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ABSTRACT: Pseudoaneurysm of lumbar artery is a rare and late complication of penetrating trauma. We report the Doppler ultrasonography and multidetector computed tomography angiography findings and endovascular embolization treatment of a pseudoaneurysm of lumbar artery in a 14-year-old girl following a gunshot wound.
Diagnostic and interventional radiology (Ankara, Turkey) 10/2009; 16(2):162-4. · 1.10 Impact Factor
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ABSTRACT: The diagnosis of acromegaly requires a glucose-suppressed growth hormone (GH) nadir greater than 1 microg/l associated with clinical symptoms and signs. Here, we present a patient who has acromegalic clinical findings associated with a nadir GH level < 1 microg/l during an oral glucose tolerance test.
Journal of pediatric endocrinology & metabolism: JPEM 08/2007; 20(8):945-9. · 0.88 Impact Factor
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ABSTRACT: Coumadin-induced renal and retroperitoneal hemorrhages are rare. Clinical and laboratory findings are not specific for the diagnosis. Computed tomography (CT) has some advantages in the evaluation of these patients. The aim of this study is to report our experience regarding renal and retroperitoneal hemorrhage due to Coumadin, and describe clinical and CT findings, treatment, and prognosis of the patients.
We reviewed our CT archive to search patients with renal and retroperitoneal hemorrhage caused by Coumadin treatment retrospectively. A total of seven patients with Coumadin-induced renal and retroperitoneal hemorrhages were included in this study.
Four patients had abdominal pain, two patients had hematuria, and one patient had abdominal pain and hematuria. There was retroperitoneal hemorrhage in three patients on abdominal CT. One patient had hemorrhage in the renal pelvis and the jejunum, another had hemorrhage in the renal pelvis and the perirenal area, and another had hemorrhage in the perirenal area and the retroperitoneal region. In the last patient with hematuria, there was no hemorrhage. None of the patients had a lesion-causing hemorrhage. Coumadin was stopped, and vitamin K and fresh-frozen plasma were given to patient. One patient with massive retroperitoneal hemorrhage died, whereas other patients were successfully treated using conservative approaches.
Hematuria and abdominal pain are the most common complaints in Coumadin-induced renal and retroperitoneal hemorrhage. CT can be the first imaging modality in these patients due to its ability to directly evaluate all peritoneal and retroperitoneal structures. It also allows evaluation of any underlying lesion that can cause hemorrhage from the renal area and the urinary tract. Conservative treatment is the first choice, and prognosis is good when diagnosed early.
Renal Failure 02/2006; 28(2):129-32. · 0.82 Impact Factor
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ABSTRACT: Percutaneous drainage with alcohol injection for hydatid cysts has been commonly used in the last two decades. Albendazole is the drug of choice in the medical treatment of hydatidosis, and has also been used as an intraoperative scolicidal solution. The side-effects of its local application are not well known and have not been investigated. The purpose of the present study was to investigate the effects of the intracystic injections of alcohol and albendazole solutions on the hydatid cysts and hepatobiliary system of rabbits.
There were three groups of eight rabbits: a control group, an alcohol group and an albendazole group. In all groups hepatic hydatidosis was obtained. The control group received no therapeutic procedure. Cyst liquid was aspirated, and alcohol or albendazole solutions were injected in the other two study groups. alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT) levels, echinococcus indirect hemagglutination (IHA) tests, and the size and volume of the residual cysts were investigated. Liver was histopathologically evaluated.
The ALT, AST, GGT, and alkaline phosphatase (ALP) levels were significantly higher in the alcohol group, whereas echinococcus IHA level was highest in the control group than in the study groups. Albendazole had similar effects but of a lesser degree (P < 0.01). After therapy, the cyst volume was greater in the control than in the albendazole group (P < 0.01). In histopathological evaluation hepatocellular necrosis, portal inflammation and fibrosis were most severe in the alcohol group (P < 0.01). Conclusions: Alcohol and albendazole solutions are effective as scolicidal solutions. Higher scolicidal effect and lesser side-effects on hepatobiliary system are the advantages of albendazole solution.
