Measurement of the coronary flow velocity reserve in patients with non-alcoholic fatty liver disease.

Background/aims: Endothelial dysfunction is an early and reversible feature in the pathogenesis of atherosclerosis. Coronary flow velocity reserve is a noninvasive test showing endothelial function of epicardial coronary arteries and coronary microcirculatory function. This study was designed to evaluate the carotid intima-media thickness and myocardial microvascular circulation in patients with non-alcoholic fatty liver disease.

Electron microscopic findings in non-alcoholic fatty liver disease: is there a difference between hepatosteatosis and steatohepatitis?

Background And Aims: Non-alcoholic fatty liver disease has long been accepted as benign; however, recent evidence suggests that the disease may progress to cirrhosis and hepatocellular carcinoma, although the natural course of the disease is still unclear. This study was designed to comparatively evaluate electron microscopic features of non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH).

Methods: Quantitative and semi-quantitative ultrastructural evaluations were performed on liver biopsies from 23 patients, 10 with NAFL and 13 with NASH.

Decreased prohepcidin levels in patients with HBV-related liver disease: relation with ferritin levels.

Background: Levels of prohepcidin, a homeostatic regulator of iron absorption, are altered in chronic hepatitis C and liver cirrhosis. However, data on the potential alterations of prohepcidin in patients with HBV-related liver disease are scarce. We investigated whether serum prohepcidin is related to iron overload and perenchymal dysfuction in HBV-related liver disease.

The quality of life in hemodialysis patients with chronic hepatitis C virus infection.

Background/aims: We aimed to determine the quality of life in treated and untreated hemodialysis patients with chronic hepatitis C virus infection.

Methods: Ninety-five chronic renal failure patients with positive antiHCV/HCV-RNA were enrolled in this prospective study. All patients were questioned using the Short Form-36 (SF-36) health survey to evaluate life quality after the treatment.

Prevalence and clinical significance of SEN-H virus in chronic hepatitis B, C and delta infections in Turkey.

Background/aims: SEN viruses are transmitted parenterally and can cause post-transfusion hepatitis. The prevalence and clinical significance of SEN viruses have been investigated in patients with chronic hepatitis C and B but not in D. We aimed to determine the prevalence and clinical significance of SEN viruses- H in patients with chronic hepatitis C, B and delta in Turkey.

Intestinal metaplasia in portal hypertensive gastropathy: a frequent pathology.

Objective: To compare the frequency of intestinal metaplasia (IM) in patients with portal hypertensive gastropathy (PHG) to the control group with functional dyspepsia.

Methods: Two-hundred and eighty-nine cases were prospectively evaluated in three groups (controls:group I--123 patients; cirrhotics: group II--135 patients; noncirrhotic portal hypertensives: group III--31 patients). Mucosal biopsies (three antrum, one angulus, two corpus) were taken and examined for atrophy, IM, dysplasia, Helicobacter pylori (Hp) and histologic PHG.

Are acquired hepatocerebral degeneration and hepatic myelopathy reversible?

Background: Acquired hepatocerebral degeneration (AHD) and hepatic myelopathy (HM) are rare complications of chronic liver disease and are usually resistant to medical therapy.

Materials And Methods: The clinical and laboratory findings of 14 male and 2 female patients with AHD or HM were evaluated.

Results: The prevalence of AHD and HM was 2% inpatient case series in the last 10 years.

Prevalence and virological features of occult hepatitis B virus infection in female sex workers who work uncontrolled in Turkey.

Background: There is little information about the prevalence of occult hepatitis B virus infection (OHBVI). We have investigated the prevalence and virological features of OHBVI among female sex workers (FSWs) in Istanbul.

Methods: Hepatitis B surface antigen (HBsAg) was tested in FSWs who work uncontrolled and were admitted to Venereal Diseases Hospital.

Lamivudine monotherapy and lamivudine plus interferon alpha combination therapy in HBeAg negative chronic hepatitis B not responding to previous interferon alpha monotherapy.

Background And Study Aims: To investigate the efficacy of the combined therapy of lamivudine (LAM) plus alpha interferon (IFN) and LAM monotherapy in HBeAg negative chronic hepatitis B (CHB) patients who were unresponsive to previous IFN monotherapy, and the incidence of YMDD mutations.

Patients-methods: Forty-five HBeAg negative patients were enrolled in this study. 24 of these were treated with LAM (100 mg/day, PO, for 24 months) alone (group 1) and 21 with combined therapy (IFN-alpha-2b, 10 MU, tiw, SC, for 6 months plus LAM 100 mg/day, PO, for 24 months) (group 2).

The role of thrombopoietin and spleen volume in thrombocytopenia of patients with noncirrhotic and cirrhotic portal hypertension.

Background/aims: To determine the role of thrombopoietin and spleen volume in thrombocytopenia diagnosed in cirrhotic and noncirrhotic portal hypertensive patients.

Methods: Seventy- four portal hypertensive patients (group 1: 28 noncirrhotic; group 2: 46 cirrhotic) were enrolled into this study. Spleen volume was measured by magnetic resonance imaging.

What is the reason of elevated alanine aminotransferase level in HBeAg negative patients with low viremia: NAFLD or chronic hepatitis?

Background And Study Aims: Increased alanine aminotransferase (ALT) levels with negative hepatitis B virus (HBV) DNA by hybridization is a common problem in Turkey where is a mild endemic region. We aimed to evaluate the causes of elevated ALT levels in patients who are negative for hepatitis B e antigen (HBeAg) and HBV DNA (by hybridization) for at least 6 months.

Patients-methods: Forty-nine patients were enrolled in this study.

