Person: DUMAN, DENİZ
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DUMAN
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DENİZ
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Publication Metadata only Endoscopic submucosal dissection for colorectal laterally spreading tumors(AVES, 2013) DUMAN, DENİZ; Hulagu, Sadettin; Senturk, Omer; Korkmaz, Ugur; Sirin, Goktug; Duman, Ali Erkan; Dindar, Gokhan; Celebi, Altay; Ogutmen Koc, Deniz; Bozkurt, Neslihan; Yilmaz, Hasan; Gurbuz, Yesim; Duman, Deniz; Tarcin, OrhanBackground/aims: Colorectal laterally spreading tumors are superficial tumors classified into two groups as granular (G-laterally spreading tumor) and non-granular (non-granular-laterally spreading tumor) types. In this study, we aimed to investigate the efficacy and feasibility of endoscopic submucosal dissection in the treatment of laterally spreading tumors. Materials and Methods: Forty-four laterally spreading tumors in 40 patients were treated with endoscopic submucosal dissection at a tertiary referral hospital. Patient data were collected retrospectively. In this study, we evaluated tumor size, macroscopic type, lesion location, histology, curative resection, and complications. Results: Of the 44 laterally spreading tumors excised by endoscopic submucosal dissection, 29 (65.9%) were G-laterally spreading tumor and 15 (34.1%) were non-granular-laterally spreading tumor. Most of the non-granular-laterally spreading tumors were localized in the right colon, while most G-laterally spreading tumors were localized in the left colon (p<0.001). There was also no difference between G-laterally spreading tumors (6/29) and non-granular-laterally spreading tumors (2/15) with regard to exhibiting malignant features (p=0.69). Although median size (40 mm vs. 27.5 mm) and procedure time (115 minutes vs. 60 minutes) for G-laterally spreading tumors were bigger and longer respectively, procedure time per cm(2) was not different (8.9 minutes vs. 8.2 minutes) between the two groups. Curative resection rates for laterally spreading tumors were quite high (95.5%), while en bloc resection rates were low (77.3%). The rates of endoscopic submucosal dissection-related complications such as perforation, major and minor bleeding were low (4.5%, 2.3%, 6.8%, respectively). Conclusion: Endoscopic submucosal dissection is an effective and safe therapeutic option with high curative rates for early-stage malignant and pre-malignant laterally spreading tumors not having an absolute indication for surgery, regardless of the lesion type and size.Publication Metadata only Microalbuminuria in nondiabetic patients with nonalcoholic fatty liver disease: association with liver fibrosis(W B SAUNDERS CO-ELSEVIER INC, 2010) ÇELİKEL, ÇİĞDEM; Yilmaz, Yusuf; Alanhdab, Yesim Ozen; Yonal, Oya; Kurt, Ramazan; Kedrah, Alla Eldeen; Celikel, Cigdem Ataizi; Ozdogan, Osman; Duman, Deniz; Imeryuz, Nese; Avsar, Erol; Kalayci, CemRecent evidence has suggested an association between microalbuminuria and ultrasound-diagnosed nonalcoholic fatty liver disease (NAFLD) in patients with diabetes and prediabetes However, few data are available on the occurrence of microalbuminuria in nondiabetic subjects with histologically proven NAFLD We thus evaluated the relationships between microalbuminuria and liver histology in a hospital-based sample of 87 adults with biopsy-proven NAFLD from Turkey An albumin excretion rate less than 30 mg/d was considered within the reference range, whereas an albumin excretion rate from 30 to 300 mg/d was considered to indicate microalbuminuria Compared with those without microalbuminuria (n = 73), NAFLD patients with microalbuminuria (n = 14) had significantly higher homeostasis model assessment of insulin resistance values (3 9 +/- 1 3 vs 5 8 +/- 3 7, P < 001) There were no differences in the prevalence of microalbuminuria in patients with definite nonalcoholic steatohepatitis, borderline nonalcoholic steatohepatitis, and simple fatty liver In the entire study cohort, mean fibrosis scores were significantly higher in patients with microalbuminuria than in those without (1 