Evaluating the patients with thalassemia major for long-term endocrinological complications after bone marrow transplantation.

The aim of this study was to evaluate the endocrinological complications of the patients with thalassemia major (TM) who underwent bone marrow transplantation (BMT) and followed-up more than two years in our center, prospectively. "BMT group" consisted of 41 patients with TM. The mean age was 12.4 ± 5.4 years and transplantation age was mean 7.5 ± 4.9 years. Post-BMT follow-up lasted from 24 to 122 months (mean 65.07 months). Also, 32 TM patients with similar age group and same history of transfusion and chelation therapy were recruited for the study as "control (C) group". The weight SDS score after transplantation was found better than before transplantation (p = 0.010). There was a negative correlation between height SDS and BMT age (p = 0.008). The height SDS scores were better in patients whose BMT age was under seven years old compared to those older than seven years old (p = 0.02). Z-scores of femur neck and L2-4 vertebrae DEXA were decreased (p = 0.032, p = 0.0001) and incidence of insulin resistance increased (p = 0.01) in patients with increased BMT age. The risk of gonadal insufficiency was significantly lower in the patients who underwent BMT <7 years of age (p = 0.009). There was no statistically significant relationship between BMT age and complications such as hypothyroidism, hypoparathyroidism, and adrenal insufficiency. The patients with TM should be evaluated for transplantation in early stage of the disease, especially before the age of seven years. Because the BMT cannot correct the endocrinological complications of TM completely, the patients should be followed up regularly after the transplantation.

Incidence of accessory ossicles and sesamoid bones in the feet: a radiographic study of the Turkish subjects.

Most accessory ossicles and sesamoid bones of the ankle and the foot remain asymptomatic; however, they have increasingly been examined in the radiology literature, because they can cause painful syndromes or degenerative changes in response to overuse and trauma. Our aim was to document a detailed investigation on the accessory ossicles and sesamoid bones of Turkish subjects in both the feet according to the sex, frequency and division of the bones, coexistence and bilaterality by radiography. A double-centered study was performed retrospectively to determine the incidence of the accessory ossicles and sesamoid bones in the ankle and foot. Accessory ossicles (21.2%) and sesamoid bones (9.6%) were detected by Radiographs of 984 subjects. The most common accessory ossicles were accessory navicular (11.7%), os peroneum (4.7%), os trigonum (2.3%), os supranaviculare (1.6%), os vesalianum (0.4%), os supratalare (0.2%), os intermetatarseum (0.2%). We observed bipartite hallux sesamoid in 2.7% of radiographs. Interphalangeal sesamoid bone of the hallux was seen in 2% of radiographs. Incidences of metatarsophalangeal sesamoid bones were found as 0.4% in the second digit, 0.2% third digit, 0.1% fourth digit and 4.3% fifth digit. We also identified the coexistencies of two different accessory ossicles as 6%, accessory ossicles and sesamoid bones as 7%, and bipartite sesamoid bones and sesamoid bones as 1.9%. Distribution of the most common accessory ossicles in male and female subjects was similar. We reported the incidence of accessory ossicles and sesamoid bones of the feet in Turkish adult population.

[MR imaging of meniscal tears at low-field (0.35 T) and high-field (1.5 T) MR units]. / Menisküs yirtiklarinin saptanmasinda düsük (0.35 T) ve yüksek (1.5 T) tesla MRG cihazlarinin tanisal degeri.

PURPOSE: To compare the effectivity of low (0.35 T) and high (1.5 T) field magnetic resonance imaging units in detecting meniscal tears. MATERIALS AND METHODS: Forty-eight knee MR imaging examinations performed in low field MR unit and 76 examinations performed in high field unit were retrospectively evaluated. MR results were compared with arthroscopy findings in all patients. RESULTS: For medial meniscus tears, sensitivity, specificity and accuracy values were 93.7%, 87.5% and 91.6%, respectively in the low field unit. For lateral meniscus tears, these values were 87.5%, 95.0% and 93.7%, respectively. In the high field unit (1.5 T), sensitivity, specificity and accuracy for the detection of medial meniscus tears were 96.6%, 88.2% and 94.7%, respectively. For lateral meniscus tears, these values were 71.4%, 98.5% and 96.0%, respectively. There was no statistically significant difference between high and low field units in the detection of medial and lateral meniscus tears. CONCLUSION: We think that low field MR units are as effective as high field units in the evaluation of meniscus tears.