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Sari R, Altinoz MA, Ozlu EBK, Sav A, Danyeli AE, Baskan O, Er O, Elmaci I. Treatment Strategies for Dopamine Agonist-Resistant and Aggressive Prolactinomas: A Comprehensive Analysis of the Literature. Horm Metab Res 2021; 53:413-424. [PMID: 34282593 DOI: 10.1055/a-1525-2131] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Despite most of the prolactinomas can be treated with endocrine therapy and/or surgery, a significant percentage of these tumors can be resistant to endocrine treatments and/or recur with prominent invasion into the surrounding anatomical structures. Hence, clinical, pathological, and molecular definitions of aggressive prolactinomas are important to guide for classical and novel treatment modalities. In this review, we aimed to define molecular endocrinological features of dopamine agonist-resistant and aggressive prolactinomas for designing future multimodality treatments. Besides surgery, temozolomide chemotherapy and radiotherapy, peptide receptor radionuclide therapy, estrogen pathway modulators, progesterone antagonists or agonists, mTOR/akt inhibitors, pasireotide, gefitinib/lapatinib, everolimus, and metformin are tested in preclinical models, anecdotal cases, and in small case series. Moreover, chorionic gonadotropin, gonadotropin releasing hormone, TGFβ and PRDM2 may seem like possible future targets for managing aggressive prolactinomas. Lastly, we discussed our management of a unique prolactinoma case by asking which tumors' proliferative index (Ki67) increased from 5-6% to 26% in two subsequent surgeries performed in a 2-year period, exerted massive invasive growth, and secreted huge levels of prolactin leading up to levels of 1 605 671 ng/dl in blood.
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Affiliation(s)
- Ramazan Sari
- Department of Neurosurgery, Acibadem Hospital, Maslak, Istanbul, Turkey
- Avrasya University, Health Sciences Faculty, Trabzon, Turkey
| | - Meric A Altinoz
- Department of Biochemistry, Acibadem University, Istanbul, Turkey
| | | | - Aydin Sav
- Department of Pathology, Yeditepe University, Istanbul, Turkey
| | - Ayca Ersen Danyeli
- Department of Pathology, Acibadem Mehmet Ali Aydinlar University, School of Medicine, Istanbul, Turkey
| | - Ozdil Baskan
- Department of Radiology, Memorial Hospital, Istanbul, Turkey
| | - Ozlem Er
- Department of Medical Oncology, Acibadem Mehmet Ali Aydinlar University, School of Medicine, Istanbul, Turkey
| | - Ilhan Elmaci
- Department of Neurosurgery, Acibadem Hospital, Maslak, Istanbul, Turkey
- Department of Neurosurgery, Acibadem Mehmet Ali Aydinlar University, School of Medicine, Istanbul, Turkey
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Elmaci I, Altinoz MA, Akdemir G, Sari R, Baskan O, Ozpinar A, Hacker E, Sav A. Neurosurgical and neuro-immunological management of IgG4-related hypertrophic sclerosing pachymeningitis. A literature survey and discussion of a unique index case. Clin Neurol Neurosurg 2020; 200:106342. [PMID: 33158629 DOI: 10.1016/j.clineuro.2020.106342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/28/2020] [Accepted: 10/27/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Dural thickening is observed in lymphoma, dural carcinomatosis, meningioma, tuberculosis, and autoimmune diseases. We encountered a patient with dural thickening and complaints of neck and back pain, numbness and loss of strength in the hands. The patient also suffered from polychondritis and had previously received steroid and methotrexate treatment for this indication. The patients' serum was also positive for ANA, yet she did not have any other findings suggesting lupus. Our radiological and pathological analysis revealed IHSP (IgG4-related hypertrophic sclerosing pachymeningitis). In this review study, we provided a detailed literature survey to increase the awareness about IHSP in the neurosurgical community. METHODS MRI (magnetic resonance imaging)-based radiological analyses revealed a posterior extramedullary spinal mass extending from C2 to T2-T3 level. The dural mass was surgically excised and a broad panel of immunohistochemical markers including S100, EMA, CD246/ALK-1, CD45, CD20, CD79a, CD138, CD68, CD1a and CD34 was studied. Immunoglobulin heavy chain/kappa chain gene rearrangement analysis was performed which ruled out a lymphoproliferative disorder. RESULTS MRI and pathological findings suggested IHSP. As the disease relapsed with a new anterior extramedullary multilobulated lesion extending from C5 to T1 level, the patient is now closely monitored for further medical and surgical treatment. CONCLUSIONS IHSP is a relatively novel entity of hypertrophic pachymeningitis and should be included in the differential diagnosis of dural thickening. The fibrosis accompanying IHSP may not respond to medical treatment, which includes steroids and immunosuppressive agents. Additionally, neurological deficits, seizures, spinal decompression, hydrocephalus, or brainstem compression necessitate early surgical intervention. A continued vigilance is also necessary as the disease may relapse long-term following surgical treatment.