27 +/- 0.26 vs 0 80 +/- 0 11, P < 05) This difference persisted after adjustment for potential confounders These results indicate the presence of a significant association between the seventy of insulin resistance and microalbuminuria in patients with NAFLD In addition, microalbuminuria may identify NAFLD patients with higher fibrosis scores (C) 2010 Elsevier Inc. All rights reservedPublication Metadata only Synchronous appearance of gastrointestinal stromal tumor and neuroendocrine tumor in stomach: Review of the literature and management strategies(AVES, 2012) DUMAN, DENİZ; Duman, Deniz Guney; Eren, Funda; Yegin, Ender Gunes; Ikinci, Aygun; Yegen, CumhurGastrointestinal stromal tumors represent the most common mesenchymal tumor of the digestive tract. Although the stomach is the most common location for gastrointestinal stromal tumor with the co-primary tumors, the synchronous appearance of a neuroendocrine tumor and gastrointestinal stromal tumor in the stomach is rare. We present here the case of a 48-year-old male with gastric well-differentiated neuroendocrine tumor and gastrointestinal stromal tumor discovered incidentally during surgical treatment of the neuroendocrine tumor. We discuss the current guidelines for the management of small gastrointestinal stromal tumors (<2 cm in diameter) and the gastric carcinoids. We also review the literature for the co-occurrence of gastrointestinal stromal tumor and neuroendocrine tumor in a gastric location.Publication Metadata only Nonalcoholic Fatty Liver Disease is Associated With Erectile Dysfunction: A Prospective Pilot Study(ELSEVIER SCI LTD, 2016) ÇELİKEL, ÇİĞDEM; Duman, Deniz Guney; Bicakci, Ercan; Celikel, Cigdem Ataizi; Akbal, CemIntroduction: Nonalcoholic fatty liver disease (NAFLD) is considered the hepatic manifestation of metabolic syndrome (MetS). Although the link between MetS and erectile dysfunction (ED) is well known, clinical studies investigating the association between NAFLD and ED are scant. Aim: To evaluate the relationship between NAFLD and ED. Methods: Male patients with biopsy-proven NAFLD were prospectively asked to fill the five-item International Index of Erectile Function (IIEF-5) questionnaire. Their clinical and histologic variables were compared with the IEFF scores. Main Outcome Measures: IIEF scores; proportions of NAFLD patients who demonstrated ED and/or MetS; association between the severity of histological hepatic damage and ED. Results: Forty male patients having an age range of 33 (24-57) and a mean age of 40.13 +/- 10.22 years with biopsy-proven NAFLD had a median IIEF-5 score of 16 (9-25) and MetS was present in 23 (57.5%). ED severity distributions as moderate, mild, and no ED were 11 (27.5%), 16 (40%), and 13 (32.5 %), respectively. Histological NAFLD score was significantly higher in patients having ED compared with patients with no ED (5.63 +/- 1.39 vs 4.15 +/- 1.46; P = .006). MetS diagnosis was significantly more common in patients having ED, compared with those without ED [19 (70.4%) vs 4 (30.8%), respectively, P = .018)]. When patients with and without ED were compared, gamma glutamyl transferase was significantly lower in ED, whereas components of MetS did not correlate with ED. After multivariate analysis, NAFLD score has remained the only significant outcome associated with ED [P = .03; OR (95% CI): 2.38 (1.079-5.238)]. Conclusion: The current clinical study demonstrates a significant association between nonalcoholic steatohepatitis and ED for the first time. Our findings suggest liver damage may play role in the pathogenesis of ED in patients with NAFLD. Future studies are needed to expand the underlying common mechanisms responsible for this novel hypothesis. Copyright (C) 2016, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.Publication Metadata only High prevalence of amebiasis in ulcerative colitis patients compared to Crohn’s disease;ten year follow-up results from a university hospital, Turkey(2006-03-24) DUMAN, DENİZ; İLKİ, ZEYNEP ARZU; HASDEMİR GÖKBOĞA, MÜNEVVER UFUK; Duman D., İlki Z. A., Hasdemir Gökboğa M. U., İmeryüz N., Tüzün N., Hamzaoğlu H.