A Case Report of Primary Malignant Pulmonary Melanoma.

We operated on primary malignant melanoma of the lung, attaching the pericardium, diaphragm, and parietal pleura. A 48-year-old female was admitted to our hospital because of persistent dyspnea and cough. A preoperative computed tomography of the chest revealed 3 lesions in the right lung and a mass on the diaphragm between the right lung's lower lobe and heart. A middle lobectomy was performed. The mass on the diaphragm had invaded the diaphragm and pericardium strictly. With a pericardiectomy and a diaphragmatic resection, the mass was removed in an en-bloc manner. Adjuvant chemotherapy was started 1 month after surgery and consisted of 5 days course of iv injection of cisplatin (90 mg/kg). The follow-up period was 5 years and uneventful. For primary pulmonary melanoma, even if it has intrapulmonary metastases, surgery and adjuvant chemotherapy can provide uneventful survival for more than 5 years.

Isolated congenital absence of the pericardium.

Absence of the pericardium can vary from partial to complete absence. Patients with complete absence of the pericardium are either asymptomatic or have nonspecific chest pain, and no treatment is needed. Patients with partial absence of the pericardium are at risk for possible symptomatic herniation of the left atrial appendage or left ventricle, leading to fatal myocardial strangulation. Therefore, it is very important to differentiate partial from complete absence of the pericardium. A 7-year-old girl presented with isolated congenital absence of the pericardium, which generally has a good prognosis. It is a relatively asymptomatic anomaly that usually requires no treatment. Some cases involve complications that require operative treatment. Absence of the pericardium can be precisely defined by computed tomography and magnetic resonance imaging.

Meningoencephalitis due to anthrax: CT and MR findings.

Anthrax is primarily a disease of herbivores, but it also causes cutaneous, respiratory and gastrointestinal infections in humans. Bacillus anthracis is an uncommon cause of meningitis and generally produces a haemorrhagic meningoencephalitis. We present the CT and MR findings of anthrax meningoencephalitis due to the cutaneous form of anthrax in a 12-year-old boy. They showed focal intracerebral haemorrhage with leptomeningeal enhancement.

Assessment of Doppler waveform patterns and flow velocities of hepatic veins in children with acute viral hepatitis.

PURPOSE: To evaluate hepatic vein flow patterns and velocities in children with acute viral hepatitis and to compare the findings to a group of healthy children, with duplex sonography. MATERIALS AND METHODS: Forty children with acute viral hepatitis were enrolled in group 1 and forty healthy children were enrolled in group 2 (control group). Both groups underwent gray scale and duplex sonography. Hepatic venous Doppler flow patterns were categorized as triphasic, biphasic, or monophasic. Peak systolic velocities of hepatic veins were recorded. RESULTS: In group 1, hepatic venous flow was triphasic in 61.6%, monophasic in 26.6%, and biphasic in 11.6% of the patients. These figures were 88.3%, 8.3%, and 3.3%, respectively, for the controls in group 2. Group 1 had fewer patients with only a triphasic flow pattern, but had a higher percentage of monophasic and biphasic flow patterns. There was a triphasic flow pattern in all three hepatic veins in 50% of group 1 and in 80% of group 2. Differences in flow patterns of hepatic veins between the groups were found to be significant according to the student t-test (p < 0.01), and this was independent of age, gender, feeding status, and activity. CONCLUSION: Similar to reports of chronic liver disease or diffuse liver disease, significant differences in the flow patterns of hepatic veins were found in children with acute viral hepatitis. Hepatic vein flow patterns were frequently monophasic or biphasic in group 1, especially when accompanied by change in hepatic echogenicity. There was no significant difference in the flow velocities of the hepatic veins between group 1 and group 2.

Sonographic evaluation of plantar fasciitis and relation to body mass index.

PURPOSE: We have investigated the role of sonography in the diagnosis of plantar fasciitis. MATERIALS AND METHODS: This study evaluates 39 patients with plantar fasciitis and control group of 22 healthy volunteers. The plantar fascia thickness was measured 5 mm distal to the insertion of the calcaneus of plantar aponeurosis. Qualitative parameters such as decreased echogenity, biconvexity, perifascial fluid and calcification of plantar fascia were also noted. RESULTS: Mean plantar fascia thickness was measured 2.9 mm in patients with unilateral heel pain, 2.2 mm for contralateral normal heel and 2.5mm for control group. There was a statistically significant difference between heel with plantar fasciitis, contralateral normal heel and control groups (p=0.009 and 0.0001, respectively). Mean body mass index was 28 kg/m(2) in patients with heel pain and 25 kg/m2 in control group. Body mass index measurements were significantly different between plantar fasciitis and control groups. We found reduced plantar fascia echogenity in 16 cases (41%), calcaneal spur in 20 cases (51%), biconvex appearance in two cases (5.1%) and perifascial fluid in one case (2.5%). CONCLUSION: We conclude that in patients with plantar fasciitis, ultrasound may detect relatively small differences in plantar fascia thickness even in clinically unequivocal plantar fasciitis.

