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Browsing by Author "Düzgün, F"

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A deep learning feature extraction-based hybrid approach for detecting pediatric pneumonia in chest X-ray images
Bal, U; Bal, A; Moral, ÖT; Düzgün, F; Gurbuz, N
Pneumonia is a disease caused by bacteria, viruses, and fungi that settle in the alveolar sacs of the lungs and can lead to serious health complications in humans. Early detection of pneumonia is necessary for early treatment to manage and cure the disease. Recently, machine learning-based pneumonia detection methods have focused on pneumonia in adults. Machine learning relies on manual feature engineering, whereas deep learning can automatically detect and extract features from data. This study proposes a deep learning feature extraction-based hybrid approach that combines deep learning and machine learning to detect pediatric pneumonia, which is difficult to standardize. The proposed hybrid approach enhances the accuracy of detecting pediatric pneumonia and simplifies the approach by eliminating the requirement for advanced feature extraction. The experiments indicate that the hybrid approach using a Medium Neural Network based on AlexNet feature extraction achieved a 97.9% accuracy rate and 98.0% sensitivity rate. The results show that the proposed approach achieved higher accuracy rates than state-of-the-art approaches.
Benign Versus Malignant Vertebral Compression, Chemical Shift MR Imaging, Is It Useful?
Ovali, GY; Düzgün, F; Farasat, M; Orguc, S
Objectives: The aim of this study was to evaluate the diagnostic accuracy of chemical shift imaging in vertebral compression. Patients and Methods: Forty-nine patients with vertebral compression with suspected malignancy or history of trauma were included in this study. MRimaging of the spine with standard conventionalMRsequences and additional chemical shift imaging was done with 1.5 Tesla MR Unit. Regions of interest (ROI) were placed on the abnormal marrow of compressed vertebrae both on the opposed phase and on the matching in phase images and signal intensity (SI) ratio values (SI out-phase/SI-in phase) were calculated. Results: Forty-nine patients had 68 spine lesions, consisting of 49 benign and 19 malignant fractures. Student t test, receiver operating characteristic (ROC) analysisandinterclass correlation test were used statistically. MeanSI ratio of benign vertebral compression (0. 68 +/- 0.29, range 0.13 - 1.53) was significantly lower than malignant SI ratio values (1.06 +/- 0.10, range 0.96 -1.35). With student t-test, there was significant difference between benign compressions compared to malignant compressions (P < 0.001). Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut off value in malignant and benign lesion definition. The optimal SI ratio cut off value was found to be 0.96 for separating benign and malignant vertebral compression. The area under the curve (AUC) value was observed as 0.92 (95% confidence interval [CI] = 0.86-0.99). According to that cutoff value, sensitivity was 100% (95% CI = 82.35% -100%) and the specificity was 86% (95% CI = 72.76% -94.06%). Interobserver reliability was studied with intraclass correlation and results were statistically significant with intraclass correlation coefficient (ICC) as 0.85 (P < 0.05). Conclusions: There is significant difference in signal values between benign and malignant compression fractures in chemical shift MR imaging. Chemical shift MR imaging has much additive data to conventional MRI in vertebral compression.
Comparison of preoperative penile elastographic ultrasound findings and pathological tissue results of patients implemented with penile prosthesis
Bozkurt, YE; Gümüs, BH; Düzgün, F; Nese, N
Objective Histopathological analysis of the relationship between penile elastography and erectile dysfunction. Material and method 12 patients who applied to our clinic for erectile dysfunction in the last 1 year and accepted this study were included. Preoperative two-dimensional shear wave elastography imaging was performed in 12 patients and recorded in the Pascal (kPa) unit. Approximately 0.5 x 0.5 x 0.5 cm tissue samples were taken from the right and left cavernous tissue during penile prosthesis implantation operation. Tissue samples were sent to the pathology department. The percentage of the area covered by muscle fibers and elastic fibers in the corpus cavernosum was noted semi-quantitatively (ratio of muscle fibers and cavernous body elastic fiber score). All data obtained were compared with each other. Results Cavernous body elastic fiber score data(Grouped Score 1, 2 and 3) and percentage of cavernous body muscle fibers data (Grouped %10, %20, %30 horizontal ellipsis %100) were compared with Shear wave elastography data (kPa). The results were not statistically significant according to the Kruskal Wallis Test. Cavernous body elastic fiber score and the percentage of cavernous body muscle fibers were also compared, it was not statistically significant according to the Kruskal Wallis test and Spearman's correlation test. Conclusions Penile shear wave elastography can be used clinically to quantitatively assess the amount of smooth muscle cells and elastic fibers in the penis, but it deserves to be studied with a larger number of patients and a more specific interpretation of the pathology preparation.
