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En Abstract Hypothesis Approximately 25% of patients with congenital sensorineural or mixed hearing loss show bony inner ear malformations on computed tomography (CT) of the temporal bone, with significantly smaller cochlear height (CH) compared with normal-hearing patients. The miniature cochlea has an apparently normal radiological appearance and could be missed if proper measurements are not taken. Inner ear measurements not only aid in the duplication of radiologically diagnosed inner ear malformation but can also provide additional information about which specific part is abnormal. Aims The aims of the present study were to establish the normal measurements of the height and width of fully developed Egyptian cochleae using high-resolution CT scans of the temporal bone in normal individuals, and to predict the characteristic radiologic sings and measurements of miniature cochlea and its implication during cochlear implant surgery. Study design The authors conducted a prospective, comparative study. Patients and methods The study comprised three groups: the control group, which comprised 50 cochleae with normal hearing and negative history for head trauma or ear surgery; the patients group, which comprised candidates for cochlear implanting with a negative history for meningitis or head trauma, and was further subclassified into group A, which comprised 22 cochleae with CH small but not less than 2 SD from the controls, and group B, which comprised nine cochleae with CH less than 2 SD from the controls. High-resolution 64-slice CT scan of 1 mm slice thickness was obtained; in addition, CH, basal turn height and width, upper turn height and width, and oval window–round window distance were estimated according to well-established definitions in the literature. Results CH in the control group ranged between 4.8 and 6.9 mm, with a mean of 6.1 ± 0.29 mm, whereas, in group A, CH showed a mean of 5.9 ± 0.34 mm, which was statistically significant compared with the control group. In group B, CH showed a mean of 3.8 ± 0.31 mm, which was also statistically significant compared with the other two groups. The basal turn width, upper turn width, and oval window to the round window distance–all showed statistically significant difference when compared within the three groups. In contrast, both basal turn height and upper turn height showed no significant difference when compared within the three groups. Conclusion In cochlear implant surgery, the detailed and good radiological analysis aids in a safe, effective, and well-planned surgery. The development of standardized measurements to complement visual inspection improved the diagnostic accuracy and helped in the subclassification of hypoplastic cochleae. We found CH to be the most essential differentiating measurement in the subclassification and diagnosis of hypoplastic and dwarf cochleae. If dwarf cochlea is radiologically diagnosed, special surgical modifications regarding electrode length and site of cochleostomy during cochlear implanting should be applied.

The study develops the 'Ostrakinda' toolkit for teaching morphologies of ancient Mediterranean cities. The methodology consists of a triple structure involving design, play, and analysis phases. In the design phase, the level of interest and actual demands of students regarding game-based learning (GBL) and ancient cities were explored through pre-experiments. The play phase involved experimental studies conducted in courses and workshops, where both physical and digital toolkits were tested by a total of 331 students. The analysis phase aimed to evaluate the impact of the game by systematically addressing five research questions. The results of the paired t-test confirm a significant difference in scores before and after playing the game, thus validating the effectiveness of the proposed strategy. Additionally, Chi-square (X2) tests revealed significant relationships between the form of play and the level of abstraction in the game outputs. Individual and group experiences during gameplay were associated with various interactions, and group experiences particularly fostered competitive and collaborative learning. The extensive analysis using the GBL Design Scale, comprising ten critical factors (GBL-Fn), showed that the challenge factor (F8) had the weakest values, while fantasy (F5) and narrative (F6) had the highest values in the correlation matrix. Overall, the study contributes methodologically and contextually to the existing literature, offering valuable findings for the future development of similar strategies in architectural education. However, it is important to acknowledge the limitations of this interdisciplinary study, particularly with regards to technical, cognitive, and archaeological aspects. Nevertheless, the clear and effective structure of the game holds promise as a valuable tool for learning.

Virtual reality, since being a new form of architectural representation; when compared to traditional forms of representations, is a medium of representation which the narrative techniques are still in the process of developing. In traditional forms of representation, the viewer is actively directed in both the navigation and view, while in the architectural representations in the virtual reality medium, the viewer who now becomes the user, is left to her/his own personal decisions. Hence, the examples produced in the field of virtual reality are less successful in conveying spatial narratives than in traditional types of representation. In this study, a method has been proposed to develop the representation possibilities of the virtual reality environment by using the denotative and connotative meaning creation techniques of cinema. In the proposed method, meaning creation techniques of the cinema were used together with the interaction element of virtual reality, which is its most unique facility. By using the lighting technique between the denotative and connotative meaning creation methods of the cinema dynamically in the virtual reality medium according to the user interaction, introducing a spatial narrative to the user is directed. The discovery of the narrative possibilities of the virtual reality environment will enable it to be used more effectively as an architectural representation and moreover it will ensure this medium to be accepted as a new genre of art production.

