Browsing by Author "Sakarya, ME"

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Abdominal Hydatid Disease: Long-Term Results of Percutaneous Treatment
(Blackwell Munksgaard, 2004) Etlik, O; Arslan, H; Bay, A; Sakarya, ME; Harman, M; Temizoz, O; Unal, O
Purpose: To evaluate the effectiveness of percutaneous treatment under sonographic guidance in abdominal hydatid cysts. Material and Methods: Fifty-two hydatid cysts in 33 patients were treated using a percutaneous approach under sonographic guidance. Forty-five cysts were located in the liver, 6 in the spleen, and I in the pancreas. Forty-nine cysts were type 1, and 3 were type II. Thirty-one cysts in 15 patients were treated with puncture and aspiration of the contents, injection of hypertonic saline solution, and respiration (PAIR); 15 cysts in 14 patients were treated with puncture, aspiration of cyst contents, injection of hypertonic saline solution, drainage, and injection of sclerosing agent (PAIDS); and 6 cysts in 4 patients were treated with puncture, aspiration of cyst contents, injection of sclerosing agent, and re-aspiration (mPAIDS). Hypertonic saline or alcohol was used as a scolicidal agent. The follow-up period was between 17 and 53 months. Results: A decrease in the dimensions of the cysts, solidification of the contents, and irregularity in the walls of cysts, all of which were considered signs of cure, were found in all patients. Recurrence was observed in one case and anaphylaxis in one. Conclusion: Percutaneous treatment of abdominal hydatid cysts is a safe, easily applicable, well-tolerated, and effective method.
Brain Abscess Drainage by Use of Mr Fluoroscopic Guidance
(Amer Soc Neuroradiology, 2005) Ünal, O; Sakarya, ME; Kiymaz, N; Etlik, O; Kayan, M; Kati, I; Harman, M
We describe herein the use of MR fluoroscopic guidance in the drainage of abscess cavities. We percutaneously drained 12 brain abscesses in 11 patients. A 0.3T open MR imaging system was used. Sixteen drainages were performed in 12 abscesses. Repeat drainage was needed in three recurrences and one residual lesion. No serious complications were seen. MR fluoroscopy-guided percutaneous brain abscess drainage in an open MR imaging system is feasible.
Bronchobiliary Fistula Due To Hydatid Disease of the Liver
(Acta Medical Belgica, 2002) Uzun, K; Özbay, B; Etlik, Ö; Kotan, Ç; Gencer, M; Sakarya, ME
As a complication of hydatid cyst disease of the liver, bronchobiliary fistula is a rare condition and manifests as bilioptysis. We report the case of a 34 year-old man with echinococcosis of the liver who developed a bronchobiliary fistula which manifested as chronic cough and bile stained sputum. A chest X-ray showed an unilateral infiltrate in the costodiaphragmatic angle. Bronchoscopy revealed bile filling the right basal bronchi. Magnetic resonance cystography revealed that the hepatic bile ducts communicated with the right basal pleural space. Percutaneous transhepatic drainage was applied. When the patient was reevaluated, the hydatid cyst had eroded into the pleural space, and a pleural effusion had developed. The condition of the patient deteriorated. Hence, surgical therapy was performed. After surgery, the condition of the patient improved. He was discharged from the hospital in good condition.
