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Öğe Gallbladder contractility in patients with cirrhotic versus malignant ascites(Wiley, 2002) Sari, R; Yildirim, B; Sevinc, A; Bahceci, F; Hilmioglu, FPurpose. The aim of this study was to evaluate differences in gallbladder contractility by measuring gallbladder wall thickness, fasting and residual gallbladder volume, and gallbladder ejection fraction in patients with cirrhotic and malignant ascites. Methods, Twenty-four patients (16 women and 8 men) with malignant ascites (2 cervical, 2 colon, 2 stomach, 6 pancreatic, and 12 ovarian carcinomas), aged 59 +/- 12 years, and 26 patients (14 women and 12 men) with cirrhotic ascites, aged 57 +/- 16 years, Were included in the study. After patients fasted overnight for 8 hours, gallbladder wall thickness, fasting gallbladder volume, and gallbladder volume and ejection fraction were measured sonographically at 10, 20, 30, 40, 50, 60, 70, 80, and 90 minutes after ingestion of a standard liquid test meal. Results. The mean gallbladder wall thickness was higher in patients with cirrhotic ascites than in those with malignant ascites (5.5 +/- 1.5 mm [standard deviation] versus 3.1 +/- 0.6 mm, respectively; p < 0.001). The mean fasting gallbladder volume was also higher in patients with cirrhotic ascites than in those with malignant ascites (27.3 +/- 11.5 cm(3) versus 17.6 +/- 8.9 cm(3); p < 0.05). Patients with cirrhotic ascites had significantly higher mean postprandial gallbladder volumes and ejection fractions than did those with malignant ascites at all times except 10 minutes after the meal (p < 0.05). Conclusions. Our findings suggest that gallbladder contractility is greater in patients with cirrhotic ascites than in patients with malignant ascites. (C) 2002 Wiley Periodicals, Inc.Öğe The importance of serum and ascites fluid alpha-fetoprotein, carcinoembryonic antigen, CA 19-9, and CA 15-3 levels in differential diagnosis of ascites etiology(H G E Update Medical Publishing S A, 2001) Sari, R; Yildirim, B; Sevinc, A; Bahceci, F; Hilmioglu, FBackground/Aims: Clinical usage of tumor markers is being limited due to low specificity. Elevated plasma levels of tumor markers may be seen in diseases other than malignancy, i.e., kidney, liver or circulatory disturbances. Methodology: In our study, we studied serum and ascites fluid alpha-fetoprotein, carcinoembryonic antigen, CA 19-9, CA 15-3 levels in patients with chronic liver disease, spontaneous bacterial peritonitis, malignancy, tuberculous and congestive heart failure in a total of 76 patients. Results: The sensitivity and specificity for ascites fluid alpha-fetoprotein levels were 28.5% and 100%, for serum alpha-fetoprotein levels 28.5% and 98.1%, for ascites fluid carcinoembryonic antigen levels 38.0% and 98.1%, for serum carcinoembryonic antigen levels 57.1% and 90.0%, for ascites fluid CA 19-9 levels 19.0% and 94.5%, for serum CA 19-9 levels 33.3% and 21.8%, for ascites fluid CA 15-3 levels 28.5% and 92.7%, and for serum CA 15-3 levels 47.6% and 81.8%, respectively. Conclusions: In conclusion, the sensitivity of serum and ascites fluid tumor markers was found to be low. High specificity may be due to low number of study participants. Serum and ascites fluid tumor markers are not found to be useful in the differential diagnosis of ascites etiology.