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Öğe Cellular mesoblastic nephroma (infantile renal fibrosarcoma): institutional review of the clinical, diagnostic imaging, and pathologic features of a distinctive neoplasm of infancy(Springer, 2009) Bayindir, Petek; Guillerman, Robert Paul; Hicks, M. John; Chintagumpala, M. MuraliCellular mesoblastic nephroma has been associated with a more aggressive course than classic mesoblastic nephroma, including local recurrences and metastases. To define the clinicopathologic and imaging features distinguishing cellular from classic mesoblastic nephroma. Retrospective review of clinical charts and imaging studies of ten children with mesoblastic nephroma from 1996 to 2007 at a large children's hospital. In six children the mesoblastic nephroma was pure cellular, in two mixed, and in two classic. The mean ages at diagnosis were 107 days for those with the cellular form, and 32 days for those with the classic form. Hypoechoic or low-attenuation regions representing necrosis or hemorrhage were found in all children with the cellular form and in none of those with the classic form. Hypertension was present in 70% and hypercalcemia in 20% of the children and resolved following nephrectomy. Two cellular tumors encased major abdominal vessels. Local recurrence and metastases occurred within 6 months of tumor resection in two children with the cellular form. Intraspinal extension and intratumoral pseudoaneurysm were seen in one child with the cellular form. The cellular tumors shared histopathologic features with infantile fibrosarcoma (IFS), and RT-PCR testing in two children with the cellular form revealed the t(12;15) ETV6-NTRK3 gene fusion common to IFS. Distinct from the classic form, cellular mesoblastic nephroma is more heterogeneous in appearance on imaging, tends to be larger and present later in infancy, and can exhibit aggressive behavior including vascular encasement and metastasis. Intraspinal extension and intratumoral pseudoaneurysm are previously unreported findings encountered in our cellular mesoblastic nephroma series. The shared histopathology and translocation gene fusion support the concept of cellular mesoblastic nephroma as the renal form of IFS.Öğe Cellular mesoblastic nephroma (infantile renal fibrosarcoma): institutional review of the clinical, diagnostic imaging, and pathologic features of a distinctive neoplasm of infancy(Springer, 2009) Bayindir, Petek; Guillerman, Robert Paul; Hicks, M. John; Chintagumpala, M. MuraliCellular mesoblastic nephroma has been associated with a more aggressive course than classic mesoblastic nephroma, including local recurrences and metastases. To define the clinicopathologic and imaging features distinguishing cellular from classic mesoblastic nephroma. Retrospective review of clinical charts and imaging studies of ten children with mesoblastic nephroma from 1996 to 2007 at a large children's hospital. In six children the mesoblastic nephroma was pure cellular, in two mixed, and in two classic. The mean ages at diagnosis were 107 days for those with the cellular form, and 32 days for those with the classic form. Hypoechoic or low-attenuation regions representing necrosis or hemorrhage were found in all children with the cellular form and in none of those with the classic form. Hypertension was present in 70% and hypercalcemia in 20% of the children and resolved following nephrectomy. Two cellular tumors encased major abdominal vessels. Local recurrence and metastases occurred within 6 months of tumor resection in two children with the cellular form. Intraspinal extension and intratumoral pseudoaneurysm were seen in one child with the cellular form. The cellular tumors shared histopathologic features with infantile fibrosarcoma (IFS), and RT-PCR testing in two children with the cellular form revealed the t(12;15) ETV6-NTRK3 gene fusion common to IFS. Distinct from the classic form, cellular mesoblastic nephroma is more heterogeneous in appearance on imaging, tends to be larger and present later in infancy, and can exhibit aggressive behavior including vascular encasement and metastasis. Intraspinal extension and intratumoral pseudoaneurysm are previously unreported findings encountered in our cellular mesoblastic nephroma series. The shared histopathology and translocation gene fusion support the concept of cellular mesoblastic nephroma as the renal form of IFS.Öğe Fat-containing lesions revealed by CT in children with right lower quadrant pain(Springer, 2009) Maxfield, Charles M.; Bayindir, PetekSuspected appendicitis is the most common indication for emergent abdominal surgery in children. The clinical diagnosis of appendicitis can be challenging, and CT is playing an increasing role in the evaluation of right lower quadrant pain. Occasionally, alternative diagnoses to appendicitis can be suggested on CT. The appreciation of a fat-containing lesion in the right lower quadrant will often allow a specific diagnosis. Importantly, many of these lesions are self-limited and treated nonoperatively. The purpose of this pictorial essay is to illustrate the spectrum of fat-containing lesions that can present as alternative diagnoses to appendicitis on CT scans performed for the evaluation of right lower quadrant pain in children.