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Objectives: This study was carried out in order to determine the prevalence of obesity among the students of the Faculty of Health Sciences and to evaluate the anthropometric measurements of the students. Materials and methods: The population of the study was in total 984 volunteering undergraduate students from Ankara University Faculty of Health Sciences, Child Development, Midwifery, Nursing, Health Management and Social Work departments. The sociodemographic characteristics of the students were obtained with the help of the questionnaire and the anthropometric measurements by the researchers. SPSS package program was used for descriptive statistics, chi-square test and multiple logistic regression analysis for assessment of data. Results: 16.5% of the students participating in the study were overweight and 4.5% were obese. Approximately half of the students who are overweight and obese reported staying in the dormitory. Average BMI value in males is 23.1 kg/m2 and 22.3 kg/m2 in females. 29.1% of females are at risk in terms of abdominal obesity and 30.6% of males in terms of waist/height ratio. Male gender and presence of an obese person in the family increases the risk of being overweight or obese. Conclusions: Risky health behaviors are observed among university students and in order to avoid such behaviors, it is necessary to provide training especially on subjects such as nutrition and physical activity. Adopting the right nutritional habits and healthy lifestyle is important in individuals who will be the future healthcare professionals, for both their and future generations' health. © 2021 European Society for Clinical Nutrition and Metabolism WOS:000757020900062

OBJECTIVE To report current results of a new surgical technique, tubularized reconstructed plate urethroplasty (TRPU) in distal hypospadias repair which allows the tubularization of urethral plate without incision or grafting. METHODS This study is a prospective single surgeon series. Between January 2019 and March 2020, total of 158 patients underwent hypospadias repair, and 29 selected patients had TRPU procedure. Demographic data, duration of follow-up, complications were recorded. A vertical incision is made starting from halfway up the glans. This incision creates a diamond like defect which enables wedge removal of a segment of spongiosum tissue from the base of urethral plate extending to the hypospadiac meatus. Vertical incision is closed horizontally. The urethral plate is stretched and loosened from the base and re-secured into its bed using quilting stitches. Reconstructed urethral plate ensures the required width to allow the formation of neourethra of adequate circumference, followed by a formal glansplasty. RESULTS Preoperative glans width was 13.4 ± 0.9 mm, urethral plate width was 6.1 ± 0.9 mm. Mean postoperative follow-up period was 13.6 months. All patients had successful functional outcome and cosmetically satisfying appearance. None of the patients required meatal calibration. The total complication rate was 3.4%. CONCLUSION Native urethral plate itself is used as a natural flap to increase the surface area of the urethral plate in this new perspective of urethroplasty method. We believe that TRPU procedure provides an alternative approach for the formation of neourethra and it is a successful and relatively simple procedure with low complication rates, good cosmetic results and promising successful functional short-term outcome.

Polycystic ovary syndrome (PCOS) is a common disorder with important clinical consequences. Many studies have proven that hypertension is one of the most important comorbid disorders in PCOS. Masked hypertension is defined as a presence of normal office blood pressure together with abnormal results in 24-h ambulatory blood pressure monitoring (ABPM). The prevalence of this condition in patients with PCOS is not well defined. The aim of this study was to evaluate the prevalence of masked hypertension in PCOS compared to control subjects.Sixty patients with PCOS and 60 control subjects were enrolled in the study. All patients with PCOS and controls without a history of hypertension underwent physical examination including office blood pressure measurement, ABPM, and measurement of laboratory and anthropometric parameters.Mean age was 30.5 ± 6.6 in control group and 26.4 ± 7.1 year in patients with PCOS (This study demonstrates increased masked hypertension prevalence in patients with PCOS. We suggest that all patients with PCOS should undergo ambulatory blood pressure monitoring for detecting masked hypertension.

Background Sternal cleft is a quite rare malformation. It is seen 1 out of 100,000 live births and makes up less than 1% of all chest wall deformities, seen more often among females. The deformity can be partial or complete. Partial deformities can be superior or inferior. It is generally diagnosed at birth when paradoxical respiratory movements are seen. Patients are often asymptomatic when they are born and generally other abnormalities accompany. As sternal clefts can be repaired primarily at early ages, they are repaired using autologous or synthetic grafts in the following years. We present a 2-month-old girl with superior partial sternal cleft repaired primary and accompanying hemangiomas in this case report. Case presentation A girl who was born in another center and had a sternal cleft, who did not have any problems in the early period, was admitted to our hospital with respiratory distress at the age of 43 days. The patient was monitored with mechanical ventilator support, and there were hemangiomas around his left ear and lips. There were paradoxical respiratory movements in front of the heart, in the upper midline of the chest. Three-dimensional computed tomography showed that the upper part of the sternum did not develop, and there were hypoplasic sternal bars on both sides. It was evaluated as superior partial sternal cleft, and surgery was planned. In the operation, the sternal bars were released from the pericardium and pleura. The periosteum in the medial of both sternal bars was then released and connected in the midline, in front of the pericardium. Conclusion Although neonates with a sternal cleft are asymptomatic at birth, respiratory symptoms may develop in later periods. In addition, because the structures are more flexible in the neonatal period, the primary repair of the cleft is easier and the risk of cardiac compression is lower. In our case, sternal bars could be approached primary, and no chondral grafts, patches, or steel wires were required.

