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Öğe 256 kesitli çift tüplü bilgisayarlı tomografi cihazında prospektif EKG tetiklemeli ve retrospektif EKG kapılamalı teknikle çekilen koroner BT anjiografi ıncelemelerinde radyasyon dozu karşılaştırması(2016) Görmeli, Cemile Ayşe; Kahraman, Aysegul Sagir; Özdemir, Zeynep Maraş; Yağmur, Jülide; Özdemir, Ramazan; Açıkgöz, Nusret; Çolak, CemilGiriş: Koroner arter hastalığı, aterosklerotik plakların meydana getirdiği, önemli mortalite ve morbiditeye sahip sık görülen kardiyovasküler bir hastalıktır. Bilgisayarlı tomografi ile koroner anjiografi tetkiki giderek artan sıklıkta invaziv kateter anjiografi yerine kullanılmaya başlanmıştır. Biz de bu çalışmamız ile koroner arter hastalıklarının değerlendirilmesi için bilgisayarlı tomografi kullanılarak prospektif EKG tetiklemeli ve retrospektif EKG kapılamalıteknikle çekilen koroner anjiografi incelemelerinde efektif radyasyon dozlarını saptamayı amaçladık. Gereç ve Yöntemler: 256 kesitli çift tüplü bilgisayarlı tomografi cihazı ile koroner anjiografi çekilen 326 hasta değerlendirildi. Çalışmamızda, hastaların kalp hızına bağlı olarak 3 farklı çekim tekniği kullanarak teknikler arasındaki efektif radyasyon dozunu karşılaştırdık. Bulgular: Teknik I ile çekilen 195 hastanın kalp hızı ortalama 96,1 atım/dk, teknik II ile yapılan 103 incelemede kalp hızı ortalama 80,7 atım/dk, teknik III ile yapılan 28 görüntülemede ise kalp hızı ortalama 57,1 atım/dk olarak saptandı. Ayrıca, ortalama efektif radyasyon dozları; teknik I ile 1,15 mSv, teknik II ile 3,98 mSv ve teknik III ile 10 mSv olarak hesaplandı. Sonuç: Prospektif EKG tetiklemeli teknikle bilgisayarlı tomografi kullanılarak çekilen koroner anjiografi, retrospektif EKG kapılamalı teknikle karşılaştırıldığında düşük efektif radyasyon dozuna neden olmaktadır. Düşük radyasyon dozunda ve optimal görüntü kalitesinde incelemeler elde etmek için, çekim hastanın kalp hızına bağlı olarak en uygun teknik belirlenerek yapılmalıdır.Öğe The Assessment of Hepatosteatosis in Living-Donor Liver Transplant: Comparison of Liver Attenuation Index and Histopathologic Results(Baskent Univ, 2017) Kahraman, Aysegul Sagir; Karakas, Hakki Muammer; Kirimlioglu, Hale; Kahraman, Bayram; Yilmaz, Sezai; Kirimlioglu, VedatObjectives: The purpose of the study was to determine the diagnostic value of computed tomography densitometry in the quantification of hepatosteatosis. Materials and Methods: Fifty-one potential liver donors, ranging in age from 19 to 52 years (mean age: 32.4 years +/- 10.2), participated in the study. The mean hepatic attenuation and mean splenic attenuation were determined using regions of interest measurements. The difference between the mean hepatic attenuation and mean splenic attenuation (or liver attenuation index), with liver attenuation index = mean hepatic attenuation - mean splenic attenuation were calcu lated. Computed tomography densitometric para meters were correlated with histopathologic results. Results: From the histopathologic analysis, the degree of macrovesicular hepatosteatosis was 0% to 8% (mean: 1.1% +/- 2%). Seven donors (13.7%) had a degree of macrovesicular steatosis of > 5%, and 12 donors (23.5%) had >= 2%. Of the 29 normal donors with histopathologic verification, computed tomography densitometry predicted <= 5% of the hepa to steatosis in 27 donors, and >= 2% hepato-steatosis in 2 subjects. The liver attenuation index was sig nificantly correlated to the histopathologic results. The mathematical relation between liver attenuation index and the degree of histopathologic hepatosteatosis was calculated using the least-squares methods, which provided quadratic polynomials. Conclusions: Computed tomography densitometry is a rapid, robust, noninvasive technique for the assessment of hepatosteatosis. When used in conjunction with clinically stable reference measurements of spleen, the density measurements of liver correctly predicted the presence of fatty infiltration with significant sensitivity (77%) and specificity (75%). This technique, which was refined during the course of our liver transplant program, minimizes the need for highly invasive percutaneous liver biopsies.