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Background: To evaluate our first experience on computed tomography (CT)-guided transthoracic lung biopsy and compare our results including complication rates, etc. with the literature. Materials and Methods: Thirty-four CT-guided transthoracic biopsies in 33 consecutive patients with lung lesions using a 15 cm long 16 gauge semi-automatic (coaxial) biopsy needle were retrospectively evaluated. Age, gender, size of the lesion, location, distance to pleura, needle insertion angle, patient position, presence of emphysema and/or complications (pneumothorax and pulmonary hemorrhage), radiological findings before, during and after the biopsy,and pathological diagnosis were retrieved from patient files. The diagnostic success and failure of the method, and complication rates were noted.Results: Pneumothorax and pulmonary hemorrhage were observed in 9 and 7 patients, respectively, and 4 patients had both. Application of a chest tube was necessary in only 4 patients (4 of 9 patients wirth pneumothorax). None of the patients with pulmonary hemorrhage required additional procedures. The biopsy sample was adequate for histopathologic evaluation in 32 patients with a diagnostic accuracy rate of 96.6%. The most frequent diagnosis was squamous cell carcinoma (11/33), followed by other types of primary lung tumors in 14, breast carcinoma metastasis in 2, and B-cell lymphoma in 1 patient. Conclusions: Our rate of complication due to CT-guided transthoracic lung biopsy seems to be comparable with the literature. Pneumothorax and pulmonary hemorrhage may occur in up to one fifth/fourth but the management of these complications does not require additional procedures in the majority of patients, and the diagnostic accuracy rate is high., Amaç: Bilgisayarlı tomografi (BT) eşliğinde transtorasik akciğer biyopsisi konusundaki ilk deneyimimizi değerlendirmek ve komplikasyon oranlarımızı vb. sonuçlarımızı literatür ile karşılaştırmak.Materyal ve Metod: Akciğer lezyonu olan 33 ardışık hastada 15 cm uzunluğunda 16 gauge yarı otomatik (koaksiyel) biyopsi iğnesi kullanılarak BT eşliğinde 34 transtorasik biyopsi işlemi retrospektif olarak değerlendirildi. Yaş, cinsiyet, lezyonun boyutu, yerleşim yeri, plevraya uzaklık, iğne giriş açısı, hasta pozisyonu, amfizem ve / veya komplikasyon varlığı (pnömotoraks ve pulmoner hemoraji), biyopsi öncesi, sırası ve sonrasında radyolojik bulgular değerlendirildi ve patolojik tanılar hasta dosyalarından elde edildi. Yöntemin tanısal başarısı, başarısızlığı ve komplikasyon oranları not edildi.Bulgular: Pnömotoraks ve pulmoner kanama sırasıyla 9 ve 7 hastada gözlendi ve 4 hastada her ikisi de vardı. Sadece 4 hastada göğüs tüpü uygulaması gerekti (9 hastanın 4'ü pnömotorakslı). Akciğer kanaması olan hastaların hiçbirine ek işlem gerektirmedi. Biyopsi örneği, tanısal doğruluk oranı % 96.6 olup, 32 hastada histopatolojik değerlendirme için yeterliydi. En sık tanı skuamöz hücreli karsinomdu (11/33), bunu 14 hastada diğer primer akciğer tümörleri, 2 hastada meme karsinom metastazı ve 1 hastada B hücreli lenfoma izledi.Sonuç: BT eşliğinde transtorasik akciğer biyopsisine bağlı komplikasyon oranımız literatür ile benzer oranlardaydı. Pnömotoraks ve pulmoner kanama beşte/dörtte bir kadar hastada ortaya çıkabilir, ancak bu komplikasyonların tedavisi hastaların çoğunda ek prosedürler gerektirmez ve tanısal doğruluk oranı yüksektir.

Background/Aim: Breast cancer is the most common type of cancer among women and one of the most common causes of cancer-related death. Breast Imaging-Reporting and Data System (BI-RADS) is widely used in breast imaging and aims to provide effective communication between physicians. This study aimed to investigate the positive predictive values (PPVs) of BI-RADS categories as assessed by different imaging modalities in reference to Tru-Cut biopsy results.Methods: This retrospective cross-sectional observational study included 415 lesions obtained by Tru-Cut biopsy between March 2018 and December 2020. The lesions were examined by ultrasound (US), mammography, and magnetic resonance imaging (MRI) and categorized as BI-RADS 3, 4, or 5. In this system, every category has its own likelihood of cancer ratio.Results: The most common malign and benign lesions were invasive ductal carcinoma and fibroepithelial lesion, respectively. The PPVs of US BI-RADS category 3, 4, and 5 lesions were 2.15%, 47.44%, and 95.19%, respectively, those of mammographic BI-RADS 3, 4, and 5 lesions were 3.79%, 53.45%, and 94.2%, respectively, and those of MRI BI-RADS 3, 4, and 5 lesions were 0%, 57.89%, and 88.1%, respectively.Conclusion: Predicting the probability of cancer in breast imaging is of significance for patient management and effective communication between the radiologist and other physicians. We demonstrated the compatibility of our experience with the literature with this study, in which we demonstrated the possibility of imaging modalities to predict cancer according to BIRADS categories.

