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Biomedical subjects

F Balkanci

Publications and source records attributed to F Balkanci.

At least 55 records · Page 3Linked to original sources

Gallbladder pathology in pediatric beta-thalassemic patients. A prospective ultrasonographic study.

Eighty-three beta-thalassemic patients, aged 1.5-19 years, were prospectively studied for evidence of gallbladder pathology by real-time, high-resolution ultrasound. Cholelithiasis was present in 7 patients (8.4%). Sludge, a clinical entity that, when it persists, can be a predisposing factor for cholelithiasis and cholecystitis, was detected in 29 patients (34.9%). Prevalence of sludge to this extent has not been reported in the literature and we believe this is due to better technology offered by modern ultrasound equipment. Pseudo-sludge, a condition that is created by a beam averaging effect (partial-volume phenomenon), at the diverging portion of the ultrasound beam, has always been confusing and a source of difficulties in the ultrasound examination of the gallbladder. For the first time, a method is described, to easily differentiate between true sludge and pseudo-sludge.

Adolescent↗

Pulmonary alveolar microlithiasis presenting with chronic cough.

A case of a 10 year old boy with pulmonary alveolar microlithiasis is presented. Although most children with this disease are asymptomatic, our patient had persistent cough for more than 3 years. It is likely that his chronic cough was a direct consequence of the disease.

Calcinosis↗

Behçet's disease in the etiology of Budd-Chiari disease.

Hepatic venous outflow obstruction (Budd-Chiari syndrome-BCS) was diagnosed in 30 patients during the period from March, 1987, to May, 1991, in Hacettepe University Hospital, Turkey. Patients with Behçet's disease constituted the major group (12/30) in the etiologic distribution. Although the vascular manifestations of Behçet's disease, including venous and arterial occlusions, varices, and aneurysms, are well known, the hepatic vein involvement has been reported in only 22 cases in the literature so far. The authors present 30 cases of BCS, of whom patients with Behçet's disease comprise the largest group (40%). The angiographic findings are not specific to Behçet's disease. It is noted, however, that inferior vena cava involvement is more common in these patients (83.3%) than it is in the rest of the group (61.1%). It is suggested that Behçet's disease should be included among the diagnostic possibilities in a case of BCS, particularly in the countries in which it is prevalent.

Adolescent↗

Budd-Chiari syndrome: analysis of 30 cases.

The authors report their experience with 30 adult patients with Budd-Chiari syndrome (BCS), which is a rare and serious disorder, characterized by hepatic outflow obstruction caused by many different conditions. The diagnosis was based on the clinical data, ultrasonography (US), vena cavography and hepatic venography, computed tomography (CT), and liver biopsy. Behçet's disease (BD) was found in 10 patients with BCS as an underlying disease. Two patients used oral contraceptive drugs, 2 had liver tumor hepatocellular carcinoma and liver lymphoma, and 1 patient had chronic lymphocytic leukemia. Despite full investigation, the authors could not find any obvious underlying cause in the other 15 patients. The results suggest that (1) BCS must be considered as a possible complication in patients with Behçet's disease when they have hepatomegaly even if there were no cardinal manifestations of the disease at the time of admission, and BD is the most common etiologic factor in BCS (33%) in Turkey, where the incidence of Behçet's disease is relatively high. (2) Anti-aggregant treatment seems to be effective in many instances. (3) There were space-occupying lesion-like appearances in the liver of 7 cases by CT and US examination in the acute stage, and these disappeared on the follow-up CT and US in 5 patients but continued in 2. BCS should thus be differentiated from other liver lesions. (4) There were other great-vessel involvements in 43% of the cases, mostly venous, but only 1 pulmonary arterial occlusion.

Adolescent↗

Case report: interruption of the inferior vena cava with anomalous intrahepatic continuation.

Infrahepatic interruption of the inferior vena cava (IVC) with azygos and hemiazygos substitution is a rare IVC anomaly which has been documented in the literature (Anderson et al, 1961; Chuang et al, 1974; Floyd & Nelson, 1976; Mayo et al, 1983). Recently Bercoff et al and Ghossain et al reported two cases with portal continuation of the interrupted IVC (Bercoff et al, 1985; Ghossain et al, 1988). In our case, we describe a left sided IVC with infrahepatic interruption which continues by both the azygos system and the hepatic veins via anomalous intrahepatic vessels. To our knowledge such a continuation with intrahepatic anomalous vessels has not been described before.

Abnormalities, Multiple↗

Spontaneous perirenal and hepatic hemorrhage in periarteritis nodosa.

The authors describe a patient with periarteritis nodosa in whom rupture of an aneurysm associated with the disease led to perirenal hematoma. As a result, right nephrectomy was performed. Seven years later hepatic hemorrhage occurred and resolved spontaneously. These complications of periarteritis nodosa are rare, and their combination in the same patient is rarer still.

