The evaluation of renal cortical density in urinary stone disease by unenhanced helical computed tomography

[No abstract available

Changes in renal Doppler ultrasonographic parameters in patients managed with rigid ureteroscopy

Background: There has been no study evaluating the intrarenal hemodynamic changes after ureteroscopy in the published literature. Purpose: To determine preoperative and postoperative intrarenal vascular parameters such as resistive index (RI), pulsatility index (PI), peak systolic velocity (PSV), end-diastolic velocity (EDV), measure changes on these values (?RI, ?PI, ?PSV, ?EDV) after ureteroscopy (URS) and compare the outcomes with the results of normal contralateral kidneys, and finally investigate possible parameters that would affect renal vascular resistance changes. Material and Methods: We prospectively studied 47 patients who underwent rigid URS. Preoperative grayscale and Doppler ultrasonography (CDUS) measurements were obtained 24 h before URS. Similarly, postoperative CDUS measurements were done 24 h after the operation. The degree of hydronephrosis and location of stones in the obstructed kidneys, diameters of both kidneys, and thickness of renal parenchyma were evaluated with gray-scale US followed by CDUS with calculation of the intrarenal RI, PI, PSV, and EDV values for each kidney. Results: For the operated kidneys, statistically significant P values were noticed when RI and PI values were considered (P< 0.001). ?RI and ?PI of the operated kidneys were also significantly greater than the values for non-operated kidneys (P< 0.001). However, it was not the case for ?PSV and ?EDV values. In Spearman correlation coefficient analysis, ?RI was found to be correlated with the parameters: "operative time" and "irrigation fluid volume". No significant relation was documented between ?RI and the other parameters: age, gender, side of ureteroscopy, stone location, and degree of hydronephrosis. Conclusion: Significant changes in RI and PI values in patients treated with URS reveal that URS can cause a significant increase in renal vascular resistance. With the increase in operative time and irrigation fluid volume used during the operation, RI seems to be significantly increased

Tamoksifen kullaniminda kalın endometriumun de ğerlendirilmesi

Objective: Aim of this study was to evaluate role of hysteroscopy in thickened endometrium (<5 mm) associated with tamoxifen therapy Materials and Methods: We performed dilatation and curettage (D&C) and hysteroscopic biopsy to patients for evaluation of thickened endometrium in tamoxifen therapy. One hundred and nine asymptomatic patients with estrogen receptor positive breast cancer treated with tamoxifen 20 mg daily. We performed hysteroscopic biopsy or D&C to patients who have thickened endometrium at transvaginal sonography. We correlate pathology report results of D&C and hysteroscopic biopsy.Results: Fifty-nine of 103 patients have thickened endometrium.Thirty-fve of 59 patients diagnosed with D&C (19 inactive endometrium, 15 endometrial polyp, 1 endometrial hyperplasia). D&C couldn't get material 24 of these patients. Hysteroscopic biopsy diagnosed endometrial polyp 11 (45.8%) of these patients.Conclusion: We can state that D&C does not seem accurate enough for detection of intrauterin pathologies in thickened endometrium associated with tamoxifen therapy. We therefore believe it is reasonable to perform hysteroscopic biopsy in asymptomatic tamoxifen treated patients who have thickened endometrium. J Turk Soc Obstet Gynecol 2014;4:215-8 © 2014, Turkish Society of Obstetrics and Gynecology. All rights reserved

Diagnostic values of detrusor wall thickness, postvoid residual urine, and prostate volume to evaluate lower urinary tract symptoms in men

PURPOSE This prospective, controlled clinical study aimed to assess the diagnostic values of detrusor wall thickness (DWT), postvoid residual urine volume (PVR), and prostate volume in men with lower urinary tract symptoms (LUTS). MATERIALS AND METHODS During an 18-month period, a total of 243 males were included in the study. Three groups were assessed due to their International Prostate Symptom Score (IPSS): men with normal lower urinary tracts (n=51; control group), men with mild LUTS (n=60; Group 1), and men with moderate to severe LUTS (n=132; Group 2). DWT, bladder, and prostate volumes and PVR were measured by suprapubic ultrasonography. DWT was measured when the bladder was full (DWT-1) and when it was empty (DWT-2). RESULTS The mean age for the study population was 60.0±0.6 years, while the mean IPSS for the whole group was 8.0±0.4. Both the bladder and prostate volumes in Group 2 were statistically significantly higher than the control group and Group 1. The mean DWT-1 values were significantly lower in the control group when compared to Groups 1 and 2. However, when study groups were compared with each other, no statistical significance was noticed (1.12 vs. 1.17 mm). In contrast, the mean PVR and DWT-2 values were significantly different in each group. There was a significant correlation between IPSS questionnaire results and all individual parameters. CONCLUSION Suprapubic transabdominal ultrasonographic assessment of the lower urinary tract in a noninvasive manner allows the clinician to assess LUTS severity in men without morbidity. Additional studies are necessary to provide further conclusions regarding this clinical procedure. © Turkish Society of Radiology 2012

