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Öğe Bilateral Supernumerary Kidney: A Very Rare Presentation(Kowsar Publ, 2014) Keskin, Suat; Batur, Abdussamet; Keskin, Zeynep; Koc, Abdulkadir; Ozcan, Irfan FiratTo our knowledge, bilateral supernumerary kidney is a very rare renal abnormality and there are five cases presented in the literature. It is difficult to diagnose supernumerary kidney and clinicians have not detected most cases preoperatively. Laboratory and imaging studies were acquired and carefully examined. The normal laboratory tests were found. Emergency ultrasonography was performed and they revealed no signs of parenchymal abnormality in both kidneys. Serial imaging study including enhanced computed tomography (CT) was performed. An imaging study identified bilateral supernumerary kidney with expanded collecting systems. On each side, significant rotation anomaly was found. In addition, there were two different renal arteries originating from the aorta. This report presents radiological determinations of supernumerary kidney bilaterally in a young man. We think that CT commonly appears to be enough for the diagnosis of supernumerary kidneys.Öğe Caroli disease with bilateral severe bullous emphysema An unknown component(Saudi Med J, 2012) Keskin, Zeynep; Keskin, Suat; Yesildag, Mihrican Y.; Yesildag, AhmetWe suspected that the multi-bullous parenchymal disease of our patient could be related to Caroli disease (CD) because he had no pulmonary pathology before the diagnosis of CD. The CD associated with bilateral multiple bullous emphysema may be an unknown component. Saudi Med J 2012; Vol. 33 (11): 1227-1228Öğe CT Findings of Mycobacterium Avium Intracellulare Infections in the Lung(Modestum Ltd, 2014) Keskin, Suat; Sakarya, Mehmet Emin; Keskin, ZeynepMycobacterium avium intracellulare (MAI) is the most common pulmonary pathogen in the population with acquired immunodeficiency syndrome (AIDS). The most common radiological pattern was multiple pulmonary nodules. The commonly observed CT findings are centrilobular, peribronchovascular nodules, bronchiectasis, consolidation, tree-in-bud, pleural thickening, pleural adhesion.Öğe CT Findings of Mycobacterium Avium Intracellulare Infections in the Lung(Modestum Ltd, 2014) Keskin, Suat; Sakarya, Mehmet Emin; Keskin, ZeynepMycobacterium avium intracellulare (MAI) is the most common pulmonary pathogen in the population with acquired immunodeficiency syndrome (AIDS). The most common radiological pattern was multiple pulmonary nodules. The commonly observed CT findings are centrilobular, peribronchovascular nodules, bronchiectasis, consolidation, tree-in-bud, pleural thickening, pleural adhesion.Öğe Evaluation of effects of bronchiectasis on bronchial artery diameter with multidetector computed tomography(Sage Publications Ltd, 2014) Kosar, Mehmet; Kurt, Aydin; Keskin, Suat; Keskin, Zeynep; Arslan, HalilBackground: Among patients with increased bronchial artery diameter there is a significant association between hemoptysis and bronchiectasis score. The higher score of bronchiectasis, the higher risk of hemoptysis development. Purpose: To investigate the association of stages of bronchiectasis based on a computed tomography (CT) grading system, with bronchial artery diameter and hemoptysis in patients with bronchiectasis. Material and Methods: Patients with lung pathologies other than bronchiectasis, which may cause hemoptysis, were excluded from the study. One hundred and forty-five patients who underwent contrast-enhanced thorax CT by a 64-detector CT for various indications, and who were diagnosed with bronchiectasis, were evaluated retrospectively. CT examinations were carried out by two radiologists with 9 and 4 years of experience with chest radiology, respectively. The diameters of the right and left bronchial arteries were measured 1 cm from the aortic origin and perpendicular to the vessel axis. Cases were assessed based on the Bhalla CT scoring system. The hemoptysis history of every patient was taken. Results: The diameters of the right and left bronchial arteries were significantly greater in patients with scores of 2 and 3 bronchiectasis than in patients with a score of 1. This was significantly greater in patients with a score of 3 than in patients with a score of 2 (P < 0.05). In patients with a score of 1, the right bronchial artery diameter was significantly greater than that of the left bronchial artery (P < 0.05). Right bronchial artery diameters were significantly greater than left bronchial artery diameters in score 3 patients (P < 0.05). A significant association was observed between hemoptysis and bronchiectasis in patients with increased bronchial artery diameter (P < 0.05). Conclusion: In patients with bronchiectasis, as the stage of bronchiectasis increases, the bronchial artery diameters and the risk of hemoptysis increase. We think that in patients who are diagnosed with bronchiectasis via multidetector CT (MDCT), based on scoring with bronchial artery diameters, the risk of hemoptysis can be estimated, and early management plans can be implemented.