Is Bone Grafting Unnecessary in the Treatment of Cystic Scaphoid Pseudoarthrosis?

PURPOSE OF THE STUDY: The basic aim of the treatment of cystic nonunion is to provide stable fi xation and mechanical compression to increase union, but there is no consensus on whether to perform bone grafting in the cystic area or not. The aim of this study was to compare the clinical and radiological results of patients with cystic scaphoid non-union who received open grafting, and internal fi xation and those treated with percutaneous fi xation without grafting. MATERIAL AND METHODS A retrospective evaluation was made of patients included those determined radiologically with Slade and Dodds grade IV scaphoid cystic non-union. Two different surgical procedures were performed. Percutaneous screw fi xation was carried out on the patients in group 1. Open curettage-grafting and screw fi xation were performed on the patients in group 2. Group 1 was comprised of 16 patients treated with percutaneous screw fi xation, and group 2 was comprised of 17 patients who had open curettage-grafting and screw fi xation. RESULTS In the radiological evaluation at the fi nal follow-up examination, union was determined in 12 of the 16 (75%) patients in group 1 and 15 of the 17 (88%) patients in group 2. There was no statistically signifi cant difference between the two groups in terms of union, functional outcomes and complication rates. DISCUSSION In the current study, the union rate was higher in the patients who had open curettage-grafting and fi xation with a headless screw (88%) than in those with percutaneous screw without grafting (75%), but the difference was not determined to be statistically signifi cant. The union rate of the group that received grafting was similar to the rates reported in the literature. CONCLUSIONS We think that both of these techniques may be successfully used for cystic scaphoid nonunions but percutaneous technique should be preferred as it is minimally invasive. Nevertheless, there is a need for further prospective, randomised studies with larger series to have better comparisons. KEY WORDS: scaphoid bone, nonunion, fracture fi xation, internal, bone grafting, bone screws.

Evaluation of Multidisciplinary Treatment Relationship between Orthodontics and Periodontology Departments by Examining Inter-Departmental Consultation Notes.

AIMS: The aim of this study is to evaluate the multidisciplinary treatment relationship between the two specialties of Dentistry, Departments of Periodontology and Orthodontics, by examining consultation request notes between the two departments. MATERIALS AND METHODS: The consultation request notes of 1685 patients who were treated at Erciyes University Faculty of Dentistry were included in the study. All notes were analyzed retrospectively and divided into categories. While the consultation request notes of 446 patients from the Department of Periodontology (DP) to the Department of Orthodontics (DO) were evaluated, the consultation request notes of 1239 patients from DO to DP were evaluated. Pearson's Chi-Squared test was used in the cloud-based TURCOSA statistical software for the statistical analysis of the obtained data. RESULTS: The highest number of requests for consultation from DP to DO was due to "Evaluation of the patient for orthodontic treatment (n = 203; 45.5%)," and the highest number of requests from DO to DP was "Gingival/Periodontal Treatment and Providing Motivation of Oral Hygiene (n = 558; 45.0%)". It was observed that most patients for whom consultation was requested were women (P < 0.05). CONCLUSIONS: This study determined the most common reasons for consultation requests between DP and DO and the sex which was the most prevalent. It was concluded that requests were made for the expertise of the other department for problems that could not be solved by the first department.

Prognostic utility of CURB-65 and E-CURB-65 scoring systems in healthcare associated pneumonia patients: Short- and long-term mortality.

