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Öğe Adrenoleukodystrophy: single voxel MR spectroscopy findings (case report)(2004) Alkan A.; Kutlu R.; Aslan M.; Yakinci C.Adrenoleukodystrophy is a rare genetic disorder. Histopathological features of this disorder include demyelination and axonal loss in white matter. We describe a six-year-old boy with significantly decreased N-acetyl-aspartate (NAA)/Creatin (Cr), increased Choline (Cho)/Cr and Myo-inositol (MI)/Cr in parieto-occipital white matter by MR spectroscopy. In contrast to the normal appearance of frontal white matter on MR imaging, increased Cho/Cr and MI/Cr ratios were detected on MR spectroscopy. These changes in involved areas could be an indication of neuroaxonal loss, demyelination and gliosis.Öğe Atlanto-axial subluxation associated with Rubinstein-Taybi syndrome(Elsevier BV, 2003) Si?irci A.; Yakinci C.; Alkan A.; Aslan M.; Si?irci A.; Kutlu R.A case of atlanto-axial subluxation in a 5-year-old boy with Rubinstein-Taybi syndrome (RTS) is presented and the imaging findings are evaluated. To the best of our knowledge, atlanto-axial subluxation has not been reported in association with this syndrome. © 2003 Elsevier Ireland Ltd. All rights reserved.Öğe Basal ganglia involvement in the late stage of vacuolating megalencephalic leukoencephalopathy(2005) Karakas H.M.; Firat A.K.; Yakinci C.; Kahraman B.Vacuolating megalencephalic leukoencephalopathy is a recently defined entity characterized by swelling of white matter, subcortical cysts in fronto-temporal regions and slow progression of neurological symptoms that contrasts with the severity of radiological findings. We present a late follow-up of a case with vacuolating megalencephalic leukoencephalopathy. There was an improvement of the brain swelling and associated sulcal enlargement. Of notice was basal ganglia involvement which has not been described previously.Öğe Cerebral atrophy and subdural haemorrhage after cerebellar and cerebral infarcts in an 8-month-old child after having been stung by a scorpion(BMJ Publishing Group, 2014) Si?irci A.; Öztürk M.; Yakinci C.A scorpion sting causing cerebellar and cerebral infarctions with corpus callosum involvement and bilateral cerebral atrophy with subdural haemorrhage in an 8-month-old girl, has not been previously described to the best of our knowledge. Copyright © 2014 BMJ Publishing Group.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 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 Encephalopathy due to hypernatremic dehydration: Computerized tomography and magnetic resonance imaging findings: Case report(Turkiye Klinikleri, 2006) Firat A.K.; Karakaş H.M.; Yakinci C.Magnetic resonance imaging (MRI) provides unique information about various pathological changes of the brain. We present CT and MRI findings of an infant with hypernatremic dehydration. CT imaging was performed at admission and MRI was obtained 4 weeks later. CT revealed hypodensity in the bilateral border zone of centrum semiovale and in the parasagital region of the left parietal lobe. These CT and MRI findings are compatible with vasogenic edema deteriorating to venous infarction. We present the early stage CT and late stage conventional MRI findings and discuss the effectiveness and priority of imaging techniques in this disease. Copyright © 2006 by Türkiye Klinikleri.Öğe Haemophilus aphrophilus brain abscess in the first decade(Medknow Publications and Media Pvt. Ltd, 2005) Bayraktar M.; Onal C.; Durmaz B.; Yakinci C.; Sonmezgoz E.This report presents a case of brain abscess due to Haemophilus aphrophilus in a six-year old boy. He was admitted to our hospital suffering from left-sided weakness. The initial radiological diagnosis was an intracranial abscess. Purulent material was obtained by puncturing the subcortical lesion and the sample was cultured on conventional media. H. aphrophilus was isolated in pure culture, identified according to conventional methods and confirmed by Becton Dickinson Laboratory (BBL) crystal system. After surgical drainage and eight weeks of antibiotic therapy, the neurological findings improved. The presented case is an example of H. aphriphilus causing brain abscess in the first decade without cardiac predisposition and with good outcome.Öğe Health education found in Nasrettin Hodja's anecdotes(2014) Almişa H.; Yakinci C.An anecdote is described as a short and concise narrative, witty, and humorous story. This important literary type caters to every segment of society, regardless of age, educational level, or social status, and through humor, relates suggestive messages in educating people. Turkish culture has a historical tradition of narrative anecdotes that continues today. This tradition has resulted in many available anecdote types. Nasrettin Hodja is one of the first names that comes to mind regarding anecdote type. With anecdotes relating to practically any topic, Nasrettin Hodja is a master of great promise. Each passage presents a new life lesson. These anecdotes address deficiencies in social issues, rules to be followed in human relations, and the importance of the right to be human and tolerant of virtue. He is literally a social scientist and presents rights, law and justice. His lyrics are valuable to humanity. These anecdotes have also included topics related to health, though to a more limited degree. They describe the state of being healthy as superior to all else. They specify from where to seek healing and describe manners related to the patient's visit. They convey that it does no harm to show people the truth. Does not feel criticism. In this study, Nasrettin Hodja anecdotes were reviewed. A content analysis of those anecdotes that can contribute to medical education, such as regarding topics of health, disease, and illness, was performed nine runs in terms of medical education messages were removed.