Browsing by Author "Demir, Senay"
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Item Acute Cerebral Venous Sinus Thrombosis: Two Different Presentations(2014) Kilicaslan, Buket; Erol, Ilknur; Demir, Senay; Yazici, Nalan; AAW-9958-2021Acute cerebral venous sinus thrombosis is a rare disorder in children, but is often secondary to infections. The clinical features of cerebral venous sinus thrombosis are based on the localization and size of the affected vessel and age of the patient. In this article we encountered two different presentations of acute cerebral venous sinus thrombosis in two children aged 8 and 12 years old.Item Anatomical assessment of chest radiographs(2018) Ozsahin, Esin; Boyan, Neslihan; Kizilkanat, Emine; Demir, Senay; Pelin, Can; Soames, Roger W.; Oguz, OzkanPurpose: The aim of this study was to determine the frequency of anatomical parameters and their measurement as seen on normal posteroanterior (PA) chest radiographs in a Turkish population. Materials and Methods: We evaluated fifty normal PA chest radiographs of Turkish population adults. The frequency of anatomical parameters and their measurement with respect to the diaphragm was evaluated. Results: The frequency of anatomical parameters and their measurement with respect to the diaphragm is as follows: level (right side higher in 98%, left and right sides same level 2%), lobulation (88% absent, 12% present), eventration (98% absent, 2% present) and contour (90% smooth, 10% not smooth); level of hilum (right and left sides same level 52%, left side higher 36%, right side higher 12%); number of pairs of ribs (twelve 96%, unable to determine 4%); number of ribs superposing the lung parenchyma (seven 2%, eight 4%, nine 24%, ten 70%); distance from the lateral margin of the vertebral body to the aorta (16.44 +/- 4.35 mm); angle between the vertebral body and the aorticopulmonary line (16.04 +/- 3.110); the carina angle (58.46 +/- 11.130) and the cardiothoracic ratio (38.75 +/- 4.27). Conclusion: The data presented in this study may be useful in understanding normal thoracic structures. A knowledge of the normal anatomy as well as variations are significant for physicians in the assessment of chest radiographs.Item Approaches to Female Congenital Genital Tract Anomalies and Complications(2017) Ince, Emine; Oguzkure, Pelin; Ezer, Semire Serin; Temiz, Abdulkerim; Gezer, Hasan Ozkan; Demir, Senay; Hicsonmez, Akgun; 0000-0002-4209-9075; 0000-0002-9597-3264; 0000-0001-8789-6003; 0000-0002-4635-2613; A-4719-2018; AAJ-9529-2021; J-3197-2013; AAK-9310-2021Objective: Female congenital genital tract anomalies may appear with quite confusing and deceptive complications. This study aims to evaluate the difficulties in diagnosis and treatment of female congenital genital tract anomalies that frequently present with complications. Summary: During a 10-year period, we evaluated 20 female patients with congenital genital tract anomalies aged between 3 days and 16 years. All patients were retrospectively analyzed in terms of the results of diagnostic studies, surgical intervention, and treatment. Methods: Ultrasonography and magnetic resonance imaging revealed hydromucocolpos or hematocolpometra, imperforate hymen, distal vaginal atresia, didelphys uterus, an obstructed right hemivagina, uterovaginal atresia, a unicornuate uterus with a noncommunicating rudimentary horn, a vesicovaginal fistula, a utero-rectal fistula, intraabdominal collection, and a vaginal calculus. Results: Two patients had Mayer-Rokitansky-Kuster-Hauser syndrome and 6 patients had obstructed hemivagina and ipsilateral renal anomaly syndrome. Definitive surgical interventions were hymenotomy, vaginal pull-through, vaginovaginostomy, and vesico-vaginal fistula repair using a transvesical approach. In conclusion, female congenital genital tract anomalies may appear with a wide range of complications. Conclusions: There is a potential to do significant harm, if the patient's anatomic problems are not understood using detailed imaging. Revealing the anatomy completely and defining the complications that have already developed are critical to tailor the optimal treatment strategies and surgical approaches.Item Diagnostic Value of T2*-Weighted Gradient-Echo MRI for Segmental Evaluation