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Biomedical subjects

Ramazan Kutlu

Publications and source records attributed to Ramazan Kutlu.

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

Subacute sclerosing panencephalitis with fulminating course: follow-up magnetic resonance spectroscopy (MRS) findings.

The fulminating form of subacute sclerosing panencephalitis is an extremely rare condition. Imaging findings are usually not correlated with clinical staging. We describe a 4-year-old girl with severe neuronal loss, demyelination, and gliosis in subcortical white matter by magnetic resonance spectroscopic examination even though she was diagnosed as clinical stage II. In 2 months' time, her clinical status worsened significantly. Follow-up magnetic resonance spectroscopy revealed findings that were consistent with clinical status. It is our opinion that magnetic resonance spectroscopy could demonstrate a rapidly progressive fulminating course of subacute sclerosing panencephalitis even in the early clinical stages.

Aspartic Acid↗
PubMed2004

[Adrenoleukodystrophy: single voxel MR spectroscopy findings (case report)].

Adrenoleukodystrophy is a rare genetic disorder. Histopathological features of this disorder include demyelination and axonal loss in white matter. We describe a six-year-old boy with significantly decreased N-acetyl-aspartate (NAA)/Creatin (Cr), increased Choline (Cho)/Cr and Myo-inositol (MI)/Cr in parieto-occipital white matter by MR spectroscopy. In contrast to the normal appearance of frontal white matter on MR imaging, increased Cho/Cr and MI/Cr ratios were detected on MR spectroscopy. These changes in involved areas could be an indication of neuroaxonal loss, demyelination and gliosis.

Adrenoleukodystrophy↗
PubMed2004

Seckel syndrome with polyarteritis nodosa.

Seckel syndrome is a rare genetic disorder with a typical "bird-headed" appearance. It could affect many organ systems but renal involvement is uncommon. Polyarteritis nodosa is systemic vasculitic disorder which also involves kidneys. We report a case of Seckel syndrome in a 9 year-old boy with renal involvement due to polyarteritis nodosa. According to the literature, this is the first report of polyarteritis nodosa in Seckel syndrome.

Abnormalities, Multiple↗
PubMed2003

Delayed myelination in a rhizomelic chondrodysplasia punctata case: MR spectroscopy findings.

Rhizomelic chondrodysplasia punctata is a member of genetic peroxisomal disorders. Delayed myelination, which is probably related to the inadequacy of plasmalogens biosynthesis, is an important feature of this disorder. Direct assessment of neuropathologic aspects of RCDP syndrome such as neuronal degeneration and delayed myelination is possible with MR spectroscopy. In this report, MR spectroscopy findings (decreased Cho/Cr and increased Ins-Gly/Cr ratios and increased levels of mobile lipids) of a rhizomelic chondrodysplasia punctata case supporting delayed myelination are presented. This is the second report of MR spectroscopy examination of the specific brain metabolic changes associated with rhizomelic chondrodysplasia punctata.

Aspartic Acid↗
PubMed2003

Proton MR spectroscopy features of normal appearing white matter in neurofibromatosis type 1.

To determine whether differences exist between neurofibromatosis type 1 (NF1) patients with or without focal lesions and healthy normal volunteers in the metabolite ratios of normal appearing white matter, 27 patients with NF1 (with parenchymal lesion, MR positive, n: 17; without parenchymal lesions, MR negative, n: 10) and 20 healthy volunteers underwent MRI and short TE (31 ms) proton MR spectroscopy (MRS). In 17 patients with parenchymal lesions, 61 focal lesions were detected by MRI. MRS was performed from normal appearing frontal and posterior parietal white matter (FWM and PWM) in NF1 and from control groups. NAA/Cr, Cho/Cr and MI/Cr ratios were calculated. Significant increase in Cho/Cr and MI/Cr ratios were found in FWM and PWM in MR negative and positive groups when compared to control group. NAA/Cr ratio in MR positive group was significantly decreased in FWM compared to control group. There were no significant differences between FWM and PWM in all metabolite ratios of MR negative group. MI/Cr ratio in MR positive group was significantly elevated in PWM compared to FWM. Metabolite changes detected by MRS could indicate demyelination and gliosis in normal appearing white matter in all NF1 patients, and additionally neuroaxonal damage in the FWM of NF1 patients with focal lesions. For that reason, in the clinical evaluation and follow-up of these patients MRS features of normal appearing white matter should be considered in addition to focal lesions.

