Researcher:
Baran, Bülent

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Faculty Member

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Bülent

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Baran

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Baran, Bülent

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2015 - 2019162020 - 20229

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    Endoscopic ultrasound-guided parenchymal liver biopsy: a systematic review and meta-analysis
    (Springer, 2021) Kale, Santosh; Patil, Prithvi; Kannadath, Bijun; Ramireddy, Srinivas; Badillo, Ricardo; DaVee, Roy Tomas; Thosani, Nirav; N/A; Baran, Bülent; Faculty Member; School of Medicine; 167583
    Background Endoscopic ultrasonography (EUS)-guided liver biopsy is a novel technique to obtain adequate liver samples for diagnosis of liver parenchymal diseases. There are studies that have evaluated the feasibility and safety of EUS-guided parenchymal liver biopsy (EUS-LB), however, factors that can influence specimen quality are yet to be determined. Our aim was to determine the diagnostic accuracy of EUS-LB and evaluate factors associated with specimen quality. Methods We performed a detailed search of PubMed/MEDLINE and Web of Science (TM) databases to identify studies in which results of EUS-guided liver parenchymal biopsies were reported published up to July 2020. A random effects model was used to estimate pooled values (mean +/- SE) for total specimen length (TSL) and complete portal tracts (CPT). Subgroup analyses were applied to find out the procedural factors associated with better specimen quality using Cochran'sQtest. A total of 10 meta-analyses were done focusing on international studies. Total of 1326 patients who underwent EUS-LB. EUS-LBs performed for suspicion of parenchymal liver disease. Pooled mean values for TSL and CPT with subgroup analyses. Results Twenty-three studies with a total of 1326 patients were included in our meta-analysis. Overall pooled mean TSL and CPT were 45.3 +/- 4.6 mm and 15.8 +/- 1.5, respectively. In subgroup analysis, core biopsy needles proved to better in terms of CPT than fine-needle aspiration needles (18.4 vs 10.99,p = 0.003). FNB with slow-pull or suction technique provided a similar TSL (44.3 vs 53.9 mm,p = 0.40), however, slow-pull technique was better in terms of CPT (30 vs 14.6,p < 0.001). Heterogeneity was present among the studies. Another limitation is the low number randomized control trials. Conclusion EUS-guided parenchymal liver biopsy is a good alternative to other methods of liver sampling. Using FNB needles with a slow-pull technique can provide better results.
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    Skin lesions indicate cause of acute gastrointestinal bleeding: neurofibromatosis type 1
    (Elsevier, 2020) Ozpolat, Hasan Tahsin; Akyuz, Filiz; Baran, Bülent; Faculty Member; School of Medicine; 167583
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    Optimizing the personalized care for the management of rectal cancer: a consensus statement
    (Aves, 2022) Aytaç, Erman; Özer, Leyla; Baca, Bilgi; Uluç, Başak Oyan; Abacioğlu, Mehmet Ufuk; Gönenç, Murat; Aygün, Cem; Yıldız, Mehmet Erdem; Ünal, Kemal; Er, Özlem; Beşe, Nuran; Ceyhan, Güralp Onur; Özbek, Uğur; Tozun, Nurdan; Erdamar, Sibel; Yakıcıer, Cengiz; Saruç, Murat; Özben, Volkan; Esen, Eren; Vardareli, Erkan; Güner, Levent; Hamzaoğlu, İsmail; Karahasanoğlu, Tayfun; N/A; Balık, Emre; Kapran, Yersu; Taşkın, Orhun Çığ; Bölükbaşı, Yasemin; Çil, Barbaros Erhan; Baran, Bülent; Erkol, Burçak; Yaltı, Mehmet Tunç; Attila, Tan; Gürses, Bengi; Bilge, Orhan; Mandel, Nil Molinas; Selek, Uğur; Kayserili, Hülya; Özoran, Emre; Buğra, Dursun; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Doctor; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Teaching Faculty; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; N/A; N/A; N/A; N/A; N/A; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; 18758; 168101; 166686; 216814; 169993; 167583; N/A; 221690; 118342; 113169; 176833; 194197; 27211; 7945; 307296; 1758
