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Nuran Sabir

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Mark van den Boogaard

Radboud University Nijmegen

Ozden Cobanoglu

Uludag University

jacques kpodonu

Harvard Medical School

University of Brighton

Chandra Mukhopadhyay

GADVASU

University of Utah

Cornell University

Félix Meutchieye

University of Dschang, Cameroon

University of Adelaide

Sarah Vigmostad

The University of Iowa

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Papers by Nuran Sabir

Radiological features of rare non-odontogenic lesions of the jaws

Current Medical Imaging Reviews, Nov 2, 2023

Dynamic contrast-enhanced mammography and breast MRI in the diagnosis of breast cancer and detection of tumor size

Turkish journal of medical sciences, 2024

The aim of this study is to evaluate the performance of contrast-enhanced mammography (CEM) and d... more The aim of this study is to evaluate the performance of contrast-enhanced mammography (CEM) and dynamic breast MRI techniques for diagnosing breast lesions, assess the diagnostic accuracy of CEM's using histopathological findings, and compare lesion size measurements obtained from both methods with pathological size. Materials and methods: This prospective study included 120 lesions, of which 70 were malignant, in 104 patients who underwent CEM and MRI within a week. Two radiologists independently evaluated the MR and CEM images in separate sessions, using the BI-RADS classification system. Additionally, the maximum sizes of lesion were measured. Diagnostic accuracy parameters and the receiver operating characteristics (ROC) curves were constructed for the two modalities. The correlation between the maximum diameter of breast lesions observed in MRI, CEM, and pathology was analyzed. Results: The overall diagnostic values for MRI were as follows: sensitivity 97.1%, specificity 60%, positive predictive value (PPV) 77.3%, negative predictive value (NPV) 93.8%, and accuracy 81.7%. Correspondingly, for CEM, the sensitivity, accuracy, specificity, PPV, and NPV were 97.14%, 81.67%, 60%, 77.27%, and 93.75%, respectively. The ROC analysis of CEM revealed an area under the curve (AUC) of 0.907 for observer 1 and 0.857 for observer 2, whereas MRI exhibited an AUC of 0.910 for observer 1 and 0.914 for observer 2. Notably, CEM showed the highest correlation with pathological lesion size (r = 0.660 for observer 1 and r = 0.693 for observer 2, p < 0.001 for both). Conclusion: CEM can be used with high sensitivity and similar diagnostic performance comparable to MRI for diagnosing breast cancer. CEM proves to be a successful diagnostic method for precisely determining tumor size.

Musculoskeletal infections through direct inoculation

Skeletal radiology, Jan 30, 2024

Musculoskeletal infections consist of different clinical conditions that are commonly encountered... more Musculoskeletal infections consist of different clinical conditions that are commonly encountered in daily clinical settings. As clinical findings and even laboratory tests cannot always be specific, imaging plays a crucial role in the diagnosis and treatment of these cases. Musculoskeletal infections most commonly occur secondary to direct inoculation into the skin involuntarily affected by trauma, microorganism, foreign bodies, or in diabetic ulcers; direct infections can also occur from voluntary causes due to surgery, vaccinations, or other iatrogenic procedures. Hematogenous spread of infection from a remote focus can also be a cause for musculoskeletal infections. Risk factors for soft tissue and bone infections include immunosuppression, old age, corticosteroid use, systemic illnesses, malnutrition, obesity, and burns. Most literature discusses musculoskeletal infections according to the diagnostic tools or forms of infection seen in different soft tissue anatomical planes or bones. This review article aims to evaluate musculoskeletal infections that occur due to direct inoculation to the musculoskeletal tissues, by focusing on the traumatic mechanism with emphasis on the radiological findings.

Randomised controlled study of seroma rates after mastectomy with and without quilting the skin flap to pectoralis muscle

Nigerian Journal of Clinical Practice, 2021

Aims: The aim of this study was to determine whether seroma formation was affected by reduction o... more Aims: The aim of this study was to determine whether seroma formation was affected by reduction of the potential dead space with the flap fixation method and obliteration of the axillary region in patients with breast cancer who underwent either mastectomy and axillary lymph node dissection or sentinel lymph node biopsy. A total of 105 patients with breast cancer were divided into two groups according to wound closure patterns. Patients and Methods: The operating time, postoperative pain and complications, time to drain removal, seroma formation, amount of fluid aspirated and number of aspirations were recorded prospectively. Results: No significant difference was found between groups in the rates of seroma development (P = 0.7), complication rates (P = 0.6), time to drain removal (P = 0.5), length of hospital stay (P = 0.3) or numbers of aspiration (P = 0.7). The operating time for fixation was determined to be longer than that of the classic procedure (P = 0.02). Conclusions: Reducing potential dead space with flap fixation and obliteration of the axillary region may be useful in decreasing the development of seroma in patients who have undergone mastectomy because of breast cancer. However, surgical technique must be careful, and appropriate patient follow-up must be conducted.

