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This study explores the role of irisin and interleukins in parotid tumors by determining the tissue staining intensity of irisin, the salivary and plasma levels of irisin, and the plasma levels of IL-4, IL-6, IL-10 and TNF-alpha in individuals with parotid tumors. Forty-eight patients and forty healthy individuals were included to the study and allocated into four group. Benign Group I (pleomorphic adenoma), Group II (Warthin's tumor), Group III (mucoepidermoid carcinoma) and Group IV (benign parotid control group, healthy control group). Parotid tissue, plasma and saliva samples were collected from each of the patients with parotid tumors, while plasma and saliva samples were collected from the healthy individuals. Normal parotid tissue for histologic evaluation was obtained from unaffected areas in patients with parotid tumors. The levels of irisin in the plasma and saliva were significantly lower in the parotid tumors, while the plasma levels of IL-6 and TNF-alpha were higher in patients with parotid tumors, but no statistically significant difference in IL-4 and IL-10 levels was found. The histopathological intensity of FNDC-5/irisin staining was significantly decreased in the parotid tumor tissues when compared to the benign parotid control group with normal parotid tissue. The low histopathological tissue staining intensity and plasma and salivary levels of irisin suggest that irisin may be a protective protein in parotid tumors.

Predictive prognostic scoring (PS) systems are not primarily applicable to elderly patients with classical Hodgkin lymphoma (cHL). The objective of this study was to develop a PS system for these patients. The derivation cohort (DC) was utilized for model development, consisting of 97 variables. The resulting algorithm was named as Hodgkin's Lymphoma Early Death in the Elderly within 12 months (HEDEL12). Internal and external validation cohorts (IVC and EVC) were employed for validation. A total of 286 patients were evaluated retrospectively. In DC 38 of 178 patients died within the first 12 months and overall survival (OS) at 12-month was 78.6%. Independent predictors of HEDEL12 were female sex, low albumin levels (<3.5 g/dL), and ECOG scores 2-4. According to HEDEL12 scores 0-1, OS at 12- months were 89.8% and 91.0% for IVC and EVC, respectively. The HEDEL12 scoring is useful in predicting the survival of advanced-stage cHL patients.

Objectives: Butterfly inlay myringoplasty is a simple and practical surgical technique used in the repair of tympanic membrane perforation offering good outcomes in terms of hearing. The present study evaluates the effects of myringosclerosis on the success of surgery by reviewing demographic data, perforation size and hearing outcomes of patients undergoing endoscopic inlay butterfly myringoplasty due to chronic otitis media., Methods: The study included 75 patients who underwent endoscopic inlay butterfly myringoplasty with the diagnosis of chronic suppurative otitis media in the Department of Otorhinolaryngology at Fırat University Faculty of Medicine between March 2018 and July 2021. The patients were divided into three groups as the following. Group I: Patients without a myringosclerotic focus in the neighborhood of tympanic membrane perforation, Group II: Patients with a less than 50% myringosclerotic focus in the neighborhood of tympanic membrane, and Group III: Patients with a more than 50% myringosclerotic focus in the neighborhood of tympanic membrane., Results: The comparison of all preoperative and postoperative parameters and the reduction in air-bone gap between the groups did not show statistically significant difference (p>0.05). The comparison of air-bone gaps between preoperative and postoperative measurements showed a statistically significant difference in all groups (p<0.05). The grafting success rate was 100% in Group I, 96.4% in Group II, and 95.6% in Group III. The mean operation time was 28.57±2.54 min in Group I, 32.14±2.44 min in Group II, and 30.69±3.43 in Group III; there was a statistically significant difference only between Group I and Group II (p = 0.001)., Conclusions: The graft success rate and hearing gain in patients with myringosclerosis were similar to those in patients without myringosclerosis. Therefore, butterfly inlay myringoplasty is applicable to patients with chronic otitis media regardless of the presence or absence of myringosclerosis., Competing Interests: Conflict of Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Background: In this study, we aimed to compare the success rates of computed tomography image-based artificial intelligence models and magnetic resonance imaging in the diagnosis of preoperative cholesteatoma., Methods: The files of 75 patients who underwent tympanomastoid surgery with the diagnosis of chronic otitis media between January 2010 and January 2021 in our clinic were reviewed retrospectively. The patients were classified into the chronic otitis group without cholesteatoma (n=34) and the chronic otitis group with cholesteatoma (n=41) according to the presence of cholesteatoma at surgery. A dataset was created from the preoperative computed tomography images of the patients. In this dataset, the success rates of artificial intelligence in the diagnosis of cholesteatoma were determined by using the most frequently used artificial intelligence models in the literature. In addition, preoperative MRI were evaluated and the success rates were compared., Results: Among the artificial intelligence architectures used in the paper, the lowest result was obtained in MobileNetV2 with an accuracy of 83.30%, while the highest result was obtained in DenseNet201 with an accuracy of 90.99%. In our paper, the specificity of preoperative magnetic resonance imaging in the diagnosis of cholesteatoma was 88.23% and the sensitivity was 87.80%., Conclusion: In this study, we showed that artificial intelligence can be used with similar reliability to magnetic resonance imaging in the diagnosis of cholesteatoma. This is the first study that, to our knowledge, compares magnetic resonance imaging with artificial intelligence models for the purpose of identifying preoperative cholesteatomas.

