Hypothyroidism and subclinical hypothyroidism are associated with fatty pancreas (Non-Alcoholic Fatty Pancreas Disease).

OBJECTIVES: Increasing visceral fat deposition with raised prevalence of obesity and metabolic syndrome is associated with many adverse conditions, especially cardiovascular diseases and diabetes. Although there are many studies that investigate hepatic steatosis in hypothyroidism and subclinical hypothyroidism, to the best of our knowledge, there is no study investigating its relationship with pancreatic steatosis. In the present study, the purpose was to investigate this relationship. METHODS: Physical and biochemical characteristics of 30 hypothyroid, 30 subclinical hypothyroid, and 30 euthyroid volunteers were recorded in this cross-sectional study. Liver and pancreatic steatosis were evaluated with ultrasonography. RESULTS: It was found that pancreatic steatosis was increased in hypothyroid and subclinical groups when compared to the control group, and hepatic steatosis was increased in the subclinical group when compared to the control group (steatosis; p = 0.002, p = 0.004, p = 0.001, p = 0.002, p = 0.002, p = 0.004). Pancreatic steatosis was positively correlated with age, hepatic steatosis, height, weight, BMI, waist circumference, hip circumference, hemoglobin, Insulin, alanine aminotransferase, Triglyceride, Creatinine, and gamma-glutamyltransferase and was negatively correlated with total cholesterol, high-density lipoproteins. CONCLUSIONS: The prevalence of pancreatic steatosis was found to be increased in hypothyroidism and subclinical hypothyroidism when compared with the euthyroid control group.

Prediction of carcinogenic human papillomavirus types in cervical cancer from multiparametric magnetic resonance images with machine learning-based radiomics models.

PURPOSE: This study aimed to evaluate the potential of machine learning-based models for predicting carcinogenic human papillomavirus (HPV) oncogene types using radiomics features from magnetic resonance imaging (MRI). METHODS: Pre-treatment MRI images of patients with cervical cancer were collected retrospectively. An HPV DNA oncogene analysis was performed based on cervical biopsy specimens. Radiomics features were extracted from contrast-enhanced T1-weighted images (CE-T1) and T2-weighted images (T2WI). A third feature subset was created as a combined group by concatenating the CE-T1 and T2WI subsets. Feature selection was performed using Pearson's correlation coefficient and wrapper- based sequential-feature selection. Two models were built with each feature subset, using support vector machine (SVM) and logistic regression (LR) classifiers. The models were validated using a five-fold cross-validation technique and compared using Wilcoxon's signed rank and Friedman's tests. RESULTS: Forty-one patients were enrolled in the study (26 were positive for carcinogenic HPV oncogenes, and 15 were negative). A total of 851 features were extracted from each imaging sequence. After feature selection, 5, 17, and 20 features remained in the CE-T1, T2WI, and combined groups, respectively. The SVM models showed 83%, 95%, and 95% accuracy scores, and the LR models revealed 83%, 81%, and 92.5% accuracy scores in the CE-T1, T2WI, and combined groups, respectively. The SVM algorithm performed better than the LR algorithm in the T2WI feature subset (P = 0.005), and the feature sets in the T2WI and the combined group performed better than CE-T1 in the SVM model (P = 0.033 and 0.006, respectively). The combined group feature subset performed better than T2WI in the LR model (P = 0.023). CONCLUSION: Machine learning-based radiomics models based on pre-treatment MRI can detect carcinogenic HPV status with discriminative accuracy.

Can stone migration be predicted preoperatively in ureteroscopic lithotripsy?

OBJECTIVE: In our study, we aimed to evaluate the parameters that are effective in predicting the possibility of stone migration during ureteroscopic lithotripsy. PATIENTS AND METHOD: We divided our patients two group whom we applied ureteroscopic lithotripsy. Patients who migrated stones during ureteroscopic manipulation to the 1st group, and the patients who did not migrate stones to the second group were included. We measured the proximal ureter diameters of the patients in both groups on their computed tomography. We compared these values statistically. In addition, we determined a cut-off value for the ureter diameter to predict the possibility of stone migration. RESULT: Especially, ureter diameters of patients with middle and lower ureter stones showed significant differences between groups. Also, stone sizes differed significantly between groups. CONCLUSION: We concluded that the possibility of stone migration is high in patients with a ureter diameter higher than 7.45 mm in the middle and lower ureteric stones. Also, we believe that stone diameter and the surgeon's experience are effective factors in stone migration.

