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PURPOSE: Height age (HA) and bone age (BA) delay is well known in the patients with short stature. Therefore assessing pituitary hypoplasia based on chronological age (CA) might cause overdiagnosis of pituitary hypoplasia. We aimed to investigate the diagnostic and prognostic value of the PH and PV based on CA, HA, or BA in the patients with GHD. METHODS: Fifty-seven patients with severe and 40 patients with partial GHD and 39 patients with ISS assigned to the study. For defining the most accurate diagnosis of pituitary hypoplasia, PH and PV were evaluated based on CA, BA and HA. The relationship of each method with clinical features was examined. RESULTS: The mean PV was significantly larger in patients with ISS compared to the GH-deficient patients. PV was more correlated with clinical features including height SDS, stimulated GH concentration, IGF-1 and IGFBP-3 SDS, height velocity before and after rGH therapy. We found BA-based PV could discriminate GHD from ISS (Sensitivity: 17%, specificity: 98%, positive predictive value: 94%, negative predictive value: 39%), compared to the other methods based on PH or PV respect to CA and HA. 3% of patients with ISS, 17% of patients with GHD had pituitary hypoplasia based on PV-BA. CONCLUSION: PV based on BA, has the most accurate diagnostic value for defining pituitary hypoplasia. But it should be kept in mind that there might be still misdiagnosed patients by this method. PV is also a significant predictor for the rGH response.

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Climatic and altitude features of living region may affect human body. Many changes in several tissues and organs and several health problems due to climatic and altitude effects were defined in the literature. However, there were limited number of studies which evaluated correlation between development of frontal sinus and climatic/altitude effect. In this study, widths, heights, AP lengths and volumes of frontal sinus were compared by Paranasal CT scans in populations living in Van which has colder climate and higher altitude and Manisa which has milder climate and lower altitude. It was found that widths, antero-posterior lengths and volumes of frontal sinus were higher in populations living in colder climate and higher altitude according to populations living in milder climate and lower altitude. Heights of frontal sinuses were on the contrary of this. These results were found appropriate to increasing of cephalic index in cold climate according to Allen's Rule. We suggest that larger population study should be made with peoples having the same or similar race and genetic structure in different climate and altitude regions and the proportional comparison of frontal sinus measurements with cephalic index should be considered in future studies.

Las características climáticas y de altitud de una región pueden afectar al cuerpo humano. En la literatura se han identificado muchos cambios en varios tejidos y órganos, como así también numerosos problemas de salud debido a los efectos climáticos y de altitud. Sin embargo, existe un número limitado de estudios que han evaluado la correlación entre el desarrollo del seno frontal y el efecto climático / altitud. En este estudio, los anchos, alturas, longitudes antero-posteriores y volúmenes de seno frontal se compararon mediante tomografía computarizada paranasal en poblaciones que viven en Van, que tiene un clima más frío y mayor altitud, y Manisa, que tiene un clima más suave y menor altitud. Se encontró que los anchos, las longitudes antero-posteriores y los volúmenes de los senos frontales eran mayores en poblaciones que vivían en un clima más frío y de mayor altitud respecto a poblaciones que vivían en clima más suave y con menor altitud. En relación a la altura de los senos frontales, se dio la situación contraria a lo anterior. Estos resultados se encontraron adecuados con el aumento del índice cefálico en la región de clima frío, de acuerdo con la Regla de Allen. Sugerimos que se realice un estudio poblacional más amplio con poblaciones de raza y estructura genética iguales o similares en diferentes regiones climáticas y de altitud. La comparación proporcional de las mediciones de los senos frontales con índice cefálico debería considerarse en futuros estudios.

