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Öğe Adrenal Ganglioneuroma: Case Report(Galenos Yayincilik, 2011) Kilicli, Fatih; Acibucu, Feffah; Dokmetas, Hatice Sebila; Elagoz, Sahande; Gokce, Gokhan; Oztoprak, IbrahimGanglioneuroma (ON) is a rare benign tumor arising mainly from neural crest cells and consisting of Schwann and ganglion cells. GN rarely occurs from the adrenal medulla and is observed most commonly in children and young adults. It is not associated with hormonal activity and is clinically asymptomatic. We present a 35-year-old woman whose abdominal ultrasonography for abdominal pain revealed in the right adrenal gland, a biochemically normal mass that was minimally hypointense on Tl-weighted and hyperintense on T2-weighted magnetic resonance images (MRI) and which was pathologically diagnosed as GN after adrenalectomy.Öğe ASSESSMENT OF THE OUTCOMES OF CEREBRAL BLOOD FLOW MEASUREMENTS AFTER ELECTRICAL STIMULATION OF UPPER RIGHT INCISOR TOOTH IN RABBITS(TAYLOR & FRANCIS LTD, 2009) Gulturk, Sefa; Gedik, Rustu; Develioglu, Hakan; Oztoprak, Ibrahim; Cetin, AliThe cerebral vessels are innervated by sympathetic, parasympathetic, and sensory nerves. A sensory innervation of the cerebral vessels originating in the trigeminal ganglion has been described in a number of species by several investigations. It has been shown that the electrical stimulation of the trigeminal ganglion causes an increase of cerebral cortical blood flow (CCoBF). The aim of the present study was to determine the effects of dental electrical stimulation the CCoBF in rabbits. A stimulating electrode was located in the upper right incisor tooth of rabbits and trigeminal ganglion was stimulated orthodromically via the infraorbital nerve. Variations in the cortical CCoBF were evaluated by laser-Doppler flowmetry. In experiment group, CCoBF increased together with the beginning of electrical stimulation (5 V, 0.5-ms impulse duration, square-shaped, 10-Hz frequency). The right and left hemisphere CCoBF values of stimulation period at 15s, 30s, 45s, 60s, 75s, and 90s were significantly higher than those of baseline and 105 and 120s (p < 0.05). The maximum increase in right and left CCoBF was 15.6% and 15.1% respectively. In post-stimulation period, the right CCoBF decreased gradually and returned to the baseline values at 120 s. In experiment groups, the CCoBF values of right hemisphere were comparable that of left hemisphereL (p > 0.05). This study demonstrated that the electrical stimulation of the trigeminal nerve's infraorbital branch via dental pulp increases the cortical right and left CCoBF under physiological conditions.Öğe Bölütlenen beyin bölgelerinin tıbbi görüntü steganografi için değerlendirilmesi(Gazi Üniversitesi, 2021) Karakış, Rukiye; Gurkahraman, Kali; Çiğdem, Burhanettin; Oztoprak, Ibrahim; Topaktas, A. SuatTıbbi görüntü steganografisinde, görüntülere veri gizlemenin neden olduğu bozulmanın sonucunda bir hastalığın tanı ve tedavisi etkilenebilir. Bu sebeple, veri görüntülerde elle ya da eşikleme gibi temel tekniklerle belirlenen ilgi olmayan bölgelerde gizlenmektedir ve bu yöntemlerin hiçbiri tümör gibi dokuları bölütlemeyi içermemektedir. Bu çalışma, bir hastalığın tanı ve tedavisinde kullanılan verilerin, bölütleme tabanlı steganografi yöntemi ile görüntüleri bozmadan tek bir ortamda birleştirilerek gizlenmesini amaçlamaktadır. Ayrık dalgacık dönüşümü (ADD) ve k-ortalama kümeleme tabanlı bölütleme yöntemi ile epilepsi hastalarının Manyetik Rezonans (MR) görüntüleri, arka plan, gri madde, beyaz madde ve tümör olarak ayrıştırılmıştır. Gizli mesaj, hasta kişisel bilgilerini, doktor yorumunu, seçilen Elektroansefalogram (EEG) sinyalini ve EEG’ye ait sağlık raporunu içermektedir. Kaotik ve hash fonksiyonlarını kullanan DNA kodlama ile şifrelenen ve ardından sıkıştırılan yüksek kapasiteli mesaj, görüntülerin tümör olmayan piksellerinin en az anlamlı bitlerinde gizlenmiştir. Çalışmada, taşıyıcı ve stego görüntüler arasındaki farklılık, sinyalin gürültü tepe oranı, yapısal benzerlik ölçümü, evrensel kalite indeksi ve korelasyon katsayısı ile tespit edilmiştir. Bu değerler sırasıyla 64,0334 desibel (dB), 0,9979, 0,99701, 0,9993 olarak elde edilmiştir. Analiz sonuçları önerilen yöntemin hastaların yüksek kapasiteli verilerini tek bir dosyada birleştirdiğini ve tıbbi verilerin hem güvenliğini hem de kayıt alanını arttırdığını göstermiştir.