98 research outputs found
The reliability of ultrasonography in developmental dysplasia of the hip How reliable is it in different hands?
No full textBackground: Developmental dysplasia of the hip (DDH) is the most common skeletal dysplasia. Two principal methods used in early diagnosis of DDH are clinical examination and ultrasonographic investigation. Dogruel et al. found a low specificity of clinical examination in patients with DDH. Additionally, Kamath et al. stated that ultrasonography performed by a radiologist in routine clinical practice is more reliable than physical examination performed by the average clinician. In clinical practice, the application and assessment of hip ultrasonography are completed by a single person. This assessment determines the followup of the patient. Thus, hip ultrasonography performed on the same person by different individuals under the same conditions will yield a more accurate assessment of the reliability of ultrasonographic assessment of DDH. Although inter-observer reliability was high in many previous studies of ultrasound image evaluation, reliability rates vary among studies of the application of ultrasonography
The morphologic analysis of a not well-known anatomical structure's calcifications (Bochdalek's Flower Basket Calcifications)
No full textBackground: The aim of the study is to define the morphology of calcifications belonging to a not very well-known anatomical structure [Calcification of foramen of luchka/Bochdalek's flower basket calcification (Boc FBC)].
Materials and methods: 264 computed tomography (CT)s belong to healthy patients were included in the study [50.0038 ± 24.78309 (0-92 years old) (mean age± SD; range)]. The morphology of the calcifications in the fourth ventricle (CFV) and Boc FBC was evaluated and compared with other common intracranial calcifications in each patient.
Results: Boc FBC was detected in 22.35% (59/264) of the patients. Out of 101 patients whose age is above 60 years old, 59 presented Boc FBC (the rate increased to 55,45%), thus in our sample 94,91% of the detected Boc FBCs (56/59) were seen after 60 years old. No Boc FBC was found under the age of 50. Statistically, there is a highly significant correlation between Boc FB and Pineal / habenular (p<0.01) as well as choroid plexus calcifications (p<0.01). The correlation between CFV and Boc FBC was significant (p<0.05). 37.3% of Boc FBCs had a conical form. This form was not accompanied by any vascular calcifications (VC) neither basilar nor vertebral. Therefore, seeing the conical form was valuable in the differential diagnosis.
Conclusions: In our study, Boc FBCs are seen in advanced age and are not encountered under the age of fifty. The conical form is seen in one-third of the cases, but it is a very beneficial finding for distinguishing Boc FBC from other calcifications if any. In the advanced age group calcifications; especially choroidal plexus calcifications and pineal/habenular calcifications; are highly associated with Boc FBC. In the presence of CFV, the probability of encountering Boc FBC is very high
A very rare cause of male breast lump: Idiopathic granulomatous mastitis
No full textWOS: 000528264300036PubMed ID: 3148618
Befunde im Endstadium einer spät diagnostizierten Fibrodysplasia ossificans progressiva
No full textFibrodysplasia ossificans progressiva (FOP) is an autosomal dominant rare disease characterized by foot deformities and concomitant heterotopic ossifications. Theoretically, in the absence of early diagnosis and medication, the patient's outcome will be poor. The patients are usually diagnosed at an early age. Hence, encountering a non-treated and terminal-period patient is rare. Our case was unique because it showed the clinical picture and atypical radiological distribution of a 20-year-old, terminally ill untreated female patient. She had hallux valgus, heterotopic ossifications and multiple osteochondromas that were detected in the right clavicula, the posterior arch of the 9th rib, the bilateral tibia and fibula. Atypically, heterotopic ossifications were not present in the soft tissues of the neck. Hand deformity, cardiac anomaly, or mental retardation was not observed. It was a sporadic case. The presentation with neurological symptoms was also