Background and purpose: Pharyngeal squamous cell carcinoma is a unique disease, and early initial diagnosis and follow-up after treatment are areas in which DWI may be very helpful. The purpose of our study was to evaluate the role of diffusion weighted MRI in initial diagnosis and post treatment follow-up of pharyngeal carcinoma. Material and methods: 25 patients with 58 lesions were included in this study, and patients were classified into two groups according to their clinical situation: pretreatment group coming for initial diagnosis or pretreatment staging and post treatment group coming for follow–up. All patients were submitted to MRI including DWI with measurement of ADC value and correlation with histopathological data. Results: In pretreatment group which includes 10 patients with 30 lesions DWI shows sensitivity of 89% compared to 71% and 82% for conventional and contrast enhanced (CE) MRI respectively. In post treatment group DWI shows PPV of 95% as compared to 81% and 87% for conventional and CE MRI respectively. Conclusion: Diffusion weighted imaging shows high sensitivity in terms of detection, staging and follow-up of pharyngeal carcinoma.

Background and purpose: Postoperative imaging of cochlear implant needs to provide detailed information on the position of individual electrodes; the aim of this study was to evaluate visualization of individual electrodes and measurement of the electrode–modiolus distance (EMD) using dual energy CT (DECT) – with low radiation dose using virtual monochromatic spectral (VMS) imaging comparing the images quality and radiation dose with those by using multidetector CT (MDCT). Materials and methods: 25 pediatric patients who underwent cochlear implantation were imaged using DECT (15 patients) and MDCT (10 patients), and the image quality and radiation dose of DECT were compared to those of MDCT. Measurement of EMD was done for 5 electrodes and the results were correlated with neural response telemetry (NRT) and behavioural mapping levels. Results: A statistically significant difference between the radiation dose of DECT and MDCT was confirmed (p = 0.002) without a statistically significant difference in images quality (weighted K = −0.129 and PABAK = 0.533). Statistically significant correlations were found between EMD and NRT threshold, T (threshold) and C (maximum comfortable) levels with p =

Introduction: Cone beam CT (CBCT) is a valuable tool for evaluation and quality control of the cochlear implant electrode position postoperatively. It provides a chance to demonstrate the delicate cochlear structures with high resolution quality, with a rapid scan time and lower radiation dose to be used in the pediatric population. Objectives: We set up a prospective study to evaluate the value of CBCT in evaluation of insertion of cohlear implant electrode and any intracochlear trauma Patients and methods: Children who underwent cochlear implantation for bilateral profound sensorineural hearing loss in Ain Shams University hospitals in the period from January 2017 till June 2017 were included. Different types of electrodes were used from all known manufacturers. Patients underwent CBCT 3-6 months following implantation. Basic films in the axial plane were taken then reconstruction was done in different planes, and the following parameters were measured: major cochlear diameter, the electrode-modiolar distance (EMD) and the angular depth of insertion of the array. Evaluation of position of electrode, whether in scala tympani or scala vestibuli, was done, noting the complete or incomplete insertion. Cochlear trauma was recorded and graded, on a scale from 0-4, according to Eshraghi et al, 2003. Results: In a total of 36 cases, the mean major cochlear diameter was 8.9 x 6.4mm; the EMD for the first electrode was 4.8mm.The mean depth of insertion was 368°. There were 4 cases with grade 1 trauma, 2 cases with grade 3 trauma and 2 cases with grade 4 trauma. Incomplete insertion was found in 6 cases. Conclusion: CBCT was very informative in evaluation of intracochlear trauma by visualization of the electrode position in relation to the osseous spiral lamina. It can also evaluate the incomplete insertion, kink of the electrode and exact location of the different electrodes inside the cochlea. [ABSTRACT FROM AUTHOR]

