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Background: In this study, we evaluated how the Merocel and nasal splint packing placed in the nose after septoplasty surgery affects the olfactory and mucociliary functions of the nose in the early period, and compared the 2 packing with each other. Material and Method: The study included 60 patients with isolated septal deviation and 30 patients in the control group. The patients were randomly divided into 2 groups. Nasal splint was inserted after septoplasty in group A (n = 30). Merocel was inserted in group B (n = 30). The Sniffin sticks test and saccharin test were applied to the patients before surgery and 15 days after the surgery. The same tests were applied to the control group consisting of 30 patients and the results were compared. Results: No complications, such as postoperative bleeding, submucoperichondrial hematoma, or abscess formation, were found in both groups. Mucociliary function was improved after septoplasty, and it was statistically significant, but there was no statistically significant difference between both packing groups. A statistically significant difference was found for the odor test in patients who used nasal splint packing in comparison with patients who used Merocel in the early period. Conclusion: The odor test showed significant differences between the 2 groups and this was statistically significant in the early period. Mucociliary function was better after surgery, but there was no statistical difference in the different nasal packing groups.

We report a case of potentially fatal cervical necrotizing fasciitis and descending necrotizing mediastinitis due to deep neck infection in a 66-year-old male patient with no history or evidence of immunocompromising disorders. On admission, he had painful neck movements and the skin over his neck was red, hot and tender. A computerized tomography (CT) scan of his neck and chest showed evidence of air collection in soft tissues. He was treated with broad-spectrum intravenous antibiotics and early massive cervical drainage. Prompt diagnosis by CT of the neck and chest enabled an early surgical treatment of cervical necrotizing fasciitis. Although acute mediastinitis is a fatal infection involving the connective tissues that fill the interpleural spaces and surround the median thoracic organs, an extensive cervicotomy combined with appropriate antibiotics can prevent the need for mediastinal drainage.

Micronucleo, ponte nucleoplasmatico e frequenze di gemme nucleari in pazienti con carcinoma laringeo.Lo scopo dello studio è quello di valutare e confrontare le frequenze relative alla presenza di micronucleo (MN), ponte nucleoplasmatico (NPB) e gemma nucleare (NBUD) in pazienti con carcinoma laringeo e popolazione sana. Lo studio è stato condotto presso un istituto universitario di medicina. Sono stati arruolati 102 volontari, 51 dei quali con carcinoma laringeo e 51 controlli sani. Il metodo di Cytokinesis-Block Micronucleus Assay (CBMN) è stato applicato ai linfociti del sangue periferico dei casi e dei controlli. Abbiamo valutato le frequenze di MN, NPB e NBUD nel paziente con carcinoma laringeo e confrontato i risultati con il gruppo dei controlli. Le frequenze MN, NPB e NBUD dei pazienti con carcinoma laringeo sono risultate significativamente più alte rispetto al gruppo di controllo (P = 0,01, P = 0,004, P = 0,01, rispettivamente). Nello studio, le frequenze MN, NPB e NBUD sono state confrontate in pazienti con e senza esposizione ai pesticidi. I risultati hanno mostrato che la media delle frequenze di NBP, MN e NBUD era significativamente più alta nei pazienti con esposizione ai pesticidi (P = 0,001, P = 0,02 rispettivamente). Il presente studio ha indicato che un aumento delle frequenze di MN, NPB e NBUD nei linfociti periferici umani potrebbe essere utilizzato per prevedere il rischio individuale di sviluppare un carcinoma laringeo. Inoltre, i nostri risultati indicano che l’esposizione ai pesticidi potrebbe aumentare il rischio di carcinoma laringeo.The aim of the study is to determine and compare micronucleus (MN), nucleoplasmic bridge (NPB) and nuclear bud (NBUD) frequencies in patients with laryngeal carcinoma and healthy controls. The study was conducted in the School of Medicine of Onsekiz Mart University. A total of 102 volunteers, 51 of whom had laryngeal carcinoma and 51 of whom were healthy control subjects, participated in this study. The Cytokinesis-Block Micronucleus Assay (CBMN) was applied to peripheral blood lymphocytes taken from patients and controls. We evaluated MN, NPBs and NBUDs frequencies in patients with laryngeal carcinoma and compared the results with those in the control group. The frequencies of MN, NPBs and NBUDs of patients with laryngeal carcinoma were found significantly higher than those in the control group (P = 0.01, P = 0.004, P = 0.01, respectively). MN, NPB and NBUD frequencies were also compared in the patients with and without pesticide exposure, and the means of all frequencies was higher in patients with pesticide exposure (P = 0.001, P = 0.02 respectively). The MN, NPBs and NBUDs frequencies of the patients with laryngeal cancer were significantly higher than those of the control group, and pesticide exposure might be a risk factor that increases genomic instability and risk of laryngeal cancer.