Sacroilii2s Associated with Using Isotre2noin: Case Report

Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi, 2019

How far can bone marrow MR signal changes help in approaching the diagnosis of diabetic foot?

Imaging of Metabolic Bone Diseases: The Spine View, Part I

Seminars in Musculoskeletal Radiology

Metabolic bone diseases comprise a wide spectrum. Of them, osteoporosis is the most frequent and ... more Metabolic bone diseases comprise a wide spectrum. Of them, osteoporosis is the most frequent and the most commonly found in the spine, with a high impact on health care systems and on morbidity due to vertebral fractures (VFs).This article discusses state-of-the-art techniques on the imaging of metabolic bone diseases in the spine, from the well-established methods to the latest improvements, recent developments, and future perspectives.We review the classical features of involvement of metabolic conditions involving the spine. Then we analyze the different imaging techniques for the diagnosis, characterization, and monitoring of metabolic bone disease: dual-energy X-ray absorptiometry (DXA) and DXA-based fracture risk assessment applications or indexes, such as the geometric parameters, Bone Strain Index, and Trabecular Bone Score; quantitative computed tomography; and magnetic resonance and ultrasonography-based techniques, such as radiofrequency echographic multi spectrometry. We...

Pyomyositis of the Iliopsoas and Piriformis Muscles Caused by Panton-valentine Leukocidin-positive Staphylococcus aureus

Pediatric Infectious Disease Journal, 2021

Distinguishing MR Imaging Characteristics of the Diabetic Foot

Poster: "ESSR 2012 / P-0025 / Distinguishing MR Imaging Characteristics of the Diabetic Foot... more

Can magnetic resonance imaging predict the success of parturition in oxytocin-induced pregnant women?

European Radiology, 2000

The aim of this study was to assess whether magnetic resonance imaging could predict the outcome ... more The aim of this study was to assess whether magnetic resonance imaging could predict the outcome of attempted vaginal delivery in a group of pregnant women whose parturition had to be induced by oxytocin. The signal intensity and morphology alterations in the cervix of 21 full-term pregnant women were analyzed before the induction of parturition. T2-weighted gradient echo sequences were utilized and signal intensity in the cervix was measured from the anterior and posterior lips of the cervix. An index indicating the brightness range of the cervix was formulated to overcome the effects of the individual intensity changes. Imaging features including the signal intensity and the evidence of effacement were correlated with the actual type of delivery performed. Images were also assessed visually by two independent radiologists. Statistical analysis of brightness indexes that were considered to have a predictive value as an indicator for possible delivery was not significant. However, visually assessed signal intensity of the cervix correlated strongly with the type of delivery. Effacement itself was the most reliable parameter in predicting the progress of the delivery. In conclusion, MR imaging seems to be useful for predicting normal parturition in full-term pregnant women who need oxytocin induction. However, the presence of effacement seems to be a more reliable and practical parameter that will be preferred in that prediction.

Malign cystic glucagonoma presented with diabetic ketoacidosis: case report with an update

Endocrine Related Cancer, 2005

A 44-year-old woman was diagnosed with type II diabetes in 1998 and 1 year later she developed ne... more A 44-year-old woman was diagnosed with type II diabetes in 1998 and 1 year later she developed necrolytic migratory erythema, which is a specific skin lesion of glucagonoma. During the clinical investigation, a nodular 6 cm mass in the distal pancreatic region and multiple cystic liver metastases were found. She was operated on, and glucagonoma was detected and the long-acting, repeatable, octreotide treatment was started. 3 years after resection of a pancreatic glucagonoma she presented to a hospital emergency department with diabetic ketoacidosis. Hepatic multiple cystic metastases were visualized by computed tomography. During hospitalization she developed severe pulmonary embolism and deep-venous thrombosis of the lower extremities. Indium-labeled octeotide scintigraphy showed multiple cystic lesions in the liver with additional lesions in the iliocecal region, which had not been visualized by computed tomography. Despite somatostatin therapy the tumor had expanded in the liver. Arterial chemoembolization was performed but 6 months later she died.

