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Öğe Acute effect of resistance exercise at different velocities on stiffness and vascularity of the biceps brachii muscle: a preliminary study(Sage Publications Ltd, 2023) Ustabasioglu, Fethi Emre; Agirdemir, Fatma Ebru; Ustabasioglu, Fatma; Sunal, Baran SerdarBackground Resistance exercise can be defined as the percentage of maximal strength (%1 repetition maximum) used for a particular exercise. Shear wave elastography (SWE) is a robust and novelty imaging technique that provides information regarding tissue stiffness. Superb microvascular imaging (SMI) is a non-irradiating technique that can provide quantitative measurement of muscle blood flow non-invasively. Purpose To compare the acute effects of low- and high-velocity resistance exercise on stiffness and blood flow in the biceps brachii muscle (BBM) using SWE and SMI. Material and Methods This prospective study included 60 healthy men (mean age=28.9 years; age range=26-34 years). BBM stiffness was measured by using SWE at rest, after low- and high-velocity resistance exercise, and muscle blood flow was also evaluated by SMI. Resistance exercise was performed using a dumbbell with a mass adjusted to 70%-80% of one-repetition maximum. Results The stiffness values increased significantly from resting to high- and low-velocity resistance exercises. There was no significant difference between the elastography values of the BBM after the high- and low-velocity resistance exercise. The blood flow increased significantly from resting to high- and low-velocity resistance exercises. Blood flow increase after low-velocity exercise was significantly higher compared to high-velocity exercise. Conclusion While muscle stiffness parameters and blood flow significantly increased from resting after both high- and low-velocity resistance exercises, blood flow significantly increased after low-velocity exercise compared to high-velocity exercise. This can mean that metabolic stress, an important trigger for muscle development, is more likely to occur in low-velocity exercise.Öğe Anatomical variations of the circle of Willis in children(Springer, 2021) Solak, Serdar; Ustabasioglu, Fethi Emre; Alkan, Aykut; Kula, Osman; Sut, Necdet; Tuncbilek, NerminBackground The morphology of the circle of Willis in adults has been thoroughly discussed in scientific literature. However, the morphology of the circle of Willis in pediatric patients is under-researched. Objectives We aimed to establish reference data for the morphology and variations of the circle of Willis in a population consisting of all pediatric age subgroups and to evaluate the possible temporal evolution of the circle of Willis in pediatric patients along with the variations between pediatric and adult populations. Materials and methods Our patient cohort included 263 pediatric patients ages 1-215 months. A total of 273 magnetic resonance (MR) angiography images were retrospectively analyzed for all circle of Willis vessels to compare the incidence of complete cases and variation frequency based on gender and age group. Result In our study of 273 MR angiograms from all age ranges in the pediatric population, we found a 56.1% circle of Willis completion rate. Overall completion rates were statistically significantly higher in the toddler and preschool age groups. The lowest completion rate was in the newborn-infant group (40%). Conclusion Circle of Willis completion rates and variations in pediatric populations are similar to those in adult populations; completion rates rise in toddler and preschooler age groups and decline as children grow into the school-age and adolescent period.Öğe Assessment of common extensor tendon vascularization using superb microvascular imaging: a potential tool in the evaluation of extracorporeal shock wave therapy and therapeutic ultrasound effectiveness in lateral epicondylitis(Sage Publications Ltd, 2023) Ustabasioglu, Fatma; Gunay, Burak; Samanci, Cesur; Ustabasioglu, Fethi EmreBackground Lateral epicondylitis, also known as tennis elbow, is the most common elbow pain in the adult age group. Purpose To evaluate common extensor tendon (CET) vascularity with superb microvascular imaging (SMI) before and after extracorporeal shock wave therapy (ESWT) and ultrasound (US) treatment in patients with lateral epycondylitis and to compare the effects of two different treatments on