OBJECTIVES This study aims to analyze the correlation between biomarkers and risks of cervical lymph node invasion, recurrence, distant metastasis and survival regarding the clinicopathological variables in laryngeal cancers. PATIENTS AND METHODS Forty-one patients with laryngeal cancers were examined retrospectively. The correlations evaluated between E-cadherin, Ki-67, c-erbB-2 expressions, tumor site, differentiation, the risk of cervical lymph node metastasis, perineural, perivascular, pericapsular invasion and recurrence as well as survival time. RESULTS There was significant correlation between T-grade and the survival rates, and between pericapsular invasion and the lowest survival rates. There was no significant correlation between E-cadherin, Ki-67, c-erbB-2 expressions and clinicopathological variables of tumor. Positive correlation between strong stain of E-cadherin and Ki-67 proliferation index was determined. CONCLUSION These markers are not reliable prognostic and predictive factors for laryngeal cancers. E-cadherin expression was protected in well-differentiated and less invasive cancers, which maintain their cell-cell adhesions whereas it was reduced in undifferentiated cancers. Positive correlation between E-cadherin and Ki-67 proliferation shows that histopathological differentiation of laryngeal cancers is maintained in spite of the high proliferation index.

The aim of this study was to identify the potential prognostic roles of the preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red cell distribution width (RDW) in patients with laryngeal squamous cell carcinoma (LSCC). 81 patients who underwent surgery for the larynx carcinoma were enrolled in the study. NLR, PLR and RDW were used as outcome measures. Local recurrence was detected in 30 (37.0 %) patients and neck lymph node metastasis was detected 6 (7.4 %) patients during follow-up period. Mortality was seen in 7 (8.6 %) patients. The mean PLR in the T1 and T2 stage tumors were significantly lower than the T4 stage. The mean RDW and PLR were significantly higher in the exitus group than the survivor group. The mean NLR in the patients with local recurrence was significantly higher than the non-recurrent patients. Progression-free survival (PFS) was lower in patients with high NLR. When analyzed by the Cox regression analysis of factors affecting the local recurrence, NLR was found to significantly affect the recurrence. According to ROC analysis for mortality, NLR was not found to be a prognostic factor, although the PLR and RDW were significant prognostic factors. According to Cox regression analysis, a high PLR increases mortality 4.2 times and a high RDW 4.6 times. Although in univariate analysis MCV, RDW and tumor grade were predictors of mortality, RDW and tumor grade independent predictors were found. Further studies involving large patient groups are required.

OBJECTIVE Chronic otitis media (COM) is a disorder characterized by perforation of the eardrum and hearing loss following chronic inflammation of the middle ear cavity, ossicules, and mastoid cells. Eustachian dysfunction plays an important role in COM etiopathogenesis and postoperative prognosis. The determinants of postoperative prognosis are still being researched. This study aimed to research the prognostic value of acoustic rhinometry (ARM) and rhinomanometry (RMM) in COM surgery in terms of eradication of the infection after operation, graft success, and hearing gain in operated cases. MATERIALS AND METHODS This study included 58 patients who underwent surgery with a diagnosis of COM. Patients were assessed in terms of age, gender, COM type, treatment methods used, eradication of infection, graft success, and hearing gain. ARM and RMM measurements were performed in the preoperative period. ARM and RMM values were statistically compared in terms of the existence of postoperative infection, graft success, and hearing gain. RESULTS In terms of ARM and RMM measurements, there was no statistically significant difference between cases where postoperative infection control was assured and cases with ongoing infection; successful and failed cases in terms of grafting; or successful and failed cases in terms of postoperative hearing. When preoperative and postoperative air-bone gap averages were compared, statistically significant differences were observed. CONCLUSION In the presence of a nasal obstruction in cases with chronic otitis, elimination of this situation is the first line of treatment. Infection control, graft success, and improvement of hearing will be possible to a greater extent in the postoperative period for patients with the nasal pathology remedied.

