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Biomedical subjects

A Besim

Publications and source records attributed to A Besim.

53 records · Page 3Linked to original sources

Hypertension because of an arteriovenous fistula between the right renal artery and the inferior vena cava secondary to a gunshot wound: a case report.

A case of a renovascular hypertension due to an arteriovenous fistula between the right renal artery and the IVC secondary to a gunshot wound 8 years previously is reported. The diagnosis was made initially by the clinical signs of a continuous bruit heard over the anterior abdomen and by the characteristic findings of diastolic hypertension. Diagnosis was confirmed by abdominal aortography. In the operation, the right renal artery was ligated and divided proximally between the aorta and the aneurysm and distally beyond the fistulous communication and a Gore-Tex graft was anastomosed between distal part of the renal artery and abdominal aorta. The result was confirmed by postoperative aortography and by disappearance of the preoperative physical findings. The present case, to our knowledge, is the sixth in the literature.

Abdominal Injuries↗

Percutaneous transcatheter ethanol sclerotherapy of postoperative pelvic lymphoceles.

Although percutaneous procedures have been used for the treatment of lymphoceles, transcatheter sclerosing therapy has not been widely applied. We present the results of transcatheter sclerotherapy of lymphoceles with 96% absolute ethanol in 7 patients who had developed lymphocele after pelvic lymphadenectomy for uterine cancer. Seven of the eight lymphoceles (88%) completely disappeared after treatment. The duration of catheter drainage ranged from 4 to 21 days. Although one lymphocele did not resolve completely, it did not require surgery as the patient's symptoms resolved.

Adult↗

Primary non-Hodgkin's lymphoma of the esophagus.

The esophagus is the least commonly involved gastrointestinal organ, accounting for fewer than 1% of patients with lymphoma. Such involvement is mostly secondary, from mediastinal lymph nodes or gastric lymphoma. The primary form arises from the esophageal wall itself and occurs much less frequently. Primary esophageal lymphoma is mostly seen in male patients with Hodgkin's disease. A primary non-Hodgkin's lymphoma of the esophagus with concomitant involvement of the bone marrow is presented, and imaging features of esophageal lymphoma are reviewed.

Aged↗

Percutaneous renal hydatid cyst treatment: long-term results.

BACKGROUND: To evaluate the effectiveness of percutaneous treatment of renal hydatid cysts. METHODS: Four male and one female (14-52 years old, mean = 37 years) patients with five renal cysts were treated percutaneously. All five cysts from the patients were pure fluid collections, which were consistent with type I hydatid cysts according to Gharbi's classification. After entering the cystic cavity under sonographic guidance, cystic fluid was aspirated, and the cavity was filled with hypertonic saline (15% NaCl). In three patients with cysts larger than 6 cm in diameter, catheterization was performed under fluoroscopic guidance, and the cavity was filled with 95% absolute alcohol to sclerotize the cyst walls. In two patients with cysts smaller than 6 cm in diameter, the procedure was carried out by a technique in which the cyst was puncture aspirated, hypertonic saline solution was injected, and the cyst was reaspirated. The patients were followed by ultrasonography and computed tomography. Follow up was 5-62 months (mean = 33.8 months). RESULTS: Sonographic follow-up examinations indicated a gradual decrease in cyst size and volume. The size reduction was significant (p < 0.05). The volume reduction rate was 55-95% (mean = 81%). During follow up, fluid components of all five cysts reduced gradually and finally disappeared, leaving a remnant that is called a "pseudotumor appearance." Neither mortality nor any dissemination was encountered during follow up. The only complication seen in this series was an abscess that was successfully treated with percutaneous drainage. CONCLUSION: According to the results of our study, percutaneous treatment of renal hydatid cysts avoids the morbidity of open surgery and preserves the residual function of the kidney.

Adolescent↗

Malignant biliary obstruction complicated by ascites: closure of the transhepatic tract with cyanoacrylate glue after placement of an endoprosthesis.

A new technique using cyanoacrylate glue is suggested for closing the transparenchymal tract following metallic endoprosthesis placement in a patient with malignant biliary obstruction complicated by ascites. With this technique, complications related to bile reflux through the transparenchymal tract would be avoided after transhepatic endoprosthesis placement in patients who have ascites. This technique would also be useful for avoiding bleeding following transhepatic portal venous puncture.

Ascites↗

A multicentre study of abdominal aorta diameters in a Turkish population.

The aim of this study was to determine the normal values for aortic diameters and the prevalence of aortic dilatation in a mixed Turkish population. Between March 1998 and May 2000, patients who were undergoing abdominal ultrasonography examination for pathologies not involving the aorta, in three different cities, were enrolled into the study prospectively. The anterior posterior aortic diameters were measured at the subdiaphragmatic and aortic bifurcation levels using ultrasonography. A total of 596 patients were included (302 females, 294 males). The mean age was 48 +/- 16 years (range, 6-88 years). The mean aortic diameter in the whole group was 19.0 +/- 3.9 mm (10-45 mm) at the subdiaphragmatic level and 15.7 +/- 3.6 mm (9-65 mm) at the aortic bifurcation level. The mean subdiaphragmatic aortic diameter was 18 +/- 3 mm in females and 19 +/- 4 mm in males. The mean aortic diameters at the bifurcation level was 15 +/- 3 mm in females and 16 +/- 4 mm in males. An aortic bifurcation diameter > 30 mm was encountered in 0.67% of the population. This ratio increased to 1.8% in patients over 55 years of age, regardless of sex. A subdiaphragmatic aorta diameter above 30 mm was observed in 1.2% of the population. In patients over the age of 55 years, this ratio increased to 2.7% (3.6% in males and 1.9% in females). In this national study, the subdiaphragmatic aortic diameters were similar to mean values reported in the world literature. The mean aortic bifurcation diameters were generally lower when compared with the literature, which may be due to difficulties in standardization of the measurements. Aneurysmal dilatation rates in this study also conform to those reported in studies conducted in other countries. Considering the significant number of patients with aneurysmal dilatation of the aorta in the elderly population, we believe it would be prudent to evaluate the aorta in all patients undergoing abdominal ultrasonographic examination.

