Paraplegia or death secondary to upper cervical spine instability and spinal cord compression are... more Paraplegia or death secondary to upper cervical spine instability and spinal cord compression are known consequences of spondyloepiphyseal dysplasia congenita (SEDC). Stabilization and occasionally decompression of the upper cervical spine are indicated to treat upper cervical instability and stenosis. The purpose of this study was to report the results of upper cervical spine fusion in children with SEDC who had upper cervical instability. Twenty children (17 females and 3 males) with SEDC who underwent upper cervical spine fusion at a mean age of 72 months were retrospectively analyzed. Three of these children were under the age of 2. Fifteen children had posterior instrumentation and fusion whereas 5 children had posterior in situ fusion without use of any implant. Thirteen of 20 children had iliac crest autograft. Radiographic and clinical results were reported. The average follow-up period was 8 years and 8 months. All children with instrumentation achieved fusion. Three of 5 children who had no instrumentation had nonunion (1 child had a stable nonunion and did not need revision; 1 had a single noninstrumented revision and ended up with a stable nonunion without further intervention; and the third one had a noninstrumented revision and had to have a second, instrumented, revision to achieve fusion). Six children had thoracolumbar scoliosis or kyphoscoliosis which required surgical management.No postoperative neurological deficits were observed. Two of the 3 children with a preoperative neurological deficit showed full recovery and the third one remained unchanged. Pseudarthrosis is the main complication for the noninstrumented group. Distal junctional instability after successful fusion is seen at long-term follow-up (average=6 y) for 13% of patients in instrumented group. Instrumentation and iliac bone grafting results in 100% upper cervical fusion for SEDC children who demonstrated instability before surgery. Level IV-therapeutic.
An aberrant subarcuate artery and its related canal are rare. The presence of this variation has ... more An aberrant subarcuate artery and its related canal are rare. The presence of this variation has a surgical significance, that is, risk of hemorrhage, if accidentally nicked. It is therefore important to be aware of this entity, and its relative anatomy, to avoid any untoward complication. We present a case of a 29-year-old man who presented with hearing loss after trauma. High-resolution computed tomographic scan of the temporal bone demonstrated an enlarged subarcuate canal.
related to osteoclast inhibition and the resulting oversuppression of bone turnover and bone remo... more related to osteoclast inhibition and the resulting oversuppression of bone turnover and bone remodeling, leading to atypical skeletal fragility .
Fetal brain magnetic resonance imaging (MRI) is a powerful tool in the diagnosis of symptomatic c... more Fetal brain magnetic resonance imaging (MRI) is a powerful tool in the diagnosis of symptomatic congenital cytomegalovirus infection, requiring a detailed search for specific features. A combination of anterior temporal lobe abnormalities, white matter lesions, and polymicrogyria is especially predictive. Fetal MRI may provide a unique opportunity to detect anterior temporal cysts and occipital horn septations, as dilation of these areas may decrease later in development. Cortical migration abnormalities, white matter abnormalities, cerebellar dysplasia, and periventricular calcifications are often better depicted on postnatal imaging but can also be detected on fetal MRI. We present the prenatal brain MRI findings seen in congenital cytomegalovirus infection and provide postnatal imaging correlation, highlighting the evolution of findings at different times in prenatal and postnatal developments.
Achondroplasia is the most common form of skeletal dysplasia. Although the radiographic features ... more Achondroplasia is the most common form of skeletal dysplasia. Although the radiographic features are well described, MRI features of the knee in achondroplasia have not been reported. To describe common MRI characteristics of the knee joint in symptomatic children and adolescents with achondroplasia. We retrospectively evaluated 10 knee MRI examinations in 8 children and young adults (age range 11-20 years, mean 16.3 years) with achondroplasia. We measured modified Insall-Salvati index, knee flexion angle, anterior cruciate ligament (ACL)-Blumensaat line angle, ACL-tibial angle, posterior cruciate ligament (PCL) angle, intercondylar notch width index, and intercondylar notch depth index. We compared our findings with an age- and gender-matched control group of 20 children (age range 15-18 years; mean 16 years) with normal knee MRIs. All 10 knees in the achondroplasia group had discoid lateral meniscus; 8 meniscal tears were identified. Patella baja was present in half of the study cases. Greater knee flexion and increased ACL-Blumensaat line and PCL angles were seen in all achondroplasia knees. ACL-tibial angle was similar in the study and in the control group. Children with achondroplasia had deeper A-shape femoral notches that extended more anteriorly than those seen in the control group. MRI findings were confirmed in all seven knees with arthroscopic correlation. Discoid lateral meniscus, often with tear, is a consistent feature in knee MRIs of symptomatic children and adolescents with achondroplasia. Other findings include patella baja, knee flexion, deep A-shape intercondylar notch, increased ACL-Blumensaat line angle and taut PCL.
