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Öğe Alstrom syndrome with liver cirrhosis: First case from Turkey(Turkish Soc Gastroenterology, 2013) Biyik, Murat; Ucar, Ramazan; Gungor, Gokhan; Ozer Cakir, Ozlem; Esen, Hasan; Aksan, Serkan; Ataseven, HuseyinAlstrom syndrome is a rare autosomal recessive genetic disorder characterized by cone-rod dystrophy, hearing loss, childhood truncal obesity, insulin resistance and hyperinsulinemia, type 2 diabetes, hypertriglyceridemia, short stature in adulthood, cardiomyopathy, and progressive pulmonary, hepatic, and renal dysfunction. Alstrom syndrome is a very rare cause of liver cirrhosis. Post-mortem biopsies of patients with Alstrom syndrome show relevant fibrosis in multiple organs especially in the liver, kidneys, heart, and lungs. We report the case of a patient with Alstrom syndrome who presented to emergency department with esophageal variceal bleeding and who was not known to have hepatic cirrhosis before.Öğe Dynamic thiol-disulfide homeostasis is disturbed in patients with non-alcoholic fatty liver disease(Walter De Gruyter Gmbh, 2018) Asil, Mehmet; Dertli, Ramazan; Biyik, Murat; Yolacan, Ramazan; Erel, Ozcan; Neselioglu, Salim; Ataseven, HuseyinBackground: Oxidative stress has been implicated in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Plasma thiols are major defense mechanisms against oxidative stress and undergo oxidation to form disulfides under oxidative conditions. This study was conducted to investigate thiol-disulfide homeostasis in NAFLD patients. Methods: Thirty patients with biopsy proven non-alcoholic steatohepatitis (NASH), 40 patients with simple steatosis and 50 healthy controls were included in the study. Serum total and native thiol concentrations and serum disulfide concentration were measured using the Erel and Neselioglu's method. Results: The mean serum total thiol concentrations in the NASH, simple steatosis and control groups were 415 +/- 64 mu mol/L, 447 +/- 38 mu mol/L and 480 +/- 37 mu mol/L, respectively (p < 0.001). The mean serum native thiol concentrations in the NASH, simple steatosis and control groups were 378 +/- 62 mu mol/L, 416 +/- 41 mu mol/L and 451 +/- 36 mu mol/L, respectively (p < 0.001). The mean serum disulfide concentrations in the NASH, simple steatosis and control groups were 18.5 +/- 6.3 mu mol/L, 15.5 +/- 4.8 mu mol/L and 14.9 +/- 3.6 mu mol/L, respectively (p = 0.005). The native thiol/total thiol ratio was significantly lower and the disulfide/total thiol and disulfide/native thiol ratios were significantly higher in the NASH group than in the simple steatosis and control groups. Conclusions: Thiol-disulfide homeostasis is disturbed and shifted toward disulfide side in NAFLD and NASH patients.Öğe Dynamic thiol-disulfide homeostasis is disturbed in patients with non-alcoholic fatty liver disease(Walter De Gruyter Gmbh, 2018) Asil, Mehmet; Dertli, Ramazan; Biyik, Murat; Yolacan, Ramazan; Erel, Ozcan; Neselioglu, Salim; Ataseven, HuseyinBackground: Oxidative stress has been implicated in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Plasma thiols are major defense mechanisms against oxidative stress and undergo oxidation to form disulfides under oxidative conditions. This study was conducted to investigate thiol-disulfide homeostasis in NAFLD patients. Methods: Thirty patients with biopsy proven non-alcoholic steatohepatitis (NASH), 40 patients with simple steatosis and 50 healthy controls were included in the study. Serum total and native thiol concentrations and serum disulfide concentration were measured using the Erel and Neselioglu's method. Results: The mean serum total thiol concentrations in the NASH, simple steatosis and control groups were 415 +/- 64 mu mol/L, 447 +/- 38 mu mol/L and 480 +/- 37 mu mol/L, respectively (p < 0.001). The mean serum native thiol concentrations in the NASH, simple steatosis and control groups were 378 +/- 62 mu mol/L, 416 +/- 41 mu mol/L and 451 +/- 36 mu mol/L, respectively (p < 0.001). The mean serum disulfide concentrations in the NASH, simple steatosis and control groups were 18.5 +/- 6.3 mu mol/L, 15.5 +/- 4.8 mu mol/L and 14.9 +/- 3.6 mu mol/L, respectively (p = 0.005). The native thiol/total thiol ratio was significantly lower and the disulfide/total thiol and disulfide/native thiol ratios were significantly higher in the NASH group than in the simple steatosis and control groups. Conclusions: Thiol-disulfide homeostasis is disturbed and shifted toward disulfide side in NAFLD and NASH patients.