tendon vascularity. Material and Methods Patients with lateral epycondylitis were divided into two groups; 30 patients were treated with ESWT (group 1) and 30 patients were treated with therapeutic US (group 2). We performed a high-frequency (14-MHz) linear array transducer to evaluate tendon anatomy and vascularity before and after treatment in both groups. Results The decrease in Patient-Rated Tennis Elbow Evaluation (PRTEE) score after treatment was statistically significant compared to pre-treatment for both groups (P < 0.001). Likewise, the decrease in visual analog scale (VAS) score after treatment was statistically significant compared to pre-treatment for both groups (P < 0.001). A significant difference was found between the CET SMI values of group 1 and group 2 after treatment, according to the chi-square test (P < 0.001). In the post-treatment VAS and PRTEE comparison of both groups, the score reduction in group 1 was higher than in group 2, and this decrease was statistically significant (P < 0.001). Conclusion We can evaluate CET vascularization with the SMI method as a new potential diagnostic tool in comparing the effectiveness of different treatments in cases of lateral epicondylitis.Öğe Cardiac Magnetic Resonance Imaging and Transthoracic Echocardiography: Investigation of Concordance between the Two Methods for Measurement of the Cardiac Chamber(Mdpi, 2019) Gurdogan, Muhammet; Ustabasioglu, Fethi Emre; Kula, Osman; Korkmaz, SelcukBackground and objectives: Cardiac magnetic resonance (CMR) imaging is the gold standard method for the detection of ventricular volumes and myocardial edema/scar. Transthoracic echocardiography (TTE) imaging is primarily used in the evaluation of cardiac functions and chamber dimensions. This study aims to investigate whether the chamber diameter measurements are concordant with each other in the same patient group who underwent TTE and CMR. Materials and Methods: The study included 41 patients who underwent TTE and CMR imaging. Ventricular and atrial diameter measurements from TTE-derived standard parasternal long axis and apical four-chamber views and CMR-derived three- and four-chamber views were recorded. The concordance between the two methods was compared using intra-class correlation coefficients (ICC) and Bland-Altman plots. Results: Of the patients, 25 (61%) were male and the mean age was 48.12 +/- 16.79. The mean ICC for LVDD between CMR observers was 0.957 (95% CI: 0.918-0.978), while the mean ICC between CMR and TTE measurements were 0.849 (95% CI: 0.709-0.922) and 0.836 (95% CI: 0.684-0.915), respectively. The mean ICC for the right ventricle between CMR observers was 0.985 (95% CI: 0.971-0.992), while the mean ICC between CMR and TTE measurements were 0.869 (95% CI: 0.755-0.930) and 0.892 (95% CI: 0.799-0.942), respectively. Passing-Bablok Regression and Bland-Altman plots indicated high concordance between the two methods. Conclusions: TTE and CMR indicated high concordance in chamber diameter measurements for which the CMR should be considered in patients for whom optimal evaluation with TTE could not be performed due to their limitations.Öğe Clinicopathological and prognostic characteristics of acral metastases in patients with malignant disease: A retrospective study(Turkish Assoc Orthopaedics Traumatology, 2021) Ciftdemir, Mert; Ustabasioglu, Fethi Emre; Colbe, Suleyman Alp; Ustun, Funda; Usta, Ufuk; Cicin, IrfanObjective: This study aimed to investigate the clinical, pathological, and prognostic characteristics of acrel metastases in patients with malignant disease and to determine the impact of different types of acral metastasis treatment on patient survival. Methods: In this retrospective study, 64 acral metastatic lesions in 46 patients (17 women, 29 men; mean age, 61.5 years; age range, 35-82 years) who were evaluated by the Bone and Soft Tissue Tumors Council of our institute from 2015 to 2019 were included. The patients' primary tumor site, tumor type. localization of acrel metastases, main symptom, duration from the diagnosis of the primary tumor to the diagnosis of acral metastasis, duration from the diagnosis of acrel metastasis to death, and survival data were analyzed. The diagnosis of acral metastasis was confirmed by histopathological evaluation in 38 patients and clinical and radiological assessment of the lesions in 8 patients. The treatment type for each acral