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OBJECTIVE: In this study, we aim at investigating the magnetic resonance (MR) imaging features of molecular subtypes, according to the BIRADS Atlas. PATIENTS AND METHODS: The preoperative MRI examinations of 104 breast cancer patients were reviewed retrospectively using the 5th Edition Breast Imaging-Reporting and Data System (BI-RADS) Atlas. According to BIRADS, cases were classified as mass or non-mass enhancement. Background parenchymal enhancements of the cases were evaluated. The population was examined for shape, contour, enhancement characteristics of masses, distribution and internal enhancement patterns of nonmass enhancements, background parenchymal enhancement, multifocal/multicentric (MFMS) status, presence of axillary LAP, ADC values, and kinetic aspects. The Kruskal-Wallis and Chi-square tests were used to explore the connection between molecular subtypes and MR data. RESULTS: The link between molecular subtypes and mass/non-mass enhancement was discovered to be statistically significant (p=0.007). The shape (p=0.001) and contour (p=0.001) properties of the masses were observed to differ depending on the molecular subtypes. The Luminal types were usually irregularly shaped with irregular/spiculated contours, whereas the HER-2 (+) and Triple (-) subtypes were mostly oval/round with smooth contours. The subtype with the highest non-mass enhancement rate (70%) was HER-2 (+). Axillary lymphadenopathy was most common (64.3%) in the Triple (-) subtype (p=0.033). CONCLUSIONS: According to the BIRADS Atlas, molecular subtypes exhibit a wide range of imaging properties in MR in our study. [ABSTRACT FROM AUTHOR]

Reports in the literature of retropharyngeal hematoma as a complication of anticoagulation therapy are rare. When this complication does occur, it can become life-threatening if the airway is compromised. However, no consensus exists as to which approach--intubation, tracheotomy, or conservative therapy--is best for managing the airway in these cases. We report a case of retropharyngeal hematoma that occurred as a sequela to a trivial blunt trauma in a 48-year-old man who had been undergoing anticoagulation therapy with warfarin. The hematoma had caused airway obstruction, and the patient was hospitalized. He was treated conservatively, and the hematoma slowly resolved over the course of 2 weeks. On the basis of our experience and the findings of our literature review, we suggest that conservative management can be initiated for small nonexpanding hematomas that do not seriously compromise the airway. Securing the airway with intubation or tracheotomy should be reserved for patients who are in serious respiratory distress; the choice between intubation and tracheotomy should be made on an individual basis. [ABSTRACT FROM AUTHOR]

An abstract of the article "Right ventricular diastolic abnormalities in rheumatoid arthritis and its relationship with left ventricular and pulmonary involvement. A tissue Doppler imaging study," by E. Seyfeli and colleagues is presented.

Objectives: Magnetic resonance imaging (MRI) is an important modality for pelvic imaging. Vaginal distension is provided by the use of vaginal contrast in pelvic MRI, and it plays an important role in staging especially cervical and vaginal cancer. The aim of this study is to show whether the use of vaginal contrast material contributes to the diagnosis in pelvic examination., Material and Methods: Between October 1, 2016 and December 30, 2020, a total of 57 patients who underwent pelvic magnetic resonance imaging with vaginal contrast in the radiology clinic were included in the study and evaluated retrospectively., Results: Cervical cancer was detected in 38 of the 57 patients included in the study, and when the vaginal pre- and post-contrast staging of the patients was performed, the pre-contrast stage was found to be high in six patients (15%). Eight of 38 patients diagnosed with cervical cancer underwent surgery. When the pathological and radiological staging of the patients who underwent surgery were compared, they were 100% compatible., Conclusions: The use of vaginal contrast material increases the diagnostic value of MRI in various pelvic pathologies, especially in cervical cancer staging.

