Measurement of normal spleen volume and dimensions in all child age groups by abdominal computed tomography

OBJECTIVE

This study aimed to calculate the spleen size and volume, portal vein diameter, splenic vein diameter, and accessory spleen presence in children aged 0-18 years in the Turkish population by computed tomography, according to age and gender.

MATERIALS AND METHODS

Abdominal computed tomography images of 406 children without systemic or organospecific disease were retrospectively analyzed in the study. Maximum interpolar length in axial and coronal sections in addition to maximum width at hilus level in axial sections of the spleen were measured in abdominal computed tomography. Luminal diameter measurements were obtained from axial sections at the level of the liver hilum of the portal vein and the hilus of the spleen of the splenic vein.

RESULTS

As age increases, the axial longest dimension (ALD), axial longest thickness (ALT) and coronal longest dimension (CLD) dimensions also increase, and this increase is statistically significant (p<0.001). The lowest splenic volume was measured in the 0-2 age group as 25.3 cm3, and the highest splenic volume was 506.2 cm3 in the 17-18 age group. Splenic vein diameter is between 1.9 mm and 11.0 mm, and the mean splenic vein diameter increases with increasing age. Portal vein diameter is between 4.1 mm and 14.9 mm, and the average portal vein diameter increases with age. The accessory spleen was seen in 22 (5.4%) children. Accessory spleen size ranged from 5 mm to 17 mm. There was a strong positive correlation between spleen volume and splenic vein diameter (r=0.696 p<0.001). Similarly, there was a strong positive correlation between spleen volume and portal vein diameter (r=0.704 p<0.001).

CONCLUSIONS

It may be helpful to know the normal spleen volume in healthy children according to age groups in making the correct diagnosis of splenomegaly. We assume that it will play an important role in the accurate diagnosis of portal hypertension to know the upper and lower limits of the portal vein and splenic vein diameters.

The first observation of antifouling organotin compounds and booster biocides in sediments from Samsun Port area, Black Sea, Turkey

The distribution of antifouling organotin compounds (OTCs) and booster biocides in surface sediments of Samsun Port (Black Sea, Turkey) in September 2014 was investigated by gas chromatography-tandem mass spectrometry (GC-MS/MS) method. The total organotin concentrations ranged from <1.0 to 669.6 ng/g, dw. Among the studied booster biocides, Diuron (<1.0-11.28 ng/g) was found in 70.58% of the investigated sediments, while Irgarol (<1.0-26.53 ng/g) was detected in two stations. Traces of fresh input organotin and high Irgarol were found at the park/repairment points of the port. The Principal Component Analysis (PCA) showed that sediment characteristic types and Total Organic Carbon (TOC) were the main relevant parameters in the accumulation of antifouling contamination in the Port area. In comparison with several types of environmental sediment quality criteria, Samsun Port is highly polluted area. The concentrations of OTCs and Diuron maybe used as a baseline reference level for future monitoring programs in Turkish Ports.

Can evaluating adrenal glands in computed tomography contribute to predicting the prognosis of hospitalized COVID-19 patients?

OBJECTIVE

The novel coronavirus disease 2019 (COVID-19) may affect the adrenal glands. Therefore, it is important to evaluate the morphologic appearance of the adrenal glands by thorax computed tomography (CT). On CT scans, stranding in peripheral fatty tissue with enlarged adrenal glands may indicate signs of adrenal infarction (SAI). The present study aimed to evaluate the incidence of SAI and determine whether this finding may contribute to predictions of the prognosis of COVID-19.

PATIENTS AND METHODS

A total of 343 patients who had been hospitalized at Malatya Training and Research Hospital between September 1 and 30, 2020, with a diagnosis of COVID-19 were enrolled in this study. All patients underwent thorax CT scans that included their adrenal glands.

RESULTS

Of the enrolled patients, 16.0% had SAI. Moreover, 41.8% of patients with SAI and 15.3% of patients without SAI were treated in the Intensive Care Unit (ICU). Patients with SAI had a significantly higher rate of ICU admission (p < 0.001). Mortality rates were also significantly higher among patients with SAI than those without p < 0.001).

CONCLUSIONS

In this study, it was found that COVID-19 patients with SAI may have a poorer prognosis. More comprehensive studies are needed on this subject, but the present study may provide helpful preliminary information in terms of prognosis.

The evaluation of the trachea as a new parameter in determining the prognosis of COVID-19: first pilot study

OBJECTIVE

Coronavirus disease-2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) follows a biphasic disease model consisting of an early viral response phase and an inflammation phase. SARS-CoV-2 has a high affinity for the upper respiratory tract and conjunctiva; hence, it can infect the upper respiratory tract and facilitate airway inflammation. COVID-19 also affects the tracheal epithelial cells. We hypothesized that the size of the trachea increases depending on the severity of the disease, and this increase is an indicator of poor prognosis. There are no studies on this subject in literature, to the best of our knowledge. For this purpose, in this study, the tracheas of 326 patients who reported to the radiology clinic were examined by evaluating the thoracic computed tomography (CT) images.