Introduction: Dynamic contrast enhanced magnetic resonance imaging "MRI" is not 100 percent accurate in distinguishing benign from malignant lesions, resulting in a large number of breast biopsy procedures recommended on the basis of imaging findings. Proton magnetic resonance spectroscopy "¹H MRS" can provide chemical information about a lesion by measuring the levels of choline compounds, which are markers of an active tumor. In most cases, the results indicate whether the lesion is cancerous without need for biopsy. In addition to being used in breast cancer diagnosis, in vivo ¹H MRS has also been used to monitor breast cancer response to chemotherapy as well as in differentiating between scar tissue and recurrent cancer after breast-conserving therapy. Aim of the work: To evaluate the diagnostic performance of magnetic resonance spectroscopy "MRS" in characterization of breast masses with histopathologic findings or follow up used as the reference standard. Methods: The studied group included 50 female patients referred for MRI breast for workup of a suspicious clinical, mammographic, or sonographic abnormality. ¹H MRS was added to the routine study. Results of the contrast enhanced bilateral breast MRI and ¹H MRS of the 50 patients were all reported and compared with the histo-pathological results of surgery or biopsy and with the results of follow up of lesions that were not surgically removed or biopsied. Results: there was a highly significant relation between ¹H MRS and histopathological. Follow Up results with p value = 0.005. The sensitivity, specificity, positive and negative predictive values of ¹H MRS for characterization of suspicious breast lesions in patients included in the study, were 90%, 93.3%, 90%, and 93.3% respectively. Conclusion: ¹H MRS is a short non-invasive scan that can be inserted easily into standard clinical breast MRI protocols as a potential adjunct that can be added routinely to conventional breast MRI. Detection of choline peak with estimation of the choline signal to noise ratio "SNR" can accurately differentiate benign from malignant breast lesions with high sensitivity and specificity especially when its results are combined with the results of the standard dynamic MRI scan. [ABSTRACT FROM AUTHOR]

Subjective: Skeletal muscle indexes are known to be one of the important prognostic indicators in many clinical situations. This study aims to evaluate the effects of laboratory values and muscle mass measures such as skeletal muscle area (SMA), skeletal muscle index (SMI), skeletal muscle density (SMD) and skeletal muscle gauge (SMG) obtained from the 12th thoracic vertebra (T12) level of patients hospitalized for COVID-19 infection on prognosis., Methods: The patients' age, comorbidity index (CCI) scores, gender, anthropometric criteria such as height, weight, and BMI, laboratory values, development of NIMV and IC need during follow-up, length of hospital stay, and hospital mortality were retrospectively screened. The relationship between clinical and laboratory variables, SMA, SMI, SMD, and SMG values, and patient outcomes such as the need for non-invasive mechanical ventilation (NIMV), need for intensive care, and mortality was investigated using multivariate logistic regression analysis., Results: It was shown in multilinear regression analysis that T12SMD (β=-0.254; p=0.036), albumin (β=-0.465; p=0.005), and procalcitonin values (β=-0.292; p=0.026) were independent risk factors on mortality for intensive care in patients hospitalized due to COVID-19 infection. T12SMD has been shown to be significantly associated with various negative outcomes such as mortality, need for NIMV, and need for intensive care independently of body mass index (BMI) in our study (Tab. 5, Fig. 2, Ref. 25).

Background: Although there are a limited number of studies investigating the changes in olfactory bulb volume (OBV) and olfactory sulcus depth (OSD) values in the acute and subacute periods after COVID-19 infection, there are no studies conducted in the chronic period., Purpose: The aim of this study is to reveal the changes in OBV and OSD after COVID-19 in the chronic period., Material and Methods: A total of 83 people were included in our study, including 42 normal healthy individuals (control group) and 41 patients with COVID-19 infection (10-12 months after infection)., Results: The COVID-19 group included 41 patients with the mean age 40.27 ± 14.5 years and the control group included 42 individuals with the mean age 40.27 ± 14.4. The mean OBV was 67.97 ± 14.27 mm 3 in the COVID-19 group and 94.21 ± 7.56 mm 3 in the control group. The mean OSD was 7.98 ± 0.37 mm in the COVID-19 group and 8.82 ± 0.74 mm in the control group. Left, right, and mean OBVs and OSD were significantly lower in patients with COVID- 19 than the control individuals (all p  < .05)., Conclusion: Our findings show that COVID-19 infection causes a significant decrease in the OBV and OSD measurements in the chronic period.

