Biomedical subjects

Sadi Gündoğdu

Publications and source records attributed to Sadi Gündoğdu.

At least 19 recordsLinked to original sources

PubMed2005

Transabdominal pulse inversion harmonic imaging improves assessment of ovarian morphology in virgin patients with PCOS: comparison with conventional B-mode sonography.

OBJECTIVE: In virgin policystic ovary syndrome (PCOS) patients transabdominal sonography is the preferential method of the pelvic examination. The purpose of this study was to determine ovarian morphology by the transabdominal route by pulse inversion harmonic imaging (PIHI) in virgin PCOS patients and to compare the diagnostic image quality with conventional B-mode ultrasonography (CBU). METHODS: Fifty-two ovaries in 26 virgin patients were evaluated by the transabdominal approach. Each ovary was examined using both PIHI and CBU. The sharpness of the follicular cysts walls, degree of internal echo definitions of the follicle cysts and overall ovarian conspicuity was assessed subjectively, using 4 point scoring (0, being worst; 3, being best score). The number of countable follicles, the size of largest and smallest ovarian follicle and ovarian volumes were assessed quantitively by both techniques. The effect of body mass index (BMI) on qualitative and quantitative scoring was evaluated. RESULTS: The sharpness of the cyst wall and internal echo structure was significantly better with PIHI than with CBU (P < 0.001 P < 0.001 and P < 0.001, respectively). PIHI improved overall ovarian conspicuity in 41 (78.8%) of 52 examination. The number of countable follicles was significantly lower with CBU (P < 0.001). The maximum diameter of the largest follicle was larger with PIHI sonography to compared CBU (P < 0.001). Mean ovarian volume was significantly larger with CBU (P < 0.001). When data were analyzed separately according to BMI, number of non-diagnostic overall ovarian conspicuity scores with CBU was markedly high in obese patients (88% with CBU versus 3.8% with PIHI). On the other hand, mean number of countable follicles with CBU became much more lower in the obese group (P < 0.001). CONCLUSION: In virgin PCOS patients, when compared to transabdominal CBU, PIHI significantly improved the detection of ovarian follicles, especially in high BMI obese subjects, through increased contrast sensitivity for cystic structures and decreased intrafollicular artifactual echoes. Transabdominal ultrasonographic examination by PIHI mode can contribute to the evaluation of ovaries.

Adolescent↗

PubMed2005

Mucinous cystadenoma mimicking simple renal parenchymal cyst in a horseshoe kidney.

We report a case of mucinous cystadenoma in a horseshoe kidney which radiologically resembled a simple renal cyst. In the published literature, three cases of mucinous cystadenoma of renal origin have been reported. Although these tumors are believed to originate from the renal pelvis, the cyst in the present case originated from renal parenchyma. The significance of this particular case is the radiological features, which mimic a simple renal parenchymal cyst and contribute to the histopathological definition of an extremely rare disease.

Adult↗

PubMed2005

Evaluation of the hippocampus and the anterior cingulate gyrus by proton MR spectroscopy in patients with post-traumatic stress disorder.

PURPOSE: Previous studies have shown that post-traumatic stress disorder (PTSD) is associated with lymbic system dysfunction. The purpose of this study is to evaluate whether or not the neuronal integrity in hippocampus and anterior cingulate gyrus is affected in PTSD as assessed by proton magnetic resonance spectroscopy. MATERIALS AND METHODS: Single voxel MRS was performed in 10 PTSD patients and 6 healthy subjects in two cerebral areas highly involved in the pathophysiology of PTSD (the hippocampus and the anterior cingulate gyrus). Spectra were obtained using PRESS sequence. Voxel sizes were 3.7 cm3 (hippocampus) and 6-7.2 cm3 (anterior cingulate gyrus). Metabolite ratios of NAA/Cr and Cho/Cr were calculated and compared to the control subjects. The severity of PTSD in the patient group was evaluated by Clinician-Administered PTSD Scale. RESULTS: Analysis of the proton MR spectra showed reductions in NAA/Cr ratio in bilateral hippocampus of PTSD subjects as compared to normal controls (p < 0.001), whereas Cho/Cr ratios were increased (p < 0.001). Reductions in NAA/Cr ratio were found in the the anterior cingulate gyrus of PTSD subjects as compared to normal controls (p < 0.01), whereas Cho/Cr ratios did not differ significantly (p > 0.05). CONCLUSION: Changes in the metabolite ratios provide support for either neuronal dysfunction or neuronal loss both in the hippocampus and the anterior cingulate gyrus and may be associated with reduced neuronal integrity. Further studies with MRS in larger patient populations are needed to clarify the relationship between brain structures and neurobiology of PTSD.

