1992 : Ege University Faculty of Medicine, IZMIR
1992 - 1993 : Diyarbakır Silvan State Hospital
1993 - 1994 : İzmir Gürçeşme İsmetpaşa Health Center
1994 - 1995 : Maltepe Military High School
1996 - 2010 : 112 Emergency Services Branch Office.
Evaluation of Hepatic Steatosis and Fibrosis in Steatotic Liver Disease Ultrasound-Derived Fat Fraction (UDFF) and Auto pSWE by Using Deep Abdominal Transducer (DAX) and Liver Biopsy Correlation
By
Kale, AB (Kale, Ahmet Burak) [1] ; Farasat, M (Farasat, Mustafa) [1] ; Pekindil, G (Pekindil, Gokhan) [1] ; Ayhan, S (Ayhan, Semin) [2] ; Tarhan, S (Tarhan, Serdar) [1] ; Buran, T (Buran, Tahir) [3]
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JOURNAL OF ULTRASOUND IN MEDICINE
Volume
44
Issue
12
Page
2243-2255
DOI
10.1002/jum.70005
Published
DEC 2025
Early Access
JUL 2025
Indexed
2025-07-27
Document Type
Article
Jump to
Abstract
Objectives To evaluate the diagnostic performance of ultrasound-derived fat fraction (UDFF) in detecting and grading hepatosteatosis using liver histology as the reference, and to assess the effectiveness of point shear wave elastography (pSWE), UDFF, and auto-pSWE in diagnosing steatohepatitis and detecting fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD).
Methods In this prospective study, patients underwent liver biopsy following UDFF and pSWE measurements using deep abdominal transducer (DAX) and conventional abdominal probes by 2 operators. Imaging findings were compared with histopathology to assess diagnostic performance. Associations between nonalcoholic fatty liver disease activity score (NAS), fibrosis stage, and imaging parameters were also evaluated.
Results A total of 121 patients were included. The median age was 50 years, and 57 (41%) were male. Histology confirmed steatotic liver disease in 43 cases. Excellent interobserver agreement was observed for UDFF (ICC = 0.974), pSWE (ICC = 0.958), and auto-pSWE (ICC = 0.960). UDFF showed a stepwise increase with steatosis grade and was moderately correlated with histological fat content (r = 0.676 for Sonographer 1, r = 0.638 for Sonographer 2; P < .001). For detecting S >= 1 steatosis, the optimal UDFF thresholds were >= 8.4% (Area Under the Curve (AUC) = 0.968; Se = 92.5%, Sp = 93.2%) for Sonographer 1 and >= 8.6% (AUC = 0.951; Se = 90.0%, Sp = 86.3%) for Sonographer 2. For moderate steatosis (S >= 2), the cutoffs were >= 10.4% (AUC = 0.932; Se = 100%, Sp = 79.6%) and >= 10.6% (AUC = 0.925; Se = 100%, Sp = 76.5%), and for severe steatosis (S = 3), >= 18.3% (AUC = 0.961; Se = 100%, Sp = 77.4%) and >= 18.7% (AUC = 0.949; Se = 100%, Sp = 77.4%) for Sonographer 1 and 2, respectively. UDFF positively correlated with body mass index and subcutaneous fat thickness, and negatively with both pSWE and auto-pSWE. A strong correlation was observed between pSWE and auto-pSWE for both observers. A weak positive correlation was found between NAS and auto-pSWE in MASLD cases. The optimal thresholds to detect fibrosis (>= F1) were 5.05 and 4.95 kPa for Sonographer 1, and 5.05 and 4.85 kPa for Sonographer 2, for pSWE and auto-pSWE measurements, respectively.
Conclusion DAX-derived UDFF and auto-pSWE are reproducible, noninvasive biomarkers with strong diagnostic value in assessing steatosis and fibrosis in MASLD.
