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Hypereosinophilic syndrome (HES) is a rare hematological disease that causes organ damage by eosinophil infiltration in the tissue with increased eosinophil production in the bone marrow. HES is a rare but important cause of stroke. Central nervous system involvement findings can be serious and life-threatening. Eosinophil values should be examined as the cause of stroke, and hypereosinophilia should be suspected, especially in young patients with no etiology. Reported herein is a case of a 47-year-old female patient who was followed up with the diagnosis of acute cerebrovascular disease due to idiopathic HES.

Mowat–Wilson syndrome (MWS) is an autosomal dominant genetic disorder caused by ZEB2 gene mutations, manifesting with unique facial characteristics, moderate to severe intellectual problems, and congenital malformations as Hirschsprung disease, genital and ophthalmological anomalies, and congenital cardiac anomalies. Herein, a case of 1-year-old boy with isolated agenesis of corpus callosum (IACC) in the prenatal period is presented. He was admitted postnatally with Hirschsprung disease (HSCR), hypertelorism, uplifted earlobes, deeply set eyes, frontal bossing, oval-shaped nasal tip, ‘‘M’’ shaped upper lip, opened mouth and prominent chin, and developmental delay. Hence, MWS was primarily considered and confirmed by the ZEB2 gene mutation analysis. His karyotype was normal. He had a history of having a prenatally terminated brother with similar features. Antenatally detected IACC should prompt a detailed investigation including karyotype and microarray; even if they are normal then whole exome sequencing (WES) should be done.

WOS:000582143700006 PubMed: 32856885 Background: Considering the critical role of early diagnosis and management of acute ischemic stroke, biomarkers that can reliable assist in the diagnosis are still needed. These biomarkers should rapidly analyze, have high specificity for brain damage, and be available in the emergency settings for early diagnosis and exclusion of other conditions that mimic acute ischemic stroke. Soluble tumor necrosis factor-like weak inducer of apoptosis, a protein involved in the regulation of several biological functions, could be a potential acute ischemic stroke biomarker. Aims: To investigate the diagnostic value of soluble tumor necrosis factor-like weak inducer of apoptosis in patients with acute ischemic stroke and examine the relationship between ischemic area volume determined at diffusion-weighted magnetic resonance imaging and soluble tumor necrosis factor-like weak inducer of apoptosis. Study Design: A prospective, case-control study. Methods: This case-control prospective study included 36 patients with acute ischemic stroke and 36 healthy volunteers. Information on age, sex, presence of chronic disease, neurological examination findings, times of presentation to the emergency department after acute ischemic stroke, soluble tumor necrosis factor-like weak inducer of apoptosis levels, ischemic area volumes at diffusion-weighted magnetic resonance imaging, and 6-month mortality rates after stroke were recorded. The results were analyzed on SPSS 22.0 software (SPSS Inc., Chicago, IL, USA), and p

WOS: 000523403800001 PubMed: 32248444 Objective The incidence of osteoarthritis is gradually increasing in public due to aging and increase in obesity. Various imaging methods are used in the diagnosis of hip osteoarthritis, and plain pelvic radiography is the first preferred imaging method in the diagnosis of hip osteoarthritis. In this study, we aimed to develop a computer-aided diagnosis method that will help physicians for the diagnosis of hip osteoarthritis by interpreting plain pelvic radiographs. Materials and methods In this retrospective study, convolutional neural networks were used and transfer learning was applied with the pre-trained VGG-16 network. Our dataset consisted of 221 normal hip radiographs and 213 hip radiographs with osteoarthritis. In this study, the training of the network was performed using a total of 426 hip osteoarthritis images and a total of 442 normal pelvic images obtained by flipping the raw data set. Results Training results were evaluated with performance metrics such as accuracy, sensitivity, specificity, and precision calculated by using the confusion matrix. We achieved accuracy, sensitivity, specificity and precision results at 90.2%, 97.6%, 83.0%, and 84.7% respectively. Conclusion We achieved promising results with this computer-aided diagnosis method that we tried to develop using convolutional neural networks based on transfer learning. This method can help clinicians for the diagnosis of hip osteoarthritis while interpreting plain pelvic radiographs, also provides assistance for a second objective interpretation. It may also reduce the need for advanced imaging methods in the diagnosis of hip osteoarthritis.

INAL, MIKAIL/0000-0003-0642-7913 WOS: 000448798800010 Objective: The aim of this study is to examine the diffusional changes in the vitreous humor in multiple sclerosis and Behcet's disease. Materials and Methods: Apparent diffusion coefficient values were investigated in diffusion magnetic resonance imaging scans of a total 111 vitreous, 31 of which were Behcet's disease patients, 40 had multiple sclerosis and 40 were healthy volunteers. Then, multiple sclerosis and Behcet's disease group were statistically compared with healthy volunteers and their apparent diffusion coefficient values amongst themselves. Results: There was no significant difference in terms of age and sex distribution among the three study groups (p>0.05). While there was no significant difference between multiple sclerosis and control groups (p>0.05), apparent diffusion coefficient values of Behcet's patients were significantly lower than multiple sclerosis and control groups (p

