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Öğe Blast Lung Injury in Children(Lippincott Williams & Wilkins, 2023) Korkmaz, Inan; Celikkaya, Mehmet EminBackgroundBombings are the most common cause of civilian deaths in wars, and unfortunately, a large proportion of civilian victims are children.ObjectiveThis study aimed to evaluate the frequency of blast lung injury (BLI), to evaluate lung injury patterns on tomographic images, and to document the relationship between blast lung and mortality in children exposed to the blast effect.MethodsThirty-six children (25.3% of pediatric patients brought to our hospital with blast injury) with BLI were included in the study. The pediatric trauma score evaluations made in the emergency department in the first admission were recorded. Lung injury findings in the computed tomography images of the patients were examined, and injuries detected in other systems were recorded.ResultsThe most common lung injury pattern was contusion (right: 69.4%, left: 80.6%). The incidence of brain damage (52.4%) and intra-abdominal injury (76.2%) in children with low pediatric trauma score value was statistically significantly higher (P = 0.049, P = 0.017, respectively). There was no statistically significant correlation between the presence of lung injury, injury patterns, and mortality. The incidence of brain damage in deceased patients (61.5%) was statistically significantly higher than the incidence of brain damage in surviving patients (26.1%) (P = 0.036). Low pediatric trauma score was observed in 11 (84.6%) of the deceased children and in 10 (43.5%) of the survivors (P = 0.016). The mean age of children with hemothorax in the right lung was statistically significantly lower than those without (P = 0.014).ConclusionOur findings revealed that pediatric BLI is common after a blast, that it is associated with other system injuries, and that a multimodal radiological approach is required in child victims.Öğe Chest CT in COVID-19 pneumonia: correlations of imaging findings in clinically suspected but repeatedly RT-PCR test-negative patients(Springer, 2021) Korkmaz, Inan; Dikmen, Nursel; Keles, Fatma Ozturk; Bal, TayibeBackground: To emphasize the importance of CT in the diagnosis of COVID-19 disease by comparing the thoracic CT findings of COVID-19 patients with positive RT-PCR results and patients with clinical suspicion of COVID-19 but with negative RT-PCR results. Results: In our study, COVID-19 patients with positive RT-PCR results (RT-PCR (+) group) and patients with clinical suspicion of COVID-19 but negative RT-PCR results (RT-PCR (-) group) were compared in terms of CT findings. In CT images, ground-glass opacity and ground-glass opacity + patchy consolidation were the most common lesion patterns in both groups. No statistically significant differences in the rates and types of lesion patterns were observed between the two groups. In both groups, lesion distributions and distribution patterns were similarly frequent in the bilateral, peripheral, and lower lobe distributions. Among the 39 patients who underwent follow-up CT imaging in the first or second month, a regression in lesion number and density was detected in 18 patients from both groups. Consolidations were completely resorbed in 16 of these patients, and five patients had newly developed fibrotic changes. The follow-up CT examination of 16 patients was normal. Conclusions: Due to the false-negative rate of RT-PCR tests caused by various reasons, clinically suspected COVID-19 patients with a contact history should be examined with CT scans, even if RT-PCR tests are negative. If the CT findings are positive, these patients should not be removed from isolation.Öğe COVID-19-Related Lung Involvement at Different Time Intervals: Evaluation of Computed Tomography Images With Semiquantitative Scoring System and COVID-19 Reporting and Data System Scoring(Springernature, 2021) Korkmaz, Inan; Keles, FatmaIntroduction: This study aimed to evaluate the frequency of typical and atypical thoracic CT findings in patient groups diagnosed during different periods of the pandemic, examine disease severity using radiological scoring methods, and determine the relationship between atypical CT findings and disease severity. Materials and methods: One hundred fifty-one patients with positive reverse transcription polymerase chain reaction (RT-PCR) test and thoracic CT scan were included in the study. The patients were divided into two groups as group 1 (March to August 2020) diagnosed in the first six months of the pandemic and group 2 (September 2020 to February 2021) diagnosed in the second six months. CT images of the patients were analyzed for the frequency of typical and atypical findings. Evaluation was made in terms of disease suspicion and severity by scoring methods, and the relationship between atypical findings and disease severity was examined. Results: There was no statistically significant difference between the frequency and distribution patterns of typical CT findings observed in both groups. The most common atypical finding in both groups was nodular lesions. Central distribution, one of the atypical findings, was not seen in group 1, whereas it was present in nine patients in group 2 (p=0.001). The mean CT severity score was higher in group 2, and there was a statistically significant difference between the mean CT scores of both groups (p<0.001). In addition, six (7.2%) patients in group 1 and 34 (50%) patients in group 2 had CT scores above the cut-off value (p<0.001). There was no statistically significant relationship between atypical findings and severity score. Conclusion: Other diseases and atypical findings that may accompany COVID-19 pneumonia may increase the rate of misdiagnosis. In the diagnosis of the disease, clinical signs and symptoms and radiological findings should be evaluated together, and it should be kept in mind that lung findings in thorax CT change over time.