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Biomedical subjects

Caner Ozer

Publications and source records attributed to Caner Ozer.

At least 19 recordsLinked to original sources

Bronchiolitis obliterans organizing pneumonia associated with sulfasalazine in a patient with rheumatoid arthritis.

Pulmonary toxicity and blood dyscrasias are rare side effects of sulfasalazine. Pulmonary pathology is variable, the most common being eosinophilic pneumonia with peripheral eosinophilia, and interstitial inflammation with or without fibrosis. We here present the case of a 68-year-old female patient treated for 6 months with sulfasalazine for rheumatoid arthritis. On laboratory examination, eosinophil count was 97 x 10(3) mm(3). Thorocoscopic biopsy was performed. Histopathologic diagnosis was bronchiolitis obliterans organizing pneumonia (BOOP). This is the first case in the literature to present with sulfasalazine-induced BOOP in a patient with seronegative RA.

Aged↗

Two episodes of anuria and acute pulmonary edema in a losartan-treated patient with solitary kidney.

Atherosclerotic renal artery stenosis (RAS) is an increasingly important cause of end-stage kidney disease, and may cause hypertension, progressive renal failure, and recurrent pulmonary edema. Herein, we report two episodes of anuria and acute pulmonary edema associated with losartan treatment in a hypertensive patient with preexisting severe renal artery stenosis in a solitary kidney. After successful percutaneous renal balloon angioplasty procedure, urine flow was started immediately, despite 10 days of anuria. Blood pressure measurements were still at acceptable levels with a low dose Beta blocker, and serum creatinine levels were normal even after eight months. PTRA should be done in such patients, even with prolonged anuria. Physicians who recommend angiotensin receptor blockers in patients with RAS, especially in patients wih hypovolemia or a solitary kidney, should be careful about this complication.

Adult↗

Diagnostic value of renal parenchymal density difference on unenhanced helical computed tomography scan in acutely obstructing ureteral stone disease.

OBJECTIVES: To evaluate the diagnostic value of the renal parenchymal density difference, detected using unenhanced helical computed tomography, as a secondary sign of acute obstruction due to a ureteral stone. METHODS: Fifty-five patients with acute flank pain, in whom a ureteral stone was detected on the symptomatic side using unenhanced helical computed tomography, and 22 control subjects with no urinary stone disease were included in this prospective study. Computed tomography was performed, starting from the upper poles of the kidneys down to the base of the urinary bladder. The renal parenchymal density was measured in the upper, middle, and lower portions of each kidney, and a mean value was calculated. The difference between the mean values of the two kidneys was used to predict the presence of an acutely obstructing ureteral stone. RESULTS: In 49 patients with a ureteral stone (89.1%), the difference between the parenchymal densities of the obstructed and nonobstructed kidneys was 5 Hounsfield units (HU) or greater and was lower on the obstructed side. In the remaining 6 patients (10.9%), the density difference was less than 5 HU but was still lower on the obstructed side. All subjects in the control group had a density difference of less than 5 HU. A renal parenchymal density difference of 5.0 HU or greater had 89.1% sensitivity, 100% specificity, 100% positive predictive value, 85.7% negative predictive value, and 93.4% accuracy in predicting the presence of an acute obstructing ureteral stone. CONCLUSIONS: These data suggest that the renal parenchymal density difference may be a valuable secondary sign of acute obstructing ureteral stone disease.

Acute Disease↗

HRCT evaluation of the accessory fissures of the lung.

INTRODUCTION: The purpose of this study was to classify the accessory fissures of the lung and to assess their frequency by using high-resolution CT. METHODS AND PATIENTS: HRCT scans of 115 patients were prospectively reviewed. 1 mm thin sections were obtained at 10 mm intervals with a scan time of 1.9 s. The fissure and its relationship to the segmental bronchovascular structures were then evaluated on transverse sections. RESULTS: Forty-four accessory fissures were detected in 35 of 115 patients. The most common accessory fissure was the inferior accessory fissure (12%). The second most common accessory fissure was the left minor fissure (8%). The right superior accessory fissure (5%), the accessory fissure between the medial and lateral segments of the right middle lobe (5%), and the accessory fissure between the superior and inferior segments of the lingula (5%) were seen in equal frequencies. Also, intersegmental accessory fissures, namely the fissure between the anterobasal and laterobasal of both the right (1%) and the left (2%) lower lobes were detected. We found only one subsegmental accessory fissure. DISCUSSION AND CONCLUSION: The inferior accessory fissure and the left minor fissure were the most common accessory fissures in our study.

