M N Akçay

Ataturk University, Kalikala, Erzurum, Turkey

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Publications (32)49.95 Total impact

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    ABSTRACT: In this paper we describe sonoelastography findings for idiopathic granulomatous mastitis (IGM), the clinical and radiological features of which often mimic those of breast carcinoma. In this retrospective study, sonoelastography findings for patients with pathologically proved IGM were studied. Twenty-seven patients with pathologically proved IGM were enrolled in the study. All were female, and the mean age was 37.81 years (standard deviation 7.10 years; range 24 to 56 years). Elasticity scores (ES), strain ratios (SR), and elastic diameters (ED) were evaluated for the lesions. Ten lesions (37.0 %) were diffuse, six (22.2 %) were tubular, six (22.2 %) were a mass, and five (18.5 %) were cystic in appearance on ultrasonography. On sonoelastography, mean ES ± standard deviation was 1.66 ± 0.55 (between 1.00 and 3.00); mean SR ± standard deviation was 1.10 ± 0.79 (between 0.29 and 4.00). ED was no different between grey-scale and sonoelastogram images. The features of idiopathic granulomatous mastitis suggest it is benign in nature.
    Japanese journal of radiology 12/2014; 33(1). DOI:10.1007/s11604-014-0378-x · 0.74 Impact Factor
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    ABSTRACT: In this retrospective study, we compared transverse short tau inversion recovery (STIR), transverse diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) map and first post-contrast fat-saturated fast low-angle shot (FLASH) 3D T1 with pathology results in terms of their accuracy in estimating breast carcinoma size.
    Journal of Medical Imaging and Radiation Oncology 07/2014; 58(5). DOI:10.1111/1754-9485.12205 · 0.95 Impact Factor
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    ABSTRACT: Completion thyroidectomy is recommended in patients who have been diagnosed with differentiated thyroid cancer on histopathological evaluation, if their first operation was a conservative approach. The critical issue is when to do the second operation. The medical records of 66 patients who underwent completion thyroidectomy for the treatment of differentiated thyroid cancer in our clinic between 2006-2013 were retrospectively analyzed. All data were compared after patients were divided into two groups according to the interval between the first surgery and completion thyroidectomy. Fifty-two patients (78.8%) were women and 14 patients (21.2%) were male. Completion thyroidectomy was performed 10-90 days after the initial surgery (group 1) in 26 patients, whereas it was performed later than 90 days in 40 patients (group 2). Temporary hypoparathyroidism occurred in two patients (7.7%) in group 1, and in 3 patients (7.5%) in group 2. Transient recurrent laryngeal nerve palsy was observed in 1 patient (3.9%) in group 1, and in 1 patient (2.5%) in group 2. There were no permanent morbidities in both groups. Residual tumor rate after completion thyroidectomy was 45.5%. There was no statistically significant difference between the two groups in terms of complications after completion thyroidectomy. Although in some studies it is recommended that completion thyroidectomy should be performed either before scar tissue development or after clinical remission of scar tissue, edema and inflammation, we believe that timing of surgery has no effect on morbidity.
    Turkish Journal of Surgery 03/2014; 30(1):18-21. DOI:10.5152/UCD.2014.2486
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    ABSTRACT: After thyroidectomy hypocalcaemia is the most significant complication for clinicians. In this study, we investigated the factors associated with development of hypocalcaemia after thyroidectomy. We investigated the patients prospectively for age, gender, preoperative diagnosis, hormonal status, operative time, operating surgeon, existence of parathyroid gland injury at the operation, parathyroid gland auto-transplantation, preoperative use of anti-thyroid drugs and amount of bleeding at the operation. After operation in 1 and 2 days, serum calcium and phosphor, and in the 1 day parathyroid hormone values were evaluated. The chi-square test was applied in the analysis of categorical variables. Logistic regression model was used to determine the risk of hypocalcaemia in the univariate analysis. Hypocalcaemia developed in 47 of 196 patients. Female gender, preoperative diagnosis of thyroid cancer and toxic nodular goitre, <3cm nodule size, parathyroid injury and auto-transplantation and low vitamin D levels were factors found to be associated with hypocalcaemia in the Logistic regression analysis. The factors associated with hypocalcaemia were defined to be "gender, preoperative diagnosis, parathyroid gland injury, nodule size and vitamin D deficiency", it is a multifactorial problem and it would not be proper to define a few etiological factors.