Objectives We aimed to investigate the effects of hesperetin as a flavanon both histopathologically and immunohistochemically on cochlear apoptosis in a rat model of cisplatin-induced ototoxicity (CIO). The evaluation of the effects of hesperetin on cisplatin-induced hearing loss was performed using distortion product otoacoustic emission (DPOAE). Methods Twenty-eight wistar albino rats were used in the current study. The rats were randomly divided into four groups with seven rats in each group. Group C was exposed to a single dose of cisplatin (12 mg/kg) by intraperitoneal injection. Group CH received intraperitoneally cisplatin (12 mg/kg) and hesperetin (20 mg/kg). Group H was exposed to hesperetin (20 mg/kg) intraperitoneally. The sham group (group S) received normal saline (6 cc) intraperitoneally. The measurements of DPOAE and signal-noise ratios (SNR) were performed before the treatment and again on the first and 6 days after administration of the drugs. Rats were sacrificed and cochleae were dissected 10 days after drug administration. The cochlear tissue was assessed in all groups by histopathologic, immunohistochemical and TUNEL assay. In addition, serum oxidative stress markers and antioxidant parameters were analyzed. Results There was a significant difference between the basal value and the sixth day at frequencies 8.4, 9.6 and 9.96 for group C. We also found a significant difference between the first and sixth day at frequencies 7.2, 8.4, 9.6 and 9.96. On the 6th day, there were significant differences between C and S groups at all frequencies except 2.4. We showed a significant difference between C and H groups at frequencies 4.8, 6.0, 8.4, 9.6 and 9.96. There was also a significant difference between C and CH groups at frequencies 2.4, and 3.6. We found lower levels of oxidants and higher levels of antioxidants in CH group as compared to C group. C group had a significantly greater number of TUNEL-positive cells than did S, H and CH groups. The number of TUNEL-positive cells in CH group was higher than in S and H groups. There was a significant difference between the positive PCNA cells of CH group compared to S and H groups in spiral ganglion and stria vascularis. In addition, there were no positive PCNA cells in C group. Conclusions Hesperetin may prevent ototoxicity by increased antioxidant enzymes and reduced oxidant parameters and protected against apoptosis resulting from a proliferation of cochlear cells in CIO.

Background:To evaluate the effects of autologous serum usage on throat pain, haemorrhage and tonsillar fossa epithelisation in patients after tonsillectomy.Methods:Thirty-two patients (aged 4–15 years) were included in the study. Tonsillectomy was performed and autologous serum was administered topically to the right tonsillar fossa during the operation, and at 8 and 24 hours post-operatively. The left side served as the control. A visual analogue scale was used to record the patient's pain every day. Each patient's oropharynx was observed on the 5th and 10th post-operative days to examine bleeding and epithelisation.Results:The pain scores for the side administered autologous serum were significantly lower than those for the control side, on the night following the operation and on the 1st, 2nd, 5th and 6th post-operative days. Tonsillar fossa epithelisation was significantly accelerated on the study side compared with the control side on the 5th and 10th post-operative days.Conclusion:In tonsillectomy patients, topically administered autologous serum contributed to throat pain relief and tonsillar fossa epithelisation during the post-operative period.