Adolescent↗
PubMed2003

Intraorbital encephalocele: an important complication of orbital roof fractures in pediatric patients.

Orbital roof fractures are uncommon, and traumatic intraorbital encephalocele formation is a very rare complication of this type of injury. We treated 43 pediatric patients with orbital roof fractures at our center over a 4-year period. The aim of this study was to retrospectively investigate conditions that may lead to intraorbital encephalocele formation in children with orbital roof fractures. Each case was reviewed, and the cause of injury, associated clinical and computerized tomography findings, the Glasgow Coma Scale score on admission, neurological status, other bodily injuries, hospitalization time and type and width of the orbital roof fracture were recorded. The findings in 6 patients who developed encephaloceles were compared to corresponding findings in the 37 patients who did not develop this complication. A total of 44 orbital roof fractures were diagnosed by axial and coronal computed tomography scanning. Six of the 43 children developed intraorbital encephaloceles in the first month after head trauma. In each of these cases, magnetic resonance imaging demonstrated the intraorbital cystic lesion in communication with the subarachnoid space. The width of each orbital roof fracture was measured on axial and coronal computed tomography slices and was confirmed by measurements during surgery. The width of the fractures in the encephalocele cases ranged from 2-4 mm. Duraplasty and orbitoplasty were performed in all the patients with encephalocele. Pediatric patients with orbital roof fractures that exhibit more than 2 mm diastasis and are associated with frontal cerebral contusion may be at greater risk for developing intraorbital encephalocele. All such cases should be monitored closely and investigated further with magnetic resonance imaging.

Adolescent↗
PubMed2003

Infantile Sandhoff's disease: multivoxel magnetic resonance spectrosecopy findings.

Sandhoff's disease is a rare, genetic lysosomal storage disease leading to delayed myelination or demyelination. Although neuroimaging findings in this disease have been reported previously, magnetic resonance spectroscopy findings have not been reported. In this report, we present magnetic resonance imaging and magnetic resonance spectrscopy features of two cases with Sandhoff's disease. Magnetic resonance spectroscopy revealed findings indicating widespread demyelination in both cases and neuroaxonal loss and anaerobic metabolism in the second case. Magnetic resonance spectroscopy could provide useful information in the explanation of the clinical picture of cases with Sandhoff's disease.

Child, Preschool↗
PubMed2003

Thrombolysis and mechanical fragmentation to treat massive pulmonary embolism in a patient with an anterior communicating artery aneurysm.

PURPOSE: To describe successful management of massive pulmonary embolism suffered by a patient with an unsecured intracranial aneurysm. CASE REPORT: An anterior communicating artery aneurysm was found 10 days after a 50-year-old woman was admitted to the intensive care unit with subarachnoid hemorrhage. The patient developed severe acute dyspnea before planned surgery; imaging demonstrated thrombus in the right and left pulmonary arteries. Heparin was contraindicated, so an emergent coil embolization procedure was undertaken. In the same session, recombinant tissue plasminogen activator was administered directly into the thrombus. After 2 hours of thrombolysis and intermittent mechanical fragmentation, lung perfusion improved, and the patient's symptoms abated. CONCLUSIONS: Mechanical fragmentation together with fibrinolytic agent administration is a safe and effective treatment for pulmonary embolism after securing cerebral aneurysms.

Embolization, Therapeutic↗
PubMed2003

Doppler waveforms and blood flow parameters of the superior and inferior mesenteric arteries in patients having Behçet disease with and without gastrointestinal symptoms: preliminary data.