Brucellar Oligoarthritis Involving the Left Temporomandibular, Left Sternoclavicular and Left Ankle Joints
(Clinical & Exper Rheumatology, 1997) Adak, B; Tekeoglu, I; Kutluhan, A; Akdeniz, H; Sakarya, ME; Ugras, S
Clinical Value of Color Doppler Ultrasonography Measurements of Full-Term Newborns With Perinatal Asphyxia and Hypoxic Ischemic Encephalopathy in the First 12 Hours of Life and Long-Term Prognosis
(Tohoku Univ Medical Press, 2002) Kirimi, E; Tuncer, O; Atas, B; Sakarya, ME; Ceylan, A
The cerebral blood flow velocities (CBFV) of infants with perinatal asphyxia and hypoxic ischemic encephalopathy (HIE) in the first 12 hours of their lives have been the chief focus of our concern in this study. Cerebral ischemia which can develop in the earlier hours of HIE, and the detection and diagnosis of this condition with color Doppler ultrasonography (cD-USG) will be put into discussion. Twenty-three full-term newborn infants who had perinatal asphyxia and HIE together with a control group constituting twenty full-term newborn infants who produced no problems, were included in our study, All of the infants underwent cD-USG in the postpartum period of the first 12 hours (mean 8.4 hours). Measurements being based upon peak systolic velocity (PSV), end diastolic velocity (EDV) and Pouecelout's resistive index (RI) in anterior and middle cerebral arteries were conducted. The infants, having been discharged from the unit they were followed up for mean 9.8 months in the outpatient clinic. PSV and EDV counts in the postpartum first 12 hours of 23 infants who were detected to have HIE were found to be significantly lower compared to the control group, whereas RI counts were found to be significantly higher (p < 0.05). The counts obtained from the right and left cerebral arteries of the infants with HIE were found to be corraleted with each others. The neonates in the patient group were observed to have gone through this prognosis: Three of them died, three of them had cerebral palsy, one of them had infantile spasms, and three of them had developmental retardation. When we compared the CBFV of the 10 neonates who had poor prognosis, retrospectively with the other 13 neonates who had good prognosis, PSV and EDV were found to be significantly lower and RI significantly higher (p < 0.05). In the light of the data we have obtained, cD-USCT can be considered to be a highly practical device in evaluating CBVF of the infants with HIE. A skillful detection of the decrease in cerebral blood flow which can develop in the postasphyxial first 12 hours and the prospective treatments being based upon this approach would contribute to the diagnosis, treatment and. prognosis of such cases. - Doppler; neonatal; cerebral blood flow velocities (C) 2002 Tohoku University Medical Press.
Clinical Value of Power Doppler Sonography in the Diagnosis of Varicocele
(John Wiley & Sons inc, 1998) Arslan, H; Sakarya, ME; Atilla, MK
The Club-Shaped Cord Terminus in Siblings With Caudal Agenesis
(Springer verlag, 1999) Ünal, Ö; Sakarya, ME; Arslan, H
We report a rare instance of caudal agenesis occurring in siblings, with MRI. Both our patients had a club-shaped spinal cord, ending at T11. Radiological and urological findings are presented.
Coexistence of Subacute Thyroiditis and Renal Cell Carcinoma
(Canadian Medical Association, 2003) Algün, E; Alici, S; Topal, C; Ugras, S; Erkoç, R; Sakarya, ME; Özbey, N
RENAL CELL CARCINOMA IS CHARACTERIZED by varied manifestations, which include unusual metastatic sites and paraneoplastic and vascular syndromes. We describe the case of a 57-year-old man who presented with high fever, weight loss, palpitations and a tender goitre. We suggest that, in this patient, subacute thyroiditis manifested as a paraneoplastic syndrome of renal cell carcinoma.
Demonstrating the Effect of Theophylline Treatment on Diaphragmatic Movement in Chronic Obstructive Pulmonary Disease Patients by Mr-Fluoroscopy
(Elsevier Sci Ireland Ltd, 2004) Etlik, O; Sakarya, ME; Uzun, K; Harman, M; Temizoz, O; Durmus, A
Introduction: The purpose of this study was to determine the increase in diaphragmatic excursion of patients with chronic obstructive pulmonary disease (COPD) treated with theophylline by MR-fluoroscopy which is an innovative method to demonstrate effectiveness of this treatment. Materials and methods: Investigations were performed on a 0.3 T open MR unit. MR-fluoroscopy images of 30 patients with COPD were obtained before and after theophylline treatment. Diaphragmatic movement values were recorded for evaluation. Results: The response of the diaphragmatic movement in COPD patients treated with theophylline was evaluated by MR-fluoroscopy and an increase of 48% in diaphragmatic contractility was determined after the treatment. The increase in contractility was found to be parallel with respiratory function tests and clinical status. Conclusion: Diaphragmatic movement and response to the medical therapy in patients with COPD can be evaluated by MR-fluoroscopy method which can allow accurate measurements. (C) 2003 Published by Elsevier Ireland Ltd.
