Backgorund and Aims: Gastroesophageal reflux disease is a common condition that negatively affects quality of life. This study aimed to determine the prevalence of gastroesophageal reflux disease symptoms among adults living in the city center of Edirne and to identify factors associated with the presence of gastroesophageal reflux disease. Materials and Methods: This population-based cross-sectional study was conducted between July and October 2018 in the city center of Edirne, Türkiye. Individuals aged 18 years and older were included using stratified sampling based on age, sex, and neighborhood distribution. Data were collected through face-to-face interviews using a structured questionnaire. Gastroesophageal reflux disease was defined as the presence of heartburn and/or regurgitation occurring at least once per week. Sociodemographic characteristics, lifestyle factors, comorbidities, and medication use were evaluated. Statistical analyses were performed using appropriate parametric and nonparametric tests, and logistic regression analysis was used to identify factors associated with gastroesophageal reflux disease. Results: A total of 1,535 participants were included in the study (50.8% female; mean age 41.66 ± 16.1 years). The prevalence of gastroesophageal reflux disease symptoms was 15.9% (n = 244). Regurgitation was the most frequently reported symptom. Gastroesophageal reflux disease prevalence was significantly higher among smokers (p < 0.001), individuals with asthma (p = 0.006), and those using calcium channel blockers (p = 0.008). Higher educational level was also significantly associated with gastroesophageal reflux disease (p = 0.002). No significant associations were found between gastroesophageal reflux disease and body mass index, alcohol consumption, tea/coffee intake, or diabetes mellitus. Conclusion: The prevalence of gastroesophageal reflux disease symptoms among adults living in the city center of Edirne was 15.9%, indicating that gastroesophageal reflux disease is a common public health problem. Smoking, asthma, and calcium channel blocker use were identified as significant risk factors. These findings highlight the importance of lifestyle modification and careful medication selection in the prevention and management of gastroesophageal reflux disease.

Aims: Gold standard technique for determining the stage of fibrosis in cirrhosis is a biopsy. Non-invasive tests are used when a biopsy is contraindicated. However, their specificity and sensitivity still fall short of expectations. Aim of the study is to develop a model capable of determining fibrosis using serum biomarkers and liver ultrasonography. Methods: A retrospective study was designed including patients with chronic hepatitis B and C underwenting liver biopsies between the time frame of 2015 to 2020 years at Trakya University School of Medicine. Epidemilogical data, ltrasonography and pathology reports were noted. Blood values were recorded and used to calculate AST / Platelet Ratio Index (APRI), Fibrosis-4 Index (FIB-4), Gothenburg University Cirrhosis Index (GUCI) noninvasive fibrosis indices. The fibrosis stages of the patients were assessed accoridng to pathology reports into three categories: advanced (F5-F6), moderate (F3-F4), and lower Ishak scores. Results: A total of 259 patients were included in the study. The median age of the patients was 54 (19-90), and 40.9% (106) were female. The median values of APRI, GUCI and FIB-4 scores were respectively: 0.6 (0-21.8), 0.6 (0-26.2) and 1.6 (0.2-8.5). The effects of ultrasonography findings were examined to improve the diagnostic performance of APRI, GUCI and FIB-4 indices. Accompanied by statistical analysis, it was observed that the FIB-4 index and the presence of hepatosteatosis in the liver had a significant effect on the detection of F?3 (respectively; p<0.001, p=0.033). A new model named FIB4u (ultrasonography) was developed. The AUC values of indices for differentiation of intermediate and advanced stages of fibrosis (?3) were respectively:FIB4u 0.760; FIB-4 0.753; GUCI 0.676; APRI 0.667 (p<0.001). The FIB4u index demonstrated considerably better performance compared to both APRI and GUCI. Conclusion: The FIB4u index, developed by combining ultrasonography and laboratory data, can be used as a new index for fibrosis assessment in the absence of advanced elastography techniques. It needs to be validated in larger patient cohorts to be used safely in the long term.

