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Biomedical subjects

Tamer Baysal

Publications and source records attributed to Tamer Baysal.

33 records · Page 2Linked to original sources

Giant axonal neuropathy: MRS findings.

Giant axonal neuropathy (GAN) is a rare genetic disease of childhood involving the central and peripheral nervous systems. Axonal loss with several giant axons filled with neurofilaments is the main histopathological feature of peripheral nerve biopsies in this disease. Routine neuroimaging studies reveal diffuse hyperintensities in cerebral and cerebellar white matter. In this case report, the authors present the brain magnetic resonance spectroscopic features (normal N-acetylaspartate/creatine and increased choline/creatine and myoinositol/creatine ratios), which might indicate the absence of neuroaxonal loss and the presence of significant demyelination and glial proliferation in white matter, of an 11-year-old boy diagnosed with GAN.

Brain↗

[MR spectroscopy in the differential diagnosis of focal brain lesions in neurofibromatosis type 1 patients].

PURPOSE: To determine the role of MR spectroscopy in the differential diagnosis of focal brain lesions in neurofibromatosis type 1. MATERIALS AND METHODS: Fifteen patients with neurofibromatosis type 1 were evaluated by routine MRI and single voxel MR spectroscopy (TE: 31). The posterior parietal white matter of 20 age-matched healthy volunteers constituted the control group. NAA/Cr, Cho/Cr and MI/Cr ratios were calculated and compared with the control group. RESULTS: A total of 58 focal brain lesions were detected by MR imaging. When patients with hamartomas and gliomas were compared with the control group, a decrease in the NAA/Cr ratio, and a significant increase in Cho/Cr and MI/Cr ratios were found. The decrease in the NAA/Cr ratio and the increase in Cho/Cr and MI/Cr ratios of gliomas were significant when compared with hamartomas. With MRI and MR spectroscopy findings, 52 hamartomas and 6 gliomas were detected. CONCLUSION: Since MR spectroscopy has the ability to detect cellular metabolic changes, it could provide additional information to MR imaging about the differential diagnosis and treatment planning of focal parenchymal lesions in neurofibromatosis type 1.

Adolescent↗

[Associated brain anomalies and clinical findings in corpus callosum dysgenesis].

PURPOSE: The aim of this study was to evaluate the relationship between the types of the corpus callosum dysgenesis, the associated brain anomalies and clinical findings. MATERIALS AND METHODS: We analyzed the MR imaging findings in 169 patients with callosal dysgenesis. Corpus callosum dysgenesis was categorized into agenesis, hypogenesis and hypoplasia. The associated brain anomalies and clinical findings were evaluated. RESULTS: Associated brain anomalies were observed in 148 patients (87.5%). Twenty-one patients (12.4%) had isolated corpus callosum dysgenesis. Dysgenesis included agenesis in 22 (%13), hypogenesis in 46 (27.2%), and hypoplasia in 101 (59.7%) patients. The clinical findings were most commonly observed in patients with hypoplasia. CONCLUSION: The presence of corpus callosum dysgenesis is a strong indication of possible associated brain anomalies. Corpus callosum dysgenesis and associated brain anomalies should be investigated in children with developmental delay, seizures and microcephaly.

Abnormalities, Multiple↗

[Celiac ganglion blockade: the effectiveness of CT guided percutaneous anterior approach].

PURPOSE: To investigate the effectiveness and safety of celiac ganglion blockade in cases with abdominal malignancies who are narcotic analgesic dependent for control of severe abdominal pain. MATERIALS AND METHODS: A total of 30 celiac ganglion blockades were performed in 27 patients between the ages of 19 and 75. A 22 G Chiba needle was placed through the percutaneous anterior approach into the celiac ganglion region under the guidance of CT, and 98% alcohol was administered. The procedure was repeated in three cases due to insufficient response. RESULTS: In 24 (88.8%) of the 27 cases, the severity of pain decreased. Total relief of the pain was achieved in 13 (48.1%) cases. In 9 (33.3%) cases pain was controlled with non-narcotic analgesics. In 2 (7.4%) cases, the dose of the narcotic analgesic decreased. There was no change in the severity of the pain in 3 (11.1%) cases. Transient complications were diarrhea in 4 (14.8%), hypotension in 6 (22.2%) cases and hemiparesis in one (3.7%) case. CONCLUSION: Celiac ganglion blockade through the percutaneous anterior approach under the guidance of CT should be preferred for the control of pain in the early periods in cases with abdominal malignancies, especially gastric and pancreatic, due to easy performance, safety, lower incidence of complications, high success rate and low cost.