    02/2014; 46(1):15-21. DOI:10.5152/eajm.2014.03
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    ABSTRACT: Magnetic resonance imaging of the breast supplies much information concerning the signal characteristics of a lesion. Among these, high signal intensity on non-fat saturated T1-weighted imaging (WI) is a special finding. Such a finding may result from different causes, such as a paramagnetic substance or fatty, bloody or proteinaceous content. In this article, we present hyperintense breast lesions on T1-WI.
    Japanese journal of radiology 08/2013; DOI:10.1007/s11604-013-0239-z · 0.74 Impact Factor
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    ABSTRACT: Juvenile papillomatosis is a rare disease affecting young women. Here we present magnetic resonance imaging features of two cases with histopathologically proven juvenile papillomatosis of the breast and review some of the relevant literature. Case 1 exhibited bilateral, well-bordered breast masses, with complex cystic and solid components. The kinetic evaluation showed continuous and plateau patterns. Case 2 featured a giant mass with a few cystic and many solid nodular components and filled the entire right breast. The kinetic evaluation showed a continuous curve.
    Japanese journal of radiology 03/2013; 31(6). DOI:10.1007/s11604-013-0197-5 · 0.74 Impact Factor
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    ABSTRACT: Infections are one of the most important and potentially serious complications of burn wounds. Quantitative biopsy cultures are useful for showing that a burn wound infection is not present, but these cultures are not useful for showing that an infection is present. Swab cultures are used to diagnosis surface colonization and may not accurately reflect the organism(s) causing the wound infection. To perform a comparison of surface swab and biopsy cultures for isolated microorganisms from burn wounds, 160 biopsy/surface swab pairs were collected from 160 patients. Seventy-seven patients (48.1%) showed positive micro-organism cultures from the burn wounds; 19.3 percent had both positive surface cultures and significant bacterial counts from the biopsy cultures, whereas 28.8 percent of the patients had only positive surface cultures. There was moderate agreement (41%) between the results of surface swab and quantitative biopsy cultures used to diagnose burn wound infections. Pseudomonas aeruginosa (45.5%) was the most predominantly isolated bacteria from the wounds, and there was good concordance between the results of the surface swab and quantitative biopsy culture samples (78%). Coagulase-negative Staphylococci (CNS) and Escherichia coli strains were only isolated from the surface swab samples because they are colonizing bacteria. The univariate analysis revealed that there were significant associations between the results of the positive biopsy cultures and the total surface body area, open flame burns, prolonged hospitalization and female gender (p<0.05). Surface swab and quantitative biopsy cultures have a high rate of concordance in predicting P. aeruginosa invasion and the colonization of E. coli and CNS strains in burn wounds.
    02/2013; 45(1):34-8. DOI:10.5152/eajm.2013.05
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    ABSTRACT: This study was aimed to identify the incidence of vancomycin-resistant enterococcus (VRE) colonization in burn patients, to collate risk factors for colonization and to determine the VRE resistance profile to different antimicrobial agents. This prospective study was carried out on the burn unit, during the period from September 2008 to January 2010, in 128 patients who were hospitalized at least 3 weeks or more. Periodic swabs were taken from burn wound, rectal, axillary, umblicaly and throat regions of the patients on admission and 7th, 14th, 21st days of hospitalization. Demographics and known risk factors were retrieved and assessed by statistical methods. Only 20 patients (15.6%) were colonized with enterococci on admission and these strains isolated from rectal, umblical and throat samples were sensitive to vancomycin. Initial VRE isolation was made in the first samples from the rectum of two patients on the 7th day. The rates of rectal, umblical, throat and axillary colonization increased to 21.9%, 3.1%, 3.1% and 3.1% at 28th day, respectively. VRE strains were the first isolated from burn wounds of only one patient (0.8%) on the 14th day and the colonization rate increased to 7.0% at the 28th day. Our study indicated that rectal colonization was seen more than other sites of colonization and was strictly correlate to colonizing enterococci between burn wound and other body regions. Multivariate analyses showed that glycopeptide use, burn depth and total burn surface area were independent risk factors for acquisition of VRE. All VSE strains were susceptible to teicoplanin, tigecycline and linezolid. VSE strains were more resistant to gentamicin and streptomycin, and VRE strains were more resistant to penicillin and ampicillin. The present study showed tigecycline and linezolid to be most active agents against VRE strains. The determined VRE colonization and risk factors of VRE acquisition are expected to be useful in establishing guidelines for preventing VRE infection in burn unit.
