Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Neuroblastoma Accompanied by Hyperaldosteronism(2014) Gulleroglu, Kaan; Bayrakci, Umut; Kinik, Sibel Tulgar; Uslu, Nihal; Atilgan, Alev O. K.; Sarialioglu, Faik; Baskin, Esra; https://orcid.org/0000-0003-1434-3824; https://orcid.org/0000-0002-6733-8669; https://orcid.org/0000-0001-8595-8880; https://orcid.org/0000-0002-8257-810X; https://orcid.org/0000-0003-4361-8508; 25340174; AAJ-8833-2021; ABC-5258-2020; AAK-3333-2021; AAL-7766-2021; B-5785-2018Background: Tumors known derived from kidneys which take place in secondary hyperaldosteronism etiology are juxtaglomerular cell tumor and Wilms' tumor. Neuroblastoma presenting with hyperaldosteronism is rare. Case: A 15-month-old girl who had been having diarrhea and fever for 2 weeks presented with a 3 day history of bilious vomiting, metabolic acidosis and severe hypokalemia. She was referred to our hospital with the pre-diagnosis of unknown manifest hypertension etiology, diarrhea, and paralytic ileus after having therapy-resistant hypokalemia and severe resistant acidosis. On her examination after being admitted to our clinic, she was weak, unwell and lethargic with a blood pressure of 140/93 mmHg. Due to the hypertension and severe hypokalemia, the patient was considered to be hyperaldosteronism. Serum aldosterone level, plasma renin activity and cortisol level were elevated. Radiologic findings were compatible with neuroblastoma. The patient underwent an abdominal surgery and the mass excision. The histopathological examination was proved neuroblastoma. Conclusion: Hyperaldosteronism can be presented by unexpected atypical forms as in our patient.Item Interobserver and Intermethod Variability in Data Interpretation of Breast Strain Elastography in Suspicious Breast Lesions(2021) Turnaoglu, Hale; Haberal, Kemal Murat; Arslan, Serdar; Yavuz Colak, Meric; Ulu Ozturk, Funda; Uslu, Nihal; https://orcid.org/0000-0002-0781-0036; https://orcid.org/0000-0002-8211-4065; https://orcid.org/0000-0001-7984-4326; https://orcid.org/0000-0002-0294-6874; https://orcid.org/0000-0003-2782-2824; 32950046; AAK-8242-2021; R-9398-2019; AAA-4360-2021; JCP-5266-2023Background/aim: Strain elastography has the disadvantage of being operator-dependent. Interobserver variability is observed during image acquisition and interpretation. This study aimed to analyze the interobserver and intermethod variability of strain elastography in image interpretation and evaluate the diagnostic performance combining elasticity score and strain ratio with ultrasonography. Materials and methods: A retrospective study was conducted on 70 breast lesions evaluated with B-mode ultrasonography and strain elastography. B-mode ultrasonography findings, elasticity scores, and strain ratio values were evaluated using static images by two radiologists. BI-RADS assessment of the lesions and the decision of both observers as to whether the biopsy was required using B-mode ultrasonography, and the combined ultrasonography+elasticity score, and the combined ultrasonography+elasticity score+strain ratio were compared with the histopathological results. Also, the interobserver agreement was analyzed for all the combinations. Results: There was very good agreement (weighted kappa = 0.865) between the observers for the elasticity scores. Very good agreement was observed between the observers for BI-RADS assessments using the combined ultrasonography+elasticity score and the combined ultrasonography+elasticity score+strain ratio (weighted kappa = 0.848, and 0.902, respectively). Area under the curve of B-mode ultrasonography, the combined B-mode ultrasonography+elasticity score, and the combined B-mode ultrasonography+elasticity score+strain ratio, were calculated as 0.859, 0.866, and 0.916 for observer 1, and 0.851, 0.829, and 0.916 for observer 2, respectively. There were no statistically significant differences between the observers' diagnostic performances in any of the combinations (P = 0.703, 0.067, and 0.972, respectively). Conclusion: In the evaluation and further assessment of breast lesions, semiquantitative strain ratio calculation may help improve diagnostic accuracy by reducing interpretational variety, when used together with B-mode ultrasonography and elasticity scoring, especially for inexperienced individuals.Item Comparison of Clinical Features and Laboratory Findings of Coronavirus Disease 2019 and Influenza A and B Infections in Children: A Single-Center Study(2021) Siddiqui, Meraj; Gultekingil, Ayse; Bakirci, Oguz; Uslu, Nihal; Baskin, Esra; https://orcid.org/0000-0002-5739-6590; https://orcid.org/0000-0001-7955-5735; 34015895; ABF-7609-2022; AAR-9945-2020Background: As the coronavirus disease 2019 (COVID-19) outbreak continues to