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ŞENTÜRK, HAKAN

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Author: ŞENTÜRK, HAKAN × End date: 2023 × Start date: 2020 × Rights: info:eu-repo/semantics/openAccess ×

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Now showing 1 - 10 of 14
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    PublicationOpen Access
    Report of a Case of Signet Ring Carcinoma Presenting as Gastric Mucosal Thickening: A Diagnostic Dilemma
    (2021-01-01T00:00:00Z) Karatoprak, Cumali; Akçakaya, Adem; Şentürk, Hakan; Çoban, Ganime; Şahin, Nurhan; Türk, Hacı Mehmet; KARATOPRAK, CUMALİ; AKÇAKAYA, ADEM; ŞENTÜRK, HAKAN; ÇOBAN, GANİME; ŞAHİN, NURHAN; TÜRK, HACI MEHMET
    The number of cancer cases has been increasing worldwide. Early diagnosis and tumor resection remain as the most effective treatments for gastric cancer. However, early diagnosis is not always possible as it is frequently not possible to make treatment decisions without pathologic diagnosis in patients with clinically suspected cancer. This causes delays in diagnosing cancer. We presented a 58 years old woman with gastric signet ring cell carcinoma that could not be diagnosed despite using four different methods of stomach biopsies. We aimed to emphasize that despite the use of advanced methods, if clinical cancer in non-diagnosed cases is suspected, we should be more aggressive for early diagnosis.
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    BOUGIE DILATATION IN BENIGN ESOPHAGEAL STRICTURES: EVALUATION OF ADJUVANT METHYLPREDNISOLONE INJECTION
    (2022-05-01T00:00:00Z) KÖKER, İBRAHİM HAKKI; ŞENTÜRK, HAKAN; KÖKER, İBRAHİM HAKKI; ŞENTÜRK, HAKAN
    Objective: Mechanical dilatation and adjuvant injection of tri-amcinolone acetate (TA) effectively preserve the opening pro-vided and reduce the number of bougie dilation (BD) in benign esophageal strictures. In this study, we aimed to evaluate the role of Methylprednisolone (MP) injection after BD in providing permanent/long-term lumen opening.
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    Comparison of LMA® Gastro™ airway and gastrolaryngeal tube in endoscopic retrograde cholangiopancreatography: a prospective randomized observational trial
    (2021-05-13T00:00:00Z) Uysal, Harun; Senturk, HAKAN; Calim, Muhittin; Daskaya, Hayrettin; Guney, Ibrahim A; Karaaslan, Kazim; UYSAL, HARUN; ŞENTÜRK, HAKAN; DAŞKAYA, HAYRETTİN
    Background: New generation airway devices with different designs have been developed as an alternative to endotracheal intubation in order to avoid adverse events associated with sedation in endoscopic procedures and to provide patent airway. We aimed to compare two supraglottic airway devices (SGADs), the LMA® Gastro™ airway and gastrolaryngeal tube (GLT), in terms of airway efficiency, performance during procedure and adverse events in endoscopic retrograde cholangiopancreatography (ERCP). Methods: A hundred-three ERCP patients without high risk of aspiration were included. Patients were randomly allocated to the LMA Gastro and GLT groups. The primary study outcomes were the comparison of the two SGADs in terms of oropharyngeal leak pressure (OLP). Secondary study outcome was SGADs-related adverse events. Results: Procedures were completed with SGADs in fifty patients in each group. The rate of successful insertion at first attempt was 72% in GLT and 96% in LMA Gastro (P=0.004). The mean OLP of LMA Gastro Group (31.8 cmH2O) was significantly higher than that of the GLT Group (26.5 cmH2O), (P=0.0001). However, endoscopists' satisfaction was higher in GLT (P=0.0001). Mucosal damage and sore throat were lower in LMA Gastro Group. Conclusions: LMA® Gastro™ had a higher OLP than GLT. However, GLT was better for endoscopist satisfaction, as it provides more satisfying maneuverability. As to secondary outcome advers events were lower in LMA® Gastro™. The lower complication rates associated with the device and providing a more patent airway also highlighted the apparent clinical efficacy of LMA® Gastro™ than GLT, in ERCP.