Öğe Effects of diclofenac sodium and octreotide on treatment of caerulein-induced acute pancreatitis in mice(E-Century Publishing Corp, 2015) Cakir, Ozlem Ozer; Esen, Hasan; Toker, Aysun; Ataseven, Huseyin; Demir, Ali; Polat, HakkiBackground: Research continues to develop novel therapeutic modalities that particularly focus on the pathogenesis of acute pancreatitis. This study aimed to assess the effects of diclofenac sodium and octreotide, alone or in combination, on pancreatic enzymes, pancreatic myeloperoxidase activity, histopathology and apoptosis of pancreas cells, using a model of experimentally induced acute pancreatitis. Objectives: We aimed to demonstrate effects of diclofenac sodium, octreotide and their combined use on pancreatic enzymes, activity of pancreatic myeloperoxidase (MPO) activity, histopathology and apoptosis of pancreas on treatment of caerulin-induced experimental acute pancreatitis. Materials and methods: Caerulin-induced acute pancreatitis model was created using a total of 58 male BALB-C mice of 25 gr in seven groups. Serum amylase, lipase levels and pancreatic myeloperoxidase activity were examined as well as apoptotic values in pancreatic acinar cells through TUNNEL method. Histopathology of pancreas was evaluated for presence of edema, hemorrhage, parenchymal necrosis, fat necrosis, leukocyte infiltration, and fibrosis. Results: In the diclofenac sodium group, apoptotic values in the pancreatic acinar cells were found to be statistically lower than in the acute pancreatitis group in terms of parenchymal necrosis and hemorrhage scores (P = 0.007, P = 0.002, and P = 0.052, respectively). No statistically significant differences were found in serum level of amylase, lipase, pancreatic myeloperoxidase activity and the other histopathological scores (P > 0.05). Conclusion: Diclofenac sodium, a cost-effective agent with a favorable side-effect profile, may represent a novel therapeutic agent for the treatment of acute pancreatitis. Findings of this study suggest a better efficacy for diclofenac sodium monotherapy as compared to octreotide alone or octreotide/diclofenac combination.Öğe Hounsfield unit density in the characterisation of bile duct lesions(Int Scientific Information Inc, 2019) Batur, Abdussamet; Kerimoglum, Ulku; Ataseven, HuseyinPurpose: To study the density of lesions in the lumens of extrahepatic bile ducts through computed tomography examinations, and to compare their characterisations with the results of pathology and/or endoscopic retrograde cholangiopancreatography (ERCP). Methods: The density of lesions along extrahepatic bile ducts were measured and compared with pathology and/or ERCP. The lesions were evaluated in two main groups: benign or malignant. The bile duct wall enhancement, intrahepatic bile ducts, and gallbladder were also evaluated. Results: The study was conducted with computed tomography scans of 197 cases (93 females, 104 males) who had optimal imaging. The results regarding density of extrahepatic intraductal lesions that were studied at BT were compared with pathology and magnetic resonance cholangiopancreatography results. Of 197 lesions, 125 (63.5%) were reported as benign and 72 (36.5%) were reported as malignant. The results for benign lesions showed an average density of 66.67 +/- 17.30 Hounsfield units (HU), and for malignant lesions the average density was 82.38 +/- 13. Conclusion: Lesion density level (HU) gives valuable information for the differentiation between benign and malign lesions in intraluminal extrahepatic bile ducts.