Umbilical Cord Serum Erythropoietin Levels and Maternal Smoking in Pregnancy

Objective. To evaluate the effect of maternal smoking during pregnancy on levels of umbilical cord erythropoietin. Methods. Erythropoietin levels were measured in umbilical cord sera of 60 newborns who were delivered vaginally at term. There were 20 (33%) smoking and 40 (67%) nonsmoking mothers. Results. Mean cord serum erythropoietin levels were significantly lower in the nonsmokers (nonsmokers, 24 ± 9 IU/L; smokers, 61 ± 46 IU/L; P < .001). There was a significant positive correlation between the number of cigarettes smoked per day and cord serum erythropoietin levels (r, 0.58; P ≤ .05). Conclusions. Smoking during pregnancy is associated with increased levels of umbilical cord erythropoietin at birth. This may indicate a risk of fetal hypoxia and growth restriction. Education and encouragement of cessation of smoking during pregnancy are important to avoid associated fetal and maternal morbidity and mortality

Dual (type IV) left anterior descending artery

Congenital coronary artery anomalies are uncommon. Dual left anterior descending coronary artery (LAD) is defined as the presence of two LADs within the anterior interventricular sulcus (AIVS), and is classified into four types. Type IV is a rarely reported subtype and differs from the others, with a long LAD originating from the right coronary artery (RCA). Dual LAD is a benign coronary artery anomaly, but should be recognised especially before interventional procedures. With the increasing use of multidedector computed tomography (MDCT), it is essential for radiologists to be aware of this entity and the cross-sectional findings

The Evaluation of Variations of The Hyoid Bone with Multidetector Computerized Tomography

The hyoid is a U shaped bone with a backward concavity. Locates at the lower edge of the mandible and lies parallel to the floor — functions as an attachment point for muscles and soft tissues of head and neck. The aim is to examine the variations and ossification of the hyoid. This study was performed retrospectively in 2010 - 2013 on 200 CT images. 3D volume rendering images of pure hyoid bone created from the axial CT images in 1 mm slice thickness.&nbsp;The morphological variation count was 23; ossification variations were 9 cases.&nbsp;No difference observed by gender, but there are differences between the age groups for ossification. Ossification rates were found as; partial 34 %, unilateral 33%, complete 22%, early 11%. Most of the morphologic variation were belong to minor horn (57%), variations of major horn were 30%.&nbsp;The clinical importance of hyoid bone has realized in recent years. Due to the close relationship of this bone with the muscles, ligaments, fascias, sternum, clavicles, its dysfunction can lead to general problems. Studies about the variations of hyoid bone found to be quite low, and we believe that our research will contribute to the content of literature

Application of first-pass contrast bolus tracking sequence for the assessment of morphology and flow dynamics in cardiac MRI

PURPOSEThere are two well-known indications for first-pass perfusion in the literature. First is the evaluation of myocardial ischemia, and the other is the evaluation of tumor vascularity. Our aim was to assess the value of a first-pass contrast bolus tracking sequence (FPCBTS) for cases unrelated to these pathologies. MATERIALS AND METHODSA total of 35 patients (age range, 1 day to 66 years; mean age, 10.4±19.2 years; median age, 4.5 months) with suspected congenital (n=31) and acquired (n=4) heart and great vessel disease were included in the study. All the patients underwent cardiac magnetic resonance imaging (MRI) and FPCBTS, and 20 patients underwent contrast enhanced magnetic resonance angiography (CE-MRA). We used cardiac MRI and CEMRA for anatomic evaluation and FPCBTS for dynamic flow evaluation. RESULTSTruncus arteriosus, double outlet right ventricle, tetralogy of Fallot, corrected transposition of great arteries, atrial and ventricular septal defect, aortic rupture, cardiac hydatid cyst, tricuspid atresia, anomalous pulmonary venous return, and interrupted aorta were detected using the technique described here. Septal defects in six patients and atrial aneurysm in two patients were excluded. The shunt gap and flow direction of the septal defects, a ruptured wall in a dissected aorta, a hydatid cyst, and the atrial relationship in two cases with paracardiac masses were diagnosed easily using this dynamic evaluation technique. CONCLUSIONFPCBTS can be performed in addition to cardiac MRI and CEMRA to reveal flow dynamics and morphology

Comparison of apparent diffusion coefficient values among different MRI platforms: a multicenter phantom study

