Person: ÖZPAR, RİFAT
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ÖZPAR
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RİFAT
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Publication Normal or elevated prolactin is a good indicator to show pituitary stalk interruption syndrome in patients with multiple pituitary hormone deficiency(Walter De Gruyter Gmbh, 2022-09-23) Eren, Erdal; Öngen, Yasemin Denkboy; Özgür, Taner; Özpar, Rıfat; Demirbaş, Özgecan; Yazıcı, Zeynep; Tarım, Ömer; EREN, ERDAL; DENKBOY ÖNGEN, YASEMİN; ÖZGÜR, TANER; ÖZPAR, RİFAT; DEMİRBAŞ, ÖZGECAN; YAZICI, ZEYNEP; TARIM, ÖMER FARUK; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Endokrinolojisi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Radyolojisi Anabilim Dalı.; 0000-0002-1684-1053; 0000-0001-6649-9287; 0000-0002-6922-5203; 0000-0002-5322-5508; KHZ-1491-2024; JPK-3909-2023; AAH-5062-2021; AAI-2303-2021; FPE-9941-2022; GQX-9760-2022; CCU-8073-2022Objectives To determine the importance of serum prolactin (PRL) in the detection of pituitary stalk interruption syndrome (PSIS) in children with multiple pituitary hormone deficiency (MPHD). We hypothesized that PRL elevation might be a diagnostic indicator of pituitary stalk pathologies. Methods Clinical, radiological, and laboratory features of the 50 cases of MPHD were studied. Results The median age at presentation of the 50 cases (52%, n=26 were female) was 6.61 (0.02-18.9) years. PSIS was detected in 60% (n=30), pituitary hypoplasia in 32% (n=16), partial empty sella in 6% (n=3), and only 2% (n=1) was reported as normal. Out of 50 patients, 21.3% (n=10) were hypoprolactinemic, 44.7% (n=19) were normoprolactinemic, and 34% (n=16) were hyperprolactinemic. The median PRL value was 27.85 (4.21-130) ng/mL in patients with PSIS and 5.57 (0-41.8) ng/mL in patients without PSIS. Additional hormone deficiencies, especially ACTH and LH were detected in follow-up. Conclusions Patients with normal or high prolactin levels deserve special attention regarding the possibility of PSIS. Furthermore, we emphasize the importance of regular follow-up and monitoring for multiple pituitary hormone deficiencies in all patients with a single pituitary hormone deficiency.Publication Non-contrast magnetic resonance venography with inhance 3D Velocity: Diagnostic performance for intracranial venous thrombosis(Springer, 2021-04-06) Özpar, Rifat; Tonkaz, Mehmet; Erkal, Duygu; Öngen, Gökhan; Hakyemez, Bahattin; ÖZPAR, RİFAT; TONKAZ, MEHMET; ERKAL TONKAZ, DUYGU; ÖNGEN, GÖKHAN; HAKYEMEZ, BAHATTİN; 0000-0001-6649-9287; 0000-0002-8201-1568; 0000-0002-3425-0740; AAH-5062-2021; DZJ-5260-2022; EUK-9600-2022; FQR-8472-2022; AAI-2318-2021Purpose The aim of this study was to evaluate the diagnostic performance of Inhance 3D Velocity (I3DV) in intracranial venous thrombosis and investigate the possible impact of venous sinus hypoplasia/aplasia on false thrombosis diagnosis made with I3DV. Methods This study included 540 patients. Contrast-enhanced magnetic resonance venography combined with conventional sequences was considered the gold standard test (GST), while I3DV was considered as diagnostic test. We accessed the diagnostic success of I3DV for intracranial venous thrombosis detection, thrombosed vessel identification, and total/partial thrombus distinction. The possible relationship between false-positive thrombus diagnosed by I3DV and venous sinus hypoplasia or aplasia diagnosed by GST was investigated. Results The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of I3DV in the detection of intracranial venous thrombosis were 95.7%, 92.1%, 64.1%, 99.3%, and 92.6%, respectively. A significant association was observed between I3DV and GST in terms of thrombosis detection and total/partial thrombus distinction (p < 0.001). A significant relationship was observed between false-positive thrombosis diagnosis in I3DV and hypoplasia in the left transverse sinus (p < 0.001). Conclusion Intracranial venous thrombosis may be diagnosed faster and more accurately than traditional phase contrast magnetic resonance angiography in I3DV. This technique can be used in situations where contrast medium application is contraindicated. As in other non-contrast magnetic resonance venography techniques, left transverse sinus hypoplasia can be diagnosed as a thrombosed vessel in I3DV.Publication Evaluation of intracranial atherosclerotic disease risk factors in patients with acute ischemic stroke(Asean Neurological Assoc, 2023-12-01) DİNÇ, YASEMİN; MESUT, GİZEM; Özpar, Rıfat; Hojjati, Farid; HOJJATI, FARID; ÖZPAR, RİFAT; Bakar, Mustafa; HAKYEMEZ, BAHATTİN; BAKAR, HACI MUSTAFA; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-6649-9287; 