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Tuberculous Spondylitis: Clinical Features of 36 Patients

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Case Reports in Clinical Medicine 2016年第10期5卷 411-417页

作者： halil Yanardag Cuneyt Tetikkurt Muammer Bilir Sabriye Demirci Bulent Canbaz Mucahit Ozyazar Department of Internal Medicine Cerrahpasa Medical Faculty Istanbul University Istanbul Turkey Department of Pulmonary Medicine Cerrahpasa Medical Faculty Istanbul University Istanbul Turkey Department of Neurosurgery Cerrahpasa Medical Faculty Istanbul University Istanbul Turkey

We report 36 cases of spinal tuberculosis who were evaluated at the Internal Medicine Department of Istanbul University between January 1990 and March 2016. Twelve cases were accompanied by active pulmonary tuberculosis while ten patients had a previous history of tuberculosis. Eight patients had diabetes mellitus;six patients were on chronic steroid treatment with a mean dose of 24 mg/day while two patients used azathioprine and methotrexate. The dominant symptom was back pain that was present in 64% of the subjects followed by low grade fever (42%), and malaise (38%). Lytic and destructive lesions were noted in various vertebrae in all of the cases while four patients had spinal compression, and two patients had iliopsoas abscess. The preliminary diagnosis was myeloproliferative disease with vertebral metastasis in eight patients. Tuberculin test was over 15 mm in 20 patients (58.8%) while ERS and Creactive protein were highly elevated in 78%, and 84% of the patients. Diagnosis of tuberculosis was confirmed by culture of aspirated material from intervertebral disc space, collection under CT guidance, sputum or bronchial lavage, and by retrospective anti-tuberculous treatment response. MRI revealed compatible findings with spinal tuberculosis in 30 (80%) patients. In endemic countries, tuberculous spondilitis should be considered in immunosuppressed patients with back pain. Current or past tuberculosis infection is not a reliable indicator for Pott’s disease in these patients. Laboratory findings were not usually useful to support the diagnosis. The low sensitivity of the tuberculin test may lead to an erronous diagnosis. Sensitivity of vertebral radiography and CT was low. MRI was the most useful radiologic investigation for the diagnosis of spinal tuberculosis. Tuberculosis of the spine is a diagnostic impasse notably in immunodeficient patients for the clinician.

关键词： Tuberculosis Spinal Vertebrae M. Tuberculosis Pott’s Disease

Is External Ventricular Drainage Life-Saving in Cerebellar Hemorrhages?

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Open Journal of Modern Neurosurgery 2019年第2期9卷 154-163页

作者： Suat Erol Celik Ajlan Uzunkol Buse Sarigul halil Olgun Peker Yunus Kurtulus Department of Neurosurgery Okmeydani Training and Research HospitalIstanbulTurkey

Background: The treatment of cerebellar hemorrhage (CH) may be different surgery or conservative according to the hematoma volume, compression of vital structures or hydrocephalus existence. In the present study, the authors investigated the risk factors, the indications and the situation of external ventricular drainage (EVD) on the treatment line. Methods: 63 pure cerebellar hemorrhage patients were enrolled in the study. 36 cases underwent surgery;the other 27 were received conservative treatment. 15 and 13 cases received EVD in both groups. Hospital stay and mortality rates were investigated. Results: 4 cases in the conservative group underwent surgery secondary to treatment failure. Both of the groups had equal rates of morbidity and mortality. On the other hand, the group that received surgical intervention had shorter median hospital stay. The EVD does not seem to be life-saving at first but it gives time for preparing for surgery. Conclusions: We found that CH was strongly associated with early hydrocephalus and mortality. The early diagnosis and surgical evacuation of the mass are mandatory and life-saving if hematoma is larger than 10 ml. The EVD may not being a life-saving instrument but majorly it may be a time earning device if acute hydrocephalus present.

关键词： Cerebellar Hemorrhage External Ventricular Drainage Hydrocephalus Hypertension

Diagnosis of long QT syndrome via support vector machines classification

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Journal of Biomedical Science and Engineering 2011年第4期4卷 264-271页

作者： halil Bisgin Orhan U. Kilinc Ahmet Ugur Xiaowei Xu Volkan Tuzcu 不详

Congenital Long QT Syndrome (LQTS) is a genetic disease and associated with significant arrhythmias and sudden cardiac death. We introduce a noninva-sive procedure in which Discrete Wavelet Trans-form (DWT) is used to extract features from elec-trocardiogram (ECG) time-series data first, then the extracted features data is classified as either abnormal or unaffected using Support Vector Machines (SVM). A total of 26 genetically identified patients with LQTS and 19 healthy controls were studied. Due to the limited number of samples, model selection was done by training 44 instances and testing it on remaining one in each run. The proposed method shows reasonably high average accuracy in LQTS diagnosis when combined with best parameter selection process in the classifica-tion stage. An accuracy of 80%is achieved when Sigmoid kernel is used in v-SVM with parameters v = 0.58 and r = 0.5. The corresponding SVM model showed a classification rate of 21/26 for LQTS pa-tients and 15/19 for controls. Since the diagnosis of LQTS can be challenging, the proposed method is promising and can be a potential tool in the correct diagnosis. The method may be improved further if larger data sets can be obtained and used.

