The minimum effective concentration (MEC90) of bupivacaine for an ultrasound-guided suprainguinal fascia iliaca compartment block for analgesia in knee surgery: a dose-finding study.

BACKGROUND: In recent years, the suprainguinal fascia iliaca compartment block (SFICB) has become more common in clinical practice. This assessor-blinded dose-finding study aimed to determine the minimum effective concentration (MEC90, MEC95) of bupivacaine for a single-injection SFICB in patients undergoing arthroscopic anterior cruciate ligament repair. METHODS: This prospective study was conducted at a tertiary hospital (postoperative recovery room and ward). The SFICB was performed as a postsurgical intervention after spinal anesthesia. Seventy patients were allocated using the biased-coin design up-and-down sequential method. The ultrasound-guided SFICB was performed using different bupivacaine concentrations, and standard multimodal analgesia was administered to all patients. Block success was defined as the absence of pain or presence of only tactile sensation during the pinprick test conducted on the anterior and lateral regions of the mid-thigh six hours postoperatively. RESULTS: According to isotonic regression and bootstrap CIs, the MEC90 value of bupivacaine for a successful SFICB was 0.123% (95% CI [0.098, 0.191]) and the MEC95 value was 0.188% (95% CI [0.113, 0.223]). CONCLUSIONS: Our study showed that the MEC90 and MEC95 values for bupivacaine administered via an SFICB for analgesia were 0.123% and 0.188%, respectively. One advantage of using lower concentrations of bupivacaine is the associated reduction in quadriceps weakness.

Follow-up of Serum Creatine Phosphokinase Levels after Ultrasound Guided Suprainguinal Fascia Iliaca Block with Bupivacaine in Total Knee Arthroplasty Patients: An Observational, Controlled Study.

OBJECTIVE: To determine the myotoxicity of bupivacaine on muscles after suprainguinal fascia iliaca block for postoperative analgesia in total knee arthroplasty (TKA) patients through changes in serum creatine phosphokinase (CPK) levels during the perioperative period. STUDY DESIGN: Observational study. Place and Duration of the Study: Postoperative Recovery Room department of Anaesthesiology and Reanimation, Samsun University, Samsun, Training and Research Hospital, Samsun, Turkiye, between December 2022 and February 2023. METHODOLOGY: Patients undergoing for the procedure of TKA surgery were recruited. (40 controls and 42 SIFIB groups). Serum CPK levels were evaluated preoperatively, at postoperative 6th hour and 24th hour. RESULTS:  From total 82 patients, 42 of them who received SIFIB as a component of multimodal analgesia had serum CPK levels comparable to those in the control group at all time points (p>0.05). While the increase in CPK level at 6th hour relative to baseline was significant in both groups (p<0.05), only the block group demonstrated a statistically significant difference between the 6th and 24th hours (p<0.05). CONCLUSION: SIFIB administration did not result in severe bupivacaine-induced myotoxicity in comparison to the control group. SIFIB administration is a safe option when used as part of multimodal analgesia in TKA. KEY WORDS:  Bupivacaine, Creatine phosphokinase, Myotoxicity, Regional anaesthesia.

Biocompatibility of different resin composites after polymerization with two light curing units: an immunohistochemical study.

Purpose: The aim of this study is to compare the biocompatibility of two different resin composites after polymerization under two different light sources in three different time periods. Materials and methods: 72 polyethylene tubes polymerized with 2 different resin composites and 2 different light sources (Elipar S10 and Valo ) [Group 1: Kalore Elipar S10 (KE), Group 2: Kalore Valo (KV), Group 3: Essentia Elipar S10 (EE), Group 4: Essentia Valo (EV)] were implanted in the dorsal connective tissue of 18 rats. 24 empty polyethylene tubes [Group 5: (Control group)] were implanted in the dorsal connective tissue of 6 rats. Then, the rats were sacrificed after 7th, 15th and 30th days in each time intervals (n=8). Biopsy samples were stained with H&E and examined for inflammation, necrosis, macrophage infiltrate, giant cell and fibrous capsule criteria. Immunohistochemical staining was performed to evaluate proinflammatory cytokines (IL-1ß, IL-6 and IL-8). Results: When the composite groups and the control groups were compared; the difference was statistically significant for the criteria of inflammation at 7th and 15th days, there was no statistical difference between the time points in terms of fibrous capsule and necrosis. When the composite groups and control groups were evaluated in terms of proinflammatory cytokines; statistically significant differences were found at 7th, 15th and 30th days. Conclusion: All CRs used in this study showed acceptable biocompatibility in the subcutaneous tissues of rats after polymerization with different light sources.

