Person: ÇELİKEL, ÇİĞDEM
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ÇELİKEL
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ÇİĞDEM
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Publication Metadata only Induced sputum as a method for detection of systemic sclerosis-related interstitial lung disease(SPRINGER HEIDELBERG, 2012) ÇELİKEL, ÇİĞDEM; Yilmaz, Neslihan; Abul, Yasin; Bicakcigil, Muge; Golabi, Pejman; Celikel, Cigdem; Karakurt, Sait; Yavuz, SuleInducted sputum (IS) is a non-invasive procedure that can be used for collection of airway secretions. The aim of our study is to evaluate the clinical usefulness of IS for detection of airway inflammation in systemic sclerosis (SSc). Bronchoalveolar lavage and IS were performed to 20 patients with SSc. Eighteen patients who were referred to pulmonary medicine for bronchoalveolar lavage due to other reasons were also recruited for cell counts comparisons. Spirometry, echocardiography and thorax CT (HRCT) imaging were also performed to all patients. Mean macrophage and lymphocyte counts were found to be increased in IS of SSc patients compared with that of control (58.4 +/- A 14.5% vs. 31.3 +/- A 16.3%, 30.2 +/- A 15.4% vs. 15.0 +/- A 11.5% P < 0.001), whereas mean neutrophil count was lower in the SSc patients (4.1 +/- A 4.5% vs. 17.2 +/- A 13.1%, P < 0.05). Significant correlations were noted between BAL and IS findings for macrophage (r = 0.55, P = 0.02) lymphocyte (r = 0.65, P < 0.01) and total cell counts (r = 0.45, P = 0.06). IS is an easy and reliable method for the detection of alveolitis and can be used for early detection of lung involvement in scleroderma.Publication Metadata only Increased serum FGF21 levels in patients with nonalcoholic fatty liver disease(WILEY-BLACKWELL, 2010) ÇELİKEL, ÇİĞDEM; Yilmaz, Yusuf; Eren, Fatih; Yonal, Oya; Kurt, Ramazan; Aktas, Bilge; Celikel, Cigdem Ataizi; Ozdogan, Osman; Imeryuz, Nese; Kalayci, Cem; Avsar, ErolP>Background The fibroblast growth factor 21 (FGF21) hormonal pathway is a metabolic signalling cascade and has been recently identified as the master hormonal regulator of glucose, lipids and overall energy balance. In this observational, case-control study, we assayed serum levels of FGF21 in patients with nonalcoholic fatty liver disease (NAFLD), a hepatic manifestation of the metabolic syndrome, and examined their association with clinical, biochemical and histological phenotypes. Materials and methods Serum levels of FGF21 were assayed by ELISA in 82 patients with biopsy-proven NAFLD and 77 controls. We analysed associations between FGF21 and the characteristics of patients with NAFLD by multiple linear regression analysis. Results Levels of FGF21 were significantly higher in patients with NAFLD (median 200 pg mL-1; interquartile range: 87-410 pg mL-1) than in healthy controls (median 93 pg mL-1; interquartile range: 70-180 pg mL-1, Mann-Whitney U-test, P < 0 center dot 001). There was a stepwise increase in serum FGF21 levels according to the liver steatosis score (median level in subjects with score 1: 170 pg mL-1; score 2: 220 pg mL-1; score 3: 280 pg mL-1, P for trend < 0 center dot 01). After stepwise linear regression analysis, serum FGF21 levels were the only independent predictor of hepatic steatosis scores in patients with NAFLD (beta = 0 center dot 26; t = 2 center dot 659, P < 0 center dot 01). Conclusions Serum FGF21 levels are increased in patients with NAFLD regardless of potential confounders and represent an independent predictor of liver steatosis. These findings support further investigation of this molecule in metabolic liver diseases.Publication Metadata only Preoperative Chemoradiation Therapy Decreases the Number of Lymph Nodes Resected During Esophagectomy(SPRINGER, 2015) ÇELİKEL, ÇİĞDEM; Issaka, Adamu; Ermerak, Nezih Onur; Bilgi, Zeynep; Kara, Volkan Hasan; Celikel, Cigdem Ataizi; Batirel, Hasan FevziBackground This study aimed to analyze the effect of preoperative chemoradiation on the adequacy of lymph node dissection. Methods Patients with esophageal cancer treated with esophagectomy by the same surgeon between 2004 and 2011 were reviewed. Specimens were examined by the same pathologist. Patients were grouped into two depending on the type of treatment received. Results Forty-seven patients with curative esophagectomy were included in the study. Twenty patients had preoperative chemoradiation followed by surgery and 27 had surgery alone. Open and hybrid esophagectomy approaches were used. The average number of lymph nodes dissected was 16 +/- 10 (1-39). There was a significant decrease in the number of