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Affiliation(s)
- Ilhan Elmaci
- Department of Neurosurgery, M.A.A. Acibadem University, Maslak Hospital, Istanbul, Turkey
| | - Meric A Altinoz
- Department of Medical Biochemistry, M.A.A. Acibadem University, Istanbul, Turkey.
| | | | - Ramazan Sari
- Department of Neurosurgery, Acibadem Maslak Hospital, Istanbul, Turkey
| | - Ozdil Baskan
- Department of Radiology, Memorial Hospital, Istanbul, Turkey
| | - Alp Ozpinar
- Department of Neurosurgery, University of Pittsburgh, United States
| | - Emily Hacker
- Department of Neurosurgery, University of Pittsburgh, United States
| | - Aydin Sav
- Department of Pathology, Yeditepe University, Istanbul, Turkey
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Yilmaz Semerci S, Demirel G, Baskan O, Tastekin A. Is thymus size at birth associated with respiratory distress syndrome in preterm infants? J Neonatal Perinatal Med 2019; 12:265-269. [PMID: 30814365 DOI: 10.3233/npm-1842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM Thymus size in neonates depend on many factors. We aimed to assess the thymus size radiographically in preterm neonates and its relationship with respiratory distress syndrome (RDS) and other complications of prematurity. METHODS Thymus size was assessed by cardiothymic: thoracic ratio (CT/T), measuring the width of the cardiothymic shadow at the level of carina and dividing it by the width of the thorax at the costophrenic angles, from the first chest radiograph in patients less than 34 weeks gestational age. RESULTS Neonates born between 30-34 weeks of gestation with RDS had smaller CT/T than non RDS group (0.34±0.1 vs 0.36±0.05, p = 0.045). Birth weight has positive correlation with CT/T (r = 0.166, p = 0.03). CONCLUSION Thymus involution in the perinatal period is a complex process and the response is variable in different clinical situations. Activated hypothalamic-pituitary-adrenal (HPA) axis may be responsible for thymic involution in preterm infants between 30-34 weeks of gestation with RDS.
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Affiliation(s)
- S Yilmaz Semerci
- Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Division of Neonatology, Istanbul, Turkey
| | - G Demirel
- Istanbul Medipol University Faculty of Medicine, Division of Neonatology, Istanbul, Turkey
| | - O Baskan
- Division of Radiology, Istanbul Medipol University, Istanbul, Turkey
| | - A Tastekin
- Division of Radiology, Istanbul Medipol University, Istanbul, Turkey
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Altinoz MA, Yilmaz M, Ucal Y, Ozpinar A, Baskan O, Elmaci I. P04.54 High Dose Progesterone Induces Growth Inhibition in Human U87 and A172 Glioblastoma Cell With Concomitant Changes in Mitochondrial and Cytoskeleton Proteins. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M A Altinoz
- Dept of Neurosurgery, Memorial Hospital, Istanbul, Turkey
| | - M Yilmaz
- Dept of Biochemistry, Acibadem University, Istanbul, Turkey
| | - Y Ucal
- Dept of Biochemistry, Acibadem University, Istanbul, Turkey
| | - A Ozpinar
- Dept of Biochemistry, Acibadem University, Istanbul, Turkey
| | - O Baskan
- Dept of Radiology, Memorial Hospital, Istanbul, Turkey
| | - I Elmaci
- Dept of Neurosurgery, Memorial Hospital, Istanbul, Turkey
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Altinoz MA, Bilir A, Ozpinar A, Baskan O, Elmaci I. P04.75 Tibolone, an estrogenic progestin of hormone replacement therapy reduces colony formation and 3-dimensional spheroid S-phase in C6 rat glioma in vitro. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M A Altinoz
- Dept of Neurosurgery, Memorial Hospital, Istanbul, Turkey
| | - A Bilir
- Histology and Embryology, Aydin University, Istanbul, Turkey
| | - A Ozpinar
- Dept of Biochemistry, Acibadem University, Istanbul, Turkey
| | - O Baskan
- Dept of Radiology, Memorial Hospital, Istanbul, Turkey
| | - I Elmaci
- Dept of Neurosurgery, Memorial Hospital, Istanbul, Turkey
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Yesilbas O, Sevketoglu E, Petmezci MT, Kihtir HS, Benzer M, Arikan C, Berdeli A, Baloglu H, Baskan O. Infant onset severe complement-mediated hemolytic uremic syndrome complicated by secondary sclerosing cholangitis. J Clin Apher 2018; 33:619-623. [PMID: 30168181 DOI: 10.1002/jca.21651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 07/06/2018] [Accepted: 07/08/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Osman Yesilbas
- Pediatric Intensive Care Unit, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Esra Sevketoglu
- Pediatric Intensive Care Unit, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Mey Talip Petmezci
- Pediatric Intensive Care Unit, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Hasan Serdar Kihtir
- Pediatric Intensive Care Unit, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Meryem Benzer
- Department of Pediatric Nephrology, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Cigdem Arikan
- Departments of Pediatric Gastroenterology, Hepatology and Nutrition, Memorial Health Group, Istanbul, Turkey
| | - Afig Berdeli
- Department of Pediatrics, Molecular Medicine Laboratory and Stem Cell Department of Health Science Institute, Ege University Medical Faculty, Izmir, Turkey
