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Öğe Epikardiyal yağ doku alanı ile koroner ateroskleroz arasındaki ilişkinin değerlendirilmesi(Hatay Mustafa Kemal Üniversitesi, 2011) Korkmaz, İnan; Balcı, AliÇalışmamızda epikardiyal yağ doku miktarı ile koroner ateroskleroz ve obstrüktif koroner arter hastalığı gelişimi arasındaki ilişkinin araştırılması amaçlanmıştır.Bu retrospektif çalışmada Mayıs 2009 ? Eylül 2011 tarihleri arasında Kardiak BT Anjiografi tetkiki için başvuran 40 hastanın (23-80 yaş aralığında, 30 erkek, 10 kadın) görüntüleri kullanıldı. Hastaların epikardiyal yağ doku alanı ve total kalsiyum skor değerleri ölçüldü. Tüm hastalara obstrüktif koroner arter hastalığı yönünden inceleme yapıldı. Epikardiyal yağ doku alanları sol ana koroner arter düzeyinden ölçüldü. Elde edilen veriler SPSS programı ile analiz edildi.13 hastada Ca skor pozitifliği ve 18 hastada koroner arter stenozu tespit edildi. Epikardiyal yağ doku alanı ile yaş ve total kalsiyum skoru arasında bağımsız ilişki saptandı( yaş: p=0,003, total Ca skoru: p=0,020). Yaptığımız ölçümler ve istatistiksel analiz sonucunda, Ca skor pozitifliği (p=0,017) ve koroner arter stenozu (p=0,019) bulunan hastaların epikardiyal yağ doku alanı istatistiksel olarak anlamlı derecede yüksek bulundu.Sonuç olarak, epikardiyal yağ doku artışının koroner arter stenozu ve koroner arterlerde kalsifik-aterosklerotik değişikliklerin gelişiminde etkili olduğu düşünülmüştür. Ayrıca epikardiyal yağ doku miktarının hesaplanmasında sol ana koroner arter düzeyinden tek kesit alan ölçümünün, daha kolay ölçüm yapılabilmesi nedeniyle total epikardiyal yağ doku hacim hesaplamalarına iyi bir alternatif olduğu düşünülmektedir.Öğe Liver trauma in children with Syrian Civil War: How should treatment management?(Ondokuz Mayis Universitesi, 2022) ÇelıKkaya, Mehmet Emin; Atici, Ahmet; Korkmaz, İnan; El, Çiğdem; Akçora, BülentPatients with liver injuries should be considered multidisciplinary cases, and the decision to operate should be made according to each patient’s clinical and hemodynamic stability. In this study, we aimed to describe treatment management approaches and appropriate operation times for children with liver injuries resulting from the Syrian Civil War. A total 32 patients who were admitted to a pediatric surgery clinic between 2010 and 2020 with liver injuries resulting from Syrian Civil War were examined retrospectively. Patients were evaluated according to age, gender, type of injury, accompanying trauma, treatment modality, and mortality. A total of 21 patients were injured with shrapnel, while 11 patients suffered from blast effect injury. The mean pediatric trauma score of the patients was 5.2, while the mean pediatric trauma score of the six patients who died was 3.11. Liver suturing was performed in four patients due to bleeding. A segmentectomy was performed in one patient with active bleeding in segment 7. This bleeding was stopped by ligating the branches of the hepatic artery. Two patients who were operated on in Syria and to whom packing was applied due to uncontrolled bleeding were referred to Turkey. One patient with inferior vena cava injury died due to excessive blood loss and instability at the time of admission, and six patients died due to accompanying head trauma and/or multiple body trauma. The main purpose in emergency operations is to stop bleeding. Rarely, however, suturing or even segment resection in the bleeding area may be required. © 2022 Ondokuz Mayis Universitesi. All rights reserved.Öğe Multislice bilgisayarlı tomografi ile median arkuat ligament sendromu tanısı : Olgu sunumu(2012) Bayaroğulları, Hanifi; Davran, Ramazan; Aslan, Ahmet; Korkmaz, İnan; Yanmaz, Rasim; Temiz, Muhyittin; Balcı, AliMedian arkuat ligament sendromu, median arkuat ligamentin çöliak arter köküne basısı sonucu oluşur ve kendini genellikle postprandial ağrı ile belli eder. Basıya bağlı, özelikle ekspiryumda daha belirgin darlık oluşur. Darlığa bağlı mezenterik iskemi ve gastro-intestinal sisteme yetersiz kan akımı olması nedeniyle sendroma ait karakteristik klinik bulgular görülür. Biz kliniğimize gelen ve multislice bilgisayarlı tomografi ile tanısı konan hastayı sunuyoruz.