Low vitamin D levels are associated with increased risk for fatty liver disease among non-obese adults.

Recent data have revealed an inverse relationship between insulin resistance, which is associated with fatty liver disease, and blood 25-hydroxy-vitamin D (25(OH)D) levels. The aim of the present study was to determine the association of vitamin D levels with the presence and stage of fatty liver disease among non-obese subjects and to determine the effect of vitamin D status on fatty liver disease development. A total of 613 non-obese (body mass index <30 kg/m(2)) gastroenterology and internal medicine outpatients (472 women and 141 men) were enrolled in the study. The patients' laboratory values, including liver function tests, lipid profiles, C-reactive protein, fasting blood glucose, insulin, calcium and 25(OH)D levels were studied. Low vitamin D levels, higher triglyceride levels and higher alanine aminotransferase levels were found to be the significant determinants for non-alcoholic fatty liver disease. When the patients were evaluated as low or normal vitamin D groups, low vitamin D levels was determined to be a risk factor for fatty liver disease, with an odds ratio of -1.59 (confidence interval -1.22 to -1.97). The increased risk for fatty liver disease among patients with low vitamin D status may be suggestive of mechanisms promoting fat flow and accumulation in the liver. Molecular studies are warranted to elucidate the action of vitamin D on the liver with respect to fat metabolism.

Pregnancy-like (pseudolactational) hyperplasia: uncommon cause of microcalcifications and mass in two cases.

Pregnancy-like (pseudolactational) hyperplasia (PLH) is an uncommon lactational change occurring independently from pregnancy and lactation. PLH has been incidentally found during breast biopsies. We report two different cases of PLH with their clinical, radiologic, and pathologic findings.

Two foreign body reactions caused by suture materials: mammograms mimic cancer as a spiculated lesion.

A spiculated breast lesion on mammogram is highly suggestive of malignancy. However, it can be seen on rare occasions in benign conditions including foreign body associated granuloma. We describe two foreign body reactions in the breast caused by suture materials and describe the clinical, radiological and pathological features.

Primary appendicealtumors: clinical imaging and pathological findings. Report of four cases.

Primary appendiceal tumors are rare clinical and radiological entities. We report 4cases including muscinous cystadenoma associated with pseudomyxoma peritonei, muscinous cystadenoma associated with mucocele, low-grade muscinous neoplasia associated with appendicitis in elderly patients, and carcinoid tumor associated with appendicitis in a young adult.

Diagnostic value of renal resistive index for the assessment of renal colic.

INTRODUCTION: The aim of this study was to investigate the value of renal resistive index (RI) for the assessment of renal colic and to determine whether it is predictive of renal stone disease. METHODS: A total of 70 participants were included in the research study. Group 1 comprised 43 patients with acute unilateral ureteral obstruction due to a stone disease (G1), while Group 2 consisted of seven patients with flank pain without stone disease (G2) and the control group comprised 20 healthy individuals with two normal kidneys (G3). Urinalysis, abdominal plain film radiography, conventional ultrasonography (US) and colour Doppler US were performed in all three groups. RI was calculated for all patients using Doppler US. The RI values in G1 were then compared with those in G2 and the control group. RESULTS: There were statistically significant differences in the RI between the stone-positive group and stone-free groups (0.71 +/- 0.07 for G1; 0.69 +/- 0.06 for G2; 0.62 +/- 0.03 for G3, p-value < 0.05). CONCLUSION: RI measurement using Doppler US can be effectively used for the assessment of renal colic patients by non-invasive means.

Ocular pulse amplitude and retrobulbar blood flow change in dipper and non-dipper individuals.

PURPOSE: To evaluate ocular pulse amplitude (OPA), IOP values, and hemodynamic changes in the ophthalmic artery, central retinal artery, and short posterior ciliary artery in dipper and non-dipper patients. METHODS: A total of 59 right eye measurements of healthy subjects with normotensive were included to the study. Ambulatory blood pressure (BP) monitoring measurement (ABPM), Doppler imaging, and OPA measurements were performed in the same day. The patients in which systolic BP decreased during the nocturnal time by 10% of the diurnal BP or more were called dippers. A patient whose nocturnal systolic BP fell by <10% or even rose was defined as non-dipper. Color Doppler imaging was used for blood flow velocity assessment of ophthalmic, central retinal, and posterior ciliary arteries. For each artery, peak systolic and end-diastolic velocities (PSV and EDV, respectively), resistive index (RI), and pulsalite index (PI) were automatically calculated by the machine. Mean IOP and OPA values were calculated after three consecutive measurements. RESULTS: The mean OPA in non-dipper patients was significantly lower compared with that of dipper patients (P=0.011). There was no significant difference in IOP levels between groups. There was no significant difference in the PSV, EDV, RI, and PI in the ophthalmic, posterior ciliary, and central retinal arteries between the groups. CONCLUSION: Our study demonstrated that OPA level in non-dippers is lower than dippers. This may give additional information about the effect of BP changes on OPA values.

