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Biomedical subjects

M Bayram

Publications and source records attributed to M Bayram.

At least 19 recordsLinked to original sources

Mandibular symphyseal distraction osteogenesis: review of three techniques.

Mandibular symphyseal distraction osteogenesis (MSDO) is an alternative strategy to correct mandibular transverse deficiencies and dental crowding. Only a limited number of practitioners have reported their clinical experience and potential complications of this procedure to widen the mandible in a large case series. This study involved retrospective analysis of 40 patients who underwent mandibular symphyseal distraction osteogenesis. Three different types of distractor were used to widen the mandible: tooth-borne in 21 patients, bone-borne in 5 patients and hybrid (both bone and tooth-borne) in 14 patients. The distraction amount ranged from 7 to 11 mm (mean 7.31 mm). While 39 patients underwent successful mandibular symphyseal distraction, there was one failure. Most of the complications were experienced in bone-borne distractors, such as breakage of the distractor rod, gingival recession, secondary infection and ptosis of the chin. In the light of these findings, it is suggested that a lingually placed tooth-borne hyrax appliance is more suitable and reliable than the other distraction devices. Further larger studies are needed in order to better evaluate the effectiveness of bone-borne or hybrid devices.

Adolescent↗

The effects of hormone replacement therapy on homocysteine and vascular histopathological changes.

The aim of the present study was to examine the effects of hormone replacement therapy on homocysteine and its relationship with atherosclerotic changes. Twenty Wistar albino rats were deployed in the study. An artificial menopause was created. Rats were randomly assigned to 2 groups. The first group received 6 cycles of 0.01 mg/kg/day conjugated equine oestrogen and the second group received the same dose of placebo. After the treatment, vitamin B12, folate and homocysteine levels were measured. Carotid arteries were removed for histopathological examination of vascular effects. Homocysteine levels were 3.35+/-0.22 and 2.28+/-0.12 micromol/l, vitamin B12 levels were 699+/-87.51 and 631+/-97.85 pg/ml and folate levels were 71.83+/-4.03 and 84.79+/-6.58 ng/ml in Groups 1 and 2, respectively. Statistical analyses revealed no significant differences between Group 1 and Group 2 with regard to vitamin B12 and folate levels. Homocysteine was found to be significantly elevated in Group 1 (P = 0.001). Histopathological examination did not reveal any pathological finding in vascular sections in either group. Even though postmenopausal HRT is not used as a means of cardiovascular protection, it is the only treatment available for vasomotor symptoms and prevention of urogenital atrophy during menopause. Until the relationships between menopause, HRT, homocysteine, folate and vitamin B12 are clearly elucidated with more comprehensive studies, including all the details leading to plasma homocysteine increment in homocysteine metabolism, we recommend that menopausal women should be provided with accurate information and risk/benefit analysis on HRT treatment and the decision should be made by the patient.

Animals↗

Hoffa's recess in the infrapatellar fat pad of the knee on MR imaging.

The infrapatellar fat pad of Hoffa is a structure that is located in the space between the back side of the patellar ligament and the real capsule. It is routinely visualized on magnetic resonance (MR) images of the knee. The purpose of this study was to determine the prevalence and shape of a fluid-like indentation at the inferior posterior margin of the infrapatellar fat pad of the knee (recess) and to look for a relation between the liquid image in the fat pad and joint effusion. Three hundred and fifty consecutive MR imaging examinations of the knee were evaluated for the presence, location, size and shape of a recess in the infrapatellar fat pad and existence of joint effusion. The study population consisted of 145 females and 205 males aged between 5 and 80 years old (mean age 37.5 years). The recess in the infrapatellar fat pad was revealed on MR imaging in 54 of 350 knees (15.43%) and had a variable shape, consisting of 35 linear or ovoid (64.81%), five pipe-shaped (9.26%) and 14 globular (25.92%). Additionally, one ganglion cyst was observed in the infrapatellar fat pad. Globular and pipe-shaped recesses may be confused with cystic infrapatellar fat pad pathologies such as ganglion cyst, meniscal cyst, loose body or nodular synovitis. The existence of an infrapatellar fat pad may not be related to the presence of joint effusion.

Adipose Tissue↗

Effect of tamoxifen on serum IL-18, vascular endothelial growth factor and nitric oxide activities in breast carcinoma patients.

