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Angiogenesis is an important component of pathogenesis of inflammatory bowel disease (IBD). Chronic inflammation and angiogenesis are two closely related processes. Chronic intestinal inflammation is dependent on angiogenesis and this angiogenesis is modulated by immune system in IBD. Angiogenesis is a very complex process which includes multiple cell types, growth factors, cytokines, adhesion molecules, and signal transduction. Lymphangiogenesis is a new research area in the pathogenesis of IBD. While angiogenesis supports inflammation via leukocyte migration, carrying oxygen and nutrients, on the other hand, it has a major role in wound healing. Angiogenic molecules look like perfect targets for the treatment of IBD, but they have risk for serious side effects because of their nature.

Background/Aims: Liver fatty acid-binding protein (LFABP) controls hepatocyte lipid metabolism and can be a biomarker in liver diseases. We compared the correlation of LFABP levels with liver histology in viral hepatitis and nonalcoholic fatty liver disease (NAFLD) and investigated the utility of serum LFABP as a biomarker for liver damage. Materials and Methods: We included 142 patients (60 chronic viral hepatitis B [CHB], 35 chronic viral hepatitis C [CHC], 47 NAFLD) and 40 healthy controls. LFABP levels were determined in all participants, and a liver biopsy was performed on patients. The nonalcoholic steatohepatitis (NASH) activity score (NAS), hepatosteatosis, liver inflammation, and fibrosis were evaluated for NAFLD patients. Ishak’s histological scores were used for viral hepatitis. The correlation between LFABP levels and histologic scores was assessed in each group. Results: Serum LFABP levels in CHB, CHC, NAFLD, and control groups were 2.2, 3.5, 7.6, and 2.1 ng/mL, respectively. LFABP levels were significantly higher in the NAFLD group compared to the control, CHC, and CHB groups. LFABP was significantly higher in the NASH group than in nonalcoholic steatohepatitis, 8 ng/mL and 5.4 ng/mL, respectively (P = .001). In the NAFLD group, LFABP levels showed a moderate positive correlation with NAS score (r = 0.58, P < .001), ballooning degeneration (r = 0.67, P < .001), and lobular inflammation (r = 0.62, P < .001). A logistic regression study showed that the level of LFABP was predictive of NASH independent of age, gender, homeostasis model of IR, body mass index, aspartate aminotransferase, and alanine aminotransferase (OR = 1.869, P = .01). Conclusion: LFABP specifically correlates with liver histology in NAFLD compared to viral hepatitis. Additionally, it can distinguish NASH from simple steatosis. LFABP may be a valuable biomarker for hepatocyte injury in NASH.

Acute pancreatitis (AP) is a clinical condition that arises acutely in the pancreas through various inflammatory pathways due to multiple causes. Turkish Society of Gastroenterology Pancreas Working Group developed comprehensive guidance statements regarding the management of AP that include its epidemiology, etiology, clinical presentation, diagnostic criteria, disease severity, treatment, prognosis, local and systemic complications. The statements were developed through literature review, deliberation, and consensus opinion. These statements were ultimately used to develop a conceptual framework for the multidisciplinary management of AP.

Background/Aims: Gastroenterologists have an important role in the treatment and management of comorbidities related to obesity. Assessment of gastroenterologists’ perception and attitude toward obesity was aimed in this study. Materials and Methods: Survey questions were determined for the study. An online questionnaire was prepared afterward. Participants were invited via e-mail by providing them with information about the study. It was ensured that those who accepted the study could access the questionnaire form with the relevant link. Participants who answered all questions were included in the study. Results: Totally 117 gastroenterologists were included in the study. The proportion of gastroenterologists who thought that obesity complicates the management of gastroenterological diseases and those who thought obesity as a factor that negatively affects the prognosis of gastroenterological diseases was determined as 88.9% and 95.7%, respectively. Among the obese patients, the proportion of those who applied diet therapy, exercise, pharmacotherapy, and endoscopic methods was 94%, 91.5%, 35%, and 37.6%, respectively. The rates of intragastric balloon therapy and intragastric botulinum toxin A injection were 30% and 21.4%, respectively. The proportion of those who agreed that obese patients lost a significant amount of weight with the treatment methods applied was 47.2%. The proportion of participants who agreed that long-term maintenance of weight loss was impossible for most obese patients was 59.8%. Conclusion: To our knowledge, this is the first study that evaluates the perception and attitude of gastroenterologists toward obesity. Our study results show that gastroenterologists think that obesity is a chronic disease and that gastroenterologists should be involved in management of obesity.

