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Öğe Acute portal vein thrombosis secondary to donor/recipient portal vein diameter mismatch after orthotopic liver transplantation.(John Wiley & Sons Inc, 2005) Yilmaz, S; Kirimlioglu, V; Kirimliogiu, H; Kutlu, R[Abstract Not Available]Öğe Brain MR spectroscopy in children with a history of rheumatic fever with a special emphasis on neuropsychiatric complications(Elsevier Sci Ireland Ltd, 2004) Alkan, A; Kutlu, R; Kocak, G; Sigirci, A; Emul, M; Dogan, S; Aslan, MPurpose: To investigate whether there are metabolite changes in basal ganglia of children with complete healing of rheumatic fever (RF), history of Syndenham chorea (SC) and obsessive compulsive-tic disorder (OCTD) developed after RF when compared with healthy controls and each other. Material and methods: A total of 49 children with history of RF and 31 healthy controls were included into the study. All patients and control group underwent a detailed neuropsychiatric evaluation. Children with the history of RF were classified into-three groups as; group 1: with history of RF without neuropsychiatric complications (NCRF), group 2: only with history of SC (HSC), group 3: with HSC and OCTD (OCTD). After MR imaging, single voxel MR spectroscopy was performed in all subjects. Voxels (15 x 15 x 15 mm) were placed in basal ganglia. N-acetyl aspartate (NAA)/creatin (Cr), and choline (Cho)/Cr ratios were calculated. Results: OCTD were detected in 13 children with HSC. NAA/Cr ratio was found to be decreased in these children when compared with NCRF (n:29), HSC without OCTD (n:7) and control groups (n:3 1). No significant difference was found in metabolite ratios of children with HSC without OCTD when compared with NCRF and control groups. There were no significant differences in Cho/Cr ratio between patient and control groups. Conclusion: Although MR imaging findings was normal, MR spectroscopy findings (decreased NAA/Cr ratio) in our study support the neuronal loss in basal ganglia of children with OCTD and could indicate the development of permanent damage. (C) 2003 Elsevier Ireland Ltd. All rights reserved.Öğe Cervical hematomyelia(Karger, 2002) Önal, Ç; Yakinci, C; Kocak, A; Erguvan, R; Tekiner, A; Kutlu, R; Özcan, CSpinal cord injury with or without trauma has been reported in the perinatal period. The prognosis depends primarily on diagnosis of the level, extent and nature of the lesion, established by correlations between clinical, imaging and electrophysiological data. A 25-day-old boy with normal birth weight delivered at term by cesarean section was transferred to Inonu University Turgut Ozal Medical Center because of respiratory distress and brachial diplegia. A suspicious medullary lesion on cervical computerized tomography was confirmed as an intramedullary lesion extending from C3 to D1 on magnetic resonance imaging (MRI). Emergent surgery consisting of exposure of the lesion site and interlaminar direct puncture of the lesion under fluoroscopy revealed that the pathology was an intramedullary hematoma. The partial evacuation of the lesion with direct puncture, the patient's neurological improvement and close follow-up of the patient with ultrasonography, electrophysiology and MRI are discussed in the light of recent literature. Copyright (C) 2002 S. Karger AG, Basel.Öğe Cervical myositis ossificans traumatica: a rare location(Springer Verlag, 1999) Baysal, T; Baysal, O; Sarac, K; Elmali, N; Kutlu, R; Ersoy, YAn unusual case of myositis:ossificans traumatica lesion located in the paraspinal region is reported. Despite the contiguity of the lesion with the cervical vertebrae and ominous appearance of the biopsy material, the history of antecedent trauma and computed tomography findings allowed preoperative accurate diagnosis. To our knowledge, myositis ossificans traumatica located in the cervical paraspinal region is very rare.Öğe The cisternal segment of the abducens nerve in man: three-dimensional MR imaging(Elsevier Sci Ireland Ltd, 2004) Alkan, A; Sigirci, A; Ozveren, AF; Kutlu, R; Altinok, T; Onal, C; Sarac, KPurpose: The goal of this study was to identify the abducens nerve in its cisternal segment by using three-dimensional turbo spin echo T2-weighted image (3DT2-TSE). The abducens nerve may arise from the medullopontine sulcus by one singular or two separated rootlets. Material and methods: We studied 285 patients (150 males, 135 females, age range: 9-72 years, mean age: 33.3 +/- 14.4) referred to MR imaging of the inner ear, internal auditory canal and brainstem. All 3D T2-TSE studies were performed with a 1.5 T MR system. Imaging