Comparison of the analgesic efficacy of the ultrasound-guided transversalis fascia plane block and erector spinae plane block in patients undergoing open inguinal hernia repair under spinal anesthesia.

BACKGROUND: Open inguinal hernia repair (OIHR) surgery is a common surgical procedure, and ultrasound guided interfascial plane blocks can also be included in current approaches to postoperative multimodal analgesia regimens. This study aimed to compare the postoperative analgesic efficacy of the erector spinae plane block (ESPB) and transversalis fascia plane block (TFPB) in patients undergoing OIHR. METHODS: This prospective, randomized, assessor-blinded comparative study was conducted in the postoperative recovery room and ward of a tertiary hospital. A total of 80 patients with American Society of Anesthesiologists physical status I-III were enrolled and allocated equally to either the ESPB or TFPB group. The patients received standard multimodal analgesia in addition to an ultrasound-guided ESPB or TFPB. During the first 24 h postoperatively, tramadol consumption was assessed and pain levels at rest and during movement were compared using numeric rating scale (NRS) scores at 1, 3, 6, 9, 12, 18, and 24 h postoperatively. RESULTS: The results showed no difference in NRS scores at any time point between the groups, except for NRS at rest in the third hour. However, tramadol consumption was lower in the TFPB group than in the ESPB group overall (88 ± 75.2 vs. 131 ± 93.7 mg, respectively; P = 0.027, mean difference: -43, 95% CI [-80.82, -5.18]). CONCLUSIONS: The TFPB leads to lower tramadol requirements in the first 24 h postoperatively than the ESPB in patients undergoing OIHR.

Mortal condition in an unusual localization, analysis of isolated tongue and tongue base abscesses.

BACKGROUND: Tongue abscess (TA) is a very rare clinical condition and its treatment is very important. Surgical drainage is at the forefront in the treatment. Our study includes patients with tongue and tongue base abscesses. AIM: To discuss the clinical and laboratory findings of these patients emphasizing the underlying causes and treatment options with the largest patient series in the English literature. METHODS: We included patients with isolated TA who applied to our clinic between January 1, 2020 and January 1, 2023. Those who lack the recorded data, those who are not between the ages of 18-66, those who have not undergone surgery-interventional procedure, and those who have infection and/or abscess in another place were excluded from the study. RESULTS: There were two female (18%) and nine male (82%) patients in our series consisting of 11 patients. Their ages ranged from 18 to 66, and the mean ± SD was 48.63 ± 16.3. Considering the localization of the abscess, three anterior abscesses (27%), two lateral abscesses (18%), and six abscesses at the base of the tongue (54%) were detected. CONCLUSION: Tongue abscesses can cause acute upper airway obstruction and respiratory collapse. It may be necessary to act quickly for the tracheotomy procedure and this procedure can usually be performed under local anesthesia as intubation cannot be achieved. When we encounter an abscess in an unexpected organ, difficulties may be encountered in the management of the patient.

Sacral Erector Spinae Plane Block As the Main Anesthetic Method for Parasacral Reconstructive Surgeries: A Single-Center Retrospective Cohort Feasibility Study.

Study objective Sacral erector spinae plane block (ESPB) is a regional anesthesia technique defined for the blockade of the posterior branches of the sacral nerves. In this study, we aimed to retrospectively evaluate our sacral ESPB applications as an anesthetic method in patients who underwent parasacral and gluteal reconstructive surgery. Methodology The design of our study is a retrospective cohort feasibility study. This study was conducted at a tertiary university hospital, and patient files and electronic data systems were used to obtain data for analysis. In total, the data of 10 patients who underwent parasacral or gluteal reconstructive surgery were evaluated. Main results During reconstructive procedures for sacral pressure ulcers and lesions in the gluteal region, the sacral ESP block was utilized. Small doses of perioperative analgesics/anesthetics were required, but moderate or deep sedation or conversion to general anesthesia was not required. Conclusion Sacral ESP block is a viable regional anesthetic technique in reconstructive surgeries of the parasacral and gluteal regions.

