Browsing by Author "Yavuz, Alpaslan"

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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.
Acoustic Radiation Force Impulse Imaging for Evaluation of Renal Parenchyma Elasticity in Diabetic Nephropathy
(Amer Roentgen Ray Soc, 2015) Goya, Cemil; Kilinc, Faruk; Hamidi, Cihad; Yavuz, Alpaslan; Yildirim, Yasar; Cetincakmak, Mehmet Guli; Hattapoglu, Salih
Objective: The goal of this study is to evaluate the changes in the elasticity of the renal parenchyma in diabetic nephropathy using acoustic radiation force impulse imaging. SUBJECTS AND METHODS. The study included 281 healthy volunteers and 114 patients with diabetic nephropathy. In healthy volunteers, the kidney elasticity was assessed quantitatively by measuring the shear-wave velocity using acoustic radiation force impulse imaging based on age, body mass index, and sex. The changes in the renal elasticity were compared between the different stages of diabetic nephropathy and the healthy control group. RESULTS. In healthy volunteers, there was a statistically significant correlation between the shear-wave velocity values and age and sex. The shear-wave velocity values for the kidneys were 2.87, 3.14, 2.95, 2.68, and 2.55 m/s in patients with stage 1, 2, 3, 4, and 5 diabetic nephropathy, respectively, compared with 2.35 m/s for healthy control subjects. Acoustic radiation force impulse imaging was able to distinguish between the different diabetic nephropathy stages (except for stage 5) in the kidneys. The threshold value for predicting diabetic nephropathy was 2.43 m/s (sensitivity, 84.1%; specificity, 67.3%; positive predictive value, 93.1%; negative predictive value 50.8%; accuracy, 72.1%; positive likelihood ratio, 2.5; and negative likelihood ratio, 0.23). CONCLUSION. Acoustic radiation force impulse imaging could be used for the evaluation of the renal elasticity changes that are due to secondary structural and functional changes in diabetic nephropathy.
Advantages of Us in Percutaneous Dilatational Tracheostomy: Randomized Controlled Trial and Review of the Literature
(Radiological Soc North America, 2014) Yavuz, Alpaslan; Yilmaz, Murat; Goya, Cemil; Alimoglu, Emel; Kabaalioglu, Adnan
Purpose: To compare procedure times and complication rates of preincisional ultrasonographic (US) evaluation and perioperative US guidance in percutaneous dilatational tracheostomy (PDT) with those of the current standard of care, PDT performed without image guidance. Materials and Methods: Between December 2007 and January 2011, 341 patients were included in this institutional review board-approved study after informed consent was obtained from the patients or their relatives. The patients were divided randomly into two groups. In group A (n = 166), the possible causes of complications, such as aberrations of tracheal, thyroidal, and vascular structures, were determined with US, and tracheal measurements were performed by using US. The clinician's initial considerations at physical examination were compared with the US findings. PDT was subsequently performed with US guidance in suitable cases. In group B (n = 175), PDT was performed solely on the basis of physical landmarks. The procedure times and complication rates were compared across groups by using the Fisher exact test. Results: In group A, the puncture sites designated at the physical examination were reconsidered in 39 (23.8%) of 164 cases. The perioperative complication rates were slightly lower in group A (7.8% [12 of 154]) than in group B (15.0% [25 of 167]); however, the difference did not achieve statistical significance (P = .054). The mean procedure times for groups A and B were 24.09 minutes +/- 8.05 (standard deviation) (range, 14-68 minutes) and 18.62 minutes +/- 6.34 (range, 12-81 minutes), respectively (P = .001), and the numbers of patients in each group who required multiple puncture attempts were six (3.9%) of 154 and 23 (13.6%) of 169 (P = .003), respectively. Conclusion: The use of US guidance before and during PDT could render the procedure easier and safer, with fewer complications but a slightly longer procedure time. (C) RSNA, 2014
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.
