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Objective: Postoperative intraabdominal adhesions still cause significant morbidity in surgical patients. This study aims to evaluate the effects of an immunosuppressor known as Sirolimus and an antiadhesive membrane which is formed with sodium hyaluronate carboxymethylcellulose-based bioresorbable membrane (Seprafilm™) to the intraabdominal adhesion formation in a rat model. Materials and Methods: This experimental study was performed at an experimental research center, Yeditepe University Faculty of Medicine, Istanbul. Spraque-Dawley Rats, at a weight of about 250±20 gr, were used. Group 1 (n=8): Abdomen was closed after applying cecal abrasion (control group), group 2 (n=8): 10 x 30 mm Seprafilm™ was applied under the abdominal wall after cecal abrasion ( Seprafilm™ group ). Group 3 (n =8): Sirolimus (0,5 mg/kg) was applied (Sirolimus group). Adhesions quantitatively evaluated by a blinded assessor according to the classification of Nair and his colleagues. Results: Statistically significant difference in terms of adhesion severity scores according to the Nair classification was found between the Sirolimus and the control group (p=0,03). Whereas, no statistically significant difference was found between the Seprafilm™ and the control group (p=0,17). Similarly, no statistically significant difference was found between Seprafilm™ and sirolimus group (p=0,64). Conclusion: Although there was no statistically significant difference between intraperitoneal application of Sirolimus and Seprafilm™ group (p = 0.57), a statistically significant difference was found when each group compared with the control group (p=0,03). Combined anti-adhesive effect of Sirolimus and Seprafilm™ can be evaluated in future studies.

The larynx-related adverse effects that depend on cisplatin decrease patient comfort and many antioxidants have been used to eliminate these side effects. We aimed to identify the laryngeal mucosal changes imposed by cisplatin and investigated whether antioxidants, and their healing effects on these changes, may help reduce laryngeal complications in patients resulting from adverse effects in the larynx. A rat model was designed to evaluate the effects of cisplatin on the larynx and the protective role of antioxidants. Single-dose cisplatin was given both intraperitoneally alone and additionally administered with p-coumaric acid, melatonin, resveratrol, vitamin D, and oleic acid over 5 days. Whole larynges were dissected and evaluated histologically, histochemically, and immunohistochemically. Varying degrees of mucosal changes cisplatin group, but neither erosion nor an ulcer was observed. Numerous variable histological effects of antioxidants were observed on cisplatin exposed laryngeal mucosa. The most obvious effects of cisplatin were edema. The results of the study showed that resveratrol was the most preventive antioxidant agent against cisplatin-dependent mucosal changes. The highest increase in the Ki67 index was in the oleic acid group. Vitamin D increased stromal cyclooxygenase-2 expression that may have an effect on increasing mucosal damage.

Objective: In this study, the effectiveness of caffeic acid phenethyl ester (CAPE) and Dehydroepiandrosterone (DHEA) in preventing ischemia reperfusion injury associated with ovarian torsion have been investigated. Materials and Methods: Twenty four adult female Wistar Albino rats were randomly divided into four groups. Ovaries were not twisted, and only healthy ovarian tissues were removed from the rats in the first group, while ovaries were twisted for 3 hours in the other groups. The second group did not receive any medications before the ovaries were untwisted, while 20 micromole/kg of CAPE was applied on peritoneal surface to the third group, and 60 mg/kg of DHEA was administered intraperitoneally to the fourth group. Results: The level of primordial follicles was higher in the third group compared to the second group after the torsion of the ovary (p=0.017). The mean level of primary follicles was higher in the first group compared to the number of follicles in the third and fourth groups after the torsion of the ovary (p

