Search

Vatansever, Alper/0000-0002-3632-1020 WOS: 000434304300097 PubMed: 29438203 Introduction:This study investigated the effect of periosteal graft + platelet-rich plasma (PRP) combination on facial bone defect healing. Methods: Five-millimeter critical sized defects in zygomatic arches of 12 adult New Zealand rabbits were created. Rabbits were randomly divided into 3 groups: First group (control group): bone defects of left zygomatic arches of 6 rabbits were wrapped with a silicone tube. Second group (periosteal graft group): bone defects of left zygomatic arches of 6 rabbits were wrapped with periosteal graft. Third group (experimental group): bone defects of right zygomatic arches of 12 rabbits were wrapped with periosteal graft-PRP combination. New bone formation was evaluated at 8th and 16th weeks. One rabbit was sacrificed at 8th week. Remaining 11 rabbits were imaged with 3-dimensional computed tomography (CT) at 16th week; then, zygomatic arches were removed for micro-CT and histologic examinations. Results: Three-dimensional CT analysis at 16th week revealed no significant difference between groups regarding new bone formation (P = 0.232). Micro-CT analysis of new regenerated bone at 16th week displayed significant differences between groups 1 and 3 regarding mean bone volume (BV, mm(3)) (P = 0.028) and mean bone mineral density (BMD, mm(2)) (P = 0.001). There was no difference between groups 2 and 3 or between groups 1 and 2, regarding BV or BMD. Histological Bone Regeneration Scorings at 16th week displayed significant difference between groups (P = 0.015). Negative correlation between 3-dimensional CT and histologic results (r = 0.120); positive correlations between BV/BMD values in micro-CT and histologic results (r = 0.524 and r = 0.456) were found. Conclusions: By enhancing bone formation capacity of periosteal grafts, periosteal graft-PRP combination provided bone formation having more volume and density comparing with silicone tube application. Duzce University Scientific Research Foundation [2013.04.02.179] The authors acknowledge the support of Duzce University Scientific Research Foundation (Project No: 2013.04.02.179).

WOS: 000383915400008 PubMed: 27442525 Purpose:Accessory cardiac bronchus (ACB) is a very rare congenital anomaly and may cause some clinical complications, such as recurrent episodes of both infection and hemoptysis. The purpose of this study was to assess the multidetector computed tomography (MDCT) characteristics of ACB and to classify this anomaly according to the MDCT aspects.Materials and Methods:The routine thoracic CT scans from 5790 patients were evaluated retrospectively. The prevalence, location, length, diameter, division angle, distance from the carina, and the type of ACB were evaluated.Results:A total of 12 ACBs were identified, with a prevalence of 0.2%. All ACBs originated from the intermediate bronchus. The median largest diameter of the ACBs was 7.75 mm (range: 5.8 to 10.30 mm), the median length was 12.1 mm (range: 8.6 to 35 mm), the median division angle was 61 degrees (range: 42 to 93 degrees), and the median distance from the carina was 16.95 mm (range: 5.7 to 22.20 mm). Six cases (50%) had a blind extremity (type 1: diverticulum or stump type), 3 cases (25%) had a mutiloculated cystic change at the end (type 2: cystic type), and 3 cases (25%) had a ventilated lobulus demarcated by an anomalous fissure (type 3: ventilated type).Conclusions:ACBs can be classified into 3 types according to their MDCT features. Recognition of ACB is important, as it is associated with clinical complications and is also salient in trauma cases.

Naldemir, Ibrahim Feyyaz/0000-0002-0804-7378 WOS: 000428231100063 PubMed: 29277494 The occipital bone is a complex structure due to its anatomy and accessory sutures. Fracture - accessory suture differential diagnosis should be performed carefully in patients with a history of head trauma [4]. In this case report we wanted to emphasize that accessory sutures can be difficult to diagnose in patients with head trauma. We also specified the points to be considered in the suture - fracture differentional diagnosis. A bilateral, symmetrical fissure line was observed in the occipital bone basal part of the patient who was admitted to our emergency department due to head trauma. The patient was followed up with accessory suture and then discharged after paying attention to important points in the differential diagnosis. (C) 2017 Elsevier Inc. All rights reserved.

