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Öğe Bioassay-guided isolation and antiproliferative efficacy of extract loaded in chitosan nanoparticles and LC-QTOF-MS/MS analysis of Achillea magnifica(Elsevier, 2020) Taskin, Turgut; Dogan, Murat; Arabaci, TuranThis study investigated the antioxidant, anti-urease, anticholinesterase, and antiproliferative activities of different extracts of A. magnifica. The active compounds were isolated from chloroform extract, which has the strongest antiproliferative and antioxidant activities. The structures of the isolated compounds (elenolic acid, luteolin, eupatilin) were examined using spectroscopic techniques (NMR, UV, HR-MS). The antioxidant and antiproliferative effects of isolated compounds showed lower biological activity than those of the chloroform extract. Therefore, chitosan nanoparticles were prepared with this extract and characterized. The cytotoxic activities of the chitosan nanoparticles were examined, and they were found to have a strong antiproliferative activity similar to that of the chloroform extract. The ethanol extract had strong anti-urease and anticholinesterase activity compared with other extracts. Therefore, phenolic compounds that might be responsible for the biological activity were analysed by LC-QTOF-MS/MS. The ferulic acid derivative, apigenin 6 C pentoside 8 C hexoside, apigenin 6,8-di C-hexoside, vitexin, and diosmetin 8-C-glucoside (orientin 4'-methyl ether) compounds from this plant were analysed for the first time. The results showed that the chloroform-loaded chitosan nanoparticles had a strong antiproliferative activity in breast cancer cell lines (MCF-7, MDA-MB-231) and no toxic effect on normal cell lines (L-929), which suggested that this extract might be a potential candidate as a herbal medicine that can be investigated and evaluated in future cancer studies. Additionally, the potential use of ethanol extract as an anti-urease and anticholinesterase agent was revealed. (C) 2020 SAAB. Published by Elsevier B.V. All rights reserved.Öğe Clinical characteristics and phenotype-genotype analysis in Turkish patients with congenital hyperinsulinism; predominance of recessive KATP channel mutations(Bioscientifica Ltd, 2014) Demirbilek, Huseyin; Arya, Ved Bhushan; Ozbek, Mehmet Nuri; Akinci, Aysehan; Dogan, Murat; Demirel, Fatma; Houghton, JayneObjective: Congenital hyperinsulinism (CHI) is the commonest cause of hyperinsulinaemic hypoglycaemia in the neonatal, infancy and childhood periods. Its clinical presentation, histology and underlying molecular biology are extremely heterogeneous. The aim of this study was to describe the clinical characteristics, analyse the genotype phenotype correlations and describe the treatment outcome of Turkish CHI patients. Design and methods: A total of 35 patients with CHI were retrospectively recruited from four large paediatric endocrine centres in Turkey. Detailed clinical, biochemical and genotype information was collected. Results: Diazoxide unresponsiveness was observed in nearly half of the patients (n= 17; 48.5%). Among diazoxide-unresponsive patients, mutations in ABCC8/KCNJ11 were identified in 16 (94%) patients. Among diazoxide-responsive patients (n=18), mutations were identified in two patients (11%). Genotype phenotype correlation revealed that mutations in ABCC8/KCNJ11 were associated with an increased birth weight and early age of presentation. Five patients had p.L1171fs (c.3512de1) ABCC8 mutations, suggestive of a founder effect. The rate of detection of a pathogenic mutation was higher in consanguineous families compared with non-consanguineous families (87.5 vs 21%; P<0.0001). Among the diazoxide-unresponsive group, ten patients were medically managed with octreotide therapy and carbohydraterich feeds and six patients underwent subtotal pancreatectomy. There was a high incidence of developmental delay and cerebral palsy among diazoxide-unresponsive patients. Conclusions: This is the largest study to report genotype phenotype correlations among Turkish patients with CHI. Mutations in ABCC8 and KCNJ11 are the commonest causes of CHI in Turkish patients (48.6%). There is a higher likelihood of genetic diagnosis in patients with early age of presentation, higher birth weight and from consanguineous pedigrees.