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  • Küçük Resim
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    Adölesan gebelerin maternal ve fetal sonuçlarının değerlendirilmesi
    (Dicle Üniversitesi Tıp Fakültesi, 2016) Ağaçayak, Elif; Alan, Bircan; Turgut, Abdülkadir; Karabel, Müsemma; Tunç, Senem Yaman; Çeter, Yasemin; Arslan, Necmi; Yalınkaya, Ahmet
    Objective: In this study, our aim is to compare discussing maternal and fetal problems non-adolescent pregnancy with maternal and fetal problems in adolescent pregnancy that seen in hospital. Methods: 15-19 years of age (50 patients) and 20-23 years (96 patients) who gave birth at the Gynaecologi­cal and Obstetric Clinic under the Faculty of Medicine of Dicle University between January 2015-October 2015 were retrospectively evaluated. Age at birth, parity, blood pressure, pulse, gestational age, complications at birth, cesarean section indications, maternal biochemical pa­rameters, patients with preeclampsia and preterm birth, maternal and fetal complications were recorded. Results: Total number of births between January 2015- October 2015 were 1715 patients in our clinic. 62 of them (3.6%) were observed in the adolescent group. Maternal blood transfusion needs were found to be significantly higher in the adolescent group (p=0.004). Fetal abnor­malities and fetal intensive care needs were found to be significantly higher in the adolescent group (p=0.014, p=0.018). Conclusion: Adolescent pregnancies were high-risk pregnancies in terms of maternal anemia and blood transfusion requirements and because of adverse perina­tal outcomes. Therefore, to reduce the adolescent preg­nancy and to minimize perinatal complications should be done more extensive studies.
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    Alternative yöntemler eşliğinde takip ettiğimiz diyabetik ayak enfeksiyonlarımız
    (Yüzüncü Yıl Üniversitesi Tıp Fakültesi, 2017) Bozkurt, Fatma; Alan, Bircan; Dayan, Saim; Selçuk, Tayyar; Aslan, Emel; Deveci, Özcan
    Amaç: Diyabetik ayak enfeksiyonları multidisipliner yaklaşım ve yoğun bir emek gerektirmesi açısından ayrı bir önem arz etmektedir. Halen hastaların organize takibi açısından pekçok hastanede sıkıntılar yaşanmaktadır. Benzer sıkıntıları yaşayan bir Üniversite Hastanesi olarak diyabetik ayak konseyi eşliğinde takip ettiğimiz hasta deneyimlerimizi paylaşmayı amaçladık. Gereç ve Yöntem: Kasım 2015 ile mart 2016 tarihleri arasında Dicle Üniversitesi Hastanesi'nde, diyabetik ayak enfeksiyon tanılı 36 hasta çalışmaya alındı. Wagner evrelemesi ile hastalar sınıflandırıldı. Hastaların yaş, cins, diyabet süresi, HbA1c seviyeleri, yara gelişim süresi, yara yerleşim yeri, ayağın vasküler ve nöropati durumunun değerlendirilmesi yapılarak osteomyelit varlığının tespiti için ayağın direk grafisi ve gerekli hastalarda manyetik rezonans görüntüleme yapıldı. Ayağın enfeksiyon ciddiyetine göre ampirik antimikrobiyal tedavi planlanmadan önce uygun ve steril şartlarda yara kültürleri alındı. Bulgular: Hastaların 21'i erkek olup yaş ortalamaları 46 ± 21 yıl idi. Hastaların 26 'si Wagner evre 3 ve üzeri idi. Hastaların 2'si septik tabloda iken diğerleri stabil idi. Ampirik tedavi olarak ampisillin-sulbaktam, piperasilintazobaktam, sefaperazon-sulbaktam, sefepim ve meropenem tedavileri başlanırken septik tabloda olan iki hastamıza meropenem ve daptomisin tedavisi başlandı. Hastalarımızın 21'i cerrahi işlem gördü. Bir hastaya debridman amacıyla kurtçuk tedavisi uygulandı. Yara bakımı ve granülasyon dokusu geliştirmek için 2 hastaya vacuum assisted closure, 2 hastaya Vacuum Assisted Closure + Epidermal Growth Factor, 2 hastaya Vacuum Assisted Closure + Hiperbarik Oksijen Tedavisi ve toplam 7 hastamıza greft ve/veya flep çevrildi. Sonuç: Mevcut tedavilerle dış merkezlerde diz altı ampütasyon önerilen 3 hastadan 1'i 2-3-4 parmak amputasyonu, diğer 2'si ise hiç amputasyon yapılmadan kurtarıldı.