In this study, we evaluated the electromechanical properties of atriums in patients with masked hypertension by using tissue Doppler echocardiographic technique to predict the predisposition to atrial arrhythmias.A total of 118 subjects were included in the study. Twenty-four-hour blood pressure monitorization (ABPM) was used to determinate the masked hypertension in the study group. Tissue Doppler imaging was used to find intra-left and -right atrial electromechanical delay (AEMD) and inter-atrial electromechanical delay. The results compared between patients with masked hypertension and without.There were 55 (%46.6) patients with masked hypertension and 63 (%53.4) patients without masked hypertension without any difference regarding age sex heart rate. No statistically significant difference was found in intra-right AEMD between the groups. Left ventricular end-diastolic and systolic diameters (Masked hypertension shares the same clinical outcomes like overt hypertension. Any effort must be given to prevent unwanted events in masked hypertensive patients. According to our findings we suggesting that masked hypertensive patients must be evaluated for atrial arrhythmia.

Purpose: Hypertension is a common chronic disorder with end organ damage. Hypertensive retinopathy is a response to elevated blood pressure characterized retinal arteriolar intimal thickening, hyperplasia of the intima-media end with sclerosis. There is a relationship between high blood pressure and retinopathy grade. Masked hypertension is a phenomenon of normal blood pressure in the office but high in out of office that associated with an increases risk of cardiovascular disease. In this study, we aimed to investigate retinopathy in masked hypertensive patients. Methods: We enrolled 92 patients with masked hypertension and 87 healthy controls in to the study. We use ambulatory blood pressure monitoring (ABPM) to detect the masked hypertension. Bilateral fundus examination was performed. Hypertensive retinopathy (HTRP) grading was determined according to the Keith-Wagener-Barker classification. We examined retinopathy grade in patients with masked hypertension and without. Results: 55 (11.6%) participants had signs of retinopathy. Fifty (54.3%) subjects had any retinopathy in patients with masked hypertension and five (5.7%) subjects had any retinopathy in controls (p < .001). Median of KWB grade was 1 (0-4) in patients with masked hypertension and 0 (0-2) in controls (p < .001). There were a positive significant correlation between KWB grade and day-time systolic blood pressure (r = 0.460, p < .001), day-time diastolic blood pressure (r = 0.448, p < .001), presence of masked hypertension (r = 0.527, p < .001). Conclusions: There was a considerable rate of any retinopathy in masked hypertension. Consequently, ophthalmoscopic examination should be as part of the care in patients who have a risk for masked hypertension. WOS:000503609300001 31856594 Q4

Laparoscopic procedures are being performed in infants and children much more frequently. Nevertheless, there is anxiety about complications resulting from port insertion due to the smaller abdominal cavity in children. Most complications are related to the entry of the first port. In this study, we present our patients who underwent laparoscopy using our modified Veress needle technique. The hospital records of the patients who underwent laparoscopy between 2010 and 2015 were evaluated retrospectively regarding intraoperative and postoperative complications. In all patients, the first port was inserted using our modified Veress needle technique. Laparoscopic procedures were performed on 139 patients. There were no major intraoperative or postoperative complications such as visceral or vascular injury in our patients. Only 5 (3.5%) minor complications were determined intraoperatively. Minor intraoperative complications included port dislocation (n = 2), intra-abdominal gas leakage (n = 1), subcutaneous emphysema (n = 1), and abdominal wall bleeding (n = 1). There were no minor complications postoperatively. In our technique, the umbilicus is pulled upwards strongly, reducing the risk of intra-abdominal injury.

Today, increased intake of sugar and sugar-sweetened beverages is seen today as an important factor in the growing prevalence of chronic diseases, such as obesity, obesity-related diabetes, and coronary heart diseases. This study involved 214 university students from the Department of Nutrition and Dietetics of Ankara University, Faculty of Health Science, which was intended to evaluate the consumption of sugar and sugar-sweetened beverages. The frequency of student consumption of beverages and the quantities and amounts of sugar taken with beverages were questioned. The average total amount of sugar added to drinks by the students was 4.69 ± 6.35 gram, while the average total amount of sugar taken with sugar-sweetened beverages was 11.34 ± 15.32 gram. Female students relative to male students, students in grade 4 compared to grades 2 and 3, and students who had daily breakfast compared to those who did not had lower average sugar consumption (p-value < 0.05). As class grades increase, the amount of sugar added to beverages and fruit juice and sweetened soft drinks and carbonated beverages decreased (p-value < 0.05). The consumption of herbal teas and dietary beverages increased and eating habits of students generally changed positively (p-value > 0.05). It is important to educate university students about the reduction in sugar intake and sugar-containing food in order to avoid many chronic diseases that may be seen in older ages.

Objective: Left ventricle systolic dysfunction is a serious cardiovascular condition that causes morbidity and mortality. Congestion is not a feature in every patient and the factors affecting congestion is not clearly defined. The aim of this study is to determine the factors causing congestion in elderly patients with left ventricle systolic dysfunction. Method: Total number of 101 patients admitted to Cardiology and Internal Medicine outpatient clinics with left ventricle systolic dysfunction (ejection fraction < 40%) were enrolled in the study. Cardiovascular risk factors, chronic obstructive lung disease and other systemic diseases of the patients were evaluated. Congestion was determined and graded according to their clinic.Results: Mean age of the patients was 62,7±6,7 and 54 (54%) were male. Mean left ventricle ejection fraction was 31.1±5.8. Multivariate regression analysis revealed that chronic obstructive lung disease (t=4,528, p

