Evaluation of the effect on the permanent tooth germ and the adjacent teeth by finite element impact analysis in the traumatized primary tooth

BACKGROUND

One of the primary concerns in the paediatric emergencies is traumatic dental injuries.

OBJECTIVE

This study aimed to create trauma in primary teeth and reveal its effects finite element analysis.

DESIGN

Three-dimensional models were created using cone-beam computed tomography images, representing a maxillary primary central incisor. An impact force moving at a speed of 10 m/s was simulated on the labial tooth surface in two directions: buccal and incisal.

RESULTS

The stress and deformation experienced in the adjacent tooth due to the primary tooth were higher than those generated in the permanent tooth. Forces applied in the incisal direction resulted in higher levels of stress and deformation in the permanent tooth germ. The difference between the stress and deformation values in primary teeth in the forces applied in the buccal and incisal directions is 21% and 75%, respectively; in the permanent tooth germ, this difference was 233% and 100%, respectively.

CONCLUSIONS

Based on the findings of this study, it is crucial to thoroughly evaluate not only the affected primary tooth but also the adjacent teeth and the permanent tooth germ in traumatic dental injuries. This comprehensive examination allows for the anticipation and management of potential long-term problems.

Caries-related salivary parameters and oral microbial flora in patients with type 1 diabetes: A meta-analysis

OBJECTIVES

This study aimed to conduct a meta-analysis by synthesising the outcomes of studies that investigated the relationship between type 1 diabetes (T1D) and salivary flow rate (SFR), salivary pH (SpH), salivary buffer capacity (SBC), streptococcus Mutans (SM), and lactobacillus (LB) counts.

MATERIAL AND METHODS

The PRISMA statement guide was followed for the meta-analysis. Electronic databases were searched, and study selection and data collection processes were performed. The risks of bias in individual studies and across studies were assessed. Mean differences (MD) and Odds Ratio (OR) were used to measure the effect estimates in the comparisons.

RESULTS

29 studies were included in the qualitative and quantitative syntheses. Significantly higher SFR (MD = -0.22, CI: -0.26, -0.18; p < 0.001) and SpH (MD = -0.59, CI: -0.81, -0.36; p < 0.001) were observed in the healthy individuals than T1D individuals. No significant difference was observed among groups in terms of SBC (MD = 0.10, CI: -0.46,0.66; p = 0.73). An increased odds ratio of SM counts were observed regarding the T1D (OR = 3.09, 95% CI: 1.16, 8.20; p = 0.02). No association was found between LB counts and T1D (OR = 2.15, 95% CI: 0.38, 11.98; p = 0.38).

CONCLUSIONS

Subjects with T1D have a significantly lesser SFR and SpH than healthy individuals. But no significant difference is available in terms of SBC. Lower SM counts were observed in individuals with T1D, while no association was observed regarding LB counts. The tendency to dental caries is more likely in subjects with T1D due to lower SFR, SpH, and higher SM.

Malignancy Rates of Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance (AUS/FLUS) Cases: A Tertiary Center Study

Aim

To evaluate the malignancy rates of Atypia of undetermined significance /follicular lesion of undetermined significance (AUS/FLUS) cases in the light of clinical and sonographic features.

Material and Methods

The percentage of AUS/FLUS cases, second fine needle aspiration cytology (FNAC) results, cyto-histopathological correlations and risk of malignancy were analyzed.

Results

113 out of 1461 thyroid FNAC samples (7.7%) were diagnosed as AUS/FLUS and included in the study. Seventy three out of 113 cases (64.6 %) underwent repeat biopsies or surgery. From 45 cases repeat biopsies were taken and 28 had thyroidectomy or lobectomy. There was a significant relation between nodule size and underwent surgery or repeat FNAC (p=0.036). Malignancy rate was 24.6% for cases which had any managements. The malignancy rates were higher in AUS/FLUS cases with cytological atypia (28.8%). After surgery the most common malignancy was papillary thyroid carcinoma, followed by follicular carcinoma.

