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    Association of Urinary Tract Infection and Ultrasonographic Finding of Bladder Debris in Pediatric Patient
    (Aves Yayincilik, Ibrahim Kara, 2019) Ulubaba, Hilal Er; Dogan, Gulec Mert; Saglik, Semih
    Objective: Early diagnosis and treatment of urinary tract infections (UTI) in children has clinical importance since the signs and symptoms can be nonspecific. The aim of this study was to investigate the association between bladder debris which is commonly seen at the process of ultrasonography (USG) and positive urine culture in pediatric patients that will alert the clinicians in the diagnosis of UTI when the signs and symptoms are nonspecific. Material and Methods: A retrospective analysis of pediatric patients who underwent USG examination between February 2017 and February 2018 was conducted. USG reports were analyzed from the aspects of layering and floating debris. Patients who were formerly diagnosed and treated for urinary tract infection (UTI) and patients who had genitourinary system abnormalities (Hydronephrosis, Vesicoureteral Reflux, neurogenic bladder etc.) was excluded from the study. In the 0-11 age group, we detected 93 patients suffering from debris, who also had urine culture. These patients were compared with 50 patients in the control group in the same age group, who had normal USG and urine culture. Results: Ninety-three patients with bladder debris were classified under two groups as layering and floating debris. In Group 1, there were 21 patients with layering debris and there were 72 patients with floating debris in Group 2. Control patients group consisting of 50 patients was referred to as Group 3. According to multiple logistic regression analysis, a statistically significant increase was detected at the rate of positive urine culture in patients with layering debris (Group 1) and patients with floating debris (Group 2) compared to control patients (Group 3). However, increase at the rate of positive urine culture (UC) was higher in patients with layering debris. Conclusion: Statistically significant increase at the rate of positive urine culture (UC) was seen in the pediatric patients who had bladder debris at ultrasonography. The increase in patients with layering debris is higher. In the pediatric patients group, bladder debris should be an alerting finding for the diagnosis of urinary tract infection (UTI).
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    Can diffusion weighted magnetic resonance imaging (DW-MRI) be an alternative to 18f-FDG PET/CT (18f fluorodeoxyglucose positron emission tomography) in nasopharyngeal cancers?
    (Scientific Publishers India, 2017) Yildirim, Ismail Okan; Ekici, Kemal; Dogan, Metin; Temelli, Oztun; Kekilli, Ersoy; Saglik, Semih; Erbay, Fatih
    Objective: This study aimed to evaluate correlations, if any, between the ADC (Apparent Diffusion Coefficient) measurements in MRI (Magnetic Resonance Imaging) and SUV max (Standardized Uptake Value) in F-18-FDG PET/CT in patients with nasopharyngeal cancers and to investigate whether DW-MRI (Diffusion Weighted MRI) can be an alternative to F-18-FDG PET/CT in the evaluation of the response to treatment and prognosis in those patients. Methods: This study was performed between January 2015 and February 2016 at Inonu University Medical Faculty, Department of Radiology on 22 patients who were diagnosed with nasopharyngeal cancer by histopathological evaluation at Department of Pathology of the same faculty. Diffusion weighted images were obtained using 1.5 T MRI in all patients. F-18-FDG PET/CT images were obtained approximately 1-2 weeks after the diffusion-weighted images. Results: Two groups were created according to the histological subtypes as keratinized (n: 8) and non-keratinized (n: 14) among the 22 cases with a definitive histopathological diagnosis of nasopharyngeal cancer. No statistical difference was found between the groups in terms of SUVmax, SUVmean and ADC mean values (p> 0.05). ADC mean values measured in patients with nasopharyngeal cancer were statistically significantly and negatively correlated with SUV max (r=-0.619, p< 0.001) and SUV mean values (r=-0.677, p< 0.001). Conclusion: Even though there are anatomic and patient-related limitations of the DW-MRI in nasopharyngeal cancers, we suggest that it may be a complementary and alternative method of F-18-FDG PET/CT in the evaluation of treatment response and prognosis detection in nasopharyngeal cancers.
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    Conventional and ZOOMit DWI for Evaluation of Testis in Patients With Ipsilateral Varicocele
    (Amer Roentgen Ray Soc, 2017) Yildirim, Ismail Okan; Saglik, Semih; Celik, Hseyin
    OBJECTIVE. The current study aimed to investigate the effects of varicocele on testis parenchyma by using ZOOMit DWI and conventional DWI and to compare both diffusion methods. SUBJECTS AND METHODS. Forty-five patients with unilateral varicocele diagnosed by physical examination and color Doppler ultrasound between July 2015 and December 2015 and 32 healthy volunteers were included in the study. ZOOMit and conventional DWI were performed for all patients with a 3-T MRI scanner. RESULTS. Apparent diffusion coefficient (ADC) values calculated using both conventional and ZOOMit DWI decreased in the patients with varicocele of the testis, when compared with the healthy volunteer control group. Furthermore, it was determined that conventional and ZOOMit ADC values for the contralateral side without varicocele also decreased when compared with the healthy volunteer control group (p < 0.05). However, there was no statistically significant difference between testes with or without varicocele in terms of conventional ADC values (p = 0.183), whereas ZOOMit ADC values for testes with varicocele were found to be statistically significantly lower than those for testes without varicocele (p < 0.05). A significant negative correlation was found between venous diameter measured both at rest and during the Valsalva maneuver and ZOOMit ADC values in testes with varicocele. CONCLUSION. For patients with varicocele, conventional and ZOOMit DWI may be predictive of histopathologic changes in the testis, and ZOOMit DWI may be more effective in the diagnosis, treatment, and postoperative response in patients with varicocele when compared with conventional DWI.