Objectives: Fine-needle aspiration biopsy (FNAB) is the gold standard in the management of thyroid nodules and specimen should be obtained from dominant nodule. In our study, we aimed to compare the FNAB and histopathology results of dominant and non-dominant nodules and to evaluate the association between nodule size and histopathology results in patients with MNG. Materials and methods: Between 2009 and 2010, 197 cases who had diagnosed MNG were analyzed. These cases were performed FNAB from both dominant nodule and non-dominant nodule. 26 patients with inadequate cytological results were excluded and 171 cases were included in the analysis. Malignant ultrasonographic (US) features were defined as showing marked hypoechogenicity, microcalcifications, solid structure and not having peripheral halo. Results: No statistically significant difference was observed between malign cytology and suspected cytology ratios of dominant nodules and non-dominant nodules (p=0.083). Malignancy rates were higher at dominant nodules not having peripheral halo and non-dominant nodules including microcalcification at US. Also statistically significant difference was not observed (p=0.485) between malign histopathology rates of dominant and non-dominant nodules after surgery. Conclusions: According to cytological and histopathological results of patients with MNG, there was no significant difference between the malignancy ratio of dominant and non-dominant nodules. There is no obvious correlation between malignancy and nodule size in patients with MNG. We think that FNAB obtained not from only dominant nodules but also nodules with suspicious features of malignancy is necessary for most accurate diagnosis., Amaç: İnce iğne aspirasyon biyopsisi (İİAB) tiroid nodüllerine yaklaşımda altın standarttır ve multinodüler guatrda (MNG) dominant nodülden İİAB yapılması önerilmektedir. Çalışmamızda MNG tanılı olgularda dominant ve dominant olmayan nodül İİAB ve histopatoloji sonuçlarını karşılaştırarak nodül boyutu ile patoloji sonuçları arasındaki ilişkiyi değerlendirmeyi amaçladık. Gereç ve yöntem: 2009–2010 tarihleri arasında hem dominat nodülden hem de dominat olmayan nodülden İİAB yapılan MNG tanılı 197 olgu incelendi. İİAB sonucu yetersiz gelen 26 olgu çalışmaya dâhil edilmedi ve 171 olgu değerlendirildi. Ultrasonografide (US) malignite kriteri olarak nodülün hipoekoik patern, solid yapı, mikrokalsifikasyon içermesi ve periferik halosu olmaması özellikleri kullanıldı. Bulgular: Dominant nodüller ile dominant olmayanların malignite veya şüpheli sitoloji oranları arasında istatistiksel olarak anlamlı fark izlenmedi (p=0.833) US de periferik halosu olmayan dominant nodüllerde ve mikrokalsifikasyon içermeyen dominant olmayan nodüllerde malignite daha yüksek oranda izlendi. Cerrahi sonrası yapılan patolojik değerlendirmede elde olunan malignite oranlarında da dominant ve dominant olmayan nodüller arasında anlamlı ilişki bulunmadı (p=0.485). Sonuç: Multinodüler guatr tanılı olguların hem sitolojik hem de histopatolojik değerlendirmesinde dominant ve dominant olmayan nodüller arasındaki malignite oranlarında anlamlı fark bulunmamaktadır. Multinodüler guatr\'lı olgularda malignite ile nodül boyutu arasında bir ilişki söz konusu değildir. Dominat nodülün yanı sıra ultrasonografide malignite özellikleri taşıyan dominant olmayan diğer nodüllerden de İİAB yapılmasının tanının daha sağlıklı konabilmesi için gerekli olduğunu düşünmekteyiz.

Hepatic alveolar echinococcosis is an uncommon parasitic disease caused by Echinococcus multilocularis. It carries high fatality rates and poor prognosis if not diagnosed early and managed correctly. We report a 29-year-old female patient who admitted to our clinic with fatigue, weight loss and abdominal bloating in her right upper quadrant. Physical examination revealed the presence of a large palpable mass in her right upper quadrant, ascites and bilateral pedal edema. Computed tomography revealed a large non-homogeneous mass located in the right lobe of the liver and a dilated paraumbilical vein arising from the left branch of the portal vein. Echinococcus serology assessed by enzyme-linked immunosorbent assay was noted to be positive. Histopathologic examination of the hepatic mass was consistent with alveolar echinococcosis. The patient's complaints were determined as being related to cirrhosis due to alveolar echinococcosis. Alveolar echinococcosis must be considered in patients with portal hypertension of uncertain etiology, especially in endemic regions.

Alper, Fatih/0000-0002-9483-8861; Acemoglu, Hamit/0000-0002-4667-8103 WOS: 000296763300069 PubMed: 20800403 Purpose: We have investigated the utility of the STIR TSE sequence in the differentiation of benign from malignant mediastinal lymph nodes in patients with esophageal cancer. Patients and methods: This study included 35 consecutive patients who were diagnosed as esophageal cancer and were undergone surgery. STIR TSE sequences were obtained as the ECG trigger. The signal intensity of the benign and malign lymph nodes, normal esophagus, and pathologic esophagus can be calculated on STIR sequence. Results: Pathologically, the number of total lymph nodes in 35 operated cases was 482. Approximately 152 lymph nodes were detected with MR imaging. Of these, 28 were thought to be malignant, and 124 were thought to be benign, although 32 were malignant and 120 were benign according pathological results. The ratio of benign lymph node intensity value to normal esophagus intensity value was 0.73 +/- 0.3. The ratio of malignant lymph node intensity value to normal esophagus intensity value ratio was 2.03 +/- 0.4. According to these results, the sensitivity of MR was 81.3%, the specificity was 98.3%. Conclusion: We think that if motionless images can be obtained with MRI, we may be able to differentiate benign lymph nodes from malignant ones. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

