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Biomedical subjects

G Engin

Publications and source records attributed to G Engin.

13 recordsLinked to original sources

[Calcification of hydrophilic acrylic intraocular lenses: clinical and pathological aspects].

PURPOSE: The aim of this study was to evaluate the clinical aspects of ten eyes with calcified hydrophilic acrylic intraocular lenses and pathological data obtained from seven explanted lenses. MATERIAL AND METHODS: Forty-seven eyes of 40 patients received the same implant in the first 6-month period of 2001. Ten eyes showed intraocular lens opacification detected 6-18 months after the operation: seven lenses were explanted and three were left in place because they were not causing a decrease in visual acuity or glare at light. Five of ten eyes were diabetic. The explanted lenses were examined under the light microscope and the electron microscope. The elemental analysis of the lens surfaces was made by energy dispersive spectrometry. RESULTS: The light microscopy showed an irregular surface covered by a gray-white opacity. The electron microscopy detected multiple granulations on the front and back surfaces of the lenses including some portions of the haptics. The size and density of these granulations were smaller on the back surface. The energy dispersive spectrometry showed the presence of calcium and phosphate on both surfaces. The spikes of calcium and phosphate were smaller for the back surface of the lenses. DISCUSSION: Calcification was predominantly seen on the surfaces that were in contact with aqueous not covered with anterior capsule. Half (5/10) of the cases were diabetic even though 18% of all patients receiving this lens were diabetic. The presence of diabetes is very common in other series. These data suggest the role of a metabolic factor influencing the milieu of the lens in this calcification process. CONCLUSION: Calcification of the hydrophilic acrylic lenses is a relatively serious complication, but the conditions leading to its appearance and the physiopathology have not yet been fully elucidated. The surgeon should be very careful in the choice of the intraocular lens to implant, and even more so if the patient is diabetic.

Aged↗

Does response to treatment of ejaculatory duct obstruction in infertile men vary with pathology?

OBJECTIVE: To describe the pathology-specific response to transurethral resection of ejaculatory ducts (TURED) in patients with complete or partial ejaculatory duct obstruction and to evaluate the role of TURED in light of powerful assisted reproductive technologies. DESIGN: Retrospective clinical study. SETTING: University hospital. PATIENT(S): Thirty-eight infertile men with obstruction of the ejaculatory ducts. INTERVENTION(S): Diagnosis by transrectal ultrasonography or magnetic resonance imaging, and treatment with TURED. MAIN OUTCOME MEASURE(S): Changes in semen variables, pregnancy outcomes, and complication rates were analyzed before and after surgery. RESULT(S): Improvement in semen variables was significantly better in patients with partial obstruction (94%) of ducts than in those with complete obstruction (59%) (P=.04). Cystic obstruction, especially midline and eccentric cysts, responded best to TURED. Before surgery, all patients were candidates for IVF/ICSI; after surgery, 32% of azoospermic men and 81% of oligospermic men conceived spontaneously or were referred for IUI instead of IVF/ICSI. CONCLUSION(S): Ejaculatory duct obstruction due to cysts appears to respond best to TURED. In addition, TURED may decrease the need for IVF/ICSI as primary treatment in many cases. Finally, TURED may allow IVF/ICSI to be performed with ejaculated rather than surgically retrieved sperm.

Adult↗

MR urography findings of a duplicated ectopic ureter in an adult man.

In this report we present the imaging findings in an adult male with a duplicated ectopic ureter which inserted into the prostatic urethra. The appearances at excretory urography, US, CT, and MR urography are described together with the potential pitfalls of the imaging techniques. Both US and MR urography accurately image the collecting system from the kidney to the point of distal ureteral insertion, and in our patient, MR urography provided similar information to US.

Adult↗

Hydatid disease with unusual localization.

Hydatid disease (HD) may develop in almost any part of the body. The liver is the most frequently involved organ (75%), followed by the lung (15%) and the remainder of the body (10%). Hydatid cysts with unusual localizations may cause serious problems in the differential diagnosis. In this article the various imaging findings of hydatid cysts with unusual localizations are reviewed, based on our experience. Findings in brain, heart, pericard, kidney, intraperitoneum, retroperitoneum, bone, soft tissue, and breast are discussed. Hydatid disease should be considered in the differential diagnosis of all cystic masses in all anatomic locations, especially when they occur in areas where the disease is endemic. The combination of clinical history, imaging findings, and serologic test results usually help the diagnosis.

