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Biomedical subjects

O Unal

Publications and source records attributed to O Unal.

At least 19 recordsLinked to original sources
PubMed2002

Chorea gravidarum: a case report.

Chorea gravidarum is a rare syndrome in pregnancy. The clinical picture is of extrapyramidal symptoms such as involuntary movements, lack of coordination and slurred speech. Neuroleptics or benzodiazepines can be used for treatment. When antiphospholipid antibodies are shown to be present, corticosteroids, and sometimes aspirin, are added to the treatment. Movement disorders can also be associated with an increased central dopamine level. In this report, we present the case of a patient with chorea gravidarum in whom an etiologic factor has not been observed. We treated the symptoms with dopamine-blocking agents such as haloperidol. We believe that, if chorea gravidarum is not accompanied by other etiologic factors (such as antiphospholipid antibodies), there is no elevated risk for the mother and the fetus.

Adult↗
PubMed2001

Successful management of an ovarian enlargement resembling ovarian hyperstimulation in a premenopausal breast cancer patient receiving tamoxifen with cotreatment of GnRH-agonist.

Tamoxifen use in breast cancer patients may cause ovarian cysts. This report presents a case of complex cyst resembling ovarian hyperstimulation in a premenopausal breast cancer patient receiving tamoxifen which resolved by administering monthly depot GnRH-agonist (GnRH-a) without abandoning the tamoxifen treatment.

Adult↗
PubMed2001

Tissue mimicking materials for a multi-imaging modality prostate phantom.

Materials that simultaneously mimic soft tissue in vivo for magnetic resonance imaging (MRI), ultrasound (US), and computed tomography (CT) for use in a prostate phantom have been developed. Prostate and muscle mimicking materials contain water, agarose, lipid particles, protein, Cu++, EDTA, glass beads, and thimerosal (preservative). Fat was mimicked with safflower oil suffusing a random mesh (network) of polyurethane. Phantom material properties were measured at 22 degrees C. (22 degrees C is a typical room temperature at which phantoms are used.) The values of material properties should match, as well as possible, the values for tissues at body temperature, 37 degrees C. For MRI, the primary properties of interest are T1 and T2 relaxations times, for US they are the attenuation coefficient, propagation speed, and backscatter, and for CT, the x-ray attenuation. Considering the large number of parameters to be mimicked, rather good agreement was found with actual tissue values obtained from the literature. Using published values for prostate parenchyma, T1 and T2 at 37 degrees C and 40 MHz are estimated to be about 1,100 and 98 ms, respectively. The CT number for in vivo prostate is estimated to be 45 HU (Hounsfield units). The prostate mimicking material has a T1 of 937 ms and a T2 of 88 ms at 22 degrees C and 40 MHz; the propagation speed and attenuation coefficient slope are 1,540 m/s and 0.36 dB/cm/MHz, respectively, and the CT number of tissue mimicking prostate is 43 HU. Tissue mimicking (TM) muscle differs from TM prostate in the amount of dry weight agarose, Cu++, EDTA, and the quality and quantity of glass beads. The 18 microm glass beads used in TM muscle increase US backscatter and US attenuation; the presence of the beads also has some effect on T1 but no effect on T2. The composition of tissue-mimicking materials developed is such that different versions can be placed in direct contact with one another in a phantom with no long term change in US, MRI, or CT properties. Thus, anthropomorphic phantoms can be constructed.

Adipose Tissue↗
PubMed2001

[Total bilateral carpal coalition with carpometacarpal fusion: one case].

Carpal coalition may involve more than two carpal bones which is more common when coalition occurs as part of a syndrome of congenital malformations. We describe an unusual case of congenital complete entire carpal coalition with massive carpometacarpal coalition except the first carpometacarpal joint and abnormal distal radioulnar joint bilaterally. In addition, radiocarpal joint surfaces were slightly irregular but compatible. There were abnormal distal radioulnar joints and ulnar styloids articulated with the ulnar side of the lunate of the both wrists.

Adult↗
PubMed2000

Congenital infiltrating lipomatosis of the face with cerebral abnormalities.

The aim of this study was to describe a possible variant of encephalo-craniocutaneous lipomatosis syndrome. Three cases of congenital infiltrating lipomatosis of the face, associated with cutaneous, subcutaneous, and cerebral abnormalities, are presented. This neurocutaneous syndrome appears very similar to encephalo-craniocutaneous lipomatosis syndrome but lacks the typical eye lesions.

Abnormalities, Multiple↗
PubMed2000

Power Doppler sonography in the diagnosis of Graves' disease.

