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Öğe Effective radiation exposure evaluation during a one year follow-up of urolithiasis patients after extracorporeal shock wave lithotripsy(POLISH UROLOGICAL ASSOC, 2015) Kaynar, Mehmet; Tekinarslan, Erdem; Keskin, Suat; Buldu, Ibrahim; Soenmez, Mehmet Giray; Karatag, Tuna; Istanbulluoglu, Mustafa OkanIntroduction To determine and evaluate the effective radiation exposure during a one year follow-up of urolithiasis patients following the SWL (extracorporeal shock wave lithotripsy) treatment. Material and methods Total Effective Radiation Exposure (ERE) doses for each of the 129 patients: 44 kidney stone patients, 41 ureter stone patients, and 44 multiple stone location patients were calculated by adding up the radiation doses of each ionizing radiation session including images (IVU, KUB, CT) throughout a one year follow-up period following the SWL. Results Total mean ERE values for the kidney stone group was calculated as 15, 91 mSv (5.10-27.60), for the ureter group as 13.32 mSv (5.10-24.70), and in the multiple stone location group as 27.02 mSv (9.41-54.85). There was no statistically significant differences between the kidney and ureter groups in terms of the ERE dose values (p = 0.221) (p >0.05). In the comparison of the kidney and ureter stone groups with the multiple stone location group; however, there was a statistically significant difference (p = 0.000) (p <0.05). Conclusions ERE doses should be a factor to be considered right at the initiation of any diagnostic and/or therapeutic procedure. Especially in the case of multiple stone locations, due to the high exposure to ionized radiation, different imaging modalities with low dose and/or totally without a dose should be employed in the diagnosis, treatment, and follow-up bearing the aim to optimize diagnosis while minimizing the radiation dose as much as possible.Öğe Nörofibromatozis tip 1: Kraniyal MRG Bulguları(2014) Keleşoğlu, Kazım Serhan; Keskin, Suat; Sivri, Mesut; Erdoğan, Hasan; Nayman, Alaaddin; Koplay, MustafaAmaç: Nörofibromatozis tip 1 (NF1, von Recklinghausen hastalığı, periferal nörofibromatozis) öncelikle nöral dokular olmak üzere birçok sistemi tutan nörokutanöz bir hastalıktır. Çocuklarda kanser yatkınlığını artırması sebebiyle bilinmesi ve tanı konması önem kazanan bir sendromdur. Amacımız kliniğimizde incelenen nörofibromatozis tip 1 hastalarının kraniyal MRG bulgularını tartışmak ve mevcut bulgular eşliğinde nörofibromatozis tip 1'in kraniyal tutulum şekillerini değerlendirmektir. Gereç ve yöntemler: Haziran 2011 ve Mart 2013 tarihleri arasında kliniğimizde Nörofibromatozis tip 1 tanısı olan ve en az 1 MRG incelemesi bulunan 21 hastanın 19'u değerlendirilmiştir. 6-32 yaş aralığında (ortalama yaş 15,3), 7 kız ve 12 erkek hastadan elde edilen kraniyal MRG incelemeleri retrospektif olarak taranmıştır. Çalışmaya dahil edilen olgulardaki lezyonların tipi ve lokalizasyonları farklı bir radyolog tarafından yeniden değerlendirilmiştir. Bulgular: Nörofibromatozis tip 1 tanısıyla takip edilen ve kraniyal MR görüntülemeleri değerlendirilen 19 hastanın 16'sında santral sinir sisteminde hamartomatöz lezyonlar, 5 hastada optik gliom ya da optik sinir kalınlaşması, 5 hastada pleksiform nörofibromlar ve 2 hastada nörofibrom odakları izlenmiştir. Sonuç: Birçok farklı tümör ve bulgu içermesi ve en sık kalıtılan santral sinir sistemi hastalığı olması Nörofibromatozis tip 1'in tanı kriterlerinin ve lezyonlarının bilinmesini ve akılda tutulmasını gerektirmektedir. Klinik bulguları Nörofibromatozis tip 1 kriterlerini karşılamayan, tanı kriterlerindeki lezyonlar gelişmeyen veya tanı konurken şüphede kalınan hastaların tanısı ve hastalığın tümöral oluşumların gelişmesine olan yatkınlığı sebebiyle Nörofibromatozis tip 1 hastalarında MR görüntüleme