Objective: We aimed to investigate the effect of platelet‑rich plasma (PRP) derivatives, which can be produced from the patient’s blood and have minimal side effects, on endometriosis.Methods: To our knowledge, this is the first study in the literature that studies the relationship between PRP and endometriosis. Endometriosis foci were created in the first operation. In the second operation (30th day), four groups were formed wherein group 1 (n = 8) was administered saline, group 2 (n = 7) leukocyte and platelet‑rich plasma (L‑PRP), group 3 (n = 8) pure platelet‑rich plasma (P‑PRP) and group 4 (n = 10) was used to obtain PRP. In the last operation (60th day), the endometriotic foci was measured and then excised.Findings: There was no statistically significant difference between the pre and post volumes of the endometriotic foci, between their volume differences, and volume difference rates (P > 0.05). However, it was observed that existing implant volumes in all groups decreased statistically significantly within their groups by the end of the experiment compared to the previous volumes (P < 0.05).Conclusion: When the implants were assessed through histopathological scoring in terms of edema, vascular congestion, inflammatory cell infiltration, hemorrhage, epithelial line, and hemosiderin accumulation, and immunohistochemical staining was assessed in terms of VEGF, there was no significant difference in the comparison between the groups. Although L‑PRP and P‑PRP generated more reduction in the endometriosis foci, they did not create any statistical differences. Key words: L‑Prp; P‑Prp; VEGF; endometriosis.

INTRODUCTION[|]Rhinitis medicamentosa (RM) is a nonallergic form of rhinitis, mostly associated with prolonged, excessive, and improper use of topical decongestants. The only effective treatment for this is nasal steroids. This study aimed to reverse the mucosal changes in RM by the use of surfactant. Different molecules were applied to each group to compare surfactant's effectiveness.[¤]METHODS[|]Thirty rats were divided into five groups. All groups were treated with topical oxymetazoline 0.05% for 30 days. Loss of cilia, congestion, edema, goblet cell growth, and increase in mucous glands, squamous metaplasia, and chronic inflammatory cell infiltration were set as the main parameters. Rats in group 5 were sacrificed; all proved the presence of mucosal changes in compliance with RM. All groups were continued to be treated with oxymetazoline even during the histopathological examination period of 15 days. Treatment modalities of each group for 15 days were as follows: saline wash (0.09% NaCl) in group 1, mometasone furoate monohydrate 50 μg 0.05% in group 2, surfactant wash solution 1 drop/100 cc in group 3, and intranasal surfactant solution with mometasone furoate monohydrate 0.05% in group 4. All rats were decapitated and sent for histopathological evaluation at the end of day 60.[¤]RESULTS[|]A significant regression in the nasal mucosal congestion was found in groups treated with saline and mometasone furoate (p=0.005). No significant difference was found between groups when evaluating for regression of loss of cilia but unpredictably was seen in saline group by 83%. Surfactant/mometasone furoate combination therapy was found to be significantly ineffective for treatment of edema (p=0.013). No statistical difference was found between the groups in terms of chronic inflammatory cell infiltration (p=0.115). Squamous metaplasia was observed in all treatment groups, and there was no statistically significant difference between the groups (p=0.076).[¤]DISCUSSION AND CONCLUSION[|]Surfactant or its combination with nasal steroid is not significantly effective in the treatment of RM.[¤]

Our aim was to investigate the effect of platelet-rich plasma (PRP) derivatives, which can be produced from the patient’s own blood and have minimal side effects, on endometriosis. To the best of our knowledge, this is the first study in the literature that studies the relationship between PRP and endometriosis. Endometriosis foci were created in the first operation. In the second operation (30th day) groups were formed. Group 1 (n= 8) was administered saline, group 2 (n= 7) leukocyte- and platelet-rich plasma (L-PRP), and group 3 (n= 8) pure platelet-rich plasma (P-PRP). Group 4 (n= 10) was used to obtain PRP. In the last operation (60th day), the endometriotic foci were measured, and then excised. There was no statistically significant difference between the pre and post volumes of the endometriotic foci, between their volume differences and volume difference rates (p > .05). However, it was observed that existing implant volumes in all groups decreased statistically significantly within their own groups by the end of the experiment compared to the previous volumes (p < .05). When the implants were assessed through histopathological scoring in terms of edema, vascular congestion, inflammatory cell infiltration, hemorrhage, epithelial line, and hemosiderin accumulation and immunohistochemical staining in terms of VEGF, there was no significant difference in the comparison between the groups. Although L-PRP and P-PRP generated more reduction in the endometriosis foci, they did not create any statistical differences.

