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Biomedical subjects

Mustafa Harman

Publications and source records attributed to Mustafa Harman.

At least 19 recordsLinked to original sources

Morphometric study of the human metatarsals and phalanges.

Mathematical relation between metatarsals and between phalanges in terms of their lengths and widths in themselves is considered to be significant with respect to its functional and aesthetic roles. The objective of this study is to conduct measurements for determining lengths and widths of metatarsals and phalanges on the foot radiographs and to determine possible mathematical correlations between metatarsals themselves and between phalanges themselves in terms of their lengths and widths. Anteroposterior right and left foot radiographs were taken from 100 volunteers (50 men and 50 women). Lengths and widths of the metatarsals and phalanges were measured in millimeter on radiographs. The mean, minimum and maximum values, and standard deviations of each bone's length and width were studied and data were put into formulation. The results were evaluated by Regression statistical test, and the relation between metatarsals and between phalanges in terms of their lengths and widths was studied. As a result of the measurements, we found fixed proportions between metatarsals in themselves and between phalanges in themselves in terms of their lengths and widths. Knowing these morphometric relations may be useful for performing any surgical procedures designed to manage any defects or imperfections of the foot, chief among them is shortness.

Adult↗

Rocky form giant synovial chondromatosis: a case report.

We report a case of painless synovial chondromatosis with an extremely large mass at the popliteal area related to the right knee joint. A hard mass at the posterior aspect of the knee was the only complaint reported by the patient. Plain X-ray studies revealed punctuated calcifications both intra-articularly and around the knee joint. With the surgical procedure performed subsequently, multiple rocky-hard giant chondroid nodules were excised from the posterior aspect of the knee. After 9 months following the surgery, the patient had full range of motion, and no complaints. We emphasize on the importance this case because these lesions may simulate tumors, and lead to misdiagnosis.

Chondromatosis, Synovial↗

Contrast-enhanced CT and MRI findings of atypical hepatic Echinococcus alveolaris infestation.

Diagnosis of liver infestation by Echinococcus alveolaris (EA) is based on serological and radiological findings. In this report, we present a 15-year-old girl with atypical hepatic EA infestation showing central punctate calcifications and contrast enhancement on the portal and late phases of CT and MRI. CT showed a hypodense mass involving more than half of the liver with prominent central calcifications. MRI revealed hypointense signal of the infiltrative mass on both T1- and T2-weighted images. Contrast enhancement is a unique finding in hepatic EA infestation that may cause difficulties with diagnosis. MRI may provide invaluable information in the diagnosis of EA infestation of the liver, either by disclosing the infiltrative pattern of infestation without significant effect to vascular structures, or by the signal characteristics.

Adolescent↗

Incidence of retro-aortic left renal vein and its relationship with varicocele.

The retro-aortic left renal vein (RLRV) is a malformation characterized by the presence of a vessel that drains the left renal blood up to the inferior vena cava crossing behind the aortic artery. Varicocele is defined as venous dilation of the pampiniform plexus, and the left side is the most commonly affected. Several theories concerning the possible aetiology of varicocele are reviewed in the literature, but RLRV was not mentioned as an aetiologic factor of varicocele. in this study we investigated the percentage of RLRVs and their relation with varicocele. A total of 1,125 contrast-enhanced abdominal CT scans was examined to identify RLRVs. RLRVs were found in nine women (1.6%) and ten men (1.7%). We performed scrotal Doppler ultrasonography (US) for all affected men except one. Varicocele of varying degrees was found in seven of the nine male patients with RLRV (77%). RLRV could be one of the aetiological factors in the development of varicocele, and the cases with RLRV should be examined by scrotal Doppler US for the presence of varicocele.

Adult↗

The role of the MR-fluoroscopy in the diagnosis and staging of the pelvic organ prolapse.