The purpose of this study was to describe the findings of CT performed on denim sandblasters with silicosis. Fifty consecutive male patients with silicosis were evaluated. Their clinical data and pulmonary function tests (PFT) were obtained. The CT findings were recorded and the correlations between CT nodular profusion score and the other parameters were assessed. The diagnoses of the patients were classified as accelerated silicosis (n = 43) and acute silicosis (n = 7). The most common CT finding was centrilobular nodules. Twenty-three patients had complicated silicosis based on pleural involvement and presence of progressive massive fibrosis (PMF). Lymphadenopathy (LAP) was positive in 50% of the patients, with calcification in 24%. The CT grade was highly correlated with the clinical data such as exposure duration and PFT. Our findings suggest that the clinical manifestation of silicosis in denim sandblasters is severe. Although the duration of exposure is shorter the rate of complicated silicosis patients with pleural involvement was unexpectedly higher in the cases. Because the most common radiological appearance was nodules and the CT grading of the nodules was highly correlated with the clinical data, nodule grading may be used in the management of such cases.

Background: Hydatid cyst (HC) continues to be endemic in the Mediterranean countries, such as Turkey. Living in a rural area is an important risk factor for the disease. HC is most commonly seen in the liver and lungs, but retroperitoneal hydatid cyst is very rare. The objective of this study was to evaluate the clinical and radiographic findings and surgical treatment of this unusual lesion. Methods: Between 1979 and 2004, 14 cases with primary retroperitoneal hydatid cyst were treated surgically at our clinic. Results: Symptoms included flank pain in eight (57.1%) and palpable mass in six patients (42.8%). The cyst was located in the right retroperitoneum in seven patients (50%), left retroperitoneum in five patients (35.7%), retrovesical region in one patient (7.1%) and paravesical region in one patient (7.1%). Surgical approaches were right paramedian extraperitoneal approach in four patients, left paramedian extraperitoneal approach in two patients and midline transperitoneal approach in eight patients. Total pericystectomy was chosen as the surgical procedure in all patients except in five (35.7%), who had partial cystectomy for cysts located near the vital structures. There were no complications and mortality postoperatively. Conclusion: A primary HC of the retroperitoneum is a distinct clinical entity that must be considered when caring for a patient with a retroperitoneal mass in endemic regions. It should be treated after the diagnosis is confirmed without any delay because of secondary spillages due to perforations and other possible complications.

Earlier publications have reported that common carotid artery intima-media thickness (CCA-IMT) was lower on the right side than on the left side and that left-handed patients have a lower risk of sudden death of brain infarction. This study aimed to determine whether there is an asymmetry and the handedness related difference in CCA-IMT. Ultrasonographic examinations were performed with the use of Aplio US system. In total sample, male and female left-handers, CCA-IMT was greater on left side than on right side. In men, both right and left CCA-IMTs, but in women only right IMT, were lower in the left-handers than in the right-handers. Both right and left CCA-IMTs was positively correlated with age in men and in women. Handedness was a significant factor influencing CCA-IMT with adjustment for sex and age. It was greater on left side than on right side, especially in the left-handers. CCA-IMTs were lower in the left-handers than in the right-handers. These results suggest that hemodynamic stress and intimal damage was larger in the left carotid artery, which was larger in the right-handers compared to the left-handers.

Saritas, Ayhan/0000-0002-4302-1093; Saritas, Ayhan/0000-0002-4302-1093; WOS: 000356604000053 PubMed: 25935813 Morel-Lavallee syndrome is a posttraumatic soft tissue injury in which the subcutaneous tissue is broken off from the underlying fascia, creating a cavity filled with hematoma and liquefied fat. It commonly occurs over the greater trochanter and, rarely, may also occur in the lumbal region. Morel-Lavallee syndrome can be often diagnosed late because of ommitted diagnosis in emergency services. The emergency physician and radiologist must keep this syndrome in mind because early diagnosis can enable conservative management, whereas delayed diagnosis may lead to surgical exploration. In this article, we present the clinical and radiologic features of 2 cases of lumbar Morel-Lavallee syndrome detected after trauma.