Objective:To validate the use of a single-question visual analog scale assessing sexual dysfunction as a screening tool before implementing the female sexual function index (FSFI).Materials and Methods:The study included 141 sexually active women over 18 years of age who were diagnosed with OAB or UI. A female sexual function-visual analog scale (FSF-VAS) was defined and developed as a one-question form in which participants were asked to mark their sexual function on a 10 cm visual analog scale. The cut-off values for the FSF-VAS in predicting FSD were determined by receiver operating characteristic curve analysis and Youden’s index.Results:A positive, moderately strong correlation was found between the FSFI score and FSF-VAS (rs=0.741). We found a cut-off value for FSF-VAS as 5.95 for in predicting both FSFI score of

Hypoparathyroidism is a rare clinical condition characterized by parathyroid hormone insufficiency, decreased serum calcium, and increased serum phosphorus levels. Neck surgery is the most common cause of acquired hypoparathyroidism in adults. Post-surgical hypoparathyroidism is reported as one of the important complications in thyroid gland surgeries and if not diagnosed timely, may be associated with severe morbidity. The clinical manifestations of hypoparathyroidism are variable and may affect almost all organ systems. It is usually manifested by symptoms associated with hypocalcemia. The most common symptom is neuromuscular irritability, which includes paresthesias and muscle spasms in hands, feet, and around mouth. Rarely, some cases may present with inflammatory low back and neck pain, widespread pain, posture disorders, muscle weakness or, limited vertebral range of motion in the long term. Some patients may be misdiagnosed as spondyloarthropathy and may receive unnecessary treatments. In this case report, we present the clinical findings of a 55-year-old male patient with delayed post-surgical hypoparathyroidism who had been previously diagnosed ankylosing spondylitis and referred to our clinics for further treatment.

Amaç: Egzersiz tedavisi, kronik non-spesifik bel ağrısı (NSKBA) tanısı alan hastalarda en yaygın önerilen tedavi şeklidir. Ancak bir egzersiz yönteminin başka bir egzersiz yöntemine üstün olup olmadığı tartışmalıdır. Gereç ve Yöntem: Bu çalışmada NSKBA olan hastalar deney grubu (gözetimli aerobik egzersiz + ev egzersizi) ve kontrol grubu (sadece ev egzersizi) olmak üzere iki gruba randomize edildi. Hastalar tedavi öncesi, tedavi bitimi ve tedavi bitiminden üç ay sonra ağrı şiddeti, spinal mobilite, lomber ektansör kas dayanıklılığı, depresif semptom varlığı ve şiddeti, özürlülük ve yaşam kalitesi bakımından değerlendirildi. Bulgular: Deney grubunda tüm değerlendirmelerde anlamlı düzelme saptanırken kontrol grubunda, ağrı, spinal mobilite ve yaşam kalitesinin fiziksel komponentinde anlamlı düzelme saptandı. Kontrol grubuna göre, deney grubunda değerlendirme parametrelerinde zamanla meydana gelen olumlu değişim anlamlı olarak daha yüksekti. Sonuç: Aerobik egzersiz, NSKBA olan hastaların yetersizliklerinin düzeltmesine, aktivite düzeylerinin ve katılım düzeylerinin arttırılmasına katkı sağlayabilir. Ancak hangi aerobik egzersiz tipinin (sıklığının, süresinin ve yoğunluğunun) daha etkili olduğuna yönelik çalışmalara ihtiyaç vardır.

