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A new preservation technique for dehumping the dorsum
(Verduci Publisher, 2023) Azizli, E.; Muluk, N. Bayar; Dundar, R.; Cingi, C.
OBJECTIVE: We aimed to offer a new preservation strategy for dehumping the dorsum by using a variation of the cartilage push- down ( Ishida) technique. PATIENTS AND METHODS: Three hundred patients (42 males and 258 females) had surgical procedures. All procedures were closed- surgery-type, primary-case procedures performed through a closed incision. Low cartilaginous septal strip resection was performed on 269 individuals, whereas high septal strip resection was performed on the remaining 31 patients. The bony cap is shielded as a separate unit and preserved, so protected from any potential damage. The cartilage roof is separated from the bone roof and lowered while wearing the bony cap component. As a result, less concealment is required. However, it is ineffective on dorsal profiles that are sharp or S-shaped, as opposed to flat. Thus, the modified cartilage push-down with bony cap rasping procedure can be carried out. The sharp hump on the bony crown of the skull is smoothed out and filled. Therefore, the bony cap above the central cartilage roof is much thinner. Because the hump is less likely to appear again, concealment is unnecessary. A median of 8.5 months was spent following-up (6-14 months). RESULTS: According to our method, among men (n=42), the hump size ranged from minor (n=5) to medium (n=25) to big (n=12). There were 258 women, 88 of whom had a little hump, 160 had a medium hump, and 10 had a huge hump. Indicative of surgeon satisfaction with low cartilaginous septal strip excision vs. high septal strip resection include the following: with a total of 269 patients, 35 males, and 234 females had low cartilaginous septal strip resections, with 98 and 96% success rates, respectively, for the surgeons. There were 31 patients, seven men and 24 women, who all underwent high septal strip resections, with a 98% and 96% success rate for the surgeons. It was found that there was a correlation between the size of the hump and the level of satisfaction felt by its bearers. Rates of male satisfaction with humps ranged from 100% for little humps to 100% for medium humps to 99% for huge humps. Satisfaction percentages among women ranged from 98% in the case of little humps to 96% among medium humps and 95% among large humps. CONCLUSIONS: O ur t echnique o f m odification of the cartilage push-down (Ishida)1 method is applied for dehumping the dorsum. High satisfaction percentages were obtained from the patients and surgeons. This technique may be a good option for patients who need dehumping.
An evaluation of ketoprofen as an intranasal anti-inflammatory agent
(Verduci Publisher, 2022) Altintas, M.; Muluk, N. Bayar; Sezer, C. Vejselova; Kutlu, H. M.; Cingi, C.
OBJECTIVE: The objective of the study was to evaluate the effect of ketoprofen when locally applied to tissue-cultured nasal epithelium. MATERIALS AND METHODS: Healthy primary nasal epithelial cells were grown in a tissue culture medium. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide) assay was used to evaluate cytotoxicity. Markers of cellular injury revealed by the MTT assay include fragmentation of DNA, condensed nuclei, and changes affecting the cellular outer membrane and cytoskeleton. Epithelial cells at body temperature in cell culture were exposed over a 24- hour period to ketoprofen. Following the MTT assay, the confocal microscopic examination was performed. The extent to which epithelial cells remained capable of proliferating was evaluated by inducing a scratch injury, waiting for the repair to occur, and then examining the result with the ordinary light microscope. RESULTS: Topically applied ketoprofen does not affect the viability of tissue-cultured nasal epithelial cells within a 24-hour period. Furthermore, there were no cellular morphological alterations observed which would indicate toxicity from ketoprofen. In the scratch assay, the cells regained a normal confluent appearance within 24 hours. Thus, ketoprofen neither increases nor alters the rate at which nasal epithelial cells proliferate. CONCLUSIONS: Ketoprofen, when applied topically for 24 hours to nasal epithelial cells in cell culture, does not cause any alterations in cellular appearance which would suggest impairment of the ability to proliferate or indicate a cytotoxic effect. Extrapolating from these results, it appears acceptable to use ketoprofen topically within the nose in cases of rhinosinusitis (acute or chronic) or nasal pain since there is minimal risk of local toxic injury.
An evaluation of the efficacy of indomethacin in experimentally induced acute sinusitis in rats
(Verduci Publisher, 2022) Kurt, Y.; Muluk, N. Bayar; Yildirim, C.; Donmez, D. Burukoglu; Erol, K.; Cingi, C.
