Challenges in Diagnosis and Treatment of Infection.

A 57-year-old female patient presented with fever, nausea, vomiting, loss of appetite, and weight loss within the last two months. Ceftriaxone and metronidazole therapy was started upon discovery of a liver abscess but provided no benefit. Following the of abscess biopsy, the patient developed fever, itching, anemia, acute renal failure, hyperbilirubinemia, and eosinophilia that required intensive care unit (ICU) admission.

Successful pregnancy after presurgical uterine artery embolization in the management of a very large cervical myoma: A case report.

Although fibroids are the most common benign tumors of the uterus in women of reproductive age, cervical fibroids are rarely seen. Since cervical fibroids are located deep in the pelvis, the incidence of complications in surgery is high. Among these complications bleeding is the most common, due to poor access to myoma, difficulty in suturing and repair, and distortion of vital neighboring structures.

In-bore MRI-guided prostate biopsy in a patient group with PI-RADS 4 and 5 targets: A single center experience.

Purpose: To determine the diagnostic yield of magnetic resonance imaging (MRI) guided in-bore biopsy in patients with high likelihood multiparametric MRI (mpMRI) findings, regarding overall and clinically significant prostate cancer (csPCa) detection rates and concordance of biopsy and radical prostatectomy (RP) Gleason scores (GS).

Methods: This retrospective study consisted of 277 Prostate Imaging Reporting and Data System (PI-RADS) assessment category 4 and 5 targets in 246 patients (mean age, 65.7 years; median prostate specific antigen value, 7.

Dealing with the gray zones in the management of gastric cancer: The consensus statement of the İstanbul Group.

The geographical location and differences in tumor biology significantly change the management of gastric cancer. The prevalence of gastric cancer ranks fifth and sixth among men and women, respectively, in Turkey. The international guidelines from the Eastern and Western countries fail to manage a considerable amount of inconclusive issues in the management of gastric cancer.

Multiparametric MRI guidance in first-time prostate biopsies: what is the real benefit?

Purpose: With the increased recognition of the capabilities of prostate multiparametric (mp) magnetic resonance imaging (MRI), attempts are being made to incorporate MRI into routine prostate biopsies. In this study, we aimed to analyze the diagnostic yield via cognitive fusion, transrectal ultrasound (TRUS)-guided, and in-bore MRI-guided biopsies in biopsy-naive patients with positive findings for prostate cancer screening.

Methods: Charts of 140 patients, who underwent transrectal prostate biopsy after the adaptation of mp-MRI into our routine clinical practice, were reviewed retrospectively.

Adrenal cortex-sparing surgery for bilateral multiple pheochromocytomas in a patient with von hippel-lindau disease.

Pheochromocytomas can be a part of familial neoplastic syndromes, in which case they tend to be multiple and involve both adrenal glands. Therefore, sparing adrenocortical function represents a major concern while dealing with these hereditary lesions. Herein, we describe the clinical characteristics and the management strategy of a patient with von Hippel-Lindau (VHL) disease who had multiple, bilateral pheochromocytomas as well as bilateral renal masses, pancreatic masses, and a paracaval mass.

Aorta after stent grafting for mycotic aneurysm.

Endovascular stent grafting is applied for the treatment of different aortic pathologies in the current medical era. It may be lifesaving in patients with comorbidities and virtually inoperable when adopting conventional techniques. This manuscript reports on a 40-year-old patient, who was previously treated for a mycotic saccular aneurysm at the aortic arch and who presented with a descending aortic rupture at the mid-term follow-up.

Cutting-balloon angioplasty in transplant renal artery stenosis as first-line treatment in the early postoperative period.

Percutaneous transluminal angioplasty has been successfully used for the treatment of transplant renal artery stenosis (RAS). Cutting-balloon angioplasty (CBA) is being used as a second option in pressure-resistant stenosis. It is thought that CBA is less traumatic and therefore restenosis occurs less frequently than in conventional angioplasty.

Diffusion weighted MR imaging of pancreatic islet cell tumors.

Purpose: The aim of our study is to demonstrate the feasibility of body diffusion weighted (DW) MR imaging in the evaluation of pancreatic islet cell tumors (ICTs) and to define apparent diffusion coefficient (ADC) values for these tumors.

Materials And Methods: 12 normal volunteers and 12 patients with histopathologically proven pancreatic ICT by surgery were included in the study. DW MR images were obtained by a body-phased array coil using a multisection single-shot echo planar sequence on the axial plane without breath holding.

Pushable springcoil embolization of pseudoaneurysms caused by gluteal stab injuries.

Purpose: To retrospectively review the outcomes of 21 patients with stab wounds to the gluteal region who underwent embolization for pseudoaneurysms causing active bleeding.