To investigate the effect of nasal septum deviation, without obstructive sleep apnea, on sleep quality.The present case-controlled study enrolled patients older than 16 years with nasal septum deviation who attended the Otorhinolaryngology Clinic between December 2013 and July 2014. The control group was selected from patients attending the clinic for another complaint. Sleep quality was evaluated via the Pittsburgh Sleep Quality Index, and differences between the groups were compared using the Mann-Whitney U test.During the study period, 55 patients with nasal septum deviation were included in the study group, and the control group consisted of 51 patients with no complaints of nasal obstruction. Compared with the control group, patients with nasal septum deviation were found to be significantly higher (P 0.05) in all parameters of Pittsburgh Sleep Quality Index.The presence of nasal septum deviation with nasal obstruction should be investigated in patients with sleep disorders. If any pathology is present, opening the nasal passages should be ensured and sleep disorders reevaluated.

To evaluate the sclerotic effect of bleomycin on the submandibular gland histopathologically and assess it as a possible alternative therapy for sialorrhea.An experimental model was designed and 18 New Zealand white rabbits were used. The rabbits were divided into two groups: a bleomycin group (n=9) and a sham group (n=9). The submandibular glands of the bleomycin group were injected with 0.3 ml bleomycin (3mg/ml) while the sham group received 0.3 ml saline. Four weeks after the procedure, the glands were removed. Histopathological studies including hematoxylin-eosin and Masson's trichrome stain were carried out. The glands were evaluated for tissue inflammation, fibrosis, edema, lipomatosis, atrophy and congestion. To investigate apoptosis, terminal deoxynucleotidyl transferase (TdT)-mediated digoxigenin-11-dUTP nick-end labeling (TUNEL) immunohistochemical staining was used.In the group injected with bleomycin, inflammation (n=8), edema (n=4), fibrosis (n=3), congestion (n=4) and lipomatosis (n=7) were observed. In the sham group, only lipomatosis was observed. The TUNEL assay results were 5.06 ± 1.18 (p0.05) for acinar cells and 8.46 ± 0.82 (p0.05) for ductal cells in the bleomycin group. This was significantly different from the results in the sham group.Apoptosis, inflammation, fibrosis, edema, lipomatosis and congestion were observed in the ductal and acinar cells of the bleomycin group. Bleomycin may be an alternative treatment for sialorrhea cases. However, more research is needed.

Amac: Kronik hipertrofik adenotonsillitin koku alma fonksiyonu ve yasam kalitesine etkisinin incelenmesi amaclanmistir. Yontem: Yedi ila 8 yaslarinda cocuk hastalar, prospektif olarak uc grup halinde calismaya dahil edilmistir: Grup I- Adenotonsiller hastaliklar (n=15); Grup II- Kontrol grubu (n=15) ve Grup III- Postoperatif grup (n=15). Hastalar 12 maddelik Sniffin'Sticksa koku tanimlama testi ve obstruktif uyku bozuklugu-6 (OSD-6) yasam kalitesi tarama testiyle degerlendirilmistir. Bulgular: Adenotonsiller hastalik (6.93±1.75 ), kontrol (8.73±1.10) ve postoperatif grubun (7.67±1.59) total koku tanimlama (SI) skorlari olculmustur. Adenotonsiller grupta total SI skoru kontrol grubununkinden anlamli derecede daha dusuktu (p

Otitis media (OM) is a common health problem. Nasal airways play an important role in etiopathogenesis of OM. The aim of this study is to evaluate nasal airways by objective methods in chronic otitis media (COM) cases. The relationship between the course of the disease and nasal parameters is also investigated. Fifty-six patients who had chosen an operation for chronic otitis media were included in the study. The control group was composed of 30 healthy patients. Patients were subjected to acoustic rhinometry and rhinomanometry. Nasal airway resistance and cross-sectional area measurements were taken. The results of the COM group and the control group were compared. Cases were classified by the course of the disease such as suppurative/progressive/active and non-suppurative/inactive and the nasal parameters of these sub-groups were compared. In cases with unilateral COM, nasal cavity results from both sides were compared. The nasal airway resistance of the COM group was statistically significantly higher than the control group (p0.05). However, there was no difference in cross-sectional area measurements. There was no significant difference between the suppurative/progressive/active and non-suppurative/inactive groups. However, the suppurative group had higher nasal resistance (p0.05). There was no statistical difference between the measurements of each side in unilateral COM cases. This study found that COM cases have greater nasal airway resistance. No significant difference was found in cross-sectional area measurements so the increase in resistance may be linked to mucosal rather than structural changes. There was no evidence for a relationship between the course of the OM and nasal airway parameters.