The Diagnosis by Fine Needle Aspiration Biopsy of Hydatid Cyst of the Pancreas
(Assoc Soc Scientifique Med Belges, 1997) Ugras, S; Sakarya, ME; Arslan, H; Bozkurt, M; AKdeniz, H
We describe a case of pancreatic hydatid cyst in which the definitive diagnosis was made at fine needle aspiration cytology. The most common site of hydatid cyst is the liver (65%), followed by the lungs (25%). The hydatid cyst of the pancreas is rare since it accounts for less than 1% of the various sites of hydatid disease. The diagnosis may be difficult when the presentation is that of an unexplained epigastric mass or cyst, despite suggestive radiological and ultrasonographic features. Modern serology tests are positive in up to 80% of the abdominal hydatid cysts. It is mandatory to obtain a fine needle aspiration biopsy for definite diagnosis and for appropriate treatment planning. Surgical removal of the hydatid cyst still remains the most effective treatment.
Duplex and Color Doppler Sonographic Findings in Active Sacroiliitis
(Amer Roentgen Ray Soc, 1999) Arslan, H; Sakarya, ME; Adak, B; Unal, O; Sayarlioglu, M
OBJECTIVE, The aim of this study was to describe the duplex and color Doppler sonographic findings in active sacroiliitis. SUBJECTS AND METHODS. Forty-one joints in 21 patients with active sacroiliitis, 20 sacroiliac joints in 10 patients with osteoarthritis, and 30 sacroiliac joints of 15 asymptomatic volunteers were investigated on duplex and color Doppler sonography. We investigated whether a vessel was present around the posterior portions of sacroiliac joints with color Doppler sonography. When an artery was detected the resistive index (RI) was measured using duplex Doppler sonography in all groups and also after treatment in the patients with active sacroiliitis. RESULTS. Vascularization around the posterior portions of sacroiliac joints was seen in 41 joints of the 21 patients with active sacroiliitis, nine joints of six patients with osteoarthritis, and 13 joints of eight volunteers. The mean RI values were 0.62 +/- 0.13, 0.91 +/- 0.09, and 0.97 +/- 0.03, respectively. In the patients with active sacroiliitis, the mean RT value was 0.91 +/- 0.07 after therapy. The RI values for the patients with active sacroiliitis were significantly different from those of the patients with osteoarthritis (p < .001) and of the volunteers (p < .001). In addition, the RI values were significantly different before and after treatment in the patients with active sacroiliitis (p < .001). CONCLUSION. Vascularization around the posterior portions of sacroiliac joints increased and RI values decreased in patients with active sacroiliitis. Color and duplex Doppler sonography were able to reveal these changes and can be used in the diagnosis of active sacroiliitis and follow-up after treatment. Thus, RI values may be a quantitative indicator for clinical symptoms in patients with active sacroiliitis.
Evaluation of Diaphragmatic Movement With Mr Fluoroscopy in Chronic Obstructive Pulmonary Disease
(Elsevier Science inc, 2000) Ünal, Ö; Arslan, H; Uzun, K; Özbay, B; Sakarya, ME
The aim of this study was to show reduction of the diaphragmatic excursion with MR fluoroscopy in patients with chronic obstructive pulmonary disease (COPD) and to compare the results with pulmonary function test (PFT). The study included 13 men and 10 women (average age 56.2) with COPD, and 9 men and 6 women (average age 55.8) as a control group. MR fluoroscopy images with Spoiled Gradient-echo pulse sequence was obtained during deep inspiration and expiration. After examination, over cine-loop display, the highest and lowest positions of the diaphragm were identified and the distance of excursion was measured. Differences in the diaphragmatic excursion between patient and healthy subjects were compared. We have also compared MR fluoroscopy results with PFT. In each person of both groups, excursion of the diaphragm was demonstrated clearly in cine-loop display. Differences of excursion between deepest and highest point of diaphragm were on average 26 and 20 mm, respectively, in the right and left side in patients and 69 and 56 mm in healthy group. Significant correlation was found between expiratory volume in 1 s and MR fluoroscopy results. MR fluoroscopy study showed that there were significant statistical differences in diaphragmatic excursion between patients with COPD and healthy subjects. Expiratory volume in 1 s is closely associated with the diaphragmatic excursion. MR fluoroscopy would seem to be a useful method for showing diaphragmatic excursion. (C) 2001 Elsevier Science Inc. All rights reserved.