Results of 301 Parotidectomies: A Twenty-Year Experience of One Single Institution.

To evaluate demographic, clinical, surgical and histopathological results and complications of 301 parotidectomies performed in southern part of Turkey. The results of 297 patients undergoing 301 parotidectomies between 2000 and 2019 were retrospectively reviewed. Four patients underwent bilateral parotidectomy. Age, gender, side and size of lesion, postoperative facial nerve function (FNF) for benign tumors and types of surgery were evaluated. There were 172 male and 125 female patients. The mean age was 52.53 ± 16.67 years (range 11-90 years). Patients with malignant tumor had higher mean age than the patients with benign diseases (p < 0.001) and the mean age of Warthin tumor (WT) patients was significantly higher than pleomorphic adenoma (PA) (p < 0.001). There was a significant male dominancy in WTs than the PAs (p < 0.001). The mean size of the malignant tumors was significantly higher than the benign tumors (p = 0.012). The mean of cigarette smoking value (pack/year) was higher in WTs than the PAs (p < 0.001). WT incidence was slightly higher than PA in between years 2010 and 2019 (p = 0.272) compared to between years 2000 and 2009. Fine needle aspiration biopsy had a sensitivity of 96% and specificity of 78% for the benign tumors. Tumor location (p < 0.001) and tumor size (p = 0.034) had negative effect on the postoperative FNF. The incidence of WT had a significant rise in the last decade. Deep lobe tumors and increased tumor size had effect postoperative FNF. Experience of surgeon is more important than nerve monitoring to prevent facial paralysis. Partial superficial parotidectomy was available methods for small benign tumors in tail of the parotid gland.

Diagnostic and therapeutic approaches in deep neck infections: an analysis of 74 consecutive patients / Abordagens diagnósticas e terapêuticas em infecções cervicais profundas: uma análise de 74 pacientes consecutivos

Abstract Introductıon: Deep neck infections are a group of diseases with serious complications and mortality, which can occur as a result of common diseases in the community and which have surgical and medical treatment options. Objectives: Patients ages, genders, complaints, physical examination findings, hospitalization complaints, history of antibiotic use before the application, additional diseases, radiological tests and analysis of examinations, type of treatment method, antibiotic agents selected in treatment, bacterial culture results, duration of hospitalization, complications, mortality rates were systematically recorded. In the study, anaerobic bacterial factors, which are difficult to produce in routine, were produced by considering special transport conditions and culture media. Methods: A total of 74 patients who were hospitalized in the Department of Otorhinolaryngology, University of Mersin, between 01.07.2016 and 01.07.2017 for deep neck infection were evaluated prospectively. The study included 37 female and 37 male patients. The ages of the patients ranged from 1 to 69 and the mean age was 31 years. Results: According to the analysis of the obtained data, there was a statistically significant relationship between the patients with additional diseases and the treatment modalities of the patients (p = 0.017). The surgical treatment rate was increased in this group of patients. In patients with a history of antibiotic use, it was found that patients in the pediatric group were in hospital longer in terms of length of stay compared to adults (p = 0.036). In adult patients who underwent surgery, the absorptive long axis was found to be longer in mm than in patients receiving isolated medical treatment (p = 0.008). Conclusions: Deep neck infections is a disease group that seriously concerns public health, with significant mortality and morbidity. Ensuring airway safety of patients should be the first intervention. Abscesses located lateral to the tonsil capsule may not drain adequately without concomitant tonsillectomy.