Öğe Cerebrospinal Fluid Dynamics in Patients with Multiple Sclerosis: The Role of Phase-Contrast MRI in the Differential Diagnosis of Active and Chronic Disease(Korean Radiological Soc, 2018) Oner, Serkan; Kahraman, Aysegul Sagir; Ozcan, Cemal; Ozdemir, Zeynep Maras; Unlu, Serkan; Kamisli, Ozden; Oner, ZulalObjective: Multiple sclerosis (MS) is an inflammatory disease characterized by demyelinating plaques in the white matter. Chronic cerebrospinal venous insufficiency (CCSVI) has been proposed as a new hypothesis for the etiopathogenesis of MS disease. MS-CCSVI includes a significant decrease of cerebrospinal fluid (CSF) flow through the cerebral aqueduct secondary to an impaired venous outflow from the central nervous system. This study aimed to determine whether CSF flow dynamics are affected in MS patients and the contributions to differential diagnosis in active and chronic disease using phase-contrast magnetic resonance imaging (PC-MRI). Materials and Methods: We studied 16 MS patients with chronic plaques (group 1), 16 MS patients with active plaques-enhanced on MRI (group 2), and 16 healthy controls (group 3). Quantitatively evaluation of the CSF flow was performed from the level of the cerebral aqueduct by PC-MRI. According to heart rates, 14-30 images were obtained in a cardiac cycle. Cardiac triggering was performed prospectively using finger plethysmography. Results: No statistically significant difference was found between the groups regarding average velocity, net forward volume and the average flow (p > 0.05). Compared with the controls, group 1 and group 2, showed a higher peak velocity (5.5 +/- 1.4, 4.9 +/- 1.0, and 4.3 +/- 1.3 cm/sec, respectively; p = 0.040), aqueductal area (5.0 +/- 1.3, 4.1 +/- 1.5, and 3.1 +/- 1.2 mm(2), respectively; p = 0.002), forward volume (0.039 +/- 0.016, 0.031 +/- 0.013, and 0.021 +/- 0.010 mL, respectively; p = 0.002) and reverse volume (0.027 +/- 0.016, 0.018 +/- 0.009, and 0.012 +/- 0.006 mL, respectively; p = 0.000). There were no statistical significance between the MS patients with chronic plaques and active plaques except for reverse volume. The MS patients with chronic plaques showed a significantly higher reverse volume (p = 0.000). Conclusion: This study indicated that CSF flow is affected in MS patients, contrary to the hypothesis that CCSVI-induced CSF flow decreases in MS patients. These findings may be explained by atrophy-dependent ventricular dilatation, which may occur at every stage of MS.Öğe Comparison of liver resection and living donor liver transplantation in patients with hepatocellular carcinoma within Milan criteria and well-preserved liver function(Kare Publ, 2023) Karakas, Serdar; Yilmaz, Sezai; Ince, Volkan; Akbulut, Sami; Dalda, Yasin; Akatli, Ayse Nur; Kahraman, Aysegul SagirBackground and Aim: Liver resection (LR) and liver transplantation (LT) are curative treatments for hepatocellular carcinoma (HCC). The main pur-pose of this study was to compare the survival of LR and LDLT in patients with HCC within the Milan criteria. Materials and Methods: The results of the LR (n=67) and LDLT (n=391) groups were compared for overall survival (OS) and disease-free survival (DFS). Twenty-six of the HCCs in the LRs met the Milan and Child A cri-teria. Also, 200 of the HCC patients in the LDLTs met the Milan criteria, of which 70 also met the Child A criteria. Results: Early mortality was higher in the LDLT group (13.9% vs 1.47%; p=0.003). The 5-year OS was higher in the LDLTs than the LRs, but not statistically significant (84.6% vs 74.2%; p=0.287). However, 5-year DFS was better in the LDLT group (96.8% vs 64.3%; p<0.001). When the LRs (n=26) and the LDLTs (n=70) that met both Milan and Child A criteria were compared, 5-year OS was similar (81.4% vs 74.2%; p=0.512), but DFS was better in the LDLTs (98.6% vs 64.3%; p<0.001). Conclusion: LR can be justified as the first-line treatment for HCC patients who meet Milan and Child A criteria in terms of and OS.