The Society for Pediatric Radiology Magnetic Resonance Imaging and Emergency and Trauma Imaging Committees' consensus protocol recommendation for rapid MRI for evaluating suspected appendicitis in children.

The imaging evaluation of acute abdominal pain in children with suspected appendicitis has evolved to include rapid abdominopelvic MRI (rMRI) over recent years. Through a collaborative effort between the Magnetic Resonance Imaging (MRI) and Emergency and Trauma Imaging Committees of the Society for Pediatric Radiology (SPR), we conducted a survey on the utilization of rMRI to assess practice specifics and protocols. Subsequently, we present a proposed consensus rMRI protocol derived from the survey results, literature review, and discussion and consensus between committee members.

The Importance of Neutrophil Gelatinase - Associated Lipocalin and Liver Type Fatty Acid Binding Protein in Acute Kidney Injury.

BACKGROUND: The most important factor in the diagnosis of AKI is to accurately and early detect the damage that occurs in the kidney before the filtration capacity of the kidney decreases. Therefore, we discussed the use of NGAL and L-FABP in the early diagnosis of acute kidney injury, evaluation of clinical severity and prognosis as well as prediction of hemodialysis decision in this prospective study. METHODS: We studied 82 participants which included 41 patients aged 18 years and older with the diagnosis of acute kidney injury. We compared the renal function tests collected at 0 and 6 hours with the plasma NGAL and LFABP levels measured using ELISA. Acute kidney injury was defined as serum creatinine increase of 0.3 mg/dL in the last 48 hours, or an increase more than 1.5 times, or an increase in the basal serum creatinine value in the last seven days, or less than 0.5/mL/kg of urine volume within six hours. We tested the power of these new biomarkers in the early diagnosis, and prediction of hemodialysis and survival of the patients with AKI using ROC analysis. RESULTS: Fifteen (36.6%) of the patients were anuric and 26 (63.4%) were oliguric. Twenty-one (51.2%) patients were KDIGO Stage 3. Seventeen (41.5%) patients underwent hemodialysis. In the patient group, the mean NGAL level was 289.7 ± 117.4 ng/mL and the mean L-FABP level was 232.7 ± 72.8. Eleven (26.9%) of 41 patients died within the first 24 hours. In the dead patients, the mean plasma NGAL level was statistically significantly high (p = 0.005). The mean NGAL level was found to be statistically increased in correlation with the severity of acute kidney injury in patients (p < 0.05). To predict acute kidney injury, the ROC analysis showed that the area under the curve (AUC) was 0.819 (95% confidence interval (CI): 0.729 - 0.909) (p < 0.001) for plasma NGAL level, and the area under the curve (AUC) was 0.891 (95% confidence interval (CI): 0.822 - 0.959) for plasma L-FABP level (p < 0.001). CONCLUSIONS: Our study provides evidence that NGAL and L-FABP are effective biomarkers for early detection of AKI as well as predicting clinical severity and hemodialysis.

Radiological picture of premature baby with manifestation of brachytelephalangic type chondrodysplasia punctata, myelomalacia.

Chondrodysplasia punctata (CDP) is a heterogeneous disease with multiple syndromic types and characterization of the CDP subtype is important for prognostic purposes. The aim of this study is to provide information about brachytelephalangic CDP, discuss its radiographic findings and emphasize the importance of cervical spine findings. Physicians must be aware of the potentially serious complications of CDP especially its cervical spine findings. In order to prevent morbidity and mortality, early imaging with CT and MRI is recommended.

Impact of abdominal visceral adipose tissue on disease outcome in pediatric Crohn's disease.

BACKGROUND: Increased abdominal visceral adipose tissue (VAT) is associated with systemic inflammation. The influence of VAT on pediatric inflammatory bowel disease (IBD) has not been studied. The objective of this study was to investigate the differences in VAT between pediatric patients with IBD and age-matched controls and identify associations between VAT and Crohn's disease (CD) outcomes. METHODS: Single-center retrospective cohort study of 114 pediatric patients with IBD (101 CD and 13 ulcerative colitis) who had abdominal computed tomography at diagnosis. VAT volumes were measured from computed tomography images. A control group of 78 age-matched patients without IBD who had abdominal computed tomography was selected for comparison. RESULTS: Median VAT was 634 cm (interquartile range, 411-1041) in the IBD group and 659 cm (interquartile range, 394-1015) in the controls. IBD group had 33% higher VAT than controls (95% confidence interval [CI], 11-58) P = 0.002 after adjusting for body mass index and age. In patients with CD, higher VAT was associated with fistulizing or fibrostenotic disease (odds ratio [OR], 1.7; 95% CI, 1.1-2.9; P = 0.03), CD hospitalizations (OR, 1.9; 95% CI, 1.2-3.4; P = 0.01), moderate or severe disease activity scores (OR, 1.8; 95% CI, 1.1-3.1; P = 0.02), and shorter intervals from diagnosis to surgery (hazard ratio, 1.4; 95% CI, 1.0-2.0; P = 0.05) after adjusting for body mass index and age. CONCLUSIONS: At diagnosis, pediatric patients with IBD have higher adjusted VAT volumes than age- and body mass index-matched controls. Higher VAT volumes in pediatric patients with CD predicted more hospitalizations, increased likelihood of complicated disease, shorter interval from diagnosis to surgery, and higher disease activity scores at diagnosis.

