Sarcopenic obesity in early breast cancer patients with metabolic syndrome: a cross-sectional study.

Aim: The importance of sarcopenic obesity (SO) in malignancy has recently been recognized. The authors aimed to investigate the clinical and body composition data of early-stage breast cancer (BC) patients by focusing on the components of metabolic syndrome (MetS) and SO. Methods: In this cross-sectional study with early-stage BC patients, the clinical and laboratory results were evaluated for diagnosing MetS. Bioimpedance analysis and muscle radiation attenuation (Hounsfield unit average calculation [HUAC]) using acquired computed tomography images were used to assess SO. Results: The age at diagnosis, BMI, visceral fat ratio, hemoglobin A1c and CEA levels in patients with MetS were significantly higher (p < 0.05). A cutoff value of 39.4 Hounsfield units was significantly related to MetS with 76.5% sensitivity and 62% specificity. The mean HUAC in patients with MetS (36.9) was significantly lower than in those without MetS (41.4; p = 0.017). Conclusion: HUAC value predicted SO in early-stage BC patients with MetS.

Change in the dimensions of the lumbar area muscles after surgery: MRI analysis.

OBJECTIVE: This study aims to assess the change in the dimensions of the lumbar muscles in patients with chronic lower back pain using Magnetic Resonance Imaging (MRI) and to determine pre/post effects of surgery. METHODS: We enrolled 28 individuals (13F/15M; age: 45.39±11.56 years) whose L2-S1 muscle measurements were obtained using MRI, before and at follow-up 6-12 months after surgery. The control group comprising 37 individuals (18F/19M; age: 34.41±10.72 years) who had no lumbar pathology but for whom retrospective archive images were available. In the axial MRI analysis, the cross-sections of m.multifidus, mm.erector spinae and m.psoas major on both sides were measured with the 'closed polygon' technique. RESULTS: The L2-3 and L4-5 levels of the m.multifidus on the right side, the L2-3, L4-5 and L5-S1 levels of the m.multifidus and the L5-S1 levels of the mm. erector spinae on the left side cross-sectional areas were significantly lower than the control group (p<0.05). The right-side m.multifidus and the left-side mm.erector spinae sectional areas were significantly lower than the pre-surgery values at the L5-S1 levels (p<0.05). CONCLUSION: This study demonstrated that chronic lower back pain causes atrophy in the lumbar muscles and established the existence and continuity of atrophy after surgery.

Radiological Imaging of Rare Intracranial Complications Secondary to Otitis Media and Mastoiditis.

Acute otitis media used to cause fatal results because of its intracranial complications before the introduction of potent and effective antibiotics. After the introduction of antibiotics, complications have started to be observed more frequently as a result of chronic otitis media and especially in children. Because clinical findings changed and became indistinct, the diagnosis of otitis and mastoiditis has been made occasionally with imaging findings only after complications occurred. Multidetector computed tomography and magnetic resonance imaging are efficient and sufficient methods in the rapid diagnosis and should be immediately referred methods.

Congenital abnormalities of the ribs: evaluation with multidetector computed tomography.

OBJECTIVE: To evaluate congenital abnormalities of ribs using multidetector computed tomography. METHODS: The retrospective study was conducted at Mustafa Kemal University Research Hospital, Hatay, Turkey and comprised data of patients aged 1-45 years who attended the Radiology Department for computed tomography of the thorax between January 2010 and July 2013. Multiplanar reconstructions, maximum intensity projections, and 3-dimensional images were acquired to investigate numerical and structural abnormalities of the ribs of the patients who underwent multidetector computed tomography for a variety of indications. RESULTS: The study comprised 650 patients. Of them, 231(35.5%) were female and 419(64.5%) male. The overall mean age was 20.9± 5.1years. However, data of 90(13.8%) patients was excluded from cervical rib evaluation and of 120(18.5%) from lumbar rib evaluation as these regions were out of the section because of the positioning. Finally, 560(86.5%) patients were included in the cervical rib evaluations, and 530(81.5%) in the lumbar rib evaluations. All the 650(100%) patients were included in the thoracic rib evaluations. Numerical abnormalities were observed in cervical ribs in 19(3.6%), in thoracic ribs in 1(0.15%) and in lumbar ribs in 7(1.3%) cases. The structural abnormalities were bifid rib in 44(6.7%) and fused type in 17(2.6%) cases. CONCLUSIONS: Multidetector computed tomography enabled evaluation of the thoracic cage as a whole.

Utility of intravaginal ultrasound gel for local staging of cervical carcinoma on MRI.

PURPOSE: The aim of this study is to evaluate the utility of intravaginal ultrasound gel for the staging of cervical carcinoma on magnetic resonance imaging (MRI) and to confirm the results with pathological staging. METHODS: Nine patients were included in the study. T2-weighted images were compared without and with vaginal gel (VG). RESULTS: Five patients were evaluated as overstaged on MRI without VG. After VG, the results were compatible with the pathological stages in all patients. CONCLUSIONS: We suggest that this technique is easy, well tolerated, and effective, and it increases the accuracy rate of MRI staging in early cervical cancer.

Left Inguinal Bladder Hernia that Causes Dilatation in the Ureter.

The scrotal bladder hernia is a rare condition that may present as scrotal swelling and urinary system obstruction or infection symptoms. Diagnosis of this condition before the operation decreases the severe complications like bladder injury during operation. In this article, a 75-year-old man presented to our clinic with right inguinal swelling and lower urinary system infection. Inguinal bladder hernia was diagnosed after performing a computed tomography. The hernia was repaired without any complications.

