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Objective:The aim of this study is to investigate the frequency of fractures and related factors in children with spina bifida who were followed up in our hospital.Materials and Methods:By retrospectively examination of the medical records of 450 patients with spina bifida, who were followed up by our clinic between 2000 and 2018, the patients were evaluated in terms of factors such as frequency of fracture, age of the first fracture, lesion level, ambulation capacity, physical therapy initiation age, fracture site and mechanism.Results:In the 450 patients examined, the fracture rate was 5.7%. While there was a relationship between low ambulatory capacity and high-level lesions and fracture risk, the early initiation of physical therapy did not protect against fracture.Conclusion:According to these data, fractures are more common in patients with spina bifida. It was concluded that the quality of mobilisation, not the duration, was the more important risk factor for fracture.

Background: to retrospectively assess the impact of prognostic nutritional index (PNI) on survival outcomes of patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC) treated with concurrent chemoradiotherapy (CCRT). Methods: this study incorporated 154 patients with LA-NPC who received exclusive cisplatinum-based CCRT. Receiver operating characteristic (ROC) curve analysis was utilized for accessibility of pretreatment PNI cutoffs influencing survival results. The primary end point was the interaction between the overall survival (OS) and PNI values, while cancer-specific survival (CSS) locoregional progression-free survival (LR-PFS), distant metastasis–free survival (DMFS), and PFS were the secondary end points. Results: a rounded PNI cutoff value of 51 was identified in ROC curve analyses to exhibit significant link with CSS, OS, DMFS, and PFS outcomes, but not LR-PFS. Patients grouping per PNI value (≥51 [N = 95] vs 5% over past 6 months (49.2% versus 11.6%; P =.002) compared to PNI < 51 group. Conclusion: low pre-CCRT PNI levels were independently associated with significantly reduced CSS, OS, DMFS, and PFS outcomes in patients with LA-NPC treated with definitive CCRT., NA

Although meningioma is mainly a central nervous system tumor, primary pulmonary meningioma is a rare lung neoplasm located outside the central nervous system. There is no clear consensus on its origin. A 42-year-old female patient, without any pre-diagnosis or symptom, was admitted to our clinic due to an incidentally detected lesion on chest X-ray during routine controls. The lesion in the lower lobe of the left lung was successfully resected by surgical intervention. In this study; primary pulmonary meningioma was examined because of its rarity and presented with the literature data.

INTRODUCTION Brain metastasis prevalence is higher in patients with positive epidermal growth factor receptor (EGFR) mutation, anaplastic lymphoma kinase (ALK) and C-ROS oncogene 1 (ROS-1) fusion change in lung adenocarcinoma. OBJECTIVES The purpose of our study is to investigate the relation between the genetic change type and the initial distant metastasis in stage IV lung adenocarcinoma patients with genetic changes. METHODS The study was conducted between January 2007 and December 2018 in a retrospective fashion with patients who had lung cancer diagnosed as stage IV adenocarcinoma. The relation between genetic mutation change (EGFR, ALK or ROS-1) and distant metastasis was analysed. RESULTS A total of 845 patients were included in the study. The median age was 62 (28-88). It was determined that lung and pleura metastases were more frequent at a significant level in patients with positive EGFR mutation (P = 0.032, P = 0.004, respectively). In patients with positive ALK fusion change, pleura metastasis was determined to be more frequent (P = 0.001). Multiple metastases were determined to be significantly more in patients with positive ALK fusion change than single metastasis (P = 0.02). CONCLUSION In patients with EGFR mutant lung adenocarcinoma, lung and pleura metastasis is more frequent and pleura metastasis is more frequent in ALK positive adenocarcinoma. Additionally, multiple organ metastases are higher in ALK positive lung adenocarcinoma.

