Comparison between 18F-FDG PET/CT and diffusion-weighted imaging in detection of invasive ductal breast carcinoma.

Objectives: Breast carcinoma is the most common type of cancer in females. This study aims to compare fluorine-18-fluorodeoxyglucose (18F-FDG) uptake pattern and apparent diffusion coefficient (ADC) value for the detection of the primary tumour and axillary metastases of invasive ductal breast carcinoma. Methods: This study included 40 breast carcinoma lesions taken from 39 patients. After staging by positron emission tomography-computed tomography (PET/CT) and diffusion-weighted magnetic resonance imaging (MRI), breast surgery with axillary lymph node dissection or sentinel lymph node biopsy was performed. Results: Primary lesion detection rate for PET/CT and diffusion-weighted MRI was high with 39 of 40 lesions (97.5%). The sensitivity and specificity for the detection of metastatic lymph nodes in axilla were 40.9%, 88.9%, with 18F-FDG PET/CT scans and 40.9%, 83.3%, for dw-MRI, respectively. No significant correlation was detected between ADC and SUVmax or SUVmax ratios. Estrogen receptor (p=0.007) and progesterone receptor (p=0.036) positive patients had lower ADC values. Tumour SUVmax was lower in T1 than T2 tumour size (p=0.027) and progesterone receptor-positive patients (p=0.029). Tumour/background SUVmax was lower in progesterone receptor-positive patients (p=0.004). Tumour/liver SUVmax was higher in grade III patients (p=0.035) and progesterone receptor negative status (p=0.043). Conclusions: This study confirmed the high detection rate of breast carcinoma in both modalities. They have same sensitivity for the detection of axillary lymph node metastases, whereas the PET/CT scan had higher specificity. Furthermore, ADC, SUVmax and SUVmax ratios showed some statistical significance among the patient groups according to different pathological parameters.

Effects of bariatric surgery on knee osteoarthritis, knee pain and quality of life in female patients.

OBJECTIVES: Bariatric surgery is an effective intervention for severe obesity and associated comorbidities. We compared symptoms, joint space and life quality of morbidly obese patients with symptomatic knee osteoarthritis before and after bariatric surgery. METHODS: 34 patients with knee osteoarthritis were evaluated with standing anteroposterior and lateral radiography, medial and lateral joint distances of the knees, Visual Analog Scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire and the Short Form 36 (SF-36) before and 6 months after surgery. RESULTS: Mean patient age was 48.53±6.91 years. Mean body mass index was 46.97±6.04 kg/m2 and 34.41±5.62 kg/m2 before and after surgery, respectively. SF-36 subscales were significantly higher after surgery (p<0.05), while mean VAS values and WOMAC scores were significantly lower postoperatively (p<0.001). Right knee medial and left knee lateral joint distance measurements were significantly higher postoperatively (p<0.05). BMI change, in linear regression analysis had no significant effect on VAS, WOMAC, SF-36 and knee lateral and medial joint distance measurements. CONCLUSIONS: Although bariatric surgery might improve pain, life quality and functionality of knee osteoarthritis in early period, improvement is not directly related to weight loss amount.

Dual-Time 18F-FDG PET/CT Imaging in Initial Locoregional Staging of Breast Carcinoma: Comparison with Conventional Imaging and Pathological Prognostic Factors.