Öğe Comparison of myocardial bridging prevalence using 64-slice versus 256-slice computed tomography scanners: What has changed with recent innovations in CT?(Scientific Publishers India, 2016) Gormeli, Cemile Ayse; Yagmur, Julide; Ozdemir, Ramazan; Ozdemir, Zeynep Maras; Kahraman, Aysegul Sagir; Colak, CemilObjective: To compare the incidence and appearance of myocardial bridging (MB) by computed tomography (CT) angiography using 64-slice versus 256-slice CT. Methods: In total, 775 consecutive patients who underwent coronary CT angiography were evaluated using a 64-slice or a 128x2-slice dual-source scanner. Results: The prevalence of MB was 13.9% using 64-slice-CT and 31.5% using 256-slice-CT. The superficial type of MB segments was detected three times more frequently by 256-slice-CT. Conclusions: A higher prevalence of MB and the superficial type of bridging were revealed with the 256-slice-CT scanner. Advances in CT technology may enable detection and potentially prevent the unwanted effects of MB.Öğe Congenital Agenesis of Right Internal Carotid Artery: A Report of Two Cases(Ubiquity Press Ltd, 2016) Kahraman, Aysegul Sagir; Kahraman, Bayram; Ozdemir, Zeynep Maras; Dogan, Metin; Kaya, Mehmet; Gormeli, Cemile Ayse; Durak, Mehmet AkifCongenital unilateral agenesis of the internal carotid artery (ICA) is a rare anomaly. Due to proper sufficient collateral circulation via the circle of Willis most cases are asymptomatic, but patients can also present with ischemic or hemorrhagic cerebrovascular insults. The absence of the bony carotid canal is essential to differentiate this anomaly from chronic ICA occlusion. Awareness of this situation by clinicians and radiologists is essential because these patients have an increased incidence of various intracranial pathologies. We report two cases of this rare developmental congenital abnormality occurring in two young patients and describe the presentation, diagnosis, determined developmental causes, imaging findings, and complications.Öğe Diffusion-weighted imaging (DWI) of the liver in assessing chronic liver disease: effects of the presence and the degree of ascites on ADC values(Springer, 2016) Kahraman, Aysegul Sagir; Kahraman, Bayram; Ozdemir, Zeynep Maras; Gormeli, Cemile Ayse; Ozdemir, Fatih; Dogan, MetinPurpose: The aim of this study was to determine the correlation between the liver and spleen apparent diffusion coefficient (ADC) values of patients with chronic liver disease and the presence and the degree of ascites. Materials and method: In this retrospective study, we assessed 107 patients with chronic liver disease and 39 control subjects who underwent upper abdominal MR imaging including echo-planar diffusion-weighted imaging (DWI). Among the 107 cirrhotic patients, 56 were classified as group 1, 25 as group 2, and 26 as group 3 according to the absence, the presence of minimal, and the presence of massive ascites, respectively. The scores of model for end-stage liver disease (MELD) were matched between groups as the standard reference. The liver ADC, spleen ADC, and normalized liver ADC values were compared between the control group and patients' groups. Results: Patients with massive ascites had significantly higher MELD score compared with the other groups. The MELD score was also significantly higher in patient groups than in control group. The liver and normalized liver ADCs of patients' groups were significantly lower than that of the control group. With some overlap among groups, the measured ADC values decreased as the amount of the ascites increased, and these relationships were statistically significant. Furthermore, compared to control group, patients with massive ascites had significantly higher spleen ADCs. Conclusion: Our results indicate that the ADC value of the liver and spleen correlates with the presence and the degree of ascites in patients with chronic liver disease, and merits further study.