OBJECTIVE: We evaluated how efficacious indomethacin, at two different doses, is in the treatment of an experimental model of sinusitis in rats. MATERIALS AND METHODS: Twenty-one Wistar albino rats (all male) were sorted at random into one of three groups: 1(st) group (n=7) was placebo. 2(nd) group (n=7). These rats had sinusitis induced experimentally, following indomethacin 3 mg/kg, 5 days was administered to them. 3(rd) group (n=7). These rats had sinusitis induced experimentally, following indomethacin 6 mg/kg, 5 days was administered to them. The animals' sinonasal mucosae were examined histopathologically by standard light microscopy. RESULTS: Experimental sinusitis was observed in the 2(nd) and 3(rd) groups, but not in the rats administered a placebo. Although the in-flammatory features of sinusitis were found to be significantly decreased in the animals administered indomethacin 3 mg/kg (the 2(nd) group), this anti-inflammatory effect was even greater in the 3(rd) group, where indomethacin 6 mg/kg had been administered. Indomethacin at either dose was superior to placebo in reducing inflammatory features of sinusitis. CONCLUSIONS: Topical use of indomethacin nasal drops decreased the inflammatory features in experimentally induced acute sinusitis. Moreover, a higher dose of indomethacin (6 mg/kg) was more efficacious than a lower dose (3 mg/kg). The present study is valuable as an initial step in showing the need to undertake human trials to see the effect of indomethacin nasal drops on sinusitis in humans. In acute rhinosinusitis, the use of topical anti-inflammatory drops may help to decrease the symptoms and may be used adjunctively with antibiotic treatment.
Assessment of olfactory function by Sniffin' sticks in bakery workers exposed to flour dust
(Verduci Publisher, 2022) Altintas, M.; Kar, M.; Muluk, N. Bayar; Cingi, C.
OBJECTIVE: This study used the Sniffin' Sticks test battery to evaluate olfactory function in employees of a bakery exposed to flour dust. SUBJECTS AND METHODS: The study enrolled 43 individuals with exposure ( i.e., to flour) plus 41 healthy volunteers as controls. Olfactory function was assessed in these subjects through the use of the Sniffin' Sticks test battery. The overall score was calculated by adding up the scores for each of the 12 separate odors. A score of 6 or less was deemed anosmia, from 7 to 10 hyposmia, and a score of 11 or 12 was taken to indicate no impairment of olfaction. RESULTS: There was a statistically significant difference between the scores obtained in the exposure group (10.09 +/- 2.29) and the control group (10.73 +/- 2.07), the exposure group having a lower score (p<0.05). Within the exposure group, men and women did not score differently (p>0.05). Furthermore, in this group, the overall score did not correlate significantly with age, sex, length of employment, or use of tobacco or alcohol use (p>0.05). Using the scheme employed in this study, 9.3% of the exposed workers were anosmic, compared to 9.8% in the controls, whereas 34.9% of baker workers were hyposmic, compared to just 14.6% of the controls. Thus, our study shows that impairment of the ability to smell was present in 44.2% of individuals exposed occupationally to flour dust. CONCLUSIONS: This study reveals that being exposed to flour dust reduces the ability to smell normally. In order to minimize the impact of being exposed, workplaces should ensure adequate ventilation and provide workers with protective facemasks.
Biologics in allergic rhinitis
(Verduci Publisher, 2023) Muluk, Nuray Bayar; Cingi, C.
This paper aims to review biologics in allergic rhinitis (AR). Biologic agents of Omalizumab, Dupilumab, Mepolizumab, Reslizumab, and Benralizumab are reviewed in detail. The search is performed in Pubmed, Google, Google Scholar and EBSCO Academic Search Ultimate (EKUAL) database of Kirikkale University Library from 2021 to 2000, and randomized and/or placebo-controlled studies, review papers, meta-analysis, and reports are taken into consideration. The search was performed with the keywords of allergic rhinitis, biologics, biologic agents, Omalizumab, Dupilumab, Mepolizumab, Reslizumab, Benralizumab, Anti IgE, Anti-IL-4/IL-13, Anti IL-5. Search is also performed in the U.S. Food and Drug Administration (FDA) and European Medicines Agency (EMA) web systems. Biological agents such as monoclonal antibodies (MAb) in treatment are called biological therapy or biotherapy. Omalizumab is a humanized Anti-Ig Emonoclonal antibody. Omalizumab treatment improved the Daily Nasal Rescue Medication Score (DNSSS) and decreased the use of antiallergic drugs in seasonal and perennial AR and rhino-conjunctivitis. Omalizumab is also used in specific immunotherapy patients with allergic rhinitis and reduced allergic reactions associated with allergen immunotherapy, such as anaphylaxis. Dupilumab is an Anti-IL-4/IL-13 biologic agent. Dupilumab treatment significantly improved sino-nasal Outcome Test (SNOT-22) total scores in perennial allergic rhinitis. Anti-IL-5 monoclonal antibodies of Mepolizumab, Reslizumab Benralizumab reduce the number of eosinophils in the blood and tissue, corticosteroid addiction and asthma attacks are reduced, and their use in the treatment of severe eosinophilic asthma has been approved. Biologics, especially Omalizumab, and Dupilumab, may be used more in allergic rhinitis.
Bromelain: a candidate to enhance wound healing after endonasal surgeries
(Verduci Publisher, 2023) Esen, E.; Muluk, Nuray Bayar; Sezer, C. Vejselova; Kutlu, H. M.; Cingi, C.
