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Öğe Benign fibrous histiocytoma arising from the intercostal space(Springer Japan Kk, 2011) Arikanoglu, Zulfu; Akbulut, Sami; Basbug, Murat; Meteroglu, Fatih; Senol, Ayhan; Mizrak, BulentBenign fibrous histiocytoma is a tumor of unknown etiology that is believed to be of mixed fibroblastic and histiocytic origin. Deep benign fibrous histiocytomas are most commonly found in the lower limbs or the head and neck region; it is relatively rare that they are seen in the intercostal space. Only six case reports of this entity are described in the literature. We report a 20-year-old woman who suffered from a painless swelling in the left chest wall, with a computed tomographic correlation. The lesion was totally excised, and histopathology revealed a benign fibrous histiocytoma. This is the first case of a benign fibrous histiocytoma that arose from the intercostal space reported in the English-language literature. The six cases reported in the medical literature are also discussed.Öğe Evaluation of liver fibrosis in chronic hepatitis B patients with 2D shear wave elastography with propagation map guidance: a single-centre study(Bmc, 2022) Kavak, Seyhmus; Kaya, Safak; Senol, Ayhan; Sogutcu, NilgunBackground The aims of this study were to evaluate liver fibrosis with two-dimensional (2D) shear wave elastography (SWE) in patients with chronic hepatitis B (CHB), to compare 2D-SWE with histopathology and to determine the change in liver stiffness values after antiviral therapy. Material and methods A total of 253 patients with CHB were included in this prospective study. 2D-SWE with propagation map guidance to measure liver stiffness, fibrosis-4 index (FIB-4) and aspartate aminotransferase to platelet ratio index (APRI) scoring and additional liver biopsy were performed in patients with CHB. Liver stiffness was measured again at 24 and 48 weeks in all patients. The Spearman rank correlation test was used to analyse the correlation between variables, and receiver operating curve analysis was used to evaluate the diagnostic performance in terms of fibrosis. Results Liver stiffness measurements made with 2D-SWE demonstrated a significant positive correlation with the fibrosis stage and FIB-4 score (r(s) = 0.774 and 0.337, respectively, p < 0.001 for both). The area under the curve value for kPa for the prediction of significant fibrosis was 0.956 (95% CIs) (0.920-0.991), and the optimal cut-off value was 8.2 kPa (sensitivity: 92.7% and specificity: 78.9%); these values were 0.978 (95% CIs, 0.945-1.000) and 10.1 kPa (sensitivity: 92.9% and specificity: 96.4%) for the prediction of severe fibrosis. After antiviral treatment, a decrease in liver stiffness values measured by 2D-SWE was detected (mean kPa values at 0 and 48 weeks; 9.24 and 7.36, respectively, p < 0.001). Conclusion In conclusion, the measurement of liver stiffness with 2D-SWE has high diagnostic performance in the determination of hepatic fibrosis and can be used to evaluate the response to treatment in patients receiving antiviral therapy.Öğe Giant vesical diverticulum: A rare cause of defecation disturbance(Baishideng Publishing Group Inc, 2009) Akbulut, Sami; Cakabay, Bahri; Sezgin, Arsenal; Isen, Kenan; Senol, AyhanVesical diverticula frequently result from bladder outlet obstructions. However, giant vesical diverticula which cause acute abdomen or intestinal obstruction are very rare. Our review of the English medical literature found 3 cases of bladder diverticula which caused gastrointestinal symptoms. Here, we present a 57-year-old man with a giant diverticulum of the urinary bladder who complained of abdominal pain, nausea and vomiting, constipation, no passage of gas or feces, and abdominal distension for 3 d. A 20 cm x 15 cm diverticulum was observed upon laparotomy. The colonic obstruction was secondary to external compression of the rectum against the sacrum by a distended vesical diverticulum. We performed a diverticulectomy and primary closure. Twelve months postoperatively, the patient had no difficulty with voiding or defecation. (c) 2009 The WJG Press and Baishideng. All rights reserved.