Aim: We evaluated the COVID-19 threat in patients receiving intravesical BCG therapy which has immunotherapeutic effects and is of vital importance in most of the individuals with high-risk non-muscle-invasive bladder cancer (NMIBC) and investigated the need for postponement of this therapy. Methods: A total of 71 patients, who were diagnosed with high-risk NMIBC and on intravesical BCG treatment regularly (induction or maintenance), were enrolled in the study. The patients were classified into two groups depending on whether they were diagnosed with COVID-19 during the pandemic period or not. Results: Of 71 patients, 26 underwent a COVID-19 polymerase chain reaction test with clinical suspicion during the pandemic period. Of these 26 patients, 4 were diagnosed with COVID-19. Age of the patients, working status (working/retired), compliance with containment measures against the pandemic, number of BCG courses, adverse effects after BCG therapy, and systemic immune-inflammation index, which is an inflammation-related parameter, were not different between groups (p>0.05). Neutrophil/lymphocyte ratio was significantly higher in the COVID-19 positive group (p

Imbalance in autonomic nervous system and impaired myocardial repolarization have been shown to increase the risk for arrhythmias in patients with arterial hypertension. This study evaluated the effects of masked hypertension on QT interval dynamicity.The study group consisted of 108 consecutive patients with masked hypertension and 102 control subjects. Twenty-four-hour Holter monitoring was performed before anti-hypertensive treatment. CONTEC holter software was used to calculate HRV and QT dynamicity parameters. All subjects had a complete history, laboratory examination, and transthoracic echocardiography.There was no significant difference in age-gender distribution between patients and controls. Non-sustained VT was present in four patients (2.9%). SDNN, RMSSD, PNN50, LFnu, HFnu were significantly decreased in masked hypertension, whereas LF/HF ratio was significantly increased. QT/RR slopes over 24 hours were significantly increased in masked hypertension for QT end and QT apex (QTapex/RR: 0,15 ± 0,12 vs 0,27 ± 0,18This study showed for the first time that masked hypertension was associated with a significant worsening of HRV and QT dynamicity parameters.

Objective: Osteoporosis defined by low Bone Mineral Density (BMD), is a progressive disease affecting especially older adults. Hip fracture is the important result of osteoporosis. For the older adults, heart failure (HF) and osteoporosis are two common chronic conditions that are gaining importance for healthcare. The aim of this study is to evaluate bone mineral density and hip fractures in patients with heart failure Method: The study population consisted of 157 patients with heart failure and 155 control subjects without any cardiovascular disease and risk factors. All subjects underwent transthoracic echocardiography, biochemical analysis, and bone DEXA study. Osteoporotic fracture history and operation for fracture, list of current and prior use of medications were obtained from each center’s medical recordings. Results: Among the 157 patients, 45 (29%) had normal BMD, 14 (9%) had osteopenia, and 98 (62%) had osteoporosis. In 155 control subjects, 68 (44%) had normal BMD, 12 (8%) had osteopenia, and 75 (46%) had osteoporosis (P=0.019). Sixteen subjects (10.2%) in heart failure group and 6 subjects (3.9%) in controls had hip fracture (p=0.029). Level of 25-hydroxyvitamin D was significantly lower in heart failure than in controls (15.1±10.2 vs. 29.1±20.4 ng/ml; p

Objective: Cardiovascular disease is the still leading cause of mortality and morbidity. Non-invasive cardiac tests are using for diagnosing CAD in symptomatic patients in clinical practice. Metabolic syndrome (MS) is a well-known risk factor for coronary artery disease (CAD). In this study we aimed to investigate the relationship between metabolic syndrome score and results of non-invasive cardiac tests. Method: The total number of 329 patients who admitted with chest pain to cardiology department were included in the study. MS score based on National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria which ranged between zero and five were calculated for each subject. After physical examination and routine laboratory tests patients with high pretest probability underwent non-invasive cardiac tests (treadmill test and myocardial perfusion scintigraphy)to rule out chest pain from non-cardiac reasons. The results of non-invasive tests evaluated with metabolic risk score of patients. Results: The study population consisted of 192 (58.4%) male, and 137 (41.6%) female subjects. The mean age was 68.3 ±9 in patients without ischemia and 69.4 ±7.2 (p=N/S) patients with ischemia. Metabolic score was 1.8±1.1 in patients without ischemia 2.67±1.3 in patients with ischemia (p=

Objective Alveolar echinococcosis (AE) is a rare life-threatening parasitic infection. Computed tomography perfusion (CTP) imaging has the potential to provide both quantitative and qualitative information about the tissue perfusion characteristics. The purpose of this study was the examination of the characteristic features and feasibility of CTP in AE liver lesions. Material and methods CTP scanning was performed in 25 patients who had a total of 35 lesions identified as AE of the liver. Blood flow (BF), blood volume (BV), portal venous perfusion (PVP), arterial liver perfusion (ALP), and hepatic perfusion indexes (HPI) were computed for background liver parenchyma and each AE lesion. Results Significant differences were detected between perfusion values of the AE lesions and background liver tissue. The BV, BF, ALP, and PVP values for all components of the AE liver lesions were significantly lower than the normal liver parenchyma (p Conclusions We suggest that perfusion imaging can be used in AE of the liver. Thus, the quantitative knowledge of perfusion parameters are obtained via CT perfusion imaging.

