The Relationship between Quiescent Infl ammatory Bowel Disease and Peripheral Polyneuropathy

( Zuleyha Akkan Cetinkaya ),( Yılmaz Cetinkaya ),( Mehmet Gencer ),( Mesut Sezikli ),( Hulya Tireli ),( Oya Ovunc Kurdas ),( Kayıhan Uluc ),( Onder Us ),( Tulin Tanrıdag ) 대한소화기기능성질환·운동학회 2011 Gut and Liver Vol.5 No.1

Background/Aims: Infl ammatory bowel disease is a chronic, recurrent disorder that involves multiple organ systems. Polyneuropathy is the most common neurological manifestation. The aim of the present study was to investigate the relationship between polyneuropathy and infl ammatory bowel disease. Methods: The study included 40 patients with infl ammatory bowel disease (20 with ulcerative colitis and 20 with Crohn`s disease) and 24 healthy controls. The patients had no clinical signs or symptoms of polyneuropathy. Nerve conduction studies were performed using an electroneuromyography apparatus. Results: Mean distal motor latencies, conduction velocities, and F wave minimum latencies of the right median nerve were signifi cantly abnormal in the patient group, compared to the healthy controls (p<0.05). Conclusions: Some electrophysiological alterations were observed in chronic infl ammatory bowel disease patients who showed no clinical signs. While investigating extra-intestinal manifestations in inflammatory bowel disease patients, nerve conduction studies must be performed to identify electrophysiological changes and subclinical peripheral polyneuropathy, which can subsequently develop. (Gut Liver 2011;5:57-60)

Effi cacy of the Combination of Tetracycline, Amoxicillin, and Lansoprazole in the Eradication of Helicobacter pylori in Treatment-Naive Patients and in Patients Who Are Not Responsive to Clarithromycin-Based Regimens: A Pilot Study

( Mesut Sezikli ),( Zuleyha Akkan Cetinkaya ),( Fatih Guzelbulut ),( Atakan Yesil ),( Mustafa Erhan Altınoz ),( Nuriye Ulu ),( Ayse Oya Ovunc Kurdas ) 대한소화기기능성질환·운동학회 2012 Gut and Liver Vol.6 No.1

Background/Aims: The aim of this study was to evaluate the eradication rate of a triple therapy regimen that included a proton pump inhibitor, amoxicillin, and tetracycline instead of clarithromycin in treatment-naive patients and in patients who did not respond to standard triple therapy. Methods: This study included 110 patients infected with Helicobacter pylori. Patients in groups A and B were treatment-naive, and those in group C were not responsive to previous standard triple therapy. Patients in group A (n=40) received lansoprazole 30 mg b.i.d., amoxicillin 1,000 mg b.i.d., and clarithromycin 500 mg b.i.d. for 14 days. Patients in groups B (n=40) and C (n=30) received lansoprazole 30 mg b.i.d., amoxicillin 1,000 mg b.i.d., and tetracycline 500 mg q.i.d. for 14 days. Results: In group A, eradication was achieved in 18 (45%) of the 40 patients included in the intention-to-treat (ITT) analysis and in 18 (47.4%) of the 38 patients included in the per-protocol (PP) analysis. In group B, eradication was achieved in 15 (37.5%) of the 40 patients included in the ITT analysis and in 15 (39.3%) of the 38 patients included in the PP analysis. In group C, eradication was achieved in 14 (46.6%) of the 30 patients included in the ITT analysis and in 14 (43.8%) of the 29 patients included in the PP analysis. There was no statistically signifi cant difference among the 3 groups with regard to eradication rates (p>0.05). Conclusions: Despite the low rate of resistance to tetracycline, the combination of lansoprazole, amoxicillin, and tetracycline instead of clarithromycin is not a good option for the eradication of H. pylori. (Gut Liver 2012;6:41-44)

Effi cacy of the Combination of Tetracycline, Amoxicillin, and Lansoprazole in the Eradication of Helicobacter pylori in Treatment-Naïve Patients and in Patients Who Are Not Responsive to Clarithromycin-Based Regimens: A Pilot Study

Mesut Sezikli,Züleyha Akkan Çetinkaya,Fatih Güzelbulut,Atakan Yeşil,Mustafa Erhan Altınöz,Nuriye Ulu,Ayşe Oya Övünç Kurdaş 거트앤리버 소화기연관학회협의회 2012 Gut and Liver Vol.6 No.1