Association of breast arterial calcification and osteoporosis in Turkish women.

OBJECTIVE: Breast arterial calcification (BAC), medial calcific sclerosis of small to medium-sized muscular arteries, is a benign finding of mammographic evaluation. Previous studies have shown the relationships between BAC and systemic disorders such as cardiovascular disease, diabetes mellitus and hypertension. The aim of this study was to determine the association between reduced bone mineral density and BAC. METHODS: The study population consisted of 567 women who had both mammography and bone mineral density evaluation. BAC (+) and BAC (-) women were compared for age, body mass index, postmenopausal duration, number of deliveries, breastfeeding duration, DM, HT, lipid treatment, osteopenia, and osteoporosis. RESULTS: BAC was seen in mammographic evaluation of 179 women and 388 subjects without BAC accepted as the control group. There was a statistically significant relationship between age, postmenopausal duration, number of deliveries, history of DM, HT, lipid treatment and BAC. While the prevalence of osteopenia was higher in control group (52.8%), the rate of osteoporosis (48.7%) was higher in group with BAC. CONCLUSION: There was statistically significant relationship between BAC and osteoporosis in postmenopausal women. Determination of BAC in routine screening mammography might be helpful in both identifying women with risk of cardiovascular disease and osteoporosis.

A practice report of bladder injuries due to gunshot wounds in Syrian refugees.

BACKGROUND: This study was intended to report our recent experience of bladder injuries due to gunshots in the Syrian conflict and review the literature regarding diagnosis and treatment. METHODS: Twenty-two cases with abdominal and inguinal firearm wounds and bladder ruptures sustained in the Syrian conflict were reported. Age, mechanism/location of damage, associated injuries, Revised Trauma Score (RTS), Injury Severity Score (ISS), Trauma Injury Severity Score (TRISS), and complications were analyzed. The severity of the bladder injuries was classified according to the American Association for the Surgery of Trauma Organ Injury Scaling (AAST-OIS grade ?II database).The type of the bladder rupture was defined according to the classification System for Bladder Injury Based on Findings at CT Cystography. RESULTS: The mean age was 26 years (range, 18-36). The mean ISS was 22 (10-57), mean TRISS was 0.64 (0.004-0.95), and mean RTS was 6.97 (3.30-7.84). In the mortality group, the mean ISS, TRISS, and RTS were 48 (36-57), 0.016 (0.004-0.090), and 4.10 (3.30-4.92), respectively; whereas, the mean ISS, TRISS, and RTS were found as 21 (10-26), 0.64 (0.49-0.95), and 7.24 (5.65-7.84), respectively in the survival group (P=0.06). CT-cystography showed seventeen type 2, three type 4, and two type 5 bladder injuries. According to AAST-OIS, there were nine grade IV, six grade III, five grade II, and two grade V injuries. CONCLUSION: In war settings, when injuries are often severe and multiple surgical exploration and closure are mandatory, mortality risk is associated with high ISS and low TRISS and RTS values.

Pseudoaneurysm of the carotid arterial system.

Pseudoaneurysms of internal, external, and common carotid arteries are seen rarely. Blunt traumas caused by automobile accidents are the prior reasons to this. Central venous catheterization, ballistic trauma, cystic medial necrosis, fibromuscular dysplasia, atherosclerosis, and other inflammatory processes are some other potential reasons for pseudoaneurysm. In contrast to true aneurysms, it does not contain 3-layer structure with adventitia, media, and intima sublayers in its wall. The wall contains coagulum and fibrous capsules. Clinically, after trauma, it presents itself as swelling after days to weeks of damage to vascular walls. Because it causes morbidity and mortality when it is ruptured, It should be treated via surgical or vascular intervention.

Orbital compression syndrome complicated by epidural hematoma and wide cephalohematoma in a patient with sickle cell disease.

Orbital wall infarctions resulting in orbital and epidural hematomas are rare manifestations of sickle cell disease (SCD). We report orbital compression syndrome associated with an epidural hematoma and wide cephalohematoma in a 15-year-old boy with SCD. An infarcted orbital bone was observed on magnetic resonance imaging and three-phase bone scintigraphy with Technetium-99m methylene diphosphonate. The patient recovered completely without surgical intervention at the end of the fourth week. Prompt diagnosis and proper management are critical for complete recovery.

Magnetic resonance imaging findings of the abducens nerves in type 1 Duane's retraction syndrome.

PURPOSE: To investigate nervus abducens and extraocular mucles in patients with Type 1 Duane's retraction syndrome using high-definition magnetic resonance imaging. METHODS: The study included 10 patients with Type I Duane's retraction syndrome who underwent magnetic resonance imaging (MRI) of the brain and orbits. RESULTS: Overall, 10 cases were included in the study. There were seven women and three men. The mean age was 5.2 years (1-15 years). MRI of the abducens nerve was performed in all cases. Of the cases, the left eye was involved in eight cases, whereas the right eye was involved in two cases. There was no bilateral eye involvement. Among the 10 patients clinically diagnosed as Type 1 Duane's retraction syndrome, the abducens nerve could not be visualized in eight cases, whereas the nerve was hypoplastic in one case and bilateral abducens nerves were present in one case by MRI. The extraocular muscles were normal in all cases on T2 weighted coronal MRI of the orbits. CONCLUSION: Absence of abducens nerve and normal extraocular muscles was detected in patients with Type 1 Duane's retraction syndrome at the affected side.