In addition to color and pulsed Doppler sonography findings, we aimed to describe power Doppler sonography findings in Graves' disease in this study. Twenty-three patients with Graves' disease were imaged with gray-scale, color and power Doppler sonography. Twenty normal volunteers were examined by the same equipment and the same technique as a control group. A subjective grading system was used to categorize the vascularization in pulsed Doppler sonography images from normal to markedly increased vascularization. Power Doppler sonography exhibited diffuse hypervascularity in the thyroid gland in all patients. The flow was covering about all the parenchyma. Four patients showed mild, 12 patients moderate and seven patients marked vascularity. The intensity of power Doppler flow pattern was not correlated with the severity of the disease. This study demonstrated that power Doppler sonography is a convenient, time saving, inexpensive and noninvasive method as compared with isotope scan and some other laboratory tests for confirmation of Graves' disease.

Adolescent↗
PubMed2000

Real-time MR imaging-guided passive catheter tracking with use of gadolinium-filled catheters.

PURPOSE: To test the hypothesis that real-time magnetic resonance (MR) imaging-guided passive catheter tracking is feasible with use of dilute gadolinium (Gd)-filled catheters, to determine the optimal Gd concentration required for tracking, and to measure catheter tip tracking accuracy. MATERIALS AND METHODS: The authors tested a real-time, T1-weighted, two-dimensional, spoiled gradient-recalled echo MR imaging sequence suitable for tracking catheters. In a yogurt phantom, the authors placed 5-F catheters filled with 2%-12% Gd solutions. MR imaging was performed with and without use of a projection dephaser that suppressed background signal. The authors measured signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and enhancement ratio to determine the optimal Gd concentration for catheter depiction. Catheter tip tracking accuracy was measured in an acrylic phantom with use of linear regression analysis, with goodness of fit assessed statistically with the F test. RESULTS: Peak catheter SNR, CNR, and enhancement ratios were obtained with 4%-6% Gd concentrations. Tip tracking accuracy was determined to be +/- 0.41 mm (R2 = 0.99; P < .0001). MR imaging reconstructions were displayed up to 3.1 frames/sec. CONCLUSIONS: Accurate MR imaging-guided passive catheter tracking was feasible in real-time with use of dilute Gd-filled catheters. This technique may have application in MR imaging-guided endovascular procedures.

Catheterization↗
PubMed2000

MR-guided angioplasty of renal artery stenosis in a pig model: a feasibility study.

PURPOSE: To test the hypothesis that magnetic resonance (MR) imaging can guide the percutaneous treatment of renal artery stenosis in a pig model. MATERIALS AND METHODS: Ameroid constrictors were surgically placed around six renal arteries in four pigs. After 30-36 days, all stenoses were documented by conventional x-ray aortograms. MR-guided renal angioplasty was attempted for three stenoses. For these pigs, MR angiography was performed with use of contrast-enhanced three-dimensional (3D) techniques. The authors visualized catheters by filling them with dilute 4% gadolinium and imaging with two-dimensional (2D) and 3D MR fast spoiled gradient recalled echo techniques. Under MR guidance, the authors advanced a selective catheter into the affected renal artery and crossed the stenosis with a nitinol guide wire. Angioplasty was performed with a balloon catheter filled with dilute gadolinium. Stenosis and luminal diameter measurements were compared before and after angioplasty. RESULTS: After ameroid constrictor placement, four significant stenoses, one mild stenosis, and one occlusion developed. Under MR guidance, the authors achieved technical success in performing three of three (100%) attempted dilations. After MR-guided angioplasty, the mean reduction in stenosis was 35% and the mean increase in luminal diameter was 1.6 mm. CONCLUSION: Use of MR guidance for the angioplasty of renal artery stenosis in pigs is feasible.

Angioplasty, Balloon↗
PubMed2000

Chiasmatic glioblastoma of childhood. A case report.

A 6-year-old girl presented with visual deterioration that had progressively worsened over 2 months. MR imaging revealed a sellar, para- and suprasellar lesion. Subtotal tumor resection was performed. Histopathological diagnosis was glioblastoma of the optic chiasma. Chiasmatic glioblastoma is rare in adults and extremely uncommon in children. Surgical resection implies a risk of severe endocrinologic and ophthalmologic complications.

Child↗
PubMed2000

Endovascular treatment of experimental canine aneurysms: feasibility with MR imaging guidance.

