A rare congenital liver anomaly: Hypoplasia of left hepatic lobe

WOS: 000388621700033PubMed ID: 28179708Morphologic anomalies of liver, as opposed tomany other visceral organs, are very rare. Hypoplasia or agenesis of left lobe of the liver is defined as the absence of liver tissue on the left side of liver without previous disease or surgery. It is usually an incidental finding revealed by imaging exams or during abdominal surgery. A 44-year-old female patient was admitted to the hospital for abdominal pain and discomfort. Physical examination revealed no specific abnormality. Routine laboratory tests were normal. Imaging studies showed the absence of the left hepatic lobe. She had no history of surgery, trauma or liver disease and was diagnosed as having congenital hypoplasia of left hepatic lobe. Anomalies of hepatic morphology are due to developmental defects during embryogenesis and are rarely seen. They are generally diagnosed incidentally based on imaging techniques. Early diagnosis of such an anatomical anomaly is necessary for surgical planning, for appropriate evaluation of intraoperative surgical findings, and for the design of the postoperative approach to therapy

Prevalence of gastric cancer precursor lesions in patients with dyspepsia

Objectives: In Southeastern cities of Turkey, high prevalencesof Helicobacter pylori infection and gastric cancerare seen. The aim of this study was to evaluate the frequencyof the precancerous gastric lesions in patientswith dyspeptic symptoms who underwent upper gastrointestinalendoscopy in Adıyaman State Hospital.Materials and methods: We analyzed gastric biopsiestaken from corpus and antrum of 234 consecutive patientswho underwent upper gastrointestinal endoscopybetween January 2009 and May 2009. According to Sydneysystem, chronic gastritis, gastric atrophy, intestinalmetaplasia and dysplasia were diagnosed by histologicalexamination.Results: The mean age of patients was 46±15 (16- 82)years. Helicobacter pylori infection was seen in 66.7% ofpatients. Normal mucosa, chronic gastritis, gastric atrophy,intestinal metaplasia and dysplasia were diagnosedin 2.7%, 78.6%, 3.4%, 11.5% and 3.8% of gastric biopsyspecimens, respectively. Helicobacter pylori infected patientsshowed a significantly higher prevalence of intestinalmetaplasia compared with that of the non infectedsubjects (9.8% vs 1.7% p=0.021). Although prevalenceof gastric atrophy and dysplasia were higher among Helicobacterpylori infected patients, the difference did notreached to a statistically significant level (3.0% vs 0.4%p=0.19 and 3.0% vs 0.8% p=0.37 respectively).Conclusion: Our findings suggested that the prevalenceof gastric precancerous lesions such as gastric atrophy,intestinal metaplasia, dysplasia and Helicobacter pyloriinfection were high in dyspeptic patients. This may be relatedto actual high incidence of gastric cancer in southeasternregion of Turkey

Factor Determining Board Size and the relationship between Board Size and Firm Performance: an Investigation of Turkish Capital Market

The main purpose of this study is to examine factors determining corporate board size and the relationship between corporate board size and firm performance. To achieve this objective data from 98 companies registered in the Istanbul Stock Exchange during the period of 2006–2007 were used. Regression and correlation analyses were used for empirical analysis. As a result of the analyses, firm size was found to be the most important factor in determining corporate board size. Moreover, there is statistically significant negative correlation between corporate board size and firm debt rati

Acute temozolomide induced liver injury: Mixed type hepatocellular and cholestatic toxicity

Temozolomide (TMZ) is an oral imidazotetrazine methylating agent which is used for the treatment of glioblastoma multiforme (GBM). We report a case of acute hepatotoxicity in a 53-year old male patient after administration of TMZ for GBM. He had fatigue, nausea, anorexia and jaundice. His laboratory analysis showed alanine aminotransferase(ALT): 632 IU/L (normal range 0-40); aspartate aminotransferase(AST): 554 IU/L (normal range 5-34); alkaline phosphatase(ALP): 1143 IU/L (normal range 40- 150); -glutamyl transpeptidase(GGT): 514 IU/L (normal range 9-64 IU/L); total bilirubin: 15.1 mg/dL (normal range 0-1.2); direct bilirubin: 13.2 mg/dL and prothrombin time(PT): 13.5 s, with international normalized ratio (INR): 1.1 (normal range 0.8-1.2). His liver biopsy specimen showed mixed-type (both hepatocellular and cholestatic) hepatic injury, compatible with a diagnosis of drug-induced hepatitis. An objective causality assessment using the Naranjo probability scale suggested that TMZ was the probable cause of the acute hepatitis. His liver function tests gradually normalized in 2 months after discontinuation of the drug. In susceptible individuals, TMZ use may lead to acute mixed type liver toxicity. Complete recovery may be possible if the drug is discontinued before severe liver injury is established

The Evaluation of Anesthesiological Approach Accompanying Spinal Anesthesia Applied in a Pregnant Woman with Behçet Disease: A Case Report

