Browsing by Author "Serter, S"

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    Doppler Sonographic Findings in Testicular Microlithiasis
    Serter, S; Orguc, S; Gumus, B; Ayyildiz, V; Pabuscu, Y
    Objective The aim of this prospective study was to compare the resistive index (RI) values, which is a parameter of testicular parenchymal perfusion, in testicular microlithiasis (TM) cases and normal cases. Materials and Methods 2179 volunteers, all healthy men (17-42 years of age) from the Annual Army Reserve Officer Training Corps training camp were included in the study. A screening scrotal ultrasound was performed and all men diagnosed with TM underwent a scrotal Doppler ultrasonography scan (US). US examinations were performed for subjects with TM and without TM as a control group and RI was determined. Results 53 men with TM were identified in the 2179 US. Spectral Doppler examination was applied to 50 randomly selected cases (100 testicles) without TM and 92 testicles with TM, 39 cases (78 testicles) with bilateral and 14 cases with unilateral involvement. However, 48 normal testicles (17 bilateral and 14 unilateral) and 47 testicles with TM (15 bilateral and 17 unilateral, 10 of which were cases with bilateral TM) where flow from the centripetal artery could be obtained and analyzed were included in the statistical analysis for resistive indices There was no significant difference regarding the RI and spectral examinations between subjects with and without TM An interesting finding was the twinkling artifact observed in three cases. Conclusion: Microliths did not alter the RI values and thus had no influence on testicular perfusion on Doppler US examination
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    Prevalence of testicular microlithiasis in an asymptomatic population
    Serter, S; Gümüs, B; Ünlü, M; Tunçyürek, Ö; Tarhan, S; Ayyildiz, V; Pabuscu, Y
    Objective. Testicular microlithiasis is a rare, usually asymptomatic, finding of the testes associated with various genetic anomalies and infertility. It is also widely believed that testicular microlithiasis is strongly associated with testicular tumor. The aim of this prospective study was to determine the true prevalence of testicular microlithiasis in an asymptomatic population by means of ultrasound screening. Material and methods. Healthy male volunteers (17-42 years old) were recruited from the annual Army Reserve Officer Training Corps training camp at Manisa, Turkey. A screening genitourinary history was obtained and a physical examination and screening scrotal ultrasound scan were performed. All men diagnosed with testicular microlithiasis underwent complete clinical evaluations, physical examinations and determination of tumor markers. Results. Fifty-three men with testicular microlithiasis were identified from the 2179 ultrasound scans, giving a prevalence of testicular microlithiasis of 2.4% in this asymptomatic population. The age (mean +/- SD) of subjects with testicular microlithiasis was 23.9 +/- 4.2 years (range 20-31 years). Conclusion. Our results suggest that there is no significant association between TM and testicular cancer, although it is difficult to rule out such an association without further studies with a longer follow-up period.
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    Testicular Tumor and Testicular Microlithiasis: Doppler US Approach
    Serter, S; Orguc, S; Tuncyurek, O; Gümü, B; Tarhan, S; Ayyildiz, V; Pabuscu, Y
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    Pulmonary hypertension in patients with chronic renal failure
    Havlucu, Y; Kursat, S; Ekmekci, C; Celik, P; Serter, S; Bayturan, O; Dinc, G
    Background: Many etiologies causing pulmonary hypertension (PH) have been reported, and one of the background disease seen with patients with PH is chronic renal failure (CRF); however, the pathogenesis of PH in this group of patients is not explained satisfactorily. Objectives: The aims of this study were to evaluate the incidence of unexplained PH among patients with CRF and to suggest possible etiologic factors. Methods: Two hundred and eleven patients with CRF were evaluated and the ones who have comorbid conditions that cause PH were excluded. Pulmonary arterial pressure (PAP) and cardiac functions were evaluated by Doppler echocardiography. Arteriovenous fistula (AVF) flow was measured by Doppler sonography. The patients were followed for at least 6 months. Results: Forty-eight CRF patients (20 males, 28 females) were included: 23 were predialysis patients, and 25 patients received hemodialysis via AVF. Patients were followed for 7.5 +/- 1.01 months. Systolic PAP>35 mm Hg was found in 56% (14/25) of patients receiving hemodialysis (36.8 +/- 10.7 mm Hg) and in 39.1% (9/23) of predialysis patients ( 29.5 +/- 9.5 mm Hg). The parathyroid hormone level, cardiac output values and CRF duration were found to be increased in patients with elevated systolic PAP (p < 0.05). AVF flow and AVF duration were positively correlated with systolic PAP in patients receiving hemodialysis (p < 0.05). There was a negative correlation between systolic PAP and residual urine volume (p < 0.05). AVF compression in hemodialysis patients decreased systolic PAP from 36.8 +/- 10.7 to 32.8 +/- 10.5 mm Hg. Systolic PAP values were increased at the end of the study in the predialysis group, whereas they were decreased at the end of the follow-up in the hemodialysis group (36.9 +/- 10.5 and 32.04 +/- 10.5 mm Hg, respectively). Conclusions: This study demonstrates a high incidence of PH among patients with CRF.CRF duration, AVF flow, parathyroid hormone level and cardiac output may be involved in the pathogenesis of PH. The effective hemodialysis and dry weight reduction decreased systolic PAP values. Copyright (c) 2007 S. Karger AG, Basel
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    Fibromuscular dysplasia-related renal artery stenosis associated with aneurysm: Successive endovascular therapy
    Serter, S; Oran, I; Parildar, M; Memis, A
    Fibromuscular dysplasia (FMD) is a nonatherosclerotic, noninflammatory vascular disease. FMD of the renal arteries is one of the leading causes of curable hypertension. The simultaneous occurrence of FMD and renal artery aneurysm has been described previously. In this case, we present a fibrodysplastic lesion and an aneurysm in a renal artery treated with a percutanous transluminal angioplasty and coil embolization.
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    Pelvic floor function and anatomy after childbirth
    Baytur, YB; Serter, S; Tarhan, S; Uyar, Y; Inceboz, U; Pabuscu, Y
    OBJECTIVE: To investigate pelvic floor musclefunction and anatomy after childbirth in continent women differing in obstetric history. STUDY DESIGN: Young, continent women, age range 20-40 years, were recruited into 3 groups: I elective prelabor cesarean delivery (n = 12); 2. vaginal delivery (n = 15); and 3. age-matched nulliparas as controls (n = 13). Pelvic floor muscle strength was measured by a perineometer and also assessed by vaginal palpation. Magnetic resonance imaging of the pelvic floor at rest and on maximal strain was performed. Statistical analysis was carried out using SPSS 10.0 (Chicago, Illinois) for Windows (Microsoft, Redmond, Washington); p < 0.05 was considered significant. RESULTS: Pelvic floor muscle strength was not different between the vaginal delivery and cesarean groups. The descent of the bladder and cervix on straining was greater in the subjects who delivered vaginally than in the cesarean delivery and nulliparous groups. There was a positive and significant correlation between the duration of labor and the area of the levator sling and also between birth weight and the descent of the cervix on straining. CONCLUSION: The results of this study show that delivery method does not affect pelvic muscle strength.
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    The comparison of MRI findings with severity score of incontinence after pubovaginal sling surgery
    Tarhan, S; Gumus, B; Temeltas, G; Ovali, GY; Serter, S; Goktan, 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 6(th) 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
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    Hepatic perfusion changes in an experimental model of acute pancreatitis: Evaluation by perfusion CT
    Tutcu, S; Serter, S; Kaya, Y; Kara, E; Nese, N; Pekindil, G; Coskun, T
    Purpose: It is known that acute pancreatitis may cause secondary changes in several organs. Liver is one of these involved organs. In different experimental studies hepatic damages were shown histopathologically in acute pancreatitis but there are a few studies about perfusion disorders that accompany these histopathologic changes. Perfusion CT (pCT) provides the ability to detect regional and global alterations in organ blood flow. The purpose of the study was to describe hepatic perfusion changes in experimental acute pancreatitis model with pCT. Materials and methods: Forty Sprague-Dawley rats of both genders with average weights of 250 g were used. Rats were randomized into two groups. Twenty rats were in control group and 20 in acute pancreatitis group. pCT was performed. Perfusion maps were formed by processing the obtained images with perfusion CT software. Blood flow (BF) and blood volume (BV) values were obtained from these maps. All pancreatic and liver tissues were taken off with laparotomy and histopathologic investigation was performed. Student's t test was used for statistical analyses. Results: In pCT we found statistically significant increase in blood volume in both lobes of liver and in blood flow in right lobe of the liver (p < 0.01). Although blood flow in left lobe of the liver increased, it did not reach statistical significance. Conclusion: The quantitative analysis of liver parenchyma with pCT showed that acute pancreatitis causes a significant perfusion changes in the hepatic tissue. Systemic mediators seem to be effective as well as local inflammatory changes in perfusion changes. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
