Browsing by Author "Turkoglu, Saim"

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Clinical Impacts of Juxtapapillary Duodenal Diverticulum Detected on Computed Tomography
(Bentham Science Publ Ltd, 2022) Dundar, Ilyas; Goya, Cemil; Hattapoglu, Salih; Ozkacmaz, Sercan; Ozgokce, Mesut; Turkoglu, Saim; Turko, Ensar
Background: Diverticula are commonly observed in the duodenum. Duodenal Diverticulum (DD) usually does not give symptoms throughout life and is diagnosed by coincidence. However, it may present with different symptoms in patients. Objective: This study aims to evaluate the prevalence of DD and Juxtapapillary Duodenal Diverticilium (JDD) and its association with other possible pathologies and to determine its clinical impact by using Computed Tomography (CT). Methods: This retrospective observational study, which was taken consecutively between the years of 2013-2020, was evaluated in the Radiology Department. The total number of cases was 4850 (male-2440; female-2410). CT images were evaluated by two experienced radiologists at the workstation. DD and JDD prevalence and clinical findings in the hospital registry system were examined. Results: The age of the patients included in the study ranged from 17 to 92 years (mean age 46.94 +/- 16.42). In patients with DD (female-130; male-101), mean age was 62.24 +/- 12.69 (21-92). The prevalence of DD was 4.76% (n=231). The prevalence of JDD was 4.02% (n=195) and increased with age (p<0.01). The average diameter of the JDD was measured as 23.29 +/- 8.22 (9.5-55.3) mm. A significant positive correlation was found between age and DD diameter (p=0.039). DDs were found most commonly 84.42% (n=195) in the second segment of the duodenum as JDD. In patients with JDD, the mean diameter of choledochus and wirsung canal were 6.7 +/- 2.4 (3-15.3) mm and 0.31 +/- 0.1 (0.1-6.5) mm respectively. The choledochal diameter was correlated with the JDD size (p - 0.004). Cholelithiasis (n 56), choledocholithiasis (n 20), cholecystitis (n=52), diverticulitis (n=15), duodenitis (n=37), pancreatitis (n=5) and hiatal hernia (n=60) with JDD were observed. Periampullary carcinoma was detected in one patient. Conclusion: Our study shows that cholelithiasis, choledocholithiasis, cholecystitis, diverticulitis, duodenitis, pancreatitis may be associated with JDD. Therefore, in contrast-enhanced abdominal CT scans taken for various reasons, investigation of the presence and characteristics of JDD and detection of pathologies that may be associated with JDD are important for patients to benefit from early diagnosis and treatment opportunities and to take precautions against possible complications.
Comparison of Microwave Ablation and Lobectomy in the Treatment of Benign Thyroid Nodules
(Wiley, 2025) Turkoglu, Saim; Yilmaz, Abdullah Hilmi; Yokus, Adem; Ulutas, Mehmet Esref
Purpose: The purpose of this study is to evaluate the efficacy, safety, and advantages of microwave ablation (MWA) compared to lobectomy in the treatment of benign thyroid nodules. Methods: A total of 105 patients were included in the study, 49 in the MWA group and 56 in the surgical group. The mean age of the patients in the MWA group was 49.5 (+/- 12.8) and 40.2 (+/- 10.1) in the surgical group (p < 0.001). 81.6% of the patients in the MWA group were female and 18.4% were male. 83.9% of the patients in the surgical group were male and 16.1% were female (p = 0.75). Patients were followed for at least 12 months. The study was completed by comparing the two groups in terms of surgery-procedure times, complications, nodule sizes, thyroid function tests, symptoms, volume reduction rates (VRR), and cosmetic improvement scores. Results: The mean maximum nodule diameter in the patient group who underwent MWA was 3.5 (+/- 1) cm at the beginning and 2.3 (+/- 0.9) cm at the end of the 12th month (p < 0.001). VRR was 73.4% (+/- 14.8) at the end of the 12th month (p < 0.001). Cosmetic score was 2.5 (+/- 1) at the first month, 1.7 (+/- 1.1) at the third month, 1 (+/- 1) at the sixth month, and 0.6 (+/- 0.7) at the 12th month (p < 0.001). The procedure time was 15.4 (+/- 4.4) minutes in the patients in the MWA group, while it was 70.7 (+/- 17.2) minutes in the surgical group (p < 0.001). No complications developed in 48 patients (98%) in the MWA group and 38 patients (67.9%) in the surgical group (p = 0.005). Voice change occurred in three patients (5.4%) in the surgical group, hematoma in two (3.6%) patients and voice change in one (1.8%) patient in the MWA group. Hypothyroidism developed in eight patients in the surgical group, while hypothyroidism did not develop in the MWA group (p = 0.007). Conclusion: MWA is a safe and effective treatment method for benign thyroid nodules. It has many advantages over thyroidectomy, such as fewer complications, shorter procedure time, no need for hospitalization and general anesthesia, and good cosmetic results.