Adult↗

Transrectal US and endorectal MR imaging in partial and complete obstruction of the seminal duct system. A comparative study.

PURPOSE: To evaluate transrectal ultrasonography (US) and MR imaging findings of infertile patients with suspected complete or partial obstruction of the seminal duct system. MATERIAL AND METHODS: Two hundred and eighteen infertile patients with low ejaculate volume were evaluated by transrectal US. Endorectal MR imaging was performed on 62/218 patients. Prostatic cysts, ejaculatory duct (ED) dilatation (>2 mm in width), ED calculi or calcifications, seminal vesicle (SV) dilatation (a.p. diameter >15 mm), SV hypo/agenesis (a.p. diameter <7 mm), SV cysts (>5 mm), vasal agenesis and chronic prostatitis (coarse calcifications, heterogeneity in prostate) were considered significant findings for obstruction of the seminal duct system. RESULTS: Pathologic findings were detected in 75% and 61% of patients with azoospermia on transrectal US and MR imaging, respectively. Transrectal US and MR imaging did not reveal any pathologies in 64.7% and 59.1% of patients with nonazoospermia, respectively. The incidences of hypoplastic/atrophic SV (12/48 vs. 5/170), SV agenesis (6/48 vs. 1/170), vasal agenesis (5/48 vs. 1/170) were significantly higher in the azoospermic subgroup (p<0.002). CONCLUSION: US is a good method for initial evaluation of these patients especially in complete obstruction. Endorectal MR imaging should be reserved for selected patients in whom results of transrectal US are not conclusive.

Adult↗

US versus conventional radiography in the diagnosis of sternal fractures.

PURPOSE: To investigate the value of ultrasonography (US) in the diagnosis of sternal fractures. MATERIAL AND METHODS: Twenty-three patients (mean age 35.4 years) with a clinical suspicion of sternal fracture after blunt chest trauma were retrospectively reviewed. At admission, a.p. and lateral chest radiographies and sternal US were obtained. Sternal fractures were classified as nondisplaced or displaced. US and conventional radiographic findings were compared. RESULTS: In 3/23 (13.0%) of the patients, no fracture was found by radiography or by US. Both radiography and US demonstrated sternal fractures in 16/23 (69.6%) of the patients. Sternal fractures were detected only by US while the conventional radiography was negative in 2/23 (8.7%) cases. Also in 2/23 (8.7%) of the patients with US positive for fracture, radiographies were suspicious. In 2 patients, the degree of fracture displacement on US was lesser than that found by radiography. CONCLUSION: US was better than lateral radiography to diagnose sternal fractures; however, conventional radiography remains the standard means of demonstrating grade of displacement.

Adolescent↗

[Cataract surgery by phacoemulsification in Werner's syndrome].

We report two cases of Werner's syndrome, a sister and a brother of 32 and 28 years, respectively, who were operated on for cataracts in both eyes. This hereditary syndrome, also called the adult progeria, is characterized by several manifestations of premature aging. Cataract surgery in this syndrome often predisposes to complications such as wound dehiscence and bullous keratopathy. The 4 eyes of the two patients were operated on using the phacoemulsification technique. The operations were successful, and we did not observe any serious complications during the 2-year follow-up period: cystoid macular edema in the brother's right eye was easily cured by topical indomethacin. This experience with these two patients showed that Werner's syndrome cataracts can be safely managed with the current phacoemulsification and small-incision surgery techniques.

Adult↗

MRI of cerebral alveolar echinococcosis.

Cerebral alveolar echinococcosis is rare. We report a case with multiple intracranial masses which show cauliflower-like contrast enhancement pattern on MRI. The lesions originated from hepatic involvement with invasion of the inferior vena cava.

Adult↗

Imaging features of thalassemia.

Thalassemia is a kind of chronic, inherited, microcytic anemia characterized by defective hemoglobin synthesis and ineffective erythropoiesis. In all thalassemias clinical features that result from anemia, transfusional, and absorptive iron overload are similar but vary in severity. The radiographic features of beta-thalassemia are due in large part to marrow hyperplasia. Markedly expanded marrow space lead to various skeletal manifestations including spine, skull, facial bones, and ribs. Extramedullary hematopoiesis (ExmH), hemosiderosis, and cholelithiasis are among the non-skeletal manifestations of thalassemia. The skeletal X-ray findings show characteristics of chronic overactivity of the marrow. In this article both skeletal and non-skeletal manifestations of thalassemia are discussed with an overview of X-ray findings, including MRI and CT findings.