Objective: To evaluate the rate of pneumococcal pneumonia (PP) among patients with community-acquired pneumonia (CAP) in Turkey and to investigate and compare features of PP and non-PP CAP patients., Material and Methods: This multicenter, non-interventional, prospective, observational study included adult CAP patients (age ≥ 18 years). Diagnosis of PP was based on the presence of at least 1 positive laboratory test result for Streptococcus pneumoniae (blood culture or sputum culture or urinary antigen test [UAT]) in patients with radiographic findings of pneumonia., Results: Four hundred sixty-five patients were diagnosed with CAP, of whom 59 (12.7%) had PP. The most common comorbidity was chronic obstructive pulmonary disease (30.1%). The mean age, smoking history, presence of chronic neurological disease, and CURB-65 score were significantly higher in PP patients, when compared to non-PP patients. In PP patients, 84.8% were diagnosed based ony on the UAT. The overall rate of PP patients among CAP was calculated as 22.8% considering the UAT sensitivity ratio of 63% (95% confidence interval: 45-81). The rate of intensive care treatment was higher in PP patients (P = .007). While no PP patients were vaccinated for pneumococcus, 3.8% of the non-PP patients were vaccinated (P = .235). Antibiotic use in the preceding 48 hours was higher in the non-PP group than in the PP group (31.8% vs. 11.1%, P = .002). The CURB-65 score and the rate of patients requiring inpatient treatment according to this score were higher in the PP group., Conclusion: The facts that PP patients were older and required intensive care treatment more frequently as compared to non-PP patients underline the burden of PP.

The recently emerged and novel coronavirus, severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2), that caused the current global pandemic was detected for the first time in Turkey in March 2020. While it continues to spread rapidly worldwide, there are still many uncertainties in the prevention and treatment of new coronavirus disease. We report a case of coronavirus disease 2019 (COVID-19) pneumonia in a patient under hydroxychloroquine (HCQ) treatment for rheumatoid arthritis. A 38-year female patient developed severe respiratory distress with SARS-CoV-2 infection and was treated in Intensive Care Unit (ICU). With this report, we aim to discuss the place of HCQ in prophylaxis in the light of the literature with a case presentation of COVID-19 pneumonia under HCQ treatment. Key Words: Coronavirus, Hydroxychloroquine, Prophylaxis, Rheumatoid arthritis, COVI-19.

Idiopathic FOP is a rare type of COP. What we know on this subject is made up of a few clinical cases published in recent years. Our patient was admitted to the hospital with an intermittent coughing complaint that worsens over time. Due to a suspicion of malignancy, a radiological evaluation was requested including a PET-CT and a transbronchial biopsy was performed. Until the last part of our algorithm, the patient profile was clinically and radiologically in favor of the diagnosis of malignancy but, in the end, the diagnosis of FOP was fixed with a follow-up decision. In conclusion, FOP is a relatively new entity that should be kept in mind in the differential diagnosis of malignancy., Competing Interests: The authors declare no competing interests., (Copyright: Emrah Dogan et al.)

Objective: To compare the serum mean platelet volume (MPV) in patients with testicular torsion and healthy control subjects., Methods: This retrospective study compared clinical and demographic data from patients who underwent surgery for testicular torsion and healthy controls. Testicular torsion was diagnosed with a physical examination and Doppler ultrasonography. Age, leukocyte count, platelet count and MPV were recorded for all participants., Results: A total of 50 patients with testicular torsion and 51 healthy control subjects were enrolled. There was no significant difference in age and platelet count between the two groups. Patients with testicular torsion had a significantly higher leukocyte count and MPV, compared with controls. According to receiver operating characteristic curve analysis performed for the prediction of testicular torsion, the best cut-off point for MPV was 7.7 fl (sensitivity 62%, specificity 96%), and the best cut-off point for leukocyte count was 9.5 × 10(9)/l (sensitivity 58%, specificity 80%)., Conclusions: The MPV may be useful as an ancillary test for the diagnosis of testicular torsion. Further studies are needed in order to confirm these preliminary results., (© The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)

Objective: Erythrocyte sedimentation rate (ESR) may serve as a reasonably good indicator for coronary heart disease as usually ESR is elevated in these patients. The measurement of ESR is a very simple and cheap laboratory test that can be performed in routine blood examinations. In this study, we investigated the association between preoperative erythrocyte sedimentation rate and postoperative midterm adverse events after coronary artery bypass grafting (CABG)., Methods: In the study, only male patients were included. The patients were divided into two groups: group 1 (preoperative sedimentation rate [&lt;20 mm/h] normal [n = 232, 63.9%]) and group 2 (preoperative sedimentation rate [&gt;20 mm/h] above normal [n = 131, 36.1%]). The hemogram and biochemistry panel values were measured one day before operation, on the postoperative first day, on the postoperative seventh day, and on the postoperative third month., Results: Among the laboratory values, there was a statistically significant difference between the two groups with respect to postoperative first-day ESR and postoperative third-month high-sensitivity C-reactive protein (P &lt; .05). In terms of postoperative morbidity, there was also a statistically significant difference (P &lt; .05) between the two groups with regard to pleural effusion, infection of the soft tissue over the sternum, pulmonary infection, return to the intensive care unit, rehospitalization, and mortality., Conclusions: Elevated preoperative sedimentation rate is associated with postoperative adverse events in patients who undergo CABG. For this purpose, we suggest that patients with higher sedimentation rates undergo detailed examination to prevent mortality and morbidity.

