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Ugurluer G, Zoto Mustafayev T, Gungor G, Abacioglu U, Atalar B, Ozyar E. Online Adaptive Magnetic Resonance-guided Radiation Therapy for Gynaecological Cancers: Preliminary Results of Feasibility and Outcome. Clin Oncol (R Coll Radiol) 2024; 36:12-20. [PMID: 38016848 DOI: 10.1016/j.clon.2023.11.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 07/17/2023] [Accepted: 11/17/2023] [Indexed: 11/30/2023]
Abstract
AIMS To present the preliminary results on the clinical utilisation of an online daily adaptive magnetic resonance-guided radiation therapy (MRgRT) for various gynaecological cancers. MATERIALS AND METHODS Twelve patients treated between September 2018 and June 2022 were included. Six patients (50%) were treated with pelvic radiation therapy followed by MRgRT boost as brachytherapy boost was ineligible or unavailable, three patients (25%) were treated with pelvic MRgRT followed by high dose rate brachytherapy, two patients (16.7%) were treated with only MRgRT, one patient (8.3%) was treated with linear accelerator-based radiation therapy followed by MRgRT boost for bulky iliac lymph nodes. RESULTS The median age was 56.5 years (range 31-86 years). Eight patients (66.7%) had a complete response, three patients (25%) had a partial response and one patient (8.3%) died due to acute renal failure. The mean follow-up time was 11.2 months (range 3.1-42.6 months). The estimated 1-year overall survival was 88.9%. The median treatment time was 47 days (range 10-87 days). During external beam radiation therapy, 10 (83.3%) patients had concomitant chemoradiotherapy. Pelvic external beam radiation therapy doses for all cohorts were 45-50.4 Gy with a fraction dose of 1.8 Gy. The median magnetic resonance-guided boost dose was 32 Gy (range 20-50 Gy) and fraction doses ranged between 4 and 10 Gy. Three patients were treated with intracavitary high dose rate brachytherapy (26-28 Gy in four to five fractions). None of the patients had grade >3 late genitourinary toxicities. CONCLUSION MRgRT is reliable and clinically feasible for treating patients with gynaecological cancers alone or in combination with brachytherapy with an acceptable toxicity and outcome. MRgRT boost could be an option when brachytherapy is not available or ineligible.
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Affiliation(s)
- G Ugurluer
- Department of Radiation Oncology, Acibadem MAA University School of Medicine, Istanbul, Turkey.
| | - T Zoto Mustafayev
- Department of Radiation Oncology, Acibadem Maslak Hospital, Istanbul, Turkey
| | - G Gungor
- Department of Radiation Oncology, Acibadem Maslak Hospital, Istanbul, Turkey
| | - U Abacioglu
- Department of Radiation Oncology, Acibadem MAA University School of Medicine, Istanbul, Turkey
| | - B Atalar
- Department of Radiation Oncology, Acibadem MAA University School of Medicine, Istanbul, Turkey
| | - E Ozyar
- Department of Radiation Oncology, Acibadem MAA University School of Medicine, Istanbul, Turkey
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Azria D, Andratschke N, Balermpas P, Boldrini L, Bourdais R, Bruynzeel A, Chuong M, De Ridder M, Fenoglietto P, Gevaert T, Gungor G, Hardy L, Kandiban S, Lagerwaard F, Maingon P, Marciscano A, Mittauer K, Nagar H, Paragios N, Pennell R, Placidi L, Riou O, Simon J, Tanadini-Lang S, Ugurluer G, Valdes S, Valentini V, Vanspeybroeck B, Ozyar E. A Multi-Centric Evaluation of AI-Driven OARs Low Field MRgRT Pelvic /Abdomen Contouring. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Azria D, Boldrini L, De Ridder M, Fenoglietto P, Gambacorta M, Gevaert T, Gungor G, Lagerwaard F, Marciscano A, Michalet M, Nagar H, Pennell R, Serbez I, Vanspeybroeck B, Zoto Mustafayev T, Caffaro A, Hardy L, Kandiban S, Oumani A, Roque T, Paragios N, Shreshtha K, Ozyar E. OC-0463 AI surpassing human expert: a multi-centric evaluation for organ at risk delineation. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02599-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Gungor G, Klausner G, Gur G, Serbez I, Temur B, Caffaro A, Hardy L, Kandiban S, Oumani A, Bertrand B, Shreshtha K, Roque T, Atalar B, Paragios N, Ozyar E. PO-1890 AI-based OAR delineation in brain T1w-MRI: Overcoming Inter- and Intra-observer variability. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03853-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fenoglietto P, Gevaert T, Boussaer M, Delasalles E, Ioannidou D, Shreshtha K, Roque T, Paragios N, Azria D, Ozyar E, Gungor G. MO-0648 Clinical evaluation of self-learning GAN based pseudo-CT generation software for low field pelvic MR. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02406-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Guneri B, Gungor G. Morphological Features of the Coccyx in the Turkish Population and Interrelationships Among the Parameters: A Computerized Tomography-Based Analysis. Cureus 2021; 13:e19687. [PMID: 34934564 PMCID: PMC8683969 DOI: 10.7759/cureus.19687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2021] [Indexed: 11/09/2022] Open
Abstract