Adult↗

PubMed2004

Assessment of image quality of a standard and three dose-reducing protocols in adult cranial CT.

The purpose of this study was to analyze the effect of various tube current settings (mAs) and optimize the image quality and dose for adult cranial CT protocol. Sixty adult patients who underwent a cranial CT scanning for different indications were subdivided into three subgroups. Subjective image and noise quality scores and quantitative noise measurements were selectively studied on three reference levels (cerebellar, basal ganglia and centrum semiovale levels). For each subgroup, only one level was studied. Head circumference (HC) and the maximum anteroposterior diameter (MAPD) of each patient were measured. At 50% decreased dose protocol, there was no poor quality score at any level. At nearly 60% decreased dose protocol, the incidence of poor quality scores was much higher at the cerebellar level than at the other two levels. For the same protocol number, quantitative noise measurements were higher at the cerebellar level than the other two supratentorial levels. The correlation was found to be significant between HC, MAPD and quantitative noise measurements, and there was a non-significant correlation between HC and subjective noise scores. In adult cranial CT, depending on the level, a dose reduction of up to 60% may be possible while maintaining image quality.

Adolescent↗

PubMed2004

Craniofacial differences according to AHI scores of children with obstructive sleep apnoea syndrome: cephalometric study in 39 patients.

BACKGROUND: Cephalometry is useful as a screening test for anatomical abnormalities in patients with obstructive sleep apnoea syndrome (OSAS). OBJECTIVE: To evaluate comprehensively the cephalometric features of children with OSAS, with or without adenotonsillar hypertrophy, and to elucidate the relationship between cephalometric variables and apnoea-hypopnoea index (AHI) severity. MATERIALS AND METHODS: The study population consisted of 39 children, aged 4-12 years, with OSAS. Cephalometry was analysed using 11 measurements of the bony structures, their relationships and the size of the airways. Additionally, adenoid and tonsillar hypertrophy were graded. RESULTS: Cranial base angles (BaSN and BaSPNS) were found to correlate with increasing levels of AHI scores (P<0.001). Protrusion of the maxilla (SNA) and mandible (SNB) did not correlate with AHI scores (P>0.05). The length of the mandibular plane (GnGo) and the minimal posterior airway space (MPAS) were inversely correlated with AHI scores (P<0.001). There was positive correlation between MPAS and GnGo (r=0.740, P<0.001), and negative correlation between MPAS and gonial angle (ArGoGn) (r=-0.541, P<0.001). There was significant correlation between cephalometric data and adenotonsillar hypertrophy concerning BaSN, BaSPNS, ArGoGn, GnGoH, BaN-GnGo, MPAS, GnGO and MPH (P<0.001). CONCLUSIONS: There is significant correlation between cephalometric data and AHI score severity in children with OSAS. Adenotonsillar hypertrophy affects the cephalometric measurements adversely. The study clearly mandates the institution of early and effective therapy of adenotonsillar hypertrophy in children with OSAS.

Adenoids↗

PubMed2004

Evaluation of paranasal sinus mucosa in coal worker's pneumoconiosis: a computed tomographic study.

