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Biomedical subjects

Fatih Kantarci

Publications and source records attributed to Fatih Kantarci.

At least 37 records · Page 2Linked to original sources

Embolization of peripheral vascular malformations with ethylene vinyl alcohol copolymer (Onyx).

PURPOSE: To demonstrate the feasibility and preliminary efficacy of endovascular embolization of peripheral congenital vascular malformations (VMs) with use of a nonadhesive liquid embolic agent, Onyx. MATERIALS AND METHODS: Nine patients with a mean age of 20.8 years had local low-flow (n = 4), local high-flow (n = 3), or diffuse high-flow (n = 2) VMs located in the upper or lower extremities. In all patients, endovascular embolization was performed via the superselective catheterization of arterial feeders of VMs with use of microcatheters in a coaxial technique. A total of 15 embolization procedures were performed with Onyx, which was composed of 6%, 8%, or 20% ethylene vinyl alcohol copolymer dissolved in dimethyl sulfoxide. RESULTS: In two of four patients with local low-flow VMs, the lesions were embolized completely. In the other two patients with local low-flow VMs, embolizations were incomplete. The remaining five high-flow lesions of local (n = 3) or diffuse (n = 2) types were also embolized incompletely. In all patients with local low-flow VMs and in one patient with a local high-flow VM, clinical signs and symptoms were resolved significantly. Other patients did show clinical benefit from embolization to varying degrees. CONCLUSION: In our experience in a limited number of cases, Onyx promises and provides important advantages over conventional embolic agents in the endovascular transcatheter embolization of congenital peripheral VMs. However, as with other embolic agents, it is far from perfect.

Adolescent↗

Testicular size and vascular resistance before and after hydrocelectomy.

OBJECTIVE: We sought to determine whether there is an association between hydroceles and testicular size and vascular resistance. SUBJECTS AND METHODS: Twenty-three patients with a mean age of 42.8 years who had a unilateral idiopathic hydrocele and who underwent unilateral hydrocelectomy were included in the study. Testicular size and resistive (RI) and pulsatility (PI) indexes of the intratesticular arteries on the involved and uninvolved sides were measured before and after the hydrocelectomy. RESULTS: We found statistically significant differences in the testicular volumes between the normal side (mean +/- SD, 15.40 +/-3.41 mL) and the side with the hydrocele (20.67 +/- 4.01 mL) before surgery (p < 0.001) and in the volumes in the side with the hydrocele before (20.67 +/- 4.01 mL) and after (16.20 +/- 2.99 mL) surgery (p < 0.001). No such a difference in volume was seen in the normal side before (15.40 +/- 3.41 mL) and after (15.28 +/- 3.24 mL) surgery (p = 0.200). The mean decrease in volume in the testis with the hydrocele after hydrocelectomy was 21%. There were statistically significant differences of RI and PI values between the normal testis (0.59 +/- 0.07 and 1.02 +/- 0.34, respectively) and the testis with hydrocele (0.79 +/- 0.11 and 1.70 +/- 0.56, respectively) before surgery (p < 0.001). In the testis with the hydrocele, we found a statistically significant decrease in RI and PI values (0.62 +/- 0.05 and 1.00 +/- 0.14, respectively) of intratesticular arteries after surgery (p < 0.001). The mean decreases in RI and PI values after hydrocelectomy were 21% and 36%, respectively. CONCLUSION: There is an association between the development of an idiopathic hydrocele and testicular size and vascular resistance. We believe that the increase in volume and vascular resistance is due to an increase in impedance to venous and lymphatic flow.

Adult↗

Normal diaphragmatic motion and the effects of body composition: determination with M-mode sonography.

