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Öğe Absence of infrarenal inferior vena cava is not a congenital abnormality(Comenius Univ, 2009) Alicioglu, Banu; Kaplan, Mustafa; Ege, TuranThe absence of inferior vena cava (IVC) is one among infrequent subtypes of IVC abnormalities that are rarely seen in general population. The absence of IVC involves either that of entire IVC or that of infrarenal segment. These two entities are relatively similar but their etiopathogeneses are still controversial. The absence of the entire IVC is thought to be a result of an embryologic disorder, whereas perinatal thrombosis is hypothesised to lead to the development of absent infrarenal IVC, thus the latter is a developmental disorder and the former occurs due to embryologic disorder. We report an adult man with renal-infrarenal absence of IVC, as well as missing common iliac veins. He clinically presented with extensive varicose collateral circulation on the thoracoabdominal wall, right varicocele and severe varices on lower limbs. Calcifications of adrenal glands indicate a hematologic disorder during perinatal period. The etiopathogenesis of this unusual abnormality is emphasized in this case report (Fig. 5, Ref. 10). Full Text (Free, PDF) www.bmj.sk.Öğe Bilateral Anterior Inferior Iliac Spine Avulsion in an Adolescent Soccer Player: A Typical Imitator of Malignant Bone Lesions(Lippincott Williams & Wilkins, 2009) Karakas, Hakki Muammer; Alicioglu, Banu; Erdem, GulnurAvulsion fractures are usually diagnosed easily in acutely presented cases. The diagnosis becomes definite if clinical and radiological follow up reflect the fracture's healing phase. A 13-year-old soccer player with bilateral anterior inferior iliac spine (AIIS) avulsion, who had been examined in other institutions with a pre-diagnosis of malignancy, is reported. Clinically, such cases display the importance of medical management of athletic injuries by specially trained physicians. From the perspective of preventive medicine, the high incidence of AIIS injuries-during soccer games, and the bilateral nature of the damage mandate a review of the training programs and shooting techniques for adolescent players.Öğe Bile duct anatomy of the Anatolian Caucasian population: Huang classification revisited(Springer France, 2008) Karakas, Hakki Muammer; Celik, Tayfun; Alicioglu, BanuBackground and objectives Living donor liver transplantations (LDLT) donor candidates are being assessed with MRCP (magnetic resonance cholangiopancreatography) to identify their suitability for standard surgical techniques. Variations of the bile duct anatomy play an important role in donor selection and in the selection of the resection technique. If bile duct anatomy is misrecognized, complications may occur. Anatomic variations are classified according to the origin of the right posterior hepatic duct (RPHD). According to the so called Huang classification, type A1 is the most, and type A5 is the least frequent variation. These frequencies were initially validated on Chinese population. Later studies revealed significant variability in frequency for the so called trifurcation, the variation in which a common junction of RHPD, right anterior hepatic duct (RAHD) and left hepatic duct (LHD) (A2) exists. In this study we aimed to determine the bile duct anatomy variations for the Anatolian Caucasians. Methods One hundred and thirty-four healthy subjects were investigated under 1.5 T MRI, with breath-hold (expiration) heavily T2-weighted turbo spin echo (TSE) static fluid imaging (TR/TE = 8,000/800). The sequence has permitted three to five oblique coronal thick sections (40 mm) around a common axis. Sequences were repeated until anatomically interpretable images were obtained. Diagnostic images could not be obtained in 22 subjects. Radiologists who were fully experienced in LDLT assessment investigated these images, and classified them for the surgical variations of the bile duct anatomy. One hundred and twelve subjects (58 men, 54 women) who were classified were between 14 and 81 years of age (mean: 39.3; SD 14.1). According to Huang classification, 61 of them (55%) were classified as type A1 (normal right and left hepatic duct junction), 16 (14%) as type A2 (common junction of RAHD, RHPD and LHD), 24 (21%) as type A3 (aberrant drainage of RPHD to left main