The Success of Deep Learning Modalities in Evaluating Modic Changes.

BACKGROUND: Modic changes are pathologies that are common in the population and cause low back pain. The aim of the study is to analyze the modic changes detected in magnetic resonance imaging (MRI) using deep learning modalities. METHODS: The sagittal T1, sagittal and axial T2-weighted lumbar MRI images of 307 patients, of which 125 were female and 182 were male, aged 19-86 years, who underwent MRI examination between 2016-2021 were analyzed. Modic changes (MC) were categorized and marked according to signal changes. Our study consists of 2 independent stages: classification and segmentation. The categorized data were first classified using convolutional neural network (CNN) architectures such as DenseNet-121, DenseNet-169, and VGG-19. In the next stage, masks were removed by segmentation using U-Net, which is the CNN architecture, with image processing programs on the marked images. RESULTS: During the classification stage, the success rates for modic type 1, type 2, and type 3 changes were 98%, 96%, 100% in DenseNet-121, 100%, 94%, 100% in DenseNet-169, and 98%, 92%, 97% in VGG-19, respectively. At the segmentation phase, the success rate was 71% with the U-Net architecture. CONCLUSIONS: Evaluation of MRI findings of MC in the etiology of lower back pain with deep learning architectures can significantly reduce the workload of the radiologist by providing ease of diagnosis.

Identification and characterization of long non-coding RNA (lncRNA) in cypermethrin and chlorpyrifos exposed zebrafish (Danio rerio) brain.

Pesticides, such as cypermethrin (CYP) and chlorpyrifos (CPF), are widely used around the world and are known to cause toxicological effects in the brains of fish and other non-target organisms. Long non-coding RNAs (LncRNAs) are a new class of non-coding RNAs that are highly expressed in the brain and play crucial roles in brain function by regulating gene expression. Many studies have investigated the toxic effects of CYP and CPF on the brain. However, no study has been conducted on the relationship between LncRNAs and the toxicity caused by these chemicals. Therefore, this study aimed to determine changes in the lncRNA expression profile in the brains of fish exposed to CYP and CPF. Out of a total of 482 lncRNAs that were differentially expressed between control and CPF groups, 53 were found to be up-regulated, and 429 were down-regulated. Similarly, among the 200 lncRNAs differentially expressed between the control and CYP groups, 71 were up-regulated, and 129 were down-regulated. Additionally, 268 differentially expressed lncRNAs were identified between CYP and CPF groups, with 240 being up-regulated and the rest being down-regulated. In addition, LncRNAs expressed from fish brains exposed to CYP and CPF were found to regulate multiple signaling pathways, including MAPK, FoxO, PPAR, TGF-ß, and Wnt signaling pathways.

Cerebral perfusion in type 2 diabetes mellitus: A preliminary study with MR perfusion.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is associated with altered cerebral vasoreactivity, cognitive impairment, and functional decline. Magnetic Resonance (MR) perfusion can be used to assess cerebral blood flow (CBF). The aim of this study is to analyze the association between diabetes mellitus and cerebral perfusion. METHODS: The study included 52 patients diagnosed with T2DM and 39 healthy individuals. The diabetic patients were classified into three groups (PRP: proliferative retinopathy, NPRP: non-proliferative retinopathy, Non-RP: non-retinopathy DM). The rCBF measurements of cortical gray matter and thalami were carried out using the region of interest. Reference quantitative measurements were performed from ipsilateral white matter. RESULTS: The comparison between the T2DM group and the control group revealed that rCBF values of bilateral frontal lobes, cingulate gyrus, medial temporal lobe, thalami and right occipital lobe were measured to be significantly lower in the T2DM group (p < 0.05). No significant difference was detected between the two groups in terms of rCBF values of the left occipital lobe and anterior aspect of the left temporal lobe (p > 0.05). The rCBF values were lower in the anterior aspect of the right temporal lobe and the difference showed borderline statistical significance (p = 0.058). No significant difference was detected regarding mean rCBF values measured in the regions of cerebral hemispheres among the three patient groups with T2DM (p˃0.05). CONCLUSION: Regional hypoperfusion was encountered in most of the lobes in the T2DM group when compared with the healthy group. However, in terms of rCBF values, there was no significant difference among the three groups with T2DM.