Öğe Hydatid cyst of the pancreas: Report of an undiagnosed case of pancreatic hydatid cyst and brief literature review(Baishideng Publishing Group Inc, 2014) Akbulut, Sami; Yavuz, Ridvan; Sogutcu, Nilgun; Kaya, Bulent; Hatipoglu, Sinan; Senol, Ayhan; Demircan, FiratAIM: To overview the literature on pancreatic hydatid cyst (PHC) disease, a disease frequently misdiagnosed during preoperative radiologic investigation. METHODS: PubMed, Medline, Google Scholar, and Google databases were searched to identify articles related to PHC using the following keywords: hydatid cyst, hydatid disease, unusual location of hydatid cyst, hydatid cyst and pancreas, pancreatic hydatid cyst, and pancreatic echinococcosis. The search included letters to the editor, case reports, review articles, original articles, meeting presentations and abstracts that had been published between January 2010 and April 2014 without any restrictions on language, journal, or country. All articles identified and retrieved which contained adequate information on the study population (including patient age and sex) and disease and treatment related data (such as cyst size, cyst location, and clinical management) were included in the study; articles with insufficient demographic and clinical data were excluded. In addition, we evaluated a case of a 48-year-old female patient with PHC who was treated in our clinic. RESULTS: A total of 58 patients, including our one new case, (age range: 4 to 70 years, mean +/- SD: 31.4 +/- 15.9 years) were included in the analysis. Twenty-nine of the patients were female, and 29 were male. The information about cyst location was available from studies involving 54 patients and indicated the following distribution of locations: pancreatic head (n = 21), pancreatic tail (n = 18), pancreatic body and tail (n = 8), pancreatic body (n = 5), pancreatic head and body (n = 1), and pancreatic neck (n = 1). Extra-pancreatic locations of hydatid cysts were reported in the studies involving 44 of the patients. Among these, no other focus than pancreas was detected in 32 of the patients (isolated cases) while 12 of the patients had hydatid cysts in extra-pancreatic sites (liver: n = 6, liver + spleen + peritoneum: n = 2, kidney: n = 1, liver + kidney: n = 1, kidney + peritoneum: n = 1 and liver + lung: n = 1). Serological information was available in the studies involving 40 patients, and 21 of those patients were serologically positive and 15 were serologically negative; the remaining 4 patients underwent no serological testing. Information about pancreatic cyst size was available in the studies involving 42 patients; the smallest cyst diameter reported was 26 mm and the largest cyst diameter reported was 180 mm (mean +/- SD: 71.3 +/- 36.1 mm). Complications were available in the studies of 16 patients and showed the following distribution: cystobiliary fistula (n = 4), cystopancreatic fistula (n = 4), pancreatitis (n = 6), and portal hypertension (n = 2). Postoperative follow-up data were available in the studies involving 48 patients and postoperative recurrence data in the studies of 51 patients; no cases of recurrence occurred in any patient for an average follow-up duration of 22.5 +/- 23.1 (range: 2-120) mo. Only two cases were reported as having died on fourth (our new case) and fifteenth days respectively. CONCLUSION: PHC is a parasitic infestation that is rare but can cause serious pancreato-biliary complications. Its preoperative diagnosis is challenging, as its radiologic findings are often mistaken for other cystic lesions of the pancreas. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.Öğe Is methotrexate an acceptable treatment in the management of idiopathic granulomatous mastitis?(Springer Heidelberg, 2011) Akbulut, Sami; Arikanoglu, Zulfu; Senol, Ayhan; Sogutcu, Nilgun; Basbug, Murat; Yeniaras, Erhan; Yagmur, YusufPurpose The treatment of choice for idiopathic granulomatous mastitis (IGM) has not yet been established. There are limited data on the use of methotrexate (MTX) in the treatment of IGM. Herein, we investigated the role of MTX in the treatment of IGM patients. Methods We present four new cases of IGM treated with MTX and a review of the English language literature concerning the use of MTX in the treatment of IGM. Results We prospectively investigated the clinicopathological features of four female patients (aged 28-37 years) who were multiparous and had used oral contraceptives. The patients were administered 7.5-15 mg MTX over 2-6 months. No recurrence was detected during the follow-up period of 4-8 months. In five published studies on MTX use in IGM, data were available for 12 patients aged 21-40 years. In nine patients, treatment was changed to MTX because of a lack of response to steroids, recurrence or steroid-induced diabetes mellitus. Steroids were used in combination with MTX as an initial treatment choice in three patients. Satisfactory results were achieved in ten patients treated with MTX, and only two demonstrated recurrence despite the treatment and underwent mastectomy. Conclusion MTX in the present cases of IGM was effective, prevented complications and limited corticosteroid side effects.