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Öğe An unusual intraosseous calcaneal lipoma: Case report(Sağlık Araştırmaları ve Stratejileri Derneği, 2018) Alkan, Ender; Erdoğan, Hasan; Kara, TurgayIntraosseous lipoma, a rare primary benign tumor of the skeleton, is most commonly found in the calcaneus. It may contain homogenous fat, but it may also contain necrosis, calcification, or ossification. It usually does not show contrast enhancement, but there is an interface enhancement between the outer fat plan and the inner fluid part. Herein, we present an unusual 22-year-old male case of calcaneal intraosseous lipoma with contrast enhancement in the fatty component. The lesion was totally curetted and replaced with bone graft. The pathological diagnosis was reported as an intraosseous lipoma. The correct diagnosis of an atypical calcaneal intraosseous lipoma is very important to prevent an unnecessary biopsy and treatment.Öğe Determination of the Cricothyroid Membrane Height by Age and Sex and Optimal Tracheal Tube Size(John Wiley and Sons Inc, 2024) Kokulu, Kamil; Alkan, Ender; Sert, Ekrem T.; Mutlu, Hüseyin; Türkücü, Çağrı; Akar, Emin H.The primary aim of this study was to determine the average cricothyroid membrane (CTM) height in healthy volunteers, and the secondary aim was to determine the hypothetical success rate for emergency cricothyrotomy with a tracheal tube with an 8.0 mm outer diameter. Methods: This study included healthy volunteers aged 18 years and older. The participants' clinical characteristics were recorded, and their CTM height was measured using ultrasound, with their necks placed sequentially in the neutral and extension positions. The relationship between the CTM height and sex, age, height, weight, body mass index, and sternomental distance was evaluated using linear regression analysis. An equation that could estimate the height of the CTM was obtained with the parameters found significant in this analysis. Results: Of the 340 participants, 208 (61.2%) were male. The mean (SD) height of the CTM in the extension position was 9.60 (1.54) mm, and it was significantly shorter in the women than in the men (8.72 [1.19] mm vs. 10.16 [1.48] mm, p < 0.001). Among the participants of short stature, the CTM was significantly shorter, regardless of sex. The hypothetical success rate for emergency cricothyrotomy was 93.3% for the males and 73.5% for the females. The equation for estimating the height of the CTM in the extension position was determined as ?4.36 + 5.27 × height (m) + 0.32 × sternomental distance (cm). Conclusions: Since the CTM height may differ according to age, sex, and height, cricothyrotomy sets should be available in various outer diameters.Öğe Global ischemia of the cerebellum: The dark cerebellar sign(Ubiquity Press Ltd, 2019) Yılmaz, Cengiz; Alkan, Ender; Erdoğan, Hasan[Abstract Not Available]Öğe Magnetic resonance imaging findings of a patient with bilateral submandibular gland aplasia(Sağlık Araştırmaları ve Stratejileri Derneği, 2018) Alkan, Ender; Kara, Turgay; Öztürk İnal, ZeynepAplasia of the major salivary glands are very rare, and commonly occurs at the parotid gland. Patients are usually asymptomatic and diagnosed incidentally. But dry mouth, difficulty in swallowing, dental problems may be seen. Also mass complaints may occur due to compensatory hypertrophy of the other major salivary glands. Herein, we presented the magnetic resonance imaging findings of a very rare case of bilateral submandibular gland aplasia with compensatory hypertrophy of sublingual glands.Öğe Morphometric study of cervical spinal canal and transverse foramen diameter using computed tomography: Sex difference and relationship to age in Turkish population(Lippincott Williams and Wilkins, 2023) Tuncer, Işık; Alkan, EnderAccurate and detailed spinal canal diameter transverse foraminal morphometry measurements are essential for understanding spinal column-related diseases and surgical planning, especially for transpedicular screw fixation. This is especially because lateral cervical radiographs do not provide accurate measurements. This retrospective study was conducted to measure the dimensions of the transverse foramen sagittal and transverse diameter (TFD), spinal canal diameter, the distance of the spinal canal from the transverse foramina at the C1 to C7 cervical level, and the anteroposterior and TFDs in the Turkish population. A total of 150 patients who underwent cervical spine computed tomographic imaging