Person: ÇİMŞİT, NURİ ÇAGATAY
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ÇİMŞİT
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NURİ ÇAGATAY
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Publication Metadata only Parenchymal density changes in acute pulmonary embolism: Can quantitative CT be a diagnostic tool? A preliminary study(ELSEVIER SCIENCE INC, 2017) ÇİMŞİT, NURİ ÇAGATAY; Duman, Ikram Eda; Cimsit, Canan; Yildizeli, Sehnaz Olgun; Cimsit, Nuri CagatayPurpose: Determine the ability of quantitative CT (QCT) in defining parenchymal density changes in acute pulmonary embolism (PE). Material & methods: Mean lung density (MLD) and percentage distribution values (PDV) were calculated in 34 patients suspected of PE using software application based on computerized volumetric anatomical segmentation. Results: Total, left, and right MLD differed significantly between emboli positive(n = 23) and negative(n = 11) groups(p < 0.006, p < 0.009, p < 0.014). PDVs differed between groups (p < 0.05) except for LUZ and RLZ. When PE was present in lobe &/segment branches, PDVs were significantly lower except RUZ. Conclusion: QCT is a promising application for defining parenchymal density changes in PE revealing potential functional impact of emboli. This preliminary study suggests QCT could provide added value to CTPA in peripheral PE. (C) 2016 Elsevier Inc. All rights reserved.Publication Metadata only Transarterial microcatheter glue embolization of the bronchial artery for life-threatening hemoptysis: Technical and clinical results(ELSEVIER IRELAND LTD, 2010) BALTACIOĞLU, FEYYAZ; Baltacioglu, Feyyaz; Cimsit, Nuri Cagatay; Bostanci, Korkut; Yuksel, Mustafa; Kodalli, NihatObjectives: To report our experience with transarterial glue embolization of the bronchial artery for life-threatening hemoptysis. Materials and methods: Twenty-five patients underwent bronchial artery embolization, using coaxial microcatheter technique, with a liquid agent, n-butyl-2-cyanoacrylate (NBCA), named glue, for life-threatening hemoptysis. The technical and clinical outcomes were followed in terms of immediate control of bleeding, recurrence of hemoptysis and complications of the procedure. Results: Four patients had acute hemoptysis when they were evaluated. The average number of arteries embolized per patient was 2.9. BAEs were successful in controlling hemoptysis immediately in all 25 patients (100%) and in 24 patients (96%) at 1 month follow-ups. One patient had recurrent hemoptysis on the tenth day after embolization. The follow-up time ranged from 2 to 63 months (mean 14 months). Six patients (25%) died all as a result of their disease process. Bleeding recurred in 3 patients after 30 days (7th, 11th, 12th months). One patient had vomitting attacks with dysphagia after the procedure that lasted 24 h. Three patients had transient thoracic pain lasting 3-5 days. There were no procedure related spinal or vascular complications. Conclusions: Glue embolization with microcatheter technique is a safe and effective treatment in cases of life-threatening hemoptysis with a very high rate of success and low rate of complications. (C) 2008 Elsevier Ireland Ltd. All rights reserved.Publication Open Access Successful treatment of an invasive fungal infection caused by Talaromyces sp. with voriconazole(ELSEVIER SCIENCE BV, 2015-06) BİLGİN, HÜSEYİN; Sili, Uluhan; Bilgin, Huseyin; Masania, Rikesh; Eryuksel, Emel; Cimsit, Nun I. Cagatay; Ayranci, Gulcicek; Richardson, Malcolm; Korten, VolkanInvasive fungal infections (lFl) are on the rise due to increasing numbers of immunosuppressed and critically ill patients. A malignant-looking pulmonary nodule in an immunosuppressed patient may indeed be caused by a fungal organism. We report a patient, who was eventually diagnosed with