in Cerebral Venous Sinus Thrombosis(2015) Altinkaya, Naime; Demir, Senay; Alkan, Ozlem; Tan, Meliha; 0000-0002-4209-9075; 0000-0003-1348-8167; 0000-0001-7526-3460; 25148696; AAK-9310-2021; AAM-5169-2021; AAM-4169-2021Objective: We evaluated the diagnostic value of gradient-echo (GRE) imaging in patients with "cerebral venous and sinus thrombosis" (CVST). Materials and Methods: In total, 130 thrombosed venous segment signal intensities in 45 patients with CVST were analyzed retrospectively using magnetic resonance imaging and magnetic resonance venography. Results: The T2* GRE sequence had a diagnostic value for detecting acute and subacute superior sagittal sinus (SSS) thrombosis and thrombosis of the deep veins (DVs), and cortical veins (CVs; P<.05). Conclusions: The T2* GRE sequence had a high diagnostic value for detecting both acute and subacute SSS, DV, and CV thromboses. (C) 2015 Elsevier Inc. All rights reserved.Item A Different Cause for Respiratory Disorder in Children: Cases with Pulmonary Langerhans Cell Histiocytosis(2017) Asilsoy, Suna; Yazici, Nalan; Demir, Senay; Erbay, Ayse; Kocer, Emrah; Sarialioglu, Faik; https://orcid.org/0000-0003-4465-8229; https://orcid.org/0000-0002-4209-9075; https://orcid.org/0000-0002-8257-810X; 26083968; AAM-5138-2021; AAK-9310-2021; AAL-7766-2021Background and AimsIn children, complaints of a respiratory disorder are very frequent. Etiology of respiratory illness is a broad spectrum that varies from a simple viral infection to a malignant disorder. Pulmonary Langerhans cell histiocytosis (PLCH) is one of these entities and it is truly rare in children. The aim of this study is to evaluate our patients with PLCH. MethodsPatients who had been diagnosed with PLCH were retrospectively evaluated. Features of medical history, onset of the complaints, date of the diagnosis, chest X-Ray and computed tomography (CT) findings, histopathology and other laboratory investigations were considered. ResultsThere were four cases with PLCH. All of them were male, ages were between 5 months and 16 years. In three cases, major complaints were chronic respiratory problems whereas in one of them there was acute respiratory distress beginning with cough and leading to pneumothorax. In all of the cases, multisystemic involvement was prominent. The diagnosis was proven by histopathology in all of the cases. In two children with smaller age, skin involvement was detected. Time from complaint to diagnosis was minimum 3 months and maximum 3 years. ConclusionPLCH is a rare disorder in children. Pulmonary involvement is generally a component of systemic involvement but in many cases it might have been detected with early respiratory complaints. So, children with chronic respiratory problems should be carefully evaluated and should be followed up for rare entities like PLCH.Item Diffusion MR Imaging in Sporadic Creutzfeldt-Jakob Disease(2014) Pekoz, Burcak Cakir; Alkan, Ozlem; Giray, Semih; Demir, Senay; Altinkaya, Naime; 0000-0001-7526-3460; 0000-0003-1348-8167; 0000-0002-4209-9075; 0000-0002-0722-3181; AAM-4169-2021; AAM-5169-2021; AAK-9310-2021; AAH-1091-2020Creutzfeldt-Jakob disease (CJD) is a rare dementing disease and is thought to caused by a prion. It is characterized by rapidly progressive dementia, ataxia, myoclonus, akineticmutism and eventual death. Brain biopsy or autopsy is required for a definitive diagnosis of CJD. Diffusion-weighted imaging became an important tool for early diagnosis of CJD because of the high sensitivity. We present 59-year-old female patient diagnosed as sporadic CJD with typical MR imagings.Item Evaluation of brain perfusion in Alzheimer disease with perfusion computed tomography and comparison to elderly patient without dementia(2016) Yildirim, Tulin; Karakurum Göksel, Basak; Demir, Senay; Tokmak, Naime; Tan, Meliha; 27513264Background/aim: The aim of this study was to evaluate perfusion computed tomography (PCT) findings in patients with Alzheimer disease and to compare them with those of patients without dementia. Materials and methods: PCT was performed in 35 patients: 20 with Alzheimer disease (mean age, 69.7 +/- 5.5 years) and 15 control subjects (mean age, 67.5 +/- 3.5 years). Control subjects were elderly individuals with no cognitive problems