Latar belakang: Rinosinusitis dengan infeksi jamur atau disebut juga rinosinusitis jamur adalahinflamasi mukosa sinus paranasal yang disebabkan oleh infeksi jamur. Gejala klinik rinosinusitis jamurmirip dengan rinosinusitis kronis. Apabila rinosinusitis tidak mengalami perbaikan sesudah terapimedikamentosa maksimal, perlu dipikirkan kemungkinan infeksi jamur.Tujuan: Mengetahui proporsikarakteristik penderita rinosinusitis kronis dengan kultur jamur positif.Metode: Penelitian observasionaldeskriptif terhadap 74 kasus rinosinusitis kronis tahun 2013-2015.Hasil: Dari 74 kasus rinosinusitis kronisyang dilakukan tindakan bedah sinus endoskopi fungsional, terdapat 30 positif jamur (40,5%). Dari 30kasus rinosinusitis dengan kultur jamur positif, 60% pada umur 20-40 tahun, 53,3% laki-laki, keluhanutama hidung tersumbat (66,6%). Hasil kultur 50% Aspergillus fumigatus. Uji statistik Fisher Exact Testp>0,05 tidak terdapat perbedaan hasil kultur jamur berdasarkan umur dan jenis kelamin pada penderitarinosinusitis kronis.Kesimpulan: Pada laporan ini penderita rinosinusitis kronis dengan kultur jamurpositif tahun 2013-2015 sebanyak 30 kasus. Rinosinusitis kronis dengan kultur jamur positif terjadi lebihbanyak pada laki-laki dengan rentang usia 20-40 tahun dan keluhan yang ditemukan hampir sama denganrinosinusitis kronis. Beberapa jenis jamur ditemukan pada hasil kultur, tetapi yang terbanyak Aspergilusfumigatus. Secara statistik tidak didapat perbedaan hasil kultur jamur berdasarkan umur dan jenis kelaminpada penderita rinosinusitis kronis. Pemberian antijamur tidak dapat diberikan pada rinosinusitis kronisdengan kultur jamur positif, karena antijamur hanya diindikasikan pada rinosinusitis jamur invasif. Kata kunci: Rinosinusitis kronis, kultur jamur positif, rinosinusitis jamur invasif ABSTRACTBackground: Fungal infection in paranasal sinuses were mostly undetected. The clinical symptomsof fungal rhinosinusitis were very similar to bacterial chronic rhinosinusitis. When maximal medicaltherapy remained unsuccessful, we must consider the possibility of fungal infection. Objective: To findout the characteristic proportion of positive fungal cultures in chronic rhinosinusitis patients. Methods:Descriptive observational study in 74 cases of chronic rhinosinusitis between 2013-2015. Results: From 74cases of chronic rhinosinusitis who underwent FESS, there were 30 positive fungal cultures (40,5%). Fromthese 30 cases, 60% were between 20-40 years old, 53,3% males, with nasal blockage (66,6%) and facialpain (16,7%) as the main complaints. Result of the cultures were 50% Aspergillus fumigatus. StatisticalFisher Exact Test p>0.05 showed that there were no differences in the results of fungal culture based onthe age and sex of patients with chronic rhinosinusitis. Conclusion: In our study, positive fungal culturein chronic rhinosinusitis cases occurred more frequently in 20-40 years of age males, and the clinicalcomplaints were similar to chronic rhinosinusitis. Several types of fungus were found on culture results,mostly were Aspergillus fumigatus. Statistically there were no differences of fungal culture based on ageand sex in chronic rhinosinusitis patients. Antifungal could not be prescribed in chronic rhinosinusitiswith positive fungal culture only. It is indicated only for invasive fungal rhinosinusitis. Keywords: Chronic rhinosinusitis, positive fungal culture, invasive fungal rhinosinusitis
Kokleada dahil olmak üzere mikrodolaşım ve hemodinamik bozukluklar, diyabetli hastalarda yaygın olarak görülür. Diyabetik sıçanlar üzerine yapılan bir çalışma, dıştaki saç hücrelerindeki histopatolojik değişiklikleri, sarmal gangliyon ve kulaktaki mitokondriyal hasarı ortaya koymuştur. Hiperglisemi, protein kinaz C (PKC) aktivasyonunu artırabilir. Bir antioksidan olan kurkumin, PKC ve Ca 2+ düzenini de etkiler. Bu çalışmanın amacı, diyabetik sıçanlarda koklear fibroblastlarda PKC ekspresyonlarının azaltılmasında kurkuminin rolünü öğrenmektir. Gereç ve Yöntemler: Yirmi dört adet Wistar sıçan 6 gruba ayrılmıştır. Grup 1: kontrol grubu; grup 2: kurkumin uygulanmayan diyabetik grup; grup 3 ve 4: kurkumin uygulanan diyabetik gruplar (sırasıyla 3 gün süreyle 200 mg/kg ve 400 mg/kg); grup 5 ve 6: kurkumin uygulaması olan diyabetik gruplar (sırasıyla 8 gün boyunca 200 mg/kg ve 400 mg/kg). Koklear dokular tüm gruplardan alındı ve immünohistokimyasal olarak boyandı ve PKC ekspresyon skorları, tek-yönlü ANOVA (0.05'lik önem derecesi) ile analiz edildi. Bulgular: Grup 1 ile grup 2, grup 2 ve grup 3, 4, 5, 6 arasında PKC ekspresyonlarında önemli farklılıklar bulundu (p<0.05). Farklı dozlar ve kurkuminin uygulama süresi ile ilgili olarak PKC ekspresyonunda önemli bir fark yoktu. Sonuç: Kurkumin, diyabetik sıçanların koklear fibroblastlarındaki PKC ekspresyonlarını azaltabilir.
INTRODUCTION:Microcirculation and hemodynamic disturbances, including in the cochlea, are commonly found in diabetic patients. A study on diabetic rats discovered the histopathological changes in outer hair cells, spiral ganglion and mitochondrial damage in the ear. Hyperglycemia can increase the activation of Protein Kinase C (PKC). Curcumin as an antioxidant also affects the regulation of PKC and Ca2+. The aim of this study is to learn the role of curcumin in decreasing the PKC expressions in the cochlear fibroblasts of diabetic rats. METHODS:An experimental study on 24 Wistar rats divided into 6 groups.Group 1: control group; group 2: diabetic group without curcumin administration; group 3 and 4: diabetic groups with curcumin administration (200 mg/kgbw and 400 mg/kgbw for 3 days, respectively); group 5 and 6: diabetic groups with curcumin administration (200 mg/kgbw and 400 mg/kgbw for 8 days, respectively). Cochlear tissues were taken from all groups and immunohistochemistry-stained, and the PKC expression scores were analysed with One-Way ANOVA (a significance level of 0.05). RESULTS:Significant differences in PKC expressions (p<0.05) were found between group 1 and group 2, group 2 and group 3, 4, 5, 6. There was no significant difference in PKC expression regarding the different doses and the duration of curcumin administration. DISCUSSION AND CONCLUSION: Curcumin can reduce the PKC expressionsin the cochlear fibroblasts of diabetic rats.
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