Direct X-Ray and Ct Findings of Gallstone Ileus
(Springer india, 2020) Turkoglu, Saim; Goya, Cemil; Kalayci, Tolga
Gallstone ileus is a complication of biliary tree stones and was first described by Bartholin in 1654. In any localization, one or more gallstones may occlude as a result of access to the gastrointestinal tract via the bilioenteric fistula. In this article, we aimed to present a rare and operate with gallstone ileus cases of radiological and surgical imaging findings. A 74-year-old male patient presented with complaints of right upper quadrant pain, nausea, vomiting, and constipation in the last few days of the emergency department. Radiographical and computed tomography examination was done. The patient was urgently operated with gallstones. The ileal stone was removed in addition to cholecystectomy in the operation, and the cholecystododenal fistula detected during the operation was repaired. Gallstone ileus is an uncommon cause of a mechanical small bowel obstruction. Gallstone ileus should also be kept in mind in the elderly patients who have recurrent abdominal operation history with abdominal obesity findings of the omentum. In our case, we wanted to emphasize the importance of the radiological approach in diagnosing gallstone ileus disease in elderly patients with diabetes mellitus.
Effectiveness of Twin-Beam Dual-Energy Computed Tomography in Characterization of Solitary Pulmonary Nodules Larger Than 5 Mm
(Brieflands, 2024) Turkoglu, Saim; Ozgokce, Mesut
Background: Advancements in technology have significantly improved the diagnosis of solitary pulmonary nodules in thelungs. Various computed tomography (CT) imaging techniques, including modern dual-energy computed tomography (DECT),have enhanced the ability to accurately classify pulmonary nodules as benign or malignant. In this study, three different dual-energy parameters - iodine load, contrast load, and visual assessment - were evaluated for their potential in characterizingpulmonary nodules. Objectives: The aim of this study was to assess the reliability and effectiveness of DECT in distinguishing benign frommalignant pulmonary nodules using different parameters, including visual assessment, iodine concentration, and contrastload. Patients and Methods: This prospective study included patients who underwent contrast-enhanced thoracic DECT forsolitary pulmonary nodules, had histopathological examination results, or had at least a two-year follow-up CT scan. Patientswith nodules smaller than 6 mm or completely calcified nodules were excluded. Patients diagnosed with a suspicious solitarypulmonary nodule on chest radiography and subsequently underwent contrast-enhanced DECT, or those diagnosed with a lungnodule on routine non-contrast CT scans and later evaluated using DECT, were included in the study. Benign and malignantnodules were compared based on gender, age, contrast load, iodine load, and color map assessment. Nodule images wereobtained 40 seconds after intravenous contrast administration using single-source DECT (120 kV split filter) with twin-beamtechnology. The visual enhancement and color map evaluation, including contrast and iodine load measurements, wereseparately calculated and recorded for each lung nodule. Results: A total of 59 patients [30 males (50.8%) and 29 females (49.2%)] with a solitary pulmonary nodule met the inclusioncriteria. Among the 59 pulmonary nodules, 16 (27.1%) were malignant, and 