Background: In inflammatory arthritis, especially rheumatoid arthritis, the upper extremities are affected in 80-90% of cases, with the wrist being most frequently affected. In these patients, the motor function of the upper extremities is often impaired, leading to disability as the disease progresses. Chronic inflammatory joint disease and/or joint degeneration may further alter the proprioceptive sense, resulting in reduced sensorimotor control. To improve motor performance and proprioceptive control, specific exercise approaches should be incorporated into the rehabilitation program. While conscious proprioception is usually assessed by measuring joint position, the unconscious component of proprioception remains a challenge as there is no established method to assess it directly. Unconscious neuromuscular control of joints involves the activation of muscles through feed-forward control mechanisms leading to changes in electromyographic (EMG) activity. In addition to measuring motor performance, analyzing the EMG activity of the surrounding muscles of the affected joint can provide valuable insights into unconscious proprioception and also help to assess the effects of exercise on muscle recruitment. Objectives: The aim of this study was to investigate the effects of proprioceptive exercises on conscious (joint position sense) and unconscious proprioception (surface EMG signals of the forearm muscles) as well as on motor performance measures such as grip and pinch strength, reaction time and upper extremity stability in healthy individuals. Methods: A total of 41 healthy individuals (25 males, 16 females) aged 20 to 30 years (mean age 23.12 ± 2.23 years) were included in this study. Participants were randomly assigned to either group 1, which received a combination of proprioceptive exercises and traditional upper extremity exercises, or group 2, which received only traditional upper extremity exercises. Both groups performed non-dominant upper extremity exercises twice a week over a 6-week period. Motor performance outcomes included measurement of wrist position sense (flexion, extension, radial and ulnar deviation) using a validated goniometric platform, measurement of grip and pinch strength using a dynamometer, measurement of reaction time using the Nelson test, and assessment of upper extremity stability using the Y-balance test. The measurements were taken at the baseline and after the 6-week training program for both extremities. Surface electromyography (EMG) results were recorded from specific forearm and finger muscles using a Noraxon EMG device. EMG analysis was performed with an amplifier gain of x1500 mV, a bandpass filter between 10-400 Hz, a sampling rate of 5000 Hz and a common mode rejection ratio (CMRR) of 90 dB. The EMG analysis included tasks involving isotonic joint motion and grasping. EMG measurements were normalized based on the participant's maximal isometric contraction. Results: Grip strength increased and reaction time decreased in both groups. However, when comparing the two groups, group 1 was found to have significantly higher EMG muscle activity in the finger flexors (p=0.01) and extensors (p=0.007) and in the wrist flexors (p=0.02; p=0.04) during grasping compared to group 2. In addition, increased activation of wrist flexors (p=0.03) and finger flexors (p=0.02) was found during isotonic motion. Conclusion: The integration of proprioceptive exercises into the rehabilitation program has been shown to yield additional benefits in improving unconscious wrist proprioception. In patients with rheumatic diseases involving wrist, such as rheumatoid arthritis, it is possible to incorporate proprioceptive exercises into the treatment program to enhance sensorimotor control of the joints. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.

Aims: We aimed to present the characteristics, indications, endoscopic ultrasonography procedure details, diagnoses and complication rate of patients who underwent endosonpgraphy in a single center. Methods: Forty six patients admitted to Trakya Unversity Faculty of Medicine and underwent EUS (±FNA) procedure between January 2021 and May 2022 were included in the study. Patients files were analysed retrospectively. Demographic characteristics, presence and types of comorbidity, presence and types of malignancy in the family, use of antithrombotic drugs, laboratory data, details of eus procedure, pathology results, adverse events were recorded. The data obtained in the study were analyzed using Statistical Package for Social Science for Windows 26 package program. Results: A total of 46 patients were included in the study. 46% (n=21) were women. The median age was 64 (28-87). Antithrombotic use was present in 25% of the patients. Comorbidities were present in 84% of patients. The indications for EUS were predominantly pancreatic lesions (n=31). Aspirations were performed in addition to ultrasonographic examination in 78% (n=36) of the patients. 19 G (Gauge) needles were used in 30 and 25 G needles were used in 6 patients. Biopsy stations were stomach (n=31), duodenum (n=4), esophagus (n=1). Median long axis of the lesions was 34 (7-173) mm and the short axis was 26 (1-76) mm. 42% of the biopsied pancreatic lesions were cystic and 58% were solid. The CA19-9 level in solid lesions was statistically significantly higher than cystic (1512 /28 U/ml; p= 0.008). CA19-9 level was found mean 2061±3295 U/ml in patients with adenocarcinoma (n=8), 71±106 U/ml in cystic neoplasm and 152±338 in benign disorders (p=0.026). Cut-off value predicting adenocarsinoma with %87,5 spesifity and %87,5 sensitivity in our cohort was 174 U/ml (( AUC 0.85 ( 0.63-1)). Spesifity and sensitivity of the level 40 ( nearest level to universaly detected upper limit: 37 U/mL) was %62,5 and %87,5 respectively. Comparing malignant and benign lesions of pancreas overall, no statistical significance was found of CA19-9 level in predicting the diagnosis of tumor (p=0.15). Of the patients who underwent biopsy, 61% were malignant and 39% were benign. Malignant diagnoses were: adenocarsinoma, cystic neoplasm, gastrointestinal stromal tumor, neuroendocrine tumor, mesenchymal tumor, lumphoma, metastasis. Benign diagnoses were: otoimmune pancreatitis, normal cyst, chronic pancreatitis, pseudocyst, walled-off necrosis, polyp, no lesion. Post-procedure complications were not observed in any of the patients. Conclusion: The availability of endoscopic ultrasonography is expanding nowadays. Endoscopy ultrasonography is a precise, advantageous, and risk-free technique when performed by trained personnel.

