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Biomedical subjects

Ozkan Unal

Publications and source records attributed to Ozkan Unal.

15 recordsLinked to original sources

Radiological and clinical course of pneumonia in patients with avian influenza H5N1.

INTRODUCTION: We evaluated chest X-ray and clinical findings of patients with lower respiratory tract infection due to influenza H5N1 and presented the radiological findings and clinical course of the infection. MATERIALS AND METHODS: Between December 2005 and February 2006, eight hospitalized patients (median age 10, 5-15 years) with avian-flu were evaluated in this study. All patients were evaluated with chest X-ray and four of them with CT scan. Post mortem pathological characterization were also available for three of the patients. RESULTS: A rapidly progressive pneumonia with high mortality rate was observed especially for cases with late admission. The major radiologic abnormalities were extensive pneumonic infiltration with segmental and multifocal distribution, mostly located in lower zones of the lung. No pleural effusion and hilar lymphadenopathy was noted. CONCLUSION: Avian flu may be presented as rapidly progressive pneumonia. The chest radiography has an important role in diagnosis and should be obtained daily because of rapid change of the findings that may necessitate prompt action.

Adolescent↗

Intracranial lipomas--a clinical study.

OBJECTIVE: This study aimed to investigate the localization of the lipoma, as well as associated intracranial and extracranial lesions in 14 patients immediately following hospital admission. The pathological findings from the neurological examinations of these patients are also investigated. METHODS: Fourteen patients who were admitted to our clinic with a variety of symptoms and diagnosed with intracranial lipoma were included in the study. Problems presented upon admission, neurological findings, and other existing system abnormalities were evaluated. Localization of the lipomas and accompanying pathologies were determined by using computerised tomography and magnetic resonance imaging. RESULTS: The most frequent reasons for admission of patients with intracranial lipomas were: headache 7 (50%), trauma 3 (21.5%), epilepsy 3 (21.5%) and one with symptoms due to the local mass effect of tumor (7%). Although the pericallosal region is accepted as the region where lipomas commonly occur, this study found the most frequent occurrence in the quadrigeminal cistern. Intracranial lipoma calcification was only evident in 1 of the 14 patients. In addition, contrary to the expectations, intracranial and extracranial lesions accompanying lipomas were rare. All patients received systematic treatment. CONCLUSION: This study showed that intracranial lipomas are more frequent in the quadrigeminal region of the brain; most are asymptomatic, generally caught incidentally; and accompanying intracranial and extracranial pathologies are less common than expected.

Adolescent↗

Cranial MRI findings in children with protein energy malnutrition.

In this study, cranial magnetic resonance imaging (MRI) findings were investigated in children with moderate and severe protein energy malnutrition (PEM) to determine cerebral abnormalities in malnutrition in childhood. A total of 20 children aged 3 months to 36 months were included in the study. Thirteen (65%) children had severe malnutrition and seven (35%) children had moderate malnutrition. Fifteen (75%) children had abnormal MRI findings: all of them had cerebral atrophy, and 10 (75%) children had cerebral atrophy plus ventricular dilatation. None of the children had abnormality in the brain stem or cerebellum. The authors did not find statistically significant differences between the groups when comparing the MRI findings for degree of malnutrition, head circumference, iron deficiency anemia, and serum albumin levels. In conclusion, the findings showed that most (75%) children with moderate/severe PEM had abnormal MRI findings. Therefore, it is suggested that children with PEM should be evaluated for cerebral atrophy.

Adolescent↗

A comparison of effects of fluoroquinolones on fracture healing (an experimental study in rats).

BACKGROUND: The objective of the present study was to test and compare the effect of fluoroquinolones on fracture healing as assessed histopathologically. METHODS: A total of twenty five Wistar rats were arbitrarily assigned to five groups with five animals each. Bilateral closed femoral fracture was constructed manually in all groups. The first group did not receive any drug as control (C). The 2nd, 3rd, 4th, and the last group were treated with norfloxacin (N), ofloxacin (O), pefloxacin (P) and ciprofloxacin (Ci) respectively. Antibiotic administration was started on the 7th day after the fracture incident. All the treatments were discontinued twenty days after the incident all the rats were sacrificed , and the fracture calluses together with affected femurs were resected en bloc at the fourth week after fracture. RESULTS: Average healing grades of control group was higher than all the other antibiotic groups. Mean healing grades of control ( 5 ; n:8), ofloxacin (4.1; n:7), ciprofloxacin (3.9; n:8), norfloxacin (3.4 ; n:9) and pefloxacin groups (2.6 ; n:10) were recorded. Statistically significant differences between antibiotherapy groups ( excluding. norfloxacin) and the control group were detected. CONCLUSIONS: The current histopathological study has shown that all the studied fluoroquinolones retarded fracture healing in rats.

Animals↗

Brain abscess drainage by use of MR fluoroscopic guidance.