Öğe Editorial for MRI-based Radiomics: Potential Abilities for Individual Preoperative Predictions of the Recurrence-Free Survival of Patients With Hepatocellular Carcinoma Treated With Conventional Transcatheter Arterial Chemoembolization(Wiley, 2020) Kahraman, Aysegul Sagir[Abstract Not Available]Öğe Editorial for Novel Associations Between Genome-Wide Single Nucleotide Polymorphisms and MR Enterograpy Features in Crohn's Disease Patients(Wiley, 2021) Kahraman, Aysegul Sagir[Abstract Not Available]Öğe THE EFFECT OF CHRONIC CARBON MONOXIDE EXPOSURE ON BRAIN IN BARBECUE WORKERS(Parlar Scientific Publications (P S P), 2014) Turtay, Muhammet Gokhan; Yumrutepe, Sevgi; Kahraman, Aysegul Sagir; Bentli, Recep; Oguzturk, Hakan; Firat, Cemal; Colak, CemilThe aim of our study is to investigate whether chronic carbon monoxide (CO) exposure has effects on the brains of the people who work as barbecue workers (BWs) for a long time. Twenty males who had been working in the indoor environments of various restaurants (Group I) and 20 healthy males who were matched by age with the other group (Group 2) were included in the study. Laboratory tests were performed in both groups of people. Magnetic Resonance Spectroscopy (MRS) was applied to the people whose blood samples were taken. In Group I, significant correlations were not detected between carboxyhemoglobin (COHb) values and the variables of age, working hours, hemoglobin (Hb), white blood cell (WBC), hematocrit (HCT), platelet (PLT), mean platelet volume (MPV), pH, oxygen saturation (Sat O2) (p>0.05). In terms of Hb, WBC, HCT, PLT, MPV, pH, Sat O2, COHb, N-acetylaspartate/creatine in basal ganglion, choline/creatine in basal ganglion, N-acetylaspartate/creatine in frontal lobe periventricular white matter, choline/creatine in frontal lobe periventricular white matter variables, significant differences between Group I and Group 2 were not determined. (p>0.05). As a result of this study; it is detected that chronic exposure to CO in BWs does not have any effects on brain with respect to MRS imaging method.Öğe The effect of the intercondylar notch width index on anterior cruciate ligament injuries : A study on groups with unilateral and bilateral ACL injury(Acta Medica Belgica, 2015) Gormeli, Cemile Ayse; Gormeli, Gokay; Ozturk, Burak Yagmur; Ozdemir, Zeynep; Kahraman, Aysegul Sagir; Yildirim, Okan; Gozukara, HarikaBackground : To evaluate the relationship of the intercondylar notch width with unilateral and bilateral ACL injury by using MR images. Materials and Methods : The intercondylar notch width index was measured on the MR images of 18 patients with a bilateral ACL injury, 38 patients with a unilateral ACL injury and 53 healthy subjects with a normal ACL and the results of all groups were compared with each other. Results : The mean NWI values were 0,227 (+/- 0.008) in bilateral injured; 0,245 (+/- 0.009) in unilateral injured and 0,272 (+/- 0.01) in control groups and 0,251(+/- 0.01) in unaffected side of the unilateral group. There were statistically significant differences in intercondylar notch width index (NWI) values between all groups and there was a significant difference between the affected and the unaffected sides in group with unilateral ACL injury. A cutoff value of 0.25 for NWI gave an odds ratio of 26.5 for bilateral and 3.23 for unilateral ACL injuries. Conclusions : The finding that NWI is significantly narrowed in patients with bilateral and unilateral ACL tears compared with the healthy controls suggest a relationship between a narrow NWI and an increased risk of ACL injury. The patients with a narrow NWI should also be screened contralaterally for assessment of ACL injury risk on the other knee. So, specialized training programmes for the people with narrow NWI can be prepared for preventing ACL injuries.