Browsing by Author "Bulut, Mehmet Deniz"

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Acoustic Radiation Force Impulse (Arfi) Elastography Quantification of Muscle Stiffness Over a Course of Gradual Isometric Contractions: a Preliminary Study
(Soc Romana Ultrasonografe Medicina Biologie-srumb, 2015) Yavuz, Alpaslan; Bora, Aydin; Bulut, Mehmet Deniz; Batur, Abdussamet; Milanlioglu, Aysel; Goya, Cemil; Andic, Cagatay
Aims: To evaluate the feasibility of quantitative analysis of muscle stiffness by Acoustic Radiation Forced Impulse (ARFI) elastography over a course of graduate isometric voluntary contractions. Material and methods: The stiffness of the bilateral biceps muscle of 13 healthy volunteers was measured in real time by ARFI elastography, while the forearm was in neutral-extended position, 90 degree self-flexed positions and 90 degree self-flexed position, with altered weights ranging from 1 to 8 kg placed on flattened palmar surfaces consecutively. The determined increases in biceps muscle stiffness were measured for both arms and correlated with the loadings weights adopted at progressive trial stages. Results: The mean shear wave velocity (SWV) values of biceps muscles in a neutral position, in 90 degree flex position and 90 degree flex position with 1 to 8 kg weights on palmar surfaces were 2.162 +/- 0.302 m/sec, 3.382 +/- 0.581 m/sec, and 3.897 +/- 0.585 to 5.562 +/- 0.587 m/sec, respectively. Significant correlations between the muscle SWV values and related palmar weights and between the SWV values of right and left sides at different trial stages were identified (r=0.951 and r=0.954, respectively). A mutual propagation path of deep regions to entire areas was described to account for the distribution of increase in stiffness with increases in palmar weights. The confidence of method regarding inter-observer difference was confirmed by the correlation analyses of the results (r=0.998). Conclusions: ARFI elastography is a feasible imaging modality for quantifying the stiffness of isometrically voluntarily contracting muscles.
Anterior Hepatic Grooves Accompanied by Chilaiditi Sign: a Retrospective Radiological Analysis of a Neglected Anatomical Fact
(Springer France, 2015) Yavuz, Alpaslan; Batur, Abdussamet; Bulut, Mehmet Deniz; Bora, Aydin; Goya, Cemil; Andic, Cagatay; Olmez, Sehmus
To evaluate anterior hepatic grooves (AHGs) associated with hepato-diaphragmatic mesocolic indentations (Chilaiditi sign) and to delineate the incidence and potential clinical significance of this association. Between November 2011 and June 2014, abdominal computed tomography examinations of 2,314 patients with varied indications were retrospectively reviewed. Patients were surveyed consecutively for the Chilaiditi sign and syndrome, and cases with grooves at the antero-inferior hepatic surface enclosing the adjacent mesocolic indents were determined. The incidence of AHGs and their predominance by gender and age were determined. The potential clinical significance of AHGs associated with Chilaiditi syndrome and their possible effect on liver volume were assessed. The incidences of AHGs were similar between genders (p = .461 and p = .646) and age (p = .113 and .621, respectively) among total cohort and patients with Chilaiditi sign, respectively. There was no significant correlation between AHGs and Chilaiditi syndrome (p = .506); no efficacies of AHGs to liver volume were assessed (p = .413). The AHGs are rare adaptive changes in shape of the liver without a significant effect on liver volume. This overlooked phenomenon is likely derived from the Chilaiditi sign, but has no significant correlation with Chilaiditi syndrome. Future studies with extended series are encouraged to reveal the possible significance of this phenomenon based on concerned surgical interventions.
Are Blank Cartridge Guns Really Harmless
(Turkish Assoc Trauma Emergency Surgery, 2014) Gulsen, Ismail; Ak, Hakan; Sosuncu, Enver; Bulut, Mehmet Deniz
Blank cartridge guns are devices that discharge sound and gas, but no bullet or shot. These devices are very similar to real guns in the form of their external design and the sound generated during their firing. Although it is widely held in society that these devices are harmless, reports from Turkey and the world have shown that these guns are not entirely innocent. Herein, we present a 26-year-old male with a head injury due to gunshot from a blank cartridge. The purpose of this presentation is to emphasize that these devices are not harmless, contrary to common public opinion.