with a 1:1 gender ratio were enrolled in the study. The sagittal and TFDs of the spinal canal, the distance of the spinal canal from the transverse foramen, and anteroposterior and TFDs in both right and left sides for all cervical levels C1 to C7. Foramina transversal diameters were measured using imaging tools of the imaging software in the radiology unit. The mean age of the study group was 47.99 ± 18.65 (range, 18–80) years. The majority of the distances of the spinal canal from the transverse foramen and antero-posterior (AP) & transverse (T) diameters for cervical vertebrae were significantly higher in male patients (P < .05). However, between age groups, a few measurements were found significantly different. Some of the distances of the spinal canal from the transverse foramen were significantly higher on the right side whereas all AP & T diameters were significantly higher on the left side in both male and female patients (P < .05). Almost all measurements were significantly higher on the left side for younger patients (<65 years) whereas only AP & T diameters were significantly higher on the left side for older patients (>65 years) (P < .05). Computed tomographic imaging is better than conventional radiographs for the preoperative evaluation of the cervical spine and for a better understanding of cervical spine morphometry. Care must be taken during transpedicular screw fixation, especially in female subjects, more so at the C2, C4, and C6 levels due to decreased distance of the spinal canal from the transverse foramina.Öğe Parotis kitlelerinin karakterizasyonunda sonoelastografinin yeri(Aksaray Üniversitesi, 2020) Alkan, Ender; Cevheroğlu, Selman; Özberk, Ömer; Tolu, İsmet; Eryılmaz, Mehmet AliAmaç: Biz bu çalışmamızda parotis lezyonlarının benign malign ayırımında non invazif yeni bir test olan sonoelastografi etkinliğini araştırdık. Gereç ve yöntem: Bu çalışmada, Haziran 2012-Ekim 2013 tarihleri arasında Konya Eğitim ve Araştırma Hastanesi Radyoloji KliniğiUltrasonografi bölümüne, parotis bezi kitlesi ön tanısı ile yönlendirilen 34 hasta prospektif olarak incelendi. Hastaların ultrasonelastografi sonuçları daha sonra kesinleşen histopatolojik tanıları ile karşılaştırmak için kaydedildi. Değerlendirme gerçek zamanlı elastografi yazılımı bulunan ultrasonografi Toshiba aplio MX cihazı ( Toshiba Medikal, Nasu; Japonya) ile 12 MHz probu kullanılarak yapıldı. Elastogramlar elde olunduktan sonra iligili alana ‘region of interest’ (ROI) yardımıyla kitlenin ve aynı hizadaki komşu normal parotis dokusunun gerinimi sayısal değer olarak ölçülüp oranlandı. Bulgular: Değerlendirilen 34 hastanın en küçüğü 14, en büyüğü 85 yaşında olup, yaş ortalamaları 51.76 idi. Hastaların 20’si erkek (%58.82), 14’ü bayan (%41.18) idi. Olguların yapılan histopatolojik değerlendirilmesinde %47.05’i benign tümör, %38.24’ü diğer benign lezyonlar ve % 14.71’i malign tümör tanısı aldı. Sadece tümöral kitleler dikkate alındığında toplam 21 vakanın 16’sı (%76.19) benign (11 pleomorfik adenom, 5 Whartin tümörü) ve 5’i (%23.81) malign idi. Ortalama gerinim oranı değerleri benign kitleler için 1.67±1.29, malign kitleler için ise 2.27±1.55 olarak hesaplandı. Malign ve benign kitlelerin gerinim ortalamasının karşılaştırılmasında istatistiksel olarak anlamlı fark saptanmadı (p=0.357). Sonuç: Parotis bezi malign ve benign kitlelerin ayırımında sonoelastografinin etkin olmadığını gözlemledik.Öğe Predictors of adverse perinatal outcomes in women at 40 weeks or more of pregnancy(Publishing Office of the University of Rzeszow, 2023) Sert, Zekiye Soykan; Evren Dilmaç, Ayşegül; Alkan, Ender; Sert, Ekrem TahaIntroduction and aim. To evaluate the clinical features of women at ?40 weeks of pregnancy and the utility of obstetric Doppler indices in predicting adverse perinatal outcomes in these pregnancies. Material and methods. This prospective study was conducted at a single academic medical center between 2020 and 2022. Women aged 18 years and older with no risk factors who were at ?40 weeks of pregnancy and delivered their babies in our hospital were included in the study. The fetal biometry, placental maturity grading, and doppler velocytometry indices of the pregnant women were evaluated. The cases were divided into two groups according to the development of adverse perinatal outcomes. The relationship between clinical features and adverse perinatal outcomes was evaluated. Results. Adverse perinatal outcomes developed in 19.6% (42) of the 214 cases. The multiple logistic regression analysis was performed to identify factors affecting perinatal outcomes. Accordingly, a maternal age of ?35 years (odds ratio [OR]: 1.74, 95% confidence interval [CI]: 1.29-3.96, p=0.038), nulliparity (OR: 1.42, 95% CI: 1.13-4.63, p=0.040), and grade 3 placental calcification (OR: 1.98, 95% CI: 1.11-4.53, p=0.029) were independent predictors of adverse perinatal outcomes. Conclusion. Care should be taken in terms of adverse perinatal outcomes in the presence of nulliparity, a maternal age of ?35 years, and grade 3 placental calcification in ?40 week pregnancies.