Use of Virtual Touch Tissue Quantification Elastography Technique in Fetal Lung Maturation: A Preliminary Study.

ABSTRACT: This study is an analysis of fetal lung stiffness by virtual touch tissue quantification (VTTQ) elastography to predict fetal lung maturation. Evaluation of fetal lungs was first performed in B mode, and fetal lungs were analyzed at 3 different periods at third trimester in each pregnant woman, at 28 to 31, 32 to 36, and 37 to 41 weeks. Fetal lung elastography was performed at regions with the least acoustic shadow and far from ribs and heart. Each fetal lung assessment were done by taking mean lung stiffness obtained by measuring stiffness of both left and right fetal lungs. T test analysis showed no significant difference in fetal lung stiffness between male and female fetuses among 3 gestational periods. Analysis of variance was performed to evaluate fetal lung stiffness of the fetuses at 3 different gestational periods (28-31, 32-36, and 37-41 weeks). This analysis showed significant difference ( P < 0.01). Duncan multiple comparison analysis did not show significant difference in fetal lung stiffness between 28 and 31 weeks and 32 and 36 weeks, whereas fetal lung stiffness of fetuses at 37 to 41 weeks were significantly greater ( P < 0.01). This study is first step to analyze fetal lung maturation noninvasively using VTTQ elastography technique by measuring fetal lung stiffness.

circRNA-based biomarker candidates for acute cypermethrin and chlorpyrifos toxication in the brain of Zebrafish (Danio rerio).

Circular RNAs (circRNAs) are a new class of non-endogenous coding RNA and an area with a lot of research interest and activity. Cypermethrin and chlorpyrifos have been shown to cause serious toxicological damage in the brain of fish and other non-target organisms. However, circRNAs associated with acute brain toxicity caused by cypermethrin and chlorpyrifos have not been studied yet. In this study, circRNAs were identified and characterized using RNA-seq in Zebrafish brains exposed to acute cypermethrin and chlorpyrifos toxicity. A total of 10,375 circRNAs were detected. It was determined that 6 circRNAs were up-regulated, 10 circRNAs were down-regulated in CYP brain samples compared to controls. In addition, it was found that 57 circRNAs are up-regulated and 3 circRNAs down-regulated in CPF brain samples compared to controls. Moreover, 62 circRNAs were down-regulated in the CYP samples, when CYP and CPF samples were compared. However, up-regulated circRNA could not be detected. It was revealed that the detected circRNAs specifically regulated the MAPK signaling pathway, endocytosis mechanism, apoptosis, and p53 signaling pathway. This study, which was conducted for the first time in terms of the subject of the study, could bring a different perspective, especially to pesticide toxicity studies.

Anterior Cerebral Artery and Anterior Communicating Artery Variations: Assessment with Magnetic Resonance Angiography.

BACKGROUND: Although anterior cerebral artery (ACA) and anterior communicating artery (AcomA) variations have been frequently investigated by contrast-enhanced angiography, the number of studies performed with magnetic resonance angiography is quite low. Our aim in this study is to investigate ACA and AcomA variations with time of flight magnetic resonance angiography (TOF MRA). METHODS: Source and maximum intensity projection images of 581 adult patients (273 males, 308 females) who were scanned for intracranial arteries with the TOF MRA method were retrospectively analyzed. RESULTS: We found the typical configuration rate of the ACA and AcomA complex to be 40.6%. The most common structural anatomic variations out of typical configuration were AcomA aplasia (18.9%) and AcomA hypoplasia (17.9%), respectively. The least frequent variation that we found was duplicated AcomA (0.9%). When we examined gender comparatively, unilateral A1 segment aplasia was found to be higher in males and azygos ACA was found to be higher in females (P = 0.001 and P = 0.029, respectively). CONCLUSIONS: In this study, in which we used the TOF MRA technique, we detected high rates of anatomic variations of ACA and AcomA. This method, which is noninvasive, does not require contrast material and does not contain ionizing radiation, can be preferred especially in the evaluation of patients with kidney disease and contrast allergy.

