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Öğe Assessment of Ten-Year-Long Results of Kidney Biopsies Performed on Children in the Thrace Region of Turkey(2016) Özkayın, Neşe; Çıplak, Gökçe; Usta, Ufuk; Gençhellaç, Hakan; Temizöz, OsmanBackground: Many children with kidney diseases can be diagnosed and treated without a biopsy. However, biopsy is a valuable method for the diagnostic and prognostic evaluation of children with kidney diseases. Aims: To evaluate the clinical and pathological profiles of the kidney biopsies in our department to provide epidemiological data for clinical practice. Study Design: Retrospective cross-sectional study. Methods: Kidney biopsies and patient's charts in pediatric patients performed between May 2005 and February 2015 at the Pediatric Nephrology Department, Trakya University School of Medicine were assessed retrospectively. Results: A total of 100 patients were examined. Their mean age was 9.62±4.26 years (range: 1-17 years); 54% of the patients were girls and 46% were boys. The most frequent indication for kidney biopsy was nephrotic syndrome (33%). The most common kidney disease was primary glomerulonephritis, which was observed in 65% of cases. IgA nephropathy (24%) was the most frequently observed subtype in primary glomerulonephritis groups. Secondary glomerulonephritis was diagnosed in 35% of cases. Systemic lupus erythematosus (51%) was the most frequently observed subtype in the secondary glomerulonephritis groups. Conclusion: IgA nephropathy and systemic lupus erythematosus were the most frequent primary and secondary glomerulonephritis in our region among children, respectively.Öğe A case of urachal malacoplakia that seems like urachal cancer(2015) İnci, Osman; Taştekin, Ebru; Gençhellaç, Hakan; Arabacı, Özcan; İşler, Serap; Atakan, İrfan HüseyinBackground: Urachal masses observed in adults should be considered malignant unless they are confuted. It is very difficult to differentiate between malignant or benign lesions, including especially calcified foci and solid areas. Case Report: Our case was a 63-year-old male patient who was diagnosed as Behçet’s Disease 26 years ago. Upon clinical examination, he was also diagnosed with adenocarcinoma of prostate. He was examined by computerized tomography to define the stage of prostatic adenocarcinoma. The existence of a hypodense multiseptated cystic lesion with irregular margins and solid areas located between anterosuperior of bladder and umbilicus was reported. Hence, the lesion was evaluated as urachal carcinoma and locally advanced prostate cancer by the urooncology council. Resection of the mass, partial cystectomy and pelvic lymphadenectomy were performed as one of the surgical approach options in urachal carcinoma. After pathological examination, the mass was diagnosed as malakoplakia and metastasis of prostate adenocarcinoma was also detected in the right obdurator lymph nodule. In the literature, case reports of urachal malakoplakia are extremely rare. It is also interesting to note the absence of specific clinical symptoms for the urachal mass and the existence of concomitant adenocarcinoma in our case. Conclusion: Malakoplakia can only be diagnosed by pathological examination. Particularly, urachal malakoplakia should also be taken into consideration in the differential diagnosis of lesions which include solid areas and are located in the urachus. Keywords: Michaelis Gutmann bodies, urachal malacoplakia, urachal malacoplakia mimicking cancerÖğe Diffusion Weighted Magnetic Resonance Imaging for the Characterization of Solitary Pulmonary Lesions(2015) Çakır, Çağlayan; Gençhellaç, Hakan; Temizöz, Osman; Polat, Ahmet; Şengül, Ersin; Duygulu, GökhanBackground: We evaluated the differential diagnosis of solitary pulmonary lesions on magnetic resonance imaging.Aims: To investigate the value of diffusion weighted imaging on the differential diagnosis of solitary pul-monary lesions.Study Design: Randomized prospective study.Methods: This prospective study included 48 solitary pulmonary nodules and masses (18 benign, 30 ma-lignant). Single shot echo planar spin echo diffusion weighted imaging (DWI) was performed with two b factors (0 and 1000 s/mm2). Apparent diffusion coeffi-cients (ADCs) were calculated. On diffusion weighted (DW) trace images, the signal intensities (SI) of the le-sions were visually compared to the SI of the thoracic spinal cord