Mustafa Kayan

Peroral CT Enterography with Lactulose Solution: Preliminary Observations

OBJECTIVE The objective of our study was to evaluate lactulose solution as a new oral contrast agent with the use of peroral CT enterography to determine the adequacy of luminal distention and conspicuity of the bowel wall. CONCLUSION Peroral CT enterography performed with lactulose solution is a simple and noninvasive method of evaluating the small bowel by obtaining good distention. It can also be used at routine abdominal examinations as a negative contrast agent instead of iodinated oral contrast medium, especially for CT angiography.

Left hemisphere and male sex dominance of cerebral hemiatrophy (Dyke–Davidoff–Masson Syndrome)

Although radiological findings of cerebral hemiatrophy (Dyke-Davidoff-Masson Syndrome) are well known, there is no systematic study about the gender and the affected side in this syndrome. Brain images in 26 patients (mean aged 11) with cerebral hemiatrophy were retrospectively reviewed. Nineteen patients (73.5%) were male and seven patients (26.5%) were female. Left hemisphere involvement was seen in 18 patients (69.2%) and right hemisphere involvement was seen in eight patients (30.8%). We conclude that male gender and left side involvement are frequent in cerebral hemiatrophy disease.

Abdominal hydatid disease: Long-term results of percutaneous treatment

Purpose: To evaluate the effectiveness of percutaneous treatment under sonographic guidance in abdominal hydatid cysts. Material and Methods: Fifty‐two hydatid cysts in 33 patients were treated using a percutaneous approach under sonographic guidance. Forty‐five cysts were located in the liver, 6 in the spleen, and 1 in the pancreas. Forty‐nine cysts were type I, and 3 were type II. Thirty‐one cysts in 15 patients were treated with puncture and aspiration of the contents, injection of hypertonic saline solution, and respiration (PAIR); 15 cysts in 14 patients were treated with puncture, aspiration of cyst contents, injection of hypertonic saline solution, drainage, and injection of sclerosing agent (PAIDS); and 6 cysts in 4 patients were treated with puncture, aspiration of cyst contents, injection of sclerosing agent, and re‐aspiration (mPAIDS). Hypertonic saline or alcohol was used as a scolicidal agent. The follow‐up period was between 17 and 53 months. Results: A decrease in the dimensions of the cysts, solidification of the contents, and irregularity in the walls of cysts, all of which were considered signs of cure, were found in all patients. Recurrence was observed in one case and anaphylaxis in one. Conclusion: Percutaneous treatment of abdominal hydatid cysts is a safe, easily applicable, well‐tolerated, and effective method.

SEASONAL AND ENVIRONMENTAL TEMPERATURE VARIATION IN THE OCCURRENCE OF ISCHEMIC STROKES AND INTRACEREBRAL HEMORRHAGES IN A TURKISH ADULT POPULATION

Seasonal and weather influence on the incidence of cerebrovascular disease has been reported previously. The aim of this retrospective study was to determine whether the time of onset of ischemic strokes (IS) and intracerebral hemorrhages (ICH) were associated with the environmental temperature or the time, as a month or season, in our region. We analyzed the monthly and seasonal incidence of stroke between 1997 and 2001. Four hundred and fifty-one cases were admitted to our clinic (IS; n = 288 and ICH; n = 163), and aged from 16 to 94 years. The study was carried out in province of Van in eastern Turkey. The present study demonstrated a peak occurrence of IS in August (n = 41). For ICH, we observed a peak occurrence in July (n = 23). The highest number of IS occurred in summer (n = 108), the most moderate amount in autumn (n = 81), and the least in spring (n = 38). The hemorrhagic events were highest in summer (n = 58), most moderate in winter (n = 61), and lowest in spring (n = 31) and autumn (n = 32). There was a significantly greater incidence of IS and ICH during the summer than any other season in the province of Van, Turkey. This may reflect the role of weather temperature in the development of stroke and allow us to take preventive measures.

MRI findings of hepatic alveolar echinococcosis

Diagnosis of liver infestation by alveolar echinococcosis (AE) is based on serologic, sonographic and computed tomography (CT) findings. Experience with magnetic resonance imaging (MRI) demonstrates that features of this disease are limited. CT and MRI findings of 14 cases with hepatic AE were compared in this report. We have described the MRI appearance of hepatic AE, which exhibits variable signal intensities on T1- and T2-weighted images. Fibrous and parasitic tissue showed low signal both on T1- and, generally, on T2-weighted images. In a few cases, a high signal on T2-weighted images may be observed, due either to central necrotic zones or to small peripheral cyst. MRI than by CT was more easily identified central necrosis. However, MRI seemed to be less effective than CT in allowing us to reach a positive diagnosis, due to its inability to show microcalcifications. In addition, MRI may not reveal small lesions. In most cases, T1-weighted images revealed more clearly than CT did the margins of the lesions and the hepatic extension, especially to hepatic veins, vena cava and perihepatic spaces.

MR findings in cardiac hydatid cyst

We report a case of a 23-year-old man with a cardiac hydatid cyst involving the left ventricle wall. The diagnosis of the cyst was obtained by magnetic resonance (MR) imaging. He was operated on for cardiac hydatid cyst using enucleation and capitonnage procedure under extracorporeal circulation. Histopathologic study confirmed hydatid cyst diagnosis.