Relationship Between Blood Monocyte-HDL Ratio and Carotid Intima Media Thickness in with Postmenopausal Women.

INTRODUCTION/BACKGROUND: The monocyte-to-high-density lipoprotein (HDL) ratio (MHR) and carotid intima media thickness may be used as a marker of inflammation and oxidative stres. This study is aimed to investigate the role of MHR in etiopathogenesis and to determine the association between MHR and carotid intima media thickness, fracture risk, and quality of life (QoL) in postmenopausal osteoporosis patients without comorbidities. METHODOLOGY: Sixty osteoporosis, sixty osteopenia and sixty control groups were included in the prospective study evaluating postmenapausal women. The monocyte, HDL, and MHR values of all patients were evaluated. The bone mineral density of the participants was determined using the dual energy X-ray absorptiometry device. The fracture risk was assessed using the Turkish model of the Fracture Risk Assessment Tool. The QoL was determined using the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41) scale, and carotid intima media thickness ultrasonography was used. RESULTS: The age, body mass index, duration of menopause, monocyte, HDL, and MHR were similar in all three groups. carotid intima media thickness was higher in the osteoporosis group than in the normal group (p=0.015). A positive correlation was found between L1-4 total T score and monocytes, major osteoporotic fracture risk and physical function from QUALEFFO-41 sub-headings, MHR and QUALEFFO-41 total score (p<0.05). When all participants were evaluated, a positive correlation was found between femoral neck T score and MHR, L1-4 total T score and monocytes, while a negative correlation was found between L1-4 total T score and CIMT (p<0.05). CONCLUSION: Among postmenopausal women without comorbidities, MHR in the osteoporosis group was similar to that of the osteopenia and normal groups. Monocyte and MHR correlate with femoral neck T score and L1-4 total T score. CIMT was associated with a decreased L1-4 total T-score and an increased fracture risk, but not with MHR.

Is tendinitis in volar plating related to the dorsally protruding screw length and its compartment?

OBJECTIVES: The aim of this study was to evaluate the relationship between the length of the protruded screws from the dorsal cortex and extensor tendon damage in all compartments. PATIENTS AND METHODS: Between May 2020 and April 2021, a total of 29 patients (13 males, 16 females; mean age: 52.3±13.0 years; range, 30 to 78 years) who were operated and followed in our clinic for AO A2 and A3 distal radius fractures were included in this prospective study. Surface ultrasound (US) imaging was made to the dorsal sides of both wrists of the operated patients at different timepoints postoperatively. The length of screws with radius dorsal cortex penetration and the presence of tendinitis were recorded. RESULTS: In 15 of 23 patients, the presence of 29 protruding screws was accompanied by tendinitis and, in eight patients, no tendinitis was observed, despite the partial protrusion of screws. A statistically significant correlation was found between the screw protrusion and presence of tendinitis (p<0.05). The number of protruding screws and tendinitis were seen mostly in the second compartment. There was a statistically significant correlation between the protruding screw length of >1.6 mm and the presence tendinitis (p<0.05). CONCLUSION: Dorsal cortex screw protrusions in the application of volar plate for distal radius fractures can cause tendinitis. Screw protrusions occur more frequently in the second compartment and the development of tendinitis in this compartment is associated with a screw length of >1.6 mm. Screw penetration can be easily identified with intraoperative US to prevent tendinitis and potential tendon ruptures.

Atrial Fibrillation after Coronary Bypass Surgery? Is Epicardial Fat a Risk Factor?

BACKGROUNDS: Postoperative atrial fibrillation (POAF) is one of the most common complication of cardiac surgery. Epicardial fat tissue may play a role in the development of atrial fibrillation (AF). The aim of this study was to evaluate relationship between epicardial fat volume (EFV) and the appearance of new-onset AF in patients undergoing isolated coronary artery bypass graft (CABG) with normal echocardiographic functions. METHODS: Between January 2017 and June 2020, 281 coronary artery disease patients undergone isolated CABG surgery with normal echocardiographic functions were included in the study. Patient characteristics, medical history, and perioperative variables were retrospectively collected. Patients with AF predisposition factors were excluded. RESULTS: Sixty-seven patients (23.8%) developed postoperatively AF during hospital stay. In univariate analysis, patients with postoperative AF were older compared with sinus rhythm patients (60.78 ± 9.03 vs. 65.46 ± 9.22, p = 0.001). There are no statistically significant differences between groups and EFV compared (107.78 ± 41.04 vs. 106.66 ± 34.98 p = 0.84). Large left atrial diameter, female patient, cardiopulmonary bypass and longer cross-clamp time showed correlation between POAF without statistical significance. CONCLUSION: Aging is the only associated factor with AF in this study. There was no EFV difference between POAF and non-AF groups in patients undergoing isolated CABG with normal echocardiographic functions.

