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Öğe An association between immune status and chest CT scores in COVID-19 patients(Wiley, 2021) Colkesen, Fatih; Poyraz, Necdet; Arslan, Sevket; Yilmaz, Pinar Diydem; Kurt, Esma Kepenek; Korkmaz, Celalettin; Yildiz, ErayBackground The characteristic features of the immune responses of COVID-19 patients and how they reflect lung involvement have not been clearly elucidated. Aim The aim of this study was to examine the immune status and the correlations thereof with chest CT scores and lung involvement of patients with COVID-19. Methods In this retrospective and single-center study, 72 patients with laboratory-confirmed COVID-19 were recruited. The counts of peripheral lymphocyte subsets (CD3(+) T cells, CD4(+) T cells, CD8(+) T cells, CD19(+) B cells and CD16(+) 56(+) NK cells) and those of serum immunoglobulins (IgA, IgG, IgM) were measured and their associations with chest CT scores analysed. Results The proportions of lymphopenia in patients with extensive lung involvement were twice that in the general study population. In the severe disease group, the levels of total lymphocytes, T cells, B cells, NK cells; and serum IgA levels, were significantly lower than in the mild disease group (all P < .05). We found that the numbers of lymphocyte subsets and the IgA level negatively correlated with the chest CT scores. On multivariate regression analysis, pretreatment decreases in total lymphocytes, CD3(+) T cells, CD4(+) T cells, and CD19(+) B cells, and serum IgA levels, were independent predictors of severe lung involvement. Conclusions The cell numbers of peripheral lymphocyte subsets and the serum IgA level were negatively correlated with the chest CT scores in COVID-19 patients. These parameters tended to independently predict severe lung involvement in such patients.Öğe Biatrial Cardiac Metastases in a Patient with Uterine Cervix Malignant Melanoma(Hindawi Ltd, 2015) Geredeli, Caglayan; Boruban, Melih Cem; Poyraz, Necdet; Artac, Mehmet; Aribas, Alpay; Koral, LokmanPrimary malignant melanomas of uterine cervix are quite rarely seen neoplasms, and long-life prognosis of patients with this disease is poor. Immunohistochemical methods and exclusion of other primary melanoma sites are used to confirm the diagnosis. As with other melanomas, cervix malignant melanomas may also cause cardiac metastases. Cardiac metastases are among rarely seen but more commonly encountered cases, compared to primary cardiac tumors. Here, we present a case of biatrial cardiac metastases in a 73-year-old patient with uterine cervix malignant melanomas. The patient underwent echocardiography, cardiac magnetic resonance imaging, and computed tomography. Our report shows the importance of advanced diagnostic techniques, such as cardiac magnetic resonance, not only for the detection of cardiac masses, but for a better anatomic definition and tissue characterization. Although the cases of malignant melanomas leading to multiple cardiac metastasis were reported in literature, the metastatic concurrence of malignant melanomas in both right and left atriums is quite rarely encountered as metastatic malignant melanomas. Also, another intriguing point in our case is that the primary lesion of our case was stemmed from uterine cervix, but not skin.Öğe Bilgisayarlı Toraks Tomografisinde Saptanan İnsidental Meme Lezyonları Incidental(2015) Poyraz, Necdet; Emlik, Ganime Dilek; Suat , Keskin; Kalkan, HavvaAmaç: Mamografi memenin primer görüntüleme yöntemi olmasına kar- şılık, değişik patolojileri saptamak amacıyla çekilen bilgisayarlı tomografilerde insidental (rastlantısal) benin ya da malin meme lezyonlarıyla giderek daha sık karşılaşılmaktadır. Dolayısıyla bu lezyonların saptanması ve doğru tanımlanması önem kazanmıştır. Bu çalışmada meme dışı patolojiler için çekilen bilgisayarlı tomografilerde saptanan insidental meme lezyonlarının sıklığını, morfolojik özelliklerini ve sonuçlarını değerlendirmeyi amaçladık. Yöntem ve Gereçler: Bölümümüzde 