metastasis was individualized by the institutional Bone and Soft Tissue Tumors Council and categorized into 3 groups: excisional surgery (amputations and resections). palliative surgery (prophylactic fixation, intralesional curettage, and bone cement augmentation), and non-surgical treatment (chemotherapy. radiotherapy, and hormone therapy). Results: A total of 16 acral metastases (25%) were identified in the upper extremity and 48 (75%) in the lower extremity. The most common primary tumor site was the lungs (32.6%), and the most common tumor type was adenocarcinoma (43.2%). The most frequent symptom and the primary reason for admission was pain (58.7%). The mean duration between the diagnosis of primary tumor and the diagnosis of acral metastasis was 19.1 (range. 0-124) months. No significant correlation was determined between the primary tumor types and duration from the diagnosis of primary tumor to the diagnosis of acral metastasis (p=0.278). Acral metastases were treated by excisional surgery in 15 (32.6%) patients, palliative surgery combined with non-surgical treatment in 10 (21.7%) patients, and only non-surgical treatment modalities in 21 (45.7%) patients. No significant correlation existed between the treatment types and patient survival (p=0.058). At the final follow-up. 30 (65.2%) patients were dead owing to the disease. The mean overall survival of the entire study group was 24.9 (range. 3-55) months. The mean duration between the diagnosis of acral metastasis and death was 7.6 (range, 3-24) months in patients who were dead owing to the disease (p=0.012). Conclusion: When the diagnosis of acral metastasis is established, it should be borne in mind that the most common primary tumor site and type are most likely the lungs and adenocarcinoma, respectively. The treatment type for acral metastasis may have no significant impact on patient survival, but the extensiveness of the disease may be a critical factor for survival.Öğe Co-Existence of Non-ossifying Fibroma and Osteoblastoma of the Tibia(Galenos Publ House, 2023) Alkan, Aykut; Ustabasioglu, Fethi Emre; Usta, Ufuk; Ciftdemir, Mert; Ustuen, Funda[Abstract Not Available]Öğe Coexistence of Anti-PD1-Induced Immune Myocarditis and Complete Atrioventricular Block: A Case Report(Excerpta Medica Inc-Elsevier Science Inc, 2023) Gurdogan, Muhammet; Yalta, Kenan; Gurlertop, Yekta; Karahan, Furkan; Bulburu, Irem Bilge; Kocyogot, Beliz; Ustabasioglu, Fethi EmreThe present report describes the late recovery of an emerging complete atrioventricular (AV block) in a patient with immune check point inhibitor-related myocarditis following a period of immunosuppresive therapy. Therefore, decision-making for permanent pace-maker implantation should be implemented after a substantial period of time owing to the potential recovery of bradyarrhythmic complications in similar cases. (c) 2023 Elsevier Inc. All rights reserved.Öğe Comparison of skeletal muscle mass loss in patients with metastatic colorectal cancer treated with regorafenib or TAS-102(Imprimatur Publications, 2019) Hacioglu, Muhammet Bekir; Kostek, Osman; Kurt, Nazmi; Kucukarda, Ahmet; Gokyer, Ali; Ustabasioglu, Fethi Emre; Karatas, FatihPurpose: To assess whether regorafenib and TAS-102 treatments are associated with a change in Skeletal Muscle Area (SMA) as well as to compare Skeletal Muscle Mass (SMM) loss levels between regorafenib and TAS-102 treatments and prognostic significance in the patients with metastatic colorectal cancer (mCRC). Methods: A total of 36 mCRC patients, who received regorafenib or TAS-102 in the third-line and subsequent settings were assessed in the analysis. SMM changes were assessed with CT scans findings, and they were categorized into two groups as SMM-loss (SMM decrease >= 2%) and SMM-stable (SMM change <2%). Results: The SMM change after regorafenib therapy was significantly worse compared with TAS-102 therapy (p=0.001). The median overall survival (OS) was longer in SMM-stable group than in SMM-loss group (12.8 months; 95%CI:9.8-15.7) vs. 6.4 months; 95%CI:5.2-7.7, respectively;p=0.04). Cox regression analysis showed that SMM loss was independent prognostic indicator for OS (HR, 2.87; 95%CI: 1.07-7.42, p=0.03). Conclusion: Although patients who received regorafenib had more SMM loss than those who received TAS-102, there was no difference in OS between drugs.