    Burns: journal of the International Society for Burn Injuries 10/2010; 37(1):49-53. DOI:10.1016/j.burns.2010.08.007 · 1.84 Impact Factor
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    ABSTRACT: Acute mesenteric venous thrombosis is a rare and potentially fatal disease, which often occurs in medically compromised elderly patients. Isolated mesenteric venous thrombosis may be encountered in young women who have underlying hypercoagulable disease. We report a case of mesenteric venous thrombosis in a young pregnant woman in whom protein S deficiency was diagnosed at a later stage. The patient underwent extensive bowel resection. On follow-up she had developed an obstruction on the intestinal anastomosis. The anastomosis was revised, but the patient died of intervening complications 3 months after the operation. Early management of acute mesenteric venous thrombosis relies on early diagnosis, which requires a high index of suspicion. The condition must be considered during evaluation of persistent abdominal pain in pregnant women with hypercoagulable disorder.
    Journal of Obstetrics and Gynaecology Research 08/2009; 35(4):804-7. DOI:10.1111/j.1447-0756.2008.01003.x · 0.93 Impact Factor
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    ABSTRACT: Following burn injury, some complex reactions are initiated that are mainly managed by the liver and that can cause injury at the liver. Alpha glutathione S-transferase (alpha-GST) is a sensitive marker that is very sensitive in the monitoring of hepatocellular damage. We tried, in this study, to demonstrate liver injury in burn patients using alpha-GST. Forty-four patients with burn injury treated at the Burn Treatment and Care unit of the Atatürk University Medical School between July 2006 and July 2007 were included in the study. Patient data were collected. Three blood samples were taken from the patients (at admittance [first sample], 120 hours after admittance [second sample], and on the fourteenth day [third sample]) for the analysis of alpha-GST, alanine amino transferase, aspartate amino transferase activities, and albumin and c-reactive protein levels. There was a statistically significant difference between alpha-GST activities of the study group at admission (P<.001), on the fifth day (P<.001), and the 14th day (P<.001) and those of the control group. There was a decrease in alpha-GST activities during the hospitalization period. Alanine amino transferase and aspartate amino transferase activities in all three samples of the study group were not different from each other and from the values obtained from the control group. The albumin levels of the study group were significantly different from those of the control group. The c-reactive protein levels of the study group were different from those of the control group at admission, on the fifth day, and fourteenth day (P<.001, P<.001, and P<.01). Our findings suggest that burn injury causes liver injury, and alpha-GST can be used to demonstrate this.
    Journal of burn care & research: official publication of the American Burn Association 06/2009; 30(4):711-6. DOI:10.1097/BCR.0b013e3181abfd65 · 1.55 Impact Factor
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    G. Akçay, M. N. Akçay, H. A. Alici
    Anaesthesia 10/2008; 56(10):1015-1016. DOI:10.1111/j.1365-2044.2001.2279-22.x · 3.85 Impact Factor
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    ABSTRACT: A serious complication of cystic echinococcus (CE) is the rupture of the cysts. Free intra-abdominal rupture occurs in approximately 3.2% of all cases. Posttraumatic rupture of liver CE is very rare. The objective of the current study was to evaluate the clinical and radiographic findings and surgical treatment of this complication. Twenty patients with posttraumatic ruptured liver CE were treated. The incidence rate of hydatid rupture was 3.06%. The common presenting symptom was abdominal pain. All patients were operated on under emergency conditions. There were 26 cysts in 20 patients, and all of the cysts were treated surgically. Hydatid cyst rupture must be kept in mind in the management of trauma patients with cystic mass in the liver in particular and free intra-abdominal fluid, especially in the endemic area. We preferred conservative (unroofing associated with various procedures for the management of the residual cavity) rather than radical procedures such as hepatic resection or pericystectomy for the surgical treatment.