OBJECTIVE: In the present study, we investigated the topical bromelain's cytotoxic effects on mouse fibroblast NIH/3T3 cells via cell culture study. MATERIALS AND METHODS: In this cell culture study, Dulbecco's Modified Eagle Medium ( DMEM) with fetal bovine serum (FBS, 10%) and penicillin/streptomycin (1%) was used as a cell growth medium for NIH/3T3 mouse fibroblast cells. MTT test was performed in 96-well plates seeded with NIH/3T3 cells 5x103/ well and under standard cell culture conditions. Bromelain doses of 3.13 to 100 mu M were administered to the wells and incubated for 24, 48, and 72 hours in the same cell culture conditions. For Confocal microscopic evaluation, NIH/3T3 cells were plated on cover slips in 6-well plates (105 cells/ well) and treated with 100 mu M concentration of bromelain for 24 h. Untreated cells were used as controls. RESULTS: M TT r esults s howed t hat b romelain is not cytotoxic on mouse fibroblast NIH/3T3 cells. All three incubation times of 24, 48, and 72 hours bromelain initiated cell growth. A statistically significant rise in cell growth was detected in the only applied highest dose of 100 mu M bromelain for all incubation times except for 24 hours. The nontoxic effect was further investigated by using confocal microscopy by applying the highest bromelain dose of 100 mu M to NIH/3T3 mouse fibroblast cells. Confocal micrographs showed that bromelain did not change the morphology of mouse fibroblast cells at the incubation time of 24h. In untreated cells and bromelain-treated cells, the nucleus of NIH/ 3T3 cells was undamaged and compact, and the cytoskeleton was fusiform and non-fragmented. CONCLUSIONS: Bromelain is not cytotoxic on mouse fibroblast NIH/ 3T3 cells and enhances cell growth. If clinical trials will confirm this, it is possible that bromelain will be used topically in humans to enhance wound healing, in rhinosinusitis and chronic rhinosinusitis with nasal polyps and endonasal surgeries due to its anti-inflammatory effects.
Can curcumin modulate allergic rhinitis in rats?
(Cambridge Univ Press, 2016) Acar, M.; Muluk, N. Bayar; Yigitaslan, S.; Cengiz, B. P.; Shojaolsadati, P.; Karimkhani, H.; Cingi, C.
Objectives: This study aimed to explore the effects of curcumin on experimental allergic rhinitis in rats. Methods: Twenty-eight male Wistar albino rats were randomly divided into four groups: a control group; a group in which allergic rhinitis was induced and no treatment given; a group in which allergic rhinitis was induced followed by treatment with azelastine hydrochloride on days 21-28; and a group in which allergic rhinitis was induced followed by treatment with curcumin on days 21-28. Allergy symptoms and histopathological features of the nasal mucosa were examined. Results: The sneezing and nasal congestion scores were higher in the azelastine and curcumin treatment groups than in the control group. Histopathological examination showed focal goblet cell metaplasia on the epithelial surface in the azelastine group. In the curcumin group, there was a decrease in goblet cell metaplasia in the epithelium, decreased inflammatory cell infiltration and vascular proliferation in the lamina propria. Conclusion: Curcumin is an effective treatment for experimentally induced allergic rhinitis in rats.
Caudal septal extension grafts: conchal cartilage or PDS foil-empowered nasal cartilage
(Verduci Publisher, 2023) Kurt, Y.; Oguz, O.; Muluk, N. Bayar; Cingi, C.
We reviewed the potential benefits of conchal cartilage or Polydioxanone (PDS) foil-empowered nasal cartilage as caudal septal extension grafts (CSEGs). Research methods included searching online databases such as Google, Google Scholar, PubMed, and Proquest Central at Kirikkale University. Use terms like caudal septal extension grafts, septal extension grafts, conchal cartilage, and PDS foil-empowered nasal cartilage to find related articles. Due to the anchoring of the lower alar cartilage to the nasal septum, the results of a CSEG rhinoplasty are relatively stable over the long term. They can be adjusted independently by the rhinoplasty surgeon. Over time, the skin and soft tissue envelope contract and a downward force for these grafts develops. It allows for independent regulation of projection and rotation, unlike conventional columellar strut procedures and lateral crural steal techniques. Inadequate cartilage may need conchal or costal cartilage, depending on the application and the need for projection and counter rotation. Costal cartilage transplant outperformed conchal cartilage graft in a rabbit model regarding tip projection and angle relapse rate. Three-patient case series show that PDS foil-enhanced nasal cartilage led to septal cartilage loss. However, other research draws a different result, finding that PDS foil-enhanced nasal cartilage prevented growth inhibition in the developing nasal septum following septoplasty, and reduced late problems in animals. The caudal septal extension grafts should prioritize septum cartilage if it is readily available, of adequate size, and with sufficient strength. If this is not possible, PDS foil-enhanced nasal cartilage fragments or conchal cartilage could be used as a backup. PDS foil will maintain the integrity and stability of the implanted cartilage. Due to its strength, stability, and convenient location, conchal cartilage will serve as the second donor site.
