Biomedical subjects
Publications and source records attributed to U Yilmaz.
Hibernoma is a rare type of soft tissue neoplasm originating from brown fat tissue. The present case is the first periureteric hibernoma concentrically surrounding the ureter with a concomitant renal pelvis stone.
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In this paper, electrical impedance tomography (EIT) ventilation images from a group of 12 patients (11 patients with emphysema and one patient with only chronic obstructive pulmonary disease (COPD) (chronic bronchitis) and a group of 15 normal subjects were acquired using a Sheffield mark 1 EIT system, at the levels of second, fourth and sixth intercostal spaces. Patients were diagnosed based on CT scans of the thorax, pulmonary function tests and posteroanterior x-ray graphs. One of the patients with emphysema has also a malignant lung tumour. Ventilation-related conductivity changes at total lung capacity (TLC) relative to residual volume were measured quantitatively in EIT images. These quantitative values demonstrate marked differences compared to those values obtained from the EIT images of 15 normal subjects. The EIT images of the patients were also compared with the CT images. In addition to the visual examination of the EIT images a statistical confidence test is applied to compare the images of the patients with the images of the normal subjects. Prior to statistical analysis all images are normalized with TLC to minimize the effect of mismatch between the TLC of different subjects. A normal mean image is created by averaging the normalized images from the normal subjects, at each intercostal space level. Than a 95% confidence interval is defined for each normal mean image. For each image of the patients, a confidence test image, which represents the deviations from the 95% confidence interval of the normal mean image, is created. The regions with emphysematous bulla and parencyhma are detectable in the confidence test images as regions of positive and negative deviations from the confidence interval of the normal mean, respectively. In the test images, it is possible to differentiate emphysematous parenchyma from emphysematous bulla, tumour structure, and COPD. However, the emphysematous bulla, the tumour structure, and COPD result in the same type of defect in the test images and are therefore indistinguishable from each other. In some case, off-plane contributions in the EIT images may result in underestimation of the defects. EIT may be a useful screening device in detecting emphysema rather than a diagnostic tool.
Two patients with paraneoplastic cerebellar degeneration accompanying Hodgkin's disease were treated with plasma exchange in combination with chemotherapy or radiation therapy, respectively. Significant improvement in neurologic symptoms was obtained in 1 of them.
To investigate the epidemiology of premature delivery, in particular regarding potential seasonal influences, a retrospective medical-record study was conducted in 3345 women who delivered prematurely over a six-year period (1988-1993). The control group was composed of 53,162 women who carried their pregnancies to term. Each study subject had delivered at least one liveborn baby, prematurely or at full term. The premature delivery rate (ratio of premature over term deliveries) was highest in May through July and decreased significantly in January and February (p < 0.05). Premature delivery rates were similar in primiparas and multiparas (p > 0.05) and were not influenced by the gender of the fetus (p > 0.05). In conclusion, premature delivery rates vary across seasons, suggesting an influence of weather conditions.
Transplant recipients are at higher risk for infection and malignancy due to therapies aimed at preventing rejection. Early detection and successful treatment of such complications is of pivotal importance for both patient and graft survival. In this study, we evaluated findings of 91 colonoscopies and colonic histopathologic findings in recipients who presented with lower gastrointestinal system complaints between January 1996 and January 2003. The study group included 79 renal and liver transplant patients. The indications for colonoscopy were diarrhea (n = 58), abdominal pain (n = 5), hematochezia (n = 19), unexplained anemia (n = 5), thickening of a colonic segment detected on computerized tomography (n = 2), screening for lymphoma (n = 1), and Kaposi's sarcoma (n = 1). During the procedures, all suspicious lesions were biopsied and specimens of normal-appearing mucosa collected when deemed necessary in relation to the clinical complaints. The endoscopic findings were classified as follows: 0 = "normal," with clear visualization of the vascular network and normal-appearing mucosa; 1 = "erythema", with tissues showing erythema, edema, hyperemia, and loss of normal vascular network; 2 = "ulcerative," with tissues exhibiting ulceration and fragility; and 3 = "coincidental findings," such as polyp or angiodysplasia. Colonoscopic and/or histopathologic abnormalities were detected in 44.5% of the 91 colonoscopy procedures. The results indicate that colonoscopy is a valuable diagnostic tool for evaluation of transplant recipients with lower gastrointestinal complaints. After an initial workup colonoscopy is important to establish an accurate diagnosis.