Öğe The Importance of Liver-Fatty Acid Binding Protein in Diagnosis of Liver Damage in Patients with Acute Hepatitis(Premchand Shantidevi Research Foundation, 2017) Cakir, Ozlem Ozer; Toker, Aysun; Ataseven, Huseyin; Demir, Ali; Polat, HakkiIntroduction: Acute hepatitis is acute inflammation of liver elicited by a large number of causes. It sometimes spontaneously recovers, sometimes may progress to chronic hepatitis. LiverFatty Acid Binding Protein (L-FABP) is a small protein that is abundant in hepatocytes, and which binds most of the longchain fatty acids present in the cytosol. Aim: The present study aimed to investigate the levels of serum and urine L-FABP in acute hepatitis and diagnostic value of serum and urine L-FABP levels in patients with acute hepatitis. Materials and Methods: The present study included a total of 85 patients. Total number of patients with acute hepatitis were 17 (five of acute hepatitis B, one of acute hepatitis A, two of acute hepatitis C, five of autoimmune hepatitis and four of toxic hepatitis), 19 of hepatic encephalopathy, 29 of liver cirrhosis, and 20 controls were included. Serum and urinary L-FABP levels were analyzed by the Enzyme-Linked Immunosorbent Assay (ELISA). Results: Serum L-FABP levels were 9110 +/- 3352.5, 9410 +/- 1355, 9715 +/- 2462 and 3672 +/- 982.5 ng/l in patients with acute hepatitis, hepatic encephalopathy and cirrhosis and control subjects, respectively. There were statistically significant positive correlations between serum levels of L-FABP and Aspartate Aminotransferases (AST), Alanine Aminotransferases (ALT), Creatinine (Cre) and Gamma Glutamyl Transferases (GGT) (p<0.001, p<0.001, p<0.001 and p<0.001, respectively). While the cut-off value of serum L-FABP for all of the patients was 5183 ng/ l {p<0.001 and Area Under Curve (AUC)0.985}, the sensitivity and specificity were 95.4% and 100%, respectively. Positive and negative predictive values for serum L- FABP were 100% and 87%, respectively. Conclusion: Serum and urine L-FABP may be a new diagnostic marker for liver damage in patients with acute hepatitis. However, our study showed that except of aminotransferases, L-FABP should be used for diagnosis of liver damage in patients with acute hepatitis, chronic hepatitis and also cirrhosis.Öğe Levels of Serum Soluble P-Selectin and E-Selectin in Psoriatic Patients(Korean Dermatological Assoc, 2014) Ataseven, Arzu; Ataseven, Huseyin; Ozturk, Perihan; Ozdemir, Mehmet; Kesli, Recep[Abstract Not Availabe]Öğe Neutrophil gelatinase-associated lipocalin in prediction of mortality in patients with hepatorenal syndrome: a prospective observational study(Wiley, 2014) Gungor, Gokhan; Ataseven, Huseyin; Demir, Ali; Solak, Yalcin; Gaipov, Abduzhappar; Biyik, Murat; Ozturk, BahadirBackground & AimsHepatorenal syndrome (HRS) is a severe complication of cirrhosis which is characterized by renal dysfunction and associated with poor survival. Neutrophil gelatinase-associated lipocalin (NGAL) is a troponin-like biomarker for human acute kidney injury. We aimed to investigate levels of plasma and urine NGAL in HRS and predictive ability of these markers for all-cause mortality, in HRS, stable cirrhosis and control subjects. MethodsA total of 64 patients with cirrhosis (8 patients with type 1 HRS, 22 with type 2 HRS, and 34 without HRS) and 23 control subjects were included in the study. Blood and urine samples were measured with Human NGAL sandwich ELISA. Patients were followed up prospectively. ResultsPatients with type 1 and type 2 HRS had significantly higher plasma and urine NGAL levels compared with stable cirrhosis and control subjects. Cox regression analysis showed that plasma NGAL and MELD-Na scores were independent predictors of mortality. ROC-curve analysis showed that the plot of the plasma NGAL, urine NGAL, MELD-Na and Child-Turcot-Pugh score could predict all-cause mortality in cirrhotic patients' area under the curve (AUC 0.819, 0.686, 0.807 and 0.795 respectively). ConclusionsNGAL could predict mortality in patients with HRS independent of other commonly used risk factors.Öğe A Novel Marker Affecting Survival in Acute Non-variceal Upper Gastrointestinal Bleeding: Cardiac Troponin I(Galenos Publ House, 2021) Dertli, Ramazan; Biyik, Murat; Yolacan, Ramazan; Keskin, Muharrem; Karakarcayildiz, Ahmet; Kayar, Yusuf; Ataseven, HuseyinIntroduction: Acute non-variceal upper gastrointestinal bleeding (ANVUGIB) is an important public health problem with high rates of morbidity and mortality. ANVUGIB results in hypovolemia, hypotension, and shock, increasing cardiac oxygen use and may cause elevated serum levels of cardiac troponin (cTn). In this study, we aimed to evaluate whether elevated cTnI has clinical significance in patients with ANVUGIB. Methods: A total of 62 patients diagnosed with