The aims of this retrospective study were to consider the diagnostic role of dual-time 18F-fluorodeoxyglucose positron emission tomography and computed tomography (18F-FDG PET/CT) in detection of breast carcinoma and axillary lymph node (ALN) status and to evaluate the primary tumor 18F-FDG uptake pattern. Preoperative staging was performed by 18F-FDG PET/CT in 78 female patients with breast carcinoma. Conventional imaging results were evaluated by breast magnetic resonance imaging (MRI) of 79 lesions in 78 patients, bilateral mammography (MMG) of 40 lesions in 40 patients, and breast ultrasonography (USG) of 47 lesions in 46 patients. The primary tumor detection rate using 18F-FDG PET/CT was higher than those using MRI, USG, and MMG. The sensitivity and specificity of 18F-FDG PET/CT scans for detecting multifocality were higher than those of MRI. The specificity of ALN metastasis detection with MRI was higher than that with 18F-FDG PET/CT, but 18F-FDG PET/CT had higher sensitivity. Higher 18F-FDG uptake levels were detected in patients with ALN metastasis, histologic grade 3, estrogen-progesterone-negative receptor status, lymphatic invasion, and moderate to poor prognostic groups. There was no statistical difference for the retention index in categorical pathological parameters except for progesterone-negative status. In conclusion, 18F-FDG PET/CT scans may be a valuable imaging technique for evaluating primary tumor and axillary status in staging breast carcinoma and 18F-FDG uptake may be a prognostic factor that indicates aggressive tumor biology and poor prognosis. Dual-time imaging in breast carcinoma staging may not be used for predicting pathological criteria and the aggressiveness of primary lesions.

The analysis of the maxillary sinus volumes and the nasal septal deviation in patients with antrochoanal polyps.

The aim of this study was to evaluate the relationship between the maxillary sinus volumes and the nasal septal deviation angles in patients with antrochoanal polyps (ACP). 76 patients who underwent ACP surgery were included in the study. Of those 36 patients who had multislice computed tomography (MSCT) were evaluated to calculate maxillary sinus volume. The records of paranasal MSCT of 36 healthy people without any paranasal sinus diseases or surgery constituted age- and gender-matched healthy controls. Maxillary sinüs volumes and septal deviation angles were calculated using the paranasal MSCT volume-rendering technique. Thirty-six patients in the ACP group were compared with 36 polyp side-matched healthy people. The mean age was 16.6 ± 6.7 years in both groups. Statistically, the mean value of the maxillary sinus volume was significantly higher in the ACP group compared with the ACP side-matched control group (15.1 ± 4.6 versus 12.0 ± 3.5 mm(3)) (p = 0.002). Furthermore, the mean value of the maxillary sinus volume in the non-polyp side (14.2 ± 4.7 mm(3)) was statistically higher in the ACP group compared with the side-matched control group volume (11.9 ± 3.8 mm(3)) (p = 0.024). In addition, Fifty-three of 76 ACP patients had septal deviation. While the septal deviation was on the same side with the ACP in 17 patients, it was on the opposite side in 36 patients. In conclusion, the maxillary sinus volumes increased in ACP patients compared with the healthy control group. Many patients had nasal septal deviation on the opposite side of the ACP.

[Kyphoplasty method for the treatment of traumatic osteoporotic vertebral compression fractures: case report]. / Travmaya bagli osteoporotik vertebra çökme kiriklarinin tedavisinde kifoplasti uygulamasi: Olgu sunumu.

The aim of the kyphoplasty method for the treatment of traumatic osteoporotic vertebral compression fractures in geriatric patients is to improve the patient's quality of life. In this report we present two elderly patients who were suffering of traumatic osteoporotic vertebral compression fractures and underwent successful kyphoplasties. Percutaneous kyphoplasty method for the surgical treatment of these fractures decreases the hospitalization, morbidity and mortality in these patients.

Vertebral body pneumatocyst in the cervical spine and review of the literature.

A pneumatocyst in the cervical spine is extremely rare and to our knowledge only a few reports have been published in the English literature. Although the etiology and natural course of vertebral body pneumatocyst is unclear, nitrogen gas accumulation is claimed. A 65-year-old-man was admitted to the emergency department with neck pain and numbness and incapacity in his both hands and fingers. The radiological images revealed a vertebral located pneumatocyst in the C4 cervical vertebra. In this report, we present a case of cervical pneumatocyst located in the C4 vertebral body. The clinical and radiological features and natural course of the pneumatocyst were evaluated.

Preoperative sonography of nonreducible inguinal masses in girls.