who were admitted with headaches. All PCT examinations were performed on a 4-slice CT unit. The PCT analysis software program was used to calculate regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV), regional time-to-peak (rTTP) values in the bilateral frontal, temporal, and occipital cortices, and bilateral lentiform nucleus. Results: rCBF values in the bilateral frontal and temporal cortices and bilateral lentiform nucleus were significantly lower in the patients with Alzheimer disease than in the control subjects. There were no significant differences in rCBV values between Alzheimer disease and the control group. rTTP values in all cortical areas and bilateral lentiform nucleus were significantly higher in the patients with Alzheimer disease than in the control subjects. Conclusion: PCT is a rapid and reliable imaging modality for evaluating brain perfusion in Alzheimer disease.Item Evaluation of the Ophtalmic Artery Flow Pattern with Color-Doppler Ultrasonography in the Patients with Carotid Artery Stenosis(2015) Demir, Senay; Akgul, Erol; Aikimbaev, Kairgeldy; Tokmak, Naime; Inal, Mehmet; Aksungur, ErolPurpose: To assess whether ophtalmic artery flow patterns reflect the status of cerebral circulation in patients with carotid artery stenosis. Material and Method: Twenty-four patients including 14 men and 10 women, with varying degrees of monolateral or bilateral carotid artery stenosis were included in the study. Patients' ages ranged between 32 and 79 years (mean 60). The control group was composed of 12 subjects without carotid artery stenosis who had undergone digital substaction angiography for different purposes. Digital substraction angiography and color-Doppler ultrasonography were performed in all the patients and the control group. Degrees of carotid artery stenosis and flow patterns and velocities, pulsatility and resistance indices of ophtalmic arteries of two groups were compared. Results: Significant differences in ophtalmic artery flow patterns and velocities, pulsatility and resistance indices between those patients with carotid artery stenosis of more than 70% and the control group were recorded. Conclusion: Imaging of the ophtalmic artery with color-Doppler ultrasonography is a useful and cost-effective method that reflects the status of cerebral circulation in patients with carotid artery stenosis.Item Impact of antenatal corticosteroid exposure on thymus size in premature infants(2022) Kilicdag, Hasan; Torer, Birgin; Demir, Senay; Hanta, Deniz; Akbas, Tugana; Mert, Mustafa Kurthan; Soker, Gokhan; 0000-0002-5505-8707; 34763993Background: This study examined the effect of corticosteroids on the thymic index (TI) and the thymus/weight index (TWI) in infants exposed to antenatal corticosteroids (ACS). Methods: This prospective study was conducted between August 2014 and October 2018. A thymus ultrasound was performed to assess thymus size on the second day of life. Thymus size was assessed as TI and TWI. Results: In total, 167 neonates (<= 34 weeks gestation) constituted the study population, including 94 ACSexposed infants and 73 untreated infants. The treatment group exhibited significantly lower birth weight and significantly shorter birth length than the ACS (-) group. Therefore, TI was smaller in the treatment group than in the untreated group (6.96 +/- 4.05 cm(3) vs. 5.64 +/- 3.39 cm(3)). The TWI was 3.69 +/- 1.8 cm(3)/kg in the ACS (-) group versus 3.32 +/- 1.56 cm(3)/kg in the ACS (+) group. The median anteroposterior diameter of the right lobe was 1.33 cm (range, 0.45-2.40) in the ACS (-) group compared to 1.15 cm (range, 0.47-2.40) in the ACS (+) group. The median anteroposterior diameter of the left lobe was 1.40 cm (range, 0.43-2.20) in the ACS (-) group and 1.19 cm (range, 0.32-2.36) in the ACS (+) group. The median largest sagittal area was 2.64 cm(2) (range, 0.5-5.46) in the ACS (-) group versus 2.20 cm(2) (range, 0.55-5.90) in the ACS (+) group. Conclusion: We found that TWI was not significantly changed by ACS exposure in premature infants. (C) 2021 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.Item Intestinal Malrotation Needs Immediate Consideration and Investigation(2016) Ezer, Semire Serin; Oguzkurt, Pelin; Temiz, Abdulkerim; Ince, Emine; Gezer, Hasan