Outcome of Surgery for Crooked Nose: An Objective Method of Evaluation

Objectives: The aim of this study was to report the authors surgical results, and to present their method of angle measurement using the Scion Image computer program to evaluate surgical results for crooked noses.Methods: The study included 27 patients with crooked noses: classified as C-type and 14 classified as I-type. Deviation angles were measured by using the Scion Image computer program on frontal views before and at least 3 months after the operation. Correction of the crooked nose was performed through an open approach with the patients under general anesthesia.Results: Significant correction was achieved for both types of crooked noses (p < 0.05). The results for the I-type crooked noses were closer to the ideal angles than those for the C-type, but the difference was not significant. The findings showed that 66.7% of the patients with crooked noses, had good or excellent results after surgery: 53.8% of those with the C-Type and 78.6% of those with the I-type.Conclusion: It is difficult to achieve satisfactory results in the correction of crooked noses. The angle measurement method using the Scion Image computer program may be helpful in evaluating the effectiveness of different surgical techniques.This study was reported as oral presentation at 27th National Meeting of the Turk Otorhinolaryngology and Head and Neck Surgery Society, Antalya, Turkey, 4–9 October 2003     

Statins prevent oxidized low-density lipoprotein- and lysophosphatidylcholine-induced proliferation of human endothelial cells

The proliferation of endothelial cells is induced by oxidized low-density lipoprotein (oxLDL) and its major component, lysophosphatidylcholine (LPC). The aim of this study was to investigate the effect of statins on the proliferation of endothelial cells derived from human umbilical cord veins (HUVEC). Cerivastatin, simvastatin and fluvastatin caused a dose-dependent inhibition of endothelial cell growth (n=12; P<.01) when using cell counts and [3H]-thymidine incorporation, respectively. The strongest inhibition of HUVEC proliferation was achieved at statin concentrations of 0.1 micromol/l (cerivastatin), 2.5 micromol/l (simvastatin) and 1 micromol/l (fluvastatin). Cell counts were significantly reduced from 22937+/-280.6 (control) to 7791+/-133.6 (cerivastatin), 7292+/-146.6 (simvastatin) and 6792+/-135.5 (fluvastatin) (n=12; P<.01). Interestingly, cell proliferation induced by oxLDL (10 microg/ml) and LPC (20 micromol/l) could be effectively prevented using statins at concentrations between 0.01 and 0.1 micromol/l (cerivastatin), 1 and 2.5 micromol/l (simvastatin) and 0.25 and 1 micromol/l (fluvastatin). This effect of the statins was abolished by preincubation with mevalonate (500 micromol/l). Our results demonstrate an interesting direct effect of statins on the proliferation of human endothelial cells induced by oxLDL and LPC, which may be beneficial to prevent vascular effects of these atherogenic lipids.     

Multiple endocrine neoplasia type 2 and sporadic medullary thyroid carcinoma: Turkish experience

Multiple endocrine neoplasia type 2 (MEN 2) is a rare autosomal dominantly inherited familial cancer syndrome caused by mutations in the ret proto-oncogene. MEN 2 has three distinct subtypes, which are MEN 2A, MEN 2B and familial medullary thyroid carcinoma. Identification of a disease gene has enabled a DNA-based strategy for detection of direct mutation in patients with MEN 2 syndromes and in patients with sporadic medullary thyroid carcinoma. The identification of mutations responsible for MEN 2 syndromes has resulted in the routine identification of gene carriers early in life before the development of disease, causing timely prophylactic thyroidectomy in these patients. This report includes our clinical and molecular experience on Turkish MEN 2 families and patients with sporadic medullary thyroid carcinoma diagnosed and treated between 1994 and 2005.     

Non-invasive mechanical ventilation with spinal anesthesia for cesarean delivery

We present the successful use of perioperative non-invasive mechanical ventilation in a morbidly obese pregnant woman with bronchial asthma, severe preeclampsia and pulmonary edema undergoing an emergency cesarean delivery with spinal anesthesia. The combination of non-invasive mechanical ventilation with neuraxial anesthesia may be of value in selected parturients with acute or chronic respiratory insufficiency requiring surgery.     

Concomitant radiotherapy and hyperthermia for primary carcinoma of the vagina: a cohort study

OBJECTIVE: To evaluate the supplementary value of adding hyperthermia to radiotherapy in patients with primary vaginal cancer. STUDY DESIGN: Cohort of 44 patients diagnosed with primary vaginal cancer between 1990 and 2002 was assessed. Survival rates and median survival of patients with primary vaginal cancer undergoing radiotherapy with and without hyperthermia were compared. Hyperthermia was solely added to radiotherapy in case of a tumor size >4 cm in diameter for FIGO stage III disease. RESULTS: The calculated overall 5-year survival of primary vaginal cancer was 63%. In comparison to histologic high grade tumors, higher survival rates for histologic low grade tumors were calculated. For FIGO stage III of disease, the addition of hyperthermia to radiotherapy for tumors >4 cm in diameter resulted similar survival rates and median survival when compared to those achieved by radiotherapy as monotherapy in tumors of <4 cm in diameter. CONCLUSIONS: The addition of hyperthermia to radiotherapy might result in better survival rates in primary vaginal cancer for tumors >4 cm in diameter. The supplementary effect of hyperthermia to radiotherapy may be a feasible and beneficial approach in the treatment of vaginal cancer.     

Intrasellar epidermoid cyst presenting as pituitary apoplexy

We herein present a patient with intrasellar epidermoid cyst presenting as pituitary apoplexy, who was operated upon with a trans-sphenoidal approach. The clinical presentation, radiological and histological differential diagnosis and type of surgical intervention for intrasellar epidermoid cysts are discussed.     

Airbags and wearing seat belts prevent cut-crush injuries or reduce severity of injury in low-speed traffic accidents

Cut-crush injury is a transverse or an oblique laceration of the face, accompanied by a crush of the nearby structures such as orbits, nose, and maxillofacial bones, and is usually caused by striking the face against a semi-sharp margin such as a dashboard. This report presents 20 patients with cut-crush maxillofacial injuries. The etiology and treatment of the injuries and their outcome will be discussed. The leading cause was traffic accidents occurring at low speeds in which safety belts were not used, and the majority of the fractures were in the midface region. The aim of this paper is to present treatment of cut-crush injuries and to emphasize the importance of wearing seat belts and using airbags.     

Cytotoxic T lymphocyte‐associated molecule‐4 polymorphism in Turkish patients with Hashimoto thyroiditis

We previously shown that in a Turkish population, the A/G polymorphism in exon 1 of the cytotoxic T cell lymphocyte‐associated molecule‐4 (CTLA‐4) gene is associated with Graves’ disease, and that the G allele may contribute to susceptibility for developing Graves’ disease. This polymorphism was identified in 197 patients with Hashimoto thyroiditis (HT) (126 women, 71 men; aged, 42.92 ± 13.4 years) and 98 healthy individuals (56 women, 21 men; aged, 42.27 ± 13.43 years) in Turkish population. Polymorphisms were analysed using a polymerase chain reaction–restriction fragment length polymorphism method. Frequency of the A/G genotypes was not significantly different in patients with HT when compared with controls in both sexes (P > 0.05). There was no statistical difference in age, sex, cigarette smoking, initial serum thyroid hormone levels, initial goiter size and thyroid autoantibodies among the patients with the three different genotypes (G/G, A/G and A/A). We concluded that A/G polymorphism of CTLA molecule is linked to occurence of Graves’ disease bu not to HT in the Turkish population.