The Association Between Retinal Nerve Fibre Layer Thickness and Corpus Callosum Index in Different Clinical Subtypes of Multiple Sclerosis
(Springer-verlag Italia Srl, 2017) Cilingir, Vedat; Batur, Muhammed; Bulut, Mehmet Deniz; Milanlioglu, Aysel; Yilgor, Abdullah; Batur, Abdussamet; Tombul, Temel
The objective of this paper is to evaluate the association between physical disability in multiple sclerosis (MS) patients, the thickness of the retinal nerve fibre layer (RNFL) and corpus callosum volumes, as expressed by the corpus callosum index (CCI). This study was based on a cohort of 212 MS patients and 52 healthy control subjects, who were age and gender matched. The MS patients included 144 women and 177 relapsing-remitting MS (RRMS) patients. Peripapillary and volumetric optical coherence tomography (OCT) scans of the macula were performed using spectral-domain OCT technology. All magnetic resonance imaging (MRI) scans were performed using 1.5-T systems. CCI and RNFL were lower in MS than healthy control subjects (0.341 versus 0.386, p < 0.01 and 92.1 versus 105.0, p < 0.01). In addition, CCI correlated with RNFL (r = 0.464, p < 0.01). This was also true for the subgroup of patients with no history of optic neuritis (ON). There is a correlation between the thickness of the RNFL and CCI values in MS patients with no history of ON, which suggests that OCT might be a suitable marker for neurodegeneration in MS clinical trials.
Bifid Rib; Report of Two Cases and the Efficacy of 3-Dimensional Computed Tomography
(derman Medical Publ, 2010) Kara, Hasan Volkan; Agladioglu, Kadir; Bulut, Mehmet Deniz; Cobanoglu, Ufuk; Oguz, Serhat
Congenital anomalies of ribs exist between 0.15% to 30%. These patients have minor symptoms or totally symptom-free. They are generally diagnosed accidentally. There are case report of bifid (forked) ribs in the literature. Bifid rib should be differenciated from other pathological situation of lung and chest wall including malignancies. 3-dimensional(3-D) computed tomography (CT) is a very effective diagnostic tool in differencial diagnosis of bifid rib. We present 2 cases of bifid rib that had the diagnosis by f 3 dimentional (3-D) computed tomography (CT) with the demonstrative images
Blepharophimosis, Ptosis, and Epicanthus Inversus Syndrome: Expanding the Phenotype
(Alliance Communications Group Division Allen Press, 2016) Kaba, Sultan; Dogan, Murat; Bulan, Keziban; Demir, Nihat; Uner, Abdurrahman; Bulut, Mehmet Deniz; Kocaman, Selami
We present a 3-month-old girl who displayed typical clinical characteristics of blepharophimosis, ptosis, and epicanthus inversus syndrome (BPES). She was referred to our clinic with an initial diagnosis of Down syndrome. Clinical features of elevated follicle stimulating hormone and low estradiol levels in the case were diagnosed as BPES syndrome and were consistent with BPES type 2. To date, there are no cases of BPES with cleft palate and cardiomyopathy, suggesting that these novel findings can be part of this condition.
Bronchogenic Cyst Mimicking an Adrenal Mass in the Retroperitoneal Region: Report of a Rare Case
(Wolters Kluwer Medknow Publications, 2015) Bulut, Gulay; Bulut, Mehmet Deniz; Bahadir, Inci; Kotan, Cetin
We report the surgical excision of a retroperitoneal bronchogenic cyst that presented as a nonfunctioning left adrenal mass in a 25-year-old woman with continuous pain in the left flank. Preoperative biochemical testing confirmed that the mass was nonfunctional. Bronchogenic cysts are mostly benign congenital abnormalities that originate from the remnants of the primitive foregut and typically occur in the lung. Subdiaphragmatic and especially, retroperitoneal locations are rare. Despite the rarity of this pathologic entity, bronchogenic cysts should be considered in the differential diagnosis of retroperitoneal cystic lesions. Diagnosis must be definitively confirmed by histology.