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    Effectiveness of Diffusion Tensor Imaging in Determining Cervical Spondylotic Myelopathy
    (Turkish Neurosurgical Soc, 2021) Er Ulubaba, Hilal; Saglik, Semih; Yildirim, Ismail Okan; Durak, Mehmet Akif
    AIM: To determine the effectiveness of diffusion tensor imaging (DTI) in diagnosing cervical spondylotic myelopathy (CSM) in patients with no findings detected in conventional magnetic resonance imaging (MRI). MATERIAL and METHODS: Fifty-four patients who presented for cervical MRI between January 2016 and June 2016, with symptoms such as neck pain, paresis, and numbness in hands, were included in the study. The patients were split into four groups based on their degrees of spinal stenosis. The obtained data were examined using special software and color-coded fractional anisotropy (FA), and apparent diffusion coefficient (ADC) maps were formed. Through these maps, using regions of interest (ROIs), FA and ADC values were calculated and the contribution of these values to the diagnosis was evaluated statistically. RESULTS: When all grades of cervical spinal canal stenosis were compared, a statistically significant negative correlation between spinal canal stenosis degree and FA values, and a positive correlation between stenosis degree and ADC values were noted (p<0.001). In the comparison of stenotic levels and non-stenotic levels for the grade 2 patient group, there was a statistically significant decrease in FA values and an increase in ADC values in stenotic levels compared with prestenotic and poststenotic levels (p<0.05). CONCLUSION: DTI and quantitative FA and ADC measurements are candidate imaging techniques for the diagnosis of early-stage CSM, which shows no findings in conventional MRI, and determining the degree of spinal cord injury.
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    Management of non-vascular complications following renal transplantation using percutaneous approach
    (Edizioni Luigi Pozzi, 2018) Yildirim, Ismail Okan; Berktas, Bayram; Saglik, Semih; Piskin, Turgut; Dogan, Murat; Sahin, Idris; Taskapan, Hulya
    OBJECTIVE: Non-vascular complications following renal transplantation can cause graft failure. In this study, we present our two-year experience with percutaneous treatment for non-vascular complications following renal transplantation. PATIENTS AND METHODS: A total of 30 patients who underwent percutaneous radiological treatment between March 2014 and July 2016 were included in the study. RESULTS: Following renal transplantation, a total of 36 percutaneous radiological procedures which includes hydronephrosis secondary to ureteral stricture (n. 15), clinical symptom producing lymphocele due to pressure (14) and creatinine elevated nondilated grafts (n. 7) after excluding other reasons of creatinine elevation, were performed. Six patients received percutaneous treatment for both ureteral stricture and lymphocele. The patients underwent balloon dilatation and double-J ureteral stent due to ureteral stricture. The mean pre- and post-procedural creatinine levels were 4.36 +/- 2.84mg/dL and 2.17 +/- 1.24 mg/dL respectively (p=0.004), indicating a significant difference. For lymphocele treatment, sclerosing agents were injected and lymphatic leakage areas were injected with percutaneous glue. The mean pre- and post-procedural creatinine values were 2.97 +/- 1.78 mg/dL and 1.75 +/- 1.18 respectively (p=0.002), indicating a significant difference. Nephrostomy catheters were placed for patients with elevated creatinine levels and non-dilated collecting system. The mean pre- and post- nephrostomy creatinine levels were 3.55 +/- 2.36 mg/dL and 2.57 +/- 1.82 mg/dL respectively (p>0.05), indicating no statistically significant difference. CONCLUSION: The results of our study suggest that percutaneous treatment is an effective method for the treatment of non-vascular complications following renal transplantation, and, therefore, should be the first option for the preservation of graft functions.
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    Management of non-vascular complications following renal transplantation using percutaneousapproach
    (Edızıonı luıgı pozzı, vıa panama 68, 00198 rome, ıtaly, 2018) Yildirim, Ismail Okan; Berktas, Bayram; Saglik, Semih; Piskin, Turgut; Dogan, Murat; Sahin, Idris; Taskapan, Hulya; Sarac, Kaya
    OBJECTIVE: Non-vascular complications following renal transplantation can cause graft failure. In this study, we present our two-year experience with percutaneous treatment for non-vascular complications following renal transplantation. PATIENTS AND METHODS: A total of 30 patients who underwent percutaneous radiological treatment between March 2014 and July 2016 were included in the study. RESULTS: Following renal transplantation, a total of 36 percutaneous radiological procedures which includes hydronephrosis secondary to ureteral stricture (n. 15), clinical symptom producing lymphocele due to pressure (14) and creatinine elevated nondilated grafts (n. 7) after excluding other reasons of creatinine elevation, were performed. Six patients received percutaneous treatment for both ureteral stricture and lymphocele. The patients underwent balloon dilatation and double-J ureteral stent due to ureteral stricture. The mean pre- and post-procedural creatinine levels were 4.36 +/- 2.84mg/dL and 2.17 +/- 1.24 mg/dL respectively (p=0.004), indicating a significant difference. For lymphocele treatment, sclerosing agents were injected and lymphatic leakage areas were injected with percutaneous glue. The mean pre- and post-procedural creatinine values were 2.97 +/- 1.78 mg/dL and 1.75 +/- 1.18 respectively (p=0.002), indicating a significant difference. Nephrostomy catheters were placed for patients with elevated creatinine levels and non-dilated collecting system. The mean pre- and post- nephrostomy creatinine levels were 3.55 +/- 2.36 mg/dL and 2.57 +/- 1.82 mg/dL respectively (p>0.05), indicating no statistically significant difference. CONCLUSION: The results of our study suggest that percutaneous treatment is an effective method for the treatment of non-vascular complications following renal transplantation, and, therefore, should be the first option for the preservation of graft functions.