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Bu çalışmanın amacı uzaktan iş sağlığı ve güvenliği (İSG) eğitimlerinin kalitesinin eğitime katılanların memnuniyet algıları üzerinde etkisini araştırmaktır. Araştırma iki aşamada (2016 ve 2019 yıllarında) Sakarya Üniversitesi amacıyla bir memnuniyet anketi düzenlenmiştir. 2016 yılında gerçekleştirilen birinci aşamada üç yılda bir düzenli olarak verilmesi kanuni zorunluluk olan İSG eğitimlerinin uzaktan eğitim şeklinde verilmesi ile ilgili Sakarya Üniversitesi çalışanlarının memnuniyet algıları ölçülmüş ve söz konusu eğitimlerin daha etkin nasıl gerçekleştirilebileceğine dair çalışan görüşleri alınmıştır. Çalışan görüşleri esas alınarak uzaktan eğitim sürecinde yapılan iyileştirmeler çerçevesinde 2019 yılında çalışan memnuniyet algıları tekrar ölçülmüş ve çalışan memnuniyetinde istatistiksel olarak anlamlı bir iyileşme sağlanıp sağlanamadığı çıkarımsal istatistiki yöntemler kullanılarak değerlendirilmiştir. Analiz sonucunda daha yetkin eğitimciler tarafından akıcı bir üslup ve görselliği artırılmış ders materyalleri kullanılarak gerçekleştirilen 2019 yılı uzaktan eğitimlerinden memnuniyetin istatistiki olarak anlamlı bir şekilde yüksek olduğu bulunmuştur. Çalışanlara yüksek kaliteli eğitim videoları aracılığıyla verilecek İSG eğitimlerinin daha etkili ve verimli olacağı sonucuna varıldı. Ayrıca, belirli bir zaman dilimi içinde belirli bir yerde eğitime katılma kısıtı bulunan çalışanlara sahip işyerlerinin İSG eğitimlerini uzaktan eğitim modunda planlamalarının daha yararlı olacağı sonucuna ulaşılmıştır.

This study was conducted to evaluate the relationship between total intrahepatic hepatitis B virus (HBV) DNA levels and liver histology in terms of the degree of histological activity index (HAI) that yields necroinflammation (HAI-NI) and fibrosis (HAI-F) of the liver.Prospectively, Tru-cut needle biopsy samples were obtained from the livers of 42 patients with chronic hepatitis B. Levels of serum and liver HBV DNA were determined by quantitative real-time PCR. Demographic data of patients, together with hepatitis B serology, alanine aminotransferase levels, and HAI-NI and HAI-F scores, were recorded.Twenty of the patients were hepatitis B e antigen (HBeAg) positive, while 22 patients were positive for antibody to HBeAg (anti-HBe). Serum and liver total HBV DNA levels were found to correlate directly with each other in the two groups (r = 0.669, p = 0.001; and r = 0.880, p0.001; respectively) and the correlation was more marked in anti-HBe-positive patients. Although serum HBV DNA levels correlated positively with HAI-NI and HAI-F scores in HBeAg-positive and HBeAg-negative patients, total liver HBV DNA levels correlated with HAI-NI and HAI-F scores in anti-HBe-positive patients only.Quantitative measurement of intrahepatic HBV DNA is a valuable marker of the histological status of the liver in anti-HBe-positive patients with chronic hepatitis B, and it may give an insight into the prognosis and the ideal time for the cessation of antiviral treatment.

We performed color Doppler sonographic examination on 4 patients, 3 of whom had preliminary diagnoses of penile fracture and 1 of whom had undergone an operation due to penile fracture a year previously. Color Doppler sonography helped evaluate the relationships between the hematoma and the vascular structures and aided in differential diagnosis of the vascular injuries that may accompany tunical rupture (or have similar clinical presentations) and Mondor's disease; thus, this method has a crucial role in choosing the treatment approach. Color Doppler sonography may also assist in the follow-up of patients after surgical or conservative treatment. © 2004 Wiley Periodicals, Inc. J Clin Ultrasound 33:38–42, 2005