Objectives: The aim of this study was to compare the effects of sildenafil, vardenafil and tadalafil in treatment for ischemia/ reperfusion injury which is created experimentally in rat ovaries. Material and methods: For this study, 30 female Wistar albino rats were used, and the rats were separated randomly into five groups consisting of six rats each: normal, torsion-detorsion, torsion-detorsion + sildenafil 1.4 mg/kg, torsion-detorsion + vardenafil 1.7 mg/kg and torsion-detorsion + tadalafil 5.0 mg/kg. The agents were given intraperitoneally 30 minutes before detorsion. An ovarian torsion procedure was implemented in all other groups for 3 hours with the exception of the normal group. Then, a detorsion procedure was implemented to the groups for 3 hours. Results: The sildenafil and vardenafil treatments showed protective effect by preventing significant increase in inflammation parameters. (p = 0.058, 0.138). The tadalafil treatment was only protective for cellular degeneration (p = 0.140). The vardenafil treatment was protective for edema (p = 0.238), vascular congestion (p = 0.111), inflammation (p = 0.138) and cellular degeneration (p = 0.532). Sildenafil, vardenafil and tadalafil inhibited the increase of atretic follicle. AMH levels were statistically different between torsion and detorsion and vardenafil group (p = 0.004, 0.004), whereas tadalafil and sildenafil groups were similar to normal group (p = 0.108, 0.108). Conclusions: PDE inhibitors were found to be effective in reducing ovarian ischemia/reperfusion injury. Sildenafil and tadalafil seem to be more effective than the vardenafil in protecting the ovarian reserve.

Objectives/hypothesis We investigated the effect of intranasal topical curcumin on nasal septum mucosa wound healing in a nasal septal perforation model produced in rabbits. Study design Experimental study. Methods Fourteen male New Zealand rabbits were included in the study. For each rabbit, 5-mm-diameter circular perforations were created at 5 mm away from the columella to the nasal septum. Curcumin (study group) and saline (control group) were administered intranasally once daily for 10 days. At the end of the 10th day, the animals were sacrificed and the nasal septum specimens were sent for histological examination. Epithelial regeneration and degeneration, cartilage degeneration and regeneration, presences of fibroblast, eosinophil, acute/chronic inflammatory and giant cells, capillary density, amounts of granulation tissue and collagen, and macroscopic closure rate of perforation parameters were compared in each group. Results Epithelial and cartilage regeneration, and the amounts of collagen and granulation tissue were significantly higher in the curcumin group compared to the control group (P .05). Conclusions Topical application of curcumin improves the wound-healing process of nasal septum perforation in the animal model. Therefore, curcumin can be used as a safe and effective medical agent to prevent the development of septal perforation. Level of evidence NA Laryngoscope, 129:E349-E354, 2019.

Follicular hybrid cysts including two or more components of the epithelial skin adnexa are very rare. The epithelial lining of hybrid cysts varies, and either contains epidermis, and trichilemmal squamous epithelium, or other epithelia of the skin adnexa. Hybrid cysts may also be associated with neoplasia, such as in situ carcinoma, Bowen's disease and squamous cell carcinoma. A 37-year-old female was complaining of a cyst on her scalp. The unilocular cystic lesion was lined with markedly atypical squamous cells with trichilemmal differentiation. Marked nuclear and cytological atypia, pleomorphism, numerous mitotic figures and atypical mitosis was detected in the squamous epithelium. The epithelium of the cyst was also composed of ductal structures lined with cuboidal epithelium. Immunohistochemical staining was positive for cytokeratin 7 (CK7) in both squamous and glandular epithelium. Luminal staining was shown by carcinoembryonic antigen (CEA), although gross cystic disease fluid protein-15 (GCDFP-15) was negative in the glandular epithelium. In addition, p16 tumor suppressor gene was strongly positive in both the squamous and glandular epithelium. Overall, the unique cystic lesion reported contained pilar squamous epithelium with in situ carcinoma and eccrine ductal structures, which was interpreted as a hybrid cyst composed of in situ trichilemmal carcinoma and a ductal eccrine component.

