatory scores in the liver.

Response to: Platelet indices in differential diagnosis of pancreatic neuroendocrine tumors from pancreatic adenocarcinomas

We thank Varol for his interest in our article [1] and his comments on the method [2]. As we stated previously, MPV was studied preoperatively 1 h before surgery. This is thought to be as an acceptable time period. Because of its retrospective nature, data of patients including obesity, smoking andblood lipid values could not been found or re-evaluated. However, we were able to access the data of diabetes mellitus (DM) and hypertension (HT) in all patients having pancreas adenocarcinoma (n = 76) and in 13 of 16 patients who had pancreatic neuroendocrine tumor (PNET). DM co-existed in 33 patients (43.4%) with pancreatic adenocarcinoma, and in 3 patients (23.1%)with PNET. The difference between groups was not significant (p = 0.17). MPV values were not statistically different in DM (+) patients of the pancreatic adenocarcinoma group when compared with those who were DM (−) [MPV values in the pancreatic adenocarcinoma group: DM (+) vs. DM (−); 8.9 ± 1.3 vs. 8.7 ± 1.2, p = 0.52]. MPV values also were not statistically different in DM (+) patients of the PNET group when compared with those who were DM (−) [MPV values in the PNET group: DM (+) vs. DM (−); 7.6 (7.3–8.3) vs. 7.9 (7.2–9.4), p = 0.4]. HT was present in 14 patients (18.4%) of the pancreatic adenocarcinoma group, and in one patient (7.7%) of the PNET group, respectively. MPV values did not significantly differ whenwe compared patientswho have additionally HT in the pancreatic adenocarcinoma group with those who have not [MPV values in the pancreas adenocarcinoma group: HT (+) vs. HT (−); 8.6±0.9 vs. 8.8±1.3, p= 0.58].MPVvalues

OBEZ VE FAZLA KİLOLU BİREYLERDE ÜRİK ASİT VE GAMMA GLUTAMİL TRANSFERAZ DÜZEYLERİNİN DEĞERLENDİRİLMESİ

Amac: Diyabetes Mellitus (DM), hipertansiyon, koroner arter hastaligi gibi onemli mor- bidite ve mortaliteye sahip hastaliklarla obezite arasinda onemli bir iliski mevcuttur. DM ve hipertansiyon (HT) ile cesitli metabolik parametreler arasindaki etkilesimler cok sayi- da calismada acik olarak gosterilmistir. Son zamanlarda gamma glutamil transferaz (GGT) ve urik asit duzeylerinin yuksekligi ile DM ve HT arasindaki siki iliski sikca arastirilmistir. Biz de buradan yola cikarak henuz DM gelismemis obez bireylerde urik asit ve GGT du- zeylerini arastirmayi amacladik. Gerec ve Yontemler: Bu retrospektif calismaya toplam 55 non-diyabetik hasta alindi. Vucut kitle indeksi (VKI) olcumlerine gore 26 hasta fazla kilolu (VKI:25-29.9), 29 hasta ise obez (VKI>30) olarak gruplandi. Bulgular: Obez grubun ortalama GGT (41±16) ve urik asit seviyeleri (4.8±1.1) fazla ki- lolulardan (GGT=32±17, urik asit=4.1±1) anlamli olarak daha yuksekti (GGT icin p=0.034 ve urik asit icin p=0.033). Sonuc: Bu retrospektif calismada non-diyabetik obez bireylerin fazla kilolu non-diyabetik bireylerden daha yuksek GGTve Urik asit degerlerine sahip olduklarini saptadik. GGT ve urik asitteki bu artisin, obezitenin yol actigi saglik sorunlarina farkli mekanizmalar yoluy- la etkili olabilecegini dusunuyoruz.