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Biomedical subjects

S Işik

Publications and source records attributed to S Işik.

At least 19 recordsLinked to original sources
PubMed2004

The role of qualitative and quantitative MRI assessment of multiple sclerosis lesions according to their in evaluating the efficacy of intravenous immunoglobulin G.

We evaluation of the role of determining the distribution of brain-stem, cerebellar and cerebral lesions in number and volume by MRI in determining the efficiency of treatment of multiple sclerosis (MS). We studied 24 patients diagnosed as having relapsing and remitting MS, of whom 12 received intravenous immunoglobulin G; a control group of 12 were given placebo. In a double-blind study, MRI was obtained initially and at 3, 6 and 9 months, and interpreted without knowledge of clinical findings, laboratory tests or treatment. The lesions were classified according to their distribution and evaluated qualitatively and quantitatively. Each patient was also examined clinically and scored according to the expanded disability status scale (EDSS) following every MRI examination. All patients in the treatment group showed significant improvement. The lesions decreased in both in size and number in all sites. In the control group lesions increased both in number and size in all sites, but only the increase between 3()and 6 months was statistically significant. In both groups, significant apparent changes were detected in the cerebellum and brain stem. Volumetric evaluation was found to be more helpful than qualitative assessment.

Adult↗
PubMed2001

Differential diagnosis of solid breast lesions: contribution of Doppler studies to mammography and gray scale imaging.

OBJECTIVE: To assess the role of Doppler sonography when used in conjunction with mammography and gray scale sonography in differentiating solid breast lesions and to find out whether lesion size is a limiting factor for Doppler evaluation. METHODS: One hundred twelve lesions (70 malignant and 42 benign) detected with mammography and sonography were prospectively examined with color, power, and pulsed Doppler sonography. Vascularity was analyzed morphologically (vessel location, form, and color tone) and semiquantitatively (by spectral indices) to determine the valuable diagnostic flow characteristics. The lesions were classified by 2 observers as benign or malignant on the basis of each diagnostic technique (namely, a combination of mammography and gray scale sonography, presence or absence of blood flow, morphologic flow analysis, and spectral flow analysis). The results were compared with the histologic diagnosis in 105 lesions and with the clinical and radiologic diagnosis after at least 2 years of follow-up in 7 lesions. RESULTS: The sensitivity and specificity of the mammography-gray scale sonography combination were 98.6% and 76.2%, respectively. Neither morphologic nor spectral Doppler analysis proved to be successful on its own, however, information obtained from investigated morphologic and spectral flow features increased the specificity of mammography and gray scale sonography for lesions 10 mm and smaller (from 88.9% to 100%) and those larger than 10 mm (from 70% to 96.6%). CONCLUSIONS: Our data show that Doppler sonography is a beneficial adjunct to mammography and gray scale sonography for solid breast lesions 10 mm and smaller and those larger than 10 mm.

Age Factors↗
PubMed2000

[Cranial gunshot injuries and treatment approaches].

21 patients with gunshot wounds were retrospectively evaluated. They were 19 male and 2 female, age range was 9-24. All of the patients underwent a plain x-ray and computed tomography evaluation. 9 patients had intracerebral hematoma, 4 had subdural hematoma, 1 had epidural hematoma and 1 had intraventricular hematoma. 9 patients were observed to have bullet in the cranium. All the patients with glasgow coma scale 3-5 at the admittance died. 15 patients underwent surgical treatment. 3 patients had cerebrospinal fluid fistula postoperatively and underwent reoperation. Extensivity of the lacerated brain, localization of the lesion and the glasgow coma scale at the admittance affect the outcome in gunshot wounds.

Adolescent↗
PubMed1999

Mammographic and ultrasonographic study of changes in the breast related to HRT.

