Endoscopic "Push-Trough" Technique Cartilage Myringoplasty in Anterior Tympanic Membrane Perforations

ObjectivesTo evaluate endoscopic push-through technique cartilage myringoplasty results.MethodsThis prospective study was performed on patients with anterior tympanic membrane perforations and endoscopic push-through technique cartilage myringoplasty was performed between 2011 and 2013. The patients who did not have any cholesteatoma or otorrhea in the previous 3 months, and had an air bone gap ≤25 dB in their preoperative audiograms were included in the study. They were followed up with endoscopic examination and audiograms at 2nd, 6th, 12th, and 24th postoperative months. Pure tone averages were calculated at 0.5, 1, 2, and 4 kHz frequencies.ResultsOf 32 patients, 19 were females and 13 were males. The mean age was 40.3 years (range, 16 to 62 years), and the mean follow-up period was 12.4 months (range, 6 to 24 months). Graft success rate was 87.5% in this study. Preoperative mean air conduction hearing threshold was 25.9 dB, and the mean air-bone gap was 11.9 dB while these values improved to 19.5 dB and 5.3 dB respectively in the postoperative period. The mean hearing gain was 6.4 dB. The analysis of preoperative and postoperative mean air conduction thresholds and air bone gap values of the patients revealed statistically significant differences.ConclusionUnderlay cartilage myringoplasty with endoscopic push-through technique in anterior quadrant tympanic membrane perforations is an effective, minimally invasive and feasible method

Maternal serum interlukin-6 level in preterm labor

Objective: The aim of this study was to measure interleukin-6 (IL-6) levels in maternal serum of women undergoing preterm labor without a clear infection. Materials and Methods: Twenty two pregnant women with diagnosis of preterm labor who presented to the outpatient clinic of 19 Mayıs University Faculty of Medicine from July 2011 through December 2011 were enrolled in the study group. Twenty two healthy pregnant women who were at the same gestational age as the study group were selected as the control group. Results: Gestational age in the study and control groups varied from 24 weeks and 4 days to 34 weeks and 6 days. In the study group, 11 patients (50%) underwent preterm birth. Pregnant women in preterm labor were compared to healthy pregnant women with regards to serum IL-6 levels. No significant difference was found in the IL-6 levels of maternal serum between the 2 groups. Conclusion: In this study, we have shown that there is no increase in IL-6 levels in patients undergoing preterm labor without clinical or biochemical infection signs

Długoterminowe wyniki radykalnej i zachowawczej chirurgii w późno rozpoznanych ciążach jajowodowych

Objective: To investigate long-term postoperative outcomes of conservative and radical surgery in ectopic tubal pregnancies, and evaluate the results of these techniques. Methods: A total of 145 patients that operated for tubal pregnancy between January 2006 and January 2009 were reviewed. Data on patient age, reproductive and surgical history, history of ectopic pregnancies, serum hCG levels at the time of diagnosis and intraoperative observation were retrospectively obtained from hospital records. Telephone interviews were used to obtain information about exact postoperative time interval in which the patients were trying to get pregnant, and the time when they spontaneously became pregnant. Results: There was no significant difference in cumulative spontaneous intrauterine pregnancy rate for a 2-year of conception period subsequent to conservative (64.3%) and radical (58.3%) surgery (p=0.636). During the same time interval, the rates of development of ectopic pregnancy for the conservative and radical surgery groups were 17.9% and 4.2%, respectively (p= 0.093). The patients who developed ectopic pregnancy after conservative surgery had significantly higher levels of serum hCG levels (7413+/-3155 IU/L) compared with those of patients who not-developed ectopic pregnancy (3436+/-2668 IU/L) (p=0.007). Conclusion: In late-diagnosed cases with higher serum hCG levels, conservative treatment should not be the first choice. Indeed, our results suggested that the cumulative pregnancy rates are not significantly higher, and the risk of ectopic pregnancy recurrence may be increased with conservative surgery in late tubal pregnancies.Cel: Badanie długoterminowych pooperacyjnych wyników leczenia zachowawczego i radykalnego w ekotopowych ciążach jajowodowych i ocena rezultatów tych metod. Metody: Przeanalizowano grupę 145 pacjentek operowanych z powodu ciąży jajowodowej pomiędzy styczniem 2006 i styczniem 2009. Dane dotyczące wieku pacjentek, przeszłości położniczej, operacji, ciąż ektopowych, poziomu hCG w surowicy w momencie postawienia diagnozy oraz obserwacje z przebiegu operacji zostały retrospektywnie uzyskane z dokumentacji szpitalnej. Informacje na temat dokładnego czasu po operacji, w którym pacjentka starała się zajść w ciążę oraz czas do zajścia w ciążę uzyskano w rozmowie telefonicznej. Wyniki: Nie znaleziono istotnej różnicy w skumulowanym wskaźniku spontanicznych ciąż wewnątrzmacicznych w ciągu 2 lat obserwacji po zachowawczym (64,3%) i radykalnym (58,3%) leczeniu operacyjnym (p=0,636). W tym samym przedziale czasu, odsetek ciąż ektopowych wynosił dla zachowawczej i radykalnej chirurgii odpowiednio, 17,9% i 4,2%, p=0,093. Pacjentki, u których doszło do rozwoju ciąży pozamacicznej po zachowawczej operacji miały istotnie wyższe poziomy surowiczego hCG (7413+/-3155 IU/L) w porównaniu do tych pacjentek, u których nie doszło do ciąży pozamacicznej (3436+/-2668 IU/L), p=0,007. Wnioski: W późno rozpoznanych przypadkach ciąży ektopowej z wyższym poziomem hCG, zachowawcze postępowanie nie powinno być leczeniem z wyboru. Nasze wyniki wskazują na to, że skumulowany wskaźnik ciąż nie jest istotnie wyższy a ryzyko ponownej ciąży pozamacicznej może być zwiększone w przypadkach późnego rozpoznania ciąży jajowodowej leczonej zachowawczą chirurgią