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    Anteriyor miyokard infarktüsü tablosu ile gelen Takayasu arteriti olgusu
    (2001) Alan, Sait; Toprak, Nizamettin; Karadede, Aziz; Alan, Bircan; Ülgen, Mehmet Sıddık
    Takayasu arteriti, aorta, aortanın majör dalları, pulmoner arteri tutan ve nadir görülen bir arterittir. Tutulan damar segmentlerinde daralma, tıkanma veya anevrizmatik dilatasyona yol açar. Renal arter tutulumu sık olmakla birlikte koroner arter tutulumu nadir fakat ciddi bir tablo oluşturur. Bu yazıda, ciddi hipertansiyonla birlikte akut anteriyor miyokard enfarktüsü tablosu ile başvuran ve aktif dönemde renal artere anjiyoplasti uygulanan bir Takayasu arteriti olgusu sunulmakta, akut miyokard infarktüsünün nadir sebeplerinden biri olan Takayasu arteritine dikkat çekilmektedir.
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    Assessment of Placental Stiffness Using Acoustic Radiation Force Impulse Elastography in Pregnant Women with Fetal Anomalies
    (Korean Radiological Soc, 2016) Alan, Bircan; Goya, Cemil; Tunc, Senem; Teke, Memik; Hattapoglu, Salih
    Objective: We aimed to evaluate placental stiffness measured by acoustic radiation force impulse (ARFI) elastography in pregnant women in the second trimester with a normal fetus versus those with structural anomalies and non-structural findings. Materials and Methods: Forty pregnant women carrying a fetus with structural anomalies diagnosed sonographically at 18-28 weeks of gestation comprised the study group. The control group consisted of 34 healthy pregnant women with a sonographically normal fetus at a similar gestational age. Placental shear wave velocity (SWV) was measured by ARFI elastography and compared between the two groups. Structural anomalies and non-structural findings were scored based on sonographic markers. Placental stiffness measurements were compared among fetus anomaly categories. Doppler parameters of umbilical and uterine arteries were compared with placental SWV measurements. Results: All placental SWV measurements, including minimum SWV, maximum SWV, and mean SWV were significantly higher in the study group than the control group ([0.86 +/- 0.2, 0.74 +/- 0.1; p < 0.001], [1.89 +/- 0.7, 1.59 +/- 0.5; p = 0.04], and [1.26 +/- 0.4, 1.09 +/- 0.2; p = 0.01]), respectively. Conclusion: Placental stiffness evaluated by ARFI elastography during the second trimester in pregnant women with fetuses with congenital structural anomalies is higher than that of pregnant women with normal fetuses.