Purpose: This study aimed to evaluate the relationship between strain elastography and immunohistochemical markers, the histologic grade, and molecular subtyping in invasive breast cancer.Materials and Methods: The relationships between the elastography index values and progesterone receptor, estrogen receptor, human epidermal growth factor receptor 2, Ki-67, the histologic grade, and molecular subtype in 171 patients who had not received neoadjuvant treatment and underwent breast-conserving surgery were evaluated. Strain elastosonography were used to evaluate elastography index. Results: The mean patient age was 46.871 ± 11.949 years. There were 135, 129, and 90 estrogen receptor-positive, progesterone receptor-positive, and human epidermal growth factor receptor 2-positive patients, respectively. Forty-seven patients had the worst histological grade. Based on molecular subtyping, human epidermal growth factor receptor 2-positive, luminal A, luminal B, and triple-negative classifications were made for 25 (14.5%), 29 (17.0%), 109 (63.7%), and 8 (4.7%) cases, respectively. There was no statistically significant correlation between the elastography index values and estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, Ki-67, histologic grade, or molecular subtype among these breast resection cases.Conclusion: The elastography index value was insufficient to predict the specified histopathological parameters., Amaç: Bu çalışmanın amacı strain elastografinin invaziv meme kanserinde immünhistokimyasal, histolojik grade ve moleküler subtiplendirmeyle ilişkisini değerlendirmektirGereç ve Yöntem: Neadjuvan tedavi almamış meme koruyucu cerrahi geçirmiş 171 hastanın (yaş ortalaması 46.871 ± 11.949 yıl) elastosonografi indeksi değerleri ile progesteron reseptörü, östrojen reseptörü, insan epidermal büyüme faktörü reseptörü 2, Ki-67, histolojik grade ve moleküler subtipi arasındaki ilişki değerlendirildi. Elastografi indeksini değerlendirmek için strain elastosonografisi kullanıldı.Bulgular: Hastaların yaş ortalaması 46.871 ± 11.949 yıldı. östrojen reseptörü-pozitif, progesteron reseptörü-pozitif ve insan epidermal büyüme faktörü (HER-2)reseptörü 2 pozitif hasta sayısı sırasıyla 135, 129 ve 90 olarak bulundu. 47 hastanın histolojik derecesi en kötüydü. Moleküler alt tiplendirmeye göre 25 (%14,5), 29 (%17,0), 109 (%63,7) ve 8 (%4,7) hasta sırayla HER-2-pozitif, luminal A, luminal B ve triple negatif olarak sınıflandırıldı. Bu meme rezeksiyonu vakaları arasında elastografi indeks değerleri ile östrojen reseptörü, progesteron reseptörü, insan epidermal büyüme faktörü reseptörü 2, Ki-67, histolojik derece veya moleküler alt tip arasında istatistiksel olarak anlamlı bir korelasyon yoktu.Sonuç:. Elastografi indeksi değeri belirtilen histopatolojik parametreleri ön görmede yetersizdir.

Bu çalışmanın amacı, farklı değişkenler açısından Ortaokul öğrencilerinin STEM tutumlarını incelemektir. Araştırma genel tarama modellinde tasarlanmış olup tekil ve ilişkisel tarama teknikleri ile kullanılarak ortaya konmuştur.Çalışmada veri toplamak için “Yılmaz , Koyunkaya ve Güzey (2017) tarafından Türkçe’ye uyarlanıp geçerlilik ve güverlik çalışmları yapılan “Fen, Teknoloji, Mühendislik, Matematik (STEM) Eğitimi Tutum Ölçeği’kullanılmıştır. Araştırma, Batı Karadeniz bölgesinde bulunan bir ilde 2018-2019 eğitim öğretim yılı 313ortaokul öğrencisi çalışma grubunu oluşturmuştır. STEM tutum ölçeğinin geçerliğini sağlamak için elde edilen verilerin dışında 240 öğrenciden toplanan veri setine Doğrulayıcı Faktör Analizi (DFA) uygulanarak sağlanmıştır. Öğrencilerin STEM ilişkin tutumları; anlamlı farklılık gösterip göstermediğini belirlemek için “standart sapma, aritmetik ortalama,t-Testi, Mann Whitney U ve Kruskal Wallis H-Testi’ testlerinden yararlanılmıştır. Çalışma verilerinden elde edilen sonuçlara göre, öğrencilerin STEM’e yönelik tutumlarının genel olarak olumlu olduğu görülmüştür. Öğrencilerin öğrenim gördükleri okul türüne tutumları farklılık göstermemiştir. Öğrencilerin aylık okudukları kitap sayısına göre ; projelerde görev alıp almama durumlarına göre; Matematik, Fen bilimleri ve Türkçe dersi başarı ortalamalarına göre anlamlı düzeyde farklılık göstermiştir

