Turk Pediatri Arsivi-turkish Archives of Pediatrics, Jun 1, 1994
Horseshoe kidney is the most common fusion anomaly of the kidney and can be associated with certa... more Horseshoe kidney is the most common fusion anomaly of the kidney and can be associated with certain syndromes While 2 3 of the cases may be asymptomatic throughout life 1 3 of may be merged with hydronephrosis calculus formation recurrent urinary tract infection or hypertension at different stages of life Out of 11 horseshoe kidney cases followed by the Istanbul University Faculty of Medicine Pediatric Nephrology Department 27 were Turner syndrome 27 had lumbar meningomyelocele 18 showed severe growth retardation and 9 had congenital heart disease VSD aorta insufficiency Forty five percent also had recurrent urinary tract infection 18 had hydronephrosis 18 had vesicoureteral reflux and 9 nephrolithiasis These results show the importance of genetics nephrourologic evaluation and follow up of children with horseshoe kidney Key words: Urinary Tract Abnormalities Hydronephrosis Nephrolithiasis Hypertension
Turk Pediatri Arsivi-turkish Archives of Pediatrics, 1994
D vitamini alimina bagli hiperkalsemi hiperkalsiuri nefrokalsinoz gelisen yaslari 5 9 ay arasinda... more D vitamini alimina bagli hiperkalsemi hiperkalsiuri nefrokalsinoz gelisen yaslari 5 9 ay arasinda ucu erkek ikisi kiz bes hasta sunuldu Uc olguda normal tedavi dozunda 2 olguda asiri yuksek doz D vitamini ile bu tablo gelismisti D vitamini entoksikasyonu aksidental nedenle yuksek doz D vitamini alinmasiyla olusabilecegi gibi bazen asiri duyarlilik sonucu normal dozlar ile de ortaya cikabilmektedir Anahtar kelimeler: D Vitamini Entoksikasyon Meduller Nefrokalsinoz Hiperkalsemi Hiperkalsiuri
BACKGROUND: In this study, we examined the hypothesis that weight gain and linear growth during t... more BACKGROUND: In this study, we examined the hypothesis that weight gain and linear growth during the first years of life influence the onset of puberty both in girls and in boys. METHODS: A cohort of 157 healthy children, aged 6-9 years, was evaluated and their growth patterns were analyzed retrospectively. Repeated measures mixed model was used to examine the longitudinal anthropometric data. RESULTS: Girls with pubertal signs were heavier than their peers starting at 9 months of age (P = 0.02), and the difference became more evident over time (Po0.001). Accelerated weight gain between 6 and 15 months of age was found to increase the odds of having a pubertal sign at the study visit (odds ratio (OR) = 34.5) after adjusting for birth weight, gestational age and current age, height, weight, and BMI (P = 0.004). Anthropometric indices of boys with or without pubertal signs were not significantly different at the study visit, but boys with accelerated height gain between 9 and 15 months of age were more likely to have pubertal signs (OR = 15.8) after adjusting for birth weight, gestational age and current age, height, weight, and BMI (P = 0.016). CONCLUSION: Early growth acceleration might be important for the timing of puberty in both genders.
