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Salih Akarca U, Unsal B, Sezgin O, Yalcin K, Akdogan M, Gonen C, Gunduz F, Ozenirler S, Sonsuz A, Dincer D, Basol Tekin S, Yucel I, Akbulut H, Alkım C, Ozyilkan O, Baygul A, Cevik ZM, Idilman R. Characteristics of Newly Diagnosed Hepatocellular Carcinoma Patients Across Turkey: Prospective Multicenter Observational 3K Registry Study. Turk J Gastroenterol 2021; 32:1019-1028. [PMID: 34876392 PMCID: PMC8975510 DOI: 10.5152/tjg.2021.201171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
AIMS To evaluate patient profile for epidemiological and clinicopathological characteristics and potential risk/prognostic factors in newly diagnosed hepatocellular carcinoma (HCC) patients across Turkey. METHODS A total of 547 patients (mean (SD) age 62.6 (10.3) years, 81.9% were males) were included in this registry study. Data on patient characteristics, etiologies of HCC, laboratory values, and tumor characteristics and stages were recorded at study enrollment. RESULTS HBV infection (68.2%) was the leading etiology, followed by HCV infection (17.2%), HDV infection (5.5%), alcohol (6.4%), and NAFLD (3.5%), as the major etiologies. Considering that 51.6% of the patients had >5 cm HCC, 44% were Child-Pugh B/C and 57% were BCLC B-D, it appears that a significant group of HCC patients were diagnosed at advanced stages. Of 540 patients, 271 (50.2%) were referred or applied with the diagnosis of HCC. Patients with HCC at presentation had larger tumor size (median (min-max) 6.6 (0-30) vs. 4.8 (0-90) cm, P < .001) and more advanced BCLC stage (Stage C-D in 40.8% vs. 26.4%, respectively, P = .005), compared to patients who were diagnosed during follow-up. CONCLUSIONS Our findings revealed that HBV infection was the leading etiology and a moderate-to-advanced disease was evident in more than half of patients at the time of diagnosis. HCC patients diagnosed at follow-up had smaller tumor size and earlier BCLC stage.
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Affiliation(s)
- Ulus Salih Akarca
- Department of Gastroenterology, Ege University Faculty of Medicine, Izmir, Turkey
- Corresponding author: Ulus Salih Akarca, e-mail:
| | - Belkis Unsal
- Clinic of Gastroenterology, Izmir Ataturk Training and Research Hospital, Izmir, Turkey
| | - Orhan Sezgin
- Department of Gastroenterology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Kendal Yalcin
- Department of Gastroenterology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Meral Akdogan
- Clinic of Gastroenterology, Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Can Gonen
- Clinic of Gastroenterology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Feyza Gunduz
- Clinic of Gastroenterology, Marmara University Faculty of Medicine Pendik Training and Research Hospital, Istanbul, Turkey
| | - Seren Ozenirler
- Department of Gastroenterology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Abdullah Sonsuz
- Department of Gastroenterology, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Dinc Dincer
- Department of Gastroenterology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Salim Basol Tekin
- Department of Oncology, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Idris Yucel
- Department of Oncology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
| | - Hakan Akbulut
- Department of Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Canan Alkım
- Clinic of Gastroenterology, Sisli Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ozgur Ozyilkan
- Department of Oncology, Adana Baskent University Faculty of Medicine, Adana, Turkey
| | - Arzu Baygul
- Department of Biostatistics, Koc University School of Medicine, Istanbul, Turkey
| | | | - Ramazan Idilman
- Department of Gastroenterology, Ankara University Faculty of Medicine, Turkey
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Sahin M, Karayakar F, Koksal AR, Yetim A, İyisoy MS, Şen İ, Alkım H, Alkım C, Colak T. Changes in Liver Tissue Trace Element Concentrations During Hepatitis B Viral Infection Treatment. Biol Trace Elem Res 2019; 188:245-250. [PMID: 29926391 DOI: 10.1007/s12011-018-1414-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 06/10/2018] [Indexed: 12/14/2022]
Abstract
Approximately 350-400 million people in the world have Hbs Ag (hepatitis B virus surface antigen) positivity. In the international guidelines, the permanent suppression of replication in chronic hepatitis B virus (HBV) infection therapy is reported as the primary therapeutic goal. Trace elements play a key role in liver diseases. The aim of our study is to determine some trace element concentrations in the liver during HBV treatment periods. The measurement of 11 trace elements (manganese, lead, nickel, chromium, cadmium, iron, copper, zinc, silver, cobalt, and aluminum) was carried out by the method of inductively coupled plasma mass spectrometry in liver biopsy materials (before starting treatment and at the sixth month of the treatment period). There was an increase in zinc and copper concentrations in liver materials at the sixth month of treatment compared to the pre-treatment values (the median zinc value was 48.05 μg/g before treatment and 74.9 μg/g at 6 months after initial treatment, p = 0.035; median copper was 2.82 μg/g before treatment and 5.31 μg/g after 6 months, p = 0.002). General estimations indicated that zinc (p = 0.002), iron (p = 0.0244), copper (p = 0.0003), and aluminum (p = 0.0239) values may be effective in HAI (histological activity index) changes. Only iron levels could be at a very low level effective on the changes caused by fibrosis (p = 0.0002). Liver tissue zinc and copper levels increased in parallel with the improvement of inflammation in antiviral-treated HBV patients. In addition, the levels of zinc and copper in the liver tissue can be useful markers for liver tissue damage detection.
