Forgotten Topological and Wiener Indices of Prime Ideal Sum Graph of Zn.

BACKGROUND: Chemical graph theory is a sub-branch of mathematical chemistry, assuming each atom of a molecule is a vertex and each bond between atoms as an edge. OBJECTIVE: Owing to this theory, it is possible to avoid the difficulties of chemical analysis because many of the chemical properties of molecules can be determined and analyzed via topological indices. Due to these parameters, it is possible to determine the physicochemical properties, biological activities, environmental behaviours and spectral properties of molecules. Nowadays, studies on the zero divisor graph of Z_n via topological indices is a trending field in spectral graph theory. METHODS: For a commutative ring R with identity, the prime ideal sum graph of R is a graph whose vertices are nonzero proper ideals of R and two distinctvertices I and J are adjacent if and only if I+J is a prime ideal of R. RESULTS: In this study the forgotten topological index and Wiener index of the prime ideal sum graph of Z_n are calculated for n=p^α,pq,p^2 q,p^2 q^2,pqr,p^3 q,p^2 qr,pqrs where p,q,r and s are distinct primes and a Sage math code is developed for designing graph and computing the indices. CONCLUSION: In the light of this study, it is possible to handle the other topological descriptors for computing and developing new algorithms for next studies and to study some spectrum and graph energies of certain finite rings with respect to PIS-graph easily.

Assessment of taste functions in allergic rhinitis patients undergoing allergen-specific immunotherapy.

BACKGROUND: We evaluated taste functions of patients with perennial allergic rhinitis (AR) before and after allergen-specific immunotherapy (AIT). METHODS: The study was designed as a prospective clinical study in our tertiary care hospital. Patients (n = 21) who were diagnosed with perennial AR on the basis of physical examination, skin prick test of at least 3* for HDM allergen and treated with AIT were enrolled in this study. A control group (n = 21) was selected from patients who were given intranasal steroids (INS) for perennial AR. Both groups had self-reported hyposmia and subjective loss of the sense of taste before treatment. Taste strips (Burghart, Wedel, Germany) were used for the taste identification scores before and after 6 months treatment. RESULTS: A total of 42 subjects were included, with a mean age of 24.1 ± 7.9 years (range 15-43 years). Overall, the AIT group showed more of an improvement of taste function, observed in the total average test scores, compared to the INS group (p < 0.05), but no change was detected between the groups before treatment. No difference was found for the bitter taste scores between the study groups (p = 0.053). CONCLUSION: Subcutaneous allergen immunotherapy resulted in more of an improvement in taste function than intranasal steroids. Further studies are needed.

Neck Muscle Mass Index as a Predictor of Post-Laryngectomy Wound Complications.

OBJECTIVE: We investigated the relationship between paravertebral muscle cross-sectional area (PVM CSA) at the third vertebra (C3) level using computerized tomography (CT) neck images and its relationship with complications after total laryngectomy. DESIGN: Retrospective analysis of 60 advanced laryngeal cancer patients who underwent total laryngectomy was performed. The cross-sectional areas of paravertebral neck muscles using neck CT at C3 level images obtained preoperatively were analyzed. RESULTS: A significant difference in PVM CSA between complication and no complication groups, F(1, 53 = 4.319, P = .043), was identified by ANCOVA. There were no significant differences in between-subject effects: T-stage ( F = 1.652, P = .204), body mass index ( F = 0.889, P = .35), albumin ( F = .359, P = .552), age ( F = 1.623 P = .208), and smoking ( F = 4.319, P = .41). CONCLUSION: The PVM CSA measured at C3 level on pretreatment CT may help identify patients at higher risk of postoperative wound complications after total laryngectomy and who may particularly benefit from preoperative optimization of nutritional status.

Effects of systemic immunotherapy on olfactory function in allergic rhinitis patients.

OBJECTIVE: Allergic rhinitis (AR), a chronic inflammatory disorder of the nasal mucosa, affects approximately 20% of the world's population and often causes olfactory dysfunction. Conventional treatments cannot cure it, but only alleviate and control the symptoms. Systemic immunotherapy (SIT) is the only curative treatment for AR, but its positive effect on olfactory function has not been quantitatively demonstrated. We measured the olfactory function in patients using a "Sniffin' Sticks" test and analyzed the effects of subcutaneous SIT. METHODS: The study included 12 patients (aged 13-44 years) who were eligible to receive subcutaneous SIT to treat AR between 2010 and 2012 in the Department of Otolaryngology, Sisli Etfal Training and Research Hospital. A 3-step Sniffin' Sticks test was performed before and 18 months after subcutaneous SIT. The data collected before and after treatment were compared for each patient. RESULTS: The average scores for smell test parameters increased after treatment. Although improvements in the mean threshold, mean discrimination, and mean total scores were not significant, the mean identification score was significantly improved after treatment (P < 0.05). Age, sex, and smoking were not significantly related to the changes in the parameters. CONCLUSIONS: Subcutaneous SIT improved the olfactory performance in AR patients. Additional studies with larger patient populations and longer follow-up periods are needed to establish subcutaneous SIT as an effective treatment for olfactory disorders in these patients.

