Browsing by Author "Pabuscu Y."
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Item Comparison of contrast-enhanced T1-weighted and 3D constructive interference in steady state images for predicting outcome after hearing-preservation surgery for vestibular schwannoma(2003) Kocaoglu M.; Bulakbasi N.; Ucoz T.; Ustunsoz B.; Pabuscu Y.; Tayfun C.; Somuncu I.We compared contrast-enhanced T1-weighted and 3D constructive interference in steady state (CISS) sequences for demonstrating possible prognostic factors in hearing-preservation surgery for vestibular schwannoma. We studied 22 patients with vestibular schwannomas having hearing-preservation surgery. Postoperatively six (27%) had a facial palsy and eight (36%) had hearing loss. There was a significant correlation between the size of the tumour and facial palsy (r=-0.72). Both techniques adequately demonstrated all tumours. Involvement of the fundus of the internal auditory canal (IAC) and a small distance between the lateral border of the tumour and the fundus were correlated significantly with hearing loss (r=-0.81 and -0.75, respectively). The 3D-CISS sequence, by virtue of its high contrast resolution was superior to T1-weighted images (P < 0.05) for detection of the fundal involvement. The direction of displacement of the facial nerve did not correlate with facial palsy or hearing loss. We think that 3D-CISS images better show the features influencing surgical outcome, but that contrast-enhanced T1-weighted images are required for diagnosis.Item Transient left paraduodenal hernia(2005) Ovali G.Y.; Orguc S.; Unlu M.; Pabuscu Y.A 52-year-old woman with acute deterioration of recurrent abdominal pain was admitted to the hospital. Spiral computed tomography (CT) of abdomen was performed. A left paraduodenal hernia was identified on CT. There was no clinical sign or imaging finding suggesting intestinal obstruction or mesenteric ischemia. She refused surgical intervention since her pain was intermittant and decreasing. On the fifth day of hospitalization the patient's pain resolved completely and the follow-up CT demonstrated regression of the herniation. © 2005 Elsevier Ltd. All rights reserved.Item Clinical and radiologic evaluations for predicting difficult tracheal intubation; [Valutazioni cliniche e radiologiche per prevedere l'intubazione tracheale difficile](2006) Topcu I.; Ovali G.Y.; Yentur E.A.; Kefi A.; Tuncyurek O.; Pabuscu Y.Objective: The aim of this study is to predict difficult endotracheal intubations preoperatively with clinical and radiographical parameters (lateral x-ray) and to assess their reliability. Design: 208 adult patients (68 male, 140 female) submitted for elective surgery under general anaesthesia were included into this study. Age, height, weight, inter-incisor gap, neck circumference, sternomental and thyromental distance, modified Mallampati classification and protruding upper teeth were measured during preoperative evaluation. Lateral cervical spine radiographs were evaluated to predict the skeletal structure associated with difficult intubation. Laryngeal view was graded according to Cormack-Lehane laryngoscopic classification. The number and duration of attempts at each tracheal intubation were recorded. Results: We obtained the percentage of difficult intubations to be 5.7%. There was no significant association between difficult intubation and age, weight, thyromental and sternomental distances, mandibular protrusion, Wilson risk scores, inter-incisor gap and neck circumference (p > 0.05). Difficult intubations were associated with male sex, Cormack-Lehane grade 3 or 4 and two and more increased Mallampati grade (p < 0.05). After taking the measurements on the radiographs, we observed a significant association between temporomandibular joint (TMJ) to tip of upper incisors (V1), length of the perpendicular from the hard palate to the tip of the upper incisors (V2), TMJ to tip of lower incisors (V5), the distance from the upper incisors to the corniculate cartilages (V17), the anteroposterior thickness of the tongue (V19) for difficult intubation with stepwise multivariate logistic regression model (p < 0.05). According to Cormack-Lehane classification we calculated the highest sensitivity as (83.3%), specificity as (95.9%), positive predictive value as (55.6%) and negative predictive value as (98.9%). Conclusion: We conclude that these clinical and radiographic measurements are of little value in predicting difficult intubation in adults when used alone. For elective cases, we advocate taking additional radiological examinations, if clinical findings predict or indicate the probability of a difficult airway.Item Prevalence of testicular microlithiasis