Iodine can be obtained by consumption of the foods that include it or to which it is added. Iodine-induced hyperthyroidism, also known as Jod-Basedow Syndrome, usually rise in the cases of an underlying thyroid disease, such as autoimmune thyroid disease, latent Graves disease, non toxic diffuse or nodular goiter or previous thyroid surgery. Iodine-induced hyperthyroidism is frequently self-limited with a period of 1-18 months after the discontinuanceation of iodine supply/replation. The prognosis is frequently favorable, the majority returns to the baseline hormonal status. The long term outcomes of Jod-Basedow effects remain unknown due to the scarcity of phenomenon. Nonetheless, it is remarkable that treatment, devoted to the underlying thyroid diseases should be addressed after resolution of the acute episode. Furthermore, an interprofessional health care team must serve and officiate not only to treat iodine-induced hyperthyroidism, but also to concern themselves actively in prophylaxis.

Objective:In this study, we aimed to evaluate the association of lower urinary tract symptoms (LUTS), overactive bladder (OAB) and urinary incontinence (UI) with age, diabetic complications and glycaemic control in diabetic women.Materials and Methods:A total of 81 women diagnosed with Diabetes Mellitus were included in the study. Demographic characteristics including age, height and weight of patients, full medical history, urine culture, serum creatinine levels and glycaemic control parameters including serum fasting blood glucose levels, serum satiety blood glucose levels and serum HbA1c levels. Turkish version of the OAB-V8, urinary distress inventory-6 (UDI-6), incontinence impact questionnaire (IIQ-7) and the International Prostate Symptom Score (IPSS) were applied.Results:The mean age was 58.6±11.8 years. Thirty-five (43.2%) of the patients had diabetes-related complications. There was no statistically significant relationship between OAB-V8, UDI-6, IPSS, IIQ-7 questionnaire scores and glycaemic control parameters, age, and presence of diabetic complications.Conclusion:To better understand the etiopathogenesis of diabetic bladder dysfunction and related complications including LUTS, OAB and UI, we need randomized controlled studies with a greater number of patients.

Objective: The aim of the present study was to compare patients with ankylosing spondylitis (AS) with healthy controls with respect to subclinical atherosclerotic cardiovascular disease (CVD). Methods: A total of 44 patients with AS with no history of CVD, diabetes mellitus, hypertension, chronic kidney disease, and lipid-lowering drug use were compared with 40 age- and sex-matched healthy controls with respect to carotid intima-media thickness (CIMT) and pulse wave velocity (PWV), which are surrogate markers of subclinical atherosclerosis. Correlation analysis was also performed to examine the association between surrogate markers and disease activity with inflammation [Ankylosing spondylitis disease activity score with C-reactive protein (ASDAS-CRP)]. Results: In addition to age and sex, both groups were comparable with respect to cigarette smoking, body mass index, and high-density lipoprotein cholesterol (p=0.425, p=0.325, and p=0.103, respectively). The level of total cholesterol was significantly lower in patients with AS (p=0.002). Nonsteroidal anti-inflammatory drug and tumor necrosis factor alpha inhibitor use ratios in patients with AS were 79.5% and 65.9%, respectively. There was no significant difference between both groups regarding PWV and CIMT (p=0.788 and p=0.253, respectively). In patients with AS, there was a significant correlation between ASDAS-CRP and CIMT (r=0.315, p=0.038), but the correlation between ASDAS-CRP and PWV was not significant (r=−0.183, p=0.234). Conclusion: The results of the present study could not provide sufficient evidence whether disease activity with inflammation caused subclinical atherosclerotic CVD in patients with AS without overt CVD. The increased atherosclerotic CVD risk is most probably multifactorial in patients with AS, but the extent of the contribution of disease activity with inflammation to increased atherosclerosis is controversial.

Spontaneous bilateral quadriceps rupture is rarely seen in systemic diseases. Although the underlying mechanism in tendon rupture is not clearly understood, β2-amyloidosis, chronic acidosis, impaired collagen metabolism, accumulation of uremic toxins and secondary hyperparathyroidism are held to be responsible. The patients with bilateral spontaneous quadriceps rupture can be able to achieve significant functional improvement with the postoperative rehabilitation program. In this article, we aimed to present a patient with hemodialysis who developed spontaneous bilateral quadriceps and unilateral triceps rupture and discuss in company with the literature.