OBJECTIVE: To evaluate by computed tomographic scanning the paranasal mucosal changes of coal workers with and without pneumoconiosis. METHODS: Examination of images and scores from paranasal computed tomographic scans. The study participants were 26 coal workers with pneumoconiosis, 29 coal workers without pneumoconiosis, and 20 controls. All were men. The extent and patterns of inflammatory paranasal sinus disease were evaluated on computed tomographic scans by 2 radiologists using the terminology and definitions of Newman and associates. RESULTS: Interobserver agreement for the presence of abnormalities was from good to excellent (kappa, 0.63-0.89). The mucosal scores of individuals and groups were higher for coal workers than for control subjects. Both scores were significantly higher in the pneumoconiosis group than in the 2 other groups. CONCLUSIONS: This study shows that paranasal sinuses were affected more severely in coal workers than in control subjects. In coal workers with pneumoconiosis, the affection was most severe. The relationship between coal dust exposure and paranasal mucosal changes needs further study.

Adult↗

PubMed2004

Migration of an intrauterine contraceptive device to the ovary.

We present the case of a 37-year-old woman with a history of 2 consecutive insertions of intrauterine contraceptive devices (IUDs) 3 years before she was referred to us for sonographic evaluation of lower abdominal pain. The first of the IUDs was presumed to have been expelled spontaneously, and 3 months after insertion of the second device, the patient had begun experiencing lower abdominal pain. Medical treatment with antibiotics and spasmolytics had been unsuccessful. We performed transvaginal sonography, which revealed the presence of an IUD in the uterus and a 2-cm linear metallic echogenic area in the left ovary, believed to represent another IUD. Anteroposterior radiography confirmed that there were 2 IUDs in the pelvis, and CT demonstrated 1 IUD in the uterus and another in the left ovary. The patient underwent laparoscopic removal of the ovarian IUD and was discharged in good condition. To our knowledge, this is the first report of migration of an IUD to the ovary detected on transvaginal sonography. We recommend consideration of this possibility during evaluation of women with unexplained chronic pelvic pain.

Abdominal Pain↗

PubMed2004

Comparison of chest radiography and high-resolution computed tomography findings in early and low-grade coal worker's pneumoconiosis.

INTRODUCTION: High-resolution computed tomography (HRCT) is more sensitive than chest X-ray (CXR) in the depiction of parenchymal abnormalities. We aimed to present and compare CXR and HRCT findings in coal workers with and without early and low-grade coal worker's pneumoconiosis (CWP). MATERIALS AND METHODS: 71 coal workers were enrolled in this study. All workers were male. The CXR and HRCT of those workers were obtained and graded by two trained readers. HRCT's were graded according to Hosoda and Shida's Japanese classification. After grading, 67 workers with CXR profusion 0/0-2/2 were included in the study. Four patients with major opacity were excluded. Profusion 0/1 to 1/1 cases were accepted as early and profusion 1/2 and 2/2 cases as low-grade pneumoconiosis. RESULTS: Discordance between CXR and HRCT was high. Discordance rate was found higher in the early pneumoconiosis cases with negative CXR than low-grade pneumoconiosis (60, 36 and 8%, respectively). When coal miners with normal CXR were evaluated by HRCT, six out of 10 cases were diagnosed as positive. In low-grade pneumoconiosis group, the number of patients with positive CXR but negative HRCT were low in comparison to patients with CXR negative and early pneumoconiosis findings. Most of the CXR category 0 patients (10/16) were diagnosed as category 1 by HRCT. Eleven cases diagnosed as CXR category 1 were diagnosed as category 0 (7/11) and category 2 (4/11) by HRCT. In CXR category 2 (eight cases), there were four cases diagnosed as category 1 by HRCT. CONCLUSIONS: Discordance between CXR and HRCT was high, especially for CXR negative and early pneumoconiosis cases. The role of CXR in screening coal workers to detect early pneumoconiosis findings should be questioned. We suggest using HRCT as a standard screening method instead of CXR to distinguish between normal and early pneumoconiosis.

Adult↗

PubMed2004

Familial acromegaly: a familial report and review of the literature.

