umit akyuz - Academia.edu (original) (raw)

Papers by umit akyuz

Research paper thumbnail of Hepatit A geçiren hastada akut ürtiker ve Guillain-Barre like sendromun birlikteliği

Zeynep Kamil tıp bülteni, Apr 1, 2004

Hepatitis A infection (HAV) may present with extrahepatic manifestations rather than causing typi... more Hepatitis A infection (HAV) may present with extrahepatic manifestations rather than causing typical hepatitis. These are: urticarial rash, vasculitis, arthritis, transient arthralgia, hemolytic anemia, thrombocytopenia, cryoglobulinemia, . Guillain-Barre Syndrome and polymyositis. We report a case of 4.5 years old boy with a rare association of acute HAV infection and urticarial rash accompanied by Guillain-Barre like Syndrome.

Research paper thumbnail of Iniencephaly: A case report

Istanbul University - DergiPark, Apr 1, 2003

Iniencephaly is a rare but almost always lethal neural tube defect with following cardinal featur... more Iniencephaly is a rare but almost always lethal neural tube defect with following cardinal features: Occipithal bone defect, partial or total absence of cervicothoracal vertebrae and fetal retroflexion.There is a defect in closure of the neural tube, which, under normal circumstances, is completely fused by 28 days of gestation. Iniencephaly is associated with malformations of central nervous system, gastrointesinal - and cardiovaskuler system. We present an iniencephalic newborn with a review of literature.

Research paper thumbnail of Zor tanı konulan bir Kawasaki sendromu Olgu Sunumu

Istanbul University - DergiPark, 2007

Kawasaki sendromu konjonktivada hiperemi, a¤›z mukozas›nda yang›, ekstremitelerde belirgin de¤ifl... more Kawasaki sendromu konjonktivada hiperemi, a¤›z mukozas›nda yang›, ekstremitelerde belirgin de¤ifliklikler, cilt bulgular› boyunda lenfadenomegali ve atefl ile seyreden bir çocukluk ça¤› vaskülitidir. Yaz›m›zda, eritema multiforme tarz›nda döküntü, ishal, hipoalbuminemi ve trombositopeni ile baflvuran, yat›fl›n›n 12. gününde el ve ayaklar›ndaki soyulmalar ve ekokardiyografi bulgular› ile Kawasaki sendromu tan›s› koydu¤umuz alt› yafl›nda bir k›z hastay› sunduk. (Türk Ped Arfl 2007; 42: 40-2) A An na ah ht ta ar r k ke el li im me el le er r: : Hemolitik üremik sendrom, Kawasaki sendromu, trombositopeni

Research paper thumbnail of Su1817 Characterization of Lean Patients With Nonalcoholic Fatty Liver Disease: Potential Role of High Hemoglobin Levels

Research paper thumbnail of Stress analysis of the human temporomandibular joint

Medical Engineering & Physics, 1998

Stress analysis of the human temporomandibular joint (TMJ) consisting of mandibular disc, condyle... more Stress analysis of the human temporomandibular joint (TMJ) consisting of mandibular disc, condyle and fossa-eminence complex during normal sagittal jaw closure was performed using non-linear finite element analysis (FEA). The geometry of the TMJ was obtained from magnetic resonance imaging (MRI). The tissue proportion was measured from a cadaver TMJ. Contact surfaces were defined to represent the interaction between the mandibular disc and the condyle, and between the mandibular disc and the fossaeminence complex so that finite sliding was allowed between contact bodies. Stresses in the TMJ components (disc, condyle and fossa-eminence complex), and forces in capsular ligaments were obtained. The results demonstrated that, with the given condylar displacement, the stress in the condyle was dominantly compressive and in the fossa-eminence complex was dominantly tensile. The cancellous bone was shielded by the shell shaped cortical bone from the external loading. The results illustrate the stress distributions in the TMJ during a normal jaw closure.