Elastofibroma Dorsi Detected Incidentally on Chest Computed Tomography: The Prevalence and Reporting Rate in Radiology Reports.

Background Elastofibroma dorsi (ED) is an uncommon benign connective-tissue tumor, usually seen in the subscapular region of women after the fifth decade. The study aimed to determine the prevalence, radiological characteristics, and the rates of mention in the initial radiology reports of ED incidentally detected by chest computed tomography (CT) imaging in a large population.  Methodology This study was conducted at Hitit University, Erol Olçok Training and Research Hospital Radiology Department in Çorum, Turkey. A total of 3,299 patients (1,554 females, 1,745 males) who underwent non-contrast chest CT for various reasons were included in this retrospective study. The presence, side, thickness, and density of ED were investigated in these patients. Differences in gender and laterality were assessed statistically. It was also reviewed whether it was stated in the initial radiology report or not. Results ED was detected in 79 (2.4%) of 3,299 patients, in 60 (75.9%) females and 19 (24.1%) males with a median age of 57.5 years (range, 18-99 years). The risk of ED presence was determined to be 3.65-fold in females than in males. In the cases determined with ED, the median age was 75 years (range, 53-96 years), and ED was not determined in any patient aged <50 years. A statistically significant correlation was determined between age and the presence of ED (p < 0.001). No statistically significant correlation was found between age and ED thickness or density (p = 0.602, p = 0.233, respectively). It was noted that none of the patients were diagnosed in the first radiological report. Conclusions ED can be easily overlooked on cross-sectional examinations because of the similar appearance and density to adjacent structures. Knowledge of the characteristic radiological features of these lesions and increased awareness of radiologists will make early diagnosis possible in asymptomatic cases.

Determination of congenital absence of palmaris longus tendon with clinical examination and ultrasonography.

OBJECTIVES: The tendon of the palmaris longus is commonly used as a tendon graft in many reconstructive surgeries. Palmaris longus absence (PLA) was found in 15% among individuals worldwide. In this prospective study, we aimed to conduct an incidence study in which physical examination methods were confirmed by ultrasonography in PLA, and to evaluate the relationship of absence with age, gender, laterality and dominant hand. METHODS: The study included 490 cases. They were initially tested to evaluated by physical examination using the Schaeffer's and Hiz-Ediz test for the assessment of the palmaris longus tendon. Additional ultrasonography was performed to confirm its absence in 129 wrists of 78 cases whose tendons could not be visualized or palpated. RESULTS: The incidence of tendon absence was 13% by physical examination methods. According to the final results when we added ultrasonography to physical examination methods, the incidence of unilateral, bilateral and overall absence of the palmaris longus were 5%, 9% and 11% respectively. There was no statistically significant difference between individuals with and without PLA in terms of gender, side, age and dominant hand (p = 0.796, p = 0.622, p = 0.397 and p = 0.187, respectively). However, bilateral PLA was statistically significantly higher than unilateral in both genders (p = 0.011). CONCLUSIONS: We think that agenesis should be proven accurately by ultrasonographic examination for the final result before any surgical procedure with palmaris longus tendon. Furthermore measuring the diameter of the palmaris longus tendon by preoperative ultrasonography can be useful for surgeons who plan a procedure that requires specific measurements.

Comparison of shoulder Magnetic Resonance Imaging findings between patients with stage 4 chronic kidney disease and hemodialysis patients with healthy controls.