evolve, it is crucially important for pediatricians to be aware of the differences in demographic and clinical features between COVID-19 and influenza A and B infections. Purpose: This study analyzed and compared the clinical features and laboratory findings of COVID-19 and influenza A and B infections in children. Methods: This retrospective study evaluated the medical data of 206 pediatric COVID-19 and 411 pediatric seasonal influenza A or B patients. Results: COVID-19 patients were older than seasonal influenza patients (median [interquartile range], 7.75 [2-14] years vs. 4 [2-6] years). The frequency of fever and cough in COVID-19 patients was lower than that of seasonal influenza patients (80.6% vs. 94.4%, P<0.001 and 22.8 % vs. 71.5%, P<0.001, respectively). Ageusia (4.9%) and anosmia (3.4%) were present in only COVID-19 patients. Leukopenia, lymphopenia, and thrombocytopenia were encountered more frequently in influenza patients than in COVID-19 patients (22.1% vs. 8.5%, P=0.029; 17.6% vs. 5.6%, P=0.013; and 13.2% vs. 5.6%, P=0.048, respectively). Both groups showed significantly elevated monocyte levels in the complete blood count (70.4% vs. 69.9%, P=0.511). Major chest x-ray findings in COVID-19 patients included mild diffuse ground-glass opacity and right lower lobe infiltrates. There were no statistically significant intergroup differences in hospitalization or mortality rates; however, the intensive care unit admission rate was higher among COVID-19 patients (2.4% vs. 0.5%, P=0.045). Conclusion: In this study, pediatric COVID-19 patients showed a wide range of clinical presentations ranging from asymptomatic/mild to severe illness. We found no intergroup differences in hospitalization rates, oxygen requirements, or hospital length of stay; however, the intensive care unit admission rate was higher among COVID-19 patients.Item Predictive Value of Early Period Doppler Ultrasonography on Early and Long-Term Allograft Function(2016) Melek, Engin; Baskin, Esra; Gulleroglu, Kaan; Uslu, Nihal; Moray, Gokhan; https://orcid.org/0000-0003-4361-8508; https://orcid.org/0000-0003-1434-3824; https://orcid.org/0000-0002-6733-8669; https://orcid.org/0000-0003-2498-7287; B-5785-2018; AAJ-8833-2021; ABC-5258-2020; AAE-1041-2021Item Liver Stiffness Measurement Using Acoustic Radiation Force Impulse (ARFI) in Living And Deceased Donor Orthotopic Liver Transplantation Patients(2016) Haberal, Murat; Turnaoglu, Hale; Ozdemir, Adnan; Uslu, Nihal; Reyhan, Nihan Haberal; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0002-8211-4065; https://orcid.org/0000-0002-0781-0036; https://orcid.org/0000-0003-0652-5396; https://orcid.org/0000-0002-6733-8669; https://orcid.org/0000-0001-9852-9911; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; R-9398-2019; AAK-8242-2021; AAH-9023-2020; ABC-5258-2020; AAK-4587-2021; AAE-1041-2021; AAJ-8097-2021Item Doppler Ultrasonography Findings During Recovery Period of Transplanted Kidney After Infarction and Necrosis Due to Renal Vein Thrombosis: A Case Report(2017) Ozturk, Funda Ulu; Uslu, Nihal; Akcay, Eda Yilmaz; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-6733-8669; 0000-0001-6831-9585; 28260477; AAJ-8097-2021; ABC-5258-2020; AAK-1960-2021A 47-year-old male patient underwent living-related renal transplant. On day 3 posttransplant, without evidence of associated clinical symptoms, the patient's serum creatinine levels had increased. The patient was given immunosuppressive medication, and a follow-up Doppler ultrasonography revealed hypoechoic areas in the inferior pole of the renal parenchyma. Eventually, on day 25, there was no perfusion in the superior and inferior poles of the transplanted kidney. No venous flow was shown in the middle segment, and only arterial vascularization with a high resistive index and negative diastolic phase was observed. Renal biopsy showed acute humoral rejection. This was interpreted as venous thrombosis secondary to acute humoral rejection. Tissue plasminogen activator infusion, plasmapheresis, and hemodialysis were administered. After 1.5 months, arterial flow returned to its normal pattern and the renal allograft recovered by gaining back its full vascularity at the end of month 8.Item Ultrasonography Findings of Acute Tubulointerstitial Nephritis and Multiple Abscesses Following Renal Transplant: A Case Report(2017) Tezcan, Sehnaz; Uslu, Nihal; Soy, Ebru H. Ayvazoglu; Haberal, Mehmet; https://orcid.org/0000-0001-7204-3008; https://orcid.org/0000-0002-6733-8669; https://orcid.org/0000-0002-0993-9917; https://orcid.org/0000-0002-3462-7632; 28260478; ABC-5258-2020; AAC-5566-2019; AAJ-8097-2021Urinary tract infection is the most common complication after kidney transplant that can cause graft loss. An early diagnosis of