BACKGROUND: The aim of our study is to evaluate whether the CURB-65 or expanded-CURB-65 score can be used in healthcare-associated pneumonia (HCAP) and subgroups of HCAP patients at the same efficiency. Thirty and 90-day mortality rates of the patients and predictive values of CURB-65 and E-CURB-65 scores were compared. PATIENTS AND METHODS: This is a retrospective study of patients who presented to the Emergency Department between January 2015 and January 2016. All patient charts above 18 years of age were evaluated according to American Thoracic Society and the Infectious Diseases Society of America (ATS/IDSA) pneumonia diagnostic criteria and pneumonia diagnoses were confirmed. RESULTS: 167 pneumonia patients (27.8%) of all pneumonia cases were grouped as HCAP and 433 (54.4%) were grouped as community-acquired pneumonia (CAP). 43% (n = 72) of HCAP patients were classified as nursing home-associated pneumonia (NHAP) and 57% (n = 95) were classified as HCAP (except NHAP) group. NHAP patients were older than the other groups. HCAP (except NHAP) group had somehow more comorbid diseases when compared with the other groups. However, the NHAP group had more unstable vital signs and confusion rates. Hospital and ICU admissions, 30-90-day mortality rates were all significantly higher in NHAP group E-CURB-65 was found to have better predictive values than CURB-65 for 30-day and 90-day mortalities overall. CONCLUSION: According to our results, commonly used scoring systems, CURB 65 and E-CURB 65, are not suitable for HCAP, NHAP, and HCAP (except NHAP) patients. NHAP patients have significant worse prognosis compared with CAP and HCAP (except NHAP) in terms of admission to intensive care and 30 and 90-day mortality rates.

Metazoan Parasites of Common Sole (Solea Solea) and Scaldfish (Arnoglossus Laterna) (Pleuronectiformes) from Sinop Coast of Black Sea.

The metazoan parasites were investigated of two flatfish the common sole, Solea solea (n:140) and the scaldfish, Arnoglossus laterna (n: 22) in the Sinop coast of Black Sea from June 2015 to June 2017. A total of 15 metazoan parasite species belonging to Digenea (6), Cestoda (3), Acanthocephala (1), Nematoda (4) and Isopoda (1) taxonomic groups were identified. Solea solea was found to be infected by Condylocotyla pilodora, Proctoeces maculatus, Opecoelidae gen. sp., Metadena sp., Stephanostomum sp., Progrillotia sp., Capillaria gracilis, Cucullanus campanae, Solearhynchus rhytidotes and Nerocila orbignyi. Arnoglossus laterna was found to be infected by Lecithochirium musculus and Grillotia erinaceus. Scolex pleuronectis, Hysterothylacium aduncum and Dichelyne minutus were determined in both flatfish. Infection prevalence and mean intensity values were recorded for each parasite species. Infection values for each parasite species in relation to season and fish size were also determined and compared as comparatively. This study is the first one assessing the metazoan parasites both of S. solea and A. laterna collected from the Turkish coast of Black Sea. While Condylocotyle pilodora and Capillaria gracilis are new parasite records for S. solea, Grillotia erinecaus is new parasite record for A. laterna. Moreover, this paper is the first report on occurrence of Opecoelidae gen. sp., Metadena and Stephanostomum genera in S. solea.

Myxosporean parasites of Ceratomyxa merlangi and Myxidium gadi in whiting Merlangius merlangus: a comparative epizootiological analysis based on samples from two localities off southern and northern coasts of the Black Sea.

Totally 690 and 423 whiting Merlangius merlangus samples were collected from two localities off Southern (Sinop) and Northern coasts (Balaklava Bay) of the Black Sea, respectively, and examined for myxosporeans in the period from May 2011 to March 2014. Ceratomyxa merlangi and Myxidium gadi were the only myxosporean parasites identified in the content of gall bladder and their infection indices of prevalence (%) and intensity were calculated for length classes and sex of fish as well as for the seasons at both sampling localities. Overall infection prevalence of C. merlangi was 22.6% in Sinop and 27.9% in Balaklava samples while those values of M. gadi were 18.4% and 28.6% in Sinop and Balaklava samples, respectively. Both parasite species were also found to be co-existed in whiting samples. This is the first comprehensive epizootiological study yielded comparable data on C. merlangi and M. gadi infections in whiting in the southern and northern coasts of the Black Sea.

Zero-valent aluminum-mediated degradation of Bisphenol A in the presence of common oxidants.

