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Öğe Cerebrospinal Fluid Dynamics in Patients with Multiple Sclerosis: The Role of Phase-Contrast MRI in the Differential Diagnosis of Active and Chronic Disease(Korean Radiological Soc, 2018) Oner, Serkan; Kahraman, Aysegul Sagir; Ozcan, Cemal; Ozdemir, Zeynep Maras; Unlu, Serkan; Kamisli, Ozden; Oner, ZulalObjective: Multiple sclerosis (MS) is an inflammatory disease characterized by demyelinating plaques in the white matter. Chronic cerebrospinal venous insufficiency (CCSVI) has been proposed as a new hypothesis for the etiopathogenesis of MS disease. MS-CCSVI includes a significant decrease of cerebrospinal fluid (CSF) flow through the cerebral aqueduct secondary to an impaired venous outflow from the central nervous system. This study aimed to determine whether CSF flow dynamics are affected in MS patients and the contributions to differential diagnosis in active and chronic disease using phase-contrast magnetic resonance imaging (PC-MRI). Materials and Methods: We studied 16 MS patients with chronic plaques (group 1), 16 MS patients with active plaques-enhanced on MRI (group 2), and 16 healthy controls (group 3). Quantitatively evaluation of the CSF flow was performed from the level of the cerebral aqueduct by PC-MRI. According to heart rates, 14-30 images were obtained in a cardiac cycle. Cardiac triggering was performed prospectively using finger plethysmography. Results: No statistically significant difference was found between the groups regarding average velocity, net forward volume and the average flow (p > 0.05). Compared with the controls, group 1 and group 2, showed a higher peak velocity (5.5 +/- 1.4, 4.9 +/- 1.0, and 4.3 +/- 1.3 cm/sec, respectively; p = 0.040), aqueductal area (5.0 +/- 1.3, 4.1 +/- 1.5, and 3.1 +/- 1.2 mm(2), respectively; p = 0.002), forward volume (0.039 +/- 0.016, 0.031 +/- 0.013, and 0.021 +/- 0.010 mL, respectively; p = 0.002) and reverse volume (0.027 +/- 0.016, 0.018 +/- 0.009, and 0.012 +/- 0.006 mL, respectively; p = 0.000). There were no statistical significance between the MS patients with chronic plaques and active plaques except for reverse volume. The MS patients with chronic plaques showed a significantly higher reverse volume (p = 0.000). Conclusion: This study indicated that CSF flow is affected in MS patients, contrary to the hypothesis that CCSVI-induced CSF flow decreases in MS patients. These findings may be explained by atrophy-dependent ventricular dilatation, which may occur at every stage of MS.Öğe Cerebrospinal fluid dynamics in patients with multiple sclerosis: the role of phase-contrast mrı inthe differential diagnosis of active and chronic disease(Korean radıologıcal soc, 121-8 yangjae-dong, seocho-gu, seoul 137-130, south korea, 2018) Oner, Serkan; Kahraman, Ayşegül Sağır; Özcan, Cemal; Özdemir, Zeynep Maraş; Ünlü, Serkan; Kamisli, Özden; Oner, ZulalObjective: Multiple sclerosis (MS) is an inflammatory disease characterized by demyelinating plaques in the white matter. Chronic cerebrospinal venous insufficiency (CCSVI) has been proposed as a new hypothesis for the etiopathogenesis of MS disease. MS-CCSVI includes a significant decrease of cerebrospinal fluid (CSF) flow through the cerebral aqueduct secondary to an impaired venous outflow from the central nervous system. This study aimed to determine whether CSF flow dynamics are affected in MS patients and the contributions to differential diagnosis in active and chronic disease using phase-contrast magnetic resonance imaging (PC-MRI). Materials and Methods: We studied 16 MS patients with chronic plaques (group 1), 16 MS patients with active plaques-enhanced on MRI (group 2), and 16 healthy controls (group 3). Quantitatively evaluation of the CSF flow was performed from the level of the cerebral aqueduct by PC-MRI. According to heart rates, 14-30 images were obtained in a cardiac cycle. Cardiac triggering was performed prospectively using finger plethysmography. Results: No statistically significant difference was found between the groups regarding average velocity, net forward volume and the average flow (p > 0.05). Compared with the controls, group 1 and group 2, showed a higher peak velocity (5.5 +/- 1.4, 4.9 +/- 1.0, and 4.3 +/- 1.3 cm/sec, respectively; p = 0.040), aqueductal area (5.0 +/- 1.3, 4.1 +/- 1.5, and 3.1 +/- 1.2 mm(2), respectively; p = 0.002), forward volume (0.039 +/- 0.016, 0.031 +/- 0.013, and 0.021 +/- 0.010 mL, respectively; p = 0.002) and reverse volume (0.027 +/- 0.016, 0.018 +/- 0.009, and 0.012 +/- 0.006 mL, respectively; p = 0.000). There were no statistical significance between the MS patients with chronic plaques and active plaques except for reverse volume. The MS patients with chronic plaques showed a significantly higher reverse volume (p = 0.000). Conclusion: This study indicated that CSF flow is affected in MS patients, contrary to the hypothesis that CCSVI-induced CSF flow decreases in MS patients. These findings may be explained by atrophy-dependent ventricular dilatation, which may occur at every stage of MS.