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Öğe Akciğer hidatik kistini taklit eden bir adenoid kistik karsinoma olgusu(1998) Karakoca, Yalçın; Şafak, Alp Alper; Fındık, Serhat; Er, Mükremin; Turut, MahmutOlgumuz 70 yaşında kadın olan bir pulmoner Adenoid Kistik Karsinoma hastasıdır. Dört yıldan beri, bilateral multipl ak-ciğer hidaük kisti ön tanısı ile ilaçla takip edilmekte olan bir hastada klinik veya radyolojik düzelme görülmemiştir. Son gelişinde hidaük kist rüptürü semptomları ile başvurması üzerine ameliyata alınmıştır. Operasyon sırasında, akciğerdeki kitlenin hidaük kist olmadığı, aksine tümöral gelişim olduğu görülmüş ve biyopsi sonucu Adenoid kistik karsinom tanısı konmuştur. Bu olgu dolayısıyla, ülkemizde kist hidaük tanısında akciğer parankimasından köken alan bu tür bir tümörün gözardı edilmemesi vurgulanmıştır.Öğe Anterior sacral meningocele simulating ovarian cyst(John Wiley & Sons Inc, 2006) Erdoğmuş, Beşir; Yazıcı, Burhan; Özdere, Betül Ayça; Şafak, Alp AlperAnterior sacral meningocele is a rare condition characterized by the herniation of meningeal membranes and cerebrospinal fluid through a defect in the anterior aspect of the sacrum. We report a case of an anterior sacral meningocele that was mimicking an ovarian cyst.Öğe Comparison of colour Doppler indices of pelvic arteries in women with bilateral hypogastric artery ligation and controls(2005) Demirci, F.; Özdemir, İsmail; Şafak, Alp Alper; Özden, Selçuk; Somunkiran, AslıThe aim of this study is to compare the blood flows of bilateral uterine, ovarian and arcuate arteries in patients who underwent bilateral hypogastric ligation (BHL), with the controls having similar characteristics. The S/D, the RI and the PI were measured on uterine, arcuate and ovarian arteries in 7 women with BHL and compared with 10 controls. There were not significant differences between the Doppler indices of the two groups. In conclusion, our study suggests that BHL preserves pelvic function and fertility. © 2005 Taylor & Francis Group Ltd.Öğe Comparison of the three age estimation methods: Which is more reliable for Turkish children?(Elsevier Ireland Ltd, 2009) Büken, Bora; Erzengin, Ömer Utku; Büken, Erhan; Şafak, Alp Alper; Yazıcı, Burhan; Erkol, ZerrinBackground: Three atlases-the GOK, the Greulich-Pyle (GP), and the Tanner-Whitehouse (TW3)-are used frequently for age determination in Turkey, The purpose of this study was to evaluate the applicability of these three methods related to the skeletal age assessment for Turkish adolescents. Materials and methods: The conventional roentgenograms of the left hands and wrists, elbows. shoulders, and pelvises of 333 healthy Caucasian children (164 females, 169 males) who fit the study and the criteria of each atlas were obtained. The mean differences (+/- standard deviation [S.D.] in years) between the chronologic age (CA) and the skeletal age (BA), which were obtained by using each age estimation method, were calculated and tested using t-test. Results: For girls, the most accurate method was the TW3 (mean differences (d): -0.21 (p < 0.05)). following by the GP (d: 0.66 (p < 0.001), and the GOK (d: 2.99 (p < 0.001)). For boys, the most accurate method was the GP (d: 0.02 (p > 0.05)), followed by the TW3 (d: 0.18 (p < 0.05)) and GOK (d: 1.05 (p < 0.001)). Discussion and conclusions: Results show that the TW3 (for girls) and the GP (for boys) methods are more appropriate than the GOK atlas for estimating the BA. GOK could be used for boys aged 11-14 years but it should not be used for girls. (c) 2008 Elsevier Ireland Ltd. All rights reserved.