Evaluation of cerebral blood flow volume using color duplex sonography in patients with untreated panic disorder

The aim of this study was to compare cerebral blood flow (CBF) using color duplex sonography in panic disorder and normal controls. We report 24 untreated patients and 20 healthy subjects. State-Trait Anxiety Inventory, Beck Depression Inventory, Beck Anxiety Inventory, and Symptom Check List-90 were completed on each subject. The internal carotid artery (ICA) and vertebral artery (VA) of both sides were explored with a 7.5-Mhz linear array transducer. CBF volume and mean ICA flow velocity were significantly higher in patients than normal subjects adjusted for age. However, we could not find a statistically significant difference in flow volume and velocity of VA and the sum of bilateral ICA volume between patients and controls adjusted for age. There was also no correlation between CBF volume and the other radiological data with STAI scores. In conclusion, we found that independent of anxiety levels, CBF volume has increased in panic disorder patients. In addition, color duplex sonography is a non-invasive and easily applicable technique and it is a preferable alternative to quantify CBF volume.     

Interdialytic weight gain and pulmonary membrane diffusing capacity in patients on hemodialysis

Background: Measurement of pulmonary diffusion capacity for carbon monoxide (DLCO) may be useful for assessing disease affecting the alveolar-capillary bed or the pulmonary vasculature. It was reported that hemodialysis (HD) therapy causes DLCO reduction via decrease of pulmonary capillary blood volume components. The aim of the study was to evaluate the effect of interdialytic weight gain on pulmonary function and especially DLCO. We further determined whether intravascular volume status, assessed by inferior vena cava diameter (IVCD) contributes to DLCO in patients on HD. Methods: Routine pulmonary function testing including forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC, forced mid-expiratory flow rate (FEF_25–75), DLCO IVCD index and other echocardiographic parameters were evaluated in 20 patients (mean age 48.6 ± 18.3 years, mean dialysis duration 17.4 ± 19.2 months) on chronic HD, 1 hour after HD and after an interdialytic period (1 hour before HD therapy). Single-breath DLCO measurements were corrected for hemoglobin concentration (cDLCO). Results: Routine pulmonary function tests (spirometry) showed no significant changes in FEV1, FVC and FEF_25–75 whereas a statistically significant fall in FEV/FVC was found. At the end of the interdialytic period a statistically significant increase in weight, IVCD index, left ventriculer diastolic diameter (LVDD), and diastolic blood pressure (DBP) were observed (P < 0.05). Using the single-breath DLCO, we found unchanged cDLCO at the end of the interdialytic period. There was no correlation of cDLCO with increases in weight, DBP, IVCD index, LVDD (P > 0.05). Conclusion: The accumulation of body water between dialyses has no significant influence on DLCO.     

Thermal injuries due to paint thinner

This study was designed to evaluate the epidemiology and outcome of burn injuries due to paint thinner in a local burn center. During a 10-year period, 32 patients were admitted to our Burn Unit for paint thinner thermal burn. Patients were reviewed regarding the age, sex, etiologic factors, extent and localization of burn, treatment methods, length of hospitalization, and results. There were 30 males and 2 females. The mean age of patients was 25.9 +/- 11 years. The most common etiologic factor was kindling a fire with paint thinner. The mean extent of burn was 33.6 +/- 24% of the total body surface area. All patients sustained burn injury on the face, arms, and hands and five patients among them had extended burn areas on the trunk and/or lower extremity. The mean length of hospitalization for the survivors was 34.5 +/- 21.6 days. Twenty-eight patients were treated by early excision and split-thickness skin grafting. In four patients, burn wounds were healed by conservative management. Five patients with burn size of over 75% of the total body surface area died. In conclusion, paint thinner may be the cause of a catastrophic thermal injury and should not be used for the purpose of kindling fire.     

The importance of genomic copy number changes in the prognosis of glioblastoma multiforme

Glial tumors are the most common tumors of the nervous system, affecting individuals at any age. Since understanding of the molecular pathologies underlying human gliomas is still very poor, the treatment and therefore prognosis of this malignancy could not yet be improved. In order to determine whether different glioblastoma-associated genomic aberrations may serve as prognostic markers in combination with histopathological findings, 20 primary glioblastoma multiforme tumors were screened by comparative genomic hybridization, and the results were compared with histopathological and clinical features. All tumors showed genomic copy aberrations detected by comparative genomic hybridization. Regional and numerical increases in chromosome 7 copy number were the most frequently seen abnormality (10/20 tumors), followed by loss of chromosome 10 (8/20). Both of these aberrations were associated with shorter surveillance time. Chromosome 12q amplification was detected in seven tumors. Loss of 17p, 1p, and 19q in combination was seen in three cases. One of them was a giant cell GBM, whereas the remaining two cases were still alive. Combination of chromosome 1p and 19q deletions was also seen in a case with long surveillance. According to the preliminary findings of this study, in addition to the EGFR gene, amplification of other genes on chromosome 7 and the deletion of PTEN gene and other cancer-related genes on chromosome 10 appeared important to the development of glioblastoma multiforme and were associated with poor prognosis, whereas the combination of chromosome 1p and 19q deletions seems to be an informative molecular marker for better prognosis. The clinical features and genetic alterations of primary and secondary glioblastoma multiforme should be compared in large series to clarify the effective prognostic markers; and further molecular analyses focused on chromosomes 7 and 10 will be very helpful for understanding the molecular mechanisms underlying the progression of glioblastoma.     