Öğe Median arcuate ligament syndrome: Multidetector computed tomography findings(Lippincott Williams & Wilkins, 2007) Ilica, Ahmet Turan; Kocaoglu, Murat; Bilici, Aslan; Ors, Fatih; Bukte, Yasar; Senol, Ayhan; Ucoz, TanerObjective: We aimed to describe the clinical and multidetector computed tomography (MDCT) angiography findings of celiac, mesenteric, and renal artery entrapment by the median arcuate ligament. Materials and Methods: Patients (n = 453) who underwent MDCT abdominal aorta angiography in a period of 3 years were retrospectively reviewed for vascular compression by median arcuate ligament known as median arcuate ligament syndrome. The MDCT examinations were performed with 16-slice (n = 292) and 64-slice scanners (n = 161). The median arcuate ligament itself and adjacent vascular branches of abdominal aorta were assessed for compression by 2 different radiologists who are experienced on MDCT angiography more than 3 years. Both axial, multiplanar reformatted images and 3-dimensional angiograpbies were used for interpretation. Results: Twelve patients were found to have clinically significant vessel entrapments by median arcuate ligament; 6 of them with celiac artery, 4 of them with renal artery, and 2 of them with both celiac and mesenteric artery involvement. Patients with celiac and mesenteric vessel entrapments presented with epigastric pain. All patients with renal artery entrapment had resistant hypertension. The MDCT showed the proximal narrowing caused by compression of median arcuate ligament. The proximal portions of renal arteries pulled down and in toward the aorta, with mild to moderate narrowing. Conclusions: The MDCT examination with multiplanar images and 3-dimensional angiography is a noninvasive imaging technique that can be used with high accuracy in the diagnosis of median arcuate ligament syndrome.Öğe Pregnancy-related atypical hemolytic uremic syndrome with renal, cardiac and obstetric complications and a satisfactory recovery: a case report(Taylor & Francis Ltd, 2021) Gunay, Emrah; Ozan, Mahsum; Kaya, Seyhmus; Ocal, Ece; Kutlu, Zeynep; Senol, Ayhan; Danis, Ramazan[Abstract Not Available]Öğe Primary Retroperitoneal Hydatid Cyst: Report of 2 Cases and Review of 41 Published Cases(Int College Of Surgeons, 2010) Akbulut, Sami; Senol, Ayhan; Ekin, Abdulselam; Bakir, Sule; Bayan, Kadim; Dursun, MehmetThis paper gives an overview of the literature between 2000 and 2010 on primary retroperitoneal hydatid cyst. We reported 2 cases of primary retroperitoneal hydatid cyst, and studies published in English literature on hydatid cyst developing in the retroperitoneal space were accessed via Pubmed and Google Scholar databases. Forty-one published primary retroperitoneal hydatid cyst cases were evaluated, and 2 patients (1 man, 78 years old; 1 woman, 75 years old) who presented with abdominal mass caused by retroperitoneal hydatid cyst were reported. Twenty-five of the patients were men (including our patient), and 18 were women; patients ranged in age from 3 to 80 years, and the median standard deviation age was 41.37 +/- 20.4 years. On presentation, 72% of the patients complained of back or abdominal pain; 13.9% had urinary tract symptoms, and 65.1% were determined as having a palpable mass. Ultrasonography was performed on 93% of the patients, computed tomography was performed on 81.4%, magnetic resonance imaging was performed on 18.6%, and intravenous pyelography test was performed on 13.9%. The results of these tests showed a cystoid mass located on the left in 32.5% of the patients, on the right in 37.2%, and in the retrovesical area in 16.2%. Serologic tests determined 67.8% of the patients were indirect hemagglutination positive, and 71.4% were positive on enzyme-linked immunosorbent assay. As a surgical approach, total exision was performed on 55.8% of patients, partial cystectomy was performed on 39.5%, and 4.6% of patients underwent unroofing. If a cystic lesion is determined in the retroperitoneal area in a patient living in an area of endemic hydatid disease, a differential diagnosis of hydatid cyst should be considered. Clinical, radiologic, serologic, and histopathologic evaluations should be made for a differential diagnosis.