The Relationship of Testicular Sonoelastography with Gonadotropin Hormone Levels and Sperm Parameters
Bozkurt, YE; Gümüs, BH; Özbay, M; Düzgün, F; Taneli, F; Kurutep, S
Background: Elastography is a non-invasive medical imaging technique that helps determine the stiffness of organs and other structures in our body. In this study, we investigated the effectiveness of elastography in the diagnosis of infertility. Aim: In this study, we aimed to examine the relationship between testicular elastography and hormonal parameters and sperm parameters. Patients and Methods: The study included 136 patients, 272 testicles were examined, and the mean age of the study participants was 30.1 years. Testicular tissue stiffness was measured by scrotal ultrasonographic shear wave elastography. Gonadotropin and testosterone hormones were measured from blood samples. Spermiogram parameters were studied manually. Results: The control group included 66 patients, and the varicocele group consisted of 70 patients. Testicular stiffness degrees of the control group were measured as 4.29 kPa for the right testis and 4.23 kPa for the left testis. The varicocele group was divided into grades 1, 2, and 3 according to physical examination. In group 1 (grade 1), the right testis was 4.07 +/- 1.24 kPa and the left testis was 3.77 +/- 0.98 kPa. In group 2 (grade 2), the right testis was 4.31 +/- 1.40 kPa and the left testis was 3.98 +/- 0.93 kPa. In group 3 (grade 3), the right testis was 4.73 +/- 1.50 kPa and the left testis was 3.99 +/- 1.68 kPa. Hormone and sperm parameters were not statistically significant when comparing the control and varicocele groups. There was no statistical significance between the testicular tissue stiffness degrees of the control and varicocele groups. Hormone and spermiogram findings were also similar in groups. Conclusion: It is known that varicocele leads to histological tissue changes in the testes. These changes result in tissue softness and loss while affecting sperm parameters and testosterone levels in a negative way. Before varicocele surgery, there is a need for new imaging methods with more sensitivity that can detect tissue changes in the testes.
Which temporal bone anatomical structures and pathologies could be best visualized by applying reconstruction to cross-sections obtained on an axial plane?
Bostanci, IE; Düzgün, F; Ovali, GY; Tarhan, S; Pabusçu, Y
Objective: In this study, we aimed to identify the position in which temporal bone anatomical structures and pathologies could be best visualized by applying reconstruction to cross-sections obtained on an axial plane in temporal bone computed tomography (CT) scans. Methods: Sixty patients were examined with temporal bone CT between July 2008 and March 2009. We obtained multiplanar reformatted images by applying retro-reconstruction on various planes from the axial plane sections. Results: We determined that the reconstructed images increased the anatomical and pathological details and significantly contributed to evaluating the relationship between anatomical structures and their pathologies with other normal components. Conclusion: Obtaining multiplanar reformatted images by retro-reconstruction decreased the need for visualization of coronal sections used in standard temporal bone CT exams since the anatomical details were diversified using the new planes. In addition, the dose of radiation received by the patients and the duration of the examination could be reduced by eliminating routine coronal plane sections and obtaining new images using retro-reconstruction.