Introduction The coccyx is well-known to be a highly variable structure considering its morphology. To our knowledge, the relationship between the coccygeal types and other morphological features has not been studied yet. In addition to the interrelations among morphological parameters, this study investigated the morphology and morphometry of coccyx more extensively in the adult Turkish population using computerized tomography images. Methods Five hundred subjects who underwent pelvic computerized tomography were included in this study. In addition to coccyx type and the counts of coccygeal vertebrae and segments, the presence of coccygeal deviation, sacrococcygeal joint (SCJ) fusion, SCJ subluxation, intercoccygeal joint (ICJ) fusion, and coccygeal spicule were evaluated. The coccygeal length, sacrococcygeal angle, and intercoccygeal angle were measured on the digital workstation. The findings were subjected to statistical analyses. Results The coccygeal vertebra count ranged between three to five, with an average of 4.04 ± 0.48. The range of coccygeal segment count was between one and five, with an average of 2.53 ± 1.02. ICJ fusion in any segment, SCJ fusion, and SCJ subluxation were identified in 397 subjects (79.4%), 343 subjects (68.6%), and 17 subjects (3.4%), respectively. The coccyx types from the most common to the least common were as follows: type 2, type 1, type 3, type 4, and type 5. Coccygeal deviation to the left side was observed in 71 subjects (14.2%), while coccygeal deviation to the right side was observed in 61 subjects (12.2%). A coccygeal spicule was identified in 73 subjects (14.6%). The subjects’ mean age demonstrated no significant difference considering the ICJ fusion (p=0.271), SCJ subluxation (p=0.51), coccygeal spicule (p=0.337), features of coccygeal deviation (p=0.83), and coccyx types (p=0.11). The subjects with SCJ fusion (50.7 ± 18.3 years) were significantly older than the subjects without SCJ fusion (46.5 ± 18.5 years) (p=0.016). The differences between the coccyx types considering the rate of SCJ fusion (p=0.002), ICJ fusion (p=0.04), and spicule presence (p<0.001) as well as the coccygeal vertebra count (p<0.001) were significant. Conclusion The presence of coccygeal spicule, a risk factor for coccydynia, is reported to be 14.6% in this study group that represents the Turkish population. This study indicates an association between the coccyx types and the frequency of SCJ fusion, ICJ fusion, and spicule presence and consequently suggests the significance of the coccyx type among the morphological features to cause susceptibility to coccydynia. Due to the multiplicity of the pain generators in the coccygeal region that is established by previous reports, the comparisons of different human populations and the knowledge on the interrelations between the morphologic parameters might facilitate the comprehension of the etiology of coccydynia. The clarification of interrelationship existence among the coccygeal morphological parameters requires further investigations.
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Affiliation(s)
- Bulent Guneri
- Orthopaedics and Traumatology, Adana City Training Hospital, Adana, TUR
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Chuong M, Herrera R, Mustafayev T, Gungor G, Ugurluer G, Atalar B, Kotecha R, Hall M, Rubens M, Mittauer K, Contreras J, Gutierrez A, Kalman N, Alvarez D, Romaguera T, McCulloch J, Garcia J, Kaiser A, Mehta M, Ozyar E. Multi-Institutional Outcomes of Stereotactic Magnetic Resonance Image-Guided Adaptive Radiation Therapy (SMART) With Median Biologically Effective Dose of 100 Gy10 for Oligometastases. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Chuong M, Kirsch C, Herrera R, Rubens M, Gungor G, Schaff E, Dolan J, Kim J, Mittauer K, Kotecha R, Gutierrez A, Doemer A, Ugurluer G, Kwon D, Khan G, Alvarez D, Ucar A, Asbun H, Ozyar E, Parikh P. Long-Term Multi-Institutional Outcomes of 5-Fraction Ablative Stereotactic MR-Guided Adaptive Radiation Therapy (SMART) for Inoperable Pancreas Cancer With Median Prescribed Biologically Effective Dose of 100 Gy10. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gungor G, Michalet M, Lombard A, Roque T, Atalar B, Temur B, Serbez I, Azria D, de Vitry L, Riou O, Paragios N, Ozyar E, Fenoglietto P. Human-Level Precision Upper Abdominal OAR Contouring With Anatomically Preserving Deep Learning During Magnetic Resonance Imaging Guided Adaptive Radiotherapy (MRgRT). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zoto Mustafayev T, Ugurluer G, Gungor G, Atalar B, Serkizyan A, Abacioglu M, Agaoglu F, Sengoz M, Guven K, Ozyar E. PO-1208 Stereotactic MR-guided online adaptive radiation therapy for management of pancreatic malignancies. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07659-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mustafayev T, Atalar B, Gungor G, Sengoz M, Abacioglu U, Ozyar E. Feasibility of Stereotactic MR-Guided Adaptive Radiotherapy in Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Girisgen I, Gungor G, Yuksel S. Evaluation of the Parathyroid Gland using Ultrasound Elastography in Children with Mineral Bone Disorder Due to Chronic Kidney Disease. Turk J Nephrol 2020; 29:45-51. [DOI: 10.5152/turkjnephrol.2020.3859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
