Detection and classification of COVID-19 by using faster R-CNN and mask R-CNN on CT images.

The coronavirus (COVID-19) pandemic has a devastating impact on people's daily lives and healthcare systems. The rapid spread of this virus should be stopped by early detection of infected patients through efficient screening. Artificial intelligence techniques are used for accurate disease detection in computed tomography (CT) images. This article aims to develop a process that can accurately diagnose COVID-19 using deep learning techniques on CT images. Using CT images collected from Yozgat Bozok University, the presented method begins with the creation of an original dataset, which includes 4000 CT images. The faster R-CNN and mask R-CNN methods are presented for this purpose in order to train and test the dataset to categorize patients with COVID-19 and pneumonia infections. In this study, the results are compared using VGG-16 for faster R-CNN model and ResNet-50 and ResNet-101 backbones for mask R-CNN. The faster R-CNN model used in the study has an accuracy rate of 93.86%, and the ROI (region of interest) classification loss is 0.061 per ROI. At the conclusion of the final training, the mask R-CNN model generates mAP (mean average precision) values for ResNet-50 and ResNet-101, respectively, of 97.72% and 95.65%. The results for five folds are obtained by applying the cross-validation to the methods used. With training, our model performs better than the industry standard baselines and can help with automated COVID-19 severity quantification in CT images.

Measurement of the facial nerve thickness and its correlation with freezing phenomenon and hypomimia in Parkinson's disease.

OBJECTIVE: Hypomimia is one of the diagnostic features in Parkinson's disease, and freezing blocks may also occur with the degenerative process. We investigated that the thickness of the cranial facial nerve that innervates facial expressions, and the relationship between bradymimia and freezing phenomena in these patients. METHODS: We included 70 patients and healthy participants in this cross-sectional study. Clinical characteristics, modified Hoehn and Yahr (mHY) stages, Unified Parkinson's Disease Rating Scale (UPDRS) scores and Freezing of Gait Questionnaire (FOG-Q) scores of Parkinson's patients were recorded. FOG-Q was scored between 1 and 4 points. The thickness of the facial nerve and its neighborhoods of numerically equal groups were measured radiologically in the internal acoustic channel (IAC) with magnetic resonance imaging of temporal lobe. Right and left facial nerve thicknesses were compared. RESULTS: The right facial nerve thicknesses of the patient and control groups were measured as 0.97 ± 0.12 mm and 1.20 ± 0.10 mm at the proximal level and 0.71 (0.69-0.81) mm and 1.21 (1.13-1.24) mm at the distal level, respectively (P < 0.001). Notably, the facial nerve was more atrophied on the right than on the left (P < 0.001). Facial nerve to IAC ratio (%) was significantly lower and cerebrospinal fluid thickness distance (%) measurement was significantly higher (P < 0.001). Also, the FOG-Q and facial nerve to IAC ratio were negatively correlated (P = 0.049, rho = -0.335). CONCLUSIONS: Our study provides new information about the facial nerve and its neighborhoods and clinical relationships in individuals with PD. In studies investigating hypomimia and FOG in Parkinson's, neuroimaging of the facial nerve can also be used. These results need to be proven with more comprehensive studies.

Association of Prostatic Volume and Carotid Intima-media Thickness in Patients With Benign Prostatic Hyperplasia.

OBJECTIVE: To assess cardiovascular risk factors and carotid intima-media thickness in patients with benign prostatic hyperplasia. MATERIALS AND METHODS: One hundred and twenty-three patients who were evaluated for the presence of benign prostatic hyperplasia with accompanying symptoms were included in the study. Patients were also examined by cardiology department to assess and measure cardiovascular risk factors, left ventricular functions, and carotid intima-media thickness. RESULTS: Cardiovascular risk factors adjusted carotid intima-media thickness was found to be different between 3 groups, being highest in the severely symptomatic group and lowest in the mildly symptomatic group. Significant correlation of prostatic volume was shown with carotid intima-media thickness after adjusting prostatic volume for body mass index and age, and carotid intima-media thickness for cardiovascular risk factors (r = 0.75 P = .01). Linear regression analysis revealed that carotid intima-media thickness significantly associated with prostatic volume (beta coefficient: 0.628; confidence interval: 37.02-60.1; P = .001). CONCLUSION: We have demonstrated that prostatic tissue has significant association with carotid intima-media thickness in patients with benign prostatic hyperplasia.