parameters used for 3DT2-TSE sequence were TR:4000, TE:150, and 0.70 mm slice thickness. A field of view of 160 mm and 256 x 256 matrix were used. The double rootlets of the abducens nerve and contralateral abducens nerves and their relationships with anatomical structures were searched in the subarachnoid space. Results: We identified 540 of 570 abducens nerves (94.7%) in its complete cisternal course with certainty. Seventy-two cases (25.2%) in the present study had double rootlets of the abducens nerve. In 59 of these cases (34 on the right side and 25 on the left) presented with unilateral double rootlets of the abducens. Thirteen cases presented with bilateral double rootlets of the abducens (4.5%). Conclusion: An abducens nerve arising by two separate rootlets is not a rare variation. The detection of this anatomical variation by preoperative MR imaging is important to avoid partial damage of the nerve during surgical procedures. The 3DT2-TSE as a noninvasive technique makes it possible to obtain extremely high-quality images of microstructures as cranial nerves and surrounding vessels in the cerebellopontine cistern. Therefore, preoperative MR imaging should be performed to detect anatomical variations of abducens nerve and to reduce the chance of operative injuries. (C) 2003 Elsevier Ireland Ltd. All rights reserved.Öğe The Crowned Dens syndrome: a rare form of calcium pyrophosphate deposition disease(Springer Verlag, 2000) Baysal, T; Baysal, O; Kutlu, R; Karaman, I; Mizrak, BThe crowned dens syndrome has been termed as acute neck pain ascribed to CPPD deposits associated with a tomographic appearance of calcification surrounding the odontoid process. This rare entity resulting in cervical cord compression is generally seen in older female patients. We present a 26-year-old woman with cervical cord compression due to massive calcification in the periodontoid area and discuss the X-ray and CT findings of the disease.Öğe Delayed myelination in a rhizomelic chondrodysplasia punctata case: MR spectroscopy findings(Elsevier Science Inc, 2003) Alkan, A; Kutlu, R; Yakinci, C; Sigirci, A; Aslan, M; Sarac, KRhizomelic chondrodysplasia punctata is a member of genetic peroxisomal disorders. Delayed myelination, which is probably related to the inadequacy of plasmalogens biosynthesis, is an important feature of this disorder. Direct assessment of neuropathologic aspects of RCDP syndrome such as neuronal degeneration and delayed myelination is possible with MR spectroscopy. In this report, MR spectroscopy findings (decreased Cho/Cr and increased Ins-Gly/Cr ratios and increased levels of mobile lipids) of a rhizomelic chondrodysplasia punctata case supporting delayed myelination are presented. This is the second report of MR spectroscopy examination of the specific brain metabolic changes associated with rhizomelic chondrodysplasia punctata. (C) 2003 Elsevier Science Inc. All rights reserved.Öğe Dieulafoy's disease(Elsevier Science Inc, 2005) Kuzucu, A; Gürses, I; Soysal, Ö; Kutlu, R; Özgel, MDieulafoy's disease is a vascular anomaly characterized by the presence of a tortuous dysplastic artery in the submucosa. The condition was first described as a cause of gastrointestinal bleeding in the stomach. Recently, there have been a few reports of Dieulafoy's disease involving the respiratory tract. Herein, we report 2 patients with massive hemoptysis who were treated with surgical resection and later diagnosed with bronchial Dieulafoy's disease.Öğe A diseased aorta with multiple fistulas(Springer, 2005) Alat, II; Kutlu, R; Akpinar, MB; Türker, G[Abstract Not Available]Öğe Doppler sonography of the inferior and superior mesenteric arteries in ulcerative colitis(Wiley, 2001) Sigirci, A; Baysal, T; Kutlu, R; Aladag, M; Sarac, K; Harputluglu, HPurpose. The purpose of this study was to evaluate the Doppler sonographic blood-flow parameters and spectral patterns in the inferior mesenteric artery (IMA) and superior mesenteric artery (SMA) in patients with active and inactive (remission-phase) ulcerative colitis (UC). Methods. The IMAs and SMAs of 25 patients with active-phase UC (group 1), 19 patients with remission-phase UC (group 2), and 22 healthy, asymptomatic subjects (control group) were evaluated by duplex Doppler sonography. The 25 patients in group 1 were categorized into 2 subgroups on the basis of the extent of disease as determined by double-contrast barium enema x-ray study and colonoscopy. The first subgroup (group 1a) consisted of 11 patients with active involvement of the left colon from the rectum to the splenic flexure. The second subgroup (group 