Öğe Donor Evaluation in Living Donor Liver Transplantation.(Wiley-Blackwell, 2013) Dirican, Abuzer; Baskiran, Adil; Dogan, Murat; Ates, Mustafa; Ozdemir, Fatih; Isik, Burak; Yilmaz, Sezai[Abstract Not Available]Öğe Factors Affecting eGFR Slope of Renal Transplant Patients During the First 2 Years(Elsevier Science Inc, 2019) Atay, Feyza Firat; Taskapan, Hulya; Berktas, Bayram; Yildirim, Okan; Dogan, Murat; Piskin, TurgutPurpose. In healthy individuals, glomerular filtration rate decreases by 1 mL/min/y after a peak level of 125.0 mL/min has been reached in adulthood. Any reduction greater than this is a progressive slope (slope more negative than 1 mL/min/y, stable [-1 to +1]), or an improvable slope if it shows more of an increase, that is, greater than +1.0 mL/min/y). The aim of the study was to determine the factors affecting estimated glomerular filtration rate (eGFR) slope during the first 2 years of renal transplant in patients with negative pretransplant panel-reactive antibody. Materials and Methods. The characteristics of 59 renal transplant patients, such as age, sex, etiology, and 2 years of laboratory data, were collected retrospectively. For each patient, the eGFR decline rate (slope) (mL/min-1/1.73 m(2)-1/y-1) was determined by linear regression analysis using all calculated eGFR values over the study period. Findings. Of 59 patients, 7 (11.8%) had a progressive slope, 22 (37.2%) had a stable slope, and 30 (50.8%) had an improvable slope. The first-year mean tacrolimus level was lower in patients with progressive slope than in the patients with stable slope and improvable slope (P < .022). The determinants of eGFR slope in multiple regression analysis were post-transplant hypertension (beta = 0.393; P = .002) and the first-year mean tacrolimus level (beta = 0.320; P =.01), whereas age, serum albumin, and 2-year mean tacrolimus level did not reach the level of significance. Conclusion. Keeping tacrolimus levels high in the first year to prevent eGFR declining is important.Öğe Management of non-vascular complications following renal transplantation using percutaneous approach(Edizioni Luigi Pozzi, 2018) Yildirim, Ismail Okan; Berktas, Bayram; Saglik, Semih; Piskin, Turgut; Dogan, Murat; Sahin, Idris; Taskapan, HulyaOBJECTIVE: Non-vascular complications following renal transplantation can cause graft failure. In this study, we present our two-year experience with percutaneous treatment for non-vascular complications following renal transplantation. PATIENTS AND METHODS: A total of 30 patients who underwent percutaneous radiological treatment between March 2014 and July 2016 were included in the study. RESULTS: Following renal transplantation, a total of 36 percutaneous radiological procedures which includes hydronephrosis secondary to ureteral stricture (n. 15), clinical symptom producing lymphocele due to pressure (14) and creatinine elevated nondilated grafts (n. 7) after excluding other reasons of creatinine elevation, were performed. Six patients received percutaneous treatment for both ureteral stricture and lymphocele. The patients underwent balloon dilatation and double-J ureteral stent due to ureteral stricture. The mean pre- and post-procedural creatinine levels were 4.36 +/- 2.84mg/dL and 2.17 +/- 1.24 mg/dL respectively (p=0.004), indicating a significant difference. For lymphocele treatment, sclerosing agents were injected and lymphatic leakage areas were injected with percutaneous glue. The mean pre- and post-procedural creatinine values were 2.97 +/- 1.78 mg/dL and 1.75 +/- 1.18 respectively (p=0.002), indicating a significant difference. Nephrostomy catheters were placed for patients with elevated creatinine levels and non-dilated collecting system. The mean pre- and post- nephrostomy creatinine levels were 3.55 +/- 2.36 mg/dL and 2.57 +/- 1.82 mg/dL respectively (p>0.05), indicating no statistically significant difference. CONCLUSION: The results of our study suggest that percutaneous treatment is an effective method for the treatment of non-vascular complications following renal transplantation, and, therefore, should be the first option for the preservation of graft functions.