Ganglion cysts usually arise from the tissues around the facet joints. It is usually associated with degenerative cahanges in facet joints. Bilateral thoracic ganglion cysts are very rare and there is no previous case that located in bilateral intervertebral foramen compressing the L1 nerve root associated with severe radiculopathy. We report a 53 years old woman who presented with bilateral groin pain and severe numbness. Magnetic resonance imaging revealed bilateral cystic mass in the intervertebral foramen between 12th thoracal and 1st lumbar vertebrae. The cystic lesions were removed after bilateral exposure of Th12-L1 foramens. The result of hystopathology confirmed the diagnosis as ganglion cyst. The ganglion cyst may compromise lumbar dorsal ganglion when it located in the intervertebral foramen. The surgeon should keep this rare entity in their mind for differential diagnosis.
Diagnosis, Differential ; Female ; Ganglion Cysts ; Groin ; Humans ; Hypesthesia ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; Radiculopathy ; Synovial Cyst ; Zygapophyseal Joint

Brucellosis is caused by gram-negative, aerobic, non-motile, facultative, intracellular coccobacilli belonging to the genus Brucella. A 50-year-old man working as an employee was admitted to neurosurgery clinic with severe low back, radicular right leg pain and hypoesthesia in right L4-5 dermatomes for 2 months. Brucella tube agglutination (Wright) test was positive in serum sample of the patient with a titer of 1/640. Brucella melitensis was isolated from blood culture. X-ray and MRI of the lomber spine showed massive collapse of L4 vertebral body. Neural tissue was decompressed and then posterior L3-5 short segment transpedicular screw fixation and stabilization was performed. Brucella melitensis was isolated from microbiologic culture of pathologic specimen. Antibiotic therapy was given as doxycycline 200 mg/day and rifampicin 600 mg/day for 6 months. Brucellosis is a systemic zoonotic infection and still an important public health problem in many geographical parts of the world. Vertebral body collapse caused by brucellosis occurs very rarely but represents a neurosurgical emergency because of its potential for causing rapidly progressive spinal cord compression and permanent paralysis. Neurosurgeons, emergency department personnel as well as infectious disease specialists should always keep a high index of suspicion and include brucellosis in the differential diagnosis of vertebral body collapse.
Agglutination ; Brucella ; Brucella melitensis ; Brucellosis* ; Communicable Diseases ; Diagnosis, Differential ; Doxycycline ; Emergencies ; Emergency Service, Hospital ; Humans ; Hypesthesia ; Leg ; Magnetic Resonance Imaging ; Middle Aged ; Neurosurgery ; Paralysis ; Public Health ; Rifampin ; Specialization ; Spinal Cord Compression ; Spine ; Zoonoses

No abstract available.
Adenocarcinoma/*complications/diagnosis ; Aged ; Esophageal Achalasia/diagnosis/*etiology/physiopathology ; Esophageal Sphincter, Upper/physiopathology ; Humans ; Lung Neoplasms/*complications/diagnosis ; Male ; Neoplasm Staging ; Predictive Value of Tests ; Risk Factors ; Tomography, X-Ray Computed

No abstract available.
Alien Hand Syndrome* ; Emigrants and Immigrants* ; Humans

Methods: A consecutive series of 141 patients who attended the neurosurgery outpatient clinic between April 2017 and September 2017 for nonspecific LBP were evaluated. Sixty-one patients with single-level Modic type I or I/II change constituted the patient group. Eighty age-, gender-, and body mass index (BMI)-matched patients without any Modic changes were recruited as the control group. A retrospective review was performed in 61 patients with Modic changes and 80 controls without Modic changes. The percentage of fatty muscle degeneration was graded by two reviewers using T2-weighted axial images at the L4–L5 level. The system was graded as follows: grade 0, normal; grade I, minimal focal or linear fat deposition; grade II, up to 25%; grade III, 25%–50%; and grade IV, more than 50%. Results: Sixty-one patients with nonspecific LBP and Modic type I or I/II change and 80 patients without Modic changes were evaluated. There was no difference between these groups in terms of age, gender, and BMI distribution. The mean muscle cross-sectional area in the patient and control groups were 1,507.37±410.63 and 1,681.64±379.69. Regarding fatty degeneration, a chi-square test of homogeneity was run, and the two multinomial probability distributions were not equal within the population analyzed. Conclusions The novel finding of this investigation is that patients with Modic type I and I/II changes have greater amounts of fatty degeneration in their lumbar paraspinal musculature.