Anthropometric indices in relation to overweight and obesity among Turkish medical students.

INTRODUCTION: The aim of this study was to present the reference anthropometric data associated with obesity for cardiovascular risk and metabolic diseases for healthy young adults in a Turkish population. MATERIAL AND METHODS: The study group consisted of 1163 second-year medical students (650 women, 513 men) aged 20-25 years from Çukurova University in Adana and the measurements were made using a flexible standard measuring tape. The data were collected during the period 2007-2011. RESULTS: From 1163 medical students, the mean values of body mass index, circumferences of waist, hip, neck, mid-arm, thigh and calf were 20.89 ±1.6 kg/m(2), 73.15 ±5.1 cm, 95.35 ±4.8 cm, 30.32 ±1.37 cm, 24.12 ±1.75 cm, 47.23 ±3.26 cm and 34.36 ±2.19 cm respectively in women, while the same measurements were 21.98 ±1.67 kg/m(2), 77.73 ±5.81 cm, 95.64 ±4.81 cm, 35.61 ±1.43 cm, 25.60 ±1.84 cm, 44.10 ±3.26 cm and 34.92 ±2.08 cm respectively in men. Moreover, waist to hip ratio, waist to height ratio and neck to height ratio were respectively 0.76, 0.44 and 0.18 in women and 0.81, 0.43 and 0.19 in men. CONCLUSIONS: The precise knowledge of anthropometric data could be used as reference values for evaluating the body composition and fat distribution of Turkish young people.

Comparison of amphotericin B lipid complex (Abelcet) and liposomal amphotericin B (Ambisome) on rat kidney: a morphological evaluation / Comparasión de la anfotericina B complejo lipídico (Abelcet) y la anfotericina B liposomal (AmBisome) en el riñón de rata: una evaluación morfológica

The aim of our study was to compare the nephrotoxic effects of liposomal amphotericin B (Ambisome) and amphotericin B lipid complex (Abelcet) on rat kidneys at short (14 days) and long term (28 days) treatment applications. Thirty-six male Wistar rats were included and divided into six groups (n=6). Groups 1 and 4 are composed as control groups by administrating intraperitoneal (ip) 0, 9 molar Serum physiologic for a period of 14 and 28 days respectively. Group 2 and 3 are treated with 5 mg/kg Ambisome and 5 mg/kg Abelcet for 14 days respectively, group 5 and 6 are treated with same agents for 28 days respectively. Then, the rats were transcardially perfused, samples were taken from cortex and medulla regions of kidneys. The micrographs of group 1 and 4 were seen as normal. For short term treatment, some morphological changes were seen in proximal tubule cells in group 3 whereas in group 2 the graphs were observed as normal. However, after long term drug using in group 5 and 6 there were vacuolization, increased lysosomal structures and deep basal folding's into tubular cells lumen. These experiments establish that renal damage were seen in short and long term use of Abelcet and long term use of Ambisome.

El objetivo de nuestro estudio fue comparar los efectos nefrotóxicos de la anfotericina B liposomal (AmBisome) y anfotericina B en complejo lipídico (Abelcet) sobre riñones de ratas, en el tratamiento de aplicación a corto (14 días) y largo plazo (28 días). Fueron incluidas en el estudio 36 ratas Wistar machos, divididas en seis grupos (n = 6). Los Grupos 1 y 4 fueron grupos de control mediante la administración intraperitoneal (ip) de 0, 9 molar de suero fisiológico durante un periodo de 14 y 28 días respectivamente. Los Grupos 2 y 3 fueron tratados con 5 mg/kg de ambisome y 5 mg/kg abelcet durante 14 días respectivamente, y finalmente los grupos Grupos 5 y 6 tratados con los mismos agentes durante 28 días, respectivamente. Luego, las ratas fueron perfundidas vía transcardíaca, y se tomaron muestras de la corteza y la médula renal. Las micrografías de los grupos 1 y 4 se observaron normal. En el tratamiento a corto plazo, algunos cambios morfológicos se observaron en las células del túbulo proximal en el grupo 3, mientras que en el grupo 2 los gráficos se observaron normales. Sin embargo, después de utilizar la droga a largo plazo en los grupos 5 y 6 hubo vacuolización, aumento de las estructuras lisosomales y un profundo plegamiento basal de las células del lumen tubular. Estos experimentos establecen que el daño renal se produce en el uso a corto y largo plazo de Abelcet, y largo plazo de Ambisome.

Morphometric MRI evaluation of corpus callosum and ventricles in normal adults.