Comparison of bone scintigraphy and whole-body diffusion-weighted magnetic resonance imaging in the detection of bone metastases
Sözütok, S; Tarhan, S; Düzgün, F; Bilgin, ES
Purpose: The aim of this study was o evaluate the efficacy and success of whole-body diffusion-weighted magnetic resonance imaging (WB-DW-MRI) as a new method for the detection of bone metastasis commonly seen in malignancies, compared to bone scintigraphy. Materials and Methods: The WB-DW-MRI findings of 21 patients with primary malignancies and bone metastases were retrospectively evaluated and compared to scintigraphy findings. Results: Twenty-one patients had 143 metastatic lesions detected by scintigraphy, and 96 of these bone metastases were also detected on WB-DW-MRI. The area where the success of WB-DW-MRI was highest was the lower extremities, for which 12 (92.3%) of 13 metastases were identified. This was followed by vertebrae, for which WB-DW-MRI detected 39 (86.6%) of 45 metastases. The metastasis detection rates for the upper extremities, pelvis, and cranium were calculated as 73.6%, 63.1%, and 60%, respectively. WB-DW-MRI was least successful in identifying metastases in ribs, with only 16 (38.1%) of 42 metastases being detected by this modality. Conclusion: In line with the findings obtained from this study, it is considered that WB-DW-MRI may be successful in the detection of bone metastases, especially in the axial skeleton. The failure observed for the ribs can be remedied by newly developed magnetic sensitivity technologies, increasing geometric resolution, and fast sequences that will prevent motion artifacts.
A mass screening survey of cystic echinococcosis by ultrasonography, Western blotting, and ELISA among university students in Manisa, Turkey
Kilimcioglu, AA; Girginkardesler, N; Korkmaz, M; Özkol, M; Düzgün, F; Östan, I; Pabuscu, Y; Dinç, G; Ok, ÜZ
Cystic echinococcosis (CE) is one of the most important zoonotic diseases in a wide geographic area, including Turkey. In the present project, a total of 4275 students from Celal Bayar University, Manisa, Turkey, were screened by ultrasonography (US) and specific antibodies for CE were examined by Western blotting (WB) and ELISA in finger prick blood samples of 2034 of 4275 volunteered students. We aimed to report the apparent prevalence of CE based on different diagnostic procedures and to compare WB and ELISA with US in diagnosis of CE in a mass screening setting. Six new cases were diagnosed as CE by US during the survey. In addition to these cases, three students were also detected to have been previously operated and pathologically confirmed for hepatic CE. US revealed parenchymal changes in these cases in concordance with their operation history; so, the prevalence of CE by US was calculated as 0.21% (9/4275) (95%CI, 0.11-0.39%) among university students in Manisa. Bands were detected at 8, 28, 32, 38, 42, 47, 70 and 90 kDa by WB and the cases were considered to be positive for CE when at least three of the bands were seen together. Apparent prevalence of CE by ELISA and WB were found to be 2.11% (43/2034) (95%CI, 1.57-2.83%) and 0.25% (5/2034) (95%CI, 0.10-0.57%), respectively. Of the six US positive cases, WB was positive in only one case with two cysts in the liver. All of four cases with liver involvement were positive by ELISA. The high prevalence of CE among university students in Manisa indicated that CE is a major health problem in this area of Turkey. Our results supported that WB is rather difficult and not feasible as a mass screening test and may not be effective for confirmation especially in asymptomatic cases. As a result, we recommend US to be used initially in mass screening surveys for CE followed by confirmation by ELISA for suspected cases. Further examination primarily by chest X-ray followed by computed tomography and/or magnetic resonance imaging, if needed, should be recommended for US negative, ELISA and WB positive individuals who may have non-abdominal cysts. (C) 2013 Elsevier B.V. All rights reserved.
Multislice computed tomographic measurements of optic nerve sheath diameter in brain injury patients
Özsaraç, M; Düzgün, F; Gölcük, Y; Pabuscu, Y; Bilge, A; Irik, M; Yilmaz, H
BACKGROUND: Currently, the measurement of optic nerve sheath diameter (ONSD) has been offered as a possible indicator of intracranial pressure (ICP). Increased ICP is observed during intracranial injury. The objective of this study was to evaluate the relationship between increased ONSD and positive intracranial findings from multislice computed tomography (CT) of the brain. METHODS: In total, CT scans of 161 patients were retrospectively reviewed. The image that showed the largest ONSD was magnified five times. RESULTS: The CT scan revealed intracranial lesions in 54 patients and no intracranial lesions in 107 patients. A significant relationship was observed between positive CT findings and increased ONSD: 5.60 +/- 0.75 mm vs. 5.35 +/- 0.75 mm (p=0.038). The area under the receiver operating characteristic curve was 0.600 (95% confidence interval, 0.508-0.692; p<0.039). A cut-off value of >= 5.0 mm had a sensitivity and specificity of 80% and 36%, respectively. CONCLUSION: This study demonstrated a significant yet poor relationship between intracranial injury and increased ONSD from the multislice CT scan. Severe structural changes in the brain and trauma that causes bleeding have only limited effects on the extension of the optic nerve.
