A neck mass with brachial plexus injury: Pott's disease

Tuberculous osteomyelitis of the spine is most commonly seen in lower thoracic and lumbar vertebrae. Cervical spine tuberculosis is a very rare condition, and it represents a very small part of all patients with Pott's disease. We present a case with thoraco-cervical Pott's disease, with left-sided neck mass and left ann and hand weakness and numbness. The patient had a paraspinal abscess under the sternocleidomastoid muscle that was compressing the brachial plexus. (C) 2009 Elsevier Inc. All rights reserved

Expression of cyclooxygenase-1 and 2 in chronic tonsillitis

Objectives: Prostaglandins are critical mediators of inflammation and affect both humoral and cell-mediated immune responses. Recent findings show that T and B cells express COX-2 upon activation. The purpose of this study is to investigate the potential occurrence of COX-1 and COX-2 immunoreactivity in cases of chronic tonsillitis and to determine the sites of their expression. In addition, their expression in adult patients is compared with that in child patients. Materials and Methods: Immunohistochemical techniques were used to evaluate the expression of the enzymes COX-1 and COX-2, in chronic tonsillitis tissue specimens from adults (n = 15) and children (n = 15). Results: There was no staining in surface epithelium or reticulated crypt epithelium. COX-1 and COX-2 expressions were observed mainly in the intraepithelial lymphoid cells in reticulated crypt epithelium and subepithelial cells. Also, COX-1 and COX-2 stained cells were found in the germinal center. There was no difference of the expressions of COX-1 and COX-2 among adults and children. The only significant difference noted between the adults and children was that, the adults had rich subepithelial plasma cells. Conclusion: Activated B and T cells express COX-1 and COX-2 in paraffin-embedded tissue sections of chronic tonsillitis. Further studies need to be performed to elucidate expression of COX enzymes and their immunologic role in tonsil diseases. They will play an important role in the treatment of chronic tonsillitis. Additional studies are warranted to study the effects of NSAIDs and selective COX-2 inhibitors in chronic tonsilliti

Grisel’s Syndrome: A Rare Complication following Adenotonsillectomy

Grisel’s syndrome is a nontraumatic atlantoaxial subluxation which is usually secondary of an infection or an inflammation at the head and neck region. It can be observed after surgery of head and neck region. Etiopathogenesis has not been clearly described yet, but increased looseness of paraspinal ligament is thought to be responsible. Patients typically present with painful torticollis. Diagnosis of Grisel’s syndrome is largely based on suspicion of the patient who has recently underwent surgery or history of infection in head and neck region. Physical examination and imaging techniques assist in diagnosis. Therefore, clinicians should be aware of acute nontraumatic torticollis after recently applied the head and neck surgery or undergone upper respiratory tract infection. In this paper, a case of an eight-year-old male patient who had Grisel’s syndrome after adenotonsillectomy is discussed with review of the literature

The effects of caspofungin and voriconazole in an experimental fungal infection of the ear due to Aspergillus

The purpose of the study was to evaluate the effectiveness of caspofungin and voriconazole in the treatment of experimental Aspergillus otits media in an experimental rabbit model. A total of 30 New Zealand white rabbits were divided into four treatment groups and one control group. The rabbits were immunosuppressed by cyclophosphamide and triamcinolone acetonide. The right ear of each rabbit was infected by an injection of the inoculum of 0.1 ml (8.6 x 103 CFU/0.1 ml) of Aspergillus fumigatus into the middle ear cavity. At 72 h after the inoculation, amphotericin B 1 mg/kg per day (n = 6), itraconazole 10 mg/kg per day (n = 6), voriconazole 10 mg/kg per day (n = 6) and caspofungin 5 mg/kg per day (n = 6) were injected to each treatment group. No antifungal drug was administered to the control group (n = 6). Clinical and histopathological examination scores and microbiological analysis of middle ear mucosa were compared.There was statistically significant difference in the clinical scores, histopathological scores, and mean CFU/g between the treatment and control groups (P < 0.05). There was no statistically significant difference among the treatment groups in the clinical and histopathological scores, whereas there was statistically significant difference in the mean CFU/g (P < 0.05). The mean CFU/g of amphotericin B and caspofungin groups were similar and both were lower than the itraconazole and voriconazole groups. Also, the mean CFU/g of voriconazole group was lower than the itraconazole group (P < 0.05). Caspofungin and voriconazole were demonstrated at least as effective as amphotericin B and itraconazole. We suggest that caspofungin and voriconazole may be considered for the treatment of fungal infection of the ear