Summary Background Aquaporins are membrane water channel proteins that are expressed in the epithelium and endothelium. Their primary function is to control the flow of water in the membranes of the cells. Objective In this study, we investigated whether there is increased expression of aquaporin-1 in the tunica vaginalis of hydrocele patients in childhood that do not regress spontaneously an whether it has an effect on the etiology of hydrocele. Study design Boys who were diagnosed with hydrocele and scheduled for surgery were included and formed the hydrocele group. Boys in the same age range who underwent surgery for inguinal hernia or undescended testicles were included as a control group. Aquaporin-1 expression was evaluated by immunohistochemical examination of capillaries in tissue samples taken from the tunica vaginalis during the operation. Aquaporin-1-positive vessels were counted by selecting 5 unrelated areas with the highest vascular density, and the average number of vessels was calculated for each case. Results A total of 48 male patients were included in the study. Of these, 27 constituted the hydrocele group (mean age 3.51 ± 2.59 years), and 21 constituted the control group (inguinal hernia, n = 17; undescended testicle, n = 4) (mean age 3.95 ± 3.80 years). The mean ages of both groups were statistically similar (p = 0.32). The mean numbers of aquaporin-1-positive vessels at the capillaries in the tunica vaginalis of the patients were 20.74 ± 7.10 in hydrocele group and 17.23 ± 4.07 in the control group. The expression of aquaporin-1 in the hydrocele group was significantly higher (p = 0.037). Discussion It was shown that aquaporin-1 expression was higher in adult cases with hydrocele. Also an increase in aquaporin-1 expression was detected in tunica vaginalis of children with hydrocele in our study. Conclusion It was thought that aquaporin-1 overexpression may play a role in non-communicating hydroceles in children. Download : Download high-res image (276KB) Download : Download full-size image Summary figure . A high power area showing vascular lumens which are positive with aquaporine-1 (x400, Aquaporine)

Lipom, sik gorulen mezensimal kokenli bir yumusak doku tumorudur. Matur yagli doku icerirler. Genellikle subkutan dokuya yerlesirler. Kas icerisine yerlesimleri nadir gorulur ve bu durumda intramuskuler lipom olarak adlandirilirlar. Ultrasonografi, secilecek ilk tani yontemidir. Ancak, kesitsel goruntuleme yontemleri tanida daha faydalidir. Manyetik rezonans goruntulemede (MRG), sinyal ozellikleri ve yag baskilama tekniklerinin katkisiyla taniya kolaylikla ulasilir. Ayrica lezyonun komsu anatomik yapilarla iliskisi de MRG ile daha iyi degerlendirilebilir. Burada, iki farkli yerlesimli intramuskuler lipom olgusu anlatilacak ve goruntuleme bulgulari gozden gecirilecektir.

Purpose: This study aimed to investigate the feasibility and diagnostic power of unenhanced 3D turbo spin echo MR angiography sequence (a technique based on subtraction of corresponding images acquired in diastole and systole, Syngo Native Space-Siemens healthcare) to identify peripheral artery disease (PAD). Materials and methods: Thirty patients (619 arterial segments in total) suspected with PAD and who were assessed with lower extremity MDCT angiography were examined starting from the level of aortic bifurcation for both lower extremities by 3D native space MR angiography. Two readers assessed the image quality of native space MR angiography and number of lesions, their degrees of stenosis and localizations. The differences and compliance between the readers in the parameters assessed were investigated. Results: Out of 619 segments; Reader 1 considered 187 segments (30.2 %) and Reader 2 considered 177 segments (28.6 %) to have poor and inadequate MR image quality. When compared to CTA, sensitivity, specificity and diagnostic accuracy of native space MR angiography were calculated as 81.0, 83.1, 82.6 %, respectively, by Reader 1, while the same parameters were calculated as 69.9, 92.6, 84.9 %, respectively, by Reader 2. When the two readers were examined together, sensitivity, specificity, diagnostic accuracy were found to be 76.3, 88.1, 83.7 %, respectively, and the positive predictive value and negative predictive value was 70.3 and 89.9 %, respectively. A significantly better image quality was acquired with the age group below 50 years (p = 0.002). Conclusion: Native space MR angiography technique can be used as the first-step imaging technique before contrast-enhanced examinations in young and middle age patients with suspected PAD and for patients with the risk of nephrogenic systemic fibrosis in chronic renal failure. © 2016, Italian Society of Medical Radiology.

Objectives: To compare pathological samples obtained from cases that underwent surgery for ureteropelvic junction (UPJ) obstruction with samples obtained during autopsies of subjects. Methods: Retrospectively, 42 patients who had undergone surgery due to UPJ obstruction (group 1) were included in the study. Histopathological and immunohistochemical features for sonic hedgehog (SHH), TBX18, and TSHZ3 of UPJ were evaluated and findings were compared with 20 autopsy cases (group 2). Results: In group 1, the scores were statistically significantly higher in terms of cytoplasmic SHH, nuclear TBX18, cytoplasmic and nuclear TSHZ3 staining. Statistically, no correlation was found between age and the staining scores belonging to these 3 antibodies in group 1 and group 2. Intense inflammation was found to be related with nuclear staining for TBX18. Conclusion: Gene product expressions of SHH, TBX18 and TSHZ3 are statistically higher in patients with UPJ obstruction, when compared with control group. The explanation may be the reactivation of the processes, which had shown their effects in the embryological period, due to the chronic inflammation and long-term micro-trauma created by the disease. Saudi Med J 2016; Vol. 37 (7): 737-743 doi:10.15537/smj.2016.7.14789 How to cite this article: Yilmaz O, Nese N, Dalgic M, Kesici GP, Genc A, Taneli C, Gunsar C, Sencan A, Cayirli H, Isisag A. Sonic hedgehog, TBX18, and TSHZ3 proteins involved in pyeloureteral motility development are overexpressed in ureteropelvic junction obstruction. An immunohistochemical, histopathological, and clinical comparative study. Saudi Med J . 2016 Jul;37(7):737-43. doi: 10.15537/smj.2016.7.14789.