Öğe Increased Amount of Visceral Fat in Patients with Psoriasis Contributes to Metabolic Syndrome(Karger, 2010) Balci, Ali; Balci, Didem Didar; Yonden, Zafer; Korkmaz, Inan; Yenin, Julide Zehra; Celik, Ebru; Okumus, NeseBackground: Psoriasis is associated with obesity and metabolic syndrome. Metabolic syndrome is associated with visceral fat accumulation. There is no study on the accumulation of visceral fat in patients with psoriasis. Objective: The aim of this study was to compare the visceral fat accumulation in patients with psoriasis and controls. Subjects and Methods: 46 patients with psoriasis and 46 sex-and age-matched control patients were included in this study. The abdominal fat area [visceral fat area (VFA), subcutaneous fat area (SFA) and total fat area (TFA)] at the level of the umbilicus was evaluated by computed tomography. Results: The mean VFA value and VFA/SFA ratio of the psoriasis patients were significantly higher compared with the control patients (123.4 +/- 80.3 vs. 81.2 +/- 59.8 cm(2) and 0.734 +/- 0.593 vs. 0.491 +/- 0.336; p = 0.005 and p = 0.017, respectively). Fasting blood sugar levels were also found to be significantly higher in psoriasis patients, compared with the control patients (101.8 +/- 43.5 vs. 83.4 +/- 9.1 mg/dl; p = 0.005). Multiple linear regression analysis indicated that waist-to-hip ratio, age, body weight, the presence of psoriasis and metabolic syndrome were significantly associated with VFA. Conclusion: Psoriasis patients had a higher amount of VFA, compared with the control patients. Copyright (C) 2009 S. Karger AG, BaselÖğe Median arcuate ligament syndrome diagnosed with multisliced computerized tomography: A case report(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2012) Bayarogullari, Hanifi; Davran, Ramazan; Aslan, Ahmet; Korkmaz, Inan; Yanmaz, Rasim; Temiz, Muhyittin; Balci, AliMedian arcuate ligament syndrome occurs when median arcuate ligament pressures the root of the celiac artery and generally it reveals itself with the post-prandial pain. Because of the pressure there will be a significant tightness especially while expirium. Mesenteric ischaemia and low blood flow to gastro-intestinal system occurs related to the tightness and because of these we see the characteristic clinical symptoms of the syndrome. We present the patient whom we diagnosed with multislicde computerized tomograpy.Öğe Our clinical experience in pelvic magnetic resonance imaging with vaginal contrast(Via Medica, 2023) Keles, Fatma Ozturk; Korkmaz, Inan; Dogan, Esin; Hakverdi, Sibel; Dolapcioglu, Kenan; Karazincir, SinemObjectives: Magnetic resonance imaging (MRI) is an important modality for pelvic imaging. Vaginal distension is provided by the use of vaginal contrast in pelvic MRI, and it plays an important role in staging especially cervical and vaginal cancer. The aim of this study is to show whether the use of vaginal contrast material contributes to the diagnosis in pelvic examination. Material and methods: Between October 1, 2016 and December 30, 2020, a total of 57 patients who underwent pelvic magnetic resonance imaging with vaginal contrast in the radiology clinic were included in the study and evaluated retrospectively. Results: Cervical cancer was detected in 38 of the 57 patients included in the study, and when the vaginal pre-and post-contrast staging of the patients was performed, the pre-contrast stage was found to be high in six patients (15%). Eight of 38 patients diagnosed with cervical cancer underwent surgery. When the pathological and radiological staging of the patients who underwent surgery were compared, they were 100% compatible. Conclusions: The use of vaginal contrast material increases the diagnostic value of MRI in various pelvic pathologies, especially in cervical cancer staging.