Öğe Radical vs conservative surgery for hydatid liver cysts: Experience from single center(Baishideng Publishing Group Inc, 2010) Akbulut, Sami; Senol, Ayhan; Sezgin, Arsenal; Cakabay, Bahri; Dursun, Mehmet; Satici, OmerAIM: To compare the efficacy and safety of radical and conservative surgical interventions for liver hydatid disease. METHODS: The study comprised 59 patients in two groups who had undergone radical and conservative surgical procedures for liver hydatid disease in our department between 2004 and 2009. Preoperative diagnostic tools, medical treatments, demographic and clinical characteristics, postoperative follow-up, and recurrence were compared in both groups. RESULTS: This non-randomized retrospective study included 59 patients who had undergone liver hydatid disease surgery. The radical technique was used in 18 patients (mean age: 42.1 +/- 13.5 years, seven male, 11 female), and the conservative technique was used in 41 patients (mean age: 43.5 +/- 13.9 years, 17 male, 24 female). The follow-up period ranged from 3 to 58 mo. Although operative time was significantly shorter in the conservative group (P < 0.001), recurrence was significantly reduced in the radical group (P = 0.045). No statistically significant differences were found in terms of hospitalization duration, cyst count and size, location, postoperative complications, scolicidal solution usage, or follow-up duration between the two groups. CONCLUSION: The more effective method for preventing postoperative recurrence is radical surgery. Endoscopic retrograde cholangiopancreatography for bile leakage in the early postoperative period may decrease the requirement for repeat surgery. (C) 2010 Baishideng. All rights reserved.Öğe Successful Treatment of COVID-19-Related Immune-Complex Glomerulonephritis, Case Report(Iranian Soc Nephrolgy, 2022) Danis, Ramazan; Gunay, Emrah; Yuksel, Enver; Kaya, Seyhmus; Kilic, Jehat; Kacar, Emrah; Senol, AyhanAcute kidney injury (AKI) , proteinuria in the nephrotic or subnephrotic range and hematuria might be seen in patients with coronavirus disease 2019 (COVID-19) infection. In this case study we present a 59 years old manwho was diagnosed with immune-complex glomerulonephritis after development of rapidly progressive kidney failure accompanied by pulmonary hemorrhage, 2 months after COVID-19 infection. The patient was hospitalised with the diagnosis of acute kidney injury and nephrotic syndrome. Hemodialysis was performed due to uremic symptoms. Cyclophosphamide, methylprednisolone and plasmapheresis were started. Pathologic examination of kidney biopsy revealed features compatible with immune complex-related acute glomerulonephritis. Cyclophosphamide and plasmapheresis were discontinued , and treatment with 1 mg/kg/day methylprednisolone was continued. Immune-complex glomerulonephritis can be seen following COVID-19 infection. ??t is important to diagnose this disease entity as soon as possible . Steroidtherapy and other supportive modalities might be sufficient in the treatment.Öğe Treatment of hypertension from renal artery entrapment by percutaneous CT-Guided botulinum toxin injection into Diaphragmatic crus as alternative to surgery and stenting(Amer Roentgen Ray Soc, 2007) Bilici, Aslan; Karcaaltincaba, Musturay; Ilica, Ahmet Turan; Bukte, Yasar; Senol, AyhanOBJECTIVE. Our objective was to describe the technique and outcome of CT-guided injection of botulinum toxin into the diaphragmatic crus in a patient with hypertension caused by left diaphragmatic crus compression of the left renal artery. CONCLUSION. After the procedure, the patient's hypertension disappeared. We propose this technique, which directly targets inhibition of overactivity of the diaphragmatic crus, for treatment of hypertension caused by diaphragmatic compression of the renal artery as an alternative to surgery and renal artery stenting.