Warthin's tumor is a benign salivary gland tumor of the parotid gland. Although bilateral or multicentric involvement of the parotid gland is common, extraparotid involvement is seen rarely. The nasopharynx is an unusual region for extraparotid involvement. In this article, we present a 52-year-old male case with a synchronized Warthin's tumor in the bilateral parotid gland and nasopharynx, and we discuss the clinical management of the disease.

The head and neck region includes many vital anatomic structures. So, diseases of this region may have a more morbid and mortal course compared to other anatomic regions. In this article, we report a patient showing various symptoms due to a suture needle which was left in the surgical region during the extraction of the left inferior molar tooth three years ago.

A 42-year-old man presented with a white plastic-like material exposed in the left medial canthal area, with a fistula and purulent discharge. He had undergone endonasal dacryocystorhinostomy 7 years earlier for left eye epiphora; he had persistent postoperative epiphora and recurrent dacryocystitis despite multiple drainage attempts and antibiotics elsewhere. Computed tomography showed bilateral enlarged cystic lacrimal sacs, with a well-defined contoured tunnel-like hole at the center of the left sac. Treatment included excision of the foreign body, which was a Griffiths' collar button nasolacrimal stent, excision of the fistula tract, and revision dacryocystorhinostomy with implantation of bicanalicular silicone stent. He recovered with no further symptoms or complications. This case highlights the importance of follow-up for removal of an implanted Griffiths' stent after dacryocystorhinostomy. Patients with recurrent dacryocystitis may benefit from a detailed history of previous surgery, careful examination, and imaging to evaluate for endogenous and exogenous foreign bodies such as lacrimal sac calculi, and retained lacrimal sac stents.

Rheumatoid arthritis is a chronic erosive rheumatic disease that can present with polyarticular involvement. Anti-TNF-alpha drugs are used in cases that are resistant to traditional disease-modifying antirheumatic drugs (DMARDs). Anti-TNF-alpha drugs are groundbreaking drugs, the efficacy of which has been proven in the treatment of rheumatoid arthritis. However, the data concerning safety remain limited and contradictory. The risk of tuberculosis reactivation, various infections, as well as lymphoproliferative disease and/or secondary malignancy is a matter of discussion. In this report, we report a 52-year-old male patient using adalimumab for active rheumatoid arthritis who presented to our polyclinic with generalized mouth and throat sores, hoarseness, and swallowing difficulty. Candida laryngitis was detected in the laryngoscopy and culture samples. Adalimumab was discontinued, and the infection was controlled with anti-fungal treatment.

Background: Sudden hearing loss developing after immunisation is a very rare situation. Rabies is a viral disease characterised by encephalitis and death. Treatment involves active and passive immunisation. Neurologic complications including Guillain-Barre syndrome or facial paralysis are reported in the literature as a side effect after rabies immunisation. Case Report: Sudden hearing loss was detected in an 11 year-old male patient who had taken the medication for rabies immunisation. Conclusion: This study presents a case report of sudden hearing loss developing after rabies immunisation - no other aetiological factors were detected and clinical management is discussed in light of the literature. Turkish Başlık: Kuduz Aşısı Sonrasında Görülen Ani İşitme Kaybı Anahtar Kelimeler: Kuduz, aşılama, yan etki, ani işitme kaybı Arkaplan: İmmünizasyon sonrası ani işitme kaybı gelişmesi oldukça nadir görülen bir durumdur. Kuduz, ensefalit ve ölüm ile karakterize bir viral hastalıktır. Kuduz hastalığının tedavisinde aktif ve pasif immünizasyon bulunmaktadır. Literatürde kuduz immünizasyonu sonrası yan etki olarak rapor edilen nörolojik komplikasyonlar (Gullian Barre sendromu, fasiyel paralizi) bulunmaktadır. Olgu Sunumu: 11 yaşında erkek çocukta kuduz aşısı sonrasında gelişen ani işitme kaybı tespit edildi. Sonuç: Bu çalışmada kuduz aşısı sonrasında gelişen ani işitme kaybı olgusu(başka bir etiyolojik neden bulunamamıştır) sunulmakta ve klinik yaklaşım tartışılmaktadır.

