Yazar "Bozkurt, Alper" seçeneğine göre listele
Listeleniyor 1 - 13 / 13
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe A Rare Case of Intracerebral Hemorrhage due to Arteriovenous Malformation Located at Petrous Portion of the Temporal Bone(Turkish Neurosurgical Soc, 2013) Gokce, Emre Cemal; Cemil, Berker; Kirbas, Ismail; Bozkurt, Alper; Erdogan, BulentPrimary intraosseous arteriovenous malformations (AVM) are not infrequently encountered. We report a case of intraosseous arteriovenous malformation arising in the left temporal bone. A 51-year-old male patient presented with loss of conscious. Computerized tomography displayed hematoma measuring 4 cm in diameter in the left temporal lobe. Digital subtraction angiography (DSA) showed that a temporal bone AVM supplied by all the branches of the external carotid artery and vertebral artery. Many treatment modalities can be considered for preoperative steps and/or for definitive treatment. We preferred embolisation for this vascular pathology. To the best of our knowledge this represents the first case of an intraosseous arteriovenous malformation located in the temporal bone.Öğe A rare case of intracerebral hemorrhage due to arteriovenous malformation located at petrous portion of the temporal bone(Turkish Neurosurgical Society, 2013) Gökçe, Emre Cemal; Cemil, Berker; Kirbaş, Ismail; Bozkurt, Alper; Erdoğan, BülentPrimary intraosseous arteriovenous malformations (AVM) are not infrequently encountered. We report a case of intraosseous arteriovenous malformation arising in the left temporal bone. A 51-year-old male patient presented with loss of conscious. Computerized tomography displayed hematoma measuring 4 cm in diameter in the left temporal lobe. Digital subtraction angiography (DSA) showed that a temporal bone AVM supplied by all the branches of the external carotid artery and vertebral artery. Many treatment modalities can be considered for preoperative steps and/or for definitive treatment. We preferred embolisation for this vascular pathology. To the best of our knowledge this represents the first case of an intraosseous arteriovenous malformation located in the temporal bone. © 2017 Elsevier B.V., All rights reserved.Öğe Acute lower gastrointestinal bleeding originating from an arteriovenous fistula of superior rectal artery(Springer, 2014) Bozkurt, Alper; Sozen, Meral; Kirbas, Ismail; Bilgic, Ismail; Kasapoglu, Benan; Nadir, Isilay[Abstract Not Available]Öğe Congenital dermal sinus tract in the cervical region of a 16-year-old girl(Elsevier Science Inc, 2014) Asal, Nese; Duymus, Mahmut; Tekin, Evrim Karadag; Yilmaz, Omer; Bozkurt, Alper[Abstract Not Available]Öğe Epicardial adipose tissue and pericoronary fat thickness measured with 64-multidetector computed tomography: potential predictors of the severity of coronary artery disease(Hospital Clinicas, Univ Sao Paulo, 2014) Demircelik, Muhammed Bora; Yilmaz, Omer Caglar; Gurel, Ozgul Malcok; Selcoki, Yusuf; Atar, Inci Asli; Bozkurt, Alper; Akin, KayihanOBJECTIVE: The aim of the present study was to investigate the relationship between pericoronary fat and the severity and extent of atherosclerosis, quantified using 64-multidetector computed tomography, in patients with suspected coronary artery disease. METHODS: The study population consisted of 131 patients who were clinically referred for noninvasive multislice computed tomography coronary angiography for the evaluation of coronary artery disease. Patients were classified as follows: no atherosclerosis, Group 1; nonobstructive atherosclerosis (luminal narrowing <50% in diameter), Group 2; and obstructive atherosclerosis (luminal narrowing >= 50%) in a single vessel or obstructive atherosclerosis in the left main coronary artery and/or multiple vessels, Group 3. Epicardial adipose tissue was defined as the adipose tissue between the surface of the heart and the visceral layer of the pericardium (visceral epicardium). Epicardial adipose tissue thickness (mm) was determined in the right ventricular anterior free wall. The mean thickness of the pericoronary fat surrounding the three coronary arteries was used for the analyses. RESULTS: The average thickness over all three regions was 13.2 +/- 2.1 mm. The pericoronary fat thickness was significantly increased in Group 3 compared with Groups 2 and 1. The epicardial adipose tissue thickness was significantly increased in Group 3 compared with Groups 2 and 1. A receiver operating characteristic curve for obstructive coronary artery disease was assessed to verify the optimum cut-off point for pericoronary fat thickness, which was 13.8 mm. A receiver operating characteristic curve for obstructive coronary artery disease was also assessed to verify the optimum cut-off point for epicardial adipose tissue, which was 6.8 cm. CONCLUSION: We showed that the epicardial adipose tissue and pericoronary fat thickness scores were higher in patients with obstructive coronary artery diseases.