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Öğe Brakial pleksopatide klinik, EMG ve MR nörografi bulgularının değerlendirilmesi(2022) Karazincir, Sinem; Turhanoğlu, Ayşe Dicle; Okuyucu, Emine Esra; Burakgazi, GülenAmaç: Çalışmanın amacı brakial pleksopatide MR nörografi sonuçlarını elektrodiagnostik test ile birlikte değerlendirmek ve MR nörografinin yararlığını saptamaktır. Yöntem: Brakial pleksopati şüphesi bulunan ve elektrodiagnostik test yapılan 50 hasta çalışmaya dahil edildi. MR nörografide Brakiyal pleksusun kök, gövde ve kord seviyesinde seyri, kalibrasyonu, sinyal yoğunluğu ve devamlılığı 2 bağımsız radyolog tarafından değerlendirildi. Bulgular: Elektrodiagnostik test altın standart tanı testi kabul edilerek yapılan analizde MR nörografinin tanısal doğruluk, duyarlılık, özgüllüğü; 1. okuyucu için sırasıyla %64, %45.16, %94.73; 2. okuyucu için sırasıyla %74, %67.74, %84.21 idi. Okuyucular arası tutarlılık %78 idi. Sonuç: Brakial pleksopati klinik şüphesi bulunan hastalarda MR’ın duyarlılığı ve okuyucular arasındaki uyum orta derecede bulundu. MR nörografi brakial pleksopatiyi gösterebilir ancak pleksusun normal görünümü pleksopati tanısını dışlamamalıdır.Öğe Bromokriptin direnci olan makroprolaktinomalı bir hastada kabergolin tedavisi ile oluşan gebelik : olgu sunumu(2016) Özsan, Müge; Karakaş, Esra; Eren, Abdülrahim; Burakgazi, Gülen; Üstün, İhsan; Gökçe, CumaliBromokriptin ve kabergolin prolaktinoma tedavisinde kullanılan en yaygın dopamin agonistleridir. Dopamin agonistlerine direnç %10-15 civarında görülmektedir. Kliniğimize amenore ve baş ağrısı şikayeti ile başvuran 19 yaşında kadın hastaya yapılan tetkikler sonucu makroprolaktinoma tanısı konuldu. Başlangıç tedavisine kabergolin ile yanıt alınan hastanın takibinde gebelik istemi olması nedeniyle ilacı kesilip bromokriptin tedavisine geçildi. Bromokriptin 15 mg/gün yaklaşık 1 yıl kullanan hastada tedaviye cevapsızlık görüldüğü için bromokriptin direnci düşünülerek kabergolin tedavisine tekrar geçildi. Kabergolin tedavisi altında gebelik oluşan bu vakada, bromokriptin direncinin makroprolaktinoma takip ve tedavisini güçleştirebileceği ve direnç gelişen hastalarda alternatif ilaçlara geçilerek başarının sağlanabileceği vurgulanmak istenmiştir.Öğe Determination of Systemic and Local Causes of Orbital Proptosis Diagnosed by Neuroradiological Modalities(2022) Cakmak, Ayse Idil; Burakgazi, GülenPurpose: To determine the demographic and etiological characteristics in patients with orbital proptosis diagnosed by neuroimaging studies. Materials and Methods: We retrospectively analyzed neuroradiological images taken in the obtained during 11-years period (between January, 2009 and July, 2020) by extracting from in the hospital information system. Record system were analyzed retrospectively. An exophthalmometer was performed on the orbital images. The patients diagnosed as orbital proptosis with available clinical and histological data were included in the study. Results: The study included 167 patients (including 30 pediatric patients). It was found that the most common cause of orbital proptosis was inflammatory diseases of orbit, namely orbital cellulitis in children and thyroid orbitopathy in adults; followed by the primary benign tumors of orbit. Among the malignant tumors, primary orbital tumors were more common in children whereas secondary orbital tumors extending from the systemic or local regions were more common in adults. Bilateral proptosis was found in 43.1% of all cases. It was observed that the numbers of systemic (69 cases, 50.3%) and local diseases causing proptosis (68 cases, 49.6%) were comparable in adults while the local diseases causing proptosis (28 cases, 93.3%) were more common than systemic diseases causing proptosis (2 cases, 6.6%) in children. Conclusion: It was found that there was both local and systemic causes of orbital proptosis including those can threaten vision and life. The knowledge of etiological reasons in this series will assist the clinician in assessment of orbital proptosis detected at presentation in patients living in the same geography, ensuring early diagnosis and treatment.