Coeliac trunk and common hepatic artery variations in children: an analysis with computed tomography angiography

Background: Understanding the coeliac trunk (CeT) and hepatic artery anatomy is important not only in preventing iatrogenic injuries but also in planning surgical procedures in children. Therefore, the aim of this study is to analyse the prevalence of CeT and common hepatic artery (CHA) variations in the paediatric population.   Materials and methods: One hundred and seventy-four children who underwent abdominal multidetector computed tomography (MDCT) angiography, either because of trauma or liver transplantation, were analysed retrospectively. The patterns of CeT, CHA and their variant branches were revealed and compared with previous studies involving adults.   Results: A total of 157 (90.2%) of the 174 patients had normal CeT anatomy, whereas 17 (9.8%) had variations. Five types of CeT variations were identified according to Song’s classification in which ‘hepatosplenic trunk + left gastric artery + superior mesenteric artery’ was the most prevalent. One hundred-twelve (64.4%) of the 174 patients had normal CHA anatomy; however, 62 (35.6%) had variations. Six types of CHA variations were identified according to Michel’s and Hiatt’s classification. The most common was ‘replaced left hepatic artery originating from left gastric artery’.   Conclusions: The prevalences of CeT and hepatic artery variations are high in children, as they are in older patients. Awareness of these variations is important in terms of avoiding iatrogenic injury and in promoting surgical procedure planning for liver transplantation or abdominal tumour surgery

Droplet formation in microfluidic T-junction generators operating in the transitional regime. II. Modeling

© APS, Glawdel, T., & Ren, C. L. (2012). Droplet formation in microfluidic T-junction generators operating in the transitional regime. III. Dynamic surfactant effects. Physical Review E, 86(2). https://doi.org/10.1103/PhysRevE.86.026308This is the second part of a two-part study on the generation of droplets at a microfluidic T-junction operating in the transition regime. In the preceding paper [Phys. Rev. E 85, 016322 (2012)], we presented our experimental observations of droplet formation and decomposed the process into three sequential stages defined as the lag, filling, and necking stages. Here we develop a model that describes the performance of microfluidic T-junction generators working in the squeezing to transition regimes where confinement of the droplet dominates the formation process. The model incorporates a detailed geometric description of the drop shape during the formation process combined with a force balance and necking criteria to define the droplet size, production rate, and spacing. The model inherently captures the influence of the intersection geometry, including the channel width ratio and height-to-width ratio, capillary number, and flow ratio, on the performance of the generator. The model is validated by comparing it to speed videos of the formation process for several T-junction geometries across a range of capillary numbers and viscosity ratios

Ovarian functions and polycystic ovary syndrome in adult women with type 1 diabetes mellitus in a Turkish population

Purpose The effect of gonadotropin-releasing hormone agonist (GnRHa) stimulation has not been studied in adult women with type 1 diabetes mellitus (DM). We investigated the baseline and stimulated hormone levels after GnRHa and the frequency and relationship between polycystic ovary syndrome (PCOS) and type 1 DM in adult women with type 1 DM. Methods We included 55 adult women (age, 17-35 years) with type 1 DM and 15 healthy women (age, 20-29 years). Hormones including total testosterone, androstenedione, dehydroepiandrosterone sulphate (DHEAS), follicle-stimulating hormone (FSH), luteinising hormone (LH), estradiol, prolactin, and thyroid-stimulating hormone were measured in the early follicular phase of the menstrual cycle. All participants underwent GnRHa stimulation test, and FSH, LH, estradiol and 17-OHP response levels were measured every 6 h for 24 h. PCOS was diagnosed according to ESHRE/ASRM (Rotterdam) criteria. Results Between patients with type 1 DM and healthy controls, no significant differences were noted in mean age and body mass index (BMI) as well as baseline and stimulated hormone levels after buserelin stimulation, except for baseline serum 17-OHP levels, which was higher in patients with type 1 DM. Polycystic ovary morphology (PCOM) was detected in 14 (25%) patients, clinical hyperandrogenism in 16 (29%), hyperandrogenemia in 25 (45%), anovulatory cycle in 72%, and PCOS in 20 (36%). Conclusion All parameters representing androgen excess disorders, except 17-OHP level, of both groups were similar, and frequencies of PCOS and anovulatory cycle in adult women with type 1 DM were 36% and 72%, respectively

