Coincidental Killian-Jamieson Diverticulum During Thyroid Surgery: A Rare Cause of Dysphagia

The aim of this case report is to demonstrate a very rare coincidental existence and management of the Killian- Jamieson diverticulum during thyroid surgery in a patient with dysphagia. An 18-year-old female patient with the complaints of progressive dysphagia and a rapidly growing mass at the anterior cervical region was undergone thyroid lobectomy. Coincidentally, a 2×2 cm Killian-Jamieson diverticulum was observed and simultaneously excised with the thyroid lobe, preserving the recurrent laryngeal nerve. Dysphagia is a frequent symptom, especially in patients with a rapidly growing thyroid mass. Thyroid surgeons should keep in mind that hypopharyngeal and upper esophageal pathologies can mimic the symptoms of a thyroid mass; therefore, detailed imaging techniques should be used for the differential diagnosis

Prognostic and Clinical Role of Contrast Enhancement on Magnetic Resonance Imaging in Patients with Bell’s Palsy

Objective:To investigate the prognostic value of the magnetic resonance imaging in Bell’s palsy patients.Methods:Patients who were diagnosed and treated with Bell’s palsy between October 2013 and March 2016 retrospectively selected. House–Brackmann grades, pre- and post-treatment pure tone audiograms, stapedial reflexes were analyzed and magnetic resonance imaging (MRI) scans with gadolinium-based contrast agents were evaluated. Contrast-enhanced segments of the facial nerve were determined. MRI findings were compared statistically with pre- and post-treatment grade, recurrence rate of Bell’s palsy, MRI scanning timing, presence of stapes reflexes and posttreatment recovery data.Results:No significant correlation was observed between pretreatment House–Brackmann grades and enhancement (p>0.05). Similarly, there was no significant correlation between clinical recovery and enhancement (p>0.05). Also, no significant correlation was observed between MRI scanning time, the recurrence rate of Bell’s palsy and MRI findings (p>0.05). None of the MRIs showed neoplastic contrast enhancement.Conclusion:The routine use of the contrast-enhanced temporal MRI is not recommended in the diagnosis and monitoring of Bell’s palsy patients, because the contrast enhancement pattern of the facial nerve has no effect on the prognosis of Bell’s palsy. MRI should be used in cases that do not heal despite treatment, for the differential diagnosis of facial nerve tumors and in patients who are candidates for surgical decompression

NAZAL POLİPOZİSTE İNTERLÖKİN 16 SEVİYESİ

Nazal polipozis; tomografik ve endoskopik değerlendirmeler ile tanısı konulan, kronik inflamatuar bir hastalıktır. Hastalığın karmasık doğası ve etyopatogenezin sınırlı anlasılmıs olması, doğru bir sekilde tedavisini güçlestirmekte ve bu yüzden nüksler sıklıkla görülmektedir. Nazal polipozis histopatolojisinde en önemli faktör doku eozinofilisidir. Doku eozinofilisinin patogenezi, kompleks immünolojik mekanizmalarla açıklanılmaya çalısılmıssa da günümüzde halen tam olarak aydınlatılamamıstır. Literatürdeki birçok inflamatuar hastalıkla iliskisi saptanmıs olan interlökin 16; hem eozinofillerin kemotaksisinden, hem de inflamasyonda diğer hücreler ile etkilesimden sorumlu önemli bir medyatördür. Literatürde ĐL-16 ve nazal polipozis iliskisini gösteren sadece bir çalısma bulunmustur. Bu çalısmanın amacı; NP’li olgulardaki serum ĐL-16 düzeyinin arastırılarak, doku eozinofilisi ve yasam kalitesi ile olan iliskisini ortaya koymaktır. Astım, alerjik, inflamatuar, granulomatöz hastalık hikayesi bulunmayan ve en az 8 hafta sistemik veya lokal medikal tedavi almamıs 17 nazal polipozis hastası bu çalısmaya dahil edilmistir. Kontrol grubu ise astım, alerjik, inflamatuar ve granulomatöz hastalık hikayesi olmayan septum deviasyonu, konka bulloza ve/veya alt konka hipertrofisi nedeniyle nazal cerrahi planlanan 10 hasta tarafından olusturulmustur. Sonuç olarak; nazal polipozis hastalarında, kontrol grubuna göre anlamlı olarak serum ĐL-16 seviyesinin yükseldiği tespit edilmistir. Ayrıca nazal polipozisteki doku eozinofilisi kontrol grubuna göre daha yüksek bulunmustur. Ancak doku eozinofilisi ile serum İL-16 seviyeleri arasında anlamlı bir iliski saptanamamıstır. Nazal polipozis etyopatogenezinde, karmasık immünolojik mekanizmalar içinde yer alan inflamatuar sitokinlere ilave olarak ĐL-16’nın da önemli bir rolü olduğu kanısına varılmıstır.Nasal polyposis is a chronic inflammatory disease which is diagnosed with endoscopic and tomographic evaluations. Because of the complex nature and the limited understanding of its etiopathogenesis makes this disease difficult to treat precisely, so that recurrence is seen oftenly. Tissue eosinophilia is the most important factor in the histopathology of the nasal polyposis. Although the pathogenesis of the tissue eosinophilia has been tried to explain by complex immunological mechanisms, to date it is not clarified entirely. Interleucin 16, which its relationship with several inflammatory diseases has been documented in the literature, is an important mediator that is responsible of not only for the eosinophil chemotaxis but also the interaction with other cells in inflammation. Only one study exists regarding the relationship between nasal polyposis and IL-16 in literature. The aim of this study is to manifest its relationship with tissue eosinophilia and quality of life by investigating the serum interleucin 16 levels in the nasal polyposis cases. Seventeen nasal polyposis patients were included in this study that had been neither given systemic or topical medication at least 8 weeks, nor had a history of asthma, allergic, inflammatory and granulomatous diseases. The control group was also consisted of ten patients, undergoing nasal surgery because of septal deviation, concha bullosa and/or inferior turbinate hipertrophy, but without history of asthma, allergic, inflammatory and granulomatous diseases. In conclusion, the significant elevation of serum IL-16 level in nasal polyposis patients according to control group is demonstrated. Moreover it is pointed that there is a significant increment in tissue eosinophilia level in nasal polyposis in comparison with control group. However, it is detected that there is no significant relationship between tissue eosinophilia and serum interleucin 16 level. It is suggested that in addition to several inflammatory cytokines in the complex immunologic mechanisms of the nasal polyposis etiopathogenesis, IL-16 is also playing an important role

2D Gold Nanoparticle Structures Engineered Through DNA Tiles for Delivery and Therapy

Self-assembly of 13 nm gold nanoparticles (AuNPs) engineered into 2D structures in solution using DNA tiles for their possible use for gene delivery and photothermal therapy is reported. The two different DNA tiles were constructed and the AuNPs coated with oligonucleotides possessing complementary sequence from the free ends were hybridized with the sticky ends of the tiles. The DNA tiles were bind to each other by mixing the tile structures without a heating and cooling step. The constructed nanostructures were 5 to 7 DNA tiles long since heat was not used to elongate them. When the DNA tiles were bound to the AuNPs, it was observed that AuNPs tend to stay in close proximity by filling the gaps between tiles. The stability of the constructed structures was tested against DNase, a DNA cleaving enzyme, for possible applications for gene delivery and photothermal therapy. It was found that the AuNP bound DNA tile structures resist the DNase cleavage up to eighty percent. Due to the presence of the AuNPs in the structure, the enzyme cannot bind to DNA sequences and this increases the DNA tile structures’ stability