Ultrasonography accurately evaluates the dimension and shape of the pilonidal sinus

PURPOSE: To study the benefits of ultrasonography for detecting the borders of pilonidal sinus tissue. The correlation between physical and ultrasonographic examination was used for surgical planning. METHOD: Between April and December 2004, 73 patients were recruited for this study. All patients were examined, and the borders of the sinus tissue were marked on the skin according to palpation before surgery. The surgeon also made a treatment plan considering the diseased tissue and marked a possible incision line. Patients were subsequently examined with ultrasonography. According to the ultrasonographic evaluation, the margins, extensions, and openings of pilonidal sinus tissue were determined and marked on the patient in a different color by a radiologist prior to surgery. The most suitable surgical treatment was decided according to the information obtained by ultrasonography. RESULTS: The average age was 23.03 ± 3.05 (range 18-39) years. We found 81 lesions in 73 patients. Ultrasonographic borders of sinus tissue were similar to the borders marked by the surgeon in 56 patients (76.7%). In the remaining 17 patients (23.3%), ultrasonography detected branches or borders that distinctly exceeded the planned incision line. After ultrasonographic examination, the surgeon changed his incision line in 14 patients and the surgical intervention in 3 patients. CONCLUSION: Palpation and methylene blue injection do not provide appropriate information in many patients. Our study revealed that pre-operative ultrasonography can improve the identification of the sinus tract and its branches when compared to palpation and methylene blue injection

Ultrasonography Accurately Evaluates the Dimension and Shape of the Pilonidal Sinus

PURPOSE: To study the benefits of ultrasonography for detecting the borders of pilonidal sinus tissue. The correlation between physical and ultrasonographic examination was used for surgical planning. METHOD: Between April and December 2004, 73 patients were recruited for this study. All patients were examined, and the borders of the sinus tissue were marked on the skin according to palpation before surgery. The surgeon also made a treatment plan considering the diseased tissue and marked a possible incision line. Patients were subsequently examined with ultrasonography. According to the ultrasonographic evaluation, the margins, extensions, and openings of pilonidal sinus tissue were determined and marked on the patient in a different color by a radiologist prior to surgery. The most suitable surgical treatment was decided according to the information obtained by ultrasonography. RESULTS: The average age was 23.03 ± 3.05 (range 18-39) years. We found 81 lesions in 73 patients. Ultrasonographic borders of sinus tissue were similar to the borders marked by the surgeon in 56 patients (76.7%). In the remaining 17 patients (23.3%), ultrasonography detected branches or borders that distinctly exceeded the planned incision line. After ultrasonographic examination, the surgeon changed his incision line in 14 patients and the surgical intervention in 3 patients. CONCLUSION: Palpation and methylene blue injection do not provide appropriate information in many patients. Our study revealed that pre-operative ultrasonography can improve the identification of the sinus tract and its branches when compared to palpation and methylene blue injection

Sacrococcygeal pilonidal disease: analysis of previously proposed risk factors

PURPOSE: Sacrococcygeal pilonidal disease is a source of one of the most common surgical problems among young adults. While male gender, obesity, occupations requiring sitting, deep natal clefts, excessive body hair, poor body hygiene and excessive sweating are described as the main risk factors for this disease, most of these need to be verified with a clinical trial. The present study aimed to evaluate the value and effect of these factors on pilonidal disease. METHOD: Previously proposed main risk factors were evaluated in a prospective case control study that included 587 patients with pilonidal disease and 2,780 healthy control patients. RESULTS: Stiffness of body hair, number of baths and time spent seated per day were the three most predictive risk factors. Adjusted odds ratios were 9.23, 6.33 and 4.03, respectively (p<0.001). With an adjusted odds ratio of 1.3 (p<.001), body mass index was another risk factor. Family history was not statistically different between the groups and there was no specific occupation associated with the disease. CONCLUSIONS: Hairy people who sit down for more than six hours a day and those who take a bath two or less times per week are at a 219-fold increased risk for sacrococcygeal pilonidal disease than those without these risk factors. For people with a great deal of hair, there is a greater need for them to clean their intergluteal sulcus. People who engage in work that requires sitting in a seat for long periods of time should choose more comfortable seats and should also try to stand whenever possible

