In this study, ossification stages of distal femoral epiphysis and proximal tibial epiphysis were retrospectively evaluated with a 1.5-T magnetic resonance imaging (MRI) scanner according to the ...newly developed five-stage Vieth method. A total of 367 male and 231 female patients aged 12-30 years were scanned between January 2012 and July 2019. A 1.5-T MRI scanner was used to obtain a T1-weighted turbo spin-echo (TSE) sequence and a fat-suppressed proton density-weighted TSE image. The kappa statistics were good level of agreement for inter- and intra-observer evaluations of the ossification stages for knee. Comparison of male and female data revealed significant between-sex differences in the ages when the stages 3, 4 and 5 ossifications of the distal femoral epiphysis and the stages 4 and 5 ossifications of the proximal tibial epiphysis were first detected. In the proximal tibial epiphysis, stage 6 was observed at age 18 years for males and at age 17 years for females. In the distal femoral epiphysis, stage 6 was initially observed at age 20 years for both sexes. Thus, stage 6 ossification, which is determined through 1.5-T MRI of the knee joint, allows for the determination of the completion of the 18th year of life in either sex.
Posterior-anterior chest x-ray (PA-CXR) is among the most commonly used imaging methods in the diagnosis both in the emergency departments (ED) and the other clinics. The aim of the present study was ...to evaluate the diagnostic reliability of PA-CXRs sent via a smartphone.
This study was conducted as an inter-observer study. PA-CXRs were photographed with a smartphone and they were sent to two separate participants (emergency medicine specialists one with 4 years experience and another with 3) via the WhatsApp application. And the participants evaluated to these images on their mobile phone.
A poor concordance was determined in a ratio of 3/8 and good concordance was detected in a ratio of 3/8 between the two participants (p < 0.05). It was observed that only the mediastinum assessments could be an alternative to the gold standard (p < 0.01).
We may conclude that the assessments done via a smartphone (photographing and sharing) may not be reliable.
Our aim is to analyse proximal tibial epiphysis and distal femoral epiphysis patterns according to the Dedouit staging method using 1.5 T magnetic resonance imaging (MRI) with fast spin echo (FSE) ...for proton density images. In addition, we discuss the results in relation to the literature for forensic age estimation. In this study, images belonging to 195 female and 277 male patients ranging in age from 10 to 30 years who had a knee MRI for any reason in our Radiology Clinic between January 2014 and December 2016 were retrospectively evaluated. According to the Dedouit et al. five-stage method, they were evaluated by two radiologists. The κ value was calculated for intra-observer and inter-observer compliance. The evaluation of knee epiphysis patterns from MRI is an alternative, efficient, radiation-free and non-invasive method that is helpful in forensic age estimation. In particular, stage 5 in distal femoral epiphysis can determine the 21st year of life in both sexes, and proximal tibial epiphysis could present evidence of age 18 in males. It should be used for evaluation in addition to other methods for determining skeletal system maturity.
Background and objective: Hyoscine-N-butyl bromide (HBB) and paracetamol (acetaminophen)are widely used in emergency departments for abdominal pain and cramps. However, there is not enough data on ...the efficacy, safety, and superiority of each other in treating acute gastroenteritis (AGE) related abdominal pain and cramps. In this study HBB and paracetamol were compared for the treatment of abdominal pain and cramps related to acute gastroenteritis.
Materials and methods: The study was conducted in a tertiary university hospital emergency department as a prospective, randomized-controlled, and double-blind study. Intravenous (IV) 1000 mg paracetamol and IV 20 mg hyoscine-N-butyl bromide (HBB) were used to treat abdominal pain and cramps related to AGE. Visual analogue scale (VAS) was used to evaluate the degree of abdominal pain before and after treatment.
Results: HBB and paracetamol groups consisted of 123 and 158 cases respectively. In both groups, it was observed that the VAS score gradually decreased from the 0th hour to the 1st and 2nd hours (p<0.001).When comparing each time within itself, it was observed that HBB and paracetamol measurements had similar values (p>0.05). No severe side effects were observed in any of the patients.
Conclusion: HBB and paracetamol were used for symptomatic treatment in AGE patients presenting with abdominal pain and cramps. A significant reduction in pain and cramps was achieved in both patient groups. There was no difference between the two drugs in terms of treatment efficacy and side effects.
IMC J Med Sci 2022; 16(1): 009
*Correspondence: Hasan Gümüşboğa, Department of Emergency, Şehitkamil State Hospital, Gaziantep, Turkey, Posta code: 27500; Email: profhasan@hotmail.com; ORCID:0000-0003-2097-7102.