    Colorectal cancer is the third most common cancer in Turkey. The current guidelines do not provide sufficient information to cover all aspects of the management of rectal cancer. Although treatment has been standardized in terms of the basic principles of neoadjuvant, surgical, and adjuvant therapy, uncertainties in the management of rectal cancer may lead to significant differences in clinical practice. In order to clarify these uncertainties, a consensus program was constructed with the participation of the physicians from the Acibadem Mehmet Ali Aydınlar and Koc Universities. This program included the physicians from the departments of general surgery, gastroenterology, pathology, radiology, nuclear medicine, medical oncology, radiation oncology, and medical genetics. The gray zones in the management of rectal cancer were determined by reviewing the evidence-based data and current guidelines before the meeting. Topics to be discussed consisted of diagnosis, staging, surgical treatment for the primary disease, use of neoadjuvant and adjuvant treatment, management of recurrent disease, screening, follow-up, and genetic counseling. All those topics were discussed under supervision of a presenter and a chair with active participation of related physicians. The consensus text was structured by centralizing the decisions based on the existing data.
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    Comparison of prognostic scoring systems for prediction of survival in hepatocellular carcinoma
    (Elsevier Science Bv, 2016) Ekinci, O.; Soyer, O. M.; Ormeci, A. C.; Gokturk, S.; Evirgen, S.; Poyanli, A.; Gulluoglu, M.; Akyuz, F.; Karaca, C.; Demir, K.; Besisik, F.; Kaymakoglu, S.; N/A; Baran, Bülent; Faculty Member; School of Medicine; Koç University Hospital; Koc University Hospital; 167583
    N/A
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    Effectiveness of a deep learning polyp detection system for colonoscopy in different colon segments, with variable bowel preparation quality
    (Mosby-Elsevier, 2018) Becq, Aymeric; Bharadwaj, Shishira; Chandnani, Madhuri; Ernest-Suarez, Kenneth; Gabr, Moamen; Sawhney, Mandeep; Pleskow, Douglas K.; Berzin, Tyler M.; Baran, Bülent; Faculty Member; School of Medicine; N/A
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    The development of extraintestinal manifestation and related risk factors in Crohn’s patients
    (Springer London Ltd, 2021) Kayar, Yusuf; Dertli, Ramazan; Konur, Şevki; Ağın, Mehmet; Örmeci, Aslı Çiftçibaşı; Akyüz, Filiz; Demir, Kadir; Beşışık, Fatih; Kaymakoğlu, Sabahattin; Baran, Bülent; Faculty Member; School of Medicine; N/A
    Background Crohn's disease (CD) primarily involves gastrointestinal tract; however, it can present with extraintestinal manifestations (EIMs), which leads to significant morbidity. Frequency of EIMs and associated risk factors vary due to genetic and environmental differences in studies. Aim To examine the frequency and risk factors associated with EIMs in CD. Method Patients with CD under follow-up from March 1986 to October 2011 were included in this study. Demographics, type of EIMs, autoimmune diseases, and clinical features of CD were recorded. Frequency of EIMs and associated risk factors were analyzed. Results Three hundred thirty-six patients with CD were included in the study (mean follow-up duration 7.54 years). 55.4% (n: 186) were male and the mean age at diagnosis of CD was 30.6 years (range, 10.3-68.2 years). At least one EIM was detected in 47.3% and multiple EIMs in 22.9% of the cohort. Oral, joint, and skin involvements (32.4%, 24.7%, 9.2%, respectively) were the most common EIMs. Female gender (OR: 2.19, 95% CI: 1.34-3.58,p = 0.001), corticosteroid usage (OR: 2.32, 95% CI: 1.28-4.22,p = 0.007), and positive family history (OR: 5.61, 95% CI: 1.95-3.58,p = 0.001) were independent risk factors for EIM development. Colonic involvement (OR: 3.93, 95% CI: 1.59-9.68,p = 0.003), no surgical operation (OR: 2.31, 95% CI: 1.14-4.68,p = 0.020), and corticosteroid usage (OR: 2.85, 95% CI: 1.07-7.61,p = 0.037) were independent risk factors for multiple EIM development. Conclusion Although the immunological and clinical associations between EIMs and CD cannot be fully elucidated, identifying specific relationships of immune-mediated diseases will help to better understand CD pathogenesis.
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    Rabbit syndrome developing during peginterferon alfa-2a use in chronic hepatitis C
    (Taylor and Francis Ltd, 2017) Soyer, Özlem Mutluay; Pehlivan, Aslıhan; Örmeci, Ash Çiftçibaşı; Şahin, Tolga; Baran, Bülent; Faculty Member; School of Medicine; 167583
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    Letter: monoclonal gammopathy of HEV infection. When is it significant?
    (Wiley-Blackwell, 2015) N/A; N/A; Öztürk, Erman; Baran, Bülent; Doctor; Faculty Member; N/A; School of Medicine; Koç University Hospital; N/A; 167583