Previous reports have indicated the association of allergy with Waldeyer's ring. The aim of this prospective study was to evaluate the correlation between the allergy and the number of eosinophils in the adenoid and tonsil tissue.101 children who were underwent adenoidectomy and/or tonsillectomy were prospectively enrolled in this study. 46 children who had positive skin-prick test for at least one of the allergen panel were sensitized and 55 children were nonsensitized as a result of skin-prick test. Hematoxylin-eosin stained sections were examined under 400× magnification in a blinded fashion in 10 random sections for all samples and compared the groups.The number of eosinophils in adenoid and tonsil tissue was significantly higher in sensitized patients. The number of eosinophils in the adenoid and tonsil samples also were interrelated too (p 0.001, kappa coefficient: 0.617). As a result of ROC analysis, patients with a cut-off of ≥5 eosinophils was in the sensitized group for adenoid samples [Sensitivity value: 72.09 and specifity value: 91.84]. Patients with a cut-off of ≥3 eosinophils are in the sensitized group for tonsil samples [Sensitivity value: 52.94 and specifity value: 92.11].Presence of sensitization can be distinguished by looking at the number of eosinophils in the adenoid and tonsil tissue. It can be used to determine whether the patient is allergic or not. Examination of the routine hematoxylin-eosin stained adenotonsillary specimen for eosinophilia will guide us the diagnosis and treatment of allergic rhinitis and also reduce the cost considerably.

Background: to retrospectively investigate the influence of pretreatment anemia and hemoglobin levels on the survival of nasopharyngeal carcinoma patients treated with concurrent chemoradiotherapy (C-CRT). Methods: a total of 149 nasopharyngeal carcinoma patients who received C-CRT were included. All patients had received 70 Gy to the primary tumor plus the involved lymph nodes, and 59.4 Gy and 54 Gy to the intermediate- and low-risk neck regions concurrent with 1-3 cycles of cisplatin. Patients were dichotomized into non-anemic and anemic (hemoglobin, NA

OBJECTIVES The effect of non-steroidal anti-inflammatory drugs (NSAID), mostly used for postoperative analgesic purposes for wound healing, is still a matter of debate. Our goal was to evaluate the effects of the most widely used NSAID and corticosteroids after surgical operations on tracheal wound healing in an experimental rat model. METHODS Thirty-nine male Wistar albino rats were included in this study. Tracheotomy was performed in 32 rats; then they were divided into 3 groups. After the first day, the animals in group 1 were treated with an NSAID (diclofenac 10 mg/kg/day) (NSAID, n = 12) for 7 days; the animals in group 2 were treated with a corticosteroid (dexamethasone, 2 × 0.1 mg/kg/day) (steroid, n = 10) for 7 days; the animals in group 3 (control, n = 10) were not given any medications. For a fourth group (histological control, n = 7), in order to evaluate normal morphological and histological characteristics, neither surgery nor medication was used. Five rats were eliminated from the study (2 rats in the NSAID group died and 3 rats in the steroid group developed local wound infections). The drop-out rate was 12.8%. Histological characteristics, inflammation, fibrosis, necrosis, neochondrogenesis, neovascularization and epithelization were evaluated in 34 rats. Non-parametric tests were used for statistical analysis. RESULTS Inflammation, vascularization and number of fibroblasts and chondrocytes were significantly higher in the control group than in the histological control group. There was some reduction in all parameters except vascularization in the NSAID group (P > 0.05). When the steroid group was compared to the NSAID group, inflammation (P 0.05) were more suppressed in the steroid group. The number of fibroblasts increased in the steroid group (P > 0.05). CONCLUSIONS Steroids and NSAID may have negative effects on tracheal wound healing, probably by suppressing inflammation and fibroblast proliferation. NSAID was mostly used postoperatively for analgesic purposes and should be avoided.

Myxomas of the nose are very rare benign neoplasms. They grow slowly, infiltrate the surrounding bone cortex, and develop multiple local recurrences with no distant metastasis. Almost, even knowing seen at any age, it is very rare in newborn. The authors present a patient with sinonasal soft tissue fibromyxoma in a newborn baby nose followed by the literature.