Assessment of Liver Volume With Computed Tomography and Comparison of Findings With Ultrasonography
(Springer, 2014) Bora, Aydin; Alptekin, Cem; Yavuz, Alpaslan; Batur, Abdussamet; Akdemir, Zulkuf; Berkoz, Mehmet
In this study, we aimed to investigate the impact of non-alcoholic hepatic steatosis on the liver volume. As investigating hepatic steatosis, we utilized computed tomography (CT) to determine the degree of steatosis and we utilized hepatobiliary ultrasonography (USG) for densitometry and correlation. As hepatosteatosis group, 35 patients over 18 years of age and whose abdominal CT scans were requested by several clinics and performed routinely were included in this study, and as control group, 40 healthy subjects without hepatosteatosis (clinically and radiologically) and correlated with hepatosteatosis group in terms of age and gender were included in this study. CT densitometry and liver attenuation index (LAI) of all individuals who participated in our study were calculated, and contrast images of patients were transferred to CT-Volume Software (Siemens Syngo Multimodality Workplace; Version VE52A). In this study, interactive and automated volume measurement techniques were used together. The volumes were measured separately in patient and control group. In this study for each stage in USG, there was found a direct correlation in terms of LAI and volume, and this correlation was statistically significant (p < 0.01). Furthermore, statistical significance between size and USG stage draws attention (p < 0.05). A significance relationship between USG stage and age could not be determined. As a result, we have reached the conclusion that CT densitometry can be used as an assistive technique along with USG to determine the degree of steatosis in the non-alcoholic fatty liver disease, and there is a positive linear correlation between the liver size and volume, and liver volume increases in the non-alcoholic fatty liver disease.
Brain Magnetic Resonance Imaging and Magnetic Resonance Spectroscopy Findings of Children With Kernicterus
(int Scientific information inc, 2015) Sari, Sahabettin; Yavuz, Alpaslan; Batur, Aabdussamet; Bora, Aydin; Caksen, Huseyin
Background: The term kernicterus, or bilirubin encephalopathy, is used to describe pathological bilirubin staining of the basal ganglia, brain stem, and cerebellum, and is associated with hyperbilirubinemia. Kernicterus generally occurs in untreated hyperbilirubinemia or cases where treatment is delayed. Magnetic resonance imaging (MRI)-based studies have shown characteristic findings in kernicterus. The objective of our study was to describe the role of 1H magnetic resonance spectroscopy (MRS) in demonstrating these metabolic changes and to review conventional MRI findings of kernicterus. Material/Methods: Forty-eight pediatric cases with kernicterus were included in this study. MRI and MRS examinations were performed on variable dates (10-29 days after birth). NAA, Cr, Cho, NAA/Cr, NAA/Cho, and Cho/Cr values were evaluated visually and by computer analysis. Results: There was no statistically significant difference between the NAA and Cho levels in the acute kernicterus patients and the control group (healthy patients), whereas both were significantly elevated in the chronic kernicterus patients. Both the mean NAA/Cr and Cho/Cr ratio values were significantly higher in the acute and chronic cases compared to the control group. The NAA/Cho ratio value was statistically lower in the acute cases than in the control group while it was similar in the chronic cases. Conclusions: Conventional MR imaging and 1H-MRS are important complementary tools in the diagnostics of neonatal bilirubin encephalopathy. This study provided important information for applying these MR modalities in the evaluation of neonates with bilirubin encephalopathy.
