Browsing by Author "Ovali G.Y."
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Item Amputated tuba-ovarian torsion in a newborn(2005) Özkol M.; Ovali G.Y.; Tunçyürek Ö.; Şencan A.; Pabuşçu Y.[No abstract available]Item Gastric stromal tumor(2005) Ovali G.Y.; Tarhan S.; Serter S.; Pabuşçu Y.Gastric stromal tumors are rare neoplasms of the stomach. In this report we present a gastric stromal tumor with an exophytic growth pattern, and describe magnetic resonance imaging and endoscopic ultrasonography findings. © Turkish Society of Radiology 2005.Item Magnetic resonance imaging findings in a case of remitting seronegative symmetrical synovitis with pitting edema(2005) Unlu Z.; Orguc S.; Ovali G.Y.; Tarhan S.; Dayan I.; Angin A.We describe a case of remitting seronegative symmetrical synovitis with pitting edema (RS3PE syndrome) in a 66-year-old man. This report discusses magnetic resonance imaging findings of RS3PE syndrome and the changes after steroid therapy. © Clinical Rheumatology 2005.Item Transient left paraduodenal hernia(2005) Ovali G.Y.; Orguc S.; Unlu M.; Pabuscu Y.A 52-year-old woman with acute deterioration of recurrent abdominal pain was admitted to the hospital. Spiral computed tomography (CT) of abdomen was performed. A left paraduodenal hernia was identified on CT. There was no clinical sign or imaging finding suggesting intestinal obstruction or mesenteric ischemia. She refused surgical intervention since her pain was intermittant and decreasing. On the fifth day of hospitalization the patient's pain resolved completely and the follow-up CT demonstrated regression of the herniation. © 2005 Elsevier Ltd. All rights reserved.Item Clinical and radiologic evaluations for predicting difficult tracheal intubation; [Valutazioni cliniche e radiologiche per prevedere l'intubazione tracheale difficile](2006) Topcu I.; Ovali G.Y.; Yentur E.A.; Kefi A.; Tuncyurek O.; Pabuscu Y.Objective: The aim of this study is to predict difficult endotracheal intubations preoperatively with clinical and radiographical parameters (lateral x-ray) and to assess their reliability. Design: 208 adult patients (68 male, 140 female) submitted for elective surgery under general anaesthesia were included into this study. Age, height, weight, inter-incisor gap, neck circumference, sternomental and thyromental distance, modified Mallampati classification and protruding upper teeth were measured during preoperative evaluation. Lateral cervical spine radiographs were evaluated to predict the skeletal structure associated with difficult intubation. Laryngeal view was graded according to Cormack-Lehane laryngoscopic classification. The number and duration of attempts at each tracheal intubation were recorded. Results: We obtained the percentage of difficult intubations to be 5.7%. There was no significant association between difficult intubation and age, weight, thyromental and sternomental distances, mandibular protrusion, Wilson risk scores, inter-incisor gap and neck circumference (p > 0.05). Difficult intubations were associated with male sex, Cormack-Lehane grade 3 or 4 and two and more increased Mallampati grade (p < 0.05). After taking the measurements on the radiographs, we observed a significant association between temporomandibular joint (TMJ) to tip of upper incisors (V1), length of the perpendicular from the hard palate to the tip of the upper incisors (V2), TMJ to tip of lower incisors (V5), the distance from the upper incisors to the corniculate cartilages (V17), the anteroposterior thickness of the tongue (V19) for difficult intubation with stepwise multivariate logistic regression model (p < 0.05). According to Cormack-Lehane classification we calculated the highest sensitivity as (83.3%), specificity as (95.9%), positive predictive value as (55.6%) and negative predictive value as (98.9%). Conclusion: We conclude that these clinical and radiographic measurements are of little value in predicting difficult intubation in adults when used alone. For elective cases, we advocate taking additional radiological examinations, if clinical findings predict or indicate the probability of a difficult airway.Item Assessment of mammographic density changes on plain film mammograms in postmenopausal women on hormone replacement therapy(2006) Orguc S.; Goktan C.; Ovali G.Y.; Karaer O.; Oruc S.Background & objectives: Mammographic screening is an effective tool for the early detection of breast