Abdominal Neoplasms↗

Criteria for judging the improvement in subclinical rheumatic valvitis.

Recent technical improvements in cross-sectional echocardiography have made it possible to detect even mild organic regurgitation of the mitral and aortic valves in patients with acute rheumatic fever. To determine the prevalence and prognosis of subclinical valvitis, we have analyzed 104 patients with acute rheumatic fever referred to our institution. Of 53 patients who had no murmur, 22 of them with polyarthritis, 29 with chorea, and 2 with polyarthritis and chorea, 23 (43.4%) had subclinical valvitis. Isolated mitral regurgitation was the most common valvar lesion, seen in 82.6% of the patients. Isolated aortic regurgitation was detected in 4.4% of the cases, and combined mitral and aortic regurgitation in the remaining 13%. During follow-up, the degree of mitral regurgitation improved in 59.1%, decreased in 18.2%, and increased or remained unchanged in 22.7% according to the length of colour jet. According to criterions of velocity, mitral regurgitation improved in 86.4% of the patients, and increased or unchanged in the remaining 13.6%. Mitral regurgitation disappeared completely in 6 of the patients (27.3%) as judged according to both the length of colour jet and the velocity of regurgitation. Aortic regurgitation improved in all the patients with this problem, disappearing completely in two of the four. Based on this experience, we suggest that not only the disappearance of regurgitation, but also improvements in the echocardiographic diagnostic criterions of regurgitation, such as the length of the colour jet less than 1 cm, or velocity less than 2.5 m/s, or indicative of regurgitation that is either intermittent or of short duration, should also be considered as criterions indicating improvement in valvar regurgitation in patients with subclinical rheumatic valvitis.

Child↗

Endovascular treatment of huge saccular abdominal aortic aneurysm in a young Behcet patient: mid-term result.

BACKGROUND: Abdominal aortic aneurysm formation is among the arterial complications of Behcet's disease. Weakness and fragility of aortic walls leads to the development of arterial complications like pseudoaneurysms. CASE PRESENTATION: A case of huge saccular abdominal aortic aneurysm in a young Behcet patient who was successfully treated with endovascular stent graft placement is reported, diagnostic and interventional procedures are discussed, and mid-term follow-up results are presented. CONCLUSIONS: Endovascular treatment of abdominal aortic aneurysm complications of young Behcet patients who are not suitable for open surgery and need intervention could be an alternative treatment modality even without performing preprocedural angiography.

Journal Article↗

Effects of testicular microlithiasis on Doppler parameters: report of three cases.

BACKGROUND: Testicular microlithiasis is a rare, usually asymptomatic, non-progressive disease of the testes associated with various genetic anomalies, infertility and testicular tumors. According to our literature search, there is no specific data about Doppler findings in this disease. CASE PRESENTATION: Doppler findings of three cases of testicular microlithiasis during last two years in our institution are presented. CONCLUSIONS: Although our hypothesis was to find increased Doppler parameters due to intratesticular arterial compression, our findings suggest that there are no Doppler findings specific to testicular microlithiasis.

Humans↗

Glutaric aciduria type I diagnosed after poliovirus immunization: magnetic resonance findings.

Glutaric aciduria type I is an uncommon inborn error of metabolism. It is a serious disease, often with a fatal outcome. Magnetic resonance imaging findings and the clinical course of monozygotic twin females with glutaric aciduria type I who were admitted with acute encephalopathic crisis symptoms 3 days after immunization for poliovirus are presented in this report. Magnetic resonance imaging findings revealed hyperintensity in the putamen, head of the left caudate nucleus, and globus pallidus, periventricular white matter (on T(2)-weighted images), arachnoid cysts in bilateral temporal regions, and enlargement of the sylvian fissures. Glutaric aciduria type I should be included in the differential diagnosis of patients with acute encephalopathic crisis occurring shortly after poliovirus immunization. Typical magnetic resonance findings guide urinary organic acid analysis in these patients.

Diagnosis, Differential↗

Fracture healing and bone mass in rats fed on liquid diet containing ethanol.

