Kulak burun boğaz ihtisas dergisi : KBB = Journal of ear, nose, and throat
This study aims to investigate the possible correlations between the heterotopic gastric mucosa (... more This study aims to investigate the possible correlations between the heterotopic gastric mucosa (HGM) islets in the cervical esophagus and laryngopharyngeal reflux (LPR). Between May 2010 and April 2011, 45 patients (36 females, 9 males; mean age 39.8±14.1 years; range 18 to 72 years) who had reflux symptom index (RSI) >10 and reflux finding score (RFS) >7 were included. The study group consisted of 21 patients who were diagnosed with HGM islets in the cervical esophagus, while control group consisted of 24 patients without any HGM islets assessed by upper gastrointestinal system endoscopy. Esophagus manometric examination and dual-channel 24-hour pH monitoring were performed on all patients. Pretreatment mean RSI and RFS were 25.6±3.5 and 15.1±3.4 in group 1, while it was found to be 21.1±4.4 and 11.9±2.6 in group 2 (p=0.001, p=0.001). A total of 29.7% of patients who underwent pH monitoring had distal reflux, whereas 43.2% of them had proximal reflux. In group 1, distal refl...
Nature Clinical Practice Gastroenterology & Hepatology, 2008
The outcome of liver transplantation for hepatitis B has markedly improved in the last two decade... more The outcome of liver transplantation for hepatitis B has markedly improved in the last two decades. This commentary discusses the findings and limitations of a study by Hwang et al., which retrospectively examined the outcome of 639 adult patients who underwent living donor liver transplantation for hepatitis B. The authors reported a 5-year HBV recurrence rate of 7.3% and concluded that high-dose hepatitis B immunoglobulin (HBIG) monotherapy and rescue antiviral therapy is an effective way to prevent HBV recurrence after liver transplantation. With the availability of safe and effective antiviral agents associated with low rates of drug resistance, HBIG monotherapy is rarely used. The standard approach involves administration of antiviral therapy to suppress HBV replication before transplantation, followed by a combination of HBIG and antiviral therapy after transplantation. Combination prophylaxis permits the dose of HBIG to be reduced, which results in cost savings and reduces rates of HBV recurrence.
Neopterin is a marker of cell-mediated immunity. It also has a fundamental role in host-defense r... more Neopterin is a marker of cell-mediated immunity. It also has a fundamental role in host-defense reactions, including interactions with reactive oxygen intermediates and the promotion of local and systemic oxidative stress. The present study aimed to assess the importance of serum neopterin levels in patients with non-alcoholic steatohepatitis (NASH). Thirty-nine patients with NASH diagnosed by liver biopsy and 32 healthy adults (controls) were enrolled in the study. Serum neopterin levels were measured with an enzyme-linked immunosorbent assay in addition to other biochemical parameters, including liver enzymes. Histopathological examinations were graded as suggested by both the necroinflammatory activity grading system and the NASH scoring system. The mean serum neopterin levels were higher in patients with NASH compared to the controls (24.1 +/- 16.4 vs 16.2 +/- 9.5, P = 0.019). The histological examination of liver biopsies revealed that 34 of the patients with NASH had grade 1 steatohepatitis and only five patients had grade 2 steatohepatitis. A higher serum mean neopterin level was detected in grade 2 patients compared to grade 1 (40.6 +/- 5.6 vs 21.7 +/- 16.1, P = 0.014). A gradual increase was also observed in serum neopterin levels with the increase of the NASH score. The serum neopterin levels were significantly higher in patients with NASH compared to the controls, and levels showed an association with the severity of liver damage.
