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Ok N, Agladioglu K, Gungor HR, Akkaya N, Akkaya S. Strain Ratio Measurements of Patellar and Achilles Tendons With Different Reference Regions in Healthy Volunteers. Ultrasound Med Biol 2019; 45:2027-2033. [PMID: 31104866 DOI: 10.1016/j.ultrasmedbio.2019.04.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 04/12/2019] [Accepted: 04/29/2019] [Indexed: 06/09/2023]
Abstract
Strain ratio measurements of tendons vary because of the reference tissue selection. The main purpose of this study is to highlight, in detail, the numeric variability attributable to the use of various reference materials on strain ratio measurements of patellar and Achilles tendons. Measurements were performed at the proximal, middle and distal thirds of the patellar and Achilles tendons on the dominant site of healthy volunteers. A total of 3 references were used: the Hoffa's fat pad for the patellar tendon, the Kager's fat pad for the Achilles tendon, subcutaneous tissue and Aquaflex gel pads (Parker Laboratories, Fairfield, NJ, USA) for both tendons. Although the same methods were used by the same physician for each tendon site on repeated measurements, strain ratio values had numeric variability with various reference materials in each measurement. Therefore, comparison of numeric strain ratio results of various studies with various reference materials could confuse the clinical interpretations of these numeric data, and, using a reference material with standard stiffness like Aquaflex ultrasound gel pads, should be considered by verifying these results with further studies.
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Affiliation(s)
- Nusret Ok
- Pamukkale University Medical Faculty, Department of Orthopedics and Traumatology, Pamukkale, Denizli, Turkey
| | - Kadir Agladioglu
- Medistate Kavacik Hospital, Department of Radiology, Kavacık, Beykoz, Istanbul, Turkey
| | - Harun R Gungor
- Pamukkale University Medical Faculty, Department of Orthopedics and Traumatology, Pamukkale, Denizli, Turkey.
| | - Nuray Akkaya
- Pamukkale University Medical Faculty, Department of Physical and Rehabilitation Medicine, Pamukkale, Denizli, Turkey
| | - Semih Akkaya
- Denipol Hospital, Department of Orthopedics and Traumatology, Merkezefendi, Denizli, Turkey
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Ufuk F, Agladioglu K, Karabulut N. CT evaluation of medial clavicular epiphysis as a method of bone age determination in adolescents and young adults. Diagn Interv Radiol 2017; 22:241-6. [PMID: 27015321 DOI: 10.5152/dir.2016.15355] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE We aimed to investigate the use of computed tomography (CT) staging of the medial clavicular epiphysis ossification in forensic bone age determination, and find a CT criterion to determine whether an individual is adult or not. METHODS Chest CT and pulmonary CT angiography exams of 354 patients between 10 and 30 years of age (mean, 21.4 years) were retrospectively evaluated for epiphyseal ossification phase of the bilateral medial clavicles (708 clavicles) and compared with the sex and chronologic age of the individuals. The ossification phase of the medial clavicular epiphyses was classified from stage I to stage V using a modified staging system. RESULTS Epiphyseal ossification center appeared from 11 to 21 years of age. Partial fusion occurred between 16 and 23 years of age. Complete fusion was first achieved at the ages of 18 and 19 years for male and female individuals, respectively. The probability of an individual being ≥18 years old was 70.8% in stage III A and 100% in stages III B, IV, and V in females and males. CONCLUSION CT evaluation of the medial clavicular epiphysis is helpful in forensic age determination and stage III B can be used as a criterion to make the prediction that an individual is older than 18 years.
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Affiliation(s)
- Furkan Ufuk
- Department of Diagnostic Radiology, University of Pamukkale, Denizli, Turkey.