Chiari Iii Malformation With a Giant Encephalocele Sac: Case Report and a Review of the Literature
(Karger, 2013) Bulut, Mehmet Deniz; Yavuz, Alpaslan; Bora, Aydin; Gulsen, Ismail; Ozkacmaz, Sercan; Sosuncu, Enver
Çocuklarda İntrakraniyal Apse
(2015) Arslan, Mehmet; Ece, İbrahim; Gulsen, İsmail; Demirören, Kaan; Üner, Abdurrahman; Garipardıç, Mesut; Bulut, Mehmet Deniz
Amaç: Bu çalışmanın amacı çocukluk çağının nadir görülen hastalıklarından biri olan intrakraniyal apselere dikkat çekmek ve alta yatan predispozan durumları irdelemekti. Yöntem: Pediatri kliniğimizde yatırılıp intrakraniyal apse tanısı konan 10 çocuk olgunun verileri retrospektif olarak elde edildi. Bulgular: Olguların yaş ortalaması 51±44 ay (4 ay-9 yıl) olup kız/erkek oranı 1/1 idi. En sık başvuru semptomu nöbet idi. İntrakraniyal apse %60 olguda parenkimal iken, %40 olguda subdural yerleşimliydi. 8 (%80) olguda predispozan faktör varlığı tespit edildi. Bunlar iki olguda menenjit, birer olguda pnömoni, Fallot tetralojisi, Fallot tetralojisi zemininde infektif endokardit, akut lenfoblastik lösemi, orbital selülit ve Brusella enfeksiyonu idi. Olguların 9'una hem medikal (antibiyoterapi), hem cerrahi tedavi, 1'ine yalnızca medikal tedavi uygulandığı ve apse sıvısından yapılan kültürlerin %40'ında Gram pozitif aerop bakteriler ürediği belirlendi. Hastaların %40'unda nörolojik sekel gelişti, ancak hiç ölüm gerçekleşmedi. Sonuç: Nöbet, baş ağrısı, kusma gibi uyarıcı semptomlar ile başvuran çocuklarda ayırıcı tanıda beyin apsesi varlığı akılda tutulmalıdır. Hızlı tanı ve uygun tedavi, nörolojik sekel ve ölüm gibi hastayı bekleyen ciddi komplikasyonları önleyecektir.
Comparison of Computed Tomography Densitometry and Shear Wave Elastography Velocity Measurements for Evaluation of the Liver Volume in the Nonalcoholic Fatty Liver Disease
(E-century Publishing Corp, 2016) Bulut, Mehmet Deniz; Ozdemir, Hayrullah; Bora, Aydin; Yavuz, Alpaslan; Arslan, Harun; Batur, Abdussamet; Ozgokce, Mesut
Purpose: The aim of the present study is to evaluate and compare the values of velocities measured by the shear wave elastography (SWE), and those of the liver attenuation index (LAI) determined by the computerized tomography (CT) densitometry, in the nonalcoholic fatty liver disease (NAFLD). In other words, we aimed to compare the values of density measured by CT and the stiffness determined by elastography, in the liver steatosis. In addition, it is to investigate the effect of NAFLD on the liver volume. Materials and methods: Forty five cases with hepatosteatosis who had undergone abdominal CT and 50 individuals who did not exist with fatty liver clinically and radiologically, were investigated by ultrasonography (US) and SWE. The liver and spleen attenuation values were then measured in the images of non-contrast CT, and the LAI indices were calculated. Contrast images of abdomen were processed by the CT-Volume software and measurements of liver volume were performed using the interactive and automatic liver segmentation techniques together. Values of the liver volume, LAI, liver dimensions, and the shear wave velocities were determined and recorded in the patients with hepatosteatosis and controls; statistical comparisons were performed then. Results: In the nonalcoholic fatty liver, the mean value of velocity measured by SWE was found to be 1.08 (+/- 0.11) m/s, and that of LAI measured by CT densitometry was 13.68 (+/- 10.6). No correlation was observed between these two parameters (P>0.05). A high statistically significant difference between the patient and control groups in terms of the liver volume, LAI values and liver size has been observed (P<0.01). Direct correlations existed between the liver volume and LAI values, and the grades in US, and highly significant differences were determined (P<0.01). The mean values of the liver volume in the patient and control groups were determined to be 1917.4 (+/- 425.9) cm(3) and 1311.4 (+/- 241.4) cm(3), respectively. A high statistically significant difference between the groups in terms of liver volumes has been observed (P<0.01). Conclusion: In our study, we determined no correlation between the values of velocity measured by SWE, and the values of LAI measured by CT densitometry, in the NAFLD (P>0.05). This result indicates that there is no relation between the degree of stiffness evaluated by SWE, and the attenuation values measured by CT densitometry, in the non-alcoholic fatty liver. The liver volume was found to increase in NAFLD. We concluded that the CT densitometry can be used as an auxiliary technique associated with the US, in determining the degree of steatosis in NAFLD.
