Congenital Toxoplasmosis: A Case Study

Acute toxoplasmosis infections that develop during pregnancy can be detrimental to the developing fetus. Although the etiology may derive from various factors, the primary cause of these maternal infections is the consumption of contaminated meat or water. The transmission of the infection to the fetus may result in devastating neurological and ocular disorders. In this article, we present a case of congenital toxoplasmosis that occurred on the 3rd live birth of a 37 year old mother's 4th pregnancy. During the pregnancy, the mother received Spiramycin as she was (+) for Toxoplasma IgM. In the initial evaluation of the neonate, there were no findings associated with toxoplasmosis. A CSF (cerebrospinal fluid) sample was taken and the patient was followed-up, a re-evaluation was conducted as the patient's PCR analysis was positive; the diagnosis was confirmed by the presence of chorioretinitis and intracranial calcification. In conclusion, congenital toxoplasmosis is an insidious disease with a slow progression. Physical examination findings may not be apparent during the early neonatal period. These patients should be carefully examined, periodically followed up, and their bodily fluids should be tested

Diffusion and Chemical Shift Magnetic Resonance Imaging Properties of Lumbar Bone Marrow; Correlation with Osteoporosis

Objective:To investigate whether or not diffusion-weighted imaging (DWI) of vertebral bone marrow or dual-echo chemical shift imaging (CSI) achieved by magnetic resonance imaging (MRI) can be used in the diagnosis of osteoporosis.Materials and Methods:Twenty-nine postmenopausal women patients (mean age 53.9±9 years) who underwent upper abdominal MRI and dual-energy X-ray absorptiometry (DXA) were included in the study retrospectively. A total of 87 lumbar vertebras which appropriate were divided into subgroups as normal, osteopenic and osteoporotic according to T-scores. Apparent diffusion coefficient (ADC) values were calculated from DWI and signal intensities (SI) that measured in T1 dual-echo sequences were compared between groups. The fat fractions of the vertebral body were measured based on the signal intensity index and vertebral spleen ratio (VSR) formulas previously used for adrenal adenomas.Results:The mean vertebral ADC values were 0.61±0.1 x 10-3 mm2/s in the normal group, 0.59±0.1 x 10-3 mm2/s in the osteopenic group, and 0.56±0.1 x 10-3 mm2/s in the osteoporotic group and there was no significant difference between them. The SI in out-of-phase sequence, SI index, and VSR were able to discriminate the osteoporotic group that had sustained fracture risks from the healthy and osteopenic ones. The sensitivities of the out-of-phase SI, SI index and VSR were 65.2%, 61.1% and 71%, respectively, while their specificities were 61.1%, 63.8%, and 61.1%, respectively.Conclusion:The diffusion properties of bone marrow are not fully affected by osteoporosis. The DXA scores appear to be moderately related to the chemical composition of bone marrow rather than its cellularity. CSI based fat quantification can be a referrer in the decision to initiate treatment by giving an idea of the presence of osteoporosi

Castleman's Disease: Due to a Rare Intraabdominal Location

Castleman disease (CD) is a rare benign disease with unknown etiology. It is also called angiofollicular lymph node hyperplasia, giant lymph node hyperplasia, lymph node hamartoma, benign giant lymphoma. Histologically, it is classified as hyaline vascular and plasma cell variant, but rarely features of two types can coexist. Most of the cases with unisentric disease are hyaline vascular and most of the cases with multicentric disease are in plasma cell histological type. Although it is frequently located in thorax, it can be found throughout the body. Salivary glands, lungs, pancreas, larynx, parotid gland, meninges, and even limb muscles can be affected as extralymphatic spread. Since it is localized in the middle and anterior mediastinum in the thorax, it should be differentiated from mediastinal autoimmune and neoplastic diseases. In this case report, we aimed to present the radiological findings of a CD case with a rare intraabdominal location

Comparison of the T2-star Values of Placentas Obtained from Pre-eclamptic Patients with Those of a Control Group: an Ex-vivo Magnetic Resonance Imaging Study

