MBL, P2X7, and SLC11A1 gene polymorphisms in patients with oropharyngeal tularemia.

CONCLUSION: A significant association was found of oropharyngeal tularemia with SLC11A1 allele polymorphism (INT4 G/C) and MBL2 C + 4T (P/Q). These results indicate C allele and Q allele might be a risk factor for the development of oropharyngeal tularemia. AIM: This study aimed to investigate the relationship of SLC11A1, MBL, and P2X7 gene polymorphism with oropharyngeal tularemia. METHODS: The study included totally 120 patients who were diagnosed with oropharyngeal tularemia. Frequencies of polymorphisms in the following genes were analyzed both in the patient and control groups in the study: SLC11A1 (5'(GT)n Allele 2/3, Int4 G/C, 3' UTR, D543N G/A), MBL (MBL2 C + 4T (P/Q), and P2X7 (-762 C/T and 1513 A/C). RESULTS: Among all polymorphisms that were investigated in this study, SLC11A1 gene showed a significance in the distriburtion of polymorphism allelle frequency at the INT4 region. Frequency of C allele was 54 (28%) in patients with oropharyngeal tularemia, and 31 (13%) in the control group (p = 0.006 and OR = 1.96 (1.21-3.20)). An association was detected between MBL2 C + 4T (P/Q) gene polymorphism and oropharyngeal tularemia (p < 0.005 and OR = 0.30 (0.19-0.48)). No significant relation was found between P2X7 (-762 C/T and 1513 A/C) gene polymorphism and oropharyngeal tularemia in this study (p > 0.05).

The effects of hypotensive anaesthesia on otoacoustic emissions: a prospective, randomized, double-blind study with objective outcome measures.

The aim of the present study was to compare pre- and post-operative otoacoustic emission examinations of patients who experienced surgery under hypotensive anaesthesia using distortion product otoacoustic emission (DPOAE) and transient evoked otoacoustic emission (TEOAE). Forty-one patients, admitted to our tertiary centre for nasal valve surgery, were prospectively and randomly assigned into two groups. Hypotensive group included 20 patients, while control group included 21 patients. All investigators and patients were blinded to anaesthesia assignment throughout the course of the study. DPOAEs and TEOAEs were performed before surgery and repeated after 15 days in both groups. In control group, DPOAE-DP1 levels per frequency increased significantly in the post-operative period when compared with the pre-operative values in all patients. However, DPOAE-DP1 levels decreased significantly in hypotensive group. Similarly, DPOAE-SNR levels per frequency decreased significantly in hypotensive group. In conclusion, we have observed that under the influence of hypotensive general anaesthesia, the amplitudes of OAEs are affected.

Impact of adenotonsillectomy on ADHD and nocturnal enuresis in children with chronic adenotonsillar hypertrophy.

OBJECTIVE: Children with chronic adenotonsillar hypertrophy (CAH) are more likely to have symptoms of attention deficit hyperactivity disorder (ADHD) and enuresis nocturna (EN) and benefit from surgery. The aim of this study was to evaluate the effect of adenotonsillectomy on ADHD and EN symptoms in children with CAH. STUDY DESIGN: Cross-sectional study was conducted. SETTING: Parent-based questionnaires. METHODS: Parents of children with CAH were given Turgay DSM-IV Based Child and Adolescent Behavior Disorders Screening and Rating Scale (T-DSM-IV) and Nocturnal Enuresis Questionnaire (NEQ) before and six months after adenotonsillectomy. Inattention (IA) and hyperactivity-impulsivity (HI) subscores of T-DSM-IV were used in the present study. The rates of ADHD and EN were compared before and after surgery. RESULTS: A total of 75 children between 5 and 16 years of age and their families participated in the study. All 75 families completed T-DSM-IV and NEQ. Mean IA (5.69 ± 4.88 versus 4.46 ± 4.40) and HI (6.53 ± 5.60 versus 5.93 ± 5.45) scores as well as total ADHD scores (12.22 ± 8.99 versus 10.42 ± 8.70) improved significantly after surgery. This significance was found to be statistically important (p<0.05). Furthermore 26 of the subjects were diagnosed with primer EN before adenotonsillectomy and 14 of these enuretic children had total remission six months after surgery. The frequency of EN dropped from 34.7% to 16.0% and this remission rate was found to be statistically significant (p<0.05). CONCLUSION: Children with CAH had high frequency of ADHD and EN symptoms in the present study. Adenotonsillectomy was found to be effective in improvement of these symptoms.

