Tracheobronchial Angle Measurements in Children: An Anthropometric Retrospective Study With Multislice Computed Tomography

Objectives The purpose of this study is to investigate if any change exists in the values of tracheal bifurcation angles (subcarinal angle [SCA] and interbronchial angle [IBA]), right and left bronchial angles (RBA and LBA) in different pediatric age groups. Methods Chest computed tomography (CT) images of children aged 18 years and younger were reviewed retrospectively by two radiologists who were blinded to each other’s measurements. One hundred and eighteen children were involved. RBA, LBA, SCA, and IBA were measured on coronal reformatted images. Subjects were classified into three groups according to their age. Measurement of IBA was done by measuring the angle between the lines drawn along the central axis of right and left main bronchi over their length. RBA and LBA were measured at the intersection points of the lines drawn along the inferior borders of the right and left main bronchi and the line passing through the longitudinal axis of trachea. Sums of RBA and LBA gave SCA. Interobserver agreement was also analyzed. Results SCA, IBA, and RBA values were statistically significant between children of ages less than 10 years and over 10 years P<0.01). Interobserver agreement was excellent with an intraclass correlation coefficient score of 0.87 (95% confidence interval) for RBA, SCA, and IBA measurements. Conclusion We concluded that tracheal bifurcation angles are wider in children of age 10 years and younger. As age increases values of SCA, IBA, and RBA decrease

Efficacy of moderate-intensity walking provided feedback by ECE PEDO on abdominal fat in overweight and obese women: A randomized, exercise study

Objectives: The aim of this study was to investigate the effectiveness of walking with Equipment for Clever Exercise (ECE PEDO) compared to supervised, moderate-intensity, aerobic, treadmill walking exercise in overweight and obese women. Patients and methods: Between September 2014 and January 2015, 28 women with overweight and obesity were assigned to two groups: supervised treadmill walking (Group 1, n=14) or walking with ECE PEDO (Group 2, n=14). The target heart rate (HR) corresponding to values of 50 to 70% VO2max were determined by submaximal treadmill test. Group 1 was instructed walking at their target HR on treadmill. The number of steps in a min corresponding to the target HR was calculated by a criterion pedometer and Group 2 was instructed walking in this step range recorded to the ECE PEDO giving audible feedback. Before and after a 12-week exercise program, all participants were evaluated by Body Mass Index (BMI) and waist circumference (WC). Ultrasonographic visceral fat thickness (VFT) and ergospirometric VO2max. Results: The VFT decreased in both walking groups in association with reduced WC and weight loss and also significant increases in the VO2max after exercise intervention (p&lt;0.05). The VFT decreased only in women by walking with ECE PEDO compared to the other group (p&lt;0.05). Conclusion: Our study results showed that both moderate-intensity exercise provided by a novel pedometer and supervised treadmill walking showed significant improvements in abdominal obesity and VO2max. © 2017 by Turkish Society of Physical Medicine and Rehabilitation

Retroperitoneal bronchogenic cyst originating from diaphragmatic crura

Bronchogenic cyst is a benign lesion which is commonly seen in the posterior mediastinum. Diaphragmatic origin in retroperitoneum is an unusual location for a bronchogenic cyst. Cross-sectional imaging modalities describe the origin and content of the cyst evidently. Magnetic resonance (MR) images of a 42-year-old male patient who attended ER with back pain revealed a huge retroperitoneal complicated bronchogenic cyst arising from the diaphragm and surrounding the abdominal aorta anteriorly. Bronchogenic cysts in the retroperitoneum rarely originate from the diaphragm and should be kept in mind in the differential diagnoses of abdominal cystic lesions. MR imaging (MRI) is superior to other imaging techniques such as computerized tomography (CT) in detecting the origin and content of these cystic lesions. © 2014, Association of Surgeons of India

Huge thymic cyst in an adult

Background: A 28-year-old male smoker (6 pack-years) presented with complaints of dyspnea, cough and chest pain. Physical examination was unremarkable except for decreased respiratory sounds within anterior mid-lung zones bilaterally. Laboratory findings were within normal limits

Relationships among Bone Metabolic Markers, Body Fat Composition and Carotid Intima–Media Thickness in Premenopausal Obese Women