Öğe Evaluation of Liver Fibrosis in Polycystic Ovary Syndrome by Shear Wave Elastography, FIB-4 Score, and Serum Periostin Levels(2023) Gürkan, Eren; Aslan, Gökçen; Burakgazi, Gülen; Özcan, OğuzhanObjective: In this study, we aimed to demonstrate the presence of liver fibrosis in patients with poly- cystic ovary syndrome at a relatively early stage of the disease using biochemical data and 2-dimen- sional shear wave elastography techniques. Methods: The study included 33 women with polycystic ovary syndrome and 33 healthy women volunteers. Serum androgen and sex hormone binding globulin levels were measured, and then free androgen index was calculated. Periostin and matrix metalloproteinase-3 levels were measured by ELISA method. Sterling formula was used to calculate FIB-4 score. Liver elasticity was evaluated using shear wave elastography. Results: Periostin and matrix metalloproteinase-3 levels were found to be significantly higher in the polycystic ovary syndrome group compared to the control group (P < .001 and P < .001, respectively). Serum testosterone level and free androgen index were also significantly higher in the polycystic ovary syndrome group (P = .044 and P = .037, respectively). However, there was no significant differ- ence between the groups in terms of liver velocity and elasticity (P = .185 and P = .172, respectively). A positive correlation was found between FIB-4 score and periostin (r = 0.433, P = .012) and between FIB-4 score and liver elasticity in the PCOS group (r = 0.374, P = .032). Conclusion: FIB-4 score was positively correlated with periostin and liver elasticity. These data sug- gest that in addition to FIB-4 score, serum periostin level and shear wave elastography may help us clinically in the detection of liver fibrosis at patients with polycystic ovary syndrome.Öğe An investigation of olfactory bulb and entorhinal cortex volumesin both patients with Alzheimer’s disease and healthy individuals,and a comparative analysis of neuropeptides(2020) Petekkaya, Emine; Kaptan, Zülal; Ünalmış, Demet; Burakgazi, Gülen; Kuş, Berna; Melek, İsmet Murat; Arpacı, AbdullahAlzheimer’s Disease (AD) is the most common neurodegenerative disease and is hard to diagnose at the early stages. The pathogenesis of AD is associated with the loss of a sense of smell. Reduction in the volumes of the Olfactory Bulb (OB) and Entorhinal Cortex (EC) is positively correlated with the decline of the smelling function where OB projects to EC. This study aims to detect the early changes in OB and EC volumes in AD patients by comparing them to healthy subjects. This study also aims to make a comparative analysis of plasma levels and the relationship between arginine-vasopressin (AVP) and Oxytocin (OT), which are neuropeptides associated with cognitive functions. The participants comprised 9 AD patients and 12 healthy individuals. We used volumetric methods such as MRICloud and IBASPM to measure the OB and EC volumes with the help of 3D MRI (Magnetic Resonance Imaging) images. We compared the left and right differentiation. Moreover, we investigated the neuropeptide levels in blood samples from the participants. We conducted a correlation analysis for all parameters. Bilateral OB atrophy was discovered in the AD patients in comparison to the control group (p=0.002 for right; p=0.015 for left). The right OB volume was measured to be larger than the left OB volume in the control group,but this asymmetry was not observed in the AD patients. The right and left EC's of the AD patients were atrophic in comparison to the control (p<0.001). The atrophy of the left EC was measured to be higher than that of the right EC (p=0.0008). There was no significant difference between the OT and AVP plasma levels of the AD patients and the control group. The study revealed that the OB and EC volumes of the AD patients were bilaterally reduced in comparison to patients of similar ages. This outcome may indicate that an MRI scan examination of OB and EC volumes may help early AD diagnosis.