Keywords
Author Keywords
deep abdominal transducer (DAX) fibrosis liver biopsy quantitative ultrasounds teatotic liver
THE ROLE OF ENDOSCOPY-INDEPENDENT GASTROINTESTINAL BLEEDING SCORES IN PREDICTING 30-DAY MORTALITY IN AGED OVER 65
By
Elbi, H (Elbi, Huseyin) [1] ; Vatansever Balcan, M (Vatansever Balcan, Merve) [2] ; Buran, T (Buran, Tahir) [3] ; Kasap, E (Kasap, Elmas) [3]
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Source
TURKISH JOURNAL OF GERIATRICS-TURK GERIATRI DERGISI
Volume
27
Issue
1
Page
79-87
DOI
10.29400/tjgeri.2024.381
Published
2024
Indexed
2024-07-14
Document Type
Article
Abstract
Introduction: The aim of this study was to assess the power of clinical findings and scoring systems to predict mortality in patients over 65 years of age with non-variceal upper gastrointestinal bleeding.
Materials and Method: Data on demographic profiles and risk estimation scores were retrospectively extracted from electronic hospital medical records and other electronic databases using a standard data extraction form. The AIMS65, pre-Rockall, modified Glasgow-Blatchford, T, and Baylor bleeding scores were calculated to estimate the 30-day mortality risk. The inclusion criteria were patients aged 65 and over who presented with active bleeding symptoms and had been diagnosed with acute upper gastrointestinal bleeding by the gastroenterology department.
Results: The mean age was 75.23 years, and 23.6% of the patients died within 30 days. The 30-day mortality was associated with albumin levels, malignancy, and intensive care unit hospitalization. An inverse relationship was found between the albumin level and mortality, whereas the presence of cancer and the need for intensive care were associated with 2.8-fold and 2.2-fold increases in the risk of death, respectively. The AIMS65 score (AUC: 0.794) had the highest discriminative ability to predict 30-day mortality among all risk scores.
Conclusion: Albumin levels, malignancy presence, and ICU admission were indicators of mortality risk in elderly patients with upper gastrointestinal bleeding. Calculating all the scores, excluding the Baylor Bleeding score, is beneficial for assessing the risk of mortality associated with upper gastrointestinal bleeding. The AIMS65 score demonstrates the highest discriminative ability. However, using these risk-scoring systems necessitates additional data.
Keywords
Author Keywords
Gastrointestinal Hemorrhage Mortality Aged
Can the FIB-4 score predict the severity of acute pancreatitis in NAFLD?
By
Kirdok, K (Kirdok, Kutay) [1] ; Yogurtcu, Ö (Yogurtcu, Ozge) [2] ; Buran, T (Buran, Tahir) [3] ; Kasap, E (Kasap, Elmas) [3]
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Source
Volume
14
Issue
1
DOI
10.1186/s43066-024-00313-y
Article Number
8
Published
JAN 27 2024
Indexed
2024-02-03
Document Type
Article
Jump to
Abstract
BackgroundNon-alcoholic fatty liver disease (NAFLD) is a liver pathology. NAFLD's prevalence is increasing in the world and because of the increase non-invasive methods are gaining importance in diagnosis. The Fibrosis 4 (FIB-4) score is one of the most commonly used non-invasive scoring methods for diagnosing NAFLD today. Acute pancreatitis is a disease with inflammation and high morbidity. There are studies indicating that acute pancreatitis progresses more severely in patients with NAFLD. In our study, it was aimed to define the possible relationship between the FIB-4 score and the severity of acute pancreatitis, which has not been investigated before and contribute to the literature.MethodsOur study was conducted by retrospectively scanning 124 patients diagnosed with acute pancreatitis between 2018 and 2020. The patients were compared with the presence of NAFLD and the FIB-4 score results in those with NAFLD.ResultsThe 48th-hour Ranson score was found to be statistically significantly higher in patients with NAFLD compared to those without NAFLD. In patients with NAFLD, the total billurbin, direct billurbin, AST, ALT, ALP, GGT, and Ranson scores were found to be statistically significantly higher in those with FIB-4 score >= 2.67.ConclusionAs liver fibrosis increases in patients with NAFLD, it is suggested that liver damage accompanying acute pancreatitis increases, and the prognosis of acute pancreatitis worsens. There is a need for further studies to be conducted while centering more on this subject, which has not been investigated before in the literature.