Clinical features of winter sports injuries: A prospective single center study

Introduction: This study aimed to present the epidemiological and clinical effects of skiing training and use of protective equipment on skiing, sledding and snowboarding injuries. Methods: The patients were evaluated in two groups according to both their skiing experience and use of protective equipment. The characteristics of the patients, such as age, gender, injury area, and injury type were statistically evaluated according to the groups. Results: A total of 191 patients, 68 (35.6%) female and 123 (64.4%) male, were evaluated. There was a significant difference between the patients with and without skiing experience (P=0.001). When the patients were evaluated according to the presence of protective equipment, 25 (59.5%) patients who had no experience did not wear protective equipment, and this rate was statistically significant compared to the experienced group (P=0.001). Concerning the diagnoses of the patients according to injury areas, joint dislocation and soft tissue trauma were mostly detected in the upper extremities, bone fractures in the lower extremities and organ injury in the thorax. Conclusion: Shoulder and wrist traumas were the most common injuries among the patients with previous skiing experience while tibial fractures were mostly seen in those without such experience. Tibia fractures were mostly observed in the patients using protective equipment, and skin incisions in those that did not use protective equipment. Therefore, in winter sports injuries, patients’ skiing experience and protective equipment use should be questioned and more attention should be paid to the above-mentioned injuries

Canonical Wnt signaling is antagonized by noncanonical Wnt5a in hepatocellular carcinoma cells

<p>Abstract</p> <p>Background</p> <p>β-catenin mutations that constitutively activate the canonical Wnt signaling have been observed in a subset of hepatocellular carcinomas (HCCs). These mutations are associated with chromosomal stability, low histological grade, low tumor invasion and better patient survival. We hypothesized that canonical Wnt signaling is selectively activated in well-differentiated, but repressed in poorly differentiated HCCs. To this aim, we characterized differentiation status of HCC cell lines and compared their expression status of Wnt pathway genes, and explored their activity of canonical Wnt signaling.</p> <p>Results</p> <p>We classified human HCC cell lines into "well-differentiated" and "poorly differentiated" subtypes, based on the expression of hepatocyte lineage, epithelial and mesenchymal markers. Poorly differentiated cell lines lost epithelial and hepatocyte lineage markers, and overexpressed mesenchymal markers. Also, they were highly motile and invasive. We compared the expression of 45 Wnt pathway genes between two subtypes. TCF1 and TCF4 factors, and LRP5 and LRP6 co-receptors were ubiquitously expressed. Likewise, six Frizzled receptors, and canonical Wnt3 ligand were expressed in both subtypes. In contrast, canonical ligand Wnt8b and noncanonical ligands Wnt4, Wnt5a, Wnt5b and Wnt7b were expressed selectively in well- and poorly differentiated cell lines, respectively. Canonical Wnt signaling activity, as tested by a TCF reporter assay was detected in 80% of well-differentiated, contrary to 14% of poorly differentiated cell lines. TCF activity generated by ectopic mutant β-catenin was weak in poorly differentiated SNU449 cell line, suggesting a repressive mechanism. We tested Wnt5a as a candidate antagonist. It strongly inhibited canonical Wnt signaling that is activated by mutant β-catenin in HCC cell lines.</p> <p>Conclusion</p> <p>Differential expression of Wnt ligands in HCC cells is associated with selective activation of canonical Wnt signaling in well-differentiated, and its repression in poorly differentiated cell lines. One potential mechanism of repression involved Wnt5a, acting as an antagonist of canonical Wnt signaling. Our observations support the hypothesis that Wnt pathway is selectively activated or repressed depending on differentiation status of HCC cells. We propose that canonical and noncanonical Wnt pathways have complementary roles in HCC, where the canonical signaling contributes to tumor initiation, and noncanonical signaling to tumor progression.</p

