Gokhan Arslan | Akdeniz University (original) (raw)

Papers by Gokhan Arslan

Research paper thumbnail of INTRAOSSEOUS LIPOMA OF THE FRONTAL BONE: A case report

Acta Radiologica, Jul 1, 2000

Intraosseous lipomas are among the most uncommon bone tumors. They arise most often in the append... more Intraosseous lipomas are among the most uncommon bone tumors. They arise most often in the appendicular skeleton. There are very few reported cases of intraosseous lipomas within the skull bones. We report a case of intraosseous lipoma of the frontal bone with conventional radiography and CT findings.

Research paper thumbnail of Anomalous Origin of the Right Pulmonary Artery from Ascending Aorta Associated with Aortopulmonary Window and Interrupted Aortic Arch: Successful Surgical Correction with a Single 3d Patch

Research paper thumbnail of Lung involvement in patients with primary Sj�gren�s syndrome: what are the predictors?

Research paper thumbnail of Huge main pulmonary arterial thrombus in a child with increased lipoprotein (a) level

Anadolu Kardiyoloji Dergisi Akd the Anatolian Journal of Cardiology, Aug 1, 2010

Research paper thumbnail of Çıkan Aortadan Anormal Kaynaklanan Sağ Pulmoner Arter, Aortopulmoner Pencere ve Kesintili Arkus Aorta Birlikteliği: Tek 3d Yama ile Başarılı Cerrahi Düzeltme

Turkiye Cocuk Hastalıkları Dergisi, Jun 10, 2014

Research paper thumbnail of Complete Congenital Sternal Cleft Associated with Pectus Excavatum

Texas Heart Institute Journal from the Texas Heart Institute of St Luke S Episcopal Hospital Texas Children S Hospital, Feb 1, 2002

We report herein a rare case of complete congenital sternal cleft (absent sternum) and anterior p... more We report herein a rare case of complete congenital sternal cleft (absent sternum) and anterior pericardial defect in association with pectus excavatum. In neonates with absent sternum, the sternal bars can be easily approximated by simple suture, due to the flexibility of the cartilaginous thorax. There is also little danger of cardiac compression when the repair is performed early in life.If reconstruction is delayed, the increased rigidity of the chest wall and the physiologic accommodation of the thoracic organs to the circumference of the chest render simple approximation impossible, without serious compromise of the heart and lungs.Our patient was a 13-year-old girl, whose case was particularly unusual because of the association of sternal cleft with pectus excavatum. After surgical correction of the pectus excavatum, we were able to construct a sternum by incising the lateral border of each sternal bar, thereby creating flaps that we sutured together at midline. The sternal bars were then approximated by loops of nonabsorbable suture around their circumference.The patient had an uncomplicated course, and at the 12-month follow-up visit, her sternal appearance was normal. (Tex Heart Inst J 2002;29:206–9)

Research paper thumbnail of A Cause of Mortal Massive Upper Gastrointestinal Bleeding: Aortoesophageal Fistula

Medical Archives, 2016

Introduction: Aortoesophageal fistula is an uncommon but mortal cause of massive upper gastrointe... more Introduction: Aortoesophageal fistula is an uncommon but mortal cause of massive upper gastrointestinal bleeding. The most common causes are thoracic aortic aneurisym, foreign body reaction, malignancy and postoperative complication. It can be seen in different pattern on upper gastrointestinal endoscopy. There are surgical, endoscopic and interventional radiological treatment options, however, definitive treatment is surgical intervention. Diagnosis and treatment desicion should be made quickly because of rapid and mortal course. Case report: In this article, a case of aortoesophageal fistula was presented that resulted in mortality as a result of massive bleeding.

Research paper thumbnail of Acute tracheobronchial injuries: early and late term outcomes

Ulusal Travma Ve Acil Cerrahi Dergisi Turkish Journal of Trauma Emergency Surgery Tjtes, May 1, 2007