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Affiliation(s)
- Memduh Sahin
- Gastroenterology Department, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
| | | | - Ali Riza Koksal
- Gastroenterology Department, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Aylin Yetim
- Pediatrics and Adolescent Department, Istanbul University, Istanbul, Turkey
| | | | - İlker Şen
- Gastroenterology Department, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Hüseyin Alkım
- Gastroenterology Department, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Canan Alkım
- Gastroenterology Department, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Tahsin Colak
- General Surgery Department, Mersin University, Mersin, Turkey
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Tabak F, Yurdaydın C, Kaymakoğlu S, Akarsu M, Akıncı EG, Akkız H, Alkım C, Çekin AH, Çuvalcı NÖ, Demir K, Değertekin B, Dökmetaş İ, Ersöz G, Hizel K, Kandemir FÖ, Önlen Y, Sonsuz A, Şenateş E, Tosun S, Tözün N, Idilman R, Guidelines Study Group VH. Diagnosis, management and treatment of hepatitis B virus infection: Turkey 2017 Clinical Practice Guidelines. Turk J Gastroenterol 2018; 28:73-83. [PMID: 29303103 DOI: 10.5152/tjg.2017.19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Fehmi Tabak
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Cihan Yurdaydın
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Sabahattin Kaymakoğlu
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Mesut Akarsu
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Esra G Akıncı
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Hikmet Akkız
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Canan Alkım
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ayhan H Çekin
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Nefise Ö Çuvalcı
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Kadir Demir
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Bülent Değertekin
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - İlyas Dökmetaş
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Galip Ersöz
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Kenan Hizel
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fatma Ö Kandemir
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Yusuf Önlen
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Abdullah Sonsuz
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ebubekir Şenateş
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Selma Tosun
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Nurdan Tözün
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ramazan Idilman
- Turkish Association for the Study of the Liver, Istanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
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Yurdaydın C, Tabak F, Kaymakoğlu S, Akarsu M, Akıncı EG, Akkız H, Alkım C, Çekin AH, Çuvalcı NÖ, Demir K, Değertekin B, Dökmetaş İ, Ersöz G, Hizel K, Kandemir FÖ, Önlen Y, Sonsuz A, Şenateş E, Tosun S, Tözün N, Idilman R, Guidelines Study Group VH. Diagnosis, management and treatment of hepatitis delta virus infection: Turkey 2017 Clinical Practice Guidelines. Turk J Gastroenterol 2018; 28:84-89. [PMID: 29303104 DOI: 10.5152/tjg.2017.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Cihan Yurdaydın
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fehmi Tabak
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Sabahattin Kaymakoğlu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Mesut Akarsu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Esra G Akıncı
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Hikmet Akkız
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Canan Alkım
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ayhan H Çekin
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Nefise Ö Çuvalcı
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Kadir Demir
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Bülent Değertekin
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - İlyas Dökmetaş
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Galip Ersöz
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Kenan Hizel
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fatma Ö Kandemir
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Yusuf Önlen
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Abdullah Sonsuz
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ebubekir Şenateş
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Selma Tosun
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Nurdan Tözün
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ramazan Idilman
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