Background: Like other acute and chronic infections, Brucella infection leads to endothelial dysfunction. Furthermore, it has been suggested that the chronic inflammatory state present in chronic infectious diseases leads to an acceleration in atherosclerosis. For the prediction of CAD, it is possible to use epicardial fat thickness (EFT) as an adjunctive marker beside the classical risk factors, as it is easily and non-invasively evaluated by transthoracic echocardiography. The purpose of this study was to investigate the presence of impaired myocardial performance as well as of increased arterial stiffness and EFT in patients who had been infected with brucellosis in the past., Methods: Included in the study were twenty-seven brucellosis patients and twenty-six healthy volunteers. Using EFT and transthoracic echocardiography, which included Doppler echocardiography in combination with tissue Doppler imaging (TDI), all the patients were examined to measure their aortic stiffness index (AoSI), aortic distensibility (AoD), and aortic elastic modulus (AoEM) values., Results: A statistically significant increase was observed in hs-CRP, aortic stiffness index, aortic elastic modulus and EFT in brucellosis patients when compared with the controls (2.46 +/- 1.40 vs. 1.71 ? 0.61, P=0.016; 9.69 +/- 6.99 vs. 2.14 +/- 0.72, P < 0.001; 11.17 +/- 8.60 vs 2.18 +/- 0.90, P < 0.001; 0.76 +/- 0.08 vs. 0.63 +/- 0.10, P < 0.001). On the other hand, there was a significant decrease in aortic strain and aortic distensibility (7.41 ? 6.82 vs 18.26 +/- 5.83, P < 0.001; 1.83 +/- 1.71 vs. 5.22 +/- 1.72, P < 0.001, respectively). No difference was observed between the two groups with respect to the left ventricular myocardial performance index (MPI) (0.62 +/- 0.15 vs. 0.61 +/- 0.13, P=0.859)., Conclusions: In this study, we demonstrated for the first time in the literature thatthere was impaired aortic elasticity and increased EFT in patients with brucellosis, while the myocardial performance index remained unaffected. We also determined that these effects had a significant correlation with inflammation.

Plasmodium vivax malaria is usually seen in our country. Plasmodium falciparum malaria is also detected in the patients who have travelled abroad. A 33 year old male patient applied to our hospital for control. One month ago our patient had travelled to Angola where P. falciparum malaria is endemic. He had been diagnosed with malaria in Iran and successfully treated with quinine, doxycycline, and clindamycin. This time in our patient without any complaints, splenomegaly and splenic infarction were found. In our patient follow-ups it was observed that splenic infarction shrank. Therefore, in this article we present this rare complication.

Background: Brucellosis is an inflammatory disease which may infect any organs or systems in the body. Mean Platelet Volume (MPV) is one of the most frequently used surrogate markers of platelet function. It reveals the presence of disease activity in many inflammatory diseases. Red blood cell distribution width (RDW) is a parameter that measures variation in red blood cell size or red blood cell volume. Its predictive value approves inflammatory and infectious diseases., Objectives: The current study aimed to determine the assessment levels of red blood cell distribution in cases with acute brucellosis., Patients and Methods: The current study investigated whether MPV and RDW played any roles in acute brucellosis diagnosis. The study was conducted from 2008 to 2014 through prospective examination of the inflammatory markers found in adult patients with acute brucellosis., Results: The follow-up within the year after treatment was examined. The values of age, gender, leukocyte count, C-reactive protein, RDW and MPV were recorded. The study included 351 subjects, 250 of them in the acute brucellosis group and 101 in the control group. The mean MPV levels were 7.64 ± 1.30 fL, and 7.67 ± 1.29 fL in the acute brucellosis and control groups, respectively (P > 0.05). The mean CRP levels were 32.57 ± 53.20 mg/dL, and 4.81 ± 4.89 mg/dL in the acute brucellosis and control groups, respectively (P < 0.05). There was no statistically significant difference between the two groups regarding the RDW level and the mean leukocyte count (P > 0.05)., Conclusions: While the CRP value was in patients with acute brucellosis in the current study, the MPV, RDW and leukocyte counts were within the normal range. CRP value remains the most valuable inflammatory marker in cases of acute brucellosis.