in an asymptomatic population(2006) Serter S.; Gümüş B.; Ünlü M.; Tunçyürek Ö.; Tarhan S.; Ayyildiz V.; Pabuscu Y.Objective. Testicular microlithiasis is a rare, usually asymptomatic, finding of the testes associated with various genetic anomalies and infertility. It is also widely believed that testicular microlithiasis is strongly associated with testicular tumor. The aim of this prospective study was to determine the true prevalence of testicular microlithiasis in an asymptomatic population by means of ultrasound screening. Material and methods. Healthy male volunteers (17-42 years old) were recruited from the annual Army Reserve Officer Training Corps training camp at Manisa, Turkey. A screening genitourinary history was obtained and a physical examination and screening scrotal ultrasound scan were performed. All men diagnosed with testicular microlithiasis underwent complete clinical evaluations, physical examinations and determination of tumor markers. Results. Fifty-three men with testicular microlithiasis were identified from the 2179 ultrasound scans, giving a prevalence of testicular microlithiasis of 2.4% in this asymptomatic population. The age (mean±SD) of subjects with testicular microlithiasis was 23.9±4.2 years (range 20-31 years). Conclusion. Our results suggest that there is no significant association between TM and testicular cancer, although it is difficult to rule out such an association without further studies with a longer follow-up period. © 2006 Taylor & Francis.Item Thorax perfusion CT in non-small cell lung cancer(2007) Ovali G.Y.; Sakar A.; Göktan C.; Çelik P.; Yorgancioǧlu A.; Nese N.; Pabuscu Y.Objectives: We aimed to determine the perfusion differences according to the histological type, stage, volume and prognoses in the non-small cell carcinoma by thorax perfusion CT. Materials and methods: Twenty-four non-small cell carcinoma patients were included in the study. Thorax perfusion CT was done to evaluate the tumors in terms of perfusion parameters: blood flow (BF) and time to peak (TTP) values. Results: The total blood flow of the tumor in squamous cell carcinoma was significantly higher than adenocarcinoma (p = 0.031). There was no statistical difference between the perfusion parameters and other parameters. Conclusions: Perfusion CT may help us in evaluating non-small cell carcinomas. © 2007 Elsevier Ltd. All rights reserved.Item A rare disorder: Idiopathic tumoral calcinosis(2007) Ovali G.Y.; Tarhan S.; Serter S.; Bayindir P.; Okcu G.; Demireli P.; Pabuscu Y.[No abstract available]Item Anatomic and hemodynamic evaluation of renal venous flow in varicocele formation using color Doppler sonography with emphasis on renal vein entrapment syndrome(2007) Unlu M.; Orguc S.; Serter S.; Pekindil G.; Pabuscu Y.Objective. To investigate the anatomic and hemodynamic properties of testicular venous drainage and its effects on varicocele formation and reflux using color Doppler ultrasound (US) with emphasis on renal vein entrapment syndrome. Material and methods. Upper abdominal and scrotal US examinations of 35 varicocele patients and 35 healthy male subjects were performed in the supine position during rest, during a Valsalva maneuver and in the erect position. The aortomesenteric angle and distance (AMA and AMD, respectively), peak mean velocities (PVs) and diameters of different segments of renal veins, testicular vein diameters and duration of flow inversion were measured. Results. In the varicocele group, the lateral segment of the left renal vein (LRV) had a larger diameter and slower PV, and the medial segment of the LRV had a smaller diameter and faster PV. The diameter of the dominant draining vein correlated with the PV of the medial and lateral segments of the LRV, whereas there was no correlation between the diameter of the dominant draining vein and the diameters of the right renal vein (RRV) and the lateral segment of the LRV or the PV of the RRV. The duration of flow inversion correlated with the diameter and PV of the medial segment of the LRV. No correlation between the diameters and PVs of the RRV and the lateral segment of the LRV was detected. Conclusions. The decreases in the AMA, AMD, diameter of the medial segment of the LRV and PV of the lateral segment of the LRV, and the increases in the PV of the medial segment of the LRV and the diameter of the lateral segment of the LRV in varicocele patients in all positions suggest the entrapment or impingement of the left renal vein between the aorta and the superior mesenteric artery. This has been defined as the "nutcracker phenomenon", which is known to affect varicocele formation. © 2007 Taylor & Francis.Item Pelvic floor function and anatomy