A rare cause of congenital portosystemic shunt: type 2 Abernethy malformation

The Abernethy malformation is characterised by congenital extrahepatic portosystemic shunts and is divided into two groups according to the type of anastomosis. In type 1, all portal venous blood is discharged into the inferior vena cava and there is no intrahepatic portal vein. In type 2, the portal vein is partially discharged to the inferior vena cava via side-by-side anastomoses. Imaging has an important role in the diagnosis and follow-up of this malformation. Magnetic resonance imaging should be preferred to demonstrate both vessel anatomy and associated anomalies. The aim of this study was to present a 17-year-old male patient and to discuss the imaging findings of Abernethy malformation

Subvalvular membrane on the left ventricular outflow tract: multidetector computerised tomography imaging

In this report, we describe a patient with a subvalvular membrane on the left ventricular outflow tract. Discrete subvalvular membrane is a cause of left ventricular outflow tract narrowing. Multidetector computerised tomography can demonstrate the anatomical three-dimensional view of this region and guide for surgery. (Folia Morphol 2011; 70, 4: 315–317

Partial anomalous pulmonary venous return associated with vascular anomalies of the aorta: multidetector computed tomography findings

Partial anomalous pulmonary venous return (PAPVR) is a congenital anomaly that involves drainage of one to three pulmonary veins directly into the right heart or systemic venous system, creating a partial left-to-right shunt. This drainage is associated with cardiac abnormalities such as mitral stenosis and pulmonary stenosis, patent ductus arteriosus, and atrial septal defects. We report a case of PAPVR associated with vascular anomalies of the aorta by multidetector computed tomography in an adult female patient

Evaluating adult cor triatriatum with total anomalous pulmonary venous connections by multidetector computed tomography angiography

A 19-year-old female patient was admitted to our hospital with dyspnea, chest pain, and shortness of breath. A chest radiograph showed mild cardiomegaly. Echocardiography revealed an extra chamber in the heart. To evaluate this abnormality, ECG-gated 16-detector-row computed tomography angiography was performed. Multidetector computed tomography (MDCT), showing cor triatriatum with total anomalous pulmonary venous connections (TAPVC), clearly revealed cardiac and vascular anatomy. ECG-gated cardiac MDCT is a useful tool for detection and characterisation of cor triatriatum and related anomalies. (Folia Morphol 2011; 70, 4: 312–314

ISINMA – KURAKLAŞMA SÜRECİNİN GÖLLER BÖLGESİNDEKİ DURUMU VE ETKİLERİ ÜZERİNE EKOLOJİK BİR DEĞERLENDİRME

Türkiye’nin Göller Bölgesinin batı tarafında; kuzeydoğudan güneybatıya doğru uzanan Daz Kırı-Hambat Kırı oluğunda Acı Göl, Keçiborlu Ovası-Yarışlı Gölü -Pınarbaşı Gölü oluğunda Burdur Gölü yer almaktadır. Ortada; kuzeyden güneye uzanan Hoyran-Eğirdir-Kovada oluğunda Eğirdir Gölü ile Kovada Gölü yer almaktadır. Doğuda kuzeybatıdan güneydoğuya uzanan Beyşehir-Suğla-Bozkır oluğunda Beyşehir Gölü ile Suğla Gölü yer almaktadır. Eber Gölü ile Akşehir Gölü ise Sultan Dağlarının kuzeyinden güneydoğuya doğru uzanan Bolvadin-Akşehir oluğunda yer almaktadır. Bu olukları yüksek dağlık kütleler ayırmaktadır (Harita 1 ve şekil 1). Kuzeydoğudan esen hakim rüzgârlar göllerin yüzeyinden buharlaşan su ile nemlenmekte ve bu nemi göllerin batısındaki dağların yamaçlarına yaslamaktadırlar. Böylece göllerin batısındaki dağ yamaçları daha nemli ve yağışlı, doğudaki dağ yamaçları daha kuru ve daha az yağışlı iklim tiplerinin etkisinde bulunmaktadır (Bkz.Harita 1 ve şekil 1). Eğirdir Gölü ile Beyşehir Gölü’nün batısındaki dağlık kütleler kuzeydoğu rüzgârlarını güneye doğru yönlendirmektedirler. Bu kuzey rüzgârları, Eğirdir ile Beyşehir göllerinin güneydeki dağlık arazi üzerine de nemli havayı taşımaktadır. Göllerin batısındaki daha nemli dağ yamaçlarında doğal sedir, göknar, karaçam ormanları yetişmiştir (Biyolojik çeşitlilik daha zengin). Göllerin doğusundaki daha kuru arazide ise meşe ormanları (Saçlı Meşe, Mazı Meşesi, Palamut Meşesi, Bozpırnal) ile ardıç ormanları yer almaktadır. Meşe ormanları baltalık orman olarak işletilmektedir. Son yıllarda Göller Bölgesindeki sığ göller kurumuş, Burdur, Eğirdir ve Beyşehir göllerinin su yüzeyleri alçalmıştır (Tablo 1). Benzer olay Tuz Gölünde de çok belirgindir. Göllerin kuruması veya su yüzeylerinin alçalması olayı havzalarında yapılmış olan göletlere ve göllerden tarım alanlarını sulamak veya hidroelektrik üretimi (Eğirdir Gölü-Kovada santralı) için su alınmasına bağlanabilir. Ancak iklimdeki “ısınma/kuraklaşma” sürecinin de göllerin su yüzeyindeki daralma ve alçalma olaylarına etkisi belirgindir. Göller Bölgesinde iklim değişimini incelemek üzere; Bölgede uzun süreli ölçme yapan 9 meteoroloji istasyonunun 1930-1970, 1970-1981, 1982-1993 ve 1994-2006 dönemleri arasındaki ölçümleri karşılaştırılmıştır. Bu ölçümler; ortalama sıcaklık, ortalama yağış, günlük en yüksek yağış, ortalama hava nemi oranları ile saat 1400’te ölçülen hava nemi oranları ve açık su yüzeyinden buharlaşma miktarlarıdır (Tablo 2 - 5 ile şekil 2 - 5). Elde edilen bulgulara ve sonuçlara göre; ortalama sıcaklık ve yağış değerleri 1982-1993 döneminde azalmış (1980-91 dört yanardağın etkisi), 1994-2006 döneminde artmıştır (Eğirdir hariç). Sıcaklığın artması buharlaşmanın da artmasına sebep olmuştur. Yıllık yağışlar artmış görünmekte ise de, kış aylarındaki yağışların azalması göllere gelen kar suyunun da azalmasına sebep olmuştur. Günlük yüksek yağışların (sağanak yağışlar) artması, yağmur suyunun yüzeysel akışa dönüşüp, toprağa sızamadan akıp gitmesi ile sonuçlanmıştır. Isınma/kuraklaşma sürecinde doğal kara ekosistemleri (ormanlar vd.) ekolojik bakımdan daha hassas bir duruma gelmişlerdir. Yağış sularının yüzeysel akışa ve sellere dönüşmeden toprağa sızdırılması, kaynaklara ve göllere ulaşmasının sağlanması gerekmektedir. Bu dengeli ve devamlı su üretimi bozuk ve kapalılığı açılmış (seyrekleşmiş) ormanlarda toprak koruma ve ağaçlandırılma çalışmaları ile mümkündür