Osteocalcin (OC) is inversely related to body fat distribution and fasting glucose levels. We sought to observe the effect of OC on fat distribution and subclinical atherosclerosis as measured by carotid intima-media thickness (CIMT) in premenopausal obese women. In this prospective observational study, totally, 73 premenopausal obese women (aged 17-55 years) and 53 healthy women (aged 20-50 years) with normal weight were included as controls. Anthropometric measurements, total fat and fat ratio, insulin, fasting blood glucose, and OC levels were estimated. Ultrasonography was used to assess fat distribution, and fat thickness was measured in 4 regions. Subcutaneous fat (SCF), visceral fat (VF), and preperitoneal fat (PPF) thicknesses were considerably higher in obese subjects (p<0.01) than healthy controls, while OC levels were significantly lower. No correlation was observed between OC levels and SCF, VF, or PPF. In a multiple regression analysis, OC was significantly positively associated with SCF (p=0.04, Beta=0.284). No associations were observed between OC levels and VF, PPF, or CIMT. A significant association was observed between parathyroid hormone (PTH) and VF (p=0.021, Beta=0.284), and vitamin D levels were inversely associated with VF (p=0.002, r=−0.366). OC levels were lower in premenopausal obese women than normal-weight healthy controls, but OC exhibited no correlation with VF or PPF, and only a weak positive association with SCF. Additionally, VF was positively correlated with PTH and inversely correlated with vitamin D. These results suggest that OC may be an early indicator of lipid accumulation in te subcutaneous area and development of atherosclerosis

Leptin receptor gene polymorphism may affect subclinical atherosclerosis in patients with acromegaly

Background: Acromegaly is associated with increased morbidity and mortality related to cardiovascular diseases. Leptin (LEP) and Leptin Receptor (LEPR) gene polymorphisms can increase cardiovascular risks. The aim of this study was to investigate association between the frequencies of LEP and LEPR gene polymorphisms and subclinical atherosclerosis in acromegalic patients. Methods: Forty-four acromegalic patients and 30 controls were admitted to study. The polymorphisms were identified by using polymerase chain reaction from peripheral blood samples. The levels of systolic and diastolic blood pressure, BMI, fasting plasma glucose, fasting insulin, IGF-I, GH, IGFBP3, leptin, triglyceride, carotid Intima Media Thickness (cIMT) and HDL and LDL cholesterol concentrations were evaluated. Results: There was statistically significant difference between the LEPR genotypes of acromegalic patients (GG 11.4%, GA 52.3%, and AA 36.4%) and controls (GG 33.3%, GA 50%, and AA 16.7%) although their LEP genotype distribution was similar. In addition, the prevalence of the LEPR gene G and A alleles was significantly different between patients and controls. No significant difference was found among the G(-2548) A leptin genotypes of groups in terms of the clinical parameters. cIMT significantly increased homozygote LEPR GG genotype group compared to AA subjects in patients. But the other parameters were not different between LEPR genotypes groups of patients and controls. Conclusion: It can be said that the LEPR gene polymorphism may affect cIMT in patients. The reason is that LEPR GG genotype carriers may have more risk than other genotypes in the development of subclinical atherosclerosis in acromegaly. © 2016, Avicenna Journal of Medical Biotechnology. All rights reserved

Occurrence of an intrathoracic desmoid tumor following breast cancer treatment: A case report

Desmoid tumors are rarely observed tumors that develop from deep muscle and aponeurotic tissues. They are histologically intermediate, and exhibit a local aggressive course. These tumors have been observed in the abdominal region, and are rarely encountered in the thoracic wall. The most effective treatment appears to be surgery. A 59-year-old female patient was admitted with the complaint of right breast pain and a palpable mass. The patient had undergone a modified radical mastectomy surgical procedure of the right breast due to invasive breast carcinoma 10 years before. A mass with a soft tissue density and a size of 44x22 mm was detected in the thoracic computed tomography of the patient, which subsequently resulted in biopsy followed by surgery. As a result of the pathological examination of the mass, the diagnosis was determined as desmoid tumor. Due to the closeness of the tumor to the surgical margin, the patient was administered radiotherapy and maintenance imatinib treatment was started

Leptin Receptor Gene Polymorphism may Affect Subclinical Atherosclerosis in Patients with Acromegaly

Abstract Background: Acromegaly is associated with increased morbidity and mortality related to cardiovascular diseases. Leptin (LEP) and Leptin Receptor (LEPR) gene polymorphisms can increase cardiovascular risks. The aim of this study was to investigate association between the frequencies of LEP and LEPR gene polymorphisms and subclinical atherosclerosis in acromegalic patients. Methods: Forty-four acromegalic patients and 30 controls were admitted to study. The polymorphisms were identified by using polymerase chain reaction from peripheral blood samples. The levels of systolic and diastolic blood pressure, BMI, fasting plasma glucose, fasting insulin, IGF-I, GH, IGFBP3, leptin, triglyceride, carotid Intima Media Thickness (cIMT) and HDL and LDL cholesterol concentrations were evaluated. Results: There was statistically significant difference between the LEPR genotypes of acromegalic patients (GG 11.4%, GA 52.3%, and AA 36.4%) and controls (GG 33.3%, GA 50%, and AA 16.7%) although their LEP genotype distribution was similar. In addition, the prevalence of the LEPR gene G and A alleles was significantly different between patients and controls. No significant difference was found among the G(-2548) A leptin genotypes of groups in terms of the clinical parameters. cIMT significantly increased homozygote LEPR GG genotype group compared to AA subjects in patients. But the other parameters were not different between LEPR genotypes groups of patients and controls. Conclusion: It can be said that the LEPR gene polymorphism may affect cIMT in patients. The reason is that LEPR GG genotype carriers may have more risk than other genotypes in the development of subclinical atherosclerosis in acromegaly