an IFI caused by an agent of hyalohyphomycosis, Talaromyces sp determined via molecular methods and succesfully treated with voriconazole. (C) 2015 The Authors, International Society for Human and Animal Mycology Published by Elsevier B.V.Publication Open Access Evaluation of BioFire Filmarray panel for respiratory pathogens: A demographic and clinical analysis in Istanbul, Turkey(2023-05-01) KARAHASAN, AYŞEGÜL; ÇİMŞİT, NURİ ÇAGATAY; Karahasan A., Çimşit N. Ç.We aimed to analyze the distribution of respiratory pathogens(RP) detected by a multiplex PCR-based method (BioFire Diagnostics, USA) among patients with suspected respiratory tract infections (RTI) and to evaluate the demographic, clinical and radiological characteristics of infected individuals . RP were detected in 1621/6376 (25.4%) of the samples in the years 2018-2020. Rhinovirus/enterovirus (RV/EV) were the most commonly detected pathogens (38.1%) followed by influenza A and B viruses (21%) and parainfluenza virus (PIV) (9.5%). Single pathogen was detected in 1361 (84%) and multi pathogens in 260 (16%) of 1621 samples. At least one comorbidity was present in 379 (30.5%) of the patients. Fever was the most common sign followed by cough and dyspnea. Thorax CT was present in 426 of 1243 RP positive patients (34.3%). Any radiological findings was found significantly related for a specific pathogen. No medication was given to 52.9% whereas antibiotics in 35.7% and antivirals in 3.8% of the patients. Film Array panel as a multiplex PCR test is not used rationally in our hospital and results were not dramatically improve management of RTI. A better communication between clinician and microbiologist is required for efficient use of laboratory and rational use of antimicrobials.Publication Open Access Ultrasonography and duplex doppler ultrasonography based indices in nodular thyroid disease(2013-10-01) ASLAN, MUHAMMED; ÇİMŞİT, NURİ ÇAGATAY; GÜLLÜOĞLU, MAHMUT BAHADIR; ASLAN A., Sancak S., ASLAN M., ÇİMŞİT N. Ç. , GÜLLÜOĞLU M. B. , Ahiskali R. A. , Akalin N. S. , ARIBAL M. E.Background. Fine needle aspiration biopsy (FNAB) is an important tool in the diagnosis of thyroid nodules. Aim. Our aim was to investigate the malignancy criteria in thyroid nodules by gray-scale ultrasonography (US) and duplex Doppler ultrasonography (DDUS), and their usefulness in reducing the number of unnecessary FNAB’s. Study design. This was a prospective observational study. Subjects and methods. 181 benign and 18 malignant thyroid nodules were evaluated by US and DDUS before FNAB or thyroidectomy. US was used to note size, shape, internal structure, nodule echogenicity, marginal properties, peripheral hypoechogenic halo, and microcalcifications. DDUS studies were used to evaluate the maximum and minimum flow velocity (Vmax and Vmin), systolic/diastolic flow velocity ratio (S/D), pulsatility index (PI), resistive index (RI), acceleration time (AT) and acceleration value. Results. Contour irregularity, size and presence of microcalcifications (p<0.001, p=0.02 and p=0.002, respectively) and S/D, Vmin, PI, RI and AT were significantly different (p=0.004, p=0.007, p=0.032, p=0.003 and p=0.003, respectively) were significant for malignant nodules. Benign and malignant nodules with or without suspicious US findings had similar DDUS findings. Vmax, Vmin, PI, RI, and AT were significantly different in the presence of microcalcification (p=0.043, p=0.001, p=0.031, p=0.04, and p=0.019 respectively). AT was significantly different in the case of absence of microcalcification (p=0.019). Comparing the irregular margins, Vmin, PI and RI were significantly different (p=0.014, p=0.003, and p=0.014 respectively). Conclusion. Benign and malignant thyroid nodules can be differentiated using gray-scale US findings and DDUS based indices