[Survey the frequency of first three formants of Persian vowels in patients with vocal polyps]

This study compared the vowel formants frequency in polyp patients with normal individuals in sustained vowels. This study is cross-sectional and descriptive-analytical. Variables are: Average of first, second and third formants in six vowels of Persian. These parameters were investigated in patients with vocal fold polyps and normal subjects. People were selected from the age group of 20 to 40 years. Samples of the study included 10 patients with natural sound [5 female and 5 male] and 10 patients with polyps [5 female and 5 male]. In men and women with vocal fold polyps, the highest and lowest values of first formant [F1] is in vowel / a / and / u /. Maximum and minimum values of second formant [F2] in both are in the / e / and / u / and maximum and minimum values of third formant [F3] vowels are in / u / and / e /. First and second formants of Persian vowels differ in normal voice and vocal fold polyps] p=0.028 [however, this was not the case in the third structure [p=0.59]. Considering the structures are useful in the diagnosis and F1 and F2 can be considered more in objective evaluations

Bronchoscopic extraction of a hydatid membrane in a 26-year-old woman with recurrent pneumonia

Cystic echinococcosis is a public health problem in endemic areas. Recurrent pneumonia is a rare complication of ruptured hydatid cysts of the lung. We report a 26-year-old lady with a recurrent right lower lobe [RLL] pneumonia. Her CXR and chest CT scan revealed involvement of RLL. In her history, it was revealed that she had undergone a surgery for liver hydatid cyst two years ago. During fiberoptic bronchoscopy [FOB] for unresolved pneumonia, we extracted the whitish-yellow bright gelatinous membrane obstructing the orifice of the posterior basal segment of RLL. A follow-up CT scan done six months later revealed clearance of RLL opacity and pleural effusion. Although treatment of pulmonary hydatid cyst by FOB is an exceptional event, our exceptional case illustrates a complete treatment without any further need for a thoracic surgical procedure which could have many complications and even morbidity

survival of patients with esophageal cancer after chemoradiation versus surgery and chemoradiation

Although significant advantages has been made in treatment of esophageal cancer, but this malignant tumor present as locally advanced disease with poor prognosis. Comparison of effect of Chemoradiation [CRT] with Surgery and Chemoradiation [CRTS] in Esophageal Cancer outcome. An analytical-descriptive study was done on 71 patients respectively from 2004 to 2006. Adequate data was achieved positive results of biopsy through the time of last visit or death. The patients divided to two groups, first, Chemoradiation [CRT] group and second, postoperative Chemoradiation [CRT-S] group. The results were analyzed with Kaplan-Meier and Log-Rank tests. From 71 patients, 42 [60%] patients were male and 29 [40%] were female. The median age was 66 +/- 10 years. 48 [68%] patients were treated with CRT treatment and 23[32%] patients had CRT-S treatment. The patients with <65 years old [14 months] had better survival from >65 years old [11 months]. Survival in female and male was 13 and 11 months, respectively. There was no significant difference between the overall survival of CRT group [11.5 months] and CRT-S group [13 months] [p>0.05]. The median time of survival was 12 months. Despite many reports that shows CRT-S have better outcome than CRT alone, but in our report there was no significant difference between two groups. We conclude that esophageal surgeon must be familiarly with CRT which is a useful protocol for treatment of esophageal carcinoma

[ case report of anterior cervical mass of thymus]

Ectopic cervical thymus is a rare cause of neck masses and can be found anywhere along its embryologic tract of descent from the angle of the mandible to the superior mediastinum, and it should be included in the differential diagnosis of neck masses, especially in children. Because most cases are not symptomatic, usually remains without diagnosis. Such anomalies are rarely diagnosed pre-operatively and often revealed by pathologic examination after operation. We introduced a 12-years-old girl with a soft left cervical mass anterior to Sternocleidomastoid muscle, from four months prior to refer, with firm consistency in touch and mild pain. With the initial diagnosis of lymphadenopathy was treated with antibiotics but did not respond to treatment. The patient underwent complete excision of the lesion and histological examination that showed an ectopic thymic cyst. This anomaly rarely diagnosed before surgery and can be mistaken easily with other cervical masses. Surgery is curative and the disease has excellent prognosis