A childhood case of intrascrotal neurofibroma with a brief review of the literature

Solitary neurofibroma unassociated with neurofibromatosis type I (NFI) arising within the scrotum is an extremely rare benign tumor. There are 8 cases reported in the literature with only 1 that occurred in childhood. In the current report the authors describe an additional adolescent patient, the second case encountered in childhood and the ninth case reported in the literature, together with a review of the related articles.     

Subacute sclerosing panencephalitis with fulminating course: follow-up magnetic resonance spectroscopy (MRS) findings

The fulminating form of subacute sclerosing panencephalitis is an extremely rare condition. Imaging findings are usually not correlated with clinical staging. We describe a 4-year-old girl with severe neuronal loss, demyelination, and gliosis in subcortical white matter by magnetic resonance spectroscopic examination even though she was diagnosed as clinical stage II. In 2 months' time, her clinical status worsened significantly. Follow-up magnetic resonance spectroscopy revealed findings that were consistent with clinical status. It is our opinion that magnetic resonance spectroscopy could demonstrate a rapidly progressive fulminating course of subacute sclerosing panencephalitis even in the early clinical stages.     

Effect of paclitaxel administration on P wave duration and dispersion

Abstract. The prototypic taxane paclitaxel, which disrupts tubulin dynamics, has been widely used in the treatment of solid malignancies. However, it has been associated with adverse cardiac effects. Therefore, the effect of the paclitaxel infusion on P wave duration and dispersion (PWD) was investigated. Twelve-lead surface ECGs were recorded twice from 12 patients with breast, ovarian and non-small-cell lung carcinoma: one just before paclitaxel infusion and the other 1 hour after the end of the infusion. The changes in maximum (Pmax) and minimum P wave duration (Pmin) were measured manually and the difference between the two values was defined as PWD. The mean heart rate, Pmin, did not change after the infusion. However, Pmax, PWD and the average P wave duration significantly increased after infusion (122 ± 5 vs. 125 ± 5 p = 0.001 and 46 ± 7 vs. 53 ± 9 p = 0.03, 97 ± 5 vs. 101 ± 5ms p = 0.02 respectively). We found that paclitaxel infusion increased PWD and this may be a result of the drugs effect on cardiac autonomic modulation.     

Intraorbital encephalocele: an important complication of orbital roof fractures in pediatric patients

Orbital roof fractures are uncommon, and traumatic intraorbital encephalocele formation is a very rare complication of this type of injury. We treated 43 pediatric patients with orbital roof fractures at our center over a 4-year period. The aim of this study was to retrospectively investigate conditions that may lead to intraorbital encephalocele formation in children with orbital roof fractures. Each case was reviewed, and the cause of injury, associated clinical and computerized tomography findings, the Glasgow Coma Scale score on admission, neurological status, other bodily injuries, hospitalization time and type and width of the orbital roof fracture were recorded. The findings in 6 patients who developed encephaloceles were compared to corresponding findings in the 37 patients who did not develop this complication. A total of 44 orbital roof fractures were diagnosed by axial and coronal computed tomography scanning. Six of the 43 children developed intraorbital encephaloceles in the first month after head trauma. In each of these cases, magnetic resonance imaging demonstrated the intraorbital cystic lesion in communication with the subarachnoid space. The width of each orbital roof fracture was measured on axial and coronal computed tomography slices and was confirmed by measurements during surgery. The width of the fractures in the encephalocele cases ranged from 2-4 mm. Duraplasty and orbitoplasty were performed in all the patients with encephalocele. Pediatric patients with orbital roof fractures that exhibit more than 2 mm diastasis and are associated with frontal cerebral contusion may be at greater risk for developing intraorbital encephalocele. All such cases should be monitored closely and investigated further with magnetic resonance imaging.     

Cervical hematomyelia: a rare entity in a neonate with cesarean section and surgical recovery

Spinal cord injury with or without trauma has been reported in the perinatal period. The prognosis depends primarily on diagnosis of the level, extent and nature of the lesion, established by correlations between clinical, imaging and electrophysiological data. A 25-day-old boy with normal birth weight delivered at term by cesarean section was transferred to In?nü University Turgut Ozal Medical Center because of respiratory distress and brachial diplegia. A suspicious medullary lesion on cervical computerized tomography was confirmed as an intramedullary lesion extending from C3 to D1 on magnetic resonance imaging (MRI). Emergent surgery consisting of exposure of the lesion site and interlaminar direct puncture of the lesion under fluoroscopy revealed that the pathology was an intramedullary hematoma. The partial evacuation of the lesion with direct puncture, the patient's neurological improvement and close follow-up of the patient with ultrasonography, electrophysiology and MRI are discussed in the light of recent literature.