Evaluation of mean platelet volume and its ratio over platelet count in children with obstructive sleep apnea syndrome.

OBJECTIVES: This study aims to determine the association between obstructive sleep apnea syndrome (OSAS) caused by adenotonsillar hypertrophy and mean platelet volume (MPV) and MPV/platelet count ratio in children, and to evaluate the impact of adenotonsillectomy on these two parameters. PATIENTS AND METHODS: This prospective study consisted of 73 child patients (38 boys, 35 girls; mean age 8.6±3.3 years, range 2 to 17 years) with chronic adenotonsillar hypertrophy who applied to Gaziosmanpasa University Faculty of Medicine, Ear, Nose and Throat policlinics due to witnessed apnea and snoring in January 2011 and January 2013. Also, 56 age and sex matched pediatric patients (28 boys, 26 girls; mean age 8.0±3.2 years; range 3 to 13 years) who admitted to our clinic due to reasons besides OSAS were included in the study as control group. Preoperative and postoperative third month hemoglobin, white blood cell, thrombocyte count, and MPV values of the patients were recorded. RESULTS: Although ratio of MPV/platelet count was higher in patient group than in control group, the difference was not statistically significant. Mean platelet volume level was 7.68±1.07 fL in patient group and 7.21±0.84 fL in control group. Preoperative MPV level in patient group was significantly higher than that in control group (p<0.05). A statistically significant decrease was detected in postoperative third month MPV level and platelet count compared with preoperative MPV and platelet count (7.68±1.07 fL and 7.17±0.97 fL, respectively; p<0.05). CONCLUSION: High MPV and MPV/platelet count in children with adenotonsillar hypertrophy may be an important risk factor for cardiopulmonary and cerebrovascular morbidities which may develop both in childhood and in adulthood. Adenotonsillectomy may reduce this risk significantly.

Mean platelet volume as an inflammatory marker of chronic otitis media with effusion.

OBJECTIVES: Our aim was to investigate whether mean platelet volume (MPV) may be utilized as an inflammatory marker of chronic otitis media with effusion (COME). METHODS: Routine hemogram tests were performed preoperatively for 51 patients diagnosed with COME that were to receive ventilation tube insertion. Hemogram tests were performed on age-matched and sex-matched healthy controls (n=54). Moreover, by performing a chart review, white blood cell count (WBC), red blood cell count (RBC), hemoglobin (Hb), hematocrit (Hct), platelet (PLT), and mean platelet volume (MPV) values were compared between COME patients and controls. RESULTS: A total of 51 COME patients were included in the study and 45.1% were male. The control group had 54 individuals and 51.9% were male. MPV (p=0.493) and platelet levels (p=0.336) for COME patients group were generally borderline higher than those measured for the control group, but this difference was not statistically significant. CONCLUSION: No statistically significant differences were identified between pediatric patients diagnosed with COME and healthy controls in terms of WBC, RBC, Hb, Hct, PLT and MPV levels.

Voice disorder in patients with Fibromyalgia.

