Nadir bir burun tıkanıklığı nedeni: dev invaziv nonfonksiyonel hipofiz adenomu

Nasal obstruction is a very rare symptom caused by a pituitary adenoma. A 57-year-old man admitted to our clinic with bilateral nasal obstruction for the last six months. Endoscopic examination revealed soft pinkish pulsatile tissues in both nasal cavities. Radiologic investigation revealed a suprasellar mass extending to the frontal lobes, spheno-ethmoidal sinuses and nasal cavities. He had bitemporal superior quadrant hemianopsia. Pituitary hormone levels were normal. Biopsies were taken from the patient endonasally. Pathological evaluations and laboratory findings were compatible with nonfunctioning pituitary adenoma.Burun tıkanıklğı hipofiz adenomun neden olduğu çok nadir bir semptomdur. Elli yedi yaşında erkek hasta altı aydır süren iki taraflı burun tıkanıklığı ile kliniğimize başvurdu. Endoskopik muayenesinde her iki burun boşluğunda yumuşak pembemsi, pulsatil doku izlendi. Radyolojik incelemelerinde frontal loba, sfeno-ethmoidal sinüslere ve burun boşluklarına uzanım gösteren suprasellar kitle izlendi. Hastada bitemporal üst kadran hemianopsi vardı. Hipofiz hormon düzeyleri normal idi. Biyopsiler hastadan endonazal yol ile alındı. Patolojik değerlendirmesi ve laboratuvar bulguları nonfonksiyonel hipofiz adenomu ile uyumluydu

60-72 ay arası çocuklarda erken okuryazarlık becerileri ile bilişsel değerlendirme sistemi arasındaki ilişkinin incelenmesi

Bu çalışmanın amacı 60-72 ay arası çocukların sözcük bilgisi, sesbilgisel farkındalık, harf bilgisi, dinlediğini anlama olarak ifade edilen erken okuryazarlık beceriyle, planlama, eşzamanlı, dikkat ve ardıl olarak tanımlanan bilişsel değerlendirme sisteminin temel boyutları arasındaki ilişkinin incelenmesidir. Bu amaçla çalışmada ilişkisel tarama modeli kullanılmıştır. Çalışmanın katılımcılarını İstanbul ilinde okul öncesi eğitim kurumlarına devam eden 60-72 ay arası 124 çocuk oluşturmaktadır. Verilerin toplanmasında Erken Okuryazarlık Testi (EROT), ve Bilişsel Değerlendirme Sistemi- (Cognitive Assesment System (CAS) ) kullanılmıştır. Yapılan istatistiki analizler sonucunda sözcük bilgisi ile bilişsel performans sistemi arasında anlamlı ilişki bulunmuştur. Bilişsel değerlendirme sistemi sözcük bilgisinin % 30’unu , ses bilgisel farkındalık becerisinin % 47’sini, harf bilgisinin % 23’ünü yordadığı görülmüştür. Buna karşın bilişsel performans sisteminin dinlediğini anlama becerisinin yordayıcısı olmadığı görüşmüştür. Erken okuryazarlık becerilerinin bilişsel performans sisteminin tüm alt boyutlarının %36’sını yordadığı görülmüştür. Çalışmanın bulguları alan yazındaki bilgiler doğrultusunda tartışılmıştı

Total resection of inferiorly located sacral chordoma with posterior only approach: case report and review of the literature