How does elevated water temperature affect fish brain? (A neurophysiological and experimental study: Assessment of brain derived neurotrophic factor, cFOS, apoptotic genes, heat shock genes, ER-stress genes and oxidative stress genes).

Water temperature is one of the most important environmental factors affecting the growth and survival of fish. Increased water temperature became a global problem and it is estimated that there will be an increase in water temperature due to global climate change. The physiological mechanism for the effects of high water temperature on the fish brain is not fully known. In the present study, fish were exposed to different temperatures (10 °C/15 °C/20 °C/25°) and brain tissues were sampled 2 h-4h-6h-8h per hour respectively and then we investigated transcriptional changes of BDNF, cFOS, apoptotic genes (caspase 3, Bax, Bcl2), heat shock genes (Hsp70 and Hsp 90) ER-Stress genes (grp78, atf6, and ire1) and oxidative stress genes (CAT, SOD, and GPx) and also immunoflourescence changes of BDNF and cFOSin rainbow trout brain. The results indicated that high temperature stress lead to physiological changes in the fish brain by causing a decrease in mRNA expression levels of CAT, SOD, GPx and Bcl2 and by causing an increase in mRNA expression of BDNF, cFOS, apoptotic genes (caspase 3, Bax), heat shock genes (Hsp70 and Hsp 90) ER-Stress genes (grp78, atf6, and ire1). This study will provide important information to elucidate the physiological mechanisms related to the effects of high water temperature on the fish brain.

Evaluation of distal femoral cartilage by B-mode ultrasonography and shear wave elastography in patients with knee osteoarthritis: a preliminary study.

BACKGROUND: Degenerative change in articular cartilage is one of the most important factors in the development of osteoarthritis. Shear wave elastography can be used to identify pathologic cartilage. PURPOSE: To evaluate distal femoral cartilage by shear wave elastography in patients with symptomatic knee osteoarthritis. MATERIAL AND METHODS: Twenty patients with bilateral knee osteoarthritis (study group) and 20 volunteers with the same demographic characteristics but without symptomatic knee pain (control group) were included in the study. A total of 80 knee joints of 40 individuals were evaluated. At the medial, intercondylar, and lateral condylar levels distal femoral cartilage thickness was measured by B-mode ultrasonography and stiffness was measured by shear wave elastography. RESULTS: The medial, intercondylar, and lateral cartilage thickness measurements were similar between the two groups and no statistically significant difference was observed (P = 0.711, P = 0.766, and P = 0.575, respectively). The shear wave velocity values in the medial and intercondylar cartilage were significantly higher in the study group (P = 0.002). Shear wave velocity values measured from lateral cartilage were higher in the study group and the difference between the groups had a borderline statistical significance (P = 0.053). CONCLUSION: Shear wave elastography seems to be a reliable, non-invasive, and acceptable method for the assessment of pathologic cartilage.

Evaluation of Computed Tomography Angiography as an Ancillary Test to Reduce Confusion After Clinical Diagnosis of Brain Death.

