The relationship between ultrasonographically measured testicular volumes and cord blood inhibin B concentrations in healthy term male neonates.

Serum inhibin B (INHB) concentrations are associated with testicular volumes (TV) in all periods of childhood. The aim of the study was to investigate the relationship between TV measured by ultrasonography (US) and cord blood inhibin B and total testosterone (TT) concentrations, stratified by mode of delivery. In total 90 male infants were included. Testes of healthy, term newborns were evaluated by US on the third day after delivery. TV were calculated using two formulae: The ellipsoid formula [length (mm) × width (mm2) × π/6] and Lambert formula [length (mm) x width (mm) x height (mm) x 0.71]. Cord blood was taken for the determination of total testosterone (TT) and INHB. TT and INHB concentrations were evaluated according to TV percentiles (<10th, 10th-90th, >90th). There was a strong positive correlation between mean TV calculated with both formulae by percentile group (r = 0.777, r = 0.804, r = 0.846; p < 0.001). Cord blood INHB, but not TT were significantly lower in newborns with TV < 10th percentile compared to those with TV between 10 and 90th percentile and > 90th percentile (p < 0.05). There was a positive correlation between left and right TV calculated by either formula, and cord blood INHB (r = 0.212, 0.313, 0.320, 0.246,p < 0.05), not TT. There was no significant difference between hormones and TV when grouped by mode of delivery (p > 0.05). The Lambert and ellipsoid formulas are equally reliable in calculating neonatal testicular by ultrasound. INHB concentration is high in cord blood and positively correlated with neonatal TV. Cord blood INHB concentration may be an indicator for early detection of testicular structure and function disorders in neonates.

Age- and Sex-Related Morphometric Changes and Asymmetry in the Orbito-Zygomatic Region.

ABSTRACT: The aims of this study were to obtain cephalometric data of orbito-zygomatic skeleton using CT axial images and to determine the presence of sexual dimorphism, normal range of facial asymmetry, and the age-related changes.This study used data from 315 CT scan series of skeletally normal subjects (159 males and 156 females) between the ages of 18 to 90. Two different levels of axial sections were used. In total, 11 measurements were performed and 5 of them were bilateral.The mean values and standard deviations were calculated. Gender and age related changes and asymmetry degree were investigated.Mean values of measurements except left medial orbital wall length, right and left medial orbital wall protrusion, right and left lateral orbital wall angle were significantly larger in males for all age groups. Majority of the measurements was formed by the individuals with larger right side. Similar tendencies were observed for craniofacial asymmetry in both sexes and in different age groups. There were no significant craniofacial asymmetries between age and gender groups in terms of the cephalometric measurements. Mid-interorbital distance had a negative correlation (r = -0.11 and P = 0.043) and interzygomatic buttress distance had a positive correlation (r = 0.15 and P = 0.005) with age.Morphological properties such as sexual dimorphism, symmetry, age related changes are important parameters especially for plastic surgery discipline. The authors hope the data can be helpful in diagnosis and surgical treatment of craniofacial diseases, estimating the prognosis and preparation of the facial prosthesis.

Ischemic chiasmal syndrome associated with posterior communicating artery (PCoA) and tuberothalamic artery (TA) infarction: a case report.

Lesions affecting the body of the optic chiasm typically produce bitemporal hemianopia. The blood supply comes from the anterior communicating artery, anterior cerebral, posterior communicating, posterior cerebral, and basilar arteries. We herein report a young patient admitted to the emergency department with acute confusion, left-sided hemiparesis, hemihypoesthesia, and dysarthria. Bitemporal hemianopia was detected after resolution of confusion. On cranial magnetic resonance imaging (MRI), infarction in the right anterolateral thalamus in the territory of tuberothalamic artery (TA) and in posterior chiasma in the territory of the posterior communicating artery (PCoA) was revealed. Cerebral MR angiography showed luminal irregularity of the PCoA. The patient was presented to draw attention to the rare entity ischemic chiasmal syndrome.

Lumbar Disc Herniation, the Association Between Quantitative Sensorial Test and Magnetic Resonance Imaging Findings.

