Serum lactate dehydrogenase levels significantly correlate with radiological extent of disease and spirometric values in patients with silicosis due to denim sandblasting.

BACKGROUND: The aim of the present study was to investigate serum lactate dehydrogenase (LD) levels in patients with silicosis due to denim sandblasting (SDDS) and also to investigate possible correlations between serum LD levels and the degree of radiological extent of disease (RED) and pulmonary function tests. METHODS: Forty-four males with SDDS and 32 healthy male subjects were included in the study. Patients and healthy controls were compared for serum LD levels. Correlations between serum LD levels, RED and spirometric values were investigated. RESULTS: Patients with SDDS had significantly higher serum LD levels than healthy controls. Patients with complicated SDDS had significantly higher serum LD levels than patients with simple SDDS. Significant correlations were found between serum LD levels and RED values. Significant correlations were found between serum LD levels and spirometric parameters. CONCLUSIONS: High serum LD levels might be considered as a marker of pulmonary parenchymal involvement in patients with SDDS. This study also suggests that the increase in serum LD levels might be closely related to the degree of pulmonary involvement in SDDS patients.

Parachute tricuspid valve in a patient with atrial septal defect detected by two- and three-dimensional echocardiography.

Atrioventricular valve parachute deformity was generally seen in the mitral position, which is called parachute mitral valve. Parachute deformity is also seen in the tricuspid position, but this has rarely been reported as sporadic cases. All of these cases were associated with other congenital defects, such as double outlet right ventricle, left to right shunt. We herein present two- and three-dimensional echocardiographic features of a parachute tricuspid valve in a patient with atrial septal defect and prominent eustachian valve.

Pararectal mass: an atypical location of splenosis.

Splenosis is the autotransplantation of splenic tissue resulting from the dissemination of cells from the pulp of the spleen after splenic injury or splenectomy. Implants can be found anywhere in the peritoneal cavity, especially on the serosal surfaces of small and large bowel, in the mesentery and diaphragm, implanted in visceral organs, within the thorax and brain, and in surgical scars and may vary in number, shape, and size. We described the sonographic, computed tomography and magnetic resonance imaging findings of pararectal splenosis in a 23-year-old man. The lesions appeared as multiple, well-circumscribed, small, round, homogenously solid masses of different sizes at the retrovesical and pelvic region detected during the imaging workup of Behçet disease.

Normal anatomical features and variations of bronchial arteries: an analysis with 64-detector-row computed tomographic angiography.

OBJECTIVE: To determine the normal anatomical features and variations of the bronchial arterial system and to determine the relationship among ectopic bronchial arteries, location (right-left) of the bronchial arteries, and variations of the aortic arch in patients as well as the sex of the patients who underwent multidetector computed tomographic angiography of the thorax for various reasons. METHODS: A total of 163 patients who underwent multidetector computed tomographic angiography of the thoracic vascular structures for various reasons were analyzed retrospectively. The right and left bronchial arteries were analyzed individually, and normal anatomic features and variations were recorded. The χ and Mann-Whitney U tests were used to evaluate relationships among the patients' sex, side and number of the bronchial arteries, aortic arch variations, and bronchial artery variations. RESULTS: There were 432 bronchial arteries (right, 229; left, 203) in 163 patients (117 men, 46 women; mean age, 51.7 years). All of the patients have at least one bronchial artery (mean, 2.65; maximum, 5). The number and diameters of the bronchial arteries were statistically higher on the right side. The number of the bronchial arteries was significantly higher in the men (P < 0.05). Ectopic bronchial arteries were present in 43 (26.4%) of the 163 patients. Aortic arch variations were present in 27 (22.5%) of 120 patients with normal bronchial arteries and in 11 (25.6%) of the 43 patients with ectopic bronchial arteries. There was no statistically significant correlation between aortic arch variations and ectopic bronchial arteries (P = 0.861). CONCLUSIONS: The anatomic features of the bronchial arteries show differences between individuals and the sexes. Multidetector computed tomographic angiography allows a precise and detailed evaluation of bronchial arterial system.

Serum prolidase activity in patients with pulmonary tuberculosis.