Consensus on methodology of experimental studies in rhinosinusitis - a narrative review
(Verduci Publisher, 2022) Eski, E.; Cingi, C.; Muluk, N. Bayar
Rhinosinusitis is one of the most common diseases today. Among diseases requiring treatment with antibiotics, it is the fifth most common. Acute rhinosinusitis is a significant medical problem that can significantly lower quality of life and can cause a large economic impact on society. Herein, we collected and analyzed data from several published studies regarding sinusitis with the aim of creating a sinusitis model. We included data from 786 studies published between 1996 and 2016 that came up on Google, Pro Quest Central or PubMed using the following keywords (or combinations thereof): sinusitis, rhinosinusitis, experimental, animal, model, rat, rabbit, guinea pig and mice. An appropriate sinusitis model must be established using the correct animal. Thus far, sinusitis models have been published in rats, mice, and rabbits, with rabbits being the most frequently used animal. These animals are used because the anatomy and physiology of their sinuses are very similar to those of humans. While these animals can be used in surgical models, it must be noted that prolonged stress can cause them high mortality rates. Several studies have used strains of Streptococcus pneumoniae to induce rhinosinusitis; however, it has recently been shown that other pathogenic agents can be used for this purpose as well. In this review, we presented several experimental sinusitis models in rats, mice, and rabbits. We hope that by presenting these methods, researchers may be better able to design and perform more useful sinusitis studies.
Could nasal septal deformities type 5 and 6 be a predictive factor of the individual genetic predilection for the onset of an acute coronary syndrome?
(Royal Belgian Soc Ear, Nose, Throat, Head & Neck Surgery, 2016) Caric, T.; Mladina, R.; Cingi, C.; Skitarelic, N.; Raguz, M.; Bergovec, M.; Muluk, N. B.
Objectives: the possible impact of nasal septal deformities (SD) on cardiac pathology has not been well studied, despite growing evidence among data showing that upper airway obstruction has a negative effect on cardiac function in general and a "deviated nasal septum" being considered one of the most frequent factors responsible for impaired nasal breathing. Methods: a retrospective, case-control, double-blind study was performed on 249 patients who survived an acute coronary syndrome (ACS) attack. All patients underwent coronary angiography and were divided into coronary angiography positive (123 pts) and coronary angiography negative (126 pts) groups. The quality of nasal breathing was not considered in this study, but morphological aspects of the nasal septum (nasal septal deformities) were observed by anterior native rhinoscopy and endoscopic examination of the nose following the application of superficial anaesthesia. Mladina classification of nasal septal deformities was used. Results: there was a statistically significant difference between coronary angiography negative and positive patients in Mladina type 1 to Mladina type 7 groups (p=0.000, X-2=54.605). The incidence of nasal SD types 5 and 6 was higher in the group of ACS patients with the positive coronary angiography, whereas general distribution of the particular types of nasal septal deformities as they appear in the general population was found in the coronary angiography negative group. Conclusion: the fact that types 5 and 6 are inherited deformities and not related to trauma against the nose suggests the possible genetic predisposition for the onset of ACS with positive coronary angiography.
Do viral infections have a role in benign paroxysmal positional vertigo?
(Royal Belgian Soc Ear, Nose, Throat, Head & Neck Surgery, 2015) Hanci, D.; Ulusoy, S.; Muluk, N. B.; Cingi, C.
Do viral infections have a role in benign paroxysmal positional vertigo? Objectives: To investigate the role of viral infection in benign paroxysmal positional vertigo (BPPV). Methods: In this retrospective study, 483 patients with BPPV were included in the study group. The control group consisted of 461 healthy subjects. In both groups, serologic analysis of viral agents (HSV1, HSV2, Herpes zoster, EBV, CMV, adenovirus, influenza, and parainfluenza virus) was performed. Results: With the exception of influenza and parainfluenza, all viral serology values were higher in the BBPV group than the control group. We also observed seasonal variation. The BPPV group exhibited elevated values for HSV1 and adenovirus in March and May, for Herpes zoster, adenovirus, and influenza in April, for HSV1 in June, and for HSV1 and CMV in September, compared to the control group. In October, the BPPV group showed increased values for all of the viruses studied, compared to the control group. Conclusion: BPPV is associated with positive viral serology, particularly during certain months of the year, mainly in spring and autumn. Viral infection might promote BPPV attacks due to the development of vestibulopathy or induce secondary BPPV via viral infection-related neurolabyrinthitis.
Effects of ceramide C2 application on human laryngeal carcinoma cells: a cell culture study
(Verduci Publisher, 2023) Oguz, O.; Manole, F.; Muluk, N. Bayar; Sezer, C. Vejselova; Kutlu, H. M.; Cingi, C.
