Browsing by Author "Göktan C."
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Item High resolution computed tomography findings in patients with asthma; [Astimli Olgularda Yüksek Rezolüsyonlu Bilgisayarli Tomografi Bulgulari.](2003) Yorgancioglu A.; Sakar A.; Tarhan S.; Celik P.; Göktan C.Recent studies suggest that thoracal high resolution computed tomography (HRCT) of the thorax can detect the irreversible structural changes in chronic asthma cases. This study is aimed to evaluate these possible changes and their relation with asthma severity. Twenty-eight stable asthmatic patients with normal conventional radiography and 10 healthy controls were included. Twenty of the patients were female (71.4%) and the mean age of the group was 43 +/- 10.5 (30-61). The groups were divided into 2; as group 1 included mild intermittent and mild persistent cases, and group 2 included moderate and severe persistent cases. Asthma and control group, and group 1 and 2 were compared according to the thickness of airwall (T), thickness to outer diameter (T/D), wall area (WA), the percentage wall area (WA%). HRCT showed that air trapping, bronchiectasis, fibrotic lesions and airwall thickening were significantly more common in asthma group (p< 0.05). Emphysema, acinar pattern, collapse and mucoid impact were common in asthma group (p> 0.05). The incidence of T and WA was higher in asthma group but also did not reach statistical significance and the thickening of airwall in small airways was significantly more in asthma group. Any correlation between HRCT findings and asthma severity was not found. So reversible and irreversible bronchial and parenchymal changes, detected by HRCT but not by plain chest radiograms, may be present in asthma cases. The early detection of these changes may lead more aggressive asthma management.Item Effect of varicocele on testicular artery blood flow in men: Color doppler investigation(2003) Tarhan S.; Gümüs B.; Gündüz I.; Ayyildiz V.; Göktan C.Objective: Varicocele can be defined as an abnormal tortuosity and dilatation of the veins of the pampiniform plexus. Contradictory results have been obtained from experimental animal models and a few clinical human studies on testicular arterial blood flow in varicocele. The purpose of this study was to determine the changes in testicular arterial blood flow parameters in patients with varicocele. Material and Methods: A total of 62 patients with a clinical diagnosis of left varicocele and a scrotal vein with a diameter of ≥3 mm on color Doppler ultrasonography were included in the study. A total of 44 fertile normal male volunteers served as controls. Results: Median testicular arterial blood flow and median flow rate in milliliters per minute per 100 g of testicular tissue were found to be significantly decreased in the patient group compared to the control group: blood flow, 1.42 and 2.00 ml/min; flow rate, 9.63 and 12.35 ml/min/100 g, respectively (p < 0.05). Positive correlations were found between sperm concentration and left testicular artery blood flow (p < 0.05) and between left testicular volume and testicular artery blood flow (p < 0.05). Conclusions: Testicular arterial blood flow was found to be significantly decreased in men with varicocele. This may be a reflection of the impaired microcirculation. Following decreased testicular arterial blood flow, impaired spermatogenesis may result from defective energy metabolism in the microcirculatory bed.Item Somatostatin infusion and hemodynamic changes in patients with non-variceal upper gastrointestinal bleeding: A pilot study(2003) Saruç M.; Can M.; Küçükmetin N.; Tuzcuoglu I.; Tarhan S.; Göktan C.; Yüceyar H.Background: Intravenous somatostatin decreases acid secretion, splanchnic blood flow, and portal pressure, but the evidence for its efficacy in the treatment of non-variceal upper gastrointestinal bleeding has been mixed. We aimed to evaluate the vasoactive effect and possible mechanisms of somatostatin infusion in the cessation of non-variceal upper gastrointestinal bleeding. Material/Methods: Patients with non-variceal upper gastrointestinal bleeding without portal hypertension were enrolled in the study. They were given somatostatin infusion in a dose of 250 μgr/hour for 72 hours. Superior mesenteric arterial average