Reliability of preoperative multidetector computed tomography scan in patients with chronic otitis media.

OBJECTIVE: The objectives of this study were to specify the objective criteria of existence of cholesteatoma in chronic otitis media on the preoperative multidetector computed tomography (MDCT) and to evaluate the complications of disease. METHODS: We compared the results of preoperative MDCT scan with intraoperative findings in 71 patients (22 women, 49 men; mean age, 16-73 years) who had mastoidectomy operation between January 2008 and May 2012. Multidetector computed tomography evaluations of temporal bone were performed on a workstation using high-spatial-resolution magnified images with intended angle and plane. RESULTS: We observed cholesteatoma formation in all patients with scutum erosion (n = 11), dural exposure (n = 6), and lateral semicircular canal fistula (n = 5). Computed tomography revealed these findings with 100% sensitivity. Distortion of ossicular integrity (n = 11) and facial canal dehiscence (n = 5) was significantly higher in cholesteatoma patients. Using the criteria of osteolysis, the sensitivity, specificity, and the accuracy rates of MDCT in detecting cholesteatoma were 71%, 93%, and 88%, respectively. The best diagnostic clue of a cholesteatoma was a mass-like soft tissue located in a retraction pocket in the posterosuperior quadrant of the Shrapnell membrane, causing widening of Prussak space and scutum erosion. Evaluation of computed tomography scan showed nearly 100% sensitivity in detecting tympanic opacification, dural height, dehiscence of lateral semicircular canal, tegmen tympani erosion, and deformation of malleoincudal articulation. However, its contribution to detecting minor ossicular erosion, facial canal dehiscence, and incudostapedial joint evaluation was limited. CONCLUSIONS: Preoperative assessment of chronic otitis media via MDCT with intended angle and plane produces important guidance to understand the extent of disease and to prevent possible intraoperative complications.

Effects of radiofrequency and intranasal steroid treatments on respiratory and olfactory functions in nasal obstruction.

OBJECTIVE: This study aimed to compare the effectiveness of radiofrequency ablation (RFA) and intranasal steroid (INS) treatments on respiratory and olfactory functions in patients with inferior concha hypertrophy and chronic nasal obstruction. STUDY DESIGN AND SETTING: This was a prospective clinical trial performed at a tertiary referral center. METHODS: We assessed patients with nasal obstruction between July 2011 and February 2012. The severity of the nasal obstruction in both groups was determined before treatment and 3 months after using a visual analog scale. For the purpose of an objective test, assessment was performed by the acoustic rhinometry. Using Sniffin' Sticks for test odor identification, the discrimination and thresholds were assessed in both groups. RESULTS: The visual analog scale score after treatment was significantly lower in each group. Radiofrequency ablation treatment significantly improved the right minimal cross-sectional area 1 (MCA1), mean MCA1, and volume 1, as well as the right MCA2, mean MCA2, volume 2, and total volume. In the INS group, improvement was detected for the left MCA1, mean MCA1, and volume 1. Minimal cross-sectional area 2, volume 2, and total volume improved significantly after RFA treatment, but not after INS treatment. CONCLUSIONS: Although RFA may be more effective in the posterior region of the nasal cavity, INS and RFA used in the treatment of inferior concha hypertrophy both had favorable effects on respiratory function. Intranasal steroid treatment provided improved discrimination and total score values, whereas RFA treatment improved only odor identification.

Is there a relationship between subjective pulsatile tinnitus and petrous bone pneumatization?

Our objective was to evaluate the relationship between subjective pulsatile tinnitus and petrous bone pneumatization. Twenty-five patients admitted between January 2012 and March 2012 were assessed. The control group data were obtained by assessment of petrous bone images of 25 cases in which paranasal sinus computed tomography (CT) was performed because of chronic sinusitis and in which no ear pathology was present. Temporal bone CT images of patients with subjective pulsatile tinnitus were compared with those of patients with no ear complaints. The presence of petrous bone pneumatization was evaluated by CT. Subjective pulsatile tinnitus complaints were present for 32 of 50 ears. Pneumatization was detected in the petrous bone of 22 (68.8%) of 32 ears with subjective pulsatile tinnitus. In the control group, 25 patients (50 ears) with no ear complaints were assessed. Petrous bone pneumatization was detected in 12 (24%) of 50 ears comprising the control group. There was a statistically significant difference between the 2 groups (P = 0.000 < 0.001). Petrous bone pneumatization might be the cause of the subjective pulsatile tinnitus.