PURPOSE: Inguinal hernia is one of the most common surgical pathologies in childhood. Any of the abdominal organs can slide into the hernial sac and become incarcerated there. In girls, the fallopian tubes, ovaries, uterus, and-rarely-ovarian cysts can form the sliding component of an inguinal hernia. The aim of this study was to investigate the diagnostic value of preoperative sonographic examination in girls with nonreducible inguinal masses. METHODS: Nine girls ranging in age from 2 months to 8 years who were admitted to our clinic with nonreducible inguinal masses were included in the study. All patients underwent sonographic examination followed by surgery on the day of admission. RESULTS: A definitive diagnosis was obtained in 6 patients on preoperative sonographic evaluation, whereas 3 patients were misdiagnosed. One patient was diagnosed sonographically as having lymphadenopathy, but surgery revealed an ovarian cyst sliding into the hernial sac. A second patient was found to have an infected lymph node at surgery instead of a strangulated bowel loop as diagnosed on sonographic examination. In the third patient, the preoperative sonographic diagnosis was an ovarian cyst in the hernia sac, but surgery revealed a cyst of the canal of Nuck. CONCLUSION: Inguinal masses in young girls must be carefully evaluated, because the sonographic preoperative diagnosis may be misleading.

Effect of Aerodiol administration on ocular arteries in postmenopausal women.

OBJECTIVE: The aim of the present study was to evaluate the alteration of ocular blood hemodynamics after intranasal administration of 17beta-estradiol, through measurement of the ophthalmic artery (OA) and the central retinal artery (CRA) using color duplex sonography. METHODS: Thirty healthy women who had been naturally postmenopausal for at least 1 year were enrolled in the study. A randomized, placebo-controlled, crossover, double-blinded study was conducted of the acute effect of 17beta-estradiol (Aerodiol; Servier, Chambrayles-Tours, France) on OA and CRA blood flow using color duplex sonography. RESULTS: The peak systolic and end diastolic velocities of the CRA were increased significantly after 17beta-estradiol administration compared with placebo. A significant decrease was also found in the pulsatility and resistive indices of the CRA. However, there were no statistically significant differences in OA flow velocities or pulsatility and resistive indices. CONCLUSIONS: Nasal 17beta-estradiol administration in postmenopausal women causes an improvement in the ocular vascular Doppler indices. These results suggest that there could be a positive effect of Aerodiol on middle-sized arteries and arterioles.

Acute effect of smoking on gallbladder emptying and refilling in chronic smokers and nonsmokers: a sonographic study.

AIM: To ultrasonographically evaluate the acute effects of smoking on gallbladder contraction and refilling in chronic smokers and nonsmokers. METHODS: Fifteen chronic smokers (21-30 years old) and fifteen nonsmokers (21-35 years old) participated in this study. Chronic smokers were selected among the volunteers who had been smoking for at least 5 years and 10 cigarettes per day (mean 17.5/d). Examinations were performed in two separate days. In the first day, basal gallbladder (GB) volumes of volunteers were measured after 8-h fasting. After the examinations, participants had a meal containing at least 30-40 gram fat. Gallbladder volume was assessed at 5, 15, 30, 60, 120 and 180 min after the meal. In the second day, participants smoked 2 cigarettes after 8-h fasting. Then, they had the same meal, and gallbladder measurements were repeated at the same time points. Same procedures were applied to both groups. RESULTS: The mean starving GB volumes were 23.3 +/- 3.3 mL in the first day, 21.9 +/- 3.0 mL in the second day in nonsmoker group and 18.3 +/- 3.0 mL in the first day, 19.5 +/- 2.8 mL in second day in smoker group. There was no significant difference between starving GB volumes. We did not find any significant difference between the GB volumes measured at 5, 15, 30, 60, 120 and 180 min in the first and second days in nonsmoker group. In smokers, post cigarette GB volume was found significantly higher at 5, 15 and 30 min which corresponded to GB contraction phase (P < 0.05). Control GB volume measurements were not significantly different between the two groups. Post-smoking GB volumes were also not significantly different between the two groups. CONCLUSION: Smoking prolongs the maximal GB emptying time both in smokers and in nonsmokers though it is not significant. It delays GB contraction in chronic smokers and causes a significant decrease in GB emptying volume. Smoking causes no significant delay in GB refilling in both smokers and nonsmokers. These effects of smoking observed in acute phase result in bile stasis in GB. Bile stasis is the underlying cause of most GB disorders in chronic process.

