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Öğe A Hybrid Schwannoma of Median Nerve(Coll Physicians & Surgeons Pakistan, 2014) Komurcu, Erkam; Kaymaz, Burak; Adam, Gurhan; Gokmen, Ferhat; Murath, AsliSchwannomas are the most common benign neoplasms of the peripheral nerves in the upper extremity originating from the schwann cells of nerve sheath. They account for 5% of all tumours in upper extremity. Schwannomas are usually solitary, encapsulated and homogeneous masses and present with slowly growing masses, sometimes associated with pain and paresthesia. Pre-operative evaluation is based on ultrasonography and magnetic resonance imaging, but final diagnosis requires histopathology. It is important to distinguish plexiform schwannoma from plexiform neurofibroma because of the possibility of malignant transformation in plexiform neurofibroma. Plexiform schwannoma may be confused with neurofibromatosis and this can lead to overtreatment. We present a very rare case of solitary mass which had a plexiform type multicentric extension: hybrid schwannoma of the median nerve of a 20-year-old young girl.Öğe A Rare Reason of Mechanical Intestinal Obstruction; Phytobezoar Images for Clinicians(Modestum Ltd, 2014) Cikman, Oztekin; Ozkan, Omer Faruk; Adam, Gurhan; Tas, Sukru; Ademoglu, Serkan; Karaayvaz, MuammerMechanical intestinal obstruction is defined as the partial or total blockage of the passage of digested food in gastrointestinal system towards the distal. If intestinal obstruction is not treated properly it can cause high incidences of morbidity and mortality. The most frequent cause is adhesion after surgery but etiological cause changes frequently with age. Known symptoms of intestinal obstructions are nausea, vomiting, abdominal ache and distention in the abdomen. In our study we aimed to present a 70 year old patient with intestinal obstruction due to phytobezoar who developed sepsis, with the help of current literature.Öğe Agenesis of Submandibular Glands: A Report of Two Cases with Review of Literature(Hindawi Ltd, 2014) Kara, Medine; Guclu, Oluz; Derekoy, Fevzi Sefa; Resorlu, Mustafa; Adam, GurhanBackground. Congenital absence of the submandibular gland (SMG) is a rare condition. Although complaints such as dry mouth, dental problems, or difficulty in swallowing may be seen, the subjects may also be asymptomatic. The absence of the SMG may be associated with hypertrophy of the contralateral SMG. Case Report. We report the case of a 44-year-old woman with incidentally detected left SMG aplasia, with contralateral SMG hypertrophy mimicking a mass, and the case of a 46-year-old woman with incidentally detected bilateral SMGaplasia, demonstrated by computerized tomography (CT) andmagnetic resonance imaging (MRI). Conclusion. It is important for the clinician to know that this very rare abnormality may exist. When such a case is encountered, symptoms and findings should be reevaluated and, if necessary, conservative therapy should be initiated. The possibility of observing additional deformities should be kept in mind and an evaluation should be done for other cases in the family.Öğe AN EXTREMELY RARE COMPLICATION OF MECKEL'S DIVERTICULUM: ENTEROCUTANEOUS FISTULIZATION OF UMBILICAL HERNIA(Colegio Brasileiro Cirurgia Digestiva-Cbcd, 2015) Cikman, Oztekin; Kiraz, Hasan Ali; Ozkan, Omer Faruk; Adam, Gurhan; Celik, Ahmet; Karaayvaz, Muammer[Anstract Not Available]Öğe An unusual case of ectopic variceal bleeding treated with percutaneous intervention(Univ Catholique Louvain-Ucl, 2014) Adam, Gurhan; Gunes, Fahri; Akbal, Erdem; Cinar, Celal; Bozkaya, Halil; Resorlu, Mustafa; Aylanc, Nilufer[Anstract Not Available]Öğe An Unusual Case of Severe Upper Gastrointestinal Bleeding Treated Using an Endovascular Technique(Southeastern Surgical Congress, 2014) Adam, Gurhan; Gunes, Fahri; Cinar, Celal; Bozkaya, Halil; Bas, Sercin; Akbal, Erdem; Uysal, Fatma[Anstract Not Available]Öğe Association between apparent diffusion coefficient and intervertebral disc degeneration in patients with ankylosing spondylitis(E-Century Publishing Corp, 2015) Resorlu, Mustafa; Gokmen, Ferhat; Resorlu, Hatice; Adam, Gurhan; Akbal, Ayla; Cevizci, Sibel; Sariyildirim, AbdullahPurpose: To assess the relation between ankylosing spondylitis (AS) and degenerative disc disease emerging in association with various intrinsic and extrinsic factors and to evaluate the correlation between degree of degeneration in intervertebral discs and apparent diffusion coefficient (ADC) values. Methods: Thirty-five patients with AS and a control group of 35 patients were included in the study. Three hundred fifty intervertebral discs were assessed in terms of degeneration by analyzing signal intensities and morphologies on T2 weighted series of a 1.5 Tesla magnetic resonance scanner. ADC values were determined in diffusion weighted images (DWI) using a b value of 500 