This study aimed to assess the usability of magnetic resonance imaging (MRI) parameters in the treatment of stroke patients whose symptom onset time is unknown.We evaluated MRI of the patients whose stroke symptoms began within 12-hours. For quantitative analysis, fluid-attenuated-inversion-recovery (FLAIR) and diffusion-weighted-imaging (DWI) signal-intensity-ratios (SIR) of the lesions were computed. For qualitative analysis, 'mismatch' between visibility of lesion on DWI-FLAIR was evaluated. Patients were analyzed according to the first 4.5/6 hours of stroke onset time.There was a moderate (r=0.569, p0.001) correlation between symptom MRI time and FLAIR SIR and a weak correlation with DWI SIR (r=0.355, p=0.001). A FLAIR SIR threshold of ≤1.18 for predicted symptom onset 4.5 hours increased specificity (0.77 vs. 0.74) and sensitivity (0.77 vs. 0.69) as compared with visual analysis. A FLAIR SIR threshold of ≤1.19 for predicted symptom onset 6 hours increased sensitivity (0.76 vs. 0.67) and equal specificity (0.75 vs. 0.75) as compared with visual analysis.In hyperacute ischemic stroke, lesion age can be determined more accurately by the FLAIR SIR analysis than visual analysis. In patients whose stroke onset time is unknown, the FLAIR SIR can be used as a biomarker in the management of stroke patients.

Cerebral air embolism is a rare and fatal complication of computed tomography-guided transthoracic lung biopsy. Lesions with pulmonary vein involvement—especially cavitary lesions—require particular care during procedures performed with a guided needle. Only 2 ml of an air embolism reaching the cerebral arteries is fatal, and a 1-ml cardiac air embolism can be fatal. Hyperbaric oxygen therapy should be started immediately to reduce mortality and ensure recovery among patients who develop unconsciousness and extremity paralysis during or after the procedure including when diagnosed with cranial CT imaging. Hyperbaric oxygen therapy has been reported to reduce mortality by up to 7% and reduces neurological deficits after 48 hours—even in delayed cases. Thus, transthoracic lung biopsy is important for the diagnosis of peripheral lung masses. Here, we present a rare complication after this procedure. Our goal here was to contribute to early diagnosis and treatment by creating awareness.

Background: Early detection of malignant thyroid nodules is possible using ultrasonography (US)-guided fine needle aspiration biopsy (US-FNAB), which is a minimally invasive and easily applicable method. There are several guidelines based on the US findings, including the Thyroid Imaging-Reporting and Data System (TI-RADS), to identify patients requiring FNAB or patients with nodules suspicious of malignancy. Objectives: To emphasize the importance of the easily applicable Kwak TI-RADS classification system. Patients and Methods: In this cross-sectional study, the radiological and pathological findings of 641 consecutive patients, who underwent US-FNAB in our center, were retrospectively evaluated. The relationship between the cytological/histopathological results and the US findings was investigated using univariate and multivariate analyses. The results were also compared with the data in the literature. Results: In the univariate analysis, US features, including the presence of a solid component, hypoechogenicity, microlobulation or irregular margins, microcalcifications, and a taller-than-wide shape, were significantly associated with malignancy (P < 0.05). However, in the multivariate analysis, only hypoechogenicity and a taller-than-wide shape significantly contributed to the diagnosis of malignancy (P < 0.05). The malignancy rates of TI-RADS 3, 4a, and 4b lesions were lower in the present study compared to the literature. Conclusions: The US features, including the presence of a solid component, microcalcifications, hypoechogenicity, microlobulation or irregular margins, and a taller-than-wide shape, must be evaluated during US examinations. Besides, the widespread use of Kwak TI-RADS classification system, similar to the Breast Imaging-Reporting and Data System (BI-RADS), should be encouraged to provide a common tool for clinicians and prevent unnecessary surgical procedures.

Ultrasound (US) is an important imaging modality used to assess breast lesions for malignant features. In the past decade, many machine learning models have been developed for automated discrimination of breast cancer versus normal on US images, but few have classified the images based on the Breast Imaging Reporting and Data System (BI-RADS) classes. This work aimed to develop a model for classifying US breast lesions using a BI-RADS classification framework with a new multi-class US image dataset. We proposed a deep model that combined a novel pyramid triple deep feature generator (PTDFG) with transfer learning based on three pre-trained networks for creating deep features. Bilinear interpolation was applied to decompose the input image into four images of successively smaller dimensions, constituting a four-level pyramid for downstream feature generation with the pre-trained networks. Neighborhood component analysis was applied to the generated features to select each network's 1,000 most informative features, which were fed to support vector machine classifier for automated classification using a ten-fold cross-validation strategy. Our proposed model was validated using a new US image dataset containing 1,038 images divided into eight BI-RADS classes and histopathological results. We defined three classification schemes: Case 1 involved the classification of all images into eight categories; Case 2, classification of breast US images into five BI-RADS classes; and Case 3, classification of BI-RADS 4 lesions into benign versus malignant classes. Our PTDFG-based transfer learning model attained accuracy rates of 79.29%, 80.42%, and 88.67% for Case 1, Case 2, and Case 3, respectively.