关键词： Long QT Syndrome Discrete Wavelet Transform Support Vector Machine Classification

Recent progress in integrated electro-optic frequency comb generation

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Journal of Semiconductors 2021年第4期42卷 5-16页

作者： Hao Sun Mostafa K.halil Zifei Wang Lawrence R.Chen Department of Electrical and Computer Engineering McGill UniversityMontreal.QC H3A 0E9Canada

Optical frequency combs have emerged as an important tool enabling diverse applications from test-and-measurement,including spectroscopy,metrology,precision distance measurement,sensing,as well as optical and microwave waveform synthesis,signal processing,and *** techniques exist to generate optical frequency combs,such as mode-locked lasers,Kerr micro-resonators,and electro-optic *** characteristics of optical frequency combs include the number of comb lines,their spacing,spectral shape and/or flatness,and intensity *** mode-locked lasers and Kerr micro-resonators can be used to obtain a large number of comb lines compared to electro-optic modulation,the latter provides increased flexibility in tuning the comb *** some applications in optical communications and microwave photonics,a high degree of integration may be more desirable over a very large number of comb *** this paper,we review recent progress on integrated electro-optic frequency comb generators,including those based on indium phosphide,lithium niobate,and silicon photonics.

关键词： electro-optic frequency comb generation integrated photonics silicon photonics integrated lithium niobate indium phosphide

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轧机牌坊设计

重型机械 1972年第1期 19-34页

作者： halil Erzurum

由于轧制压力日益增加,现代轧机的牌坊承受的负载也越来越大。若考虑屈服强度方面的破坏因素,轧机牌坊危险断面上产生的应力是特别低的。在大多数情况下,轧机牌坊是根据为防止牌坊挠曲所需的刚性来设计的,以便能更精确地控制轧材的厚度。

关键词：轧机牌坊矩形框架惯性矩中心线偏角转动惯量牌坊立柱方程式方程轧制压力轧制力

Conservative approach in drilling-cutting tool injuries

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Journal of Acute Disease 2018年第4期7卷 167-174页

作者： Osman Kones Murat Akarsu Cevher Akarsu Mehmet Emin Günes halil Dogan Department of General Surgery Bakirkoy Dr Sadi Konuk Training and Research HospitalIstanbulTurkey Department of Internal Medicine Bakirkoy Dr Sadi Konuk Training and Research HospitalIstanbulTurkey Department of Emergency Medicine University of Health Sciences Bakirkoy Dr.Sadi Konuk Training and Research HospitalIstanbulTurkey

Objective: To prevent unnecessary laparotomies by evaluating the effectiveness of conservative approach in abdominal trauma cases due to drilling-cutting ***: Demographic data, effected region of the body, additional findings of trauma, hemodynamic parameters, duration of admission, diagnostic methods and treatment modalities were retrospectively evaluated in 217 cases with abdominal injury (lower thoracic region, abdominal wall and back) among 1128 victims with drilling-cutting instrument injuries between January 1, 2012 and December 31, 2017. The conservative approach was based on physical examination, hemogram follow-up and hemodynamic ***: Totally 177 (81.6%) cases of 217 patients were followed conservatively while 25 cases were operated at early (1-8 hours) and 15 were operated at late (9-48 hours) periods. Two patients who underwent surgery in the early period and two patients who underwent surgery in the late period were accepted as negative laparotomy while 1 patient in the late operated group was regarded as non-therapeutic laparotomy. Diagnostic laparoscopy was performed in 81 cases. Complications developed in 7 patients who were operated in the early period and 10 patients who were operated in the late period. The mean hospital stay period was 5.3 days (1-33) in all cases, 4.5 days (2-20) in conservative treatment group and 8.4 days (3-33) in the operated patients;and the difference was statistically ***: Detailed physical examination, accurate assessment and effective use of different diagnostic methods reduce the frequency of negative and non-therapeutic laparotomies in abdominal stab wound injuries.

关键词： Conservative approach Drilling Cutting Injuries Trauma

Differentiation of Exophytic Renal Masses with Determination of the Angular Interface with Renal Parenchyma in US and CT

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Open Journal of Medical Imaging 2012年第2期2卷 80-83页

作者： Duzgun Yildirim halil Bozkurt Abdullah Cirakoglu Mutlu Sahin Bengi Gurses Baki Ekci Department of Radiology Iskenderun Military Hospital Hatay Turkey Department of Radiology Yeditepe Unversity Hospital Istanbul Turkey Department of Surgery University of Washington Seattle USA Department of Surgery Yeditepe Unversity Hospital Istanbul Turkey Department of Urology Karaman Public Hospital Karaman Turkey Department of Urology Kasimpasa Military Hospital Istanbul Turkey