Endovascular coil treatment of a coronary artery aneurysm related to polyarteritis nodosa
Bayturan, Ö; Tarhan, S; Cöpkiran, Ö; Düzgün, F; Tezcan, UK
A Comparison Study in Children with Lower Respiratory Tract Infections: Chest X-ray and Lung Ultrasound
Gürbüz, N; Zengin, N; Karaburun, NC; Düzgün, F; Bal, A
Aim: Lower respiratory tract infections (LRTIs) are one of the leading causes of mortality and morbidity in children. Chest X-rays, which are frequently used in diagnosis, cause ionizing radiation exposure and a loss of time. We aimed to compare the diagnostic accuracy of chest radiography (CR) and lung ultrasonography (US) in patients with LRTIs.Materials and Methods: This study was designed as methodological research. Of the 62 patients evaluated in our study, four refused to participate, and eight were excluded from the study due to their underlying chronic diseases. All 50 remaining patients (between the ages of 0-18 years) were evaluated with a preliminary LRTI diagnosis. Lung US was performed by a 3rd-year pediatric resident who had six hours of onlineResults: The mean age of the 50 cases included in this study was five years and three months; 35 of the 50 patients (70%) had a clinical diagnosis of pneumonia, 15 (30%) of them had a clinical diagnosis of bronchiolitis. Statistically significant interobserver agreement was found between US and CR [Kappa value 0.772, 95% confidence interval (0.590-0.925) (p=0.000)]. The sensitivity of lung US was 95%, and its specificity was 85.7% when CR was accepted as the gold standard.Conclusion: Our study demonstrates that lung US can be used instead of CR to diagnose and follow-up pediatric cases with LRTIs.
Is Computed Tomography Perfusion a useful Method for Distinguishing between Benign and Malignant Neck Masses?
Düzgün, F; Tarhan, S; Ovali, GY; Eskiizmir, G; Pabusçu, Y
Evaluation of neck masses is frequent in ear, nose, and throat clinics. Successful outcomes associated with neck mass are directly related to rapid diagnosis and accurate treatment for each patient. Late diagnosis of a malignant mass increases the magnitude of morbidity and the rate of mortality of the disease. Although magnetic resonance imaging and computed tomography (CT) examinations are important tools for evaluating head and neck pathologies, they do not allow functional evaluation. For this reason, CT perfusion (CTP) as a method of functional evaluation for distinguishing benign from malignant masses is gaining attention. The utility of CTP for distinguishing between benign and malignant mass lesions was investigated in 35 patients with masses in the neck (11 benign, 24 malignant). CTP was shown to be a useful method for identifying head and neck tumors and blood volume values to enable the differential diagnosis of benign and malignant head and neck tumors.
A Rare Case of Ascites: Eosinophilic Gastroenteritis
Dogan, G; Düzgün, F; Yilmaz, O; Ayhan, S; Gülen, H; Kasirga, E
Eosinophilic gastroenteropathies are rare disorders. An 18-year-old girl presented to the hospital with abdominal pain and distension. Abdominal tenderness and grade 2 ascites, serious peripheral eosinophilia and high immunoglobulin E level were found. Laparoscopic antrum biopsy showed subserosal eosinophilic infiltration. Eosinophilic gastroenteropathy was suspected, diet elimination was given, no steroid treatment was used.
Does Pituitary Volume have the Diagnostic Value on Growth Hormone Deficiency and Prognostic value on the Response to Growth Hormone Therapy?