2011-2013 tarihleri arasında çekilen bilgisayarlı tomografilerde insidental saptanan meme lezyonları de- ğerlendirildi. Daha önce tanı konmuş meme lezyonu olan hastalar çalışma dışında bırakıldı. Histopatolojik tanısı olan ya da en az 2 yıl boyunca takip edilmiş hastalar çalışmaya alındı. Bulgular: Çalışma grubunu oluşturan ortalama 551,38 yaşındaki (aralık 37-78 yıl) toplam 33 kadının 12sinde (%36) malin, 21inde (%64) benin ya da normal bulgular saptandı. En sık saptanan patoloji malin lezyonlar arasında invaziv duktal karsinom, benin lezyonlarda ise fibroadenomdu. En önemli bilgisayarlı tomografi bulgusu, malin lezyonlarda düzensiz kontur yapısı ve lenfadenopati varlığı, benin lezyonlarda ise düzgün kontur yapısıydı. Sonuç: Bilgisayarlı tomografi incelemelerde kesite girdiğinde meme mutlaka dikkatli bir şekilde değerlendirilmelidir. Meme lezyonlarının uygun şekilde raporlanması erken tanı ve tedaviye olanak sağlayacaktır.Öğe Clinical and radiologic features and their relationships with neurofunctional scores in patients with acute cerebellar infarct(Medknow Publications & Media Pvt Ltd, 2016) Kozak, Hasan Huseyin; Uca, Ali Ulvi; Poyraz, Necdet; Anliacik, Suleyman Omer; Tokgoz, Osman SerhatBackground: Cerebellar infarct is a rare condition with very nonspecific clinical features. The aim of this study was to assess the full spectrum of the clinical characteristics, neuroimaging findings and neurofunctional analyses of cerebellar infarction, and the relationship between them. Materials and Methods: Data were collected from 59 patients admitted to our department during an 8-year period. We retrospectively analyzed the relationship between demographic characteristics, clinical symptomatology, etiological factors, functional condition, vascular distribution, frequency of subcortical white matter lesions (WMLs), and concomitant lesion outside the cerebellum in patients with acute cerebellar infarct (ACI) at time of admission. Results: The mean age in our series was 65.2 years, with most being male (57.6%). The posterior inferior cerebellar (PICA) artery was the most commonly affected territory at 62.7%. There was concomitant lesion outside the cerebellum in 45.7%. The main etiology in PICA was cardioembolism. While mean National Institutes of Health Stroke Scale on admission was 2.08 +/- 1.67 in study group, modified Rankin Scale (mRS) on admission was detected to be mRS1 (n: 44, 74.5%) and mRS2 (n: 12, 20.3%) most frequently. Fourteen (35%) patients were detected to be in Fazekas stage 0; 11 (27.5%) patients in Fazekas stage 1; 6 (15%) patients in Fazekas stage 2; and 9 (22.5%) patients in Fazekas stage 3. Conclusion: Cerebellar infarct is very heterogeneous. The other cerebral area infarcts which accompany ACI negatively affect neurologic functional scores. Although it is difficult to detect the relationship between WMLs and neurologic functional severity, timely detection of risk factors and their modulation may be associated with prevention and treatability of WMLs, and this may be one of the important points for prevention of stroke-related disability.Öğe Clinical efficacy and safety of transcatheter embolization for vascular complications after percutaneous nephrolithotomy(Termedia Publishing House Ltd, 2017) Poyraz, Necdet; Balasar, Mehmet; Gokmen, Ibrahim Erdem; Koc, Osman; Sonmez, Mehmet Giray; Aydin, Arif; Goger, Yunus EmreIntroduction: Percutaneous nephrolithotomy (PNL) is the preferred procedure for safe and effective surgical treatment of kidney stones. Hemorrhage is the most serious complication of PNL, resulting from pseudoaneurysm (PA) or arteriovenous fistula (AVF), and can usually be controlled with conservative treatment. Aim: To evaluate endovascular treatments and outcomes of vascular complications observed after PNL. Material and methods: We retrospectively reviewed data on 19 patients who underwent renal embolization due to post-PNL renal artery bleeding between March 2005 and September 2016. Embolization materials included embolization