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    Anterior hepatic grooves accompanied by Chilaiditi sign: a retrospective radiological analysis of a neglected anatomical fact
    (Springer France, 2015) Yavuz, Alpaslan; Batur, Abdussamet; Bulut, Mehmet Deniz; Bora, Aydin; Goya, Cemil; Andic, Cagatay; Beyazal, Mehmet
    To evaluate anterior hepatic grooves (AHGs) associated with hepato-diaphragmatic mesocolic indentations (Chilaiditi sign) and to delineate the incidence and potential clinical significance of this association. Between November 2011 and June 2014, abdominal computed tomography examinations of 2,314 patients with varied indications were retrospectively reviewed. Patients were surveyed consecutively for the Chilaiditi sign and syndrome, and cases with grooves at the antero-inferior hepatic surface enclosing the adjacent mesocolic indents were determined. The incidence of AHGs and their predominance by gender and age were determined. The potential clinical significance of AHGs associated with Chilaiditi syndrome and their possible effect on liver volume were assessed. The incidences of AHGs were similar between genders (p = .461 and p = .646) and age (p = .113 and .621, respectively) among total cohort and patients with Chilaiditi sign, respectively. There was no significant correlation between AHGs and Chilaiditi syndrome (p = .506); no efficacies of AHGs to liver volume were assessed (p = .413). The AHGs are rare adaptive changes in shape of the liver without a significant effect on liver volume. This overlooked phenomenon is likely derived from the Chilaiditi sign, but has no significant correlation with Chilaiditi syndrome. Future studies with extended series are encouraged to reveal the possible significance of this phenomenon based on concerned surgical interventions.
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    Decreased Vertebral Artery Hemodynamics in Patients with Loss of Cervical Lordosis
    (Int Scientific Information, Inc, 2016) Bulut, Mehmet Deniz; Alpayci, Mahmut; Senkoy, Emre; Bora, Aydin; Yazmalar, Levent; Yavuz, Alpaslan; Gulsen, Ismail
    Background: Because loss of cervical lordosis leads to disrupted biomechanics, the natural lordotic curvature is considered to be an ideal posture for the cervical spine. The vertebral arteries proceed in the transverse foramen of each cervical vertebra. Considering that the vertebral arteries travel in close anatomical relationship to the cervical spine, we speculated that the loss of cervical lordosis may affect vertebral artery hemodynamics. The aim of this study was to compare the vertebral artery values between subjects with and without loss of cervical lordosis. Material/Methods: Thirty patients with loss of cervical lordosis and 30 controls matched for age, sex, and body mass index were included in the study. Sixty vertebral arteries in patients with loss of cervical lordosis and 60 in controls without loss of cervical lordosis were evaluated by Doppler ultrasonography. Vertebral artery hemodynamics, including lumen diameter, flow volume, peak systolic velocity, end-diastolic velocity, and resistive index, were measured, and determined values were statistically compared between the patient and the control groups. Results: The means of diameter (p=0.003), flow volume (p=0.002), and peak systolic velocity (p=0.014) in patients were significantly lower as compared to controls. However, there was no significant difference between the 2 groups in terms of the end-diastolic velocity (p=0.276) and resistive index (p=0.536) parameters. Conclusions: The present study revealed a significant association between loss of cervical lordosis and decreased vertebral artery hemodynamics, including diameter, flow volume, and peak systolic velocity. Further studies are required to confirm these findings and to investigate their possible clinical implications.
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    Herlyn-Werner-Wunderlich Syndrome: Merits of Sonographic and Magnetic Resonance Imaging for Accurate Diagnosis and Patient Management in 13 Cases
    (Elsevier Science Inc, 2015) Yavuz, Alpaslan; Bora, Aydin; Kurdoglu, Mertihan; Goya, Cemil; Kurdoglu, Zehra; Beyazal, Mehmet; Akdemir, Zulkuf
    Study Objective: To review the main sonographic and magnetic resonance imaging manifestations of Herlyn-Werner-Wunderlich syndrome, characterized by uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis, and to discuss the value of techniques for its diagnosis and treatment. Participants: Thirteen patients with Herlyn-Werner-Wunderlich syndrome referred to our department with acute abdomen were identified for the period from 2009-2012. Design: Retrospective chart review. Setting: Two tertiary academic centers. Interventions: None. Main Outcome Measures: The evaluation of the clinical features, ultrasonography and magnetic resonance imaging findings, and the treatment protocols. Results: Ultrasonographic evaluation of didelphic or double uterus in 10 and bicomuate-bicollis uterus in 3 patients with hematocolpos or hematometrocolpos associated with agenesis of the ipsilateral kidney revealed the diagnosis. In 10 patients, magnetic resonance imaging provided extra information. In 1 patient, a 25-week pregnancy was additionally detected and follow-up was suggested. Seven patients underwent surgical excision of the septum and drainage of the obstructed vagina. Total hysterectomy and hemicolpectomy were performed in 1 patient with 2 children suffering from severe chronic pelvic pain due to pelvic inflammatory disease. Conclusions: Despite its rarity, accurate diagnosis and morphologic description of Herlyn-Werner-Wunderlich syndrome with radiologic modalities are of importance in relieving the clinical complaints by enabling the suitable surgical treatment to be identified.
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    Primary Alveolar Soft Part Sarcoma of the Scapula
    (Karger, 2013) Yavuz, Alpaslan; Goya, Cemil; Bora, Aydin; Beyazal, Mehmet
    Alveolar soft part sarcoma (ASPS) is an unusual soft tissue malignity, occurring in less than 1% of sarcomas and typically found in the head and neck tissues in children or, in adults, in the deep soft tissues of the lower extremities. In this report, we present a 33-year-old male with primary ASPS in the right scapular bone and discuss the radiologic features of this tumor in the context of the current literature. (C) 2013 S. Karger AG, Basel
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    Successful Retrieval of the Detached Porous Metallic Tip of a Mechanical Aspiration Catheter during Thrombectomy in a Case with May-Thurner Syndrome: A Case Report
    (Thieme Medical Publ Inc, 2016) Yavuz, Alpaslan; Andic, Cagatay; Gur, Ali Kemal; Goya, Cemil; Bora, Aydin; Beyazal, Mehmet
    Modern, minimally invasive techniques used to treat deep venous thrombosis, such as percutaneous mechanical thrombectomy (PMT) and catheter-directed thrombolysis, have gained worldwide acceptance. PMT has the advantage of speed and is also associated with improved outcomes, shortened hospital stays, and low complication rates. The main complications associated with PMT have been primarily due to iatrogenic vascular damage resulting in perforation, embolic occlusion, and arteriovenous fistula formation; to date, there has been no publication in the literature describing complications resulting from device failure. We present an unusual complication of PMT resulting from detachment of the catheter tip during thrombectomy and bailout technique employed.