Adenosine deaminase 2 produced by infiltrative monocytes promotes liver fibrosis in nonalcoholic fatty liver disease.

Elevated circulating activity of adenosine deaminase 2 (ADA2) is associated with liver fibrosis in nonalcoholic fatty liver disease (NAFLD). In the liver of NAFLD patients, ADA2-positive portal macrophages are significantly associated with the degree of liver fibrosis. These liver macrophages are CD14- and CD16-positive and co-express chemokine receptors CCR2, CCR5, and CXCR3, indicating infiltrative monocyte origin. Human circulatory monocytes release ADA2 upon macrophage differentiation in vitro. When stimulated by recombinant human ADA2 (rhADA2), human monocyte-derived macrophages demonstrate upregulation of pro-inflammatory and pro-fibrotic genes, including PDGF-B, a key pro-fibrotic cytokine. This PDGF-B upregulation is reproduced by inosine, the enzymatic product of ADA2, but not adenosine, and is abolished by E359N, a loss-of-function mutation in ADA2. Finally, rhADA2 also stimulates PDGF-B production from Kupffer cells in primary human liver spheroids. Together, these data suggest that infiltrative monocytes promote fibrogenesis in NAFLD via ADA2-mediated autocrine/paracrine signaling culminating in enhanced PDGF-B production.

[Anatomical and functional results of open cavity tympanomastoidectomy]. / Açik kavite timpanomastoidektominin anatomik ve fonksiyonel sonuçlari

OBJECTIVES: In this study, we aimed to evaluate the anatomical and functional results of open cavity tympanomastoidectomy due to chronic otitis media with cholesteatoma. PATIENTS AND METHODS: Between January 2003 and October 2009, 166 patients who underwent open cavity tympanomastoidectomy due to chronic otitis media with cholesteatoma in our clinic were retrospectively analyzed. Seventy-two ears of 69 patients (40 males, 29 females; mean age 36.7±17.7 years; range 9 to 64 years) who visited on a regular basis due to acquired middle ear cholesteatoma were included. Cholesteatoma was classified as attic, sinus and tensa retraction cholesteatoma, according to its localization. Audiological findings were compared based on the localization of cholesteatoma and intraoperative ossicular status. RESULTS: The mean follow-up was 36.3±27.0 months (range 6 to 88 months). There were six (8.4%) greft failures, four (5.6%) graft retractions, and one (1.4%) recurrent cholesteatomas in the ears of the patients. There were also five (7%) pearly residual cholesteatomas. At the last visit following surgery, 97.2% of cavities were dry and self-cleaning. The mean preoperative pure tone air threshold was 53.5±22 dB, while it reduced to 52.2±23.3 dB at the last visit in 48 ears operated open cavity tympanomastoidectomy type 1, 2, 3, and 4 in combination with hearing reconstruction (p=0.454). There was a statistically significant reduction in the mean air-bone gap of the attic cholesteatomas, decreasing from 27.2±14.6 dB to 21.6±12.2 dB (p=0.007). Air-bone gap values were lower than 20 dB in 23 (47.9%) of the cases and the gain was more than 10 dB in 17 (35.5%). No statistically significant correlation was found between the localization of cholesteatoma and intraoperative ossicular status (p>0.05). CONCLUSION: Open cavity tympanomastoidectomy, which allows total removal of the pathology, is an applicable surgical approach with satisfactory outcomes for hearing reconstruction.

[Evaluation of operation success in patients with nasal septal deviation with quality of life scale and objective methods]. / Nazal septum deviyasyonlu hastalarda ameliyat basarisinin yasam kalitesi ölçegi ve objektif yöntemler ile degerlendirilmesi.

OBJECTIVES: In this study we aimed to evaluate the quality of life during, before and after septoplasty in patients who were diagnosed with nasal septal deviation and also to demonstrate the role and importance of acoustic rhinometry and rhinomanometry methods in objectively demonstrating surgical success. PATIENTS AND METHODS: This study was carried out in 44 patients undergoing septoplasty surgery. Patients' preoperative complaints were evaluated by Nasal Obstruction Symptom Evaluation (NOSE) scale. The pre- and post-decongestion acoustic rhinometry and rhinomanometry data of the patients were recorded simultaneously. One month after Cottle's septoplasty performed as the septal surgery method, patients were re-evaluated by NOSE scale, acoustic rhinometry and rhinomanometry and the findings were compared with the preoperative data. RESULTS: Compared to the patients' preoperative values, a significant decrease in NOSE scores (p<0.05); a significant increase in the minimal cross-sectional area (MCA1, MCA2) and volume values measured by acoustic rhinometry (p<0.05) and a significant decrease in the nasal resistance values measured by rhinomanometry (p<0.05) were observed. No significant relationship was found between the change in patients' pre- and postoperative NOSE score values and the change in their acoustic rhinometry and rhinomanometry data (p>005). CONCLUSION: Nowadays, evidence-based medical practices are increasingly gaining importance and acoustic rhinometry and rhinomanometry are methods that can be used in objective evaluation of operation success.

[Incidental thyroid carcinoma found during surgery for laryngeal carcinoma: a case report]. / Larenks karsinomu nedeniyle boyun diseksiyonu yapilan olgularda rastlantisal tiroid karsinomu: Olgu sunumu.

At the histopathologic examination of neck dissection specimens of the patients who underwent surgical treatment with the diagnosis of laryngeal cancer, thyroid cancer metastases may also be detected in addition to laryngeal cancer metastases. Were retrospectively reviewed the files of 74 patients who were diagnosed with laryngeal cancer and underwent total or partial laryngectomy and neck dissection in our clinic between January 2008 and July 2010. Thyroid papillary carcinoma was found in neck dissection specimen of two patients who underwent partial laryngectomy and neck dissection. Total thyroidectomy was performed to complete the treatment. No recurrence or metastasis was found during the postoperative follow-up for an average of 9.5 months (range 5 to 14 months). Although it is a rare condition, the possibility of coexisting thyroid carcinoma in laryngeal cancer patients and the possible need for completion surgery when required should always be kept in mind.