Cardiac myxomas are benign primary cardiac tumors that are less common than rhabdomyomas and fibr... more Cardiac myxomas are benign primary cardiac tumors that are less common than rhabdomyomas and fibromas in children. Cardiac myxoma is an intracavitary neoplasm that is attached to the endocardium. The majority of the myxomas occur in the left (75%) and right (20%) atrium. In this report, we present cardiac magnetic resonance imaging (MRI) findings of a 5-year-old girl with pathologically
Yekeler E, Dursun M, Emeksiz E, Akkoyunlu M, Akyol Y, Demir F, Gökçay G, Demirkol M. Prediction o... more Yekeler E, Dursun M, Emeksiz E, Akkoyunlu M, Akyol Y, Demir F, Gökçay G, Demirkol M. Prediction of premature atherosclerosis by endothelial dysfunction and increased intima-media thickness in glycogen storage disease types Ia and III. Turk J Pediatr 2007; 49: 115-119.
The complications linked directly to coronary artery catheter itself are very rare. We presented ... more The complications linked directly to coronary artery catheter itself are very rare. We presented a case in which the broken right coronary artery catheter was successfully removed from the ascending aorta. The removal of catheter was accomplished via an aortic incision, which was created for saphenous vein graft in the site of anastomosis during an emergency coronary artery bypass graft surgery. We believe that a broken catheter in the aorta is a catastrophic event, which could be removed safely in the operating room even with concomitant bypass surgery.
Although the MR imaging features of cardiac masses and their differential diagnosis are well defi... more Although the MR imaging features of cardiac masses and their differential diagnosis are well defined in the literature, we present a report of two lately observed myxoma cases, which were not seen on non-contrasted sequences, but were well visualized after contrast administration. From this point of view, we think that it would be adequate to call these tumors as "ghost tumors". To the best of our knowledge, this is the very first report of MR imaging findings of mobile pediculated intracardiac masses, and it is our belief that mobile intracardiac masses do not cause a phase difference and therefore cannot be observed on non-contrasted sequences. Furthermore, we would like to stress that contrast administration is required in order to differentiate "ghost tumors" from completely resolved intracardiac thrombus.
Paraplegia or death secondary to upper cervical spine instability and spinal cord compression are... more Paraplegia or death secondary to upper cervical spine instability and spinal cord compression are known consequences of spondyloepiphyseal dysplasia congenita (SEDC). Stabilization and occasionally decompression of the upper cervical spine are indicated to treat upper cervical instability and stenosis. The purpose of this study was to report the results of upper cervical spine fusion in children with SEDC who had upper cervical instability. Twenty children (17 females and 3 males) with SEDC who underwent upper cervical spine fusion at a mean age of 72 months were retrospectively analyzed. Three of these children were under the age of 2. Fifteen children had posterior instrumentation and fusion whereas 5 children had posterior in situ fusion without use of any implant. Thirteen of 20 children had iliac crest autograft. Radiographic and clinical results were reported. The average follow-up period was 8 years and 8 months. All children with instrumentation achieved fusion. Three of 5 children who had no instrumentation had nonunion (1 child had a stable nonunion and did not need revision; 1 had a single noninstrumented revision and ended up with a stable nonunion without further intervention; and the third one had a noninstrumented revision and had to have a second, instrumented, revision to achieve fusion). Six children had thoracolumbar scoliosis or kyphoscoliosis which required surgical management.No postoperative neurological deficits were observed. Two of the 3 children with a preoperative neurological deficit showed full recovery and the third one remained unchanged. Pseudarthrosis is the main complication for the noninstrumented group. Distal junctional instability after successful fusion is seen at long-term follow-up (average=6 y) for 13% of patients in instrumented group. Instrumentation and iliac bone grafting results in 100% upper cervical fusion for SEDC children who demonstrated instability before surgery. Level IV-therapeutic.
An aberrant subarcuate artery and its related canal are rare. The presence of this variation has ... more An aberrant subarcuate artery and its related canal are rare. The presence of this variation has a surgical significance, that is, risk of hemorrhage, if accidentally nicked. It is therefore important to be aware of this entity, and its relative anatomy, to avoid any untoward complication. We present a case of a 29-year-old man who presented with hearing loss after trauma. High-resolution computed tomographic scan of the temporal bone demonstrated an enlarged subarcuate canal.
related to osteoclast inhibition and the resulting oversuppression of bone turnover and bone remo... more related to osteoclast inhibition and the resulting oversuppression of bone turnover and bone remodeling, leading to atypical skeletal fragility .