Familial acromegaly without features of multiple endocrine neoplasie type 1 (MEN 1) is an exceptional clinical entity. We report in this article three cases of acromegaly due to pituitary macroadenomas without any other endocrinopathy in a family. A 31-year-old woman (subject A) and her 34-year-old sister (subject B) with elevated basal rolactin (PRL) levels, elevated growth hormone (GH) levels during the oral glucose tolerance test (OGTT) and a pituitary adenoma in Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) were diagnosed as acromegaly. Subject A was treated only with radiotherapy and Lysuride. Subject B underwent transsphenoidal microsurgical extirpation 15 years ago. 11 years later her 24-year-old son (subject C) also presented with typical signs of acromegaly, elevated basal PRL level and elevated GH levels during OGTT. A pituitary macroadenoma was identified by MRI and he also underwent transsphenoidal adenomectomy. Pathology reports confirmed the diagnosis of GH-secreting pituitary adenoma in subject B and C. Immunocytochemistry revealed that tumours of subject B (> 20% of tumour cells) and C (> 50% of tumour cells) were positive for GH. Tumours of subject B (> 10% of tumour cells) and C (> 50% of tumour cells) also exhibited immunoreactivity for PRL. On investigation of histocompatibility antigens, it was observed that the subject A, B, and C shared the same haplotypes [HLA A24(9), HLA B13(6), HLA B35, HLA DQ7(3), HLA DR13(6)] and so it is very possible that investigation of HLA antigens in patients with pituitary tumour, contributes to better identification of its familial nature and frequency. Here we describe an acromegaly family and the distributions of HLA antigens.

Acromegaly↗

PubMed2004

Epinephrine in digital block: color Doppler flow imaging.

BACKGROUND: Epinephrine is currently added to local anesthetics for its advantageous vasoconstrictive effects. Traditionally, however, its use is not advised for digital block anesthesia due to the risk of digital gangrene. OBJECTIVE: To observe vasoconstrictive effect of epinephrine in digital block anesthesia. METHODS: Digital blocking with epinephrine containing lidocaine was performed in 24 subjects undergoing surgical procedure of their finger and toes. Digital artery blood flows were studied with color Doppler ultrasonography before digital blocking and at 10th, 60th, and if needed 90th minutes after blocking. Doppler parameters such as peak systolic velocity, end diastolic velocity, and resistive index values were studied. RESULTS: There were statistically significant decrease of blood flow rates and an increase of resistive index in all patients within 10 minutes. At the 10th minute of digital block, four patients had no measurable blood flow, which was restored within 60 or 90 minutes. Others showed diminished but persistent blood flow, which returned to normal within 60 minutes. No systemic or local complication related with epinephrine usage was observed. CONCLUSION: Vasoconstrictive effect of epinephrine in local anesthetics is not persistent and resolves within 60 or 90 minutes. Its use seems to be safe in selected patients.

Adult↗

PubMed2004

Gallbladder and urinary tract precipitations associated with ceftriaxone therapy in children: a prospective study.

The incidence and outcome of gallbladder and urinary tract complications in children receiving ceftriaxone therapy were evaluated prospectively. The subjects were given intravenous ceftriaxone, 100 mg/kg/day, in two divided doses infused over 20-30-minute periods, for 5-14 days. Serial abdominal ultrasonography revealed gallbladder and urinary tract precipitations in five of 35 children, three of whom had gallbladder pseudolithiasis, one gallbladder sludge and one gallbladder pseudolithiasis and urinary bladder sludge. The children who had gallbladder sludge and gallbladder pseudolithiasis with urinary bladder sludge had abdominal pain, nausea and vomiting. Three children remained symptom-free. The gallbladder precipitations were found after 4-9 days of ceftriaxone therapy, and resolved completely 7-19 days after the end of treatment. The urinary tract precipitation was found on the 5th day after cessation of ceftriaxone therapy and resolved 7 days later. Ceftriaxone-associated gallbladder pseudolithiasis, gallbladder sludge and urinary bladder sludge usually resolve spontaneously and physicians should be aware of these complications so as to avoid unnecessary therapeutic procedures.

