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Öğe Assessing volumetric changes in abdominal aortic aneurysms following endovascular repair(Clinics Cardive Publ Pty Ltd, 2021) Gunerhan, Yalcin; Isik, Mehmet; Dereli, Yuksel; Tanyeli, Omer; Kadiyoran, Cengiz; Iyisoy, Mehmet Sinan; Gormus, NiyaziObjective: Volumetric changes in the aneurysm sac were evaluated following endovascular aortic repair (EVAR) in intact abdominal aortic aneurysm (AAA) patients who underwent EVAR. Methods: Fifty-two patients, who underwent EVAR from 2015 to 2019, were analysed retrospectively. A total of 158 computed tomography angiography scans was examined by performing reconsctructive volumetric calculations. Total aneurysm volume (TAV), patent lumen volume (PLV) and thrombus-coated aneurysm wall volume (TCAWV) were calculated. The results obtained at six, 12 and 24 months postoperatively were compared with those of the pre-operative period. Results: Mean TAV had regressed 7% by the sixth month (p = 0.1), 27% by the 12th month (p = 0.0003) and 19% by the 24th month (p = 0.0008). Mean TCAWV had increased 2% by the sixth month (p = 0.3), and regressed 26% by the 12th month (p = 0.3) and 14% by the 24th month (p = 0.8). Mean PLV had regressed by 20% by the sixth month (p = 0.008), 29% by the 12th month (p = 0.0002) and 26% by the 24th month (p = 0.0006). For each individual proximal, middle and distal measurement, regression was observed at six and 12 months; however, an increase was observed at 24 months compared to the previous follow ups. Conclusion: The expansion measurements of TAV in the 24th month support the doubts on the medium- to long-term results of EVAR. The largest regression in the aneurysm sac was observed in the distal portion, then in the proximal portion, and the least regression was observed in the middle section.Öğe Clinical Evaluation of Acute Pancreatitis Caused by SARS-CoV-2 Virus Infection(Hindawi Ltd, 2021) Vatansev, Hulya; Yildirim, Mehmet Aykut; Kuccukturk, Serkan; Karaselek, Mehmet Ali; Kadiyoran, CengizIntroduction. Coronavirus 2019 disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has spread to more than 200 countries worldwide. We aimed to present acute pancreatitis (AP) cases caused by SARS-CoV-2 viral infection. Methods. The study was conducted retrospectively between April 2020 and June 2020 in Necmettin Erbakan University Meram, Medical Faculty Hospital, and 150 hospitalized patients diagnosed with COVID-19 were included. The degree of acute pancreatitis was determined according to the Atlanta classification. Organ failures of the patients were evaluated in terms of respiratory, cardiovascular, and nephrology according to the modified Marshall scoring (MMS) system, and CTSI (Balthazar score) and Imrie score were determined. Modified Marshall score >= 2 was considered organ failure. Results. A total of 29 patients were diagnosed with acute pancreatitis. All 29 patients with pancreatitis had respiratory failure during hospitalization. After the diagnosis of pancreatitis, there was no change in respiratory failure. According to the Atlanta classification, 19 patients had mild AP and 10 patients had moderate AP. Patients with acute pancreatitis were scored according to the CTSI (Balthazar score), and there were no patients with >= 6 severe pancreatitis. The CTSI score of 4 patients was 3. In addition, the Imrie score of the patients was determined and 8 patients with Imrie score >= 3 were identified. Conclusion. The rate of pancreatic damage in SARS-CoV-2 infection was found to be 19% (n=29) in our study. In our study, we highlight acute pancreatitis as a complication associated with COVID-19 and the importance of pancreatic evaluation in patients with COVID-19 and abdominal pain is demonstrated.