BACKGROUND: Studies in animal models for alcohol abuse have suggested that ethanol inhibits bone growth, decreases bone formation, and increases fracture risk. METHODS: Experimental tibia fracture healing in rats fed a liquid diet containing 7.2% ethanol for 8 weeks was investigated with histological and osteodensitometric studies with respect to the control group. After 4 weeks of vitamin A- and sucrose-enriched milk containing 7.2% ethanol feeding, we created closed tibia fractures, which were then fixed with intramedullary nails, in 10 rats. After a follow-up time of 4 weeks, the rats were killed for examination. The same procedure was performed in another 10 rats, which were fed on the same diet (isocaloric modified liquid diet) but without ethanol and used as the control group. A histological scoring system was developed for fracture healing. RESULTS: Histological evaluation of fracture region revealed an average fracture healing score of 1.9 in the ethanol-fed group versus 2.6 in the control group (p = 0.014). In the test group, dual-energy x-ray absorptiometry measurements in the fracture region showed a mean bone mineral density of 0.11 +/- 0.03 g/cm(2), whereas it was 0.130 +/- 0.051 g/cm(2) in the control group (p = 0.000). The mean bone mineral content in the fracture region was 0.103 +/- 0.08 g/cm(3) in the test group versus 0.128 +/- 0.06 g/cm(3) in the control group (p = 0.000). A significant correlation was found among histological scores, bone mineral density (r = 0.64, p = 0.04), and bone mineral content (r = 0.63, p = 0.04). CONCLUSIONS: This study showed that rats fed on a diet mixed with ethanol have a histologically delayed fracture healing associated with decreased bone density and mineral content. Besides the negative effects of ethanol on bone metabolism, it also interferes with the fracture-healing process.

Animals↗

Quantitative Doppler evaluation of the splenoportal venous system in various stages of cirrhosis: differences between right and left portal veins.

PURPOSE: The purpose of our study was to evaluate the relationship between the splenoportal hemodynamics in patients with cirrhosis and the stage of the disease. METHODS: Patients with cirrhosis were grouped according to modified Child-Pugh scoring into stages A, B, and C of cirrhosis. A control group of healthy volunteers was included. After gastroenterologic clinical and laboratory examinations, all participants underwent a splenoportal Doppler sonographic evaluation in which the vessels' diameter, area, and blood flow velocity were measured and blood flow rate and the congestion index in the splenoportal venous system were calculated. RESULTS: Seventy-five patients with cirrhosis (25 women and 50 men) were enrolled; the control group consisted of 30 healthy volunteers (15 women and 15 men) with no liver disease. The mean age (+/- standard deviation) of the patients was 54.4 +/- 14.8 years (range, 13-80 years) and of the control subjects was 47.3 +/- 14.5 years (range, 18-72 years). No significant differences in vessel diameter, blood flow velocity, and blood flow rate were found in the main and left portal veins between the study group and the control group. In the right portal vein, we found decreases in the vessel diameter, blood flow velocity, and blood flow rate, and in the splenic vein, we found increases in vessel diameter and blood flow rate. The congestion index was increased in the main portal and splenic veins but was unchanged in the left portal vein. CONCLUSIONS: Although our data indicate that there is no difference in Doppler sonographic parameters of the main portal vein according to Child-Pugh scores, the hemodynamic differences between the left and right branches of the portal vein may be clinically useful in patients with cirrhosis.

Blood Flow Velocity↗

Pulmonary arterial pressure in children with croup syndrome.

PURPOSE: Croup syndrome or laryngotracheitis is one of the frequent causes of transient upper airway obstruction by laryngeal and tracheal blockage in infants and children. Upper airway obstruction may lead to increased pulmonary arterial pressure in children. In this study, the relationship between croup syndrome and pulmonary arterial pressure was investigated. MATERIALS AND METHODS: Forty children with croup syndrome and 14 healthy, age- and sex-matched control subjects were enrolled in this study. Of all patients, 12 with severe symptoms, such as dyspnea, cyanosis, hypoventilation, were accepted as "high croup score" (croup score >or=6). All patients with high croup score were treated with dexamethasone. We assessed pulmonary arterial pressure of patients during therapy using serial echocardiographic measurements. RESULTS: Our results showed that children with croup syndrome have significantly higher pulmonary arterial pressures than healthy subjects at the time of diagnosis. Pressure values of patients with high croup score were found to be significantly higher when compared with those of the low -core group (P < .05). However, there was no difference between 2 groups at the end of therapy. CONCLUSIONS: It is suggested that pulmonary arterial pressure increased to different extents in the acute stage of illness and that the degree of increase was related to the severity of disease and average hospital stay. In addition, increased pulmonary arterial pressure due to croup syndrome is reversible. Furthermore, evaluation of children with croup syndrome by using Doppler echocardiography may be useful in the monitoring of pulmonary arterial pressure and in the follow-up of their therapy.