0009-0006-2052-6335; IUQ-6999-2023Background & Objective: Intracranial atherosclerotic disease (ICAD) is a prevalent cause of ischemic stroke and is related to recurrent strokes. In this study, we aim to identify the ICAD rate and establish the risk factors in patients with acute ischemic stroke (AIS) in our population in Turkey. Methods: Eight hundred sixty-two patients diagnosed with AIS in our tertiary centre between 01-01.2019 and 01.01.2021 were retrospectively included in this study. Results: We detected ICAD in 172 ( 20%) patients. While the independent risk factors of anterior ICAD were hypertension and diabetes mellitus, the risk factors of posterior ICAD were advanced age, diabetes mellitus, hyperlipidaemia and vertebral artery hypoplasia. There were more frequent posterior ICAD. Conclusion: There was difference in the risk factors for anterior ICAD and posterior ICAD in this Turkish study.Publication The association between the CT severity index and the pulmonary artery area in COVID-19 pneumonia(Sage Publications Ltd, 2022-01-24) Ongen, Gökhan; Gökalp, Gökhan; Nas, Ömer Fatih; Özpar, Rıfat; Candan, Selman; ÖNGEN, GÖKHAN; GÖKALP, GÖKHAN; NAS, ÖMER FATİH; ÖZPAR, RİFAT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-6649-9287; FQR-8472-2022; GMO-0473-2022; AAG-8561-2021; AAH-5062-2021Background The pulmonary artery area (PAA) is a valuable non-invasive method for the diagnosis of pulmonary hypertension. Purpose To compare the change in PAA in patients with COVID-19 with the computed tomography (CT) severity index using follow-up imaging. Material and Methods A total of 81 patients who were followed up and underwent CT assessment more than once at our hospital's pandemic department were evaluated retrospectively. Patients with progression were separated into three groups: progression ranging from mild-to-mild infiltration (Group A, CT severity index of 0-2); progression from mild to severe infiltration (Group B, CT severity index of 0-2 to 3-5); and progression from severe-to-severe infiltration (Group C, CT severity index of 3-5). The PAAs were calculated separately. Results The mean age was 56 +/- 12 years. In terms of those patients showing progression in the CT images, the number of patients in Groups A, B, and C was 29, 40, and 12 in the right lung; 32, 45, and 4 in the left lung; 23, 45, and 13 on both lungs, respectively. There was no significant difference between the main, right, and left PAAs in Group A (P > 0.05). In Group B, there were significant increases in the areas of the main, right, and left PAAs (P < 0.05). There were also significant increases in the areas of the right and main pulmonary arteries in Group C (P < 0.05). Conclusion PAAs increase as disease involvement advances in cases with COVID-19 pneumonia, which is thought to be correlated with progression.Publication Reply: "Spinal nerve pathology in Guillain-Barre syndrome associated withCOVID-19 infection"(Wiley, 2020-08-10) Oğuz-Akarsu, Emel; Özpar, Rıfat; Hakyemez, Bahattin; Karlı, Necdet; OĞUZ AKARSU, EMEL; ÖZPAR, RİFAT; HAKYEMEZ, BAHATTİN; KARLI, HAMDİ NECDET; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-6649-9287; 0000-0001-6649-9287; 0000-0002-3425-0740; AAI-2318-2021; AAA-8936-2021; AAN-4912-2021; AAH-5062-2021; IZQ-0662-2023Publication Vertebral artery hypoplasia as an independent risk factor of posterior circulation atherosclerosis and ischemic stroke(Lippincott Williams & Wilkins, 2021-09-24) Dinç, Yasemin; Özpar, Rıfat; Emir, Büsra; Hakyemez, Bahattin; Bakar, Mustafa; DİNÇ, YASEMİN; ÖZPAR, RİFAT; HAKYEMEZ, BAHATTİN; BAKAR, HACI MUSTAFA; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyolog Anabilim Dalı.; 0000-0001-6649-9287; 0000-0002-3425-0740; IWC-9957-2023; AAH-5062-2021; AAI-2318-2021; EKN-8251-2022Vertebral artery hypoplasia (VAH) is a frequent anatomical variation of vertebral arteries, with emerging evidence suggesting that it contributes to posterior circulation ischemia. However, the relationship between VAH and ischemic stroke remains unknown. Hence, this study aimed to determine the prevalence of VAH in patients diagnosed with acute ischemic stroke who were followed up in a neurology clinic and to determine if it can potentially be a risk factor for atherosclerotic stenosis in vertebrobasilar circulation. This retrospective study included 609 patients diagnosed with acute ischemic stroke between January 1, 2019 and January 1, 2020. Demographic of patients, risk factors, radiological and clinical characteristics were evaluated. Posterior circulation was very common in patients with VAH, and the most common locations of atherosclerotic