Objective: Predictive factors that could affect the cure and complication rates of midurethral slings (MUS) in the treatment of stress urinary incontinence (SUI) were investigated. Materials and Methods: A total of 594 women (outside-in transobturator in 285, inside-out transobturator in 91, and retropubic in 218) with SUI and who had undergone MUS were evaluated. The median age was 53.9 (27-82) years. Univariate analyses were done using chi-square test, Student’s t-test and the Mann-Whitney U test. Multivariate analyses were done using logistic regression analysis to determine predictive factors affecting cure and complication rates. Results: The mean follow-up time was 48 months. The subjective cure rate was 84% and complication rate was 11.2%. On univariate and multivariate analyses, the cure rate was found to be increased in younger patients [odds ratio (OR): 0.97, 95% confidence interval (CI): 0.95-0.99, p=0.038] and in patients with pure SUI (OR: 2.17, 95% CI: 1.31-3.60, p=0.002). The type of surgery was the only statistically significant parameter affecting the complication rate, which was significantly higher in retropubic MUS procedure (OR: 6.28, 95% CI: 3.51-11.22, p

Objective: It is known that Pseudomonas has been isolated more frequently in health care-related urinary tract infections (UTIs). It was aimed to determine the risk factors and empiric therapies due to antibiotic resistance in Pseudomonas-related male UTIs, and assess the effect of Pseudomonas isolation on treatment and length of hospital stay. Materials and Methods: The study was conducted between January 2011 and January 2013 with 228 male health care-related complicated UTI patients hospitalized in the Urology and Infectious Diseases Inpatient Clinics at Gazi University Faculty of Medicine. Three hundred UTI attacks in 228 patients were evaluated retrospectively with regard to agents. Results: Pseudomonas was isolated in 37 of 300 complicated UTI attacks in 228 male patients. Nephrolithiasis, recurrent UTI and internal urinary catheterization were determined as the risk factors for Pseudomonas related with health care-related UTI. It was understood that nephrolithiasis increased Pseudomonas isolated UTI risk 3.5 fold and recurrent UTI increased the risk 8.9 fold. The antibiotic resistance of Pseudomonas was higher than other agents. Pseudomonas related UTIs prolonged the duration of hospital stay and antibiotic treatment. Conclusion: In the presence of nephrolithiasis, recurrent UTI and internal urinary catheterization, drugs against Pseudomonas would be appropriate empiric treatment for health care-related complicated UTI. Ciprofloxacin use should be restricted when local antibiotic resistance, which leads empiric treatment, is taken into consideration. Increases in hospital stay and antibiotic treatment duration were thought to be associated with recurrent infection frequency and high antibiotics resistance in Pseudomonas related UTIs.

Objective Prostate cancer (PCa) is observed in men aged 50 years and older. The incidence increases in parallel to aging. Survival rate for PCa increases with effective screening programs and therapies. Elongated life expectancy may lead to a decrease in quality of life, muscle strength and physical activity level; an increase in fatigue and sleep problems. To preclude the occurrence of these symptoms, the preventive physiotherapy approaches may be used in PCa patients. The aim of this study was to investigate the attitude of patients with PCa towards preventative physiotherapy approaches. Materials and Methods Patients who were diagnosed with PCa in Gazi University Faculty of Medicine, Department of Urology were invited to participate in the preventive physiotherapy services provided in Gazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Oncologic Rehabilitation Unit. Results Three hundred forty-four patients were invited, only 20 (5.8%) patients participated in the study. Twenty (5.8%) patients did not attend the appointment despite agreeing to participate in the study. Other 304 (88.4%) patients did not join the study for several reasons. Conclusion The reason for low participation rate may be inadequate information of PCa patients about preventive physiotherapy. The results of this study highlight the need for making preventive physiotherapy applications recognizable for PCa patients.

