Role of percutaneous radiological treatment in biliary complications associated with adult left lobe living donor liver transplantation: a single-center experience

PURPOSEBiliary complications develop at a higher rate in living donor liver transplantation (LDLT) compared with cadaveric liver transplantation. Almost all studies about biliary complications after LDLT were made with the right lobe. The aim of this study was to determine the frequency of biliary complications developing after adult left lobe LDLT and to evaluate the efficacy of the algorithm followed in diagnosis and treatment, particularly percutaneous radiological treatment.METHODSA total of 2185 LDLT operations performed in our center between May 2009 and December 2019 were retrospectively reviewed and patients receiving left lobe LDLT were analyzed regarding biliary complications and treatments. Biliary complications were treated via percutaneous drainage under ultrasound (US) guidance, endoscopic retrograde cholangiopancreatography (ERCP), and percutaneous transhepatic cholangiography (PTC)/ percutaneous transhepatic biliary drainage (PTBD). Patient demographics, ERCP procedures before percutaneous treatment, and percutaneous treatment indications were analyzed.RESULTSA total of 69 adult patients received left lobe LDLT. Biliary complications requiring endoscopic and/or percutaneous treatment developed in 28 patients (40%). Of these patients, 4 had bile leakage (14%), 20 had anastomosis stricture (72%), and 4 had both leakage and anastomosis stricture (14%). External drainage treatment under ultrasound guidance was sufficient for 2 of 4 patients with bile leakage, and these cases were accepted as minor bile leakage (7%). Overall, 26 patients underwent ERCP; of these, 8 were referred for PTC/PTBD because the guidewire and/or balloon-stent could not pass the anastomosis stricture (n=7) and common bile duct cannulation could not be obtained because of duodenal diverticulum (n=1). Diagnostic PTC was performed in 10 patients, 8 were referred after inadequate/failed ERCP procedure and two were referred directly without ERCP. Anastomosis stricture was found in 7 patients and anastomosis stricture and bile leakage in 3. In 7 patients determined to have stricture, balloon dilatation was applied and then biliary drainage was performed. In 3 patients who had leakage and anastomosis stricture, balloon dilatation was applied for stricture; after dilatation, an IEBD catheter was placed through the leakage region in 2 patients, while a covered metallic stent passing through the leakage region was placed in one patient.CONCLUSIONGenerally, ERCP is the first preferred method in biliary complications of LDLT; however, in cases where a response cannot be obtained by endoscopic treatment or require complex and/or aggressive treatment, percutaneous radiological treatment should be the treatment of choice before surgery in left lobe LDLT

Determination of genetic relatedness among Turkish apple germplasm based on ISSR markers

Apple (Malus domestica Borkh) is the most economically important pome fruits worldwide and Turkey is within origin center of apple. In this research, inter-simple sequence repeat (ISSR) markers were used to determine relationships among the Turkish apple accessions and some selected foreign cultivars and species.  Fourteen ISSR primers produced a total of 111 fragments and 76 of them were polymorphic. The number of average polymorphic fragments per primer was 5.4. The mean polymorphism information content (PIC) was 0.37. The unweighted pair group method arithmetic average (UPGMA) analysis demonstrated that the accessions had a similarity range from 0.79 to 0.98. All accessions studied were discriminated and many subgroups were determined in the dendrogram based on the UPGMA analysis. High level of variation among the Turkish apples existed. Foreign cultivars, M.baccata, M. prunifolia and M. sylvestris accessions studied mix-clustered among the Turkish accessions. For sub-structuring Bayesian analysis, 71 loosely or uncorrelated markers with less than 10% missing data were used. This indicated absence of subpopulations, meaning well and equal introgression of genetic backgrounds or species available among the accessions. It can be concluded that Turkey was rich in apple genetic diversity, which may provide opportunity for apple breedind programs

