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Ozdemir G, Eren A, Aygul R, Eren F, Kizildag N, Kocaturk I, Mammadi A, Ersoy AN, Korez MK. Endovascular treatment for M3 occlusions. Interv Neuroradiol 2024; 30:202-209. [PMID: 36124395 PMCID: PMC11095351 DOI: 10.1177/15910199221127357] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 06/23/2022] [Accepted: 09/02/2022] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Endovascular treatment (ET) is a beneficial treatment for M1-2 occlusions of the middle cerebral artery. Mortality and disability rates are high if large vessel occlusions are not treated. While these rates are lower in M3 occlusions, important branch blockages can lead to disability. Endovascular treatment of small vessel occlusions is difficult, and there are no studies on the effectiveness of endovascular treatment for M3 occlusions. Accordingly, in this study, our aim was to assess the feasibility, safety, and preliminary efficacy of endovascular therapy for M3 occlusions. METHODS This study involved a retrospective analysis of a prospectively collected from two centres for acute ischemic stroke of the anterior system between July 2015 and April 2020. Demographic, radiologic, procedural and outcome variables were collected for patients who underwent endovascular therapy for acute ischemic stroke of the anterior system. RESULTS Complete or near complete reperfusion (mTICI 2b-3) of the M3 occlusion was achieved in 15 cases (38.5%). Complete (mTICI 3) reperfusion was achieved in 24 cases (61.5%). Twenty-six patients were treated for primary M3 occlusion, while 13 patients with M3 occlusion were treated as a rescue strategy after successful treatment of a proximal greater vascular occlusion. Complete or near complete reperfusion (mTICI 2b-3) of primary occlusion was achieved in eight cases (30.8%), and complete (mTICI 3) reperfusion was achieved in 18 cases (69.2%). In addition, complete or near complete reperfusion (mTICI 2b-3) of rescue M3 occlusion was achieved in seven cases (%53.8), while complete (mTICI 3) reperfusion was achieved in six cases (46.2%). Only one patient with primary M3 occlusion had ICH due to extravasation. The patient's neurological examination one month later was normal. CONCLUSIONS This retrospective study demonstrates that endovascular treatment of M3 occlusions is safe, effective and reliable.
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Affiliation(s)
- Gokhan Ozdemir
- Department of Neurology, Center of Stroke, Selcuk University Medical Faculty, Konya, Turkey
| | - Alper Eren
- Department of Neurology, Center of Stroke, Ataturk University Medical Faculty, Erzurum, Turkey
| | - Recep Aygul
- Department of Neurology, Center of Stroke, Selcuk University Medical Faculty, Konya, Turkey
| | - Fettah Eren
- Department of Neurology, Center of Stroke, Selcuk University Medical Faculty, Konya, Turkey
| | - Nazım Kizildag
- Erzurum Education and Research Hospital, Erzurum, Turkey
| | - Idris Kocaturk
- Department of Neurology, Binali University Medical Faculty, Erzincan, Turkey
| | - Azer Mammadi
- Department of Neurology, Center of Stroke, Selcuk University Medical Faculty, Konya, Turkey
| | - Ayse Nur Ersoy
- Department of Neurology, Center of Stroke, Selcuk University Medical Faculty, Konya, Turkey
| | - Muslu Kazım Korez
- Department of Biostatistics, Selcuk University Medical Faculty, Konya, Turkey
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Guler AH, Ates MC, Avcı F, Seher N, Cintesun E, Bilgi A, Korez MK, Koplay M, Celik C. The role of shear wave elastography in predicting endometrial cancer in patients presenting with abnormal uterine bleeding. Eur Rev Med Pharmacol Sci 2024; 28:365-372. [PMID: 38235888 DOI: 10.26355/eurrev_202401_34925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
OBJECTIVE Shear Wave Elastography (SWE) is an objective quantitative ultrasound elastography technique that can demonstrate the stiffness of anatomical structures to aid in their detection and characterization. We aimed to evaluate the role of shear wave elastography in differentiating endometrial carcinoma from benign uterine pathologies in women with abnormal uterine bleeding. PATIENTS AND METHODS This prospective study was conducted at our institution from January 2020 to April 2020. A hundred patients with endometrial sampling planned and SWE due to abnormal uterine bleeding were included in the study. According to the histopathological results of the patients, those with normal and atrophic endometrium results were defined as group I (control group), those with benign results such as polyps and endometrial hyperplasia were defined as group II, and those with endometrial cancers were defined as group III. RESULTS After adjustment for age, a statistically significant difference was found in Emean (mean and adjusted mean) value between the study groups (F2.96=86.37, p<.001, η2=0.64). The post-hoc analysis was performed with a Bonferroni adjustment. The mean Emean value was found to be statistically significantly higher in group III (17.14±0.40) compared to group I (10.39±0.26) and group II (11.49±0.32) (p<0.001). In addition, a statistically significant difference was found between the benign and normal groups. CONCLUSIONS As a new diagnostic technique in gynecology, elastography appears to be a valuable tool in differentiating malign endometrial pathologies from normal or benign endometrial pathologies in females with abnormal uterine bleeding.