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    Diagnosis of pre-eclampsia and assessment of severity through examination of the placenta with acoustic radiation force impulse elastography
    (Wiley, 2016) Alan, Bircan; Tunc, Senem; Agacayak, Elif; Bilici, Aslan
    Objective: To assess the value of placental shear wave velocity (SWV) measurement by acoustic radiation force impulse (ARFI) imaging for the diagnosis of pre-eclampsia and to determine the relationship between the SWV and the severity of pre-eclampsia. Methods: A prospective study was performed at a center in Turkey between August 2014 and March 2015. The study included consecutive pregnant women in the second or third trimester diagnosed with pre-eclampsia and healthy pregnant women without pre-eclampsia of similar ages. Patients with pre-eclampsia were divided into two groups (severe or mild disease) on the basis of revised American College of Obstetricians and Gynecologists criteria. All patients underwent ARFI, and the SWV was measured at several placental locations. Results: Overall, 86 women were enrolled (42 with pre-eclampsia, 44 controls). Minimum, maximum, and mean SWV values were significantly higher in the pre-eclampsia group than in the control group (P < 0.001 for all). These values were also significantly higher among patients with severe pre-eclampsia than among patients with mild pre-eclampsia (P < 0.001 for all). Conclusion: Measurement of the placental SWV with ARFI imaging is a useful additional method for the diagnosis of pre-eclampsia and for determination of the disease severity. (C) 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
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    Differential diagnosis of idiopathic granulomatous mastitis and breast cancer using acoustic radiation force impulse imaging
    (Springer Japan Kk, 2017) Teke, Memik; Teke, Fatma; Alan, Bircan; Turkoglu, Ahmet; Hamidi, Cihad; Goya, Cemil; Hattapoglu, Salih
    Purpose Differentiation of idiopathic granulomatous mastitis (IGM) from carcinoma with routine imaging methods, such as ultrasonography (US) and mammography, is difficult. Therefore, we evaluated the value of a newly developed noninvasive technique called acoustic radiation force impulse imaging in differentiating IGM versus malignant lesions in the breast. Methods Four hundred and eighty-six patients, who were referred to us with a presumptive diagnosis of a mass, underwent Virtual Touch tissue imaging (VTI; Siemens) and Virtual Touch tissue quantification (VTQ; Siemens) after conventional gray-scale US. US-guided percutaneous needle biopsy was then performed on 276 lesions with clinically and radiologically suspicious features. Malignant lesions (n = 122) and IGM (n = 48) were included in the final study group. Results There was a statistically significant difference in shear wave velocity marginal and internal values between the IGM and malignant lesions. The median marginal velocity for IGM and malignant lesions was 3.19 m/s (minimum-maximum 2.49-5.82) and 5.05 m/s (minimum-maximum 2.09-8.46), respectively (p < 0.001). The median internal velocity for IGM and malignant lesions was 2.76 m/s (minimum-maximum 1.14-4.12) and 4.79 m/s (minimum-maximum 2.12-8.02), respectively (p < 0.001). Conclusion The combination of VTI and VTQ as a complement to conventional US provides viscoelastic properties of tissues, and thus has the potential to increase the specificity of US.
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    Diyabetes mellituslu hastalarda ortak karotid arter duvar kalınlığı ve arteryel distansibilite'nin değerlendirilmesi
    (2000) Alan, Sait; Karadede, Aziz; Koşar, Feridun; Toprak, Nizamettin; Ülgen, Sıddık; Alan, Bircan
    AMAÇ: Bu çalışmanın amacı ateroskleroza zemin hazırladığı bilinen diyabetes mellituslu hastalarda karotid arter intima-media kalınlığı (IMK) ve arteryel distansibiliteyi (AD) araştırmak idi. YÖNTEM: Kırk DM'lu hasta ve cinsiyeti, yaşı uyumlu 40 kontrol bireyi aterosklerotik risk faktörleri açısından değerlendirildi ve karotid arterler eko-Doppler tekniğiyle incelendi. İMK ve AD ortak karotid arterde kompütür tekniğiyle ölçüldü. Ayrıca, plak veya karotid aterosklerozunun varlığı araştırıldı. BULGULAR: DM'lu hastalar kontrol grubuyla karşılaştırıldığında daha fazla İMK, daha yüksek trigliserit, glukoz ve total kolesterol düzeyine ve daha düşük AD'ye sahipti. DM'lu hastalarda İMK ile yaş, sistolik kan basıncı ve diyabet süresi pozitif olarak ilişkiliyken, AD ile negatif olarak ilişkili idi. Plak veya karotid aterosklerozunun yaygınlığı DM grubunda %35 ve kontrol grubunda %10 idi. SONUÇLAR: Kontrol grubu ile DM grubu karşılaştırıldığında DM'lu hastalarda İMK'da artış ve AD'de azalma vardı. Ayrıca, DM grubunda İMK ile AD önemli derecede negatif ilişkiliydi. İMK ve AD ölçümlerinin ateroskleroz varlığının saptanması ve ateroskleroz gelişme riski yüksek olan DM'lu hastaların belirlenmesini mümkün kılan faydalı testler olabileceği kanısına varıldı.