Öğe Outcomes in Paediatric Patients Presenting with a Complaint of Breast Swelling: A Retrospective Single-centre Study(Logos Medical Publishing, 2023) Atıcı, Ahmet; Çelikkaya, Mehmet Emin; Korkmaz, İnan; Akçora, BülentObjective: Although malignancy is very rare in paediatric breast lesions, the presence of breast swelling is generally worrying for patients and their families. Breast masses affect approximately 2% to 3% of females in childhood. However, the rate of breast swelling associated with normal pubertal development in children admitted to hospital with a complaint of breast swelling is unknown. This study aimed to retrospectively examine the diagnoses of children presenting with a complaint of breast swelling. Methods: A retrospective sample comprising the medical case records of paediatric patients (N=50; male:13; female: 37; mean age: 13.2 years old) admitted to the Mustafa Kemal University hospital with a complaint of breast swelling between April 2017 and December 2021 was included in the study Results: For males, the most common cause of breast swelling was normal pubertal development (53.8 %; n=7), followed by gynecomastia (30.7%; n=4), and neonatal breast hypertrophy (15.3%; n=2). For females, the most common cause of breast swelling was a mass in the breast (35.1%; n=13), followed by a breast cyst (16.2%; n= 6), normal pubertal development (29.8%; n=11), and finally asymmetric breast development (18.9%; n=7). The majority of cases (86%; n=43) were treated conservatively; the remainder (14%; n=7) underwent surgical treatment. Conclusion: There is a wide spectrum of diagnoses in children presenting with a complaint of breast swelling, most of them are benign. It should be kept in mind that anxious patients who present with a complaint of breast swelling may only be experiencing normal pubertal development. Although all the patient cases examined in the present study involved benign masses, it is important to plan diagnosis and treatment without delay to ensure the early diagnosis of malignant diseases. © Turkish Journal of Pediatric Surgery is the official joint publication of the Turkish Society of Pediatric Surgery and Pediatric Urology Association.Öğe Outcomes in Paediatric Patients Presenting with a Complaint of Breast Swelling: A Retrospective Single-centre Study(2022) Atıcı, Ahmet; Çelikkaya, Mehmet Emin; Korkmaz, İnan; Akçora, BülentObjective: Although malignancy is very rare in paediatric breast lesions, the presence of breast swelling is generally worrying for patients and their families. Breast masses affect approximately 2% to 3% of females in childhood . However, the rate of breast swelling associated with normal pubertal development in children admitted to hospital with a complaint of breast swelling is unknown. This study aimed to retrospectively examine the diagnoses of children presenting with a complaint of breast swelling. Methods: A retrospective sample comprising the medical case records of paediatric patients (N=50; male:13; female: 37; mean age: 13.2 years old) admitted to the Mustafa Kemal University hospital with a complaint of breast swelling between April 2017 and December 2021 was included in the study Results: For males, the most common cause of breast swelling was normal pubertal development (53.8 %; n=7), followed by gynecomastia (30.7%; n=4), and neonatal breast hypertrophy (15.3%; n=2). For females, the most common cause of breast swelling was a mass in the breast (35.1%; n=13), followed by a breast cyst (16.2%; n= 6), normal pubertal development (29.8%; n=11), and finally asymmetric breast development (18.9%; n=7). The majority of cases (86%; n=43) were treated conservatively; the remainder (14%; n=7) underwent surgical treatment. Conclusion: There is a wide spectrum of diagnoses in children presenting with a complaint of breast swelling, most of them are benign. It should be kept in mind that anxious patients who present with a complaint of breast swelling may only be experiencing normal pubertal development. Although all the patient cases examined in the present study involved benign masses, it is important to plan diagnosis and treatment without delay to ensure the early diagnosis of malignant diseases.