Öğe The evaluation of non-ischemic dilated cardiomyopathy with T1 mapping and ECV methods using 3T cardiac MRI(Springer-Verlag Italia Srl, 2017) Gormeli, Cemile Ayse; Ozdemir, Zeynep Maras; Kahraman, Aysegul Sagir; Yagmur, Julide; Ozdemir, Ramazan; Colak, CemilThe aim of this study was to examine the correlation between ventricular function and the extracellular volume fraction (ECV) in patients with non-ischemic dilated cardiomyopathy (NIDCM) using 3.0 T magnetic resonance imaging (MRI). We also hypothesized that native T1 and ECV values would be increased in patients with NIDCM, independent of the left ventricular ejection fraction (LVEF). The findings of our study could lead to further studies of the follow-up protocols. In total, 53 consecutive dilated cardiomyopathy patients who had undergone cardiac MRI were functionally evaluated and underwent tissue characterization. The mean native T1 value was 1235 +/- 10 ms, and the mean ECV value was 35.4 +/- 2.7% in the myocardia. The LVEF values ranged from 29 to 44%. No significant correlations were observed between functional analysis measurements and native T1 or ECV values. Our results showed that myocardial fibrosis is unrelated to cardiac functional findings in NIDCM patients. Therefore, we propose that these patients should be evaluated using MRI and tissue characterization techniques, in addition to cardiac functional analysis.Öğe Image-Guided Percutaneous Bone Biopsy with a Simulated Van Sonnenberg Removable Hub System(Aves, 2015) Ozdemir, Zeynep Maras; Kahraman, Aysegul Sagir; Baysal, Tamer; Kutlu, Ramazan; Ozturk, Mehmet Halil; Hekimoglu, Baki; Guvercinci, MeltemObjective: To retrospectively examine the success and complication rates associated with image-guided percutaneous bone biopsy with a simulated Van Sonnenberg removable hub system. Materials and Methods: During a 3.5-year period, 27 bone lesions at different anatomic locations with an indication for biopsy based on plain film, computed tomography (CT) and/or magnetic resonance imaging (MRI) findings were determined, and a total of 28 image-guided (fluoroscopy or CT) percutaneous biopsies were performed using a simulated Van Sonnenberg -removable hub system. This technique entailed the use of a cut-out Chiba needle hub that performed as a guide for the insertion of a larger needle. Either core and aspiration biopsy or core biopsy alone was utilized. Results: The procedure yielded diagnostic material 89% of the cases (48% infection, 22% benign lesions, and 19% malignant lesions). Combined use of core and aspiration biopsy resulted in a higher diagnostic accuracy as compared to core biopsy alone. No false positive or false negative diagnoses were observed. No serious complications such as neurological deficits, bleeding, or organ injury were observed. Conclusion: The simulated Van Sonnenberg removable hub system provides a useful technique for percutaneous bone biopsies and is particulary suitable for deep seated (such as vertebral) lesions with its ability to facilitate the accessibility of the lesion with its built-in guidance needle. The procedure is safe in light of the literature data.Öğe Incidental Hepatocellular Carcinoma after Liver Transplantation: Clinicopathologic Features and Prognosis(Mdpi, 2023) Ozdemir, Fatih; Ince, Volkan; Usta, Sertac; Carr, Brian I. I.; Bag, Harika G. G.; Akatli, Ayse Nur; Kahraman, Aysegul SagirBackground: The prognostic impact and clinicopathologic features of incidental hepatocellular carcinoma (iHCC) detected in explanted livers of patients undergoing liver transplantation (LT) has been a controversial issue in previous studies when compared with patients who are diagnosed with hepatocellular carcinoma (pdHCC) before LT. We aimed to review and compare these patient groups in a high-volume LT