using a 5-point scale: 1: hypointense, 2: moderately hypointense, 3: isointense, 4: moderately hyperintense, 5: significantly hyperintense. For the quantitative evaluation, the lesion to thoracic spinal signal intensity ratios and the ADCs of the lesions were compared between groups.Results: On visual evaluation, taking the density of the spinal cord as a reference, most benign lesions were found to be hypointense, while most of the malignant lesions were evaluated as hyperintense on DWI with a b factor of 1000 s/mm2. In contrast, on T2 weighted images, it was seen that the distinction of malignant lesions from benign lesions was not statistically significant. The ADCs of the malignant lesions were significantly lower than those of benign lesions (mean ADC was 2.02×10-3 mm2/s for malignant lesions, and 1.195×10-3±0.3 mm2/s for benign lesions). Setting the cut-off value at 1.5×10-3, ADC had a sensitivity of 86.7% and a specificity of 88.9% for the differentiation of benign lesions from malignant lesions.Conclusion: DWI may aid in the differential diagnosis of solitary pulmonary lesions. (ClinicalTrials.gov Iden-tifier: NCT02482181)Öğe Febril nötropenik bir olguda gelişen Listeria monocytogenes pnömonisi(2006) Karagöl, Hakan; Otkun, Tatman Müşerref; Karagöl, Çiğdem; Çiçin, İrfan; Uzunoğlu, Sernaz; Çelik, Doğan Aygül; Gençhellaç, HakanListeria monocytogenes, özellikle hastalığa veya uygulanan kemoterapilere bağlı immün sistemi bozulan kanser hastalarında izole bakteriyemi, meningo-ensefalit veya peritonit gibi değişik klinik tablolarla karşımıza çıkabilmektedir. Bu olgu sunumunda, Non- Hodgkin lenfoma nedeniyle kemoterapi gören, sonrasında nötropeni ve ardından L monocytogenes'e bağlı pnömoni gelişen 65 yaşında bir erkek hasta bildirilmiş ve bununla beraber onkolojik hastalarda görülen Listeria infeksiyonları ile ilgili genel bir değerlendirme yapılmıştır.Öğe A rare case of schwannoma arising from a diverticulum in the first portion of duodenum(2012) Gençhellaç, Hakan; Temizöz, Osman[Abtract Not Available]Öğe Rektuma linitis plastika şeklinde metastaz yapan ve primer rektum kanseri gibi görünen mide adenokarsinomu: Olgu sunumu(2008) Uzunoğlu, Sernaz; Çiçin, İrfan; Karagöl, Hakan; Tanrıverdi, Özgür; Gençhellaç, Hakan; Usta, UfukGastrointestinal sistemde linitis plastika şeklindeki metastazlar nadir olup sıklıkla primer tümörün mide olduğu bildirilmektedir. Biz rektuma linitis plastika şeklinde metastaz yapan mide adenokarsinom olgumuzu ender rastlanması ve primer lokal ileri rektum kanseri şeklinde karşımıza çıkması sebebiyle literatür bilgileri ışığında, gastrik adenokarsinomaların intestinal metastazlarının klinik, radyolojik ve patolojik özelliklerini de tartışarak sunmayı amaçladık.Öğe Two-detector Computed Tomography Map of the Inferior Epigastric Vessels for Percutaneous Transabdominal Intervention Procedures(2014) Gençhellaç, Hakan; Dursun, Memduh; Temizöz, Osman; Çağlı, Bekir; Demir, Mustafa K.Background:It is crucial to know anatomic variations and the exact course of an inferior epigastric artery (IEA) to prevent any complica-tions during percutaneous abdominal interventions. Aims:The aim of this study was to map the inferior epigastric ves-sels using reconstructed two-detector computed tomography images and measure the distance from the inferior epigastric artery (IEA) to the midline to determine a safe route for percutaneous abdominal interventions. Study Design: Retrospective comparative study.Methods:Coronal reconstructed two-detector computed tomogra-phy images of 200 patients were evaluated to measure the distances between the IEA and midline at three levels (origin, middle, and dis-tal). Vein and artery arrangements were documented.Results:The most frequently encountered arrangement (41.5%) was a single vein and artery on both sides. Mean distances on the right and left sides were 4.01 and 4.47 cm at the umbilical level, 3.81 and 4.26 cm at the midlevel, and 5.62 and 5.51 cm at the origin level. On both sides, measurement differences between the three levels were highlysignificant (p<0.05). In addition, a total of 56 IEA bifurcations were depicted in all 200 patients. Thirteen of the 56 bifurcations occurredonly on the right side, 11 only on the left side, and 32 on both sides.Conclusion:It is important to be attentive to the IEA's course, at different midline levels, when attempting percutaneous interventions via an abdominal approach.
