[Show abstract][Hide abstract] ABSTRACT: Resistive index (RI) is an indirect measurement of blood flow resistance that can be used to evaluate vascular damage in ophthalmologic diseases. The purpose of this study was to evaluate the association between RI values of orbital arteries by using the color Doppler imaging (CDI) in type II diabetes mellitus (DM) patients with microalbuminuria.
We evaluated 91 type II DM patients with microalbuminuria and 27 healthy subjects. The DM patients with microalbuminuria were grouped into two: group 1 consisted of patients with retinopathy (n = 51) and group 2 consisted of patients without retinopathy (n = 40). Healthy subjects constituted group 3 (n = 27). The mean RI values of ophthalmic artery (OA), central retinal artery (CRA), and posterior ciliary artery (PCA) were measured using CDI.
Compared to diabetic group 2, group 1 had significantly higher mean RIs of OA, CRA, PCA, and HbA1c levels (p < 0.001 for all). Besides, there were no statistical differences in mean RIs of OA, CRA, and PCA between the control group and group 2 (p = 1.0; p = 0.44; p = 0.67, respectively). Mean RIs of OA and PCA were significantly correlated with age in group 1 (r = 0.549, p < 0.001; r = 0.407, p = 0.003, respectively). Mean RI of CRA was significantly correlated with the duration of diabetes and age in group 1 (r = 0.296, p = 0.035; r = 0.486, p < 0.001, respectively).
Our study indicates that RI might be a useful marker for early diagnosis and follow-up of diabetic retinopathy, and orbital RI assessment would be beneficial for diabetic patients with retinopathy.
[Show abstract][Hide abstract] ABSTRACT: Resistive index (RI) is an indirect measurement of blood flow resistance that can be used to evaluate vascular damage.
The purpose of this study is to evaluate the association between RI values of orbital and intrarenal arteries by means of Doppler ultrasonography (US).
We evaluated 103 diabetic patients. As a control group, 30 subjects were examined. The patients were divided into two groups. Group 1 consisted of patients with urinary albumin excretion (UAE) <300 mg/day and estimated glomerular filtration rate (eGFR) levels >90 ml/min (n = 50); Group 2 had a UAE >300 mg/day and/or eGFR levels between 89 and 60 ml/min (n = 53). The association between RI values obtained with Doppler US of the ophthalmic artery, central retinal artery, posterior ciliary artery and intrarenal arteries were calculated.
Both orbital and intrarenal arterial RI values in Group 1 and Group 2 were higher than the control group (p = 0.001); furthermore, values were higher in Group 2 than in Group 1 (p = 0.0004/0.029/0.036, p = 0.016, respectively). A positive correlation was found between orbital and intrarenal arterial RI values in Group 2 (r = 0.475, 0.285, 0.363, p < 0.01, respectively).
Both orbital and renal arterial RI values were shown to be higher than the control group. Further, a trend towards higher RI values was observed with renal disease. RI may be useful as one of the markers for early diagnosis and follow-up of diabetic nephropathy and retinopathy.
Kidney and Blood Pressure Research 03/2012; 35(5):332-9. DOI:10.1159/000336105 · 2.12 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of the kyphoplasty method for the treatment of traumatic osteoporotic vertebral compression fractures in geriatric patients is to improve the patient's quality of life. In this report we present two elderly patients who were suffering of traumatic osteoporotic vertebral compression fractures and underwent successful kyphoplasties. Percutaneous kyphoplasty method for the surgical treatment of these fractures decreases the hospitalization, morbidity and mortality in these patients.
Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES 01/2010; 16(1):95-7. · 0.38 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Inguinal hernia is one of the most common surgical pathologies in childhood. Any of the abdominal organs can slide into the hernial sac and become incarcerated there. In girls, the fallopian tubes, ovaries, uterus, and-rarely-ovarian cysts can form the sliding component of an inguinal hernia. The aim of this study was to investigate the diagnostic value of preoperative sonographic examination in girls with nonreducible inguinal masses.
Nine girls ranging in age from 2 months to 8 years who were admitted to our clinic with nonreducible inguinal masses were included in the study. All patients underwent sonographic examination followed by surgery on the day of admission.
