Comparison of anthropometric measurements for prediction of the atherosclerosis and liver histology in young adults with nonalcoholic fatty liver disease.

AIM: Anthropometry is a good evaluation tool that establishes the association between body fat distribution and metabolic risk factors precisely. The aim of this study was to test the association of anthropometric measurements with subclinical atherosclerosis and liver fibrosis. METHODS: A total of 78 patients with nonalcoholic fatty liver disease (NAFLD) patients who had no known cardiovascular disease risk factors and 26 volunteered healthy controls were enrolled. Patients with suspected fatty liver underwent a liver biopsy. BMI, waist circumference (WC), hip circumference, and neck circumference (NC) were measured. To detect the presence of subclinical atherosclerosis, carotid intima-media thickness and carotid-femoral pulse wave velocity (cf-PWV) were examined. RESULTS: NAFLD patients with fibrosis had higher NC, WC, and hip circumference levels, but no difference was observed between NAFLD patients without fibrosis and controls in these parameters. BMI was statistically different among the three groups (P < 0.05). After adjusting for confounding risk factors, the only significant parameter associated with histologic severity of NAFLD was WC, with odds ratio of 1.10. All anthropometric measurements were correlated positively with fibrosis, cf-PWV, and each other. While the association between BMI and cf-PWV remained significant, WC was found to be an independent risk factor for carotid intima-media thickness after adjustment of known cardiovascular risk factors. CONCLUSION: WC is the strongest predictor of liver fibrosis as the anthropometric indexes in patients with NAFLD. NC can be used as an additional useful screening test for the primary evaluation of patients with NAFLD, even if it is not an independent risk factor.

The relation between ankle morphology and osteochondritis dissecans of talus.

The purpose of this study is to describe, if there is, any relation between ankle morphology and development of talus osteochondritis dissecans (OCD) using certain morphological parameters derived from high resolution magnetic resonance imaging (MRI). Study included a total of 93 patients: 26 patients with traumatic medial talus OCD, 30 patients with idiopathic medial talus OCD and 37 patients with normal ankle as the control group. Five MRI morphological parameters (Maximal Tibial Thickness (MTiTh), Malleolar Width (MalW), Length of Trochlea Tali Arc (TaL), Height of Trochlea Tali Arc (TaH) and Angle of Trochlea Tali Inclination (TaIA)) that are expected to be relevant to talus OCD formation are measured and compared for the three groups. Significant difference was found between the idiopathic and the traumatic group in terms of age and gender. Two of five morphologic parameters (MalW and TaL) also showed significant difference for the traumatic and idiopathic group compared to healthy volunteers. Two morphologic parameters that were found to be significantly different from healthy controls may suggest that ankle morphology be a possible factor for talus OCD. Age and gender difference between the traumatic and idiopathic group also may point out different underlying mechanisms for OCD formation.

The association of fatty pancreas with subclinical atherosclerosis in nonalcoholic fatty liver disease.

INTRODUCTION: Ectopic fat accumulation in many tissues has been shown to be a risk factor for developing cardiovascular disease. No study to date has investigated whether fatty pancreas plays a role in the development of subclinical atherosclerosis. We aimed to assess the relationship between fatty pancreas and subclinical atherosclerosis in patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD) and healthy controls. PATIENTS AND METHODS: One hundred patients with biopsy-proven NAFLD and 38 healthy controls were included. Transabdominal ultrasonography examination was performed on all the cases with high-resolution ultrasonography (Acuson S3000) using 6 mHz convex probes. The measurements of carotid intima-media thickness (CIMT) and carotid-femoral pulse wave velocity (cf-PWV) were performed to investigate the relationship between fatty pancreas and atherosclerosis. RESULTS: The rate of newly diagnosed DM and prediabetes in the NAFLD patients was 6 and 21%, respectively. Most of the patients with NAFLD (97%) were found to have an increased echogenicity of the pancreas at ultrasound examination. Grade of fatty pancreas was correlated positively with cf-PWV levels (P<0.05), whereas no correlation was found with CIMT (P>0.05). The presence of fatty pancreas was associated significantly with higher CIMT and cf-PWV levels (P<0.05). The results for cf-PWV and CIMT did not remain significant after adjustment for confounding factors. Although the levels of cf-PWV and CIMT increased with increasing grade of fatty pancreas, there was no significant association. CONCLUSION: We have shown for the first time that fatty pancreas is a contributing factor for the development of atherosclerosis in patients with NAFLD. This study also confirms the strong association between NAFLD and fatty pancreas.