atypical.Fibrodysplasia ossificans progressiva (FOP) ist eine autosomal-dominante, seltene Krankheit, die sich durch Fußdeformitäten und gleichzeitige heterotope Verknöcherungen auszeichnet. Wird die Krankheit nicht frühzeitig diagnostiziert und medikamentös behandelt, sind die Aussichten für die Patienten theoretisch schlecht. Die Diagnose erfolgt in der Regel in einem frühen Alter der Patienten. Daher ist es selten, einen unbehandelten Patienten im Endstadium anzutreffen. Unser Fall war einzigartig, weil er das klinische Bild und die atypische radiologische Verteilung bei einer 20-jährigen, unheilbar kranken, unbehandelten Patientin zeigte. Sie hatte einen Hallux valgus, heterotope Verknöcherungen und multiple Osteochondrome, die in der rechten Clavicula, dem hinteren Bogen der 9. Rippe und beidseitig in Tibia und Fibula entdeckt wurden. Heterotopische Verknöcherungen in den Weichteilen des Halses waren untypischerweise nicht vorhanden. Handdeformitäten, Herzanomalien oder geistige Entwicklungsstörungen wurden nicht beobachtet. Es handelte sich um einen sporadischen Fall. Das Auftreten neurologischer Symptome war ebenfalls atypisch
Edebî Türlerden Cenk-Nâme/Gazavat-Nâme Karşılaştırması ve Muhammed Hanefî-Tabut Cengi’nin Yeni Bir Nüshası
No full text“Cenk-nâme”, das durch die Zusammensetzung der Begriffe „Cenk“, das „kämpfen“ bzw. „schlagen“ bedeutet und „Nâme“, das „Erlass“ bzw. „Brief“ bedeutet, ist „der Name, der prosaischen und in Versform verfassten Werken gegeben wurde, in denen die Kriege während der Zeit der Expansion des Islams und Hz. Ali als Anführer und vorbildlicher Mensch in diesen Kriegen thematisiert werden“. In den Cenk-nâmes, die beim türkischen Volk sehr beliebt sind, auswendig gelernt wurden und ein Genre sind, das mit der Zeit eine anonyme Form annahm, wird nicht nur von Hz. Ali, sondern auch von den Heldentaten der Söhne Hz. Alis, Hasans, Huseyns und Muhammed Hanefîs erzählt. Cenk-nâmes, in denen Muhammed Hanefî der Hauptheld ist und die mit Namen wie Dâsitân-ı Muhammed Hanefî, Kitâb-ı Muhammed Hanefî, Menâkıb-ı Muhammed Hanefî und Hikâye-i Muhammed Hanefî geschrieben worden sind, waren sehr beliebt und wurden auswendiggelernt. Sie wurden in Begleitung der Langhalslaute (Saz) vorgetragen und haben sich mit der Zeit in anonyme Werke verwandelt, deren Autoren nicht bekannt sind. Das vorgestellte Werk befindet sich zwischen den Seiten 151-170 im Schriftexemplar mit der Nummer 06 Mil Yz A 3158-2. Es ist ein Mesnevi, dessen Metrik im Versmaß fâilâtün fâilâtün fâilün geschrieben wurde und aus 491 Versen besteht. Auch wenn beim Bibliothekseintrag als Autor des Werkes, das mit Naschī-Schrift geschrieben wurde, Isa angegeben wurde, konnten keine biographischen Informationen über den Autor gefunden werden. Das festgestellte Werk ist trotz von Zeit zu Zeit übersprungenen Versen und Metrikfehlern als neues Exemplar der Cenk-nâme Tradition wertvoll. Das erste bekannte Exemplar der Muhammed Hanefî-Tabut Cenk-Schrift gehört Tursun Fakih und Cenk-nâmes, die zum gleichen Thema geschrieben wurden, wurden in großem Maße vom Werk Tursun Fakihs beeinflusst, auch wenn ihre Autoren unterschiedlich sind. Nachdem im Artikel Informationen über die Genres Cenk-nâme und Gazavat-Nâme, die die Fortführung der türkischen Epos-Tradition darstellen, sowie über historische Entwicklungen gegeben wurden, wurde versucht, sowohl die Gründe zu erklären, wieso die beiden Genres sich vermischt haben, als auch die Unterschiede zu erläutern. Die akademischen Arbeiten zum Thema Muhammed Hanefî wurden aufgelistet. Für Leser aus anderen Fachgebieten wurde neben dem transkribierten Text der Muhammed Hanefî-Tabut Cenk-Schrift auch die ins heutige Türkisch übersetzte Prosaform beigefügt.