[Clinical signs, symptoms, diagnosis and outcomes of patients with complicated lung hydatid cysts]

Hydatid cysts caused by the Echinococcus Granulosus and Multilocularis. Liver and them lungs are the most common sites of lodgment of it. Because the clinical symptoms, diagnosis and outcome of treatment are not well discussed, we want to discussion this problem. Survey of the clinical signs, symptoms, diagnosis and outcomes of patients with complicated lung hydatid cysts. We retrospectively examined 54 records of patients with ruptured lung hydatid cyst in 152 patients who were hospitalized in Rasht hospitals, since 1993 to 2005, and were surgically treated. Data collection tools were a predetermined review form; and findings are presented in relative frequencies tables. 54 cases 38[70.3%] were male. Age rang of patients was 4-63 years. Chief complaints of the patients were cough in 47 cases [87%], dyspnea in 42[77.8%], sputum in 37[68.5%], chest pain in 31[57.5%], and hemoptysis in 13[24%]. Most common lodgment of cysts in the lungs was right lower lobe in 38[57.5%]. Ruptures occurred in tracheobronchial tree in 39[73%], and in pleural space in 10[23%]. Complication after surgery occurred in 15 patients. Three patients [5.5%] were needed reoperation for treatment: bronchopleural fistula treatment in two cases and bilio-pleural fistula in one case. After surgical treatment, 53 patients [98.1%] were completely cured; recurrence occurred in one patient [1.9%] who treated with Albendazol. There was no hospital mortality. In endemic area all cystic lesions of lung must be ruled out for hydatid cysts; because some patients with lung hydatid cysts present complications: the cause of complication are, lately referring to physician and delay in diagnosis. Early treatment with medical and surgical approach recommended

Substernal goiters: Clinical presentation, diagnosis, and surgical management

Intrathoracic goiter [ITG] or substernal goiter [SSG] includes any thyroid enlargement in which over 50% portion of the thyroid permanently located under the thoracic inlet and lower pole of thyroid is not palpable with the neck in hyperextended position. Between Jan 1993 and July 2002, 334 patients underwent thyroidectomy for goiters in Rasht [North of Iran]. In this investiagation, initial presentations, surgical managements and complications of 32 patients with substernal goiter have been evaluated retrospectively. Results: There were 20 women and 12 men, with a mean age of 40 years [range 45-67 yrs]. Twenty-two patients presented with respiratory symptoms, two had dysphagia, four complained of hoarseness, and five patients were detected incidentally by CXR. Chest X-ray was the first step in diagnosis, and C. T Scan was the best imaging examination for diagnosis. Isotope scanning was helpful only in five patients. Twenty-one patients were operated with the collar incision, seven with collar incision, and in some along with partially sternotomyfour and four patients were operated by median sternotomy. In 17 patients the goiters were in the right anterior mediastinum and in 14, in the left anterior mediastinum, in one patient goiter was seen in the hilum of the right lung. Pathologic reports were as follows: multinodular goiter in 22 patients papillary cell carcinoma in seven patients anaplastic carcinoma in one patient and lymphoma in one patient. Medullary cell carcinoma in one patient. There was no hospital mortality. Postoperative complications occured in five patients. This study recommends that intrathoracic goiter should be operated early under suitable conditions because of malignant transformation and other hemorrhagic or serious complications

Anaplastic thyroid carcinoma, a report on 10 cases

Anaplastic thyroid carcinomas are undifferentiated and highly aggressive tumors of the thyroid follicular epithelium, with a disease-specific mortality approaching 100 percent. This study reports ten cases with advanced anaplastic thyroid carcinoma with ineffective surgical interventions. Between 2001-2006, we treated 10 patients with anaplastic carcinoma of the thyroid. All patients presented with advanced phase and were documented by pathological study. The surgical intervention was thyroidectomy in 3 cases, debunking surgery in other three, just tracheostomy in three cases, and only biopsy in one patient. All of our patients died in 4 days to 8 months after surgery. Surgical intervention had no benefit in treatment of advanced anaplastic carcinoma of the thyroid and the suitable surgical intervention was to maintain an open airway. Early recognition of the disease is essential to allow prompt initiation of therapy. There is no cure for advanced situations, and surgery, radiotherapy, and chemotherapy play no important role in the treatment