Purpose: To evaluate signs of atherosclerosis in carotid and brachial arteries in patients with aortic regurgitation (AR). Material and Methods: The sonograms of 33 patients (24 M and 9 F, 16-67 years old) with pure AR and 20 control subjects (15 M and 5 F, 19-49 years old) were evaluated. Patients with AR and control subjects completed a questionnaire with SMART risk score based on pre-existing vascular disease and risk factors. AR patients and control subjects were assessed for intima-media thickness (IMT) of common carotid artery (CCA), IMT of brachial artery (BA), CCA diameter, and resistivity index (RI) of CCA and RI of internal carotid artery (ICA). Results: There was no significant difference in the cardiovascular risk score between the patients with AR and control subjects. All measured parameters were statistically significantly greater in AR patients than in control subjects with P values 0.0233 for CCA IMT, 0.0034 for BA IMT, 0.0429 for CCA diameter, Conclusion: AR is associated with signs generally considered to represent atherosclerosis, such as increased CCA and BA IMT, CCA diameter, and CCA and ICA RI.

l-2 hydroxyglutaric aciduria is a rare, autosomal recessively inherited metabolic disorder of organic acid metabolism. A 5-year-old boy presented with eyelid myoclonia with absences that proved difficult to control with first-line anticonvulsants. An electroencephalogram produced profoundly abnormal results, with generalized spike-and-wave discharges. The patient became seizure-free with a combination therapy of clonazepam, levetiracetam, and lamotrigine. Magnetic resonance imaging demonstrated subcortical white matter and basal ganglia alterations. Urinary organic acid analysis demonstrated increased excretion of l-2 hydroxyglutaric acid. Although rare, seizures can occur as a presenting sign of slowly progressing organic acidurias, e.g., l-2 hydroxyglutaric aciduria. Both eyelid myoclonia with absences and l-2 hydroxyglutaric aciduria comprise rare disorders. To our knowledge, this case report is the first of l-2 hydroxyglutaric aciduria presenting with symptomatic eyelid myoclonia with absences.

Endoscopic endonasal surgery has been performed in children. Therefore, we need to know the precise anatomy and anatomic variations of the lateral nasal wall. This is important in order to achieve better surgical results and avoid complications. We also need to know the relationship between the anatomic variations and sinonasal disease. For the purpose of this study we assessed the anatomic variations of the lateral nasal wall and the association of these variations with chronic sinusitis in children. Forty-seven children with chronic sinus disease were included in the study. There were 25 female and 22 male patients with ages ranging from 2 to 16 years (mean 10.5+/-3.8 years). On coronal and axial computed tomographic (CT) scans, the anatomic variations of the lateral nasal wall and sinusitis were assessed. A pneumatized middle concha (MC) was the most common anatomic variation, followed by pneumatization of the superior concha (SC), Haller cell and agger nasi cell. Secondary MC, large ethmoidal bulla, maxillary sinus hypoplasia, Onodi cell, and uncinate process pneumatization were relatively rare. Maxillary sinusitis was the most common sinus infection, followed by ethmoidal, sphenoidal and frontal sinusitis in that order. There was no significant relationship between the sinusitis and anatomic variations except for some minor associations. In conclusion, anatomic variations in the lateral nasal wall are common in children. Local, systemic or environmental factors appear to be more important in pediatric sinusitis than the anatomic variations. Due to the absence of a definitive relationship between the anatomic variations and sinus disease, aggressive surgical interventions should be avoided while performing endonasal endoscopic surgery in the children.

Bu calismanin amaci; elit gurescilerde uygulanan aerobik ve anaerobik antrenman programinin, vucut kompozisyonu uzerine etkilerini arastirmaktir. Arastirmaya katilan, yas ortalamasi (deney; 15.20 ± 4.61, n=10, kontrol; 15.90 ± 2.08, n=10) olan, 20 elit guresci ogrenci, rastgele yontemle 10 kisilik iki gruba ayrildi. Deney grubuna 8 hafta devam eden, hafta da 6 gun “bir gun aerobik-bir gun anerobik” olmak uzere antrenman prensiplerine uygun olarak belirlenen, kuvvet ve dayaniklilik antrenman programi uygulandi. Kontrol grubu ise normal rutin gures teknik antrenmanina devam etti. Deney grubundan ve kontrol grubundan 8 haftalik antrenman periyodu oncesinde ve 8 haftalik egzersiz periyodu sonlandiktan sonra, vucut analizi olcumleri alindi (Tanita-TBF 300A). Calismanin sonuclarina gore; deney grubunun beden kompozisyonu gostergelerinden empedans, beden yag yuzdesi, yag kutlesi, ontestten son teste anlamli olarak azalirken, yagsiz beden kutlesi ve toplam vucut suyu anlamli olarak artmistir (p 0.05). Kontrol grubunun ise, beden kompozisyonu gostergelerinden vucut agirligi, yagsiz beden kutlesi ve toplam vucut suyu degerleri ontestten sonteste anlamli olarak artmistir (p 0.05). Sonuc olarak; her iki gruptaki ontest ve sontest degisimleri benzer olup, gruplar arasinda anlamli bir farklilik bulunamamistir (p>0.05). Istatistiksel analizlerde grup ici karsilastirmalar icin es-orneklem t testi (paired-samples t test), gruplararasi karsilastirmalar icin bagimsiz orneklem t testi (independent sample t test) kullanildi. Anlamlilik seviyesi p