Purpose: We aimed to evaluate the postnatal development and the maturation of the sternum and sternal variations using multidetector computed tomography (MDCT). Additionally, we aimed to examine the roles of gender and age in sternal development., Materials and Methods: Two hundred and fifty patients who underwent thorax MDCT examinations were evaluated for sternal development and variations. Coronal curved planar reconstruction and maximum intensity projection images were used to better assess the ossification centers in the manubrium and the body of the sternum. Multiplanar images were used to accurately measure the thickness and the sagittal dimension of the manubrium, the sagittal dimension of the body, and the total sagittal dimension of the sternum in the sagittal plane., Results: No significant differences in the manubrium measurements were observed between the genders. The thickness and sagittal dimension of the manubrium, sagittal dimension of the body, and total sagittal dimension of the sternum in the sagittal plane were significantly different between the age groups. We evaluated the ossification centers; shape and developmental variations in the manubrium and body; direction, calcification, and termination of the xiphoid process; developmental variations in the xiphoid process; and manubriosternal and sternoxiphoidal fusion. Significant variations were observed from person to person., Conclusion: The anatomy and the developmental properties of the sternum should be well understood in cases of potential chest and sternum injuries and in several surgical procedures. Therefore, knowledge of the development and the maturation of the sternum, and sternal variations and anomalies is important. We suggest that the postnatal development and the morphogenesis of the sternum can be adequately assessed using MDCT.

Objective: The aim of this study was to compare the efficacy and the safety of ultrasound (US)-guided vs. blind steroid injections in patients with carpal tunnel syndrome (CTS)., Design: This prospective randomized single-blind clinical trial included 46 patients with CTS (46 affected median nerves). The subjects were randomized-to either the US-guided or the blind injection group-before they received 40 mg of methylprednisolone. They were evaluated using the Boston Carpal Tunnel Questionnaire symptom/function at baseline and at 6 wks and 12 wks after injection, and the side effects were noted., Results: The symptom severity and functional status scores improved significantly in both groups at 6 wks after treatment, and these improvements persisted at 12 wks after treatment (all P < 0.05). The improvement in symptom severity scores in the US-guided group at 12 wks was higher than in the palpation-guided group (P < 0.05). Average time to symptom relief was shorter in the US-guided group (P < 0.05). There was no significant difference between the two groups in terms of side effects (P > 0.05)., Conclusions: Although both US-guided and blind steroid injections were effective in reducing the symptoms of CTS and improving the function, an earlier onset/better improvement of symptom relief suggests that US-guided steroid injection may be more effective than are blind injections in CTS.

Objective: To evaluate the intrathyroidal hemodynamic changes and thyroidal volume in sickle cell disease (SCD) patients., Methods: Thirty-two patients with homozygous SCD and 32 control subjects were examined with color Doppler ultrasonography. None of the patients and control subjects had clinical or laboratory evidence of thyroid disease., Results: SCD patients had significantly higher resistance index (RI) and pulsatility index (PI) values and lower thyroid volume compared with control group., Conclusion: Increased intrathyroidal RI and PI and decreased thyroid volume may be due to impaired thyroidal microcirculation. Further and follow-up studies are needed to explain the relationship between Doppler parameters and thyroid functions., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Prior radiation exposure is the best known risk factor for thyroid cancers, and papillary thyroid carcinoma (PTC) may arise from dyshormonogenetic goiter. A 17-year-old female patient was admitted to the department of chest diseases with respiratory symptoms. The patient had undergone a thyroid surgery for goiter at the age of 9. A bilateral nodular opacity was detected by radiological examination. The histopathologic examination of the specimen obtained from computed tomography guided trucut biopsy was diagnosed as PTC. We present a very rare case of PTC with lung metastasis that had undergone subtotal thyroidectomy due to dyshormonogenetic goiter eight years ago.

Objective: The aim of this study was to evaluate the microstructure of various regions of the brain using diffusion-tensor imaging (DTI) in patients with sickle cell disease (SCD) and in age- and sex-matched healthy control subjects. We also investigated the fiber tractography findings of the corpus callosum (CC) and corticospinal tracts (CSTs)., Subjects and Methods: Sixteen right-handed patients with SCD and 14 age- and sex-matched right-handed healthy control subjects were scanned using conventional MR sequences and DTI. Fractional anisotropy (FA) and apparent diffusion coefficients (ADCs) were calculated and regions of interest were selected in various brain areas (superior and inferior frontal, parietal, occipital, and temporal white matter areas), anterior and posterior periventricular areas, centrum semiovale, basal ganglia (lentiform nucleus, head of caudate nucleus), thalamus, cerebral peduncles, pons, cerebellar white matter areas, and CC. Diffusion-tensor tractography of the CC and CSTs was also performed., Results: For the patients with SCD, significantly reduced FA values, increased ADC values, or both were seen clustered in several brain areas, including the CC, frontal white matter, centrum semiovale, periventricular areas, head of the caudate nucleus, thalamus, brainstem, and pons (p < 0.05). Statistically significant reductions in fiber counts in the first and fifth segments of the CC and in CSTs bilaterally were also observed in patients with SCD (p < 0.05)., Conclusion: DTI shows microstructural abnormalities of various brain areas in patients with SCD.