PURPOSE:We aimed to compare apparent diffusion coefficient (ADC) values among magnetic resonance imaging (MRI) scanners from different vendors.MATERIALS AND METHODS:We used a custom-made phantom solution consisting of distilled water, 0.9% NaCl, 25% NaCl, and shampoo for diffusion-weighted MRI (DW-MRI) examinations. DW-MRI was performed with similar sequence parameters using six different 1.5 Tesla MR scanners (scanners A–F). ADC maps were automatically constructed for all DW-MR images (b factors of 0 and 1000 s/mm2). ADC measurements were performed using regions of interest and seven different software programs, including four different postprocessing workstations, two different picture archiving and communication systems, and operator console software for each MR scanner.RESULTS:The ADC values generated by scanners A and F were higher and those of scanner B were lower than those generated by the other scanners (P = 0.002). The intravendor difference in the ADC values averaged from scanners D, E, and F was statistically significant (P < 0.001). The difference between the ADC values obtained by scanners C and E was not statistically different (P = 0.15).CONCLUSION:ADC values may differ among different MRI systems used for DW-MRI. Thus, the MRI vendor should be considered when using DW-MRI in a clinical setting

Kist hidatik hastalığının perkütan tedavisinde hipertonik tuzlu serum ve albendazol solüsyonlarının etkinliği

Kist Hidatiğin perkütan tedavisinde skolosidal ajan olarak hipertonik tuzlu serum(%20) ve albendazol solüsyonlannın etkinliği değerlendirildi. Elli dokuz olguda çaplan 30-250rnm arasında değişen 117 kist hidatiğe ultrasonografi veya bilgisayarlı tomografi rehberliğinde aspirasyon uygulandı ve kist kavitesi hipertpnik tuzlu serum veya albendazol solüsyonları ile iniğe edildi. 44 kistte hipertonik tuzlu serum, 73 kistte albendazol solüsyonu kullanıldı. Kistler karaciğer, dalak, böbrek, periton, meme ve akciğerde lokalize idi. 104 kist univeziküler (Tipi), 11 kist multiveziküler (Tip3), 2 kist de membranı çökmüş (Tip2) görünümde idi. Olgulara işlemden 48 saat önce başlayarak ve iki ay süreyle oral yoldan albendazol tedavisi uygulandı. Kist kavitesinin daha kısa sürede küçülmesini sağlamak için 17 kiste perkütan drenaj uygulandı. Kistlerin tümünde işlem sırasında endokistin perikistten aynlması gözlendi. Kontrol uitrasonografilerinde kist kavitesinin ekojenitesinin arttığı (heterojen eko patern), kist boyutlannın küçüldüğü ve sonuçta uniform ekojenik görünüm aldığı(psödotümör) görüldü, îşlem sırasında anafılaktik şok ve ani ölüm gibi majör kompîikasyon görülmedi. Hipotansiyon ve orta derecede ateş gibi minör komplikasyonlar da semptomatik olarak tedavi edildi. İşlemden sonra hiçbir olguda biliyer fistül gelişmedi ancak üç kist kavitesi enfekte oldu. 117 kistten birinde (%0.85) nüks görüldü ancak bu da oral albendazol ile tedavi edildi. Serolojik titreler 19 olguda tedricen düştü ve 28 olguda negatif oldu. Kist hidatiğin perkütan aspirasyonu, hipertonik tuztı saum veya albendazol solüsyonlannın enjeksiyonu eîki bir tedavi şekMr ve gelecekte cerrahi tedaviye alternatif olacak gibi gözükmektedir. Aynca perkütan girişim hastanede katış süresini de belirgin şekilde kısaltmaktadır.It was evaluated the effectiveness of the hypertonic saline(20%) and Albendazole solutions as a scolocidal agent in the percutaneous treatment of the hydatid disease. 117 hydatid cysts (diameters between 30-250 mm) in 59 patients were aspirated and irrigated with hypertonic saline or albendazole solutions(hypertonic saline in 44 cysts, albendazole in 73 cysts) under sonographic or CT guidance. The cysts were localised in the liver, peritoneum, spleen, kidney, breast and lung. 104 cysts were univesicular (Type-1), 11 cyst were multivesicular(Type-3) and 2 cysts had a ruptured membrane (Type-2). Albendazole was administered orally 48 hours before and two months after intervention to reduce the risk of seeding scoleces. Percutaneous drainage was performed with 17 of the 117 cysts. Separation of the endocyst from pericyst were observed in all cysts. Serial sonographic examinations revealed high-level echoes in the cyst cavity (heterogeneous echo pattern), which ultimately became uniformly echogenic (pseudotumour) and decreased cysts size. Major complications such as anaphylactic shock and sudden death were not occurred at the time of aspiration. Minor complications were limited to hypotension and mild fever that cleared with antipyretic agents and intravenous fluid administration. No biliary fistula developed after the intervention but 3 cysts cavity were infected. Recurrence occurred in one of the 117 cysts(0.85%), but it was treated with oral albendazole administration. Serologic titers substantially decreased in 19 cases and became negative in 28 cases. It is concluded that percutaneous aspiration and hypertonic saline or albendazole solutions injection for hydatid disease seem to be sn^c?^imn(£trçı^n^r&sMm^ ^&t^ipmvQto\x; an alternative to siirgieal intervention. This procedure requires a shorter hospital stay