BACKGROUND: The diagnosis of brain death (BD) is mainly a clinical diagnosis. Ancillary tests may be used in confusing situations. Although computed tomography angiography (CTA) has high sensitivity and specificity, it can give false-positive results in cases with craniotomy. OBJECTIVE: The aim of this study is to emphasize the importance of accurate and detailed clinical diagnosis and to reveal that there is organ loss as a result of prolonged supportive tests, especially in developing countries. MATERIAL AND METHODS: This retrospective study included patients who were diagnosed with BD in the intensive care unit of Van Yüzüncü Yil University, between September 2014 and August 2017 in Turkey. The study included 14 male and 8 female patients. Patients who did not show any spontaneous respiratory symptoms after the apnea test were diagnosed with clinical BD. Patients on neurodepressant medications who were hypothermic or hypoxic or had a severe endocrine or metabolic disorder were excluded from the study. CTA was used as an ancillary test in compliance with legal requirements. Age, sex, hospitalization days, day of clinical diagnosis of BD, first radiologic evaluation by CTA, clinical diagnosis, and radiologic evaluation were recorded for all patients. RESULTS: Radiologic evaluation was not compatible with the clinical evaluation in 5 patients. Although 2 of these 5 patients had BD diagnosis clinically, blood flow could be expected during CTA because of cranial injury. Unlike in the literature, false positivity was found in 3 patients with hypoxic ischemic encephalopathy in the present study. CONCLUSIONS: Proper management of limited resources and the facilitation of cadaver organ donation in developing countries are important and humanitarian global responsibilities. Revision of the country's legal regulations is important and is warranted in this regard.

Comparison of Efficiencies Between Shear Wave Elastography, Fine-Needle Aspiration Biopsy and American College of Radiology Thyroid Imaging Reporting and Data System Scoring System in Determining the Malignity Potential of Solid Thyroid Nodules.

ABSTRACT: We aimed to evaluate the efficiencies of quantitative shear-wave elastography, fine-needle aspiration (FNA) biopsy and American College of Radiology (ACR)-thyroid imaging reporting and data system (TIRADS) scoring system in determining the malignity potential of solid thyroid nodules. In period between September 2014 and January 2016, 191 solid thyroid nodules of 189 patients were enrolled in this study. The mean shear wave velocities of the nodules were recorded by acoustic radiation force impulse method. All nodules were classified according to ACR-TIRADS scoring system and underwent FNA procedure. The cytopathologic results (after FNA) were benign in nature, atypical-cytology/suspiciously malign and highly suspicious of malignity in 117, 28, and 21 nodules, respectively. The specimen from FNA was insufficient in 25 nodules. Thirty-four nodules of 33 enrolled patients were operated, and the efficiencies of shear wave elastography, FNA, and ACR-TIRADS procedures were statistically analyzed; relying on the histopathologic results, the shear-wave elastography had 83.3% sensitivity, 93.7% specificity (with a cutoff value of 2,74 m/s), the FNA had 94.4% sensitivity, 87.5% specificity, and ACR-TIRADS had 88.2% sensitivity, 94.1 specificity in determining malignant tyroid nodules (P < 0.005). Quantitative shear wave elastography is concluded to be an effective, noninvasive, and practical imaging modality with a lesser sensitivity and specificity values than TIRADS unless a lower sensitivity but a higher specificity values than FNA (93.7% vs 87.5%) in considering the malignity potential of solid thyroid nodules.

HIV-ASSOCIATED NON HODGKIN LYMPHOMA: A CASE SERIES STUDY FROM TURKEY.

BACKGROUND: Human immunodeficiency virus (HIV) is a global health concern with major risks for opportunistic infections and predisposition to malignancies including Kaposi sarcoma associated with Human Herpes Virus-8 (HHV-8) and non-Hodgkin lymphoma (NHL) commonly associated with Epstein Barr Virus (EBV). Although the exact mechanisms of predisposition to certain malignancies are unclear, HIV (+) cancer patients typically have poorer prognosis. MATERIALS AND METHODS: We included all five HIV positive NHL patients receiving antiretroviral therapy (ART) and chemotherapy in our clinic and aim to determine their follow-up outcomes associated with ART. RESULTS: The use of ART in conjunction with chemotherapy regimens lead to better therapeutic outcome in our cases with no mortality over three years of follow-up despite high rates of poor prognostic factors and studies demonstrating 1-year survival rates of approximately 30% in HIV-associated lymphoma. No significant adverse effect has been recorded. CONCLUSION: We recommend use of ART along with chemotherapy regimens in HIV positive lymphoma patients for better treatment response.