OBJECTIVE: To evaluate the quantitative measurement of diaphragmatic motion in healthy subjects and to investigate the effects of different variables such as body mass index and waist circumference on the diaphragmatic motion. METHODS: The study included 164 healthy subjects. The subjects were grouped according to age, sex, body mass index, and waist circumference. Measurements of diaphragmatic motion were made by a 3.5-MHz sonographic unit in the M-mode of the system. The posterior diaphragm on both sides was identified, and measurements were performed during deep inspiration. RESULTS: The mean diaphragmatic motion measurements +/- SD were 49.23 +/- 10.98 and 50.17 +/- 11.73 mm on right and left sides, respectively. Female subjects had statistically significantly (P < .05) decreased diaphragmatic motion (right, 46.93 +/- 10.37 mm; left, 47.57 +/- 10.36 mm) than male subjects. The mean diaphragmatic motion (right, 40.90 +/- 8.89 mm; left, 39.37 +/- 9.15 mm) was less in subjects who were underweight (P < .05) when compared with subjects who were of normal weight, overweight, and obese. Subjects who had a waist circumference of less than 70 cm showed a statistically significant decrease (P < .05) in diaphragmatic motion (right, 42.55 +/- 9.12 mm; left, 42.24 +/- 9.73 mm) when compared with subjects who had a waist circumference of 70 to 85, 85 to 100, and greater than 100 cm. Also, subjects younger than 30 years had statistically significantly (P < .05) decreased diaphragmatic motion (right, 44.57 +/- 10.57 mm; left, 44.44 +/- 11.37 mm). CONCLUSIONS: Sex, body mass index, waist circumference, and age may affect the diaphragmatic motion to some extent. Healthy persons of younger age with a smaller body mass index and waist circumference may show a decreased amount of diaphragmatic motion.

Adolescent↗

An isolated complete pancreatic fracture primarily diagnosed by ultrasound.

Pancreatic fractures due to blunt abdominal trauma are rare and are usually symptom-free and silent in many cases. Therefore, a high degree of suspicion is required either early in the course of trauma or later during follow-up. Computed tomography (CT) is the primary imaging modality for the diagnosis of traumatic pancreatic injuries. In this report, we present a 10-year-old child in whom ultrasound enabled the detection of a complete fracture between the body and tail of the pancreas, while initial CT findings were not suggestive of a lesion. The need for ultrasonography is emphasized especially in the presence of a history of trauma even if CT scans appear normal.

Abdominal Injuries↗

Radiological work-up in Peutz-Jeghers syndrome.

BACKGROUND: The development of modern imaging studies such as high-resolution US and various MR imaging sequences have enabled their application to the examination of the gastrointestinal tract. OBJECTIVE. To compare radiological contrast studies, US and MRI in patients with Peutz-Jeghers syndrome (PJS). MATERIALS AND METHODS: Ten members of two families were evaluated. The patients were divided into three groups according to the presence of perioral pigmentations and current clinical symptomatology. Patients were examined using US, MRI and radiological contrast studies. RESULTS: In the disease-free family members ( n=3), no pathological findings were found. In asymptomatic ( n=4) and symptomatic patients ( n=3), polyps were demonstrated using contrast studies in all cases. MRI demonstrated all the polyps. Ultrasound revealed the polyps in three out of six patients. In addition to the polyps, intussusceptions were shown. There was no evidence of malignant transformation on any of the studies. CONCLUSIONS: Although PJS is a childhood or teenage disease, patients should be closely monitored during adulthood because of the development of gastrointestinal and extragastrointestinal malignancies. Contrast studies remain the gold standard. However, radiological follow-up could be undertaken by US or MRI, which would not impose a radiation burden during life-time follow-up.

Adolescent↗

The effect of an acute decrease in serum estrogen concentration on vessel walls: determination with color and pulsed Doppler ultrasound.

The aim of this study was to determine the effects of an acute decrease in serum estrogen concentration on endothelial function in women with surgically induced menopause through the use of color Doppler ultrasonography. There were 40 women scheduled to undergo total abdominal hysterectomy and bilateral salpingo-oopherectomy who participated in the study; 15 women not undergoing surgery also participated as a control group. Color Doppler ultrasonographic examinations of each surgical patient were obtained 3 days prior to and 7 days after surgery. Baseline measurements of the brachial arteries, including peak systolic velocity, end-diastolic velocity, true mean velocity, arterial diameter, and volume flow, were obtained for each patient. After baseline measurements were established, hyperemia was induced by inflating a blood pressure cuff on each patient's upper arm to suprasystolic pressures for 5 min. To evaluate endothelium-dependent vasodilation, the ultrasonographic appearance of the brachial artery was evaluated after the cuff was deflated and removed from the arm. Measurements of peak systolic velocity, end-diastolic velocity, true mean velocity, arterial diameter, and volume flow were obtained, and were repeated at 1, 3, 5, 10, and 20 min subsequent to removal of the blood pressure cuff. The differences between baseline and maximum values of each Doppler parameter after the cuff deflation were calculated. No significant differences were identified in terms of laboratory findings or systolic and diastolic pressures in pre- and postoperative status of surgical patients, or between surgical patients and the control group. A significant difference in serum estradiol levels during pre- and postoperative periods ( P<0.001) was detected. No significant difference in serum estradiol levels was detected among preoperative surgical patients and members of the control group ( P=0.72). All net changes detected within each group during reactive hyperemia were statistically significant. No significant difference in values was detected among pre-, postoperative, and control subjects. Our study reveals that acute decrease in serum estrogen level does not appear to affect endothelial function; thus, we assume that this is mainly due to the result of postoperative surgical stress.