Background: Knee osteoarthritis, a common musculoskeletal disorder, can cause considerable pain and disability. This study investigates the effect of certain foot deformities on the functional status of women with knee osteoarthritis., Methods: The common foot deformities pes planus and hallux valgus were evaluated in 115 women with knee osteoarthritis and Kellgren-Lawrence grade 2 and 3 osteoarthritis. Anteroposterior and lateral foot-ankle standard radiographs were obtained bilaterally. A lateral talometatarsal angle greater than 4 degrees was defined as pes planus. A hallux valgus angle greater than 21 degrees was defined as hallux valgus. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to objectively assess functional impairment. Knee pain intensity was measured with a visual analog scale., Results: Fifty-nine patients had bilateral pes planus, hallux valgus, or both. The mean visual analog scale value was higher for the deformity group, but the difference was not statistically significant. There was a significant difference in WOMAC scores between the group with foot deformities versus the group without (P = .000). Visual analog scale scores were positively correlated with WOMAC scores (r = 0.499, P = .000). Also, there was a significant correlation between WOMAC scores and lateral talometatarsal angle (r = 0.266, P = .004) and hallux valgus angle (r = 0.362, P = .000) values., Conclusions: There is a significant correlation between indicators of pain and disability (visual analog scale and WOMAC scores). Also, the presence of foot deformities increased disability levels in women with knee osteoarthritis.

Objective: The purposes of this study were to determine the prevalence of abnormalities in the middle ear and mastoid cavity on the magnetic resonance imaging (MRI) in children and correlate the results with clinical data, tympanometric findings and paranasal sinus changes., Materials and Methods: A total of 85 consecutive pediatric patients for suspected non-inflammatory intracranial pathologies were prospectively examined. MRI was conducted for the suspected intracranial pathology. All patients were also examined by an otolaryngologist for otologic pathologies. A tympanometry examination was performed in patients prior to MRI scan., Results: In 23 (27.1%) of 85 (39 males, 46 females) children, MRI demonstrated middle ear and/or mastoid cavity abnormalities. MRI abnormalities of the middle ear and/or mastoid cavity were correlated with clinical data and tympanometric findings., Conclusions: Incidental abnormal signal intensities in the middle ear and/or mastoid cavity are frequent in children, especially in first years of life. MRI will demonstrate incidental middle ear and mastoid cavity abnormalities seems to have clinical significance.

Aim: This study was designed to investigate effect of gradual detorsion on testicular ischemia reperfusion injury., Materials and Methods: A total of 21 male rats were divided into 3 groups, each containing 7 rats. Torsion was created by rotating the left testis 720 degrees in a clockwise direction. Group 1 underwent sham operation. Group 2 (sudden detorsion) served as a torsion/detorsion group, receiving 2 hours torsion and 2 hours detorsion. In group 3, 360 degrees detorsion was done for 20 minutes after 720 degrees torsion for 2 hours. Then, testis was done full detorsion for 100 minutes. At the end of the experiments (fourth hour), left orchiectomy was performed to measure the tissue levels of malondialdehyde (MDA), superoxide dismutase, and glutathione peroxidase and to perform histologic examination in testes., Results: The MDA levels of testis tissues were significantly increased in the sudden detorsion group as compared with the sham group. We found decrease of the MDA level in gradual detorsion group, but it was not a statistically significant amount. Significant decrease was found in the superoxide dismutase and glutathione peroxidase activities in the sudden detorsion group as compared with the sham and gradual detorsion groups. Histologic examinations were in accordance with the testicular tissue MDA levels., Conclusion: In the light of our biochemical and histopathologic findings, we can say that gradual detorsion has a trend to decrease the degree of testicular reperfusion injury in the rat torsion/detorsion model.

