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Öğe A Case of Cervical Lipoma-related Radiculopathy(Galenos Yayincilik, 2018) Resorlu, Mustafa; Karatag, Ozan; Toprak, Canan Akgun[Anstract Not Available]Öğe A Case of Posterior Mediastinal Ganglioneuroma: The Importance of Preoperative Multiplanar Radiological Imaging(Galenos Publ House, 2013) Kizildag, Betul; Alar, Timucin; Karatag, Ozan; Kosar, Sule; Akman, Tarik; Cosar, MuratGanglioneuromas are mostly seen in adolescents and young adults and they are neurogenic tumors originating from sympathetic ganglions with a benign histology. Although ganglioneuromas are benign, the treatment is surgical as they can cause pain or compression symptoms, can be locally aggressive and can lead to cord compression. We present a young adult female with a ganglioneuroma of the right posterior mediastinum who presented with lower back pain, together with the clinical features, Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) findings, differential diagnosis tips and their contribution to surgical planning.Öğe Amyand's hernia detected incidentally in two patients(BMJ Publishing Group, 2017) Resorlu, Mustafa; Aylanç, Nilüfer; Karatag, Ozan; Ozturk, Muhsin O.The appendix is rarely present inside the inguinal hernia sac. The risk of appendicitis increases in these patients since the blood supply to the appendix can be impaired. The condition is frequently asymptomatic, and even if symptomatic it gives rise to non-specific symptoms. There is no specific laboratory finding. Diagnosis is frequently made with radiological imaging. We report two cases diagnosed as Amyand's hernia with CT. © 2017 BMJ Publishing Group Ltd. All rights reserved.Öğe An uncommon cause of multiple pulmonary nodules; hereditary hemorrhagic telangiectasia(Turkish Assoc Tuberculosis & Thorax, 2016) Kosar, Sule; Kizildag, Betul; Canan, Arzu; Karatag, Ozan; Gonlugur, Ugur; Sariyildirim, AbdullahHereditary hemorrhagic telangiectasia ( HHT), or Rendu-Osler-Weber syndrome ( ROWS) is a very rare hereditary disease. The diagnosis is based on the clinical findings such as recurrent epistaxis, telangiectases, visceral arteriovenous malformations (AVMs) and family history. AVMs are found in the liver, lung or brain and could mimick the masses of these organs. Radiologic evaluation plays a critical role during diagnostic and therapeutic management of ROWS. Hence, radiologists should be aware of the diagnosis of HHT in the patients with AVMs, history of epistaxis and family history. We report a patient with multiple pulmonary AVMs secondary to HHT who has referred to our interventional radiology department for computed tomography guided transthorasic lung biopsy procedure with suspicious of malignancy.Öğe Association Between Inherited Thrombophilia and Impaired Right Ventricular Function in Deep Vein Thrombosis Without Symptomatic Pulmonary Embolism(Sage Publications Inc, 2014) Asgun, Halil Fatih; Kirilmaz, Bahadir; Saygi, Serkan; Ozturk, Okan; Sılan, Fatma; Karatag, Ozan; Kosar, SuleThe aim was to evaluate the right ventricular function in patients with inherited thrombophilia and deep vein thrombosis (DVT) without pulmonary embolism. A total of 38 patients with DVT without symptomatic pulmonary embolism and 30 patients with varicose veins were enrolled. Clinical data, echocardiography, and 2 thrombophilic mutations were analyzed. Factor V Leiden (FVL) polymorphism was significantly frequent in the study group (P = .007). The difference in prothrombin G20210A polymorphism between the study and control groups was at a near-significant level (P = .058). There was statistically significant decrease in tricuspid annular plane systolic excursion values in patients with FVL and prothrombin G20210A polymorphism. Combined FVL and prothrombin G20210A polymorphisms were more closely related to the decrease in this value (P = .006). Deep vein thrombosis had no additional adverse effects on right ventricle. Impaired right ventricular systolic function occurs in FVL and prothrombin G20210A polymorphisms.