Metin Dogan

Pituitary volume in patients with panic disorder.

Panic patients have many functional deficiencies in the hypothalamic-pituitary-adrenal (HPA) axis. Previous studies have shown changed pituitary gland volume in some psychiatric disorders that have functional deficiencies in the HPA axis. However, to date no study has evaluated the pituitary gland volume in patients with panic disorder (PD). We investigated the pituitary gland volume in patients with PD (n=27) and age- and sex-matched healthy controls (n=27), using 1.5-T magnetic resonance imaging in this study. Analysis showed that patients with PD had significantly smaller pituitary volume compared to healthy subjects. Patients with agoraphobia especially had a significantly smaller pituitary volume than patients without agoraphobia. There was a significant relationship between the pituitary volume and both the severity of symptoms and the illness duration in the patient group. The results show that patients with PD have reduced pituitary volume, which may reflect the functional abnormalities seen in this disorder. These findings may help us better understand the pathology of PD.

Brain Perfusion MRI Findings in Patients with Behcet’s Disease

Objective. To search brain perfusion MRI (pMRI) changes in Behcets disease (BD) with or without neurological involvement. Materials and Method. The pMRI were performed in 34 patients with BD and 16 healthy controls. Based on neurologic examination and post-contrast MRI, 12 patients were classified as Neuro-Behcet (group 1, NBD) and 22 patients as BD without neurological involvement (group 2). Mean transit time (MTT), time to peak (TTP), relative cerebral blood volume (rCBV), and relative cerebral blood flow (rCBF) were obtained and compared to those of healthy control group (group 3). Results. There was a significant difference in the MTT and rCBF within the pons and parietal cortex in groups 1 and 2. rCBV increased in cerebral pedicle in group 1 compared with groups 2 and 3. In the temporal lobe white matter, prolonged MTT and decreased rCBF were found in groups 1 and 2. In the corpus striatum, internal capsule, and periventricular white matter, rCBF increased in group 1 compared with group 3 and decreased in groups 1 and 2. Conclusion. Brain pMRI is a very sensitive method to detect brain involvement in patients with BD and aids the clinical diagnosis of NBD, especially in patients with negative MRI findings.

Synovial chondromatosis of the temporomandibular joint: radiologic and histopathologic findings.

Abstract Synovial chondromatosis is a formation of multiple intrasynovial nodules resembling osteochondromas, resulting from proliferative changes in the synovial linings of joints; as the disorder progresses, nodules increasingly withdraw from the intrasynovial areas for the joint cavities. This is a relatively unusual case that can arise at unilateral large joints, such as knee, hip, and elbow, with the temporomandibular joint being the rarest one of them. Early recognition of the signs and symptoms with resultant accurate diagnosis, as well as proper surgical treatment, offers patients the best hope of recovery and improved quality of life. We report a conventional radiologic film, computed tomography, magnetic resonance imaging, and histopathologic findings of the synovial chondromatosis presenting as a large right preauricular mass arising from the temporomandibular joint without bone destruction.

Detecting the Shape Differences of the Corpus Callosum in Behçet's Disease by Statistical Shape Analysis

The aim of this study was to assess the shape differences of the corpus callosum (CC) in patients with Behçets disease using statistical shape analysis (SSA). Additionally, an attempt was made to investigate the changes in CC size according to disease duration. Twenty‐five adults with clinically diagnosed Behçets disease and 25 age‐ and gender‐matched controls were examined by high‐resolution structural magnetic resonance imaging. The data obtained from the coordinate of landmarks were analyzed with Euclidean distance matrix analysis and a thin‐plate spline analysis. SSA and growth curve models were performed to investigate group differences and to fit the curves. A significant difference was determined between CC shape of Behçet patients and controls (P = 0.006). Based on the analysis, a decrease occurred in the CC size of the Behçet patients as the duration of disease increased. Maximum deformations were determined in the landmarks of interior notch of the splenium, inferior tip of the splenium, posterior‐most point of the CC, and topmost point of the CC. Similarly, the landmark of anterior‐most point of the CC was identified as having the minimum deformation. Behçet patients had significantly different CC shapes from control subjects. The results suggest that SSA is a promising tool for distinguishing Behçet patients from normal subjects, and that it can give useful information to assist clinicians. Additionally, SSA might be applied to detect shape differences in anatomical structures that are affected by a broad range of neurological diseases. Anat Rec, 2011.

Superior Ophthalmic Vein Thrombosis Developed after Orbital Cellulitis

Abstract A 65-year-old female patient presented with eye pain, swelling and blurred vision in the left eye. Routine biochemistry and microbiological analyzes were conducted. Orbital tomography (CT), magnetic resonance imaging (MRI) findings, and cerebral angiography were performed. Orbital cellulitis due to a complication of ethmoidal sinusitis was diagnosed with thrombosis of the SOV in the patient. Systemic broad-spectrum antibiotic and anticoagulant therapy was started on the patient. The patients symptoms were recorded at the end of two weeks of the treatment.

