Splenic infarction is not rare in granulomatosis with polyangiitis

Splenic involvement is rarely reported in patients with ANCA-associated vasculitides (AAVs), particularly in those with granulomatosis with polyangiitis (GPA) and is in fact considered to be underestimated. We aimed to investigate the frequency of splenic lesions-mainly infarction-and related factors in patients with AAVs. Patients with AAV whose abdominal or thoracic computed tomographies (CTs) were performed at or after diagnosis were included in the study. CT images were examined for splenic lesions. Overall, 69 patients (median age at diagnosis 54 [IQR 24] years; 55% with GPA, 29% with microscopic polyangiitis, and 16% with renal-limited disease) were included in the analysis. Splenic pathologies were detected in 19 (28%) patients; 12/19 (63%) splenomegaly and 7/19 (37%) splenic infarction. All patients with splenic infarction exhibited GPA with PR3-ANCA-positive serology. Three of these seven patients had autosplenectomy. Patients with splenic infarction were younger at diagnosis (p = 0.018) with also significantly higher ear-nose-throat (ENT) (%100 vs 37; p = 0.002) and eye involvement (%50 vs %12; p = 0.044) than patients without splenic infarction. Splenic pathologies are not rare in AAVs. Furthermore, infarction can help separate GPA from MPA. In young patients with GPA, particularly those with ENT and eye involvements, physicians should consider splenic infarction

Computed tomography findings of an unusual maxillary sinus mass: Brown tumor due to tertiary Hyperparathyroidism

Brown tumor is a non-neoplastic bone lesion that develops secondary to hyperparathyroidism and it is very rare in the maxillofacial region. We report the case of a 59-year-old man who presented with pain and a swelling in the left cheek. Computed tomography (CT) demonstrated an expansile and radioluscent lesion in the left maxillary sinus. Incisional biopsy was performed, and the diagnosis was Brown tumor. Brown tumor must be considered in the differential diagnosis of expansile lesions of maxillary sinus

The utility of detecting ovulation to predict success in ovulation induction and intrauterine insemination cycles — a prospective observational study

Objectives: The success of ovulation induction-intrauterine insemination (OI-IUI) procedures may be limited by the absence of ovulation detection. The aim of this study was to evaluate the empirical use of ultrasonography and luteal phase progesterone (P4) as ovulation indicators and determine its effect on pregnancy outcome in OI-IUI cycles. Material and methods: This prospective observational study, which was performed in a university setting, included 107 women with unexplained infertility. Following OI, IUI was performed 36 hours after human chorionic gonadotropin (hCG). P4 was measured 72–96 hours after hCG. At the same time, the appearance of ovaries and signs indicative of ovulation, which are decreased follicle dimensions, irregularity of follicular walls, and the presence of free fluid in the Douglas pouch, were noted. Results: In 58 patients (54.2%), ovulation was detected at the P4 level of > 10 ng/mL. Eighty-nine patients had ultrasound images suggestive of ovulation. However, only 50 of these were confirmed ovulation as indicated using P4. Implantation was observed in a total of 13 patients (12.1%). All patients were in the ovulation detected group with P4 > 10 ng/mL (AUC: 0.750; p = 0.004). P4 of > 21.5 ng/mL detected successful ovulation and was strongly associated with implantation with 77% sensitivity and 61% specificity (OR: 9.9; 95% CI: 2.4–41.2). Body mass index (BMI) > 23.9 kg/m2 was a reliable anovulation indicator as a secondary outcome (AUC: 0.696; p = 0.02). Conclusions: In 45.8% of the patients, ovulation did not occur even with OI treatment. The association of progesterone measurement and ovarian ultrasound scanning between 72 and 96 hours after hCG treatment can be used to detect ovulation. In doing so, we can find the optimal treatment for patients with infertility in their next cycle

Isolated Tympanic Plate Fracture Frequency and Its Relationship to Mandibular Trauma

Purpose: This study evaluated the prevalence of isolated tympanic fractures and their correlation with mandibular fractures by using maxillofacial computed tomography (CT)

Diagnostic value of strain elastography for differentiation between renal cell carcinoma and transitional cell carcinoma of kidney

