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    Atraumatic Osteonecrosis After Estrogen Replacement Therapy Associated with Low Protein S Level in a Patient with Turner Syndrome
    (Sage Publications Inc, 2010) Üreten, Kemal; Öztürk, M. Akif; Bostancı, Ahmet; Çeneli, Özcan; Özbek, Mustafa; Haznedaroğlu, İbrahim C.
    Atraumatic osteonecrosis has been associated with a variety of clinical conditions including corticosteroid usage, alcoholism, infections, hyperbaric events, storage disorders, marrow-infiltrating diseases, coagulation defects, and some autoimmune diseases. Osteonecrosis due to thrombophilia is an extremely rare condition with only few cases reported previously in the literature. Hormone-replacement therapies cause increased risk of venous thrombosis, probably by causing a synergistic effect with inherited clotting defects. In this article, we report a young female with Turner syndrome, who developed avascular necrosis of the femoral head during treatment with oral estrogen, which was associated with low protein S levels.
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    Automated Classification of Rheumatoid Arthritis, Osteoarthritis, and Normal Hand Radiographs with Deep Learning Methods
    (Springer, 2022) Üreten, Kemal; Maraş, Hadi Hakan
    Rheumatoid arthritis and hand osteoarthritis are two different arthritis that causes pain, function limitation, and permanent joint damage in the hands. Plain hand radiographs are the most commonly used imaging methods for the diagnosis, differential diagnosis, and monitoring of rheumatoid arthritis and osteoarthritis. In this retrospective study, the You Only Look Once (YOLO) algorithm was used to obtain hand images from original radiographs without data loss, and classification was made by applying transfer learning with a pre-trained VGG-16 network. The data augmentation method was applied during training. The results of the study were evaluated with performance metrics such as accuracy, sensitivity, specificity, and precision calculated from the confusion matrix, and AUC (area under the ROC curve) calculated from ROC (receiver operating characteristic) curve. In the classification of rheumatoid arthritis and normal hand radiographs, 90.7%, 92.6%, 88.7%, 89.3%, and 0.97 accuracy, sensitivity, specificity, precision, and AUC results, respectively, and in the classification of osteoarthritis and normal hand radiographs, 90.8%, 91.4%, 90.2%, 91.4%, and 0.96 accuracy, sensitivity, specificity, precision, and AUC results were obtained, respectively. In the classification of rheumatoid arthritis, osteoarthritis, and normal hand radiographs, an 80.6% accuracy result was obtained. In this study, to develop an end-to-end computerized method, the YOLOv4 algorithm was used for object detection, and a pre-trained VGG-16 network was used for the classification of hand radiographs. This computer-aided diagnosis method can assist clinicians in interpreting hand radiographs, especially in rheumatoid arthritis and osteoarthritis.
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    Corneal thickness and endothelial changes in long-term hydroxychloroquine use
    (Taylor & Francis Ltd, 2019) Oğurel, Tevfik; Özer, Murat Atabey; Akbulut, Yaprak; Gökçınar, Nesrin Büyüktortop; Onaran, Zafer; Üreten, Kemal
    Objective: To determine possible associations between long-term HCQ use and corneal changes in patients who used HCQ for at least 3 years. Materials and methods: The study included 62 healthy controls and 62 consecutive patients who used HCQ for the treatment of rheumatologic disease and were referred to the ophthalmology department between August 2018 and November 2018 for HCQ retinal toxicity screening. Central corneal thickness (CCT), corneal endothelial cell density (ECD), the coefficient of variation (CV) of cell size, and the percentage of hexagonal cells (HEX%) were measured to evaluate changes in the cornea. Results: The mean age of the patient group and control group was 50.10 +/- 10.91 and 50.53 +/- 10.67 years, respectively. The mean ECD was 2742 +/- 347 (cells/mm(2)) in the patient group and 2875 +/- 188 cells/mm(2) in the control group. There was a significant difference between groups (p = 0.01). The mean CCT was 567.05 +/- 32.35 mu m in the patient group and 540.15 +/- 38.50 mu m in the control group. CCT was significantly higher in the patient group compared with control group (p < 0.001). There was no significant difference between groups in terms of mean CV and HEX values (p > 0.05). Conclusions: Patients using long-term HCQ demonstrated lower ECD and higher CCT than the control group. However, the CV of cell sizes and the HEX % values were not significantly different from the controls.