center. Methods: The present study involves a retrospective analysis of 406 HCC patients who received LT between January 2002 and April 2022. Among these patients, demographic data, histopathologic features and prognosis for iHCC and pdHCC were evaluated. Results: In our series, 406 patients' final diagnosis was HCC after they had received LT, nevertheless 54 patients in this HCC group were diagnosed incidentally after the pathological evaluation of the explanted livers. The etiology of the underlying liver disease between pdHCC (n = 352) and iHCC (n = 54) groups had some differences in our study population. Most of the patients in the pdHCC group had moderately differentiated tumors (45.7%). On the other hand, most of the patients in the iHCC group had well differentiated tumors (79.6%). There were 158 (44%) patients who met the Milan criteria in the pdHCC group while there were 48 (92%) patients in the iHCC group (p < 0.001). IHCC patients had statistically better 1, 3, 5 and 10 years disease-free and overall survival rates when compared with pdHCC patients. There was only 1 (1.8%) patient who had tumor recurrence in the iHCC group while 76 (21%) patients had tumor recurrence in the pdHCC group (p = 0.001). There is no disease free and overall survival difference when iHCC patients are compared with pdHCC patients who met the Milan criteria. Conclusion: It is the first study to show that iHCC patients may differ from pdHCC patients in terms of etiological features. IHCC tumors show better histopathologic features than pdHCC with low recurrence rate and iHCC patients have better survival rates than pdHCC patients.Öğe Ischiofemoral Space on MRI in an Asymptomatic Population: Normative Width Measurements and Soft Tissue Signal Variations(Springer, 2015) Ozdemir, Zeynep Maras; Aydingoz, Ustun; Gormeli, Cemile Ayse; Kahraman, Aysegul SagirTo make normative width measurements of the ischiofemoral (IF) space in an asymptomatic population and to record soft tissue MRI signal variations within the IF space in order to determine whether such variations are associated with IF space dimensions. Normative width measurements of the IF space were prospectively made in 418 hips on 1.5 T MR images of 209 asymptomatic volunteers. Quantitative and qualitative assessments of the IF soft tissues including the quadratus femoris (QF) muscle were also made. The mean IF space width was 2.56 +/- 0.75 cm (right, 2.60 +/- 0.75 cm; left, 2.53 +/- 0.75 cm). Soft tissue MRI signal abnormalities were present within the IF space in 19 (9.1 %) of 209 volunteers. Soft tissue abnormalities within the IF space included oedema (3/209, 1.4 %) of the QF and/or surrounding soft tissue, and only fatty infiltration (16/209, 7.7 %) of the QF. Bilateral IF spaces are asymmetrical in asymptomatic persons. There is a parts per thousand yen10 % of width difference between right and left IF spaces in approximately half of asymptomatic individuals. Fatty infiltration and oedema can be present at the IF space in a small portion of the asymptomatic population, who also have narrower IF spaces than those without soft tissue MRI signal abnormalities. aEuro cent Bilateral IF spaces are commonly asymmetrical in asymptomatic individuals. aEuro cent MRI signal abnormalities can be observed within IF space in asymptomatic people. aEuro cent Abnormal quantitative/qualitative MRI findings are not necessarily related to IF impingement.