Öğe How is retention of information provided in medical education?(Cocuk Sagligi ve Hastaliklan Dergisi, 2015) Seren L.P.; Yakinci C.Medical education is a long and exhaustive process that demands a great deal of work and effort. The concentrated and substantive nature of the information imparted to students during their education may cause confusion, and thus the material they are supposed to have learned may be in large part forgotten. This problem can only be resolved through the use of entertaining and attractive methods of teaching, which may encourage continuous learning over a lifetime. In this study, varied and motivating learning methods, which will result in retention of information and make a correlation between the information learned during formal study and its application in daily life, are reviewed.Öğe Mapping of blood coagulation via image processing method(Institute of Electrical and Electronics Engineers Inc., 2016) Onar B.; Bayindir M.I.; Bilgili H.; Erkurt M.A.; Yakinci C.; Yakinci M.E.Biomedical applications based on image process algorithms are developed to aid doctors for diagnostic of some diseases. Several conventional tests are available about measuring blood coagulation such as PTZ, aPTZ, PTZ-INR. These tests are performed before every surgical operation even during some critical operations especially in cardiovascular and liver operations. Then, images are taken by a microscope connected to a computer in every 15 seconds, in such a way that 45 images are obtained till end of coagulation. These images are processed in an image processing algorithm in Matlab software. Hence, a graphical representation is produced for every subject. Results obtained from the proposed method prove that it can be a useful alternative to conventional methods. © 2015 IEEE.Öğe MRI and MR spectroscopy findings of a case of subacute sclerosing panencephalitis affecting the corpus callosum(BMJ Publishing Group, 2015) Öztürk M.; Si?irci A.; Yakinci C.Subacute sclerosing panencephalitis (SSPE) is a rare, slowly progressive, fatal, inflammatory and neurodegenerative disease that is seen mostly in children and young adolescents, and primarily affects the parieto-occipital lobes. The corpus callosum, cerebellum and basal ganglia are less frequently involved. MR spectroscopy (MRS) may illustrate the pathophysiological features of SSPE. To the best of our knowledge, this is the second report of MRS findings of corpus callosum involvement in a stage 3 SSPE case. Copyright 2015 BMJ Publishing Group. All rights reserved.Öğe The power of aphorisms in medical education(2013) Yakinci C.; Yakinda H.; Akin K.Aphorisms are didactic guides formed by individual experiences, and they reflect life and living traditions. Aphorisms tell of both general life events as well as aspects of certain occupations. In medical education, over the centuries as a product of traditions, aphorisms have been used for teaching both medical ethics and professions. Today, in evidence-based medicine, medical aphorisms are accepted as traditional and are referred to only rarely, despite the fact that a single aphorism can relate a life experience more succinctly and effectively than can several sentences. In light of these data, teachers in the field of medical education must generate new, valid, didactic, and effective aphorisms incorporating their own professional experiences. In this study, we aimed to suggest the use of medical aphorisms, which are easy to remember, facilitate learning, and contribute to the formation of a professional identity and professional sensitivity in medical education.Öğe The power of story-telling in medical education(2012) Yakinci C.; Almis H.; Kavruk H.The aim of medical education is to raise up physicians who are well informed regarding medical problems and have the skills to overcome them, who uphold ethical rules, and who, as investigators, have the desire to renew themselves. The concepts taught through medical education must be related with real life, so that the knowledge gained will extend beyond merely discrete terms memorized for examinations. An interesting teaching method that relates medical knowledge with real life must be developed. In order to achieve this, story-telling must be used in medical education. The aim of this review is to emphasize that learned knowledge will be better retained and more enjoyable and lead to a new dimension in medical education if physicians internalize human values by incorporating story-telling into medical education.Öğe Problems of Turkish medical language(2004) Yakinci C.; Aslan M.; Biçak U.Language is as alive as the society using it and is ever-changing. Great developments in medicine have led to many new words or terms being adopted and used in the same form as the foreign origin. Use of these words in lectures, conferences, briefings and reviews has caused some problems and confusion in use of the language. These problems can only be overcome of a common and standard language form is adopted. The purpose of this study was to raise the problems of the Turkish medical language.