Ozkan; Demir, Senay; Hicsonmez, Akgun; 0000-0002-4209-9075; 0000-0001-8789-6003; 0000-0002-4635-2613; 0000-0002-9597-3264; 27353636; AAK-9310-2021; J-3197-2013; AAJ-9529-2021; A-4719-2018BackgroundThe aim of this study was to evaluate clinical presentation, diagnostic studies, and volvulus rate and to describe the unusual clinical clues of intestinal malrotation. MethodsA retrospective descriptive review was carried out of all patients diagnosed with intestinal malrotation between 2002 and 2014. Patients were divided into two groups: infants (1year, n=16; group 1); and children (>1year, n=12; group 2). Patient demographics, clinical history, symptoms, physical examination, diagnostic work-up, operative findings and early outcome were evaluated. ResultsBilious vomiting was the cardinal complaint in both groups. Unusual symptoms such as respiratory insufficiency, dehydration, afebrile convulsion, and lethargy were prominent symptoms in six patients in group 1, whereas history of frequent hospitalization due to recurrent abdominal pain and feeding intolerance were prominent in six patients in group 2. Midgut volvulus was identified in 15 patients, four of whom were in group 2. Standard Ladd's procedure was done in addition to correction of volvulus. ConclusionMalrotation with or without midgut volvulus is not a rare condition and should be kept in mind for any age group. Specific signs of diagnosis are not easily identified. In the case of unusual clinical presentation, diagnosis may be delayed and can result in catastrophic consequences if intestinal perfusion occurs. Although midgut volvulus is seen most frequently in infants, risk and complication rate are high beyond 1year of age as well, and can manifest as failure to thrive, food intolerance, and abdominal pain needing recurrent hospitalization. Diagnostic suspicion and interdisciplinary coordination are essential for timely diagnosis and surgical treatment.Item Monitorization of Chemotherapy Response Using Diffusion-Weighted Imaging in Neuroblastoma Reply(2016) Demir, Senay; https://orcid.org/0000-0002-4209-9075; 27099878; AAK-9310-2021Item Mucormycosis with Orbital Apex Syndrome in a Renal Transplant Recipient(2015) Haberal, Mehmet; Kursun, Ebru; Turunc, Tuba; Demiroglu, Yusuf Ziya; Yabanoglu, Hakan; Demir, Senay; Caliskan, Kenan; Moray, Gokhan; Arslan, HandeMucormycosis is a rarely encountered invasive fungal infection with high mortality. Solid organ transplantation is one of the risk factors for mucormycosis. Mucormycosis can be classified in six different groups according to the anatomical localization; rhinocerebral, pulmonary, cutaneous, gastrointestinal, disseminated, and other less common involvements. This paper presented a mucormycosis case with rhinoorbitocerebral involvementin a renal transplantation receiver, which manifested with orbital apex syndrome.Item Pancreatic Tumors in Children(2021) Gezer, Hasan Ozkan; Temiz, Abdulkerim; Ezer, Semire; Yazici, Nalan; Demir, Senay; Hasbay, Bermal; Oguzkurt, Pelin; 0000-0002-4635-2613; 0000-0002-4209-9075; 0000-0001-6702-7265; A-4719-2018; AAJ-9529-2021; AAM-5138-2021; AAK-9310-2021Objective: Pancreatic rumors in children are exceedingly rare and hence present diagnostic and therapeutic challenges to pediatric surgeons. In this study, we aimed to present our experiences and treatment outcomes related to these rare tumors. Methods: The clinical data, laboratory investigations, radiological imaging, and the pathology and surgical details of patients with pancreatic tumors who were diagnosed between 2005 and 2019 were retrospectively reviewed. Results: A total of 9 patients (5 men) were included in the study. The most common symptom at the time of presentation was vague abdominal pain. A pancreatic rumor was detected incidentally in 4 patients. All tumors were non-functional primary rumors. Histopathological diagnosis of these tumors were solid-pseudopapillary tumors (n=3), congenital pancreatic cysts (n=3), pancreatoblastoma (n=1), rhabdomyosarcoma (n=1), and an undifferentiated carcinoma (n=1). In addition, 8 patients were treated surgically (through tumor excision, central pancreatectomy + distal pancreaticojejunostomy, distal pancreatectomy, and cystogastrostomy). Two deaths from tumor dissemination