43 (72.9%) were benign. Of the benign lesions, 23(53.5%) were found in males and 20 (46.5%) in females. The mean age of patients with benign nodules was 53.5 +/- 12 years (range:25 - 73 years), while for those with malignant nodules, it was 69.2 +/- 5.59 years (range: 57 - 75 years). There was no statisticallysignificant difference in age between the two groups (P = 0.506). The median contrast load was 0.0 Hounsfield units (HU)[interquartile range (IQR: 64)] in benign nodules and 63 HU (IQR: 154) in malignant nodules. Malignant nodules had asignificantly higher contrast load than benign nodules (P = 0.003). Using a cut-off value of 22 HU for contrast load in malignancydiagnosis, the sensitivity was 100%, specificity was 58.14%, positive predictive value (PPV) was 47.06%, and negative predictivevalue (NPV) was 100%. The area under the curve (AUC) was 0.746. The median iodine load was 0.0 mg/dL (IQR: 4.5) in benignnodules and 4.5 mg/dL (IQR: 11.8) in malignant nodules. Malignant nodules had a significantly higher iodine load than benignnodules (P < 0.001). Using a cut-off value of 1 mg/mL for malignancy diagnosis, the sensitivity was 100%, specificity was 62.79%,PPV was 50%, and NPV was 100% (AUC: 0.768). Conclusion: Dual-energy computed tomography provides valuable contributions in differentiating benign and malignantpulmonary nodules. In this study, the diagnostic value of three different approaches - visual iodine coverage color map, iodineconcentration, and contrast load - was demonstrated in distinguishing these lesions.
Efficiency of Diffusion-Weighted Mri for Differentiating Radiologically Similar Simple and Type I Hydatid Cysts of the Liver
(Sage Publications Ltd, 2022) Dundar, Ilyas; Ozgokce, Mesut; Durmaz, Fatma; Ozkacmaz, Sercan; Turkoglu, Saim; Goya, Cemil
Background Determining the nature of purely cystic hepatic lesions is essential because different kinds have different follow-ups, treatment options, and complications. Purpose To explore the potential of apparent diffusion coefficient (ADC) values of diffusion-weighted imaging (DWI) for the differentiation of type I hydatid cysts (HC) and simple liver cysts (SLC), which have similar radiological appearances. Material and Methods This single-center prospective study was conducted during 2016-2019. Round, homogenous, anechoic liver cysts >1 cm were classified according to at least two years of imaging follow-up, radiological features, serology, as well as puncture aspiration injection reaspiration procedure and pathology results. ADC values of 95 cysts (50 type I HCs and 45 SLCs) were calculated on DWI. The differences in ADC values were analyzed by independent t-test. Results Of 51 patients, 28 were female, 23 were male (mean age 32.07 +/- 22.95 years; age range 5-82 years). Mean diameter of 45 SLCs was 2.59 +/- 1.23 cm (range 1.2-7.6 cm) and ADC(mean) value was 3.03 +/- 0.47 (range 2.64-5.85) while mean diameter of 50 type I HCs was 7.49 +/- 2.95 cm (range 2.8-14 cm) and ADC(mean) value was 2.99 +/- 0.29 (range 2.36-3.83). There was no statistically significant difference in ADC values between type I HCs and SLCs Conclusion Some studies report that ADC values of type I HCs are statistically significantly lower than those of SLCs. Others suggest no significant difference. In our study with a higher number of cases, using ADC parameters similar to those in previous studies, we did not find any statistically significant difference.