Resting Metabolic Rate and Anthropometric Measurements in Male Sleep Apnea Patients

Objective Obstructive Sleep Apnea Syndrome (OSAS) is a common sleep-related breathing disorder. Associations among Apnea-Hypopnea Index (AHI), Resting Metabolic Rate (RMR), body habitus differences, and otorhinolaryngologic abnormality may clarify the characteristics of patients with OSAS. In order to test this hypothesis, we aimed to compare the RMR, Modified Mallampati Scores (MMS), anthropometric measurements and body composition of male OSAS patients with simple snorers and to investigate the association among these parameters

The prevalence of obstructive sleep apnoea syndrome in ankylosing spondylitis patients

Objective. To assess the prevalence of obstructive sleep apnoea syndrome (OSAS) in AS patients

Prevalence of Sleep Disordered Breathing Symptoms and Their Relation with Concomitant Diseases in Afyon, Turkey: A Population Based Study

Objective: To estimate the prevalence of symptoms of sleep-disordered breathing (SDB) and to evaluate the relationship between these symptoms and concomitant systemic disorders in Turkish adults. Material and Methods: A sample group representing whole Afyon city filled, a questionnaire consisting of questions about demographic features, SDB symptoms and concomitant diseases. Body mass indices of the subjects were calculated. Results: There was no significant difference for snoring between males and females, whereas witnessed apnea and excessive daytime sleepiness were significantly higher in females. Obesity was more prevalent among females. SDB symptoms were more common among obese subjects. Diabetes (DM), hypertension (HT), hyperlipidemia and congestive heart failure (CHF) were significantly more prevalent among snorers. There was a 1.7 folds increase in HT risk and a 1.4 folds increase in DM risk in snorers. We also found a 1.4 folds increased risk for hyperlipidemia and 2.1 folds increased risk for CHF in our snorer population. Snoring and witnessed apnea were found as risk factors for hypertension independently from smoking status. BMI and age. Conclusion: The frequency of SDB symptoms were high in Afyon city, with a greater than expected rate for females. Snoring and witnessed apnea were found as independent risk factors for hypertension

Inner Ear Involvement in Children with Familial Mediterranean Fever

OBJECTIVE: Familial Mediterranean fever (FMF) is the most common and best understood disease of hereditary periodic fever syndromes. Various degrees of sensorineural hearing loss can be seen in the progression of some hereditary periodic fever syndromes. There are very limited and controversial studies in the literature with regard to hearing loss in patients diagnosed with FMF. We aimed to evaluate cochlear function in children with FMF. MATERIALS and METHODS: Forty-nine patients diagnosed with FMF and 49 age- and sex-matched controls were included in the study. All of the children had undergone a routine ear-nose-throat examination. Patients with pathological findings in the otologic examination or a history of recurrent otitis media; using proven ototoxic drugs; or having an abnormal tympanometry finding were excluded from the study. Following audiologic evaluation, tympanometry and distortion product otoacoustic emissions testing were conducted on all subjects. Pure-tone and high-frequency audiometry were carried out on 40 subjects from both groups who could cooperate in the testing. RESULTS: Hearing thresholds of FMF patients were found to be increased at all frequencies (250 to 16,000) (p<0.001). The difference between the hearing thresholds of the two groups could be seen more prominently at higher frequencies, and despite a statistically significant difference, the hearing thresholds of the two groups were within the normal range of tonal audiometry frequencies. In the otoacoustic emission evaluation, the distortion products and signal/noise ratio of children with FMF were lower in the tested frequencies from 1000 to 4000 Hz (p<0.001). CONCLUSION: Our results demonstrated that FMF disease may cause hearing loss in children with FMF. Hearing loss in children with familial Mediterranean fever has been observed, showing increased hearing thresholds at all frequencies in audiometry, together with decreased distortion products and signal: noise ratios, demonstrated by distortion product otoacoustic emissions testing. We think this might be due to cochlear involvement. Regular follow-up of auditory function in FMF children may be helpful for determining early possible hearing loss

