The Relationship of Gastrocnemius-Soleus Muscle Architecture with Balance and Functional Strength in Acute Stroke Patients.

Balance and functional impairment could occur due to the weakness of the gastrocsoleus muscles in acute stroke patients. This study was planned to determine the muscle architecture and its relationship to balance and functional strength functional ability in patients with acute stroke. A cross-sectional analysis of 22 stroke patients (68.59 ± 8.16) was performed in this study. Gastrocnemius muscle thickness and cross-sectional area were significantly greater on the non-paretic than on the paretic sides (p = 0.004, p = 0.005, respectively). Partial correlation analysis showed that soleus muscle thickness and cross-sectional area was significantly correlated with Berg Balance Scale, Single Leg Stance Test, Five Times Sit to Stand Test and Tandem test results in the paretic side (r = 0.49-0.77, p < 0.05). The gastrocnemius muscle thickness of the non-paretic side had a significant relationship with balance (r = 0.45-0.65, p < 0.05). The muscle thickness and cross-sectional area of the soleus muscle on the paretic sides was significantly related with the functional strength and balance after stroke. It may be beneficial to develop clinical assessment and intervention programs focusing on distal plantar flexor muscle groups in order to improve the functional status and balance.

Bilateral Barotraumatic Involvement of the Infraorbital Nerve with Dehiscence and Ectopic Course: A Case Report.

The infraorbital nerve is responsible for the sensory innervation of the lower eyelid, the lateral nose, the cheek, the upper lip, and the maxillary teeth. It passes along the infraorbital canal, which runs superior to the maxillary sinus. Dehiscence of the infraorbital canal and its ectopic course in the maxillary sinus is a rare variation. A nerve with these variations may be affected by pathologies in the maxillary sinus and this may constitute a rare cause of facial pain. In this report, we present the clinical symptoms of a 29-year-old male patient who had an infraorbital nerve with an ectopic course and dehiscence in light of the literature.

Atypical Lipomatous Tumor Originating From the Nasopharynx in a Patient with Chronic Lymphocytic Leukemia.

Atypical lipomatous tumor, also known as well-differentiated liposarcoma, is rare in the head and neck region. The primary and most effective option in the treatment of this malignancy with a good prognosis is excision with clean surgical margins. Therefore, it is important to distinguish this malignancy from lesions that require more aggressive treatment. In this article, we present the case of an atypical lipomatous tumor originating from the nasopharynx and almost completely obstructing the oropharynx in a 38-year-old male patient with chronic lymphocytic leukemia. To the best of our knowledge, this is the first report in the literature of an atypical lipomatous tumor case originating from the nasopharynx.

Coexistence of Adenoid Cystic Carcinoma and Sialolithiasis in Submandibular Gland: Case Report.

Sialolithiasis is the primary cause of swelling in the major salivary glands. The etiopathogenesis is not clear. Adenoid cystic carcinoma is a slow-growing salivary gland malignancy with a poor prognosis. There are only a few cases in the literature reporting the coexistence of sialolithiasis and adenoid cystic carcinoma. In this report, we present a case that was thought to have sialolithiasis in the foreground because of the calcified image on computed tomography, but was diagnosed with adenoid cystic carcinoma after excision, together with a discussion of the relationship between sialolithiasis and carcinogenesis.

Comparison of Medical Treatment Efficiency With Shear Wave Elastography Values of Thrombus in Patients With Lower Extremity Deep Vein Thrombosis.

ABSTRACT: In lower-extremity deep vein thrombosis (DVT), thrombus age is essential for successful treatment. The aim of our study was to compare the shear wave elastography (SWE) values measured before treatment and achieved lumen patency after treatment in lower-extremity DVT patients with total occlusion. Patients diagnosed with DVT in the acute-subacute stage (<4 week) with total thrombosis in lower extremity were included in this prospective study. Shear wave elastography measurements were performed where the thrombus was most prominent and homogeneous. To evaluate patient response to treatment, lumen patency (partial [>25%] or total recanalization) was examined using color Doppler imaging in the first and third months posttreatment. Shear wave elastography values with and without patency were compared using an independent t test. Among 75 patients in this study, at the first-month color Doppler imaging examination, the SWE values were 1.77 ± 0.49 (1.09-3.03) m/s in patients who achieved lumen patency (n = 42) and 2.21 ± 0.54 (1.24-3.36) m/s in those who did not show lumen patency (n = 33). The difference between the groups' mean elastography value was statistically significant ( P < 0.001). At the third-month examination, the SWE values were 1.76 ± 0.46 (1.09-3.03) m/s in patients with lumen patency (n = 55) and 2.52 ± 0.48 (1.74-3.36) in patients without lumen patency (n = 20). The difference between the 2 groups' mean elastography value was statistically significant ( P < 0.001). We concluded that it is more difficult to achieve lumen patency in veins occluded by thrombus with higher elasto values, and endovascular interventional procedures should be considered during the initial treatment of high SWE value thrombosis.

