An Uncommon Cause of Acute Abdomen in a Pediatric Patient: Caecal Diverticulitis

Cecal diverticulitis is a rare condition in pediatric age groups. It is often misdiagnosed because it has nonspesific symptoms mimicking acute appendicitis. Without using any further radiological imaging techniques such as ultrasound (US) and/or computed tomography (CT), it is difficult to distinguish the cecal diverticulitis from acute appendicitis. Optimal management options of the disease are controversial but uncomplicated cases can be treated conservatively with appropriate antibiotics. However, surgical option can be preserved for the complicated cases. In this paper we presented a pediatric cecal diverticulitis case with lower right quadrant pain. We emphasized the diagnostic difficulty of the disease and the importance of CT in the correct diagnosis. The management options was also discussed. [Med-Science 2016; 5(3.000): 900-7

Osteosarcoma of the Proximal Humerus in Adult Male Patients

Osteosarcoma is the most common primary bone malignancy. The incidence rate of the disease has peak in the adolesance period in which the bone growth is the most rapid. Primary osteosarcoma is typically seen in 10-20 year-old age adolesants. 75% of the cases are under the age of 20. The incidence of osteosarcoma is 1.5 times higher in males than females. Osteosarcoma commonly occurs in the metaphyseal region of the long bones where the most common affected sites are knee and humerus by the ranges of 60% and 10%, respectively. In this paper we presented the clinical and radiological findings of osteosarcoma which was detected in the proximal humerus of a young adult male patient referring us with shoulder pain complaint and pointed out the diagnostic value of direct radiography. [Med-Science 2015; 4(1.000): 1959-65

Post-Traumatic Fibular Aneurismal Bone Cyst

Aneurismal bone cysts are benign and rarely encountered lesions of the skeletal system. They are usually seen in the first decade of life, often in the long bones. The case is presented here of a 13-year old male who presented at our polyclinic with complaints of pain in the right knee following an acute trauma and was incidentally determined with an aneurismal bone cyst in the proximal fibula which had progressed without any symptoms. The MRI and direct radiography findings are presented. The aim of this paper was to draw attention to diseases which may be asymptomatic and present with complaints of frequent pain, swelling or pathological fractures. [Med-Science 2015; 4(1.000): 2080-6

Obsessive-Compulsive Disorder and Chiari Malformation: a Case Report

Obsessive compulsive disorder is a common psychiatric disorder that severely disrupts functionality due to obsessions and compulsions. An attempt has previously been made to explain the disorder with the psychoanalytic theory and fixation to the anal period but studies on the neurobiology of obsessive compulsive disorder have gradually gained importance in recent years and important findings have been reported. The Chiari malformation is a congenital malformation that emerges with a shift in the structures developing from the hindbrain towards the vertebral channel. It is more commonly seen in women and the etiology is thought to be multifactorial. There are some case reports showing that Chiari malformation and anxiety disorders can exist together. We present a case with obsessive compulsive disorder and Chiari Type 1 malformation comorbidity in this article. [Med-Science 2016; 5(3.000): 908-13

Brain metabolite rates in amygdala and hippocampus in vaginismus patients

Vaginismus has complex etiology. Regarding its clinical manifestation, it is a condition associated with anxiety and fear. The fact that hippocampus and amygdala are critical regions for the modulation of anxiety suggests that they might be playing a role in the neurobiology of vaginismus. In the present study, therefore, we aimed to investigate the concentrations of cerebral metabolites in both the amygdala and hippocampus in vaginismus patients and healthy controls via magnetic resonance spectroscopy method. A total of 39 vaginismus patients and 26 sexually active healthy controls were enrolled into the study. All the patients and healthy controls underwent magnetic resonance spectroscopy procedure. Comparison of the groups revealed no difference in terms of concentrations of cerebral metabolites in the amygdala, whereas median Cholin (Cho) concentration in the hippocampus was significantly higher in the patient vs. the control group. High concentration of Cho in the hippocampus of vaginismus patients might be indicating the changes in myelination or signal transduction in the relevant region. Considering the role of the hippocampus in fear con-ditioning and fear memory, such changes in the patients are considered as the neurobiological reflections of fear conditioning. Repeated and further studies will further contribute to the clarification of this subject. [Med-Science 2020; 9(2.000): 450-3

The Role of First-Pass Perfusion Computed Tomography in the Differentiation of Centrally Located Lung Cancer and Distal Atelectasis

Our aim in this study was to differentiate postobstructive consolidation from lung cancer by means of first-pass perfusion CT in centrally located malignancies. We studied 20 patients (18 males and 2 females) diagnosed as lung cancer with untreated central masses and distal postobstructive atelectasis. In order to localize the slice position showing the appropriate mass-consolidation area to be included in contrast-enhanced dynamic imaging, we first performed scout and baseline acquisition without contrast media, followed by dynamic acquisition after intravenous contrast media injection. Three different ROIs were placed on the central mass while avoiding the peripheral regions as much as possible and on the peripheral locations of distal consolidation using dynamic contrast-enhanced images. The BV, BF, TTP and MTT perfusion parameters were automatically calculated in the ROI locations. We were able to differentiate the central masses from distal consolidations by means of statistical differences in the first-pass BV and BF parameters between the mass and distal consolidation areas. The mean values of parameters that were calculated in the mass and consolidation areas were BV:7.69±4.28 ml/100g, BF:48.87±25.54 ml/100g/min, TTP:27.94±7.32 sec., MTT:9.56±3.47 sec. and BV:11.83±5.34 ml/100g, BF:78.75±39.41 ml/100g/min, TTP:29.72±6.05 sec., MTT:11.44±4.93 sec., respectively. We concluded that first-pass perfusion CT may be used as a functional imaging method to differentiate central lung cancer from distal consolidation and could be useful in reducing the target cancer volume in patients who are candidates for radiation therapy. [Med-Science 2016; 5(2.000): 432-47

Importance of diffusion weighted magnetic resonance imaging in evaluation of the treatment efficacy in multiple sclerosis patients with acute attacks

BACKGROUND: We planned to investigate contribution of DWMR to the treatment efficacy with ADC values which were measured in acute and chronic plaque before and after MS treatment. ADC changes in normal appearing white matter (NAWM) in patients with MS and healthy volunteers were also evaluated in this study. MATERIAL AND METHODS: 25 patients with MS and 30 healthy subjects with normal brain MR findings were included to our study. Contrast enhancement in plaque was evaluated as an acute, and non-contrast enhancement in plaque was evaluated as a chronic. Also, ADC measurements were performed using the same parameters in NAWM in plaque neighborhood and volunteers. Results were compared with appropriate statistical methods. RESULTS: ADC values in acute and chronic plaques were decreased after the treatment, and these reductions were statistically significant for acute plaqus in b500 and for chronic plaques in b500 and b1000. The mean ADC values were measured as 1.53±0.49×10–3 and 1.43±0.58×10–3 in acute plaques and 1.40±0.35×10–3 and 1.34±0.36×10–3 mm2/sec in chronic plaques before and after the treatment. CONCLUSIONS: We think that DWMR have important role due to quantitative measurement ability in the evaluation of the treatment efficacy of the MS patients with acute attack in addition to contrast-enhanced MR sequence