Background: In 2006, a new medical payment framework such as fixed-payment method was implemented in Turkey and then cancelled 5 months later. The aim of this study was to explore the effects of this payment method on the demand for imaging tests., Methods: Data were obtained retrospectively from electronic medical records. The main outcome measures were the number of imaging tests, the payment per outpatient and the rate of negative results of imaging tests., Results: The overall mean number of imaging tests per outpatient was 0.75 +/- 0.13. This value decreased significantly after implementation of the fixed-payment method, and then increased after its cancellation (P < 0.01). The overall mean payment per outpatient was $14.1 +/- 2.3. For patients with social security, there was a significant decrease in the mean payment after implementation of the new method, followed by an increase after its cancellation (P = 0.02); in contrast, no significant changes were observed in patients not covered by social security (P > 0.05). No significant differences were observed in the rate of negative results for imaging tests (P > 0.05)., Conclusions: The use of a fixed-payment method reduces the demand for imaging tests when there is a strong financial relationship between the hospital and its personnel.

Purpose: The aim of this study was to evaluate the type and prevalence of abdominal ultrasonographic abnormalities in patients with sickle cell disease., Materials and Methods: A total of 102 patients with sickle cell disease at the Center of Hemoglobinopathy of the Antakya State Hospital were screened for intra-abdominal abnormalities by abdominal ultrasonography (US). Eightyfour patients were homozygous for sickle-cell disease (S/S), and 18 patients were compound heterozygotes for sickle cell-Beta thalassemia (S/Beta(thal)). At the time of examination, 15.7% (16/102) of patients had undergone splenectomy, and 18.6% (19/102) of patients had undergone cholecystectomy., Results: The most frequent US findings (expressed as percentages of all patients) were hepatomegaly (71.6%), renal enlargement (30.4%), autosplenectomy (33.3%), cholelithiasis (30.4%) and splenomegaly (17.4%). A bright liver was identified in 6 patients (5.9%), an echogenic pancreas in 4 patients (3.9%), and pancreatic punctate echogenic foci were identified in 5 patients (4.9%). Medullary or diffusely increased renal echogenicity was observed in 16 patients (15.7%). Sonographic findings typical of renal papillary necrosis were observed in one patient with S/S. Periportal lymphadenopathy was detected in 10 (11.9%) of 84 patients of the S/S group, and 2 (11.1%) of 18 patients of S/Beta(thal) group., Conclusion: Abdominal ultrasonographic imaging of patients with sickle cell disease revealed a high prevalence of abdominal abnormalities, especially in solid organs.

Background: Accessory ovaries are rare anomalies and cysts arising from accessory ovaries are extremely rare. Their reported incidence is 1/29,000-1/700,000. Establishing the diagnosis preoperatively is difficult. Radiologic methods are usually inadequate in recognizing the origin of these tumors. Thus, they are usually confused with other intraabdominal tumors., Case: A 22-year-old nulliparous girl presented with abdominal pain and tumoral growth for 1.5 years. Abdominal ultrasound and computed tomography revealed a 33 x 26 x 15 cm cystic mass filling the abdominal cavity. The preoperative diagnosis was a mesenteric cyst. Diagnostic laparotomy revealed a giant cystic mass arising in an accessory ovary. The left tuba and fimbrias were adhered to the cyst. The tumor was totally removed and fimbrioplasty performed., Conclusion: In spite of being rare entities, paraovarian anomalies should be considered in the differential diagnosis of intraabdominal tumors, especially when the origin is not identified by radiologic means., Case: A 22-year-old single, nulliparious female was admitted to our hospital with abdominal pain, nausea and a growing abdominal swelling since 1.5 years. A tumoral mass was palpated on physical examination. Abdominal ultrasound and computed tomography revealed a 33 x 26 x 15 cm cystic mass filling the abdominal cavity. The origin of the tumor could not be detected. Operation revealed a giant cystic mass arising from an accessory ovary. Histopathologic diagnosis was serous cystadenoma., Conclusion: Ovarian or accessory ovarian pathologies must be considered in the differential diagnosis of intraabdominal tumors, especially in young female population.