Öğe A Comparison Between Hyaluronic Acid Filler and Dermofat Grafts With or Without Tie-Over Dressing for Lip Augmentation(Lippincott Williams & Wilkins, 2024) Ince, Bilsev; Zuhour, Moath; Kadiyoran, Cengiz; Avunduk, Mustafa Cihat; Dadaci, MehmetBACKGROUND There are many different autologous grafts used for lip augmentation, such as fat, fascia, or dermofat grafts (DFG). However, filling with synthetic materials such as hyaluronic acid (HA) fillers is the most preferred method.OBJECTIVE The authors aimed to compare DFG with HA fillers regarding cost, permanence, complication rate, gained volume, and satisfaction rate. The authors investigated the effect of tie-over dressings on the viability of DFG.PATIENTS AND METHODS Patients who received hyaluronic acid fillers were referred to as Group H. Patients who received grafts without tie-over and with tie-over dressings formed Groups D1 and D2, respectively. The lip index (LI) was used for volume comparisons. The viable area of the grafts was measured using ultrasound imaging.RESULTS At postoperative month 6, the only significant difference was found between Group D1 and Group D2 (p < .05). At the postoperative first year, Groups D1 and D2 had a statistically higher LI value compared with Group H. Group D2 had a higher viable area than Group D2 (p < .05). Group H and Group D2 showed higher satisfaction scores than Group D1 (p < .05).CONCLUSION Dermofat grafts with or without tie-over dressings can be considered a reliable and inexpensive choice for patients who seek a more permanent procedure. Tie-over dressings increase the predictability of DFG and reduce the need for overcorrection.Öğe COVID-19 infection can cause chemotherapy resistance development in patients with breast cancer and tamoxifen may cause susceptibility to COVID-19 infection(Churchill Livingstone, 2020) Vatansev, Hulya; Kadiyoran, Cengiz; Cure, Medine Cumhur; Cure, ErkanBreast cancer is the most common cancer in women and is the second most common cause of death in women. Estrogen plays an important role in breast tumor etiopathogenesis. Tamoxifen and other anti-estrogen drugs are used in breast cancer patients who have a positive estrogen receptor (ER). While angiotensin II plays a key role in breast cancer etiology and causes tamoxifen resistance, angiotensin 1-7 has been reported to may reduce the spread and invasion of breast cancer. During the COVID-19 infection, the virus blocks ACE2, and angiotensin 1-7 production discontinued. Angiotensin III production may increase as angiotensin II destruction is reduced. Thus, aminopeptidase upregulation may occur. Increased aminopeptidase may develop resistance to chemotherapy in breast cancer patients receiving chemotherapy. Estrogen can have a protective effect against COVID-19. Estrogen increase causes ER-a upregulation in T lymphocytes. Thus, estrogen increases the release of interferon I and III from T lymphocytes. Increasing interferon I and III alleviates COVID-19 infection. Tamoxifen treatment causes down-regulation, mutation, or loss in estrogen receptors. In the long-term use of tamoxifen, its effects on estrogen receptors can be permanent. Thus, since estrogen receptors are damaged or downregulated, estrogen may not act by binding to these receptors. Tamoxifen is a P-glycoprotein inhibitor, independent of its effect on estrogen receptors. It suppresses T cell functions and interferon release. We think tamoxifen may increase the COVID-19 risk due to its antiestrogen and P-glycoprotein inhibitory effects.Öğe Deep femoral artery branching by MDCT in a Turkish population and its potential clinical implications(Soc Anatomica Espanola, 2023) Keles, Ali; Yilmaz, Mehmet T.; Kadiyoran, Cengiz; Saygin, Duygu A.The deep femoral artery and its branches are vital for the arterial circulation of the lower ex-tremity. The aim of the current study is to obtain morphometric and morphological data on the deep femoral artery and its branches and to in-vestigate their clinical importance in the Turkish population. Morphometric measurements of the deep femoral artery and femoral artery were per-formed. The diameters of the femoral artery and deep femoral artery were measured in the axial plane. Classification was made according to the size of these diameters. A morphological classifi- cation was obtained by examining the variations of the deep femoral artery branches. The distance from the origin of the deep femo-ral artery