Öğe Secondary blast injury: radiological characteristics of shrapnel injuries in children(Springer Heidelberg, 2023) Korkmaz, Inan; Celikkaya, Mehmet Emin; Atici, AhmetPurposeThe aim of this study is to examine the radiological images of child victims suffering from secondary blast injuries, to reveal organ-based injury patterns and their interrelationships, and to record mortality rates that may develop due to injured systems.MethodsA total of 65 patients with secondary blast injury due to bomb explosion were included in the study. Injury findings due to shrapnel in radiologic images of the patients were examined. Injured systems and types of injuries were recorded.ResultsThe most common injuries were intra-abdominal injuries (63%) and fractures (58.5%). Lung injury was observed in 4 (9.8%) of 41 patients with intra-abdominal injury, while 37 (90.2%) did not, and this was statistically significant (p = 0.003). The most common intra-abdominal organ injury was a small bowel injury in 23 (35.4%) patients. The coexistence of small bowel injury and large bowel injury was present in 8 patients (34.8%), and it was statistically significant (p = 0.019). A total of 14 (21.5%) of the patients died. There was no significant relationship between mortality and gender (p = 319). Brain damage was present in 10 (71.4%) of the 14 (21.5%) patients who died, which was statistically significant (p < 0.001).ConclusionOur results showed that the most common injuries were intra-abdominal injuries, damage to different organs could occur at the same time, and deaths were especially associated with brain injuries. For this reason, it should not be forgotten that CT scans will have an important place in the triage of the patient, especially in victims with shrapnel at the abdominal and cranial levels in radiography examinations.Öğe Type 1 Crouzon syndrome with headache(2013) Arica, Vefik; Tutanç, Murat; Bayaro?ullari, Hanifi; Günher Arica, Seç; Başarslan, Fatmagül; Davran, Ramazan; Korkmaz, InanCrouzon syndrome defined by French neurosurgeon Crouzon in 1912. Crouzon syndrome which is characterized by craniosynostosis and dysmorphic facial appearance. This autosomal dominant disease has an incidence rate of 16/1,000,000. Craniosynostosis premature closure of cranial sutures, results in craniofacial anomalies. 4.5% of cases with craniosynostosis have Crouzon syndrome. Craniosynostosis can occur in utero or in the first three years of life. It rarely occurs later. Phenotypically specific types of craniosynostosis have been linked to fibroblast growth factor receptor gene (FGFR) mutations. Clinical findings of Crouzon, Apert and Pfeifer syndromes are secondary to FGFR-2 gene mutations. In Crouzon syndrome brachycephaly, ptosis, exophthalmos, hypertelorism, acanthosis nigricans, rostrate type nose, ear and palate anomalies can occur of as a result of premature closure of cranial sutures. In this report we present a 5 years old male with headache. He has Crouzon Syndrome and beaten copper appearance in craniography.Öğe TYPE 1 CROUZON SYNDROME WITH HEADACHE(Nobel Ilac, 2013) Arica, Vefik; Tutanc, Murat; Bayarogullari, Hanifi; Arica, Secil Gunher; Basarslan, Fatmagul; Davran, Ramazan; Korkmaz, InanCrouzon syndrome defined by French neurosurgeon Crouzon in 1912. Crouzon syndrome which is characterized by craniosynostosis and dysmorphic facial appearance. This autosomal dominant disease has an incidence rate of 16/1,000,000. Craniosynostosis premature closure of cranial sutures, results in craniofacial anomalies. 4.5% of cases with craniosynostosis have Crouzon syndrome. Craniosynostosis can occur in utero or in the first three years of life. It rarely occurs later Phenotypically specific types of craniosynostosis have been linked to fibroblast growth factor receptor gene (FGFR) mutations. Clinical findings of Crouzon, Apert and Pfeifer syndromes are secondary to FGFR-2 gene mutations. In Crouzon syndrome brachycephaly, ptosis, exophthalmos, hypertelorism, acanthosis nigricans, rostrate type nose, ear and palate anomalies can occur of as a result of premature closure of cranial sutures. In this report we present a 5 years old male with headache. He has Crouzon Syndrome and beaten copper appearance in craniography.Öğe Ultrasound-Guided vs. Blind Steroid Injections in Carpal Tunnel Syndrome A Single-Blind Randomized Prospective Study(Lippincott Williams & Wilkins, 2013) Ustun, Nilgun; Tok, Fatih; Yagiz, Abdullah Erman; Kizil, Nurhan; Korkmaz, Inan; Karazincir, Sinem; Okuyucu, EsraObjective: The aim of this study was to compare the efficacy and the safety of ultrasound (US)-guided vs. blind steroid injections in patients with carpal tunnel syndrome (CTS). Design: This prospective randomized single-blind clinical trial included 46 patients with CTS (46 affected median nerves). The subjects were randomized-to either the US-guided or the blind injection group-before they received 40 mg of methylprednisolone. They were evaluated using the Boston Carpal Tunnel Questionnaire symptom/function at baseline and at 6 wks and 12 wks after injection, and the side effects were noted. Results: The symptom severity and functional status scores improved significantly in both groups at 6 wks after treatment, and these improvements persisted at 12 wks after treatment (all P < 0.05). The improvement in symptom severity scores in the US-guided group at 12 wks was higher than in the palpation-guided group (P < 0.05). Average time to symptom relief was shorter in the US-guided group (P < 0.05). There was no significant difference between the two groups in terms of side effects (P > 0.05). Conclusions: Although both US-guided and blind steroid injections were effective in reducing the symptoms of CTS and improving the function, an earlier onset/better improvement of symptom relief suggests that US-guided steroid injection may be more effective than are blind injections in CTS.