We describe herein the use of MR fluoroscopic guidance in the drainage of abscess cavities. We percutaneously drained 12 brain abscesses in 11 patients. A 0.3T open MR imaging system was used. Sixteen drainages were performed in 12 abscesses. Repeat drainage was needed in three recurrences and one residual lesion. No serious complications were seen. MR fluoroscopy-guided percutaneous brain abscess drainage in an open MR imaging system is feasible.

Adolescent↗

MRI demonstration of cervical spondylodiscitis and distal full-length bilateral paraspinal cold abscesses successfully treated by drug regimen only.

OBJECTIVE: Cold abscesses, although common in spinal tuberculosis, are usually localized to the level of infection, follow tissue planes, and may extend into the spinal canal at any level. They may cause symptoms resulting from neurovascular compression, hemorrhage, and direct mass effect. DESIGN AND PATIENTS: We present an unusual case of cervical tuberculous spondylodiscitis in a 25-year old man with a cold abscesses involving the retropharyngeal, mediastinal, and retroperitoneal areas bilaterally. The abscess tracked from the neck to the psoas muscles bilaterally. Following the diagnosis the patient received 9 months of antituberculous therapy. RESULTS: MRI showed resolution on medical treatment alone. CONCLUSIONS: Even in the presence of massive paravertebral cold abscesses medical treatment alone may well suffice for this common worldwide disorder. MRI is ideal for monitoring regression of massive abscesses in deep anatomical locations.

Abscess↗

When can lateral sinus thrombosis be treated conservatively?

OBJECTIVE: The purpose of this study was to review the clinical manifestations, radiologic findings, and treatment modalities of our cases with lateral sinus thrombosis (LST). METHOD: Documents of patients with LST, diagnosed and treated from 1995 to 2001 in our clinic, were examined retrospectively. RESULTS: Four patients with the diagnosis of LST were treated during this period. Among the clinical manifestations of these patients, the most frequently encountered symptoms were earache and headache, in addition to otorrhea and hearing loss. Four cases had chronic otitis media, three with cholesteatoma and one with polyps. Delta sign was detected in three cases on computed tomography, whereas a suspicious image was noted in one case. This case underwent magnetic resonance angiography, and the diagnosis of LST was established conclusively. In two cases, because pus was aspirated via lateral sinus punctures performed intraoperatively, these sinuses were explored and obliterated following radical mastoidectomy. Because pus was not aspirated via punctures of the other two cases, their sinuses were not explored. Only radical mastoidectomy was performed surgically for these cases. Dual antibiotics and low-dose anticoagulant therapy were given concomitantly to all cases in the postoperative period. Recanalizations of the nonobliterated lateral sinuses were detected with Doppler ultrasonography of internal jugular vena at 15 days and 3 months after the termination of postoperative treatment. CONCLUSION: Clinical findings and radiologic techniques play an important role in the diagnosis of LST. In the treatment, if pus is found in the lateral sinuses, it is necessary to explore, clean, and obliterate them, whereas in cases in which the aspirates do not contain pus, mastoidectomy is sufficient. On the other hand, a low dose of anticoagulant can be used together with antibiotics in the nonobliterated lateral sinuses.

Adolescent↗

[Posterior cerebral artery involvement in Moyamoya disease].

A ten-year-old girl arrived at the hospital with progressive loss of muscular strength on the right side of the body. The cranial MRI showed left fronto-parietal ischemia and atrophic changes in the left parietal lobe. Brain MRI initially disclosed a narrow left MCA. MRA and digital angiography confirmed the diagnosis of brain obstructive chronic vascular disease (Moyamoya). Angiography results demonstrated occlusion of the left MCA and right posterior cerebral artery, with Moyamoya vessels. It therefore appears that in some patients Moyamoya disease is accompanied by posterior circulation involvement.

Angiography, Digital Subtraction↗

MR fluoroscopy-guided transthoracic fine-needle aspiration biopsy: feasibility.

The purpose of this study was to evaluate the feasibility of using an open-configuration magnetic resonance (MR) imaging system with MR fluoroscopic guidance to perform percutaneous transthoracic fine-needle aspiration biopsy in patients with lung masses. Percutaneous transthoracic aspiration biopsies were performed with MR fluoroscopic guidance in 14 patients. The masses were 2-7 cm in diameter (mean, 4.1 cm). The needle was positioned by using a free-hand technique with MR fluoroscopic guidance. The needle tip reached the target lesion, and biopsy was performed. Analysis of the biopsy specimens facilitated a specific diagnosis in all patients. Pneumothorax was noted in two patients (14%) with chronic obstructive pulmonary disease. Study results showed that the described MR fluoroscopy-guided transthoracic biopsy technique can be used safely and successfully for lung masses. MR fluoroscopy can be used to reach the target lesion easily and accurately.

Adult↗

Hemangioma with phleboliths in the sublingual gland: as a cause of submental opacity.

