Effect of nasal packing and haemostatic septal suture on mucociliary activity after septoplasty: an assessment by rhinoscintigraphy

Nasal packing may influence the mucociliary clearance of the nose in the postoperative healing phase. In an attempt to overcome some of this problem, a haemostatic septal suturing technique was conceived. In this prospective study, we aimed to investigate the effects of nasal packing and septal suturing technique on mucociliary clearance by rhinoscintigraphy. Forty-eight adult patients who had undergone septoplasty were included in the investigation. Preoperatively, the patients were allocated into three groups: group 1, fingerstall packs filled with gauze and smeared with vaseline were used (11 male, 4 female); group 2, silicon septal splint packs were used (11 male, 4 female); group 3, haemostatic septal sutures were used (14 male, 4 female). Mucociliary clearance was measured by rhinoscintigraphy in all patients before surgery and 6 weeks after surgery. The nasal mucociliary clearance was presented as the velocity (mm/min) of nasal mucociliary transport of the ^99mTc-MAA droplet. The mean velocity of nasal mucociliary clearances before and after surgery for group 1, group 2 and group 3 were 1.85 ± 0.67 versus 2.43 ± 0.78 mm/min, 2.36 ± 0.80 versus 2.92 ± 0.96 mm/min and 2.03 ± 0.58 versus 2.62 ± 0.65 mm/min, respectively. A significant difference in nasal mucociliary clearance was observed after surgery in all groups (p < 0.001). No significant differences were found between the groups regarding mucociliary clearance before and after surgery. Patients with septal deviation have a prolonged mucociliary transit time as compared with postoperative. Nasal packing did not significantly influence the mucociliary clearance in the postoperative healing phase.     

A case of herpes simplex encephalitis revealed by decompressive craniectomy

A 15-year-old girl was referred to our hospital due to fever, headache, and vomiting of 7 days duration and focal motor convulsion at the day of referral. Her clinical signs and cerebral imaging findings were found to be compatible with herpes simplex encephalitis. In spite of prompt acyclovir administration, her consciousness deteriorated gradually. Emergent cranial magnetic resonance imaging demonstrated a shift of midline intracranial structures. Decompressive surgery resulted in partial improvement in the shift of midline intracranial structures and potentially saved the patient’s life. This case report stresses the importance of proper management of increased intracranial pressure in patients with herpes simplex encephalitis.     

Effectiveness of Functional Electrical Stimulation - Cycling Treatment in Children with Cerebral Palsy

AimThe purpose of this study was to evaluate the effects of functional electrical stimulation (FES) bicycle therapy system on motor function, gait pattern, spasticity, daily living activities, and aerobic capacity in children with cerebral palsy (CP) and to compare the results with sham stimulation and standard treatment.MethodsPatients with cerebral palsy who received botulinum toxin type-A injections to lower extremities and those with Gross Motor Function Measure Classification System (GMFCS) levels I – III, were included in the study. Twenty-five patients were randomly assigned into three treatment groups for 4-weeks: Group 1, FES-cycling and standard treatment; Group 2, Sham stimulus FES-cycling and standard treatment; Group 3, Standard treatment. Clinical assessment tools included the Modified Ashworth Scale (MAS), Modified Tardieu Scale (MTS), Pediatric Functional Independence Measure (WeeFIM), GMFCS, Gross Motor Function Measure-88 (GMFM-88), selective motor control tests, 6-minute walk test, and Visual Gait Analysis (VGA).ResultsIn all groups, there were significant improvements in MAS, MTS, WeeFIM, GMFM-88, 6-minute walk test, and VGA scores. No changes in GMFCS levels were observed in any group. At the end of the study, there was no significant difference among the groups in terms of any clinical assessment parameter.ConclusionsAll groups showed statistically significant improvements in motor function, walking pattern, spasticity, daily living activities, and aerobic capacity in patients with CP following the rehabilitation period. Although FES-cycling demonstrated no superiority over the other approaches and provided no additional benefit to the results, FES appears to be safe and well-tolerated in children with CP, at least as much as standard exercise treatment.     

Clinical importance of phosphatase of regenerating liver-3 expression in breast cancer

Background

Several biomarkers have been previously studied for breast cancer to define risk of recurrence and metastasis. Phosphatase of regenerating liver-3 (PRL-3) is one of them. High PRL-3 expression has been found to be correlated with axillary lymph node metastasis and survival in breast cancer. Herein, we evaluated the prognostic significance of PRL-3 expression and the relationship between PRL-3 and other clinicopathological factors.