A rare case: Retrocecal appendicitis adherent to the liver capsule.

The cases of appendicitis take an important place in the hospital emergency departments and it must be kept in mind in the differential diagnosis of patients presenting with abdominal pain. Related to cecum, the appendix can be found in many different positions; however, it is mostly observed descending intraperitoneally (31-74%) and at the retrocecal region (26-65%). In this case report, we present the case of a 26-year-old female patient admitted to the emergency room with a colic pain in the right upper quadrant for about 2 days. Computed tomography revealed contamination in the fatty plans around the cecum and adhesive retrocecal appendicitis from the liver to the retroperitoneum. Appendectomy was performed. The pathology result was gangrenous appendicitis. In the literature, there is no similar case of appendicitis with hepatic adhesions. In conclusion, we want to emphasize that physicians and surgeons in the emergency departments must be more careful during the differential diagnosis of a patient with appendicitis and atypical symptoms and a more detailed investigation is required.

The association between gallstone disease and plaque in the abdominopelvic arteries.

BACKGROUND: The aim of this study was to assess the atheromatous plaque, in the abdominopelvic arteries as a marker of cardiac risk in patients with or without gallstone disease (GD). MATERIALS AND METHODS: A total of 136 patients were enrolled in this cross-sectional study. Forty-eight patients had GD and the remaining 88 patients did not. The presence or absence of gallstones was noted during abdominal ultrasonography while vascular risk factors such as plaque formation, intima-media thickness, plaque calcification, mural thrombus, stenosis, aneurysm, and inflammation were recorded during an abdominopelvic computed tomography scan. In addition, percentage of the abdominopelvic aorta surface covered by atheromatous plaque was calculated. RESULTS: The mean age of patients with GD and without GD was 50.81 ± 16.20 and 50.40 ± 12.43, respectively. Patients with GD were more likely to have diabetes mellitus, a higher body mass index (BMI) (P < 0.001), and higher cholesterol (P < 0.01), and low-density lipoprotein-cholesterol (P < 0.02) levels. No significant differences were found between the groups regarding other atherosclerotic risk factors. Patients with GD had significantly higher rates of the vascular risk factors as intima-media thickness, plaque formation, calcification, aneurysm, mural thrombosis, stenosis, and inflammation in all abdominal arterial segments other than aneurysm in the femoral arteries. In addition, patients with GD had severe atheromatous plaques in the abdominal aorta, common iliac, external iliac, and common femoral artery (CFA). In patients with GD, parameters of age, BMI, and systolic and diastolic blood pressure were all correlated with the severity of the atheromatous plaque in abdominal aorta, common iliac, external iliac, and CFA. CONCLUSION: We demonstrated a direct relationship between GD and abdominopelvic atheromatous plaque, which is a marker for increased cardiovascular risk, for the first time in the literature. Patients with GD exhibit greater abdominopelvic atherosclerosis and therefore, have a higher risk of cardiovascular disease.

The relationship of patent foramen ovale location with severity of stroke: A new risk factor for paradoxical embolism.

OBJECTIVE: Patent foramen ovale (PFO) is a common developmental anomaly and is well associated with paradoxical embolism and cryptogenic stroke. The aim of this study was to investigate the relationship of PFO location with severity of cryptogenic stroke. MATERIALS AND METHODS: Fifty patients with cryptogenic stroke and echocardiographically proven PFO were classified according to the severity of stroke. In order to define the location of PFOs, an imaginary line dividing the length of interatrial septum vertically into two equal parts was drawn manually at axial plane on cardiac multidetector computed tomography. PFOs located at superior part of this imaginary line was defined as superiorly located PFO, while PFOs located at inferior part of this imaginary line was defined as inferiorly located PFO. RESULTS: Fourteen patients (28%) revealed mild, 20 patients (40%) revealed moderate and 16 patients (32%) had severe stroke. Based on PFO location, there were 34 patients (68%) with superiorly (group 1), and 16 patients (32%) with inferiorly (group 2) located PFO. It was found that patients of group 1 had significantly higher frequency of moderate or severe stroke compared to those of group 2 (p < 0.005) CONCLUSION: In conclusion, the patients with superiorly located PFO had higher frequency of severe stroke compared to the patients with inferiorly located PFO. Since this is a preliminary study, clinical application and importance of this finding necessitates further large-scale interventional studies.