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    Anatomic and hemodynamic evaluation of renal venous flow in varicocele formation using color Doppler sonography with emphasis on renal vein entrapment syndrome
    Unlu, M; Orguc, S; Serter, S; Pekindil, G; Pabuscu, Y
    Objective. To investigate the anatomic and hemodynamic properties of testicular venous drainage and its effects on varicocele formation and reflux using color Doppler ultrasound (US) with emphasis on renal vein entrapment syndrome. Material and methods. Upper abdominal and scrotal US examinations of 35 varicocele patients and 35 healthy male subjects were performed in the supine position during rest, during a Valsalva maneuver and in the erect position. The aortomesenteric angle and distance (AMA and AMD, respectively), peak mean velocities (PVs) and diameters of different segments of renal veins, testicular vein diameters and duration of flow inversion were measured. Results. In the varicocele group, the lateral segment of the left renal vein (LRV) had a larger diameter and slower PV, and the medial segment of the LRV had a smaller diameter and faster PV. The diameter of the dominant draining vein correlated with the PV of the medial and lateral segments of the LRV, whereas there was no correlation between the diameter of the dominant draining vein and the diameters of the right renal vein (RRV) and the lateral segment of the LRV or the PV of the RRV. The duration of flow inversion correlated with the diameter and PV of the medial segment of the LRV. No correlation between the diameters and PVs of the RRV and the lateral segment of the LRV was detected. Conclusions. The decreases in the AMA, AMD, diameter of the medial segment of the LRV and PV of the lateral segment of the LRV, and the increases in the PV of the medial segment of the LRV and the diameter of the lateral segment of the LRV in varicocele patients in all positions suggest the entrapment or impingement of the left renal vein between the aorta and the superior mesenteric artery. This has been defined as the nutcracker phenomenon, which is known to affect varicocele formation.
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    Early renal parenchymal histological changes in an experimental model of vesico-ureteral reflux and the role of apoptosis
    Sencan, A; Vatansever, S; Yilmaz, Ö; Genç, A; Serter, S; Gümüser, G; Kurutepe, S; Pekindil, G; Günsar, C; Mir, E
    Objectives. To observe early renal parenchymal cellular changes in an experimental model of vesico-ureteral reflux (VUR) and to show whether the apoptotic pathway plays a role in these cellular changes. Material and methods. Fourteen New Zealand breed rabbits were used and were divided into two equal groups (control and experimental groups). Urine samples were obtained in a sterile manner and cultured. In the study group, reflux was created in the right kidneys surgically. Renal scintigraphy and voiding cystourethrography (VCUG) were performed in both groups on Day 17. The kidneys were examined in terms of histology, apoptotic activity and caspase activity. Results. No growth was observed in urine cultures in either group. VUR was manifested in only two rabbits in the experimental group on VCUG. On renal scintigraphy, no renal scarring was observed in either of the groups and renal uptake values were in the normal range. There was a greater increase in collagen in the right kidneys in the experimental group than in the control group and apoptotic activity was significantly increased in the study group: 0% in the control group, 10.8%0.7% in the experimental group (p0.001). Caspase-6 activity was strongly positive and caspase-8 and -9 activities were moderately positive in the right kidneys of the experimental group. Caspase-6 activity was moderately positive, and caspase-8 and -9 activities were weakly positive in the contralateral kidneys of the experimental group. Caspase activities in the control group were negative (p0.001). Conclusions. In this experimental model of VUR, apoptotic activity was initiated via the caspase-8 and -9 pathway and collagen tissue increased in the renal parenchyma where reflux occurred. The balance of apoptotic activity may play a key role in the occurrence of reflux nephropathy.