Determination of anomalous pulmonary venous return with high-pitch low-dose computed tomography in paediatric patients

Background: In this study, we aimed to image pulmonary venous return anomalies and associated cardiovascular and pulmonary abnormalities by high-pitch low-dose computed tomography (CT) in children. Materials and methods: Forty-one patients with total or partial anomalous pulmonary venous return anomalous between May 2012 and June 2019 were retrospectively reviewed. The anomalies were determined using high-pitch low-dose CT. The patients’ mean age was 3 years (6 months to 15 years), and 24 of them were female. Results: There were 10 patients with total pulmonary venous return anomalies (TPVRA) and 31 patients with partial pulmonary venous return anomalies (PPVRA). Six (60%) patients with TPVRA had the supracardiac type, 2 (20%) had the cardiac type, and 2 (20%) had the mixed type. All patients with TPVRA had a large atrial septal defect (ASD), 1 patient also had patent ductus arteriosus, and 1 patient had right cardiac hypertrophy. Forty cases of PPVRA were found in 31 patients. Twenty-seven (67%) of them were right-sided, and 13 were left-sided (33%). Twenty (65%) patients also had an additional cardiovascular anomaly (ASD in 12 patients, persistent superior vena cava in 4 patients, patent ductus arteriosus in 3 patients, and aortic coarctation in 2 patients). Of the 27 patients with right-sided PPVRA, it drained into the superior vena cava in 19 patients, the right atrium in 5 patients, and the inferior vena cava in 3 patients. In left-sided cases, the anomalous pulmonary vein drained into the left innominate vein in 9 patients, and in 4 patients, there were accessory pulmonary veins that drained into the left innominate vein. Many of the patients had additional lung anomalies, including pneumonic infiltration (n = 12), atelectasis (n = 8), and lobar emphysema (n = 5), and some of these findings coexisted. Conclusions: Anomalous pulmonary venous drains and associated cardiac and extra-cardiac anomalies can be detected reliably and quickly with high-pitch low-dose CT without sedation in paediatric patients

Impact of Orthodontic Forces on Plasma Levels of Markers of Bone Turnover and Inflammation in a Rat Model of Buccal Expansion.