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Mustafayev T, Sahin B, Gungor G, Aydin G, Serbez I, Teymur B, Gur G, Arabaci G, Atalar B, Yapici B, Abacioglu U, Agaoglu F, Sengoz M, Ozyar E. Time Analysis in Magnetic Resonance Image-Guided Radiotherapy Workflow. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yildiz E, Gungor G, Yilmaz H, Gocmen D. Changes in bioaccessibility, phenolic content and antioxidant capacity of novel crackers with turmeric (Curcuma longa L.) and mahaleb (Prunus mahaleb L.) powders. Quality Assurance and Safety of Crops & Foods 2019. [DOI: 10.3920/qas2018.1334] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- E. Yildiz
- Uludag University, Faculty of Agriculture, Department of Food Engineering, Gorukle-Bursa 16059, Turkey
| | - G. Gungor
- Uludag University, Faculty of Agriculture, Department of Food Engineering, Gorukle-Bursa 16059, Turkey
| | - H. Yilmaz
- Uludag University, Faculty of Agriculture, Department of Food Engineering, Gorukle-Bursa 16059, Turkey
| | - D. Gocmen
- Uludag University, Faculty of Agriculture, Department of Food Engineering, Gorukle-Bursa 16059, Turkey
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Atalar B, Mustafayev T, Sio T, Sahin B, Gungor G, Aydin G, Yapici B, Ozyar E. P2.16-15 Toxicities and Survival after Stereotactic Ablative Radiotherapy (SABR) for Centrally Located Lung Tumors. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ozmen I, Karakurt Z, Salturk C, Kargin F, Takir HB, Aksoy E, Sari R, Celik E, Tuncay EA, Yildirim E, Mocin OY, Adiguzel N, Oztas S, Gungor S, Gungor G. Can N-terminal pro B-type natriuretic peptide, neutrophil-to-lymphocyte ratio, C-reactive protein help to predict short and long term mortality? ACTA ACUST UNITED AC 2016; 117:587-594. [PMID: 27826974 DOI: 10.4149/bll_2016_114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND There is limited data about ICU, short and long-term mortality prediction of severe CAP with neutrophil-to-lymphocyte ratio (NLR): N-terminal proB- type natriuretic peptide (NT-proBNP): C-reactive protein (CRP). AIM Besides the known severity indexes of ICU, can NLR, NT-proBNP, CRP predict ICU, short and long term mortality? METHODS A retrospective cohort study was carried out in a level III ICU of a tertiary training hospital for chest diseases and thoracic surgery. RESULTS Over the study period, a total of 143 patients were enrolled in the study. The APACHE II scoring showed a significantly higher predicting performance for ICU mortality (p = 0.002). The performance for predicting short term mortality NLR (p = 0.039) and long term mortality NTproBNP (p = 0.002) had a significantly higher performance. The survival analysis revealed that mortality was significantly higher in patients with CURB65 score ≥ 4 (p = 0.047). CONCLUSION NLR, NTproBNP > 2000pg/mL can be used to predict pneumonia severity in ICU alike CURB65 and PSI. Higher NLR, APACHE II and atrial fibrillation can cause an important mortality factor in long term. Consequently, clinicians should take an attention for good cardiac evaluation and cardiac follow-up of patients with CAP (Tab. 4, Fig. 3, Ref. 36).
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Bozkurt P, Gungor G, Ozen Z, Unlusoy EO, Ugur O, Sayilgan C, Buluc S, Guneyli C, Colakoglu N, Umutoglu T, Beyoglu I, Abut Y, Pekel AF, Basaranoglu G, Kocoglu FO, Kartal E, Emre IE, Selcukcan Erol C, Pismisoglu H, Salihoglu Z, Yuceyar L, Erolcay H, Karaca S, Turgut P, Gulsecen S. Abstract PR285. Anesth Analg 2016. [DOI: 10.1213/01.ane.0000492682.07025.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Yurttutan N, Gungor G, Bilal N, Kizildag B, Baykara M, Sarica MA. Interpretation of thyroid glands in a group of healthy children: real-time ultrasonography elastography study. J Pediatr Endocrinol Metab 2016; 29:933-7. [PMID: 27159916 DOI: 10.1515/jpem-2015-0409] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 03/29/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND This study aimed to determine the strain index (SI) of normal thyroid parenchyma in a group of healthy children, using ultrasound elastography (USE). METHODS The participants consisted of 54 healthy children. The USE of the normal thyroid parenchyma was performed by using the Hitachi Hi VisionPreirus model ultrasonography (US) device. By following sinusoidal waves at the base of the screen, regular and slight compressions and decompressions were made by the transducer. After the regular sinusoidal waves were acquired, standard region of interest (ROI) circles were used to measure the SI values of the thyroid glands by placing one ROI on a superficial part of the normal thyroid gland parenchyma and the other on the adjacent soft tissue at the same depth (within 10-mm proximity). Three measurements were obtained for each (right and left) thyroid gland, and the mean value was used for statistics. RESULTS The mean SI value of normal thyroid glands was 0.54±0.38 for the whole group. There was no statistically significant difference between girls and boys on the basis of age, weight, height, BMI (body mass index), and thyroid SI values (p=0.15, p=0.18, p=0.12, p=0.31, and p=0.96, respectively). No correlation was found between thyroid gland SI values and each of the following variables: age (r=0.22, p=0.15), gender (r=0.007, p=0.96), and BMI (r=0.26, p=0.09). CONCLUSIONS The study determined the normal elasticity values of thyroid glands in healthy children. Such information can serve as a baseline from which thyroid diseases can be examined.
