Difficulty of Differential Diagnosis: Granulomatous Diseases of Nasal Cavity and Paranasal Sinuses

Infectious diseases are important causes of granulomatous diseases of the nasal cavity and paranasal sinuses. The most frequent bacterial agents responsible for granulomatous infections are Mycobacterium species (spp.) and Actinomyces spp. In the case of fungal pathogens, Aspergillus spp. are the most frequent. Mucor spp., Cryptococcus spp. and Histoplasma spp. are the other fungal microorganisms causing granulomatous reactions. In this case report, a patient suffering from a chronic nasal cavity lesion for 4 years with a recently developed premaxillary skin lesion is presented. Despite many biopsies having been performed and pathological studies conducted, a definitive diagnosis and an effective treatment could not be achieved. Finally, Aspergillus growth was observed in the fungal growth media when the material of the last skin biopsy was sent to microbiology as well as pathology. The patient was diagnosed as “chronic nasal fungal infection” and voricanozole treatment was initiated. Nine months after therapy, symptoms were almost totally resolved. In order to prevent similar difficulties of differential diagnosis, biopsy materials should be sent for aerobic, tuberculosis and fungal cultivation, as well as pathological examination, in order not to miss infectious diseases from the aetiology

Does metoclopramide exposure alter endometrial receptivity and decrease pregnancy rates?

WOS: 000375027200028PubMed ID: 26421644Objective: The aim of this study was to investigate the effect of metoclopramide on endometrial receptivity with an immunohistochemical investigation of integrin beta 3 expression in pregnant rats. Materials and methods: In the present study, the pregnant mice administrated by different doses of metoclopramide were used to explore the effect of metoclopramide on embryo implantation, especially on the endometrial receptivity. Results: The statistical results showed that the number of implanted embryos was gradually declining along the increasing dose of metoclopramide. When the administrated dose of metoclopramide was 3 mg/kg per day, great changes were observed in the exposed uterine morphology and down-regulated integrin beta 3 were also found in high dose metoclopramide-exposed mice. Conclusion: Metoclopramide exposure, especially in high doses may alter endometrial receptivity by effecting integrin expression on decidual tissue which can decrease pregnancy rates. This drug should only be recommended for use during pregnancy when benefit outweighs the risk

Do tumor size and location affect survival in upper urinary tract urothelial carcinoma?

Aim: This study aimed to evaluate the effect of tumor location based on clinicopathologic features on cancer-specific survival (CSS) of patients who were treated surgically for locally/locally advanced upper tract urothelial carcinoma (UTUC). Materials and Methods: A single-center series of 145 patients with UTUC who underwent radical nephroureterectomy between May 2010 and August 2019 were included in the study. Patients were stratified based on the location of the tumor as renal pelvis and ureter located tumor. Clinicopathologic characteristics and oncological outcomes were compared according to tumor location and CSS rates after surgery were graphically explored using Kaplan–Meier curves. Results: At a mean follow-up time of 41.8 (4-124) months after surgery, 65 patients (44.8%) died from UTUC. Kaplan-Meier curves showed that tumor location was not associated with CSS in the analysis performed according to tumor stage, grade, and size. In the analysis that was conducted without regard to tumor location, worse CSS was found for patients with pT3 disease versus those with ≤pT2 and with high-grade tumors versus those with low-grade (p=0.025 and p=0.011, respectively). Conclusion: Tumor location was not associated with CSS in any of the analyses. Regardless of tumor location, patients with pT3 disease and high-grade tumors, have a worse prognosis. Further studies on prognostic factors are needed to evaluate the advantages of these factors in the management of patients with UTUC

Benign prostat hiperplazisi nedeniyle transüretral prostat rezeksiyonu uygulanan hastalarda tedavi etkinliği ile ilişkili parametrelerin araştırılması