Renal resistive index in healthy children.

OBJECTIVE: The objective of the study was to investigate the relationship between age and renal resistive index (RI) and to determine the normal values and ranges of RI in intrarenal arteries in healthy children. MATERIALS AND METHOD: Color duplex Doppler sonography of interlobar or arcuate arteries was performed in 115 children without clinical or laboratory pathologic changes of the urinary tract. Of these 115 healthy children, 23 were under 12 months of age (group 1), 24 between 12 and 35 months (group 2), 23 between 36 and 71 months (group 3), and 45 between 72 months and 16 years (group 4). Normative data for RI were established for each age group. RESULTS: When age groups were compared, statistically significant differences were observed between age groups 1 and 2 (P=0.007), 1 and 3 (P=0.00), 1 and 4 (P=0.00) and 2 and 4 (P=0.00). No significant differences were observed between age groups 2 and 3 (P=0.452), and 3 and 4 (P=0.078). There was no significant difference between mean RI values of right and left kidney within any age group (P=0.315). CONCLUSION: Results obtained in this study demonstrates that RI is age dependent; it is the highest at birth, from birth declines gradually with increasing age and stabilizes in a certain range (mean RI range regarded as normal for adults) by reaching adult levels.

Neurofibroma of the breast in a boy with neurofibromatosis type 1.

Neurofibromas occurring in the breast are very rare. A 10-year-old boy with neurofibromatosis type 1 (NF1) presented with a palpable mass on his left breast. US showed a well-defined and hypoechoic solid mass within the subcutaneous fat tissue in the areolar area. Mass was isointense compared to muscle and hypointense compared to fat tissue on TIW and T2W MR images. Excisional biopsy was applied to the mass. The diagnosis of gynecomastia and neurofibroma was made on the basis of histopathological and immunohistochemical findings.

[Uterine arteriovenous malformation: US, color Doppler US and MRI findings (case report)]. / Uterin arteryovenöz malformasyon: US, renkli Doppler US ve MRG bulgulari.

Uterine arteriovenous malformations are rare but life threatening lesions. Sixty nine-year old, multiparous, postmenopausal patient complained of intermittent vaginal hemorrhage for 4 years. Serum beta-HCG level of the patient who had no history of uterine curettage or pelvic operation was normal. Noninvasive diagnosis of arteriovenous malformations with congenital or acquired etiology can be made by color Doppler ultrasonography and MRI.

Airway wall thickness in patients with COPD and healthy current smokers and healthy non-smokers: assessment with high resolution computed tomographic scanning.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterized by airflow obstruction caused by emphysema or airway narrowing, or both. Recently airway dimensions have been measured using high-resolution computed tomography (HRCT). To evaluate large and small airway dimensions by HRCT and compare them with pulmonary function tests in patients with COPD and in smokers with or without airflow obstruction. METHODS: We used HRCT scanning to measure airway wall thickness at the segmental and sub-segmental levels in COPD patients (group II, stage II, n = 17, and group III, stage III, n = 5), healthy current smokers (group I, n = 10) and healthy non-smokers (group 0, n = 10). RESULTS: FEV1 was lower in patients with severe or moderate COPD than in healthy current smokers and non-smokers. FEV1 was lower in group I than group 0 (p < 0.005). There was no statistically significant difference between patients with moderate COPD and severe COPD in the ratio of airway wall thickness to outer diameter (T/D ratio) or the percentage wall area (WA%). Both groups II and III had higher T/D ratios than group I (p < 0.01), and group I had a higher T/D ratio than group 0 (p < 0.001). Both groups II and III had higher WA% than group I (p < 0.01 and p < 0.05, respectively), and group I had a higher WA% than group 0 (p < 0.001). A negative correlation was found between airway wall thickness and FEV1. CONCLUSIONS: Computed tomography measurements of large and small airway dimensions are useful for evaluating lung function in patients with COPD and healthy current smokers. Airway wall thickening is inversely related to the degree of airflow obstruction and positively related to cumulative smoking history.