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Menzilcioglu MS, Duymus M, Citil S, Gungor G, Saglam M, Gungor O, Boysan SN, Sarıca A, Avcu S. The comparison of resistivity index and strain index values in the ultrasonographic evaluation of chronic kidney disease. Radiol Med 2016; 121:681-7. [PMID: 27290720 DOI: 10.1007/s11547-016-0652-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 05/23/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Chronic kidney disease (CKD) is a disorder progressing to end-stage kidney failure. Early diagnosis and treatment are important for medical care. The aim of this prospective study was to define the strain index (SI) and resistivity index (RI) values in the same CKD group for each kidney separately at the same time, and also to compare the efficacy of SI and RI in the differentiation of normal population and CKD patients. MATERIALS AND METHODS Toshiba Aplio 500 USG device and 3.5-5 MHz convex probe were used for USG, CDUSG, and USG elastography examinations. The patients were referred to radiology clinique from nephrology and endocrinology cliniques after GFR calculation. Patients with renal cyst, tumor, or obstructive renal disease were excluded. Healthy volunteers according to laboratory and clinical examinations were selected from non-kidney disease patients. RESULTS A total of 121 CKD (68 men, 53 women) and 40 healthy volunteers (19 men, 21 women) were participated. The mean SI and RI values of CKD were significantly higher than the normal healthy volunteers (p < 0.05). The SI and RI values of right and left kidney did not show any difference in CKD patients (p values were 0.381 for SI and 0.821 for RI). The sensitivity and the specificity of the SI were higher than RI. CONCLUSION The RI and SI values of kidneys in CKD patients were significantly higher than those of apparently normal kidneys. SI was more sensitive than RI in our study. Determining cut-off SI and RI values between normal and damaged renal parenchyma can help in the diagnosis and follow up of CKD patients. ADVANCES IN KNOWLEDGE To the best of our knowledge, this is the first study comparing RI and SI in CKD patients, and SI is found to be more sensitive than RI for the evaluation of CKD.
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Affiliation(s)
| | - Mahmut Duymus
- Department of Radiology, Gazi University School of Medicine, Ankara, Turkey
| | - Serdal Citil
- Clinic of Radiology, Kahramanmaras Necip Fazıl City Hospital, Kahramanmaras, Turkey
| | - Gulay Gungor
- Clinic of Radiology, Kahramanmaras Necip Fazıl City Hospital, Kahramanmaras, Turkey
| | - Mustafa Saglam
- Clinic of Nephrology, Turkey Kahramanmaras Necip Fazıl City Hospital, Kahramanmaras, Turkey
| | - Ozkan Gungor
- Clinic of Nephrology, Turkey Kahramanmaras Necip Fazıl City Hospital, Kahramanmaras, Turkey
| | - Serife Nur Boysan
- Clinic of Endocrinology, Kahramanmaras Necip Fazıl City Hospital, Kahramanmaras, Turkey
| | - Akif Sarıca
- Department of Radiology, Kahramanmaras University School of Medicine, Kahramanmaras, Turkey
| | - Serhat Avcu
- Department of Radiology, Gazi University School of Medicine, Ankara, Turkey
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Gungor G, Yurttutan N, Bilal N, Menzilcioglu MS, Duymus M, Avcu S, Citil S. Evaluation of Parotid Glands With Real-time Ultrasound Elastography in Children. J Ultrasound Med 2016; 35:611-615. [PMID: 26903660 DOI: 10.7863/ultra.15.03073] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 07/23/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES The aim of this study was to determine the strain index for parotid glands in children by using ultrasound elastography. METHODS In this prospective study, apparently healthy children were referred from the ear-nose-throat clinic to the radiology clinic for elastographic examinations. Conventional sonographic and elastographic examinations of the parotid glands were performed. A linear 5-12-MHz transducer was used to obtain the images. RESULTS A total of 54 children were enrolled in this prospective study. The normal mean strain index value ± SD for the parotid glands was 1.24 ± 0.67 (range, 0.29-1.39) regardless of sex. The mean age of girls was 7.42 ± 2.94 years (range, 3-14 years), and the age of boys was 8.50 ± 3.46 years (range, 4-16 years). The strain index values for the parotid glands in boys was 1.25 ± 0.76, and in girls it was 1.22 ± 0.55. There was no statistically significant difference in the strain index values between girls and boys (P= .986). There was no correlation between the strain index and age (r = 0.026) or body mass index (r = 0.066). CONCLUSIONS This study determined the mean strain index values for apparently healthy children. Such information can serve as a baseline from which pathologic parotid diseases can be diagnosed with ultrasound elastography in combination with other sonographic criteria.
