MRI and CT imaging of an intrasphenoidal encephalocele : a case report

Background: Intrasphenoidal encephalocele (ISE) is a rare clinical entity. The incidence of congenital encephalocele is very low. Accurate diagnosis and surgical approach is of critical value. Case Reports: We present a case of intrasphenoidal encephalocele in a 40-year-old man. He complained of cerebrospinal fluid (CSF) rhinorrhea and recurrent meningitis. In images of computed tomography (CT) and magnetic resonance imaging (MRI), intrasphenoidal encephalocele herniating through a defect of the left lateral sphenoid sinus wall was determined. Incisional biopsies were taken by endoscopic transnasal approach and histopathological examination revealed an encephalocele. In the differential diagnosis, ISE can be taken for inflammatory or malignant sinusoidal soft tissue masses. ISE is differentiated from other entities by demonstrating continuity with normal brain tissue. Conclusions: MRI clearly demonstrates that the herniating soft tissue is isointense with brain and continuous with brain tissue via the sphenoid sinus, thereby the treatment decision-making process is very important

Echocardiographic Measurement of Epicardial Adipose Tissue in Obese Children

The echocardiographic measurement of epicardial adipose tissue (EAT) has been suggested as an easy method for evaluation of the visceral adipose tissue and its related cardiovascular risks in adults. However, a direct effect of obesity on cardiac function is not well established, and echocardiographic EAT thickness has not been studied in children. The aims of this study were to evaluate cardiac function and echocardiographic EAT thickness and to correlate EAT with the other echocardiographic findings in obese children. The study population included 106 obese and 62 lean children. Echocardiographic indexes of systolic and diastolic function were obtained. We measured EAT thickness on the free wall of the right ventricle from parasternal long-axis views. The septal and posterior wall thicknesses, relative wall thickness, left atrial diameter, and left ventricular mass were increased (p = 0.001) in obese children. However, systolic and diastolic functions of the left ventricle were normal in the patients. The obese children had a significantly thicker EAT (p = 0.001) compared to the lean subjects. EAT thickness correlated significantly with body mass index (r = 0.50, p = 0.001), left atrial diameter (r = 0.37, p = 0.001), and left ventricular mass (r = 0.33, p = 0.001). In conclusion, the present study demonstrates a close relationship between EAT thickness and obesity in children. Assessment of EAT thickness in routine echocardiographic examinations might be used as a feasible and reliable method for the evaluation of obesity and its related cardiovascular risks during childhood

Sonoelastographic Evaluation Of The Distal Femoral Cartilage In Patients With Anterior Cruciate Ligament Reconstruction

Objectives: This study aims to evaluate sonoelastographic properties of the distal femoral cartilage in patients with anterior cruciate ligament (ACL) reconstruction. Patients and methods: Demographic characteristics and operative data of 28 patients (27 males, 1 female; mean age 31.7 +/- 7.1 years; range 22 to 48 years) with unilateral ACL reconstruction were evaluated. Reconstruction was performed with patellar tendon graft in 22 patients (78.6%) and hamstring tendon graft in six patients (21.4%). Lysholm knee score was used for functional evaluation and chair stand test was used for lower extremity strength. Medial, intercondylar, and lateral distal femoral cartilage thicknesses of operated knees and healthy knees were measured with B-mode ultrasound, while strain ratios were measured with real time sonoelastography. Results: Postoperative mean follow-up duration was 20.4 +/- 9.8 months. Mean Lysholm knee and patient satisfaction scores were 88.0 +/- 8.5 and 8.2 +/- 1.8, respectively. Cartilage thicknesses were similar between operated and healthy knees (all p>0.05). Sonoelastographic strain ratio of medial distal femoral cartilage in operated knees was significantly higher (softer cartilage) (p=0.026). There was a negative correlation between strain ratio difference of medial cartilage of operated knees and lower extremity muscle strength (p=0.009, r=-0.487). Conclusion: While there was no difference for cartilage thickness between operated and healthy knees in B-mode ultrasound evaluation, detection of sonoelastographic strain ratio changes in medial distal femoral cartilage on the operated sides may indicate early structural changes following ACL reconstruction. Further studies are required to highlight the clinical effects of this relationship between the changes in cartilage structure and sonoelastography features.WoSScopu

The Effects of Smoking on Ultrasonographic Thickness and Elastosonographic Strain Ratio Measurements of Distal Femoral Cartilage

Although adverse effects of smoking on bone health are all well known, data on how smoking interacts with cartilage structure in otherwise healthy individuals remains conflicting. Here, we ascertain the effects of cigarette smoking on sonoelastographic properties of distal femoral cartilage in asymptomatic adults. Demographic characteristics and smoking habits (packets/year) of healthy volunteers were recorded. Medial, intercondylar, and lateral distal femoral cartilage thicknesses and strain ratios on the dominant extremity were measured with ultrasonography (US) and real time US elastography. A total of 88 subjects (71 M, 17 F; aged 18–56 years, N = 43 smokers and N = 45 nonsmokers) were evaluated. Mean amount of cigarette smoking was 10.3 ± 8.9 (1–45) packets/year. Medial, intercondylar and lateral cartilage were thicker in smokers than nonsmokers (p = 0.002, p = 0.017, and p = 0.004, respectively). Medial distal femoral cartilage strain ratio was lower in smokers (p = 0.003). The amount of smoking was positively correlated with cartilage thicknesses and negatively correlated with medial cartilage strain ratios (p < 0.05). Femoral cartilage is thicker in smokers but has less strain ratio representing harder cartilage on the medial side. Future studies are needed to understand how these structural changes in the knee cartilage should be interpreted with regard to the development of knee osteoarthritis in smokers.PubMedWoSScopu

Factors associated with left atrial size in obese children: an observational study

Objective: Left atrial size can be considered an independent risk factor for cardiovascular diseases. The measurements of left atrium may be used to assess obesity, which is an important risk factor of cardiovascular diseases. It is aimed to determine the factors that effect to the left atrial size, which is an indicator of cardiac risk in obese children without hypertension