Öğe Pediatrik apandisit olgularında ultrasonografinin tanısal duyarlılığı(2022) Korkmaz, İnan; Seyfettin, Ayça; Çelikkaya, Mehmet EminAmaç: Bu çalışmada pediatrik yaş grubunda ultrasonografinin apandisit tanısındaki duyarlılığının araştırılması amaçlanmıştır. Yöntem: Operasyon sonucu apandisit tanısı alan, preoperatif USG tetkiki gerçekleştirilmiş olan ve akut batın sebebi olabilecek ek patolojisi bulunmayan 87 pediatrik olgu çalışmaya dahil edildi. Olguların USG raporları retrospektif olarak incelenerek USG’ nin apandisit tanısındaki duyarlılığı araştırıldı. Ayrıca olguların lökosit sayıları, nötrofil oranları ve CRP değerleri hastane arşivinden ve varsa BT tetkikleri PACS sisteminden incelendi. Bulgular: Olguların % 71’i akut apandisit, %29’u perfore apandisitti. Olguların %74’ünün USG’si apandisit ile uyumlu olup USG’nin tanı duyarlılığı %74’dü, %16 olguda USG’de sekonder apandisit bulguları izlenirken %10 olguda USG tetkiki tamamen normaldi. USG ile tanı konulamayan %26 olgudan %10’unun tanısı BT ile konulmuştu. %16 olguda tanıya klinik bulgularla gidilmişti. Olguların %62’sinde lökositoz, %84’ünde nötrofil oranında artış (sola kayma), %86’sında ise CRP yüksekliği bulunmaktaydı ve olguların tamamında bu parametrelerin en az biri yüksekti. Sonuç: Ultrasonografi her durumda tanı koymak için yeterli olmasa da bu çalışmada ulaşılan yüksek duyarlılık oranı, ultrasonografinin akut apandisit şüphesi bulunan pediatrik hastalarda ilk seçenek tanı aracı olarak kullanılabileceği bilgisini desteklemektedir.Öğe The Relationship between Platelet İndices and Radiological İnvolvement in Pulmonary Thromboembolism(2023) Akgün, Kadir Burak; Korkmaz, İnan; Karadağ, MehmetObjective: Pulmonary thromboembolism (PTE) is a disease characterized by occlu- sion of the pulmonary artery and its branches by thrombus material as a result of stasis, hypercoagulability, and/or endothelial damage. Recent studies have focused on platelet (PLT) parameters, mortality of the disease, and its use as a diagnostic parameter. In particular, a significant relationship was found between high mean PLT volume (MPV) values and mortality and disease risk in the meta-analyses. The aim of our study is to examine the relationship between PLT parameters and the severity of radiological involvement. Material and Methods: The files of patients who were followed up with the diag- nosis of pulmonary thromboembolism between 2012 and 2021 were reviewed ret- rospectively. The patients were radiologically divided into 3 groups: (1) those with major branch involvement, (2) those with segmental branch involvement without ma- jor branch involvement, and (3) those with only subsegmental branch involvement. In addition, patients were examined in two separate groups according to whether there was more than 50% of involvement in the main branch radiologically and whether the right ventricle/left ventricle ratio was above 0.9 or not, radiologically. PLT, neutrophil, lymphocyte, platelet/lymphocyte ratio (PLR), neutrophil/lymphocyte ratio, MPV, plateletcrit (PCT), platelet distribution width (PDW), and PLT large cell ratio data in complete blood count measurements taken from patients at the time of diagnosis were also recorded. Results: There was a significant correlation between rising in PLR and occlusion in the major branch more than 50% (p=0.041). PLT, PDW, PCT, and neutrophil values differed radiologically according to the involvement of major, segment, and subseg- ment; however, subgroup analyses did not provide the linear difference that we ex- pected in our study.Conclusion: An increase in the PLR appears to be associated with radiological weight in pulmonary thromboembolism. We think that the relationship between PLT indices and radiological involvement should be supported by multicenter studies.Öğe Splenic Artery Aneurysm Rupture In Children: Imaging Findings And Treatment Protocols(Logos Medical Publishing, 2022) Çelikkaya, Mehmet Emin; Atıcı, Ahmet; Korkmaz, İnan; Seyfettin, Ayça; Ersoy, Cigdem; Akçora, BülentSplenic artery aneurysm, although rare, is the third most common intraabdominal aneurysm and follows aortic and iliac artery aneurysms. Although the prevalence of splenic artery aneurysm in the general population is not known clearly, studies show that splenic artery aneurysms occur in 1-10% of health individuals and the incidence increases with age. The importance of splenic arteryaneurysm is the potential rupture and life-threatening bleeding risk of 10-25% in non-pregnant patients and up to 70% in pregnancy. There are few reports on the incidence and rupture of splenic artery aneurysms in children. Pediatric arterial aneurysms are rare and underlying processes are frequently associated with liver failure, infection, connective tissue diseases, non-infectious arteritis, and congenital malformations. Early detection of splenic artery aneurysms