PATIENTS AND METHODS

The patients who were admitted to the Malatya Training and Research Hospital between September and December 2020, had a positive SARS-CoV-2 nasopharyngeal reverse transcription-polymerase chain reaction result, and had undergone thoracic CT, were included in the study. The thoracic CT scans without respiratory artifacts were evaluated, and anteroposterior (AP) and transverse diameters of the trachea were measured at the thyroid and bifurcation levels.

RESULTS

We believe that a tracheal AP diameter of >20 mm at the thyroid level and a tracheal AP diameter of 18 mm at the thyroid bifurcation level (according to Group 3 and Group 4) may be indicators of poor prognosis. In terms of survival, a tracheal AP diameter of >18 mm at the bifurcation level can be considered as a poor prognostic factor.

CONCLUSIONS

The tracheal diameter may increase in proportion to the severity of inflammation, indicating or accompanying a poor prognosis. Patients with extensive involvement should be monitored closely for the development of tracheal stenosis.

Clinical characteristics and prognosis of cardiac tamponade patients: 5‑year experience at a tertiary center

BACKGROUND

Cardiac tamponade (CT) is characterized by compression of the cardiac chambers due to pericardial fluid accumulation. The etiology and prognosis may vary in different regions, and thus patient series from various regions can be useful for exploring the etiological and prognostic disparities. The aim of this study was to determine the clinical characteristics of patients with imminent CT, to evaluate the diagnostic performance of biochemical, microbiologic, and pathologic laboratory analysis, and to ascertain the prognosis of CT patients.

METHODS

We enrolled all patients with imminent CT who underwent percutaneous pericardiocentesis between July 2012 and December 2017 in this retrospective study. The patients were classified into three etiology groups: (a) malignancy (MRCT); (b) iatrogenic/mechanical complication of myocardial infarction (IMCT); and (c) other causes (OCT). Clinical information, laboratory findings, and survival data were recorded.

RESULTS

In total, 186 pericardiocentesis procedures were performed on 153 consecutive patients with CT. The median follow-up was 137 days (range: 1-1937). The MRCT group had the highest mortality rate (79%) in 12 months, while the OCT group had the lowest rate (27%). We determined that increased age, higher serum urea levels, and malignancy-related CT were independent predictors of mortality. The mortality rates of the MRCT and IMCT groups were similar, with both of them being significantly higher than the rate of the OCT group. In all, 15 patients were diagnosed with a new malignancy via pericardial fluid cytology.

CONCLUSION

Patients in the MRCT and IMCT groups had a poor prognosis. The presence of malignancy was found to be the most powerful predictor of mortality in CT patients.

Long-term vitamin-K antagonist use and coronary artery calcification

BACKGROUND

The aim of this study was to investigate the impact of vitamin K antagonist (VKA) therapy on coronary artery calcification (CAC) by comparing long-term VKA users with metallic prosthetic valves (MPVs) and VKA-free patients undergoing coronary calcium scoring for cardiovascular (CV) risk stratification.

METHODS

A total of 108 patients (43 VKA users with MPV and 65 gender-, age-, and risk-factor-matched VKA-free patients) were included in the study. CAC was determined via computed tomography (CT) and quantified on the basis of the Agatston score. The VKA group comprised patients who had an MPV for longer than 5 years, which entailed long-term VKA use.

RESULTS

Long-term VKA users had more calcified coronary arteries compared with the control group (178.1 ± 278 vs. 61.1 ± 130.6, p = 0.01). There was no difference between groups in terms of traditional CV risk factors. The mean duration of VKA use was 15 ± 7 years for the patients with MPV. There was no correlation between the duration of VKA use and mean Agatston score (r = 0.2, p = 0.215).

CONCLUSION

With its unique selection of patient groups, our study extends the findings of previous research that long-term VKA use is related to CAC as detected via CT scanning. The longer and more potent VKA regimen required for MPV patients is the primary cause of CAC in this group.

Ecological Risk Assessment of HCH and DDT Residues in a Sediment Core from the Küçükçekmece Lagoon, Turkey

The residues of organochlorine pesticides (HCHs and DDTs) in a dated (¹³⁷Cs and ²¹⁰Pb) sediment core from the Küçükçekmece Lagoon, an urban lake at the southern entrance of the future Canal Istanbul Project, an artificial watercourse, were analyzed with the gas chromatograph equipped with electron capture detector (GC ⁶³Ni-ECD). Concentrations of ∑HCH and ∑DDT along the core varied between 0.4 and 469.4 (average 51.4) ng g^-1 dw, and between 0.5 and 72.0 (average 7.4) ng g^-1 dw, respectively. α-HCH was the predominant isomer (98%) and followed by γ-isomer (2%). The highest concentrations of technical HCH were found in the sediments dated 1963-1972, whilst the DDT concentrations had their maximum around 1945. The highest concentrations of γ-HCH and p,p'-DDT exceeded probable-effect level values which can lead to frequently cause adverse effects on aquatic biota.

