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Biomedical subjects

S Akpek

Publications and source records attributed to S Akpek.

At least 19 recordsLinked to original sources
PubMed2006

Central nervous system aspergillosis: magnetic resonance imaging, diffusion-weighted imaging, and magnetic resonance spectroscopy features.

Aspergillus infection is invasive in nature in the immunosuppressed population and disseminates throughout the body, with the brain being a common site. Conventional magnetic resonance imaging (MRI) combined with diffusion-weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) play a life-saving role in the early diagnosis and treatment monitoring of this potentially fatal infection. We present MRI, DWI, and MRS findings of a case of central nervous system aspergillosis with treatment follow-up.

Adult↗
PubMed2006

Persistent notochordal canal mimicking compression fracture: a case report.

A persistent notochordal canal is a rare anomaly that is generally discovered by chance. The radiographic appearance of this entity is characteristic and usually does not require further investigation. However, in some cases plain films may fail to depict this appearance, and computed tomography or magnetic resonance imaging (MRI) is required for final diagnosis. We report the MRI findings of a young woman with persistent notochordal canal who, based on plain radiographs, had first been misdiagnosed as having a compression fracture.

Adult↗
PubMed2006

Corpus callosum hematoma secondary to isolated inferior sagittal sinus thrombosis.

A 45-year-old female was admitted with headache and vomiting. Cranial computed tomography (CT) demonstrated a callosal hematoma. Magnetic resonance imaging (MRI) showed no venous flow and thrombus replacing the inferior sagittal sinus (ISS) lumen. Under appropriate medical treatment and close follow-up she recovered quickly and, after 2 years, was doing well with corpus callosum infarcts. Isolated inferior sagittal sinus thrombosis is an extremely rare condition with only one previously reported case in the literature. Although it is very rare, isolated inferior sagittal sinus thrombosis should be considered in the differential diagnosis of non-traumatic corpus callosum hematoma.

Corpus Callosum↗
PubMed2005

Endovascular treatment of obstructive iliac artery dissections.

PURPOSE: To report our results from a study of the endovascular treatment of flow restricting chronic atherosclerotic or catheter-induced segmental iliac artery dissections with bare stents. MATERIAL AND METHODS: Thirty symptomatic patients with 32 lesions, including chronic atherosclerotic (n = 21) and catheter-induced (n = 11) segmental arterial dissections, were treated with primary stenting. The common iliac artery was involved in 19 lesions and the external iliac artery in the remaining 13. Two patients had two lesions in the same vessel. Technical success was defined as restoration of the smooth contoured luminal patency with no more than 20% residual stenosis in diameter in atherosclerotic dissections associated with plaque formation or total obliteration of the false lumen in catheter-induced dissections. Complete relief of, or marked improvements in, presenting symptoms, or at least single category improvement, was assessed for clinical success. RESULTS: Technical success rate was 100%. No procedure-related complications such as distal emboli or early occlusions were observed. Complete symptom relief was achieved in all patients with catheter-induced dissection and in all but three cases with chronic spontaneous atherosclerotic dissection. In two cases, occlusion of the stents occurred during the follow-up period. Clinical and radiological mean follow-up for 24 months (range 3-55) revealed patency of all other stented segments. Cumulative primary patency rate was 97% over 12 months and 90% over 24 months. CONCLUSION: Endovascular treatment of chronic atherosclerotic and catheter-induced short obstructive iliac arterial dissections with bare stents is safe and effective. Patency of the diseased arterial segment with a smooth lumen can be sustained for an extensive period.

Adult↗
PubMed2003

Intra-arterial simultaneous administration of anandamide attenuates endothelin-1 induced vasospasm in rabbit basilar arteries.

BACKGROUND: Anandamide induces not only endothelium-dependent vasodilatation through cannabinoid receptors but also some endothelium- independent vasodilator effect by calcitonin gene-related peptide release through vanilloid receptors. Endothelin-1, a powerful vasoconstrictive peptide derived from endothelial cells, has been shown to be converted to its active form after cleaving by a vascular matrix metalloproteinase which is also involved in inactivation of calcitonin gene-related peptide. The purpose of this study was to investigate whether anandamide inhibits the acute vascular and morphological effects of Endothelin-1 applied intra-arterially on rabbit basilar arteries. METHOD: Fifteen albino rabbits were anaesthetised and underwent placement of a vertebral artery catheter for angiography of the basilar artery. Animals were divided, arbitrarily, into animals in which there was either intra-arterial injection of saline (Group I, n=5), Endothelin-1 (Group II, n=5) and Endothelin-1 and anandamide (Group III, n=5). The diameter of the basilar artery between the pre and post injection angiograms was measured in each of the three groups and transmission electron microscopic investigations on basilar arteries were performed. FINDINGS: Angiographic studies showed that simultaneous administration of anandamide significantly attenuated Endothelin-1 induced vasoconstriction. Furthermore, it was demonstrated that anandamide reversed the morphological changes induced by Endothelin-1 on the vessel wall. INTERPRETATION: These results indicated that anandamide overcomes the angiographic and morphological effects of intrarterially administered ET-1 induced vasospasm in rabbit basilar arteries probably by induction of CGRP related vasodilatation through vanilloid receptors and prevents the acute ET-1 induced ultrastructural vessel wall damage.

