This study aims to predict the undrained shear strength of remolded soil samples using non-linear regression analyses,fuzzy logic,and artificial neural network modeling.A total of 1306 undrained shear strength results...This study aims to predict the undrained shear strength of remolded soil samples using non-linear regression analyses,fuzzy logic,and artificial neural network modeling.A total of 1306 undrained shear strength results from 230 different remolded soil test settings reported in 21 publications were collected,utilizing six different measurement devices.Although water content,plastic limit,and liquid limit were used as input parameters for fuzzy logic and artificial neural network modeling,liquidity index or water content ratio was considered as an input parameter for non-linear regression analyses.In non-linear regression analyses,12 different regression equations were derived for the prediction of undrained shear strength of remolded soil.Feed-Forward backpropagation and the TANSIG transfer function were used for artificial neural network modeling,while the Mamdani inference system was preferred with trapezoidal and triangular membership functions for fuzzy logic modeling.The experimental results of 914 tests were used for training of the artificial neural network models,196 for validation and 196 for testing.It was observed that the accuracy of the artificial neural network and fuzzy logic modeling was higher than that of the non-linear regression analyses.Furthermore,a simple and reliable regression equation was proposed for assessments of undrained shear strength values with higher coefficients of determination.展开更多
BACKGROUND In cases of coronavirus disease 2019(COVID-19),favipiravir is commonly included to the therapy regimen.Drug interactions between favipiravir and other COVID-19 therapy drugs are frequently researched.Howeve...BACKGROUND In cases of coronavirus disease 2019(COVID-19),favipiravir is commonly included to the therapy regimen.Drug interactions between favipiravir and other COVID-19 therapy drugs are frequently researched.However,no research on possible drug interactions between Favipiravir and radiocontrast agents,which have become almost crucial in diagnostic processes while not being part of the treatment,has been found.AIM To determine potential medication interactions between Favipiravir and radiocontrast agents.METHODS The study comprised patients who were taking Favipiravir for COVID-19 therapy and underwent a contrast-enhanced computed tomography(CT)or magnetic resonance imaging(MRI)test while taking the medicine.The computerized patient files of the cases included in the study,as well as the pharmacovigilance forms in the designated hospital,were evaluated for this purpose.RESULTS The study included the evaluation of data from 1046 patients.The study sample's mean age was 47.23±9.48 years.The mean age of cases with drug interactions was statistically significant greater than that of cases with no drug interactions(P=0.003).When evaluated with logistic regression analysis,a 1-year raises in age increases the risk of developing drug interactions by 1.63 times(P=0.023).There was no statistically significant difference in the occurrence of medication interactions between the sexes(P=0.090).Possible medication interactions were discovered in 42 cases(4%).CONCLUSION The findings of this study revealed that the most notable findings as a result of the combined use of contrast agents and favipiravir were increased creatinine and transaminase values,as well as an increase in the frequency of nausea and vomiting.The majority of drug interactions discovered were modest enough that they were not reflected in the clinic.Drug interactions become more common as people get older.展开更多
Android smartphones largely dominate the smartphone market. For this reason, it is very important to examine these smartphones in terms of digital forensics since they are often used as evidence in trials. It is possi...Android smartphones largely dominate the smartphone market. For this reason, it is very important to examine these smartphones in terms of digital forensics since they are often used as evidence in trials. It is possible to acquire a physical or logical image of these devices. Acquiring physical and logical images has advantages and disadvantages compared to each other. Creating the logical image is done at the file system level. Analysis can be made on this logical image. Both logical image acquisition and analysis of the image can be done by software tools. In this study, the differences between logical image and physical image acquisition in Android smartphones, their advantages and disadvantages compared to each other, the difficulties that may be encountered in obtaining physical images, which type of image contributes to obtaining more useful and effective data, which one should be preferred for different conditions, and the benefits of having root authority are discussed. The practice of getting the logical image of the Android smartphones and making an analysis on the image is also included. Although root privileges are not required for logical image acquisition, it has been observed that very limited data will be obtained with the logical image created without root privileges. Nevertheless, logical image acquisition has advantages too against physical image acquisition.展开更多
Diabetes mellitus(DM)is a complicated,globally expanding disease that is influenced by hereditary and environmental variables.Changes in modern society’s food choices,physical inactivity,and obesity are significant f...Diabetes mellitus(DM)is a complicated,globally expanding disease that is influenced by hereditary and environmental variables.Changes in modern society’s food choices,physical inactivity,and obesity are significant factors in the development of type 2 DM(T2DM).The association between changes in intestinal flora and numerous disorders,including obesity,diabetes,and cardiovascular diseases,has been studied in recent years.The purpose of this review is to analyze the mechanisms underlying the alteration of the diabetic patients’intestinal flora,as well as their therapeutic choices.Also included is a summary of the antidiabetic benefits of natural compounds demonstrated by studies.The short-chain fatty acids theory,the bile acid theory,and the endotoxin theory are all potential methods by which intestinal flora contributes to the establishment and progression of T2DM.Due to an intestinal flora imbalance,abnormalities in shortchain fatty acids and secondary bile acids have been found in diabetic patients.Additionally,metabolic endotoxemia with altering flora induces a systemic inflammatory response by stimulating the immune system via bacterial translocation.The agenda for diabetes treatment includes the use of short-chain fatty acids,probiotics,prebiotics in the diet,fecal bacteria transplantation,and antibiotics.Animal studies have proven the antidiabetic benefits of numerous bioactive substances,including Flavonoids,Alkaloids,Saponin,and Allicin.However,further research is required to contribute to the treatment of diabetes.展开更多
AIM:To assess the clinical and genetic characteristics of children diagnosed with retinoblastoma(RB)at Gazi University Faculty of Medicine’s Department of Pediatric Oncology.METHODS:All cases diagnosed with RB and re...AIM:To assess the clinical and genetic characteristics of children diagnosed with retinoblastoma(RB)at Gazi University Faculty of Medicine’s Department of Pediatric Oncology.METHODS:All cases diagnosed with RB and received treatment and follow-up in the Ophthalmology and Pediatric Oncology Department,October 2016 to May 2021 were evaluated retrospectively.The RB1 gene was analyzed by next-generation sequencing(NGS)technique in DNAs obtained from peripheral blood samples of the patients.RESULTS:This study included 53 cases with 67 RBaffected eyes during the study period.The mean age was 24.6(median:18.5,range:3–151)mo.There were 15(22.3%)Group D eyes and 39(58.2%)Group E eyes.The RB1 gene was sequenced by the NGS method in 19 patients.Heterozygous RB1:NM_000321.3:c.54_76del(p.Glu19AlafsTer4)variant was detected in a 15-month-old female with bilateral RB.Heterozygous RB1:NM_000321.3:c.1814+3A>T variant was detected in a 5.5-month-old male with bilateral RB.The intronic RB1:NM_000321.3:c.1332+4A>G variant was detected in patient 14,a 13-month-old male with unilateral RB.The RB1:NM_000321.3:c.575_576del(p.Lys192SerfsTer10)variant was found in an 18-month-old female with an allele frequency of 37%.These variants have not been reported in the literature and mutation databases.CONCLUSION:Four novel variants are described and one of them is found in two different patients.This data is crucial for assessing prognosis.It serves as a guide for estimating the long-term risk of secondary malignancy as well as the short-term risk of developing additional malignancies in the same eye and the other eye.展开更多