Osteochondrosis of Ischiopubic Synchondrosis: Van Neck–Odelberg Disease

The Journal of Pediatrics, 2021

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Diz Eklemine Ait Varyasyonlar

Türk Radyoloji Seminerleri, 2021

How often can MRI detect a knee joint at risk of osteonecrosis ?

Poster: "ESSR 2014 / P-0031 / How often can MRI detect a knee joint at risk of osteonecrosis... more

Effects of Sibutramine on Insulin Resistance, Metabolic Parameters and Abdominal Fat Mass

Turkiye Klinikleri Tip Bilimleri Dergisi, 2007

Objective: Obesity is recognized as a major worldwide health problem. In particular, visceral fat... more Objective: Obesity is recognized as a major worldwide health problem. In particular, visceral fat accumulation is usually accompanied by insulin resistance or type 2 diabetes mellitus, hyp ertension, hypertriglyceridemia, high uric acid and low high- density lipoprotein cholesterol levels defined as metabolic syndrome. M etabolic syndrome is strongly associated with increased risk of cardiovascular morbidity and mortality. The objective of this stud y wa s to assess the effects of sibutramine therapy on body mass ind ex (BMI), body fat distribution, visceral fat mass (VF) accum ulation, insulin resistance and plasma lipid profile in central obes e patients. Material and Methods: Demographic, biochemical and anthropometric measurements, i nsulin resistance that was calculated by using homeostasis model assessment of 43 obese patients treated with 15 mg/day sibutramine for 6 months were evaluated. Abdominal fat distributions were determined by ultrasound exa mination. Results: Sibutra...

Rare Presentation of Hydatid Cyst

Respirology, 2018

The aim of this study was to evaluate the clinical utility of pneumococcal and legionella urinary... more The aim of this study was to evaluate the clinical utility of pneumococcal and legionella urinary antigen testing and its cost effectiveness within Western Health, a tertiary public hospital servicing the west of Melbourne. Methods: A retrospective audit of medical records was performed. All adult patients discharged from Western Health between 1 st May and 31 st October 2017 with a diagnosis of community-acquired pneumonia were included. Medical records were reviewed to evaluate the proportion of cases where antibiotic treatment was de-escalated in the setting of a positive urinary antigen result. Observance of local guidelines for diagnostic testing and evaluation of cost-benefit analysis of urinary antigens were also assessed. Results: Preliminary results demonstrate a low prevalence of positive urinary antigen in our study population. Positive urinary antigen tests resulted in de-escalation from empirical to targeted antibiotics in only a small proportion of cases. Conclusion: The diagnostic and clinical utility of pneumococcal and legionella urinary antigens is low in community-acquired pneumonia. Due to the low prevalence of positive urinary antigen results, routine testing in hospitalised patients is not cost-effective.

Cerebral lateral ventricular asymmetry on CT: how much asymmetry is representing pathology?

Surgical and Radiologic Anatomy, 2008

The purpose of this study was to evaluate the association of asymmetric lateral ventricle (ALV) w... more The purpose of this study was to evaluate the association of asymmetric lateral ventricle (ALV) with clinical and structural pathologies and assess its clinical importance. Materials and methods We analyzed 170 consecutive ALV cases on computed tomography (CT) and 170 control group patients with normal head CT. Patients who had apparent etiologic causes for ALV were excluded. The diVerential diagnosis of ALV and unilateral hydrocephalus (UH) was made by using three diVerent ventricle-brain ratios (VBRs). The measurements of the ALV were made at the frontal horn level. Patients with asymmetry were divided into three subgroups including mild, moderate and severe groups to eloborate the grade of the ventricular asymmetry. Additional CT Wndings including septal deviation, diVuse enlargement, atrophy and the densities of constant sites were also recorded systematically for each patient. Clinical and handedness data were collected and analyzed. Results The prevalence of ALV in the study population was 6.1%. Headache was the most common reason for head CT examination and was signiWcantly more common in the asymmetry group (61.7% in group A, 42.9% in group B, P = 0.001). Transient ischemic attack, focal neurologic Wndings, vertigo, ataxia, visual and hearing disturbances were similar in both groups (P > 0.5). There was no diVerence in smoking and alcohol habits in both patient groups. Ten (5.8%) patients in group A and 16 (9.4%) patients in group B had neuropsychiatric disorders, which did not achieve statistical signiWcance. In group A patients, the larger ventricle was more common in the left side than in the right (left = 70.0%, right = 30.0%). Group A consisted of 57.0% mild (grade 1, n = 97), 26.5% moderate (grade II, n = 45) and 16.5% severe (grade III, n = 28) patients. There was no signiWcant correlation between handedness and ALV. The density of diVerent brain sites was found close similar on both sides in ALV and control group (P > 0.5). Choroidal cystic or solid neoplasm or periventricular dysplasia was detected in six ALV patients in group A (3.5%), on their additional MR examinations. Conclusion The physician should not overlook an ALV Wnding on unenhanced CT, particularly in cases with severe degree of asymmetry or diVuse ventricular enlargement, and search for possible accompanying disorders.