Effect of radiation dose reduction on image quality in adult head CT with noise-suppressing reconstruction system with a 256 slice MDCT

WOS: 000354950100028PubMed ID: 26103494The purpose of our study was to investigate the effect of iterative reconstruction (IR) as a dose reduction system on the image quality (IQ) of the adult head computed tomography (CT) at various low-dose levels, and to identify ways of setting the amount of dose reduction. We performed two noncontrast low-dose (LD) adult head CT protocols modified by lowering the tube current with IR which were decided in the light of a group of phantom studies. Two groups of patients, each 100 underwent noncontrast head CT with LD-I and LD-II, respectively. These groups were compared with 100 consecutive standard dose (STD) adult head CT protocol in terms of quantitative and qualitative IQ. The signal-to-noise ratio (SNR) of the white matter (WM) and gray matter (GM) and contrast-to-noise ratio (CNR) values in the LD groups were higher than the STD group. The differences were statistically significant. When the STD and the LD groups were compared qualitatively, no significant differences were found in overall quality. By selecting the appropriate level of IR 34%, radiation dose reduction in adult head CT can be achieved without compromising IQ

İstanbul Sultangazi Regional Incidence of Newborn Developmental Dysplasia of Hip

Aim: In Turkey, there is a growing consciousness of developmental dysplasia of the hip (DDH), especially after 2012, when the ministry of health has started the obligatory national DDH screening program. Despite many previous studies, exact national DDH incidence is not known yet. In this study, we aimed to report the incidence of DDH in İstanbul, for adding new data to the literature. Methods: We reviewed the ultrasonography (USG) records of 1491 babies who had undergone hip USG examination during a one-year period (Jan 2, 2016-Dec 30, 2016). We assessed the hips using Graf’s classification of DDH. The incidence of DDH was calculated from these data. Result: We identified six type 2a (0.40%) and 1 type 2b (0.06%) cases, and we could not identified any case of type 2c, 2d, 3 and 4. Overall DDH incidence was found to be 0.46%. Of the seven DDH cases, five were female and two were male. None of the hips worsened during the two weeks of follow-up period, but most immature hips healed. Conclusion: This study suggests that the incidence of DDH in north-west İstanbul is lower than in other regions of Istanbul and Turkey. To have a more precise national incidence analysis, prospective multi-centered trials should be organized

Bir çocukta serebellumun disembriyoplastik nöroepiteliyal tümörü

Dysembryoplastic neuroepithelial tumors are benign neoplasms with typical supratentorial location. 12 year old patient, who applied to a local hospital with complaints of loss of consciousness and postural tonus, was referred to our hospital with cerebellar mass diagnosis. According to the anamnesis, similar complaints also appeared when the patient was 3 and 10 years old, however no anomaly was found in the examinations done by pediatric cardiologist and pediatric neurologist in that period. Physical examination and routine laboratory examinations of the patient were normal. The mass identified in the cerebellum was totally removed. The patient was diagnosed as dysembryoplastic neuroepithelial tumor by histopathological evaluation of the tissue. The patient has still been under outpatient follow-up and in complete remission without any evidence of recurrence for 5 years. In this report a child patient having dysembryoplastic neuroepithelial tumor with cerebellar location is aimed to be shared with the literature.Disembriyoplastik nöroepitelyial tümörler (DNT) tipik olarak supratentorial yerleşen benign neoplazmalardır. Bilinç ve postural tonus kaybı şikayetleri ile bir lokal hastaneye başvuran 12 yaşındaki erkek hasta saptanan serebellar kitlesi nedeniyle hastanemize refere edildi. Hikayesinden benzer şikayetlerinin 3 ve 10 yaşlarında da tekrar ettiği ancak o dönemde pediatric kardiyolog ve pediatric nörolog tarafından yapılan incelemelerde herhangi bir anomaliye rastlanmadığı öğrenildi. Hastanın fizik muayenesi ve rutin laboratuvar tetkikleri normaldi. Serebellumda saptanan kitle total olarak çıkarıldı. Alınan dokunun histopatolojik değerlendirmesi ile hastaya DNT tanısı konuldu. Hasta halen, 5 yıldır, herhangi bir nüks belirtisi olmadan ayaktan takip edilmektedir. Bu yazıda serebellum yerleşimli DNT'ye sahip bir çocuk vakanın literatürle paylaşılması amaçlanmıştır

