The Effect of Insulin Like Growth Factor-1 on Recovery of Facial Nerve Crush Injury

OBJECTIVES: The aim of this study is to investigate the efficacy of locally applied insulin-like growth factor 1 (IGF-1) on the recovery of facial nerve functions after crush injury in a rabbit model. METHODS: The rabbits were randomly assigned into three groups. Group 1 consisted of the rabbits with crush injury alone; group 2, the animals applied saline solution onto the crushed facial nerve and group 3, IGF-1 implemented to the nerve in the same manner. Facial nerve injury was first electrophysiologically studied on 10th and 42nd days of the procedure. The damage to the facial nerves was then investigated histopathologically, after sacrification of the animals. RESULTS: In the electrophysiological study, compound muscle action potential amplitudes of the crushed nerves in the second group were decreased. In pathological specimens of the first and second groups, the orders of axons were distorted; demyelination and proliferation of Schwann cells were observed. However, in IGF-1 treated group axonal order and myelin were preserved, and Schwann cell proliferation was close to normal (P < 0.05). CONCLUSION: Local application of IGF-1 in a slow releasing gel was found efficacious in the recovery of the facial nerve crush injury in rabbits. IGF-1 was considered worthy of being tried in clinical studies in facial nerve injury cases.

Evaluation of curative and palliative radiotherapy efficacy in extensive stage small cell lung cancer

To evaluate the efficacy of curative and palliative radiotherapy in the treatment of extensive stage small cell lung cancer [E-SCLC], and compare therapy effect on survival with or without metastatic disease. From January 1998 through December 2004, 128 patients with E-SCLC were treated with radiotherapy and concomitants combined chemotherapy. Radical radiotherapy, consisting of approximately 60 Gy given in up to 30 fractions was performed in 53 [41.4%] of these patients. Others [58.6%] were treated with palliative dose radiotherapy. In all patients, chemotherapy was planned with cisplatin [80 mg/m2] intravenously [i.v.] on day 1, and etoposide [120 mg/m2] i.v. on days 1, 2 and 3, every 3 weeks for 3-6 cycles. Conventional follow-up of patients was conducted at Izmir Oncology Center, Izmir, Turkey. All results were evaluated statistically. One hundred and twenty-four patients [96.9%] were males. The mean age was 58.49 [ +/- 9.01], ranging from 37-78 years. Metastases were initially determined in 64 patients [50%]. The median follow up of patients was 287.41 days and median survival was 354.87 days. One year survival rate was 35.8%, and 2-year survival rates was 16.9% in the radical radiotherapy group, while these rates were 26.6% and 8% in the others. According to the statistical findings; the gains in duration of median survival with the curative thoracic irradiation are 151.97 days in all 128 patients. This study shows that curative radiotherapy at the primary tumor provides an additional survival benefit in patients with metastatic disease compared with palliative radiotherapy. This finding raises the question of whether treatment with radical thoracic radiotherapy with concomitant chemotherapy, consisting of first-line drugs, might be more beneficial and cost-effective as well as a less toxic treatment of E-SCLC

Comparison of underlying lesions in pediatric and adult ovarian torsion

To compare the pediatric and adult ovarian torsion and explore a quantitative value to predict a possible underlying tumor. This study included 32 pediatric and 33 adult female cases diagnosed with ovarian torsion and underwent surgical treatment in Dr. Behcet Uz Children's Research Hospital and Ataturk Education and Research Hospital, Izmir, Turkey between 1989 and 2005. We evaluated the properties of the cases statistically. The mean age of pediatric was 8 years and 3 months and adult cases was 39 years and 8 months. Six cases had an underlying tumor in both pediatric and adult group. The mean diameter and volume difference were 6.84 cm, 91 cc in pediatric and 12.69 cm and 1087 cc in the adult group. In statistical analysis, the diameter and volume increase were significantly higher in cases with underlying tumor in pediatric group. The cut-off value was 7 cm in diameter and 104 cc in volume increase. In the adult group, the diameter and volume increase were not significant in tumor positive and negative group. Torsion of the ovary requiring surgery, is rare and is the mot common reason of abdominal/pelvic mass. These cases are often difficult to decide for surgical procedure especially in pediatric cases. We conclude that an underlying lesion more commonly occurs in children with an increase in ovarian volume of more than 104 cc and a diameter more than 7 cm. Great care should be taken for laparoscopic conservative management especially in these cases. The quantitative analysis is not predictive for the underlying solid lesion in adult cases