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    A rare disorder: idiopathic tumoral calcinosis
    Ovali, GY; Tarhan, S; Serter, S; Bayindir, P; Okcu, G; Demireli, P; Pabuscu, Y
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    Does maxillary arch remodeling exist in nasal polyposis?
    Gunhan, K; Can, F; Uz, U; Serter, S; Unlu, H
    Background: The potential transformation in the maxillary complex morphology is mostly complete during childhood. Recent studies suggest a nasal tissue remodeling both in the overlying mucosa and in the underlying sinus bone in nasal polyposis (NP). Our evaluation of computed tomography (CT) revealed that the maxillary arch is more flat and shallow in patients with chronic rhinosinusitis with NP. The purpose of this study was to determine the possible effects of NP to the maxillary arch morphology in adulthood and to investigate a possible remodeling of the maxillary bone during the course of NP. Methods: A prospective study was performed on 25 patients. Grading of the polyps, acoustic rhinometry and rhinomanometry assessments, and CT scans were documented initially, 1 year after diagnosis, and 2 years postoperatively. Twenty-five subjects' CT scans randomly selected from our CT database formed the comparison group. The plane angle between the maxillary alveolar processes (MAP) and the palatine process of the maxillary bone (MPP), and the depth of the maxillary arch of both groups were compared. Results: The results pointed out that the maxillary arch was shallower and the bilateral angles between MAP and MPP were significantly greater than those of the comparison group in all evaluation periods. This difference was less at the end of the postoperative follow-up period. Conclusion: Although it is a common belief that maxillofacial formation expires in childhood, this may not be the case under some special conditions such as NP in adulthood. NP might cause maxillary arch remodeling in adults. (Am J Rhinol Allergy 24, 428-432, 2010; doi: 10.2500/ajra.2010.24.3546)
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    Sonographic evaluation of spleen size and prevalence of accessory spleen in a healthy male Turkish population
    Serter, S; Ceylan, C; Tunçyürek, Ö; Örgüc, S; Pabuçcu, Y
    Objective: It is known that the measurement of splenic length in routine clinical practice is a very good indicator of actual splenic size. Knowledge of the normal range of spleen size in the population being examined is a prerequisite. Racial differences in splenic length could result in incorrect interpretation of splenic measurements. The purpose of this study was to establish the range of spleen length in a young male Turkish population. Material and Methods: A total of 2179 volunteers, healthy men aged 17-42 years, from the annual Army Reserve Officer Training Corps training camp at Manisa were included in the study. Sonographic measurements of spleen length were performed on 2179 military personnel. Presence of accessory spleen was also determined. In addition, the height, weight, and age of each volunteer were recorded. Using linear regression analysis, the relation of spleen length and body height, weight and body mass index (BMI) was evaluated. Additionally, the prevalence of accessory spleen detected on ultrasound was calculated. Results: The mean +/- SD height was 173,1 +/- 6,5 cm, mean weight 69,1 +/- 9,7 kg, and mean BMI 22,62 +/- 2,87. Mean spleen length was 10,76 +/- 1,8 cm. The length of the spleen was below 12,80 cm in 95% of the subjects. No statistically significant correlation (p<0.01) between spleen length and body height, weight and BMI was found. The prevalence of accessory spleen was determined as 2.5% on ultrasound screening. Conclusion: It was found that in healthy Turkish men, mean spleen length was 10,76 1,8 cm. This data should be taken into consideration when the diagnosis of splenomegaly is established in Turkish males. (Turk,l Hematol 2010; 27: 25-8)
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    Bilateral breast edema in intestinal lymphangiectasia
    Goktan, C; Pekindil, G; Orguc, S; Coskun, T; Serter, S
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    Transformation of the maxillary bone in adults with nasal polyposis: a CT morphometric study
    Serter, S; Günhan, K; Can, F; Pabusçu, Y
    PURPOSE Nasal polyposis (NP) in adult population is a common problem in otorhinolaryngology outpatient practice. Computed tomography (CT) is the ideal imaging method to investigate paranasal sinus diseases. There is yet no study in the literature measuring the morphometry of maxillary bone in NP. The objectives of this study are to correlate the airway variables obtained by CT findings of both chronic nasal airway obstruction and control group in an adult population, and to investigate whether the bony structure of the airway is affected or not. MATERIALS AND METHODS Forty NP cases that were followed up for 1-5 years by an otorhinolaryngologist were included in this retrospective study. Forty subjects who had normal findings reported on paranasal CT scans were randomly selected from our CT database as the control group. Maxillary and palatine bones (PB) were evaluated: the plane angle between the maxillary alveolar processes (MAP) and PB, and depth of the maxillary arch of both groups were compared. RESULTS The mean angle between MAP and PB plane was wider in the NP group (right 128.1 +/- 8.5 degrees and left 126.2 +/- degrees 8.5) than control group (right 106.6 +/- 8.1 degrees and left 105.5 +/- 7.3 degrees). The mean depth of maxillary arch was significantly smaller in the NP group (1.2 +/- 0.2 cm) than in the control group (1.4 +/- 0.2 cm). CONCLUSION There could be a relationship between nasal polyposis in adults and maxillary shape. The flattening and shallowing of the maxillary arch detected in patients with NP may indicate that the bony structural changes continue in adulthood.
