Fatma Beyazal Çeliker

Restoration of Anterior Vertebral Height by Short-Segment Pedicle Screw Fixation with Screwing of Fractured Vertebra for the Treatment of Unstable Thoracolumbar Fractures

BACKGROUND The treatment of unstable thoracolumbar fractures remains controversial. Long-segment pedicle screw constructs may be stiffer and impart greater forces on adjacent segments compared with short-segment constructs. Short-segment pedicle screw fixation alone may be associated with instrumentation failure. Reinforcement fractured vertebra by the placement of an additional 2 screws at fracture level may be useful in thoracolumbar fractures for restoration of anterior vertebral height. MATERIAL AND METHODS We retrospectively analyzed 35 patients (21 males, 14 females) with unstable thoracolumbar fractures. The patients were divided into 2 groups. In group I, patients were operated with posterior approach via the use of pedicle screws fixed long (2 levels above and 1 or 2 levels below of the fractured vertebra). In group II patients, short-segment stabilization with additional screwing at fracture level was made. Immediate postoperative radiologic evaluations were done by measuring the correction and maintenance of kyphotic angle at the fracture level, Cobb angle, and height of fractured vertebra. RESULTS Average local kyphosis angle, anterior kyphotic angle at the fracture level, and Cobb angle were not statistically significantly different in the postoperative period (P > 0.05); however, postoperative anterior height of fractured vertebra was statistically significantly different between the 2 groups (P < 0.05). CONCLUSIONS We compared a standard long-segment construct with a short-segment construct using instrumentation of the fractured segment. Short-segment pedicle screw fixation with screwing of fractured vertebra in unstable thoracolumbar fracture levels is an effective method to restoring anterior vertebral height for the treatment of unstable thoracolumbar fractures. It also provides anterior column support.

Magnet dislocation during 3T magnetic resonance imaging in a pediatric case with cochlear implant.

O implante coclear (IC) é um dispositivo fixado cirurgicamente, concebido para o tratamento de perda auditiva neurossensorial grave em pacientes pediátricos e adultos. Com a tecnologia avançada e os resultados satisfatórios, as indicações de IC gradualmente se expandem.1 Contudo, o aumento dos implantes trouxe também alguns problemas e um dos principais é aquele vivenciado pelos usuários de IC durante a imagem por ressonância magnética (RM). A RM é um método de imagiologia radiológica padrão usado para o diagnóstico de muitas doenças. O campo magnético gerado durante o exame pode levar a problemas indesejáveis, tais como falhas e deslocamento do dispositivo, correntes elétricas indesejadas e desmagnetização.2,3 Um

Submandibular Lateral Ectopic Thyroid Tissue: Ultrasonography, Computed Tomography, and Scintigraphic Findings

Ectopic thyroid can be encountered anywhere between the base of tongue and pretracheal region. The most common form is euthyroid neck mass. Herein, we aimed to present the findings of a female case with ectopic thyroid tissue localized in the left submandibular region. A 44-year-old female patient, who underwent bilateral subtotal thyroidectomy four years ago with the diagnosis of multinodular goiter, was admitted to our hospital due to a mass localized in the left submandibular area that gradually increased in the last six months. Neck ultrasonography, contrast-enhanced computed tomography, and scintigraphic examination were performed on the patient. On thyroid scintigraphy with Tc-99m pertechnetate, thyroid tissue activity uptake showing massive radioactivity was observed in the normal localization of the thyroid gland and in the submandibular localization. The focus in the submandibular region was excised. Pathological examination of the specimen showed normal thyroid follicle cells with no signs of malignancy. The submandibular mass is a rarely encountered lateral ectopic thyroid tissue. Accordingly, ectopic thyroid tissue should also be considered in the differential diagnosis of masses in the submandibular region.

First report of perforation of ligamentum flavum by sequestrated lumbar intervertebral disc

Disc fragments are well known to migrate to superior, inferior, or lateral sites in the anterior epidural space, posterior epidural migrated lumbar disc fragments is an extremely rare disorder, 61 cases have been reported to date. However, there were no cases with perforated ligamentum flavum (LF). We report a different case with perforation of ligamentum ligamentum by disc fragment. To the best of our knowledge, this is the first report of perforation LF by a posterior epidural migrated sequester disc.

A Case Report of Acute Acalculous Cholecystitis and Acute Hemorrhagic Cystitis due to Salmonella Typhi

Acute acalculous cholecystitis and acute hemorrhagic cystitis due to Salmonella Typhi are a rare condition. A 24-year-old female patient was admitted to our clinic with abdominal pain, nausea, fever, headache, urinary burning, and bloody urine. Based on clinical, laboratory, and radiological evaluations, the patient was diagnosed with acute acalculous cholecystitis and acute hemorrhagic cystitis due to Salmonella Typhi. The patient was treated with intravenous ceftriaxone for two weeks. After the treatment, the patients clinical and laboratory findings improved. Acute acalculous cholecystitis due to Salmonella Typhi concomitant with acute hemorrhagic cystitis is very rare and might be difficult to diagnose. Infectious agents such as Salmonella Typhi should be considered when acute acalculous cholecystitis and acute hemorrhagic cystitis are detected in adult patients with no underlying diseases.