Decreased Vertebral Artery Hemodynamics in Patients With Loss of Cervical Lordosis
(int Scientific information, inc, 2016) Bulut, Mehmet Deniz; Alpayci, Mahmut; Senkoy, Emre; Bora, Aydin; Yazmalar, Levent; Yavuz, Alpaslan; Gulsen, Ismail
Background: Because loss of cervical lordosis leads to disrupted biomechanics, the natural lordotic curvature is considered to be an ideal posture for the cervical spine. The vertebral arteries proceed in the transverse foramen of each cervical vertebra. Considering that the vertebral arteries travel in close anatomical relationship to the cervical spine, we speculated that the loss of cervical lordosis may affect vertebral artery hemodynamics. The aim of this study was to compare the vertebral artery values between subjects with and without loss of cervical lordosis. Material/Methods: Thirty patients with loss of cervical lordosis and 30 controls matched for age, sex, and body mass index were included in the study. Sixty vertebral arteries in patients with loss of cervical lordosis and 60 in controls without loss of cervical lordosis were evaluated by Doppler ultrasonography. Vertebral artery hemodynamics, including lumen diameter, flow volume, peak systolic velocity, end-diastolic velocity, and resistive index, were measured, and determined values were statistically compared between the patient and the control groups. Results: The means of diameter (p=0.003), flow volume (p=0.002), and peak systolic velocity (p=0.014) in patients were significantly lower as compared to controls. However, there was no significant difference between the 2 groups in terms of the end-diastolic velocity (p=0.276) and resistive index (p=0.536) parameters. Conclusions: The present study revealed a significant association between loss of cervical lordosis and decreased vertebral artery hemodynamics, including diameter, flow volume, and peak systolic velocity. Further studies are required to confirm these findings and to investigate their possible clinical implications.
Hepatic Artery Pseudoaneurysm: Delayed Presentation After a Blunt Trauma
(int Scientific information inc, 2015) Batur, Abdussamet; Yavuz, Alpaslan; Toktas, Osman; Bora, Aydin; Bulut, Mehmet Deniz
Background: Ruptured hepatic artery pseudoaneurysm is a rare condition that is life-threatening if not diagnosed and treated rapidly. We present a case of a spontaneously ruptured hepatic artery pseudoaneurysm that occurred after a blunt trauma, and provide a review of the current literature on this topic. This case study demonstrates a spontaneously ruptured hepatic artery pseudoaneurysm which emerged following a blunt trauma and it also presents current literature studies on the topic. Case Report: A man at the age of 34 years with blunt trauma dating back to 1.5 month was admitted to the emergency department of a hospital with hematemesis and epigastric tenderness. He also had a duodenal ulcer, blood in the gastric lumen and a large pseudoaneurysm that developed from the left hepatic artery. Soon after the diagnosis, the patient worsened and underwent distal gastrectomy and cholecystectomy that included removing the bleeding aneurysm. Conclusions: Ruptured hepatic artery pseudoaneurysm stands as a deadly condition which has to be diagnosed and managed as soon as possible. Physicians need to take aneurysms of abdominal arteries into consideration after routine diagnostic practises as long as the cause of gastrointestinal haemorrhage is unidentified.
Hepatic Metastases of Primary Jejunal Carcinoid Tumor: a Case Report With Radiological Findings
(Medknow Publications & Media Pvt Ltd, 2009) Avcu, Serhat; Ozen, Ozkan; Bulut, Mehmet Deniz; Bora, Aydin
Context: Carcinoid tumors represent a group of well-differentiated tumors originating from the diffuse endocrine system outside the pancreas and thyroid. The overall prevalence of carcinoid tumors in the United States is estimated to be one to two cases per 100,000 persons. Various sites of origin of this neoplasm are appendix -3 0-45%, small bowel - 25-35% (duodenum 2%, jejunum 7%, ileum 91%, multiple sites 15-35%), rectum 10-15%, caecum - 5%, and stomach - 0.5%. Liver metastases from jejunal and ileal carcinoids are generally hypervascular. Case report: Here we report a case of primary jejunal carcinoid tumor in a 66-year-old woman metastasizing to liver with ultrasonography, computed tomography, and diffusion-weighted magnetic resonance imaging (DWI) findings. Conclusion: Primary jejunal carcinoid tumor is a rare entity. DWI can help in the differential diagnosis of hepatic hypervascular metastatic mass lesions from benign ones, as well as in the diagnosis of carcinoid tumor.