Aims: Hydatid cyst disease is a rare cause of upper gastrointestinal bleeding. Peculiarly if it's resulted from a ruptured hepatic artery aneurysm in the hydatid cyst cavity which is fistulated into the duodenum. We here present a case of hepatic artery pseudoaneurysm due to a complicated hydatid cyst with synchronous duodenal fistula. Case: A 45-year-old male was admitted to the emergency department with hematemesis and hematochezia. The patient had a history of a hydatid cyst of liver and a surgical procedure of lung ecinoccosis. Endoscopy revealed an unusual ulcerated lesion in the duodenum. Yellow membranes were observed in the midst and blood oozing. After unsuccessful endoscopic sclerotherapy, a Computerized Tomography (CT) was performed. CT revealed a ruptured hydatid cyst into the duodenum and bleeding from the formed hepatic artery pseudoaneurysm. Hepatic artery coil embolization was performed urgently and a percutaneous transhepatic drainage catheter was applied to maintain the bile flow. Subsequently, a 10 Fr , 10 cm plastic stent was inserted via Endoscopic Retrograde Cholangiopancreatography (ERCP). The rare complication which was observed after embolization was the hepatic abscess. Although a percutaneous catheter was inserted initially, drainage wasn’t successful. As a last option, surgical debridement was considered. Conclusion: If a patient who presented with upper gastrointestinal bleeding with a previous history of liver hydatid cyst, cyst complications must be listed as a differential diagnosis. Besides endoscopy, contrast-enhanced CT and ЕRCP are the essential diagnostic and therapeutic approaches.

Background: Although studies are investigating the perception and beliefs about treatment and adherence to treatment in different societies related to inflammatory bowel disease, there are no studies on this subject in Turkish people with different sociocultural structures. In our study, we aimed to evaluate the beliefs about treatment and its effect on adherence to treatment in the Turkish population with inflammatory bowel disease. Methods: In the study, the "Medication Adherence Report Scale" and "Beliefs about Medicines Scale" scales were used to evaluate the treatment compliance and perception and beliefs about treatment. Characteristics that could affect treatment compliance were evaluated by statistical analysis. Results: A total of 253 patients, 167 with ulcerative colitis and 86 with Crohn's disease, were included in the study. The non-adherence rate to the treatment was found as 41.9% in ulcerative colitis and 24.4% in Crohn's disease (P =.006). Intentional (29.3% in ulcerative colitis and 16.3% in Crohn's disease [P =.031] and unintentional non-adherence to treatment (28.1% in ulcerative colitis, 16.3% in Crohn's disease [P =.037] were significantly higher in ulcerative colitis than in Crohn's disease. Female gender (odds ratio = 2.59, P =.005), low education level (odds ratio = 4.8, P =.015), distal involvement in ulcerative colitis (P =.014), and thoughts about the disease would last too soon in Crohn's disease (odds ratio = 4.17, P =.049) were risk factors for non-adherence to treatment. Conclusion: The negative perception of treatment in inflammatory bowel disease affects adherence to the treatment. Considering some social factors that affect adherence to the treatment and taking measures to enhance the adherence to treatment will increase the success of treatment.