lymph nodes examined in patients with preoperative chemoradiotherapy in comparison to surgery alone (p = 0.001). Median length of stay was 12 days. R0 resection rate was 96 %. The median survival was 36.3 months, with a 42 % 5-year survival. Seven patients (25 %) had complete pathologic response following chemoradiation. No significant difference was recorded in terms of disease recurrence (p = 0.3). While morbidity was higher in the preoperative therapy group with 30 day mortality of 10 %, type of surgical approach does not seem to influence the number of lymph nodes dissected (p = 0.7). Conclusions Preoperative chemoradiation decreases the number of harvested lymph nodes following esophagectomy regardless of the surgical technique used. The optimum number of lymph nodes currently recommended to be dissected for accurate nodal staging and survival needs revision in this group of patients.Publication Metadata only A comparison of FibroMeter (TM) NAFLD Score, NAFLD fibrosis score, and transient elastography as noninvasive diagnostic tools for hepatic fibrosis in patients with biopsy-proven non-alcoholic fatty liver disease(INFORMA HEALTHCARE, 2014) ÇELİKEL, ÇİĞDEM; Aykut, Umut Emre; Akyuz, Umit; Yesil, Atakan; Eren, Fatih; Gerin, Fatma; Ergelen, Rabia; Celikel, Cigdem Ataizi; Yilmaz, YusufBackground: Noninvasive markers that purport to distinguish patients with non-alcoholic fatty liver disease (NAFLD) with fibrosis from those without must be evaluated rigorously for their classification accuracy. Herein, we seek to compare the diagnostic performances of three different noninvasive methods (FibroMeter (TM) NAFLD score, NAFLD Fibrosis score (NFSA), and Transient Elastrography [TE]) for the detection of liver fibrosis in NAFLD patients. Methods: A total of 88 patients with biopsy-proven NAFLD were included. The Kleiner system was used for grading fibrosis in liver biopsies. The FibroMeter (TM) NAFLD score was determined using a proprietary algorithm (regression score). The NFSA score was calculated based on age, hyperglycemia, body mass index, platelets, albumin and serum aminotransferase levels. TE was performed using the Fibroscan apparatus. Results: The sensitivities/specificities for the FibroMeter (TM) NAFLD score, NFSA, and TE for the diagnosis of significant fibrosis (F2 + F3 + F4 fibrosis) were 38.6%/86.4%, 52.3%/88.6%, and 75.0%/93.2%, respectively. The areas under the receiver operating characteristic curves of TE were significantly higher than those of both the FibroMeter (TM) NAFLD score and NFSA. No significant differences were found between the FibroMeter (TM) NAFLD score and NFSA for the detection of significant and severe fibrosis, although the diagnostic performance of the FibroMeter (TM) NAFLD score was higher than that of the NFSA score for cirrhosis. Conclusions: In summary, TE showed the best diagnostic performance for the noninvasive assessment of liver fibrosis in NAFLD patients. The diagnostic performances of the FibroMeter (TM) NAFLD score and NFSA did not differ significantly for the detection of both significant and severe fibrosis.Publication Metadata only Protective effect of cysteinyl leukotriene receptor antagonist montelukast in bleomycin-induced pulmonary fibrosis(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2018) CEYHAN, BERRİN; Topaloglu, Nurhayat; Yildizeli, Sehnaz Olgun; Sener, Goksel; Lacin, Tunc; Sehirli, Ozer; Bozkurtlar, Emine; Celikel, Cigdem; Ceyhan, BerrinBackground: This study aims to investigate the early- and late-term effects of pharmacological inhibition of cysteinyl leukotriene activity by using montelukast in bleomycin-induced inflammatory and oxidative lung injury in an animal model. Methods: The study included 48 male Wistar albino rats (weighing 250 g to 300 g). Rats were administered intratracheal bleomycin or saline and assigned into groups to receive montelukast or saline. Bronchoalveolar lavage fluid and lung tissue samples were collected four and 15 days after bleomycin administration. Results: Bleomycin resulted in significant increases in tumor necrosis factor-alpha levels (4.0 +/- 1.4 pg/mL in controls vs. 44.1 +/- 14.5 pg/mL in early-term vs. 30.3 +/- 5.7 pg/mL in late-term, p<0.001 and p<0.001, respectively), transforming growth factor beta 1 levels (28.6 +/- 6.6 pg/mL vs. 82.3 +/- 14.1 pg/mL in early-term vs. 60.1 +/- 2.9 pg/mL in late-term, p<0.001 and p<0.001, respectively), and fibrosis score (1.85 +/- 0.89 in early-term vs. 5.60 +/- 1.14 in late-term, p<0.001 and p<0.01, respectively). In bleomycin exposed rats, collagen content increased only in the late-term (15.3 +/- 3.0 mu