The aim of this study was to evaluate the incidence of myocardial bridging in 626 patients examined with MDCT angiography of the coronary arteries.Six hundred twenty-six patients who were referred to Florence Nightingale and Atatürk University Hospitals were involved in this study. These patients had atypical chest pain, symptoms suggestive of coronary artery disease, or no significant cardiac complaint. Patients were in sinus rhythm and were premedicated with metoprolol tartrate (5 mg/mL IV bolus) to decrease the heart rate and nitroglycerin (5 mg sublingual 1 min before the examination) to dilate the coronary arteries. MDCT was performed on two different 16-MDCT scanners.Among the 626 patients, 22 cases (3.5%) of myocardial bridging were detected. Fifteen cases of myocardial bridging (2.4%) were located at the middle third of the left anterior descending coronary artery (LAD), five (0.8%) were at the distal third of the LAD, and two (0.3%) were at the proximal third of the LAD. In these patients, the length of tunneled artery was between 6 and 22 mm, with a mean of 17 mm, and the depth of tunneled artery was between 1.2 and 3.3 mm, with a mean of 2.5 mm.We found the incidence of myocardial bridging in this patient group to be 3.5%. This result is in agreement with some of the angiographic studies in the literature. Our study showed that MDCT is a reliable and noninvasive tool for diagnosing coronary myocardial bridging. After evaluating resource axial images, it is necessary to also evaluate the sagittal multiplanar reconstruction images for myocardial bridging.

In this paper, we report on clinical and laboratory findings of pigeon breeder's lung (PBL) in a mother and her 2 children: 2 with the chronic recurrent form, and 1 with the chronic insidious form without any symptoms or signs, who was diagnosed during family screening. The index case was diagnosed as having primary pulmonary hypertension on admission. However, on evaluation, the diagnosis was of pigeon breeder's lung in the index case and her symptomatic mother. High-resolution computerized tomography (HRCT) revealed interstitial lung disease in an asymptomatic sister of the index case. All cases responded to steroid treatment, and at the end of the third month, HRCT findings disappeared. In conclusion, in patients with acute respiratory symptoms and rapidly recovering pulmonary hypertension after hospitalization, PBL should be remembered. All family members of the index case should be screened by HRCT in terms of interstitial lung disease, even if they are asymptomatic.

Purpose The aim of this study was to assess the accuracy of multidetector computed tomography (MDCT), including virtual endoscopy (VE) for detection, precise localization, preoperative evaluation and staging of esophageal cancer (EC) by comparison with surgical and histopathological findings. Materials and methods Between September 2003 and April 2005, 44 patients with histologically proven EC underwent MDCT and VE. Among 44 patients, the findings were confirmed in 24 at surgery. The accuracy of three-dimensional MDCT for detection, localization, and staging of EC was determined, and compared with surgical finding and histopathology. Results The overall accuracy of three-dimensional multidetector row CT for detection of EC was 100% (24/24). MDCT staging was correct in 20 patients (83.3%). The T parameter was correctly assessed in 22 (91.7%) cases (understaged in 1 and overstaged in 1). The N parameter was correctly evaluated in 20 (83.4%) patients (understaged in 2 and overstaged in 2). The overall accuracy of VE for the morphologic classification of EC was 81.5%. Conclusions Three-dimensional MDCT, along with VE is a promising method for preoperative evaluation and staging of EC. Although accuracy in N staging remains low in comparison to PET, it provides a larger amount of diagnostic and staging information.

SUMMARY. The purpose of the present study is to estimate tumor volumes of 10 patients with esophageal carcinoma on serial CT images that are obtained before and after chemoradiotherapy using a stereological method. In this study, tumor volume was measured using the Cavalieri method of modern design stereology with a combination of three separate stages. Firstly, detailed systematic series of axial CT images of 1-cm thickness were obtained throughout the whole tumor area of each subject and to magnify them all CT images were projected on a screen by overhead projector and then were marked by manually tracing the outline of areas with tumor on serial CT images that are projected onto the screen. Secondly these images were drawn on paper. Finally the images on paper were evaluated with a point-counting method. It was shown in a pilot study analyzed that 100 test points counted on about 6--8 serial slices through for esophagus wall, lumen and wall + lumen are sufficient to secure coefficient of error (CE) on the estimates of volumes as in this study. It was found that tumor volumes before and after radiotherapy for esophagus wall, lumen and wall + lumen was 10.34 cm(3), 1.15 cm(3) and 11.75 cm(3) before and 5.93 cm(3), 1.43 cm(3) and 7.65 cm(3) after radiotherapy, respectively. When only esophagus wall and lumen volumes or wall + lumen volumes before and after radiotherapy were statistically compared, the difference between either esophagus wall (P

We describe a 9-year-old child with a history of trichoptysis caused by intrapulmonary teratoma and we present the CT and MRI findings of the teratoma. A heterogeneous mass containing cystic and solid elements was detected on both CT and MRI scans. Histopathological examination confirmed the diagnosis of teratoma. Teratomas arising from lung parenchyma, as in this case, are extremely rare in childhood. In the thoracic region, the most common localization of teratomas is the anterior mediastinal compartment. We also discuss the CT and MRI findings and the differential diagnosis of teratomas.

Oxalosis is a rare metabolic disorder in which an enhanced production of oxalic acid leads to hyperoxalemia and deposition of calcium oxalate in different organs. Although the findings related to oxalosis in other organs have been reported, cerebrorenal oxalosis has been mentioned but their radiological finding has not been described. Therefore we aimed to describe the magnetic resonance imaging findings of an interesting case with cerebrorenal oxalosis manifesting as cerebral infarcts.

