Namik Kemal Altinbas

An unusual growth of ovarian cystic teratoma with multiple floating balls during pregnancy: A case report

We report a case of ovarian cystic teratoma with an important growth during pregnancy and the sonographic appearance of intracystic multiple, mobile, polygonal structures called intracystic “fat balls.” Due to the rapid growth of the lesion, which exceeded 15 cm in diameter, a right oophorectomy was performed. Histopathologic diagnosis confirmed the mature cystic teratoma. The presence of floating balls composed of keratin and fat is rarely seen but is pathognomonic of mature cystic teratomas. Growth of a teratoma during pregnancy is a rare condition.

Concomitant Imperforate Hymen and Transverse Vaginal Septum Complicated with Pyocolpos and Abdominovaginal Fistula

A 13-year-old patient with a complaint of worsening lower abdominal pain during the past 4 months was admitted to the emergency department. An abdominopelvic ultrasound scan revealed a distended uterocervical cavity suggestive of hematometrocolpos. Imperforate hymen was observed on examination of the external genitalia. MRI scan revealed an air-fluid level representing pyometrocolpos within a distended vagina. Posterior vaginal extraperitoneal leakage as the sign of a fistula between the vagina and the rectovaginal space was detected. Although laparoscopic approach was planned, malodorous pus expelled after the insertion of the Veress needle, it was decided to proceed to laparotomy. Pus with peritoneal microabscess formations was observed at laparotomy. The imperforate hymen and TVS were excised vaginally. A more complex anomaly should be suspected in cases with hematometra and concomitant imperforated hymen without any bulging and thorough evaluation using radiological imaging techniques should be performed before surgical approach.

Effect of Carotid Artery Stenting on Ophthalmic Artery Flow Patterns

The purpose of this study was to assess the effect of carotid artery stenting on ophthalmic artery blood flow using transorbital color and spectral Doppler sonography and review the changes in relation to cerebral hemodynamics.

Real-Time Sonoelastography of Parotid Gland Tumors

We sought to determine the performance of real‐time sonoelastography in the differential diagnosis of parotid gland tumors.

Preliminary results of a new tool to evaluate cavernous body fibrosis following radical prostatectomy: penile elastography

Development of cavernous tissue fibrosis due to neurovascular bundle damage during radical prostatectomy has been shown in many trials with invasive methods. In this study, we evaluated the changes in cavernous tissue elasticity by elastography in patients who underwent radical prostatectomy with or without neurovascular bundle preservation. Data from 65 patients underwent open retropubic radical prostatectomy between April 2014 and December 2015 was collected prospectively. Patients were grouped with respect to nerve‐sparing status (non‐, unilateral, and bilateral nerve sparing). International Index of Erectile Function scores, penile lengths, and elasticity scores were recorded at preoperative and postoperative follow‐up visits (at 3rd and 6th months). The primary endpoint of the study was to evaluate the changes of the elasticity scores in all groups. Elasticity scores were measured with real‐time elastography by a single experienced radiologist. Mean age, baseline total testosterone level, IIEF‐5 score, elasticity scores of the cavernous body, and penile length were comparable in all groups. At postoperative 3rd and 6th months, statistically significant higher (in favor for fibrosis) mean cavernous body elasticity scores (p = 0.0001), lower mean IIEF‐5 scores (p = 0.0001), and shorter penile lengths (p < 0.05) were observed in non‐nerve‐sparing group compared to other groups while there were no statistically significant differences between unilateral and bilateral nerve‐sparing groups. Very strong negative correlation was detected between IIEF‐5 and elasticity scores (p = 0.0001). According to our results, preservation of the neurovascular bundle in at least one side mediates lower elasticity scores, better International Index of Erectile Function scores, and penile lengths. Preliminary results of the penile elastography studies are promising for prediction of erectile functions and cavernous tissue fibrosis.

The Role of Computerized Tomography in the Assessment of Perivesical Invasion in Bladder Cancer

Summary Background The aim of the present study was to identify the contrast patterns of a tumor, and to evaluate the possibility of assessing the invasion of the perivesical fatty tissue in bladder cancer. Material/Methods In this study, 26 patients with bladder cancer were included. Multiphasic CT examination was performed to determine the stage of the disease before radical cystectomy. Results There were statistically significant differences in tumor and perivesical fatty tissue densities between pre- and post-contrast phases (p<0.05). Conclusions Increases in focal density suspected of being invasion of the perivesical fatty tissue can show perivesical invasion with high specificity.