Immune thrombocytopenia (ITP) is a rare autoimmune disorder presenting with isolated thrombocytopenia. Splenectomy is still one of the treatment alternatives for these patients. Here we aim to analyze long term follow-up data of splenectomy in immune thrombocytopenia. This retrospectively designed study was conducted in a tertiary health clinic. Patients with ITP who were splenectomized between 1990 and 2015 were included. Response to treatment was interpreted as 'complete response', 'response' or 'no response'. The incidence of response loss was evaluated. Perioperative and long term complications and overall survival rates were determined. Out of 51 patients, who underwent splenectomy after 12 months of diagnosis, 47 achieved a response (92.2%). Of 47 patients who had a platelet count at least 30.000/µL, 41 (87.2%) had CR. Incidence of loss of response was 10.5% (95% confidence interval (CI): 4%-26.1%) at 30 months. Two patients died, and overall survival rate was 97.4% (95% CI: 82.8%-99.6%) at 30 months of follow up. Considering the complications: two patients had venous thromboembolism, 11 had minor bleeding episodes and 15 suffered from perioperative infections. Our study suggests that splenectomy promises a high level of response with acceptable complication rates. Although less preferred recently, splenectomy should still be taken into consideration when remission is not achieved especially after 12 months of disease., Competing Interests: Conflict of interestThere are no potential relationships/conditions/circumstances that present a potential conflict of interest., (© Indian Society of Hematology and Blood Transfusion 2021.)

Objective: Because of the anatomically close relationship between the cochlea and the vestibular organs, cochlear function disorders may be accompanied by vestibular disorders. This study aimed to evaluate vestibular functions in patients with idiopathic sudden sensorineural hearing loss using VEMP, caloric test, and VNG test battery and its relation to prognosis., Materials and Methods: For this study, 42 patients aged 18-55 years with idiopathic sudden sensorineural hearing loss and 30 volunteers who had no hearing and balance problems were included. Audiometry, cVEMP, oVEMP, caloric tests, and VNG tests were performed. Moreover, the effects of age, sex, time of admission, degree and configuration of hearing loss, accompanying vertigo, tinnitus, and ear fullness on improvement in hearing were evaluated., Results: Of the 42 patients in the study group, 26 (56.52%) were male, 20 (43.48%) were female, and the mean age was 41.54 ± 12.23 years. Of the 30 individuals in the control group, 19 (63.3%) were male, 11 (36.7%) were female, and the mean age was 39.53 ± 13.03 years. There was no significant difference in the incidence of sudden sensorineural hearing loss in terms of sex and age, and the prognosis was better for female patients. Early admission to treatment was a factor of good prognosis; profound hearing loss, bilateral hearing loss and vertigo were factors of poor prognosis. Prognosis was better in patients with rising type audiogram configuration, while the prognosis was worse in patients with flat, descending and total hearing loss. Tinnitus and ear fullness had no effect on the prognosis. No anomalies were observed in VNG findings. Moreover, abnormal caloric response was higher in patients with profound hearing loss and total hearing configuration. Shortening was observed in cVEMP / oVEMP P1 and N1 latency after treatment. Furthermore, there was an improvement in abnormal responses after treatment., Conclusion: In this study, vestibular function was affected in patients with idiopathic sudden sensorineural hearing loss. The present study can help the development of a clinical strategy in the evaluation of the vestibular system in idiopathic SSNHL, patient follow-up, patient information, and the implementation of vestibular rehabilitation. Note that additional studies involving larger patients series are required., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2021. Published by Elsevier B.V.)

Objective: To determine prestin levels in patients with sensorineural hearing loss and to assess whether the prestin level could be a determining factor in predicting sensorineural hearing loss., Material and Methods: The study was carried out with patients that presented to the Department of Otorhinolaryngology of Fırat University. Patients were divided into four groups of 30 subjects. Group 1: individuals aged ≥55 years with no hearing loss (control group); Group 2: individuals aged 20 to 55 years with no hearing loss (control group); Group 3: individuals aged 20 to 55 years with sensorineural hearing loss; Group 4: individuals aged ≥55 years with presbycusis. Following an audiometry examination, 5 cc blood was taken from all patients to assess serum prestin levels., Results: Prestin levels were 445.32 pg/mL in Group 1; 452.79 pg/mL in Group 2; 123.64 pg/mL in Group 3; and 79.54 pg/mL in Group 4. No difference was found between the serum prestin levels of the younger patients with hearing loss (Group 3)] and of the patients with presbycusis (Group 4) (p=0.084). No difference was found between the serum prestin levels of the younger (Group 1) and the older (Group 2) patients with presbycusis (p=0.399). Significant differences (with higher levels in the control groups) were found in between the prestin levels of between Group 3 (the younger patients with sensorineural hearing loss) and Group 2 (younger controls), and between Group 4 (older patients with presbycusis) and Group 1 (older controls) (p<0.001 and p <0.001, respectively)., Conclusion: Serum prestin levels can be used as biomarkers for assessing patients with presbycusis and sensorineural hearing loss. They can also be used together with audiometry tests to predict the patient's potential level of hearing loss., Competing Interests: Declaration of competing Interest The authors declare that they have no conflicts of interest., (Copyright © 2021. Published by Elsevier B.V.)