Adolescent↗

PubMed2004

[High resolution MR neurography in patients with cervical radiculopathy].

PURPOSE: To image the cervical spinal nerves directly in patients with clinical and radiographic evidence of cervical radiculopathy via high resolution MR neurography by means of a qualitative and quantitative analysis. MATERIALS AND METHODS: Twenty symptomatic patients with cervical radiculopathy and five asymptomatic volunteers were examined. A phased-array coil system was used to obtain high-resolution coronal T1-weighted spin echo and coronal/axial short tau inversion recovery (STIR) images of the cervical spine and spinal nerves. On the axial STIR images, nerve/muscle signal intensity ratio of the cervical spinal nerves were measured on both sides and compared with paired samples t test. P values below 0.05 were considered statistically significant (p<0.05). RESULTS: A markedly increased signal in the distal portion of the affected spinal nerves was found. Nerve/muscle signal intensity ratio measurements of the affected spinal nerves showed a significantly increased intensity compared with the noninvolved spinal nerves (p<0.05). In controls, nerve/muscle signal intensity rate was nearly identical on both sides (p>0.05). CONCLUSION: Magnetic resonance neurography performed with phased-array coils can detect signal abnormalities within compressed cervical spinal nerves in patients with corresponding radicular symptoms and findings. This technique may be helpful especially in evaluating patients with multi-level disc disease of the cervical spine.

Adult↗

PubMed2004

[Double inversion recovery sequence in temporal lobe epilepsy: preliminary results].

PURPOSE: DIR (double inversion recovery) is a sequence with the hybrid contrast of both FLAIR and STIR sequences, produced by the application of double inversion recovery pulse. It has been suggested that DIR provides high sensitivity to lesions with low T2 contrast. The purpose of this study was to test the hypothesis that DIR sequence is superior to conventional sequences in the identification of mesial temporal sclerosis and other temporal lobe lesions in patients with temporal lobe epilepsy. MATERIALS AND METHODS: Thirty-three subjects with a prediagnosis of temporal lobe epilepsy and ten healthy control subjects with no abnormality on magnetic resonance imaging studies have been studied with DIR, FLAIR and T2W sequences. Coronal images through temporal lobes and hippocampus were acquired. Qualitatively, overall sensitivity to the presence of lesions, hippocampal lesion detectability, temporal horn dilatation and artifacts were evaluated in temporal lobe epilepsy cases and quantitatively, hippocampal and white matter signal-to-noise ratio as well as hippocampus-white matter contrast-to-noise ratio were calculated in the healthy subjects. Subjective scores were graded on a scale of 3 or 4 points. RESULTS: Signal-to-noise ratio scores were higher on T2W sequence, however contrast-to-noise ratio scores were higher on DIR sequence compared to the other two sequences. Imaging findings were compatible with mesial temporal sclerosis in seven patients, tumoral mass in two, and chronic infarct in four. DIR sequence was less sensitive to hippocampal atrophy than the other two sequences because of cerebrospinal fluid artifacts. Overall sensitivity to the presence of lesions and hippocampal lesion detectability scores, although similar among three sequences, were highest with DIR sequence. However, lesion sensitivity scores were highest for lesions compatible with mesial temporal sclerosis and for solid masses and lowest for cystic lesions on DIR sequence. CONCLUSION: Despite the presence of artifacts, DIR is a sequence providing high sensitivity to mesial temporal sclerosis like lesions at hippocampus. DIR might be useful as an additional sequence when the other conventional sequences reveal a suspicious lesion with no accompanying hippocampal atrophy.

Adolescent↗

PubMed2004

[The role of three dimensional MR myelography in lumbar discogenic disease].