Resumo Introdução: As infecções cervicais profundas constituem um grupo de doenças com graves complicações e mortalidade, que podem ocorrer como resultado de doenças comuns na comunidade e que têm opções de tratamento médico e cirúrgico. Objetivo: Detectar bactérias anaeróbias e comparar a eficácia do tratamento médico-cirúrgico em diferentes faixas etárias. Método: Foram sistematicamente registrados idade dos pacientes, sexo, queixas, achados do exame físico, queixas na hospitalização, histórico de uso de antibióticos, doenças adicionais, exames radiológicos e análise dos exames, tipo de tratamento, agentes antibióticos selecionados no tratamento, resultados de cultura bacteriana, duração da hospitalização, complicações e taxas de mortalidade. No estudo, culturas bacterianas anaeróbias, difíceis de obter rotineiramente, mesmo considerando-se condições especiais de transporte e meios, foram obtidas. Foram avaliados prospectivamente 74 pacientes internados no Departamento de Otorrinolaringologia da Universidade de Mersin, entre 01.07.2016 e 07.07.2017, devido a infecção cervical profunda. O estudo incluiu 37 pacientes do sexo feminino e 37 do masculino. A idade dos pacientes variou de 1 a 69 anos e a média foi de 31. Resultados: De acordo com a análise dos dados obtidos, houve uma relação estatisticamente significante entre os pacientes com doenças adicionais e as modalidades de tratamento dos pacientes (p = 0,017). A taxa de tratamento cirúrgico foi maior nesse grupo de pacientes. Em pacientes com histórico de uso de antibióticos, verificou-se que aqueles do grupo pediátrico permaneceram mais tempo hospitalizados em comparação aos adultos (p = 0,036). Nos pacientes adultos submetidos à cirurgia, verificou-se que o eixo longo absortivo era mais longo em mm do que nos pacientes que receberam tratamento médico isolado (p = 0,008). Conclusão: As infecções cervicais profundas constituem um grupo de doenças que são preocupantes na saúde pública, com sua mortalidade e morbidade. Garantir a segurança das vias aéreas dos pacientes deve ser a primeira intervenção. Os abscessos localizados lateralmente à cápsula tonsilar podem não apresentar drenagem sem a tonsilectomia.

Diagnostic and therapeutic approaches in deep neck infections: an analysis of 74 consecutive patients.

INTRODUCTiON: Deep neck infections are a group of diseases with serious complications and mortality, which can occur as a result of common diseases in the community and which have surgical and medical treatment options. OBJECTIVES: Patients ages, genders, complaints, physical examination findings, hospitalization complaints, history of antibiotic use before the application, additional diseases, radiological tests and analysis of examinations, type of treatment method, antibiotic agents selected in treatment, bacterial culture results, duration of hospitalization, complications, mortality rates were systematically recorded. In the study, anaerobic bacterial factors, which are difficult to produce in routine, were produced by considering special transport conditions and culture media. METHODS: A total of 74 patients who were hospitalized in the Department of Otorhinolaryngology, University of Mersin, between 01.07.2016 and 01.07.2017 for deep neck infection were evaluated prospectively. The study included 37 female and 37 male patients. The ages of the patients ranged from 1 to 69 and the mean age was 31 years. RESULTS: According to the analysis of the obtained data, there was a statistically significant relationship between the patients with additional diseases and the treatment modalities of the patients (p = 0.017). The surgical treatment rate was increased in this group of patients. In patients with a history of antibiotic use, it was found that patients in the pediatric group were in hospital longer in terms of length of stay compared to adults (p = 0.036). In adult patients who underwent surgery, the absorptive long axis was found to be longer in mm than in patients receiving isolated medical treatment (p = 0.008). CONCLUSIONS: Deep neck infections is a disease group that seriously concerns public health, with significant mortality and morbidity. Ensuring airway safety of patients should be the first intervention. Abscesses located lateral to the tonsil capsule may not drain adequately without concomitant tonsillectomy.

Adipose derived mesenchymal stem cell treatment in experimental asherman syndrome induced rats.

Asherman syndrome (AS) occurs due to fibrosis or uterine adhesions as a result of damage to the basal layer of the endometrium. The aim of this study is investigating the effects of adipose tissue-derived mesenchymal stem cell (ADMSC) application on the expression of vascular endothelial growth factor (VEGF), insulin-like growth factor (IGF-1), miRNA-98, miRNA199a in endometrial tissue in rats with AS. Study groups were designed as, control (C), Asherman syndrome (AS), AS + oral estrogen (ASO), AS + ADMSC (ASSC), AS + oral estrogen + ADMSC (ASSCO) with 7 samples in each group. Characterization and differentiation experiments were performed in ADMSC obtained. Two weeks after the development of the AS, ADMSC therapy was applied. BrdU (5-bromo-2'-deoxyuridine) labeling was performed to show the presence of ADMSC in the tissues. Rats were sacrificed after 8 weeks and bilateral uterine horn resection was performed. Tissues were fixed in formaldehyde. After routine tissue follow-up, sections were taken and evaluated with hematoxylin eosin staining. VEGF1 and IGF1 expressions were evaluated by immunohistochemical staining and western blot analysis. Expression changes of miR-98 and miR-199a were detected by RT-PCR. Our results showed that stem cells and estrogen giving together reduced inflammation and fibrosis in the endometrium. Immunohistochemistry and western blot results suggested that this effect was achieved especially through IGF-1. In our study, decreased miR-98 and miR-199a expressions were determined in Asherman syndrome. Furthermore, no changes of miRNA expressions were observed in treatment groups.