INAL, MIKAIL/0000-0003-0642-7913 WOS: 000347167300005 PubMed: 25763192 Introduction: Superior mesenteric artery syndrome is an uncommon cause of duodenal obstruction, and its manifestations are generally associated with compression on the third part of the duodenum between the abdominal aorta and superior mesenteric artery. Case Presentation: In this report, a patient is described presenting with epigastric pain and weight loss due to superior mesenteric artery syndrome. The patient has also nutcracker syndrome, which is the compression of the left renal vein between the aorta and the superior mesenteric artery at its origin. Conclusions: In addition to an appropriate clinical history, CT findings indicating decreased aortomesenteric angle and a shortened aortomesenteric distance can suggest the diagnosis for both the superior mesenteric artery syndrome and accompanying nutcracker syndrome.

INAL, MIKAIL/0000-0003-0642-7913 WOS: 000347164400012 PubMed: 25780548 Background: Surgery of appendicitis carries 7-11% negative appendectomy rates. Sonographically visualized normal appendix precludes unnecessary computed tomography (CT) examination and may reduce negative appendectomy rates. Tissue harmonic imaging (THI) has been reported to improve the overall image quality. Objective: We aimed to assess whether THI is more successful than conventional ultrasonography (US) in detecting normal and pathologic appendices. Patients and Methods: The study was performed on 185 patients who applied for routine US examinations in whom clinical findings of appendicitis were detected in 25. We searched for the appendix; applying both THI and conventional US to each patient, one before and the other after the routine US examinations. Patients were divided into two groups; one was evaluated first with conventional US and the other first with THI. When the appendix was found, localization, diameter and time spent for visualization were recorded. Twelve patients were operated; all of whom had appendicitis pathologically. Two methods were compared for: 1. Success rates in all patients; female, male and child groups separately; 2. Visualization of pathologic and normal appendices; 3. Time for visualization of appendix; 4. Comparison of success rates in the adult and child population. The relationship between the rate of visualization and body mass index was evaluated. Results: The appendix was visualized better by THI in all patients, and in the female and male groups (P < 0.001). In children, both methods were more successful compared to adults (P < 0.001, compared to male group, P < 0.001, compared to female group), with no difference between the methods (P = 0.22). When only the normal appendices were concerned, there was significant difference between both methods (P < 0.000). Both methods detected pathologic appendices better than normal ones, with a higher ratio for THI (P = 0.022 for the THI group, and chi(2) = 7.22, P = 0.07 for the conventional US group). THI visualized the appendix faster. Both methods were more successful in lean patients (P = 0.004 for THI, P = 0.001 for conventional US imaging). Conclusions: THI visualizes appendix better than conventional US. It is a simple and time saving method that may eliminate further diagnostic imaging, and it may decrease negative appendectomy rates and related complications.

INAL, MIKAIL/0000-0003-0642-7913 WOS: 000343525300002 Nutcracker syndrome (NCS) is a rare pathology, caused by compression of the left renal vein (LRV) between the abdominal aorta (AA) and the superior mesenteric artery (SMA), due to reduction of the angle between AA and SMA. This leads to LRV varices, left gonadal vein varices and therefore, the pelvic congestion syndrome. For this reason, coexistence of NCS and pelvic congestion syndrome has been described. It manifests by hematuria, proteinuria, and nonspecific pelvic pain secondary to pelvic congestion, dyspareunia and persistent genital arousal We report a 27-year-old woman who experienced hematuria and left flank pain. The diagnosis of NCS accompanied by pelvic congestion syndrome was missed initially but later on the diagnosis was made by color Doppler ultrasound, abdominal computed tomography (CT) and CT angiography that were later performed. She refused interventional and surgical treatments, and was lost to follow up.

To the Editor, Here, we report an extremely rare endoscopic finding, intramural duodenal diverticulum (IDD), a windsock diverticulum, in a 38-year-old woman who was admitted to our outpatient clinic with the complaint of dyspepsia. Her medical history and physical examination were unremarkable. All laboratory findings, including whole blood count, total biochemistry, erythrocyte sedimentation rate, and C-reactive protein, were in the normal range. Abdominal ultrasonography was normal. An upper gastrointestinal endoscopy revealed antral gastritis, and gastric biopsies were performed for H. pylori infection. Also, a juxtapapillary flat diverticulum was detected in the second portion of the duodenum (Figure 1). When the endoscope was inserted into the diverticulum, there was an orifice approximately 11 mm in diameter at the end of the diverticulum, surrounded with a totally normal mucosa, which revealed that it was a natural orifice (Figure 2). The third portion of the duodenum could be visualized from the orifice. When methylene blue was sprayed from the orifice with a sclerotherapy catheter, it was confirmed that the diverticulum was connected with the third portion of the duodenum via this orifice. Due to the typical endoscopic finding, the diverticulum was thought to be a duodenal windsock diverticulum, and abdominal computerized tomography was performed for possible co-existing gastrointestinal abnormalities, which revealed normal findings. In the follow-up, the patient was symptom free after H. pylori eradication therapy.

