Anatomic variations of the sphenoid sinus on computed tomography.

Anatomic variations of the vital structures adjacent to the sphenoid sinus can be jeopardized during functional endoscopic sinus surgery (FESS). The knowledge of the size and extent of pneumatization of the sphenoid sinus (SS) is an important condition for adequate surgical treatment of its disease. The bony anatomic variations of SS as well as its relationship with adjacent vital structures were reviewed in this paper. The study was performed on 267 patients with a complaint of chronic or recurrent sinusitis. Computed tomographic (CT) scans were obtained upon completion of therapy. The evaluations of the sphenoid sinuses were regarded separately, so as 534 sides were examined. Especially bony anatomic variations as well as mucosal abnormalities of the sphenoid sinuses were examined. Pneumatization of the pterygoid process and anterior clinoid process were found in 39.7% and 17.2% of the patients respectively. Vidian canal protrusion was found in a total of 158 sides of which 60 were bilateral. These entities were encountered usually when pneumatization of the pterygoid process occurred. Carotid canal and optic canal protrusions were found in 5.2% and 4.1% of the patients respectively. Mucosal thickening, and polyps or cysts of sphenoid sinuses were detected in 20.6% and 4.5% of the patients respectively. There was a statistically significant correlation between pterygoid pneumatization and vidian canal protrusion (p < 0.001), and vs. foramen rotundum protusion (p = 0.004). While the optic canal protrusion was found significantly associated with the anterior clinoid pneumatization (p < 0.001), there was no statistically significant correlation between a carotid canal protrusion and anterior clinoid pneumatization (p = 0.250). Sphenoid sinus surgery is very risky, because of changing variations of the cavity. We are in the opinion that detailed data from CT scans of SS will enable the surgeon to interpret any anatomic variations and pathological conditions before initiation of the surgical therapy.

Effect of extratesticular hematoma on testicular blood flow and the histology of the testis and dartos fascia. an experimental study.

INTRODUCTION: Hematoma is a common complication of inguinoscrotal surgery in childhood. We aimed to identify the possible effects of extratesticular hematoma on blood flow and the histology of testes in the early period. Also, the dartos tissue was evaluated histologically. MATERIALS AND METHODS: Unilateral extratesticular hematoma was created in 12 New Zealand rabbits. Parenchyma of the testes and scrotum walls was evaluated by B-mode ultrasound and the spectrum from the intratesticular vessels was obtained by color Doppler ultrasound on days 1, 7 and 15 of the procedure. Testes and scrotal walls were removed at the end of the study for histologic evaluation. RESULTS: There were no significant pathologic findings in the evaluation of the parenchyma and hemodynamia of the testes on days 1, 7 and 15. A well-organized but continuing hematoma was observed on day 15. Increased fibroblastic activity, dense inflammatory cells, necrotic areas and destruction of the muscular layer were observed at pathologic evaluation of the scrotum. CONCLUSIONS: Extratesticular hematoma has no effect on testicular histology and hemodynamia in the early period. Pathologic evaluation revealed fibrosis of the dartos fascia at the end of the second week. Destruction and fibrosis of this tissue may have an adverse effect on spermatogenesis by altering thermoregulation.

Helicobacter pylori seropositivity and atherosclerosis risk factors.

Certain viral and bacterial infections may contribute to the initiation and progression of atherosclerosis. The aim of this study is to determine whether Helicobacter pylori (HP) seropositivity contributes to conventional atherosclerosis risk factors in the development of an early sign of atherosclerosis: intima-media thickness (IMT) of the carotid artery. Eighty-four patients who had at least two conventional atherosclerosis risk factors and a control group of 50 patients having no risk factors for atherosclerosis were enrolled in the study. None of the patients had ever received HP eradication treatment. HP IgG antibodies were determined by enzyme-linked immunosorbent assay. Carotid artery IMT was measured 1 cm before the carotid bifurcation. Seventy-five percent of the study group was HP seropositive. HP seropositive (n=64) and seronegative (n=21) groups were identical in terms of sex distribution, smoking pattern, mean age, hemoglobin, leukocyte, platelet, C-reactive protein, erythrocyte sedimentation rate, glucose, cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein, systolic blood pressure and diastolic blood pressure levels. There was no significant difference between the mean carotid IMT of HP seropositive (0.8+/-0.3 mm) and negative (0.8+/-0.3 mm) patients in the study group. Similar to the study group, there was no statistically significant difference between mean carotid IMT of HP seropositive (0.56+/-0.19 mm) and negative patients (0.67+/-0.13 mm) in the control group (p=0.2). Future studies concerning virulent strains are needed to determine the probable role of HP in atherosclerosis.