Magnetic resonance imaging with rectal Gd-DTPA: new tool for the diagnosis of perianal fistula

International Journal of Colorectal Disease, 2000

This study investigated the effectiveness of magnetic resonance imaging (MRI) with rectal adminis... more This study investigated the effectiveness of magnetic resonance imaging (MRI) with rectal administration of the enteral contrast agent gadolinium diethylene triamine pentaacetic acid (Gd-DTPA) in the diagnosis of recurrent perianal fistulae, assessing the number, anatomical extent, location, and signal intensities of various lesions. Fistulas were examined by MRI before and after rectal administration of Gd-DTPA in 50 patients (excluding fistulas due to inflammatory bowel disease). Surgical findings were compared with both pre- and postcontrast T1-weighted, T2-weighted, and short T1 inversion recovery (STIR) sequences. Of the 68 fistulous tracts detected surgically, precontrast imaging identified 16 by T1-weighted images (hypointense), 27 by T2-weighted images (hyperintense or iso- to weakly hyperintense), and 54 by STIR. Postcontrast imaging identified 29 by T1-weighted images, 58 by T2-weighted, and 54 by STIR. MRI with rectal administration of Gd-DTPA thus facilitates determination of fistula tracts, which are better resolved by precontrast STIR than by either precontrast T1- or T2-weighted images. Postcontrast T2-weighted images were substantially superior to T1-weighted. Both noncontrast STIR and postcontrast T2-weighted sequences were adequate for classifying fistulas in ano, but in complex recurrent anal fistula postcontrast T2-weighted images were more helpful.

Stromal Tumor of the Sex Cord in a Woman with Testicular Feminization Syndrome: Imaging Features

American Journal of Roentgenology, 2002

Diz Eklemi: Kikirdak

Türk Radyoloji Seminerleri, 2017

Eklem kıkırdağı net ağırlığının %4’ü kondrositlerden, geri kalan büyük kısmı ekstraselüler matrik... more Eklem kıkırdağı net ağırlığının %4’ü kondrositlerden, geri kalan büyük kısmı ekstraselüler matriksten oluşur. Ekstraselüler mesafenin %65-85’ini su, çok az bir kısmını proteoglikan ve tip II kollajen oluşturur [1, 2]. Yüksek sıkıştırma kuvvetine dayanmayı sağlayan proteoglikan kıkırdak net ağırlığının %3-10'unu oluştururken, gerilme kuvvetinden sorumlu kollajen %15-20’sini yapar [1]. Eklem kıkırdağının lenfatiklerden, kan damarı ve sinirlerden yoksun olması iyileşme ve onarım potansiyelini kısıtlar [2]. Eklem kıkırdağının makromoleküler matris yapısının korunması eklem sağlığı için hayatidir. Tip II kollajenin kompleks üç boyutlu oryantasyonu doku anizotropisinden sorumludur [3]. Kıkırdağın eklem yüzeyi lamina splendis ile korunur; yoğun kollajen demetlerinin yüzeyindeki lubrisin adı verilen proteoglikan ve sinovyal sıvı kayganlık sağlar [4]. Kıkırdağın yüzeyel zonu kollajen lifleri ve eklem yüzeyine paralel elonge kondrositlerden; orta zon yuvarlak kontrositler ile rastgele konumlanmış kollajen fiberlerinden; derin zon ise kemik yüzeye dik olarak yerleşmiş elonge kondrositlerden ve kalın kollajen demetlerinden oluşur. Derin zonda radyal uzanan kollajen fibrilleri subkondral kemiğe bağlanmak için kalsifiye zona uzanır [2]. Ayak bileği kıkırdak kalınlığı ortalama 1,1 mm iken; patella kıkırdağı farklı olarak 5 mm ve üzeri olabilir [5, 6]. Farklı eklemlerdeki farklı kıkırdak yapıları gelişen farklı tipte kıkırdak lezyonlarını da açıklar; örneğin idyopatik osteoartrit diz eklemi kıkırdağında daha sık iken osteokondral lezyonlar daha sık ayak bileğinde görülür [7].