Öğe Management of non-vascular complications following renal transplantation using percutaneousapproach(Edızıonı luıgı pozzı, vıa panama 68, 00198 rome, ıtaly, 2018) Yildirim, Ismail Okan; Berktas, Bayram; Saglik, Semih; Piskin, Turgut; Dogan, Murat; Sahin, Idris; Taskapan, Hulya; Sarac, KayaOBJECTIVE: Non-vascular complications following renal transplantation can cause graft failure. In this study, we present our two-year experience with percutaneous treatment for non-vascular complications following renal transplantation. PATIENTS AND METHODS: A total of 30 patients who underwent percutaneous radiological treatment between March 2014 and July 2016 were included in the study. RESULTS: Following renal transplantation, a total of 36 percutaneous radiological procedures which includes hydronephrosis secondary to ureteral stricture (n. 15), clinical symptom producing lymphocele due to pressure (14) and creatinine elevated nondilated grafts (n. 7) after excluding other reasons of creatinine elevation, were performed. Six patients received percutaneous treatment for both ureteral stricture and lymphocele. The patients underwent balloon dilatation and double-J ureteral stent due to ureteral stricture. The mean pre- and post-procedural creatinine levels were 4.36 +/- 2.84mg/dL and 2.17 +/- 1.24 mg/dL respectively (p=0.004), indicating a significant difference. For lymphocele treatment, sclerosing agents were injected and lymphatic leakage areas were injected with percutaneous glue. The mean pre- and post-procedural creatinine values were 2.97 +/- 1.78 mg/dL and 1.75 +/- 1.18 respectively (p=0.002), indicating a significant difference. Nephrostomy catheters were placed for patients with elevated creatinine levels and non-dilated collecting system. The mean pre- and post- nephrostomy creatinine levels were 3.55 +/- 2.36 mg/dL and 2.57 +/- 1.82 mg/dL respectively (p>0.05), indicating no statistically significant difference. CONCLUSION: The results of our study suggest that percutaneous treatment is an effective method for the treatment of non-vascular complications following renal transplantation, and, therefore, should be the first option for the preservation of graft functions.Öğe A Novel Technique in the Treatment of Lymphoceles After Renal Transplantation: C-Arm Cone Beam CT-Guided Percutaneous Embolization of Lymphatic Leakage After Lymphangiography(Lippincott Williams & Wilkins, 2018) Yildirim, Ismail Okan; Piskin, Turgut; Duman, Enes; Firat, Ali; Dogan, Murat; Taskapan, Huelya; Sahin, IdrisBackground We aimed to evaluate the efficacy of percutaneous embolization after lymphangiography using C-arm cone-beam computed tomography (CBCT) performed at the site of lymphatic leakage in patients with postrenal transplant lymphocele. Methods Between July 2014 and August 2017, 13 patients not responding to percutaneous ethanol sclerotherapy and conservative treatment for recurrent lymphocele after renal transplant were included. The mean age of the patients was 56.38 9.91 (range, 36-70) years, and it comprised 9 men and 4 women. All patients underwent intranodal lymphangiography. C-arm CBCT-guided percutaneous embolization was performed in patients with confirmed lymphatic leakage. Patients who had no lymphatic leakage underwent drainage with fibrin glue injection. Results Lymphatic leakage was observed in 9 patients after lymphangiography, and they underwent CBCT-guided percutaneous N-butyl-2-cyanoacrylate embolization. The volume of lymphatic drainage reduced to less than 10 mL in 8 patients. One patient who was not responding to embolization was treated surgically, after percutaneous drainage and fibrin glue injection. Lymphatic leakage was not observed in 4 patients after lymphangiography. Of these, 3 patients showed a reduction in the amount of lymphatic drainage after lymphangiography. All 4 patients underwent percutaneous drainage and fibrin glue injection. One patient did not respond to the treatment and was treated surgically. Prelymphangiography and postlymphangiography and embolization, the volume of lymphatic drainage was 113.07 +/- 21.75 mL, and 53.84 +/- 30.96 mL, respectively, and statistically significant decrease was detected (P < 0.005). Conclusions Lymphangiography and CBCT-guided percutaneous embolization procedures might be an effective treatment method for patients with lymphocele refractory to treatment.