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Öğe Bilateral seminal vesicle and unilateral renal agenesis in case with primary infertilism(2007) Erdem G.; Karakaş M.H.; U?ra-ces M.; Alkan A.; Altinok T.; Do?anay S.Introduction: Agenesia of the seminal vesicle is an uncommon cause of the male infertility. While unilateral agenesia of seminal vesicle is observed in 0.6-1% of male population, bilateral agenesia is extremely rare. These malformations may be associated with unilateral or bilateral agenesia of the vas deferens or unilateral renal agenesia. 70-80% of the cases with bilateral agenesia of the seminal vesicle have gene mutations related to cystic fibrosis. In his article we presented the ultrasenographic and magnetic resonance imaging findings of bilateral agenesia of the seminal vesicle and unilateral renal agenesia in primary infertile case who has not cystic fibrosis. Materials and Methods: Pelvic magnetic resonance imaging (MRI) and abdominal ultrasonography was utilized in 29 years old male patient with primary infertility. Results: Bilateral seminal vesicle agenesis was found in MRI. In spermiogram, neither live nor dead spermium was detected. Abdominal ultrasonography was yielded as unilateral renal agenesis and contralateral compensatris hypertrophy consecutively on left and right sides. Conclusion: Pelvic and transrectal ultrasonography gives valuable data on investigation of the etiology of primary infertility. Pelvic MRI is important to distinguish the hypoplasia and the agenesis of the seminal vesicle.Öğe Clinical outcomes of neonatal hypoxic ischemic encephalopathy evaluated with diffusion-weighted magnetic resonance imaging(2006) Da? Y.; Firat A.K.; Karakaş H.M.; Alkan A.; Yakinci C.; Erdem G.Purpose: Detection of early phase neurological deficit in babies with hypoxic-ischemic encephalopathy (HIE) is the most important step to determine the appropriate preventive treatment methods. Diffusion-weighted imaging (DWI) is the most sensitive radiological modality to detect ischemic changes in the brain, in their earliest phase. Herein, we present the results of our study about the role of DWI in the diagnosis and determining the prognosis of HIE in neonates. Materials and methods: The study included 36 cases (4 preterm, 32 term babies) who were diagnosed with HIE within 24 hours of birth and classified according to modified Samat staging. They were examined for the presence of neurological sequelae at 3 and 6 months of age with electroencephalography (EEG), visual evoked potential (VEP), brainstem auditory evoked potential (BAEP), and Denver II developmental screening tests. All 36 patients underwent conventional magnetic resonance (MR) imaging and DWI within the first 24 hours of birth; survivors underwent repetitive imaging exams at the end of the first week and then after a month. Results: Seventeen stage I cases (47%), 12 stage II cases (33%), and 7 stage III cases (20%) were detected. DWI obtained within the first 24 hours showed high sensitivity (100%) in detecting the permanent neurological sequelae but with very low specificity (20%). The negative predictive value of DWI in this period was 100%; however, in DWI obtained at the end of the first month, not only its sensitivity was preserved, but its specificity reached 80%. The negative predictive value of DWI in this period was preserved and the positive predictive value improved. The importance of DWI in detecting sequelae at the end of the first month was also demonstrated by McNemar (p = 0.250) and Kappa (Kappa = 0.719) tests. There was no difference between conventional MR imaging and DWI in detecting sequelae at the end of first month. Conclusion: DWI is superior to other imaging modalities in detecting ischemia; not only because of its high sensitivity in the early phase, but also because of its high sensitivity and specificity in the late phase. Moreover, with its high negative predictive value, DWI can be used for excluding the possibility of sequelae development in the early phase of HIE cases for medico-legal purposes. © Turkish Society of Radiology 2006.Öğe Coronary artery system in a dog [2] [Köpekte koroner arter sistemi](2005) Alat I.; Erdem G.; Akpinar M.B.[No abstract available]Öğe Diffusion weighted MR findings of brain involvement in tuberous sclerosis(2006) Firat A.K.; Karakaş H.M.; Erdem G.; Yakinci C.; Biçak U.Purpose: Diffusion Weighted Imaging (DWI) is effective in identifying microstructural cerebral parenchymal changes. We studied the diffusion characteristics of hamartomas and normal white matter in cases with tuberous sclerosis (TS). Materials and methods: Diffusion weighted images of 6 TS cases (ages between 3-15 years, mean 9.0 years, SD 4.4 years) that presented to our center for magnetic resonance (MR) imaging have been retrospectively evaluated. In addition to 56 non-calcified hamartomas of TS patients, apparent diffusion coefficient (ADC) values measured from frontal, parietal normal white matter, and basal ganglions of TS patients were compared with values obtained from 9 normal subjects (ages 1-13 years, mean 8.9 years, SD 3.4 years). Hamartomas were divided into 3 subgroups based on their locations, and the ADC values measured in these groups were compared. Results: ADC values of all hamartomas were between 838 and 2230, with a mean value of 1408 mm2/sec × 10-3 (SD: 273.2); ADC values of the white matter of normal subjects were between 695 and 857, with a mean value of 776.1 mm2/sec × 10-3 (SD: 44.23) (p < 0.0001). ADC values of subependymal nodules, white matter hamartomas, and subcortical tubers were 838-2230 (mean: 1440.5 mm2/sec × 10-3; SD: 526.46), 1046-1622 (mean: 1328.6 mm2/sec × 10-3; SD: 189.4), and 981-1973 (mean: 1417.4 mm2/sec × 10-3; SD: 219.5), respectively (p = 0.666). Conclusion: Diffusion characteristics of white matter hamartomas resulting from TS clearly differ from those of normal white matter, but no significant difference was observed in ADC values of these lesions based on their locations. Moreover, the ADC measurements of normal white matter in these cases did not differ from those of the control group, indicating that the disease does not cause a common explicit damage in white matter and central gray matter, other than hamartomas, which can be detected by DWI. DWI may only be used in the differential diagnosis of hamartomas from secondary lesions with T1 and T2W signal intensities similar to those of hamartomas and with different diffusion characteristics. © Turkish Society of Radiology 2006.