Report of a rare case of anterior mediastinum goiter

The primary ectopic goiters of mediastinum, specially of posterior mediastinum is rare and estimated on 1% of the goiters of retro sternal and mediastinum and their blood supplies is from intra thoracic vessels. We introduce a patient who referred with the complain of a huge mass in the anterior medistinum. His complain presented by dyspnea breathlessness and chronic cough at first. This mass was removed easily through collar incision and partial strernotomy. Through surgery we found that blood supply of mass arised from thoracic vessels and inominate artery, with drainage to inominate vein. Following mass removal, all the symptoms of the patient were resolved. We presented an uncommon true primary ectopic mediastinal goiter resected through a median strnotomy with complete excision and relief of all symptoms

[Intravitreal triamcinolone acetonide in chronic refractory uveitis]

To evaluate the effect of intravitreal triamcinolone acetonide injection for management of chronic refractory uveitis in terms of inflammation, visual acuity and macular thickness. This interventional case series was conducted on uveitic eyes with no remission despite proper administration of periocular and/or systemic steroids. After systemic and rheumatologic evaluations and confirmation of non-infectious nature of uveitis, 18 eyes of 10 patients underwent intravitreal injection of 4 mg triamcinolone acetonide. Changes in intraocular inflammation, bestcorrected visual acuity [BCVA], intraocular pressure [IOP] and macular thickness on optical coherence tomography were assessed during six months of follow-up. Mean BCVA increased from a baseline value of 0.81 +/- 0.29 to 0.35 +/- 0.33 LogMAR one week and to 0.17 +/- 0.07 LogMAR one month after the injection, respectively [P<0.001]. It decreased thereafter to 0.46 +/- 0.3 LogMAR at the sixth month visit, but was still significantly greater than the baseline value [P<0.001]. Mean IOP reached its maximum level one month post-injection with an increase of 7.36 +/- 0.48 mmHg compared to the baseline value, however only two eyes had IOP>22 mmHg which were successfully controlled using topical IOP-lowering medication. Mean central macular thickness decreased from 339.8 +/- 24.1 microm to its minimum value [197.18 +/- 12.7 microm] one month after the injection [P<0.001] and then increased to 203.57 +/- 9.06 microm at sixth month visit, still less than the baseline value [P< 0.001]. Intravitreal injection of triamcinolone acetonide in chronic refractory uveitis improves visual acuity and decreases central macular thickness which is sustained for at least six months. The only noticeable complication, transient IOP elevation can be controlled with topical medications

Synthesis and anticonvulsant activity of novel 2-amino-5-[4-chloro-2-[2-chlorophenoxy] phenyl] -1, 3, 4-thiadiazole derivatives

Several novel 2-amino-5-[4-chloro-2-[2-chlorophenoxy]phenyl]-1, 3, 4-thiadiazole derivatives 4a-d were synthesized and their anticonvulsant activity was determined by evaluation of the ability of theses compounds to protect mice against convulsion induced by a lethal doses of pentylentetrazole [PTZ] and maximal electroshock [MES]. The result of anticonvulsant data shows that among the synthesized compounds, 5-[4-chloro-2-[2-chlorophenoxy]phenyl]-N-ethyl-1, 3, 4-thiadiazol-2-amine 4c was the most active compound in both MES and PTZ tests with an ED[50] of 20.11 and 35.33 mg/kg, respectively

[Characteristics of patients with central retinal artery occlusion in an Iranian tertiary eye center]

To evaluate the etiologic and epidemiologic findings in central retinal artery occlusion [CRAO] patients in a tertiary eye center in Tehran, Iran. All patients with CRAO refered to the emergency department of Farabi Hospital during 200 1-2002 were enrolled in the study. All patients received routine treatment and were followed for 3 months. Cardiology consult was done for all patients. From 36 patients, 6 patients had cilioretinal artery sparing. Age of patients ranged from 18 to 80 years [56.3 +/- 15.7]. Interval from onset of symptoms to admission was between 4 48 [20 +/- 8] hours. Prevalence of NVI, hypertension, and diabetes mellitus was 6.6%, 36.7%, and 16.7%, respectively. The lower mean age in our patients compared to other studies is probably due to longer duration of life in western countries or decreasing atherosclerosis age in our country. The low prevalence of hypertension and diabetes mellitus in our patients require further evaluation in great scale studies. The low prevalence of NVI in our study may be due to earlier presentation of our patients or special characteristics of this disease in our country

Neurogenic hypertension: report of five cases to highlight the controversy

The entity of "neurogenic hypertension" is defined as arterial hypertension caused explicitly by derangement of the intricate network of the central nervous system. Among 193 cases of cranial rhizopathies operated on between 1984 and 1995 at this center, 5 cases of established arterial hypertension with concomitant rhizopathies also underwent ventrolateral medullary decompression. The elevated blood pressure showed an incredible decline, reaching normal values after vascular decompression. The systolic blood pressure however showed a much greater fall than the diastolic component. An endeavour is made to throw light on the cases operated on with special emphasis on the central nervous system as an etiological factor to explain the cause of essential hypertension

pivotal role of cranial nerve root decompression

Reported are a total of 81 microsurgical operations for cranial nerve root decompression comprising of 66 trigeminal, 10 facial vestibular, one vagus and three accessory nerve dysfunction syndromes from 1983 to 1990. Almost all cases of trigeminal neuralgia [TNG] secondary to vascular [59 cases] and minute mass [10 cases] compression, and those with hemifacial spasm [HFS] [nine out of 10 cases] recovered with microsurgical decompression of these nerves. A comparison of results of different treatment modalities of TNG are discussed. Some recently reported series in the literature indicate the superiority of microvascular decompression [MVD] of th 5th nerve for the treatment of TNG. MVD of the 7th nerve has currently been accepted as a procedure of choice, albeit with reservations, in managing HFS. Despite our effective surgical outcome and satisfactory results obtained by others with MVD of the 8th, 10th and 11th nerves, long-term follow up of selected cases may further clarify the role of MVD on caudal cranial nerves