duct), and 11 (10%) as type A4 (aberrant drainage of RPHD to main hepatic duct). When subjects, in whom the distance (d) between RPHD insertion and the right and left hepatic duct junction is less than 1 cm, are classified as type A2, the type A1 prevalence decreases to 28%. For the entire population that distance was between 3 and 25 mm (mean: 9.8, SD: 4.8). Accordingly, the frequency of type A1 anatomy was 8-29% lower than the respective frequency in Chinese population. Conclusion From the surgical perspective, close proximity (d < 1 cm) of RPHD to right and left hepatic duct junction is considered as type A2 variation. According to that concept, type A1, usually accepted as the dominant anatomic variation, is encountered only in 28% of the Anatolian Caucasians. We have proposed a modified surgical classification in which Huang type 2 was subdivided into types K2a (close proximity) and K2b (trifurcating). The predominance of K2 types in the population of the study may necessitate the use of bench ductoplasty in many liver grafts.Öğe Blind-ending duplicate ureter with giant cystic dilatation(Aves, 2009) Kaplan, Mustafa; Alicioglu, Banu; Aktoz, Tevfik; Altaner, Semsi; Inci, OsmanBlind-ending ureter is a rare ureteric duplication anomaly. Most cases are asymptomatic and are detected incidentally. Blind-ending ureter with a huge cystic dilatation is extremely unusual. A 46-year-old man with a complaint of low back pain was referred from the neurosurgery department upon demonstration of a large cystic mass in the retroperitoneum by lumbar magnetic resonance imaging. Ultrasonography showed a large cystic mass filling the right side of the abdomen and the entire pelvis. Intravenous urography showed malrotation and lateral deviation of the right kidney with grade 1 hydronephrosis, severe dilatation of the ureter with proximal kinking, and medial deviation of the ureter. Computed tomography revealed a huge cystic mass beginning at the medial aspect of the upper pole of the right kidney, filling the right half of the abdomen and all the pelvis. The cyst had septations in the pelvis. Cyst aspiration yielded no atypical cells. During surgical exploration, it was noted that the cyst extended to the level of the upper pole of the right kidney and opened into the bladder with an ectopic orifice superior to the right ureter, suggesting the presence of a blind-ending ureter. The normal ureter was dilated and compressed. During resection of the cystic mass, the right ureter was injured and ureteroneocystostomy was performed. Histopathologic identification of the cystic lesion was made as uroepithelial cells. No complication was seen in postoperative period.Öğe Congenital upper thoracic spondyloptosis with multiple other associated anomalies(Wiley-Blackwell Publishing, Inc, 2009) Alicioglu, Banu; Demir, Mustafa Kemal; Durmus, Yavuz[Abstract Not Available]Öğe Does abdominal obesity cause increase in the amount of epidural fat?(Springer, 2008) Alicioglu, Banu; Sarac, Armagan; Tokuc, BurcuIt is known that epidural fat does not alter in obese people. This study aims to find out a possible relationship with epidural fat and abdominal obesity. In this cross-sectional study, 63 patients who were referred to our clinic for lumbar magnetic resonance imaging (MRI) examination were evaluated. Patients with the history of steroid treatment, thyroid disease or Cushing disease were excluded. Waist circumferences (WC), body weight and height were measured and subsequently body-mass index (BMI) was calculated (kg/m(2)). On midsagittal T1-weighted images, anterior epidural fat (AEF), posterior epidural fat (PEF) and posterior subcutaneous fat (SCF) thicknesses were measured at the S1 level. The results were compared with age, gender, body weight, height, WC and BMI. There were 31 men and 32 women, age ranged 19-77 years (mean 49). The mean BMI was 29.25 kg/m(2) (20.7-52.7); the mean WC was 97.4 +/- 13.2 cm (72-122) in women and 97.6 +/- 9.8 cm (72-118) in men. Cutoff value of WC was considered as 88 cm for women and 95 cm for men. BMI > 27.5 was considered to be obese. No statistical difference with respect to epidural fat thickness between genders was determined in AEF and PEF (P = 0.237, P = 0.616). SCF was significantly thicker in women (P = 0.021). A very poor and negative correlation was found between age and PEF (r = 0.373, P = 0.003), and a very poor and positive correlation between weight and PEF was found (r = 396, P = 0.001). The thickness of the epidural fat was not differ between obese and nonobese people (p = 0.571 for AEF and p = 0.307 for PEF). The thickness of the epidural fat was not different in people whose WC was greater than normal values in both gender (p > 0.05). Epidural fat is not affected by age, gender, BMI and WC which means that epidural fatty layer. A clear correlation has not been found between epidural fat amount and obesity or abnormal fat distribution yet.