Materials And Methods: Between 1997 and 2007, 3 superior gluteal artery, 2 inferior gluteal artery and 16 deep femoral artery muscular branch pseudoaneurysms detected by digital subtraction angiography were selectively catheterized with diagnostic catheters with hydrophilic coating and embolized with pushable springcoils. 17 of the 21 pseudoaneurysms were located in a distal end of an artery where outflow vessels could not be depicted.

Endovascular treatment of a superior mesenteric artery aneurysm secondary to Behcet's disease with Onyx (ethylene vinyl alcohol copolymer).

Behcet's disease is a complex multisystemic chronic inflammatory disease that is characterized by oral and genital aphtous ulcers and vasculitis. Aneurysms of major arteries are the most important cause of mortality in Behcet's disease. Four patients with superior mesenteric artery (SMA) aneurysms related to Behcet's disease have been reported in the literature.

Cystic echinococcal liver disease: new insights into an old disease and an algorithm for therapy planning.

Human cystic echinococcosis (CE) continues to be a major health problem in developing countries. A review of current literature discloses four alternatives for the management of active CE, consisting of surgery, percutaneous treatment (PT), chemotherapy, and follow-up without intervention, but no clear guidelines for directing patients to the different management options. Palliation of symptoms or prevention of complications is the main rationale for the treatment of CE.

Endoluminal stenting of mycotic saccular aneurysm at the aortic arch.

Endovascular grafts have been widely used for the treatment of aneurysms since the early 1990s. They are preferred especially for use in patients in whom conventional surgical methods carry high risks of death and morbidity. Increasing operator experience and technical refinements in endovascular grafting have enabled these procedures to be performed even in critical segments of the aorta, such as the thoracic and arch levels.

Endoscopic and radiologic interventions as the leading causes of severe cholangitis in a tertiary referral center.

Background: Iatrogenic factors became the leading mechanisms of severe cholangitis in a referral center.

Patients And Methods: The records of the 58 patients treated for severe cholangitis between 1996 and May 2004 (inclusive) were evaluated.

Results: The most frequent underlying diseases were periampullary tumors and mid-bile duct carcinomas (22), followed by proximal cholangiocarcinomas (14).

Alveolar echinococcosis in Turkey. Experience from an endemic region.

Background: Radical resection is the only potentially curative treatment for hepatic alveolar echinococcosis (AE). Although Turkey is an endemic region, population screening is not performed and early diagnosis is rare. Consequently, surgeons are compelled to explore possibilities such as near-total resection and biliodigestive anastomosis for palliation of jaundice.

MR imaging and electrophysiological evaluation in carpal tunnel syndrome.

The objective of this study was to compare the MRI findings of wrists in patients diagnosed with CTS with those of the healthy controls, and to evaluate the correlation between the MRI differences and the electrophysiological findings in the patient group. This study involved 55 wrists, 30 of which were clinically and electrophysiologically diagnosed with CTS and 25 healthy controls. These 55 wrists were evaluated electrophysiologically, and in terms of median nerve diameter, ratio of median nerve diameter at psiform bone level to distal radio-ulnar joint level, the flexor retinaculum bulging ratio and the median nerve intensity by MRI.

Separate origins of the left internal and external carotid arteries from the aortic arch: MR angiographic findings.

Agenesis of the left common carotid artery with independent origins of the internal and external carotid arteries arising directly from the aortic arch is an extremely rare congenital anomaly. We present MR angiographic findings in a case with agenesis of left common carotid artery that, to our knowledge, is unique by virtue of its detection and description with MR angiography.

Palliative treatment of inoperable malignant esophageal strictures with metal stents: one center's experience with four different stents.

Purpose: Our center's experience with Ultraflex, Flamingo, SR stent and Flexstent for the palliation of malignant esophageal strictures is reported, and current pertinent literature is reviewed.

Material And Methods: Stents have been placed under fluoroscopic guidance between August 1993 and February 2002 for the palliation of malignant dysphagia in 116 patients. 59 patients received Ultraflex, 33 patients received Flamingo Wallstent, 20 patients received the SR stent and four patients received Flexstent.

Intervention in gastrointestinal tract: the treatment of esophageal, gastroduodenal and colorectal obstructions with metallic stents.

With the development of newer stent designs and delivery systems, metallic stents are currently established component of nonsurgical treatment of gastrointestinal obstructions. The use of metallic stents is not intended to be curative but palliative. This palliation may be intended for the rest of the patient's life with unresectable disease or as a temporary procedure prior to a definitive surgical procedure to allow time to improve the patient's overall medical condition or quick and noninvasive decompression of the intestinal obstruction.