Öğe CAN MAGNETIC RESONANCE SPECTROSCOPY ADEQUATELY DIFFERENTIATE NEOPLASTIC FROM NON-NEOPLASTIC AND LOW-GRADE FROM HIGH-GRADE LESIONS IN BRAIN MASSES?(Marmara Univ, Fac Medicine, 2010) Karatag, Ozan; Karatag, Gulden Yenice; Uysal, Ender; Can, S. Meltem; Erturk, Mehmet; Basak, MuzafferObjective: The aim of this study was to evaluate the usefulness of Magnetic Resonance Spectroscopy in the differential diagnosis of brain lesions. Materials and Methods: Forty-six patients with cerebral lesions were examined by Magnetic Resonance Spectroscopy. Choline, creatine, N-acetyl aspartate and lipid-lactate peaks were evaluated. Forty of the 46 patients underwent stereotactic biopsy or surgery. Histopathological results were compared with the Magnetic Resonance Spectroscopy results. Results: The Choline / N-acetyl aspartate ratio had the highest sensitivity (87.2%) in neoplastic versus nonneoplastic differentiation and the specificities of the Choline / Creatine, Choline / N-acetyl aspartate and Choline+Creatine / N-acetyl aspartate ratios were found to be 100%. Choline / Creatine ratios showed the highest sensitivity (95.7%) in low-grade versus high-grade differentiation and specificities of Choline / N-acetyl aspartate, Choline+Creatine / N-acetyl aspartate ratios and lipid-lactate levels were found to be 100%. Consequently, a value of Choline / Creatine > 2.2 and an accompanying lipid-lactate peak differentiated neoplasms as low-grade versus high-grade with a sensitivity of 100% (82.2-100%) and a specificity of 100% (71.7-100%). Conclusion: The presence of elevated Choline and decreased N-acetyl aspartate levels are effective in the differetiation of neoplastic versus non-neoplastic lesions with high sensitivity and specificity. A proposed ratio of Choline / Creatine > 2.2 and an accompanying lipid-lactate peak provide valuable information in differentiating low-grade from high-grade lesions.Öğe Cervical necrotizing fasciitis associated with descending necrotizing mediastinitis(Biomed Central Ltd, 2011) Gonlugur, Ugur; Guclu, Oguz; Karatag, Ozan; Mirici, Arzu; Derekoy, SefaWe report a case of potentially fatal cervical necrotizing fasciitis and descending necrotizing mediastinitis due to deep neck infection in a 66-year-old male patient with no history or evidence of immunocompromising disorders. On admission, he had painful neck movements and the skin over his neck was red, hot and tender. A computerized tomography (CT) scan of his neck and chest showed evidence of air collection in soft tissues. He was treated with broad-spectrum intravenous antibiotics and early massive cervical drainage. Prompt diagnosis by CT of the neck and chest enabled an early surgical treatment of cervical necrotizing fasciitis. Although acute mediastinitis is a fatal infection involving the connective tissues that fill the interpleural spaces and surround the median thoracic organs, an extensive cervicotomy combined with appropriate antibiotics can prevent the need for mediastinal drainage.Öğe Computed tomography analysis of the infraorbital canal and adjacent anatomical structures(Wiley, 2024) Karatag, Ozan; Guclu, Oguz; Ozer, Sule; Oztoprak, Bilge; Resorlu, Mustafa; Oztoprak, IbrahimThis study aimed to investigate the incidence of infraorbital canal (IOC) protrusion into the maxillary sinus via computed tomography (CT) and classify its variations. Additionally, it sought to identify nearby sinonasal variations that might elevate the risk of iatrogenic injury. Paranasal sinus CT of 500 patients was evaluated retrospectively. The IOC types were categorized. The length of the IOC, septum, the distance between the maxillary ostium and IOC (dOI), the presence of Haller cells, IOC-related intra-sinus opacity, and IOC dehiscence were investigated. The prevalence of type 3 IOC was 12%, of which 9.2% were type 3c. The maximum length of the IOC was positively correlated with type 3 IOC. A significant difference was found between IOC types in terms of dOI only on the left side. On both