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Biomedical subjects

S Işik

Publications and source records attributed to S Işik.

At least 37 records · Page 2Linked to original sources

Tl-201 scintigraphy, mammography and ultrasonography in the evaluation of palpable and nonpalpable breast lesions: a correlative study.

PURPOSE: To determine the feasibility of Tl-201 as a tumor localizing agent in palpable and nonpalpable breast lesions, in comparison with mammography and ultrasonography (US), and to evaluate the contribution of these modalities to each other in obviating biopsy. MATERIALS AND METHODS: Seventy-two palpable and nonpalpable breast lesions were prospectively classified as benign, indeterminate, or malignant according to the sonographic and mammographic criteria and were further analyzed with Tl-201 scanning. These classifications were compared with biopsy results. The sensitivity, specificity, accuracy, false positive and false negative rates (FPR, FNR), negative and positive predictive values (npv, ppv) were calculated for each individual modality and combination of modalities to evaluate the contribution of these three techniques to each other. RESULTS: Of 72 lesions 52 were histologically malignant and 20 were benign. Overall, mammography was the most sensitive (92%) and Tl-201 was the most specific (75%) of the three modalities. Mammography + Tl combination was the most specific (90%) and accurate (97%) of dual combinations. In mammographically or sonographically indeterminate cases, Tl-201 was much more specific (75% versus 37% for mammography and US) and more accurate (82% versus 36% for mammography and 54% for US) than the other two modalities, and mammography + Tl combination was significantly superior to other dual combinations (87% specific and 91% accurate). Use of Tl-201 scanning as an adjunct to mammography + US combination increased the specificity, ppv, and accuracy rates overall, particularly in mammographically or sonographically indeterminate cases. CONCLUSIONS: In mammographically and sonographically indeterminate breast lesions thallium scanning may be offered as a third step of investigation to obviate biopsy.

Adult↗

Subcutaneous metallic mercury injection: early, massive excision.

The case of a patient who injected 10 cc of metallic mercury subcutaneously into his left forearm through multiple punctures in an attempt at suicide is presented. Diagnosis was made by plain radiography of his left forearm, which exhibited redness, edema, and tenderness on the third day postinjection. Early excision of all affected subcutaneous tissues including metallic mercury deposits was performed on the fifth day postinjection. Blood and urine mercury levels that were initially found in high levels decreased dramatically to normal ranges after the excision and remained unchanged at the follow-up period of 6 months. No renal or hepatic functional impairment was encountered. The patient was free of toxic symptoms and mercury embolism. The local, aseptic lytic property of metallic mercury, which could cause severe damage to vital structures, was observed perioperatively. Early diagnosis and early, massive excision of mercury deposits in affected tissues is the important treatment modality in these rare cases.

Adult↗

201Tl scintigraphy in the evaluation of palpable and nonpalpable breast lesions: correlation with mammography and ultrasonography.

AIM: Our goal was to determine the clinical usefulness of Tl-201 to identify breast cancer in patients with suspicious breast lesions on clinical examination, and/or abnormal radiologic (mammography and/or ultrasonography) findings. METHODS: Tl-201 scintigraphy were performed in sixty-eight patients with 70 breast abnormalities (51 palpable, 19 nonpalpable) and compared with mammography and ultrasonography (US). Early (15 min) and late (3 h) images of the breasts were obtained following the injection of 111 MBq (3 mCi) of Tl-201. Visual and semiquantitative interpretation was performed. RESULTS: Final diagnosis confirmed 52 malignant breast lesions and 18 benign conditions. Tl-201 visualized 47 of 52 (90%) overall malignant lesions. Thirty-eight of 40 (95%) palpable and 9 of 12 (75%) nonpalpable breast cancers were detected by Tl-201 scintigraphy. The smallest mass lesion detected by Tl-201 measured 1.5 x 1.0 cm. Eleven breast lesions were interpreted as indeterminate by mammography and/or sonography. Tl-201 scintigraphy excluded malignancy in 7 of 8 (88%) patients with benign breast lesions interpreted as indeterminate. Five of the 18 (28%) benign breast lesions showed Tl-201 uptake. None of the fibroadenoma and fibrocystic changes accumulated Tl-201. Tl-201 scintigraphy, mammography and ultrasonography showed 90%, 92%, 85% overall sensitivity and 72%, 56%, 61% overall specificity respectively. Twenty-one of the 28 (75%) axillary nodal metastatic sites were also detected by Tl-201. In malignant and benign lesions, early and late lesion/contralateral normal side (L/N) ratios were 1.58 +/- 0.38 (mean +/- SD) and 1.48 +/- 0.32 (p > 0.05), 1.87 +/- 0.65 and 1.34 +/- 0.20 (p < 0.05) respectively. The mean early and late L/N ratios of malignant and benign groups did not show statistical difference (p > 0.05). CONCLUSION: Overall, Tl-201 scintigraphy was the most specific of the three methods and yielded favourable results in palpable breast cancers, while it showed lower sensitivity in nonpalpable cancers and axillary metastases. Combined use of Tl-201 scintigraphy with mammography and US seems to be useful in difficult cases, such as dense breasts and indeterminate breast lesions.

Adult↗

An unusual case of lightning strike: full-thickness burns of the cranial bones.

An unusual full-thickness burn of the scalp and cranial bones due to a lightning strike is reported. A thick nylon cover protected the head from the direct effects of the lightning injury, but heated water over the thick nylon cover caused full-thickness burn of the scalp and cranial bones. The relevant literature has been reviewed.

