Ömer Topalak

YMDD motif variants in inactive hepatitis B carriers detected by Inno-Lipa HBV DR assay

Introduction:  Mutations of hepatitis B virus (HBV) polymerase, especially occurring at the highly conserved YMDD region, are related to resistance to lamivudine. Although these mutations are frequently secondary to lamivudine use, they can also occur naturally. The aim of the present study was to determine the prevalence of YMDD variants that exist naturally in patients who are inactive HBV carriers.

Immunohistochemical detection of pS2 protein and heat shock protein-70 in pancreatic adenocarcinomas. Relationship with disease extent and patient survival.

We investigated pS2 and HSP-70 protein expression in 36 pancreatic adenocarcinomas for their effect on disease extent and patient outcome. The cases were reviewed, histologically diagnosed, typed, graded, and staged. Lymphatic vessel, blood vessel and perineural invasion as well as lymph node, resection margin and adjacent organ involvements were re-evaluated. The standard streptavidin biotin immunperoxidase method was used for immunostaining with pS2 and HSP-70 antibodies. Cytoplasmic staining with both antibodies was scored semiquantitatively. The scores were compared with histopathological prognostic parameters using statistical methods. Standard prognostic parameters and staining scores were tested by survival analysis in terms of their effect on survival. All the tumors showed a positive cytoplasmic reaction with HSP-70 antibody. Seventy-seven percent of the tumors showed positive cytoplasmic staining with pS2 antibody (22.2% +, 13.9% ++ and 41.7% +++). There was a statistically significant difference between HSP-70 staining scores with N status and final stages of the tumors (Chi-square, p = 0.03 and p = 0.026, respectively), while neither direct nor inverse correlation was detected for both parameters. PS2 staining scores showed no statistically significant relationship with tumor grade T, M status, perineural invasion, lymph and blood vessel invasion. In tumors with extensive staining with pS2, tumor stage tended to be low (Chi square, p = 0.024, Kendall Tau-b, r: -0.336, p = 0.036). There was a statistically significant difference and inverse correlation between tumors with extensive pS2 staining and tumors with less intense staining in terms of lymph node metastasis (Chi-square, p = 0.041, Kendall Tau: p = 0.024, r = -0,373). In the R0 resection group, in univariate analysis, we found that with higher scores of HSP-70 staining, the prognosis of the patient tended to improve. (Cox regression, p = 0.013). In multivariate analysis, HSP-70 expression was found to be an independent prognostic factor. We found no relationship between pS2 staining and patient survival.

Isolated mesosigmoidal hydatid cyst as an unusual cause of colonic obstruction: report of a case.

Abstract We report herein an unusual case of primary mesosigmoidal hydatid cyst that presented as acute left colonic obstruction mimicking sigmoid colon cancer. A 61-year-old man with a 3-day history of abdominal pain, distention, obstipation, vomiting, and fever was admitted to the emergency department of our hospital. Surgery was performed under a presumptive diagnosis of acute left colonic obstruction. The intraoperative findings were highly suggestive of sigmoid colonic carcinoma and Hartmanns procedure was performed. Histopathological examination of the pathological specimen revealed an isolated hydatid cyst embedded in mesosigmoid which had caused mechanical sigmoidal obstruction. Primary extrahepatic, intra-abdominal localization of a hydatid cyst is not unusual. Therefore, as a hydatid cyst may cause a wide variety of clinical syndromes, it should be kept in mind in the differential diagnosis of mechanical bowel obstruction, especially in endemic regions.

Ultrasonography and magnetic resonance imaging findings of solitary fibrous tumor of the liver.

Solitary fibrous tumor of the liver is a rare neoplasm which has been reported in only 27 patients in the English literature. A limited number of reports have described the radiological findings of this tumor. We report the radiological and pathological findings in a patient with solitary fibrous tumor located in the liver.

Sedation for endoscopic retrograde cholangiopancreatography (ERCP) in a pregnant patient.

Anesthesiology management of endoscopic retrograde cholangiopancreatography (ERCP) in the twenty-first week of pregnancy of a woman patient is reported. The patient gave birth to a healthy male baby at 40 weeks of gestation.

Turkey 2017 Clinical Practice Guidelines on recommendations for screning diagnosing and managing hepatitis C virus

The present guideline updates the Turkish recommendations for the screening, diagnosis and management of Hepatitis C virus (HCV) infection prepared by the Turkish Association for the Study of the Liver (TASL) and Viral Hepatitis Society (VHS). The aim of this guidance was to provide updates recommendations to physicians, who are interested in HCV care on the optimal screening, diagnosis and pre-treatment management for patients with HCV infection in Turkey. These recommendations, produced by panel experts, were aimed to addresses the management issues ranging from diagnosis and linkage to care, to the optimal treatment regimen in patients with HCV infection. Recommendations are based on evidence and opinions of more than 70% of the panelists. This guidance is supported by the memberships of two societies and not by pharmaceutical companies. This guidance will be updated frequently as new data become available.

Kolorektal tümör gelişiminde insülin benzeri büyüme Faktörü-1 reseptör sunumunun rolü*

Background and aim: Recent human and animal study findings have indicated that insulin-like growth factor I and its receptor (IGF-I/ IGFIR) system activation play a critical role in cell transformation and Tumoragenesis. Although IGF-I and IGF-IR expression have been shown in neoplastic intestinal cells of humans and rats, the modulation of IGF-IR expression during progression of normal colonic mucosa to adenoma, carcinoma and metastasis has not yet been investigated sufficiently. Meterial and methods: In this retrospective study, we studied the expression of IGF-IR in 35 normal colonic mucosa, 31 colonic adenomas and 71 colorectal adenocarcinomas. Formalin-fixed, paraffinembedded tissues of each patient were immunostained using streptavidin- biotin-peroxidase method. An anti-IGF-IR b(H-60) rabbit polyclonal antibody (Santa Cruz Biotechologen, SC-9038 Inc. U.S; dilution 1/100) was used. Results: IGF-IR positivity rates were 92 % (65/71) in the colorectal cancer patients, 71 % (22/31) among those with adenoma and 0 % among the normal mucosa specimens. When the intensity of the stain was semiquantitatively evaluated, strong IGF-IR positivity was identified in colorectal cancer patients compared to adenomas (p=0.000). In colorectal cancer patients, strong IGF-IR positivity was also significantly related with higher-stage tumors (p=0.037). Conclusion: Our findings suggested that IGF-IR expression may have an important role during the progression of normal mucosa to colorectal adenoma and adenocarcinoma