sides, the incidence of Haller cells was greater in patients with type 2 IOC than in those with type 1 and in patients with type 3 IOC than in those with type 2. IOC-related opacity and IOC dehiscence were more common in types 2 and 3 IOCs. The assessment of preoperative IOC types and neighboring anatomical structures by CT imaging is of great significance in preventing iatrogenic damage. This study aimed to investigate the incidence of infraorbital canal (IOC) types and sinonasal variations via computed tomography. The length of the IOC, septum, the distance between the maxillary ostium and IOC (dOI), presence of Haller cells, IOC-related intra-sinus opacity, and IOC dehiscence were also investigated. The CT assessment of preoperative IOC types and neighboring anatomical structures is of great significance in preventing iatrogenic damage.imageÖğe Diffusion Weighted MRI for Hepatic Fibrosis: Impact of b-Value(Kowsar Publ, 2014) Ozkurt, Huseyin; Keskiner, Firat; Karatag, Ozan; Alkim, Canan; Erturk, Sukru Mehmet; Basak, MuzafferBackground: Hepatic fibrosis is a typical complication of chronic liver diseases resulting in cirrhosis that remains a major public health problem worldwide. Liver biopsy is currently the gold standard for diagnosing and staging hepatic fibrosis. Percutaneous liver biopsy; however, is an invasive procedure with risks of complications. Therefore, there is need for alternative non-invasive techniques to assess liver fibrosis and chronic liver diseases. In recent years, MRI techniques, including diffusion weighted imaging (DWI), have been developed for in vivo quantification of liver fibrosis. Objectives: The purpose of this study is to evaluate the utility of diffusion weighted MRI in the diagnosis and quantification of the degree of hepatic fibrosis and to investigate the influence of b-value. Patients and Methods: Twenty-four patients (13 males, 11 females), with a mean age of 46 years (36-73 years) diagnosed as chronic hepatitis and histopathologically proven liver fibrosis and 22 other patients (8 males, 14 females) with no clinical or biochemical findings of liver disease, with a mean age of 51.2 years (32-75 years) were included in the study. All patients with chronic hepatitis underwent percutaneous liver biopsy by an experienced hepatologist without sonographic guidance. The Knodell histology activity index (HAI) for grading of necroinflammatory changes and Metavir scoring system for staging of the liver fibrosis were used to record the severity of the disease. All patients were examined with a 1.5 Tesla MRI system and the patients underwent diffusion weighted imaging (DWI) with a routine hepatic MRI protocol. Different b-values including 250, 500, 750, and 1000 sec/mm(2) were used to calculate apparent diffusion coefficients. Results: We detected decreased apparent diffusion coefficient values in patients with hepatic fibrosis compared to patients without chronic hepatitis and there was a trend toward decrease in hepatic apparent diffusion coefficient values with an increasing degree of fibrosis. Conclusions: Our findings suggest that hepatic apparent diffusion coefficient measurement with a b-value of 750 sec/mm(2) or greater is useful in accurate quantification of liver fibrosis and necroinflammation.Öğe Dural sinus filling defect: Intrasigmoid encephalocele(2013) Karatag, Ozan; Cosar, Murat; Kizildag, Betul; Sen, Halil MuratFilling defects of dural venous sinuses are considered to be a challenging problem especially in case of symptomatic patients. Many lesions have to be ruled out such as sinus thrombosis, arachnoid granulations and tumours. Encephalocele into dural sinus is also a rare cause of these filling defects of dural sinuses. Here, we report an extremely rare case with spontaneous occult invagination of temporal brain tissue into the left sigmoid sinus and accompanying cerebellar ectopia. Copyright 2013 BMJ Publishing Group. All rights reserved.