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    Accessory occipital suture mimicking fracture in head trauma
    (W B Saunders Co-Elsevier Inc, 2018) Naldemir, İbrahim F.; Güçlü, Derya; Altınsoy, H. Baki; Çanga, H. Berk; Önbaş, Ömer
    The occipital bone is a complex structure due to its anatomy and accessory sutures. Fracture - accessory suture differential diagnosis should be performed carefully in patients with a history of head trauma [4]. In this case report we wanted to emphasize that accessory sutures can be difficult to diagnose in patients with head trauma. We also specified the points to be considered in the suture - fracture differentional diagnosis. A bilateral, symmetrical fissure line was observed in the occipital bone basal part of the patient who was admitted to our emergency department due to head trauma. The patient was followed up with accessory suture and then discharged after paying attention to important points in the differential diagnosis. (C) 2017 Elsevier Inc. All rights reserved.
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    Assessment of interrupted aortic arch with magnetic resonance angiography
    (Elsevier Doyma Sl, 2014) Beşir, Fahri Halit; Türker, Yasemin; Türker, Yasin; Önbaş, Ömer
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    Cervical involvement in Morquio syndrome
    (Elsevier Science Inc, 2015) Büyükkaya, Ayla; Özel, Mehmet Ali; Önbaş, Ömer
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    Complex split cord malformation
    (Elsevier Science Inc, 2015) Büyükkaya, Ayla; Özel, Mehmet Ali; Büyükkaya, Ramazan; Önbaş, Ömer
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    A Critically Ill Patient with Aspergillus Fumigatus Sepsis-Related Ischemic Colitis
    (Erciyes Univ Sch Medicine, 2022) Akbaş, Türkay; Coşkun, Gökhan; Torun, Serkan; Akın, Gül; Önbaş, Ömer
    Background: Invasive aspergillosis (IA) is an opportunistic infection generally encountered in patients with hematological malignancies. However, IA is increasingly recognized in non-neutropenic and critically ill patients in the absence of classic risk factors.Case Report: An 81-year-old man with diabetes mellitus (DM), chronic renal failure (CRF), and heart failure, who had had 1-week complaints of diarrhea, nausea, and vomiting, was admitted to the intensive care unit with septic shock, acute respi-ratory failure, and acute kidney injury. Chest computed tomography showed cavitary lung lesions and colonoscopy revealed ischemic ulcers in the descending colon. Other causes of cavitary lung lesions were excluded and all cultures were negative, except for bronchoalveolar lavage yielding Aspergillus fumigatus. Thus, Aspergillus fumigatus sepsis with multiorgan failures was diagnosed.Conclusion: Inhaled Aspergillus conidia are kept under control by alveolar macrophage. DM, CRF, and aging are the con-ditions that disrupt phagocytic activity of macrophages and predispose to IA.
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    A Critically Ill Patient with Aspergillus Fumigatus Sepsis-Related Ischemic Colitis
    (2022) Coşkun, Gökhan; Torun, Serkan; Akbaş, Türkay; Akin, Gul; Önbaş, Ömer
    Background: Invasive aspergillosis (IA) is an opportunistic infection generally encountered in patients with hematological malignancies. However, IA is increasingly recognized in non-neutropenic and critically ill patients in the absence of classic risk factors. Case Report: An 81-year-old man with diabetes mellitus (DM), chronic renal failure (CRF), and heart failure, who had had 1-week complaints of diarrhea, nausea, and vomiting, was admitted to the intensive care unit with septic shock, acute respi- ratory failure, and acute kidney injury. Chest computed tomography showed cavitary lung lesions and colonoscopy revealed ischemic ulcers in the descending colon. Other causes of cavitary lung lesions were excluded and all cultures were negative, except for bronchoalveolar lavage yielding Aspergillus fumigatus. Thus, Aspergillus fumigatus sepsis with multiorgan failures was diagnosed. Conclusion: Inhaled Aspergillus conidia are kept under control by alveolar macrophage. DM, CRF, and aging are the con- ditions that disrupt phagocytic activity of macrophages and predispose to IA.