Purpose: The purpose of this study was to determine the normal range of the main pulmonary artery diameter (MPAD) by computed tomography (CT) in persons with normal pulmonary artery pressure, and then to evaluate the relationship of the diameter with age, gender, and body surface area (BSA)., Materials and Methods: Between October 2005 and June 2007, among patients who had previously undergone a contrast-enhanced thorax CT scan, 112 persons (47 females, 65 males) without pulmonary pathology were selected for the study. All patients had normal mean pulmonary artery pressure. The widest diameter perpendicular to the long axis of the main pulmonary artery was measured at the pulmonary artery bifurcation level. The outer limits of the contrast were used to determine vessel diameter., Results: Pulmonary artery diameters showed a homogeneous distribution; the CT-determined mean pulmonary artery diameter was 26.6 +/- 2.9 mm. The mean MPAD in males was 27 +/- 2.8 mm, and 25.9 +/- 3.0 mm in females. This difference was considered to be statistically significant (P = 0.048). There was a significant relationship between the MAPD and age and BSA (P = 0.043, P < 0.001)., Conclusion: The present study demonstrated that in individuals with normal pulmonary artery pressure, the upper limit of the MPAD is 32.6 mm and that MPAD is wellcorrelated with BSA.

Purpose: To investigate the effects of various degrees of diffuse fatty infiltration of the liver on portal vein blood flow with Doppler sonography., Methods: One hundred forty subjects were examined with color and spectral Doppler sonography. The subjects were divided into 4 groups of 35 subjects each according to the degree (normal, grade 1, grade 2 and grade 3) of hepatic fatty infiltration assessed on gray-scale images. The portal vein pulsatility index (VPI) and time-averaged mean flow velocity (MFV) were calculated for each subject. VPI was calculated as (peak maximum velocity - peak minimum velocity) / peak maximum velocity., Results: VPI and MFV values were, respectively, 0.32 +/- 0.06 and 16.8 +/- 2.6 cm/second in the normal group, 0.27 +/- 0.07 and 14.2 +/- 2.2 cm/second in the group with grade 1 fatty infiltration, 0.22 +/- 0.06 and 12.2 +/- 1.8 cm/second in the group with grade 2 fatty infiltration, and 0.18 +/- 0.04 and 10.8 +/- 1.5 cm/second in the group with grade 3 fatty infiltration. There was a negative inverse correlation between the grade of fatty infiltration and both VPI (f = 55.3, p < 0.001) and MFV (f = 43.9, p < 0.001)., Conclusion: The pulsatility index and mean velocity of the portal vein blood flow decrease as the severity of fatty infiltration increases., ((Copyright) 2007 Wiley Periodicals, Inc.)

In a 20-year-old male patient, a 180 degree inversion of visual image was found as a manifestation of multiple sclerosis. Upside down reversal of vision is not a well-known sign in multiple sclerosis. Exact mechanism is still unknown. Lesions involving cortical areas, mainly the parieto-occipital region, have occasionally been documented. To our knowledge this is the first report of upside-down reversal of vision in multiple sclerosis with cerebra lesion on MRI.

Purpose: To investigate the long-term effect of varicocele repair on ipsilateral intratesticular arterial resistance index (RI) using color Doppler sonography (CDS)., Methods: A total of 26 infertile patients with left varicocele who underwent a testicular artery and lymphatic-sparing subinguinal varicocelectomy were examined with CDS for intratesticular flow parameters before and at least 6 months after surgery. We also evaluated preoperative and postoperative semen parameters., Results: The mean values of RI, end-diastolic velocity and pulsatility index decreased significantly after surgery, whereas no significant change was observed in peak systolic velocity. Repair of the varicocele resulted in a statistically significant increase in the total sperm count, motility, morphology, and total motile sperm count. However, no significant correlation was found between sperm parameters and RI values (p > 0.05)., Conclusions: Our data show that a significant improvement occurs in testicular blood supply and sperm parameters after surgical varicocele repair, without significant correlation between these 2 changes., ((Copyright) 2007 Wiley Periodicals, Inc.)