Radiological features of rare non-odontogenic lesions of the jaws

Current Medical Imaging Reviews, Nov 2, 2023

Dynamic contrast-enhanced mammography and breast MRI in the diagnosis of breast cancer and detection of tumor size

Turkish journal of medical sciences, 2024

The aim of this study is to evaluate the performance of contrast-enhanced mammography (CEM) and d... more The aim of this study is to evaluate the performance of contrast-enhanced mammography (CEM) and dynamic breast MRI techniques for diagnosing breast lesions, assess the diagnostic accuracy of CEM's using histopathological findings, and compare lesion size measurements obtained from both methods with pathological size. Materials and methods: This prospective study included 120 lesions, of which 70 were malignant, in 104 patients who underwent CEM and MRI within a week. Two radiologists independently evaluated the MR and CEM images in separate sessions, using the BI-RADS classification system. Additionally, the maximum sizes of lesion were measured. Diagnostic accuracy parameters and the receiver operating characteristics (ROC) curves were constructed for the two modalities. The correlation between the maximum diameter of breast lesions observed in MRI, CEM, and pathology was analyzed. Results: The overall diagnostic values for MRI were as follows: sensitivity 97.1%, specificity 60%, positive predictive value (PPV) 77.3%, negative predictive value (NPV) 93.8%, and accuracy 81.7%. Correspondingly, for CEM, the sensitivity, accuracy, specificity, PPV, and NPV were 97.14%, 81.67%, 60%, 77.27%, and 93.75%, respectively. The ROC analysis of CEM revealed an area under the curve (AUC) of 0.907 for observer 1 and 0.857 for observer 2, whereas MRI exhibited an AUC of 0.910 for observer 1 and 0.914 for observer 2. Notably, CEM showed the highest correlation with pathological lesion size (r = 0.660 for observer 1 and r = 0.693 for observer 2, p < 0.001 for both). Conclusion: CEM can be used with high sensitivity and similar diagnostic performance comparable to MRI for diagnosing breast cancer. CEM proves to be a successful diagnostic method for precisely determining tumor size.

Musculoskeletal infections through direct inoculation

Skeletal radiology, Jan 30, 2024

Musculoskeletal infections consist of different clinical conditions that are commonly encountered... more Musculoskeletal infections consist of different clinical conditions that are commonly encountered in daily clinical settings. As clinical findings and even laboratory tests cannot always be specific, imaging plays a crucial role in the diagnosis and treatment of these cases. Musculoskeletal infections most commonly occur secondary to direct inoculation into the skin involuntarily affected by trauma, microorganism, foreign bodies, or in diabetic ulcers; direct infections can also occur from voluntary causes due to surgery, vaccinations, or other iatrogenic procedures. Hematogenous spread of infection from a remote focus can also be a cause for musculoskeletal infections. Risk factors for soft tissue and bone infections include immunosuppression, old age, corticosteroid use, systemic illnesses, malnutrition, obesity, and burns. Most literature discusses musculoskeletal infections according to the diagnostic tools or forms of infection seen in different soft tissue anatomical planes or bones. This review article aims to evaluate musculoskeletal infections that occur due to direct inoculation to the musculoskeletal tissues, by focusing on the traumatic mechanism with emphasis on the radiological findings.

Randomised controlled study of seroma rates after mastectomy with and without quilting the skin flap to pectoralis muscle

Nigerian Journal of Clinical Practice, 2021

Aims: The aim of this study was to determine whether seroma formation was affected by reduction o... more Aims: The aim of this study was to determine whether seroma formation was affected by reduction of the potential dead space with the flap fixation method and obliteration of the axillary region in patients with breast cancer who underwent either mastectomy and axillary lymph node dissection or sentinel lymph node biopsy. A total of 105 patients with breast cancer were divided into two groups according to wound closure patterns. Patients and Methods: The operating time, postoperative pain and complications, time to drain removal, seroma formation, amount of fluid aspirated and number of aspirations were recorded prospectively. Results: No significant difference was found between groups in the rates of seroma development (P = 0.7), complication rates (P = 0.6), time to drain removal (P = 0.5), length of hospital stay (P = 0.3) or numbers of aspiration (P = 0.7). The operating time for fixation was determined to be longer than that of the classic procedure (P = 0.02). Conclusions: Reducing potential dead space with flap fixation and obliteration of the axillary region may be useful in decreasing the development of seroma in patients who have undergone mastectomy because of breast cancer. However, surgical technique must be careful, and appropriate patient follow-up must be conducted.

