Schwannoma of the cervical vagus nerve: A rare benign neurogenic tumor

A schwannoma, also known as an acoustic neuroma, is a benign nerve sheath tumor composed of schwann cells, which normally produce the insulating myelin sheath covering the peripheral nerves. Schwannoma, originating from the cervical vagus nerve, is an extremely rare neoplasm that usually occurs in men between the 3rd and 6th decades of life. The most common presentation is a painless, slow-growing, lateral neck mass;this appears in a large proportion of cases. Complete surgical resection with care to protect the nerve of origin is the recommended treatment of choice. Here, we report a case of cervical vagal schwannoma in a 55-year-old male who admitted with the complaint of a firm and painless mass lesion on the right side of the neck. The management of the case is discussed along with the relevant literature.Keywords: Neurilemmoma; Neoplasms; Vagus nerve; Treatment

Cardiac thrombi in a patient with protein-C and S deficiencies: a case report

We report a case of multiple mobile intra-cardiac thrombi accompanying recurrent pulmonary embolism that has been successfully treated by fibrinolytic therapy. Control transesophageal echocardiographic examination showed that prolonged thrombolytic treatment completely removed the thrombi. Surgical removal of emboli has been validated but cannot be proposed to all patients since it is a high-risk intervention. Fibrinolysis is generally efficient but exposes the patient to risk of migration of the intra-cavity thrombus, with occasionally deleterious evolution. Systemic thrombolytic therapy is usually recommended if (a) it is not contraindicated and (b) the thrombi are demonstrated in more than one cardiac chamber, entailing a higher risk of surgical intervention. However, the infusion rate and duration of thrombolytic therapy are important determinants of successful and uncomplicated lysis. Low dose and long infusion time should be chosen to avoid fragmentation of the thrombus and related complications. © 2004 Ercan et al; licensee BioMed Central Ltd

Decreased soluble cell adhesion molecules after tirofiban infusion in patients with unstable angina pectoris

AIM: The inflammatory response, initiated by neutrophil and monocyte adhesion to endothelial cells, is important in the pathogenesis of acute coronary syndromes. Platelets play an important role in inflammatory process by interacting with monocytes and neutrophils. In this study, we investigated the effect of tirofiban on the levels of cell adhesion molecules (soluble intercellular adhesion molecule-1, sICAM-1, and vascular cell adhesion molecule-1, sVCAM-1) in patients with unstable angina pectoris (AP). METHODS: Thirty-five patients with unstable AP (Group I), ten patients with stable AP (Group II) and ten subjects who had angiographycally normal coronary arteries (Group III) were included the study. Group I was divided into two subgroups for the specific treatment regimens: Group IA (n = 15) received tirofiban and Group IB (n = 20) did not. Blood samples for investigating the cell adhesion molecules were drawn at zero time (baseline; 0 h) in all patients and at 72 h in Group I. RESULTS: The baseline levels of sICAM-1 and sVCAM-1 were higher in Group I than in Groups II and III. They were higher in Group IA than in Group IB. However, the sICAM-1 and sVCAM-1 levels decreased significantly in Group IA after tirofiban infusion. In contrast, these levels remained unchanged or were increased above the baseline value in Group IB at 72 h. CONCLUSION: The levels of cell adhesion molecules in patients with unstable AP decreased significantly after tirofiban infusion. Inhibition of platelet function by specific glycoprotein IIb/IIIa antagonists may decrease platelet-mediated inflammation and the ischemic end-point

Early Paper Patching Versus Observation in Patients With Traumatic Eardrum Perforations: Comparisons of Anatomical and Functional Outcomes

SIMSEK, GOKCE/0000-0001-5281-0986WOS: 000345012000052PubMed: 25377961The purpose of this study was to compare the outcomes of patients with acute tympanic membrane perforation after spontaneous healing and paper-patching procedure. Methods: Design, Setting, and Participants: In this study, we performed a retrospective chart review with a prospective follow-up in 63 patients with tympanic membrane perforations. The patients undergoing a paper-patching procedure were assigned to group 1 (n = 33), whereas the patients that healed spontaneously were included in group 2 (n = 30). Retrospective analyses of the otoscopic examination findings and audiometric test results of the groups at the sixth-week follow-up were compared. Results: Eardrum healing was achieved in 90.9% of the patients in group 1 and 76.7% of the patients in group 2 at the sixth week (P > 0.05). The mean values of air conduction were significantly improved, and the air-bone gap was markedly decreased in the patients treated with paper patching, when compared with the patients in group 2 (P < 0.001). The area of perforation was found to be inversely related to the healing success. Conclusions: Early intervention by paper patching, which is a readily applicable procedure, may be offered to the patients with acute perforation of the tympanic membrane, because of the slightly better closure rates and significantly higher hearing functions when compared with simple observation