| | - Huseyin Baloglu
- Department of Pathology, Anadolu Medical Center, Kocaeli, Turkey
| | - Ozdil Baskan
- Department of Radiology, Memorial Health Group, Istanbul, Turkey
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Surov A, Ginat DT, Lim T, Cabada T, Baskan O, Schob S, Meyer HJ, Gihr GA, Horvath-Rizea D, Hamerla G, Hoffmann KT, Wienke A. Histogram Analysis Parameters Apparent Diffusion Coefficient for Distinguishing High and Low-Grade Meningiomas: A Multicenter Study. Transl Oncol 2018; 11:1074-1079. [PMID: 30005209 PMCID: PMC6067084 DOI: 10.1016/j.tranon.2018.06.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 06/23/2018] [Accepted: 06/25/2018] [Indexed: 01/11/2023] Open
Abstract
Low grade meningiomas have better prognosis than high grade meningiomas. The aim of this study was to measure apparent diffusion coefficient (ADC) histogram analysis parameters in different meningiomas in a large multicenter sample and to analyze the possibility of several parameters for predicting tumor grade and proliferation potential. Overall, 148 meningiomas from 7 institutions were evaluated in this retrospective study. Grade 1 lesions were diagnosed in 101 (68.2%) cases, grade 2 in 41 (27.7%) patients, and grade 3 in 6 (4.1%) patients. All tumors were investigated by MRI (1.5 T scanner) by using diffusion weighted imaging (b values of 0 and 1000 s/mm2). For every lesion, the following parameters were calculated: mean ADC, maximum ADC, minimum ADC, median ADC, mode ADC, ADC percentiles P10, P25, P75, P90, kurtosis, skewness, and entropy. The comparison of ADC values was performed by Mann–Whitney-U test. Correlation between different ADC parameters and KI 67 was calculated by Spearman's rank correlation coefficient. Grade 2/3 meningiomas showed statistically significant lower ADC histogram analysis parameters in comparison to grade 1 tumors, especially ADC median. A threshold value of 0.82 for ADC median to predict tumor grade was estimated (sensitivity = 82.2%, specificity = 63.8%, accuracy = 76.4%, positive and negative predictive values were 83% and 62.5%, respectively). All ADC parameters except maximum ADC showed weak significant correlations with KI 67, especially ADC P25 (P = −.340, P = .0001).
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Affiliation(s)
- Alexey Surov
- Department of Radiology, Martin-Luther-University Halle-Wittenberg, Germany; Department of Diagnostic and Interventional Radiology, University of Leipzig, Germany.
| | - Daniel T Ginat
- University of Chicago, Pritzker School of Medicine, Chicago, IL, USA
| | - Tchoyoson Lim
- Department of Neuroradiology, National Neuroscience Institute, Singapore
| | - Teresa Cabada
- Servicio de Radiologia, Hospital de Navarra, Pamplona, Spain
| | - Ozdil Baskan
- Department of Radiology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Stefan Schob
- Department of Neuroradiology, University of Leipzig
| | - Hans Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Germany
| | | | | | | | | | - Andreas Wienke
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther University Halle-Wittenberg, Halle, Germany
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Ozek E, Bolukbasi FH, Baskan O, Altinoz MA, Sav A, Elmaci I. Prepontine Chordoma Presenting with MRI Features of an Epidermoid Cyst: Case Presentation and a Mini-Review. Curr Med Imaging 2017. [DOI: 10.2174/1573405612666161009221512] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Erdinc Ozek
- Department of Neurosurgery, Memorial Hospital, Istanbul, Turkey
| | | | | | | | - Aydin Sav
- Nisantasi Pathology, Istanbul, Turkey
| | - Ilhan Elmaci
- Department of Neurosurgery, Memorial Hospital, Istanbul, Turkey
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Abstract
AIM Failed cranioplasty attempts may lead to numerous complications in a broad spectrum including cosmetic problems, infection, neurological deterioration and even death. Selection of the most appropriate surgical technique for second and further surgical attempts for these patients still remains a debate. We aimed to share our experience and technical pitfalls on management of failed cranioplasty, particularly for patients with large cranial defects. MATERIAL AND METHODS A retrospective data analysis of cranioplasty cases in our series was performed including the time period between 2002 and 2012. Patients required recurrent cranioplasty were analyzed in detail. RESULTS Totally, 101 patients underwent cranioplasty for bony defect. Of 101 patients, eleven required a revision surgery due to infection or spontaneous resorption of the bone flap. All patients underwent revision cranioplasty with pre-surgical plaster cast mold technique modified from previous studies and/or tissue expansion technique. Polymethyl-metacrylate (PMMA) was used as substitute for reconstructions. Mean follow-up was 36 months. Two out of eleven cases (18.1%) developed major complications, which led to further revision. At the end, a satisfactory reconstruction was achieved for all patients. CONCLUSION Our modified molded plaster cast technique is a safe and cost-effective approach for the revision of failed cranioplasty. We believe that the tissue expanding techniques have also great contribution to achieve successful results.