Journal of Gastroenterology and Hepatology 10/2005; 20(9):1442-7. · 2.87 Impact Factor
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ABSTRACT: There are contradictory reports about the prevalence of cholelithiasis in chronic kidney disease (CKD). The pathogenesis of gallstones is associated with the lithogenic changes of bile composition, increased tendency to nucleation, and decreased gallbladder motility. The studies related to these factors can predict the development of cholelithiasis. The aim of this study was to evaluate the ultrasonic gallbladder function in CKD and to compare it in predialysis (PreD), hemodialysis (HD), and continuous ambulatory peritoneal dialysis (CAPD) patients.
Age, gender, and body mass index matched 49 CKD patients (14 PreD, 19 HD, 16 CAPD), and 17 control individuals were included in the study. Diabetic and cirrhotic patients were not included. Ultrasonic gallbladder volume was evaluated in pre- and postprandial period, and ejection fraction was calculated. We also measured several biochemical parameters (cholesterol, triglyceride, blood urea nitrogen (BUN), creatinine, calcium, Phosphorus, parathormone, albumin, total protein) in blood.
Preprandial gallbladder volume in PreD, HD, CAPD, and control groups were 26.7 +/-13.6, 20.8+/-10.4, 23.2+/-14.7, and 26.4+/-14.8 mL, respectively (p > 0.05). Ejection fractions were 54.1 +/- 22.9%, 54.9 +/- 23.9%, 48.6 +/- 15.9%, and 51.8 +/- 19.2% in PreD, HD, CAPD, and control groups, respectively (p > 0.05). Serum triglyceride was higher in PreD patients than control group (207 +/- 144 vs. 110 +/-48 mg/dL) (p<0.05). Serum BUN, Cre, P, and PTH levels were higher in CKD groups than the control group, whereas serum total protein and albumin levels were higher in the control group (p<0.05). Serum Ca was lower in PreD and HD patients than in the controls (p<0.05).
In conclusion, CKD and renal replacement therapy (HD and CAPD) do not affect gallbladder functions, but more studies are needed to evaluate prevalence of gallstones, gallbladder motility, and the composition of bile in CKD.
Renal Failure 01/2005; 27(6):677-81. · 0.82 Impact Factor
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ABSTRACT: Twenty-four patients with hypoxic-ischemic encephalopathy were examined with serial magnetic resonance imaging up to 4 years of age. Magnetic resonance imaging studies were performed in the neonatal period, at the fourth month and the fourth year of age, and the findings were compared with the patients' neurodevelopmental outcome at the fourth year of age. Periventricular signal alterations and deep gray matter involvement were usually evident in the initial magnetic resonance imaging studies, and encephalomalacia, periventricular leukomalacia, and atrophy were the common findings on follow-up magnetic resonance imaging studies. In the patients with hypoxic-ischemic encephalopathy, some correlation between magnetic resonance imaging findings and neurodevelopmental outcome was recognized. The patients with deep gray matter involvement on the initial magnetic resonance imaging had a poor prognosis, and the ones with normal magnetic resonance imaging findings had a favorable neurodevelopmental outcome. On the follow-up magnetic resonance imaging findings, encephalomalacia and periventricular leukomalacia were associated with poor neurodevelopmental outcome. In predicting the neurologic outcome at 4 years of age, magnetic resonance imaging findings of the neonatal period had the highest negative predictive value, whereas magnetic resonance imaging findings at 4 months of age and 4 years of age had the highest positive predictive value.
Pediatric Neurology 11/2004; 31(4):267-74. · 1.52 Impact Factor
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ABSTRACT: The aim of this study was to investigate gallbladder motility in children with Down syndrome by measuring gall-bladder volume and contraction index.
This study, performed between January 2001 and December 2002 at the Ondokuz Mayis University, School of Medicine, Department of Paediatric Neurology, Samsun, Turkey, included 21 patients with Down syndrome (study group) and 22 healthy children (control group). After an 8-hour fast, gallbladder diameters in both groups were measured in length, width, and height by ultrasonography before and 30 minutes after a test meal. The volume of gallbladder before and after a test meal was determined, and the contraction index was calculated. Blood triglyceride and cholesterol levels were measured, and 5-hydroxyindoleacetic acid (5-HIAA) levels in urine were determined.