Öğe Integration of radiology and clinical score in pediatric appendicitis(Wiley, 2018) Aydin, Derya; Turan, Caner; Yurtseven, Ali; Bayindir, Petek; Toker, Bade; Dokumcu, Zafer; Sezak, Murat; Saz, Eylem UlasBackgroundThe efficacy of ultrasonography (US) and abdominal X-ray in combination with Pediatric Appendicitis Score (PAS) is complicated in the diagnosis of acute appendicitis. Abdominal X-ray is as useful as US with clinical assessment when evaluated by experienced pediatric radiologist in acute appendicitis. The aim of this study was to determine the value of US and abdominal X-ray for appendicitis in children when combined with clinical assessment based on PAS, and to establish a practical pathway for acute appendicitis in childhood. MethodsA prospective, observational cohort study was conducted at an urban, academic pediatric emergency department. Patients were classified at low (PAS 1-4), intermediate (PAS 5-7), or high (PAS 8-10) risk for appendicitis. Low-risk patients were discharged with telephone follow-up in 10days; those at intermediate risk underwent X-ray and US. High-risk patients received immediate surgical consultation. Patients were grouped on histopathology as having either proven acute appendicitis or no appendicitis. ResultsA total of 288 children were analyzed. Surgery was performed in 134 patients (46.5%), and 128 (95.5%) had positive histopathology. Mean PAS in the patients with and without appendicitis was 7.091.42 and 4.97 +/- 2.29, respectively (P=0.00). The rate of missed cases was 6/288 (2%), and the negative appendectomy rate was 6/134 (4.4%). When the score cut-off was set at 6, the sensitivity and specificity of PAS was 86.7% and 63.1%, respectively. The diagnostic performance of daytime US had a sensitivity of 91.1% and specificity of 71.1%. Also, positive US or PAS >6 or both, had sensitivity and specificity 96.7% and 59.9%, respectively. ConclusionUS or abdominal X-ray in children with possible appendicitis should be integrated with PAS to determine the next steps in management. In the case of discordance between the clinical findings and radiology, prolonged observation or further imaging are recommended.Öğe Is the ventrogluteal site suitable for intramuscular injections in children under the age of three?(Wiley-Blackwell, 2016) Gunes, Ulku Yapucu; Ceylan, Burcu; Bayindir, PetekAim. This study was conducted to determine whether the ventrogluteal site could be used for intramuscular injections in children under the age of 3 and to compare the subcutaneous and muscle layer thickness at the anterolateral, deltoid and ventrogluteal site in the different age groups and in both sexes. Background. Although recent literature has reported that the ventrogluteal area can be an alternative site for intramuscular injections in children <= 12 months of age, little research-based evidence has been found for the use of the ventrogluteal site in infants and toddlers. Design. A descriptive study which took place between November 2013-August 2014. Method. A total of 142 children between the ages of 1-36 months were selected by random sampling and ultrasound measurements were made of subcutaneous and muscle thicknesses in the anterolateral, deltoid and ventrogluteal areas. Measurements were analysed using one-way ANOVA and independent samples t-test. Results. The subcutaneous tissue thicknesses in the deltoid, anterolateral and ventrogluteal areas in children between 1-12 months old (n = 56) were 5.20, 6.62 and 7.26 mm respectively, while in children between 13-24 months old (n = 42), these measurements were 4.35, 6.72 and 7.98 mm; in children between 2536 months old (n = 44), the measurements were 5.92, 7.97 and 13.5 mm. The muscle thicknesses in the deltoid, anterolateral and ventrogluteal areas in children 1-12 months old were 5.86, 9.10 and 8.17 respectively, while in children between 13-24 months old, the measurements were 7.71, 12.92 and 17.32 mm; in children 25-36 months old, the measurements were 9.28, 18.81 and 19.62 mm. Conclusion. This study found that the muscle in the ventrogluteal site is adequately developed, even in infants between the ages of 1-12 months and that in particular, in children 12-36 months old, the ventrogluteal site is even thicker than the anterolateral.