Objective: To report a case of Churg-Strauss syndrome who had asthma and allergic rhinitis treated with montelukast. Clinical Presentation and Intervention: A nonsmoking 59-year-old woman presented with fever, hemoptysis and dyspnea. Past medical history included allergic rhinitis and asthma which were diagnosed 18 years ago. The asthma was treated successfully with inhaled salmeterol and beclamethasone. She also received montelukast (10 mg/day) for 3 years. Although her chest X-ray was normal a week earlier, she had widespread bilateral pulmonary infiltrates on admission. She had leukocytosis (12.5 × 109/l) with eosinophilia (15.6%). Her total IgE count was 550 U/ml. Testing for protoplasmic-staining antineutrophil cytoplasmic antibodies was positive. Bronchoalveolar lavage could not be performed due to bronchospasm and severe hypoxemia; however, mucosal biopsies were obtained, which revealed eosinophil leukocytes in the lumen and walls of small vessels. She was diagnosed to have Churg-Strauss syndrome and had remarkable clinical improvement on day 5 with high-dose of oral prednisolone (50 mg/day). Radiological improvement was detected at the end of the second week. Conclusion: This case shows the importance of being aware that leukotriene receptor antagonists could cause Churg-Strauss syndrome, in spite of the uncertainty about its mechanism.

Introduction: Several markers have been investigated to predict the prognosis of lung cancer. In the present study, the prognostic values of epithelial growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), E-cadherin, and p120 catenin expression were investigated by immunohistochemistry in patients with a surgically resected non-small cell lung carcinoma (NSCLC). Patients and method: EGFR, VEGF, E-cadherin, and p120 catenin expression were prospectively determined in resected specimens from patients with NSCLC who had undergone surgery between 2003 and 2007. Patients’ and disease-related general characteristics and survival rate were recorded.

A 21-year-old woman presented with nausea, vomiting, decrease in appetite, and weight loss of 6 months and right chest pain of 5 days' duration. Earlier diagnostic work-ups had been inconclusive, and she was referred for the evaluation of the bilateral lung lesions as seen on her chest x-ray. Thoracic computed tomography scan showed a 6-cm mass in the right lower lobe, a minimal right pleural effusion, and a peripheral 2-cm cavitary nodule in the inferior lingular segment. Ultrasonography-guided transthoracic cutting needle biopsy of the right-sided mass and following right lower lobectomy both yielded benign specimens pathologically assessed as "inflammatory myofibroblastic tumor." The chest x-ray and thoracic computed tomography scans obtained 1 month following the thoracotomy showed spontaneous and almost complete resolution of the left-sided nodule. In follow-up 1 year after the surgery, no clinical, laboratory, or radiologic recurrence was detected. She is being closely followed as an outpatient.

Introduction Several markers have been investigated to predict the prognosis of lung cancer. In the present study, the prognostic values of epithelial growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), E-cadherin, and p120 catenin expression were investigated by immunohistochemistry in patients with a surgically resected non-small cell lung carcinoma (NSCLC). Patients and method EGFR, VEGF, E-cadherin, and p120 catenin expression were prospectively determined in resected specimens from patients with NSCLC who had undergone surgery between 2003 and 2007. Patients’ and disease-related general characteristics and survival rate were recorded. Results One hundred seventeen patients with a mean age of 61.3 years were included in the study. After a mean follow-up of 27.5 months, the median survival was determined to be 44.0 months and the 5-year survival was 46.2%. The 5-year survival in negative and positive staining groups were as follows; 32% and 66.7% for EGFR (P=.02), 37.8%, and 50.7% for VEGF (P=.5), 41% and 66% for E-cadherin (P=.19), and 46% and 50% for p120 catenin (P=.27). The differentiation, N status, stage, and EGFR staining were variables significantly affecting survival (P=.001, .006, .03, and .02, respectively). In multivariate Cox analysis, the EGFR staining level and N status were variables those significantly affecting survival (P=.021 and P=.010). Conclusions While negative staining of EGFR was related with poor survival, staining of VEGF, E-cadherin, and p120 catenin were not related with survival in patients with resected NSCLC.