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Affiliation(s)
- Ramazan Sari
- Memorial Health Group, Department of Neurosurgery, Istanbul, Turkey
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Erol C, Baskan O, Gungoren FZ, Guzelburc V, Kılıçarslan R. Meandering right pulmonary vein associated with retrocaval ureter and vertebral fusion anomalies. Wien Klin Wochenschr 2016; 128:626-629. [DOI: 10.1007/s00508-014-0695-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Accepted: 12/01/2014] [Indexed: 11/24/2022]
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Sari R, Bolukbasi FH, Onoz M, Baskan O, Altinoz MA, Sav A, Elmaci I. P11.05 Whorling-sclerosing type of meningioma. CD34 and P53 IHC-positivity with lack of malignant features in a rare meningioma type. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Baskan O, Silav G, Demirci S, Canoz O, Turanli G, Elmaci I. Focal megalencephaly: intraoperative ultrasound imaging in epilepsy surgery. J Med Ultrason (2001) 2015; 42:127-31. [PMID: 26578502 DOI: 10.1007/s10396-014-0569-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 08/14/2014] [Indexed: 11/25/2022]
Abstract
Hemimegalencephaly is a rare neuronal migration disorder that can be defined as abnormal neural and glial proliferation localized to all or part of a cerebral hemisphere. Most patients demonstrate intractable epilepsy, with early onset before 1 year of age. Surgical resection is one of the treatment options. In recent years, many advanced intraoperative techniques have been used for brain surgery for various pathologies. Intraoperative ultrasonography is a time-saving and noninvasive method for intraoperative imaging. In this report, we present the use of intraoperative ultrasonography in a patient with focal megalencephaly as an anatomical navigation with the functional navigation system, electrocorticography. In this report, we present the use of intraoperative ultrasonography in a patient with focal megalencephaly as an anatomical navigation with the functional navigation system, electrocorticography.
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Affiliation(s)
- Ozdil Baskan
- Department of Radiology, School of Medicine, Istanbul Medipol University, TasliCikis sk. 8/4 KabatasBeyoglu, 34427, Istanbul, Turkey.
| | - Gokalp Silav
- Department of Neurosurgery, School of Medicine, Istanbul Medipol University, TEM AvrupaOtoyoluGoztepeCikisi No: 1 Bagcılar, 34214, Istanbul, Turkey
| | - Sema Demirci
- Department of Neurology, School of Medicine, Istanbul Medipol University, TEM AvrupaOtoyoluGoztepeCikisi No: 1 Bagcılar, 34214, Istanbul, Turkey
| | - Ozlem Canoz
- Department of Medical Pathology, School of Medicine, Istanbul Medipol University, TEM AvrupaOtoyoluGoztepeCikisi No: 1 Bagcılar, 34214, Istanbul, Turkey
| | - Guzide Turanli
- Department of Pediatrics Neurology, Istanbul Medipol Mega University Hospital, TEM AvrupaOtoyoluGoztepeCikisi No: 1 Bagcılar, 34214, Istanbul, Turkey
| | - Ilhan Elmaci
- Department of Neurosurgery, School of Medicine, Istanbul Medipol University, TEM AvrupaOtoyoluGoztepeCikisi No: 1 Bagcılar, 34214, Istanbul, Turkey
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Baskan O, Silav G, Bolukbasi FH, Canoz O, Geyik S, Elmaci I. Relation of apparent diffusion coefficient with Ki-67 proliferation index in meningiomas. Br J Radiol 2015; 89:20140842. [PMID: 26537690 DOI: 10.1259/bjr.20140842] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The purpose of this study was to investigate the relationship between Ki-67 proliferation indexes and apparent diffusion coefficient (ADC) values of low-grade and atypical/anaplastic (high-grade) meningiomas. METHODS Pre-operative diffusion-weighted imaging and histopathological evaluation of 44 patients with meningiomas were performed retrospectively. Regions of interest (ROIs) were manually drawn on the ADC images. In total six ROI measurements were taken in three consecutive slices, and the average of the mean ADC value was used. The relationship between the ADC and Ki-67 values was investigated, and the ADC values of the low-grade and high-grade meningiomas were compared. RESULTS 31 (70%) patients had low-grade the meningiomas. 10 (23%) patients had atypical and 3 (7%) had anaplastic meningiomas. ADC values of the low-grade and high-grade meningiomas were 0.81 ± 0.12 × 10(-3) and 0.66 ± 0.08 × 10(-3) mm(2) s(-1), respectively. Ki-67 proliferation indexes were 2.19% ± 1.14% for low-grade and 11.20% ± 9.80% for high-grade meningiomas. A statistically significant negative correlation between Ki-67 proliferation index and ADC values of the low-grade and high-grade meningiomas was detected (r(2) = 0.326, p < 0.001). High-grade meningiomas had lower ADC values than that of low-grade meningiomas. There was statistically significant difference between the ADC values of the low-grade and high-grade meningiomas (p < 0.001). CONCLUSION Our data provide an inverse correlation between the ADC and Ki-67 proliferation index values of meningiomas. ADC values can be used for histopathological characterization of the meningiomas and pre-surgical planning. ADVANCES IN KNOWLEDGE The purpose of this study was to investigate the relationship between Ki-67 proliferation indexes and ADC values of low-grade and atypical/anaplastic (high-grade) meningiomas. In addition, we compared the ADC and Ki-67 proliferative index values of the low-grade and atypical/anaplastic (high-grade) meningiomas. We concluded that there was an inverse correlation between the ADC and Ki-67 proliferation index values in meningiomas, and we have found statistically significant difference between the ADC values of the low-grade and high-grade meningiomas. ADC values can be used for histopathological characterization of the meningiomas and pre-surgical planning.