Öğe The Effects of Smoking after Meals on Superior Mesenteric Artery and Portal Vein Haemodynamics: A Doppler Ultrasonography Study(Marmara Univ, Fac Medicine, 2011) Babaoglu, Orhan; Alicioglu, Banu; Sacit, EmenObjective: To assess changes in mesenteric blood flow caused by smoking after meals in healthy young adults. Subjects and Methods: A total of 50 participants, 22 smokers and 28 non-smokers, were enrolled in the study. Volunteers were divided into three groups: group A, non-smokers (n=28), group B, smokers and smoked postprandially (n=18), group C, smokers but were not allowed to smoke postprandially (n=16). Twelve people participated in both groups B and C. Doppler sonography was performed when the participants were hungry (baseline) and was repeated 30, 60, and 90 minutes after a standard meal. SMA (superior mesenteric artery) and PV (portal vein) flow parameters were measured. Results: The peak systolic velocity (PSV) of the SMA were significantly higher both baseline and postprandial in group B (p=0.048). The mean vessel diameters and flow volume group averages did not differ based on smoking (F=1.542, p=0.222; F=2.082, p=0.134). Variations in SMA diameter averages in the three groups were different (F=6.406, p<0.001). The mean maximum velocity of the PV and the peak systolic velocity of the SMA were the lowest in group C (p=0.048 and p=0.026). Conclusion: Both smoking and breaking the habit of postprandial smoking diminish mesenteric flow.Öğe Imaging Features of the Total Anomalous Pulmonary Venous Connection to the Portal Vein Shown by Multidetector Computed Tomography Angiography(Springer, 2009) Karakas, Ilakki Muammer; Alicioglu, Banu; Kandaz, Asli[Abstract Not Available]Öğe An incidental case of triple gallbladder(Baishideng Publishing Group Inc, 2007) Alicioglu, BanuTriplication of the gallbladder is a very rare congenital anomaly of the biliary tract; there are only eleven reported cases to date. Gallbladder multiplications are not likely to be discovered unless associated with cholelithiasis, sludge, cholecystitis and carcinoma. Here we report an incidentally diagnosed triplicate gallbladder in a patient with sigmoid diverticulitis; two of the triplicate gallbladder were demonstrated with ultrasound and computed tomography, and an additional galballder was found at surgery. (C) 2007 The WJG Press. All rights reserved.Öğe Injuries associated with motorcycle accidents(Turkish Assoc Orthopaedics Traumatology, 2008) Alicioglu, Banu; Yalniz, Erol; Eskin, Deniz; Yilmaz, BarisObjectives: In recent years, there has been a significant increase in motorcycle accidents in parallel with the increasing number of motorcyclists. Data on motorcycle accidents/injuries are relatively limited in Turkey. This study sought to determine the injury profile of patients involved in motorcycle accidents. Methods: This retrospective study included 212 patients (204 males, 8 females; mean age 36 16 years; range 2 to 79 years) who were hospitalized for injuries caused by motorcycle accidents. Data on age and sex, injury patterns, length of hospitalization were recorded. Injuries were grouped according to localization. Results: The frequencies of injuries in descending order were as follows: musculoskeletal system injuries (n=106, 50% skull injuries (n=103, 48.6%), maxillofacial injuries (n=38, 17.9%), thoracic (n=15, 7.1% vertebral (n=10, 4.7%), and abdominal (n=6, 2.8%) injuries. Multiple fractures in upper and lower extremities were seen in 17 (8%) and 43 (20.3%) patients, respectively. The most frequent extremity injuries were tibia-fibula fractures (17.9%) followed by shoulder injuries (11.3%). Both extremity and skull injuries were seen in 23 patients (10.9%). The mean hospital stay was 12.2 +/- 16.8 days (range 1 to 150 days). Eight patients required intensive care for a mean of seven days. As a complication, one patient (0.5%) with olecranon and tibial plateau fractures developed pulmonary embolism. Motorcycle accidents resulted in mortality in nine patients (4.3%). Conclusion: Since motorcycle accidents are preventable or associated risks for injuries are reducible, risk factors for our country should be determined, necessary laws and restrictive regulations should be put into practice, and educational programs should be implemented.