Corpus callosum thickness: A predictive factor for the first drug efficiency of self-limited epilepsy with centrotemporal spikes (selects)?

OBJECTIVE: To investigate the existence of a possible linkage between the thickness of corpus callosum (CC) regions and the first antiepileptic drug response in patients with Selects. MATERIALS AND METHODS: CC thickness of 68 patients with Selects and 42 healthy controls between 4 and 12 years of age were measured using brain magnetic resonance imaging (MRI). Clinical and EEG features of newly diagnosed Selects patients were recorded. Patients were divided into two groups: good-response (patients without seizures within 24 weeks) and poor-response (patients with ≥ 1 seizure within 24 weeks). Thickness of CC was compared between patients (good-response and poor-response groups).and healthy controls. RESULTS: The thicknesses of genu and isthmus were significantly reduced in the Selects group than healthy controls. Isthmus and splenium were significantly thinner in poor responders than those in the good-response group (p = 0.005 and p < 0.001, respectively). The total number of seizures was negatively correlated with the thickness of the body, isthmus, and splenium (p < 0.001). There was no significant difference in CC thickness of the children with and without electrical status epilepticus in sleep (ESES). The thickness of the isthmus and splenium were significantly thinner in patients receiving ≥ 2 antiepileptic drugs (p = 0.002 and p = 0.001, respectively). CONCLUSIONS: Our study highlights the notable differences in areas of CC in Selects patients. These changes may help uncover the underlying cause of seizure recurrence and antiepileptic drug (AED) response. Different thinner parts of CC may be a protective mechanism to prevent seizure spread to other brain regions. CC thickness can be used as a new radiologic biomarker for predicting first AED response and seizure recurrence in Selects patients.

Kidney growth and renal functions under the growth hormone replacement therapy in children.

OBJECTIVE: The aim of this study was to investigate the kidney growth and renal functions in children receiving recombinant human growth hormone (rhGH) treatment. MATERIALS AND METHODS: A total of 37 children who received rhGH for 1.5 years before the study was started and 48 healthy controls were included at first evaluation. Hormone levels were determined and kidney sizes were measured by ultrasound. Kidney functions were assessed by serum creatinine and estimated glomerular filtration rate (eGFR). After 3 years of first evaluation, 23 patients were re-assessed. RESULTS: Kidney sizes were found to be lower in rhGH received children compared with controls at first evaluation (p<0.05). Significant positive correlations were found between anthropometric measurements and kidney length and kidney volume (p<0.05). Height was the most significant predictor of kidney volume in rhGH received children (p<0.001). After 3-years of follow-up significantly increases were found in kidney length and volume compared with the first measurements (p<0.05). Increase percentage of body height was similar to increasing percent of kidney length and liver long axis (14.2%, 11.7.1% and 7.7%, respectively, p>0.05). Although no abnormal renal function test results were found at first and second evaluations; rhGH received children had significantly lower eGFR, at first evaluation, compared with controls; however, renal functions significantly increased after 3 years of follow-up (p<0.05). CONCLUSIONS: In conclusion, effect rhGH treatment on kidney growth is parallel to growth in body height and other visceral organs. A 3-years rhGH treatment resulted in significant increases in renal functions.

Extended field-of-view sonography: evaluation of the superficial lesions.

OBJECTIVE: To evaluate the usefulness of extended-field-of-view 2-dimensional ultrasonography technique in superficial lesions. METHODS: During a 6-month period, 44 patients with superficial lesions on various parts of their bodies were evaluated with extended-field-of-view ultrasonography in addition to routine traditional 2-dimensional ultrasonography. If the diagnosis could not be made without the extended-field-of-view images, it was considered diagnostic. The radiologist decided if the extended-field-of-view ultrasonography helped spatial orientation, communicate findings, or compare the contralateral side in a single image, or if it was useful for follow-up evaluation. RESULTS: By using extended-field-of-view imaging including the surrounding anatomy, 22 musculoskeletal, 8 scrotal, 8 thyroid, 2 breast, and 4 abdominal wall lesions were documented successfully as a single image. Nevertheless, no new cases were diagnosed solely based on the extended-field-of-view images. Extended-field-of-view ultrasonography was considered helpful for spatial orientation in 25 cases (56.8%), for comparing the contralateral side in 16 cases (36.3%), and for communicating findings in 20 cases (45.4%). It was useful for follow-up evaluation in 13 cases (29.5%). CONCLUSIONS: None of the extended-field-of-view images was diagnostic. However, they did provide valuable additional information and better documentation of the lesions.

Kidney growth in children with congenital hypothyroidism.

The effect of hypothyroidism on kidney size has not been studied in children. The aim of this study was to examine the role of congenital hypothyroidism and levothyroxine (L-thyroxine) treatment on renal growth. Forty children with congenital hypothyroidism and 37 healthy controls were prospectively included. The mean age of patients was 8.2+/-4.7 years. Patients had lower height and weight standard deviation scores compared with controls. The mean L-thyroxine initial age and treatment duration were 37.0 and 60.5 months, respectively. In 62.5% of patients, L-thyroxine was initiated after 6 months of age, and 60.0% of patients had severe hypothyroidism. Patients had lower kidney length and total kidney volume compared with controls (P < 0.05). No significant differences were found in kidney volume/body weight and kidney volume/ body height ratios between patients and controls (P > 0.05). Multiple regression analysis showed significant relationship between relative kidney volume and average free thyroxine level (P < 0.05). No significant differences in kidney sizes were found between patients who had L-thyroxine initiated before and after 6 months of age or between mild/moderate and severe hypothyroidism at diagnosis (P > 0.05). In conclusion, normal renal growth can be accomplished with L-thyroxine replacement despite considerable delay in treatment initiation and/or severe hypothyroidism.

Evaluation of the normal appendix at low-dose non-enhanced spiral CT.

PURPOSE: To evaluate the frequency of visualization, thickness and location of the normal appendix at non-enhanced spiral computed tomography (CT). MATERIALS AND METHODS: Low-dose spiral CT scans obtained for renal colic assessment in 243 patients were retrospectively reviewed. The frequency of visualization, thickness and location of normal appendices were recorded without knowledge of the patients' history for the appendectomy. RESULTS: Forty of 234 patients had a past history of appendectomy (17%). Sensitivity, specificity, positive and negative predictive values, and accuracy of visualization of the normal appendix were 71%, 85%, 96%, 37% and 73%, respectively. When no intraluminal content was visualized, this area was excluded from the measurement and the mean thickness was 3.4 mm+/-0.66. CONCLUSION: The normal appendix is frequently seen at nonenhanced spiral CT. Knowing the normal thickness of the appendix can help reduce false positive and false negative diagnoses of acute appendicitis when reviewing non-enhanced spiral CT.