Öğe Langerhans Cell Histiocytosis with Atypical Intervertebral Disc and Sacroiliac Joint Involvement Mimicking Osteoarticular Tuberculosis in an Adult(Aves, buyukdere cad 105-9, mecıdıyekoy, sıslı, ıstanbul 34394, turkey, 2016) Ozdemir, Zeynep Maras; Kahraman, Aysegul Sagir; Gormeli, Cemile Ayse; Sevimli, Resit; Akpolat, NusretBackground: Langerhans cell histiocytosis (LCH), typically found in children, is a rare single or multisystem disorder with a wide range of clinical and radiological manifestations. Unusual presentations of LCH are occasionally encountered and it may be difficult to distinguish LCH from an infection or a benign or malignant tumor. Results: A 35-year-old female presented with pain in her back and left buttock, malaise, and weight loss, with a duration of several months. Her laboratory test results were within the normal ranges except for the levels of acute phase reactants, which were elevated. Magnetic resonance imaging and computed tomography revealed a unilateral destructive sacroiliac lesion, and multiple vertebral lesions with adjacent discal involvement and extensive soft tissue extensions. She was initially misdiagnosed with multifocal osteoarticular tuberculosis. An open biopsy and joint curettage was performed. Histopathological examination showed that she had LCH. Conclusion: To the best of our knowledge, this is the first case of LCH associated with a destructive unilateral sacroiliac lesion, discal involvement, and involvement of the adjacent vertebrae, in an adult patient; the LCH mimicked osteoarticular tuberculosis. Disease onset in adulthood is rare, and this can potentially delay diagnosis. Familiarity with the imaging features of unusual LCH manifestations is necessary to ensure accurate diagnosis and appropriate treatment.Öğe Liver Transplantation for Hepatocellular Carcinoma at Inonu University(Springer, 2017) Kayaalp, Cuneyt; Ince, Volkan; Ersan, Veysel; Karakas, Serdar; Kahraman, Aysegul Sagir; Yilmaz, SezaiThere is a great effort in the world to find a new drug in hepatocellular carcinoma (HCC) treatment. Turkey has a limited number of basic science studies to discover a new therapeutic drug for HCC. It seems that Turkey is distanced from the global drug discovery race and competition, however, Turkey has the advantage of a wide experience in living donor liver transplantation, like South Korea and Japan. Turkey can plan new studies on HCC, particularly with living donor liver transplantation. Neoadjuvant treatment methods before living donor liver transplantation for advanced tumors would be a good idea for study in Turkey. Because Inonu University has the busiest liver transplantation program in Turkey, the contribution of Inonu University to trials like this can improve the depth of the studies. To conclude, the Inonu University Liver Transplantation Institute has the busiest program in Turkey with 1,600 transplantations in eight years. The program is based on living donor liver transplantations (80%). Living donor liver transplantation for advanced HCC patients is our favorite topic to study.Öğe A Novel Physical Examination Test for Ischiofemoral Impingement: Validation With Magnetic Resonance Imaging Correlation(Lippincott Williams & Wilkins, 2021) Ozdemir, Zeynep Maras; Yildirim, Tulay; Karaca, Leyla; Kahraman, Aysegul Sagir; Aydingoz, UstunObjective The purpose of this study was to propose and validate a novel physical examination test for ischiofemoral impingement with magnetic resonance imaging (MRI) correlation. Methods We prospectively studied 24 women with buttock (deep gluteal) pain and 27 asymptomatic women. Each group underwent a 2-stage physical examination test that featured hip adduction-external rotation-extension and knee flexion. Visual analog scale pain scores were noted just before and during test stages on both sides. The MRI findings of the ischiofemoral impingement were evaluated quantitatively and qualitatively. Results Mean ages were 56.0 and 55.2 years (P = 0.797), and mean body mass indexes were 29.1 and 28.8 kg/m(2) (P = 0.817) in symptomatic and asymptomatic groups, respectively. Ischiofemoral spaces were significantly narrower (P < 0.001), ischial angles were wider (P < 0.001, right; P = 0.002, left), and soft tissue edema at the ischiofemoral space was more common (P < 0.001) in the symptomatic group, which also had higher pretest visual analog scale scores (P < 0.001) that increased significantly during both upright standing (P = 0.003, right; P < 0.001, left) and recumbent (P < 0.001 for both sides) stages of the physical examination test. Conclusions A novel physical examination test significantly increases symptoms of ischiofemoral impingement with positive MRI correlation.