Objective: In this study, we investigated the relationships between 10 year fracture risk calculated with FRAX assessment tool and bone turnover markers (BTM) in women with diagnosed as postmenopausal osteoporosis for the first time. Materials and Methods: After exclusion of the causes of secondary osteoporosis 61 postmenopausal women diagnosed with osteoporosis for the first time were enrolled. Height and weight measurements, comorbid diseases, menopause age, and laboratory investigations were recorded. Lumbar and femur neck and femur total T scores were measured by dual-energy x-ray absorptiometry (DXA). As BTM, serum osteocalcin (OC) and urine deoxypridinoline levels were measured. 10-year fracture risk of hip and major osteoporotic fracture was calculated with FRAX assessment tool. Results: The mean age of patients was 61±39 years. Median value of menopause year was 15.13 years (min: 2, max: 40). The median 10-year hip fracture and major osteoporotic fracture risks were calculated as 1.10% (min: 0, max: 23), 6.9% (min: 3, max: 34) respectively. There was no significant relationship between BTM and fracture risk. Positive significant correlation was found between menopause year and hip fracture risk, and between menopause year and major osteoporotic fracture risks (p=0.031, 0.276; p=0.025, r=0.287). Negative significant correlation was detected between body mass index and hip fracture risk (p=0.002, r=-0.392). Conclusion: In our study, we couldn’t find relationship between BTM and fracture risks assessed by using FRAX tool in patients with initially diagnosed of postmenopausal osteoporosis. Further studies are needed to investigate the relationship between BTM and fracture risk in different patient groups. (Turkish Journal of Osteoporosis 2015;21: 58-62)

The aim of this study was to test the hypothesis that postconditioning (POC) would reduce the detrimental effects of the acute intestinal ischemia–reperfusion (I/R) compared to those of the abrupt onset of reperfusion. POC has a protective effect on intestinal I/R injury by inhibiting events in the early minutes of reperfusion in rats. Twenty-four Wistar–Albino rats were subjected to the occlusion of superior mesenteric artery for 30 minutes, then reperfused for 120 minutes, and randomized to the four different modalities of POC: (1) control (no intervention); (2) POC-3 (three cycles of 10 seconds of reperfusion–reocclusion, 1 minute total intervention); (3) POC-6 (six cycles of 10 seconds of reperfusion–reocclusion, 2 minutes total intervention); and (4) sham operation (laparotomy only). The arterial blood samples [0.3 mL total creatine kinase (CK) and 0.6 mL malondialdehyde (MDA)] and the intestinal mucosal MDA were collected from each after reperfusion. POC, especially POC-6, was effective in attenuating postischemic pathology by decreasing the intestinal tissue MDA levels, serum total CK activity, inflammation, and total histopathological injury scores. POC exerted a protective effect on the intestinal mucosa by reducing the mesenteric oxidant generation, lipid peroxidation, and neutrophil accumulation. The six-cycle algorithm demonstrated the best protection.

Çalışma alanı Eskişehir grabeni içinde Eskişehir ilinin doğusunda, Sevinç Mahallesi ile Ağapınar Köyü’nün kuzeyinde yer alır. Sahada temel kayaçları Paleozoyik yaşlı metamorfitler ve Mesozoyik yaşlı ofiyolitler oluşturur. Temel kayaçları üzerine uyumsuz olarak Miyosen yaşlı çökeller gelir. Miyosen yaşlı çökellerin tabanında çakıltaşı, kumtaşı ve kiltaşından oluşan m1 serisi yer alır. Üzerine gelen m2 serisi, tabandan tavana doğru yer yer çakıllı, yeşil renkli kiltaşı, kömür, gri renkli kumtaşı, koyu gri yeşil renkli silttaşı, bitümlü marn, kiltaşı, kömür ve yeşil renkli kiltaşı, kumtaşı, ince taneli çakıltaşı ardışımından oluşan bir istif sunar. Daha üstte ise, yer yer gözlenen kireçtaşı ve çakıltaşından oluşan m3serisi ile gevşek çakıltaşı, kiltaşı düzeylerinden oluşan Pliyosen yaşlı çökeller yer alır. Neojen yaşlı çökeller ile kaplı olan bölgede stratigrafik istif, Maden Tetkik ve Arama Genel Müdürlüğü’ne ait ruhsatlarda yapılan araştırma ve rezerv sondajları ile belirlenmiştir. Havzada arazi şartları (ekili alanlar, sulama kanalları, porsuk çayı, demiryolu hattı vs) ve yapılan sondaj lokasyonları dikkate alınarak birbirini kesen iki hat üzerinde yüksek çözünürlüklü sığ sismik yansıma verisi toplanmıştır. Toplanan bu veriler Maden Tetkik ve Arama Genel Müdürlüğü Jeofizik Etütleri Dairesi Sismik Etütler Birimi veri işlem merkezinde değerlendirilerek sismik yansıma final kesitleri elde edilmiştir. Elde edilen sismik yansıma kesitleri hatların üzerinden ya da çok yakınından geçen sondaj verileri ile deneştirilmiştir. Sismik kesitler genel olarak ele alındığında tüm kesitler boyunca sürekli olarak izlenebilen yansıma yüzeyi (sarı renkli seviye) sismik temel girişi olarak belirlenmiş olup, sondaj verileri ile yapılan korelasyon sonucunda bu seviyenin ofiyolitlere karşılık geldiği saptanmıştır. Yorumlanmış kesitler üzerinde özellikle sismik temelin basamaklı süreksizlik yüzeyleri ile derinleştiği alanlarda izlenen ve sismik temel yamaçlarına yaslanan yansıma yüzeyleri (yeşil renkli seviyeler) kömür-kil giriş-çıkış zonu olarak belirlenmiş ve bölgede devam eden sondaj çalışmalarından elde edilen veriler ile sismik kesitlerden yapılan jeofiziksel yorumların örtüştüğü ortaya konmuştur.