The Relation of Androgenetic Alopecia Severity with Epicardial Fat Thickness.

BACKGROUND: Androgenetic alopecia (AGA) is the most commonly encountered baldness pattern in men. Epicardial fat tissue is found on the cardiac surface between the myocardium and visceral pericardium. Both AGA and epicardial fat thickness (EFT) are related to coronary artery disease, which is also reflected by an increase in carotid intima media thickness (CIMT). OBJECTIVE: The purpose of this study was to investigate the relation of AGA severity with EFT. METHODS: One hundred twenty-six male patients with AGA aged 18 to 55 years without histories of chronic disease were enrolled. Subjects were divided into three groups (mild, moderate, and severe) on the basis of the Hamilton baldness scale as modified by Norwood. Maximum EFT was measured at end-systole on the midventricular free wall of the right ventricle. CIMT was also recorded for all patients. RESULTS: The groups did not have statistically significant differences with respect to age, height, weight, body mass index, left ventricular ejection fraction, or left atrial diameter (p>0.05 for all comparisons), but the severe group had a higher EFT compared with the moderate (p<0.001; z score, -7.040) and mild groups (p<0.001; z score, -6.667). The moderate group also had higher EFT than the mild group (p<0.001; z score, -5.931). Mean CIMT value in the severe group was significantly higher compared with the value in the other groups. CONCLUSION: The study showed that subjects in advanced stages of AGA had increased EFT, which was measured via echocardiography.

Hepatic vein and portal vein Doppler ultrasound of maternal liver in normal pregnancy.

OBJECTIVE: The purpose of our study was to evaluate the changes occurring in maximum flow velocity and waveform patterns of the portal and hepatic veins during pregnancy in second and third trimesters. METHODS: A total of 204 patients were randomly divided into the study and control groups. The control group was classified as group I; the study group was divided into two groups: group II, second trimester pregnancy (14-26 weeks, n = 91) and group III, third trimester pregnancy (26-40 weeks, n = 63). Vein waveforms were classified as triphasic, biphasic and monophasic. RESULTS: Maximum flow velocities of both right hepatic vein and main portal veins were lower in group III compared with group I and group II (p < 0.05). On the basis of hepatic vein and portal vein waveforms, the incidence of biphasic pattern was prominent in group II (p < 0.05) whereas the monophasic pattern was prominent in group III (p < 0.05). CONCLUSION: The results demonstrate that as gestational age progresses, maximum flow velocities of both right hepatic vein and main portal veins intend to be decreased with an increased incidence of monophasic wave form pattern, and may be accepted as sensitive parameters of indicators of physiological adaptations related to pregnancy.

Exploration of orbital and orbital soft-tissue volume changes with gender and body parameters using magnetic resonance imaging.

The aim of the present study was to examine the total orbital volume (TOV) and total orbital fat volume (TOFV) in normal orbits in different age groups and to investigate the correlation of these measurements with age, gender and body parameters by magnetic resonance imaging (MRI). MRI data were acquired retrospectively from a total of 1,453 subjects divided into five age groups with 10-year intervals. The TOV and TOFV were measured using T1-weighted MRI for each subject and body parameters were also obtained. The measurements demonstrated that TOV increased with age and that the volume was larger in men than in women. While weight and height exhibited positive correlations with TOV in male and female subjects in the 20-29, 30-39 and 40-49-year-old age groups, only weight showed a positive correlation with TOV in female subjects in the 50-59 and 60-69-year-old age groups. However, TOFV increased by age in all groups and the increments were larger in women than in men. These results provide basic information about the effect of age, gender and body parameters on TOV and TOFV. The variations in TOV are associated with orbital soft-tissues changes rather than with TOFV.

Multislice Computed Tomography Angiography of an Extremely Uncommon Variation of Hepatic Arteries: Michel's Type XI.

Variations of hepatic vascular system have been more important with improvements in some clinical procedures such as hepatic transplantation or radiologic chemoembolization of hepatic tumors. Multidetector computed tomography is a useful noninvasive imaging tool for differentiating such variations.

Weight bearing the same day versus non-weight bearing for 4 weeks in Achilles tendon rupture.