Adolescent↗

Bone mineral density in patients with Behçet's disease.

Behçet's disease is a complex, multisystemic, inflammatory disorder characterized clinically by recurrent oral and genital ulcerations as well as uveitis, sometimes leading to blindness. The etiology and pathogenesis of this syndrome remain obscure. However, various factors are suspected, including genetic propensity, infectious precipitants, and immunological abnormalities. Considering the chronicity and unclear etiology of the disease, we conducted a prospective investigation of a possible alteration in the bone mineral density of affected persons. Thirty-five patients (18 males and 17 females, mean age 38.02+/-7.93 years) diagnosed with Behçet's disease and 33 sex- and age-matched healthy controls (14 males and 19 females, mean age 40.06+/-7.66 years) were seen on an outpatient basis, and bone densitometry measurements were done from June 2000 to December 2002 at the Mersin University Hospital in Turkey. Postmenopausal women with Behçet's disease and patients receiving oral corticosteroid therapy were excluded from the study. The mean disease duration was 6.68+/-7.05 years. Bone mineral density was measured with dual X-ray absorptiometry at the lumbar spine and right femur. The mean Z scores of the patient and control groups were -0.50+/-1.06 and -0.13+/-0.92 at the lumbar spine, respectively, and 0.38+/-1.07 and 0.45+/-1.20 at the right femur, respectively. No significant differences in bone mineral density values were detected in the groups at either the lumbar (P = 0.15) or right femur (P = 0.82) site. Body mass index and disease duration did not influence bone mineral density, and age had a positive correlation with bone mineral density in patients with Behçet's disease. In conclusion, although it is difficult to draw definite conclusions due to the relatively small sample size, our study confirms that bone mineral density in Behçet's disease was not lower than in healthy subjects.

Adult↗

Transient partial amnesia complicating cardiac and peripheral arteriography with nonionic contrast medium.

The aim of this study was to present a case of disruption of the blood-brain barrier during the coronary and lower extremity angiographies with radiological and clinical findings. This condition was secondary to intraarterial use of a nonionic, monomeric contrast medium. A total of 450 cc contrast media was used. Computed tomography examination showed contrast enhancement of the right occipital and frontoparietal cortical regions, which returned to normal one day after. The patient also fully recovered from the neurological symptoms within 24 h. We discussed the possible mechanism for blood-brain barrier disruption in this case.

Amnesia↗

Arachnoid granulations in the transverse sinuses of a patient with ocular melanoma.

Arachnoid granulations show typical imaging features that allow their distinction from dural sinus thrombosis and intrasinus tumor. These features include a mid-lateral transverse sinus location, focality, common adjacent entering superficial veins, origin of attachment, low density on computed tomography (CT), isointensity-hypointensity on T1-weighted magnetic resonance imaging (MRI) and hyperintensity on T2-weighted MRI. We report the CT and MRI findings of incidentally detected bilateral arachnoid granulations in the transverse sinuses of a patient with ocular melanoma.

Aged↗

Involvement of the proximal tibiofibular joint in osteoarthritis of the knee.

This study was performed to evaluate the possible involvement of the proximal tibiofibular joint in primary osteoarthritis of the knee. A total of 40 patients with primary osteoarthritis of the knee who had magnetic resonance imaging scans were reexamined for proximal tibiofibular joint involvement. The patient was questioned if pain was present in the proximal tibiofibular joint while at rest, when walking and climbing stairs. Symptoms were evaluated by applying moderate compression over the proximal tibiofibular joint during active ankle and knee motions. Magnetic resonance imaging scans were reexamined by two radiologists. Three of the 40 patients had minimal or moderate pain in the proximal tibiofibular joint during stair-climbing and on clinical examination. Magnetic resonance imaging scans of these three patients revealed osteophyte or subchondral cyst formation, or both. Degenerative changes in the proximal tibiofibular joint may be evident in association with osteoarthritis of the knee and may result in lateral-sided pain at the knee.

Bone Cysts↗

Diagnostic value of sonohysterography in the evaluation of submucosal fibroids and endometrial polyps.

AIMS: To evaluate the diagnostic value of sonohysterography in the evaluation of submucosal fibroids and endometrial polyps. METHODS: Thirty-two women whose preliminary transvaginal ultrasound suggested endometrial abnormality underwent sonohysterography. The findings were then compared with histopathological results. RESULTS: The sonohysterographic diagnosis was fibroid in seven patients, endometrial polyp in 23 patients and simple hyperplasia in two patients. Histopathological findings confirmed our diagnosis in all except three patients with endometrial polyps, who had normal secretory endometrium. Sonohysterography was found to have a sensitivity of 100%, a positive predictive value of 90% and diagnostic accuracy of 90.6%. CONCLUSION: Sonohysterography is a useful, minimally invasive and accurate technique to evaluate the pathologies involving endometrium and uterine cavity.

