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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 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 Efficacy of diffusion weighted imaging in sacroiliac joint MRI in children(Kare Publ, 2023) Tasar, Sevinc; Ciraci, Saliha; Yilmaz, Pinar Diydem; Oysu, Aslihan Semiz; Bukte, Yasar; Sozeri, BetulOBJECTIVE: Because of the immature bone marrow signal in children, assessment of the sacroiliac joint is more difficult than in adults. Aim of this study is to evaluate the efficacy of diffusion-weighted imaging (DWI) in sacroiliac joint magnetic resonance imaging (MRI). METHODS: Sacroiliac joint MRI, including DWI sequences, were evaluated by two pediatric radiologists in 54 patients with sacroiliitis and 85 completely normal controls. In MRI evaluation, subchondral bone marrow edema and contrast enhance-ment in the sacroiliac joints were considered as active sacroiliitis. Apparent diffusion coefficient (ADC) measurements were made in six areas from each sacroiliac joint. A total of 1668 fields were evaluated retrospectively without their diagnosis being known. RESULTS: When the postcontrast T1W series were referenced, the sensitivity, specificity, positive predictive value, and neg-ative predictive value of short time inversion recovery (STIR) images in the diagnosis of sacroiliitis were 88%, 92%, 83% and 94% respectively, compared to contrast-enhanced images. False positive results in STIR images were observed secondary to the flaring signal in the immature bone marrow. ADC measurements obtained from diffusion-weighted images were recorded in all patients and healthy groups. The ADC values were 1.35x10-3 mm2/s (SD: 0.21) in the areas of sacroiliitis, 0.44x10-3 mm2/s (SD: 0.71) in the normal bone marrow and 0.72x10-3 mm2/s (SD: 0.76) in the immature bone marrow areas. CONCLUSION: Although STIR studies are an effective sequence in the diagnosis of sacroiliitis, they cause false positive results in immature bone marrow in children in inexperienced hands. DWI is an objective method that prevents errors in the assessment of sacroiliitis by means of ADC measurements in the immature skeleton. In addition, it is a short and effective MRI series that makes important contributions to the diagnosis without the need for contrast-enhanced examinations in children.Öğe Efficacy of diffusion weighted imaging in sacroiliac joint MRI in children(Kare Publ, 2023) Tasar, Sevinc; Ciraci, Saliha; Yilmaz, Pinar Diydem; Oysu, Aslihan Semiz; Bukte, Yasar; Sozeri, BetulOBJECTIVE: Because of the immature bone marrow signal in children, assessment of the sacroiliac joint is more difficult than in adults. Aim of this study is to evaluate the efficacy of diffusion-weighted imaging (DWI) in sacroiliac joint magnetic resonance imaging (MRI). METHODS: Sacroiliac joint MRI, including DWI sequences, were evaluated by two pediatric radiologists in 54 patients with sacroiliitis and 85 completely normal controls. In MRI evaluation, subchondral bone marrow edema and contrast enhance-ment in the sacroiliac joints were considered as active sacroiliitis. Apparent diffusion coefficient (ADC) measurements were made in six areas from each sacroiliac joint. A total of 1668 fields were evaluated retrospectively without their diagnosis being known. RESULTS: When the postcontrast T1W series were referenced, the sensitivity, specificity, positive predictive value, and neg-ative predictive value of short time inversion recovery (STIR) images in the diagnosis of sacroiliitis were 88%, 92%, 83% and 94% respectively, compared to contrast-enhanced images. False positive results in STIR images were observed secondary to the flaring signal in the immature bone marrow. ADC measurements obtained from diffusion-weighted images were recorded in all patients and healthy groups. The ADC values were 1.35x10-3 mm2/s (SD: 0.21) in the areas of sacroiliitis, 0.44x10-3 mm2/s (SD: 0.71) in the normal bone marrow and 0.72x10-3 mm2/s (SD: 0.76) in the immature bone marrow areas. CONCLUSION: Although STIR studies are an effective sequence in the diagnosis of sacroiliitis, they cause false positive results in immature bone marrow in children in inexperienced hands. DWI is an objective method that prevents errors in the assessment of sacroiliitis by means of ADC measurements in the immature skeleton. In addition, it is a short and effective MRI series that makes important contributions to the diagnosis without the need for contrast-enhanced examinations in children.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 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 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.