Makale Koleksiyonu

Bu koleksiyon için kalıcı URI

https://hdl.handle.net/20.500.12587/17875

Listeleniyor 1 - 20 / 200

Aseptic meningitis caused by Coronavirus OC43 in a child: A case report
(Bayrakol Medical Publisher, 2022) Demirbaş, Yasemin; Alpcan, Ayşegül; İnal, Mikail; Güney, Şeyma; Tursun, Serkan; Kandur, Yaşar
Human coronavirus OC43 (HCoV-OC43) is one of the coronaviruses that cause the mild cold. On the other hand, extra-respiratory manifestations such as cen-tral nervous system infections with HCoV-OC43 are very rarely reported. We present a case of a previously healthy immunocompetent child with acute aseptic meningitis, as a result of HCoV-OC43 who admitted to the emergency department with a complaint of unconsciousness.. Respiratory tract and cerebrospinal fluid culture showed HCoV-OC43 in viral screening. During the follow-up period, the patient was completely asymptomatic, with normalized consciousness. The clinicians should keep in mind that HCoV-OC43 can be the etiological agent in the differential diagnosis of aseptic meningitis in immunocompetent individuals with reversible neurological symptoms.
Evaluation of the anterior shoulder instability using ultrasound shear wave elastography
(Turkish Joint Diseases Foundation, 2023) Sarıkaya, Pelin Zeynep Bekin; Sarıkaya, Baran; Bozkurt, Celal; Dere, Osman; Batur, Elif Balevi; Duşak, Abdurrahim
Objectives: This study aims to evaluate the soft tissue stiffness which has a prominent role in shoulder instability using ultrasound (US) shear wave elastography (SWE) and to compare the results with healthy shoulders. Patients and methods: Between December 2018 and January 2020, a total of 33 male patients (mean age: 26 +/- 4.3 years; range, 18 to 35 years) who underwent arthroscopic repair for traumatic isolated anterior glenohumeral instability were included in this prospective study. The shoulder girdle was evaluated with US SWE in patients with traumatic anterior instability. Deltoid (D), supraspinatus (SS), infraspinatus (IS), subscapularis (SSC), and long head of biceps (LHB) tendons forming the shoulder girdle and anterior labrum (L) were evaluated with SWE. The elasticity and velocity of the tissues were quantitatively measured. The operated shoulders of 33 patients due to isolated traumatic anterior instability were named Group 1, while the healthy shoulders of these patients were named Group 2. Thirty volunteers with healthy shoulders were considered as the control group (Group 3, n=30). Results: All three groups were compared in terms of SS, D, LHB, and SSC tendon velocity and elasticity; however, no statistically significant difference was observed among the groups (p < 0.05). The anterior labrum of these three groups did not significantly differ in terms of SWE measurements (p < 0.05). Conclusion: The stiffness of shoulder girdle muscle tendons and labrum measured with US SWE does not constitute a risk factor for traumatic anterior shoulder instability.
Anatomical Considerations: The Relationship Between The Vertebral Artery And Transverse Foramina At Cervical Vertebrae 1 To 6 In Patients With Vertigo
(2018) Kültür, Turgut; Muluk, Nuray Bayar; Iyem, Cihan; Inal, Mikail; Burulday, Veysel; Alpua, Murat; Çelebi, Umut Orkun
Objective: In this study, we aimed to investigate the relationship between the size of the vertebral artery and that of the transverse foramina at the C1 to C6 vertebral level in patients suffering from vertigo thought to be related to vertebrobasilar insufficiency (VBI). Materials and Methods: In this retrospective study, two groups were compared in terms of cervical computed tomography (CT): 22 adult patients with vertigo; and a control group consisting of 23 healthy adult indivıduals. Measurement of the vertebral artery and transverse foramina (i.e. sagittal and transverse dimensions, plus area) were performed bilaterally at levels C (cervical vertebra) 1 to C6. Results: For the cases group, at C6 level the right vertebral artery area, sagittal and transverse diameter were larger than in the control group at the level of statistical significance. At C1 level, the area of the right transverse foramina in the cases group was significantly higher than in the control group. At levels C1 to C5, the values obtained for vertebral artery area were positively correlated with the values for the ipsilateral transverse foramina (transverse foramen sagittal and transverse dimensions plus areas). Where the sagittal or transverse dimensions of the transverse foramina, or the area of the transverse foramina were found to be decreased, vertebral artery areas were also observed to have decreased at C1 to C5 levels. Conclusion: We concluded that a decrease in diameter of the bony structures or transverse foramina may cause a decrease in the cross-sectional area of the vertebral artery on the ipsilateral side. Since it is only the left vertebral artery which is dominant for cerebral blood flow, any compensatory increase in right vertebral artery area cannot offset decreased cerebral blood flow. Decreased blood flow (i.e. VBI) on the left side may play a role in the development of vertigo.
