Behcet’s disease impairs voice quality without laryngeal and hypopharyngeal involvement

The objective of the study was to investigate voice evaluation parameters in Behcet’s disease patients. A prospective controlled study was performed in a tertiary referral center. A total of 31 patients (21 female, 10 male) with a diagnosis of Behcet’s disease had voice evaluations by means of laryngostroboscopy, acoustic analysis, aerodynamic measurements and perceptual assessment. Data obtained from the patients were compared to 31 healthy control subjects. Laryngeal endoscopy was within normal limits in all patients. The mean fundamental frequency in male control subjects (134?±?14?Hz) was significantly higher than in male patients (124?±?20?Hz), (p?=?0.043). Mean intensity was significantly higher in control subjects (74?±?5?dB) than in the patients (63?±?4.6?dB), (p?<?0.001). Shimmer in patients (3.4?±?2.5) was significantly higher than in control subjects (2?±?1.3), (p?=?0.01). Maximum phonation time in control subjects (25?±?5.8?s) was significantly longer than in patients (20?±?7.9?s), (p?=?0.007), and s/z ratio was found to be nearly equal between patients (0.9?±?0.2) and control subjects (0.96?±?0.1), (p?>?0.05). The patients showed a mean GRBAS score of 1.8?±?1.9 and the control group showed a mean score of 0.48?±?1.06, (p?=?0.002). The VHI-10 scale revealed a mean score of 2.2?±?4.8 in BD patients and 2?±?2 in control subjects (p?>?0.05). Behcet’s disease impaired voice quality without laryngostroboscopically visible laryngeal and hypopharyngeal involvement. This impairment was documented by objective voice evaluation methods including acoustic analysis and aerodynamic voice measurements and by subjective voice evaluation method including perceptual assessment.     

Comparison of clinical and histopathological features of patients who underwent incidental or emergency appendectomy

BACKGROUND Incidental appendectomy can be defined as the removal of a clinically normal appendix during another surgical procedure unrelated to appendicitis or other appendicular diseases.AIM To compare the demographic, biochemical, and histopathological features of the patients who underwent incidental and standard appendectomy.METHODS The demographic, biochemical, and histopathological data of 72 patients(Incidental App group) who underwent incidental appendectomy during living donor hepatectomy at our Liver Transplant Center between June 2009 and December 2016 were compared with data of 288 patients(Acute App group) who underwent appendectomy for presumed acute appendicitis. The Incidental App group was matched at random in a 1:4 ratio with the Acute App group in the same time frame. Appendectomy specimens of both groups were re-evaluated by two experienced pathologists.RESULTS Statistically significant differences were found between groups in terms of age(P= 0.044), white blood cell count(P 0.001), neutrophil(P 0.001), lymphocyte(P 0.001), red cell distribution width(P = 0.036), mean corpuscular hemoglobin(P= 0.001), bilirubin(P = 0.002), appendix width(P 0.001), and presence of acute appendicitis histopathologically(P 0.001). However, no statistically significant differences were found between groups in terms of gender, platelet, mean platelet volume, mean corpuscular volume, platelet distribution width, appendix length. While the most common histopathological findings in the Incidental App group were normal appendix vermiformis(72.2%), fibrous obliteration(9.7%)and acute appendicitis(6.9%), the most common histopathological findings in the Acute App group were non-perforated acute appendicitis(62.8%), perforated appendicitis(16.7%), lymphoid hyperplasia(8.3%), and appendix vermiformis(6.3%).CONCLUSION Careful inspection of the entire abdominal cavity is useful for patients undergoing major abdominal surgery such as donor hepatectomy. We think that experience is parallel to the surgeon's foresight, and we should not hesitate to perform incidental appendectomy when necessary     

Invasive micropapillary carcinoma of the breast: clinical,mammographic, and sonographic findings with histopathologic correlation

OBJECTIVE: The purpose of our study was to investigate the imaging features of invasive micropapillary carcinoma of the breast, which is a recently described, rare variant of infiltrating ductal carcinoma. CONCLUSION: Invasive micropapillary carcinoma of the breast usually manifests as a firm, immobile mass. Findings on mammography are of a spiculated, irregular or round, high density mass with or without associated microcalcifications. On sonography, the common findings are of a homogeneously hypoechoic, irregular or microlobulated mass with posterior acoustic shadowing or normal sound transmission. Axillary lymph nodes are frequently involved. Although these findings are not specific and may be seen with other breast malignancies, invasive micropapillary carcinoma should be included in the differential diagnosis for breast masses with these imaging features. Also, radiologic findings may help in the histopathologic differentiation of cases that are difficult to diagnose, such as metastatic tumors.     