Research paper thumbnail of Measurements of serum procollagen-III peptide and M30 do not improve the diagnostic accuracy of transient elastography for the detection of hepatic fibrosis in patients with nonalcoholic fatty liver disease

European Journal of Gastroenterology & Hepatology, 2015

Background Transient elastography (TE) has recently emerged as an accurate noninvasive imaging me... more Background Transient elastography (TE) has recently emerged as an accurate noninvasive imaging method for the diagnosis of liver fibrosis in nonalcoholic fatty liver disease (NAFLD). Here, we tested whether adding serum measures of serum procollagen-III peptide (PIIIP) and caspase-cleaved cytokeratin 18 fragment (M30) to TE could improve its diagnostic accuracy in patients with biopsy-proven NAFLD. Patients and methods TE was performed in 87 patients with NAFLD. Serum PIIIP and M30 levels were determined by enzymelinked immunosorbent assay. Liver histology was considered the gold standard. The diagnostic accuracies were assessed by measuring the area under the receiver operating curve. Results At histopathological examination, 34 patients (39.1%) had significant fibrosis (F2-F4) and 19 patients (21.8%) had advanced fibrosis (F3-F4). Both TE and serum M30 levels were independent predictors of fibrosis, whereas no association was found with PIIIP. No significant differences in terms of sensitivity and specificity for both significant and advanced fibrosis were evident for TE, serum M30, or their combination. Moreover, the area under the receiver operating curves of serum M30 combined with TE did not differ significantly from those of either test alone. Conclusion Both TE and serum M30 levels are accurate for the noninvasive diagnosis of fibrosis in NAFLD. However, their combination did not improve the overall diagnostic accuracy.

Research paper thumbnail of Endoscopic repair of duodenal perforation with over-the-scope clipping system and endoclips: A case report

The Turkish Journal of Gastroenterology, 2014

Herein, we present an endoscopic repair of iatrogenic duodenal perforation by over-the-scope clip... more Herein, we present an endoscopic repair of iatrogenic duodenal perforation by over-the-scope clipping system (OTSC) and endoclips in an 84-year-old woman that occurred during linear endosonography (EUS) examination. One OTSC and 8 clips were used for repairing the perforation hole. After 3 days in the intensive care unit (ICU) by chest tube and without oral feeding, she was discharged from the hospital at 6. admission day, and she also had an acute coronary attack during 4. hospital day. OTSC and clipping devices are very useful for repair of iatrogenic perforations, especially in older patients who have comorbid diseases and who can not tolerate the surgery.

Research paper thumbnail of Role of serum myeloperoxidase, CPK, CK-MB, and cTnI tests in early diagnosis of myocardial ischemia during ERCP

The Turkish Journal of Gastroenterology, 2014

Background/Aims: Some patients may experience retrosternal pain during ERCP, which may be a pione... more Background/Aims: Some patients may experience retrosternal pain during ERCP, which may be a pioneer of a serious myocardial problem, and early diagnosis is very important for the prognosis and management. In the study, we aimed to investigate the role of serum cardiac biomarkers, such as myeloperoxidase (MPO), creatine phospokinase (CPK), creatine kinase-myocardial band (CK-MB), and cTnI, on early diagnosis of myocardial ischemia during endoscopic retrograde cholangio pancreaticograpy (ERCP) procedures. Materials and Methods: In this prospective observational study, ERCP patients were separated into ischemic cardiac (n:48) and non-ischemic (n:76) groups. Serious cardiac, kidney, and liver disease patients were excluded from the study. Changes in electrocardigrapy (ECG), blood pressure, pulse rate, oxygen saturation, and serum MPO, CPK, CK-MB, and cTnI levels were investigated before and after the ERCP. Results were evaluated statistically (p<0.05). Results: Mean age was 59.76±16.62 (55♀, 69♂). Only one patient had clinically unimportant retrosternal pain (0.8%). ST-elevation was detected in 10.4% (n:5), ST-depression in 12.5% (n:6), and negative-T in 31.3% (n:15) of ischemic patients during ERCP. Systolic and diastolic blood pressure and pulse rates in both groups and oxygen saturations in the ischemic group were reduced after ERCP. Significance was not detected with MPO and CPK tests. CK-MB levels showed an increase after the ERCP in the non-ischemic group (p<0.001). cTnI means were higher among the ischemics when pre-and post-ERCP periods (p:0.001) were compared. Conclusion: Clinically unimportant retrosternal pain, T negativity, and ST segment changes as well as reduced systolic, diastolic blood pressure, and heart rates can be seen during ERCP. MPO and CPK levels remain insignificant if myocardial injury does not develop. Increased CK-MB levels in non-ischemic patients and increased cTnI levels in ischemics may be seen.