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    Does Periosteal Graft Combined With Platelet-Rich Plasma Enhance the Healing of Bone Defect?
    (Lippincott Williams & Wilkins, 2018) Türkseven, Arzu; Özçelik, Derya; Çalış, Mert; Çelik, Hakan Hamdi; Yılmaz, Fahri; Önbaş, Ömer; Toplu, Gaye
    Introduction:This study investigated the effect of periosteal graft + platelet-rich plasma (PRP) combination on facial bone defect healing. Methods: Five-millimeter critical sized defects in zygomatic arches of 12 adult New Zealand rabbits were created. Rabbits were randomly divided into 3 groups: First group (control group): bone defects of left zygomatic arches of 6 rabbits were wrapped with a silicone tube. Second group (periosteal graft group): bone defects of left zygomatic arches of 6 rabbits were wrapped with periosteal graft. Third group (experimental group): bone defects of right zygomatic arches of 12 rabbits were wrapped with periosteal graft-PRP combination. New bone formation was evaluated at 8th and 16th weeks. One rabbit was sacrificed at 8th week. Remaining 11 rabbits were imaged with 3-dimensional computed tomography (CT) at 16th week; then, zygomatic arches were removed for micro-CT and histologic examinations. Results: Three-dimensional CT analysis at 16th week revealed no significant difference between groups regarding new bone formation (P = 0.232). Micro-CT analysis of new regenerated bone at 16th week displayed significant differences between groups 1 and 3 regarding mean bone volume (BV, mm(3)) (P = 0.028) and mean bone mineral density (BMD, mm(2)) (P = 0.001). There was no difference between groups 2 and 3 or between groups 1 and 2, regarding BV or BMD. Histological Bone Regeneration Scorings at 16th week displayed significant difference between groups (P = 0.015). Negative correlation between 3-dimensional CT and histologic results (r = 0.120); positive correlations between BV/BMD values in micro-CT and histologic results (r = 0.524 and r = 0.456) were found. Conclusions: By enhancing bone formation capacity of periosteal grafts, periosteal graft-PRP combination provided bone formation having more volume and density comparing with silicone tube application.
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    Effectiveness of the STIR turbo spin-echo sequence MR imaging in evaluation of lymphadenopathy in esophageal cancer
    (Elsevier Ireland Ltd, 2011) Alper, Fatih; Türkyılmaz, Atila; Kurtcan, Serpil; Aydın, Yener; Önbaş, Ömer; Acemoğlu, Hamit; Eroğlu, Atilla
    Purpose: We have investigated the utility of the STIR TSE sequence in the differentiation of benign from malignant mediastinal lymph nodes in patients with esophageal cancer. Patients and methods: This study included 35 consecutive patients who were diagnosed as esophageal cancer and were undergone surgery. STIR TSE sequences were obtained as the ECG trigger. The signal intensity of the benign and malign lymph nodes, normal esophagus, and pathologic esophagus can be calculated on STIR sequence. Results: Pathologically, the number of total lymph nodes in 35 operated cases was 482. Approximately 152 lymph nodes were detected with MR imaging. Of these, 28 were thought to be malignant, and 124 were thought to be benign, although 32 were malignant and 120 were benign according pathological results. The ratio of benign lymph node intensity value to normal esophagus intensity value was 0.73 +/- 0.3. The ratio of malignant lymph node intensity value to normal esophagus intensity value ratio was 2.03 +/- 0.4. According to these results, the sensitivity of MR was 81.3%, the specificity was 98.3%. Conclusion: We think that if motionless images can be obtained with MRI, we may be able to differentiate benign lymph nodes from malignant ones. (C) 2010 Elsevier Ireland Ltd. All rights reserved.