Öğe Multidetector computed tomographic assessment of the normal diameters for the thoracic aorta and pulmonary arteries in infants and children(Sage Publications Ltd, 2016) Bayindir, Petek; Bayraktaroglu, Selen; Ceylan, Naim; Savas, Recep; Alper, H. HudaverBackground: Knowledge of the normal size of the thoracic aorta and pulmonary arteries is important regarding the detection of the abnormal and valuable in the treatment of patients with congenital and acquired cardiovascular diseases. Purpose: To determine the normal diameters of the thoracic vascular structures of pediatric participants on contrast-enhanced multidetector computer tomography (MDCT) scans. Material and Methods: Between July 2010 and July 2014, the MDCT examinations obtained from 520 participants (age range, 0-18 years; mean age, 8.49 years +/- 5.54 [standard deviation]; male:female ratio, 1.6:1) with normal cardiovascular examinations were retrospectively evaluated. Patients were divided into six groups according to their age. Diameters of the ascending aorta (AA), descending aorta (DA), main pulmonary artery (MPA), right pulmonary artery (RPA), and left pulmonary artery (LPA) were measured. Results: The diameters of the thoracic vascular structures increased with age and the statistical difference among the age groups and genders were significant. The vascular structures in male patients tended to have higher dimensions than female patients. The LPA demonstrated higher mean values than the RPA in each age group. The mean ratio PA (MPA/AA) is 0.93 +/- 0.08 for pediatric participants and it is slightly higher in girls compared to boys (0.93 +/- 0.07 and 0.92 +/- 0.07, respectively). The level of pulmonary artery bifurcation moves caudally with increasing age with thoracal 6 vertebra being the most common for all age groups (53.3%). Conclusion: We believe that the results of our study can serve as a potential reference in differentiating the normal from the abnormal size of the aorta and pulmonary arteries on chest MDCT studies in the pediatric population.Öğe Persistent Mullerian Duct Syndrome with Transverse Testicular Ectopia: A Novel AMH Receptor Mutation(Karger, 2016) Korkmaz, Ozlem; Ozen, Samim; Ozcan, Nurhan; Bayindir, Petek; Sen, Sait; Onay, Huseyin; Goksen, Damla; Avanoglu, Ali; Özkınay, Ferda; Darcan, SukranÖğe Persistent Mullerian Duct Syndrome with Transverse Testicular Ectopia: A Novel Anti-Mullerian Hormone Receptor Mutation(Galenos Yayincilik, 2017) Korkmaz, Ozlem; Ozen, Samim; Ozcan, Nurhan; Bayindir, Petek; Sen, Sait; Onay, Huseyin; Goksen, Damla; Avanoglu, Ali; Özkınay, Ferda; Darcan, SukranPersistent Mullerian duct syndrome is the result of either anti-Mullerian hormone (AMH) deficiency or AMH receptor resistance. A long tubular structure was palpated during the physical examination of a 13-month-old male patient who had presented with bilateral undescended testes. At physical examination, the testes were not palpable. The patient's karyotype was XY, SRY (+), and his AMH level was 22 ng/mol. Structures suggestive of ovaries, a uterus, and fallopian tubes were observed during the laparoscopic examination of the ectopic testis. AMHR2 gene sequence analysis performed with a preliminary diagnosis of AMH receptor resistance revealed a previously unreported homozygous c.24G > A (p. W8X) mutation. The patient was assessed as a case of AMH receptor resistance. Orchiopexy was performed.Öğe A province-based study using sampling method to investigate the prevalence of cystic echinococcosis among primary school children in Manisa, Turkey(Elsevier Science Bv, 2007) Ok, Ulgen Z.; Ozkol, Mine; Kilimcioglu, Ali A.; Dinc, Goenuel; Bayindir, Petek; Ostan, Ipek; Pabuscu, Yueksel; Ozcan, Cemil; Korkmaz, Metin; Coskun, Senol; Yuksel, Hasan; Girginkardesler, NogayA province-based field study using a portable ultrasound scanner (US) was performed for the first time using sampling method to investigate the prevalence of cystic echinococcosis (CE) in primary school children in Manisa, Turkey. A total of 6093 children from 37 primary schools was selected as the representative sample of the total number of 166,766 primary school children, and examined by the US. Prevalence was found to be 0.15%, as nine children were diagnosed with CE, seven new and two previously operated. A questionnaire applied to the children revealed no significant relationship between the risk factors and the infection (P > 0.05). In conclusion, it would be advisable to repeat the study at the same schools in eight years' time, in order to evaluate the efficacy of the control programs, since nearly all students involved in this study will have graduated by then. Besides, it is recommended to choose a sampling group to find the prevalence of an infection in a defined region. (c) 2007 Elsevier B.V. All rights reserved.Öğe Using Dynamic Maneuvers in the Computed Tomography/Magnetic Resonance Assessment of Lesions of the Head and Neck(Elsevier Science Bv, 2013) Celebi, Irfan; Oz, Aysel; Sasani, Mehdi; Bayindir, Petek; Sozen, Esra; Vural, Cetin; Basak, MuzafferDespite advances in technology, the radiologic assessment of certain head and neck lesions may still pose difficulties because of the complex anatomy of this region, the small and mobile structures that this region harbors, and the apposition of mucosal surfaces in the neutral position. Certain maneuvers have been described in the literature to overcome these difficulties. We review the use of the Valsalva and the modified Valsalva maneuver, the puffed-cheek technique, phonation, and inspiration, with possible applications in head and neck imaging.
