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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 Evaluation of the Relation Between Hepatic Fibrosis and Basic Laboratory Parameters in Patients With Chronic Hepatitis B Fibrosis and Basic Laboratory Parameters(Kowsar Publ, 2014) Demir, Nazlim Aktug; Kolgelier, Servet; Ozcimen, Serap; Gungor, Gokhan; Sumer, Sua; Demir, Lutfi Saltuk; Inkaya, Ahmet CagkanBackground: The hepatitis B virus is an important healthcare problem. According to current clinical practice, a liver biopsy is required for the diagnosis and treatment of chronic liver disease. However, a liver biopsy is an invasive, inconvenient procedure, which requires an expert pathologist opinion. Therefore requirement of biochemical tests, which are considered to indicate hepatic fibrosis and may be repeated easily, increases gradually today. Objectives: This study evaluated the correlation between hepatic fibrosis and routine laboratory values in patients with chronic hepatitis B. Patients and Methods: The files of 456 patients with CHB (chronic hepatitis B) who were referred to the infectious diseases and clinical microbiology clinic between January 2009 and March 2012 were screened retrospectively. Liver biopsy samples were examined according to Ishak scoring. Laboratory parameters and histopathology reports were recorded, and correlations between the fibrosis grade and laboratory parameters were analyzed. Results: There were 320 male and 136 female patients, with a mean age 36.7 +/- 12.1 years. According to liver biopsy results, a low fibrosis score (stage 0-2) was detected in 281 patients (61.6%), and a high fibrosis score ( stage 3-5) was detected in 175 patients (38.4%). Patients with a high fibrosis score had significantly higher ALT (alanine amino transferase), AST (aspartate aminotransferase), and HBV-DNA values and a significantly lower platelet count compared with those with a low fibrosis score (P=0.001, 0.001, 0.025, and 0.001, respectively). A positive correlation was detected between the fibrosis score and age, BMI, HAI, ALT, and AST values, and a negative correlation was detected between the fibrosis score and albumin and platelet counts. In the regression analysis performed to evaluate the factors associated with high-stage fibrosis, fibrosis was determined to be associated with thrombosis, ALT, and gender. The results of the regression analysis demonstrated that the risk of fibrosis was 4.6 fold higher in men. Conclusions: According to the results obtained in our study, advanced age, higher BMI, AST, ALT, and HBV-DNA levels, and low albumin and platelet levels are correlated with advanced fibrosis in patients with CHB.Öğe IRRITABLE BOWEL SYNDROME PREVALENCE IN PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER(Carbone Editore, 2015) Kucuk, Adem; Biyik, Murat; Solak, Yalcin; Ucar, Ramazan; Polat, Ilker; Pektas, Fatih; Gungor, GokhanIntroduction: Patients with Familial Mediterranean Fever (FMF) and Irritable bowel syndrome (IBS) share some clinical features including abdominal pain, constipation and diarrhea. Furthermore, some patients with FMF do not have typical abdominal pain and fever attacks rather they have nonspecific symptoms. This makes the diagnosis of FMF harder and lead to a delay in starting the colchicine treatment. Both diseases lack specific diagnostic tests. We aimed to determine the prevalence of IBS in patients with established diagnosis of FMF. Materials and methods: FMF patients who had been diagnosed according to Tel-Hashomer criteria in Rheumatology clinic of a university hospital were included in the study between January 2011 and December 2011. 10 point IBS questionnaire according to Rome III criteria was used to determine the presence of IBS. Patients with recent FMF attack and abdominal pain from other reasons were excluded. Results: One-hundred and thirteen patients (67 females and 46 males) with an established diagnosis of FMF were included in the study. The mean duration of FMF was 6.4 +/- 6.7 years. IBS prevalence based on Roma III criteria was 40.7% (n=46). IBS prevalence was 30.4% (n=14) in male patients and 47.8 % (n=32) in female patients (p=0.06). In female patients IBS subtypes were as follows; IBS mixed type (IBS-M) 37% (n=12), IBS diarrhea predominant (IBS-D) 22% (n=7), IBS unsubtyped (MS-U) 22% (n=7), and IBS constipation predominant (IBS-C) 19% (n=6), whereas in male patients, IBS-M 57% (n=8), IBS-C 29% (n=4), IBS-D 7% (n=1) and IBS-U 7% (n=1). The most common subtype of IBS was IBS-M in both sexes. Conclusion: IBS is frequent in FMF patients when Rome HI criteria are used for diagnosis. The question to be answered is whether increased frequency or merely the failure of Rome III criteria to differentiate IBS in such patient groups with abdominal discomfort.Öğe Liver abscess after implantation of dental prosthesis(Baishideng Publishing Group Inc, 2012) Gungor, Gokhan; Biyik, Murat; Polat, Hakki; Ciray, Hilal; Ozbek, Orhan; Demir, AliPyogenic liver abscesses are rare but a life-threatening important condition. Dental procedures constitute only rare cases of pyogenic liver abscesses, with only a few cases in the literature. We report a patient with liver abscess following a dental procedure. A 74 years old diabetic male patient was admitted to our hospital with complaints of fatigue, 40 degrees C fever, rigors and right upper quadrant pain, 3-4 d after a dental procedure. Physical examination revealed fever and tenderness in the right upper quadrant. Laboratory examination revealed leucocytosis, elevated erythrocyte sedimentation rate and C-reactive protein and moderately elevated transaminases. An abscess was detected in radiological examination in the medial part of the left lobe of liver, neighboring the gall bladder. He was successfully treated with percutaneous abscess drainage and antibiotherapy. (C) 2012 Baishideng. All rights reserved.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 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]
