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Nephrolithic non-functioning kidney and malakoplakia are major health problems. Kidney function cannot be fulfilled and also this leads to a high risk of development of urothelial neoplasm. We report herein a case of urothelial carcinoma concomitant with malakoplakia in non-functioning nephrolithic kidneys.

Arterial cannulation is a common anaesthetic procedure that might be challenging and time-consuming in elderly patients. To establish an appropriate wrist joint position for arterial cannulation is crucial for ultrasound (US)-guided cannulation success. This study aimed to find out the optimal wrist joint angle for long axis in-plane (LA-IP) US-guided approach in radial artery cannulation in elderly patients. One hundred patients over 60 years old, who were assumed to require an arterial catheter for continuous blood pressure monitoring or frequent blood gas analysis in the intensive care unit or in the operating room were included in this prospective randomized study. Patients were randomized to five groups according to the wrist positions (0°, 15°, 30° 45° and 60° groups) for LA-IP approach for radial artery cannulation. Cannulation time (s), number of attempts, total success rate (%), first attempt success rate were recorded in all patients. Mean radial artery height was increased in 45° group compared to other groups (p < 0.05). Distance between skin and radial artery in 45° and 60° groups were statistically significantly decreased compared to 0° group (p < 0.05 for all comparisons). Mean cannulation time of 45° group was statistically decreased compared to other groups (p < 0.05). Number of attempts and total success rate were similar among groups, whereas first attempt success rate was significantly increased in 45° group compared to other groups (p < 0.05). Mean arterial height of the first attempt successful group was statistically increased compared to the first attempt failed group (p < 0.001) and mean cannulation time and mean number of attempts were also negatively correlated with arterial height (p < 0.001; for all comparisons). The 45° wrist angle increment might be advantageous in US-guided LA-IP radial artery cannulation in elderly patients in view of cannulation time and first attempt success rate. [ABSTRACT FROM AUTHOR]

Background and Aim: Resistive index (RI) is an indirect measurement of blood flow resistance that can be used to evaluate vascular damage in ophthalmologic disease. The purpose of this study was to evaluate the association between RI values of orbital arteries using the color Doppler imaging (CDI) in geriatric hypertensive patients with or without retinopathy. Setting and Design: Designed as a cross.sectional study. Materials and Methods: We evaluated 60 geriatric patients with hypertension (Group 1) and 30 healthy subjects (Group 2). Further, the patients with hypertension were grouped into two: Group 1a consisted of patients with retinopathy (n = 30), and group 1b consisted of patients without retinopathy (n = 30). The mean RI values of ophthalmic artery (OA), central retinal artery (CRA), and posterior ciliary artery (PCA) were measured using CDI. Results: Compared to group 2, group 1 had significantly higher mean resistive index of PCA levels (P = 0.017), whereas there were no statistical difference in mean resistive indexes of OA and CRA (both P > 0.05). Besides, there were no statistical difference in mean resistive indexes of OA, CRA, and PCA between the group 1a and group 1b (P > 0.05 for all). Mean resistive indexes of OA, CRA, and PCA were significantly correlated with the duration of hypertension (r = 0.268, P = 0.038; r = 0.315, P = 0.014; r = 0.324, P = 0.012, respectively). Conclusions: Our study indicates that RI might be a useful marker for the ocular hemodynamic of retinal vessels, provides morphologic and vascular information in hypertension and hypertensive retinopathy. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to evaluate the efficacy of multidetector computed tomography (CT) imaging in diagnosis of pleural exudates and transudates using attenuation values.Materials and Methods: This retrospective study included 106 patients who were diagnosed with pleural effusion between January 2010 and June 2012. After the patients underwent chest CT, thoracentesis was performed in the first week. The attenuation values of the pleural effusions were measured in all patients.Results: According to Light's criteria, 30 of 106 patients with pleural effusions had transudates, and the remaining patients had exudates. The Hounsfield unit (HU) value of the exudates (median, 12.5; range, 4-33) was significantly higher than that of the transudates (median, 5; range, 2-15) (P = 0.001). Additionally, when evaluated by disease subgroups, congestive heart failure and empyema were predictable in terms of median HU values of the pleural effusions with high and moderate sensitivity and specificity values (84.6% and 81.2%, respectively; 76.9% and 66.7%, respectively). Compared with other patients, the empyema patients had significantly more loculation and pleural thickening.Conclusion: CT attenuation values may be useful in differentiating exudates from transudates. Although there is an overlap in most effusions, exudate can be considered when the CT attenuation values are >15 HU. Because of overlapping HU values, close correlation with clinical findings is essential. Additional signs, such as fluid loculation and pleural thickness, should be considered and may provide further information for the differentiation. [ABSTRACT FROM AUTHOR]

Joubert syndrome is a rare disease characterised by clinical and radiological findings. Among the classic clinical findings of JS are hypotonia, ataxia, mental-motor retardation, respiratory and opthalmological findings. The paediatric cases included in the study comprised nine patients. There was familial consanguinty in seven cases. Clinically, all cases had mental-motor retardation and hypotonia. Episodic hyperpnoea attacks were observed in one case. Facial dysmorphism was the most common additional systemic anomaly and four cases had additional opthalmic findings. Brain MRI examination revealed that all cases had molar tooth sign, bat-wing appearance and vermian cleft. The majority of cases also had vermian hypoplasia. Cerebellar folial disorganisation was observed in approxiamtely half of the cases. Three cases had corpus callosum anomaly and atretic occipital encephalocoele. No pathology was determined in other organs. This study aimed to evaluate the clinical and radiological findings of 9 patients diagnosed with Joubert syndrome.

Moyamoya disease is a cerebrovasculopathy of unknown etiology during the course of which the main and terminal veins of the internal carotid artery undergo progressive vein occlusion. Leigh syndrome is a mitochondrial encephalomyopathy that occurs due to "cytochrome c oxidase deficiency" characterized by psychomotor retardation, difficulty in eating, seizures, hypotonia, respiratory disorders and high lactate levels. Many diseases and syndromes have been defined that are associated with Moyamoya disease. To the best of our knowledge, the association of moyamoya disease with Leigh syndrome has not been defined as yet. In this study, the clinical and imaging results of a 3-year-old male child displaying the association of Moyamoya disease and Leigh syndrome are presented.

Cystic hygroma is a rare congenital malformation of the lymphatic system. It is most frequently detected in the head and neck region. Ultrasonography is performed as the first step for radiological diagnosis of these lesions. Magnetic resonance imaging provides important information for diagnosis and to guide treatment. In this paper, a case is reported of cervicomediastinal large cystic hygroma in a male infant.