Cold War in Asia: China's Involvement in the Korean and Vietnam War

As essential components of the Cold War, the Korean War and the Vietnam War have played significant roles in global policy among the Western forces under the leadership of the United States and the Eastern bloc led by the Soviet Union in the 20th century. Communist China, founded in 1949, was also part of the countries behind the Iron Curtain and provided substantial support to North Korea and North Vietnam in their fight against their ideological enemies. Despite the extensive research by scholars on the Korean War and the Vietnam War, as well as China’s role in both of these wars, it is interesting to know whether China’s role and attitude had changed from one war to the other. This thesis examines and compares China’s military interference in the Korean War in the beginning of the 1950s with its involvement more than ten years later in the Vietnam War through the investigation of China’s motives to enter the wars and their ways of support in connection with the development of foreign relations. While contrasting China’s role and involvement in Korea and Vietnam, similarities, but also major differences become distinguishable. This thesis argues that these major differences indicate a Chinese rethinking about a possible involvement in Vietnam because of China’s domestic problems and its foreign policy developments at that time

Fragmented QRS complexes are associated with left ventricular systolic and diastolic dysfunctions in patients with metabolic syndrome

Background: Metabolic syndrome (MetS) is found to be associated with deterioration of the left ventricular (LV) systolic and diastolic functions. One of the factors for this impairment is myocardial fibrosis. Fragmented QRS (fQRS) complexes are found to be associated with myocardial fibrosis. The aim of the study was to evaluate if the presence of fQRS on electrocardiogram (ECG) can detect pronounced impairment in the LV systolic and diastolic functions in MetS patients. Methods: The study included 111 (mean age 47 ± 9, 49.5% male) MetS patients and 96 (mean age 45 ± 9, 58.3% male) control subjects without MetS. ECG was evaluated for the presence of fQRS. Each patient underwent conventional echocardiography and tissue Doppler imaging. Results: Fragmented QRS was more common among MetS patients (26.1% vs. 14.6%, p = 0.041). MetS was associated with subclinical LV systolic and LV diastolic dysfunctions. In subgroup analyses of MetS patients, the presence of fQRS on ECG had a higher E/E’ ratio and lower E’ velocity, indicating pronounced diastolic dysfunction, as well as lower isovolumic acceleration (IVA), indicating profound subclinical LV systolic dysfunction. E/E’ ratio and IVA were independent predictors of fQRS presence in patients with MetS. Conclusions: Fragmented QRS is more common among MetS patients compared to non-MetS patients. The presence of fQRS is associated with pronounced subclinical LV systolic and diastolic dysfunctions in MetS patients

Giant Vertebral Notochordal Rest: Magnetic Resonance and Diffusion Weighted Imaging Findings

A giant vertebral notochordal rest is a newly described, benign entity that is easily confused with a vertebral chordoma. As microscopic notochordal rests are rarely found in adult autopsies, the finding of a macroscopic vertebral lesion is a new entity with only seven previously presented cases. We report here radiological findings, including diffusion weighted images, of a patient with a giant notochordal remnant confined to the L5 vertebra, with an emphasis on its distinction from a chordoma

Left ventricular non-compaction in children and adolescents: Clinical features, treatment and follow-up