The use of a commercial, nano-scale zero-valent aluminum (ZVA) powder was explored for the treatment of aqueous Bisphenol A (BPA). The study focused on the (i) activation of hydrogen peroxide (HP) and persulfate (PS) oxidants with ZVA to accelerate BPA degradation, (ii) comparison of the treatment performance in pure and real surface water (SW) samples, (iii) effects on toxicity and (iv) reuse potential of ZVA nanoparticles after ZVA/HP and ZVA/PS treatments. In pure water, ZVA coupled with HP or PS provided an effective means of BPA treatment particularly when PS was employed as the oxidant. On the other hand, in BPA-spiked SW, the ZVA/HP treatment combination outperformed ZVA/PS oxidation in terms of BPA removal, whereas ZVA/PS oxidation was superior in terms of organic carbon removal. According to the bioassays conducted in pure and real SW samples with the marine photobacteria Vibrio fischeri and the freshwater microalgae Pseudokirchneriella subcapitata, the toxicity response of BPA and its oxidation products was sensitive to the test organism and water matrix. The inhibitory effect of the reaction solution increased at the early stages of ZVA/PS treatment. The reuse potential of the ZVA/HP treatment system was higher than that of the ZVA/PS treatment system.

Levels of infection and seasonal occurrence of Gyrodactylus alviga (Monogenea: Gyrodactylidae) on the whiting Merlangius merlangus off the Turkish and Russian coasts of the Black Sea.

Gyrodactylus alviga is a generalist species reported in many Black Sea fish species, but whiting is known to be its main host. It is the only monogenean parasite that has been reported so far on the skin, fins and gills of whiting Merlangius merlangus in the Black Sea. A total of 690 fish from Turkey and 423 fish from Russia were examined to detect parasites. Infection indices of prevalence, mean intensity and mean abundance values were calculated for length classes and sex of fish, as well as for the seasons. There is a gradual increase in infection indices in relation with increasing host length classes and there are higher infection indices on female fish. Furthermore, despite lower prevalence indices in spring and winter, higher parasite intensity values were determined in these seasons. It is concluded that larger fish provided more space and food for G. alviga, and female fish were more parasitized as they were more active in searching for food, which enables the parasite to switch between hosts. In addition, winter and spring were more appropriate for reproduction of G. alviga.

Evaluation of the intraocular pressure in obese adolescents.

AIM: The aim of this study was to evaluate the intraocular pressure (IOP) levels of children with normal and high Body Mass Index (BMI) and to find out the potential correlation between glaucoma and obesity. METHODS: Thirty obese and thirty healty children were enrolled in this study. Physical examinations and anthropometric measurements of all patients and controls were performed. Obesity was defined as a BMI exceeding the 95th percentile for the patients according to age and sex. All participants were underwent a complete eye examination. The results of these measurements were considered for statistical analysis. RESULTS: Mean age was 13.5±2.1 years in obese group and 13.3±2.0 years in control group. Mean BMIs were 28.1±3.9 kg/m2 and 19.7±1.2 kg/m2 in obese and control groups, respectively. No significant difference was found in mean IOP levels of both right and left eyes between two groups (P=0.837 and P=0.755, respectively). There was no significant difference in cup/disc ratios of each eyes and mean central corneal thickness of both right and left eyes between obese patients and controls. In visual field analysis, no statistically significant difference in mean false negativeness and mean false positiveness were found between two groups. There were not also any significant correlations in both mean deviation of each eyes (P=0.78 and P=0.94, respectively) and pattern standart deviation of right and left eyes (P=0.89 and P=0.90, respectively) between obese cases and controls. CONCLUSION: In this study, there were no significant difference in IOP measurements, central corneal thicknesses, cup/disc ratios and visual field parameters between obese and normal children. No significant correlation was found between obesity and glaucoma or elevated IOP in children.

Clinical significance of p95HER2 overexpression, PTEN loss and PI3K expression in p185HER2-positive metastatic breast cancer patients treated with trastuzumab-based therapies.

