Pinar Polat

Effects of tamoxifen on pulmonary fibrosis after cobalt-60 radiotherapy in breast cancer patients.

BACKGROUND AND PURPOSE This study was performed to investigate whether the tamoxifen (TAM) induced the development of pulmonary fibrosis after post-mastectomy cobalt-60 (Co-60) irradiation of chest wall and regional lymphatics in patients with breast cancer along with patient age, menopausal status, body weight, observation time and adjuvant chemotherapy regimens. MATERIALS AND METHODS In this prospective study, 74 patients treated with post-mastectomy adjuvant radiotherapy (RT) and TAM and 37 patients treated with RT were evaluated by axial computerized tomography (CT). CT was first performed before initiation of radiotherapy and TAM treatment. A total of 824 thorax CT sections were evaluated by a radiologist blindly. Comparison of pre-treatment and post-treatment CT sections was used to monitor the development of pulmonary fibrosis. RESULTS Pulmonary fibrosis developed in 26 of 74 patients who were treated with RT and TAM combination. It was found in five of 37 women treated only with RT. The difference was statistically significant (P<0.01). The median time for the development of pulmonary fibrosis was 8 months in TAM-treated patients whereas it was 10 months in non-TAM-treated patients. Among 111 patients who participated in that study, 65 were in the post-menopausal state and 46 in pre-menopausal state. In the multivariate analysis, the independent prognostic factors were age (P=0.010) and menopausal status (P=0.019). Advanced age and post-menopausal status predisposed to pulmonary fibrosis. The time interval in the development of lung fibrosis and body weight did not significantly influence the results. The time interval which is one independent prognostic factor was found to be associated with lung fibrosis under only-RT group in multivariate analysis (P<0.01). CONCLUSION TAM treatment during post-mastectomy RT in breast cancer patients significantly increases the risk of the development of lung fibrosis along with the patient age and menopausal status.

Bone mineral density in children with cerebral palsy.

Abstract Background : The purpose of the present study was to evaluate the severity of and factors related to osteopenia in children with cerebral palsy (CP).

Complications of albendazole treatment in hydatid disease of lung.

We present rupture of lung hydatid cyst in a patient with multiple organ involvement during albendazole treatment. The patient was first provided mechanical ventilation than residue cavity and the other intact cyst was treated surgically. We concluded that albendazole should be used in postoperative period in patients with hydatid disease of the lung to prevent recurrent disease.

Mammary tuberculosis – importance of recognition and differentiation from that of a breast malignancy: report of three cases and review of the literature

BackgroundWhile tuberculosis of the breast is an extremely uncommon entity seen in western populations, it accounts for up to 3% of all treatable breast lesions in developing countries.Case presentationsWe reviewed three female cases of mammary tuberculosis that were diagnosed and treated in Turkey during the same calendar year. All three patients presented with a painful breast mass. In all cases, fine needle aspiration was nondiagnostic for mammary tuberculosis. However, the diagnosis of mammary tuberculosis was confirmed by histopathologic evaluation at the time of open surgical biopsy. All three patients were treated with antituberculous therapy for six months. At the end of the treatment period, each patient appeared to be clinically and radiologically without evidence of residual disease.ConclusionThe diagnosis of mammary tuberculosis rests on the appropriate clinical suspicion and the histopathologic findings of the breast lesion. Its recognition and differentiation from that of a breast malignancy is absolutely necessary. Antituberculous chemotherapy, initiated immediately upon diagnosis, forms the mainstay of treatment for mammary tuberculosis.

Magnetic resonance imaging brain size/IQ relations in Turkish University students.

Abstract The relation of IQ (Cattells Culture Fair Intelligence Test) to brain size was studied in 103 right- and left-handed men and women at Ataturk University in eastern Turkey. Cerebral areas were measured on a midsagittal section of the brain using MRI. An overall correlation of 40 was found between MRI-measured total area and IQ thereby further supporting the IQ–brain size hypothesis. Additional analyses suggested that these results may need qualification. In men, only anterior cerebral area correlated with IQ. In women, total and posterior cerebral areas were correlated with IQ. Other results varied by handedness.