Öğe Gangrenous Appendicitis in a Boy with Mobile Caecum(Kowsar Publ, 2015) Keskin, Suat; Keskin, Zeynep; Gunduz, Metin; Sekmenli, Taner; Kivrak, Hatice YazarA mobile caecum and ascending colon is an uncommon congenital disorder, and it is even rarer as the cause of an acute abdomen during childhood. This report presents the case of a 6-year-old boy with acute gangrenous appendicitis with a mobile caecum and ascending colon. Data from the surgical course, as well as laboratory and imaging studies, were acquired and carefully examined. Emergency ultrasound (US) was performed and revealed no signs of appendicitis in the right lower quadrant. Serial imaging study, including non-enhanced computed tomography (CT), was performed. An imaging study identified epigastric appendicitis with mobile caecum. Surgery was executed under general anesthesia with a median incision extending from the epigastrium to the suprapubic region. The caecum was mobile and placed in the right epigastric area, next to the left lobe of the liver and gallbladder. The gangrenous appendix was discovered posterior to the caecum and transverse colon, enlarging to the left upper quadrant. Appendectomy was executed, the gangrenous appendix was confirmed pathologically, and the patient was released 4 days later. In the US, if there are unusual clinical findings or no findings in patients with abdominal pain, CT is beneficial in determining the location of the caecum and appendix and preventing misdiagnosis in children.Öğe Hepatosellüler karsinomda radyolojik algoritma ve görüntüleme yöntemleri(2014) Küçükapan, Ahmet; Keskin, Suat; Keskin, Zeynep; Poyraz, NecdetRadyolojik görüntülemenin amacı hepatosellüler karsinomu erken evrede tespit etmektir. Bunun amacı lezyonu küratif tedavi evre- sinde yakalayabilmektir. Son yıllarda özellikle küçük karsinomların erken tespit edilebilmesi için fazlaca çaba sarf edilmektedir. Bu derlemenin amacı hepatosellüler karsinomların tespiti ve tanımlanmasında ultrasonografi, bilgisayarlı tomografi, manyetik rezonans görüntüleme, radyonüklid görüntüleme, pozitron emisyon tomografi ve dijital subtraksiyon anjiografi gibi invaziv olmayan görüntü- leme yöntemlerinin etkinliğini belirlemektir.Öğe The İncidence Of Renal Artery Stenosis İn Patients With Significant Stenosis Of Lower Extremity Arteries(2012) Keskin, Zeynep; Küçükay, Fahrettin; Keskin, SuatBu çalışmanın amacı, renal arter stenozu ile periferik arter hastalığı birlikteliğini değerlendirmek ve periferik arter hastalığı olan hastalarda insidental renal arter stenozu sıklığını saptamaktır. Bu çalışmaya alt ekstremite arterlerine yönelik DSA yapılan ve en az bir segmentinde %50 ve üzeri stenoz saptanan toplam 1502 hasta dahil edildi. Alt ekstremite arterleri aortoiliak, femoropop- liteal ve infrapopliteal olarak 3 segmente ayrılarak değerlendirildi. Segmentler tek segment ve multisegment tutulumu olarak sınıflandırıldı. Multisegmentler aortoiliakfemoropopliteal, aortoiliakinfrapopliteal, femoropoplitealinfrapopliteal ve aorto ilaikfemoropoplitealinfrapopliteal olarak isimlendirildi. En az bir segmentde %50 ve üzeri stenozu olanlar çalışmaya alındı. Segmental periferal arter hastalığı ve renal arter stenozu birlikteliğini karşılaştırmada ki-kare testi kullanıldı. Periferik vasküler hastalığı olan 1502 hastanın 228 inderenal arter stenozu saptandı. Renal arter stenozu sıklığı tek segment tutulumu olanlarda multi segment tutulumuna göre daha az bulundu (p0.03). Renal arter stenozu sıklığı tek segment tutulumunda %11,9 ve multi- segment tutulumunda %16,4 bulundu. Renal arter stenozu sıklığı diğerleriyle karşılaştırıldığında infrapopliteal tutulumda (%6) daha az bulundu (p0.027). Sağ, sol ve bilateral renal arter stenozuyla segment tutulumları karşılaştırıldığında segment grupları arasında fark bulunmadı (p0.086, p0.219). Kadınlarda renal arter stenozu sıklığı daha yüksek oranda bulundu (%23.6, p0.01). Renal arter stenozu periferal vasküler hastalığı olanlarda %15,2 sıklıkla görülmektedir. Renal arter stenozu infrapopliteal segment tutulumunda daha görüşmektedir. Multisegment tutulumu ile karşılaştırıldığında tek segment tutulumunda renal arter stenozu sıklığı kadınlarda erkeklere nazaran daha sıktır.