Background: ETV-r mutations had been reported in up to 6% of LVD-r HBV patients in a phase III tr... more Background: ETV-r mutations had been reported in up to 6% of LVD-r HBV patients in a phase III trial and in isolated cases of nucleoside naive HBV patients. The impact of preexisting ETV-r mutations on response to ETV treatment is unclear. Aim: To determine (i) the prevalence of ETV-r mutations in nucleoside naive and in LVD-r HBV patients, and (ii) the impact of ETV-r mutations on response to subsequent ETV treatment. Methods: Baseline samples from 25 nucleoside naive HBV patients and samples at the time of virological breakthrough in 69 LVD-r HBV patients were tested for antiviral-drug resistant mutations using direct sequencing and a sensitive line probe assay (InnoLipa DRv.3). Samples with ETV-r mutations were further tested by sequencing of 20-25 clones. Results: ETV-r mutations were detected in 1/25 (4%) nucleoside naive and in 10/69 (14%) LVD-r patients who had not been exposed to ETV by DRv.3 assay but no ETV-r mutation was detected by direct sequencing. The nucleoside naive patient had S202G on DRv.3 and in 2/22 clones analyzed. HBV DNA became undetectable within 6 months of ETV treatment in this patient and in 17/24 (71%) nucleoside naive patients without ETV-r mutation at baseline. Of the 10 LVDr patients who had ETV-r mutation before any exposure to ETV, 7 had S202G and 1 had M250I in association with M204V. The other 2 patients had dual ETV-r mutations: T184A+M250L and S202G+M250I in association with A181V but not M204 mutations. Both patients had M204V/I mutation only at the time of LVD breakthrough, ETV-r and A181V mutations were detected 6 and 8 months after switching to adefovir (ADV) monotherapy. ETV-r mutations were present in 1-3 clones analyzed while LVD-r or ADV-r mutations were present in most clones. In 2 LVD-r patients with ETV-r mutation (M204V + S202G) at baseline, HBV DNA decreased by 3.4 and 2.6 log after 6 months of ETV treatment, and both remained HBV DNA positive after 7 and 14 months of ETV. In comparison, in 8 LVDr patients without ETV-r mutation at baseline, HBV DNA decreased by a mean of 4.6 and 5.6 log after 6 and 12 months ETV treatment, respectively and 4 (50%) had undetectable HBV DNA at month 6. Conclusions: ETV-r mutations were detected in 4% nucleoside naive and in 14% LVD-r HBV patients who had not been exposed to ETV. Virologic response to ETV was impaired in patients with both LVD-r and ETV-r mutations but appeared to be unaffected in one patient with ETV-r mutation alone. Switching from LVD to ADV monotherapy in LVD-r patients did not eliminate the risk of selection for ETV-r mutations.
Gastroenterology, Volume 134, Issue 4, Pages A-806, April 2008, Authors:Bulent Degertekin;Jessica... more Gastroenterology, Volume 134, Issue 4, Pages A-806, April 2008, Authors:Bulent Degertekin;Jessica Tan; Stephen N. Wong; Scott Fung; Munira T. Hussain; Anna S. Lok. ...
Kulak burun boğaz ihtisas dergisi : KBB = Journal of ear, nose, and throat
This study aims to investigate the possible correlations between the heterotopic gastric mucosa (... more This study aims to investigate the possible correlations between the heterotopic gastric mucosa (HGM) islets in the cervical esophagus and laryngopharyngeal reflux (LPR). Between May 2010 and April 2011, 45 patients (36 females, 9 males; mean age 39.8±14.1 years; range 18 to 72 years) who had reflux symptom index (RSI) >10 and reflux finding score (RFS) >7 were included. The study group consisted of 21 patients who were diagnosed with HGM islets in the cervical esophagus, while control group consisted of 24 patients without any HGM islets assessed by upper gastrointestinal system endoscopy. Esophagus manometric examination and dual-channel 24-hour pH monitoring were performed on all patients. Pretreatment mean RSI and RFS were 25.6±3.5 and 15.1±3.4 in group 1, while it was found to be 21.1±4.4 and 11.9±2.6 in group 2 (p=0.001, p=0.001). A total of 29.7% of patients who underwent pH monitoring had distal reflux, whereas 43.2% of them had proximal reflux. In group 1, distal refl...
Nature Clinical Practice Gastroenterology & Hepatology, 2008
The outcome of liver transplantation for hepatitis B has markedly improved in the last two decade... more The outcome of liver transplantation for hepatitis B has markedly improved in the last two decades. This commentary discusses the findings and limitations of a study by Hwang et al., which retrospectively examined the outcome of 639 adult patients who underwent living donor liver transplantation for hepatitis B. The authors reported a 5-year HBV recurrence rate of 7.3% and concluded that high-dose hepatitis B immunoglobulin (HBIG) monotherapy and rescue antiviral therapy is an effective way to prevent HBV recurrence after liver transplantation. With the availability of safe and effective antiviral agents associated with low rates of drug resistance, HBIG monotherapy is rarely used. The standard approach involves administration of antiviral therapy to suppress HBV replication before transplantation, followed by a combination of HBIG and antiviral therapy after transplantation. Combination prophylaxis permits the dose of HBIG to be reduced, which results in cost savings and reduces rates of HBV recurrence.