To evaluate the early and long-term outcomes of acute tracheobronchial injuries (TBI). Twelve pat... more To evaluate the early and long-term outcomes of acute tracheobronchial injuries (TBI). Twelve patients (10 males, 2 females; mean age 28; range 10 to 65 years) diagnosed as tracheobronchial injury and managed during between December 1997 and December 2004 were evaluated retrospectively. Clinical presentation, diagnostic evaluation, associated traumas, surgical management and outcome were reviewed. Follow-up ranged from 1 to 7 years. All patients underwent surgical debridement and primary repair (anastomosis). There were three tracheal, eight bronchial and one laryngotracheal injury. Accompanying simultaneous traumas were treated at the same session in all cases. One case was discharged from the hospital with permanent tracheostomy. Control bronchoscopies were performed one week and one month after the surgical repair. Bronchiectasia developed in one case after five years and left lower lobectomy was performed. One case died 23rd day after the primary repair. In the remaining ten cases no complication was determined. In all cases with a suspicion of TBI, bronchoscopy should be performed immediately by specialist physicians. Early recognition of tracheobronchial injury and expedient institution of appropriate surgical intervention are lifesaving in these potentially lethal injuries. Concomitant injuries are the most important mortality factor.

Research paper thumbnail of Concha bullosa and nasal septal deviation Author's replay

American Journal of Neuroradiology, 2005

Research paper thumbnail of Concha bullosa and nasal septal deviation

AJNR. American journal of neuroradiology, 2005

Research paper thumbnail of Enlarging vertebral pneumatocysts in the cervical spine

AJNR. American journal of neuroradiology

Research paper thumbnail of Complete congenital sternal cleft associated with pectus excavatum

Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2002

We report herein a rare case of complete congenital sternal cleft (absent sternum) and anterior p... more We report herein a rare case of complete congenital sternal cleft (absent sternum) and anterior pericardial defect in association with pectus excavatum. In neonates with absent sternum, the sternal bars can be easily approximated by simple suture, due to the flexibility of the cartilaginous thorax. There is also little danger of cardiac compression when the repair is performed early in life. If reconstruction is delayed, the increased rigidity of the chest wall and the physiologic accommodation of the thoracic organs to the circumference of the chest render simple approximation impossible, without serious compromise of the heart and lungs. Our patient was a 13-year-old girl, whose case was particularly unusual because of the association of sternal cleft with pectus excavatum. After surgical correction of the pectus excavatum, we were able to construct a sternum by incising the lateral border of each sternal bar, thereby creating flaps that we sutured together at midline. The sternal...

Research paper thumbnail of Incidental Detection of a Benign Thymoma on Tc-99m MIBI Myocardial Perfusion Study

Malecular Imaging and Radionuclide Therapy, 2011

Technetium-99m methoxy-isobutylisonitrile (Tc-99m MIBI) is a routinely used radiopharmaceutical f... more Technetium-99m methoxy-isobutylisonitrile (Tc-99m MIBI) is a routinely used radiopharmaceutical for myocardial perfusion scintigraphy (MPS). It is also a tumor seeking agent. Here, we present a case of 51 year old male who underwent Tc-99m MIBI myocardial perfusion study due to permanent chest pain after coronary angiography. Abnormal MIBI uptake in the thorax was detected in the raw images. This single finding led to further investigation and thoracotomy proved that the lesion was benign thymoma. Thymomas are often asymptomatic or have a non-specific presentation. They are often detected coincidentally on images performed for any other reasons. We wanted to emphasize that during of MPS, the raw data should always be reviewed as occasionally valuable additional information on noncardiac pathology could be recognized by extracardiac uptake, as in this case.

Research paper thumbnail of Common bile duct obstruction caused by hydatid cyst membranes: US and CT imaging

Pediatric Radiology, 1998

Research paper thumbnail of Metachronous malignant mesothelioma and pulmonary adenocarcinoma

Turkish Journal of Pathology, 2013

The prevalence of multiple primary malignant neoplasms in a single patient is reported in a wide ... more The prevalence of multiple primary malignant neoplasms in a single patient is reported in a wide variation. The coexistence of malignant mesothelioma and pulmonary carcinoma is a rare entity. Herein, we reported a 60-year-old man who was a retired employee and heavy smoker. He had a suspicious history of asbestos exposure. He complained of chest pain and computerized tomography revealed a mass in the lower lobe of left lung. The patient underwent a left lower lobectomy and was diagnosed as pulmonary adenocarcinoma. During follow-up two years after surgery, the patient complained of dyspnea and chest computerized tomography scan revealed right pleural effusion and diffuse pleural thickening. For the differential diagnosis, the patient underwent wedge biopsy from the right lower lobe and was diagnosed as epithelial diffuse malignant mesothelioma. The development of malignant pleural mesothelioma and lung carcinoma could be associated with asbestos exposure. However, a history of asbestos exposure is not required for the diagnosis. The influence of effective anticancer therapies that improve the survival rates and increase the population ages could be related to the occurrence of a second malignancy.

