Researcher:
Deniz, Sinan

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Doctor

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Sinan

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Deniz

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Deniz, Sinan

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2018 - 201922020 - 20224

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    A novel method for hemodynamic analysis of penile erection
    (Springernature, 2022) Yıldırım, Canberk; Ertürk, Hakan; Şerefoğlu, Ege Can; Department of Mechanical Engineering; N/A; Pekkan, Kerem; Deniz, Sinan; Faculty Member; Doctor; Department of Mechanical Engineering; College of Engineering; N/A; N/A; Koc University Hospital; 161845; N/A
    Measurement of blood flow velocity through the cavernosal arteries via penile color Doppler ultrasound (PDUS) is the most common objective method for the assessment of erectile function. However, in some clinical cases, this method needs to be augmented via the invasive intracavernosal pressure (ICP) measurement, which is arguably a more direct index for erectile function. The aim of this study is to develop a lumped parameter model (LPM) of the penile circulation mechanism integrated to a pulsatile, patient-specific, bi-ventricular circulation system to estimate ICP values non-invasively. PDUS data obtained from four random patients with erectile dysfunction are used to develop patient-specific LPMs. Cardiac output is estimated from the body surface area. Systemic pressure is obtained by a sphygmomanometer. Through the appropriate parameter set determined by optimization, patient-specific ICP values are predicted with only using PDUS data and validated by pre- and post-papaverine injection cavernosometry measurements. The developed model predicts the ICP with an average error value of 3 mmHg for both phases. Penile size change during erection is predicted with a similar to 15% error, according to the clinical size measurements. The developed mathematical model has the potential to be used as an effective non-invasive tool in erectile function evaluation, expanding the existing clinical decision parameters significantly.
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    Ultrasound-guided popliteal sciatic block provides adequate analgesia during urgent endovascular treatment of critical limb ischemia with resting pain
    (Springer, 2018) N/A; N/A; N/A; N/A; Türeli, Derya; Deniz, Sinan; Ünlükaplan, Aytekin; Oğuzkurt, Levent; Doctor; Doctor; Doctor; Faculty Member; N/A; N/A; N/A; School of Medicine; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; N/A; N/A; N/A; 13559
    Purpose: To demonstrate feasibility and safety of ultrasound-guided popliteal sciatic nerve block for providing analgesia during urgent endovascular treatment of critical limb ischemia with resting pain. Materials and Methods: Ultrasound-guided popliteal sciatic blocks were performed by an interventional radiologist in angiography suite immediately prior to commencement of urgent endovascular treatment of 30 critical limb ischemia patients. Subjective pain levels prior to and following sciatic block were assessed using the visual analog scale (VAS). Need for any supplemental anxiolytics or analgesics during treatment was recorded. Post-procedural evaluation of patient and operator satisfaction levels regarding the intervention was also documented. Results: Ultrasound-guided sciatic block provided adequate analgesia in all patients; VAS scores were 0 (no pain) in 87% and 1–3 (mild to annoying pain) in 13%. Two patients required anxiolytic premedication. Additional analgesia was not required during course of endovascular treatment of any patients. Time necessary to perform sciatic block ranged 3–9 (mean 5.9 ± 1.3) min. Median number of needle attempts was 1 (range 1–3). Onset of satisfactory block ranged from 5 to 20 min (mean 9.4 ± 2.6 min). Mean treatment time was 102.2 ± 36.7 min, and balloon time was 22.4 ± 6.1 min. Patient and operator satisfaction with pain control were very good in all cases. There were no procedure-related complications. Conclusions: Ultrasound-guided popliteal sciatic block is a feasible and safe alternative for providing adequate analgesia during urgent endovascular treatment of critical limb ischemia with resting pain.
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    Contribution of ultrasonography and magnetic resonance imaging to the diagnosis of carpal tunnel syndrome