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    Ruptured dissecting aneurysms arising from non-vertebral arteries of the posterior circulation: endovascular treatment perspective
    Oran, I; Çinar, C; Yagci, B; Tarhan, S; Kiroglu, Y; Serter, S
    PURPOSE Most intracranial dissecting aneurysms involve the posterior circulation, and the intradural segment of the vertebral artery is affected in majority of these. The aim of this report is to summarize the results of endovascular treatment in patients with ruptured dissecting aneurysms of the non-vertebral posterior circulation. MATERIALS AND METHODS During the past six years, the medical records of 23 patients with subarachnoid hemorrhage related to dissecting aneurysm arising from non-vertebral arteries of the posterior circulation were reviewed retrospectively. RESULTS The locations of the aneurysms were as follows: seven in the posterior cerebral artery, five in the superior cerebellar artery, six in the basilar artery trunk, and five in the posterior inferior cerebellar artery. Two basilar artery aneurysms were treated in the chronic stage with stent-assisted coil embolization. In the remaining patients, the aneurysm was coiled with or without parent vessel occlusion in the acute stage. One patient re-bled and died 20 days after initial treatment. At follow-up, recanalization had occurred in two patients, whose aneurysms were re-embolized successfully. Overall, three patients had permanent neurological sequelae, two had transient neurological sequelae, and one patient died. CONCLUSION Embolization with or without parent artery occlusion is feasible with an acceptable morbidity and mortality rate in the treatment of dissecting aneurysms confined to non-vertebral arteries of the posterior circulation.
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    Metabolic syndrome and carotid intima-media thickness in chronic obstructive pulmonary disease
    Alpaydin, AO; Arslan, IK; Serter, S; Coskun, AS; Celik, P; Taneli, F; Yorgancioglu, A
    Background: The aim of this study is to investigate the prevalence of metabolic syndrome (MetS), carotid intima media thickness (IMT), and serum C-reactive protein (CRP) levels in patients with chronic obstructive pulmonary disease (COPD), and the possible relationships among them. Methods: Fifty stable COPD patients and 40 healthy controls were included in the study. The participants were further divided into four groups according to their smoking status. Pulmonary function tests were performed in COPD patients. Anthropometric measurements and blood chemistry analysis, serum CRP levels and carotid intimamedia thickness (IMT) measurements were performed in all the study population. Results: Prevalence of metabolic syndrome was 43% in COPD patients and 30% in the control group (p = 0.173). FEV1% and FEV1/FVC were higher in COPD patients with MetS (p = 0.001 and p = 0.014, respectively) compared to those without MetS. Prevalence of MetS was significantly different among the COPD patients with different stages (p = 0.017) with the highest value in stage 2 (59%). Carotid IMT was significantly higher in COPD patients than in control group (1.07 +/- 0.25 mm and 0.86 +/- 0.18 mm, respectively; p < 0.001). Serum CRP levels were not different in COPD patients and controls, however they were higher in individuals with MetS compared to those without MetS regardless of COPD presence (p = 0.02). Conclusions: Early markers of atherogenesis, in terms of carotid IMT, were found to be higher in COPD patients than in healthy controls. MetS prevalence was observed to decrease as the severity of airflow obstruction increased. Therefore, screening COPD patients for these cardiovascular risk factors would be a novel approach even in absence of symptoms.