Objective: Cholesteatoma is an aggressive form of chronic otitis media (COM). For this reason, it is important to distinguish between COM with and without cholesteatoma. In this study, the role of artificial intelligence modelling in differentiating COM with and without cholesteatoma on computed tomography images was evaluated., Methods: The files of 200 patients who underwent mastoidectomy and/or tympanoplasty for COM in our clinic between January 2016 and January 2021 were retrospectively reviewed. According to the presence of cholesteatoma, the patients were divided into two groups as chronic otitis with cholesteatoma (n = 100) and chronic otitis without cholesteatoma (n = 100). The control group (n = 100) consisted of patients who did not have any previous ear disease and did not have any active complaints about the ear. Temporal bone computed tomography (CT) images of all patients were analyzed. The distinction between cholesteatoma and COM was evaluated by using 80% of the CT images obtained for the training of artificial intelligence modelling and the remaining 20% for testing purposes., Results: The accuracy rate obtained in the hybrid model we used in our study was 95.4%. The proposed model correctly predicted 2952 out of 3093 CT images, while it predicted 141 incorrectly. It correctly predicted 936 (93.78%) of 998 images in the COM group with cholesteatoma, 835 (92.77%) of 900 images in the COM group without cholesteatoma, and 1181 (98.82%) of 1195 images in the normal group., Conclusion: In our study, it has been shown that the differentiation of COM with and without cholesteatoma with artificial intelligence modelling can be made with highly accurate diagnosis rates by using CT images. With the deep learning modelling we proposed, the highest correct diagnosis rate in the literature was obtained. According to the results of our study, we think that with the use of artificial intelligence in practice, the diagnosis of cholesteatoma can be made earlier, it will help in the selection of the most appropriate treatment approach, and the complications can be reduced., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Purpose: To investigate whether there is a relationship between the VEGF polymorphisms and idiopathic heavy menstrual bleeding (HMB-E)Query., Methods: Sixty-five patients diagnosed with HMB-E according to the FIGO classification system and 65 female healthy volunteers were included in the study. The polymorphic regions rs699947 (- 2578C > A), rs1570360 (- 1154G > A), rs2010963 (+ 405G > C), rs3025039 (+ 936C > T), rs25648 (c534C > T) in the VEGF were detected using Next Generation DNA Sequencing method., Results: The - 2578C > A polymorphism CC genotype, CA + AA genotypes, and C allele, as well as the - 1154G > A polymorphism AA genotype, and A allele were associated with increased risk of HMB-E (p < 0.05 for all). However, no statistically significant difference was found between the patient group and the control group in terms of genotype and allele distributions in the 405G > C, + 936C > T, c534C > T polymorphic regions (p > 0.05 for all). While the - 2578/ - 1154/ + 405/c534 AGGC haplotype decreased the risk of HMB-E, the CAGC haplotype was found to increase the risk of HMB-E., Conclusion: VEGF - 2578C > A and - 1154G > A polymorphisms were significantly associated with the risk of HMB-E in the Turkish population., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Numbness of the nasal skin is one of the most common complications following rhinoplasty., Objectives: The present study investigated postoperative changes in nasal skin sensation among primary and revision rhinoplasty patients and evaluated the recovery outcomes for both groups., Methods: A prospective, randomized blinded study was undertaken involving 100 primary and 34 revision open rhinoplasty patients and 50 volunteers as control group. Semmes-Weinstein monofilament testing was performed on 7 designated nasal points preoperatively and at postoperative months 1, 3, 6, and 12, and the results were evaluated., Results: Among the primary rhinoplasty patients, the change in reduced sensation on pressure to the tip and infratip over time was significant (P < 0.001), whereas there was no statistically significant difference for the other points. Among the revision rhinoplasty patients, the change in reduced sensation on pressure to the tip, infratip, and base of columella over time was significant (P < 0.001), whereas there was no statistically significant difference at the other points. In a comparison of the revision and primary rhinoplasty patients at all timepoints, a statistically significant reduction in sensation was noted on the application of pressure to all points in the revision patient group (P < 0.001)., Conclusions: This study found that the sense of touch on pressure returned to normal, aside from at the tip and infratip, by the end of month 12 in primary rhinoplasty patients. The revision rhinoplasty patients, in turn, were observed to have reduced sensation on pressure by the end of month 12, with the greatest reduction at the tip, infratip, and columellar base., (© 2021 The Aesthetic Society. Reprints and permission: journals.permissions@oup.com.)

Electrical stimulation is proposed to exert an antimicrobial effect according to studies performed using bacterial and cell cultures. Therefore, we investigated the effects of electrification on inflammation in septic rats. Twenty-eight male Wistar albino rats were divided into 4 groups: healthy control (C), electrified healthy (E), sepsis (S), and electrified sepsis (SE) groups. Staphylococcus aureus (1 x 109 colonies) in 1 ml of medium was intraperitoneally injected into rats to produce a sepsis model. The rats in the E and SE groups were exposed to a low direct electrical signal (300 Hz and 2.5 volts) for 40 min and 1 and 6 h after bacterial infection. Immediately after the second electrical signal application, blood and tissue samples of the heart, lung, and liver were collected. An antibacterial effect of a low direct electrical signal was observed in the blood of rats. The effects of electrical signals on ameliorating changes in the histological structure of tissues, blood pH, gases, viscosity and cell count, activities of some important enzymes, oxidative stress parameters, inflammation and tissue apoptosis were observed in the SE group compared to the S group. Low direct electrical signal application exerts antibacterial, antioxidant, anti-inflammatory and antiapoptotic effects on septic rats due to the induction of electrolysis in body fluids without producing any tissue damage., Competing Interests: This study was supported by AVB Biotech, Barbaros Street, Deluxia Palace, Number: 3/40, Istanbul, Turkey. ST and ST designed and developed Dr. Biolyse, and RA, IK and GBT are employees of AVB Biotech, the sponsor of the study, and they participated in the application of Dr. Biolyse. IM and SU also serve as scientific advisors to BVU Biotech for Dr. Biolyse. Other authors do not have any conflicts of interest to declare. This statement does not alter our adherence to PLOS ONE policies on sharing data and materials.

Tularemia is a zoonotic disease and endemic in the northern hemisphere. The aim of this study was to evaluate the epidemiological, clinical and laboratory characteristics of tularemia patients, and to re-analyze their lymphadenopathy during the follow-up. The patients who were diagnosed with tularemia were reviewed. They were invited for the long term, physical and radiological evaluations. 69.8% patients had lived in rural areas. 54.7% patients were associated with animal husbandry, the 18.9% had contact with rodents. The most common form was the glandular type (62.3%). The frequency of granulomatous lymphadenitis was significantly higher in patients diagnosed later than 30 days from the onset of symptoms. Lymphadenopathy was undetectable in 61.5% patients, its severity was reduced in 38.4% patients compared to its state at the admission. In rural areas, avoiding contact with wild animals can ensure the protection from the pathogen. Public communities should be made aware of the disease.