This study aimed to determine the frequency of typical and atypical computed tomography (CT) findings of COVID-19 and their effect on hospitalization.We retrospectively assessed 414 patients who were diagnosed with COVID-19 by real-time reverse transcription-polymerase chain reaction and who had lung involvement in their admission chest CT. We evaluated the frequency of typical and atypical chest CT findings and analyzed the relationship between typical and atypical findings of COVID-19 in patients treated in ambulatory versus inpatient settings.Ground-glass opacities were the most common typical finding of COVID-19 chest CT scans. The frequencies of other typical findings, including consolidation, air bronchogram, pulmonary vascular enlargement (PVE), airway changes, crazy paving pattern, and reticular pattern, were similar to those reported in the literature. Atypical findings were less common and found at varying frequencies. Crazy paving pattern, air bronchogram, reticular pattern, and PVE were significantly more common in hospitalized patients (p0.001). The frequencies of other typical and atypical findings were not significantly different between ambulatory and hospitalized patients.Increased recognition of typical and atypical findings of COVID-19 and their frequencies, as well as knowledge of admission chest CT findings that are associated with hospitalization, will facilitate medical care during the pandemic.

Purpose To measure the degree of fatty liver using non-contrast enhanced chest computed tomography (CT) and investigate its relationship with the severity and prognosis of coronavirus disease 2019 (COVID-19) in adult patients. Methods This retrospective study included consecutive patients who had been diagnosed with COVID-19 using real-time reverse-transcription polymerase chain reaction (RT-PCR) and subsequently underwent non-contrast enhanced chest CT between October 10 and December 10, 2020. Hepatic attenuation values were measured from Couinaud segments 2, 4, and 8 based on the CT images and the relationships between these values and the Pneumonia Severity Score (PSS), requirement of hospitalization, and the length of hospital and intensive care unit (ICU) stay were analyzed. Results The study included 414 patients (182 were female, 43.96%), among whom 106 (25.6%) were diagnosed with hepatosteatosis (HS). In the patients with HS, the PSS scores were higher (10.8 ± 4.96 vs. 8.07 ± 5.12; p

Objective: To investigate any possible effects of mean platelet volume (MPV) on short-term stroke prognosis and functional outcome in patients with first-ever acute ischemic stroke (FEAIS). Methods: This retrospective cross-sectional study included 798 FEAIS patients admitted to the emergency department of a tertiary care hospital in Adiyaman, Turkey between January 2013 and June 2015. The data were evaluated according to whether alive or dead, MPV levels, modified Rankin scale (MRS) scores, National Institutes of Health Stroke Scale (NIHSS) scores. The patients were divided into 3 groups based on MPV level as 4.4-7.4 fL, 7.5-10.4 fL, higher than 10.4 fL. Results: A total of 250 patients with FEAIS were included in the study. In both those who survived and those who died, the area under the curve related to hospitalization days, time interval of venipuncture (TIV), and MPV measurements was not statistically significant (p>0.05). The 3 MPV groups showed no significant differences in terms of MRS score, median NIHSS score, hospitalization, and TIV. In subgroups based on MRS scores, there were no statistically significant differences according to median latency (p=0.087), median hospitalization (p=0.394), TIV (p=0.201), and MPV levels (p=0.847). Furthermore, there were no differences in MPV levels between the MRS based groups (p=0.527). Conclusion: The results showed that MPV was not a significantly associated and reliable marker for the prediction of prognosis or functional outcome of FEAIS attack.

Vitamin B12 plays an important role in the mechanisms which are responsible for myelinization in the central nervous system. It can particularly lead to hematological and neuropsychiatric symptoms when serum levels fall due to insufficient intake with diet or absorption problems. The purpose of this study was to show the cognitive effects in vitamin B12 deficiency cases that have not reached clinical symptom level using neuropsychological tests, and to show possible cerebral neuronal damage using diffusion tensor imaging (DTI) method. A total of 62 asymptomatic vitamin B12 deficiency patients and 40 healthy subjects were included in the study and both groups were subjected to Standardized Mini-Mental State Examination, Montreal Cognitive Assessment Test, Rey Auditory Verbal Learning Test, forward and backward digit span (WMS-R forward and backward), Visual Reproduction Subtest (WMS-III), Category Fluency Test, Trail Making (Trail A-B) (21) and Similarities (BENZ) tests. DTI examinations were performed on both groups. Patient group was determined to get lower scores in all neuropsychological tests compared to control group. In DTI examination, a significant decrease in FA values of bilateral hippocampus and a prominent increase in apparent diffusion coefficient (ADC) values were determined in the patient group compared to control group. In this study, it was determined that there was microstructural damage in the brain in the presence of vitamin B12 deficiency even in the asymptomatic period, and the patients revealed cognitive decline. In accordance with this result, early treatment of the easily diagnosed and treated vitamin B12 deficiency may prevent possible irreversible damage in the future.

