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    Can the Gut Microbiota Serve as a Guide to the Diagnosis and Treatment of Childhood Epilepsy?
    (Elsevier Science Inc, 2023) Turay, Sevim; Cangur, Sengul; Kahraman, Gozde; Kayabasi, Eda; Cetiner, Omer Faruk; Aydin, Burak; Ozturk, Cihadiye Elif
    Background: To investigate the activity of the gut-brain axis in the pathogenesis of childhood epilepsy and to define biomarkers capable of assisting with determining new strategies in that context. Methods: Twenty children with epilepsy of unknown etiology and seven healthy controls in the same age group were included in the study. The groups were compared using a questionnaire. Stool samples were stored in tubes containing DNA/RNA Shield (Zymo Research) with a sterile swab. Sequencing was carried out using the MiSeq System (Illumina). The 16S rRNA sequencing of samples using nextgeneration sequencing involved V4 variable region polymerase chain reaction amplification concluded by 2 x 250-bp paired-end sequencing of amplicons and at least 50,000 reads (>Q30) per sample. DNA sequences were classified at the genus level using the Kraken program. Bioinformatics and statistical analysis were then performed.Results: Individuals' gut microbiota relative abundance values differed between the groups at the genus, order, class, family, and phylum levels. Flavihumibacter, Niabella, Anoxybacillus, Brevundimonas, Devosia, and Delftia were seen only in the control group, whereas Megamonas and Coriobacterium were observed only in the epilepsy group. The linear discriminant analysis effect size method identified 33 taxa as important in differentiating the groups. Conclusions: We think that bacterial varieties (such as Megamonas and Coriobacterium) that differ be-tween the two groups can be employed as useful biomarkers in the diagnosis and follow-up of epileptic patients. We also predict that, in addition to epilepsy treatment protocols, the restoration of eubiotic microbiota may increase the success of treatment.& COPY; 2023 Elsevier Inc. All rights reserved.
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    Metastatic Melanoma of the Common Bile Duct Presented with Dyspepsia
    (Korean Soc Gastroenterology, 2024) Cetiner, Omer Faruk; Dundar, Huseyin Emre; Kantarcioglu-Coskun, Sinem; Torun, Serkan; Tokmak, Salih
    Malignant melanoma (MM) is an aggressive tumor that can metastasize to any organ, but biliary tract metastasis is scarce. We describe a very rare case of MM metastasis to the common bile duct (CBD), presented with only dyspeptic symptoms. The patient had mildly elevated alkaline phosphatase and gamma-glutamyl transferase levels. Magnetic resonance cholangiopancreatography demonstrated a dilated common bile duct with a distal stricture. The MM diagnosis was established with the ampulla of Vater biopsy specimens obtained by endoscopic retrograde cholangiopancreatography (ERCP), and the patient's symptoms were resolved after biliary stenting. Both primary CBD cancer and other cancer types like MM that metastasize to CBD can cause obstruction and can be manifested only by dyspeptic symptoms. MM metastasis to CBD can cause obstruction manifested only by dyspeptic symptoms without obstructive jaundice. ERCP can be employed as a promising option for treatment and diagnosis. New-onset dyspeptic symptoms in patients with a history of MM should be investigated thoroughly, especially in the context of biliary metastasis.