Quantitative assessment of new MRI-based measurements to differentiate low and high stages of pelvic organ prolapse using support vector machines.

INTRODUCTION AND HYPOTHESIS: The objective of this study was to quantitatively assess the ability of new MRI-based measurements to differentiate low and high stages of pelvic organ prolapse. New measurements representing pelvic structural characteristics are proposed and analyzed using support vector machines (SVM). METHODS: This retrospective study used data from 207 women with different types and stages of prolapse. Their demographic information, clinical history, and dynamic MRI data were obtained from the database. New MRI measurements were extracted and analyzed based on these reference lines: pubococcygeal line (PCL), mid-pubic line (MPL), true conjugate line (TCL), obstetric conjugate line (OCL), and diagonal conjugate line (DCL). A classification model using SVM was designed to assess the impact of the features (variables) in classifying prolapse into low or high stage. RESULTS: The classification model using SVM can accurately identified anterior prolapse with very high accuracy (>0.90), and apical and posterior prolapse with good accuracy (0.80 - 0.90). Two newly proposed MRI-based features were found to be significant in the identification of anterior and posterior prolapse: the angle between TCL and MPL for anterior prolapse, and the angle between DCL and PCL for posterior prolapse. The overall accuracy of posterior prolapse identification increased from 47% to 80% when the newly proposed MRI-based features were taken into consideration. CONCLUSIONS: The proposed MRI-based measurements are effective in differentiating low and high stages of pelvic organ prolapse, particularly for posterior prolapse.

Assessment of a semiautomated pelvic floor measurement model for evaluating pelvic organ prolapse on MRI.

INTRODUCTION AND HYPOTHESIS: The objective of this study was to assess the performance of a semiautomated pelvic floor measurement algorithmic model on dynamic magnetic resonance imaging (MRI) images compared with manual pelvic floor measurements for pelvic organ prolapse (POP) evaluation. METHODS: We examined 15 MRIs along the midsagittal view. Five reference points used for pelvic floor measurements were identified both manually and using our semiautomated measurement model. The two processes were compared in terms of accuracy and precision. RESULTS: The semiautomated pelvic floor measurement model provided highly consistent and accurate locations for all reference points on MRI. Results also showed that the model can identify the reference points faster than the manual-point identification process. CONCLUSION: The semiautomated pelvic floor measurement model can be used to facilitate and improve the process of pelvic floor measurements on MRI. This will enable high throughput analysis of MRI data to improve the correlation analysis with clinical outcomes and potentially improve POP assessment.

Seroepidemiological investigation of toxocariasis in the isparta region of Turkey.

BACKGROUND: Toxocariasis is a common disease around the world. Our objective was to determine Toxocara seroprevalence in humans in the city of Isparta, Southwest Turkey, in respect of some determinants such as age, socio-economic level, residence in city center or rural area etc. METHODS: Five hundred and thirty four individual participants from Isparta center and 85 from Asagi Gokdere village were included in the study. T. cati specific antibodies were analyzed using excretory-secretory (ES)-enzyme-linked immunosorbent assay (ELISA) method. RESULTS: T. cati antibodies were detected as positive in 73 (13.6%) of 534 samples which were collected from subjects living in the city center and 24 (28.2%) of 85 samples from Asagi Gokdere village. Toxocara seropositivity was detected among 15.6% of whole study group. The seroprevalence of toxocariasis was significantly higher among subjects from village than in subjects from city center (P=0.001). While gender, high school education, source of the water which is used, family income and geophagia/eating nail behaviors were the features which were detected as being associated with toxocariasis seropositivity (odds ratios=0.5; 6.52; 3.61; 0.43; 0.13 respectively), owning dogs or cats and hand washing were detected as being not associated with toxocariasis seropositivity (P>0.05). Furthermore, Toxocara seropositivity was significantly higher among subjects in 0-10 than >40 year-old group (P=0.02). CONCLUSION: It can be suggested that untreated lost pet population, environmental contamination, and way of life have influence on the epidemiology of toxocariasis.

Assessment of spatial-contrast function and short-wavelength sensitivity deficits in patients with migraine.

