Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Intravesical BCG Immunotherapy: Sepsis and Multiorgan Failure Developed After Traumatic Catheterization(2014) Cicek, Tufan; Togan, Turhan; Erinanc, Hilal; Ugur, Murat; Gonulalan, Umut; Cifci, Egemen; 0000-0003-1401-6356; AAL-1268-2021Intravesical Bacillus Calmette-Guerin (BCG) instillation is a prophylactic therapy using for treating bladder cancer to prevent tumour progression and recurrence. Both local and systemic complications can arise after the installation. Although local complications are common, this therapy is generally well tolerated. Systemic complications are rarely than local complications but can be fatal. We report a case who died from severe complications such as sepsis, pneumonia, renal failure and granulomatous hepatitis after receiving the first maintanence installation of intravesical BCG immunotherapy for bladder transitional cell carcinoma.Item Predisposing Factors in Posterior Circulation Infarcts: A Vascular Morphological Assessment(2015) Coban, Gokcen; Cifci, Egemen; Yildirim, Erkan; Agildere, Ahmet Muhtesem; 0000-0002-4010-2883; 0000-0002-9057-722X; 0000-0003-4223-7017; 25666230; P-7533-2014; ABI-3856-2020; AAB-5802-2020The aim of the study is to assess the effect of shape, diameter, elongation and deviation criteria of basilar artery (BA), convergence angle and diameter variations of vertebral arteries, and concurrent chronic diseases on posterior circulation infarcts. Between January 2010 and May 2013, 186 patients who underwent brain and diffusion magnetic resonance imaging (MRI) with suspected cerebrovascular accident and were diagnosed with posterior circulation infarct and 120 infarct negative control subjects were included in this case-control retrospective study. Vertebral artery (VA) and BA diameter, right (R) and left (L) VA angles at the level of bifurcation, and BA elongation-deviation, and shape of BA were assessed in a total of 306 subjects. Ischemic lesions in the posterior circulation were classified according to their anatomical location and vascular perfusion areas. No significant difference was noted between the control and patient groups with respect to BA diameter (p = 0.676). The most effective risk factors for posterior circulation infarcts were as follows: BA elongation of 2 or 3, BA transverse location of 2 or 3, increase in left VA angle, and history of hypertension, hypercholesterolemia, and diabetes mellitus. Our results suggest that prominent elongation and deviation, C and J shape of BA, and increased L VA angle may be the predictors of at-risk patients in posterior circulation infarcts. Reporting marked morphological BA and VA variations detected at routine brain MRI will aid in selection of patients. Timely detection and treatment of at-risk patients may be life-saving.Item Treatment of Endoleaks After Endovascular Abdominal Aorta Aneurysm Repair(2016) Duman, Enes; Cifci, Egemen; Yildirim, Erkan; Boyvat, Fatih; 0000-0002-9057-722X; ABI-3856-2020; F-4230-2011Percutaneous thrombin injection is an effective procedure for the treatment of pseudoaneurysms. In this article, we report two cases who had endoleaks after endovascular aneurysm repair and were successfully treated with computed tomography-guided thrombin injection.Item The Diagnostic Value of Magnetic Resonance Urography Using A Balanced Turbo Field Echo Sequence(2016) Cifci, Egemen; Coban, Gokcen; Cicek, Tufan; Gonulalan, Umut; 26984432The aim of the study was to compare the inter-observer variability and the accuracy of magnetic resonance urography (MRU) using a thin sectional balanced-turbo field echo (B-TFE) sequence for detecting ureteral calculi and to determine the effect of additional factors (size, density and location of the calculus) on the sensitivity and specificity of the MRU. MRU and CT images were evaluated independently by two radiologists according to presence, density and localization of calculi. The degrees of inter-rater agreement for categorical items were evaluated by the Kappa coefficient. According to the 1st and 2nd observers, the sensitivity of MRU was 65.9 %, 71.8 % and the specificity of MRU was 95.9 %, 100 %, respectively. Inter-observer agreement was 84.6 % for stone detection. The larger size had a better effect on detectability (p < 0.05). Also, the higher density had a better impact on detectability (p < 0.05). Our study has shown that B-TFE MRU was useful to detect ureteral calculi. However, B-TFE MRU has low sensitivity and high specificity in comparison with CT