Blood Pressure↗

Pulmonary arterial pressure in children with allergic rhinitis.

BACKGROUND: Chronic upper airway obstruction may lead to increased pulmonary arterial pressure in childhood. Allergic rhinitis is one of the frequent causes of upper airway obstruction by nasal blockage. The aims of the study were to evaluate the pulmonary arterial pressures in children with allergic rhinitis and the effect of topical corticosteroid therapy. METHODS: Forty-nine children composed of 27 subjects with seasonal and 22 subjects with perennial allergic rhinitis were enrolled in this study. The pulmonary arterial pressures were measured by using Doppler echocardiography. RESULTS: The pretreatment pulmonary arterial systolic, mean, and diastolic pressures of study group were significantly higher than in healthy controls (p < 0.05). The pulmonary arterial systolic and mean pressures of the patient group significantly decreased at the end of study (p < 0.05), whereas the decrease of the diastolic pressure was not statistically significant (p > 0.05) after the treatment of a topical corticosteroid, mometasone furoate (100 microg per day), for 8 weeks. CONCLUSION: Our results showed that children with allergic rhinitis have higher pulmonary arterial pressure levels compared with healthy controls and that increased pulmonary arterial pressure levels due to allergic rhinitis are reversible by using nasal topical corticosteroids. Further studies are needed to determine the clinical aspect of increased pulmonary arterial pressure.

Anti-Allergic Agents↗

Congenital aneurysm of the muscular interventricular septum in a child.

Congenital aneurysms of the muscular interventricular septum without ventricularseptal defect are extremely rare. We describe a five-month-old girl patient with congenital aneurysm, pathological ST changes and minimal right ventricular outflow tract obstruction. The electrocardiogram showed Wolf-Parkinson-White syndrome, pathological ST changes and combined ventricular hypertrophy criteria. The transthoracic echocardiography and cardiac catheterization demonstrated a septal aneurysm which was bulging into the right ventricle and systolic pressure gradients between the main pulmonary artery and right ventricle outflow tract with normal coronary arteries. The patient has shown no symptoms, but some rhythm disturbances may be expected because of her electrocardiographic anomalies. Therefore, these patients should be followed carefully because of possible complications.

Aneurysm↗

Prevalence and distribution of children with congenital heart diseases in the central Anatolian region, Turkey.

Congenital heart diseases (CHD) are the most frequent malformation at birth. The aims of this study were to assess the prevalence of congenital heart disease, their different types, and the detection rate among children in the central Anatolian region in Turkey. The study was conducted during an eight-year period (March 1995-December 2002). The prevalence of CHD in a large tertiary care hospital in the central Anatolian region in Turkey was studied. The diagnosis of a structural defect was based on echocardiographic study. The following age groups were considered: neonates, infants and toddlers, preschool children, schoolchildren, and adolescents. In the study period, 1,693 children were found to have CHD; 1253 patients were neonates and infants. Total prevalence of CHD over the study period was 7.77 per 1000 live-born. The prevalence increased from 6.35 to 9.65 per 1000 live births between 1995 and 2002 (p < 0.05). The average age at diagnosis was 2.2 +/- 3.64 years (1 day to 18 years, median 5 months). There were 863 (51%) boys and 830 (49%) girls, with a male/female ratio of 1:1. Isolated ventricular septal defect (32.6%) was the most frequent acyanotic anomaly, and tetralogy of Fallot (5.8%) was the most frequent cyanotic anomaly. The commonest non-cardiac anomalies with CHD were musculoskeletal anomalies. Down syndrome was determined in 83 patients (78.3%) from all syndromic CHD cases. Congenital heart disease is a very significant health problem. It requires urgent measures in terms of organization of early diagnosis and proper management. The prevalence rate is comparable to that of similar developed countries. Increasing incidence of CHD might be attributed to more diagnoses with new technologic development or it may indicate a real increase in the defects.

Adolescent↗