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.

Red Cell Distribution Width: A Novel Marker of Activity in Infl ammatory Bowel Disease

Atakan Yeşil,Ebubekir Şenateş,İbrahim Vedat Bayoğlu,Emrullah Düzgün Erdem,Refi k Demirtunç,Ayşe Oya Kurdaş Övünç 거트앤리버 소화기연관학회협의회 2011 Gut and Liver Vol.5 No.4

Background/Aims: Studies concerning red cell distribution width (RDW) for use in the assessment of infl ammatory bowel disease (IBD) activity are limited. We investigated whether RDW is a marker of active disease in patients with IBD. Methods: In total, 61 patients with ulcerative colitis (UC)and 56 patients with Crohn’s disease (CD) were enrolled in the study group, and 44 age- and-sex-matched healthy volunteers were included as the control group. A CD activity index >150 in patients with CD indicated active disease. Patients with moderate and severe disease based on the Truelove-Witts criteria were considered to have active UC. In addition to RDW, serum C-reactive protein levels, erythrocyte sedimentation rates, and platelet counts were measured. Results: Twenty-nine (51.7%) patients with CD and 35 (57.4%)patients with UC had active disease. The RDW was significantly higher in patients with CD and UC than in controls (p<0.001 and p<0.001, respectively). A subgroup analysis indicated that for a RDW cut-off of 14%, the sensitivity for detecting active CD was 79%, and the specicity was 93% (area under curve [AUC], 0.935; p<0.001). RDW was the most sensitive and specifi c marker for active CD. However, it was not valid for UC, as the ESR at a cutoff of 15.5 mm/hr showed a sensitivity of 83% and a specicity of 76% (AUC, 0.817;p<0.001), whereas the RDW at a cutoff of 14% showed 17%sensitivity and 84% specicity for detecting active UC. Conclusions:RDW was elevated in IBD in comparison with healthy controls and increased markedly in active disease. RDW may be a sensitive and specifi c marker for determining active CD,whereas ESR is an important marker of active UC.

Modified Artificial Neural Networks and Support Vector Regression to Predict Lateral Pressure Exerted by Fresh Concrete on Formwork

Amirreza Kandiri,Pshtiwan Shakor,Rawaz Kurda,Ahmed Farouk Deifalla 한국콘크리트학회 2022 International Journal of Concrete Structures and M Vol.16 No.6

In this study, a modified Artificial Neural Network (ANN) and Support Vector Regression (SVR) with three different optimization algorithms (Genetic, Salp Swarm and Grasshopper) were used to establish an accurate and easy-to-use module to predict the lateral pressure exerted by fresh concrete on formwork based on three main inputs, namely mix proportions (cement content, w/c, coarse aggregates, fine aggregates and admixture agent), casting rate, and height of specimens. The data have been obtained from 30 previously piloted experimental studies (resulted 113 samples). Achieved results for the model including all the input data provide the most excellent prediction of the exerted lateral pressure. Additionally, having different magnitudes of powder volume, aggregate volume and fluid content in the mix exposes different rising and descending in the lateral pressure outcomes. The results indicate that each model has its own advantages and disadvantages; however, the root mean square error values of the SVR models are lower than that of the ANN model. Additionally, the proposed models have been validated and all of them can accurately predict the lateral pressure of fresh concrete on the panel of the formwork.

Radiologically inserted gastrostomy complications: A case series

George Zhang,Hayden Matthews,Osanna Wong,Dylan Kurda 소화기인터벤션의학회 2022 International journal of gastrointestinal interven Vol.11 No.3

Radiologically inserted gastrostomy (RIG) is performed in patients who cannot safely or sufficiently receive oral nutrition; however, postoperative complications are not uncommon. The risk of major complications such as peritonitis, migration, infection, malposition, and bleeding is small but appreciable, although mortality as a direct consequence of gastrostomy placement is rare. In this case series, we describe the major gastrostomy complications (arterial haemorrhage, gastric fluid leak, peritonitis, RIG site infection, ileus and colon perforation) that occurred in four patients at our hospital over a 27-month period in which 152 RIG procedures were performed (an incidence rate of 2.6%). Herein, we describe the gastrostomy procedures, clinical course, and surgical corrections required for these patients before discussing the complication risks for common gastrostomy procedures and potential methods to reduce and prevent such complications.