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Affiliation(s)
- Ozdil Baskan
- 1 Department of Radiology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Gokalp Silav
- 2 Department of Neurosurgery, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Fatih Han Bolukbasi
- 2 Department of Neurosurgery, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Ozlem Canoz
- 3 Department of Medical Pathology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Serdar Geyik
- 1 Department of Radiology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Ilhan Elmaci
- 2 Department of Neurosurgery, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
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Baskan O, Speetjens MFM, Metcalfe G, Clercx HJH. Direct experimental visualization of the global Hamiltonian progression of two-dimensional Lagrangian flow topologies from integrable to chaotic state. Chaos 2015; 25:103106. [PMID: 26520072 DOI: 10.1063/1.4930837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Countless theoretical/numerical studies on transport and mixing in two-dimensional (2D) unsteady flows lean on the assumption that Hamiltonian mechanisms govern the Lagrangian dynamics of passive tracers. However, experimental studies specifically investigating said mechanisms are rare. Moreover, they typically concern local behavior in specific states (usually far away from the integrable state) and generally expose this indirectly by dye visualization. Laboratory experiments explicitly addressing the global Hamiltonian progression of the Lagrangian flow topology entirely from integrable to chaotic state, i.e., the fundamental route to efficient transport by chaotic advection, appear non-existent. This motivates our study on experimental visualization of this progression by direct measurement of Poincaré sections of passive tracer particles in a representative 2D time-periodic flow. This admits (i) accurate replication of the experimental initial conditions, facilitating true one-to-one comparison of simulated and measured behavior, and (ii) direct experimental investigation of the ensuing Lagrangian dynamics. The analysis reveals a close agreement between computations and observations and thus experimentally validates the full global Hamiltonian progression at a great level of detail.
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Affiliation(s)
- O Baskan
- Fluid Dynamics Laboratory, Department of Applied Physics, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands
| | - M F M Speetjens
- Energy Technology Laboratory, Department of Mechanical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands
| | - G Metcalfe
- Commonwealth Scientific and Industrial Research Organisation, Melbourne, Victoria 3190, Australia; and Swinburne University of Technology, Department of Mechanical Engineering, Hawthorn VIC 3122, Australia
| | - H J H Clercx
- Fluid Dynamics Laboratory, Department of Applied Physics, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands
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Baskan O, Erol C, Ozbek H, Paksoy Y. Effect of radiation dose reduction on image quality in adult head CT with noise-suppressing reconstruction system with a 256 slice MDCT. J Appl Clin Med Phys 2015; 16:5360. [PMID: 26103494 PMCID: PMC5690139 DOI: 10.1120/jacmp.v16i3.5360] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 01/23/2015] [Accepted: 01/21/2015] [Indexed: 11/23/2022] Open
Abstract
The purpose of our study was to investigate the effect of iterative reconstruction (IR) as a dose reduction system on the image quality (IQ) of the adult head computed tomography (CT) at various low‐dose levels, and to identify ways of setting the amount of dose reduction. We performed two noncontrast low‐dose (LD) adult head CT protocols modified by lowering the tube current with IR which were decided in the light of a group of phantom studies. Two groups of patients, each 100 underwent noncontrast head CT with LD‐I and LD‐II, respectively. These groups were compared with 100 consecutive standard dose (STD) adult head CT protocol in terms of quantitative and qualitative IQ. The signal‐to‐noise ratio (SNR) of the white matter (WM) and gray matter (GM) and contrast‐to‐noise ratio (CNR) values in the LD groups were higher than the STD group. The differences were statistically significant. When the STD and the LD groups were compared qualitatively, no significant differences were found in overall quality. By selecting the appropriate level of IR 34%, radiation dose reduction in adult head CT can be achieved without compromising IQ. PACS number: 87.57.‐s
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Abstract
Magnetic resonance imaging (MRI) depicts infectious foci in the perianal region better than any other imaging modality. MRI allows definition of the fistula, associated abscess formation and its secondary extensions. Accurate information is necessary for surgical treatment and to obtain a decrease in the incidence of recurrence and complications. Radiologists should be familiar with anatomical and pathological findings of perianal fistulas and classify them using the MRI – based grading system. The purpose of this article was to provide an overview for evaluation of perianal fistulas, examples of various fistula types and their classification.
