M N Akçay

Ataturk University, Kalikala, Erzurum, Turkey

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Publications (32)55.07 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; · 0.73 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; · 0.98 Impact Factor
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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; · 0.73 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; · 0.73 Impact Factor
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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. · 1.95 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. · 0.84 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. · 1.54 Impact Factor
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    G. Akçay, M. N. Akçay, H. A. Alici
    Anaesthesia 01/2008; 56(10):1015-1016. · 3.49 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. · 2.36 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. · 1.50 Impact Factor
  • Z. Ozkurt, M. N. Akcay, S. Erol, A. Aras
    International Journal of Antimicrobial Agents - INT J ANTIMICROBIAL AGENTS. 01/2007; 29.
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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. · 3.34 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. · 1.80 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. · 1.80 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;
  • Burns 04/2005; 31(2):237-9. · 1.80 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.
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    ABSTRACT: To examine the bacterial isolates from the burn patients and to compare the antibiograms of the predominant bacteria isolated from 51 patients who were hospitalized at least 3 weeks or more over a period of 7 months, a prospective study was undertaken. Periodic swabs were taken from burn wound, nasal, axillary, inguinal, and umbilical region of the patients on admission and on 7th, 14th, and 21st days of hospitalization. Mean hospital stay was 36.5 days. A total of 1098 microbial isolates were detected during the study period. Coagulase-negative staphylococci (CNS, 63.0%) and Staphylococcus aureus (19.7%) were the most prevalent isolates in admission cultures. During the next weeks, these bacteria were superceded by mainly Pseudomonas aeruginosa. Between admission and 21st day, the rates of methicillin resistance of staphylococci strains increased steadily. There was no vancomycin resistance in any staphylococci strains, although nine of the S. aureus isolates (2.7%) were resistant to teicoplanin. There were no strains producing inducible beta lactamase (IBL) among P. aeruginosa strains. One extended-spectrum beta-lactamase (ESBL)-producing strain was recovered on admission, although strains producing IBL and ESBL were detected at rates of 79.6 and 57.1%, respectively, on the 21st day. The nature of microbial wound colonization, flora changes, and antimicrobial sensitivity profiles should be taken into consideration in using empirical antimicrobial therapy of burned patients.
    Burns 12/2004; 30(7):660-4. · 1.80 Impact Factor
  • M N Akçay, K Y Polat, D Oren, G Oztürk
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    ABSTRACT: Tuberculous liver abscess (TLA) is an extremely rare condition, even in the country where tuberculosis is an alarming public health problem. Primary TLA, with no evidence of infection elsewhere, is even less common. Herein, we report a case with primary TLA and review the literature.
    International Journal of Clinical Practice 07/2004; 58(6):625-7. · 2.43 Impact Factor
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    ABSTRACT: To determine time related changes of microbial colonization of burn wounds and body flora of burned patients, a prospective study was carried out. Fifty-one patients who were hospitalized at least 3 weeks were enrolled in the study. Periodic swabs were taken from burn wound, nasal, axillary, inguinal, and umbilical regions of the patients on admission and 7th, 14th, and 21st days of hospitalization. The mean body surface area burned was 22.9%. A total of 1098 microbial isolates were detected during the study period. Coagulase-negative staphylococci (CNS, 63.0%) and Staphylococcus aureus (19.7%) were the most prevalent isolates in admission cultures. There was a gradual decrease in the number of isolates of CNS and a marked increase in the numbers of S. aureus and Pseudomonas aeruginosa from admission to 21st day. At the 21st day, the most frequent organisms were S. aureus (37.6%), CNS (34.7%), and P. aeruginosa (16.2%). Methicillin resistance of staphylococci strains were increased constantly in study period. While 35.3% of burn wounds were sterile on admission, microbial colonization reached 86.3% within the first week. Nasal carriage of methicillin resistant S. aureus increased from 3.9% to 62.7% at 21st day. The nature of microbial wound colonization and flora changes should be taken into consideration in empirical antimicrobial therapy of burned patients.
    Burns 07/2004; 30(4):357-61. · 1.80 Impact Factor