Keywords
Author Keywords
NAFLDAcute pancreatitisFIB-4Ranson criteria Billurbine
Molecular analyses of ADAMTS-1,-4,-5, and IL-17 a cytokine relationship in patients with ulcerative colitis
By
Buran, T (Buran, Tahir) [1] ; Batir, MB (Batir, Muhammet Burak) [2] ; Çam, FS (Cam, Fethi Sirri) [3] ; Kasap, E (Kasap, Elmas) [1] ; Çöllü, F (Collu, Fatih) [2] ; Çelebi, HBG (Celebi, Hamide Betul Gerik) [4] ; Sahin, M (Sahin, Mustafa) [5]
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Source
Volume
23
Issue
1
DOI
10.1186/s12876-023-02985-z
Article Number
345
Published
OCT 5 2023
Indexed
2023-10-30
Document Type
Article
Jump to
Abstract
BackgroundUlcerative colitis (UC) is a chronic inflammatory bowel disease that develops due to the impaired immune response in genetically susceptible individuals, and its etiopathogenesis is not fully elucidated. IL-17 A is a cytokine that is produced by a type of immune cell called Th17 cells and is involved in the immune response and inflammation. On the other hand, ADAMTS-1, -4, and - 5 are enzymes that are involved in the breakdown of extracellular matrix proteins, including proteoglycans, which are important components of the intestinal wall. This study aimed to evaluate the relationship between interleukin 17 (IL-17 A) cytokine, which plays a role in the pathogenesis of ulcerative colitis, and the inflammation-controlled a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-1, -4, and - 5 protein members.MethodsBowel tissue samples and blood serum from 51 patients with UC and 51 healthy controls were included in this study. mRNA expression levels of the ADAMTS-1, -4, -5, and IL-17 A were analyzed by RT-qPCR, and immunohistochemical analyses were performed to evaluate ADAMTS-1, -4, -5, and IL-17 A proteins in tissue samples. In addition, ELISA analysis determined serum levels of the ADAMTS-1, -4, -5, and IL-17 A.ResultsRT-qPCR results reveal that the expression of ADAMTS-1, -4, -5, and IL-17 A genes in the UC tissue samples were significantly high according to the control tissue samples. Also, ADAMTS-1, -4, -5, and IL-17 A proteins revealed enhanced expression pattern UC groups according to the control. Also, ADAMTS-1, -4, -5, and IL-17 A protein showed cytoplasmic localization patterns in both control and UC groups. The serum levels of ADAMTS-1,-5, and IL-17 A were significantly higher in UC samples than in the control group.ConclusionsWe observed a positive correlation between the ADAMTS-1, -5 and IL17A cytokine expression in UC samples. These results provide a new understanding of controlling crucial ADAMTS family protein members by IL-17 A cytokines with UC.
Keywords
Author Keywords
Ulcerative colitis IL-17AADAMTS Inflammation
The Role of Endoplasmic Reticulum Stress in Gastroesophageal Reflux Disease Symptoms and Treatment
By
Kasap, E (Kasap, Elmas) [1] ; Buran, T (Buran, Tahir) [1] ; Avcu, AT (Avcu, Aysun Toraman) [2] , [5] ; Hasdemir, PS (Hasdemir, Pinar Solmaz) [2] , [6] ; Balcan, E (Balcan, Erdal) [3] ; Aktan, Ç (Aktan, Cagdas) [4] ; Korkmaz, M (Korkmaz, Mehmet) [2]
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Source
TURKISH JOURNAL OF GASTROENTEROLOGY
Volume
34
Issue
5
Page
533-541
DOI
10.5152/tjg.2023.21282
Published
MAY 2023
Indexed
2023-09-30
Document Type
Article
Abstract