A definitive diagnosis was obtained in 6 patients on preoperative sonographic evaluation, whereas 3 patients were misdiagnosed. One patient was diagnosed sonographically as having lymphadenopathy, but surgery revealed an ovarian cyst sliding into the hernial sac. A second patient was found to have an infected lymph node at surgery instead of a strangulated bowel loop as diagnosed on sonographic examination. In the third patient, the preoperative sonographic diagnosis was an ovarian cyst in the hernia sac, but surgery revealed a cyst of the canal of Nuck.
Inguinal masses in young girls must be carefully evaluated, because the sonographic preoperative diagnosis may be misleading.
[Show abstract][Hide abstract] ABSTRACT: The aim of the present study was to evaluate the alteration of ocular blood hemodynamics after intranasal administration of 17beta-estradiol, through measurement of the ophthalmic artery (OA) and the central retinal artery (CRA) using color duplex sonography.
Thirty healthy women who had been naturally postmenopausal for at least 1 year were enrolled in the study. A randomized, placebo-controlled, crossover, double-blinded study was conducted of the acute effect of 17beta-estradiol (Aerodiol; Servier, Chambrayles-Tours, France) on OA and CRA blood flow using color duplex sonography.
The peak systolic and end diastolic velocities of the CRA were increased significantly after 17beta-estradiol administration compared with placebo. A significant decrease was also found in the pulsatility and resistive indices of the CRA. However, there were no statistically significant differences in OA flow velocities or pulsatility and resistive indices.
Nasal 17beta-estradiol administration in postmenopausal women causes an improvement in the ocular vascular Doppler indices. These results suggest that there could be a positive effect of Aerodiol on middle-sized arteries and arterioles.
[Show abstract][Hide abstract] ABSTRACT: A pneumatocyst in the cervical spine is extremely rare and to our knowledge only a few reports have been published in the English literature. Although the etiology and natural course of vertebral body pneumatocyst is unclear, nitrogen gas accumulation is claimed. A 65-year-old-man was admitted to the emergency department with neck pain and numbness and incapacity in his both hands and fingers. The radiological images revealed a vertebral located pneumatocyst in the C4 cervical vertebra. In this report, we present a case of cervical pneumatocyst located in the C4 vertebral body. The clinical and radiological features and natural course of the pneumatocyst were evaluated.
[Show abstract][Hide abstract] ABSTRACT: Atherosclerotic vascular disease is a major cause of morbidity and mortality for patients with end-stage renal disease on maintenance hemodialysis. Early atherosclerotic changes of the arterial wall can be evaluated by intima-media thickness (IMT), presence and structure of plaques and parameters of vascular resistance. The aim of the present study has been to investigate the relationship between carotid IMT and pulsatility index (PI) or resistive index (RI) values in hemodialysis patients.
We studied 36 hemodialysis patients (21 female, 15 male; median age 39.5 years, IQR 33.0-54.7 years) and 38 healthy volunteers (20 women, 18 men; median age 41.0 years IQR 32.5-53.5 years). All subjects underwent ultrasonography of common carotid artery, with determination of IMT, PI and RI.
Bilateral and mean carotid IMT were found to be significantly higher in hemodialysis patients than in the control group (P<0.0001). Right and left carotid artery RI values were determined to be lower in hemodialysis patients than in the control group (P=0.007 for both). Similarly, right and left carotid PI values were also determined significantly lower in the hemodialysis group (P=0.005 and P=0.004, respectively). There was a moderate negative correlation between the right carotid IMT and right PI (r=-0.258, P=0.026).
In contrast to previous studies in patients with diabetes, hypertension or cerebrovascular disease, PI and RI values decrease when IMT increases in hemodialysis patients. This finding may be a result of peripheral vasodilatation secondary to anemia in hemodialysis patients.
International Urology and Nephrology 02/2008; 40(3):779-84. DOI:10.1007/s11255-007-9314-7 · 1.52 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Obesity is associated with insulin resistance, which is the main pathogenic factor for nonalcoholic fatty liver disease (NAFLD). NAFLD can progress without associated elevations in liver enzymes. Therefore, we investigated the effects of weight loss on normal transaminase levels in obese subjects who are at risk for NAFLD.
Thirty-seven obese patients with normal ALT levels were evaluated. All patients received an individualized low-calorie diet over at least 6 months. Twenty-two patients who achieved weight loss of at least 5% body weight were identified as the study group and the others as the control group. Transaminases, insulin resistance, and body mass index were compared before and after the intervention.