Yilmaz, SK; Ovali, GY; Düzgün, F; Kizilay, D; Ersoy, B
Long term follow-up results of ablation treatment for patients with small renal mass
Gümüs, BH; Albaz, AC; Düzgün, F; Üçer, O; Temeltas, G; Müezzinoglu, T; Tarhan, S
Objective The aim of this study is to evaluate the outcome of ablation therapy in our clinic for the treatment of patients with a small renal mass Materials and Methods: We retrospectively evaluated the technic and follow-up data of 30 patients with 36 tumours who underwent Radiofrequency Ablation (RFA) and Microwave Ablation (MWA) in our clinic. Demographic data, ablation type, tumour characteristics, peroperative and postoperative complications and treatment success of the patients were evaluated. Results A total of 36 tumours who underwent ablation treatments, 23 were treated with RFA, 13 with MWA. The mean tumour size was 28.9 +/- 6.92 mm in RFA and 29.3 +/- 7.70 mm in MWA. The mean follow-up period was 49.6 +/- 24.7 months in patients with RFA and mean follow-up was 16 +/- 8.05 months in MWA treatments. The overall success in MWA administration was calculated as 76.9%, while the overall success in RFA was 80%. Conclusion Long-term oncologic efficacy of RFA appears to be successful in the treatment of T1a renal carcinomas. Further studies can be conducted to elucidate the influence of MWA on long-term oncological outcomes.
Image-Guided Percutaneous Drainage Reduces the Need for Surgical Interventions in Patients with Tubo-Ovarian Abscess: A Cohort Study
Hasdemir, PS; Düzgün, F; Uçar, D; Cengiz Özyurt, B; Pekindil, G
Objective: Management of tubo-ovarian abscess (TOA) is a challenging healthcare problem especially in reproductive age women. The aim of this study is to determine the current role of image-guided primary percutaneous drainage in avoidance of surgical intervention in the management of TOA. Material and Methods: A total of 76 patients hospitalized in our tertiary care center with the diagnosis of TOA were retrospectively evaluated. The study population was divided into 2 groups based on the treatment modalities as antibiotic treatment (n=48) and image-guided percutaneous drainage (n=28) and evaluated in terms of clinical and laboratory characteristics and the requirement for surgical intervention. Results: Surgical intervention was required in 1 (3.6%) patient treated with percutaneous drainage and in 10 (20.8%) patients treated with antibiotics (p=0.036). The choice of treatment modality was independent of demographic characteristics, clinical and laboratory findings. The size of TOA in percutaneous drainage group was significantly larger compared to the antibiotic treatment group (mean 6.75 +/- 1.886 cm versus 5.92 +/- 5.88 cm, respectively, p=0.047). Rehospitalization during follow-up was higher among patients treated with antibiotics only compared to percutaneous drainage group (p=0.06). Conclusion: Percutaneous drainage is an acceptable treatment option including large-sized TOA and decreases the requirement of surgical intervention in selected cases.
Percutaneous embolization of congenital portosystemic venous shunt in an infant with respiratory distress
Alkan, F; Düzgün, F; Yüksel, H; Tarhan, S; Coskun, S
A 5-month-old boy with progressive respiratory distress was admitted to our hospital. Physical examination revealed mild tachypnea and retraction. The left main bronchus was found as severely collapsed between the right pulmonary artery and the descending aorta, on the bronchoscopic evaluation. Further evaluation revealed persistent ductus venosus (PDV). As in the fetal period the ductus venosus arises from the posterior aspect of the left portal vein, a PDV is considered another type of intrahepatic portosystemic shunt. Therefore, he was diagnosed with congenital portosystemic venous shunt, leading to persistent respiratory distress. The PDV was closed with Amplatzer vascular plug II, and then he had immediate clinical improvement. Congenital portosystemic venous shunts (CPSS) are rare vascular malformations associated with severe complications. Here we presented a case with progressive respiratory distress as a result of CPSS and rapid improvement after embolization.