Chordoma is a primary sacral neoplasm of ectodermal origin and makes up %1-4 of all primary bone tumors. It is usually present on the midline cerebrospinal axis and the most common locations are the spheno-clival region and the sacrum. The treatment of primary sacral tumors represents a challenge because of a large tumor mass at presentation and a hemorrhage risk in surgery. Sacral tumors may present a difficult problem to the surgeon who desires to obtain a clear margin of excision. Using the retrorectal fat tissue as a cleavage line in the posterior approach guides the neurosurgeon to resect the tumor totally and reduce the hemorrhage in sacral chordomas. In this case report, we tried to discuss the advantages of using of retrorectal fat tissue as a cleavage line in sacral chordomas under the literature.Kordoma ektodermal kaynaklı primer sakral neoplazmdır ve tüm primer kemik tümörlerinin %1-4’ünü oluşturur. Genellikle serebrospinal aksın orta hattında bulunurlar ve çoğunlukla yerleşim yerleri sfenoklival bölge ve sakrumdur. Primer sakral tümörlerin tedavisi; ilk ortaya çıktıklarında büyük bir kitle oluşturmuş olmaları ve cerrahide kanama riskleri nedeniyle çözülmesi gereken bir sorun olarak durmaktadır. Sakral tümörler, net bir eksizyon sınırı sağlamak isteyen cerrahlar için zorlu bir problem oluşturur. Posterior yaklaşımda retrorektal yağ dokusunun klavaj hattı olarak kullanılması; beyin cerrahına tümörün tümüyle rezeke edilmesi için yol gösterir ve sakral kordomalarda kanamayı azaltır. Bu olgu sunumunda, sakral kordomalarda retrorektal yağ dokusunun klavaj hattı olarak kullanılmasının yararlarını literatür eşliğinde tartışmak istedik

Supraclavicular thoracic duct cyst

[No Abstract Available

Bloody nipple discharge in 2 infants with interesting cytologic findings of extramedullary hematopoiesis and hemophagocytosis

Bloody nipple discharge in the infantile period is an uncommon finding. Despite its stressful course to the parents, it is generally a benign condition with a spontaneous resolution. The approach to bloody nipple discharge in the infantile period is well documented in the literature even though the number of these cases is limited. We report 2 infants with unilateral bloody nipple discharge. Their physical examination, laboratory, and ultrasound findings were normal but the cytologic examinations of the discharge revealed signs of extramedullary hematopoiesis and hemophagocytosis. These extraordinary findings made us brainstorm on the probable ongoing processes in the infantile breast tissue

Coexistence of three malignancies: Two different lung cancers synchronous with lymphoma

Epithelial tumors synchronous with hematologic malignancies are very rare. The hystopathologic type and stage of synchronous tumors are very important for prognosis. A 77-year-old male patient was diagnosed with lymphoma after an excisional biopsy was taken from the retroauricular region. Positron emission tomography, performed for lymphoma staging, revealed a positive solid nodule (SUVmax: 24.3) in the posterobasal segment of the right lower lobe and a negative subsolid nodule in the anterior segment of the upper lobe. Right lower lobectomy and wedge resection for subsolide nodule in the upper lobe were performed. Histopathological examination revealed mildly differentiated squamous cell carcinoma for the solid nodule and mildly differentiated adenocarcinoma with lepidic pattern for the subsolid nodule. The patient was treated for only lymphoma according to the decision of the tumor board, and his condition is stable for 1 year without any evidence of lung cancer recurrence. This case presents the treatment approach and the fact that triple synchronic malignant cases are rare in the literature

Development and Assessment of a Coping Scale for Infertile Women in Turkey

Infertile women feel more psychological stress and pressure than their husbands, and the prevalence of anxiety and depression among them are higher. This study aimed to develop a culture-specific measurement tool to identify the strategies of infertile women in dealing with infertility-related problems. This was a scale development study. This study was carried out in three different fertility centers in the three largest cities in Turkey. The data were collected using personal information form and through the application of a Coping Scale for Infertile Women (CSIW) protocol. Ways of Coping with Stress Inventory. Cronbach‘s alpha, Intraclass Correlation Coefficient and Spearman‘s Rank correlation analyses were used to determine the reliability of the scale. The results of explanatory factor analysis and a factor structure of the Coping Scale for Infertile Women, comprising 50 items, were examined, and the data were determined to be suitable to perform factor analysis. The internal consistency of the scale was found to be 0.880. The number of factors in the scale was 10, and the internal consistency of the factors was 0.720. The results showed that the CSIW had good reliability and validity.Keywords: Infertility, Women, Coping, Scale developmen

Histopathologic evaluation of hyaluronic acid and plasma-rich platelet injection into rabbit vocal cords: an experimental study