is important because of the spontaneous rupture and life-threatening bleeding. Splenic artery aneurysms, although rarely seen in pediatric patients, are a serious life-threatening condition in case of rupture and can occurarious reasons. Children with hepatic insufficiency should be monitored closelydue to the possibility of rupture and inability to apply elective treatment methods in case of delay, and it should be kept in mind in the differential diagnosis of hypovolemic children admitted to the emergency department with abdominal pain. Here, a cesepresenting with spontaneous rupture of splenic artery aneurysm and imaging findings and treatment options of splenic artery aneurysm will be discussed. © Cocuk Cerrahisi Dergisi 2022.Öğe Splenic Artery Aneurysm Rupture In Children: Imaging Findings And Treatment Protocols(2022) Çelikkaya, Mehmet Emin; Atıcı, Ahmet; Korkmaz, İnan; Seyfettin, Ayça; Ersoy, Cigdem; Akçora, BülentSplenic artery aneurysm, although rare, is the third most common intraabdominal aneurysm and follows aortic and iliac artery aneurysms. Although the prevalence of splenic artery aneurysm in the general population is not known clearly, studies show that splenic artery aneurysms occur in 1-10% of health individuals and the incidence increases with age. The importance of splenic arteryaneurysm is the potential rupture and life-threatening bleeding risk of 10-25% in non-pregnant patients and up to 70% in pregnancy. There are few reports on the incidence and rupture of splenic artery aneurysms in children. Pediatric arterial aneurysms are rare and underlying processes are frequently associated with liver failure, infection, connective tissue diseases, non-infectious arteritis, and congenital malformations. Early detection of splenic artery aneurysms is important because of the spontaneous rupture and life-threatening bleeding. Splenic artery aneurysms, although rarely seen in pediatric patients, are a serious life-threatening condition in case of rupture and can occurarious reasons. Children with hepatic insufficiency should be monitored closelydue to the possibility of rupture and inability to apply elective treatment methods in case of delay, and it should be kept in mind in the differential diagnosis of hypovolemic children admitted to the emergency department with abdominal pain. Here, a cesepresenting with spontaneous rupture of splenic artery aneurysm and imaging findings and treatment options of splenic artery aneurysm will be discussed.Öğe Üst yüz ve orbita bölgesinden alınan genişlik ölçülerinin cinsiyet tayininde kullanımı(2022) Can, Alı Rıza; Korkmaz, İnan; Atamtürk, Derya; Karazincir, Sinem; Duyar, İzzetAmaç: Cinsiyet ayrımı açısından öne çıkan anatomik bölgelerden birisi yüz bölgesi ve bu bölgeyi oluşturan kemik yapılardır. Yapılan çalışmalar yüz bölgesindeki genişlik ölçülerinin, özellikle de bizigomatik genişliğin önemli bir cinsiyet ayırıcı değişken olduğunu ortaya koymakla birlikte üst yüz bölgesini oluşturan diğer elemanlar bu açıdan yeterince incelenmemiştir. Bu çalışmanın amacı, üst yüz bölgesini mercek altına alarak, görece az incelenmiş genişlik ölçülerinin cinsiyet ayrımında kullanılıp kullanılamayacağı sorusuna cevap aramaktır. Yöntem: Bu çerçevede, yaşları 18 ve 75 arasında değişen 200 yetişkin bireyin (100 kadın, 100 erkek) BT (bilgisayarlı tomografi) görüntüsü üzerinden 5 genişlik ölçüsü alınmıştır. Bu ölçüler şunlardır: (1) bimalar (interzigomatik) genişlik, (2) bizigomaksiller genişlik, (3) orbital genişlik, (4) biorbital genişlik ve (5) interorbital genişlik. Ölçülerin seksüel dimorfizm dereceleri, tek değişkenli ve çok değişkenli diskriminant fonksiyonları oluşturularak analiz edilmiştir. Bulgular: Analiz sonuçları, tek değişkenli fonksiyonların cinsiyeti doğru belirleme oranının %63.5 ila %76.5 arasında değiştiğini ortaya koymuştur. Cinsiyeti en iyi ayıran değişkenler sırasıyla bimalar (interzigomatik) genişlik (%76.5) ve biorbital genişliktir (%73). Cinsiyetleri doğru olarak ayıran en başarılı çok değişkenli fonksiyonda bimalar genişlik ve orbital genişlik olup, bu eşitliğin cinsiyeti doğru belirleme oranı %77 olarak tespit edilmiştir. Sonuç: Bulgular, üst yüz ve orbita bölgesindeki genişlik ölçülerinin cinsiyet belirlemedeki başarısının orta seviyede olduğunu, dolayısıyla pelvisi oluşturan kemik elemanların ele geçmediği durumlarda üst yüz bölgesindeki genişlik ölçülerine başvurulabileceğini ortaya koymaktadır.