OBJECTIVE: To investigate several perceptual, acoustic and aerodynamic voice evaluation parameters in Fibromyalgia patients. METHODS: A total number of 30 Fibromyalgia patients had voice evaluations by means of laryngostroboscopy, acoustic analysis (jitter, shimmer, and harmonic to noise ratio), aerodynamic measurements (maximum phonation time, s/z ratio), and perceptual analysis (GRBAS and Voice Handicap Index-10 scales). Data obtained from the patients was compared to control subjects. RESULTS: Mean intensity was found to be significantly higher in control subjects (73.70±4.73dB) than Fibromyalgia patients (64.50±6.92dB), (p<0.001). There was no statistically significant difference in fundamental frequency, perturbation parameters (jitter and shimmer) and harmonic to noise ratio between groups. Maximum phonation time in control subjects (22.53±4.95s) was found to be significantly longer than Fibromyalgia patients (16.07±4.87s), (p<0.001), and s/z ratio was found to be nearly equal between patients (1.00±0.24) and control subjects (0.96±0.16). On the basis of perceptual evaluation by using a GRBAS scale, the patients showed a mean score of 2.50±1.97 and the control group showed a mean score of 0.56±1.04 (p<0.001). "Grade" and "asthenia" parameters of GRBAS scale in Fibromyalgia patients were significantly different from the parameters of control group (p<0.001). The Voice Handicap Index-10 scales revealed a mean score of 7.90±7.58 in Fibromyalgia patients and 1.83±2.82 in control subjects (p<0.001). CONCLUSION: Fibromyalgia impairs perceived voice quality either in patient self evaluated or in clinician evaluated rating scales. Furthermore, the results confirm that Fibromyalgia caused short maximum phonation time and low voice intensity. This study is the first report with regards to voice evaluation in Fibromyalgia and in order to make a generalization further researches are needed.

Tortuosity of the internal carotid artery detected during tonsillectomy: two case reports.

Tonsillectomy is one of the most common performed surgical procedures in childhood. Tortuosity of the internal carotid artery (ICA) is an anatomical variation of the course of the ICA, and can be seen at any levels along the course of the artery, even in lateral oropharyngeal wall. In this article, we present two cases in which ICA tortuosity detected as a pulsating mass in the lateral oropharyngeal wall in an eight-year and a five-year-old girls, during tonsillectomy.

Comparison of transient and distortion-product otoacoustic emissions during the luteal and follicular phases of the menstrual cycle.

We conducted a study to examine cochlear activity in women with a naturally occurring menstrual cycle by measuring transient otoacoustic emissions (TOAEs) and distortion-product otoacoustic emissions (DPOAEs). Our study population was made up of 11 women aged 20 to 40 years (mean: 35.6) who were not taking a contraceptive medication or hormone therapy. Measurements of TOAEs and DPOAEs were made during both the follicular phase and the luteal phase of the menstrual cycle. We found no statistically significant difference in any of the TOAE amplitude values between the two phases. Although a sharp decrease at the 0.75 kHz frequency was seen in DPOAEs during both phases, none of the amplitude values in the tested frequencies were significantly different between the two phases. The absence of TOAE and DPOAE amplitude changes suggests that it is unnecessary to take into account the phase of the menstrual cycle when interpreting the results of otoacoustic emissions testing.

Behcet's disease impairs voice quality without laryngeal and hypopharyngeal involvement.

The objective of the study was to investigate voice evaluation parameters in Behcet's disease patients. A prospective controlled study was performed in a tertiary referral center. A total of 31 patients (21 female, 10 male) with a diagnosis of Behcet's disease had voice evaluations by means of laryngostroboscopy, acoustic analysis, aerodynamic measurements and perceptual assessment. Data obtained from the patients were compared to 31 healthy control subjects. Laryngeal endoscopy was within normal limits in all patients. The mean fundamental frequency in male control subjects (134 ± 14 Hz) was significantly higher than in male patients (124 ± 20 Hz), (p = 0.043). Mean intensity was significantly higher in control subjects (74 ± 5 dB) than in the patients (63 ± 4.6 dB), (p < 0.001). Shimmer in patients (3.4 ± 2.5) was significantly higher than in control subjects (2 ± 1.3), (p = 0.01). Maximum phonation time in control subjects (25 ± 5.8 s) was significantly longer than in patients (20 ± 7.9 s), (p = 0.007), and s/z ratio was found to be nearly equal between patients (0.9 ± 0.2) and control subjects (0.96 ± 0.1), (p > 0.05). The patients showed a mean GRBAS score of 1.8 ± 1.9 and the control group showed a mean score of 0.48 ± 1.06, (p = 0.002). The VHI-10 scale revealed a mean score of 2.2 ± 4.8 in BD patients and 2 ± 2 in control subjects (p > 0.05). Behcet's disease impaired voice quality without laryngostroboscopically visible laryngeal and hypopharyngeal involvement. This impairment was documented by objective voice evaluation methods including acoustic analysis and aerodynamic voice measurements and by subjective voice evaluation method including perceptual assessment.