AIM: To investigate serum prolidase activity (SPA) in patients with pulmonary tuberculosis (PTB). MATERIAL AND METHODS: Twenty-nine PTB patients and 32 controls were included in the study. PTB patients (cavitary and non-cavitary) and controls were compared in terms of mean SPA. Correlations were evaluated between SPA and acute phase reactants. RESULTS: Mean SPA was significantly higher in PTB patients than in the control group. Mean SPA was significantly higher in patients with cavitary TB than non-cavitary TB. Mean SPA in patients with mild PTB was lower than patients with moderate and severe disease. We found significant correlations between SPA and CRP, ESR, albumin, platelet counts, HDL-cholesterol and LDH activity. CONCLUSION: This study has shown that PTB patients have higher SPA than controls. The increase in SPA might be related to tissue destruction, increased immunoglobulin, complement levels and increased fibroblastic activity; all of which are involved in the natural history of PTB.

Optimum height from the roof of the choana for seeking the sphenoid ostium.

OBJECTIVE: The purpose of this study was to investigate the optimum height that the sphenoid sinus ostium can be probed safely from the roof of choana in a large group of patients. METHODS: The study was performed retrospectively. The 200 sphenoid ostia of the 100 patients whose thin-section computed tomography (CT) including the sphenoid sinus region, made for various reasons, were included in the study. The height of the sphenoid ostium and the skull base from the choana roof were measured on sagittal images of CT. Also, by calculating the ratio of first measurement to the second one, the location of the sphenoid ostium at the anterior wall of sphenoid sinus was determined proportionally. RESULTS: The mean height of the sphenoid ostium from the choana roof was 10.9 (SD, 2.3) mm (range, 5.7-21.5 mm), and the mean height of skull base along the anterior wall of sphenoid sinus from the choana roof was 21.3 (SD, 3.2) mm (range, 13.3-30.6 mm). The ratio of the first measurement to the second measurement was 0.5 (SD, 0.08) (range, 0.29-0.77). CONCLUSIONS: In conclusion, under endoscopic view, the sphenoid sinus ostium can be safely probed between 13.3 mm (the minimum skull base height) and 5.7 mm (the minimum sphenoid sinus ostium height) distance upward from the choana, but determining the height of the sphenoid sinus ostium preoperatively on CTs for each patient separately will increase the chance of success in probing the sphenoid sinus.

Pulmonary artery embolism due to a ruptured hepatic hydatid cyst: clinical and radiologic imaging findings.

Hydatid pulmonary embolism is an uncommon condition resulting from the rupture of a hydatid heart cyst or the opening of a visceral hydatid cyst into the venous circulation. We report a rare case with multiple intra-arterial pulmonary hydatid cyst emboli originating from a hepatic hydatid cyst ruptured into the hepatic segment of the inferior vena cava. We present the ultrasonography findings of hepatic hydatid cyst and multidetector computed tomography pulmonary angiography images demonstrating both multiple hydatid cyst emboli and their hepatic origin.

Yttrium-90 (Y-90) resin microsphere therapy for patients with unresectable hepatocellular carcinoma. Identification of successful treatment response predictors and patient selection.

AIM: Selective intraarterial radionuclide therapy (SIRT) with Yttrium-90 (Y-90) resin microspheres has been applied for hepatocellular carcinoma (HCC) lately. The aim of this study is to present our clinical experience of radiomicrosphere therapy in the treatment of unresectable HCC and determine the proper cases who could benefit from this therapy according to response results yielded by initial staging and control imaging modalities. METHODS: We administered 43 Y-90 microsphere therapy to 34 patients with unresectable HCC (twice in 9 patients). Patients with histopathologically confirmed HCC having a life expectancy of ≥3 months; Child A-B, Okuda stage 1-2 and BCLC stage A-B-C classifications were included in the study. The patients were divided into two groups: Group A consisted of 29 patients who responded to Y-90 therapy (complete response, partial response and stable disease), Group B 5 of non-responders (progressive disease). Predefined parameters were evaluated for response to SIRT and compared between two groups. RESULTS: We found a significant decrease in platelet and lymphocyte counts one month after therapy (p=0.02, p=0.01, respectively). On control imaging tests performed 3 months later, we observed complete response in 19% (n=6), partial response in 44% (n=15), stable disease in 25% (n=8) and progressive diease in 12% (n=5) of the patients. Mean overall survival (OS) was 19 (median value: 14) months. CONCLUSIONS: Y-90 microsphere therapy is a safe and effective treatment option for the patients with unresectable HCC without any serious side effect. Mean tumor dose delivery and lack of bilobar disease seem the best predictors for treatment success. KEY WORDS: Selective intraarterial Radionuclide therapy, Yttrium-90, hepatocellular carcinoma.