Öğe Coexistence of Single Coronary Artery Anomaly and Aortic Arch Anomaly(Derman Medical Publ, 2015) Otlu, Yilmaz Omur; Oner, Serkan; Hidayet, Siho[Abstract Not Available]Öğe COMPARISON OF CONVENTIONAL PHYSICAL THERAPY AND MULLIGAN MOBILIZATION TECHNIQUE IN THE TREATMENT OF CERVICOGENIC HEADACHE(Turkey Assoc Physiotherapists, 2022) Argali Deniz, Mine; Kose, Evren; Ercan, Meryem; Yagar, Derya; Oner, Serkan; Ozbag, DavutPurpose: The aim of this investigate the effectiveness of the conventional physical therapy and Mulligan mobilization technique in the treatment of Cervicogenic Headache (CH) and to compare the effectiveness of these two methods. Methods: A total of 40 patients with CH were randomized into conventional physical therapy group (Group 1, n=20) and Mulligan mobilization group (Group 2, n=20). Neck lordosis, range of motion (ROM), Cervical Performance Tests, Visual Analogue Scale (VAS), Neck Disability Index, Beck Depression Scale measurements were recorded at baseline and at two weeks after the treatment. Results: VAS, Neck Disability Index and Beck Depression Scale decreased and ROM, cervical performance and lordosis angle increased significantly in both groups (p=0.010). Conclusions: Both treatments were found to have positive effects on radiological and clinical findings of CH, but Mulligan mobilization technique was found to be more effective in all evaluations except neck extension and right lateral flexion ROM measurements.Öğe The correlation between deformity and metatarsus projection area and the ratios of projection to all metatarsi in direct radiographs in hallux valgus cases(2020) Yedigul, Meral; Oner, Serkan; Oner, ZulalAim: Hallux valgus (HV) is a common deformity where the hallux deviates laterally in the metatarsophalangeal joint. Although various radiographic measurements have been developed to assess HV, not all are considered universally necessary and the correlations between these methods were not determined. The present study aimed to investigate the correlation between the metatarsus (MT) projection area and the projection rates to all MTs and deformity observed in direct radiographs in HV cases.Material and Methods: We retrospectively analyzed foot radiographs of 100 female cases (20-60 years old). The cases were divided into two groups of 50 HV and 50 non-HV based on HV angles (HVA). HVA>15˚ was accepted as HV. The MT projection areas and the projection rates to all MTs, HVA, and intermetatarsal angle (IMA) were measured in HV cases. Paired t-tests were used to compare continuous numeric variables (Significance: p ≤ 0.05).Results: HVA was higher in HV cases (mean, 22.2˚) when compared to the non-HV group (mean, 7.4˚) (p = 0.000). There was no difference between the mean MT projection areas in HV and non-HV groups. While there was no significant difference between the ratios of the projection area in MT I, II, III and IV to total MT area in HV and non-HV groups, the ratio of the projection area of MT V to the total MT area was lower in HV cases when compared to that of the non-HV group (p = 0.027).Conclusion: Although it was observed that HV did not affect the projection area of each MT, when the total MT area was considered, it was observed that the projection area of MT V was lower. This finding supported that HV is a condition that affects the whole foot.Öğe Quantitative Evaluation of Normal Aqueductal Cerebrospinal Fluid Flow Using Phase-Contrast Cine MRI According to Age and Sex(Wiley, 2017) Oner, Zulal; Kahraman, Aysegul Sagir; Kose, Evren; Oner, Serkan; Kavakli, Ahmet; Cay, Mahmut; Ozbag, DavutThe aim of this study was cerebrospinal fluid (CSF) flow quantification in the cerebral aqueduct using phase-contrast cine magnetic resonance imaging (PCC-MRI) according to both sexes and three different age groups to obtain normative data. Seventy two volunteers with no cerebral pathology were included in this study. Subjects were divided into three age groups: 20-34 years, 35-49 years, and 50-65 years including equal gender groups. CSF flow's quantitatively evaluation was performed with images that were obtained by 1.5 T Magnetic Resonance (MR) unit from cerebral aqueduct level on the semi-axial plan. Between groups, peak velocity (cm sec21), average velocity (cm/s), forward volume (mL), reverse volume (mL), net forward volume (mL), and average flow over range (ml/ min)values of current flowing through aqueduct and average aqueductal areas were compared. There were no statistically significant differences in CSF flow parameters among different age groups and between sexes (P> 0.05). There was a statistically significant difference in average cerebral aqueduct area between the age group of 50-65 years and the other age groups (P50.002). The average aqueductal area was higher in the age group of 50-65 years. Normal aqueductal CSF flow parameters evaluated with PCC-MRI don't show a significant difference by age and sex. We have achieved the lower and upper values of these parameters would be useful in future clinical studies. The size of aqueductal area may also be explained by atrophy-dependent ventricular system dilatation in the elderly. (C) 2016 Wiley Periodicals, Inc.