Manganese-superoxide dismutase and glutathione peroxidase 1 polymorphisms in recurrent tonsillitis and tonsillar hypertrophy.

OBJECTIVES: To investigate the association of manganese-superoxide dismutase and glutathione peroxidase 1 polymorphisms with susceptibility to recurrent tonsillitis and tonsillar hypertrophy. METHODS: The study consisted of 103 patients with recurrent tonsillitis, 105 patients with tonsillar hypertrophy and 106 control subjects with similar age and sex. Genomic DNA was extracted from peripheral leukocytes of whole blood which were obtained from all patients and control subjects. Genotyping was performed to identify MnSOD Ala-9Val and GPx1 Pro198Leu polymorphisms by a method based on PCR amplification and detection of polymorphisms with hybridization probes labeled with fluorescent dyes. Genotype and allele frequencies were compared between patients with recurrent tonsillitis and tonsillar hypertrophy and 106 healthy control subjects. RESULTS: The genotype distribution of the MnSOD Ala-9Val single nucleotide polymorphism was significantly different for the controls and the recurrent tonsillitis patients (P=0.009). Whereas, no significant difference was found between the patients with tonsillar hypertrophy and the control group (P=0.369). The frequency of the MnSOD CC genotype was lower, and that of the T allele was significantly higher, in recurrent tonsillitis patients than in control subjects. In addition, the frequency of tonsillitis was significantly higher in recurrent tonsillitis patients with the MnSOD Ala-9Val polymorphism than the patients with wild-type (P=0.008). Also, no significant difference was found between patient groups and control subjects in the distribution of the genotype and allele frequency of the GPx1 Pro198Leu single nucleotide polymorphism. CONCLUSIONS: The MnSOD Ala-9Val polymorphism causes susceptibility to recurrent tonsillitis in Turkish children. And we suggest that there may be a possible relation between local and recurrent infections or inflammation of the tonsillar tissue and the MnSOD Ala-9Val single nucleotide polymorphism in pediatric patients with RT.

Histopathologic examination of routine tonsil and adenoid specimens: is it a necessary approach?

OBJECTIVES: This study aims to investigate whether it is necessary to perform histopathologic examination of the specimens of tonsillectomy and/or adenoidectomy. PATIENTS AND METHODS: In this retrospective and multicenter study, 1021 pediatric and adult patients (557 males, 464 females; median age 8 years; range 5 to 13 years) who underwent adenoidectomy and/or tonsillectomy were included. Of the patients, 809 (79.3%) were pediatrics, while 212 (20.7%) were adult. Age, gender, histopathologic diagnosis and risk for malignancy in the patients with malignant diagnosis were reviewed using present patient records. RESULTS: Adenotonsillectomy was performed on 396 patients (38.8%), tonsillectomy on 266 patients (26%) and adenoidectomy on 359 patients (35.2%). Of the 1021 patients, 1011 (99%) received a benign histopathologic diagnosis, while 11 (1%) receieved malignant diagnosis. Malignant diagnosis was present only in adult patients. All patients diagnosed with a malignancy had one or more preoperative risk factors. No unexpected malignant diagnosis was found in any of the patients without preoperative risk factors. CONCLUSION: We concluded that histopathologic diagnosis may not be required for the patients without preoperative risk factors, particularly pediatric patients.

Effect of pentoxifylline and 5-fluorouracil/triamcinolone on laryngotracheal stenosis developing as a complication of tracheostomy: study in rats.