Introduction: In this study, we examined the effects of Brucella infection on endothelial dysfunction. Flow-mediated dilatation (FMD) measurement is indicator of the endothelial function, and abnormal values indicating endothelial dysfunction are accepted as the first stage of atherosclerosis., Methodology: Twenty-four patients who had been treated for acute brucellosis two years before, and who had had no relapses in the follow-up, were prospectively included in the study, along with 30 healthy individuals in the control group., Results: While the highly sensitive C-reactive protein (hs-CRP) value was 2.42 ± 1.45 in the patient group, it was 1.72 ± 0.61 in the control group (p = 0.025). While the FMD value was 3.50 ± 1.58 in the patient group, it was 5.88 ± 1.88 in the control group (p < 0.001). While the percentage increase in FMD was 9.88 ± 4.92 in the patient group, it was 17.49 ± 6.3 in the control group (p < 0.001). It was observed that FMD value, the percentage increase in FMD, and basal radius were correlated with hs-CRP (r = -0.644, p < 0.001; r = - 0.558, p = 0.002; r = 0.444, p = 0.018, respectively). The carotid artery intima media thickness (IMT) value was found to be 0.61 ± 0.17 in the patient group and 0.49 ± 0.12 in the control group (p = 0.004)., Conclusions: The abnormal FMD and IMT values observed in brucellosis patients might be an indicator of more frequent arterial dysfunction, increased cardiovascular risk, and atherosclerosis.

Although there is no other underlying disease, women can sometimes experience rare and serious diseases such as ovarian vein thrombosis (OVT) and renal vein thrombosis (RVT) after giving birth. The widespread development of thrombosis is treated for the first time in this study. Stasis, coagulation factor abnormalities, and intimal damage to the venous thrombosis risk can increase during pregnancy. It was mentioned that it diagnoses an abnormality in the hypercoagulability half of women with OVT. Despite the hypercoagulant abnormality observed in pregnant women, it was very unusual that the renal vein thrombosis led to this complication. It can lead to severe complication of OVT which can even cause death. It was the first time that the renal vein and ovarian vein thrombosis were observed in the postpartum period, and there was no coagulation abnormality. It is known that the thrombus in the postpartum period can be observed with the fever of unknown origin. The problematic, but rarely observed, postpartum disease such as ovarian venous thrombosis (OVT) is generally observed in the right ovarian vein. In this disease, avoiding the resulting laparotomy heparin and intravenous antibiotics is best solution for the patient. If it is to be noted a fever for unknown reasons, that it be thrombosis.

The diagnosis of thyroid cartilage invasion in patients presenting with laryngeal carcinoma is essential for pre-therapeutic staging. Compared to CT, diffusion-weighted magnetic resonance imaging (MRI) has a similar ability to define the interface between fat and tumor, but is superior for assessing muscle and cartilage invasion. Diffusion-weighted MRI may be indicated if there are equivocal findings in the CT, including possible cartilage invasion. The aim of this study is to assess the validity of diffusion-weighted MRI in predicting inner and outer thyroid cartilage laminae invasion in patients with laryngeal carcinoma. A prospective study was carried out between August 2011 and May 2013. The study included 26 patients. Twenty-three patients underwent total laryngectomy and three patients underwent partial laryngectomy. Histopathology reports of resected specimens and pre-operative staging were blind to the consultant radiologist who reviewed the scans to comment on thyroid cartilage invasion with special emphasis on inner and outer lamina invasion by conventional MRI criteria, contrast enhancement and DWI. The sensitivity, specificity, efficiency (correct classification rate), and positive and negative predictive values of MRI for identification of inner thyroid lamina invasion were: 93, 82, 88, 88 and 90 % respectively, while those of outer thyroid lamina invasion were: 85, 85, 85, 85 and 85 %, respectively. Diffusion-weighted MRI showed high validity and precision in detecting inner and outer thyroid lamina invasion. This can have an important impact on the decision making for management of laryngeal carcinoma.