Ya z›fl ma Ad re si/Ad dress for Cor res pon den ce: Dr. Fehmi Narter, Kartal Dr. Lutfi Kirdar Egitim ve Arastirma Hastanesi, Uroloji Klinigi, Istanbul, Turkiye E-mail: fehminarter66@gmail.com Ge lis Ta ri hi/Re cei ved: 20.06.2016 Ka bul Ta ri hi/Ac cep ted: 05.09.2016 © Uroonkoloji Bulteni, Ga le nos Ya yi ne vi ta ra fin dan ba sil mis tir. Bu makale “Creative Commons Alinti-Gayriticari-Turetilemez 4.0 Uluslararasi Lisansi (CC BY-NC 4.0)” ile lisanslanmistir. Objective: In this study, we aimed to evaluate the presence and thickness of pseudocapsule after partial nephrectomy in renal cell carcinoma (RCC) cases. Materials and Methods: A total of 100 patients who were admitted to our clinic and diagnosed with RCC were included in the study. Histopathological specimens of the patients who underwent partial nephrectomy were re-evaluated retrospectively. Results: The histopathological results revealed pseudocapsule in 87 cases (87%, median thickness: 0.708 mm). Pseudocapsule median thickness was noted respectively 0.483, 0.691, 0.737, 0.954 mm in Fuhrman Grade 0, 1, 2, 3/4 groups (p

Background/aims This study aimed to evaluate the relationship between irritable bowel syndrome (IBS) and plasma and tissue ghrelin levels. Materials and methods Patients who had undergone gastroscopy procedure for any reason previously were enrolled in the study. Among these, patients with IBS symptoms were evaluated according to the Roma III criteria. The healthy control group comprised patients with no IBS symptom and had undergone gastroscopy procedure for another reason. The plasma ghrelin level and tissue ghrelin level obtained by immunohistochemical examination of biopsy specimens taken from the gastric antrum and corpus were evaluated in all participants. Results The mean age of 90 participants was 43.64}12.64 years. The median value of the plasma ghrelin level was 3.29 (1.2-12.7) in the diarrhea group (IBS-D), 1.49 (0.82-7.08) in the constipation group (IBS-C), and 1.5 (0.2-3.7) in the control group. The plasma ghrelin levels between the groups were found to be significantly higher in IBS-D than in IBS-C and the control groups (p=0.001 and p=0.001, respectively). On comparing antral mucosal gland biopsy outcomes among the groups, staining intensity score was found to be significantly high in IBS-C as compared with the control group, whereas no significant difference was observed between IBS-D and the control groups (p=0.020 and p=0.429, respectively). Conclusion The plasma ghrelin level in IBS-D and the staining intensity in the antral mucosal gland in IBS-C were found to be significantly higher. In addition, there was no difference between the groups in terms of ghrelin staining intensity in the gastric corpus.

INTRODUCTION[|]The aim of the present study was to determine the density of nerve fibers in the functional layer of the endometrium in patients with endometriosis in order to determine if it could be used as a minimally invasive diagnostic method for endometriosis. A secondary goal was to assess the relationship between the severity of pelvic pain due to endometriosis and the density of nerve fibers in endometrial sampling materials.[¤]METHODS[|]Endometrial sampling was performed in 67 patients who presented at the hospital between August 2011 and November 2012. Endometriosis was diagnosed by surgical histopathological examination. A total of 34 patients diagnosed with endometriosis were selected as the study group. Thirty-three patients who were operated on for benign conditions other than endometriosis were selected as a control group. Immunohistochemical detection of the nerve fiber marker protein gene product 9.5 (PGP 9.5) was used to analyze the endometrial samples for nerve fibers. Visual Analogue Scale scores were used to evaluate the correlation between nerve fiber density and the severity of pelvic pain. Statistical analyses were calculated with SPSS Statistics for Windows, Version 17.0 (SPSS, Inc., Chicago, IL, USA).[¤]RESULTS[|]The mean density of nerve fibers was 1.85+-1.74 fibers/mm2 in the endometriosis group. In the control group, the mean density was 1.15+-1.48 fibers/mm2. There was no statistically significant difference between the groups (p=0.08). The pelvic pain score did not correlate with PGP 9.5 intensity. [¤]DISCUSSION AND CONCLUSION[|]The detection and measurement of nerve fibers in the eutopic endometrium using the PGP 9.5 marker was not found to be a decisive noninvasive method to diagnose endometriosis.[¤]

Glomus tumor is a vascular tumor that originates from glomus body. It is typically seen in young adults and localized in distal extremities and nail beds. It often presents with stuffiness, rhinorrhea and pain. Glomus tumor is rare in the head and neck region. A 79 year-old-male who presented with stuffiness and ear congestion, was found to have a mass located in the posterior of the nasal cavity on rhinoscopic examination. Macroscopically, the excisional biopsy of the mass had an irregular surface and hyperemia. Pathology of the biopsy showed that the lesion consisted vascular structures, which were surrounded by solid epithelioid, acidophilic and smooth muscle actin positive cells. The case was diagnosed as nasal glomus tumor.