Background: Endotel dysfunction, vasoconstriction, and oxidative stress are described in the pathophysiology of pre-eclampsia, but its aetiology has not been revealed clearly. Aims: To examine whether there is a difference between the placentas of pre-eclamptic pregnant women and those of a control group in terms of their T2 star values. Study Design: Case-control study. Methods: Twenty patients diagnosed with pre-eclampsia and 22 healthy controls were included in this study. The placentas obtained after births performed via Caesarean section were taken into the magnetic resonance imaging area in plastic bags within the first postnatal hour, and imaging was performed via modified DIXON-Quant sequence. Average values were obtained by performing T2 star measurements from four localisations on the placentas. Results: T2 star values measured in the placentas of the control group were found to be significantly lower than those in the pre-eclampsia group (p<0.01). While the mean T2 star value in the pre-eclamptic group was found to be 37.48 ms (standard deviation ± 11.3), this value was 28.74 (standard deviation ± 8.08) in the control group. The cut-off value for the T2 star value, maximising the accuracy of diagnosis, was 28.59 ms (area under curve: 0.741; 95% confidence interval: 0.592-0.890); sensitivity and specificity were 70% and 63.6%, respectively. Conclusion: This study, the T2 star value, which is an indicator of iron amount, was found to be significantly lower in the control group than in the pre-eclampsia group. This may be related to the reduction in blood flow to the placenta due to endothelial dysfunction and vasoconstriction, which are important in pre-eclampsia pathophysiolog

Us-Guided Botulinum Toxin Injection For Excessive Drooling In Children

PURPOSE We aimed to evaluate the safety and efficacy of botulinum toxin A (BTX-A) injections under ultrasonography (US) guidance for children with excessive drooling. MATERIALS AND METHODS Between January 2006 and January 2011,44 BTX-A injections into bilateral submandibular glands were performed in 20 children (mean age, 9.1 years; ran e, 3-16 years; gender, 151 boys and 5 girls) under intravenous Sedation. Efficacy of the injections was evaluated 4-12 weeks after the injection. Severity of drooling was assessed using the Teacher Drooling Scale (TDS). If the patient or the patient's caregiver reported a good initial response, injections were then repeated periodically when drooling reached the preinjection score. If there was no response or suboptimal response, a booster injection of BTX-A was given after one month. RESULTS Technical success rate was 100%. No procedure-related major or minor complication was detected. One family (5%) reported intermittent problems with swallowing due to viscous saliva. A successful outcome was defined as a minimum two point reduction in TDS score. This outcome occurred. for 8 of 20 patients four weeks after the first injection. After consecutive sessions, clinical success was achieved at the end of the 12 weeks for 16 patients (80%). The mean TDS score decreased from 4.75 to 2.1 at the end of the study for all patients (P < 0.05). Four patients did not respond to BTXA injection. Submandibular resection was applied to 3 of 4 unresponsive patients. Two patients had complete remission after surgery, but one patient showed excessive drooling that could not be controlled. CONCLUSION US-guided submandibular BTX-A injection is a safe and effective procedure in treating drooling in children. It can be performed under intravenous sedation and does not require general anesthesia

Type 3B Malrotation Presented With Acute Appendicitis As Left Renal Colic

Midgut malrotation is a rare anatomic anomaly that complicates the diagnosis and managemant of acute abdominal pain. It is a congenital anomaly that arises from incomplete rotation or abnormal position of the midgut during embryonic development. We report a case of a patient who have very rare form (Nonrotation of the proximal loop associated with partial rotation of the distal loop) of malrotation with ruptured appendicitis. Left-sided acute appendicitis should be considered in the differential diagnosis of patients with pain with localized in the left lower quadrant.PubMe

