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Öğe Anatomical variations of the aortic arch branching pattern using CT angiography: a proposal for a different morphological classification with clinical relevance(Springer, 2022) Acar, Gulay; Cicekcibasi, Aynur Emine; Uysal, Emine; Koplay, MustafaThe aortic arch (AA) branching pattern variations are usually asymptomatic, but they may lead to complications during cardiovascular procedures. In this retrospective study, we aimed to analyze the frequency of anatomical variations of the AA and to develop a different approach of morphological classification based on radiological criteria. 1026 computed tomography angiography scans of adults were evaluated and the presence of left-sided (LAA) and right-sided (RAA) AA were determined in 1023 (99.71%) and 3 (0.29%) of patients, respectively. According to the number of branches, LAA branching pattern of each patient was subclassifed in five morphological types. Based on the order and type-specific reference points, an anomalous LAA variants were classified into 20 subtypes. Type 1 (Typical branching pattern) LAA was identifed in 781 (76.12%) of the patients. Among 242 aberrant LAA variants (four types, 23.58%), the most common subtypes; Type 2A with brachiocephalico-carotid trunk (BCT), Type 4A(1) with an aberrant left vertebral artery (ALVA), and Type 3A(1), in which BCT coexisted with ALVA, were observed in 17.6%, 3.6%, and 0.88% of the cases, respectively. The frequency of remaining LAA variants ranged from 0.39% to 0.097%. In addition, Type 3B(2) and Type 4C were first identified in our study. We observed Type I and II RAA in one female (0.097%) and two cases (male and female, 0.19%), respectively. Knowledge of AA branching variations is of great interest in neck and thoracic surgery and the new morphological types in clinically applicable form recommended in this study can be used in endovascular interventions.Öğe Anatomical Variations of the Celiac Trunk and Hepatic Arteries with a New Classification, Based on CT Angiography(Coll Physicians & Surgeons Pakistan, 2022) Acar, Gulay; Cicekcibasi, Aynur Emine; Koplay, Mustafa; Seher, NusretObjectives: To analyse the distribution of anatomical variations in both celiac trunk (CeT) and hepatic artery (HA) branching patterns on computed tomography (CT) angiography images; as well as to propose a new classification by unifying the already reported classifications of the CeT and HA vascular anatomy. Study Design: Observational study. Place and Duration of Study: Department of Radiology, Faculty of Medicine, Selcuk University, Konya, Turkey, from February 2019 to March 2020. Methodology: CT angiography-based evaluation of the CeT and HA branching patterns was performed in patient undergoing routine contrast-enhauced CT of abdomen. Types of variation were determined and classified into five types (1-5) and ten subtypes. Distribution was also sorted by age and gender. Results: Type 1 (classic CeT and HA branching pattern) was detected in 240 (70.6%) out of 340 cases (126 females, 214 males). Sixty-five (19.12%) had Type 2 subtypes, in which HA branching pattern coexists with normal CeT configuration; whereas, Type 3a and 3d, Type 4 and 5 having anomalous CeT variants, with typical HA pattern, were observed in 5.87% (20/340) of the cases. The frequency of the concurrent variations (Type 3b and 3c) was 4.41% (15/340). The least frequent subtypes, Type 4 and 5, were observed in one (0.29%) and three (0.88%) cases, respectively. There was no significant differences in branching types frequency by gender and age (p>0.05). Conclusion: Awareness of the range of anatomical variation in both the CeT and HA branching patterns, especially concurrent variations, is vital when planning surgical and radiological interventions to prevent possible iatrogenic injury and complications.Öğe Behçet Hastalığında İyatrojenik Sağ İnternal Mamaryan Arter Çalma Sendromu(2014) Erol, Cengiz; Paksoy, Yahya; Kanat, Fikret; Özbek, Seda; Kıvrak, Ali Sami; Koplay, Mustafa; Özbek, OrhanSubklaviyan arter anevrizması nedeniyle opere edilen bir Behcet olgusunda anevrizmaya açılan vertebral arter ve sağ internal mamaryan arterin, anevrizma kesesi içerisinde bırakılması sonucu, post operatif dönemde iatrojenik olarak ortaya çıkan sağ internal mamaryan arter çalma sendromunun görüntüleme bulgularını sunmak istedik. Bizim bilgilerimize göre bugüne kadar, sağ internal mamaryan arterin sorumlu olduğu çalma sendromu literatürde tariflenmemiştir. Kesitsel noninvaziv radyolojik görüntüleme yöntemleri, bu olguda anatomik detayın gösterilmesi, cerrahi sonrası değişen ve yeni ortaya çıkan anatominin ortaya konmasında oldukça başarılı olmuştur.