Tanriverdi, Halil Ibrahim/0000-0002-2760-9954, WOS: 000501498200028, PubMed: 31474504, Introduction Laparoscopic pyeloplasty for ureteropelvic junction obstruction in children has gained increasing importance over the last decade. Intracorporeal knot tying still remains a technical challenge for the surgeon. Self-anchoring suture incorporates a new concept for tissue approximation and reduces intracorporeal knot tying problems. There are very few reports on self-anchoring knotless suture and its application for laparoscopic pyeloplasty in children. We present our results of a series of consecutive children undergoing laparoscopic pyeloplasty with knotless barbed sutures. Material and method We prospectively evaluate 15 consecutive patients who underwent laparoscopic pyeloplasty with knotless barbed sutures (VLoc (TM), Covidien) for ureteropelvic anastomosis. the decision of the operation was given by pediatric nephrology-urology-radiologic imaging diagnostic team, and all patients were operated by a single surgeon. Pyeloplasty was performed without pelvic reduction, and the anastomosis was made by barbed sutures using running fashion. Results the mean age of the patients were 5.39 (3 months-17 years). Two cases had undergone a right-sided pyeloplasty, and thirteen had undergone a left-sided pyeloplasty. the duration of the operative procedure was 60-110 min. Neither intraoperative nor postoperative complication was encountered in any of the cases. Patients were followed by ultrasonographic evaluation. the anteroposterior diameter (AP) diameter of renal pelvis and hydronephrosis grade Society for Fetal Urology (SFU) are significantly different when compared with pre-operative and postoperative period (p = 0.001 and p = 0.001, respectively). Owing to the renal parenchymal thickness change by age pre-operative and postoperative thickness comparison is adjusted by age, because age is considered as a covariate (confounder variable). We observed statistically significant (p = 0.003) difference in parenchymal thickness in all cases. Follow-up periods of the 15 consecutive pediatric pyeloplasty cases were 6-54 months. Conclusion in the present study, successful outcome of the laparoscopic pyeloplasty using barbed suture was shown for the first time in children in literature. We believe that successful outcome of laparoscopic pyeloplasty could be achieved by eliminating knots and less manipulation on the wound edge also minimizes tissue injury during the procedure.

Purpose The aim of this study was to assess whether there is prejudice toward obese persons among student nurses and registered nurses. Design and method A total of 379 participants were included (190 student nurses, 189 registered nurses). The Fat Phobia Scale and Belief About Obese Persons Scale were used to determine the prejudice. Findings Registered nurses were found to have more negative prejudices toward obese persons than those of student nurses. These prejudices were determined to be influenced by the nurses' body mass index and having an obese person in the family. Practical implications Both groups had negative prejudices toward obese persons, there was a higher level of prejudice among the registered nurses. These prejudices can have a negative impact on healthcare practices.

Objectives: To compare the time interval of the procedure, possible complications, post-operative pain levels, additional analgesics, and nurse satisfaction in ultrasonography-guided and standard caudal block applications. Methods: This retrospective study was conducted in Celal Bayar University Hospital, Manisa, Turkey, between January and December 2014, included 78 pediatric patients. Caudal block was applied to 2 different groups; one with ultrasound guide, and the other using the standard method. Results: The time interval of the procedure was significantly shorter in the standard application group compared with ultrasound-guided group ( p =0.020). Wong-Baker FACES Pain Rating Scale values obtained at the 90th minute was statistically lower in the standard application group compared with ultrasound-guided group ( p =0.035). No statistically significant difference was found on the other parameters between the 2 groups. The shorter time interval of the procedure at standard application group should not be considered as a distinctive mark by the pediatric anesthesiologists, because this time difference was as short as seconds. Conclusion: Ultrasound guidance for caudal block applications would neither increase nor decrease the success of the treatment. However, ultrasound guidance should be needed in cases where the detection of sacral anatomy is difficult, especially by palpations. Saudi Med J 2016; Vol. 37 (2): 147-150 doi: 10.15537/smj.2016.2.13501 How to cite this article: Erbuyun K, Acikgoz B, Ok G, Yilmaz O, Temeltas G, Tekin I, et al. The role of ultrasound guidance in pediatric caudal block . Saudi Med J 2016; 37: 147-50.