Prognostic Predictors of Fertility in Young Adult Patients With Varicocele: Peak Retrograde Flow Velocity and Reflux Grade.

OBJECTIVES: The purpose of this study was to determine prognostic factors affecting semen parameters in patients with varicocele during the postadolescent period. METHODS: This study was approved by the Institutional Review Board. Between May 2013 and May 2015, we prospectively obtained demographic and sonographic data from postadolescent patients with varicocele. Potential risk factors affecting semen parameters, including age at diagnosis, height, weight, body mass index, varicocele laterality, varicocele grade, left testicular volume, right testicular volume, total testicular volume, testicular atrophy index, testicular volume differential, right and left maximum vein diameters, peak retrograde flow velocity, reflux flow volume, and reflux grade in both supine and standing positions, were recorded. RESULTS: The left peak retrograde flow velocity, reflux flow volume, and reflux grade in the supine and standing positions, left testicular volume, right testicular volume, total testicular volume, and follicle-stimulating hormone level were found to be associated with abnormal semen parameters (P < .05). By multivariate analysis, the follicle-stimulating hormone level was associated with the sperm concentration and morphologic characteristics, and the left peak retrograde flow velocity in the standing position was associated with deterioration of sperm motility and morphologic characteristics. Additionally, the left reflux grade in the standing position was associated with the sperm concentration, and the left testis volume was associated with motility. CONCLUSIONS: The left peak retrograde flow velocity and reflux grade in the standing position were significantly associated with all semen analysis parameters. This finding supports the use of testicular duplex Doppler sonography as a noninvasive tool for evaluation of testicular function in patients with varicocele and helps clinicians determine patients' fertility status.

MRI diagnosis of dural sinus - Cortical venous thrombosis: Immediate post-contrast 3D GRE T1-weighted imaging versus unenhanced MR venography and conventional MR sequences.

OBJECTIVE: Primary aim is to compare the diagnostic value of contrast-enhanced 3D GRE T1-weighted sequences with unenhanced MR venography and conventional magnetic resonance imaging (MRI), in detection of dural venous sinus (DVS) and cortical venous thrombosis; secondary aim is to determine the relationship between DVS thrombosis/site and gender, age, infarction or hemorrhage. METHODS: We retrospectively reviewed conventional MR images, unenhanced MR venography and immediate post-contrast 3D GRE T1-weighted MR images in 30 patients (17 male and 13 female, 21-70 years old, mean age 40.1) with clinically suspected DVS thrombosis. MR examinations had been performed with 1.5T or 3T MR Scanners. DVSs were evaluated in 10 sub-segments, including cortical veins. Each set of MR images were examined separately, blinded to the final diagnosis. Associated findings were also noted and sensitivity, specificity and accuracy of each MRI technique were calculated. RESULTS: Final diagnosis of cortical venous and/or dural sinus thrombosis was established in 24 (80%) of 30 cases and 67 (22.3%) out of 300 segments. For detection of the thrombotic segment, sensitivity, specificity, and accuracy were 83.6%, 95.3%, and 92.7% by conventional MR sequences, 89.6%, 91.8%, and 91.3% by unenhanced MR venography, and 92.5%, 100%, and 98.3% by contrast-enhanced 3D GRE T1-weighted sequence, respectively. Infarction and hemorrhage were more frequent in cases with cortical venous thrombosis, while gender and age had no significant relation with DVS thrombosis or its site. Conventional MR sequences and unenhanced MR venography were helpful due to additional information they provided in some cases with isolated cortical venous thrombosis, with hyperintense thrombus material and with associated hemorrhage or infarction. CONCLUSION: Contrast-enhanced 3D GRE T1-weighted MRI is the most accurate imaging method for the detection of DVS and/or cortical venous thrombosis. Infarction and hemorrhage were more frequent in cases with cortical venous thrombosis.