Vascular endothelial growth factor (VEGF) is a multi-functional cytokine that has been suggested to be a major angiogenic factor in breast cancer. Nitric oxide (NO) is a potent biological molecule that participates in the multi-step process of carcinogenesis. Interleukin (IL)-18 has been shown to have potent anti-tumour effects. In this study, we investigated the effect of tamoxifen therapy on serum VEGF, NO and IL-18 activity in breast cancer patients. Serum levels of VEGF, nitrate + nitrite and IL-18 were measured in 34 postmenopausal breast cancer patients before and 3 months after the tamoxifen therapy. Both serum VEGF and IL-18 levels decreased after tamoxifen therapy (P = 0.051, P < 0.05, respectively). Serum VEGF levels increased in patients with endometrial thickness, while patients without endometrial thickness had a significant reduction in serum VEGF levels after therapy (P < 0.05). Serum nitrate + nitrite levels increased after the therapy, but this was not statistically significant (P > 0.05). A decrease in serum VEGF levels with tamoxifen therapy may be a reflection of reduced angiogenic activity in patients without endometrial thickness. The negative effect of tamoxifen therapy on IL-18, which is known to have a potent antitumour activity, may be related to the decreased tumour growth by induction of NO and reduction of VEGF activity as a feedback mechanism.

Adult↗

Assessment of mastoid air cell size versus sigmoid sinus variables with a tomography-assisted digital image processing program and morphometry.

We assessed the mastoid air cell size and variables of the sigmoid sinus in healthy ears and ears with chronic otitis media (COM). Thirty-eight patients with unilateral COM [15 with cholesteatoma (COM/+) and 23 without cholesteatoma (COM/-)], and 20 subjects with healthy ears, were included in the study. Assessment was performed using a quantitative digital image processing computed tomography (CT) program, and the volume of the mastoid bone was measured using the morphometric method of Cavalieri. In both COM/+ and COM/- patients the sigmoid to suprameatal spine distance and mastoid size were greater on the healthy side than on the diseased side ( p<0.05). The distance and area were significantly greater in the healthy control subjects than in either the healthy or the diseased ears of the patients with COM ( p<0.05). In the healthy ears of COM patients, there was significant correlation between the sigmoid to suprameatal spine distance and air cell size and mastoid volume ( p<0.05). In the diseased ears of COM patients, this correlation was absent ( p>0.05). The sigmoid sinus shape was of the half-moon type (62%), protrusive type (22%) and saucer type (16%). The digital image processing CT program allowed us to estimate the individual area of the air and soft tissue filled mastoid air cells. The mastoid size in both intact and disease ears of COM patients was smaller than in the healthy controls. The mastoid size may be determined genetically. However, environmental factors such as infection may also affect the mastoid size. Therefore, both genetic and environmental factors may be related to COM as far as the size of the mastoid air cells is concerned.

Adult↗

The normal menisci: in vivo MRI measurements.

The aim of this study was to determine dimensions of the normal menisci in 174 healthy subjects by using MRI. The menisci were divided into three zones (anterior horn, mid-body, posterior horn). The height and width of the both menisci were measured. For the medial meniscus; the height and width of the anterior horn were 5.32 mm and 7.78 mm, the height and width of the mid-body were 5.03 mm and 7.37 mm, and the height and width of the posterior horn were 5.53 mm and 11.71 mm, respectively. For the lateral meniscus, the height and width of the anterior horn were 4.33 mm and 8.88 mm, the height and width of the mid-body were 4.94 mm and 8.37 mm, and the height and width of the posterior horn were 5.36 mm and 9.70 mm, respectively. Three cases (1.7%) of discoid lateral meniscus were encountered. The results of this study should help to establish standard measurements, and to differentiate between normal and pathologic conditions of the menisci of the knee joint.

Adolescent↗

Conservative management of intrahepatic perforation of the gallbladder secondary to acalculous cholecystitis.

Gallbladder (GB) perforation is a rare complication of acute acalculous cholecystitis. This complication mostly manifests as acute free perforation into the peritoneal cavity, subacute pericholecystic abscess, or chronic perforation with cholecystoenteric fistula. Perforation of the GB into the liver is extremely rare, and was reported only in adults, of whom all were treated surgically. The authors present an intrahepatic GB perforation secondary to acute acalculous cholecystitis, and its successful conservative management in a 13-year-old boy.

Acalculous Cholecystitis↗

Anatomic variations of the paranasal sinus area in pediatric patients with chronic sinusitis.