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Affiliation(s)
- Ozdil Baskan
- Department of Radiology, Medipol University, School of Medicine, Istanbul, Turkey
| | - Mustafa Koplay
- Department of Radiology, Selcuk University, Medical Faculty, Konya, Turkey
| | - Mesut Sivri
- Department of Radiology, Selcuk University, Medical Faculty, Konya, Turkey
| | - Cengiz Erol
- Department of Radiology, Medipol University, School of Medicine, Istanbul, Turkey
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Baskan O, Geyik S. Frontal lobe lipoma associated with cortical dysplasia and abnormal vasculature. Neuroradiol J 2014; 27:671-5. [PMID: 25489889 DOI: 10.15274/nrj-2014-10082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Accepted: 08/04/2014] [Indexed: 11/12/2022] Open
Abstract
Intracranial lipomas (ICLs) are rare lesions, the vast majority encountered as incidental findings on imaging studies. ICLs are generally pericallosal midline lesions and thought to be asymptomatic and can be accompanied by additional intracranial congenital malformations. We describe a 17-year old male with an unusual case of ICL on the frontal lobe associated with cortical dysplasia and abnormal vasculature mimicking arteriovenous malformation on magnetic resonance images.
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Affiliation(s)
- Ozdil Baskan
- Department of Radiology, Istanbul Medipol University School of Medicine; Istanbul, Turkey -
| | - Serdar Geyik
- Department of Radiology, Istanbul Medipol University School of Medicine; Istanbul, Turkey
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18
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Baskan O, Durdag E, Geyik S, Elmaci I. Spinal arteriovenous malformation: use of intraoperative color Doppler ultrasonography guidance for surgical resection. Case report. Med Ultrason 2014; 16:386-388. [PMID: 25463896 DOI: 10.11152/mu.201.3.2066.164.ozb1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Spinal arteriovenous malformations (AVMs) may be associated with sensory and motor deficits, bowel or bladder dysfunction, radicular pain or deficit, and back pain. Hemorrhage can occur in the parenchyma leading to the acute onset of symptoms. Neurosurgical resection is one of the way of treatment. Several techniques including intraoperative angiography, dye-injection and the micro Doppler method have proven to be useful during the surgical resection of spinal vascular lesions. Herein, we report our experience with intraoperative ultrasonography (IOUS) and color Doppler ultrasonography guidance for visualizing a spinal cord AVM during surgery. IOUS is a time-saving and noninvasive method for intraoperative imaging of spinal AVM.
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Affiliation(s)
- Ozdil Baskan
- Department of Radiology,Istanbul Medipol University, School of Medicine, Istanbul, Turkey.
| | - Emre Durdag
- Department of Neurosurgery, Istanbul Medipol University, School of Medicine, Istanbul, Turkey
| | - Serdar Geyik
- Department of Radiology,Istanbul Medipol University, School of Medicine, Istanbul, Turkey
| | - Ilhan Elmaci
- Department of Neurosurgery, Istanbul Medipol University, School of Medicine, Istanbul, Turkey
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19
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Baskan O, Ozdenkaya Y, Erol C, Dolay K. Median Arcuate Ligament: Should Be Recognised before the Surgery; Importance in Pancreaticoduodenectomy. Balkan Med J 2014. [DOI: 10.5152/balkanmedj.2014.14082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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20
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Abstract
Endometriosis is an important gynecological disorder which is characterized by proliferation of the functional endometrial tissue outside the uterine cavity, affects most commonly the ovaries and less frequently the gastrointestinal tract, chest, urinary tract, and soft tissues. Endometriosis invading the sciatic nerve is a rare manifestation of a common disease. The cyclic rhythm of pain, associated with the magnetic resonance imaging (MRI) signal of the lesion should suggest a diagnosis of endometriosis. Early diagnosis and treatment are important to prevent irreversible damage to the sciatic nerve.
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21
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Baskan O, Erol C, Sahingoz Y. Portal biliopathy, magnetic resonance imaging and magnetic resonance cholangiopancreatography findings: a case series. Gastroenterol Rep (Oxf) 2014; 4:68-72. [PMID: 25216728 PMCID: PMC4760058 DOI: 10.1093/gastro/gou062] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 08/06/2014] [Indexed: 12/15/2022] Open
Abstract
Portal biliopathy (PB) is a rare disorder, characterized by biliary ductal and gallbladder wall abnormalities seen in patients with portal hypertension. It most commonly occurs due to idiopathic extrahepatic portal vein obstruction (EHPVO). The abnormalities consist mainly of bile duct compression, stenoses, fibrotic strictures and dilation of both extrahepatic and intrahepatic bile ducts, as well as gallbladder varices. PB may mimic cholangiocarcinoma, sclerosing cholangitis, or choledocholithiasis. Misdiagnosis can be avoided using appropriate imaging modalities to prevent complications. We present the magnetic resonance imaging (MRI) and magnetic resonance cholangiography (MRCP) features of three patients with PB.
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Affiliation(s)
- Ozdil Baskan
- Department of Radiology, School of Medicine, Istanbul Medipol University, Turkey and
| | - Cengiz Erol
- Department of Radiology, School of Medicine, Istanbul Medipol University, Turkey and
| | - Yusuf Sahingoz
- Department of Radiology, Istanbul Medipol Mega University Hospital, Turkey
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22
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Baskan O, Erol C, Paksoy Y. Dual (type IV) left anterior descending artery. SA J Radiol 2013. [DOI: 10.4102/sajr.v17i4.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Congenital coronary artery anomalies are uncommon. Dual left anterior descending coronary artery (LAD) is defined as the presence of two LADs within the anterior interventricular sulcus (AIVS), and is classified into four types. Type IV is a rarely reported subtype and differs from the others, with a long LAD originating from the right coronary artery (RCA). Dual LAD is a benign coronary artery anomaly, but should be recognised especially before interventional procedures. With the increasing use of multidedector computed tomography (MDCT), it is essential for radiologists to be aware of this entity and the cross-sectional findings.