Pregnancy and lactation in a patient with Gaucher disease receiving enzyme replacement therapy: Case report

Gaucher disease (GD) is a lysosomal storage disorder characterized with beta-glucocerebrosidase enzime deficiency. The disease is progressive with several manifestations including hematologic abnormalities, organomegaly and bony abnormalities. Pregnancy may excerbate this manifestations. Enzyme replacement therapy (ERT) has been used to improve clinical signs and reverse organomegaly and disease progress. Studies showed that ERT with imiglucerase reduce the risk of abortion and GD related complications. However, there have been only a few published data regarding the effects of imiglucerase on fetus, on newborn and on infant. In this case we report a succesfull pregnancy, delivery and healthy 2-year follow-up of GD under ERT with imiglucerase. Copyright © 2015 by Türkiye Klinikleri

Experimental investigation of flow characteristics of corrugated channel flow us ing PIV

The aim of the study is to determine the flow characteristics of corrugated duct. The whole study has been conducted for Reynolds numbers, Re=4000 and 6000. The corrugated duct geometry was designed for aspect ratios, s/H=0.3 and phase shift angle, ?=180°. Variations in flow characteristics of corrugated duct were investigated using the Particle Image velocimetry (PIV) technique. Time-averaged velocity distributions, patterns of streamline and corresponding turbulent statistics were determined. Augmentation of the Reynolds number leads to an increase in velocity due to the sharp corner edges of cavity. Dimensionless turbulent kinetic energy, contours indicate that the magnitude of turbulent kinetic energy, increases as a result of sharp corner edges of the cavities. High rate of momentum transfer is expected due to an increase of turbulence intensity

Role of hysteroscopy in evaluation of postmenopausal bleeding hysteroscopy in menopause

Objective: As a possible sign of endometrial cancer postmenopausal bleeding should be evaluated carefully. Dilatation and curettage (D&C) is still gold standard for assessment of postmenopausal bleeding. The development of hysteroscopy has provided a minimally invasive approach for endometrial assessment. We aimed to correlate hysteroscopic impressions and pathological findings in postmenopausal bleeding in this study. Material and Methods: This is a retrospective cross-sectional study. This study involves case records of one hundred thirteen women with postmenopausal bleeding. One hundred thirteen women with postmenopausal bleeding who underwent hysteroscopy with diagnostic D&C between January 2012 and January 2013 at Bursa Zübeyde Hanim Maternity Hospital, Department of Obstetrics and Gynecology. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values of hysteroscopy were calculated. D&C was set as the 'gold standard'. Results: For the assessment of postmenopausal bleeding hysteroscopy has high sensitivity and specificity for endometrial space occupying lesions (polyp 100%, 93%; fibroid 100%, 91.8%). However for endometrial hyperplasia, hysteroscopy has low sensitivity (75%). Conclusion: Hysteroscopy is a good diagnostic method especially for detecting intrauterine spaceoccupying (polyp, fibroid) lesions, but moderate for endometrial hyperplasia. Hysteroscopic view combined with hysteroscopy guided endometrial biopsy could be a gold standard for endometrial assessment in postmenopausal bleeding. Copyright © 2015 by Türkiye Klinikleri

A Comparison of Low and High Flow Desflurane Anaesthesia in Children

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Ectopic thyroid in the adrenal presenting as an adrenal incidentaloma

Adrenal incidentalomas are clinical dilemmas for the clinicians. The work up, to differentiate between malignant and benign lesions, and hyperfunctioning and nonfunctioning lesions is mandatory before the consideration of surgical resection. Ectopic thyroid tissue located in the adrenal gland (ETTAG) is a very rare condition. We report a case of ETTAG presenting with adrenal incidentaloma. A 57-year-old woman was admitted with incidental right adrenal mass. Hormone evaluation showed no hormonal activity. Magnetic resonance imaging revealed a 20x17 mm lobulated solid mass, which contained millimetric hypointense nodular areas consistent with calcifications. Loss of signal intensity on out-of-phase could not be evaluated because of the calcifications. Right adrenalectomy was performed to establish the histopathological diagnosis and to rule out malignancy. Histopathological diagnosis revealed ETTAG. Her medical history was positive for multinodular goiter and bilateral subtotal thyroidectomy 32 years ago. Thyroid ultrasonography showed residual thyroid tissue in both the right and left lobes, and colloid thyroid nodules. Fine needle aspiration biopsy from the nodules revealed benign nodules. The patient has been followed up for six years, and no change in thyroid nodule sizes and no evidence of metastatic foci have been detected. ETTAG would be considered in the differential diagnosis of adrenal mass showing no hormonal activity, especially when magnetic resonance images are not consistent with adrenal adenoma. Long follow-up duration of this case suggests that it was a benign condition