Introduction: Submandibular glands are exposed to many effects due to diseases and therapeutic interventions. A study evaluating the effect of submandibular gland dysfunction on the parotid gland has not been presented in the literature., Objective: The aim of this study was to evaluate the histopathological changes in the parotid gland following submandibular gland failure., Methods: Three groups of seven randomly selected female New Zealand rabbits weighing 2500-3000g were studied. Unilateral and bilateral submandibular glands were removed in Groups 1 and 2, respectively. No procedure was performed in Group III, the control group. The parotid glands were removed 30 days later. Histological parameters were evaluated and graded between 0 (none) and 3 (severe). Differences between groups were compared using the Mann-Whitney U test., Results: Mean mucus accumulation in acinar cells was 2.57±0.53 and 1.71±0.75 in Groups 1 and 2, respectively (p<0.05). This value was 0.57±0.53 in Group 3, which was significantly lower than in Groups 1 and 2 (p<0.05). Mean dilatation of the intercalated ducts' lumen was 1.28±0.48 and 1.57±0.53 in Groups 1 and 2, respectively (p>0.05). This value was 0.28±0.48 in Group 3, which was significantly lower than in Groups 1 and 2 (p<0.05). Mean mucus accumulation in the intercalated ducts' lumen was 2.00±0.81 and 1.00±0.57 in Groups 2 and 3, respectively (p<0.05)., Conclusion: The findings of this study indicate that only 1 month after submandibular gland failure, the parotid glands exhibit significant changes., (Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.)

Purpose: Primary ocular adnexal lymphomas are cured by radiotherapy; however, complications are frequent and relapses may occur. In this case, we aimed to report the efficacy and safety of extended systemic rituximab (anti-CD 20 monoclonal antibody) therapy of conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma., Methods: In the standard regimen, rituximab is used as four consecutive weekly infusions of 375 mg/m 2 in patients with low-grade lymphomas. We treated a patient who had bilateral conjunctival MALT lymphoma with rituximab 375 mg/m 2 intravenously once weekly for 10 weeks as a first-line therapy., Results: During the examination of the sixth week, we observed partial response of the lesions in both eyes. At the end of the tenth cure, complete remission was achieved. No local or systemic adverse effect was observed. The patient has no signs of recurrence during the 22-months follow-up period., Conclusion: Extended rituximab therapy may be an effective and well-tolerated first-line treatment option for bilateral conjunctival MALT lymphoma.

Objectives: Auditory brainstem responses (ABR) are used to evaluate the peripheral and central functions of the auditory tract. Air and bone-conduction auditory stimuli are used to evaluate the type and degree of hearing loss. The wave latencies and interpeak latencies (IPLs) are the important diagnostic data in ABR tests. Gender and age of the patients are some of the factors affecting these latencies. This study investigated the effects of age and gender on the wave and IPLs of bone-conduction ABR., Materials and Methods: One hundred healthy individuals (50 women and 50 men) aged between 10 and 60 years were enrolled into this study, and both ears of all subjects (200 ears total) were included in the assessments. Based on their age, the subjects were equally divided into five groups, and each group consisted of 10 men and 10 women., Results: The findings showed a significant difference in wave latencies and IPLs between the two genders (p<0.05). Depending on stimulus intensity, wave latencies also showed statistically significant differences between the age groups (p<0.05). However, no significant difference was noted between the age groups regarding IPLs., Conclusion: Normative values that covered wave latencies and IPLs evoked at stimulus intensities of 50, 30, and 10 dB nHL were established for the clinical use and use as a reference for the bone-conduction ABR testing procedure.

Objective: The aim of this report is to evaluate whether cortexin provides any protective activity against ototoxicity of cisplatin., Materials and Methods: The study was performed on 30 healthy adult Wistar Albino rats, and rats were randomly divided into three groups of ten. Group I (Control group) was given intraperitoneal (ip) saline solution 1 mL/day. Group II (Cisplatin group) was given ip cisplatin for 2 days at doses of 10 mg/kg. Group III (Cisplatin + Cortexin group) was given ip cisplatin for 2 days at same doses with ip cortexin 2 mg/day for 7 days. Before and on the fourth day of the study, all subjects underwent auditory brainstem response (ABR) and distortion product otoacoustic emissions (DPOAE) tests. At the end of fourth day, half of the subjects in all three groups were decapitated, and their cochlea were removed for histopathologic examination. On the eighth day, tests of the remaining subjects and histopathological examinations were repeated., Results: ABR tests on the fourth and eighth days showed elevations in the mean hearing thresholds of Groups II and III compared to Group I (p < 0.05). DPOAE tests revealed a loss in emission values on the fourth and eighth days of the study compared to the baseline in Groups II and III. Comparison of Groups II with III showed that emission loss was higher in Group II at both time points, and the difference was more pronounced on the eighth day. Histopathological findings supported these tests., Conclusion: Cortexin provide protective activity against cisplatin-induced ototoxicity.

Background: Background: Demodex mites are acari that reside in the pilosebaceous unit of the skin and have been associated with skin disorders., Objective: The objective of this study was to investigate the prevalence of Demodex folliculorum (D. folliculorum) mites in polycystic ovary syndrome patients as well as to examine the relationship between Demodex infestation and the presence of acne and oily or dry skin types in polycystic ovary syndrome patients., Methods: 41 polycystic ovary syndrome patients and 47 non-polycystic ovary syndrome control subjects were enrolled in the study. polycystic ovary syndrome was diagnosed according to the revised 2003 ESHRE/ASRM polycystic ovary syndrome Consensus Workshop Group diagnostic criteria. Microscopic examination of D. folliculorum mites was carried out by standardized skin surface biopsy. The result was considered positive when there were more than 5 mites per cm2., Results: D. folliculorum was positive in 53.7% of the polycystic ovary syndrome patients and 31.9% of the non-polycystic ovary syndrome group (p=0.052). Demodex positivity was significantly associated with acne (p=0.003) and oily skin (p=0.005) in the polycystic ovary syndrome patients but not in the controls., Study Limitation: Our study is limited by the relatively small number of subjects and the observational nature of the study design., Conclusion: Demodex mites might have a role in acne pathogenesis in patients with polycystic ovary syndrome. Anti-Demodex treatment may increase the response to treatment of acne. Further studies are indicated.