Öğe A case of spinal extradural angiolipoma(DRUNPP-SARAJEVO, 2012) Ozer, Hatice; Tuncer, Ersin; Gurelik, Mustafa; Oztoprak, Ibrahim; Egilmez, Reyhan; Ozum, UnalAngiolipoma is a benign tumor composed of mature adipocytes admixed with vascular elements. This article presents a case of spinal extradural angiolipoma in 52-year-old man, who underwent surgical treatment with preoperational diagnosis of schwannoma. This rare clinical entity must be considered in the differential diagnosis for any spinal epidural lesion.Öğe Cerebral Venous Sinus Thrombosis Presenting as Transient Ischemic Attacks in a Case With Homozygous Mutations of MTHFR A1298C and CG677T(ELSEVIER SCIENCE BV, 2012) Yildiz, Ozlem Kayim; Cevik, Seyda; Cil, Gulsum; Oztoprak, Ibrahim; Bolayir, Ertugrul; Topaktas, SuatWe report a case with recurrent, transient attacks of slurred speech, weakness, and numbness of the right half of the face and the right arm without seizure activity, accompanied by headache and double vision. Neurologic examination revealed bilateral papilledema and right abducens palsy. Brain magnetic resonance imaging revealed thrombosis of the dural venous sinuses and the cortical veins, with no evidence of parenchymal lesion. Homozygous mutations were found for methylenetetrahydrofolate reductase (MTHFR) A1298C and MTHFR CG677T. Anticoagulation with heparin and warfarin resulted in prompt cessation of the transient attacks, as well as the signs and symptoms of increased intracranial pressure. This report documents that, although rare, transient ischemic attacks can result from cerebral venous thrombosis.Öğe Chordoid Meningioma - A Case Report: Clinicopathological Features and Differential Diagnosis of an Uncommon Tumor(DE GRUYTER OPEN LTD, 2016) Ozer, Hatice; Tuncer, Ersin; Saray, Gonul; Gurelik, Mustafa; Oztoprak, Ibrahim; Egilmez, ReyhanMeningiomas are tumors that originate from the arachnoid cell and the majority are benign and grade I tumors according to World Health Organization. Chordoid meningioma is an uncommon variant of meningioma and corresponds to grade II tumor in the World Health Organization Classification of Tumors of the Nervous System 2007 because of its more aggressive behavior and increased likelihood of recurrence. A 75-year-old female was referred to the neurosurgery department complaining of headache, syncope, and seizure. Radiological examination revealed a mass lesion in the neighbourhood of the frontal lobe that destructed bone and was associated with peritumoral edema. The patient underwent surgery. The tumor was totally excised with the dura beneath. Histopathological examination showed that the tumor was composed of clusters and cords of small polygonal cells with fine chromatin and eosinophilic vacuolated cytoplasm embedded in a myxoid matrix, and also focal whorls of spindle-shaped cells. Two mitoses were seen in 10 high power fields. Vascular proliferation was observed in some tumoral areas. Bone invasion was present. Immunohistochemical analysis of the tumor cells revealed widespread strong membranous and cytoplasmic expression of epithelial membrane antigen. The Ki67 labeling index was 6-8%. All of these findings were consistent with a diagnosis of chordoid meningioma, the neoplasm was identified as grade II based on the World Health Organization Classification, 2007. In this report we present a case of chordoid meningioma without classical radiological findings of meningioma with areas of vascular proliferation that mimicked glial tumors at histopathologic examination.Öğe Comparison of CT-guided sclerotherapy with using 95% ethanol and 20% hypertonic saline for managing simple renal cyst(KOREAN RADIOLOGICAL SOC, 2007) Egilmez, Hulusi; Gok, Vedat; Oztoprak, Ibrahim; Atalar, Mehmet; Cetin, Ali; Arslan, Mubeccel; Gultekin, Yener; Solak, OrhanObjective: We wanted to compare the efficacies of 95% ethanol and 20% hypertonic saline (HS) sclerotherapies that were performed in a single session under CT guidance for the management of simple renal cysts. Materials and Methods: A prospective series of 74 consecutive patients (average age: 57.6 +/- 8.1 years) with simple renal cysts were enrolled in this study. They were randomized into two groups and 95% ethanol or 20% HS, respectively, corresponding to 25% of the aspiration volume, was injected. Treatment success was determined six months later with follow-up clinical evaluation and performing