Neopterin is a marker of cell-mediated immunity. It also has a fundamental role in host-defense r... more Neopterin is a marker of cell-mediated immunity. It also has a fundamental role in host-defense reactions, including interactions with reactive oxygen intermediates and the promotion of local and systemic oxidative stress. The present study aimed to assess the importance of serum neopterin levels in patients with non-alcoholic steatohepatitis (NASH). Thirty-nine patients with NASH diagnosed by liver biopsy and 32 healthy adults (controls) were enrolled in the study. Serum neopterin levels were measured with an enzyme-linked immunosorbent assay in addition to other biochemical parameters, including liver enzymes. Histopathological examinations were graded as suggested by both the necroinflammatory activity grading system and the NASH scoring system. The mean serum neopterin levels were higher in patients with NASH compared to the controls (24.1 +/- 16.4 vs 16.2 +/- 9.5, P = 0.019). The histological examination of liver biopsies revealed that 34 of the patients with NASH had grade 1 steatohepatitis and only five patients had grade 2 steatohepatitis. A higher serum mean neopterin level was detected in grade 2 patients compared to grade 1 (40.6 +/- 5.6 vs 21.7 +/- 16.1, P = 0.014). A gradual increase was also observed in serum neopterin levels with the increase of the NASH score. The serum neopterin levels were significantly higher in patients with NASH compared to the controls, and levels showed an association with the severity of liver damage.
Background: ETV-r mutations had been reported in up to 6% of LVD-r HBV patients in a phase III tr... more Background: ETV-r mutations had been reported in up to 6% of LVD-r HBV patients in a phase III trial and in isolated cases of nucleoside naive HBV patients. The impact of preexisting ETV-r mutations on response to ETV treatment is unclear. Aim: To determine (i) the prevalence of ETV-r mutations in nucleoside naive and in LVD-r HBV patients, and (ii) the impact of ETV-r mutations on response to subsequent ETV treatment. Methods: Baseline samples from 25 nucleoside naive HBV patients and samples at the time of virological breakthrough in 69 LVD-r HBV patients were tested for antiviral-drug resistant mutations using direct sequencing and a sensitive line probe assay (InnoLipa DRv.3). Samples with ETV-r mutations were further tested by sequencing of 20-25 clones. Results: ETV-r mutations were detected in 1/25 (4%) nucleoside naive and in 10/69 (14%) LVD-r patients who had not been exposed to ETV by DRv.3 assay but no ETV-r mutation was detected by direct sequencing. The nucleoside naive patient had S202G on DRv.3 and in 2/22 clones analyzed. HBV DNA became undetectable within 6 months of ETV treatment in this patient and in 17/24 (71%) nucleoside naive patients without ETV-r mutation at baseline. Of the 10 LVDr patients who had ETV-r mutation before any exposure to ETV, 7 had S202G and 1 had M250I in association with M204V. The other 2 patients had dual ETV-r mutations: T184A+M250L and S202G+M250I in association with A181V but not M204 mutations. Both patients had M204V/I mutation only at the time of LVD breakthrough, ETV-r and A181V mutations were detected 6 and 8 months after switching to adefovir (ADV) monotherapy. ETV-r mutations were present in 1-3 clones analyzed while LVD-r or ADV-r mutations were present in most clones. In 2 LVD-r patients with ETV-r mutation (M204V + S202G) at baseline, HBV DNA decreased by 3.4 and 2.6 log after 6 months of ETV treatment, and both remained HBV DNA positive after 7 and 14 months of ETV. In comparison, in 8 LVDr patients without ETV-r mutation at baseline, HBV DNA decreased by a mean of 4.6 and 5.6 log after 6 and 12 months ETV treatment, respectively and 4 (50%) had undetectable HBV DNA at month 6. Conclusions: ETV-r mutations were detected in 4% nucleoside naive and in 14% LVD-r HBV patients who had not been exposed to ETV. Virologic response to ETV was impaired in patients with both LVD-r and ETV-r mutations but appeared to be unaffected in one patient with ETV-r mutation alone. Switching from LVD to ADV monotherapy in LVD-r patients did not eliminate the risk of selection for ETV-r mutations.
Gastroenterology, Volume 134, Issue 4, Pages A-806, April 2008, Authors:Bulent Degertekin;Jessica... more Gastroenterology, Volume 134, Issue 4, Pages A-806, April 2008, Authors:Bulent Degertekin;Jessica Tan; Stephen N. Wong; Scott Fung; Munira T. Hussain; Anna S. Lok. ...
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