Effect of Prone and Supine Positioning on Computed Tomography Urography Examination.

OBJECTIVES: The aim of this study is to evaluate the effects of performing computed tomography (CT) urogram in the prone position in terms of diagnosis. METHODS: CT urograms of 208 patients imaged randomly in the prone and supine positions were included in this study. A total of 199 patients and 370 collecting systems were examined in total. Axial raw data and reconstructed coronal thin and thick MIP images with a slice thickness of 5 mm were evaluated by 2 independent radiologists blinded to the initial diagnosis. Renal collecting system, ureters, and bladder were included in radiological evaluation. Anatomically, the renal collecting system was separated into 7 regions. Filling and dilatation of collecting systems were evaluated via images at urogram phase by scoring. RESULTS: Filling in lower pole infundibulum (p = 0.006), distal ureter (p = 0.006); and highly dilated lower pole calyx (p = 0.020), pelvis (p = 0.006), and bladder (p < 0.001) were determined to be better in images in the prone position compared to the supine position. There were no statistical differences in other regions. CONCLUSION: Better contrast material filling is achieved in dilated or non-dilated lower pole collecting system, dilated renal pelvis, non-dilated distal ureter of kidney, and in the bladder only by imaging the urogram phase in the prone position compared to the supine position. Additionally, presence of dilatation is a factor that could adversely affect filling. Studies in the future may investigate the contribution of prone positioning to CT urogram with larger series comparing it with other methods and modalities.

The effects of chronic smoking on total cerebral blood volume measured by carotid and vertebral artery doppler ultrasonography.

PURPOSE: To evaluate the effects of chronic cigarette smoking on total cerebral blood flow in healthy adults by Doppler ultrasonography (US). METHODS: We evaluated 50 smoker (median age 29) and 50 nonsmoker (median age 28) healthy, 20- to 40-year-old subjects without any cardiovascular and cerebrovascular disease. Peak systolic maximal blood flow velocity (PSV), end-diastolic maximal blood flow velocity (EDV), time-averaged mean blood flow velocity (TAMV), resistance index (RI), and pulsatility index (PI) were measured in the left and right carotid and vertebral arteries, and total cerebral blood flow volume was calculated. RESULTS: There was no significant difference of smoking rate between genders. Blood pressure and PSV values were similar in both groups. EDV values of internal carotid artery (ICA) and vertebral artery (VA) were lower and RI and PI values were higher in smokers. TAMV, total ICA (-10.8%) and VA (-6%) flow volume, and tCBF (-9.2%) were lower in smokers. CONCLUSIONS: Doppler US is an effective tool to detect tCBF volume decrease in chronic cigarette smokers. Although minimal, this decrease, as demonstrated here in asymptomatic, healthy people, might be critical in patients with subclinical cerebral arterial insufficiency. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:561-565, 2017.

Vasoactive Intestinal peptide modulates c-Fos activity in the trigeminal nucleus and dura mater mast cells in sympathectomized rats.

Neurogenic inflammation in the dura mater caused by trigeminal nociceptive activation has been implicated in the pathophysiology of migraine. Vasoactive intestinal polypeptide (VIP) is a powerful neuroprotective neuropeptide that can modulate mast cell behavior. Migraine is also associated with sympathetic insufficiency. This study investigates the effects of VIP on the number of mast cells in the dura mater and on c-Fos expression in the trigeminal nucleus of sympathectomized rats. Experiments were carried out with 32 Sprague-Dawley male rats with body weights of 200-250 g. In the sympathectomized group, the left superior cervical sympathetic ganglion was removed. In the sympathectomized + VIP group, postoperative VIP 25 ng/kg/day (0.2 ml) was administered for 5 days. In the sham group, the ganglion and nerves were exposed but not dissected. Dura maters were stained with toluidine blue, and brainstems were labeled by indirect immunohistochemistry for c-Fos. Sympathectomy significantly increased the number of mast cells in both the ipsilateral and the contralateral dura mater (P < 0.001). VIP decreased the number of mast cells in both sides of the dura mater in sympathectomized rats. VIP also decreased c-Fos expression in the ipsilateral trigeminal nucleus of sympathectomized rats (P < 0.001). In the context of an experimental superior cervical ganglionectomy model of migraine, VIP is an efficient modulator of neurogenic inflammation of the dura.

Analysis of trauma patients in a rural hospital in Turkey.