OBJECTIVE: In the present study, we investigated the effects of Ceramide C2 application on human laryngeal carcinoma cells. MATERIALS AND METHODS: Human larynx epidermoid carcinoma HEp-2 (ATCC (R) CCL-23 (TM)) cells were purchased from the American Type Culture Collection (ATCC, USA). Human larynx epidermoid carcinoma HEp-2 cells were cultured in complete Dulbecco's Modified Eagle's Medium (DMEM) supplemented with fetal bovine serum (FBS) (10%) and penicillin/streptomycin (1%) in a CO2 (5%) incubator under standard cell culture conditions. Ceramide C2 was prepared, and further dilutions ranging from 3.13 to 100 mu M were prepared in a fresh culture medium. Cells on 96 well plates were exposed to the prepared concentrations of ceramide C2 for 24 and 48 hours. Cytotoxicity evaluation was performed by MTT. Apoptosis profiles of HEp-2 cells were detected by annexin-V analysis. The activated caspases 3/7 on HEp-2 cells after ceramide C2 exposure were evaluated with flow cytometric analysis. The morphological changes on HEp2 cells caused by ceramide C2 were evaluated by staining with phalloidine and acridine orange via confocal microscopy. For the Wound Healing Assay, HEp-2 cells were cultured in 6 well-plates until they became confluent. RESULTS: MTT cytotoxicity test findings revealed that the viability of human laryngeal carcinoma cells decreased with the increased application of ceramide C2 for 24 hours compared to untreated (control) cells. The highest growth inhibition by ceramide C2 for short-term application for 24 hours was detected at the highest concentration of ceramide C2 (100 mu M). Annexin-V findings showed that 98.97 of HEp-2 cells were alive, and 1.63% were detected as early apoptosis for the control group. The results showed that ceramide C2 triggered apoptosis on HEp-2 cells with a percentage of total apoptotic cells of 61,40 compared to untreated HEp-2 cells. Cysteine proteases (caspases) 3/7 activation percentages of HEp-2 cells exposed to ceramide C2 for 24 hours were compared to control cells, and the morphology of HEp-2 cells was changed with clear apoptotic signs that underlined the cytotoxicity and pro-apoptotic activity of ceramide C2. Scratch Assay assessed the migration capability of HEp-2 cells before and after the exposure to ceramide C2. It showed that ceramide C2 reduced human laryngeal carcinoma cells' migration capability and proliferation for 24 hours. CONCLUSIONS: Based on all study findings, it can be considered that short-chain ceramide C2 exerted cytotoxicity on human laryngeal carcinoma cells in a dose and time-dependent manner and reduced the viability via inducing caspase-dependent apoptosis. The overall effect might be derived from the elevated intracellular ceramide levels by the exogenous application of ceramide C2. Consequently, it was concluded that ceramide C2 has good potential to cause cytotoxicity and apoptosis in human laryngeal carcinoma cells and, after deeper in vitro and in vivo investigations, can be a good candidate for designing anti-cancer drugs with high efficiency.
Efficacy and toxicity of Anatolian propolis on healthy nasal epithelial cells
(Verduci Publisher, 2022) Samanci, A. E. Tanugur; Muluk, N. Bayar; Sezer, C. Vejselova; Kutlu, H. M.; Topsakal, V.; Cingi, C.
OBJECTIVE: In our study we aimed to evaluate the effects of applying propolis topically to epithelial cells of the nasal cells, to discover whether this causes any toxic effect upon the cells. the cells. MATERIALS AND METHODS: Samples of healthy human primary nasal epithelium harvested during septoplasty from volunteers were incubated in cell culture. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assays may be utilized when assessing cellular damage (toxicity), as evidenced by DNA fragmentation, nuclear condensation, alteration in the outer plasma membrane and cytoskeletal alteration. This was the method used in the study. Cultured epithelial cells were incubated with propolis (Bee&You) for 24 hours at 37 degrees C. The MTT assay was then performed, and the cell morphology was examined by confocal microscopy. In addition, via wound healing assay, cellular proliferation was assessed by the artificial scratch method followed by light microscopy. RESULTS: MTT assay results showed that the primary nasal cells were not affected from the topical application of propolis for 24 hours. All of the applied doses not changed significantly the viability of the cells. The agent was not found to cytotoxic to the primary nasal cells in the application time of 24 hours. Our confocal microscopy findings supported the MTT findings. According to the confocal images control cells that were not treated with test agent were with compact morphology and undamaged fusiform cell shape and nucleus. In test group of nasal cells, Propolis found not to be cytotoxic on the cellular morphology and not changed the cells. When evaluating the results from the wound healing assay, the clear area of scratch obtained at the start of incubation (0th) was closed totally with the proliferated primary nasal cells after incubation of 24 hours with propolis. These findings are supported by our MTT findings that imply to the slight induce of proliferation of the primary cells by Propolis. CONCLUSIONS: Topically applied propolis did not have a cytotoxic effect on nasal epithelium cells. Considering its antibacterial and antioxidant effects, it has been concluded that topical application in sinonasal inflammatory diseases (e.g., acute and chronic rhinosinusitis) may have an auxiliary effect in treatment. Moreover, there is a slight induce of proliferation of the primary cells by propolis which may help wound healing in septal surgeries and epistaxis.
