Anatomic Variations of the Intrahepatic Bile Ducts: Analysis of Magnetic Resonance Cholangiopancreatography in 1,011 Consecutive Patients

Objectives: The aim of the study was to evaluate the frequency of anatomic variations of the hepatic duct bifurcation using magnetic resonance cholangiopancreatography (MRCP). Methods: A total of 1,160 consecutive patients, referred to our department for MRCP due to suspected pancreatobiliary disease or before liver transplantation, were reviewed retrospectively. A total of 149 patients with less than optimal results due to imaging limitations or secondary differentiations of bile duct anatomy were excluded from the study. The final study population was composed of 1,011 cases. Results: Of the 1,160 patients, 149 were excluded from the analysis. Typical biliary anatomy was observed in 79.4% of cases, but female potential living liver donors more frequently presented an anatomic variation. Typical anatomy was present in 75.7% of the females and 85.3% of the males (p < 0.05). Out of the remaining 1,011 patients, 208 (20.57%) were diagnosed with different levels of various anatomic variations of the intra-and extrahepatic biliary ducts. Of the 208 cases with diagnosed variations, 204 (98.07%) and 4 (1.92%) turned out to have 1 and 2 different variations, respectively. The trifurcation variant was observed in 81 cases (8.01%), while 73 subjects (7.23%) had an aberrant right biliary duct draining into the common hepatic duct. A right dorsocaudal branch draining into the left hepatic duct was present in 42 cases (4.15%). Four cases (0.4%) had 2 different variations and 8 (0.8%) had uncommon anatomic variations. Conclusions: Typical intrahepatic biliary anatomy is present in about 80% of the inhabitants of the Aegean region of Turkey, but anatomic variants seem to be more frequent in females as compared to males. Trifurcation was the most common anatomic variation in our study population. The presence of an aberrant right hepatic duct emptying into the common hepatic duct was the second most common observation amongst our findings. (C) 2014 S. Karger AG, Base

Alteration of cardiovascular risk parameters in women with polycystic ovary syndrome who were prescribed to ethinyl estradiol-cyproterone acetate

We aimed to evaluate the alteration of cardiovascular and metabolic risk parameters of polycystic ovary syndrome (PCOS) patients after a 6-month treatment with an oral contraceptive (OC) containing cyproterone acetate (CPA)

The effect of tumor volume on survival in patients with renal cell carcinoma.

PURPOS

The combined use of brachial artery flow-mediated dilatation and carotid artery intima-media thickness measurements may be a method to determine vasculogenic erectile dysfunction

The aim of this study was to investigate the relationship between penile color Doppler sonography (CDS) findings and sonographic endothelial parameters in patients with erectile dysfunction (ED), including intima-media thickness (IMT) of common carotid arteries (CCA) and flow-mediated dilatation (FMD) of brachial artery. Fifty-six ED patients were included in the study. Penile CDS, IMT of CCA and FMD of brachial artery were performed in all patients. According to penile CDS findings, 27 (48%) patients had non-vasculogenic and 29 (52%) patients had vasculogenic ED. Among 29 patients, 17 (30%) patients had cavernous veno-occlusive disease (CVOD) and 12 (22%) patients had arterial/combined insufficiency (AI). Median (interquartile range) FMD values of nonvasculogenic ED, CVOD and AI were 12.50 (6.54)%, 12.82 (7.41)% and 6.25 (7.17)%, respectively. FMD was found to be impaired significantly in AI group when compared to the other groups. FMD values of CVOD group were lower when compared to non-vasculogenic group, but the difference was not statistically significant. IMT values of vasculogenic ED patients were higher than nonvasculogenic ED patients (P<0.05). Although IMT values were higher in AI group when compared to CVOD, the difference was not statistically significant. The combined use of IMT and FMD established the diagnosis of vasculogenic ED with 100% sensitivity and 59.2% specificity. The positive predictive value was 72%, negative predictive value 100% and accuracy 80%. The combined use of brachial artery FMD and carotid arteries IMT measurements may be suggested as an alternative method to evaluate vasculogenic ED

The effectiveness of long-pulse 1064 nm neoymium-doped yttrium aluminum garnet laser for recalcitrant palmoplantar and ungual warts

Amaç: Palmoplantar ve ungual siğillerin bir kısmı geleneksel tedavilere dirençlidir. Biz bu çalışmada; 1064 nm uzun atımlı Nd: YAG lazerin, tedaviye dirençli palmoplantar ve ungual siğiller üzerindeki etkinliğini araştırmayı amaçladık. Gereç ve Yöntem: Geleneksel tedavilere dirençli palmar, plantar veya ungual siğili olan 63 hasta alındı. Dört hafta arayla 4 seans uygulama yapıldı. İşlemlerimizde neodimyum katkılı itriyum alüminyum granat (Nd: YAG) (80 W) lazer cihazı kullanıldı. Uygulamalar 4 mm başlık ile 150 J/cm2, 15 milisaniye şeklinde yapıldı. Tedaviye yanıtlar istatistiksel olarak değerlendirildi ve yan etkiler kaydedildi. Bulgular: Siğilleri tamamen temizlenen hasta sayısı 37 (%66), kısmi temizlenen hasta sayısı 15 (%26) idi ve 4 (%8) hastada ise tedaviye cevap vermedi. Yapılan istatistiksel analizde, palmar, plantar veya ungual bölgedeki siğillerde tam temizlenme açısından fark saptanmadı (p=0,20, p=0,82, p=0,94 sırasıyla). Ayrıca lezyon sayısı ile tam temizlenme arasında da anlamlı bir ilişki yoktu (p=0,97). Sonuç: Uzun atımlı Nd: YAG lazerler özellikle konvansiyonel tedavilere dirençli palmoplantar ve ungual siğillerde etkili, yan etkisi az ve günlük yaşam aktivitelerini bozmayan alternatif bir tedavi yöntemi olarak önerilebilirBackground and Design: Some of palmoplantar and ungual warts are resistant to conventional treatments. In this study, we aimed to investigate the efficacy of non-ablative 1064 nm long pulsed neoymium-doped yttrium aluminum garnet (Nd: YAG) laser treatment on recalcitrant palmoplantar and ungual warts. Materials and Methods: Sixty-three patients with recalcitrant palmar, plantar and ungual warts were included in the study. Laser is applied in 4 sessions at 4-week intervals. The study employed the Nd: YAG (80 W). The following parameters were used: spot size: 4 mm; pulse duration: 15 msec; and fluence: 150 J/cm2. Treatment responses were evaluated statistically and side effects were recorded. Results: The number of patients who were completely cleaned and partially cleaned were 37 (66%) and 15 (26%), respectively. Four patients (4%) did not respond to treatment. In statistical analysis, there were no significant differences in palmar, plantar or ungual sites in term of complete clearance (p=0.20, p=0.82 and p=0.94, respectively). In addition, there was no association between the number of lesions and complete clearance (p=0.97). Conclusion: Long-pulsed Nd: YAG laser, which does not affect daily activity, is a safe and alternative method and may be recommended for patients with recalcitrant palmoplantar and ungual warts