BACKGROUND: There is a grey zone about the epidemiology of trauma in eastern Turkey. The present study was aimed at obtaining data on this subject. METHODS: Trauma patients who applied to the emergency department (ED) between January 2006 and December 2007 were analyzed. RESULTS: There were 6183 patients, of whom 87% were male. The mean age was 26.2 ± 13.6 years. Assault was the most common cause (63.2%). Motor vehicle injury (MVI) and fall were encountered at frequencies of 21.2% and 6.5%, respectively. The most frequently injured body regions were head-neck and extremities. The majority of patients were managed and discharged from the ED (89.8%) with no consultation (81.8%). Interestingly, the discharge rate of assault cases was 98.7%. Patients were hospitalized (4.2%) mostly for MVI (32.6%) and fall (19%); however, hospitalization rates for firearm and piercing/cutting injury (36.1% and 16.7%) were significantly high. Among the transported patients (5.3%), the rates of MVI and fall were high (41.5% and 24.3%, respectively). In groups, for burn and firearm injuries, these were 42.1% and 24.1%, respectively. Forty-eight patients (0.8%) died, mostly from MVI by number, but by self-infliction and firearm by rate (8.3% and 6%). CONCLUSION: Assault cases caused an excessive trauma patient density in the ED, as 98.7% were discharged from the ED. Further studies are needed regarding the high rate of assault cases.

4-(3,4-dihydroxybenzoyloxymethyl)phenyl-O-ß-D-glucopyranoside effect in liver regeneration.

Following an injury or resection, the mammalian liver has the capacity to regain its former volume and functioning by restoring itself. Studies have demonstrated that antioxidants play a role in hepatic regeneration. This study investigated the effect of 4-(3,4-dihydroxybenzoyloxymethyl) phenyl-O-ß-D-glucopyranoside (PG) obtained from Origanum micranthum on liver regeneration. Sixty Wistar Albino rats were used. In the sham-operated group, a midline abdominal laparotomy was performed without hepatectomy. In the partial hepatectomy (PHx) group, the median and left lateral lobes were removed. Rats in the PHx group received 20 mg/kg/day PG intraperitoneally before being sacrificed at 24, 48, and 72 hrs, and 7 days later. Liver tissues were collected for immunohistochemical analysis and electron microscopic evaluation. We found an increase in mitotic index, and the numbers of Ki-67 stained hepatocytes in all PHx early stage groups (24 hr, 48hr, 72 hr), but not in 7-day groups. The regeneration mediators eNOS, iNOS, TNF-α and NF-κB were shown to increase in PHx groups. This increase was more prominent dependening on time. In the PHx treatment (PHx+PG) groups, while eNOS was still high, iNOS, TNF-α and NF-κB had decreased. The apoptotic index was markedly high in the PHx groups; this was prevented by PG treatment. These findings were supported by the ultrastructural results. Our findings indicate that PG supports liver regeneration, hepatocyte proliferation, reduced liver damage, and inflammatory mediators following PHx.

Does diagnostic sonography alter thyroid and parathyroid hormone levels?

PURPOSE: To investigate possible alterations in the levels of thyroid and parathyroid hormones (PTHs) and thyroglobulin (TG) in healthy individuals following diagnostic sonographic examination of the thyroid gland. METHODS: Thirty healthy women with no pathologic findings underwent sonographic examination, followed 6 weeks later by a second examination involving a probe-only application (PA) with the ultrasound scanner switched off. Duration times were identical for both examinations. Blood was drawn before and after the 2 applications. Thyroid hormone, PTH, and TG levels before and after the 2 applications were compared, and the difference between the variations for each parameter in the first and second applications was assessed. Blood samples were taken before and after the sonographic examination and the PA, and the serum concentrations of sensitive thyrotropin, total and free thyroxine, total and free tri-iodothyronine, TG, and PTH were measured. The pre- and post-examination levels of the hormones for the 2 applications were then compared and the difference between the variations for each parameter in the first and second application was then assessed. RESULTS: The only significant variations observed were in the TG levels after PA and PTH levels after both sonographic examination and PA. The comparison between the 2 difference values revealed no significant difference except for PTH. CONCLUSION: This preliminary report on the possible influence of sonographic examination of the thyroid on the serum levels of thyroid and parathyroid hormones suggests that gland secretions such as PTH may be affected by external factors, including ultrasound. Clinicians should be aware of alterations in hormone levels by external factors.