bulguları erken ve doğru tanı açısından önemlidirÖğe A novel modified PAIR technique using a trocar catheter for percutaneous treatment of liver hydatid cysts: a six-year experience(AVES, 2016) Nayman, Alaaddin; Guler, Ibrahim; Keskin, Suat; Erdem, Tuba Berra; Borazan, Hale; Kucukapan, Ahmet; Ozbiner, HuseyinPURPOSE We aimed to demonstrate the success and reliability of a novel puncture, aspiration, injection, and reaspiration (PAIR) technique in liver hydatid cysts. METHODS Percutaneous treatment with ultrasonographic guidance was performed in 493 hepatic hydatid cysts in 374 patients. Patients were treated with a new PAIR technique by single puncture method using a 6F trocar catheter. The results of this novel technique were evaluated with regards to efficacy and safety of the procedure and complication rates. RESULTS Out of 493 cysts, 317 were Gharbi type I (WHO CE 1) and 176 were Gharbi type II (WHO CE 3A). Of all cysts, 13 were referred to surgery because of cystobiliary fistulization. Recurrence was observed in 11 cysts one month later. Therefore, the success rate of the PAIR technique was 97.7% (469/480). Minor complications (fever, urticaria-like reactions, biliary fistula) were seen in 44 treated patients (12%, 44/374); the only major complication was reversible anaphylactic shock which was observed in two patients (0.5%, 2/374). CONCLUSION This novel modified PAIR technique may be superior to catheterization by Seldinger technique due to its efficiency, easier application, lower severe complication rate, and lower cost. Further comparative studies are required to confirm our observations.Öğe Prognostic value of preoperative neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios, and multiphasic renal tomography findings in histological subtypes of renal cell carcinoma(BMC, 2014) Keskin, Suat; Keskin, Zeynep; Taskapu, Hakan Hakki; Kalkan, Havva; Kaynar, Mehmet; Poyraz, Necdet; Toy, HaticeBackground: To determine the relationship between renal cell carcinoma subtypes and the associated mortality and biochemical parameters. An additional aim was to analyze multiphasic multidetector computed tomography findings. Methods: This study is a hospital-based retrospective investigation, using 211 patients with a diagnosis of renal cell carcinoma upon computed tomography examination. The histological subtypes included clear cell in 119 patients, chromophobe cell in 30 patients, papillary cell in 25 patients, mixed cell in 32 patients, and sarcomatoid cell in 4 patients. Results: The mean age of the patients participating in this study was 61.18 +/- 11.81 years, and the mortality rate was 10.4% (n = 22) through the 2-year follow-up. The ratios of both the neutrophil-to-lymphocyte upon admission to the hospital and platelet-to-lymphocyte of the non-surviving group were significantly higher than those of the surviving group (p < 0.05). When the analysis of the 2-year survival of the patients was examined according to the median platelet-to-lymphocyte ratio values, the Kaplan-Meier survival curves were significantly different between the surviving and non-surviving groups (p = 0.01). In two-way analysis of variance test, statistically significant results which were influenced by mortality (p = 0.028) and were found between renal cell carcinoma subtypes in the computed tomography density of corticomedullary phase (p = 0.001). Conclusions: The neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio may represent widely available biomarkers in renal cell carcinoma, and the logistic regression model indicated that neutrophil-to-lymphocyte ratio was a significant predictor for mortality. According to the median platelet-to-lymphocyte ratio values, the Kaplan-Meier survival curves were significantly different between the surviving and non-surviving groups.
