Objectives/Hypothesis
To analyze whether there is correlation between branching patterns of anterior inferior cerebellar artery/posterior inferior cerebellar artery (AICA/PICA) in cerebellopontine ...angle (CPA) area, as demonstrated by three‐dimensional fast imaging employing steady‐state acquisition (3D FIESTA) magnetic resonance imaging (MRI) and 1) idiopathic sudden sensorineural hearing loss (ISSNHL) outcomes and 2) recovery of ISSNHL.
Study Design
We evaluated patients with idiopathic SSNHL for branching patterns of AICA/PICA in CPA area, as demonstrated by 3D FIESTA MRI.
Methods
Sixty‐eight patients with SSNHL (32 47.1% women; mean age 45.3 ± 14.6 minimum–maximum: 18–77) and 38 healthy volunteers 17 (44.7%) women; mean age 48.6 ± 14.0 (minimum–maximum: 26–81) were included in this study. We evaluated patients for branching patterns and classified as type IA, IB, IIA, and IIB. Branching patterns were evaluated at the diseased side of the patients and both sides of the control group. Pretreatment and posttreatment audiological values were also studied.
Results
AICA/PICA branching patterns in control group versus study group in the affected side were: 26 (34.2%) versus 12 (17.6%) subjects had type IA; seven (9.2%) versus nine (13.2%) subjects had type IB; 31 (40.8%) versus 23 (33.8%) subjects had type IIA; and 12 (15.8) versus 24 (35.3%) subjects had type IIB branching patterns, respectively. Presence of vascular loops entering internal acoustic channel (type IIB branching pattern) was more prominent in the study group (P = 0.017). In addition, type IIB branching pattern was significantly associated with unresponsiveness to treatment (18 75% of 24 patients with type IIB were unresponsive and 14 47.0% of 30 patients with nontype IIB were unresponsive, P < 0.001).
Conclusion
Type IIB branching pattern has been shown to be more common in patients with ISSNHL, and these patients come across with unresponsiveness to standard therapy more than the other branching types.
Level of Evidence
3b. Laryngoscope, 127:210–215, 2017
The aim of this study is to measure the significant parameters on scapula at computed tomography images and to determine the effects of these parameters for sex determination. The second aim is to ...find the most effective single and combined parameters to use for sex determination using scapula in Turkish population. In this study, morphometric measurements of scapula on the computed tomography images of 60 male and 60 females were evaluated and their impacts on sex determination were examined via stepwise logistic regression analysis. 10 parameters and 6 indexes calculated via using these parameters were measured. Scapular breadth of the right scapulae (86.7%), maximum scapular length of the left scapulae (85%), scapular breadth of all scapulae (80%) were found to be the most effective single parameters. Combination of the scapular breadth and maximum scapular length were 85%, 90%, 86.7% effective in sex determination on the right scapulae, on the left scapulae and on all of the scapulae, respectively. We believe that the results of this study will contribute to sex determination studies using the scapula in Turkish population for anatomist, anthropologist and forensic scientists.
Patient doses from CT examinations in Turkey Ataç, Gökçe Kaan; Parmaksız, Aydın; İnal, Tolga ...
Diagnostic and interventional radiology (Ankara, Turkey),
09/2015, Letnik:
21, Številka:
5
Journal Article
Recenzirano
Odprti dostop
We aimed to establish the first diagnostic reference levels (DRLs) for computed tomography (CT) examinations in adult and pediatric patients in Turkey and compare these with international DRLs.
CT ...performance information and examination parameters (for head, chest, high-resolution CT of the chest HRCT-chest, abdominal, and pelvic protocols) from 1607 hospitals were collected via a survey. Dose length products and effective doses for standard patient sizes were calculated from the reported volume CT dose index (CTDIvol).
The median number of protocols reported from the 167 responding hospitals (10% response rate) was 102 across five different age groups. Third quartile CTDIvol values for adult pelvic and all pediatric body protocols were higher than the European Commission standards but were comparable to studies conducted in other countries.
The radiation dose indicators for adult patients were similar to those reported in the literature, except for those associated with head protocols. CT protocol optimization is necessary for adult head and pediatric chest, HRCT-chest, abdominal, and pelvic protocols. The findings from this study are recommended for use as national DRLs in Turkey.
The aim of this study was to measure the volume of interscalene space in thoracic outlet region on cadavers and radiological images and to analyze the potential value of these measurements in ...diagnosis and treatment of thoracic outlet syndrome (TOS).
The dimensions of the anterior interscalene space in 8 formalin-fixed human cadavers were studied by direct measurement and additionally evaluation of the volume of this space were done by using mold and volume calculation formula of square pyramid, due to resembling a pyramid. In the second phase of this study, interscalene space volume was calculated by formula and compared to calculations from computed tomography (CT) sections in 18 TOS and 16 control patients.