Öğe Increased microalbuminuria prevalence among patients with nonalcoholic fatty liver disease(Taylor & Francis Ltd, 2016) Kasapoglu, Benan; Turkay, Cansel; Yalcin, Kadir Serkan; Boga, Salih; Bozkurt, AlperAim: To determine the prevalence of microalbuminuria, that is an indirect predictor of coronary artery disease, among non-obese and non-diabetic patients with fatty liver disease. Material and method: This retrospective study was carried out on non-obese (body mass index (BMI)<30) and non-diabetic 290 female and 189 male, totally 479 cases. All subjects underwent liver ultrasonography scanning to determine the presence and stage of fatty liver disease. Results: The subjects were grouped according to the ultrasound findings as follows: 182 (37.9%) cases without any fat accumulation in liver were regarded as control group; and among remaining cases, 124 (25.8%) had mild, 93 (19.4%) had moderate, and 80 (16.7%) had severe fatty liver disease. There was not any statistically significant difference between groups in regards to the age, gender, liver function tests, renal function tests or glomerular filtration rate. However urinary protein/creatinine ratio was statistically significantly higher in severe nonalcoholic fatty liver disease (NAFLD) group than the other three groups. In moderate and severe NAFLD groups, microalbuminuria was statistically significantly more common compared with the control and mild NAFLD groups. Regarding the results of multiple logistic regression analysis, presence of fatty liver disease increased the risk of microalbuminuria for 1.87 times independently from increased BMI and increased HOMA-IR values. Conclusion: We have determined that microalbuminuria is more prevalent among NAFLD cases compared with control cases and microalbuminuria prevalence was increasing with the advanced stages of NAFLD although two main etiologic factors of microalbuminuria, type 2 diabetes, and obesity were excluded.Öğe MTHFR 677C/T and 1298A/C mutations and non-alcoholic fatty liver disease(Roy Coll Phys London Editorial Office, 2015) Kasapoglu, Benan; Turkay, Cansel; Yalcin, Kadir Serkan; Kosar, Ali; Bozkurt, AlperCommon genetic mutations encountered in folate metabolism may result in increased homocysteine (Hcy) levels. It has been reported that increased serum Hcy levels may affect the intracellular fat metabolism and may cause enhanced fatty infiltration in the liver resulting in non-alcoholic fatty liver disease (NAFLD). In total, 150 patients diagnosed with FLD by ultrasound examination and 136 healthy control patients that do not have any fatty infiltration in the liver were included in the study. Patients were grouped as mild (n=88), moderate (n=38) or severe (n=24) according to the stage of fatty liver in ultrasound. Serum liver function tests, Hcy, folic acid and vitamin B12 levels of the patients were studied. The genetic MTHFR C677T and A1298C polymorphisms of the patients were also evaluated. Although there was no significant difference in vitamin B12 and folic acid levels, in the severe group, Hcy levels were significantly higher than that of control and mild groups (p<0.001). By contrast, there was no significant difference in heterozygote MTHFR 677C/T and 1298A/C mutations, both MTHFR 677C/T and MTHFR 1298A/C mutations were more common in NAFLD groups compared with the control patients (p<0.001). We have determined increased Hcy levels and increased prevalence of homozygote MTHFR 677C/T and MTHFR 1298A/C mutations in patients with NAFLD compared with healthy controls. Larger studies are warranted to clarify the etiological role of the MTHFR mutations and Hcy levels in FLD.