after childbirth(Journal of Reproductive Medicine, Inc., 2007) Baytur Y.B.; Serter S.; Tarhan S.; Uyar Y.; Inceboz U.; Pabuscu Y.OBJECTIVE: To investigate pelvic floor muscle function and anatomy after childbirth in continent women differing in obstetric history. STUDY DESIGN: Young, continent women, age range 20-40 years, were recruited into 3 groups: 1. elective, prelabor cesarean delivery (n = 12); 2. vaginal delivery (n = 15); and 3. age-matched nulliparas as controls (n = 13). Pelvic floor muscle strength was measured by a perineometer and also assessed by vaginal palpation. Magnetic resonance imaging of the pelvic floor at rest and on maximal strain was performed. Statistical analysis was carried out using SPSS 10.0 (Chicago, Illinois) for Windows (Microsoft, Redmond, Washington); p < 0.05 was considered significant. RESULTS: Pelvic floor muscle strength was not different between the vaginal delivery and cesarean groups. The descent of the bladder and cervix on straining was greater in the subjects who delivered vaginally than in the cesarean delivery and nulliparous groups. There was a positive and significant correlation between the duration of labor and the area of the levator sling and also between birth weight and the descent of the cervix on straining. CONCLUSION: The results of this study show that delivery method does not affect pelvic muscle strength. © Journal of Reproductive Medicine®, Inc.Item Doppler ultrasonography imaging of hemodynamic alteration of retrobulbar circulation in type 1 diabetic children and adolescents without retinopathy(2008) Yilmaz Ovali G.; Ersoy B.; Tuncyurek O.; Urk V.; Ozkol M.; Ozhan B.; Baser E.; Pabuscu Y.Aim: We aimed to investigate the retrobulbar blood circulation using Colour Doppler Imaging (CDI) in type 1 diabetic children and adolescents who had no diabetic retinopathy and to compare the results with their healthy peers. Methods: Forty-nine patients with type 1 diabetes mellitus with no retinopathy on fundoscopic examination were included in the study. Forty-nine healthy children were defined as the control group. Central retinal artery (CRA), ophthalmic artery (OA) and posterior ciliary artery (PCA) were examined with Doppler US bilaterally. Peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive indices (RI) for each artery were recorded. Results: Blood flow velocity of the OA was significantly different in diabetic patients (p < 0.05). EDV of the OA was significantly higher (p = 0.011) and RI was significantly lower (p = 0.027) in patients with diabetes duration of longer than 5 years. RI of the CRA was significantly higher in patients who had higher microalbuminuria levels (p = 0.016). Conclusion: EDV of the OA increases and RI of the OA decreases in diabetes duration longer 5 years. Raised AER increases RI of the CRA. These findings may be the initial changes in the arterial circulation before vascular rigidity develops. © 2007 Elsevier Ireland Ltd. All rights reserved.Item Comparison of 3 Physical Therapy Modalities For Acute Pain in Lumbar Disc Herniation Measured by Clinical Evaluation and Magnetic Resonance Imaging(2008) Unlu Z.; Tasci S.; Tarhan S.; Pabuscu Y.; Islak S.Objective: This study measures and compares the outcome of traction, ultrasound, and low-power laser (LPL) therapies by using magnetic resonance imaging and clinical parameters in patients presenting with acute leg pain and low back pain caused by lumbar disc herniation (LDH). Methods: A total of 60 patients were enrolled in this study and randomly assigned into 1 of 3 groups equally according to the therapies applied, either with traction, ultrasound, or LPL. Treatment consisted of 15 sessions over a period of 3 weeks. Magnetic resonance imaging examinations were done before and immediately after the treatment. Physical examination of the lumbar spine, severity of pain, functional disability by Roland Disability Questionnaire, and Modified Oswestry Disability Questionnaire were assessed at baseline, immediately after, and at 1 and 3 months after treatment. Results: There were significant reductions in pain and disability scores between baseline and follow-up periods, but there was not a significant difference between the 3 treatment groups at any of the 4 interview times. There were significant reductions of size of the herniated mass on magnetic resonance imaging after treatment, but no differences between groups. Conclusions: This study showed that traction, ultrasound, and LPL therapies were all effective in the treatment of this group of patients with acute LDH. These results suggest that conservative measures such as traction, laser, and ultrasound treatments might have an important role in the treatment