Double intussusception in a child: the triple-circle sign.
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Child↗
Biomedical subjects
Ercan Kocakoc
Publications and source records attributed to Ercan Kocakoc.
Postnephrectomy renal arteriovenous fistula.
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Adult↗
Sonographic measurement of the fetal cerebellum, cisterna magna, and cavum septum pellucidum in normal fetuses in the second and third trimesters of pregnancy.
PURPOSE: Absence of the cavum septum pellucidum (CSP), the cisterna magna (CM), or both, and enlargement of either or both structures are associated with various central nervous system malformations. In an effort to determine normal sizes and relationships between these cranial structures, we measured the CSP and CM in normal fetuses in the second and third trimesters of pregnancy using transabdominal sonography. METHODS: Women with uncomplicated pregnancies and normal singleton fetuses between 16 and 38 weeks' menstrual age were included in this prospective study. The width and anteroposterior (AP) diameters of the CSP were measured on the transverse transventricular plane, and the AP diameter of the CM was measured on the transcerebellar plane from the posterior aspect of the cerebellar vermis to the inner edge of the cranium. The transverse and AP diameters of the cerebellum were also measured. In addition, we measured the biparietal diameters (BPDs). RESULTS: In total, 130 women participated; 64 were examined in their second trimester and 66 in their third trimester. The mean age of the women was 27.4 +/- 4.8 years (range, 18-38 years), and the mean menstrual age of the fetuses was 26.9 +/- 6.7 weeks (range, 16-38 weeks). The mean BPD was 66.8 +/- 18.7 mm (range, 30-96 mm). The mean width and AP diameter of the CSP and the mean AP diameter of the CM differed significantly between the second and third trimesters (p < 0.001). All measured parameters correlated significantly with menstrual age and BPD. CONCLUSIONS: In normal fetuses, the CSP and CM should be visible on transabdominal sonography between 16 and 38 weeks' menstrual age. Because abnormalities in these cranial structures may be indicative of central nervous system malformations, the availability of mean sonographic measurements from normal fetuses should be helpful in determining the need for additional testing in fetuses with abnormal measurements.
Adult↗
Lung findings on high resolution CT in early ankylosing spondylitis.
OBJECTIVE: Ankylosing spondylitis (AS) is a chronic inflammatory disease mainly affecting the axial skeleton and pulmonary involvement is a well known feature of the disease. The aim of this study was to investigate the pulmonary high resolution computed tomography (HRCT) findings of patients with early AS. The relationship between pulmonary function tests (PFT) and HRCT findings was also determined. SUBJECTS AND METHODS: Twenty-eight patients with AS (mean age 30.8+/-7.4 and disease duration 7.0+/-2.6) were included in the study. Patients with a disease duration of >10 years or had other pulmonary diseases were excluded. All patients underwent plain chest radiography (posteroanterior and lateral views), thoracic HRCT and PFT. RESULTS: All chest radiographs were normal and HRCT revealed abnormalities in 18 patients. The most common abnormalities seen on HRCT were mosaic pattern (ten of 28), subpleural nodule (seven of 28) and parenchymal bands (five of 28). Seven of ten patients with mosaic pattern revealed air trapping areas on end expiratory scans. Twelve patients had abnormal PFT and all had restrictive type of involvement. Ten of these 12 patients had abnormal HRCT and the remaining two patients had normal HRCT. On the other hand, eight patients with normal PFT had abnormalities on HRCT. CONCLUSION: Patients with early AS frequently have abnormalities on HRCT, even though they have normal PFT and chest X-ray. Small airway involvement was found as frequent as interstitial lung disease in early AS.
Adult↗
Color Doppler sonographic evaluation of inter-relations between diameter, reflux and flow volume of testicular veins in varicocele.
OBJECTIVE: Reflux is an important criterion for the diagnosis of varicoceles and in the existence of reflux more than 1 s is the lower limit for the diagnosis of varicoceles. We proposed to assess the relationship of vein diameters with the incidence, duration and flow volume of reflux using color Doppler sonography (CDS) in patients with clinically diagnosed varicocele. MATERIALS AND METHODS: Forty-seven patients with varicocele (aged 16-43) were included into the study. Reflux was assessed in spectral analysis using CDS and the duration, velocity and flow volume were measured. RESULTS: Mean duration of reflux on right side was 1.5 +/- 0.3 s in 14 patients, throughout the Valsalva's maneuver in eight patients and no reflux in 25 patients. Mean duration of reflux on the left side was 1.5 +/- 0.3 s in 25 patients, throughout the Valsalva's maneuver in 18 patients and no reflux in four patients. The incidence of reflux in the testicular veins with a diameter lower than 3 mm was 62.3% whereas 94.4% in veins more than 3 mm in diameter. Flow volume of reflux was less than 10 ml/min in four patients and 21.7 +/- 24.3 ml/min in 18 patients on right side. Four patients had flow volume of reflux less than 10 ml/min and 39 patients had 27.9 +/- 35.6 ml/min on the left side. Flow volume meaningfully rose with increasing in vein diameter (r=0.83 on right; r=0.65 on left, P<0.01). CONCLUSION: Measurement of flow volume of reflux has been considered as a more valuable method with respect to presence of reflux and/or measurement of venous diameter since flow volume reflects a combination of the vein diameters, duration and velocity of reflux.