flow velocity (SMA-V), SMA pulsatility index (SMA-PI), portal venous volume flow (PV-F), and renal artery resistance index (RA-RI) were measured two times for each patient by Doppler ultrasound; oncee on the first day of infusion therapy and again 6 hours or more after stopping the infusion. Results: 21 patients (12 male, mean age 44.1±9.9) with bleeding peptic ulcer were enrolled. During somatostatin infusion, PV-F was 33.7±19.7 cm3/sec. After stopping infusion, it increased to 56.3±16.0 cm3/sec (p=0.001). SMA-V was 39.7±13.1 cm/ sec and 64.4±15.1 cm/sec during somatostatin infusion and after cessation of somatostatin respectively (p=0.01). SMA-PI was 2.0±0.8 during somatostatin infusion but 2.8±0.8 without somatostatin infusion (p=0.02). However, RA-RI showed no difference between states with or without somatostatin infusion (p>0.05). Conclusions: Somatostatin infusion causes a decrease in arterial blood flow to the stomach and duodenum in patients with non-variceal upper gastrointestinal bleeding without portal hypertension. Somatostatin therapy also decreases portal blood flow while not altering renal blood.Item Case of Lemierre's syndrome presenting with thyroid abscess(Springer Verlag, 2004) Kara E.; Sakarya A.; Keleş C.; Borand H.; Pekindil G.; Göktan C.Lemierre's syndrome is an uncommon condition characterized by post-anginal septicemia due to anaerobes. Reported here is a case of Lemierre's syndrome presenting with thyroid and liver abscesses. At presentation, the 70-year-old female patient complained of fever, jaundice and neck pain. Computed tomography (CT) and ultrasound confirmed the presence of a left-sided internal jugular vein thrombosis as well as abscesses in the left thyroid lobe and the right lobe of the liver with pleural effusion. The thyroid abscess was treated with a left lobectomy. © Springer-Verlag 2004.Item Barium sulphate allergy (case report); [Baryum sülfat allerjisi.](2004) Tarhan S.; Yilmaz G.; Serter S.; Göktan C.Barium sulphate is a commonly used agent in the radiographic studies of the gastrointestinal tract and has been regarded as a safe contrast medium. Barium sulphate allergy is very rare. We present a case of barium sulphate allergy which occurred during an upper gastrointestinal study in a 24-year-old woman.Item Effects of betaxolol and latanoprost on ocular blood flow and visual fields in patients with primary open-angle glaucoma(Wichtig Editore s.r.l., 2004) Erkin E.F.; Tarhan S.; Kayikçioǧlu Ö.R.; Deveci H.; Güler C.; Göktan C.PURPOSE. To evaluate the effects of betaxolol and latanoprost on ocular blood flow and visual fields in patients with primary open-angle glaucoma (POAG) by means of an observer-masked, prospective clinical study. METHODS. Thirty-two patients with newly diagnosed POAG were included in the study. The patients were randomized into two groups. The first group was treated with betaxolol 0.50% twice daily and the second group with latanoprost 0.005% once daily. Baseline and post-treatment examinations on the first and third months of treatment included intraocular pressure (IOP) measurement, automated visual field testing, and ocular blood flow assessment. For evaluation of visual fields, mean defect and pattern standard deviation indices were used. Ocular blood flow was assessed by means of color Doppler imaging of the central retinal artery (CRA) and the temporal short posterior ciliary artery (PCA). For each vessel, peak systolic (PSV) and end-diastolic (EDV) blood flow velocities were measured and resistivity index (RI) calculated. RESULTS. After exclusion of one noncompliant patient, the study was completed with 31 eyes of 31 patients. Both drugs significantly reduced IOP (p<0.05). The mean IOP lowering effect of latanoprost was significantly higher than that of betaxolol (p=0.03). Visual field indices exhibited no significant changes in either group (p>0.05). There were no significant changes in PSV or EDV measurements of CRA or PCA in either group (p>0.05). RI decreased in both CRA and PCA with both drugs. The mean changes between baseline and 3 month blood flow measurements were not significantly different between betaxolol and latanoprost (p>0.05). CONCLUSIONS. Over a treatment period of 3 months, both betaxolol and latanoprost tended to improve ocular blood flow without one of them being superior to the other. The results suggest that the direct (non IOP-dependent) influence on ocular circulation is better for betaxolol than for latanoprost. In addition, neither drug caused significant generalized improvements in visual fields during this period.Item Mammography-related pain and anxiety (multiple letters)(2005) Göktan C.; Taşkin O.; Alimoǧlu E.