Renal agenesis in a child with ipsilateral hemihypertrophy.

Hemihypertrophy is a clinical condition defined as an asymmetric enlargement of one side of the body. Inguinal hernias, renal cysts, cryptorchidism, ectasias of collecting tubes, medullary sponge kidney and horse-shoe kidney are examples of abnormalities associated with hemihypertrophy that have been described in the literature. We report here a 17.2-year-old patient with a left hemihypertrophy and renal agenesis with contralateral right compensatory renal hypertrophy together with normal renal function and blood pressure in the absence of proteinuria. He also presented with faint macular hyperpigmented skin lesions on his left upper arm, forehead and abdomen. To the best of our knowledge, this is the first report of renal agenesis and hemihypertrophy in the same patient. Hemihypertrophy can be seen as a component of Klippel-Trenaunay-Weber syndrome. The other components of this syndrome are varicose veins, skin naevus and arteriovenous malformations. Although renal agenesis, hemihypertrophy and hyperpigmented macular skin lesions (skin naevuses) may be incidental findings, together they may form a variant of Klippel-Trenaunay-Weber syndrome, as in our case.

Yttrium-90 (Y-90) Resin Microsphere Therapy for Patients with Unresectable Hepatocellular Carcinoma: a Single-Center Experience.

BACKGROUND/AIM: Selective intraarterial radionuclide therapy (SIRT) with yttrium-90 (Y-90) resin microspheres presently has successful results in primary or metastatic inoperable liver tumors. This procedure, which is also known as radioembolisation, delivers high doses of radiation selectively to hepatic tumors while minimum healthy liver exposure. The aim of this study was to present our clinical experience of radiomicrosphere therapy for the treatment of patients with unresectable hepatocellular carcinoma (HCC). METHODS: We performed 40 Y-90 microsphere therapies in 28 patients (5 females, 23 males; mean age ± SD 48 ± 8) with HCC during the period from April 2008 through December 2016. Pretreatment Tc-99m microaggregated albumin (MAA) scintigraphy was performed to all patients in order to detect eligibility for SIRT. All patients had pre- and post-biochemical tests (hemogram and serologic tests) and imaging methods (CT or MRI or PET/CT) at regular intervals to detect any possible complication and determine response rates. RESULTS: The mean shunting to the lungs on MAA scan was 6.5% and the mean ± SD administered dose of Y-90 was 1.55 ± 0.32 GBq in all patients. The estimated doses to the target tumors, normal liver parenchyma and lungs were 105.7 ± 55.3, 25.5 ± 8.2 and 5.8 ± 1.7 Gy, respectively. No significant complication was observed during or early after (first week) the treatment procedure and it was well tolerated by all the patients. Only one patient developed a treatment-related gastroduodenal ulcer 3 weeks after the treatment. In control imaging tests (MRI or FDG PET/CT) performed 2.5 months after the treatment, we observed complete response in 2 (7%) patients, partial response in 10 (36%) patients, stable disease in 5 (18%) patients and progressive disease in 11 (39%) patients. CONCLUSION: According to our clinical experience, we can conclude that Y-90 microsphere therapy is a safe and effective treatment option for the patients with unresectable HCC without any serious side effects.

Gadolinium-enhanced 3D MR angiography of pulmonary hypoplasia and aplasia.

OBJECTIVE: The goal of this study was to determine the role of gadolinium-enhanced 3D MR angiography (MRA) in patients with suspected pulmonary hypoplasia and aplasia in a retrospective analysis of MRA and digital subtraction angiography in 11 patients with clinical and/or radiologic suspicion of pulmonary hypoplasia and aplasia. CONCLUSION: Gadolinium-enhanced 3D MRA is capable of diagnosing pulmonary hypoplasia and aplasia rapidly and accurately. Both pulmonary hypoplasia and aplasia can be shown morphologically in a noninvasive manner, obviating digital subtraction angiography.

Complete currarino syndrome recognized in adulthood.

Currarino syndrome is a hereditary pathology that is characterized by sacrococcygeal bone defect, presacral mass, and anorectal malformation. Sacrococcygeal bone defect is almost always a part of the syndrome. The complete form of this entity displays all three abnormalities and is very uncommon. In this report, we present the magnetic resonance imaging findings of a case with complete form of Currarino syndrome recognized in adulthood.