فهرست مطالب

  • Volume:11 Issue: 4, 2014
  • تاریخ انتشار: 1393/10/06
  • تعداد عناوین: 13
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  • Adam Domonkos Tarnoki*, David Laszlo Tarnoki, Katalin Klara Kiss, Pal Bata, Kinga Karlinger, Andras Banvolgyi, Norbert Wikonkal, Viktor Berczi Page 5316
    Gorlin-Goltz syndrome (GGS) consists of ectodermal and mesodermal abnormalities. In this case report we will investigate lower extremity lesions of GGS. A 52-year-old man with GGS underwent skull and lower extremity computer tomography. Radiographic findings included cervical spondylosis, transparent areas with slurred margins, and cerebral falx calcification. Tibial and fibular specific cortical lesions (thin cortical and subcortical cystic lesions) were seen on the radiography, which was confirmed by computer tomography. To our knowledge, this is the first report of such a long lesion of the tibia and fibula. Specific lower extremity cortical lesions (thin cortical and subcortical cystic lesions) may occur and these abnormalities can be found on radiography or CT, which are most probably attributed to retinoid treatment.
    Keywords: Basal Cell Nevus Syndrome, Lower Extremity, Tomography, X-ray Computed
  • Farzaneh Motamed, Abbas Khalili, Payman Salamati*, Golnaz Moradi, Mehri Najafi Sani, Ahmad Khodadad, Gholam Hossein Fallahi, Fatemeh Farahmand, Maryam Monajjemzadeh Page 6382
  • Francesco Cicone *, Carolina Del Mastro, Francesco Scopinaro Page 9057
  • Zeynep Ilerisoy Yakut *, Ahmet Yagmur Bas, Aynur Turan, Nihal Demirel, Tulin Hakan Demirkan Page 10107
    Neurocutaneous melanosis (NCM) is a rare, congenital non-hereditary syndrome, characterized by multiple pigmented nevi. We report the radiologic findings of a newborn who had extensive cutaneous melanotic nevus with satellite lesions in the brain. Ultrasound showed multiple echogenic foci in the cerebral parenchyma. Subsequent MRI confirmed these lesions as characteristic deposits of melanin. The infant was asymptomatic, but presence of risk factors such as malign transformation or neurological manifestations makes early diagnosis very important. We present this case to emphasize on the radiological findings of this syndrome in order to reach an early diagnosis..
    Keywords: Neurocutaneous Melanosis, Newborn, Ultrasound
  • Mojgan Kalantari, Shahrzad Zadeh Modares, Firoozeh Ahmadi *, Vajihe Hazari, Hadieh Haghighi, Mohammad Chehrazi, Melika Razaghi Page 10513
    Background
    Hysterosalpingography (HSG) is considered as a primary test in infertility work up worldwide due to its reliability in evaluating abnormalities related to the uterus and fallopian tubes.
    Objectives
    To assess the efficacy of applying eutectic mixture of local anesthetics (lidocaine-prilocaine cream) (EMLA) on the uterine cervix in reducing pain during HSG.Patients and
    Methods
    Eighty patients undergoing HSG as part of infertility evaluation were randomly allocated to groups receiving either EMLA (N = 40) or placebo cream (N = 40) in a double-blinded prospective study. Fifteen minutes before HSG, 5 grams of 5% cream was applied to the uterine cervix using a cervical applicator. The degree of pain experienced by the patient was evaluated during and after HSG at five predefined steps on a visual analogue scale (VAS).
    Results
    There was no significant difference in the efficacy between EMLA and placebo creams in pain perception during the entire procedure. There was no significant difference in long term pain perception half an hour after the HSG performance.
    Conclusions
    This study does not support the use of EMLA for HSG.
    Keywords: Hysterosalpingography, Eutectic Lidocaine, Prilocaine, Pain, Visual Analog Scale
  • Xiaona Li, Zhigang Peng, Jingpin Zhao, Zekun Zhang* Page 10848
    Thisis a case report of a 24-year-old man who presented with increased pain and firm swelling of the right foot after a minor twisting injury. Radiography, computed tomography (CT) and magnetic resonance imaging (MRI) findings showed ancillary information that was helpful for surgical treatment. The final diagnosis was confirmed aschondroblastoma of the navicular bone based on the pathology report. The navicularbone is a very rare site in the foot, where we should pay attention tochondroblastoma.
    Keywords: Chondroblastoma, Bone, Magnetic Resonance Imaging
  • Suat Keskin*, Abdussamet Batur, Zeynep Keskin, Abdulkadir Koc, Irfan Firat Ozcan Page 11069
    To our knowledge, bilateral supernumerary kidney is a very rare renal abnormality and there are five cases presented in the literature. It is difficult to diagnose supernumerary kidney and clinicians have not detected most cases preoperatively. Laboratory and imaging studies were acquired and carefully examined. The normal laboratory tests were found. Emergency ultrasonography was performed and they revealed no signs of parenchymal abnormality in both kidneys. Serial imaging study including enhanced computed tomography (CT) was performed. An imaging study identified bilateral supernumerary kidney with expanded collecting systems. On each side, significant rotation anomaly was found. In addition, there were two different renal arteries originating from the aorta. This report presents radiological determinations of supernumerary kidney bilaterally in a young man. We think that CT commonly appears to be enough for the diagnosis of supernumerary kidneys..
