Early adolescent primary ciliary dyskinesia associated with broncholithiasis

Primary ciliary dyskinesia (PCD), is a rare congenital disease group, and contained Kartageners syndrome. This syndrome is characterized with situs viscerum inversus, sinusitis and bronchiectasis. In some elderly patients, broncholithiasis may be associated with PCD. The coexistence of early adolescence PCD and broncolithiasis has not been reported yet. We report here a case of a 14-year-old early adolescent male who had typically presented as PCD-based Kartageners syndrome and developed broncholithiasis which diagnosed with computed tomography.     

Do women with polycystic ovary syndrome really have predisposition to atherosclerosis?

The elastic properties of the aorta were studied in 28 women with polycystic ovary syndrome (PCOS) and in 26 regularly menstruating healthy women. In PCOS and control groups, systolic and diastolic blood pressure, aortic systolic diameter, aortic diastolic diameter, aortic distensibility, aortic stiffness index, and aortic elastic modulus were similar. It is likely that PCOS does not have any innate adverse effects on the cardiovascular system if its undesirable metabolic consequences are successfully controlled.     

Two-year follow-up of a patient with oligodontia treated with implant- and tooth-supported fixed partial dentures: a case report

Dental implants have become an accepted treatment modality for aging patients with either completely or partially edentulous arches. However, growing patients with congenitally missing primary and/or permanent teeth often need dental implant treatment, even before puberty, for optimum functional and/or psychosocial development. From a developmental perspective, dental implants cannot accompany the physiologic differentiation of the alveolar bone because of the difference in anchorage between an osseointegrated dental implant and a tooth in bone. Nevertheless, reports in the literature suggest that dental implants can be used successfully in partially and completely edentulous arches affected by congenital disorders such as ectodermal dysplasia. In this case report, a multidisciplinary team approach, which included an orthodontist, an oral surgeon, and prosthodontists, in the treatment of a patient with oligodontia is discussed. The orthodontic and prosthodontic treatment sequence, growth analysis from age 14 to 18 years, and successful therapy of an implant associated with late failure is presented.     

The use of computerized tomography for diagnosis and treatment planning in implant dentistry

Preoperative radiographic imaging of recipient sites for implant placement is imperative to obtain a functional and aesthetic implant-supported prosthesis. Although conventional radiographic techniques have inherent problems that restrict accurate imaging, the main drawback of panoramic and periapical radiography is the two-dimensional image. Computerized tomography provides cross-sectional radiographic images that facilitate proper assessment of potential recipient sites for implant placement. This paper reviews the role of computerized tomography in implant dentistry.     

Assessment of survival rates compared according to the Tamai and Yamano classifications in fingertip replantations

Background:The fingertip is the most frequently injured and amputated segment of the hand. There are controversies about defining clear indications for microsurgical replantation. Many classification systems have been proposed to solve this problem. No previous study has simultaneously correlated different classification systems with replant survival rate. The aim of the study is to compare the outcomes of fingertip replantations according to Tamai and Yamano classifications.Results:Of the 34 fingertips, 26 (76.4%) survived. Ten (66.6%) of 15 digits replanted in Tamai zone 1 and 16 (84.2%) of 19 digits replanted in Tamai zone 2 survived. There were no replantation failures in Yamano type 1 injuries (100%) and only two failed in Yamano type 2 (75%). Replantation was successful in 14 of 20 Yamano type 3 injuries, but six failed (70%). The percentage of success rates was the least in the hybridized groups of Tamai zone 1-Yamano type 2 and Tamai zone 1-Yamano type 3. Although clinically distinct, the survival rates between the groups were not statistically significantly different.Conclusions:The level and mechanism of injury play a decisive role in the success of fingertip replantation. Success rate increases in proximal fingertip amputations without crush injury.     

Is it possible to predict para-aortic lymph node metastasis in endometrial cancer?

Objective

The purpose of this study was to determine the histopathologic risk factors for pelvic lymph node (PLN) and para-aortic lymph node (PALN) metastasis in endometrial cancer (EC) and to identify in which patients PALN dissection should be performed.