Endoscopic endonasal surgery has been performed in children. Therefore, we need to know the precise anatomy and anatomic variations of the lateral nasal wall. This is important in order to achieve better surgical results and avoid complications. We also need to know the relationship between the anatomic variations and sinonasal disease. For the purpose of this study we assessed the anatomic variations of the lateral nasal wall and the association of these variations with chronic sinusitis in children. Forty-seven children with chronic sinus disease were included in the study. There were 25 female and 22 male patients with ages ranging from 2 to 16 years (mean 10.5+/-3.8 years). On coronal and axial computed tomographic (CT) scans, the anatomic variations of the lateral nasal wall and sinusitis were assessed. A pneumatized middle concha (MC) was the most common anatomic variation, followed by pneumatization of the superior concha (SC), Haller cell and agger nasi cell. Secondary MC, large ethmoidal bulla, maxillary sinus hypoplasia, Onodi cell, and uncinate process pneumatization were relatively rare. Maxillary sinusitis was the most common sinus infection, followed by ethmoidal, sphenoidal and frontal sinusitis in that order. There was no significant relationship between the sinusitis and anatomic variations except for some minor associations. In conclusion, anatomic variations in the lateral nasal wall are common in children. Local, systemic or environmental factors appear to be more important in pediatric sinusitis than the anatomic variations. Due to the absence of a definitive relationship between the anatomic variations and sinus disease, aggressive surgical interventions should be avoided while performing endonasal endoscopic surgery in the children.

Adolescent↗

Significance of the auditory tube angle and mastoid size in chronic ear disease.

The aim of this study was to determine whether a relationship exists between mastoid size and auditory tube angle (ATA) and chronic ear disease. A radiological and clinical study was undertaken of the temporal bones of 36 subjects. There were 24 patients with unilateral chronic otitis media (COM) and 12 healthy controls (HC): the contralateral healthy ears of the COM patients were also used as control (CLHC). From each CT scan the distance between Henle spine and the sigmoid sinus (H-SS) and the ATA was assessed. The angle between a longitudinal line bisecting the transverse length of the external auditory canal and the longitudinal axis of the AT was calculated. A direct correlation between H-SS and ATA, both in COM and HC (p < 0.01), was observed, but not in CLHC (p > 0.05). There was no significant difference in the ATA results between COM and CLHC, or between COM and HC (p > 0.05), however there was a significant difference between CLHC and HC (p = 0.02). H-SS distances were not significantly different between COM and CLHC, or COM and HC, or CLHC and HC (p > 0.05). An association between ATA and mastoid size in both healthy and diseased ears was observed. The anatomical relationships of the AT, mastoid and middle ear, which form a functional unit, are not significantly important in chronic ear disease.

Adult↗

Fusiform enlargement of the nasolacrimal canal: a rare anatomic variation.

To determine the standard width and shape of the nasolacrimal canal (NLC) in the coronal plane, a retrospective review of 950 coronal paranasal CT sections was undertaken. The coronal diameter of NLC was measured at its upper and lower ends and anomalies in its configuration noted. The mean diameters of the NLC were 4.8 +/- 1.2 mm and 4.7 +/- 1.1 mm on the right and left sides, respectively. There was no difference in the mean NLC diameter between the right and left sides, upper and lower portions or males and females. In two cases, an abnormal dilation of the NLC at its inferior portion was encountered. A marked enlargement of the NLC can occur in the absence of a neoplastic or obstructive process and may be detected as an isolated finding representing idiopathic or congenital enlargement. Segmental NLC dilatation is not always an indicator of pathology, particularly in asymptomatic cases, and should be considered a rare anatomic variation.

Adolescent↗

Important anatomic variations of the sinonasal anatomy in light of endoscopic surgery: a pictorial review.

Advances in surgical techniques and instrumentations, utilization of the imaging tools, and understanding the regional anatomy have served to make functional operations with less complications in the paranasal sinus area. In the context of this article, some of these anatomical structures and their variations were reviewed through images. These structures were as follows: course of the anterior ethmoidal artery; roof of the ethmoid; lamina papyracea; uncinate process; optic nerve; and internal carotid artery.

Arteries↗

Anxiety and depression before and after the menopause.