Animals↗
PubMed2001

Renal infarct: contrast-enhanced power Doppler sonographic findings.

Power Doppler sonography (PDUS) is a promising technique for the diagnosis of renal infarcts. PDUS's efficacy may be enhanced by using sonographic contrast agents. We evaluated 3 cases of renal infarction using PDUS and the sonographic contrast agent Levovist. The findings were compared with those of other imaging modalities, such as scintigraphy, CT, and angiography. In case 1, PDUS showed a patent interlobar artery only in the lower part of the right kidney and no other perfusion of the right renal parenchyma. Contrast-enhanced PDUS showed patchy areas of preserved perfusion in the lower and middle-upper anterior portions of the kidney. In case 2, PDUS showed diffuse and patchy perfusion defects in the anterolateral portion of the right kidney. On contrast-enhanced PDUS, no signal enhancement was seen in these areas, but the perfusion defects were better delineated. In case 3, PDUS showed no perfusion in the upper pole of the kidney; the nonperfused area extended to the posterior upper portion of the kidney but could not be distinguished from normal tissue. After injection of the contrast agent, there was no enhancement of the posterior extension of the upper pole infarct, but Doppler signals from the surrounding normal parenchyma were enhanced, so the area was more clearly demarcated. The administration of the contrast agent facilitated the visualization of the infarcts in all 3 cases.

Angiography↗
PubMed2001

Evaluation of osteoporosis in thalassemia by quantitative computed tomography: is it reliable?

This study was conducted to quantify the degree of osteoporosis in thalassemic patients by single energy quantitative computed tomography (SEQCT) and to test the reliability of this method. On 38 thalassemic patients with osteoporosis and 38 normal control subjects, bone mineral density (BMD) measurements were done by SEQCT. BMD and standard deviation (SD) of the x-ray attenuation numbers of pixels within region of interest (ROI) of the measurement areas were compared between two groups. Mean BMD values for thalassemic patients and control group were 173.4 and 158.2 mg/cm3, respectively. Mean BMD value for thalassemic patient group was significantly higher. Mean SD values of ROI for control group and thalassemic patients were 41.4 and 71.1, respectively. The difference between the SD values was also statistically significant. Positive correlation was noted between SD values and patients' ages in the thalassemic group. Results of SEQCT method may not reflect the clinical and conventional radiographic findings of osteoporosis seen in thalassemic patient group and should be used cautiously. Other methods of BMD measurement, such as photon absorbsiometry and x-ray absorbsiometry, should also be investigated for their accuracy in this patient group.

Adolescent↗
PubMed1998

MR imaging and MR angiography in popliteal artery entrapment syndrome.

Popliteal artery entrapment (PAE) syndrome is an uncommon congenital anomaly seen in young adults causing ischemic symptoms in the lower extremities. It is the result of various types of anomalous relationships between the popliteal artery and the neighboring muscular structures. The purpose of this study was to define the role of MR imaging combined with MR angiography in the diagnosis of PAE cases. Four cases with segmental occlusion and medial displacement of popliteal artery in digital subtraction angiography (DSA) examinations were diagnosed as PAE syndrome by MR imaging and MR angiography. The DSA and MRA images are compared. All of the cases showed various degrees of abnormal intercondylar insertion of the medial head of the gastrocnemius muscle. The MR images showed detailed anatomy of the region revealing the cause of the arterial entrapment. Subclassification of the cases were done and fat tissue filling the normal localization of the muscle was evaluated. The DSA and MRA images demonstrated the length and localization of the occluded segment and collateral vascular developments equally. It is concluded that angiographic evaluation alone in PAE syndrome might result in overlooking the underlying cause of the arterial occlusion, which in turn leads to unsuccessful therapy procedures such as balloon angioplasty. Magnetic resonance imaging combined with MR angiography demonstrates both the vascular anatomy and the variations in the muscular structures in the popliteal fossa successfully, and this combination seems to be the most effective way of evaluating young adults with ischemic symptoms suggesting PAE syndrome.

Adult↗
PubMed1996

Treatment of recurrent nasolacrimal duct obstructions with balloon-expandable metallic stents: results of early experience.

PURPOSE: To evaluate the efficacy of Palmaz balloon-expandable metallic stents for the maintenance of luminal patency in the treatment of recurrent nasolacrimal duct, obstructions after failed transluminal balloon dilatation. METHODS: Metallic stents were implanted in the nasolacrimal duct of four patients with recurrent epiphora. All the patients had already undergone transluminal balloon dilatation of the nasolacrimal duct with no or only temporary improvement. In two eyes, 9.5-mm-long Palmaz stents were used; in the other two eyes, 20-mm-long articulated-design Palmaz stents were placed under digital fluoroscopic monitoring. In each case, the upper tip protruded slightly into the lacrimal sac and the lower end was positioned inside the nasolacrimal duct. RESULTS: The stents were placed accurately in all cases, and no complications were observed. After stent placement, all patients had complete resolution of epiphora. During the follow-up period of 10 months, although complete obstruction did not occur in any case, complete resolution of epiphora was maintained only in one of four eyes. In two eyes, improvement was remarkable. In one eye with partial improvement, intrastent balloon dilatation was performed. CONCLUSION: Treatment of recurrent nasolacrimal duct obstructions with balloon-expandable metallic stents is a noninvasive, efficient, and safe outpatient procedure that may be an alternative to surgery as a means for managing epiphora.