One of the most common types of threats to the digital world is malicious software.It is of great importance to detect and prevent existing and new malware before it damages information assets.Machine learning approac...One of the most common types of threats to the digital world is malicious software.It is of great importance to detect and prevent existing and new malware before it damages information assets.Machine learning approaches are used effectively for this purpose.In this study,we present a model in which supervised and unsupervised learning algorithms are used together.Clustering is used to enhance the prediction performance of the supervised classifiers.The aim of the proposed model is to make predictions in the shortest possible time with high accuracy and f1 score.In the first stage of the model,the data are clustered with the k-means algorithm.In the second stage,the prediction is made with the combination of the classifier with the best prediction performance for the related cluster.While choosing the best classifiers for the given clusters,triple combinations of ten machine learning algorithms(kernel support vector machine,k-nearest neighbor,naive Bayes,decision tree,random forest,extra gradient boosting,categorical boosting,adaptive boosting,extra trees,and gradient boosting)are used.The selected triple classifier combination is positioned in two stages.The prediction time of the model is improved by positioning the classifier with the slowest prediction time in the second stage.The selected triple classifier combination is positioned in two tiers.The prediction time of the model is improved by positioning the classifier with the highest prediction time in the second tier.It is seen that clustering before classification improves prediction performance,which is presented using Blue Hexagon Open Dataset for Malware Analysis(BODMAS),Elastic Malware Benchmark for Empowering Researchers(EMBER)2018 and Kaggle malware detection datasets.The model has 99.74%accuracy and 99.77%f1 score for the BODMAS dataset,99.04%accuracy and 98.63%f1 score for the Kaggle malware detection dataset,and 96.77%accuracy and 96.77%f1 score for the EMBER 2018 dataset.In addition,the tiered positioning of classifiers shortened the average prediction time by 76.13%for the BODMAS dataset and 95.95%for the EMBER 2018 dataset.The proposed method’s prediction performance is better than the rest of the studies in the literature in which BODMAS and EMBER 2018 datasets are used.展开更多
Energy restriction is defined as reducing nutrient intake without dragging the organism into malnutrition. Energy restriction is preferred because it is a non-genetic intervention that increases life expectancy. Nicot...Energy restriction is defined as reducing nutrient intake without dragging the organism into malnutrition. Energy restriction is preferred because it is a non-genetic intervention that increases life expectancy. Nicotinamide adenine dinucleotide(NAD~+)and adenosine monophosphate(AMP)levels, which are the indicators of intracellular energy deficiency, increase with energy restriction. The increase in NAD~+ level stimulates sirtuin(SIRT)enzymes, and the increase in AMP level stimulates AMP-activated protein kinase(AMPK). Various mechanisms are regulated by stimulating these enzymes. By Forkhead box O(FoxO)transcription factors, the ability of resistance to oxidative stress increases, and antioxidant genes, DNA repair, and autophagy genes are stimulated. Apoptosis is induced by stimulation of the p53 protein, and tumor growth is suppressed by the disruption of aging cells. The suppression of phosphoinositide 3-kinase(PI3K)-/-Akt, and therefore mTOR signal stimulates autophagy and mitophagia, and cleanses damaged cells and organelles. Mitochondrial biogenesis is stimulated, antioxidant capacity increases, and inflammatory response decreases. Adipose tissue and lipid metabolism are regulated by the regulation of fatty acid synthesis and oxidation. As a consequence, the effects of caloric restriction on cellular metabolism are regulated through the genetic pathways.展开更多
The use of fog computing in the Internet of Things(IoT)has emerged as a crucial solution,bringing cloud services closer to end users to process large amounts of data generated within the system.Despite its advantages,...The use of fog computing in the Internet of Things(IoT)has emerged as a crucial solution,bringing cloud services closer to end users to process large amounts of data generated within the system.Despite its advantages,the increasing task demands from IoT objects often overload fog devices with limited resources,resulting in system delays,high network usage,and increased energy consumption.One of the major challenges in fog computing for IoT applications is the efficient deployment of services between fog clouds.To address this challenge,we propose a novel Optimal Foraging Algorithm(OFA)for task placement on appropriate fog devices,taking into account the limited resources of each fog node.The OFA algorithm optimizes task sharing between fog devices by evaluating incoming task requests based on their types and allocating the services to the most suitable fog nodes.In our study,we compare the performance of the OFA algorithm with two other popular algorithms:Genetic Algorithm(GA)and Randomized Search Algorithm(RA).Through extensive simulation experiments,our findings demonstrate significant improvements achieved by the OFA algorithm.Specifically,it leads to up to 39.06%reduction in energy consumption for the Elektroensefalografi(EEG)application,up to 25.86%decrease in CPU utilization for the Intelligent surveillance through distributed camera networks(DCNS)application,up to 57.94%reduction in network utilization,and up to 23.83%improvement in runtime,outperforming other algorithms.As a result,the proposed OFA algorithm enhances the system’s efficiency by effectively allocating incoming task requests to the appropriate fog devices,mitigating the challenges posed by resource limitations and contributing to a more optimized IoT ecosystem.展开更多
BACKGROUND Pharmacovigilance(PV)is the activities and scientific studies conducted to detect,evaluate,understand or prevent adverse reactions and other drug-related problems.AIM To define the awareness and experiences...BACKGROUND Pharmacovigilance(PV)is the activities and scientific studies conducted to detect,evaluate,understand or prevent adverse reactions and other drug-related problems.AIM To define the awareness and experiences of the clinicians on PV and adverse drug reactions(ADRs)in Turkey.METHODS The study was cross-sectional and analytical.Data were obtained through a questionnaire.The questionnaire was sent via e-mail.The survey was sent to 2030 physicians and 670 participated.RESULTS The most appropriate definition of PV was correctly defined by 53.9%of the participants.The most important goal of PV was correctly defined by 54.9%of the participants,and 27.3%of the participants were aware of the Turkish Pharmacovigilance Center.Nonsurgical physicians had better PV knowledge than surgical physicians.A total of 80.9%of the physicians who encountered ADRs,filled in the ADR notification form,and 8.8%received training on how to fill in the form.PV knowledge of the clinicians was not sufficient.Although half of the physicians encountered ADRs,the rates of seeing and filling in the ADR form were low.CONCLUSION Few of the physicians followed the current information about PV.The results provide more comprehensive data on PV practices and ADR reporting at a national level.展开更多