Sacroilii2s Associated with Using Isotre2noin: Case Report

Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi, 2019

How far can bone marrow MR signal changes help in approaching the diagnosis of diabetic foot?

Imaging of Metabolic Bone Diseases: The Spine View, Part I

Seminars in Musculoskeletal Radiology

Metabolic bone diseases comprise a wide spectrum. Of them, osteoporosis is the most frequent and ... more Metabolic bone diseases comprise a wide spectrum. Of them, osteoporosis is the most frequent and the most commonly found in the spine, with a high impact on health care systems and on morbidity due to vertebral fractures (VFs).This article discusses state-of-the-art techniques on the imaging of metabolic bone diseases in the spine, from the well-established methods to the latest improvements, recent developments, and future perspectives.We review the classical features of involvement of metabolic conditions involving the spine. Then we analyze the different imaging techniques for the diagnosis, characterization, and monitoring of metabolic bone disease: dual-energy X-ray absorptiometry (DXA) and DXA-based fracture risk assessment applications or indexes, such as the geometric parameters, Bone Strain Index, and Trabecular Bone Score; quantitative computed tomography; and magnetic resonance and ultrasonography-based techniques, such as radiofrequency echographic multi spectrometry. We...

Pyomyositis of the Iliopsoas and Piriformis Muscles Caused by Panton-valentine Leukocidin-positive Staphylococcus aureus

Pediatric Infectious Disease Journal, 2021

Distinguishing MR Imaging Characteristics of the Diabetic Foot

Poster: "ESSR 2012 / P-0025 / Distinguishing MR Imaging Characteristics of the Diabetic Foot... more

Can magnetic resonance imaging predict the success of parturition in oxytocin-induced pregnant women?

European Radiology, 2000

The aim of this study was to assess whether magnetic resonance imaging could predict the outcome ... more The aim of this study was to assess whether magnetic resonance imaging could predict the outcome of attempted vaginal delivery in a group of pregnant women whose parturition had to be induced by oxytocin. The signal intensity and morphology alterations in the cervix of 21 full-term pregnant women were analyzed before the induction of parturition. T2-weighted gradient echo sequences were utilized and signal intensity in the cervix was measured from the anterior and posterior lips of the cervix. An index indicating the brightness range of the cervix was formulated to overcome the effects of the individual intensity changes. Imaging features including the signal intensity and the evidence of effacement were correlated with the actual type of delivery performed. Images were also assessed visually by two independent radiologists. Statistical analysis of brightness indexes that were considered to have a predictive value as an indicator for possible delivery was not significant. However, visually assessed signal intensity of the cervix correlated strongly with the type of delivery. Effacement itself was the most reliable parameter in predicting the progress of the delivery. In conclusion, MR imaging seems to be useful for predicting normal parturition in full-term pregnant women who need oxytocin induction. However, the presence of effacement seems to be a more reliable and practical parameter that will be preferred in that prediction.

Malign cystic glucagonoma presented with diabetic ketoacidosis: case report with an update

Endocrine Related Cancer, 2005

A 44-year-old woman was diagnosed with type II diabetes in 1998 and 1 year later she developed ne... more A 44-year-old woman was diagnosed with type II diabetes in 1998 and 1 year later she developed necrolytic migratory erythema, which is a specific skin lesion of glucagonoma. During the clinical investigation, a nodular 6 cm mass in the distal pancreatic region and multiple cystic liver metastases were found. She was operated on, and glucagonoma was detected and the long-acting, repeatable, octreotide treatment was started. 3 years after resection of a pancreatic glucagonoma she presented to a hospital emergency department with diabetic ketoacidosis. Hepatic multiple cystic metastases were visualized by computed tomography. During hospitalization she developed severe pulmonary embolism and deep-venous thrombosis of the lower extremities. Indium-labeled octeotide scintigraphy showed multiple cystic lesions in the liver with additional lesions in the iliocecal region, which had not been visualized by computed tomography. Despite somatostatin therapy the tumor had expanded in the liver. Arterial chemoembolization was performed but 6 months later she died.

Osteochondrosis of Ischiopubic Synchondrosis: Van Neck–Odelberg Disease

The Journal of Pediatrics, 2021

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Diz Eklemine Ait Varyasyonlar

Türk Radyoloji Seminerleri, 2021

How often can MRI detect a knee joint at risk of osteonecrosis ?