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    The effect of ACE gene polymorphisms on Doppler blood flow parameters of carotid and brachial arteries in patients with myocardial infarction
    (Sage Publications Inc, 2006) Bilici, Aslan; Ulgen, Mehmet Siddik; Nazaroglu, Hasan; Ozturk, Onder; Ekici, Faysal; Akgul, Cihan; Alan, Bircan
    The authors investigated the relationship between the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism and the blood flow characteristics of common carotid (CCA) and brachial arteries (BA) by color Doppler ultrasound (CDUS) in patients with acute anterior myocardial infarction (AAMI). Sixty four patients (11 women and 53 men), aged 25 to 77 years, with AAMI were studied. The ACE genotypes were established. Peak-systolic (PSV) and end-diastolic velocity (EDV) of right and left CCA, PSV of right BA, and intimal-medial thickness (IMT) of both CCAs were measured by CDUS. All results were evaluated statistically. The ACE genotypes were distributed as follows: 43.8% DD, 43.8% ID, and 12.5% II. PSVs of BA and both CCAs were lower in patients with DD and ID than with 11 (p < 0.05). EDVs of both CCAs were also lower in the same groups, but statistically not significant (p > 0.05). IMTs of both CCAs did not differ among patients with various ACE genotypes (p > 0.05). These results suggest that ACE I/D polymorphism influences Doppler blood flow parameters of both BA and CCA, but does not affect IMT of CCA.
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    Evaluation of Maternal Hemorrhage in Placenta Accreta
    (2016) Tunç, Senem Yaman; Gül, Talip; Alan, Bircan; Başaranoğlu, Serdar; Yalınkaya, Ahmet; Evsen, Mehmet Sıddık; Ağaçayak, Elif
    OBJECTIVE: The aim of the present study is to provide a retrospective evaluation of placenta accretacases to identify the factors affecting the blood transfusion requirement, which stands as one of the mostimportant causes of maternal mortality and morbidity.STUDY DESIGN: A total of 110 patients who presented to the outpatient clinic of gynaecology and obstetrics of the Faculty of Medicine of Dicle University and were diagnosed with placental attachment before or during a caesarean section (C-section) between January 2006 and June 2015 were included inthis study. The patients' data were collected from the hospital's records.RESULTS: During the study period, 21674 births were realised and 110 (1/200) of these patients exhibited placenta accreta. 86 of these 110 patients (78,2%) received at least one unit of blood. The groupof patients that had received blood transfusion exhibited significantly higher values in age, parity, number of C-sections, length of stay (p = 0.003, 0.004, 0.024, 0.000, respectively). Multiple logistical regression analysis led to the identification of a significant association between the length of stay and theblood transfusion requirements (OR 95% Cl 2.005(1.213-3.314) p= 0.007).CONCLUSION: Patients of advanced age as well as grand multiparous patients and patients with a history of multiple repeat caesarean deliveries should be evaluated more carefully during pregnancy. Thesepatients should be referred to hospitals that provide multidisciplinary care and management before thedelivery or even at the early stages of pregnancy in an effort to decrease maternal mortality and morbidity rates..