CAKIR, Volkan/0000-0002-3039-8262WOS: 000377453100014PubMed: 26880174The objective of our study was to prospectively evaluate the diagnostic performance of strain elastography for differentiation between renal cell carcinomas (RCCs) and transitional cell carcinomas (TCCs) of kidney. A total of 99 consecutive patients who were referred to our hospital because of a newly diagnosed solid renal mass suspicious for malignancy on radiological screenings were evaluated with sonography, including strain elastography. Strain elastography was used to compare the stiffness of the renal masses and renal cortex. The ratio of strain in a renal mass and nearby renal cortex was defined as the strain index value. Mean strain index values for RCCs and TCCs were compared, and mean strain index values between histological subtypes of RCC were also compared. Although TCCs were smaller than RCCs (p < 0.001), there were no significant differences in gender distribution and mean age of the patients, and mean probe-tumor distance between RCC and TCC. The mean strain index value +/- SD for TCC (5.18 +/- 1.12) was significantly higher than the value for RCC (4.04 +/- 0.72; p < 0.001). Mean strain index value for papillary cell carcinomas (4.09 +/- 0.45) was slightly higher than that for clear cell carcinomas (3.85 +/- 0.78): however, the difference was not statistically significant (p = 0.51). Strain elastography can be used as a valuable imaging technique for preoperative differentiation between RCC and TCC of kidney

The role of SPIO-enhanced MRI in the detection of malignant liver lesions

The aim of this study was to evaluate the efficacy of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) in the detection of malignant liver tumors. MRI, using fast spin-echo T-2-weighted and gradient-echo T-1-weighted imagings before and after SPIO infusion, was performed in 32 patients with known or suspected hepatic lesions. Statistical analysis was performed using lesion-by-lesion analysis. SPIO-enhanced T-2-weighted MRI showed results comparable to those of unenhanced T-2-weighted MRI in the detection of focal liver lesions. (C) 2006 Elsevier Inc. All rights reserved

Effect of Doxycycline on Aseptic Reperfusion Injury in Ovarian Torsion

Objective: Reperfusion injury occurs when the condition causing ischemia in ovarian torsion is corrected and the blood supply is re-established. The aim of this study is to evaluate whether doxycycline treatment reduces reperfusion injury in a rat model. Study Design: Thirty-five female albino Wistar rats were split into the five groups. Sham: Sham operation; ischemia (I): 2 hours of ischemia; ischemia and reperfusion (I/R): 2 hours of ischemia followed by 2 hours of reperfusion; Sham-Dc: Sham operation and doxycycline 10-mg/kg (2 hours prior to surgery); I/R-Dc: 2-hours of ischemia and doxycycline 10-mg/kg and 2-hours of reperfusion. The groups were compared in terms of histological and biochemical features. A semi-quantitative histological assessment scoring system was used for the histological examination. Follicular cell degeneration, vascular congestion, haemorrhage and inflammatory cell count were evaluated for histological analysis. For biochemical analysis of reperfusion injury, the body's total antioxidant status and total oxidant status were measured using a fully automatic method. The oxidative stress index was calculated by dividing total antioxidant status by total oxidant status. Results: In the sham group the ovaries were histologically normal. Oedema, vascular congestion, bleeding, leukocyte infiltration and follicle degeneration were increased in other groups (p<0.05). There was less leukocyte infiltration in the I/R-Dc group compared to I/R group. Other histological features were similar in these groups. Doxycycline increased the malondialdehyde, total antioxidant and total oxidant status levels in Sham-Dc and I/R-Dc groups. This increase was statistically significant between Sham and Sham-Dc groups. However, although there was an increase in the biochemical markers in the I/R-Dc group, this increase was not significant compared to I/R group. Conclusion: Doxycycline treatment in ovarian torsion does not reduce I/R injury. Doxycycline may even increase reperfusion injury, according to biochemical findings

Predictors of hepatic steatosis in living liver donors

38th Annual Meeting of the European-Association-for-the-Study-of-the-Liver -- MAR 29-APR 01, 2003 -- ISTANBUL, TURKEYWOS: 000182174500505European Assoc Study Live