cancer. Hormone replacement therapy (HRT) has been shown to increase mammographic density and thus may hinder early detection of small tumours. We undertook this study to determine and compare the frequency and degree of change in mammographic density in postmenopausal women in HRT using two different methods: the classical Wolfe classification and a new semiquentitative method, which we named as the comparison wheel. Methods: This study included 285 women, 206 under hormone treatment, and 79 control subjects. All women underwent baseline mammographic study before the beginning of treatment. Mean interval of the follow up mommograms was 16 months. The methods were compared in evaluating the effects of three types of hormone therapies on mammographic density. Results: The frequency of change was only significant in the combined hormone replacement group when Wolfe classification was used. However, the frequency of increase in density (estrogen group 21%, combined therapy group 42%, tibolone group 28%) was markedly higher when the comparison wheel was used. The inter-rater Kappa value was calculated as 0.977 for the first and 0.957 for the second readings of the two radiologists for the comparison wheel, and 0.973 and 0.968 for the Wolfe classification. The intra-rater Kappa values were determined as 0.972 and 0.957 for the first and and 0.963 and 0.926 for the second radiologist for comparison wheel and Wolfe classification respectively. Interpretation & conclusion: Our findings indicate that the estimated increase of mammographic density depends on the selected hormone regimen, as well as the method of evaluation. The comparison wheel is a semiquantitative method of evaluating changes of mammographic density and is sensitive and reproducible with high inter- and intra-rater Kappa values. This method can be used as an alternative for comparison of digital mammographic applications in the future.Item Traumatic nerve root avulsion and pseudomeningocele diagnosed by three dimensional MRI technique (CISS sequence): A case report(Centauro SRL, 2006) Oncu J.; Ovali G.Y.; Kitis O.; Ozturk C.; Hepguler S.; Calli C.; Yunten N.This case report demonstrates the importance of the CISS sequence, a fast imaging technique in MRI, in case of suspected nerve root avulsion. We present a case of traumatic pseudomeningoceles at T1-T2 root levels with right T2 ventral root avulsion without associated skeletal fracture diagnosed by MRI using the three dimensional CISS technique. A 28-year-old man presented to the Emergency Department following a motorcycle accident. Clinical examination revealed paresis in intrinsic muscles of the right hand. Traumatic pseudomeningoceles at T1-T2 root levels bilaterally with right T2 ventral root avulsion without associated skeletal fracture were diagnosed by three dimensional cervicothoracic MRI with CISS technique.Item A case of mycetoma successfully treated with itraconazole and co-trimoxazole(2006) Gündüz K.; Örgüç Ş.; Demireli P.; Inanir I.; Sürücüoglu S.; Ovali G.Y.A 29-year-old woman with swelling, multiple nodules and discharging sinuses of her right foot is presented. A single nodule on the sole was excised 15 years ago and since then she has had recurrent attacks of swelling and discharging sinuses that improved partially with antibiotics. Magnetic resonance images (MRI) revealed an ill-defined mass predominantly with low signal intensity on T2W images. Within the granulomata, multiple unenhancing foci, with low T1W and T2W signal most likely representing the fungal balls or grains were detected. Histopathological examination revealed large clusters of microorganisms resembling fungal hyphae and bacteria, which were surrounded by mixed inflammatory infiltrate cells and stained positively by PAS and Gomori's methenamine silver stain. As minimal regression was seen on MRI with 4 months' itraconazole (200 mg day-1) treatment, co-trimoxazole (160 TMP/800 SMX b.i.d.) was added to treatment. Complete remission was established by MRI examination after 10 months with this combination therapy. © 2006 The Authors.Item Musculus sternalis: A normal but rare mammographic finding and magnetic resonance imaging demonstration(2006) Goktan C.; Orguc S.; Serter S.; Ovali G.Y.