Pleomorphic adenoma is a slow-growing salivary gland tumor frequently arising from the parotid gland. In this study, we investigated the role of the insulin-like growth factor I-II receptor (IGFI-IIR) levels on the development of parotid gland pleomorphic adenomas. The study included 20 males and 20 females who had superficial parotidectomy with a histopathological diagnosis of pleomorphic adenoma in Fırat University Otorhinolaryngology Clinic between 2000 and 2011. The ages of the patients ranged between 20 and 50 years. The control tissues were obtained unilaterally from the parotid glands of five female and five male cadavers during autopsy, and consisted of 0.5 × 0.5 cm sized normal parotid gland tissues. The expression of IGFI-IIR were measured in both tumor and tumor-free normal parotid tissue in the study group while only the normal parotid tissues were studied in the cadavers. Primary polyclonal antibodies against IGFI-IIR were used with "Streptavidin-Biotin Complex" method for immunohistochemical staining of both the study and the control groups' tissue sections. In this study, the IGFI-IIR levels were found significantly higher in the pleomorphic adenoma tissue (p < 0.05). In addition, IGFI-IIR expression was greater in normal parotid tissues of the study group when compared to the normal parotid tissues of the cadavers. However, the difference was not statistically significant (p > 0.017). Greater expression for IGFI-IIR in pleomorphic adenoma when compared to normal parotid tissues of the patients and the cadavers suggests that IGFI-II may be important factors in the development of pleomorphic adenoma.

Background: Combined surgery for cesarean delivery and preperitoneal mesh repair for inguinal hernia has not been previously reported., Objectives: Our aim was to describe the method and to present the results of this simultaneous surgery through a single incision., Methods: From 2012 to 2014, 15 patients underwent cesarean delivery combined with preperitoneal mesh repair for inguinal hernia. All patient characteristics and perioperative findings were recorded., Results: Among 15 patients, 13 had unilateral inguinal hernias and two had bilateral hernias. The mean times spent for unilateral and bilateral hernias were 35.8 minutes (range, 30-45 minutes) and 67.5 minutes (range, 65-70 minutes), respectively. Direct and indirect hernias were present in one and 15 patients, respectively. One patient had mixed hernia. No significant complication was observed perioperatively. Hospital stay ranged from 1 day to 3 days (mean, 1.87 days), and all patients were discharged without any problem. No recurrence was found during the follow-up periods., Conclusion: Single anesthesia, single incisional scar, and single hospitalization are the major advantages of this simultaneous approach of cesarean delivery and preperitoneal mesh repair for inguinal hernia. Our analysis suggests that this combined procedure can be performed safely in selected cases., (Copyright © 2016. Published by Elsevier Taiwan.)

Objective: The aim of this study was to determine the air-bone gaps in adults with mixed-type hearing loss using air-conduction auditory brainstem response (ABR) latencies., Materials and Methods: Thirty adults with mixed-type hearing loss (study group) and 30 adults with normal hearing (control group) were included in this study. Before performing ABR measurements, ear, nose, and throat examinations, pure tone audiometry, speech audiometry, acoustic immittance audiometry, and transient evoked autoacoustic emission testing were performed for all participants. Absolute latencies of I, III, and V waves and interpeak latencies (IPL) at 90 decibel hearing level dB nHL were evaluated and compared with air-bone gap results., Results: ABR latencies using click and tone-burst stimulation were obtained and found to be longer in the mixed-type hearing loss group than in the normal hearing group (p<0.05). A moderate positive relationship was detected between the air-bone gap and wave III/V latencies at 0.5/1 kHz, I-V/I-III/III-V IPL at 1 kHz. Only one strong relationship was found between 1 kHz air-bone gap and I-V IPL., Conclusion: In this study, the magnitude of the air-bone gap could not determined using prolonged ABR latencies. Delays in ABR latencies were observed, but prolonged ABR latencies was not helpful for calculating the air-bone gap on mixed-type hearing loss.