The impact of myasthenia gravis on lower urinary tract functions.

AIM: To assess the functions of the lower urinary tract (LUT) in patients with myasthenia gravis (MG). MATERIALS AND METHODS: A total of 36 patients (18 males and 18 females) with MG and 29 healthy controls were enrolled. Participants completed a 3-day voiding diary and responded to questionnaires "Overactive Bladder Symptom Score" (OABSS) and "International Consultation on Incontinence-Short Form" (ICIQ-SF). All patients underwent uroflowmetry and ultrasonography (US). The data were compared based on the onset of disease and serological status. RESULTS: The most common urinary symptoms were nocturia (80.5%), incontinence (61%) and urgency (47%). OABSS was higher in patients than controls (P = .008). Duration of urinary symptoms was longer, and nocturia was more common in late-onset MG (LOMG) than in early-onset MG (EOMG; P = .029, P = .023). The duration of disease and urinary symptoms statistically increased in ACh-Ab (-) group compared with ACh-Ab (+) group (P = .003, P = .027). Night-time urination frequency significantly increased while daytime voided volume (VV) decreased in LOMG compared with EOMG (P = .003 and P = .01). Residual volume on the US was significantly higher in LOMG than that in EOMG (P = .004). The duration of disease was positively correlated with tQmax and daytime urination frequency (P = .013, r = .48; P = .016, r = .398). A negative association was found between duration of disease and daytime VV (P = .04, r = -.344). CONCLUSION: LUT dysfunction may manifest disease in MG, particularly in late-onset forms. The lack of ACh-Ab seemed to prolong the duration of disease and urinary disturbances.

Diagnostic Value of Real-Time Elastography in Diagnosing Lymph Node Metastasis of Skin Cancer.

Objective The purpose of this study was to examine the diagnostic performance of real-time tissue elastography in detecting lymph node involvement in skin cancers. Methodology We retrospectively analyzed B-mode sonography and real-time elastography (RTE) images of 70 lymph nodes from 34 patients diagnosed with squamous cell carcinoma (SCC) or malignant melanoma (MM). In the B-mode examination, the appearance or loss of the hilar architecture in the lymph node, contour lobulation, and the presence of focal cortical thickening were evaluated. Elastography scores were classified according to the ratio of soft and hard areas across the lymph node on a 4-point scale system. Largely soft lymph nodes were scored as "1" and largely hard lymph nodes were scored as "4". Results When patients with SCC and MM were evaluated together, the sensitivity of elastography was 94%, specificity was 70%, and the accuracy rate was 86% in detecting lymph node involvement. When both tumor groups were evaluated separately, for SCC, the sensitivity of elastography was 90%, specificity was 61%, and the accuracy rate was 80% in detecting lymph node involvement. When the receiver operating characteristic (ROC) curve was taken, the area under the curve (AUC) was 0.78 for SCC. Elastography showed full compliance with pathology in lymph node metastases of MM and the AUC was 1.00. Conclusions Based on our findings, RTE provides important contributions to B-mode ultrasonography (USG) in evaluating lymph node metastases of skin cancers.

Real-time ultrasound elastography for the differentiation of malignant and benign masses in the head and neck.