Dynamic area coverage with small unmanned aerial vehicle(UAV)systems is one of the major research topics due to limited payloads and the difficulty of decentralized decision-making process.Collaborative behavior of a ...Dynamic area coverage with small unmanned aerial vehicle(UAV)systems is one of the major research topics due to limited payloads and the difficulty of decentralized decision-making process.Collaborative behavior of a group of UAVs in an unknown environment is another hard problem to be solved.In this paper,we propose a method for decentralized execution of multi-UAVs for dynamic area coverage problems.The proposed decentralized decision-making dynamic area coverage(DDMDAC)method utilizes reinforcement learning(RL)where each UAV is represented by an intelligent agent that learns policies to create collaborative behaviors in partially observable environment.Intelligent agents increase their global observations by gathering information about the environment by connecting with other agents.The connectivity provides a consensus for the decision-making process,while each agent takes decisions.At each step,agents acquire all reachable agents’states,determine the optimum location for maximal area coverage and receive reward using the covered rate on the target area,respectively.The method was tested in a multi-agent actor-critic simulation platform.In the study,it has been considered that each UAV has a certain communication distance as in real applications.The results show that UAVs with limited communication distance can act jointly in the target area and can successfully cover the area without guidance from the central command unit.展开更多
The aim of this study was to examine the prognostic factors and treatment outcomes of cervical esophageal carcinoma(CEC)patients who underwent definitive chemoradiotherapy(CRT).The clinical data of 175 biopsyconfirmed...The aim of this study was to examine the prognostic factors and treatment outcomes of cervical esophageal carcinoma(CEC)patients who underwent definitive chemoradiotherapy(CRT).The clinical data of 175 biopsyconfirmed CEC patients treated with definitive CRT between April 2005 and September 2021 were retrospectively analyzed.The prognostic factors predicting overall survival(OS),progression-free survival(PFS),and local recurrence-free survival(LRFS)were assessed in uni-and multivariable analyses.The median age of the entire cohort was 56 years(range:26–87 years).All patients received definitive radiotherapy with a median total dose of 60 Gy,and 52%of the patients received cisplatin-based concurrent chemotherapy.The 2-year OS,PFS,and LRFS rates were 58.8%,46.9%,and 52.4%,respectively,with a median follow-up duration of 41.6 months.Patients’performance status,clinical nodal stage,tumor size,and treatment response were significant prognostic factors for OS,PFS,and LRFS in univariate analysis.Non-complete treatment response was an independent predictor for poor OS(HR=4.41,95%CI,2.78–7.00,p<0.001)and PFS(HR=4.28,95%CI,2.79–6.58,p<0.001),whereas poor performance score was a predictor for worse LRFS(HR=1.83,95%CI,1.12–2.98,p=0.02)in multivariable analysis.Fifty-two patients(29.7%)experienced grade II or higher toxicity.In this multicenter study,we demonstrated that definitive CRT is a safe and effective treatment for patients with CEC.Higher radiation doses were found to have no effect on treatment outcomes,but a better response to treatment and a better patient performance status did.展开更多
AIM: To compare the benefi cial effects of early enteral nutrition (EN) with prebiotic fiber supplementation in patients with severe acute pancreatitis (AP).METHODS: Thirty consecutive patients with severe AP, who req...AIM: To compare the benefi cial effects of early enteral nutrition (EN) with prebiotic fiber supplementation in patients with severe acute pancreatitis (AP).METHODS: Thirty consecutive patients with severe AP, who required stoppage of oral feeding for 48 h, were randomly assigned to nasojejunal EN with or without prebiotics. APACHE Ⅱ score, Balthazar’s CT score and CRP were assessed daily during the study period.RESULTS: The median duration of hospital stay was shorter in the study group [10 ± 4 (8-14) d vs 15 ± 6 (7-26) d] (P < 0.05). The median value of days in intensive care unit was also similar in both groups [6 ± 2 (5-8) d vs 6 ± 2 (5-7) d]. The median duration of EN was 8 ± 4 (6-12) d vs 10 ± 4 (6-13) d in the study and control groups, respectively (P > 0.05). Deaths occurred in 6 patients (20%), 2 in the study group and 4 in the control group. The mean duration of APACHE Ⅱ normalization (APACHE Ⅱ score < 8) was shorter in the study group than in the control group (4 ± 2 d vs 6.5 ± 3 d, P < 0.05). The mean duration of CRP normalization was also shorter in the study group than in the control group (7 ± 2 d vs 10 ± 3 d, P < 0.05).CONCLUSION: Nasojejunal EN with prebiotic fiber supplementation in severe AP improves hospital stay, duration nutrition therapy, acute phase response and overall complications compared to standard EN therapy.展开更多
AIM:To determine the effect of exogenous leptin on acute lung injury (ALI) in cerulein-induced acute pancreatitis (AP). METHODS:Forty-eight rats were randomly divided into 3 groups. AP was induced by intraperitoneal (...AIM:To determine the effect of exogenous leptin on acute lung injury (ALI) in cerulein-induced acute pancreatitis (AP). METHODS:Forty-eight rats were randomly divided into 3 groups. AP was induced by intraperitoneal (i.p.) injection of cerulein (50 μg/kg) four times,at 1 h intervals. The rats received a single i.p. injection of 10 μg/kg leptin (leptin group) or 2 mL saline (AP group) after cerulein injections. In the sham group,animals were given a single i.p. injection of 2 mL saline. Experimental samples were collected for biochemical and histological evaluations at 24 h and 48 h after the induction of AP or saline administration. Blood samples were obtained for the determination of amylase,lipase,tumor necrosis factor (TNF)-a,interleukin (IL)-1β,macrophage inflammatory peptide (MIP)-2 and soluble intercellular adhesion molecule (sICAM)-1 levels,while pancreatic and lung tissues were removed for myeloperoxidase (MPO) activity,nitric oxide (NOx) level,CD40 expression and histological evaluation. RESULTS:Cerulein injection caused severe AP,confirmed by an increase in serum amylase and lipase levels,histopathological findings of severe AP,and pancreatic MPO activity,compared to the values obtained in the sham group. In the leptin group,serum levels of MIP-2,sICMA-1,TNF-a,and IL-1b,pancreatic MPO activity,CD40 expression in pancreas and lung tissues,and NOx level in the lung tissue were lower compared to those in the AP group. Histologically,pancreatic and lungdamage was less severe following leptin administration. CONCLUSION:Exogenous leptin attenuates inflammatory changes,and reduces pro-inflammatory cytokines,nitric oxide levels,and CD40 expression in ceruleininduced AP and may be protective in AP associated ALI.展开更多