Aims: Hydatid cyst disease is a rare cause of upper gastrointestinal bleeding. Peculiarly if it's resulted from a ruptured hepatic artery aneurysm in the hydatid cyst cavity which is fistulated into the duodenum. We here present a case of hepatic artery pseudoaneurysm due to a complicated hydatid cyst with synchronous duodenal fistula. Case: A 45-year-old male was admitted to the emergency department with hematemesis and hematochezia. The patient had a history of a hydatid cyst of liver and a surgical procedure of lung ecinoccosis. Endoscopy revealed an unusual ulcerated lesion in the duodenum. Yellow membranes were observed in the midst and blood oozing. After unsuccessful endoscopic sclerotherapy, a Computerized Tomography (CT) was performed. CT revealed a ruptured hydatid cyst into the duodenum and bleeding from the formed hepatic artery pseudoaneurysm. Hepatic artery coil embolization was performed urgently and a percutaneous transhepatic drainage catheter was applied to maintain the bile flow. Subsequently, a 10 Fr , 10 cm plastic stent was inserted via Endoscopic Retrograde Cholangiopancreatography (ERCP). The rare complication which was observed after embolization was the hepatic abscess. Although a percutaneous catheter was inserted initially, drainage wasn’t successful. As a last option, surgical debridement was considered. Conclusion: If a patient who presented with upper gastrointestinal bleeding with a previous history of liver hydatid cyst, cyst complications must be listed as a differential diagnosis. Besides endoscopy, contrast-enhanced CT and ЕRCP are the essential diagnostic and therapeutic approaches.

Background and study aims: Cirrhosis is a multisystem disorder characterized by hyperdynamic circulation which can progress to multiple organ dysfunctions. Recent studies have demonstrated autonomic dysfunction and cirrhotic cardiomyopathy including diastolic dysfunction, systolic dysfunction with electrophysiologic abnormalities in patients with cirrhosis. Due to the long and complicated course of the disease, health related quality of life is affected. We aimed to evaluate the frequency of diastolic dysfunction and autonomic dysfunction in cirrhosis, and the effects on health-related quality of life. Patients and methods: Hundred cirrhotic patients were enrolled in the study. According to the Child-Pugh classification 35 patients were of Child A, 36 of Child B and 29 of Child C. The proportion of autonomic dysfunction was 52%, and diastolic dysfunction 51%. Autonomic dysfunction was diagnosed using bedside maneuvers and tests; diastolic dysfunction was diagnosed using the E/A ratio in echocardiographic findings. Health-related quality of life measurements was obtained from an SF-36 questionnaire. Results: Patients with advanced Child-Pugh classifications were found to have significantly lower health-related quality of life values (p < 0.05). Likewise, health-related quality of life values were observed to be significantly lower in patients with autonomic dysfunction (p < 0.05). No significant difference was found in health related quality of life measurements between patients with and without diastolic dysfunction. Conclusion: Our study showed that autonomic dysfunction and diastolic dysfunction are found in patients with cirrhosis. Further studies are needed to assess the effects of autonomic dysfunction and diastolic dysfunction on health-related quality of life. (C) 2020 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved.

Background and Aims: Ulcerative colitis is an idiopathic, chronic inflammatory disease with a high relapse rate. Smoking contributes to the development and progression of ulcerative colitis. We determined total rectal wall thickness in patients with ulcerative colitis who had a smoking history. Materials and Methods: We included 19 patients with ulcerative colitis (ulcerative colitis group) and 19 controls (control group) and compared total rectal wall thickness among them. Total rectal wall thickness was significantly greater in the ulcerative colitis group. We also compared total rectal wall thickness between patients with and without smoking history in both groups. Results: Of the 19 patients with ulcerative colitis, 4 and 15 were females and males, respectively, with a mean age of 46.8±13.3 years. Of the 19 controls, 5 and 14 were females and males, respectively, with a mean age of 46.6±11.8 years. While 9 patients with ulcerative colitis were active, 10 were in remission. The median (interquartile range) total rectal wall thickness was significantly higher in the ulcerative colitis group (4.1 mm [3.1–4.6]) than in the control group (2.5 mm [2.0-3.7]) (p=0.003). The median total rectal wall thickness was significantly higher in patients with ulcerative colitis and a smoking history than in those without (4.6 mm [4.3-4.9] vs. 3.8 mm [2.6-4.1], respectively; p=0.025). Total rectal wall thickness did not differ according to smoking history in the control group. Conclusion: Smoking history is associated with total rectal wall thickness increase patients with ulcerative colitis on transrectal ultrasonography.