Öğe Magnetic resonance imaging predictors of surgical outcome in degenerative lumbar spinal stenosis(Springer, 2012) Alicioglu, Banu; Yilmaz, Baris; Bulakbasi, Nail; Copuroglu, Cem; Yalniz, Erol; Aykac, Bilal; Urut, Devrim UlasTo identify any MRI predictors for surgical outcomes of patients with degenerative lumbar spinal stenosis (DLSS) having instrumented posterior decompression (IPD) surgery. Seventy patients with DLSS who underwent IPD were reviewed retrospectively. The clinical score of each patient was assessed using the JOAS (Japanese Orthopedics Association Scoring) system, which is mainly based on the subjective symptoms and physical signs of the patients before (JOAS-I) and after (JOAS-II) surgery. Healing rate (HR) was calculated as: [(JOAS-II) - (JOAS-I)] x 100/[15 - (JOAS-I)]. HR > 50 % was considered clinical improvement. Radiological stenosis was assessed on MRI and was graded from 0 to 3 at the laminectomy level in terms of thecal sac-nerve root compression, foraminal stenosis, and facet degeneration. Mean HR of the improved patients (n = 39) was 81.94; HR of the unimproved patients (n = 31) was 34.75 (p < 0.05). There was no statistical difference in radiological stenosis parameters between the two groups (p > 0.05). HR was worse in patients with severe facet degeneration. Surgical outcomes of DLSS depend on multiple variables. It is not possible to predict the outcomes by assessing only one parameter. The possible outcomes should be analyzed by considering all the factors individually.Öğe The Morphometric Analysis of Crista Phallica in Identification of Sexes(Soc Chilena Anatomia, 2009) Ulucam, Enis; Alicioglu, Banu; Cikmaz, Selman; Yilmaz, Ali; Sut, NecdetCrista phallica (CP) is used to determine sex in anthropology and criminal forensic medicine; however, it does not exist in anatomic and radiological terminology. The purpose of this retrospective study is morphometric analysis of the CP. We studied radiographs displaying several different clinical indications from patients whose bone maturation were fully complete. The crista phallica located on both sides of the medial portion of ischiopubic ramus (IPR) were localized and their peak points were determined. The distance from these peak points to the inner cortex of IPRs were measured, as well as the angles between the tangents passing the peak points from both sides. We determined the distance of the IPR (DIPR) for males and females sequentially as 21.3+/-3.5 mm, and 17+/-2.8 mm, angle of CP (ACP) as 149.1 degrees+/-15.7, and 163.5 degrees+/-13.4. It was identified that ACP for females is less than ACP for males (p<0.001). ACP and DIPR alone are not sufficient criteria to determine sex. Therefore, the results of our findings show that it would be more useful to study other specifications and their metric analysis in order to determine sex.Öğe PENILE AND PROSTATIC METASTASIS FROM PRIMARY RENAL SARCOMA(Aves, 2007) Kaplan, Mustafa; Alicioglu, Banu; Usta, Ufuk; Aktoz, Tevfik; Atakan, Irfan Huseyin; Inci, OsmanIntroduction: Urological sarcomas are rare. Renal sarcomas represent 1% to 2% of all malignant renal tumors and their prognosis is worse than other urogenital sarcomas. High grade sarcomas commonly metastasize, with the lungs, lymph nodes, and liver being a primary site of spread. Penile and prostatic metastases of renal sarcomas are extremely rare, and are generally accepted as a manifestation of systemic spread and survival after their presentation is limited. We report the first case of simultaneous penile and prostatic metastases from a primary sarcoma of the kidney.