Research paper thumbnail of Characterization of lean patients with nonalcoholic fatty liver disease: potential role of high hemoglobin levels

Scandinavian Journal of Gastroenterology, 2014

Overweight and obesity are major risk factors for the development of nonalcoholic fatty liver dis... more Overweight and obesity are major risk factors for the development of nonalcoholic fatty liver disease (NAFLD). However, a minority of NAFLD patients have a body mass index (BMI) &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;25 kg/m(2) (lean NAFLD). We sought to investigate whether significant differences exist between lean NAFLD and more common forms of NAFLD associated with overweight/obesity. A total of 483 consecutive patients with biopsy-proven NAFLD were enrolled. Lean NAFLD was defined as having a BMI &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;25 kg/m(2). We identified 37 patients with lean NAFLD (7.6%). Compared with NAFLD patients with overweight/obesity, lean NAFLD patients were younger, had lower blood pressure values, higher levels of hemoglobin, a lower prevalence of the metabolic syndrome, and less severe hepatic fibrosis. In NAFLD patients with overweight/obesity, diabetes was the only independent predictor of nonalcoholic steatohepatitis (NASH). In lean NAFLD, the only variable independently associated with NASH was hemoglobin. Alanine aminotransferase and diabetes were independent predictors of fibrosis ≥2 in NAFLD patients with overweight/obesity, whereas hemoglobin was the only independent predictor of fibrosis ≥2 in lean NAFLD. In summary, lean NAFLD patients are younger and show less severe hepatic fibrosis. However, such subjects have higher hemoglobin levels, which seem to predict the histological severity.

Research paper thumbnail of A comparison of FibroMeter™ NAFLD Score, NAFLD fibrosis score, and transient elastography as noninvasive diagnostic tools for hepatic fibrosis in patients with biopsy-proven non-alcoholic fatty liver disease

Scandinavian Journal of Gastroenterology, 2014

Noninvasive markers that purport to distinguish patients with non-alcoholic fatty liver disease (... more Noninvasive markers that purport to distinguish patients with non-alcoholic fatty liver disease (NAFLD) with fibrosis from those without must be evaluated rigorously for their classification accuracy. Herein, we seek to compare the diagnostic performances of three different noninvasive methods (FibroMeter™ NAFLD score, NAFLD Fibrosis score (NFSA), and Transient Elastrography [TE]) for the detection of liver fibrosis in NAFLD patients. A total of 88 patients with biopsy-proven NAFLD were included. The Kleiner system was used for grading fibrosis in liver biopsies. The FibroMeter™ NAFLD score was determined using a proprietary algorithm (regression score). The NFSA score was calculated based on age, hyperglycemia, body mass index, platelets, albumin and serum aminotransferase levels. TE was performed using the Fibroscan apparatus. The sensitivities/specificities for the FibroMeter™ NAFLD score, NFSA, and TE for the diagnosis of significant fibrosis (F2 + F3 + F4 fibrosis) were 38.6%/86.4%, 52.3%/88.6%, and 75.0%/93.2%, respectively. The areas under the receiver operating characteristic curves of TE were significantly higher than those of both the FibroMeter™ NAFLD score and NFSA. No significant differences were found between the FibroMeter™ NAFLD score and NFSA for the detection of significant and severe fibrosis, although the diagnostic performance of the FibroMeter™ NAFLD score was higher than that of the NFSA score for cirrhosis. In summary, TE showed the best diagnostic performance for the noninvasive assessment of liver fibrosis in NAFLD patients. The diagnostic performances of the FibroMeter™ NAFLD score and NFSA did not differ significantly for the detection of both significant and severe fibrosis.

