Multiple regenerative nodular hyperplasia in the left infrarenal vena cava accompanied by abernethy malformation

The current study presents the case of a 19-year-old male patient who was detected with an increased alanine aminotransferase and aspartate transaminase levels during a preoperative evaluation of the right inguinal hernia operation and was later found to have Abernethy malformation accompanied by multiple regenerative nodular hyperplasia and left intra renal inferior vena cava. Regenerative nodular hyperplasia accompanying these two abnormalities is extremely rare and to the best of our knowledge, such a case has not been reported to date. Abdominal ultrasound (US) and color Doppler US, dynamic abdominal magnetic resonance imaging (MRI), and portography examinations were performed and a type 2 abernethy malformation, partial malrotation of the inferior vena cava, and regenerative nodular hyperplasia were detected. We aimed to discuss the radiological signs of these two accompanying abnormalities with a literature review.     

Gossypiboma mimicking posterior urethral stricture

INTRODUCTIONForeign bodies in the urogenital tract are not uncommon. Hairpins, glass rods, umbilical tapes, ball point pen are described in lower urogenital tract. Retained gauze piece (gossypiboma) in posterior urethra may cause diagnostic dilemma. Symptoms and investigations may mimic stricture of posterior urethra.PRESENTATION OF CASETwo cases of retained gauze pieces in the urethra are described here. The micturating cystourethrogram was suggestive of posterior urethral stricture.DISCUSSIONTwo cases described here had retained gauze piece as a cause of filling defect and abnormal appearance in the micturating cystourethrogram. Gossypiboma may be a possibility where posterior urethral stricture are seen after previous surgery in paediatric age group.CONCLUSIONIn the setting of previous urogenital surgery gossypiboma should be kept in the differential diagnosis where posterior urethral stricture are seen in the paediatric age group.     

Computer-extracted MR imaging features are associated with survival in glioblastoma patients

Automatic survival prognosis in glioblastoma (GBM) could result in improved treatment planning for the patient. The purpose of this research is to investigate the association of survival in GBM patients with tumor features in pre-operative magnetic resonance (MR) images assessed using a fully automatic computer algorithm. MR imaging data for 68 patients from two US institutions were used in this study. The images were obtained from the Cancer Imaging Archive. A fully automatic computer vision algorithm was applied to segment the images and extract eight imaging features from the MRI studies. The features included tumor side, proportion of enhancing tumor, proportion of necrosis, T1/FLAIR ratio, major axis length, minor axis length, tumor volume, and thickness of enhancing margin. We constructed a multivariate Cox proportional hazards regression model and used a likelihood ratio test to establish whether the imaging features are prognostic of survival. We also evaluated the individual prognostic value of each feature through multivariate analysis using the multivariate Cox model and univariate analysis using univariate Cox models for each feature. We found that the automatically extracted imaging features were predictive of survival (p = 0.031). Multivariate analysis of individual features showed that two individual features were predictive of survival: proportion of enhancing tumor (p = 0.013), and major axis length (p = 0.026). Univariate analysis indicated the same two features as significant (p = 0.021, and p = 0.017 respectively). We conclude that computer-extracted MR imaging features can be used for survival prognosis in GBM patients.     

A randomised comparison of two intranasal dexmedetomidine doses for premedication in children

We compared sedation levels in children following administration of intranasal dexmedetomidine. One hundred and sixteen children aged between 1 and 8 years were enrolled in this prospective, randomised trial. Children were assigned to receive either intranasal dexmedetomidine 1 μg.kg^?1 (Group 1) or 2 μg.kg^?1 (Group 2). Thirty‐one (53%) patients from Group 1 and 38 (66%) patients from Group 2 were satisfactorily sedated at the time of anaesthetic induction. Logistic regression showed a significant interaction effect (p = 0.049), with the odds ratio between Group 2 over Group 1 estimated as 1.1 (95% CI 0.5–2.7) for the 1–4 year age group, and 10.5 (95% CI 1.4–80.2) for the 5–8 year age group. Both doses produced a similar level of satisfactory sedation in children aged 1–4 years, whereas 2 μg.kg^?1 resulted in a higher proportion of satisfactory sedation in children aged 5–8 years. There were no adverse haemodynamic effects. We conclude that intranasal dexmedetomidine in a premedication dose of 2 μg.kg^?1 resulted in excellent sedation in children.