There are asymmetries in the sizes of transverse sinus and intraocular pressure. The purpose of this study was to investigate possible relationships between the asymmetry of transverse sinuses in TOF MR venography and intraocular pressures of right and left eyes. In this study, subjects were 63 male and 42 female medical school students, aged 18-21 years (mean+/-SD; 19.72+/-0.67 years). Subjects with neurological and ophthalmologic disease, particularly dural sinus thrombosis, myopia, trauma and glaucoma, were excluded the study. Subjects were divided into five groups according to the magnitudes of the right- and left-transverse sinuses in MR venography results. There is a functional relation between intraocular pressures of the right and left eyes and asymmetry of the transverse sinus. If the transverse sinus on one side is larger and its venous drainage is greater, the intraocular pressure of the eye on this side is lower. It can be speculated that the transverse sinus size may be associated with pathogenesis of diseases with increased intraocular pressure such as glaucoma. We aim to determine the relation between the size and drainage of transverse sinuses in TOF MR venography and intraocular pressure in patients with open-angle glaucoma in our next study.

The objective of the present study was to determine the presence and level of occlusion in the cerebral arteries using three-dimensional time-of-flight (TOF) MR angiography. Routine axial T1-weighted, axial or coronal T2-weighted MR imaging, proton MR spectroscopy, diffusion-weighted MR imaging and TOF MR angiography of the brain were performed in nine patients with DDMS (five congenital and four acquired). Of congenital cases, three with an occlusion at the root of the MCA (cases 3,4,5) and one with an occlusion on M1, M2 and M3 (case 7) had severe clinical findings, and one with an occlusion on M2 and M3 (case 8) had moderate clinical findings. Cerebral encephalomalacia was found in four congenital DDMS cases (cases 3,4,7,8). Of four acquired DDMS cases; one with an occlusion on M1, M2 and M3 (case 1), and one with an occlusion on M2 and M3 (case 6) had moderate clinical findings, and one with an occlusion on M2 (case 2) and one with an occlusion on M3 (case 9) had mild clinical findings. Contrary to the congenital DDMS cases (4/5), only one of acquired cases (1/4) had encephalomalacia. Our results suggest that unilateral cerebral arterial occlusion is the main factor which results in DDMS, and the level of occlusion has a significant effect on the severity of clinical findings. TOF MR angiography, which is a non-invasive technique, provides prognostic information by showing the occluded arteries and the level of occlusion.

Replacement lipomatosis of the kidney is the result of severe atrophy or destruction of the renal parenchyma, often caused by calculous disease with secondary marked proliferation of renal sinus, renal hilus, and perirenal fatty tissue. Different diagnostic tools have been used to define this entity, with ultrasonography (US), i.v. pyelography (IVP) and computed tomography (CT) used most commonly. We report MR urography and MR appearance of replacement lipomatosis in a 38-year-old man. We think that it combines the advantages of IVP, US and CT.

Trigeminal neuralgia (TN) is a neuropathic pain described as intense and electric shock-like pain episodes in the trigeminal nerve territory. Most of the time, trigeminal neuralgia is called as idiopathic TN since the cause is not known. Sometimes, space occupying lesions such as meningiomas, trigeminal neuromas and aneurysms may trigger TN. Cerebellopontine angle’s tumors are 6-10% of all intracranial tumors (1). Epidermoid cyst is the most common cause of TN and meningiomas and neurinomas can also cause TN (2). These tumors can cause trigeminal neuralgia in 3 ways; aThe tumor presses on the nerve directly, bThe tumor compresses the nerve root by pushing arterial vessels, cCompression of tumor to pons can cause irritation of the trigeminal nerve nuclei (2). The tumors which are causing TN have different Magnetic resonance imaging (MRI) characteristics. For instance, epidermoids usually do not compression to adjacent structures, no enhancement and bright on DWI. Schwannomas expand the nerve and extend into the internal auditory canal. Meningiomas have dural tail, generally strong and homogeneous contrast enhancement (3).

The aim of this study was to assess the spectrum of radiographic findings in primary hyperparathyroidism (PHPT). The study group consisted of 16 women and 7 men whose Ca levels were at least two or three times higher than normal. The average age was 55.3 in women and 49.4 in men. We detected carcinoma in 1, hyperplasia in 1, multiple adenomas in 4, single adenoma in 17 patients. The most common finding in the skeletal system was the decreased bone mineral density (BMD) and the complete loss of the lamina durae dentium. BMD was found lower in women than in men. This result attributed the increased number of postmenopausal patients in our study group. The second most common finding in our study group was subperiosteal bone resorption. Brown tumors (BTs) were located at maxilla in one, widespread in one, mandibula in two, long tubular bones in four patients. Renal stone disease was found in five, spastic colon in two, gastric ulcer in one, mitral valve calcification in one patients. We demonstrated no pathologic changes consistent with PHPT in remaining seven patients.

