COMPARISON OF COMPUTERIZED TOMOGRAPHIC AND HISTOPATHOLOGICAL ,TUMOR (T) STAGING OF LARYNGEAL CANCERS

Amaç: Larenks kanserlerinde bilgisayarlı tomografi (BT) bulgularının ameliyat sonrası histopatolojik sonuçlarla karşılaştırılması. Gereç ve yöntem: Biopsi ile larenks kanseri tanısı almış yaş ortalaması 54,5 olan, 49'u erkek 52 hasta ameliyat öncesi BT tetkiki ile tümör lokalizasyonu (T) ve derin invazyon (preepiglottik ve paraglottik boşluk, subglottik alan ve kıkırdaklar) yönünden değerlendirildi. Sonuçlar patolojik (p) bakı sonuçları ile karşılaştırıldı. Bulgular: Doğruluk oranı glottik yerleşimli olanlarda %80, supraglottik yerleşimli olanlarda %64, transglottik olanlarda %76 olup, genel doğruluk oranı %73 olarak bulundu. Sonuç: T3 ve T4 evredeki tümörlerde BT evre doğruluk oranı, T1 ve T2 evre tümörlere göre yüksek bulundu. Bu doğruluk oranları literatürdekine paraleldir. Klinik muayeneyle birlikte BT değerlendirilmesi histopatolojik evrelemenin doğruluğunu arttırmaktadır. Objective: We compare the findings of computerized tomographic (CT) imaging with histopathologic results in larengeal cancer. Patients and method: Fifty-two patients (49 males, mean age 54,5) were evaluated preoperatively by CT with regard to localization (T) and deep involvement (preepiglottic space, laryngeal cartilages, paraglottic and subglottic areas). The results were correlated with histopathologic (p) findings. Results: The accuracy of CT were 80% for glottic; 64% for supraglottic, 76% for transglottic region tumors. Overall accuracy was 73%. Conclusion: Histopathologic and CT staging results are highly correlated in T3 and T4 stage tumors than T1 and T2 stage tumors, similar to those in the literature. The accuracy of histopathologic staging enhances by concomitant use of clinical and radiologic findings

A giant deep palmar lipoma presented with compressive neuropathy

Lipomlar, en yaygın benign yumusak doku tümörlerinden biridir. Üst ekstremite sıklıkla yerlesim bölgesi olmakla birlikte, derin palmar yerlesim nadirdir ve saptandıklarında bu düzeyde genellikle çevre dokulara basıya neden olmazlar. 42 yasında kadın olgu, sag el palmar yüzde, karpo-metakarpal bölgede, büyük boyutlarda agrısız yumusak doku sisligi, 1-4. parmaklarda agrı, parestezi, hareketlerde kısıtlılık ve basparmakta güç kaybı sikayetleri ile basvurdu. Ultrasonografide yag içerikli kitle lezyonu saptandı. Manyetik rezonans görüntülemede, derin palmar bölgede, iyi sınırlı, proksimalinde karpal tünele dogru uzanımgösteren, median sinire basıya neden olan 6x5x4 cm boyutlarda lipom saptandı. Klinik bulgu vermesi nedeniyle, operasyon kararı verilen olguda, operasyon ardından klinik sikayetleri geriledi.Lipomas are one of the commonest benign soft tissue tumors. Lipomas are common in upper limbs, but they rarely occur in the deep palm and usually do not compress the surrounding structures when diagnosed. A42 years old female patient presented with a large painless swelling at right palmar metacarpophalengial area, paresthesia and pain of the 1-4. fingers, movement limitation and thumb weakness. Ultrasound examination suggested the swelling to be of fatty nature. MRI showed a well circumscribed soft tissue swelling (6x5x4cm) in the deep palmar, carpal-metacarpal space, pressuring the median nerve. The patient was operated due to the presence of the clinical symptoms and become symptom free after surgery

Magnetic Resonance Sialography Findings of Submandibular Ducts Imaging

Purpose. We aimed to assess the problem solving capability of magnetic resonance sialography (MR sialography), a noninvasive method for imaging submandibular gland ducts and determining duct-related pathologies, by comparing diseased and healthy cases. Materials and Methods. We conducted radiological assessment on a total of 60 submandibular glands (mean age 44.7) in 20 cases and 10 volunteers. MR sialography examinations were conducted with single-shot fast spin-echo sequence by using a surface coil placed on the submandibular gland. Each gland was evaluated in terms of the length, width and stricture of the main duct, as well as the difference between the intraparenchymal duct width, and the main duct width. Statistical analysis was performed. Results. In the MR sialography the primary duct mean length was determined as 51 mm (40–57 mm) in all submandibular glands. On the MR sialography imaging, the visualization ratio of the ductal system of submandibular gland was evaluated in the cases and volunteers. Conclusion. MR sialography is an effective and a noninvasive method in imaging submandibular gland ducts, demonstrating the presence, location and degree of stricture/dilatation, and elucidating the disease etiology

Did radiation exposure increase with chest computed tomography use among different ages during the COVID-19 pandemic? A multi-center study with 42028 chest computed tomography scans

PURPOSETo determine whether radiation exposure increased among different ages with chest computed tomography (CT) use during the coronavirus disease-2019 (COVID-19) pandemic.METHODSPatients with chest CT scans in an 8-month period of the pandemic between March 15, 2020, and November 15, 2020, and the same period of the preceding year were included in the study. Indications of chest CT scans were obtained from the clinical notes and categorized as infectious diseases, neoplastic disorders, trauma, and other diseases. Chest CT scans for infectious diseases during the pandemic were compared with those with the same indications in 2019. The dose-length product values were obtained from the protocol screen individually.RESULTSThe total number of chest CT scans with an indication of infectious disease was 21746 in 2020 and 4318 in 2019. Total radiation exposure increased by 573% with the use of chest CT for infectious indications but decreased by 19% for neoplasia, 12% for trauma, and 43% for other reasons. The mean age of the patients scanned in 2019 was significantly higher than those scanned during the pandemic (64.6 vs. 50.3 years). A striking increase was seen in the 10–59 age group during the pandemic (P < 0.001). The highest increase was seen in the 20–29 age group, being 18.6 fold. One death was recorded per 58 chest CT scans during the pandemic. Chest CT use was substantially higher at the beginning of the pandemic.CONCLUSIONChest CT was excessively used during the COVID-19 pandemic. Young and middle-aged people were exposed more than others. The impact of COVID-19-pandemic-related radiation exposure on public health should be followed carefully in future years

A novel mutation in the glycine decarboxylase gene in patient with non-ketotic hyperglycinemia

Non-ketotic hyperglycinemia (NKH) is a rare inborn error of metabolism and is caused by a glycine cleavage system deficiency. Eighty-five percent of patients present with the neonatal type of NKH, the infants initially develop lethargy, seizures, and episodes of apnea, and most often death. Between 60-90% of cases are caused by mutations in the glycine decarboxylase (GLDC). We believed that more mutation reports especially for rare disease as NKH help to evaluate the genotype-phenotype relationship in patients with GLDC. In this study, we describe a case of a neonate admitted to intensive care unit with hypotonia, respiratory failure, lethargy, poor feeding. Due to the history of 2 non-ketotic hyperglycinemia diagnosed male siblings, molecular prenatal diagnosis in patient was performed and a novel c.2963G>A (Arg998Gln) homozygous mutation within the GLDC gene has been detected. We aimed to contribute to mutation knowledge pool of GLDC gene with a novel mutation