Objectives To investigate the clinical and laboratory outcomes both objectively and subjectively in nasal polyposis patients with or without comorbidity (CoM; asthma and allergy). Patients and methods Thirty-three nasal polyposis patients (13 women and 20 men) were included into the study. Their mean age was 39.23 +/- 9.13 years. CoM(+) and CoM(-) nasal polyposis patients were compared with each other. Evaluations contained endoscopic nasal examination, acoustic rhinometry, rhinomanometry, visual analog scale score of nasal blockage, olfactory function score, respiratory function test, skin prick tests, and paranasal sinus computed tomography. Results Recovery was statistically significant in all observed evaluations for endoscopic and radiologic staging, nasal obstruction, and sense of smell compared with the first evaluation in all patients regardless of the subgroups. Although objective measurements of respiratory functions did not show any change, clinical improvement was detected in CoM(+) patients with a decrease of need to their antiasthmatic medical treatment. Conclusions Results of CoM(+) patients led to no statistical difference when compared with CoM(-) subgroup. When applying predefined nasal polyposis treatment protocol, the polyp patients with CoMs do not need close follow-up compared to the patients without CoMs.

Fibröz displazi fibroplastik proliferasyon ve normal kemiğin progresif fibröz doku ile yerdeğiştirmesi ile karakterize nonneoplastik fibroosseöz bir lezyondur. Fibröz displazi sıklıkla sinonazal bölgede olmak ile birlikte orta konka kemiğinde oluşumu oldukça nadirdir. Genellikle asemptomatiktir ancak ileri olgularda hastalığın yayılımı ile burun tıkanıklığı, sinir basısından ötürü ağrı veya patolojik kırıklar olabilir. Genellikle bağlı kemiklerden hastalığın uzanıma seconder olarak gelişir. Bu olgu sunumunda tek taraflı burun tıkanıklığı olan 54 yaşında bayan hasta literature bilgileri gözden geçirilerek sunuldu.

We present the case of a 16-year-old boy admitted with a large mediastinal mass. Both in the mediastinal tru-cut biopsy and the bone marrow biopsy, a malignant small round cell tumor was determined. The clinical diagnosis was leukemia or lymphoma. The cytoplasmic CD20 expression was shown on the tumor cells of the mediastinal tru-cut biopsy. Rhabdomyosarcoma was diagnosed by the flow cytometric analysis and immunohistochemical demonstration of muscle markers. Rhabdomyosarcomas are traditionally distinguished from lymphomas by their absence of lymphoid markers such as CD20. But in this case we have encountered CD20 expression in the tumor cells. This finding lead us to conclude that the presence of a lymphoid phenotype does not absolutely exclude the diagnosis of rhabdomyosarcoma.

Adiaspiromycosis is a world wide airborne infection and is a pulmonary disease in humans caused by the fungus Chrysosporium parvum var crescens (Emmonsia parva). It is caused by inhalation of spores of the saprophytic soil fungus. The spherules induce a granulomatous reaction, in which a single spherule is surrounded by a fibronecrotic and suppurative or fibrous granuloma. The disease can be localized and asymptomatic, or disseminated, occasionally severe, or even fatal. Reticulonodular infiltrates are the most common radiographic manifestations, with localized infiltrates occurring occasionally. We present a case with bilateral diffuse interstitial micronodular infiltration and granulomatous inflammation in the lung. The larvae of adiaspiromycosis visualized in the center of granulomatous inflammation by histopathologic examination of the lung biospy specimens. We aimed to discuss the very rare cause of diffuse interstitial and granulomatous inflammation of lung.