were recorded. The patients were followed-up at a mean duration of 72 months (range: 6-120 months). Conclusion: Pediatric pancreatic tumors arc rare and are usually benign in nature. They present symptoms that are often nonspecific. In non-metastatic cases, surgical tumor removal is the preferred method for the treatment. For most tumors, surgical resection is the optimal treatment that may be successfully performed with low morbidity rate when the lesion is either in the body or in the tail of the pancreas. The long-term outcomes with this approach are generally good.Item Primary B-Cell Lymphoma of Liver And Spleen: Report of Two Cases(2015) Demir, Senay; Gezer, Hasan Ozkan; Yazici, Nalan; Ozdemir, Handan; Torun, Nese; Sarialioglu, Faik; 0000-0002-7528-3557; 0000-0002-8257-810X; 0000-0002-4209-9075; 0000-0002-5597-676X; X-8540-2019; AAL-7766-2021; AAK-9310-2021; AAE-2718-2021; AAM-5138-2021; J-3197-2013Item A Rare Complication Developing After Hematopoietic Stem Cell Transplantation: Wernicke's Encephalopathy(2015) Solmaz, Soner; Gereklioglu, Cigdem; Tan, Meliha; Demir, Senay; Yeral, Mahmut; Korur, Asli; Boga, Can; Ozdogu, Hakan; 25912759Thiamine is a water-soluble vitamin. Thiamine deficiency can present as a central nervous system disorder known as Wernicke's encephalopathy, which classically manifests as confusion, ataxia, and ophthalmoplegia. Wernicke's encephalopathy has rarely been reported following hematopoietic stem cell transplantation. Herein, we report Wernicke's encephalopathy in a patient with acute myeloid leukemia who had been receiving prolonged total parenteral nutrition after haploidentical allogeneic hematopoietic stem cell transplantation. To the best of our knowledge, this is the first case reported from Turkey in the literature.Item Solid Variant of Aneurysmal Bone Cyst of The Rib Presenting As A Left Intrathoracic Mass Without Radiological Bone Destruction(2014) Gezer, Hasan Ozkan; Oguzkurt, Pelin; Temiz, Abdulkerim; Demir, Senay; Hicsonmez, Akgun; https://orcid.org/0000-0002-4635-2613; https://orcid.org/0000-0001-8789-6003; https://orcid.org/0000-0002-4209-9075; 25341605; J-3197-2013; A-4719-2018; AAK-9310-2021An aneurysmal bone cyst (ABC) is a benign but often rapidly expanding osteolytic multi-cystic osseous lesion that occurs as a primary, secondary, intra-osseous, extra-osseous, solid, or conventional lesion. A 15-year-old boy presented with a left-sided intrathoracic mass displacing the lung without bone destruction. The mass was totally resected without rib resection, and the pathological diagnosis was ABC. The clinical manifestations, etiology, management, and pathology are discussed, with a brief discussion regarding the difficulty in the preoperative differential diagnosis.Item Spleen Salvaging Treatment Approaches in Non-parasitic Splenic Cysts in Childhood(2016) Gezer, Hasan Ozkan; Oguzkurt, Pelin; Temiz, Abdulkerim; Ince, Emine; Ezer, Semire Serin; Kocer, Nazim Emrah; Demir, Senay; Hicsonmez, Akgün; 27574347The aim of this study was to evaluate our experience with primary non-parasitic splenic cysts (NPSC) which are relatively rare in children and consist almost exclusively of single case reports or small case series in the literature. The medical records of all patients who presented to our clinic with NPSC between 2005 and 2015 were evaluated retrospectively. There were 22 children whose ages ranged from 2 months to 14 years (mean 9.2 +/- 4.7 years). The size of the cysts was in the range of 5 to 200 mm (mean 55.4 +/- 48.2 mm). Ten patients underwent surgery for splenic cysts. Partial splenectomy (n = 2), total cyst excision (either open n = 4 or laparoscopically n = 1), and total splenectomy (n = 3) were performed. The non-operated patients were asymptomatic and followed with ultrasound (US). The follow-up period in non-operated patients ranged from 6 months to 5 years (mean 2.27 +/- 1.29 years). Complete regression was observed in four (33 %) non-operated patients. The regressed cyst measurements were 10, 16, 30, and 40 mm, respectively. Approximately half of the NPSC is diagnosed incidentally. Small (< 5 cm) asymptomatic cysts should be under regular follow-up with US/physical examination for regression. If surgery is required, we prefer open cyst excision as