Chiari III malformation is an extremely rare condition, and is characterized by the hindbrain herniation into a low occipital or high cervical encephalocele together with the pathologic and imaging features of the Chiari II malformation. In this report, an unusual variant of the Chiari III malformation was diagnosed in an 11-year-old girl. She had an encephalocele operation when she was a newborn, and has been asymptomatic since then. The clinical and imaging findings of this case were presented.

Purpose: The presence of hernia was investigated prospectively by US in both groins of children with clinically suspected or apparent unilateral inguinal hernia. Material and Methods: One hundred and twenty-eight (103 boys, 25 girls) were classified into three groups according to age: 0-2, 3-5 and 6-15 years. The widest diameter of the inguinal canal was measured in the longitudinal plane while the children were in the supine position and at rest. The patent processus vaginalis (PPV) values of 4 mm and higher were accepted as hernia. The groins diagnosed clinically and/or ultrasonographically as hernia were explored surgically. The clinical and US findings were compared with surgical results. The relations between hernia diameters and the age groups, sex, right/left and inguinal/scrotal hernias were analyzed statistically. Results: In 128 children, 138 groins were treated with surgery. One hundred and eleven cases were unilateral hernia (73 right, 38 left) and 10 were bilateral. Seven cases were found to be normal. Ten cases with clinically unilateral hernia were bilateral at US and surgery. One hundred and thirty-one of 138 groins were correctly diagnosed by US. The accuracy, specificity and sensitivity of US were 94.9%, 85.7% and 95.4%, respectively. The accuracy of physical examination was 87.7%. There were no significant differences between hernia diameters and the age groups, sex and right/left side except the difference between inguinal and scrotal hernia diameters ( p Conclusion: US can be used routinely in the pre-operative diagnosis of inguinal hernia in children. PPV values higher than 4 mm, with a high accuracy indicate hernia.

Purpose Brucellosis is an enzootic disease that is frequently transmitted from Brucella-infected animals and their products to humans through the gastrointestinal tract. Genitourinary complications are seen in 2–10% of cases. We used sonography to investigate such complications in patients from a Brucella-endemic area. Methods Between 1992 and 1996, 246 patients were clinically and serologically diagnosed as having brucellosis and were examined by sonography. Results Genitourinary complications were identified by sonography in 26 patients. Fifteen of these patients had unilateral epididymo-orchitis, 6 had diffuse orchitis, and 5 had a focal hypoechoic testicular lesion. An increase in the vascularity of the lesions was seen in the 14 patients who also underwent color Doppler examination. Spectral waveform analysis showed a decrease in the resistance index in 9 patients. After medical treatment, all but 1 of the lesions disappeared within 2 months; the last lesion persisted for 6 months. Conclusions In areas in which brucellosis is endemic, when scrotal abnormalities are seen with gray-scale or color Doppler sonography, the possibility of genitourinary tract complications of brucellosis should be considered. Simple Brucella tests may prevent unnecessary surgery. © 1997 John Wiley & Sons, Inc. J Clin Ultrasound25: 443–447, 1997.

2Department of Radiology, Medical Faculty, Gaziantep University, Gaziantep, Turkey. ommunication of a hydatid disease with the biliary tree has been described in up to 90% of hepatic hydatid cysts [1]. This is due to the incorporation of biliary radicles into the pericyst [2]. However, frank rupture into the biliary tree occurs in only 5–15% of cases [1]. Although the communication with the intrahepatic bile ducts is common, its occurrence between a hepatic hydatid cyst and the gallbladder is rare [3]. We present an unusual case of a fistulous communication between a hepatic hydatid cyst and the gallbladder. The MR cholangiopancreatography (MRCP) features have been discussed.