Research paper thumbnail of Optic Neuritis Following Hepatitis B Vaccination in a 9-year-old Girl

Journal of the Chinese Medical Association, 2009

Research paper thumbnail of A critical observation about the pathogenesis of abdominoscrotal hydrocele

Journal of Pediatric Surgery, 2001

Research paper thumbnail of Konvülziyon ve karpopedal spazm ile acil servise başvuran tip 1 otoimmün poliglandüler sendrom ve heliotropik raş birlikteliği

Adolesan donemde hipokalsemik konvulziyon ile basuran hastalarda nadir olmakla beraber Otoimmun p... more Adolesan donemde hipokalsemik konvulziyon ile basuran hastalarda nadir olmakla beraber Otoimmun poliglanduler sendrom ( OPS) gorulebilir. Otoimmun poliglanduler sendrom, birden fazla endokrin organin disfonksiyonu ile seyreden bir sendromdur. Uc tip OPS tanimlanmistir. Olgu: konvulziyon ve karpopedal spazm ile basvuran 15 yasindaki kiz cocugunda hipokalsemi nedeni ile yapilan ileri tetkikler sonucunda Tip 1 OPS tanisi konuldu. Hastada bir-iki yildir tekrarlayan mukokutanoz kandidiazis enfeksiyon oykusu mevcuttu. Fizik muayenesi heliotropik ras disinda normal idi.Hastanin kan kalsiyum: 5.8 mg/dl, fosfor: 11.9 mg/dl,ALP: 350 UI/L, PTH: 5.57pg/ml(N: 15-65pg/ml), 25(OH)D3:10,3 ng/ml (Normal: 19-57,6 ng/ml, antitir o globulin antikorlari: 75 IU/ml (N: < 70 IU/ml) degerlerde bulundu. ilk 3 gun parenteral kalsiyum tedavisi ile hastanin konvulziyonlari kontrol altina alindi. Tedaviye oral kalsiyum ve kalsitriol (aktif D3) ile devam edildi. Sonuc. Adolesan cocuklarda gelisen hipokalsemik ...

Research paper thumbnail of Hepatit A geçiren hastada akut ürtiker ve Guillain-Barre like sendromun birlikteliği

Zeynep Kamil tıp bülteni, Apr 1, 2004

Hepatitis A infection (HAV) may present with extrahepatic manifestations rather than causing typi... more Hepatitis A infection (HAV) may present with extrahepatic manifestations rather than causing typical hepatitis. These are: urticarial rash, vasculitis, arthritis, transient arthralgia, hemolytic anemia, thrombocytopenia, cryoglobulinemia, . Guillain-Barre Syndrome and polymyositis. We report a case of 4.5 years old boy with a rare association of acute HAV infection and urticarial rash accompanied by Guillain-Barre like Syndrome.

Research paper thumbnail of Iniencephaly: A case report

Istanbul University - DergiPark, Apr 1, 2003

Iniencephaly is a rare but almost always lethal neural tube defect with following cardinal featur... more Iniencephaly is a rare but almost always lethal neural tube defect with following cardinal features: Occipithal bone defect, partial or total absence of cervicothoracal vertebrae and fetal retroflexion.There is a defect in closure of the neural tube, which, under normal circumstances, is completely fused by 28 days of gestation. Iniencephaly is associated with malformations of central nervous system, gastrointesinal - and cardiovaskuler system. We present an iniencephalic newborn with a review of literature.

Research paper thumbnail of Zor tanı konulan bir Kawasaki sendromu Olgu Sunumu

Istanbul University - DergiPark, 2007

Kawasaki sendromu konjonktivada hiperemi, a¤›z mukozas›nda yang›, ekstremitelerde belirgin de¤ifl... more Kawasaki sendromu konjonktivada hiperemi, a¤›z mukozas›nda yang›, ekstremitelerde belirgin de¤ifliklikler, cilt bulgular› boyunda lenfadenomegali ve atefl ile seyreden bir çocukluk ça¤› vaskülitidir. Yaz›m›zda, eritema multiforme tarz›nda döküntü, ishal, hipoalbuminemi ve trombositopeni ile baflvuran, yat›fl›n›n 12. gününde el ve ayaklar›ndaki soyulmalar ve ekokardiyografi bulgular› ile Kawasaki sendromu tan›s› koydu¤umuz alt› yafl›nda bir k›z hastay› sunduk. (Türk Ped Arfl 2007; 42: 40-2) A An na ah ht ta ar r k ke el li im me el le er r: : Hemolitik üremik sendrom, Kawasaki sendromu, trombositopeni

