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Biomedical subjects

A Memis

Publications and source records attributed to A Memis.

At least 19 recordsLinked to original sources
PubMed2006

Extragastrointestinal stromal tumor of the retroperitoneum mimicking kidney tumor.

A case of extragastrointestinal tumor of the retroperitoneum in a 48-year-old woman complaining right sided flank pain without hematuria is reported. The mass was excised from the kidney without a positive margin. The histopathological examination revealed an extragastrointestinal stromal tumor of the retroperitoneum. These tumors usually originate from the small intestine or stomach. On the other hand, they are rarely located in the retroperitoneum. These tumors typically exhibit CD117 immunoreactivity, whereas they may reveal CD34, neuron specific enolase, smooth muscle actin, desmin and S-100 protein. In our case the specimen of the patient was positive for CD117, actin and desmin.

Diagnosis, Differential↗
PubMed2005

Sinistral portal hypertension; imaging findings and endovascular therapy.

Sinistral portal hypertension, a rare and localized form of portal hypertension, is the result of splenic vein thrombosis or obstruction and may cause gastrointestinal hemorrhages from the esophageal and gastric varices. This report presents two cases (69- and 10-year-old females) of bleeding gastric varices. The patients were diagnosed as having sinistral portal hypertension. Splenic artery embolization was performed in both patients to overcome intractable bleeding, and the clinical outcome was good.

Aged↗
PubMed2004

Bioembolisation for unresectable hepatocellular carcinoma: preliminary results of a translational research study.

Lack of effective treatment for surgically unresectable hepatocellular carcinoma has made this disease dismal. Although, systemic and/or locoregional chemotherapy and chemo-embolization are among the established treatment options, the results of these modalities are still far from being satisfactory. Systemic interferon administration is also used for the treatment of this disease however it has high toxicity rates. We conducted a pharmacology guided phase I/II study with the aim to explore the effect of hypoxy and interferon alpha-2a in vitro using the HepG2 Hepatoma cell line. We then translated the in-vitro results to the clinical setting and designed a treatment protocol. This schema consisted of lipiodol embolisation via a hepatic artery port in between two sets of seven loco-regional injections of IFNalpha-2a, 3 MU every other day. The in-vitro study revealed the best sequence of hypoxy and IFN as IFN-Hypoxy-IFN. Based on this finding, ten patients with HCC were treated with loco-regional IFN and lipiodolisation. Seven of them achieved partial response and the mean duration of response was 10 months. There was no Grade 4 toxicity. In conclusion, our preliminary clinical results suggest that the combined use of IFN and lipiodolisation in the optimal sequence may provide a new therapeutic option for patients with HCC.

Adult↗
PubMed2003

The reliability and validity of the Turkish version of Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO).

The purpose of this study was to investigate the reliability and validity of the Turkish version of Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). The patient group included 43 females aged between 55 and 78 years with vertebral fractures due to osteoporosis. The control group consisted of 43 healthy female volunteers whose ages matched those of the patients. All of the participants were evaluated using both QUALEFFO and SF-36. In the reliability studies, internal consistency within the domain of QUALEFFO was generally good, with Cronbach's alpha values ranging between 0.70 and 0.96. Convergent and discriminant validity rates of domains were both found to be between 89% and 100%. Significant correlations existed between scores of similar domains of QUALEFFO and the SF-36, especially for pain, physical function, social function and general health perception. The receiver operating characteristic (ROC) curve analysis of QUALEFFO and the SF-36 indicated that all five domains in each questionnaire were significantly predictive of vertebral fractures. However, when comparing similar domains of the two questionnaires, the social function domain of QUALEFFO demonstrated a significantly better performance. In conclusion, the Turkish version of QUALEFFO was found to be reliable and valid in the evaluation of patients with vertebral fractures due to osteoporosis. Our study also suggests that the patients with vertebral fractures due to osteoporosis have impairment in quality of life.

Aged↗
PubMed2003

Liver transplantation in a patient with Budd-Chiari syndrome secondary to factor V Leiden mutation.

A point mutation in the factor V Leiden gene is the most common hereditary thrombophilic state and an important risk factor for Budd-Chiari syndrome. We report on a patient with Budd-Chiari syndrome secondary to factor V Leiden mutation, who underwent successful liver transplantation. Following liver transplantation, his thrombophilic state was corrected and he did not require anticoagulation therapy. There has been no recurrent venous thrombosis for 14 months after transplantation. Although his activated protein C sensitivity was normal, showing the normalization of protein C-factor V interaction, PCR analysis demonstrated that heterozygosity for factor V Leiden mutation was still present. We suggest checking resistance to activated protein C, rather than PCR analysis of factor V Leiden mutation in patients with Budd-Chiari syndrome after liver transplantation; the presence of the second does not effect clinical outcome.

