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Yayın Degeneration of the lumbar spine and dual-energy X-ray absorptiometry measurements in patients without osteoporosis(ELSEVIER SCIENCE INC, 2009) Atalay, Ayce; Kozakcioglu, Meral; Cubuk, Rahmi; Tasali, Nuri; Guney, SefikAim: The aim of this study was to evaluate the effects of degenerative findings on the accuracy of readings obtained by dual-energy X-ray absorptiometry (DXA) in patients without osteoporosis. Methods: Twenty-four female patients who had undergone both DXA and lumbar magnetic resonance imaging were included in the study. Conclusion: This study has demonstrated that degenerative radiologic changes, especially in the osteophyte area, affect bone mineral density measurements, so degeneration should be considered in the evaluation of this measurement. (C) 2009 Elsevier Inc. All rights reserved.Yayın Do Nuss bars compromise the blood flow of the internal mammary arteries?(OXFORD UNIV PRESS, 2013) Yuksel, Mustafa; Ozalper, Mehmet Hakan; Bostanci, Korkut; Ermerak, Nezih Onur; Cimsit, Cagatay; Tasali, Nuri; Yildizeli, Bedrettin; Batirel, Hasan FevziOBJECTIVES: Minimally invasive repair of pectus excavatum, the so-called Nuss procedure, has become a popular technique in recent years. The internal mammary arteries (IMAs) lie on the posterolateral surface of the sternum, and the Nuss bar is likely to obstruct the blood flow in these arteries. This obstruction could become important in the later stages of the lives of these young people if they were to require coronary artery bypass grafting. The goal of this study is to investigate the extent of obstruction of the IMAs caused by Nuss bars. METHODS: Data were collected prospectively on all patients who underwent the Nuss procedure between October 2011 and May 2012. Patients with a history of pectus excavatum repair by open surgery and those who were younger than 16 years of age were excluded. Computed tomography-angiography (CTA) was performed for the detection of IMA blood flow preoperatively and on the 10th postoperative day. Blood flow in the IMAs was evaluated blindly by two radiologists and classified as blood flow unaffected (group I) or affected (group II) by comparing the assessment of preoperative and postoperative CTAs. The patients in group II were also categorized as having blood flow obstructed bilaterally, blood flow obstructed unilaterally and others (diminished unilaterally/diminished on one side or obstructed on the other side). RESULTS: Thirty-four patients (31 male and three female; mean age 20.7 +/- 4.2 years) underwent surgery. Blood flow was affected in 15 patients (44%), with bilateral obstruction in five, unilateral obstruction in seven, and unilateral diminished flow in two patients. In one patient, blood flow was diminished on one side and obstructed on the other. There was no significant difference between unaffected group I patients and affected group II patients in terms of sex, age, type of deformity, Haller index and the number of bars placed. CONCLUSIONS: Nuss bars cause pressure on the IMAs, but a risk factor for this effect could not be identified. This is a relatively common clinical consequence of minimally invasive repair of pectus excavatum, and the long-term effects will be apparent following bar removal.Yayın Lumbar Disc and Facet Degeneration: Correlation with Age and Facet Orientation(AVES YAYINCILIK, IBRAHIM KARA, 2009) Cubuk, Rahmi; Kozakcioglu, Meral; Tasali, Nuri; Atalay, Ayce; Celik, LeventObjectives: The influence of age on orientation of the facet joint remains controversial. We aimed to examine facet joint degeneration, orientation and their relationships with disc degeneration in a group of patients in different age groups. Patients and Methods: The study included 106 patients with low back pain and/or leg symptoms who had undergone magnetic resonance imaging of L1-S1 lumbar segments. For evaluation of osteoarthritis of the facet joints grading described by Weishaupt et al. and for evaluation of disc degenerations grading by Pfirmann et al. were used. Results: Orientation of the facet joints were similar among age groups. Age was not correlated with facet joint orientation. Facet joint orientation was not correlated with facet or disc degeneration in neither female nor male patients. Age was positively correlated with facet degeneration at all spinal levels. At all levels except L3-4 level, facet joint degeneration was more prominent in male subjects. Conclusion: This study have demonstrated that facet joint orientation is similar