Biomedical subjects
Publications and source records attributed to M Ozkan.
Although the patellar (infrapatellar) branch of the saphenous nerve is vulnerable to direct trauma, traumatic prepatellar neuroma has rarely been reported in the literature. It should be considered in the differential diagnosis of disorders causing anterior knee pain. Point tenderness, a palpable fusiform nodule and a positive Tinel's sign are the diagnostic features. Simple excision is curative.
In a double-masked, randomized and controlled clinical trial, the effectiveness and safety of lodoxamide 0.1% eye drops were compared with N-acetyl aspartyl glutamic acid 6% (NAAGA) drops in the treatment of 120 patients with vernal keratoconjunctivitis. There were 60 patients in each of the two study groups. The drugs were instilled 4 times daily for 60 days. Follow-up examinations were made on days 7, 30 and 60. Of the 120 patients, 98 (50 in lodoxamide and 48 in NAAGA groups) were still available for follow-up on day 7, 89 (45 in lodoxamide and 44 in NAAGA groups) on day 30 and 75 (38 in lodoxamide and 37 in NAAGA groups) on day 60. Lodoxamide was clinically more effective than NAAGA. Statistically significant trends toward improvement were noted in the lodoxamide group in resolving papillae on day 30, decreasing corneal staining on days 30 and 60, relieving photophobia on day 60, tearing on days 7, 30 and 60 and itching on days 30 and 60. Lodoxamide 0.1% was more effective in lowering the mean scores for corneal staining on days 30 and 60 (p < 0.05). The composite scores for clinical signs and symptoms calculated by averaging the mean scores for signs and symptoms showed clinically significant differences in favor of the lodoxamide group. More frequent follow-up visits might have resulted in better statistical correlations. Treatment-related adverse events were reported in both groups with similar frequency but none were permanent or serious.
Fibroma of the tendon sheath is an uncommon soft-tissue tumor. Intraarticular localization has not been previously reported. The patient presented with unexplained recurrent swelling of the knee not associated with recent trauma. The soft-tissue tumor was identified by magnetic resonance imaging. Arthroscopy confirmed the diagnosis. Arthrotomy was performed because of the large size of the lesion.
Pericardial and lung involvement in rheumatoid arthritis (RA), suspected to be less severe in a developing nation (Turkey), have been evaluated. We have studied clinical, echocardiographic and pulmonary findings (radiological and functional) in 93 consecutive Turkish patients with definite/classical RA. Findings were compared with those of a group of patients with osteoarthritis or local rheumatological conditions (n = 60) in a blind protocol. Fifty patients with systemic lupus (SLE) were studied as a high risk control group for pericardial involvement. While pericardial disease was detected in 5.5% (5/90) of RA patients, it was detected in 6.6% (4/60) of the control patients. SLE patients had a 26% (13/50) prevalence. Interstitial lung disease was found in 27.7% of RA patients but it was present in 6.6% (4/60) of the control patients. We observed that a group of patients with RA in Turkey had a low prevalence of pericardial disease. This is further evidence that RA has a mild course in developing countries.
Thirty patients were prospectively studied to assess the value of radionuclide ventriculography (RNV) during step-wise dobutamine infusion for the detection of coronary artery disease (CAD). Radionuclide ventriculography was performed under basal conditions and during dobutamine infusion at each 10 micrograms kg-1 min-1 dose increment from 10 to a maximum of 40 micrograms kg-1 min-1. The test response was considered positive if the ejection fraction (EF) decreased by more than 5% or if segmental contraction abnormalities developed. Dobutamine stress testing was well tolerated, no complications and no significant arrhythmia were observed. In nine of 11 patients without CAD, EF increased more than 5% of the rest value and the left ventricular wall motion was normal in 10 of them during dobutamine infusion (specificity 91%). In 18 of 19 patients with CAD, new wall motion abnormalities (WMA) were identified in segments corresponding to the arterial lesions diagnosed by angiography (sensitivity 94%). Ejection fraction response was significantly different in normal subjects and in patients with CAD: 11 +/- 5.9% versus 1.9 +/- 9.5% (P < 0.01). However, abnormal EF response was found in seven of 19 CAD patients and development of new WMA was found to be a more sensitive and specific parameter than EF response for dobutamine RNV. It is concluded that dobutamine RNV is an accurate, widely available and cost-effective test for detecting CAD, especially in patients unable to exercise.