Öğe Complete agenesis of dorsal pancreas with pancreatic cyst: A case report(Kare Publ, 2021) Ustabasioglu, Fethi Emre; Kurt, Nazmi; Tuncbilek, NerminAgenesis of the dorsal pancreas (ADP) is extremely rare disease with no specific symptoms and there is no clear pathogenesis. Approximately half of the affected individuals develop diabetes resulting from reduced islet cell mass secondary to lack of endocrine structures. In this case, we aimed to present a 17-year-old female patient with ADP accompanied by a pancreatic cyst.Öğe CT visual quantitative evaluation of hypertensive patients with coronavirus disease (COVID-19): Potential influence of angiotensin converting enzyme inhibitors / angiotensin receptor blockers on severity of lung involvement(Taylor & Francis Inc, 2021) Samanci, Cesur; Saylan, Bengu; Gulsen, Gokce; Akkaya, Yuksel; Yesildal, Melike; Isik, Sinem Akkaya; Ustabasioglu, Fethi EmreObjective There is not enough data on the effect of angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) on lung involvement in patients with COVID-19 pneumonia and hypertension (HT). Our aim was to compare the lung involvement of the HT patients hospitalized for COVID-19 using ACEIs/ARBs with the patients taking other anti-HT medications. Methods : Patients who have a diagnosis of HT among the patients treated for laboratory-confirmed COVID-19 between 31 March 2020 and 28 May 2020 were included in the study. One hundred and twenty-four patients were divided into two as ACEIs/ARBs group (n = 75) and non-ACEIs/ARBs group (n = 49) according to the anti-HT drug used. The chest CT involvement areas of these two groups were evaluated quantitatively by two observers including all lobes, and total severity score (TSS) was calculated. These TSS values were compared between drug groups and clinical groups Results In clinical classification; there were 4 (%3.2) asymptomatic, 5 (4.0%) mild type, 92 (74.1%) common type, 14 (11.3%) severe type, 9 (7.3%) critical type patients. ACEI/ARB group's TSS (mean +/- SD, 7.74 +/- 3.54) was statistically higher than other anti-HT medication group (mean +/- SD, 4.40 +/- 1.89) (p < .001). Likewise, severe-critical clinical type's TSS (mean +/- SD, 9.17 +/- 3.44) was statistically higher than common type (mean +/- SD, 5.76 +/- 3.07) (p < .001). Excellent agreement was established between the two blinded observers in the TSS measurements. Conclusions Quantitative evaluation of CT and TSS score can give an idea about the clinical classification of the patient. TSS is higher in ACEI/ARB group than non-ACEIs/ARBs group.Öğe The Diagnostic Value of Superb Microvascular Imaging in Prediction of Uterine Artery Embolization Treatment Response in Uterine Leiomyomas(Wiley, 2021) Samanci, Cesur; Ozkose, Burak; Ustabasioglu, Fethi Emre; Erol, Burak Caglar; Sirolu, Sabri; Yilmaz, Fatma; Ozkose, Zeynep GedikObjectives We aimed to determine if superb microvascular imaging (SMI) can predict response to uterine artery embolization (UAE) as compared with power Doppler ultrasound. Methods The blood flow and the volume of the dominant leiomyoma was evaluated by power Doppler ultrasonography (PDUS) and SMI 1 day before and 3 months after the UAE procedure. SMI and PDUS blood flow were classified to 4 grades of vascularity. The change in fibroid volume in Grades 0-2 (hypovascular group) was compared to the hypervascular Grade 3 group. Results Twenty-eight women (mean age, 40.9 years; range, 33-53 years) were examined with PDUS and SMI before and 3 months after UAE. The volume reduction was statistically significantly higher hypervascular group (P < .05). When we accept 30% or more volume reduction as a good response to UAE, the positive predictive value, negative predictive value, sensitivity, specificity, and accuracy of SMI were 100, 64, 73.6, 100, and 82.1%, respectively. There was excellent agreement between the two blinded observers in SMI measurements. Conclusions SMI, with its high reproducibility, provides further microvessel information than PDUS in uterine fibroids. It may be a useful tool in prediction of response to UAE treatment and improve counseling and patient selection for UAE versus medical or surgical treatment options.Öğe Double Coronary-Cameral Fistula Draining to the Right Ventricle in a Patient with Mitral Stenosis: is it Clinically Relevant?