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Öğe Diagnostic performance of prostate imaging reporting and data system v2.1: Single center experience(2019) Bekci, Tumay; Oguz, Ural; Tosun, Alptekin; Demirelli, Erhan; Ogreden, Ercan; Sengul, DemetAim: To assess the diagnostic accuracy of PI-RADS v2.1 using multi-parametric magnetic resonance imaging (mpMRI) to detect prostate cancer (pCa) and comparison with transrectal biopsy/radical prostatectomy results.Material and Methods: Between June 2017 and April 2019, 124 patients who underwent mpMRI prior to transrectal biopsy/ radical prostatectomy were evaluated by a pathology results-blinded uroradiologist using PI-RADS v2.1 categories, retrospectively. PIRADS v2.1 category results were compared with transrectal biopsy/radical prostatectomy results. All clinical data were used in statistical analysis.Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy values of mpMRI using PI-RADS v2.1 categorization were 96%, 44%, 73%, 88% and 75%, respectively. A significant correlation was observed between a high PI-RADS score and high pathological grade (p0.001). The inter observer agreement expressed as the ICC was 0.65 (95% CI: 0.33–0.84, p 0.001).Conclusions: The mpMRI, used in conjunction with PI-RADS v2.1, is a useful and promising imaging method in detection of pCa. Keywords: Prostate cancer; multiparametric MRI; PI-RADS; transrectal biopsy; radical prostatectomy.Öğe Does dutasteride have any cardioprotective effect in elderly men? A prospective randomised controled study(2019) Oguz, Ural; Karagoz, Ahmet; Tosun, Alptekin; Demirelli, Erhan; Usta, Murat; Ogreden, Ercan; Karagoz, Emel; Karadayi, Mehmet; Koseoglu, Mehmet Hicri; Baser, Bengi; Yalcin, OrhanAim: To investigate whether the increased serum levels of testosterone secondary to Dutasteride therapy has any protective effect on cardiovascular system.Material and Methods: A prospective analysis of 50 patients diagnosed benign prostatic enlargement between May 2015 and May 2017 was performed. After randomization 25 patients treated with daily administration of 0.5 mg dutasteride (Dutasteride Group), and 25 patients were not given dutasteride (Control Group). We analyzed some serum novel cardiaovascular marker levels at baseline and after 6 months of the treatment. Echocardiography, carotid intima-media thickness and brachial artery resistive index (RI) were evaluated at baseline and after 6 months of the treatment.Statistical analyses were performed using SPSS, version 21. While “t test” was used for comparison the independent groups, paired t test was used in the matched groups. Statistical significance was considered at p0.05.Results: The differences in serum Lp a, hs-CRP and NT-proBNP levels were not statistically significant (p>0.05). Additionally, echocardiographic parameters, carotid intima-media thickness and brachial artery RI were similar before and after dutasteride tratment. Conclusion: After the short-term use of dutasteride, there was not a statistically significant difference in serum Lp a, hs-CRP and NT-proBNP levels. Additionally, echocardiographic parameters, carotid intima-media thickness and brachial artery RI were also similar.Öğe Mechanochemical ablation of varicose veins with N-Butyl Cyanoacrylate: Six-month follow-up(2019) Bekci, Tumay; Tosun, AlptekinAim: The endovenous treatment with n-butyl cyanoacrylate (NBCA) is a new nontumescent ablation technique for symptomatic saphenous vein reflux. The aim of the present study is to present six-month follow-up results of NBCA (VenaBlock) mechanochemical ablation technique. Material and Methods: Endovenous ablation was performed on 29 saphenous veinsof 23 patients between January 2017 and October 2018 in our university hospital. All patients with six-month follow-up results were included. Patients’ pre- and postoperative data were recorded. Results: This procedure was performed on eight small saphenous veins in seven patients and 21 great saphenous veins in 16 patients. The mean saphenous vein diameters for great and small saphenous vein were 7.1 and 3.8, respectively. The mean lengths for great and small saphenous vein were 45 cm and 19 cm, respectively. Closure rates were 100% at one week, 100% at one month, 100% at three months and 96% at six months. CEAP score was significantly improved (p<0.001). There was one deep venous thrombosis patient as a complication. Conclusion: The NBCA-based vein ablation technique is a fast end affective treatment method with no tumescent anesthesia requirement and high patient toleration. Further large-scale studies with long-term follow-up results are required.Öğe Morphometric Evaluation of the Craniovertebral Junction Using Computed Tomography: A Sex-Based Analysis of 500 Adults(Wiley, 2026) Fidan, Nuri; Cetin, Aymelek; Tosun, AlptekinBackground and Objective: The anatomy of the craniovertebral junction (CVJ) varies considerably across populations, yet comprehensive Turkish-specific morphometric data remain limited. We aim to establish normative CVJ measurements in Turkish males and females using computed tomography (CT). Study Design: Retrospective morphological study. Materials and Methods: A retrospective analysis of CT images from 500 patients (250 females and 250 males, aged 25-40 years) was conducted between January and December 2022. CVJ measurements were obtained, and sex-related differences were assessed. Results: The mean atlantodental interval was 1.45 +/- 0.01 mm, posterior atlantodental interval 19.35 +/- 0.09 mm, McGregor line 79.78 +/- 0.21 mm, Chamberlain line 76.95 +/- 1.21 mm, McRae line 36.27 +/- 0.12 mm, Wachenheim clivus-canal angle 154.65 +/- 0.45 degrees, sphenoid angle 121.15 +/- 0.39 degrees (no sex difference, p = 0.083), Welcher basal angle 130.02 +/- 0.28 degrees (higher in females, p < 0.001), basion-axial interval 7.13 +/- 0.07 mm (higher in males, p = 0.011), basion-dental interval 5.32 +/- 0.06 mm, and craniocervical tilt angle 123.94 +/- 0.44 degrees (higher in males, p < 0.001). Conclusion: This study provides a comprehensive CT-based analysis of CVJ measurements in Turkish adults, establishes normative morphometric values, and shows that most parameters exhibit sex-based differences. These population- and sex-specific reference data may be crucial for improving the accuracy of clinical assessments and surgical planning.