Adolescent↗

Intraperitoneal involvement in rhabdomyosarcoma CT findings in a child.

Intraperitoneal neoplastic involvement in rhabdomyosarcoma is rare and its incidence and imaging characteristics need to be further described. We present the computerized tomography (CT) findings of a case with pelvic rhabdomyosarcoma and intraperitoneal neoplastic involvement. Enhanced peritoneal and retroperitoneal masses were seen around the liver, spleen, in the paracolic gutters, and in the lesser sac without evidence of ascites, mesenteric nodules or omental caking. Our case also showed that absence of ascites does not preclude the presence of peritoneal involvement. Progression in the peritoneal disease was also well demonstrated by CT.

Adolescent↗

Intracranial calcification in dihydropteridine reductase deficiency.

We described the clinical status and computerized tomographic findings of two patients with tetrahydrobiopterin (BH4) deficiency due to impaired BH4 regeneration. In addition to an unfavorable course, cranial computerized tomography scans demonstrated severe cortical and subcortical atrophy and bilateral corticomedullary and basal ganglia calcifications in these two cases. The occurrence of calcification in the same distribution following the use of methotrexate, a folic acid antagonist, supported the hypothesis that there is a link between the metabolism of pterins and folate.

Brain↗

Tuberculous peritonitis: ultrasonic diagnosis.

Tuberculous peritonitis is an uncommon manifestation of tuberculosis and specific radiologic features of it have not been defined. The diagnosis of tuberculous peritonitis has been made prospectively in 4 patients with sonography. The findings included free ascites; multiple, fine, delicate septations and incomplete mobile strands of fibrin; peritoneal thickening and nodularity. In the differential diagnosis of tuberculous peritonitis, peritoneal carsinomatosis, peritoneal mesothelioma, pyogenic peritonitis, and hemoperitoneum should be considered.

Adolescent↗

Computed tomography and angiographic findings of childhood moyamoya disease.

Moyamoya disease is a rare entity consisting of bilateral stenosis or occlusion of internal carotid arteries with abnormal collateral vessels at the base of the brain. We present five Turkish children with this disease, which is more common in Japan. Focal neurologic deficits and/or epilepsy were the common presenting symptoms in two girls and three boys between the ages of 1.5 and 11 years. Multiple cerebral infarcts were diagnosed in all of the cases by Computed Tomography (CT). Abnormal net-like vessels at the base of the brain were detected in three patients. Cerebral angiography, which is necessary to confirm the diagnosis, showed moyamoya vessels and bilateral stenosis or occlusion of the internal carotid arteries in all cases. Although the angiographic staging was advanced in three patients, neither clinical status nor parenchymal abnormalities detected with CT were different from the other two cases.

Angiography, Digital Subtraction↗

Multiple sclerosis in a six-year-old boy (case report).

A 6-year-old boy with multiple sclerosis, youngest diagnosed in our hospital, is presented. In addition to the clinical findings, the diagnosis was supported by increased immunoglobulin levels, positive IgG index and oligoclonal bands in the cerebrospinal fluid, normal cranial angiography, typical lesions on the cranial computed tomography and magnetic resonance imaging.

Brain↗

Magnetic resonance imaging (MRI) findings in isolated growth hormone deficiency.

In this study the presence of pituitary-hypothalamic abnormalities was searched by magnetic resonance (MR) imaging in 30 children (18 males and 12 females, aged 7.4 to 23 years) with isolated growth hormone deficiency (IGHD). Small anterior pituitary was demonstrated in 18 patients and ectopic posterior pituitary (EPP) in four of them. Pituitary stalk was found to be thin in two patients with anterior pituitary hypophasia and EPP and was visible only in post-gadolinium images. In one patient, a hypothalamic mass was found and the bright spot of the posterior pituitary was found without diabetes insipidus, possibly due to a variation in the intensity of the bright signal. Eight patients had normal pituitary imaging suggesting functional damage. In all five patients with familial growth hormone deficiency the anterior pituitary was hypoplastic. We conclude that a high percentage of patients with IGHD had anomalies of the hypothalamo-pituitary region, which could be demonstrated by MR imaging. Furthermore, the low frequency of perinatal abnormalities in these patients suggested developmental defect as the cause of the morphostructural abnormalities. The presence of the familial cases with the same defect pointed to the genetic origin in some instances.

Adolescent↗

Hydatid cyst mimicking pulmonary hematoma in a patient with hemophilia A.

We present a patient of 2.5 years of age with hemophilia A and a pulmonary hydatid cyst. A chest x-ray taken by chance showed a paracardiac opacity resembling an intrapulmonary hematoma which did not reduce in size after infusions of fresh frozen plasma and factor VIII but rather enlarged. Transabdominal ultrasound, colored echocardiography, thoracic computed tomography and magnetic resonance imaging findings were consistent with a cyst that was firmly attached on the border of the right atrium and also indented it; the wall was remarkably thick with no internal echoes. Hydatid cyst was diagnosed after thoracotomy.

Child, Preschool↗