Palyatif Bakım Ünitesinde Yatan Hastalar İçin Yapılan Harcamalara Genel Bakış: Tek Merkez Deneyimi
(2020) Karahan, İrfan; Özdemir, Adnan
AMAÇ: Palyatif bakım, yaşamı tehdit eden hastalıkları olan bireylerde yaşam kalitesini artırmayı hedefleyen yaklaşım olarak özetlenebilir. Ülkemizde palyatif bakım ünitelerinin sayısı son zamanlarda artmış olup, harcamalarıyla ilgili ayrıntılı veri bulunmamaktadır. Bu çalışmada hastanemiz palyatif bakım ünitesindeki harcama gruplarının belirlenmesi amaçlanmıştır. GEREÇ VE YÖNTEM: Kırıkkale Üniversitesi, Tıp Fakültesi, İbn-i Sina Palyatif Bakım Ünitesi’nde Mart 2019-Aralık 2019 arasında yatan 333 hastanın arşiv kaydı hasta harcamaları açısından retrospektif olarak incelendi. Harcamalar; ilaçlar ve medikal tedavi, laboratuvar incelemeleri, radyolojik inceleme ve girişimler, tıbbi malzemeler ve diğer harcamalar olarak gruplandı. BULGULAR: Gruplar arasında en pahalı harcama türü ilaç ve medikal tedaviydi. İlaçların içerisinde de en pahalı grubun antibiyotikler olması dikkati çekti. SONUÇ: Giderlerin belirlenmesi; palyatif bakımın doğru kullanımı ve düzgün planlama için önemli olabilir. İlaç ve özellikle antibiyotik giderlerinin ön planda olması akılcı ilaç kullanımının önemini vurgulayabilir.
Biseps Uzun Başı Tendon Subluksasyonunda Biseps-Glenoid Açısı Ve Subskapularis Tendon Patolojileri Arasındaki İlişkinin Mrg İle Değerlendirilmesi
(2018) Şahan, Mehmet Hamdi; Asal, Neşe
Amaç: Manyetik rezonans görüntülemede (MRG) biseps uzun başı tendonunda (BUBT) subluksasyon tespit edilen olgularda biseps-glenoid açısındaki değişkenliklerin tespiti ve subskapularis tendon patolojileri ile ilişkisinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: Ocak 2014-Mart 2018 tarihleri arasında Kırıkkale Üniversitesi Tıp Fakültesi Radyoloji Anabilim Dalı’nda çekilen omuz manyetik rezonans görüntüleri incelendi. BUBT’da subluksasyon olan 30 hasta ve subluksasyon olmayan 32 kontrol hastası karşılaştırıldı. T2 ağırlıklı oblik-koronal MRG görüntülerde, BUBT’un supraglenoid tuberküle yapışma düzeyinden geçen kesitte, biseps tendonuna çizilen paralel çizgi ile glenoid kemik çatıya çizilen teğet çizgi arasındaki biseps glenoid açısı ölçüldü. Ayrıca subskapularis tendon patolojileri normal, parsiyel ve tam kat yırtık açısından analiz edildi. Bulgular: BUBT’da subluksasyon olan grupta 12 erkek, 18 kadın olup yaş ortalaması 61.0±13.6 yıl idi. BUBT’da subluksasyon olmayan grupta 14 erkek, 18 kadın olup yaş ortalaması 55.9±14.0 yıl idi. Subluksasyon olan grupta bisepsglenoid açı ortalaması 84.1º±4.9º ve subluksasyon olmayan grupta 92.8º±4.7º idi (p<0.05). BUBT’da subluksasyon olan olguların da %80’inde subskapularis tendon patolojisi mevcuttu. Sonuç: BUBT’da subluksasyon olan hastalarda, bisepsglenoid açı değerleri, subluksasyon olmayanlara göre düşüktür. BUBT subluksasyonu tanısında arada kalınan olgularda biseps-glenoid açı ölçümü yardımcı olabilir. Ayrıca BUBT subluksasyonuna, subskapularis tendon patolojileri sıklıkla eşlik etmektedir.
