Fakülteler / Faculties
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Item Evaluation of Retrobulbar Blood Flow and Choroidal Thickness in Patients with Rheumatoid Arthritis(2018) Kal, Ali; Duman, Enes; Sezenoz, Almila Sariguel; Ulusoy, Mahmut Oguz; Kal, Oznur; https://orcid.org/0000-0001-7544-5790; https://orcid.org/0000-0002-7030-5454; https://orcid.org/0000-0002-7751-4961; 28730400; AAJ-4936-2021; AAJ-4860-2021; AAJ-7586-2021PurposeTo evaluate whether retrobulbar blood flow and choroidal thickness (CT) are affected in patients with rheumatoid arthritis (RA), and the relationship between these values.MethodsWe evaluated 40 eyes of 20 RA patients and 40 eyes of 20 healthy controls. The enhanced depth imaging optical coherence tomography, color Doppler imaging, was held. Statistical analysis was performed.ResultsPeak systolic velocity (PSV) of ophthalmic (OA) and central retinal artery (CRA) were significantly higher in RA. No significant difference was observed when end-diastolic velocity (EDV) of OA and CRA was compared between the groups. The resistivity index (RI) of OA and CRA was higher in RA. Perifoveal/subfoveal CT was lower in RA. Negative correlation was detected between the RI of OA and the perifoveal CT, and a positive correlation was detected between RI of CRA and CT.ConclusionsOcular hemodynamics is effected by RA and can exaggerate ocular complications of various vascular diseases such as diabetes mellitus, hypertension, retinal vascular occlusions.Item A Case with Multifocal Pyomiyositis Due to Staphylococcus Aureus(2016) Ozden, Hale Turan; Coban, Gokcen; Duman, Enes; Togan, Turhan; https://orcid.org/0000-0002-4010-2883; P-7533-2014Primary pyomyositis, a pyogenic infection of the skeletal muscle, is often seen in tropical and subtropical regions. In this article, we present a 16 years-old male patient, who applied to the emergency department with fever, hip pain, and inability to walk without history of trauma. The Multifocal pyomyositis diagnosis was made on the basis of clinical, laboratory and radiologic evaluation of gluteus maximus, medius and minimus, priformis and ilipsoas muscles. Meticilin sensitive Staphylococcus aureus was grown in patient's blood cultures. The patient was successfully treated with intravenous antibiotics (Sulbactam-ampicillin and ciprofloxacin) and ultrasonography guided drainage of abscesses. Although this infectious disease is rare, primary pyomyositis should be considered in the differential diagnosis of patients with fever, hip pain and claudication.Item Severe Hypernatremia Associated Catheter Malposition in An Intensive Care Patient(2016) Silahli, Musa; Gokdemir, Mahmut; Duman, Enes; Gokmen, Zeynel; 0000-0003-0944-7178; 0000-0002-2746-0547; 0000-0002-5676-2747; 27555161; AAB-5059-2022; AAX-9343-2021; AAJ-8069-2021; N-4174-2014We present a catheter related severe hypernatremia in a 2-month-old baby who was admitted to the pediatric intensive care. Imbalance of plasma sodium is commonly seen in pediatric intensive care patients. The water and sodium balance is a complex process. Especially, brain and kidneys are the most important organs that affect the water and sodium balance. Other mechanisms of the cellular structure include osmoreceptors, Na-K ATPase systems, and vasopressin. Hypernatremia is usually an iatrogenic condition in hospitalized patients due to mismanagement of water electrolyte imbalance. Central venous catheterization is frequently used in pediatric intensive care patients. Complications of central venous catheter placement still continue despite the usage of ultrasound guidance. Malposition of central venous catheter in the brain veins should be kept in mind as a rare cause of iatrogenic hypernatremia. (C) 2016 Elsevier Inc. All rights reserved.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 Effectiveness of Computed Tomography-Guided Lumbar Epidural Steroid Injections for Spinal Pain Management: A Single Center Experience with 2-Year Follow-Up(2017) Harman, Ali; Duman, Enes; Ozdemir, Adnan; 0000-0002-7386-7110; 0000-0001-5221-1879; K-9824-2013; K-4333-2018Purpose: To determine the therapeutic value and long-term effects of Computed Tomography (CT)-guided translaminar and transforaminal lumbar epidural steroid injections for spinal pain management. Materials and methods: Between December 2011 and June 2013, 428 CT-guided epidural steroid injections of the lumbar spine for 310 patients were assessed retrospectively. There were 325 Translaminar (TL) (in 225 patients) and 103 Transforaminal (TF) (in 85 patients) injections performed. The clinical effectiveness of the injection after the therapy was assessed using Visual Analog Scale (VAS). The patients were classified into three groups (A-C) after injections according to the reduction in the VAS's. Results: Technical success rate of 100% without any major complication related to needle placement or drug administration. There were 27 (6.3%) reported minor complications (n: 3 orthostatic hypotension (0.7%) and n: 24 transient motor weaknesses of lower extremities (5.6%). The mean visual analog scores before and after the injections were recorded as 8.9 +/- 1.1 and 4.8 +/- 2.5 retrospectively (p 0.001). In 23 of 310 patients epidural injections were repeated in different times during study and 73 epidural injections (n: 61 TL and n: 12 TF) were performed. Conclusion: CT guided epidural injection in the lumbar spine is safe, repeatable and efficacious pain management technique. Both translaminar and transforaminal