Using dynamic maneuvers in the computed tomography/magnetic resonance assessment of lesions of the head and neck.

Despite advances in technology, the radiologic assessment of certain head and neck lesions may still pose difficulties because of the complex anatomy of this region, the small and mobile structures that this region harbors, and the apposition of mucosal surfaces in the neutral position. Certain maneuvers have been described in the literature to overcome these difficulties. We review the use of the Valsalva and the modified Valsalva maneuver, the puffed-cheek technique, phonation, and inspiration, with possible applications in head and neck imaging.

Is the tragal cartilage necessary for type 1 tympanoplasties?

The use of cartilage grafts in tympanoplasties is recommended in cases with a higher probability of failure. Many grafting techniques have been reported, including palisade, cartilage island, and cartilage shield grafts. Cartilage minimizes the inflammatory tissue reaction, ensures resistance against infection during the recovery process, and provides good support against the retraction by virtue of its rigidity.This study compared the anatomic and functional results of conchal cartilage, tragal cartilage, and temporal muscle fascia grafts in primary type 1 tympanoplasty. Between January 2007 and January 2011, 79 patients with subtotal dry tympanic membrane perforation and an intact ossicular chain underwent primary type 1 tympanoplasty in our clinic. The postoperative perforation closure ratios, air and bone pure tone averages, and mean air-bone gap (ABG) in the 3 groups were compared with the preoperative values. The improvement in the mean ABG was assessed.The perforation closure ratio was 80.6%, 100%, and 88.5% in the muscle fascia, conchal cartilage, and tragal cartilage groups, respectively, and the mean increase in the ABG was 5.7, 8.9, and 9.7 dB, respectively.The island graft with cartilage perichondrium, which has recently become popular, can be also used in type 1 tympanoplasty. Because it does not require a second incision, conchal cartilage can be used routinely in tympanoplasties performed via a postauricular approach.

[Minimally invasive video-assisted thyroidectomy for treatment of benign thyroid nodules]. / Benign tiroid nodüllerinin tedavisinde minimal invaziv video yardimli tiroidektomi.

OBJECTIVES: This study aims to evaluate patients who underwent minimally invasive video-assisted thyroidectomy (MIVAT) and to discuss the advantages and disadvantages of this technique in the light of literature data. PATIENTS AND METHODS: Between May 2008 and February 2009, 20 patients (18 females, 2 males; mean age 44.5±13.6 years; range 23 to 68 years) who underwent MIVAT using a 4 mm and 30° rigid endoscope and ultrasonic scalpel for dissected the main thyroid vessels were included in the study. Inclusion criteria were benign thyroid nodules of <30 mm and ultrasonographically thyroid volume of <20 ml. RESULTS: The mean length of incision was 2.6±0.5 cm, the mean operation time was 111.7±39.7 min and the mean amount of bleeding was 82.8±84.1 cc. A statistically significantly positive relationship was found between the operation time and the nodule size and the amount of bleeding and also between the length of the incision and cosmetic satisfaction scale scores (p<0.05). However, no statistically significant correlation was found between the operation time and postoperative pain and between the length of incision and postoperative pain (p>0.05). Although 30% of the patients had mild to moderate pain, 50% had moderate pain and 20% had severe pain in the early postoperative period, no patient had pain in the postoperative third day. No postoperative persistent vocal cord paralysis was observed in the patients. CONCLUSION: Minimally invasive video-assisted thyroidectomy is a safe and useful approach in the treatment of the patients with benign thyroid nodules.

Does the open rhinoplasty incision decrease nasal projection?

To evaluate the effects of open rhinoplasty incisions on tip projection using digitized photographs. Thirty-one patients, who underwent open technique rhinoplasty were prospectively included in the study. The lateral aspect photographs were taken before the operations. Following midcolumellar incision septal elevation was done until septal cartilage was shown. After replacing the skin totally back and suturing midcolumellar incision, the intraoperative photographs were taken. The projection indexes were measured by Goode method from the photographs and the measurements were compared. A statistically significant decline of the nasal projection was established after open technique approach. Open rhinoplasty approach led to the decrease of the nasal tip projection. This result was thought to be the effect of ligamentous disruption.

