Gokce Yeter H, Kosemehmetoglu K, Soylemezoglu F. Poorly differentiated chordoma: review of 53 cases. APMIS 2019; 127: 607-615.Poorly differentiated chordoma (PDC) is a newly described variant of chordomas, which is not considered as a subtype yet, but has its own distinct features in terms of morphology, immunohistochemical and molecular characteristics, and clinical outcome. To provide a brief review of clinical, morphological, immunohistochemical, and molecular features of poorly differentiated chordoma. PubMed search using keyword 'poorly differentiated chordoma'. A critical review of all studies with a total of 53 cases using inclusion criteria of involvement of axial skeleton (vertebra and clivus), INI1 loss (either with the aid of immunohistochemistry or various molecular techniques), and immunohistochemical brachyury expression. PDC is characterized by a young population with slight female predominance, clivus/cervix location, multinodular sheets of epithelioid cells with eosinophilic cytoplasm and prominent pleomorphism, and loss of SMARCB1/INI1 expression, which can be demonstrated both with immunohistochemical and molecular studies, and is unexpected for other types of chordoma. However, classical chordomas lacking SMARCB1/INI1 expression were also reported and how to classify these cases has not been addressed yet. This unique entity is a candidate to be recognized and distinguished from other types of chordoma or SMARCB1-deficient tumors which are clinically important differential diagnoses that represent a challenging task for the pathologists.

There is a passive blood flow to the stomach during oral and nasal surgery. It may cause postoperative nausea and vomiting (PONV). We researched the relationship between gastric decompression (GD) and severity of PONV in ear, nose, and throat (ENT) surgery. 137 patients who have been into ENT surgery were included in the study. In Group I (n = 70), patients received GD after surgery before extubation; patients in Group II (n = 67) did not receive GD. In postoperative 2nd, 4th, 8th, and 12th hours, the number and ratio of patients demonstrating PONV were detected to be significantly more in Group II as compared to Group I. PONV was also significantly more severe in Group II as compared to Group I. In Group I, the PONV ratio in the 2nd hour was significantly more for those whose amounts of stomach content aspired were more than 10 mL as compared to those whose stomach content aspired was less than 10 mL. In the 4th, 8th, and 24th hours, there is no statistically significant difference between the stomach content aspired and PONV ratio. GD reduces the incidence and severity of PONV in ENT surgery.

In contrary to the diagnostic lumbar puncture, reinsertion of the stylet after spinal anesthesia with 25-gauge Quincke needles does not reduce the incidence of PDPH.

Background and objectives: This study was conducted to investigate the effects of reinsertion of the stylet after a spinal anesthesia procedure on the Post Dural Puncture Headache (PDPH). Methods: We have enrolled into this study 630 patients who were undergoing elective operations with spinal anesthesia and randomized them to Group A (stylet replacement before needle removal) and Group B (needle removal without stylet replacement). These patients were observed for the duration of 24 hours in the hospital and they were checked for PDPH on the 3 rd and the 7 th day of the study. Results: Overall, the PDPH incidence was at 10.8% (68 patients). Thirty-three of these patients (10.5%) who were in Group A (stylet replacement before needle removal) and the other 35 patients (11.1%) who were in Group B (needle removal without stylet replacement) experienced PDPH. There was no signifi cant difference between the two groups with respect to the PDPH. Conclusions: In contrary to the diagnostic lumbar puncture, reinsertion of the stylet after spinal anesthesia with 25-gauge Quincke needles does not reduce the incidence of PDPH.

In contrary to the diagnostic lumbar puncture, reinsertion of the stylet after spinal anesthesia with 25-gauge Quincke needles does not reduce the incidence of PDPH.