Background. Congenital absence of the submandibular gland (SMG) is a rare condition. Although complaints such as dry mouth, dental problems, or difficulty in swallowing may be seen, the subjects may also be asymptomatic. The absence of the SMG may be associated with hypertrophy of the contralateral SMG.Case Report. We report the case of a 44-year-old woman with incidentally detected left SMG aplasia, with contralateral SMG hypertrophy mimicking a mass, and the case of a 46-year-old woman with incidentally detected bilateral SMG aplasia, demonstrated by computerized tomography (CT) and magnetic resonance imaging (MRI).Conclusion. It is important for the clinician to know that this very rare abnormality may exist. When such a case is encountered, symptoms and findings should be reevaluated and, if necessary, conservative therapy should be initiated. The possibility of observing additional deformities should be kept in mind and an evaluation should be done for other cases in the family.

Actinomycotic abscess of the thyroid gland is rare especially in childhood. In this article, we report the second pediatric case in literature, at age of 18 months. Although spread of actinomycotic infection to the thyroid gland from upper aerodigestive tract by preformed pathways such as piriform sinus fistula seems rational, it was demonstrated neither in current nor in previous cases. Therefore, further work-up such as barium swallow, which is onerous to perform in a child may be reserved for recurrent cases.

Objective:To investigate endoscopic staging, and nitric oxide levels in the polyp tissue, in patients with nasal polyposis undergoing glucocorticoid therapy.Methods:Nasal polyposis was evaluated using endoscopic staging and measurement of polyp tissue nitric oxide levels (chemiluminescence method). Forty-five nasal polyposis patients received either nasal therapy (n = 15), oral therapy (n = 15) or combined therapy (n = 15). Pre-treatment and post-treatment staging and nitric oxide levels were evaluated.Results:Endoscopic grading indicated significant post-treatment staging improvements in the oral (p = 0.016) and combined (p = 0.016) groups. Post-treatment staging differed significantly between the three groups (p = 0.041), with greater improvements in the oral and combined groups. All groups showed significantly lower post-treatment nitric oxide levels, compared with baseline, but post-treatment levels did not differ significantly between groups. A significant association was found between treatment response and nitric oxide level alteration.Conclusion:This study demonstrates the favourable effects of glucocorticoids on nasal polyposis, and alteration in nitric oxide tissue levels post-treatment. Nitric oxide level in nasal polyp tissue could be an indicator of treatment response, and may aid surgical decision-making by detecting cases that probably will not respond to medical treatment.

Objectives: We investigated whether the maxillary sinus plays a stimulatory role in nasal nitric oxide (NO) synthesis. Research on sinusitis and nasal polyps has found low NO levels in exhaled air and linked this to obstruction of the ostium. However, the major source of NO in exhaled air is thought to be the nasal mucosa. In this study, Streptococcus pneumoniae was applied to the maxillary sinus to investigate changes in NO synthesis of the nasal mucosa. Methods: An experimental study was performed with New Zealand white rabbits. Three groups, pneumococcus, control and sham, were created. The maxillary sinus of the pneumococcal group was exposed to Streptococcus pneumoniae suspension. Before and after the exposure, bilateral biopsy specimens were taken from the inferior turbinate. Specimens were examined by RT-PCR for expressions of endothelial nitric oxide synthase (e-NOS) and inducible nitric oxide synthase (i-NOS). Physiological saline solution was administered to the maxillary sinus in the control group and biopsies were obtained. The sham group underwent only biopsy. Results: A significant increase in i-NOS expression of tissue samples from the pneumococcal group on the same and opposite sides were detected. There was no increase in e-NOS expression in this group. The control and sham groups had no significant change in i-NOS or e-NOS expression. Conclusion: In the acute period after the maxillary sinus is exposed to a pathogen, i-NOS expression increases in the nasal mucosa, but endothelial NOS expression is not affected. Consequently, a combined response in the maxillary sinus and the nasal mucosa for nitric oxide synthesis is shown in the present study.