Background: Gastroesophageal reflux disease is a common condition worldwide. There is no curative treatment for gastroesophageal reflux disease. Endoplasmic reticulum stress leads to the activation of the unfolded protein response and has an important role in inflammation. The aim is to determine the role of endoplasmic reticulum stress in the follow-up of individuals with gastroesophageal reflux disease and the temporal changes of endoplasmic reticulum stress markers with treatment. Methods: Twenty-four subjects in total were recruited prospectively, of whom 15 had nonerosive reflux disease. Two biopsies from 2 cm above the esophagogastric junction, 2 biopsies from gastric antrum mucosa, and 2 biopsies from gastric corpus mucosa were taken. Simultaneously, 2 tubes of venous blood samples were drawn from each individual (1 tube for studying the genetic markers and 1 tube for analyzing the CYP2C19 polymorphism). Results: The mean age was 42.3 +/- 17.6 for women and 34.66 +/- 11.2 for men. Pantoprazole, esomeprazole, rabeprazole, and lansoprazole preparations were used for treatment. There was no significant difference between tissue and blood samples for panel genes ATF-6, XBP-1, DDIT-3, DNAJC-10, and EIF-2-AK before treatment. There was a significant decrease in the level of ATF-6, XBP-1, DNAJC-9, EIF2-AK, and NF-2L-2 genes in blood after treatment. In the comparison of proton pump inhibitors, significant decreases in the expression of the ATF-6, XBP-1, and DNAJC-9 mRNAs were detected in blood from individuals after treatment. Conclusion: Endoplasmic reticulum stress can be for evaluating the clinical improvement and the effectiveness of treatment in gastroesophageal reflux disease.
Keywords
Author Keywords
Endoplasmic reticulum stress GERD heartburn proton pump inhibitors regurgitation
Recent trends in the antibiotic resistance of Helicobacter pylori in patient with dyspepsia
By
Buran, T (Buran, Tahir) [1] ; Surucuoglu, S (Surucuoglu, Suheyla) [2] ; Kurutepe, S (Kurutepe, Semra) [2] ; Gazi, H (Gazi, Horu) [2]
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Source
Volume
101
Issue
26
DOI
10.1097/MD.0000000000029801
Article Number
e29801
Published
JUL 1 2022
Indexed
2022-07-10
Document Type
Article
Jump to
Abstract
The aim of this study was to determine the resistance status and to identify the point mutations conferring resistance to clarithromycin and fluoroquinolones among dyspeptic patients in Manisa, Turkey. The study included a sample of 140 patients with an indication for upper gastrointestinal endoscopy randomly selected from 2100 dyspeptic patients attending to the Gastroenterology and Endoscopy Unit at Manisa Celal Bayar University Hafsa Sultan Hospital between April 2016 and May 2018. A commercially available GenoType Helico DR test was used to detect the presence of Helicobacter pylori and mutations associated with resistance to clarithromycin and fluoroquinolones in biopsy specimens. In total, 116 (82.9%) of 140 biopsies obtained from the same number of dyspeptic patients were positive for H pylori and 82 (approximately 71%) of them harbored resistance mutations in 23SrRNA and/or gyrA. Resistance to clarithromycin, levofloxacin, or both were detected in 43.1% (50/116), 27.6% (32/116), and 16/116 (13.8%) of tested biopsies, respectively. The most common mutation conferring resistance to clarithromycin was A2147G (96%, 48/50). Resistance to fluoroquinolones was frequently due to mutation in codon 91 and the most common mutation detected was D91G (34.4%). Heteroresistance patterns were observed in 48.0% (24/50) of clarithromycin-resistant samples and 28.1% (9/32) of levofloxacin-resistant samples. The resistance rates and detected mutations in this study are in line with the country data. However, to achieve better H pylori eradication and to prevent the spread of multidrug-resistant strains in Turkey, the molecular-based susceptibility tests should be considered routinely. Further studies are needed to determine the various mutations among resistant strains.