Behçet’s disease (BD) is a chronic inflammatory disease with multisystem involvement, first described by Hulusi Behçet in 1937. Recurrent mouth and genital area ulcers, skin findings and uveitis are characteristic features. BD is most commonly seen in the Far East, the Middle East and Mediterranean countries in all ethnic groups, and the frequency in our country has been reported to be 110-420/100.000. Since BD is a multisystemic disease, anesthetic drug administration and management are challenging in patients with BD. We aimed to present a 26-year-old pregnant patient with BD undergoing cesarean section with spinal anesthesia and evaluate the anesthetic techniques in the light of the current literature

Efficacy Of 180° Cyclodiode Transscleral Photocoagulation For Refractory Glaucoma

Objectives: To evaluate the efficacy and safety of transscleral cyclophotocoagulation (TS-CPC) limited to 180° of ciliary body ablation in patients with various forms of refractory glaucoma. Materials and Methods: Thirty eyes with refractory glaucoma treated with 180° TS-CPC were retrospectively analyzed for intraocular pressure (IOP) reduction and success rates. Patients’ age, gender, type of glaucoma, number of diode laser treatment sessions, postoperative complications, number of hypotensive medications required to control IOP, and best corrected visual acuity (BCVA) were evaluated. The criteria for success were defined as postoperative IOP 20% decrease in IOP with or without additional medical treatment. Results: The mean age of all patients was 51.3±26.9 years (range,1-84 years). The mean postoperative IOP level (23.9±8.5 mmHg) was significantly lower than preoperative IOP (39.2±8.9 mmHg) (p<0.001). The success rate was 66.6% after the first laser treatment and reached 86.7% following repeat laser treatments over an average follow-up period of 22.2±19.9 months. The need for topical hypotensive medications decreased from 2.8±1.0 preoperatively to 2.4±1.3 following TS-CPC (p=0.048). Two patients (6.6%) had a one-line decrease in their BCVA following TS-CPC. Transient hypotony and hyphema developed in 4 patients (13.3%). Total laser energy delivered did not correlate with either preoperative (rho=0.10; p=0.594) or postoperative IOP (rho=0.21; p=0.260). Conclusion: TS-CPC limited to 180° of ciliary body ablation is associated with a reasonable success rate and low incidence of adverse effects in patients with refractory glaucoma.PubMedScopu

Intrahepatic cholestasis of pregnancy: Spontaneous vs in vitro fertilization

Aim: Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease in pregnancy. Although it was shown that multiple pregnancy and hormone therapies increase the risk of ICP, there is limited information that compared spontaneous fertilization and in vitro fertilization (IVF) from the aspect of developing ICP. In our study, we investigated the potential relationship between ICP and IVF/ spontaneous pregnancy.Materials and methods: We reviewed the records (between June 2007 and December 2014) of pregnancies with ICP who were referred to gastroenterology clinics in three different hospitals. Fifty-nine pregnancies (43 spontaneous fertilization, 16 IVF) with ICP were analyzed from the aspect of age, fertilization type, multiple/singleton pregnancy, delivery week, and biochemical results.Results: We found that serum bile acid levels were higher in the IVF group than the spontaneous fertilization group (32.8 ± 20 vs 19.6 ± 19 μmol/L; p < 0.05). There was a significant inverse correlation between serum bile acid levels and gestational age (r = -0.42, p < 0.01) in the whole group. There was no difference between IVF and spontaneous fertilization groups in term of age, onset time of symptoms, serum alanine aminotransferase (ALT), alkaline phosphatase (ALP), total and direct bilirubin levels, prothrombin time (PT), international normalized ratio (INR), and platelet count.Conclusion: Our results suggest that the serum bile acid levels are higher in IVF than in spontaneous pregnancies with ICP, but its clinical implications are not clear. Further prospective studies with large number of ICP cases are needed to clarify the effect of IVF on ICP

Acute temozolomide induced liver injury: Mixed type hepatocellular and cholestatic toxicity

Temozolomide (TMZ) is an oral imidazotetrazine methylating agent which is used for the treatment of glioblastoma multiforme (GBM). We report a case of acute hepatotoxicity in a 53-year old male patient after administration of TMZ for GBM. He had fatigue, nausea, anorexia and jaundice. His laboratory analysis showed alanine aminotransferase(ALT): 632 IU/L (normal range 0-40); aspartate aminotransferase(AST): 554 IU/L (normal range 5-34); alkaline phosphatase(ALP): 1143 IU/L (normal range 40-150); ?-glutamyl transpeptidase(GGT): 514 IU/L (normal range 9-64 IU/L); total bilirubin: 15.1 mg/dL (normal range 0-1.2); direct bilirubin: 13.2 mg/dL and prothrombin time(PT): 13.5 s, with international normalized ratio (INR): 1.1 (normal range 0.8-1.2). His liver biopsy specimen showed mixed-type (both hepatocellular and cholestatic) hepatic injury, compatible with a diagnosis of drug-induced hepatitis. An objective causality assessment using the Naranjo probability scale suggested that TMZ was the probable cause of the acute hepatitis. His liver function tests gradually normalized in 6 months after discontinuation of the drug. In susceptible individuals, TMZ use may lead to acute mixed type liver toxicity. Complete recovery may be possible if the drug is discontinued before severe liver injury is established