Adult↗

Tuberculous pleural effusions: ultrasonic diagnosis.

Twenty patients with tuberculous pleural effusions were studied with ultrasonography. In 18 patients, ultrasonography demonstrated regular pleural thickening which was less than 1 cm except in 1 case. In 4 cases there were a few pleural nodules, whereas in 2 cases the pleural surface showed small nodularity. The latter finding may be diagnostic for a tuberculous etiology. Eighteen patients had multiple, delicate, mobile septations in the effusions, and a lattice-like appearance had formed in 6 cases. Computed tomography was obtained in 7 cases, and pleural thickening was demonstrated in 6 of them. Ultrasonography is a useful imaging modality in the diagnosis of tuberculous pleurisy.

Adolescent↗

Life threatening chylous pleural and pericardial effusion in a patient with Behçet's syndrome.

Chylothorax and chylopericardium secondary to thrombosis of the superior vena cava and the innominate and subclavian veins were diagnosed in a patient with Behçet's syndrome. Immunosuppressive treatment, diet, and underwater seal drainage led to a diminished volume of pleural fluid and pericardial fluid and to a diminished concentration of triglyceride in them; pleurodesis with tetracycline was then performed.

Adult↗

Pulmonary arterial embolism secondary to hydatid cyst of the liver.

Complications may develop after spontaneous or traumatic rupture of hydatid cysts. A rare complication is pulmonary embolism after rupture of such a cyst into the venous system. The authors present the pulmonary radiologic findings for a patient whose pulmonary complaints gradually increased after surgical removal of a hepatic hydatid cyst.

Adult↗

Bile duct varices or "pseudo-cholangiocarcinoma sign" in portal hypertension due to cavernous transformation of the portal vein.

A total of 832 patients with portal hypertension resulting from different etiology was studied by ultrasonograph as a screening test. In 17 of the 832 patients, cavernous transformation of the portal vein was detected by means of ultrasonography. We have prospectively studied these 17 patients, and the diagnosis of cavernous transformation was confirmed by portography in all patients. To evaluate how much biliary tract has been affected from cavernous transformation of the portal vein, and to explain the cause of mildly increased alkaline phosphatase and serum bilirubin levels, endoscopic retrograde cholangiopancreatography (ERCP) was performed in 16 of the 17 patients. There were narrowing, irregularity, undulation and nodular extrinsic defects resulting from compression of thrombosis of the portal vein and the collateral vessels, mimicking cholangiocarcinoma spreading along the common bile duct on the extrahepatic biliary tract in all 16 patients who underwent ERCP. Similar ERCP findings were not found in six patients with portal hypertension due to liver cirrhosis. The ultrasonographic, portographic, and ERCP findings corresponded to surgical findings in six patients who had undergone splenectomy for either hypersplenism or bleeding from esophageal varices. The results indicate that cavernous transformation of the portal vein cause the above-mentioned radiographic findings that we propose to call "pseudo-cholangiocarcinoma sign."

Adolescent↗

Vascular involvement in Behçet's disease.

Behçet's disease (BD) is a multisystem disorder characterized by recurrent oral and genital ulcerations with uveitis. At onset it may present with manifestations of vascular involvement instead of the classical triad. We analyzed 137 patients with BD and 38 had vascular involvement with a prevalence of 27.7%. Male to female ratio was 4.4 and associations of positive pathergy test (76.3%) and eye lesions (57.8%) were higher compared to patients without vascular involvement. Patients with subcutaneous thrombophlebitis were more likely to develop major venous occlusions (22.2%) in the lower extremities and inferior vena cava. Arterial lesions were less frequent features constituting 12.0% of vascular complications in BD.

Adult↗

A digital splenoportography: more sensitive method of detecting spontaneous splenorenal shunt.

Splenoportography was performed upon 195 pediatric patients, including 137 by conventional technique and 58 by digital subtraction technique. The results obtained were compared, and it was found that the percentage of diagnosis of spontaneous splenorenal shunt was higher with digital than with conventional technique. In conclusion digital technique is a more sensitive and safer method than the conventional method.

Angiography, Digital Subtraction↗

DMSA renal scanning versus urography for detecting renal scars in vesicoureteral reflux.

32 children admitted to Hacettepe University Hospital for surgical treatment of vesicoureteral reflux (VUR) between 1987 and 1988 were included in this prospective double-blind study. All patients underwent intravenous urography (IVU), voiding cystouretrography and 99mTc DMSA renal scanning. The sensitivity and specificity of the DMSA scan and IVU for detecting renal scarring were investigated. With regard to the presence of renal scarring, the sensitivity and specificity of IVU and DMSA were not found to be statistically different. But when the scars were scored, DMSA was found to have a higher scoring index compared to IVU. In patients who were candidates for surgical management of VUR, renal scars could be detected both by IVU and DMSA scan but, for the follow-up, the DMSA scan was found to be the investigation of choice.

Adolescent↗