BACKGROUND: Overexpression of p185HER2 is an established poor prognostic factor in breast cancer, portending an aggressive course and potential for early metastasis. On the other hand, monoclonal antibody trastuzumab is widely used in the clinic to target this overexpressed oncogene. Unfortunately, ~30-40% of all patients overexpressing HER2 respond to trastuzumab, warranting further research regarding the structure and additional modulation of the receptor. In this study, we aimed to investigate the response to trastuzumab in terms of the potential roles of several oncogenic pathways (phosphatase and tensin homologue (PTEN) and phosphatidylinositol 3-kinase (PI3K)) and a truncated receptor protein, p95HER2, retrospectively. MATERIALS AND METHODS: Paraffin-embedded primary tumour tissues of 100 HER2-positive metastatic breast cancer patients who received trastuzumab with combination cytotoxic chemotherapy were analysed with immunohistochemical method for p95HER2, p85 (PI3K) and PTEN. Relationship between variables were tested via χ(2), Fischer's exact test and Mann-Whitney U tests, wherever appropriate. Progression-free survival (PFS) and overall survival (OS) periods were calculated with Kaplan-Meier method and survival curves of subgroups were compared with log-rank test. RESULTS: Percentage of patients was found to be 33%, 57% and 42% positive for p95 expression, PTEN and PI3K, respectively. p95-expressing tumours had statistically lower response rates for trastuzumab than tumours not expressing p95 (P=0.001). On the contrary, PTEN-expressing tumours had statistically higher response rates for trastuzumab than tumours not expressing PTEN (P=0.012). PI3K expression had no significant effect on trastuzumab response. Median PFS for p95-expressing and not expressing tumours were 8 months (95% CI, 2.5-13.4 months) and 22 months (95% CI, 9.9-34 months), respectively (P=0.0001). Median PFS for PTEN-expressing and not expressing tumours were 15.3 months (95% CI, 12.6-34 months) and 12.1 months (95% CI, 7.9-16.2 months), respectively (P=0.04). Median OS for p95-expressing and not expressing tumours were 24 months (95% CI, 8.3-40.4 months) and 29.1 months (95% CI, 8.6-43.2 months), respectively (P=0.045). Median OS for PTEN-expressing and not expressing tumours were 25.1 months (95% CI, 7.5-40.1 months) and 26.8 months (95% CI, 8.1-42 months), respectively, which was not statistically significant (P=0.5). Level of PI3K expression had no effect on PFS and OS in our patient population. Presence of visceral metastases HR=2.38 ((95% CI, 1.2-4.5), P=0.009), p95 expression HR=2.1 ((95% CI, 1.1-3.7), P=0.03) and response to trastuzumab HR=2.2 ((95% CI, 1.18-4.47), P=0.014) are identified as factors independently affecting PFS. Response to trastuzumab HR=1.7 ((95% CI, 1.14-3.47), P=0.013) was identified as the single parameter influencing survival by Cox regression analysis. CONCLUSIONS: Presence of p95 predicted a poorer response to trastuzumab treatment, shorter PFS and OS in our HER2-positive metastatic breast cancer cohort. In addition, loss of PTEN predicted a poorer response to trastuzumab treatment and shorter PFS but not OS. We could not find an effect of PI3K expression on the above-mentioned parameters.

Clinical significance of p95HER2 overexpression, PTEN loss and PI3K expression in p185HER2-positive metastatic breast cancer patients treated with trastuzumab-based therapies.

Retraction to: British Journal of Cancer (2014) 110, 1968-1976; doi:10.1038/bjc.2014.72. It has been brought to our attention that, as a result of a miscommunication, the antibody used in this study in order to determine the expression of p95 HER2 in metastatic breast cancer patients is in fact directed against p95 NBS1, a component of the MRN complex, and is completely unrelated to p95 HER2. Therefore, a relationship between p95 HER2 overexpression and outcome cannot be established based on the results described and we wish to retract our paper. The authors, the editors of British Journal of Cancer, and the referees of this paper are grateful to colleagues in the field who have brought this problem to our attention and we apologise for any confusion that has, inadvertently, been caused.