coils and glue. The incidence of post-PNL vascular complications and their endovascular treatments, outcomes, and the follow-up data were analyzed. Results: Nineteen (1.1%) of 1,609 patients (mean age: 44.9 years, range: 19-75 years) underwent angiography and subsequent transcatheter embolization to control bleeding. The mean time to onset of hemorrhage was 7.2 days after PNL (range: 3-18 days). The PNL entry site was the lower calyx in 15 patients, the middle calyx in 3, and the upper calyx in 1. PA, AVF, and PA plus AVF occurred in 14, 5, and 3 of the 19 renal angiography patients, respectively. Embolization of the affected vessels was successful in all 19 patients. The embolization materials of coil, glue, and coil plus glue were used in 16, 3, and 2 patients, respectively. Conclusions: Severe hematuria is a rare complication of PNL and can be successfully treated with transcatheter embolization.Öğe Comparison of mammography sensitivity after reduction mammoplasty targeting the glandular and fat tissue(2015) Çakır, Murat; Küçükkartallar, Tevfik; Tekin, Ahmet; Selimoğlu, Nebil; Poyraz, Necdet; Belviranlı, Mehmet Metin; Kartal, AdilAmaç: Meme küçültme cerrahisi geçiren kadınların meme kanseri teşhis ve taramasında mamografinin bazı sınırlılıkları vardır. Bu çalışmada postoperatif değişikliğe bağlı meme dokusunda gelişen yapısal bozuklukların mamografiye nasıl yansıdığını araştırmayı amaçladık.Gereç ve Yöntemler: Meme küçültme operasyonu geçiren ve genel cerrahi kliniği tarafından meme kanseri taraması amacıyla mamografi çekilmesi istenen hastaların dosyaları retrospektif olarak incelendi. Hastaların yaş, cerrahi işlem, postoperatif takip süresi, çıkarılan doku miktarı, histopatolojik ve mamografik bulguları değerlendirildi. Hastalar 3 grupta incelendi: 40 yaş üzerinde glandüler doku ağırlıklı redüksiyon mammoplasti uygulanan (1. grup), 40 yaş altında yağ dokusu ağırlıklı redüksiyon mammoplasti uygulanan (2. grup) ve 40 yaş üstünde meme hipertrofisi tanısı almış ve opere edilmeyen (3. grup) hastalardan oluşmaktadır.Bulgular: Hastaların ortalama takip süresi 6 yıldı. Çıkarılan ortalama doku miktarı 1. grupta 1120 gr (6802070), 2. grupta 1220 gr idi. Ameliyat yaş ortalaması 1. grupta 45 , 2. grupta 35 idi. Histopatolojik incelemede tüm gruplar benigndi. Birinci grup hastaların tamamı BIRADS 1-2, 2. grup hastaların 28'i BIRADS 1-2, 4'ü BIRADS 3 ve 8'i BIRADS 0 idi. Üçüncü grup hastaların 35'i BIRADS 1-2, 4'ü BIRADS 3 ve 1'i BIRADS 0'dı.Sonuç: Kırk yaş üzeri hastalarda glandüler doku ağırlıklı meme küçültme cerrahisi uygulanmasının mamografi duyarlılığını artırdığı kanısındayızÖğe Computed tomography findings in pulmonary involvement of wegener's granulomatosis: Pictorial review(Turkish Assoc Tuberculosis & Thorax, 2015) Poyraz, Necdet; Korkmaz, Celalettin; Yavsan, Durdu Mehmet; Keskin, Suat; Teke, Turgut; Odev, KemalWegener's granulomatosis is a necrotising granulomatous vasculitis which has a variable manifestations in the chest that are best described on computed tomography. Imaging findings may include masses or nodules, which may cavitate; consolidations and ground-glass opacities. Wegener's granulomatosis can mimic pneumonia, malignancy, and noninfectious inflammatory diseases. The purpose of this pictorial essay is to demonstrate the characteristic computed tomography findings of pulmonary Wegener's granulomatosis.Öğe Could Hemiplegia Vegetativa Alterna be a Cerebral Sign of Heart Valve Disease?(2014) Uca, Ali Ulvi; Kozak, Hasan Hüseyin; Seyithanoğlu, Abdullah; Poyraz, NecdetÖğe Could Hemiplegia Vegetativa Alterna be a Cerebral Sign of Heart Valve Disease?