ultrasonography. Results: The sclerotherapy was accepted as technically successful without major complications in all except two patients who were excluded because of a communication between the simple renal cyst and the pelvicalyceal collecting system. Thirty-six patients in the ethanol group received sclerotherapy with 95% ethanol and 36 patients in the HS group underwent sclerotherapy with 20% HS. The complete regression ratio of the ethanol group was significantly higher (94% versus 72%, respectively) than that of the HS group. There was one patient with partial regression in each group. The failure ratio of the ethanol group was significantly lower (3% versus 25%, respectively) than that of the HS group. Conclusion: Ethanol sclerotherapy under CT guidance is a successful and safe procedure and it can be used for the treatment of simple renal cysts. Sclerotherapy with 95% ethanol is more effective than 20% HS sclerotherapy. Sclerotherapy with HS may be an option for patients preferring to undergo a less painful treatment procedure.Öğe Complete remission after bevacizumab plus temozolomide in a patient with recurrent glioblastoma multiforme(INFORMA HEALTHCARE, 2012) Kilickap, Saadettin; Oztoprak, Ibrahim; Yucel, Birsen…Öğe Consciousness disturbance and poikilothermia revealing brain involvement in neuromyelitis optica(SPRINGER HEIDELBERG, 2012) Yildiz, Ozlem Kayim; Cevik, Seyda; Oztoprak, IbrahimA 21-year-old woman was admitted due to altered mental status and hypothermia. The patient had a diagnosis of neuromyelitis optica (NMO) for 12 years and she was positive for serum anti-aquaporin 4 antibody. On admission, physical examination revealed coma with decerebration rigidity and poikilothermia. Magnetic resonance images of the brain revealed widespread, gadolinium enhancing lesions in the periventricular areas and the diencephalic structures. Laboratory investigations revealed hyponatremia and hypothyroidism. The patient was treated with high dose steroids. Both symptomatic and asymptomatic brain lesions may develop in patients with NMO. However, poikilothermia has not been reported in patients with NMO before.Öğe Diffusion-Weighted Imaging Study in Euthymic Patients with Bipolar I Disorder(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2012) Erden, Aslihan C.; Kugu, Nesim; Oztoprak, Ibrahim; Dogan, Orhan; Akyuz, GamzeObjective: To examine the possible presence of white matter abnormalities and apparent diffusion coefficient (ADC) changes by using diffusion-weighted magnetic resonance (MR) imaging, in patients with euthymic bipolar I disorder. Method: Thirty patients (12 women, 18 men) were included in this study. The patients, whose total Young Mania Rating Scale points were 5 or less at least for four weeks, and whose total Hamilton Depression Rating Scale points were 7 or less were considered as euthymic. The control group was consisted of age and gender matched 30 healthy individuals. ADC values were obtained symmetrically from the frontal, temporal, and occipital lobes and the genu of the corpus callosum, where white matter tissue was the largest. Results: The mean ADC value of the bipolar group was determined as 856.53 +/- 88.31x10(-3)mm/s, and that of the control group was 778.89 +/- 89.67x10(-3)mm/s. The mean ADC values on the right frontal area was found to be lower in bipolar patients as compared to that of the control group, but the difference was statistically insignificant. However, it was found significantly lower on the left hemisphere (p<0.05). The increases of the mean ADC values obtained from both right and left temporal and occipital lobes of bipolar group were found to be statistically significant as compared to those of the control group (p<0.05). Conclusions: According to the results of this study, the increased ADC values in euthymic bipolar patients may probably be related to the disintegration of white matter. Besides, decreased ADC values obtained from the frontal areas suggest that the disintegration might be reversible.