Öğe Diffusion-weighted magnetic resonance imaging and magnetic resonance spectroscopy features of abdominal viscera in a patient with Gaucher's disease(Malaysian Journal of Medical Sciences, 2014) Kalayci T.O.; Erdem G.; Kutlu R.; Kahraman A.; Alkan A.A 46-year-old woman with Gaucher's disease (GD) consulted our clinic for abdominopelvic magnetic resonance imaging (MRI), as physical examination had revealed hepatosplenomegaly. Upper abdominal MRI showed massive hepatosplenomegaly and innumerable hypointense splenic nodules on T1-weighted images. Diffusion-weighted MRI (DW-MRI) and magnetic resonance spectroscopy (MRS) were performed to liver parenchyma and splenic nodules. MRS revealed lactate, lipid, acetate, and alanine peaks in splenic nodules, and choline, creatine, lipid, myo-inositol-glycine, and lactate peaks in the liver parenchyma. The DW-MRI showed diffusion restriction in splenic nodules. It was concluded that MRI is a reliable method for the diagnosis and follow up of GD. Coupling DW-MRI and MRS allows quantitative evaluation, thereby increasing the efficacy of the method. This is the first report in the literature presenting advanced abdominal MRI findings in GD. © Penerbit Universiti Sains Malaysia, 2014.Öğe Plasminogen activator inhibitor -1 levels in patients with primary varicose vein(2012) Erguzel N.; Yetkin E.; Erdem G.; Erdil N.; Yetkin G.; Heper G.; Celik T.Aim. Plasmin is involved in extracellular matrix remodeling by activating some matrix metallo-proteinases and degrading extracellular matrix; therefore component of fibrinolytic system such as tissue plasminogen activator and plasminogen activators inhibitors (PAI-1) might have a role in the pathogenesis of vascular remodeling. In our study we aimed to investigate the levels of PAI-1 levels in patients with primary varicose veins (VV) and in their age and gender matched control group. Methods. Forty-one consecutive patients with peripheral varicose veins and 37 healthy age and gender-matched control subjects were included in the study from the outpatient cardiology and cardiovascular surgery clinic. Study population consisted of 41 consecutive patients who met the inclusion criteria and diagnosed as having class II primary VV according to CEAP classification. Routine biochemical and hematological analysis were performed in all patients and control subjects. Results. Plasma levels of PAI-1 were found to be lower in patients than those in control subjects (5.19±2.2 ng/mL vs. 6.47±2.6 ng/mL, P=0.025). Logistic regression analysis revealed that only the plasma levels of PAI-1 were found to be independently but inversely associated with the presence of primary VVs (Odds ratio: 0.80 CI: 0.64-0.99, P=0.04). Conclusion. We have shown that PAI-1 levels are significantly decreased in patients with pVVs and it has an independent association with the presence of pWs. However, its exact relation and role via matrix metlalloproteinases on the pathogenesis of the disease remains to be elucidated in further studies.Öğe Spontaneous intracranial hypotension with pituitary adenoma(Springer Milan, 2006) Firat A.K.; Karakas H.M.; Firat Z.Y.; Kahraman B.; Erdem G.Spontaneous intracranial hypotension (SIH) is an unusual syndrome that is characterised by positional headache, neck rigidity, nausea and vomiting. The characteristic magnetic resonance imaging (MRI) findings are diffuse smooth pachymeningeal thickening and enhancement, downward displacement of posterior fossa structures and pituitary gland enlargement. An unusual case of SIH with pituitary macro-adenoma and subsequent subdural haemorrhage is presented, and its clinical picture, MRI findings and possible pathophysiological mechanism are discussed. © Springer-Verlag Italia 2006.Öğe Transient renal medullary hyperechogenicity in newborns with acute renal failure and dehydration: Ultrasonography follow-up(2006) Çelik T.; Firat A.K.; Kahraman A.S.; Erdem G.; Karakaş H.M.; Yakinci C.Our purpose was to assess the time interval between the visualization of renal medullary hyperechogenicity and its resolution in neonates with acute renal failure. Seven newborns with renal medullary hyperechogenicity and acute renal insufficiency noted on ultrasonography (US) were included in the study group. Their ages were ranged between three and six days. All of the patients underwent US at the first presentation and in the follow-up. In all of the patients diffuse medullary hyperechogenicity was noted in the bilateral kidney. Biochemistry examinations revealed abnormal BUN and creatine level in all neonates and additional hypernatremia in four of them. The medullary hyperechogenicity totally disappeared between the 10th and 30 th days of the neonatal period. Renal functions had normalized before the resolution of medullary hyperechogenicity between the 7th and 10th days. Transient medullary hyperechogenicity may be delayed due to presence of abnormal renal functions. For this reason, while deciding to examine these patients for metabolic disease. persistent renal medullary hyperechogenicity after 10 days in the neonatal period should be evaluated in accordance with biochemistry findings.