AIM: To compare results of double balloon enteroscopy (DBE) procedures in pediatric and adult patients. METHODS: The medical files of patients who underwent DBE at Gazi University School of Medicine, Ankara, Turkey be...AIM: To compare results of double balloon enteroscopy (DBE) procedures in pediatric and adult patients. METHODS: The medical files of patients who underwent DBE at Gazi University School of Medicine, Ankara, Turkey between 2009 and 2011 were examined retrospectively. Adult and pediatric patients were compared according to DBE indications, procedure duration, final diagnosis, and complications. DBE procedures were performed in an operating room under general anesthesia by two endoscopists. An oral or anal approach was preferred according to estimated lesion sites. Overnight fasting of at least 6 h prior to the start of the procedure was adequate for preprocedural preparation of oral DBE procedures. Bowel cleansing was performed by oral administration of sennosides A and B solution, 2 mL/kg, and anal saline laxative en-ema. The patients were followed up for 2 h after the procedure in terms of possible complications. RESULTS: DBE was performed in 35 patients (5 pediatric and 30 adult). DBE procedures were performed for abdominal pain, chronic diarrhea, bleeding, chronic vomiting, anemia, and postoperative evaluation of anastomosis. Final diagnosis was diffuse gastric angiodysplasia (n = 1); diffuse jejunal angiodysplasia (n = 1); ulceration in the bulbus (n = 1); celiac disease (n = 1); low differentiated metastatic carcinoma (n = 1); PeutzJeghers syndrome (n = 1); adenomatous polyp (n = 1) and stricture formation in anastomosis line (n = 1). During postprocedural follow-up, abdominal pain and elevated amylase levels were noted in three patients and one patient developed abdominal perforation. CONCLUSION: With the help of technological improvements, we may use enteroscopy as a safe modality more frequently in younger and smaller children.展开更多
AIM:To evaluate the red cell distribution width(RDW)as an indicator of the presence of non-alcoholic steatohepatitis(NASH)and its association with fibrotic scores.METHODS:A retrospective study was carried out that inc...AIM:To evaluate the red cell distribution width(RDW)as an indicator of the presence of non-alcoholic steatohepatitis(NASH)and its association with fibrotic scores.METHODS:A retrospective study was carried out that included sixty-two biopsy proven NASH,32 simple steatosis patients and 30 healthy controls.The correlation between the clinical and histopathological features of NASH patients and RDW values was evaluated.Liver fibrosis scores were measured using a 0 to 4 point scale and were divided in to two groups;fibrosis scores0-1 were termed mild and fibrosis scores 2-4 were termed advanced fibrosis.RDW values were compared between NASH,simple steatosis and healthy controls.Univariate and multivariate analyses were performed to evaluate the independent predicting factors for the presence of liver fibrosis caused by NASH.RESULTS:Patients with NASH had higher RDW values compared with simple steatosis and healthy control groups[14.28%±0.25%vs 13.37%±0.12%,12.96%±0.14%(P<0.01),respectively].Patients with advanced fibrosis had higher RDW values than the mild fibrosis group(15.86%±0.4%vs 13.63%±0.67%,P<0.01,respectively).RDW also correlated with fibrotic scores(r=0.579 andP<0.01).The variables that were significant in the univariate analysis were evaluated in multivariate logistic regression analysis,and RDW was an independent predicting factor of NASH(OR=1.75,95%CI:1.129-2.711,P<0.05).CONCLUSION:RDW a new non-invasive marker that can be used to demonstrate the presence of NASH and indicate advanced fibrotic scores.展开更多
AIM: To evaluate how Helicobacter pylori(H. pylori) is able to evade the immune response and whether it enhances systemic immune tolerance against colorectal cancer.METHODS: This prospective randomized study involved ...AIM: To evaluate how Helicobacter pylori(H. pylori) is able to evade the immune response and whether it enhances systemic immune tolerance against colorectal cancer.METHODS: This prospective randomized study involved 97 consecutive colorectal cancer patients and 108 cancer-free patients with extra-digestive diseases. Colorectal cancer and cancer-free patients were assigned into subgroups according to H. pylori Ig G seropositivity. Exposure to H. pylori was determined by Ig G seropositivity which was detected by enzyme linked immunoassay(ELISA). Serum neopterin levels were measured by ELISA. Serum tryptophan, kynurenine, and urinary biopterin concentrations were measured by high performance liquid chromatography. Serum nitrite levels were detected spectrophotometrically. Serum indoleamine 2,3-dioxygenase activity was estimated by the kynurenine to tryptophan ratio and by assessing the correlation between serum neopterin concentrations and the kynurenine to tryptophan ratio. The frequencies of increased serum kynurenine to tryptophan ratio of H. pylori seronegative and seropositive colorectal cancer subgroups were estimated by comparing them with the average kynurenine to tryptophan ratio of H. pylori seronegative tumor-free patients.RESULTS: Compared with respective controls, in both H. pylori seronegative and seropositive colorectal cancer patients, while serum tryptophan levels were decreased(controls vs patients; seronegative: 20.37 ± 0.89 μmol/L vs 15.71 ± 1.16 μmol/L, P < 0.05; seropositive: 20.71 ± 0.81 μmol/L vs 14.97 ± 0.79 μmol/L, P < 0.01) the kynurenine to tryptophan ratio was significantly increased(controls vs patients; seronegative: 52.85± 11.85 μmol/mmol vs 78.91 ± 8.68 μmol/mmol, P < 0.01, seropositive: 47.31 ± 5.93 μmol/mmol vs 109.65 ± 11.50 μmol/mmol, P < 0.01). Neopterin concentrations in cancer patients were significantly elevated compared with controls(P < 0.05). There was a significant correlation between serum neopterin levels and kynurenine/tryptophan in control and colorectal cancer patients groups(r s = 0.494, P = 0.0001 and r s= 0.293, P = 0.004, respectively). Serum nitrite levels of H. pylori seropositive cancer cases were significantly decreased compared with seropositive controls(controls vs patients; 26.04 ± 2.39 μmol/L vs 20.41 ± 1.48 μmol/L, P < 0.05) The decrease in the nitrite levels of H. pylori seropositive cancer patients may be attributed to excessive formation of peroxynitrite and other reactive nitrogen species.CONCLUSION: A significantly high kynurenine/tryptophan suggested that H. pylori may support the immune tolerance leading to cancer development, even without an apparent upper gastrointestinal tract disease.展开更多
AIM:To determine the association between H pylori infection and serum ghrelin levels in patients without atrophic gastritis.METHODS:Fifty consecutive patients(24 males and 26 females)with either H pylori-positive gast...AIM:To determine the association between H pylori infection and serum ghrelin levels in patients without atrophic gastritis.METHODS:Fifty consecutive patients(24 males and 26 females)with either H pylori-positive gastritis(n = 34)or H pylori-negative gastritis(n = 16)with normal gastric acid secretion determined by 24-h pHmetry and without atrophic gastritis in histopathology were enrolled in this study.Thirty-four H pylori-infected patients were treated with triple therapy consisting of a daily regimen of 30 mg lansoprazole bid,1 g amoxicillin bid and 500 mg clarithromycin bid for 14 d,followed by an additional 4 wk of 30 mg lansoprazol treatment.H pylori infection was eradicated in 23 of 34(67.6%)patients.H pylori-positive patients were given eradication therapy.Gastric acidity was determined via intragastric pH catethers.Serum ghrelin was measured by radioimmunoassay(RIA).RESULTS:There was no signifficant difference in plasma ghrelin levels between H pylori-positive and H pylori-negative groups(81.10 ± 162.66 ng/L vs 76.51 ± 122.94 ng/L).In addition,there was no significant difference in plasma ghrelin levels and gastric acidity levels measured before and 3 mo after the eradication therapy.CONCLUSION:H pylori infection does not influence ghrelin secretion in patients with chronic gastritis without atrophic gastritis.展开更多
AIM:To determine the association between Helicobacter pylori(H.pylori)and globus sensation(GS)in the patients with cervical inlet patch. METHODS:Sixty-eight patients with esophageal inlet patches were identified from ...AIM:To determine the association between Helicobacter pylori(H.pylori)and globus sensation(GS)in the patients with cervical inlet patch. METHODS:Sixty-eight patients with esophageal inlet patches were identified from 6760 consecutive patients undergoing upper gastrointestinal endoscopy prospectively.In these 68 patients with cervical inlet patches, symptoms of globus sensation(lump in the throat), hoarseness,sore throat,frequent clearing of the throat,cough,dysphagia,odynophagia of at least 3 mo duration was questioned prior to endoscopy. RESULTS:Cervical heterotopic gastric mucosa(CHGM) was found in 68 of 6760 patients.The endoscopic prevalence of CHGM was determined to be 1%.H.pylori was identified in 16(23.5%)of 68 patients with inlet patch.53 patients were classified as CHGMⅡ.This group included 48 patients with globus sensation,4 patients with chronic cough and 1 patient with hoarseness.All the patients who were H.pylori(+)in cervical inlet patches had globus sensation.CONCLUSION:Often patients with CHGM have a long history of troublesome throat symptoms.We speculate that disturbances in globus sensation are like non-ulcer dyspepsia.展开更多