Adult↗

Radiologic evaluation of urinary tract infection.

This prospective study was designed to investigate the most relevant radiological approach for the evaluation of urinary tract infections (UTI) in childhood. In the first 48 hours following the diagnosis of UTI, all patients underwent 99mTc dimercaptosuccinic acid (DMSA) scanning, ultrasonography (US) and intravenous urography (IVU). For the imaging of renal parenchymal infection the sensitivity of IVU and US as compared to DMSA scanning were found to be 9.09% and 25%, respectively. It was concluded that 99mTc DMSA, where available, should be the first step for the accurate diagnosis and follow-up of patients with UTI.

Algorithms↗

Sella turcica fractures in a trauma series and their clinical significance.

BACKGROUND: Fractures in the region of the sella turcica (ST) are usually associated with severe blunt head trauma and may produce many complications. The true incidence is difficult to assess since there have been only about 30 cases reported in the literature. METHODS: A total of 470 computed tomography (CT) sections--with optimum bone window images of skull bone--of 1600 head trauma patients who were admitted between 1979 and 1992, inclusive, to the Neurosurgery Department of Gazi University Medical School were analyzed retrospectively. RESULTS: There were a total of 17 patients with a fracture of the ST, constituting an incidence of 3.6%, and there was a preponderance of children. CONCLUSIONS: Computed tomography was very helpful in assessing the extent of ST fractures. In our cases, these fractures were not associated with a high complication or death rate, although a cerebrospinal fluid fistula was present in 53%.

Adolescent↗

Parasternal sonography of the internal mammary lymphatics in breast cancer: CT correlation.

The purpose of this study was to evaluate the efficacy of parasternal ultrasonography (US) in diagnosing internal mammary lymph node metastases in breast cancer, an important site of occult metastases, adversely affecting the disease-free interval and long-term survival. Thirty-five patients who were diagnosed with breast cancer were examined for internal mammary lymph node (IMLN) involvement with parasternal US, and results were correlated with computed tomography (CT). Longitudinal and transverse images of the first through sixth parasternal rib interspaces were evaluated with a 7.5-MHz linear-array transducer. The enlarged nodes were demonstrated as discrete, spherical or ovoid hypoechoic lesions in six cases with parasternal US, and corresponding CT scans confirmed the presence of lymphadenopathy. Our results suggest that parasternal US may be helpful in the evaluation of IMLN metastases in breast cancer as a part of staging the disease.

Adult↗

Sonographic demonstration of intestinal involvement in Henoch-Schönlein syndrome.

We evaluated the efficacy of intestinal sonography in the diagnosis of gastrointestinal involvement of Henoch-Schönlein syndrome (HSS). Intestinal sonography was performed in 20 children who were clinically diagnosed as HSS and sonographic findings of the intestinal system were reviewed. Out of 20 patients, 10 who suffered from abdominal pain demonstrated sonographic findings consistent with small intestinal involvement (dilatation of intestinal segments, hypomotility, and eccentric thickening of the intestinal wall). Our results reveal that sonography of the intestine may be useful in the evaluation of the involvement of HSS.

Abdominal Pain↗

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↗

Diagnosis of ocular involvement in Behçet's disease: value of spectral and color Doppler sonography.

OBJECTIVE: The purpose of this study was to determine the value of duplex and color Doppler sonography in the detection of ocular involvement in Behçet's disease. SUBJECTS AND METHODS: Duplex and color Doppler sonography was done in 21 patients with Behçet's disease and ocular involvement and in 22 patients with Behçet's disease but without ocular involvement. Twenty health volunteers also were examined as a control group. Flow velocities in the central retinal artery, posterior ciliary arteries, and ophthalmic artery were measured in the patients with Behçet's disease. RESULTS: In patients with Behçet's disease and ocular involvement, peak systolic velocities in the central retinal, posterior ciliary, and ophthalmic arteries were 7.3 +/- 2.3, 12.8 +/- 3.1, and 35.8 +/- 7.2 cm/sec, respectively. In patients with Behçet's disease but without ocular involvement, these values were 10.0 +/- 1.9, 17.3 +/- 3.4, and 33.5 +/- 4.0 cm/sec, respectively. In control subjects, the respective calculated values were 12.3 +/- 1.0, 16.5 +/- 1.6, and 35.8 +/- 4.4 cm/sec. For the central retinal and posterior ciliary arteries, peak systolic and diastolic velocities were significantly lower in patients with Behçet's disease and ocular involvement than in control subjects and patients with Behçet's disease but without ocular involvement (p < .001). Peak systolic and diastolic velocities in the central retinal artery were significantly lower in patients with Behçet's disease but without ocular involvement than in the control group (p < .001); however, no difference was observed for the posterior ciliary artery. Flow velocities in the ophthalmic artery were not significantly different among groups. CONCLUSION: These findings suggest that duplex and color Doppler sonography may be helpful in the diagnosis of ocular involvement in patients with Behçet's disease.

Adolescent↗

Digital subtraction sialography: technique, advantages and results in 107 cases.

Sialographic examinations with the digital subtraction technique were performed in 107 salivary glands (90 parotid and 17 submandibular) of 99 patients. Diagnostic and technical advantages of the digital imaging and subtraction for sialography were investigated. Superior quality enabled detailed imaging of the entire ductal system. Reduced radiation exposure, short examination time and almost painless examinations with good patient tolerance proved to be the major advantages of digital subtraction sialography as a diagnostic tool.

Adolescent↗

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↗