Fat graft myringoplasty with the newly developed surgical technique for chronic tympanic membrane perforation

The purpose of this prospective clinical trial was to evaluate the success rate of our newly developed surgical technique for fat graft myringoplasty (FGM). We also aimed to assess the correlations between the size of perforations and closure rates, as well as the results of re-gained hearing in successful cases with respect to sizes of perforations. Thirty consecutive patients with persistent tympanic membrane perforation were included in this study. All patients underwent fat graft myringoplasty with a newly developed technique. Treatment success was defined as an intact tympanic membrane (TM) at the 3-month follow-up visit. Bone conduction (BC) and air conduction (AC) thresholds at the frequencies of 0.5, 1, 2, 3, and 4 kHz were recorded preoperatively and at the 3rd month postoperatively. The range of perforation sizes among the 30 patients was 7 mm in 13 of the patients (43 %), 6 mm in 8 of the patients (27 %), and 5 mm in nine of the patients (30 %). Closure of tympanic membrane perforations with this new technique was achieved in 27 out of the 30 patients, with a success rate of 90 %. The average of the air-bone gap (dB) was similar in preoperative and postoperative periods for 5- and 6-mm sized perforation groups (p = 0.09 and p = 0.49). However, in the 7-mm sized perforation group, the average of the air-bone gap (dB) was higher in the preoperative period than the postoperative period (p = 0.004). The average of the air-bone gap (dB) for all patients was higher in the preoperative period than the postoperative period (p = 0.001). In conclusion, FGM performed with this technique may be used as an alternative for the closure of tympanic membrane perforations larger than 5 mm.     

Uterine adenosarcoma with ovarian sex cord-like differentiation: a case report and review of the literature

ObjectivesTo determine the prognosis of uterine adenosarcoma with ovarian sex cord like-differentiation after treatment and to review the literature.Case ReportA 47-year-old premenopausal unmarried woman presented with irregular menstrual bleeding and uterine mass. Sonographic examination, suggested two uterine fibroids located in the uterine fundus and cervix measuring 4 × 3 cm and 3 × 3 cm, respectively. Total abdominal hysterectomy with bilateral salpingo-oopherectomy was performed and the histopathology report confirmed the diagnosis of uterine adenosarcoma with ovarian sex cord like-differentiation. The patient received neither chemotherapy nor other adjuvant therapy because the tumor had low malignant potential, and the extent of myometrial invasion was less than half of the whole myometrium. The patient had an uneventful recovery, and no recurrence was detected for 2 years in the follow-up period.ConclusionUterine adenosarcomas mostly have relatively low malignant potential. Surgery is the optimal standard treatment for patients. Although there is not enough data in the present literature, benign epithelial differentiations, such as sex cord-like elements may reflect the behaviour of the tumour and shows the tendency to have a benign course in most of cases.     

Intraocular pressure elevation after intravitreal triamcinolone acetonide injection: a Meta-analysis

AIM: To report on intraocular pressure (IOP) after intravitreal injections of triamcinolone acetonide. METHODS: Systematic literature review of studies that investigated the effects of an injection of triamcinolone intravitreal triamcinolone acetonide on IOP was conducted according to the Cochrane Collaboration methodology and the reported effects have been analyzed with Meta-analysis. RESULTS: We found that the IOP follows an inverted-U shape pattern over time starting with an average value of 14.81±1.22 mm Hg before the injection, rising to a maximum of 19.48±2.15 mm Hg after one month of injection and falling down to 16.16±1.92 mm Hg after 6mo. Moreover, country of study, age, previous history of glaucoma and gender compositions matter for cross-study were different in reported IOP changes. CONCLUSION: Our findings may be helpful in determining pressure elevation risk of intravitreal triamcinolone acetonide therapy as well as comparing it with those of more recent therapies such as the anti-vascular endothelial growth factor agents.     

Urethroplasty and vaginoplasty by a single small bowel interposition graft: a novel technique for cloacal reconstruction

Despite the advances in surgical management of anorectal malformations, repair of cloacal malformations remains a challenging condition for many pediatric surgeons. Posterior cloaca is present where urogenital sinus deviates posteriorly to form a cloaca with rectum. Often, achieving adequate urethral and vaginal length can be challenging. We describe a novel technique where a loop of small bowel on a single mesenteric blood supply could be constructed in 2 functional tubular structures: one for urethral and the other for vaginal replacement.     

The effect of testosterone treatment on urodynamic findings and histopathomorphology of pelvic floor muscles in female rats with experimentally induced stress urinary incontinence

Objective  

In recent studies, it has been observed that androgen receptors are densely located in pelvic floor muscles. We aimed to investigate the effect of testosterone on urodynamic findings and histopathomorphology of pelvic floor muscles in rats with experimentally induced stress urinary incontinence.     

Biomechanical properties of the body and angle of the sheep mandible under bending loads

Abstract – Aim: ;The aim of the study was to compare the body and angle of the sheep mandible in terms of bone density and biomechanical competence under bending load conditions. Material and Methods: ;Nineteen sheep mandibles were used in this study. The mandibles were separated at the symphysis into two halves. Three regions of interest on the body and angle of the hemi‐mandibles were selected for measurements of bone mineral density (g cm^?2) by dual energy X‐ray absorbtiometry. Biomechanical properties of the left mandibular body and right mandibular angle were measured by three‐point bending test using a material testing machine. The load and deformation were recorded, and the load–deformation curves were obtained. The values of failure load (FL), yield load (YL), yield deformation (YD), postyield deformation (PD), stiffness, energy to yield point (EY) and energy to failure point (EF) were calculated with the analysis of load–deformation curves. Groups were compared using independent samples Student’s t‐test. Results: ;The mandibular angle exhibited the lower bone density (?64%) and biomechanical properties (FL; ?45%, YL; ?40%, PD; ?7% stiffness, ?40% EY; ?48% and EF; ?34%) than the mandibular body under bending loads, and there was no significant difference in values of YD between the two regions. Conclusion: ;Our results show that the mandibular angle is weaker than the mandibular body under bending loads.