We aimed to investigate the prophylactic effect of pentoxifylline (PTX) and 5-fluorouracil (5-FU) on laryngotracheal stenosis in tracheotomised rats by evaluating blood glutathione peroxidase (GPx) and superoxide dismutase activities and by histopathological evaluation of laryngotracheal segment. Randomized prospective single-blind study. Standard vertical tracheotomy was performed on 24 rats. Then, the animals were randomly divided into three groups. Intraperitoneal PTX administered to group A (study group) for 10 days. 5-FU was injected in paratracheal tissues in group B (study group) for 10 days. In group C (control group), intraperitoneal saline was administered for 10 days. After 10 days, tracheal cannules were removed. For biochemical analysis, two blood samples were obtained. Three weeks later, all animals were euthanized and trachea specimens were harvested. Stenosis index and mean wall thickness in PTX group were lower as compared to other groups but the difference was statistically insignificant. Minimum inflammation and fibrosis plus maximum epithelial regeneration were seen in PTX group. In addition, GPx activity was at highest level in PTX group and a statistically significant difference was found between control and PTX groups (P = 0.024) though the difference between remaining groups was statistically insignificant (P = 0.121). Superoxide dismutase activity was highest in PTX group but no statistically significant difference was found between the three groups (P = 0.305). The administration of PTX increases GPx activity and it may have some effect on tracheal scar formation which develops following tracheostomy.

Clinical and laboratory findings of tularemia: a retrospective analysis.

OBJECTIVES: This study aims to define demographic characteristics and clinical and laboratory findings of the patients with tularemia and to assess the treatment outcomes. PATIENTS AND METHODS: A total of 58 consecutive patients (26 males, 32 females; mean age 37±22 years; range 6 to 80 years) with tularemia were retrospectively analyzed in this study. Demographic characteristics, laboratory findings, physical examination findings and treatment outcomes were recorded. RESULTS: Forty patients (86.2%) had glandular tularemia; seven (12.1%) had oropharyngeal tularemia, and one (1.7%) patient had oculoglandular tularemia. The most common symptoms were swollen neck lymph nodes high fever and sore throat. Fifty seven patients (98.2%) had swollen neck lymph nodes; 39 (67.2%) patients had high fever (67.2%) and 36 (62.1%) patients had sore throat. Complete recovery was obtained in 45 patients (77.6%), while 13 (22.4%) were unresponsive to the treatment. The most frequent laboratory findings were high level of C-reactive protein (CRP) and increased erythrocyte sedimentation rate (ESR). Mean leukocyte counts, aspartate aminotransferase (AST), alanine aminotransferase (ALT), urea and creatinine levels were within normal range in all patients. CONCLUSION: Tularemia should be differentiated from upper respiratory tract infections and cervical lymphadenopathy. The most commonly used hematological and biochemical assays do not provide significant benefits for the diagnosis of tularemia. However, increased level of ESR and CRP at one month may support the diagnosis. Early diagnosis and appropriate treatment may prevent therapeutic failure.

A comparison of the efficacy of 5-fluorouracil/triamcinolone, carnitine and dexamethasone therapy on wound healing in tracheal injury: potential for preventing tracheal stenosis?

The aim of the study was to investigate the efficacy of 5-flourouracil/triamcinolone acetonide (5-FU/TA), carnitine and dexamethasone on wound healing in an animal model of tracheal injury. Twenty-eight rats underwent surgical injury of the tracheal mucosa and perichondrium under general anesthesia, and were randomized into four groups. Group I (the control group) received nothing after tracheal trauma. Group II received intratracheal 5 mg 5-FU/TA combined with 0.2 ml sodium hyaluronic acid once. Group III received intraperitoneal carnitine 100 mg/kg/day for 20 days. Group IV received intramuscular dexamethasone 0.1 mg/day for 20 days. After 1 month, the levels of superoxide dismutase enzyme activity (SOD) and levels of malondialdehide (MDA) and nitric oxide (NO) in serum were measured and the tracheal specimens were harvested for histopathologic examination. SOD was significantly lower in the carnitine group compared to the control group. A statistically significant decrease in MDA levels were observed in the 5-FU/TA and carnitine groups compared to the control group. NO levels were significantly lower in the 5-FU/TA group, but significantly higher in the dexamethasone group, compared to the control group. The fibrotic tissue volumes of tracheal specimens were significantly lower in both the 5-FU/TA and carnitine groups than those of the control group, but trended toward higher volumes in the dexamethasone group when compared to controls. We concluded that 5-FU/TA and carnitine diminish the occurrence of tracheal stenosis (TS) secondary to experimentally induced tracheal trauma.

