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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 CT findings of a rare case of mesenteric injury due to blunt abdominal trauma(2017) Unlu, Serkan; Derya, SerdarÖğe CT findings of a rare case of mesenteric injury due to blunt abdominal trauma(Inonu University Faculty of Medicine Emergency Medicine Department, Malatya, Turkey, 2017) Unlu, Serkan; Derya, Serdar[Abstract Not Acailable]Öğe Evaluation of aqueductal cerebrospinal fluid flow dynamics with phase-contrast cine magnetic resonance imaging in normal pediatric cases(Elsevier Science Inc, 2016) Ozturk, Mehmet; Sigirci, Ahmet; Unlu, SerkanPurpose: This study aimed to determine differences according to age groups and gender in the parameters of aqueductal cerebrospinal fluid (CSF) flow in childhood using phase-contrast cine magnetic resonance imaging (MRI) method. Materials and methods: This prospective study included 47 boys and 36 girls for a total of 83 healthy children. The cases were divided into three groups depending on age as infants (1-12 months), children (12-120 months), and adolescents (120-204 months). To quantitatively evaluate CSF flow, images in the transverse plane were taken at the cerebral aqueduct level using the phase-contrast MR angiography technique in a 1.5-T MR unit. Peak and average velocity (cm/s), cranial direction, caudal direction and net volume (ml), and aqueduct area (mm2) were calculated. To assess differences between the groups, a one-way analysis of variance and least significant difference tests were used. Results: A statistically significant difference was determined between children and adolescents in peak velocity and caudal direction volume (P=.012 and P=.039, respectively) and between infants and children in cranial direction volume (P=.036). Peak velocity, cranial direction, and net volume were higher in boys (P=.050, P=.016, and P=.029, respectively). There were no differences by age and gender in the aqueduct area. Conclusion: In conclusion, this study determined the normal values for the CSF flow parameters of velocity, volume, and aqueduct area using phase-contrast MRI in healthy children. Velocity and volume parameters varied according to age and sex and were not affected in the aqueductal area. Published by Elsevier Inc.Öğe Is acute appendicitis complicated or uncomplicated? Approaching the question via computed tomography(Sage Publications Ltd, 2023) Akcicek, Mehmet; Ilgar, Mehtap; Unlu, SerkanBackground The distinction between complicated and uncomplicated appendicitis is very important for the selection of the treatment method. Purpose To investigate the sensitivity and specificity of computed tomography (CT) in differentiating between complicated and uncomplicated appendicitis to demonstrate that false negativity in differentiating these cases can be reduced when CT findings are incorporated into the clinical evaluation of patients. Material and Methods All patients aged >= 18 years who underwent appendectomy at Malatya Training and Research Hospital in 2020 and 2021 were retrospectively screened. Of them, 283 patients were included in the study who had undergone CT before the operation. Patients with appendicitis were divided into two groups: complicated and uncomplicated, according to the results of their pathology tests. Demographic data, laboratory results, and CT images of the patients were evaluated. Results The patients with complicated appendicitis had a significantly higher mean age (P<0.001). The most common CT findings in patients with complicated appendicitis were moderate or severe peri-appendiceal fat stranding (PFS) and appendix wall enhancement defect (AWD). The findings with the highest sensitivity were PFS (77.9%) and AWD (69.4%). Although abscess, phlegmon, and peri-appendiceal air had the highest specificity (100%), these findings were the ones with the lowest sensitivity. According to the scoring system was developed for the differential diagnosis, CT had a sensitivity of 83.3% and a specificity of 79.2%. Conclusion Based on the sensitivity and specificity values measured for CT according to the findings of our study, the scoring system may be useful for the differential diagnosis of complicated appendicitis.Öğe Is anemia a risk factor in pneumonia progression in covid-19-infected patients?(Wolters Kluwer Medknow Publications, 2022) Akcicek, Mehmet; Ilgar, Mehtap; Unlu, SerkanBackground Determining the factors contributing to the development of severe coronavirus 2019 disease (COVID-19) disease is of great importance for health guidance. In this study, the authors aimed to investigate whether there is a relationship between anemia and progression of COVID-19 pneumonia. Patients and methods Records of 201 patients whose RT-PCR positivity for COVID-19 was confirmed between August 2020 and October 2020, when admissions and hospitalizations were at their peak, were retrospectively reviewed. The scoring system based on visual evaluation was used for evaluating the severity of the disease on each computed tomography (CT). To determine the progression status of pneumonia, the score difference was calculated by the difference between two CT scores. The patients were divided into two groups according to their hemoglobin levels as anemic and nonanemic patients. Results A significant difference was reported between the CT score difference groups in terms of mean age (P < 0.001). The mean age of the group that did not show progression was significantly lower than the other groups. Although the mean hemoglobin level of the group that did not show progression was higher than the other groups, no significant difference was reported between the groups (P=0.768). There was no significant difference between the CT score difference groups in terms of the presence or absence of anemia (P=0.791). Conclusion No significant relationship was found between hemoglobin levels, anemia, and pneumonia progression in COVID-19-infected patients.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 A Rare Disease in the Differential Diagnosis of Acute Pancreatitis: Acute Brucellosis(Japan Soc Internal Medicine, 2014) Berber, Ilhami; Erkurt, Mehmet Ali; Yetkin, Funda; Unlu, Serkan; Yilmaz, Sami; Bentli, Recep; Bazna, SezaiSome infectious organisms may give rise to acute pancreatitis; brucellosis, however, extremely rarely leads to acute pancreatitis. A 40-year-old man was diagnosed with acute pancreatitis, the etiology of which was determined to be acute brucellosis. The patient was discharged without complications approximately 15 days after the initiation of trimethoprim-sulfamethoxazole and doxycycline treatment. Brucella infections may rarely be complicated by acute pancreatitis. Thus, brucellosis should be remembered in the etiology of acute pancreatitis in regions such as Turkey, where Brucella infections are endemic.Öğe Thrombotic thrombocytopenic purpura presenting with pathologic fracture: a case report(Pergamon-Elsevier Science Ltd, 2014) Berber, Ilhami; Erkurt, Mehmet Ali; Kuku, Irfan; Kaya, Emin; Unlu, Serkan; Ertem, Kadir; Nizam, IlknurThrombotic thrombocytopenic purpura is an acute syndrome with abnormalities in multiple organ systems, which becomes manifest with microangiopathic hemolytic anemia and thrombocytopenia. The hereditary or acquired deficiency of ADAMTS-13 activity leads to an excess of high molecular weight von Willebrand factor multimers in plasma, leading to platelet aggregation and diffuse intravascular thrombus formation, resulting in thrombotic thrombocytopenic purpura. Thrombotic lesions occurring in TTP leads to ischemia and convulsion. Depending on the properties of the bony tissue, fractures are divided into three groups as traumatic, pathological, and stress fractures. A pathologic fracture is a broken bone caused by disease leading to weakness of the bone. This process is most commonly due to osteoporosis, but may also be due to other pathologies such as cancer, infections, inherited bone disorders, or a bone cyst. We herein report a case with a pathologic fracture due to convulsion secondary to thrombotic thrombocytopenic pupura. Thrombotic lesions occurring in TTP may lead to ischemia and convulsion, as in our patient and pathological fractures presented in our case report may occur as a result of severe muscle contractions associated with convulsive activity. Thrombotic thrombocytopenic pupura is a disease that involves many organ systems and thus may have a very wide spectrum of clinical presentations. (C) 2014 Published by Elsevier Ltd.