Perception of bronchoconstriction in obstructive pulmonary diseases (disease-specific dyspnoea).

The perception of dyspnoea differs between subjects with obstructive pulmonary diseases, partly because the underlying mechanisms for bronchoconstriction are different. We investigated the perception of bronchoconstriction in subjects with bronchiectasis, asthma and chronic bronchitis and possible contributing factors. Forty-seven non-smoking subjects with bronchiectasis, 50 subjects with asthma and 31 with chronic bronchitis were challenged with histamine. The Borg score was assessed before and after each challenge. The perception score corresponding to a fall in the forced expiratory volume in 1 s (FEV(1)) by 20% (PS(20)) was calculated. The mean values of DeltaBorg/DeltaFEV(1) (the Borg score change divided by the change in FEV(1) as a percentage of the baseline FEV(1)) and PS(20) of subjects with bronchiectasis and chronic bronchitis were significantly lower than in subjects with asthma after histamine challenge. The ratio of non-perceivers was higher in bronchiectasis (25.5%) and in chronic bronchitis (32.3%) than in asthma (4.0%). When all subjects were considered, DeltaBorg/DeltaFEV(1) values were significantly related to female sex ( r (2)=11.5%, P =0.0001), but not to age, duration of the disease, PD(20) or baseline FEV(1)%. The present study indicates that perception of histamine-induced bronchoconstriction is lower in patients with bronchiectasis and chronic bronchitis than in asthmatic patients, and that sex partially contributes to this difference.

Magnetic resonance imaging of the intratemporal facial nerve in idiopathic peripheral facial palsy.

The aim of this study was to investigate the prevalence of facial nerve involvement with gadolinium-enhanced magnetic resonance imaging (Gd-MRI) in patients with idiopathic peripheral facial palsy (IPFP), and to discuss the localization and the pattern of enhancement. A total of 13 patients (9 female, 4 male) with IFPF were included in this study. Topographic tests and electromyography (EMG) were performed, and MRI was taken. Ten subjects whose cranial MRIs were taken for nonorganic pathology served as the control group. Twelve of 13 paralytic facial nerves had enhancement on postcontrast images. Two facial nerves of the control group demonstrated enhancement. We found a correlation between the enhancement of the facial nerve and the time for recovery. The average time from the onset of facial palsy to the recovery in patients with enhancement was 14 weeks, whereas it was 6 weeks in patient with no enhancement. Finally, all patients had complete recovery of the facial nerve function. We concluded that contrast enhancement of the paralytic facial nerve can be a radiological sign of a neural inflammation and may indicate a prolonged recovery.

Resistance index in fetal interlobar renal artery with renal pelvic dilatation up to 10 mm.

PURPOSE: The purpose of this study was to compare the resistance indices (RIs) in the fetal interlobar renal arteries (IRAs) of third-trimester fetuses with or without pelvicaliceal dilatation of up to 10 mm and to compare them with those of the full-term healthy infants. METHODS: Women with uncomplicated, low-risk, singleton third-trimester pregnancies were examined sonographically. The RIs in the IRAs were measured in the fetuses, who were stratified into 3 groups according to the anteroposterior diameter of the renal pelvic dilatation: group I, no dilatation; group II, 1-5-mm dilatation, and group III, 6-10-mm dilatation. RESULTS: In total, 178 women were examined. We could study both kidneys in 139 of the fetuses; in the other 39, only 1 kidney could be imaged perfectly. This yielded a total of 317 kidneys. Group I fetuses included 172 (54%); group II, 98 (31%); and group III, 47 (15%) of the kidneys. The mean (+/- standard deviation) RIs in the IRAs were 0.81 +/- 0.09, 0.80 +/- 0.07, and 0.80 +/- 0.06 in the 3 groups, respectively, with no statistically significant difference between the groups (p = 0.72). There was also no statistically significant difference between the RIs recorded in the right and left kidneys. The mean RI in the IRAs of the 34 infants who were available for follow-up 6-12 weeks after delivery was 0.73 +/- 0.07, which was significantly less than that recorded in the third-trimester fetuses (p = 0.005). CONCLUSIONS: The RI in the fetal IRA does not differ in fetuses with and without renal pelvic dilatation of up to 10 mm. Thus, an increase in the RI or an RI that significantly differs between the right and left kidneys should be investigated further for possible renal pathology.