OBJECTIVES: The objective of this study was to evaluate head and neck masses with real-time elastography to differentiate malignant masses. MATERIALS AND METHODS: Between January 2011 and December 2012, a total of 51 patients with a palpable mass in the neck region were included in this study. Excisional histopathologic data were compared with elastographic results and Doppler ultrasonography. RESULTS: The study group comprised 27 males (52.9%) and 24 females (47.1%) (mean [SD] age, 41.47 [19.59] y; range, 4-80 y). Fourteen masses were malignant (27.5%) and 37 were benign (72.5%). Comparing the elastographic results of benign and malignant masses, elastographic scores of the malignant masses were significantly higher than those of the benign masses (P < 0.005).The elastographic scores were divided into 2 groups: 34 (91.9%) patients with the diagnosis of benign mass had the score of 1 to 2, whereas 9 (64.3%) patients with the diagnosis of malignant cases had the score of 3 to 4. There was a significant difference between the groups (P < 0.005).However, 2 squamous cell carcinomas (28.6%) and 1 lymphoma (8.1%) were diagnosed with an elastographic score of 1 (Table 2). This showed that even an elastographic score of 1 was not enough to issue a diagnosis of benign masses. CONCLUSIONS: With improvements in the device and increased experience, this modality can become a useful tool for the routine use. However, this modality cannot be used for screening to merely provide additional information about the nature of the masses.

Is it necessary to do temporal bone computed tomography of the internal auditory canal in tinnitus with normal hearing?

OBJECTIVE: To investigate the compression of the vestibulocochlear nerve in the etiology of the tinnitus in the normal hearing ears with temporal bone computed tomography scans. METHODS: A prospective nonrandomized study of 30 bilateral tinnitus and 30 normal hearing patients enrolled in this study. RESULTS: A total of 60 patients (ages ranged from 16 to 87) were included. The tinnitus group comprised 11 males and 19 females (mean age 49,50 ± 12,008) and the control group comprised 6 males and 24 females (mean age 39,47 ± 12,544). Regarding the right and left internal acoustic canals measurements (inlet, midcanal, and outlet canal lengths), there were no significant differences between the measurements of the control and tinnitus groups (P > 0.005). There was no narrowness in the internal acoustic canal of the tinnitus group compared with the control group. High-frequency audiometric measurements of the right and left ears tinnitus group at 8000, 9000, 10000, 11200, 12500, 14000, 16000, and 18000 Hz frequencies were significantly lower than the control group thresholds (P < 0.05). There was high-frequency hearing loss in the tinnitus group. CONCLUSION: There were no anatomical differences in the etiology of tinnitus rather than physiological degeneration in the nerves.

The reconstruction of nasal septal perforation with high density porous polyethylene covered with fascia lata: an experimental study on rabbit model.

OBJECTIVES: Evaluation of a new material, high-density porous polyethylene (HDPP), which is covered with fascia lata, for experimental nasal septal perforation closure. METHODS: Twenty New Zealand albino rabbits were included and divided into study and control groups. A lateral incision was made from the lateral aspect of the left nares to the incisura nasomaxillaris. After exposure of the cavum nasi, the nasal mucoperichondrium was elevated bilaterally. A full-thickness 0.5×0.5-cm perforation was created over the septum nasi with a No. 11 surgical blade. A fascia lata graft was used for the study group. The HDPP was covered with fascia lata and placed under the elevated mucosa. HDPP without a fascial covering was used in the control group. Four months after the procedure, magnetic resonance imaging was performed to evaluate resorption of the material. The animals were sacrificed, and the nasal septum was completely removed. Macroscopic and histopathological examinations were performed on the nasal septum. RESULTS: All rabbits had survived after the 4-month period. Macroscopically, nine of 10 (90%) perforations were closed in the fascia lata-covered HDPP group. Histopathological examination of these nine rabbits revealed that the continuity of cartilage was disturbed in the perforation areas. Granulation tissue was inverted in areas in which the cartilage continuity was disturbed. The HDPP had remained intact at the edge of the perforation. In the HDPP group, six of 10 implants were still perforated (60%) and four (40%) were closed. The fascia lata-covered HDPP implant had a significantly higher perforation closure rate than that of the HDPP implant alone (P<0.05). CONCLUSION: In cases of septal perforation, it is better to cover the HDPP implant with fascia lata. This covered implant can be used for the repair of nasal septal perforations. HDPP implants are easy to work with and avoid the increased operative time and morbidity associated with harvesting autografts.