of acute LDH. © 2008 National University of Health Sciences.Item Sonographic-guided injection of corticosteroid in the treatment of lateral epicondylitis(2009) Unlu Z.; Tarhan S.; Ovali G.Y.; Pabuscu Y.Objective: In this study the advantage of ultrasonography [US] in diagnosis and therapy of lateral epicondylitis [LE] was investigated in patients with lateral elbow pain and clinically diagnosed as LE. Methods: Fifty-two patients with LE were examined using sonography. For the patients in whom normal US examination was found, a blind injection of methylprednisolone 20 mg and 0.5 ml one percent lignocaine was performed [Group 1]. The patients whose clinical diagnosis was confirmed with US received a sonographic-guided injection of methylprednisolone 20 mg and 0.5 ml one percent lignocaine [Group 2]. Outcome measurements were performed at baseline, two weeks, one month, and three months. Pain and functional status were assessed using a visual analog scale, physical functioning and bodily pain scales of the Medical Outcomes Study 36 Item Short-Form Health Survey, a patient-rated forearm evaluation questionnaire, and a patient-specific functional scale. Painless grip strength bilaterally was also measured. Results: Twenty-four [46.2 percent] patients had a normal-appearing common extensor origin on US. The group in which diagnosis of LE was confirmed on US and sonographic-guided corticosteroid injections improved significantly from the baseline to the third month follow up [P < 0.000] in both clinical assessment and physical examination findings. Conclusions: Our case series suggested that sonography of the common extensor origin can be used to confirm LE in patients with lateral elbow pain. Although sonographic-guided injections produced more clinical improvement, further studies are needed to determine effectiveness of sonographic-guided injections. © 2009 by Informa Healthcare USA, Inc. All rights reserved.Item Perfusion computed tomography could be a new tool for single-session imaging of ureteric obstructive pathology: an experimental study in rats(2009) Yilmaz O.; Ovali G.Y.; Genc A.; Tarhan S.; Ozcan T.; Tuncyurek O.; Pabuscu Y.; Taneli C.Background/Purpose: Perfusion imaging redefines computed tomography (CT) as a technique that can now depict vascular physiology in addition to detailed anatomy. The major clinical applications of perfusion CT are in acute stroke and oncology. Currently, there are very limited data on the application of perfusion CT in urology. The aim of the present study is to investigate the potential value of perfusion CT in anatomic and functional evaluation of obstruction in a single session on experimental hydronephrosis model in rats. Thus, we evaluate the perfusion CT in a new clinical application. Methods: Twenty-eight rats were randomly allocated into 4 groups each consisting of 7 rats. At the third week of experimental intervention, postoperative renogram curves and perfusion parameters of the right kidneys' cortex and pelvis were assessed by CT. The right ureter was sutured as proximal complete obstruction in group 1, as distal complete obstruction in group 2, and as proximal partial obstruction in group 3. Group 4 served as the sham control group. Computed tomography was performed with single-slice tomography. Dynamic examination was performed with the help of perfusion software through contrast-enhanced tomography examination. Results: In all study groups, the aorta time/density curves showed a rapid increase after a rapid decrease, and the duration to reach peak concentration in the normal kidney cortex was observed to be later than the aorta as expected. In groups 1, 2, and 3, the duration to reach peak concentration lengthened and the peak concentration values decreased. The time/density curves gradually increased as a result of the accumulation of the contrast agent in the pelvis, and a peak was observed at the end of the procedure in all study groups. In groups 1, 2, and 3, a statistically significant decrease (P = .01, P = .01, and P = .01, respectively) was observed in the peak concentration values of the contrast agent in comparison to group 4. The flow and blood volume values gradually decreased as the grade of the obstruction increased and the localization of the obstruction or grade of obstruction moved closer to the kidney. Conclusion: In conclusion, perfusion CT technique, performed in a single session, is a useful method for anatomic visualization, together with functional evaluation, in the diagnosis of ureteric obstructive pathology of experimental hydronephrosis model. © 2009 Elsevier Inc. All rights reserved.Item Perfusion CT evaluation in experimentally induced testicular