AIM:During liver regeneration cellular proliferation and apoptosis result in tissue remodeling to restore normal hepatic mass and structure.Main regulators of the apoptotic machinery are the Bcl-2 family proteins but ...AIM:During liver regeneration cellular proliferation and apoptosis result in tissue remodeling to restore normal hepatic mass and structure.Main regulators of the apoptotic machinery are the Bcl-2 family proteins but their roles are not well defined throughout the liver regeneration.We aimed to analyze the expression levels of bcl-2gene family members during resection induced liver regeneration. METHODS:We performed semi-quantitative RT-PCR to examine the expression level of bak,bax,bcl-2 and bcl-x_L in 70% hepatectomized rat livers during the whole regeneration process and compared to that of the sham and normal groups. RESULTS:The expression of bak and bax was decreased whereas that of bcl-2and bd-X_L was increased in hepatectomized animals compared to normal liver at most time points.We also reported for the first time that sham group of animals had statistically significant higher expression of bak and bax than hepatectomized animals.In addition,the area under the curve (AUC) values of these genes was larger in sham groups than the hepatectomized groups. CONCLUSION:The expression changes of bak,bax,bcl-2 and bcl-X_L genes are altered not only due to regeneration, but also due to effects of surgical operations.展开更多
文摘This study aims to predict the undrained shear strength of remolded soil samples using non-linear regression analyses,fuzzy logic,and artificial neural network modeling.A total of 1306 undrained shear strength results from 230 different remolded soil test settings reported in 21 publications were collected,utilizing six different measurement devices.Although water content,plastic limit,and liquid limit were used as input parameters for fuzzy logic and artificial neural network modeling,liquidity index or water content ratio was considered as an input parameter for non-linear regression analyses.In non-linear regression analyses,12 different regression equations were derived for the prediction of undrained shear strength of remolded soil.Feed-Forward backpropagation and the TANSIG transfer function were used for artificial neural network modeling,while the Mamdani inference system was preferred with trapezoidal and triangular membership functions for fuzzy logic modeling.The experimental results of 914 tests were used for training of the artificial neural network models,196 for validation and 196 for testing.It was observed that the accuracy of the artificial neural network and fuzzy logic modeling was higher than that of the non-linear regression analyses.Furthermore,a simple and reliable regression equation was proposed for assessments of undrained shear strength values with higher coefficients of determination.
文摘BACKGROUND In cases of coronavirus disease 2019(COVID-19),favipiravir is commonly included to the therapy regimen.Drug interactions between favipiravir and other COVID-19 therapy drugs are frequently researched.However,no research on possible drug interactions between Favipiravir and radiocontrast agents,which have become almost crucial in diagnostic processes while not being part of the treatment,has been found.AIM To determine potential medication interactions between Favipiravir and radiocontrast agents.METHODS The study comprised patients who were taking Favipiravir for COVID-19 therapy and underwent a contrast-enhanced computed tomography(CT)or magnetic resonance imaging(MRI)test while taking the medicine.The computerized patient files of the cases included in the study,as well as the pharmacovigilance forms in the designated hospital,were evaluated for this purpose.RESULTS The study included the evaluation of data from 1046 patients.The study sample's mean age was 47.23±9.48 years.The mean age of cases with drug interactions was statistically significant greater than that of cases with no drug interactions(P=0.003).When evaluated with logistic regression analysis,a 1-year raises in age increases the risk of developing drug interactions by 1.63 times(P=0.023).There was no statistically significant difference in the occurrence of medication interactions between the sexes(P=0.090).Possible medication interactions were discovered in 42 cases(4%).CONCLUSION The findings of this study revealed that the most notable findings as a result of the combined use of contrast agents and favipiravir were increased creatinine and transaminase values,as well as an increase in the frequency of nausea and vomiting.The majority of drug interactions discovered were modest enough that they were not reflected in the clinic.Drug interactions become more common as people get older.
文摘Android smartphones largely dominate the smartphone market. For this reason, it is very important to examine these smartphones in terms of digital forensics since they are often used as evidence in trials. It is possible to acquire a physical or logical image of these devices. Acquiring physical and logical images has advantages and disadvantages compared to each other. Creating the logical image is done at the file system level. Analysis can be made on this logical image. Both logical image acquisition and analysis of the image can be done by software tools. In this study, the differences between logical image and physical image acquisition in Android smartphones, their advantages and disadvantages compared to each other, the difficulties that may be encountered in obtaining physical images, which type of image contributes to obtaining more useful and effective data, which one should be preferred for different conditions, and the benefits of having root authority are discussed. The practice of getting the logical image of the Android smartphones and making an analysis on the image is also included. Although root privileges are not required for logical image acquisition, it has been observed that very limited data will be obtained with the logical image created without root privileges. Nevertheless, logical image acquisition has advantages too against physical image acquisition.
文摘Diabetes mellitus(DM)is a complicated,globally expanding disease that is influenced by hereditary and environmental variables.Changes in modern society’s food choices,physical inactivity,and obesity are significant factors in the development of type 2 DM(T2DM).The association between changes in intestinal flora and numerous disorders,including obesity,diabetes,and cardiovascular diseases,has been studied in recent years.The purpose of this review is to analyze the mechanisms underlying the alteration of the diabetic patients’intestinal flora,as well as their therapeutic choices.Also included is a summary of the antidiabetic benefits of natural compounds demonstrated by studies.The short-chain fatty acids theory,the bile acid theory,and the endotoxin theory are all potential methods by which intestinal flora contributes to the establishment and progression of T2DM.Due to an intestinal flora imbalance,abnormalities in shortchain fatty acids and secondary bile acids have been found in diabetic patients.Additionally,metabolic endotoxemia with altering flora induces a systemic inflammatory response by stimulating the immune system via bacterial translocation.The agenda for diabetes treatment includes the use of short-chain fatty acids,probiotics,prebiotics in the diet,fecal bacteria transplantation,and antibiotics.Animal studies have proven the antidiabetic benefits of numerous bioactive substances,including Flavonoids,Alkaloids,Saponin,and Allicin.However,further research is required to contribute to the treatment of diabetes.