s/mm(2). Patients in the AS and control groups were compared in terms of intervertebral disc degeneration, and association between degree of degeneration and ADC values was analyzed. Results: The mean of total degeneration degrees for five lumbar intervertebral discs was significantly higher in the patients with AS compared to the control group (16.77 +/- 4.67 vs 13.00 +/- 4.08, respectively; P=0.001). When intervertebral discs were analyzed separately, disc degeneration was again significantly higher in patients with AS compared to the control group, with the exception of L5-S1. Age, cholesterol level, triglyceride level, duration of disease and BASFI index were significantly associated with degree of degeneration in patients with AS. A negative correlation was determined between disc degeneration and ADC value. Conclusion: AS is a risk factor for degenerative disc disease due to its systemic effects, the fact it leads to posture impairment and its inflammatory effects on the vertebrae. A decrease in ADC values is observed as degeneration worsens in degenerative disc disease.Öğe Association between mean platelet volume and bone mineral density in patients with ankylosing spondylitis and diagnostic value of diffusion-weighted magnetic resonance imaging(Soc Physical Therapy Science, 2015) Resorlu, Hatice; Resorlu, Mustafa; Gokmen, Ferhat; Akbal, Ayla; Adam, Gurhan; Komurcu, Erkam; Goksel, Ferdi[Purpose] The aim this study was to assess the relation between bone mineral density (BMD) and mean platelet volume (MPV) in ankylosing spondylitis (AS) patients, and evaluate the diagnostic role of the diffusion-weighted magnetic resonance imaging (MRI). [Subjects and Methods] Fifty patients diagnosed with AS were divided into two groups on the basis of BMD, a normal group (n=30) and an osteopenic (n=20) group. [Results] Duration of disease in the group with a normal BMD was 10.3 +/- 7.0 years, while it was 16.7 +/- 12.2 years in the osteopenia group. MPV was high in the osteopenia group, while no significant differences were observed between the groups in terms of apparent diffusion coefficient (ADC) and platelet distribution width (PDW). There was a positive correlation between MPV and duration of disease. Correlations between ADC value and the lumbar T score, femoral neck T score, and duration of disease were insignificant. A negative correlation was observed between BMD and disease duration. [Conclusion] Diffusion-weighted imaging provides valuable results in osteoporosis but is not a suitable technique for evaluating BMD in patients with AS because of the local and systemic inflammatory effects in the musculoskeletal system. The common pathophysiology of atherosclerosis and osteoporosis plays an important role in the negative correlation observed between MPV and BMD in patients with AS.Öğe Association of Congenital Left Renal Vein Anomalies and Unexplained Hematuria: Multidetector Computed Tomography Findings(Karger, 2015) Resorlu, Mustafa; Sariyildirim, Abdullah; Resorlu, Berkan; Sancak, Eyup Burak; Uysal, Fatma; Adam, Gurhan; Akbas, AlpaslanObjectives: To investigate whether congenital renal vein anomalies are involved in the etiology of hematuria by analyzing abdominal multidetector computed tomography (MDCT) results. Methods: Six hundred and eighty patients undergoing MDCT for various abdominal pathologies in whom possible causes of hematuria were excluded were retrospectively assessed in terms of left renal vein anomalies, such as circumaortic left renal vein (CLRV), retroaortic left renal vein (RLRV) and multiple renal vein (MRV). Patients with CLRV, RLRV or MRV and patients with normal left renal veins were compared in terms of the presence of hematuria. Results: Left renal vein anomalies were detected in 100 patients (14.7%). RLRV, CLRV and MRV were identified in 5.4, 2.5 and 6.8% of patients, respectively. Hematuria was determined in 8.1% of patients with an RLRV anomaly and in 10.5% of patients with no RLRV anomaly (p = 0.633). Hematuria was detected in 23.5% of patients with a CLRV anomaly and 10.1% of those without (p = 0.074), and in 21.7% of patients with an MRV anomaly and 9.6% of those without (p = 0.009). Condusions: In addition to increasing risk of complication during retroperitoneal surgery, numeric congenital renal vein anomalies are also significant in terms of leading to clinical symptoms such as hennaturia. (C) 2014 S. Karger AG, BaselÖğe Can the ankle brachial pressure index (ABPI) and carotis intima media thickness (CIMT) be new early stage markers of subclinical atherosclerosis in patients with rheumatoid arthritis?