Research paper thumbnail of The canal of the posterior ampullar nerve: an important anatomic landmark in the posterior fossa transmeatal approach

Surgical and Radiologic Anatomy, 2001

The canal of the posterior ampullar nerve is located between the inferior part of the internal ac... more The canal of the posterior ampullar nerve is located between the inferior part of the internal acoustic meatus and ampulla of the posterior semicircular canal. It permits a more accurate localisation of the underlying labyrinth in innerear surgery. An anatomical and radiological study was undertaken to determine the importance the relationship between the canal and the labyrinth. Ten dry and 10 cadaveric temporal bone dissections, together with 20 high resolution CT scans of the same temporal bones were studied in an attempt to describe the anatomy of the canal of the posterior ampullar nerve. The length of the canal of the posterior ampullar nerve, the length of internal acoustic meatus, and distances from porus acusticus to the singular foramen and the transverse crest, and from the singular foramen to the vestibule and transverse crest, and from operculum to the sigmoid sinus and to the porus acusticus were measured. During the transmeatal posterior cranial fossa approach using the canal of the posterior ampullar nerve as a landmark enables more bone to be safely removed from the internal acoustic meatus thus preserving hearing. The canal of the posterior ampullar n. (PAN) is located between the ampulla of the posterior semicircular canal and the posterior inferior wall of the internal acoustic meatus. It is used as an important landmark in several approaches to the petrous pyramid. The purpose of the present study was to provide anatomical guidelines to permit safer drilling of the posterior wall of the internal acoustic meatus (IAM), thereby preventing accidental fenestration to the labyrinth. Material and methods This study was conducted using 10 dry and 10 cadaveric temporal bone dissections, together with 20 high resolution CT scans of the same temporal bones, to describe the anatomy of the canal of the PAN as well as providing a better understanding of its relationship to closely related structures (Figs. 1, 2).

Research paper thumbnail of Lung involvement in patients with primary Sjögren’s syndrome: what are the predictors?

Rheumatology International, 2010

The aim of this study was to investigate the prevalence, predictors and radiological findings of ... more The aim of this study was to investigate the prevalence, predictors and radiological findings of primary Sjögren's syndrome (pSS)-associated lung involvement. This retrospective cohort study included 123 patients with demographic, clinical, laboratory and radiological data who were diagnosed with pSS. Lung involvement was defined based on the presence of pulmonary signs/symptoms and/or impaired pulmonary function tests along with alterations in high-resolution computerized tomography (HRCT). Thirty patients (24.4%) had pulmonary signs/symptoms at the initial presentation and/or during the follow-up period. Based on the criteria, 14 patients (11.4%) were defined as having pSS with lung involvement. The smoking rate, male/female ratio and the mean ages were found to be higher in patients with lung involvement (P < 0.05). Positive IgM-rheumatoid factor (RF), anti-La and anti-Ro results, the presence of hypergammaglobulinemia and lymphopenia had high specificity despite the low sensitivity rates to detect pSS-associated lung disease. A significant difference was found in forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV(1)) results between the patients with and without lung involvement. Impaired FEV(1) had high specificity and positive predictive value compared to impaired FVC, particularly in non-smoker patients. The most frequent HRCT finding was ground-glass attenuation (64.3%). Other common findings were bronchiectasis, reticular pattern and honeycombing. The lesions involved predominantly the lower lobes. In conclusion, the presence of hypergammaglobulinemia and lymphopenia, positivity for RF, anti-La and anti-Ro, and impaired (FVC) and/or FEV(1) values could be the predictive parameters with a high specificity despite the low sensitivity rates. Smoking history, male gender and age are also risk factors. These parameters may be helpful to distinguish pSS-associated lung involvement from lung disorders unrelated to pSS.

Research paper thumbnail of Epidural emphysema associated with spontaneous pneumothorax

European Journal of Radiology Extra, 2005

Spinal epidural emphysema, air in epidural space, is caused by traumatic or nontraumatic several ... more Spinal epidural emphysema, air in epidural space, is caused by traumatic or nontraumatic several causes. The amount epidural air is small and can easily be seen by CT. We report the radiologic findings of the rare case with epidural emphysema as a cause of spontaneous pneumothorax and pneumomediastinum.