Traditional medicinal plants of Agri Province, Turkey.

ETHNOPHARMACOLOGICAL RELEVANCE: This study serves as the first investigation of the knowledge of traditional medicinal plants used in Agri Province. The mountainous and strongly fragmented area, diversity of local flora, limited access to modern medicines because of the people's seminomadic lifestyle, and harsh climatic conditions have prompted the locals to benefit from natural resources, principally plants. AIM OF THE STUDY: Although the use of medicinal plant is common in the area, documentation and inventory analysis are not available on the plant taxa used in traditional medicine in Agri Province. This study focused on the answer of the following question: What are the most medicinally valuable plant taxa in the province? Therefore, this study aimed to (i) document medicinal plant taxa used in Agri Province; (ii) determine the endemic plant species and their risk categories; (iii) determine the most widely used plant taxa for specific ailments to further contribute to drug discovery; (iv) determine the local names, plant part(s) used, preparation, and utilization methods of these local plant medicines to assist with pharmaceutical studies; and (v) reveal the origin(s) of traditional medicinal knowledge of Agri Province. MATERIALS AND METHODS: Ethnopharmacological field studies were conducted between 2014 and 2016 in 638 locations within Agri Province. Plant samples used in folk medicine were determined through face-to-face interviews with 120 local healers. Traditional medicinal plant samples were collected from wild areas with the help of the local healers and transported to Van Pharmaceutical Herbarium (Van, Turkey) for botanical identification. The statistical analyses of data were conducted using the informant consensus factor (ICF) method. RESULTS: In this study, 118 medicinal taxa belonging to 35 families of plants were determined to be used in Agri Province. Ninety-three different local names were recorded, which mainly described the plant's morphological characteristics. Data analysis (ICF) revealed that the traditional medicinal plants used in Agri Province might offer promising information for new pharmaceuticals. CONCLUSIONS: The local population in the study area has a preserved and comprehensive knowledge of traditional medicine because of its limited access to modern medicine, seminomadic lifestyle, isolated geographical position, traditional taste habits, climatic conditions, diversity of local flora, and mountainous and rugged geography. The medicinal plants presented in this study might provide valuable leads for the identification of bioactive compounds for pharmaceutical use and represent a vast and underutilized resource for the development of newer and more efficient pharmacological treatments.

The Effect of Methylphenidate on the Hearing of Children with Attention Deficit Hyperactivity Disorder

Abstract Introduction There has been a sudden idiopathic hearing loss case presented after methylphenidate treatment in a child with attention deficit hyperactivity disorder (ADHD). Objective This study was performed to reveal the probable ototoxic side effects of methylphenidate use in patients with ADHD. Methods Thirty pediatric patients with ADHD were included in the study. Pure tone audiometry, speech discrimination scores, waves I, III, V absolute latencies and waves IIII, I-V, III-V interpeak latencies at the 80 dB nHL intensity after click stimulus auditory brainstem response (ABR) results were compared before and 3 months after methylphenidate treatment. Results There were no statistically significant difference between pretreatment and posttreatment pure tone and speech audiometry findings and ABR results (p > 0.05 for all parameters). Conclusion Methylphenidate can be regarded as a safe drug regarding ototoxic side effects. Additional studies with a larger sample size and longer follow-up may be needed.

