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Objective: Hirsutism affects 5-15% of women of reproductive age. Health-related quality of life (HQOL) is a multidimensional assessment of well-being that considers the physical, social, and emotional aspects associated with a specific disease. The aim of this study is to evaluate HQOL in patients diagnosed with idiopathic hirsutism (IH) and compare it with patients diagnosed with polycystic ovary syndrome (PCOS). Methods: This cross-sectional observational study was performed on 183 female individuals, consisting of 51 patients diagnosed with idiopathic hirsutism, 76 patients diagnosed with PCOS, and 56 healthy volunteers. Participants with a history of neuropsychiatric disorders, under 18 and over 45 years of age, during pregnancy and lactation, with any chronic disease that could interfere with diagnostic laboratory tests, and who had previously been treated for IH or PCOS were excluded from the study. Demographic, anthropometric, laboratory, and clinical data on the cases were recorded. The Short Form-36 (SF-36) questionnaire, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI) were administered in a face-to-face interview by related authors involved in the study. Results: The mean age, level of education, lifestyle, and marital status of all three groups were similar. There were no significant differences in body mass index (BMI) or waist circumference between the groups. Mean modified Ferriman-Gallwey (mFG) scores were similar in the IH and PCOS groups. In the IH patients, the general health and mental health domains of the SF-36 questionnaire scores were significantly lower than in the control group (p<0.001 and p=0.026, respectively). When the SF-36 questionnaire scores were compared between the IH and PCOS groups, the general health and role emotional domains were significantly lower in the PCOS group (p=0.013 and p<0.001, respectively), and the other domains were similar. All SF-36 questionnaire domains were significantly and negatively correlated with BMI and waist circumference measurements in IH patients. Both BDI and BAI scores were significantly and positively correlated with BMI (r=0.348, p<0.001, and r=0.162, p=0.012, respectively) and waist circumference (r=0.326, p<0.001, and r=0.344, p<0.001, respectively). Six out of eight domains of the SF-36 QOL scores were significantly and negatively correlated with the mFG scores. Conclusion: Patients diagnosed with IH have impaired HQOL, similar to patients diagnosed with PCOS. Improving HQOL should be a goal when deciding on a management approach for hirsutism, which is one of the most common reasons for referral to endocrinology and dermatology outpatient clinics. [ABSTRACT FROM AUTHOR]

Objectives: The major cause of primary hyperparathyroidism (pHPT) is parathyroid adenoma. Today, minimally invasive parathyroidectomy (MIP) has become the standard treatment for patients in whom the pathological gland can be localized with pre-operative imaging methods. In this study, we aimed to evaluate the role of 4D-CT in pre-operative localization in patients with pHPT who are negative for ultrasonography (USG) and/or sestamibi single-photon emission computed tomography/CT (SPECT/CT) and will undergo primary surgery. Methods: Patients whom were operated between 2018 and 2023 were included to this study. 4D-CT results of patients with one-or two-negative USG and SPECT/CT results were evaluated retrospectively. Results: In this study, 19 patients (5 men and 14 women) with a mean age of 57.1±8.5 years were evaluated. Pathology results were consistent with parathyroid adenoma in 18 patients (94.7%) and parathyroid hyperplasia in 1 patient (5.3%). USG was negative in six patients, SPECT/CT was negative in 14 patients, and both were negative in four patients. In 4D-CT, positive images were detected in 15 patients and these results were finalized as true positive in 14 patients and false positive in 1 patient. The sensitivity of 4D-CT was 82.4% (95% CI: 60.4-95.3%), positive predictive value was 93.3% (95% CI: 73.8-99.6%), accuracy was 78.9%, and localization rate was 73.7%. In 14 (73.7%) patients, the pathological glands were removed by MIP. Conclusion: In approximately 75% of patients with negative USG and/or SPECT/CT, the pathological gland can be localized with 4D-CT and MIP can be applied in these patients. [ABSTRACT FROM AUTHOR]