to the midpoint of the inguinal ligament was 39.56 & PLUSMN; 8.52 mm, and the distances from the origin of the lateral circumflex femoral artery to the medial circumflex femoral artery were 17.15 & PLUSMN; 4.79 mm and 12.52 & PLUSMN; 4.58 mm, respectively. The study results show that there was a sig-nificant difference between genders in terms of the diameters measured. In the classification made by using the diameters, Type D (39%) had the highest rate, whereas Type C had the lowest rate (7.3%). According to the morphological clas- sification, Type I (52.1%) was the most common in all individuals, and Type V and Type VII (2.3%) were the least common. Our study includes both morphometric and morphological information about the femoral artery and deep femoral ar-tery of the Turkish population. We consider that the current study will be useful for cardiologists, interventional radiologists, orthopedists, and re-gional surgeons in clinical practice.Öğe Early Computed Tomography Findings of Novel Coronavirus Disease 2019 (COVID-19) Pneumonia(Briefland, 2020) Yilmaz, Pinar Diydem; Kadiyoran, Cengiz; Bakdik, Suleyman; Poyraz, Necdet; Vatansev, HulyaBackground: Novel coronavirus disease (COVID-19) pneumonia is caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), which is highly contagious and threatens human health. Chest computed tomography (CT) is an accurate imaging modality for diagnosis and follow-up. Objectives: To investigate early CT features of COVID-19 pneumonia. Methods: Retrospective study. Sixty-three patients with COVID-19 pneumonia (28 men, 35 women; age range, 21 - 85 years; mean, 59 years) confirmed by reverse transcription-polymerase chain reaction (RT-PCR) were enrolled in this retrospective study and CT findings were evaluated. Patients were classified into three groups for estimating COVID-19 pneumonia, according to CT features. Results: Nineteen (30%) patients classified as out of COVID-19 pneumonia had normal CT findings. Twenty-eight (44%) patients, classified as highly suggestive for COVID-19 pneumonia, had typical findings for COVID-19 pneumonia. In highly suggestive for COVID-19 pneumonia group most common CT features were peripheral (64%), multilobar (96%), patchy, and round (54%) ground-glass opacity (GGO) (57%). Air bronchogram (93%), crazy-paving patterns (79%), and vascular thickening (61%) were the mostcommon special findings. We only detected these rare findings such as halo sign, reverse halo sign, lymphadenopathy, pleural and pericardial effusion, pleural thickening, and fibrotic lines in patients with COVID-19 with chronic diseases. Conclusions: The early CT findings are peripheral, multilobar, patchy, and round ground glass opacities accompanied by vascular thickening, crazy-paving pattern, or air bronchogram sign. Rare findings are only seen in the presence of concomitant diseases.Öğe Is there a relationship between adenomyosis and nabothian cyst?(Int Scientific Information Inc, 2022) Yilmaz, Pinar Diydem; Kadiyoran, Cengiz; Horasanli, JulePurpose: The aim of this study was to investigate whether there is a relationship between adenomyosis and nabothian cyst (NC) in a large patient series. Material and methods: The patient's data were scanned retrospectively and patients with a junctional zone thickness of 12 mm and above on magnetic resonance imaging were accepted as group adenomyosis (group A). Patients with a junctional zone thickness of less than 12 mm were not admitted as adenomyosis (control group). Both groups were compared for NC. Results: In group A, 176 (69.8%) patients had NC (n = 250), while in the control group (n = 202), 57 (28.2%) patients had NC. NC was significantly higher in group A than in the control group (p < 0.001). Conclusions: The aetiology of NC is still unclear. According to our results, similar factors may affect adenomyosis and NC aetiopathogenesis.