Hepatitis C virus (HCV) infection is common in patients with end-stage renal disease. The severity of liver damage, including fibrosis, in these cases varies widely. Although many investigators have searched for noninvasive alternatives to liver biopsy for evaluating the extent of liver fibrosis, no useful noninvasive predictors have been found. Currently, liver biopsy is essential to assess the degree of fibrosis. The aim of this retrospective study was to investigate a range of clinical and laboratory parameters in HCV-infected hemodialysis (HD) patients and identify possible predictors of fibrosis. Ninety-five consecutive HD patients with HCV infection underwent liver biopsy. Each specimen was evaluated for fibrosis stage. Correlations were sought between the degree of fibrosis and the age, HD duration, time since first possible HCV exposure, body mass index, HCV RNA titer, serum ferritin level, and serum alanine aminotransferase (ALT) level. The analysis revealed no significant correlations between fibrosis stage and the parameters investigated (mean age: r =.017, P =.89; mean HD duration: r =.066, P =.576; body mass index r =.231, P =.152; HCV RNA titer: r =.015, P =.091; serum ferritin: r =.134, P =.32; serum ALT r =.108, P =.927). Links with serum ALT were reevaluated with upper normal levels arbitrarily set at 30 IU/L and 20 IU/L, but these analyses also revealed no correlations between fibrosis stage and ALT level (P =.98 and P =.449, respectively). Therefore liver biopsy is still essential for accurate assessment of liver pathology in HD patients with HCV.
To assess cavernous nerve integrity, we measured evoked cavernous activity (ECA) in 16 men who underwent nerve sparing radical prostatectomy (NS group) and 11 men who underwent non-nerve-sparing surgery (non-NS group). The right median nerve was electrically stimulated and ECA was recorded with two concentric electromyography needles placed into the right and left cavernous bodies. We simultaneously recorded hand and foot sympathetic skin responses (SSRs) as controls. All subjects had recordable SSR, and all subjects following nerve-sparing radical prostatectomy had reproducible ECA. Of the 11 non-NS subjects, eight had no response, indicating interrupted corporal innervation. Three subjects had reproducible ECA, one of whom had a very late latency, suggesting residual innervation was present. The mean latencies of ECA were similar to foot SSR mean latencies (P>0.05), but not to hand SSR latencies. The non-NS group was significantly different from the NS group for the presence of ECA (P<0.001). ECA is a viable method of evaluating the autonomic innervation of the penis.
Small bowel enteroscopy has been reported useful in the non-surgical evaluation of the small intestine in patients with obscure gastrointestinal bleeding but findings may be limited due to incomplete small bowel intubation and a lack of tip deflection. Intra-operative enteroscopy (IOE) is accepted as the ultimate diagnostic procedure for complete evaluation of the small bowel in these patients. Two patients with obscure gastrointestinal bleeding and deep anemia underwent IOE during surgical exploration. Angiodysplastic lesion with a diameter of 3 cm was found at jejunum in the first patient and segmental jejunal resection was performed. Enteroscopy showed red punctate lesions with a diameter of 1-3 mm located at proximal jejunum and extending to the ileum in the second patient. Total jejunal resection was performed. There was no recurrence of gastrointestinal bleeding during 36 months follow-up.
BACKGROUND/AIMS: There are reports of treatment of biliary cutaneous fistulae by endoscopically placed nasobiliary drains. We report our fistulae treatment results from this method. MATERIALS AND METHODS: We treated 11 patients with bronchobiliary fistulas (BBFs) endoscopically during the last 6 years. In most cases, the BBF's were the result of Hydatid cyst operations. Six patients had simultaneous biliocutaneous fistula (BCF). RESULTS: All BBFs and BCFs closed after the nasobiliary drain placement without any complication. Three patients who developed fistula recurrence healed with endoscopic treatment. CONCLUSION: Endoscopic treatment is a viable alternative to surgical treatment.
BACKGROUND/AIMS: The cases in the present study were reviewed retrospectively with the aim to demonstrate the characteristics of these strictures as well as the effectiveness of endoscopic stenting and to discuss the possible mechanisms of stricture formation. METHODOLOGY: Thirteen cases of postoperative benign biliary strictures secondary to hepatic hydatid disease (HHD) surgery were diagnosed between 1989 and 1994. All of these cases had had surgery for HHD one or more times. Endoscopic stenting was performed in 11 of the cases. Eight cases were followed-up. RESULTS: In 3 (29%) of the 8 cases, the stents were removed after a mean period of 35.6 months, and the patients were considered cured. These cases have been followed-up for 28 months. The remaining 5 cases have been followed-up for a mean period of 14.2 months. The overall morbidity was 18%, and there were no mortalities. The postoperative benign biliary strictures secondary to HHD were long, multiple, and located proximally. Due to these properties, surgical repair was not indicated for these cases. CONCLUSION: Endoscopic stenting is a safe method in the treatment of postoperative benign biliary strictures secondary to hepatic hydatid disease.