    American journal of surgery 10/2007; 194(3):313-6. DOI:10.1016/j.amjsurg.2006.11.014 · 2.41 Impact Factor
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    ABSTRACT: Hydatid cyst (HC) continues to be endemic in the Mediterranean countries, such as Turkey. Living in a rural area is an important risk factor for the disease. HC is most commonly seen in the liver and lungs, but retroperitoneal hydatid cyst is very rare. The objective of this study was to evaluate the clinical and radiographic findings and surgical treatment of this unusual lesion. Between 1979 and 2004, 14 cases with primary retroperitoneal hydatid cyst were treated surgically at our clinic. Symptoms included flank pain in eight (57.1%) and palpable mass in six patients (42.8%). The cyst was located in the right retroperitoneum in seven patients (50%), left retroperitoneum in five patients (35.7%), retrovesical region in one patient (7.1%) and paravesical region in one patient (7.1%). Surgical approaches were right paramedian extraperitoneal approach in four patients, left paramedian extraperitoneal approach in two patients and midline transperitoneal approach in eight patients. Total pericystectomy was chosen as the surgical procedure in all patients except in five (35.7%), who had partial cystectomy for cysts located near the vital structures. There were no complications and mortality postoperatively. A primary HC of the retroperitoneum is a distinct clinical entity that must be considered when caring for a patient with a retroperitoneal mass in endemic regions. It should be treated after the diagnosis is confirmed without any delay because of secondary spillages due to perforations and other possible complications.
    ANZ Journal of Surgery 07/2007; 77(6):455-9. DOI:10.1111/j.1445-2197.2007.04094.x · 1.12 Impact Factor
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    ABSTRACT: This study was designed to investigate the local subcutaneous fat thickness in sacrococcygeal pilonidal disease. Subcutaneous fat thickness was measured by ultrasonography in 125 patients with sacrococcygeal pilonidal disease and 125 age-matched, body mass index-matched and gender-matched controls. The sacrococcygeal subcutaneous fat thickness was 14.4 +/- 2.9 mm, 18.3 +/- 3.1 mm, and 22 +/- 2.2 mm, respectively, in normal, overweight, and obese patients with sacrococcygeal pilonidal disease and 9.1 +/- 3.1 mm, 11.3 +/- 2.6 mm, and 20 +/- 1.8 mm, respectively, in normal, overweight, and obese controls. Sacrococcygeal fat was significantly thicker in normal and overweight patients with pilonidal disease compared with controls with same body mass index (P< 0.01). There were no significant differences in fat thickness between obese patients and obese controls (P > 0.05). Sacrococcygeal fat thickness, as a local factor, is closely associated with pilonidal disease.
    Diseases of the Colon & Rectum 12/2006; 49(11):1755-7. DOI:10.1007/s10350-006-0672-5 · 3.20 Impact Factor
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    ABSTRACT: Well-differentiated thyroid cancer typically presents as a thyroid mass. Common sites of metastases presentation include cervical lymph nodes, lung, and bone; less common are brain, liver, and skin. We describe 4 cases with unusual presentations of differentiated thyroid carcinomas.
    The Endocrinologist 05/2006; 16(3):136-139. DOI:10.1097/01.ten.0000218511.86762.0c · 0.12 Impact Factor
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    ABSTRACT: This study was conducted to determine the risk factors for acquisition of imipenem-resistant Pseudomonas aeruginosa (IRPA) in the burn unit. Patients hospitalized in the burn unit from July 2003 to November 2004 were included in this study. The features of patients with isolated IRPA were compared with those of patients with isolated imipenem-susceptible P. aeruginosa (ISPA). Demographic features, total burn surface area (TBSA), burn depth, antimicrobials used in 15-day period before isolation, and presence of IRPA in the unit at the same period were included in the risk factors analysis. P. aeruginosa was recovered from 133 patients in this period, 93 were IRPA and 40 were ISPA. There was no significant difference between patients with ISPA and patients with IRPA in terms of age, TBSA, and burn depth. In multivariate logistic regression analysis, hospital stay before isolation (odds ratio (OR): 3.6), carbapenem usage (OR: 7.4), broad-spectra antibiotic usage (OR: 6.5), previous presence of ISPA in the patient (OR: 1.7) and presence of IRPA in the unit at the same period (OR: 2.6) were independent risk factors for acquisition of IRPA. Long hospitalization time, previous imipenem/meropenem use, previous broad-spectra antibiotic use, previous presence of ISPA in a patient and presence of IRPA in a unit at the same period were associated with acquisition of IRPA in the burn unit. In order to decrease the incidence of IRPA isolation, the usage of broad-spectra antibiotics, especially carbapenem, should be restricted, hospitalization time should be shortened if possible, and universal isolation precautions should be strictly applied to prevention cross-contamination.