1b) consisted of 14 patients with active involvement of the entire colon. The peak systolic velocity (PSV), end diastolic velocity (EDV), mean velocity (Vmean), resistance index (RI), and pulsatility index (PI) were determined from the Doppler spectral analysis. The inner diameter and cross-sectional area of the IMA and SMA were measured, and the blood-flow volume was calculated. The results were compared between the patient groups and control subjects. Results. In the IMA, the mean blood-flow volume, mean PSV, mean EDV, and Vmean were significantly higher, the mean PI was significantly lower, and the mean diameter and the mean cross-sectional area were significantly larger in group 1 than in group 2 or in the control group (p < 0.001). The mean PSV and the Vmean of the IMA were significantly higher in group la than in group Ib (p < 0.05). The mean blood-flow parameters in the SMA were not significantly different between groups 1 and 2 or between either group 1 or group 2 and the control subjects. The mean EDV in the SMA was significantly higher and the mean PI and the mean RI were significantly lower in group 1b than in group 1a (p < 0.01). Conclusions. Duplex Doppler sonography of the IMA and SMA can be used to evaluate inflammatory disease of the large bowel, to assess disease extent, and to document response to therapy. (C) 2001 John Wiley & Sons, Inc.Öğe Doppler waveforms and blood flow parameters of the superior and inferior mesenteric arteries in patients having Behcet disease with and without gastrointestinal symptoms -: Preliminary data(Amer Inst Ultrasound Medicine, 2003) Sigirci, A; Senol, M; Aydin, E; Kutlu, R; Alkan, A; Altinok, MT; Yologlu, SObjective. To evaluate hemodynamic changes in mesenteric arteries in patients with Behcet disease with and without gastrointestinal symptoms. Methods. Doppler sonography of mesenteric arteries was performed in 25 symptomatic and 15 asymptomatic patients having Behcet disease and in 25 healthy control subjects. The peak systolic, minimal, and mean velocities, resistive and pulsatility indexes, inner diameter, cross-sectional area, and blood flow volume of mesenteric arteries were evaluated. The results were compared between patient groups and controls. Results. The mesenteric artery flow was significantly greater in patients in the symptomatic group than in those in the asymptomatic group or in controls. In the superior mesenteric artery, mean velocity and mean blood flow volume (0.35+/-0.18 m/s and 711+/-404 mL/min, respectively; P<.0001) in the symptomatic group were significantly higher than in the asymptomatic group (0.16±0.07 m/s and 305±168 mL/min, respectively) or in controls (0.15±0.07 m/s and 290±123 mL/min, respectively). The mean peak systolic velocity (1.23±0.47 m/s; P<.005) in the symptomatic group was significantly higher than in controls (0.93+/-0.23 m/s). In the inferior mesenteric artery, mean velocity and mean blood flow volume (0.25+/-0.10 m/s and 139+/-79 mL/min) in the symptomatic group were significantly higher than in the asymptomatic group (0.16+/-0.07 m/s; P<.006; and 78±26 mL/min; P<.007) or in controls (0.17+/-0.07 m/s; P<.0031; 83±48 mL/min; P<.004). Conclusions. In this study, symptomatic patients with gastrointestinal Behcet disease were associated with a significant increase in mesenteric artery flow that could be evaluated easily on spectral patterns of arteries during Doppler sonography. The Doppler sonographic findings also revealed that intestinal involvement in patients with Behcet disease without gastrointestinal symptoms is not significantly different from that of healthy controls.Öğe Duplicate origin of left vertebral artery with thrombosis at the origin(Wiley, 1998) Mahmutyazicioglu, K; Saraç, K; Bölük, A; Kutlu, RWe describe a rare case of vertebral artery duplication in a patient with vertigo, weakness, and nausea. A color Doppler examination revealed a duplicate origin of the left vertebral artery and a hyperechoic thrombus at the origin of 1 of the duplicated arteries. CT angiography of the lower neck area demonstrated duplicated vertebral arteries on the left side. MR angiography of the vertebrobasilar system did not show duplication, indicating that the duplicated vertebral arteries fused at a level higher than C2. (C) 1998 John Wiley & Sons, Inc.