Osteopetrosis: A Case Report
Ozkol, M; Er, A; Düzgün, F
Osteopetrosis, also called as marble bone, stone bone or Albers-SchOnberg disease is a very rare hereditary entity. In this disease, the balance between bone-forming osteoblasts and bone resorbing osteoclasts is altered. Our patient was an 8-year-old girl who was diagnosed with osteopetrosis and followed by the pediatric hematology department. She has been referred to our hospital several times with the complaints of cough, fatigue and hip and leg pain. X-ray examinations showed typical signs of osteopetrosis. The patient also had anemia, thrombocytopenia and hepatosplenomegaly and received blood transfusions several times. In these patients, usually the sign of sclerotic bone detected by x-ray establishes the diagnosis. Our patient had anemia, hepatosplenomegaly and loss of vision in addition to the typical radiologic signs. In newborns, the diagnosis of osteopetrosis can be established if osteosclerosis is associated with widening of the long bones. Since the signs were prominent in the newborn period, our patient was assumed to have autosomal recessive (OR) form of the disease which has a poorer prognosis. In conclusion, anemia, thrombocytopenia, and hepatosplenomegaly, which are common, but are not specific signs, must suggest osteopetrosis when sclerosis of bone accompanies and, the child must be given a chance for bone marrow transplantation.
Neonatal Cholestasis as Initial Presentation of Portosystemic Shunt: A Case Report
Dogan, G; Düzgün, F; Tarhan, S; Appak, YÇ; Kasrga, E
Congenital intrahepatic portosystemic shunts are rare in children. Portosystemic venous malformations are characterized by extreme clinical variability. We report a full-term 33-day-old male infant presenting with neonatal jaundice. On physical examination, he had generalized icterus and the liver was palpable 3.5 cm below the right costal margin. He had no other symptoms. Laboratory tests showed AST 632 U/L, ALT 198 U/L, total bilirubin 12.1 mg/dL, conjugated bilirubin 10.2 mg/dL, alkaline phosphatase 753 U/L, GGT 47 U/L and glucose 67 U/L. Colour Doppler ultrasonography showed the left portal vein was more dilated than the right portal branch and communication with dilated left hepatic vein. There was no evidence of portal hypertension, heart failure, hepatopulmonary syndrome and encephalopathy during his hospital stay, so he was discharged from the pediatric department and his parents advised to attend monthly follow-up. Congenital portosystemic shunts are rarely observed in the childhood period. 1 Depending on anatomic characteristics they may be intrahepatic or extrahepatic. 2 Intrahepatic portosystemic shunts (PSS) are observed between the portal vein and hepatic vein or vena cava inferior. 3,4 Small shunts may close themselves before the age of 2 years. 5 With the increase in use of imaging methods, diagnosing PSS has become easier, with an increase in the number of cases reported. 6 Neonatal cholestatis is a frequent complication of PSS. 1 We present a case presenting with neonatal cholestasis diagnosed with congenital intrahepatic PSS.
The short-and long-term effectiveness of transcatheter arterial embolization in patients with intractable hematuria
Korkmaz, M; Sanal, B; Aras, B; Bozkaya, H; Çinar, C; Güneyli, S; Gök, M; Adam, G; Düzgün, F; Oran, I
Purpose: Selective transarterial embolization (TAE) of the internal iliac artery is a well-known alternative technique to control intractable bladder hemorrhage (IBH). We explored the shortand long-term effectiveness of, and clinical outcomes after, TAE in patients with IBH. Materials and methods: In this retrospective study, we reviewed the hospital records of 18 IBH patients non-responsive to conservative medications who underwent TAE between January 2003 and May 2014. The early-and long-term effectiveness of TAE was investigated in the context of hematuria control, complications, mortality, requirement for blood transfusions, and hematocrit level. Results: Sixteen of the 18 patients underwent endovascular treatment; the technical success rate was 88%. TAE allowed complete remission in 16 patients (100% clinical success). On follow-up, mean hematocrit (P = 0.003) and hemoglobin (P = 0.005) levels significantly improved. Thirteen of the 16 patients (81%) required no further emergency admission after TAE during a mean follow-up period of 18.1 months (range, 3-105 months). Conclusion: TAE is a feasible, effective, and safe technique in both the short-and long-term for the treatment of IBH. (C) 2015 Editions francaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.
Idiopathic thoracic spinal epidural lipomatosis causing spinal cord compression
Korkmaz, M; Gök, M; Bozkaya, H; Güneyli, S; Düzgün, F; Oran, I

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