(Springer Wien, 2015) Kurt, Tolga; Temiz, Ahmet; Gokmen, Ferhat; Adam, Gurhan; Ozcan, Sedat; Ozbudak, Ersan; Sacar, MustafaIt takes years for atherosclerosis to manifest symptoms. However, it needs to be identified earlier because of the premature cardiovascular risk factors in patients with rheumatoid arthritis (RA). In this study, we aimed to investigate the effect of atherosclerosis on the ankle brachial pressure index (ABPI) and carotis intima media thickness (CIMT) in patients with RA. RA patients attending the rheumatology clinic were examined retrospectively; then we called them for the measurements of ABPI and CIMT prospectively. Subjects were divided into four groups, as follows (Table 1): group 1 comprised RA patients with an ABPI less than 0.9; group 2 included RA patients with an ABPI between 0.9 and 1.2; group 3 was made up of RA patients with an ABPI greater than 1.2; and group 4 included patients without RA with an ABPI between 0.9 and 1.2 as a control group. Patients' demographic data were recorded. Hypertension (HT), diabetes mellitus, ABPI and CIMT measurements were taken by specialists. Duration of RA and disease scores (disease activity score-28, health assessment questionnaire score and visual assessment score) were recorded. The prevalence of peripheral vascular disease in patients with RA was twice as high as that in the normal population of equivalent age. Patients in group 2, with RA and normal ABPI, exhibited a significant higher mean in CIMT (mm) compared with the control group (p < 0.01), despite having normal ABPI. This confirms that these patients have a higher risk of stroke compared with the control group. Group 1's newly diagnosed HT (p < 0.01) and systolic blood pressure (SBP) values (p < 0.01) were higher and statistically significant when compared with the group 4 (control group); in addition, significant plaque levels were observed in the carotid arteries (p < 0.01). Group 3 patients had a similar history of HT and increased SBP compared with patients in group 4 (p < 0.01), and had similar characteristics to with group 1. No statistically significant differences were found between the groups in terms of inflammatory markers such as C-reactive protein and rheumatoid factor, anti-cyclic citrullinated peptide and white blood cell counts. Based on the present findings, patients with RA need to be evaluated in the early stage of the disease for subclinical peripheral artery disease using the ABPI, as well as CIMT, which is also a non-invasive technique, in terms of cerebrovascular events. Inflammatory markers exhibited no statistically significant difference. We think that the atherosclerotic process stems not only from the inflammatory effects of RA, but also perhaps from its immunological nature.Öğe Cesarean Scar Pregnancy Diagnosis, Management, and Follow-up(Wiley, 2013) Uysal, Fatma; Uysal, Ahmet; Adam, GurhanCesarean scar pregnancy is a very rare form of pregnancy and a life-threatening situation. It has become an important and serious problem over the last 10 years, as a result of the worldwide increase in cesarean births. In this retrospective series, the diagnosis of cesarean scar pregnancy, management, treatment methods, risk factors, and possibility of subsequent normal pregnancy are discussed, and case descriptions are presented.Öğe Comparison of individuals consuming natural spring water and tap water in terms of urinary tract stone disease(Pagepress Publ, 2014) Resorlu, Mustafa; Arslan, Muhammet; Resorlu, Eylem Burcu; Gulpinar, Murat Tolga; Adam, Gurhan; Sancak, Eyup Burak; Akbas, AlpaslanObjectives: To compare individuals consuming natural spring water and tap water in terms of presence of urinary tract stone disease. Patients and methods: Patients were divided into two groups on the basis of the type of water: tap water (Group I) vs natural spring water consumers (Group II). The two groups were compared in terms of presence of urolithiasis. In addition to the type of water consumed, participants were investigated in terms of age, sex, occupation, body mass index (BMI) and presence of hypertension (HT) and diabetes mellitus in order to evaluate if they constituted a risk factor for urolithiasis. Results: Two hundred fifty-nine patients consuming tap water and 254 consuming natural spring water were included in this study. Presence of urinary stone disease was determined in 27% of patients in Group I and 26% of Group II (p = 0.794). At multivariate analysis involving all variables that might be correlated with the presence of urolithiasis; male gender, high BMI and presence of HT emerged as being significantly associated with urolithiasis. Conclusions: Although we showed that male gender, presence of HT and high BMI affect stone formation, no difference was demonstated in terms of presence of stone among patients consuming tap or natural spring waterÖğe Comparison of Osteoporosis in Two Different Regions of Turkey(Galenos Yayincilik, 2014) Golge, Umut Hatay; Komurcu, Erkam; Kaymaz, Burak; Goksel, Ferdi; Guzel, Yunus; Adam, Gurhan; Erbay, PirilObjective: The aim of the study was to investigate the effect of different climate and geographic conditions on bone mineral density. Materials and Methods: The patients who had been examined with Dual X-ray Absorptiometry (DXA) for the suspicion of osteoporosis in two different regions of Turkey were included in the study. Medical records of these 2457 patients were evaluated retrospectively. Age, gender, body mass index (BMI) and osteoporosis etiology of these patients were recorded. Results: Dual X-ray Absorptiometry measurements of the femoral neck and lomber vertebras of these patients were investigated. 