Comparison of doppler ultrasonographic findings in complicated and uncomplicated lower-limb varicose veins

Comparing anatomicopathologic findings in complicated and uncomplicated lower-limb varicose veins by ultrasonography. Totally, 231 consecutive patients [148 [64%] men; mean age, 46.8 +/- 14.3 years [range: 16-88 years]]; 155 [54%] left and 132 [46%] right variceal legs were evaluated by Doppler ultrasonography with color-flow imaging using a 7.5-10 MHZ linear probe. The lower extremity venous system [including perforators and valves] were evaluated in the supine and standing position, at rest and during Valsalva's maneuver. Chi square and Fischer's exact tests were used for statistical analysis. We also performed a logistic regression analysis considering presence of any type of complication as the dependent variable and anatomic pathologies as independent variables. Of the 287 limbs with varicose veins, 124 [43%] had at least one complication [ulceration, pigmentation or infection]. The highest complication rate was seen simultaneously with chronic deep vein thrombosis [DVT] with segmental obstruction [76.9] and the lowest complication rate in the incompetent valves was seen in patients with perforan vein reflux [50.4%]. Mostly, the complication rate was higher in patients with the pathology in comparison to patients without it [p values<0.005]. In a multivariate logistic regression model, presence of DVT and saphenofemoral incompetency were statistically significant in the model in comparison to other pathologies [OR=10.6 and 7, respectively, p values<0.02]. In 175 patients [75.8%] one of the legs were involved Presence of ulcer, pigmentation and infection are significantly associated with a higher incidence of DVT, deep vein, saphenofemoral and saphenopopliteal incompetency in patients with lower limb varices

Intracranial manifestations of tuberous sclerosis: a pictorial essay

Tuberous sclerosis is an autosomal dominant genetic disease that involves multiple organs. Hamartomas are the predominant lesions. Classically, tuberous sclerosis has been characterized by a classical clinical triad of facial angiofibromas [90%], mental retardation [50-80%], seizure [80-90%] and all three in 30% of the patients. Two major features or one major feature plus two minor features are necessary for the definite diagnosis of this disease. We had some patients admitted with different presentations of tuberous sclerosis and a past history of convulsion from childhood, skin lesions and also mental retardation with a new onset headache and a changed pattern of convulsion. In physical examination, facial angiofibromas and subungual fibromas were apparently detected. Brain CT scan study with contrast showed multiple calcified nodules associated with tubers, ventriculomegaly and also enhancing enlarged nodules at the foramen of Monro, which were suggestive of subependymal giant cell astrocytoma [SGCA]. MRI showed the same brain findings [tubers, white matter lesions and subependymal nodules associated with SGCA], which were detected better. After surgery, SGCA was proved. In abdominal and pelvic CT scan and ultrasonography, massive bilateral angiomyolipomatosis and focal hypodense hyperechoic liver lesions were detected