Turk Pediatri Arsivi-turkish Archives of Pediatrics, Jun 1, 1994
Horseshoe kidney is the most common fusion anomaly of the kidney and can be associated with certa... more Horseshoe kidney is the most common fusion anomaly of the kidney and can be associated with certain syndromes While 2 3 of the cases may be asymptomatic throughout life 1 3 of may be merged with hydronephrosis calculus formation recurrent urinary tract infection or hypertension at different stages of life Out of 11 horseshoe kidney cases followed by the Istanbul University Faculty of Medicine Pediatric Nephrology Department 27 were Turner syndrome 27 had lumbar meningomyelocele 18 showed severe growth retardation and 9 had congenital heart disease VSD aorta insufficiency Forty five percent also had recurrent urinary tract infection 18 had hydronephrosis 18 had vesicoureteral reflux and 9 nephrolithiasis These results show the importance of genetics nephrourologic evaluation and follow up of children with horseshoe kidney Key words: Urinary Tract Abnormalities Hydronephrosis Nephrolithiasis Hypertension
Objective: Premature adrenarche (PA) has been suggested as a risk factor for future health proble... more Objective: Premature adrenarche (PA) has been suggested as a risk factor for future health problems, such as metabolic syndrome and early menarche. However, not all girls with PA have these features and it is not certain who will develop them. We propose that these abnormalities might be identified earlier, even before they are visible. Design: Case-control study. Setting: Tertiary care hospital. Participants: Forty-eight girls with premature pubarche due to PA and age (mean age 7.6 ± 1.0 years), weight, body mass index (BMI), birth weight and gestational agematched 49 girls with no palpable breast tissue. Measurements: Early pubertal pelvic and breast ultrasonographic changes and their associations with obesity and metabolic parameters were evaluated. Blood samples were collected, breast and pelvic ultrasound examinations were performed and bone ages were assessed. Results: Girls with PA were taller and their bone ages were higher (p = .049 and p = .005). Fasting blood glucose, insulin, triglycerides, high-density lipoprotein and low-density lipoprotein cholesterol were not different between the groups. Luteinizing hormone (LH), follicle-stimulating hormone (FSH) and estradiol were not different either. Ultrasonography revealed breast gland tissue in 30% of girls with PA and 5% of controls (p = .006). Uterine volume and endometrial thickness were higher in girls with PA (p = .03 and p = .04). Endometrial thickness was positively associated with serum insulin levels in the whole study group and after adjusting for age, diagnosis, BMI, mean ovarian volume and LH, FSH, estradiol levels, this association remained with a borderline p-value (R 2 = 0.486, p = .050). Conclusions: We found early changes in uterus and breast glands of girls with PA and endometrial thickness was positively associated with insulin levels.
on multiple measurements, and observer error may approach 25% [4]. Relatively recently, 3D ultras... more on multiple measurements, and observer error may approach 25% [4]. Relatively recently, 3D ultrasound has been studied for use in the measurement of renal parenchymal volume [5]. Deviation in renal size from established normal values indicates alteration in normal renal growth and is an important criterion in the diagnosis of renal disease. Research on prenatally detected hydronephrosis and monitoring of its clinical course have increased our knowledge and insight, shedding new light on the accepted traditional imaging algorithms [6]. To facilitate general acceptance of the algorithms, the European Society of Uroradiology and the European Society of Pediatric Radiology published a consensus statement
bstructive uropathy is a common clinical problem, and urethral calculi constitute the least commo... more bstructive uropathy is a common clinical problem, and urethral calculi constitute the least common form of calculous disease leading to obstructive uropathy. Urethral calculi may originate anywhere in the urinary tract, usually the bladder, and then migrate to the urethra. The clinical presentation is variable. Patients may have acute retention, dysuria, or a weak urine stream. 1 Sonography is a useful technique in detecting urethral calculi because urethral stones are easily identified by sonographic examination. Urethral calculi are most often identified in the prostatic urethra but may also be seen in the penile urethra. Sometimes it is difficult to differentiate prostatic urethral calculi from prostatic calcifications. 2,3 Therefore, this condition makes diagnosis cumbersome. Transrectal voiding sonourethrography or a trans-scrotal approach (which is generally used for urethral strictures) can be used liberally in this situation. Here we describe our experience with the value of real-time transrectal voiding sonourethrography in detecting a prostatic urethral calculus.
Purpose: To determine whether cyclic voiding cystourethrography (VCUG) examinations can be perfor... more Purpose: To determine whether cyclic voiding cystourethrography (VCUG) examinations can be performed without using real-time fluoroscopic monitoring. Materials and methods: VCUG examinations were performed in 209 children (133 girls and 76 boys). In each child, it was performed in a cyclic manner (three consecutive cycles) without using fluoroscopic monitoring and one radiograph was taken in each cycle of the examination. All patients were sedated by midazolam prior to examination. The degree of vesicoureteric reflux (VUR) was graded for each of the kidney ureter units (KUU) (total 418 KUU) separately. Statistical analysis included the comparison of the presence and absence of VUR and three ordinal-matched comparisons of each cycle. Results: VCUG was detected in 37.3% of the children (78/209) and 28.7% (120/418) of the KUU. The absence of or same degree of VUR in three consecutive cycles were obtained in 345 KUU and the agreement was calculated as 82.5%. The same degree and presence of reflux were found in 85 and 89 refluxing KUU, the same negative findings (absence of VUR) in 306 and 298 KUU, and discordant findings in 27 and 31 KUU (between the first and second and between first and third cycles), respectively. Therefore, the agreement was 93.5 and 92.5% between the first and second cycles (p = 0.70) and between the first and the third cycles (p = 0.15), respectively. Conclusion: Both the cyclic nature of this study and the results indicated that VCUG without real-time fluoroscopic monitoring could be used where adequate fluoroscopic examination is not possible for children in whom VUR detection is necessary and impacts treatment. However, the responsibility of pediatric radiologist always must also include the task to provide proper equipment for imaging children with suspected VUR.
