İlhan Kılınç

64-MDCT pulmonary angiography and CT venography in the diagnosis of thromboembolic disease.

OBJECTIVE The purpose of our study was to investigate whether CT venography (CTV) performed after CT pulmonary angiography (CTPA) using 64-MDCT provides additional findings in the diagnosis of thromboembolic disease. MATERIALS AND METHODS Three hundred six consecutive patients in whom pulmonary embolism (PE) was clinically suspected were included in the study. The study group was classified according to the diagnostic quality of the CTPA examinations, the presence or absence of PE and deep venous thrombosis (DVT), and the most proximal localization that the embolus could lodge in the pulmonary artery. RESULTS The diagnostic quality of CTPA was insufficient in 5.9%, acceptable in 8.2%, and excellent in 85.9% of the patients. The diagnostic quality of CTV was insufficient in 11.4%, acceptable in 47.4%, and excellent in 41.2%. The percentages of nondiagnostic examinations for CTPA and CTV were 5.2% and 10.8%, respectively. Acute PE and acute DVT were observed in 25.2% and 18.0%, respectively. The percentage of subsegmental emboli among patients with acute PE was 15.6%. The percentage of patients with thromboembolic disease was 29.1%. Of patients who were diagnosed as having thromboembolic disease, 13.5% (12 of 89 patients) had DVT only. Of all patients, 3.9% (12 of 306) had only isolated DVT. The number of patients with subsegmental PE who had DVT was two (0.7% all patients). CONCLUSION As in MDCT scanning with a smaller number of slices, the combination of CTV with CTPA in 64-MDCT results in a small but definitive increase in the percentage of patients with a diagnosis of thromboembolic disease.

Central nervous system blastic crisis in chronic myeloid leukemia on imatinib mesylate therapy: a case report

SummaryChronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by a reciprocal translocation between chromosomes 9 and 22. Imatinib mesylate is a potent and selective inhibitory of the BCR/ABL tyrosine kinase. Imatinib is a first choice of treatment of chronic phase CML. It has also shown activity in patients with CML in accelerated or blastic phases. However, the penetration of the drug and its active metabolites into the central nervous system (CNS) is poor. Therefore, the CNS is sanctuary site for malignant cells in patients treated with imatinib. Herein, we report a patient with CML in accelerated phase that developed central nervous system disease while on imatinib mesylate therapy.

Thrombosis of temporal artery and renal vein in Kimura-disease-related nephrotic syndrome.

Kimura disease (KD) is an angiolymphoid proliferative disorder of unknown etiology, occurs mainly in Asian patients, presenting with subcutaneous slowly growing masses, with a predilection for preauricular and submandibular regions. The clinical course of the disease is thought to be benign. Concomitant peripheral blood eosinophilia and elevated serum immunoglobulin E levels are often observed. Main systemic manifestation of the KD is renal involvement. Renal abnormalities, notably proteinuria and nephrotic syndrome have been found to be associated with KD. We report a 42-year-old man with KD and a steroid-sensitive membraneous nephrotic syndrome with bilaterally temporal artery and renal vein thrombosis. This is the first reported case of KD associated nephrotic syndrome complicated with wide arterial and venous thrombosis from Anatolia.

Horseshoe lung associated with rare bilateral variant of scimitar syndrome: demonstration by 64-slice MDCT angiography

Scimitar syndrome with bilateral abnormal venous drainage and horseshoe lung is extremely rare. These rare complex anomalies were diagnosed in a 5-year-old boy by 64-slice multidetector CT (MDCT). This technique provides high-quality visualization of vascular, bronchial and parenchymal structures in a single session, such that no further invasive techniques are required. One obvious disadvantage of MDCT is the radiation exposure, especially in paediatric patients. The use of a single phase of contrast material administration reduces radiation exposure. The workstation platforms of MDCT systems allow multiplanar 2-D and 3-D postprocessing. As a result, various complex pathologies, such as that discussed here, can be diagnosed following a single imaging session with a certain precision.

Dev üreter tası: olgu sunumu

The articles about various pneumoconiosis in dental technicians who work in inconvenient conditions have been increasing in recent years. Exposure to dust and fume that occur during the dental procedure may play role in pneumoconiosis of dental technicians. A 53 years old male patient conveyed that he has worked in dental prosthesis procedures for 22 years (1968-1990).Environmental asbestosis was not established in the history of the case but there were calcified pleural plaques in the chest x-ray graphy.There were appearance of calcific asbest plaques in many section of thorax CT.A case of pneumoconiosis in dental technician who work in unadequate preventive conditions was reported in this paper. Probably ,exposure to the asbest fibers that occurs during the procedure of dental prosthesis were the main reason for developing calcific pleural lesions.The aim of this study was to investigate the efficacy of occlusion treatment on different age group patients with anisometropic amblyopia. Occlusion treatment was applied to 34 patients, 15 preschool children (age between 4-6 years), and 19 school age children (7-11 years). Daily duration of occlusion was minimum 6 hours. Best corrected visual acuity of patients was measured initially, at the end of 1st, 3rd and 6th months. Data belonging to amblyopia groups was compared with one another and with the controls. Initial visual acuity of two amblyopia groups were similar, however there was a significant difference between the amblyopia groups and the controls (PChest pain is a frequently encountered problem in childhood. In this study we aimed to asses the relationship between exertional chest pain and asthma by using the peek expiratory flow rate measurements. For this study, 64 otherwise healthy children with chest pain (chest pain group), 9-16 years of age (mean 11.9) and 58 healthy (control group), 8-11 years (mean 11.5) were compared with the use of peak flow-meter. Ages, weights, heights, systolic-diastolic blood pressures, pulses recorded. Preexertional and postexertional peak flow measurements (PEFR) at 2, 5 and 10 minutes determined. There was a decrease more than 15% in PEFR measures in 7 (10.9%) of chest pain group and in 1 (1.7%) of control group children (p

Pediatrik Toraks Patolojilerinde Çok Dedektörlü BT\'nin Rolü

Ectopic neurohypophysis is an anomaly of the Pituitary gland which may be associated with short stature due to Growth hormone deficiency. MRI is the modality of choice in diagnosing this condition. We present a case of pituitary dwarfism and ectopic neurohypophysis with clinical and radiological findings. 21 year-old male admitted with short stature. All hormones, except prolactin, of anterior hypophysis were low. Bright spot was ectopically located at level of median eminence on enhanced MRI of hypophysis and stalk of hypophysis was not observed. Ectopic neurohypophysis may be present with pituitary dwarfism. Cranial MRI may be useful to investigate related pathologies in such cases.