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      • SCOPUSKCI등재

        Lipid accumulation product is a predictor of nonalcoholic fatty liver disease in childhood obesity

        Ozcabi, Bahar,Demirhan, Salih,Akyol, Mesut,Akay, Hatice Ozturkmen,Guven, Ayla The Korean Pediatric Society 2019 Clinical and Experimental Pediatrics (CEP) Vol.62 No.12

        Background: Lipid accumulation product (LAP) is associated with the presence and severity of nonalcoholic fatty liver disease (NAFLD) in adults. Purpose: Here we evaluated the ability of LAP to predict NAFLD in obese children. Methods: Eighty obese children (38 girls; age 6-18 years) were included. Anthropometric measurements and biochemical values were obtained from the patients' medical records. LAP was calculated as [waist circumference (WC) (cm) - 58]×triglycerides (mmol/L) in girls; [WC (cm) - 65]×triglycerides (mmol/L) in boys. The minLAP and adjLAP were described (3% and 50% of WC values, respectively) and the total/high-density lipoprotein cholesterol index (TC/HDL-C) was calculated. NAFLD was observed on ultrasound, and patients were divided into 3 groups by steatosis grade (normal, grade 0; mild, grade 1; moderate-severe, grade 2-3). The area under the curve (AUC) and appropriate index cutoff points were calculated by receiver operator characteristic analysis. Results: LAP was positively correlated with puberty stage (rho=0.409; P<0.001), fasting insulin (rho= 0.507; P<0.001), homeostasis model assessment of insulin resistance (rho=0.470; P<0.001), uric acid (rho=0.522; P<0.001), and TC/HDL-C (rho=0.494; P<0.001) and negatively correlated with HDL-C (rho=-3.833; P<0.001). LAP values could be used to diagnose hepatosteatosis (AUC=0.698; P=0.002). The LAP, adjLAP, and minLAP cutoff values were 42.7 (P=0.002), 40.05 (P=0.003), and 53.47 (P= 0.08), respectively. For LAP, the differences between the normal and mild groups (P=0.035) and the normal and moderate-severe groups were statistically significant (P=0.037), whereas the difference between the mild and moderate-severe groups was not (P>0.005). There was a statistically significant difference between the normal and mild groups for adjLAP (P=0.043) but not between the other groups (P>0.005). There was no significant intergroup difference in minLAP (P>0.005). Conclusion: LAP is a powerful and easy tool to predict NAFLD in childhood. If LAP is ≥42.7, NAFLD should be suspected. This is the first study to assess LAP diagnostic accuracy for childhood obesity.

      • KCI등재후보

        Nasogastric tube placement into the hepaticojejunostomy anastomosis in pancreaticoduodenectomy

        Bulent Kaya,Yetkin Ozcabi,Iksan Tasdelen,Ender Onur,Kemal Memisoglu 한국간담췌외과학회 2016 한국간담췌외과학회지 Vol.20 No.2

        Hepaticojejunostomy is an important part of many surgical procedures including pancreaticoduodenectomy. Biliary leakage from hepaticojejunostomy may be associated with intraabdominal abscess formation, biliary peritonitis, and even mortality. A 72-year-old female patient was admitted to our hospital with obstructive jaundice. After initial evaluation, she was diagnosed with distal common bile duct obstruction without accurate diagnosis. Before planned pancreaticoduodenectomy, biliary drainage with a T-tube was performed due to the presence of cholangitis. After the first operation, pancreaticoduodenectomy was performed. Postinflammatory changes around the hilar region made the hepaticojejunostomy risky. A bilio-digestive anastomosis was performed using a new technique. A nasogastric tube was placed into the common bile duct proximal to the anastomosis. The postoperative course of the patient was uneventful. The use of a nasogastric tube as a stent in risky hepaticojejunostomies is a simple technique that can be beneficial.

      • KCI등재후보

        Nasogastric tube placement into the hepaticojejunostomy anastomosis in pancreaticoduodenectomy

        Bulent Kaya,Yetkin Ozcabi,Iksan Tasdelen,Ender Onur,Kemal Memisoglu 한국간담췌외과학회 2016 Annals of hepato-biliary-pancreatic surgery Vol.20 No.2

        Hepaticojejunostomy is an important part of many surgical procedures including pancreaticoduodenectomy. Biliary leakage from hepaticojejunostomy may be associated with intraabdominal abscess formation, biliary peritonitis, and even mortality. A 72-year-old female patient was admitted to our hospital with obstructive jaundice. After initial evaluation, she was diagnosed with distal common bile duct obstruction without accurate diagnosis. Before planned pancreaticoduodenectomy, biliary drainage with a T-tube was performed due to the presence of cholangitis. After the first operation, pancreaticoduodenectomy was performed. Postinflammatory changes around the hilar region made the hepaticojejunostomy risky. A bilio-digestive anastomosis was performed using a new technique. A nasogastric tube was placed into the common bile duct proximal to the anastomosis. The postoperative course of the patient was uneventful. The use of a nasogastric tube as a stent in risky hepaticojejunostomies is a simple technique that can be beneficial.

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