Öğe Diploe thickness and cranial dimensions in males and females in mid-Anatolian population: An MRI study(ELSEVIER IRELAND LTD, 2012) Sabanciogullari, Vedat; Kosar, Mehmet Ilkay; Salk, Ismail; Erdil, Fatma Hayat; Oztoprak, Ibrahim; Cimen, MehmetBackground: The objective of this study is the classification of the thickness of diploe and dimensions of cranium at different points of cranium in men and women according to age groups. Material and method: In the radiology archive, measurements were made at different points in magnetic resonance (MR) images of 305 (188 females and 117 males) patients, the average ages of whom were 40.98 +/- 20.44 (age range: 4-90) and who had no disorder of the bones. To determine diploe thickness, midfrontal, back and front bregma, lambda, opisthocranion and euryon points were used in the measurement. As for the determination of cranial volume, distances between glabella-opisthocranion, basion-vertex, basion-opisthion, euryon-euryon, nasion-basion, nasion-bregma, bregma-lambda and lambda-opisthocranion were measured. The data were loaded to Statistical Package for the Social Sciences (SPSS) 16.0 program. T-test, Mann-Whitney U, Pearson correlation coefficient and Kruskal-Wallis variance analysis were used in the statistical assessment. Results with a p value smaller than 0.05 were accepted as significant. Results: There was a statistically significant positive correlation between age and diploe thickness in all measurement points. The diploe thickness was also increased with age (p < 0.05). In all points, average diploe thickness was higher in age 61 and over than the other groups (p < 0.001). At the same time, diploe thickness in parietal bones was lower than frontal and occipital bones in both sexes. According to craniometric results cranium in males was bigger (p < 0.001). While the distance between glabella-opisthocranion increased in both sexes aged 61 and over, basion-vertex height decreased in women in the same group (p < 0.05). Interestingly, there was no meaningful statistical difference among age groups in terms of maximum cranial width (p > 0.05). Foramen magnum length decreased related to age in both men and women (p < 0.001). Conclusion: These results related to diploe thickness and cranium dimension may be leading in the determination of sex and age; surgical interventions to the cranium and bone graft choice may increase the reliability of the operation. (C) 2011 Elsevier Ireland Ltd. All rights reserved.Öğe A DWI study of the contralateral hemisphere in cerebral hemiatrophy(ELSEVIER SCIENCE BV, 2016) Oztoprak, Bilge; Oztoprak, Ibrahim; Bozkurt, Huseyin; Cigdem, Burhanettin; Yildiz, Ozlem KayimBackground and aim: Cerebral hemiatrophy (CHA) is a congenital or acquired loss of volume in one hemisphere of the brain. The MR findings of the affected hemisphere have been a subject of many studies, however, the contra-lateral hemisphere has not been investigated. There is, in fact, an integrity between two hemispheres of the brain through transverse connection fibers. The aim of this study is to investigate the changes in the contralateral hemisphere in CHA. Materials and methods: Apparent diffusion coefficient (ADC) values were measured in deep gray and white matter areas in the normal-appearing contralateral hemisphere in 23 patients with CHA, in order to get in vivo information about a possible Wallerian degeneration or microstructural changes. Results were compared with the control group. Results: Normal ADC values were encountered in the contralateral hemisphere in all (100%) CHA patients. The difference between the ADC values of gray and white matter in CHA patients and the control group was not statistically significant. Conclusion: Normal ADC values in the contralateral hemisphere in CHA patients suggests a compensatory mechanism restricting Wallerian degeneration or diffusion alteration. (C) 2016 Elsevier B.V. All rights reserved.Öğe Evaluation of segmented brain regions for medical image steganography(Gazi Univ, Fac Engineering Architecture, 2021) Karakis, Rukiye; Gurkahraman, Kali; Cigdem, Burhanettin; Oztoprak, Ibrahim; Topaktas, A. SuatIn medical image steganography, diagnosis and treatment of a disease can be affected as a result of the distortion caused by the embedding data in the images. For this reason, data is embedded in the region of non-interest determined by basic techniques such as manual or thresholding, and none of these methods involve the segmentation of brain tissues such as tumours. The present study aims to hide the data used in the diagnosis and treatment of a disease without affecting the medical information in the images with a segmentation-based steganography method by combining them into one file format. Magnetic Resonance (MR) images of