A Multicenter Evaluation of Blood Culture Practices, Contamination Rates, and the Distribution of Causative Bacteria

Background: The prognostic value of blood culture testing in the diagnosis of bacteremia is limited by contamination. Objectives: In this multicenter study, the aim was to evaluate the contamination rates of blood cultures as well as the parameters that affect the culture results. Materials and Methods: Sample collection practices and culture data obtained from 16 university/research hospitals were retrospectively evaluated. A total of 214,340 blood samples from 43,254 patients admitted to the centers in 2013 were included in this study. The blood culture results were evaluated based on the three phases of laboratory testing: the pre-analytic, the analytic, and the post-analytic phase. Results: Blood samples were obtained from the patients through either the peripheral venous route (64%) or an intravascular catheter (36%). Povidone-iodine (60%) or alcohol (40%) was applied to disinfect the skin. Of the 16 centers, 62.5% have no dedicated phlebotomy team, 68.7% employed a blood culture system, 86.7% conducted additional studies with pediatric bottles, and 43.7% with anaerobic bottles. One center maintained a blood culture quality control study. The average growth rate in the bottles of blood cultures during the defined period (1259 - 26,400/year) was 32.3%. Of the growing microorganisms, 67% were causative agents, while 33% were contaminants. The contamination rates of the centers ranged from 1% to 17%. The average growth time for the causative bacteria was 21.4 hours, while it was 36.3 hours for the contaminant bacteria. The most commonly isolated pathogens were Escherichia coli (22.45%) and coagulase-negative staphylococci (CoNS) (20.11%). Further, the most frequently identified contaminant bacteria were CoNS (44.04%). Conclusions: The high contamination rates were remarkable in this study. We suggest that the hospitals’ staff should be better trained in blood sample collection and processing. Sterile glove usage, alcohol usage for disinfection, the presence of a phlebotomy team, and quality control studies may all contribute to decreasing the contamination rates. Health policy makers should therefore provide the necessary financial support to obtain the required materials and equipment.

A Newborn with Massive Congenital Astroblastoma

1Department of Pathology, Inonu University School of Medicine, Malatya, Turkey; 2Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas; 3Department of Radiology, Inonu University School of Medicine, Malatya, Turkey; 4Department of Pediatrics, Inonu University School of Medicine, Malatya, Turkey; 5Division of Neonatology, Department of Pediatrics, Inonu University School of Medicine, Malatya, Turkey

Effects of contrast material on the metabolite ratios in single-voxel MR Spectroscopy of intraaxial brain tumors.

AIM The purpose of our study was to determine whether the administration of contrast material affects the results of MR Spectroscopy (MRS) in different intraaxial brain tumors. MATERIALS AND METHODS Thirty-three patients (median range 46.72 ± 2.95, range 9-77) with intraaxial brain tumors underwent MRS before and 5 min after intravenous administration of gadolinium based contrast material at the standard dose of 0.1 mmol/kg (Gadodiamide or Gd-DOTA). Metabolite ratios (N-acetyl aspartate (NAA)/Creatine (Cr), Choline (Cho)/Cr, and NAA/Cho) were calculated. RESULTS There was no significant difference between the pre and postcontrast MRS spectra as regards to NAA/Cr (p:0.4), Cho/Cr (p:0.2), and NAA/Cho (p:0.2) ratios obtained from the intraaxial brain tumors. CONCLUSION Contrast material administration did not change the metabolite ratios of MRS. Contrast administration would be useful in guiding voxel localization in MRS evaluation of intraaxial brain tumors.

Diffusion-weighted imaging (DWI) of the liver in assessing chronic liver disease: effects of the presence and the degree of ascites on ADC values

PurposeThe aim of this study was to determine the correlation between the liver and spleen apparent diffusion coefficient (ADC) values of patients with chronic liver disease and the presence and the degree of ascites.Materials and methodIn this retrospective study, we assessed 107 patients with chronic liver disease and 39 control subjects who underwent upper abdominal MR imaging including echo-planar diffusion-weighted imaging (DWI). Among the 107 cirrhotic patients, 56 were classified as group 1, 25 as group 2, and 26 as group 3 according to the absence, the presence of minimal, and the presence of massive ascites, respectively. The scores of model for end-stage liver disease (MELD) were matched between groups as the standard reference. The liver ADC, spleen ADC, and normalized liver ADC values were compared between the control group and patients’ groups.ResultsPatients with massive ascites had significantly higher MELD score compared with the other groups. The MELD score was also significantly higher in patient groups than in control group. The liver and normalized liver ADCs of patients’ groups were significantly lower than that of the control group. With some overlap among groups, the measured ADC values decreased as the amount of the ascites increased, and these relationships were statistically significant. Furthermore, compared to control group, patients with massive ascites had significantly higher spleen ADCs.ConclusionOur results indicate that the ADC value of the liver and spleen correlates with the presence and the degree of ascites in patients with chronic liver disease, and merits further study.

Evaluation of Vertebral Artery Involvement by Doppler Sonography in Patients With Behçet Disease

Neurologic lesions in Behçet disease are most frequently observed in areas supplied by the vertebrobasilar system. We aimed to evaluate possible vertebral artery involvement by Doppler sonography in patients with Behçet disease.