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Biomedical subjects

F Balkanci

Publications and source records attributed to F Balkanci.

71 records · Page 4Linked to original sources
PubMedDate not supplied

Superior mesenteric artery aneurysm in Behçet's disease.

Behçet's disease is a multisystem disorder characterized by recurrent orogenital ulcerations and uveitis. Vascular involvement can include both arteries and veins, with a preponderance of venous lesions. Aneurysms of splanchnic arteries due to Behçet's disease have been rarely reported. We present an unusual case of superior mesenteric artery aneurysm due to Behçet's disease diagnosed by ultrasonography and angiography.

Adult↗
PubMedDate not supplied

Embolization of a high-output postnephrectomy aortocaval fistula with Gianturco coils and cyanoacrylate.

The authors describe the endovascular treatment of a high-output, large-caliber, postnephrectomy aortocaval fistula using a mixture of cyanoacrylate and lipiodol combined with Gianturco coil embolization. Thirty-nine coils were used to decrease the flow through the fistula so that a fast-polymerizing glue mixture could be injected into the fistula. During rapid polymerization, the N-butyl-2-cyanoacrylate (NBCA) mixture was trapped within the coils, providing an easily controllable glue cast in the fistula, thereby preventing inadvertent embolization into the lungs. This approach can be of considerable benefit for the endovascular treatment of central high-output fistulas.

Aged↗
PubMedDate not supplied

Placement of mechanically detachable spiral coils in the endovascular treatment of intracranial aneurysms. Work in progress.

PURPOSE: To determine the usefulness of mechanically detachable spiral tungsten coils (MDSs) in the endovascular, endosaccular occlusion of intracranial aneurysms. MATERIALS AND METHODS: Anterior communicating artery aneurysms shown at angiography in two patients and a basilar tip aneurysm shown in one patient were treated with MDSs. RESULTS: In the basilar artery aneurysm, eight coils were delivered. Two additional coils were placed at 3 months because of filling of the residual aneurysm neck. Angiography at 1 year showed no recanalization. The smaller aneurysm in the anterior communicating artery was totally occluded by a single coil. Angiography at 6 months showed no recanalization. The other aneurysm was occluded by two coils, with a small amount of residual filling. A third coil was withdrawn before detachment. The patient had aspiration pneumonia and electrolyte imbalance, but he was in stable condition 3 weeks later and was discharged. CONCLUSION: The pliable, soft, retrievable MDS system provides instantaneous release of a spiral coil.

Adult↗
PubMedDate not supplied

Imaging of "iliac horns" in nail-patella syndrome.

Hereditary osteo-onychodysplasia, also known as the nail-patella syndrome (NPS), consists of a clinical tetrad of nail dysplasia, hypoplastic or absent patella, radial head dislocation, and iliac horns. Bilateral posterior iliac horns are observed only in NPS and present in >80% of patients. We describe the appearance, location, and structure of iliac horns by CT, MRI, and 3-dimensional CT reconstruction.

Adult↗
PubMedDate not supplied

Peripheral arterial thrombosis in systemic lupus erythematosis and nephrotic syndrome: possible association with protein S deficiency.

Arterial thrombosis in systemic lupus erythematosus (SLE) and nephrotic syndrome have been infrequently reported. A 16-year-old boy with SLE and longstanding nephrotic syndrome presented with peripheral arterial thrombosis when his lupus was at an inactive stage. He did not have antiphospholipid antibodies but had low serum antithrombin III and protein S levels. We suggest that the thrombotic event is not related to antiphospholipid antibodies but to nephrotic syndrome and possibly to acquired protein S deficiency.

Adolescent↗
PubMedDate not supplied

Hypophosphatasia in a newborn infant.

Infantile type hypophosphatasia, an autosomal recessive disease with severe clinical manifestations, is characterized biochemically by subnormal activities of circulating alkaline phosphatase. In this report, we presented a five-day-old male with this rare disorder. His parents were first cousins, and he was first seen for jaundice. He had soft calvaria, large fontanel, extremely wide cranial sutures, low-set ears, a depressed nasal bridge, funnel chest, and short and bowed distal limbs. Roentgenographic studies showed widened sutures and poor ossification of the skull, bowing of the femora and slight modeling defects in the long bones. A low serum alkaline phosphatase activity led us to measure excretion of phosphoethanolamine and found it to be increased.

Alkaline Phosphatase↗
PubMedDate not supplied

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↗
PubMedDate not supplied

A comparison of chemoembolization with conventional chemotherapy and symptomatic treatment in cirrhotic patients with hepatocellular carcinoma.