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Bostancı Ö, Battal M, Yazıcı P, Demir U, Alkım C. Management of iatrogenic injuries due to endoscopic sphincterotomy: Surgical or conservative approaches. Turk J Surg 2018; 34:24-27. [PMID: 29756102 PMCID: PMC5937654 DOI: 10.5152/turkjsurg.2017.3820] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 04/20/2017] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The best therapeutic approach for endoscopic retrograde cholangiopancreatography-related perforations remains controversial; while some authors suggest routine conservative management, others advocate mandatory surgical exploration. We aimed to evaluate our clinical experience of perforations during endoscopic sphincterotomy. MATERIAL AND METHODS A retrospective chart review from January 2010 to October 2015 identified 20 patients with endoscopic retrograde cholangiopancreatography-related perforations. Data collection included demographics, time to diagnosis, type of perforation, treatment strategy, surgical procedure, complications, hospital stay, and outcome. All patients were classified into two groups on the basis of radiological and operative findings. RESULTS Only five patients underwent surgical treatment, whereas 15 patients were managed conservatively. The mean time to diagnosis was 7.8 hrs (range: 1 to 36 hrs). In patients who underwent surgical treatment, the types of perforations included type I and III in one patient each and type II in three patients. Surgical procedures included laparoscopic and open cholecystectomy with t-tube drainage in two patients each and primary repair of duodenal injury with hepaticojejunostomy in one patient. Among conservatively managed patients, eight, four, and three had type II, type III, and type IV injuries, respectively. Of these 15 patients, 60% (n=9) underwent percutaneous procedures. The mean length of hospital stay was similar for conservatively and surgically treated patients (12 vs. 12.4 days, respectively, p=0.790). One patient (5%) with type I injury died of multiorgan deficiency. CONCLUSION With close close clinical follow-up, medical treatment can be beneficial for most patients, and surgical procedures should be reserved for patients with type I (definite) and type II/III injuries; in patients with these clinical parameters, conservative management will likely be unsuccessful.
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Affiliation(s)
- Özgür Bostancı
- Department of General Surgery, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| | - Muharrem Battal
- Department of General Surgery, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| | - Pınar Yazıcı
- Department of General Surgery, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| | - Uygar Demir
- Department of General Surgery, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| | - Canan Alkım
- Department of Gastroenterology, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
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Ersoy Ö, Alkım C, Onuk MD, Demirsoy H, Argon D. A rare cause of Fatty liver and elevated aminotransferase levels: chanarin-dorfman syndrome: a case report. Int J Hepatol 2011; 2011:341372. [PMID: 21994851 PMCID: PMC3170759 DOI: 10.4061/2011/341372] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Revised: 10/25/2010] [Accepted: 01/06/2011] [Indexed: 11/20/2022] Open
Abstract
Chanarin-Dorfman syndrome is a rare, inherited metabolic disorder of neutral lipid storage characterized by ichthyosis, lipid vacuoles in leukocytes, and involvement of several internal organs, mostly the liver. Since the initial case was reported by Dorfman in 1974, nearly 50 cases have been reported, and the majority were from Middle East countries. Here, we report a 20-year-old patient with ichthyosis from Turkey, diagnosed as Chanarin-Dorfman syndrome presented with asypmtomatic elevated transaminases and hepatosteatosis, and also briefly review the updated clinical implications and management of this rarely seen syndrome. Prompt diagnosis of this syndrome avoids further unnecessary investigations in patients with ichthyosis.
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Affiliation(s)
- Özdal Ersoy
- Department of Gastroenterology, Şişli Etfal Training and Research Hospital, 34377 Istanbul, Turkey,*Özdal Ersoy:
| | - Canan Alkım
- Department of Gastroenterology, Şişli Etfal Training and Research Hospital, 34377 Istanbul, Turkey
| | - Mehmet Derya Onuk
- Department of Gastroenterology, Şişli Etfal Training and Research Hospital, 34377 Istanbul, Turkey
| | - Hüseyin Demirsoy
- Department of Gastroenterology, Şişli Etfal Training and Research Hospital, 34377 Istanbul, Turkey
| | - Dilek Argon
- Department of Hematology, Şişli Etfal Training and Research Hospital, 34377 Istanbul, Turkey
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