Blood Coagulation↗
PubMed2002

Spontaneous bilateral perirenal hematoma as a complication of polyarteritis nodosa in a patient with human immunodeficiency virus infection.

We present a 29-year-old man with polyarteritis nodosa (PAN) having human immunodeficiency virus (HIV) infection. This patient fulfilled the American College of Rheumatology (ACR) 1990 criteria for PAN, and the diagnosis was confirmed by typical arteriographic findings, including microaneurysms. Due to the rupture of microaneurysms, perirenal hematomas occurred in both kidneys. Unilateral nephrectomy was performed, and renal histology confirmed that aneurysm rupture was the etiology of the perirenal hematoma. The occurrence of renal hematomas is a usual complication of PAN. However, bilateral renal hematoma during the course of HIV-associated PAN is quite rare, and to our knowledge, this would be the second case reported in the literature. When compared with other viral agents, the association of HIV with PAN may be considered rare. However, as suggested by various reports in the literature, HIV infection should always be kept in mind while evaluating patients with PAN.

Adult↗
PubMed2002

Granulomatous mastitis: imaging findings with histopathologic correlation.

OBJECTIVE: The purpose of this study is to evaluate the mammographic and ultrasonographic characteristics of granulomatous mastitis and to correlate the imaging features with the histologic findings. MATERIALS-METHODS: 15 patients with diagnosis of idiopathic granulomatous mastitis were examined with mammography and ultrasonography. The clinical, pathologic and imaging features were retrospectively reviewed and correlated in all patients. RESULTS: Mammographic examination showed an asymmetric density with no distinct margins in 8 patients and an ill-defined mass in 3 patients. In 4 cases, no abnormal finding was detected on the mammography. Sonographic examination demonstrated an irregular mass with tubular connections in 5 patients, single or multiple hypoechoic tubular/nodular structures in 6, and focally or segmentally decreased parenchymal echogenity with acoustic shadowing in 4 patients. The imaging findings suggested a malignant tumor in 7 patients, while an inflammatory process or intraductal papilloma was considered in the differential diagnosis of the other patients. CONCLUSION: Granulomatous mastitis usually presents with clinical findings mimicking a carcinoma. The most common mammographic appearance of the lesion is an asymmetrically increased density, which is not characteristic for this entity. Sonographic patterns of the disease are varied and appear to relate to the histologic features. Findings include a mass-like appearance, tubular/nodular hypoechoic structures and focal decreased parenchmal echogenicity with acoustic shadowing. With awareness of the findings granulomatous mastitis can be considered in the differential diagnosis.

Adult↗
PubMed2002

Epididymal metastasis from gastric signet ring cell adenocarcinoma.

We report a 55 year old man complaining of painless left testicular swelling that developed over 2 months. The imaging studies revealed an epididymal mass separate from the testicle. The patient underwent left radical orchiectomy. The histopathological examination of the orchiectomy specimen revealed poorly differentiated signet cell metastatic adenocarcinoma.

Carcinoma, Signet Ring Cell↗
PubMed2001

Aortic origin of right hepatic artery and superior mesenteric origin of splenic artery: two rare variations demonstrated angiographically.

Anatomical variations of the celiac trunk and superior mesenteric artery are not infrequent. Knowledge of the existing aberrations is important in planning and conducting surgical or radiological procedures. A case of right hepatic artery arising independently from the aorta supplying an hepatocellular carcinoma was identified, through which transarterial chemoembolization was successfully performed. A second case is presented with a common splenomesenteric trunk branching into the splenic and superior mesenteric arteries. These two cases represent exceptional arterial variations in the upper abdomen.

Angiography↗
PubMed2001

A severely disabling disorder: fibrodysplasia ossificans progressiva.

Fibrodysplasia ossificans progressiva (FOP) is an extremely rare hereditary disorder characterised by progressive heterotopic ossification of the soft tissues. The resulting progressive immobilisation of the limbs, jaw and chest wall generally leads to severe disability. We present an 18-year-old girl with advanced FOP. She had three operative interventions to excise her ectopic bones but all resulted in failure. Treatment strategies for this disorder should include the avoidance of exacerbating factors.