Hemangiomas are the most common lesions of the major salivary glands during infancy and early childhood. Changes in blood flow dynamic within hemangioma results in thrombus and phleboliths. There have been a number of reports of hemangiomas with phleboliths in parotid and submandibular glands. We present the first case of a hemangioma with multiple phleboliths in the subligual gland as a cause of submental opacity, and discussed the diagnosis of radiopaque masses in the sublingual and submental regions.

Adolescent↗

A morphometric study on the humerus for intramedullary fixation.

In recent years, the popularity of intramedullary humeral nailing is on the rise in spite of its handicaps. There are many problems in intramedullary humeral stabilization because of the anatomic structure of the bone. We performed various methods and measurements to determine shape, length and diameter and curvature of the medullary canal of the humerus in 57 human dry cadaver bones. Anterior angulation with an average of 21 cm apart from greater tubercle was found at 1/3 distal part. Mean degree of angulation was 9 degrees (max: 15, minutes: 5, S.D.: 2.84). Humerus bones with septal aperture (supratrochlear foramen) at the fossa coronoidea were observed to have very narrow medullary canal. The best point for nail insertion was found to be an area on the line from greater tubercle anteromedially to caput humeri. This study revealed that carefully evaluated structure of humeral medullary canal and various congenital constructions such as septal aperture, and correct selection of a nail with proper length and diameter are essential for successful nailing.

Adult↗

Seasonal and environmental temperature variation in the occurrence of ischemic strokes and intracerebral hemorrhages in a Turkish adult population.

Seasonal and weather influence on the incidence of cerebrovascular disease has been reported previously. The aim of this retrospective study was to determine whether the time of onset of ischemic strokes (IS) and intracerebral hemorrhages (ICH) were associated with the environmental temperature or the time, as a month or season, in our region. We analyzed the monthly and seasonal incidence of stroke between 1997 and 2001. Four hundred and fifty-one cases were admitted to our clinic (IS; n = 288 and ICH; n = 163), and aged from 16 to 94 years. The study was carried out in province of Van in eastern Turkey. The present study demonstrated a peak occurrence of IS in August (n = 41). For ICH, we observed a peak occurrence in July (n = 23). The highest number of IS occurred in summer (n = 108), the most moderate amount in autumn (n = 81), and the least in spring (n = 38). The hemorrhagic events were highest in summer (n = 58), most moderate in winter (n = 61), and lowest in spring (n = 31) and autumn (n = 32). There was a significantly greater incidence of IS and ICH during the summer than any other season in the province of Van, Turkey. This may reflect the role of weather temperature in the development of stroke and allow us to take preventive measures.

Adolescent↗

Hepatic cavernous hemangiomas: patterns of contrast enhancement on MR fluoroscopy imaging.

PURPOSE: The purpose of this study was to assess the patterns of contrast enhancement of hepatic hemangiomas on gadolinium-enhanced MR fluoroscopy imaging prospectively. METHOD: Investigation was performed on a 0.3-T open MR unit. Gadolinium-enhanced MR fluoroscopy images were obtained in 24 patients with 28 hepatic hemangiomas. Each MR fluoroscopy image was obtained in 2 s and MR fluoroscopy lasted for 10-25 min for each investigation. RESULTS: Three patterns of contrast enhancement were observed in 24 patients on MR fluoroscopy images. Four small lesions were not detected on MR fluoroscopy images. Uniform enhancement was seen in nine lesions (29%), peripheral nodular enhancement progressing centripetally to uniform enhancement was seen in nine lesions (29%), and peripheral nodular enhancement with persistent central hypointensity was seen in six lesions (22%). CONCLUSION: Enhanced MR fluoroscopy technique could obtain dynamic images of hepatic hemangiomas. It can be suggested as a useful technique for the showing of enhancement of hepatic hemangiomas, keeping in mind its low sensitivity in the diagnosis of small hemangiomas.

Adult↗

Laryngeal amyloidosis: a rare cause of laryngocele.

Laryngocele may be defined as an abnormal dilatation of the saccule of the ventricle and its pathogenesis is uncertain. We report a laryngocele caused by amyloidosis localized to larynx in a 60-year-old male patient. We would like to mention that amyloidosis should be evaluated in the etiology of patients diagnosed as having a laryngocele.

Amyloidosis↗

Left hemisphere and male sex dominance of cerebral hemiatrophy (Dyke-Davidoff-Masson Syndrome).

Although radiological findings of cerebral hemiatrophy (Dyke-Davidoff-Masson Syndrome) are well known, there is no systematic study about the gender and the affected side in this syndrome. Brain images in 26 patients (mean aged 11) with cerebral hemiatrophy were retrospectively reviewed. Nineteen patients (73.5%) were male and seven patients (26.5%) were female. Left hemisphere involvement was seen in 18 patients (69.2%) and right hemisphere involvement was seen in eight patients (30.8%). We conclude that male gender and left side involvement are frequent in cerebral hemiatrophy disease.

Adolescent↗