WOS: 000345298000021 PubMed: 24671337 …

Holoprosencephaly (HPE) and polycystic kidney disease (PKD) are genetically heterogeneous anomalies which can make up part of various syndromes or chromosomal anomalies. Due to the rapid lethality prognosis, early and precise prenatal diagnosis would be of great value. This case report describes extensive PKD involvement, already present in utero, in a patient with HPE and subdural effusion visible by MR imaging. The detailed anatomic information obtained by the MR imaging can guide the surgical planning and can aid antenatal counseling.

Spinal cavernous malformations are collections of abnormal blood vessels in the spinal cord. They are rare and frequently accompany cranial cavernous angiomas. They exhibit clinical features representing the region of the spine affected by the cavernous malformation. We present a 12-year-old boy with bilateral hypothermia predominantly in the left arm and motor weakness of the upper extremities, and lesser involvement of the lower extremities The case had normal cranial magnetic resonance imaging, but MRI of cervical region revealed an intramedullary cavernous haemangioma confirmed with histopathological examination. The lesion was totally excised and hypothermia completely improved within 2 weeks after operation. We suggested that hypothermia in the extremities may be added as a rare finding to the list of the clinical features in cervical myelopathy.

Mesenteric cysts (MCs) are defined as cystic masses located in the mesentery. These are commonly located at the ileal mesentery, but they also can be found anywhere at the mesentery from the duodenum to the rectum [1]. The incidence of mesenteric cysts has been estimated to be 1:100,000 in the adult population, with a male:female ratio of 1:1 [2]. The etiopathogenesis of the disease remains unknown, and many pathologic processes have been reported, including benign proliferation of ectopic lymphatics, obstructions of the lymphatics, abdominal traumas and local degeneration of some lymph nodes [2, 3]. Most MCs remain asymptomatic [4]. A total of 40% are diagnosed incidentally during surgery. Abdominal pain, nausea and vomiting are the most frequent symptoms [1]. We present a case with an unknown abdominal mass, diagnosed as giant ileal MC and treated surgically.

Objective – The objective of the present study was to investigate the possible correlation between the common carotid artery (CCA) intima-media thickness (IMT) and the infarct side. Method – The CCA IMTs in patients with atherosclerotic non-lacunar stroke were measured. Results – The mean age of the patients was 64.3 ± 10.7 years (range 40–83 years) and 42 of 100 patients were male. The infarcts were at the left side in 53 patients and at the right side in 47 patients. The mean CCA IMT was 1.02 ± 0.18 mm at the infarct side and 0.87 ± 0.17 mm at the contralateral side. The difference between them was statistically significant (P

Spinal hydatid cyst is an uncommon but serious condition. Intradural presentation is extremely rare. The case reported herein describes an unusual recurrent hydatidosis with progression of recurrence and spreading into intradural extramedullary field.

Acute disseminated encephalomyelitis is an immune-mediated demyelinating disorder usually encountered in children or adolescents and characterized by multifocal neurologic deficits of rapid onset. It is often preceded by various infectious diseases or vaccination, but acute disseminated encephalomyelitis developing after hepatitis A virus infection is rare. We present such a case in a 9-year-old patient who illustrates the importance of considering acute disseminated encephalomyelitis in patients who develop multifocal neurologic signs after hepatitis A virus infection. We suggest that patients with acute disseminated encephalomyelitis be screened for hepatitis A virus because of the occurrence of asymptomatic hepatitis A virus infection.

Congenital hypertrophic pyloric stenosis (CHPS) is the most common cause of gastric outlet obstruction during the first 3 months of life. Different diagnostic tools have been used to define this entity, with ultrasonography (US) and a barium meal (UGI) used most commonly. We report MR appearance of CHPS on half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequence in a 2-month-old infant. We think that it combines the advantages of US and barium meal.

Hepatic portal venous gas is an uncommon radiographic finding. The mechanism for the appearance of gas in the portal vein is unknown. The most important predisposing factor is the dam - age to the intestinal mucosa combined with bowel distension or bacterial gas production. Our case presented with abdominal pain, fever, diarrhea and abdominal distension. We diagnosed portal vein thrombosis in computed tomography and saw gas image in the portal vein. It is important to know the underlying pathology for decision making on portal vein gas occurrence. If there is no intestinal ischemic injury requiring surgery, conservative follow up may be the therapeutic option. a Irfan KORUK, MD, Assis.Prof., b

WOS: 000293108900041 99mTechnetium human polyclonal immune globulin (99mTc-HIG) is a useful radiopharmaceutical in diagnosing infection. A 61-year-old woman with painful left knee prosthesis was investigated for septic loosening. In addition to prosthetic infection which presented as diffusely increased uptake surrounding left knee, a focally increased uptake below the medial side of right knee was noticed on 99mTc-HIG images. Although background and vascular activity were diminished at 24 hours after injection, the area of activity below the right knee was more apparent. We assumed this finding was due to soft tissue infection, however, a superficial varicose vein was shown by Doppler ultrasound. We conclude that varicose veins may be misinterpreted as a site of infection and thus may cause false positive results on 99mTc-HIG scintigraphy.