Radiologically inserted gastrostomy complications: A case series

George Zhang,Hayden Matthews,Osanna Wong,Dylan Kurda 소화기인터벤션의학회 2022 Gastrointestinal Intervention Vol.11 No.3

Radiologically inserted gastrostomy (RIG) is performed in patients who cannot safely or sufficiently receive oral nutrition; however, postoperative complications are not uncommon. The risk of major complications such as peritonitis, migration, infection, malposition, and bleeding is small but appreciable, although mortality as a direct consequence of gastrostomy placement is rare. In this case series, we describe the major gastrostomy complications (arterial haemorrhage, gastric fluid leak, peritonitis, RIG site infection, ileus and colon perforation) that occurred in four patients at our hospital over a 27-month period in which 152 RIG procedures were performed (an incidence rate of 2.6%). Herein, we describe the gastrostomy procedures, clinical course, and surgical corrections required for these patients before discussing the complication risks for common gastrostomy procedures and potential methods to reduce and prevent such complications.

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)

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)

The Woven EndoBridge Device for the Treatment of Intracranial Aneurysms: Initial Clinical Experience within an Australian Population

Jay Gajera,Julian Maingard,Michelle Foo,Yifan Ren,Anthony Lamanna,Daniel Nour,Jonathan Hall,Dylan Kurda,David Tan,Shivendra Lalloo,Ramon Martin Francisco Bañez,Jeremy Russell,Lee-Anne Slater,Ronil Vik 대한신경중재치료의학회 2022 Neurointervention Vol.17 No.1

Purpose: Advances in endovascular technology have expanded the treatment options for intracranial aneurysms. Intrasaccular flow diversion is a relatively new technique that aims to disrupt blood inflow at the neck of the aneurysm, hence promoting intrasaccular thrombosis. The Woven EndoBridge device (WEB; MicroVention, Aliso Viejo, CA, USA) is an US Food and Drug Administration approved intrasaccular flow diverter for wide-necked aneurysms. We report the early interim clinical and radiological outcomes of patients with both ruptured and unruptured intracranial aneurysms (IAs) treated using the WEB device in an Australian population. Materials and Methods: A retrospective analysis was done of patients with ruptured or unruptured IAs who received treatment with WEB across 5 Australian neuroendovascular referral centers between May 2017 and November 2020. Angiographic occlusion was assessed with time-of-flight magnetic resonance angiography. Complications were recorded and clinical outcomes were assessed using the modified Rankin scale at follow-up. Results: In total, 66 aneurysms were treated in 63 patients, with successful deployment of the WEB device in 98.5% (n=65). Eighteen (26.9%) ruptured aneurysms were included. Failure of deployment occurred in a single case. Adjunct coiling and/or stenting was performed in 20.9% (n=14) cases. Sixty-two patients with 65 aneurysms using a WEB device were followed up (mean=9.1 months), and 89.4% of these had complete aneurysm occlusion while 1.5% remained patent. Functional independence was achieved in 93.5% of cases. Conclusion: Early results following the use of WEB devices in Australia demonstrate safety and adequate aneurysm occlusion comparable to international literature.

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)

Original Article : Red Cell Distribution Width: A Novel Marker of Activity in Infl ammatory Bowel Disease

( Atakan Yesil ),( Ebubekir Senates ),( Ibrahim Vedat Bayoglu ),( Emrullah Duzgun Erdem ),( Refi K Demirtunc ),( Ayse Oya Kurdas Ovunc ) 대한간학회 2011 Gut and Liver Vol.5 No.4

Background/Aims: Studies concerning red cell distribution width (RDW) for use in the assessment of infl ammatory bowel disease (IBD) activity are limited. We investigated whether RDW is a marker of active disease in patients with IBD. Methods: In total, 61 patients with ulcerative colitis (UC) and 56 patients with Crohn`s disease (CD) were enrolled in the study group, and 44 age- and-sex-matched healthy volunteers were included as the control group. A CD activity index >150 in patients with CD indicated active disease. Patients with moderate and severe disease based on the Truelove-Witts criteria were considered to have active UC. In addition to RDW, serum C-reactive protein levels, erythrocyte sedimentation rates, and platelet counts were measured. Results: Twenty-nine (51.7%) patients with CD and 35 (57.4%) patients with UC had active disease. The RDW was significantly higher in patients with CD and UC than in controls (p<0.001 and p<0.001, respectively). A subgroup analysis indicated that for a RDW cut-off of 14%, the sensitivity for detecting active CD was 79%, and the specicity was 93% (area under curve [AUC], 0.935; p<0.001). RDW was the most sensitive and specifi c marker for active CD. However, it was not valid for UC, as the ESR at a cutoff of 15.5 mm/hr showed a sensitivity of 83% and a specicity of 76% (AUC, 0.817; p<0.001), whereas the RDW at a cutoff of 14% showed 17% sensitivity and 84% specicity for detecting active UC. Conclusions: RDW was elevated in IBD in comparison with healthy controls and increased markedly in active disease. RDW may be a sensitive and specifi c marker for determining active CD, whereas ESR is an important marker of active UC. (Gut Liver 2011;5:460-467)