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    Can Preoperative Parameters of Inflammation be Used to Predict Acute Kidney Injury in Pediatric Liver Transplant Recipients? A Single-Center Retrospective Study
    (Galenos Publ House, 2024) Demiroz, Duygu; Ozdes, Oya Olcay; Colak, Yusuf Ziya; Erdogan, Mehmet Ali; Gazioglu, Tugce; Karakas, Serdar; Tasolar, Sevgi Demiroz
    Introduction: Inflammation is one of the factors involved in the occurrence and progression of acute kidney injury (AKI). We evaluated the relationship between preoperative systemic inflammatory markers and early postoperative AKI development in pediatric liver transplantation (LT) patients. Methods: Data from 190 pediatric patients were retrospectively analyzed. The preoperative neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and pan-immune-inflammation value (PIV) levels were calculated. AKI was classified according to the Kidney Disease: Improving Global Outcomes staging. Patients who did not develop AKI in the early postoperative period were classified as group 0, patients with stage 1 AKI were classified as group 1, and patients with stage 2-3 AKI were classified as group 2. The relationship between the inflammatory parameters and AKI was evaluated. Results: AKI developed in 20% of patients, and 16.31% of these patients had severe AKI. The NLR, SII, and PIV values were significantly higher in patients with severe AKI (p<0.001). Preoperative high PIV values were found to be an independent predictor of AKI development. Conclusion: High preoperative PIV values may be used as a predictive factor for the development of early AKI in patients undergoing pediatric LT.
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    Comparison of Urinary Tract Dilatation and Society of Fetal Urology systems in the detection of vesicourethral reflux and renal scar
    (Int Scientific Information Inc, 2021) Dogan, Gulec Mert; Sigirci, Ahmet; Cengiz, Aslinur; Tasolar, Sevgi Demiroz; Yildiz, Turan; Tabel, Yilmaz; Elmas, Ahmet Taner
    Purpose: The presence and degree of hydronephrosis is very important in the management of many diseases of the urinary tract. In this study, we aim to compare the sensitivity and specificity of 2 classification systems that are used for hydronephrosis grading in ultrasound, for reflux and scar detection. The classification systems were the Society of Fetal Urology (SFU) and Urinary Tract Dilatation (UTD). Material and methods: Ultrasounds and dimercaptosuccinic acid scintigraphies (DMSA) of all patients who underwent voiding cystourethrogram (VCUG) due to urinary tract infection were examined retrospectively. DMSA was accepted for scar detection and VCUG for reflux detection as reference methods. SFU classification was used for hydronephrosis in ultrasound reports, and UTD classification was made over the reports. Sensitivity, specificity, and positive and negative predictive values of UTD and SFU classification systems for reflux and scar detection were calculated, and these 2 systems were compared. Results: 103 (39%) of the patients were male and 162 (61%) were female. Pathologies were detected in 192 (35%) of 530 kidneys in ultrasound. In 110 (42%) of the children, reflux was detected in VCUG. Scars in DMSA were detected in only 16% (44) of 266 kidneys. Sensitivity, positive and negative predictive values of the UTD classification system were statistically significantly higher than the SFU system for scar and reflux detection (p < 0.01). Conclusions: If we use the UTD system in ultrasounds of patients with urinary tract infections, children reported as UTD 0 may not need VCUG, which reduces radiation exposure to children and the cost of the diagnostic interventions.
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    Evaluation of Salivary Glands by Ultrasonography and Inflammatory Markers in Children with Autoimmune Thyroiditis
    (Galenos Publ House, 2023) Tasolar, Sevgi Demiroz; Sigirci, Ahmet; Ciftci, Nurdan; Cengiz, Aslinur; Dogan, Gulec Mert; Akinci, Aysehan
    Introduction: Although more common in adults, autoimmune thyroiditis (AT) is one of the most common thyroid diseases in children and adolescents. Salivary gland involvement has been described in many studies of patients with AT. Several inflammatory scores are used to assess the inflammatory status of patients with systemic autoimmune diseases. We aimed to sonographically evaluate the parotid and submandibular salivary glands with inflammatory parameters in patients with AT in our study. Methods: Our study population consisted of 37 consecutive pediatric AT patients and 29 healthy control subjects. Ultrasonographic and laboratory evaluations of the study population were performed. Jamovi and MedCalc software were used to analyze the data. Results: The volume of the thyroid gland in the patients was significantly higher than that in the control group (p=0.030), while there was no difference in the volume of the salivary glands. Multiple logistic regression analysis was planned to assess the predictability of salivary gland involvement in patients with the disease. Both systemic immune-inflammation index (SII) and pan-immune inflammation value (PIV) were found to be predictors of salivary gland involvement in AT patients. Conclusion: We found that both SII and PIV inflammatory markers are predictive of salivary gland parenchymal changes in patients with AT, and SII is likely to be more valuable than PIV at this time.