Introduction: This study evaluated the applicability of diffusion tensor imaging (DTI) of therapeutic ultrasound (US) and wrist splints in addition to clinical and electrophysiological assessments of patients with carpal tunnel syndrome (CTS). Methods: This prospective study analyzed 41 patients (30 women, 11 men; 56 wrists) with CTS. Therapeutic US and wrist splints were performed for 3 and 4 weeks, respectively. Fractional anisotropy and the apparent diffusion coefficient (ADC) were evaluated in addition to a visual analog scale (VAS), symptom severity scale (SSS), functional status scale (FSS), and electrodiagnostic studies (EDX) before and after treatment. Results: There were significant decreases in the mean ADC, VAS, SSS, FSS, and EDX after treatment. Conclusions: This study suggests that DTI parameters provide helpful information that complements clinical and electrophysiological assessments for evaluating the efficacy of nonsurgical treatment of patients with CTS. Muscle Nerve 50: 950–955, 2014

Rationale and Objectives In this study, we investigated the diagnostic and grading value of diffusion tensor imaging (DTI) in patients with carpal tunnel syndrome (CTS). Materials and Methods Of the 120 subjects included in the present study, 72 were in the CTS group and 48 were in the healthy control group. In addition, the patients with CTS were further divided into three subgroups based on severity (mild, moderate, and severe) according to electrophysiological studies (EPS). DTI-derived parameters (fractional anisotropy [FA] and apparent diffusion coefficient [ADC]) were evaluated at four median nerve levels. The mean FA and ADC values of the CTS groups and healthy controls were compared separately. Correlations and possible relationships between DTI parameters and EPS results were analyzed. Receiver operating characteristics analysis was used to calculate the FA and ADC cutoff values for CTS diagnosis and grading. Results Statistically significant differences were observed in mean FA and ADC between the normal and mild, mild and moderate, and moderate and severe subgroups. Significant correlations were found between DTI parameters and EPS measurements based on severity. FA and ADC threshold values, as well as the sensitivity and specificity levels, for diagnosing and grading CTS were determined. Conclusions DTI parameters can provide helpful information for CTS. The correlations of FA and ADC measurements versus EPS measurements based on severity were significant. Moreover, FA and ADC threshold values were sufficient for the diagnosis and grading of CTS.

20 years old female patient, who had operated from congenital syndactyly on her left hand at five age, admitted to neurology policlinic with involuntary movement on her hands. We saw mirror movement (MM) when she writing, catching with her left hand. This movement is had low amplitude in the right hand than left. Cervical MRG revealed no abnormality. Brain MRG revealed right middle, inferior cerebellary peduncle, olive and pyramid hypoplasia. Mirror movement shows homolog muscle activity which simulating contralateral movement, during a spesific task. This movement is seen usually upper extremity especially in the hand. Corticospinal tract dysfunction is often considered in the pathogenesis. MM may present as part of cervico medullary junction abnormality, cerebral palsy, cerebrovasculary disease, Parkinson disease. We wanted to discuss the patogenesis of MM in our patient with syndactyly and MRG abnormality.

Diffusion tensor imaging (DTI) has revealed evidence of subcortical white matter abnormalities in the frontal area in juvenile myoclonic epilepsy (JME). Decreased fractional anisotropy (FA) and increased mean diffusivity (MD) in the corticothalamic pathway have been detected in adult patients with JME. It has been demonstrated that, in adult patients with JME, frontal dysfunction is related to subcortical white matter damage and decreased volume in frontal cortical gray matter and the thalamus. Many studies have focused on adult patients. Twenty-four patients and 28 controls were evaluated. The group with JME had significantly worse results for the word fluency, trail-B, and Stroop tests that assessed executive functions. A significant decrease in FA values in the dorsolateral prefrontal cortex (DLPFC), the supplementary motor area (SMA), the right thalamus, the posterior cingulate, the corpus callosum anterior, the corona radiata, and the middle frontal white matter (MFWM) and an increase in ADC values in patients with JME were detected. The correlation between FA values in DLPFC and the letter fluency test results was positive, and the correlation with the Stroop and trail-B test results was negative. We found a negative correlation between SMA, anterior thalamus, and MFWM FA values and the trail-B test results and a positive correlation between the SMA, anterior thalamus, and MFWM FA values and the letter fluency test results. We detected white matter and gray matter abnormalities in patients with new-onset JME using DTI. In addition, we determined the relationship between cognitive deficit and microstructural abnormalities by evaluating the correlation between the neuropsychological test battery results and DTI parameters. We evaluated newly diagnosed patients with JME in our study. That leads us to believe that microstructural abnormalities exist from the very beginning of the disease and that they result from the genetic basis of the disease.