Background: Renal calyceal microlithiasis refers to a hyperechogenic spot in renal calyces <3 mm ... more Background: Renal calyceal microlithiasis refers to a hyperechogenic spot in renal calyces <3 mm in diameter detected on renal sonography. These spots possibly represent the first step in calculus formation. The aim of this study was to analyze the clinical presentation, predisposing factors, prognosis and clinical importance of these hyperechogenic spots in renal calyces, renal calyceal microlithiasis, during childhood. Methods: The data of 292 children (135 girls, 157 boys) with microlithiasis diagnosed between January 1998 and December 2010 were evaluated retrospectively. Demographic data, serum biochemistry, urinary metabolic factors, and renal sonography results were obtained from patient files. A total of 228 patients were re-evaluated at least 6 months after the first observation of renal calyceal microlithiasis and at 6-12 month intervals thereafter. Results: Mean age was 16.8 ± 14.9 months, and mean follow-up duration was 14.6 ± 5.9 months. Presenting symptoms were abdominal or flank pain (41.1%), hematuria (35.6%), dysuria (24.7%) and urinary tract infection (34.6%). Previous ultrasounds were normal in 35% of the children. Metabolic and anatomic abnormalities were found in 55.5% and 17.8%, respectively. Hypercalciuria was the most common metabolic abnormality (88.9%). Among 228 patients who had been re-evaluated, microlithiasis disappeared in 37.7%; decreased in number or size in 23.7%; progressed to renal stone formation in 10.6%; increased in number of microlithiasis in 19.0%; and remained unchanged on radiology in 9.0%. Conclusion: Renal calyceal microlithiasis represents a spectrum of clinical situations and underlying metabolic abnormalities that need further investigation in children.
crotal neoplasms can be divided into those that are intratesticular and extratesticular in origin... more crotal neoplasms can be divided into those that are intratesticular and extratesticular in origin. Intratesticular neoplasms are more prevalent than extratesticular neoplasms. Ultrasonography is the method of choice for imaging scrotal pathologic entities. However, detection and differentiation of an extratesticular neoplasm are more sophisticated than for intratesticular neoplasms. It is also not always possible to differentiate an extratesticular mass originating from the paratesticular tissues from an intratesticular mass. If the lesion is confined to the epididymis, the differentiation can easily be made. 1 However, if the lesion is originating from the tunics of the testis, the differentiation can be troublesome. We report a case of an adenomatoid tumor in the lamina parietalis of the tunica vaginalis (LPTV) testis. This report is unique that it describes a maneuver that helped us differentiate the mass as being extratesticular in location.
bstructive uropathy is a common clinical problem, and urethral calculi constitute the least commo... more bstructive uropathy is a common clinical problem, and urethral calculi constitute the least common form of calculous disease leading to obstructive uropathy. Urethral calculi may originate anywhere in the urinary tract, usually the bladder, and then migrate to the urethra. The clinical presentation is variable. Patients may have acute retention, dysuria, or a weak urine stream. 1 Sonography is a useful technique in detecting urethral calculi because urethral stones are easily identified by sonographic examination. Urethral calculi are most often identified in the prostatic urethra but may also be seen in the penile urethra. Sometimes it is difficult to differentiate prostatic urethral calculi from prostatic calcifications. 2,3 Therefore, this condition makes diagnosis cumbersome. Transrectal voiding sonourethrography or a trans-scrotal approach (which is generally used for urethral strictures) can be used liberally in this situation. Here we describe our experience with the value of real-time transrectal voiding sonourethrography in detecting a prostatic urethral calculus.