Efficacy of endodontic applications of ozone and low-temperature atmospheric pressure plasma on root canals infected with Enterococcus faecalis.

UNLABELLED: This study aimed to compare the antimicrobial efficacy of low-temperature atmospheric pressure plasma (LTAPP) design and gaseous ozone delivery system with 2.5% NaOCl on Enterococcus faecalis in root canal walls and dentine tubules. The samples were divided into LTAPP (n = 12), ozone (n = 12), NaOCl (positive control, n = 12) and saline (negative control, n = 6) groups. Microbial samples were collected using paper points and dentin chips from root canals. Antimicrobial efficacy was assessed by counting the colony-forming units of Ent. faecalis before and after each irrigation protocol. Data were analysed using Kruskal-Wallis, Wilcoxon signed-rank, Friedman and Bonferroni t (Dunn's test)-tests (P = 0.05). The microbial sampling with paper points showed antibacterial efficacy of NaOCl, LTAPP, ozone and saline in descending order, respectively (P < 0.05). The microbial sampling with dentin chips demonstrated a superior efficacy of LTAPP compared with NaOCl in the middle third (P < 0.05), while both had similar effects in coronal and apical thirds (P > 0.05). NaOCl and LTAPP were better than ozone at the coronal and middle parts of the root canals (P < 0.05). These findings led us to suggest that LTAPP, which has no thermal and chemical effects, may be of great aid in endodontic treatment. SIGNIFICANCE AND IMPACT OF THE STUDY: The present study handles different perspectives on chemomechanical preparation of root canals. Ozone and low-temperature atmospheric pressure plasma (LTAPP) were investigated to determine whether they could be an alternative for NaOCl. Up to now, chemical solutions (NaOCl, chlorhexidine digluconate, etc...) have been used to disinfect the root canals. When the reported effects of LTAPP on biological and chemical decontamination were taken into consideration, a question rose whether it has antimicrobial efficacy in root canals infected with E. faecalis. According to the findings of the present study, LTAPP may constitute a promising aid in endodontics in disinfection of root canals.

Comparison of interfragmentary pinning versus the extension block technique for acute Doyle type 4c mallet finger.

The aim of this study was to compare the closed reduction interfragmentary pinning method (IPM) with the extension block technique (EBT) for bony mallet finger. Patients who underwent mallet finger operations were screened retrospectively for the following inclusion criteria: Doyle type 4c, age between 18 and 75 years, less than 4 weeks to surgery, and more than 1 year of follow-up time. Group I underwent a closed reduction IPM, and group II underwent the EBT. Lateral radiographs taken during the preoperative and final examination were used to evaluate the size and amount of displacement from the distal interphalangeal (DIP) joint and the dorsal fragment as well as the articular surface. Operation times were compiled from patient records. During the final examination, pain and DIP joint range of motion (ROM) were assessed and complications were recorded. The Crawford criteria were used for functional results. Fifteen patients in group I (8 men, 7 women) and 17 patients in group II (10 men, 7 women) were evaluated. Age, gender, time to surgery and follow-up time showed no statistically significant differences between the two groups. The differences in fragment size, preoperative and postoperative joint displacement, amount of dorsal displacement and DIP joint ROM were not statistically significant between the two groups. However, the operation time was significantly shorter time in group I than in group II (p=0.000). The average time to fracture union was significantly longer in group I (7.3 weeks) than in group II (6 weeks) (p=0.013). The EBT has faster time to union and is a safer method with lesser risk of arthritis and fragmentation. The IPM can be an alternative with shorter operation time, less pin bed infection and nail bed damage, especially in Doyle type 4c cases with large fragments.

Effect of pharynx epithelial cells surface desialylation on receptor-mediated adherence of Staphylococcus aureus.