Adolescent↗
PubMed2001

Fat necrosis of the breast: clinical, mammographic and sonographic features.

OBJECTIVE: the purpose of this study was to describe and quantitate the clinical, mammographic and sonographic (US) features and to evaluate the evolution of fat necrosis in the breast. MATERIALS AND METHODS: a retrospective review of the clinical, mammographic and US findings of 126 fat necrosis lesions in 94 patients, diagnosed between 1989 and 1999, was done. All the cases included in the study had at least 3 years follow-up mammograms. In addition, 48 patients with a total of 62 fat necrosis lesions, also had an US follow-up. Fat necrosis was diagnosed on the basis of histologic (n=25) and initial or follow-up imaging (n=69) findings. RESULTS: the predominant mammographic features of the 114 lesions apparent on mammograms were radiolucent oil cyst (n=34, 26.9%), round opacity (n=16, 12.6%), asymmetrical opacity or heterogenicity of the subcutaneous tissues (n=20, 15.8%), dystrophic calcifications (n=34, 26.9%), clustered pleomorphic microcalcifications (n=5, 3.9%), and suspicious speculated mass (n=5, 3.9%). In five patients with 12 (9.5%) palpable masses, mammograms were normal. The predominant US features of the 112 lesions apparent on sonograms were solid (n=18, 14.2%), anechoic with posterior acoustic enhancement (n=21, 16.6%), anechoic with posterior acoustic shadowing (n=20, 15.8%), cystic with internal echoes (n=14, 11.1%), cystic with mural nodule (n=5, 3.9%) and increased echogenicity of the subcutaneous tissues (n=34, 26.9%). In five patients with 14 (11.1%) lesions, sonographic examination was normal. Mammographic follow-up showed that five of the radiolucent oil cysts developed curvilinear calcifications, six of the round opacities decreased in size and density, and another two disappeared. Eleven of the dystrophic calcifications became even more coarse. Six of the asymmetrical opacities became vague and one developed an oil cyst and coarse calcifications. The only nonoperated speculated mass developed a typical small radiolucent oil cyst in the centre. US follow-up showed that 18 of the 29 increased subcutaneous tissue echogenicity turned back to normal, while in the remaining 11 small cysts formed. In 19 solid appearing masses, 15 showed decrease in size, while four remained stable (biopsy disclosed fat necrosis). The four complex masses in two patients showed increase in size and appeared more cystic (FNAB was consistent with fat necrosis). CONCLUSION: a spectrum of imaging findings is associated with fat necrosis. Knowledge of the mammographic and US appearance and evolution of these patterns may enable imaging follow-up of these lesions, reducing the number of unnecessary biopsies.

Adult↗
PubMed2001

The pelvi-femoral incomplete bone bridge in a patient with mild haemophilia.

A 15-year-old boy with mild haemophilia who regularly participates in contact sports presented with right hip pain radiating to the groin and buttock areas and difficulty in walking. Conventional radiography disclosed a heterotopic new bone formation in the adductor region. The reformatted and three-dimensional reconstructed images of computerized tomography (CT) scans detailed an incomplete pelvi-femoral bone bridge formation in the quadratus femoris muscle, which was located very close to the sciatic nerve but did not cause any clinical symptoms. Postural exercises and clinical survey were selected as the primary treatment.

Adolescent↗
PubMed2001

The use and efficacy of the American Urological Association Symptom Index in assessing the outcome of urethroplasty for post-traumatic complete posterior urethral strictures.

OBJECTIVE: To determine if the American Urological Association (AUA) Symptom Index is an accurate and reliable instrument for use in assessing the outcome after urethroplasty. PATIENTS AND METHODS: The AUA Symptom Index questionnaire was answered by 33 men (mean age 31.3 years) who underwent end-to-end urethral reconstruction after complete urethral disruption; the index was completed at a mean of 6 months after surgery. The scores were then correlated with maximum flow rates (Qmax) and presence of re-stenosis on retrograde urethrography. RESULTS: The initial mean (SD) AUA score was 10.42 (9.6) and the Qmax 22.12 (9.37) mL/s. Of the 33 patients, six (18%) had re-stenosis, with a mean score of 30 and Qmax of 6 mL/s. There was a significant inverse correlation between the AUA symptom score and Qmax (r = - 0.401, P < 0.05). CONCLUSION: The AUA Symptom Index is inversely correlated with Qmax and may indicate the presence of re-stenosis after urethroplasty. The AUA score can thus be used as a cost-effective and easy method in the first-line screening of the outcome of urethroplasty.