文摘AIM:To assess the clinical and genetic characteristics of children diagnosed with retinoblastoma(RB)at Gazi University Faculty of Medicine’s Department of Pediatric Oncology.METHODS:All cases diagnosed with RB and received treatment and follow-up in the Ophthalmology and Pediatric Oncology Department,October 2016 to May 2021 were evaluated retrospectively.The RB1 gene was analyzed by next-generation sequencing(NGS)technique in DNAs obtained from peripheral blood samples of the patients.RESULTS:This study included 53 cases with 67 RBaffected eyes during the study period.The mean age was 24.6(median:18.5,range:3–151)mo.There were 15(22.3%)Group D eyes and 39(58.2%)Group E eyes.The RB1 gene was sequenced by the NGS method in 19 patients.Heterozygous RB1:NM_000321.3:c.54_76del(p.Glu19AlafsTer4)variant was detected in a 15-month-old female with bilateral RB.Heterozygous RB1:NM_000321.3:c.1814+3A>T variant was detected in a 5.5-month-old male with bilateral RB.The intronic RB1:NM_000321.3:c.1332+4A>G variant was detected in patient 14,a 13-month-old male with unilateral RB.The RB1:NM_000321.3:c.575_576del(p.Lys192SerfsTer10)variant was found in an 18-month-old female with an allele frequency of 37%.These variants have not been reported in the literature and mutation databases.CONCLUSION:Four novel variants are described and one of them is found in two different patients.This data is crucial for assessing prognosis.It serves as a guide for estimating the long-term risk of secondary malignancy as well as the short-term risk of developing additional malignancies in the same eye and the other eye.
文摘One of the most common types of threats to the digital world is malicious software.It is of great importance to detect and prevent existing and new malware before it damages information assets.Machine learning approaches are used effectively for this purpose.In this study,we present a model in which supervised and unsupervised learning algorithms are used together.Clustering is used to enhance the prediction performance of the supervised classifiers.The aim of the proposed model is to make predictions in the shortest possible time with high accuracy and f1 score.In the first stage of the model,the data are clustered with the k-means algorithm.In the second stage,the prediction is made with the combination of the classifier with the best prediction performance for the related cluster.While choosing the best classifiers for the given clusters,triple combinations of ten machine learning algorithms(kernel support vector machine,k-nearest neighbor,naive Bayes,decision tree,random forest,extra gradient boosting,categorical boosting,adaptive boosting,extra trees,and gradient boosting)are used.The selected triple classifier combination is positioned in two stages.The prediction time of the model is improved by positioning the classifier with the slowest prediction time in the second stage.The selected triple classifier combination is positioned in two tiers.The prediction time of the model is improved by positioning the classifier with the highest prediction time in the second tier.It is seen that clustering before classification improves prediction performance,which is presented using Blue Hexagon Open Dataset for Malware Analysis(BODMAS),Elastic Malware Benchmark for Empowering Researchers(EMBER)2018 and Kaggle malware detection datasets.The model has 99.74%accuracy and 99.77%f1 score for the BODMAS dataset,99.04%accuracy and 98.63%f1 score for the Kaggle malware detection dataset,and 96.77%accuracy and 96.77%f1 score for the EMBER 2018 dataset.In addition,the tiered positioning of classifiers shortened the average prediction time by 76.13%for the BODMAS dataset and 95.95%for the EMBER 2018 dataset.The proposed method’s prediction performance is better than the rest of the studies in the literature in which BODMAS and EMBER 2018 datasets are used.
文摘Energy restriction is defined as reducing nutrient intake without dragging the organism into malnutrition. Energy restriction is preferred because it is a non-genetic intervention that increases life expectancy. Nicotinamide adenine dinucleotide(NAD~+)and adenosine monophosphate(AMP)levels, which are the indicators of intracellular energy deficiency, increase with energy restriction. The increase in NAD~+ level stimulates sirtuin(SIRT)enzymes, and the increase in AMP level stimulates AMP-activated protein kinase(AMPK). Various mechanisms are regulated by stimulating these enzymes. By Forkhead box O(FoxO)transcription factors, the ability of resistance to oxidative stress increases, and antioxidant genes, DNA repair, and autophagy genes are stimulated. Apoptosis is induced by stimulation of the p53 protein, and tumor growth is suppressed by the disruption of aging cells. The suppression of phosphoinositide 3-kinase(PI3K)-/-Akt, and therefore mTOR signal stimulates autophagy and mitophagia, and cleanses damaged cells and organelles. Mitochondrial biogenesis is stimulated, antioxidant capacity increases, and inflammatory response decreases. Adipose tissue and lipid metabolism are regulated by the regulation of fatty acid synthesis and oxidation. As a consequence, the effects of caloric restriction on cellular metabolism are regulated through the genetic pathways.
文摘The use of fog computing in the Internet of Things(IoT)has emerged as a crucial solution,bringing cloud services closer to end users to process large amounts of data generated within the system.Despite its advantages,the increasing task demands from IoT objects often overload fog devices with limited resources,resulting in system delays,high network usage,and increased energy consumption.One of the major challenges in fog computing for IoT applications is the efficient deployment of services between fog clouds.To address this challenge,we propose a novel Optimal Foraging Algorithm(OFA)for task placement on appropriate fog devices,taking into account the limited resources of each fog node.The OFA algorithm optimizes task sharing between fog devices by evaluating incoming task requests based on their types and allocating the services to the most suitable fog nodes.In our study,we compare the performance of the OFA algorithm with two other popular algorithms:Genetic Algorithm(GA)and Randomized Search Algorithm(RA).Through extensive simulation experiments,our findings demonstrate significant improvements achieved by the OFA algorithm.Specifically,it leads to up to 39.06%reduction in energy consumption for the Elektroensefalografi(EEG)application,up to 25.86%decrease in CPU utilization for the Intelligent surveillance through distributed camera networks(DCNS)application,up to 57.94%reduction in network utilization,and up to 23.83%improvement in runtime,outperforming other algorithms.As a result,the proposed OFA algorithm enhances the system’s efficiency by effectively allocating incoming task requests to the appropriate fog devices,mitigating the challenges posed by resource limitations and contributing to a more optimized IoT ecosystem.
文摘BACKGROUND Pharmacovigilance(PV)is the activities and scientific studies conducted to detect,evaluate,understand or prevent adverse reactions and other drug-related problems.AIM To define the awareness and experiences of the clinicians on PV and adverse drug reactions(ADRs)in Turkey.METHODS The study was cross-sectional and analytical.Data were obtained through a questionnaire.The questionnaire was sent via e-mail.The survey was sent to 2030 physicians and 670 participated.RESULTS The most appropriate definition of PV was correctly defined by 53.9%of the participants.The most important goal of PV was correctly defined by 54.9%of the participants,and 27.3%of the participants were aware of the Turkish Pharmacovigilance Center.Nonsurgical physicians had better PV knowledge than surgical physicians.A total of 80.9%of the physicians who encountered ADRs,filled in the ADR notification form,and 8.8%received training on how to fill in the form.PV knowledge of the clinicians was not sufficient.Although half of the physicians encountered ADRs,the rates of seeing and filling in the ADR form were low.CONCLUSION Few of the physicians followed the current information about PV.The results provide more comprehensive data on PV practices and ADR reporting at a national level.
文摘Dynamic area coverage with small unmanned aerial vehicle(UAV)systems is one of the major research topics due to limited payloads and the difficulty of decentralized decision-making process.Collaborative behavior of a group of UAVs in an unknown environment is another hard problem to be solved.In this paper,we propose a method for decentralized execution of multi-UAVs for dynamic area coverage problems.The proposed decentralized decision-making dynamic area coverage(DDMDAC)method utilizes reinforcement learning(RL)where each UAV is represented by an intelligent agent that learns policies to create collaborative behaviors in partially observable environment.Intelligent agents increase their global observations by gathering information about the environment by connecting with other agents.The connectivity provides a consensus for the decision-making process,while each agent takes decisions.At each step,agents acquire all reachable agents’states,determine the optimum location for maximal area coverage and receive reward using the covered rate on the target area,respectively.The method was tested in a multi-agent actor-critic simulation platform.In the study,it has been considered that each UAV has a certain communication distance as in real applications.The results show that UAVs with limited communication distance can act jointly in the target area and can successfully cover the area without guidance from the central command unit.