Primer Kronik Venöz Yetmezlikli Hastalarda Tiroid Hormon Durumu

Amaç: Kronik venöz yetmezlik (KVY), varis oluşumu ve ven kapaklarındaki işlev bozukluğu ile karakterizedir. Tiroid hormonlarındaki eksikliğin damar duvar bileşenlerinde değişikliklere yol açtığı deneysel modellerle gösterilmiştir. Literatürde konuyla ilgili klinik çalışma bulunmamaktadır. Bu çalışmada; primer kronik venöz yetmezlikli (KVY) hastalarda tiroid fonksiyon bozukluğu prevelansı ve tiroid hormon seviyelerinin sağlıklı kontroller ile kıyaslanması amaçlanmıştır.Gereç ve Yöntem: Klinik ve radyolojik verilerle primer KVY tanısı konan hastalardan, son bir yıl içerisinde kan tiroid hormon seviyeleri bakılan 96 hasta, retrospektif olarak dahil edildi. Bilinen tiroid hastalığı olmayan, sağlıklı erişkinlerden oluşan 94 hasta, kontrol grubu olarak alındı.Bulgular: Toplam 180 hastanın yaş ortalaması 44,76 (aralık 18-77) idi. Hasta ve kontrol grubu arasında yaş ve cinsiyet açısından farklılık yoktu. Tutulan damarların sıklığı vena safena manga %81,2, vena safena parva %4,1, perforan ven %4,1, derin ven %0,1 idi. KVY hastalarının %12,5’inde tiroid fonksiyon bozukluğu olup, bunlardan %7,2’sinde subklinik hipotiroidizm, %5,2’sinde subklinik hipertiroidizm saptandı. Kontrol ile hasta grubu arasında serbest tiroksin düzeyi açısından fark izlenmezken, tiroid stimulan hormon düzeyi hasta grubunda anlamlı olarak yüksekti (p&lt;0,05).Sonuç: KVY’li hastalarda tiroid fonksiyonları ve hormon seviyeleri ilk defa araştırılmış ve normal erişkinlere kıyasla tiroid fonksiyon bozukluğu prevelansında ve tiroid stimulan hormon düzeylerinde artış bulunmuştur. KVY gelişimi için, bozulmuş tiroid fonksiyonları özellikle hipotiroidizm risk oluşturabilir. Geniş kapsamlı ve prospektif çalışmalara ihtiyaç vardır.Anahtar kelimeler: Hipotiroidizm, Kronik venöz yetmezlik, Tiroid hormonlar

A giant choledochal cyst in infancy: a case report

Choledochal cyst is a dilation that encloses the intrahepatic or both extra- and intrahepatic portions of the biliary ducts. Postnatally, ultrasonography is the initial diagnostic modality of choice, allowing for precise measurements of intra- or extrahepatic duct dilatation and identification of stones and sludge. Symptoms depend on the age at presentation. Common bile duct malformations should be considered as a differential diagnosis of a cystic mass regardless of the cyst's size or patient's age, especially in children presenting with abdominal pain, jaundice, and palpable mass. To the best of our knowledge, we report the largest choledochal cyst in infancy

Transarterial Chemo And Radioembolization (Yttrium90) Of Hepatic Metastasis Of Neuroendocrine Tumors: Single Center Experience

The aim of this study was to present our single center experience with short ( 3 months) follow-up results of patients who underwent transarterial radioembolization with yttrium-90 microsphere (Y-90) or transarterial chemoembolization (TACE) for hepatic metastasis of neuroendocrine tumors (hmNETs). The results of 14 patients treated with either Y-90 or TACE were reviewed retrospectively. Clinical, laboratory, and imaging follow-up was performed. Efficacy was assessed by clinical and morphologic response. Survival was estimated by Kaplan-Meier analysis. Eight patients receiving 12 TACE treatments and 6 patients receiving 7 Y-90 treatments. Response rates were similar with two treatments at short-term follow-up, but there were a lower response rate and higher being progressive disease in the TACE group than Y-90 group at intermediate-term follow-up. However, progression-free survival was lower in Y-90 group (7.5 months) than TACE group (18 months). Regarding our limited experience, both Y-90 treatment and TACE have advantages and disadvantages in treatment of patients with hmNETs, however, randomized controlled studies, are needed.WoSScopu