    Burns 12/2005; 31(7):870-3. DOI:10.1016/j.burns.2005.04.015 · 1.84 Impact Factor
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    ABSTRACT: The prevalence of metallo-beta-lactamases (MBLs) produced by isolates of Pseudomonas aeruginosa and Acinetobacter baumannii and the activities of various antmicrobial combinations against MBL producer strains were investigated. During the period from June 2003 till July 2004, 120 P. aeruginosa and 9 A. baumannii nonduplicate isolates were obtained from burn wounds. Forty strains (37 P. aeruginosa, 3 A. baumannii) were selected because of resistance to carbapenems. Screening for MBL production was performed in the latter isolates by the combined disk method which depends on comparing the zones given by disks containing imipenem with and without ethylenediaminetetraacetic acid (EDTA). Of imipenem resistant P. aeruginosa strains, 21 and 1 of A. baumannii were found metallo-beta-lactamase producers. Disk approximation studies were then performed to test for in vitro activities of various antimicrobial combinations. For a total of 21 P. aeruginosa strains, synergy was demonstrated predominantly by ciprofloxacin in combination with ceftazidime and imipenem, by ofloxacin in combination with astreonam. Against MBL producer A. baumannii strain, synergy was detected only with imipenem-ofloxacin combination. None of the combinations were antagonistic. These results suggest that MBL producing P. aeruginosa and A. baumanni strains have been introduced into burn centers, and to prevent the further spread of MBL producers, it is essential for carbapenem resistant isolates to be screened for MBLs.
    Burns 10/2005; 31(6):707-10. DOI:10.1016/j.burns.2005.02.017 · 1.84 Impact Factor
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    ABSTRACT: Hepatocellular carcinoma (HCC) has a tendency for fatal spontaneous rupture leading to massive haemorrhage. A 64-year-old man presented with sudden, severe epigastric pain for 6 h. Systolic blood pressure was 80/50 mmHg, and pulse rate was 100/min. The patient's history did not reveal any operation or disease up to date. Contrast enhancement-axial computed tomography (CT) scan showed a tumoral lesion with a necrotic centre measuring 6 x 5 cm within 6th segment of the liver and a fluid collection (haemoperitoneum) at the periphery of the liver. At exploratory laparotomy, the liver was found to be cirrhotic, and an actively bleeding tumour confirmed in 6th segment of the liver. The tumour was resected. Post-operative recovery was unremarkable, and the patient was discharged on the 14th post-operative day. Ruptured HCC should be included in the differential diagnosis of non-traumatic intra-abdominal haemorrhage.
    International journal of clinical practice. Supplement 05/2005; 59(147):103-5. DOI:10.1111/j.1742-1241.2004.00257.x
  • Burns 04/2005; 31(2):237-9. DOI:10.1016/j.burns.2004.08.009 · 1.84 Impact Factor
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    ABSTRACT: Cellular adhesion molecules are expressed by activated endothelial cells in severe bum. The release of these molecules can lead to organ damage. We measured E-selectin levels in the blood of 20 severe-burn patients. Then the patients were divided into two groups of 10 patients each. In the study group, atorvastatin 20 mg/day was administered orally for 14 days. In the control group, an equal volume of placebo was administered orally for 14 days. In both groups, following the last dose of the agents, serum E-selectin levels were measured again. Mean burn size and the percentage of third-degree bums of total burned area were not significantly different between the groups. Serum E-selectin level obtained at the beginning of the treatment was 23.69 +/- 2.71 ng/ml in the atorvastatin group and 18.08 +/- 0.97 ng/ml in the control group. Serum E-selectin level obtained at the end of the treatment was 10.86 +/- 1.36 ng/ml in the atorvastatin group and 21.69 +/- 2.11 ng/ml in the control group. The difference between the two groups was statistically significant (p < 0.05). In the comparison of early and late serum E-selectin levels in the atorvastatin group, a significant decrease was obtained (p < 0.05). In the control group, serum E-selectin levels were found to be increased in the late period. However, the difference between the early and late values was nonsignificant (p > 0.05). We concluded that atorvastatin is effective in the prevention of E-selectin release in severely burned patients.
    International journal of clinical pharmacology research 02/2005; 25(2):65-9.