Objective: The present study evaluated the results of the graft success rate and hearing gain of children who underwent endoscopic inlay butterfly myringoplasty due to chronic otitis media., Methods: The study included 32 pediatric patients aged between 8 and 17, who had endoscopic inlay butterfly myringoplasty with the diagnosis of chronic otitis media between September 2012 and January 2015 in Elazig Training and Research Hospital Otorhinolaryngology Clinic and Firat University Otorhinolaryngology Clinic. All patients' demographics, perforation size, and hearing status were examined., Results: Tympanic membrane perforation was ≤3mm in 12 patients and between 3 and 6mm in 20 patients. The air-bone gap (ABG) of the patients was 18.5±6.29dB preoperatively, 8.81±3.53dB postoperatively second month, 8.09±3.55dB postoperatively sixth month, and 7.96±3.32dB postoperatively 12th month. Two (6.3%) of the patients had postoperative myringitis. Two (6.3%) patients had recurrent perforation in the postoperative follow-ups., Conclusion: In children, endoscopic inlay butterfly tympanoplasty is a surgical technique with short duration, high graft success, effective hearing reconstruction, and high levels of postoperative patient comfort., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Background: The prognostic significance of complete cytogenetic response (CCyR) is well defined in patients with chronic phase chronic myeloid leukemia treated with imatinib as first-line therapy. However, the effect on outcomes of obtaining molecular response itself and the depth of it is not clear. In this study we aimed to determine the frequency of complete molecular response (CMR) during long-term follow-up and the clinical significance of CMR on patient outcomes and survival., Patients and Methods: We retrospectively evaluated the files of 178 chronic phase chronic myeloid leukemia patients using imatinib therapy. Forty-seven patients with missing data were excluded from the study and the assessment was done in 131 patients. CMR was defined as undetectable BCR-ABL transcripts using real-time quantitative polymerase chain reaction with a sensitivity level of ≥ 10 4 in 2 consecutive analyses at least 3 months apart. Cytogenetic and molecular monitoring during treatment was performed according to the European LeukemiaNet recommendations criteria. Our primary objective was to analyze the association of deeper molecular response with differences in progression-free survival (PFS)., Results: Eighty-eight patients (67%) achieved CMR at any time in a median of 65 months of follow-up. The rate of CMR was higher in patients who achieved CCyR at 12 months and major molecular response (MMR) at 18 months. Fewer events occurred in the CMR group than the MMR group (26.1% vs. 50.0%). Overall survival was not different in both groups. CMR was associated with longer PFS with borderline significance., Conclusion: Prolonged imatinib therapy helps to achieve a deeper molecular response in the long-term. Achieving deeper molecular response at any time positively affects maintaining the cytogenetic and molecular responses, and decreases the transformation to accelerated and/or blastic phase. The slight prolongation in PFS did not reach statistical significance., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease of the paranasal sinuses, and its pathophysiology is not yet precisely known. It is suggested that oxygen free radicals play an important role in the pathogenesis of nasal polyposis. This study aimed to identify genetic polymorphisms of superoxide dismutase (SOD 2), catalase (CAT), and inducible nitric oxide synthase (iNOS) enzymes in eosinophilic CRSwNP and non-eosinophilic CRSwNP patients; the study also aimed to evaluate the effect of genetic polymorphism of antioxidant enzymes on CRSwNP etiopathogenesis. One hundred thirty patients, who received endoscopic sinus surgery due to CRSwNP, and 188 control individuals were included in this study. Nasal polyp tissues were divided into two groups histopathologically as eosinophilic CRSwNP and non-eosinophilic CRSwNP. Venous blood samples were taken from the patient and control groups. Polymorphisms in the Ala16Va1 gene, which is the most common variation of SOD-2 gene, and 21 A/T polymorphisms in catalase gene were evaluated with the restriction fragment length polymorphism method and -277 C/T polymorphism in the iNOS gene was evaluated with the DNA sequencing method. The GG genotype distribution for the (-277) A/G polymorphism in the iNOS gene was a statistically significant difference between eosinophilic CRSwNP and control groups (p < 0.05). The CC genotype distribution for the SOD2 A16V (C/T) polymorphism was not statistically significant in all groups (p > 0.05). The TT genotype distribution for the A/T polymorphism in catalase gene at position -21 was statistically significant differences in eosinophilic CRSwNP and control groups (p < 0.05). Increased free oxygen radical levels, which are considered effective factors in the pathogenesis of CRSwNP, can occur due to genetic polymorphism of enzymes in the antioxidant system and genetic polymorphism of antioxidant enzymes in eosinophilic CRSwNP patients might contribute to the pathophysiology.

Objective: The aim was to investigate the efficacy of cortexin and methylprednisolone on recovery in cases of traumatic facial nerve paralysis occurring after facial nerve trauma., Materials and Methods: The study was performed on 21 healthy rabbits. The buccal branches of the left facial nerves of all the rabbits were pressed, and facial nerve paralysis occurred. The rabbits were randomly divided into three equal groups: 3 mg/day cortexin intramuscularly, 1 mg/kg/day methylprednisolone intramuscularly, and 3 mg/day saline intramuscularly were administered for 10 days in Group I (cortexin group), Group II (methylprednisolone group), and Group III (control group), respectively. Electromyography was performed on the 7th, 14th, and 21st days to evaluate their improvement. Following this, the traumatic buccal branches of the facial nerves of rabbits were extracted and subjected to histopathological examination., Results: There was a significant difference between the cortexin and methylprednisolone groups and the control group in terms of neural fibrotic degeneration, myelin degeneration, axonal degeneration, normal myelin production, and edema. When the cortexin and methylprednisolone groups were compared with each other, there was no significant difference between them, except for an increase in collagen fibers. Cortexin significantly reduced the collagen fiber increase to a greater extent than methylprednisolone. The electromyography findings did not show any significant difference between the groups or within the groups., Conclusion: Our study suggests that cortexin and methylprednisolone are effective for healing traumatic facial nerve paralysis with intact nerve integrity; however, cortexin is unable to cause significant improvement, which is superior to that caused by methylprednisolone.

Background: This study investigated genetic polymorphisms affecting the inducible nitric oxide synthase, superoxide dismutase and catalase enzymes in chronic otitis media patients with and without tympanosclerosis, and the role of genetic susceptibility in the disease aetiology., Methods: A total of 162 patients who underwent surgery for chronic otitis media were divided into two study groups: a tympanosclerosis group and a chronic otitis media group. A third, the control, group comprised 188 healthy volunteers. Venous blood samples were evaluated using reverse transcriptase polymerase chain reaction., Results: There was a significant difference in GG genotype distribution of the -277A>G polymorphism in the NOS2 gene between the tympanosclerosis and control groups (p T) polymorphism in the SOD2 gene (p > 0.05). There were significant differences in the TT genotype distribution of the -21A>T polymorphism in the CAT gene between the tympanosclerosis and control groups, and between the chronic otitis media and control groups (p < 0.05)., Conclusion: These results suggest that genetic predisposition may play a role in the aetiopathogenesis of tympanosclerosis.