Aim: To investigate the role of Diffusion-weighted magnetic resonance imaging and apparent diffusion coefficient (ADC) values in the differential diagnosis of solid lesions of the breast. Materials and Methods: Diffusion-weighted images and ADC values from 36 women with 37 solid lesions definitely diagnosed through breast biopsy and post-surgical histopathology were evaluated retrospectively. ADC values obtained from malignant and benign solid lesions of the breast were compared using the t-test. The optimum threshold value for use in differentiating benign and malignant lesions was determined using ROC analysis, and sensitivity and specificity values were calculated.Results: Histological analysis identified 23 lesions and 14 benign lesions. Mean age (49 ± 7.8 years) was higher in the group with malignant breast lesions than in the group with benign breast lesions (37.3 ± 8.2) (p 0.05). The mean ADC value (1.1 ± 0.2 × 10-3 mm2/s) in the patients with malignant breast lesions was significantly lower than in the group with benign breast lesions (1.49 ± 0.18 × 10-3 mm2/s) (p 0.05). When the threshold value to be used in the ROC curve was applied the differentiation of benign and malignant solid lesions, the sensitivity was 78.3% and specificity was 100%.Conclusions: Diffusion-weighted MRI and ADC values have the potential to contribute to the diagnosis of solid lesions in the breast at conventional MR examination by differentiating between benign and malignant tumors. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the role of magnetic resonance (MR) diffusion tensor imaging (DTI) in the assessment of liver fibrosis and inflammation in chronic viral hepatitis by measuring apparent diffusion coefficient (ADC) and fractional anisotropy (Fa) values. Material and Methods: Twenty-seven patients (5 women and 22 men;mean age39.8±11.3) with hepatic fibrosis were included in our study. The relationship between ADC, Fa values and histological activity index (HAI) score were evaluated using Spearman's correlation coefficient. Patients were subgrouped as group A (fibrosis score 1) and group B (fibrosis score 3). The mean ADC and Fa values of groups A and B were compared using Student's t-test. To evaluate the use of ADC and Fa values in distinguishing group A from group B, ROC analysis was applied; sensitivities and specificities were calculated. Results: Fa values correlated with HAI scores significantly (r=0.397, p<0.05) The difference was significant between the mean ADC values (group A:1.46± 0.191x103mm2/s; group B:1.105± 0.141x10-3 mm2/s; p<0.001) and Fa values (group A: 0.473±0.091; group B: 0.643± 0.007; p<0.001) between the groups. For distinguishing group A from group B, ADC had a sensitivity of 81.8% and a specificity of 93.8%. The sensitivity and specificity of Fa were 90.9% and 100%, respectively. Conclusion: Diffusion tensor imaging may play a role in the evaluation of fibrosis and HAI scores in patients with liver fibrosis. [ABSTRACT FROM AUTHOR]

Background: The objective of this study is to bring attention to the importance of differential diagnosis in adolescent patients with skeletal involvement and hypercalcemia. Case: A 17-year-old male patient with a complaint of severe leg pain was admitted to our hospital. Seven months before he had a fracture of his distal humerus after falling on to his left shoulder and was treated conservatively. Five months previously, he had a rupture of his quadriceps tendon. Magnetic resonance imaging (MRI) was performed for the quadriceps tendon rupture and was evaluated as polyostotic fibrous dysplasia (PFD). Doctors decided to operate for the ruptured tendon but they detected severe hypercalcemia in the pre-operative blood tests and noticed that the main disease was primary hyper-parathyroidisim (PHPT) which was caused by a giant parathyroid adenoma. Conclusions: Giant parathyroid adenoma can present in adolescent patients with multiple bone lesions and severe hypercalcemia. PHPT should be considered in the differential diagnosis of pathological bone fractures and benign bone tumors in every age. This may prevent patients from miss or delayed diagnosis of PHPT. [ABSTRACT FROM AUTHOR]