“Cenkname”, formed of the words “cenk”, which means fighting, batting, and “name”, which means edict, letter, is “the name of prosaic and poetic texts that put forward the battles carried out during the spreading of Islam, and Ali as a leader and a role model in these battles”. “Cenkname”, a genre which was loved and memorized by Turkish people and became anonymous over time, describes not only Ali’s braveries, but also the braveries of his sons Hasan, Huseyin and Muhammed. “Cenknames”, named Dasitan-i Muhammed Hanefi, Kitab-i Muhammed Hanefi, Menakib-i Muhammed Hanefi, Hikaye-i Muhammed Hanefi, etc. in which Muhammed Hanefi is the main character, were loved and memorized, read accompanied with saz and over time turned into anonymous texts whose author is unknown. The text in question is a “mesnevi” (a poetic form) which consists of 491 couplets, written with a specific prosody pattern (“failatün failatün failün”) and found between 151-170. leaves of the edition numbered 06 Mil Yz A 3158-2. Although the information that the author of this text, written in a certain calligraphy without vowel marks, is Isa exists in the library records, there is no biographical information about him. The text in question is valuable in terms of being a new example of the “cenkname” tradition, despite some omitted couplets and prosody defects. The first known example of the Muhammed Hanefi-Tabut Battle belongs to Tursun Fakih and although the authors of the “cenknames” written on the same subject are different, they were greatly influenced by Tursun Fakih’s text. The paper gives information about the genres of “cenkname” and “gazavatname”, which are a continuation of the Turkish epic tradition, and their historical development, and afterwards it discusses the differences between the two genres and the reasons of their intertwining. The paper lists academic studies on Muhammed Hanefi and presents the text of Muhammed Hanefi-Tabut Battle translated into contemporary Turkish for the readers from different fields together with its transcription.“Savaşma, vuruşma” anlamına gelen cenk kelimesine, ferman mektup anlamındaki “nâme”nin eklenmesi ile oluşan cenk-nâme edebiyatta “İslamiyetin yayılma dönemi içerisinde yapılan savaşların ve bu savaşlar içerisinde de Hz. Ali’nin lider ve örnek insan olarak öne çıkarıldığı mensur ve manzum eserlere verilen ad”dır. Türk halkı tarafından çok sevilip ezberlenen ve zamanla anonim bir hâl alan bir tür olan cenk-nâmelerde yalnızca Hz. Ali değil Hz. Ali’nin oğulları Hasan, Hüseyin ve Muhammed Hanefî’nin kahramanlıkları da anlatılır. Muhammed Hanefî’nin başkahraman olduğu, Dâsitân-ı Muhammed Hanefî, Kitâb-ı Muhammed Hanefî, Menâkıb-ı Muhammed Hanefî, Hikâye-i Muhammed Hanefî gibi isimlerle yazılan cenk-nâmeler çok sevilip ezberlenmiş, saz eşliğinde okunmuş ve zamanla yazarı belli olmayan, anonim eserlere dönüşmüştür.Tanıtılan eser, 06 Mil Yz A 3158-2 numaralı yazma nüshanın 151-170. varakları arasında bulunan, aruzun fâilâtün fâilâtün fâilün vezni ile kaleme alınmış 491 beyitlik bir mesnevidir. Harekesiz nesih hatla yazılmış eserin yazarının İsa olduğu bilgisi kütüphane kaydında verilmişse de bu bilgi teyit edilemedi, yazar hakkında biyografik bilgi bulunamadı. Tespit edilen eser, zaman zaman atlanan beyitleri ve aruz kusurlarına rağmen cenk-nâme geleneğinin yeni bir örneği olması yönüyle kıymetlidir. Muhammed Hanefî-Tabut cenginin bilinen ilk örneği Tursun Fakih’e aittir ve aynı konuda yazılan cenk-nâmeler yazarları farklı olsa da Tursun Fakih’in eserinden büyük ölçüde etkilenmişlerdir. Makalede Türk destan geleneğinin devamı niteliğinde olan cenk-nâme ve gazavat-nâme türleri ve tarihi gelişimleri hakkında bilgi verildikten sonra, iki türün iç içe geçme sebepleri ve birbirinden farklı tarafları açıklanmaya çalışıldı. Muhammed Hanefî konusunda yapılan akademik çalışmalar sıralandı. Farklı alanlardan okuyucular için Muhammed Hanefî-Tabut Cengi’nin transkripsiyonlu metninin yanında günümüz Türkçesine çevrildiği nesir hâli de verildi
Utilizing real-time location data for performance monitoring in healthcare systems:
No full textAlthough both public and private healthcare expenditures have been very high in the US when compared to other wealthy and industrialized nations; the quality and reach of services provided have constantly been in dispute. For that reason, improving the efficiency of healthcare services has emerged to be an important goal. However, the unpredictable and complex nature of the healthcare environments makes this goal difficult to achieve. Recently industrial engineering methods started being applied to improve hospital efficiencies. In addition, the utilization of technological advancements such as RFID based real time location systems (RTLS) in the healthcare sector provides an additional opportunity to apply industrial engineering methods to healthcare.