Conclusion

The risk of malignancy of AUS/FLUS cases is quite high because of the heterogeneity of the group. The sub-classification of this category according to cytological or/and architecture atypia may be more useful in predicting malignancy risk. Further larger studies with ancillary techniques including molecular analysis may be more useful in determining the malignancy risk and appropriate management of this heterogeneous category.

Antibacterial characteristics of glass ionomer cements containing antibacterial agents: an in vitro study

PURPOSE

The objective of this study was to evaluate the antibacterial activity (ABA), Vickers microhardness numbers (VHN) and cumulative fluoride-releasing (CFR) patterns of conventional glass ionomer cement (GIC) containing AB agents.

METHODS

Chlorhexidine (CHX), Cetrimide (CT) and Cetylpyridinum Chloride (CPC) were added to the powder and Benzalkonium Chloride (BC) was added to liquid of GIC in concentrations of 1% and served as the experimental group (EG). Antibacterial-free GIC was used a control group (CG).

RESULTS

Compared to the CG, a statistically significantly higher level of ABA was detected at the 1st and 7th day against Streptococcus mutans (SM) and on all days against Lactobacillus casei (LC). The CG had statistically significantly high microhardness values in all time periods compared to the EG. With regard to fluoride ion release, there was no statistical difference between CG and EG at all times. A statistically significant increase was observed in both CG and EG during the 1st day to the 30th day.

CONCLUSION

The results of this in vitro investigation demonstrated that AB agents added to the GIC can exhibit AB effects against SM and LC without seriously damaging the physical and chemical properties of the material.

Investigation the relaxant effects of proton pump ınhibitors and their relaxation mechanism on sheep sphincter of Oddi

Background

Using a relaxant agent before an endoscopic retrograde cholangiopancreatography (ERCP) might reduce complications.

Study Aims

We aimed to investigate the relaxant effects of proton pump inhibitors (PPIs) on sheep sphincter of Oddi (SO) and the mechanisms that might take part in this relaxant effect.

Patients and Methods

The sheep SO was mounted in an organ bath filled with Krebs-Ringer bicarbonate solution under 1.5 g tension and the relaxant effects of PPIs were evaluated in the tissues precontracted by carbachol (10^-6 mol/l). The relaxant responses to the PPIs were tested in the presence of various blockers to enlighten the underlying mechanism by the PPIs.

Results

The PPIs exerted relaxant responses in a concentration-dependent manner in the sheep SO (P < 0.05). Esomeprazole produced the strongest relaxation. The administration of atropine, indomethacin, L-NAME, methylene blue, clotrimazole, glibenclamide, and 4-aminopyridine into the organ baths did not change the relaxations induced by PPIs in vitro (P> 0.05). On the other hand, Ca⁺²-activated potassium channel blocker tetraethylammonium (TEA) reduced the relaxation responses created by PPIs (P < 0.05).

Conclusions

The present study suggests that PPIs create relaxation on SO partially via Ca⁺²-activated potassium channels. PPIs, especially esomeprazole, may be beneficial during the ERCP procedure. Further clinical studies are needed to confirm our results.

The antifungal activity and cytotoxicity of silver containing denture base material

OBJECTIVE

Denture base materials are susceptible to fungal adhesion, which is an important etiological issue in the pathogenesis of denture stomatitis. The purpose of this in vitro study was to evaluate the antifungal activity and cytotoxicity of denture base material containing silver microparticles.

MATERIALS AND METHODS

The polymethyl methacrylate (PMMA) denture base material was used, and silver microparticles were added to the polymer powder in different concentrations by volume (0%, 0.25%, 0.5%, and 1%). Their antifungal activity against Candida albicans was assessed in terms of colony-forming units. PMMA disc specimens containing silver microparticles were eluted with culture medium for 1, 2, and 5 days. The cytotoxicity of the eluates to cultured L929 mouse fibroblast cells was evaluated using a real-time cell analysis (RTCA) system and the 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay.