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    Lumbar Morel-Lavallee lesion after trauma: a report of 2 cases
    (W B Saunders Co-Elsevier Inc, 2015) Büyükkaya, Ayla; Güneş, Harun; Özel, Mehmet Ali; Büyükkaya, Ramazan; Önbaş, Ömer; Sarıtaş, Ayhan
    Morel-Lavallee syndrome is a posttraumatic soft tissue injury in which the subcutaneous tissue is broken off from the underlying fascia, creating a cavity filled with hematoma and liquefied fat. It commonly occurs over the greater trochanter and, rarely, may also occur in the lumbal region. Morel-Lavallee syndrome can be often diagnosed late because of ommitted diagnosis in emergency services. The emergency physician and radiologist must keep this syndrome in mind because early diagnosis can enable conservative management, whereas delayed diagnosis may lead to surgical exploration. In this article, we present the clinical and radiologic features of 2 cases of lumbar Morel-Lavallee syndrome detected after trauma.
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    Ötiroid multinodüler guatrlı olguların sitoloji ve histopatoloji sonuçları: Ultrasonografi özellikleri ile karşılaştırılması
    (2012) Yazgan, Ömer; Beşir, Fahri Halit; Aydın, Yusuf; Yazgan, Sibel; Erhan, Melih Engin; Yazıcı, Burhan; Önbaş, Ömer
    Amaç: İnce iğne aspirasyon biyopsisi (İİAB) tiroid nodüllerine yaklaşımda altın standarttır ve multinodüler guatrda (MNG) dominant nodülden İİAB yapılması önerilmektedir. Çalışmamızda MNG tanılı olgularda dominant ve dominant olmayan nodül İİAB ve histopatoloji sonuçlarını karşılaştırarak nodül boyutu ile patoloji sonuçları arasındaki ilişkiyi değerlendirmeyi amaçladık. Gereç ve yöntem: 2009–2010 tarihleri arasında hem dominat nodülden hem de dominat olmayan nodülden İİAB yapılan MNG tanılı 197 olgu incelendi. İİAB sonucu yetersiz gelen 26 olgu çalışmaya dâhil edilmedi ve 171 olgu değerlendirildi. Ultrasonografide (US) malignite kriteri olarak nodülün hipoekoik patern, solid yapı, mikrokalsifikasyon içermesi ve periferik halosu olmaması özellikleri kullanıldı. Bulgular: Dominant nodüller ile dominant olmayanların malignite veya şüpheli sitoloji oranları arasında istatistiksel olarak anlamlı fark izlenmedi (p0.833) US de periferik halosu olmayan dominant nodüllerde ve mikrokalsifikasyon içermeyen dominant olmayan nodüllerde malignite daha yüksek oranda izlendi. Cerrahi sonrası yapılan patolojik değerlendirmede elde olunan malignite oranlarında da dominant ve dominant olmayan nodüller arasında anlamlı ilişki bulunmadı (p0.485). Sonuç: Multinodüler guatr tanılı olguların hem sitolojik hem de histopatolojik değerlendirmesinde dominant ve dominant olmayan nodüller arasındaki malignite oranlarında anlamlı fark bulunmamaktadır. Multinodüler guatr’lı olgularda malignite ile nodül boyutu arasında bir ilişki söz konusu değildir. Dominat nodülün yanı sıra ultrasonografide malignite özellikleri taşıyan dominant olmayan diğer nodüllerden de İİAB yapılmasının tanının daha sağlıklı konabilmesi için gerekli olduğunu düşünmekteyiz.
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    Paraneoplastic Severe Sensorimotor Axonal Polyneuropathy in Pancreatic Neuroendocrine Carcinoma: A Case Report and Review of the Literature
    (Duzce Univ, Fac Medicine, 2022) Akbaş, Türkay; Coşkun, Sinem Kantarcıoğlu; Torun, Serkan; Öztürk, Ayhan; Esbah, Onur; Önbaş, Ömer
    Objective: Paraneoplastic neurological syndromes (PNSs) are a diverse group of neurological disorders affecting any part of the nervous system before or during cancer. Case: A 78-year-old man first experienced pain and burning in the upper extremity three years previously, to which muscle weakness was added a short time later. The same symptoms developed in the lower extremities one year previously. He was admitted to the intensive care unit due to pneumonia and was conscious but quadriplegic with a modified Rankin score of 5. Abdominal computed tomography showed mass lesions in the liver and pancreas. Biopsies revealed pancreatic small cell neuroendocrine carcinoma. Electrophysiological studies revealed severe sensorimotor axonal polyneuropathy. Paraneoplastic sensorimotor axonal polyneuropathy was diagnosed since other causes of polyneuropathy had been excluded. Palliative care was considered due to the patient's poor functional state. Conclusions: Early diagnosis of cancer is of paramount importance in patients with PNSs if appropriate treatment is to be provided.