Öğe Memory impairment in patients with cirrhosis(Natl Med Assoc, 2005) Bahceci, F; Yildirim, B; Karincaoglu, M; Dogan, I; Sipahi, BBackground and Aim: Subdinical hepatic encephalopathy (HE) in cirrhotic patients is usually characterized by memory impairment and psychomotor slowing. Our aim was to investigate memory status in cirrhotic patients with and without clinically overt HE. Material and Methods: Thirty-two cirrhotic patients (10 female and 22 male) aged 49 17 years and 20 healthy subjects (six female and 14 male) aged 46 12 years were included in the study. Memory status was defined by Wechsler Memory Scale, verbal memory process and complex memory process tests. Results: Grade-1 HE was detected in 7 (22%) patients with cirrhosis. We detected 36 to 92% decrement in various memory tests in cirrhotic patients without HE as compared to healthy subjects. The scores for all psychometric testing results were significantly lower in cirrhotic patients without HE as compared to healthy subjects. We detected 42.9 to 100% decrement in various memory tests in cirrhotic patients with HE than cirrhotic patients without HE. However, there was no statistical significant difference between cirrhotic patients with and without HE. There was no statistical significant difference in cirrhotic patients with Child-Pugh A, B, and C. Conclusion: In conclusion, memory status was influenced in which patients with cirrhosis yet has a normal mental and neurological status to routine clinical examination (subclinical HE). Occasionally, decreased memory performance may adversely affect the satisfaction and lifestyle of these patients. Therefore, subclinical HE is an important social problem.Öğe Renal failure in a patient with autosomal dominant polycystic kidney disease and coexisting dermato-polymyositis: First report in the literature(Natl Med Assoc, 2004) Bahceci, F; Sari, R; Sarikaya, M; Atik, E; Karincaoglu, Y; Sevinc, AAutosomal dominant polycystic kidney disease is a multisystem disorder characterized by multiple, bilateral renal cysts and is also associated with cysts in other organs, such as the liver, pancreas, and arachnoid membranes. Dermatomyosiltis is a disease which mainly involves the skin and muscles, although occasionally other organs are affected. In this report, a 56-year-old male patient with a four-year history of autosomal dominant polycystic kidney disease was presented. Renal failure was exacerbated by a coexisting dermato-polymyositis. Prednisone treatment with hemodialysis improved the situation. This is the first report renal failure in a patient with autosomal dominant polycystic kidney disease and dermato-polymyositis.Öğe Serum and ascites fluid cytokine levels in patients with chronic heart failure(Acta Cardiologica, 2001) Sari, R; Yildirim, B; Sevinc, A; Bahceci, F; Ozdemir, R; Hilmioglu, FObjective - Cytokines that are capable of modulating cardiovascular function were reported to be elevated in patients with advanced heart failure. We evaluated the diagnostic importance of cytokines both in the serum and ascites. Material and methods - We determined serum and ascites fluid TNF-alpha, IL-1 beta, IL-6, IL-8, and soluble IL-2 receptor levels in 14 patients with congestive heart failure (group I) and in 15 patients with chronic liver disease (group 2). Results - Ascites fluid IL-8 and soluble IL-2 receptor levels were found to be significantly elevated in group I when compared with group 2 (p = 0.014 and p = 0.005). There were no statistical differences in serum TNF-alpha, IL-1 beta, IL-6, IL-8, and soluble IL-2 receptor levels and ascites fluid TNF-alpha, 1L- I (IL-1 beta, and IL-6 Ievels. Ascites fluid/serum IL- I (IL-1 beta and IL-8 ratio was lower in group 1 when compared with group 2 (p = 0.001 and p = 0.005). Ascites fluid/serum IL-2 and IL-6 ratio was higher in group I when compared with group 2 (p = 0.035 and p = 0.025). Conclusion - Cytokine levels in ascites fluid, but not in serum, are important in congestive heart failure. Ascites fluid/serum cytokine level ratios were detected to be more conclusive and valid in the diagnosis work-up of ascites aetiology.Öğe Transient severe thrombocytopenia in a patient on CAPD after intravenous iron administration(Multimed Inc, 2003) Taskapan, H; Bahceci, F; Taskapan, C; Sahin, I; Kaya, E; Aydogdu, I[Abstract Not Available]