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    Evaluation of Parathyroid Lesions With Point Shear Wave Elastography
    (Amer Inst Ultrasound Medicine, 2016) Hattapoglu, Salih; Goya, Cemil; Hamidi, Cihad; Tasdemir, Bekir; Alan, Bircan; Durmaz, Mehmet Sedat; Teke, Memik
    Objectives-The aim of our study was to evaluate the shear wave velocity (SWV) of parathyroid lesions by point shear wave elastography (SWE) and to compare their stiffness with that of thyroid nodules and normal thyroid parenchyma quantitatively. Methods-Thirty-six patients considered to have parathyroid disorders by clinical and laboratory tests and scintigraphy were enrolled in the study between January 2012 and February 2015. Conventional sonography, Doppler sonography, and the Virtual Touch tissue quantification (VTQ) method of point SWE (Siemens Medical Solutions, Mountain View, CA) were conducted with a linear transducer (4-9 MHz) while the patients were in the supine position. Then we compared our VTQ measurements with pathologic results. Results-The 36 patients included 31 female and 5 male patients with a mean age +/- SD of 49 +/- 15.7 years (range, 15-79 years). The mean SWV of parathyroid hyperplasia lesions (n = 4) was 1.46 +/- 0.23 m/s, whereas the mean SWV of parathyroid adenomas (n = 32) was 2.28 +/- 0.50 m/s. The mean SWV of normal thyroid parenchyma (n = 36) was 1.62 +/- 0.20 m/s, and the mean SWV of benign thyroid nodules (n = 21) was 2.25 +/- 0.51 m/s. A significant difference was found between SWV values of normal thyroid parenchyma and parathyroid adenoma (P<.001). A cutoff value of 1.73 m/s for adenomas led to 90.0% sensitivity and 80.6% specificity. Conclusions-The VTQ method of point SWE may contribute to the discrimination of parathyroid adenomas from the thyroid gland. However, more comprehensive studies are needed.
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    Evaluation of postoperative undescended testicles using point shear wave elastography in children
    (Elsevier Science Bv, 2016) Hattapoglu, Salih; Goya, Cemil; Arslan, Serkan; Alan, Bircan; Ekici, Faysal; Tekbas, Guven; Yildiz, Ismail
    Purpose: To demonstrate the difference in tissue stiffness by comparing the value of the shear wave velocity (SWV) of postoperative undescended testicles with that of normal testes. Methods: This study included 39 patients and 30 healthy controls. US and p-SWE (VTQ) were performed using with a linear probe (4-9 MHz). Forty-seven operated undescended testicles comprised Group A, 27 testes with normal scrotal placement since birth in patient population comprised Group B. A total of 60 testes in 30 healthy controls were included as Group C. Finally, the testes of Group A, B, C were statistically compared in terms of the SWV and volume. Results: The shear wave values of the 47 testes in Group A were 0.75-2.8 (median, 1.1) m/s, and the SWVs of the 27 testes in Group B were 0.62-1.2 (median, 0.84) m/s. The SWVs of the 60 testes in Group C were 0.65-1 (median, 0.82) m/s. The testicular volumes of Group A ranged from 0.19 to 4.7 (median, 0.15) cm(3), Group B ranged from 0.34 to 8 (median, 0.74) cm(3) and Group C ranged as 0.4-15.5 (median, 0.91) cm(3). Conclusions: VTQ method of p-SWE is a new method that may reveal the difference in stiffness between scrotally placed testes and postoperative undescended testicles. (C) 2016 Elsevier B.V. All rights reserved.
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    İndirekt inguinal herni kesesine uzanan danbıl şeklinde mesane divertikülü
    (Avrasya Üroonkoloji Derneği, 2016) Dusak, Abdurrahim; Alan, Bircan; Utangaç, Mehmet Mazhar; Bilici, Aslan
    Mesane çıkım obstruksiyonlarında özellikle benign prostat hiperplazilerinde, mesanede intraluminal basınç artışına sekonder, artmış trabekülasyon ve divertikül formasyonu sık karşılaşılan bulgulardandır. Mesane divertikülleri boyut artışı göstererek potansiyel boşluklara uzanım göstermesi nadirdir. Bu çalışmada indirekt inguinal herni kesesine uzanan mesane divertikülü olgusunu literatür ışığında sunmayı planladık.