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Objective. Marine-Lenhart Syndrome (MLS) is defined as concomitant occurrence of autonomously functioning thyroid nodule (AFTN) with Graves’ disease (GD). Malignancy in a functional nodule is rare. We aimed to present an extremely rare case of papillary thyroid cancer in a MLS nodule with lateral lymph node metastases. Case. A 43-year-old male presented with hyperthyroidism and Graves’ ophthalmopathy. On Tc99m pertechnetate scintigraphy, a hyperactive nodule in the left upper thyroid pole was detected and the remaining tissue showed a mildly increased uptake. The ultrasonography demonstrated 15.5 × 13.5 × 12 mm sized hypoechoic nodule in the left upper pole of the thyroid and round lymph nodes on the left side of the neck. Fine needle aspiration biopsy (FNAB) of the nodule and lymph node revealed cytological findings consistent with papillary cancer. Total thyroidectomy with central and left modified radical neck dissection was performed. On pathologic examination, two foci of micropapillary cancer were detected. The skip metastases were present in three lymph nodes on the neck. Conclusion. AFTN can be seen rarely in association with GD. It is not possible to exclude malignancy due to the clinical and imaging findings. In the presence of suspicious clinical and sonographic features, FNAB should be performed. [ABSTRACT FROM AUTHOR]

The article presents information on diffusion tensor imaging of cysts, hemangiomas, and metastases of the liver. Topics discussed include diffusion-weighted magnetic resonance imaging (DW-MRI), use of MR diffusion tensor imaging (DTI), and evaluation of DTI using apparent diffusion coefficients (ADCs).

Background Disordered mineral metabolism is implicated in the pathogenesis of vascular calcification in hemodialysis (HD) patients. Fibroblast growth factor 23 (FGF-23) is the main regulator of phosphate metabolism. In this prospective study, we aimed to investigate the association of serum FGF-23 with progression of coronary artery calcification in HD patients. Methods Seventy-four HD patients(36 male/38 female,mean age:52 ± 14 years) were included. Serum FGF-23 levels were measured by ELISA. Coronary artery calcification score(CACS) was measured twice with one year interval. Patients were grouped as progressive (PG)(36 patients-48%) and non-progressive (NPG). Results Age, serum phosphorus, baseline and first year CACS were found to be significantly higher in the PG compared to NPG group. Serum FGF-23 levels were significantly higher in PG [155 (80-468) vs 147 (82-234), p = 0.04]. Patients were divided into two groups according to baseline CACS (low group, CACS ⩽ 30; high group, CACS > 30). Serum FGF-23 levels were significantly correlated with the progression of CACS (ΔCACS) in the low baseline CACS group (r = 0.51, p = 0.006), but this association was not found in high baseline CACS group (r = 0.11, p = 0.44). In logistic regression analysis for predicting the PG patients; serum FGF-23, phosphorus levels and baseline CACS were retained as significant factors in the model. Conclusions Serum FGF-23 was found to be related to progression of CACS independent of serum phosphorus levels. FGF-23 may play a major role in the progression of vascular calcification especially at the early stages of calcification process in HD patients. [ABSTRACT FROM AUTHOR]

Purpose: The use of electrocautery for tissue dissection is becoming increasingly popular, despite the associated risk of poor wound healing and excessive scarring. We conducted this study to compare the wound complications and early and late clinical results resulting from electrocautery versus the scalpel to create a cutaneous flap during thyroidectomy. Methods: The subjects of this study were 100 patients, randomized prospectively to either a scalpel group (group S, n = 50) or an electrocautery group (group E, n = 50). Results: Thickness of tissue damage, postoperative thickness of the flap, discomfort in the neck 7 days after surgery, and hypoesthesia and paresthesia in the neck 3 months after surgery were significantly higher in group E than in group S. There were no significant differences in overall postoperative wound complications, postoperative pain, satisfaction with the cosmetic result, or overall outcome of the operation between the groups. Although the incidence of seroma was higher in group E (20%) than in group S (8%), the difference was not significant. Conclusion: Although electrocautery was associated with increased histological tissue damage, postoperative flap edema, discomfort, and other complications in the early stage, the clinical and cosmetic results of flaps made using electrocautery or a scalpel were similar and satisfactory 6 months after surgery. [ABSTRACT FROM AUTHOR]