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Affiliation(s)
- A H Guler
- Department of Obstetrics and Gynecology, Faculty of Medicine, Selcuk University, Konya, Turkey.
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Ozdemir G, Eren F, Aygul R, Kizildag N, Kocaturk I, Mammadi A, Ersoy AN, Ildiz OF, Gunduz ZB, Korez MK. Endovascular treatment for anterior cerebral artery occlusions. Interv Neuroradiol 2023:15910199231162669. [PMID: 36916134 DOI: 10.1177/15910199231162669] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND We sought to examine the feasibility, safety and preliminary efficacy of anterior cerebral artery (ACA) occlusions in patients undergoing endovascular treatment. METHODS Four hundred five consecutive patients with large-vessel occlusion treated with endovascular treatment were analysed to identify all patients with acute ACA occlusion who underwent endovascular treatment. RESULTS Twenty had ACA occlusion (primary ACA occlusion: 9, rescue ACA occlusion: 11), 395 patients had other occlusions (internal carotid artery and MCA). The median [IQR] mRS score in the third month was significantly higher in the ACA-rescue occlusion group versus the ACA-primary occlusion group. The rate of haematoma in patients with ACA-occlusions was significantly higher compared with the ACA-primary occlusion group. Moreover, the three-month mortality rate was higher in patients with ACA-rescue than the patients with ACA-primary. CONCLUSIONS Although endovascular treatment can be considered in patients with primary ACA occlusions, our data suggest that future clinical trials are needed to determine the efficacy of endovascular treatment for ACA occlusions. Unfavourable outcomes in our study were considered to occur in the rescue ACA occlusions.
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Affiliation(s)
- Gokhan Ozdemir
- Department of Neurology, Center of Stroke, Selcuk University Medical Faculty, Konya, Turkey
| | - Fettah Eren
- Department of Neurology, Center of Stroke, Selcuk University Medical Faculty, Konya, Turkey
| | - Recep Aygul
- Department of Neurology, Center of Stroke, Selcuk University Medical Faculty, Konya, Turkey
| | - Nazım Kizildag
- Department of Neurology, Stroke Center, Ataturk University, Erzurum, Turkey
| | - Idris Kocaturk
- Department of Neurology, Binali University Medical Faculty, Erzincan, Turkey
| | - Azer Mammadi
- Department of Neurology, Center of Stroke, Selcuk University Medical Faculty, Konya, Turkey
| | - Ayse Nur Ersoy
- Department of Neurology, Center of Stroke, Selcuk University Medical Faculty, Konya, Turkey
| | - Omer Faruk Ildiz
- Department of Neurology, Center of Stroke, Selcuk University Medical Faculty, Konya, Turkey
| | | | - Muslu Kazım Korez
- Department of Biostatistics, 485663Selcuk University Medical Faculty, Konya, Turkey
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Tezcan EA, Levendoglu F, Durmaz MS, Kara H, Batur EB, Gezer IA, Korez MK. Carpal Tunnel Syndrome in Patients with Psoriatic Arthritis: Ultrasonography and Magnetic Resonance Imaging Findings. J Rheum Dis 2023; 30:36-44. [PMID: 37476525 PMCID: PMC10351357 DOI: 10.4078/jrd.22.0028] [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] [Received: 08/03/2022] [Revised: 11/24/2022] [Accepted: 11/24/2022] [Indexed: 07/22/2023]
Abstract
Objective The aim of the present study is to assess carpal tunnel syndrome's (CTS's) ultrasonography (US) and magnetic resonance imaging (MRI) findings in patients with psoriatic arthritis (PsA) and compare them with healthy controls. Methods Thirty-nine PsA and twenty-eight healthy volunteers were examined in this study. Demographic and clinical features were recorded. CTS-6, a diagnostic algorithm, was used to estimate the probability of CTS. Electrodiagnostic study (EDS) was applied to all wrists included in the report, where the diagnosis of CTS was made by EDS. The cross-sectional area (CSA) of the median nerve was measured at pisiform bone level by US and MRI. Results Regarding to the demographic characteristics, no statistically significant difference was found between the groups. Twelve of 39 (30.76%) PsA patients had CTS, whereas CTS was not detected in the control group (p=0.001). US and MRI showed increased median nerve CSA in PsA patients compared to healthy controls (p=0.005, p<0.001; respectively). Also, US and MRI showed increased median nerve CSA in CTS patients compared to others (p=0.002, p<0.001; respectively). The Pearson correlation coefficient between MRI and US measurements of the CSA was 0.85 (p<0.001). Conclusion CTS frequency in PsA patients is found higher than healthy controls. The relationship between CTS diagnosed by EDS and CSA measured by both US and MRI was observed in PsA patients.
