Comparison of tomographic kidney volumes measured by semiautomatic segmentation method with scintigraphic split renal function in predicting posttransplant kidney functions.

INTRODUCTION: In this study, it was aimed to compare scintigraphic split renal function (SRF) and computed tomographic (CT) kidney volumes by semiautomatic segmentation method in predicting graft functions after kidney transplantation. METHODS: One hundred and twelve patients (77 males, 35 females) who had a living-donor kidney transplant between 2015 and 2017 in our centre were included in the study. While SRF was calculated with technetium-99m-diethylenetriaminepentaacetic acid (99m Tc-DTPA) scintigraphy, CT angiography was used for volumetric calculations. RESULTS: CT-volumetric measurements, especially renal cortical volume (RCV: 103.8 ± 20 ml) and ratio to body mass index (RCV/BMI: 4.45 ± 1.3) were found to be more significant than 99m Tc-DTPA-SRF in predicting graft functions. The correlations between SRF and RCV with 6th-month estimated glomerular filtration rate (eGFR) (rSRF: 0.052, rRCV: 0.317, p = 0.041) and 1st-year eGFR (rSRF: 0.104, rRCV: 0.374, p = 0.033) were found to be more significant in favour of RCV. The correlation between SRF/BMI and RCV/BMI with 1st-, 6th- and 12th-month eGFR (respectively, p = 0.02/0.048/0.024) were found to be more significant in favour of RCV/BMI. Although univariate analysis showed a significant relationship between most volumetric measurements and 1st-year graft functions, in multivariate analysis only RCV [odds ratio (OR): 1.04 (1.01-1.07), p = 0.023] and RCV/BMI [OR: 2.5 (1.27-5.39), p = 0.013] showed a significant relationship between graft functions. CONCLUSION: In our study, it was shown that CT-based renal volumetric measurements, especially RCV and RCV/BMI, predicted graft functions more strongly than scintigraphic 99m Tc-DTPA-SRF.

A New Practical Intracerebral Hematoma Volume Calculation Method and Comparison to simple ABC/2.

AIM: To find a more practical and effective formula than simple ABC/2 (sABC/2) to calculate the hematoma volume in patients with subdural and parenchymal haemorrhage. MATERIAL AND METHODS: We reviewed the records of 157 patients who underwent brain computed tomography examinations for stroke from January to October 2017. Our method, sABC/2 formula, and the planimetric method (the gold standard) were used for measuring the volumes of hematoma. RESULTS: The concordance in brain hematoma volumes calculated by sABC/2 and the proposed method as compared to planimetry were 0.92 and 0.93, respectively (p < 0.05). The proposed method calculates the subdural hematoma volumes much better than the conventional one, and the root mean square error (RMSE) values were 32.17 and 20.62 ml for sABC/2 and our new method, respectively, whereas the RMSE values for parenchymal hematomas were 25.01 and 20.46 ml for sABC/2 and our new method, respectively. CONCLUSION: Our new formula for calculating the volume of subdural and parenchymal hematomas is as practical as sABC/2 and allows the clinician to apply the method bedside.

Automated segmentation of the injured kidney due to abdominal trauma.

The objective of this study is to propose and validate a computer-aided segmentation system which performs the automated segmentation of injured kidney in the presence of contusion, peri-, intra-, sub-capsular hematoma, laceration, active extravasation and urine leak due to abdominal trauma. In the present study, total multi-phase CT scans of thirty-seven cases were used; seventeen of them for the development of the method and twenty of them for the validation of the method. The proposed algorithm contains three steps: determination of the kidney mask using Circular Hough Transform, segmentation of the renal parenchyma of the kidney applying the symmetry property to the histogram, and estimation of the kidney volume. The results of the proposed method were compared using various metrics. The kidney quantification led to 92.3 ± 4.2% Dice coefficient, 92.8 ± 7.4%/92.3 ± 5.1% precision/sensitivity, 1.4 ± 0.6 mm/2.0 ± 1.0 mm average surface distance/root-mean-squared error for intact and 87.3 ± 8.4% Dice coefficient, 84.3 ± 13.8%/92.2 ± 3.8% precision/sensitivity and 2.4 ± 2.2 mm/4.0 ± 4.2 mm average surface distance/root-mean-squared error for injured kidneys. The segmentation of the injured kidney was satisfactorily performed in all cases. This method may lead to the automated detection of renal lesions due to abdominal trauma and estimate the intraperitoneal blood amount, which is vital for trauma patients.

