Association between myocardial hypertrophy and apical diverticulum: more than a coincidence?

PURPOSEWe aimed to investigate the possible association between the myocardial hypertrophy and the development of an apical diverticulum.MATERIALS AND METHODSWe retrospectively reviewed 786 multidetector computed tomography (MDCT) coronary angiography examinations (520 males, 266 females; mean age, 57±15 years; age range, 18–78 years). The end-diastolic left ventricle wall thickness was measured in all patients, and a wall thickness of 11 mm was determined to be the cut-off value for myocardial hypertrophy. The ventricular apex and subvalvular area were evaluated for ventricular diverticula. The difference between the apical diverticula in patients with and without myocardial hypertrophy was determined.RESULTSThere were 12 myocardial hypertrophy and nine apical diverticulum cases. Myocardial hypertrophy was observed in four (44%) of nine patients who had apical diverticula, and an apical diverticulum was observed in four (33%) of 12 patients who had myocardial hypertrophy. There was statistically significant difference for myocardial wall thickness between the apical diverticula in patients with myocardial hypertrophy and those without myocardial hypertrophy (P = 0.011).CONCLUSIONDiagnosis of apical diverticula has become easier by using imaging modalities such as MDCT. There may be an association between myocardial hypertrophy and apical diverticulum

A Simple Procedure may Cause Severe Results

Capillary blood sampling via a heel puncture is a common procedure performed on hospitalized neonates. If not performed properly, a heelstick can lead to complications. The clinical and financial impact of complications can be significant. Also in some situations, the procedure could be complicated with skin infections, hematomes, soft tissue infections, arthritis and osteomyelitis. We report an infant complicated with arthitis and soft tissue infection secondary to heel puncture and we want to emphesize the importance of neonatal procedures

The role of coronary CT angiography in diagnosis of patent foramen ovale

PURPOSE:We aimed to examine the incidence of patent foramen ovale (PFO) and atrial septal aneurysms (ASA) in the Turkish population using coronary computed tomography angiography (CTA); assess the feasibility of coronary CTA for PFO diagnosis by conducting a comparison with transthoracic echocardiography (TTE); and determine the diagnostic role and characteristics of the interatrial tunnel, free flap valve (FFV), and shunts.METHODS:The present study was conducted retrospectively and included a sample of 782 patients. Coronary CTA results for all patients were evaluated for the following parameters: the presence of PFO, the degree of contrast jet (if present due to PFO), ASA existence, free flap valve (FFV) length, and PFO tunnel diameters (1 and 2). Coronary CTA and TTE results for PFO detection were also compared for 19 patients who underwent both procedures.RESULTS:PFO was present in 118 patients (15%). In 19 patients who underwent both CTA and TTE, the shunt was present in 15 patients on TTE compared with nine patients on CTA. The sensitivity and specificity of CTA for shunt existence were 53% (8/15) and 75% (3/4), respectively. FFV was observed on CTA in 118 patients (15%). No significant relationship was observed between shunt existence and FFV length (P = 0.148), or between shunt existence and tunnel diameter-1 (P = 0.638) or diameter-2 (P = 0.058). ASAs were present in 16 patients (2%), while accompanying PFO was present in three patients (2.4%) .CONCLUSION:Coronary CTA constitutes a more practical and efficient alternative to TTE for PFO diagnosis. Further, it allows the clear visualization of anatomical details of the interatrial tunnel, shunts, and associated abnormalities and detects ASAs

Are Hepatic Portal Venous System Components Distributed Equally in the Liver? A Multidetector Computerized Tomography Study

Objective: We aimed to evaluate the relationships between the splenic index, right and left hepatic lobe volumes, diameters of splenic vein (SV), superior mesenteric vein (SMV) and the portal vein (PV) by Multidetector Computerized Tomography (MDCT). We also investigated indirect signs of portal venous flow pattern using these parameters.Material and Methods: Following their contrast thoracoabdominal and abdominal 64-MDCT examinations, the images of 100 cases (61 males and 39 females) were evaluated retrospectively. For each case, the splenic index, total hepatic volume, left and right hepatic volumes were calculated on the post-contrast portal venous phase (50th sec) images. Spearman correlation tests were carried out with the purpose of determining the relationships between the variables. Statistical significance level was set at p<0.005.Results: A statistically significant relation was demonstrated between the diameter of the SMV and right hepatic lobe volume (p<0.0001), and according to Pearson’s correlation analysis, a positive correlation of medium strength (r=0.36) was observed. A positive correlation was demonstrated between the diameter of the splenic vein and left hepatic lobe volume (r=0.36). Statistically significant relation between the diameters of the splenic vein and right hepatic lobe was not observed (p=0.62). A strong correlation between the left hepatic lobe volume and the splenic index (r=0.556) was observed.Conclusion: We observed a positive correlation and a significant relation between the diameter of the SMV and the right hepatic lobe, and a relation between the splenic vein and splenic index and both hepatic lobes. We believe that this situation is related to the streamline flow in the portal vein, and as demonstrated in the literature, the flow in the SMV is directed at the right lobe, whereas the splenic vein empties into the liver homogenously. Our study is the first study in the literature performed by multidetector CT, which is a technique that reveals the relations between the streamline flow in the portal vein, the splenic index and the hepatic lobe volumes

Basit Bir Prosedür Ciddi Sonuçlara Yol Açabilir

Capillary blood sampling via a heel puncture is a common procedure performed on hospitalized neonates. If not performed properly, a heelstick can lead to complications. The clinical and financial impact of complications can be significant. Also in some situations, the procedure could be complicated with skin infections, hematomes, soft tissue infections, arthritis and osteomyelitis. We report an infant complicated with arthitis and soft tissue infection secondary to heel puncture and we want to emphesize the importance of neonatal procedures.Hastaneye yatan yenidoğanlarda topuk delerek alınan kapiller kan örneği genel bir prosedürdür. Eğer düzgün olarak yapılmazsa, komplikasyonlara yol açabilir. Komplikasyonların klinik ve finansal etkileri önemli olabilir. Ayrıca bazı koşullarda işlem deri enfeksiyonları, hematomlar, yumuşak doku enfeksiyonları, artrit ve osteomyelit ile komplike hale gelebilir. Biz,topuk kanı alımına ikincil artrit ve yumuşak doku enfeksiyonu ile komplike hale gelen bir infantı rapor ederek yenidoğanlardaki işlemlerin önemini vurgulamak istiyoruz