A Rare Case of Laryngeal Osteosarcoma Causing Diagnostic Challenges.

Laryngeal osteosarcomas are extremely rare. They cause diagnostic difficulty for the otolaryngologist and pathologist. Differentiation from sarcomatoid carcinoma is challenging but important, as clinical features and treatment strategies are different. Total laryngectomy is generally the preferred surgical approach for laryngeal osteosarcomas. Since lymph node metastasis is not expected, neck dissection is not needed. In this report, we present a case diagnosed with laryngeal osteosarcoma post the examination of the total laryngectomy specimen of a laryngeal tumor that could not be histopathologically differentiated by punch biopsy.

Quantitative Evaluation of late Gadolinium Enhancement to the Differential Diagnosis of Prostate Cancer and Prostatitis in mpMRI.

OBJECTIVE: To evaluate the late gadolinium enhancement ratio (LGER) quantitatively in late post-contrast images in multiparametric prostate MRI (mpMRI) for the differential diagnosis of chronic prostatitis and prostate cancer (PCa). STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Department of Radiology, Suleyman Demirel University, Isparta, Turkey, from January 2018 to October 2021. METHODOLOGY: The data of 111 patients with a diagnosis of PCa and chronic prostatitis, were retrospectively analysed who underwent mpMRI of the prostate were retrospectively analysed. Histopathological verification was available in 57 of 57 prostate carcinoma patients and 20 of 54 chronic prostatitis cases. The detection of lesions from the images and the correlation of the detected lesions with their histopathological diagnoses were made by the joint decision of two radiologists. The LGER measurements were made independently by both radiologists. Signal intensity (SI) values of the lesions were obtained by placing a hand-drawn ROI on pre-contrast and late post-contrast images. Late enhancement ratio was calculated from the ratio of the difference between the pre- and post-contrast SI values to the pre-contrast SI values. The LGER values obtained were statistically compared between the pathologically proven PCa and chronic prostatitis patient groups. RESULTS: The prostatitis LGER values (103.40 ± 31.54%) were significantly higher than the PCa values (79.71±27.39, p<0.001). The LGER values of lesions with a Gleason score <7 were lower than those of lesions scoring ≥7 (p = 0.004). The LGER values of PI-RADS-3 PCa lesions were lower than those of PI-RADS-4 and PI-RADS-5 (p = 0.002). In the late post-contrast phase, low signal measurements in PI-RADS-3 lesions excluded the presence of prostatitis. CONCLUSION: Late contrast enhancement quantitative SI measurements performed in the late contrast phase of mpMRI may enable the differential diagnosis of PCa/prostatitis and a more accurate evaluation of PI-RADS scores in terms of malignancy. KEY WORDS: Prostate cancer, Prostatitis, Gadolinium, Dynamic contrast-enhanced magnetic resonance imaging.

Cemento-Ossifying Fibroma With Cerebral Involvement.

Cemento-ossifying fibroma (COF) is a rare fibro-osseous tumor. The lesion is most commonly seen in people in the third and fourth decade. There are three variants of ossifying fibroma; juvenile trabecular ossifying fibroma, juvenile psammomatoid ossifying fibroma, and COF. COF is highly cellular and contains a fibrous tissue that has different amounts of calcified tissue. Although histologically benign, it has a significant growth potential.

Effect of intramuscular fat in the thigh muscles on muscle architecture and physical performance in the middle-aged women with knee osteoarthritis.