    Keywords: Supernumerary, Supernumerary Kidney, Congenital Anomaly, Hypertension, Computed Tomography
  • Xiao Zhi Zheng, Bin Yang *, Jing Wu Page 11393
    Background
    The timely diagnosis of presence or absence of reperfusion injury after cardiac operation is critical for the patient’s outcome. Whether transesophageal echocardiography (TEE) acquisition of regional grayscale intensity (TI), velocity, and displacement (D) after cardiac operation can discriminate between patients with ST-segment elevation ischemic reperfusion injury(STEIRI) and normal reperfusion state remains unknown.
    Objectives
    In this study, we investigated whether these parameters can effectively reflect the situation of ST-segment elevation ischemic reperfusion injury (STEIRI) in patients after cardiac operation and which has a higher performance of discrimination between patients with and without STEIRI.Patients and
    Methods
    The maximal and minimal grayscale intensity in the cardiac cycle [TI (max), TI (min)], the difference of TI (max) and TI (min) [TI (max-min)], the cyclic variation index of TI [TI (CVI)], the systolic velocity (Vs), the early diastolic velocity (Ve), the late diastolic velocity (Va) and the peak displacement in the cardiac cycle (D) at the lateral side of the mitral annulus were measured and compared between patients with and without STEIRI. The performance of these parameters in discriminating between patients with and without STEIRI was analyzed.
    Results
    Compared with the patients without STEIRI, the patients with STEIRI had significantly smaller TI (max-min), TI (CVI), Vs, Ve, Va and D (P<0.05). With the use of these parameters as the criteria to distinguish patients with STEIRI from patients without STEIRI, the areas under the receiver operating characteristic curve were 0.86 for TI (max-min), 0.99 for TI (CVI), 0.89 for Vs, 0.71 for Ve, 0.85 for Va and 0.82 for D. For the best cut-off value of TI (CVI) of less than 34.45%, the sensitivity, specificity and accuracy for the prediction of patients with STEIRI were 94.74%, 97.05%, and 96.22%, respectively.
    Conclusion
    The myocardial grayscale intensity, velocity and displacement can effectively reflect the situation of STEIRI in patients after cardiac operation, and TI (CVI) has a higher performance in discriminating between patients with and without STEIRI.
    Keywords: Grayscale Intensity, Velocity, Displacement, Cardiac Operation
  • Azadeh Ebrahimzadeh, Mahyar Mohammadifard*, Godratallah Naseh Page 13575
    Background
    Tuberculosis is a chronic pulmonary infectious disease that has affected one-third of the people in the world. It causes nine million new cases and two million deaths per year. Chest radiography associated with Ziehl-Neelsen acid-fast staining procedure significantly helps the diagnosis of pulmonary tuberculosis (PTB). Chest radiography can help the diagnosis of tuberculosis in patients with a negative smear sample result that is mainly diagnosed with delay.
    Objectives
    In this study, chest X-ray findings of PTB were compared in two groups of smear positive and smear negative patients.Patients and
    Methods
    In this retrospective descriptive-analytical study, 376 patients who had been confirmed with PTB were referred to Birjand Health Care Center from 2001 to 2006. Out of the 376 patients, 100 patients with a positive smear based on WHO criteria were selected. In addition, among negative smear patients, 100 were selected in whom similar demographic characteristics with positive smear patients were seen. All of them had undergone chest radiographies that were then interpreted by two expert radiologists independently. Moreover, all patients’ sputa were examined by an expert laboratory technician at the reference laboratory of the health center. The obtained data were analyzed by means of frequency distribution table and descriptive statistics using SPSS (version 15) and Chi-square statistical test.
    Results
    Except reticulo-nodular infiltration, the relative frequency of other radiographic findings in positive smear patients were more than negative smear patients; and only differences in calcification variables, mediastinal widening, patchy infiltration and hilar adenopathy were statistically significant (P < 0.05).
    Conclusions
    Based on the results of this study, although radiographic findings are not diagnostic in PTB, they are helpful if the assessment associates with the view of clinical manifestations and sputum smears.
    Keywords: Pulmonary Tuberculosis, Smear Positive, Smear Negative, Radiological Findings
  • Ahmad Enhesari, Alireza Saied*, Lotfollah Mohammadpoor, Alia Ayatollahi Mousavi, Fateme Arabnejhad Page 14441
    Background
    Carpal tunnel syndrome (CTS) describes a set of symptoms caused by compression of the median nerve in the wrist, which is the most common site of nerve compression in the upper limb. This syndrome is a primary source of pain and reduced function in these patients, and the cause is compression of the median nerve where it passes beneath the flexor retinaculum in the wrist.
