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Öğe A comprehensive morphometric analysis of crista galli for sex determination with a novel morphological classification on computed tomography images(Springer France, 2021) Komut, Erdal; Golpinar, MuratPurpose This study aimed to examine the morphometry of the crista galli (CG) on paranasal sinus computed tomography (PNCT) images to develop a new approach of morphological classification with objective radiological criteria and to investigate the relationship of morphometric and morphological characteristics with gender. Methods The height, width, and length of the CG were measured on the PNCT images of 533 subjects (266 males, 267 females). Based on the dimensions and the presence of the cavitary component of the CG, the CG was classified into three morphological types. The success of CG dimensions and new morphological classification of CG in the determination of gender was evaluated with ROC and Paired Logistic Regression analyses. Results The morphometric cutoff values of the height, width, and length of the CG for the estimation of gender were determined as 15.15, 3.45, and 13.25 mm, respectively. CG length (accuracy 83.7%) showed more successful classification rate on gender determination as compared to height (accuracy: 81.4%), and width (accuracy 81.2%) of the CG. The presence of ossified type CG accurately identified the male sex at a rate of 88.7%, and teardrop type CG determined female sex at a rate of 82.9%. Tubular type CG identified male sex correctly at the rate of 65.8%. Conclusion The height, length, and width measurements of CG on PNCT images and the new morphological types recommended in this study can be used in the determination of gender with high accuracy rates.Öğe Can developmental dysplasia of the hip be identified in the prenatal period? A pilot study: Ultrasonographic evaluation and postnatal follow-up results of fetal hips in the third trimester(2021) Komut, Erdal; Zehir, SinanObjective: This study aimed to determine the predictability of developmental dysplasia of the hip (DDH) in the prenatal period by means of evaluating fetal hips using the Graf method on obstetric ultrasonography (US) after the 34th week of gestation. Methods: A total of 84 pregnant women (mean age = 27.04; age range = 19-46 years), who were referred to our radiology clinic for an obstetric US examination in the third trimester, and their fetuses were included in this study. In the obstetric US, alpha angles of both hips of the fetuses were measured based on Graf’s method, and each case was assessed ultrasonographically by a second physician at 6-10 postnatal weeks. Prenatal and postnatal hips were then classified according to alpha angles as ? 60° or < 60°. The kappa coefficients between the diagnoses based on prenatal and postnatal alpha angles were calculated. Results: According to the postnatal alpha angle, 77 fetuses were diagnosed to have type 1 right hip and 7 fetuses had type 2A right hip. The prenatal alpha angle provided the same results (77 type 1 and 7 type 2A right hips). Similarly, the postnatal alpha angle revealed type 1 left hip in 82 fetuses and type 2A left hip in 2 fetuses, which was the same as the diagnoses based on the prenatal alpha angles. There was a complete agreement between prenatal and postnatal alpha measurements for both the left and right hips (kappa = 1.00, P < 0.001). Conclusion: Evidence from this study has revealed that DDH can be identified by obstetric ultrasonographic examinations in the prenatal period. Level of Evidence: Level II, Diagnostic StudyÖğe Novel prognostic grayscale ultrasonographic findings in the testis from a comprehensive analysis of pediatric patients with testicular torsion(Elsevier Sci Ltd, 2019) Afşarlar, Çağatay Evrim; Çakmakçı, Emin; Demir, Emre; Güney, Güven; Komut, Erdal; Elizondo, Rodolfo; Koh, Chester J.Introduction Although grayscale and Doppler ultrasound (US) findings of testicular torsion (TT) have previously been described in the literature, other US findings may provide more prognostic information to families. Objective The authors hypothesized that a comprehensive analysis of US findings of TT that focused on time-dependent changes would lead to additional ultrasonographic morphologic findings and clinically relevant prognostic information. Study design The authors reviewed the records of pediatric patients with acute TT from 2010 to 2017. The sizes and parenchymal characteristics of the torsed and contralateral testes on US were analyzed in relation to the time duration from the onset of scrotal pain to the time of surgery (0-6 h, 6-12 h, 12-24 h, 24-48 h, and >48 h), torsion degree, and clinical outcomes of the testes. Results Patient demographics, time intervals, and US measurements of the torsed and contralateral testes showed significant differences with respect to testicular viability (Summary Table). The mean volume ratios of torsed to contralateral testis showed significant differences between the 0-6 h and the 12-24 h time groups as well as the 6-12 h and the 12-24 h time groups (P = 0.003 and P = 0.035, respectively), as well as significant differences between the viable and non-viable testes (P = 0.005). Regarding testicular heterogeneity, two novel grayscale sonographic findings were noted: (1) multiple hypoechoic lines that were termed 'testicular fragmentation' and (2) hyperechoic patches that were termed 'testicular patching'. The presence of these two findings were significantly increased as TT time duration increased (P < 0.001), and these findings were significantly associated with testicular non-viability (P < 0.001). Torsion degree was also noted to be significantly higher in the non-viable testes (P < 0.001). Presence of hydrocele or scrotal edema also showed significant differences between the TT time groups (P < 0.001). Discussion The results of this study demonstrated ultrasonographic findings related to time dependent changes in TT and provided prognostic information regarding testicular viability. Conclusions Specific US grayscale findings in torsed testes (testicular fragmentation and testicular patching) were identified that provide prognostic information regarding time duration of testicular torsion and testicular viability. Testicular fragmentation and testicular patching significantly increased as TT time increased, with increasing risk for testicular nonviability.