Evaluation of Celiac Disease With Uniphasic and Multiphasic Dynamic Mdct Imaging
(Springer, 2021) Goya, Cemil; Dundar, Ilyas; Ozgokce, Mesut; Turkoglu, Saim; Turko, Ensar; Ozkacmaz, Sercan; Almali, Necat
Purpose An analysis of dynamic contrast MRI has been shown to provide valuable information about disease activity in Crohn's disease and Celiac disease (CD). However, there are no reports of dynamic multi-detector computer tomography use in patients with CD. The aim of this study is to determine and compare the perfusion dynamics of the patients treated with control subjects and the perfusion dynamics in patients with untreated CD, using dynamic contrast in MDCT and compare studying contrast dynamics in Marsh types as well. Methods In this retrospective study, uniphasic and multiphasic MDCT, untreated, treated, incompatible CD patients and healthy control group duodenum wall thickness and HU values were compared in terms of patient groups and modified Marsh types. Result In dynamic CT, the highest contrast curve was observed in the untreated group and Marsh type 1. While the contrast curve of the untreated and non-compliant patients increased rapidly and showed wash out, the type 4 contrast curve was observed, whereas the treated and control group slowly increased type 5 contrast curve. In the contrast-enhanced CT in the venous phase, in the ROC analysis between Marsh 1-2 and Marsh 3a-c, the sensitivity was 97% and the specificity was 87% when the cut off was taken as 4.45 mm for wall thickness (p: 0.005). Conclusion Contrast-enhanced single-phase and dynamic MDCT imaging in CD patients may be useful in evaluating the inflammatory and pathological process in the small intestine. [GRAPHICS] .
Is There a Relation Between Computed Tomography Findings and Electrocardiography Findings in Covid-19
(Assoc Medica Brasileira, 2021) Ozturk, Fatih; Babat, Naci; Goya, Cemil; Turkoglu, Saim; Karaduman, Medeni; Coldur, Rabia; Tuncer, Mustafa
OBJECTIVE: COVID-19 can cause lung damage and may present with pneumonia in patients. In the present study, the correlation between the severity of pneumonia and electrocardiography parameters of COVID-19 were examined. METHODS: A total of 93 COVID-19 patients and a control group consisting of 62 volunteers were studied. Computed thorax tomography evaluation was performed; each lung was divided into three zones. For each affected zone, scores were given. The main computed thorax tomography patterns were described in line with the terms defined by the Fleischner Society and peer reviewed literature on viral pneumonia. We compared Computed thorax tomography of patients with corrected QT (QTc) and P wave dispersion (Pd) time. RESULTS: There is a significant difference between the patient and control groups in terms of QTc values (413.5 +/- 28.8 msec vs. 395.6 +/- 16.7 msec p<0.001). Likewise, the Pd value of the patient group is statistically significantly higher than that of the control group (50.0 +/- 9.6 ms computed thorax tomography ec vs. 41.3 +/- 5.8 msec p<0.001). In the patient group, a reverse correlation was detected between computed thorax tomography score and Pd value according to partial correlation coefficient analysis (correlation coefficient: -0.232, p=0.027). In the patient group, the correlation between computed thorax tomography score and QTc value was similarly determined according to partial correlation coefficient analysis (Correlation coefficient:0.224, p=0.017). CONCLUSIONS: COVID-19 prolongs QTc and P wave dispersion values; and as the severity of pneumonia increases, QTc value increases. However, whereas the severity of pneumonia increases, P wave dispersion value decreases.