Background. Curcumin has been shown to decrease ischemia-reperfusion (I/R) injury in kidney or brain tissues. In thisstudy, the effects ofcurcumin were evaluated in skeletal muscle during I/R injury. Materials and Methods. Hind limb ischemia was induced by clamping the common femoral artery and vein. After 4 h ischemia, the clamp of the femoral vesselsofanimalswastakenoffandtheanimalunderwent 2 h reperfusion. We measured plasma concentrations of interleukin-1b (IL-1b) and tumor necrosis factora (TNF-a) using enzyme-linked immunosorbent assay (ELISA). The right gastrocnemius muscle was harvested and immediately stored at L30 � C for the assessment of superoxide dismutase (SOD), catalase (CAT) activities, and measurement of glutathione (GSH), malondialdehyde (MDA), and protein oxidation (PO) levels. Curcumin (100 mg/kg), a-tocopherol, and normal saline (10 mL /kg1) were administered intraperitoneally 1 h prior reperfusion. Results. Plasma TNF-a or IL-1b levels increased significantly in I/R group. The plasma levels of these proinflammatory cytokines were reduced in curcumin group. Muscle tissues of I/R groups revealed significantly higher antioxidant enzyme (superoxide dismutase, glutathione peroxidase, catalase) activities, and increased levels of malondialdehyde, nitric oxide, and protein carbonyl content compared with the SHAM group. Levels of these parameters in muscle revealed significant reductions in the I/R D curcumin group compared witho the I/R group. Curcumin has more potent antioxidant activity than vitamin E in the skeletal muscle I/R. Conclusion. Inthisstudy,protectiveeffectsofcurcumin against skeletal muscle ischemia-reperfusion injury have been revealed. We underscore the necessity of human studies with curcumin that would be hypothetically beneficial preventing skeletal muscle I/R injury. Crown Copyright 2012 Publishedby ElsevierInc. All rights reserved.

Tularemia is a disease caused by Francisella tularensis and widely seen at northern hemisphere of the world. In Turkey, oropharyngeal infections caused by a less virulent serotype F.tularensis subsp. Holarctica are more prevalent. The aim of this study was to present the results of an epidemiological research performed after the detection of tularemia cases from Biga county of Canakkale province, Turkey, in December 2009. Following the report of two tularemia suspected cases from two villages (Baliklicesme and Sinekci) of Biga, an epidemiological investigation was undertaken to inspect the situation in this area. Water samples, clinical samples as throat swabs, wound swabs and serum samples were collected. Samples were cultured on heart agar supplemented with sheep blood, cysteine and antibiotics. Cultures were incubated at 37°C in 5% CO(2) and followed for 10 days. Suspected colonies were identified by slide agglutination test using F.tularensis antisera. F.tularensis antibodies were investigated by standard tube agglutination method. Positive results obtained with agglutination test were also checked for a probable crossreaction with Brucella antibodies by Rose-Bengal test. Water and wound samples were investigated using real-time polymerase chain reaction (RT Taqman PCR; Quantica, Techne Inc, UK) with probe and primers specific for ISFtu2 gene. All of the cultures yielded negative results, however eight of 16 water samples, one lymph node aspirate and one throat sample were found positive in F.tularensis TaqMan RT-PCR test. In tube agglutination test positive antibody titers between 1:20-1:1280 were detected in 36 of 115 serum samples. Two cases with antibody titers of 1:1280 and accompanying acute clinical findings, were diagnosed as tularemia and treated accordingly. Lymphatic drainage fluid samples obtained from one of these patients yielded positive result in PCR, however clinical sample could not be obtained from the other patient. The only epidemiological linkage between these acute cases (n= 2) and the other seropositive subjects (n= 34) was the use of local water supply system. It was learned that water obtained through reverse osmosis system had been used as drinking water at Baliklicesme village. Pre- and post-reverse osmosis system water samples from Baliklicesme village and samples from water supply of Sinekci village revealed positive results for F.tularensis by PCR. Since the only epidemiological relation between these two villages was using local water supply, tularemia cases encountered in this area were attributed to a waterborne epidemic and an automatic chlorination system was set up at each water reservoir in these villages. The establishment of these preventive measures curbed the growth of the epidemic. The cases presenting with throat sore, fever, lymphadenopathy (more than 2 cm), non-responsive to beta-lactam antibiotics, should be further investigated for tularemia. This work emphasizes that systematic setup and control of water disinfection systems are crucial to prevent tularemia outbreaks. Community and related authorities should be educated about the importance of water sanitation and chlorination.

