Contribution of diffusion weighted MRI to diagnosis and staging in gastric tumors and comparison with multi-detector computed tomography.

BACKGROUND: Diagnostic performance of Diffusion-Weighted magnetic resonance Imaging (DWI) and Multi-Detector Computed Tomography (MDCT) for TNM (Tumor, Lymph node, Metastasis) staging of gastric cancer was compared. PATIENTS AND METHODS: We used axial T2-weighted images and DWI (b-0,400 and b-800 s/mm2) protocol on 51 pre-operative patients who had been diagnosed with gastric cancer. We also conducted MDCT examinations on them. We looked for a signal increase in the series of DWI images. The depth of tumor invasion in the stomach wall (tumor (T) staging), the involvement of lymph nodes (nodal (N) staging), and the presence or absence of metastases (metastatic staging) in DWI and CT images according to the TNM staging system were evaluated. In each diagnosis of the tumors, sensitivity, specificity, positive and negative accuracy rates of DWI and MDCT examinations were found through a comparison with the results of the surgical pathology, which is the gold standard method. In addition to the compatibilities of each examination with surgical pathology, kappa statistics were used. RESULTS: Sensitivity and specificity of DWI and MDCT in lymph node staging were as follows: N1: DWI: 75.0%, 84.6%; MDCT: 66.7%, 82%;N2: DWI: 79.3%, 77.3%; MDCT: 69.0%, 68.2%; N3: DWI: 60.0%, 97.6%; MDCT: 50.0%, 90.2%. The diagnostic tool DWI seemed more compatible with the gold standard method (surgical pathology), especially in the staging of lymph node, when compared to MDCT. On the other hand, in T staging, the results of DWI and MDCT were better than the gold standard when the T stage increased. However, DWI did not demonstrate superiority to MDCT. The sensitivity and specificity of both imaging techniques for detecting distant metastasis were 100%. CONCLUSIONS: The diagnostic accuracy of DWI for TNM staging in gastric cancer before surgery is at a comparable level with MDCT and adding DWI to routine protocol of evaluating lymph nodes metastasis might increase diagnostic accuracy.

The Distribution and the Antimicrobial Susceptibility Features of Microorganisms Isolated From the Burn Wounds: A 10-Year Retrospective Analysis.

In this study, we aimed to evaluate the distribution features and antimicrobial susceptibility test results of the microorganisms isolated from the wounds of pediatric and adult patients with burn. The culture and susceptibility test results of the microorganisms, isolated from the wound swabs of the patients hospitalized in a tertiary-burn care center in 10-year period, were retrospectively screened on the microbiology department databases. Their distribution of isolated microorganisms regarding species and susceptibility test results were compared with previous studies. A total of 367 microorganisms, isolated from the burn wounds of 293 patients (13 ± 18.9 years, F/M: 0.93) (73 adults and 220 pediatric patients), were included in this study. A solitary agent was isolated in 239 (81.6%) patients, while 2 were isolated in 43 (14.7%) and 3 or more agents in 11 (3.8%). From these, 33% of the isolated microorganisms were gram-positive cocci, 61% were gram-negative bacteria, and 6% were Candida spp. The most common isolated microorganisms were Staphylococcus aureus (18.5%), Pseudomonas spp. (16.9%), and Escherichia coli (11.2%), while the least common was Streptococcus spp. (2.5%). Methicillin resistance was 15% among the S. aureus strains. No resistance was observed against levofloxacin, vancomycin, teicoplanin, linezolid, daptomycin, fusidic acid, and tigecycline in S. aureus strains. The highest resistance rates were observed against levofloxacin (64%), tobramycin (64%), pip/tazobactam (63%), imipenem (63%), and the lowest against colistin (5%) and ceftazidime (29%), among Pseudomonas spp. The most common causative agents in burn wound infections and their current antimicrobial susceptibility features should be well identified, in order for prevention of serious complications and optimal management the condition to occur.

Advanced Oxidation Protein Product (AOPP) Levels in Second- and Third-Degree Thermal Burns.

Burn is a systemic injury affecting the entire organism according to its etiology and severity. The aim of this study was to investigate plasma AOPP levels before and after treatment of second- and third-degree thermal burn patients and determine the changes in this parameter, and also, to find out the relationship between AOPP level and hospitalization period and total body surface area (TBSA). The study material consisted of pediatric patients with the complaint of second- and third-degree thermal burns aged between 1 and 18 years, with a burn area exceeding 10%. Blood samples were taken twice before and after treatment. AOPP level in blood plasma was measured in ELISA. It was observed that in the second-degree thermal burn group, AOPP level was 25.85 ± 2.82 ng/ml before the treatment decreased to 22.16 ± 3.62 ng/ml after treatment, whereas in the third-degree thermal burn group before the treatment AOPP was 25.96 ± 3.49 ng/ml, and after the treatment dropped to 21.70 ± 3.79 ng/ml, decreases were significantly important (P < .05). There was no statistically significant difference between the two groups in terms of AOPP levels (P > .05). Correlation analyses in the second- and third-degree thermal burn group did not show any correlation between AOPP levels and burn area and length of hospitalization period. As a result, AOPP level has been studied, for the first time, in burn cases. In both groups, the level of AOPP increased due to oxidative stress before treatment and decreased after treatment.

Uncommon Caecum Diverticulitis Mimicking Acute Appendicitis.

Diverticulum of the cecum is a rarely seen reason of acute abdomen and it is difficult to be distinguished from appendicitis. The diagnosis is generally made during operation. We have presented this case in order to remember that it is a disease which should be kept in mind in cases of right lower quadrant pain.

A Case of Metastatic Esophageal Carcinoma in a Pregnant Woman with Radiologic Findings.

The incidence of all malignant tumours during pregnancy is extremely rare and esophageal carcinoma ranges from 0.07 to 0.1% of all malignant neoplasms. The physiological changes during pregnancy frequently mask the complaints and symptoms related to the disease. The physical and physiological clinical conditions limit the diagnostic approaches. Therefore, the stage of cancer at the time of diagnosis is usually advanced. The management with cancer surgery and chemotherapy regimens must be modified in pregnant women in order to minimize fetal and maternal risks. Here, we report a very rare case of metastatic esophagus cancer in a 39-year-old woman with 28 weeks of pregnancy and aim to show the ultrasound (USG) and magnetic resonance imaging (MRI) findings with treatment and follow up management.