g/mg in controls vs. 29.6 +/- 9.1 mu g/mg in late-term, p<0.001). Montelukast treatment reversed all these biochemical indices as well as histopathological alterations induced by bleomycin. Conclusion: Montelukast attenuates bleomycin-induced inflammatory and oxidative lung injury and prevents lung collagen deposition and fibrotic response. Thus, cysteinyl leukotriene receptor antagonists might be regarded as new therapeutic agents for idiopathic pulmonary fibrosis.Publication Metadata only Comparison of the clinicopathological features of flat and polypoid colorectal adenomas that are smaller than or equal to five millimeters(AVES, 2014) ÇELİKEL, ÇİĞDEM; Yener, Nese Arzu; Midi, Ahmet; Celikel, Cigdem AtaiziBackground/Aims: Colorectal flat adenomas (FAs) may represent a different histogenesis, since their malignant potential is thought to be higher than polypoid adenomas of the same size. In this study, we classified FAs of <= 5 mm into three subgroups-superficially elevated adenomas (SEAs), completely flat adenomas (CFAs), and depressed adenomas (DAs)-based on their low microscopic shapes and compared their clinicopathological features with polypoid tubular adenomas (pTAs) with the same size. Materials and Methods: One hundred one pTAs and 46 FAs with tubular morphology with the same size (<= 5 mm) were studied. Results: The percentages of high-grade dysplasia in FAs and pTAs were 19.56% and 12.87%, respectively. The percentages of the high-grade dysplasia were 28.57%, 13.63%, and 20.00% in the DA, SEA, and CFA subgroups, respectively. FAs had a significantly higher number of normal epithelium at the basal crypts of the lesion than the pTAs (p=0.001). The presence of pericryptal mesenchymal cells was higher in pTAs than the FAs (78.21% vs 10.86%) (p<0.001). Conclusion: Flat adenoma represents a distinct type of colorectal adenoma with special histopathological properties-existence of a normal epithelium at the basal crypts, lack of pericryptal mesenchymal cells, and a high percentage of high-grade dysplasia-especially when it has a depressed shape at low magnification.Publication Metadata only Comparison of Doppler ultrasound and transient elastography in the diagnosis of significant fibrosis in patients with nonalcoholic steatohepatitis(SPRINGER, 2016) ÇELİKEL, ÇİĞDEM; Ergelen, Rabia; Yilmaz, Yusuf; Asedov, Ruslan; Celikel, Cigdem; Akin, Hakan; Bugdayci, Onur; Altun, Ersan; Tuney, DavutBackground: Liver fibrosis is an important prognostic determinant in patients with nonalcoholic steatohepatitis (NASH). Hepatic artery resistivity index (HARI) is a doppler ultrasonography (US) parameter that is used to follow up microcirculatory resistance in fatty liver. We aimed to asses whether it is possible to demonstrate significant fibrosis by means of doppler US in comparison with transient elastography (TE) and liver biopsy in NASH patients. Patients and methods: A total of 63 (mean age 47.1 +/- 8.4 years, 39 male, 24 female) biopsy-proven NASH patients were enrolled in this prospective study. The study population was classified into two groups: significant and no-significant fibrosis patients. Doppler US and TE were performed in two groups. Results: HARI and TE values were significantly higher in significant fibrosis group (0.81 +/- 0.05 vs. 0.63 +/- 0.14, p < 0.0005; 15.9 +/- 4.8 vs. 6.2 +/- 2.6 kilopascals, p < 0.0005; respectively). Based on the ROC curve, the optimal cut-off value of HARI for a significant fibrosis was >0.75, which yielded a sensitivity of 78% and a specificity of 75%, with the area under the curve at 0.90. The optimal cut-off value of TE for a significant fibrosis was >9.8 kilopascals, which yielded a sensitivity of 90% and a specificity of 91%, with the area under the curve at 0.95. HARI values were moderately correlated with TE values (r = 0.53, p < 0.001). Conclusion: Doppler US has moderate % sensitivity and % specificity, which is lower compared with TE for the diagnosis significant fibrosis. However, it may be used as an alternative method for the assessment of fibrosis in patients with NASH who are not good candidates for TE evaluation.Publication Metadata only Endobronchial Metastasis of Malignant Melanoma Presenting with Dyspnea: Case Report and Literature Review(ORTADOGU AD PRES & PUBL CO, 2011) ÇELİKEL, ÇİĞDEM; Abul, Yasin; Eryuksel, Emel; Celikel, Cigdem; Tosuner, Zeynep; Yazici, Zuleyha; Karakurt, SaitMalignant melanoma occurs due to malignant transformation of melanocytes. It has a high mortality rate. Pulmonary metastases are rarely seen and occur via pulmonary arterial embolism. Other sites for metastases are regional lymph nodes, bones and central nervous system. Endobronchial metastatic solid tumors can simulate bronchogenic carcinoma and can present with cough, dyspnea, hemoptysis and wheezing. Malignant melanoma with endobronchial seeding is rare. Histopathological features of the bronchoscopic biopsy and brushing usually reveal the definitive diagnosis in the cases of endobronchial metastasis. We report a case of malignant melonoma with endobronchial metastases diagnosed via bronchoscopy.Publication Metadata only What is the diagnostic utility of endoscopic scoring systems in children?