Öğe Epidural Abscess Due to a Mycobacterium tuberculosis Strain with Primary Resistance to Isoniazid and Ethambutol(Ankara Microbiology Soc, 2012) Sener, Alper; Alper Akçalı; Karatag, Ozan; Kosar, Sule; Degirmenci, Yildiz; Akman, TarikTuberculosis is primarily characterized by pulmonary involvement, however, one third of the cases exhibit extrapulmonary tuberculosis. In this report, a case of epidural abscess due to Mycobacterium tuberculosis with primary resistance to isoniazid and ethambutol was presented. A 57-year-old male patient was admitted to emergency service with ten days history of weakness in legs, disability of walking and fever. Neurological examination revealed paraplegia of lower extremities, numbness distal to T2 disc level and hyperactivity of deep tendon reflexes indicating transverse myelitis. Laboratory findings were as follows; ESR: 74 mm/hour, CRP: 22 g/L, ALT: 42 IU/L, AST: 45 IU/L and white blood cell count 23.000/mm(3) (45% polymorphonuclear leukocyte, 45% lymphocyte, 10% monocyte). Spinal magnetic resonance imaging showed a fusiform abscess localized at anterior epidural space and extending along levels of C5-6 and C6-7. The longitudinal dimension of the abscess was 3 cm. The lesion was hypoin-tense on T1 and hyperintense on T2 weighted MRI images with prominent rim shaped contrast enhancement on contrast-enhanced T1-weighted images. At fourth day of hospitalization the patient underwent neurosurgical management. M.tuberculosis was isolated from the cultures of operation material by Mycobacteria Growth Incubator Tube system (MGIT, BBL; BD, USA) on the 12th day. The isolate was found susceptible to streptomycin and rifampisin, but resistant to isoniazid and ethambutol. The treatment was initiated with rifampicin 600 mg/day, pyrazinamid 2 g/day, ethambutol 1.5 g/day and levofloxacin 500 mg/day. At the end of second month levofloxacin 500 mg/day and rifampisin 600 mg/day combination was sustained and total treatment period was planned as nine months. As far as the national literature was considered, this was the first case of extrapulmonary tuberculosis with primary resistance to isoniazid and ethambutol.Öğe Frequency and Clinical Significance of Incidental Findings Detected in Internal Acoustic Canal Magnetic Resonance Imaging of Patients with Audiovestibular Symptoms(Kare Publ, 2022) Eker, Nebil; Karatag, Ozan; Resorlu, Mustafa; Ozer, Sule; Eker, Esen; Guclu, Oguz; Ozkurt, HuseyinObjectives: Retrocochlear pathology associated with audiovestibular symptoms is detected in very few of the patients, and most of the internal acoustic canal magnetic resonance imaging examinations (IAC-MRIs) are either completely normal or include accompanying incidental findings (IFs). The aim of our study is to reveal the presence and frequency of IFs in IAC-MRIs, together with retrocochlear lesions. In addition, we intend to emphasize the clinical importance of these IFs. Methods: A retrospective analysis of 374 serial IAC-MRI scans. Results: Gender distribution: 201 males and 173 females. Age range: 2-82 years. Seventy-two scans (19.25%) were totally normal. Fifteen scans (4.01%) demonstrated only pontocerebellar angle findings (PCAFs). The presence of PCAF and IF was together in 57 scans (15.24%). In 230 (61.50%) of the scans, only IFs were present. The incidence of IFs in all IAC-MRIs was 76.74% (287 of 374). Critical findings that may require clinical further evaluation and examination were present in 34 scans (9.09%). IFs that did not require further examination were observed in 253 scans (67.65%). Conclusion: Various IFs can be detected with IAC-MRI that may cause similar symptoms with PCAF. And unfortunately, some of these IFs may be of very high clinical importance. All referral clinicians should know well that these audiovestibular symptoms can appear as IFs anywhere in the auditory pathway, and how they should be followed in their clinical approach.