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    Early prediction of the severe course, survival, and ICU requirements in acute pancreatitis by artificial intelligence
    (2023-01-01) İnce A. T.; Silahtaroğlu G.; Seven G.; Koçhan K.; Yıldız K.; Şentürk H.; İNCE, ALİ TÜZÜN; SEVEN, GÜLSEREN; KOÇHAN, KORAY; ŞENTÜRK, HAKAN
    AbstractObjectiveTo evaluate the success of artificial intelligence for early prediction of severe course, survival, and intensive care unit(ICU) requirement in patients with acute pancreatitis(AP).MethodsRetrospectively, 1334 patients were included the study. Severity is determined according to the Revised Atlanta Classification(RAC). The success of machine learning(ML) method was evaluated by 13 simple demographic, clinical, etiologic, and laboratory features obtained on ER admission. Additionally, it was evaluated whether Balthazar-computerized tomography severity index(CTSI) at 48-h contributed to success. The dataset was split into two parts, 90% for ML(of which 70% for learning and 30% for testing) and 10% for validation and 5-fold stratified sampling has been utilized. Variable Importance was used in the selection of features during training phase of machine. The Gradient Boost Algorithm trained the machine by KNIME analytics platform. SMOTE has been applied to increase the minority classes for training. The combined effects of the measured features were examined by multivariate logistic regression analysis and reciever operating curve curves of the prediction and confidence of the target variables were obtained.ResultsAccuracy values for the early estimation of Atlanta severity score, ICU requirement, and survival were found as 88.20%, 98.25%, and 92.77% respectively. When Balthazar-CTSI score is used, results were found as 91.02%, 92.25%, and 98% respectively.ConclusionsThe ML method we used successfully predicted the severe course, ICU requirement and survival, with promising accuracy values of over 88%. If 48-h Balthazar-CTSI is included in the calculation, the severity score and survival rates increase even more.
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    The clinical feature and outcome of groove pancreatitis in a cohort: A single center experience with review of the literature
    (2022-08-01T00:00:00Z) DEĞER, KAMURAN CUMHUR; KÖKER, İBRAHİM HAKKI; Destek, Sabahattin; TOPRAK, HÜSEYİN; Yapalak, Yunus; GÖNÜLTAŞ, CEREN; ŞENTÜRK, HAKAN; DEĞER, KAMURAN CUMHUR; KÖKER, İBRAHİM HAKKI; TOPRAK, HÜSEYİN; GÖNÜLTAŞ, CEREN; ŞENTÜRK, HAKAN
    BACKGROUND: Groove pancreatitis (GP) is a rare form of chronic pancreatitis that is less common and is now gaining awareness with multimodal imaging modalities. Our aim is to analyze the mid-long term outcomes of patients diagnosed with GP with different treatment approaches.
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    PublicationOpen Access
    Cyst Fluid Carcinoembryonic Antigen Level Difference between Mucinous Cystic Neoplasms and Intraductal Papillary Mucinous Neoplasms.