Dedouit et al, Kramer et al and Vieth et al defined different staging methods over different sequences in knee MRI for bone age determination. Our study aims to examine three different methods in ...which the maturation stages of the knee epiphyses are evaluated by MRI in the same population, to compare the methods and results and evaluate them for some age thresholds and to discuss their applicability in forensic age estimation.
In this study, 597 knee images obtained using a 3.0T MR scanner were evaluated retrospectively. The
weighted and proton density-weighted sequences were evaluated by two observers. Knee bone development was staged on the femur and tibia, and descriptive statistics were calculated for each stage according to age and sex. Descriptive statistics were presented according to the age and sex of the cases, and intra- and interobserver agreements were evaluated by the κ and κw statistics obtained by the Fleiss approach.
Significant changes were found in stages depending on age. The intra- and interobserver agreement levels were very good (κ > 0.80) for each method. The methods of Dedouit, Kramer and Vieth can be used as an additional criteria for forensic age estimation for 14, 15, 18 and 21 year thresholds.
Knee MRI stands out as an alternative modality for age estimation and it is necessary to prefer the method intended for the investigated age range with an individual-specific approach.
Our study stands out as the first study in which current classification methods were applied and compared in the same population for age estimation with knee MRI.
Aim: Percutaneous imaging-guided core needle breast biopsy has become widely used as an alternative to incisional biopsy in the diagnosis of breast lesions. In this study, it was aimed to evaluate ...and report our core needle breast biopsy experiences performed with 14- and 18-gauge needles.
Material and Methods: Patients who underwent core needle breast biopsy between March 2012 and December 2019 in our radiology department and whose biopsy specimens were evaluated in the pathology department, of all age groups and both sexes, were included in this study. A total of 628 (615 female and 13 male) patients with breast masses were examined.
Results: The mean age of the patients was 52.20±13.94 (median= 51, range, 13-96) years, 90.4% (n=568) of the lesions were masses and the majority of lesions (53.2%, n=334) were 11-20 mm in size. The most of cases (47.2%, n=268) were BI-RADS 5. There was no significant difference between the two needles in terms of gender distribution, age, type of surgery, and core needle breast biopsy results. In 86.5% (n=141) of the patients, there was diagnostic accuracy between the surgical specimen and the core needle breast biopsy result.
Conclusion: We demonstrated that the 14-gauge and 18-gauge needles have similar performance of results. Smaller needles should be used for ultrasound-guided breast biopsies, which is less invasive, less painful, and creates less risk of hemorrhage. Moreover, no patient admitted to the emergency department because of the core needle breast biopsy acute complications such as hematoma, bleeding, etc. during this time.
Amaç: Perkutan görüntüleme eşliğinde kor iğne meme biyopsisi, meme lezyonlarının teşhisinde insizyonel biyopsiye alternatif olarak yaygın bir şekilde kullanılmaktadır. Bu çalışmada; 14 ve 18 gauge iğnelerle yapılan kor iğne meme biyopsisi deneyimlerimizin değerlendirilmesi ve sunulması amaçlanmıştır.
Gereç ve Yöntemler: Bu çalışmaya, Mart 2012 ve Aralık 2019 tarihleri arasında Radyoloji Anabilim Dalında kor iğne meme biyopsisi uygulanmış olan ve biyopsi örnekleri Patoloji Anabilim Dalında değerlendirilmiş olan, tüm yaş gruplarından ve her iki cinsiyetten hastalar dahil edilmiştir. Meme lezyonu olan toplam 628 (615 kadın ve 13 erkek) hasta incelenmiştir.
Bulgular: Hastaların ortalama yaşı 52.20±13.94 (medyan= 51, aralık, 13-96) yıl olup, lezyonların %90,4'ü (n=568) kitle lezyonu şeklindeydi ve lezyonların büyük çoğunluğu (53.1%; n=334) 11-20 mm boyutundaydı. Vakaların çoğu (%47,2; n=268) BI-RADS 5 idi. İki iğne arasında cinsiyet dağılımı, yaş, ameliyat türü ve kor iğne meme biyopsisi sonuçları açısından anlamlı bir farklılık yoktu. Hastaların %86,5'ünde (n=141) cerrahi olarak çıkartılan materyallerin histopatolojik sonucu ve kor iğne meme biyopsisi sonucu arasında tanısal doğruluk vardı.
Sonuç: 14-gauge ve 18-gauge iğnelerin benzer sonuç gösterme potansiyeline sahip olduğu tespit edilmiştir. Daha az invaziv, daha az ağrılı ve daha az kanama olma riski içeren ultrason eşliğindeki meme biyopsileri için daha küçük iğnelerin kullanılması daha uygundur. Ayrıca, çalışma süresi içinde hematom, kanama vb. gibi akut kor iğne meme biyopsisi komplikasyonları nedeniyle hiçbir hasta acil servise başvurmamıştır.