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Isik-Balci Y, Agladioglu S, Agladioglu K, Kilic-Toprak E, Kilic-Erkek O, Ozhan B, Polat A, Bor-Kucukatay M. Impaired Hemorheological Parameters and Increased Carotid Intima-Media Thickness in Children with Subclinical Hypothyroidism. Horm Res Paediatr 2017; 85:250-6. [PMID: 26934063 DOI: 10.1159/000444363] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 02/01/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Subclinical hypothyroidism (SH) is defined as elevated serum thyroid-stimulating hormone (TSH) concentration associated with normal serum-free thyroxine levels. Effects of hypothyroidism on hemorheology had widely attracted the attention of researchers during the last decade. OBJECTIVE The purpose of this study is to determine alterations in hemorheological parameters and carotid intima-media thickness (CIMT) in children with SH. METHODS Fifty-three SH children and 31 healthy controls were enrolled. Erythrocyte deformability and aggregation were determined by an ektacytometer and plasma viscosity (PV) by a cone-plate rotational viscometer. CIMT was evaluated sonographically. RESULTS Erythrocyte deformability of the SH group measured at 0.53 and 1.69-30 Pa was lower than that of the control group. The erythrocyte aggregation index, aggregation half time and PV were not different between the groups. However, the aggregation amplitude and mean corpuscular hemoglobin concentration were significantly higher in SH compared to the control group. There was a negative correlation between TSH and deformability values measured at 5.33-30.0 Pa. CIMT in patients with SH was significantly higher than in the control group (p = 0.001; SH = 0.48 ± 0.04 mm, control group = 0.43 ± 0.03 mm). CONCLUSION Impaired hemorheology and increased CIMT are well-known risk factors for developing cardiovascular pathologies. The results of the current study suggest the treatment of children with SH in order to avoid early circulatory problems.
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Affiliation(s)
- Yasemin Isik-Balci
- Department of Pediatric Hematology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
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Gungor HR, Ok N, Agladioglu K. Comment on: Measurement of the knee joint line in Turkish population. Acta Orthop Traumatol Turc 2016; 50:480-1. [PMID: 27522315 PMCID: PMC6197159 DOI: 10.1016/j.aott.2016.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 09/29/2015] [Indexed: 11/20/2022]
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Herek D, Karabulut A, Agladioglu K. Usefulness of transabdominal real-time sonoelastography in the evaluation of ovarian lesions: preliminary results. Br J Radiol 2016; 89:20160173. [PMID: 27351692 DOI: 10.1259/bjr.20160173] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE We aim to evaluate and describe the tissue elasticity characteristics of various ovarian lesions with sonoelastography. METHODS 35 patients (age range 16-85 years; mean age 40.8 years) underwent sonoelastography and later MRI. Histopathological confirmation of all lesions was carried out, except eight of endometriomas and six of septated cysts which were confirmed on MRI and follow-up ultrasonography. Strain ratios and elastogram patterns were recorded. Lesions were classified into three groups (Group 1: cystic lesions, Group 2: benign tumours and Group 3: malignant lesions) and findings were compared between groups for both observers. Interobserver agreement was analyzed. Optimal cut-off values for strain ratios were achieved with receiver operating characteristic curve analysis. RESULTS Ovarian endometriomas and complex cystic lesions were observed hard on elastograms with high strain ratios, and malignant lesions were observed mostly soft with very small strain ratios. Benign tumours had average tissue stiffness, observed harder than the malignant lesions, and strain ratios ranged from 4 to 14. The differences in patterns and strain ratios between groups were statistically significant (p < 0.05 for both observers). CONCLUSION Our study revealed that malignant ovarian lesions have softer tissue property than benign lesions and cystic lesions in terms of elastogram patterns and strain ratios. ADVANCES IN KNOWLEDGE Most ovarian lesions contain solid and cystic parts which make the malignant and benign lesions look similar on imaging modalities. Using real-time sonoelastography as an adjunct to other imaging modalities may improve the differentiation of malignant ovarian lesions from benign lesions.