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Affiliation(s)
- Gulay Gungor
- Clinics of Radiology (G.G., S.C.) and Ear-Nose-Throat (N.B.), Kahramanmaras Necip Fazıl City Hospital, Kahramanmaras, Turkey; Department of Radiology, Kahramanmaras University School of Medicine, Kahramanmaras, Turkey (N.Y.); and Department of Radiology, Gazi University School of Medicine, Ankara, Turkey (M.S.M., M.D., S.A.)
| | | | - Nagihan Bilal
- Clinics of Radiology (G.G., S.C.) and Ear-Nose-Throat (N.B.), Kahramanmaras Necip Fazıl City Hospital, Kahramanmaras, Turkey; Department of Radiology, Kahramanmaras University School of Medicine, Kahramanmaras, Turkey (N.Y.); and Department of Radiology, Gazi University School of Medicine, Ankara, Turkey (M.S.M., M.D., S.A.)
| | | | - Mahmut Duymus
- Clinics of Radiology (G.G., S.C.) and Ear-Nose-Throat (N.B.), Kahramanmaras Necip Fazıl City Hospital, Kahramanmaras, Turkey; Department of Radiology, Kahramanmaras University School of Medicine, Kahramanmaras, Turkey (N.Y.); and Department of Radiology, Gazi University School of Medicine, Ankara, Turkey (M.S.M., M.D., S.A.)
| | - Serhat Avcu
- Clinics of Radiology (G.G., S.C.) and Ear-Nose-Throat (N.B.), Kahramanmaras Necip Fazıl City Hospital, Kahramanmaras, Turkey; Department of Radiology, Kahramanmaras University School of Medicine, Kahramanmaras, Turkey (N.Y.); and Department of Radiology, Gazi University School of Medicine, Ankara, Turkey (M.S.M., M.D., S.A.)
| | - Serdal Citil
- Clinics of Radiology (G.G., S.C.) and Ear-Nose-Throat (N.B.), Kahramanmaras Necip Fazıl City Hospital, Kahramanmaras, Turkey; Department of Radiology, Kahramanmaras University School of Medicine, Kahramanmaras, Turkey (N.Y.); and Department of Radiology, Gazi University School of Medicine, Ankara, Turkey (M.S.M., M.D., S.A.)
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Menzilcioglu MS, Duymus M, Citil S, Avcu S, Gungor G, Sahin T, Boysan SN, Altunoren O, Sarica A. Strain wave elastography for evaluation of renal parenchyma in chronic kidney disease. Br J Radiol 2015; 88:20140714. [PMID: 25806412 DOI: 10.1259/bjr.20140714] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE Chronic kidney disease (CKD) is an important and costly health problem in developed countries and has a tendency to progress to end-stage renal disease regardless of the aetiology. This progress ends in interstitial fibrosis, which decreases the elasticity of tissue. Elastography is a developing technique to assess tissue elasticity. The aim of this study was to determine the difference of strain index (SI) value of renal parenchyma between patients with CKD and healthy individuals. In addition, SI differences of inter-stages were studied. METHODS Toshiba (Toshiba Medical Systems Corporation, Otawara, Japan) Aplio™ 500 ultrasound device and 3.5- to 5.0-MHz convex probe were used for the elastography examinations. RESULTS A total of 58 patients with CKD from nephrology and endocrinology clinics (30 males and 28 females; mean age, 56.14 ± 11.60 years) and 40 normal healthy individuals (19 males and 21 females; mean age, 51.70 ± 11.71 years) were included in this prospective study. The mean SI of normal healthy individuals and patients with CKD (regardless of stages) was 0.42 ± 0.30 and 1.81 ± 0.88, respectively (p < 0.001). SI values were not statistically significant among the CKD stages (except CKD Stages 1 and 3). The area under the receiver operating characteristic curve was 0.956 for SI. The optimal cut-off value for the prediction of CKD was 0.935 (sensitivity, 88% and specificity, 95%). CONCLUSION SI value of sonoelastography can be used to differentiate patients with CKD and healthy individuals. Sonoelastography is an acceptable technique to approach patients with CKD, but we have not shown that it can reliably differentiate different stages. ADVANCES IN KNOWLEDGE Determining a cut-off SI value between normal and diseased renal parenchyma can help in the diagnosis of CKD.