Objective: We aimed to establish the values of the internal jugular vein (IJV) sizes in Turkish children aged between 0 and 6 years., Methods: Ninety-four normal children included in this study. All of the children were imaged by ultrasonography (USG) at the level of the cricoid cartilage. The maximal antero-posterior (AP) and transverse (T) diameters of the IJV were measured during regular breathing and Valsalva maneuver., Results: The mean transverse diameter of the right and left IJV were 8.11+/-3.01 and 7.64+/-2.68 mm in resting state. These values changed to 12.57+/-4.34 and 10.82+/-3.80 mm in Valsalva state, respectively. The AP diameters were found to be 5.43+/-2.07 for the right and 5.86+/-4.53 mm for the left IJV at rest. During VM, these values changed to 8.70+/-2.40 and 8.30+/-2.90 mm for the right and left IJV, respectively. There was no significant difference on the evaluation of the relationship between the right and left diameters of the IJV. While there were significant differences in sizes between the resting and Valsalva states. Also, the T diameter of the right IJV during Valsalva state was greater than those of the left. There were significant correlations between the diameters of the IJV and the age, weight and height of the children., Conclusion: The results we obtained in this study may be important in an attempt of intravascular intervention to IJV. These values may also be important for the comparison with the IJV sizes of the patients who have phlebectasia.

We aimed to investigate the relationship between nail involvement and joint manifestations and whether there was a correlation between nail psoriasis severity and bone manifestations in psoriatic patients without symptomatic psoriatic arthritis in plaque type psoriasis. Thirty-one patients with nail involvement (16 men, 15 women, mean age 45.29+/-18.73) and 39 patients without nail involvement (16 men, 23 women, mean age 38.41+/-17.33) were enrolled in the study. X-ray of the hands and feet with magnification were performed. The distal interphalangeal (DIP) joint and bone (tuft of terminal phalanx) were evaluated. A scoring method was performed on the patients with nail involvement. There was no difference in DIP joint involvement in patients with or without finger- and toenail involvement (p=0.085 and p=0.062, respectively). However, the prevalence of bone involvement was higher in patients with finger- and toenail involvement than without finger- and toenail involvement (p=0.039 and p=0.021, respectively). A positive correlation was also determined between finger- and toenail psoriasis severity and bone involvement severity (r=0.379, p=0.001 and r=0.288, p=0.015).

We report on the case of a 56-year-old man in whom a Morel-Lavallée lesion developed in the thigh. Ultrasound revealed a well-defined thick-walled cystic mass between the hypodermis and fascial planes that in some areas constituted hyperechoic papillar extensions in its wall. Magnetic resonance T(1)-weighted images showed that the mass was well circumscribed and mildly inhomogeneous and had a high signal intensity. On T(2)-weighted images, the mass had mixed signal intensity and a fluid-fluid level. We also discuss both the difficulty in making a differential diagnosis for and the treatment of this lesion.

Objective: The purpose of this study was to investigate the incidence of the retroaortic left renal vein (RLRV) in patients with varicocele., Methods: The left renal vein was ultrasonographically investigated for the presence of the RLRV in 140 patients with varicocele and a control group of 137 age-matched patients. The main diagnostic criteria for varicocele were the presence of a varicose vein with a diameter of 3 mm or larger at rest and with a reflux lasting more than 2 seconds during the Valsalva maneuver. The RLRV was defined as a posterior course of the left renal vein to the aorta at the level of the origin of the superior mesenteric artery., Results: The RLRV was observed in 13 (9.3%) of the 140 patients with varicocele and 3 (2.2%) of the control patients. The incidence of the RLRV was found to be significantly higher in patients with varicocele compared with the control patients (P = .018, Fisher exact test). In 13 patients with the RLRV, left varicocele and bilateral varicocele were detected in 10 and 3 cases, respectively., Conclusions: In this study, the incidence of the RLRV was found to be significantly higher in patients with varicocele compared with control patients. Thus, we suggest that the presence of the RLRV may be considered one of the etiologic factors in the development of varicocele.