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23
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Gecmen C, Candan O, Guler A, Aung SM, Karabay CY, Baskan O, Cihan D. Unusual Left Atrial Mass: Inverted Left Atrial Appendage Caused by Massive Pericardial Effusion. Echocardiography 2011; 28:E134-6. [DOI: 10.1111/j.1540-8175.2011.01409.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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24
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Gecmen C, Candan O, Karabay CY, Guler A, Elveran A, Baskan O, Keles C, Esen AM. Hydatid cyst in the right atrium and pulmonary hypertension secondary to cystic embolism. Hellenic J Cardiol 2011; 52:160-162. [PMID: 21478127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Affiliation(s)
- Cetin Gecmen
- Kartal Kouyolu Heart & Research Hospital, Cardiology Clinic, Istanbul, Turkey
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25
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Cincin AA, Ozben B, Tanrikulu MA, Baskan O, Agirbasli M. Large apical thrombus in a patient with persistent heart failure and hypereosinophilia: Löffler endocarditis. J Gen Intern Med 2008; 23:1713-8. [PMID: 18618193 PMCID: PMC2533383 DOI: 10.1007/s11606-008-0705-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2008] [Revised: 04/30/2008] [Accepted: 06/12/2008] [Indexed: 11/25/2022]
Abstract
Idiopathic hypereosinophilic syndrome is an uncommon leukoproliferative systemic disorder characterized by the overproduction of eosinophils and poor prognosis. A major source of morbidity and mortality of this syndrome is the associated cardiac involvement represented by endocardial thickening and mural thrombi. We report a 64-year-old woman with persistent symptoms of heart failure despite standard medical therapy. Echocardiography revealed reduced left ventricular filling due to a large apical mass; an abnormal diastolic filling pattern was also noticed. Complete blood count revealed remarkable hypereosinophilia. Cardiac magnetic resonance imaging demonstrated an apical thrombus and intense linear enhancement of the endocardium, which were compatible with Löffler endocarditis. Medical therapy, including corticosteroids and anticoagulation, was initiated promptly. The symptoms improved as the peripheral hypereosinophilia resolved in 15 days. The patient was asymptomatic at the 1-year follow-up visit with complete regression of the apical thrombus and no evidence of restrictive cardiomyopathy. We report this case to draw attention to this particularly rare condition with poor prognosis since quick and accurate diagnosis and prompt initiation of therapy may improve symptoms and survival.
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Affiliation(s)
- A Altug Cincin
- Department of Cardiology, Marmara University Faculty of Medicine, Istanbul, Turkey
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26
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Uluc K, Baskan O, Yildirim KA, Ozsahin S, Koseoglu M, Isak B, Scheper GC, Gunal DI, van der Knaap MS. Leukoencephalopathy with brain stem and spinal cord involvement and high lactate: a genetically proven case with distinct MRI findings. J Neurol Sci 2008; 273:118-22. [PMID: 18619624 DOI: 10.1016/j.jns.2008.06.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2007] [Revised: 05/20/2008] [Accepted: 06/03/2008] [Indexed: 12/15/2022]
Abstract
Leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL) is a recently described disorder with autosomal recessive mode of inheritance. Lately, mutations in the DARS2 gene, which encodes mitochondrial aspartyl-tRNA synthetase, have been found as the underlying defect. We report a 19-year-old male patient with cerebellar, pyramidal and dorsal column dysfunctions and specific magnetic resonance imaging (MRI) and characteristic magnetic resonance spectroscopy (MRS) abnormalities. The patient was compound-heterozygous for two mutations in DARS2. MRI showed selective involvement of cerebral and cerebellar white matter and superior and inferior cerebellar peduncles, without contrast enhancement. The U-fibers were spared. The sensory and the pyramidal tracts were affected over their entire length. Involvement of the intraparenchymal trajectories of the trigeminal nerves and mesencephalic trigeminal tracts was demonstrated. In the spinal cord, signal abnormalities were identified in the dorsal columns and the lateral corticospinal tracts. Proton-MRS of the frontal and cerebellar white matter showed elevated lactate, reduced N-acetylaspartate, increased myoinositol and mildly elevated choline. In LBSL, distinct MRI findings should lead to the diagnosis, which can be confirmed by the analysis of the disease gene DARS2.
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Affiliation(s)
- Kayihan Uluc
- Marmara University Hospital, Department of Neurology, Istanbul, Turkey.
