Arteriovenous Malformation Incidentally Found by Ultrasonography in a Thigh Hematoma after Contusion

Vascular malformations in extremities are difficult to detect in cases of minor trauma. The authors report a case of an arteriovenous malformation (AVM) incidentally found by ultrasonography in a contusion. After a slip down, a 52-year-old man who had undergone total arthroplasty in both hips 10 years earlier complained of an ovoid right hip swelling that had gradually increased in size. Suspecting a simple cyst or hematoma, the swelling was examined by ultrasonography, which revealed a subcutaneous hematoma with arterial flow connected to muscle. Arteriography revealed an AVM around the right hip joint. Due to the presence of multiple arteriovenous shunts, a conservative treatment course was adopted and after 3 weeks of treatment the swelling almost completely resolved. It appears that the small AVM may have existed congenitally before hip surgery and the contusion over the AVM had led to hematoma rather than an arteriovenous fistula. The authors emphasize the usefulness of ultrasonography for the diagnosis of posttraumatic swelling

Radiological Spectrum of Hepatic Mesenchymal Hamartoma in Children

OBJECTIVE: A hepatic mesenchymal hamartoma is an uncommon benign tumor in children and little is known about the spectrum of its radiological features. The purpose of this study is to describe the spectrum of radiological features of a hepatic mesenchymal hamartoma in children. MATERIALS AND METHODS: Thirteen children with a pathologically confirmed hepatic mesenchymal hamartoma (M:F = 7:6; mean age, 3 years 2 months) were included in our study. Ultrasonography (US) was performed in nine patients including color and power Doppler US (n = 7). CT scans were performed in all patients. We evaluated the imaging findings of the hepatic mesenchymal hamartomas and the corresponding pathological features. RESULTS: Each patient had a single tumor (mean diameter: 13 cm [1.8-20 cm]). On CT and/or US, four patients (31%) had a "multiseptated cystic tumor", five patients (38%) had a "mixed solid and cystic tumor", and four patients (31%) had a "solid tumor." The septa of the cystic portion were thin in the multiseptated cystic tumors and irregularly thick in the mixed solid and cystic tumors as seen on US. On a post-contrast CT scan, solid portions or thick septa of the tumors showed heterogeneous enhancement. The amount of hepatocytes was significantly different among the three tumor groups according to the imaging spectrum (p = 0.042). CONCLUSION: A hepatic mesenchymal hamartoma in children can show a wide spectrum of radiological features, from a multiseptated cystic tumor to a mixed solid and cystic tumor, and even a solid tumor

Clinical features of infantile hepatic hemangioendothelioma

PurposeInfantile hepatic hemangioendothelioma (IHHE) is the most common type of hepatic vascular tumor in infancy. We conducted this study to review our clinical experience of patients with IHHE and to suggest management strategies.MethodsWe retrospectively analyzed the medical records of 23 IHHE patients (10 males, 13 females) treated at the Asan Medical Center between 1996 and 2009.ResultsMedian age at diagnosis was 38 days (range, 1 to 381 days). Seven patients (30%) were diagnosed with IHHE based on sonographically detected fetal liver masses, 5 (22%) were diagnosed incidentally in the absence of symptoms, 5 (22%) had congestive heart failure, 3 (13%) had skin hemangiomas, 2 (9%) had abnormal liver function tests, and 1 (4%) had hepatomegaly. All diagnoses were based on imaging results, and were confirmed in three patients by histopathology analysis. Six patients were observed without receiving any treatment, whereas 12 received corticosteroids and/or interferon-alpha. One patient with congestive heart failure and a resectable unilobar tumor underwent surgical resection. Three patients with congestive heart failure and unresectable tumors were managed by hepatic artery embolization with/without medical treatment. At a median follow-up of 29 months (range, 1 to 156 months), 21 (91%) patients showed complete tumor disappearance or >50% decrease in tumor size. One patient died due to tumor-related causes.ConclusionIHHE generally has a benign clinical course with low morbidity and mortality rates. Clinical course and treatment outcome did not differ significantly between medically treated and non-treated groups. Surgically unresectable patients with significant symptoms may be treated medically or with hepatic artery embolization

Çekirge benzeri sıçrama mekanizmasının biyobenzetim yaklaşımla geliştirilmesi ve analizi.

Highly effective and power efficient biological mechanisms are common in nature. The use of biological design principles in engineering domain requires adequate training in both engineering and biological domains. This requires cooperation between biologists and engineers that leads to a new discipline of biomimetic science and engineering. Biomimetic is the abstraction of good design from nature. Because of the fact that biomimetic design has an important place in mechatronic applications, this study is directed towards biomimetic design of grasshopper-like jumping mechanism. A biomimetic design procedure is developed and steps of the procedure have followed through all the study. A literature survey on jumping mechanisms of grasshoppers and jumping robots and bio-robots are done and specifically apteral types of grasshoppers are observed. After the inspections, 2D and 3D mathematical models are developed representing the kinematics and dynamics of the hind leg movements. Body-femur, femur-tibia and tibia-ground angles until take-off are obtained from the mathematical leg models. The force analysis of the leg models with artificial muscles and biological muscles are derived from the torque analysis. A simulation program is used with a simple model for verification. The horizontal displacement of jumping is compared with the data obtained from the simulation program and equation of motion solutions with and without air resistance. Actuators are the muscles of robots that lead robots to move and have an important place in robotics. In this scope, artificial muscles are studied as a fourth step of biomimetic design. A few ready-made artificial muscles were selected as an actuator of the grasshopper-like jumping mechanism at the beginning of the study. Because of their disadvantages, a new artificial muscle is designed and manufactured for mini bio-robot applications. An artificial muscle is designed to be driven by an explosion obtained due to the voltage applied in a piston and cylinder system filled with dielectric fluid. A 3.78-mm diameter Teflon piston is fitted with a clearance into a Teflon cylinder filled with a 25.7- mm fluid height and maximum 225 V is applied to the electrodes by using an electrical discharge machine (EDM) circuit. The force on the piston is measured by using a set-up of Kistler piezoelectric low level force sensor. The data obtained from the sensor is captured by using an oscilloscope, a charge meter, and a GPIB connecting card with software, Agilent. From the experiments, the new artificial muscle force is about 300 mN giving a 38:1 force to weight ratio and percentage elongation is expected to be higher than that of the natural muscles and the other artificial muscles. From the force analysis of the leg model, it is shown that the measured force is not enough alone for jumping of an about 500 mgr body. An additional artificial muscle or a single muscle designed with the same operating principle giving higher force to weight ratio is recommended as a future study.M.S. - Master of Scienc