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AIM: We aimed to investigate the retrobulbar blood circulation using Colour Doppler Imaging (CDI) in type 1 diabetic children and adolescents who had no diabetic retinopathy and to compare the results with their healthy peers. METHODS: Forty-nine patients with type 1 diabetes mellitus with no retinopathy on fundoscopic examination were included in the study. Forty-nine healthy children were defined as the control group. Central retinal artery (CRA), ophthalmic artery (OA) and posterior ciliary artery (PCA) were examined with Doppler US bilaterally. Peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive indices (RI) for each artery were recorded. RESULTS: Blood flow velocity of the OA was significantly different in diabetic patients (p<0.05). EDV of the OA was significantly higher (p=0.011) and RI was significantly lower (p=0.027) in patients with diabetes duration of longer than 5 years. RI of the CRA was significantly higher in patients who had higher microalbuminuria levels (p=0.016). CONCLUSION: EDV of the OA increases and RI of the OA decreases in diabetes duration longer 5 years. Raised AER increases RI of the CRA. These findings may be the initial changes in the arterial circulation before vascular rigidity develops.

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Carbon monoxide (CO) intoxication is usually a serious condition, which can result in neurological disturbances or death. In some patients with CO intoxication, but not usually, a biphasic pattern can be seen. In this condition, after antitoxic treatment, patients may completely recover and after a short recovery period, neurological and/or psychiatric symptoms appear again. This condition is known as delayed encephalopathy and its occurrence rate is between 0.06% and 11.8%. Herein, we report a case with delayed encephalopathy after CO intoxication, which began with neurological symptoms and continued with obsessive-compulsive disorder, depression, kleptomania, and psychotic disorder. The 41-year-old female patient had no psychiatric or neurological symptoms or disorders prior to CO intoxication. Increased signal intensity changes in the basal region of the left temporal lobe (including the cortex and subcortical white matter), globus pallidus (bilateral), and cerebellar cortical and subcortical white matter (bilaterally symmetrical) was detected on axial T2-weighted magnetic resonance imaging (MRI). In addition, there were atrophic changes in both cerebellar hemispheres. To the best of our knowledge, this is the first case of kleptomania described after CO intoxication in the literature. We discuss the organic etiology of kleptomania and the other psychiatric symptoms of this patient in the light of recent research. We concluded that the kleptomania seen in this patient was related to concurrent lesions in the temporal lobe and globus pallidus; in other words, her kleptomania may have been related to dysfunction simultaneously seen in both the temporolimbic and frontal-subcortical circuits.

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A case of pseudo-pseudohypoparathyroidism (PPH) with shortening of the left femur and tibia and coalition of the base of the fourth metacarpals with capitatum and hamatum in bilateral wrist joints was presented. Involvement of the fourth digits both in hands and feet were more prominent on the left side, with shortening of the left leg.

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The aim of the study was to define a simple system for the identification of unknown bodies by using CT images of frontal sinus and to discuss whether it was worth to add measurements to the system or not. The system was including simple features as F (presence or absence of frontal sinus), S (intersinus and intrasinus septum) and S (scalloping), and named as FSS system. Measurements selected for the study were width, height, anteroposterior length, total width of two sinuses, the distance between the highest points of the two sinuses and the distance of each sinus to its maximum lateral limit. The study was conducted retrospectively on the paranasal CT scans of 100 cases (38 male and 62 female) who had no apparent sinonasal pathology. All the features and measurements were coded according to the system defined by the authors for each case and coded formulas were compared. At least 93% of the formulas could be eliminated for a case by using FSS system. The rate of success was increased to 98% by adding measurements. Contrary to objective criteria of FSS system, measurements were prone to bias. Therefore, in practice success rate would be expected to be lower than calculated. In the study population, instead of making 100 measurements, eliminating the most of the cases with FSS system and later discriminating the rest by pattern matching was seen logical.

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Ochronosis is a rare hereditary disorder of tyrosine metabolism. Severe degenerative arthritis and spondylosis occur in the later stages of this disease. Radiologic examinations may reveal changes considered almost pathognomonic for ochronosis. We present the radiologic features of the lumbar spine in two ochronotic patients who were diagnosed after radiologic examinations in the late stages of the disease.

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