Objective: Serum biomarkers are frequently used to assess disease activities in ulcerative colitis (UC) and Crohn disease (CD).But none of them are specific for intestinal inflammation.There are studies showing that hematological parameters predict inflammation in the body.Although previous studies have shown that the neutrophil/lymphocyte ratio (NLR) is associated with disease activity in UC, this relationship has not been shown in CD.In our study, the relationship of NLR and other hematological parameters to disease activity in UC and CD was evaluated. Material and Method:A total of 197 UC (107 active, 90 remission), 97 CD (50 active, 47 remission) and 26 age and sex matched healthy control groups were included in the study.The disease activity and CRP, ESR, hemogram parameters were recorded.NLR, Platelet/lymphocyte (PLR), MPV/platelet and RDW/platelet ratios were calculated.Parameters were compared between UC, CD and control groups according to activity status. Results:In UC, leukocyte, neutrophil, monocyte, platelet, plateletcrit (Pct), PLR, ESR, CRP values were found to increase significantly in the control, remission and active groups with a certain trend, respectively.Hemoglobin (Hb), hematocrit (HCT) and RDW/platelet were shown to decrease respectively.NLR and MPV/platelets were significantly different between the groups of active UC, UC in remission and control.Other parameters were not statistically significant.In CH, ESR, CRP, platelet, Pct, PLR were found to increase significantly with a certain trend in control, remission and active groups, respectively.Hb, HCT, MCV, MCH and RDW/platelets were found to decrease with a certain trend.Leukocyte, neutrophil, lymphocyte, monocyte count, MCHC, NLR and MPV/platelet were significantly different between the CD and control groups.In CD, eosinophil count and RDW were not statistically significant.ESR, CRP, NLR and PLR had acceptable sensitivity-specificity in predicting active patients in CD and UC.ESR, CRP, WBC, neutrophil, monocyte, platelet, Pct, NLR, PLR, MPV/platelet and RDW/platelet parameters were significant factors in predicting active disease in UC and CD. Conclusion:Many hemogram parameters change with activity in IBD.Although not specific for IBD, NLR and PLR are as effective as CRP and ESR in detecting active patients in IBD and can be used as markers to demonstrate activity.

Inflamatuvar barsak hastaliklari, agirlikli olarak gastrointestinal sistemi tutan sistemik kronik inflamatuvar bir hastalik grubudur. Inflamatuvar barsak hastaliklarinda ekstraintestinal bulgular siklikla birlikte bulunmaktadir. Bunlar icinde metabolik kemik hastaliklari azimsanmayacak olcude siktir. Calismamizda kendi inflamatuvar barsak hastaliklari kohortumuzda osteoporoz ve osteopeni sikligini ortaya koymayi amacladik. Bu calismaya 71 ulseratif kolit, 44 Crohn hastasinin kemik mineral dansite verileri retrospektif olarak degerlendirildi. Inflamatuvar barsak hastaliginda tani, tutulum paterni, hastalik davranisi, cinsiyet ve kemik mineral dansite lokalizasyonlarina gore kemik dansiteleri, T ve Z skorlari karsilastirildi. Ulseratif kolit hastalarinin %53,5’inde, Crohn hastalarinin %50’sinde osteopeni saptandi. Ulseratif kolit ile Crohn hastaligi arasinda anlamli fark yoktu. Ulseratif kolit hastalarinin %22,5’inde, Crohn hastalarinin %25’inde osteoporoz saptandi. Ulseratif kolit ile Crohn hastaligi arasinda anlamli fark yoktu. Crohn hastaliginda osteopeni en sik femur boynu ve wards ucgeninde (%47,7 ve %47,7), ulseratif kolit hastalarinda osteopeni en sik wards ucgeninde (%52,1) saptandi . Ulseratif kolit ve Crohn hastaliginda osteoporoz en sik lomber bolgede (sirasiyla %15,5 ve %18,2) tespit edildi. Ulseratif kolit ve Crohn hastaligi arasinda osteoporoz ve osteopeni acisindan anlamli fark izlenmedi. Ulseratif kolit ve Crohn hastaliginda alttip, davranis, cinsiyet ve kemik mineral dansite lokalizasyon acisindan karsilastirildiginda anlamli fark saptanmadi. Inflamatuvar barsak hastaliginda osteoporoz ve osteopeni sikligi artmistir. Bulgularimizi dogrulamak icin daha buyuk orneklem buyukluguyle ve iyi dizayn edilmis prospektif calismalara ihtiyac vardir.