文摘The aim of this study was to examine the prognostic factors and treatment outcomes of cervical esophageal carcinoma(CEC)patients who underwent definitive chemoradiotherapy(CRT).The clinical data of 175 biopsyconfirmed CEC patients treated with definitive CRT between April 2005 and September 2021 were retrospectively analyzed.The prognostic factors predicting overall survival(OS),progression-free survival(PFS),and local recurrence-free survival(LRFS)were assessed in uni-and multivariable analyses.The median age of the entire cohort was 56 years(range:26–87 years).All patients received definitive radiotherapy with a median total dose of 60 Gy,and 52%of the patients received cisplatin-based concurrent chemotherapy.The 2-year OS,PFS,and LRFS rates were 58.8%,46.9%,and 52.4%,respectively,with a median follow-up duration of 41.6 months.Patients’performance status,clinical nodal stage,tumor size,and treatment response were significant prognostic factors for OS,PFS,and LRFS in univariate analysis.Non-complete treatment response was an independent predictor for poor OS(HR=4.41,95%CI,2.78–7.00,p<0.001)and PFS(HR=4.28,95%CI,2.79–6.58,p<0.001),whereas poor performance score was a predictor for worse LRFS(HR=1.83,95%CI,1.12–2.98,p=0.02)in multivariable analysis.Fifty-two patients(29.7%)experienced grade II or higher toxicity.In this multicenter study,we demonstrated that definitive CRT is a safe and effective treatment for patients with CEC.Higher radiation doses were found to have no effect on treatment outcomes,but a better response to treatment and a better patient performance status did.
文摘AIM: To compare the benefi cial effects of early enteral nutrition (EN) with prebiotic fiber supplementation in patients with severe acute pancreatitis (AP).METHODS: Thirty consecutive patients with severe AP, who required stoppage of oral feeding for 48 h, were randomly assigned to nasojejunal EN with or without prebiotics. APACHE Ⅱ score, Balthazar’s CT score and CRP were assessed daily during the study period.RESULTS: The median duration of hospital stay was shorter in the study group [10 ± 4 (8-14) d vs 15 ± 6 (7-26) d] (P < 0.05). The median value of days in intensive care unit was also similar in both groups [6 ± 2 (5-8) d vs 6 ± 2 (5-7) d]. The median duration of EN was 8 ± 4 (6-12) d vs 10 ± 4 (6-13) d in the study and control groups, respectively (P > 0.05). Deaths occurred in 6 patients (20%), 2 in the study group and 4 in the control group. The mean duration of APACHE Ⅱ normalization (APACHE Ⅱ score < 8) was shorter in the study group than in the control group (4 ± 2 d vs 6.5 ± 3 d, P < 0.05). The mean duration of CRP normalization was also shorter in the study group than in the control group (7 ± 2 d vs 10 ± 3 d, P < 0.05).CONCLUSION: Nasojejunal EN with prebiotic fiber supplementation in severe AP improves hospital stay, duration nutrition therapy, acute phase response and overall complications compared to standard EN therapy.
基金a grant from The Scientific and Technical Research Council of Turkey, TUBITAK,project no:105S018 (SBAG-HD-5)Gazi University,Scientific Research Projects Unit,No.G.U.ET-05.013
文摘AIM:To determine the effect of exogenous leptin on acute lung injury (ALI) in cerulein-induced acute pancreatitis (AP). METHODS:Forty-eight rats were randomly divided into 3 groups. AP was induced by intraperitoneal (i.p.) injection of cerulein (50 μg/kg) four times,at 1 h intervals. The rats received a single i.p. injection of 10 μg/kg leptin (leptin group) or 2 mL saline (AP group) after cerulein injections. In the sham group,animals were given a single i.p. injection of 2 mL saline. Experimental samples were collected for biochemical and histological evaluations at 24 h and 48 h after the induction of AP or saline administration. Blood samples were obtained for the determination of amylase,lipase,tumor necrosis factor (TNF)-a,interleukin (IL)-1β,macrophage inflammatory peptide (MIP)-2 and soluble intercellular adhesion molecule (sICAM)-1 levels,while pancreatic and lung tissues were removed for myeloperoxidase (MPO) activity,nitric oxide (NOx) level,CD40 expression and histological evaluation. RESULTS:Cerulein injection caused severe AP,confirmed by an increase in serum amylase and lipase levels,histopathological findings of severe AP,and pancreatic MPO activity,compared to the values obtained in the sham group. In the leptin group,serum levels of MIP-2,sICMA-1,TNF-a,and IL-1b,pancreatic MPO activity,CD40 expression in pancreas and lung tissues,and NOx level in the lung tissue were lower compared to those in the AP group. Histologically,pancreatic and lungdamage was less severe following leptin administration. CONCLUSION:Exogenous leptin attenuates inflammatory changes,and reduces pro-inflammatory cytokines,nitric oxide levels,and CD40 expression in ceruleininduced AP and may be protective in AP associated ALI.
文摘AIM: To compare results of double balloon enteroscopy (DBE) procedures in pediatric and adult patients. METHODS: The medical files of patients who underwent DBE at Gazi University School of Medicine, Ankara, Turkey between 2009 and 2011 were examined retrospectively. Adult and pediatric patients were compared according to DBE indications, procedure duration, final diagnosis, and complications. DBE procedures were performed in an operating room under general anesthesia by two endoscopists. An oral or anal approach was preferred according to estimated lesion sites. Overnight fasting of at least 6 h prior to the start of the procedure was adequate for preprocedural preparation of oral DBE procedures. Bowel cleansing was performed by oral administration of sennosides A and B solution, 2 mL/kg, and anal saline laxative en-ema. The patients were followed up for 2 h after the procedure in terms of possible complications. RESULTS: DBE was performed in 35 patients (5 pediatric and 30 adult). DBE procedures were performed for abdominal pain, chronic diarrhea, bleeding, chronic vomiting, anemia, and postoperative evaluation of anastomosis. Final diagnosis was diffuse gastric angiodysplasia (n = 1); diffuse jejunal angiodysplasia (n = 1); ulceration in the bulbus (n = 1); celiac disease (n = 1); low differentiated metastatic carcinoma (n = 1); PeutzJeghers syndrome (n = 1); adenomatous polyp (n = 1) and stricture formation in anastomosis line (n = 1). During postprocedural follow-up, abdominal pain and elevated amylase levels were noted in three patients and one patient developed abdominal perforation. CONCLUSION: With the help of technological improvements, we may use enteroscopy as a safe modality more frequently in younger and smaller children.