together to reduce the number of unnecessary FNAB’s.Publication Metadata only Ultrasonografi̇ ile tanimlanan sternum kırığı(2006-10-16) LAÇİN, TUNÇ; BUĞDAYCI, ONUR; ÇİMŞİT, NURİ ÇAGATAY; BOSTANCI, KORKUT; YÜKSEL, MUSTAFA; CENGİÇ İ., LAÇİN T., BUĞDAYCI O., AKPINAR İ. N. , ÇİMŞİT N. Ç. , BOSTANCI K., YÜKSEL M.Publication Metadata only Pelizaeus-merzbacher-benzeri hastalık: GJC 2 gen mutasyonlu pediatrik bir olguda manyetik rezonans görüntüleme bulguları(2021-10-31) YAPICI, ÖZGE; POLAT, HAMZA; ÇİMŞİT, NURİ ÇAGATAY; YAPICI Ö., ALMUS E., ASLAN B., POLAT H., ÖZTÜRK G., ÇİMŞİT N. Ç.Giriş-Amaç: Pelizaeus-Merzbacher benzeri hastalık (PMBH), bir gap-junction proteini olan connexin’i (Cx47) kodlayan GJC2 genindeki mutasyonların neden olduğu otozomal resesif bir hastalıktır (1). PMLD, X’e bağlı Pelizaeus-Merzbacher hastalığı (PMH) ile aynı klinik ve radyolojik özellikleri paylaşır, ancak PMH’da beklendiği gibi PLP1 geninde bir mutasyon yoktur. Manyetik Rezonans Görüntüleme (MRG)’de hipomiyelinasyon ile, klinik açıdan ise erken başlangıçlı nistagmus, gecikmiş motor kilometre taşları, progresif spastisite ve ataksi ile karakterizedir (1,2). Burada, GJC 2 gen mutasyonuna sahip 22 aylık bir erkek çocuğunun MRG bulgularını sunuyoruz. Olgu Sunumu: 22 aylık erkek bebek, konuşma ve motor disfonksiyonu şikayetleri ile kranial MRG için radyoloji bölümüne sevk edildi. Fizik muayenesinde bilateral nistagmus ve görme kaybı mevcuttu. Geçmiş klinik öyküsünde 38. gebelik haftasında 2. derece akraba evliliğinden sezaryen ile doğduğu öğrenildi. 6. ayda başını tutma, 9. ayda desteksiz oturma, 12. ayda emekleme yeteneğine sahipken desteksiz yürüyebilme yeteneği hiç gelişmemişti. Kraniyal MRG’de, subkortikal ve periventriküler beyaz cevherde, internal ve eksternal kapsüllerde, beyin sapı ve korpus kallozumda T2 ağırlıklı görüntülerde (T2AG) simetrik hiperintensite izlendi (Şekil 1). T1 ağırlıklı görüntülerde (T1AG) serebrum ve serebellum’da gri ve beyaz cevher arasındaki ayrımın kaybolması, hipomyelinasyon ile uyumlu olarak değerlendirildi(Şekil 2). Sentrum semiovale, korpus kallozum ve mezensefalonun bazı kısımlarında T1AG’de hafif hiperintensite görülmesi bu düzeylerde az da olsa miyelinasyonun gerçekleştiğini düşündürmekte idi (Şekil 2). MRG’yi takiben genetik test için sevk edilen olgunun, homozigot GJC2 mutasyonuna sahip olduğu bulundu. TartışmaSonuç: PMBH, PMH’dakine benzer şekilde, beyinde miyelin birikiminin kalıcı kaybına bağlı klinik olarak nistagmus, serebellar ataksi ve spastisite ile karakterizedir (3). PMH’nın aksine PMBH’de semptomlar daha yavaş ilerler, kognitif fonksiyonlar daha çok korunur ve MRG’de kortikospinal traktların parsiyel miyelinasyonu görülür (3). PMBH olgularında, PMH ile benzer şekilde, kranial MRG’de serebral beyaz cevherde homojen T2 hiperintensite şeklinde prezente olan yaygın hipomiyelinasyon paterni görülür (2). Kortikospinal yolların değişken miyelinasyonu ile birlikte, pons’un T2 hiperintensitesi tipiktir. Olgumuzda gözlemlediğimiz gibi iç kapsülün arka bacağında kısmi miyelinasyon da bildirilmiştir (1,3). Olgumuzda olduğu gibi, serebellar beyaz cevher, korunmuş hacmi ile daha az etkilenebilir. Bazal ganglionlar ve talamus genellikle normaldir (1). Olgumuzun tanısı, daha ileri radyolojik inceleme gerektirmeden genetik çalışmalarla konmuştur. PMBH için spesifik bir tedavi yoktur ve tıbbi bakım çoğunlukla destekleyici tedavi ile sınırlıdır (2)Publication Metadata only Transarterial glue embolization in iatrogenic renovascular injuries(SPRINGER, 2008) BALTACIOĞLU, FEYYAZ; Cimsit, Nuri Cagatay; Baltacioglu, Feyyaz; Cengic, Ismet; Akpinar, Ihsan Nuri; Ilker, Yalcun; Turkeri, LeventIatrogenic injuries of the intrarenal arterial system include pseudoaneurysms and fistulas. They can cause hematuria and life-threatening hemodynamic instability, and