OBJECTIVE: To determine the frequency and degree of change in mammographic densities, and new solid or cystic formations in the breast tissue, during different types of hormone replacement therapy (HRT). SUBJECTS AND METHODS: This prospective study included 118 postmenopausal women, 88 under hormone replacement therapy and 30 control subjects. Four types of hormone therapies were compared for their effects on mammograms and sonograms obtained before and during therapy. Mean duration of follow-up was 16.92 +/- 7.65 months in the treated and 21.56 +/- 11.49 months in the control group. Density changes on mammograms were evaluated subjectively. RESULTS: Density increase was recorded in 34% of the patients receiving HRT and in none of the control subjects (P < 0.01). Highest frequency of density increase was found in the groups treated with estrogen plus cyproterone acetate (46%) and with estrogen plus medroxyprogesterone acetate (43%). Frequencies of density increase in the tibolone users, and in estrogen alone users were 28% and 18%, respectively. Degree of density increase was evidently minimal in tibolone users, compared to others. New cysts occurred in six patients receiving HRT (6%) which was not statistically different from the control group (16%) (P > 0.05). New cyst formation was not related to the degree of density increase. New solid mass formation was not observed. CONCLUSION: Our findings show that mammographic density changes related to HRT are dependent on the selected hormone regimen. Formations of breast cysts or solid lesions do not seem to be related to HRT.

Adult↗
PubMed1999

Prevention of restrictive adhesions in primary tendon repair by HA-membrane: experimental research in chickens.

Hyaluronic acid (HA) is a glycosaminoglycan polymer that has been found to have some beneficial effects on the prevention of adhesions in primary tendon repairs. The need for slow elimination preparations of HA has been identified. We have combined HA and carboxymethylcellulose (CMC) in order to get a slow elimination preparation of HA and studied its possible effect on primary tendon healing. A gel form of NaHe (19 mg/ml; mw: 6.5 x 10(6)) was mixed with Na CMC (degree of substitution: 0.8) under sterile conditions. A jelly like mixture was thinned and HA membrane was achieved after drying in the refrigerator. The right legs of Leghorn chickens (n = 30) were prepared under IM ketamine anaesthesia by making partial cuts (75%) of flexor profundus tendons at zone II in the second, third and fourth toes, and repaired using a modified Kessler type suture (5/0 nylon). HA-membranes were applied around the repair sites in the third toes while 0.5 ml of hyaluronic acid and saline were poured on to the repair sites in the second and fourth toes, respectively. Skin incisions were closed and the legs were splinted for 15 days. Biomechanical and histological controls were made at the first, second and third postoperative months. No wound dehiscence or exposure of repaired tendons was observed on the operated toes. After collection of samples by amputation at MP levels, two-phalanx free biomechanical assessment was done. The calculated peaks of differential joint motion were very similar to the corresponding non-operated contralateral toes in the HA-membrane treated group. The toe tip displacement curves also resembled the non-operated ones in this group. HA membrane was detected as blue particles on specimens taken at the 30th day following surgery. There were few adhesions in this group microscopically at the third month. Adhesions were similar in the HA treated group while dense adhesions were seen in the saline treated group. These findings suggest that HA membrane acting as a physicochemical barrier can prevent restrictive adhesions in primary tendon repairs.

Animals↗
PubMed1999

Repair of high-energy-induced tissue defects of the dorsal foot by free muscle transfer and skin graft.

Various alternative methods have been used for repair of extensive dorsal foot defects due to high-energy-induced injuries. The authors reconstructed such defects with free muscle transfers and skin grafts in 9 male patients (average age, 21.7 years) between the years 1995 and 1998. Patients (right foot, 5; left foot, 4) presented with injuries due to military rifle gunshot (N = 4), mine explosion (N = 2), high-voltage electricity (N = 2), and traffic accident (N = 1). The patient injured in a traffic accident was treated with skin grafting only, and experienced osteomyelitis and skin breakdown. The other 8 patients were injured acutely and were hospitalized within 3 weeks of injury. After serial debridement of necrotic tissues, surgery was performed at an average of 6 weeks postinjury. Metatarsal bone defects of 5 cm in 3 patients were repaired by iliac (N = 2) and fibular (N = 1) bone grafts. Free muscle latissimus dorsi (N = 4) and rectus abdominis (N = 5) flaps were transferred microsurgically. The transferred muscle flaps were covered with split-thickness skin grafts. Mean operation duration was 5 hours 12 minutes. All flaps survived. The average area of soft-tissue defect repaired was 93 cm2 (range, 36-231 cm2). Average follow-up was 25 months. No symptoms of osteomyelitis and skin breakdown were encountered in the 8 acutely injured patients. Monofilament sensory tests revealed diminished protective sensation in 5 patients and absence of protective sensation in 4 patients. Partial resorption of bone grafts occurred in 2 patients. Thinning of the flaps was performed by tangential excision in 2 patients whose muscle flaps did not diminish in thickness. All patients were able to wear normal shoes. The authors suggest the use of free muscle transfer in reconstructing extensive soft-tissue defects of the dorsal foot.