Can balneotherapy improve the bowel motility in chronically constipated middle-aged and elderly patients?

Balneotherapy or spa therapy is usually known for different application forms of medicinal waters and its effects on the human body. Our purpose is to demonstrate the effect of balneotherapy on gastrointestinal motility. A total of 35 patients who were treated for osteoarthritis with balneotherapy from November 2013 through March 2015 at our hospital had a consultation at the general surgery for constipation and defecation disorders. Patients followed by constipation scores, short-form health survey (SF-12), and a colonic transit time (CTT) study before and after balneotherapy were included in this study, and the data of the patients were analyzed retrospectively. The constipation score, SF-12 score, and CTT were found statistically significant after balneotherapy (p < 0.05). The results of our study confirm the clinical finding that a 15-day course of balneotherapy with mineral water from a thermal spring (Bursa, Turkey) improves gastrointestinal motility and reduces laxative consumption in the management of constipation in middle-aged and elderly patients, and it is our belief that treatment with thermal mineral water could considerably improve the quality of life of these patients.

Automated segmentation of the injured spleen.

PURPOSE: To develop a novel automated method for segmentation of the injured spleen using morphological properties following abdominal trauma. Average attenuation of a normal spleen in computed tomography (CT) does not vary significantly between subjects. However, in the case of solid organ injury, the shape and attenuation of the spleen on CT may vary depending on the time and severity of the injury. Timely assessment of the severity and extent of the injury is of vital importance in the setting of trauma. METHODS: We developed an automated computer-aided method for segmenting the injured spleen from CT scans of patients who had splenectomy due to abdominal trauma. We used ten subjects to train our computer-aided diagnosis (CAD) method. To validate the CAD method, we used twenty subjects in our testing group. Probabilistic atlases of the spleens were created using manually segmented data from ten CT scans. The organ location was modeled based on the position of the spleen with respect to the left side of the spine followed by the extraction of shape features. We performed the spleen segmentation in three steps. First, we created a mask of the spleen, and then we used this mask to segment the spleen. The third and final step was the estimation of the spleen edges in the presence of an injury such as laceration or hematoma. RESULTS: The traumatized spleens were segmented with a high degree of agreement with the radiologist-drawn contours. The spleen quantification led to [Formula: see text] volume overlap, [Formula: see text] Dice similarity index, [Formula: see text] precision/sensitivity, [Formula: see text] volume estimation error rate, [Formula: see text] average surface distance/root-mean-squared error. CONCLUSIONS: Our CAD method robustly segments the spleen in the presence of morphological changes such as laceration, contusion, pseudoaneurysm, active bleeding, periorgan and parenchymal hematoma, including subcapsular hematoma due to abdominal trauma. CAD of the splenic injury due to abdominal trauma can assist in rapid diagnosis and assessment and guide clinical management. Our segmentation method is a general framework that can be adapted to segment other injured solid abdominal organs.

A rare condition of anorectal dysfunction in a patient with multiple sclerosis: Coexistence of faecal incontinence and mechanical constipation: Report of case.

INTRODUCTION: Multiple sclerosis is a chronic demyelinating neurological disease and causing a variety of neurological symptoms, including discomfort of anorectal function. Constipation and faecal incontinence present as anorectal dysfunction in MS and anal manometry, colonic transit time, electromyography, and defecography can be used for assessment. PRESENTATION OF CASE: We presented a thirty-three years old woman with rare condition of anorectal dysfunction in multiple sclerosis. Anal manometry, defecography were done, and synchronously anal incontinence and mechanical constipation due to rectocele and anismus were detected in this patient. DISCUSSION: Although anal incontinence and constipation are seen often in patients with multiple sclerosis, in the literature, coexistence of animus, rectocele and anal incontinence are quite rare. CONCLUSION: Defecography and anal manometry are useful diagnostic methods for demonstration of anorectal dysfuntions in patients with MS.