[No abstract available]Item Assessment of symptomatic patients after endoscopic sinus surgery with special reference to the frontal sinus: Comparative radiologic analysis(2006) Unlu H.H.; Eskiizmir G.; Tarhan S.; Ovali G.Y.Purpose: To reveal the role of potential risk factors in frontal recess dissection (FRD), middle turbinate resection (MTR), sinonasal polyposis, and extension of disease in postoperative frontal sinus opacification by determining radiologic changes after endoscopic sinus surgery (ESS) in symptomatic cases using computed tomography (CT). Study Design: Retrospective analysis of prospectively collected data from symptomatic patients after ESS. Methods: Postoperative CT scans were taken in all symptomatic patients during their least symptomatic period or after maximal medical therapy. The radiologic findings of each sinus were compared, and the outcome of ESS was statistically evaluated. Furthermore, FRD, MTR, sinonasal polyposis, and extension of disease were analyzed for postoperative frontal sinus opacification. Results: In our study, 101 sinuses of 61 symptomatic patients were examined. A significant improvement in opacification in all sinuses was detected postoperatively. Multivariate analysis of all potential risk factors revealed that postoperative frontal sinus opacification was affected only by sinonasal polyposis (odds ratio [OR] 3.32; 95% confidence interval [CI] 1.04-10.58) and extension of disease (OR 16.93; 95% CI 4.33-66.23). Conclusions: Our study revealed that surgical procedures such as FRD and/or MTR may not directly affect postoperative frontal sinus opacification. On the contrary, sinonasal polyposis and extension of disease seemed to be the main risk factors of this issue.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 Chondroid chordoma of the thoracic spine: Case report [7](Taylor and Francis Ltd., 2007) Demireli P.; Ovali G.Y.; Yegen G.; Temiz C.; Tarhan S.[No abstract available]Item Inverted papilloma with new bone formation: Report of three cases(2007) Unlu H.H.; Songu M.; Ovali G.Y.; Nese N.Background: An inverted papilloma (IP) is a benign sinonasal tumor of ectodermal origin, which is locally aggressive and destructive, tends to recur if incompletely removed, and has significant malignant potential. On CT scan, the appearance of an IP is variable and nonspecific but most commonly it appears to have soft tissue density. The association of IPs and new bone formation is extremely rare; to the best of our knowledge, only one case has been reported in the literature to date. Methods: We report three cases with existence of bony mass surrounded by polypoid soft tissue diagnosed as IP histopathologically. Results: The nature, shape, and location of the bony mass were not in concordance with trapped bone, with tumoral calcifications, or with osteoma. Conclusion: We propose that with regard to the three cases presented here, new bone formation may be associated with IP pathologically. We also believe that additional investigations are required to characterize the pathophysiological mechanisms involved in neoplasm-induced osteogenesis. Copyright © 2007, OceanSide Publications, Inc.Item A rare disorder: Idiopathic tumoral calcinosis(2007) Ovali G.Y.; Tarhan S.; Serter S.; Bayindir P.; Okcu G.; Demireli P.; Pabuscu Y.[No abstract available]Item No pituitary gland volume change in medication-free depressed patients(2008) Eker C.; Ovali G.Y.; Ozan E.; Eker O.D.; Kitis O.; Coburn K.; Gonul A.S.Increased serum cortisol levels and a hyperactive hypothalamo-pituitary-adrenal (HPA) axis have been proposed to play an important role in the pathophysiology of Major Depressive Disorder (MDD). However, there are inconsistent results regarding pituitary gland volume (PGV), which is one of the key elements of the HPA axis evaluated by MRI in depressed patients. In this study, we analyzed the PGV of medication-free moderately depressed MDD patients (N = 34) and age and sex matched healthy controls (N = 39). PGV did not differ between MDD patients and healthy controls [mean volume ± S.D.; 0.76 ± 0.17 cm3 and 0.75 ± 0.14 cm3; ANCOVA, F1,69 = 1.25 p > 0.05; respectively]. Our results confirm that volumetric PGV changes are not crucial for depression pathophysiology among unmedicated, moderately depressed adults. © 2008 Elsevier Inc. All rights reserved.Item CT study on morphometry of frontal sinus(2008) Tatlisumak E.; Ovali G.Y.; Asirdizer M.; Aslan A.; Ozyurt B.; Bayindir P.; Tarhan S.The aim of this study was to determine the prevalence and morphological characteristics of the frontal sinus in an adult population. This study was conducted retrospectively