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    Efficacy of a Modified Sequential Therapy Including Bismuth Subcitrate as First-Line Therapy to Eradicate Helicobacter pylori in a Turkish Population
    (WILEY-BLACKWELL, 2012) Uygun, Ahmet; Ozel, A. Melih; Sivri, Bulent; Polat, Zulfikar; Genc, Halil; Sakin, Yusuf Serdar; Celebi, Gurkan; Uygur-Bayramicli, Oya; Ercin, Cemal Nuri; Kadayifci, Abdurrahman; Emer, Ozdes; Gunal, Armagan; Bagci, Sait
    Background Eradication rates of Helicobacter pylori with standard triple therapy are not satisfactory. Sequential therapy is an alternative method to overcome this problem. Objectives The aim of this study was to assess efficacy of a modified sequential therapy with the addition of a bismuth preparation, as first-line treatment in the eradication of H. pylori infection. Materials and Methods One hundred and forty-two H. pylori-positive patients were included in the study. Patients were given a 14-day sequential therapy program consisting of pantoprazole, 40 mg (b.i.d. for 14 days); colloidal bismuth subcitrate, 300 mg 4 (two tablets before breakfast and dinner, for 14 days); amoxicillin, 1 g (b.i.d.for the first 7 days); tetracycline, 500 mg (q.i.d. for the second 7 days); and metronidazole, 500 mg (t.i.d. for the second 7 days). Eradication was tested by urea breath test (UBT) 6 weeks after completion of treatment. Results Of the 142 patients included, 131 completed the study. Per-protocol and intention-to-treat analyses revealed high eradication rates in this group (92.095% CI, 87.296.8%, and 81.095% CI, 74.587.4%, respectively). There was no relation to sex and age with this modified sequential therapy. Compliance was satisfactory (11 patients four women and seven men were unavailable for follow-up), and side effects were minimal (six patients had to stop treatment metronidazole-related facial swelling and numbness on the face and hands in two patients; tetracycline-related fever and epigastric pain and nausea and vomiting in two patients; and amoxicillin-related diarrhea and vaginal discharge in two patients). These side effects were reversible and resolved after the cessation of the related medication. Conclusions This 14-day modified sequential treatment, including bismuth, achieves a significantly high eradication rates in patients with H. pylori infection, with five satisfactory patient compliance and minor side effects.
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    Initial experience of 3 tesla apparent diffusion coefficient values in differentiating benign and malignant thyroid nodules
    (WILEY, 2013) Ilica, A. Turan; Artas, Hakan; Ayan, Asli; Gunal, Armagan; Emer, Ozdes; Kilbas, Zafer; Meric, Coskun; Atasoy, Mehmet Mahir; Uzuner, Ovsev
    Purpose: To evaluate the role of diffusion-weighted magnetic resonance imaging (DWMRI) in differentiating benign and malignant thyroid nodules using a 3 Tesla (T) MRI scanner. Materials and Methods: Twenty-eight nodules in 25 patients and 14 healthy control cases were included in the study. DWMRI was acquired with 6 b values with a 3T MRI scanner. The apparent diffusion coefficient (ADC) values of the nodules were calculated from reconstructed ADC map images and were compared with the final histopathological diagnoses. Results: The mean ADC value of the benign nodules was 1548 +/- 353.4 (x106 mm2/s), and the mean ADC of the malignant nodules was 814 +/- 177.12 (x106 mm2/s). The normal thyroid tissue had a mean ADC value of 1323.43 +/- 210.35 x 106 mm2/s (9581689 x 106 mm2/s) in the healthy control group. The ADC values were significantly different among the three groups (P = 0.001). An ADC value of 905 x 106 mm2/s was determined to be the cutoff value for differentiating benign and malignant nodules, with 90% (55.598.3) sensitivity and 100% (81.3100.0) specificity. Conclusion: This study suggests that the ADC values of nodules measured with a 3T MRI scanner could help in differentiating benign thyroid nodules from malignant nodules. J. Magn. Reson. Imaging 2013;37:10771082. (c) 2012 Wiley Periodicals, Inc.
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    Sonography of fat necrosis of the breast: Correlation with mammography and MR imaging
    (WILEY, 2013) Atasoy, Mehmet Mahir; Oren, Nisa Cem; Ilica, Ahmet Turan; Guvenc, Inanc; Gunal, Armagan; Mossa-Basha, Mahmud
    Fat necrosis (FN) of the breast is a benign nonsuppurative inflammatory process of the adipose tissue. The radiologic appearance ranges from benign to suspicious for malignancy; therefore, it is very important to know the distinguishing radiologic features of FN on different modalities. Mammography is more helpful in identifying FN than ultrasonography in most of the cases, and MRI may also be used to rule out malignancy as an adjunct to mammography and sonography. Even when modern diagnostic modalities are used, biopsy may still be unavoidable for some cases. In conclusion, an accurate history and familiarity with the radiologic findings are crucial to recognizing FN and avoiding unnecessary interventions. (c) 2013 Wiley Periodicals, Inc. J Clin Ultrasound41:415-423, 2013