Klippel-Feil syndrome associated with pneumatocyst of the right cervical rib.

A patient with Klippel-Feil syndrome reported with a pneumatocyst of the proximal epiphysis of a right cervical rib. There was no additional skeletal abnormality except for fusion of the C3 and C4 vertebral bodies. To the best of our knowledge, this is the first reported instance of this particular association.

Effect of Aerodiol administration on cerebral blood flow volume in postmenopausal women.

OBJECTIVE: The aim of the study was to evaluate the acute effect of the intranasal 17beta-estradiol (Aerodiol, Servier, Chambray-les-Tours, France) administration on cerebral blood flow (CBF) volume. METHODS: Eighteen healthy women who had been natural postmenopausal for at least 1 year were enrolled in the study. We conducted an experimental, randomized, placebo-controlled, crossover, double-blinded study of the acute effect of 17beta-estradiol on the internal carotid artery (ICA), vertebral artery (VA) and, CBF volume using color duplex sonography. RESULTS: There were significant increases in the ICA, VA flow volumes and CBF volume after 17beta-estradiol administration compared to placebo measurements. However, there was no statistically significant difference in flow velocities or pulsatility indices. CONCLUSION: Nasal 17beta-estradiol administration in postmenopausal women causes significant increases in CBF volume due to its vasodilatatory effect on ICA and VA.

Delay in diagnosis of hypopituitarism after traumatic head injury: a case report and review of the literature.

Neuroendocrine complications are among important and frequently missed complications of traumatic brain injury. Hypopituitarism, the partial or complete insufficiency of anterior pituitary secretion may be underrecognized due to its subtle clinical manifestations in traumatic patients. We report a case of 14.5-year-old girl who was admitted due to growth failure and had been diagnosed to have multiple hypophyseal hormone deficiency including thyroid-stimulating hormone, gonadotropins, adrenocorticotropin hormone which developed years after traumatic head injury.

Welder's lung associated with pneumothorax.

A 23-year-old male working in welding for 8 years was admitted to the hospital with chest pain. A large right pneumothorax with complete lung collapse was seen radiographically and a tube thoracostomy performed. At high-resolution computed tomography, multiple bilateral well-marginated nodules with surrounding ground-glass opacity were seen. Welder's lung was considered in this patient because of his work in welding for 8 years with iron dust exposure, multiple nodules with ground-glass opacity were seen on HRCT, and serum ferritin and ferritin levels in bronchoalveolar lavage fluid were elevated. The granules in alveolar macrophages obtained from parenchymal biopsy and bronchoalveolar lavage stained strongly with iron dyes. Following avoiding exposure to welding fumes, the lung lesions disappeared without additional therapeutic interventions after a 3-week period. Welder's lung with associated lung lesions has been described, although complicating pneumothorax is unique to the case presented herein.

Ganglioglioma of the right optic tract: case report and review of the literature.

We describe a case of ganglioglioma of the right optic tract in a 52-year-old woman. Review of the general literature discloses only 11 cases of tumors of the visual pathway that meet the histological criteria for such neoplasm. A detailed radiological description of our case and a review of the literature is provided.

An isolated complete pancreatic fracture primarily diagnosed by ultrasound.

Pancreatic fractures due to blunt abdominal trauma are rare and are usually symptom-free and silent in many cases. Therefore, a high degree of suspicion is required either early in the course of trauma or later during follow-up. Computed tomography (CT) is the primary imaging modality for the diagnosis of traumatic pancreatic injuries. In this report, we present a 10-year-old child in whom ultrasound enabled the detection of a complete fracture between the body and tail of the pancreas, while initial CT findings were not suggestive of a lesion. The need for ultrasonography is emphasized especially in the presence of a history of trauma even if CT scans appear normal.