Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Renal Pseudoaneurysm after Micropercutaneous Nephrolithotomy(2014) Cicek, Tufan; Istanbulluoglu, Okan; Yildirim, Erkan; Buldu, Ibrahim; Kaynar, Mehmet; Ulas, Huseyin; 0000-0002-9057-722X; 0000-0002-6957-9060; ABI-3856-2020Postoperative bleeding due to pseudoaneurysm formation is the major cause of percutaneous kidney interventions. Micro percutaneous nephrolithotomy is a one step procedure that used mostly lower pole stones. There are small series that reports technical feasibility and safety of microperc using the All-seeing needle. Here we state the first report of pseudoaneurysm and its treatment after microperc in the literature.Item A Rare Cause of Duodenal Obstruction: Intramural Hematoma(2014) Coban, Goken; Cifci, Bilal Egemen; Gokturk, Savas; Unler, Ayse Gulhan Kanat; Yildirim, Erkan; 0000-0002-9057-722X; ABI-3856-2020; P-7533-2014Small bowel obstruction due to intramural hematoma secondary to anticoagulant therapy is a rare complication. Other risk factors include hemophilia, idiopathic thrombocytopenic purpura, leukemia, lymphoma, myeloma, chemotherapy, vasculitis, pancreatitis, and pancreatic cancer. The presentation of patients is usually with abdominal pain, nause and vomiting. The patients who were admitted to the emergency clinic with acute abdominal pain and had a history of anticoagulant use with prolonged international normalized ratios should alert to search for intraabdominal hematoma. Herein, we present a patient who was admitted to the emergency clinic with acute abdominal pain, severe nausea and vomiting, and diagnosed by abdominal computed tomography.Item MRI Findings of Lumbosacral Metastasis from Occult Follicular Thyroid Cancer: Report of A Case(2014) Coban, Gokcen; Yildirim, Erkan; Gemici, Kazim; Erinanc, Hilal; https://orcid.org/0000-0002-9057-722X; https://orcid.org/0000-0003-1401-6356; 23129029; P-7533-2014; ABI-3856-2020; AAL-1268-2021A 63-year-old female was admitted to our hospital with bowel and bladder incontinence. Magnetic resonance imaging (MRI) showed a 13 x 12 x 12 cm mass invading the posterior regions of the L4, L5, S1 and S2 vertebrae with broad paravertebral soft tissue invasion. A Tru-cut biopsy of the mass was performed. The histopathological examination revealed metastatic follicular carcinoma of the thyroid. Thyroid functional tests were within the normal limits. Thyroid sonography revealed a heterogeneous, ill-defined, 14 x 9 mm hypoechoic solid nodule in the right lobe of the thyroid gland. On thyroid scintigraphy, an area of focal hyperactivity was detected in the right lobe at the nodule localization. Total thyroidectomy was performed, and the primary tumor pathology was determined to be follicular thyroid cancer. To our knowledge, only a few cases of lumbosacral cord compression as the initial manifestation of follicular thyroid carcinoma have been reported in the literature. We aimed to discuss the MRI findings of tumors in this age group with lumbosacral localization.Item A Prospective Clinical Study of Flow-Mediated Dilatation in Burn Injury(2014) Turk, Emin; Caliskan, Mustafa; Karagulle, Erdal; Aydogan, Cem; Oguz, Hakan; Kulaksizoglu, Sevsen; Yildirim, Erkan; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0003-4766-3373; https://orcid.org/0000-0002-8522-4956; https://orcid.org/0000-0003-1547-1297; https://orcid.org/0000-0002-7613-2240; https://orcid.org/0000-0002-9057-722X; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 24165669; AAJ-5609-2021; JYO-9455-2024; C-6247-2017; AAJ-5296-2021; AAI-8932-2021; ABI-3856-2020; AAE-1041-2021; AAJ-8097-2021Item Body Mass Index, Cholecystitis, Cholelithiasis, Pancreatitis and Imaging of Common Bile Duct Stones(2014) Coban, Gokcen; Yildirim, Erkan; Gokturk, Savas; Caliskan, Zuhal; Turk, Emin; Akcil, Mehtap; https://orcid.org/0000-0002-4010-2883; https://orcid.org/0000-0002-9057-722X; https://orcid.org/0000-0003-4766-3373; 23838577; P-7533-2014; ABI-3856-2020; AAJ-5609-2021Purpose:Studies to date have not investigated whether body mass index (BMI) affects the sensitivity and specificity of magnetic resonance cholangiopancreatography (MRCP). The purpose of this study was to investigate the effect of BMI and also concomitant pancreatitis, cholecystitis and cholelithiasis on the sensitivity and specificity of MRCP.Materials and Methods:Between January 2004 and December 2011, 185 patients were included in the study and divided into 3 groups according to BMI as normal, overweight or obese. Both MRCP and endoscopic retrograde cholangiopancreatography (ERCP) were performed in all patients. ERCP was accepted as the gold standard. The accuracy, sensitivity and specificity values of the 3 groups were calculated to determine any effects on the results of the MRCP.Results:Before separating into groups according to BMI, the statistical results for MRCP in the detection of stone disease were as follows: specificity 74.3%, sensitivity 81.7% and accuracy 79%. After dividing the patients into 3 groups according to BMI, the specificity of stone detection with MRCP in the normal-weight group was 93.8% but decreased to 65.5% in the overweight group and to 72% in the obese group. The sensitivity of stone detection with MRCP in the normal-weight group was 85.2% but decreased to 75% in the overweight group and increased to 88.9% in the obese group. The accuracy was 88.3% in the normal-weight group but decreased to 71.6% in the overweight group and to 81.9% in the obese group.Conclusion:Our study showed that MRCP performance was decreased in the overweight and obese groups.