Mesh Displacement in Enhanced-View Totally Extraperitoneal Versus Totally Extraperitoneal Bilateral Inguinal Hernia Repair Without Mesh Fixation
(Elsevier Singapore Pte Ltd, 2025) Yilmaz, Abdullah Hilmi; Ulutas, Mehmet Esref; Turkoglu, Saim
Purpose: International guidelines recommend laparoscopic surgical repair for bilateral inguinal hernia. One of the laparoscopic procedures with rapid recovery, less chronic pain and less chance of infection is enhanced totally extraperitoneal (eTEP). The eTEP technique is useful in bilateral hernias, large inguinal-scrotal hernias, incarcerated hernias, obese patients and patients with a short distance between the umbilicus and pubic tubercle. However, eTEP inherently involves extensive extraperitoneal dissection. Both bilateral hernia repair and the use of the eTEP technique reveal that the extraperitoneal space is even larger. This can be considered as a factor for mesh displacement. The aim of this study was to compare eTEP and totally extraperitoneal (TEP) techniques without mesh fixation in bilateral laparoscopic inguinal hernia repair. Methods: Form January 2023 to June 2023, 40 consecutive patients with bilateral inguinal hernia were randomized into two groups; eTEP group (n = 20) and TEP group (n = 20) without mesh fixation. Study was registered at http://Clinicaltrials.gov (NCT06070207). The meshes were marked with three radiopague clips. Pelvic radiographs was performed to evaluate the displacement of the mesh. The primary outcome of this study was mesh displacement. In addition, this is the first study in the literature to compare eTEP and TEP technique in terms of mesh displacement without fixation in laparoscopic bilateral inguinal hernia. Results: There was no significant difference between the groups in terms of mesh displacement, recurrence, postoperative VAS scores, operation time, length of hospital stay, accidental pneumoperitoneum, hematoma, seroma formation and surgical site infection. Conclusion: There was no more mesh displacement in the eTEP group in which more extraperitoneal space was created. Both bilaterality and without mesh fixation did not cause any difference in mesh displacement in both groups. Despite both bilaterality and larger extraperitoneal space dissection, the absence of mesh fixation in the bilateral eTEP technique is safe. Mesh displacement in laparoscopic bilateral inguinal hernia repair is minimal and similar in the TEP and eTEP technique. Trial registration clinicaltrials number: NCT06070207. (c) 2025 Asian Surgical Association and Taiwan Society of Coloproctology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).
Prospective Randomized Study Comparing Mesh Displacement in Enhanced-View Totally Extraperitoneal Versus Totally Extraperitoneal Laparoscopic Inguinal Hernia Repair Without Mesh Fixation
(Springer, 2024) Yilmaz, Abdullah Hilmi; Ulutas, Mehmet Esref; Turkoglu, Saim
PurposeIn laparoscopic inguinal hernia repair, it is thought that the mesh can be displaced more in the enhanced-view totally extraperitoneal (eTEP) technique. The aim of this study was to compare eTEP and totally extraperitoneal (TEP) techniques without mesh fixation in terms of mesh displacement and hernia recurrence.MethodsBetween December 2022 and April 2023, 60 consecutive patients with unilateral inguinal hernia were randomized into two groups; eTEP group (n = 30) and TEP group (n = 30). There was without mesh fixation in both groups. Study was registered at http://Clinicaltrials.gov (NCT06070142). The mesh was marked with three radiopaque clips. Pelvic radiographs were performed to evaluate the displacement of the mesh. The primary outcome of this study was mesh displacement. In addition, this is the first study in the literature to compare eTEP and TEP techniques in terms of mesh displacement without fixation in laparoscopic inguinal hernia.ResultsThere was no significant difference between the groups in terms of mesh displacement, recurrence, postoperative VAS scores, length of hospital stay, hematoma, and seroma formation. The operation time was higher in the eTEP group and was statistically significant.ConclusionWithout mesh fixation, the eTEP technique does not increase the risk of mesh displacement and recurrence. The eTEP technique can be safely applied without mesh fixation in laparoscopic inguinal hernia repairs.Trial registrationClinicalTrials number: NCT06070142.