WOS: 000345814000009 PubMed: 25455945 …

WOS: 000280519300018, PubMed: 20639669, Objective: To present a case of a rare variation of the renal artery and multiple (7) renal arteries by multidetector computed tomography (MDCT) angiography. Clinical Presentation and Intervention: A 36-year-old male patient was admitted to our hospital as a potential living donor for renal transplantation. An MDCT angiography was performed using a 16-detector row CT scanner to obtain a detailed image of vascular structures and associated pathologies. The MDCT clearly revealed the presence of 3 right and 2 left renal arteries arising from the abdominal aorta. Additionally, the accessory renal artery arose from the inferior mesenteric artery on the left side and from the common iliac artery on the right side. Conclusion: This case highlights the importance of awareness of renal artery variations if surgical procedures are indicated in this region. Copyright (C) 2010 S. Karger AG, Basel

This study was designed to review the outcomes of emergent treatment of sigmoid colon volvulus. The records of 827 patients were reviewed retrospectively. The mean age was 57.9 years (range, 10 weeks to 98 years), and 688 patients (83.2 percent) were male. Nonoperative reduction was applied in 575 patients (barium enema in 13, rigid sigmoidoscopy in 351, and flexible sigmoidoscopy in 211, with rectal tube placement in all patients). The results were as follows: success of 78.1 percent, mortality of 0.9 percent, complication of 3 percent, and early recurrence of 3.3 percent. Surgical treatment was performed on 393 patients (detorsion in 46, mesosigmoidopexy in 56, exteriorization in 4, resection with Hartmann’s procedure in 146, resection with Mikulicz procedure in 14, resection with primary anastomosis in 51, tube cecostomy and colonic cleansing with resection in 75, and laparotomy in 1). The results were as follows: mortality of 15.8 percent, complication of 37.2 percent, early recurrence of 0.8 percent, and late recurrence of 6.7 percent. Nonoperative reduction is the initial treatment of sigmoid colon volvulus, and flexible sigmoidoscopy with rectal tube placement can be used successfully. Patients in whom bowel gangrene or peritonitis is present or nonoperative treatment is unsuccessful need emergency surgery. In surgical treatment, resection and primary anastomosis is the first choice, and it can be performed with acceptable mortality and morbidity rates if the patient is stable and a tension-free anastomosis is possible. Nondefinitive procedures have high recurrence rates; thus, definitive surgical techniques must be preferred.

WOS: 000364173900003 PubMed: 26096480 …

The incidence of intestinal tuberculosis (ITB) has been increasing in the West, due to the AIDS epidemic, transglobal immigration, IV drug abuse, an aging population, and an increase in the number of immunocompromised patients. Obstruction and perforation of the intestine are the most common and serious complications of ITB. Another complication, tuberculous liver abscess (TLA), is rare and usually associated with foci of infection in the lung or gastrointestinal tract. We report a case of a 17-year-old boy with Down syndrome who presented with multiple TLAs secondary to obstructive and multiple perforated ileal tuberculosis.

Fournier's gangrene is a fatal synergistic infectious disease with necrotizing fasciitis of the perineum and abdominal wall along with the scrotum and penis in men and the vulva in women.The clinical and operative records of 45 patients with Fournier's gangrene during a 14-year period were analyzed.The etiology of the infection was identified in 39 patients. The most common causes were colorectal diseases and urogenital diseases. Four patients died with an overall mortality of 8.8%. The mortality rate was higher in patients with diabetes mellitus, but it was not statistically different. The age, duration of the symptoms, and the presence of rectal abscess were not found to be significant factors regarding mortality rate.Surgery with extensive debridement of all necrotic tissue is the main stay of treatment.

Objective: To evaluate whether images obtained during the reconstruction window responding to the isovolumic relaxation period could be used for rapid and easy postprocessing. Methods: One hundred ten consecutive patients with suspected coronary artery disease who had previously had a multidetector computed tomography (MDCT) scan for imaging coronary arteries were enrolled in this study. The age of the patients was 59 ± 13 years (range: 33-78 years), and 77 (70%) were male. Multi-detector computed tomography was performed on a 16-detector-row computed tomography scanner during 1 breath hold (16-24 seconds). Seven different sets of images reconstructed at every 10% of the R-R interval from 30% to 90% for contrast-enhanced scans at levels containing the first several centimeters of the left and right coronary arteries were analyzed. The best of these reconstruction windows were then compared with the images reconstructed at the isovolumic relaxation period, which is the last portion of the T wave at the end of the systole, where there is not any change in ventricular volume, which causes stepladder artifacts. The step artifact was classified as excellent, good, or poor. Image quality was assessed by 2 radiologists who were not aware of each other's interpretation. Results: According to the routinely used reconstructions, there were 76 patients with excellent image quality, 28 with good image quality, and 6 with poor image quality. For the period of isovolumic relaxation, there were 74 patients with excellent image quality, 25 with good image quality, and 11 with poor image quality. Conclusion: If one begins image analysis with the isovolumic relaxation period reconstruction window, spending less time for postprocessing analyses, good image quality can be obtained such as with other good reconstruction windows.