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 Effects of the Cerebral Aneurysm Treatment Method on Coil Packing Density and Its Relationship with the Ostium Area(2022) Kesim, Cagri; Ozcan, Umit Can; Yildirim, Erkan; https://orcid.org/0000-0002-8964-291X; https://orcid.org/0000-0002-4447-0296; 35283278; AAD-5996-2021; AAM-3467-2021Purpose: To test the following hypotheses: (a) balloon or stent assistance increases coil packing density (CPD) in the endovascular treatment of intracranial aneurysms, and (b) CPD correlates to ostium area (OA) and aneurysm volume (AV). Materials and Methods: This retrospective study included 60 aneurysms (54 ruptured and 6 unruptured) treated with simple coiling (SC) (n = 18), balloon-assisted coiling (BAC) (n = 7), or stent-assisted coiling (SAC) (n = 35) at the authors' institution between August 2017 and December 2019. AV and OA measurements were obtained from 3-dimensional digital subtraction angiography images using commercial software. Coil sizes were retrieved from patient files, and coil volume (CV) measurements were obtained from https://www.angiocalc.com/. Analysis of covariance, multivariate covariance analysis, and Pearson correlation analyses were performed. Results: The median value for AV, CV, CPD, and OA was 63.4 mm(3) (range, 5.5-1,771.4 mm(3)), 23.13 mm(3) (range, 2.03-296.95 mm(3)), 33.29% (range, 13.41%-81.02%), and 10.7 mm(2) (range, 2.7-49.9 mm(2)), respectively. Multivariate analysis showed that the CPD values were not significantly different among the treatment groups, although OA significantly differed between the SC and SAC groups (P <.05). Pearson correlations showed that similar to AV, OA was negatively correlated with CPD (r = -0.321, P <.05). Conclusions: The CPD value in cerebral aneurysms treated with BAC or SAC did not differ from that in aneurysms treated with SC.Item The importance of craniovertebral and cervicomedullary angles in cervicogenic headache(2014) Coban, Goken; Coven, Ilker; Cifci, Bilal Egemen; Yildirim, Erkan; Yazici, Ayse Canan; Horasanli, BahriyePURPOSE Many studies have indicated that cervicogenic headache may originate from the cervical structures innervated by the upper cervical spinal nerves. To date, no study has investigated whether narrowing of the craniovertebral angle (CVA) or cervicomedullary angle (CMA) affects the three upper cervical spinal nerves. The aim of this study was to investigate the effect of CVA and/or CMA narrowing on the occurrence of cervicogenic headache. MATERIALS AND METHODS Two hundred and five patients diagnosed with cervicogenic headache were included in the study. The pain scores of patients were determined using a visual analog scale. The nonheadache control group consisted of 40 volunteers. CVA and CMA values were measured on sagittal T2-weighted magnetic resonance imaging (MRI), on two occasions by two radiologists. Angle values and categorized pain scores were compared statistically between the groups. RESULTS Intraobserver and interobserver agreement was over 97% for all measurements. Pain scores increased with decreasing CVA and CMA values. Mean angle values were significantly different among the pain categories (P < 0.001). The pain score was negatively correlated with CMA (Spearman correlation coefficient, r(s), -0.676; P < 0.001) and CVA values (r(s), -0.725; P < 0.001). CONCLUSION CVA or CMA narrowing affects the occurrence of cervicogenic headache. There is an inverse relationship between the angle values and pain scores.Item Effect of Topical Tetracycline on Seroma Formation in the Lichtenstein Technique: A Prospective Randomized Study(2014) Turk, Emin; Karagulle, Erdal; Coban, Gokcen; Yildirim, Erkan; Moray, GokhanWe sought to investigate whether application of topical tetracycline has a limiting effect on seroma formation in patients undergoing hernia repair using a polypropylene mesh. This study was conducted in 96 patients undergoing an elective groin hernia repair. Patients were randomized and divided into 2 groups. After the graft was placed, and before external oblique muscle aponeurosis was closed, 5 mL tetracycline was administered on the graft in the tetracycline group (tetra group, n = 50), and 5 mL isotonic saline was administered in the control group (n = 46) without putting in a drain. Seroma checks via surface ultrasonography were done. Seroma amounts measured on the first day were significantly higher in the tetra group (P = 0.04). There were no significant differences regarding seroma measurements on the seventh day or in the first and second months. Topical tetracycline application has no limiting effect on seroma formation after a groin hernia operation.