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    Diagnostic Magnetic Resonance Imaging of the Breast
    (Aves, 2012) Kilic, Fahrettin; Ogul, Hayri; Bayraktutan, Ummugulsum; Gumus, Hatice; Unal, Ozlem; Kantarci, Mecit; Yilmaz, M. Halit
    Contrast enhanced breast magnetic resonance imaging is a modality that is frequently used into the breast radiologist's daily clinical practice. MRI examination should have optimal technical proficiency in order to attain diagnostic quality avoiding false positive and negative diagnoses. Furthermore, due to increasing usage fields of the examinations uniting with high sensitivity phenomenon, excessive usage and excision/interventional procedures are inevitable. Therefore, we hope to highlight the appropriate usage of the MRI technique and it's clinical applications.
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    Our experience with percutaneous nephrolithotomy in preschool children
    (Aves, 2012) Sancaktutar, Ahmet Ali; Soylemez, Haluk; Penbegül, Necmettin; Atar, Murat; Bozkurt, Yasar; Hatipoglu, Namik Kemal; Kilic, Fahrettin
    Objective: Our aim is to present our experiences with PNL performed on a group of preschool-age children in our clinics. Materials and methods: A total of 23 renal units of 23 patients (10 male, and 13 female patients) with a mean age of 4.3 months (22-72 months) underwent PNL. In 11 patients, the stones were in the right kidneys, and in 12 patients, the stones were in the left kidneys. The stones were localized in the renal pelves (n=10), lower (n=8), middle (n=5), upper pole (n=5) calices or proximal ureters (n=1). In addition, concomitant stones in the distal segment of the ipsilateral (n=2 patients) and contralateral (n=1) ureter were present. In all renal units, following the mechanical dilatation of the nephrostomy access tract, a 17-Fr nephroscope was inserted to perform PNL. Results: The mean stone surface area was 212 mm(2) (110-720 mm2). Average durations of anesthesia, PNL were 77 minutes (45-155 min), and 56 minutes (19-135 min), respectively. Average fluoroscopic manipulation time was 3.4 minutes (2-8 min). To facilitate access, prior mechanical dilatation was performed. Three patients with concomitant ureteral stones underwent ureteroscopy with a 4-Fr semi-rigid ureteroscope, followed by PNL. At the end of postoperative 1 month period, 17 (74%) patients achieved a completely stone-free state, while 5 (21%) cases were fully stone-free after postoperative shock wave lithotripsy. Major bleeding was encountered in one patient after intrarenal introduction of the nephroscope closer to the stone. In 2 patients, blood replacement was also required during the early postoperative period. Average hospitalization time was 1.9 days (1-7 days). Conclusion: Although some major and minor complications were observed, PNL should be the first alternative in the management of renal stones in preschool children. Earlier recognition of complications and institution of necessary interventions on time require close collaboration with the anesthesia team.
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    Öğe
    Ultrasound-guided Percutaneous Nephrolithotripsy in the Supine Position in a Patient with Severe Kyphoscoliosis
    (Marmara Univ, Fac Medicine, 2011) Penbegül, Necmettin; Soylemez, Haluk; Sancaktutar, Ahmet Ali; Atar, Murat; Bozkurt, Yasar; Yildirim, Kadir; Kilic, Fahrettin
    Percutaneous nephrolithotomy (PNL) is the gold standard for the treatment of kidney stones larger than 2 cm. In patients with anatomical anomalies or musculoskeletal deformities PNL can be challenging due to abnormal anatomy. Kyphoscoliosis is a musculoskeletal disorder in which there is abnormal relationship of kidney to surrounding organs. We present a case of ultrasound-guided percutaneous nephrolithotripsy in supine position in a 38-year-old male patient with severe kyphoscoliosis.