ISSN 1301 - 0883 / E-ISSN 1309 - 3886


Eastern J Med: 19 (4)
Volume: 19  Issue: 4 - 2014
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1.Computed tomography: Are we aware of radiation risks in computed tomography?
Aydın Bora, Güneş Açıkgöz, Alpaslan Yavuz, Mehmet Deniz Bulut
Pages 164 - 168
People are constantly exposed to varying radiation and almost all of this exposure is due to diagnostic procedures. Although radiation has been proven to have adverse biological effects on living organisms, radiological examinations have an indispensable role in the diagnosis. Particularly, Computed Tomography (CT) is valuable imaging tool and plays an important role in the evaluation of many diseases. Radiation doses from CT scans ought to be kept to the ALARA (as low as reasonably achievable) and it shouldn’t be forget that procedures are important in patient safety during imaging in the diagnostic radiology departments. The purpose of this review article is to support that no radiation doses can be considered completely safe and all efforts must be made to reduce both the radiation dose and damage.

2.Paraoxonase-1, malondialdehyde and glutathione reductase in Type 2 Diabetic patients with nephropathy
Waleed Samy Mohamed, Mohammed A. Hassanien, Khalid EL Sayed Abokhosheim
Pages 169 - 174
Numerous experimental and epidemiologic studies shown that oxygen-free-radicals are elevated in uncontrolled diabetes mellitus (DM). Paraoxonase-1 (PON1) has been reported to confer antioxidant activities by decreasing the accumulation of lipid peroxidation products. This study was designed to investigate the role of PON1 activity, glutathione reductase (GR), and lipid peroxidation in patients with diabetic nephropathy (DN). 70 subjects were included in the study: 30 as a control, 20 with type 2 DM (T2DM) with nephropathy (DN), 20 T2DM without nephropathy. All studied groups are subjected to the following laboratory investigations after their consents: fasting and postprandial blood glucose, Serum triglycerides (TG), total cholesterol (TC), high density lipoprotein (HDL) and low density lipoprotein (LDL), HbA1c, blood urea, serum creatinine, urine microalbumin, serum PON1 activity, serum malondialdehyde (MDA), and serum GR activity. Fasting and postprandial blood glucose levels, and HbA1c was significantly higher in the DN group than the diabetic or control group (p=0.0001). Serum creatinine show a significant rise in the DN group than diabetic or control group (p=0.0001). Microalbuminuria show a significant rise in the DN group than the control or diabetic group as well as in the diabetic group than control group (p=0.0001). Serum PON1 activity and GR level showed significant decrease in diabetic patients with or without nephropathy compared to the control group with a significant decrease in its activity in the DN group while there was a significant a rise of MDA in diabetic groups than control with a significant rise in DN. The decreased antioxidant enzyme activities in DN patients, suggesting that oxidative stress may contribute to the development of DN and other microvascular complications beside chronic hyperglycemia and dyslipidemia. Measurement of PNO1, MDA and GR levels may be a helpful marker in the diagnosis and follow up DN.

3.Index finger pollicization for treating a congenitally nonfunctioning thumb in patients with radial longitudinal deficiency
Mahmut Kömürcü, Serdar Yücel, Osman Yüksel Yavuz, İsmail Uraş, Murat Uygun, Mustafa Kürklü
Pages 175 - 181
Radial longitudinal deficiency (radial club hand) is a congenital deformity in the upper extremity that can present with a range of thumb deficiencies. A variety of surgical procedures to correct for absence of a thumb have been described, such as pollicization, osteoplastic reconstruction, toe to hand transfer, and extension with distraction. We have reviewed 8 index finger pollicizations in 6 patients after correction of the radial club hand deformity through wrist centralization. Four hands used were the dominant hand. Buck-Gramcko’s technique was used with a mean age of 4.6 (range from 2 to 14) years. The mean follow-up time was 6 (range from 2 to 10) years. The mean active range of motion at the pollicized digit was 121.4 (range from 83 to 150) degrees. The result was considered excellent in 5 cases (62.5%), good in 2 cases (25%), and fair in 1 case (12.5%) in accordance with Percival’s scoring system; none of the outcomes were poor. The younger patients adapted easier. Index finger pollicization is a method that provides dramatic improvement to hand function in thumb aplasia or severe hypoplasia, which may be preferred in treatment. The operations improved hand cosmetic appearance and functional ability.