Korpus Kallosumun Difüzyon Ağırlıklı Ve Konvansiyonel Manyetik Rezonans Görüntüleme İle Yaşa Göre Değerlendirilmesi
(2018) Karasu, Rabia; Bilgili, Yasemin
Amaç: Difüzyon ağırlıklı görüntüleme, beyin dokusunun canlılığı hakkında fikir veren önemli bir yöntem olup kuvvetli manyetik alan gradientleri kullanılmaktadır. Buna bağlı olarak difüzyon ağırlıklı görüntüleme tekniği su moleküllerinin mikroskopik hareketlerindeki değişikliklerin saptanmasını mümkün kılmaktadır. Çalışmamızda, difüzyon ağırlıklı görüntüleme ile su moleküllerinin aksonlar boyunca olan hareketlerinden yararlanarak elde edilen Apparent Diffusion Coefficient (ADC) değişikliklerinin yaşa göre değişiminin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmamıza dahil edilen 94 olgunun ADC haritaları üzerinden korpus kallosumun farklı bölgelerinden ADC değerleri değerlendirildi. Bulgular: ADC değerinin minimum ve maksimum değerleri 0.589-0.819 mm²/sn x 10-³, ortalama ADC değeri ise 0.735 ± 0.043 mm²/sn x 10-³ olarak bulunmuştur. Çalışmamızda yaş arttıkça, korpus kallosumun ortalama ADC değerlerinde istatistiksel olarak belirgin derecede artış bulunmuştur (p <0.01). Sonuç: İlerleyen yaşla beyaz cevherdeki suyun difüzyon kabiliyetindeki artış yönündeki teorimiz, verilerimizdeki istatistiksel olarak anlamlı sonuçlarla desteklenmiştir. Yani suyun korpus kallosumda difüzyon kabiliyetinin yaş ilerledikçe arttığı saptanmıştır. Sonuç olarak, fonksiyonel bir görüntüleme yöntemi olan difüzyon ağırlıklı görüntüleme, yaşlanmaya bağlı değişiklikleri sayısal olarak da ortaya koyabilen bir yöntemdir.
Asperger sendromunda proton manyetik rezonans spektroskopi: Nöropsikolojik testlerle ilişkisi
(2009) Öner, Özgür; Özgüven, Halise Devrimci; Öktem, Ferhunde; Yağmurlu, Banu; Baskak, Bora; Ölmez, Şenay; Munir, Kerim
Amaç: Daha önceki çalışmalarda otizm spektrum bozukluklarında zihin kuramı (ZK) sorunları olduğu gösterilmiştir, ancak bu olgularda ZK performansı ile beyin nörokimyasal bulguları arasındaki ilişki incelenmemiştir. Bu çalışmanın amacı 1H Manyetik Rezonans Spektroskopi (MRS) yöntemiyle dorsolateral prefrontal korteks (DLPFK) ve anterior singulat korteks (ASK) N-Asetil-Aspartat (NAA)/Kolin (Cho), NAA/Kreatin (Cr) ve Cho/Cr değerlerinin ZK performansı ile ilişkisinin incelenmesidir. Yöntem: Onüç sağ elini kullanan, yetişkin erkek Asperger Sendromu (AS) olgusu (yaş 17-37) ve bu olgularla yaş, cinsiyet, el kullanımı ve Weschler Yetişkinler İçin Zeka Ölçeği, Gözden Geçirilmiş Form Toplam Zeka Bölümü bakımlarından benzeştirilmiş 20 sağlıklı kontrol çalışmaya dahil edilmiştir. Bulgular: Bulgular AS olgularının ZK performansının anlamlı şekilde daha düşük olduğunu göstermiştir. DLPFK NAA/Cho düzeyi ZK puanı ile ters korelasyon göstermektedir (r=-.738, p=. 004). Öte yandan ZK performansı ile DLPFK Cho/Cr arasında düz korelasyon bulunmaktadır (r=. 656, p=. 015). ASK MRS değişkenleri ile ZK performansı arasında ise anlamlı bir ilişki bulunmamıştır. Tartışma: Sonuçlar DLPFK Cho düzeyi arttıkça AS olgularında ZK performansının arttığını düşündürmektedir.