(Galenos Publ House, 2023) Ebik, Mustafa; Ozturk, Cihan; Ustabasioglu, Fethi Emre[Abstract Not Available]Öğe EVALUATION OF ACCURACY OF SHEAR WAVE ELASTOGRAPHY AND SUPERB MICROVASCULAR IMAGING METHODS IN DIAGNOSIS OF PIRIFORMIS SYNDROME: A PRELIMINARY STUDY(Elsevier Science Inc, 2022) Gulsaran, Ugur; Ustabasioglu, Fatma; Gunay, Burak; Ustabasioglu, Fethi EmrePiriformis syndrome is a neuromuscular disease resulting from sciatic nerve compression caused by an abnormal condition in the piriformis muscle. Superb microvascular imaging (SMI) is a new ultrasound imag-ing technique that visualizes low-velocity and small-diameter blood vessel flow. In our prospectively designed study, we aimed to evaluate the accuracy of diagnosis of piriformis syndrome with innovative methods such as shear wave elastography (SWE) and SMI. Thirty-two patients diagnosed with unilateral piriformis syndrome were accepted to the statistical stage. The side without symptoms was considered the unaffected side Bilateral piriformis muscles were examined by ultrasonography. Muscle thickness was determined on gray scale, stiffness on SWE and vascularity characteristics on power Doppler and SMI by two independent radiologists. Piriformis muscle stiffness on the non-pathological (unaffected) side was measured by SWE as 18.27 +/- 7.301 kPa, and the mean stiffness on the pathological side was 29.70 +/- 10.095 kPa. Pathological side muscle stiffness was signifi-cantly higher (p < 0.05). Using innovative methods such as SWE and SMI in addition to conventional ultrasonog-raphy as much as possible in our daily practice and research helps us in making the correct diagnosis in piriformis syndrome. (E-mail addresses: ugurgulsaran@yandex.com.tr fatmaustabasioglu@gmail.com drburakgunay@gmail.com ustabasioglu@hotmail.com) (c) 2022 World Federation for Ultrasound in Medicine & Biology. All rights reserved.Öğe Evaluation of placenta in patients with gestational diabetes using shear wave elastography and superb microvascular imaging(Sage Publications Ltd, 2024) Celik, Ahmet Onur; Gunay, Burak; Coker, Gonca Busra; Ustabasioglu, Fethi Emre; Ates, Sinan; Tuncbilek, NerminBackground: Gestational diabetes mellitus (GDM) is a common disease, and the placenta shows various functional and morphological changes in these patients. Superb microvascular imaging (SMI) and shear wave elastography (SWE) are innovative ultrasound (US) methods that provide detailed information about tissue vascularization and elasticity.Purpose: To evaluate placental changes in patients with GDM with SMI and SWE methods.Material and methods: For this case-control study, 20 healthy and 20 women with GDM were included. Women at >21 weeks of pregnancy were evaluated with SMI and SWE by two independent radiologists. Mean SMI values and mean SWE values from three different region of interest-based measurements were compared between the two groups.Results: We identified that the mean SMI and SWE value of the GDM group was found to be significantly higher than that of the control group (P = 0.002, P = 0.001 respectively). Using a receiver operating characteristic curve, the cutoff value of the SMI ratio, which maximizes the prediction of the presence of GDM, was 0.1234279750 (95% confidence interval [CI] = 0.625-0.920), the SWE cut-off value was 15.5 kPa (95% CI = 0.794-0.989).Conclusion: We have demonstrated that evaluation with SMI and SWE might allow quantitative assessment of the morphological changes of placentas in women with GDM. We believe that the use of innovative methods such as SMI and SWE in addition to conventional US examinations in daily practice and studies will provide significant clinical benefits to patient management.Öğe Evaluation of the factors affecting survival and local recurrence in thigh soft tissue sarcomas(Turkish Joint Diseases Foundation, 2024) Yildirim, Savas; Ciftdemir, Mert; Ustabasioglu, Fethi Emre; Ustun, Funda; Usta, UfukObjectives: The aim of this study was to evaluate the factors affecting local recurrence and survival in patients with soft-tissue sarcomas located in the thigh.Patients and methods: This retrospective cross-sectional study evaluated 41 soft tissue sarcoma patients (21 males, 20 females; mean age: 57.9 +/- 13.7 years; range, 18 to 90 years) with thigh involvement between January 2010 and December 2020. All surgical intervention was performed by one surgeon with an experience of 15 years in orthopedic oncologic surgery. Epidemiological, radiological, histopathological, and metabolic features, as well as surgical and oncological