Renal complications of lipodystrophy: A closer look at the natural history of kidney disease

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144612/1/cen13732_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144612/2/cen13732.pd

Volume CXIV, Number 4, November 7, 1996

Objective: Turner syndrome (TS) is a chromosomal disorder caused by complete or partial X chromosome monosomy that manifests various clinical features depending on the karyotype and on the genetic background of affected girls. This study aimed to systematically investigate the key clinical features of TS in relationship to karyotype in a large pediatric Turkish patient population.Methods: Our retrospective study included 842 karyotype-proven TS patients aged 0-18 years who were evaluated in 35 different centers in Turkey in the years 2013-2014.Results: The most common karyotype was 45,X (50.7%), followed by 45,X/46,XX (10.8%), 46,X,i(Xq) (10.1%) and 45,X/46,X,i(Xq) (9.5%). Mean age at diagnosis was 10.2±4.4 years. The most common presenting complaints were short stature and delayed puberty. Among patients diagnosed before age one year, the ratio of karyotype 45,X was significantly higher than that of other karyotype groups. Cardiac defects (bicuspid aortic valve, coarctation of the aorta and aortic stenosis) were the most common congenital anomalies, occurring in 25% of the TS cases. This was followed by urinary system anomalies (horseshoe kidney, double collector duct system and renal rotation) detected in 16.3%. Hashimoto's thyroiditis was found in 11.1% of patients, gastrointestinal abnormalities in 8.9%, ear nose and throat problems in 22.6%, dermatologic problems in 21.8% and osteoporosis in 15.3%. Learning difficulties and/or psychosocial problems were encountered in 39.1%. Insulin resistance and impaired fasting glucose were detected in 3.4% and 2.2%, respectively. Dyslipidemia prevalence was 11.4%.Conclusion: This comprehensive study systematically evaluated the largest group of karyotype-proven TS girls to date. The karyotype distribution, congenital anomaly and comorbidity profile closely parallel that from other countries and support the need for close medical surveillance of these complex patients throughout their lifespa

High temperature Ho2O3-ZrO2 insulation coatings on AgMg sheathed Bi-2212 superconducting tapes by sol-gel technique for magnet technology

High temperature 0, 5, 8 and 12 mol % Ho2O3-ZrO2 insulation coatings were successfully deposited on Ag and AgMg/Bi-2212 superconducting tapes using sol-gel technique for magnet technologies. With this purpose, transparent solutions were prepared from Ho and Zr-based precursor materials and then Ho2O3 effect on thermal, structural and microstructural properties were observed and discussed in the present study. It was found that Ho2O3 additive has a propensity to generate tetragonal ZrO2 and help to stabilize it. It was observed that insulation coatings with a mosaic structure having cracks were fully compatible with Ag/AgMg sheathed Bi-2212 tape substrates because of oxygen permeability, high and low actual temperatures and W&R process in comparison with the conventional insulation process. In addition, surface roughness decreased with increasing Ho2O3 content, thereby decreasing the grain size. Although porosity values vary considerably from one porosity mesurement expression to another, porosities of the insulation coatings can be estimated to be in the range of 3 and 30 vol %

Production and characterization of the halogen-free and nanostructured flame retardant reinforced composite coatings

In this study, composite coatings reinforced with huntite/hydromagnesite, antimony (III) oxide (Sb2O3), and boric acid minerals having the inorganic-based flame retardant properties were produced. Before the composite coatings were produced, the huntite/hydromagnesite and Sb2O3 were reduced to the nano-size by milling. The structural, chemical, and morphological properties of the reinforcement materials and composite coatings were characterized by PSD, XRD, XPS, FT-IR, and SEM devices. In addition, thermal and flame retardant properties of composite coatings were performed by DTA-TG and candle flame test (according to IEC 62441 standard) method. The mean particle sizes of the huntite/hydromagnesite and Sb2O3 reinforcement materials after milling were determined as 121 and 141 nm. When we examined the thermal behavior and flame retardant properties, the reinforced composite coatings according to the pure paint exhibited very good flame retardant properties. Of these materials, the best results were determined in 10% huntite/hydromagnesite reinforced composite coatings