    Objectives
    The aim of the present cross sectional study is to assess the absence of palmaris longus and fifth superficial flexor digitorum tendon as normal anatomic variations on the sonographic measurement of median nerve surface area in healthy individuals’ wrists.Patients and
    Methods
    Ninety-three healthy volunteers underwent clinical evaluation for determining the presence of tendons in both wrists and sonographic measurement of median nerve surface area.
    Results
    In 41 of 186 (22%) hands, the palmaris longus tendon was absent and absence of the fifth flexor digitorum tendon was noted in eight (4.30 %). The median surface area in the hands without palmaris longus was meaningfully lower than the hands with it (P = 0.025), while the difference in the median surface area was not statistically significant with regard to presence of the fifth flexor digitorum tendon (P = 0.324).
    Conclusions
    Based upon the findings of the present study, it seems that the median surface area as a sonographic finding is probably related to presence or absence of the palmaris longus tendon, so that hands with the tendon present have larger surface areas. In addition, it seems that this sonographic finding does not depend on the function of the fifth superficial flexor digitorum tendon. Therefore, no correlation between CTS and the presence of palmaris longus tendon should be observed.
    Keywords: Carpal Tunnel Syndrome, Tendons, Ultrasonography
  • Seon Hee Choi, Hak Jin Kim*, Lee Hwangbo, Yong, Woo Kim Page 14887
    Background
    Triolein emulsion infusion into the brain produces transiently increased vascular permeability.
    Objectives
    The purpose of this study was to find the minimum percentage of triolein emulsion required for studying vascular permeability with minimal brain edema.
    Materials And Methods
    Sixty healthy cats were divided into six groups according to the concentration of emulsified triolein infused into the carotid artery: group 1, 0.125% (n = 10); group 2, 0.25% (n = 10); group 3, 0.5% (n = 10); group 4, 1% (n = 10); group 5, 2% (n = 10); and group 6, saline infusion (control group, n = 10). T2-, T1- and contrast enhanced T1-weighted MR images were obtained 2 hours after infusing triolein emulsion. Contrast enhancement ratios (CERs) and signal intensity ratios (SIRs) versus contralateral hemispheres were calculated. Statistical analysis was performed by analysis of variance followed by Tukey’s test. P values of ≤ 0.05 were considered significant.
    Results
    The lesion hemispheres showed mild hyperintensity due to edema on T2-weighted images, and contrast enhancement on post-contrast T1-weighted images in cats of group 1-5. CERs showed statistically significant differences between the control group and group 3 (P = 0.006), group 4 (P = 0.003), and group 5 (P < 0.001). However, SIRs were significantly different between the control group and group 5 only (P < 0.001).
    Conclusion
    The minimum concentration of triolein emulsion required to increase vascular permeability adequately with minimal brain edema in a cat model was 0.5%.
    Keywords: Triolein, Emulsions, Blood, Brain Barrier, Vascular Permeability, MRI
  • Mikail Inal *, Birsen Unal, Yasemin Karadeniz Bilgili Page 18114
    Background
    Surgery of appendicitis carries 7-11% negative appendectomy rates. Sonographically visualized normal appendix precludes unnecessary computed tomography (CT) examination and may reduce negative appendectomy rates. Tissue harmonic imaging (THI) has been reported to improve the overall image quality.
    Objective
    We aimed to assess whether THI is more successful than conventional ultrasonography (US) in detecting normal and pathologic appendices.Patients and
    Methods
    The study was performed on 185 patients who applied for routine US examinations in whom clinical findings of appendicitis were detected in 25. We searched for the appendix; applying both THI and conventional US to each patient, one before and the other after the routine US examinations. Patients were divided into two groups; one was evaluated first with conventional US and the other first with THI. When the appendix was found, localization, diameter and time spent for visualization were recorded. Twelve patients were operated; all of whom had appendicitis pathologically. Two methods were compared for: 1. Success rates in all patients; female, male and child groups separately; 2. Visualization of pathologic and normal appendices; 3. Time for visualization of appendix; 4. Comparison of success rates in the adult and child population. The relationship between the rate of visualization and body mass index was evaluated.
    Results
    The appendix was visualized better by THI in all patients, and in the female and male groups (P < 0.001). In children, both methods were more successful compared to adults (P < 0.001, compared to male group, P < 0.001, compared to female group), with no difference between the methods (P = 0.22). When only the normal appendices were concerned, there was significant difference between both methods (P < 0.000). Both methods detected pathologic appendices better than normal ones, with a higher ratio for THI (P = 0.022 for the THI group, and χ2 = 7.22, P = 0.07 for the conventional US group). THI visualized the appendix faster. Both methods were more successful in lean patients (P = 0.004 for THI, P = 0.001 for conventional US imaging).
    Conclusions
    THI visualizes appendix better than conventional US. It is a simple and time saving method that may eliminate further diagnostic imaging, and it may decrease negative appendectomy rates and related complications.
    Keywords: Appendix, Appendicitis, Tissue Harmonic Imaging, Ultrasound Imaging, Diagnosis