Research paper thumbnail of Su1817 Characterization of Lean Patients With Nonalcoholic Fatty Liver Disease: Potential Role of High Hemoglobin Levels

Research paper thumbnail of Stress analysis of the human temporomandibular joint

Medical Engineering & Physics, 1998

Stress analysis of the human temporomandibular joint (TMJ) consisting of mandibular disc, condyle... more Stress analysis of the human temporomandibular joint (TMJ) consisting of mandibular disc, condyle and fossa-eminence complex during normal sagittal jaw closure was performed using non-linear finite element analysis (FEA). The geometry of the TMJ was obtained from magnetic resonance imaging (MRI). The tissue proportion was measured from a cadaver TMJ. Contact surfaces were defined to represent the interaction between the mandibular disc and the condyle, and between the mandibular disc and the fossaeminence complex so that finite sliding was allowed between contact bodies. Stresses in the TMJ components (disc, condyle and fossa-eminence complex), and forces in capsular ligaments were obtained. The results demonstrated that, with the given condylar displacement, the stress in the condyle was dominantly compressive and in the fossa-eminence complex was dominantly tensile. The cancellous bone was shielded by the shell shaped cortical bone from the external loading. The results illustrate the stress distributions in the TMJ during a normal jaw closure.

Research paper thumbnail of Measurements of serum procollagen-III peptide and M30 do not improve the diagnostic accuracy of transient elastography for the detection of hepatic fibrosis in patients with nonalcoholic fatty liver disease

European Journal of Gastroenterology & Hepatology, 2015

Background Transient elastography (TE) has recently emerged as an accurate noninvasive imaging me... more Background Transient elastography (TE) has recently emerged as an accurate noninvasive imaging method for the diagnosis of liver fibrosis in nonalcoholic fatty liver disease (NAFLD). Here, we tested whether adding serum measures of serum procollagen-III peptide (PIIIP) and caspase-cleaved cytokeratin 18 fragment (M30) to TE could improve its diagnostic accuracy in patients with biopsy-proven NAFLD. Patients and methods TE was performed in 87 patients with NAFLD. Serum PIIIP and M30 levels were determined by enzymelinked immunosorbent assay. Liver histology was considered the gold standard. The diagnostic accuracies were assessed by measuring the area under the receiver operating curve. Results At histopathological examination, 34 patients (39.1%) had significant fibrosis (F2-F4) and 19 patients (21.8%) had advanced fibrosis (F3-F4). Both TE and serum M30 levels were independent predictors of fibrosis, whereas no association was found with PIIIP. No significant differences in terms of sensitivity and specificity for both significant and advanced fibrosis were evident for TE, serum M30, or their combination. Moreover, the area under the receiver operating curves of serum M30 combined with TE did not differ significantly from those of either test alone. Conclusion Both TE and serum M30 levels are accurate for the noninvasive diagnosis of fibrosis in NAFLD. However, their combination did not improve the overall diagnostic accuracy.

Research paper thumbnail of Endoscopic repair of duodenal perforation with over-the-scope clipping system and endoclips: A case report

The Turkish Journal of Gastroenterology, 2014

Herein, we present an endoscopic repair of iatrogenic duodenal perforation by over-the-scope clip... more Herein, we present an endoscopic repair of iatrogenic duodenal perforation by over-the-scope clipping system (OTSC) and endoclips in an 84-year-old woman that occurred during linear endosonography (EUS) examination. One OTSC and 8 clips were used for repairing the perforation hole. After 3 days in the intensive care unit (ICU) by chest tube and without oral feeding, she was discharged from the hospital at 6. admission day, and she also had an acute coronary attack during 4. hospital day. OTSC and clipping devices are very useful for repair of iatrogenic perforations, especially in older patients who have comorbid diseases and who can not tolerate the surgery.