ANVUGIB whose serum cTnI levels were studied at the time of admission and follow-up in our clinic from January 2015 to January 2016 were included in the study. Patients with acute cardiac diseases that may cause elevated cTn were excluded from the study. Results: Forty-three of the patients were male (69.4%), and the mean age of all patients was 71.52 +/- 13.30 years. The mean cTnI level was 0.042 +/- 0.097 in all patients, with cTnI levels higher than the reference value in nine (14.5%) patients. In logistic regression analysis, the factors found to contribute to cTnI were tachycardia, chronic kidney disease, and coronary artery disease. In receiver operating characteristic analysis, cutoff values of 0.025 and 6.5 were found for cTnI and the Rockall score, respectively. In addition, cTnI and the Rockall score were shown to affect survival [log-rank (Mantel-Cox) test: p=0.011; log-rank (Mantel-Cox) test: p=0.014; respectively]. Conclusion: We believe that serum cTnI levels studied during the first admission will be found useful as a biomarker in addition to the other existing risk determination systems, in order to identify patients at risk, even if findings of acute coronary syndrome are not observed in patients presenting with ANVUGIB.Öğe A polypoid mass in the common bile duct(Aves, 2016) Asil, Mehmet; Dertli, Ramazan; Biyik, Murat; Oltulu, Pembe; Ataseven, Huseyin; Polat, Hakki; Demir, Ali[Abstract Not Availabe]Öğe Predictive Ability of Liver Fatty Acid Binding Protein for All Cause Mortality in Patients With Hepatic Encephalopathy: A Prospective Observational Study(Nature Publishing Group, 2017) Cakir, Ozlem Ozer; Toker, Aysun; Ataseven, Huseyin; Demir, Ali; Polat, Hakki; Gungor, Gokhan; Biyik, Murat[Abstract Not Availabe]Öğe Predictive Ability of Liver Fatty Acid Binding Protein for All Cause Mortality in Patients With Hepatic Encephalopathy: A Prospective Observational Study(Nature Publishing Group, 2017) Cakir, Ozlem Ozer; Toker, Aysun; Ataseven, Huseyin; Demir, Ali; Polat, Hakki; Gungor, Gokhan; Biyik, Murat[Abstract Not Availabe]Öğe SERUM AND URINE NGAL LEVELS IN PATIENTS WITH CIRRHOSIS AND HEPATO-RENAL SYNDROME(Oxford Univ Press, 2012) Gungor, Gokhan; Ataseven, Huseyin; Demir, Ali; Solak, Yalcin; Biyik, Murat; Ozturk, Bahadir; Polat, Ilker[Abstract Not Availabe]Öğe Ultra-mini Percutaneous Hepatolithotomy in Patients With Large and Multiple Hepatolithiasis(Lippincott Williams & Wilkins, 2021) Ozturk, Ahmet; Sonmez, Mehmet Giray; Bakdik, Suleyman; Ecer, Gokhan; Altinkaya, Nurullah; Ataseven, Huseyin; Aksoy, FarukBackground: In this study, we applied the ultra-mini percutaneous hepatolithotomy (UM-PHL) technique on hepatolithiasis patients with multiple and large stones on which other minimally invasive methods failed, and our aim was to report its results, sharing in series for the first time. Materials and Methods: Preoperative and postoperative data, laboratory parameters, radiologic findings, and preoperative and postoperative details were recorded for a total of 14 patients for whom the UM-PHL technique was applied between April 2017 and December 2019. As all patients had multiple stones and extreme stone load and had bile duct surgery, they did not have a normal anatomy. All patients were radiologically confirmed to have had preprocedural magnetic retrograde cholangiopancreatography. Results: Operation duration of the patients was 137.6 +/- 44.9 minutes, while intraoperative blood loss was 69.2 +/- 24.9 mL, drainage catheter removal time was 2.85 +/- 0.86 days, and the hospitalization time was 4.28 +/- 2.55 days. Intraoperative balloon dilation was applied to enlarge the stricture area in 5 patients (35.7%). On the basis of the Clavien-Dindo classification, grade 2 complication was observed in 2 patients (14.2%) due to postoperative cholangitis. Patients were followed up for an average of 15 months, and nonsymptomatic radiologic stone recurrence was detected in the 12th month control of 1 patient (7.1%). Conclusion: The UM-PHL technique is a successful method that facilitates stone clearance by providing minimal dilatation through percutaneous intervention and by using instruments with small diameter, and it can safely be applied with its low complication level, low recurrence ratio, and short hospitalization time.