Öğe Intima-media thickness of the common carotid artery in highway toll collectors(John Wiley & Sons Inc, 2006) Erdoğmuş, Beşir; Yazıcı, Burhan; Annakkaya, Ali Nihat; Bilgin, Cahit; Şafak, Alp Alper; Arbak, Peri; Tugay, AliPurpose. To assess the effects of exposure to exhaust particles on intima-media thickness of the common carotid artery in highway toll collectors, Methods. Sixty-one highway toll collectors (HTCs) between 24 and 56 years of age (mean, 36.2 +/- 7.3) and 48 controls between 24 and 64 years of age (mean, 42.6 +/- 10.6) were evaluated with gray-scale sonography to measure intima-media thickness (IMT) of the common carotid artery (CCA). Subgroups were categorized according to duration of exhaust exposure and further divided according to tobacco use. Results. CCA IMT was higher (0.8 +/- 0.2 mm) in HTCs than in the control group (0.6 +/- 0.1 mm; p < 0.001) and remained higher when subgroups with similar smoking habits were compared. In HTCs, IMT was greater when the number of years working in tollbooths was greater (p = 0.023). IMT was lower in HTCs with an exposure duration of < 10 years compared with a duration of 10-20years (p = 0.017) or > 20years (p value not significant). Conclusion. Air pollution has a widely acknowledged negative effect on humans. This study confirms that exposure to exhaust particles might cause wall thickening of carotid arteries.Öğe Is the "Gök Atlas" sufficiently reliable for forensic age determination of Turkish children?(2008) Büken, Bora; Büken, Erhan; Şafak, Alp Alper; Yazici, Burhan; Erkol, Zerrin; Mayda, Atilla SenihAim: We investigated whether the contemporary use of the Gök Atlas method is sufficiently reliable for forensic age estimations of Turkish children. Materials and Methods: Plain radiographs of 248 females and 298 males between 11 and 22 years of age were taken. Paired sample t-tests, Pearson correlation coefficients, and linear regression were used to determine the differences and model the relationships between mean skeletal (bone) age (BA) and mean chronological age (CA), using SPSS 11.5 statistical software. Results: In all cases, the CA and BA scores were significantly different and showed high correlation (P < 0.05). The regression model was significant (P < 0.01). According to age groups, the BA was greater than the CA for all age groups by 0.09-3.10 years for boys and 0.44-3.05 years for girls, and this difference was significant for all age groups >14 years for boys and for those 11-18 years of age for girls. The standard deviation of the difference between BA and CA for boys between 11 and 18 years of age and for girls between 11 and 20 years of age was >1 year. Conclusions: We found a large discrepancy between CA and BA according to the Gök Atlas. This discrepancy may be significantly misleading, especially in criminal liability cases. © TÜBİTAK.Öğe Is the Tanner–Whitehouse (TW3) method sufficiently reliable for forensic age determination of Turkish children?(2010) Büken, Bora; Şafak, Alp Alper; Büken, Erhan; Yazıcı, Burhan; Erkol, Zerrin; Erzengin, Ömer UtkuAim: The purpose of our study was to determine the accuracy of Tanner-Whitehouse 3 (TW3-RUS) bone age (BA) assessments for forensic age estimations of Turkish children. Materials and methods: Plain radiographs of left hands and wrists of 324 children were evaluated. Mean chronological age (CA) was compared with mean bone age (BA) according to the TW3 atlas for each sex, and differences by age group were determined. Pearson correlation coefficients and cubic regression were used to determine the differences and model the relationships between mean BA and CA. Statistical analyses were carried out using R-project. Results: The difference between the mean CA and the mean BA was statistically significant, and there was a high correlation between them for both sexes. No P values were statistically significant for any age group for girls but P values were statistically significant at 13 and 14 years for boys. The dispersion formula was determined for each sex. Conclusion: We propose that this atlas can be used for Turkish children, until a new atlas that has been distributed and formed according to the results of multiple studies made throughout the country.Öğe Is the “Gök Atlas” sufficiently reliable for forensic age determination of Turkish children?