Öğe A novel technique in the treatment of lymphoceles after renal transplantation: c-arm cone beamct-guided percutaneous embolization of lymphatic leakage after lymphangiography(Lıppıncott wıllıams & wılkıns, two commerce sq, 2001 market st, phıladelphıa, pa 19103 usa, 2018) Yildirim, Ismail Okan; Piskin, Turgut; Duman, Enes; Firat, Ali; Dogan, Murat; Taskapan, Huelya; Sahin, Idris; Sarac, KayaBackground We aimed to evaluate the efficacy of percutaneous embolization after lymphangiography using C-arm cone-beam computed tomography (CBCT) performed at the site of lymphatic leakage in patients with postrenal transplant lymphocele. Methods Between July 2014 and August 2017, 13 patients not responding to percutaneous ethanol sclerotherapy and conservative treatment for recurrent lymphocele after renal transplant were included. The mean age of the patients was 56.38 9.91 (range, 36-70) years, and it comprised 9 men and 4 women. All patients underwent intranodal lymphangiography. C-arm CBCT-guided percutaneous embolization was performed in patients with confirmed lymphatic leakage. Patients who had no lymphatic leakage underwent drainage with fibrin glue injection. Results Lymphatic leakage was observed in 9 patients after lymphangiography, and they underwent CBCT-guided percutaneous N-butyl-2-cyanoacrylate embolization. The volume of lymphatic drainage reduced to less than 10 mL in 8 patients. One patient who was not responding to embolization was treated surgically, after percutaneous drainage and fibrin glue injection. Lymphatic leakage was not observed in 4 patients after lymphangiography. Of these, 3 patients showed a reduction in the amount of lymphatic drainage after lymphangiography. All 4 patients underwent percutaneous drainage and fibrin glue injection. One patient did not respond to the treatment and was treated surgically. Prelymphangiography and postlymphangiography and embolization, the volume of lymphatic drainage was 113.07 +/- 21.75 mL, and 53.84 +/- 30.96 mL, respectively, and statistically significant decrease was detected (P < 0.005). Conclusions Lymphangiography and CBCT-guided percutaneous embolization procedures might be an effective treatment method for patients with lymphocele refractory to treatment.Öğe Surgical complications after pediatric kidney transplantation; Single center experience(2021) Okut, Gokalp; Dogan, Gulec Mert; Dogan, MuratAim: Kidney transplantation is the most effective treatment for end stage renal disease in all age groups. In this study, we analyzed our surgical complications after pediatric kidney transplantation. Materials and Methods: The data of pediatric patients who underwent kidney transplantation in our center between April 2009 and April 2019 were retrospectively analyzed. We divided the complications of the patients requiring secondary surgery into two groups as early and late according to their appearance in the first week and after. Wound problems, local or systemic infections, incisional hernias were not included in the surgical complication group. Results: Among the 27 pediatric kidney transplant procedures performed in our center, there were 11 surgical complications (6% early and 5 late complications) (40%). 4 of the complications in the early transplant period were due to bleeding, 1 was due to the torsion of the vascular structures belonging to the graft, and 1 was due to lymphocele development. Three of the late complications were ureteral stenosis, and two were due to vesicoreteral reflux to the transplant kidney. In our study group, there was no patient loss due to transplantation. Graft loss was not related to surgical complication in any patient. Conclusion: Pediatric kidney transplantation is a procedure that can be safely performed in our center, by looking at our patient and graft survival results and low surgical complications. Immediate identification and treatment of any complications are critical to the graft and patient survival.