(Aves, 2014) Ulvi, Ali; Huseyin, Hasan; Seyithanoglu, Abdullah; Poyraz, Necdet[Abstract Not Availabe]Öğe COVID-19 Pneumonia Presenting with Multiple Nodules Mimicking Metastases: An Atypical Case(Ubiquity Press Ltd, 2022) Babaoglu, Seyma; Poyraz, Necdet; Sahin, OzlemCoronavirus disease 2019 (COVID-19) is an outbreak causing pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and computed tomography (CT) images are a significant part of the diagnosis of COVID-19 related pneumonia. Typical chest CT findings are bilateral peripheral ground-glass opacities (GGO) with or without consolidation. Although rare, atypical CT findings have been described, no case of COVID-19 causing multiple solid pulmonary nodules has been reported. In this article, atypical CT findings of a 45-year-old female patient with multiple solid pulmonary nodules mimicking metastasis diagnosed with COVID-19 confirmed by reverse transcription polymerase chain reaction (RT-PCR). Teaching point: COVID-19 pneumonia may mimic multiple metastatic nodules radiologically.Öğe The determination of the cross-sectional area of the lumbar erector spinae muscles of Olympic style weightlifting athletes by using MRI(Ios Press, 2020) Erdagi, Kenan; Poyraz, NecdetOBJECTIVE: The study aims to measure the cross-sectional area of the lumbar erector spinae muscles from L3-L4 intervertebral disc levels by using magnetic resonance images of Olympic style weightlifting athletes (male n = 15, female n = 15) and sedentary individuals (male n = 15, female n = 15). METHODS: A 1.5 Tesla device was used for the magnetic resonance imaging process of all participants. The images were then executed in ImageJ software and the cross-sectional area was measured after the required synchronization steps were conducted. RESULTS: On the images taken from L3-L4 intervertebral disc levels, we observed that right-left cross-sectional area measurements of erector spinae muscles of sedentary males and females in the control groups were smaller than those of male and female athletes in Olympic style weightlifting. We also found a symmetry between right-left cross-sectional area measurements of groups of athletes. CONCLUSIONS: From the study findings, we might conclude that trainings of Olympic style weightlifting possess a hypertrophic effect on the cross-sectional area of erector spinae muscles of Olympic style weightlifting athletes.Öğe Digital breast tomosynthesis and ultrasonography: diagnostic performance and effect on recall rates versus digital mammography in category O(E-Century Publishing Corp, 2017) Emlik, Ganime Dilek; Poyraz, Necdet; Altunkeser, AysegulThe purpose of this study was to compare diagnostic performance and screening recall rates of digital breast tomosynthesis (DBT) and ultrasound (US) added to digital mammography (DM) in the category O. This study was approved by the local ethics committee and informed consent was obtained. The additional breast US and DBT performed 216 women categorized as BI-RADS category O according to screening DM between January 2014 and February 2015. A total of 22 women that previously underwent breast surgery, radiotherapy, chemotherapy were excluded. Finally 194 patients were enrolled in this study. The DM+DBT images and DM+DBT images with US images of patients were independently reviewed by three breast radiologists and than recategorized according to BI-RADS category. Among 194 lesions, 165 (85%) were benign and 29 (14.9%) were malign. DBT reduced recall rate by 70%. For DBT, sensitivity, specificity, PPV, NPV and diagnostic accuracy were 97%, 82%, 48%, 99%, and 84%, whereas for US sensitivity, specificity, PPV, NPV and diagnostic accuracy were 93%, 79%, 47%, 98%, and 81%, respectively. AUC value was 0.89 and 0.86 for DBT and US. In conclusion, DBT reduced recall rates. DBT showed better diagnostic performance than breast US for category O. Reduction in RR was independent from breast parenchymal patterns.