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    Intra-Abdominal Hydatidosis: Hydatid Cyst Related to Right Hepatic Colon Lumen
    (Aydın ECE, 2016) Alan, Bircan
    Hydatid disease is very common in endemic areas and is one of the most frequent parasitoses in Turkey. We present a rare case of hydatidosis related to the right hepatic colon lumen. Hydatid cysts were present on the liver, in the right adrenal region, and also on the hepatic flexura, surrounded by the right colon and omentum. In our case, a cyst adjacent to the ascending colon had ruptured into the colon lumen and developed a cystocolonic communication. Cysts may not always be detectable by ultrasound (US); adrenal and right colonic cysts may not be detected, depending on the patient’s colonic gas superposition factors or other reasons related to the operator. In our case, multiple hydatid cysts and cystocolonic communication of complications of the cyst were found with multidetector computerized tomography (MDCT), and then, a colonoscopy identified the cystocolonic communication. These results reveal the important role of CT in the differential diagnosis process. J Clin Exp Invest 2016; 7 (2): 207-210
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    Karotis intima-media kalınlığının koroner arter hastalık şiddetini belirleyen Gensini skoru ile ilişkisi
    (Dicle Üniversitesi Tıp Fakültesi, 2015) Alan, Bircan; Hattapoğlu, Salih; Dusak, Abdurrahim; Aktan, Adem
    Amaç: Bu çalışmada karotis intima media kalınlığının (KİMK) koroner arter hastalarında (KAH) hastalığın ciddiyetini göstermede objektif bir bulgu olan Gensini skoru ile ilişkisini araştırmayı amaçladık. Yöntemler: Göğüs ağrısı nedeniyle kardiyoloji kliniğine başvurmuş, koroner anjiyografisi yapılarak KAH tespit edilen 76 hasta (41 erkek, 35 kadın) (yaş ortalaması 60.7±11.2 yıl; yaş aralığı 42-83 yıl) çalışmaya dahil edildi. Tüm hastalarda Gensini skoru hesaplanarak <25 (hafif KAH) ve ≥25 (ciddi KAH) olmak üzere 2 gruba ayrıldı. Tüm gruplarda KİMK ölçüldü. Gruplar arasında KİMK ile gensini skoru (KAH şiddeti) karşılaştırıldı. Bulgular: Ciddi KAH grubu ile hafif KAH grubu karşılaştırıldığında, ciddi KAH gurubunda KİMK anlamlı düzeyde yüksekti [sırasıyla 1,2±0,16 (aralık: 0,90-1,50) ve 0,97±0,07 (aralık: 0,90-1,10), p <0,01]. KİMK ile Gensini skoru, yaş, vücut kitle indeksi (VKİ) ve LDL kolesterol arasında anlamlı korelasyonunlar saptandı [sırasıyla, r=0,365, p<0,01; r=0,327, p=0,03; r=-0,341, p<0,01; ve r= 0,385, p<0,01). Sonuç: Koroner arter hastalarında hastalığın ciddiyetini belirlemede kullanılan objektif bir kriter olan Gensini skoru ile KİMK arasında anlamlı bir ilişki bulundu.
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    MRI-based evaluation of the factors leading to pituitary iron overload in patients with thalassemia major
    (Masson Editeur, 2016) Cetincakmak, Mehmet Guli; Hattapoglu, Salih; Menzilcioglu, Sait; Alan, Bircan; Uluca, Unal; Ucar, Ahmet; Soker, Murat
    Aim: Given the lack of studies evaluating pituitary iron overload in patients with thalassemia major, we used magnetic resonance imaging (MRI) to evaluate these patients and the factors affecting the disease process. Materials and methods: The 84 patients with beta-thalassemia major who were included in this study were referred to our clinic for cardiac and hepatic T2* MRI. T2*-weighted images of the pituitary gland, heart, and liver were obtained using a 1.5-tesla MRI unit and a multi-echo gradient-echo sequence. Associations between pituitary T2*, cardiac T2*, hepatic T2*, pituitary height, serum ferritin (SF) level, patient age, and other demographic findings were assessed. Results: Pituitary T2* values correlated with hepatic TZ values, cardiac T2* values, SF level, and patient age (P <= 0.001, 0.001, 0.001, 0.01, respectively) but not with pituitary height (P=0.76). Pituitary and cardiac T2* values were lower in the subset of patients who underwent splenectomy (P=0.046 and P= 0.002, respectively). Conclusion: Pituitary iron overload rapidly increases during puberty and in this study correlated with cardiac and hepatic T2* values, patient age, SF level, and liver size, but not with the height of the pituitary. Pituitary iron overload also increases following splenectomy. Together, these findings indicate that numerous factors contribute to pituitary iron overload. (C) 2016 Elsevier Masson SAS. All rights reserved.