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
Coexistence of Gastric Diverticulum and Gastric Cancer
(Lippincott Williams & Wilkins, 2018) Olmez, Sehmus; Aslan, Mehmet; Yavuz, Alpaslan; Saritas, Bunyamin
A Comparative Evaluation of Cataract Classifications Based on Shear-Wave Elastography and B-Mode Ultrasound Findings
(Springer international Publishing Ag, 2019) Ozgokce, Mesut; Batur, Muhammed; Alpaslan, Muhammed; Yavuz, Alpaslan; Batur, Abdussamet; Seven, Erbil; Arslan, Harun
In this study, a comparison is made of the findings of B-mode ultrasound and ultrasound elastography with the Lens Opacities Classification (LOCS) grade in patients with senile cataracts. A total of 74 patients with cataracts and 32 age-matched healthy volunteers as the control group were evaluated in the departments of ophthalmology and radiology between 2016 and 2017. In the patient group, cataracts were graded according to LOCS, and B-mode sonographic appearance and elasticity measurements were recorded, after which the cataract grade and sonoelastography/B-mode ultrasound findings were compared using statistical methods. Among the 74 patients with cataracts, 38 were females (51.4%) and 36 were males (48.6%), and the mean age was 62.05 +/- 7.95 (43-78) years. A Chi-square test revealed a significant relationship between ultrasound echogenicity of cataract and grade of cataract (p < 0.005). The ultrasound elastography revealed a mean shear-wave velocity of 2.90 m/s +/- 0.371 (2.13-3.53) among patients with grade 3 cataracts, 3.1 m/s +/- 0.45 (2.26-3.98) among patients with grade 4, 3 m/s +/- 0.58 (2.35-4.60) among patients with grade 5 and 3 m/s +/- 0.528 (2.31-4.50) among patients with grade 6 cataracts, and 3 m/s +/- 0.258 (2.36-3.58) among the normal subjects. No statistically significant difference was noted in the analysis of variance (p > 0.005). While cataract grade and B mode echogenicity were directly proportional, there was no significant difference in lens elasticity.
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.
Comparison of Conventional Magnetic Resonance Imaging, Cine-Magnetic Resonance Imaging, and Operation Findings in Invasion Assessment of Esophageal Cancer
(Baycinar Medical Publ-baycinar Tibbi Yayincilik, 2017) Ozgokce, Mesut; Alper, Fatih; Sade, Recep; Yavuz, Alpaslan; Ogul, Hayri; Aydin, Yener; Eroglu, Atilla
Background: This study aims to compare the conventional magneticresonance imaging and cine-magnetic resonance imaging findings with the operation results in terms of invasion existence in esophageal cancer. Methods: This prospective study included a total of 37 suspected cases (21 males, 16 females; mean age 63.3 years; range 28 to 81 years) with respect to whether or not invasion in esophageal masses between January 2012 and February 2016. Initially, conventional magnetic resonance imaging (T-1-weighted, T-2-weighted, short tau inversion recovery), lesion characteristics and invasion areas were evaluated in all cases. The cases with invasion were re-evaluated according to dynamic moving features of the lesion and adjacent tissue by cine-magnetic resonance imaging in three planes. The relative motion of the mass with adjacent tissues, fatty planes, and invasion status were evaluated according to size and structure. Results: The presence of invasion was detected by conventional magnetic resonance imaging in all of the cases. Invasion was not detected in 28 of 37 cases, while it was observed in nine cases by cine-magnetic resonance imaging. Twenty of 28 non-invasion cases were operated and results were compatible with the cine-magnetic resonance imaging results. The remaining eight cases were not operated due to severe comorbidities and the refusal of operation. Conclusion: Cine-magnetic resonance imaging may contribute to detect invasion accurately in esophagus cancer which is adjacent to moving tissues such as heart and main vascular structures. Based on our study results, cine-magnetic resonance imaging appears to be superior to conventional magnetic resonance imaging.