AIMS: To study spatial-contrast function and short-wavelength sensitivity deficits in a migraine population with a disease duration of 30 years or less. MATERIALS AND METHODS: In this prospective, cross-sectional study, we evaluated 28 subjects with migraine headache and 15 nonheadache healthy controls. Visual fields were evaluated using the Humphrey Field Analyzer 750i and the 30-2, blue and yellow threshold programme. Contrast sensitivity (CS) was measured at 1.5, 3, 6, 12, and 18 cpd spatial frequencies, using the Functional Acuity Contrast Test (F.A.C.T.). The results of the visual field parameters (mean defect (MD) and pattern standard defect (PSD)) and CS were compared with 15 age-equivalent normal subjects. RESULTS: Short-wavelength amplitude perimetry (SWAP) parameters and CS scores at all spatial frequencies were significantly altered in the migraine patients when compared with the control subjects. Visual field parameters correlated significantly with contrast sensitivity scores: positively for MD (r=0.39, P=0.01; r=0.43, P=0.005; r=0.56, P=0.0001; r=0.45, P=0.003; r=0.48, P=0.0001) and negatively for PSD (r=-0.45, P=0.003; r=-0.45, P=0.003; r=-0.51, P=0.001; r=-0.53, P=0.0001; and r=-0.67, P=0.0001) at all (1.5, 3, 6,12, and 18 cpd) spatial frequencies, respectively. Migraine duration correlated negatively with MD (r=-0.42, P=0.04) and positively with PSD (r=0.42, P=0.03). CONCLUSION: Migraineurs had significantly altered visual field and contrast function at all spatial frequencies to the normal population. These defects share some features with early stages of glaucoma and may relate a possibility for a common vascular disease pathogenesis in these two conditions.

Acute unilateral total visual loss after retrogasserian phenol injection for the treatment of trigeminal neuralgia: a case report.

Phenol is a neurolytic agent that is widely used by percutaneous retrogasserian injection in the treatment of trigeminal neuralgia. We report a 78-year-old man who had acute unilateral total visual loss after retrogasserian phenol injection for the treatment of trigeminal neuralgia. The patient's visual acuity, eye movements and the pupillary defect did not improve in the affected eye even after mechanical decompression within 30 minutes and medical treatment, neither in the early period nor during the following two months. The visual loss in this patient seems to result from phenol neurotoxicity rather than mechanical compression of the intraorbital optic nerve. This case demonstrates that although percutaneous retrogasserian phenol injection is a relatively safe and noninvasive method of treatment for trigeminal neuralgia, severe complications may occur.

[Pott disease in the differential diagnosis of low back pain]. / Bel agrisinin ayirici tanisinda Pott hastaligi.

Tuberculosis of skeletal system is frequently located in spine and is called as "Pott disease". Pott disease is frequently located in lumbar vertebrates and it can be interfered with the other diseases which cause low back pain. Our patient which was operated because of breast cancer nearly 10 years ago, has had waist and leg pain for 6 weeks. The story of breast cancer reminded us the possibility of a metastasis. But there were no findings in favour of metastasis except the high scores of sedimentation rate. There was a disc herniation according to the MR imaging of lumbar region. Therefore we performed epidural steroid injection but 10 days later the patient was unable to walk. We present this case to understand the importance of the differential diagnosis of Pott disease.

Excision and cryosurgery in the treatment of conjunctival malignant epithelial tumours.

PURPOSE: To evaluate the long-term results of combined treatment with excision and cryosurgery for malignant epithelial tumours of the conjunctiva. METHODS: We retrospectively reviewed the medical records of patients diagnosed with conjunctival malignant epithelial tumours and treated with excision and cryosurgery between 1980 and 1998. The demographic features of the patients, characteristics of the tumours, and the peculiarities of the recurrences were recorded. The SPSS V 9.05 computed program was used for the statistical analysis of the results. Kaplan-Meier plots were used to determine the recurrence-free survival, and the logrank test was used to compare the recurrences according to histological classification. RESULTS: A total of 55 subjects (57 eyes), 19 female and 36 male, were included in the study. Their ages ranged between 15 and 82 years (mean 55+/-14 years). Histological diagnosis was conjunctival intraepithelial neoplasia (CIN) in 26 (46%) and invasive squamous cell carcinoma (SCC) of the conjunctiva in 31 eyes (54%). All eyes were treated with excision and cryosurgery with nitrous oxide probe. During the follow-up period of 6 months to 15 years, seven (12.3%) recurrences were observed. The success rate for patients with CIN and invasive SCC was 88.5 and 87.1%, respectively. There was no difference for recurrence rates between CIN and invasive SCC groups according to logrank test (P=0.68). CONCLUSIONS: Over the long-term follow-up, cryosurgery following excision is a successful method in the treatment of conjunctival intraepithelial tumours and invasive squamous cell carcinoma of conjunctiva with favourable outcome and minimal complications.

Dural cavernous hemangioma originating from superior petrosal sinus.

Cavernous angiomas of the dura are rare and have been described in the literature particularly in the middle cranial fossa. We present a case of cavernous hemangioma of the middle cranial fossa arising from the superior petrosal sinus. In our review of the literature, this is the 2(nd) report describing a cavernous hemangioma in such a location.