Hepatic steatosis was found in 83.8% of obese patients. ALT was correlated with HOMA-IR in all patients at baseline (r = 0.363, P = 0.027). At the end of the follow-up, mean weight loss achieved in the study and control groups were 9.2% (8.7 +/- 3.0 kg) and 0.3% (0.5 +/- 2.8 kg), respectively. In the study group, HOMA-IR and ALT decreased from 4.0 +/- 1.8 to 2.4 +/- 0.9 and from 21.4 +/- 6.6 IU/L to 16.8 +/- 5.5 IU/L, respectively (P = 0.005 and P = 0.044).
The results demonstrate that weight loss results in a decrease in normal ALT levels as well as insulin resistance. Therefore, the normal range for ALT may need to be reassessed.
The American Journal of the Medical Sciences 12/2007; 334(5):327-30. DOI:10.1097/MAJ.0b013e3181557702 · 1.39 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Although there is an increased prevalence of pulmonary hypertension in hemodialysis patients, the relationship between arteriovenous (AV) fistula blood flow and pulmonary hemodynamics is not known. The aim of this study was to evaluate the relationship between blood flow rate of AV fistula and pulmonary artery pressure (PAP) in hemodialysis patients.
Thirty-two hemodialysis patients were included in this study. Within 1 h of completion of dialysis, blood flow rate of AV fistula and pulmonary hemodynamics were evaluated using Doppler sonography. Pulmonary hypertension was defined as mean PAP > or = 25 mmHg at rest.
Mean PAP, median blood flow rate of AV fistula, and mean cardiac index were 22.5 +/- 10.0 mmHg (range 8-39), 978.0 ml/min (interquartile range 762.0-1,584.5) and 3,043.0 +/- 694.3 ml/ min per m2 (range 1,251-4,140), respectively. Mean PAP has a relationship to cardiac index (r = 0.453, P = 0.014). However, there was no correlation between mean PAP and blood flow rate of AV fistula, hemoglobin, calcium-phosphorus (CaxP) product, and parathormone. Pulmonary hypertension was present in 43.7% of patients. Patients with pulmonary hypertension had significantly higher cardiac index (P = 0.036).
We found there was no direct relationship between blood flow rate of AV fistula and PAP. Other factors may play a role in the development of pulmonary hypertension.
International Urology and Nephrology 11/2007; 40(2):509-13. DOI:10.1007/s11255-007-9269-8 · 1.52 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To evaluate the effects of sonographic characteristics of thyroid nodules, the diameter of needle used for sampling, and sampling technique on obtaining sufficient cytological material (SCM).
We performed sonography-guided fine-needle biopsy (FNB) in 232 solid thyroid nodules. Size-, echogenicity, vascularity, and localization of all nodules were evaluated by Doppler sonography before the biopsy. Needles of size 20, 22, and 24 G were used for biopsy. The biopsy specimen was acquired using two different methods after localisation. In first method, the needle tip was advanced into the nodule in various positions using a to-and-fro motion whilst in the nodule, along with concurrent aspiration. In the second method, the needle was advanced vigorously using a to-and-fro motion within the nodule whilst being rotated on its axis (capillary-action technique).
The mean nodule size was 2.1+/-1.3 cm (range 0.4-7.2 cm). SCM was acquired from 154 (66.4%) nodules by sonography-guided FNB. In 78 (33.6%) nodules, SCM could not be collected. There was no significant difference between nodules with different echogenicity and vascularity for SCM. Regarding the needle size, the lowest rate of SCM was obtained using 20 G needles (56.6%) and the highest rate of adequate material was obtained using 24 G needles (82.5%; p=0.001). The SCM rate was 76.9% with the capillary-action technique versus 49.4% with the aspiration technique (p<0.001).
Selecting finer needles (24-25 G) for sonography-guided FNB of thyroid nodules and using the capillary-action technique decreased the rate of inadequate material in cytological examination.
[Show abstract][Hide abstract] ABSTRACT: We describe the case of a 37-year-old patient with mycotic aneurysm of the right peroneal artery associated with episodes of endocarditis. There are only 7 cases of mycotic aneurysms of the crural arteries reported in the literature. To the best of our knowledge, this is the first reported case of a mycotic aneurysm of the peroneal artery in an adult.
