Aim: The present study evaluated the effect of differences in the peak systolic velocity (PSV) and resistive index (RI) in the testicular artery (TA), capsular artery (CA), and intratesticular artery (ITA) after microscopic subinguinal varicocelectomy (MSV) on postoperative pain and semen parameters. Patients and Methods: Scrotal color Doppler ultrasound (CDUS) measurements were made in 33 patients (age 18-31 years) prior to MSV and 3 and 6 months after MSV. Pain was recorded using a visual analog scale and sperm concentration was determined to analyze the predictive value of the CDUS parameters regarding surgical outcome. Results: A significant decrease in pain scores was observed in most patients at both follow-ups. The first postoperative CDUS revealed a significant increase in the TA-PSV (p<0.001) and a decrease in the TA-RI (p=0.002) and CARI (p=0.006). The second postoperative CDUS also revealed a significant increase in the TA-PSV and a decrease in the TA-RI, and the PSV in the ITA and CA and RI in the ITA and CA were significantly different from the values obtained pre-operatively and at the first follow-up. A negative correlation was found between the pain level and TA-PSV (r=-0.433, p=0.012), whereas sperm concentration positively correlated with both the TA-PSV and CA-PSV (r=0.534, p=0.001 and r=0.455, p=0.008, respectively).Conclusions: The PSV and RI are useful parameters for detecting changes in testicular microhemodynamics after MSV. In addition, the TA-PSV and CA-PSV can be used to predict improvements in pain and sperm concentration.

BackgroundIn the present study, the role and efficiency of strain elastography (SE) were evaluated in diagnosis and staging of acute appendicitis in pediatric patients.Material/MethodsWe enrolled 225 pediatric patients with suspected clinical and laboratory findings of acute appendicitis. Gray-scale sonographic findings were recorded and staging was made by the colorization method of SE imaging. Appendectomy was performed in all patients and the results of the surgical pathology were compared with the imaging findings. The sensitivity, specificity, and accuracy of SE imaging were determined in terms of evaluating the “acute appendicitis”.ResultsSonographic evaluation revealed acute appendicitis in 100 patients. Regarding the SE analysis, cases with appendicitis were classified into 3 groups as: mild (n=17), moderate (n=39), and severe (n=44). The pathological evaluation revealed 95 different stages of appendicitis and normal appendix in 5 cases: acute focal (n=10), acute suppurative (n=46), phlegmonous (n=27), and perforated (n=12), regarding the results of surgical pathology. Five patients with pathologically proven “normal” appendix were noted as “mild stage appendicitis” based on gray scale and SE analysis. In total, when gray-scale and SE results were compared with pathology results regardless of the stage of appendicitis, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rates were 96%, 96%, 95%, 96.8%, and 96%, respectively. No statistically significant difference was detected between other groups (P<0.05).ConclusionsIn acute appendicitis, the use of SE imaging as a supportive method for the clinical approach can be useful in diagnosis, and its results are closely correlated with the histopathologic stage of appendix inflammation.

Synovial hemangiomas are rare benign tumors of vascular origin. A 23-year-old boy presented with knee pain and swelling. The boy had developed symptoms 18-months earlier. He was diagnosed with synovial hemangioma based on magnetic resonnance imaging examination and histopathologic findings of the arthroscopic biopsy tissue. We present the magnetic resonance imaging and histopathologic findings of synovial hemangioma of the knee.

Psoriasis is a chronic inflammatory disease affecting up to 3% of the general population. The disease is multifactorial; genetic and environmental factors play a role in the pathogenesis. 1 Nail involvement is observed in 10% of psoriatic patients, but the risk of occurrence of such changes during a patient's lifetime may be as high as 80%-90%. 2 Nail psoriasis has a significant negative impact on quality of life, and it may also be considered an indicator for patients at risk for future psoriatic joint damage. 3,4 The severity of nail psoriasis is evaluated using the Nail Psoriasis Severity Index (NAPSI). This index evaluates the matrix of each nail from 0 to 4 (pitting, leuconychia, red spots in the lunula, and nail plate crumbling) and the bed of each nail from 0 to 4 (onycholysis, splinter haemorrhages, subungual hyperkeratosis and oil spot/salmon patch). Although NAPSI is an objective and reproducible tool for calculating the degree of nail involvement, it is time-consuming. 5 Ultrasound is a useful, non-invasive and inexpensive imaging tool for screening superficial tissues, such as nails. 6,7 Shear-wave elastography (SWE) is a newer, cost-effective diagnostic ultrasound technique that assesses tissue stiffness and thickness. It has many advantages, such as real-time B-mode imaging, lack of operator

In this retrospective study, an unenhanced DECT was found to be accurate for in vivo determination of stone type, and thus it can be used easily without any extra burden to the patient or cost while providing additional information.