Öğe Reaching unknowns using our own knowledge in medical term science(2013) Yakinci C.; Akin K.; Almiş H.Individuals experience difficulties when first faced with medical terms, which are formed from Greek and Latin roots, since these terms have unusual settings and structures with no associated connotations. This problem is frequently seen among first-year medical students. Individuals pursuing a medical education can solve this problem by using old familiar words to learn new ones. Terms encountered for the first time can be learned by using the meaning, connotation and simulation properties of previously known terms. Such a learning method will be more permanent as well as more effective. Learning medical terms using previously known words can be utilized as a new method in educational life. In this study, we aimed to present this new method with examples to contribute toward a more effective method of teaching medical terms.Öğe The reasons of childhood mortality between 1996-2002 in Malatya(2006) U?raş M.; Yakinci C.; Güneş G.; Yücel N.Mortality statistics are easy to provide, so are widely used to show child health status in the population. Previous studies have shown that, graveyard recordings are reliable to evaluate childhood deaths. We documented the number and reasons of childhood deaths during 1995-2002 in Malatya city, and compared these findings with childhood deaths between 1990-1995. One month-1 year old childhood deaths made up 35.65% of general population mortality, while newborn death was 22.61%, 1 to 6-year-old death was 21.55%, 11 to 18 year-old death was 14.88 and 7 to 11 year-old death was 5.34%. In the present study, childhood deaths constituted 13.82% of whole deaths. In the last 7 years, there was a striking decrease in newborn deaths and deaths between 7-11 years-old children. Prematurity and its complications, including respiratory problems, pneumonia and cerebral problems, were the most common reasons of newborn deaths. We suggest there are some reasons for the decrease in newborn deaths: a) Families became more conscious and refer to a health care unit as their babies get ill. b) improvement in the quality of newborn care units in our city c) babies are delivered in hospitals even in villages. The increase of deaths in 1 month-1 year, 1-6 year and 11-18 year-old groups is attributed to infant infection(pneumonia and diarrhea being the most common reasons), and accidents. As doctors have a leading role for the public to be conscious about prevention and coping with diseases and preventible accidents. In a country like Turkey with high children mortality rates both public doctors and pediatricians have too much to do.Öğe Reversible posterior leukoencephalophaty in a child with acute glomerulonephritis: Follow-up MR imaging(2003) Alkan A.; Kutlu R.; Baysal T.; Si?irci A.; Sönmezgöz E.; Yakinci C.Hypertensive encephalopathy is the most common cause of reversible posterior leukoencephalopathy syndrome, which is quite rare in the pediatric age group. Diffuse vasogenic edema in the posterior circulation territories at the initial stages and complete disappearance of edema on follow-up imaging is the characteristic feature of this syndrome. Frontal and temporal lobe involvement is rarely seen. In this report we present the follow-up MR and diffusion weighted imaging findings of reversible posterior leukoencephalopathy syndrome in a pediatric case with this rare involvement in addition to characteristic involvement localization.Öğe Seckel syndrome with polyarteritis nodosa(2004) Kutlu R.; Alkan A.; Kutlu O.; Yakinci C.Seckel syndrome is a rare genetic disorder with a typical "bird-headed" appearance. It could affect many organ systems but renal involvement is uncommon. Polyarteritis nodosa is systemic vasculitic disorder which also involves kidneys. We report a case of Seckel syndrome in a 9 year-old boy with renal involvement due to polyarteritis nodosa. According to the literature, this is the first report of polyarteritis nodosa in Seckel syndrome.Öğe Serum nitrite and nitrate levels in epileptic children using valproic acid or carbamazepine(Elsevier B.V., 2004) Karabiber H.; Yakinci C.; Durmaz Y.; Temel I.; Mehmet N.In experimental epilepsy studies, nitric oxide was found to act as both proconvulsant and anticonvulsant. The objective of this study was to investigate the effects of valproic acid and carbamazepine on serum levels of nitrite and nitrate, which are the metabolites of nitric oxide. To achieve this goal, serum nitrite and nitrate levels were determined in active epileptic 34 children using valproic acid and 23 children using carbamazepine and in non-active epileptic 38 children (control group) not using any antiepileptic drug. In the valproic acid group serum nitrite and nitrate levels were 2.66±2.11?mol/l and 69.35±23.20?mol/l, 1.89±1. 