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27
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Tanrikulu MA, Ozben B, Cincin AA, Baskan O, Agirbasli M. A pedunculated left ventricular hemangioma initially misdiagnosed as thrombus in a woman with atypical chest pain. J Thromb Thrombolysis 2008; 27:227-32. [PMID: 18246465 DOI: 10.1007/s11239-008-0201-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Accepted: 01/21/2008] [Indexed: 10/22/2022]
Abstract
The incidence of cardiac masses increased as echocardiography is becoming increasingly popular. Benign tumors of the heart constitute about 72% of all primary cardiac neoplasms and hemangioma accounts for 5-10% of benign cardiac tumors. Cardiac hemangiomas are generally asymptomatic and diagnosed incidentally during echocardiography or magnetic resonance imaging (MRI). We reported a 52-year-old woman presented with atypical chest pain and exertional dyspnea. The echocardiographic examination revealed a hyperechoic round mass in the left ventricle. With an initial diagnosis of left ventricular thrombus, the patient underwent cardiac MRI. The mass was found compatible with cardiac hemangioma. It was removed surgically and histopathologic evaluation identified a cardiac hemangioma. As reports of cardiac hemangioma are extremely rare and cardiac masses are mostly thought to be thrombi or myxomas (being the most common primary cardiac tumor), such hemangioma cases warrant attention as possibility of hemangioma should also be kept in mind.
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Affiliation(s)
- M Azra Tanrikulu
- Department of Cardiology, Faculty of Medicine, Marmara University, Yildiz Caddesi Konak Apartmani No. 43/24, 34353 Besiktas, Istanbul, Turkey
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Oztürk HS, Türkmen C, Erdogan E, Baskan O, Dengiz O, Parlak M. Effects of a soil conditioner on some physical and biological features of soils: results from a greenhouse study. Bioresour Technol 2005; 96:1950-4. [PMID: 16084376 DOI: 10.1016/j.biortech.2005.01.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 10/05/2004] [Accepted: 01/25/2005] [Indexed: 05/03/2023]
Abstract
A soil amendment substance-organic bio-stimulator, Terralyt Plus (TP), was used to observe its impact on the properties of clay loam (CL), sandy clay loam (SCL) and sandy loam (SL) soils and the growth of corn (Zea mays indentata L.) and wheat (Triticum aestivum ssp./vulgare Vill. v. lutescens) under greenhouse conditions. The diluted TP solutions (1:500, 1:1000 and 1:2000) were sprayed onto the soil surfaces. The wheat growth increased for CL and SCL with the application of TP at 1:1000. The highest dry weights were detected with 1:500 TP and corn in all the soils. Penetration resistance of CL containing corn increased with increasing TP concentration. TP was also effective in improving the aggregate stability for CL but not for the other soils. Catalase enzyme activity (CEA), soil evolution (SE) and the total aerobic bacterial population (TABP) were significantly increased (P<0.05) by spraying TP at 1:1000 onto CL.
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Affiliation(s)
- H S Oztürk
- Department of Soil Science, Faculty of Agriculture, Ankara University, Diskapi, 06110 Ankara, Turkey.
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Abstract
PURPOSE To compare the diagnostic values of fluid-attenuated inversion recovery (FLAIR) and gradient spin-echo (GRASE) with those of conventional spin-echo (SE) and fast SE T2-weighted sequences in the evaluation of acute cerebrovascular lesions at 0.5 T. MATERIAL AND METHODS Twenty-two consecutive patients with the clinical diagnosis of acute cerebrovascular accident were examined by MR imaging within the first 48 h of ictus. MR examination included 5-mm axial conventional SE and turbo SE (TSE) T2-weighted, dual-echo GRASE and FLAIR sequences. The patients also had pre- and postcontrast T1-weighted axial images. Two examiners evaluated the images and scored the conspicuity of the acute lesions. RESULTS Regardless of location, FLAIR provided the best lesion conspicuity in the detection of acute infarcts, followed by the GRASE sequence. In the posterior fossa, TSE and SE demonstrated the lesions better than GRASE and FLAIR techniques. In the detection of hemorrhagic elements within the ischemic region, TSE demonstrated statistically significant superiority over other sequences. CONCLUSION In the detection of acute ischemic lesions in locations other than the posterior fossa, FLAIR provided the best lesion conspicuity among four T2-weighted sequences, including SE, TSE, GRASE and FLAIR. However, for the posterior fossa examination, preference of SE or TSE T2-weighted sequences is suggested.
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Affiliation(s)
- I Saatci
- Radiology Department, Hacettepe University Hospital, Ankara. Turkey
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30
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Saatci I, Baskan O, Cekirge HS, Besim A. COMPARISON OF MR SEQUENCES IN EARLY CEREBRAL INFARCTION AT 0.5 T. Acta Radiol 2000. [DOI: 10.1034/j.1600-0455.2000.041006553.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Abstract
Langerhans cell histiocytosis (LCH) is a disease of unknown cause characterised by proliferation of histiocytic granulomas in tissues; the primary cerebral manifestation is diabetes insipidus caused by hypothalamic infiltration. We present a patient in whom, except for the absence of high signal on T1 weighting in the posterior pituitary, consistent with central diabetes insipidus, MRI showed no evidence of hypothalamic involvement by histiocytosis, despite the long duration of the disease. However, there was bilateral, symmetrical involvement of the cerebellum and globus pallidus in addition to a calvarial lesion. High signal in the cerebellar white matter on T2-weighted images may represent demyelination, gliosis and cell loss, as previously reported on pathologic examination.
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Affiliation(s)
- I Saatci
- Department of Radiology, Hacettepe University Hospital, Ankara, Turkey.
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