[Show abstract][Hide abstract] ABSTRACT: In this study of obstructive sleep apnoea (OSA), glucose tolerance and liver steatosis in females from an obesity unit, 45 patients (mean age 46.8 years, mean body mass index 39.4 kg/m(2), all non-diabetic and alcohol abstainers) underwent nocturnal polysomnography, a 2 h oral glucose tolerance test and abdominal ultrasonography. OSA, defined as an apnoea-hypopnoea index (AHI) of > or = 10 events/h, was present in 20 patients (44%). Impaired glucose tolerance (IGT) was found in eight patients (40%) with OSA and three patients (12%) without OSA; there was a positive linear relationship between AHI and post-load glucose levels. On multivariate logistic regression analysis, IGT was predicted by OSA independently of age, waist circumference, systolic blood pressure and current smoking. Liver steatosis was present in 37 women (82.2%), of whom six had grade III steatosis. Of the variables tested, IGT was the only predictor of grade III steatosis. In conclusion, OSA is an independent predictor of IGT which, in turn, is associated with severe liver steatosis in an obesity unit-based sample of women.
The Journal of international medical research 07/2007; 35(4):458-66. DOI:10.1177/147323000703500404 · 1.44 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We investigated the diffusion-weighted MRI changes, apparent diffusion coefficient (ADC) values, and conventional MRI findings in specific brain areas during migraine attacks in patients with and without aura.
Included in the study were 22 patients (2 male, 20 female) aged between 17 and 49 years who were diagnosed as having migraine according to the diagnostic criteria of the International Headache Society. Also included in the study were 18 age- and sex-matched healthy volunteers. Hyperintense lesions were evaluated in conventional MR images. Heavily diffusion-weighted images, ADC maps, and segmented ADC maps generated for regional ADC (rADC) measurements, were also studied. ADC values from specific brain areas were used with appropriate region of interests (ROI).
Migraine with aura was diagnosed in 13 patients and migraine without aura was diagnosed in 9 patients. A total of 23 hyperintense lesions within the periventricular white matter and deep white matter were detected in five patients (21.8%). All of these hyperintense lesions were seen in migraine patients with aura. In only one patient did a hyperintense lesion show an increased diffusion pattern on diffusion-weighted images and ADC maps. One hyperintense lesion was detected in the control group (5.5%). There was no significant difference in ADC values between the migraine and control groups.
T2-weighted hyperintense lesions were significantly more frequent in migraine patients especially in those with aura than in the control group. No diffusion alterations in diffusion-weighted images were detected in the infra- and supratentorial brain areas during migraine attacks in patients with and without aura.
[Show abstract][Hide abstract] ABSTRACT: We aimed to evaluate the effects of l-dopa use on apparent diffusion coefficient (ADC) values of different brain regions in Parkinson's disease (PD) patients. Thirty-five subjects underwent magnetic resonance imaging (MRI), including 21 PD patients (13 men, 8 women; mean age, 63 years+/-8), and 14 sex and age-matched control subjects. PD patients were separated into two groups according to the duration of l-dopa usage: patients using l-dopa less and more than 1 year. According to the disease duration two other groups were formed: patients diagnosed less and more than 1 year. Unified Parkinson Disease Rating Scale (UPDRS) scores of PD patients were detected. Diffusion weighted images (DWI) and ADC maps of patients and controls were evaluated and regional ADC (rADC) measurements were performed. Patients' age was not significantly different between groups. UPDRS was significantly different between the patient groups. There was no significant difference of rADC values between PD and control groups, and within the different PD groups. Short- and long-term l-dopa usage in PD patients did not cause any change rADC values in various brain regions.
[Show abstract][Hide abstract] ABSTRACT: To assess via Doppler sonography the hemodynamic changes in the cephalic vein after creation of an arteriovenous fistula, and to compare radiocephalic and brachiocephalic fistulas.
Thirty-three hemodialysis patients and 54 controls were enrolled in the study. The cephalic vein was examined with a 7.5-MHz linear-array transducer. Doppler waveform parameters (resistance index, pulsatility index), time-averaged maximum flow velocity (TAV), peak systolic velocity (PSV), end-diastolic velocity (EDV), and the cross-sectional area of the vessel (A) were measured. Cephalic vein flow volume (CVFV) was calculated as TAV x A.
CVFV, PSV, EDV, A, RI, and PI were 45.5, 7.2, 6.7, 7.7, 1.2, and 1.32 times higher, respectively, in the cephalic vein of hemodialysis patients compared with controls. Both CVFV and A were higher in brachiocephalic patients compared with radiocephalic patients (1,983 +/- 1,199 versus 870 +/- 322 ml/min [p < 0.05] and 50.3 +/- 38.9 versus 21.0 +/- 7.8 mm(2) [p < 0.05], respectively).