Research paper thumbnail of Right top pulmonary vein: Evaluation with 64 section multidetector computed tomography

European Journal of Radiology, 2008

Purpose: To evaluate the incidence and anatomic features of the rare variant of the pulmonary vei... more Purpose: To evaluate the incidence and anatomic features of the rare variant of the pulmonary veins named "right top pulmonary vein" as depicted with 64 section multidetector computed tomography (MDCT). Materials and methods: MDCT of 610 patients obtained over 12 months period for diagnosis of suspected thoracic or cardiac pathology were routinely reviewed in transverse and 3D images. The frequency of right top pulmonary vein (RTPV) was determined and anatomic features were also documented. Results: Right top pulmonary vein (RTPV) is a supernumerary vein arising from the roof of the right part of the left atrium separately from the orifice of the right superior pulmonary vein. It crosses behind the intermediate bronchus and drains mainly posterior segment of the right upper lobe but also receives few subsegmental branches of superior segment of the right lower lobe. It was detected in 2.2% of patients (14/610). The mean diameter of RTPV was 5.1 mm. Conclusion: The RTPV is a rare venous drainage variation of pulmonary veins. It is important to be aware of this anatomic pattern for avoiding misinterpretation of pulmonary venographic findings, inadvertent ablation of pulmonary vein and perioperative bleeding during video assisted thorocoscopic lobectomy.

Research paper thumbnail of Intrapulmonary right brachiocephalic vein associated with azygos lobe

Clinical Imaging, 2000

A rare case of right brachiocephalic vein (RBV) following an extramediastinal and intrapulmonary ... more A rare case of right brachiocephalic vein (RBV) following an extramediastinal and intrapulmonary course in the anterior portion of the azygos fissure is presented. The appearance of the RBV and superior vena cava (SVC) on the chest radiograph in patients with an azygos lobe reflects the variable relationship between these veins and their mediastinal attachments. Computed tomography (CT) can easily demonstrate the mediastinal vascular anatomy thereby allowing identification of such variants and differentiation from anomalous pulmonary veins draining into the systemic vein.

Research paper thumbnail of INTRAOSSEOUS LIPOMA OF THE FRONTAL BONE: A case report

Acta Radiologica, Jul 1, 2000

Intraosseous lipomas are among the most uncommon bone tumors. They arise most often in the append... more Intraosseous lipomas are among the most uncommon bone tumors. They arise most often in the appendicular skeleton. There are very few reported cases of intraosseous lipomas within the skull bones. We report a case of intraosseous lipoma of the frontal bone with conventional radiography and CT findings.

Research paper thumbnail of Anomalous Origin of the Right Pulmonary Artery from Ascending Aorta Associated with Aortopulmonary Window and Interrupted Aortic Arch: Successful Surgical Correction with a Single 3d Patch

Research paper thumbnail of Lung involvement in patients with primary Sj�gren�s syndrome: what are the predictors?

Research paper thumbnail of Huge main pulmonary arterial thrombus in a child with increased lipoprotein (a) level

Anadolu Kardiyoloji Dergisi Akd the Anatolian Journal of Cardiology, Aug 1, 2010

Research paper thumbnail of Çıkan Aortadan Anormal Kaynaklanan Sağ Pulmoner Arter, Aortopulmoner Pencere ve Kesintili Arkus Aorta Birlikteliği: Tek 3d Yama ile Başarılı Cerrahi Düzeltme

Turkiye Cocuk Hastalıkları Dergisi, Jun 10, 2014

Research paper thumbnail of Complete Congenital Sternal Cleft Associated with Pectus Excavatum

Texas Heart Institute Journal from the Texas Heart Institute of St Luke S Episcopal Hospital Texas Children S Hospital, Feb 1, 2002