Free Hydatid Cyst Only Covered With Germinative Membrane Disrupted From Fibrotic Capsule in the Peritoneal Cavity: a Case Report
(Assoc Soc Scientifique Med Belges, 1998) Arslan, H; Sakarya, ME; Bozkurt, M; Dilek, FH; Yilmaz, Y; Dilek, ON; Er, R
Echinococcosis, an endemic disease on the Asian continent, is caused by ecinococcus granulosus and rarely ecinococcus alveolaris. Although it occurs frequently in the liver and the lung, it can be localized in all tissues and organs. The purpose of this study is to report a rare localization and the complication of hydatid cyst in the pelvis : it pushed forward and upward the urine bladder and there was bilateral hydroureteronephrosis causing uraemia because of outflow obstruction. To our knowledge, a similar case has not been published before in English literature.
Hepatic Cavernous Hemangiomas -: Patterns of Contrast Enhancement on Mr Fluoroscopy Imaging
(Elsevier Science inc, 2002) Ünal, Ö; Sakarya, ME; Arslan, H; Tuncer, I; Etlik, Ö
Purpose: The purpose of this study was to assess the patterns of contrast enhancement of hepatic hemangiomas on gadolinium-enhanced MR fluoroscopy imaging prospectively. Method: Investigation was performed on a 0.3-T open MR unit. Gadolinium-enhanced MR fluoroscopy images were obtained in 24 patients with 28 hepatic hemangiomas. Each MR fluoroscopy image was obtained in 2 s and MR fluoroscopy lasted for 10-25 min for each investigation. Results: Three patterns of contrast enhancement were observed in 24 patients on MR fluoroscopy images. Four small lesions were not detected on MR fluoroscopy images. Uniform enhancement was seen in nine lesions (29%), peripheral nodular enhancement progressing centripetally to uniform enhancement was seen in nine lesions (29%), and peripheral nodular enhancement with persistent central hypointensity was seen in six lesions (22%). Conclusion: Enhanced MR fluoroscopy technique could obtain dynamic images of hepatic hemangiomas. It can be suggested as a useful technique for the showing of enhancement of hepatic hemangiomas, keeping in mind its low sensitivity in the diagnosis of small hemangiomas. (C) 2002 Elsevier Science Inc. All rights reserved.
Late Systolic Wave on Brachial Artery Blood Flow Velocity Pattern in Patients With Coronary Artery Disease and Its Relation To Vascular Stiffness
(Westminster Publ inc, 2001) Güler, N; Eryonucu, B; Bile, M; Etlik, Ö; Erkoç, R; Sakarya, ME
Duplex-Doppler study typically exhibits triphasic brachial artery blood flow velocity pattern in subjects classified as normal without clinically evident atherosclerotic complications, heart disease, hypertension, or diabetes mellitus. In this study, the authors described the late systolic wave on the brachial artery blood flow velocity pattern in patients with coronary artery disease and investigated the relation between late systolic wave and vascular stiffness. Blood flow profile and velocity of the brachial artery were determined noninvasively by ultrasound pulsed-Doppler technique under the guidance of a B-mode ultrasound image in 96 patients with coronary artery disease (CAD). The control group consisted of 23 healthy subjects with no or maximally 2 risk factors (only among age, cigarette smoking, obesity, and gender) for vascular disease. None of the patients and controls had clinical evidence of arterial disorders at upper extremities. In 32 patients (33%) with CAD, a late systolic wave was observed in the brachial artery Doppler study. On the other hand, no late systolic wave was observed in the healthy subjects. In addition, multivessel disease, hypertension, advanced age, diabetes, and smoking were significantly more frequent in patients with the late systolic wave. In conclusion, peripheral arterial abnormalities induced by vascular stiffness may produce alterations in regional wave reflections, and the normal triphasic pattern of the brachial artery blood flow may change by the appearance of the late systolic wave.