Purpose: To investigate with color Doppler imaging the effects of phacoemulsification surgery under topical anesthesia on retrobulbar vessels hemodynamics. Methods: In this prospective study, color Doppler imaging was used to measure the maximum (Vmax) and minimum flow velocity (Vmin) of the central retinal vein, and the Vmax and Vmin, pulsatility index and resistance index of the central retinal artery, nasal, and temporal posterior ciliary arteries, and ophthalmic artery blood flow before and 1 day after phacoemulsification surgery under topical anesthesia. Results: After phacoemulsification surgery under topical anesthesia, Vmin of the central retinal artery increased (p ≤ 0.05), whereas the other variables showed no significant change. Conclusions: Phacoemulsification surgery under topical anesthesia has a minor effect on retrobulbar blood flow. Therefore topical anesthesia should be suitable for patients with ocular perfusion disorders (eg, glaucoma). © 2012 Wiley Periodicals, Inc. J Clin Ultrasound, 2012

Purpose: To investigate the effects of intravitreal ranibizumab on retrobulbar blood flow in patients with neovascular age-related macular degeneration (AMD). Methods:Thirty-one eyes of 30 patients with neovascular AMD were examined prospectively by both color Doppler imaging and fundus fluorescein angiography. Color Doppler imaging was used to measure the maximum and minimum velocities of the central retinal vein, peak systolic/end-diastolic velocities of blood flows, and pulsatility index and resistivity index values in the central retinal artery, nasal/temporal posterior ciliary arteries (NPCA/TPCA) and ophthalmic artery. The t test for paired samples was used for comparing retrobulbar blood flow values before and after intravitreal ranibizumab (Lucentis®) injection in the study and control groups. Results:There was a statistically significant (p < 0.05) difference between the pre-injection and post-injection end-diastolic velocities of the NPCA and TPCA and resistivity index values of TPCA. The other parameters showed no statistically significant difference. Conclusion: Our results show that intravitreal ranibizumab injection increases retrobulbar blood flow.

Background. To investigate the effects of intravitreal bevacizumab on retrobulbar circulation in patients with neovascular age-related macular degeneration (AMD). Method. Thirty patients with neovascular age-related macular degeneration were assessed prospectively by both color Doppler imaging and fundus fluorescein angiography. Spectral Doppler analysis allowed the measurement of the maximum velocity (Vmax) and minimum velocity (Vmin) of the central retinal vein (CRV), and peak systolic (PSV), end-diastolic (EDV) velocities of blood flows, and pulsatility index (PI) and resistance index (RI) values in the central retinal artery (CRA), nasal and temporal posterior ciliary arteries (NPCA, TPCA), and ophthalmic artery (OA). The t test for paired samples was used to compare retrobulbar blood flow values before and after intravitreal bevacizumab injection. Result. PSV and EDV of the NPCA and PSV of the TPCA were significantly decreased after intravitreal bevacizumab injection (p < 0.05). There was no statistically significant difference in the other parameters. Conclusion. Our results suggest that intravitreal bevacizumab therapy has a measurable effect on retrobulbar blood flow. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound 2010

Purpose To determine whether twinkling artifacts on color and power Doppler sonography could be used as a new sonographic sign of intrauterine fetal demise (IUFD). Methods In this prospective study, 24 consecutive pregnant women with IUFD were included after fetal sonographic examinations. Sonographic examination included gray-scale, color, power, and spectral Doppler imaging. The sonograms were then analyzed for the presence, appearance, and intensity of the twinkling artifacts. Results Twinkling artifacts on color Doppler were observed in all of the 24 IUFD as a rapidly changing color Doppler signal complex associated persistently with different parts of the fetal body. The artifacts were localized especially in the neck, back, and iliac regions. Artifact intensity correlated with the time elapsed since death. Conclusion Twinkling artifact was noted in all dead fetuses on color, power, and spectral Doppler examinations. Thus, the observation of these artifacts may be considered as a new sonographic sign of fetal demise, which may reflect the time elapsed since death. © 2007 Wiley Periodicals, Inc. J Clin Ultrasound, 2008