PURPOSE: To evaluate the role of the three dimensional (3D) MR myelography (MRM) in the diagnosis of the lumbar discogenic disease compared with conventional MR imaging. MATERIALS AND METHODS: Fifty consecutive patients with clinical symptoms of lumbar disc herniation were enrolled for the study. Conventional MR imaging and coronal 3D MRM were performed on a 1.5 T MR system. At each disc space level, the presence and the location of disc herniation and nerve root compression were evaluated. Note was also made if MRM had additional contribution to the determination of most significant level in the cases of multilevel disc disease and lumbar spinal stenosis. RESULTS: Disc herniation was found in 60 disc space levels on conventional MR imaging and in 54 disc space levels on 3D-MRM imaging. As regards to disc herniation, the sensitivity, specificity, and accuracy of 3D-MRM was 90%, 100%, and 96%, respectively. Nerve root compression was seen in 91 levels on conventional MR images, as opposed to 98 on 3D-MRM. Regarding nerve root compression, the sensitivity, specificity, and accuracy of 3D-MRM was 100%, 97%, and 98%, respectively. In all of 13 patients with multilevel disc disease and lumbar spinal stenosis, 3D-MRM had additional contribution. CONCLUSION: Scan time of 3D-MRM is short. It can be easily added to routine lumbar MR imaging. It may be a valuable modality in the diagnosis of the lumbar discogenic disease. The presence of false-negative and false-positive examinations necessitates caution in interpreting 3D-MRM images. 3D MRM technique may be useful in selected cases such as patients with multilevel disc abnormalities or lumbar spinal stenosis where it allows a rapid and easy appreciation of the level most likely to account for the pathology.

False Positive Reactions↗

PubMed2004

[3D-CT investigation of craniofacial and cervical spine anomalies in congenital muscular torticollis].

PURPOSE: To investigate the accompanied craniofacial and cervical spine anomalies in congenital muscular torticollis (CMT) with three-dimensional computerized tomography (3D-CT). MATERIALS AND METHODS: We examined six cases of CMT. Cranial and cervical 3D CT was performed in all cases. Facial midline deviation angle (FDA), upper hemifacial width, lower hemifacial width (LHFW), length of hemimandible and zygomatic arcus, posterior hemicranial width (PHCW), anterior hemicranial width and cranial base midline deviation angle (CBDA) were measured on cranial 3D-CT images. Value of orbital index was calculated. Data achieved both ipsilaterally and contralaterally were compared with paired t-test. Atlanto-axial rotation angle (AARA) and atlantodental interval (ADI) values were measured on cervical 3D-CT images. RESULTS: Ages ranged between 2-26 years with a M/F ratio of 1/5. Facial asymmetry was diagnosed in all cases and LHFW was significantly undersized when compared to contralateral side (p < 0.05). FDA was measured 5.4+/-2.0 degrees on the average. Zygomatic arcus and hemimandible were significantly undersized on the side of torticollis (p < 0.05). Occipital plagiocephaly existed in all cases and PHCW was significantly extensive on torticollis side (p < 0.05). CBDA was measured 4.5+/-1.7 degrees on the average. Rotational movement of atlas over axis was observed in all cases where the AARA was 15.0+/-7.4 degrees. ADI was lesser than 3 mm in all cases. CONCLUSION: Even occipital plagiocephaly, maxillary and orbital deformity were commonly found in cases of CMT, most dominant asymmetry was observed in lower hemifacial region, zygomatic arcus and mandible by 3D-CT imaging. Rotational movement of first cervical vertebra over the second one was determined in all cases.

Adolescent↗

PubMed2003

[Comparison of three-dimensional gradient echo, turbo spin echo and steady-state gradient echo sequences in axial MRI examination of the cervical spine].

