Left–right asymmetry in neck lymph nodes distribution in patients with bilateral laryngeal cancer

Objective

We aimed to examine left–right asymmetry in involved and total neck lymph nodes distribution in patients with bilateral laryngeal cancer in the present study.

Methods

Forty-six patients with bilateral laryngeal cancer was included the study. The oncologic database of our otorhinolaryngology department was used. The right and left lymph node with and without involvement by cancer cells counts were retrieved from pathological reports.

Results

The numbers of both involved and total neck lymph nodes were significantly higher on right side than on left side for all neck levels in laryngeal malignancies.

Conclusions

The results of the present study suggest the existence of a left–right asymmetry in neck lymph node distribution and in the neck lymph node distribution involved by laryngeal cancer cells. The stronger cell-mediated immune activity in the left side of humans may be associated with the blocking of the metastatic invasion of cancer cells from laryngeal malignancies in the left body side.     

Intrauterine upper extremity thrombosis successfully treated with recombinant tissue plasminogen activator, enoxaparin and collagenase

Intrauterine ischemia of the limbs is a rare condition involving thrombosis and ischemia of the extremities before birth. The clinical presentation depends on the extremity affected as well as the timing of thrombosis. Very few cases with extremity hypoperfusion and gangrene due to intrauterine thrombosis have been reported in the literature, and therefore there is no consensus on the optimal therapeutic strategy for such cases. Presented here is a case of a newborn with intrauterine brachial arterial thrombosis of the right upper extremity who was successfully treated by a combination of recombinant tissue plasminogen activator, enoxaparin and collagenase application followed by surgery.     

Serum prolidase activity,oxidative stress,and nitric oxide levels in patients with bladder cancer

Objectives

Prolidase is a member of the matrix metalloproteinase family. It plays a major role in collagen turnover, matrix remodeling and cell growth. Nitric oxide (NO) regulates many processes such as collagen synthesis and matrix remodeling. Thus, NO may augment angiogenesis, tumor invasion, and metastasis. The aim of this study was to investigate total antioxidant status (TAS), malondialdehyde (MDA) and NO levels in patients with bladder cancer and to determine their relationship with prolidase activity.

Design and methods

Thirty-five patients with bladder cancer and 32 controls were enrolled. Serum TAS, MDA, prolidase activity and NO levels were determined.

Results

Serum prolidase activity, NO levels and MDA levels were significantly higher in bladder cancer than controls (all, P < 0.05), while TAS levels were significantly lower (P < 0.05).

Conclusions

Our results show that increased prolidase seems to be associated with increased NO levels and oxidative stress along with decreased antioxidant levels in bladder cancer.

     

Effects of Low Sodium Dialysate in Chronic Hemodialysis Patients: An Echocardiographic Study

Background. Chronic kidney disease (CKD) and hemodialysis (HD) patients who cannot restrict sodium consumption in their diets sometimes develop significant saline excess and hypertension between dialyses. This study assessed the effect of relatively low sodium dialysate dialysis on changes of echocardiography in hemodialysis patients. Methods and Results. Eighteen patients with end stage renal failure on chronic HD were studied (8 females, 10 males) with a mean age 48.3 ± 14.6 (24–70) years. The mean time on HD was 30.8 ± 14.0 (12–60) months. Patients with hematocrit levels under 24% were excluded from the study. In all patients, echocardiography was performed thrice weekly before and after eight-week HD treatment with low sodium dialysate hemodialysis by the same operator (135 mEq/L for patients with sodium levels less than 137, 137 for patients with sodium levels over 137). Left atrium (LA) and left ventricle (LV) volumes and ejection fractions were measured, specifically: LV systolic diameter (LVSD), LV diastolic diameter (LVDD), interventricular septum (IVS), tricuspid regurgitation (TR), mitral regurgitation (MR), pulmonary artery pressure (PAP), and inferior vein cava diameter (IVCD). Results. In terms of echocardiographic parameters, LVSD, TR, PAP, and IVCD were statistically decreased after low-sodium dialysate treatments (p?=?0.002, 0.04, 0.013, and 0.00, respectively). Predialysis systolic and diastolic blood pressure (BP), post-dialysis systolic blood pressure, and interdialytic weight gain was statistically decreased when compared to basal levels (p?=?0.00, p?=?0.011, p?=?0.022, p?=?0.001, respectively). Conclusion A reduction of the dialysate sodium concentration based on the predialysis sodium levels of the patients could reduce the systolic BP and decrease the volume load on the heart as assessed by echocardiography. Within this short period, postdialysis diastolic BP could not be lowered. The effect of this approach should be studied in broad and lengthy series.     

Teratoma Presenting As a Cystic Lesion on the Chest Wall: Case Report

A 28-year-old woman presented with a rare case of chest-wall teratoma. Computed tomography of a cystic lesion located in the anterior chest wall revealed a hyperdense object with the appearance of a tooth. The cystic mass was totally excised via a chest-wall incision without thoracotomy. Pathologic examination showed a benign teratoma containing an immature tooth.