    (2020-12-11T00:00:00Z) Köker, İbrahim Hakkı; Ünver, Nurcan; Malya, Fatma Ümit; Uysal, Ömer; Keskin, Elmas Biberci; Şentürk, Hakan; MALYA, FATMA ÜMİT; UYSAL, ÖMER; BİBERCİ KESKİN, ELMAS; ŞENTÜRK, HAKAN
    Background/aims: The role of cyst fluid carcinoembryonic antigen (CEA) level in differentiating mucinous pancreatic cystic lesions (PCLs) is controversial. We investigated the role of cyst fluid CEA in differentiating low-risk (LR)-intraductal papillary mucinous neoplasms (IPMNs) from high-risk (HR)-IPMNs and LR-mucinous cystic neoplasms (MCNs). Methods: This was a retrospective study of 466 patients with PCLs who underwent endoscopic ultrasound-guided fine-needleaspiration over a 7-year period. On histology, low-grade dysplasia and intermediate-grade dysplasia were considered LR, whereas high-grade dysplasia and invasive carcinoma were considered HR. Results: Data on cyst fluid CEA levels were available for 50/102 mucinous PCLs with definitive diagnoses. The median CEA (range) levels were significantly higher in HR cysts than in LR cysts (2,624 [0.5-266,510] ng/mL vs. 100 [16.8-53,445]ng/mL, p=0.0012). The area under the receiver operating characteristic curve (AUROC) was 0.930 (95% confidence interval [CI], 0.5-0.8; p<0.001) for differentiating LR-IPMNs from LR-MCNs. The AUROC was 0.921 (95% CI, 0.823-1.000; p<0.001) for differentiating LR-IPMNs from HR-IPMNs. Both had a CEA cutoff level of >100ng/mL, with a negative predictive value (NPV) of 100%. Conclusion: Cyst fluid CEA levels significantly vary between LR-IPMNs, LR-MCNs, and HR-IPMNs. A CEA cutoff level of >100ng/mL had a 100% NPV in differentiating LR-IPMNs from LR-MCNs and HR-IPMNs.
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    PublicationOpen Access
    Mucinous Pancreatic Cysts: Comparison of Cyst Size and Location in Certain Mucinous Cyst Subgroups
    (2021-09-01T00:00:00Z) KÖKER, İBRAHİM HAKKI; Elagoz, Sahende; GÜCİN, ZÜHAL; MALYA, FATMA ÜMİT; ŞENTÜRK, HAKAN; KÖKER, İBRAHİM HAKKI; GÜCİN, ZÜHAL; MALYA, FATMA ÜMİT; ŞENTÜRK, HAKAN
    Background: There are studies reporting that the location of intraductal papillary mucinous neoplasia (IPMN) predicts malignancy. Therefore, we evaluated the cyst location’s relationship with malignancy, and the possibility of using cyst size and location to distinguish between non-main duct (non-MD)-IPMNs, mucinous cystic neoplasia (MCN), and cystic pancreatic ductal adenocarcinoma (PDAC). Methods: We performed a retrospective analysis of data from 122 patients with a definite cyto-histological diagnosis of non-MDIPMNs, LR-MCNs, and cystic PDACs via endoscopic ultrasound fine-needle aspiration between October 2011 and October 2020. We grouped the cyst locations as head, uncinate, neck (HUN), and corpus or tail (CT). On histology, low-grade dysplasia and intermediategrade dysplasia were considered low risk (LR), whereas high-grade dysplasia and invasive carcinoma were considered high risk (HR). Results: Of the 122 patients (61 (50%) women, median age 61.5 years (range 19-85), there were 34 (27.9%) LR-non-MD-IPMNs, 33 (27%) HR-non-MD-IPMNs, 19 (15.6%) LR-MCNs, and 36 (29.5%) cystic PDACs. We found no significant difference between LRand HR-non-MD-IPMN locations (P = .803). Low-risk non-MD-IPMNs were significantly smaller than HR-non-MD-IPMNs (P < .001), LR-MCNs (P = .002), and cystic PDACs (P < .001). The area under the receiver operating characteristic curve (AUROC) was 0.819 (95% CI: 0.716-0.902; P < .0001), and demonstrated a cyst size cut-off <2.2 cm to differentiate LR cysts, while cysts <1.6 cm had a negative predictive value (NPV) of 100% in non-MD-IPMNs. Conclusion: Cyst location is not predictive of malignancy in non-MD-IPMNs. Low-risk non-MD-IPMNs were smaller than HR-non-MDIPMNs, LR-MCNs, and cystic PDACs. The cyst size cut-off was 2.2 cm; however, <1.6 cm had a 100% NPV differentiating LR- from HR-non-MD-IPMNs
