ORIGINAL ARTICLE PURPOSE We aimed to evaluate the postnatal development and the maturation of the sternum and sternal variations using multidetector computed tomography (MDCT). Additionally, we aimed to examine the roles of gender and age in sternal development. MATERIALS AND METHODSTwo hundred and fifty patients who underwent thorax MDCT examinations were evaluated for sternal development and variations. Coronal curved planar reconstruction and maximum intensity projection images were used to better assess the ossification centers in the manubrium and the body of the sternum. Multiplanar images were used to accurately measure the thickness and the sagittal dimension of the manubrium, the sagittal dimension of the body, and the total sagittal dimension of the sternum in the sagittal plane. RESULTSNo significant differences in the manubrium measurements were observed between the genders. The thickness and sagittal dimension of the manubrium, sagittal dimension of the body, and total sagittal dimension of the sternum in the sagittal plane were significantly different between the age groups. We evaluated the ossification centers; shape and developmental variations in the manubrium and body; direction, calcification, and termination of the xiphoid process; developmental variations in the xiphoid process; and manubriosternal and sternoxiphoidal fusion. Significant variations were observed from person to person. CONCLUSIONThe anatomy and the developmental properties of the sternum should be well understood in cases of potential chest and sternum injuries and in several surgical procedures. Therefore, knowledge of the development and the maturation of the sternum, and sternal variations and anomalies is important. We suggest that the postnatal development and the morphogenesis of the sternum can be adequately assessed using MDCT.T he sternum is a flat bone that extends vertically through the middle of the anterior thoracic cage. The sternum consists of the following three parts: the manubrium, the body, and the xiphoid process (XP) (1, 2). The sternum develops over a long period of time, which begins during the prenatal period and continues through the third and fourth decades of the postnatal period (3-6). Ossification centers in the manubrium and the body form on cartilage plates that are located on both sides of the middle line during the prenatal period. The ossification centers in the manubrium generally merge before birth. Two or more ossification centers that develop on each segment of the mesosternum (body) are referred to as sternebrae, which are located on cartilage plates on both sides of the middle line. From 6-12 years of age, the ossification centers usually merge completely into a single ossification center. The calcification and the fusion of the sternebrae are usually complete by 25 years of age (6-8). Postnatal development, maturation, and ossification center development of the sternum differ significantly from person to person.Several radiographic studies in the literature have evaluated sternal deve...
Licorice originates from the root of Glycyrrhiza glabra, which has a herbal ingredient, glycyrrhizic acid, and has a mineralocorticoid-like effect. Chronic intake of licorice induces a syndrome similar to that found in primary hyperaldosteronism. Excessive intake of licorice may cause a hypermineralocorticoidism-like syndrome characterized by sodium and water retention, hypertension, hypokalemia, metabolic alkalosis, low-renin activity, and hypoaldosteronism. In this case report, an association of hypokalemia, edema, and thrombocytopenia that is developed due to the excessive intake of licorice is presented. There are case reports in the literature, which suggest that toxicity findings may emerge with hyperaldosteronism-like manifestations such as hypokalemia, edema, and hypertension. However, any knowledge of thrombocytopenia as a resultant was not encountered among these reported toxic effects. Our case is important because it shows that the excessive intake of licorice may cause a toxic effect in the form of thrombocytopenia. This report is the first presented case to show thrombocytopenia due to licorice syrup consumption.
Pulmonary agenesis is a rare congenital anomaly, the etiology of which is not clearly known. Other systemic comorbidities such as cardiovascular, gastrointestinal, musculoskeletal, and urogenital system anomalies can be observed in more than half of the patients. It is usually diagnosed during childhood. Diagnosis in adulthood is very rare. We present a case of pulmonary agenesis diagnosed in an adult.
The aim of this work is to describe our experience with the management of osteomas of the fronto-ethmoidal region, and to evaluate the limits and possibilities of different approaches: endonasal endoscopic versus external surgical resection of symptomatic osteomas. A review of 26 patients with detected osteomas in tertiary health care center was accomplished. We analysed the 26 adult patients, which detected paranasal sinus (PNS) osteomas--patients who underwent paranasal sinus CT examinations almost exclusively for other reasons. We analysed the patient's symptoms, localization and size of osteomas, clinical and imaging signs, in relation to adjacent structures. Of the 26 cases, 16 located in the etmoid sinus, eight in the frontal sinus, of which two with orbital one with an ethmoid extension, and one isolated maxillary and sphenoid sinus were involved. We treated 11 patients with endoscopic (eight cases) and external surgical approaches (three cases). Besides this surgical excision; 15 cases were kept in follow up, because of asymptomatic nature of the PNS osteomas or patients lack of consent. While the extranasal approach is still a part of the treatment concept for removing osteomas; over the last years, in suitable cases, the endoscopically controlled endonasal approach has greatly gained importance due to the improved surgical equipment and experience.
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