Efficacy and toxicity of anise oil as a potential topical wound healer: a cell culture study
(Verduci Publisher, 2023) Sungur, I; Muluk, N. Bayar; Sezer, C. Vejselova; Kutlu, H. M.; Cingi, C.
OBJECTIVE: We studied the cytotoxic effects of topical anise oil on NIH/3T3 fibroblast cells using a cell culture assay. MATERIALS AND METHODS: NIH/3T3 fibroblast cells were grown in Dulbecco's Modified Eagle Medium (DMEM) supplemented with fetal bovine serum (10%) and penicillin/streptomycin under standard cell culture conditions in a humidified incubator containing 5% carbon dioxide. For the MTT cytotoxicity experiment, NIH/3T3 cells were plated in triplicate at a concentration of 3x10(3) per well in 96-well plates and incubated for 24 hours. The cells were treated with anise oil concentrations ranging from 3.13 to 100 mu M, and the plates were cultured for 24, 48, and 72 hours under standard cell culture conditions. For assessment by confocal microscopy, NIH/3T3 cells were seeded on sterilized coverslips in 6-well plates at a concentration of 105 cells per well in triplicate. For 24 hours, cells were treated with 100 mu M of anise oil. Three wells that were not treated with anise oil served as the control group. RESULTS: The MTT findings demonstrated that anise oil is not cytotoxic to NIH/3T3 fibroblast cells. Anise oil stimulated cell growth and triggered cell division at all three incubation intervals of 24, 48, and 72 hours. The maximum growth was obtained in the applied highest concentration of 100 mu M anise oil. At doses of 25, 50, and 100 mu M, there was also a statistically significant improvement in cell viability. At 72 hours of incubation, dosages of 6.25 and 12.5 micro of anise oil were shown to be viability-inducing for NIH/3T3 cells. In the confocal microscopy pictures, it was found that anise oil was not cytotoxic on NIH/ 3T3 cells at the applied maximal dose. The experimental group of NIH/3T3 cells exhibited the same cell morphology as the untreated control group. In both sets of NIH/3T3 cells, the nucleus was round and undamaged, and the cytoskeleton was determined to be compact. CONCLUSIONS: Anise oil is not cytotoxic on NIH/ 3T3 fibroblast cells and initiates cell growth. Anise oil could be used topically to enhance wound healing after surgical procedures if clinical trials will confirm experimental data.
Efficacy of butterbur in allergic rhinitis: a cell culture study
(Verduci Publisher, 2023) Coskun, Z. Ozergin; Muluk, N. Bayar; Cosan, D. Turgut; Cingi, C.
OBJECTIVE: The study aims to define butterbur's impact on nasal cells' viability and proliferation. After topically administering butterbur to the nasal epithelial cells, research has been done to see if butterbur has any harmful effect on the nasal cells. MATERIALS AND METHODS: Specimens of healthy primary nasal epithelium were collected from the subjects and incubated in cell culture in due course of septoplasty. After implementing 2.5 mu M butterbur in cultured cells, cell viability was defined via trypan blue assay, and proliferation was defined via the XTT method. The number of total cells, viability, and proliferation was defined. XTT (2, 3-bis-(2-methoxy-4-nitro-5-sulphophenyl)-2H-tetrazolium-5-carboxanilide) experiments can be used to evaluate cellular toxicity. RESULTS: The findings of the XTT experiment reveal no harm to nasal cells after topical implementation of butterbur. No significant change in the proliferation of the cells, no matter what the doses are. There was no cytotoxic effect on the primary nasal cells at the end of 24 hours of implementation, and no side effects were found. There was no difference in cells' viability between the experimental group with butterbur application and the control group. CONCLUSIONS: Cytotoxicity on nasal cells was not observed after the butterbur application. Even if there have been some indications of liver toxicity, butterbur can be suggested as a safe option for seasonal allergic rhinitis. Further studies related to the toxicity of topical butterbur are also recommended, even though this study indicates no cytotoxicity from the topical application on nasal cells.
Efficacy of traditional herbal formulas on human immunity
(Verduci Publisher, 2023) Cingi, C.; Muluk, N. Bayar; Tezol, A.; Cukurova, I.