Immunological follow-up of hydatid cyst cases.

Hydatid disease is caused by Echinococcus granulosus. In this study, we aimed to investigate the benefit of monitoring cases with hydatid cyst by means of immune components in patients in a long-term follow-up after surgery. Eighty-four preoperative and postoperative serum samples from 14 cases undergoing surgery for hydatid disease were evaluated in terms of immune parameters, such as total and specific IgE, IgG, IgM, IgA and complement. Total and specific IgE were determined by ELISA. Specific IgG levels were measured by indirect hemagglutination. Total IgG, IgM, IgA and complement (C3 and C4) were detected by nephelometry. Imaging studies were also carried out during the follow-up. In none of the patients hydatid cysts were detected during the follow-up. Total IgE levels in the sera of the patients decreased to normal six months after surgery. Although specific IgE against echinococcal antigens decreased one year after operation, levels were still significantly high. There were no changes in the levels of anti-Echinococcus IgG and total IgG in follow-up period. Additionally, other parameters, such as IgA, IgM, C3 and C4, were not affected.

Clinical course of ocular Behçet's disease in siblings.

PURPOSE: Familial occurrence has been reported in approximately 8% of Turkish patients with Behçet's disease. Our aim was to compare the clinical course of ocular Behçet's disease among siblings. METHODS: We retrospectively studied five pairs of siblings with ocular involvement of Behçet's disease. No other family member of these siblings had any symptom of Behçet's disease. RESULTS: The siblings comprised three sister-brother pairs, one sister-sister pair, and one brother-brother pair. There was a 5-10-year difference between the age at onset of ocular disease among siblings. Three of the five pairs (two sister-brother, one brother-brother) had a dissimilar course of disease activity. Female siblings had an earlier age at onset and tended to have a worse prognosis than their brothers. CONCLUSIONS: It is generally acknowledged that male sex is associated with a worse prognosis. In this study, however, we observed that, among siblings with a dissimilar course, female patients were more severely affected than male patients. Poor ocular prognosis in a patient does not indicate aggressive treatment in his/her sibling. We believe that each sibling should be managed on an individual basis.

Treatment of aggressive periodontitis by osseointegrated dental implants. A case report.

BACKGROUND: Generalized aggressive periodontitis is described as a clinical entity affecting both deciduous and permanent dentition with extensive alveolar bone loss, mobility, and exfoliation of all or many teeth. Controversy exists on dental implant use to restore missing dentition in younger patients. METHODS: This case report presents a patient diagnosed with aggressive periodontitis who has lost all but 4 of her teeth. Her personal and functional desires led us to include implant therapy in her treatment plan. The hematological data are presented with an analysis of the immunological profile. RESULTS: Dental implants were placed, and following 3 months of osseointegration, an implant-supported prosthesis was completed. The patient was followed up for 36 months. CONCLUSIONS: This case report presents an alternative treatment for rehabilitating dentition in a young patient treated for aggressive periodontitis. Similar case studies may help eliminate some of the controversy that exists regarding the use of dental implants in aggressive periodontitis patients.

Potential salvage therapy for accidental intrathecal vincristine administration: a preliminary experimental study.

BACKGROUND: Accidental intrathecal vincristine (VCR) administration results in severe neurotoxicity, usually fatal in outcome. No specific therapy for initrathecal VCR toxicity has been reported so far. In our recent report, complete in vitro degradation of VCR by hypochlorous acid (HOCl) was demonstrated. METHODS: In this comparative study, we examined the in vivo effectiveness of HOCl in the cerebrospinal fluid of 24 New Zealand rabbits following intracisternal VCR administration. RESULTS: There were no significant clinical or histopathologic abnormalities in the control and HOCl groups; however, multiple necrotic foci on histopathological examination of brain sections in the VCR group were determined. There were significantly lower numbers of necrotic foci in brain sections of rabbits which received HOCl administration than those without therapy. CONCLUSION: Our results indicate that HOCl may reduce VCR neurotoxicity.

A Novel Catechol Oxidase Enzyme Electrode for the Specific Determination of Catechol.

An enzyme electrode for the specific determination of catechol was developed by using catechol oxidase (EC 1.10.3.1) from eggplant (Solanum melangena L.) in combination with a dissolved oxygen probe. Optimization studies of the prepared catechol oxidase enzyme electrode established a phosphate buffer 50 mM at pH 7.0 and 35°C to provide the optimum conditions for affirmative electrode response. The enzyme electrode response depended linearly on a catechol concentration range of 5•10(-7)-30•10(-5) M with a response time of 25 sec and substrate specificity of the catechol oxidase electrode of 100%. The biosensor retained its enzyme activity for at least 70 days.