Advanced alveolar echinococcosis disease associated with Budd–Chiari syndrome

AbstractIntroductionAlveolar echinococceal disease of the liver is rare. Echinococcus multilocularis is responsible for the development of the related clinical conditions. Advanced disease may result with serious complications such as end stage liver disease and Budd–Chiari syndrome.Presentation of caseIn this presentation, a 28 years-old woman who was a case with advanced alveolar echinococcosis complicated with a Budd–Chiari syndrome and was performed successful living donor liver transplantation, has been demonstrated with clinical and radiological images.DiscussionInitially there may be no clinical evidence of the disease in humans for years. Severity and fatality are the significant characteristics of the natural history. Extension to the surrounding tissues and metastasis of the parasitic mass may be observed. Prevention is essential in disease control. Serologic assay may identify the parasite. However, early diagnosis is rare. Staging is based on radiologic imaging. Some patients with advanced disease may require surgery. Hepatic resection and liver transplantation are accepted procedures in selected patients.ConclusionThe importance of early diagnosis to prevent advanced complications such as development of Budd–Chiari syndrome and metastasis has been underlined

The chemical composition of essential oil and in vitro antibacterial activities of essential oil and methanol extract of Ziziphora persica Bunge

This study was designed to examine the chemical composition of essential oil and the in vitro antibacterial activities of essential oil and methanol extracts of Ziziphora persica. The inhibitory effects of essential oil and methanol extracts of Ziziphora persica were tested against 98 laboratory strains belonging to 51 bacteria species by using disc-diffusion assay and micro-broth dilution methods, respectively. GC and GC/MS analyses revealed that the essential oil predominantly contains (+)-pulegone (79.33%), limonene (6.78%) and piperitenone (4.2%). The antibacterial test results showed that both methanol extract and in particular essential oil of Ziziphora persica had antibacterial activity against a number of bacteria tested. The lowest MIC values (7.81 mu g/ml) were obtained with the essential oil of Ziziphora persica against Bacillus dipsauri, Corynebacterium cystitidis and Corynebacterium flavescens. (c) 2006 Elsevier Ireland Ltd. All rights reserved

Antibacterial Activities of Red Colored Radish Types (Raphanus sativus L.)

The root parts of red skin colored radish cultivars cv. Antep and cv. Cherry Belle which are belongs to Raphanus sativus L. were harvested from Erzurum region of Turkey and their methanol extracts were evaluated for antibacterial activity against 52 food borne bacteria by using disc diffusion assay. Extracts had a broad-spectrum antibacterial activity against food borne bacteria in broth micro dilution bioassays. Maximum antibacterial activity was observed against Arthrobacter ilicis, Corynebacterium ammoniagenes, Enterobacter hormaechei, Kocuria rosea, Neisseria subflava, Pantoea agglomerans, Proteus vulgaris, Psychrobacter immobilis and Shigella dysenteriae. However, cv. Antep showed antibacterial activity against Bacillus sphaericus and Corynebacterium flavescens and cv. Cherry Belle showed antibacterial activity against Arthrobacter atrocyaneus as well as. These inhibitory effects are interesting in relation to the prevention of microbial contamination in many foods

IN VITRO ANTIBACTERIAL ACTIVITIES OF BLACK AND WHITE RADISHES (RAPHANUS SATIVUS L.)

The present study was conducted to evaluate the in vitro antibacterial activities of methanol extracts of white and black coloured peel taproots of two radish types belonging to Raphanus sativus L. The antibacterial activities of the extracts were tested against 100 laboratory strains belonging to 52 bacteria species by using disc diffusion assay. The results showed that methanol extract in taproots of both black and white radishes had antibacterial activity against Arthrobacter atrocyaneus, Corynebacterium ammoniagenes, Enterobacter hormaechei, Kocuria rosea, Neisseria subflava, Pantoea agglomerans, Proteus vulgaris, Psychrobacter immobilis and Shigella dysenteriae. White radish type showed antibacterial activity against Bacillus sphaericus and Corynebacterium flavescens as well. Based on results, it is possible to conclude that white radish has a stronger and broader spectrum of antibacterial activity as compared to black radish