Research paper thumbnail of Role of serum myeloperoxidase, CPK, CK-MB, and cTnI tests in early diagnosis of myocardial ischemia during ERCP

The Turkish Journal of Gastroenterology, 2014

Background/Aims: Some patients may experience retrosternal pain during ERCP, which may be a pione... more Background/Aims: Some patients may experience retrosternal pain during ERCP, which may be a pioneer of a serious myocardial problem, and early diagnosis is very important for the prognosis and management. In the study, we aimed to investigate the role of serum cardiac biomarkers, such as myeloperoxidase (MPO), creatine phospokinase (CPK), creatine kinase-myocardial band (CK-MB), and cTnI, on early diagnosis of myocardial ischemia during endoscopic retrograde cholangio pancreaticograpy (ERCP) procedures. Materials and Methods: In this prospective observational study, ERCP patients were separated into ischemic cardiac (n:48) and non-ischemic (n:76) groups. Serious cardiac, kidney, and liver disease patients were excluded from the study. Changes in electrocardigrapy (ECG), blood pressure, pulse rate, oxygen saturation, and serum MPO, CPK, CK-MB, and cTnI levels were investigated before and after the ERCP. Results were evaluated statistically (p<0.05). Results: Mean age was 59.76±16.62 (55♀, 69♂). Only one patient had clinically unimportant retrosternal pain (0.8%). ST-elevation was detected in 10.4% (n:5), ST-depression in 12.5% (n:6), and negative-T in 31.3% (n:15) of ischemic patients during ERCP. Systolic and diastolic blood pressure and pulse rates in both groups and oxygen saturations in the ischemic group were reduced after ERCP. Significance was not detected with MPO and CPK tests. CK-MB levels showed an increase after the ERCP in the non-ischemic group (p<0.001). cTnI means were higher among the ischemics when pre-and post-ERCP periods (p:0.001) were compared. Conclusion: Clinically unimportant retrosternal pain, T negativity, and ST segment changes as well as reduced systolic, diastolic blood pressure, and heart rates can be seen during ERCP. MPO and CPK levels remain insignificant if myocardial injury does not develop. Increased CK-MB levels in non-ischemic patients and increased cTnI levels in ischemics may be seen.

Research paper thumbnail of Characterization of lean patients with nonalcoholic fatty liver disease: potential role of high hemoglobin levels

Scandinavian Journal of Gastroenterology, 2014

Overweight and obesity are major risk factors for the development of nonalcoholic fatty liver dis... more Overweight and obesity are major risk factors for the development of nonalcoholic fatty liver disease (NAFLD). However, a minority of NAFLD patients have a body mass index (BMI) &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;25 kg/m(2) (lean NAFLD). We sought to investigate whether significant differences exist between lean NAFLD and more common forms of NAFLD associated with overweight/obesity. A total of 483 consecutive patients with biopsy-proven NAFLD were enrolled. Lean NAFLD was defined as having a BMI &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;25 kg/m(2). We identified 37 patients with lean NAFLD (7.6%). Compared with NAFLD patients with overweight/obesity, lean NAFLD patients were younger, had lower blood pressure values, higher levels of hemoglobin, a lower prevalence of the metabolic syndrome, and less severe hepatic fibrosis. In NAFLD patients with overweight/obesity, diabetes was the only independent predictor of nonalcoholic steatohepatitis (NASH). In lean NAFLD, the only variable independently associated with NASH was hemoglobin. Alanine aminotransferase and diabetes were independent predictors of fibrosis ≥2 in NAFLD patients with overweight/obesity, whereas hemoglobin was the only independent predictor of fibrosis ≥2 in lean NAFLD. In summary, lean NAFLD patients are younger and show less severe hepatic fibrosis. However, such subjects have higher hemoglobin levels, which seem to predict the histological severity.