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Affiliation(s)
- Duygu Herek
- 1 Department of Radiology, School of Medicine, Pamukkale University, Denizli, Turkey
| | - Aysun Karabulut
- 2 Department of Gynecology and Obstetrics, School of Medicine, Pamukkale University, Denizli, Turkey
| | - Kadir Agladioglu
- 1 Department of Radiology, School of Medicine, Pamukkale University, Denizli, Turkey
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Ok N, Agladioglu K, Gungor HR, Kitis A, Akkaya S, Akkoyunlu NS, Demirkan F. Relationship of side dominance and ultrasonographic measurements of pronator quadratus muscle along with handgrip and pinch strength. Med Ultrason 2016; 18:170-176. [PMID: 27239650 DOI: 10.11152/mu.2013.2066.182.qua] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIMS We ascertained effects of hand dominance in both right and left-handed volunteers on the thickness and cross sectional area (CSA) of pronator quadratus (PQ) muscle as measured by the axial and sagittal views of ultrasound imaging. Secondly, we also aimed to document the extent of the relationship between the PQ measurements and handgrip. MATERIALS AND METHODS Healthy adults from the volunteer medical staff were included in the study. Handedness was assessed via The Flinders Handedness survey. The sonographic appearance of the PQ was evaluated on sagittal and axial images for both hands. CSA of PQ muscle was digitally drawn and calculated on the axial plane. Handgrip was measured by using adjustable-handle dynamometer. RESULTS Eighty-nine healthy volunteers were included (54 right and 35 left-handed). Significant difference was detected between dominant and non-dominant hands in CSA and muscle thickness in both right and left-handed volunteers (p<0.05). These measurements were correlated with the handgrip strength (p<0.05, r=0.55, and r=0.43 for right-handed volunteers, r=0.67 and r=0.48 for left-handed volunteers, respectively). There were also significantly high correlations between the measurements of CSA and PQ thickness of the corresponding extremity in both right-handed and left-handed volunteers (p<0.05). CONCLUSIONS A statistically significant difference exists between dominant and non-dominant hands in CSA and muscle thickness measured by US in both right and left handed volunteers, and this is correlated with handgrip strength. Hand dominance should be considered to compare healthy and affected sites during US of PQ while investigating for occult fractures of distal forearm or PQ atrophy due to anterior interosseous nerve injury.
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Affiliation(s)
- Nusret Ok
- Pamukkale University Medical Faculty Orthopedics and Traumatology Department, Denizli, Turkey
| | - Kadir Agladioglu
- Pamukkale University Medical Faculty Radiology Department, Denizli, Turkey
| | - Harun R Gungor
- Pamukkale University Medical Faculty Orthopedics and Traumatology Department, Denizli, Turkey.
| | - Ali Kitis
- Pamukkale University School of Physical Therapy and Rehabilitation Department, Denizli, Turkey
| | - Semih Akkaya
- Pamukkale University Medical Faculty Orthopedics and Traumatology Department, Denizli, Turkey
| | | | - Fahir Demirkan
- Pamukkale University Medical Faculty Orthopedics and Traumatology Department, Denizli, Turkey
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Gungor HR, Agladioglu K, Akkaya N, Akkaya S, Ok N, Ozçakar L. The Effects of Smoking on Ultrasonographic Thickness and Elastosonographic Strain Ratio Measurements of Distal Femoral Cartilage. Int J Environ Res Public Health 2016; 13:434. [PMID: 27110800 PMCID: PMC4847096 DOI: 10.3390/ijerph13040434] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 04/05/2016] [Accepted: 04/07/2016] [Indexed: 11/23/2022]
Abstract
Although adverse effects of smoking on bone health are all well known, data on how smoking interacts with cartilage structure in otherwise healthy individuals remains conflicting. Here, we ascertain the effects of cigarette smoking on sonoelastographic properties of distal femoral cartilage in asymptomatic adults. Demographic characteristics and smoking habits (packets/year) of healthy volunteers were recorded. Medial, intercondylar, and lateral distal femoral cartilage thicknesses and strain ratios on the dominant extremity were measured with ultrasonography (US) and real time US elastography. A total of 88 subjects (71 M, 17 F; aged 18–56 years, N = 43 smokers and N = 45 nonsmokers) were evaluated. Mean amount of cigarette smoking was 10.3 ± 8.9 (1–45) packets/year. Medial, intercondylar and lateral cartilage were thicker in smokers than nonsmokers (p = 0.002, p = 0.017, and p = 0.004, respectively). Medial distal femoral cartilage strain ratio was lower in smokers (p = 0.003). The amount of smoking was positively correlated with cartilage thicknesses and negatively correlated with medial cartilage strain ratios (p < 0.05). Femoral cartilage is thicker in smokers but has less strain ratio representing harder cartilage on the medial side. Future studies are needed to understand how these structural changes in the knee cartilage should be interpreted with regard to the development of knee osteoarthritis in smokers.
