Petek Bayindir

Effects of pesticides used in agriculture on the development of precocious puberty

The present study aims to evaluate the effects of pesticides on premature breast development. Forty-five girls (group 1) with premature breast development living in the Menderes region, where greenhouse cultivation is the main income, 16 girls (group 2) living in Izmir city with early puberty, and 33 girls (group 3) who had no signs of puberty were included in the study. Endosulphan 1, endosulphan 2, endosulphan sulphate, methoxychlor, vinclozolin, 4,4-dichlorodiphenyldichlorethylene (DDE), 4,-dichlorodiphenyltrichloroethane (DDT), and 2,4-DDT were evaluated in the serum and adipose tissues of the groups by using a gas chromatography–mass spectrometry method. With the exception of 4,4′-DDE, the pesticides studied were undetectable in the serum and adipose tissue samples. The levels of basal luteinizing hormone (LH), stimulated LH, follicle-stimulating hormone, and the long axis of the uterus and both ovaries were significantly different in the girls who had premature thelarche and detectable 4,4′-DDE levels compared to the girls who had premature thelarche and undetectable 4,4′-DDE levels in serum and adipose tissues. The presence and levels of pesticides in serum and adipose tissues were not related to precocious puberty (PP). The mechanisms that lead to PP may also result in obesity, and obesity may be the underlying cause for PP in this group.

Melanotic paraganglioma arising in the temporal horn following Langerhans cell histiocytosis

Intracerebral paragangliomas are rare because of the lack of paraganglial cells in the cerebral tissue. We report a rare case of melanotic paraganglioma arising from the temporal horn of the lateral ventricle in a patient with prior Langerhans cell histiocytosis (LCH) treated with chemotherapy and radiation.

Multidetector computed tomographic assessment of the normal diameters for the thoracic aorta and pulmonary arteries in infants and children.

Background Knowledge of the normal size of the thoracic aorta and pulmonary arteries is important regarding the detection of the abnormal and valuable in the treatment of patients with congenital and acquired cardiovascular diseases. Purpose To determine the normal diameters of the thoracic vascular structures of pediatric participants on contrast-enhanced multidetector computer tomography (MDCT) scans. Material and Methods Between July 2010 and July 2014, the MDCT examinations obtained from 520 participants (age range, 0–18 years; mean age, 8.49 years ± 5.54 [standard deviation]; male:female ratio, 1.6:1) with normal cardiovascular examinations were retrospectively evaluated. Patients were divided into six groups according to their age. Diameters of the ascending aorta (AA), descending aorta (DA), main pulmonary artery (MPA), right pulmonary artery (RPA), and left pulmonary artery (LPA) were measured. Results The diameters of the thoracic vascular structures increased with age and the statistical difference among the age groups and genders were significant. The vascular structures in male patients tended to have higher dimensions than female patients. The LPA demonstrated higher mean values than the RPA in each age group. The mean ratio PA (MPA/AA) is 0.93 ± 0.08 for pediatric participants and it is slightly higher in girls compared to boys (0.93 ± 0.07 and 0.92 ± 0.07, respectively). The level of pulmonary artery bifurcation moves caudally with increasing age with thoracal 6 vertebra being the most common for all age groups (53.3%). Conclusion We believe that the results of our study can serve as a potential reference in differentiating the normal from the abnormal size of the aorta and pulmonary arteries on chest MDCT studies in the pediatric population.

Using dynamic maneuvers in the computed tomography/magnetic resonance assessment of lesions of the head and neck.

Despite advances in technology, the radiologic assessment of certain head and neck lesions may still pose difficulties because of the complex anatomy of this region, the small and mobile structures that this region harbors, and the apposition of mucosal surfaces in the neutral position. Certain maneuvers have been described in the literature to overcome these difficulties. We review the use of the Valsalva and the modified Valsalva maneuver, the puffed-cheek technique, phonation, and inspiration, with possible applications in head and neck imaging.

Integration of radiology and clinical score in pediatric appendicitis

The efficacy of ultrasonography (US) and abdominal X‐ray in combination with Pediatric Appendicitis Score (PAS) is complicated in the diagnosis of acute appendicitis. Abdominal X‐ray is as useful as US with clinical assessment when evaluated by experienced pediatric radiologist in acute appendicitis. The aim of this study was to determine the value of US and abdominal X‐ray for appendicitis in children when combined with clinical assessment based on PAS, and to establish a practical pathway for acute appendicitis in childhood.

Fat-containing lesions revealed by CT in children with right lower quadrant pain

Suspected appendicitis is the most common indication for emergent abdominal surgery in children. The clinical diagnosis of appendicitis can be challenging, and CT is playing an increasing role in the evaluation of right lower quadrant pain. Occasionally, alternative diagnoses to appendicitis can be suggested on CT. The appreciation of a fat-containing lesion in the right lower quadrant will often allow a specific diagnosis. Importantly, many of these lesions are self-limited and treated nonoperatively. The purpose of this pictorial essay is to illustrate the spectrum of fat-containing lesions that can present as alternative diagnoses to appendicitis on CT scans performed for the evaluation of right lower quadrant pain in children.