Jab1 expression is associated with TGF-ß1 signaling in chronic rhinosinusitis and nasal polyposis.

Jab1, which is a fifth component of COP9 signalosome, plays an essential role in cell growth and proliferation. Jab1 is also shown to regulate transforming growth factor-beta (TGF-ß) signaling in carcinoma cells. The aim of the present study was to investigate the expression and the correlation of Jab1 and TGF-ß1 in chronic rhinosinusitis and nasal polyposis. Here, we show the elevated expression of Jab1 and TGF-ß1 in diseased mucosa without nasal polyps and a correlation between Jab1 and TGF-ß1 expression. Forty-six samples (26 patients with nasal polyps, 10 patients with chronic rhinosinusitis and 10 control subjects) were included to this study. Immunohistochemistry and Western blotting were performed for the assessment of Jab1 and TGF-ß1 localization and the expression of proteins. Double staining of both proteins showed that Jab1 and TGF-ß1 were colocalized in the epithelium, inflammatory cells and the vascular endothelium of nasal mucosa. There was a significant increase in the expression of TGF-ß1 and Jab1 in patients without nasal polyps and a significant decrease in patients with nasal polyps compared to controls. Moreover, correlation was detected between the expression of Jab1 and TGF-ß1 in chronic rhinosinusitis and nasal polyposis. Our results demonstrate that chronic rhinosinusitis is characterized by elevated expression of Jab1 and TGF-ß1 compared to nasal polyposis and Jab1 may play a vital role in the pathogenesis of both chronic rhinosinusitis and nasal polyposis.

The effectiveness of steroids for edema, ecchymosis, and intraoperative bleeding in rhinoplasty.

BACKGROUND: The aim of this study was to investigate the dose-related effectiveness of steroids on periorbital edema, ecchymosis, and intraoperative bleeding in patients who underwent open rhinoplasty with osteotomy. METHODS: Forty patients were divided into three groups: those in group 1 (n = 15) were given a single dose of 1-mg/kg intravenous (i.v.) methylprednisolone, those in group 2 (n = 15) were given a single dose of 3-mg/kg i.v. methylprednisolone preoperatively, and group 3 (n = 10) was the control group. Eyelid edema and periorbital soft-tissue ecchymosis were evaluated separately using a scale of 0-4. RESULTS: In groups using the steroid preoperatively, periorbital edema and ecchymosis were significantly lower compared with the control group (p < 0.05). No significant differences were seen clinically or statistically in preventing or reducing either the periorbital ecchymosis or the periorbital edema between groups 1 and 2. Also, there was no significant difference among the groups in terms of bleeding (p > 0.05). No complications with regard to the operation or steroid use were observed. CONCLUSION: Our results support that steroids significantly decrease periorbital ecchymosis and periorbital edema in open rhinoplasty with osteotomy. Additionally, our results suggest that if the dose of steroids is adjusted according to body weight, there is no significant benefit in a single dose of 3 mg/kg of methylprednisolone over a lower dose of 1 mg/kg and there is no need for higher doses of methylprednisolone administration.

Does mitomycin-C increase collagen turnover as a modulator of wound healing in tracheostomyzed rats?

OBJECTIVES: This study aims to investigate the effect of mitomycin-C in the wound healing process on collagen synthesis in tracheostomyzed rats. MATERIALS AND METHODS: Fourteen healthy, in both sexes, mean weight of 270 g (range 250-300 g), Wistar-Albino type rats underwent tracheotomy and tracheal mucosa was damaged with micro-scissors on both sides of tracheostomyzed area. The rats were divided into two groups: The experimental group (group 1) received immediate topical application of mitomycin-C 0.2 mg/ml; the control group (group 2) received saline solution. The rats were sacrificed after a period of one month. Subsequently, the tracheostomyzed region was excised and vertically divided into the two parts. The level of hydroxyproline in the dry tissue was measured in one part of the tissue. Fibroblast count was performed in the other part of the tracheostomyzed region using the stereological method. RESULTS: The hydroxyproline level was much higher in the mitomycin-C group when compared to the control group (p<0.05). In contrary, the number of fibroblasts was lower in the mitomycin-C group than control group (p<0.05). CONCLUSION: When used in wound healing, mitomycin-C may increase collagen synthesis or quicken the wound healing process after one month.