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    Multiplanar reformatted CT enterography in acute abdomen
    (Maltepe University, 2016) Dusak, Abdurrahim; Alan, Bircan; Güzel, Abdulmenap; Çakmak, Muharrem; Taşkesen, Fatih; Göya, Cemil; Bilici, Aslan
    Aim: To investigate the correlation between surgical - histopathological data and CT enterography CTE in patients with acute abdomen due to mecanical ileus. Methods: Ninety one 46 female, 45 male; 44±11 year- old consecutive acute abdomen cases admitted to emergency department and operated in general surgery department with a preoperative diagnoses of mechanical ileus were included in this study. CTE was carried-out using Multi sliced CT 64 detector CT, Philips Brilliance . Subjects were scanned from xiphoid process to symphysis pubis during a single breath-hold. Correlation analyses were done between radiological findings and surgical and histopathological findings. Result: Gastrointestinal tract GIT obstruction finding was evident in 82% of subjects with mecanical ileus and acute abdomen. Sensitivity and specificity of CTE was 85% and 55% respectively in terms of demonstration of etiopathology. 80% of cases had small bowel obstruction and remaining 20% had large bowel obstruction. Bridled ileus, mass, hernia, mesenteric ischemia, perforation, peritonitis carcinomatosa, volvulus, invagination, narrowed anastomosis, torsion, abscess, gossypiboma, gallstone ileus and malrotation were among underlying etiological factors. Statistically significant correlation found between GIT obstruction and findings such as mesenteric stranding, intra abdominal free fluid, string of pearls sign and transition-zone. In contrary, bowel wall thickening, mass lesion, faeces sign, peritoneal nodule, whirl sign, target sign, intra abdominal free air, pneumatosis intestinalis were not statistically significantly correlated with GIT obstruction. Conclusion: CT Entherography is an efficient imaging modality with high diagnostic value in demonstrating the existence and etiopathology of bowel obstruction.
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    Pelvic And Bilateral Symetric Lower Extremities Involvement Of Extensive Fetal Cystic Lymphangioma: A Case Report
    (Düzce Üniversitesi, 2015) Dusak, Abdurrahim; Durmaz, Mehmet Sedat; Bilici, Aslan; Alan, Bircan
    Extensive fetal cystic lymphangioma is a rare congenital malformation of the lymphatic system.Their prognosis depends on the size and location of the lesions as well as other accompanyinganomalies. Our case was 35 years, fetal BPD was 27 weeks . Herein, we present a case ofextensive fetal cystic lymphangioma that began at the pelvic area and symmetrically spannedthe bilateral proximal and distal lower extremities. Numerous extensive and sharplycircumscribed, thin walled multilobular cystic lesions in different sizes were observed in thesubcutaneous superficial and deep soft tissue beginning from the pelvic area and extending toboth lower extremities to the distal in the fetüs. To our knowledge, a case involving bothextremities has not yet been reported in the literature
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    Relationship between osteopenic syndrome and severity of coronary artery disease detected with coronary angiography and Gensini score in men
    (Dove Medical Press Ltd, 2016) Alan, Bircan; Akpolat, Veysi; Aktan, Adem; Alan, Sait
    Background: Many studies have shown that evidence supporting the relationship between low bone mineral density (BMD) and coronary artery disease (CAD) has been increasing. There is a significant increase of myocardial infarction in men with low BMD. Purpose: We aimed to detect the relationship between BMD and CAD in patients whose CAD was detected with coronary angiography, and its severity and prevalence was detected with Gensini score. Methods: A total of 55 patients were selected who were found to have single or multiple infarctions through using coronary angiography in the cardiology clinic. The CAD severity was evaluated by calculating the Gensini score. These patients were divided into two groups: mild CAD and severe CAD groups. Femur bone mineral density (FBMD) was measured with dual energy X-ray absorptiometry. T score values were determined to be normal if the values were >-1.0 (n=22, 40%), and osteopenia-osteoporosis (osteopenic syndrome) if the T score values were <=-1 (n=33, 60%). Results: The FBMD of severe CAD according to the Gensini risk score was found to be significantly lower. FBMD values in patients decreased as their Gensini scores increased. Conclusion: There was a significant relationship between CAD and osteopenic syndrome. FBMD level in men with severe CAD is significantly low when compared with patients who have mild CAD.