torsion(2009) Ovali G.Y.; Yilmaz O.; Tarhan S.; Genc A.; Demireli P.; Tunçyurek O.; Unden C.; Taneli C.; Pabuscu Y.Introduction: In this study, we define the characteristics of perfusion computed tomography (CT) in an experimental model of testicular torsion. Methods: Twenty male Sprague-Dawley rats were included for the study. Torsion was applied to 10 rats and perfusion CT was performed in the first hour to evaluate the following perfusion parameters: blood flow (BF), blood volume (BV) and time to peak (TTP) values. Detorsion was done for the same rats, and perfusion CT was repeated 2 hours later to evaluate reperfusion. Ten rats were left as part of the control group. Results: There is significant statistical correlation between the BF and BV values in the torsion and control groups (p = 0.001 and p = 0.001, respectively). There is no statistical correlation of the TTP parameters between the groups. No correlation was found between torsion and detorsion perfusion parameters. Conclusion: Perfusion CT can demonstrate the testicular perfusion insult in an experimental model of torsion. Perfusion CT may be an alternative method for diagnosis of torsion in indeterminate cases. Following detorsion an interval of 2 hours is not sufficient for demonstrating luxury perfusion of the testis. © 2009 Canadian Urological Association.Item The role of patellar tendon morphometry on anterior knee pain(2010) Tuncyurek O.; Ozkol M.; Ozic U.; Pabuscu Y.Purpose: To investigate the morphometry of patellar tendon with magnetic resonance imaging (MRI) and to reveal the relation between patellar tendon properties and anterior knee pain (AnKP). Methods: Twenty-three patients with AnKP and nine healthy individuals were included in the study. Patients with knee anomaly that may cause AnKP were excluded from the study. The patellar tendon examination was performed on sagittal and coronal sections of MRI. Freehand technique was used to frame the area of tendon and calculations were done by generic software. Results: There were 23 patients in AnKP (+) and 9 individuals in AnKP (-) group. The morphometric results were not different among groups (p = 0.2). Higher body mass index was correlated with increased patellar tendon surface area in women (R2 = 0.37). Conclusion: Patellar tendon length, thickness and surface area do not seem as a significant parameter to explain the aetiology of AnKP. Given the well-defined role of patellar tendon to support knee kinetics, the clinical value of tendon morphometry is to be determined. © 2009 Springer-Verlag.Item Is melatonin protective in contrast material related renal failure?; [Melatonin kontrast madde ile ilişkili renal yetmezlikten korur mu?](Journal of Clinical and Analytical Medicine, 2015) Tuncyurek O.; Gunay O.; Taneli F.; Ayhan S.; Nese N.; Pabuscu Y.Aim: The aim of the study was to investigate the effect of melatonin on the renal injury resulting from radiocontrast media and myoglobinuria in male Wistar albino rats. Material and Method: 50% glycerol at equal amounts was intramuscularly administered to both hind legs of all animals under ether anesthesia at the dose of 10 mg/kg. Three hours later, the groups were ad-ministered the following: Group I (number:7): Iopromide(Ultravist -300®) at the dose of 2 ml/kg (intracardiac); Group II (number:7): Iopromide(Ultravist -300®) and intraperitoneally administered Melatonin at the dose of 10 mg/kg (Melatonin was dissolved in 7.5% absolute ethanol and further dilutions were made in saline.); and Group III (number:7): 2 ml/kg of sterile physiologic saline (Control group). The levels of Uurea, Ccreatinine and Ccystatin C were studied on the blood samples collected. The renal samples were evaluated by 2two distinct pathologists who did not know the protocol. Results: There was no difference in the values of Creatinine and cystatin c between Groups 2 and 3 (p=0.9; 0.2). Discussion: In conclusion, we evaluated the possible prevention of contrast-induced oxidative stress in the kidney with using melatonin. How-ever, additional clinical studies are needed to evaluate the role of preventive melatonin treatment in humans. © 2015, Journal of Clinical and Analytical Medicine. All rights reserved.Item Is computed tomography perfusion a useful method for distinguishing between benign and malignant neck masses?