Comparison of Efficiencies Between Shear Wave Elastography, Fine-Needle Aspiration Biopsy and American College of Radiology Thyroid Imaging Reporting and Data System Scoring System in Determining the Malignity Potential of Solid Thyroid Nodules
(Lippincott Williams & Wilkins, 2021) Yavuz, Alpaslan; Akbudak, Ibrahim; Ucler, Rifki; Ozgokce, Mesut; Arslan, Harun; Batur, Abdussamed
We aimed to evaluate the efficiencies of quantitative shear-wave elastography, fine-needle aspiration (FNA) biopsy and American College of Radiology (ACR)-thyroid imaging reporting and data system (TIRADS) scoring system in determining the malignity potential of solid thyroid nodules. In period between September 2014 and January 2016, 191 solid thyroid nodules of 189 patients were enrolled in this study. The mean shear wave velocities of the nodules were recorded by acoustic radiation force impulse method. All nodules were classified according to ACR-TIRADS scoring system and underwent FNA procedure. The cytopathologic results (after FNA) were benign in nature, atypical-cytology/suspiciously malign and highly suspicious of malignity in 117, 28, and 21 nodules, respectively. The specimen from FNA was insufficient in 25 nodules. Thirty-four nodules of 33 enrolled patients were operated, and the efficiencies of shear wave elastography, FNA, and ACR-TIRADS procedures were statistically analyzed; relying on the histopathologic results, the shear-wave elastography had 83.3% sensitivity, 93.7% specificity (with a cutoff value of 2,74 m/s), the FNA had 94.4% sensitivity, 87.5% specificity, and ACR-TIRADS had 88.2% sensitivity, 94.1 specificity in determining malignant tyroid nodules (P < 0.005). Quantitative shear wave elastography is concluded to be an effective, noninvasive, and practical imaging modality with a lesser sensitivity and specificity values than TIRADS unless a lower sensitivity but a higher specificity values than FNA (93.7% vs 87.5%) in considering the malignity potential of solid thyroid nodules.
Complications Following Endoscopic Retrograde Cholangiopancreatography: Minimal Invasive Surgical Recommendations
(Public Library Science, 2014) Koc, Bora; Bircan, Huseyin Yuce; Adas, Gokhan; Kemik, Ozgur; Akcakaya, Adem; Yavuz, Alpaslan; Karahan, Servet
Background: ERCP has a complication rate ranging between 4% and 16% such as post-ERCP pancreatitis, hemorrhage, cholangitis and perforation. Perforation rate was reported as 0.08% to 1% and mortality rate up to 1.5%. Besides, injury related death rate is 16% to 18%. In this study we aimed to present a retrospective review of our experience with post ERCP-related perforations, reveal the type of injuries and management recommendations with the minimally invasive approaches. Methods: Medical records of 28 patients treated for ERCP-related perforations in Okmeydani Training and Research Hospital between March 2007 and March 2013 were reviewed retrospectively. Patient age, gender, comorbidities, ERCP indication, ERCP findings and details were analyzed. All previous and current clinical history, laboratory and radiological findings were used to assess the evaluation of perforations. Results: Between March 2007 and March 2013, 2972 ERCPs were performed, 28 (0.94%) of which resulted in ERCP-related perforations. 10 of them were men (35.8%) and 18 women (64.2%). Mean age was 53.36 +/- 14.12 years with a range of 28 to 78 years. 14 (50%) patients were managed conservatively, while 14 (50%) were managed surgically. In 6 patients, laparoscopic exploration was performed due to the failure of non-surgical management. In 6 of the patients that ERC-Prelated perforation was suspected during or within 2 hours after ERCP, underwent to surgery primarily. There were two mortalities. The mean length of hospitalization stay was 10.46 +/- 2.83 days. The overall mortality rate was 7.1%. Conclusion: Successful management of ERCP-related perforation requires immediate diagnosis and early decision to decide whether to manage conservatively or surgically. Although traditionally conventional surgical approaches have been suggested for the treatment of perforations, laparoscopic techniques may be used in well-chosen cases especially in type II, III and IV perforations.
Computed Tomography and Magnetic Resonance Imaging Findings of Primary Bladder Angiosarcoma: a Case Report
(Elsevier Science inc, 2014) Beyazal, Mehmet; Pirincci, Necip; Yavuz, Alpaslan; Ozkacmaz, Sercan; Bulut, Gulay
Primary bladder angiosarcomas are extremely rare but aggressive tumors. Due to the small number of cases (less than 30) reported to date, the information about natural tumor progression, optimal treatment procedure and prognosis are limited. Also, published reports of bladder angiosarcoma have not adequately featured imaging findings. Herein we report computed tomography and magnetic resonance imaging findings of a 20-year-old male with primary angiosarcoma of the bladder. (C) 2014 Elsevier Inc. All rights reserved.