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    Renal acoustic radiation force impulse elastography in the evaluation of coronary artery disease
    (Sage Publications Ltd, 2017) Alan, Bircan; Goya, Cemil; Aktan, Adem; Alan, Sait
    Background: Renal insufficiency may occur in patients with coronary artery disease (CAD). Acoustic radiation force impulse (ARFI) is a method for quantifying tissue elasticity, which could be used as an additional diagnostic test for renal insufficiency and provide an additional contribution to the determination of CAD. Purpose: To evaluate ARFI elastography with shear wave velocity (SWV) measurements in the diagnosis of mild-to-moderate chronic kidney disease (CKD) in CAD patients, and to analyze the relationship between the severity of CAD assessed by the Gensini scoring system and kidney stiffness. Material and Methods: The study included 76 CAD patients and 79 healthy volunteers. SWV was measured for each kidney in the both groups. The CAD group was divided into two subgroups based on Gensini score: mild CAD and severe CAD. SWV values of the CAD patients were compared to those of the healthy volunteers; values of subgroups were also compared with each other. Results: The patient group had significantly lower renal mean SWV values than those of the healthy group (1.87 +/- 0.58 vs. 2.34 +/- 0.38, P < 0.01). The SWV value decreased as the eGFR level decreased. Mean SWV values for kidneys of the patients with severe CAD were lower than those of the mild CAD patients (1.64 +/- 0.39 vs. 2.42 +/- 0.60, P < 0.01). Conclusion: renal mean SWV values of CAD patients decreased in proportion to the reduction in eGFR, and the SWV values decreased as the severity of CAD increased. ARFI elastography is a novel technique for diagnosing CKD and defining illness severity in CAD patients.
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    Öğe
    Role of Acoustic Radiation Force Impulse (ARFI) Elastography in Determination of Severity of Benign Prostate Hyperplasia
    (Int Scientific Literature, Inc, 2016) Alan, Bircan; Utangac, Mazhar; Goya, Cemil; Daggulli, Mansur
    Background: The aim of this study was to investigate the potential contribution of acoustic radiation force impulse (ARFI) elastography to the determination of the severity of benign prostate hypertrophy (BPH) by performing shear wave velocity (SWV) measurements of the prostate using ARFI technology. Material/Methods: Sixty BPH patients and 40 healthy volunteers were included in this study. SWV measurements of the prostate were performed by transabdominal ultrasonography (US), both in the BPH patients and control subjects. The BPH patients also underwent uroflowmetry measurements. Using the International Prostate Symptom Score (IPSS), the BPH patients were divided into two subgroups, a mild-to-moderate BPH group and a severe BPH group, to compare SWV values. Results: The BPH patients had higher SWV values for the central area of the prostate compared to the control subjects (2.52 +/- 0.59 m/s and 1.47 +/- 0.42 m/s, p< 0.01). The SWV values of the central area of prostate were higher in the severe BPH group compared to the mild-to-moderate BPH group (2.62 +/- 0.58 and 2.25 +/- 0.55, p= 0.02). Conclusions: Our ARFI elastography results indicated that the central prostate SWV values of BPH patients were significantly higher relative to those of a healthy control group. The central prostate SWV values increased in proportion to the increased severity of BPH. Measurement of SWV by ARFI technology constitutes a non-invasive alternative to other methods for the determination of BPH severity.