The aim of this study was to evaluate the relationship between the maxillary sinus volumes and the nasal septal deviation angles in patients with antrochoanal polyps (ACP). 76 patients who underwent ACP surgery were included in the study. Of those 36 patients who had multislice computed tomography (MSCT) were evaluated to calculate maxillary sinus volume. The records of paranasal MSCT of 36 healthy people without any paranasal sinus diseases or surgery constituted age- and gender-matched healthy controls. Maxillary sinüs volumes and septal deviation angles were calculated using the paranasal MSCT volume-rendering technique. Thirty-six patients in the ACP group were compared with 36 polyp side-matched healthy people. The mean age was 16.6 ± 6.7 years in both groups. Statistically, the mean value of the maxillary sinus volume was significantly higher in the ACP group compared with the ACP side-matched control group (15.1 ± 4.6 versus 12.0 ± 3.5 mm(3)) (p = 0.002). Furthermore, the mean value of the maxillary sinus volume in the non-polyp side (14.2 ± 4.7 mm(3)) was statistically higher in the ACP group compared with the side-matched control group volume (11.9 ± 3.8 mm(3)) (p = 0.024). In addition, Fifty-three of 76 ACP patients had septal deviation. While the septal deviation was on the same side with the ACP in 17 patients, it was on the opposite side in 36 patients. In conclusion, the maxillary sinus volumes increased in ACP patients compared with the healthy control group. Many patients had nasal septal deviation on the opposite side of the ACP.
Thyroid tuberculosis is a very rare entity and its diagnosis is based
IntroductionHomocystinuria is a hereditary disease caused by a defect in the enzymes involved in metabolizing methionine. Homocystinuria can influence many systems and may be mistaken for other diseases, including Moyamoya disease. Here, we report the case of a 10-year-old male patient with a diagnosis of Moyamoya disease who had been monitored for that for an extended period. The patient’s diagnosis was changed to homocystinuria as a result of lens subluxation and cataract findings.Case PresentationA 10-year-old male patient presented with vomiting, headache, lethargy, muscular weakness, and eye redness. The patient was mentally retarded, his right pupil was hyperemic, and he had muscle weakness on his left side. In addition, his blood pressure was high. The patient’s history included a diagnosis of Moyamoya. A neck and cranial computed tomography (CT) angiography showed no flow bilaterally past the bifurcation of the carotid artery. The patient’s bilateral internal carotid arteries were determined to be occluded. It was considered that his eye findings could be compatible with a metabolic disease. On metabolic screening, the patient’s homocysteine level was very high. In addition, a heterozygous A1298C mutation was identified in MTHFR. Therefore, the patient was started on a diet free from homocysteine and methionine. In addition, his treatment regimen included vitamins B12 and B6. With these treatments, the patient’s complications regressed.ConclusionsIn cases of unusual vascular lesions, metabolic diseases must be considered. In homocystinuria, early diagnosis and treatment are important. Blood homocysteine levels can be returned to normal, and some complications can be prevented.
Breast is one the least common location for tuberculosis (TB) infec
Systemic polyarteritis nodosa (PAN) is characterized by necrotizing inflammatory changes in medium and small-sized arteries (1). Because the range of symptoms is a wide and no specific serological test exists, diagnosis of PAN could be difficult. Gastrointestinal systems such as the liver, appendix, and gallbladder are rarely affected (2). A 9-year-old female patient was admitted with severe abdominal pain that started 15 days previously. She has a tenderness in the epigastric region. However, other systemic examinations were unremarkable. Laboratory values were as follows: hemoglobin, 11.2 g/dL; white blood cell count, 22,200/mL; platelet count, 663,000/ mL; erythrocyte sedimentation rate, 84 mm/h; and Creactive protein, 156 mg/dL (normal range, 0-5). Serum fibrinogen level was 468 mg/dL (normal range, 18-350 mg/dL) and ferritin level was 558.9 ng/mL (normal range, 7.0-276.8 ng/mL). Antinuclear antibody, antineutrophil cytoplasmic antibody, anticardiolipin antibody, lupus anticoagulant, and Hepatitis B surface antigen were negative. A gastroscopy showed normal findings. Abdominal ultrasonography revealed a large number of micro-aneurysmal dilatations in the liver. Magnetic resonance imaging (MRI) angiography showed multiple arterial microaneursyms and ruptured thromboses in the liver (Figure 1). These imaging findings were consistent with PAN. A diagnosis of PAN with hepatic involvement was established based on clinical and imaging findings. Combined therapy consisting of prednisone (2 mg/kg/ day), cyclosporin A (CPA) (1000 mg/m 2 /month, total six doses) and azathioprine (75 mg/day) was started. Her symptoms began to decline for the next 10 days, and at the control abdominal MRI angiography at the end of four months we observed that microaneursyms disappeared (Figure 2). The typical presentation of PAN in children is of isolated organ involvement with constitutional symptoms. But multiple organ systems could be involved in systemic PAN (3). Although involvement Turk
Kist hidatik, Echinococcus granulosusun neden olduğu paraziter bir hastalıktır. Çocukluk çağında akciğer en sık tutulan organdır. Öksürük, göğüs ağrısı, hemoptizi gibi nonspesifik semptomlarla ortaya çıkabilir. Tanıda radyolojik bulgular önemlidir. Bu yazıda, nonspesifik bulgular ile başvuran ve görüntüleme yöntemleri ile tanı konulan akciğer kist hidatikli 10 olgu literatürler eşliğinde tartışılmıştır. Yöntemler: Çocuk polikliniğine Mayıs 2011-31 Mayıs 2012 tarihleri arasında başvuran, kist hidatik tanısı alan 10 hastamız; yaş, cinsiyet, başvuru yakınmaları, kistlerin büyüklük ve lokalizasyonu, hayvanlarla temas öykülerine göre incelendi. Tanı, görüntüleme yöntemleri ve serolojik testlerle konuldu. Bulgular: Olgularımızın en küçüğü 4, en büyüğü 15 yaşındaydı. Hastalarımız başvuru yakınmaları öksürük, göğüs ağrısı, halsizlik, ateş yüksekliği, solunum sıkıntısı, kanlı ve sulu balgam çıkarma idi. Dört olguda sol akciğer, beş olguda sağ akciğerde kist saptandı. Bir olguda her iki akciğerde kistik lezyon saptandı. Hastalarımızın beşinde hem karaciğer hem de akciğerde kist hidatik saptandı. Kistlerin büyüklüğü ortalama 5-13 cm arasındaydı. Beş olgumuzda komplikasyon geliştiği görüldü. Hastalarımızın beşinde hayvanlarla temas öyküsü vardı. Kist hidatik indirekt hemaglütinasyon testi sekiz hastada pozitifti. Hastalarımız çocuk cerrahisi kliniği tarafından opere edildi. Sonuç: Türkiye kist hidatik hastalığı açısından endemik ülkeler arasındadır. Hastalığın önlenmesinde çocukların ve ailelerin konu ile ilgili olarak bilgilendirilmesi toplum sağlığı açısından önemlidir.
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