Purpose: To determine the visualization rate of the appendix in children without appendicitis and investigate factors affecting it. Methods: Between January 2010 and April 2010, 205 consecutive children (103 boys and 102 girls; mean age: 9 years) without clinical signs of appendicitis were examined by ultrasound (US). The location of appendix was determined. The outer appendiceal diameter with and without compression was measured and the content of the lumen and mural vascularity on color Doppler was determined. The appendix diameter was correlated with age, weight, and height using Pearson correlation. For age, weight, and height, children with a visualized appendix were compared with those in whom the appendix was not visualized using Student's t test. Results: The appendix was visualized in 142 of 205 (69.3%) children. The mean diameters of the appendices without and with compression were 4.2 ± 0.9 mm and 3.5 ± 0.8 mm, respectively, with 53.5% of the appendices in the mid-pelvic location. Appendiceal lumen was empty in 35.2% of children. Only one appendix showed mural vascularity on color Doppler. There was no correlation between the diameter (compressed or noncompressed) of the appendix and age, weight, or height. Mean ± SD age, weight, and height of the children with a visualized appendix (8.6 ± 0.3 years, 29.9 ± 0.9 kg, 127.7 ± 1.7 cm, respectively) were significantly lower than those in children with a nonvisualized appendix (9.8 ± 0.4 years, 36.0 ± 1.8 kg, 134.7 ± 2.5 cm, respectively) (p < 0.05 for all three parameters). Conclusion: In the majority of the children, the appendix can be visualized with US. Age, weight, and height affect the visualization rate of the normal appendix. [ABSTRACT FROM AUTHOR]

Penile Mondor's disease is an unusual condition, which is characterized by thrombosis in superficial dorsal penile vein. Here, we report the sonographic findings of this disease in a 35-year-old male along with the absence of right dorsal penile artery. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare the ultrasonographic features of benign nodules, follicular lesions and malignant nodules in the thyroids of patients who underwent fineneedle aspiration biopsy. We retrospectively analyzed the ultrasonographic features of 231 nodules, which were diagnosed as benign, follicular lesion or malignant nodules with respect to solitariness, echogenicity, echostructure, border characteristics, presence or absence of calcifications, internal vascularity and the presence of a halo. The ultrasono-graphic features of benign nodules, follicular lesions and malignant nodules were compared using the Fisher-Freeman-Halton exact test. Differences were statistically significant if p < 0.05. With regard to cytopathology, there were 186 benign nodules, 10 follicular lesions and 35 malignant nodules. The distribution of frequencies of the ultrasonographic features including hypoechogenicity [46/186 (24.7%), 4/10 (40%), 29/35 (82.9%)], solid echostructure [63/186 (33.9%), 7/10 (70%), 34/35 (97.2%)], irregular margin [29/186 (15.6%), 3/10 (30%), 27/35 (77.1%)], microcalcification [16/186 (8.6%), 2/10 (20%), 15/35 (42.9%)] and absence of a halo [55/186 (29.5%), 5/10 (50%), 33/35 (94.2%)] between benign nodules, follicular lesions and malignant nodules, respectively, was statistically significant (Fisher-Freeman-Halton, p < 0.05). The frequencies of solitariness [35/186 (18.8%), 2/10 (20%), 7/35 (20%)] and internal vascularity [101/186 (54.3%), 7/10 (70%), 21/35 (60%)] between benign nodules, follicular lesions and malignant nodules, respectively, were not statistically significant (p > 0.05). Ultrasound features including hypoechogenicity, solid echostructure, irregular margin, presence of microcalcification and absence of a halo might be effective in the differentiation of malignant nodules and follicular lesions from benign nodules. [Copyright &y& Elsevier]