BACKGROUND AND OBJECTIVES: Genetic predisposition is an important risk factor for coronary artery disease (CAD). In this study, we aimed to evaluate the impact of rs10757274 and rs2383206 polymorphisms in chromosome 9p21 on presence and severity of CAD in a Turkish population. SUBJECTS AND METHODS: A total of 646 patients who underwent coronary angiography were included in this study. Coronary vessel score and Gensini score were calculated to assess the angiographic severity of CAD. Alleles of AA, AG, and GG were determined for rs10757274 (polymorphism-1) and rs2383206 (polymorphism-2) polymorphisms located in chromosome 9p21 from the blood samples. RESULTS: There was a significant difference between the alleles in polymorphism-1 in the presence of coronary artery disease (38.9% in AA, 48.0% in GG and 56.4% in AG, p=0.017). However, there was no difference between the alleles in polymorphism-2. According to vessel scores, there was a significant difference between the alleles in polymorphism-1 (AA 0.71±1.04, GG 0.88±1.07, AG 1.06±1.12, p=0.018). In polymorphism-2, vessel scores did not show a difference between the alleles. In polymorphism-1, there was a significant difference in Gensini score (p=0.041). Gensini scores did not differ between the alleles in polymorphism-2 (p>0.05 for all). In multivariate analyses, none of the alleles was an independent factor for presence of CAD. CONCLUSION: The presence of rs10757274 polymorphism including AG allele in chromosome 9p21 was related to CAD. However, this relationship was not independent of other cardiovascular risk factors.
Alleles ; Atherosclerosis ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Genetic Predisposition to Disease ; Genetics ; Humans ; Multivariate Analysis ; Risk Factors

BACKGROUND AND PURPOSE: Multiple sclerosis (MS) is an autoimmune disease characterized by inflammatory demyelination. Recent studies have shown that long-term exposure to air pollutants (including PM10 particulates) is potentially an environmental risk factor for MS. We aimed to determine the prevalence rates of MS in two cities with different levels of air pollution. METHODS: This door-to-door population-based study was conducted between April 2014 and June 2015. Two cities were screened for the prevalence rates of MS: 1) Karabük, which borders an iron-and-steel factory, and 2) Akçakoca, which is a coastal city located in the same region. A validated survey form was used for screening MS. The 2010 McDonald Criteria were used for diagnosing MS. The patients were examined twice, first by a neurology assistant in the field and then by a senior neurologist in public health centers in the cities. RESULTS: The prevalence of MS was 95.9/100,000 in Karabük and 46.1/100,000 in Akçakoca. In total, 33 patients were diagnosed with clinically definite MS. The female/male ratio was 1.5, and 21 patients were diagnosed with relapsing-remitting MS, 9 with secondary progressive MS, and 3 with primary progressive MS. CONCLUSIONS: We found that the prevalence of MS was more than two fold higher in Karabük than in Akçakoca, which supports a link between air pollution and the pathogenesis of MS. However, larger etiological and epidemiological studies are needed to confirm this hypothesis.
Air Pollutants ; Air Pollution ; Autoimmune Diseases ; Demyelinating Diseases ; Epidemiologic Studies ; Humans ; Iron* ; Mass Screening ; Multiple Sclerosis* ; Neurology ; Prevalence* ; Public Health ; Risk Factors ; Steel* ; Turkey

PURPOSE: . To evaluate and compare the effect of impression type (conventional vs digital) and the number of implants on the time from the impressions to the generation of working casts of mandibular implant-supported fixed completearch frameworks, as well as on patient satisfaction. MATERIALS AND METHODS: . 17 participants, 3 or 4 implants, received 2 types of digital impression methods (DI) and conventional (CI). In DI, two techniques were performed: scanning with the scan bodies (SC) and scanning with a device attached to the scan bodies (SD) (BR 10 2019 026265 6). In CI, the making of a solid index (SI) and open-tray impression (OT) were used. The outcomes were used to evaluate the time and the participant satisfaction with conventional and digital impressions. The time was evaluated through the timing of the time obtained in the workflow in the conventional and digital impression. The effect of the number of implants on time was also assessed. Satisfaction was assessed through a questionnaire based on seven. The Wilcoxon test used to identify the statistical difference between the groups in terms of time. The Mann-Whitney test was used to analyze the relationship between the time and the number of implants. Fisher's test was used to assess the patient satisfaction (P <.05). RESULTS: . The time with DI was shorter than with CI (DI, x~=02:58; CI, x~=31:48) (P <.0001). The arches rehabilitated with 3 implants required shorter digital impression time (3: x~=05:36; 4: x~=09:16) (P <.0001). Regarding satisfaction, the DI was more comfortable and pain-free than the CI (P <.005). CONCLUSION . Digital impressions required shorter chair time and had higher patient acceptance than conventional impressions.

PURPOSE: The purpose of this diagnostic study was to assess the accuracy and time efficiency of a digital method to draw the denture foundation extension outline on preliminary casts compared with the conventional technique. MATERIALS AND METHODS: A total of 28 preliminary edentulous casts with no anatomical landmarks were digitized using a laboratory scanner. The outlining of the entire basal seat of the denture was performed on preliminary casts and digitized. Casts with no extension outline were digitized and outlines were drawn using software (DWOS, Straumann). The accuracy of the extension outlined between both techniques was evaluated in the software (GOM Inspect; GOM GmbH) by file superimposition. Specificity and sensitivity tests were applied to measure accuracy. The paired t-test (95% CI) was used to compare the mean total area and the working time. RESULTS: The accuracy ranged from 0.57 to 0.92. The buccal and labial frenulum showed a lower value in the maxilla (0.57); while the area between the retromolar pad and buccal frenulum (0.64) showed a lower score in the mandible. The maxillary denture foundation and the working time for both arches were significantly longer for the digital method (P < .001). CONCLUSION The denture foundation extension outline exhibited a sufficiently excellent accuracy for the digital method, except for the maxillary anterior region.However, the digital method required a longer working time.