Öğe Nörofibromatozis tip 1: Kraniyal MRG Bulguları(2014) Keleşoğlu, Kazım Serhan; Keskin, Suat; Sivri, Mesut; Erdoğan, Hasan; Nayman, Alaaddin; Koplay, MustafaAmaç: Nörofibromatozis tip 1 (NF1, von Recklinghausen hastalığı, periferal nörofibromatozis) öncelikle nöral dokular olmak üzere birçok sistemi tutan nörokutanöz bir hastalıktır. Çocuklarda kanser yatkınlığını artırması sebebiyle bilinmesi ve tanı konması önem kazanan bir sendromdur. Amacımız kliniğimizde incelenen nörofibromatozis tip 1 hastalarının kraniyal MRG bulgularını tartışmak ve mevcut bulgular eşliğinde nörofibromatozis tip 1'in kraniyal tutulum şekillerini değerlendirmektir. Gereç ve yöntemler: Haziran 2011 ve Mart 2013 tarihleri arasında kliniğimizde Nörofibromatozis tip 1 tanısı olan ve en az 1 MRG incelemesi bulunan 21 hastanın 19'u değerlendirilmiştir. 6-32 yaş aralığında (ortalama yaş 15,3), 7 kız ve 12 erkek hastadan elde edilen kraniyal MRG incelemeleri retrospektif olarak taranmıştır. Çalışmaya dahil edilen olgulardaki lezyonların tipi ve lokalizasyonları farklı bir radyolog tarafından yeniden değerlendirilmiştir. Bulgular: Nörofibromatozis tip 1 tanısıyla takip edilen ve kraniyal MR görüntülemeleri değerlendirilen 19 hastanın 16'sında santral sinir sisteminde hamartomatöz lezyonlar, 5 hastada optik gliom ya da optik sinir kalınlaşması, 5 hastada pleksiform nörofibromlar ve 2 hastada nörofibrom odakları izlenmiştir. Sonuç: Birçok farklı tümör ve bulgu içermesi ve en sık kalıtılan santral sinir sistemi hastalığı olması Nörofibromatozis tip 1'in tanı kriterlerinin ve lezyonlarının bilinmesini ve akılda tutulmasını gerektirmektedir. Klinik bulguları Nörofibromatozis tip 1 kriterlerini karşılamayan, tanı kriterlerindeki lezyonlar gelişmeyen veya tanı konurken şüphede kalınan hastaların tanısı ve hastalığın tümöral oluşumların gelişmesine olan yatkınlığı sebebiyle Nörofibromatozis tip 1 hastalarında MR görüntüleme bulguları erken ve doğru tanı açısından önemlidir.Öğe A Rare Anomalous Origin of the Right Vertebral Artery from the Right Aortic Arch with the Left Aberrant Subclavian Artery Arising from Kommerell's Diverticulum(Wolters Kluwer Medknow Publications, 2022) Acar, Gulay; Koplay, MustafaRight-sided aortic arch (RAA) with left aberrant subclavian artery (LASA) is a rare vascular variant due to the failure in regression process during embryologic development of the aortic arch. The prevalence of it ranges from 0.04% to 0.1% in radiology series. We report the case of a 44-year-old female shown to have the presence of a RAA with LASA arising from the Kommerell's diverticulum, and also in association with an aberrant aortic origin of the right vertebral artery using computed tomography angiography. Considering the diameter of the diverticulum <5 cm and the absence of severe external esophageal or tracheal compression, thoracic surgery was not indicated and it was decided to keep the patient under clinical follow-up at regular intervals. Based upon this present case and literature review, the knowledge of this anomalous anatomy and its embryologic basis appear to be important for diagnostic endovascular interventions and planning thoracic surgery.Öğe The Relationship Between the Pneumatization Patterns of the Frontal Sinus, Crista Galli and Nasal Septum: A Tomography Study(Turkish Neurosurgical Soc, 2020) Acar, Gulay; Cicekcibasi, Aynur Emine; Koplay, Mustafa; Kelesoglu, Kazim SerhanAIM: To provide detailed information about anterior skull base anatomy. MATERIAL and METHODS: Interms of gender and laterality, the drainage pathways and anatomical variations of the frontal sinus, crista galli and nasal septum in 402 patients were evaluated via computed tomography scans. RESULTS: The pneumatization patterns of the frontal sinus were as follows: absent, 3.7%; unilateral, 8%; bilateral, 75.1% and triple, 13.2%. The pneumatized crista galli was identified in 120 (29.8%) patients, and its drainage pathway was observed in 54.1% of patients. The sinus septi nasi was identified in 92 (22.8%) and its drainage pathway was observed in 16.3%. The prevalences of the position types of crista galli regarding the cribriform plate were as follows; type 1,18.3%; type II,64.9%; type III, 16.8%. CONCLUSION: Despite meticulous knowledge of anatomy, preoperative radiologic evaluation creates the base for successful treatment of anterior skull base pathologies with safer and effective surgery.Öğe Silver Nanoparticles Synthesis by Grape Seeds (Vitis vinifera L.) Extract and Rooting Effect on Grape Cuttings(Springer, 2021) Kara, Zeki; Sabir, Ali; Koc, Fatma; Sabir, Ferhan Kucukbasmaci; Avci, Ahmet; Koplay, Mustafa; Dogan, OsmanPropagation of grape rootstocks with cuttings is one of the routine processes of viticulture. Cutting studies for nursery production under nursery conditions often fall below the expected productivity level due to biotic and abiotic stress. To increase nursery yield remains on the agenda of vine researchers. Encapsulated silver nanoparticles (AgNPs) were produced by the green synthesis method from grape seed extract (Vitis vinifera L. cv okuzgozu) with high phenolic content and silver nitrate (AgNO). The size of AgNPs was determined by Transmission Electron Microscope (TEM) as 10-50 nm and was not agglomerated and browned in colour. The effect