Fetal brain magnetic resonance imaging (MRI) is a powerful tool in the diagnosis of symptomatic c... more Fetal brain magnetic resonance imaging (MRI) is a powerful tool in the diagnosis of symptomatic congenital cytomegalovirus infection, requiring a detailed search for specific features. A combination of anterior temporal lobe abnormalities, white matter lesions, and polymicrogyria is especially predictive. Fetal MRI may provide a unique opportunity to detect anterior temporal cysts and occipital horn septations, as dilation of these areas may decrease later in development. Cortical migration abnormalities, white matter abnormalities, cerebellar dysplasia, and periventricular calcifications are often better depicted on postnatal imaging but can also be detected on fetal MRI. We present the prenatal brain MRI findings seen in congenital cytomegalovirus infection and provide postnatal imaging correlation, highlighting the evolution of findings at different times in prenatal and postnatal developments.
Achondroplasia is the most common form of skeletal dysplasia. Although the radiographic features ... more Achondroplasia is the most common form of skeletal dysplasia. Although the radiographic features are well described, MRI features of the knee in achondroplasia have not been reported. To describe common MRI characteristics of the knee joint in symptomatic children and adolescents with achondroplasia. We retrospectively evaluated 10 knee MRI examinations in 8 children and young adults (age range 11-20 years, mean 16.3 years) with achondroplasia. We measured modified Insall-Salvati index, knee flexion angle, anterior cruciate ligament (ACL)-Blumensaat line angle, ACL-tibial angle, posterior cruciate ligament (PCL) angle, intercondylar notch width index, and intercondylar notch depth index. We compared our findings with an age- and gender-matched control group of 20 children (age range 15-18 years; mean 16 years) with normal knee MRIs. All 10 knees in the achondroplasia group had discoid lateral meniscus; 8 meniscal tears were identified. Patella baja was present in half of the study cases. Greater knee flexion and increased ACL-Blumensaat line and PCL angles were seen in all achondroplasia knees. ACL-tibial angle was similar in the study and in the control group. Children with achondroplasia had deeper A-shape femoral notches that extended more anteriorly than those seen in the control group. MRI findings were confirmed in all seven knees with arthroscopic correlation. Discoid lateral meniscus, often with tear, is a consistent feature in knee MRIs of symptomatic children and adolescents with achondroplasia. Other findings include patella baja, knee flexion, deep A-shape intercondylar notch, increased ACL-Blumensaat line angle and taut PCL.
Cardiac myxomas are benign primary cardiac tumors that are less common than rhabdomyomas and fibr... more Cardiac myxomas are benign primary cardiac tumors that are less common than rhabdomyomas and fibromas in children. Cardiac myxoma is an intracavitary neoplasm that is attached to the endocardium. The majority of the myxomas occur in the left (75%) and right (20%) atrium. In this report, we present cardiac magnetic resonance imaging (MRI) findings of a 5-year-old girl with pathologically
Yekeler E, Dursun M, Emeksiz E, Akkoyunlu M, Akyol Y, Demir F, Gökçay G, Demirkol M. Prediction o... more Yekeler E, Dursun M, Emeksiz E, Akkoyunlu M, Akyol Y, Demir F, Gökçay G, Demirkol M. Prediction of premature atherosclerosis by endothelial dysfunction and increased intima-media thickness in glycogen storage disease types Ia and III. Turk J Pediatr 2007; 49: 115-119.
The complications linked directly to coronary artery catheter itself are very rare. We presented ... more The complications linked directly to coronary artery catheter itself are very rare. We presented a case in which the broken right coronary artery catheter was successfully removed from the ascending aorta. The removal of catheter was accomplished via an aortic incision, which was created for saphenous vein graft in the site of anastomosis during an emergency coronary artery bypass graft surgery. We believe that a broken catheter in the aorta is a catastrophic event, which could be removed safely in the operating room even with concomitant bypass surgery.
Although the MR imaging features of cardiac masses and their differential diagnosis are well defi... more Although the MR imaging features of cardiac masses and their differential diagnosis are well defined in the literature, we present a report of two lately observed myxoma cases, which were not seen on non-contrasted sequences, but were well visualized after contrast administration. From this point of view, we think that it would be adequate to call these tumors as "ghost tumors". To the best of our knowledge, this is the very first report of MR imaging findings of mobile pediculated intracardiac masses, and it is our belief that mobile intracardiac masses do not cause a phase difference and therefore cannot be observed on non-contrasted sequences. Furthermore, we would like to stress that contrast administration is required in order to differentiate "ghost tumors" from completely resolved intracardiac thrombus.
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