PURPOSE: To evaluate the feasibility of using magnetic resonance (MR) imaging to guide and monitor endovascular therapeutic procedures. MATERIALS AND METHODS: Endovascular therapeutic procedures were performed with MR imaging guidance in eight dogs by using a 1.5-T MR unit with echo-planar imaging capabilities. Carotid arterial aneurysms were surgically created in four dogs. The ability to depict, track, and position catheters, guide wires, and Guglielmi detachable coils was assessed. Catheters were first positioned with fluoroscopic guidance. Tracking and depiction were achieved with MR imaging by using commercially available catheters filled with a gadopentetate dimeglumine solution and a fast, two-dimensional, time-resolved, variable-rate k-space sampling technique. RESULTS: When either a catheter or the coaxial space between a catheter and a guide wire was filled with a solution of gadopentetate dimeglumine, catheter movement was always depicted. In the animals with aneurysms, it was possible to depict movement of a catheter into and out of the aneurysm. This was achieved by superimposing reconstructed images obtained during catheter movement onto a previously acquired MR angiogram ("road map"). Prototype Guglielmi detachable coils were successfully positioned and detached. Aneurysm obliteration was monitored with the acquisition of new road map images. CONCLUSION: The results demonstrate the feasibility of using MR imaging to guide endovascular therapeutic procedures.

Aneurysm↗
PubMed2000

Fronto-orbitonasal intradiploic meningioma in a child.

Intradiploic meningioma, which may be classified as a subgroup of intraosseous meningioma, is a rarely encountered disorder. To date, less than 10 cases have been reported. Here, we report a case of fronto-orbitonasal intradiploic meningioma. A 12-year-old female with exophthalmos and diplopia was operated on for a cranial intradiploic mass lesion. Histopathological evaluation of the specimen confirmed the diagnosis of intradiploic psammomatous meningioma. Her exophthalmos did not change, but the diplopia disappeared. This case is unique in that it is an extensive case of intradiploic meningioma of the orbital roof and frontal base in a child. Intradiploic meningiomas generally are of psammomatous type. Especially tumors adjacent to the orbita cause exophthalmos; cases located on the other side of the calvarium may not cause any symptom or sign other than headache or sometimes a mass on the scalp. Treatment, as with meningiomas located in the intracranial cavity, is total resection of the lesion.

Biopsy↗
PubMed2000

Power Doppler scanning in the diagnosis of carotid body tumors.

The aim of this work was to show contribution of power Doppler imaging in the diagnosis of the carotid body tumors. Six patients with a nontender mass beneath the mandibular angle were evaluated with gray scale and power Doppler sonography. Well-defined, solid, weakly hyperechoic masses were noted on gray scale sonography in the carotid bifurcation. Power Doppler sonography showed abundant flow, characterized as an intense blush, throughout the entire tumor in all patients. We believe that invasive and expensive diagnostic modalities are not necessary to evaluate carotid body tumors. Gray scale sonography and power Doppler imaging are sufficient for primary diagnosis of carotid body tumors.

Adult↗
PubMed2000

Utility of CT angiography and MR angiography for the follow-up of experimental aneurysms treated with stents or Guglielmi detachable coils.

BACKGROUND AND PURPOSE: Previous studies have depicted arterial and aneurysmal anatomy with three-dimensional time-of-flight (3D-TOF) MR angiography before and after treatment with Guglielmi detachable coils (GDCs) and with CT angiography before and after treatment with stents and stent-grafts. We investigated the ability of time-resolved contrast-enhanced 3D MR angiography (3D MR digital subtraction angiography [DSA]) to accurately depict the anatomy of experimental lateral aneurysms before and after treatment with GDCs and a variety of stents or stent-grafts, and compared these findings with 3D-TOF MR angiography without and with contrast enhancement and CT angiography. METHODS: Two nitinol stents, two nitinol-polytetrafluoroethylene (PTFE) stent-grafts, and two stainless steel stents were deployed in three dogs with experimental carotid aneurysms. In a fourth animal, one of three aneurysms was completely occluded with GDCs. The other two aneurysms were loosely packed to ensure persistence of some residual aneurysmal lumen. Cut-film angiography, CT angiography, 3D-TOF MR angiography without and with contrast enhancement, and 3D MR DSA were performed in all dogs before and 3 weeks after treatment. RESULTS: 3D MR DSA was superior to conventional 3D-TOF MR angiography without and with contrast enhancement in accurately depicting experimental lateral aneurysms and superior to CT angiography in depicting aneurysms treated by GDCs. 3D MR DSA and CT angiography were comparable in depicting vessels treated with nitinol stents and stent-grafts, whereas CT angiography was superior for showing vessels treated by stainless steel stents. CONCLUSION: We recommend further development and clinical evaluation of 3D MR DSA for imaging cerebral aneurysms before and after treatment with GDCs. 3D MR DSA or CT angiography may be useful for evaluating vessels containing nitinol stents or nitinol-PTFE stent-grafts, whereas CT angiography should be used for follow-up of vessels treated by stainless steel stents.

Animals↗