文摘AIM:To evaluate the red cell distribution width(RDW)as an indicator of the presence of non-alcoholic steatohepatitis(NASH)and its association with fibrotic scores.METHODS:A retrospective study was carried out that included sixty-two biopsy proven NASH,32 simple steatosis patients and 30 healthy controls.The correlation between the clinical and histopathological features of NASH patients and RDW values was evaluated.Liver fibrosis scores were measured using a 0 to 4 point scale and were divided in to two groups;fibrosis scores0-1 were termed mild and fibrosis scores 2-4 were termed advanced fibrosis.RDW values were compared between NASH,simple steatosis and healthy controls.Univariate and multivariate analyses were performed to evaluate the independent predicting factors for the presence of liver fibrosis caused by NASH.RESULTS:Patients with NASH had higher RDW values compared with simple steatosis and healthy control groups[14.28%±0.25%vs 13.37%±0.12%,12.96%±0.14%(P<0.01),respectively].Patients with advanced fibrosis had higher RDW values than the mild fibrosis group(15.86%±0.4%vs 13.63%±0.67%,P<0.01,respectively).RDW also correlated with fibrotic scores(r=0.579 andP<0.01).The variables that were significant in the univariate analysis were evaluated in multivariate logistic regression analysis,and RDW was an independent predicting factor of NASH(OR=1.75,95%CI:1.129-2.711,P<0.05).CONCLUSION:RDW a new non-invasive marker that can be used to demonstrate the presence of NASH and indicate advanced fibrotic scores.
文摘AIM: To evaluate how Helicobacter pylori(H. pylori) is able to evade the immune response and whether it enhances systemic immune tolerance against colorectal cancer.METHODS: This prospective randomized study involved 97 consecutive colorectal cancer patients and 108 cancer-free patients with extra-digestive diseases. Colorectal cancer and cancer-free patients were assigned into subgroups according to H. pylori Ig G seropositivity. Exposure to H. pylori was determined by Ig G seropositivity which was detected by enzyme linked immunoassay(ELISA). Serum neopterin levels were measured by ELISA. Serum tryptophan, kynurenine, and urinary biopterin concentrations were measured by high performance liquid chromatography. Serum nitrite levels were detected spectrophotometrically. Serum indoleamine 2,3-dioxygenase activity was estimated by the kynurenine to tryptophan ratio and by assessing the correlation between serum neopterin concentrations and the kynurenine to tryptophan ratio. The frequencies of increased serum kynurenine to tryptophan ratio of H. pylori seronegative and seropositive colorectal cancer subgroups were estimated by comparing them with the average kynurenine to tryptophan ratio of H. pylori seronegative tumor-free patients.RESULTS: Compared with respective controls, in both H. pylori seronegative and seropositive colorectal cancer patients, while serum tryptophan levels were decreased(controls vs patients; seronegative: 20.37 ± 0.89 μmol/L vs 15.71 ± 1.16 μmol/L, P < 0.05; seropositive: 20.71 ± 0.81 μmol/L vs 14.97 ± 0.79 μmol/L, P < 0.01) the kynurenine to tryptophan ratio was significantly increased(controls vs patients; seronegative: 52.85± 11.85 μmol/mmol vs 78.91 ± 8.68 μmol/mmol, P < 0.01, seropositive: 47.31 ± 5.93 μmol/mmol vs 109.65 ± 11.50 μmol/mmol, P < 0.01). Neopterin concentrations in cancer patients were significantly elevated compared with controls(P < 0.05). There was a significant correlation between serum neopterin levels and kynurenine/tryptophan in control and colorectal cancer patients groups(r s = 0.494, P = 0.0001 and r s= 0.293, P = 0.004, respectively). Serum nitrite levels of H. pylori seropositive cancer cases were significantly decreased compared with seropositive controls(controls vs patients; 26.04 ± 2.39 μmol/L vs 20.41 ± 1.48 μmol/L, P < 0.05) The decrease in the nitrite levels of H. pylori seropositive cancer patients may be attributed to excessive formation of peroxynitrite and other reactive nitrogen species.CONCLUSION: A significantly high kynurenine/tryptophan suggested that H. pylori may support the immune tolerance leading to cancer development, even without an apparent upper gastrointestinal tract disease.
文摘AIM:To determine the association between H pylori infection and serum ghrelin levels in patients without atrophic gastritis.METHODS:Fifty consecutive patients(24 males and 26 females)with either H pylori-positive gastritis(n = 34)or H pylori-negative gastritis(n = 16)with normal gastric acid secretion determined by 24-h pHmetry and without atrophic gastritis in histopathology were enrolled in this study.Thirty-four H pylori-infected patients were treated with triple therapy consisting of a daily regimen of 30 mg lansoprazole bid,1 g amoxicillin bid and 500 mg clarithromycin bid for 14 d,followed by an additional 4 wk of 30 mg lansoprazol treatment.H pylori infection was eradicated in 23 of 34(67.6%)patients.H pylori-positive patients were given eradication therapy.Gastric acidity was determined via intragastric pH catethers.Serum ghrelin was measured by radioimmunoassay(RIA).RESULTS:There was no signifficant difference in plasma ghrelin levels between H pylori-positive and H pylori-negative groups(81.10 ± 162.66 ng/L vs 76.51 ± 122.94 ng/L).In addition,there was no significant difference in plasma ghrelin levels and gastric acidity levels measured before and 3 mo after the eradication therapy.CONCLUSION:H pylori infection does not influence ghrelin secretion in patients with chronic gastritis without atrophic gastritis.
文摘AIM:To determine the association between Helicobacter pylori(H.pylori)and globus sensation(GS)in the patients with cervical inlet patch. METHODS:Sixty-eight patients with esophageal inlet patches were identified from 6760 consecutive patients undergoing upper gastrointestinal endoscopy prospectively.In these 68 patients with cervical inlet patches, symptoms of globus sensation(lump in the throat), hoarseness,sore throat,frequent clearing of the throat,cough,dysphagia,odynophagia of at least 3 mo duration was questioned prior to endoscopy. RESULTS:Cervical heterotopic gastric mucosa(CHGM) was found in 68 of 6760 patients.The endoscopic prevalence of CHGM was determined to be 1%.H.pylori was identified in 16(23.5%)of 68 patients with inlet patch.53 patients were classified as CHGMⅡ.This group included 48 patients with globus sensation,4 patients with chronic cough and 1 patient with hoarseness.All the patients who were H.pylori(+)in cervical inlet patches had globus sensation.CONCLUSION:Often patients with CHGM have a long history of troublesome throat symptoms.We speculate that disturbances in globus sensation are like non-ulcer dyspepsia.
基金Supported by Bilkent University Faculty Development Grant and Bilkent University Research Grant
文摘AIM:During liver regeneration cellular proliferation and apoptosis result in tissue remodeling to restore normal hepatic mass and structure.Main regulators of the apoptotic machinery are the Bcl-2 family proteins but their roles are not well defined throughout the liver regeneration.We aimed to analyze the expression levels of bcl-2gene family members during resection induced liver regeneration. METHODS:We performed semi-quantitative RT-PCR to examine the expression level of bak,bax,bcl-2 and bcl-x_L in 70% hepatectomized rat livers during the whole regeneration process and compared to that of the sham and normal groups. RESULTS:The expression of bak and bax was decreased whereas that of bcl-2and bd-X_L was increased in hepatectomized animals compared to normal liver at most time points.We also reported for the first time that sham group of animals had statistically significant higher expression of bak and bax than hepatectomized animals.In addition,the area under the curve (AUC) values of these genes was larger in sham groups than the hepatectomized groups. CONCLUSION:The expression changes of bak,bax,bcl-2 and bcl-X_L genes are altered not only due to regeneration, but also due to effects of surgical operations.