Methods

PRL-3 expression was analyzed immunohistochemically in 122 invasive breast cancer tissues. We evaluated the correlation between PRL-3 and other clinicopathological factors by ??2 test. Kaplan?CMeier test and log rank method were used to define prognostic importance of PRL-3 expression.

Results

Of 122 breast cancer tumor samples, 46 (37.7?%) were negative while 76 (62.3?%) were positive in respect to PRL-3 expression. There was significant correlation between PRL-3 expression and other clinicopathological factors, such as histology, lymphovascular invasion (LVI), necrosis, progesterone receptor (PR) status, and the presence of triple negative disease. Tumors with LVI and necrosis had more positive PRL-3 expression compared to tumors without LVI or necrosis (P?=?0.05 and 0.03, respectively). Triple negative and cerb-B overexpressed breast cancers were found to be more positive PRL-3 expression than hormone receptor positive with cerb-B negative groups (luminal A) (P?=?0.02).We could not find any relationship between PRL-3 expression and overall survival (OS) or disease-free survival (DFS) (P?>?0.05).

Conclusion

Although PRL-3 expression was related to LVI or necrosis which is important for tumor invasiveness, we could not find that PRL-3 as an important prognostic factor in breast cancer patients. In addition, triple negative and cerb-B overexpressed tumors, which had worse prognosis compared to hormone receptor positive without cerb-B expressed group, associated with also PRL-3 positivity more than PRL-3 negative group.     

Metastatic tumours to the thyroid gland: report of 3 cases and brief review of the literature

Background

Metastases to the thyroid are encountered rarely in clinical practice, but the number of cases seems to have increased in recent years. The reason of this increase may be a more frequent use of fine-needle aspiration biopsy (FNAB) and the use of more sophisticated, complicated imaging techniques in patients with thyroid masses. Also, in addition to these reasons, the use of more organo-specific immunohistochemical antibodies in the examination of surgical specimens may affect the differential diagnosis of malignant tumours.

Case reports

Three metastatic tumours to thyroid were found in the retrospective review of malignant thyroid tumours diagnosed between January 1993 and December 2007. The primary tumours were clear cell carcinoma of the kidney, squamous cell carcinoma of the lung and breast carcinoma-ductal type.

Conclusions

A detailed clinical history, careful histological examination and essential immunohistochemistry helped in attaining the correct diagnosis.     

The Effects of Monocrotophos to Different Tissues of Freshwater Fish <Emphasis Type="Italic">Cirrhinus mrigala</Emphasis>

The histopathological effects of monocrotophos on the gill, kidney and intestine tissues of the Cirrhinus mrigala were determined by light microscopy. The changes in the gills were characterized by epithelial hyperplasia, aneurism, epithelial necrosis, desquamation, epithelial lifting, oedema, lamellar fusion and curling of secondary lamellae. Pycnotic nuclei in tubular epithelium, hypertrophied epithelial cells of renal tubules, contraction of the glomerulus and expansion of space inside the Bowman’s capsule were observed in the kidney tissues of fish after exposure to monocrotophos. In the intestine tissues of fish exposed to monocrotophos, oedema, necrosis and atrophy of epithelial cells were observed.     

Evaluation of the effect of fluorescein angiography on retinal vessel diameter: an optical coherence tomography study

Purpose

To evaluate the effect of fluorescein angiography on retinal vessel diameter with Optical Coherence Tomography (OCT).

Methods

In this cross-sectional study, a total of 81 eyes of 81 patients who were performed fluorescein angiography (FA) procedure were included. Retinal vessels were examined with the Spectral-domain OCT at baseline and immediately after FA procedure. A cube scan consisting of seven horizontal scans were placed at the inferior border of the disk to include the inferior temporal retinal vessels. Vessels diameters were measured at five measurement points (480–1440 μm inferiorly from the optic disk border).

Results

The mean age of the study subjects was 58.02 ± 14.1 years. At baseline, the mean diameter of the retinal artery was 120.16 ± 24.56 µm and of the vein 157.94 ± 32.34 µm at the measurement point of 480 μm, with a gradual decrease to 114.91 ± 25.59 and 152.17 ± 28.17 µm, respectively, at 1440 μm. After FA procedure, the mean diameter of the retinal artery was 122.85 ± 26.35 and of the vein 158.30 ± 32.21 µm at the measurement point of 480 μm, with a gradual decrease to 115.22 ± 22.91 and 151.94 ± 28.93 µm, respectively, at 1440 μm. There were no statistical differences for either of these comparisons at any of the points of both artery and vein measurements.

Conclusion

There was not any clinically significant change in retinal artery diameter such as a dilatatory response after FA procedure in patients with hypertension, diabetes, and age-related macular degeneration (AMD).