on paranasal CT scans in the axial and coronal planes of 300 cases (123 male and 177 female). The mean age was 40.74 ± 13.34 (range 20-83). Measurements of the width, height and anteroposterior length for each sinus and total width were obtained from CT scans. Measurements were compared statistically with relation to side and sex. The cases were divided into subgroups according to age for each sex and each measurement parameter was also compared among the subgroups. All measurements tended to be larger on the left side and were significantly larger in males than females. There was a significant difference in the anteroposterior lengths of right and left sides in both males and females and height for males and width for females. In both sexes, the highest values of measurements were usually observed at the 31-40 age group and there was a tendency to decrease with aging. The larger diameters of the left frontal sinus imply that it may be more possibly violated during surgical interventions. Morphometric features differed significantly in the two sexes at different ages and comparison with previous studies presented great regional variability. The size of the frontal sinus was seen to be related to age and sex. The knowledge provided in the present study is useful for some surgical procedures and widens the anthropometric knowledge of humanity. © 2008 Wiley-Liss, Inc.Item Sonographic-guided injection of corticosteroid in the treatment of lateral epicondylitis(2009) Unlu Z.; Tarhan S.; Ovali G.Y.; Pabuscu Y.Objective: In this study the advantage of ultrasonography [US] in diagnosis and therapy of lateral epicondylitis [LE] was investigated in patients with lateral elbow pain and clinically diagnosed as LE. Methods: Fifty-two patients with LE were examined using sonography. For the patients in whom normal US examination was found, a blind injection of methylprednisolone 20 mg and 0.5 ml one percent lignocaine was performed [Group 1]. The patients whose clinical diagnosis was confirmed with US received a sonographic-guided injection of methylprednisolone 20 mg and 0.5 ml one percent lignocaine [Group 2]. Outcome measurements were performed at baseline, two weeks, one month, and three months. Pain and functional status were assessed using a visual analog scale, physical functioning and bodily pain scales of the Medical Outcomes Study 36 Item Short-Form Health Survey, a patient-rated forearm evaluation questionnaire, and a patient-specific functional scale. Painless grip strength bilaterally was also measured. Results: Twenty-four [46.2 percent] patients had a normal-appearing common extensor origin on US. The group in which diagnosis of LE was confirmed on US and sonographic-guided corticosteroid injections improved significantly from the baseline to the third month follow up [P < 0.000] in both clinical assessment and physical examination findings. Conclusions: Our case series suggested that sonography of the common extensor origin can be used to confirm LE in patients with lateral elbow pain. Although sonographic-guided injections produced more clinical improvement, further studies are needed to determine effectiveness of sonographic-guided injections. © 2009 by Informa Healthcare USA, Inc. All rights reserved.Item Perfusion computed tomography could be a new tool for single-session imaging of ureteric obstructive pathology: an experimental study in rats(2009) Yilmaz O.; Ovali G.Y.; Genc A.; Tarhan S.; Ozcan T.; Tuncyurek O.; Pabuscu Y.; Taneli C.Background/Purpose: Perfusion imaging redefines computed tomography (CT) as a technique that can now depict vascular physiology in addition to detailed anatomy. The major clinical applications of perfusion CT are in acute stroke and oncology. Currently, there are very limited data on the application of perfusion CT in urology. The aim of the present study is to investigate the potential value of perfusion CT in anatomic and functional evaluation of obstruction in a single session on experimental hydronephrosis model in rats. Thus, we evaluate the perfusion CT in a new clinical application. Methods: Twenty-eight rats were randomly allocated into 4 groups each consisting of 7 rats. At the third week of experimental intervention, postoperative renogram curves and perfusion parameters of the right kidneys' cortex and pelvis were assessed by CT. The right ureter was sutured as proximal complete obstruction in group 1, as distal complete