Öğe Gaucher's disease in a patient presenting with hip and abdominal pain(Assoc Medica Brasileira, 2017) Resorlu, Mustafa; Aylanc, Nilufer; Karatag, Ozan; Toprak, Canan AkgunGaucher's disease is characterized by glucocerebroside accumulation in the cells of the reticuloendothelial system. There are three subtypes. The most common is type 1, known as the non-neuropathic form. Pancytopenia, hepatosplenomegaly and bone lesions occur as a result of glucocerebroside accumulation in the liver, lung, spleen and bone marrow in these patients. Findings associated with liver, spleen or bone involvement may be seen at radiological analysis. Improvement in extraskeletal system findings is seen with enzyme replacement therapy. Support therapy is added in patients developing infection, anemia or pain. We describe a case of hepatosplenomegaly, splenic infarction, splenic nodules and femur fracture determined at radiological imaging in a patient under monitoring due to Gaucher's disease.Öğe Glenohumeral joint tuberculosis with multiple cold abscesses: An uncommon cause of shoulder pain(2013) Kizildag, Betul; Sener, Alper; Komurcu, Erkam; Karatag, Ozan; Kosar, SuleThe musculoskeletal system involvement of tuberculosis (TB) other than spinal TB is a rare and less-known entity. Furthermore symptoms of musculoskeletal involvement of TB infection are non-spesific, relatively slow and indolent. The diagnosis of TB is less considered by clinicians among other common causes of shoulder pain including traumatic and degenerative conditions. We reported a 72-year-old patient suffering shoulder pain for the last 2 years who was diagnosed with glenohumeral joint TB arthrithis associated with multiple cold abscesses in adjacent soft tissues; emphasising significant clinical and imaging findings.Öğe Incidentally Diagnosed Osteopoikilosis: A Case Report(Galenos Yayincilik, 2017) Resorlu, Mustafa; Karatag, Ozan; Toprak, Canan Akgun; Doner, DavutOsteopoikilosis is a rare bone dysplasia. Patients are generally asymptomatic and are frequently identified during radiological imaging by coincidence. The epiphysis and metaphysis of the long bones, the phalanges and pelvic bones are the localizations which frequently involved. It appears as oval or round, homogeneous, symmetrical, uniform, radio-opacities. Osteoblastic metastases, mastocytosis, tuberous sclerosis and Paget's disease should be considered in differential diagnosis.Öğe Invasive lobular carcinoma of the breast: mammographic and sonographic evaluation(Aves, 2011) Albayrak, Zeynep Kirkali; Onay, Hulya Kapran; Karatag, Gulden Yenice; Karatag, OzanPURPOSE To evaluate the efficacy of mammography and sonography together in the assessment of patients with pure invasive lobular carcinomas (ILCs) of the breast. MATERIALS AND METHODS We retrospectively reviewed 38 cases of pure invasive lobular carcinomas of the breast. The tumors were evaluated both mammographically and sonographically. The mammographic images were reviewed by two experienced mammographers. All patients underwent surgical management. Histopathologic assessments were made by experienced breast pathologists. RESULTS On physical examination, six tumors (15.7%) showed no clinical findings. The most common mammographic result was a spiculated mass or architectural distortion (42%). Eleven lesions (29%) were mammographically negative. Five cases (13%) showed pleomorphic or heterogeneous calcifications that were compatible with Breast Imaging Reporting and Data System (BI-RADS) 4 or 5. The most common sonographic result was a hypoechoic mass with or without shadowing (60.5%). Four tumors (10.5%) were sonographically invisible. Two cases (5%) were negative, and 25 cases (65.8%) were positive in both modalities. The overall sensitivity was 71.05% for mammography and 89.47% for sonography. The number of tumors detected by either of these two modalities was 36, and the overall sensitivity was 94.73%. CONCLUSION Mammography and ultrasonography are useful imaging methods in the evaluation of invasive lobular carcinoma. Because of the low rate of suspicious calcifications and low density of lesions, the false-negative rate tends to be high for these tumors. With the use of sonography and mammography together, invasive lobular carcinomas can be detected with a sensitivity of 94.73%. We recommend additional sonographic evaluations for all patients, especially those with dense breast tissue with or without positive mammographic findings.