WOS: 000353553700065 PubMed: 25910334 …

WOS: 000249820100010 PubMed: 17607091 Background and aims: This study aimed to determine whether there is an adrenomedullin (AM)-mediated protective effect of postmenopausal estroger/progestin therapy (HRT) against cardiovascular disorders. Methods: A total of 22 post-menopausal women without hysterectomy undergoing postmenopausal symptoms (aged 43-52) were treated with conjugated equine estrogen (0.625 mg/die) plus medroxyprogesterone acetate (2.5 mg/die) for six months. The flow velocity of the right middle cerebral artery [measured as resistance index (RI) and pulsatility index (PI)], plasma levels of adrenomedullin and endothelin-1 (ET-1), mean baseline ratio of AM to ET-1, and lipid profiles were assessed before and after HRT. Results: A statistically significant difference was found for triglycerides, total cholesterol, AM/ET-1 ratio and right middle cerebral artery PI (p < 0.05), without any significant differences in HDL, LDL, AM, ET-1, systolic blood pressure, diastolic blood pressure, a right middle cerebral artery RI (p > 0.05) between pre- and post-HRT. Conclusions: Adrenomedullin may be added to other vasoactive peptides as a new potential candidate for HRT-mediated vascular protection. The ratio of AM/ET-1 vs AM or ET-1 alone may be a useful biological marker of this protection.

WOS: 000227685200006 PubMed: 15756661 Purpose. We used Doppler sonography to determine the resistance index (RI) and pulsatility index (PI) of the normal lacrimal artery (LA) in both females and males. We also compared the values obtained at various periods of reproductive life. Methods. The study was performed in 25 prepubertal girls, 28 females of reproductive age, and 27 postmenopausal women, 23 pregnant women, and 104 healthy males. Doppler sonography was used to determine the RI and PI of the LA. Results. The mean PI for the entire patient population was 1.48 +/- 0.60 and the RI was 0.72 +/- 0.09. The RI and PI values of the LA did not differ between males and females. Similarly, the mean RI and PI values of the LA did not change significantly between the various reproductive phases. Conclusion. The PI and Rl of the lacrimal gland are similar in both sexes. Moreover, they are not altered by changes in levels of sex steroids. (c) 2005 Wiley Periodicals, Inc. J Clin Ultrasound 33:123-126, 2005; Published online in Wiley InterScience (www.interscience.wiley.com).

Batislam, Ertan/0000-0002-7493-4573 WOS: 000227307000045 Abscess as a complication of extracorporeal shock wave lithotripsy is a rare condition, We present the computed tomography findings of an abdominal wall abscess that occurred after extracorporeal shock wave lithotripsy for which prophylactic antibiotics had not been given. The abscess destroyed the posterior abdominal wall muscles and dissected into the thorax. The muscles were thickened and showed enhancement. A parenchymal defect in the right kidney adjacent to a caliceal stone, with strands extending from this defective region to the abscess, was observed, and was thought to be the result of parenchymal destruction caused by the shock waves. Other parts of the kidney and psoas muscle were normal. Microbiologic examination revealed Escherichia coli. UROLOGY 65: 389.e16-389.e18, 2005. (C) 2005 Elsevier Inc.

We report a case with a defect in the medial orbital wall, causing a protrusion of orbital contents into the ethmoidal cells. Both the coronal and axial computed tomography of the paranasal sinuses demonstrated the protrusion and focal wall defect properly. © 2004 Elsevier Ireland Ltd. All rights reserved.

WOS: 000223113900007 PubMed: 15284462 Objective. We aimed to search for differences between observers and automatic and manual measurements in calculations of Doppler parameters. Methods. The middle cerebral artery (MCA), central retinal artery, ophthalmic artery (OA), common carotid artery (CCA), vertebral artery (VA), popliteal artery (PA), interlobar renal artery (IRA), and arcuate renal artery (ARA) were evaluated in 20 healthy subjects bilaterally Peak systolic velocity (PSV), end-diastolic velocity (EDV), time-averaged maximum velocity (TAMAX), resistive index (RI), and pulsatility index (Pi) were measured from the same spectrum manually by 3 observers and automatically. Results of 4 measurements were compared by analysis of variance and Pearson tests. Results. The comparison of the 4 measurements revealed significant differences for most parameters except TAMAX of the OA, VA, and ARA and PSV EDV and PI of the PA. An automatic calculator yielded lower PSV, RI, and PI values (except the MCA and PA) and higher EDV values compared with manual measurements. The magnitudes of difference were in the range of 1% to 16% for velocities and 4% to 14% for RI and PI. The means of difference were 3.185 cm/s for PSV of the CCA and 0.054 for RI of the IRA. Correlation was high for PSV, EDV, and TAMAX in all arteries (except TAMAX of PA) and relatively low for PI and RI in most of the arteries. Conclusions. Although our study was performed on healthy subjects, our results showed that, in most cases, readers and the automatic approach disagreed on evaluation of Doppler parameters. This may be important in preventing false diagnoses in cases with Doppler values close to upper limits and may necessitate establishment of new limits for each method.