obstruction in group 2, and as proximal partial obstruction in group 3. Group 4 served as the sham control group. Computed tomography was performed with single-slice tomography. Dynamic examination was performed with the help of perfusion software through contrast-enhanced tomography examination. Results: In all study groups, the aorta time/density curves showed a rapid increase after a rapid decrease, and the duration to reach peak concentration in the normal kidney cortex was observed to be later than the aorta as expected. In groups 1, 2, and 3, the duration to reach peak concentration lengthened and the peak concentration values decreased. The time/density curves gradually increased as a result of the accumulation of the contrast agent in the pelvis, and a peak was observed at the end of the procedure in all study groups. In groups 1, 2, and 3, a statistically significant decrease (P = .01, P = .01, and P = .01, respectively) was observed in the peak concentration values of the contrast agent in comparison to group 4. The flow and blood volume values gradually decreased as the grade of the obstruction increased and the localization of the obstruction or grade of obstruction moved closer to the kidney. Conclusion: In conclusion, perfusion CT technique, performed in a single session, is a useful method for anatomic visualization, together with functional evaluation, in the diagnosis of ureteric obstructive pathology of experimental hydronephrosis model. © 2009 Elsevier Inc. All rights reserved.Item Value of ultrasonography on diagnosis and assessment of pain and grip strength in patients with lateral epicondylitis(2009) Tarhan S.; Ünlü Z.; Ovali G.Y.; Pabuşçu Y.Objective: Lateral epicondylitis (LE) is generally diagnosed clinically. Ultrasonography (US) can provide useful information about the location, extent, and severity of LE. Our objective was to use US to confirm LE and to investigate the relationships between pain, grip strength, physical examination, and disability in these patients. Material and Methods: Fifty-two patients with unilateral LE were examined by US. Pain and functional status were assessed using a visual analog scale (VAS), physical functioning and bodily pain scales of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and a patient-rated forearm evaluation questionnaire (PRFEQ). Grip strength and manual tests for LE were evaluated. Results: Clinical diagnosis of LE was confirmed by US in 28 (53.8%) patients. Our results showed close associations between clinical examination findings and SF-36 and PRFEQ assessments with pain in patients who had sonographic abnormalities. Grip strength was also correlated with clinical and functional evaluations in these cases. Conclusion: We concluded that evaluation of disability in LE requires methods different from those included in the traditional clinical examination. Pain and grip strength measurements provide numerical and quantitative data for evaluation of severity and disability in patients with sonographic findings of LE.Item Perfusion CT evaluation in experimentally induced testicular torsion(2009) Ovali G.Y.; Yilmaz O.; Tarhan S.; Genc A.; Demireli P.; Tunçyurek O.; Unden C.; Taneli C.; Pabuscu Y.Introduction: In this study, we define the characteristics of perfusion computed tomography (CT) in an experimental model of testicular torsion. Methods: Twenty male Sprague-Dawley rats were included for the study. Torsion was applied to 10 rats and perfusion CT was performed in the first hour to evaluate the following perfusion parameters: blood flow (BF), blood volume (BV) and time to peak (TTP) values. Detorsion was done for the same rats, and perfusion CT was repeated 2 hours later to evaluate reperfusion. Ten rats were left as part of the control group. Results: There is significant statistical correlation between the BF and BV values in the torsion and control groups (p = 0.001 and p = 0.001, respectively). There is no statistical correlation of the TTP parameters between the groups. No correlation was found between torsion and detorsion perfusion parameters. Conclusion: Perfusion CT can demonstrate the testicular perfusion insult in an experimental model of torsion. Perfusion CT may be an alternative method for diagnosis of torsion in indeterminate cases. Following detorsion an interval of 2 hours is not sufficient for demonstrating luxury perfusion of the testis. © 2009 Canadian Urological Association.