Objective: the mean platelet volume (MPV) is a good indicator of platelet activity; it is reported to increase in diseases associated with inflammatory processes and in vascular diseases. This study investigated the importance of mean platelet volume in patients with chronic venous insufficiency (CVI) and whether the MPV was likely to be a predictor of the CVI. Methods: 117 patients who were diagnosed as CVI by colored Doppler Ultrasound (CDU) method and 49 healthy volunteers (forming the control group) were en­rolled to this study, which was planned retrospectively. The patients’ blood count values taken within one month before and after the CDU evaluation were recorded by the hospital information system. The complete blood count, routine biochemical tests and thyroid function tests of the patients diagnosed with CVI were compared to the control group. Results: Significant differences were not detected be­tween the patients and the control group in terms of the levels of creatinine, aspartate aminotransferase, total cholesterol, LDL cholesterol, HDL cholesterol, triglycer­ides, erythrocyte, sedimentation speed, leukocyte, hae­moglobin and thrombocyte (p>0.05). The thyroid stimulat­ing hormone and the MPV levels were significantly lower in the control group (p

Objectives: To examine the relationship between platelets (PLT) and platelets indices such as mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) as noninvasive biomarkers with testicular artery blood flow and fertility. Methods: Fifty-seven healthy and fertile men with normal semen values and 52 patients with abnormal semen values were included in the study. The participants’ PLT, MPV, PDW and PCT values were analyzed. Four different levels of the testicular artery, peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) were measured using color Doppler ultrasound. Results: There was no significant difference in terms of platelet and platelet indices (MPV, PDW and PCT) between the fertile and infertile group. There were no between group differences in the RI values of the testicular- and intra-testicular artery. When all fertile and infertile participants were considered together, there was no statistically significant correlation between the parameters of the testicular artery blood flow (PSV, EDV and RI) and platelet and platelet indices (MPV, PDW and PCT) (P > 0.05). Conclusions: There is not statistically significant correlation between any of the following parameters: platelets and platelet indices such as MPV, PDW and PCT, RI of the testicular artery, and fertility.

Local and systemic release of transforming growth factor beta 1 (TGF-beta1) is known to increase during the process of fracture healing and this cytokine stimulates bone healing. The majority of the non steroidal anti inflammatory drugs (NSAIDs) inhibit fracture healing. Granulocyte colony stimulating factor (G-CSF) is a hematopoietic growth factor that stimulates bone marrow. In this study, the effects of the NSAID naproxen sodium, G-CSF, and both of them in combination on the TGF-beta1 serum level in rats with tibia fractures were measured and fracture healing was evaluated by histopathologic and radiologic examination. The TGF-beta1 serum levels obtained on day one (24 h after fracture but before administration of naproxen or G-CSF) were found to be similar in all of the five groups (p0.05). At the end of the first week, TGF-beta1 levels were significantly lower in naproxen-treated rats than those of the other groups excluding control (p = 0.002). Similar changes in TGF-beta1 levels were found at the end of the second and fourth weeks. TGF-beta1 levels were significantly higher in G-CSF-treated rats at the end of the first, second and fourth weeks (p0.05). Fracture healing scores measured with histopathological and radiological methods were higher in G-CSF-treated rats than in naproxen-treated ones. When both naproxen and G-CSF were given, the scores resumed to normal. The results point to the negative effect of naproxen sodium on fracture healing is due to its decreasing effect on the level of TGF-beta1, which may be a new possible mechanism. Moreover, this negative effect can be inhibited by the use of G-CSF.

STUDY DESIGN Case report. OBJECTIVE To present a case of primary hydatid cyst in the lumbar subcutaneous tissue affecting posterior paravertebral muscle and mimicking disc herniation. SUMMARY OF BACKGROUND DATA Cystic hydatid disease is a rare but significant parasitic disease in endemic areas. Musculoskeletal or soft tissue hydatidosis accounts for about 0.5% to 5% of all echinococcal infections in endemic areas and is almost secondary to the hepatic or pulmonary disease. Primary lumbar subcutaneous hydatid cyst affecting paravertebral muscle and extending to neural foramina is a very rare condition even in endemic areas. METHODS A 25-year-old-female patient was admitted with swelling and pain in the right lumbar region for 3 months. The pain was reflecting in the right gluteal region and the right leg. Lumbar extension and right lateral flexion was painful and straight leg raising test was positive at right side. There was a mild hypoesthesia at L5 dermatome. According to the magnetic resonance image that the clinician obtained for initial diagnosis of lumbar disc herniation, we found multi-cystic masses located at the right paravertebral muscle at the level of L3-L5 which extended to L4-L5 neural foramina and at subcutaneous tissue at the right gluteal region. RESULTS The patient was operated for the purpose of removal of cysts. Postoperatively, diagnosis of hydatid cyst was confirmed by histopathology. CONCLUSION By this case, we emphasize that cystic hydatid disease should be taken into consideration in the differential diagnosis of low back pain and could mimic disc herniation. LEVEL OF EVIDENCE N/A.