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Affiliation(s)
- Harun R Gungor
- Orthopedics and Traumatology Department, Medical Faculty, Pamukkale University, Denizli 20070, Turkey.
| | - Kadir Agladioglu
- Radiology Department, Medical Faculty, Pamukkale University, Denizli 20070, Turkey.
| | - Nuray Akkaya
- Physical and Rehabilitation Medicine Department, Medical Faculty, Pamukkale University, Denizli 20070, Turkey.
| | - Semih Akkaya
- Orthopedics and Traumatology Department, Medical Faculty, Pamukkale University, Denizli 20070, Turkey.
| | - Nusret Ok
- Orthopedics and Traumatology Department, Medical Faculty, Pamukkale University, Denizli 20070, Turkey.
| | - Levent Ozçakar
- Physical and Rehabilitation Medicine Department, Medical Faculty, Hacettepe University, Ankara 06100, Turkey.
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Abstract
BACKGROUND The appropriate sequence of different imagings and indications of thoracic computed tomography (TCT) in evaluating chest trauma have not yet been clarified at present. The current study was undertaken to determine the value of chest X-ray (CXR) in detecting chest injuries in patients with blunt trauma. METHODS A total of 447 patients with blunt thoracic trauma who had been admitted to the emergency department (ED) in the period of 2009-2013 were retrospectively reviewed. The patients met inclusion criteria (age>8 years, blunt injury to the chest, hemodynamically stable, and neurologically intact) and underwent both TCT and upright CXR in the ED. Radiological imagings were re-interpreted after they were collected from the hospital database by two skilled radiologists. RESULTS Of the 447 patients, 309 (69.1%) were male. The mean age of the 447 patients was 39.5±19.2 (range 9 and 87 years). 158 (35.3%) patients were injured in motor vehicle accidents (MVA). CXR showed the highest sensitivity in detecting clavicle fractures [95%CI 78.3 (63.6-89)] but the lowest in pneuomediastinum [95%CI 11.8 (1.5-36.4)]. The specificity of CXR was close to 100% in detecting a wide array of entities. CONCLUSION CXR remains to be the first choice in hemodynamically unstable patients with blunt chest trauma. Moreover, stable patients with normal CXR are candidates who should undergo TCT if significant injury has not been ruled out.
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Affiliation(s)
- Kadir Agladioglu
- Department of Radiology, Medical Faculty, Pamukkale University, Denizli, Turkey
| | - Mustafa Serinken
- Department of Emergency Medicine, Medical Faculty, Pamukkale University, Denizli, Turkey
| | - Onur Dal
- Department of Emergency Medicine, Medical Faculty, Adnan Menderes University, Aydin, Turkey
| | - Halil Beydilli
- Department of Emergency Medicine, Medical Faculty, Mugla University, Mugla, Turkey
| | - Cenker Eken
- Department of Emergency Medicine, Medical Faculty, Akdeniz University, Antalya, Turkey
| | - Ozgur Karcioglu
- Department of Emergency Medicine, Istanbul Education and Research Hospital, Istanbul, Turkey
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Agladioglu K, Pekel G, Yagci R, Citisli V. Reply: Choroidal thickness shows diurnal variation. J Clin Ultrasound 2016; 44:169. [PMID: 26875594 DOI: 10.1002/jcu.22342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 01/15/2016] [Indexed: 06/05/2023]
Affiliation(s)
| | - Gökhan Pekel
- Ophthalmology Department, Pamukkale University, Denizli, Turkey
| | - Ramazan Yagci
- Ophthalmology Department, Pamukkale University, Denizli, Turkey
| | - Veli Citisli
- Neurosurgery Department, Pamukkale University, Denizli, Turkey
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Agladioglu K, Pekel G, Altintas Kasikci S, Yagci R, Kiroglu Y. An evaluation of ocular elasticity using real-time ultrasound elastography in primary open-angle glaucoma. Br J Radiol 2016; 89:20150429. [PMID: 26838949 DOI: 10.1259/bjr.20150429] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare sonoelastographic findings in the retina-choroid-sclera (RCS) complex and vitreous in glaucomatous and healthy eyes. METHODS For this cross-sectional comparative study, 20 patients with primary open-angle glaucoma and 20 healthy volunteers were recruited. Ultrasound elastography measurements were taken with a sonographic scanner of the RCS complex, anterior vitreous (AV), posterior vitreous (PV), retrobulbar fat tissue (RFT), optic disc (OD) and optic nerve (ON) in each eye. RESULTS The elasticity index of the RCS complex, RFT, OD, ON, AV and PV was similar in both groups (p > 0.05), although the AV/PV strain ratio in the group of patients with glaucoma was significantly higher (p = 0.04). CONCLUSION Glaucoma increases the AV/PV strain ratio. In providing reproducible and consistent values, the real-time elastography (RTE) technique may be helpful in elucidating the mechanisms of glaucoma in some aspects. ADVANCES IN KNOWLEDGE This study can help to evaluate the elasticity of the RCS complex and vitreous in glaucomatous eyes with RTE.