Öğe Early MRI findings in stab wound of the cervical spine(Springer-Verlag, 2002) Alkan, A; Baysal, T; Saraç, K; Sigirci, A; Kutlu, RMR imaging was found to be the most sensitive modality for the detection of spinal cord abnormalities in the acutely injured spine. Although it is reported that traumatic pneumomyelogram indicates a base-of-skull or middle cranial fossa fracture and is almost certainly associated with intracranial subarachnoid air, early MR imaging may demonstrate subarachnoid air in penetrating trauma of the spinal cord without head injury. We report two cervical-spine stab-wound cases, one of which had subarachnoid air on early MR findings.Öğe Early- and late-state subacute sclerosing panencephalitis: Chemical shift imaging and single-voxel MR spectroscopy(Amer Soc Neuroradiology, 2003) Alkan, A; Sarac, K; Kutlu, R; Yakinci, C; Sigirci, A; Aslan, M; Baysal, TBACKGROUND AND PURPOSE: Subacute sclerosing panencephalitis (SSPE) is a rare, progressive, inflammatory neurodegenerative disease. Our aim was to determine the metabolic abnormalities of brain in early- and late-stage SSPE by using MR spectroscopy and to assess areas of involvement in the early stages when MR imaging findings were normal. METHODS: Children with stage II (n = 3) or III (n = 3) SSPE and 10 healthy, age-matched children underwent MR imaging, multivoxel MR spectroscopy, and short-echo single-voxel MR spectroscopy (SVS). Areas of involvement in the brain were determined with chemical shift imaging. For SVS, 2 x 2 x 2-cm voxels were placed in the frontal subcortical white matter (FSWM) and parieto-occipital white matter (POWM). N-acetylaspartate (NAA)/creatine (Cr), choline (Cho)/Cr, myo-inositol (Ins)/Cr, and NAA/Cho ratios were calculated. RESULTS: Comparisons of NAA/Cr, Cho/Cr, Ins/Cr and NAA/Cho ratios between patients and control subjects showed significant differences in FSWM and POWM (P <.0l). In patients with SSPE, NAA/Cr ratios in POWM were significantly less than those in FSWM (P <.0l). NAA/Cr ratios in patients with stage II SSPE and those in the control group were not significantly different; this may reflect the absence of neuronal loss. Decreased NAA/Cr, increased Cho/Cr and Ins/Cr ratios, and increased lactate and lipid peaks were found in patients with stage III SSPE. CONCLUSION: MR spectroscopy showed findings suggestive of inflammation in stage II and findings of demyelination, gliosis, cellular necrosis, and anaerobic metabolism in stage III. MR spectroscopy could be a promising technique for early diagnosis and treatment planning in cases of SSPE.Öğe Ectopic thymic tissue: A cause of emphysema in infants(Elsevier Science Inc, 1999) Baysal, T; Kutlu, R; Kutlu, O; Yakinci, C; Karaman, IEctopic thymic tissue can present a diagnostic dilemma when it is located in the posterior mediastinum. The diagnosis can be made by awareness of it and bq use of computed tomography (CT) and magnetic resonance imaging (MRI). Rarely, ectopic thymus are reported to cause airway obstruction. In infants ectopic thymic tissue should also be considered in the differential diagnosis of secondary pneumonias and emphysema especially located in the upper lung zones. (C) Elsevier Science Inc., 1999.Öğe Effects of caffeic acid phenethyl ester and epidermal growth factor on the development of caustic esophageal stricture in rats(W B Saunders Co, 2001) Koltuksuz, U; Mutus, HM; Kutlu, R; Özyurt, H; Çetin, S; Karaman, A; Gürbüz, NBackground/Purpose: An experimental study was performed to modify the healing response in caustic esophageal burns to prevent stricture development. Two different agents with different modes of actions, caffeic acid phenethyl ester (CAPE) and epidermal growth factor (EGF), were studied. CAPE has antiinflammatory, immunomodulatory, antioxidant, and antimitotic properties. EGF has known properties in supporting wound healing and in protecting esophagus from injuries. Methods: The model described by Gehanno and its modification by Liu was used to create standard esophageal burns with 50% NaOH. The study was performed with 76 rats in 4 main groups (sham, CAPE, EGF, and control) and 2 subgroups in each for 5 and 28 days of observation. Efficacy of treatment was assessed in 28-day subgroups by measuring weight gain, contrast esophagograms on day 27, histologic evaluation by measuring stenosis index (wall thickness/lumen diameter), and collagen deposition, and biochemically by determining tissue hydroxy proline (OHP) content. Results: In the end of the study, increase rates of mean body weights of the animals in the 28-day subgroups were as follows: sham, 30%; CAPE, 23%; EGF, 22%; and control, 14%. Although all the animals in subgroups significantly gained weight, the mean weight gain was significantly low in controls when compared with sham, CAPE, and EGF groups (P < .05). Contrast esophagograms on day 27 showed no stenosis in the sham, mild stenosis in CAPE and EGF, and severe