OBJECTIVE: Quantitative sensorial tests (QST) are used for evaluating specific sensorial nerve function. In this study, QST and magnetic resonance imaging (MRI) findings are compared in lumbar disc herniation patients, and the accuracy of QST data was investigated. MATERIAL AND METHODS: Sixty-four patients between 18 and 70 years of age suffering from radicular pain with positive Lasegue's test were included in this study. Specific criteria included complaints due to L5 discopathy. MRI findings were classified according to the Pfirmann grading system, and QST was applied to the L5 dermatoma of both symptomatic and nonsymptomatic legs of all patients. Vibration detection threshold, heat detection threshold, cold detection threshold, and heat pain detection threshold values were obtained, and MRI findings were classified according to the Pfirmann grading system. RESULTS: When we compared the symptomatic and nonsymptomatic legs of participants, there were significant differences by means of all QST parameters (0 = 0.00). In a comparison of the QST and MRI Pfirmann grading systems, there is also a strong parallel statistical correlation between the Pfirmann grade and QST parameters (P < 0.05). CONCLUSIONS: According to the results of our study, QST has an additive effect to MRI for nerve root compression evaluation in the clinical basis, which might enable more sensitive diagnosis and treatment protocol. QST can also be an alternative method for evaluation of nerve root compression in patients who have contraindications for MRI.

Is computed tomography perfusion a useful method for distinguishing between benign and malignant neck masses?

Evaluation of neck masses is frequent in ear, nose, and throat clinics. Successful outcomes associated with neck mass are directly related to rapid diagnosis and accurate treatment for each patient. Late diagnosis of a malignant mass increases the magnitude of morbidity and the rate of mortality of the disease. Although magnetic resonance imaging and computed tomography (CT) examinations are important tools for evaluating head and neck pathologies, they do not allow functional evaluation. For this reason, CT perfusion (CTP) as a method of functional evaluation for distinguishing benign from malignant masses is gaining attention. The utility of CTP for distinguishing between benign and malignant mass lesions was investigated in 35 patients with masses in the neck (11 benign, 24 malignant). CTP was shown to be a useful method for identifying head and neck tumors and blood volume values to enable the differential diagnosis of benign and malignant head and neck tumors.

Symptomatic Spinal Migration of Subarachnoid Hemorrhage due to Ruptured Intradural Vertebral Artery Aneurysm.

A 55-year-old patient was admitted to the hospital with severe acute back pain. Thoracolumbar magnetic resonance (MR) imaging showed hemorrhage in subarachnoidal-subdural space. On cranial MR imaging and MR angiography, an aneurysm was suspected in the V4 segment of the right vertebral artery. Angiography showed a fusiform dissecting aneurysm in the V4 segment of right vertebral artery. The final diagnosis was ruptured V4 segment aneurysm with subsequent symptomatic migration of hemorrhage into the spinal subarachnoidal-subdural space. The patient was treated endovascularly by coil occlusion of both the aneurysm and vertebral artery. This rare cause and possible mechanisms for spinal migration of intracranial hemorrhage after aneurysmal rupture is discussed.

Perfusion CT evaluation in experimentally induced testicular torsion.

INTRODUCTION: In this study, we define the characteristics of perfusion computed tomography (CT) in an experimental model of testicular torsion. METHODS: Twenty male Sprague-Dawley rats were included for the study. Torsion was applied to 10 rats and perfusion CT was performed in the first hour to evaluate the following perfusion parameters: blood flow (BF), blood volume (BV) and time to peak (TTP) values. Detorsion was done for the same rats, and perfusion CT was repeated 2 hours later to evaluate reperfusion. Ten rats were left as part of the control group. RESULTS: There is significant statistical correlation between the BF and BV values in the torsion and control groups (p=0.001 and p=0.001, respectively). There is no statistical correlation of the TTP parameters between the groups. No correlation was found between torsion and detorsion perfusion parameters. CONCLUSION: Perfusion CT can demonstrate the testicular perfusion insult in an experimental model of torsion. Perfusion CT may be an alternative method for diagnosis of torsion in indeterminate cases. Following detorsion an interval of 2 hours is not sufficient for demonstrating luxury perfusion of the testis.

Perfusion CT evaluation in experimentally induced testicular torsion.

INTRODUCTION: In this study, we define the characteristics of perfusion computed tomography (CT) in an experimental model of testicular torsion. METHODS: Twenty male Sprague-Dawley rats were included for the study. Torsion was applied to 10 rats and perfusion CT was performed in the first hour to evaluate the following perfusion parameters: blood flow (BF), blood volume (BV) and time to peak (TTP) values. Detorsion was done for the same rats, and perfusion CT was repeated 2 hours later to evaluate reperfusion. Ten rats were left as part of the control group. RESULTS: There is significant statistical correlation between the BF and BV values in the torsion and control groups (p = 0.001 and p = 0.001, respectively). There is no statistical correlation of the TTP parameters between the groups. No correlation was found between torsion and detorsion perfusion parameters. CONCLUSION: Perfusion CT can demonstrate the testicular perfusion insult in an experimental model of torsion. Perfusion CT may be an alternative method for diagnosis of torsion in indeterminate cases. Following detorsion an interval of 2 hours is not sufficient for demonstrating luxury perfusion of the testis.