Mean gallbladder volume before test meal in the study group and controls was 8,412.4 +/- 5,174 mm and 16,516.8 +/- 6,796.1 mm (P < 0.001), respectively. The mean contraction index of the study group was 41.2% +/- 19.4% and of controls, 75.0% +/- 12.3% (P < 0.001). The mean triglyceride level of the study group was significantly higher than controls (P < 0.05). The mean urine 5-HIAA level of the study group was lower than controls (P < 0.05).
CI was lower in patients with Down syndrome, suggesting gallbladder hypomotility. Hypomotility may be a feature associated with the high prevalence of gallstones in Down syndrome.
Journal of Pediatric Gastroenterology and Nutrition 09/2004; 39(2):187-91. · 2.30 Impact Factor
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ABSTRACT: The aim of this study is to investigate the diagnostic value of unenhanced helical computed tomography in choledocholithiasis.
Unenhanced helical computed tomography was performed in 37 patients with findings of obstructive jaundice and suspicion of choledocholithiasis. Results were classified as choledocholithiasis and others. In 35 patients the results were confirmed by endoscopic retrograde cholangiopancreatography, and in 2 by surgery.
Choledocholithiasis was detected by unenhanced helical computed tomography in 16 patients. In 13 patients, choledocholithiasis was proven by endoscopic retrograde cholangiopancreatography and in one patient by surgery. Unenhanced helical CT had 93.3% sensitivity and 90.9% specificity in the diagnosis of choledocholithiasis.
Unenhanced helical computed tomography may be used as a noninvasive, reliable, and rapid alternative diagnostic method in the diagnosis of choledocholithiasis.
Tanısal ve girişimsel radyoloji: Tıbbi Görüntüleme ve Girişimsel Radyoloji Derneği yayın organı 07/2003; 9(2):213-9.
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ABSTRACT: Maxillary myxoma is a rare benign mesenchymal tumor of unknown etiology. Although odontogenic myxomas are benign and nonmetastasizing tumors, they are locally invasive and have a propensity to recur if incompletely resected. We report a case of odontogenic myxoma involving the anterior part of the maxilla and discuss the role and findings of radiologic imaging.
Tanısal ve girişimsel radyoloji: Tıbbi Görüntüleme ve Girişimsel Radyoloji Derneği yayın organı 04/2003; 9(1):54-6.
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Tanısal ve girişimsel radyoloji: Tıbbi Görüntüleme ve Girişimsel Radyoloji Derneği yayın organı 04/2003; 9(1):124-5.
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ABSTRACT: We aimed to determine the effect of informing patients about side effects of the contrast material on the level of patients' anxiety.
Two hundred-ninety seven patients undergoing computed tomography examination were enrolled in the study. Patients were grouped in three categories: (1) patients informed about adverse effects of contrast material and waiting for i.v. contrast material injection, (2) uninformed patients waiting for i.v. contrast material injection, (3) uninformed patients undergoing unenhanced CT examination. All patients were requested to complete a questionnaire including a standard anxiety test. The results were compared statistically.
The mean anxiety scores calculated by variant analysis were 39.2 +/- 11.7, 42 +/- 10.4, and 38.6 +/- 9.5 in groups 1, 2, and 3, respectively. No statistically significant difference was found between the anxiety scores of the 3 groups.
Informing patients about the adverse effects of the contrast material does not affect their anxiety level.
Tanısal ve girişimsel radyoloji: Tıbbi Görüntüleme ve Girişimsel Radyoloji Derneği yayın organı 04/2003; 9(1):10-3.
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ABSTRACT: To assess the prevalence of cysts in the epididymis, seminal vesicles, prostate, and testes of patients with autosomal dominant polycystic kidney disease (ADPKD) and determine their clinical significance. Extrarenal cystic involvement is a well-known manifestation of ADPKD. Although a few reports exist about cysts in the epididymis, seminal vesicles, prostate, and testes, the true prevalence of cysts in these organs is not well known.