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    Prevalence of the Accessory Cardiac Bronchus on Multidetector Computed Tomography: Evaluation and Proposed Classification
    (Lippincott Williams & Wilkins, 2016) Ünlü, Elif Nisa; Aydın, Leyla Yılmaz; Bakırcı, Sinan; Önbaş, Ömer
    Purpose:Accessory cardiac bronchus (ACB) is a very rare congenital anomaly and may cause some clinical complications, such as recurrent episodes of both infection and hemoptysis. The purpose of this study was to assess the multidetector computed tomography (MDCT) characteristics of ACB and to classify this anomaly according to the MDCT aspects.Materials and Methods:The routine thoracic CT scans from 5790 patients were evaluated retrospectively. The prevalence, location, length, diameter, division angle, distance from the carina, and the type of ACB were evaluated.Results:A total of 12 ACBs were identified, with a prevalence of 0.2%. All ACBs originated from the intermediate bronchus. The median largest diameter of the ACBs was 7.75 mm (range: 5.8 to 10.30 mm), the median length was 12.1 mm (range: 8.6 to 35 mm), the median division angle was 61 degrees (range: 42 to 93 degrees), and the median distance from the carina was 16.95 mm (range: 5.7 to 22.20 mm). Six cases (50%) had a blind extremity (type 1: diverticulum or stump type), 3 cases (25%) had a mutiloculated cystic change at the end (type 2: cystic type), and 3 cases (25%) had a ventilated lobulus demarcated by an anomalous fissure (type 3: ventilated type).Conclusions:ACBs can be classified into 3 types according to their MDCT features. Recognition of ACB is important, as it is associated with clinical complications and is also salient in trauma cases.
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    A Rare Cause of Trigeminal Neuralgia: Cerebellopontine Angle Meningioma
    (2016) Özel, Mehmet Ali; Beşir, Fahri Halit; Yaman, Hüseyin; Dikici, Süber; Sarıtaş, Ayhan; Önbaş, Ömer
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    A Superficial Varicose Vein Mimicking Soft Tissue Infection on 99mTc Human Polyclonal Immune Globulin Scintigraphy: Original Image
    (Ortadogu Ad Pres & Publ Co, 2011) Aşık, Muhammet; Erkan, Melih Engin; Yılmaz, Ayşe; İzgi, Erdinç; Yazgan, Ömer; Önbaş, Ömer; Doğan, Ahmet Semih
    99mTechnetium human polyclonal immune globulin (99mTc-HIG) is a useful radiopharmaceutical in diagnosing infection. A 61-year-old woman with painful left knee prosthesis was investigated for septic loosening. In addition to prosthetic infection which presented as diffusely increased uptake surrounding left knee, a focally increased uptake below the medial side of right knee was noticed on 99mTc-HIG images. Although background and vascular activity were diminished at 24 hours after injection, the area of activity below the right knee was more apparent. We assumed this finding was due to soft tissue infection, however, a superficial varicose vein was shown by Doppler ultrasound. We conclude that varicose veins may be misinterpreted as a site of infection and thus may cause false positive results on 99mTc-HIG scintigraphy.
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    Teaching NeuroImages: Striatocapsular infarct presumed due to intracranial lipoma
    (Lippincott Williams & Wilkins, 2015) Beşir, Fahri Halit; Önbaş, Ömer
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