Isolated spontaneous common carotid artery (CCA) dissection is rare. So far, surgical or medical treatment have only been reported in a few cases in the literature. We report a 39-year-old man, diagnosed as isolated spontaneous CCA dissection one year ago, who experienced a new minor stroke despite medical treatment. Because of the presence of new ischemic lesions on new magnetic resonance imaging despite medical treatment, and critical narrowing of internal carotid artery (ICA) orifice with jet and turbulence flow pattern at the bulbar portion of the ICA, endovascular management was performed with carotid stent deployment. To the best of our knowledge, this is the first case of spontaneous isolated CCA dissection treated with stenting of the carotid artery reported in literature. - OZET - Izole spontan common carotid arter (CCA) diseksiyonu nadirdir. Literaturde sadece birkac adet, medikal veya cerrahi tedavi uygulanan, CCA diseksiyonu olgusu bildirilmistir. Bildirimizde, bir yil once izole spontan CCA diseksiyonu tanisi almis ve medikal tedavi altinda iken yeni minor strok geciren 39 yasinda erkek olguyu sunuyoruz. Olgunun yeni magnetik rezonans goruntulemesinde (MRG), sol posterior frontal ve pariyetal loblarda yeni iskemik lezyonlarin ortaya ciktigi goruldu. Renkli Doppler ultrasonografi (RDUS) incelemesinde eski incelemesine gore darligin arttigi izlendi. Karotis anjiografide de internal karotis arter baslangicinda jet ve turbulans akima neden olan kritik darlik saptanmasi uzerine endovaskuler tedavi planlandi. Femoral girisimle koruyucu filtre kullanilarak self ekspandibl stent yerlestirildi ve postdilatasyon balon uygulandi. Islemden 24 saat sonra alinan difuzyon MRG incelemesinde yeni iskemik alan gorulmedi. Birinci ve 3. ay kontrollerinde, norolojik muayenesinde yeni bulgu saptanmadi. RDUS incelemelerinde stentin acik oldugu goruldu. Karotis artere stent yerlestirimesi cerrahiye alternatif bir tedavi olup daha az invazivdir. Stent uygulamasi, spontan ve travmatik internal karotis arter darliklarinda kullanilmis, ancak izole spontan CCA diseksiyonunda kullanilmamistir. Olgumuz nadir gorulen izole spontan CCA diseksiyonu olgularindan biri olup stent yerlestirilerek tedavi edilmistir. Sonuc olarak, medikal tedaviye ragmen tekrarlayan semptomlari olan izole spontan CCA diseksiyonu olgularda tromboemboli kaynaginin kontrol altina alinmasi ve yeterli karotis akiminin saglanmasi icin stent yerlestirilmesi gerekebilir.

Cerebral venous thrombosis presenting with subarachnoid hemorrhage (SAH) is very rare. We report a case of cerebral venous sinus thrombosis as an initial manifestation of SAH. A 14-year-old boy was admitted with progressive headache, nausea, vomiting, diplopia, and gait disturbance. Cerebral computed tomography scan showed a widely SAH in the basal cisterns, bilateral sylvian fissures, and anterior interhemispheric fissure. Cerebral angiography was performed to detect any aneurysm in intracranial vasculature as a cause of SAH; however, the totally thrombosed superior sagittal sinus, galenic vein, and straight sinus were the sole abnormal findings.

In this study, we aimed to assess anatomical relationship between the anterior inferior cerebellar artery (AICA) and cochleovestibular nerve (CNV) in patients with non-specific cochleovestibular symptoms using magnetic resonance imaging (MRI). One-hundred and forty patients with non-specific neuro-otologic symptoms were assessed using cranial and temporal MRI. Classification was performed according to four different types of anatomical relationship observed between the AICA and CVN. In type 1 (point compression), the AICA compresses only a limited portion of the CVN. In type 2 (longitudinal compression), the AICA approaches the CVN as both traverse parallel to each other. In type 3 (loop compression), the vascular loop of the AICA encircles the CVN. In type 4 (indentation), the AICA compresses the CVN so as to make an indentation in the nerve. The anatomical relationship between the CVN and AICA was encountered in 19 out of 140 (13.6%) patients (20 ears). The VCC was unilateral in 18 patients (94.7%) and bilateral in one patient (5.3%). There was no other vascular structure causing VCC to the CVN except for vertebral artery that was seen in 2 out of 140 patients (1.4%). These were unilateral cases. There were tinnitus, vertigo or dizziness, hearing loss, and both hearing loss and vertigo in 5 (25%), 13 (65%), 1 (5%) and 1 (5%) ears of 20 patients, respectively. There was no relationship between the cochleovestibular symptoms and type of compression (p > 0.05). Neurovascular relationship between the CVN and AICA can be imaged properly using MR and MR based classification may help reporting this relationship in a standard way. Although, MR images can show the anatomical relationship accurately, diagnosis of vascular conflict should not be based on imaging findings alone.