BACKGROUND: Shoulder involvement is frequently observed in chronic renal disease (CRD) and hemodialysis patients. OBJECTIVE: Our aim is to compare shoulder Magnetic Resonance Imaging (MRI) findings of stage 4 CRD patients naive to dialysis, hemodialysis patients and healthy controls. METHODS: Twenty hemodialysis patients with shoulder pain (Group 1), 30 hemodialysis patients without shoulder pain (Group 2), 20 patients with stage 4 CRD (Group 3) and 30 healthy controls (Group 4) were enrolled. Urea, creatinine and ß2 microglobulin were measured. Thickness, homogeneity and integrity of rotator cuff and presence of effusion were examined by MRI. RESULTS: Supraspinatus tendon was thicker in Group 1 compared to other groups, whereas infraspinatus tendon was thicker in Group 1 compared to Groups 2 and 4. Although all tendons thickness was higher in Group 3 than Group 4, there was no significant difference. Most effusion areas were present in Group 1, followed by Groups 2 and 3. There was a significant correlation between glomerular filtration rate and thickness of supraspinatus, infraspinatus tendons and between ß2 microglobulin and thickness of infraspinatus, subscapularis tendons and total number of areas with effusion. CONCLUSIONS: Increased shoulder tendon thickness and effusion were detected in symptomatic dialysis patients, while greater effusion areas were detected in asymptomatic dialysis patients and in stage 4 CRD patients who do not require dialysis compared to healthy controls.

Is the presence of echo-rich periportal cuffing in the liver indicator for abdominal inflammation in pediatric patients?

AIMS: Hyperechoic/echo-rich periportal cuffing (ErPC) is defined as an increase in echogenicity relative to the adjacentliver parenchyma. Thickening in the periportal area may occur with proliferation of bile ducts, hemorrhage, oedema, fibrosis,inflammatory changes or a combination of these. The aim of this study is to determine which intraabdominal inflammatory diseases are associated with the presence of ErPC in the pediatric population and to calculate the sensitivity and specificity of this finding. MATERIAL AND METHODS: In this prospective study 200 consecutive children who underwent abdominal ultrasonography (US) were included: group 1, the patient group (100 children with appendicitis, gastroenteritis, mesenteric lymphadenitis, intestinal infection, terminal ileitis and invagination as cause of intra-abdominal inflammation) and group 2, the control group (100 children). RESULTS: The ErPC was positive in 74 (74%) cases in the patient group and in 3 (3%) in the control group. According to final diagnoses, we found ErPC in most of patients with gastroenteritis (16/17), perforated appendicitis (10/11), mesenteric lymphadenitis (5/6) and acute appendicitis (27/37). The sensitivity of ErPC in indicating intra-abdominal inflammation was 0.80 and its specificity was 0.87. No significant correlation between ErPC and age, gender and CRP was found but a moderate and significant positive correlation between ErPC and WBC (p=0,010; r=0.255) was detected. Very good concordance between observers in terms of the presence of ErPC on abdominal US was found (concordance 97% and kappa 0.93). CONCLUSIONS: We consider that the presence of ErPC in pediatric patients, when evaluated alongside clinical and laboratory findings, has a high sensitivity and specificity for inflammatory intra-abdominal pathology.

Correlation of serum galectin-3 level with renal volume and function in adult polycystic kidney disease.

PURPOSE: The decrease in kidney functions in autosomal dominant polycystic kidney disease (ADPKD) is strongly correlated with the severity and growth of kidney cysts. Total kidney volume (TKV) was shown to be an early marker of the severity of the disease and a predictor of reduction in kidney functions. New treatment approaches for ADPKD have led to a need for easily applicable strong biomarkers predicting progression of the disease. The profibrotic mediator of galectin-3 (Gal-3) is linked to development of renal fibrosis. METHODS: The study included 74 patients with ADPKD diagnosis and 40 healthy controls. The TKV of patients was calculated using the manual tracing method on MR images. The serum Gal-3 levels of patient and healthy control groups were measured with the ELISA method. The correlations between serum Gal-3 value with TKV and kidney function were assessed in patients. RESULTS: As the stage of chronic kidney disease (CKD) increased, serum Gal-3 and TKV values increased (p < 0.001, p = 0.049, respectively). Correlation analysis found a negative relationship between serum Gal-3 levels and eGFR (r: - 0.515, p < 0.001); however, there was no relationship between serum Gal-3 and TKV (r = 0.112, p = 0.344). Linear regression analysis showed the major parameter affecting Gal-3 was eGFR (p = 0.016). CONCLUSIONS: In our study, we showed that renal impairment is an important determinant of Gal-3, and there is no correlation of Gal-3 and TKV in ADPKD. As a result, there is an urgent clinical need for new biomarkers to identify individuals with the chance of treatment in the early stage among ADPKD patients.