Öğe Percutaneous transluminal balloon angioplasty in stenosis of native hemodialysis arteriovenous fistulas: technical success and analysis of factors affecting postprocedural fistula patency(Turkish Soc Radiology, 2015) Aktas, Ayse; Bozkurt, Alper; Aktas, Bulent; Kirbas, IsmailPURPOSE We aimed to determine the predictors of technical success and patency after percutaneous transluminal angioplasty (PTA) of de novo dysfunctional hemodialysis arteriovenous fistulas (AVF). METHODS We performed a retrospective analysis of first time PTA in 228 patients (129 men, 99 women; mean age, 56.8 +/- 14.6 years). Anatomical (location, length, grade, and number of stenoses) and clinical variables (sex, age, prior AVF, diabetes mellitus, AVF age, side, and location) were reviewed. RESULTS A total of 330 stenoses were found in 228 patients. PTA was technically successful in 96.3% of the stenoses (n=319). Clinical success was achieved in 97.2% (n=321). Early dysfunction (within six months) was positively correlated with patient age (P < 0.001) and diabetes (P < 0.005). Older age (P < 0.001) and diabetes (P = 0.002) were associated with a lower primary patency rate. Patient age (P < 0.001), presence of diabetes (P = 0.023), length of stenosis (P = 0.003), early recurrence (P = 0.003) and presence of residual stenosis (P = 0.014) were associated with a lower secondary patency rate. CONCLUSION Patency of dysfunctional hemodialysis fistulas can be maintained safely with continuous follow-up and repeated interventions without shortening the venous segment by surgical revision. Percutaneous approach to hemodialysis access stenosis is an alternative to the conventional surgical approach and PTA is an effective treatment method for dysfunctional AVF.Öğe Pharmacomechanical Thrombectomy in the Management of Deep Vein Thrombosis Using the Cleaner Device: An Initial Single-Center Experience(Elsevier Science Inc, 2015) Bozkurt, Alper; Kirbas, Ismail; Kosehan, Dilek; Demircelik, Bora; Nazli, YunusBackground: Pharmacomechanical thrombectomy (PMT) has appeared as an effective treatment modality for deep venous thrombosis (DVT). The study aimed to assess the efficacy of the Cleaner(TM) thrombectomy device for acute DVT. Methods: Sixteen consecutive patients presenting with extensive iliofemoral and/or femoropopliteal acute DVT and managed at our institution between February 2013 and May 2014 were retrospectively reviewed. The patients underwent PMT with the Cleaner device after insertion of vena caval filters. For underlying stenotic lesions, balloon angioplasty and/or stent placement was performed. Results: PMT with the Cleaner device was successful in 14 patients with complete restoration of flow. No clinical signs of pulmonary thromboembolism was recorded after the procedure. Thrombectomy failed in 2 patients. For the rest of the patients, balloon angioplasty was performed to relieve underlying stenotic lesions. Nine of them underwent additional stenting. Conclusions: Our initial experience suggests that the Cleaner device can be used in acute DVT. However, further studies involving larger patient populations are warranted to determine long-term results.Öğe Relationship between late arteriovenous fistula (AVF) stenosis and neutrophil-lymphocyte ratio (NLR) in chronic hemodialysis patients(Taylor & Francis Ltd, 2014) Yilmaz, Hakki; Bozkurt, Alper; Cakmak, Muzaffer; Celik, Huseyin Tugrul; Bilgic, Mukadder Ayse; Bavbek, Nuket; Akcay, AliObjectives: Primary cause of late arteriovenous fistula (AVF) dysfunction is venous stenosis as result of neointimal hyperplasia. The mechanism of AVF stenosis is not exactly understood. But inflammation is a contributing factor for development of AVF stenosis. Neutrophil-lymphocyte ratio (NLR) reflects systemic inflammation, and it was investigated in many diseases. The aim of this study was to investigate the relationship between NLR and AVF stenosis in chronic hemodialysis patients. Materials and methods: Of 593 patients applied to the department of interventional radiology between January 2011 and November 2012, a total of 108 patients meeting the appropriate criteria were included in this study. All patients were assessed with Color Doppler ultrasonography and then digital subtraction angiography was used for the patients with abnormal results. Sixty-four patients were classified as patients with AVF stenosis (group 1) and 44 patients without AVF stenosis (group 2). Routine biochemical and complete blood count values measured six months ago were recorded for all patients. Results: Mean NLR (3.47 +/- 0.46 vs. 2.27 +/- 0.22; p < 0.001) was higher in group 1 compared to group 2, whereas high-density lipoprotein (HDL; 31.8 +/- 12.6 mg/dL vs. 51.5 +/- 11.9 mg/dL; p < 0.001) was lower in group 1. NLR level was correlated with degree of AVF stenosis (r = 0.625; p < 0.01). Receiver operating characteristic curve analysis showed that NLR (optimal-cut-off = 2.70) was a useful parameter in prediction of AVF stenosis (AUC = 0.893, sensitivity = 98.4% and specificity = 75%; p < 0.001). NLR level and HDL530 mg/dL in logistic regression analysis are independent predictors of AVF stenosis. Conclusions: For hemodialysis patients with increased level of NLR and decreased level of HDL, regular monitoring with regard to the development of AVF stenosis may be beneficial. Our study suggests that the mechanism of AVF stenosis might have similarities to that of atherosclerosis.