We report herein a rare case of complete congenital sternal cleft (absent sternum) and anterior p... more We report herein a rare case of complete congenital sternal cleft (absent sternum) and anterior pericardial defect in association with pectus excavatum. In neonates with absent sternum, the sternal bars can be easily approximated by simple suture, due to the flexibility of the cartilaginous thorax. There is also little danger of cardiac compression when the repair is performed early in life.If reconstruction is delayed, the increased rigidity of the chest wall and the physiologic accommodation of the thoracic organs to the circumference of the chest render simple approximation impossible, without serious compromise of the heart and lungs.Our patient was a 13-year-old girl, whose case was particularly unusual because of the association of sternal cleft with pectus excavatum. After surgical correction of the pectus excavatum, we were able to construct a sternum by incising the lateral border of each sternal bar, thereby creating flaps that we sutured together at midline. The sternal bars were then approximated by loops of nonabsorbable suture around their circumference.The patient had an uncomplicated course, and at the 12-month follow-up visit, her sternal appearance was normal. (Tex Heart Inst J 2002;29:206–9)

Research paper thumbnail of A Cause of Mortal Massive Upper Gastrointestinal Bleeding: Aortoesophageal Fistula

Medical Archives, 2016

Introduction: Aortoesophageal fistula is an uncommon but mortal cause of massive upper gastrointe... more Introduction: Aortoesophageal fistula is an uncommon but mortal cause of massive upper gastrointestinal bleeding. The most common causes are thoracic aortic aneurisym, foreign body reaction, malignancy and postoperative complication. It can be seen in different pattern on upper gastrointestinal endoscopy. There are surgical, endoscopic and interventional radiological treatment options, however, definitive treatment is surgical intervention. Diagnosis and treatment desicion should be made quickly because of rapid and mortal course. Case report: In this article, a case of aortoesophageal fistula was presented that resulted in mortality as a result of massive bleeding.

Research paper thumbnail of Acute tracheobronchial injuries: early and late term outcomes

Ulusal Travma Ve Acil Cerrahi Dergisi Turkish Journal of Trauma Emergency Surgery Tjtes, May 1, 2007

To evaluate the early and long-term outcomes of acute tracheobronchial injuries (TBI). Twelve pat... more To evaluate the early and long-term outcomes of acute tracheobronchial injuries (TBI). Twelve patients (10 males, 2 females; mean age 28; range 10 to 65 years) diagnosed as tracheobronchial injury and managed during between December 1997 and December 2004 were evaluated retrospectively. Clinical presentation, diagnostic evaluation, associated traumas, surgical management and outcome were reviewed. Follow-up ranged from 1 to 7 years. All patients underwent surgical debridement and primary repair (anastomosis). There were three tracheal, eight bronchial and one laryngotracheal injury. Accompanying simultaneous traumas were treated at the same session in all cases. One case was discharged from the hospital with permanent tracheostomy. Control bronchoscopies were performed one week and one month after the surgical repair. Bronchiectasia developed in one case after five years and left lower lobectomy was performed. One case died 23rd day after the primary repair. In the remaining ten cases no complication was determined. In all cases with a suspicion of TBI, bronchoscopy should be performed immediately by specialist physicians. Early recognition of tracheobronchial injury and expedient institution of appropriate surgical intervention are lifesaving in these potentially lethal injuries. Concomitant injuries are the most important mortality factor.

Research paper thumbnail of Concha bullosa and nasal septal deviation Author's replay

American Journal of Neuroradiology, 2005

Research paper thumbnail of Concha bullosa and nasal septal deviation

AJNR. American journal of neuroradiology, 2005

Research paper thumbnail of Enlarging vertebral pneumatocysts in the cervical spine

AJNR. American journal of neuroradiology

Research paper thumbnail of Complete congenital sternal cleft associated with pectus excavatum

Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2002

We report herein a rare case of complete congenital sternal cleft (absent sternum) and anterior p... more We report herein a rare case of complete congenital sternal cleft (absent sternum) and anterior pericardial defect in association with pectus excavatum. In neonates with absent sternum, the sternal bars can be easily approximated by simple suture, due to the flexibility of the cartilaginous thorax. There is also little danger of cardiac compression when the repair is performed early in life. If reconstruction is delayed, the increased rigidity of the chest wall and the physiologic accommodation of the thoracic organs to the circumference of the chest render simple approximation impossible, without serious compromise of the heart and lungs. Our patient was a 13-year-old girl, whose case was particularly unusual because of the association of sternal cleft with pectus excavatum. After surgical correction of the pectus excavatum, we were able to construct a sternum by incising the lateral border of each sternal bar, thereby creating flaps that we sutured together at midline. The sternal...

