Yıldırım, Utku Mahir
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Yildirim, Utku Mahir
Yıldırım, Mahir Utku
Yıldırım, Mahir Utku
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utku.mahir@ieu.edu.tr
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09.02. Internal Sciences
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Sustainable Development Goals
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14
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44
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4
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25
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87
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4
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4
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Article Diagnostic Accuracy of Kidney Shear Wave Elastography at the Diagnosis of Ureteral Stones(2022) Serter, Selim; Yıldırım, Mahir Utku; Ors, Bumin; Şahin, Erkan; Solak, AynurAim: To determine the efficacy of kidney shear wave elastography (SWE) in patients diagnosed with ureteral stones Method: Both kidneys of 30 patients were evaluated prospectively with SWE. The ureteral stone size and the degree of hydronephrosis were determined by sonographic examination. The contralateral kidney was accepted as the control parameter. Stone size, grade of hydronephrosis and kidney shear wave speed changes were noted and their relations were examined for statistical significance. Results: Affected kidney group had significantly increased SWE values than the control group. (3.87+-1.22 vs 2.06+-0.72 m/sec) (p=0.01). Neither the stone size nor the kidney SWE values showed a correlation with the gender. There was a positive correlation between the grade of hydronephrosis and the stone size (p=0.047, r=0,36). Kidneys with grade 2 hydronephrosis had significantly higher SWE values than those with grade 1 hydronephrosis. Conclusion: SWE is a promising tool to observe the parenchymal elasticity changes in patients with hydronephrosis secondary to ureteral stones. Further studies are necessary to confirm the research results.Article Evaluation of the Elasticity and Thickness of the Heel Fat Pad With Ultrasound in Plantar Fasciitis(2022) Yıldırım, Mahir Utku; Biçen, Ahmet Çağdaş; Ünal, Abdullah MeriçObjective The aim of this study was to evaluate thickness and elasticity of heel fat pad in patients with unilateral plantar fasciitis and to investigate the effects of age, sex, body mass index (BMI), and functional scores on plantar fasciitis. Material and Method 70 patients who had been suffering from unilateral plantar fasciitis longer than 6 months were enrolled in the study. The thickness and elasticity of fat pad were compared between the painful and healthy feet of the patients with ultrasound. For measurement of elasticity, shear wave elastography (SWE) was used. Comparative analysis was performed for thickness and elasticity variables between the painful and healthy feet with Mann–Whitney U and independent samples t-test. Results Average of age of the patients was 44±11.66. The average thickness of the heel fat pad was 17.9±3.1 mm on the affected side and 18.3±3.3 mm on the healthy side. The mean SWE value of the painful side was 23.9 m/s (range 9.3-32) and was 24.7 m/s (range 10.8-34) on the healthy side. Heel fat pad thickness was greater in the healthy feet than in the painful feet, but there was no statistical significance (p=0.448). The painful feet were stiffer, but the difference was statistically similar (p=0.347). BMI had a statistically significant impact on thickness of heel fat pad. Conclusion The results showed that a decrease in the heel fat pad thickness was a supporting finding of plantar fasciitis in patients with normal BMI but not in patients with BMI>25.Article Successful Application of Chemosaturation With Percutaneous Hepatic Perfusion in Metastatic Uveal Melanoma Patient Progressing After Systemic Treatment Options: a Case Report(Frontiers media sa, 2024) Günenç, Damla; Özluk, Ahmet Anil; Yıldırım, Utku Mahir; Ascierto, Paolo A.; Karaca, BurcakUveal melanoma (UM) is a rare subtype of melanoma, accounting for less than 5% of all melanoma cases. Metastatic UM differs notably from cutaneous melanoma, exhibiting variations in etiology, prognosis, driver mutations, metastatic patterns, and poor responses to immune checkpoint inhibitors (ICI). Beyond local treatment options, such as resection, radiation therapy, and enucleation, and systemic treatments, such as ICIs, the approval of tebentafusp, a bispecific gp100 peptide-HLA-directed CD3 T-cell engager, marks a breakthrough in treating HLA-A*02:01 metastatic UM. Despite the advancements in treatment options, the long-term survival rates remain inadequate. We report a patient with metastatic UM who previously received ICI and progressed on tebentafusp treatment but subsequently exhibited a remarkable response to local treatment targeting liver metastasis. Such observations highlight the significance of exploring sequential therapeutic strategies for advanced UM, offering potential avenues to enhance treatment efficacy and patient prognosis.Article Comparison of Contrast-Enhanced Magnetic Resonance Angiography and Digital Subtraction Angiography in the Evaluation of Renal Artery Stenosis and Detecting of Accessory and Polar Arteries(2021) Başaran, Ceyla; Yıldırım, Mahir UtkuObjectives: Renal artery stenosis (RAS) is the most common cause of secondary hypertension. RAS may cause renal insufficiency, uncontrolled hypertension and is associated with increased cardiovascular morbidity and mortality. We aimed to evaluate the accuracy of contrast enhanced Flash 3D Renal Magnetic Resonance Angiography (MRA) in the depiction of the RAS also detecting of accessory and polar renal arteries with intraarterial digital subtraction angiography (DSA) still serving as the reference standard.Methods: In this retrospective case-control study, we reviewed contrast enhanced Flash 3D Renal MRA and DSA of 71 patients who were suspected of having RAS and underwent DSA after MRA within 15 days. DSA was accepted as gold standart and the specificity, sensitivity and accuracy of MRA were determined.Results: Overall sensitivity and specificity values of contrast enhanced Flash 3D Renal MRA in detecting stenosis were 96.1% and 76.3% respectively.Conclusions: Contrast enhanced Flash 3D Renal MRA is a reliable noninvasive imaging modality in the diagnosis of RAS.