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    Quantitative Assessment of Extrinsic Tongue Muscle Stiffness in Obstructive Sleep Apnea Using Shear Wave Elastography
    (Mdpi, 2025) Ulubaba, Hilal Er; Dag, Nurullah; Tasolar, Sevgi Demiroz; Ciftci, Rukiye; Ermis, Hilal
    Background/Objectives: This study aimed to quantitatively and noninvasively evaluate the changes in the Genioglossus (GG) and Geniohyoid (GH) muscles in patients with Obstructive Sleep Apnea (OSA) using ultrasonography (US) and shear wave elastography (SWE). Methods: This prospective study included 94 adults (18-73 years) who underwent polysomnography (27 normal; 67 OSA). GG and GH muscle thickness was measured with US, and stiffness with SWE. Participants were grouped as non-OSA (Group 0) and OSA (Group 1). OSA patients were further divided by apnea-hypopnea index (AHI) into mild, moderate, and severe (Groups 1-3), forming four groups including controls. Results: No significant differences were observed in genioglossus or geniohyoid muscle thickness between groups. Shear wave elastography revealed significantly higher stiffness values for both the genioglossus and geniohyoid muscles bilaterally in OSA patients compared with non-OSA individuals (approximately 2.7 m/s vs. 2.4-2.5 m/s, p < 0.01). Geniohyoid muscle stiffness on both sides increased progressively with OSA severity, with significantly higher values in severe compared with mild OSA (p < 0.05). In contrast, genioglossus stiffness did not differ significantly across OSA severity subgroups. Conclusions: In patients with OSA, GH and GG muscle thickness remains unchanged, but their stiffness measured by SWE increases. GH stiffness also rises with increasing disease severity. These results indicate that GG and GH muscle stiffness may serve as useful noninvasive markers for OSA.
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    Risk factors for acute symptomatic seizure in children with cerebral sinovenous thrombosis: Experience from a tertiary center
    (Elsevier, 2024) Yucel, Gul; Arslan, Ahmet Kadir; Ozgor, Bilge; Sahin, Murat caglar; Oncul, Yurday; Tasolar, Sevgi Demiroz; Akyay, Arzu
    Objective: To investigate the risk factors for acute symptomatic seizure (ASS) in children with Cerebral Sinovenous Thrombosis (CSVT) and to evaluate the effect of ASS on outcome. Methods: Cross-sectional, single-center, hospital-based retrospective analysis of 42 children with neuroimagingconfirmed CSVT recorded between December 2009 and January 2023. ASS was defined as a seizure occurring within 7 days after CSVT. Predictors for ASS were analyzed by univariate and multivariate logistic regression. Functional outcomes were evaluated using the Pediatric Stroke Outcome Measure (PSOM). Results: The average age of the 42 patients included in the study sample was 105.36 +/- 63.1 months. Almost onethird (28.6 %) of patients with CSVT developed ASS. In univariate analysis, factors associated with seizure risk were young age, low Glasgow Coma Scale at admission, long hospital stay, headache, change of consciousness, focal neurological findings, cerebral hemorrhage, motor deficit and high D-dimer level (p=0.018, p<0.001, p= 0.016, p= 0.001, p=0.014, p<0.001, p<0.001, p=0.019 and p=0.013, respectively). In multivariate analysis young age, focal neurological findings and D-dimer levels were potential predictors of ASS (p=0.004, p=0.003, p=0.036, respectively). Receiver operating characteristic (ROC) analysis for D-dimer diagnostic accuracy in patients with CSVT revealed D-dimer > 498 ng/mL (AUC=0.743). In both cohorts, PSOM scores at last follow-up were worse in those with acute seizures compared to those without (p<0.001). Conclusion: Acute seizures occurred in approximately one-third of our cohort. Young age, focal neurological findings, and high D-dimer levels are potential predictors of ASS in children. Children with ASS had worse outcomes than those without.
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    Use of apparent diffusion coefficient values to differentiate lymph nodes from testicular tissue in patients with undescended testes
    (Oxford Univ Press, 2026) Tasolar, Sevgi Demiroz; Sigirci, Ahmet; Yavuz, Serkan; Yildiz, Turan
    Background This study investigated the anatomical location of non-palpable undescended testes (UTs), which account for approximately 20% of all cases of UTs. Radiological imaging is essential to determine the location of such testes in the abdomen or groin. Other studies have examined the diagnostic performance of diffusion-weighted MRI (DWI) in detecting and localizing non-palpable UTs. However, no study has used apparent diffusion coefficient (ADC) values to differentiate UT tissue. Methods This study included consecutive children referred to a pediatric surgery clinic with a prediagnosis of UT. Diffusion-weighted images were used to evaluate lymph nodes (LNs) and testicular tissue. Apparent diffusion coefficient values were measured by placing a circular region of interest at the center. Results The study enrolled 44 boys (73 testes) who underwent pelvic MRI. Age and testicular volume were significantly positively correlated (P < .001). Testicular ADC values were higher in both inguinal and abdominal locations than in scrotal locations. However, the ADC values of LNs were significantly lower than those of testes. Our ROC analysis revealed that an ADC value < 940 10(-3)/mm(2) could differentiate between LNs and testes (AUC = 0.826, P < .001). Conclusion Measuring ADCs using a DWI imaging sequence is an accurate method of differentiating between testes and LNs. Advances in knowledge This study is the first to show that ADC values from diffusion-weighted MRI can reliably differentiate non-palpable UTs from LNs. Apparent diffusion coefficient mapping appears to be a novel and accurate tool for detecting testicular localization when conventional assessment is inadequate.