[No abstract available]Item Hemangioma of the rib(2006) Yilmaz Ovali G.; Göktan C.; Tarhan S.; Örgüç Ş.; Ayhan S.; Saribülbül O.; Zeybek R.[No abstract available]Item Lung involvement in inflammatory bowel diseases [3](King Faisal Specialist Hospital and Research Centre, 2006) Sarioǧlu N.; Türkel N.; Şakar A.; Ćelik P.; Saruç M.; Demir M.A.; Göktan C.; Kirmaz C.; Yüceyar H.; Yorgancioǧlu A.[No abstract available]Item CT and MRI examinations left behind in the radiology department(2007) Göktan C.; Pekindil G.; Örgüc Ş.; Tunçyürek Ö.; Bayindir P.; Öner M.Purpose: To retrospectively document the reported computerized tomography (CT) and magnetic resonance imaging (MRI) examinations that were left behind in our radiology department, to calculate their cost, and to determine possible sources of waste in order to draw attention to this subject. Materials and methods: The reported and billed CT and MRI examinations for 2003 that were not taken from the radiology department were documented, and the percentage they represented of all CT and MRI performed that year were determined. The total cost of the examinations, including contrast media, was calculated. Results: In all, 200 CTs out of 4390 and 95 MRIs out of 7003 were left behind in the radiology department during 2003. Total cost of the examinations, including the contrast media, was 31,320 YTL. Conclusion: The percentages of CT and MRI examinations left behind in the radiology department were evaluated in this preliminary report. Since we did not find any similar study in the literature, we could not comment on the limits of acceptability of the results; however, we think other radiology departments should determine the percentages CTs and MRIs that are left behind and take the necessary precautions to minimize waste and reduce expenses. © Turkish Society of Radiology 2007.Item Thorax perfusion CT in non-small cell lung cancer(2007) Ovali G.Y.; Sakar A.; Göktan C.; Çelik P.; Yorgancioǧlu A.; Nese N.; Pabuscu Y.Objectives: We aimed to determine the perfusion differences according to the histological type, stage, volume and prognoses in the non-small cell carcinoma by thorax perfusion CT. Materials and methods: Twenty-four non-small cell carcinoma patients were included in the study. Thorax perfusion CT was done to evaluate the tumors in terms of perfusion parameters: blood flow (BF) and time to peak (TTP) values. Results: The total blood flow of the tumor in squamous cell carcinoma was significantly higher than adenocarcinoma (p = 0.031). There was no statistical difference between the perfusion parameters and other parameters. Conclusions: Perfusion CT may help us in evaluating non-small cell carcinomas. © 2007 Elsevier Ltd. All rights reserved.Item Clinical significance of lung perfusion defects in children with post-infectious bronchiolitis obliterans(2009) Yüksel H.; Yilmaz Ö.; Ürk V.; Yüksel D.; Göktan C.; Savaş R.; Sayit E.Clinical significance of segmental lung perfusion defects in children with bronchiolitis obliterans (BO), have not been reported before. The aim of this study was to evaluate clinical significance of lung perfusion defects in children with BO and to reveal its impact on follow up. The study included 38 children aged 9 to 60 months (17.8 ± 13.4 months) with BO. Diagnosis was based on persistent respiratory findings beyond six weeks and oligemic-mosaic pattern in lung high resolution computerized tomography. Chest X-ray, 24 hour esophageal pH monitoring, sweat chloride test, immunoglobulin levels and respiratory viral screening were carried out in all. Lung perfusion scintigraphy was carried out at least three months after the first clinical sign of BO. Perfusion defects were scored. Scintigraphy demonstrated perfusion defects in 24 (63.2%) patients but was normal in 14 (36.8%). Number of segments having perfusion defects was 2.9 ± 2.6. Mean number of exacerbations and days of hospitalization during