927 of the patients were found to be osteoporotic and 907 of the patients to be osteopenic. There was no difference between the groups in terms of age, gender and BMI. Lumbar vertebras (L1-4) and femoral neck T scores of the patients with similar age and gender in these 2 different regions were compared and the difference between the groups was found to be statistically significant (p<0.001). Conclusion: The effect of geography and climate conditions on the bone quality is well known. In this respect regional strategies in the prevention and treatment of the osteoporosis may be judicious.Öğe Cubital tunnel syndrome secondary to gouty tophi: A case report(Pakistan Medical Assoc, 2017) Resorlu, Hatice; Zateri, Coskun; Akbal, Ayla; Gokmen, Ferhat; Adam, Gurhan; Bilim, Serhad; Bozkurt, EmreGout is a chronic rheumatic disease resulting from accumulation of monosodium urate crystals in tissues. The most important risk factor for the disease is hyperuricaemia. Precipitation of uric acid in the joint in the form of monosodium urate crystals is the main factor responsible for triggering attacks of arthritis. Tophi occur as a result of urate crystals that precipitate into joints and surrounding tissues. Tophi can erode the bone where they are located and cause compression in soft tissue due to a mass effect. The following case report describes a case of cubital tunnel syndrome developed in association with tophaceous compression and resolved with surgical decompression in a patient with chronic gouty arthritis.Öğe Effects of Local Administration of Boric Acid on Posterolateral Spinal Fusion with Autogenous Bone Grafting in a Rodent Model(Humana Press Inc, 2015) Komurcu, Erkam; Ozyalvacli, Gulzade; Kaymaz, Burak; Golge, Umut Hatay; Goksel, Ferdi; Cevizci, Sibel; Adam, GurhanSpinal fusion is among the most frequently applied spinal surgical procedures. The goal of the present study was to evaluate whether the local administration of boric acid (BA) improves spinal fusion in an experimental spinal fusion model in rats. Currently, there is no published data that evaluates the possible positive effects if the local administration of BA on posterolateral spinal fusion. Thirty-two rats were randomly divided into four independent groups: no material was added at the fusion area for group 1; an autogenous morselized corticocancellous bone graft was used for group 2; an autogenous morselized corticocancellous bone graft with boric acid (8.7 mg/kg) for group 3; and only boric acid was placed into the fusion area for group 4. The L4-L6 spinal segments were collected at week 6, and the assessments included radiography, manual palpation, and histomorphometry. A statistically significant difference was determined between the groups with regard to the mean histopathological scores (p=0.002), and a paired comparison was made with the Mann-Whitney U test to detect the group/groups from which the difference originated. It was determined that only the graft+BA practice increased the histopathological score significantly with regard to the control group (p=0.002). Whereas, there was no statistically significant difference between the groups in terms of the manual assessment of fusion and radiographic analysis (respectively p=0.328 and p=0.196). This preliminary study suggests that BA may clearly be useful as a therapeutic agent in spinal fusion. However, further research is required to show the most effective dosage of BA on spinal fusion, and should indicate whether BA effects spinal fusion in the human body.Öğe Endovascular treatment of delayed hemorrhage developing after the pancreaticoduodenectomy procedure(Springer Wien, 2014) Adam, Gurhan; Tas, Sukru; Cinar, Celal; Bozkaya, Halil; Adam, Fusun; Uysal, Fatma; Resorlu, MustafaDelayed hemorrhage after pancreaticoduodenectomy (PD) is still one of the most common causes of mortality. However, the case series regarding interventional treatment of delayed hemorrhage after PD are limited. In this retrospective study, we aimed to evaluate functional outcomes of interventional treatment of late hemorrhages developing after PD. We retrospectively evaluated 16 patients who received endovascular treatment for delayed arterial hemorrhage after PD procedure. Postsurgical nonhemorrhagic complications, time of hemorrhage, site of hemorrhage, endovascular treatment technique, postprocedural complications, and mortality rates were