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Biomedical subjects

Ismail Mihmanli

Publications and source records attributed to Ismail Mihmanli.

At least 37 records · Page 2Linked to original sources
PubMed2004

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↗
PubMed2004

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↗
PubMed2003

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↗
PubMed2003

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↗
PubMed2003

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↗
PubMed2003

Incidence of gallstones in chronic renal failure patients undergoing hemodialysis: experience of a center in Turkey.

OBJECTIVE: In this case-control study, we sought to determine whether the incidence of gallbladder stones (GBS) was increased in chronic renal failure (CRF) patients on a hemodialysis (HD) program. We also evaluated factors, such as lipid profiles and gallbladder motility, that could affect the formation of GBS. In addition, we reviewed other available studies on this subject and compared the factors that might have some influence on the development of GBS. METHODS: A total of 182 CRF patients (135 male, 47 female, mean age 32.1 yr) undergoing chronic HD and who were referred to our transplantation center in the last 10 yr and 194 healthy controls (137 male, 57 female, mean age 33.3 yr) were included in the study. Abdominal ultrasound was performed on all patients, and ALT, AST, and lipid profiles were determined. In addition, 19 patients with CRF (12 male, 7 female, mean age 33.5 yr) and 22 controls (14 male, 8 female, mean age 33.2 yr) who were age and sex matched were randomly chosen for gallbladder emptying, monitored by ultrasound at 30-min intervals for 2 h after a mixed meal. Fasting volume, minimal residual volume, and ejection fraction of the gallbladder were assessed. For statistical analysis, chi(2), t test, and logistic regression analysis were used. RESULTS: GBS were detected in seven patients with CRF (3.85%, 5 male, 2 female) and three controls (1.55%, one male, two female) (p > 0.05). The mean follow-up time of CRF patients after diagnosis was 39.3 months (range: 2-168), the mean duration of HD was 21.8 months (range: 1-120). The analysis of seven stones in the CRF group revealed that five were cholesterol-rich stones, and two were mixed (cholesterol and bilirubin) stones. Cholesterol levels were higher in the control group, and triglycerides were higher in the CRF group, but these findings were nonsignificant (p > 0.05). Other biochemical values were not significantly different between the groups. CRF patients with and without GBS were similar in their duration of CRF and HD, age, and other biochemical parameters (p > 0.05). When gallbladder emptying was considered, there was no difference between the two groups in fasting volume, residual volume, and ejection fraction (CRF: 89.7%; controls: 92.3%) of the gallbladders (p > 0.05). CONCLUSIONS: We detected similar incidences of GBS in CRF patients undergoing HD and healthy controls, and this was comparable to the results of most of the previous studies. Young male CRF patients had a nonsignificantly higher incidence of GBS than control males. Although cholesterol-rich GBS were predominant, we could not find any significant difference between the groups when factors that could affect GBS formation, such as lipid profiles and gallbladder motility, were taken into account.

Adolescent↗
PubMed2003

Effects of low and high doses of atorvastatin on arterial compliance.

At the beginning of atherosclerosis before evidence of morphological lesions or plaques, vascular distensibility or arterial compliance decreased gradually. This endothelial dysfunction is regarded as an early feature of atherosclerosis. In a randomized, double-blind study design, group 1 (12 patients; 7 males, 5 females) with serum LDL-C levels higher than 170 mg/dL and without any other risk factor for atherosclerosis received three months of 20 mg/day atorvastatin treatment while group 11 (8 males, 4 females) with the same characteristics received 80 mg/day. Baseline and posttreatment serum lipid fractions and arterial compliance were measured. Arterial compliance was measured noninvasively in the left common carotid artery with color Doppler ultrasound. Atorvastatin reduced total cholesterol (TC), LDL-C, and triglyceride levels by 32% (P < 0.001), 40.8% (P < 0.001), and 19% (P < 0.001), respectively, and increased HDL-C by 6.9%, (P = 0.002) in the first group. In the second group these reductions were 38.5% (P < 0.001), 46.2% (P < 0.001), and 26.78% (P < 0.001), respectively, and the increase in HDL was 7.8% (P = 0.03). It was observed that the decrease in serum TC, LDL-C and triglyceride levels were significantly higher in the second group than the first group. With atorvastatin, the distensibility coefficient (DC) and compliance coefficient (CC) increased from 18.7 +/- 3.4 to 21.3 +/- 2.9 10(-3) x kPa(-1) (P < 0.001) and from 0.69 +/- 0.05 to 0.77 +/- 0.03 mm2 x kPa(-1) (P < 0.001) in the first group while they changed from 18.3 +/- 3.6 to 21.9 +/- 3.0 10(-3) x kPa(-1) (P < 0.001) and from 0.70 +/- 0.04 to 0.81 +/- 0.01 mm2 x kPa(-1) (P < 0.001) respectively, in the second group. DC and CC increased in both groups, but the differences between the groups were not significant. High doses of atorvastatin reduce blood lipid levels more than conventional doses, however, the change in compliance is not dose-dependent. As endothelial dysfunction is regarded as an early feature of atherosclerosis, there would be no need to administer aggressive doses in a patient without any risk factors other than hyperlipidemia.

Anticholesteremic Agents↗
PubMed2003

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↗
PubMed2003

MRI findings of hypoxic cortical laminar necrosis in a child with hemolytic anemia crisis.

We present magnetic resonance imaging findings of a 5-year-old girl who had a rapidly installing hemolytic anemia crisis induced by trimethoprim-sulfomethoxazole, resulting in cerebral anoxia leading to permanent damage. Magnetic Resonance imaging revealed cortical laminar necrosis in arterial border zones in both cerebral hemispheres, ischemic changes in subcortical white matter of left cerebral hemisphere, and in the left putamen. Although cortical laminar necrosis is a classic entity in adulthood related to conditions of energy depletions, there are few reports available in children. A wide review of the literature is also presented.

Anemia, Hemolytic↗
PubMed2003

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↗
PubMed2002

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↗