Research paper thumbnail of Incidental Detection of a Benign Thymoma on Tc-99m MIBI Myocardial Perfusion Study

Malecular Imaging and Radionuclide Therapy, 2011

Technetium-99m methoxy-isobutylisonitrile (Tc-99m MIBI) is a routinely used radiopharmaceutical f... more Technetium-99m methoxy-isobutylisonitrile (Tc-99m MIBI) is a routinely used radiopharmaceutical for myocardial perfusion scintigraphy (MPS). It is also a tumor seeking agent. Here, we present a case of 51 year old male who underwent Tc-99m MIBI myocardial perfusion study due to permanent chest pain after coronary angiography. Abnormal MIBI uptake in the thorax was detected in the raw images. This single finding led to further investigation and thoracotomy proved that the lesion was benign thymoma. Thymomas are often asymptomatic or have a non-specific presentation. They are often detected coincidentally on images performed for any other reasons. We wanted to emphasize that during of MPS, the raw data should always be reviewed as occasionally valuable additional information on noncardiac pathology could be recognized by extracardiac uptake, as in this case.

Research paper thumbnail of Common bile duct obstruction caused by hydatid cyst membranes: US and CT imaging

Pediatric Radiology, 1998

Research paper thumbnail of Metachronous malignant mesothelioma and pulmonary adenocarcinoma

Turkish Journal of Pathology, 2013

The prevalence of multiple primary malignant neoplasms in a single patient is reported in a wide ... more The prevalence of multiple primary malignant neoplasms in a single patient is reported in a wide variation. The coexistence of malignant mesothelioma and pulmonary carcinoma is a rare entity. Herein, we reported a 60-year-old man who was a retired employee and heavy smoker. He had a suspicious history of asbestos exposure. He complained of chest pain and computerized tomography revealed a mass in the lower lobe of left lung. The patient underwent a left lower lobectomy and was diagnosed as pulmonary adenocarcinoma. During follow-up two years after surgery, the patient complained of dyspnea and chest computerized tomography scan revealed right pleural effusion and diffuse pleural thickening. For the differential diagnosis, the patient underwent wedge biopsy from the right lower lobe and was diagnosed as epithelial diffuse malignant mesothelioma. The development of malignant pleural mesothelioma and lung carcinoma could be associated with asbestos exposure. However, a history of asbestos exposure is not required for the diagnosis. The influence of effective anticancer therapies that improve the survival rates and increase the population ages could be related to the occurrence of a second malignancy.

Research paper thumbnail of The canal of the posterior ampullar nerve: an important anatomic landmark in the posterior fossa transmeatal approach

Surgical and Radiologic Anatomy, 2001

The canal of the posterior ampullar nerve is located between the inferior part of the internal ac... more The canal of the posterior ampullar nerve is located between the inferior part of the internal acoustic meatus and ampulla of the posterior semicircular canal. It permits a more accurate localisation of the underlying labyrinth in innerear surgery. An anatomical and radiological study was undertaken to determine the importance the relationship between the canal and the labyrinth. Ten dry and 10 cadaveric temporal bone dissections, together with 20 high resolution CT scans of the same temporal bones were studied in an attempt to describe the anatomy of the canal of the posterior ampullar nerve. The length of the canal of the posterior ampullar nerve, the length of internal acoustic meatus, and distances from porus acusticus to the singular foramen and the transverse crest, and from the singular foramen to the vestibule and transverse crest, and from operculum to the sigmoid sinus and to the porus acusticus were measured. During the transmeatal posterior cranial fossa approach using the canal of the posterior ampullar nerve as a landmark enables more bone to be safely removed from the internal acoustic meatus thus preserving hearing. The canal of the posterior ampullar n. (PAN) is located between the ampulla of the posterior semicircular canal and the posterior inferior wall of the internal acoustic meatus. It is used as an important landmark in several approaches to the petrous pyramid. The purpose of the present study was to provide anatomical guidelines to permit safer drilling of the posterior wall of the internal acoustic meatus (IAM), thereby preventing accidental fenestration to the labyrinth. Material and methods This study was conducted using 10 dry and 10 cadaveric temporal bone dissections, together with 20 high resolution CT scans of the same temporal bones, to describe the anatomy of the canal of the PAN as well as providing a better understanding of its relationship to closely related structures (Figs. 1, 2).

Research paper thumbnail of Lung involvement in patients with primary Sjögren’s syndrome: what are the predictors?