epidural steroid injections can provide reliable pain relief for up to average 5.5 and 5.6 months respectively.Item The Relationship Between Placental Transfusion, and Thymic Size and Neonatal Morbidities in Premature Infants - A Randomized Control Tiral(2018) Silahli, Musa; Duman, Enes; Gokmen, Zeynel; Toprak, Erzat; Gokdemir, Mahmut; Ecevit, Ayse; 0000-0002-2746-0547; 0000-0002-2877-1232; 0000-0002-5676-2747; 0000-0002-2232-8117; 30410129; AAX-9343-2021; AAJ-8069-2021; ABI-5902-2020; N-4174-2014; AAJ-4616-2021Objectives: To compare the effect of umbilical cord milking and early cord clamping on thymic size, and neonatal mortality and morbidity in preterm infants. Methods: This single-center, prospective, double-blind, randomised controlled study was conducted at Baskent University, Konya Education and Research Centre, Konya, Turkey, between October 2015 and April 2016. Pregnant women who delivered before 32 weeks of gestation were randomised to receive umbilical cord milking (group 1) or early cord clamping (group 2). Ultrasonographic evaluation was performed in each newborn by an experienced radiologist within the first 24 hours of life. Thymic size was estimated in line with literature. SPSS 15 was used for all data analyses. Results: There were 38 subjects in group 1 and 37 in group 2. There were as many infants in the two groups (p>0.05) The haemoglobin levels was higher in group 1, but not significantly (p=0.213). The absolute neutrophil count in group 1 was significantly lower (p=0.017) than group 2. In terms of neonatal mortaility and morbidity, there were no significant differences between the groups (p>0.05). Conclusion: Umbilical cord milking was not associated with thymic size during the the first 24h of life.Item Vesicouterina fistula: Youssef's syndrome(2015) Cicek, Tufan; Duman, Enes; Toprak, Erzat; Kosan, MuratVesico-uterin fistula is a rare type of fistulas and can be diagnosed frequently after surgery. First described by Youssef in 1957. Clasically findings are; cyclic haematuria without urinary incontinence and secondary amenorrhea. The patient was referred to our clinic for cyclic hematuria and she was diagnosed with vesicouterine fistula by radiological imaging methods and a cystoscopy procedure. Being a rare occurrence, this case was reported with a discussion of the relevant literature.Item Balloon Dilatation of Iatrogenic Ureteral Strictures after Upper Urinary Tract Reconstruction(2015) Duman, Enes; Yildirim, Erkan; Akillioglu, Ishak; Yucesan, SelcukPurpose: Open pyeloplasty is the gold standard treatment of uretero-pelvic junction (UPJ) stenosis. Although failure after open pyeloplasty or uretero-neosistosmy is not common, percutaneous or endoscopic interventions must be necessary in some cases. We present treatment of 6 pediatric patients by balloon dilatation after failed surgery. Material and Methods: Between 2008 and 2013 6 children were treated. Five patients had undergone open pyeloplasty for UP stenosis and, one has uretero-vesical anastomosis stricture after ureteroneosistostomy. Percutaneous antegrade balloon dilatation and double J stent placement were performed in three of six patients. In the other three patients retrograde endoscopic balloon dilatation and double J stent placement were performed. Results: Primary technical success was %50 and %100 for antegrade and retrograde approach respectively. Antegrade approach has failed in 3 patients (%50) and, retrograde approach and treatment were successful in all of these patients. Secondary and tertiary balloon dilatations were done through antegrade approach in 3 patients. Mean duration of double J stent was 114 days. As of today, five patients are followed smoothly. One patient who has UP stenosis underwent secondary open surgery. Conclusion: Balloon dilatation can be used safely in both antegrade and retrograde approaches because of lower profile of balloon catheters, so it could be considered as a first line treatment option after failed surgical treatment of upper urinary tract stenosis in children.Item Endovascular Treatment of Acute Stroke due to the Floating Carotid Thrombus with Intra-Arterial Tissue Plasminogen Activator and Stenting(2015) Duman, Enes54-year-old male patient was admitted to emergency service with bilateral loss of sight, consciousness and a Glasgow Coma Scale score of 15. His neurologic examination revealed no lateralized deficit but left homonymous hemianopia. Brain CT and diffusion MRI showed acute infarction in the right parietal and occipital lobes. There was a wide penumbra region on brain perfusion CT. The selective angiography showed preocclusive stenosis at the origin of right internal carotid artery (ICA) and massive floating thrombus (FT) in the cervical ICA segment. We report successful endovascular treatment of FT in the ICA using intra-arterial tissue plasminogen activator and stenting.Item Association between treatment with coil embolization of renal artery aneurysm and resistant hypertension(2016) Duman, Enes; Yildirim, Erkan; Ciftci, Ozgur; Cifci, EgemenHypertension is the number one risk factor in preventable causes of death in the world. Resistant hypertension is defined as blood pressure that remains uncontrolled despite at least three antihypertensive medications including a diuretic. Treatment of hypertension includes many modalities from lifestyle changing to multiple drug using, angioplasty. In this case report, we aim to emphasize the effects of renal artery aneurysm treatment on resistant hypertension.