Beyin Difüzyon Ağırlıklı Manyetik Rezonans Görüntüleme Tetkikinde Akut İskemili Hastalarda Görünen Difüzyon Katsayısı Ölçümlerinin Değerlendirilmesi
(2018) Hırslı, Canan; Bilgili, Yasemin
Amaç: Difüzyon ağırlıklı görüntüleme ile akut iskemisi olan hastalarda, iskemik “kor” dan ne kadar uzaklıkta görünen difüzyon katsayısı değerlerinin normale ulaştığının tespiti amaçlandı. Gereç ve Yöntem: Akut iskemisi olan 44 hasta çalışmamıza dahil edildi. Difüzyon ağırlıklı görüntüleme ile iskemi alanı dış sınırına 4mm, 8mm ve 12 mm uzaklıktan dörder ölçüm yapılarak görünen difüzyon katsayısı değerleri elde edildi. Bu değerler simetrik noniskemik hemisfer ile istatistiksel olarak kıyaslandı. Bulgular: Dört ve 8 mm uzaklıktaki dörder ölçümün ortalaması noniskemik hemisferdeki simetrik ölçümlerin görünen difüzyon katsayısı değerlerinden istatistiksel olarak anlamlı düzeyde düşük olarak saptanırken, 12 mm uzaklıkta elde olunan ölçümler ile noniskemik hemisferdeki ölçümler arasında istatistiksel olarak anlamlı farklılık saptanmadı. Sonuç: Çalışmamız verileri ışığında ve mevcut hasta grubunda iskemik kor dokusundan 12 mm mesafede görünen difüzyon katsayısı değerlerinin; hücresel düzeyde difüzyonun karşı hemisferle eş düzeye geldiği sonucuna varılmıştır. Bu mesafenin manyetik rezonans perfüzyon tetkiki ile kurtarılabilir penumbra dokusu ile ne kadar örtüştüğünün saptanması, difüzyon ağırlıklı görüntülemenin kontrastsız ve kısa sürede elde edilebilen bir tetkik olarak penumbra tespitinde kullanılabilme olasılıklarını gündeme getirmektedir
MR ile incelenen lomber disklerdeki difüzyon değerlerinin dejenerasyonla ve yaşla olan ilişkisi
(2008) Yazgan, Hatice Çisel; Kara, Simay; Evliyaoğlu, Çetin
Amaç: Bu çalışmada lomber disklerdeki difüzyon değerlerinin dejenerasyonla ve yaşla olan ilişkisi ADC ölçümleriyle değerlendirildi. Gereç ve Yöntem: Bel ağrısı yakınmasıyla başvuran yaşları 14-64 arasında değişen 50 olguya (24 kadın, 26 erkek) difüzyon ağırlıklı MR görüntüleme uygulandı. T2 ağırlıklı sagital görüntülerde dejenere diskler belirlendi. Dejenere diskler hafif ve ağır olarak gruplandırıldı. Her bir disk düzeyi için ADC değerleri ölçüldü. Normal disklerin ortalama ADC değerlerinin anatomik düzeyle ve yaşla olan ilişkisi değerlendirildi. Dejenere disklerin ortalama ADC değerleri normal disklerle karşılaştırıldı. Bulgular Mann Whitney testi, Kruskal Wallis testi ve Sperman’s korelasyon katsayısıyla analiz edildi. Bulgular: Ortalama ADC değerleri normal disklerde 1.82 ± 0.20 x 10-3 mm2/sn, dejenere disklerde 1.30 ± 0.47 x 10-3 mm2/sn olarak bulundu (p< 0.01). Normal disklerde anatomik düzeyle ortalama ADC değerleri arasında anlamlı ilişki saptanmadı. Yaşla ortalama ADC değerleri arasında negatif korelasyon yönünden anlamlı ilişki mevcuttu. Sonuç: Dejenere disklerin ADC değerleri normal disklere göre belirgin olarak azalmıştır. Dejeneratif disk hastalığının değerlendirilmesinde difüzyon MR görüntüleme son derece faydalı bir yöntem olabilir
MRG ile normal görünümlü beyaz ve gri cevherde yaşlanmanın etkilerinin ADC değerleri ile saptanabilirliği
(2004) Bilgili, Karadeniz Yasemin M.; Ünal, Birsen; Kendi, Tuba; Şimşir, İlknur; Erdal, Haydar; Huvaj, Sinef; Kara, Simay
AMAÇ Çalışmamızda, MRG ile normal görünümlü beyaz ve gri cevherde, yaşlanma ile beyin dokusunda izlenen mikroskopik değişikliklerin, su difüzyonu değerinin matematiksel ölçümü olan ADC değeri (apparent diffusion coefficient= görünürdeki difüzyon katsayısı) ile saptanabilirliği araştırılmıştır. GEREÇ VE YÖNTEM MRG ve difüzyon ağırlıklı tetkikleri doğal olan, dekadlara göre sekiz alt gruba ayrılan 45 hastanın, "trace" ağırlıklı ADC haritaları kullanılarak, frontal ve oksipital beyaz cevherden ve talamustan ADC değerleri elde olundu. Elde olunan ADC değerlerinin artan hasta yaşı ile istatistiksel fark gösterip göstermediği araştırıldı. ADC ortalama değeri frontal beyaz cevherde 0.753±0.054 x 10-3 mm2/sn, okspital beyaz cevherde 0.673±0.085 x 10-3 mm2/sn, talamusta 0.763±0.063 x 10-3 mm2/sn olarak saptanmıştır. Frontal ve oksipital beyaz cevherde yaşla birlikte ADC değerlerinde istatistiksel olarak anlamlı artış saptanmış olmakla birlikte, talamusta yaşla ADC değerlerinde saptanan artış istatistiksel olarak farklılık oluşturmamaktadır. SONUÇ İlerleyen yaşla birlikte, MRG ile normal olarak saptanan beyaz cevherde, difüzyon ağırlıklı seriler ile su difüzyonunda artış saptanmış olup, bu veri yaşlanmanın getirdiği yapısal değişikliğin yansıması olarak düşünülmüştür.