PURPOSE: The aim of this study was to assess the detectability of the structures that are affected by cervical spondylosis by different 3D MRI sequences and compare the image quality of those sequences. MATERIALS AND METHODS: Twenty healthy volunteers were examined using a 1.5 T MR unit. T2* weighted 3D-gradient echo sequence with magnetization transfer saturation pulse (3D-FFE-MTC), T2 weighted 3D turbo spin echo (TSE) sequence with and without spectral presaturation inversion recovery pulse (T2-3D-TSE/SPIR+ and T2-3D-TSE/SPIR-) and balanced-FFE (b-FFE) sequences were compared. Spinal cord signal-to-noise ratio (SNR), cerebrospinal fluid (CSF) SNR, and CSF-spinal cord contrast-to-noise ratio (CNR) were calculated quantitatively. The detectability of neural foramina, spinal nerve roots, uncinate process and ligamentum flava were graded on a 5-point scale (0: minimum, 4: maximum) qualitatively. The presence of the artifacts and overall image quality were graded on a 4-point scale (0: minimum, 3: maximum). RESULTS: Balanced-FFE sequence yielded the best results for each of three quantitative evaluation. In terms of qualitative evaluation, for the uncinate process T2-3D-TSE/SPIR- sequence was superior to the other three sequences (p < 0.01). For the ligamentum flava T2-3D-TSE/SPIR- and b-FFE sequences were superior to the other two (p < 0.01). For the neural foramina b-FFE yielded the lowest score (3), however the other three sequences were not significantly different (3.2-3.5) (p > 0.05). Artifacts were most commonly seen using 3D-FFE-MTC. In terms of overall image quality T2-3D-TSE/SPIR- yielded the highest score, followed by b-FFE. CONCLUSION: 3D-FFE-MTC sequence is frequently preferred for cervical spinal MRI studies. However our study yielded best scores for T2-3D-TSE/SPIR, followed by b-FFE in the quantitative and qualitative evaluation of the structures affected by cervical spondylosis.

Adolescent↗

PubMed2003

[Venous reflux: Measurement variability due to positional differences].

PURPOSE: The purpose of this study was to evaluate the role of the subject's position and two different maneuvers in the reflux measurements in femoral veins. MATERIALS AND METHODS: Venous reflux times in the common femoral vein (CFV) and superficial femoral vein (SFV) were studied in 50 healthy subjects (25 women, 25 male) aged between 22-57 years-old while the subjects were in supine and standing positions. Reflux was provocated only by Valsalva maneuver (VM) when the subject was lying down, whereas it was provocated by (1) Valsalva maneuver and (2) compression and release maneuver, respectively, when the subject was standing. Reflux times were recorded with each of the three methods. RESULTS: Regarding CFV, a reflux time of 1 second or more was recorded in 29 limbs (29%) only in the supine position. Of these 29 measurements, 19 were between 1 and 1.9 sec and 8 between 2 and 2.9 sec. When the subjects were examined in the standing position, the prevalence of reflux lasting more than 1 sec substantially decreased (5%). The prevalence of reflux lasting less than 0.5 sec was 97% with standing compression maneuver, 84% with standing VM and 27% with supine VM. Similarly, prevalence of reflux of longer than 0.5 sec or 1 sec was lower in the standing position than in the supine position in SFV. In CFV, mean reflux time was 1.3 sec in the supine position, whereas it was 0.7 sec and 0.4 sec with standing compression and standing Valsalva maneuvers, respectively. Corresponding values in SFV were 0.5 sec, 0.3 sec and 0.2 sec, respectively. CONCLUSION: The probability of making a false positive diagnosis of pathological reflux is high with supine examinations. When an examination in the supine position reveals a reflux time of longer than 1 second, making the patient stand up is expected to yield more reliable results. Compression and release maneuver, with its lowest false positive reflux prevalence, is the most reliable method in the evaluation of venous insufficiency.

Adult↗

PubMed2003

[Brown tumor of the maxillary sinus: a case report].

Brown tumor of the paranasal sinuses is rare. It is a benign fibro-osseous lesion, typically presenting as an expansile mass that leads to a cortical defect. We presented the radiological findings of a brown tumor of the right maxillary sinus in a 13-year-old boy who presented with complaints of swelling in the right maxillary region, headache, and epistaxis. Biochemical findings were compatible with primary hyperparathyroidism. The lesion was removed by partial parathyroidectomy. No recurrences or residual mass were detected during a six-month follow-up period.

Adolescent↗