Adult↗
PubMed2000

Crutch-Induced Axillobrachial Artery Stenosis: Management With Vascular Stent.

This paper describes a patient with clinical and angiographic evidence of axillobrachial artery stenosis, secondary to the misuse of axillary crutch. Although crutch-induced axillobrachial artery injuries have long been described, percutaneous transluminal angioplasty in such cases has recently been introduced into the literature, and vascular stent treatment as in our patient has not previously been reported.

Journal Article↗
PubMed2000

Spondyloepiphyseal dysplasia tarda with progressive arthropathy.

Spondyloepiphyseal dysplasia tarda with progressive arthropathy, described by Wynne-Davies et al., is a rare autosomal recessive disorder. It is characterised by generalised platyspondyly and epiphyseal involvement, with enlargement of both ends of the short tubular bones of the hands. Clinical features include onset in childhood, a disproportionately short stature and premature osteoarthritis. We describe the clinical and radiographic findings of a young woman suffering from spondyloepiphyseal dysplasia tarda with progressive arthropathy.

Adult↗
PubMed2000

Mucinous (colloid) breast cancer: mammographic and US features with histologic correlation.

OBJECTIVE: Mucinous carcinoma of the breast presents with different survival rates in pure and mixed types. The purpose of this study was to correlate the mammographic and ultrasonographic findings of mucinous carcinoma with histologic features in different types and mucin rates. MATERIAL AND METHODS: Thirty-four patients (2.3%) had mucinous cancer after retrospective review of the 1439 breast cancers diagnosed between 1990 and 1996. Twenty-seven patients, 19 pure and eight mixed type of mucinous carcinomas of the breast, were included in this study to evaluate the imaging findings. In 22 of these, the microscopic slides were available and re-evaluated to estimate the volume of extracellular mucin. The volume of the extracellular mucin was classified histologically as: (+), less than 50% of mucin; (++), 50-80% of mucin; and ( ), more than 80% of mucin. Mammographic features with emphasis on margin characteristics and sonographic echo pattern of tumors were correlated with histologic findings. RESULTS: Ten cases (53%) of pure mucinous type carcinomas had a circumscribed mass lesion on the mammograms. The well-defined, lobulated margins of the masses were well correlated with pure histologic type (P<0.01; chi(2) analysis) Two-thirds of these tumors had high volume extracellular mucin. All mixed type mucinous carcinomas demonstrated poorly defined or spiculated margins with no relation to the mucin rates (P<0.01). The sonographic appearances of the tumors showed correlation with histologic types. Most of the pure type carcinomas (53%) were seen with isoechogenic echo texture relative to that of subcutaneous fat, while all of the mixed type carcinomas were hypoechogenic (P<0.01). CONCLUSION: The mammographic and sonographic features of mucinous breast carcinoma show differences in pure and mixed types of the tumor. The most common mammographic appearance of pure mucinous carcinomas with high percentages of mucin is a mass lesion having well-defined margins, which is isoechogenic relative to fat on the sonographic examination. Pure type of carcinomas with small percentages of mucin and mixed type carcinomas have more aggressive imaging characteristics.

Adenocarcinoma, Mucinous↗
PubMed2000

Management of patients with malignant obstructive jaundice. Nursing perspective from the interventional radiology room.

Most patients with obstructive jaundice caused by primary pancreaticobiliary malignancies and metastatic disease cannot be cured by surgical resection when diagnosed. Biliary drainage in the management of obstructive jaundice therefore represents one of the most important issues in the palliative treatment of these patients. For more than 20 years, percutaneous transhepatic biliary drainage procedures have allowed a nonsurgical approach to the management of malignant biliary obstruction. Improvements in radiologic access systems have extended the use of the percutaneous biliary approach, especially since the advent of metallic stents. Nursing care of these patients before, during, and after the percutaneous biliary intervention is challenging. Patient and family need to be educated about the aim and consequences of the procedure as well as its complications. To care for these patients, the nurse must understand the techniques of percutaneous transhepatic biliary drainage. The purpose of this article is briefly to review the etiology of biliary obstruction, the current treatments to relieve obstructive jaundice, and the basic steps of biliary intervention techniques. The nursing management throughout the procedure, the patient preparation before the procedure, and most importantly, the postprocedural nursing care are discussed.

Biliary Tract Neoplasms↗