To determine the diagnostic accuracy of 3D-CTA using volume rendering (VR) in the detection of residual or recurrent cerebral aneurysms after clipping. Between January 2006 and November 2007, 45 patients (20 female, 25 male) with 50 intracranial aneurysms treated using titanium clips were enrolled in this study. IADSA and 3D-CTA were performed within 1 month after surgery in 27 (60%) patients, after 1 year in 12 (26%) patients and after 5 years in six (13%) patients. In blinded fashion, CTA and DSA images were independently interpreted by two senior neuroradiologists with 7 years of experience in vascular diagnostic neuroradiology. The diagnostic performance of MDCTA compared with DSA for the detection of aneurysm remnants was measured by receiver operating characteristic (ROC) analysis. The area under the ROC curve, 95% confidence interval (CI), sensitivity, and specificity were calculated. For the detection of residue–recurrent aneurysm; the sensitivity and specificity of MDCTA were 87.5% (95% CI = 52.9–97.8%) and 97.4% (95% CI = 86.5–99.5%) for the first reader and 87.5% (95% CI = 52.9–97.8%) and 100% (95% CI = 90.8–100%) for the second reader respectively. Receiver operating characteristic (ROC) analysis revealed good diagnostic performance for 3D-CTA (mean area under ROC curve (Az) = 0.98 and 0.99 for the first and the second observer, respectively) The kappa values extracted from the interobserver concordance analysis for agreement observers regarding the use of MDCTA for assessment of a remnant neck was 0.62. Using MDCTA, it is possible to demonstrate the status of intracranial aneurysms after surgical clipping in the immediate postoperative period as well as long-term follow-up with an high sensitivity and specificity when comparing with the findings of DSA. [ABSTRACT FROM AUTHOR]

We present a case of a 48-year-old female with a history of cholecystectomy and recurrent attacks of pancreatitis whose initial abdominal sonography (US) revealed multiple conglomerated stones in the descending part of the duodenum. Abdominal CT, MRI, and magnetic resonance cholangiopancreatography showed the same findings. The distended sacciform distal intramural segment of the common bile duct was protruding into the duodenum. The imaging findings explained the etiology of the patient's recurrent attacks of pancreatitis and led to surgical excision of the choledococele. © 2011 Wiley Periodicals, Inc. J Clin Ultrasound 40:448-450, 2012 [ABSTRACT FROM AUTHOR]

Renal involvement is a fairly frequent development in children with acute lymphoblastic leukemia, but palpable renal enlargement at time of diagnosis is very unusual. We report the case of a young girl who presented with enlarged kidneys and was diagnosed with this form of leukemia. This case is of interest because of the rarity of this presentation. The importance of renal biopsy in identifying the etiology of this patient's nephromegaly is emphasized. [ABSTRACT FROM AUTHOR]

Duodenal duplication is a rare cause of acute pancreatitis in children. We report a case of acute pancreatitis in which abdominal sonography revealed an enlarged hypoechoic edematous pancreas with mildly dilated main pancreatic duct and a cystic structure with layered wall in the second part of duodenum. Abdominal CT yielded similar findings. The diagnosis of duodenal duplication was confirmed at surgery and subsequent histopathologic examination. [ABSTRACT FROM AUTHOR]

Background: Disordered mineral metabolism is implicated in the pathogenesis of vascular calcification in hemodialysis (HD) patients. Fibroblast growth factor 23 (FGF-23) is the main regulator of phosphate metabolism. In this prospective study, we aimed to investigate the association of serum FGF-23 with progression of coronary artery calcification in HD patients.Methods: Seventy-four HD patients (36 male/38 female, mean age: 52 ± 14 years) were included. Serum FGF-23 levels were measured by ELISA. Coronary artery calcification score (CACS) was measured twice with one year interval. Patients were grouped as progressive (PG) (36 patients-48%) and non-progressive (NPG).Results: Age, serum phosphorus, baseline and first year CACS were found to be significantly higher in the PG compared to NPG group. Serum FGF-23 levels were significantly higher in PG [155 (80-468) vs 147 (82-234), p = 0.04]. Patients were divided into two groups according to baseline CACS (low group, CACS ≤ 30; high group, CACS > 30). Serum FGF-23 levels were significantly correlated with the progression of CACS (ΔCACS) in the low baseline CACS group (r = 0.51, p = 0.006), but this association was not found in high baseline CACS group (r = 0.11, p = 0.44). In logistic regression analysis for predicting the PG patients; serum FGF-23, phosphorus levels and baseline CACS were retained as significant factors in the model.Conclusions: Serum FGF-23 was found to be related to progression of CACS independent of serum phosphorus levels. FGF-23 may play a major role in the progression of vascular calcification especially at the early stages of calcification process in HD patients. [ABSTRACT FROM AUTHOR]

Describes the case of a patient with diastematomyelia. Case history; Results of computed tomography and magnetic resonance imaging; Types of diastematomyelia; Presence of one dural sheath associated with a bony spur.