Background: Left ventricular non-compaction (LVNC) is a specific cardiomyopathy that occurs following a disruption of endomyocardial morphogenesis. This study presents clinical findings, diagnostic features, treatment and follow-up of pediatric patients diagnosed with LVNC. Methods: Patients with LVNC who were followed from January 2006 to March 2010 were included in this study. Diagnosis was made with the use of characteristic findings of magnetic resonance imaging and echocardiography. Holter electrocardiography and metabolic screening tests were also performed in all patients. Results: A total of 24 patients were studied (18 male, six female). Patient age at diagnosis was 50 &#177; 60 months (eight days to 15 years). Average follow-up period was 22 &#177; 12 months (four months to four years). Findings at diagnosis were as follows: eight (33%) patients had heart failure, five (20%) had rhythm abnormalities, five (20%) had cardiomegaly, two had murmurs, two had cyanosis, and two presented with fatigue. Ten (41%) patients had been followed previously with other diagnoses. In 21 (87.5%) patients, electrocardiographic abnormalities were noted, especially left ventricular hypertrophy and ST-T changes. Patients had an average ejection fraction of 46% (18-73%) and three of them had additional congenital heart disease (patent ductus arteriosus, aortopulmonary window and complex cyanotic heart disease). Scanning for metabolic diseases revealed fatty acid oxidation disorder in one patient, and mitochondrial disease in another. During follow-up, a permanent pacemaker was implanted in a patient with severe bradycardia and ventricular dysfunction, and three patients died. Conclusion: LVNC can be diagnosed at any age from newborn to adolescent and has a variable clinical course. Closer study of patients with cardiomegaly and heart failure can reduce delays in diagnosis of LVNC. (Cardiol J 2011; 18, 2: 176-184

Understanding the effects of chitosan, chia mucilage, levan based composite coatings on the shelf life of sweet cherry

Sweet cherry (Prunus avium L.) fruits are prone to quality and quantity loss in shelf-life conditions and cold storage due to their short post-harvest life. Until now efforts have been made to extend the shelf life of the sweet cherry. However, an efficient and commercially scalable process remains elusive. To contribute to this challenge, here in this study, biobased composite coatings consisting of chitosan, mucilage, and levan, were applied on sweet cherry fruits and tested for postharvest parameters in both market and cold storage conditions. Results demonstrated that the shelf life of sweet cherries can be extended until the 30th day while retaining important post-harvest properties like decreased weight loss, fungal deterioration, increased stem removal force, total flavonoid, L-ascorbic acid, and oxalic acid. Given the cost-effectiveness of the polymers used, the findings of this study indicate the feasibility of extending the shelf-life of sweet cherries on a larger scale

The diagnostic value of serum copeptin levels in an acute pulmonary embolism

Background: Acute pulmonary embolism (APE) is a common disease which is associated with high mortality and morbidity. Circulating level of copeptin, which was demonstrated to be elevated in heart failure, acute myocardial infarction and pulmonary arterial hypertension, were reported to be independent predictors of poor outcome in recent studies. The aim of the present study was to investigate the clinical utility of copeptin in the diagnosis of APE. Methods: A total of 90 consecutive patients, admitted to emergency service due to acute chest pain and/or dyspnea and who underwent pulmonary computerized tomography angiography (CTA) due to suspicion of APE, were included in this prospective study. The patients diagnosed with APE were defined as APE (+) group and the remaining individuals with normal pulmonary CTA result were defined as APE (–) group. Results: Copeptin levels (7.76 ± 4.4 vs. 3.81 ± 1.34 ng/dL; p &lt; 0.001) were higher in the APE (+) group as compared to the APE (–) group. Copeptin was significantly positively correlated with B-type natriuretic peptide (r = 0.434, p &lt; 0.001), D-dimer (r = 0.315, p = 0.003) and troponin I (r = 0.300, p = 0.004) and inversely correlated with arterial oxygen saturations (r = –0.533, p &lt; 0001). When the correlation of copeptin with right ventricular dysfunction parameters was investigated, it was significantly inversely correlated with the tricuspid annular plane systolic excursion (r = –0.521, p &lt; 0.001) and positively correlated with right to left ventricle ratio (r = 0.329, p = 0.024). Copeptin (OR 1.836, 95% CI 1.171–2.878, p = 0.008) was found as a significant independent predictor of APE in a multivariate analysis, after adjusting for other risk parameters.  Conclusions: Copeptin is a promising new biomarker, which may be used to support the need for further investigations and to improve the diagnosis of patients with APE.