Relation of age and sex with carotid intima media thickness in healthy children

Background/aim: To investigate the age- and sex-associated carotid intima media thickness (cIMT) changes in healthy children to determine the age- and sex-specific normal range of values for childhood. Materials and methods: This study examined 91 healthy school-age children aged 7-15 years prospectively. Standardized sonographic cIMT measurements and analyses were performed. Body mass index and blood pressure were obtained, and atherosclerotic risk factors were investigated. Age- and sex-specific cIMT measurements for different age groups were calculated and the relation with sex was investigated. Results: Regarding the total study group, mean cIMT measurements for age groups 7-9, 10-12, and 13-15 years were 4.1 ± 0.5 mm, 4.4 ± 0.6 mm, and 4.6 ± 0.4 mm, respectively. cIMT did not differ between boys and girls in the same age group. Age related analyses showed significant variations among the age groups with positive correlation between cIMT and age. Conclusion: Our results suggest that age-related physiologic thickening of the carotid artery intima-media occurs not only in adults but also in children and that sex is not a factor for cIMT differences in childhood. © TÜBİTAK

Low dose helical CT examination in patients with ureteral calculi

Bu çalışmanın amacı, üreter taşına ait primer ve sekonder bulguların saptanmasında, düşük doz tekniği ile uygulanan kontrastsız helikal BT'nin görüntüleme özellikleri ve tanısal duyarlılığının değerlendirilmesidir. Pamukkale Üniversitesi Tıp Fakültesi Radyodiagnostik Anabilim Dalı'nda, Aralık 2004 -Temmuz 2005 tarihleri arasında SDBT incelemelerinde üreter taşı saptanan 33 olguda, 30 mAs/kesit efektif tüp akımı kullanılarak DDBT tetkikleri yapıldı. DDBT sonuçları standart doz verileri ile karşılaştırıldı. DDBT uygulaması ile, olguların abdomen çevresi arttıkça görüntülerdeki gürültü miktarında da artış saptandı. Ancak DDBT'deki görüntü kaliteleri radyolojik değerlendirme için yeterli bulundu. DDBT ile hastaya verilen radyasyon miktarında %82'nin üzerinde azalma elde edildi. SDBT altın standart kabul edilerek yapılan karşılaştırmada, DDBT'nin taşlı üreteri ve taşları tek tek göstermedeki duyarlılığı sırasıyla %94.6 ve %92.9 bulundu. Taşları tanımlamada ve taşa bağlı sekonder bulguları göstermede de SDBT ile DDBT arasında istatistiksel fark saptanmadı. Üreter taşına bağlı akut renal kolik hastalarında, taşa ait primer ve sekonder bulguları yüksek duyarlılıkta tanımlayabilen kontrastsız düşük doz helikal BT incelemesi, hasta radyasyon dozunu ciddi oranda azaltması nedeniyle, özellikle genç hasta grubunda ve tekrarlanan tetkiklerde ilk tercih edilmesi gereken yöntem olmalıdır.The aim of this study is to evaluate the imaging properties and diagnostic sensitivity of low dose unenhanced CT technique in detecting primary and secondary signs of ureteral calculi. In Pamukkale University Faculty of Medicine Department of Radiology, 33 patients with ureteral calculi on SDCT underwent LDCT at effective tube current of 30 mAs/slice, between December 2004 - July 2005. The results from LDCT were compared with the data of standard dose. As the abdominal circumferences of the patients increase, an increase in noise was also detected on LDCT. However, imaging quality of LDCT was good enough for radiological evaluation. A decrease of more than 82 % in radiation exposure to the patients was obtained with LDCT. Accepting the SDCT as gold standard, the sensitivity of LDCT in showing the ureters with calculi and the calculus itself were 94.6 % and 92.9 %, respectively. There was no statistical difference between SDCT and LDCT in depicting the calculi and the secondary signs related to the calculi. Low dose unenhanced helical CT can describe the primary and secondary signs with high sensitivity in acute renal colic patients with ureteral calculi. Since it decreases the radiation exposure significantly, LDCT should be the first choice of imaging method, particularly in young patients and those who need multiple CT examinations for new stone formations