Purpose: To determine whether benign exophytic renal masses can be distinguished from malignant lesions by using the angular interface sign in ultrasonography (US) and computerized tomography (CT). Materials and Methods: A total of 71 cases with exophytic renal mass (2 cm or greater) were examined on the basis of angular interface in US (n = 23), CT (n = 21) and US + CT (n = 16) between January 2008 and June 2010 were included in this study. The renal interface relationships were examined by 2 radiologists and classified as having angular or wide interface. Results: No statistically significant difference was found between the findings of two readers. There was almost perfect interobserver agreement for the interface sign. For cystic lesions, the angular interface sign was determined in all but two Bosniak category 1 cases. Also, the angular interface sign was positive in all but one Bosniak category 2 - 3. For cystic lesions with solid component and pure solid lesions, in the benign group, the angular interface sign was positive in all except three cases (vascular malformation, oncocytoma and Xanthogranulomatous pyelonephritis). In the malignant group, the angular interface sign was determined in only two RCC cases;in other primary or metastatic malignant lesions there was a wide interface sign. Conclusion: Exophytic renal masses can be differentiated as malignant or benign with 87% accuracy using only the angular interface sign in US or CT and also in opposition to dynamic-contrast examinations. This method entails a lack of additional radiation or contrast media exposure, time-saving, and costeffectivity.

关键词： Renal Neoplasms Differential Diagnosis Ultrasonography Computed Tomography Sign

Effect of Colchicine on Total Antioxidant Capacity,Antioxidant Enzymes and Oxidative Stress Markers in Patients with Knee Osteoarthritis

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International Journal of Clinical Medicine 2012年第5期3卷 377-382页

作者： Metin Erden Levent Ediz Ozcan Hiz Yasin Tuluce halil Ozkol Murat Toprak Fahrettin Demirdag Physical Medicine and Rehabilitation Department District Education and Research HospitalVanTurkey Physical Medicine and Rehabilitation Department Yuzuncu Yil University Medical FacultyVanTurkey Medical Biology Department Medical FacultyYuzuncu Yil UniversityVanTurkey Physical Medicine and Rehabilitation Department District Education and Research HospitalElazigTurke

Background/Aim: We aimed to investigate the effects of colchicine on clinical recovery, as well as oxidative stress markers and total antioxidant capacity (TAC) in whole blood of patients with knee osteoarthritis (OA). Materials and methods: Sixty patients with grade 2 - 3 knee OA according to ACR knee OA criteria whom examination of the knee joint synovial fluid by polarized light microscopy demonstrated CPDD crystals existence were included in the study. Fifty healthy subjects were included as a control group. Patients were divided randomly into two groups. The first group (paracetamol group) was given only paracetamol 3 gr daily p.o and the second group (colchicine and paracetamol group) was given colchicine 1,5 gr and paracetamol 3 gr daily p.o for six months. For outcome measures WOMAC and VAS were used. Superoxide dismutase (SOD), Catalase (CAT) ezyme activities and Glutathione (GSH) and Malondialdehyde (MDA) levels and TAC all were measured. Results: WOMAC scores were improved in both patient groups compared with pre-treatment evaluation (p 0.05). TAC was signifcantly increased only in colchicine/paracetamol group. Oxidant parameter MDA levels were significantly decreased in both paracetamol group and colchicine/paracetamol group. CAT, SOD enzyme activities and GSH levels did not change before and after treatment protocols in both patient groups. Conclusion: Both paracetamol 3000 mg/day and 3000 mg paracetamol plus 1,5 gr/day colchicine is effective in the treatment of patients with knee osteoarthritis. But the addition of colchicine to paracetamol produced significantly greater symptomatic benefit than paracetamol alone. Our study also showed that colchicine lowers whole blood MDA which is a lipid peroxidation compound and elevates TAC levels in patients with knee OA. This may show probable disease modifying effect of colchicine in knee OA which require further long period laboratory and radiologic investigations.

关键词： Knee Osteoarthritis Colchicine Paracetamol Total Antioxidant Capacity Malondialdehyde Oxidative Stres

Unfused Crossed Renal Ectopia with Nephrolithiasis Diagnosed Incidentally in Emergency Room

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Journal of Health Science 2014年第6期2卷 300-302页

作者： Mehmet Akeimen Tuba Cimilli Ozturk Hasan Demir Yalman Eyinc halil Aliskan Ozge Ecmel Onur Emergency Medicine Department Fatih Sultan Mehmet Education and Research Hospital Istanbul Turkey

Crossed renal ectopia is the second most common fusion anomaly of the kidney after horseshoe kidney. The incidence of both fused and unfused cases is 1 in 7000 in autopsies. The unfused crossed renal ectopia is much rare with an incidence of 1/75000 in autopsies. Ninety percent ofectopic kidneys are fused to their ipsilateral mate and the ureter of the ectopic kidney inserts into its normal position in the bladder at the contralateral side. But demonstration of the anomaly may provide to search for accompanying congenital anomalies and to plan a follow-up program for possible future complications in most of the cases. However it may remain asymptomatic for years as in the patients. Here the authors are presenting a 64-year-old male patient, with a right sided unfused crossed renal ectopia anomaly without any complaints until this age.

关键词： Renal anomaly crossed renal ectopia renal ectopia fusion anomaly.