    (Süleyman Demirel Üniversitesi Tıp Fakültesi, 2020) Altan, Aylin; Deniz, Sinan; Doctor; Koç University Hospital
    Objective The present study aimed to evaluate the contribution of ultrasonography (US) and magnetic resonance (MR) imaging to the diagnosis of patients diagnosed with carpal tunnel syndrome (CTS) based on clinical and electrodiagnostic studies. Matherial and Methods A total of 41 wrists of 27 patients with positive findings in electromyography (EMG) studies performed due to a pre-diagnosis of CTS were included in the study to be examined by US and MR imaging. Patients with a history of wrist trauma, surgery, and steroid injection were excluded. Results The mean age of the cases was 46.1 years and 92.6% of the cases were female. 6 patients had right-sided, 7 had left-sided and 14 patients had been proved to have bilateral CTS findings. Primary and secondary findings favouring CTS were detected by US and MR imaging in 90.2% and 92.7% of the 41 wrists, respectively. Moreover, degenerative cystic resorption of the carpal bones was detected in two, ganglion cyst was detected in one, and bifid median nerve was detected in one case. Conclusion US and MR imaging in patients with CTS are valuable both in terms of exhibiting the signs of median nerve injury and detecting concomitant anatomical and pathological conditions prior to treatment. /Öz: Amaç Çalışmada; klinik ve elektrodiagnostik inceleme sonucu karpal tünel sendromu (KTS) tanısı alan hastalarda ultrasonografi (US) ve manyetik rezonans (MR) görüntülemenin tanıya katkısını değerlendirmek amaçlanmıştır. Gereç ve Yöntem KTS ön tanısı ile uygulanan elektromiyografi (EMG) incelemesi pozitif sonuçlanan 27 hastanın 41 el bileği, US ve MR ile tetkik edilmek üzere çalışmaya dahil edildi. El bileği bölgesini ilgilendiren geçirilmiş travma, operasyon ve steroid enjeksiyonu öyküsü olan vakalar çalışma dışı bırakıldı. Bulgular Olguların yaş ortalaması 46,1 yıl olup %92,6’sı kadındı. Tutulum olguların 6’sında sağ, 7’sinde sol ve 14’ünde bilateral idi. US ile 41 el bileğinin %90,2’sinde, MR ile %92,7’sinde KTS’yi destekleyecek primer ve sekonder bulgular saptandı. Ayrıca iki olguda karpal kemiklerde dejeneratif kistik rezorpsiyon, bir olguda ganglion kisti ve bir olguda bifid median sinir varyasyonu tespit edildi. Sonuç Klinik muayene ve/veya elektrodiagnostik tetkik ile KTS tanısı alan hastalarda US ve MR değerlendirmeleri; öngörülecek medikal veya cerrahi tedavi öncesinde gerek median sinirin hasarı ile ilişkili bulguları ortaya koyması gerekse yandaş anatomik ve patolojik durumları ortaya çıkarması yönünden yararlıdır.
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    A potential therapeutic pitfall in the treatment of venous reflux due to variant planar anatomy of varicose segments
    (Sage, 2018) N/A; N/A; N/A; N/A; Deniz, Sinan; Türeli, Derya; Erkan, Burcu; Oğuzkurt, Levent; Doctor; Doctor; Faculty Member; Faculty Member; N/A; N/A; School of Medicine; School of Medicine; Koç University Hospital; N/A; N/A; N/A; 13559
    Purpose To elaborate on a planar anatomic variant of great saphenous vein as a potential therapeutic pitfall in the treatment of venous reflux. Materials and methods Lower extremity veins in 568 limbs with great saphenous vein insufficiency were sonographically mapped. A rather overlooked variation, the saphenous bow, was studied with emphasis on anatomic clarification and its involvement in venous insufficiency. Results This variation, observed in 5.1% (n=29) of limbs, comprised two segments; one uninterrupted great saphenous vein proper coursing throughout saphenous compartment and one extra-compartmental segment originating distally from and proximally fusing with it. Venous arch remains within compartment only briefly during take-off and re-entry. Extra-compartmental venous arch had reflux either alone (10.3%) or together with intra-compartmental segment (75.9%). Conclusion This variation, part of saphenous segmental aplasia/hypoplasia complex, is associated with venous insufficiency. Meticulous mapping of great saphenous vein territory and identification of such variants during planning stage is indispensable for optimal clinical outcomes of treatment.
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    PublicationOpen Access
    Classification of reflux patterns in patients with great saphenous vein insufficiency and correlation with clinical severity
    (Aves, 2021) Çakır Peköz, Burçak; Yılmaz, Sezen Güçlü; Dinçer, Neris; Deniz, Sinan; Oğuzkurt, Levent; Undergraduate Student; Doctor; Faculty Member; School of Medicine; Koç University Hospital; N/A; N/A; N/A; 13559