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Affiliation(s)
- Ezgi Akyildiz Tezcan
- Department of Physical Medicine and Rehabilitation, Cumra State Hospital, Konya, Turkey
| | - Funda Levendoglu
- Department of Physical Medicine and Rehabilitation, Konya, Turkey
| | | | - Hasan Kara
- Department of Physical Medicine and Rehabilitation, Erciyes University Medical Faculty, Kayseri, Turkey
| | | | | | - Muslu Kazım Korez
- Department of Biostatistics, Selcuk University Medical Faculty, Konya, Turkey
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Duzova M, Basaran H, Inan G, Gul OV, Eren OO, Korez MK. Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: Outcomes of survival, toxicity, sphincter preserving and prognostic factors. Transpl Immunol 2021; 69:101489. [PMID: 34687908 DOI: 10.1016/j.trim.2021.101489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND This study aimed to compare preoperative chemoradiotherapy (CRT) with postoperative CRT regarding survival, local control, disease control, sphincter preservation, toxicity and also prognostic factors for the treatment of locally advanced rectal cancer. METHODS Records of 140 patients with locally advanced rectal cancer who received preoperative or postoperative CRT were analyzed retrospectively. We compared the treatment groups (preoperative vs postoperative) according to baseline characteristics (demographic and rectal cancer disease characteristics), and also carried out the survival analyses. RESULTS From January 2010 to December 2019, 140 patients were included in the analysis, 65 received preoperative treatment and 75 postoperative treatment. There was no difference in survival, recurrence or distant metastasis rate in both treatment groups. The ratios of the failure to complete adjuvant chemotherapy (32% vs 4.6%) and acute grade 3-4 toxicity (32% vs 6.2%) were higher in the postoperative group (p < 0.001). In lower located tumors (≤5 cm from anal verge) the ratio of the sphincter preserving in the preoperative group was 60.7% (n = 17/28), and was 16.6% (n = 3/18) in the postoperative group (Yates χ2 = 5.829, p = 0.005). CONCLUSION This study showed no difference in recurrence and survival rate. Preoperative CRT is the preferred treatment for patients with locally advanced rectal cancer, given that it is associated with a superior overall treatment compliance rate, reduced toxicity, and an increased rate of sphincter preservation in low-lying tumors, but not for overall survival.
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Affiliation(s)
- Mursel Duzova
- Selcuk University, Faculty of Medicine, Department of Radiation Oncology, Konya, Turkey.
| | - Hamit Basaran
- Selcuk University, Faculty of Medicine, Department of Radiation Oncology, Konya, Turkey.
| | - Gokcen Inan
- Selcuk University, Faculty of Medicine, Department of Radiation Oncology, Konya, Turkey.
| | - Osman Vefa Gul
- Selcuk University, Faculty of Medicine, Department of Radiation Oncology, Konya, Turkey.
| | - Orhan Onder Eren
- Selcuk University, Faculty of Medicine, Department of Medical Oncology, Konya, Turkey
| | - Muslu Kazım Korez
- Selcuk University, Faculty of Medicine, Biostatistics Department, Konya, Turkey.
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Batur AF, Aydogan MF, Kilic O, Korez MK, Gul M, Kaynar M, Goktas S, Akand M. Comparison of De Ritis Ratio and other systemic inflammatory parameters for the prediction of prognosis of patients with transitional cell bladder cancer. Int J Clin Pract 2021; 75:e13743. [PMID: 32991771 DOI: 10.1111/ijcp.13743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/13/2020] [Accepted: 09/23/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To investigate the clinical value of preoperative De Ritis ratio (aspartate aminotransferase/alanine aminotransferase) (DRR) in patients with transitional cell bladder cancer (TCBC) at initial diagnosis. The secondary objective was to investigate the status of systemic inflammatory parameters, such as neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR) and platelet-monocyte ratio (PMR). MATERIALS AND METHODS The records of patients with primary TCBC who underwent transurethral resection were retrospectively evaluated. The relationship of DRR and systemic inflammatory parameters with clinicopathological findings, recurrence and progression status was evaluated separately. RESULTS There was no significant difference in the DRR according to the clinicopathological findings, recurrence and progression. Significant differences were found between the NLR and the patient groups for tumour diameter, tumour stage, tumour grade and progression. In univariate analysis, the LMR was found to be associated with progression, and also the PLR and LMR were found to be associated with recurrence. Decrease in LMR and increase in LMR score demonstrated by multiple analysis was shown as independent predictors of progression and recurrence development. CONCLUSIONS This paper shows a positive correlation between poor prognosis in TCBC and the systemic inflammatory markers, namely NLR, LMR, PLR and PMR, but not DRR.