Radiological Finding Cholangiopathy S of Recurrent Pyogenic
(Emergency Medicine Physicians Assoc Turkey, 2024) Turkoglu, Saim; Gurbuz, Esra
Recurrent pyogenic cholangiopathy (RPC), formerly known as oriental cholangiopathy, is an entity characterized by stenosis of the intrahepatic and extrahepatic bile duct, formation of pigmented intraductal Stones and dilation. Our objective was to discuss the presence of recurrent pyogenic cholangiopathy in our present presentation with radiological images. RPC is a destructive disease caused by the intrahepatic and extrahepatic bile ducts, recurrent attacks of cholangitis, stasis in the bile ducts, formation of abscesses, strictures, and dilatations, as well as parasitic infections in etiology. Patients with RPC produce most commonly E. coli, pseudomonas, klebsiella, proteus species, and anaerobes in biliary cultures. Sonographic and CTfindings include intrahepatic or extrahepatic duct stones, extrahepatic duct dilatation, relatively intermediate or intrahepatic duct dilatation, focal or large area bile duct dilatation, increased periportal echogenicity, segmental hepaticatrophy, and existinggall stones. Stones in the intrahepatic biliary tract can be removed by interventional radiology or surgery.
Ultrasound Elastography in the Differentiation of Simple Cyst and Type I Hydatid Cyst of the Liver
(Lippincott Williams & Wilkins, 2021) Durmaz, Fatma; Ozgokce, Mesut; Turkoglu, Saim; Dundar, Ilyas; Goya, Cemil
Hydatid cyst (HC) is a parasitic disease that is endemic particularly to the sheep-breeding regions of the world, our country included. Given their propensity to materialize most commonly in the liver, our study evaluates the value of ultrasound elastography in the differential diagnosis of simple cyst and type I HCs of the liver. The study involved a total of 73 cysts (22 simple cysts, 51 type I HCs) that were removed using the puncture aspiration injection reaspiration technique between 2016 and 2018. All measurements were made using a Siemens ACUSON S2000 (Siemens Healthcare, Erlangen, Germany) device with a 4-MHZ 4C1 convex probe, an acoustic radiation force impulse elastography procedure, and a Virtual Touch IQ option. The difference between the mean shearwave elastography (SWE) values of both groups was analyzed with an independent t test. Of the 70 patients involved in the study, 29 were female and 41 were male, with a mean +/- SD age of 38.85 +/- 17.62 years (range, 5-82 years). Upon the examination of the 22 simple cysts and the 51 HCs, the mean +/- SD SWE values were found to be 2.6 +/- 0.96 (0.96-4.25) and 2.8 +/- 1.69 (0.66-4.84), respectively. No statistically significant difference was identified between the SWE values of type I HCs and simple cysts (P > 0.005). Although HCs and simple cysts had similar radiological appearances, and a relative difference was noted in the differentiation of the elastographic measurements, this difference was not statistically significant. Accordingly, more comprehensive and various studies are needed.
Use of Virtual Touch Tissue Quantification Elastography Technique in Fetal Lung Maturation
(Lippincott Williams & Wilkins, 2023) Arslan, Harun; Kucukbas, Gokce Naz; Turkoglu, Saim; Akdemir, Zulkuf; Yokus, Adem; Gunduz, Ali Mahir; Sahin, Hanim Guler
This study is an analysis of fetal lung stiffness by virtual touch tissue quantification (VTTQ) elastography to predict fetal lung maturation. Evaluation of fetal lungs was first performed in B mode, and fetal lungs were analyzed at 3 different periods at third trimester in each pregnant woman, at 28 to 31, 32 to 36, and 37 to 41 weeks. Fetal lung elastography was performed at regions with the least acoustic shadow and far from ribs and heart. Each fetal lung assessment were done by taking mean lung stiffness obtained by measuring stiffness of both left and right fetal lungs. T test analysis showed no significant difference in fetal lung stiffness between male and female fetuses among 3 gestational periods. Analysis of variance was performed to evaluate fetal lung stiffness of the fetuses at 3 different gestational periods (28-31, 32-36, and 37-41 weeks). This analysis showed significant difference (P < 0.01). Duncan multiple comparison analysis did not show significant difference in fetal lung stiffness between 28 and 31 weeks and 32 and 36 weeks, whereas fetal lung stiffness of fetuses at 37 to 41 weeks were significantly greater (P < 0.01). This study is first step to analyze fetal lung maturation noninvasively using VTTQ elastography technique by measuring fetal lung stiffness.