Öğe Liver metastasis in colorectal cancer: evaluation of segmental distribution(Termedia Publishing House Ltd, 2019) Kadiyoran, Cengiz; Cizmecioglu, Hilal Akay; Cure, Erkan; Yildirim, Mehmet Aykut; Yilmaz, Pinar DiydemIntroduction: It is known that the liver is the main target for metastasis in colorectal cancer. However, we do not know enough from the literature to describe the segmental distribution of liver metastatic lesions of colorectal cancers. Aim: To investigate which liver segment is affected. Material and methods: A total of 326 patients (female/male, n = 115/221; age: 53 +/- 8/51 +/- 7 years) were included in our study, classified according to their pathological diagnosis. After liver metastases of the patients were determined, they were divided according to Couinaud classification. Results: While the total number of metastases detected in the right lobe was 691 (70.1%), the number of metastases detected in the left lobe was 294 (29.9%), and the difference was highly significant (p < 0.0001). Metastases in the right lobe anterior segment amounted to 279 (40.4%), and metastasis in right lobe posterior segment was 412 (59.6%), and the difference was significant. When the total number of metastatic lesions is evaluated by excluding segment I, the largest number of lesions were observed in segment VIII. The liver segments with the highest number of metastatic lesions were, respectively, VII, IV, VI, V, III, and II. In this case, the fewest metastatic lesions were observed in segment II. Conclusions: Liver metastases of colorectal cancer are more common in the right lobe than in the left lobe. The right lobe posterior segment (segment VI) is the main target of metastases.Öğe Liver-Spleen Ratio: Can It Be Used for the Prediction of Coronary Artery Disease?(Aves, 2022) Poyraz, Necdet; Ozer, Hakan; Baloglu, Ismail; Kadiyoran, Cengiz; Yilmaz, Pinar Diydem; Sertdemir, Ahmet Lutfu; Turkmen, KultiginBackground: Considering that ectopic fat accumulation in various organs, especially the heart and liver, is a cardiometabolic risk factor, the need for easily accessible markers of ectopic fat accumulation is inevitable. The main starting point of the study is based on the hypothesis of predicting cardiovascular disease risk through the link that can be established between the liver-spleen ratio, which is one of the strong indicators of hepatosteatosis, and epicardial adipose tissue volume. Methods: This was a retrospective study. The records of 283 consecutive patients who underwent coronary computed tomography angiography in our Radiology Department were reviewed retrospectively from our hospital's system. All patients' epicardial adipose tissue volume and liver-spleen ratio were calculated using appropriate criteria on non-contrast computed tomography images. Additionally, the Coronary Artery Disease-Reporting and Data System was calculated on contrast computed tomography images. The participating patients were divided into groups according to the liver-spleen ratio and Coronary Artery Disease-Reporting and Data System score. Results: We found that while there was a negative correlation between the liver-spleen ratio and epicardial adipose tissue volume in the hepatosteatosis group, this relationship was not observed in the non-steatosis group. In addition, we observed that the family history of cardiovascular disease and the frequency of cardiovascular disease were higher in the hepatosteatosis group than in the other group, and there was a correlation between cardiovascular disease and the liver-spleen ratio. Also, we found that age and liver- spleen ratio values were found to be independent predictors of coronary artery disease. Conclusion: In our study, we found that the frequency of cardiovascular disease was lower in patients with a high liver-spleen ratio. We also demonstrated in the study that the liver-spleen ratio, which indicates a low level of epicardial adipose tissue volume accumulation, is an independent predictor of cardiovascular disease. In addition, the use of liver-spleen ratio, which is more valuable than liver attenuation in predicting hepatic steatosis, may be more useful in evaluating the risk of hepatosteatosis-related cardiovascular disease.