BACKGROUND: Rheumatic valvular disease has been reported to be associated with HLA antigens. To determine whether genetic factors could be involved in the pathogenesis of rheumatic heart disease (RHD), we analyzed the distribution of HLA-A, HLA-B, and HLA-DR antigens in Turkish patients with chronic rheumatic heart disease. METHODS AND RESULTS: The association of class I and class II HLA antigens was examined in 107 ethnic Turkish patients with chronic RHD. The diagnosis was supported by echocardiography, cardiac catheterization, angioventriculography, and histological findings in patients who underwent valve replacement. Two hundred three control subjects, also of Turkish origin, were chosen. The phenotypes B16, DR3, and DR7 were encountered in a significantly higher frequency in patients with RHD compared with the control population (corrected p < 0.05, p < 0.00005, and p < 0.0005, respectively). There also was a decrease in the antigen frequency of DR5 in patients compared with controls (corrected p < 0.005). CONCLUSIONS: The results are consistent with the hypothesis that susceptibility to RHD is genetically linked, and this in turn may be associated mainly with HLA class II antigens and weakly with class I antigens, with DR3, DR7, and B16 influencing susceptibility and DR5 conferring protection.
The cardiac involvement in Behçet's syndrome in sixty-five patients (mean disease duration 5.7 +/- 4.1 SD years) was studied, in comparison with 70 healthy, age- and sex-matched controls. The electrocardiograms, chest radiographs and M-mode, 2-D and Doppler echocardiography were evaluated in a blind protocol. There were no significant differences in the prevalence of cardiac findings between the probands and the controls. It is concluded that cardiac involvement in Behçet's syndrome occurs only sporadically.
This is the case report of a forty-five-year-old woman who manifested clinical findings characteristic of arrhythmogenic right ventricular dysplasia (ARVD) except for fluorescent antinuclear antibody (FANA) positiveness. To the authors' knowledge, this is the first report of FANA positiveness associated with ARVD.
SUMMARY: This article adds 2 more cases of bilateral discoid medial menisci to the previously reported 9 cases. The radiographs of the first case revealed bilateral cupping of the medial tibial plateaus and a small lytic lesion of the left distal medial femoral metaphysis. Beside the posteriorly unstable incomplete type discoid medial meniscus, the left knee had several associated arthroscopic findings: depression of the medial tibial plateau with exposed subchondral bone, anomalous insertion of the anterior horn of the discoid meniscus to the anterior cruciate ligament, a pathological medial plica, and longitudinal deep fissures in the trochlea. The second case was a complete type with peripheral horizontal cleavage tears. Following arthroscopic surgery, magnetic resonance imaging (MRI) scans of the contralateral knees were obtained in both cases to search for bilaterality. MRI revealed discoid medial menisci in the unoperated knees as well. The short-term results of arthroscopic meniscectomy may not be as satisfactory as those reported for normal menisci.
Rubbertuator (Rubber-Actuator) robot arm is a pneumatic robot, unique with its lightweight, high power, compliant and spark free nature. Compressibility of air in the actuator tubes and the elastic nature of the rubber, however, are the two major sources of increased non-linearity and complexity in motion control. Soft computing, exploiting the tolerance of uncertainty and vagueness in cognitive reasoning has been offering easy to handle, robust, and low-priced solutions to several non-linear industrial applications. Nonetheless, the black-box approach in these systems results in application specific architectures with some important design parameters left for fine tuning (i.e. number of nodes in a neural network). In this study we propose a more systematic method in defining the structure of a soft computing technique, namely the backpropagation neural network, when used as a controller for rubbertuator robot systems. The structure of the neural network is based on the physical model of the robot, while the neural network itself is trained to learn the trajectory independent parameters of the model that are essential for defining the robot dynamics. The proposed system performance was compared with a well-tuned PID controller and shown to be more accurate in trajectory control for rubbertuator robots.
To verify the precise anatomy of the radial tunnel, 60 cadaver elbows were dissected with special reference to 7 parameters: (1) the distance between the lateral intermuscular septum and the site of division of radial nerve into its superficial and posterior interosseous branches was 92 mm (85 to 120 mm), (2) the length of the posterior interosseous nerve from its division to the arcade of Frohse (AF) was 46 mm (35 to 65 mm), (3) the average distance between the radial head and AF was 21 mm (17 to 30 mm), (4) the average length of its branch to the extensor carpi radialis brevis muscle from its division to AF was 28 mm (20 to 45 mm), (5) the average distance of the supinator branch from its division to AF was 21 mm (15 to 28 mm), (6) the relationship between the posterior interosseous nerve and the recurrent radial artery showed several variations, and (7) the texture of AF was fibrous in 80% and was membranous in 20%. We recommend that anatomic variations should be kept in mind to avoid complications during radial tunnel surgery.