Öğe Relationship of late arteriovenous fistula stenosis with soluble E-selectin and soluble EPCR in chronic hemodialysis patients with arteriovenous fistula(Springer, 2015) Bilgic, Mukadder Ayse; Yilmaz, Hakki; Bozkurt, Alper; Celik, Huseyin Tugrul; Bilgic, Ismail Celal; Gurel, Ozgul Malcok; Kirbas, IsmailVascular access dysfunction caused by stenosis is a major complication for hemodialysis (HD) patients. However, physiopathology of late arteriovenous fistula (AVF) stenosis is still under investigation. The aim of the present study was to evaluate the association between plasma soluble EPCR (sEPCR) with serum soluble E-selectin (sE-selectin) concentration and late AVF stenosis in HD patients. Plasma sEPCR and serum sE-selectin concentrations were measured in 94 HD patients. Using these data, we studied the association of sEPCR and sE-selectin with the presence and degree of AVF stenosis using ultrasonography and fistulogram. Fifty-one patients have AVF stenosis, and the others (n = 43) have patent AVF. The degree of AVF stenosis was correlated with serum sE-selectin levels (r = 0.351, p = 0.01), but not sEPCR (r = 0.075, p = 0.702). The median level of sE-selectin was statistically higher in the group of AVF stenosis than in the group of patent AVF [463.2 pg/ml (275.4-671.4) vs. 162.5 pg/ml (96.7-285.3), p = 0.001]. Increased sE-selectin levels [OR (OR) = 6.356, p = 0.015] and high levels of LDL (OR = 4.321, p = 0.044) were independent predictors of late AVF stenosis in the multivariate model. sE-selectin and the LDL were the most important predictors of late AVF stenosis. In addition, sE-selectin correlated with the degree of AVF stenosis. We suggested that atherosclerosis might be contributing factor for development of late AVF stenosis.Öğe The Value of Preoperative Lesion Dedicated Ultrasound of Breast Cancer before Conserving Surgery for Optimizing Margins(Wiley, 2017) Kosehan, Dilek; Dener, Cenap; Akin, Kayihan; Bozkurt, Alper; Bilgic, Ismail; Cakir, BanuTo investigate the effect of US performed immediately before breast conserving surgery (BCS) by radiologist accompanied by the surgeon. All patients scheduled for BCS in the last year (group 1, n = 46) were evaluated with US immediately before surgery. About 108 patients (group 2) who were treated with BCS before the study were included as the control group. Tumor size and localization, the distances between tumor-skin and tumor-pectoralis muscle fascia were noted. Re-excision rate due to positive margins was significantly lower in group 1. Statistically significant difference was detected in re-excision rates for nonpalpable tumors. Preoperative US is an effective and practical method.Öğe Use of the Amplatzer Type 2 Plug for Flow Redirection in Failing Autogenous Hemodialysis Fistulae(Springer, 2015) Bozkurt, Alper; Kirbas, Ismail; Kasapoglu, Benan; Teber, Mehmet AkifTo present our experience with redirecting the outflow of mature arteriovenous fistulae (AVFs) in patients with cannulation and/or suboptimal flow problems by percutaneous intervention using the Amplatzer Vascular Plug II (AVP II). We retrospectively reviewed patients who presented with difficulty in cannulation and/or suboptimal flow in the puncture zone of the AVF and who underwent intervention using the AVP II to redirect the outflow through a better cannulation zone from March 2009 to November 2012. The mean survival rate of all AVFs was estimated, and the effects of patient age, sex, and AVF age on the AVF survival time were determined. In total, 31 patients (17 male and 14 female) with a mean age of 57.8 years (range, 20-79 years) were included. In 2 patients, the AVF failed within the first 15 days because of rapid thrombosis. In 9 patients, the new AVF route was working effectively until unsalvageable thrombosis developed. One of the 31 patients died 9 months before the last radiologic evaluation. The new AVF route was still being used for dialysis in the remaining 19 patients. The mean AVF survival rate was 1,061.4 +/- A 139.4 days (range, 788-1,334 days). Patient age, sex, and AVF age did not affect the survival time. We suggest that the AVP II is useful for redirecting the outflow of AVFs with cannulation problems and suboptimal flow. Patency of existing AVFs may be extended, thereby extending surgery-free or catheter intervention-free survival period.