of AgNPs on rooting of standard lignified 41B (Vitis vinifera L. cv. Chasselas x Vitis berlandieri) rootstocks pure and with Indole 3 Butyric Acid (IBA) (control, 0.5 mg L-1 AgNPs, 0.5 mg L-1 AgNPs 50 ppm IBA, 1 mg L-1 AgNPs, 1 mg L-1 AgNPs 50 ppm IBA and 50 ppm IBA) were tested. The effects of the applications on the cuttings in the greenhouse 1:1 perlite peat medium, leaf chlorophyll content, vegetative growth parameters and the effects on the vascular tissues were evaluated by micro tomography (microCT). Applications of pure AgNPs and combined with IBA did not altered the leaf chlorophyll content. While 1 mg L-1 AgNPs application, which was the closest level to 50 ppm IBA, provided the root and shoot development, while the application of 1 mg L-1 AgNPs encouraged the development of shoot most. The 1 mg L-1 AgNPs + 50 ppm IBA application resulted in the highest number of nodes in shoots developing from cuttings. In microCT analysis of rooted and unrooted grapevine cuttings, tissue damage was determined that was attributed to result in drying due to embolism and loss of nursery material. AgNPs applications are thought to increase the nursery success in grapevine rootstock cuttings.Öğe Surface anatomy and lumbar lordosis angle(Springer, 2021) Acar, Gulay; Cicekcibasi, Aynur Emine; Koplay, Mustafa; Seher, NusretAwareness of the anatomical variations in abdominal surface anatomy with emphasis on relation to the abdominal planes may facilitate anatomical education and physical examination and inconvenience surgical intervention by giving surgeons more insight in surgical planning and training. This study was designed to verify whether the anatomical planes promote to the comprehension of surface anatomy and how the lumbar lordosis angle affects the vertebral level of the bifurcation of great vessels. This retrospective study was performed using computed tomography angiography images of 155 patients ranging from 18 up to 82 years. The vertebral levels of the celiac truncus, superior mesenteric artery, portal vein confluence, right and left renal arteries were within the transpyloric plane in 60%, 70%, 56.1% and 48.3-36.2% of patients, respectively. The inferior mesenteric artery was below the subcostal plane in 58% of patients. The aortic bifurcation (AB) was mostly corresponded to the level of L4 and was located within the umbilical plane in 73.1% of patients. The level of the inferior vena cava (IVC) confluence was within the supracristal plane in 54% of patients. We measured the mean value of the AB, IVC and lumbar lordosis angles as 39.54 degrees, 58.05 degrees and 54.26 degrees, respectively. The AB and IVC levels showed a downward shift with decreasing lumbar lordosis angle. Precise knowledge of these relationships is crucial in clinical practice and surgical approaches to the anterior lumbosacral spine for safer and effective surgery.Öğe Texture analysis of multiparametric magnetic resonance imaging for differentiating clinically significant prostate cancer in the peripheral zone(Tubitak Scientific & Technological Research Council Turkey, 2023) Ozer, Halil; Koplay, Mustafa; Baytok, Ahmet; Seher, Nusret; Demir, Lutfi Saltuk; Kilincer, Abidin; Kaynar, MehmetBackground/aim: Texture analysis (TA) provides additional tissue heterogeneity data that may assist in differentiating peripheral zone (PZ) lesions in multiparametric magnetic resonance imaging (mpMRI). This study investigates the role of magnetic resonance imaging texture analysis (MRTA) in detecting clinically significant prostate cancer (csPCa) in the PZ.Materials and methods: This retrospective study included 80 consecutive patients who had an mpMRI and a prostate biopsy for sus-pected prostate cancer. Two radiologists in consensus interpreted mpMRI and performed texture analysis based on their histopathology. The first-, second-, and higher-order texture parameters were extracted from mpMRI and were compared between groups. Univariate and multivariate logistic regression analyses were performed using the texture parameters to determine the independent predictors of csPCa. Receiver operating characteristic (ROC) curve analysis was conducted to assess the diagnostic performance of the texture parameters.Results: In the periferal zone, 39 men had csPCa, while 41 had benign lesions or clinically insignificant prostate cancer (cisPCa). The majority of texture parameters showed statistically significant differences between the groups. Univariate ROC analysis showed that the ADC mean and ADC median were the best variables in differentiating csPCa (p < 0.001). The first-order logistic regression model (mean + entropy) based on the ADC maps had a higher AUC value (0.996; 95% CI: 0.989-1) than other texture-based logistic regres-sion models (p < 0.001).Conclusion: MRTA is useful in differentiating csPCa from other lesions in the PZ. Consequently, the first-order multivariate regression model based on ADC maps had the highest diagnostic performance in differentiating csPCa.