Adult↗

Antrolithiasis: a retrospective study.

In this retrospective study, the computed tomography (CT) archives of paranasal sinus examinations were reviewed and three cases of antroliths are presented. The archives of paranasal sinus CT studies of 1957 patients (1023 females, 934 males, mean age 36.5 years) were surveyed. CT studies were performed using 3 mm collimation and interval in the coronal, axial or both coronal and axial planes. Three out of 1957 patients demonstrated antroliths, all in the left maxillary sinus. Associated sinusitis was detected in all three patients. Only one patient was operated. The chemical analysis of the antrolith revealed it to be a calcium oxalate stone. All the relevant literature is reviewed and only 25 other cases of true antrolithiasis were encountered. The clinical and radiological features of antroliths, as well as differential diagnosis were discussed. Antrolithiasis should be considered in any case of sinusitis, that does not respond to appropriate medical therapy.

Adult↗

A case of missing mitral valve leaflet: radiological detection.

Intravascular foreign bodies may be introduced into the circulation as a complication of minimally invasive or interventional techniques, or during cardiac valve surgery. Prosthetic heart valve leaflets have been rarely described as intravascular foreign bodies. Herein we report a case of prosthetic heart valve leaflet embolization to the aortic bifurcation with computed tomography and ultrasonography findings, and the importance of radiographic imaging in the localization of missing leaflet fragment is pointed out.

Adult↗

Disseminated pneumocephalus secondary to an unusual facial trauma.

Pneumocephalus can be secondary to a postintrathecal procedure, sinus fracture, basilar skull fracture, congenital skull defect, neoplasm, gas producing organism, barotrauma, neurosurgery, paranasal sinus surgery, mask or nasal continuous positive-airway pressure. Unusual facial traumas can also be rare causes of pneumocephalus. Here, we present such a case in whom an air compressor tip injury to both eyes led to the disseminated pneumocephalus. We report this rare case with the computed tomography findings and try to explain the possible mechanism of the pnemocephalus.

Adolescent↗

Primary diffuse tracheobrochial amyloidosis: case report.

Respiratory amyloidosis is a rare disease that occurs in three forms: tracheobronchial, nodular parenchymal and diffuse parenchymal involment. Tracheobronchial amyloidosis is characterized by focal or diffuse deposition of amyloid in the submucosa of the trachea and proximal bronchi. Herein, we report a case of diffuse tracheobronchial amyloidosis with plain radiography and thorax computed tomography findings.

Amyloidosis↗

Inferomedially projecting pneumatised secondary middle turbinate.

Secondary middle turbinate (SMT), a rare variation of the nasal cavity, is a bony projection covered by soft tissue that arises from the lateral nasal wall. It is almost always bilateral and usually projects superomedially without any ostiomeatal unit obstruction. Herein, we report a case of bilateral inferomedially projecting secondary middle turbinates, one of which is pneumatised and hypertrophied, resembling a large ethmoid bulla extending into the middle meatus. The recognition of this variation is important since it may predispose to inflammatory sinus disease, by narrowing the ostiomeatal unit.

Humans↗

Iatrogenic intravascular pneumocephalus secondary to intravenous catheterization.

The presence of pneumocephalus without a history of intracranial or intrathecal procedures is a significant radiographic finding. Although pneumocephalus means a violation of the dural barrier or the presence of infection, intravascular pneumocephalus is different from intraparenchymal pneumocephalus and its benign nature must be known in the presence of intravenous catheterization. Herein, we present a case of iatrogenic intravascular pneumocephalus with CT findings. To our knowledge, there are only a few reported cases of iatrogenic intravascular pneumocephalus in the literature. Careful intravenous catheterization and diagnosis of the condition on imaging helps to prevent unnecessary treatment procedures.

Catheterization↗

Comparison of reliabilities of the delayed images of helical renal CT in detecting small renal masses.

The reliabilities of the delayed images of helical computed tomography (CT) in detecting renal mass lesions of 30 mm or less in diameter was compared. Nephrographic, excretory and nephrographic+excretory phase images of all patients were evaluated separately to detect mass lesions of < or = 5 and 5-30 mm. There was not any statistically significant difference in the results of three groups. Nephrographic, excretory and nephrographic + excretory phase images are not different from or superior to each other in lesion detection.

Adult↗