Purpose: To investigate the angulation, length, and structural variations of the styloid process (SP) by multidetector computed tomography (MDCT). Material and Methods: MDCT scans were performed in 283 cases (127 M and 156 F, age range 18–77 years). The length of the SP and its angulation on the transverse and sagittal planes were measured. Structural variations of the SP were observed by means of three-dimensional (3D) and multiplanar reconstruction (MPR) images. Results: The length of the bony SP on both sides varied from 0 to 62 mm (mean 26.8±10.0 mm). Angulation ranged between 55° and 90.5° (7 2.7±6.6) in the transversal plane and between 76° and 110° (93.5±6.9) in the sagittal plane. Morphologically, the SP showed a considerable amount of variation. A solitary SP was present in 168 individuals (59.4%). In 9 individuals (3.1%), the SP was duplicated (4 unilateral and 5 bilateral). Sixty-one persons (21.6%) showed an incomplete ossified SP (42 unilateral and 19 bilateral), whereas in 7 individuals (2.5%) a bony SP was absent entirely (7 unilateral). In 38 individuals (13.4%), the stylohyoid ligament was ossified (16 entirely, 22 partial). In all individuals, 3D and MPR images showed the SP in its entire length. Conclusion: MDCT with 3D CT and MPR of SP may show further detailed information related to SP. Not only the length of the SP, but also its 3D orientation, should be in focus in anatomical and clinical studies.

In this study we aimed to investigate the value of contrast enhanced dynamic MR imaging (DMI) in the diagnosis of nodular abdominal endometriosis.Fourteen patients with surgically and pathologically proven endometriosis were examined with DMI. The patients were 22-54 years old (mean age 30.8 years). The dynamic MR studies of these patients were retrospectively reviewed by two radiologists who were aware of the clinical data. Nodular masses showing enhancement were evaluated for size, margins, and signal intensity on T1- and T2-weighted MR sequences. The protocol was tailored to selectively determine the diagnostic utility of signal intensity time course analysis for the behavior of nodular endometriosis and endometrial tissue, in DMI. Contrast-enhanced DMI was performed and the time-intensity curves of the lesions and the uterine endometrial tissue of each patient were compared. Mean enhancement values were calculated. Each DMI was evaluated for signal intensity value.In 8 (57%) of 14 patients, we found endometriosis in the abdominal wall. All patients with abdominal wall endometriosis had pelvic surgical operation history. Diameter of nodular endometriosis determined in the abdominus muscle ranged between 3 and 40 mm. Of eight cases, five had only one lesion and three had multiple lesions. Remaining 6 (43%) cases had deep pelvic endometriosis located in the uterosacral ligaments (n = 3), rectosigmoid (n = 2), and rectovaginal septum (n = 1). Diameter of pelvic endometriosis ranged between 9 and 53 mm. Noncontrast mean signal intensity of endometriosis and endometrial tissue were 280 +/- 73 and 216 +/- 20, respectively. The mean values of both endometriosis and normal endometrial tissue were calculated for each patient examined with five-slice DMI. All of the curves showed significant correlation. The lesion showed significant enhancement in the course of time similar to the endometrial tissue in all patients.Our study was inspired from the fact that endometriosis is the ectopic endometrial tissue and we thought that endometrial tissue and endometriomas should have similar vascularity. In this way imaging with MR, getting the time-intensity curves and experiencing the correlation between the endometriosis and endometrial tissue may support the diagnosis in the cases with suspected endometriosis. This first study shows that the ectopic nodular endometriosis can easily be identified with dynamic MRI. It may be used to differentiate nodular endometriosis from the other pathologic conditions of abdominal wall and pelvis.

Interrupted aortic arch (IAA) is a rare severe congenital heart defect defined as complete luminal and anatomic discontinuity between ascending and descending aorta. Although its association with various congenital heart defects has been reported, absence of left common carotid artery (CCA) in patients with IAA has not been reported previously. We report a case of IAA associated with the absence of left CCA which was clearly shown on multidetector-row spiral CT.

Cerebral air embolism may be caused by iatrogenic or post-traumatic introduction of air into arterial or venous systems. It is usually revealed by computerized tomography. In this paper, we report a case with thorax trauma and loss of consciousness, in whom cerebral massive air embolism was detected and its distribution was demonstrated by using 3D spiral CT reconstruction. To our knowledge, this is the first case in whom 3D spiral CT reconstruction was used for demonstration of cerebral arterial air embolism.