Purpose: To determine the changes of multiple hemodynamic parameters and pulse wave contour in pure aortic regurgitation (AR) and to present a new indicator of the severity of AR (shrink ratio of proximal common carotid artery). Material and Methods: The sonograms of 42 patients (31 M, 11 F; 16–68 years) with pure AR and 18 control subjects (15 M, 3 F; 20–47 years) were assessed for velocities and indices, and change of pulse wave contour (bisferious pattern, zero level and retrograde diastolic flow) in each carotid artery. Shrink ratio (maximum diameter–minimum diameter/maximum diameter) of each proximal common carotid artery was calculated. Results: Bisferious waveforms seen in patients with AR grade 1, grade 2, and grade 3–4 were 66%, 83%, and 88%, respectively. Diastolic reversed flow was determined in 7 (39%) of 18 patients with AR grade 3–4. Three patients (25%) with AR grade 2 and 4 patients (22%) with AR grade 3–4 had zero level diastolic flow in the common carotid artery. Statistically significant changes of decreased end‐diastolic velocity, increased peak systolic velocity/end‐diastolic velocity, resistivity index, and pulsatility index were revealed, especially in AR grade 3–4 compared to controls. Significantly increased shrink ratio was seen only in AR grade 3–4. Conclusion: Increased shrink ratio or changes in hemodynamics or pulse waveform can be used in recognition of AR.

We assessed the morphological and radiological characteristics of ethmomaxillary sinus (EMS), which is an enlarged posterior ethmoidal air cell occupying the superior portion of the maxillary sinus while draining into superior meatus. This study is based on 1450 patients submitted to CT examination of the paranasal sinuses between 1998 and 2002. Sequential CT scans were obtained in the coronal plane in all the patients with 2.5- to 5-mm section thickness and were evaluated for EMS. The diagnosis of EMS was made when there was a posterior ethmoidal cell occupying the superior part of the maxillary sinus while draining to the superior meatus. When EMS was diagnosed, the morphology of the septum between the and maxillary sinus, and width of the superior meatus, were noted. The EMS was found in 10 of 1450 (0.7%) patients. The coexisting anatomic variations were concha bullosa (50%), upper concha pneumatization (20%), maxillary sinus hypoplasia (20%), uncinate bulla (10%), hypertrophied inferior concha (10%), paradoxic middle concha (10%), and septate maxillary sinus (10%). There was no relation between EMS and sinus disease. The EMS is a rare anatomic variation and does not appear to be associated with sinusitis. The EMS is not a well-studied anatomic variation, and the literature is lacking adequate information about this anatomic variation. This study performed in a large series of patients will possibly contribute to better understanding of this particular anomaly.

The subcutaneous herniation of gallbladder through the abdominal wall is very rare, and to our knowledge, only two cases were reported previously in the literature [Clin. Radiol. 42 (1990) 283; J. Clin. Ultrasound 25 (1997) 398]. In both of these cases, the gallbladders were found to be distended. To our knowledge, the present case is the first case report in the literature in which a morphologically normal gallbladder herniated into the subcutaneous tissue.

The aim of this study was to determine whether a relationship exists between mastoid size and auditory tube angle (ATA) and chronic ear disease. A radiological and clinical study was undertaken of the temporal bones of 36 subjects. There were 24 patients with unilateral chronic otitis media (COM) and 12 healthy controls (HC): the contralateral healthy ears of the COM patients were also used as control (CLHC). From each CT scan the distance between Henle spine and the sigmoid sinus (H-SS) and the ATA was assessed. The angle between a longitudinal line bisecting the transverse length of the external auditory canal and the longitudinal axis of the AT was calculated. A direct correlation between H-SS and ATA, both in COM and HC (p < 0.01), was observed, but not in CLHC (p > 0.05). There was no significant difference in the ATA results between COM and CLHC, or between COM and HC (p > 0.05), however there was a significant difference between CLHC and HC (p = 0.02). H-SS distances were not significantly different between COM and CLHC, or COM and HC, or CLHC and HC (p > 0.05). An association between ATA and mastoid size in both healthy and diseased ears was observed. The anatomical relationships of the AT, mastoid and middle ear, which form a functional unit, are not significantly important in chronic ear disease.

