Peripheral neuropathy after burn injury.

OBJECTIVES: Peripheral neuropathy is a well-documented disabling sequela of major burn injury. These lesions are associated with both thermal and electrical injuries that may be frequently undiagnosed or overlooked in clinical settings. The purpose of this study was to evaluate the prevalence of burn-related neuropathy in our database and to investigate the clinical correlates for both mononeuropathy and generalized peripheral polyneuropathy. PATIENTS AND METHODS: Out of 648 burn patients, admitted to our clinic forty-seven burn patients with the diagnosis of peripheral neuropathy were evaluated retrospectively. The demographic and clinical data collected were gender, age, degree, site and percent surface area of burn, type of burn, and the results of electrodiagnostic examination, including electromyography and nerve conduction assessments and associated pathology if existed. RESULTS: Peripheral neuropathy is the most frequent disabling neuromuscular complication of burn, that may be undiagnosed or overlooked. In current study, peripheral neuropathy associated with burn all of our patients were identified by electrodiagnostic study. After treatment in Burn Unit, clinical and electrodiagnostic studies were applied. Motor and sensory distal latencies were prolonged and sensory nerve action potentials reduced in amplitude. CONCLUSIONS: The findings of our study have shown that polyneuropathies and axonal neuropathy were more frequent than mononeuropathy and demyelination.  

Prediction of survival and evaluation of diagnostic accuracy whole body 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography in the detection carcinoma of unknown primary origin.

PURPOSE: The aim of the current study was to determine the diagnostic accuracy of whole-body 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in detecting carcinoma of unknown primary (CUP). MATERIALS AND METHODS: A total of 7,636 patients were investigated by FDG-PET/CT examinations at our Institution. We retrospectively evaluated the file records of 432 patients who were referred to FDG PET/CT imaging with a diagnosis of cancer of unknown primary, and included 316 of the patients with histopathologic verification at the final diagnosis. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated. The Kaplan-Meier test was used for survival analysis. Median survival rate was calculated to evaluate the prognostic value of the FDG-PET/ CT findings. RESULTS: In the search for a primary, FDG-PET/CT findings correctly diagnosed lesions as the site of the primary true positive in 238 cases, 10 findings diagnosed no site of a primary and none was subsequently proven true negative, 12 diagnoses were false positive and 56 were false negative. The sensitivity of FDG-PET/CT is 81% and the specificity 45%. Positive predictive value, negative predictive value and diagnostic accuracy were 95%, 15% and 78%, respectively. CONCLUSIONS: Whole-body FDG-PET/CT imaging is proven to be useful method in the search for the primary focus and metastases in patients with cancer of unknown primary.

Indirect measurement of the temporomandibular joint disc elasticity with magnetic resonance imaging.

OBJECTIVES: The radiological evaluation of the temporomandibular joint (TMJ) consists of demonstrating the morphological features of the disc and the condyle in closed and open mouth positions using MRI. We aimed to determine elasticity of the disc by measuring the amount of elongation during mouth opening. METHODS: The study population included 49 patients. Coronal T(1) and multiplane oblique T(2) weighted gradient recalled echo sequences were acquired in open and closed mouth positions. Biconcave TMJ disc lengths were measured on sagittal oblique images in both positions. Elongation ratio (ER) was calculated for each patient. According to the findings, TMJs are classified into subgroups: normal (N), dislocated with reduction (DWR), pure DWR (p-DWR), DWR with additional findings (DWR-a) and dislocated without reduction (DWOR). Statistical analysis was performed using the χ(2) test and receiver operating characteristic analysis. RESULTS: Out of 98 discs, 22 of them were evaluated as N, 60 as DWR (28 p-DWR, 32 DWR-a) and 16 as DWOR. There was no significant difference among the disc lengths in three subgroups at the closed mouth position (P = 0.15), whereas there was significant difference in the open mouth position (P = 0.0001). There was significant difference among subgroups as far as ER is concerned (P < 0.05). CONCLUSIONS: ER is a strong indicator of elasticity. Compared with the N group, elasticity of the disc was not significantly different in the p-DWR group but the disc elasticity was very degraded in DWR-a and in DWOR. A negative conversion or one smaller than 1.4 mm means a compromised disc, although sometimes it will possess normal anatomical configurations or signal characteristics.