Poster: "ESSR 2014 / P-0031 / How often can MRI detect a knee joint at risk of osteonecrosis... more

Effects of Sibutramine on Insulin Resistance, Metabolic Parameters and Abdominal Fat Mass

Turkiye Klinikleri Tip Bilimleri Dergisi, 2007

Objective: Obesity is recognized as a major worldwide health problem. In particular, visceral fat... more Objective: Obesity is recognized as a major worldwide health problem. In particular, visceral fat accumulation is usually accompanied by insulin resistance or type 2 diabetes mellitus, hyp ertension, hypertriglyceridemia, high uric acid and low high- density lipoprotein cholesterol levels defined as metabolic syndrome. M etabolic syndrome is strongly associated with increased risk of cardiovascular morbidity and mortality. The objective of this stud y wa s to assess the effects of sibutramine therapy on body mass ind ex (BMI), body fat distribution, visceral fat mass (VF) accum ulation, insulin resistance and plasma lipid profile in central obes e patients. Material and Methods: Demographic, biochemical and anthropometric measurements, i nsulin resistance that was calculated by using homeostasis model assessment of 43 obese patients treated with 15 mg/day sibutramine for 6 months were evaluated. Abdominal fat distributions were determined by ultrasound exa mination. Results: Sibutra...

Rare Presentation of Hydatid Cyst

Respirology, 2018

The aim of this study was to evaluate the clinical utility of pneumococcal and legionella urinary... more The aim of this study was to evaluate the clinical utility of pneumococcal and legionella urinary antigen testing and its cost effectiveness within Western Health, a tertiary public hospital servicing the west of Melbourne. Methods: A retrospective audit of medical records was performed. All adult patients discharged from Western Health between 1 st May and 31 st October 2017 with a diagnosis of community-acquired pneumonia were included. Medical records were reviewed to evaluate the proportion of cases where antibiotic treatment was de-escalated in the setting of a positive urinary antigen result. Observance of local guidelines for diagnostic testing and evaluation of cost-benefit analysis of urinary antigens were also assessed. Results: Preliminary results demonstrate a low prevalence of positive urinary antigen in our study population. Positive urinary antigen tests resulted in de-escalation from empirical to targeted antibiotics in only a small proportion of cases. Conclusion: The diagnostic and clinical utility of pneumococcal and legionella urinary antigens is low in community-acquired pneumonia. Due to the low prevalence of positive urinary antigen results, routine testing in hospitalised patients is not cost-effective.

Cerebral lateral ventricular asymmetry on CT: how much asymmetry is representing pathology?

Surgical and Radiologic Anatomy, 2008

The purpose of this study was to evaluate the association of asymmetric lateral ventricle (ALV) w... more The purpose of this study was to evaluate the association of asymmetric lateral ventricle (ALV) with clinical and structural pathologies and assess its clinical importance. Materials and methods We analyzed 170 consecutive ALV cases on computed tomography (CT) and 170 control group patients with normal head CT. Patients who had apparent etiologic causes for ALV were excluded. The diVerential diagnosis of ALV and unilateral hydrocephalus (UH) was made by using three diVerent ventricle-brain ratios (VBRs). The measurements of the ALV were made at the frontal horn level. Patients with asymmetry were divided into three subgroups including mild, moderate and severe groups to eloborate the grade of the ventricular asymmetry. Additional CT Wndings including septal deviation, diVuse enlargement, atrophy and the densities of constant sites were also recorded systematically for each patient. Clinical and handedness data were collected and analyzed. Results The prevalence of ALV in the study population was 6.1%. Headache was the most common reason for head CT examination and was signiWcantly more common in the asymmetry group (61.7% in group A, 42.9% in group B, P = 0.001). Transient ischemic attack, focal neurologic Wndings, vertigo, ataxia, visual and hearing disturbances were similar in both groups (P > 0.5). There was no diVerence in smoking and alcohol habits in both patient groups. Ten (5.8%) patients in group A and 16 (9.4%) patients in group B had neuropsychiatric disorders, which did not achieve statistical signiWcance. In group A patients, the larger ventricle was more common in the left side than in the right (left = 70.0%, right = 30.0%). Group A consisted of 57.0% mild (grade 1, n = 97), 26.5% moderate (grade II, n = 45) and 16.5% severe (grade III, n = 28) patients. There was no signiWcant correlation between handedness and ALV. The density of diVerent brain sites was found close similar on both sides in ALV and control group (P > 0.5). Choroidal cystic or solid neoplasm or periventricular dysplasia was detected in six ALV patients in group A (3.5%), on their additional MR examinations. Conclusion The physician should not overlook an ALV Wnding on unenhanced CT, particularly in cases with severe degree of asymmetry or diVuse ventricular enlargement, and search for possible accompanying disorders.