(AVES, 2013) ÇELİKEL, ÇİĞDEM; Tutar, Engin; Kutluk, Gunsel; Bayrak, Nevzat Aykut; Celikel, Cigdem Ataizi; Pehlivanoglu, Ender; Ertem, DenizBackground/aims: The aim of this study was to evaluate the consistency of the Savary-Miller, the Hetzel-Dent and the Los Angeles endoscopic classification systems and to compare them with the esophageal histopathology in children. Material and Methods: Children between the ages of 5-17 years who underwent esophagogastroduodenoscopy were included in the study. The endoscopic reports and the still images of the esophagus were reclassified by the same gastroenterologist according to the Savary-Miller, Hetzel-Dent and Los Angeles scoring systems. The esophageal biopsies were also reevaluated by the same pathologist and the consistency between endoscopic and histopathologic esophagitis was evaluated. Results: A total of 113 out of 192 pediatric patients were included in the study. Seventy-three patients (64.6%) had esophagitis according to the Hetzel-Dent classification, whereas only 20 (17.7%) patients were defined as having esophagitis according to the other two classification systems. The consistency between the Savary-Miller and Los Angeles classifications was excellent (kappa: 0.92) but the agreement between the Hetzel-Dent and Savary-Miller and between the Hetzel-Dent and Los Angeles classifications were poor. A total of 82 patients (72.6%) had histopathological esophagitis, and there was a weak consistency between all 3 endoscopic scoring systems and the histopathology. Conclusions: Since pediatric patients have milder esophagitis than in adults, the use of endoscopic scoring systems developed for adults seems to be inapplicable for children. The inclusion of minimal endoscopic changes in endoscopic scoring systems by using more sensitive and novel endoscopic techniques would increase the sensitivity of these scoring systems in children.Publication Metadata only Validation of ultrasound imaging for Achilles entheseal fibrocartilage in bovines and description of changes in humans with spondyloarthritis(B M J PUBLISHING GROUP, 2010) ÇELİKEL, ÇİĞDEM; Aydin, Sibel Zehra; Bas, Emine; Basci, Onur; Filippucci, Emilio; Wakefield, Richard J.; Celikel, Cigdem; Karahan, Mustafa; Atagunduz, Pamir; Benjamin, Mike; Direskeneli, Haner; McGonagle, DennisBackground Entheseal fibrocartilage (EF) derangement is hypothesised to be pivotal to the pathogenesis of spondyloarthritis. Ultrasound is useful for visualisation of the enthesis but its role in EF visualisation is uncertain. This work aimed to demonstrate face and content validity of ultrasound for EF visualisation both by bovine histological evaluation and EF imaging in spondyloarthritis. Methods Achilles enthesis of 18 bovine hindfeet was visualised using a MyLab 70 ultrasound machine. The presence of tissue with EF characteristics was documented and histological confirmation was performed on five randomly selected sections using Masson trichrome staining. Ultrasound of the Achilles tendon (AT) was performed in 19 patients with spondyloarthritis and 21 healthy controls (HC). Results The bovine EF could be visualised in all cases and seen as a thin, uncompressible, well-defined, anechoic layer between the hyperechoic bone and the hyperechoic fibrils of the enthesis both in longitudinal and transverse scans. This region corresponded to EF on histological examination. The same pattern of low signal corresponding to EF location was seen in 17/19 patients and all HC. Discontinuities of the anechoic layer around the erosions and enthesophytes were observed in the spondyloarthritis group. The thickness of the anechoic layer was not significantly different in spondyloarthritis and HC (0.5 +/- 0.1 vs 0.5 +/- 0.2 mm, p=0.9) whereas the thickness of the EF was greater in men (0.6 +/- 0.2 vs 0.5 +/- 0.1 mm; p=0.009) compared with women. Conclusion Ultrasound can visualise EF of the AT insertion, which can be abnormal in cases of spondyloarthritis. This has implications for a better understanding of enthesopathy.