Study design

A total of 204 consecutive patients, with EC and underwent systematic pelvic and para-aortic lymphadenectomy extending to the renal vessels, were studied retrospectively. Statistical significance between risk factors was examined using multivariant logistic regression analysis.

Results

Cell type, depth of myometrial invasion and tumor size were found to be independently related to PLN metastasis. PLN metastasis in any site and lymphovascular invasion (LVSI) were independent prognostic factors for predicting PALN metastasis. The sensitivity, specificity and the NPV of PLN metastasis for detecting PALN metastasis were 80.8%, 89.3% and 97%, respectively. Furthermore, the 204 patients were divided into two groups according to the presence of one of these following factors: (1) non-endometrioid cell type, (2) PLN metastasis, (3) LVSI, (4) adnexal metastasis and (5) serosal involvement. Among these 204 patients, 104 had one or more of these factors (group A), and 100 patients had none of these factors (group B). PALN metastasis was significantly greater in group A, compared to group B. The sensitivity and the NPV of these combined prognostic factors for predicting PALN metastasis were 96.2% and 99%, respectively.

Conclusions

Presence of non-endometrioid cell type, PLN metastasis, LVSI, adnexal metastasis or serosal involvement diagnosed by frozen section (FS) seem to be poor prognostic factor for PALN metastasis in EC. Also, PALN dissection should be extended to the level of the renal vessels in all patients who will undergo PALN dissection, due to frequent involvement of the supramesenterial region.     

Mycophenolate mofetil and daclizumab targeting T lymphocytes in bleomycin-induced experimental scleroderma

Background. T lymphocytes induce the transformation of fibroblasts into myofibroblasts, the main mediators of fibrogenesis. The inosine 5′‐monophosphate dehydrogenase inhibitor mycophenolate mofetil (MMF) and the anti‐CD25 monoclonal antibody daclizumab (DCZ) have been reported to suppress the proliferation of T lymphocytes. Aim. To evaluate the preventive effects of MMF and DCZ in early stages of bleomycin (BLM)‐induced scleroderma. Methods. This study involved five groups of Balb/c mice (n = 10 per group). Mice in four of the groups were injected subcutaneously (SC) with BLM [100 μg/day in 100 μL phosphate‐buffered saline (PBS)] for 4 weeks; the remaining (control) group received only 100 μL PBS. Three of the BLM‐treated groups also received either intraperitoneal MMF 50 or 150 mg/kg/day, or SC DCZ 100 μg/week. At the end of the fourth week, all mice were killed, and blood and tissue samples were obtained for further analysis. Results. In the BLM‐treated group, increases were seen in inflammatory‐cell infiltration, α‐smooth muscle actin‐positive (α‐SMA+) fibroblastic cell count, tissue hydroxyproline content, and dermal thickness. Dermal fibrosis was histopathologically prominent. In BLM‐treated mice also given MMF or DCZ, inflammatory‐cell infiltration, tissue hydroxyproline content and dermal thickness were decreased. In the MMF groups, decreases were also noted in α‐SMA+ fibroblastic cell count. Conclusion. In this BLM‐induced dermal fibrosis model, MMF and DCZ treatments prevented the development of dermal fibrosis. Further studies are needed to evaluate whether targeting T lymphocytes is effective in resolving pre‐existing fibrosis in human scleroderma.     

Vaginal evisceration after trauma unrelated to previous pelvic surgery

Background  Vaginal evisceration is described as extrusion of intraperitoneal contents secondary to the disruption of the vagina. It is an extremely rare emergency condition. Objectives  To describe a very rare case of vaginal evisceration that occurred after blunt trauma in a patient with no prior pelvic surgery. Case report  This report describes vaginal evisceration in a 73-year-old female with no prior pelvic surgery, after blunt trauma. The patient was handled by the cooperation of gynecology and general surgery departments. An immediate surgery was performed after stabilization of the patient and no postoperative complications occurred. Conclusion  Whatever be the treatment approach, emergency management of vaginal evisceration is critical to the preservation of a viable bowel. Repositioning of viable bowels into the abdominal cavity and appropriate surgical repair are cornerstones of the treatment.