Relationship between cerebral arterial pulsatility and carotid intima media thickness in diabetic and non-diabetic patients with non-alcoholic fatty liver disease.

Non-alcoholic fatty liver disease (NAFLD) is considered a risk factor for atherosclerosis. The aim of the present study was to investigate the association of the pulsatility index (PI) of basilar artery (BA) and carotid intima media thickness (IMT) in diabetic and non-diabetic NAFLD patients. We compared a group of 80 stroke-free, diabetic and non-diabetic NAFLD patients and a control group of 26 healthy subjects without NAFLD. We then evaluated the PI of the BA by transcranial Doppler ultrasonography, and carotid IMT. The PI was significantly higher in diabetic NAFLD patients than in controls (p<0.003). Carotid IMT and asymmetrical dimethylarginine (ADMA) levels were higher in NAFLD patients than controls respectively (p<0.003, p<0.04). The PI of the BA was significantly correlated with age (R=0.369, p<0.001), male gender (R=0.207, p=0.035), diabetes (R=0.332, p=0.001), carotid IMT (R=0.296, p=0.002) and ADMA (R=0.349, p=0.015). A multiple regression analysis was performed with PI as the dependent variable with known clinical risk factors. Age (beta=3.54, p<0.001), diabetes (beta=2.32, p=0.022), gender (beta=2.20, p<0.03), ADMA (beta=2.25, p<0.031), and carotid IMT (beta=2.41, p<0.017), were independent predictive factors of BA PI. Adjustment for age and gender did not alter these relative risks, exhibiting a significant independent contribution to PI. The increased PI observed in this study represents enhanced cerebrovascular resistance, and we observed that the age, male gender, diabetes, ADMA levels, and carotid IMT were independent predictive factors of BA PI.

Usefulness of virtual colonoscopy in the diagnosis of symptomatic large colonic lipomas.

Lipomas of the colon are uncommon tumour of the gastrointestinal tract, but cause diagnostic difficulty when they are symptomatic. We reported two cases of symptomatic, large colonic lipoma. Colonoscopy was incomplete because of the narrowing lumen caused by lipomas. By the help of computed tomography colonography/virtual colonoscopy, colonic lipomas were diagnosed correctly, but also proximal colon was examined.

Nephrolithiasis associated with ceftriaxone therapy: a prospective study in 51 children.

BACKGROUND: Ceftriaxone, a third generation cephalosporin, is widely used for treating infection during childhood. The kidneys eliminate approximately 33-67% of this agent, and the remainder is eliminated via the biliary system. Ceftriaxone may bind with calcium ions and form insoluble precipitate leading to biliary pseudolithiasis. The aim of this study was to assess whether ceftriaxone associated nephrolithiasis develops by the same mechanism, and whether this condition is dose related. METHODS: The study involved 51 children with various infections. Of these, 24 were hospitalized with severe infection and received 100 mg/kg/day ceftriaxone divided into two equal intravenous doses. The other 27 patients received a single daily intramuscular injection of 50 mg/kg/day. Serum and urine parameters were evaluated before and after treatment, and abdominal ultrasonographic examinations were also carried out before and after treatment. RESULTS: Serum urea, creatinine, and calcium levels were normal in all patients before and after treatment. Post-treatment ultrasound identified nephrolithiasis in four (7.8%) of the 51 subjects. The stones were all of small size (2 mm). Comparison of the groups with and without nephrolithiasis revealed no significant differences with respect to age, sex distribution, duration of treatment, or dose/route of administration of ceftriaxone. The renal stones disappeared spontaneously in three of the four cases, but were still present in one patient 7 months after ceftriaxone treatment. CONCLUSIONS: Conclusions: The study showed that children taking a 7 day course of normal or high dose ceftriaxone may develop small sized asymptomatic renal stones. The overall incidence of nephrolithiasis in this study was 7.8%.

Growth of the fetal lens and orbit.

OBJECTIVES: To present normal lens and orbital measurement ranges by gestational age. METHODS: Three hundred and thirty-five women with uneventful pregnancies were evaluated from the 15th to the 40th week of gestation. Lens and orbital measurements were added to routine biometric measurements for normal fetuses. RESULTS: A strong linear correlation was observed between gestational age (GA) and lens diameter (R(2)=0.89; P<0.0001), circumference (R(2)=0.89; P<0.0001), and surface (R(2)=0.90; P<0.0001). A linear correlation was also found between GA and orbital diameter (R(2)=0.92; P<0.0001), circumference (R(2)=0.92; P<0.0001) and surface (R(2)=0.95; P<0.0001). A linear growth function was observed between biparietal diameter and both lens diameter (R(2)=0.90; P<0.0001) and orbital diameter (R(2)=0.94; P<0.0001). CONCLUSION: Lens and orbital measurements provide normative data for fetal growth and development. These data may be also helpful in detecting fetal ocular anomalies.

Nasopharyngeal tuberculosis.

Isolated nasopharyngeal tuberculosis is a rare disease. It has been reported as cases in recent years. An incidentally found case without any nasal or otological symptoms is presented.