Propofol-fentanil anestezisinin tavşanlarda aorta ve renal hemodinami üzerine etkilerinin Doppler US ile değerlendirilmesi
(2004) Apan, Alpaslan; Bilgili, Karadeniz M. Yasemin; Çağlayan, Fatma
AMAÇ Anestezik ajanlardan propofol ve fentanilin hemodinamik etkileri, sistemik arter basıncı ve kalp hızında azalma ile karakterizedir. Çalışmamızda, hayvan modeli kullanarak, bu hemodinamik değişikliklerin aorta ve renal arter kan akımı üzerine olan etkilerinin, Doppler US ile belirlenmesi amaçlandı. GEREÇ VE YÖNTEM Çalışma, 8 adet "New Zealand White" cinsi erkek tavşanda planlandı. Hayvanların, bazal aorta ve renal arter Doppler parametreleri (rezistif indeks, pulsatilite indeksi, maksimal ve minimal hızlar) intramüsküler 30 mg/kg ketamin ile sedasyon sonrası elde olundu. Bu esnada sağ femoral arter kanülasyonu ile arter basıncı ve kulaktan puls oksimetre değerleri izlendi. Kulak veninden 5-7 mg/kg propofol ve 1-2 µg/kg fentanil uygulamasından sonra renal arter ve aortaya ait Doppler parametre ölçümleri tekrarlandı. Tavşanların bazal ölçüm değerlerine göre propofol ve fentanil anestezisi sırasında arter basıncı ve solunum hızında belirgin bir azalma (sırası ile %27 ve %53, p<0.05) saptanmasına rağmen aorta ve renal arter Doppler parametrelerinde istatistiksel farklılık saptanmadı. SONUÇ Propofol-fentanil anestezisi renal arter ve aorta Doppler parametrelerinde istatistiksel olarak anlamlı farklılık yaratmamaktadır; postoperatif dönemde rezistif indeks ve pulsatilite indeksi değerlerinde değişiklik saptanması durumunda bu değişikliğin propofol-fentanil anestezisi kökenli olmadığının bilinmesi klinik olarak önem taşımaktadır.
Relation between optic and carotid canals with sphenoid sinus in patients with communicant hydrocephalus: a computed tomography evaluation study
(SAGE PUBLICATIONS LTD, 2020) Sencan, Ziya; Muluk, Nuray Bayar; Yilmazsoy, Yunus; Özdemir, Adnan; Mutlucan, Havva Meltem
Background There are neuro-ophthalmologic findings in patients with communicant hydrocephalus (CH). Purpose To investigate the relationships of the optic canal and carotid canal classifications at sphenoid sinus and anterior clinoid process (ACP) pneumatization in patients with CH. Material and Methods In this multicentric retrospective cross-sectional study, the cranial computed tomography (CT) images of 38 patients with CH (20 men, 18 women) and 40 controls (25 men, 15 women) were included. Optic and carotid canal classification at sphenoid sinus, ACP pneumatization, and sphenoid sinus septation were evaluated. Results In the CH group, type 3 optic canal was detected in 21.1% of the patients and type 4 optic canal was detected in 2.6% of the patients on the left side which was significantly different from the control group (P<0.05). In the CH group, type 3 carotid canal was detected in 21.1% of the patients (left) and 18.4% of the patients (right). ACP pneumatization was present in 13.2% of the patients in the CH group bilaterally. There were positive correlations between optic canal classifications and ACP pneumatization (P<0.05). There were also positive correlations between the right and left carotid canal classifications and ACP pneumatization (P<0.05). Conclusion To avoid complications, CT should be evaluated carefully in patients with CH before surgical interventions in sphenoid sinuses and surgeons should work carefully in the sphenoid sinus or adjacent structures. The protrusion possibility of the optic canal or carotid canal to the sphenoid sinus may be higher in pneumatized ACP patients.