We have taken interest in the article by Hides and Stanton which has been published in your journal (Hides et al., 2017). First, we congratulate the authors for their effort in calling attention to the use of ultrasound (US) for scanning the multifidus and quadratus lumborum (QL) muscles. Errors in quantification might stem mainly from two reasons; failure to capture an appropriate image and failure to technically quantify it (Ozcakar et al., 2011 and 2013). This article is protected by copyright. All rights reserved.

Amaç: Kronik hastalıklarda, hastaların büyük çoğunluğu hastalığın getirdiği ağrı, yorgunluk ve depresif semptomlarla birlikte sosyal yaşamlarında kısıtlılıklar, fiziksel aktivitelerini gerçekleştirmede güçlükler yaşamaktadır. Buna bağlı yaşam kalitesi etkilenmektedir. Kronik hepatitli hastalarda, hastalığının erken evrelerinde hiçbir semptom bulunmazken, ileri evrede siroza bağlı komplikasyonlar yaşam kalitesini belirgin şekilde bozabilir. Çalışmamızda farklı evrelerdeki kronik hepatit B (KHB) ve C (KHC)’li hastalarda yaşam kalitesinin karşılaştırılması planlanmıştır.Gereç-Yöntem: Hastalığın farklı evrelerindeki toplam 175 kronik hepatit (129 KHB ve 46 KHC) hastası ve 20 sağlıklı gönüllü çalışmaya alındı. Hastalara SF-36 yaşam kalite indeksi anketi uygulandı.Bulgular: Her iki hastalık için de SF-36’nın internal uyumluluğu yüksekti (Cronbach α KHB ve KHC için:0.95, kontrol için:0.90). KHB’de evre arttıkça fiziksel ve sosyal fonksiyonlarda daha çok kısıtlanma, canlılık ve enerjide daha fazla azalma ve sağlığının daha çok kötüleşeceğine inanma izlenmektedir. Genel olarak fiziksel ve mental sağlık ile genel yaşam kalitesi evre arttıkça anlamlı derecede azalmaktadır. KHC’de ise evre arttıkça sadece fiziksel sağlığın bozulmasından dolayı işte ve günlük etkinliklerde daha fazla kısıtlama olmaktadır. Univaryant regresyon analizinde, tanı ve hastalık evresinin yanında yaşadığı çevre, eğitim seviyesi, sigara ve medeni durum yaşam kalitesine etki eden faktörler olarak tespit edildi.Sonuç: KHC ve KHB’de, hastalık süresinin uzun olması, beraberinde komplikasyonların gelişmesi ve psikolojik morbidite ile özellikle KHC’de ve siroz hastalarında tedavilerin yan etkileri hastalarda yaşam kalitesini ciddi oranda düşürmektedir. Yaşam kalitesinin arttırılması için tedavi opsiyonlarının hastaya göre oluşturulması ve yaşam kalitesini etkileyen diğer faktörlerin saptanıp en aza indirilmesi gerekmektedir.Anahtar Kelimeler: Kronik hepatit B; Kronik hepatit C; Yaşam kalitesi