Imaging Findings for Bilateral Giant Vestibulocochlear Schwannoma
(Acad Medical Sciences I R Iran, 2016) Bulut, Mehmet Deniz; Yavuz, Alpaslan; Bora, Aydin; Gulsen, Ismail; Batur, Abdussamet
Neurofibromatosis type 2 mostly develops with multiple neoplasms of the central and penpheral nervous system and is associated with ocular abnormalities The presented case is a 19-year-old female patient with bilateral vestibulocochlear schwannomas in both pontocerebellar corners, intradural intra-e)dramedullary masses, and multiple neurofibromas in the spinal canal. The clinical picture for NF-2, also called central neurofibromatosis, is completely different from von Recklinghausen disease. Untreated Bilateral vestibulocochlear schwannoma may cause hydrocephalus in NF-2, and lead to death. Therefore, it is recommended to carefully monitor and treat Bilateral vestibulocochlear schwannonia in accordance with its stage.
Indications of Brain Computed Tomography Scan in Children Younger Than 3 Years of Age With Minor Head Trauma
(Hindawi Ltd, 2014) Gulsen, Ismail; Ak, Hakan; Karadas, Sevdegul; Demir, Ismail; Bulut, Mehmet Deniz; Yaycioglu, Soner
Objective. To investigate the indications to receive brain computed tomography (CT) scan and to define the pathological findings in children younger than three years of age with minor head trauma in emergency departments. Methods. In this study, hospital case notes of 1350 children attending the emergency department of Bitlis State Hospital between January 2011 and June 2013 were retrospectively reviewed. 508 children under 3 years of age with minor head trauma were included in this study. We also asked 37 physicians about the indications for requiring CT in these children. Results. This study included 508 children, 233 (45,9%) of whom were female and 275 were male. In 476 (93,7%) children, the brain CT was completely normal. 89,2% of physicians asked in the emergency department during that time interval reported that they requested CT scan to protect themselves against malpractice litigation. Conclusion. In infants and children with minor head trauma, most CT scans were unnecessary and the fear of malpractice litigation of physicians was the most common reason for requesting a CT.
Knee Joint Examinations by Magnetic Resonance Imaging: the Correlation of Pathology, Age, and Sex
(Medknow Publications & Media Pvt Ltd, 2010) Avcu, Serhat; Altun, Ersan; Akpinar, Ihsan; Bulut, Mehmet Deniz; Eresov, Kemal; Biren, Tugrul
Aims: The aim of our study was to investigate the incidence and coexistence of multiple knee joint pathologies and the distribution of knee joint pathologies according to age and sex. Patients and Methods: A retrospective analysis was performed using the clinical data of patients evaluated with magnetic resonance imaging (MRI) of the knee joint. Data from 308 patients examined between August 2002 and July 2003 were included into this study. A Pearson correlation analysis was performed to examine the relationship between the pathological findings and the age and sex of the patients. Results: The ages of the patients ranged between 1 and 74 years (mean: 43.3 years). Age was significantly correlated with meniscal degeneration and tears, medial collateral ligament degeneration, parameniscal cyst, and chondromalacia patellae. There was a significant correlation between male gender and anterior cruciate ligament injury. Meniscal injury was significantly correlated with bursitis, as well as medial collateral ligament injury. Bone bruise was significantly correlated with medial collateral ligament injury, lateral collateral ligament injury, Baker's cyst, and anterior cruciate ligament injury. Chondromalacia patellae was significantly correlated with anterior cruciate ligament injury, patellae alta, and osteochondral lesion. Bursitis (in 53.2% of the patients) followed by grade-II meniscal degeneration (in 43% of the patients) were the most common knee pathologies observed by MRI. Conclusions: MRI findings of select knee pathologies are significantly correlated with each other and the age and sex of the patient.