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.
Diffuse Nodular Lymphoid Hyperplasia of the Small Bowel Associated With Common Variable Immunodeficiency and Giardiasis: a Rare Case Report
(Springer Wien, 2014) Olmez, Sehmus; Aslan, Mehmet; Yavuz, Alpaslan; Bulut, Gulay; Dulger, Ahmet Cumhur
Diffuse nodular lymphoid hyperplasia (DNLH) of the intestine is an extremely rare lymphoproliferative disorder of uncertain etiology. Typically, numerous polypoid nodules composed of hyperplastic benign lymphoid tissue are present in the small and/or large intestinal mucosa. DNLH has been observed in association with common variable immunodeficiency (CVID). A 38-years-old man was admitted to our clinic due to dyspeptic complaints. An upper gastrointestinal system endoscopic examination revealed DNLH in the duodenum. A biopsy specimen showed the presence of nodular lymphoid hyperplasia and a Giardia lamblia infection in the duodenum. CVID was suspected, and the diagnosis was established by demonstrating a significant reduction in the serum gamma-globulin levels. DNLH is a rare benign condition with regards to diagnosis and treatment of unknown etiology. In patients with DNLH, screening for the immune deficiencies is being important in addition to histopathological examinations.
The Effects of Aging on Lymphocyte Subgroups in Males and Females
(int Scientific Literature, inc, 2014) Inal, Ali; Koc, Bora; Bircan, Huseyin Yuce; Ogan, Ebru; Yavuz, Alpaslan; Kemik, Ozgur
Background: Age-associated immune senescence is a catch-all phrase that has been used to describe a plethora of changes to the immune system across the lifespan. Aging is associated with a decline in immune function. Our aim in this study was to investigate how lymphocyte subgroups in peripheral blood are affected by aging among males and females. Material/Methods: Study participants were 70 healthy individuals from 3 different age groups, observed from January 2010 to January 2012. The average levels of CD3+, CD4+, CD8+, CD19+, CD16+/CD56+, CD3+/CD69+, and CD19+/CD69+ were determined for each group and compared in terms of age and sex. Results: We found significant reduction in the level of CD3+T cells related with age, but no significant changes in CD19+ B cell levels (p<0.005). Aging significantly reduces activated B cell (CD19+/CD69+) levels in males (p<0.005). Conclusions: Our results show that there may be differences between males and females in terms of immune senescence.
Efficacy of Strain Elastography in Diagnosis and Staging of Acute Appendicitis in Pediatric Patients
(int Scientific Literature, inc, 2018) Arslan, Harun; Akdemir, Zulkuf; Yavuz, Alpaslan; Gokcal, Fahri; Parlakgumus, Cemal; Islamoglu, Necat; Akdeniz, Huseyin
Background: In the present study, the role and efficiency of strain elastography (SE) were evaluated in diagnosis and staging of acute appendicitis in pediatric patients. Material/Methods: We enrolled 225 pediatric patients with suspected clinical and laboratory findings of acute appendicitis. Gray-scale sonographic findings were recorded and staging was made by the colorization method of SE imaging. Appendectomy was performed in all patients and the results of the surgical pathology were compared with the imaging findings. The sensitivity, specificity, and accuracy of SE imaging were determined in terms of evaluating the "acute appendicitis". Results: Sonographic evaluation revealed acute appendicitis in 100 patients. Regarding the SE analysis, cases with appendicitis were classified into 3 groups as: mild (n=17), moderate (n=39), and severe (n=44). The pathological evaluation revealed 95 different stages of appendicitis and normal appendix in 5 cases: acute focal (n=10), acute suppurative (n=46), phlegmonous (n=27), and perforated (n=12), regarding the results of surgical pathology. Five patients with pathologically proven "normal" appendix were noted as " mild stage appendicitis" based on gray scale and SE analysis. In total, when gray-scale and SE results were compared with pathology results regardless of the stage of appendicitis, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rates were 96%, 96%, 95%, 96.8%, and 96%, respectively. No statistically significant difference was detected between other groups (P<0.05). Conclusions: In acute appendicitis, the use of SE imaging as a supportive method for the clinical approach can be useful in diagnosis, and its results are closely correlated with the histopathologic stage of appendix inflammation.