the first year of follow up were 4.7 ± 4.4 and 26.9 ± 29.8 respectively. It was detected that number of perfusion defects correlated significantly with the number of exacerbations and duration of hospitalization (r= 0.66 and p= 0.00). In conclusion, number and extent of segments with perfusion defects in lungs of children with BO are correlated with clinical severity. Therefore, evaluation of lung perfusion status may aid in clinical determination of disease severity and its follow-up.Item The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery; [Pubovajinal sling operasyonu sonrası inkontinans şiddet indeksi ile MRG bulgularının karşılaştırılması](Turkiye Klinikleri Journal of Medical Sciences, 2010) Tarhan S.; Gümüş B.; Temeltaş G.; Yilmaz Ovali G.; Serter S.; Göktan C.Aim: To investigate the relationship between postoperative MRI findings and the severity score of incontinence in patients treated with pubovaginal sling surgery. & Materials and methods: Fifty-two female patients treated with pubovaginal slings were included in the study. These patients' severity scores of incontinence were evaluated in the postoperative 6th month. All the patients were examined using MRI on the same day. A T2-weighted sagittal image of the midline structures, including the symphysis, urethra, and coccyx, was obtained at rest and at maximal strain. The mobility of the bladder floor and change in the posterior urethrovesical angle were calculated for each patient. Relationships between the severity score of incontinence and mobility of the bladder floor and change in the posterior urethrovesical angle were analyzed using Spearman's rank correlation coefficients by means of SPSS.& Results: A positive correlation was found between the severity score of incontinence and the mobility of the bladder neck and also between the score and the degree of posterior urethrovesical angle (r = 0.797, P = 0.000; r = 0.62, P = 0.000, respectively). There was also a positive correlation between the severity score of incontinence and the increase in posterior urethrovesical angle during Valsalva's maneuver (r = 0.47, P = 0.02). & Conclusion: MRI is a non-invasive diagnostic method for the evaluation of bladder floor position, mobility of the bladder neck, and posterior urethrovesical angle in patients with stress urinary incontinence. It can play a major role in the postoperative follow up of stress urinary incontinence. MRI can also be used for the assessment of success in pubovaginal sling surgery. © TÜBİTAK.Item Primary squamous cell carcinoma of the breast: A case report and immunohistochemical features for differential diagnosis; [Memenin primer skuamöz hücreli karsinomu: Olgu sunumu ve Ayırıcı tanı açı;sından İmmunohistokimyasal özellikleri](Ekin Tibbi Yayincilik, 2010) Temiz P.; Kandiloǧlu A.R.; Şimşek G.; Coşkun T.; Göktan C.We present a 68-year-old postmenopausal woman with a rapidly growing right breast mass. It was diagnosed as "invasive ductal carcinoma" on tru-cut biopsy owing to infiltrative pattern and c-erbB-2 (HER2/neu) and progesterone receptor positivities. Partial response was obtained after four cure chemotherapy (adriamycin and cyclophosphamide). Then, she underwent a modified radical mastectomy with axillary lymph node dissection (level III). Grossly, a white-tan, solid, ill-defined tumor with 5 cm diameter located in the upper inner and outer quadrant of the breast was detected. Central portion of the tumor showed necrotic and hemorrhagic changes. Microscopic examination revealed poorly differentiated squamous cell carcinoma (SCC) having intraductal epithelial hyperplasia with squamous cell metaplasia and multiple small tumor foci at the periphery. The tumor had patchy necrotic, hemorrhagic and fibrotic areas representing regressive changes due to chemotherapy effect. Immunohistochemically, the tumor stained diffusely with CK7, CK8, CK19, HMW-CK and E-cadherin, whereas focally with CEA. Estrogenand progesterone receptors and c-erbB-2 were negative in the tumor. Five out of 20 lymph nodes dissected from the specimen were metastatic. Clinically, other organs were ruled out as the originating site of the tumor. She had taken oral chemotherapy (capecitabine) after surgery and has been living healthy for one year. © Medical Journal of Trakya University.