obtained. Mean duration of delayed hemorrhage after PD was 18 days. Computed tomography angiography images for the hemorrhage period were available for 15 patients. We observed extravasation alone in seven patients and pseudoaneurysm alone in five. Pushable coil was used in 15 patients and covered stent in 1. Two patients died due to hepatic failure, and one patient died because of multiple organ dysfunction syndrome (MODS). Delayed hemorrhage after PD is difficult to identify, but accurate and early diagnosis is of vital importance. To date, most appropriate management of this complication remains unclear. Although endovascular treatment techniques may vary for every patient, it is a reliable and effective method for halting hemorrhage. Therefore, interventional procedures must be primarily considered rather than surgical interventions.Öğe Epicardial adipose tissue thickness in patients with ankylosing spondylitis(Springer London Ltd, 2015) Resorlu, Hatice; Akbal, Ayla; Resorlu, Mustafa; Gokmen, Ferhat; Ates, Can; Uysal, Fatma; Adam, GurhanThe purpose of our study was to measure epicardial adipose tissue (EAT) thickness as a novel indicator of atherosclerosis and cardiovascular risk factor in ankylosing spondylitis (AS) patients and to show the relationship with clinical parameters and inflammatory markers. Forty AS patients (42.75 +/- 12.43 years) and 40 healthy individuals with no cardiovascular risk factor as the control group (43.02 +/- 14.78 years) were included in the study. Carotid intima-media thickness (CIMT) and EAT thickness were measured in AS patients and the control group. Total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, glucose, erythrocyte sedimentation rate, urea, and blood pressure were investigated in both groups. In addition, the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were used to evaluate the association between clinical findings and CIMT and EAT in the patient group. CIMT and EAT thickness were higher in the AS patients compared to the control group. CIMT was 0.76 +/- 0.19 and 0.57 +/- 0.12 mm (p < 0.001) and EAT thickness was 4.35 +/- 1.56 and 3.03 +/- 0.94 mm (p < 0.001) in the AS and control groups, respectively. A correlation was determined between EAT thickness and CIMT. Triglyceride level, patient age, blood pressure, and duration of disease were correlated with both CIMT and EAT thickness. Increased CIMT and EAT thickness in AS patients compared to the control group shows a risk for subclinical atherosclerosis and cardiovascular disease.Öğe Ergotamine-induced vasospastic ischemia mimicking arterial embolism: unusual case(Turkish Assoc Trauma Emergency Surgery, 2014) Adam, Gurhan; Kurt, Tolga; Cinar, Celal; Sariyildirim, Abdullah; Resorlu, Mustafa; Uysal, Fatma; Yener, Ali UmitErgotamine toxicity is an important and rare condition, including tachycardia, arterial spasm which occurring as a result of accidental overdosing or drug interactions. We assessed the consequences of delayed diagnosis of peripheral arterial vasoconstriction occurring after simultaneous macrolide use by a 35-year-old woman using an ergot-derived drug for migraine. Diagnosis of ergotamine intoxication begins with suspicion. Interventional radiologists and surgeons should be aware of this acute dangerous condition.Öğe Evaluating the Use of Computed Tomography for Orthopedic Trauma Patients in the Emergency Department(Elsevier Science Bv, 2013) Imerci, Ahmet; Kaya, Ahmet; Bozoglan, Muhammet; Adam, Gurhan; Canbek, Umut; Savran, AhmetObjectives The purpose of this study is to evaluate the necessity of computed tomography (CT) scans requested to examine the spine, extremity, or pelvis of orthopedic trauma patients in the emergency department. Methods We retrospectively screened the medical records of all patients who had a CT scan during their emergency department (ED) evaluation. All data were classified as either child (aged 0-14 years) or adult (aged > 14 years). Results Of the 32, 685 patients examined in the child and adult emergency trauma unit over one year, 1, 664 were recommended for an extremity, pelvis, or spine CT (7.02%). The mean age of the patients was 38.6 years (range 2-94 years). Of these patients, 145 of the computed tomography scans (CTs) (80.1%) in the child group and 1, 108 CTs (74.7%) in adult group were negative. Conclusions The unnecessary use of CT in the emergency department to examine orthopedic trauma patients has drawn attention. Considering the risk of radiation to the patient, it is necessary to develop protocols to determine which emergency department patients should undergo computed tomography.Öğe Evaluation of Platelet Distribution Width and Mean Platelet Volume in Patients With Carotid Artery Stenosis: Author's Reply(Sage Publications Inc, 2015) Adam, Gurhan; Kocak, Erdem; Resorlu, Mustafa[Anstract Not Available]
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