There was a strong correlation between the volume calculated by formula (4.79 ± 2.18 cm3) and by mold (4.84 ± 1.58 cm3), (R = 0.934, p = 0.001) in cadavers. The average volume measured in TOS patients (2.05 ± 0.32 cm3) was significantly smaller than control patients (4.30 ± 1.85 cm3, p < 0.0001). There were excellent or good results in 14 patients whereas in 4 patients who had neurogenic TOS achieved fair results after surgery. In these 4 patients the average volumes of abnormal sides were close to the healthy sides.
In our study, volume of interscalene space in TOS patients was statistically smaller than control group. Also, the volume was even smaller in patients with excellent or good results after surgery. In this respect, volumetric measurements from CT sections could be used in diagnosis and treatment selection in TOS patients.
This study aimed to investigate the role of inflammatory markers in decreasing negative appendectomy rate (NAR) based on their relation with findings of acute appendicitis (AA) on computed tomography ...(CT).
Ninety-two patients who underwent CT examination with suspected AA were included. We investigated the relation between CT findings of AA and laboratory inflammatory markers and also performed receiver operating characteristic (ROC) analysis to calculate cut-off values of inflammatory markers and CT findings of AA. Appendectomy cases were re-evaluated considering cut-off values to make the operation decision and NAR was recalculated. Chi-squared test was used to compare the actual and recalculated NAR.
Cut-off values of appendiceal diameter, appendiceal wall thickness, and caecal wall thickness were 7.9, 2, and 2.3 mm, respectively, for the diagnosis of AA. Cut-off values of WBC , NLR, and CRP on ROC analysis were 7.47, 4.06 and 13, respectively, for the diagnosis of AA. When the actual and recalculated NAR (21.9% versus 9.1%) were compared, the difference was found to be almost significant (p=0.058).
Inflammatory markers are not sufficiently powerful on their own to accurately diagnose AA. However, particularly in equivocal cases, proposed cut-off values may be helpful for accurate diagnosis and a lower NAR can be achieved.
Incidence of pulmonary embolism during COPD exacerbation Akpinar, Evrim Eylem; Hoşgün, Derya; Akpinar, Serdar ...
Jornal brasileiro de pneumologia,
2014 Jan-Feb, 2014-01-00, 20140101, 2014-01-01, Letnik:
40, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Because pulmonary embolism (PE) and COPD exacerbation have similar presentations and symptoms, PE can be overlooked in COPD patients. Our objective was to determine the prevalence of PE during COPD ...exacerbation and to describe the clinical aspects in COPD patients diagnosed with PE.
This was a prospective study conducted at a university hospital in the city of Ankara, Turkey. We included all COPD patients who were hospitalized due to acute exacerbation of COPD between May of 2011 and May of 2013. All patients underwent clinical risk assessment, arterial blood gas analysis, chest CT angiography, and Doppler ultrasonography of the lower extremities. In addition, we measured D-dimer levels and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels.
We included 172 patients with COPD. The prevalence of PE was 29.1%. The patients with pleuritic chest pain, lower limb asymmetry, and high NT-pro-BNP levels were more likely to develop PE, as were those who were obese or immobile. Obesity and lower limb asymmetry were independent predictors of PE during COPD exacerbation (OR = 4.97; 95% CI, 1.775-13.931 and OR = 2.329; 95% CI, 1.127-7.105, respectively).
The prevalence of PE in patients with COPD exacerbation was higher than expected. The association between PE and COPD exacerbation should be considered, especially in patients who are immobile or obese.
The purposes of this study were to identify possible compression points along the transit route of the subclavian artery and to provide a detailed anatomical analysis of areas that are involved in ...the surgical management of the thoracic outlet syndrome (TOS). The results of the current study are based on measurements from cadavers, computed tomography (CT) scans and dry adult first ribs.
The width and length of the interscalene space and the width of the costoclavicular passage were measured on 18 cervical dissections in 9 cadavers, on 50 dry first ribs and on CT angiography sections from 15 patients whose conditions were not related to TOS.
The average width and length of the interscalene space in cadavers were 15.28 ± 1.94 mm and 15.98 ± 2.13 mm, respectively. The widths of the costoclavicular passage (12.42 ± 1.43 mm) were significantly narrower than the widths and lengths of the interscalene space in cadavers (P < 0.05). The average width and length of the interscalene space (groove for the subclavian artery) in 50 dry ribs were 15.53 ± 2.12 mm and 16.12 ± 1.95 mm, respectively. In CT images, the widths of the costoclavicular passage were also significantly narrower than those of the interscalene space (P < 0.05). The measurements from cadavers, dry first ribs and CT images were not significantly different (P > 0.05).
Our results showed that the costoclavicular width was the narrowest space along the passage route of the subclavian artery. When considering the surgical decompression of the subclavian artery for TOS, this narrowest area should always be kept in mind. Since measurements from CT images and cadavers were significantly similar, CT measurements may be used to evaluate the thoracic outlet region in patients with TOS.
