Yakup Yesilkaya

Persistent left superior vena cava draining to the left atrium: A case report and review of the literature.

Summary Background: Persistent left superior vena cava is a rare but important congenital vascular anomaly. However, PLSVC with absent RSVC (isolated PLSVC) is a very rare venous malformation We report on a rare case of persistent left superior vena cava (PLSVC) with absent right superior vena cava (RSVC). Case Report: This venous malformation was identified incidentally in a 69-year-old woman during chest multi-detector computed tomography (MDCT). On chest MDCT, the SVC was noted on the left side. A bridging vein drained the right jugular and right subclavian veins and joined the left brachiocephalic vein in order to form the PLSVC, which descended on the left side of the mediastinum and drained into the left atrium (LA). The patient had no additional cardiac anomaly. Conclusions: Isolated PLSVC is usually asymptomatic but it can pose difficulties for establishing central venous access, pacemaker implantation and cardiothoracic surgery. This condition is also associated with an increased incidence of congenital heart disease, arrhythmias and conduction disturbances. A wide spectrum of clinicians should be aware of this anomaly, its variations and possible complications.

The association between thyroid volume, L-thyroxine therapy and hepatocyte growth factor levels among patients with euthyroid and hypothyroid goitrous and non-goitrous Hashimoto’s thyroiditis versus healthy subjects

ABSTRACT Objective: Hashimoto’s thyroiditis (HT) is the most common etiology of hypothyroidism in regions where iodine deficiency is not a concern. To date, many clinical investigations have been conducted to elucidate its pathogenesis. Several growth factors have been shown to have a role in its development. Hepatocyte growth factor (HGF) is one of the aforementioned molecules. We aimed to demonstrate whether HGF is responsible for HT and goiter development. Also, we aimed to test the hypothesis that levo-thyroxine sodium therapy will suppress HGF levels. Materials and methods: Sixty-one premenopausal women who were admitted to our outpatient clinic between November 2010 and September 2011 were enrolled. Three groups were determined according to their thyroid function tests (TFTs) as euthyroid Hashimoto’s, control and subclinical hypothyroid Hashimoto’s groups. Basal TFTs, anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-tg), thyroid ultrasonography (USG) and HGF were studied and recorded. Subclinical hypothyroid HT patients received levo-thyroxine sodium replacement therapy, and were re-assessed for the same laboratory and radiologic features after a median 3.5 month follow-up. Results: Basal HGF levels were not different between groups. In the subclinical hypothyroidism group, HGF levels (752.75 ± 144.91 pg/ml vs. 719.37 ± 128.05 pg/ml; p = 0.496) and thyroid volumes (12.51 ± 3.67 cc vs. 12.18 ± 4.26 cc; p = 0.7) before and after treatment did not change significantly. No correlations were found between HGF and other parameters. HGF levels were similar between subjects with nodular goiter and normal thyroid structure. Conclusions: HGF was not shown to be associated with HT and goiter development. In addition, levo-thyroxine sodium replacement therapy did not alter serum HGF levels significantly.

Autologous blood-clot embolisation of cavernosal artery pseudoaneurysm causing delayed high-flow priapism.

Summary Background: High-flow priapism is a rare condition characterized by a prolonged and painless erection. Since it may permanently impair erectile function, it must be managed and treated as soon as possible, in order to restore potency. The case we are presenting here was successfully treated by embolizing the penile artery using an autologous clot. Case Report: A case of delayed painless high-flow priapism that occured after blunt straddle-type perineal trauma, that was persistent for more than 30 days is being presented. Doppler ultrasonographic examination of the cavernosal artery revealed a 1.5 cm-diameter pseudoaneurysm at the right cavernosal artery, together with a high-velocity shunt between the two cavernous arteries. Extravasation from the proximal sites of both of the cavernous arteries and a right cavernosal artery pseudoaneurysm was detected on angiography. The patient was successfully treated by embolization of the penile artery with an autologous clot in two sessions with a 3-day interval. Conclusions: This experience along with a survey of the literature made us conclude that embolization of cavernous artery by means of an autologous clot is a very effective procedure and a method of choice for treatment of high-flow priapism and for restoration of penile erectile function. What makes our case even more interesting and important, is the fact that priapism of one month’s duration could well be treated by means of this method.

Eccrine Spiradenoma of the Thigh Sonographic Findings and Review of the Literature

Eccrine spiradenoma is a well-recognized benign tumor arising from the intradermal straight portion of the eccrine or merocrine sweat glands. It is usually a small, solitary lesion in the cutis and the subcutaneous tissues. As with other lesions in the cutis and the subcutaneous tissue, few cases describing the sonographic findings of eccrine spiradenoma have been reported. This case study demonstrates these sonography findings in a case of eccrine spiradenoma distributed in the right thigh.

MRI findings of intracranial malformations in a case with Fraser syndrome.

Introduction Fraser syndrome (FS) is a rare autosomal recessive genetic disorder that is characterized by cryptophthalmos, cutaneous syndactyly, malformations of the larynx and urogenital tract, cranial dysmorphism, orofacial clefting, mental retardation, and skeletal abnormalities. This rare but well-known congenital malformation syndrome was first described by Fraser (1962). Thomas et al. (1986) defined the diagnostic criteria for FS, discussing the differential diagnosis between syndromic and nonsyndromic cryptophthalmos. They described four major criteria (cryptophthalmos, syndactyly, abnormal genitalia, an affected sib) and eight minor criteria (congenital malformations of the nose, ears, and larynx; cleft lip with or without a cleft palate; skeletal symptoms; umbilical hernia; renal agenesis; and mental retardation). The diagnosis was proposed to be established in the presence of two major and one minor or one major and four minor criteria. Since then, a few studies have evaluated the clinical aspects of FS in the literature (Slavotinek and Tifft, 2002). Here, we report the clinical and radiographic findings of an FS patient with central nervous system malformations. These findings have not been reported previously in the literature.