In the present study, we reviewed the efficacy of traditional herbal formulas on human immunity. A literature survey was performed in PubMed, UpToDate, Proquest Central Databases of Kirikkale University, Google and Google Scholar databases from the internet. Search key words were immune, immune system, herbal, Pelargonium Sidoides, Echinacea Purpurea, Sambucus Nigra, Beta Glucan, Vitamin C, Zinc. The immune system is a natural self-defense mechanism made up of cells that assist the body in distinguishing between self and non-self-molecules. All immune system components must be regularly modified in order to keep the body defenses up against the ever-evolving microbes that are constantly looking for new ways to attack the host. A Chinese herbal formulation is a combination of several herbs. The practitioner begins with one or two major substances that are intended to treat the ailment. The reproducibility of the efficacy of herbal medicines is dependent on the consistency of the quality of each unique raw herb. Pelargonium Sidoides, Echinacea Purpurea, Sambucus Nigra, Beta Glucan, Vitamin C, and Zinc are some herbal treatments utilized for their benefits on human immunity. Herbal remedies are undoubtedly valuable in boosting impaired immune function, particularly where damage has occurred due to malnutrition, chronic disease or previous infections. At present, however, an invincible immune system remains firmly in the realm of fantasy.
Evaluation of ciprofloxacin used as an intranasal antibiotic
(Verduci Publisher, 2022) Azizli, E.; Muluk, N. Bayar; Sezer, C. Vejselova; Kutlu, H. M.; Cingi, C.
OBJECTIVE: The objective of this research was to examine the effects of topical ciprofloxacin on cultured nasal epithelial cells of human origin. MATERIALS AND METHODS: Human nasal epithelial cells were collected from patients who voluntarily donated tissue left over following septorhinoplasty. The samples were from individuals without any indication of rhinosinusitis. An assay that may be employed to investigate toxic effects at the cellular level is MTT ( 3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide). This test reveals where DNA becomes fragmented, the nuclei condense, the outer cell membrane is altered, or the cytoskeleton appears disrupted. The present study employed this technique. Nasal epithelium in cell culture was exposed to ciprofloxacin for 24 hours at a temperature of 37 degrees C, following which the MTT assay was undertaken before examining the cells by confocal microscopy to look for alterations indicating cytotoxicity. Another test of toxicity, the artificial scratch technique, was also used. Cells treated in this way were assessed using a light microscope. RESULTS: The nasal epithelial cells in culture that were exposed to topical ciprofloxacin for 24 hours were less viable than controls and this result was statistically significant. For this length of exposure, the IC50 was calculated as 1.565 mg/mL. The peak reductions in cellular viability occurred with exposure at a concentration of 1.25 mg/mL and 0.625 mg/mL. These was only a mild decrease in viability at other concentrations, but these results were of statistical significance. The MTT assay and confocal microscopy confirmed this result. Cultured nasal epithelium not exposed to ciprofloxacin (i.e., controls) exhibited a compact morphological appearance when examined with confocal microscopy. The epithelial cells had a regular fusiform boundary, and the nuclei were intact. By contrast, the cultures with exposure to the antibiotic were of decreased size and their outline changed from fusiform to round. The epithelial cells cultures where scratch injury was induced were examined by light microscopy, the extent of closure of the denuded area being assessed after 24 hours. It was noted that the area opened up by the experimental scratch was not closed completely by 24 hours later. This result shows that ciprofloxacin decreases the viability of nasal epithelial cells. CONCLUSIONS: Topical application of ciprofloxacin to the nasal lining is not recommended, since this resulted in decreased cellular viability, cellular shrinking and alteration in outline from fusiform to round in cultured nasal epithelial cells. These changes indicate that topically applied ciprofloxacin is toxic to nasal epithelial cells. The outcomes of this study should be studied and correlated in vivo models.
Evaluation of spiramycin for topical applications: a cell culture study
(Verduci Publisher, 2023) Aghayarov, O. Yagiz; Muluk, N. Bayar; Sezer, C. Vejselova; Kutlu, H. M.; Cingi, C.