In this thesis, a data transformation and analysis framework is developed to be employed as part of a RTLS schema in a hospital unit. This framework consists of a software agent that is capable of monitoring, analyzing and predicting the performance of a process from RTLS data. The software agent performs its task by means of several statistical methods customized for specific purposes. It can identify steady state behavior, changes in the mean and transient states such as learning curves. Its main purpose is to detect the effects of modifications on the system and forecast the future performance level. A simulation model is built to produce tracking data of entities in a hypothetical hospital unit to be fed into the software agent via a database structure. This completes the framework and enables the testing of the developed agent using realistic data.
RTLSs typically suffer from accuracy issues which result in imperfect tracking data. This makes performance monitoring very infeasible or even impossible. To overcome this issue, a data cleaning algorithm is developed which can be fully integrated with the developed performance agent. The algorithm utilizes a Bayesian approach in a sliding window analysis. Testing of the data cleaning algorithm is performed for various scenarios.M.S.Includes bibliographical references (p. 60-61)by Cenk Demi
Production and characterization of nanoparticles from microalgae
No full textBu tez çalışması kapsamında yeşil sentez yöntemi ile hücre içi ve hücre
dışı zengin metobolitler içeren Galdieria sulphuraria mikroalgi kullanılarak
titanyum dioksit ve gümüş nanopartikül sentezleme ve kozmetik alanında
kullanım potansiyeli araştırılmıştır.
İlk olarak ön optimizasyon çalışmaları doğrultusunda metal çözeltisi
konsantrasyonu ile hücre dışı metal: süpernatant ve hücre içi metal: biyokütle
oranı iki farklı parametre olarak optimize edilmiştir. Nanopartiküllerin
karakterizasyon analizi UV-Vis spektrofotometre, Zeta Sizer Nanorange ve
antibakteriyal aktivite testi ile gerçekleştirilmiştir. 3,4 mM Titanyum (IV)
bis(amonyum laktat) hidroksit metal çözeltisi derişimi ve 7,8 metal
çözeltisi/süpernatant (v/v) oranı ile optimum koşullarda nanopartiküller ile elde
edilmiştir. Kontrollü bir şekilde ölçek büyüterek titanyum dioksit nanopartiküller
sentezlenmesi için Foto-Biyojenik Nanopartikül Reaktör (FBNP) sistemi
kullanılmıştır. Bu reaktör sisteminde sentez sırasında nanopartikül boyut ve
stabilitesini etkileyen inkübasyon süresi, pH ve karıştırma hızı parametleri
optimize edilmiştir. Bu çalışma doğrultusunda pH 8,5‟te 285 rpm karıştırma hızı
ve 22 dakikalık inkübasyon süresi sonunda ortalama 120 nm çapında nanopartikül
üretilmiştir. Optimum koşullarda sentezlenen titanyum dioksit nanopartiküllerinin
karakterizasyonu işlemi gerçekleştirilerek kozmetik alanda kullanım potansiyelleri
in vitro hücre kültürü denemeleri ile incelenmiştir.In this thesis, the aim is to investigate green synthesis of titanium dioxide
and silver nanoparticle from Galdieria sulphuraria microalgae that containing
rich intracellular and extracellular metabolites and potential use in cosmetics.
