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Objective: To investigate whether rhinoplasty with osteotomies for the treatment of deformed nose induces changes in intraocular pressure (IOP). Design: Prospective, nonrandomized study. Setting: University-affiliated medical center. Patients: Thirty patients who underwent rhinoplasty with osteotomies for the nose were prospectively enrolled in this study. Fifteen patients had lateral osteotomies with the external perforating technique, and fifteen with an internal continuous technique with periosteal elevation. We excluded patients with diabetes mellitus, hypertension, glaucoma, previous ocular trauma, history of ocular surgery, and previous use of topical corticosteroid eye drops. Main outcome measures: The intraocular pressure (IOP) in each patient was measured by Goldmann tonometry preoperatively and postoperatively on days 1, 2, and 7. Results: 23 women and 7 men with a mean age of 27 years were enrolled in the study. The mean ± SD IOP of the eye was 15.69 ± 2.37 mmHg preoperatively. Postoperatively, the mean ± SD IOPs were 15.96 ± 1.92 mmHg on day 1, 15.45 ± 2.55 mmHg on day 2, and 15.72 ± 2.86 mmHg on day 7 ( P = .863). Conclusions: Although osteotomes during rhinoplasty caused variations in the IOP compartment, the changes in IOP were not statistically significant. Therefore, rhinoplasty should be a safe surgical procedure with respect to ocular physiological function, however monitoring IOP peri-operatively is advised. To our best knowledge, this is the first clinical trial to determine the effect of rhinoplasty with osteotomy on intraocular pressure.

Background: Primary malignant chest-wall tumors (PMCWTs) are a heterogeneous group of tumors. They require a special experience in designing resection and reconstruction. They account for less than 1% of all primary malignant tumors. This study is designed to clarify different factors contributing to the outcome of patients with PMCWTs in our institution. Methods: A retrospective study included 98 patients with pathology proven PMCWTs, treated at the National Cancer Institute (NCI), Cairo University, Egypt, during the past 10 years. Used variables were: age, sex, forced expiratory volume in the 1 st second (FEV1), site, size, multiplicity, pathologic subtype, tumor grade, safety margin (SM), excised ribs, complications, estimated blood loss (EBL), neo-adjuvant and adjuvant treatments, Overall and disease free survival (DFS) were obtained using Kaplan-Meier method and compared using Log rank test. Cox regression was used to identify DFS predictors. Results: PMCWTs represented 10.5% of all thoracic malignancies in our institution. There were 51 females (52%). The median age was 39 years [interquartile range (IQR) =25–52.3)] years. Chondrosarcoma was the commonest tumor histology (20.4%). The median tumor size was 8 cm (IQR =5–14). Tumor multiplicity was found in 18.4% of patients. Bone resection was performed in 76 patients (78.3%), ribs resection was performed in 59 patients and the median number of resected ribs per patient was 3 (IQR =1–3) ribs. Sternal resection was done in 7 (7.1%) cases. R0 resection was achieved in 62.2% of patients. There was one operative related mortality (1.02%) and 17.3% patients suffered procedure related complications. Local recurrence developed in 35 (35.7%) patients. The overall survival (OS) at 1, 3 and 5 years was 73.9%, 45.6% and 34.6% respectively and the median OS was 33 months (95% CI, 21.8–44.2), while median DFS was 24 months (95% CI, 19.6–28.4). Predictors of better DFS were –ve SM (P Conclusions: In primary malignant CWTs (PMCWTs) achievement of wide resection margins is of great importance to minimize the local tumor recurrence that will have an adverse impact on long-term survival.

Background: Malignant pleural mesothelioma is a lethal disease and hence the strong need for identifying new prognostic factors. Methods: This is a retrospective study including all eligible patients with advanced malignant pleural mesothelioma (MPM) presenting to National Cancer Institute, Cairo University. Neutrophil lymphocyte (N/L) ratio was assessed before second line chemotherapy. 2.5 was used as the cutoff point. Endpoints were the assessment of correlation between N/L ratio and clinical response (CR), progression free survival (PFS) and overall survival (OS). Results: 52 patients (19 stage III and 33 stage IV) MPM were included and followed up during the period from July 2009 till November 2012 with a median follow-up period of 2.6 months. 87.5% of patients with N/L ratio > 2.5 showed progressive disease versus 91.7% in patients with N/L ratio 2.5 versus 14% for patients with N/L ratio 2.5 versus 66% for patients with N/L ratio

The penis is an important genitourinary organ and its reconstruction needs certain requirements in order to obtain a satisfactory outcome. This paper presents modifications in the technique of total penile reconstruction utilizing the free radial forearm flap (RFF) including the use of the remnant phallic skin and corpora, the use of the deep inferior epigastric artery as a donor artery to supply the flap after transfer and the use of the saphenous vein to augment flap venous drainage. These modifications shared in improving the outcome as regards a better operative time, avoiding exposure of large vessels, namely the femoral vessels, and providing sensory and erotic sensation to the flap

A chordoma is a slow-growing tumor representing about 5% of all malignant bone tumors. Mediastinal chordoma is very rare. We report a giant thoracic chordoma in a 32-year-old woman who presented with chest pain, progressive dyspnea, and cough. Open biopsy confirmed a definitive preoperative diagnosis, and complete surgical excision of the tumor was accomplished.

Yolk-sac tumor mimics the yolk sac of the embryo, and the presence of alpha fetoprotein in the tumor cells is highly characteristic. We present an 18-year-old boy with primary pulmonary yolk-sac tumor diagnosed postoperatively. A computed tomographic scan revealed a huge intrathoracic soft tissue mass 20 x 25 cm occupying most of the left hemithorax. Two trials of computed tomographic-guided needle biopsy were nonconclusive. A left upper lobectomy was performed with a complete tumor resection. Postoperatively, the patient's alpha fetoprotein (AFP) was 10,512 IU/mL with gradual decline under chemotherapy. The patient is alive 10 months after surgery and is disease free.