OBJECTIVES: The aim of this study was to determine the normal values of subregions of corpus callosum and ventricles in healthy adult people in our population using magnetic resonance imaging (MRI) and to establish gender differences. METHODS: The MRI of 52 healthy individuals (29 females and 23 males) aged 20-50 years was obtained. The measurements were performed from MRI on a workstation. The midsagittal images were used for measurements of the subregions of corpus callosum and axial images were for lateral and third ventricles. RESULTS: The mean values of the widths of genu, body, splenium, and height of the corpus callosum were 13·28±2·10, 7·64±1·07, 12·52±1·35, and 25·47±2·20 mm, respectively in females; whereas, the same measurements were 13·23±2·41, 6·89±2·12, 11·90±1·94, and 25·03±3·38 mm, respectively in males. Moreover, the mean value for the longitudinal dimension of the brain was 150·12±5·04 mm, while that for the corpus callosum was 71·27±3·70 mm in females. Additionally, the mean frontal horn width of the lateral ventricle and the transverse inner diameter of the skull were 34·06±3·05 and 130·76±6·71 mm in females and 34·03±2·78 and 129·96±10·61 mm in males, respectively. Due to these measurements, the values of Evans index which is reflecting the lateral ventricle enlargement were estimated to be 0·25±1·90 and 0·25±1·14 in females and males, respectively. According to our last measurement result, the mean values for the third ventricle width were 3·79±0·85 and 4·12±0·94 mm in females and males, respectively. These findings show that there are differences between the averages of some indices of corpus callosum of our population and the other populations.

The effects of maternal deprivation on the hippocampal structure in adult rats.

OBJECTIVES: To examine the ultrastructural effects of maternal deprivation during developmental periods of limbic-hypothalamo-pituitary-adrenal system on hippocampal dendritic structures in adult rats. METHODS: The experiments were carried out with male and female Wistar rats in our department. The rats were mated and, after birth, the pups were divided into four groups. The first group (control group) pups remained undisturbed with their dam until postweaning day 22. Maternal deprived groups were separated from their dams for 24 hours at postnatal day 4, 9 and 18. The subjects were provided with food and water ad libitum until 3-months-of-age. At the third month, the rats were transcardially perfused, samples were taken from CA1 and CA3 regions of the hippocampus. Tissues were prepared for electron microscopy. RESULTS: When the data were analyzed, there were no differences between male and female rats in both ultrastructure and semiquantitative analysis of axodendritic synapses. The ultrastructure of Group 1 was seen as normal while in the second Group some neurons nuclear envelope made deep invagination into the nucleus. Additionally, axodendritic synapses were found normal. In Group 3, micrographs and axodendritic synapses were showed normal structure. However, in Group 4 in some neurons invaginations were seen similar to Group 2. Axodendritic synapses were found to be normal. CONCLUSION: These experiments establish that MD in rats produces slight ultrastructural changes and decreases the number of synapses in CA1 and CA3 subregions of the hippocampus.

Determination of normal calf and ankle values among medical students.

The current study was undertaken to determine the mean values of surface measurements from right and left calves and ankles. These measurements were taken from 150 second-year medical students (75 women and 75 men, ages 18 to 23 years) from Cukurova University in Turkey using a flexible standard measuring tape. The mean values for calf circumference, length of the medial head of the gastrocnemius muscle, distance between the inferior border of the medial head of the gastrocnemius muscle and the medial malleolus of tibia, and ankle circumference were analyzed. The observations presented in the report have defined anatomic parameters that need to be taken into consideration when cosmetic surgical procedures are performed in the calf and ankle area for this population.

Morphometry of the external ear in our adult population.

This study aimed to determine the mean values of the different morphometric measurements from right and left ears. These measurements were taken from 341 healthy young adults (150 women and 191 men) ages 18 to 25 years using an electronic digital caliper. The results showed the mean values for total ear height, lobular height and width, distances from tragus to antihelix and to helix, and ear projection and width to be, respectively, 59.7 +/- 3 mm, 17.5 +/- 1.4 mm, 18.5 +/- 2.2 mm, 16.6 +/- 1.7 mm, 25.1 +/- 2 mm, 16.6 +/- 2 mm, and 31.3 +/- 2.2 mm for the left ear, and 59.5 +/- 3.1 mm, 17.9 +/- 1.5 mm, 18.9 +/- 2 mm, 16.5 +/- 1.8 mm, 25.2 +/- 1.9 mm, 17 +/- 1.9 mm, and 31.2 +/- 2.2 mm for the right ear in the young women. However, in the young men, these values were, respectively, 63.1 +/- 3.6 mm, 18.3 +/- 1.7 mm, 19.4 +/- 2 mm, 17.2 +/- 1.8 mm, 26.3 +/- 1.9 mm, 17 +/- 2.3 mm, and 33.3 +/- 2.2 mm for the left ear, and 62.9 +/- 3.5 mm, 18.4 +/- 1.7 mm, 19.8 +/- 1.9 mm, 17.2 +/- 1.8 mm, 26.6 +/- 1.9 mm, 17.6 +/- 2.1 mm, and 33.1 +/- 2.1 mm for the right ear.