Detoxification and reproductive system-related gene expression following exposure to Cu(OH)2 nanopesticide in water flea (Daphnia magna Straus 1820).

The extensive use of copper-based nanopesticides in agriculture has led to their release into the aquatic environment and causes a potential risk to aquatic biota. However, there is a lack of knowledge regarding the possible toxic effect of these nanopesticides on non-target aquatic organisms including invertebrates. Therefore, in this study, effects of commonly used copper-based nanopesticide "Kocide 3000" on gene expression related to detoxification (cyp360a8, gst, P-gp, and hr96) and reproductive system (cut, cyp314, dmrt93, and vtg) in Daphnia magna was investigated through an acute toxicity test. In general, exposure to the nanopesticide caused significant down-regulation of detoxification genes after 24 h and then significant up-regulation after 48 h. Exposure to the nanopesticide, however, significantly induced cut expression after 24 h. Moreover, dmrt93 and vtg genes were up-regulated after 48 h exposure to the nanopesticide. On the other hand, the expression of dmrt93 and vtg down-regulated at high concentration of Cu(OH)2 nanopesticide (1.5 ppm) after 96 h. The results of this study provide first evidence into the crucial role of genes related to detoxification and reproductive system in response to Cu(OH)2 nanopesticide. The use of physiological, biochemical bioassays, as well as gene expression, can help explain the toxic effect of copper-based nanopesticides and provide more insight into the exact mechanism of toxicity in non-target aquatic organisms.

A comparative evaluation of cataract classifications based on shear-wave elastography and B-mode ultrasound findings.

In this study, a comparison is made of the findings of B-mode ultrasound and ultrasound elastography with the Lens Opacities Classification (LOCS) grade in patients with senile cataracts. A total of 74 patients with cataracts and 32 age-matched healthy volunteers as the control group were evaluated in the departments of ophthalmology and radiology between 2016 and 2017. In the patient group, cataracts were graded according to LOCS, and B-mode sonographic appearance and elasticity measurements were recorded, after which the cataract grade and sonoelastography/B-mode ultrasound findings were compared using statistical methods. Among the 74 patients with cataracts, 38 were females (51.4%) and 36 were males (48.6%), and the mean age was 62.05 ± 7.95 (43-78) years. A Chi-square test revealed a significant relationship between ultrasound echogenicity of cataract and grade of cataract (p < 0.005). The ultrasound elastography revealed a mean shear-wave velocity of 2.90 m/s ± 0.371 (2.13-3.53) among patients with grade 3 cataracts, 3.1 m/s ± 0.45 (2.26-3.98) among patients with grade 4, 3 m/s ± 0.58 (2.35-4.60) among patients with grade 5 and 3 m/s ± 0.528 (2.31-4.50) among patients with grade 6 cataracts, and 3 m/s ± 0.258 (2.36-3.58) among the normal subjects. No statistically significant difference was noted in the analysis of variance (p > 0.005). While cataract grade and B mode echogenicity were directly proportional, there was no significant difference in lens elasticity.

The effects on brown trout (Salmo trutta fario) of different concentrations of deltamethrin.