it gives excellent results and preserves splenic immune function.Item Tuberous sclerosis complex; a single center experience(2015) Erol, Ilknur; Savas, Tulin; Sekerci, Sevda; Yazici, Nalan; Erbay, Ayse; Demir, Senay; Saygi, Semra; Alkan, Ozlem; 26078697Aim: This study was planned with the aim of retrospectively reviewing the clinical and laboratory findings and therapies of our patients diagnosed with tuberous sclerosis and redefining the patients according to the diagnostic criteria revised by the 2012 International Tuberous Sclerosis Complex Consensus Group and comparing them with the literature. Material and Methods: 20 patients diagnosed with tuberous sclerosis complex in the Pediatric Neurology Clinic were examined retrospectively in terms of clinical findings and therapies. The diagnoses were compared again according to 1998 and 2012 criteria. Results: It was observed that the complaint at presentation was seizure in 17 of 20 patients and hypopigmented spots on the skin in 3 of 20 patients. On the initial physical examination, imaging findings related with the disease were found in the skin in 17 of the patients, in the eye in 5, in the kidneys in 7 and in the brain in 17. No cardiac involvement was observed in the patients. Infantile spasm was observed in 7 of the patients who presented because of seizure (n=17), partial seizure was observed in 7 and multiple seizure types were observed in 3. It was found that sirolimus treatment was given to 9 of 20 patients because of different reasons, 7 of these 9 patients had epileptic seizures and sirolimus treatment had no effect on epileptic seizures. According to 2012 diagnostic criteria, no marked change occured in the diagnoses of our patients. Conclusions: It was observed that the signs and symptoms of our patients were compatible with the literature. Molecular genetic examination was planned for the patients who were being followed up because of possible tuberous sclerosis complex. It was observed that sirolimus treatment had no marked effect on the seizure frequency of our patients.Item An Unusual Site, Breast Involvement in An Adolescent Girl with Burkitt's Lymphoma(2015) Yazici, Nalan; Sarialioglu, Faik; Nursal, Gul Nihal; Pourbagher, Aysin; Demir, Senay; Kocer, Nazim Emrah; 0000-0002-8257-810X; 0000-0002-5302-4386; 0000-0002-4209-9075; 0000-0002-5943-9283; AAL-7766-2021; R-3735-2016; AAM-5138-2021; AAK-9310-2021; AAM-5436-2021Item Value of Sonographic Anterior-Posterior Renal Pelvis Measurements Before and After Voiding for Predicting Vesicoureteral Reflux in Children(2015) Demir, Senay; Tokmak, Naime; Cengiz, Nurcan; Noyan, Aytul; 0000-0002-4209-9075; 25545034; GPX-7059-2022; AAD-5713-2021; AAK-9310-2021PurposeVoiding cystourethrography (VCUG) is the gold standard for diagnosing vesicoureteral reflux (VUR), but it is important to minimize the use of VCUG because of the urinary catheterization and radiation exposure required. Ultrasound (US) observations suggest that pelvicalyceal dilatation varies according to the degree of bladder fullness in children with urinary tract infection. The aim of this study was to assess whether anterior-posterior (AP) measurements of the renal pelvis on US before and after voiding can be used as a screening tool while predicting the presence of VUR in children. MethodsThe subjects were toilet-trained children older than 4 years who required VCUG. Two groups were established based on the VCUG results: a VUR group of 40 kidney units (each unit defined as calyces and ureter) that exhibited different severities of reflux, and a control group of 68 kidney units unaffected by VUR. Prior to VCUG, US AP measurements of the renal pelvis of each kidney unit were recorded when the urinary bladder was full and again after bladder emptying. The change in AP measurement from before to after voiding was compared between the two groups. ResultsThe mean change in AP measurements from before to after voiding in the VUR group was significantly greater than that in the control group (p=0.003). ConclusionsComparing US AP measurements of the renal pelvis before and after voiding is useful for identifying children who are suspected to have VUR and thus require immediate VCUG. (c) 2014 Wiley Periodicals, Inc. J Clin Ultrasound 43:490-494 2015