Pegylated interferon Alfa-2b monotherapy and pegylated interferon Alfa-2b plus lamivudine combination therapy for patients with hepatitis B virus E antigen-negative chronic hepatitis B.

Forty-eight hepatitis B virus (HBV) E antigen-negative chronic hepatitis B patients received pegylated interferon alfa-2b either alone or with lamivudine for 48 weeks and were followed for an additional 24 weeks. At the end of follow-up, virological response rates (HBV DNA levels of <400 copies/ml) were similar in the monotherapy (24%) and combination therapy (26%) groups.

The effects of rosiglitazone, metformin, and diet with exercise in nonalcoholic fatty liver disease.

Our aim was to evaluate effects of metformin, rosiglitazone, and diet with exercise in nonalcoholic fatty liver disease. Forty-seven patients (mean age, 44+/-10 years; 17 female) whose ALT levels had been high for at least 6 months and with hepatosteatosis detected by liver biopsy and/or USG were enrolled in this study. Of these, 12 were treated with 850 mg/day metformin (group 1), 11 with 4 mg/day rosiglitazone (group 2), and 24 with diet and exercise (group 3) for 1 year.

HFE gene mutation, chronic liver disease, and iron overload In Turkey.

We aimed to determine the relationships between iron overload and HFE gene mutation in chronic liver disease in Turkey. One hundred thirteen chronic liver disease patients and 138 healthy controls were evaluated regarding their clinical, biochemical, and genetic parameters. Each group was divided into two subgroups according to transferrin saturation (TS) (45% and >45%).

Long-term results of interferon alpha monotherapy in patients with HBeAg-negative chronic hepatitis B.

We sought to evaluate the long-term results of interferon-alpha (IFN-alpha) therapy in patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B. Eighty HBeAg-negative naive patients (62 men; mean age, 39.9 years) who received IFN-alpha for 6 months were studied.

An asymptomatic huge hepatocellular carcinoma with intra-atrial tumor thrombus in a patient with chronic hepatitis B viral infection.

Hepatocellular carcinoma is the most important complication of cirrhosis. All types of cirrhosis predispose to hepatocellular carcinoma, but 10 to 20% of cases may develop in patients without cirrhosis. Here, we present an asymptomatic precirrhotic patient with hepatocellular carcinoma and intra-atrial tumor thrombus.

Treatment of hepatic hydrothorax with terlipressin in a cirrhotic patient.

Hepatic hydrothorax is a complication of cirrhosis that is uncommon and difficult to treat. Diuretic therapy, thoracentesis, transjugular intrahepatic portosystemic shunt and liver transplantation are the main therapeutic options. Here, we report on a 47-year-old man with decompensated liver cirrhosis related to hepatitis B and D virus infections and who had complications of hepatic hydrothorax and hepatorenal syndrome.

Risk factors for the transmission of hepatitis C virus infection in the Turkish population.

The risk factors for the transmission of hepatitis C virus (HCV) infection varies substantially between countries and geographic regions. The aim of this investigation was to determine the risk factors which may be involved in the transmission of HCV infection in the Turkish population. This study included patients who were admitted to the Department of Gastroenterohepatology, Istanbul Medical Faculty, Istanbul University, between 1996 and 2002 and found to be anti-HCV positive during hospitalization or during follow-up as outpatients.

Intrahepatic and peripheral T-cell responses in genotype 1b hepatitis C virus-infected patients with persistently normal and elevated aminotransferase levels.

Aim: To evaluate whether the cytokine responses in liver and serum differ in chronic hepatitis C patients with normal and high alanine aminotransferase (ALT) levels.

Methods: Thirty-three (16 with normal ALT level as group 1 and 17 with elevated ALT level as group 2) patients infected with genotype 1b hepatitis C virus (HCV) were examined. Liver infiltrating lymphomononuclear cells (LILMCs) were isolated from liver biopsy by collagenase type 1 and stimulated with phytohemagglutinin and interleukin 2 (IL-2).

Alverine induced toxic hepatitis: a case report.

Drug-induced hepatotoxicity is an important cause of hepatocellular injury. Hepatic necrosis may range from asymptomatic elevations in transaminases to fulminant hepatic failure and death. Alverine is an antispasmodic drug which is especially used in patients with irritable bowel syndrome.

Efficacy of cyclosporin in severe ulcerative colitis attack.

Background/aims: Cyclosporin-A is used as a alternative medical therapy in steroid resistant ulcerative colitis with severe activity. In spite of its known efficacy, the long term effects of are not entirely clear.

Methods: The records of 13 steroid resistant patients treated with cyclosporin-A were retrospectively assessed.

Relationships between hemodynamic alterations and Child-Pugh Score in patients with cirrhosis.

Background/aims: In this study, central and nonsplanchnic hemodynamic alterations in liver cirrhosis and correlation between Child-Pugh Score and these hemodynamic alterations were evaluated.

Methodology: With this aim, angiotensin-I, aldosterone, femoral blood flow, cardiac index, free water clearance and renal blood flow index were evaluated in 30 cirrhotic patients and 10 healthy control subjects.

Results: Child-Pugh score was found to be directly related with serum levels of angiotensin-I and aldosterone, cardiac and renal blood flow index (r = 0.

Is there any medical therapeutic option in hepatopulmonary syndrome? A case report.

Hepatopulmonary syndrome (HPS) is a well-known complication characterized by abnormalities of arterial oxygenation in patients with chronic liver disease, with or without portal hypertension. There is no definitive treatment for HPS except liver transplantation. We report on a patient with HBV-related liver cirrhosis and HPS who received garlic and lamivudine for 3 years.