During pregnancy, cutaneous and appendageal alterations manifest and may cause concern in the subject. The nails may be affected by pregnancy. This study investigated the frequency and nature of nail changes occurring during pregnancy in 312 healthy, 18-40-year-old pregnant women in gestation weeks 16-40. After a routine obstetric examination at the obstetrics and gynecology clinic at the study institution, all subjects submitted to an examination of all fingernails and toenails. Only nail alterations that had developed during pregnancy were recorded. Any nail changes that had occurred before the start of gestation were not considered. Data were presented as percentages. The Shapiro-Wilk and chi-squared tests were used to make categorical comparisons. A P-value of < 0.05 was considered to indicate statistical significance. No nail pathologies were detected in 116 (37.2%) of the 312 subjects. The most commonly found nail change was leukonychia (24.4%). Ingrown toenail (9.0%) and onychoschizia (9.0%) represented the second most common nail changes. Rapid nail growth and subungual hyperkeratosis were observed in 6.7% and 4.2%, respectively, of subjects. When the alterations were evaluated according to gestational age, the most common nail pathology was leukonychia at both 14-28 weeks (16.3%) and 29-42 weeks (27.4%) of pregnancy. Leukonychia, onychoschizia, onycholysis, and brittle nail pathologies were frequently observed at 29-42 weeks of pregnancy (P = 0.047). A large proportion of nail changes that occur during pregnancy are benign and do not require treatment. However, these changes may cause significant cosmetic stress in women., (© 2016 The International Society of Dermatology.)

Intrauterine growth retardation/restriction (IUGR) is associated with fetal malnutrition. It has consequences for later life including increased incidence of obesity, diabetes mellitus, cardiovascular disease (CVD), and metabolic syndrome. Adipokines (adiponectin and leptin), adropin, and endothelin-1 are associated with obesity and metabolic syndrome regulation. Intrauterine changes in these mediators could affect programming of later adult obesity and metabolic syndrome. Our objectives were to compare the levels of these mediators in both cord and maternal blood between IUGR pregnancies and control, healthy pregnancies, and to study the correlation of adipokines with adropin and endothelin-1 in maternal and cord blood in IUGR pregnancies as well as in healthy control pregnancies. Maternal and cord blood samples were taken from 16 women with IUGR pregnancies and 16 women with healthy pregnancies. Serum levels of leptin, adiponectin, adropin, and endothelin-1 were measured by ELISA. Maternal blood adropin levels were significantly lower in the IUGR group than in the control group; the other mediators did not differ significantly. There was a positive correlation between maternal blood adropin and endothelin levels. (r=0.731, P=0.001) in the control but not the IUGR group. Cord blood adropin and adiponectin levels were significantly lower in the IUGR group compared with the control group, while leptin or endothelin-1 did not differ significantly. There was a negative correlation between adropin and leptin (r=-0.704, P=0.001) in the IUGR but not the control group cord blood. There were also positive correlations between endothelin and adropin for both groups (r=0.594, P=0.006; r=0.560, P=0.010, respectively); to the best of our knowledge, this is the first report of such a correlation. Differences in fetal expression of adropin and adiponectin in IUGR could influence programming of obesity, metabolic syndrome, diabetes, and CVD in later life.

Aim: To analyze diagnostic and therapeutic methods used in the diagnosis and treatment of foreign body aspiration (FBA) and to determine the impact of technical infrastructure on mortality and morbidity., Methods: Hospital records of patients diagnosed with FBA between the years 1987 and 2015 were retrospectively evaluated. The patients were grouped according to the length of time until their admission to the hospital as follows: Group I (0-24 h); Group II (1-7 days); Group III (>7 days). Age, sex, history, existing symptoms, physical examination, endoscopic and radiological findings, time to treatment, type and location of the foreign body, treatment modality, mortality and morbidity rates were recorded. A rigid bronchoscopy procedure was performed between 1987 and 2005 (Phase 1) without the need for an optic telescope, while between 2006 and 2015, it was performed using a rigid bronchoscope equipped with an optical telescope and HD camera (Phase 2)., Results: A total of 513 patients [male, n = 328 (63.9%) and female, n = 185 (36%)] who had complaints of FBA were evaluated. The mean age of the patients was 3.7 ± 3.5 years. In order of decreasing frequency, sunflower seeds, peanuts, and hazelnuts (38% of all patients) were extracted. Bronchoscopy could not detect a foreign body in 127 (24.7%) patients. Foreign bodies were mostly observed in the right (43.3%) main bronchus. When the locations of the foreign bodies were analyzed, significant differences were found for subglottic foreign bodies (FBs) between Groups I and III and for FBs located within the bifurcation between Groups II and III. The most prevalent symptom was sudden onset of coughing in 231 (45%) patients. A significant difference was detected between Groups I and II, as well as Groups I and III, for sudden onset of coughing, decrease in breathing sounds, wheezing, and fever. No abnormal radiological signs were detected in 136 (26.5%) patients. Manifestations of emphysema were significantly more frequent in Group I, pneumonia in both Groups II and III, and pleural effusion in Group III. When complications related to bronchoscopy were evaluated, a significant increase was observed in transient complications in Group III compared with Groups I and II. The negative bronchoscopy rate in Phase I was statistically significantly higher than that in Phase II., Conclusions: When the length of time elapsed till admission to a hospital was considered, a decrease in morbidity rates was observed in patients who presented at a hospital within the first 24 hours. In the diagnosis of suspect patients, virtual bronchoscopy seriously decreased the incidence of negative bronchoscopy. The authors determined that for bronchoscopic procedures, the renewal of technical ultrastructure with technological advances strongly contributed to a decrease in mortality and morbidity as a result of FBA in paediatric patients.

Aim: Extranodal mucosa-associated lymphoid tissue (MALT) arises a number of epithelial tissues, including the stomach, salivary gland, lung, small bowel, and elsewhere. Here we present a male patient with an uncommon site of extranodal MALT such as a pelvic mass diagnosed after a long period of evaluation, which initially presented with an incidental pulmonary nodule., Method: We report a 60 years old man presenting with pulmonary nodules and consolidation. He refused invasive procedures and 3 years later was administered to our clinic with disseminated pulmonary nodules on chest X-ray. Subsequently a thin needle aspiration biopsy was performed and candida geotrichum was suspected in the specimen of the lung biopsy by light microscopic examination. After this time the patient was referred to our clinic, bronchoscopy, mediastinoscopy and abdominal computerized tomography (CT) scans were performed., Results: Lymphoid hyperplasia was seen in the mediastinal lymph nodes biopsy specimens and the pelvic mass (52 × 18 mm) on the superior iliac muscles not related to any organs. Thin needle biopsy revealed MALT lymphoma and pathological examination of pulmonary nodule was similar to pelvic mass (MALT lymphoma). After the diagnosis, the thin needle biopsy of lung was repeated. The specimen appeared to be similar to the pelvic mass (MALT lymphoma) in the pathologic examination. The patient survived 5 years after initial diagnosis., Conclusion: MALT has an affinity for the different tissues however has not been located in the pelvis. Our case represent an unusual presentation in a 60 years old man with lung and a pelvic mass.