    Purpose: this study aims to establish a clinically applicable classification of reflux patterns in patients with great saphenous vein insufficiency and to evaluate the relationship between this classification, the demographics, and severity of clinical findings. Methods: this is a retrospective study from prospectively collected data of 503 patients who had the complaint of varicose vein. All patients had complete physical examination and their medical history was recorded. Lower limbs of all patients were examined with Doppler ultrasonography. A total of 787 limbs with great saphenous vein insufficiency were included in the analysis. The reflux patterns of great saphenous vein insufficiency were classified into 4 types as: type 1, great saphenous vein reflux without involvement of malleolar region and saphenofemoral junction (SFJ); type 2, reflux involving malleolar region with competent SFJ; type 3, reflux involving SFJ with competent malleolar region; and type 4, reflux involving both the SFJ and the malleolar region. We evaluated the association between the classification of great saphenous vein insufficiency and age, sex, body mass index (BMI), disease duration, clinical, etiological, anatomical and pathophysiological elements (CEAP) classification and venous clinical severity score (VCSS). Results: the mean age of the patients was 45.3±11.7 years, with a male-to-female ratio of 2:3. The most common reflux pattern in patients with great saphenous vein insufficiency was type 3 (48.9%), while 14.8% of patients had type 1, 10.4% had type 2, and 25.7% had type 4. Patients with type I reflux pattern were younger in age (p = 0.002), had lower BMI (p = 0.002), fewer number of children (p = 0.008), as well as milder clinical severity score (p = 0.002) compared to other reflux types. Duration of disease symptoms was not significantly correlated with the reflux patterns, but VCSS increased with the involvement of malleolar region as in type 2 compared to type 1 (2.82±1.67 vs. 2.74±2.31), and further increased with the involvement of SFJ as in type 3 (4.13±2.92 vs. 2.82±1.67). Patients with diffuse reflux pattern (type 4) had the most severe clinical presentation (4.59±2.9). Conclusion: we developed a clinically applicable classification of reflux patterns in patients with great saphenous vein insufficiency based on the involvement of malleolar region and/or SFJ. We showed an association between weight, BMI, VCSS, CEAP classification and the extent of insufficiency.
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    PublicationOpen Access
    The use of focused, radioguided parathyroidectomy in geriatric patients with a history of thyroid surgery
    (Hellenic Society of Nuclear Medicine, 2020) Falay, Fikri Okan; Ağcaoğlu, Orhan; Karahan, Salih Nafiz; Deniz, Sinan; Gökler, Ozan; Aydemir, Yeliz; Taşkın, Orhun Çığ; Tezelman, Tevfik Serdar; Demirkol, Mehmet Onur; Teaching Faculty; Faculty Member; Researcher; Doctor; Teaching Faculty; Faculty Member; Faculty Member; Faculty Member; School of Medicine; Koç University Hospital; 246484; 175476; N/A; N/A; 311179; N/A; 166686; N/A; 196946
    Objective: geriatric patients are often reluctant to undergo parathyroid surgery under general anesthesia because of the major comorbidities. The use of minimally invasive techniques for parathyroid lesions under local anesthesia have been published. Radioguided lesion localization has been known to decrease operative time and reduce the occurrence of positive margins in breast cancer surgery. We hypothesize that it could also be effectively used in focused parathyroid surgery in geriatric patients with in history of thyroid surgery. Materials and methods: our study group consists of geriatric patients with a history of thyroid surgery who underwent focused parathyroid surgery between February 2017 and October 2019. Group-1 included 18 patients who had parathyroidectomy under radioguidance. Group-2, 22 patients who had surgery without it. Patient demographics, operative time, number of frozen sections and length of hospital stay were analyzed. Results: analyzed data were similar between groups. The mean age of the patients was 72.56±12.65 years (range: 65-88). The operative times for group-1 and group-2, were 65.42±7.78 and 74.63±15.98 minutes, respectively (P=0.002). All patients were discharged uneventfully on postoperative day-2. Conclusion: radioguidance parathyroidectomy positively affected the operative time and also decreased the need for additional frozen section.