Magnetic resonance imaging with rectal Gd-DTPA: new tool for the diagnosis of perianal fistula

International Journal of Colorectal Disease, 2000

This study investigated the effectiveness of magnetic resonance imaging (MRI) with rectal adminis... more This study investigated the effectiveness of magnetic resonance imaging (MRI) with rectal administration of the enteral contrast agent gadolinium diethylene triamine pentaacetic acid (Gd-DTPA) in the diagnosis of recurrent perianal fistulae, assessing the number, anatomical extent, location, and signal intensities of various lesions. Fistulas were examined by MRI before and after rectal administration of Gd-DTPA in 50 patients (excluding fistulas due to inflammatory bowel disease). Surgical findings were compared with both pre- and postcontrast T1-weighted, T2-weighted, and short T1 inversion recovery (STIR) sequences. Of the 68 fistulous tracts detected surgically, precontrast imaging identified 16 by T1-weighted images (hypointense), 27 by T2-weighted images (hyperintense or iso- to weakly hyperintense), and 54 by STIR. Postcontrast imaging identified 29 by T1-weighted images, 58 by T2-weighted, and 54 by STIR. MRI with rectal administration of Gd-DTPA thus facilitates determination of fistula tracts, which are better resolved by precontrast STIR than by either precontrast T1- or T2-weighted images. Postcontrast T2-weighted images were substantially superior to T1-weighted. Both noncontrast STIR and postcontrast T2-weighted sequences were adequate for classifying fistulas in ano, but in complex recurrent anal fistula postcontrast T2-weighted images were more helpful.

Stromal Tumor of the Sex Cord in a Woman with Testicular Feminization Syndrome: Imaging Features

American Journal of Roentgenology, 2002

Diz Eklemi: Kikirdak

Türk Radyoloji Seminerleri, 2017

Eklem kıkırdağı net ağırlığının %4’ü kondrositlerden, geri kalan büyük kısmı ekstraselüler matrik... more Eklem kıkırdağı net ağırlığının %4’ü kondrositlerden, geri kalan büyük kısmı ekstraselüler matriksten oluşur. Ekstraselüler mesafenin %65-85’ini su, çok az bir kısmını proteoglikan ve tip II kollajen oluşturur [1, 2]. Yüksek sıkıştırma kuvvetine dayanmayı sağlayan proteoglikan kıkırdak net ağırlığının %3-10'unu oluştururken, gerilme kuvvetinden sorumlu kollajen %15-20’sini yapar [1]. Eklem kıkırdağının lenfatiklerden, kan damarı ve sinirlerden yoksun olması iyileşme ve onarım potansiyelini kısıtlar [2]. Eklem kıkırdağının makromoleküler matris yapısının korunması eklem sağlığı için hayatidir. Tip II kollajenin kompleks üç boyutlu oryantasyonu doku anizotropisinden sorumludur [3]. Kıkırdağın eklem yüzeyi lamina splendis ile korunur; yoğun kollajen demetlerinin yüzeyindeki lubrisin adı verilen proteoglikan ve sinovyal sıvı kayganlık sağlar [4]. Kıkırdağın yüzeyel zonu kollajen lifleri ve eklem yüzeyine paralel elonge kondrositlerden; orta zon yuvarlak kontrositler ile rastgele konumlanmış kollajen fiberlerinden; derin zon ise kemik yüzeye dik olarak yerleşmiş elonge kondrositlerden ve kalın kollajen demetlerinden oluşur. Derin zonda radyal uzanan kollajen fibrilleri subkondral kemiğe bağlanmak için kalsifiye zona uzanır [2]. Ayak bileği kıkırdak kalınlığı ortalama 1,1 mm iken; patella kıkırdağı farklı olarak 5 mm ve üzeri olabilir [5, 6]. Farklı eklemlerdeki farklı kıkırdak yapıları gelişen farklı tipte kıkırdak lezyonlarını da açıklar; örneğin idyopatik osteoartrit diz eklemi kıkırdağında daha sık iken osteokondral lezyonlar daha sık ayak bileğinde görülür [7].