Gida isinlama, besinleri korumak, kalitesini ve raf omrunu arttirmak ve olasi zararli ozelliklerini ortadan kaldirmak icin uygulanan bir yontemdir. Gida isinlama teknolojisi; yumurtaya, et urunlerine, baharatlara, su urunlerine ve kabuklu yemisler gibi besinlere uygulanmaktadir. Besinlerin korunmasi, besin kaynakli hastalik ve enfeksiyonlarin onlenmesi, filizlenme ve olgunlasmanin kontrolu ve geciktirilmesi, bocek ve hasere kontrolu ve sterilizasyon gibi cesitli amaclarla kullanilmaktadir. Yararli etkilerine ragmen gida isinlamada uygun doz ve sure kullanilmadiginda bazi istenmeyen etkiler de gozlenebilmektedir. Gida isinlamanin yararli ve zararli etkilerini acikliga kavusturmak ve kesinlestirmek icin bu alanda daha fazla calisma yapilmali ve tuketiciler bilgilendirilmelidir. Bu calismada, gida isinlama teknolojisi uygulanan besinler ve uygulama sonucu olusabilecek bazi sorunlarin aciklanmasi amaclanmistir

This study evaluated the effect of retroperitoneal adipose tissue on testicular venous drainage and tested the nutcracker phenomenon by clinical and imaging findings. A total of 95 patients were included. The patients were evaluated with a detailed medical history and physical examination for varicocele. Their weight, height and waist circumference were also recorded. Body mass index was calculated as weight (kg)/height squared (m(2) ). Pampiniform plexus diameters were measured by scrotal colour Doppler ultrasonography, and retroperitoneal adipose tissue was evaluated by noncontrast abdominal computed tomography. We determined an almost significant correlation between BMI and varicocele presence by physical examination (P = 0.06). However, there was a significant relationship between WC and varicocele identified by physical examination (P = 0.021). There was a positive and significant relationship between BMI and pampiniform plexus diameters. Furthermore, we detected a negative correlation between retroperitoneal adipose tissue measurements and CDU findings. Additionally, there was a significant correlation between WC, pampiniform plexus diameters and CT findings. It is concluded that increasing BMI and increasing WC may play a protective role in the development of varicocele. There is a need for further studies to verify the effect of obesity on varicocele formation.

Background To investigate the transthoracic computed tomography (CT)-guided lung nodule biopsy complications and risk factors associated with the development of these complications. Methods We retrospectively evaluated a total of 41 CT-guided transthoracic biopsy complications. Data was analyzed by chi-square and independent sample t-tests. Results Twenty-seven patients (28.7%) developed pneumothorax and eight patients (8.5%) developed parenchymal hemorrhage, and four patients (4.3%) hemothorax and two (2.1%) patients developed subcutaneous emphysema. A significant correlation was obtained between the development of pneumothorax and lesion size (P = 0.040), and the distance that traversed the parenchyma (P = 0.001). There was a statistically significant difference between the parenchymal hemorrhage and lesion size and the distance from passed parenchyma (P values were 0.021 and 0.008, respectively). An increased incidence of parenchymal hemorrhage and pneumothorax was observed at small size and deep-seated lesions. Conclusion Lesion size and the distance that traversed the parenchyma on the biopsy tract are the most important factors that influence the development of complications in CT-guided transthoracic biopsy.

PURPOSE We aimed to investigate the effectiveness and complications of transthoracic CT-guided biopsy techniques. METHODS A total of 94 CT-guided percutaneous transthoracic biopsy procedures performed in 85 patients were retrospectively evaluated. Core biopsy technique was used in 87 procedures and transthoracic fine-needle aspiration biopsy was used in seven procedures. RESULTS Diagnostic results were achieved in 79 of 94 biopsy procedures. Pathology results were malignant in 54 patients, suspicious for malignancy in three patients, benign in five patients, and benign nonspecific in 17 patients. Specific diagnoses were obtained in 59 patients (62.8%) using core biopsy, but no specific diagnosis could be reached with transthoracic fine-needle aspiration biopsy. Complications included pneumothorax in 27 patients (28.7%) and parenchymal hemorrhage during and after the procedure in eight patients (8.5%). CONCLUSIONS CT-guided percutaneous transthoracic needle biopsy is a highly accurate procedure for histopathological diagnosis of thoracic masses. In addition, percutaneous transthoracic biopsy has an acceptably low complication rate and it reduces the need for more invasive surgical procedures.

Objective : The aim of the present study is to investigate the effect of Nissen fundoplication to the pacemaker cells of an intestinal system and the serotonin receptors on an ICC membrane. Methods : Sixteen adult male rats were taken into study. Rats were divided in to the following two groups. Nissen fundoplication was performed to study group (Group 1) and no surgical procedures were applied to control group (group 2). The rats who were subjected to surgery and the rats without surgery were sacrificed on to postoperative 14 days. Specimens for the pathologic analysis were obtained from upper esophagus (group A) and esophagogastric junction (EGJ) (group B). Distribution of ICC and 5HT-3A were evaluated separately. Results : There was a significant difference ( p = 0.01, p = 0.02, respectively) regarding number of cells stained with CD117 between the group 1B-2B and group 2A-2B. Also there was a significant difference between ( p = 0.01, p = 0.01 respectively) number of cells stained with 5HT-3A in groups 1A-1B and 2A-2B. However, no correlation was detected between group 1B-2B for 5HT-3A. Conclusion : A reduction in the number of ICC was observed in esophagogastric junctions of the fundoplication group but 5HT-3A distribution did not show a significant difference. A decrease in the number of ICC may be effective at postfundoplication dysphagia.