No pituitary gland volume change in medication-free depressed patients.

Increased serum cortisol levels and a hyperactive hypothalamo-pituitary-adrenal (HPA) axis have been proposed to play an important role in the pathophysiology of Major Depressive Disorder (MDD). However, there are inconsistent results regarding pituitary gland volume (PGV), which is one of the key elements of the HPA axis evaluated by MRI in depressed patients. In this study, we analyzed the PGV of medication-free moderately depressed MDD patients (N=34) and age and sex matched healthy controls (N=39). PGV did not differ between MDD patients and healthy controls [mean volume+/-S.D.; 0.76+/-0.17 cm3 and 0.75+/-0.14 cm3; ANCOVA, F1,69=1.25 p>0.05; respectively]. Our results confirm that volumetric PGV changes are not crucial for depression pathophysiology among unmedicated, moderately depressed adults.

CT study on morphometry of frontal sinus.

The aim of this study was to determine the prevalence and morphological characteristics of the frontal sinus in an adult population. This study was conducted retrospectively on paranasal CT scans in the axial and coronal planes of 300 cases (123 male and 177 female). The mean age was 40.74 +/- 13.34 (range 20-83). Measurements of the width, height and anteroposterior length for each sinus and total width were obtained from CT scans. Measurements were compared statistically with relation to side and sex. The cases were divided into subgroups according to age for each sex and each measurement parameter was also compared among the subgroups. All measurements tended to be larger on the left side and were significantly larger in males than females. There was a significant difference in the anteroposterior lengths of right and left sides in both males and females and height for males and width for females. In both sexes, the highest values of measurements were usually observed at the 31-40 age group and there was a tendency to decrease with aging. The larger diameters of the left frontal sinus imply that it may be more possibly violated during surgical interventions. Morphometric features differed significantly in the two sexes at different ages and comparison with previous studies presented great regional variability. The size of the frontal sinus was seen to be related to age and sex. The knowledge provided in the present study is useful for some surgical procedures and widens the anthropometric knowledge of humanity.

Inverted papilloma with new bone formation: report of three cases.

BACKGROUND: An inverted papilloma (IP) is a benign sinonasal tumor of ectodermal origin, which is locally aggressive and destructive, tends to recur if incompletely removed, and has significant malignant potential. On CT scan, the appearance of an IP is variable and nonspecific but most commonly it appears to have soft tissue density. The association of IPs and new bone formation is extremely rare; to the best of our knowledge, only one case has been reported in the literature to date. METHODS: We report three cases with existence of bony mass surrounded by polypoid soft tissue diagnosed as IP histopathologically. RESULTS: The nature, shape, and location of the bony mass were not in concordance with trapped bone, with tumoral calcifications, or with osteoma. CONCLUSION: We propose that with regard to the three cases presented here, new bone formation may be associated with IP pathologically. We also believe that additional investigations are required to characterize the pathophysiological mechanisms involved in neoplasm-induced osteogenesis.

Thorax perfusion CT in non-small cell lung cancer.

OBJECTIVES: We aimed to determine the perfusion differences according to the histological type, stage, volume and prognoses in the non-small cell carcinoma by thorax perfusion CT. MATERIALS AND METHODS: Twenty-four non-small cell carcinoma patients were included in the study. Thorax perfusion CT was done to evaluate the tumors in terms of perfusion parameters: blood flow (BF) and time to peak (TTP) values. RESULTS: The total blood flow of the tumor in squamous cell carcinoma was significantly higher than adenocarcinoma (p=0.031). There was no statistical difference between the perfusion parameters and other parameters. CONCLUSIONS: Perfusion CT may help us in evaluating non-small cell carcinomas.

Assessment of symptomatic patients after endoscopic sinus surgery with special reference to the frontal sinus: comparative radiologic analysis.

