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Öğe Elastography to assess the effect of varicoceles on testes: a prospective controlled study(Wiley, 2016) Dede, O.; Teke, M.; Daggulli, M.; Utangac, M.; Bas, O.; Penbegul, N.Varicoceles are the most common and treatable cause of male infertility. The pathophysiology of varicoceles primarily includes elevated temperature, adrenal hormone reflux, gonadotoxic metabolite reflux, altered testicular blood flow, antisperm antibody formation and oxidative stress. The diagnosis of a varicocele is mainly clinical. However, a Doppler ultrasound is used to obtain clinical data and to more accurately measure testicular size. Acoustic radiation force impulse (ARFI) is an additional technique to simultaneously show different areas with different densities in a colour-coded image and a B-mode or greyscale image. This can be used for structural analysis of testicular tissue and has become an additional method for detecting pathologic tissue alterations. We enrolled 30 patients who had clinically diagnosed with left varicoceles and male infertility (Group 1). All patients were evaluated by history taking, physical examination, a spermiogram and an endocrine profile. Thirty control patients (Group 2) were randomly chosen from patients who had applied to an andrology clinic for infertility; their physical examinations and laboratory results showed normal findings. Mean elastography results were significantly different between the groups, and significantly lower in patients who had varicoceles. The relationship between hormonal profiles and elastography parameters was calculated as statistically significant negative correlations between FSH and elasticity. Additionally, a negative correlation was determined between varicocele grade and elasticity of testes. In conclusion, our prospective study showed that ARFI imaging may be more useful than palpation for determining early damage of testicular structure by varicoceles.Öğe Importance of arterial distensibility in patients with vasovagal syncope(Verduci Publisher, 2015) Alan, B.; Teke, M.; Hattapoglu, S.; Alan, S.OBJECTIVE: Vasovagal syncope (VS) has a significant place in the etiology of syncope; tilt table (TT) test is used for identification of patients with vasovagal syncope (VS); however, the repeatability of the TT test is low. Upon repeated administration of TT test to patients with a positive result, the test may reveal a negative result. This feature of the test renders it inadequate particularly in evaluating therapeutical efficacy in patients receiving treatment. The left ventricular (LV) volume changes are important in the pathology of VS; in addition, LV volume changes are directly affected by the changes in the arterial system and therefore, the present study investigated arterial distensibility (AD) in this patient population. PATIENTS AND METHODS: A total of 142 VS patients with a positive TT test result (A group) and 93 healthy individuals (B group) were enrolled in the study. The patients received tilt training treatment for 6 months. VS patients were further classified into two: syncope (+) or syncope (-) subgroup according to having at least one or more syncope episode during the 6 months of training program. All patients and controls underwent Doppler echocardiography and AD measurement which were repeated at the end of 6th month in syncope (+) and (-) subgroups. RESULTS: The mean AD value of patients in group A was significantly lower than that of participants in group B (0.39 +/- 0.1 vs. 0.42 +/- 0.1, p = 0.025). In Group A, AD was significantly correlated with left ventricular diastolic filling time (DFT), isovolumetric relaxation time and right ventricular DFT (r = 0.38, p < 0.05; r = -0.42, p < 0.05; r = 0.35, p < 0.05, respectively). Syncope (+) subgroup had lower mean AD value compared to syncope (-) subgroup (0.38 +/- 0.1 vs. 0.44 +/- 0.1, p < 0.001). CONCLUSIONS: AD may have valuable contribution to understanding the pathophysiology underlying VS and AD may be used in evaluating therapeutical efficacy for vasovagal syncope.Öğe A Surprising Case: A Supernumerary Heterotopic Hemicerebellum(Springer Heidelberg, 2015) Hattapoglu, S.; Hamidi, C.; Goya, C.; Cetincakmak, M. G.; Teke, M.; Ekici, F.[Abstract Not Available]