BackgroundRenal calyceal microlithiasis refers to a hyperechogenic spot in renal calyces <3 mm... more BackgroundRenal calyceal microlithiasis refers to a hyperechogenic spot in renal calyces <3 mm in diameter detected on renal sonography. These spots possibly represent the first step in calculus formation. The aim of this study was to analyze the clinical presentation, predisposing factors, prognosis and clinical importance of these hyperechogenic spots in renal calyces, renal calyceal microlithiasis, during childhood.MethodsThe data of 292 children (135 girls, 157 boys) with microlithiasis diagnosed between January 1998 and December 2010 were evaluated retrospectively. Demographic data, serum biochemistry, urinary metabolic factors, and renal sonography results were obtained from patient files. A total of 228 patients were re‐evaluated at least 6 months after the first observation of renal calyceal microlithiasis and at 6–12 month intervals thereafter.ResultsMean age was 16.8 ± 14.9 months, and mean follow‐up duration was 14.6 ± 5.9 months. Presenting symptoms were abdominal or ...
Aim: To evaluate the role of further grading of classical testicular microlithiasis (CTM) on the ... more Aim: To evaluate the role of further grading of classical testicular microlithiasis (CTM) on the prevalence of associated testicular tumors. Methods: Patients diagnosed with CTM using scrotal ultrasound over a 5-year period from a referral radiology clinic were included in this study. Patients with CTM were categorized as group 1 (grade I; 5–10 microliths/image), group 2 (grade II 10–20 microliths/image), and group 3 (grade III > 20 microliths/image). Other pathological findings were also recorded. The prevalence of testicular cancer was compared statistically between groups using the χ2 test. Results: Seventy-eight of 4,310 (1.8%) patients were found to have CTM. Of these, 17 (21.7%) had ultrasonographically detected testicular cancer. In patients without CTM (n = 4,232), 58 (1.1%) testicular cancers were found. This accounted to a 19.7-fold increase in the detection rate of testicular cancer in patients with CTM compared to patients without CTM. The rates of testicular cancer d...
Adrenal hemorrhage in newborns is not uncommon. The clinical presentation may be very protean and... more Adrenal hemorrhage in newborns is not uncommon. The clinical presentation may be very protean and the diagnosis difficult. Ultrasonography is useful in making the diagnosis. A patient presenting with severe neonatal jaundice due to adrenal hemorrhage is described.
Turk Pediatri Arsivi-turkish Archives of Pediatrics, Jun 1, 1994
Horseshoe kidney is the most common fusion anomaly of the kidney and can be associated with certa... more Horseshoe kidney is the most common fusion anomaly of the kidney and can be associated with certain syndromes While 2 3 of the cases may be asymptomatic throughout life 1 3 of may be merged with hydronephrosis calculus formation recurrent urinary tract infection or hypertension at different stages of life Out of 11 horseshoe kidney cases followed by the Istanbul University Faculty of Medicine Pediatric Nephrology Department 27 were Turner syndrome 27 had lumbar meningomyelocele 18 showed severe growth retardation and 9 had congenital heart disease VSD aorta insufficiency Forty five percent also had recurrent urinary tract infection 18 had hydronephrosis 18 had vesicoureteral reflux and 9 nephrolithiasis These results show the importance of genetics nephrourologic evaluation and follow up of children with horseshoe kidney Key words: Urinary Tract Abnormalities Hydronephrosis Nephrolithiasis Hypertension
Turk Pediatri Arsivi-turkish Archives of Pediatrics, 1994
D vitamini alimina bagli hiperkalsemi hiperkalsiuri nefrokalsinoz gelisen yaslari 5 9 ay arasinda... more D vitamini alimina bagli hiperkalsemi hiperkalsiuri nefrokalsinoz gelisen yaslari 5 9 ay arasinda ucu erkek ikisi kiz bes hasta sunuldu Uc olguda normal tedavi dozunda 2 olguda asiri yuksek doz D vitamini ile bu tablo gelismisti D vitamini entoksikasyonu aksidental nedenle yuksek doz D vitamini alinmasiyla olusabilecegi gibi bazen asiri duyarlilik sonucu normal dozlar ile de ortaya cikabilmektedir Anahtar kelimeler: D Vitamini Entoksikasyon Meduller Nefrokalsinoz Hiperkalsemi Hiperkalsiuri
BACKGROUND: In this study, we examined the hypothesis that weight gain and linear growth during t... more BACKGROUND: In this study, we examined the hypothesis that weight gain and linear growth during the first years of life influence the onset of puberty both in girls and in boys. METHODS: A cohort of 157 healthy children, aged 6-9 years, was evaluated and their growth patterns were analyzed retrospectively. Repeated measures mixed model was used to examine the longitudinal anthropometric data. RESULTS: Girls with pubertal signs were heavier than their peers starting at 9 months of age (P = 0.02), and the difference became more evident over time (Po0.001). Accelerated weight gain between 6 and 15 months of age was found to increase the odds of having a pubertal sign at the study visit (odds ratio (OR) = 34.5) after adjusting for birth weight, gestational age and current age, height, weight, and BMI (P = 0.004). Anthropometric indices of boys with or without pubertal signs were not significantly different at the study visit, but boys with accelerated height gain between 9 and 15 months of age were more likely to have pubertal signs (OR = 15.8) after adjusting for birth weight, gestational age and current age, height, weight, and BMI (P = 0.016). CONCLUSION: Early growth acceleration might be important for the timing of puberty in both genders.