OBJECTIVE: Our purpose was to investigate the anxiety and depression at postmenopausal women. METHODS: We studied 32 postmenopausal and 32 premenopausal patients aged between 40-55 years in Kinrikkale University Medical Faculty Obstetric and Gynecology Department. We performed Beck depression scale and State Trait Anxiety Inventory (STAI) I and II on those patients. Blood samples were taken from each patient. We used student's t test, pearson correlation analysis. RESULTS: Beck depression test results were 21.3 +/- 6.7 and 15.1 +/- 5.6 in postmenopausal and premenopausal women respectively (p < 0.001). STAI-I were 50.4 +/- 9.1 and 47.5 +/- 8.5 in this 2 groups (p = 0.19) and STAI-II values were 47.5 +/- 9.1 and 45.4 +/- 7.5 (p = 0.33). We could not find a correlation between anxiety-depression and blood FSH, LH and E2 levels. We found a correlation between parity and depression (r = 0.423 p = 0.01). There were positive correlations between anxiety and depression tests (r = 0.489 p = 0.01 for STAI-I and r = 0.398 p) = 0.01 for STAI-II). CONCLUSION: Depression rate is significantly higher in menopausal women.

Adult↗

The Chiari III malformation: an unusual and asymptomatic variant in an 11-year old child.

Chiari III malformation is an extremely rare condition, and is characterized by the hindbrain herniation into a low occipital or high cervical encephalocele together with the pathologic and imaging features of the Chiari II malformation. In this report, an unusual variant of the Chiari III malformation was diagnosed in an 11-year-old girl. She had an encephalocele operation when she was a newborn, and has been asymptomatic since then. The clinical and imaging findings of this case were presented.

Brain↗

A new approach to the classification of maxillary sinus hypoplasia with relevant clinical implications.

The purpose of this study was to discover the prevalence of maxillary sinus hypoplasia (MSH) and associated malformations. A total of 490 consecutive axial and coronal computerized tomographic (CT) scans of the paranasal sinuses were obtained from patients with chronic sinusitis. CT scans were assessed for the presence of MSH and associated anatomic variations. A new classification of MSH was made, and the diagnostic criteria listed. The frequency of anatomic variations coexisting with MSH was also estimated. MSH was encountered in 21 (4.2%) of the 490 patients. Unilateral types I, II and III MSH were seen in 7 (1.4%), 6 (1.2%) and 8 (1.6%) respectively. MSH was bilateral only in 3 (0.6%) patients, one of which was a bilateral type II. In the remaining two bilateral MSH cases, there was a type II MSH on one side and type III MSH on the other in each patient. Middle conchal pneumatization was the most common coexisting anatomic anomaly in MSH, followed by agger nasi cell, secondary middle concha, paradoxical middle concha and superior conchal pneumatization. A patient with MSH should be carefully evaluated prior to any sinus surgery in order to avoid surgical complications. With precise CT assessments, an MSH can be diagnosed and distinguished from other maxillary sinus anomalies. With the additional criterion of orbital enlargement, and the help of reproducible measurement techniques explained in this study, an objective diagnosis and classification can be made in further investigations of MSH.

Adolescent↗

Variations of sphenoid and related structures.

The aim of this study was to delineate the precise relationship between the sphenoid sinus and internal carotid artery and the optic nerve, as well as to assess incidence of the anatomic variations of these structures. A review of 92 paranasal sinus tomographic scans was made for anatomic variations of the sphenoid sinus and related bony and neurovascular structures. Coronal and axial tomographic sections were obtained with 2.5-mm section thickness. We assessed the protrusion of the internal carotid artery (ICA) and the optic nerve (ON) into the sphenoid sinus, bone dehiscence of these structures, and pneumatization of the anterior clinoid process (ACP) and pterygoid recess (PR), as well as the variations of the sphenoid sinus septum. The protrusion of the ICA into the sphenoid sinus was found in 24 (26.1%) patients. An ON protrusion was present in 29 (31.5%) patients. Pneumatization of the PR was encountered in 27 (29.3%) patients. There was not a statistically significant relationship between the pneumatization of the PR and ICA protrusion into the sphenoid sinus (chi2 = 0.258, p = 0.168). A significant relationship between the ACP pneumatization and protrusion of the ON into the sphenoid sinus was found (chi2= 0.481,p = 0.007). Preoperative recognition of the anatomic variations by the radiologist is beneficial for identification of the limits of dissection. This is particularly important in the sphenoid sinus area where extensive pneumatization of the skull base bones may distort the anatomic configuration. Therefore, axial and coronal CT sections should always be obtained prior to any surgery in the sphenoid sinus area.

Adolescent↗