Important landmarks and distances for posterior fossa surgery measured by temporal MDCT
(SPRINGER, 2020) Burulday, Veysel; Bayar Muluk, Nuray; Komurcu Erkmen, Selmin Perihan; Akgul, Mehmet Huseyin; Ozdemir, Adnan
In this retrospective study, we aimed to present important anatomical structures and distances for posterior fossa surgery by temporal multidetector computed tomography (MDCT). The temporal MDCT images of 317 adult patients (158 males and 159 females) were retrieved from the hospital's picture archiving and communication system (PACS). In the coronal temporal MDCT views, the cochlea-carotid canal and jugular bulb-mastoid bone outer surface were measured. In the axial MDCT views, the carotid canal-jugular bulb and carotid canal-posterior fossa distances were measured; the carotid canal and jugular bulb anterior-posterior (AP) and transverse dimensions were also measured. The bilateral cochlea-carotid canal, jugular bulb-mastoid bone outer surface, and right carotid canal-jugular bulb distances were significantly greater in the males than those in the females (p < 0.05). The carotid canal-posterior fossa distance was not different in both genders (p > 0.05). The carotid canal-jugular bulb and the carotid canal-posterior fossa distances were greater on the left side than those on the right side in both genders (p < 0.05). In males, the outer surface distance was greater on the left jugular bulb-mastoid bone than that on the right side of that bone (p < 0.05). The difference between the carotid canal AP dimensions was not significant between males and females (p > 0.05). However, the carotid canal transverse dimension, jugular bulb AP, and transverse dimensions were significantly greater in the males than those in the females, bilaterally (p < 0.05). In each gender separately, the carotid canal AP and transverse dimensions were greater on the left side and the jugular bulb AP and transverse dimensions were greater on the right side than those on the left side (p < 0.05). Positive correlations were found between the cochlea-carotid canal, the jugular bulb-mastoid bone outer surface, and the carotid canal-jugular bulb distances as well as between the jugular bulb-mastoid bone outer surface and the carotid canal-posterior fossa distances (p < 0.05). In older patients, the carotid canal-posterior fossa distances were shorter on the left side (p < 0.05). Vascular and neural localizations should be well understood in the operative area before applying the surgical approach in the posterior fossa. Computed tomography (CT) has a greater role in the evaluation of bone structures and vascular canals in this area.
Evaluation of the medial rectus muscle and optic nerve using strain and shear wave elastography in Graves' patients
(SPRINGER, 2020) Ozdemir, Adnan; Sahan, Mehmet H.; Asal, Nese; Inal, Mikail; Gungunes, Askin
Purpose The purpose of this study was to describe the elastic properties of the medial rectus muscle and optic nerve in Graves' patients without clinically apparent ophthalmopathy using strain elastography (SE) and shear wave elastography (SWE) and to determine whether these elastic properties could be used to aid in the diagnosis of the medial rectus muscle or optic nerve involvement. Materials and methods Thirty participants diagnosed with Graves' disease without ophthalmopathy and 30 healthy volunteers (control group) were prospectively examined between November 2018 and August 2019. SE and SWE findings in both groups were compared using the chi(2)test and the independent samplesttest. Results A statistically significant softening of the medial rectus muscle was observed in the SE patterns of the Graves' patients (p = 0.009). A statistically appreciable distinction was observed between the medial rectus muscle (7.64 +/- 2.1 and 9.20 +/- 1.7 kPa,p = 0.000) and the optic nerve (8.35 +/- 2.8 and 9.37 +/- 1.5 kPa,p = 0.019) in the SWE modulus of the Graves' patients and healthy volunteers. Conclusion SE and SWE can be used to identify structural alterations to the medial rectus muscle and optic nerve before clinically apparent Graves' ophthalmopathy has developed.
Assessment of the optic nerve using strain and shear-wave elastography in patients with pseudotumour cerebri
(W B SAUNDERS CO LTD, 2020) Asal, N.; Inal, M.; Sahan, M. H.; Say, B.
AIM: To evaluate the optic nerve using strain elastography (SE) and shear-wave elastography (SWE) in idiopathic intracranial hypertension (IIH) patients in comparison to participants in the control group. MATERIALS AND METHODS: Eighty eyes were evaluated in 40 cases consisting of 20 IIH patients and 20 participants in the control group. This study was conducted using SE and SWE in addition optic nerve sonography measurements of participants in the IIH patient group and the control group. SE patterns were categorised using three main types and two subtypes. Quantitative measurements of optic nerve stiffness with SWE were expressed in kilopascals. RESULTS: In the IIH patient group, type 2 and type 1 elasticity patterns were primarily observed, followed by type 3 patterns. In the control group, type 3 elasticity patterns were most often observed, while type 2 elasticity patterns were seen less frequently. Statistically significance differences in the types of elasticity strain patterns were observed between the groups (p<0.01). Quantitative analysis was also performed, and the SWE moduli were obtained for the control group (10.1 +/- 0.28 kPa) and the IIH patient group (26.97 +/- 1 kPa). A statistically significant difference in the SWE modulus was found between the groups (p<0.01). CONCLUSION: Biomechanical changes may have occurred in the optic nerve secondary to increased intracranial pressure in IIH patients. Strain and shear elastography may have potential as assistive diagnostic techniques for the detection and follow-up of these changes. (C) 2020 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
Is there a relationship between high birth weight and umbilical vein diameter?