INTRODUCTION: Achilles tendon rupture (ATR) often occurs in 40- to 50-year-old men. Multiple studies discuss the correct treatment strategy based on surgical or nonsurgical intervention, including early mobilization. We aimed to compare the outcomes of bearing weight on the same day with non-weight bearing over a 4-week period of ATR patients. MATERIALS AND METHOD: Forty-seven ATR patients were conservatively treated and entered into our study. Group 1 consisted of 23 patients treated with partial weight bearing beginning the same day of conservative treatment; Group 2 consisted of 24 patients treated with non-weight bearing after a 4-week period. Patients were at least 18 years old and were followed for 12 months. Evaluation criteria were mechanism of injury, admission time to our clinic, complication rate, and time to return to work. Symptoms and physical activity levels of all patients were assessed on 6 and 12 months after treatment began, according to the Achilles Tendon Total Rupture Score (ATRS), Physical Activity Scale (PAS), and American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. RESULTS: Rerupture rates were rate 17.4% (4 patients) in Group 1 and 12.5% (3 patients) in Group 2 (p = 0.81). Time to return to work was shorter in Group 1 compared with Group 2, but it was not statistically significant (p = 0.86). AOFAS, ATRS, and PAS scores at 6 and 12 months showed no significant differences between groups (p = 0.69, p = 0.59, p = 0.89, p = 0.77, p = 0.94, p = 0.66, respectively). CONCLUSION: This study showed that a well-conducted early-weight-bearing treatment has good clinical outcomes, with a complication rate no higher than non-weight-bearing treatment.

Relationship between kidney volume and body indexes in the Turkish population determined using ultrasonography

Objective To estimate the kidney volume of the healthy Turkish population using ultrasound and to evaluate the relationship between kidney volume and body indexes. Materials and methods Kidney ultrasound evaluation was performed on 152 patients (mean age: 42±13.7 years). Kidney length, width and thickness were measured using ultrasound. Mean total and parenchymal volume were also calculated. Patients’ age, sex, weight, height and body mass index (BMI) (kg/m2) were recorded. Results According to ultrasound, kidney lengths were 10.3±7.8 cm for the right and 10.4±9 cm for the left. Volumes were 158±39 cm3 for the right and 168±40 cm3 for the left. Volumes in women were 151.8±39 cm3 for the right and 159.8±37 cm3 for the left, and 164.3±38 cm3 for the right and 175.8±41 cm3 for the left in men. Kidney measurements correlated with body height and weight. A strong correlation with total kidney volume and kidney measurements was determined for body weight for both kidneys (p<0.001). A significant correlation with kidney volume and width was determined for both kidneys (p<0.001). A positive correlation was also found between parenchymal and total kidney volume for both kidneys (p<0.001). Conclusion The most significant factors associated with kidney volume for both kidneys in the Turkish population are kidney width and body weight. Measuring kidney volume with ultrasound is a feasible modality and is widely available for daily clinical practice. .

Intestinal malrotation: a rare cause of small intestinal obstruction.

Background. The diagnosis of intestinal malrotation is established by the age of 1 year in most cases, and the condition is seldom seen in adults. In this paper, a patient with small intestinal malrotation-type intraperitoneal hernia who underwent surgery at an older age because of intestinal obstruction is presented. Case. A 73-year-old patient who presented with acute intestinal obstruction underwent surgery as treatment. Distended jejunum and ileum loops surrounded by a peritoneal sac and located between the stomach and transverse colon were determined. The terminal ileum had entered into the transverse mesocolon from the right lower part, resulting in kinking and subsequent segmentary obstruction. The obstruction was relieved, and the small intestines were placed into their normal position in the abdominal cavity. Conclusion. Small intestinal malrotations are rare causes of intestinal obstructions in adults. The appropriate treatment in these patients is placement of the intestines in their normal positions.

Impaired aortic elasticity and diastolic functions are associated with findings of coronary computed tomographic angiography.