(2008) Büken, Bora; Büken, Erhan; Şafak, Alp Alper; Yazıcı, Burhan; Erkol, ZerrinAim: We investigated whether the contemporary use of the Gök Atlas method is sufficiently reliable for forensic age estimations of Turkish children. Materials and Methods: Plain radiographs of 248 females and 298 males between 11 and 22 years of age were taken. Paired sample t-tests, Pearson correlation coefficients, and linear regression were used to determine the differences and model the relationships between mean skeletal (bone) age (BA) and mean chronological age (CA), using SPSS 11.5 statistical software. Results: In all cases, the CA and BA scores were significantly different and showed high correlation (P < 0.05). The regression model was significant (P < 0.01). According to age groups, the BA was greater than the CA for all age groups by 0.09–3.10 years for boys and 0.44-3.05 years for girls, and this difference was significant for all age groups >14 years for boys and for those 11-18 years of age for girls. The standard deviation of the difference between BA and CA for boys between 11 and 18 years of age and for girls between 11 and 20 years of age was >1 year. Conclusions: We found a large discrepancy between CA and BA according to the Gök Atlas. This discrepancy may be significantly misleading, especially in criminal liability cases.Öğe Kontrast madde nefropatisinin önlenmesinde dopamin kullanımı(2004) Bicik, Zerrin; Şafak, Alp Alper; Şahin, İdris; Karakuş, HayriyeAmaç : Kontrast madde nefropatisinin (KMN) literatürde çok çeşitli tanımı mevcuttur. En sık kabul gören tanımı, kontrast madde alımından 48-72 saat sonra serum kreatinin değerinde yükselme olarak kabul edilmektedir. Kontrast nefropatisi, tanısal veya girişimsel amaçlı kontrast madde kullanımı sonucu özellikle diyabetes mellitus, hipertansiyon, hipovolemi gibi risk taşıyan kişilerde görülmektedir. Çalışmamızda dopaminin. KMN proflaksisi için kullanılabilirliğini incelemeyi amaçladık. Yöntem ve gereçler : Çalışmaya Radyoloji Ünitesine başvuran kontrast kullanan 60 hasta dahil edildi. Olguların üçü uyumsuzluk nedeni ile çalışma dışı bırakıldı. Olgular iki gruba ayrıldı. Birinci gruba %5 Dext-roz solüsyonu içinde 0.2 mgr/kg/dk hızında dopamin infüzyonu yapıldı, ikinci gruba dopamin olmaksızın sadece %5 Dextroz solüsyonu aynı dozda verildi. Her iki gruba da kontrast kullanımını takiben 6 saat süre içinde verildi. Olgulardan BUN, kreatinin, ürik asit tayini için 6. ve 72. saatte kan örnekleri alındı. Bulgular: Her iki grubun sonuçları karşılaştırıldı. Ayrıca riskli olan ve olmayan gruplar da kendi arasında karşılaştırıldı. Plasma kreatinin düzeyi birinci grupta belirgin olarak yükseldi (p=0.04). Diyabetes mellitus, hipertansiyon, piyelonefrit, ürolitiyazis, konjestif kalp yetmezliği, nefrotoksik ajan kullanımı risk faktörü olarak kabul edildi. Rsik faktörleri hastaların öykülerinden belirlendi. Diyabetli, piyelonefritli ve konjestif kalp yetmezliği olan hasta sayısı subgrup analizi için yeterli sayıda değildi. Dopamin almayan hipertansif hasta grubunda serum kreatinin düzeyleri dopamin alanlara göre istatistiksel olarak anlamlı olmaya yakın derecede artmıştı (p=0.07). Nefrotoksik ilaç alım öyküsü olan ve dopamin almayan olgularda serum kreatinin düzeyi dopamin alanlara göre anlamlı derecede yüksek saptandı (p=0.02). Kontrast maddenin ürolitiyazis üzerinde etkisi görülmedi. Sonuçlar : Dopamin, KMN proflaksisinde, özellikle riskli hastalarda kullanılabilecek bir ajandır. Ancak kesin bir sonuca varabilmek için geniş serili özellikle riskli hastaları içeren çalışmalara ihtiyaç vardır.Öğe Multiseptate gallbladder with acute acalculous cholecystitis(John Wiley & Sons Inc, 2004) Erdoğmuş, Beşir; Yazıcı, Burhan; Şafak, Alp Alper; Özdere, Betül AyçaMultiseptate gallbladder is a rare congenital malformation of the gallbladder. In some cases, right upper quadrant pain, recurrent abdominal pain, and gallstones were present. We present the sonographic findings in a case of multiseptate gallbladder with acute cholecystitis, which (to our knowledge) has not been reported before. We hypothesize that bile sludge accumulated and subsequent cholecystitis developed as a result of bile stasis in our case because the classic predisposing factors that have been described were absent.Öğe Pachymeningitis and epilepsy in rheumatoid arthritis, MRI findings(Edizioni Centauro, 2004) Öztürk, Ayhan; Öztürk, Elif; Şafak, Alp AlperRheumatoid arthritis is a systemic disease in which cerebral involvement and epilepsy association are rare. Here, we describe a 37-year-old woman with a three-year history of rheumatoid arthritis presenting with headache and convulsive attack. The patient complained of severe headache and two generalized convulsions during the previous week. Laboratory data revealed positive RA test. MRI disclosed rheumatoid pachymeningitis. After oral diphenylhydatoin, methylprednisolone administration her headache subsided. In a two-year follow-up no additional convulsion attacks occurred. Hypertrophy of the dura disappeared. It is difficult to diagnose pachymeningitis when patients manifest only headache or convulsions. We suggest carrying out MRI in these cases.