Laringeal İnflamatuar Myofibroblastik Tümör: Nadir Bir Olgu
(2015) Bayram, İrfan; Erten, Remzi; Bulut, Mehmet Deniz; Turan, Mahfuz; Bulut, Gülay; Almalı, Ayşe Öter
İnflamatuar myofibroblastik tümör malignite potansiyeli belirsiz, borderline bir neoplazmdır. En sık yerleşim yeri akciğerlerdir. Baş-boyun bölgesinde larinks yerleşimi oldukça nadirdir. On-bir yaşında kız hastanın üç yıldır devam eden ses kısıklığı şikayeti vardı. Yapılan laringoskopide sol vokal kordu boylu boyunca tutan, geniş tabanlı polipoid doku izlendi. Polipoid doku tamamen eksize edildi. Yapılan histopatolojik incelemede miksoid bir stroma içerisinde mikst iltihabi infiltratla karışık halde, intranükleer psödoinklüzyonları olan çok sayıda miyofibroblast izlendi. Belirgin atipi, mitoz, nekroz görülmedi. Yapılan immünhistokimyasal incelemede neoplastik hücrelerde vimentin, ALK, EMA ile pozitif boyanma izlendi. Alcian blue ile miksoid stromada boyanma görüldü. Histopatolojik ve immünhistokimyasal bulgular eşliğinde olguya laringeal inflamatuar miyofibroblastik tümör tanısı konuldu. Nadir bir antite olan laringeal inflamatuar myofibroblastik tümör, malign laringeal tümörlerden mutlaka ayırt edilmelidir. Doğru teşhis, hastada gereksiz agresif tedavi yöntemlerinden kaçınmayı ve inflamatuar myofibroblastik tümör için yeterli olan organ koruyucu komplet rezeksiyon yapılmasını sağlar
Mandibular Actinomyces Infection Mimicking a Malignancy: Case Report
(Federation Turkish Pathology Soc, 2017) Bulut, Gulay; Bayram, Yasemin; Bulut, Mehmet Deniz; Garca, Mehmet Fatih; Bayram, Irfan
Actinomycosis is a rare, chronic, suppurative and granulomatous disease caused by Actinomyces israelii, which is a filamentous, anaerobic, gram-positive, saprophytic organism in the oral cavity. Diagnosis of actinomycosis depends on positive culture or identification of Actinomyces colonies and sulfur granules in histological specimens. In our case, a mass had been growing in the mandible for eight months. The mass appeared to be malignant, both clinically and radiologically. A histopathological examination of the mandible revealed actinomycosis. It should be noted that actinomycosis can mimic a malignancy, and for differential diagnosis, bone biopsy or fine-needle aspiration should be performed pre-operatively.
Penetration of Arcus Aorta by Tunneled Cuffed Catheter: Should Fluoroscopic Guidance Be Preferred
(Wichtig Publishing, 2014) Yavuz, Alpaslan; Yuksel, Enver; Gur, Ali Kemal; Bora, Aydin; Bulut, Mehmet Deniz; Emre, Habib
Polispleni Sendromu, İnkomplet Anüler Pankreas ve Retroaortik Renal Ven Birlikteliği
(2009) Bora, Aydın; Ozen, Ozkan; Bulut, Mehmet Deniz; Avcu, Serhat
Polispleni sendromu sol izomerizm ile karakterize, kardiyopulmoner ve abdominal anomalilerineşlik ettiği nadir bir konjenital anomalidir. Lenfoma öntanısı ile abdomen ve toraks BT tetkiki yapılan 41 yaşındaki erkek hastada inferior vena kavanın suprarenal düzeyden itibaren kesintiye uğrayarak, genişlemiş azigos veni ile devam ettiği görüldü. Hepatik venler doğrudan sağ atriyumaaçılıyordu. Sol renal ven retroaortik seyir göstermekteydi. Sol üst kadranda iki adet dalak mevcuttu. Pankreas kuyruk kesimi hipoplazikti ve pankreas başı duodenum ikinci kısmını parsiyel olarak sarmaktaydı (inkomplet anüler pankreas). Bu yazıda rastlantısal olarak tanı konan, inkompletanüler pankreas ve retroaortik renal venin eşlik ettiği çok nadir bir polispleni sendromu olgusununBT bulgularını sunmayı amaçladık.