Gastric carcinoid tumor after laparoscopic sleeve gastrectomy

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Effect of Ursodeoxycholic Acid Alone and Ursodeoxycholic Acid Plus Domperidone on Radiolucent Gallstones and Gallbladder Contractility in Humans

Background/Aims. The aim of this study was to compare the effects of ursodeoxycholic acid (UDCA) alone and UDCA plus domperidone on dissolution of solitary or multiple gallstones. Methods. Fifty-three patients with cholesterol gallstones were randomized into three treatment groups: group I (n = 22) was given UDCA (15 mg/kg/day) alone and group II (n = 18) was treated with domperidone (30 mg/day) in addition to UDCA. The control group (n = 13) was followed without a medical treatment. Gallbladder volumes and ejection fractions were measured sonographically in all patients before and after treatment. Results. After 12 months of treatment, stone dissolution was found in 9 (40.9%) of the patients in group I and 7 (38.8%) of the patients in group II. The difference was statistically significant compared to controls in both treatment groups (P < 0.05) but the two groups did not show a difference between each other (P > 0.05). All the patients that achieved dissolution had multiple gallstones except for one patient with a solitary stone in group I. Neither monotherapy of UDCA nor the combination with domperidone affected the ejection fraction of gallbladder. Conclusions. Combination with domperidone did not potentiate the efficacy of UDCA. It has been observed that both UDCA alone and UDCA plus domperidone treatment did not affect ejection fraction of gallbladder

Serum neudesin levels in patients with polycystic ovary syndrome

Objectives: We aimed to investigate serum neudesin levels that has neural, metabolic functions in patients with polycystic ovary syndrome (PCOS). Material and methods: The study included 180 women (age range, 18–44 years) with a diagnosis of PCOS and a control group that included 100 healthy females (age range, 18–46 years). Body mass index (BMI), waist circumference, Ferriman-Gallwey score, was evaluated and plasma glucose, lipid profile, estradiol, progesterone, total testosterone, prolactin, insulin, dehydroepiandrosterone sulfate (DHEA-S), FSH, LH, free T3, free T4, thyroid stymulating hormone (TSH), anti-thyroperoxidase (anti-TPO) antibody and neudesin levels were evaluated in all participants. Results: BMI and waist circumference were similar between two groups. Ferriman-Gallwey score was significantly higher in the patient group. Fasting blood glucose, HbA1C, lipid parameters except triglyceride levels, free T3, free T4, TSH, anti-TPO were similar between the two groups. Triglyceride, insulin and HOMA values were significantly higher in PCOS patients. While follicle-stimulating hormone (FSH), estradiol, progesterone, prolactin and DHEAS levels were similar, LH was significantly higher in patients with PCOS. Serum neudesin level was significantly lower in PCOS patients with respect to controls (p = 0.015). Neudesin was positively correlated with insulin (r = 0.224, p = 0.037), and progesterone (r = 0.716, p = 0.001). Multiple regression analysis revealed that neudesin correlated with only progesterone (beta = 0.308, p = 0.001). Conclusions: Due to the association of decreased levels of neudesin with PCOS and correlation of neudesin with progesterone, neudesin may be related with one of patophysiologic pathways of PCOS. Still, it is not certain that decreased neudesin is involved in the pathogenesis of PCOS or is the result of the disorder

Concentrations of Connective Tissue Growth Factor in Patients with Nonalcoholic Fatty Liver Disease: Association with Liver Fibrosis

Aim: In this study, we aimed to investigate the relationship between the histological fibrosis stage of nonalcoholic fatty liver disease (NAFLD) and serum connective tissue growth factor (CTGF) to determine the usefulness of this relationship in clinical practice. Methods: Serum samples were collected from 51 patients with biopsy-proven NAFLD and 28 healthy controls, and serum levels of CTGF were assayed by ELISA. Results: Levels of CTGF were significantly higher in patients with NAFLD compared with controls (P = 0.001). The serum CTGF levels were significantly increased, that correlated with histological fibrosis stage, in patients with NAFLD [in patients with no fibrosis (stage 0) 308.2 ± 142.9, with mild fibrosis (stage 1–2) 519.9±375.2 and with advanced fibrosis (stage 3–4) 1353.2 ± 610 ng/l, P < 0.001]. Also serum level of CTGF was found as an independent predictor of histological fibrosis stage in patients with NAFLD (β = 0.662, t = 5.6, P < 0.001). The area under the ROC curve was estimated 0.931 to separate patients with severe fibrosis from patients with other fibrotic stages. Conclusion: Serum levels of CTGF may be a clinical utility for distinguishing NAFLD patients with and without advanced fibrosis

Estimation of total prostate specific antigen values through artificial intelligence modelling

It has been indicated that total prostate specific antigen (PSA) screening, one of the serum markers used for the diagnosis of prostate cancer, has been clinically beneficial. In this research, it was aimed to estimate the total PSA values by Multilayer Perceptron (MLP) artificial neural network (ANN) model. Data on total PSA values in this study (n = 1422) were randomly selected using the structured query language (SQL) from the database of patients records of Urology Department of Medical School at Inonu University. Total PSA values as a target/dependent variable, and age (year), blood group (A/B/0/AB), Exitus (EX) status (alive/death), Lymphocyte (LY) (%), Hemoglobin (HGB) (g / dL), Neutrophil (NE) (%), Albumin (g / dL), Calcium (mg / dL), Mean Corpuscular Hemoglobin (MCH), Leukocyte count (WBC) (103 / ml), Platelet (PLT) (103/ ml) as predictor variables were evaluated in the analyses. Outlier/extreme observations were analysed, and quantitative variables were rescaled by the transformation of Z-score or Box-Cox, and the MLP ANN model was constructed to estimate the total PSA values after variable selection method was used. Estimation performance of the model was examined by the values of mean absolute error, standard deviation and correlation coefficient. The MLP ANN model was created using a total of 1422 data sets as 993 of which were in training and 429 in the testing. Values of the mean absolute error, standard deviation, and correlation coefficient were calculated for training data set as; 0.744, 0.895 and 0.452; for the test data set as; 0.773, 0.935 and 0.355. The estimated accuracy of the generated model is predicted as 20.3%. In the MLP ANN model, the importance levels of the variables were obtained as 0.33 for HGB, 0.22 for NE, 0.16 for Calcium, 0.13 for PLT, 0.10 for age and 0.06 for EX. The MLP ANN model was established for the estimation of the total PSA values based on the selected variables, and calculated the importance levels of the related variables. Better prediction results in the estimation of total PSA values can be provided by using different additional variables, various resampling methods and alternative models. [Med-Science 2018; 7(2.000): 350-4

Metastatic gastric melanoma: a challenging diagnosis

Background. The stomach is regarded as a rare site for metastasis. When a gastric mass is observed macroscopically, the presumed diagnosis is usually a primary gastric carcinoma. However, the stomach may be involved in metastatic malignant melanoma. Besides a possible macroscopical misdiagnosis, metastatic gastric melanoma may also be misdiagnosed microscopically as adenocarcinoma due to its protean histological characteristics. These features make metastatic gastric melanoma a challenging diagnosis in some cases