Öğe The incidence of biliary sludge in first trimester pregnancies with hyperemesis gravidarum and its effect on the course of hyperemesis gravidarum(Taylor & Francis, 2022) Sağlam, Aylin; Derwig, Iris; Sezik, Mekin; Tuncer, Sibel Çiğdem; Özçil, Mustafa D.; Kasap, Burcu; Mısırlıoğlu, Mesut; Alkan, Ender; Özkan, NamıkPregnancy is one of the risk factors for biliary sludge (BS) formation. In this cross-sectional study, a total of 959 pregnant women were included. Serum aspartate aminotransferase, alanine aminotransferase, sodium, potassium, triglycerides, cholesterol levels and the presence of ketones in urine were determined. The presence of BS was investigated using maternal abdominal ultrasound. The incidence of BS in pregnancies complicated by hyperemesis gravidarum (HG) was 14%. The degree of ketonuria and low birth weight were statistically higher in pregnancies with maternal BS than women without sludge. Total weight gain during pregnancies with BS was statistically lower than controls. The incidence of BS in pregnancies with HG does not appear to increase due to HG-related complications, such as dehydration, starvation and weight loss. However, the severity of HG may be worse when HG is associated with sludge.Impact Statement What is already known on this subject? The incidence of biliary sludge (BS) in pregnant women ranges between 10.9% and 36%. Some clinical conditions, such as pregnancy, prolonged fasting, total parenteral nutrition, rapid weight loss and ceftriaxone treatment can play a role in the formation of gallbladder sludge. What do the results of this study add? This is the first study to investigate the incidence of BS in hyperemesis gravidarum (HG) pregnancies. Results show that HG may transiently be associated with BS. HG is more likely to cause a transient increase in new sludge formation. The symptoms and complications related to HG may be more severe when HG is associated with BS. What are the implications of these findings for clinical practice and/or further research? Our study showed that BS can be found in HG patients, and HG can be a predisposing factor for new sludge formation, although this association is generally driven by advanced maternal age and increased baseline serum lipid and alanine aminotransferase levels. BS may also be independently associated with an increased risk of subsequent preterm delivery in women with HG.Öğe The relationship between saphenofemoral junction insufficiency and varicocele(Blackwell Publishing Ltd, 2020) İnal, Hasan Ali; Gönen, Murat; Tolu, İsmet; Alkan, EnderThe aim of the study was to investigate whether or not there is a significant relationship between varicocele and SFJ insufficiency. This study included 200 men with (study group) and 200 men without (control group) primary varicocele which was initially diagnosed by observation during the Valsalva manoeuver. Subsequently, scrotal and lower extremity venous Doppler ultrasonography (USG) was performed by a senior radiologist, and participants with testicular veins >3.0 mm in diameter and reverse blood flow were determined to have varicocele. SFJ insufficiency was defined as retrograde flow in the SFJ of longer than 0.5 s. Retrograde venous flow in the pampiniform plexus was determined 3.5% (study) versus 0.0% (control) and 77.0% (study) versus 0.0% (control) in the right testis and left testis, respectively, and bilaterally at 11.5% (study) versus 0.0% (control). The presence of SFJ insufficiency was also found to be higher in the study group than in the control group (unilaterally: 26.0% versus 15.0%; bilaterally: 14.0% versus 5.0%). The current study demonstrates a statistically significant relationship between varicocele and SFJ insufficiency and supports the argument that varicocele is not a local disease and may be attributable to a systemic vascular insufficiency. Additional studies with larger series are needed to further elucidate this topic.