Öğe Partial status epilepticus in cerebral venous sinus thrombosis, initial manifestation of polycythemia vera(Wolters Kluwer Medknow Publications, 2019) Eliaçık, Sinan; Savaş, Ömer Önder; Komut, Erdal; Uysal Tan, FundaCVT Cerebral venous sinus thrombosis (CVT) is a heterogeneous disorder, with a wide spectrum of clinical presentation and marked risk factors mainly genetic or acquired prothrombotic disorders.[1] We present a case of polycythemia vera (PV) initially presenting with cerebral venous sinus thrombosis (CVT).Öğe Relationship between internal carotid artery stenosis grade and optic nerve sheath diameter measured by transorbital ultrasonography(Wiley, 2021) Komut, Erdal; Murat, Muammer; Buyuksireci, Mehmet; Komut, Seval; Kozaci, NalanPurpose To assess the consequence of the presence, grade, and asymmetry of carotid artery stenoses on the optic nerve sheath diameter (ONSD) measured by ultrasonography. Methods ONSD was measured with B-mode ultrasonography in 129 patients referred for duplex and color Doppler imaging of the carotid arteries. Internal carotid artery stenosis was graded on the basis of peak systolic flow velocity. Results The mean ONSD was 3.04 +/- 0.38 mm in the patients without or with 70% stenosis. There was an average difference of 0.58 mm between the ONSD of the patients with 70% stenosis. Conclusion ONSD is lower in patients with carotid artery stenosis. Carotid arteries should be investigated, especially in patients with cardiovascular risk factors or diseases, before interpreting ONSD values.Öğe Relationship between renal tubulointerstitial fibrosis and serum prolidase enzyme activity(Walter De Gruyter Gmbh, 2020) Eser, Barış; Doğan, İbrahim; Komut, Erdal; Koyuncu, Sümeyra; Aydemir, Nihal; Çolak, Aysel; Kayadibi, HüseyinObjectives: The severity of interstitial fibrosis/tubular atrophy (IFTA) is the most important determinant of the irreversible progression of chronic kidney disease (CKD). Prolidase is the key enzyme in collagen turnover and is associated with an extracellular matrix increase. We aimed to evaluate the relationship between the presence and degree of IFTA and serum prolidase enzyme activity (SPEA) in patients undergoing a renal biopsy. Methods: This cross-sectional study included 56 patients who underwent a renal biopsy (30 males; mean age 45.3 +/- 16.8 years) and also 54 healthy volunteers (21 males; mean age 42.7 +/- 8.2 years). IFTA scoring was performed on the basis of percentage of IFTA presence in renal biopsy tissues (1=<10%; 2=10-24%; 3=25-50%; 4=>50%). SPEA was measured by spectrophotometric method. Results: The proteinuria and SPEA levels of the patients were significantly higher than the controls (p<0.001 and p<0.001, respectively). SPEA decreased significantly when the IFTA score increased (p<0.002). In the correlation analysis, the IFTA score was negatively correlated with SPEA (r(s)=-0.461, p<0.001), and positively correlated with proteinuria (r(s)=0.274, p=0.041). Conclusion: These findings suggest that increased collagen turnover decreases over time concerning the progression of renal fibrosis. Monitoring of SPEA level may useful as a biomarker for early determination of CKD progression and severity.Öğe The Measurement of Elderly Volunteers' Optic Nerve Sheath Diameters by Ocular Ultrasonography(Mdpi, 2019) Avci, Mustafa; Kozaci, Nalan; Komut, Erdal; Komut, Seval; Caliskan, Gulsum; Tulubas, GulBackground and objectives: The optic nerve is a component of the central nervous system, and the optic nerve sheath is connected to the subarachnoid space. For this reason, intracranial pressure (ICP) increases are directly transmitted to the optic nerve sheath. Knowing the normal optic nerve sheath diameter (ONSD) range in a healthy population is necessary to interpret this measurement as a sign of intracranial pressure in clinical practice and research. In this study, we aimed to determine the standard ONSD value in healthy adultsaged65 years of age or older who had not previously been diagnosed with a disease that could increase the ICP. Materials and Methods: The right and left ONSD values and ONSD differences were compared, according to the gender of the patients. The patients were divided into 3 groups, according to their age. The age groups were assigned as follows: Group 1: 65-74 years of age; Group 2: 75-84 years of age; and Group 3: 85 years of age or older. The ONSDs and the ONSD difference between the left and right eyes of Group 1, Group 2 and Group 3 were compared. Results: The study included 195 volunteers. The mean ONSD of both eyes was 4.16 +/- 0.69 mm, and the difference between the ONSD of the left and right eyes was 0.16 +/- 0.18 mm. There was no difference between genders in terms of right ONSD, left ONSD, mean ONSD and ONSD difference between the left and right eyes. There was no correlation between age and ONSD and ONSD difference. When the age groups and ONSD were compared, no difference was found between the groups. Conclusions: In conclusion, the ONSDs of both eyes do not vary with age in healthy adults aged65 years or older. ONSD does not vary between genders. The calculation of ONSD difference can be used to determine ICP increase.
