Şule Berk Ergun, Mahmut Asfuroğlu, Fırat Selen, U. Toprak, Aysun Okay Erdoğan, M. Alp, Emine Yıldız Özdemir
Aims: The choroid, one of the body's most highly vascularized tissues, receives its blood supply from the ophthalmic and posterior ciliary arteries, which stem from the internal carotid artery. The utilization of spectral-domain optical coherence tomography (SD-OCT) for both qualitative and quantitative assessment of the retina is increasing. The recent introduction of enhanced depth imaging OCT (EDI-OCT) has offered a novel approach to evaluate the choroid using commercially accessible SD-OCT devices. EDI-OCT enables the in vivo examination and measurement of the choroid. The main objective of our study is to evaluate choroidal thickness using EDI-OCT in patients with unilateral significant carotid stenosis; the secondary objective is to observe whether hemodynamic changes affect choroidal thickness. Methods: The study is prospectively designed as a cross-sectional, controlled, and single-blind study, encompassing patients who underwent neck computed tomographic angiography within a one-year period due to any disease. Included patients had carotid stenosis of 50% or more on one side and less than 50% on the other side. The eyes on the side with higher carotid stenosis constituted the study group, while the other side formed the control group. Anterior and posterior segment examinations of the patients, visual acuity according to Snellen Chart, and choroidal thickness were measured. Results: A total of 30 eyes of 15 patients were evaluated. Of the patients included in the study, 9 were men and 6 were women; the average age was 67.9 years (49-85). In the study group, the average choroidal thickness measurements were 211 µm in the nasal, 221 µm in the central and 209 µm in the temporal; in the control group, they were measured as 223 µm in the nasal, 243 µm in the central, and 231 µm in the temporal, respectively. Despite the choroidal thickness being thinner in the study group, the difference did not reach statistical significance. Conclusion: Additional research is required to pinpoint the factors contributing to the dynamics of choroidal thickness and to delineate its significance in carotid artery stenosis more comprehensively.
{"title":"Assessing the impact of internal carotid artery stenosis on choroidal thickness using Cirrus optical coherence tomography","authors":"Şule Berk Ergun, Mahmut Asfuroğlu, Fırat Selen, U. Toprak, Aysun Okay Erdoğan, M. Alp, Emine Yıldız Özdemir","doi":"10.51271/kmj-0135","DOIUrl":"https://doi.org/10.51271/kmj-0135","url":null,"abstract":"Aims: The choroid, one of the body's most highly vascularized tissues, receives its blood supply from the ophthalmic and posterior ciliary arteries, which stem from the internal carotid artery. The utilization of spectral-domain optical coherence tomography (SD-OCT) for both qualitative and quantitative assessment of the retina is increasing. The recent introduction of enhanced depth imaging OCT (EDI-OCT) has offered a novel approach to evaluate the choroid using commercially accessible SD-OCT devices. EDI-OCT enables the in vivo examination and measurement of the choroid. The main objective of our study is to evaluate choroidal thickness using EDI-OCT in patients with unilateral significant carotid stenosis; the secondary objective is to observe whether hemodynamic changes affect choroidal thickness.\u0000Methods: The study is prospectively designed as a cross-sectional, controlled, and single-blind study, encompassing patients who underwent neck computed tomographic angiography within a one-year period due to any disease. Included patients had carotid stenosis of 50% or more on one side and less than 50% on the other side. The eyes on the side with higher carotid stenosis constituted the study group, while the other side formed the control group. Anterior and posterior segment examinations of the patients, visual acuity according to Snellen Chart, and choroidal thickness were measured.\u0000Results: A total of 30 eyes of 15 patients were evaluated. Of the patients included in the study, 9 were men and 6 were women; the average age was 67.9 years (49-85). In the study group, the average choroidal thickness measurements were 211 µm in the nasal, 221 µm in the central and 209 µm in the temporal; in the control group, they were measured as 223 µm in the nasal, 243 µm in the central, and 231 µm in the temporal, respectively. Despite the choroidal thickness being thinner in the study group, the difference did not reach statistical significance.\u0000Conclusion: Additional research is required to pinpoint the factors contributing to the dynamics of choroidal thickness and to delineate its significance in carotid artery stenosis more comprehensively.","PeriodicalId":490838,"journal":{"name":"Kastamonu Medical Journal","volume":"37 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140282942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Coronary artery anomalies are structural variations which are usually detected incidentally as a result of coronary angiographies. Clinically, they are usually asymptomatic. The prevalence of the coronary anomalies was detected to be 1.3% in patients undergoing coronary angiography. Among coronary artery anomalies; the anomaly in which all coronary arteries are originating from a single coronary is called the single coronary artery (SCA). Among the single coronary artery anomalies; the right coronary artery (RCA) originating from the left anterior descending artery (LAD) is an even rarer condition with a rate around 0.009%. In this anomaly, while the RCA usually originates from the left main coronary artery (LMCA), it may also rarely be seen as a branch of the LAD.