The purpose of this study was to discover the prevalence of maxillary sinus hypoplasia (MSH) and associated malformations. A total of 490 consecutive axial and coronal computerized tomographic (CT) scans of the paranasal sinuses were obtained from patients with chronic sinusitis. CT scans were assessed for the presence of MSH and associated anatomic variations. A new classification of MSH was made, and the diagnostic criteria listed. The frequency of anatomic variations coexisting with MSH was also estimated. MSH was encountered in 21 (4.2%) of the 490 patients. Unilateral types I, II and III MSH were seen in 7 (1.4%), 6 (1.2%) and 8 (1.6%) respectively. MSH was bilateral only in 3 (0.6%) patients, one of which was a bilateral type II. In the remaining two bilateral MSH cases, there was a type II MSH on one side and type III MSH on the other in each patient. Middle conchal pneumatization was the most common coexisting anatomic anomaly in MSH, followed by agger nasi cell, secondary middle concha, paradoxical middle concha and superior conchal pneumatization. A patient with MSH should be carefully evaluated prior to any sinus surgery in order to avoid surgical complications. With precise CT assessments, an MSH can be diagnosed and distinguished from other maxillary sinus anomalies. With the additional criterion of orbital enlargement, and the help of reproducible measurement techniques explained in this study, an objective diagnosis and classification can be made in further investigations of MSH.

We report a thyroglossal duct cyst with calcification, the second case in the world literature. The ultrasound and CT findings are described and we highlight the differential diagnosis.

Perforation of the uterus is rare but potentially fatal. During puerperium when the uterus is small and its wall is thin, the risk of perforation increases. We report a rare complication from an intrauterine contraceptive device (IUD) which caused deviation of the right ureter in a 31-year-old woman who presented with complaints of insomnia and abdominal pain. Our case shows that perforation of the uterus by an IUD can cause a silent urological complication. The possibility of ureteral involvement and displacement should be kept in mind in a woman in whom a missing IUD is encountered.

Advances in surgical techniques and instrumentations, utilization of the imaging tools, and understanding the regional anatomy have served to make functional operations with less complications in the paranasal sinus area. In the context of this article, some of these anatomical structures and their variations were reviewed through images. These structures were as follows: course of the anterior ethmoidal artery; roof of the ethmoid; lamina papyracea; uncinate process; optic nerve; and internal carotid artery.

The aim of this study was to delineate the precise relationship between the sphenoid sinus and internal carotid artery and the optic nerve, as well as to assess incidence of the anatomic variations of these structures. A review of 92 paranasal sinus tomographic scans was made for anatomic variations of the sphenoid sinus and related bony and neurovascular structures. Coronal and axial tomographic sections were obtained with 2.5-mm section thickness. We assessed the protrusion of the internal carotid artery (ICA) and the optic nerve (ON) into the sphenoid sinus, bone dehiscence of these structures, and pneumatization of the anterior clinoid process (ACP) and pterygoid recess (PR), as well as the variations of the sphenoid sinus septum. The protrusion of the ICA into the sphenoid sinus was found in 24 (26.1%) patients. An ON protrusion was present in 29 (31.5%) patients. Pneumatization of the PR was encountered in 27 (29.3%) patients. There was not a statistically significant relationship between the pneumatization of the PR and ICA protrusion into the sphenoid sinus (chi2 = 0.258, p = 0.168). A significant relationship between the ACP pneumatization and protrusion of the ON into the sphenoid sinus was found (chi2= 0.481,p = 0.007). Preoperative recognition of the anatomic variations by the radiologist is beneficial for identification of the limits of dissection. This is particularly important in the sphenoid sinus area where extensive pneumatization of the skull base bones may distort the anatomic configuration. Therefore, axial and coronal CT sections should always be obtained prior to any surgery in the sphenoid sinus area.

Intrathoracic ectopia of the kidney(s) denoting partial or complete renal protrusion above the level of the diaphragm into the posterior mediastinum is a rare developmental abnormality. This type of ectopia is identified at 1/13,000 to 1/15,000 autopsies and less than 5% of all patients with ectopia have an intrathoracic kidney.1 Since 1840 at least 92 cases have been collected in the literature, including 4 involving bilateral kidneys.2 When associated with superior ectopia of the kidney(s), the predominance is 1.5:1 and the sex ratio favors males at a ratio of 3:1. This entity has been detected in all age groups. The majority of individuals with this anomaly remain asymptomatic. Most cases are discovered on routine chest x-ray or at thoracotomy for a suspected mediastinal tumor. Although associated abnormalities are rare, cases have been reported with an accompanying ectopic adrenal gland.3 No consistent anomalies have been described in other organ systems. In our case, in addition to thoracic ectopia of the left kidney, the spleen was in an intrathoracic position.