4.Can cancer detection rate increase when transrectal biopsies were taken from the laterally?
Ayhan Karakose, Mehmet Bilgehan Yuksel, Necip Pirincci, Sacit Nuri Gorgel, Yusuf Ziya Atesci, Bilal Gumus
Pages 182 - 184
Acording to general opinion when biopsy is taken from the prostate’s lateral peripheral zone. More cancer is seen. In our study, the incidence of cancer in the lateral peripheral zone biopsies was investigated. In our study, 93 patients were analyzed retrospectively transrectal prostate biopsy. 12 core biopsies were taken from each patient. Medial peripheral zone (MPZ) and lateral peripheral zone (LPZ) biopsies compared the detection of prostate cancer. The average age of the patients was 67.2±10.3. Total PSA value in patients was found as 13.7 ng/mL. Prostate cancer was detected at the rate of 22.5% (21 patients) in 93 patients. 3 patients (14.3%) had prostate cancer in MPZ and 8 patients (38%) had prostate cancer in LPZ. Prostate cancer was detected at MPZ and LPZ at the rate of 47.7% (10 patients) in patients. Prostate cancer was more commonly detected in LPZ (p<0.05). Prostate biopsies of the LPZ biopsies more commonly cancer is seen. We believe it will increase the capture rate for prostate cancer if a sufficient number of biopsies were taken from the LPZ.

5.Anatomic, functional and cognitive asymmetries in monozygotic twins with discordant handedness
Ozlem Ergul Erkec, Yalçın Yetkin
Pages 185 - 190
Discordant handedness was observed at a higher rate than expected in monozygotic (MZ) twins. This study was designed to investigate the degree of asymmetry in terms of anatomical, functional (motor) and cognitive (IQ and visual memory) features on 27 MZ twins for discordant handedness according to Edinburgh Handedness Inventory (EHI). There was statistically significant difference between EHI and Yetkin Laterality Questionnaire (YLQ). Ambidextrous were found lack of cerebral dominance. Both left and right handed subjects were found left hemisphere dominance. There was no significant difference in terms of anatomic or cognitive features between MZ twin members with discordant handedness.

6.Retroperitoneal Castleman Disease with paravertebral localization mimicking nephrolithiasis: A rare case
Mehmet Kaba, Necip Pirinççi, Alpaslan Yavuz, Aydın Bora, Lokman Soyoral, Gülay Bulut
Pages 191 - 193
Castleman’s Disease (CD), is a rare condition of uncertain etiology, involves a massive proliferation of lymphoid tissues and typically presents as mediastinal masses. In general, CD is an incidentally diagnosed disease with an asymptomatic course in most cases. We aimed to present a 48-year old woman who presented with left flank pain and had calcifications at the localization of left kidney on abdomen x-ray. The retroperitoneal mass with paravertebral localization was evaluated, because the size of mass in our case was larger than traditional sizes seen in Castleman Disease and calcifications and localization of the mass on KUB x-ray can mimic renal stone disease.

7.Endoscopic drainage of superior subperiosteal orbital abscess
Min Han Kong, Che Hamzah Jemaima, Asnida Nasaruddin Rona, Singh Gendeh Balwant
Pages 194 - 197
Subperiosteal abscess (SPA) complicating sinusitis is commonly located lateral to the lamina papyracea. There are multiple routes of spread from ethmoidal sinus into subperiosteal space and direct spread through the thin lamina papyracea is one of the routes. Superiorly located SPA is traditionally drained by open approach. We report a 56-year-old man with right SPA located in the superior orbital roof with medial extension secondary to frontal sinusitis successfully drained endoscopically avoiding additional external skin incision and achieve a complete evacuation of abscess without evidence of recurrence on follow up at 1 year.

8.Concurrent demyelinizing central nervous system involvement in a case of Familial Mediterranean Fever with the M694V mutation
Adile Ozkan, Sule Kosar, Ahmet Uludag, Mete Haznedaroglu, Handan Isın Ozısık Karaman
Pages 198 - 201
Familial Mediterranean Fever (FMF) is a hereditary disease seen mainly around the Mediterranean. The most common mutations are M694V, M680I, V726A and E148. Neurological findings and magnetic resonance imaging (MRI) abnormalities resembling multiple sclerosis have been reported in a few cases. We present a case where an M694V mutation was found together with familial Mediterranean fever and multiple sclerosis-type demyelinizing disease as this combination is rarely seen.

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