Ramazan Albayrak

The Effects of Weight Loss on Normal Transaminase Levels in Obese Patients

Background:Obesity is associated with insulin resistance, which is the main pathogenic factor for nonalcoholic fatty liver disease (NAFLD). NAFLD can progress without associated elevations in liver enzymes. Therefore, we investigated the effects of weight loss on normal transaminase levels in obese subjects who are at risk for NAFLD. Methods:Thirty-seven obese patients with normal ALT levels were evaluated. All patients received an individualized low-calorie diet over at least 6 months. Twenty-two patients who achieved weight loss of at least 5% body weight were identified as the study group and the others as the control group. Transaminases, insulin resistance, and body mass index were compared before and after the intervention. Results:Hepatic steatosis was found in 83.8% of obese patients. ALT was correlated with HOMA-IR in all patients at baseline (r = 0.363, P = 0.027). At the end of the follow-up, mean weight loss achieved in the study and control groups were 9.2% (8.7 ± 3.0 kg) and 0.3% (0.5 ± 2.8 kg), respectively. In the study group, HOMA-IR and ALT decreased from 4.0 ± 1.8 to 2.4 ± 0.9 and from 21.4 ± 6.6 IU/L to 16.8 ± 5.5 IU/L, respectively (P = 0.005 and P = 0.044). Conclusions:The results demonstrate that weight loss results in a decrease in normal ALT levels as well as insulin resistance. Therefore, the normal range for ALT may need to be reassessed.

Preoperative sonography of nonreducible inguinal masses in girls.

Inguinal hernia is one of the most common surgical pathologies in childhood. Any of the abdominal organs can slide into the hernial sac and become incarcerated there. In girls, the fallopian tubes, ovaries, uterus, and—rarely—ovarian cysts can form the sliding component of an inguinal hernia. The aim of this study was to investigate the diagnostic value of preoperative sonographic examination in girls with nonreducible inguinal masses.

Agenesis of sphenoid sinus: three cases

Paranasal sinus agenesis is an unusual clinical condition. The frontal sinus agenesis is more frequently seen, whereas agenesis of the sphenoid sinus is extremely rare. This report presents three new cases of sphenoid sinus agenesis. The absence of the sphenoid sinus was demonstrated by computed tomography (CT) in all cases.

Klippel-feil syndrome associated with pneumatocyst of the right cervical rib

A patient with Klippel-Feil syndrome reported with a pneumatocyst of the proximal epiphysis of a right cervical rib. There was no additional skeletal abnormality except for fusion of the C3 and C4 vertebral bodies. To the best of our knowledge, this is the first reported instance of this particular association.

Venous Insufficiency in Patients With Toenail Onychomycosis

Onychomycosis is a common fungal infection of the toenails and can originate secondary to vascular abnormalities. The aim of this study was to evaluate the relationship between onychomycosis and venous insufficiency.

Effects of Sildenafil Citrate (Viagra®) on Renal Arteries: An Evaluation with Doppler Ultrasound

Introduction: We aimed to determine hemodynamic alterations in renal arteries that may have resulted from oral intake of sildenafil citrate in healthy volunteers. Materials and Methods: Twelve healthy volunteers were included in our study. Renal Doppler ultrasonography (US) was performed before the drug intake to assess the basal values. Maximum peak systolic velocity, and resistivity and pulsatility indices were measured from the segmental branches of both renal arteries in all the ex- aminations. After the basal measurements 50 mg of sildenafil or placebo were randomly given to the 12 subjects. Renal Doppler US examinations were carried out 1 h after sildenafil or placebo intake. On the following day sildenafil was administered to the subjects who had previously taken placebo or vice versa. Renal Doppler US was repeated after 1 h. The effect of sildenafil on renal vascular hemodynamics was evaluated by comparison of basal values with postplacebo and postsildenafil values. Results: No statistically significant differences were found between the basal values of bilateral renal arteries and maximum peak systolic velocity, and resistivity and pulsatility index values measured after the placebo or sildenafil intake. Conclusion: We demonstrated that single-dose sildenafil did not cause any significant effect on renal artery hemodynamics in healthy individuals.