(TAYLOR & FRANCIS LTD, 2020) Tutus, Sadan; Asal, Nese; Uysal, Gulsum; Sahin, Hatice
Objective The aim of the study was to evaluate the associations between sonographical measurements of the umbilical cord and birth weight in 20-24 weeks of gestations. Methods This cross-sectional study was conducted with the participation of 220 low-risk pregnant women between 20-24 gestational weeks. Biparietal diameter, head and abdominal circumference, and femur length were measured for anthropometric calculations. Umbilical cord including umbilical vein diameters, placental thickness, umbilical artery. Doppler measurements (RI, PI) were recorded. Results In accordance with the results of statistical computations, an inverse relationship was found between umbilical vein diameter and birth weight of a large gestational age (LGA) newborn in 20-24 gestational weeks (p < .05). There was no significant relationship between other parameters and birth weight of LGA newborns. Conclusion There is an inverse relationship between birth weights of newborns with LGA and umbilical vein diamater at 20-24 weeks of pregnancy. The umbilical vein diameter in the second trimester may be a promising measurement on predicting LGA fetus. The researches have not confirmed the physiopathology of this finding yet, but it is paving the path for future studies.
The Diagnostic Value of sTWEAK in Acute Ischemic Stroke
(GALENOS YAYINCILIK, 2020) Comertpay, Ertan; Vural, Sevilay; Eroglu, Oguz; Badem, Nermin Dindar; Bilgili, Yasemin Karadeniz; Coskun, Figen
Background: Considering the critical role of early diagnosis and management of acute ischemic stroke, biomarkers that can reliable assist in the diagnosis are still needed. These biomarkers should rapidly analyze, have high specificity for brain damage, and be available in the emergency settings for early diagnosis and exclusion of other conditions that mimic acute ischemic stroke. Soluble tumor necrosis factor-like weak inducer of apoptosis, a protein involved in the regulation of several biological functions, could be a potential acute ischemic stroke biomarker. Aims: To investigate the diagnostic value of soluble tumor necrosis factor-like weak inducer of apoptosis in patients with acute ischemic stroke and examine the relationship between ischemic area volume determined at diffusion-weighted magnetic resonance imaging and soluble tumor necrosis factor-like weak inducer of apoptosis. Study Design: A prospective, case-control study. Methods: This case-control prospective study included 36 patients with acute ischemic stroke and 36 healthy volunteers. Information on age, sex, presence of chronic disease, neurological examination findings, times of presentation to the emergency department after acute ischemic stroke, soluble tumor necrosis factor-like weak inducer of apoptosis levels, ischemic area volumes at diffusion-weighted magnetic resonance imaging, and 6-month mortality rates after stroke were recorded. The results were analyzed on SPSS 22.0 software (SPSS Inc., Chicago, IL, USA), and p<0.05 was considered statistically significant. Results: A soluble tumor necrosis factor-like weak inducer apoptosis cut-off value of 995.5 pg/mL exhibited a sensitivity of 80.5% and a positive predictive value of 82.5% with an area under the curve of 0.84 (95% confidence interval: 0.74-0.94; p<0.001). The mean soluble tumor necrosis factor-like weak inducer of apoptosis level - in the acute ischemic stroke group (1968.08=1441.99 mu g/L) were significantly higher than those in the control group (704.81 +/- 291.72 14,1) (p<0.001). No correlation was observed between soluble tumor necrosis factor-like weak inducer of apoptosis levels and ischemic area volume measured at diffusion-weighted magnetic resonance imaging (r=-0.008; p=0.07). The mean ischemic area volume was 505.68 +/- 381.10 and 60.96=80.89 mm(3) in the nonsurviving and surviving patients, respectively (p =.002). Conclusion: Soluble tumor necrosis factor-like weak inducer of apoptosis can be used in the diagnosis of acute ischemic stroke. However, it is inconclusive in estimating ischemic area volume and early mortality following acute ischemic stroke. Ischemic area volume measured at diffusion-weighted magnetic resonance imaging is a marker of poor prognosis and can be used in predicting early mortality.