Effect of the use of dry (rigid) or wet (soft) temporal fascia graft on tympanoplasty.

OBJECTIVE: The aim of this study was to research the advantages and disadvantages of using a wet or dry temporalis fascia graft in myringoplasty surgery. STUDY DESIGN: Randomized prospective study. SETTING: Teaching and research hospital. METHODS: Dry graft was used in 210 cases, and wet graft was used in 174 cases in 384 patients who underwent tympanoplasty. OUTCOMES MEASURES: (1) Rate of primary closure of perforation, (2) rate of recurrent and residual perforation, (3) difference in hearing improvement between the two groups, (4) total operation time and graft placement time, and (5) histologic properties of wet and dry fascia grafts. RESULTS: The success rate was 91.4% (159 of 174) in the wet graft group and 88.6% (186 of 210) in the dry graft group. There were no differences between groups regarding recurrent disease, residual disease, and postoperative hearing results (p > .05). The mean operation time and graft placement time were shorter in group 2 (wet graft), and this difference was found to be statistically significant (p < .01). Histologically, the number of fibroblast nuclei was higher in group 2 (wet graft), and this was statistically significant (p < .01). CONCLUSION: The temporal fascia graft has a high success rate regardless of its use, either wet or dry. Using wet grafts can shorten the operation time and result in a high number of fibroblast nuclei histologically.

Thyroid dysfunction after combined therapy for laryngeal cancer: a prospective study.

OBJECTIVE: The purpose of this study was to assess the incidence of the thyroid dysfunction in a group of patients treated with laryngectomy and radiotherapy for larynx cancer and to analyze the risk factors related to the development of hypothyroidism. STUDY DESIGN: This was a prospective study conducted in a tertiary center hospital. SUBJECTS AND METHODS: Thyroid function tests have been applied to 75 patients treated with surgery and radiotherapy preoperatively, before radiotherapy, and postoperatively. Risk factors have been analyzed by carrying out a multivariate analysis. RESULTS: All the patients were men with the mean age of 59.4 and an average follow-up of 28.6 months. The incidence of hypothyroidism was 49.3 percent. The average time to detection of hypothyroidism was 6 months after the completion of treatment. Radiotherapy dose, type of laryngectomy, extent of neck dissection, implementation of thyroid lobectomy, and presence of thyroiditis in specimens were risk factors for thyroid dysfunction. CONCLUSIONS: It is important to check the thyroid function periodically in these patients especially with risk factor to obtain early diagnosis and appropriate treatment.

Assessment of long- and short-term neurotoxic effects of glass ionomer bone cement by electromyography and histopathologic examination: experimental study.

OBJECTIVE: The objective of this study was to investigate the possible neurotoxic effects of bone cement on the peripheral nerves. STUDY DESIGN: Experimental study. SETTING: Teaching and research hospital. METHODS: Twenty New Zealand rabbits were included in this study. The sciatic nerves of both legs of the 10 rabbits were exposed surgically under general anesthesia and closed primarily without any intervention and constituted the control group (group 1). Following surgical exploration, glass ionomer cement (GIC) was applied to the left sciatic nerves of the 10 rabbits for 10 seconds and then aspirated (group 2). GIC material was also applied to the right sciatic nerves of these rabbits but without aspiration (group 3). OUTCOME MEASURES: All rabbits were sacrificed at the end of 8 weeks postoperatively following electromyographic investigation. The sections were stained with hematoxylin-eosin and Immune Olig 2 staining technique for histopathologic examination under light microscopy. RESULTS: There was no statistically significant difference in distal latency, which indicates the conduction speed of the nerve, between all groups by electromyography. Histopathologic examination of all specimens revealed no demyelinization or axonal degeneration, and all had an intact myelin structure. There was no statistically significant difference in inflammation of the specimens between groups. (p>.05). CONCLUSION: GIC has no neurotoxic effects on the nerves in short- and long-term applications.

Arteriovenous malformation of the nasopharynx: a case report.

Arteriovenous malformation (AVM) of the head and neck is a rare vascular anomaly but when present is persistent and progressive in nature and can represent itself truly as a lethal benign disease. We present here an unusual case of an AVM with the size of 1.5 cm x 0.8 cm at the adenoid tissue found in an 8-year-old boy, which is not previously reported in the literature where we treated the patient with surgery alone. Although bleeding is a common presentation with vascular malformations, we have not seen any bleeding in our case. After the surgery, paranasal sinus and neck CT were undertaken. They showed no other AVM.