Tamer Kaya

CT-guided pleural needle biopsy in the diagnosis of malignant mesothelioma.

Objective Our goal was to determine the sensitivity of CT-guided closed pleural needle biopsy (CPNB) for the histopathologic diagnosis of diffuse malignant pleural mesothelioma (DMPM). Materials and Methods Thirty patients with DMPM were studied with CT-guided CPNB. Tumor specimens were classified according to their cell types. Results In 25 (83.3%) patients, the diagnosis was made by CT-guided CPNB. The remaining five patients were diagnosed by thoracoscopy, thoracotomy, or excisional biopsy of the chest wall mass. Pneumothorax was observed in 9.5% of patients and local seeding of tumor in 21.7% of patients who underwent CPNB. Conclusion Properly performed CPNB under CT guidance may yield an increased sensitivity for the diagnosis of diffuse malignant pleural mesothelioma..

Evaluation of Labral Pathology and Hip Articular Cartilage in Patients with Femoroacetabular Impingement (FAI): Comparison of Multidetector CT Arthrography and MR Arthrography.

Summary Background To compare the multidetector computed tomography (MDCT) arthrography (CTa) and magnetic resonance (MR) arthrography (MRa) findings with surgical findings in patients with femoroacetabular impingement (FAI) and to evaluate the diagnostic performance of these methods. Material/Methods Labral pathology and articular cartilage were prospectively evaluated with MRa and CTa in 14 hips of 14 patients. The findings were evaluated by two musculoskeletal radiologists with 10 and 20 years of experience, respectively. Sensitivity, specificity, accuracy, and positive predictive value were determined using surgical findings as the standard of reference. Results While the disagreement between observers was recorded in two cases of labral tearing with MRa, there was a complete consensus with CTa. Disagreement between observers was found in four cases of femoral cartilage loss with both MRa and CTa. Disagreement was also recorded in only one case of acetabular cartilage loss with both methods. The percent sensitivity, specificity, and accuracy for correctly assessing the labral tearing were as follows for MRa/CTa, respectively: 100/100, 50/100, 86/100 (p<0.05). The same values for acetabular cartilage assessment were 89/56, 40/60, 71/71 (p>0.05) and for femoral cartilage assessment were 100/75, 90/70, 86/71 (p>0.05). Inter-observer reliability value showed excellent agreement for labral tearing with CTa (κ=1.0). Inter-observer agreement was substantial to excellent with regard to acetabular cartilage assessment with MRa and CTa (κ=0.76 for MRa and κ=0.86 for CTa) Conclusions Inter-observer reliability with CTa is excellent for labral tearing assessment. CTa seems to have an equal sensitivity and a higher specificity than MRa for the detection of labral pathology. MRa is better, but not statistically significantly, in demonstrating acetabular and femoral cartilage pathology.

A Sign of Arteriogenic Insufficiency on Penile Doppler Sonography Retrograde Flow in Penile Cavernosal-Spongiosal Communications

The purpose of this study was to evaluate the diagnostic usefulness of determining retrograde flow in the penile cavernosal‐spongiosal communications (CSCs) with Doppler sonography.

Mazabraud's Syndrome Coexisting with a Uterine Tumor Resembling an Ovarian Sex Cord Tumor (UTROSCT): a Case Report

The association of intramuscular myxoma and fibrous dysplasia is a rare disease known as Mazabrauds syndrome. We present a case of Mazabrauds syndrome coexisting with a uterine tumor and resembling an ovarian sex cord tumor (UTROSCT). This uterine tumor showed a high mitotic index and cytological atypia. To the best of our knowledge, the coexistence of the two different entities has not been reported in the literature.

Co-existence of renovascular hypertension, polyarteritis nodosa, antiphospholipid syndrome and methylenetetrahydrofolate reductase mutation

We present a hypertensive child with a co‐existence of polyarteritis nodosa, anti‐phospholipid antibodies (aPL), methylenetetrahydrofolate reductase (MTHFR) mutation and increased lipoprotein a level. Elevated renin, aldosterone and aPL levels, micro‐aneurysms, occlusion and thrombosis at left and right renal artery were found. Anti‐hypertensive agents, prednisolone and pulse cyclophosphamide therapy were started and a stent was inserted in the left renal artery. Two months later, brain magnetic resonance imaging/magnetic resonance imaging angiography showed acute infarct area of the left parietofrontal lobe and middle cerebral artery stenosis. We found bilateral peripheral neuropathy, persistent aPL and elevated Lp(a) level and heterozygous A1298C/MTHFR mutation. Intravenous immunoglobulin and low‐molecular‐weight heparin treatment was added. In conclusion, our observation suggests that in patients with systemic vasculitis, such as polyarteritis nodosa, aPL are probably associated with greater thrombotic risks. The investigation of the LP(a) levels and MTHFR mutations as a synergic pro‐coagulant effect might also be considered for determining patients with vasculitis at risk for severe thrombotic events.

Acute renal failure in two infants due to ureteropelvic fungi balls.

Fungal infections occur in infants and may be responsible for serious and occasionally fatal disease.1 As the survival rates for premature infants improve, they are more susceptible to opportunistic fungal infections. Because of the use of intravascular catheters, parenteral nutrition and broad-spectrum antibiotics are predisposing factors for the development of fungal infections, especially in those premature infants who have poor host defenses against infections.1 Renal candidiasis in infants is a potential fatal complication of systemic candidiasis or ascending candidiasis.2 The clinical and sonographic features of two prematurely born infants aged 2/2 and 4/2 months with renal candidiasis were presented. It is suggested that in any infant with a clinical suspicion of renal candidiasis, renal ultrasonography should be performed to facilitate early diagnosis and treatment of renal fungal disease.