01?mol/l and 49.39±10.61?mol/l in the carbamazepine group, and 1.22±0.55?mol/l, 29.53±10.05?mol in the control group, respectively. Nitrite and nitrate levels were significantly high in both valproic acid and carbamazepine groups compared to the control group (P<0.01). When valproic acid and carbamazepine groups were compared to each other, level of nitrate was found statistically higher in the valproic acid group in relation to the carbamazepine group (P<0.01), however, there was no statistically significant difference in the levels of nitrite (P>0.05). No relation could be found between serum drug levels and nitrite and nitrate levels. According to these results, it can be suggested that valproic acid and carbamazepine might have antiepileptic effects through nitric oxide. © 2003 Elsevier B.V. All rights reserved.Patients:95 children (52 boys, 43 girls) with an age range of 2 to 17 were included in the study. 23/95 were given Tegretol (13 boys, 10 girls) with a mean age of 9.45 ± 3.73, 34/95 were given valproic acid (17 boys, 17 girls) with a mean age of 7.90 ± 3.93 and 38/95 served as controls (epileptic children who had take antiepileptic drugs previously but were followed up without any medication) (22 boys, 16 girls) with a mean age of 9.01 ± 3.57TypeofStudy:The objective of this comparative, controlled clinical study was to investigate the effects of valproic acid (VPA) and Tegretol on the levels of nitrite and nitrate as an indicator of nitric oxide (NO) level in epileptic children.DosageDuration:Dosage not stated. Duration of treatment at least 6 months.ComparativeDrug:Valproic acid (dose not stated, duration of treatment was for at least 6 months).Results:In the valproic acid group serum nitrite and nitrate levels were 2.66 ± 2.11 mcmol/l and 69.35 ± 23.20 mcmol/l, 1.89 ± 1.01 mcmol/l and 49.39 ± 10.61 mcmol/l in the Tegretol group, and 1.22 ± 0.55 mcmol/l, 29.53 ± 10.05 mcmol in the control group, respectively. Serum nitrite and nitrate levels of both VPA and Tegretol groups were found to be significantly higher than the control group statistically (P < 0.01). When VPA and Tegretol groups were compared to each other, no statistically significant difference could be found in the nitrite levels (P > 0.05), however, nitrate levels of VPA group were found to be statistically significantly higher than the Tegretol group (P < 0.01). Routine biochemical parameters (fasting glucose level, urea, creatinine, AST, ALT, ALP) and complete blood count values were in normal ranges both in antiepileptic users and the control group and no difference could be found between the groups statistically. When NO and drug levels in the blood were compared, there was no statistically significant correlation between them.AdverseEffects:No adverse events were mentioned.AuthorsConclusions:Although carbamazepine and VPA are effective in different ways, nitrite and nitrate levels were found to be higher in both groups in our study when compared to the control group. Since liver, kidney and heart diseases that could elevate nitrite and nitrate levels were excluded previously, the results obtained reflect the data of epileptic patients. With reference to the fact that high levels of nitric oxide have an anticonvulsive effect, the antiepileptic effect of VPA and carbamazepine might be through elevating the level of NO directly or indirectly. When VPA and carbamazepine groups were compared to each other, there were no statistical differences between nitrite levels, however, nitrate levels in the VPA group were found to be significantly higher. VPA may have a stronger effect on NO synthesis than Tegretol and may use NO synthesis pathway more in demonstrating its anticonvulsive effect. Even though the cause of increase in the level of NO cannot be explained clearly, it can be suggested that VPA and carbamazepine might have antiepileptic effects through nitric oxide. Further studies dealing with antiepileptic drugs and NO levels and a more clear demonstration of the relation may lead to new treatment methods in refractory epileptics.FreeText:The children had been diagnosed as having epilepsy according to the clinical and electroencephalographic (EEG) findings and had been followed at least for 6 months. Treatment group included children taking Tegretol or VPA regularly at least for the last 6 months and the control group comprised of children who had taken antiepileptic medication previously and did not get any treatment at least for the last 6 months and had no convulsion as well. All children were evaluated in the aspects of mental-motor retardation, renal or hepatic disorders, heart diseases and hypertension. After getting consent of the families, systemic complaints of the children were inquired prior to the study and physical examinations, complete blood count, hepatic and renal function tests were carried out and Tegretol or VPA levels in the blood were measured as well. Fasting blood glucose, alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), urea, creatinine, Na, K, Cl , Ca and other routine biochemical analyses were also determined. Following the deproteinization of all samples by adding NaOH/ZnSO4, nitrite and nitrate levels were analyzed together. Nitrite was analyzed directly, however, nitrate was first transformed to nitrite by cadmium reduction and then analyzed by the same method. Results were analyzed using statistical analysis. Serum nitrite and nitrate levels were compared among VPA, Tegretol and control groups by one-way analysis of variance (ANOVA).Indications:23 patients with epilepsy (2/23 tonic, 3/23 atonic, 4/23 complex partial and 14 generalized tonic clonic seizures).