INTRODUCTION: The aim of the study is to investigate the efficacy of the magnetic resonance fluoroscopy in the diagnosis and staging of the pelvic prolapse. MATERIALS AND METHODS: The study consisted of 46 patients who were known to have pelvic prolapses from their vaginal examination. Thirty women who underwent vaginal exam and shown not have pelvic prolapse were selected as a control group. Firstly, pelvic sagittal FSE T2 weighted images of all the women were acquired in 0.3 T open MR equipment than sagittal MR-fluoroscopic images using spoiled gradient echo sequences were obtained during pelvic strain. Physical examination and MR-fluoroscopic findings were compared. The relationship between the stages of prolapse established by both of the methods was evaluated statistically with Pearson's correlation analysis. RESULTS: Physical examination and MR findings were very concordant in the diagnosis of pelvic prolapse and statistical correlations in the stages of prolapse were established between both of the methods (P<0.01 for anterior and middle comportment, P<0.05 for posterior comportment). CONCLUSION: We conclude that MR-fluoroscopy is a non-invasive, easily applied, dynamic useful method without contrast agent in the diagnosis and staging of pelvic organ prolapse.

Adult↗

Peroral CT enterography with lactulose solution: preliminary observations.

OBJECTIVE: The objective of our study was to evaluate lactulose solution as a new oral contrast agent with the use of peroral CT enterography to determine the adequacy of luminal distention and conspicuity of the bowel wall. CONCLUSION: Peroral CT enterography performed with lactulose solution is a simple and noninvasive method of evaluating the small bowel by obtaining good distention. It can also be used at routine abdominal examinations as a negative contrast agent instead of iodinated oral contrast medium, especially for CT angiography.

Administration, Oral↗

Brain abscess drainage by use of MR fluoroscopic guidance.

We describe herein the use of MR fluoroscopic guidance in the drainage of abscess cavities. We percutaneously drained 12 brain abscesses in 11 patients. A 0.3T open MR imaging system was used. Sixteen drainages were performed in 12 abscesses. Repeat drainage was needed in three recurrences and one residual lesion. No serious complications were seen. MR fluoroscopy-guided percutaneous brain abscess drainage in an open MR imaging system is feasible.

Adolescent↗

Intracardiac extension of intravenous leiomyoma.

Intravenous leiomyoma with intracaval and intracardiac extension is a rare benign neoplasm affecting women. We report a case in which an intravenous leiomyoma originated from the right iliac vein and extended through the inferior vena cava into the right atrium. The correct diagnosis was made intraoperatively, after resection of the intracardiac extension of the tumor, which was 28 cm in length. At the 2nd stage of the operation, a right common iliac venotomy enabled the removal of all residual tumor from the inferior vena cava.

Female↗

A case of antiphospholipid syndrome presenting with pulmonary truncus and main pulmonary artery thrombosis.

In patients with antiphospholipid syndrome (APS), thromboembolism and pulmonary hypertension are the most common pulmonary manifestations. Thrombotic obstruction at the level of the main and/or proximal pulmonary arteries is rare. We report a 40-year-old woman without any history of previous arterial and/or venous thrombosis who presented with severe dyspnea and was found to have pulmonary hypertension and positivity for anticardiolipin antibodies. Computed tomography revealed pulmonary truncus thrombosis extending to both right and left pulmonary arteries. The patient and her family refused surgical treatment. She had a prolonged hospital course, was unresponsive to thrombolytic, anticoagulant, antiplatelet, and immunosuppressive treatments, and died of right ventricle and respiratory failure 5 weeks later. This is the first reported case with thrombosis of pulmonary truncus and main pulmonary arteries concurrent with APS.

Adult↗

Popliteal artery pseudoaneurysm: a rare complication of brucellosis.

Brucellosis is still a public health problem, particularly in developing countries. After the primary infection subsides, a chronic stage characterized by nonspecific manifestations can develop, during which it may not be possible to isolate Brucella organisms and agglutination test titers may or may not be high. We present the case of a 49-year-old man who had only nonspecific symptoms and a 2-month history of a pulsatile painful swelling in his right popliteal region. He had no history of trauma or surgery in that region, but he did ingest unpasteurized milk products. The patient's agglutination test titers were high, and Brucella melitensis was isolated from a bone marrow culture. Color Doppler sonography, T2-weighted MRI, and digital subtraction angiography were performed. Treatment with ultrasound-guided compression of the pseudoaneurysm failed because of high blood flow in its neck. Aneurysmectomy was undertaken, and the excised material was consistent with that from a mycotic pseudoaneurysm. Although both MRI and angiography provided useful information, the color Doppler sonography findings were characteristic of a pseudoaneurysm in the popliteal artery, and only that modality could detect the flow dynamics within the pseudoaneurysm.

