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Mustafa Harman

Publications and source records attributed to Mustafa Harman.

27 records · Page 2Linked to original sources

[Case report: Treatment with arterial embolization in a destroyed cervical pregnancy].

Cervical pregnancy is a rare form of ectopic pregnancy. It is frequently associated with extensive hemorrhage, which, in severe cases, may be stopped only by hysterectomy. We report a case of a destroyed cervical pregnancy simulating cervical cancer. The patient was conservatively managed with simple selective uterine artery embolization without methotrexate administration. Her vaginal bleeding ceased after embolization. No additional treatment was given. The patient resumed normal menstruation two months after embolization.

Adult↗

[Uterine leiomyoma embolization: Role of power Doppler ultrasonography].

PURPOSE: The vascularity of uterine leiomyoma was evaluated by power Doppler ultrasonography (PDUS) before and after bilateral uterine artery embolization (UAE) in order to establish the efficacy of the procedure and contribution to the treatment. MATERIALS AND METHODS: UAE was performed in 20 symptomatic patients with uterine leiomyoma. In addition to MRI and gray scale US, patients were evaluated by PDUS to assess the vascularity of the uterus and leiomyomas before and 6 months after the embolization and the findings were compared with angiography. Vascularity was categorized into 3 groups as mild (5 cases), moderate (7 cases) and marked (8 cases). Relationship between the findings of PDUS and treatment results were analyzed statistically by one-way ANOVA and post-hoc Tukey tests. RESULTS: In PDUS except their calcified and degenerated regions leiomyomas displayed more vascularity peripherally than centrally, before the embolization. Six months after the embolization, a decrease of 37%, 44% and 59% was observed in the mass of the leiomyomas that had revealed mild, moderate and marked vascularity before the embolization. Greater mass reduction occurred in leiomyomas with high pre-embolization vascularity (p < 0.05). CONCLUSION: PDUS gives important information about the vascularity of uterine leiomyomas before and after uterine artery embolization, which became a widespread treatment option in recent years. It can be helpful in the selection of patients for uterine artery embolization by revealing the vascularity of the leiomyomas. Also it is a non-invasive and cheap method in the determination of the efficacy of the procedure in the early and late periods after embolization.

Adult↗

Primary malignant fibrous histiocytoma of the small intestine presenting as an intussusception: report of a case.

Malignant fibrous histiocytoma occurs most commonly in the extremities and trunk, but rarely in the visceral organs. Malignant fibrous histiocytoma of the small intestine is an extremely rare condition. To our knowledge, only ten cases of primary tumors involving the small intestine have been described up to now. Among them only one case has been reported to lead to intussusception. This case report documents the appearance of a storiform-pleomorphic type primary malignant fibrous histiocytoma of the ileum, which led to intussusception, in a 58-year-old man with a 3-month history of dyspepsia, weight loss, general fatigue, and nonspecific abdominal pain. The patient was well with no sign of disease at 8 months after surgery. The clinical and pathologic characteristics of malignant fibrous histiocytoma of the small intestine as found in the literature are also reviewed.

Histiocytoma, Benign Fibrous↗

Two giant cavernous hemangioma caused cavernous transformation of the portal vein in a pregnant woman.

We report a case with two giant hemangiomas of the liver that caused cavernous transformation of the portal vein in a 45-yr-old full term pregnant woman. The patient had no serious complaints other than a mass and slight pain in the right upper quadrant and there were no abnormalities in laboratory values. Delivery was performed without complication. In the six month follow-up period, no changes were seen in the lesions.

Journal Article↗

Evaluation of the patellofemoral joint with kinematic MR fluoroscopy.

OBJECTIVE: The aim of this study was to evaluate the diagnostic effectiveness of kinematic magnetic resonance fluoroscopy (KMRF) on patients with patellofemoral incongruency. MATERIALA AND METHODS: 17 patients (20 knees) and 10 healthy volunteers (20 knees), all men (mean age 29.4 years, S.D. 9, range 16-50), were included to our study. Only male subjects were studied because of potential biomechanical differences between sexes. KMRF was used to perform kinematic MR imaging of patellar alignment and tracking in 10 healthy subjects and 17 patients with a provisional clinical diagnosis of abnormal patellofemoral joints. The patellofemoral joints were examined with the knee in different angles of active flexion. At each knee position, real time kinematic and axial MRF image was used to focus on the sagittal plane, followed by an axial image focused through the middle of the patella. Three angles were measured: patellar tilt angle (PTA), sulcus angle (SA) and congruence angle (CA). RESULTS: Five patterns of malalignment were identified and studied. Two patellofemoral joints were normal, 10 had lateralization of the patella, 2 had patellar tilt, 2 had lateralization and patellar tilt (i.e. excessive lateral pressure syndrome) and 4 had medialization of the patella. CONCLUSION: KMRF is an effective method in evaluating patellofemoral incongruency. Short time duration of investigation, ability to get nearly real time images, suitable temporal contrast resolution and investigation from very different angles of knee are important advantages of the method.

Adolescent↗

MR arthrography in chondromalacia patellae diagnosis on a low-field open magnet system.