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    PublicationOpen Access
    Correlation of Endoscopic Ultrasonography Features with the Mitotic Index in 2- to 5-cm Gastric Gastrointestinal Stromal Tumors
    (2021-04-01T00:00:00Z) Seven, Gulseren; Arici, Dilek Sema; Senturk, HAKAN; SEVEN, GÜLSEREN; ŞENTÜRK, HAKAN
    Background: Predicting the malignancy potential of gastrointestinal stromal tumor (GIST) before resection could improve patient management strategies as gastric GISTs with a low malignancy potential can be safely treated endoscopically, but surgical resection is required for those tumors with a high malignancy potential. This study aimed to evaluate endoscopic ultrasound (EUS) features of 2- to 5-cm gastric GISTs that might be used to predict their mitotic index using surgical specimens as the gold standard. Patients and methods: Forty-nine patients (30 females and 19 males; mean age 55.1 ± 12.7 years) who underwent EUS examinations, followed by surgical resections of 2- to 5-cm gastric GISTs, were retrospectively reviewed. Results: The mean tumor size was 3.44 ± 0.97 (range 2.1-5.0) cm. A univariate analysis revealed no significant differences in age, sex, and tumor location in the low mitotic index and high mitotic index groups (all p > 0.05). In terms of EUS features, there were no significant differences in the mitotic indexes with respect to the shape, surface lobulation, border regularity, echogenicity, homogeneity, growth patterns, presence of mucosal ulceration, hyperechogenic foci, anechoic spaces, and hypoechoic halos (all p > 0.05). However, the tumor size was larger in the high mitotic index group than that in the low mitotic index group (3.97 ± 1.05 vs. 3.27 ± 0.9 cm, p = 0.03). Conclusion: Conventional EUS features are not reliable for predicting the mitotic index of 2- to 5-cm gastric GISTs. Further modalities for predicting the mitotic index are needed to prevent unnecessary surgical resections in patients with a low risk of malignancy.
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    PublicationOpen Access
    The relationship of Serum Histone H3.3 and H4 with chronic Hepatitis B
    (2020-09-01T00:00:00Z) Sümbül, Bilge; Şentürk, Hakan; Köker, İbrahim Hakkı; Koçhan, Koray; İnce, Ali Tüzün; Biberci Keskin, Elmas; İNCE, ALİ TÜZÜN; BİBERCİ KESKİN, ELMAS; SÜMBÜL, BİLGE; KOÇHAN, KORAY; KÖKER, İBRAHİM HAKKI; ŞENTÜRK, HAKAN
    Objective: To determine the role of serum histone H3.3 and H4 in patients with chronic hepatitis B to explore any relationship between the two.Methods: The prospective controlled clinical pilot study was conducted in the Gastroenterology Clinic of Bezmialem Vakif University, Istanbul, Turkey, from January to October 2017, and comprised biopsy-proven patients with chronic hepatitis B and healthy controls. Demographics, hepatitis B virus deoxyribonucleic acid quantity, hepatitis B e-antigen, aspartate aminotransferase, alanine transaminase, international normalized ratio, total/direct bilirubin, albumin and thrombocyte counts as well as histological activity index and fibrosis scores were noted. Data was analysed using SPSS 22.Results: Of the 140 subjects, 70(50%) each were cases and controls. The overall mean age of the sample was 43.38±15.07 years (range: 18-70 years). There was positive correlation of histone H3.3 with hepatitis B virus deoxyribonucleic acid, aspartate aminotransferase, alanine transaminase and international normalized ratio levels. Histone H4 levels only correlated with hepatitis B virus deoxyribonucleic acid and international normalized ratio. Hepatitis B e-antigen positivity was present in 14(20%) of the cases.Conclusion: Histone H3.3 levels appeared to be associated with pathophysiological changes in chronic hepatitis B patients, suggesting that future treatments should target H3.3.Keywords: Histone H3.3, Histone H4, Extracellular histone, Chronic Hepatitis B, HBV.(JPMA 70: 1596; 2020)DOI:https://doi.org/10.5455/JPMA.19365