Aneurysm, False↗

Demonstrating the effect of theophylline treatment on diaphragmatic movement in chronic obstructive pulmonary disease patients by MR-fluoroscopy.

INTRODUCTION: The purpose of this study was to determine the increase in diaphragmatic excursion of patients with chronic obstructive pulmonary disease (COPD) treated with theophylline by MR-fluoroscopy which is an innovative method to demonstrate effectiveness of this treatment. MATERIALS AND METHODS: Investigations were performed on a 0.3 T open MR unit. MR-fluoroscopy images of 30 patients with COPD were obtained before and after theophylline treatment. Diaphragmatic movement values were recorded for evaluation. RESULTS: The response of the diaphragmatic movement in COPD patients treated with theophylline was evaluated by MR-fluoroscopy and an increase of 48% in diaphragmatic contractility was determined after the treatment. The increase in contractility was found to be parallel with respiratory function tests and clinical status. CONCLUSION: Diaphragmatic movement and response to the medical therapy in patients with COPD can be evaluated by MR-fluoroscopy method which can allow accurate measurements.

Adult↗

Desmoplastic medulloblastoma in a 48-year-old male.

Medulloblastoma is a malignant invasive embryonal tumor of the cerebellum with preferential manifestation in children. The peak of occurrence is seven years of age. Seventy percent of medulloblastomas occur in individuals younger than 16. In adulthood, 80% of medulloblastomas arise in the 21-40 years age group. A 48-year-old male patient was admitted to the hospital with complains of headache, ataxia, morning vomiting and difficulty in speech was operated with the diagnosis of presence of mass of 4 x 7 cm size retaining a diffuse homogenous contrast in the posterior fossa. The diagnosis of desmoplastic medulloblastoma was given after histopathological examination. Immunohistochemical examination revealed that neoplastic cells showed staining with neuron-specific enolase and synaptophysin but not with glial fibrillary acidic protein. This lesion showed nodular, reticulin free-zones (pale islands) surrounded by densely packed, highly proliferative cells. The pale regions within the tumor did not contain reticulin fibers. Desmoplastic medulloblastoma is encountered especially in adulthood. This type of tumor rarely occurs beyond the fifth decade of life. We present a case of desmoplastic medulloblastoma in a 48-year-old male.

Adolescent↗

[Posterior cerebral artery involvement in Moyamoya disease].

A ten-year-old girl arrived at the hospital with progressive loss of muscular strength on the right side of the body. The cranial MRI showed left fronto-parietal ischemia and atrophic changes in the left parietal lobe. Brain MRI initially disclosed a narrow left MCA. MRA and digital angiography confirmed the diagnosis of brain obstructive chronic vascular disease (Moyamoya). Angiography results demonstrated occlusion of the left MCA and right posterior cerebral artery, with Moyamoya vessels. It therefore appears that in some patients Moyamoya disease is accompanied by posterior circulation involvement.

Angiography, Digital Subtraction↗

[Multidetector computed tomography in the diagnosis of parathyroid adenomas: contribution of contrast enhancement pattern to diagnosis].

