Delayed assessment of the nasolacrimal system at naso-orbito-ethmoid fractures and a modified technique of dacryocystorhinostomy

Nineteen patients between 8 and 65 years of age (mean age 32) who were treated for naso-orbito-ethmoid area traumas and suffering from epiphora were evaluated. The time after the trauma was at least 4 months. The patients were divided into two groups. The first group consisted of 10 (52.7%) patients who have undergone a surgical procedure for the fractures before. The second group has 9 (47.3%) members who have never been surgically treated after trauma. All of the patients were evaluated with dacryocystography. Obstruction was found to be in the bony nasolacrimal canal in 13 (68.4%) patients. The nasolacrimal canal was intact in six (31.6%) of the patients. Dacryocystorhinostomy (DCR) was essential for five (50%) of the patients in the first group and eight (88.8%) of the patients in the second group. No additional surgical intervention was carried out for nasal deformities of the patients resulting from naso-orbito-ethmoid fractures. Palpebral malposition was present in six (32%) patients. Relief in tear flow was supplied in all patients. Our aim is to compare the outcomes of a modified technique of DCR and incidence of nasolacrimal system injury in patients with naso-orbito-ethmoid fractures and epiphora on whom reduction was or was not carried out. In conclusion, early surgical reduction of naso-orbito-ethmoid fractures should be performed to prevent problems and deformities of the nasolacrimal system.     

A new approach to alar rim defects: mucocartilaginous turnover flap

The main principle of reconstructive surgery is replacement of the defective tissues with like tissues. A full-thickness defect of the nasal ala should be reconstructed in three layers: innermost mucosal layer, outermost skin, and the cartilage in-between. The aim of this study is to describe a technique for single-stage, three-layer reconstruction of the full-thickness ala nasi defects. This technique was used on three patients with tumors involving the nasal ala. Resulting full-thickness defects are reconstructed with a mucocartilaginous turnover flap planned from the contralateral side. Aesthetically acceptable results are obtained without the compromise of the nasal airway and with minimal donor site morbidity. None of the patients requested a revision operation. In conclusion, this is a novel technique with minimal donor site morbidity and good postoperative results. Moreover, lost tissues are replaced with exactly the same kind of tissues.     

An evaluation of five different dressing materials on split‐thickness skin graft donor site and full‐thickness cutaneous wounds: an experimental study

The objective of this study was to investigate the healing effect of five different products on split‐thickness skin graft (STSG) donor sites and full‐thickness cutaneous wounds (FTCWs) using an occlusive dressing model. Six groups were included: 1 control and 5 experimental groups, with a total of 24 rats, using an occlusive dressing model. STSG donor sites and FTCWs were established in two separate areas, to the right and left on the animals' backs. Wound sites were dressed with one of the following materials: fine mesh gauze, microporous polysaccharide hemosphere (MPH), clinoptilolite, alginate, hydrogel or biosynthetic wound dressing (Biobran^®). These materials were compared in terms of healing rate, healing quality and histopathological findings. Occlusive dressings were applied to each wound on days 0, 3, 5, 7, 10 and 14. Area measurements were taken using images of each dressing. The alginate and clinoptilolite groups gave the best healing rate results for both STSG donor sites (P = 0·003) and FTCWs (P = 0·003). MPH came third in each group. The alginate group produced better results in terms of healing quality criteria, followed by hydrogel, MPH, clinoptilolite and Biobran^®, in that order. Statistically significant results were obtained in all groups compared to the control group (P < 0·0007). Rapid and good healing quality for both the STSG donor sites and FTCWs were obtained with alginate. Healing with clinoptilolite and MPH was rapid, but poor quality, while slower but good healing quality was obtained with hydrogel. Slower and worse quality healing was obtained with Biobran^®.     

Physiological-dose steroid therapy in sepsis [ISRCTN36253388

Introduction  

The aim of the study was to assess the prognostic importance of basal cortisol concentrations and cortisol response to corticotropin, and to determine the effects of physiological dose steroid therapy on mortality in patients with sepsis.     

A novel mutation of sgk-1 gene in central serous chorioretinopathy

AIM

To investigate the association of serum glucocorticoid kinase gene-1 (SGK-1) DNA variants with chronic central serous chorioretinopathy (CSC).

METHODS

We enrolled 32 eyes of 32 patients who were diagnosed with chronic CSC and composed 32 normal eyes as a control group. Peripheral blood was used for DNA extraction and polymerase chain reaction (PCR) amplification. SGK1 gene was sequenced by using BigDye^® Terminator v3.1 cycle sequencing KIT (Applied Biosystems, Foster City, CA, USA). The SGK1 gene and its variants were investigated in CSC patient group and control group.

RESULTS

We identified a new polymorphism M32V in two person in the patient group (Minor allele frequency (MAF)=0.009) on the region of 1-60 amino acids. The rs1057293 was located in the encoder region of the SGK 1 gene but not associated with CSC (P=0.68). An intrinsic rs1743966 is also not associated (P=0.28).

CONCLUSIONS

The new polymorphism M32V is located on the region of 1-60 amino acids which is necessary for localization to the mitochondria in CSC patient. This mutation is probably important for the energy metabolism and plays an important role in the cellular response to hyperosmotic stress and other stress stimuli. Both rs1057293 and rs1743966 are not associated with CSC.     

Does moxifloxacin alter oxidant status in the cornea? An experimental study

Objective: In this experimental study, we investigated the possible effects of intracameral moxifloxacin on oxidative stress parameters and endothelial cell morphology in corneal tissue.

Methods: In total, 30 rats were randomly assigned to three groups of 10 rats: the sham group (Group 1, n?=?10); the control group (Group 2), where balanced salt solution (BSS) was administered at a dose of 0.01?cc (n?=?10); and the treatment group (Group 3), where moxifloxacin was administered at a dose of 0.05?mg/0.01?cc (n?=?10). Total antioxidant status (TAS) and total oxidant status (TOS) in corneal tissue and blood samples were measured and the oxidative stress index (OSI) was calculated. Also, corneal tissue histopathology was evaluated with caspase-3 and caspase-8 staining. Apoptotic activity was also evaluated.

Results: In blood samples, TAS, TOS, and OSI levels were not statistically significantly different (all p?>?0.05). Compared with the sham and control groups, TOS and OSI levels in cornea tissue were significantly different in the moxifloxacin group (all p?p?>?0.05). Compared with the sham and control groups, apoptotic activity was higher in the moxifloxacin group, in both immunohistochemical staining for caspase-3 and caspase-8.

Conclusions: Intracameral moxifloxacin injection seems to be safe systemically, but it may have toxic effects on corneal tissues, as suggested by oxidative stress parameters and a histopathological evaluation.