BACKGROUND: Coronary artery disease (CAD) is the leading cause of mortality and morbidity worldwide. Aortic elasticity and diastolic functions are helpful parameters in assessment of CAD. In this study we aimed to learn whether diastolic function and aortic elastic properties measured by echocardiography are associated with coronary calcium score (CACS), epicardial fat volume (EFV), and plaque area measured by coronary tomographic angiography. MATERIAL AND METHODS: We enrolled 106 consecutive patients suspected of CAD undergoing coronary CTA and transthoracic echocardiography in this prospective study. Total CACS, plaque area, and EFV were calculated via CTA. Aortic stiffness index (ASI) and aortic distensibility (AD) were measured via echocardiography. RESULTS: The patients with diastolic dysfunctions of any degree had significantly higher ASI, higher CACS, higher plaque area, and EFV. We found that as the ASI increases, the CACS and total coronary plaque area both increase, showing that there is a strong positive correlation between ASI, CACS, and total coronary plaque area. There was a significant correlation between ASI and EFV, but with a lower statistical value. CONCLUSIONS: Aortic elasticity was correlated with CACS and plaque area. Diastolic dysfunction was observed more commonly among patients with higher CACS and EFV. Epicardial fat volume was not as strong as CACS in reflecting aortic elasticity.

A rare cause of pleural effusion: ruptured primary pleural hydatid cyst.

Hydatidosis is an endemic parasitic disease in Mediterranean countries, often caused by the dog tapeworm Echinococcus granulosus. The disease predominantly affects the liver (60-70%) and lungs (30%), and the surgical management is considered as the gold standard for treatment. Besides anaphylactic reactions, the most frequent complication of the hydatid disease is rupture into neighbouring structures, often affecting the bronchi, gastrointestinal tract and peritoneal/pleural cavities, according to its location. Primary pleural hydatidosis is an extremely rare entity and we present a ruptured pleural hydatid cyst with unusual location.

Relationship between kidney volume and body indexes in the Turkish population determined using ultrasonography.

OBJECTIVE: To estimate the kidney volume of the healthy Turkish population using ultrasound and to evaluate the relationship between kidney volume and body indexes. MATERIALS AND METHODS: Kidney ultrasound evaluation was performed on 152 patients (mean age: 42 ± 13.7 years). Kidney length, width and thickness were measured using ultrasound. Mean total and parenchymal volume were also calculated. Patients' age, sex, weight, height and body mass index (BMI) (kg/m²) were recorded. RESULTS: According to ultrasound, kidney lengths were 10.3 ± 7.8 cm for the right and 10.4 ± 9 cm for the left. Volumes were 158 ± 39 cm3 for the right and 168 ± 40 cm3 for the left. Volumes in women were 151.8 ± 39 cm3 for the right and 159.8 ± 37 cm3 for the left, and 164.3 ± 38 cm3 for the right and 175.8 ± 41 cm3 for the left in men. Kidney measurements correlated with body height and weight. A strong correlation with total kidney volume and kidney measurements was determined for body weight for both kidneys (p<0.001). A significant correlation with kidney volume and width was determined for both kidneys (p<0.001). A positive correlation was also found between parenchymal and total kidney volume for both kidneys (p<0.001). CONCLUSION: The most significant factors associated with kidney volume for both kidneys in the Turkish population are kidney width and body weight. Measuring kidney volume with ultrasound is a feasible modality and is widely available for daily clinical practice.

CT assessment of bone remodeling in the otic capsule in chronic renal failure: association with hearing loss.

OBJECTIVE: Hearing loss (HL) is common in patients with chronic renal failure (CRF), but its cause is controversial. The aim of this study was to determine the effect of CRF on the bone density of the otic capsule using densitometric measurements with MDCT and to evaluate the relationship between changes in the otic capsule density and HL in patients with CRF. MATERIALS AND METHODS: The study included 34 patients with nonsyndromic CRF undergoing hemodialysis and 35 healthy control subjects. A CT was obtained, for a variety of reasons, in control subjects who did not have CRF or HL, but patients with trauma and infection were excluded. Control subjects were chosen on the basis of a normal CT and pure tone audiometry findings. Densitometric measurements were made using CT in the region anterior to the oval window and anterior to the internal auditory canal. These measurements were compared between patients and control subjects. Pure tone audiometry was performed to detect HL. The average levels of parathyroid hormone in the previous 6 months and the duration of hemodialysis in patients were documented. The association between the levels of parathyroid hormone, the duration of hemodialysis, and the region-of-interest density values in the patient groups were evaluated using the Pearson correlation coefficient. RESULTS: HL was found in 40 of 68 ears (58.8%) in the patient group. A significant difference in the otic capsule density was found between the ears with and without HL. There was a strong negative correlation between the parathyroid hormone level and the densitometric measurement of the otic capsule. CONCLUSION: There is osseous remodeling of the otic capsule in CRF with loss of bone density, and this is associated with HL in CRF.