PURPOSE: Contrast enhancement patterns of parathyroid adenomas in the arterial and venous phases were evaluated with multidetector computed tomography and specificity of the method to characterize the lesions was investigated. MATERIALS AND METHODS: Arterial and venous enhancement patterns of parathyroid adenomas were evaluated retrospectively with multidetector computed tomography in 12 patients. All adenomas were removed surgically and the diagnosis was confirmed histopathologically. An area from the mandibular angle to the aortic arch was scanned with 1.5 mm section thickness in the arterial phase (20 seconds delay time) and venous phase (70 seconds delay time) after bolus injection of 50 ml of iodinated contrast media. Arterial and venous contrast enhancement of parathyroid adenomas was evaluated in the axial and coronal reformat images. RESULTS: Ten (83.3%) of 12 parathyroid adenomas showed a heterogeneous enhancement with a hypodense small central area in the arterial phase and a homogeneous enhancement in the venous phase. However, two small lesions, four and five mm in diameter respectively, showed homogeneous contrast enhancement in the arterial phase unlike the larger lesions which displayed a hypodense center in this phase. CONCLUSION: Dynamic scanning with multidetector computed tomography after contrast administration may be helpful in characterizing parathyroid adenomas.

Adenoma↗

[Tibial osteomyelitis following intraosseous infusion: a case report].

Fluids, medications, and blood products can be rapidly administered via intraosseous infusion under emergency conditions, particularly to pediatric patients aged from 0 to 2 years. A five-month-old infant who had been hospitalized with a diagnosis of sepsis developed swelling and hyperemia at the infusion site 10 days after an intraosseous infusion in the right proximal tibia. Physical examination showed a serous discharge from a fistula on the anteromedial side of the right proximal cruris. Plain radiographs demonstrated periosteal reaction in the right tibia and osteolytic areas in the proximal metaphysis. With a diagnosis of acute osteomyelitis, drainage and medullary irrigation were performed and parenteral antibiotic treatment was initiated. Cultures from the surgical site yielded Candida albicans, upon which fluconazole (8 mg/kg) treatment was administered for four weeks. A complete clinical and radiographic improvement was observed at the end of a 12-month follow-up.

Antifungal Agents↗

Fibrosing mediastinitis and thrombosis of superior vena cava associated with Behçet's disease.

We present CT, MRI and venography findings in 13-year boy with mediastinal fibrosis and superior vena cava (SVC) thrombosis associated with Behçet's disease. Fibrosing mediastinitis is an excessive fibrotic reaction that occurs in the mediastinum and may lead to compression of mediastinal structures (especially vascular). This condition is usually idiopathic, though many (and perhaps most) cases in the USA are thought to be caused by an abnormal immunologic response to Histoplasma capsulatum infection. SVC syndrome secondary to extrinsic compression by mediastinal fibrosis combined with Behçet's disease has rarely been described. Radiological investigations of this syndrome are necessary to avoid a useless anticoagulant therapy.

Adolescent↗

The effects of ursodeoxycholic acid alone and ursodeoxycholic acid plus low-dose acetylsalicylic acid on radiolucent gallstones.

BACKGROUND/AIMS: Mucin, a high molecular weight glycoprotein secreted by the gallbladder and biliary duct epithelium, is a pronucleating agent in experimental and human gallstone disease. Blockage of mucin release with aspirin inhibits the formation of primary gallstones in animal models. The aim of this study was to compare the effects of ursodeoxycholic acid alone and plus low-dose aspirin on dissolution of solitary or multiple gallstones. METHODS: There were three treatment groups comprising 43 patients with cholesterol gallstones: Group I (n=16, 13 females, three males) was given ursodeoxycholic acid (15 mg. kg. day) alone and Group II (n=14, 12 females, two males) was treated with aspirin (100 mg/day) in addition to ursodeoxycholic acid cholic. Group III was a control group of 13 cases (11 females, two males) who were monitored without medical treatment. Stone dissolution rates were evaluated sonographically in all patients at three month intervals during the treatment period. RESULTS: After 12 months of treatment, stone dissolution was found in six (37.5%) of the patients in Group I and six (42.8%) of the patients in Group II. The difference in both treatment groups was significant compared to controls (p<0.05) but there was no significant difference between the two treatment groups (p>0.05). Of the cases in whom dissolution was achieved, all patients had multiple gallstones except for one with a solitary stone in Group I. Gallstones were not dissolved of any subject of group III. CONCLUSIONS: The results showed that ursodeoxycholic acid cholic therapy is more effective in the dissolution of multiple gallstones than of solitary ones. Combination with aspirin did not potentiate the efficacy of ursodeoxycholic acid cholic.

Adult↗