Öğe Penile metastasis from small cell carcinoma of the urinary bladder(Int Scientific Literature, Inc, 2008) Kaplan, Mustafa; Aktoz, Tevfik; Puyan, Fulya O.; Alicioglu, Banu; Atakan, Irfan H.; Inci, OsmanBackground: Small cell carcinoma of the urinary bladder is a rare and highly aggressive tumor that has been described in case reports or small series. It accounts for < 1% of all urinary bladder carcinomas. The prognosis of patients with small cell carcinoma of the urinary bladder is poor and depends on the extend of the disease. Case Report: Herein we report a case of a penile metastasis from small cell carcinoma of the urinary bladder. A 70-year-old man was treated for small cell carcinoma of the bladder with radical cystectomy and ileal conduit in 2007. Pathological examination of the radical sistoprostatectomy material revealed an ulcerated, necrotic invasive undifferentiated tumor with bladder wall invasion. Left vesicula seminalis and prostatic tissue was also infi ltrated by the tumor cells. Small cell cancer of the urinary bladder was diagnosed. Adjuvant chemotherapy was planned but the patient did not accept it. Two months after the operation he has noticed a painful swelling on the right side of the penis. But he ignored it. Four months later he admitted to our clinic with a swollen, painful penis. Physical examination revealed a hard, ovoid nodule (3x3 cm in diameter) along the shaft of the penis near its base on the right side. Ultrasound revealed a 3x3 cm mass on the right side of the penis that not involved the corpus cavernosum. Pathology of the penile lesion revealed metastatic tumor. Morphological and immonohistochemical fi ndings of the tumor cells were identical to the primary tumor cells. Conclusions: Metastases to the penis are uncommon. Most penile metastases present with swollen and frequently tender penis, pain and/ or priapism. In cases with bladder carcinoma which had metastasized to penis, the histopathologic type is mostly urothelial carcinoma. Small cell carcinoma of the bladder is uncommon and unlike urothelial carcinoma it behaves aggressively. And this is the fi rst case of small cell carcinoma of the bladder which has metastasized to the penis.Öğe Radiological Analysis of Human Hand in Terms of Artistic Anatomy(Ortadogu Ad Pres & Publ Co, 2010) Yilmaz, Ali; Alicioglu, Banu; Sut, Necdet; Ulucam, Enis; Cikmaz, SelmanObjective: The hands are one of the most conspicuous parts of the body. The aim of this study was to investigate the relationship between the bones that comprise the hands and their aesthetic importance in terms of the Fibonacci series. Material and Methods: In this study, which was designed retrospectively, 123 digital hand roentgenograms of adult patients were reviewed. Each finger was measured in terms of metacarpal, proximal, middle, and distal phalangeal lengths by using a digital caliper. The proximal phalangeal length was subtracted from the sum of the lengths of the middle and distal phalanges and the metacarpal length was subtracted from sum of the lengths of the proximal and middle phalanges, to investigate the conformity to Fibonacci sequence. The Bland-Altman method was used to evaluate the measurements. Results: There is a mathematical harmony between all finger bones in terms of the Fibonacci sequence. The first, second, and fifth metacarpals conform to the Fibonacci sequence; however the third and fourth metacarpals do not. Conclusion: It can be easily proven that all of the bones that form fingers are in accordance with the Fibonacci sequence. These results convince us that Fibonacci sequence can be used for the reconstruction of human hand after a serious trauma or congenital anomalies.Öğe A simple method to decrease surgical trauma in wire localization procedures(Turkish Soc Radiology, 2008) Alicioglu, Banu; Yuecesoy, CueneytMinimally invasive breast biopsies of nonpalpable lesions are used for early diagnosis and treatment of breast cancer. This report describes a simple method to decrease surgical trauma in wire localization procedures. After wire localization with mammography or ultrasound, the course of the wire in the breast was marked on the skin to guide the surgeon. As a result, fewer tissue samples were taken and smaller hematomas occurred. This method is particularly useful in deep lesions and in large breasts, leading to shortened surgery time and improved cosmetic results. This technique can be used in any wire-guided procedure.