Adult↗
PubMed1995

Computed tomographic evaluation of surgically significant vascular variations related with the temporal bone.

Variations of the vascular structures related with the temporal bone may cause important problems in diagnosis, treatment planning and surgery. High resolution computed tomography (CT) scans of 700 temporal bones of 350 patients were retrospectively examined for the incidence of dehiscent jugular bulb, high jugular bulb, diverticulum of jugular bulb, anteriorly located sigmoid sinus and dehiscent internal carotid artery. Dehiscent jugular bulb was seen in 27 (3.9%), high jugular bulb was seen in 142 (20.3%), jugular bulb diverticulum was seen in 55 cases (7.9%). The average distance between external acoustic canal and sigmoid sinus was found to be 13.3 mm and in 12.4% of the cases this distance was < 10 mm. Of 700 temporal bones, 10 (1.4%) showed dehiscent carotid canal. To aid diagnosis, treatment planning and surgery, CT scanning is currently a very reliable tool in determining these conditions. Special attention should be paid to the position of the vascular structures in the preoperative temporal bone CT scans.

Carotid Artery, Internal↗
PubMed1995

Cost-effectiveness of computed tomography in the evaluation of patients with headache.

We report a retrospective study to determine the cost-effectiveness of cranial computed tomography in patients with headache without neurological finding. Five hundred ninety-two neurologically normal patients were examined between 1990 and 1993 for the complaint of headache. Examination results were reevaluated from written report and image archive systems. Results were divided into three groups. In group P0, we included patients with normal cranial computed tomography findings. In group P1, patients showed some minor pathologies like ischemic or atrophic changes. These findings neither explained the reason for headache nor changed the clinical or therapeutic approach. The third group (P2) was to include patients with gross intracranial pathology like space-occupying lesions or bleeding. Five hundred forty-six of 592 patients were in the P0 group (92%), and the remaining 46 patients were in the P1 group (8%). No patient was found to have serious intracranial pathology detected by computed tomography. Cost of detection of a case with significant pathology was calculated. It is our opinion that computed tomography is an unrewarding technique in the evaluation of patients with chronic headache whose neurological examinations are normal.

Adolescent↗
PubMed1995

Transluminal balloon dilatation of the lacrimal drainage system for the treatment of epiphora.

OBJECTIVE: The purpose of this study was to evaluate the efficacy of transluminal balloon dilatation done under digital subtraction fluoroscopic monitoring in the treatment of incomplete and complete obstruction of the lacrimal drainage system (LDS) in patients with epiphora. SUBJECTS AND METHODS: Transluminal balloon dilatation of the LDS was attempted in 19 eyes with incomplete and 61 eyes with complete obstruction, including six cases of anastomotic obstruction after failed dacryocystorhinostomy. A soft plastic arterial sheath over a stump-guiding metal probe was introduced through the superior canaliculus into the nasolacrimal apparatus. A 0.016-in. specially angled steerable guidewire was introduced through the sheath and across the site of obstruction, advanced into the nasal cavity, and brought forward through the external nare. A low-profile angioplasty balloon dilatation catheter was passed retrograde over the guidewire through the nasal aperture to the site of obstruction and inflated for dilatation. RESULTS: Technical success was achieved in all 19 eyes with incomplete obstruction and in 46 (75%) of 61 eyes with complete obstruction. Initial success was achieved in all 19 eyes with incomplete obstruction and in 36 (59%) of 61 eyes with complete obstruction. In a follow-up period of 6-18 months (mean, 13 months), reobstruction occurred in none of the eyes with incomplete and in two eyes with complete obstruction. CONCLUSION: Our experience shows that transluminal balloon dilatation is an effective treatment for incomplete obstruction of the LDS. The procedure has a high failure and recurrence rate when the obstruction is complete.

Adult↗
PubMedDate not supplied

Bilateral perirenal urinoma with mediastinal extension.

We report a unique case of adult-type polycystic kidney disease (PKD) having bilateral chronic perirenal fluid collection with unusual extension. Fluid collections at both sides are connected across the midline anterior to the abdominal aorta and inferior vena cava. In addition, supradiaphragmatic extension through aortic hiatus was well demonstrated by computed tomography (CT). Antomical boundaries and relations between two perirenal spaces are evaluated.

Adult↗
PubMedDate not supplied

High-flow arterioportal fistula: treatment with detachable balloon occlusion.

Transarterial embolization is one of the treatment choices for symptomatic hepatic arterioportal fistula that has low mortality and morbidity. Proper selection of the technique and embolic material is very important for the success of the procedure. We present a case with high-flow arterioportal fistula treated with transarterial embolization using detachable balloons.

Adolescent↗