Focal Biliary System Obstruction and Atypical Liver Mass: Intrabiliary Ruptured Cyst Hydatid Case Report.

BACKGROUND: Hydatid disease can involve any part of the body, but the liver is the most frequently affected organ. Intrabiliary rupture is one of the most serious complications of a hepatic hydatid cyst. Radiological findings, especially magnetic resonance imaging and magnetic resonance cholangiopancreatography (MRI/MRCP), are helpful in the diagnosis of hydatid disease. CASE REPORT: We present a 48-year-old female patient with complaints of abdominal pain and jaundice. Radiological examination showed a heterogeneous lesion that contained cystic-solid components and millimetric calcifications in the liver. Adjacent intrahepatic bile ducts were dilated. CONCLUSIONS: In geographical areas endemic for hydatid disease, cyst rapture into the bile ducts should be included in the differential diagnosis even in seronegative cases, although it is not typical for hydatid cyst to be found as a mass lesion in the liver on US in patients with right upper quadrant pain and jaundice.Detailed imaging by MRI/MRCP should be done.

Painful and painless shoulder magnetic resonance imaging comparisons in hemodialysis patients and correlation with clinical findings.

BACKGROUND: Shoulder pain is frequently observed in haemodialysis patients. OBJECTIVE: To compare haemodialysis patients with or without shoulder pain in terms of shoulder motion ranges, ß2 microglobulin levels and magnetic resonance imaging findings. METHODS: Forty-three patients undergoing dialysis were enrolled, of which 23 patients had explicit shoulder pain at night, which appeared during dialysis. Range of joint motion and impingement tests were evaluated. ß 2 microglobulin value was recorded. MRI was used to evaluate rotator cuff tendons for thickness, homogeneity, integrity and presence of effusion. RESULTS: Ranges of motion were significantly lower in the painful shoulder group. Supraspinatus tendon thickness and the number of areas with effusion were higher in the painful group. There was a positive correlation between the ß 2 microglobulin level and supraspinatus (r:0.352 p< 0.05) and subscapular (r:0.454 p< 0.05) tendon thicknesses. While effusion areas and pain (r:0.351 p< 0.05) showed positive correlation, there was a negative correlation between pain and shoulder motion ranges. CONCLUSIONS: Shoulder pain in dialysis patients can be related with tendon thickness and effusion. While the ß 2 microglobulin level affects tendon thickness, it has no relation to pain and movement constraint.

Assessment of Pineal Gland Volume and Calcification in Healthy Subjects: Is it Related to Aging?

PURPOSE: The human pineal gland is a small neuroendocrine organ which produces melatonin. The main goal of this study was to provide a reference range for pineal volume in all age groups and to determine calcified and noncalcified tissue and their proportions, which may be a reflection of melatonin production in all age groups, by using very thin computerized tomography (CT) slices. MATERIALS AND METHODS: A total of 167 outpatients had undergone cranial CT. Each of the subject's total pineal volume (TPV), calcified pineal volume (CPV) and noncalcified pineal volume (NPV) according to age groups were calculated in cubic millimeters. Also, proportion of calcification (POC) was noted. RESULTS: The median values were 88.5 mm3 (12.3 mm3-411mm3) for TPV, 74.3 mm3 (12.3 mm3-298 mm3) for NPV, and 3.9 mm3 (0 mm3-141 mm3) for CPV. POC showed a gradual increase from 0-49 years. In the ≥70 group, when compared with the 60-69 age group, CPV and POC values were significantly lower (P: 0.036, P: 0.034, respectively). CONCLUSION: This study brings a radiological point of view to the distribution of pineal calcification according to age that has a link with melatonin secretion.