Rheumatology International, 2010

The aim of this study was to investigate the prevalence, predictors and radiological findings of ... more The aim of this study was to investigate the prevalence, predictors and radiological findings of primary Sjögren's syndrome (pSS)-associated lung involvement. This retrospective cohort study included 123 patients with demographic, clinical, laboratory and radiological data who were diagnosed with pSS. Lung involvement was defined based on the presence of pulmonary signs/symptoms and/or impaired pulmonary function tests along with alterations in high-resolution computerized tomography (HRCT). Thirty patients (24.4%) had pulmonary signs/symptoms at the initial presentation and/or during the follow-up period. Based on the criteria, 14 patients (11.4%) were defined as having pSS with lung involvement. The smoking rate, male/female ratio and the mean ages were found to be higher in patients with lung involvement (P < 0.05). Positive IgM-rheumatoid factor (RF), anti-La and anti-Ro results, the presence of hypergammaglobulinemia and lymphopenia had high specificity despite the low sensitivity rates to detect pSS-associated lung disease. A significant difference was found in forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV(1)) results between the patients with and without lung involvement. Impaired FEV(1) had high specificity and positive predictive value compared to impaired FVC, particularly in non-smoker patients. The most frequent HRCT finding was ground-glass attenuation (64.3%). Other common findings were bronchiectasis, reticular pattern and honeycombing. The lesions involved predominantly the lower lobes. In conclusion, the presence of hypergammaglobulinemia and lymphopenia, positivity for RF, anti-La and anti-Ro, and impaired (FVC) and/or FEV(1) values could be the predictive parameters with a high specificity despite the low sensitivity rates. Smoking history, male gender and age are also risk factors. These parameters may be helpful to distinguish pSS-associated lung involvement from lung disorders unrelated to pSS.

Research paper thumbnail of Epidural emphysema associated with spontaneous pneumothorax

European Journal of Radiology Extra, 2005

Spinal epidural emphysema, air in epidural space, is caused by traumatic or nontraumatic several ... more Spinal epidural emphysema, air in epidural space, is caused by traumatic or nontraumatic several causes. The amount epidural air is small and can easily be seen by CT. We report the radiologic findings of the rare case with epidural emphysema as a cause of spontaneous pneumothorax and pneumomediastinum.

Research paper thumbnail of Right top pulmonary vein: Evaluation with 64 section multidetector computed tomography

European Journal of Radiology, 2008

Purpose: To evaluate the incidence and anatomic features of the rare variant of the pulmonary vei... more Purpose: To evaluate the incidence and anatomic features of the rare variant of the pulmonary veins named "right top pulmonary vein" as depicted with 64 section multidetector computed tomography (MDCT). Materials and methods: MDCT of 610 patients obtained over 12 months period for diagnosis of suspected thoracic or cardiac pathology were routinely reviewed in transverse and 3D images. The frequency of right top pulmonary vein (RTPV) was determined and anatomic features were also documented. Results: Right top pulmonary vein (RTPV) is a supernumerary vein arising from the roof of the right part of the left atrium separately from the orifice of the right superior pulmonary vein. It crosses behind the intermediate bronchus and drains mainly posterior segment of the right upper lobe but also receives few subsegmental branches of superior segment of the right lower lobe. It was detected in 2.2% of patients (14/610). The mean diameter of RTPV was 5.1 mm. Conclusion: The RTPV is a rare venous drainage variation of pulmonary veins. It is important to be aware of this anatomic pattern for avoiding misinterpretation of pulmonary venographic findings, inadvertent ablation of pulmonary vein and perioperative bleeding during video assisted thorocoscopic lobectomy.

Research paper thumbnail of Intrapulmonary right brachiocephalic vein associated with azygos lobe

Clinical Imaging, 2000

A rare case of right brachiocephalic vein (RBV) following an extramediastinal and intrapulmonary ... more A rare case of right brachiocephalic vein (RBV) following an extramediastinal and intrapulmonary course in the anterior portion of the azygos fissure is presented. The appearance of the RBV and superior vena cava (SVC) on the chest radiograph in patients with an azygos lobe reflects the variable relationship between these veins and their mediastinal attachments. Computed tomography (CT) can easily demonstrate the mediastinal vascular anatomy thereby allowing identification of such variants and differentiation from anomalous pulmonary veins draining into the systemic vein.