Anti-mullerian hormone (AMH) levels and antral follicle counts (AFC) may predict ovarian reserves before systemic chemotherapy (SC) in women with breast cancer (BC): A prospective clinical study

44th Congress of the European-Society-for-Medical-Oncology (ESMO) -- SEP 27-OCT 01, 2019 -- Barcelona, SPAINucuncu, Muhammed zubeyr/0000-0003-4638-1059;WOS: 000491295501072[No abstract available]European Soc Med Oncol, Japanese Soc Med Onco

Follow-up of chemotherapy induced changes in anti-Mullerian hormone, antral follicle number and ovary volume in premenopausal breast cancer patients

41st Annual Congress of the European-Society-for-Medical-Oncology (ESMO) -- OCT 07-11, 2016 -- Copenhagen, DENMARKWOS: 000393912500202…European Soc Med Onco

The prognostic impact of chemotherapy induced amenorrhea in women treated with early stage breast cancer

42nd European-Society-for-Medical-Oncology Congress (ESMO) -- SEP 08-12, 2017 -- Madrid, SPAINWOS: 000411324000099…European Soc Med Onco

Comparison of total, salivary and calculated free cortisol levels in patients with severe sepsis.

BACKGROUND: The purposes of the study were to compare serum total cortisol (STC), salivary cortisol (SaC) and calculated free cortisol (cFC) levels at baseline and after the adrenocorticotrophic hormone (ACTH) stimulation test in patients with severe sepsis (SS) and determine the suitability of use of SaC and cFC levels instead of STC for the diagnosis of adrenal insufficiency (AI) in patients with SS. And secondary aims of this study were to compare these parameters in patients with SS with healthy controls and check their effects on survival status of the patients. METHODS: Thirty patients with SS (15 men and 15 women) were compared with 16 healthy controls. Low-dose (1 μg) ACTH stimulation test was performed to the patients on the first, seventh and 28th days of diagnosis of SS, but in control group, 1 μg ACTH stimulation test was performed only once. STC, SaC and cFC levels were measured during ACTH stimulation test. RESULTS: Patients were categorized as having low or high baseline STC according to a cut-off level of 10 μg/dL. In high STC group, baseline and peak SaC levels were found to be 2.3 (0.2–9.0) and 3.4 (0.5–17.8) μg/dL on D1 and 1.1 (0.8–4.6) and 2.6 (1.3–2.9) μg/dL on D7, respectively. In the control group, baseline and peak SaC levels were 0.4 (0.1–1.4) and 1.1 (0.4–2.5) μg/dL, respectively. Baseline and peak SaC levels after ACTH stimulation were found to be higher in high STC group than in controls, but they were found to be similar in low STC and control groups. In high STC group, cFC levels were 0.3 (0.1–0.3) and 0.4 (0.3–0.7) μg/dL on D1 and 0.2 (0.1–0.3) and 0.4 (0.1–0.7) μg/dL on D7, respectively. In the control group, baseline and peak cFC levels were 1.7 (0.4–1.9) and 1.8 (1.0–6.6) μg/dL, respectively. cFC levels were found to be lower in patients with SS subgroups than in the control group. Baseline and stimulated STC, SaC and cFC levels did not differ according to the survival status. SaC, cFC and STC levels were found to be correlated with each other. CONCLUSIONS: SS is associated with increased SaC, but decreased cFC levels when baseline STC is assumed to be sufficient. When STC level is assumed to be insufficient, SaC levels remain unchanged, but cFC levels are decreased. Lower STC levels is not associated with increased mortality in patients with SS. More data are needed in order to suggest the use of SaC and cFC instead of STC. TRIAL REGISTRATION: ClinicalTrials.gov No: NCT0258943

Can basal cortisol measurement be an alternative to the insulin tolerance test in the assessment of the hypothalamic-pituitary-adrenal axis before and after pituitary surgery?

Background: The aims of this study were to evaluate the validity of preoperative basal serum cortisol levels measured in predicting preoperative adrenal insufficiency and also the validity of basal serum cortisol levels and early postoperative insulin tolerance test (ITT) in predicting postoperative adrenal insufficiency