Öğe Monocyte-to-High-Density Lipoprotein Ratio may be Related to the Coronary Artery Disease Reporting and Data System Score and Increased Left Ventricular Mass(Briefland, 2022) Kadiyoran, Cengiz; Yilmaz, Pinar DiydemBackground: Activation of monocytes and lower high-density lipoprotein (HDL) levels accelerate atherosclerosis. The monocyteto-HDL ratio (MHR) and the coronary arterydisease-reporting and data system (CAD-RADS) score are recognized as proper indicators of the atherosclerotic process. Objectives: This study aimed to investigate the relationship between the CAD-RADS score and the left ventricular mass (LVM) and MHR and to evaluate the role of MHR as a predictive marker for the CAD-RADS score. Methods: In this study, the data of 160 patients, who underwent coronary computed tomography angiography (CCTA) for cardiac assessment in our radiology unit between January 2019 and January 2021, were collected and evaluated retrospectively. The CADRADS score, LVM, and MHR were calculated for the patients. Patients and Methods: The multivariate analysis showed independent relationships between CAD-RADS scores and high-sensitive C-reactive protein (hs-CRP) (beta = 407, P < 0.001), MHR (beta = 351, P < 0.001), age (beta = 0.254, P < 0.001), male sex (beta = 0.179, P < 0.001), and diabetes mellitus (beta = 0.122, P = 0.008). The cutoff values of MHR (9.4 for CAD-RADS-1,11.5 for CAD-RADS-2,12.8 for CAD-RADS-3, and 14.0 for CAD-RADS-4) showed high sensitivity and specificity for the CAD-RADS scores. Conclusion: Based on the results, MHR may be associated with the CAD-RADS score and increased LVM. As an inexpensive and reliable test, MHR may be useful for the early diagnosis and follow-up of atherosclerotic heart diseases.Öğe Prognostic Significance of Radiologic Extranodal Extension in Nasopharyngeal Cancer(Sage Publications Inc, 2022) Eryilmaz, Melek Karakurt; Kadiyoran, CengizObjective. The aim of the present study was to evaluate the prognostic value of radiologic extranodal extension (rENE) in patients with nasopharyngeal cancer. Study Design. Retrospective review. Setting. Tertiary university hospital. Methods. We identified patients with nasopharyngeal cancer and lymph node metastasis who underwent pretreatment neck computed tomography or magnetic resonance imaging and evaluated rENE from the involved lymph node. Univariate Kaplan-Meier and multivariate Cox regression analyses were used to compare rENE1 and rENE- groups for local regional relapse-free survival, distant metastasis-free survival, and overall survival. Results. Of 61 cases, 24 (39.3%) were rENE1 and 37 (60.7%) were rENE-. The median follow-up was 65.5 months. The 5-year distant metastasis-free survival and overall survival rates were lower in the rENE1 group than the rENE- group (70.8% vs 89.2%, P =.016; 66.7% vs 89.2%, P =.01, respectively). Differences in locoregional control between the groups were not significant (P =.18). The 5-year rates for local regional relapse-free survival were 87.5% for rENE1 and 91.9% for rENE-. In multivariate analysis, the presence of rENE was a significant independent adverse prognostic factor for distant metastasis-free survival and overall survival. Conclusions. We showed that rENE is an independent prognostic factor for poor distant control and survival in patients with nasopharyngeal cancer.Öğe Proprotein convertase subtilisin/kexin type 9 is associated with atherosclerosis in patients with Behcet's disease(Taylor & Francis Inc, 2022) Aydogan Baykara, Rabia; Yilmaz, Pinar Diydem; Goktepe, Mevlut Hakan; Kadiyoran, Cengiz; Ogul, Mustafa; Kucuk, Adem; Cumhur Cure, MedineObjectives The incidence of cardiovascular disease is increased in patients with Behcet's disease (BD). Proprotein convertase subtilisin/kexin type 9 (PCSK9) causes the acceleration of atherosclerosis. We aimed to investigate whether there is a relationship between PCSK9 with carotid artery intima-media thickness (cIMT), a marker of subclinical atherosclerosis, and BD disease activity. Methods Fifty-eight patients with BD and 58 age-, gender-, and body mass index (BMI)-matched healthy control subjects were included in the study. The disease activity of the patients was