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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 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.Öğe THE VALUE OF MAGNETIC RESONANCE IMAGING IN BILATERAL SYNCHRONOUS BREAST CANCER(Kare Publ, 2005) Tuncbilek, Nermin; Okten, Ozerk Omur; Karakas, Hakki Muammer; Tokatli, FusunThe prevalence of synchronous bilateral breast cancer is approximately 1-3%. It has a greater risk for distant metastasis than unilateral breast cancer. The early determination of the bilaterality and multifocality of the breast cancer could change the therapeutic options, and subsequently reduce the mortality and morbidity rates. Current screening methods for the breast cancer are mammography and clinical examination. In this paper, we evaluated the additional diagnostic value of dynamic contrast-enhancement magnetic resonance mammography to conventional techniques.
