Decellularization of Trachea With Combined Techniques for Tissue-Engineered Trachea Transplantation

OBJECTIVES: The purpose of this study is to shorten the decellularization time of trachea by using combination of physical, chemical, and enzymatic techniques. METHODS: Approximately 3.5-cm-long tracheal segments from 42 New Zealand rabbits (3.5±0.5 kg) were separated into seven groups according to decellularization protocols. After decellularization, cellular regions, matrix and strength and endurance of the scaffold were followed up. RESULTS: DNA content in all groups was measured under 50 ng/mg and there was no significant difference for the glycosaminoglycan content between group 3 (lyophilization+deoxycholic acid+de-oxyribonuclease method) and control group (P=0.46). None of the decellularized groups was different than the normal trachea in tensile stress values (P>0.05). Glucose consumption and lactic acid levels measured from supernatants of all decellularized groups were close to group with cells only (76 mg/dL and 53 mg/L). CONCLUSION: Using combination methods may reduce exposure to chemicals, prevent the excessive influence of the matrix, and shorten the decellularization time.

Submental Ultrasonographic Parameters among Patients with Obstructive Sleep Apnea.

Objective This study aimed to determine the value of submental ultrasonography (US) parameters for diagnostic workup among patients with obstructive sleep apnea (OSA) and to determine whether there is a correlation between US findings and the severity of OSA. Study Design Cross-sectional analysis. Setting Tertiary education hospital. Subjects and Methods The study included 147 patients with suspected OSA who underwent submental US to evaluate various parameters following overnight polysomnography. US findings were compared with the apnea-hypopnea index and other parameters. Results All US parameters, except for subcutaneous tissue thickness, were significantly different among patients with OSA. Of note, distance between lingual arteries (DLA), geniohyoid muscle thickness (GMT), and lateral parapharyngeal wall thickness (LPWT) were significantly greater in the patients with severe OSA than those with mild and moderate OSA ( P < .001). GMT had the strongest correlation with OSA ( r = 0.419, P < .001); LPWT and DLA also had high correlation coefficient values ( r = 0.343, P < .001, and r = 0.342, P < .001, respectively). Stepwise regression analysis showed that GMT (beta = 0.243, P = 0.004), LPWT (beta = 0.236, P = 0.004), and DLA (beta = 0.204, P = 0.008) were the most significant factors for predicting the severity of OSA according to the apnea-hypopnea index. Conclusion Submental US can be used to determine whether there is a correlation between US findings and severity of OSA. GMT could be considered a novel parameter for determining the severity of OSA.

The effects of radioactive iodine therapy on olfactory function.

PURPOSE: To determine the possible adverse effects of radioactive iodine (RAI) treatment on the olfactory functions of patients with differentiated thyroid carcinoma. MATERIALS AND METHODS: This prospective clinical study included 63 Turkish patients who had been diagnosed with papillary thyroid carcinoma only to ensure homogeneity. The Connecticut Chemosensory Clinical Research Center olfactory test was administered at 1 week before treatment and at the third week and the first year after treatment. Triiodothyronine, thyroxine, thyroid stimulating hormone, thyroglobulin, and antithyroglobulin levels were measured 1 week before treatment and 2 weeks after treatment. RESULTS: The smell threshold test, smell identification test, and total smell scores showed statistically significant decreases after treatment when compared with the pretreatment scores (p = 0.000). No significant differences were noted between the late term and early term after RAI for either the identification score (p = 0.502) or the total score (p = 0.051). The Spearman correlation analysis indicated a significant correlation between age and RAI before and after treatment for the smell threshold test, smell identification test, and total smell scores (p < 0.05). A total of 54% of the patients displayed normosmia in the posttreatment period. A few patients had mild hyposmia before RAI, 27% had mild hyposmia in the early stage after RAI, and 29% had mild hyposmia in the late stage. CONCLUSION: The olfactory function deteriorated in almost half of the patients in the early stage after RAI. Mild and moderate hyposmia in particular occurred in the first year after RAI.

Results of primary ossiculoplasty and prognostic factors in canal wall-down tympanoplasty.

The ideal goals of chronic middle ear surgery should be the permanent removal of disease and the preservation of good hearing function. The postoperative outcome of hearing and the status of middle ear after canal wall-down tympanoplasty with primary ossiculoplasty were studied in 192 ears with chronic middle ear disease. Cholesteatoma was present in 121 (63.0%) of 192 cases; in the remaining 71 cases (27.0%), there was middle ear mucosa disease without cholesteatoma. The stapes superstructure was present in 142 (73.9%) of 192 cases. The results of preoperative and postoperative pure-tone averages were 55.12 (SD, 4.92) and 35.81 (SD, 4.84) dB, respectively. The preoperative and postoperative air-bone gaps in 192 cases were 32.70 (SD, 5.18) and 21.16 (SD, 5.09) dB, respectively. The mean hearing gain of the 192 ears was 19.17 (SD, 6.09) dB. The presence of stapes superstructure positively affects hearing status. Also, better hearing results were obtained in cholesteatoma cases presented. Recurrences of disease were seen rarely compared with literature. It was revealed that the postoperative outcome of primary canal wall-down tympanoplasty with ossicular chain reconstruction is suitable for safe ear and hearing ear.