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Affiliation(s)
- M S Menzilcioglu
- 1 Department of Radiology, Gazi University School of Medicine, Ankara, Turkey
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Menzilcioglu MS, Duymus M, Gungor G, Citil S, Sahin T, Boysan SN, Sarica A. The value of real-time ultrasound elastography in chronic autoimmune thyroiditis. Br J Radiol 2014; 87:20140604. [PMID: 25315887 DOI: 10.1259/bjr.20140604] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Chronic autoimmune thyroiditis (CAT) (chronic lymphocytic thyroiditis-Hashimoto's thyroiditis), which is the most common inflammatory disorder of the thyroid gland, causes hypothyroidism. Ultrasound elastography is a newly developed sonographic technique that provides an estimation of tissue elasticity by measuring the degree of tissue displacement under the application of an external force. In this study, our aim was to evaluate the accuracy of strain index ratio with real-time ultrasound elastography and to calculate the cut-off point for the diagnosis of CAT. Our aim was also to lead further studies on other pathological changes such as lymphoma, malign nodules etc. based on CAT by using this cut-off point. The gains from this study and further studies will assist clinical diagnoses and follow-up. METHODS Aplio™ 500 ultrasound machine (Toshiba Medical Systems Co. Ltd, Otawara, Japan) with linear 4.8-11.0 MHz transducers and elastography software was used. Routine B-mode (dimensions and parenchymal echogenicity) ultrasound evaluation was performed prior to the ultrasound elastography. RESULTS A total of 31 randomized patients (3 males, 28 females) with a mean age of 39.13 ± 10.16 years (range, 16-58 years) with CAT and 21 healthy controls (6 males, 15 females) with mean age of 34.67 ± 16.31 years (range, 14-81 years) were prospectively examined. The mean values of thyroid-stimulating hormone (TSH; normal TSH value is 0.27-4.20 IU ml(-1)) and anti-thyroid peroxidase (anti-TPO; normal anti-TPO value is 0-34 IU ml(-1)) were 3.40 ± 2.70 and 373.66 ± 148.94 IU ml(-1), respectively. No correlation was detected between serum TSH and thyroid tissue strain index (Spearman r coefficient of TSH was -0.290). Positive-sided correlation was detected between anti-TPO values and thyroid tissue strain index ratio (Spearman r coefficient of anti-TPO was 0.682). The median strain index ratio of patients with CAT (1.39 ± 0.72) was significantly higher than the mean ratio of the controls (0.76 ± 0.55). The area under the receiver operating characteristic curve was 0.775 (95% confidence interval). The optimal cut-off value (in which the sum of sensitivity and specificity was highest) for the prediction of diffuse thyroid pathology was 0.677. For this cut-off ratio, thyroid stiffness had 96% sensitivity and 67% specificity. A total of 30 of 31 patients (96%) and a total of 7 of 21 healthy controls (33%) exceeded the cut-off points. CONCLUSION The strain index ratio was higher in CAT than in normal thyroid parenchyma in real-time ultrasound elastography. Thus, it seems to be a useful method for the assessment of CAT with real-time ultrasound elastography, and further studies assessing the correlation of sonoelastography findings and histopathological subtypes of CAT would enrich the findings of the present study. ADVANCES IN KNOWLEDGE In our study, we detected the stiffness ratio of the thyroid tissue in patients with CAT. The cut-off value should be helpful for diagnosis or follow-up of the recently developed lesions such as lymphoma, malign nodule, etc. based on CAT. This study should also encourage new studies about CAT and ultrasound elastography.
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Affiliation(s)
- M S Menzilcioglu
- 1 Department of Radiology, Gazi University, Faculty of Medicine, Ankara, Turkey