treatments and prognoses, were assessed. The data was statistically analyzed to determine factors affecting local recurrence and survival in these cases, staged using Enneking and the American Joint Committee on Cancer classifications.Results: Liposarcomas were the most common type of tumor (39%), followed by undifferentiated pleomorphic sarcomas (32%). Tumors >10 cm were associated with decreased survival rates. High-grade tumors, tumor necrosis, Ki-67 index >20%, and positive surgical margins were also associated with lower survival rates. Metastatic patients had significantly lower survival rates. Local recurrence was significantly more frequent in patients with positive surgical margins. Survival rates were significantly lower in metastatic patients.Conclusion: There are many factors that affect local recurrence and survival of soft tissue sarcomas. The size of the mass, the presence of necrosis, a high Ki-67 index, positive surgical margins, and the presence of metastasis are the main factors that should be taken into consideration.Öğe Iatrogenic Coronary Artery Dissection: Early or Late Intervention?(Galenos Publ House, 2022) Taylan, Gokay; Ustabasioglu, Fethi Emre; Yalta, Kenan[Abstract Not Available]Öğe Iatrogenic gluteus medius muscle insertion injury while trochanteric entry nailing due to trochanteric fractures: a comparative study in forty patients with gray-scale ultrasound and shear-wave elastography(Springer, 2021) Colbe, Suleyman Alp; Ciftdemir, Mert; Ustabasioglu, Fethi Emre; Ozgur, CihanIntroduction Trochanteric entry nailing potentially causes damage to the gluteus medius (GM) tendon. The aim of this study is to determine the amount of iatrogenic damage to the tendon during reaming by measuring the thickness and stiffness of the GM muscle in patients with trochanteric fractures who are treated with trochanteric entry nails using gray-scale ultrasound (GSUS) and shear-wave elastography (SWE). Methods Thickness and stiffness values of bilateral GM muscles in 40 patients with trochanteric fractures treated with PFN-A were measured using GSUS and SWE at post-operative sixth week or later. Harris Hip Scores and bilateral active hip abduction measurements of the patients were recorded. The data was analyzed using statistical methods to assess the extent and amount of iatrogenic injury that occurred during trochanteric entry. Results Mean age of the patients was 70. Thirty-three fractures occurred with low-energy trauma. In the SWE evaluation, there was no statistically significant difference between ipsi- and contralateral GM muscle thickness measurements or ipsi- and contralateral GM muscle stiffness measurements. Also, the difference between the clinical evaluation results of the ipsi- and contralateral hip functions was not statistically significant. Discussion In this study, we used the Harris Hip Score and hip abduction range of motion in addition to SWE and GSUS in order to assess the patients' functional status. There are studies in the literature that report significant injury to the GM tendon with cephalomedullary nailing. The majority of these studies are cadaver studies with only clinically irrelevant or uncertain evidence. In this study, we aimed to evaluate the potential negative effects of the iatrogenic damage to the bone-tendon junction during nailing, by measuring the stiffness (consistency) and atrophy of the GM muscle alongside the functional evaluation. Conclusion We have found no statistically significant difference between operated and intact side GM muscles in terms of stiffness, atrophy, and functional evaluation in patients with TFs treated using PFN-A. The results of our study should not be interpreted as trochanteric entry nailing does not cause any damage on the GM tendon.Öğe Intrathoracic extrapleural lung herniation: A new type of lung hernia(Kare Publ, 2021) Ozgur, Cihan; Ustabasioglu, Fethi Emre; Tuncbilek, Nermin[Abstract Not Available]Öğe Local Recurrence of Metatarsal Aneurysmal Bone Cyst after Percutaneous Sclerotherapy(Galenos Publ House, 2022) Gunay, Burak; Ustabasioglu, Fethi Emre; Ciftdemir, Mert; Uslu, Burak; Usta, Ufuk[Abstract Not Available]Öğe Primary Cystic Echinococcosis of the Spine: A Rare Case Misdiagnosed as Chordoma(Wolters Kluwer Medknow Publications, 2023) Celik, Ahmet Onur; Ajredini, Mirac; Ustabasioglu, Fethi Emre; Akinci, Ahmet Tolgay; Puyan, Fulya Oz[Abstract Not Available]