[Evaluation of transhiatal esophagectomy for esophageal cancer]

Introduction: Esophageal cancer is an invasive tumor with a poor prognosis. Unfortunately, this malignant tumor has a considerable prevalence in north part of Iran, especially near the Caspian Sea. It is also an important cause of cancer-related mortality. Surgery is the most effective approach for cure and also is used for palliation. Transmittal esophagectomy is a popular method of resection with a low morbidity and mortality

Objective: We designed this study to document the clinic pathologic characteristics of patients undergoing this procedure for esophageal cancer and to determine the contributing factors survival of patients

Materials and Methods: This descriptive study was performed between 1993 and first half of 2003 on 162 patients in Rasht Razi hospital. Patients' medical records were surveyed regarding their age, sex, stage of dysphagia, complications of surgery, mortality, stage of cancer and level of survival. Data were analyzed by EPI-6 software

Results: There were 102 male and 60 female patients. The mean age of patients was 57 years. 29.1% of them were urban versus 70.9% who were rural. The most frequent presenting symptoms were dysphagia [100%]. The most common site of tumor was lower third of esophagus [56%] and cardia] 22%]. 47.1% of patients required tube thoracostomy after surgery.9.8% of patients were splenectomized because of splenic injury. Recurrent nerve damage was observed in 4% of patients. 18.4% of patient's required mechanical ventilation. Pneumonia, Mediastinitis and Chylothorax was observed in 10, 2 and 2% of patients respectively. 13% had anastomosis leak in neck, which was managed conservatively. 83.1% of patients, were discharged from hospital in two weeks. The mean duration of hospital stay was 9.94 +/- 4.14 days. 14% of patients expired during first month of hospitalization. Survival in 1,2,3,4 and 5 years were 80%, 50%, 40%, 30% and 20% respectively

Conclusion: In this study mortality and morbidity were comparable with previous studies. On the other hand there wasn't any significant difference between results of this procedure and transthoracic approach that is used in other centers. Therefore it is recommended that transhiatal esophagectomy with appropriate selection of patients is the procedure of choice for curative and palliative means

Evacuation and bronchial opening closure "the result of 100 surgeries for Lung Hydatid Cyst"

Hydatid cysts are an endemic zoonosis in Iran. Lung is second most common site of involvement [10-15%]. There are different methods for hydatid cyst surgery: Video Assisted Thoracic Surgery, cystectomy, lobectomy, Evacuation and Bronchial Opening Closure [EBOC]. This is a retrospective study of 120 patients operated between 1368 to 1380[1990 to 2002]. Our patients aged between 3 to 60 years; 62% males and 38% females. Patients present by symptoms as cough, sputum, bloody stained sputum, dyspnca, chest pain in 92% of cases; 4% of patients discovered incidentally, there were 10% of patients with bloody stained sputum; 5% had intact hydatid cysts. All patients were operated via posterolateral thoracotomies. We did EBOC in 100 patients, labectomy in 8 and cystectomies in 5 patients. Wedge resections performed in 7 patients. We did not use Video Assisted Thoracotomy Surgery. Broncho pleural fistula occurred in 2% of patients, that forced us in one case to performing lobectomy, but another case was treated by chest tube insertion. Also there were 2 patients affected with empyema, treated with conservative treatments. Superficial wound infection occurred in 4 patients which was treated with drainage and all of them cured. There were no additional complication in one-year follow up and residual cavity gradually faded, up to 6 months. Evacuation and Bronchial Opening Closure is a safe, simple, and non-invasive procedure; it is applicable in a shorter time compared with other procedures; and then suggest using E BOC for lung hydatid cysts