Objective: Various materials are used by otolaryngologists for vocal cord injections in the management of vocal cord paralysis. An ideal injection material should be long-term effective, readily available, cheap, easy to prepare, have no donor morbidity, easy to use, biocompatible, resistant to resorption or migration, and easy to extract during revision. In this study, we aimed to see the histopathological effects of hyaluronic acid (HYA) and platelet-rich plasma (PRP) injections into the vocal cords of New Zealand rabbits. Methods: PRP was injected into the right vocal cords of twelve rabbits, which was prepared from their serum (PRP group). HYA was injected into the left vocal cords of first six rabbits (numbered 1-6) (HYA group), and the left vocal cords of the other six rabbits (numbered 7-12) were followed with no intervention (control group). Two months later, histomorphological findings in the vocal cords were assessed by two experienced pathologists in seven parameters: chronic inflammation, mucosal atrophy, necrosis, neovascularization, fibrosis, foreign body reaction, and muscular atrophy. They were scored double-blinded as negative (0), mild (+ 1), moderate (+ 2), and severe (+ 3). Fisher's chi-square test was used to evaluate any statistical significance among the three groups. Results: Chronic inflammation, mucosal atrophy, necrosis, foreign body reaction, and muscular atrophy parameters were scored as 0 for each preparate by both pathologists. For neovascularization and fibrosis, a stasistically significant difference was seen among the three groups (p<0.05). Neovascularization was increased in the PRP and HYA groups compared with the control group. No significant difference was observed in fibrosis when the groups were compared separately. After two months, two of the six vocal cords injected with HYA revealed HYA; however, none of the PRP-injected vocal cords showed PRP. Conclusion: HYA and PRP can be safely injected into vocal cords. Our findings show that HYA is a biocompatible and safe injection material for clinical use. Only two of the six vocal cords showed HYA at the end of two months, suggesting that HYA is a short-term effective material. Similarly, PRP was also shown to be a short-term effective material and can be used in patients for testing purpose before using a long-term effective material. The advantages of PRP are that it is inexpensive, readily available, and completely inert as it is prepared from the subject itself

The frequency of Duchenne muscular dystrophy/Becker muscular dystrophy and Pompe disease in children with isolated transaminase elevation: results from the observational VICTORIA study

IntroductionElevated transaminases and/or creatine phosphokinase can indicate underlying muscle disease. Therefore, this study aims to determine the frequency of Duchenne muscular dystrophy/Becker muscular dystrophy (DMD/BMD) in male children and Pompe disease (PD) in male and female children with isolated hypertransaminasemia.MethodsThis multi-center, prospective study enrolled patients aged 3–216 months with serum alanine transaminase (ALT) and/or aspartate transaminase (AST) levels &gt;2× the upper limit of normal (ULN) for ≥3 months. Patients with a known history of liver or muscle disease or physical examination findings suggestive of liver disease were excluded. Patients were screened for creatinine phosphokinase (CPK) levels, and molecular genetic tests for DMD/BMD in male patients and enzyme analysis for PD in male and female patients with elevated CPK levels were performed. Genetic analyses confirmed PD. Demographic, clinical, and laboratory characteristics of the patients were analyzed.ResultsOverall, 589 patients [66.8% male, mean age of 63.4 months (standard deviation: 60.5)] were included. In total, 251 patients (188 male and 63 female) had CPK levels above the ULN. Of the patients assessed, 47% (85/182) of male patients were diagnosed with DMD/BMD and 1% (3/228) of male and female patients were diagnosed with PD. The median ALT, AST, and CPK levels were statistically significantly higher, and the questioned neurological symptoms and previously unnoticed examination findings were more common in DMD/BMD patients than those without DMD/BMD or PD (p &lt; 0.001).DiscussionQuestioning neurological symptoms, conducting a complete physical examination, and testing for CPK levels in patients with isolated hypertransaminasemia will prevent costly and time-consuming investigations for liver diseases and will lead to the diagnosis of occult neuromuscular diseases. Trial RegistrationClinicaltrials.gov NCT04120168