Diagnosis and Surgical Treatment of Morgagni Hernia: Report of Three Cases

Morgagni hernia is a rare congenital disorder, which is usually asymptomatic, but may cause respiratory or gastrointestinal symptoms. We reviewed the clinical findings of three patients with a Morgagni hernia, diagnosed and treated in our department between 1997 and 2000. The Morgagni hernia caused various symptoms in all three patients and surgery was performed via posterolateral thoracotomy in two, and via laparatomy in one. The hernial defect was closed by primary suturing in two patients and by synthetic mesh in one. All three patients had an uneventful postoperative recovery. We believe that the transthoracic approach is an effective way of repairing Morgagni hernia.

Relations among Hand Preference, Craniofacial Asymmetry, and Ear Advantage in Young Subjects

The relations for hand preference with craniofacial asymmetry and ear advantage, and between craniofacial asymmetry and ear advantage were investigated in young healthy subjects. Ear advantage was recorded as duration of hearing, craniofacial asymmetry by computerized tomography in 44 right-handed and 38 left-handed male and female high school students. Right-handers had a right ear advantage and a larger left craniofacial region, whereas left-handers had a left ear advantage and a larger right craniofacial region. These results are consistent with the speculation that hand preference may be related to craniofacial and consequently aural asymmetries.

Color Doppler Sonographically Guided Transthoracic Needle Aspiration of Lung and Mediastinal Masses

Objective. This study investigated the diagnostic value of color Doppler sonographically guided transthoracic needle aspiration in lung and mediastinal masses. Methods. B‐mode and color Doppler sonographic images were obtained in 48 patients with mediastinal or peripheral pulmonary tumors. Color Doppler sonography was used to show the vascular structures before the transthoracic needle aspiration procedure. It was also used to locate the needle tip during the procedure by showing the twinkling sign. This maneuver was performed with motion of the inner stylet. Pathologic and microbiological examination of the aspirates was made. Results. Vascular structures were detected in 37 cases on color Doppler images and in 10 cases on B‐mode images. Similarly, the needle tip was observed in 39 cases on color Doppler images but in only 9 cases on B‐mode images. No complications were observed except partial pneumothorax in 2 cases. The method had sensitivity of 90.0%, specificity of 87.5%, a positive predictive value of 97.2%, a negative predictive value of 63.6%, and diagnostic accuracy of 89.6%. Conclusions. Color Doppler sonographically guided transthoracic needle aspiration is a safe diagnostic method in malignant lung tumors, especially peripheral tumors, because of its ability to differentiate vascular structures within a tumor before the transthoracic needle aspiration procedure. It provides additional information about the location of the needle tip.

Quiz case of the month

A 24-year-old man presented with coarsening of the facial features, thickening of the skin of the face and scalp with ptosis and excessive sweating at the age of 18 years. Physical examination showed excessive furrowing, especially of the subcutaneous tissue of the face, scalp and forehead, cutis verticis gyrata, mechanical ptosis due to bilateral tars and soft tissue hypertrophy. The extremities, hands and feet were enlarged. Height and weight were within normal limits. Peripheral vision was normal. Endocrinologic and neurologic evaluation failed to establish any abnormality. Growth hormone level was normal. Skull radiograph of the patient showed slightly enlarged sinuses, and a normal sella and mandibular angle. At brain computed tomography (CT), the brain parenchyma, calvarium and base of the skull were normal. The scalp and forehead skin was prominent with excessive folding (Fig. 1). Plain radiographs of the extremities showed a slightly increased bone density and cortical thickening. The proximal and medial phalanges of the hands and distal phalanges of the feet were enlarged and squared (Fig.2). Diaphyseal and cortical enlargement was detected in all tubular bones. There was shaggy periosteal new bone formation extending to the epiphyses but dense in the diaphyses and metaphyses (Fig. 3). Increased bone density and enlargement were present at the ribs, clavicles and scapulae. Periosteal shaggy new bone formation was also present on the scapulae. There was no pathology at the spine other than narrowing of the intervertebral disc spaces. Eur. Radiol. 9, 361±362 (1999) Ó Springer-Verlag 1999

Handedness Differences in Widths of Right and Left Craniofacial Regions in Healthy Young Adults

In this work, handedness differences in the widths of right and left craniofacial regions were studied in a healthy sample of 39 male and 43 female students, 17 to 23 years old. Width of craniofacial regions was assessed by computerized tomography. Handedness was associated with the left face width especially for women. The left facial region was larger for right-handers than left-handers. The smaller measure for the left face of left-handers might be associated with an advantage of left ear sensitivity.