Comparison of microRNA profiles between benign and malignant salivary gland tumors in tissue, blood and saliva samples: a prospective, case-control study / Comparação de perfis de microRNA entre tumores de glândula salivar benignos emalignos em amostras de tecido, sangue e saliva: estudo caso-controle prospectivo

Abstract Introduction: Salivary gland tumors (SGTs) are rare head and neck malignancies consisting of a spectrum of tumors with different biological behaviors. Objective: In this study we aimed to find out differential expression of microRNA profiles between benign and malignant SGTs. Methods: We investigated the possible role of 95 microRNAs in the 20 patients with salivary gland tumors with comparison of 17 patients without malignancy or salivary gland diseases. Sixteen of the tumors were benign (seven pleomorphic adenomas, nine Warthin tumors), four of them were malignant (two squamous cell carcinomas, one high grade mucoepidermoid carcinoma, one adenocarcinoma). Serum and saliva samples were collected from both patients and control group. Tissue samples of tumor masses were also collected from patient group. Results: Among studied microRNAs miR-21, miR-23a, miR-27a, miR-223, miR-125b, miR-126, miR-146a, miR-30e were down regulated in the benign group compared to control group in the serum samples (p-values are 0.04, 0.00005, 0.00005, 0.0022, 0.031, 0.00008, 0.044, and 0.0007, respectively). When tissue samples were studied miR-21, miR-31, miR-199a-5p, miR-146b, miR-345 were up-regulated in the malignant group compared to benign group (p values are 0.006, 0.02, 0.013, 0.013, 0.041, respectively). miR-30e showed statistically significant up-regulation in malignant tumor group's plasma samples compared to benign group (p = 0.034). There was no statistically significant difference in saliva samples between groups. Conclusion: Our results showed that different microRNAs may play role in salivary tumor pathogenesis according to biological behavior. Although there was no difference in saliva samples between groups, according to tissue and serum samples miR-21 and 30e may have an important role; since they were down-regulated in benign tumors whereas up-regulated in malignant ones.

Resumo Introdução: Os tumores da glândula salivar (TGS) são lesões malignas raras de cabeça e pescoçoque consistem em um espectro de tumores com diferentes comportamentos biológicos. Objetivo: Neste estudo, tivemos como objetivo identificar a expressão diferencial de perfis demicroRNA entre TGS benignos e malignos. Método: Investigamos a possível participação de 95 microRNA em 20 pacientes com tumoresde glândulas salivares comparados com 17 pacientes sem doença maligna ou doenças das glân-dulas salivares; 16 dos tumores eram benignos (sete adenomas pleomórficos, nove tumores deWarthin), quatro eram malignos (dois carcinomas espinocelulares, carcinoma mucoepidermoidede alto grau, um adenocarcinoma). As amostras de soro e saliva foram coletadas de pacien-tes e do grupo controle. Amostras de tecido dos tumores também foram colhidas do grupo depacientes com tumores. Resultados: Entre os microRNA estudados, miR-21, miR-23a, miR-27a, miR-223, miR-125b, miR-126, miR-146a, miR-30e foram infrarregulados no grupo benigno em comparação com o grupocontrole nas amostras do soro (os valores de p são 0,04, 0,00005, 0,00005, 0,0022, 0,031,0,00008, 0,044 e 0,0007, respectivamente). Quando as amostras de tecido foram estudadas,miR-21, o miR-31, o miR-199-5p, miR-146b, o miR-345 foram suprarregulados no grupo malignoem relação ao grupo benigno (valores de p são 0,006, 0,02, 0,013, 0,013, 0,041, respectiva-mente). O miR-30e apresentou suprarregulação estatisticamente significativa em amostras deplasma do grupo de tumor maligno em relação ao grupo benigno (p = 0,034). Não houve diferençaestatisticamente significativa em amostras de saliva entre os grupos. Conclusão: Nossos resultados mostraram que diferentes microRNA podem desempenhar umpapel na patogenia do tumor salivar de acordo com o comportamento biológico. Embora nãotenha havido diferença em amostras de saliva entre os grupos, de acordo com as amostras detecido e de soro, miR-21 e 30e podem ter um papel importante, já que foram infrarreguladosnos tumores benignos enquanto suprarregulados nos tumores malignos.

Stapler Esophageal Closure During Total Laryngectomy.

