Unexpected synchronous diagnosis of papillary thyroid carcinoma in a patient with lower lip squamous cell carcinoma

The presentation of differentiated thyroid carcinoma occurring as a second primary associated with head and neck squamous cell carcinoma is quite unusual. Here, we present an unexpected synchronous diagnosis of two independent head and neck malignancies. A 78-year-old male with a rapidly growing, firm, and ulcerated lesion on the lower lip was referred to our clinic. Positron emission tomography-computed tomography scan performed for systemic screening demonstrated a dense hypermetabolic activity located in the right thyroid lobe, suggesting a second malignancy. Fine-needle aspiration cytology of the right thyroid gland performed to differentiate the presence of a metastatic lesion, or primary thyroid cancer was compatible with malign cytology related to papillary thyroid carcinoma. Multiple malignancies may be diagnosed synchronously in the head and neck region and these patients with multiple malignant lesions should be evaluated carefully before being accepted as metastatic

The cientificWorldJOURNAL Research Article Does Thrombocyte Size Give Us an Idea about Thrombocytosis Etiology?

In the presence of a pathogenetic mutation in JAK2 or MPL, a differential diagnosis of essential thrombocythemia (ET) from reactive causes is relatively simple. However, in patients with suspected ET who lack JAK2 and MPL mutations, the exclusion of secondary causes is especially important. The study was aimed to explore the clinical application of particularly mean platelet volume (MPV), hemoglobin, red blood cell indices, white blood cell, serum iron profile, and C-reactive protein level in the differential diagnosis of thrombocytosis. Medical records of 49 patients, consisting of reactive thrombocytosis (RT) and ET were retrospectively reviewed. The mean MPV level in RT group was 7.49 fL, and in ET group was 8.80 fL (P < 0.01). A cutoff point of <8.33 fL was found to have significant predictive value according to ROC curve analysis. This cutoff was associated with 83% positive predictive value (PPV) and 74% negative predictive value (NPV) in the diagnosis of ET and had a sensitivity of 65% and specificity of 89% for ET. Investigation of MPV is cheap, quick, and noninvasive, and may serve as a predictor of primary thrombocytosis. High sensitivity, specificity, PPV, and NPV enable this test an important tool and a possible surrogate marker in clinical practice

The Oblique Split Method A Novel Technique For Carving Costal Cartilage Grafts

Importance: Autogenous rib cartilage is widely used in the septorhinoplasty cases with major structural grafting requirements. However, there is a risk of warping over time. Objective: To introduce a novel method for carving costal cartilage grafts to obtain straight grafts of varying thicknesses and to eliminate the risk of warping. Design: Between 2007 and 2011, a total of 43 consecutive patients underwent septorhinoplasty using autogenous costal cartilage grafts carved by the oblique split method (OSM). Setting: The Ankara Training and Research Referral Hospital, Ankara, Turkey. Participants: The study included 43 patients with saddle nose deformity and revisional rhinoplasty with a depleted source. All patients were followed-up for a period ranging from 12 to 37 months (mean, 19.2 months) after surgery. Interventions: All patients underwent open or closed septorhinoplasty. Autogenous costal cartilage was carved with the OSM to obtain grafts suitable for use as columellar strut, dorsal onlay, L-strut, lateral crural strut, caudal extension, and tip or speader grafts in selected cases. Main Outcome Measures: Patients were evaluated by inspection, palpation, and photographic documentation before surgery. Inspection, palpation, and photographic documentation were carried out every 6 months and 12 months after surgery and once a year thereafter. Results: Patient satisfaction in terms of form and function was achieved in 41 patients (95%). Two patients required reoperation for further tip projection (n=1) and alar batten graft displacement (n=1). No complication was observed as a result of graft warping, resorption, or fracture. Conclusions and Relevance: The OSM provides straight costal cartilage grafts of varying thicknesses without the risk of warping. Because they strictly preserve their straight form, the grafts may safely be modified into rectangular shape or carved asymmetrically and/or have their edges beveled. Current data from this study suggest that the OSM offers a flexible and reliable reconstructive option for the rhinoplasty surgeon.WoSScopu

Does Thrombocyte Size Give Us an Idea about Thrombocytosis Etiology?

In the presence of a pathogenetic mutation in JAK2 or MPL, a differential diagnosis of essential thrombocythemia (ET) from reactive causes is relatively simple. However, in patients with suspected ET who lack JAK2 and MPL mutations, the exclusion of secondary causes is especially important. The study was aimed to explore the clinical application of particularly mean platelet volume (MPV), hemoglobin, red blood cell indices, white blood cell, serum iron profile, and C-reactive protein level in the differential diagnosis of thrombocytosis. Medical records of 49 patients, consisting of reactive thrombocytosis (RT) and ET were retrospectively reviewed. The mean MPV level in RT group was 7.49 fL, and in ET group was 8.80 fL (P<0.01). A cutoff point of <8.33 fL was found to have significant predictive value according to ROC curve analysis. This cutoff was associated with 83% positive predictive value (PPV) and 74% negative predictive value (NPV) in the diagnosis of ET and had a sensitivity of 65% and specificity of 89% for ET. Investigation of MPV is cheap, quick, and noninvasive, and may serve as a predictor of primary thrombocytosis. High sensitivity, specificity, PPV, and NPV enable this test an important tool and a possible surrogate marker in clinical practice

The Effect of Metabolic Syndrome upon the Success of Varicocelectomy

We aimed to investigate the impact of metabolic syndrome (MetS) on the varicocele treatment. 101 patients underwent spermatic vein ligation between 2007 and 2010 were retrospectively analyzed. Those patients were divided into two groups as without (n: 56, Group 1) or with MetS (n: 48, Group 2). All the patients underwent left microsurgical subinguinal spermatic vein ligation. Groups were compared by the improvement on sperm parameters and spontaneous pregnancy rates at a mean of 19 (±4) months followup. When sperm parameters were compared postoperatively, the significant improvement in total sperm count, motile sperm count percentage, and normal sperm percentage was reported. The groups were compared to each other and the improvement seemed significantly better in Group 1. There was no statistically significant improvement difference in the normal sperm percentage between groups. Spontaneous pregnancy rate after two years was 45% in Group 1 and 34% in Group 2 (). Patients with MetS and varicocele improved after surgery, but not as well as the similar group without MetS. This may help to show that MetS can be a factor for male infertility