Background/Aims: The aim of this study was to evaluate the eradication rate of a triple therapy regimen that included a proton pump inhibitor, amoxicillin, and tetracycline instead of clarithromycin in treatment-naïve patients and in patients who did not respond to standard triple therapy. Methods: This study included 110 patients infected with Helicobacter pylori. Patients in groups A and B were treatment-naïve, and those in group C were not responsive to previous standard triple therapy. Patients in group A (n=40) received lansoprazole 30 mg b.i.d., amoxicillin 1,000 mg b.i.d., and clarithromycin 500 mg b.i.d. for 14 days. Patients in groups B (n=40) and C (n=30) received lansoprazole 30 mg b.i.d., amoxicillin 1,000 mg b.i.d., and tetracycline 500 mg q.i.d. for 14 days. Results: In group A, eradication was achieved in 18 (45%) of the 40 patients included in the intention-to-treat (ITT) analysis and in 18 (47.4%) of the 38 patients included in the per-protocol (PP) analysis. In group B, eradication was achieved in 15 (37.5%) of the 40 patients included in the ITT analysis and in 15 (39.3%) of the 38 patients included in the PP analysis. In group C, eradication was achieved in 14 (46.6%) of the 30 patients included in the ITT analysis and in 14 (43.8%) of the 29 patients included in the PP analysis. There was no statistically signifi cant difference among the 3 groups with regard to eradication rates (p>0.05). Conclusions: Despite the low rate of resistance to tetracycline, the combination of lansoprazole, amoxicillin, and tetracycline instead of clarithromycin is not a good option for the eradication of H. pylori.

A Lower Serum Gamma-Glutamyltransferase Level Does Not Predict a Sustained Virological Response in Patients with Chronic Hepatitis C Genotype1

( Fatih Guzelbulut ),( Mesut Sezikli ),( Zuleyha Akkan Cetinkaya ),( Selvinaz Ozkara ),( Can Gonen ),( Ayse Oya Kurdas Ovunc ) 대한소화기학회 2013 Gut and Liver Vol.7 No.1

Background/Aims: Low gamma-glutamyltransferase (GGT) level was shown to be an independent predictor of a sustained virological response (SVR) in chronic hepatitis C. We aimed to determine factors associated with high GGT level, and to evaluate whether low GGT level is an independent predictor of a SVR in chronic hepatitis C genotype 1. Methods: We retrospectively reviewed our data of patients with chronic hepatitis C genotype 1 treated with pegylated interferon-α and ribavirin. Baseline features were compared between patients with normal and high GGT levels. Factors associated with high GGT level and those associated with a SVR were determined by univariate and multivariate analysis. Results: This study included 57 patients. Mean age was 52.28±9.35 years. GGT levels was elevated in 27 patients (47.4%). GGT levels were normal in 63.3% of the patients who achieved a SVR and in 40.7% of those who did not achieve a SVR (p>0.05). By multivariate logistic regression analysis, the presence of cirrhosis (odds ratio [OR], 9.41; 95% confidence interval [CI], 1.08 to 102.61) and female gender (OR, 6.77; 95% CI, 1.23 to 37.20) were significantly associated with high GGT level, and only rapid virological response was associated with a SVR (OR, 8.369; 95% CI, 1.82 to 38.48). Conclusions: Low GGT level does not predict a SVR; however, it may be a predictor of high fibrosis scores. (Gut Liver 2013;7:74-81)

Evaluation of Aqueductal Patency in Patients with Hydrocephalus: Three-Dimensional High-Sampling-Efficiency Technique (SPACE) versus Two-Dimensional Turbo Spin Echo at 3 Tesla

Murat Ucar,Melike Guryildirim,Nil Tokgoz,Koray Kilic,Alp Borcek,Yusuf Oner,Koray Akkan,Turgut Tali 대한영상의학회 2014 Korean Journal of Radiology Vol.15 No.6

Objective: To compare the accuracy of diagnosing aqueductal patency and image quality between high spatial resolution three-dimensional (3D) high-sampling-efficiency technique (sampling perfection with application optimized contrast using different flip angle evolutions [SPACE]) and T2-weighted (T2W) two-dimensional (2D) turbo spin echo (TSE) at 3-T in patients with hydrocephalus. Materials and Methods: This retrospective study included 99 patients diagnosed with hydrocephalus. T2W 3D-SPACE was added to the routine sequences which consisted of T2W 2D-TSE, 3D-constructive interference steady state (CISS), and cine phase-contrast MRI (PC-MRI). Two radiologists evaluated independently the patency of cerebral aqueduct and image quality on the T2W 2D-TSE and T2W 3D-SPACE. PC-MRI and 3D-CISS were used as the reference for aqueductal patency and image quality, respectively. Inter-observer agreement was calculated using kappa statistics. Results: The evaluation of the aqueductal patency by T2W 3D-SPACE and T2W 2D-TSE were in agreement with PC-MRI in 100% (99/99; sensitivity, 100% [83/83]; specificity, 100% [16/16]) and 83.8% (83/99; sensitivity, 100% [67/83]; specificity, 100% [16/16]), respectively (p < 0.001). No significant difference in image quality between T2W 2D-TSE and T2W 3D-SPACE (p = 0.056) occurred. The kappa values for inter-observer agreement were 0.714 for T2W 2D-TSE and 0.899 for T2W 3D-SPACE. Conclusion: Three-dimensional-SPACE is superior to 2D-TSE for the evaluation of aqueductal patency in hydrocephalus. T2W 3D-SPACE may hold promise as a highly accurate alternative treatment to PC-MRI for the physiological and morphological evaluation of aqueductal patency.