Öğe Is there an advantage of three dimensional computed tomography scanning over plain abdominal radiograph in the detection of retained needles in the abdomen?(Elsevier Science Bv, 2013) Hacivelioglu, Servet; Karatag, Ozan; Gungor, Aysenur Cakir; Gencer, Meryem; Kosar, Sule; Kizildag, Betul; Yildiz, Yavuz[Anstract Not Available]Öğe Laparoscopic Repair of Combined Right Diaphragm and Liver Injuries with a Sharp Object: A Case Report(Hindawi Ltd, 2013) Arik, M. Kasim; Tas, Sukru; Ozkul, Faruk; Sahin, Hasan; Karatag, Ozan; Karaayvaz, MuammerIntroduction. Diaphragm injuries develop following penetrating or blunt traumas. The purpose of the case report is to present a 28 year old male patient with stable hemodynamic findings treated with laparoscopic approach following a liver injury combined with a right diaphragm injury caused by a sharp penetrating object. Case. 4 cm long transverse laceration was observed near the middle axillary line in the 6th right intercostal space in the examination performed on a 28 year old male patient who applied to the emergency service due to sharp penetrating object injury. Respiratory sounds were decreased in the right side and the examination revealed sensitivity in the abdomen. Elevation in the right diaphragmand hemopneumothorax was monitored in chest X-ray and computerized tomography. Closed subaqueous thorax drain was placed and the patient was taken to the surgery with a right diaphragm injury prediagnosis. Laparoscopic exploration was performed to the patient with stable hemodynamic findings by entering through 10 mm port above the abdomen. 6 cm long injury at the right side of diaphragm and approximately 2 cm deep at the deepest point and 5 cm long linear laceration was observed in the 7th segment of the liver. The diaphragm was repaired laparoscopically with sutures that do not melt on their own. Tampon was applied to the laceration in the liver and bleeding control was performed with suture. Patient was discharged on the 3rd day because he had no problems during postoperative follow-ups. Result. No noticed right side diaphragm rupture and possible concomitant visceral organ injuries following a penetrant injury that can cause significant mortality and morbidity should be definitely kept in mind. The detection of right side diaphragm and liver injury is vital with high mortality in case of delayed diagnosis, and direct radiography and computerized tomography are helpful in the diagnosis. Surgical treatment with laparoscopic approach is a method that leads to less hospitalization duration and less pain in cases that are hemodynamically stable.Öğe Lumbar magnetic resonance imaging findings in Guillain-Barre syndrome(Elsevier Science Inc, 2016) Resorlu, Mustafa; Guven, Mustafa; Aylanc, Hakan; Karatag, Ozan[Anstract Not Available]Öğe Malignant fibrous histiocytoma in a patient presenting with urinary system symptoms(Assoc Medica Brasileira, 2017) Resorlu, Mustafa; Karatag, Ozan; Uysal, Fatma; Ozturk, MuhsinMalignant fibrous histiocytoma is a rare tumor. It is most commonly seen in individuals between the fifth and seventh decades of life, in extremities, and less frequently in the retroperitoneum. Although its etiology is not clearly known, radiotherapy, chemical agents, previous history of surgery, trauma and fracture, and Hodgkin lymphoma have been blamed. Leiomyosarcoma, liposarcoma and rhabdomyosarcoma should be taken into account in differential diagnosis. It is seen on computed tomography as a mass lesion with irregular borders and density similar to that of the surrounding muscle tissue. Necrotic and hemorrhagic components in the mass are characterized as heterogeneous low density areas. Fluid-fluid levels can be detected by computed tomography and magnetic resonance imaging.