Adolescent↗
Calcaneal apophysitis due to brucellosis.
Brucellosis is still a major health problem in many geographical areas. Osteoarticular complications are important owing to their high prevalence. We report an unusual case of childhood brucellosis presenting with septic apophysitis of the calcaneus and abscess formation in a 12-year-old boy. The patient was successfully treated with a combination of antibiotics. The importance of early recognition of the disease and differential diagnosis is emphasized. Early recognition of infection, prolonged treatment, and long-term follow-up may improve the outcome.
Abscess↗
Evaluation of the effects of sildenafil citrate (Viagra) on canine renal artery, carotid and aortic blood flow with the aid of color Doppler sonography.
INTRODUCTION: Erectile dysfunction is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Oral use of sildenafil citrate has been proved to be effective in the treatment of erectile dysfunction. Although the effects of sildenafil citrate have been investigated in several studies, its effect on aortic, carotid and renal artery blood flow is unknown. The aim of this study was to investigate the early and late phase effects of sildenafil citrate on canine aortic, carotid and renal artery blood flow using color Doppler sonography (CDS). MATERIALS AND METHODS: A total of 6 healthy adult dogs was used in this study. With the aid of CDS peak systolic flow rate, end diastolic flow rate, resistivity index (RI) and pulsatility index in aortic, renal and carotid artery were determined before the administration of sildenafil citrate, 45-75 min after drug administration and after 15 days of drug administration. Data were statistically analyzed using Friedman and Wilcoxon rank tests. p < 0.05 was considered to be statistically significant. RESULTS AND CONCLUSIONS: Significant changes were determined in only 4 out of 28 parameters studied. The significantly changed parameters were as follows: a significant increase in the early and late phase of the postdrug peak of systolic aortic blood flow compared to values before drug administration, an increase in pre- and postdrug RI values of the aorta, a significant decrease in maximum velocity of the right carotid artery, and peak systolic maximum velocity of the left renal segmental artery after drug administration compared to their respective predrug basal values. The results from this study indicate that sildenafil citrate has no significant effects on aortic, renal and carotid artery blood flow rate either in the early or in the late phase. Since this study involved only 6 dogs there is a need for further clinical studies involving larger groups of subjects to conclude that this drug is safe with respect to the hemodynamic parameters evaluated in this study.
Animals↗
Spontaneous occlusion of a traumatic false aneurysm of the peroneal artery.
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Adult↗
Incidence and importance of reflux in testicular veins of healthy men evaluated with color duplex sonography.
PURPOSE: Reflux in the testicular veins plays a crucial role in the diagnosis of a varicocele. The aim of this study was to evaluate the incidence and the sonographic features-duration and velocity-of reflux in testicular veins of healthy men using color duplex sonography (CDS). METHODS: Healthy male volunteers, 18-45 years old, whose physical examinations and semen analyses were normal, were recruited for this study. The maximum diameters of testicular veins during both normal respiration and Valsalva's maneuver were measured by CDS using a 7.5-MHz linear-array transducer. Veins greater than 2 mm in diameter were considered to be a varicocele, and the subjects in these cases were excluded from the analysis. In cases in which reflux was present, the velocity and duration of reflux in the testicular veins during Valsalva's maneuver were measured. RESULTS: Seventy men, whose mean (+/- standard deviation) age was 27 +/- 7 years, were enrolled in this study. Fourteen of the 70 patients had a left varicocele and thus were excluded from the analysis. Of the 112 hemiscrotums in the remaining 56 patients, 61 (54%) had reflux induced by Valsalva's maneuver and 51 (46%) did not. Twenty-two (39%) of refluxes were on the right side, with a mean duration of 1.1 +/- 0.5 seconds, and a mean velocity of 4.2 +/- 2.1 cm/second; 39 (70%) of the refluxes were on the left side, with a mean duration of 1.1 +/- 0.5 seconds and a mean velocity of 4.9 +/- 2.3 cm/second. The incidence of reflux was significantly higher on the left side (p = 0.003). The duration and velocity of the reflux did not differ significantly between the right and left sides. The difference in the testicular vein diameters between the right (1.3 +/- 0.2 mm; n = 56) and left (1.6 +/- 0.2 mm; n = 56) sides was statistically significant (p < 0.001). CONCLUSIONS: Normal-sized testicular veins in healthy subjects had a remarkably high incidence of reflux induced by Valsalva's maneuver. The presence of reflux in subfertile men with normal testicular vein diameters is a diagnostic criterion, but it is necessary to quantify the reflux to prevent misdiagnosis of a varicocele and unnecessary surgery. The measurement of the duration and velocity limits of reflux in a large series of subjects may provide a reliable indicator for the diagnosis of varicocele.