A prospective study, consisting of 104 male patients and 62 male controls, was designed at three medical centers to evaluate the prevalence of epididymal, seminal vesicle, prostatic, and testicular cysts in patients with ADPKD by abdominal, transrectal, and scrotal ultrasound examinations.
Among the 104 patients, epididymal cysts were present in 19 (18%), seminal vesicle cysts were present in 41 (39%), and prostatic cysts were present in 7 patients (7%); the proportion in the control group was 24% (P >0.05), 2% (P <0.01), and 5% (P >0.05), respectively. Testicular cysts were detected in only 3 control patients. Of the 104 patients, 96 were married, and primary infertility was present in 5 patients (5%).
We suggest that seminal vesicle cysts are frequent in ADPKD; epididymal cysts are not uncommon in ADPKD, but the frequency is not higher than in the control group; ADPKD should be looked for in patients with seminal vesicle cysts; and additional studies are necessary to evaluate the association between epididymal and seminal vesicle cysts and infertility in patients with ADPKD.
Urology 07/2002; 60(1):138-41. · 2.43 Impact Factor
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ABSTRACT: Proboscis lateralis is a rare craniofacial anomaly. It consists of a soft, trunk-like process that originates from the medial portion of the orbital roof and it may be accompanied by a number of facial and cerebral anomalies. The characteristics and relationship of the lesion to adjacent structures should be known, and associated anomalies should be detected before surgical correction. The patient should undergo neuroimaging studies besides clinical evaluation to obtain this information in detail. The neuroimaging findings of only one previous case are available in the literature. We report two cases of proboscis lateralis evaluated by CT and MRI before corrective surgery.
Pediatric Radiology 03/2002; 32(2):99-101. · 1.67 Impact Factor
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ABSTRACT: The oropharyngeal airways are smaller in those who snore than in those who do not. We sought to determine which soft-tissue component surrounding the airways contributes to upper airway narrowing in those who snore.
Ten control subjects and 19 snoring patients underwent CT, with 2-mm-thick axial sections obtained every 0.6 seconds during the respiration cycle at the same oropharyngeal level. We selected two sections with the widest and narrowest parts of the oropharyngeal airway to measure the anteroposterior and lateral dimensions of the airway and the thickness of the bilateral parapharyngeal fat pads, pterygoid muscles, and parapharyngeal walls. Mean values were calculated for each phase. For each subject, differences were calculated by subtracting the values in narrowest phase from those in the widest phase.
Changes in airway dimension (P < .05) and lateral parapharyngeal wall thickness (P < .01) were significantly different between snorers and control subjects. Changes in parapharyngeal wall thickness and transverse oropharyngeal airway diameter changes were significantly related (P < .01) in those who snored but not in control subjects.
Airway narrowing predominantly occurs in the lateral dimension in people who snore. Changes in the lateral pharyngeal wall are more important than the parapharyngeal fat pads in airway calibration. Narrowing of the upper airway area at the end of the expirium and the beginning of the inspirium is thought to be the cause of snoring and due to augmented muscle mass and prolonged laxity rather than inadequate activation of the pharyngeal dilating muscles.
American Journal of Neuroradiology 25(10):1846-50. · 2.93 Impact Factor
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The Breast Journal 9(2):133-7. · 1.64 Impact Factor
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ABSTRACT: Rhinoliths are rare foreign bodies of the nose formed by in situ mineralization of endogenous or exogenous foreign material. They are often asymptomatic but may have various clinical presentations, with purulent rhinorrhea and nasal obstruction being the most common. They may go unnoticed for a long period and be diagnosed accidentally during a routine examination. We report a 6.5-year-old girl with rhinolithiasis complicated with sinusitis, frontal osteomyelitis and epidural abscess; she had a history dating back four years.
The Turkish journal of pediatrics 52(2):187-90. · 0.44 Impact Factor
