BRAF V600E is a possible biomarker for risk stratification and prognostication in papillary thyroid carcinoma. Studies on its association with aggressive clinicopathological features among East Asian populations are limited. This study examines the clinical and histopathological features of this mutation in Filipinos with conventional papillary thyroid carcinoma. Methods: Formalin-fixed, paraffin embedded thyroid tissue blocks of papillary carcinoma for the study period January 2010 to December 2012 were retrieved. Slides were reviewed and described according to tumour size, variant type, sclerosis, multifocality, subcapsular location, extra-thyroidal extension, nodal metastasis, and nodal extracapsular spread. Medical records were reviewed for patient demographics and characteristics. Mutation status was determined using realtime polymerase chain reaction and sequencing. Results: Sixty-five patients were included in this study. BRAF V600E mutation prevalence was 38.46%. The mutation positive group was predominantly female, young (mean age 36 years), with tumour size less than 4 cm, and late-stage disease. Extra-thyroidal extension (60%), significant sclerosis (96%), and subcapsular tumour location (72%) were the most frequent findings. Eighty-three percent of patients with nodal metastasis had extracapsular spread. Conclusions: Compared to some Asian populations, this study of Filipino patients shows a lower prevalence of BRAF V600E mutation. The clinical and histopathological features of mutation positive patients raise important issues regarding extent of surgical excision and appropriate management of neck metastasis for this group.

OBJECTIVE: To present a case of relapsing polychondritis initially presenting with hoarseness and difficulty breathing and to discuss the diagnostic criteria and typical CT scan findings of relapsing polychondritis.
METHODS:
Design: Case Report
Setting: Tertiary Private Hospital in Metro Manila
Patient: One
RESULT: A 21-year-old man who was initially managed as a case of bronchial asthma for persistent hoarseness and recurrent difficulty breathing was found to have severe laryngeal edema on endoscopy, and soft tissue expansion of the cricoid cartilage with calcifications and irregular first tracheal ring on CT scan. He also had recurrent eye redness and developed bilateral aural inflammation, and was subsequently diagnosed to have relapsing polychondritis.
CONCLUSION: Relapsing polychondritis is a rare autoimmune disease characterized by recurrent inflammation and eventual destruction of cartilage throughout the body. Typical manifestations may not always be present, causing a delay in diagnosis. It should be considered in patients with intractable respiratory symptoms not responsive to treatment for upper respiratory tract infections or asthma. A CT scan may reveal signs of cartilage destruction and help in diagnosis.                 

Human ; Male ; Young Adult ; Hoarseness ; Edema ; Asthma ; Laryngeal Edema

Objective: To determine the usability of a smartphone application (ImageMeter) by ENT surgeons for pre-operative photographic analysis of facial angles for rhinoplasty using the USE questionnaire. 

Methods:

Design:           Post-Test Only Non-Experimental Evaluation Study

Setting:           Tertiary Private Training Hospital Outpatient Clinic

Participants: Twenty-five (25) ENT residents and consultants

Results: Of 45 ENT surgeons invited, 25 ENT residents and consultants (16 males, 9 females) aged 28 to 52-years-old (mean age 36 years old) trialed the use of the Image Meter application in measuring the naso-facial, naso-frontal, and naso-labial angles of pre-selected lateral images of 10 volunteers and completed our survey.  The usability of the application was measured using the USE questionnaire, through usefulness (Cronbach ? = 0.99), ease of use (? = 0.85), ease of learning (? = 0.66), and satisfaction (?= 0.69).  On a scale of 1-7, results showed that for the ENT surgeons surveyed, the app was generally useful (M = 6.10, SD = 0.73), easy to use (M = 6.13, SD = 0.63), easy to learn (M = 6.31, SD = 0.62) and satisfactory (M = 6.06, SD = 0.7).  As for overall outcome, the ENT surgeons found the application usable (M = 6.15, SD = 0.11).

Conclusion: When applied to human facial analysis, the ImageMeter measurement of angles feature may be a usable tool for ENT surgeons in the pre-operative evaluation of patients undergoing rhinoplasty.  Based on USE questionnaire responses, it is easy to use, quick to learn, useful, and satisfactory in the preoperative measurement of facial angles. 

Keywords: imageMeter; photography; esthetic; rhinoplasty; face; anthropometry

Human ; Photography ; Rhinoplasty ; Face ; Anthropometry