Accidents, Traffic↗
PubMed1999

Role of endosonography in the evaluation of gastric malignancies.

The aims of this study were to stage gastric malignancies and differentiate between carcinomas and lymphomas. Twenty-two patients were evaluated with endosonography. Tumoral infiltration depth (T stage) and presence of metastatic lymph nodes (N stage) were investigated. Five percent of the cases were staged as T2, 36% as T3, and 59% as T4. According to the endosonographic examination, 14% were NO, 68% were N1, and 18% were N2 malignancies. When compared with results of surgery and histopathologic examination, the accuracy was 82% for both T and N stages. It can be concluded that endosonography is a valuable imaging modality for the local staging of gastric malignancies. Early stage lymphomas can be differentiated from carcinomas, but in advanced stages both have similar appearance.

Adult↗
PubMed1998

Thiophene-2-carbaldehyde N-(2,4-dinitrophenyl)-N-methylhydrazone.

Molecules of the title compound, C12H10N4O4S, are linked through intermolecular hydrogen bonds to form a dimeric structure. The crystal structure of the dimer is stabilized by two intermolecular hydrogen bonds of the C-H...O type. The C...O intermolecular contact distance is 3.339(3) A, and the C=N and N-N distances are 1.279(2) and 1.371(7) A, respectively. One O atom of the 2-nitro group is disordered over two sites.

Anti-HIV Agents↗
PubMed1998

Clinical significance of acute traumatic intracranial pneumocephalus.

Among 1142 patients with head injuries hospitalized in the Neurosurgery Department of Gazi University Medical School during the period between 1979 and 1992, 583 had initial CT scans. A retrospective analysis of these initial CT images revealed intracranial air on admission in only 21 cases. These were classified as acute traumatic intracranial pneumocephalus: a potentially serious complication of head injury. CT scans were re-evaluated so as to reveal whether air was situated in the epidural, subdural, or subarachnoid spaces or intracerebrally; whether associated space-occupying lesions were present and whether the air bubbles were single or multiple. Clinical data such as the presence of persistent rhinorrhea and/or otorrhea, tension pneumocephalus, severity and type of trauma, and outcome were were also assessed to determine the significance of this rare finding.

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↗
PubMed1998

Saving the zone of stasis in burns with recombinant tissue-type plasminogen activator (r-tPA): an experimental study in rats.

Hypercoagulability 2-3 h following scald injury and vessel thrombosis are well-known complications of burn injury. The present study was designed to determine the effect of recombinant tissue-type plasminogen activator (r-tPA) on vessels thrombosis in zones of stasis postburn. Twenty rats were assigned to experimental and control groups (N:10). After shaving the backs, a 'comb burn' was given bilaterally on the back of the rats 0.5 cm lateral and parallel to the midline by using a brass probe consisting of four rows (10 x 20 mm) and three interspaces (5 x 20 mm). Standardized full-thickness burns of the experimental group were treated with r-tPA via femoral veins 2 h after the burn, while the control group rats were infused the same volume of saline. Interspaces between the rows and vertical space area were evaluated as zone of stasis. The skin blood flow measurements of interspaces revealed a decreased level immediately and 2 h after the burn injury, averaging 11.3 and 9.8 perfusion units, respectively. On day 7, blood flow measurements of interspace and vertical space areas significantly differed between the groups, averaging 11.9 PU in the experimental and 1.8 PU in the control groups (P<0.05). To evaluate perfusion, each rat received 3 mCi of technetium-99m methoxyisobutylisonitrile on the first or seventh day postburn. After 30 min, the entire back skins including the panniculus carnosus muscle layer were dissected away. Gamma camera images revealed that in the experimental group the interspace areas took up 60-90 per cent more radioactivity than the burned areas while in the control group 20-50 per cent more activity was taken up by the interspace area when compared to burned areas. Autoradiography gave the exact borders of the necrotic and survived tissues. The percentage of live interspace and vertical space areas in the experimental group was 87.8 per cent on day 7, while it was 31.8 per cent in the control group (P<0.05). Dry/wet ratios did not reveal any significant difference at 24 h postburn. These results confirm that treatment with this selective fibrinolytic agent (r-tPA) after burn injury would have some benefits on saving the zone of stasis in burns.