stenosis with proximal dilatation in controls. Stenosis indices of the subgroups were as follows: sham, 0.29; CAPE, 0.41; EGF, 0.41; control, 0.84. Index was significantly higher in controls (P < .05). Collagen accumulation scores in the esophageal wall were as follows: Sham, 0.0; CAPE, 0.87; EGF, 0.30; control, 2.70. Scores also were significantly higher in controls (P < .05). Tissue (OHP) levels were as follows (mg/g dry tissue): Sham, 1.48; CAPE, 1.53; EGF, 1.90; control, 4.01. Production of OHP was significantly higher in controls. Conclusions: The results of the parameters in the study indicate that administration of CAPE and EGF has beneficial effects in the prevention of caustic esophageal strictures. Those effects of CAPE may occur through its antiinflammatory, immunomodulatory, and antioxidant properties, and EGF may occur through its induced proliferative properties on the esophagus. Copyright (C) 2001 by WB. Saunders Company.Öğe Effects of misoprostol on bone loss in ovariectomized rats(Elsevier Science Inc, 1999) Sonmez, AS; Birincioglu, M; Özer, MK; Kutlu, R; Chuong, CJThis study was performed to investigate whether misoprostol (prostaglandin Fl analogue) (Cytotec, Searle, England) is effective for restoration of bone loss. Four-month-old parous female Sprague-Dawley rats (n = 30) were subjected either to bilateral ovariectomy (OVX, 24 fats) or to sham surgery (sham, 6 rats), The OVX rats were divided into four groups 60 days after the surgery. Six of them were killed, and dual-energy X-ray absorption (Norland xr-36, Norland Corporation, Fort Atkinson, WI, USA) measurements were performed, called pretreatment OVX group. The remaining groups teach had 6 rats) treated orally with 0 (control), 100, 200 mu g/kg/day misoprostol for 60 days. All rats were killed 60 days after having treatment, and bone loss of the lumbar spine was measured by dual-energy X-ray absorption. The bone mineral density was decreased by 25.4% in control group and 23.6% in pretreatment group compared to sham group, but restored by 86% and 96% in groups treated with 100 and 200 mu g/kg/day misoprostol, respectively. These results suggest that misoprostol restores bone loss in the lumbar spine of OVX rats in a dose-dependent manner. (C) 1999 Elsevier Science Inc. All rights reserved.Öğe The efficacy of acetazolamide on visual functions in a patient with choroid metastasis of breast carcinoma(Medicom International, 2001) Sari, R; Camci, C; Kutlu, R; Totan, Y; Sevinc, A; Buyukberber, SBreast carcinoma is the most frequent cancer in women and is the second leading cause of death. Choroid metastasis of breast carcinoma can be found either at presentation or in remission. It is frequently encountered in disseminated breast cancer with multiple organ metastasis. It has been proposed that the oedema-reducing effect of acetazolamide is due to stimulated ion and fluid removal from the retina to the choroid. A 40-year-old female patient on adjuvant chemotherapy for breast cancer was found to have an isolated choroid metastasis. Clinical and radiological remission was achieved after orbital radiotherapy, chemotherapy and acetazolamide treatment. In this case report, we emphasise the possible beneficial effect of acetazolamide in patients with choroid metastasis.Öğe En-plaque tuberculomas of tentorium in a pregnant woman(Springer-Verlag, 2003) Alkan, A; Parlak, M; Baysal, T; Sigirci, A; Kutlu, R; Altinok, TEn-plaque tuberculoma is a rare manifestation of CNS tuberculosis and presents as a solitary, focal, caseous plaque-like lesion. It is difficult to differentiate en-plaque like meningeal tuberculoma from true primary or secondary meningeal neoplasia. Good response to antituberculosis treatment in a patient with tuberculosis history and typical MR findings confirm the diagnosis. We present the follow-up MR imaging findings of a case in which an enplaque tuberculoma on tentorium was diagnosed during pregnancy in a patient with a history of tuberculosis. To the best of our knowledge, enplaque tuberculomas of tentorium during pregnancy have not been reported before.Öğe An end plate chondroma mimicking calcified lumbar disc herniation -: A case report and review of the literature(Walter De Gruyter & Co, 1999) Erten, SF; Koçak, A; Mizrak, B; Kutlu, R; Çolak, AThe authors report a case of chondroma arising from a vertebral end-plate and mimicking lumbar disc herniation. This tumor became calcified within 2 weeks. It was completely removed surgically, after which the patient's symptoms were relieved and neurological deficits regressed.
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