Research paper thumbnail of A comparison of FibroMeter™ NAFLD Score, NAFLD fibrosis score, and transient elastography as noninvasive diagnostic tools for hepatic fibrosis in patients with biopsy-proven non-alcoholic fatty liver disease

Scandinavian Journal of Gastroenterology, 2014

Noninvasive markers that purport to distinguish patients with non-alcoholic fatty liver disease (... more Noninvasive markers that purport to distinguish patients with non-alcoholic fatty liver disease (NAFLD) with fibrosis from those without must be evaluated rigorously for their classification accuracy. Herein, we seek to compare the diagnostic performances of three different noninvasive methods (FibroMeter™ NAFLD score, NAFLD Fibrosis score (NFSA), and Transient Elastrography [TE]) for the detection of liver fibrosis in NAFLD patients. A total of 88 patients with biopsy-proven NAFLD were included. The Kleiner system was used for grading fibrosis in liver biopsies. The FibroMeter™ NAFLD score was determined using a proprietary algorithm (regression score). The NFSA score was calculated based on age, hyperglycemia, body mass index, platelets, albumin and serum aminotransferase levels. TE was performed using the Fibroscan apparatus. The sensitivities/specificities for the FibroMeter™ NAFLD score, NFSA, and TE for the diagnosis of significant fibrosis (F2 + F3 + F4 fibrosis) were 38.6%/86.4%, 52.3%/88.6%, and 75.0%/93.2%, respectively. The areas under the receiver operating characteristic curves of TE were significantly higher than those of both the FibroMeter™ NAFLD score and NFSA. No significant differences were found between the FibroMeter™ NAFLD score and NFSA for the detection of significant and severe fibrosis, although the diagnostic performance of the FibroMeter™ NAFLD score was higher than that of the NFSA score for cirrhosis. In summary, TE showed the best diagnostic performance for the noninvasive assessment of liver fibrosis in NAFLD patients. The diagnostic performances of the FibroMeter™ NAFLD score and NFSA did not differ significantly for the detection of both significant and severe fibrosis.

Research paper thumbnail of Optic Neuritis Following Hepatitis B Vaccination in a 9-year-old Girl

Journal of the Chinese Medical Association, 2009

Research paper thumbnail of A critical observation about the pathogenesis of abdominoscrotal hydrocele

Journal of Pediatric Surgery, 2001

Research paper thumbnail of Konvülziyon ve karpopedal spazm ile acil servise başvuran tip 1 otoimmün poliglandüler sendrom ve heliotropik raş birlikteliği

Adolesan donemde hipokalsemik konvulziyon ile basuran hastalarda nadir olmakla beraber Otoimmun p... more Adolesan donemde hipokalsemik konvulziyon ile basuran hastalarda nadir olmakla beraber Otoimmun poliglanduler sendrom ( OPS) gorulebilir. Otoimmun poliglanduler sendrom, birden fazla endokrin organin disfonksiyonu ile seyreden bir sendromdur. Uc tip OPS tanimlanmistir. Olgu: konvulziyon ve karpopedal spazm ile basvuran 15 yasindaki kiz cocugunda hipokalsemi nedeni ile yapilan ileri tetkikler sonucunda Tip 1 OPS tanisi konuldu. Hastada bir-iki yildir tekrarlayan mukokutanoz kandidiazis enfeksiyon oykusu mevcuttu. Fizik muayenesi heliotropik ras disinda normal idi.Hastanin kan kalsiyum: 5.8 mg/dl, fosfor: 11.9 mg/dl,ALP: 350 UI/L, PTH: 5.57pg/ml(N: 15-65pg/ml), 25(OH)D3:10,3 ng/ml (Normal: 19-57,6 ng/ml, antitir o globulin antikorlari: 75 IU/ml (N: < 70 IU/ml) degerlerde bulundu. ilk 3 gun parenteral kalsiyum tedavisi ile hastanin konvulziyonlari kontrol altina alindi. Tedaviye oral kalsiyum ve kalsitriol (aktif D3) ile devam edildi. Sonuc. Adolesan cocuklarda gelisen hipokalsemik ...