Mechanical esophageal closure with stapler during total laryngectomy has been used by various authors to decrease the surgical time and pharyngocutaneous fistula (PCF) rates. In a few of the studies, surgical site infection (SSI) rates are mentioned and none of the studies emphasize the effect of decreased surgical time on postoperative cardiovascular and cerebrovascular complications. In this study, the authors compared the PCF rates, SSI rates, operation times between 30 mechanical stapler and 40 manual esophageal closure during total laryngectomy for laryngeal cancer patients. National Nasocomial Infections Surveillance system (NNISS) scores were recorded and compared between groups. Total laryngectomy and total operation times were lower in the stapler group patients (P < 0.001 for total laryngectomy time, P = 0.024 for total operation time). There were lower rates of pharyngocutaneous fistula (P = 0.032), surgical site infection (P = 0.019), and NNISS scores (P = 0.009) in the stapler group. There was no statistically significant difference between groups regarding postoperative systemic complications (P = 0.451). In conclusion, stapler esophageal closure decreases operation time, PCF, SSI rates, and NNISS scores but not the systemic complication rates. Comorbid illnesses and prolonged surgical time are risk factors for postoperative systemic complications in total laryngectomy patients, but patients with additional illnesses must not encourage the surgeon to use stapler for decreasing postoperative systemic complications.

Comparison of microRNA profiles between benign and malignant salivary gland tumors in tissue, blood and saliva samples: a prospective, case-control study.

INTRODUCTION: Salivary gland tumors (SGTs) are rare head and neck malignancies consisting of a spectrum of tumors with different biological behaviors. OBJECTIVE: In this study we aimed to find out differential expression of microRNA profiles between benign and malignant SGTs. METHODS: We investigated the possible role of 95 microRNAs in the 20 patients with salivary gland tumors with comparison of 17 patients without malignancy or salivary gland diseases. Sixteen of the tumors were benign (seven pleomorphic adenomas, nine Warthin tumors), four of them were malignant (two squamous cell carcinomas, one high grade mucoepidermoid carcinoma, one adenocarcinoma). Serum and saliva samples were collected from both patients and control group. Tissue samples of tumor masses were also collected from patient group. RESULTS: Among studied microRNAs miR-21, miR-23a, miR-27a, miR-223, miR-125b, miR-126, miR-146a, miR-30e were down regulated in the benign group compared to control group in the serum samples (p-values are 0.04, 0.00005, 0.00005, 0.0022, 0.031, 0.00008, 0.044, and 0.0007, respectively). When tissue samples were studied miR-21, miR-31, miR-199a-5p, miR-146b, miR-345 were up-regulated in the malignant group compared to benign group (p values are 0.006, 0.02, 0.013, 0.013, 0.041, respectively). miR-30e showed statistically significant up-regulation in malignant tumor group's plasma samples compared to benign group (p=0.034). There was no statistically significant difference in saliva samples between groups. CONCLUSION: Our results showed that different microRNAs may play role in salivary tumor pathogenesis according to biological behavior. Although there was no difference in saliva samples between groups, according to tissue and serum samples miR-21 and 30e may have an important role; since they were down-regulated in benign tumors whereas up-regulated in malignant ones.

The Role of Oxidative Stress and Inflammatory Mediators in Benign Paroxysmal Positional Vertigo.

OBJECTIVE: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral cause of vertigo. It can be defined as transient vertigo induced by rapid changes in head position associated with a characteristic paroxysmal positional nystagmus. The aim of this study was to search for the possible role of oxidative stress and inflammatory mediators in the pathogenesis of BPPV. MATERIALS AND METHODS: Total antioxidant status as well as paraoxonase, tumor necrosis factor alpha, interleukin (IL) 6, and IL-1ß levels were evaluated in peripheral venous serum samples of 30 BPPV and 30 control patients. RESULTS: Total antioxidant status levels were lower in the BPPV group than in the control group (p=0.008). After Epley's repositioning maneuver in the vertigo group, there was a statistically significant decline in IL-1ß levels at the first and third month visits (p=0.014 for first month and p=0.013 for third month). CONCLUSION: Our findings suggested that IL-1ß and oxidative stress contributed to the pathogenesis of BPPV.

Mesenchymal Stem Cells and C-type Natriuretic Peptide Signaling: A Proposal for a New Treatment Approach for Skeletal Dysplasias.