Turk Pediatri Arsivi-turkish Archives of Pediatrics, Jun 1, 1994
Horseshoe kidney is the most common fusion anomaly of the kidney and can be associated with certa... more Horseshoe kidney is the most common fusion anomaly of the kidney and can be associated with certain syndromes While 2 3 of the cases may be asymptomatic throughout life 1 3 of may be merged with hydronephrosis calculus formation recurrent urinary tract infection or hypertension at different stages of life Out of 11 horseshoe kidney cases followed by the Istanbul University Faculty of Medicine Pediatric Nephrology Department 27 were Turner syndrome 27 had lumbar meningomyelocele 18 showed severe growth retardation and 9 had congenital heart disease VSD aorta insufficiency Forty five percent also had recurrent urinary tract infection 18 had hydronephrosis 18 had vesicoureteral reflux and 9 nephrolithiasis These results show the importance of genetics nephrourologic evaluation and follow up of children with horseshoe kidney Key words: Urinary Tract Abnormalities Hydronephrosis Nephrolithiasis Hypertension
Objective: Premature adrenarche (PA) has been suggested as a risk factor for future health proble... more Objective: Premature adrenarche (PA) has been suggested as a risk factor for future health problems, such as metabolic syndrome and early menarche. However, not all girls with PA have these features and it is not certain who will develop them. We propose that these abnormalities might be identified earlier, even before they are visible. Design: Case-control study. Setting: Tertiary care hospital. Participants: Forty-eight girls with premature pubarche due to PA and age (mean age 7.6 ± 1.0 years), weight, body mass index (BMI), birth weight and gestational agematched 49 girls with no palpable breast tissue. Measurements: Early pubertal pelvic and breast ultrasonographic changes and their associations with obesity and metabolic parameters were evaluated. Blood samples were collected, breast and pelvic ultrasound examinations were performed and bone ages were assessed. Results: Girls with PA were taller and their bone ages were higher (p = .049 and p = .005). Fasting blood glucose, insulin, triglycerides, high-density lipoprotein and low-density lipoprotein cholesterol were not different between the groups. Luteinizing hormone (LH), follicle-stimulating hormone (FSH) and estradiol were not different either. Ultrasonography revealed breast gland tissue in 30% of girls with PA and 5% of controls (p = .006). Uterine volume and endometrial thickness were higher in girls with PA (p = .03 and p = .04). Endometrial thickness was positively associated with serum insulin levels in the whole study group and after adjusting for age, diagnosis, BMI, mean ovarian volume and LH, FSH, estradiol levels, this association remained with a borderline p-value (R 2 = 0.486, p = .050). Conclusions: We found early changes in uterus and breast glands of girls with PA and endometrial thickness was positively associated with insulin levels.