Öğe Preoperative evaluation of liver volume in living donor liver transplantation(Kare Publ, 2018) Baskiran, Adil; Kahraman, Aysegul Sagir; Cicek, Ipek Balikci; Sahin, Tolga; Isik, Burak; Yilmaz, SezaiOBJECTIVE: The aim of the present study was to retrospectively evaluate the difference between the preoperative estimated volume and the actual intraoperative graft volume determined in donor right hepatectomies and to evaluate the possible effect of age, gender, and body mass index on the difference. METHODS: A total of 225 donor hepatectomies performed at the center between 2016 and 2017 were evaluated for the study. Left hepatectomies and left lateral segmentectomies were excluded from the analysis. As a result, 174 donor right hepatectomies were included in the study. Volumetric analysis was performed with dynamic hepatic computed tomography (CT), including non-contrast analysis, followed by non-ionic, contrast-enhanced arterial, portal, and hepatic-phase, thin-slice scanning. Volumetric analysis was performed based on the CT images using automatic volume calculating software. RESULTS: The mean preoperatively estimated graft volume was 800 +/- 112 g and the mean intraoperatively measured actual graft volume was 750 +/- 131 g. There was a statistically significant difference (p=0.003). Age and body mass index had a significant impact on the discrepancy between the predicted and actual graft volume, while gender did not. CONCLUSION: A thorough preoperative evaluation of the donor graft volume should be performed in order to prevent donor morbidity and mortality, as well as small-for-size and large-for-size phenomena in the implanted grafts. Physicians working in the field of transplantation should be aware of the fact that a difference of 10% between the predicted and the actual graft volume is usually encountered.Öğe Quantitative Evaluation of Normal Aqueductal Cerebrospinal Fluid Flow Using Phase-Contrast Cine MRI According to Age and Sex(Wiley, 2017) Oner, Zulal; Kahraman, Aysegul Sagir; Kose, Evren; Oner, Serkan; Kavakli, Ahmet; Cay, Mahmut; Ozbag, DavutThe aim of this study was cerebrospinal fluid (CSF) flow quantification in the cerebral aqueduct using phase-contrast cine magnetic resonance imaging (PCC-MRI) according to both sexes and three different age groups to obtain normative data. Seventy two volunteers with no cerebral pathology were included in this study. Subjects were divided into three age groups: 20-34 years, 35-49 years, and 50-65 years including equal gender groups. CSF flow's quantitatively evaluation was performed with images that were obtained by 1.5 T Magnetic Resonance (MR) unit from cerebral aqueduct level on the semi-axial plan. Between groups, peak velocity (cm sec21), average velocity (cm/s), forward volume (mL), reverse volume (mL), net forward volume (mL), and average flow over range (ml/ min)values of current flowing through aqueduct and average aqueductal areas were compared. There were no statistically significant differences in CSF flow parameters among different age groups and between sexes (P> 0.05). There was a statistically significant difference in average cerebral aqueduct area between the age group of 50-65 years and the other age groups (P50.002). The average aqueductal area was higher in the age group of 50-65 years. Normal aqueductal CSF flow parameters evaluated with PCC-MRI don't show a significant difference by age and sex. We have achieved the lower and upper values of these parameters would be useful in future clinical studies. The size of aqueductal area may also be explained by atrophy-dependent ventricular system dilatation in the elderly. (C) 2016 Wiley Periodicals, Inc.