Determination of Domoic Acid in Plankton Net Samples from Golden Horn Estuary, Turkey, Using HPLC with Fluorescence Detection

This study focused on the fluctuations of domoic acid (DA) levels in plankton net samples collected from the Golden Horn Estuary (GHE), Turkey, between August 2011 and July 2012. DA concentrations were determined by high-performance liquid chromatography (HPLC), using a fluorenylmethoxycarbonyl (FMOC) derivatization technique. Monthly and biweekly data were evaluated with environmental variables, and their influence on DA production is discussed. DA levels in plankton net samples varied between 0.36 and 94.34 µg L^- 1. DA levels showed remarkable seasonal variation and they were generally higher in May, 2012, but no DA was detected between February and April, 2012. DA production was mostly controlled by temperature, with nitrate and silicate limitations being secondary factors that influenced DA concentrations.

CSF flow patterns in the brain in patients with neuro-Behçet disease and Behçet disease

OBJECTIVE

In the etiopathogenesis of Behcet disease (BD) and Neuro-Behcet disease (NBD), vascular eclipse occurs in both the arteries and veins. The disease affects all vascular structures. The present study evaluates the use of Phase Contrast (PC) Cerebral Spinal Fluid (CSF) Flow Magnetic Resonance Imaging (MRI), a non-invasive technique for measuring CSF dynamics, for determining the level of aqueducts that are influenced in BD and NBD.

PATIENTS AND METHODS

The quantitative evaluation of CSF flow in BD and NBD was performed using images obtained at the level of the cerebral aqueduct on the semi-axial plane. The PC-MRI angiography technique was used.

RESULTS

There is no distinctive difference between BD and NBD that can be distinguished by the aqueduct diameters of both conditions. A clear increase in aqueduct diameter occurred BD and NBD group when compared to the control group. While there were no differences found between the BD group and the control group regarding peak velocity, average velocity, forward flow, reverse flow, net forward flow, and flow, there were distinctive increases in these various factors in the NBD group.

CONCLUSIONS

Using the non-invasive PC-MRI technique, this study found that in BD and NBD patients, changes occurred in CSF flow figures. Increases in CSF parameters were also observed in NBD patients, a finding which may be helpful for future distinction between BD and NBD during diagnosis.

Evaluation of sediment contamination by monoaromatic hydrocarbons in the coastal lagoons of Gulf of Saros, NE Aegean Sea

The concentrations and distribution of monoaromatic hydrocarbons (benzene, toluene, ethyl benzene and the sum of m-, p- and o-, xylenes) were determined in the sediments of coastal lagoons of the Gulf of Saros, using a static headspace GC-MS. The total concentrations of BTEX compounds ranged from 368.5 to below detection limit 0.6μgkg^-1 dw, with a mean value of 61.5μgkg^-1 dw. The light aromatic fraction of m-, p-xylene was the most abundant compound (57.1% in average), and followed by toluene (38.1%)>ethylbenzene (4.1%)>o-xylene (2.5%)>benzene (1.1%). The factor analysis indicated that the levels and distribution of BTEX compounds depend on the type of contaminant source (mobile/point), absorbance of compounds in sediment, and mobility of benzene compound and degradation processes. Point sources are mainly related to agricultural facilities and port activities while the dispersion of compounds are related with their solubility, volatility and effect of sea/saline waters on lagoons.

The First Observation of Domoic Acid in Plankton Net Samples from the Sea of Marmara, Turkey

This study reports the first evidence of domoic acid (DA), an algal neurotoxin produced by the genus Pseudo-nitzschia, from plankton net samples collected in the Sea of Marmara in December, 2010 and February, 2011. DA concentrations of plankton net samples were analyzed by high-performance liquid chromatography (HPLC), using the fluorenylmethoxycarbonyl fluorescence derivatization technique (detection limit 0.2 ng DA). The biotoxin concentrations in samples from coastal waters varied between 0.96 and 5.25 µg DA/mL. We also investigated possible correlations between physicochemical parameters and DA concentration. The DA levels appear to be correlated negatively with silica and nitrite concentrations for both sampling periods. These data may be used to evaluate the probability of finding similar conditions in coastal waters of the Sea of Marmara in order to determine the potential risks to local aquaculture and fisheries.