Mr Findings in Cardiac Hydatid Cyst
(Elsevier Science inc, 2002) Sakarya, ME; Etlik, O; Sakarya, N; Ozen, S; Temizoz, O; Evirgen, O; Kayan, M
We report a case of a 23-year-old man with a cardiac hydatid cyst involving the left ventricle wall. The diagnosis of the cyst was obtained by magnetic resonance (MR) imaging. He was operated on for cardiac hydatid cyst using enucleation and capitonnage procedure under extracorporeal circulation. Histopathologic study confirmed hydatid cyst diagnosis. (C) 2002 Elsevier Science Inc. All rights reserved.
Mr Findings in Pericardial Hydatid Cyst
(Tohoku Univ Medical Press, 2003) Sakarya, ME; Irmak, H; Etlik, Ö; Evirgen, Ö; Temizöz, O; Sakarya, N
Pericardial hydatid cyst is rare. We present a 32-year-old man with a pericardial. hydatid cyst. Chest x-ray film showed a spherical mass located left mediastinum. A pericardial cyst with low signal intensity was noted on T1 weighted magnetic resonance (MR) images. The cyst had high signal intensity, but signal intensity of folded parasitic membranes in the cyst were seen lower intensity on T2 weighted MR images. Based on these MR findings, pericardial hydatid cyst was diagnosed. The patient underwent surgical removal of the cyst. Histologic study of the cyst confirmed hydatid cyst diagnosis. (C) 2003 Tohoku University Medical Press.
Mr Fluoroscopy-Guided Transthoracic Fine-Needle Aspiration Biopsy: Feasibilitty
(Radiological Soc North America, 2003) Sakarya, ME; Unal, O; Ozbay, B; Uzun, K; Kati, I; Ozen, S; Etlik, O
The purpose of this study was to evaluate the feasibility of using an open-configuration magnetic resonance (MR) imaging system with MR fluoroscopic guidance to perform percutaneous transthoracic fine-needle aspiration biopsy in patients with lung masses. Percutaneous transthoracic aspiration biopsy in patients with lung masses. Percutaneous transthoracic aspiration biopsies were performed with MR fluoroscopic guidance in 14 patients. The masses were 2-7 cm in diameter (mean, 4.1 cm). The needle was positioned by using a free-hand technique with MR fluoroscopic guidance. The needle tip reached the target lesion, and biopsy was performed. Analysis of the biopsy specimens facilitated a specific diagnosis in all patients. Pneumothorax was noted in two patients (14%) with chronic obstructive pulmonary disease. Study results showed that the described MR fluoroscopy-guided transthoracic biopsy technique can be used safely and successfully for lung masses. MR fluoroscopy can be used to reach the target lesion easily and accurately. (C) RSNA, 2003.
Power Doppler Findings in Nasopharingeal Angiofibroma
(Elsevier Science inc, 1998) Arslan, H; Bozkurt, M; Sakarya, ME; Poyraz, N
Juvenile nasopharingeal angiofibroma (JNA) is a rare, histologically benign but clinically malign hypervascular tumor localized in the nasopharynx which occurs exclusively in adolescent boys. There is no definite attitude towards etiology of angiofibroma. in diagnostics, besides epypharyngoscopy, computed tomography and magnetic resonance imaging are the primary diagnostic tests. Angiography is used for preoperative embolization. In this case report, we aim to demonstrate the vascularity of JNA with power Doppler sonography (PDS) and advanced vasculature was observed into tumoral lesion with PDS. (C) Elsevier Science Inc., 1998.
Power Doppler Scanning in the Diagnosis of Carotid Body Tumors
(Amer inst Ultrasound Medicine, 2000) Arslan, H; Ünal, Ö; Kutluhan, A; Sakarya, ME
The aim of this work was to show contribution of power Doppler imaging in the diagnosis of the carotid body tumors. Six patients with a nontender mass beneath the mandibular angle were evaluated with gray scale and power Doppler sonography. Well-defined, solid, weakly hyperechoic masses were noted on gray scale sonography in the carotid bifurcation. Power Doppler sonography showed abundant flow, characterized as an intense blush, throughout the entire tumor in all patients. We believe that invasive and expensive diagnostic modalities are not necessary to evaluate carotid body tumors. Gray scale sonography and power Doppler imaging are sufficient for primary diagnosis of carotid body tumors.