{"title":"A rare coronary anomaly: the right coronary artery originating from the left anterior descending artery","authors":"S. Akyel","doi":"10.51271/kmj-0137","DOIUrl":"https://doi.org/10.51271/kmj-0137","url":null,"abstract":"Coronary artery anomalies are structural variations which are usually detected incidentally as a result of coronary angiographies. Clinically, they are usually asymptomatic. The prevalence of the coronary anomalies was detected to be 1.3% in patients undergoing coronary angiography. Among coronary artery anomalies; the anomaly in which all coronary arteries are originating from a single coronary is called the single coronary artery (SCA). Among the single coronary artery anomalies; the right coronary artery (RCA) originating from the left anterior descending artery (LAD) is an even rarer condition with a rate around 0.009%. In this anomaly, while the RCA usually originates from the left main coronary artery (LMCA), it may also rarely be seen as a branch of the LAD.","PeriodicalId":490838,"journal":{"name":"Kastamonu Medical Journal","volume":"40 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140279189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims: The aim of this study is to evaluate the predictive value of first trimester biochemical markers in the subsequent development of gestational diabetes mellitus. Methods: Data were retrospectively collected from the file records of 361 pregnant patients, who were admitted to the 1st Obstetrics and Gynecology Clinic at Sisli Etfal Education and Training Hospital for first trimester prenatal screening test between 11-14 weeks of their gestation and who later had undergone 50 gram glucose challenge test at 24-28 weeks of their gestation, between November 2007 and February 2011. Age, patient weight, Crown rump length (CRL), gestational week, Pregnancy-Associated Plasma Protein-A (PAPP-A) concentration, PAPP-A multiple of median (MoM) value, Beta-human koryonik gonadotropin (B-HCG) concentration, B-HCG MoM value, 50 and 100 g oral glucose challange test result were recorded from the files. Gestational diabetes was diagnosed according to National Diabates Data Grup cutt-off values and criteria. The association between first trimester biochemical markers and subsequent development of gestational diabetes was evaluated. Results: In this study low PAPP-A and/or HCG MoM values and increased Nuchal translucency (NT) MoM values were found to be statistically significant for subsequent development of gestational diabetes. Conclusion: GDM is an important health problem that carries many risks of complications for both mother and fetus. Pregnant women with GDM may have high blood sugar levels before diagnosis at 24 weeks of gestation, so fetal growth may be negatively affected by maternal hyperglycemia. Use of first trimester screening maternal serum biomarkers may lead to early diagnosis of GDM and interventions to improve maternal and fetal outcomes.
{"title":"The predictive value of first trimester maternal serum pregnancy-associated plasma protein-a (papp-a) level in predicting gestational diabetes mellitus","authors":"Necim Yalçın, Adil Hakan İlhan, Aysun Alcı","doi":"10.51271/kmj-0133","DOIUrl":"https://doi.org/10.51271/kmj-0133","url":null,"abstract":"Aims: The aim of this study is to evaluate the predictive value of first trimester biochemical markers in the subsequent development of gestational diabetes mellitus.\u0000Methods: Data were retrospectively collected from the file records of 361 pregnant patients, who were admitted to the 1st Obstetrics and Gynecology Clinic at Sisli Etfal Education and Training Hospital for first trimester prenatal screening test between 11-14 weeks of their gestation and who later had undergone 50 gram glucose challenge test at 24-28 weeks of their gestation, between November 2007 and February 2011. Age, patient weight, Crown rump length (CRL), gestational week, Pregnancy-Associated Plasma Protein-A (PAPP-A) concentration, PAPP-A multiple of median (MoM) value, Beta-human koryonik gonadotropin (B-HCG) concentration, B-HCG MoM value, 50 and 100 g oral glucose challange test result were recorded from the files. Gestational diabetes was diagnosed according to National Diabates Data Grup cutt-off values and criteria. The association between first trimester biochemical markers and subsequent development of gestational diabetes was evaluated.\u0000Results: In this study low PAPP-A and/or HCG MoM values and increased Nuchal translucency (NT) MoM values were found to be statistically significant for subsequent development of gestational diabetes.\u0000Conclusion: GDM is an important health problem that carries many risks of complications for both mother and fetus. Pregnant women with GDM may have high blood sugar levels before diagnosis at 24 weeks of gestation, so fetal growth may be negatively affected by maternal hyperglycemia. Use of first trimester screening maternal serum biomarkers may lead to early diagnosis of GDM and interventions to improve maternal and fetal outcomes.","PeriodicalId":490838,"journal":{"name":"Kastamonu Medical Journal","volume":"18 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140268361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acute bilateral internal carotid artery (ICA) occlusion is a rare stroke syndrome presenting with acute coma, and patients usually have preserved brainstem function on initial examination. In this clinical image, we report a case of acute concurrent bilateral ICA occlusion. Acute bilateral ICA occlusion is an unusual entity with a poor outcome. It can mimic metabolic encephalopathies and posterior circulation infarcts and can be differentiated by careful evaluation of brainstem functions.
{"title":"Acute concurrent bilateral internal carotid artery occlusion: a teaching clinical image","authors":"Oğuzhan Durgan, Doruk Arslan","doi":"10.51271/kmj-0138","DOIUrl":"https://doi.org/10.51271/kmj-0138","url":null,"abstract":"Acute bilateral internal carotid artery (ICA) occlusion is a rare stroke syndrome presenting with acute coma, and patients usually have preserved brainstem function on initial examination. In this clinical image, we report a case of acute concurrent bilateral ICA occlusion. Acute bilateral ICA occlusion is an unusual entity with a poor outcome. It can mimic metabolic encephalopathies and posterior circulation infarcts and can be differentiated by careful evaluation of brainstem functions.","PeriodicalId":490838,"journal":{"name":"Kastamonu Medical Journal","volume":"21 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140278636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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