At first step, in the line with preliminary optimization studies, extracellular
metal: supernatant ratio and intracellular metal: biomass ratio with metal solution
concentration as two different parameters were optimized. The characterization
analysis of nanoparticles was carried out with UV-Vis spectrophotometer,
Zetasizer Nano Range, and antibacterial activity test. Nanoparticles synthesized
under optimum conditions with 3,4 mM Titanium (IV) bis (ammonium lactate)
dihydroxide metal solution concentration and 7,8 metal solution/ supernatant (v/v)
ratio. Photo-Biogenic Nanoparticle Reactor (FBNP) system was used to
synthesize titanium dioxide nanoparticles by scaling up in a controlled manner. In
this reactor system, incubation time, pH and mixing rate parameters that affect on
nanoparticle size and stability were optimized. In reactor system, titanium
nanoparticles with an average of 120 nm diameter were produced after 22 minutes
incubation period at a pH of 8,5 at 285 rpm. Titanium dioxide nanoparticles
produced under optimum conditions were characterized and the potential use in
cosmetics was also investigated by in vitro cell culture assays
Intraoperative doppler and b-mode sonography for the evaluation and management of renal tumors
No full textAMAÇ: Çalışmamızın amacı MRG ile evrelemesi yapılan ve nefrektomi kararı verilmiş olan böbrek tümörlerini İOUS ile incelemek, cerrahi ekip tarafından belirlenen parsiyel ya da radikal nefrektomi kararı üzerindeki etkisini araştırmak ve histopatolojik inceleme sonuçlarını altın standart kabul ederek İOUS bulguları ile MRG bulgularını karşılaştırmaktır. GEREÇ ve YÖNTEM: Temmuz 2008-Eylül 2009 tarihleri arasında DEÜTF Radyoloji AD'nda böbrek kitlesi saptanmış ya da dış kurumdan aynı bulgularla hastanemize başvurmuş toplam 53 tümörü olan 49 hasta ile çalışmaya başlanmıştır. Bazı hastalar çeşitli nedenlerle çalışma dışı bırakılmıştır. Sonuç olarak çalışmaya 46 tümörü olan 44 hasta dahil edilmiştir. DEÜTF Radyoloji kliniğinde elde olunan ve dış kurumda bu kriterleri karşılayan nitelikte elde olunmuş MRG incelemeleri çalışmaya dahil edilmiş ve tüm hastalara İOUS incelemesi yapılmıştır. MRG incelemeleri eş deneyimdeki 2 radyolog tarafından kör olarak değerlendirilmiştir. İOUS incelemeleri US konusunda deneyimli 3. bir radyolog tarafından yapılmış ve yorumlanmıştır. Patolojik spesimenler alanında deneyimli bir patolog tarafından değerlendirilmiştir. Çalışmanın birinci basamağındaæ operasyon öncesi MRG'leri değerlendiren iki radyolog, İOUS incelemelerini yapan 3. radyolog ve patolog radikal-parsiyel nefrektomi kriterlerini göz önüne alarak tümörlere uygulanmasını önerdikleri cerrahi tipini skorlamışlardır. Skorlama:1- Radikal yapılmalı 2- Parsiyel denenebilir 3- Parsiyel yapılmalı şeklinde yapılmıştır. Çalışmanın ikinci basamağındaæ değerlendirilebilir makroskopik spesimen fotoğrafı olan 25 hasta, eş deneyimdeki iki cerrah tarafından kör ve geriye dönük olarak değerlendirilmiş ve benzer şekilde önerilen cerrahi yöntem skorlanmıştır. Tüm değişkenlerin frekans dağılımına bakılmış, inceleme yöntemleri arasındaki korelasyonu değerlendirmek için Spearman testi uygulanmış, patoloji verileri altın standart alınarak değişkenler arasındaki ilişki ki-kare testi ile değerlendirilmiştir. BULGULAR: Çalışmanın birinci basamağında İOUS ve MRG bulguları altın standart olarak kabul edilen patoloji sonuçları ile kıyaslanmıştır. İOUS bulguları ile patoloji bulguları karşılaştırıldığında, İOUS'nin duyarlılık, özgüllük, pozitif öngörü, negatif öngörü ve doğruluk oranları %100 olarak bulunmuştur. Her iki MRG gözlemcisinin bulguları patoloji bulguları ile karşılaştırıldığında birinci gözlemci için duyarlılık %100, özgüllük %65.2, pozitif öngörü %74.2, negatif öngörü %100 ve doğruluk oranı %82.6 ve ikinci gözlemci için duyarlılık %91,3, özgüllük %69.5, pozitif öngörü %75, negatif öngörü %88.9 ve doğruluk oranı %80.4 bulunmuştur. Çalışmanın