The Efficiency of Acoustic Radiation Force Impulse (Arfi) Elastography in the Diagnosis and Staging of Carpal Tunnel Syndrome
(Springer Japan Kk, 2018) Arslan, Harun; Yavuz, Alpaslan; Ilgen, Ferda; Aycan, Abdurrahman; Ozgokce, Mesut; Akdeniz, Huseyin; Batur, Abdussamet
The aim of the present study was to quantify the stiffness of the median nerve (MN) at the carpal tunnel inlet by acoustic radiation force impulse (ARFI) elastography and to evaluate whether ARFI can be used in diagnosis and staging of carpal tunnel syndrome (CTS). Sonographic examinations of 96 wrists in 50 patients were included in the study. The cross-sectional area and stiffness of the MN were quantitatively measured by B-mode ultrasonography (USG) and ARFI. The findings of CTS were assigned to four groups: (I) normal (n = 21), (II) mild (n = 39), (III) moderate (n = 38), and (IV) severe (n = 19). The differences between CTS patients and controls and the differences in electrodiagnostic tests among subgroups were statistically compared. ROC analysis was performed to determine the cut-off values between subgroups. Bilateral CTS was present in 46 patients (92 wrists) and unilateral CTS in four patients. Of the 96 nerves in the 50 symptomatic "idiopathic CTS" patients (48 women, 2 men; mean age 45.9 years, range 23-73 years), 39 (40.4%) were mild, 38 (39.8%) were moderate, and 19 (19.8%) were severely affected. When compared to controls, MN stiffness was significantly higher in the CTS group (P < 0.001); furthermore, it was higher in the severe or extreme severity group than the mild or moderate severity group (P < 0.001). A 3.250 m/s cut-off value on ARFI revealed sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 81, 82, 95.1, 50, and 82%, respectively. The MN stiffness measured by ARFI elastography is significantly higher in patients with CTS then in controls. ARFI elastography appears to be a highly efficient imaging modality for the diagnosis and staging of these patients.
The Efficiency of Apparent Diffusion Coefficient Quantification in Diagnosis of Acute Cholecystitis and in Differentiation of Cholecystitis From Extrinsic Benign Gallbladder Wall Thickening
(Springer, 2014) Beyazal, Mehmet; Avcu, Serhat; Celiker, Fatma Beyazal; Yavuz, Alpaslan; Toktas, Osman
The aim of the current study was to assess the efficiency of the apparent diffusion coefficient (ADC) measurement in diagnosis of acute cholecystitis and in differentiation of cholecystitis from extrinsic benign gallbladder wall thickening. Forty patients who were diagnosed to have acute cholecystitis by ultrasonographic examination were included in this study. The control group consisted of 18 patients without symptoms of gallstones and cholecystitis whose gallbladder walls were thickened due to cirrhotic ascites. Both groups were examined using diffusion weighted imaging, and the mean ADC values were compared using Student's t-test. The diagnoses of the 40 patients were proven by histopathological examination. The mean ADC values of patients diagnosed with cholecystitis (1.68 +/- A 0.36 x 10(-3) mm(2)/s) were significantly lower than the mean ADC values of the control group (2.35 +/- A 0.24 x 10(-3) mm(2)/s) (p < 0.05). Receiver operating characteristics curve analysis based on ADC revealed a cut-off value of 2.04 x 10(-3) mm(2)/s for the diagnosis of cholecystitis, with a sensitivity of 94 % and a specificity of 89.7 %. ADC value quantification may be an efficient method for making a diagnosis of cholecystitis and in differential diagnosis of cholecystitis from the extrinsic benign gallbladder wall thickening that can be seen during the course of cirrhotic ascites.