(Medquest Communications LLC, 2017) Duzgun F.; Tarhan S.; Ovali G.Y.; Eskiizmir G.; Pabuscu 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.Item The role of facial canal diameter in the pathogenesis and grade of Bell's palsy: a study by high resolution computed tomography; [O papel do diâmetro do canal facial na patogenia e grau de paralisia de Bell: estudo por tomografia computadorizada de alta resolução](Elsevier Editora Ltda, 2017) Celik O.; Eskiizmir G.; Pabuscu Y.; Ulkumen B.; Toker G.T.Introduction The exact etiology of Bell's palsy still remains obscure. The only authenticated finding is inflammation and edema of the facial nerve leading to entrapment inside the facial canal. Objective To identify if there is any relationship between the grade of Bell's palsy and diameter of the facial canal, and also to study any possible anatomic predisposition of facial canal for Bell's palsy including parts which have not been studied before. Methods Medical records and temporal computed tomography scans of 34 patients with Bell's palsy were utilized in this retrospective clinical study. Diameters of both facial canals (affected and unaffected) of each patient were measured at labyrinthine segment, geniculate ganglion, tympanic segment, second genu, mastoid segment and stylomastoid foramen. The House-Brackmann (HB) scale of each patient at presentation and 3 months after the treatment was evaluated from their medical records. The paired samples t-test and Wilcoxon signed-rank test were used for comparison of width between the affected side and unaffected side. The Wilcoxon signed-rank test was also used for evaluation of relationship between the diameter of facial canal and the grade of the Bell's palsy. Significant differences were established at a level of p = 0.05 (IBM SPSS Statistics for Windows, Version 21.0.; Armonk, NY, IBM Corp). Results Thirty-four patients – 16 females, 18 males; mean age ± Standard Deviation, 40.3 ± 21.3 - with Bell's palsy were included in the study. According to the HB facial nerve grading system; 8 patients were grade V, 6 were grade IV, 11 were grade III, 8 were grade II and 1 patient was grade I. The mean width at the labyrinthine segment of the facial canal in the affected temporal bone was significantly smaller than the equivalent in the unaffected temporal bone (p = 0.00). There was no significant difference between the affected and unaffected temporal bones at the geniculate ganglion (p = 0.87), tympanic segment (p = 0.66), second genu (p = 0.62), mastoid segment (p = 0.67) and stylomastoid foramen (p = 0.16). We did not find any relationship between the HB grade and the facial canal diameter at the level of labyrinthine segment (p = 0.41), tympanic segment (p = 0.12), mastoid segment (p = 0.14), geniculate ganglion (p = 0.13) and stylomastoid foramen (p = 0.44), while we found significant relationship at the level of second genu (p = 0.02). Conclusion We found the diameter of labyrinthine segment of facial canal as an anatomic risk factor for Bell's palsy. We also found significant relationship between the HB grade and FC diameter at the level of second genu. Future studies (MRI-CT combined or 3D modeling) are needed to promote this possible relevance especially at second genu. Thus, in the future it may be possible to selectively decompress particular segments in high grade BP patients. © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-FacialItem Vascular calcification and growth arrest specific protein 6 levels in chronic renal disease; [Calcificación vascular y niveles de la proteína específica del gen 6 de la detención del crecimiento en la enfermedad renal crónica](Asociacion Regional de Dialisi y Transplantes Renales de Capital Federal y Provincia de Buenos Aires, 2019) Toraman A.; Cetintepe L.; Elbi H.; Taneli F.; Yildiz R.; Duzgun F.; Pabuscu Y.; Horasan G.D.; Kürşat S.Introduction: Cardiovascular disease is the main cause of mortality and morbidity in chronic renal failure. It’s known that vascular calcification (VC) and carotid intima media thickness (CIMT) are strongly associated with cardiovascular diseases. Growth arrest specific protein 6 (Gas6) is a vitamin K-dependent protein and regulates various processes such as proliferation, cell survival, migration and inflammation. Gas6 is known to protect endothelial cells and vascular smooth muscle cells against apoptosis by inhibiting Bcl-2 induced Caspase 3 activation. The relationship between Gas6 and cardiovascular diseases has been demonstrated in many mouse models and cell cultures. However, there are conflicting reports whether Gas6 levels are increasing or decreasing in human studies of diabetic and/or chronic renal failure. In present study the aim was to examine plasma Gas6 levels and its relation with CIMT and coronary artery calcification score (CACS) in chronic kidney disease (CKD) patients. Methods: Total of 137 patients of which 32 chronic hemodialysis and 105 predialysis patients as well as 73 healthy controls were enrolled in the study. Human Gas6 levels in serum samples were studied by ELISA method. CIMT was measured by ultrasonography. CACS was measured by multislice computed tomography. Results: The mean age was 54.37±16.61 years in dialysis group, 55.20±14.80 years in predialysis group and 53.26±9.04 years in control group. Serum creatinine was 0.78±0.16 mg/dl in the control group and 1.96±1.64 mg/dl in the predialysis and 5.94±1.55 mg/dl in the dialysis group. 