Polyp in concha bullosa: a case report and review of the literature

Polyp originating within a concha bullosa is uncommon; we report only the third such case in the English literature. A 45-year-old man presented with nasal obstruction and headache. Examination of the nose revealed right septal deviation and a hypertrophic left middle concha. Computed tomography confirmed right septal deviation and identified left concha bullosa with thickening of the mucosa covering this lesion. The lateral lamella of the affected turbinate was removed and a mass was excised. Histopathologic examination of the excised mass revealed polypoid hyperplasia. The rare finding of polyp in concha bullosa is discussed with a review of the literature. In any case of concha bullosa, computed tomography images should be carefully evaluated before surgery to check for other pathologies that might have arisen within the lesion

Metal-free restorations: esthetic considerations, treatment planning, preparation, manufacturing, luting, and followup

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A rare cause of recurrent gastrointestinal bleeding: mesenteric hemangioma

Lower gastrointestinal hemorrhage accounts for approximately 20% of gastrointestinal hemorrhage. The most common causes of lower gastrointestinal hemorrhage in adults are diverticular disease, inflammatory bowel disease, benign anorectal diseases, intestinal neoplasias, coagulopathies and arterio-venous malformations. Hemangiomas of gastrointestinal tract are rare. Mesenteric hemangiomas are also extremely rare

Wpływ testosteronowej terapii zastępczej na stężenia witaminy D i FGF-23 w hipogonadyzmie wrodzonym

Introduction: Patients with hypogonadism are at increased risk of cardiac and metabolic diseases and osteoporosis. Vitamin D and Fibroblast growth factor-23 (FGF-23) play role in the regulation of bone mineral metabolism and endothelial functions. Low vitamin D levels are reported in hypogonadism, while there is no data about the effect of testosterone replacement therapy (TRT). We investigated the effect of TRT on vitamin D and FGF-23 levels along with endothelial functions and insulin resistance in hypogonadal patients. Material and methods: Patients with congenital hypogonadotrophic hypogonadism (CHH) (n=32, age 20.6 ±1.58 years) were enrolled. TRT was implemented in transdermal form. The demographic parameters, FGF-23, 25(OH)D3, Asymmetric dimethylarginine (ADMA) and homeostatic model assessment of insulin resistance (HOMA-IR) levels were measured both before and after TRT. Results: After a follow-up period of 3.63±1.33 months, ADMA and FGF-23 levels were significantly increased (p=0.03 and p=0.005 respectively), while the 25(OH)D3 and HOMA-IR index were not significantly changed. The body mass index and waist circumference levels of the patients were also increased (p<0.001 and p=0.02) along with a significant decrease in the HDL cholesterol levels (p=0.006). Conclusions: The results show that a short term TRT increases plasma FGF-23 and ADMA levels, in young, treatment naive patients with CHH. Whether this is an early implication of TRT related adverse effects in this very young and treatment naïve population of CHH is not clear. Future prospective studies are required to find out the long-term effects of TRT on cardio-metabolic morbidity and mortality in this specific population.  Wstęp: U chorych z hipogonadyzmem występuje zwiększone ryzyko chorób sercowych I metabolicznych oraz osteoporozy. Witamina D i czynnik wzrostu fibroblastów-23 (FGF-23) uczestniczą w regulacji metabolizmu kostnego i czynności śródbłonka. Istnieją doniesienia na temat niskiego stężenia witaminy D w hipogonadyzmie, natomiast brakuje danych dotyczących wpływu testosteronowej terapii zastępczej (TRT) na to stężenie. Autorzy zbadali wpływ TRT na stężenia witaminy D i FGF-23 oraz na czynność śródbłonka i poziom insulinooporności u chorych z hipogonadyzmem. Materiał i metody: Do badania włączono chorych z wrodzonym hipogonadyzmem hipogonadotropowym (CHH) (n = 32, wiek 20,6 ± 1,58 roku). Chorzy otrzymywali TRT w postaci przezskórnej. Przez rozpoczęciem leczenia i po jego zakończeniu u chorych zebrano dane demograficzne, zmierzono stężenia FGF-23, 25(OH)D3 i asymetryczej dimetyloargininy (ADMA) oraz określono wskaźnik insulinooporności HOMA-IR. Wyniki: Po okresie obserwacji trwającym 3,63 ± 1,33 miesiąca stwierdzono istotne zwiększenie stężeń ADMA i FGF-23 (odpowiednio p = 0,03 i p = 0,005), natomiast stężenie 25(OH)D3 i wskaźnik HOMA-IR nie zmieniły się istotnie. Ponadto zaobserwowano u chorych zwiększenie wskaźnika masy ciała i obwodu pasa (p < 0,001 I p = 0,02) oraz istotne zmniejszenie stężenia cholesterol frakcji HDL (p = 0,006). Wnioski: Wyniki badania pokazują, że krótkotrwałe stosowanie TRT u młodych chorych z CHH, uprzednio nieleczonych, powoduje zwiększenie osoczowego stężenia FGF-23 i ADMA, lecz nie wpływa na stężenie witaminy D. Nie jest jasne, czy jest to wczesny efekt działań niepożądanych TRT w tej grupie bardzo młodych pacjentów z CHH. Konieczne są dalsze prospektywne badania w celu ustalenia długookresowego wpływu TRT na chorobowość i śmiertelność w związku z chorobami sercowymi i metabolicznymi w tej szczególnej populacji

Analysis of Serum Cytokine Levels in Larynx Squamous Cell Carcinoma and Dysplasia Patients

ABSTRACT Background: Although the imbalance of cytokines in Head and Neck Squamous Cell Carcinoma (HNSCC) is well known, there is scarce data regarding its occurrence during dysplasia, before the malignant transformation. Objective: To determine whether laryngeal dysplasia patients show a different cytokine profile than patients with cancer and healthy controls. Methods: Seventeen newly diagnosed, untreated larynx squamous cell carcinoma (SCC) and six laryngeal dysplasia patients as well as 22 healthy controls were analyzed for circulating cytokines. A flowcytometry Th1/Th2 cytokine array kit was used to quantitatively measure Interleukin-2 (IL-2), IL-4, IL-6, IL-10, Tumor Necrosis Factor-α (TNF-α) and Interferon-γ (IFN-γ) levels. Additionally, IL-8 levels were determined through ELISA. Results: IL-6, IL-8 and IL-10 were determined to be statistically increased in SCC patients (p<0.05). IL-8 and IL-10 levels were also higher in SCC patients than dysplasia patients (p<0.05). Additionally, IL-6 and IL-10 were all found to be markedly increased in dysplasia patients compared with controls (p<0.05). Conclusion: Our results demonstrate an imbalance of IL-6 and IL-10 not only in HNSCC but also in laryngeal dysplasia