Objective: The aim of this study was to investigate factors associated with thrombosis that may contribute to recurrent pregnancy loss (habitual abortion), specifically differences in serum levels of platelet-activating factor and thrombin-activatable fibrinolysis inhibitor (carboxypeptidase B2) between women with a history of recurrent miscarriage and those with no recurrent miscarriage history., Materials and Methods: A case-controlled, prospective study design was adopted to compare women with a history of two or more first-trimester miscarriages (n = 42) with those with no history of recurrent miscarriage (n = 36). Participants were recruited from the Department of Obstetrics and Gynecology of Turgut Ozal University Hospital. Platelet-activating factor and thrombin-activatable fibrinolysis inhibitor levels in serum samples were measured by an enzyme-linked immunosorbent assay., Results: Platelet-activating factor levels were significantly (p = 0.018) higher in the recurrent miscarriage group. There was no difference in levels of thrombin-activatable fibrinolysis inhibitor expression between the groups., Conclusion: Platelet-activating factor is significantly higher in serum of patients with a history of recurrent miscarriage than in those without such a history, with potential implications for placental function and fetal growth, which could be relevant to miscarriage recurrence. Larger studies are indicated to further examine these findings., (Copyright © 2016. Published by Elsevier B.V.)

Eltrombopag was used in patients with chronic primary immune thrombocytopenia (ITP) who did not tolerate or were refractory to two or more previous treatments. The primary aims of the study were to determine the efficacy and safety of long-term eltrombopag treatment. Data were extracted from medical chart records retrospectively. Platelet count of at least 50 000/μl at any time point during the treatment was defined as the 'response'. Median duration of eltrombopag treatment was 29 weeks (11-74). The number of patients who had a platelet count of at least 50 000/μl at any time point was 26 (83.9%). The response was achieved by the second week in most of the patients. Concomitant ITP medications were withdrawn in nine out of the 11 patients. Eltrombopag was discontinued in one patient due to sustained response despite discontinuation of the treatment. Age, sex, concomitant ITP treatments, and previous ITP treatment failures had no impact on the treatment response. The treatment was discontinued due to thrombosis in only four patients. Four patients experienced a minor bleeding event. Hepatotoxicity and all other adverse events were mild and manageable. Eltrombopag is effective, safe, and well tolerated in the long-term treatment of chronic ITP patients.

Objective: This study aimed to assess the histopathological effect of OK-432 (Picibanil) on rabbit nasal turbinates., Methods: A total of 21 rabbits were divided into 3 treatment groups and various parts of both nasal turbinates were injected with 0.5 ml OK-432, 0.2 ml OK-432 or 0.6 ml saline (control). Bilateral nasal turbinates were later excised and studied under light microscopy to assess any histopathological changes., Results: Animals in the 0.2 ml and 0.5 ml OK-432 groups exhibited mild ciliary loss, goblet cell loss and epithelial damage, and a marked increase in inflammatory cell infiltration, submucosal vascularisation and fibrosis. There was a significant difference in histopathological changes between the two OK-432 treated groups. In addition, each OK-432 treated group had significantly more inflammatory cell infiltration, increased submucosal vascularisation and fibrosis compared with controls., Conclusion: The marked fibrosis observed in OK-432-injected turbinates may be responsible for a reduction in turbinate size.

Although carotid body tumor (CBT) is a rare neoplasm, it should always be considered in differential diagnosis of lateral neck masses. We shared the 10 years of CBT experience in our clinic and started a discussion on CBT with literature support. A total of 21 patients with CBT diagnosis in Fırat University Hospital, Otorhinolaryngology Clinic, participated in the study. Patients were evaluated based on demographical data and particularities of the tumor. Participant patients were 19 women and 2 men, and their ages were between 21 and 79 (mean age 54.06 ± 12.48). The most frequent reason for the patients to apply to the hospital was painless swelling in the neck (76.2%). Tumor was located in the right side of the neck in 10 patients (47.6%), and in the left side of the neck in 11 (52.4%). Twenty patients (95.2%) had undergone computerized tomography angiography. Surgical treatment was applied to 19 patients (90.5%) and the tumor was totally excised. According to Shamblin classification, 15 of the tumors of these patients were class II (78.9%) and 4 were class III (21.1%). In 1 patient (5.3%), postoperative contusion infection that recovered after medical treatment was observed; in 2 patients (10.5%), n. vagus injury was observed because of tumor's pervasion of n. vagus; and in 1 of these patients vocal cord paralysis was developed and this patient was later taken into thyroplasty surgery. Two patients (10.5%) suffered n. hypoglossus injury, 1 of these recovered within 3 months postoperative and the other developed n. hypoglossus palsy. The size and extension of the tumor should be determined by preoperative imaging for the correct planning of surgical procedure. It should be taken into consideration that despite advanced surgical techniques, the rate of postoperative cranial nerve damage is still high.

The human JAK2 gene is mainly targeted by two types of genetic lesions that play roles in the pathogenesis of hematologic malignancies: intragenic mutations and chromosomal translocations. Chromosomal translocations of JAK2 are typically associated with myeloid or lymphoid malignancies with an aggressive course and poor outcome. Here we report a t(9;22)(p24;q11.2) translocation, in a MDS patient and review results associated with BCR-JAK2 fusion reported in the literature.