Plasma levels of protein analytes might be markers to predict and monitor the kinetics of bone and tissue remodeling, including maximization of orthodontic treatment stability. They could help predict/prevent and/or diagnose possible adverse effects such as bone dehiscences, gingival recession, or root resorption. The objective of this study was to measure plasma levels of markers of bone turnover and inflammation during orthodontic force application in a rat model of orthodontic expansion. Two different orthodontic forces for bilateral buccal expansion of the maxillary arches around second and third molars were applied in 10 rats equally distributed in low-force (LF) or conventional force (CF) groups. Four rats served as the control group. Blood samples were collected at days 0, 1, 2, 3, 6, 13, 21, and 58. Longitudinal concentrations of osteoprotegerin (OPG), soluble receptor activator of nuclear factor kappaB ligand (sRANKL), interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor α (TNF), and parathyroid hormone (PTH) were determined in blood samples by a multiplex immunoassay. CF and LF resulted in a significantly maxillary skeletal expansion while the CF group demonstrated significantly higher expansion than the LF group in the long term. Bone turnover demonstrated a two-phase response. During the "early phase" (up to 6 days of force application), LF resulted in more sRANKL expression and increased sRANKL/OPG ratio than the CF and control animals. There was a parallel increase in PTH levels in the early phase in response to LF. During the "late phase" (6-58 days), the markers of bone turnover were stable in both groups. IL-4, IL-6, and IL-10 levels did not significantly change the test groups throughout the study. These results suggest that maxillary expansion in response to different orthodontic forces follows different phases of bone turnover that may be force specific

The utility of multidetector computed tomography for evaluation of congenital heart disease

Background: Congenital heart diseases (CHD) are the leading cause of birthdefect-related deaths. Multidedector computed tomography (MDCT) plays animportant role for imaging CHD in addition to echocardiography and providesa comprehensive evaluation of complex heart malformations for the referringcardiologist. The aim of the study was to evaluate the utility of MDCT in theassessment of CHD.Materials and methods: A 102 patients with CHD were investigated after initialassessment by echocardiography. The information obtained by MDCT and findingsof echocardiography were reviewed together by paediatric cardiologistsand cardiac radiologists. Perioperative anatomic descriptions, wherever available(n = 34) formed the gold standard for the comparison.Results: The clinical consensus diagnosis defined 154 cardiovascular lesions inthe patients. The results were classified in groups. We present the appearanceof various congenital cardiac lesions seen in clinical practice.Conclusions: MDCT provides important information about anatomic details ofCHD for the referring cardiologist. The evaluation of different anatomic structuressuch as heart, great vessels, lungs and abdomen is possible in one acquisitionwith this technique

Pruning Edge Research with Latency Shears

Edge computing has gained attention from both academia and industry by pursuing two significant challenges: 1) moving latency critical services closer to the users, 2) saving network bandwidth by aggregating large flows before sending them to the cloud. While the rationale appeared sound at its inception almost a decade ago, several current trends are impacting it. Clouds have spread geographically reducing end-user latency, mobile phones? computing capabilities are improving, and network bandwidth at the core keeps increasing. In this paper, we scrutinize edge computing, examining its outlook and future in the context of these trends. We perform extensive client-to-cloud measurements using RIPE Atlas, and show that latency reduction as motivation for edge is not as persuasive as once believed; for most applications the cloud is already 'close enough' for majority of the world's population. This implies that edge computing may only be applicable for certain application niches, as opposed to a general-purpose solution.Peer reviewe

Non-invasive detection of biliary leaks using Gd-EOB-DTPA-enhanced MR cholangiography: Comparison with T2-weighted MR cholangiography

Objective: To evaluate the added role of T1-weighted (T1w) gadolinium ethoxybenzyl diethylenetriamine penta-acetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance cholangiography (MRC) compared with T2-weighted MRC (T2w-MRC) in the detection of biliary leaks. Methods: Ninety-nine patients with suspected biliary complications underwent routine T2w-MRC and T1w contrast-enhanced (CE) MRC using Gd-EOB-DTPA to identify biliary leaks. Two observers reviewed the image sets separately and together. MRC findings were compared with those of surgery and percutaneous transhepatic cholangiopancreatography. The sensitivity, specificity and accuracy of the techniques in identifying biliary leaks were calculated. Results: Accuracy of locating biliary leaks was superior with the combination of Gd-EOB-DTPA-enhanced MRC and T2w-MRC (P < 0.05).The mean sensitivities were 79 % vs 59 %, and the mean accuracy rates were 84 % vs 58 % for combined CE-MRC and T2w-MRC vs sole T2w-MRC. Nineteen out of 21 patients with biliary-cyst communication, 90.4 %, and 12/15 patients with post-traumatic biliary extravasations, 80 %, were detected by the combination of Gd-EOB-DTPA-enhanced MRC and T2w-MRC images, P < 0.05. Conclusions: Gd-EOB-DTPA-enhanced MRC yields information that complements T2w-MRC findings and improves the identification and localisation of the bile extravasations (84 % accuracy, 100 % specificity, P < 0.05). We recommend Gd-EOB-DTPA-enhanced MRC in addition to T2w-MRC to increase the preoperative accuracy of identifying and locating extravasations of bile. Key Points: • Magnetic resonance cholangiography (MRC) does not always detect bile leakage and cysto-biliary communications. • Gd-EOB-DTPA-enhanced MRC helps by demonstrating extravasation of contrast material into fluid collections. • Gd-EOB-DTPA-enhanced MRC also demonstrates the leakage site and bile duct injury type. • Combined Gd-EOB-DTPA-enhanced and T2w-MRC can provide comprehensive information about biliary system. • Gd-EOB-DTPA-enhanced MRC is non-invasive and does not use ionising radiation. © 2013 The Author(s)