Objectives/hypothesis: To determine the dimensions of the compensatory hypertrophic inferior turbinate and investigate the radiological changes in the morphology of the conchal bone in patients with septal deviation., Study Design: A retrospective chart review., Methods: The mucosal and bone compartments of the hypertrophic turbinate were measured using computed tomography (CT) in patients with septal deviation, and the conchal bones were classified radiologically as lamellar, compact, and combined types. The results were compared with those of controls., Results: The dimensions of the bony and mucosal components of the inferior turbinate were significantly greater than those of controls in the anterior and middle segments, while the morphological changes in the conchal bone were not different., Conclusion: The significant bony and mucosal enlargement in the anterior and middle segments of the inferior turbinate supports turbinate reduction at the time of septoplasty and the CT findings should be considered when making a decision about the reduction type.

Case Report: We present the clinical, radiologic, and histopathologic features of an orbital mass in a 10-year-old boy. Immunohistochemistry confirmed the diagnosis of primary peripheral primitive neuroectodermal tumour., Comments: This recently recognized rare tumour of the orbit should be considered in the differential diagnosis of hypercellular small round cell tumour of the orbit.

Background: Our aim is to determine comorbidities associated with pulmonary hypertension (PHT) in clinically stable sickle-cell disease (SCD) patients and to evaluate left ventricular (LV) and right ventricular (RV) function in those patients., Methods: Echocardiography was performed in 87 SCD patients that were divided into group I (without PHT) and group II (with PHT). Both groups were compared with healthy controls., Results: A history of retinopathy and leg ulcer was more frequent in group II than group I (p < 0.01). Haemoglobin levels were lower (p < 0.05), whereas blood urea nitrogen, lactate dehydrogenase and total bilirubin levels were higher in group II (p < 0.01). Although group II patients had larger LV end-diastolic, LV end-systolic and RV diastolic diameters compared with group I patients and controls (p < 0.05), LV ejection fraction was similar in the three groups. The mitral peak early diastolic inflow velocity to peak late diastolic inflow velocity (E/A) ratio was similar in group I, group II and the control group. The tricuspid E/A ratio was lower in group II than group I and controls (p < 0.05)., Conclusion: End organ damage occurs more often and haemolysis is severer in SCD patients with PHT than SCD patients without PHT. Although LV systolic and diastolic function is well preserved, RV diastolic function is disturbed in those patients with PHT., (Copyright 2007 S. Karger AG, Basel.)

Objectives: To investigate right ventricular diastolic function in rheumatoid arthritis (RA) and its relationship with left ventricular and pulmonary involvement., Methods: Thirty-five RA patients and 30 healthy subjects were submitted to conventional Doppler (CE) and tissue Doppler echocardiography (TDE) to assess left and right systolic and diastolic function and to estimate maximal arterial systolic pulmonary pressure (PAP). To detect pulmonary involvement, pulmonary function tests and high-resolution computed tomography (HRCT) scans were performed in all RA patients., Results: An abnormal RV filling, as expressed byan inverted tricuspid (Tr.) E/A ratio, was detected in 12 (34%) of the 35 RA patients and in 2 (7%) of the 30 controls (P<0.004). If compared to CE findings, prevalence of RV diastolic abnormalities were found higher in patients with RA by TDE (RV annulus Em/Am ratio <1 (in 31 (89%) of 35 patients) (P = 0.002). Twenty-two (63%) of 35 patients had abnormal HRCT findings. Pulmonary involvement with pulmonary hypertension (PHT) (36+/-5 mmHg) was detected in 10 (29%) of 35 RA. In this group, increase of RV annulus and basal Am wave, decrease of Tr. E/A ratio and RV annulus Em/Am ratio were statistically significant compared to RA (12 (34%) of 35) patients with pulmonary involvement who had normal PAP (19+/-5 mmHg), (P = 0.014, P = 0.006, P = 0.015, P = 0.049, respectively)., Conclusions: This study points out an impaired RV filling in a significant part of RA patients without overt heart failure. Impairment of RV diastolic function may be a predictor of subclinic myocardial and pulmonary involvement in patients with RA.