Animals↗
PubMed1998

Normal liver, spleen, and kidney dimensions in neonates, infants, and children: evaluation with sonography.

OBJECTIVE: The objective of this study was to determine the normal range of dimensions for the liver, spleen, and kidney in healthy neonates, infants, and children. SUBJECTS AND METHODS: This prospective study involved 307 pediatric subjects (169 girls and 138 boys) with normal physical or sonographic findings who were examined because of problems unrelated to the measured organs. The subjects were 5 days to 16 years old. All measured organs were sonographically normal. At least two dimensions were obtained for each liver, spleen, and kidney. Relationships of the dimensions of these organs with sex, age, body weight, height, and body surface area were investigated. Suggested limits of normal dimensions were defined. RESULTS: Dimensions of the measured organs were not statistically different in boys and girls. Longitudinal dimensions of all three organs showed the best correlation with age, body weight, height, and body surface area. Height showed the strongest correlation of all. This correlation was a polynomial correlation. CONCLUSION: Determination of pathologic changes in size of the liver, spleen, and kidney necessitates knowing the normal range of dimensions for these organs in healthy neonates, infants, and children. Presented data are applicable in daily routine sonography. Body height should be considered the best criteria to correlate with longitudinal dimensions of these organs.

Adolescent↗
PubMed1997

MRI in neuro-Behçet's disease.

Our purpose was to characterise specific MRI findings and to determine their value in neuro-Behçet's disease. We examined 17 patients (14 men, 3 women) with neuro-Behçet's disease using T1- and T2-weighted spin-echo images and contrast-enhanced images at 0.5 T. There were 13 patients (76.5%) who had single or multiple lesions. Most of these were in the basal ganglia, brain stem or deep white matter region, giving high signal on T2-weighted images and isointense or low signal on T1-weighted images. In 3 cases (17.6%) there was linear high signal along the posterior limb of the internal capsule on T2-weighted images. This was considered as a potential differentiating feature of neuro-Behçet's disease. Contrast-enhancement was seen in 17 lesions in 7 patients.

Adult↗
PubMed1997

Free musculofasciocutaneous medial plantar flap for reconstruction of thenar defects.

Functional reconstruction of thenar skin defects complicated by muscle loss is possible by transfer of a medial plantar flap with the underlying abductor hallucis muscle. Three patients with severe flexion-adduction contractures of the thumb due to gunshot injuries were reconstructed by using this musculofasciocutaneous flap. At surgery, after release of the skin contractures, all dysfunctional fibrotic muscles were excised. A medial plantar flap and the abductor hallucis muscle were dissected together; the motor branch of the abductor hallucis was preserved by intraneural dissection and sutured to the thenar motor branch of the median nerve. The muscle ends were sutured across the defects of the thenar muscles. All flaps survived without any loss at follow-up of 6-9 months. The flaps adapted to the thenar region completely by providing sufficient thenar bulk and a good skin colour match with palmar skin. Electromyography of the transferred muscle showed an interference pattern with an amplitude of about 200 mV in two cases and 100 mV in one case. Clinically, these findings were supported by voluntary opposition of the thumbs with good strength.

Adult↗