Popliteal artery entrapment syndrome (PAES) is a very rare pathology that can cause lower extremity ischemia in healthy young people. Anomalous anatomic relationships between the popliteal artery ...(PA) and the surrounding musculo-tendinous structures cause PAES. We present 31 patients with PAES in 35 limbs that were treated surgically in our clinic within a 12-year period.
From 2001 to 2015, 31 patients (mean age: 32 ± 7.4 years) underwent surgery for PAES. ; 4 patients presented had bilateral PAES. Doppler ultrasonography (US), magnetic resonance angiography (MRA), and conventional angiography were performed as diagnostic procedures. We detected Type I PAES in 4 limbs and Type II PAES in 12 limbs. In the remaining 19 limbs, we diagnosed Type III or Type IV PAES. Simple release of the PA, PA embolectomy and simple release, and the radial artery (RA) patch angioplasty, with or without thromboendarterectomy (TEA), were performed. In 12 limbs, PA continuity was provided by RA interposition.
With the exception of 5 patients, no complications were seen after surgery. Haematoma was detected in 2 patients and local infection in 2 patients. One patient required a revision for recurrent PA thromboembolic event 12 h after surgery. At a median follow- up of 23 months (range: 11-29 months), there were no postoperative complications.
PAES can result in lower limb ischemia due to chronic vascular trauma in young healthy patients. The use of diagnostic tools such as US, a non-invasive method, and MRA are effective diagnostic tools for early diagnosis. With their combined approach, exact and early diagnosis can be achieved. PA release, alone or with arterial bypass using RA, is a viable treatment option when intervention is necessary to prevent limb loss in the early stages of the disease.
Although lipomas are encapsulated benign tumors, systemic lipomatosis defines infiltrative nonencapsulated tumors resembling normal adipose tissue. Abdominal lipomatosis and intestinal lipomatosis ...are different clinicopathological entities with similar clinical symptoms. We describe here a case presenting with upper gastrointestinal bleeding from eroded submucosal lipoma at duodenum secondary to intestinal lipomatosis and abdominal lipomatosis.
In forensic medicine practice, age estimation—both in living and deceased individuals—can be requested due to legal requirements. Radiologic methods, such as X-rays, for the estimation of bone age ...have been discussed, and ethical concerns have been raised. Given these factors, radiologic methods that reduce radiation exposure have gained importance and have become one of the research topics in forensic medicine. In this study, the MR images of the ankles of patients aged between 8 and 25 years, obtained with a 3.0 T MR scanner, were evaluated retrospectively according to the staging method defined by Vieth et al. In the study, the ankle MR images of 201 cases (83 females and 118 males) with sagittal T1-weighted turbo spin echo and T2-weighted short tau inversion recovery sequences were evaluated independently by two observers. According to the results of our study, the intra- and inter-observer agreements are at a very good level for both the distal tibial and calcaneal epiphyses. All the cases detected as stages 2, 3, and 4 in both sexes for both the distal tibial and the calcaneal epiphyses have been determined to be under the age of 18 years. According to the data obtained from our study, we consider that stage 5 for males and stage 6 for both sexes in the distal tibial epiphysis and stage 6 for males in the calcaneal epiphysis can be used to estimate the age of 15 years. As far as we know, our study is the first to evaluate ankle MR images with the method defined by Vieth et al. Further studies should be conducted to evaluate the validity of the procedure.
•This study demonstrates that there may be a potential association between the intergenerational transmission of a mass trauma and brain structures.•Bilateral amygdala volumes were found to be ...smaller in the children of mothers exposed social trauma during adolescence, compared to the control group.•The right amygdala and right hippocampus volumes are smaller than the left side in the children of mothers exposed social trauma during adolescence.
Traumatic events have an important effect in human life and may lead to psychopathological disturbances by affecting the personal and social lives of individuals. Recently, various studies have been reported in the literature showing that the traumatic experiences may be associated with intergenerational psychopathologies. However, there is limited data regarding the neuroimaging studies investigating changes in brain structures in children of traumatized mothers. In this study, we aimed to investigate the potential changes in the hippocampus and amygdala volumes in the children of mothers exposed to mass trauma. The traumatic event experienced by the mothers was the two devastating earthquakes they experienced when they were teenagers. Hippocampus and amygdala volumes were evaluated in magnetic resonance imaging of 40 children whose mothers were exposed to earthquakes and 27 children in control group. Bilateral amygdala volumes were significantly smaller in the children of mothers exposed to earthquake compared to the control group. In addition, right amygdala and hippocampus volumes were smaller in children of mothers exposed to earthquakes than left. This is one of the pioneering neuroimaging studies on the intergenerational transmission of trauma. Our study shows that there may be a potential relationship between intergenerational trauma and various brain structures.
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