Background: Urinary tract infections (UTIs) are important causes of morbidity and mortality in patients with spinal cord injury and 22% of patients with acute spinal cord injury develop UTI during the first 50 days., Objectives: The aim of this study was to determine the prevalence, etiologic agents and risk factors for asymptomatic bacteriuria and symptomatic urinary tract infections in patients with spinal cord injury., Patients and Methods: This was a prospective investigation of spinal cord injury patients with asymptomatic bacteriuria and symptomatic urinary tract infections in Baskent University Medical Faculty Ayas Rehabilitation Center and Ankara Physical Therapy and Rehabilitation Center between January 2008 and December 2010. The demographic status, clinical and laboratory findings of 93 patients with spinal cord injury were analyzed in order to determine the risk factors for asymptomatic or symptomatic bacteriuria., Results: Sixty three (67.7%) of 93 patients had asymptomatic bacteriuria and 21 (22.6%) had symptomatic urinary tract infection. Assessment of the frequency of urinary bladder emptying methods revealed that 57 (61.3%) of 93 patients employed permanent catheters and 24 (25.8%) employed clean intermittent catheterization. One hundred and thirty-five (48.0%) of 281 strains isolated form asymptomatic bacteriuria attacks and 16 (66.6%) of 24 strains isolated from symptomatic urinary tract infection attacks, totaling 151 strains, had multidrug resistance (P > 0.05). One hundred (70.4%) of 142 Escherichia coli strains and 19 (34.5%) of 55 Klebsiella spp strains proliferated in patients with asymptomatic bacteriuria; 8 (80%) of 10 E. coli strains and 4 (80%) of 5 Klebsiella spp. strains were multidrug resistant., Conclusions: The most common infectious episode among spinal cord injury patients was found to be urinary tract ınfection. E. coli was the most common microorganism isolated from urine samples. Antibiotic use in the previous 2 weeks or 3 months, hospitalization during the last one-year and previous diagnosis of urinary tract ınfection were the risk factors identified for the development of infections with multi-drug resistant isolates. Urinary catheterization was found to be the only independent risk factor contributing to symptomatic urinary tract infection.

Background and Aim: Tigecycline is a semi-synthetic tetracycline with activity against most multidrug-resistant (MDR) bacteria., Methods: We studied in vitro activity of tigecycline by agar dilution (AD) and Etest methods to evaluate their correlation. The study included 206 isolates of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli, Klebsiella pneumoniae and MDR Acinetobacter baumannii recovered from blood cultures of patients of Baskent University between 2008 and 2010., Results: ESBL-producing E. coli had MIC50/MIC90 values of 0.5/0.5 µg/ml by AD and 0.25/0.5 µg/ml by Etest. ESBL-producing K. pneumoniae had MIC50/MIC90 values of 1/2 µg/ml by AD and 0.75/2 µg/ml by Etest, whereas MDR A. baumannii had MIC50/MIC90 values of 4/4 µg/ml by AD and 2/4 µg/ml by Etest. The correlation between AD and Etest was weak for ESBL-producing E. coli and strong for ESBL-producing K. pneumoniae and MDR A. baumannii. Tigecycline MIC values for ESBL-producing E. coli were lower than the tigecycline concentration, while they were higher than the concentrations attainable by treatment doses for A. baumannii., Conclusion: Tigecycline is an appropriate agent in the treatment of E. coli bacteremia, but it is not for treating A. baumannii bacteremia. Tigecycline could be used for K. pneumoniae bacteremia treatment after determining its MIC value. Determining the MIC value by gold-standard methods is more appropriate due to the correlation between Etest and AD at high MIC values.

Background: The level of platelet volume (MPV) has been reported to be a laboratory marker in inflammatory cases., Objectives: The aim of this study was to seek whether MPV has a role in the diagnosis of acute appendicitis. It was also aimed to show the relationship of MPV with leukocyte count and C-reactive protein (CRP) level., Materials and Methods: This study was conducted via retrospective assessment of the hospital records of the adult patients who were operated for acute appendicitis between January 2010 and December 2012 and had a pathology report that confirmed the diagnosis of acute appendicitis. The patients in the control group were selected from healthy adults of similar age who applied to check-up clinic. The number of essential cases was defined by performing power analysis. Age, gender, leukocyte count, CRP, and MPV values were recorded. This study is a case controlled retrospective clinical study., Results: A total of 503 patients in the acute appendicitis group and 121 patients in the control group were included, making up a total of 624 subjects. The median MPV levels were 7.92 ± 1.68 fL in the acute appendicitis group, while 7.43 ± 1.34 fL in the control group. CRP, leukocyte count, and MPV level were significantly higher in the acute appendicitis group (P < 0.001). MPV, leukocyte count, and CRP had a sensitivity and specificity of 66% and 51%; 91% and 74%; and 97% and 41%, respectively. No correlation was found between MPV, CRP, and leukocyte count., Conclusions: MPV level was higher in patients with acute appendicitis. MPV may guide the diagnostic process of acute appendicitis. However, we detected that the sensitivity and specificity of leukocyte count and CRP were superior to those of MPV in the diagnosis of acute appendicitis.