on multiple measurements, and observer error may approach 25% [4]. Relatively recently, 3D ultras... more on multiple measurements, and observer error may approach 25% [4]. Relatively recently, 3D ultrasound has been studied for use in the measurement of renal parenchymal volume [5]. Deviation in renal size from established normal values indicates alteration in normal renal growth and is an important criterion in the diagnosis of renal disease. Research on prenatally detected hydronephrosis and monitoring of its clinical course have increased our knowledge and insight, shedding new light on the accepted traditional imaging algorithms [6]. To facilitate general acceptance of the algorithms, the European Society of Uroradiology and the European Society of Pediatric Radiology published a consensus statement
bstructive uropathy is a common clinical problem, and urethral calculi constitute the least commo... more bstructive uropathy is a common clinical problem, and urethral calculi constitute the least common form of calculous disease leading to obstructive uropathy. Urethral calculi may originate anywhere in the urinary tract, usually the bladder, and then migrate to the urethra. The clinical presentation is variable. Patients may have acute retention, dysuria, or a weak urine stream. 1 Sonography is a useful technique in detecting urethral calculi because urethral stones are easily identified by sonographic examination. Urethral calculi are most often identified in the prostatic urethra but may also be seen in the penile urethra. Sometimes it is difficult to differentiate prostatic urethral calculi from prostatic calcifications. 2,3 Therefore, this condition makes diagnosis cumbersome. Transrectal voiding sonourethrography or a trans-scrotal approach (which is generally used for urethral strictures) can be used liberally in this situation. Here we describe our experience with the value of real-time transrectal voiding sonourethrography in detecting a prostatic urethral calculus.
Purpose: To determine whether cyclic voiding cystourethrography (VCUG) examinations can be perfor... more Purpose: To determine whether cyclic voiding cystourethrography (VCUG) examinations can be performed without using real-time fluoroscopic monitoring. Materials and methods: VCUG examinations were performed in 209 children (133 girls and 76 boys). In each child, it was performed in a cyclic manner (three consecutive cycles) without using fluoroscopic monitoring and one radiograph was taken in each cycle of the examination. All patients were sedated by midazolam prior to examination. The degree of vesicoureteric reflux (VUR) was graded for each of the kidney ureter units (KUU) (total 418 KUU) separately. Statistical analysis included the comparison of the presence and absence of VUR and three ordinal-matched comparisons of each cycle. Results: VCUG was detected in 37.3% of the children (78/209) and 28.7% (120/418) of the KUU. The absence of or same degree of VUR in three consecutive cycles were obtained in 345 KUU and the agreement was calculated as 82.5%. The same degree and presence of reflux were found in 85 and 89 refluxing KUU, the same negative findings (absence of VUR) in 306 and 298 KUU, and discordant findings in 27 and 31 KUU (between the first and second and between first and third cycles), respectively. Therefore, the agreement was 93.5 and 92.5% between the first and second cycles (p = 0.70) and between the first and the third cycles (p = 0.15), respectively. Conclusion: Both the cyclic nature of this study and the results indicated that VCUG without real-time fluoroscopic monitoring could be used where adequate fluoroscopic examination is not possible for children in whom VUR detection is necessary and impacts treatment. However, the responsibility of pediatric radiologist always must also include the task to provide proper equipment for imaging children with suspected VUR.
Background: Renal calyceal microlithiasis refers to a hyperechogenic spot in renal calyces <3 mm ... more Background: Renal calyceal microlithiasis refers to a hyperechogenic spot in renal calyces <3 mm in diameter detected on renal sonography. These spots possibly represent the first step in calculus formation. The aim of this study was to analyze the clinical presentation, predisposing factors, prognosis and clinical importance of these hyperechogenic spots in renal calyces, renal calyceal microlithiasis, during childhood. Methods: The data of 292 children (135 girls, 157 boys) with microlithiasis diagnosed between January 1998 and December 2010 were evaluated retrospectively. Demographic data, serum biochemistry, urinary metabolic factors, and renal sonography results were obtained from patient files. A total of 228 patients were re-evaluated at least 6 months after the first observation of renal calyceal microlithiasis and at 6-12 month intervals thereafter. Results: Mean age was 16.8 ± 14.9 months, and mean follow-up duration was 14.6 ± 5.9 months. Presenting symptoms were abdominal or flank pain (41.1%), hematuria (35.6%), dysuria (24.7%) and urinary tract infection (34.6%). Previous ultrasounds were normal in 35% of the children. Metabolic and anatomic abnormalities were found in 55.5% and 17.8%, respectively. Hypercalciuria was the most common metabolic abnormality (88.9%). Among 228 patients who had been re-evaluated, microlithiasis disappeared in 37.7%; decreased in number or size in 23.7%; progressed to renal stone formation in 10.6%; increased in number of microlithiasis in 19.0%; and remained unchanged on radiology in 9.0%. Conclusion: Renal calyceal microlithiasis represents a spectrum of clinical situations and underlying metabolic abnormalities that need further investigation in children.