epilepsy patients were segmented as background, gray matter, white matter, and tumour by discrete wavelet transform (DWT) and k-means clustering-based segmentation method. The hidden data includes confidential patient information, doctor's comment, selected Electroencephalogram (EEG) signals, and EEG health reports. The high-capacity message, which encoded by DNA encryption using chaotic and hash functions, and then compressed, is hidden in the least significant bits of non-tumour pixels of images. In the study, the difference between the cover and the stego images was measured by the peak signal-to-noise ratio, the structural similarity measure, the universal quality index, and the correlation coefficient. These values were obtained as 64.0334 decibels (dB), 0.9979, 0.9971, 0.9993, respectively. A comparison of the results indicates that the proposed method combines the high capacity data of the patients in a single file format and increases both the security and recording space of medical data.Öğe Evaluation of Thalamus Volumes in Patients with Diabetic Polyneuropathy Using Magnetic Resonance Imaging Method(2022) Öztürk, Ayşegül; Sabanciogullari, Vedat; Taştemur, Yaşar; Oztoprak, IbrahimThe neurological process in diabetes is not limited to peripheral nerves but also affects the central nervous system (CNS). In addition, magnetic resonance images (MRI) showing that this condition can occur early in the neuropathic process are also available. This study was conducted to investigate whether peripheral sensory nerve dysfunction causes changes in thalamus volume in patients with diabetic polyneuropathy (DPNP) who experience sensory loss. Our study is a retrospective study consisting of diabetes mellitus (DM), DPNP and a healthy control group, where brain MRI of 204 individuals aged between 20-90 with no neurological disorder that might affect thalamus. Morphometric measurements for thalamus and cerebrum volumetry were performed in conventional MRI. In order to measure the microstructural changes of thalamus, the apparent diffusion coefficient (ADC) was calculated by the diffusion-weighted imaging method. In conclusion of our measurements, it was found that individuals with DM and DPNP had a decrease in volume of both thalami(p<0.05) and cerebrum(p<0.05). However, no significant difference was found in ADC values(p>0.05). According to the results of research, DM and DPNP affect not only the peripheral nervous system but also the CNS. This effect caused atrophy of thalamus and cerebrum in patients of all age groups.Öğe H1N1-Related Encephalitis in the Postpandemic Era(TURKISH NEUROLOGICAL SOC, 2017) Yildiz, Ozlem Kayim; Bolayir, Asli; Gokce, Seyda Figul; Cigdem, Burhanettin; Oztoprak, Ibrahim…Öğe Intracranial arachnoid cyst family with autosomal recessive trait mapped to chromosome 6q22.31-23.2(SPRINGER WIEN, 2012) Bayrakli, Fatih; Okten, Ali Ihsan; Kartal, Ugur; Menekse, Guner; Guzel, Aslan; Oztoprak, Ibrahim; Pinarbasi, Ergun; Kars, Hamit ZaferArachnoid cysts are congenital fluid-filled compartments within the cerebrospinal fluid cisterns and cerebral fissures. They most commonly occur sporadically, and familial occurrence has rarely been reported. In this study, we showed the first genetic linkage in the literature in a pure intracranial arachnoid cyst family with autosomal recessive trait. We identified an intracranial arachnoid cyst family in southern Turkey whose six of seven offspring had intracranial arachnoid cysts in different localizations, and collected venous blood from seven offspring of the family. Whole-genome linkage analysis was performed in all offspring. A theorical maximum logarithm of the odds score of 4.6 was identified at chromosome 6q22.31-23.2. This result shows strong genetic linkage to this locus. We present the first genetic linkage analysis result in a pure intracranial arachnoid cyst family in literature. Further investigation of this linkage area can reveal a causative gene causing the intracranial arachnoid cyst phenotype and can illuminate the pathogenesis of this disease.