A 65-year-old female patient presented with eye pain, swelling and blurred vision in the left eye. Routine biochemistry and microbiological analyzes were conducted. Orbital tomography (CT), magnetic resonance imaging (MRI) findings, and cerebral angiography were performed. Orbital cellulitis due to a complication of ethmoidal sinusitis was diagnosed with thrombosis of the SOV in the patient. Systemic broad-spectrum antibiotic and anticoagulant therapy was started on the patient. The patient's symptoms were recorded at the end of two weeks of the treatment.

Calciphylaxis is a poorly understood and highly morbid syndrome of vascular calcification and skin necrosis. Hypercalcemia, hyperphosphatemia, and secondary hyperparathyroidism are the factors implicated in the pathogenesis of calciphylaxis, which is generally identified in patients with hyperparathyroidism secondary to end-stage renal disease. It has also been observed in primary hyperparathyroidism, end-stage liver disease, and rheumatoid arthritis, in the absence of renal disease. There are few case reports of calciphylaxis occurring in hypercalcemia of malignancy. An unusual case is reported of calciphylaxis associated with malignant melanoma of the soft parts in the absence of renal or parathyroid disease. This is the first reported case of this soft tissue sarcoma showing calciphylactic changes.

Objectives: We investigated the imaging features of Cavernous angioma (CA) lesions and the value of Susceptibility-weighted imaging (SWI) by comparing with T2*-weighted gradient echo (GRE) sequences in patients with familial CA disease. Material and methods: We retrospectively evaluated 19 familial CA patients (8 men, 11 women; mean age, 36 years). T1-weighted, T2-weighted, T2*-weighted GRE, and SWI sequences were performed to all patients. The numbers of CA lesions seen on T2*-weighted GRE and SWI sequences were analyzed. The correlations between the numbers of lesions on both sequences with age were evaluated. CA lesions were classified according to the classification of Zabramski et al. Results: The number of CA lesions was higher on SWI than T2*-weighted GRE significantly (P

Transient osteoporosis of the hip is one of the causes of hip pain starts suddenly. It is a rare clinical condition characterized by dissapperance of hip pain after a while and osteoporosis view in the femoral head comes into the picture later on. The disease begins without any trauma. It manifests itsels with hip pain in middle aged men and third trimester pregnant women. The disease responds to treatment with resting and analgesics. In this article, a case of a third trimester pregnant woman who had admitted to the hospital with hip and leg pain and had been diagnosed as transient hip osteoporosis after some clinical and radiological examinations was presented. As a result, hip and leg pain sudden onset of the third trimester in pregnancy the differential diagnosis of transient osteoporosis of the hip should be kept in mind., Kalçanın geçici osteoporozu ani başlangıçlı kalça ağrısı nedenlerinden biridir. Kalça ağrısının bir süre sonra ortadan kalkması ve femur başında geç beliren osteoporoz görünümü ile karakterize olan ve nadir rastlanan bir klinik durumdur. Hastalık travma olmaksızın başlar. Genellikle orta yaş grubundaki erkeklerde ve üçüncü trimester gebelerde kalça ağrısıyla seyreder. İstirahat ve analjezik tedavisine yanıt verir. Bu makalede, kalça ve bacak ağrısı nedeniyle başvuran, klinik muayene ve radyolojik incelemeler sonucunda geçici kalça osteoporozu tanısı alan 3. trimesterdeki bir gebe olgu sunuldu. Sonuç olarak üçüncü trimester gebelerde ani başlangıçlı kalça ve bacak ağrısında geçici kalça osteoporozu ayırıcı tanıda akılda tutulmalıdır.

Congenital malformations of the lung, which may vary in degrees of severity, are very rare diseases. Pulmonary artery agenesis is a rare anomaly that may occur during the early involution of the proximal portions of the sixth aortic arch, during embryological development of the heart. This agenesis may be accompained by a complete or partial absence of the lung and its bronchus on the same side, which is diagnosed as pulmonary agenesis. In the great majority of the cases, the diagnosis is usually made at or soon after birth and it can be associated with multiple anomalies. However, extremely rare asymptomatic cases may go unnoticed until adulthood. We are presenting a patient with unilateral right pulmonary agenesis, who survived through adulthood without any symptoms and other congenital anomalies. The multislice computed tomography findings and differential diagnoses have been discussed.