BACKGROUND/AIMS: The results of transcatheter arterial chemoembolization (TACE) in 28 cirrhotic patients with advanced hepatocellular carcinoma (HCC) were compared to those obtained in 15 cirrhotic patients with HCC treated with systemic chemotherapy, and 14 patients with HCC receiving no specific anti-cancer treatment. MATERIALS AND METHODS: From November, 1986 through May 1994, 235 patients with HCC were seen by the investigators. Twenty eight of these patients actually received TACE. The chemotherapeutic agent used was mitomycin C mixed with Lipiodol and arterial embolization was achieved using Gelfoam. In 19 of 28 cases treated with TACE, the embolization was limited to an artery feeding the tumor, thereby avoiding liver cell injury in non-tumor tissue. In 9 others, the main left or right hepatic artery was embolized. The results obtained in these 28 cases were compared to those obtained in 15 patients with HCC larger than 5 cm. who received systemic mitomycin C and doxorubicin chemotherapy and with those obtained in 14 patients who received no specific anti-tumor therapy. RESULTS: One patient died of liver failure related to the TACE and three patients died of bleeding from esophageal varices within weeks of the TACE procedure. Two of the remaining 24 patients are alive with a follow-up of 6 and 22 months. Twenty-six of the 28 patients treated with TACE died within 1 and 28 months of the initiation of the TACE therapy. The mean survival of those receiving TACE was 13.0 months. Chemotherapy without embolization yielded a mean survival of 7.2 months. The mean survival of the patients receiving no specific anti-cancer treatment was only 6.9 months. There was no statistical differences between the survival of those receiving systemic chemotherapy and those receiving no specific treatment. In contrast, the mean survival of the group receiving TACE was significantly greater than that of either of the other two groups (p < 0.005). CONCLUSIONS: These data suggest that TACE provides the best survival for individuals with larger hepatocellular carcinomas (> 5 cm) not eligible for surgery or percutaneous ethanol injection (PEI).

Antibiotics, Antineoplastic↗
PubMedDate not supplied

Cavernous transformation of the portal vein is associated with pancreatic duct atrophy.

BACKGROUND/AIMS: To determine whether or not portal venous obstruction affects pancreatic duct size. MATERIAL AND METHODS: The ERCP findings of 43 of 51 subjects with cavernous transformation of the portal vein (CTPV) were studied prospectively. In three, the ERCP failed to demonstrate the pancreatic duct (PD) for technical reasons and in 8 of the original 51 subjects, the ERCP was not attempted because of a lack of indications and unwillingness of the subject to undergo the procedure. The ERCP findings of the remaining 40 subjects were compared with those of 23 normal concurrent controls and those of reference controls. RESULTS: In 21 of the 51 patients, an underlying disorder responsible for portal vein thrombosis and cavernous transformation was identified. Despite a full clinical, radiologic, hematologic and biochemical evaluation, no etiology for CTPV was found in the remaining 30 patients. The pancreatic duct diameter was measured at the widest portion of the duct where it traverses the head of the pancreas. In 34 of the 40 patients with CTPV and a successful ERCP, the pancreatic duct was smaller (less than 2.28 mm in diameter) than that of concurrent control subjects and a reference control group (p < 0.05). In only 6 subjects with CTPV was the pancreatic duct size within normal limits. In 3 of these 6, a confounding common bile duct stone was shown to be present and may have accounted for the pancreatic duct enlargement as compared to the other 34 subjects with CTPV. CONCLUSIONS: These results indicate that a smoothly narrowing pancreatic duct hypoplasia or atrophy can be demonstrated in 85% of cases with CTPV. It is speculated that this finding is a consequence of the obstructed pancreatic venous drainage that occurs with CTPV.

Adult↗
PubMedDate not supplied

Congenital tracheoesophageal fistula without atresia: an incidental finding.

A four-year-old boy who had a long history of upper respiratory tract infections and growth retardation was admitted because of recurrent abdominal pain. During upper gastrointestinal series to search for a gastric or duodenal ulcer, the examiner noticed a minute amount of contrast medium within the trachea. Repeat esophagography on an angiographic table led to the correct diagnosis of a congenital H-type fistula. The patient did not have the classical symptoms of a history of choking and cyanosis after feeding during infancy or recurrent lower respiratory tract infections. The only finding consistent with a fistula was growth retardation, and the diagnosis was established incidentally during a work-up for abdominal pain.

Abdominal Pain↗
PubMedDate not supplied

Congenital hepatic fibrosis associated with cavernous transformation of the portal vein.

BACKGROUND/AIMS: Congenital hepatic fibrosis (CHF), which is one of the fibropolycystic diseases, occurs in various forms. Portal hypertension, a very common clinical feature of this condition, has been attributed to the compression of portal vein radicles in the fibrous bands. We investigated whether there are any other contributing factors in the development of portal hypertension in patients with CHF. METHODOLOGY: A total of 1285 patients with portal hypertension of different etiologies were studied using ultrasonography as the screening test. Forty-seven (including portal vein involvement and/or CHF) of these 1285 patients were prospectively studied to evaluate the etiology of the portal hypertension by portography, abdominal computed tomography, exploratory laparotomy, peritonoscopy, liver biopsy and laboratory tests. The patients with CHF were divided into two groups, according to whether or not they had portal vein involvement. RESULTS: Eleven (0.8%) of the 1285 patients with portal hypertension had CHF, and 41 (3.2%) had cavernous transformation of the portal vein (CTPV), resulting from different or unknown etiologies. Five patients had both pathologies (CTPV and CHF). In the 11 patients with CHF, there was CTPV in 5 patients, Caroli's disease in 2 patients, cholangiocarcinoma in 1 patient, inferior vena caval obstruction in 1 patient, and CHF in only 2 patients. There were statistically significant differences in the age of the CHF patients at clinical onset, the incidence of bleeding from esophageal varices, and laboratory findings between the 2 groups with and without CTPV. Despite a thorough investigation, we could not distinguish any predisposing factor in 25 of the 41 patients with CTPV. The incidence of CTPV was 48% in patients with CHF and 3.2% in patients with portal hypertension. CONCLUSIONS: These results suggest that the association of CTPV with CHF is not coincidental, but that CTPV may be associated with CHF and a new possible factor in portal hypertension, and that it can be a major factor in the manifestation of esophageal bleeding from varices.

Adolescent↗