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Miyazaki N, Matsumoto J, Alberici F, Palmisano A, Maritati F, Oliva E, Buzio C, Vaglio A, Mjoen G, Norby GE, Vikse BE, Svarstad E, Rune B, Knut A, Szymczak M, Kuzniar J, Kopec W, Marchewka Z, Klinger M, Arrizabalaga P, Silvarino R, Sant F, Espinosa G, Sole M, Cervera R, Gude D, Chennamsetty S, Demin A, Kozlov V, Lisukov I, Kotova O, Sizikov A, Sergeevicheva V, Demina L, Borjesson O, Wendt M, Avik A, Qureshi AR, Bratt J, Miller EJ, Gunnarsson I, Bruchfeld A, Sugiyama K, Hasegawa M, Yamamoto K, Hayashi H, Koide S, Murakami K, Tomita M, Yoshida S, Yuzawa Y, Yew S, Jayne D, Westman K, Hoglund P, Flossman O, Mahr A, Luqmani R, Robson J, Thervet E, Levi C, Guiard E, Roland M, Nochy D, Daniliuc C, Guillevin L, Mouthon L, Jacquot C, Karras A, Kimura Y, Morita H, Debiec H, Yamada H, Miura N, Banno S, Ronco P, Imai H, Shin DH, Famee D, Koo HM, Han SH, Choi KH, Yoo TH, Kang SW, Fofi C, Fofi C, Scabbia L, Festuccia F, Stoppacciaro A, Mene' P, Shimizu A, Fukui M, MII A, Kaneko T, Masuda Y, Iino Y, Katayama Y, Fukuda Y, Kuroki A, Matsumoto K, Akizawa T, Jurubita R, Ismail G, Bobeica R, Rusu E, Zilisteanu D, Andronesi A, Motoi O, Ditoiu V, Copaci I, Voiculescu M, Irazabal MV, Eirin A, Lieske JC, Beck LH, Dillon JJ, Nachman PH, Sethi S, Erickson SB, Cattran DC, Fervenza FC, Svobodova B, Hruskova Z, Janatkova I, Jancova E, Tesar V, Seo MS, Kwon SH, Lee EB, You JY, Hyun YK, Woo SA, Park MY, Choi SJ, Jeon JS, Noh H, Kim JG, Han DC, Hwang SD, Choi TY, Jin SY, Kwon SH, Loiacono E, Loiacono E, Defedele D, Puccinelli MP, Camilla R, Gallo R, Peruzzi L, Rollino C, Beltrame G, Ferro M, Vergano L, Campolo F, Amore A, Coppo R, Knoop T, Vikse BE, Svarstad E, Bostad L, Leivestad T, Bjorneklett R, Teranishi J, Yamamoto R, Nagasawa Y, Shoji T, Iwatani H, Okada N, Moriyama T, Yamauchi A, Tsubakihara Y, Imai E, Rakugi H, Isaka Y, Koo HM, Doh FM, Kim SJ, Kang SW, Choi KH, Han DS, Han SH, Suzuki Y, Matsuzaki K, Suzuki H, Okazaki K, Yanagawa H, Maiguma M, Muto M, Sato T, Horikoshi S, Novak J, Hotta O, Tomino Y, Gutierrez* E, Zamora I, Ballarin J, Arce Y, Jimenez S, Quereda C, Olea T, Martinez-Ara J, Segarra A, Bernis C, Garcia A, Goicoechea M, Garcia de Vinuesa S, Rojas J, Praga M, Ristovska V, Petrushevska G, Grcevska L, Knoop T, Vikse BE, Svarstad E, Bostad L, Leivestad T, Bjorneklett R, Satake K, Shimizu Y, Mugitani N, Suzuki H, Suzuki Y, Horikoshi S, Honda S, Shibuya K, Shibuya A, Tomino Y, Papale M, Rocchetti MT, DI Paolo S, Suriano IV, D'apollo A, Vocino G, Montemurno E, Varraso L, Grandaliano G, Gesualdo L, Huerta A, Bomback AS, Canetta PA, Radhakrishnan J, Herlitz L, Stokes B, D'agati V, Markowitz G, Appel GB, Ristovska V, Grcevska L, Mouna H, Nasr BD, Mrabet I, Ahmed L, Sabra A, Mohamed Ammeur F, Mezri E, Habib S, Innocenti M, Pasquariello A, Pasquariello G, Mattei P, Bottai A, Fumagalli G, Bozzoli L, Samoni S, Cupisti A, Caldin B, Hung J, Repizo L, Malheiros DM, Barros R, Woronik V, Giammarresi C, Bono L, Ferrantelli A, Tortorici C, Licavoli G, Rotolo U, Huang X, Wang Q, Shi M, Chen W, Liu Z, Scarpioni R, Cantarini L, Lazzaro A, Ricardi M, Albertazzi V, Melfa L, Concesi C, Vallisa D, Cavanna L, Gungor G, Ataseven H, Demir A, Solak Y, Biyik M, Ozturk B, Polat I, Kiyici A, Ozer Cakir O, Polat H, Martinez-Ara J, Castillo I, Carreno V, Aguilar A, Madero R, Hernandez E, Bernis C, Bartolome J, Gea F, Selgas R, El Aggan HAM, El Banawy HS, Wagdy E, Tchebotareva N, LI O, Bobkova I, Kozlovskaya L, Varshavskiy V, Golicina E, Chen Y, Gong Z, Chen X, Tang L, Zhou J, Cao X, Wei R, Koo EH, Koo EH, Park JH, Kim HK, Kim MS, Jang HR, Lee JE, Huh W, Kim DJ, Oh HY, Kim YG, Tchebotareva N, Bobkova I, Kozlovskaya L, LI O, Eskova O, Shvetsov M, Golytsina E, Varshavskiy V, Popova O, Quaglia M, Monti S, Fenoglio R, Menegotto A, Airoldi A, Izzo C, Rizzo MA, Dianzani U, Stratta P, Vaglio A, Vaglio A, Alberici F, Gianfreda D, Buzio C. Primary and secondary glomerulonephritis I. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Atalar B, Aydin G, Gungor G, Caglar H, Yapici B, Ozyar E. Dosimetric comparison of robotic and conventional linac-based stereotactic lung irradiation in early-stage lung cancer. Technol Cancer Res Treat 2012; 11:249-55. [PMID: 22417057 DOI: 10.7785/tcrt.2012.500293] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