Öğe Spinal leptomeningeal metastasis in a patient with squamous cell lung cancer(Elsevier Doyma Sl, 2008) Alicioglu, Banu; Saynak, MertSpinal leptomeningeal metastasis Occurs rarely in solid tumors, and the prognosis is extremely poor. Adenocarcinomas and small-cell carcinomas are the most common histological type detected among lung tumors. A 58-year-old man with a history of squamous-cell lung carcinoma with mediastinal invasion and brain metastasis was examined because of his low back pain and weakness in both lower limbs. Spinal MRI revealed subpial enhancement in the spinal cord; and innumerable nodules with thickening of the cauda equina fibres. To our knowledge, this is the second reported case of squamous cell lung cancer with spinal leptomeningeal metastasis.Öğe Symphysis pubis distance in adults: a retrospective computed tomography study(Springer France, 2008) Alicioglu, Banu; Kartal, Ozcan; Gurbuz, Hulya; Sut, NecdetBackground In this retrospective study, symphysis pubis (SP) distance was measured by transverse computed tomography scans. The relation between the SP distance and age, gender, number of birth and body-mass index was studied. Methods Symphysis pubis joint distances were evaluated for the patients who had undergone abdominal or pelvic computed tomography examination for other medical reasons between the dates of March and May 2007. Anterior, middle, and posterior SP joint distances were measured at transverse planes. Normal joint width in women and men was determined. The relation between obtained values, and age, gender, number of birth, as well as body-mass index was studied. Results Symphysis pubis narrows at anterior concurrently with ageing (r = -0.115; P = 0.007). Narrowing, though less, is also observed at posterior (r = -1.50 P = 0.000); however, middle part does not change (r = 0.030; P = 0.489). Number of birth and body-mass index values do not affect SP width. The widths measured at anterior and middle of the SP were significantly higher in women (P = 0.010 and P = 0.002). Conclusions Osteoarthritic changes develop in SP with ageing. However, osteoarthritis in SP, was found to be clinically and radiologically different from that in other symphyseal joints, as SP hardly ever moves, and vertically processing interpubic disc combines pelvis girdle with counterforces, and is supported by very strong ligaments and muscles. Anterior and middle part of the SP joint is wider in women, because fibrocartilaginous disc is too thick to provide the mobility.Öğe Symphysis pubis distance in adults: a retrospective computed tomography study (vol 30, pg 153, 2008)(Springer, 2008) Alicioglu, Banu; Kartal, Ozcan; Gurbuz, Hulya; Sut, Necdet[Abstract Not Available]Öğe Total body height estimation using sacrum height in Anatolian Caucasians: multidetector computed tomography-based virtual anthropometry(Springer, 2011) Karakas, Hakki Muammer; Celbis, Osman; Harma, Ahmet; Alicioglu, BanuEstimation of total body height is a major step when a subject has to be identified from his/her skeletal structures. In the presence of decomposed skeletons and missing bones, estimation is usually based on regression equation for intact long bones. If these bones are fragmented or missing, alternative structures must be used. In this study, the value of sacrum height (SH) in total body height (TBH) estimation was investigated in a contemporary population of adult Anatolian Caucasians. Sixty-six men (41.6 +/- 14.9 years) and 43 women (41.1 +/- 14.2 years) were scanned with 64-row multidetector computed tomography (MDCT) to obtain high-resolution anthropometric data. SH of midsagittal sections was electronically measured. The technique and methodology were validated on a standard skeletal model. Sacrum height was 111.2 +/- 12.6 mm (77-138 mm) in men and 104.7 +/- 8.2 (89-125 mm) in women. The difference between the two sexes regarding SH was significant (p < 0.0001). SH did not significantly correlate with age in men, whereas the correlation was significant in women (p < 0.03). The correlation between SH and the stature was significant in men (r = 0.427, p < 0.0001) and was insignificant in women. For men the regression equation was [Stature = (0.306 x SH) + 137.9] (r = 0.54, SEE = 56.9, p < 0.0001). Sacrum height is not susceptible to sex, or to age in men. In the presence of incomplete male skeletons, SH helps to determine the stature. This study is also one of the initial applications of MDCT in virtual anthropometric research.