Is neck dissection necessary in early stage lower lip carcinomas necessary?

Lower lip tumours are the most common among the oral cavity tumours. The purpose of this article is to analyse neck metastasis rates of early stage lower lip carcinomas and to evaluate possible related histological parameters with neck metastasis. The dissection types, preoperative detection of lymphadenopathy by palpation or computed tomography (CT), tumour sizes and tumour histological differentiation degrees of 37 patients were reviewed retrospectively. In addition, an experienced pathologist re-evaluated the specimens and examined tumour depth and muscle invasion. Types of neck dissection were bilateral supraomohyoid in 20, unilateral supraomohyoid in 8, bilateral suprahyoid in 5 and unilateral suprahyoid in 1 patients. All the carcinomas were squamous cell carcinoma (SCC) and T stages were T1 in 32 and T2 in 5. Preoperatively, 4 patients had palpable lymph nodes and 9 patients had lymph nodes in CT scan, but it was found out that none of these patients had histological positive lymph node metastasis. Histological node metastasis was found only in 1 patient who had stage T1 tumour, no palpable or detected lymph node, no muscular invasion and very limited tumour depth.Tumour size, differentiation degree, tumour depth and muscle invasion seems insensitive for predicting lymph node metastasis in early stage lower lip carcinomas. The necessity of neck dissection in early stage lower lip carcinomas should be reconsidered in large series of patients. [Med-Science 2016; 5(4.000): 933-6

Aerobic and Anaerobic Exercise Capacities in Obstructive Sleep Apnea and Associations with Subcutaneous Fat Distributions

Obesity is a strong risk factor for the development and progression of sleep apnea. Responses to exercise by patients with obstructive sleep apnea syndrome (OSAS) are clinically relevant to reducing body weight and cardiovascular risk factors. This study aimed to clarify the aerobic and anaerobic exercise capacities and their possible relationships with other findings in patients with OSAS. Forty patients (30 males, 10 females) and 40 controls (30 males, 10 females) were enrolled in this study. Questionnaires (excessive daytime sleepiness, daytime tiredness, morning headache, waking unrefreshed, and imbalance), overnight polysomnography, indirect laryngoscopy, and aerobic and anaerobic exercise tests were performed. Triceps, subscapular, abdomen, and thigh skinfold thicknesses were measured. Subcutaneous abdominal fat (abdomen skinfold) was significantly higher in OSAS patients than in controls. Maximal anaerobic power and anaerobic capacity were not different significantly between the patients and controls. We found that aerobic capacity was significantly lower in OSAS patients than in controls. Aerobic capacity was negatively correlated with upper-body subcutaneous fat (triceps and subscapular skinfolds) but not correlated with subcutaneous abdominal fat in OSAS patients. In multivariate analyses using all patients, the apnea-hypopnea index remained a significant independent predictor of aerobic capacity after controlling for a variety of potential confounders including body mass index. Our data confirm that central obesity (subcutaneous abdominal fat) is prominent in patients with OSAS. Our results suggest that lower aerobic exercise capacity in patients with OSAS might be due to daily physical activity that is restricted by OSA itself. This study also suggests that the degree of subcutaneous abdominal fat cannot be used for predicting aerobic capacity level. We think that upper-body subcutaneous fat might be suitable for determining the physical fitness of patients with OSAS