AIMS: To characterize the interaction between cell surface carbohydrates and Staphylococcus aureus. METHODS AND RESULTS: In the present study, in vitro adherence of S. aureus to Detroit 562 cells, amount of cell surface desialylation and effect of subterminal monosaccharides on desialylated glycoproteins on adherence was studied with colony counting, HPLC, fluorescence microscopy and fluorometric techniques. According to our findings, S. aureus adherence to pharynx cells was enhanced (40%) after neuraminidase treatment, and neuraminidase also cleave great amount of Detroit 562 cells surface sialic acid (39-60%). Adherence assay with various monosaccharides-pretreated bacteria, and lectin competitive inhibition, showed that the residual subterminal galactose, fucose and N-acetyl-D-glucosamine remaining on desialylated Detroit 562 cell surface glycoproteins responsible for this binding. CONCLUSION: The results are the first to show that galactose, fucose and N-acetyl-D-glucosamine remaining on desialylated pharynx cell surface glycoproteins serve as the adhesine receptors for S. aureus. SIGNIFICANCE AND IMPACT OF THE STUDY: This study may explain the predisposition of severe S. aureus pneumonia complication in respiratory viral infections.

Postoperative beneficial effects of esmolol in treated hypertensive patients undergoing laparoscopic cholecystectomy.

BACKGROUND: In an attempt to decrease haemodynamic instability and early postoperative complications such as nausea, vomiting, and pain, esmolol was added to the routine alfentanil infusion of patients with treated hypertension undergoing laparoscopic cholecystectomy. METHODS: Forty consecutive ASA class II patients with controlled hypertension about to undergo laparoscopic cholecystectomy were randomized into two groups: an esmolol group (Group E, n=20) was given a 1 mg kg(-1) bolus of esmolol and a placebo group (Group P, n=20) was given an identical volume of Ringer's lactate. The rate of esmolol infusion was adjusted to keep the heart rate between 65 and 75 beats min(-1) and was 5-10 microg kg(-1) min(-1) throughout the procedure. After operation, patients reported their nausea using a four-point scale. RESULTS: Esmolol had an opioid-sparing effect intraoperatively (P=0.001). Postoperative requirements for antiemetics were significantly less in the esmolol group, with no antiemetics given to eight patients. In the placebo group, however, all patients required at least one dose of antiemetic (P=0.007). The frequency of PONV did not correlate to the amounts of alfentanil, propofol, postoperative antiemetics consumed, or to female gender, non-smoking status, and history of PONV or motion sickness. Postoperative analgesic consumption in Group E was significantly lower than in Group P (P=0.012). CONCLUSIONS: Esmolol had an opioid-sparing effect in the intraoperative and immediate postoperative period in hypertensive patients undergoing laparoscopy. When combined with alfentanil, it was more effective than placebo in decreasing early PONV.

Bilateral drop-foot after orthotopic liver transplant.

Patients may demonstrate various neuromuscular abnormalities after liver transplantation. We report a patient who developed bilateral drop foot after orthotopic liver transplantation. He was diagnosed with critical illness polyneuropathy. During follow-up, his complaints gradually recovered and his electrodiagnostic findings improved.

Effects of conventional vs high-dose rocuronium on the QTc interval during anesthesia induction and intubation in patients undergoing coronary artery surgery: a randomized, double-blind, parallel trial.

Myocardial ischemia, as well as the induction agents used in anesthesia, may cause corrected QT interval (QTc) prolongation. The objective of this randomized, double-blind trial was to determine the effects of high- vs conventional-dose bolus rocuronium on QTc duration and the incidence of dysrhythmias following anesthesia induction and intubation. Fifty patients about to undergo coronary artery surgery were randomly allocated to receive conventional-dose (0.6 mg/kg, group C, n=25) or high-dose (1.2 mg/kg, group H, n=25) rocuronium after induction with etomidate and fentanyl. QTc, heart rate, and mean arterial pressure were recorded before induction (T0), after induction (T1), after rocuronium (just before laryngoscopy; T2), 2 min after intubation (T3), and 5 min after intubation (T4). The occurrence of dysrhythmias was recorded. In both groups, QTc was significantly longer at T3 than at baseline [475 vs 429 ms in group C (P=0.001), and 459 vs 434 ms in group H (P=0.005)]. The incidence of dysrhythmias in group C (28%) and in group H (24%) was similar. The QTc after high-dose rocuronium was not significantly longer than after conventional-dose rocuronium in patients about to undergo coronary artery surgery who were induced with etomidate and fentanyl. In both groups, compared with baseline, QTc was most prolonged at 2 min after intubation, suggesting that QTc prolongation may be due to the nociceptive stimulus of intubation.