Congenital nasal midline lesions are rarely observed pathologies. While relatively frequently encountered lesions are dermoid cyst, glioma, encephalocele, nasal polyp and epidermoid cyst, an other very rare reason is the congenital panfollicular nevus. The treatment of this syndrome appearing with a recurrent discharge in clinic is the surgical excision. We will hereby present the excision of the case of congenital panfollicular nevus with three different fistula openings.

OBJECTIVE Cisplatin is a chemotherapeutic agent that is widely used in cancer treatment. Numerous side effects have been detected, one of which is ototoxicity. Melatonin, a product of the pineal gland, has a neuroendocrinoimmunological role in vertebrates. In the present study, we investigated the effects of melatonin on cisplatin-induced ototoxicity. MATERIALS AND METHODS Twenty-four Wistar albino rats were divided into three groups. Group 1 was administered both intraperitoneal and transtympanic saline; Group 2, 12 mg/kg of intraperitoneal single-dose cisplatin and transtympanic saline; and Group 3, 12 mg/kg of intraperitoneal single-dose cisplatin and 0.1 mg/mL of transtympanic melatonin for 5 days. Before and after the procedure, distortion product otoacoustic emissions and auditory brainstem responses of all the rats were measured. At the end of the procedure, the cochleas of the rats were investigated at the microscopic level. RESULTS Group 3 had lesser threshold shift in otoacoustic emissions and auditory brainstem responses at all frequencies than Group 2 (p

Objectives: Osseous dysplasias are the most common subtype of fibro-osseous lesions of the maxillofacial bones. They are benign and often present as incidental asymptomatic lesions. Diagnosis can be made with clinical and radiographic examination. Case report: This article reports the case of a 47-year-old man with a huge cementifying osseous dysplasia of the maxilla that presented with secondary infection after teeth extraction and repair of oroantral fistula. A subtotal maxillectomy had to be done after conservative treatment failed to resolve the infection. Discussion/Conclusion: Biopsy, tooth extraction or surgical trauma to the affected bones of osseous dysplasia could easily lead to severe secondary infection, the treatment of which may be very difficult, and thus should be avoided if possible.

OBJECTIVE Head and neck cancers account for 17.6% of all malignant neoplasms. Data on the incidence of head and neck cancers and histological subtypes in Turkey are limited. This study aimed to provide an overview of statistics for head and neck cancers. MATERIAL AND METHOD This retrospective and descriptive study included 1973 cases of in-situ carcinomas, malignant and borderline neoplasia from the head and neck region in a period of 5 years, diagnosed at Dr.Lutfi Kirdar Kartal Education and Research Hospital's Department of Pathology. Demographic data of patients and data from histopathological report were recorded. The topography of all tumours was coded according to the International Classification of Diseases for Oncology, 2nd and 3rd edition and histological and behavioral codes were given according to ICD-O-3. Data was entered and analyzed using Microsoft Excel™, version 2010. RESULTS Male and female ratio was 1.03 for head and neck cancers. The most common sites for males were described as the ratio in head and neck cancers and all malignant tumours as follows: the skin (non-melanoma) (48.4%-8.2%), the larynx (12.6%-2.3%), the thyroid (11.1%-1.2%), the lips (7.8%-1.3%), and the nasopharynx (3.1%-0.5%). The most common sites for females were as follows: the thyroid (45.3%-8.3%), the skin (non-melanoma) (39.6%-7.3%), the lips (3.6%-0.6%), the nasopharynx (2.2%-0.4%) and the eye (1.7%-0.3%). The male: female ratio was 25.2 for larynx cancers. The most common histological types and rates for males and females were also given. CONCLUSION This descriptive epidemiological pathology-based cancer incidence study has relative value for describing head and neck cancer incidences in the Istanbul region and shown that pathology report-based descriptive epidemiological studies are still valuable for determination of the regional distribution of cancer incidence out of the active cancer registration regions.