Sonographic Findings of Median Nerve and Prevalence of Carpal Tunnel Syndrome in Computer Mouse Users

The purpose of this study was to evaluate the median nerve sonographically and estimate the prevalence of carpal tunnel syndrome (CTS) in computer mouse users. Forty-nine right wrists of 49 employees who had used a computer mouse were included in the study. Thirty-three right wrists of 33 non-mouse user employees were studied as a control group. Both the mouse user and non-mouse user employees underwent sonography and electromyography (EMG). Axial sonograms of the median nerve were obtained proximally, in the middle and distally in the carpal tunnel. At each level, flattening ratio and the cross-sectional area of the median nerve were calculated. We found no significant difference in any parameters between mouse users and control group (p>0.05). However, when we compared mouse users according to the presence of pain, there was a significant increase in the cross-sectional area of the median nerve proximally in the mouse users having pain (p<0.05). Of all mouse users, eight (16.3%) were diagnosed as sensory CTS, four (8.2%) as motor CTS by EMG. We also found that four (50%) CTS patients had a proximal cross-sectional area of median nerve exceeding 10 mm2 and five (62.5%) had a distal flattening ratio over three. Prolonged use of a mouse may pose an occupational risk for employees. Sonography can serve as an initial step in symptomatic patients for diagnosis of CTS.

Evaluation of cerebral blood flow volume using color duplex sonography in patients with untreated panic disorder

Abstract  The aim of this study was to compare cerebral blood flow (CBF) using color duplex sonography in panic disorder and normal controls. We report 24 untreated patients and 20 healthy subjects. State–Trait Anxiety Inventory, Beck Depression Inventory, Beck Anxiety Inventory, and Symptom Check List‐90 were completed on each subject. The internal carotid artery (ICA) and vertebral artery (VA) of both sides were explored with a 7.5‐Mhz linear array transducer. CBF volume and mean ICA flow velocity were significantly higher in patients than normal subjects adjusted for age. However, we could not find a statistically significant difference in flow volume and velocity of VA and the sum of bilateral ICA volume between patients and controls adjusted for age. There was also no correlation between CBF volume and the other radiological data with STAI scores. In conclusion, we found that independent of anxiety levels, CBF volume has increased in panic disorder patients. In addition, color duplex sonography is a non‐invasive and easily applicable technique and it is a preferable alternative to quantify CBF volume.

Doppler Sonographic Evaluation of Cerebral Blood Flow in Anemia Resulting From Chronic Renal Failure

This study was undertaken to describe Doppler sonographic measurement of cerebral blood flow in anemia secondary to chronic renal failure and to compare the results with data gathered from healthy control subjects. We also aimed to compare vertebral and internal carotid artery blood flows to see whether any alteration of dominance in cerebral blood supply would occur.

Effect of Aerodiol administration on ocular arteries in postmenopausal women

Objective. The aim of the present study was to evaluate the alteration of ocular blood hemodynamics after intranasal administration of 17β-estradiol, through measurement of the ophthalmic artery (OA) and the central retinal artery (CRA) using color duplex sonography. Methods. Thirty healthy women who had been naturally postmenopausal for at least 1 year were enrolled in the study. A randomized, placebo-controlled, crossover, double-blinded study was conducted of the acute effect of 17β-estradiol (Aerodiol®; Servier, Chambrayles-Tours, France) on OA and CRA blood flow using color duplex sonography. Results. The peak systolic and end diastolic velocities of the CRA were increased significantly after 17β-estradiol administration compared with placebo. A significant decrease was also found in the pulsatility and resistive indices of the CRA. However, there were no statistically significant differences in OA flow velocities or pulsatility and resistive indices. Conclusions. Nasal 17β-estradiol administration in postmenopausal women causes an improvement in the ocular vascular Doppler indices. These results suggest that there could be a positive effect of Aerodiol® on middle-sized arteries and arterioles.