Öğe Is the brain spared in Crimean-Congo haemorrhagic fever? An MR-SWI study to reveal CNS involvement(SPRINGER, 2018) Oztoprak, Bilge; Oztoprak, Ibrahim; Engin, AynurThe aim of this prospective study is to investigate the central nervous system involvement in Crimean-Congo haemorrhagic fever (CCHF) with magnetic resonance imaging (MRI) in conjunction with clinical and laboratory findings. Between July 2015 and August 2016, 36 patients with CCHF were undergone brain MRI including SWI. Two MRIs, one at the time of admission and the second in the convalescent period, were performed for each patient in order to see if there is any sign of central nervous system (CNS) involvement, especially in terms of intracranial haemorrhage or viral encephalitis. Clinical severity scoring was also done and laboratory findings were noted in order to correlate with clinical and imaging findings. None of the 36 patients showed any MRI findings of an acute intracranial event during the course of the disease. There was a significant difference between mild cases and moderate cases in terms of some laboratory parameters (p < 0.05). Although CCHF is a highly lethal disease which involves multiple organs and systems, CNS involvement seems to be extremely rare in mild and moderate cases. aEuro cent MRI is the imaging method of choice to diagnose microbleeds and encephalitis aEuro cent Although CCHF causes multisystem bleeding, intracranial haemorrhage seems to be very rare aEuro cent CNS complications are uncommon, even in the setting of suggestive symptoms aEuro cent Death usually results from extracranial bleeding and multiorgan failure aEuro cent Severity scoring is associated with some laboratory abnormalities in CCHF.Öğe Isolated Cortical Vein Thrombosis After Epidural Anesthesia: Report of Three Cases(TAYLOR & FRANCIS LTD, 2010) Yildiz, Ozlem Kayim; Balaban, Hatice; Cil, Gulsum; Oztoprak, Ibrahim; Bolayir, Ertugrul; Topaktas, SuatCerebral venous thrombosis rarely develops after lumbar puncture and spinal anesthesia with accidental dural puncture, however, occurrence of isolated cortical vein thrombosis after epidural anesthesia is extremely rare. We report three cases who developed postural headache and isolated cortical vein thrombosis after epidural anesthesia. We postulate that intracranial hypotension is the cause of compensatory venous dilatation and resultant thrombosis.Öğe Magnetic resonance imaging mesencephalic tectum dimensions according to age and gender(RIYADH ARMED FORCES HOSPITAL, 2013) Sabanciogullari, Vedat; Salk, Ismail; Balaban, Hatice; Oztoprak, Ibrahim; Kelkit, Seref; Cimen, MehmetObjective: To analyze and classify normal MRI tectum length and colliculus dimensions according to age and gender. Methods: Tectum length and colliculus diameters were measured on the T1 midsagittal and axial cranial MR images in the radiology archive of 532 (344 women, 188 men) patients aged 37.36 +/- 21.49 (range: 4-91) years old on average, and with no disorders affecting the mesencephalic tectum. All 532 patients underwent clinical MR imaging of the cranium at the MRI Unit of Sivas Numune Hospital and Sivas Cumhuriyet University Hospital, Sivas, Turkey between February and December 2011. Results: Although there was a positive linear correlation between tectum length and age, there was a negative correlation between the anteroposterior diameter of the colliculus superior and colliculus inferior and age (p<0.01). While tectum length (M3) increases with age, the anteroposterior diameter of the colliculus superior and inferior (M1 and M2) decreased (p<0.01). The colliculi were larger, and the tectum was longer in men. Although there was no difference in size between right and left superior colliculi, the left colliculus inferior was larger than the right one. Conclusion: In addition to the fact that normal mesencephalic tectum dimensions provide information on the brain development of individuals, they may also be beneficial for the detection and treatment of related pathologies. Neurosciences 2013; Vol. 18 (1): 33-39Öğe Multidetector computed tomographic angiography findings in a rare case of popliteal artery entrapment syndrome(ELSEVIER SCIENCE INC, 2008) Oztoprak, Ibrahim; Gumus, Cesur; Egilmez, Hulusi; Manduz, Sinasi; Oztoprak, Bilge; Emrecan, BilginPopliteal artery entrapment syndrome (PAES) is a disorder of the young age group characterized by ischemia of the lower extremities due to an abnormal association between the popliteal artery and adjacent musculotendinous structures. Several underlying anatomical abnormalities causing this syndrome are described and classified. In this study, we present an unusual case of PAES along with multidetector computed tomographic angiography findings.