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Affiliation(s)
- Kadir Agladioglu
- 1 Pamukkale University, Medical School, Department of Radiology, Denizli, Turkey
| | - Gökhan Pekel
- 2 Pamukkale University, Medical School, Department of Ophtalmology, Denizli, Turkey
| | | | - Ramazan Yagci
- 2 Pamukkale University, Medical School, Department of Ophtalmology, Denizli, Turkey
| | - Yilmaz Kiroglu
- 1 Pamukkale University, Medical School, Department of Radiology, Denizli, Turkey
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Gungor HR, Ok N, Agladioglu K. "Outliers" in Osteoarthritic Knees Concerning Distal Femoral Valgus Angle and Femoral Rotation Angle. J Arthroplasty 2016; 31:550. [PMID: 26235523 DOI: 10.1016/j.arth.2015.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 07/01/2015] [Indexed: 02/01/2023] Open
Affiliation(s)
- Harun R Gungor
- Orthopedics and Traumatology Department, Medical Faculty, Pamukkale University, Kinikli, Denizli, Turkey
| | - Nusret Ok
- Orthopedics and Traumatology Department, Medical Faculty, Pamukkale University, Kinikli, Denizli, Turkey
| | - Kadir Agladioglu
- Orthopedics and Traumatology Department, Medical Faculty, Pamukkale University, Kinikli, Denizli, Turkey
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Agladioglu K, Herek D, Herek O, Agladioglu S, Cördük N, Ozhan B. Can ultrasound elastography be used as a new technique in the differentiation of undescended testes and reactive lymph nodes in children? Clin Radiol 2015; 70:1269-75. [DOI: 10.1016/j.crad.2015.06.099] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 06/03/2015] [Accepted: 06/29/2015] [Indexed: 12/21/2022]
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Agladioglu K, Pekel G, Citisli V, Yagci R. Choroidal thickness and retinal vascular caliber correlations with internal carotid artery Doppler variables. J Clin Ultrasound 2015; 43:567-572. [PMID: 25802013 DOI: 10.1002/jcu.22269] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 01/20/2015] [Indexed: 06/04/2023]
Abstract
PURPOSE Decreased retinal arteriolar caliber and increased retinal venular caliber have been associated with increased cardiovascular mortality. This study aimed to evaluate correlations of choroidal thickness and retinal vascular caliber measurements with internal carotid artery (ICA) Doppler ultrasound variables. METHODS In this cross-sectional and observational study, 43 eyes and ICAs of 43 healthy volunteers were examined. Spectral domain optical coherence tomography was used to measure subfoveal choroidal thickness (SFCT) and retinal vascular caliber. The ICA Doppler ultrasonographic parameters were diameter, flow volume, peak-systolic velocity, end-diastolic velocity, resistance index (RI), and pulsatility index (PI). RESULTS Negative correlations emerged between ICA RI and SFCT (p = 0.017, r = -0.36) as well as between ICA PI and retinal arteriolar caliber (p = 0.015, r = -0.37). A negative linear correlation appeared between ICA diameter and SFCT (p = 0.005, r = -0.42), although ICA diameter and flow volume showed no association with retinal vessel caliber (p > 0.05). CONCLUSIONS Choroidal thickness is negatively correlated with ICA diameter and ICA RI, while retinal arteriolar caliber is inversely related with ICA PI in normal volunteers.