Trifurcation of the Left Common Carotid Artery.

Summary Background Trifurcation of the common carotid artery is an unusual variation. Case Report We report a case of left common carotid artery trifurcation in a 74-year-old man. The left common carotid artery divided into the internal carotid, external carotid and facial arteries. Herein, the anatomy of the carotid arteries and the Doppler sonography and CT angiography findings of the left common carotid artery trifurcation were described with images. Conclusions The variations of the carotid arteries should be known to avoid and reduce the complications during the invasive procedures.

Radiofrequency ablation of hepatocellular cancer: complication and residual tumor rates

Aim: To investigate the feasibility, technical success and complication rates of RF ablation in hepatocellular carcinoma (HCC). Material and Methods: 34 patients (26 male, 8 female) with HCC who underwent percutaneous RF ablation were analyzed, retrospectively. In order to diagnose HCC, using criteria defined by American Association for the Study of Liver Diseases guidelines and the inclusion criteria were determined according to Barcelona criteria. Ultrasound (n=24) or CT (n=10) were used as guideline imaging method for ablation. All ablation procedures were performed with a monopolar ablation device. The successful procedure was defined as the tolerance of patient and completion of the RF ablation with normal vital sing. Technical success was defined as the lack of residual tumor on the follow-up imaging at one month. Residual tumor and complication rate were recorded in each patient. Results: The procedure was successfully performed in all patients (100%). There was a residual tumor in just one subcapsular localized lesion (2.9%). The technical success rate was 97.%. As a major complication in 2 patients (5.9%), pneumothorax was detected. There was no procedure-related mortality. Conclusions: RF ablation was a safe and an effective treatment for HCC, with high technical success rates and low complication rates.

Comparison of Drug-Eluting Balloon and Standard Balloon Angioplasty for Infrapopliteal Arterial Diseases in Diabetic Patients

Objective: To consider the clinical outcomes and restenosis rates of drug-eluting balloons (DEBs) and percutaneous transluminal angioplasty (PTA) in diabetic patients with infrapopliteal (IP) arterial disease. Materials and Methods: This retrospective, single-center study included 51 patients (37 males; mean age: 63.43 ± 9.81 years) with diabetes mellitus having IP arterial disease, from October 2012 to September 2014. Twenty-two patients were treated with PTA, and 29 patients were treated with DEBs. After intervention, the patients were evaluated in the first week and every 3 months, clinically and radiologically. Univariate and multivariate analyses were used to evaluate the clinical outcomes of diabetic patients with IP arterial disease who were treated with either DEBs or PTA. Results: There were no statistically significant differences between the groups in terms of age and gender, risk factors, characteristics of lesions, or the diameters or length of the balloons (P > .05). Primary patency was higher in the DEB group than in the PTA group (97.8% vs 81.1%, P = .020) in the first 3 months. However, there was no statistically significant difference at 1-year follow-up (68.2% vs 48.5%, P = .131). At the 12-month follow-up, there was no difference in clinical improvement between the groups (P = .193). Conclusion: The findings of this study reveal that DEB is a safe alternative treatment method for IP arterial disease in diabetic patients.

PD06-06 THE EFFECT OF NEUROVASCULAR BUNDLE PRESERVATION ON CHANGES IN PENIS LENGTHS AND ELASTICITY SCORES FOLLOWING RADICAL PROSTATECTOMY

RESULTS: 128 patients (40%) were found to have CaP in their biopsies: 61 patients (19%) had insignificant CaP and 67 patients (21%) had csCaP. 52 (78%) of 67 patients with missed csCaP had Gleason 3+41⁄47. 105 patients (32%) were in Active Surveillance at the time of their biopsies. Of these, 27 patients (26%) had csCaP with negative mpMRI. Logistic regression indicated that patients with high PCA3, high PSA density, a prior positive biopsy and smaller prostate volume are directly related to having csCaP in the presence of negative mpMRI (p<0.05). CONCLUSIONS: Despite recent advancement of MRI technology, negative mpMRI cannot rule out csCaP completely. 40% of men with negative mpMRI were diagnosed with CaP. Of these, 21% of men harbored csCaP. All clinical factors should be considered before eliminating a systematic biopsy because the MRI is unrevealing.