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 Endovascular treatment of complex intracranial aneurysms by pipeline flow-diverter embolization device: a single-center experience(Maney Publishing, 2015) Keskin, Fatih; Erdi, Fatih; Kaya, Bulent; Poyraz, Necdet; Keskin, Suat; Kalkan, Erdal; Ozbek, OrhanObjective: Endovascular coil embolization has become an effective treatment modality for most intracranial aneurysms. However, complex aneurysms including large and giant aneurysms, fusiform shaped aneurysms, wide necked aneurysm, or small aneurysm that are unsuitable for coil embolization are still deterrent to be treated. Flow diversion is a novel concept that is applied in the treatment of these complex intracranial aneurysms. Method: We review the results and important features of 25 aneurysms in 24 patients who underwent endovascular treatment by using the pipeline flow-diverter embolization device. Result: At 6 month follow-up, all aneurysms (100%) showed total occlusion in our series. Only one patient who had giant vertebrobasilar aneurysm experienced major complication related to endovascular treatment. Discussion: We suggest that parent artery reconstruction via flow diversion with the PED is a valid and safe treatment modality.Öğe Erlotinib Response in a Non-Small Cell Lung Cancer Patient with EGFR Exon 20 Mutation(Akad Doktorlar Yayinevi, 2016) Korkmaz, Levent; Artac, Mehmet; Karaagac, Mustafa; Er, Zehra; Boruban, Melih C.; Poyraz, Necdet; Kaya, Bugra[Abstract Not Availabe]Öğe Erlotinib Response in a Non-Small Cell Lung Cancer Patient with EGFR Exon 20 Mutation(2016) Korkmaz, Levent; Artaç, Mehmet; Karaagaç, Mustafa; Er, Zehra; Boruban, Melih C; Poyraz, Necdet; Kaya, Buğra; Tavlı, Lema; Ödev, KemalÖğe Fracture with Urethral Injury: Evaluation by Retrograde Urethrogram(2017) Balasar, Mehmet; Poyraz, Necdet; Pişkin, Mehmet Mesut; Kandemir, AbdulkadirPenile fracture is a rare condition. It primarily involves the rupture of the corpus cavernosum during erection, which may also affect the corpus spongiosum and urethra. We describe the case of a 35-year-old man who presented with acute penile pain, penile swelling, and a hematuria after a blunt trauma during sexual intercourse. The emergency retrograde urethrogram revealed a rare condition, extravasation of the opaque material from the penile urethra into the cavernous structure. The partial rupture of the corpus cavernosum with urethral disruption was repaired surgically. At the 3-month postoperative follow-up control, no complications were reported by the patient who has had both normal erectile and voiding functions. In cases of penile fracture with suspected urethral injury, retrograde urethrogram can be used for definitive diagnosis.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 Imaging Features of Breast Plasmacytoma(Galenos Publ House, 2022) Babaoglu, Seyma; Poyraz, Necdet; Kaya, Bugra; Findik, Siddika; Demircioglu, Sinan[Abstract Not Availabe]Öğe Imaging of pleural diseases: evaluation of imaging methods based on chest radiography(Turkish Assoc Tuberculosis & Thorax, 2017) Poyraz, Necdet; Kalkan, Havva; Odev, Kemal; Ceran, SamiThe most commonly employed radiologic method in diagnosis of pleural diseases is conventional chest radiograph. The commonest chest-X- Ray findings are the presence of pleural effusion and thickening. Small pleural effusions are not readily identified on posteroanterior chest radiograph. However, lateral decubitus chest radiograph and chest ultrasonography may show small pleural effusions. These are more efficient methods than posteroanterior chest radiograph in the erect position for demonstrating small amounts of free pleural effusions. Chest ultrasonograph may be able to help in distinguishing the pleural pathologies from parenchymal lesions. On chest radiograph pleural effusions or pleural thickening may obscure the visibility of the underlying disease or parenchymal abnormality. Thus, computed tomography (CT) may provide additional information of determining the extent and severity of pleural disease and may help to differentiate malign pleural lesions from the benign ones. Moreover, CT may provide the differentiation of parenchmal abnormalities from pleural pathologies. CT (coronal and sagittal reformatted images) that also show invasion of chest wall, mediastinum and diaphragm, as well as enlarged hilar or mediastinal lymph nodes. Standart non-invasive imaging techniques may be supplemented with magnetic resonans imaging (MRI).
