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Placenta previa percreta with bladder ınvasion: ultrasound and mrı findings

Placenta previa percreta is an abnormal placental implantation due to decidual deficiency. Placenta previa percreta with invasion of the urinary bladder is an uncommon and serious condition if not recognized before delivery. We report color Doppler ultrasound (CDUS) and magnetic resonance imaging (MRI) findings in two cases of placenta previa percreta with bladder invasion. Both cases presented with sudden painless vaginal bleeding and had previous cesarean delivery. CDUS and MRI findings are helpful for the prenatal diagnosis of plasenta previa percreta with invasion of the urinary bladder to prevent perinatal complications with this condition. 

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A study of distal sensory nerves in patients with newly diagnosed asymptomatic type 2 DM

Aim: This study aimed to determine the importance of Medial Plantar (MP), Dorsal Sural (DS) and Medial Dorsal Cutaneous (MDC) sensory nerve conduction studies in addition to the other routine electrophysiological studies performed in newly diagnosed Type II Diabetes Mellitus (DM) for diagnosing diabetic polyneuropathy (PNP) at an early stage. Material and Method: This study included a total of 35 patients aged less than 60 years with newly diagnosed, untreated Type II Diabetes, and 30 healthy volunteers who applied to the Outpatient Clinic of Internal Medicine and Endocrinology at Şanlıurfa Training and Research Hospital and Harran University Faculty of Medicine Research and Application Hospital between April 2014 and August 2014. Results: Our study enrolled a total of 35 Type II Diabetes patients (20 females, 15 males) with a mean age of 47.22±8.15 years, and 30 healthy controls (17 females and 13 males) with a mean age of 49.30±6.56 years. The two groups did not significantly differ with respect to age and sex (p>0.05). MP, MDC, and DS sensory nerve conduction studies, performed additionally to the standard PNP protocol, revealed that the amplitudes and conduction velocities of each of the three nerves were significantly lower than those of the control group (p<0.01). Discussion: It is possible to diagnose diabetic PNP at an early, asymptomatic stage by studying sensory nerves conduction properties of MP, MDC, and DS in addition to the standard electrophysiological PNP protocol. Detection of PNP by these methods at an early stage may help taking measures to prevent progression into symptomatic PNP

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Computed Tomographic Based Determination with all Aspect of Spontaneous Passage of Ureteral Stone

Aim: The objective of this study is to determine tomographic measurement parametres that are effective on spontaneous passage (SP) of ureteral stones in patients who will undergo unenhanced multidetector computed tomographic examinations (MDCT). Material and Method: The patients who presented with complaints of renal colic to our clinic during 2013-2015 were retrospectively evaluated. The medical files of 813 patients were reviewed and the medical records of 331 cases who had undergone CT were examined. A total of 217 patients whose stone size was less than 10 mm were included in the study. The patients whose stones passed were included in Group 1, and those whose stones did not pass spontaneously were included in Group 2. Data about age and gender of the patients, location, laterality, history of spontaneous stone passage from the ipsilateral side, ureteroscopy, shock wave lithotripsy (SWL), anteroposterior (AP) diameter of the renal pelvis, diameter of the stone as measured on coronal and axial planes, stone volume, and average thickness of the renal parenchyma were evaluated. Parametres effecting passage of the stone were statistically analysed. Results: The mean age of the patients (female, n=152, and male, n=65) was 42.3 years. The patients had upper (n=73) and lower (n=144) ureteral stones. The median diameter of the renal pelvis (17.2 mm), stone diameter on the coronal plane (6.1 mm) and the axial plane (4.6 mm), and thickness of the renal parenchyma (20 mm) were measured. Statistical analysis revealed that the location, volume, diameter of the stone on the coronal and axial planes were influential factors on spontaneous stone passage. In logistic regression analysis, only the location of the stone and its diameter on the coronal plane were found to be independent effective factors on spontaneous stone passage. Discussion: In our study based on data retrieved from MDCT, the location and size of the stone were found to be independent factors affecting spontaneous stone passage. However, a surprising result is that the AP diameter of renal pelvis and renal parenchymal thickness, both of which are factors important for urologists, were not effective on SP.

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