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Son yıllarda bilgisayarlı tomografi (BT) kullanımı hastalara tanı koyabilme açısından vazgeçilmez bir görüntüleme teknolojisi olduğu tüm otoritelerce kabul edilmekle birlikte BT kullanımının aşırıya kaçtığı da kabul edilmektedir. Çok hızlı olan çok kesitli BT cihazlarının kullanıma girmesi ile çocuk hastalarda anestezi uygulamasına gerek kalmadan tetkikleri yapılabilmiştir. Bu durum da çocuk hastalarda BT kullanımında aşırı artışa sebep olmuştur. Yetişkinlerde ise aşırı artışın büyük bir bölümünü asemptomatik hastalarda BT kolonoskopi, kardiyak anjiyo ve tüm vücut tarama gibi tetkikler oluşturmaktadır. BT kullanımının bu kadar aşırı olması da beraberinde radyasyona maruz kalma riskini artırmaktadır. Bu çalışmada, BT tetkiklerinde hastanın maruz kaldığı gerçek radyasyon dozunun ortaya konması amacıyla BT cihazından okunan değer ile gerçekte hastanın aldığı radyasyon dozunun karşılaştırılması yapılmıştır. Bunun için 25 hasta üzerine termolüminesans (TLD) detektörleri yerleştirilmiştir. BT cihazından okunan radyasyon dozu ile TLD kristallerinden okunan radyasyon dozu arasında %4 farklılık olduğu bulunmuştur.

Objective:Head-neck computed tomography (CT) imaging is one ofthe most common tomography examinations in medical imaging. Lenses and thyroidare among the most sensitive organs to radiation. The aim of this study was todetermine the radiation dose levels to which the patient's lens, oral mucosa, andthyroid were during head and neck CT imaging.Methods:Thyroid, oral mucosa and lens areas of humanequivalent Alderson rando phantom were placed in thermoluminescence dosimeter(TLD) dosimeters and computerized tomography imaging of head-neck of phantomwas performed in this study. A total of 18 TLD dosimetry was used in thisstudy. Firstly, dosimeters were calibrated. 6 of these dosimeters were placedon the thyroid of the phantom and 4 of them were placed in the mouth and 4 ofthem were in the lens. 4 dosimeters were used for background measurementsResults:The radiation dose in TLDs placed at the center ofthe lens was between 15.03 and 23.71 mSv (mean 19.83±3.93 mSv), the oral mucosawas 10.36 to 19.47 mSv (mean 15.15±2.96 mSv), and the thyroid gland was between11.21 and 16.73 mSv (mean 13.97±3.90 mSv).Conclusion:The permissible radiation dose for whole body andeye lenses in ICRP reports is 20 mSv/year for radiation officers. Likewise,there is no definite limit for patients, it is aimed to keep the dose level toa minimum. Therefore, knowing the reference dose is important for imagingplanning., Amaç: Baş ve boyun bilgisayarlı tomografi (BT)görüntülemesi, en sık kullanılan radyolojik incelemelerinden biridir. Birçokhastalığın tanısında önemli rol oynar. Lens ve tiroid bezi radyasyona karşı enduyarlı organlardandır. Bu çalışmanın amacı, BT görüntülemesi yapılanhastaların, lens, oral mukoza ve tiroid dokusunun maruz kaldığı radyasyondozunun belirlenmesidir.Yöntem:Çalışmada, insan eşdeğeri olan Alderson Randofantomunun tiroid, oral mukoza, lens bölgelerine termolüminesans dozimetreleri(TLD) yerleştirilmiş ve fantomun baş-boyun bölgesinin BT görüntülemesiyapılmıştır. Toplam 18 adet TLD kullanılmıştır. Öncelikle dozimetrelerinkalibrasyon işlemleri yapılmıştır. Bu dozimetrelerden 6 tanesi fantomun tiroidbölgesine, 4 tanesi oral mukozaya, 4 tanesi de lens bölgesineyerleştirilmiştir. 4 tane dozimetre ise arkaplan (background) ölçümleri içinkullanılmıştır.Bulgular:Lens merkezine yerleştirilen TLD’lerdeki radyasyondozu 15,03 ile 23,71 mSv arasında (ortalama 19,83±3,93 mSv), oral mukozada10,36 ile 19,47 mSv arasında (ortalama 15,15±2,96 mSv), tiroid bezinde ise11,21 ile 16,73 mSv arasında (ortalama 13,97±3,90 mSv) bulunmuştur.Sonuç:Uluslararası Radyolojik Koruma Komisyonu(ICRP)raporlarında tüm vücut ve lensler için müsaade edilen radyasyon dozu,radyasyon görevlilerinde 20 mSv/yıl’dır. Hastalar için kesin bir limitolmamakla beraber, doz düzeyinin minimum tutulması amaçlanır. Bu nedenlereferans dozunun bilinmesi çekim planlaması için önemlidir.