Esophageal perforation is a medical emergency associated with high morbidity and mortality. There is no consensus on the optimal treatment of this life-threatening condition. Conventional treatment of esophageal perforation is surgical. However, more recently, endoscopic treatment has become the treatment of choice given its less invasive nature compared to surgical treatment. This includes endoscopic clip administration, endoscopic stent placement, endoscopic suturing, endoscopic vacuum therapy and tissue sealants which are all administered via the endoluminal route. Whilst small defects (

Background: Stafne bone cavities (SBCs) are typically seen on panoramic radiographs as unilocular, rounded or ovoid shaped, well-defined corticated radiolucencies that are located between the mandibular first molar and the angle of the mandible below the inferior alveolar canal, but they may rarely have different radiographic appearances and locations. Objectives: The purpose of this study was to evaluate the imaging features of SBC presenting various typical and atypical features and to show the contribution of different imaging techniques to diagnosis. Patients and Methods: Seventeen patients who had a panoramic radiograph that revealed an image compatible with SBC were investigated in this study. In addition to panoramic radiography, lateral oblique mandible projection for three patients, cone beam computed tomography (CBCT) for nine patients, magnetic resonance imaging (MRI) for two patients were performed to determine the exact location of the cavity and to confirm the diagnosis. Results: Seventeen patients were diagnosed with SBC. Two patients had bilobed SBC, one patient had a SBC on the buccal surface of the posterior mandible, one patient had a SBC located in the ramus mandible, one patient had a SBC located in the canine-premolar region namely anterior lingual variant as rare conditions. Conclusion: Imaging techniques such as CBCT and MRI have provided detailed information about definitive diagnosis of SBC in addition to panoramic radiographs. These techniques show the size, location and content of the SBC. If the SBC is atypical, complementary imaging techniques gain more importance.

Purpose: The purpose of this study was to document clinical findings and management of a patient with bilateral globe luxation and optic nerve transection. Materials and Methods: A 25-year-old female patient was admitted to the emergency department with bilateral traumatic globe luxation following a motor vehicle accident. Results: Visual acuity testing showed no light perception. The right pupil was dilated and bilaterally did not react to light. The globes were bilaterally intact. A computed tomography scan revealed Le Fort type II fractures, bilateral optic nerve transection and disruption of all extraocular muscles. The globes of the patient were bilaterally reduced into the orbit. However, the patient developed phthisis bulbi in the right eye at month 3. Conclusion: Globe luxation presents a dramatic clinical picture, and may lead to the development of severe complications due to the concomitance of complete optic nerve dissection and multiple traumas. Even if the luxated globe is repositioned into the orbit, there is still an increased risk of the development of phthisis due to ischemia.

Perfusion computed tomography (CT) has a great potential for determining hepatic and portal blood flow; it offers the advantages of quantitative determination of lesion hemodynamics, distinguishing malignant and benign processes, as well as providing morphological data. Many studies have reported the use of this method in the assessment of hepatic tumors, hepatic fibrosis associated with chronic liver disease, treatment response following radiotherapy and chemothera-p y, and hepatic perfusion changes after radiological or surgical interventions. The main goal of liver perfusion imaging is to improve the accuracy in the characterization of liver disorders. In this study, we reviewed the clinical application of perfusion CT in various hepatic diseases. © Turkish Society of Radiology 2014.

OBJECTIVE: The aim of the present study was to investigate the relationship between pericoronary fat and the severity and extent of atherosclerosis, quantified using 64-multidetector computed tomography, in patients with suspected coronary artery disease. METHODS: The study population consisted of 131 patients who were clinically referred for noninvasive multislice computed tomography coronary angiography for the evaluation of coronary artery disease. Patients were classified as follows: no atherosclerosis, Group 1; nonobstructive atherosclerosis (luminal narrowing

OBJECTIVES This study aims to investigate the effect of acromioclavicular joint (ACJ) degeneration on orthopedic shoulder tests (OST) and to determine complementary role of ACJ injections in the treatment of subacromial shoulder impingements. PATIENTS AND METHODS At a secondary care center, 62 patients (56 females, 6 males; mean age 55.8±9.3 years; range 35 to 74 years) with the clinical and radiological diagnosis of shoulder impingement syndrome were enrolled to the study. Two injections were applied to ACJ and subacromial space. Patients were assessed through OSTs (Neer, Hawkins-Kennedy, empty can, full can, external rotation resistance, lift-off and cross-body adduction tests) at baseline and after injection to ACJ and subacromial space. Visual analog scale was used for overall pain. RESULTS Two injections and three sets of OSTs were performed on the patients. A significant difference was found in the all OSTs after ACJ injection (p

Familial Mediterranean fever (FMF) is a systemic hereditary autoinflammatory disorder. The present study aimed to investigate the relationship of enthesitis to FMF and to search the potential association between enthesitis and MEFV gene missense variations in patients with FMF. The study consisted of 72 FMF patients (mean age 29.12 +/- 11.47 years, 32 females), 29 patients with ankylosing spondylitis (AS) (mean age 34.14 +/- 11.73 years, 16 females), and 34 healthy volunteers (mean age 23.06 +/- 6.41 years, 8 females). FMF patients were classified according to the kind of MEFV gene mutation. Doppler ultrasound was used to determine enthesitis based on the Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT) scoring system. OMERACT score was significantly different between FMF patients and control group (p < 0.001 in all patients, p = 0.009 in men, and p = 0.002 in women). However, it was not significantly different between FMF and AS patients in both sexes. OMERACT score did not differ between FMF patients with and without M694V gene mutation. The best cutoff point of OMERACT score to predict enthesitis was found as a parts per thousand yen0.5 with sensitivity of 29 %, specificity of 100 %, positive predictive value of 100 %, and negative predictive value of 40 %.