OBJECTIVE: The purpose of this study was to compare the diagnostic efficacy conventional MRI and MR arthrography (MRA) in the diagnosis of chondromalacia patella (CP) on a low-field open magnet system (LFOMS), correlated with arthroscopy. SUBJECTS AND METHODS: Forty-two patients (50 knees) with pain in the anterior part of the knee were prospectively examined with LFOMS, including T1-weighted, proton density-weighted and T2-weighted sequences. All were also examined T1-weighted MRI after intraarticular injection of dilue gadopentetate dimeglumine. Two observers, who reached a consensus interpretation, evaluated each imaging technique independently. Thirty-six of the 50 facets examined had chondromalacia shown by arthroscopy, which was used as the standard of reference. The sensitivity, specificity and accuracy of each imaging technique in the diagnosis of each stage of CP were determined and compared by using the McNemar two-tailed analysis. RESULTS: Arthroscopy showed that 16 facets were normal. Four (30%) of 13 grade 1 lesions were detected with T1. Four lesions (30%) with T2 and three lesions (23%) with proton-weighted images were detected. Seven (53%) of 13 grade 1 lesions were detected with MRA. Grade 2 abnormalities were diagnosed in two (33%) of six facets with proton density-weighted pulse sequences, two (33%) of six facets with T1-weighted pulse sequences, in three (50%) of six facets with T2-weighted pulse sequences, in five (83%) of six facets with MRA sequences. Grade 3 abnormalities were diagnosed in three (71%) of seven facets with proton density- and T1-weighted images, five (71%) of seven facets with T2-weighted pulse sequences, six (85%) of seven facets with MRA sequences. Grade 4 CP was detected with equal sensitivity with T1-, proton density- and T2-weighted pulse sequences, all showing seven (87%) of the eight lesions. MRA again showed these findings in all eight patients. All imaging techniques were insensitive to grade 1 lesions and highly sensitive to grade 4 lesion, so that no significant difference among the techniques could be shown. CONCLUSION: All imaging technique studied had high specificity and accuracy in the detection and grading of CP; however, MRA was more sensitive than T1-weighted and proton density-weighted MR imaging on a LFOMS. Although the arthrographic techniques were not significantly better than T2-weighted imaging, the number of false-positive diagnosis was greatest with T2-weighted MRI.

Adult↗

Calcaneal brown tumor with primary hyperparathyroidism caused by parathyroid carcinoma: an atypical localization.

Brown tumors are one of the characteristics of primary hyperparathyroidism, although, in some cases, they are noted with secondary hyperparathyroidism as well. The authors present a case of a 50-year-old woman with primary hyperparathyroidism caused by parathyroid carcinoma with an unusual location of a brown tumor in the calcaneus. She first presented with pain and swelling over the heel and ankle, and the diagnosis was suspected by radiographs. Biopsy of the calcaneal lesion confirmed a brown tumor. After the parathyroid lesion was removed surgically, her symptoms were relieved. The calcaneal lesion was treated with immobilization of the foot.

Bone Neoplasms↗

Chronic pseudoaneurysm of the aortic arch: a case report.

Pseudoaneurysm of the thoracic aorta is a rare condition and usually occurs following blunt trauma. It is almost fatal in the absence of prompt surgical treatment. We describe the case of a 56-year-old male suffering from intermittent non-massive hemoptysis, mild dysphagia, and atypical chest pain for 1 month who has no history of trauma. A saccular aneurysm at the aortic arch between left common carotid artery and left subclavian artery was diagnosed by magnetic resonance imaging. Intraoperatively, compression of surrounding structures including trachea and esophagus by the aneurysmal sac (6 x 8 cm in diameter) was seen. Pseudoaneurysm adherent to the upper lobe of the left lung was resected and entire aortic arch replacement with a prosthetic graft was performed. Postoperative course was uneventful and neither specific changes on histologic examination nor any evidence of infection could be detected.

Aneurysm, False↗

Virtual computed tomography cystoscopy in bladder pathologies.

OBJECTIVE: Assessed the usefulness of virtual cystoscopy performed with multidetector computed tomography (CT) in patients with different urinary bladder pathologies compared to the conventional cystoscopy. MATERIALS AND METHODS: Eighteen patients with different bladder pathologies, which consisted of 11 tumors, 3 diverticula, 2 trabecular changes and 2 stones, were assessed with conventional cystoscopy and virtual CT cystoscopy. The results of virtual CT cystoscopy were compared with the findings of conventional cystoscopy. We determined the detection rate and positive predictive value of CT imaging based virtual cystoscopy in the diagnosis of urinary bladder lesions. RESULTS: CT scanning was well tolerated by all patients, and no complications occurred. Images in 16 (88%) of the 18 virtual cystoscopic examinations were either of excellent or good quality. All tumors except one, 2 trabecular changes and 2 stones were characterized with similar findings in the both of methods. The masses ranged from 0.4 to 7.0 cm in diameter. While conventional cystoscopy could not evaluate interior part of the diverticulum, virtual CT cystoscopy could demonstrate clearly within it. There were no false-positive findings in our series. CONCLUSION: Virtual CT cystoscopy is a promising technique to be used in the detection of bladder lesions. It should be considered especially at the evaluation of bladder diverticula. In the future, it may be possible or even advantageous to incorporate into the imaging algorithm for evaluation of bladder lesion.

Adult↗