Preoperative Evaluation of Axillary Lymph Nodes in Malignant Breast Lesions with Ultrasonography and Histopathologic Correlation.

PURPOSE: Our aim is to define the sonographic criteria for assessing involved axillary nodes and to evaluate the accuracy of axillary ultrasound in the staging workup of individuals with breast cancer. MATERIALS AND METHODS: Thirty-five patients with breast cancer were prospectively evaluated with preoperative ultrasonography (US) to determine the presence of axillary lymph node metastasis. We determined whether there was axillary lymph node metastasis after axillary lymph node dissection or sentinel lymph node biopsy. If metastasis was found, the number of metastatic lymph nodes was recorded and compared with preoperative axillary US findings using histopathological evaluation as a reference. RESULTS: Metastatic lymph node detection in sonographic evaluation was associated with echogenic hilus obliteration, complete hypoechoic or anechoic appearance of lymph nodes, and asymmetric/nodal or diffuse cortical thickening greater than 3.8 mm. The overall sensitivity, specificity, positive predictive value, and negative predictive value of US were calculated as (20/22) 91 percent, (10/13) 77 percent, (20/23) 87 percent, and (10/12) 83 percent, respectively. CONCLUSION: Ultrasonography examination is a valuable method for evaluating the axilla in newly diagnosed breast cancer patients and provides valuable information for planning proper breast cancer management.

Jejunal Diverticulosis Presented with Acute Abdomen and Diverticulitis Complication: A Case Report.

BACKGROUND: Jejunal diverticulosis is a rare, usually asymptomatic disease. Its incidence increases with age. If symptomatic, diverticulosis may cause life-threatening acute complications such as diverticulitis, perforation, intestinal hemorrhage and obstruction. In this report, we aimed to present a 67-year-old male patient with jejunal diverticulitis accompanying with abdominal pain and vomiting. CASE REPORT: A 67-year-old male patient complaining of epigastric pain for a week and nausea and fever for a day presented to our emergency department. Ultrasonographic examination in our clinic revealed diverticulum-like images with thickened walls adjacent to the small intestine loops, and increase in the echogenicity of the surrounding mesenteric fat tissue. Contrast-enhanced abdominal computed tomography showed multiple diverticula, thickened walls with showing contrast enhancement and adjacent jejunum in the left middle quadrant, increased density of the surrounding mesenteric fat tissue, and mesenteric lymph nodes. The patient was hospitalized by general surgery department with the diagnosis of jejunal diverticulitis. Conservative intravenous fluid administration and antibiotic therapy were initiated. Clinical symptoms regressed and the patient was discharged from hospital after 2 weeks. CONCLUSIONS: In cases of diverticulitis it should be kept in mind that in patients with advanced age and pain in the left quadrant of the abdomen, diverticular disease causing mortality and morbidity does not always originate from the colon but might also originate from the jejunum.

The fate of abstracts presented at Turkish national radiology congresses in 2010-2012.

PURPOSE: This study aims to evaluate the analysis and publication rates of abstracts presented at the Turkish National Radiology meetings in 2010-2012. METHODS: Abstracts presented in the national radiology meetings of 2010, 2011, and 2012 were included in the study. The presentations were classified according to presentation type (oral or poster presentations), study type, study design, imaged organ or body systems, imaging modalities, time interval between the presentation and the publication date, and the journal in which the article was published. The conversion rate of presentations into full-text articles in peer-reviewed journals were surveyed through PubMed. The time from presentation in the meetings to publication was determined. The distribution of journals was also demonstrated. RESULTS: The total number of presentations submitted in three national radiology meetings was 3,192. The publication rate was 11% for the 2010 meeting, 8.2% for the 2011 meeting, and 9.6% for the 2012 meeting. A total of 300 papers were published, with an average of 15 months (range, 0-42 months) between presentation and final publication. The first three refereed international journals with the most number of papers derived from these meetings were Diagnostic and Interventional Radiology, Clinical Imaging, and European Journal of Radiology. CONCLUSION: The overall publication rate of scientific abstracts from Turkey was lower than those from overseas countries. Encouraging the authors to conduct higher-quality research would raise the publication rate as well as improve the quality and success of our scientific meetings.