BACKGROUND/AIMSInflammatory bowel diseases are chronic, relapsing, inflammatory conditions. They have a genetic backround resulting in patient susceptibility. The aim of our study is to investigate the involvement of IL23R, JAK2, and STAT3 polymorphisms in inflammatory bowel diseases in a Turkish population.MATERIALS AND METHODSPolymorphisms in IL23R (rs11209026), JAK2 (rs10758669), and STAT3 (rs3816769, rs2293152, rs744166, rs957970, rs8074524) were genotyped in 69 Crohn's disease patients, 157 ulcerative colitis patients, and 89 healthy controls.RESULTSThe presence of (C) in rs10758669, (T) and (TT) in rs957970, and (TT) in rs744166 were found to increase the susceptibility to Crohn's disease (p=0.049, p=0.016, p=0.010, p=0.035, respectively), while rs2293152 (GC), rs744166 (CT), and rs957970 (CT) provide protection against Crohn's disease (p=0.007, p=0.043, p=0.043, respectively). While rs2293152 (GC) was protective, rs2293152 (CC) increased the susceptibility to ulcerative colitis (p=0.009, p=0.001). All the polymorphisms were associated with age-at-diagnosis, except rs11209026. Furthermore, rs2293152 was associated with an extension in ulcerative colitis, while rs10758669, rs3816769, rs744166, rs2293152, and rs957970 were associated with the subphenotype in Crohn's disease. The presence of rs10758669 (AC) was protective against perianal Crohn's disease (p=0.016). Additionally, rs10758669 and rs2293152 in Crohn's disease and rs8074524, rs3816769, and rs10758669 in ulcerative colitis were associated with the requirement of immunsuppression. Finally, rs8074524 and rs10758669 in Crohn's disease and rs11209026 in ulcerative colitis were associated with disease-related operation.CONCLUSIONThis is the first study of the single marker association of IL23R, JAK2, and STAT3 polymorphisms with ulcerative colitis and Crohn's disease in a Turkish population. It was demonstrated that these polymorphisms may be effective in the etiology of inflammatory bowel disease in this Turkish population.

BACKGROUND AND OBJECTIVE:Inflammatory bowel disease is a group of chronic inflammatory conditions affecting gastrointestinal tract. Lots of genes have been identified resulting in susceptibility to inflammatory bowel disease. Any polymorphism leading to functional modifications in tyrosine kinase-2 may precipitate excessive immune response in the intestinal mucosa. The aim of our study is to investigate the involvement of tyrosine kinase-2 polymorphisms in the patients with inflammatory bowel disease in Turkish population. METHODS:Four single nucleotide polymorphisms in tyrosine kinase-2 (rs280523, rs2304256, rs280519 and rs280496) were genotyped in 60 Crohn's disease, 151 ulcerative colitis patients and 89 unrelated healthy controls. These polymorphisms were detected by real-time polymerase chain reaction. RESULTS:The presence of genotype (CC) in rs2304256 and (AA) in rs280519 were found to increase the susceptibility to ulcerative colitis (P=0.024, 0.025, respectively). rs2304256 (CA) and rs280519 (AG) have provided protection against ulcerative colitis (P=0.021, 0.012, respectively). rs280519 (AG) was protective against Crohn's disease (P=0.045). rs2304256 (CC) increased the susceptibility to inflammatory Crohn's disease (P=0.014). The presence of rs2304256 (A) increased the susceptibility to perianal Crohn's disease (P=0.03). Both rs280519 and rs2304256 polymorphisms were associated with the requirement of corticosteroid and immunosuppressive therapy in ulcerative colitis. CONCLUSION:This study is the first demonstration of the single marker association of tyrosine kinase-2 polymorphisms with ulcerative colitis and Crohn's disease in Turkish population. They may be effective in the etiology of inflammatory bowel disease in our population. Disparity between our study and others may be related to ethnic differences.

Malign melanom (MM) gastrointestinal sistemi primer olarak veya metastaz yaparak tutabilen agresif seyirli bir hastaliktir. Primer tutulum ile metastatik MM’u, ozellikle ciltteki lezyon regrese olmus ise ayirmak zor olabilir. Biz mide disinda primer odak saptanamayan karaciger metastazli MM vakasini sunmayi amacladik.

Malign melanoma is an agressive tumor that can involve the gastrointestinal tract as metastasis or primary gastrointestinal lesions. Discrimination of primary lesions from metastatic ones may be difficult, especially when the tumor in the skin regresses. We aimed to present a case of primary gastric MM with liver metastasis.