among different age groups. The finding of greater prevalence and degree of facet arthrosis in men at all lumbar levels is in accordance with some recent studies. Our study supported the notion that disc degeneration precedes facet arthrosis.Yayın MRI in Stress Urinary Incontinence Endovaginal MRI With an Intracavitary Coil and Dynamic Pelvic MRI(UROL & NEPHROL RES CTR-UNRC, 2012) Tasali, Nuri; Cubuk, Rahmi; Sinanoglu, Orhun; Sahin, Kemal; Saydam, BulentPurpose: To evaluate both morphology of the urethra and its supporting structures using endovaginal magnetic resonance imaging (EV-MRI) and the grade of the bladder neck prolapsus using dynamic pelvic MRI (DP-MRI) in women with stress urinary incontinence (SUI). Materials and Methods: We compared 25 women with SUI and 8 controls according to the different layers of the urethra, the degree of distortion in the periurethral, paraurethral, and pubourethral ligaments, the vesicourethral angle, the retropubic space, and the thickness of the puborectal muscle. The SUI group was also evaluated according to the number of deliveries and degree of the bladder neck prolapsus. Results: Significant differences were found in the thickness of each three layers of the urethra between the two groups (P < .05). There was a significantly higher pubourethral ligament distortion (P = .024) and larger vesicourethral angle (P = .000) in women with SUI. In women with SUI, there was no significant relationship between the number of deliveries and the degree of the bladder neck prolapsus (P > .05). Conclusion: The combined usage of the EV-MRI and DP-MRI can provide complementary information concerning certain structural abnormalities with specific dysfunction, such as vesicourethral angle increase and pubourethral ligament distortion in patients with SUI.Yayın Unexpected Finding on Mammography and MRI due to Accumulation of Iron Oxide Particles Used for Sentinel Lymph Node Detection(AVES, 2019) Arslan, Gozde; Yilmaz, Cem; Celik, Levent; Cubuk, Rahmi; Tasali, NuriWe present a case with imaging artefacts on mammography and Magnetic Resonance Imaging (MRI) caused by iron oxide particles. After being diagnosed with the medullary cancer of the breast, the female patient had a breast conserving surgery on right breast. Iron oxide particles were used for the detection of the sentinel lymph node during operation. On follow ups, a de novo density on mammography, which was initially thought to be a new tumour, was found. MR images proved that the lesion is an artefact caused by iron oxide accumulation. Our aim in this case study is to underline and discuss the imaging artefacts caused by these particles and raise awareness.Yayın Vacuum-assisted stereotactic biopsy for isolated BI-RADS 4 microcalcifications: evaluation with histopathology and midterm follow-up results(AVES, 2015) Atasoy, Mehmet Mahir; Tasali, Nuri; Cubuk, Rahmi; Narin, Burcu; Deveci, Uğur; Yener, Nese; Celik, Levent; Deveci, UğurPURPOSE The aim of this study was to evaluate the 10-gauge vacuum-assisted stereotactic biopsy (VASB) of isolated Breast Imaging Reporting and Data System (BI-RADS) 4 microcalcifications, using histology and follow-up results. METHODS From January 2011 to June 2013, VASB was performed on 132 lesions, and 66 microcalcification-only lesions of BI-RADS 4 were included into our study. VASB was performed using lateral decubitis stereotaxy for all patients. Pathologic results of VASB and further surgical biopsies were reviewed retrospectively. Patients who were diagnosed to have benign lesions by VASB were referred for follow-up. VASB and surgical histopathology results were compared to determine the underestimation ratios. RESULTS Fifteen out of 66 lesions from 63 patients (median age, 47 years; range, 34-88 years) were identified as malignant by VASB. Pathological results after surgery revealed three cases of invasive ductal carcinoma among the 12 VASB-diagnosed ductal carcinoma in situ (DCIS) lesions, for a DCIS underestimation rate of 25%. The atypical ductal hyperplasia underestimation rate was 0% for the three lesions. The follow-up period was at least 10 months, with an average of 22.7 months for all patients and 21.2 months for patients with VASB-diagnosed benign lesions. None of the patients had malignancy during the follow-ups. The false-negative rate was 0% in the follow-up of 48 patients. CONCLUSION VASB should be the standard method of choice for BI-RADS 4 microcalcifications. This method obviates the need for a surgical procedure in 73% of BI-RADS 4 microcalcification-only patients.