OBJECTIVE: To evaluate hemodynamic changes in mesenteric arteries in patients with Behçet disease with and without gastrointestinal symptoms. METHODS: Doppler sonography of mesenteric arteries was performed in 25 symptomatic and 15 asymptomatic patients having Behçet disease and in 25 healthy control subjects. The peak systolic, minimal, and mean velocities, resistive and pulsatility indexes, inner diameter, cross-sectional area, and blood flow volume of mesenteric arteries were evaluated. The results were compared between patient groups and controls. RESULTS: The mesenteric artery flow was significantly greater in patients in the symptomatic group than in those in the asymptomatic group or in controls. In the superior mesenteric artery, mean velocity and mean blood flow volume (0.35 +/- 0.18 m/s and 711 +/- 404 mL/min, respectively; P < .0001) in the symptomatic group were significantly higher than in the asymptomatic group (0.16 +/- 0.07 m/s and 305 +/- 168 mL/min, respectively) or in controls (0.15 +/- 0.07 m/s and 290 +/- 123 mL/min, respectively). The mean peak systolic velocity (1.23 +/- 0.47 m/s; P < .005) in the symptomatic group was significantly higher than in controls (0.93 +/- 0.23 m/s). In the inferior mesenteric artery, mean velocity and mean blood flow volume (0.25 +/- 0.10 m/s and 139 +/- 79 mL/min) in the symptomatic group were significantly higher than in the asymptomatic group (0.16 +/- 0.07 m/s; P < .006; and 78 +/- 26 mL/min; P < .007) or in controls (0.17 +/- 0.07 m/s; P < .003; 83 +/- 48 mL/min; P < .004). CONCLUSIONS: In this study, symptomatic patients with gastrointestinal Behçet disease were associated with a significant increase in mesenteric artery flow that could be evaluated easily on spectral patterns of arteries during Doppler sonography. The Doppler sonographic findings also revealed that intestinal involvement in patients with Behçet disease without gastrointestinal symptoms is not significantly different from that of healthy controls.

Adolescent↗
PubMed2003

Early- and late-state subacute sclerosing panencephalitis: chemical shift imaging and single-voxel MR spectroscopy.

BACKGROUND AND PURPOSE: Subacute sclerosing panencephalitis (SSPE) is a rare, progressive, inflammatory neurodegenerative disease. Our aim was to determine the metabolic abnormalities of brain in early- and late-stage SSPE by using MR spectroscopy and to assess areas of involvement in the early stages when MR imaging findings were normal. METHODS: Children with stage II (n = 3) or III (n = 3) SSPE and 10 healthy, age-matched children underwent MR imaging, multivoxel MR spectroscopy, and short-echo single-voxel MR spectroscopy (SVS). Areas of involvement in the brain were determined with chemical shift imaging. For SVS, 2 x 2 x 2-cm voxels were placed in the frontal subcortical white matter (FSWM) and parieto-occipital white matter (POWM). N-acetylaspartate (NAA)/creatine (Cr), choline (Cho)/Cr, myo-inositol (Ins)/Cr, and NAA/Cho ratios were calculated. RESULTS: Comparisons of NAA/Cr, Cho/Cr, Ins/Cr and NAA/Cho ratios between patients and control subjects showed significant differences in FSWM and POWM (P <.01). In patients with SSPE, NAA/Cr ratios in POWM were significantly less than those in FSWM (P <.01). NAA/Cr ratios in patients with stage II SSPE and those in the control group were not significantly different; this may reflect the absence of neuronal loss. Decreased NAA/Cr, increased Cho/Cr and Ins/Cr ratios, and increased lactate and lipid peaks were found in patients with stage III SSPE. CONCLUSION: MR spectroscopy showed findings suggestive of inflammation in stage II and findings of demyelination, gliosis, cellular necrosis, and anaerobic metabolism in stage III. MR spectroscopy could be a promising technique for early diagnosis and treatment planning in cases of SSPE.

Aspartic Acid↗
PubMed2003

The relationship between the concha bullosa, nasal septal deviation and sinusitis.

OBJECTIVES: To evaluate the possible relationship between concha bullosa, nasal septal deviation and sinusitis. PATIENTS AND METHODS: Paranasal sinus computed tomography scans of patients suffering from rhinosinusitis were examined. Fifty-four patients with concha bullosa were included in the study. The relationship between concha bullosa, nasal septal deviation and sinusitis was investigated. RESULTS: A statistically significant relationship between unilateral concha bullosa and nasal septal deviation was found (p < 0.01). The relationships of unilateral and bilateral concha bullosa with sinusitis, and bilateral concha bullosa with nasal septal deviation were not statistically significant (p > 0.05). CONCLUSION: In order to define the relation between the concha bullosa, nasal septal deviation and sinusitis, more detailed investigations are needed.

Adult↗
PubMed2003

Giant axonal neuropathy: MRS findings.