Amaç: Kronik obstrüktif akciğer hastalığı tanısı konmuş hastalarda,
kantitatif toraks bilgisayarlı tomografi (BT)’nin KOAH fenotiplerinin
belirlenmesindeki rolünü araştırmaktır.
Materyal ve Metodlar: ...Ocak 2007- Eylül 2013 tarihleri arasında Ufuk
Üniversitesi Dr. Rıdvan Ege Hastanesi Göğüs Hastalıkları polikliniği/
servisinde değerlendirilen 104 hasta ve 20 kontrol olgusu çalışmaya
alındı. Hastaların spirometrik parametrelerine SFT kayıtlarından, toraks BT
verilerine ise Radyoloji arşivinden ulaşıldı. Tüm toraks BT’lerin kantitatif
incelemesi Radyoloji Anabilim Dalında belirlenen tek bir Radyoloji Uzmanı
tarafından yapıldı. Görüntü Arşivleme ve İletişim sisteminden elde edilen
toraks BT incelemeleri Radyoloji servisinde kullanılan iş istasyonuna
yüklendi. Bu amaçla Adwanced Workstation 4.2 Sun Workstation
kullanıldı.
Bulgular: Çalışmamızda sağ ve sol akciğer amfizem hacimleri ortalama
değerleri sırasıyla 205,8±303,3 ml ve 210,3±363,8 ml olup kontrol
grupları ile aralarında anlamlı bir fark bulundu (p<0,001). Olguların
ROC analizinden elde edilen amfizem hacmi eşik değeri %2,1 olarak
alındığında, FEV1/FVC <%70’in altında olma durumunu tahmin etmedeki
duyarlılığı %62,3, seçiciliği %94,4, pozitif prediktif değeri ise %98,5 olarak
bulundu. Kronik bronşit ise direk bronş duvar kalınlığı ölçümleriyle bir
cut-off belirlenemedi. Katılımcıların spirometri değerleri incelendiğinde
kronik bronşitlilerin (n=39) FEV1, FEV1/FVC ve FEF 25-75 değerleri
amfizemli olgularınkinden (n=65) anlamlı olarak yüksek bulunmuştur
(p<0,05). Spirometri değerlerinden, YÇBT’deki amfizem yüzdesi ile en
yüksek negatif korelasyon gösteren parametre FEV1/FVC idi (r=-0,539)
(p<0,001). Diğer spirometri değerlerinin aksine FEV1/FVC (%) değeri
ile bronş duvar kalınlığı arasında negatif korelasyon izlendi (r=-0,214)
(p<0,05).
Sonuç: Kantitatif BT’de amfizem ve kronik bronşit varlığının fonksiyonel
değerlendirme sonuçlarını öngördüğü ancak, yıllık atak sayısı ve semptom
skorları açısından belirleyici olmadığı izlenmiştir. Ayrıca kantitatif BT’de
amfizem hacmi eşik değeri %2,1 olarak bulundu. Radyolojik bulguların
klinikle korelasyonu değerlendirilip fenotip belirlenmesi için ileri
araştırmalara ihtiyaç vardır.
Objective: To describe the relationship between atherosclerosis and hearing thresholds in prediabetic patients with impaired fasting glucose (IFG) and to determine the efficacy of glycated albumin in ...predicting carotid artery atherosclerosis in patients with isolated IFG. Subjects and Methods: The study included 82 patients (aged 53.73-80 years) divided into two groups based on fasting glucose levels, the IFG group: 59 patients (32 females, 54.2%), and the normal fasting plasma glucose level group: 23 patients (12 females, 52.2%). Patients underwent audiological testing to determine hearing thresholds, and carotid intima-media thickness (CIMT) was measured using carotid artery Doppler sonography. Multivariate analyses were performed to determine whether or not the plasma glycated albumin levels could predict hearing loss and CIMT. Results: Patients in the IFG group (mean age: 59.8 ± 9.5 years) had higher hearing thresholds and pure-tone average scores (PTA) than those in the group with normal glucose levels (mean age: 56.2 ± 10.1 years) (left ear: 27.65 ± 8.85 vs. 25.75 ± 21.96 dB, p = 0.021; right ear: 29.22 ± 8.51 vs. 22.39 ± 6.99 dB, p = 0.001). The CIMT was significantly higher in the IFG group than the control group (0.75 ± 0.26 vs. 0.56 ± 0.16 mm, p < 0.001 for the left and 0.74 ± 0.26 vs. 0.51 ± 0.19 mm, p < 0.001 for the right carotid arteries). Glycated albumin levels were independently related with increased CIMT (left CIMT: r = 0.32, p = 0.003; right CIMT: r = 0.42, p < 0.001), and serum glycated albumin levels were significantly associated with PTA (left ear: r = 0.28, p = 0.01; right ear: r = 0.30, p = 0.006). Conclusion: Sensorineural hearing loss was more common in patients with IFG. Plasma glycated albumin levels were strongly correlated with CIMT and carotid plaques as a marker of atherosclerosis and with hearing impairment thought to develop due to atherosclerosis in patients with IFG.
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