Thymoma with an incidental benign laryngeal mass mimicking laryngeal carcinoma: Case report

SIMSEK, GOKCE/0000-0001-5281-0986WOS: 000370834200006PubMed: 26930331Thymic carcinomas are rarely seen. Because of recurrent laryngeal nerve involvement, hoarseness is a common presenting symptom. Persistent hoarseness in a male smoker past his fifth decade is also a distinctive symptom for laryngeal carcinoma. Stroboscopic laryngeal examination and biopsy are required for the diagnosis. In this article we describe a case involving a patient with thymic carcinoma who, interestingly, also presented with a benign laryngeal mass with unilateral vocal fold fixation. We emphasize the importance of keeping in mind nonlaryngeal pathologies invading the recurrent laryngeal nerve in patients with persistent hoarseness and a nonspesific laryngeal mass

Atorwastatyna zmniejsza aktywność zapalną i proteolityczną u chorych z hipercholesterolemią

Background: Statins have anti-inflammatory and anti-platelet effects, which are known as non-lipid effects. Statin treatment can decrease endogenous inflammatory response.Aim: To study the effects of atorvastatin on matrix metalloproteinase-9 (MMP-9) and high sensitive C-reactive protein (hs-CRP) - markers of the proteinolytic and inflammatory activity.Methods: In this prospective study 44 patients with hypercholesterolemia were randomly assigned into 2 groups; Group 1 (n=22) treated with atorvastatin and diet for 2 months, and Group 2 (n=22) - diet alone. MMP-9 and hs-CRP were measured at baseline and two months later.Results: Groups were matched for age, sex and baseline characteristics. Lipid levels decreased by 32% (LDL from 153.9&#177;26.6 to 94.5&#177;20.8 mg/dl,

Comparison of montelukast and mometasone furoate in the prevention of recurrent nasal polyps

Background: The aim of our study was to compare the effects of montelukast and mometasone furoate nasal spray on the postoperative course of patients with nasal polyposis. Patients and methods: Fifty patients diagnosed with nasal polyposis between March 2006 and August 2007 were included in the study. All patients underwent bilateral endoscopic sphenoethmoidectomy and were randomized postoperatively into two groups. Group A ( n = 25) received 10 mg montelukast per day and group B ( n = 25) received 400 µg mometasone furoate nasal spray twice daily. All patients were followed up for 6 months. Sino-Nasal Outcome Test (SNOT)-22 scores, polyp grades, computerized tomography (CT) scores (Lund–Mackay), eosinophils in peripheral blood and polyp tissue were evaluated before and after surgery. Results: There was a significant reduction in SNOT-22 scores in both groups throughout the study period. There was a significant difference in the recurrence rate between both groups with a marginal advantage of mometasone furoate nasal spray. Eosinophils in peripheral blood were found to be effective on the recurrence rate ( p < 0.05). Conclusions: In conclusion, both drugs seem to have a complementary action and further studies are needed to determine which patients should receive which treatment

Detection of XRCC1 gene polymorphisms in Turkish head and neck squamous cell carcinoma patients: a comparative analysis with different populations

Purpose: X-ray repair cross-complementing (XRCC1) is one of the most important genes for the maintenance of genomic integrity and protection of cells from DNA damage. Although tobacco and alcohol consumption are the major risk factors for the development of head and neck squamous cell carcinoma (HNSCC), sequence variation in XRCC1 gene may alter HNSCC susceptibility. Reports on the relationship between HNSCC and polymorphisms in XRCC1 gene have been inconsistent so far. The aim of this study was to investigate the association of XRCC1 Ar-g194Trp and Arg399Gln single nucleotide polymorphisms (SNP), smoking and alcohol consumption with the risk of HNSCC in Turkish population and also to compare to these results with the ones from both Turkish and different populations in the literature. The frequencies of Arg194Trp and Arg399G1n SNPs were studied in 55 HNSCC and 69 healthy individuals