Öğe Radiological findings of the primary female urethral malignant melanoma: a rare case report(European journal of therapeutıcs, 2018) Oner, Serkan; Erdem, Gulnur; Özdemir, Zeynep Maraş; Gunes, Ali; Unlu, SerkanPrimary malignant melanomas of the female urethra are rare tumors with poor prognosis. Biopsy of the detected urethral mass was performed in a 71-year-old woman who presented with hematuria and voiding dysfunction. No other localized lesions were detected. The patient was diagnosed with primary malignant melanoma of the urethra according to the histopathologic and immunohistochemical findings. Immunohistochemical staining revealed that the tumor cells were immunoreactive for vimentin, HMB-45, S-100, and Melan-A. The present study aimed to present radiological findings of very rare primary urethral malign melanoma with histopathologic correlation and to review the relevant literature.Öğe Radiological Findings of the Primary Female Urethral Malignant Melanoma: A Rare Case Report(Aves, 2019) Oner, Serkan; Erdem, Gulnur; Ozdemir, Zeynep Maras; Gunes, Ali; Unlu, SerkanPrimary malignant melanomas of the female urethra are rare tumors with poor prognosis. Biopsy of the detected urethral mass was performed in a 71-year-old woman who presented with hematuria and voiding dysfunction. No other localized lesions were detected. The patient was diagnosed with primary malignant melanoma of the urethra according to the histopathologic and immunohistochemical findings. Immunohistochemical staining revealed that the tumor cells were immunoreactive for vimentin, HMB-45, S-100, and Melan-A. The present study aimed to present radiological findings of very rare primary urethral malign melanoma with histopathologic correlation and to review the relevant literature.Öğe The right vertebral artery originating from the right occipital artery and the absence of the transverse foramen: a rare anatomical variation(Springer France, 2017) Oner, Zulal; Oner, Serkan; Kahraman, Aysegul SagirVariations in the origin of the vertebral artery (VA) is a congenital anomaly that occurs during embryological development. Multiple variations related to VA origin have been reported in the literature. Abnormal VA origin is usually determined as incidental findings during angiographic or postmortem anatomical studies. Although most of the cases are asymptomatic, in patients with VA anomaly symptoms such as dizziness have been described. The anomalous variation in the origin of the right VA is rare and separated into three categories: (1) originating from the aorta, (2) originating from the carotid arteries, (3) duplicated origin. In this case, we aimed to present the right VA originating from the right occipital artery and concomitant anomalies of the transverse foramen that have not been reported previously according to our knowledge in literature. In a 32-year-old female patient referred to our hospital because of dizziness, the right VA was not observed on magnetic resonance imaging and computed tomography angiography (CTA) examination was performed. CTA showed hypoplasia of the right transverse foramen at the levels of the C1, C5 and C6 vertebrae and aplasia of the right transverse foramen at the levels of the C2, C3 and C4 vertebrae. The right VA originating from the right occipital artery continues to its normal course by entering the cranium through the foramen magnum at the level of the atlantooccipital junction.Öğe Usage length of sternum components and sternal angle through images obtained by computerized tomography image reconstruction in gender determination(2019) Oner, Zulal; Oner, Serkan; Kurtul, Ibrahim; Sahin, BunyaminAim: This study investigates the total sternum length and the lengths of each part of the sternum using computed tomography (CT) images oriented orthogonally to reveal whether there are any significant gender differences with respect to these values. Material and Methods: Thin-section thorax CT images from 60 subjects (30F, 30M) between 20 and 40 years of age were used, oriented to the orthogonal plane using an image-processing program.The sternal angle (SA), manubrium length (ML), corpus length (CL), xiphoid processlength (XPL), total sternum length (TSL), manubrium-corpus length proportion (sternal index; SI), and the proportion of the three parts separate from the TSL were compared by gender. Results: The values of the ML (M: 5.36 cm, F: 4.76 cm), CL (M: 10.11 cm, F: 8.75 cm), and TSL (M: 19.18 cm, F: 16.28 cm) were longer in males (p≤0.05) than in females. No statistically significant difference was determined in the ratios of the XPL, SI, and sternum parts to the TSL (p>0.05). The mean values of the SA in males and females were 161.4° and 160.51°, respectively (p>0.05). In an ROC analysis, the most significant measurement for gender determination was found to be the CL, and the linear discriminant analysis yielded a correct determination rate of 86% for males and 93% for females. Conclusions: Although metric measurements of the sternum could provide high accuracy rates in gender determination, to increase reliability, image analyses should be conducted in the orthogonal plane to remove errors that could be caused by the differences in orientation.