Magnetic resonance imaging findings of a 38-year-old man with epithelioid sarcoma of the penis is presented. It started as a firm, painless and slowly growing nodule at the base of his penis 6 months previously which caused pain radiating to the testis during coitus. It has been well known that sarcomas may well mimic reactive processes. Initial presentation of epithelioid sarcoma may provoke considerable diagnostic difficulty, and its differentiation from benign lesions, such as Peyronie's disease and chronic inflammation, may be a clinical problem. In our present report the MR findings are compared with those of the epithelioid sarcomas of various locations reported in the literature and differential diagnosis of the entity is discussed. To our knowledge, this is the first report regarding the MR findings of the epithelioid sarcoma of penis.

Purpose: the purpose of this study was to present the CT findings of complicated pulmonary hydatid cysts on the basis of the CT appearances. Material and Methods: Preoperative CT examinations of 19 cases with hydatid cysts were evaluated retrospectively for the number and various features of the cysts and secondary changes in adjacent structures. the results were compared with surgical findings. Results: While 7 patients had multiple pulmonary hydatid cysts, 12 patients had solitary cyst. the total number of the cysts was 29. Eleven of them were intact cysts. Two of the 18 complicated cysts were only ruptured, while the remaining 16 complicated cysts were ruptured and infected. the endocyst was separated from a pericyst in a local area in one ruptured cyst. Air-bubbles were seen within 14 infected cysts. Nine of the infected cysts had characteristic appearances of hydatid disease. the other 2 infected cysts showed soft tissue density. Conclusion: CT can provide the specific diagnosis of pulmonary hydatid cysts by demonstrating the number and features of the cysts, characteristic appearances of complicated cysts, and secondary changes in adjacent structures. Whether there are characteristic signs or not, the demonstration of air-bubbles within the cyst, together with ring enhancement, are strong indicators for infected hydatid cysts.

A 40-year-old man developed massive subarachnoid hemorrhage following attempted radiofrequency ablation for trigeminal neuralgia. The patient had a 10-year history of trigeminal neuralgia at the ophthalmic and maxillary branches of the left trigeminal nerve. After the procedure, the patient’s pain resolved completely, but one hour later sudden onset of severe headache in the frontal region was appeared. Computed tomography (CT) scan of the cranium showed massive subarachnoid hemorrhage, and an air bubble was observed in the left cavernous sinus. Herein, we present the CT feature of this rare complication. Keywords: Radiofrequency ablation; subarachnoid hemorrhage; traumatic; trigeminal neuralgia

Ossification of the ligamentum flavum (OLF) is a disease of ectopic bone formation within the ligamentum flavum, which may result in mass effect and neurological symptoms. It mainly occurs in the thoracic spine, and this is followed by the cervical then rarely in the lumbar spine. Herein, we present a rare case of OLF of the lumbar spine with radiological findings.

Evaluating the performance of magnetic resonance imaging (MRI) and comparison with mammography, ultrasound (US) and histopathology results in cases of women with suspicious breast lesions. Forty nine cases on which histopathology was performed included in the study. All cases were applied mammography and US, and then MRI. Biopsy or post-operational results have been generated. Among the 49 cases, 27 (55%) benign and 22 (45%) were malign lesions. Using mammography, of the 49 cases, 24 (49%) were deemed to be malign. True positive cases were 20 (41%). In ultrasound, 25 (51%) were malign, 24 (49%) were benign. True positive cases were 21 (43%). Lesions were detected in all of the 49 cases using MRI. All of the 22 (45%) malign cases were diagnosed as malign lesion. Sensitivities of mammography, US and MRI in detecting lesions were 83%, 95% and 100%, and specificities were 85%, 85% and 92% respectively. In MRI, all cases were applied dynamic contrast sequences, for the cases with lesions detected, time signal intensity (SI) curves were drawn. 23 cases were detected as Type 1 (47%), 2 cases were Type 2 (4%), 24 cases were Type 3 (49%) SI curve. According to SI curves sensitivity in detecting malignities was 95% and specificity was 81%. MRI has been found superior to mammography and US in detecting masses especially with its characteristics of higher spatial resolution, less binding of dynamic properties evaluation on user. There may be a decrease of unnecessary interventional operations in benignmalign detection of breast lesions using dynamic breast MRI.

Surgical treatment of a case of pulmonary and cardiac hydatid cysts is described. The role of computed tomography in demonstrating multivesicular cystic lesions is highlighted.