Blood Flow Velocity↗

Percutaneous drainage for treatment of infected pancreatic pseudocysts.

BACKGROUND: Infection of pancreatic pseudocysts is a potentially fatal complication that must be treated immediately. Despite numerous published reports about percutaneous treatment, the effectiveness of percutaneous catheter drainage (PCD) of infected pancreatic pseudocysts is still under discussion. METHODS: In this study, 30 patients (17 women) with 30 infected pancreatic pseudocysts were administered local anesthesia and underwent PCD performed with the use of a single-step trocar technique with computed tomographic guidance. The patients' ages varied from 27 to 74 years (mean age, 45 yr). The etiology was acute pancreatitis in 18 patients, chronic pancreatitis in 11 patients, and surgical trauma in 1 patient. RESULTS: No complications related to the procedure occurred in our series. The success rate was 96% (29 of 30 patients), with no recurrence during follow-up, which ranged from 2 to 58 months (mean follow-up, 27.2 mo). One patient had unsuccessful PCD and was subsequently treated surgically. CONCLUSION: Our findings indicate that PCD is a safe and effective front-line treatment for patients with infected pancreatic pseudocysts.

Adult↗

Duplication of the superficial femoral artery diagnosed primarily on the basis of color Doppler ultrasonography.

Variations of the lower extremity venous system are common, and radiologists may frequently be confronted with such variations during daily clinical practice. However, variations in the arterial system of the lower extremity are extremely rare. The profunda femoris artery and arteries of the cruris are mainly subject to variation. This report describes an extremely rare arterial variation, duplication of the superficial femoral artery (SFA), in terms of the radiologic findings, clinical importance, and embryologic basis.

Femoral Artery↗

Enteroclysis in obscure gastrointestinal system hemorrhage of small bowel origin.

BACKGROUND/AIMS: The diagnostic value of enteroclysis in patients with obscure gastrointestinal bleeding of small bowel origin was evaluated. Further diagnostic approaches in patients in whom enteroclysis did not yield a source for bleeding are discussed. METHODS: A total of 62 patients with gastrointestinal bleeding of obscure origin were retrospectively evaluated by enteroclysis. Patients in whom a specific pathology could not be identified on enteroclysis were further followed-up clinically and by laboratory examinations. Recurrent gastrointestinal bleeding had been considered an indication for further diagnostic evaluation. RESULTS: Accurate cause of the pathology which may explain the source of bleeding was achieved via enteroclysis in 29 of the patients. Of the pathologies, most were inflammatory bowel disease (n=18), followed by neoplasms (n=4), malabsorption (n=3) and miscellaneous disorders (n=4). Thirty-three patients had normal findings on enteroclysis. Six patients were diagnosed as angiodysplasia on angiography and nine patients had either gastritis or duodenitis. A final diagnosis to explain the source of bleeding could not be achieved in 18 cases. CONCLUSION: Enteroclysis provides essential information in gastrointestinal bleeding of obscure origin and its role in the diagnosis should not be undermined. Recurrent and consistent GI bleeding should be considered an indication for further diagnostic evaluation.

Adolescent↗

Renal transplant ureteral stenosis: treatment by self-expanding metallic stent.

We report the use of a metallic stent in a transplant ureteral stenosis. A 28-year-old man with chronic renal failure due to chronic pyelonephritis, who received a living-donor renal transplant, presented with transplant ureteral stenosis. The stenosis was unresponsive to balloon dilation and was treated by antegrade placement of a self-expanding Memotherm stent. The stented ureter stayed patent for 3 years. It may be reasonable to treat post-transplant ureteral stenosis resistant to balloon dilation with self-expanding metallic stents. However, long-term follow-up is required to evaluate the efficacy of this treatment.

Adult↗