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Affiliation(s)
| | - Gökhan Pekel
- Department of Ophthalmology, Pamukkale University, Denizli, Turkey
| | - Veli Citisli
- Department of Neurosurgery, Pamukkale University, Denizli, Turkey
| | - Ramazan Yagci
- Department of Ophthalmology, Pamukkale University, Denizli, Turkey
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Gungor HR, Agladioglu K. Clarification of terminology: sonographic appearance of the pronator quadratus muscle in healthy volunteers. J Ultrasound Med 2015; 34:174. [PMID: 25542957 DOI: 10.7863/ultra.34.1.174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Harun R Gungor
- Department of Orthopedics and Traumatology (H.R.G.), Department of Radiology (K.A.), Pamukkale University, Denizli, Turkey
| | - Kadir Agladioglu
- Department of Orthopedics and Traumatology (H.R.G.), Department of Radiology (K.A.), Pamukkale University, Denizli, Turkey
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Gungor HR, Ok N, Agladioglu K, Akkaya S, Kiter E. Significance of asymmetrical posteromedial and posterolateral femoral condylar chamfer cuts in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2014; 22:2989-94. [PMID: 25257681 DOI: 10.1007/s00167-014-3342-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 09/17/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE Orthopedic surgeons remove more bone from the posteromedial femoral condyle than the posterolateral condyle to achieve the desired femoral component rotation. Here, the correlation between the asymmetry of chamfer cuts and femoral component rotation in total knee arthroplasty was determined. METHODS A model was built to simulate anterior chamfer cuts performed during total knee arthroplasty to measure posterior condylar offset. Right knee axial magnetic resonance imaging slices were examined from 280 consecutive patients (142 men, 138 women; mean age 31.4 ± 6.6 years). The anatomic and surgical transepicondylar axes, as well as the posterior condylar joint line, were drawn. Differences in the posteromedial and posterolateral offsets and the femoral rotation angles relative to the posterior joint line were measured. RESULTS The mean surgical femoral rotation angle was 4.8° ± 1.2°, and the mean posterior condylar offset difference was 4.4 ± 1 mm, with a strong correlation (p < 0.0001; r = 0.803). There was no statistically significant difference between genders. Linear regression analyses revealed that a 0.8-mm difference between the anteroposterior dimensions of the medial and lateral posterior condylar offsets corresponded to 1° of femoral external rotation (p < 0.0001, R (2) = 0.645). CONCLUSION The accuracy of the applied technique intra-operatively can be verified by correlating the asymmetry of posterior chamfer cuts with the achieved femoral component rotation, as determined by measuring the thicknesses of posterior chamfer cuts with a caliper. Technical errors can also be minimized by confirming the association between the femoral component rotation-as predicted by the posterior condylar offset difference-and the preoperatively measured femoral rotation angle. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Harun R Gungor
- Orthopedics and Traumatology Department, Medical Faculty, Pamukkale University, 20070, Kinikli, Denizli, Turkey,
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Agladioglu K, Ardic FN, Tumkaya F, Bir F. MRI and CT Imaging of an Intrasphenoidal Encephalocele: A Case Report. Pol J Radiol 2014; 79:360-2. [PMID: 25324915 PMCID: PMC4199461 DOI: 10.12659/pjr.890795] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 04/25/2014] [Indexed: 11/10/2022] Open
Abstract
Background Intrasphenoidal encephalocele (ISE) is a rare clinical entity. The incidence of congenital encephalocele is very low. Accurate diagnosis and surgical approach is of critical value. Case Reports We present a case of intrasphenoidal encephalocele in a 40-year-old man. He complained of cerebrospinal fluid (CSF) rhinorrhea and recurrent meningitis. In images of computed tomography (CT) and magnetic resonance imaging (MRI), intrasphenoidal encephalocele herniating through a defect of the left lateral sphenoid sinus wall was determined. Incisional biopsies were taken by endoscopic transnasal approach and histopathological examination revealed an encephalocele. In the differential diagnosis, ISE can be taken for inflammatory or malignant sinusoidal soft tissue masses. ISE is differentiated from other entities by demonstrating continuity with normal brain tissue. Conclusions MRI clearly demonstrates that the herniating soft tissue is isointense with brain and continuous with brain tissue via the sphenoid sinus, thereby the treatment decision-making process is very important.