Keywords
Author Keywords
antimicrobial resistance clarithromycin Helicobacter pylori levofloxacine
Enzyme Replacement Therapy in a Gaucher Family
By
Erdem, N (Erdem, Neslihan) [1] ; Buran, T (Buran, Tahir) [2] ; Berber, I (Berber, Ilhami) [3] ; Aydogdu, I (Aydogdu, Ismet) [4]
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Source
JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION
Volume
110
Issue
4
Page
330-333
DOI
10.1016/j.jnma.2017.06.013
Published
AUG 2018
Indexed
2018-08-31
Document Type
Article
Abstract
Gaucher disease is a lipid storage disorder due to deficiency of beta glucocerebrosidase. It's an autosomal recessive disease and as a result of this enzyme deficiency, glucocerebroside accumulates in various types of tissues like liver, brain spleen and bone marrow. We aimed to describe the effects of enzyme replacement therapy in three members of a family with Gaucher disease and to emphasize screening of the family members of the patients with Gaucher disease. Furthermore, late diagnosis and treatment in these patients have a minimal effect on improvement of the quality of Fie, and early diagnosis and treatment are very important in Gaucher disease.
Keywords
Author Keywords
Gaucher Enzyme replacement therapy Early treatment
Determination of Drug Resistance Mutations of NS3 Inhibitors in Chronic Hepatitis C Patients Infected with Genotype 1
By
Sanlidag, T (Sanlidag, Tamer) [1] , [2] ; Sayan, M (Sayan, Murat) [2] , [3] ; Akçali, S (Akcali, Sinem) [1] ; Kasap, E (Kasap, Elmas) [4] ; Buran, T (Buran, Tahir) [4] ; Arikan, A (Arikan, Ayse) [5] , [6]
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Source
Volume
51
Issue
2
Page
145-155
DOI
10.5578/mb.53824
Published
APR 2017
Indexed
2017-06-12
Document Type
Article
Abstract
Direct-acting antiviral agents (DAA) such as NS3 protease inhibitors is the first class of drugs used for chronic hepatitis C (CHC) treatment. NS3 inhibitors (PI) with low genetic barrier have been approved to be used in the CHC genotype 1 infections, and in the treatment of compensated liver disease including cirrhosis together with pegile interferon and ribavirin. Consequently, the development of drug resistance during DAA treatment of CHC is a major problem. NS3 resistant variants can be detected before treatment as they can occurnaturally. The aim of this study was to investigate new and old generation NS3 inhibitors resistance mutations before DAA treatment in hepatitis C virus (HCV) that were isolated from CHC. The present study was conducted in 2015 and included 97 naive DAA patients infected with HCV genotype 1, who were diagnosed in Manisa and Kocaeli cities of Turkey. Magnetic particle based HCV RNA extraction and than RNA detection and quantification were performed using commercial real-time PCR assay QIASypmhony + Rotorgene Q/ArtusHCV QS-RGQ and COBAS Ampliprep/COBAS TaqMan HCV Tests. HCV NS3 viral protease genome region was amplified with PCR and mutation analysis was performed by Sanger dideoxy sequencing technique of NS3 protease codons (codon 32-185). HCV NS3 protease inhibitors; asunaprevir, boceprevir, faldaprevir, grazoprevir, pariteprevir, simeprevir and telaprevir were analysed for resistant mutations by Geno2pheno-HCV resistance tool. HCV was genotyped in all patients and 88 patients (n= 88/97, 91%) had genotype 1. Eight (n= 8/97, 8.2%) and 80 (n= 80/97, 82.4%) HCC patients were subgenotyped as 1a and 1b, respectively. Many aminoacid substitutions and resistance mutations were determined in 39/88 (44%) patients in the study group. Q80L, S122C/N, S138W were defined as potential substitutions (6/88 patients; 7%); R109K, R117C, S122G, I132V, I170V, N174S were described as potential resistance (34/88 patients; 39%); V36L, T54S, V55A, Q80H were characterized as resistance (7/88 patients; 8%) and Q80K, A156S were defined as high resistance (3/88 patients; 3%) mutations. Based on resistance and high resistance mutations, clinically significant mutations were defined in 10/88 (11%) of the patients. Our study shows that it is essential to analyse HCV NS3 protease inhibitors drug resistance before DAA treatment of CHC patients. On the other hand, our results pointed out that analysis of NS5A and NS5B genome region mutations may also be required in the near future.
Keywords
Author Keywords
Chronic hepatitis CHCV sequence analysis genotype/subtype drug resistance mutation