images. MRU is a reasonable alternative imaging technique for follow-up periods of selective groups like patients with large urinary stones, children or pregnant patients when ionizing radiation is undesirable. aEuro cent According to 1st and 2nd observers, sensitivity of MRU was 65.9 %, 71.8 %, respectively. aEuro cent According to 1st and 2nd observers, MRU specificity was 95.9 %, 100 %, respectively. aEuro cent Interobserver agreement was found to be over 84 % for stone detection. aEuro cent B-TFE sequence provides calculus follow-up without radiation. aEuro cent Larger calculi and more dense calculi individually have the better effect on detectability.Item The effect of pneumoperitoneum on the cross-sectional areas of internal jugular vein and subclavian vein in laparoscopic cholecystectomy operation(2016) Pinar, Huseyin Ulas; Dogan, Rafi; Konuk, Ummu Mine; Cifci, Egemen; Duman, Enes; Karagulle, Erdal; Turk, Emin; Karaca, Omer; 27515323Background: Increased central venous pressure secondary to an increase in intraabdominal pressure has been reported during laparoscopic surgery. However, no study has yet determined the effect of pneumoperitoneum on cross-sectional area (CSA) of central veins by ultrasonography during laparoscopic cholecystectomy. Herein, we aimed to quantify changes in CSAs of internal jugular (IJV) and subclavian veins (SCV) by ultrasonography during this surgery. Methods: This study included 60 ASA I-II patients scheduled for laparoscopic cholecystectomy surgery under general anesthesia. Pneumoperitoneum was performed with CO2 at 12 mmHg. The CSAs of right IJV and right SCV were measured using a 6 Mhz ultrasonography transducer in supine and neutral positions before anesthesia induction (T1), 5 min after connecting to mechanical ventilator (T2), 5 min after creation of pneumoperitoneum (T3), at the end of pneumoperitoneum (T4), and 5 min after desufflation and before extubation (T5) both at end-expiration and end-inspiration. Results: The comparison of IJV CSA at inspiration showed significant increase in T3 value compared to T2 value (p < 0.001). Similarly the expiratory measurements of IJV CSA demonstrated significant increase in T3 value compared to T2 value (p < 0.001). The comparison of inspiratory CSA measurements of SCV showed significantly increased in T3 (p = 0.009) than T2 value. In expiratory measurements there was a significant increase in T3 (p = 0.032) value compared to T2. All measurements of IJV and SCV SCAs both end-inspiration and end-expiration T5 values significantly decreased compared to T4 values (p < 0.001). Conclusions: Pneumoperitoneum with an intraabdominal pressure of 12 mmHg produces significant increases in IJV and SCV CSAs during laparoscopic cholecystectomy procedure. We believe that this finding may enhance our understanding of pneumoperitoneum-induced hemodynamic changes and facilitate catheterization attempts.Item IS THERE A REAL CORRELATION BETWEEN RED CELL DISTRIBUTION WIDTH AND PERIPHERAL ARTERIAL DISEASE?(2017) Duman, Enes; Kulaksizoglu, Sevsen; Cifci, Egemen; Ozulku, Mehmet; 0000-0002-7613-2240; 30581327; AAI-8932-2021Background: Few data is available concerning the association between peripheral arterial disease (PAD) and red cell distribution width (RDW). In this study, we analyzed the relationship between RDW and atherosclerosis of the vessels other than coronary arteries in patients who had undergone digital substraction angiography (DSA). Methods: This study included 730 patients who had undergone DSA. Patients were divided into two groups according to their angiographic images. The association between RDW and atherosclerosis of peripheral arteries was analyzed. The relationship between atherosclerosis and smoking, hypertension (HT), diabetes mellitus (DM), hs-CRP, hemoglobin, white blood cell (WBC), triglyceride, total cholesterol, HDL and LDL cholesterol levels was assessed. Results: Atherosclerosis was observed more common in male and patients with older age, HT, DM and smoking (p< 0.001). hs-CRP and WBC levels were both in significantly positive association with atherosclerosis (p< 0.05). However, there were no significant differences in the RDW levels, hemoglobin, triglyceride, total cholesterol, LDL and HDL cholesterol levels in the groups (p> 0.05). Conclusions: Our results seem to demonstrate that older age, male gender, HT, DM and smoking are powerful risk factors for PAD. In contrast to the previous reports, RDW levels are found not to be associated with atherosclerosis of peripheral arteries.