24 hours urine protein levels were significally higher in the dialysis group than the predialysis and the control group. CIMT values were similar in predialysis and dialysis groups. These values were significantly higher than control group. Although CACS was higher in dialysis group than predialysis and control group, the results were not statistically significant since the distribution range was very wide. Gas6 was 98.84±53.32 ng/mL in the control group and statistically higher than dialysis (63.85±38.92 ng/mL) and predialysis groups (54.96±38.49 ng/mL) (p=0.001). Gas6 levels were lower in diabetic patients than non-diabetics (53.69±35.26 ng/mL, 69.26±47.50 ng/mL, p=0.023, respectively). Negative correlation was detected between Gas6 and age, BMI, CACS, carotid IMT and proteinuria. In the logistic regression analysis, Gas6 remained significantly associated with BMI, CIMT and proteinuria. Conclusion: In our study, a negative correlation of Gas6 with BMI, CACS, CIMT and proteinuria and lower Gas6 levels in diabetic patients support that decreased Gas6 levels in chronic renal failure may have a role in vascular calcification through altered glucose tolerance, chronic inflammation, endothelial dysfunction and increased apoptosis. Our study has an importance because it is the first study showing a relation between Gas6 and proteinuria, CACS and carotid IMT in patients with chronic renal failure. © 2019, Asociacion Regional de Dialisi y Transplantes Renales de Capital Federal y Provincia de Buenos Aires. All rights reserved.Item The ratio of facial nerve to facial canal as an indicator of entrapment in Bell's palsy: A study by CT and MRI(Elsevier B.V., 2020) Celik O.; Ulkumen B.; Eskiizmir G.; Can F.; Pabuscu Y.; Kamiloglu U.; Toker G.T.; Vidin N.Objectives: To find out if the ratio of facial nerve to facial canal diameter plays any role in the etiopathogenesis and grade of Bell's palsy. Patients and methods: Twenty-nine consecutive patients (16 females, 13 males) diagnosed with unilateral Bell's palsy were enrolled into the study. At admission, 5 patients were grade V, 11 were grade IV, 11 were grade III and 2 were grade II. The grade of Bell's palsy was documented by House–Brackmann facial nerve grading system at admission, 15th day, 1st month and 3th month. Temporal MRI and CT scans were obtained at the time of diagnosis. Diameter of facial nerve and facial canal at the middle of five different segments were measured equidistantly at the same workstation. Both sides of every patient (affected and unaffected) were measured by one radiologist who was not informed about the side of the paralysis. MRI and CT values of each segment were compared between affected and unaffected sides. In addition, FN/FC ratio of affected and non-affected sides was calculated and compared for each segment. We also analyzed if a relationship exists between above-mentioned measurements and the House–Brackmann grade. Results: Considering MRI values; statistically significant thickening of facial nerve between affected and unaffected sides was found at labyrinthine (p = 0.012), tympanic (p = 0.023) and geniculate parts (p = 0.04). Considering CT values; statistically significant difference between affected and unaffected sides was not found at any segment. Comparison of FN/FC ratio of both sides revealed statistically significant increment of the affected side at labyrinthine segment (p = 0.015) and geniculate ganglion (p = 0.032). We determined positive correlation between diameter of FN and HB grade at labyrinthine segment (p = 0.03, R = 0.531). On the other hand, we determined negative correlation between diameter of FC and HB grade at labyrinthine segment (p < 0.001, R = −318). A positive correlation between HB grade and FN/FC ratio was found only at the labyrinthine segment (p = 0.003, R = 0.673). Conclusion: FN/FC ratio of labyrinthine segment and geniculate ganglion was found to be increased in patients with Bell's palsy. In addition, a positive correlation was determined between this ratio and grade of Bell's palsy particularly at labyrinthine segment. Basing the current study, if FN decompression is recommended in Bell's palsy patients with objective findings of bad prognosis, conservative surgery targeting the labyrinthine segment and geniculate ganglion alone might be safer. © 2020 Elsevier B.V.