Endochondral ossification is under the regulation of endocrine, paracrine and otocrine factors including transforming growth factor-&#946; superfamily members, fibroblast growth factors, retinoids, products of hedgehog gene, parathyroid hormone-related peptide, molecules involved in cell adhesion, and extracellular matrix components. Natriuretic peptide receptor-B, and its ligand C-type natriuretic peptide have also been implicated in the regulation of limb bone development. Results of recent studies are promising in terms of systemic elevation of C-type natriuretic peptide level inducing growth. In addition, same strategy also overcomes the dwarf phenotype of achondroplasia, the most frequently seen skeletal dysplasia in human, in a mouse model. Based on this literature and a series of recent experiments discussed here, this perspective underlines the abundant C-type natriuretic peptide expression in trabecular bone derived mesenchymal stem cells of human, chicken, and rat origin, and proposes the potential use of mesenchymal stem cells as a part of growth inducing treatment strategy in osteochondrodisyplasias in the future.

Endoscopic Sphenopalatine Artery Ligation in Posterior Epistaxis: Retrospective Analysis of 30 Patients.

OBJECTIVE: Although posterior epistaxis is rarely seen, it is an important medical problem that both decreases the quality of life of the patient and causes difficulties in the management for otorhinolaryngologists. In this study, we aimed to present the results of 30 patients who underwent transnasal endoscopic sphenopalatine artery ligation (TESPAL) for posterior epistaxis in our department. METHODS: The records of 30 patients who underwent TESPAL from January 2014 to April 2016 were analyzed retrospectively, and the relationship between perioperative factors and need for revision surgery was assessed. RESULTS: The success rate of TESPAL in posterior epistaxis was 90%. There was no relationship between surgical failure and antiaggregant use (p=0.224), anticoagulant use (p=0.534), hypertension (p=0.564), previous nasal surgery (p=0.279), and bilateral TESPAL application (p=0.279). TESPAL was seen to be effective in cases with Osler-Weber-Rendu disease, pregnancy, and uncontrollable epistaxis after rhinoplasty surgery. Mortality was seen in one of our patients not related to endoscopic ligation in the follow-up period. CONCLUSION: TESPAL is an effective method in the treatment of posterior epistaxis. Hypertension, antiaggregant or anticoagulant use, bilateral sphenopalatine artery ligation, and previous nasal surgery do not seem to be factors leading to surgical failure.

Evaluation of temperature rises during the application of different power levels of potassium titanyl phosphate and neodymium-doped:yttrium aluminum garnet lasers to external primary root canals.

BACKGROUND/PURPOSE: Nowadays, laser systems play crucial roles in endodontic treatments. Therefore, these systems should be investigated in terms of parameters that may prevent periodontal tissues damages during laser irradiation. In this context, the purpose of this study was to evaluate temperature rises during the application of different power levels of potassium titanyl phosphate (KTP) and neodymium-doped:yttrium aluminum garnet (Nd:YAG) lasers to external primary root canals. MATERIALS AND METHODS: Sixty primary mandibular molars were selected and chemomechanical preparation was performed. KTP laser treatment was applied to 30 of these 60 samples and the remaining 30 received Nd:YAG laser treatment. The teeth samples received laser application (KTP or Nd:YAG) at three different power levels (1 W, 1.5 W, and 2 W, respectively, applied to 10 samples from each group). Nine holes were drilled (1 mm in diameter) through the level of the coronal, middle, and apical third of each tooth canal to provide entry for a Type L thermocouple wire, which was used to measure temperature changes. Data were assessed with two-way analysis of variance and the Tukey test. RESULTS: All power levels indicated statistically significant differences between Nd:YAG and KTP laser systems (P < 0.05). Moreover, the same regional (apical, middle, and coronal) comparisons performed between Nd:YAG and KTP laser systems showed statistically significant differences (P < 0.05). CONCLUSION: All parameters of KTP laser indicated lower temperature rises than Nd:YAG laser. Therefore, KTP laser may be preferable to protect the periodontal tissues from harmful thermal effects during the endodontic treatment of primary root canals.

Accessory Nostril: A Rare Congenital Nasal Anomaly.

Accessory nostril is a very rare congenital anomaly with an unknown etiology also known as supernumerary nostril. A few accessory nostrils have been reported up to the present time, and extremely rare cases located on columella. A newborn infant with respiratory distress was referred to our hospital. The authors observed that accessory nasal nostril is not related to normal nasal cavity on the median line of columella. In this article, the authors reported accessory nostril case in newborn and review the literature.