ikinci basamağında her iki cerrah arasındaki uyum %96 olarak saptanmış olup her iki cerrah toplam 5 hastada radikal nefrektomi uygulamış olmalarına rağmen geriye dönüp baktıklarında parsiyel nefrektomi yapılması gerektiğini düşünmüşlerdir. Bu hastaların tamamında İOUS patoloji ile benzer şekilde doğru tanı koymuştur. SONUÇ: MRG'nin kesin olarak radikal nefrektomi endikasyonu olan santral-periferik yerleşimli büyük lezyonlarda, renal sinüs uzanımı belirgin olan lezyonlarda ya da parsiyel nefrektomi endikasyonu olan periferik yerleşimli ve renal sinüse uzak lezyonlarda doğru tanı oranı oldukça yüksektir. Ancak özellikle santral yerleşimli ve renal sinüs uzanımı net olmayan lezyonlarda MRG'nin doğru tanı oranı belirgin olarak azalmaktadır. İOUS'nin ise hem kesin olarak radikal ya da parsiyel nefrektomi endikasyonu olan olguların tanısında hem de MRG'nin değerlendirme güçlüğü çektiği santral yerleşimli tümörlerde tama yakın doğru tanı oranı mevcuttur. Sonuç olarak MRG ile net olarak tanımlanamayan santral yerleşimli, renal sinüs uzanımı kuşkulu, küçük lezyonları olan seçilmiş olgularda İOUS kullanılabilir bir inceleme yöntemidir. İOUS özellikle parsiyel nefrektomi uygulanacak lezyonlarda lezyonun sınır özelliklerinin tanımlanması ve aberan vasküler yapıların varlığını değerlendirmek için kullanılabilir. İOUS kullanımı operasyonlarda gelişebilecek kanama nedenli koplikasyonları ve morbidite oranlarını azaltabilir. PURPOSE: Main aim of our study is reexamining renal tumors-whose staging were evaluated by MRI which leaded to nephrectomy decisions-by using IOUS and inspecting effects of IOUS results on partial or radical nephrectomy decisions made by surgical groups and comparing findings of MRI and IOUS utilizing results of histopathologic examination as the gold standart. MATERIALS AND METHODS: Study attempt was initiated with participation of patients whose renal masses were detected in our instution or patients applied to our institution having similar results in other instutions during time period between July 2008 and September 2009, with a total of 49 patients having 53 renal tumors. Some of the patients were excluded due to various reasons, as a result, 44 patients having 46 tumors were included in our study. MRI scans obtained in our instution or MRI scans acquired in other instutions satisfying criteria of our instution were used in our research and IOUS scan were applied to all of the patients. MRI scans were evaluated in a blind study by two radiologists having same level of experience and expertise. IOUS examinations were performed and annotated by a third radiologist specialized in ultrasound. Pathologic specimens were examined and evaluated by a pathologist experienced in his respected field of expertise. In the first part of our study, two radiologists who evaluated pre-op MRI data, the third radiologist who applied IOUS scans and the pathologist scored surgical method they suggest while taking radical-partial nephrectomy criteria into account. Following scoring scheme was used: 1:"Radical nephrectomy decision" 2:"Partial nephrectomy may be given a chance" 3:"Only partial nephrectomy must be applied". In the second part of our study, 25 patients with assessable macroscopic specimen photographs were evaluated retrospectively by two surgeons with similar level of experience and expertise and suggested surgical method was scored using same scoring scheme mentioned above. In our study, spectra of all variables were checked, Spearman Test was applied to evaluate correlation between inspection methods and "Chi-Square" test was utilized to inspect correlation between variables by using pathological data as the gold standart. RESULTS: In the first part of the study, IOUS and MRI findings were compared to pathological results which were used as the gold standart. In a comparison between pathological findings and IOUS findings, specificity, sensitivity, negative