Explore the source record for details and available documents.
BACKGROUND: Enucleation is an approach used for unresponsive end-stage ocular disease often resulting in blind, painful or cosmetically unacceptable eyes. METHODS: We reviewed the clinicopathological data on 3506 enucleations performed over a 50-year period, 1945-1995. Histopathological data were divided into eight groups according to the causes leading to enucleation: trauma, phthisis, corneal disease, inflammation, vitreoretinal disease, glaucoma, tumors and infections. RESULTS: The study considered 3506 enucleated eyes of 3482 patients, 2467 (70.8%) males and 1011 (29.1%) females (4 sex unspecified). The z-test showed there were significantly more enucleations in males for phthisis (p < 5.05), infections (p < 0.01), trauma (p < 0.01) and inflammation (p < 0.01) and more enucleations for tumors in females (p < 0.01). There were no differences between males and females with regard to enucleations for glaucoma, vitreoretinal and corneal diseases (p > 0.05). The 0-9 years age group was most frequently affected, accounting for 29.7% of the cases. Patients aged less than 30 years constituted 53.6% of all enucleations. The primary or underlying causes leading to enucleation were tumors (1185 eyes, 33.8%), phthisis (587 eyes, 16.7), glaucoma (561 eyes, 16.0%), vitreoretinal diseases (320 eyes, 9.1%), infections (259 eyes, 7.4%), corneal disease (229 eyes, 6.5%), trauma (209 eyes, 6.0%) and inflammation (156 eyes, 4.4%). Time trends in enucleating eyes with different causes showed the number of enucleations for phthisis, infections, corneal diseases, trauma and inflammations had dropped during the ten-year period 1986-1995 compared to 1976-1985 (z-test, p < 0.01). There were no real changes in enucleations for glaucoma and vitreoretinal diseases and there was an increase in the number of enucleations for tumors (p < 0.01). CONCLUSIONS: Improved diagnostic and therapeutic methods, widespread use of photocoagulation in vascular disorders and vitreoretinal surgery in traumas, effective antimicrobial treatment, increasing use of corticosteroids and immunosuppressants, have contributed to the decreasing frequency of enucleation. Tumor patients generally presented late with advanced tumors totally filling the eye, not salvageable by other non-invasive treatment methods. Prompt diagnosis of intraocular malignant tumors (retinoblastoma and malignant melanoma) may reduce the need for enucleation.
Interscalene brachial plexus block (ISB) anaesthesia is widely used with or without general anaesthesia in patients undergoing shoulder surgery, which is generally done with the patient in a sitting position. This position affects haemodynamics, and supplementing ISB with general anaesthesia can exaggerate these haemodynamic changes. This study compared ISB combined with general anaesthesia, with ISB alone, in 29 patients undergoing elective shoulder surgery. Heart rate and oxygen saturation remained stable throughout the study in both groups. Mean arterial pressure was significantly decreased when the patient moved into the sitting position in those given combined anaesthesia, whereas in those given ISB alone mean arterial pressure did not change significantly. Neither pain scores nor patient satisfaction scores differed significantly between the two groups. All of the patients were either satisfied or entirely satisfied with their anaesthesia/analgesia. There were no significant differences in side-effects and no severe complications in either group. We advocate using ISB alone for patients undergoing shoulder surgery, but further larger studies are needed to confirm the present results.
We aimed to evaluate the correlation between aortic regurgitation severity and brain natriuretic (BNP) levels as a marker for left ventricular dysfunction. Sixty consecutive male patients (mean age 22 +/- 3 years) with isolated chronic aortic regurgitation were enrolled in the study together with a control group of 30 age-matched healthy volunteers (group A). Patients were classified with regard to aortic regurgitation vena contracta width as follows: group B, < 3 mm, mild (n = 16); group C, > or = 3 and < 6 mm, moderate (n = 26); group D, > or = 6 mm, severe (n = 18). BNP measurements were performed with a fluorescence immunoassay kit. BNP levels were increased in patients with aortic regurgitation, and severity of regurgitation had a significant influence on BNP levels. This effect can be explained by the volume loading effect of aortic regurgitation.