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Affiliation(s)
| | - Fazıl Necdet Ardic
- Department of Otolaryngology Head and Neck Surgery, Pamukkale University, Denizli, Turkey
| | - Funda Tumkaya
- Department of Otolaryngology Head and Neck Surgery, Pamukkale University, Denizli, Turkey
| | - Ferda Bir
- Department of Pathology, Pamukkale University, Denizli, Turkey
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Kucukazman M, Ata N, Yavuz B, Dal K, Sen O, Deveci OS, Agladioglu K, Yeniova AO, Nazligul Y, Ertugrul DT. Evaluation of early atherosclerosis markers in patients with nonalcoholic fatty liver disease. Eur J Gastroenterol Hepatol 2013; 25:147-51. [PMID: 23085576 DOI: 10.1097/meg.0b013e32835a58b1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Nonalcoholic fatty liver disease (NAFLD) is characterized by the excessive accumulation of fat in the liver cells. It is strongly associated with cardiovascular risk factors for atherosclerosis. Flow-mediated dilation (FMD) and carotid intima-media thickness (CIMT) are noninvasive methods for the evaluation of endothelium. They are considered early markers of atherogenesis. The aim of this study was to evaluate early atherosclerosis markers in patients with NAFLD. METHODS We examined 161 patients. All the patients underwent hepatic ultrasonography, transthoracic echocardiography, and brachial artery and carotid artery imaging. Fasting blood samples were drawn from all patients for the determination of lipids, insulin, C-peptide, and fasting blood glucose. HOMA-IR was calculated. RESULTS Among the 161 patients, 44 had normal hepatic ultrasonography, 42 had stage 1 hepatosteatosis, 53 had stage 2 hepatosteatosis and 22 had stage 3 hepatosteatosis. FMD was reduced in patients with NAFLD as compared with the healthy controls (5.9 ± 3.1 vs. 9.6 ± 2.7%, P<0.001). There was a significant negative moderate correlation between ultrasonographic hepatosteatosis grade and FMD (r=-0.556, P<0.001). The mean CIMT was significantly increased in patients with NAFLD as compared with the controls (0.40 ± 0.19 vs. 0.27 ± 0.18, P<0.001). There was a significant positive weak correlation between ultrasonographic hepatosteatosis grade and mean CIMT (r=0.376, P<0.001). CONCLUSION This study showed that NAFLD is associated with impaired CIMT and FMD, which are early markers of atherosclerosis. These findings may play a crucial role in understanding the pathophysiology of the atherosclerotic process in patients with NAFLD.
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Affiliation(s)
- Metin Kucukazman
- Department of Internal Medicine, Division of Gastroenterology, Kecioren Teaching and Research Hospital, Ankara, Turkey.
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Ozdemir O, Hizli S, Abaci A, Agladioglu K, Aksoy S. Echocardiographic measurement of epicardial adipose tissue in obese children. Pediatr Cardiol 2010; 31:853-60. [PMID: 20461364 DOI: 10.1007/s00246-010-9720-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2009] [Accepted: 04/22/2010] [Indexed: 12/01/2022]
Abstract
The echocardiographic measurement of epicardial adipose tissue (EAT) has been suggested as an easy method for evaluation of the visceral adipose tissue and its related cardiovascular risks in adults. However, a direct effect of obesity on cardiac function is not well established, and echocardiographic EAT thickness has not been studied in children. The aims of this study were to evaluate cardiac function and echocardiographic EAT thickness and to correlate EAT with the other echocardiographic findings in obese children. The study population included 106 obese and 62 lean children. Echocardiographic indexes of systolic and diastolic function were obtained. We measured EAT thickness on the free wall of the right ventricle from parasternal long-axis views. The septal and posterior wall thicknesses, relative wall thickness, left atrial diameter, and left ventricular mass were increased (p = 0.001) in obese children. However, systolic and diastolic functions of the left ventricle were normal in the patients. The obese children had a significantly thicker EAT (p = 0.001) compared to the lean subjects. EAT thickness correlated significantly with body mass index (r = 0.50, p = 0.001), left atrial diameter (r = 0.37, p = 0.001), and left ventricular mass (r = 0.33, p = 0.001). In conclusion, the present study demonstrates a close relationship between EAT thickness and obesity in children. Assessment of EAT thickness in routine echocardiographic examinations might be used as a feasible and reliable method for the evaluation of obesity and its related cardiovascular risks during childhood.
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Affiliation(s)
- Osman Ozdemir
- Department of Paediatric Cardiology, Kecioren Training and Research Hospital, Sanatoryum Caddesi, Pinarbasi Mahallesi, Ardahan Sokak, Kecioren Egitim ve Arastirma Hastanesi, Ankara, Turkey.
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Kara V, Agladioglu K, Ozyol A, Kocer B, Atac K, Oguz S. ANTERIOR CHEST WALL DEFORMITIES AND ACCOMPANYING CARDIAC PROBLEMS FOR YOUNG MILITARY PERSONNEL. Chest 2009. [DOI: 10.1378/chest.136.4_meetingabstracts.134s-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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