The increase in cross-sectional area and flow volume of the cephalic vein is larger in patients with brachiocephalic fistulas than in those with radiocephalic fistulas; however, flow velocities and waveform parameters are not different.
[Show abstract][Hide abstract] ABSTRACT: We present diffusion MR imaging findings and ADC values in acute methanol intoxication in a 32-year-old man. T2-weighted and FLAIR images showed bilateral increased signal in the caudate nuclei, putamen, cerebral peduncle, and centrum semiovale. Diffusion MR showed hyperintensity in same localization, and splenium of corpus callosum. ADC values of these areas were markedly reduced consistent with restricted diffusion.
European Journal of Radiology Extra 02/2007; 61(2):41-44. DOI:10.1016/j.ejrex.2006.12.001
[Show abstract][Hide abstract] ABSTRACT: Doppler ultrasound of extracranial internal carotid artery (ICA) and vertebral artery (VA) were performed and total cerebral blood flow volume (tCBFV) was evaluated in chronic obstructive pulmonary disease (COPD) patients. CBFV changes due to blood gas changes were also evaluated.
Bilateral ICA and VA have been examined with 7.5 MHz linear array transducer in COPD patients. Angle-corrected time averaged flow velocity and cross-sectional areas of vessels have been measured. Flow volumes and tCBFV have been calculated. Flow velocities and waveform parameters have been measured.
tCBFV, anterior-posterior CBFVs, left-right ICA flow volumes, bilateral ICA and VA cross-sectional areas and left ICA peak-systolic velocity were significantly higher in COPD patients than control group. Among COPD patients tCBFVs were highest in hypoxemic-hypercapnic ones, and lowest in normocapnic ones. Bilateral VA flow volumes, bilateral ICA (except left ICA V(ps)) and VA flow velocities and waveform parameters were not different in COPD patients compared with control group. When compared among the subgroups of COPD patients, there were no significant differences for all parameters.
tCBFVs were found to be significantly higher in COPD patients. This increment which is probably due to balancing the oxygen deficit is low with hypoxemia and high with hypercapnia and hypoxemia. Particularly, bilateral ICA and VA cross-sectional area changes and increased left ICA V(ps) were considered as the main reason for increased tCBFV in COPD patients.
Respiratory Medicine 11/2006; 100(10):1826-33. DOI:10.1016/j.rmed.2006.01.015 · 3.09 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To ultrasonographically evaluate the acute effects of smoking on gallbladder contraction and refilling in chronic smokers and nonsmokers.
Fifteen chronic smokers (21-30 years old) and fifteen nonsmokers (21-35 years old) participated in this study. Chronic smokers were selected among the volunteers who had been smoking for at least 5 years and 10 cigarettes per day (mean 17.5/d). Examinations were performed in two separate days. In the first day, basal gallbladder (GB) volumes of volunteers were measured after 8-h fasting. After the examinations, participants had a meal containing at least 30-40 gram fat. Gallbladder volume was assessed at 5, 15, 30, 60, 120 and 180 min after the meal. In the second day, participants smoked 2 cigarettes after 8-h fasting. Then, they had the same meal, and gallbladder measurements were repeated at the same time points. Same procedures were applied to both groups.
The mean starving GB volumes were 23.3 +/- 3.3 mL in the first day, 21.9 +/- 3.0 mL in the second day in nonsmoker group and 18.3 +/- 3.0 mL in the first day, 19.5 +/- 2.8 mL in second day in smoker group. There was no significant difference between starving GB volumes. We did not find any significant difference between the GB volumes measured at 5, 15, 30, 60, 120 and 180 min in the first and second days in nonsmoker group. In smokers, post cigarette GB volume was found significantly higher at 5, 15 and 30 min which corresponded to GB contraction phase (P < 0.05). Control GB volume measurements were not significantly different between the two groups. Post-smoking GB volumes were also not significantly different between the two groups.
Smoking prolongs the maximal GB emptying time both in smokers and in nonsmokers though it is not significant. It delays GB contraction in chronic smokers and causes a significant decrease in GB emptying volume. Smoking causes no significant delay in GB refilling in both smokers and nonsmokers. These effects of smoking observed in acute phase result in bile stasis in GB. Bile stasis is the underlying cause of most GB disorders in chronic process.
World Journal of Gastroenterology 09/2006; 12(34):5540-3. · 2.37 Impact Factor