Objective We aimed to investigate the location and size of ischemic stroke lesions that were frequently overlooked by diffusion-weighted imaging (DWI). Materials and methods We retrospectively reviewed the medical records of 162 patients who had symptoms suggesting ischemic stroke. National Institutes of Health Stroke Scale and Modified Rankin Scale scores, lesion size, magnetic resonance imaging (MRI) findings, delay between onset of symptoms and initial MRI (MRI latency), and vascular distribution of the stroke lesions were analyzed in patients with false-negative DWI findings. Results Of the 116 patients with a final diagnosis of acute ischemic stroke, 11 patients (9.48%) had false-negative DWI findings in the initial period. The mean (SD) MRI latency was 4.3 (1.2) hours. There was no statistically significant difference in point of lesion size, the National Institutes of Health Stroke Scale, and the Modified Rankin Scales scores. Conclusions False-negative DWI findings in acute stroke can be observed both in association with the posterior circulation/small lesions and the anterior circulation/large lesions.

Introduction. The limbic system primarily responsible for our emotional life and memories is known to undergo degradation with aging and diffusion tensor imaging (DTI) is capable of revealing the white matter integrity. The aim of this study is to investigate age-related changes of quantitative diffusivity parameters and fiber characteristics on limbic system in healthy volunteers.Methods. 31 healthy subjects aged 25–70 years were examined at 1,5 TMR. Quantitative fiber tracking was performed of fornix, cingulum, and the parahippocampal gyrus. The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) measurements of bilateral hippocampus, amygdala, fornix, cingulum, and parahippocampal gyrus were obtained as related components.Results. The FA values of left hippocampus, bilateral parahippocampal gyrus, and fornix showed negative correlations with aging. The ADC values of right amygdala and left cingulum interestingly showed negative relation and the left hippocampus represented positive relation with age. The cingulum showed no correlation. The significant relative changes per decade of age were found in the cingulum and parahippocampal gyrus FA measurements.Conclusion. Our approach shows that aging affects hippocampus, parahippocampus, and fornix significantly but not cingulum. These findings reveal age-related changes of limbic system in normal population that may contribute to future DTI studies.

Morphologic measurements of the lateral sacral mass (LSM) and adjacent bone structures were made on dried sacrum specimens, together with radiologic evaluations on computed tomography (CT) scans in order to assess the appropriateness of this area in iliosacral screw applications.On thirty dried human sacral bone specimens, morphologic measurements of the LSM were made by a compass sensitive to millimeters. Computed tomographic views of S1 and S2 pedicle-bodies and intervertebral foramina were obtained to make radiologic measurements by a millimeter-sensitive ruler to examine the relationship between LSM and the neural canal and intervertebral foramina.The average widths of the LSM on the posterior and anterior surfaces of the sacrum were as follows. Posterior aspect: 24.1 mm on S1, 18.4 mm on S2 levels on the right; 24.5 mm on S1 and 18.8 mm on S2 levels on the left. Anterior aspect: 28.9 mm on S1, 22.6 mm on S2 levels on the right; 29.1 mm on S1 and 23 mm on S2 levels on the left. The average (oblique) heights of LSM on the postero-lateral surface were 39 mm on S1, 28.6 mm on S2 levels on the right; 37.4 mm on S1, 27.6 mm on S2 levels on the left. The average depth of the sacral ala was 50.6 mm on the right, 50.7 mm on the left. The average posterior alar height was 26 mm on both sides. On CT scans, the average widths of pedicle+sacral ala were measured as 37.6 mm (right) and 36.3 mm (left) at the S1 pedicle-body level. The average widths of LSM were 22 mm (right) and 22.3 mm (left) at the S1 intervertebral foramina level. The average widths of pedicle+LSM were 27.8 mm (right) and 26.4 mm (left) at the S2 pedicle-body level. The average widths of LSM at the S2 intervertebral foramina level were 15.9 mm (right) and 16.3 mm (left).Our results suggest that iliosacral screw fixation may be more safely performed, especially at the S1 pedicle-body level and lateral to the sacral neural canal and intervertebral foramina. Injury to the neural tissues and surrounding structures is more unlikely if preoperative measurements of LSM are made on CT scans.

Introduction: Pathologically sialolithiasis is a disease which results in the obstruction of a salivary gland by a sialolith. sialolith is generally seen in small size and their sizes range from 1 mm to 1 cm. Large salivary gland calculi are infrequent and defined as the size of 1.5 cm or larger. Only a few cases of large sialolith of the submandibular glands have been reported in literature. Imaging methods have an important role in making a diagnosis and in planning further management, operative or otherwise. case report: A 52-year-old male patient with multiple stones in the submandibular gland admitted to our hospital with swelling at submandibular region. Plain films show large stones at the region of submandibular gland. the maximum stone size was 1.8x0.8 mm. submandibular gland size increased due to the sialoadenitis caused by stones. After surgery, the patient had a nearly normal function of the glands for three months. conclusion: the swelling which is seen in the submandibular region most commonly originates from sialolithiasis of submandibular gland, so it should be carefully evaluated by clinicians. Diagnostic imaging methods may complement each other in examining glands with sialolithiasis and may offer a promising