Adrenal Glands↗

CT findings of pulmonary artery aneurysms during treatment for Behçet's disease.

OBJECTIVE: The purpose of this study was to evaluate the CT findings of pulmonary artery aneurysms in patients being treated for Behçet's disease. MATERIALS AND METHODS: Thirteen patients with Behçet's disease who had a total of 46 aneurysms were included in the study. All patients underwent helical CT before and after treatment. Both initial and follow-up CT scans were evaluated for location, number, and size of aneurysms and for thrombosis and pulmonary parenchyma changes. RESULTS: Thirty-five (76%) of the 46 aneurysms completely disappeared during the 3-42 months of treatment (mean, 21 months), and the remaining 11 aneurysms (24%) became smaller. Both disappearance and regression of aneurysms were preceded by thrombus formation. In 15 initially thrombosed aneurysms (33%), the thrombus increased in size during treatment. After treatment, the thrombus regressed and the pulmonary artery aneurysms disappeared. Thirty-one initially nonthrombosed aneurysms (67%) first became thrombosed during treatment; later, the thrombus regressed and the aneurysm decreased in size. Perianeurysmal consolidation and air-space nodules detected in seven patients disappeared in the early stages of treatment. Mosaic attenuation areas were seen in eight patients and disappeared in seven (88%) after treatment. CONCLUSION: Pulmonary artery aneurysms in Behçet's disease may become smaller or disappear with medical treatment. Mural thrombotic changes may be observed during the regression of pulmonary artery aneurysms. Helical CT is helpful in the diagnosis and follow-up of aneurysms and thrombosis in Behçet's disease.

Adult↗

Granulomatous mastitis: gray-scale and color Doppler sonographic findings.

PURPOSE: We examined the roles of gray-scale and color Doppler sonography in the diagnosis of granulomatous mastitis. METHODS: We retrospectively studied the clinical, mammographic, and sonographic findings in 10 women 24-57 years old (mean age, 35.9+/-13.9 years) who had a histopathologic diagnosis of granulomatous mastitis. All patients underwent gray-scale sonographic examination, and 8 patients were further examined with color Doppler imaging. Seven patients had previously undergone mammography. RESULTS: Mammographic findings were nonspecific in all 7 patients. Gray-scale sonographic findings were compatible with mastitis in 6 (60%) of 10 patients. Doppler examination showed increased arterial and venous vascularization within and around the lesion in 5 of 8 patients, but the spectral analysis findings were not specific for granulomatous mastitis. CONCLUSIONS: Neither mammography nor Doppler sonography plays a significant role in the differential diagnosis of granulomatous mastitis versus fibroadenoma or carcinoma. Gray-scale sonography shows findings specific for granulomatous mastitis in some cases, but all cases require histopathologic confirmation for final diagnosis.

Adult↗

Imaging of extrapulmonary tuberculosis.

Diagnosis of extrapulmonary tuberculosis is often difficult. Although positive chest radiographic findings or a positive tuberculin skin test supports the diagnosis, negative results do not exclude extrapulmonary tuberculosis. However, recognition and understanding of the radiologic findings of extrapulmonary tuberculosis can help in diagnosis. The spine is the most common site of skeletal involvement. The femur, tibia, and small bones of the hands and feet are most commonly involved by tuberculous osteomyelitis. Tuberculosis of the joints is characteristically monoarticular; the knee and hip are most frequently affected. Central nervous system tuberculosis takes various forms, including meningitis, tuberculoma, abscess, cerebritis, and miliary tuberculosis. Ileocecal involvement is seen in 80%-90% of patients with abdominal tuberculosis. The most common manifestation of abdominal tuberculosis is lymphadenopathy. Genitourinary tuberculosis is the most common manifestation of extrapulmonary tuberculosis. Lymphatic tuberculosis is more common among children, with cervical or supraclavicular nodes most frequently involved. Tuberculosis of the breast is extremely rare and occurs most often in young, multiparous, lactating women. The radiologic features of extrapulmonary tuberculosis mimic those of many diseases. A high level of suspicion is required, especially in high-risk populations. A positive culture or histologic analysis of biopsy specimens is still required in many patients for definitive diagnosis.

Adult↗