predictive value, pozitive predictive value, ratio of accuracy, were observed to be 100% in each category. Furthermore, in a comparision between the findings of two MRI reviewers and findings of pathological inspection, for the first expert sensitivity, specificity, negative predictive value, pozitive predictive value, ratio of accuracy was respectively, 100%, 65.2%, 74.2%, 100%, 82.6%, and for the second expert sensitivity, specificity, negative predictive value, pozitive predictive value, ratio of accuracy was respectively, 91.3%, 69.5%, 75%, 88.9%, 80.4%. In the second part of the study, it was found out that coherence between two surgical experts was observed to be 96% and both of the experts decided applying partial nephrectomy would be more appropriate on 5 patients though they decided to apply radical nephrectomy on those patients. It was also revealed that diagnoses of IOUS methodology and pathologic inspection were in complete coherence on these 5 patients. CONCLUSION : Rate of the correct diagnosis using MRI in cases of definite radical or partial nephrectomy indications was observed to be considerably high, however, in cases of renal sinus invasion was not clear and central localized lesions, diagnostic capabilities of MRI was revealed to decrease significantly but IOUS's diagnostic capabilites in cases of definite radical or partial nephrectomy indications and incases of renal sinus invasion was not clear and central localized lesions, where MRI had difficulties in correct diagnose,observed to be close to 100%. As a result, in selected cases having renal sinus invasion was not clear, central localized and small lesions which cannot be clearly detected by MRI, IOUS is a useful method in examination. Additionally, IOUS can also be used in evaluating existence of abberan vascular structures and determining border properties of the lesion especially for the cases subject to a partial nephrectomy operation. Usage of IOUS can significantly lower complications during operation due to hemorrhage and rates of morbidity
Böbrek tümörlerinde intraoperatif gri-skala ve doppler ultrasonografinin parsiyel-radikal nefrektomi kararı alınmasındaki yeri
No full textThe Necessity of Upper Extremity Neurologic Examination while Evaluating Breast Pain
No full textWOS: 000580658100007Introduction:Breast pain is one of the most frequent complaints and occurs in 45-69% of all women. Cervical disc herniation is a common cause of cervical radiculopathy with an incidence rate of 18.6 per 100,000, and it should be considered as a cause of breast pain.Objective:To identify the extent to which upper extremity neurologic findings and cervical root disorders accompany breast pain.Methods:We prospectively collected clinical features of patients with breast pain. An upper extremity neurologic examination was performed in patients and controls. Patients who had neurologic findings underwent cervical spine magnetic resonance imaging (MRI) to identify cervical root disorders.Results:Out of the 554 participants, 233 had breast pain, and 321 were controls. Women with breast pain had more numbness (116 [49.8%] vs. 104 [32.4%],p 0.05). The number of women with one neurologic finding was significantly greater in the group with breast pain (119 [51.1%] vs. 111 [34.6%],p< 0.001). Ninety (16.2%) patients underwent a cervical vertebra MRI, which showed that 86 (95.6%) patients had cervical root disorders including 21 (23.3%) cases of bulging, 9 (10%) of annular tear, and 56 (62.2%) of central disc protrusion; 4 (4.4%) patients had normal findings. The multivariate logistic regression analysis revealed that age was the only significant predictor of neurologic findings in patients with breast pain (p< 0.05, OR: 1.02, CI: 1.002-1.053).Conclusions:Cervical root disorders should be considered as a cause of extramammary breast pain
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