OBJECTIVE: Through a cell culture test, we analyzed the cytotoxic effects of topical spiramycin on NIH/3T3 fibroblast cells. MATERIALS AND METHODS: Dulbecco's Modified Eagle Medium (DMEM) supplemented with 10% fetal bovine serum and 1% penicillin/ streptomycin was used for the growth of NIH/3T3 fibroblast cells in a 5% CO 2 incubator. Spiramycin's cytotoxicity was measured using the MTT assay. 5,000 NIH/ 3T3 cells per well of a 96-well plate were seeded in each well, and the cells were treated with spiramycin (3.13-100 mu M) for 24, 48 and 72 hours while the plates were incubated at 37 degrees C in a humidified 5% CO 2 atmosphere. First, 105 NIH/3T3 cells were seeded onto coverslips in 6-well plates for morphological analysis of both untreated and spiramycin-treated cells. For 24 hours, NIH/3T3 cells were exposed to a 100 mu M dosage of spiramycin. The cells in the control group were grown in complete growth media alone. RESULTS: Spiramycin was non- toxic to NIH/3T3 fibroblast cells in a MTT test. The concentration of spiramycin used to stimulate cell growth increased as the concentration was increased. After 24 and 48 hours of treatment with 100 mu M NIH/3T3, the cells showed the most significant increase in size. Cell viability was shown to be significantly reduced at spiramycin doses of 50 and 100 mu M. All MTT findings revealed that spiramycin enhanced cell viability and was not harmful to the fibroblast cells for short-term application of 24 and 48 hours but lowered the viability of fibroblast cells at the doses of 50 and 100 mu M for long-term application duration of 72 hours. Confocal micrographs showed that spiramycin treatment did not affect the cytoskeleton or nucleus of fibroblast cells, in contrast to the control NIH/ 3T3 cells. Both untreated and treated with spiramycin, fibroblast cells were found to be fusiform and compact, with their nuclei remaining unaltered and unreduced in size. CONCLUSIONS: It was concluded that spiramycin has a beneficial effect on fibroblast cells and is safe for use over short periods. Spiramycin reduced fibroblast cell viability when applied for 72 hours. Confocal micrographs showed that fibroblast cell skeletons and nuclei were unharmed and undamaged, that cell shapes were fusiform and compact, and that nuclei were neither broken nor shrunken. Topical spiramycin could be recommended for septorhinoplasty procedures due to anti-inflammatory effects for short-term usage if clinical trials will confirm experimental data.
Facial pain: sinus or not?
(Pacini Editore, 2018) De Corso, E.; Kar, M.; Cantone, E.; Lucidi, D.; Settimi, S.; Mele, D.; Cingi, C.
Facial pain remains a diagnostic and therapeutic challenge for both clinicians and patients. In clinical practice, patients suffering from facial pain generally undergo multiple repeated consultations with different specialists and receive various treatments, including surgery. Many patients, as well as their primary care physicians, mistakenly attribute their pain as being due to rhinosinusitis when this is not the case. It is important to exclude non-sinus-related causes of facial pain before considering sinus surgery to avoid inappropriate treatment. Unfortunately, a significant proportion of patients have persistent facial pain after endoscopic sinus surgery (ESS) due to erroneous considerations on aetiology of facial pain by physicians. It should be taken into account that neurological and sinus diseases may share overlapping symptoms, but they frequently co-exist as comorbidities. The aim of this review was to clarify the diagnostic criteria of facial pain in order to improve discrimination between sinogenic and non-sinogenic facial pain and provide some clinical and diagnostic criteria that may help clinicians in addressing differential diagnosis.
Fillers around the nose
(Verduci Publisher, 2023) Esen, E.; Muluk, N. Bayar; Yagci, T.; Cingi, C.
OBJECTIVE: The aim of this paper is to investigate the efficacy of filler applications which were evaluated in terms of nasal deformity and quality of life of the patients, and to review the fillers around the nose. PATIENTS AND METHODS: Forty patients who underwent filler application were included into the study and were divided into Group 1 ( Deep Radix), Group 2 (Minor irregularities due to rhinoplasty), Group 3 (Shallow dorsum) and Group 4 (Dorsal irregularity). There were 10 patients in each of the groups. In all groups, nasal deformity score was evaluated with a 1 to 5 scale as following: 1- No deformity, 2- Hardly visible deformity, 3- Visible deformity, 4- Moderate deformity, 5- Apparent deformity. Quality of life was evaluated by a 1 to 10 scale, 1 showing very low and 10 showing very high. RESULTS: Our results showed that there were statistically significant improvements (decreased) in nasal deformity evaluation scores after the procedure compared to the before the procedure scores in Group 1 (Deep Radix), Group 3 (Shallow dorsum) and Group 4 (Dorsal irregularity) (p<0.05) However in Group 2 ( Minor irregularities due to rhinoplasty), there were no significant differences between the nasal deformity evaluation scores after and before the procedure (p> 0.05). For nasal deformity evaluation after the procedure, Group 1 (Deep Radix), Group 3 (Shallow dorsum) and Group 4 (Dorsal irregularity) scores were significantly lower (better) than Group 2 (Minor irregularities due to rhinoplasty) scores ( p adjusted < 0.0125). In all four groups (Deep Radix, Minor irregularities due to rhinoplasty, Shallow dorsum, Dorsal irregularity), quality of life scores were significantly improved (increased) after the procedure compared to before the procedure ( p< 0.05). For Quality of life (VAS) before the procedure, Group 3 (Shallow dorsum) scores were significantly higher (improved, increased) than Group 1 (Deep Radix) and Group 4 (Dorsal irregularity) ( p adjusted <0.0125). CONCLUSIONS: Filler applications improved (decreased) nasal deformity evaluation scores and improved (increased) quality of life scores. Fillers can be applied for deep radix, minor irregularities due to rhinoplasty, shallow dorsum and dorsal irregularity. It is essential to choose carefully appropriate materials and procedures for patients to obtain optimum results.

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