The role of diffusion weighted MR imaging for differentiation between Graves' disease and Hashimoto thyroiditis.

OBJECTIVE: The aim of this study was to evaluate the usefulness of diffusion-weighted magnetic resonance imaging (DWMRI) for differentation between Graves' disease and Hashimoto's thyroiditis. PATIENTS AND METHODS: Fifty patients (27 Graves diseases and 23 Hashimoto thyroiditis) and twenty healthy volunteers were examined using T1, T2 and DWMRI. The patients were diagnosed on the basis of physical findings and the results of thyroid function tests and serological tests. Circular ROIs were positioned on the bilateral thyroid lobes and isthmus. All measurements were repeated three different b values including 100, 600 and 1000 s/mm2 in all cases. ADC (Apparent diffusion coefficient) maps were calculated automatically with the MR system. RESULTS: Mean ADC values were 2.93 × 10-3, 1.97 × 10-3 and 1.62 × 10-3 mm2/s in the healthy volunteers; 3.47 × 10-3, 2.25 × 10-3 and 1.64 × 10-3 mm2/s in Graves' disease; 2.53 × 10-3, 1.76 × 10-3, 1.28 × 10-3 mm2/s in Hashimoto thyroiditis for b100, b600 and b1000, respectively. The ADC values of the Graves diseases were higher than healty volunteers and Hashimoto thyroiditis. ADC values were statistically significant for differentation between Hashimoto thyroiditis and Graves' disease all b values (p < 0.05). CONCLUSIONS: DWMRI is fast sequence and does not require contrast agent. Quantitative assessment of the lesion is possible using ADC map. So, DWMRI may be useful differentiation of the Hashimoto thyroiditis and Graves' disease.

Primary angiosarcoma of the breast: Diagnosis with computer-assisted MRI-guided radio-guided occult lesion localization (ROLL) technique.

Primary angiosarcoma of the breast is a rare type of breast cancer that represents approximately 0.04% of all primary breast tumors. We report herein a case of primary breast angiosarcoma that was only visible on magnetic resonance imaging (MRI) examination. The patient presented with a palpable right breast lump that was not visible either on ultrasonography and mammography. MRI showed a lesion of the right breast that presented washout kinetics. MRI-guided biopsy allowed histopathological examination of the tumor that was further confirmed as primary angiosarcoma. Subsequently, MRI guided ROLL (radio-guided occult lesion localization) technique was used for localizing the lesion prior to surgery.

The menopausal age, related factors and climacteric symptoms in Turkish women.

An interview based survey to reveal age at menopause and associated factors was conducted in a clinic based sample of Turkish women living mainly in an urban area. Interviews by a psychologist were obtained from 1500 women aged 41-70. The study included only women who had undergone natural menopause and had their last menstrual bleeding at least 1 year previously. The mean and median age at menopause was 47.8 +/- 4.0 and 51, respectively. Parity and BMI had a statistically significant impact on the age of menopause (P = 0.0397 and 0.0403). The most common symptoms were muscle and- or joint and- or bone pain (82.3%) and hot flushes (73.9%). Although the population was clinic based, this study is the first one of its kind in Turkish women.

A rare cerebellar malformation: rhombencephalosynapsis.

Rhombencephalosynapsis is a rare cerebellar malformation characterized by absence of the vermis and midline fusion of hemispheres. It is easily recognized by MRI. No specific syndrome has been described in association with this cerebellar anomaly. Early diagnosis is possible especially when coexisting brain anomalies are present. We report a symptomatic case of rhombencephalosynapsis with moderate hydrocephalus.