Objective: Basal cell adenomas are rare form of monomorfic adenomas of the parotid gland. This rare form of the tumors are mostly seen on suprafacial part of the parotid gland. Basal cell adenomas are well demarcated and asymptomatic tumors that can be treated by surgical removal. *Corresponding author: Demir MG, M.D., Yenisehir mah.Sena sok. dumankaya konsept sitesi 20.parsel, A2/6 kurtkoy, Pendik-Istanbul/Turkey, 34860, Fax: +902163520083, Tel: +902164413900, GSM: +90 5300403925, E-mail: mgokhandemir@yahoo.com Demir MG*1, Aydin S2 and Basak K3 Citation: Demir MG, Aydin S, Basak K (2014) Basal Cell Adenoma of the Parotid Gland: Case Report. SAJ Cas Rep 1(3): 301. doi: 10.18875/2375-7043.1.301 Volume 1 | Issue 3 Volume 1 | Issue 3 Case Report Open Access SAJ Case Reports www.scholarena.com Salivary gland tumors constitute only 2% to 6, 5% of all head and neck region tumors. Because of lots of types are defined, it is hard to diagnose the tumor definitely. Basal cell adenoma (BCA) is a rare neoplasm consisting of a monomorphic population of basaloid epithelial cells and accounts for 1-3% of all salivary gland tumors [1]. Most of these tumors are located on the parotid region. Also most of the parotid benign tumors are located on the superficial lobe. Introduction ISSN: 2375-7043 Case report: 48 years old female referred to our clinic with complaint of right sided asymptomatic preauricular swelling over 8 months. On the magnetic resonance examination on the right side of the parotid region, there was a contrast enhanced well demarcated, about 1,9x1,5 cm in size, round shaped mass lesion on T2 weighted view. Fine needle aspiration biopsy was not conclusive. Treatment and Prognosis: We planned superfacial parotidectomy but during surgery we recognize that the tumor was located on the deep lobe of the gland so performed partial parotidectomy for diagnosis and treatment. The pathologic investigation revealed basal cell adenoma. Recurrence was not detected in the 2 year follow up. Conclusion: Basal cell adenomas are rare form of parotid benign adenomas which can be misdiagnosed with malign tumors such as adenoid cystic carcinoma. The diagnosis with fine needle aspiration is difficult so when detected on physical examination on parotid region we should not insist on fine neddle aspiration biopsy to diagnosis. We represent basal cell adenoma of the parotid gland which was located on the deep lobe of the gland with unusual location The tumor was excised successfully without total parotidectomy. A 48 year-old female patient was admitted to our clinic, who suffered from asymptomatic right preauricular mass lesion for about 8 months. On the physical examination there was a palpable approximately 1x1 cm in size, well demarcated, painless, mobile mass located on anterior side of the tragus. According to the magnetic resonance image (MRI) examination on the right side of the parotid region, there was a contrast enhanced well demarcated, about 1,9x1,5 cm in size, round shaped mass lesion on T2 weighted view (Figure 1a,b). Case report Article history: Received: 14 October 2014 Accepted: 11 February 2015 Published: 13 February 2015

The objective of this study was to investigate the cystic changes in radiographically normal follicles associated with impacted lower third molars (ILTM). The relation between the cystic changes and both the angular position and the contact of ILTM with the adjacent tooth was also evaluated.Follicular spaces of patients who were referred to our clinic for removal of ILTM for a variety of reasons were measured from panoramic radiographs by each author independently. Pericoronal tissues of radiographically normal impacted third molars were examined histopathologically. Then the data were analyzed for associations with age, sex, angular position, and contact of the ILTM with the second molar.There were 30 male and 64 female patients, ages ranging from 14 to 45 years (mean = 21.11). Forty-seven (50%) of the 94 specimens showed cystic changes as the only pathological condition other than inflammation. Most of the cystic changes occurred in the 20-25 year age range. The relation between cystic changes and angular position was statistically significant (chi 2 = 7.46, P.05). The higher probability of cystic changes was found in the vertically positioned ILTM. The relation between the cystic changes and communication of ILTM with the second molar was not statistically significant (chi 2 = 2.068, P.05).Cystic changes may be encountered in the histopathologic examination of asymptomatic third molars, especially in patients older than 20 years. Vertically positioned ILTM especially may be suspected for the higher possibility of cystic changes.