Retrospectif Analysis of 1545 Patients: Neuroimaging in Headache
(Gazi Univ, Fac Med, 2020) Say, Bahar; Ergun, Ufuk; Tunc, Mehmet; Alpua, Murat; Dogan, Adil
Objective: Neuroradiological imaging is also used to differentiate between primary and secondary headaches. The aim of this study was to evaluate retrospectively the significant abnormal neuroradiological imaging results and rates in the primary headache group. In addition, it was also planned to analysis the results of all headaches with imaging and discuss the imaging in the headache with the literature. Methods: Medical records of headache patients of the neurology outpatient clinic at the tertiary care center were reviewed. Patients who required brain imaging and did not have any disease that could cause pathology in imaging were included. Neuroradiological images were grouped as brain computed tomography (CT), brain magnetic resonance imaging (MRI) and others. Results were normal, significant abnormal findings and others. Results: Total 1545 patients were included. Primary headache 992, secondary headache 91, painful cranial neuropathies and other headaches were observed in 462 patients. Significant abnormal radiological findings were found to be 4.3% in primary headache, 14.3% in secondary headache, and 6.6% in painful cranial neuropathy and other headaches. Significant findings in primary headache were Arnold Chiari Malformation, sinus thrombosis, intracranial mass, choroid plexus xanthogranuloma, hydrocephalus, vascular malformation. Conclusion: In this series, the rate of significant findings in neuroradiological imaging in primary headache is low. Secondary headaches require neuroimaging because of the presence of underlying life-threatening causes, although the rate of abnormal neuroradiological imaging is low. History, examination, and red flags in headache may lead to imaging, but patient and physician concerns may also increase imaging rates.
Sonoelastographic evaluation of the sciatic nerve in patients with unilateral lumbar disc herniation
(Springer, 2019) Celebi, Umut Orkun; Burulday, Veysel; Ozveren, Mehmet Faik; Dogan, Adil; Akgul, Mehmet Huseyin
ObjectiveThe aim of this study was to compare strain elastography (SE) and shear wave elastography (SWE) findings of the sciatic nerve in patients with unilateral lumbar disc herniation (LDH) and healthy control subjects.Materials and methodsThe study group included patients with complaints of unilateral sciatica for 3-12months, with foraminal stenosis due to one level of LDH (L4-L5 or L5-S1). An age- and gender-matched control group was formed of healthy subjects. Evaluations were performed on both the axial and longitudinal planes from the bilateral gluteal region using a 5-9MHz multifrequency convex probe.ResultsThere were 40 patients (20 male, 20 female) with a mean age of 43.112.7years in the study group, and 40 healthy subjects (22 male, 18 female) with a mean age of 42.9 +/- 10.7years in the control group (p>0.05). The sciatic nerve stiffness assessed on both the axial (12.3 +/- 3.7 kPA) and longitudinal (14.3 +/- 3.8 kPA) planes of the involved side was significantly higher than non-involved side (axial: 6.8 +/- 2.1 and longitudinal: 8.3 +/- 2.3 kPA) in the patient group (p<0.001).Conclusions p id=Par4 Patients with unilateral LDH have increased stiffness of the sciatic nerve compared to healthy control subjects. Although the findings in this preliminary study show that shear wave elastography can detect a change in sciatic nerve stiffness in patients with unilateral LDH, larger studies are required to determine the clinical utility of this technique.
Morphometric Analysis of the Fronto-maxillary Sinuses in Adult Patients with Traumatic Septal Deviations
(Bentham Science Publ Ltd, 2019) Inal, Mikail; Simsek, Gokce; Kaya, Ahmet; Kilic, Rahmi
Objective: The aim of the current study was to investigate a change in the volume of the frontal and maxillary sinuses in patients with nasal septum deviations due to physical trauma. Materials and Methods: Paranasal sinus computed tomography data of 100 patients admitted to Kirikkale University medical faculty hospital between November 2013 and June 2014 were retrospectively analyzed. The side of the nasal septal deviation, the deviation angle, the severity of the deviation, and bilateral frontal and maxillary sinus volumes were calculated using a computer program. The relationship between sinus volumes and deviated septum characteristics was investigated. Results: The maxillary sinus volumes did not differ between the two genders. However, the female patients had significantly decreased frontal sinus volumes when compared with the male patients (p < 0.05). A right-sided septal deviation was found to be associated with a significantly decreased maxillary sinus volume (p < 0.001), and the severity of the deviation was a significant determinant of the maxillary sinus volume (p < 0.001). The age of the patient at the time of the septal trauma was significantly associated with their maxillary sinus volumes. Patients who had experienced this trauma after 12 years of age had significantly increased maxillary sinus volumes when compared with those who experienced the trauma before the age of 12. Conclusion: A distorted septal anatomy was found to be a significant parameter for developing paranasal sinuses. Right-sided and severe traumatic deviations with an onset before the age of 12 were significantly associated with a decreased maxillary sinus volume.

Güncel Gönderiler