The safety and efficacy of the Angio-Seal closure device in diagnostic and interventional neuroangiography setting: a single-center experience with 1,443 closures

Introduction We evaluated the safety and efficacy of the Angio-Seal closure device used to close arterial puncture sites in patients who had undergone diagnostic cerebral angiography and neurointerventional procedures. Methods A total of 1,443 Angio-Seal devices were placed in 1,099 patients in the Interventional Neuroradiology Unit between May 2005 and August 2006. Of these, 670 were interventional and 745 were diagnostic cerebral angiographic procedures. In 28 patients bilateral puncture of the femoral arteries was performed for endovascular treatment. In 167 patients 286 repeat diagnostic procedures were performed and 30 interventional procedures were followed by re-closure with an Angio-Seal device at the time of repeat puncture. Results The procedural success rate for antegrade closures was 99.7% for all procedures. The device failed in 5 of 745 diagnostic procedures (0.7%). Major complication occurred in one patient only (0.13%) in the diagnostic group. No minor complications were observed in this group. In the interventional group, the major complication rate was 1.4% (10 of 698 closures) and the minor complication rate was 2.4% (17 of 698 closures). However, in the subgroup of patients with cerebral aneurysms who received heparin in combination with antiplatelet agents after the procedure, the major complication rate was 5.3%, but in the carotid/vertebral stenting group it was 0.8%. Conclusion Our experience in a relatively large series of patients shows that the use of the Angio-Seal STS vascular closure device is safe and effective in patients undergoing cerebral diagnostic angiography and neurointerventional procedures with an acceptable rate of complications, although the complication rate was higher in the group of patients who received heparin and/or antiplatelet medication.     

The relationship between the sphenoid and the posterior ethmoid sinuses and the optic nerves in Turkish patients

The sphenoid and the posterior ethmoid sinuses are surrounded by more vital structures than any other sinus. With the widespread acceptance and expanding role of endoscopic sinus surgery, a proper understanding of the anatomy of the sphenoid and the posterior ethmoid sinuses is achieved. We reviewed 100 CT studies of the paranasal sinuses belonging to patients examined for a chronic inflammatory disease of the nasal cavity and the paranasal sinuses. The relationship between the optic nerves and the paranasal sinuses is classified into four discrete categories. Type 1 with a proportion of 64% is observed to be the most often localized optic nerve. Type 2 is detected in 22% of the cases; types 3 and 4 are both 7% of the total number. A bony dehiscence was detected in 13.5% of the total cases, while it was observed in 39% of type 2 and 43% of type 3. We found a pneumatization of the anterior clinoid process in 11% of the patients. The proportion of pneumatization of the anterior clinoid process in type 3 configurations is found out to be as high as 86%. Optic nerve dehiscence was seen with a proportion of 23% in cases of pneumatization of the anterior clinoid process. Pneumatization of the posterior nasal septum was detected in 15% of the 100 cases. When the optic nerves were evaluated in these cases, mostly the type 1 configuration with a proportion of 63% was observed. An extensively pneumatized sphenoid sinus was detected in 4% of the 100 cases. Five of the investigated 8 optic nerves of these 4 cases were found out to be type 3 (62.5%). No significant optic nerve variations were met in patients with pneumatization of the posterior nasal septum. Nevertheless while performing surgery, it is important to bear in mind that there may be significant optic nerve variations with pneumatization of the anterior clinoid process and extensively pneumatized sphenoid sinuses.     

Effectiveness of bendamustine in relapsed or refractory lymphoma cases: a Turkish Oncology Group study

IntroductionWe aimed to investigate the efficacy and side effects of bendamustine in relapsed/refractory lymphoma patients in Turkey.Material and methodsIn this retrospective study, we included relapsed/refractory Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) patients who underwent multiple lines of chemotherapy. The primary endpoint was to determine the objective response and toxicity.ResultsNinety-nine patients with a median age of 59.8 years were included in the study. Eighty-one patients had NHL (follicular lymphoma: 10, diffuse large B-cell lymphoma: 27, mantle-cell lymphoma: 18, marginal zone lymphoma: 9, small lymphocytic lymphoma/chronic lymphocytic leukemia: 17) and 18 patients had HL. The patients had previously received a median of three lines of chemotherapy (range: 2–8) except autologous stem cell transplantation (ASCT); 19 patients (HL: 11, NHL: 8) had undergone ASCT. The objective response rate (ORR) was 74.3%, the complete response rate was 57% (= 53), and the partial response rate was 16.6% ( = 19). The overall survival (OS) rate at 1 year was 74.6%. The progression-free survival (PFS) rate at 1 year was 62.5%. The most common side effects were lymphopenia, anemia and neutropenia. Side effects which were observed as grade 3 and higher levels were lymphopenia (14.1%), neutropenia (10.1%) and fatigue (7.1%).ConclusionsObjective response rate of bendamustine was found to be 74.3% in relapsed/refractory HL and NHL patients. It appears to be an effective option as a salvage treatment for patients who have previously received multiple lines of therapy.