Deltamethrin (DMN) exposure causes severe damage to the gill and liver tissues of aquatic organisms, as well as neurotoxic effects and metabolic disorders. The goal of the present study was to assess the impacts of DMN toxicity on blood biochemistry, malondialdehyde (MDA) levels, catalase (CAT) levels, behavior disorder, acetylcholinesterase (AChE) activity, histopathology and 8-hydroxy-2-deoxyguanosine (8 OHdG) of brown trout (Salmo trutta fario). Acute concentrations (1.0 and 2.0µg/L) of DMN caused behavioral disorder such as rapid swimming, loss of balance, aggressiveness and increasing in the surface activity and inactivity in brown trout. A significant increase in malondialdehyde (MDA), aspartate aminotransferase (AST), alanine aminotransferase (ALT) levels, and a significant decrease in CAT, AChE, blood albumin, and blood total protein content were observed. Histopathologically, both doses of DMN have caused steatosis, necrosis, and degeneration in hepatocytes and hyperemia in the liver. Also, they led to inflammation, adhesion and fusion depending on severe hyperplasia in secondary lamellae, hyperemia and lamellar edema in gill tissues when compared to control group. Additionally, 8-hydroxy-2-deoxyguanosine (8 OHdG) levels at 2.0 µg/L dose of DMN in liver tissues were more severe according to 1.0 µg/L dose of DMN. Finally, different concentrations of DMN led to changes of the histopathology, 8OHdG, the CAT levels, plasma AChE activity, and the serum metabolites, as well as behavioral disorder in brown trout.

Shear-Wave Elastography in the Characterization of Pleural Effusions.

The aim of the study was to investigate the efficacy of shear-wave elastography (SWE) in the differentiation of transudative and exudative pleural effusions. This monocentric study comprised 60 cases (17 transudative, 43 exudative).Transthoracic SWE was performed in 60 cases for whom to use thoracentesis for the pleural fluid analysis was planned. The mean SWE values of each patient were recorded, and the correlation between the biochemical analysis results of pleural fluid after thoracentesis and SWE findings was evaluated. The effusion SWE values and biochemical analysis results were compared. Of the 60 patients who participated in this study, 32 (53.4) were male and 28 (46.6%) were female. The mean ± SD age was 59 ± 17.09 years (range = 21-89 years). Simultaneous serum biochemical analysis was performed for the patients with PE. The mean ± SD shear-wave velocity value of the transudative fluid was calculated 2.29 ± 0.41 (1.6-2.94), whereas the mean ± SD shear-wave velocity value of the exudative pleural fluid was calculated as 3.29 ± 0.63 (2.01-4.88) (P < 0.001). The receiver operating characteristic analysis showed that sensitivity and specificity were found as 91% and 76.5%, respectively, when the cutoff value was selected as 2.52 m/s in the differentiation of the transudative and exudative effusions.Shear-wave elastography may help in the differentiation of transudative and exudative of the pleural effusions.

Shear-wave elastography - virtual touch tissue quantification of fetal placentas with a single umbilical artery.

OBJECTIVE: In this study, we aimed to evaluate the elasticities of fetal placentas with a single umbilical artery using the Virtual Touch Tissue Quantification (VTTQ) technique. MATERIALS AND METHODS: Pregnant women with fetuses with a single umbilical artery (SUA) and pregnant women with fetuses having three vessel cord (3VC) at 18-22 weeks of gestation were enrolled in the research. The placentas were evaluated and divided into three equal parts as the inner 1/3 of the placenta (fetal edge), the outer 1/3 of the placenta (maternal edge) and the central 1/3 of the placenta (central part). Shear-wave velocity (SWV) measurements were used in the elastographic evaluation of placentas by VTTQ. RESULTS: Forty pregnant women were included in the study (n = 20 SUA, n = 20 three vessel cord pregnant women). The placental Acoustic Radiation Force Impulse (VTTQ) of the placenta regarding SWV measurement values of the fetal edge of the placenta in the fetuses with SUA and the control group were 0.876 and 0.957 m/sec, respectively. A significant statistical difference was found between the groups regarding the measurement of the stiffness of fetal placenta (p = 0.021). There was no significant difference between the measured stiffness values of the central or outer region of the placentas. CONCLUSIONS: In this study, we found lower SWV scores for the fetal edge of the placenta with SUA. This finding may reflect tissue elasticity level, and we hope that the use of the VTTQ technique may contribute to predicting the pregnancy-related morbidities of fetuses with SUA in the future.

Usability of Transthoracic Shear Wave Elastography in Differentiation of Subpleural Solid Masses.