PURPOSE: To reveal the role of potential risk factors in frontal recess dissection (FRD), middle turbinate resection (MTR), sinonasal polyposis, and extension of disease in postoperative frontal sinus opacification by determining radiologic changes after endoscopic sinus surgery (ESS) in symptomatic cases using computed tomography (CT). STUDY DESIGN: Retrospective analysis of prospectively collected data from symptomatic patients after ESS. METHODS: Postoperative CT scans were taken in all symptomatic patients during their least symptomatic period or after maximal medical therapy. The radiologic findings of each sinus were compared, and the outcome of ESS was statistically evaluated. Furthermore, FRD, MTR, sinonasal polyposis, and extension of disease were analyzed for postoperative frontal sinus opacification. RESULTS: In our study, 101 sinuses of 61 symptomatic patients were examined. A significant improvement in opacification in all sinuses was detected postoperatively. Multivariate analysis of all potential risk factors revealed that postoperative frontal sinus opacification was affected only by sinonasal polyposis (odds ratio [OR] 3.32; 95% confidence interval [CI] 1.04-10.58) and extension of disease (OR 16.93; 95% CI 4.33-66.23). CONCLUSIONS: Our study revealed that surgical procedures such as FRD and/or MTR may not directly affect postoperative frontal sinus opacification. On the contrary, sinonasal polyposis and extension of disease seemed to be the main risk factors of this issue.

A case of mycetoma successfully treated with itraconazole and co-trimoxazole.

A 29-year-old woman with swelling, multiple nodules and discharging sinuses of her right foot is presented. A single nodule on the sole was excised 15 years ago and since then she has had recurrent attacks of swelling and discharging sinuses that improved partially with antibiotics. Magnetic resonance images (MRI) revealed an ill-defined mass predominantly with low signal intensity on T2W images. Within the granulomata, multiple unenhancing foci, with low T1W and T2W signal most likely representing the fungal balls or grains were detected. Histopathological examination revealed large clusters of microorganisms resembling fungal hyphae and bacteria, which were surrounded by mixed inflammatory infiltrate cells and stained positively by PAS and Gomori's methenamine silver stain. As minimal regression was seen on MRI with 4 months' itraconazole (200 mg day(-1)) treatment, co-trimoxazole (160 TMP/800 SMX b.i.d.) was added to treatment. Complete remission was established by MRI examination after 10 months with this combination therapy.

Assessment of mammographic density changes on plain film mammograms in postmenopausal women on hormone replacement therapy.

BACKGROUND & OBJECTIVES: Mammographic screening is an effective tool for the early detection of breast cancer. Hormone replacement therapy (HRT) has been shown to increase mammographic density and thus may hinder early detection of small tumours. We undertook this study to determine and compare the frequency and degree of change in mammographic density in postmenopausal women in HRT using two different methods: the classical Wolfe classification and a new semiquantitative method, which we named as the comparison wheel. METHODS: This study included 285 women, 206 under hormone treatment, and 79 control subjects. All women underwent baseline mammographic study before the beginning of treatment. Mean interval of the follow up mammograms was 16 months. The methods were compared in evaluating the effects of three types of hormone therapies on mammographic density. RESULTS: The frequency of change was only significant in the combined hormone replacement group when Wolfe classification was used. However, the frequency of increase in density (estrogen group 21%, combined therapy group 42%, tibolone group 28%) was markedly higher when the comparison wheel was used. The inter-rater Kappa value was calculated as 0.977 for the first and 0.957 for the second readings of the two radiologists for the comparison wheel, and 0.973 and 0.968 for the Wolfe classification. The intra-rater Kappa values were determined as 0.972 and 0.957 for the first and and 0.963 and 0.926 for the second radiologist for comparison wheel and Wolfe classification respectively. INTERPRETATION & CONCLUSION: Our findings indicate that the estimated increase of mammographic density depends on the selected hormone regimen, as well as the method of evaluation. The comparison wheel is a semiquantitative method of evaluating changes of mammographic density and is sensitive and reproducible with high inter- and intra-rater Kappa values. This method can be used as an alternative for comparison of digital mammographic applications in the future.

Transient left paraduodenal hernia.

A 52-year-old woman with acute deterioration of recurrent abdominal pain was admitted to the hospital. Spiral computed tomography (CT) of abdomen was performed. A left paraduodenal hernia was identified on CT. There was no clinical sign or imaging finding suggesting intestinal obstruction or mesenteric ischemia. She refused surgical intervention since her pain was intermittant and decreasing. On the fifth day of hospitalization the patient's pain resolved completely and the follow-up CT demonstrated regression of the herniation.

Magnetic resonance imaging findings in a case of remitting seronegative symmetrical synovitis with pitting edema.

We describe a case of remitting seronegative symmetrical synovitis with pitting edema (RS3PE syndrome) in a 66-year-old man. This report discusses magnetic resonance imaging findings of RS3PE syndrome and the changes after steroid therapy.