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Affiliation(s)
- Ali Furkan Batur
- Department of Urology, Selcuk University School of Medicine, Konya, Turkey
| | | | - Ozcan Kilic
- Department of Urology, Selcuk University School of Medicine, Konya, Turkey
| | - Muslu Kazım Korez
- Department of Biostatistics, Selcuk University School of Medicine, Konya, Turkey
| | - Murat Gul
- Department of Urology, Selcuk University School of Medicine, Konya, Turkey
| | - Mehmet Kaynar
- Department of Urology, Selcuk University School of Medicine, Konya, Turkey
| | - Serdar Goktas
- Department of Urology, Selcuk University School of Medicine, Konya, Turkey
| | - Murat Akand
- Department of Urology, Selcuk University School of Medicine, Konya, Turkey
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Yormaz B, Menevse E, Cetin N, Esin Celik Z, Bakir H, Tulek B, Korez MK, Suerdem M. Diagnostic value of thymus and activation-regulated chemokine and of periostin in eosinophilic asthma: A prospective study. Allergy Asthma Proc 2021; 42:e30-e39. [PMID: 33404399 DOI: 10.2500/aap.2021.42.200102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background: Serum thymus and activation-regulated chemokine (TARC) and periostin are reliable biomarkers in eosinophilic asthma. Objective: This study was carried out to determine the use of periostin and TARC as biomarkers in asthma and to compare the superiority of one over the other, especially in asthma with an eosinophilic phenotype. Methods: The study was conducted with 87 patients with asthma and 42 healthy control subjects. Patients with asthma were also divided into eosinophilic and non-eosinophilic phenotypes. A pulmonary function test was performed in all the participants, and serum and induced sputum TARC, periostin concentrations, eosinophils, and total immunoglobulin E values were examined. Results: TARC and periostin levels were significantly higher in the asthma group than in the control group (p < 0.001). The serum TARC level in the eosinophilic group was significantly higher than in the non-eosinophilic and control groups (p < 0.001). The induced sputum TARC level was significantly higher in the non-eosinophilic group than in the control group (p < 0.001). The TARC and periostin levels of the patients were evaluated by using receiver operator characteristic analysis. The cutoff value for TARC was determined to be 1415.39 ng/L; likewise, the cutoff value for periostin was 107.60 ng/L. The present study detected that serum levels of TARC correlated to serum levels of periostin (r = 0.54; p = 0.032). Furthermore, when evaluating correlations between serum and sputum levels, there was a correlation detected between TARC and periostin in serum, whereas this correlation was stronger in sputum: r = 0.66, p = 0.020; and r = 0.62, p = 0.028, respectively. Conclusion: Serum and sputum TARC and periostin may contribute for monitoring the improvement of patients, particularly those with asthma. Furthermore, TARC was a more reliable biomarker than periostin for patients with eosinophilic asthma.
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Affiliation(s)
- Burcu Yormaz
- From the Faculty of Medicine, Department of Pulmonology, Selcuk University, Konya, Turkey
| | - Esma Menevse
- From the Faculty of Medicine, Department of Pulmonology, Selcuk University, Konya, Turkey
| | - Nihal Cetin
- From the Faculty of Medicine, Department of Pulmonology, Selcuk University, Konya, Turkey
| | - Zeliha Esin Celik
- From the Faculty of Medicine, Department of Pulmonology, Selcuk University, Konya, Turkey
| | - Hasan Bakir
- From the Faculty of Medicine, Department of Pulmonology, Selcuk University, Konya, Turkey
| | - Baykal Tulek
- From the Faculty of Medicine, Department of Pulmonology, Selcuk University, Konya, Turkey
| | - Muslu Kazım Korez
- From the Faculty of Medicine, Department of Pulmonology, Selcuk University, Konya, Turkey
| | - Mecit Suerdem
- From the Faculty of Medicine, Department of Pulmonology, Selcuk University, Konya, Turkey
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