Arachnoid cysts (ACs) are commonly encountered fluid collections in the central nervous system. Most cranial ACs are found incidentally and can be managed conservatively. This review presents and discusses clinical findings, diagnostic methods and management of intracranial ACs in 32 patients who were surgically treated in our clinic. The study included 23 male and nine female patients. Most of them were pediatric cases (77%) at the time of surgery. All diagnoses were confirmed on neuroradological examination. Twenty-six of the cysts were supratentorial (81.2%). The most common symptoms at presen- tation were seizures (50%), headache (37.5%), weakness (23%), and hydrocephalus (9%). Cystoperitoneal shunt placement, cra- niotomy, or endoscopic fenestration, are the surgical methods. Long-term outcome was favorable in most of these patients. Untreated, ACs may cause permanent severe neurological damage due to the progressive expansion of the cyst or hemorrhage. However, with surgical treatment most individuals with ACs do well.

Background. The incidence of infantile Blount disease is rising in parallel to the increasing obesity in children. Material and methods. Seven children (3 female) between the ages of 17 and 30 months (21.8 ± 4.3 months) were included in the study. Results. All patients had complaints of inward bowing of the legs and excess weight gain. The biochemical and hormonal assessments of all patients yielded normal results. Patients were diagnosed with infantile Blount disease based on clinical, laboratory, and radiological findings. Conclusion. This disease should be differentiated from physiological genu varum, and the potential psychosocial and physical complications are prevented with early diagnosis and treatment.

Infantil hemanjioendotelyoma 3 yasin altindaki cocuklarda karacigerde gorulebilen nadir bir tumordur. Genellikle insidental saptanmakla birlikte karaciger buyumesiyle de ortaya cikabilirler. Burada hepatosplenomegalisi olan ve takibinde solunum-dolasim yetmezligi gelisen yenidogan bir hasta karacigerinde infantil hemanjioendotelyoma olgusu literatur esliginde sunulmaktadir. Anahtar kelimeler: Infant, karaciger, fatal, infantil hemanjiyoendotelyoma

Objective: To evaluate the hemodynamic changes in mild–moderate preeclampsia using ophthalmic artery Doppler ultrasonography technique. Methods: Ophthalmic artery pulsatility and resistivity indices were calculated in 30 mild–moderate preeclamptic women and 30 normotensive gravid women of matched gestational age. Student's t-test was performed to test the significance of difference. Results: Both indices of peripheral resistance were found to be significantly lower in the ophthalmic arteries of mild–moderately preeclamptic women than those measured in normotensive gravid women at similar stage of pregnancy. In a small number patients whose disease progressed to severe preeclampsia, both indices increased. Conclusion: In patients with mild–moderate preeclampsia, ophthalmic artery color Doppler ultrasonography detects hemodynamic changes that are not present in normotensive gravid women. Reversal of Doppler patterns in a small number of patients with progressive disease supports the hypotheses suggesting the presence of early vasodilation and late vasospasm in the etiology of preeclampsia.

Complete androgen insensitivity syndrome (CAIS) associated with Müllerian remnant is rare during childhood. The Müllerian system usually regresses because of the presence of the anti-Müllerian hormone (AMH) originating from the Sertoli cells of the gonads. Rarely, residual Müllerian structures may exist. We present two cases from the same family, raised as females. They were 12 and 18 years old, respectively, and they had Tanner V breast development but Tanner I-II pubic hair. The older patient had primary amenorrhea. Both have a 46,XY genotype. Pelvic ultrasonography revealed no uterus and ovaries. The patients underwent bilateral laporoscopic gonadectomy. Both had residual Müllerian structures. Mutation analyses were performed, and both patients were found to be carrying a point mutation in exon 4 of the AR gene consisting of a G nucleotide deletion at position c.1890delG, followed by a frame-shift mutation and a stop codon. This mutation has not been described yet in the literature. Although the association with CAIS and Müllerian remnant is rare, no genetic defect specific to androgen insensitivity with Müllerian remnants has been identified so far.