BACKGROUND: We investigated intramuscular fat (IMF) in quadriceps femoris (QF) and hamstring muscles in the middle-aged women with knee osteoarthritis (KOA). We also examined the relationship between muscular infiltration of QF and hamstring muscles and muscle architecture and physical performance of the women with KOA. METHODS: In this cross-sectional study, 72 women were included. Body muscle and fat mass were measured by BIA, isometric muscle strength was evaluated by hand-held dynamometer. IMF and muscle architecture were calculated from rectus femoris (RF), vastus intermedius (VIM), vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), semitendinosus (ST) and semimembranosus (SM) using B-mode ultrasonography. KOA-related symptoms and functions were assessed with KOOS. The functional performance assessments were evaluated with Stair Climbing Test, 20-Meter Walking Test. RESULTS: Women with KOA had more IMF in RF, VIM, VL, VM and BF, ST, SM muscles compared to the healthy women. Pennation angles decreased as the IMF in the RF, VM, BF and ST decreased. As the IMF of the RF and VM increased isometric knee extensor strength decreased and KOOS symptom score, pain score and ADL score increased in women with KOA. Walking and stair climbing speed deteriorated as the IMF in RF, VIM, VM, BF increased in the middle-aged women. As the IMF in BF increased isometric knee flexor strength decreased and KOOS scores increased. Physical performance scores deteriorated as the IMF in BF increased in middle-aged women with KOA. CONCLUSION: IMF in QF and hamstring muscles were higher in the middle-aged women with KOA group compared with that in the healthy group. Weakness of the QF and hamstring muscles may due to the changes in architectural properties of muscle depending on muscular infiltration. IMF in knee muscles is an important determining factor in performance and physical function of middle-aged women with KOA.

Case Report of a Patient With Posttraumatic Perilymphatic Fistula.

On a perilymphatic fistula, there is an extravasation of the perilymph fluid into the middle ear cavity. Cross-sectional imaging techniques have very important role in evaluation of inner and middle ear structures and temporal bone. While thin section CT scans can show successfully pneumolabyrinth and temporal bone fracture, high-resolution 3D volumetric MRI sequences can help to demonstrate posttraumatic ear effusion and cerebrospinal fluid fistula into inner ear or middle ear.

Artificial Intelligence in Healthcare Competition (TEKNOFEST-2021): Stroke Data Set.

OBJECTIVE: The artificial intelligence competition in healthcare was organized for the first time at the annual aviation, space, and technology festival (TEKNOFEST), Istanbul/Türkiye, in September 2021. In this article, the data set preparation and competition processes were explained in detail; the anonymized and annotated data set is also provided via official website for further research. MATERIALS AND METHODS: Data set recorded over the period covering 2019 and 2020 were centrally screened from the e-Pulse and Teleradiology System of the Republic of Türkiye, Ministry of Health using various codes and filtering criteria. The data set was anonymized. The data set was prepared, pooled, curated, and annotated by 7 radiologists. The training data set was shared with the teams via a dedicated file transfer protocol server, which could be accessed using private usernames and passwords given to the teams under a nondisclosure agreement signed by the representative of each team. RESULTS: The competition consisted of 2 stages. In the first stage, teams were given 192 digital imaging and communications in medicine images that belong to 1 of 3 possible categories namely, hemorrhage, ischemic, or non-stroke. Teams were asked to classify each image as either stroke present or absent. In the second stage of the competition, qualifying 36 teams were given 97 digital imaging and communications in medicine images that contained hemorrhage, ischemia, or both lesions. Among the employed methods, Unet and DeepLabv3 were the most frequently observed ones. CONCLUSION: Artificial intelligence competitions in healthcare offer good opportunities to collect data reflecting various cases and problems. Especially, annotated data set by domain experts is more valuable.

Transoral penetrating upper cervical injury: a case report.

Transoral penetrating foreign body injury of the neck involving the cervical spine is a rare condition. We present an injury caused by transoral penetration of a broken piece of a wooden plank into the neck with injury to the upper cervical spine in a 31-year-old male patient. The foreign body was removed transorally with the patient making a full recovery under close observation and was discharged and followed up with no complications. This paper highlights the types of neck injuries, the key points to be considered in zone III neck injury in light of existing literature and a discussion on the management of these patients.