Amaç: Benign prostat büyümesi nedeniyle transüretral prostat rezeksiyonu yapılan hastalarda postoperatif yarar oranlarını ve postoperatif yararla ilişkili olabilecek çeşitli parametreleri değerlendirerek, transüretral prostat rezeksiyonunun tedavi etkinliğini değerlendirmeyi ve bunu öngörebilecek parametrelere ulaşılıp ulaşılamayacağını araştırmayı amaçladık. Gereç ve Yöntem: 2015-2016 Temmuz tarihleri arasında kliniğimizde transüretral prostat rezeksiyonu yapılan 100 hasta retrospektif olarak değerlendirildi. Preoperatif tahmini prostat ağırlığı (TPA), uluslararası prostat semptom skoru (IPSS), maksimum akım hızı (Qmax) ve işeme sonrası rezidü idrar hacmi (PVR) değerleri ve rezeke edilen prostat dokusu ağırlıkları (RDA) kaydedildi. Postoperatif altı hafta ile altı ay arası dönemde hastaların verileri tekrar kaydedilip istatistiksel analizler yapıldı. Bulgular: Uluslararası prostat semptom skorundaki azalmanın 11,40 (%53,4), Qmax’taki artışın 11,10 ml/sn (%110) ve PVR’deki azalmanın 59,60 ml (%59) olduğu tespit edildi. IPSS’deki düşüş, preoperatif IPSS ? 20 olanlarda, preoperatif Qmax ? 10 ml/sn olanlarda ve PVR >100 ml olanlarda istatistiksel anlamlı olarak daha fazla saptandı (sırasıyla p0,001, p=0,038, p=0,012). Preoperatif PVR > 100 ml olan hastalarda Qmax’daki artış ve PVR’deki azalma istatistiksel anlamlı olarak daha fazla bulundu (sırasıyla p=0,012, p0,001). TPA > 50 gr olan hastalarda ve RDA / TPA ? 0,3 olan hastalarda PVR azalması istatistiksel anlamlı olarak daha fazla bulundu (sırasıyla p=0,027 ve p=0,008) Sonuç: Transüretral prostat rezeksiyonu tedavi etkinliği ile ilişkili olabilecek daha net verilere ulaşılmasının hasta takibi ve tedavi seçimi konusunda klinisyenleri yönlendirebileceğini ve bu konuda daha fazla çalışma yapılması gerektiğini düşünmekteyiz

Bipolar Release Technique In Neglected Congenital Muscular Torticollis

Background Congenital Muscular Torticollis (CMT) is the third most common congenital musculoskeletal anomaly.After the age of 5 years, the efficiency of the surgery is controversial. . The aim of this prospective study was to report the functional and cosmetic results after bipolar release of the sternocleidomastoid muscle (SCM) in patients older than 5 years of age. Method : Between 2012 and 2015, 8 patients with a mean age of 17.3 years (range, 7 - 22 years) were diagnosed with neglected CMT and were surgically treated. The bipolar release technique was performed in all patients under general anesthesia. Physiotherapy was started immediately after surgery. Preoperative and final assessment was made again using Lee's scoring system.Conclusions Patients with congenital muscular torticollis can benefit from surgical treatment even in adulthood. Bipolar release of the SCM muscle should be considered even in adults with irreversible deformities such asfacial asymmetry with low complication rates

Abortifacient effect of decreased decidual and placental galectin-1 expression due to metoclopramide exposure in pregnant rats

OBJECTIVE: To investigate the abortifacient effect of metoclopramide on decidual and trophoblastic tissues with immunohistochemical investigation of galectin-1 expression in pregnant rats. STUDY DESIGN: A total of 24 pregnant rats were selected for the study and divided into 3 groups as untreated, low-dose (1 mg/kg) metoclopramide applied, and high-dose (3 mg/kg) metoclopramide applied from days 5-15 of pregnancy. All rats were laparotomized on day 19 of pregnancy, and number of implantation sites, resorption, and dead or alive fetuses were recorded for evaluating abortifacient activity. Galectin-1 expression was investigated from decidual and trophoblastic tissues via immunohistochemical staining. RESULTS: The mean percentage of abortion was detected higher in the high-dose group than both control and low-dose groups. Galectin-1 staining was more intense and universal in the untreated group than both high- and low-dose metoclopramide exposed groups in labyrinth trophoblasts and decidual tissue. CONCLUSION: Metoclopramide exposure, especially in high doses, may cause abortion, and this drug should be recommended for use during pregnancy only when the benefit outweighs the risk

Biomechanical analysis of multilevel discectomy and excision of posterior longitudinal ligament: An in vitro study in sheep

Aim: This experimental biomechanical study was performed to determine the effects of multilevel anterior cervical discectomy and excision of posterior longitudinal ligament (PLL) to stabilize the cervical spine using an in vitro animal model. Materials and Methods: Fifty fresh cadaveric C3-C6 sheep spine specimens were divided into five experimental groups: Group A was the control group; Group B, one-level discectomy; Group C, two-level discectomy, Group D, three-level discectomy, and Group E, three-level discectomy and excision of PLL, respectively. The specimens were subjected to non-destructive loads cycled from zero to five Newton-meter for flexion, extension, right and left lateral bending, and axial rotation on an electrohydraulic test machine. Load displacement curves were obtained via collected data using strain gauges. The values were obtained for all five groups, statistical differences were determined respectively (P 0.05). Conclusion: Our data suggested that cervical discectomy decreases stability of sheep spine pieces