crotal neoplasms can be divided into those that are intratesticular and extratesticular in origin... more crotal neoplasms can be divided into those that are intratesticular and extratesticular in origin. Intratesticular neoplasms are more prevalent than extratesticular neoplasms. Ultrasonography is the method of choice for imaging scrotal pathologic entities. However, detection and differentiation of an extratesticular neoplasm are more sophisticated than for intratesticular neoplasms. It is also not always possible to differentiate an extratesticular mass originating from the paratesticular tissues from an intratesticular mass. If the lesion is confined to the epididymis, the differentiation can easily be made. 1 However, if the lesion is originating from the tunics of the testis, the differentiation can be troublesome. We report a case of an adenomatoid tumor in the lamina parietalis of the tunica vaginalis (LPTV) testis. This report is unique that it describes a maneuver that helped us differentiate the mass as being extratesticular in location.
bstructive uropathy is a common clinical problem, and urethral calculi constitute the least commo... more bstructive uropathy is a common clinical problem, and urethral calculi constitute the least common form of calculous disease leading to obstructive uropathy. Urethral calculi may originate anywhere in the urinary tract, usually the bladder, and then migrate to the urethra. The clinical presentation is variable. Patients may have acute retention, dysuria, or a weak urine stream. 1 Sonography is a useful technique in detecting urethral calculi because urethral stones are easily identified by sonographic examination. Urethral calculi are most often identified in the prostatic urethra but may also be seen in the penile urethra. Sometimes it is difficult to differentiate prostatic urethral calculi from prostatic calcifications. 2,3 Therefore, this condition makes diagnosis cumbersome. Transrectal voiding sonourethrography or a trans-scrotal approach (which is generally used for urethral strictures) can be used liberally in this situation. Here we describe our experience with the value of real-time transrectal voiding sonourethrography in detecting a prostatic urethral calculus.
BackgroundRenal calyceal microlithiasis refers to a hyperechogenic spot in renal calyces <3 mm... more BackgroundRenal calyceal microlithiasis refers to a hyperechogenic spot in renal calyces <3 mm in diameter detected on renal sonography. These spots possibly represent the first step in calculus formation. The aim of this study was to analyze the clinical presentation, predisposing factors, prognosis and clinical importance of these hyperechogenic spots in renal calyces, renal calyceal microlithiasis, during childhood.MethodsThe data of 292 children (135 girls, 157 boys) with microlithiasis diagnosed between January 1998 and December 2010 were evaluated retrospectively. Demographic data, serum biochemistry, urinary metabolic factors, and renal sonography results were obtained from patient files. A total of 228 patients were re‐evaluated at least 6 months after the first observation of renal calyceal microlithiasis and at 6–12 month intervals thereafter.ResultsMean age was 16.8 ± 14.9 months, and mean follow‐up duration was 14.6 ± 5.9 months. Presenting symptoms were abdominal or ...
Aim: To evaluate the role of further grading of classical testicular microlithiasis (CTM) on the ... more Aim: To evaluate the role of further grading of classical testicular microlithiasis (CTM) on the prevalence of associated testicular tumors. Methods: Patients diagnosed with CTM using scrotal ultrasound over a 5-year period from a referral radiology clinic were included in this study. Patients with CTM were categorized as group 1 (grade I; 5–10 microliths/image), group 2 (grade II 10–20 microliths/image), and group 3 (grade III > 20 microliths/image). Other pathological findings were also recorded. The prevalence of testicular cancer was compared statistically between groups using the χ2 test. Results: Seventy-eight of 4,310 (1.8%) patients were found to have CTM. Of these, 17 (21.7%) had ultrasonographically detected testicular cancer. In patients without CTM (n = 4,232), 58 (1.1%) testicular cancers were found. This accounted to a 19.7-fold increase in the detection rate of testicular cancer in patients with CTM compared to patients without CTM. The rates of testicular cancer d...
Adrenal hemorrhage in newborns is not uncommon. The clinical presentation may be very protean and... more Adrenal hemorrhage in newborns is not uncommon. The clinical presentation may be very protean and the diagnosis difficult. Ultrasonography is useful in making the diagnosis. A patient presenting with severe neonatal jaundice due to adrenal hemorrhage is described.
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