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)

Slide Session : OS-END-25 ; Endocrinology : Is There a Relation Between Thyroid Autoantibodies and MPV in Hypothyroidism ?

( Serkan Yucesan ),( Meral Mert ),( Zeynep Erturk ),( Selcuk Sezikli ),( Yildiz Okuturlar ),( Ozlem Harmankaya ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Hypothyroidism is a prevalent endocrine disorder. The most common cause of hypothyroidism is autoimmune thyroid disorder. A possible prothrombotic effect of elevated thyrotropin (TSH) has been suggested. MPV can be used as a marker of platelet activity. The objective of the present study was to determine if there is an association between the MPV, serum TSH and auto-antibody(anti-TPO and anti-TG) concentrations. Methods: We studied 145 adults with hypothyroidism (TSH >5 mlU/L ). We evaluate the mean values MPVs and their relation with auto-antibody and TSH levels. Results: 126 female and 19 male patients were in enrolled in our study retrospectively. The mean level of the MPV in all patients was 8.41 femtoliters (fL) and the mean level of TSH was 13.41 mlU/L. Negative correlation (r:0.015) between MPV, age, and anti-TPO ve TG was found. There was no correlation between MPV and TSH. There was no statistically significant difference between TSH, MPV, auto-antibody levels and age. Conclusions: MPV is reported to be increased in vascular events like atherosclerotic thrombosis and to be decreased in acute infl ammation. The main pathophysiological process is inflammation in autoimmune thyroid disease, so the possible explanation of negative correlation between MPV and autoantibodies is autoimmunity.

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)

Poster Session : PS 0446 ; Infectious Disease ; Fever of Unknown Cause Which is the Cause of Intestinal Tuberculosis

( Tugrul Burak Genc ),( Yildiz Okuturlar ),( Ozlem Harmankaya ),( Suut Gokturk ),( Bulent Durdu ),( Samet Sayilan ),( Selcuk Sezikli ),( Meral Mert ),( Abaki Kumbasar ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: In developing countries, tuberculosis (tbc) incidence is reduced; but immunocompromised patients still remain at high risk for the disease. Malignancy and Crohn`s disease should be considered in the differential diagnosis of gastrointestinal (GIS) tbc in immunocompromised patients. We present here the clinical course of a patient with fever of unknown origin and rectal bleeding. Methods: A 31-year-old male cachectic patient was admitted to hospital with abdominal pain, fever and diarrhea. The history of the patient revealed systemic lupus erythematosus, lupus nephritis and left middle cerebral artery infarction. Right hemiparesis was present. He was on warfarin 5mg/day, cilazapril 2,5mg/day, methylprednisolone 4mg/day, mycophenolate mofetil 2g/day, hydroxychloroquine 200mg/ day, levodopa+benserazide 375mg/day, levetiracetam 1 g/day. Creatinine was 2,79mg/dL, and C-reactive protein was 10 mg/dL. No pneumonic infi ltration was shown. Blood, urine and faeces cultures, Chlamydia IgM, mycoplasma IgM, toxoplasma IgM, EBV IgM, CMV IgM and PPD test were negative. Transesophageal echocardiography excluded infective endocarditis. Empiric antibiotic treatment with ceftriaxone, piperacillin-tazobactam and moxifi oxacin, and antifungal fi uconazole was started. On the 15th day hematochezia occured. Colonoscopy revealed three different massive lesions straightening the lumen in caecum, hepatic fi exure of colon and transverse colon (figure-1). Results: Pathologic examination demonstrated granulomatous lesion. Considering the positive results of Tbc-PCR treatment, the patient was diagnosed as GIS tbc and isoniazid, rifampicin, pyrazinamide and ethambutol were started. Conclusions: The ileocecal region is the most frequent localization of intestinal tbc. Colonic tbc is often localized in proximal colon and caecum, and usually associated with ileal tbc. It is rarely seen in transverse colon. Our patient is a rare case of gastrointestinal tbc presenting without pneumonic infi ltration and with an unusual localization in colon.

A Study of Antidiabetic and Antioxidant Effects of Helichrysum graveolens Capitulums in Streptozotocin-Induced Diabetic Rats

Mustafa Aslan,Didem Deliorman Orhan,Nil?fer Orhan,Ekrem Sezik,Erdem Yesilada 한국식품영양과학회 2007 Journal of medicinal food Vol.10 No.2

Helichrysum graveolens(Bieb.) Sweet (Asteraceae) grows widely in Turkey. Capitulums of H. graveolensareused in the treatment of many diseases such as jaundice and wound healing and as a diuretic in the rural areas of Anatolia.The decoction from the capitulums of the plant is consumed for the symptoms of diabetes mellitus in folk medicine. In thepresent study, the hypoglycemic, antihyperglycemic, and antioxidant potentials of water and ethanol extracts of H. graveolenswere evaluated by using in vivomethods in normal and streptozotocin-induced diabetic rats. Blood glucose levels of animalswere measured by the glucose oxidase method. The antioxidant activity of these extracts was also studied in liver, kidney,and heart tissues. In order to determine antioxidant activity, tissue malondialdehyde and reduced glutathione levels were mea-sured by using spectrophotometric methods. The experimental data obtained from water and ethanol extracts of capitulumsconfirmed the folkloric utilization. In order to discuss the role of polyphenolic components in the relevant activity, total phe-nol and flavonoid contents of each extract were also determined using the Folin-Ciocalteu reagent, and a positive correlationwas observed.