estimated. Individuals' cIMT values were measured, and PCSK9 levels were studied. Results Patients with BD' cIMT (0.51 +/- 0.1 vs 0.41 +/- 0.1 mm, p < .001) and PCSK9 (623.2 +/- 101.7 +/- 10.1 vs 528.3 +/- 242.7 ng/ml, p = .007), values were significantly higher than the control group. In stepwise regression analysis, there was an independent relationship between cIMT with PCSK9 (beta = 0.179, p < .050). There was no independent relationship between disease activities with PCSK9. Based on the ROC curve analysis, the PCSK9 optimal cutoff value for cIMT was 595.1 ng/ml, sensitivity 66.7%, specificity 64.7% (AUC = 0.672; 95% CI: 0.530-0.815, p = .040). Conclusion There is a strong independent association between subclinical atherosclerosis and PCSK9 in patients with BD. There may be no independent association between PCSK9 and disease activity.Öğe Spontaneous Resolution of an Orbital Mass After Delivery: A Diagnostic Challenge(Lippincott Williams & Wilkins, 2018) Dadaci, Zeynep; Kadiyoran, Cengiz; Golen, Mustafa; Cizmecioglu, Hilal AkayThe authors report a 35-year-old woman who presented 1 month after delivery with the complaint of pain behind her left eye which started during her pregnancy. The patient described increased fullness with dependent head position and pain on left gaze but she had no proptosis and her ocular examination was normal. Magnetic resonance imaging (MRI) revealed an intraconal mass with inhomogeneous contrast enhancement. As the authors did not suspect malignity and her ocular examination was normal without any signs of inflammation, the authors followed the patient closely. Repeat MRI obtained 6 months after delivery revealed complete resolution of the mass. Upon disappearance of the lesion, the authors reviewed the case thoroughly and decided that orbital venous anomaly with intralesional hemorrhage/thrombosis was the most probable diagnosis. As hemorrhage or thrombosis occurring in orbital vascular anomalies may be a diagnostic challenge because of the localized lesion and distinct borders, careful interpretation of clinical characteristics and MRI findings and close follow-up is important in interpretation of orbital mass lesions, especially in pregnant or puerperal women.Öğe Syndecan 1 may slow the progression of subclinical atherosclerosis in patients with ankylosing spondylitis(Taylor & Francis Inc, 2023) Yilmaz, Pinar Diydem; Kadiyoran, Cengiz; Goktepe, Mevlut Hakan; Akkubak, Yasemin; Icli, Abdullah; Kucuk, AdemBackground Subclinical atherosclerosis may be seen at an early age of ankylosing spondylitis (AS). Syndecan 1 (S1) expression is increased in response to proinflammatory cytokine and inflammation. High S1 may reduce carotid atherosclerosis progression. We aimed to investigate the relationship between S1 levels and subclinical atherosclerosis in patients with AS. Methods Fifty-eight patients diagnosed with AS and 58 age-, sex-, and body mass index-matched controls were included in the study. S1 level and carotid intima-media thickness (cIMT) were evaluated using appropriate methods. Results AS patients' cIMT (0.53 +/- 0.1 vs 0.45 +/- 0.1 mm, p = .008), S1 (6.0 [1.7-149.2] vs 5.5 [1.0-29.8] ng/ml, p = .020), CRP (C-reactive protein) (2.1 [0.1-19.7] vs 1.1 [0.3-9.6] mg/dl, p = .012), fibrinogen (330.2 +/- 87.0 vs 278.0 +/- 54.5 mg/dl, p < .001) values were significantly higher than the values of the control group. There was a negative correlation between cIMT and CRP (p = .034), age (p < .001), disease duration (p = .005), BASDAI (p = .048) and fibrinogen (p = .009) in AS patients. There was a negative correlation between cIMT and S1 (p = .029). In multivariate analysis, an independent relationship was found between cIMT and age (beta = 0.611, p < .001) and syndecan (beta = -0.196, p = .046). Conclusion S1 level may rise in AS patients to suppress the inverse effects of proinflammatory cytokines and inflammation. A negative relationship between the cIMT values of AS patients and S1 level may reveal that S1 has a protective effect on the development of atherosclerosis in AS patients, independent of disease activity.