stenosis were V1 and V4 segments of the vertebral artery and the middle segment of basilar artery. Analysis of the risk factors for atherosclerotic stenosis in patients with posterior circulation acute ischemic stroke suggested that VAH was an independent risk factor. Findings of the study suggest that VAH pre-disposes atherosclerotic stenosis in vertebrobasilar circulation, although its mechanism remains unknown. Hemodynamic parameters associated with atherosclerosis could not be measured in vivo. Thus, to better understand the underlying mechanism, conducting studies that examine blood flow parameters with high-resolution magnetic resonance angiography in patients diagnosed with acute cerebral ischemia patients with VAH is warranted.Publication Identifying the risk factors for intracranial herniation in patients with cerebral venous thrombosis(Assoc Arquivos Neuro- Psiquiatria, 2023-05-01) Dinç, Yasemin; Özpar, Rıfat; Hakyemez, Bahattin; Bakar, Mustafa; DİNÇ, YASEMİN; ÖZPAR, RİFAT; HAKYEMEZ, BAHATTİN; BAKAR, HACI MUSTAFA; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-6649-9287; 0000-0003-0342-5939; AAH-5062-2021; AAI-2318-2021; IWC-9957-2023; EKN-8251-2022Background Cerebral venous sinus thrombosis (CVST) is not as well understood as an ischemic stroke of arterial origin. Although the prognosis of CVST is usually good, parenchymal lesions may occur in some patients, and the development of intracranial herniation may result in death. For this reason, recognizing the risk factors for intracranial herniation and accurately determining those patients who should undergo decompressive craniectomy is important.Objective This study aims to determine the risk factors for intracranial herniation in patients with CVST.Methods A total of 177 patients diagnosed with CVST between 2015 and 2021 in our tertiary center were retrospectively included in this study.Results Of the 177 patients, 124 were female and 53 were male with mean ages of 40.65 +/- 13.23 and 44.13 +/- 17.09, respectively. Among those, 18 patients had developed intracranial herniation. A significant statistical relationship was observed between superior sagittal sinus thrombosis, sinus rectus thrombosis, venous collateral score, nonhemorrhagic venous infarct, presence of malignancy, small juxtacortical hemorrhage, and cortical vein thrombosis. The binary logistic regression analysis results showed that the most significant variables were the venous collateral score of 0, malignancy, and small juxtacortical hemorrhages.Conclusion This study identified small juxtacortical hemorrhages, the presence of malignancy, and a venous collateral score of 0 to be independent risk factors for intracranial herniation in CVST patients. Drawing on these results, we recommend close clinical observation of CVST patients, as they may be candidates for decompressive craniectomy.Publication Examination of the development and asymmetry of the cerebellum and its lobules in individuals aged 1-18 years: A retrospective mri study(Springer, 2023-08-08) IŞIKLAR, SEFA; Demir, İmren; DEMİR AKKUŞ, İMREN; Özdemir, Senem Turan; Özpar, Rıfat; ÖZPAR, RİFAT; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anatomi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloj Anabilim Dalı.; 0000-0002-2070-5193; 0000-0001-6649-9287; AAK-3779-2021; JCN-7254-2023Developmental studies of cerebellar lobules were limited. To our knowledge, structural asymmetry has not been studied in immature cerebellar lobules in the 1-18 age group. This study investigated the effect of age and gender on the volumetric development and asymmetry of the global cerebellum and cerebellar lobules in children and adolescents. In this retrospective study, we included 670 individuals [376 (56.1%) males] aged 1-18 years with normal brain MRIs between 2012 and 2021. volBrain CERES automatically segmented the right and left sides of the cerebellar lobules on three-dimensional T1-weighted MRIs. Volume and asymmetry data from individuals in 16 different age ranges were compared with SPSS (ver.28). The absolute volumetric development of the total cerebellum was consistent with the "S" development model in both sexes. The developmental trajectories of the cerebellar lobules were different from each other and showed sexual dimorphism. In the 1-18 age group, the absolute volumes of the total cerebellum and cerebellar lobules were significantly greater in males (p < 0.05). Absolute volumes of lobules IV, VIIB, VIIIA and VIIIB in the age groups had more gender differences. However, sexual dimorphism was insignificant in the cerebellum's total and lobular relative volume. Lobules IV, V, VI, VIIIA and VIIIB had left > right asymmetry and other lobules and total cerebellum had right > left asymmetry. This study confirmed the developmental heterogeneity and sexual dimorphism in the cerebellar lobules. It also provided volumetric data of the immature cerebellum to enable comparison in various neurological and neuropsychiatric diseases.Publication Evaluation of clinical, radiological, and demographic characteristics of juxtacortical hemorrhages in cerebral venous thrombosis(Türk Nöroloji Derneği, 2021-12-01) Dinç, Yasemin; Özpar, Rıfat; Bakar, Mustafa; Hakyemez, Bahattin; DİNÇ, YASEMİN; ÖZPAR, RİFAT; BAKAR, HACI MUSTAFA; HAKYEMEZ, BAHATTİN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı; 0000-0001-6649-9287; 0000-0002-3425-0740; IUQ-6999-2023; AAH-5062-2021; EKN-8251-2022; AAI-2318-2021Objective: Cerebral venous thrombosis (CVT) is a rare form of cerebrovascular disease. Intracranial hemorrhage may occur in 40% of the patients with CVT. The morphology of the intracranial hemorrhages ranges from small juxtacortical hemorrhages (JH) to large parenchymal hematomas. Although it has been suggested that JH is a characteristic of CVT, studies examining the relationship between JH and CVT are limited. In this study, it was aimed to determine the clinical, radiological, and demographic characteristics of JH in patients with CVT.Materials and Methods: In this study, a total of 157 patients who were followed up with the diagnosis of CVT between 2015 and 2021 were included retrospectively. Patients were categorized as, those with and without JH. Variables associated with JH were determined by comparing the demographic, clinical, and radiological characteristics, CVT etiologies and clinical outcomes of the patients.Results: When the clinical, demographic, and radiological characteristics of the patients with and without JH were compared; female gender (p=0.037), clinical initial symptom (0.003), early superior sagittal sinus (SSS) thrombosis (p<0.001), venous collateral scale (VCS) (p<0.001), being in the postpartum period (p=0.006), development of intracranial herniation (p<0.001), and poor clinical outcome (p<0.001) were significantly related with JH. When the significant variables were evaluated with the binary logistic regression, the most significant and independent variables were found to be SSS thrombosis (p=0.043), cortical vein thrombosis (CoVT) (p=0.010), and seizures after CVT (p=0.004). By contrast, no relationships were found between the groups in terms of VCS in binary logistic regression.Conclusion: Diagnosis of CVT is possible with high clinical suspicion and correct interpretation of radiological imaging. JH could be detected with non-contrast cranial computed tomography, which is the first imaging modality, and may cause the clinician to suspect from SSS thrombosis and CoVT. More precise results could be obtained with the prospective multicenter studies.Publication Statistical shape analysis of putamen in early-onset Parkinson's disease(Elsevier, 2021-10) Sığırlı, Deniz; Özdemir, Senem Turan; Erer, Sevda; Şahin, İbrahim; Ercan, İlker; Özpar, Rifat; Örün, Muhammet Okay; Hakyemez, Bahattin; SIĞIRLI, DENİZ; ERER ÖZBEK, ÇİĞDEM SEVDA; ERCAN, İLKER; ÖZPAR, RİFAT; HAKYEMEZ, BAHATTİN; Özdemir, Senem Turan; Şahin, İbrahim; Bursa Uludağ Üniversitesi/Tıp Fakültesi; 0000-0001-9031-3040; 0000-0002-3425-0740; 0000-0001-6649-9287; AAA-7472-2021; FPU-9468-2022; DVY-9744-2022; HII-7787-2022; ABF-2367-2020; AAH-5062-2021; AAI-2318-2021Objective: To investigate the shape differences in the putamen of early-onset Parkinson's patients compared with healthy controls and to assess and to assess sub-regional brain abnormalities. Methods: This study was conducted using the 3-T MRI scans of 23 early-onset Parkinson's patients and age and gender matched control subjects. Landmark coordinate data obtained and Procrustes analysis was used to compare mean shapes. The relationships between the centroid sizes of the left and right putamen, and the durations of disease examined using growth curve models. Results: While there was a significant difference between the right putamen shape of control and patient groups, there was not found a significant difference in terms of left putamen. Sub-regional analyses showed that for the right putamen, the most prominent deformations were localized in the middle-posterior putamen and minimal deformations were seen in the anterior putamen. Conclusion: Although they were not as pronounced as those in the right putamen, the deformations in the left putamen mimic the deformations in the right putamen which are found mainly in the middle-posterior putamen and at a lesser extend in the anterior putamen.