therefore should be treated promptly. Endovascular treatment is recommended for these cases due to its effectiveness. Among the different agents used for embolization, n-butyl-2-cyanoacrylate (glue) has rarely been used. We present 15 patients with pseudoaneurysms and/or arteriovenous or caliceal fistulas who were treated by glue embolization. In our patient group, five had a history of percutaneous nephrolithotomy, six had renal biopsies, three had nephron-sparing surgery, and one had percutaneous nephrostomy. Glue embolizations were performed with the microcatheter technique. All patients were successfully treated, and all but one had excellent follow-ups. One patient suffered from disseminated intravascular coagulation secondary to transfusion and died after the procedure. We think glue embolization is a safe and effective treatment for this group of patients and present our experience along with the technical approach.Publication Metadata only Accuracy and reliability of magnetic resonance imaging in the diagnosis of idiopathic intracranial hypertension(2022-10-01) ULUÇ, KAYIHAN; ÇİMŞİT, NURİ ÇAGATAY; ILGIN, CAN; DERİCİOĞLU, VOLKAN; KAHRAMAN KOYTAK, PINAR; Kuzan B. N. , ILGIN C., Kuzan T. Y. , DERİCİOĞLU V., KAHRAMAN KOYTAK P., ULUÇ K., ÇİMŞİT N. Ç.© 2022 Elsevier B.V.Purpose: To determine the diagnostic utility of brain magnetic resonance imaging (MRI) findings in patients with idiopathic intracranial hypertension (IIH) and to investigate the significance of evaluating radiological findings together with neurological and ophthalmological data in the diagnosis of IIH. Materials and Methods: All consecutive patients diagnosed with IIH in our tertiary neuro-ophthalmology center between January 1, 2018 and March 15, 2020, were included in the study. The clinical, radiological, and ophthalmological findings of IIH patients were compared with the control group with similar demographic characteristics. Results: A total of 98 patients, 49 cases and 49 controls, were included in the study. Lateral ventricular index had the highest area under the curve (AUC) value (0.945) for prediction of disease group followed by sella height category (AUC = 0.915) and optic nerve tortuosity (AUC = 0.855) According to the multivariate model we developed, caudate index (OR = 0.572, 95% CI 0.329–0.996), lateral ventricle index (OR = 3.969, 95% CI 1.851–8.509) and bilateral optic nerve tortuosity (OR = 22,784, 95% CI 2.432–213.450) were significant predictors for disease group. Conclusion: Tortuosity in the optic nerve, lateral ventricular index and caudate index can be used as MRI parameters supporting the diagnosis of IIH in clinically suspicious cases. A holistic approach to the clinical and radiological findings of the cases in the diagnosis of IIH can prevent overdiagnosis and enable early correct diagnosis.Publication Metadata only Esophageal perforation: A rare but fatal complication of urgent sengstaken blakemore tube intubation [Özofagus perforasyonu: Acil sengstaken blakemore tüp kullani{dotless}mi{dotless} sonrasi{dotless} gelişen nadir fakat ölümcül komplikasyon](Turkish Society of Medical and Surgical Intensive Care Medicine, 2014) BİLGİN, HÜSEYİN; Akbaş T., Bilgin H., Yeǧin E.G., Çimşit N.C., Özdoǧan O.C., Karakurt S.Acute variceal bleeding is an important cause of mortality among cirrhotic patients. Endoscopic band ligation and medical vasoactive drugs are the main treatment options for actively bleeding varices. In some cases, these therapies can fail and a Sen-gstaken Blakemore tube (SBT) is used to stop the bleeding by direct compression of varices. Although it is very effective in stopping variceal bleeding, SBT has some lethal complications. In this paper, we discuss the case of a patient who developed esopha-geal perforation after insertion of the SBT.