Purpose: The aim of this study was to seek whether red cell distribution width (RDW) has a role in the diagnosis of acute appendicitis. It was also aimed to show the relationship of RDW with leukocyte count and C-reactive protein (CRP) level., Methods: This study was conducted via retrospective assessment of the hospital records of the adult patients who were operated for acute appendicitis between January 2010 and February 2013 and had a pathology report that confirmed the diagnosis of acute appendicitis. The patients in the control group were selected from healthy adults of similar age who applied to check-up clinic. Age, gender, leukocyte count, CRP, and RDW values were recorded. This study is a case controlled retrospective clinical study., Results: A total of 590 patients in the acute appendicitis group and 121 patients in the control group were included, making up a total of 711 subjects. The mean RDW levels were 15.4 ± 1.5% in the acute appendicitis group, while 15.9 ± 1.4% in the control group. CRP, leukocyte count were significantly higher in the acute appendicitis group, and RDW level were significantly lower in the acute appendicitis group (p < 0.001, p < 0.001, p = 0.001, respectively). RDW, leukocyte count, and CRP had a sensitivity and specificity of 47% and 67%; 91% and 74%; and 97% and 41%, respectively in acute appendicitis. RDW was not correlated with CRP and leukocyte levels. However, we found a correlation between CRP and leukocyte levels., Conclusion: RDW level was lower in patients with acute appendicitis. The magnitude of difference in RDW seen between acute appendicitis and controls was so slight as to be of no utility in diagnostic testing.

The breast is as aesthetically important as it is physiologically. Physicians and women have practiced various methods for breast aesthetics and augmentation. We report a female veterinarian who injected fish oil into her breast, which led to inflammation and necrosis of breast tissue. When all medical therapies failed, bilateral subcutaneous mastectomy was performed. We did not find a case in the literature where fish oil had been used for breast augmentation. However, we did find that many agents have been injected for breast augmentation, the results of which were tragic, just as the case presented herein., (© 2013 Wiley Periodicals, Inc.)

Objective: The musculoskeletal system is one of the most commonly affected systems in brucellosis. The objective of this study was to determine the frequency, types, and clinical features of osteoarticular involvement among cases with brucellosis in the Central Anatolia region of Turkey and to establish the differences between patients with and without osteoarticular involvement., Methods: Included in this study were 202 patients with Brucellosis presented between June 2003 and June 2009. The diagnosis of osteoarticular system complications was established by physical examination and radiological findings obtained by diagnostic imaging tools. Magnetic resonance images of thoracic, lumbar or sacral vertebrae were acquired from patients with back pain, low back pain and sacro-iliac joint pain., Results: Osteoarticular involvement was noted in 94 patients (46.5%). The most common sources of infection are employment in farming and/or consumption of un-pasteurized milk or dairy products, especially fresh cheese in 53 (75.7%) cases. The mean age is 46.7±18 years. Sacroiliitis is the most frequent osteoarticular involvement (60.6%), 82.4% of which is bilateral. Sacroiliitis was followed by spondylodiscitis in 36 (38.3%), peripheral arthritis in 15 (16%), bursitis in 1(1.1%) case. Patients with osteoarticular involvement received medical treatment for at least three months., Conclusion: The ratio and anatomical region of osteoarticular involvement in brucellosis show variability among countries. In this study, it is demonstrated that sacroiliitis is the most common form of osteoarticular involvement in the Central Anatolia region of Turkey. In endemic countries such as Turkey, this disease should be included in the differential diagnosis for patients with symptoms of sacroiliitis, spondylodiscitis or those with articular pain.

We have cloned a gene that complements the cold-sensitive growth of cdc50-1 mutant strain of Saccharomyces cerevisiae at 14 degrees C. The CDC50 gene was found to be identical to YCR094w on chromosome III and contains 1173 nucleotides encoding 391 amino acids. We found a missense mutation at the first initiation codon of cdc50-1. The disruption of the CDC50 gene revealed that it is not essential for growth, but the disruptant caused the same cold-sensitive phenotype as cdc50-1, suggesting that the cdc50-1 is a null mutation resulted from the mutation in the first codon. The cdc50-1 mutant arrests at START in G1 phase at the non-permissive temperature. The CDC50 gene product has strong structural similarity to two other proteins in Saccharomyces cerevisiae encoded by YNR048w and YNL323w. The over-expression of either YNR048w or YNL323w suppressed the cdc50-1 mutant and the double disruption of either CDC50 and YNR048w or CDC50 and YNL323w resulted in a severe slow-growth phenotype. We conclude that these three genes constitute a family with redundant function. We also found that the CDC39 gene was a multicopy suppressor of cdc50-1 mutation, suggesting that the CDC50 family is involved in regulation of transcription via CDC39.