Giant axonal neuropathy (GAN) is a rare genetic disease of childhood involving the central and peripheral nervous systems. Axonal loss with several giant axons filled with neurofilaments is the main histopathological feature of peripheral nerve biopsies in this disease. Routine neuroimaging studies reveal diffuse hyperintensities in cerebral and cerebellar white matter. In this case report, the authors present the brain magnetic resonance spectroscopic features (normal N-acetylaspartate/creatine and increased choline/creatine and myoinositol/creatine ratios), which might indicate the absence of neuroaxonal loss and the presence of significant demyelination and glial proliferation in white matter, of an 11-year-old boy diagnosed with GAN.

Brain↗
PubMed2003

[MR spectroscopy in the differential diagnosis of focal brain lesions in neurofibromatosis type 1 patients].

PURPOSE: To determine the role of MR spectroscopy in the differential diagnosis of focal brain lesions in neurofibromatosis type 1. MATERIALS AND METHODS: Fifteen patients with neurofibromatosis type 1 were evaluated by routine MRI and single voxel MR spectroscopy (TE: 31). The posterior parietal white matter of 20 age-matched healthy volunteers constituted the control group. NAA/Cr, Cho/Cr and MI/Cr ratios were calculated and compared with the control group. RESULTS: A total of 58 focal brain lesions were detected by MR imaging. When patients with hamartomas and gliomas were compared with the control group, a decrease in the NAA/Cr ratio, and a significant increase in Cho/Cr and MI/Cr ratios were found. The decrease in the NAA/Cr ratio and the increase in Cho/Cr and MI/Cr ratios of gliomas were significant when compared with hamartomas. With MRI and MR spectroscopy findings, 52 hamartomas and 6 gliomas were detected. CONCLUSION: Since MR spectroscopy has the ability to detect cellular metabolic changes, it could provide additional information to MR imaging about the differential diagnosis and treatment planning of focal parenchymal lesions in neurofibromatosis type 1.

Adolescent↗
PubMed2003

[Associated brain anomalies and clinical findings in corpus callosum dysgenesis].

PURPOSE: The aim of this study was to evaluate the relationship between the types of the corpus callosum dysgenesis, the associated brain anomalies and clinical findings. MATERIALS AND METHODS: We analyzed the MR imaging findings in 169 patients with callosal dysgenesis. Corpus callosum dysgenesis was categorized into agenesis, hypogenesis and hypoplasia. The associated brain anomalies and clinical findings were evaluated. RESULTS: Associated brain anomalies were observed in 148 patients (87.5%). Twenty-one patients (12.4%) had isolated corpus callosum dysgenesis. Dysgenesis included agenesis in 22 (%13), hypogenesis in 46 (27.2%), and hypoplasia in 101 (59.7%) patients. The clinical findings were most commonly observed in patients with hypoplasia. CONCLUSION: The presence of corpus callosum dysgenesis is a strong indication of possible associated brain anomalies. Corpus callosum dysgenesis and associated brain anomalies should be investigated in children with developmental delay, seizures and microcephaly.

Abnormalities, Multiple↗
PubMed2003

[Celiac ganglion blockade: the effectiveness of CT guided percutaneous anterior approach].

PURPOSE: To investigate the effectiveness and safety of celiac ganglion blockade in cases with abdominal malignancies who are narcotic analgesic dependent for control of severe abdominal pain. MATERIALS AND METHODS: A total of 30 celiac ganglion blockades were performed in 27 patients between the ages of 19 and 75. A 22 G Chiba needle was placed through the percutaneous anterior approach into the celiac ganglion region under the guidance of CT, and 98% alcohol was administered. The procedure was repeated in three cases due to insufficient response. RESULTS: In 24 (88.8%) of the 27 cases, the severity of pain decreased. Total relief of the pain was achieved in 13 (48.1%) cases. In 9 (33.3%) cases pain was controlled with non-narcotic analgesics. In 2 (7.4%) cases, the dose of the narcotic analgesic decreased. There was no change in the severity of the pain in 3 (11.1%) cases. Transient complications were diarrhea in 4 (14.8%), hypotension in 6 (22.2%) cases and hemiparesis in one (3.7%) case. CONCLUSION: Celiac ganglion blockade through the percutaneous anterior approach under the guidance of CT should be preferred for the control of pain in the early periods in cases with abdominal malignancies, especially gastric and pancreatic, due to easy performance, safety, lower incidence of complications, high success rate and low cost.

Abdominal Neoplasms↗