Objective To investigate the relationship between depth of maxillopalatal arch and deviation of posterior septum. Methods This study is based on paranasal sinus CT (PNSCT) scan in the coronal plane evaluation, and sinus paranasal scans were obtained from the database. One-hundred and fifty PNSCT scans were randomly chosen among the PNSCT scans which belong to adult (18 and older) patients. All scans were divided to three different groups. The first group constituted by those patients who had more convex deviation. The second group had those patients with either crest or spur deviations. The last group (control group) had no septum deviation. The data collected from each group were statistically compared. Exclusion criteria: CT imaging which has a chronic sinusitis, nasal cavity mass, and nasal polyps. Main outcome measures: angle and distance measures were taken on maxillopalatal arch and posterior nasal septum. Results Strongly positive correlation between posterior septum deviation and depth of maxillopalatal arch was determined (r = 0.479, p = 0.001). Conclusion These findings suggest that posterior septum deviations are considered as a result of increase in maxillopalatal depth.

WOS: 000393204400005, PubMed: 27503115, Purpose: To compare unenhanced three-dimensional (3D) NATIVE (R) true fast imaging with steady-state precession (TrueFISP) magnetic resonance (MR) angiography with the more conventional MR angiography technique obtained after intravenous administration of a gadolinium chelate in the evaluation of renal arteries and their branches in patients with suspected renal artery stenosis. Materials and methods: A total of 39 patients (25 men, 14 women) with a mean age of 51.4 +/- 17.5 years (SD) (range: 10-82 years) were included in the study. All patients with suspected renal artery stenosis underwent unenhanced 3D NATIVE (R) TrueFISP MR angiography and contrast- enhanced MR angiography. The two MR angiography methods were compared by two independent readers for image quality using a four-point scale, diagnostic performance and grading of renal artery stenosis on a total of 78 renal arteries. Results: For both readers image quality of unenhanced 3D NATIVE (R) TrueFISP MR angiography(3.12 to 3.63) was greater than that of contrast-enhanced MR angiography (1.94 to 2.71) for renal artery ostium-trunk and the left renal artery segmental branches. The sensitivity of 3D NATIVE (R) TrueFISP MR angiography for the diagnosis of renal artery stenosis was 100% for both readers for the right renal artery and 66% and 80% for the left renal artery for reader 1 and reader 2, respectively. Agreement between 3D NATIVE (R) TrueFISP MR angiography and CE-MR angiography was 95% (74/78) for reader 1 and 92% (72/78) for reader 2. Conclusion: Unenhanced NATIVE (R) TrueFISP magnetic resonance angiography can play an additional role in the evaluation of renal arteries in patients with hypertension, especially in subjects at risk of nephrogenic systemic fibrosis. (C) 2016 Editions francaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Background Our purpose was to evaluate the effectiveness of different kilovolt (kV) uses in computed tomography pulmonary angiography (CTPA) in the diagnosis of pulmonary thromboembolism (PTE). We also aimed to establish the optimal kV value and investigate the possibility of obtaining appropriate imaging quality with minimal radiation dose. Material/Methods We compared 120, 100, and 80 kV CTPA for 90 patients in whom PTE was clinically considered. The examinations were carried out using a 128 multislice CT device (Definition AS, Siemens Medical Solutions, Forchheim, Germany). Each kV value was used on 30 patients in 3 groups. Patients in all groups were compared with respect to the mean radiation dose they received, pulmonary arterial attenuation values, image quality, and motion artefacts. Results With respect to pulmonary arterial attenuation values, imaging with 80 kV yielded significantly higher values (p

To evaluate image quality of carotid computed tomography angiography (CTA) using a low voltage (80kV) and low amount of iodinated contrast material.A total of 101 patients referred for carotid CTA were randomly assigned to receive a specific protocol. In group A patients received intravenous administration of contrast material at a dose of 1mL/kg and CTA examinations were performed at 100kV. In group B, patients received intravenous administration of contrast material at a dose of 0.5mL/kg and CTA examinations were performed at 80kV. The same nonionic iodinated contrast material containing 370mg of iodine per mL was used in both groups. Attenuation values were measured from the center of specific arterial segments using regions of interest. Attenuation values above 300HU were accepted as significant. Institutional review board approval was obtained.A total of 50 patients were included in group A (38 men, 12 women; mean age, 63.56 years±13.18 [SD]) and 51 patients in group B (33 men, 18 women; mean age, 59.60 years±16.63 [SD]). A total of 1615 arterial segments (1515 common carotid artery-middle cerebral artery and 101 aortic arches) were analyzed. Venous contamination was not observed in either group. The mean attenuation values of all arterial segments in both groups were greater than 300HU. Mean arterial attenuation value in group B (499.22HU±97.25 [SD]) was significantly greater than in group A (374.36HU±73.79 [SD]) (P0.01). Hemodynamically significant stenosis (grade III stenosis or70%) was detected in 2 segments in group A and in 3 segments in group B, while grade IV stenosis (occlusion) was detected in 2 segments in group B. Distal common carotid artery dissection was detected in 1 patient and aortic dissection was detected in 1 patient in group B. Total dose-length product (DLP) value was significantly greater in group A (225.74mGy·cm±21.80 [SD]) than in group B (116.60mGy·cm±21.22 [SD]) (P0.01). The mean tube current was similar in group A (2013.11mAs±195.92 [SD]) and in group B (2096.64 mAs±309.03 [SD]) (P0.05).Carotid and cerebral CTA examinations using 128-section CT can be successfully obtained using an imaging protocol that combines low voltage and 50% reduction in the volume of iodinated contrast material. This provides good image quality with low radiation dose.