Öğe Morphometric risk factors effects on anterior cruciate ligament injury(Turkish Joint Diseases Foundation, 2023) Gultekin, Muhammet Zeki; Dincel, Yasar Mahsut; Keskin, Zeynep; Arslan, Serdar; Yildirim, AhmetObjectives: This study aims to compare the morphometric differences between patients with and without an anterior cruciate ligament (ACL) injury and to investigate the anatomical risk factors associated with ACL injury. Patients and methods: Between February 2020 and February 2022, a total of 100 patients (57 males, 43 females; mean age: 36.2 +/- 6.8 years; range, 18 to 45 years) who were operated for isolated non-contact ACL tear as the patient group and a total of 100 healthy individuals (58 males, 42 females; mean age: 35.0 +/- 6.9 years; range, 18 to 45 years) without an ACL tear as the control group were included. Magnetic resonance imaging scans of the knee joint were included in the study. Morphological variables of the ACL, distal femur, proximal tibia, and menisci were measured. Results: The mean ACL inclination angle and medial meniscus bone angle were 37.7 +/- 3.8 and 20.2 +/- 2.9 in the patient group and 48.1 +/- 3.3 and 25.0 +/- 2.9 in the control group. According to the results of multivariate analysis, those with small ACL inclination angle and medial meniscus bone angle were more likely to have ACL tear (odds ratio: 0.128, intraclass correlation coefficient: 0.038-0.430, p= 0.001). Conclusion: Small ACL inclination angle and medial meniscus bone angle can be a risk factor for ACL tear.Öğe Photoclinic Diagnosis: Primary Lipoma of the Diaphragm and Enormous Pericardial Fat Pad Presenting with Long-term Dyspnea(Acad Medical Sciences I R Iran, 2013) Keskin, Zeynep; Keskin, Suat; Yesildag, Mihrican; Yesildag, Ahmet[Abstract Not Availabe]Öğe Prognostic value of preoperative neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios, and multiphasic renal tomography findings in histological subtypes of renal cell carcinoma(Bmc, 2014) Keskin, Suat; Keskin, Zeynep; Taskapu, Hakan Hakki; Kalkan, Havva; Kaynar, Mehmet; Poyraz, Necdet; Toy, HaticeBackground: To determine the relationship between renal cell carcinoma subtypes and the associated mortality and biochemical parameters. An additional aim was to analyze multiphasic multidetector computed tomography findings. Methods: This study is a hospital-based retrospective investigation, using 211 patients with a diagnosis of renal cell carcinoma upon computed tomography examination. The histological subtypes included clear cell in 119 patients, chromophobe cell in 30 patients, papillary cell in 25 patients, mixed cell in 32 patients, and sarcomatoid cell in 4 patients. Results: The mean age of the patients participating in this study was 61.18 +/- 11.81 years, and the mortality rate was 10.4% (n = 22) through the 2-year follow-up. The ratios of both the neutrophil-to-lymphocyte upon admission to the hospital and platelet-to-lymphocyte of the non-surviving group were significantly higher than those of the surviving group (p < 0.05). When the analysis of the 2-year survival of the patients was examined according to the median platelet-to-lymphocyte ratio values, the Kaplan-Meier survival curves were significantly different between the surviving and non-surviving groups (p = 0.01). In two-way analysis of variance test, statistically significant results which were influenced by mortality (p = 0.028) and were found between renal cell carcinoma subtypes in the computed tomography density of corticomedullary phase (p = 0.001). Conclusions: The neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio may represent widely available biomarkers in renal cell carcinoma, and the logistic regression model indicated that neutrophil-to-lymphocyte ratio was a significant predictor for mortality. According to the median platelet-to-lymphocyte ratio values, the Kaplan-Meier survival curves were significantly different between the surviving and non-surviving groups.Öğe Strain elastography in the characterization of renal cell carcinoma and angiomyolipoma(Canadian Urological Association, 2015) Keskin, Suat; Guven, Selcuk; Keskin, Zeynep; Ozbiner, Huseyin; Kerimoglu, Ulku; Yesildag, AhmetIntroduction: We evaluate the diagnostic performance of strain elastography to differentiate renal cell carcinoma (RCC) from angiomyolipoma (AML). Methods: Strain elastography was performed in 65 patients (mean age 55.5 years; range: 32-81) who had renal lesions (24 AMLs and 41 RCCs) prospectively. Lesions were classified according to lesion size and histological subtypes. The strain ratios of the RCCs and AMLs were evaluated by a radiologist. The area under the curve and the cut-off point were used to assess diagnostic performance. Sensitivity, specificity, and positive and negative predictive values were obtained. Results: In assessing the mean strain ratio, we divided the groups in 3 according to size: (1) <20-mm lesions; (2) 20- to 40-mm lesions; and (3) >40-mm lesions; the respective mean strain ratios were: 1.5 +/- 0.5 (range: 0.06-5.92), 2.8 +/- 0.4 (range: 0.17-9.92), 2.7 +/- 0.3 (range: 0.08-6.15). When RCCs and AMLs were compared, there was a statistically significant difference in the strain ratio among the 3 groups divided per lesion size (p < 0.01). For the strain ratio, the mean +/- standard deviation was 1.1 +/- 0.1 for AMLs and 3.4 +/- 0.3 for RCCs (p < 0.01). When lesion subtypes were compared, there was a statistically significant difference in the strain ratio between the AML and clear cell RCC (p < 0.01). Conclusions: For assessing renal lesions, strain elastography and strain ratio values may be useful in differentiating RCCs from AMLs.