Adolescent↗
Achondrogenesis type II with normally developed extremities: a case report.
We present a case of achondrogenesis type II with normally developed extremities that was confirmed with postmortem ultrasonographic and radiographic examination. The length of the long bones may vary and the diagnosis of achondrogenesis should not be ruled out with normally developed extremities. Intrauterine sonographic examination of the vertebrae is very important and the absence of vertebral body ossification may be the unique finding of achondrogenesis type II. Axial ultrasonographic images and postmortem plain radiographs are useful to clarify the pathology.
Abortion, Eugenic↗
Incidence of varicoceles in patients with ankylosing spondylitis evaluated by physical examination and color duplex sonography.
OBJECTIVES: To assess the incidence of varicocele in ankylosing spondylitis (AS) in comparison to healthy age-matched controls. METHODS: Twenty-one male patients with AS who were not taking disease-modifying antirheumatic drugs (eg, sulfasalazine, a well-known cause of drug-induced infertility) and age-matched healthy controls were evaluated with both physical examination and color duplex sonography for varicocele. The maximal vein diameters of pampiniform plexus and duration of reflux were recorded. Semen samples were also analyzed in both groups. RESULTS: Patients with AS had a higher incidence of clinical varicoceles (52%) compared with the healthy age-matched controls (20%). On color Doppler examination, 12 patients (57%) had varicocele (3 bilateral and 9 on the left side) and 6 controls had varicocele on the left side. The patients with AS had significantly greater vein diameters of pampiniform plexus on the left and right side compared with the controls. CONCLUSIONS: The incidence of varicocele is increased in patients with AS, and its clinical relevance needs to be evaluated.
Adolescent↗
Osteophyte-induced dysphagia: report of three cases.
Dysphagia is a common complaint of patients seen by physicians. Osteophyte compression due to diffuse idiopathic skeletal hyperostosis (DISH) or Forestier's disease and cervical spondylosis has been identified as a cause of dysphagia. We report three elderly male cases of whom two had dysphagia due to DISH and one had dysphagia due to osteophyte compression associated with severe cervical spondylosis. Clinical and radiographical findings including barium oesophagogram and computed tomography are presented. Endoscopy should be carefully performed to rule out additional pathology in such patients. Medical treatment preferably with liquid forms of NSAIDs and diet may cause satisfactory improvement.
Aged↗
Acromegalic arthropathy of the hand with sesamoid involvement: a case report.
Acromegalic arthropathy may affect the hand joints with characteristic radiological changes. Sesamoid involvement in the hand may be presented with unusual changes. A case of a female patient with characteristic hand joint and sesamoid bone osteophytic changes related to acromegalic arthropathy is presented.
Acromegaly↗
Xanthogranulomatous pyelonephritis with nephrocutanous fistula and coexisting renal replacement lipomatosis: the report of a rare case.
Renal replacement lipomatosis (RRL) is the result of rare, usually unilateral, and severe atrophy and destruction of the renal parenchyma often caused by renal calculi. It may be associated with, sometimes, aging, atrophy, long-standing chronic inflammation and urinary infection, such as renal tuberculosis. We report magnetic resonance (MR) and computed tomography (CT) findings of our case, which has xanthogranulomatous pyelonephritis (XGP) and RRL additionally associated with nephrocutanous fistula.
Adult↗
Pediatric idiopathic pulmonary hemosiderosis diagnosed by sputum analysis: plain radiography and computed tomography findings.
OBJECTIVE: Idiopathic pulmonary hemosiderosis (IPH) is an uncommon disorder, which is characterized by recurrent hemoptysis, iron deficiency anemia and diffuse parenchymal infiltration on chest radiographs in pediatric patients. We wish to present clinical and radiological (plain radiography and CT) findings of this rare pathology. CLINICAL PRESENTATION AND INTERVENTION: A 14-year-old girl was admitted to the pediatric emergency department with complaints of cough, dyspnea, fatigue and bloody sputum for 6 months. She had been hospitalized 3 times during this period and received antibiotics and blood transfusion. Chest X-rays revealed prominent perihilar and bibasilar consolidation. CT showed a ground glass pattern and consolidated areas with increased density. Sputum analysis yielded hemosiderin-laden macrophages. With presumptive diagnosis of IPH, prednisolone was administered. Her symptoms improved on the 5th day of treatment and 1 month later, plain chest radiography demonstrated marked improvement. CONCLUSION: Although IPH is a rare condition, the diagnosis of IPH should be considered, among others, in a patient with hemoptysis and bilateral infiltration in the chest X-ray. This may prevent antibiotic misuse and risk of death due to severe hemorrhage.
Adolescent↗