Minimal endometriosis and intrauterine insemination: does controlled ovarian hyperstimulation improve pregnancy rates?

Fifty normally menstruating women staged laparoscopically as having minimal endometriosis were given an option to be treated with intrauterine insemination with or without ovarian stimulation. Twenty-five patients had unmedicated natural cycles (ie, no medication for follicular stimulation), and 25 underwent controlled ovarian hyperstimulation. All subjects received hCG to time ovulation, followed 36 hours later with intrauterine insemination. Sixteen pregnancies, eight in each group, resulted from a total of 132 cycles. The cumulative probabilities of conception for the first, second, and third cycles were 0.13, 0.26, and 0.38 in the natural-cycles group and 0.12, 0.25, and 0.34 in the medicated-cycles group, respectively (P greater than .05). Monthly fecundity was 0.14 for the natural-cycles group and 0.13 for the medicated-cycles group (P greater than .05). We conclude that there is no difference in pregnancy rates or monthly fecundity over a 3-month period with controlled ovarian hyperstimulation as opposed to natural cycles combined with intrauterine insemination.     

Intravascular papillary endothelial hyperplasia of the central nervous system--four case reports

Four rare cases of intracranial intravascular papillary endothelial hyperplasia (IPEH) manifesting as cranial nerve disturbances occurred in 16-, 18-, 24-, and 28-year-old females. Magnetic resonance imaging showed all lesions as isointense with strong enhancement on T1-weighted images, and as hyperintense on T2-weighted images. All lesions were removed via craniotomies. Histological examination found vascular structures and papillary spaces lined with endothelial cells showing immunoreactivity for CD31. Complete removal was curative in two cases, whereas incomplete removal resulted in cure in one case and residual deficits in one case. Iatrogenic deficits should be avoided in IPEH treatment by surgery. Differentiation from neoplasm such as angiosarcoma depends on histological characteristics.     

Secretory meningiomas

Secretory meningiomas are a rare meningioma subtype. Among meningiomas, the frequency of secretory meningiomas is 1.6%. Unlike other meningioma types, most of the patients were female (ratio 3:1). No recurrence was reported during the 24–180 months follow-up period of our secretory meningiomas in which, a low level of 0.3% Ki-67 proliferative index was reported. In this meningioma subtype, the percentage of cases with positive progesterone receptor is 33%. With carcinoembryonic antigen, cytokeratin and epithelial membrane antigen, in all the cases positivity was observed in both, the inclusions and the cells surrounding them. With human milk fat globulin 2, a high ratio (92%) of positivity was observed. Majority of the cases were negative with CA125, only three of the cases had suspicious positivity. Distribution of inclusions was irregular and their positive reactions showed varying staining features. Positivity with alpha-1-antitripsin was seen not only in the inclusions but also in some meningothelial cells as well. Ubiquitin was positive in inclusions of the 83% of cases. Staining features of the inclusions pointed out the possibility of them being in a varying age and/or content. Secretory meningiomas are a different type compared to other meningiomas, not only with their histological features but also with their clinical features as well.     

Problems pertaining to the long head of the biceps brachii in subacromial impingement syndrome

In this paper, we presented the pathological changes occurring in the long head of the biceps muscle in subacromial impingement syndrome, and evaluated treatment approaches in the light of the relevant data.     

Analyses of demographical and injury characteristics of adult and pediatric patients injured in Syrian civil war

Purpose

Aimed to analyze demographical data and injury characteristics of patients who were injured in the Syrian Civil War (SCW) and to define differences in injury characteristics between adult and pediatric patients.

Intradural spinal hydatid cysts

Spinal hydatid cysts are very rare and comprise only 1% of all bony involvement. Intradural hydatid cysts are extremely rare compared to other types of spinal hydatid cysts. We report the case of a 19-year-old man with lumbar intradural hydatid cysts. He complained of paraparesis and urinary hesitancy. Myelography revealed a block of the contrast medium at the L4 level and multiple round radiolucent lesions rostrally. At surgery, multiple hydatid intradural cysts were extirpated. The patient’s neurologic deficits improved postoperatively, but recurred 6 weeks later. Reoperation led to partial improvement of deficits. Primary intradural hydatid cysts are extremely rare. It is difficult to explain an isolated intradural location of multiple cysts. In our patient, the cysts were multiple and the patient’s cerebral CT scan was normal; he had undergone no previous lumbar puncture. So we can hypothesize that intradural spinal cysts may be primarily multiple. Received: 7 May 1996 Revised: 9 August 1996 Accepted: 17 August 1996     

The Efficiacy of Anterior and Posterior Archs Suturation at Inferior Tonsillar Pole for Posttonsillectomy Pain Control

The aim of our study was to investigate the efficiacy of the suturation technique after completing the tonsillectomy procedure for posttonsillectomy pain control in adult patients. August 2010–February 2011, 44 adult patients, ages ranged from 16 to 41 years old who underwent tonsillectomy at Elazi? Training and Research Hospital Otorhinolaryngology Clinic were included to the study. After tonsillectomy procedure, anterior and posterior tonsillar archs were sutured each other and so, the area of tonsillectomy lodges which covered with mucosa were increased. Twenty two patients who applied posttonsillectomy suturation were used as study group and remnant 22 patients who did not applied posttonsillectomy suturation were used as control group. The visual analogue score (VAS) was used to evaluate the postoperative pain degree (0 no pain, 10 worst pain). ANOVA test (two ways classification with repeated measures) was used for statistical analysis of VAS values. P < 0.05 was accepted as statistically significant. The effect of time (each post-operative day) on VAS values was significant. The mean VAS values between study and control group on post-operative day 1st, 3rd, 7th, and 10th were statistically significant (P < 0.05). The severity of posttonsillectomy pain was less in study group patients than control group patients. The suturation of anterior and posterior tonsillar archs after tonsillectomy procedure was found effective to alleviate the posttonsillectomy pain in adult patients.     

Basal cell adenocarcinoma of the minor salivary gland: a case report

Basal cell adenocarcinoma (BCA) is an uncommon salivary gland neoplasm. The majority of salivary gland tumors are located in the parotid gland, while only a few involves the minor salivary gland of the oral cavity. Pathological diagnosis is important to differentiate BCA from other neoplasms, as the prognosis of the diseases is significantly different. In this article, we present a 41-year-old-male with BCA involving the upper labial mucosa.