urinary infections decreases morbidity and mortality. Besides clinical and laboratory examinations, ultrasonography is considered as the primary imaging modality for the diagnosis of urinary tract infections. Here, we report a 53-year-old woman who presented with fever and pain at surgical site. Ultrasonography examination showed multiple, ill-defined or irregularly margined hypoechoic areas within the cortex. Ultrasonography-guided percutaneous renal biopsy was performed. Histopathologic findings were compatible with acute tubulointerstitial nephritis and multiple abscesses. Ultrasonography is the most widely applied imaging modality for diagnoses of complications after renal transplant. Although ultrasonography findings of infections are generally nonspecific, it still plays an important role in the diagnosis of urinary infections after renal transplant.Item Can Strain Elastography Combined with Ultrasound Breast Imaging Reporting and Data System Be A More Effective Method in The Differentiation of Benign and Malignant Breast Lesions?(2017) Arslan, Serdar; Uslu, Nihal; Ozturk, Funda Ulu; Akcay, Eda Yilmaz; Tezcaner, Tugan; Agildere, Ahmet Muhtesem; https://orcid.org/0000-0001-7984-4326; https://orcid.org/0000-0002-6733-8669; https://orcid.org/0000-0001-6831-9585; https://orcid.org/0000-0002-3641-8674; https://orcid.org/0000-0003-4223-7017; 28154989; AAH-9796-2019; ABC-5258-2020; AAK-1960-2021; AAD-9865-2021; AAB-5802-2020To investigate whether a novel method that combines breast imaging reporting and data system (BI-RADS) with strain elastography contributes to diagnostic performance in differentiation of malignant and benign breast lesions. In 81 patients, 81 breast lesions were prospectively investigated. Breast lesions were separately evaluated with ultrasonography and strain elastography. While evaluations with ultrasonography were based on 2003 BI-RADS-US, strain elastography evaluations were based on a 5-point scale and strain ratio. Diagnostic performances of ultrasonography, strain elastography, and the combined method were compared. Among 81 lesions, 43 (53.1%) were benign and 38 (46.9%) were malignant. When a cutoff point of category 3 was used, sensitivity, specificity, positive and negative predictive values, and accuracy for BI-RADS were 100, 11.6, 50, 100, and 53%, respectively. When BI-RADS and strain ratio were combined, sensitivity, specificity, positive and negative predictive values, and accuracy were 89.5, 93, 91.9, 90.9, and 91.3%, respectively. When BI-RADS and elastography scores were combined, sensitivity, specificity, positive and negative predictive values, and accuracy were 86.8, 97.7, 97.1, 89.4, and 92.5%, respectively. The combination of strain elastography and BI-RADS was found to have better diagnostic performances to diagnose breast lesions than BI-RADS alone.Item The Predictive Value of Resistive Index Obtained by Doppler Ultrasonography Early After Renal Transplantation on Long-Term Allograft Function(2017) Melek, Ergin; Baskin, Esra; Gulleroglu, Kaan; Uslu, Nihal; Kirnap, Mahir; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0003-4361-8508; https://orcid.org/0000-0003-1434-3824; https://orcid.org/0000-0002-6733-8669; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 27900821; B-5785-2018; F-3294-2013; ABC-5258-2020; AAH-9198-2019; AAE-1041-2021; AAJ-8097-2021DUSG is a useful diagnostic tool for the follow- up of renal transplant recipients. The measurement of intrarenal arterial RI by DUSG has been proven to predict short-term AF. The aim of the study was to evaluate the predictive value of DUSG performed during the early after RTx on long-term AF. Seventy patients were enrolled into study. DUSG was performed at third and seventh days after RTx. Patients were divided into two groups according to rate of recovery of graft function as patients with normal graft function and abnormal graft function. Although the RI values were correlated with the AF early after transplantation, they were not correlated with long-term AF. However, the rate of recovery of graft function at early period after RTx was correlated with creatinine level at first year and with glomerular filtration rate at first year and last visit. Although the RI has no predictive value for long-term AF, the rate of recovery of graft function at early post-transplantation period has predictive value for long-term AF; patients with higher RI values early after RTx should be followed carefully for the development of chronic allograft injury.Item Biopsy Related Renal Allograft Arteriovenous Fistulas: A Series of 5 Cases(2018) Sezer, Rahime; Uslu, Nihal; Akdur, Aydincan; Haberal, Mehmet; 0000-0002-6733-8669; 0000-0002-8726-3369; 0000-0002-3462-7632; ABC-5258-2020; AAA-3068-2021; AAJ-8097-2021