Oxytetracycline has been suggested as an alternate therapy for chronic recurrent sialadenitis and sialorrhea. We conducted an experimental study to investigate the sclerotic effect of this drug on the submandibular gland by histopathologic methods. Our subjects were 20 New Zealand white rabbits, which were divided into two groups of 10. The right submandibular gland of the rabbits in the active-treatment group was injected with 0.3 ml of oxytetracycline (100 mg/ml), and that of the controls was injected with saline. Four weeks after the injections, all the glands were removed. Histopathologic studies, including hematoxylin and eosin and Masson trichrome staining, were carried out. The glands were evaluated for tissue inflammation, congestion, fibrosis, edema, lipomatosis, and atrophy. To investigate apoptosis, terminal deoxynucleotidyl transferase-mediated dUTP-digoxigenin nick-end labeling (TUNEL) immunohistochemical staining was used. In the study group, inflammation (n = 9), congestion (n = 9), fibrosis (n = 6), edema (n = 6), and lipomatosis (n = 4) were observed; in the sham group, only lipomatosis was seen (n = 5). The TUNEL assay results for acinar cells were 4.51 ± 1.41% in the oxytetracycline group and 2.08 ± 1.76% in the control group (p = 0.006); the corresponding figures for the duct cells were 7.05 ± 0.87% and 3.10 ± 2.26% (p = 0.001). Based on our findings, we conclude that oxytetracycline might be a viable alternative for the treatment of chronic recurrent sialadenitis and sialorrhea. However, more research in this area is needed.

Castleman hastalığı, lenfoproliferatif hastalıkların heterojen bir grubu olup tek bir hastalık olarak düşünülmemelidir. Bu hastalık çeşitli klinik şekillerde ortaya çıkmaktadır. Üç histolojik çesidi olan hastalığın etyopatogenezinde IL-6, HİV ve HHV- 8 yer almaktadır. Bu hastalığı anlamada önemli yollar kat etmiş ve tedavi tecrübelerimiz rituximab, tokilizumab ve siltuximab gibi ilaçlarla artmış olsa da, halen etyolojisi, prognozu ve tedavisi hakkında cevapsız sorular bulunmaktadır. Aşağıdaki olgumuzda, meduller tiroid kanser tanısı ile takipte olan hasta boyunda kitle nedeni ile tarafımıza başvurmuş, boyun diseksiyonu sonrası patoloji sonucu castleman hastalığı olarak rapor edilmiştir., Castleman disease is a heterogeneous group of non clonal lymphoproliferative disorders, so it should not be considered as a single disease. This disease has a wide spectrum of clinical expressions. Three histological types have been reported. IL-6, HIV and HHV-8 are involved in the etiopathogenesis of Castleman disease. Despite recent significant advances in our understanding of this disease and the increasing therapeutic experience with rituximab, tocilizumab and siltuximab, there are still difficult questions concerning its etiology, prognosis and optimal treatment. In this paper, follow up patient with medullary thyroid cancer was admitted because of mass in the neck and neck dissection was performed, pathology result was reported as Castleman disease.