Prävalenz und klinische Bedeutung von mittels koronarer Multidetektor CT-Angiographie zufällig entdeckten nicht-koronaren kardiovaskulären Befunden

WOS: 000341425800003PubMed ID: 24970312The purpose of this study was to determine the prevalence and clinical importance of incidental findings of noncoronary cardiac structures and mediastinal great vessels in patients who underwent coronary computed tomography angiography (CCTA). The study included 2,096 consecutive patients (1,472 men and 624 women, with a mean age of 55 years). Cardiovascular findings were categorized into three groups according to the clinical importance: group 1 included findings necessitating immediate treatment or intervention; group 2 included findings requiring clinical awareness, follow-up, or further clinical and/or radiological investigations; and group 3 included findings not requiring any follow-up or further tests. We also evaluated whether there was any previous diagnosis of cardiovascular findings. A total of 174 abnormalities (8.3 %) were detected in 170 patients. Of these abnormalities, 21 findings (12 %) were considered as group 1, 121 (69.5 %) as group 2, and 32 (18.5 %) as group 3. The majority of cardiovascular findings (140 of 174, 80.5 %) were unknown by the reporter during the interpretation of CCTA examinations and regarded as incidental findings. Noncoronary incidental cardiovascular findings in patients who underwent CCTA are common. It is important to be aware of these findings necessitating immediate treatment or intervention, and follow-up or further investigations, and careful attention must be paid to all the structures included in the images.Ziel der Studie war es, die Prävalenz und klinische Bedeutung von zufällig erhobenen Befunden nichtkoronarer kardialer Strukturen und mediastinaler großer Gefäße bei Patienten zu erheben, bei denen eine Koronare Computertomographische Angiographie (KCTA) durchgeführt worden war. Methodik Die Studie schloss 2096 konsekutive Patienten (1472 Männer und 624 Frauen – mittleres Alter: 55 Jahre) ein. Die kardiovaskulären Befunde wurden in 3 Gruppen entsprechend ihrer klinischer Bedeutung eingeteilt: Gruppe 1: der Befund machte eine sofortige Behandlung oder Intervention notwendig. Gruppe 2: die Befunde gaben Anlass zu klinischer Achtsamkeit, Kontrolle und/oder weiteren klinischen und/oder radiologischen Untersuchungen. Gruppe 3: die Befunde erforderten keine Kontrollen oder weitere Untersuchungen. Wir untersuchten auch, ob die erhobenen kardiovaskulären Diagnosen vor der Untersuchung schon bekannt waren. Ergebnisse Insgesamt wurden 174 Anomalitäten (8,3%) bei 170 Patienten entdeckt. 21 Befunde (12%) wurden als der Gruppe 1 zugehörig eingestuft, 121 Befunde (69,5%) der Gruppe 2 und 32 Befunde (18,5%) der Gruppe 3. Der Großteil der kardiovaskulären Befunde (140/174; 80,5%) waren vor der KCTA nicht bekannt und wurden daher als Zufallsbefunde gewertet. Schlussfolgerungen Nicht koronare kardiovaskuläre abnorme Befunde sind bei Patienten, bei denen eine KCTA durchgeführt wird, häufig. Es ist wichtig, diese Ergebnisse zu kennen, da solche Befunde eine sofortige Behandlung oder Intervention benötigen können. Bei der Befundung sollten daher alle dargestellten kardiale Strukturen mit großer Achtsamkeit betrachtet werden