Trihcofolliculoma is an uncommon, benign hamartomatous neoplasm of the hair fol - licle, most commonly occurring in the head and neck region of the adults. It tends to locate on the face and scalp. Other rare sites of occurrence include vulva, eyelid and upper lip. Clinically, the le - sions are small, range from 0.2 to 0.5 cm in diameter, and appear as whitish-red or pearly papules or as smooth nodules, sometimes with a central pore containing wool-like wisps of immature hair. External auditory canal is an extremely rare localization of trichofolliculoma, and to the best of our knowledge, only three cases have been reported in the literature until now. In this report, we pre - sented an unusual case of trichofolliculoma localized in the external auditory canal leading to hear - ing loss. In this case, surgical excision was enough to treat external auditory canal mass which was a trichofolliculoma.

Hepatic encephalopathy and elevated serum ammonia levels occur commonly after portacaval shunt and are hypothesized to be, in part, due to decreased hepatic blood flow. Prior work has demonstrated increased blood flow to the liver following hepatic periarterial neurectomy. In this experimental study, we investigated the functional, hemodynamic, and histopathological changes in the liver and kidney occurring after the addition of hepatic periarterial neurectomy to side-to-side portacaval shunt in dogs. It is our hypothesis that the addition of hepatic periarterial neurectomy to portacaval shunt will decrease postshunt ammonia levels. Side-to-side portacaval shunt was performed in 12 dogs (group I). Hepatic periarterial neurectomy was added to portacaval shunt in 9 dogs (group II). Serum levels of ammonia, urea, creatinine, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, albumin, and bilirubin together with hepatic blood flow were determined in both groups preoperatively and on postoperative day 21. The pre- and postoperative histopathologic changes of the liver and kidney were evaluated. There was significantly less postoperative elevation of serum ammonia and aspartate aminotransferase when hepatic periarterial neurectomy was added to the portacaval shunt procedure. Hemodynamic studies of hepatic artery and hepatic tissue indicated better blood flow in group II. The histopathologic evaluation of group II showed expansion of sinusoids, portal vessels, and portal areas and increased portal fibrosis as compared to group I. The results of this experimental study show that adding hepatic periarterial neurectomy to the portacaval shunt procedure improves postoperative serum levels of ammonia and aspartate aminotransferase and hepatic artery and tissue blood flow.

Oncocytic cystadenoma is a benign tumor of salivary glands, histologically characterized by multicystic growth of the oncocytic epithelial lining. Crystals in different shapes and nature associate oncocytic type of salivary gland neoplasms. An 82 year-old woman with right parotideal mass had an operation of superficial parotidectomy. Histological examination revealed multiple unilocular or multilocular cystic lesions with incomplete fibrous capsule, papillary foldings, and 1 or 2 layers of oncocytic epithelium lines. The epithelium lining the cysts were positive for CK8, CK14, CK18, CK19, and negative for SMA, S-100, and p63 immunohistochemically. Cystadenomas were described as mostly multilocular and we presented a multifocal cystic neoplastic lesion lined by oncocytic type epithelial cells with intraluminal crystalloids. Multiple cysts forming morphology, incomplete fibrous capsule of most cysts and immunohistocemical findings were considered as multiple oncocytic cystadenoma with intraluminal crystalloids in the parotid gland.

Fibromyxomas are uncommonly encountered pathologies in the head and neck region. They are slow growing, which result in expansion of the surrounding bony cortices. In this article, we report an extremely rare case of frontal sinus fibromyxoma which occluded the frontal sinus and expanded anterior ethmoid cells and nasal dorsum. Initially, it was suspected to be a mucocele. Surgical resection with a wide excision was performed and it was diagnosed as fibromyxoma, histopathologically.

Annular elastolytic giant cell granuloma is a rare disease characterized by annular configurated lesions with typical histopathologic findings. We report a case of annular elastolytic giant cell granuloma in a 50-year-old male patient. Treatment modalities for this disease are limited and mostly unsatisfactory, although isotretinoin was found to be effective in a single case. However, systemic isotretinoin treatment of 12 weeks' duration was of no benefit in the presented case.