Congenital laryngoptosis: an unusual case.

Laryngoptosis is a rare anomaly of the larynx. The larynx is localized in a position lower than its normal position. A 15-year-old boy presented with hoarseness of voice. Physical examination showed that the larynx was in an abnormal position. There were no palpated tracheal rings. A low-pitched monotonic voice was the only symptom of laryngoptosis. Magnetic resonance imaging showed that the larynx was almost localized on the manibrium sterni, and the diagnosis was laryngoptosis.

Distribution of matrix metalloproteinases MMP-1, MMP-2, MMP-8 and tissue inhibitor of matrix metalloproteinases-2 in nasal polyposis and chronic rhinosinusitis.

Nasal polyposis (NP), a chronic inflammatory disease of the upper airway, is a subgroup of chronic rhinosinusitis (CRS). Matrix metallo-proteinases (MMPs) and their tissue inhibitors (TIMPs) are considered to play important roles in the pathogenesis of nasal polyposis. The aim of the current study was to evaluate and compare the levels of MMP-1, MMP-2, MMP-8 and TIMP-2 in NP and CRS with normal nasal mucosa by using immunohistochemistry. Twenty-five patients with NP and fifteen patients with CRS underwent endoscopic sinus surgery. Diseased mucosal samples were obtained from ethmoidal sinuses. Control nasal mucosa (n=10) was obtained from inferior nasal turbinate. Immunohistochemistry for MMP-1, MMP-2, MMP-8 and TIMP-2 was performed. The expression of MMP-1, MMP-2 and MMP-8 significantly increased in NP and CRS compared with control (p<0.05). The distribution of TIMP-2 was higher in CRS than control and NP respectively (p<0.05). MMP-1 immunoreactivity was distributed in the extracellular matrix whereas MMP-2, MMP-8 and TIMP-2 immunostaining was present in the epithelium, submucosal glands, vascular endothelium and inflammatory cells in CRS and NP. We suggest that differences in histological features between CRS and NP might be related to the expression of MMP-1, MMP-2, MMP-8 and their tissue inhibitor-2.

The comparison of bacteremia and amount of bleeding during adenotonsillectomy.

OBJECTIVE: Adenoidectomies and/or tonsillectomies are among the most frequently performed otolaryngological surgical procedures.The goals of this study were to investigate the relationship between the amount of bleeding and bacteremia during adenoidectomy and/or tonsillectomy procedures. METHODS: Seventy-eight patients who underwent tonsillectomy with or without adenoidectomy and adenoidectomy with or without tube insertion were included in the study. Patients with severe chronic underlying diseases (including cardiovascular disorders, renal or hepatic disease, or immunodeficiency) were excluded from study, as were those who had suffered an acute episode of respiratory infection or had received antibiotics for any reason within three weeks prior to the operation. The amount of bleeding was measured and recorded for each patient during the surgery. Preoperative blood cultures immediately after the induction of anesthesia and postoperative blood cultures 20 min after the operation were collected. RESULTS: While none of the blood cultures taken preoperatively was positive for any organisms, the cultures obtained postoperatively were positive in 16 (20.5%) of 78 patients who underwent tonsillectomy with or without adenoidectomy and adenoidectomy with or without tube insertion, and bacteremia was more frequent among those with greater amount of bleeding during the surgery. CONCLUSION: The results of this study suggest that although bacteremia had no clinical consequences in patients, it should be kept in mind that patients with greater amount of bleeding are at higher risk for developing bacteremia and it may produce vital results in patients at risk.