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Öğe Diffusion-weighted MR imaging of pleural fluid(Springer, 2004) Baysal, T; Bulut, T; Gökirmak, M; Kalkan, S; Dusak, A; Dogan, MThe aim of this study was to evaluate the ability of diffusion-weighted MRI in differentiating transudative from exudative pleural effusions. Fifty-seven patients with pleural effusion were studied. Diffusion-weighted imaging (DWI) was performed with an echo-planar imaging (EPI) sequence (b values 0, 1000 s/mm(2)) in 52 patients. The apparent diffusion coefficient (ADC) values were reconstructed from three different regions. Subsequently, thoracentesis was performed and the pleural fluid was analyzed. Laboratory results revealed 20 transudative and 32 exudative effusions. Transudates had a mean ADC value of 3.42+/-0.76x10(-3) mm(2)/s. Exudates had a mean ADC value of 3.18+/-1.82x10(-3) mm(2)/s. The optimum cutoff point for ADC values was 3.38x10(-3) mm(2)/s with a sensitivity of 90.6% and specificity of 85%. A significant negative correlation was seen between ADC values and pleural fluid protein, albumin concentrations and lactate dehydrogenase (LDH) measurements (r=-0.69, -0.66, and -0.46, respectively; p<0.01). The positive predictive value, negative predictive value, and diagnostic accuracy of ADC values were determined to be 90.6, 85, and 88.5%, respectively. The application of diffusion gradients to analyze pleural fluid may be an alternative to the thoracentesis. Non-invasive characterization of a pleural effusion by means of DWI with single-shot EPI technique may obviate the need for thoracentesis with its associated patient morbidity.Öğe Effects of micronised purified flavonoid fraction on pain, spermiogram and scrotal color Doppler parameters in patients with painful varicocele -: Results of a pilot study(Karger, 2005) Kiliç, S; Günes, A; Ipek, D; Dusak, A; Günes, G; Balbay, MD; Baydinç, YCPurpose: Micronised purified flavonoid fraction (MPFF) is a phlebotropic drug improving venous tone, elasticity and lymphatic drainage, decreasing venous distensibility, venous emptying times, reflux time of venous blood and capillary hyperpermeability, and having antioxidant activities. Since varicocele is a venous pathology, we evaluated the effects of MPFF on pain, spermiogram and color Doppler parameters in patients with painful varicocele. Material and Methods: Semen analyses and Doppler sonography were performed in 16 patients ( aged 20 - 62 years, mean 31.2 +/- 10.9) before and after 1,000 mg/day MPFF treatment. Pain change was assessed with visual analogue scale scored between 0 and 10. Patient satisfaction with outcome and side effects were recorded. Results: Mean pain scores at 1, 3, and 6 months were 1.25 +/- 1.34, 0.25 +/- 0.68, and 0.12 +/- 0.34, respectively, all being significantly lower ( p < 0.001 for each) than baseline ( 4.93 +/- 1.77). Mean score at 12 months (0.93 +/- 1.06) was still lower than baseline ( p < 0.001) but higher than at 6 months ( p = 0.019). Respectively, 14 (87.5%) and 2 (12.5%) patients reported complete and very significant resolution of pain at the 6th month. All patients were very satisfied with the outcome. While semen volume, total sperm count, sperm concentration and morphology did not change significantly, motility increased significantly ( p = 0.009) due to decrease of grade 0 sperms ( p = 0.006) and increase of grade 3 + 4 sperms ( p < 0.001). Reflux time of left spermatic vein during the Valsalva maneuver decreased significantly ( p = 0.003). No significant change occurred in reflux time of the right spermatic vein. No side effect was recorded. Conclusions: Results of this preliminary study suggest the safety and efficacy of MPFF in the treatment of varicocele-associated pain. However, no recommendation for the use of MPFF in the treatment of pain associated with varicocele can be made before these preliminary results are confirmed by a randomized placebo-controlled trial. Copyright (C) 2005 S. Karger AG, Basel.Öğe Intratesticular arteriovenous malformation - Color Doppler sonographic findings(Amer Inst Ultrasound Medicine, 2003) Kutlu, R; Alkan, A; Soylu, A; Sigirci, A; Dusak, AArteriovenous malformations (AVMs) of male genitalia are rare. In the literature there are reports of AVMs involving the scrotum,(1,2) penis,(3) spermatic cord,(4) testis, and epididymis(5) and interventional. treatment of scrotal AVMs.(6) In our literature search, we found no report about intratesticular AVMs. In this report we present the sonographic features of a small intratesticular AVM, which was incidentally found in a patient during scrotal examination for infertility evaluation. This rare entity should be considered in the differential diagnosis of intratesticular masses.Öğe Proton MRS in Behcet's disease with and without neurological findings(Springer, 2003) Baysal, T; Ozisik, HI; Karlidag, R; Sarac, K; Baysal, O; Dusak, A; Hazneci, EOur aim was to investigate whether neurological impairment in Behcet's disease (BD) can be assessed by means of proton MRS and whether it can assist in prognosis. We used single-voxel MRS to measure metabolites in regions of normal-appearing pons, basal ganglia and periventricular white matter (PWM) in 32 patients with chronic BD patients with and without neurological deficits and 29 control subjects. Patients had significantly higher N-acetylaspartate (NAA)/creatine (Cr) and choline (Cho)/Cr ratios in the basal ganglia than the controls. The Cho/Cr ratio in the PWM was also significantly higher in the patients. MRS enabled clear discrimination of patients and controls and also revealed spectral differences between non-neuro-Behcet's disease and neuro-Behcet's disease in the basal ganglia. MRS can be used to assess brain involvement in BD even if structural changes are absent.