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    Preloaded 22-gauge fine-needle system facilitates placement of a higher number of fiducials for image-guided radiation therapy compared with traditional backloaded 19-gauge approach
    (Mosby-Elsevier, 2021) Brown, Jeremy R. Glissen; Perumpail, Ryan B.; Duran, Jose F.; Bharadwaj, Shishira; Becq, Aymeric; Hurwitz, Martina; McLaughlin, Matthew; Kaplan, Irving D.; Cohen, Jonah; Gabr, Moamen; Pleskow, Douglas K.; Sawhney, Mandeep S.; Berzin, Tyler M.; Baran, Bülent; Faculty Member; School of Medicine; N/A
    Background and Aims: Image-guided radiation therapy (IGRT) often relies on EUS-guided fiducial markers. Previously used manually backloaded fiducial needles have multiple potential limitations including safety and efficiency concerns. Our aim was to evaluate the efficacy, feasibility, and safety of EUS- guided placement of gold fiducials using a novel preloaded 22-gauge needle compared with a traditional, backloaded 19-gauge needle. Methods: This was a single-center comparative cohort study. Patients with pancreatic and hepatobiliary malignancy who underwent EUS-guided fiducial placement (EUS-FP) between October 2014 and February 2018 were included. The main outcome was the technical success of fiducial placement. Secondary outcomes were mean procedure time, fiducial visibility during IGRT, technical success of IGRT delivery, and adverse events. Results: One hundred fourteen patients underwent EUS-FP during the study period. of these, 111 patients had successful placement of a minimum of 2 fiducials. Fifty-six patients underwent placement using a backloaded 19-gauge needle and 58 patients underwent placement using a 22-gauge preloaded needle. The mean number of fiducials placed successfully at the target site was significantly higher in the 22-gauge group compared with the 19-gauge group (3.53 +/- .96 vs 3.11 +/- .61, respectively; P =.006). In the 22-gauge group, the clinical goal of placing 4 fiducials was achieved in 78%, compared with 23% in the 19-gauge group (P <.001). In univariate analyses, gender, age, procedure time, tumor size, and location did not influence the number of successfully placed fiducials. Technical success of IGRT with fiducial tracking was high in both the 19-gauge (51/56, 91%) and the 22-gauge group (47/58, 81%; P = .12). Conclusions: EUS-FP using a preloaded 22-gauge needle is feasible, effective, and safe and allows for a higher number of fiducials placed when compared with the traditional backloaded 19-gauge needle.
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    Can Helicobacter pylori be eradicated with high-dose proton pump inhibitor in extensive metabolizers with the CYP2C19 genotypic polymorphism?
    (Verduci Publisher, 2016) Örmeci, Aslı; Emrence, Zeliha; Soyer, Orkun S.; Göktürk, Suut.; Evirgen, Sami; Akyüz, Filiz; Karaca, Çetin; Beşışık, Fatih; Kaymakoğlu, Sabahattin; Üstek, Duran; Demir, Kadir; Baran, Bülent; Faculty Member; School of Medicine; 167583
    Proton pump inhibitors (PPI) metabolism and pharmacokinetics are regulated by cytochrome P450 enzymes in the liver. Cytochrome P450 2C19 (CYP2C19) polymorphism plays an import role in the metabolism of PPIs. The three possible genotypes for CYP2C19 each has a distinct effect on the pharmacodynamics of PPIs. Homozygote extensive metabolizers (HomEM) are the most frequent genotype and have two wild-types (non-mutant) (*1/*1) alleles. HomEM is associated with increased enzyme activity, which increases the rate of PPI metabolism. Intragastric pH, which is required for eradication, is lowest in HomEM. In HomEMs, an insufficient increase in intragastric pH results in decreased anti-Helicobacter pylori (HP) efficacy of the antibiotics and, therefore, lower eradication rates. We determined whether the HP eradication rate would increase after high-dose PPI treatment of extensive PPI metabolizers who had been treated unsuccessfully with a standard PPI dose. In our report, increasing the PPI dosage in patients with genotype polymorphisms may be effective on eradication rates. Eradication rates are directly affected by CYP2C19 polymorphisms, and eradication treatments should be planned considering such genotypic polymorphisms. Hence, CYP2C19 genotyping prior to treatment may facilitate determination of the optimum PPI dose to improve the therapeutic outcome. However, further researches are required to confirm this hypothesis.