Öğe Non-inflammatory and non-neoplastic softtissue lesions of the tympanic cavity(2020) Burakgazi, Gülen; Bayaroğulları, HanifiObjectives: Tympanic cavity (TC) is an anatomically challenging region for the diagnosis of lesions located inside it.Radiological diagnosis and demonstration of the anatomic localization of sporadic lesions such as vascular malformationsand meningocele are essential for the prevention of complications that may occur during operation and recurrent unnecessary interventions. The aim of the present study was to demonstrate the radiological appearance of the vascular variationsand the post-traumatic soft tissue lesions which are rarely encountered in TC. Methods: A total of 3525 temporal multi-slice computed tomography (MSCT) images were evaluated between 2010–2018.Twelve cases with non-inflamatory and non-neoplastic soft tissue lesions in TC were detected and 2 with meningocele wereincluded in the study. Results: Of the 12 cases, 6 were males and 6 were females. The mean age of the patients was 26.16 years. Four cases had anaberrant internal carotid artery (ICA), being bilateral in 2 cases and right sided in the remaining 2 cases. Six cases had dehiscentmega jugular bulb (DMJB); and 2 cases had post-traumatic meningocele. Conclusion: Vascular malformations and meningoceles are rarely observed in TC. They may present nonspecific clinical signsand symptoms; however, they should be evaluated with MSCT and MRI before the surgical interventions regarding the middle ear to prevent possible complications.Öğe Proptozisin Görüntü İşleme ve Analizi ile Değerlendirilmesi(2021) Cakmak, Ayse Idil; Çetin, Şirin; Burakgazi, Gülen; Özseven, TurgutAmaç: Proptozisli hastaların orbita manyetik rezonans görüntüleri üzerinde görüntü işleme ve analizle elde edilen antropometrik ölçümleri değerlendirmek. Gereç ve Yöntem: Geriye dönük olan bu çalışmada hastane kayıt sisteminde değerlendirilen 1-18 yaş arası çocukların orbita manyetik rezonans görüntüleri üzerinde ekzoftalmometre yapıldı. Proptozis olduğu belirlenmiş 17 hasta (hasta grubu) ile proptozis olmayan 17 hastanın (kontrol grubu) T2 ağırlıklı manyetik rezonans görüntülerinden en net alınan aksiyel ve koronal kesitleri üzerinde 15 adet ant-ropometrik ölçüm yapıldı. Bu görüntüler Matlab yazılım programında analiz edildi. Her iki grubun analiz sonuçları birbirleri ile karşılaştırıldı. Analizlerde istatistiksel anlamlılık düzeyi p?0,05 olarak belirlendi. Bulgular: Hasta grubu (9±5.65 yaş) (6 kız, 11 erkek) ve kontrol grubu (7.82±5.46 yaş) (7 kız, 10 erkek) arasında cinsiyet ve yaş açısından anlamlı farklılık gözlenmedi (sırasıyla p=0,360, p=0,734). Hastaların %82’sinde sağ gözde proptozis mevcuttu. Hasta grubunun ant - ropometrik ölçümleri ile kontrol grubunun antropometrik ölçümleri birbirleri ile istatistiksel olarak karşılaştırıldı. İstatistiksel analiz sonucuna göre hasta grupta göz küresinin arkası ile temporal kemik iç tabulası arasında ölçülen mesafenin her iki göz arasındaki farkı, her iki göz küresinin dış kenarının birbirlerine olan uzaklığı ve her iki göz küresi nazal sınırının frontal lob ve nazal septum anteriorunu birleştiren orta hatta olan uzak farkı anlamlı oranda daha yüksek; sağ göz lens kalınlık ölçümleri ise anlamlı oranda daha düşük saptandı (sırasıyla p=0,003, p=0,030, p=0,014 ve p=0,05). Sonuç: Orbital patolojileri olan hastaların orbita manyetik rezonans görüntülerinin görüntü işleme ve analizle yapılan antropometrik ölçümleri proptozisli hastalarda önemli farklılıklar göstermiştir. Bu çalışma, bu konuda ileride yapılacak çalışmalar için temel bir çalışma işlevi görebilir.Öğe Radiological Evaluation of Benign Bone Tumors of Sinonasal Region(2020) Burakgazi, Gülen; Bayaroğulları, HanifiAim: To evaluate radiologically the benign bone masses in the sinonasal region and their relationship with adjacentstructures.Methods: Multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) of the sinonasal region were evaluated retrospectively between 2010-2016. Based on radiological findings, 41 cases rarely seen dueto their size, histopathologic features and localizations were included in the study.Results: Twenty-two of 41 cases had osteoma, sixteen had fibrous dysplasia, others had aneurysmal bone cyst,enchondroma and brown tumor.Conclusion: When imaging benign bone tumours of sinonasal region, MDCT and MRI are the frequently used modalities. Radiography may show the presence of a lesion in some cases but is insufficient when it is aimed to determinethe nature of the lesion as well as the relations between the lesion and the neighbouring structures.
