BACKGROUND AND OBJECTIVES: Balloon sizing remains the main technique for determining occluder device size for atrial septal defects (ASDs). New evidence has proposed that accurate estimation of device size could be possible without using the balloon technique. Operators have predicted the amount of possible enlargement depending on their experiences. Thus, selection criteria have mostly relied on personal observations and experiences. The objective of this study was to determine the relationship between age, sex, defect size, and deployed device size based on the balloon technique. SUBJECTS AND METHODS: Sixty-six patients who underwent percutaneous ASD closure with a Cardi-O-Fix occluder between 2011 and 2012 were retrospectively evaluated. Patients whose maximum defect size and device size were available were included. Enlargement amount (EA) (device size−defect size) and enlargement ratio (ER) (EA/defect size) were calculated. The relationship between these 2 calculations and age, sex, and defect size were analyzed. RESULTS: EA and ER were 5.2±3.6 mm (min: 0, max: 15, median: 5) and 39.3%±31.5% (min: 0, max: 125, median: 32), respectively. EA and ER did not differ between genders (p=0.800; p=0.430). EA and ER were not correlated with maximum defect size (p=0.310; p=0.050). EA and ER showed no correlation with age (p=0.970; p=0.640). However when patients were dichomotized based on age 40, ER was significantly lower in older group (p=0.030). Unexpectedly, no difference was observed between the 2 groups in terms of EA (p=0.110). Size of deployed device had a strong correlation with defect size measured with two-dimensional (2D) transesophageal echocardiography (TEE; device size=1.1177×TEE defect size+3.5297; R=0.84; p<0.010). CONCLUSION: EA and ER did not show a significant correlation with sex and defect size in our study. Patients older than 40 had a significantly lower ER compared to younger patients. Device size was strongly correlated with defect size measured with TEE.
Aged* ; Echocardiography ; Echocardiography, Transesophageal ; Heart Defects, Congenital ; Heart Septal Defects, Atrial* ; Humans ; Patient Selection ; Retrospective Studies

A patient with a 2-year history of pain in the left arm, and decreased strengths unrelieved by non-steroidal anti-inflammatory therapy, was being referred for repeating radiography. The radiologic examinations have demonstrated a unique pattern of non-contiguous osteolysis in the left elbow, proximal and distal radius, ulna, wrist, carpal bones, proximal and distal metacarpals and phalanges. Multi-site biopsies were being performed and confirmed the diagnosis of massive osteolysis. To our knowledge, this is the first case in which multifocal, non-contiguous osteolysis with skip lesions without associated nephropathy and without a hereditary pattern is being described in one extremity.
Adult ; Biopsy, Fine-Needle ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Male ; Osteolysis, Essential/*diagnosis ; Tomography, X-Ray Computed/*methods ; Ulna/*pathology/radiography

Fibroadenoma is the most common breast tumor in women. Malignant transformation occurs rarely within fibroadenoma at older ages. Clinicians, radiologists, and pathologists need to be aware of malignant transformation within fibroadenomas. Radiologic studies play an important role in the diagnosis of fibroadenoma; however, radiologic findings are often nonspecific for malignancy and may appear completely benign. We detected an occult ductal carcinoma in situ that originated inside a fibroadenoma by using shear wave elastography. We report shear wave elastography findings of ductal carcinoma in situ within fibroadenoma and discuss the diagnostic role of this modality.
Breast Neoplasms ; Carcinoma, Intraductal, Noninfiltrating* ; Diagnosis ; Elasticity Imaging Techniques* ; Female ; Fibroadenoma* ; Humans