Renal Artery Dissection in a Patient With Degenerative Scoliosis: A Rare Complication Caused by Lumbar Vertebra Osteophyte

Isolated spontaneous renal artery dissection (RAD) without known trauma is rare, and its etiology has not been determined. However, notable risk factors including hypertension, strenuous exercise, connective tissue disorders, atherosclerosis, extracorporeal shock wave lithotripsy, and cocaine abuse have been reported. To the best of our knowledge, isolated RAD caused by lumbar vertebra osteophytes in patients with degenerative lumbar scoliosis has not been reported in the literature. In this article, we present a case of RAD caused by lumbar vertebra osteophyte in a patient with degenerative scoliosis and discuss the management of the disease.

Tinnituslu hastalarda 3 boyutlu T2 ağırlıklı manyetik rezonans görüntüleme ile serebelopontin kenardaki vasküler değişikliklerin değerlendirilmesi

Amac: Serebelopontin kose (CPA) vaskuler ve noral yapilarin anatomik etkilesimleri isitsel-vestibuler semptomlarla iliskili oldugu dusunulmektedir. Manyetik rezonans goruntuleme, bu karmasik anatomik bolgeyi degerlendirmek icin tercih edilen bir yontem haline gelmistir. Bu calismada, 3-boyutlu T2 agirlikli MRI ile tinnitus hastalarda CPA’da vaskuler loop varyasyon iliskisini degerlendirmeyi amacladik. Materyal ve Metod: Bu calismada, aciklanamayan tinnitus olan ve kulak MRI tetkiki yapilan 149 hasta yer almistir. Hastalarin tinnitusu olan kulaklari calisma grubunu, sikâyet olmayan kulaklari kontrol grubunu olusturdu. Cift tarafli tinnitusu olanlar iki taraf ayri ayri olarak calisma grubuna dâhil edildi. MRI taramalari, CPA’da vaskuler varyasyon varligina iliskin olarak degerlendirildi. Bulgular: Sol tarafta tinnitusu olan hastalarda Tip 1 (CPA duzeyinde) (p=0.001) ve Tip A (vestibuloklear ve/veya fasial ile temas) (p<0.001) vaskuler loop anlamli derecede yuksekti. Sag tarafta tinnitusu olan hastalarda, sadece Tip A vaskuler loop anlamli derecede yuksekti (p=0.005). Cift tarafli tinnituslu hastalar icin sag kulakta Tip 2 vaskuler loop (internal akustik kanali proksimal [IAC]) (p=0.035) ve sol kulakta Tip A vaskuler loop(p<0.001) anlamli derecede yuksekti. Sonuc: Bu calisma, 3D T2W MRI kullanilarak tinnitus etyolojisini arastiran en buyuk olcekli calismadir. CPA ve IAC’deki vaskuler loop sikligi oncelikle tani teknigine baglidir. Bulgularimiz, vaskuler varyasyon nedenlerin yuksek cozunurluklu goruntuleme yontemleri kullanilarak daha net gosterilebilecegini gosterdi. Buna gore, tedavi secenekleri etiyolojinin aydinlatilmasiyla daha iyi belirlenebilir.

Effects of gadolinium-based MRI contrast agents on liver tissue: Effects of Gadolinium-Based Agents on Liver

MRI with contrast is often used clinically. However, recent studies have reported a high accumulation of gadolinium‐based contrast agents (GBCAs) in kidney, liver, and spleen tissues in several mouse models.

Effects of Gadodiamide and Gadoteric Acid on Rat Kidneys: A Comparative Study: Effects of Gadodiamide and Gadoteric Acid

Gadolinium‐based contrast agents are complex chelates to provide contrast in NRI. However, recent studies have highlighted the deposition of free Gd+3 ion in various tissues.

The relation between retrobulbar blood flow and posterior ocular changes measured using spectral-domain optical coherence tomography in patients with obstructive sleep apnea syndrome

PurposeTo investigate the effect of posterior ocular hemodynamics on the retinal nerve fiber layer (RNFL), choroid thickness (CT) and central macular thickness (CMT) in patients with obstructive sleep apnea syndrome (OSAS) and to reveal the association with glaucomatous optic neuropathy.MethodsThe research was planned as a prospective, randomized study. The ophthalmic, retinal and posterior ciliary artery pulsatile index (PI) and resistive index (RI) were measured by colored Doppler sonography. RNFL thickness, CMT and CT were then measured by spectral-domain optical coherence tomography.ResultsSixty subjects were divided into four groups—mild, moderate and severe OSAS and a control group. There were 16 subjects in the control group, 14 in the mild OSAS group, 15 in the moderate OSAS group and 15 in the severe OSAS group. Ophthalmic artery and central retinal artery PI and RI values of the OSAS patients did not show statistically significant difference than those of the control group, but posterior ciliary artery (PCA) PI and RI values were significantly higher. In addition, mean, superior and inferior RNFL thickness values were significantly lower than those in the control group. Moreover, the glaucoma prevalence of the OSAS patients in this study was 6.8% and all of these patients were in the severe OSAS group.ConclusionPI and RI values of the PCA, which supplies the optic nerve, show a linear increase as the apnea hypoxia index values in OSAS. As the grade of OSAS improves, this situation leads to a more serious ischemic optic neuropathy. Furthermore, the prevalence of glaucoma in this study is found to be higher in the severe OSAS group.