Introduction: Thyroid nodule is a common clinical finding. Ultrasound (US) and Fine-needle Aspiration (FNA) are the main methods used for investigating thyroid nodules, with questionable predictive values in Multinodular Goiter (MNG) compared to Solitary Thyroid Nodule (STN) due to the presence of multinodularity.

Objective: The present study was conducted to detect the independent predictors of malignancy in patients with MNG.

Patients & Methods: Medical records of patients who were admitted for thyroidectomy at Alexandria Main University Hospital and Medical Research Institute Hospital between January 2013 and January 2016 were reviewed. Demographic and clinical data, US reports, FNA reports, and final histopathological results were recorded and analyzed by univariate and multivariate analysis. Patients with a STN, hyper- or hypo-thyroidism, previous history of surgery for thyroid cancer or those with incomplete data were excluded.

Results: Reports of 1014 patients were reviewed, 419 patients with euthyroid MNG were included in the study. Malignancy rate was 19.3% (81/419). Micro-calcification, solid consistency, ill-defined margins, and presence of suspicious cervical lymph nodes by US were statistically significant predictors. Rate of malignancy in Bethesda II was 8.9% (false negative). Malignant rate increased with increasing in Bethesda rating from Bethesda IV (17.4%) to Bethesda V (51.7%), and lastly Bethesda VI (90.9%). Multivariate analysis revealed that micro-calcifications, suspicious cervical lymph nodes and Bethesda VI FNA were the independent predictors of malignancy. Other malignancy predictors that were only significant by univariate analysis were solid component of the nodule, and ill-defined margins.

Conclusion: Based on the data presented, it may be concluded that the independent predictors of malignancy in patients with MNG were US findings of micro-calcifications and suspicious cervical LNs as well as Bethesda VI on FNA

The major aim of this article is to report experimental results about the numerical quantities of the different shapes of human are ear concha as well as to classify them into defined shape groups. To the best of the author knowledge this approach has never been applied. The results are based on 2425 pictures of ears. The major results are: (1) The author has succeeded to classify all ears concha into 36 groups demonstrated in Figure 2. On the left is the absolute number of concha of a certain type where on the right is the percentage of it. (2) The most widespread concha, number 29, is that which appeared 393 times and is 16.2% of the total number. The less widespread shape, number 34, appears one time namely 0.04% of the total. In addition to the numerical results the following subjects are elaborated with respect to human’s ear: its anatomy, its different shapes as well as their relation to human’s character

Objective: We aimed to investigate the differences in incidence of nasal anatomic abnormalities between the patients with and without headache and the outcome of surgical treatment for the headache patients with mucosal contact point.

Background: “Mucosal contact point headache” has been defined by Headache Classification Committee of the International Headache Society. Whether the type of nasal anatomic abnormalities associates with incidence of headache and whether surgical treatment is necessary remain undefined.

Study Design: Observational study.

Methods: We recruited 107 subjects without headache and 78 subjects with refractory headache for more than 2 years. Subjects underwent high-resolution sinus CT scans and the incidence of nasal anatomic abnormalities was calculated in both groups and results were compared. An additional 25 patients underwent surgical treatment.

Results: Mucosal contact points were observed in 85.9% of patients with refractory headache and also in 80.4% of subjects without headache. The most common mucosal contact point among headache group patients was between deviated nasal septum and lateral nasal wall (55.1%) and the incidence of this type of contact point was significantly different between groups (P <0.05). An additional 25 headache patients with mucosal contact point were corrected via endoscopic surgery. Average pain scale scores decreased significantly between pre- and post-operative measurements (P<0.001). Only 44% of patients had recovered from headache 7 days postoperatively.

Conclusion: Some patients with recurrent headache and mucosal contact point may not meet the diagnostic criteria of mucosal contact point headache since pain was not resolved within 7 days after surgical treatment.

The major aim of this article is to report experimental results about the numerical quantities of the different shapes of human nose as well as to classify them into defined shape groups. To the best of the author knowledge this approach has never been applied. The results are based on 1793 pictures of noses of which 403 are artworks, 498 are photographs taken by the author in Europe - Holland, Belgium and France - while visiting these places, 801 were photographed in Israel and 91 are not clear where exactly photographed. 1081 were photographs of men and 712 of women. The author has succeeded to classify all the noses into 14 groups demonstrated in Figure 2 where for each nose shape it was possible to find also an artistic demonstration. The detailed results for the number of noses versus their shape and sources: artworks and photographing places - Europe and Israel - are reported in Table 1. The most widespread nose is shape 1, the fleshy nose in Figure 2, 24.2%, where the less widespread nose is shape 4, turned-up nose, 0.45%. It should be emphasized also that shape 14 photographed in Israel is extremely unique and the only one existing among the 1793 noses that were considered. In addition to the numerical results the following subjects are elaborated with respect to human’s nose: its anatomy, its different shapes as well as their relation to human’s character and facial attractiveness. And finally it is important to mention the development of electronic/artificial noses as systems for the automated detection and classification of odors, vapors, and gases.

Objectives: To observe difference of Substance P (SP) and NK-1 Receptor (NK-1R) expression in tissues at contact point and non-contact point among the patients with intranasal mucosal contact point headache and speculate the role of SP and NK-1R in mucosal contact point headache.

Methods: SP and NK-1R in tissues of contact point and non-contact point among 40 patients with intranasal mucosal contact point headache were stained histologically by immunohistochemistry, and the mRNA level was detected by RT-PCR.

Results: SP was located in cytoplasm of acini epithelial cells, distributed in nasal mucosa tissues at both contact point and non-contact point. But stain intensity was significantly increased at contact point (Z=-2.554, P<0.05). NK-1R was located in cytoplasm of acinar epithelial cells, inflammatory cells and nerve fibers of contact point; only in cytoplasm of acinar epithelial cells and nerve fibers of non-contact point. Tinctorial rate of NK-1R increased significantly at contact point (χ2 =40.438, P<0.01). mRNA level of SP and NK-1R was up-regulated in nasal mucosa at contact point compared with non-contact point.

Conclusion: Distribution of SP and NK-1R, especially NK-1R, in nasal mucosal tissue at contact point was higher compared with non-contact point. It was suggested that SP and NK-1R were associated with mucosal contact point headache.