We aimed to compare dosimetric characteristics of conventional linear accerator-based treatment plans to those created using the robotic CyberKnife® (CK) treatment planning system for patients with early-stage lung cancer. Eight early-stage lung cancer patients treated with stereotactic body radiotherapy (SBRT) using a conventional linac-based (LIN) system were included in this study. New treatment plans were created for the patients with the CK treatment planning system in order to compare the two platforms' dosimetric characteristics. Planning computed tomographies (CT) were obtained in three phases: free-breathing, full exhalation and inhalation. The three GTVs were then added together for internal target volume (ITV) with LIN, whereas no ITV was used for CK. Planning target volumes (PTV) were constituted by adding 5-mm margin to GTV and ITV. Treatment plan was 54 Gy in three fractions. Five-field, seven-field, and dynamic-conformal arc planning techniques were used in LIN plans. Plans were compared according to dose heterogenity (D(max)-maximum dose), volume of 54 Gy (V54) and 27 Gy isodose (V27), conformity index (CI(54) and CI(27)) and lung volumes. PTVs were significantly smaller in CK plans (p=0.012). D(max) was significantly lower in ARC plans (p=0.01). Among all plans, CK had significantly tightest isodose shell received 54 Gy and 27 Gy (p=0.0001). Among LIN plans, V54 was significantly (p=0.03) smaller in ARC plans; but no difference was observed for V27 values. LIN plans have better plan quality (CI(27) and CI(54)) than CK. No statistically significant difference was observed for lung volumes. CK plans had superior V54 and V27 values compared to LIN plans due to smaller PTV. LIN plans had better CI(27) and CI(54) values. Advantages of LIN treatment were no neccessity for fiducial marker use, which may cause pneumothorax, and significantly shorter beam-on treatment times. Both CK and LIN methods are suitable for lung SBRT.
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Affiliation(s)
- B Atalar
- Department of Radiation Oncology, Acibadem University, Istanbul, Turkey.
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Tekinalp M, Akilli H, Ari H, Erdogan H, Yazici M, Gungor G. PP-222: PERICARDIAL EFFUSION IN A PATIENT WITH ULCERATIVE COLITIS: A CASE REPORT. Int J Cardiol 2011. [DOI: 10.1016/s0167-5273(11)70414-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Koksal GM, Sayilgan C, Gungor G, Oz H, Sen O, Uzun H, Aydin S. Effects of sevoflurane and desflurane on cytokine response during tympanoplasty surgery. Acta Anaesthesiol Scand 2005; 49:835-9. [PMID: 15954968 DOI: 10.1111/j.1399-6576.2005.00677.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND This study was devised to compare the effects of sevoflurane and desflurane anaesthesia on the cytokine response. METHODS Sixty ASA I-II patients, scheduled for tympanoplasty, were randomly allocated to be anaesthetized with either sevoflurane or desflurane at maintenance inspiratory concentrations of 1-1.5 MAC of either agent. Blood samples were taken for plasma tumour necrosis factor alpha (TNFalpha), interleukin 1beta and interleukin-6 assay before induction of anaesthesia, before surgery, and at the end of surgery. Alveolar cells were obtained after induction of anaesthesia and at the end of surgery. RESULTS Plasma TNFalpha was greater with desflurane than sevoflurane both before surgery (45.1 +/- 3.5 pg ml(-1) for desflurane vs. 23.2 +/- 2.5 pg ml(-1) for sevoflurane, P < 0.01) and (62.0 +/- 5.3 pg ml(-1) vs. 35.5 +/- 4.6 pg ml(-1), P < 0.001). Interleukin 1beta was similarly greater with desflurane than sevoflurane before (39.3 +/- 4.0 pg ml(-1) vs. 17.4 +/- 3.0 pg ml(-1); P < 0.01) and after surgery (46.0 +/- 3.4 pg ml(-1) vs. 23.3 +/- 3.2 pg ml(-1), P < 0.001). There were similar results for interleukin 6 before (42.3 +/- 3.5 pg mls(-1). 29.0 +/- 2.6 pg ml(-1), P < 0.001) and after surgery (86.0 +/- 4.5 pg ml(-1) vs. 45.9 +/- 6.3 pg ml(-1), P < 0.001). Alveolar cell TNFalpha concentrations after surgery were also greater with desflurane than sevoflurane (96.3 +/- 12.4 pg ml(-1) vs. 64.8 +/- 10.1 pg ml(-1), P < 0.001), as were interleukin 1beta (75.4 +/- 6.2 pg ml(-1) vs. 32.0 +/- 8.3 pg ml(-1), P < 0.001) and interleukin 6 concentrations (540.1 +/- 65.3 pg ml(-1) vs. 363.6 +/- 29.2 pg ml(-1), P < 0.001). CONCLUSION Desflurane appears to cause a greater systemic and intrapulmonary pro-inflammatory response than sevoflurane during anaesthesia for ear surgery.
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Affiliation(s)
- G M Koksal
- Department of Anaesthesiology and Reanimation, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey. gunizkoksalhotmail.com
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Erdal N, Ece F, Kosku M, Gungor G. The prognostic factors in malignant pleural mesothelioma patients. Lung Cancer 2000. [DOI: 10.1016/s0169-5002(00)80769-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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