Female adnexial tumors of probable Wolffian origin (FATWO) are rare tumors derived from the remnants of the mesonephric duct. These tumors generally exhibit a low malignant potential, but recurrence and or metastasis is possible during the course of the disease according to the tumors’ possible malignant potential. We report a case of FATWO without estrogen and progesterone receptors and with negative immunostaining for Ki-67 (a proliferation marker) as a probable low-malignant-potential tumor. A 55-year-old woman presented with a complaint of heavy menstrual bleeding and pelvic pain. Preoperative ultrasonographic evaluation revealed an intramural uterine leiomyoma of 4 cm in diameter and a right adnexial solid mass measuring 5 cm in diameter. Following total abdominal hysterectomy and bilateral salpingo-oophorectomy, immunostaining based on the labeled streptavidin-biotin method was performed on sections from representative blocks of paraffin-embedded tissues sampled from the mass, revealing a low mitotic index with negative Ki-67 immunostaining. Immunohistochemical staining with promising new markers and pathological investigation of the entire tumor are needed to determine the malignant behavior of an individual FATWO. Ki-67 is a helpful marker for determining Wolffian duct tumors’ potential malignant behavior.

EDITORIAL COMMENT The prevalence of overactive bladder (OAB) in the general population is nearly 16% and it increases with age. In non-responders who are managed with oral therapies, there is a need for the intradetrusor injections of onabotulinumtoxinA (Botox). Adverse effects, including the potential risk of urinary retention requiring catheterization are among the greatest concerns for OAB patients considering Botox injections. The efficacy of Botox (100 U) in the treatment of refractory OAB has been proven in several clinical trials, however, the risk factors for the occurrence of urinary retention after Botox injections are still not well recognized. Studies do not describe the factors for the prediction of urine retention after Botox (100 U) injections in patients with refractory OAB. As the dose of Botox increases, urinary retention risk increases, but recurrent injections decreases the risk. In this study, the risk factors for urinary retention was observed in 208 women who were treated with 100 IU Botox injections for refractory OAB. The study revealed the risk factors for urinary retention as 3 or more vaginal deliveries and advanced age. No need for clean intermittent self-catheterization (CISC) was seen for more than 12 weeks. The minimum duration of CISC was 20 days and a maximum of 83 days with a mean of 45.5 days. No potential risk factors for the duration of CISC were observed. Although all patients should be warned before receiving Botox injections about the potential risk of urine retention, elderly women and multiparous women are at an increased risk.

Ectomesenchymal chondromyxoid tumor is a rare tumor seen in the anterior dorsal aspect of the tongue. Diagnosis of this lesion without a prediagnosis clinically is made only with histopathological findings including the immunohistochemical examinations. However, diverse results are being reported in the literature with keratin staining. While glial fibrillary acid protein positiveness maintain being a fixed repeating feature, we emphasized for our case of a 28-year-old Caucasian woman having the findings of qualities supporting the ectomesenchymal origin of the mentioned tumor.