Öğe Pankreatikoduodenektomi ardından gelişen aferent ans obstrüksiyonuna bağlı sarılığın perkütan barsak drenajı ile tedavisi(2003) Yazıcı, Burhan; Şafak, Alp Alper; Pehlivan, Mevlüt; Gökgöz, TanerWe present percutaneous biliary drainage in a patient with jaundice due to afferent loop obstruction following a pancreatoduodenectomy. Treatment strategy for this type of jaundice is discussed with a review of the literature. The dilated loop of the jejunum was drained percutaneously with 10 F abscess drainage catheter. The obstructive jaundice was improved.Öğe Simple and cost effective cannula for sialography: Technical note(2003) Yazıcı, Burhan; Şafak, Alp Alper; Erdoğmuş, BeşirWe developed a simple and cost-effective modified cannula for sialography. The cannulae were made from nineteen, twenty-one and twenty-three gauge winged infusion set which are generally used for injection of contrast material in radiological imaging. In this article, we intend to introduce this cannula and discuss its utility.Öğe Sonographic assessment of the normal limits and percentile curves of liver, spleen, and kidney dimensions in healthy school-aged children(Amer Inst Ultrasound Medicine, 2005) Şafak, Alp Alper; Şimşek, Enver; Bahçebaşı, TalatObjective. The purpose of this study was to determine the normal standards of liver, spleen, and kidney dimensions and the relationship of each with sex, age, body weight, height, body mass index, and body surface area in. healthy school-aged children. Methods. Seven hundred twelve healthy school-aged children (7-15 years) in 2 neighboring cities, including rural areas and, city centers, were evaluated prospectively. Sex, age, weight, height, body mass index, and body surface area were determined for each case. Organ dimensions were measured 3 times, and the mean values were recorded. All Measured organs had a normal position, shape, and echo texture. The children were separated into 5 groups according to body weight. Results. There were no significant differences in organ dimensions with respect to sex (P >.05). The mean right kidney length was shorter than the left kidney length, and the difference was significant (P =.009). Body weight showed the best correlation with liver, spleen, and kidney dimensions. The results were also supported by the variance and covariance of the correlation coefficients. Conclusions. The normal limits of the liver, spleen, and kidneys are important parameters during a sonographic examination. This study revealed that organ dimensions showed the best correlation with body weight. To our knowledge, in clinical practice there are no pediatric organ dimension percentile graphs for interpretation of sonographic examinations. We hope this study contributes to daily practice in radiology clinics.Öğe Tunica albuginea kisti ve eşlik eden skrotal kalkül olgusu(2013) Büyükkaya, Ramazan; Büyükkaya, Ayla; Erdoğmuş, Beşir; Yazici, Burhan; Şafak, Alp Alper; Çalişkan, Mustafa; Yazgan, ÖmerUltrasonografinin üroloji pratiğinde kullanımının yaygınlaşması sonucu testiküler lezyonlarla daha sık karşılaşılmaktadır. Testis ile ilişkili kistler basit kist, tunika albuginea kisti,epidermoid kist ve rete testis ektazisi olarak sınıflanabilir.Tunika albuginea kaynaklı kistler oldukça nadirdir, bu kistlerkapsül kaynaklı olup testis çevresinde yerleşir. Tunica albuginea kistleri genelde insidental saptanmalarına rağmenhastalar ağrı, şişlik ve iğne başı büyüklüğünde sert bir kitle ilebaşvurabilirler. Bu kistlerin mezotelyal orijinli oldukları düşünülmektedir. Fizik muayenede tunica albuginea kistleriyanlışlıkla malign testiküler tümörlerle karışmasına rağmensonografi ile doğru tanı koyularak gereksiz cerrahiden kaçınılmalıdır. Biz bu yazıda, tunica albuginea kisti ve scrotalkalkül tanısını eş zamanlı olarak koyduğumuz bir olguyusunduk.