In this study, the effectiveness of transthoracic ultrasound elastography in the benign and malign distinction of subpleural/pleural solid lesions was investigated.Between July 2015 and December 2016, 33 consecutive patients with subpleural solid lesions detected via computed tomography (CT) of the thorax were identified and prospectively included in this study. The average for each lesion's shear wave velocity (SWV) value was detected, and benign and malignant lesions' SWV values are statistically compared. The CT and pathology results were used as a reference to compare these values. A receiver operating characteristic analysis was used to determine the cutoff value for benign/malignant neoplasms.The 33 patients (10 female, 23 male) included in the study had a mean age of 56.2 ± 15.40 years (range, 17-84 years), and the mean SWV value of the lesions in 13 (39%) cases evaluated benign after a CT scan, histopathological examination, or both 2.18 ± 0.49 m/s. The mean SWV value of the lesions which were histopathologically diagnosed as malign in 23 (61%) cases was 3.50 ± 0.69 m/s. (P < 0.001). When the cutoff value was set as 2.47 m/s for the SVW value, sensitivity and specificity were determined to be 97.7%.The present study has shown that transthoracic ultrasound shear wave elastography can be an effective radiological examination method in the benign and malign differentiation of subpleural lesions and has the potential for use in the routine clinical application of transthoracic ultrasound elastography, a noninvasive method for evaluating the malignancy potentials of such lesions.

Reliability of testicular stiffness quantification using shear wave elastography in predicting male fertility: a preliminary prospective study.

AIMS: To evaluate the reliability of testicular stiffness quantification using shear wave elastography in predicting the fertility potential of males and for the pre-diagnosis of disorders based upon sperm quantification. MATERIAL AND METHODS: One hundred males between the ages of 19-49 years (mean age of 28.77±6.11), ninety of whom with complaints of infertility, were enrolled in this prospective study. Scrotal grey-scale, Doppler ultrasound (US), and mean testicular shear wave velocity quantifications (SWVQs) were performed. The volumes of testes, as well as the grade of varicocele if present, were recorded. The mean shear wave velocity values (SWVVs) of each testis and a mean testicular SWVV for each patient were calculated. The semen-analyses of patients were consecutively performed. RESULTS: There were significant negative correlations between the mean testicular SWVVs of patients and their sperm counts or the testis volumes (r=-0.399, r=-0.565; p<0.01, respectively). A positive correlation was found between testicular volumes and sperm counts (r=0.491, p<0.01). The cut-off values regarding mean testicular SWVV to distinguish normal sperm count from azoospermia and oligozoospermia were 1.465 m/s (75.0% sensitivity and 75.0% specificity) and 1.328 m/s (64.3% sensitivity and 68.2% specificity), respectively, and the value to distinguish oligozoospermia from azoospermia was 1.528 m/s (66.7% sensitivity, 60.7% specificity). CONCLUSION: The mean testicular SWVQ using the ARFI shear wave technique was a reliable, non-invasive and acceptably stable method for predicting male infertility, especially related to sperm count issues.

Primary Spinal Lymphoma Masquerading as Meningioma: Preoperative and Postoperative Magnetic Resonance Imaging Findings.

A 55-year-old male who complained of frequent back pain accompanied by increasing weakness in the lower extremities was admitted to our hospital's Neurosurgery Department. No additional disease was in his history. Magnetic resonance imaging of the thoracic area, anterior epidural space, and paravertebral area revealed an approximately 55 × 9 mm lymphoma pressuring the spinal cord from the anterior. It was fusiformed with a dural tail, hypointense on sagittal T1-weighted imaging series, and hypointense on sagittal T2-weighted imaging series compared with the spinal cord, showing contrast enhancement. After gadolinium application, an extra-axial mass lesion was detected. The lesion was surgically removed from the patient, whom we thought had meningioma on the basis of radiology. However, histopathology resulted in the diagnosis of diffuse large B-cell non-Hodgkin lymphoma.