RESULTS

The antifungal effect against C. albicans increased with the percentage of silver microparticles (P < 0.05). For both tests, both RTCA and the MTT assay, no time- or silver-dependent cytotoxicity of PMMA denture base material containing silver microparticles was observed.

CONCLUSIONS

PMMA denture base material containing silver microparticles have antifungal activity and no cytotoxic effect.

Evaluation of the Internal and Marginal Discrepancies of Co-Cr Metal Copings Prepared via CAD/CAM and Conventional Casting

The aim of this study was to assess the internal and marginal discrepancies of chromium-cobalt (Co/Cr) copings fabricated using different techniques. A typodont molar tooth was prepared and replicated in die stone and scanned. Forty Co-Cr alloy copings were produced using four different production techniques: conventional casting (Cgroup), direct metal laser sintering (DMLS-group), micro-stereolithography/casting combination (μSLA-group), and computer-aided milling (M-group) (n = 10). The internal and marginal discrepancies at various reference points were determined via digital microscopy. Analysis of variance (ANOVA) and Tukey's multiple comparisons tests were used for statistical analysis (p=0.05). The marginal and cervical discrepancies of the C-group were similar to those of the M-group (p⟩0.05) and better than those of the μSLA-group (p⟨0.05). The marginal and internal discrepancies of all groups were within clinically acceptable limits, but further improvements in the μSLA and DMLS techniques may be required prior to clinical implementation.

Preliminary results with non-centrifuged autologous fat graft and percutaneous aponeurotomy for treating Dupuytren's disease

The aim of this study was to describe our experience with treating Dupuytren's disease using needle aponeurotomy and non-centrifuged autologous fat grafting. The study included 17 patients (18 hands). Patients were treated with needle aponeurotomy and non-centrifuged autologous fat graft under general anesthesia. The fat grafts were injected into the surgical area so as to stay in contact with the operated site. An extension splint was used for 1 week postoperatively and the patients received hand therapy for 3 weeks. Before the treatment, the contracture in the proximal interphalangeal and metacarpophalangeal joints was a mean of 45.06 ± 13.44 degrees and 36.56 ± 13.09 degrees, respectively. It was 1.61 ± 1.65 and -0.56 ± 3.78 degrees at 3 months, respectively. The difference between these measurements was statistically significant. The mean follow-up period was 12 months. The results were satisfactory and no complications were observed during the follow-up period. Based on the results of the study, percutaneous aponeurotomy with non-centrifuged autologous fat grafting was found to have significantly beneficial effects in the treatment of Dupuytren's disease.

Is choroidal thickness related with disease activity and joint damage in patient with rheumatoid arthritis

OBJECTIVE

Aim of the study was to evaluate the choroidal thickness (CT) in patients with RA and detect the relation with disease activity and joint damage in patients with rheumatoid arthritisBACKGROUND: Rheumatoid arthritis (RA) is a systemic inflammatory disease associated with various extra-articular organ manifestations including ocular manifestationsMATERIALS AND METHODS: We included 59 eyes of 59 patients with RA and 59 eyes of 59 controls without RA in the study. Subfoveal and perifoveal CT were measured using enhanced depth imaging optic coherence tomography. Disease activity score 28 (DAS 28) and Larsen score were calculated for each patient with RA and compared with measurements of CT.

RESULTS

CT was statistically thinner in patients with RA than controls, at subfoveal CT (p = 0.008), at 500 μm temporal to the fovea (p = 0.004), at 1000 μm temporal to the fovea (p = 0.010), at 1500 μm temporal to the fovea (p = 0.005), at 500 μm nasal to the fovea (p = 0.035). Additionally there was no correlation measurements of CT with disease activity and joint damage.

CONCLUSIONS

Subfoveal and perifoveal CT was significantly thinner in patients with RA than in healthy controls but there was no correlation detected between CT measurements and DAS 28 or Larsen scores (Tab. 5, Ref. 33).

Evaluation of MRI-detected White Matter Changes in Relation to Hemodialysis Duration and Renal Transplantation

Compared to the normal population, renal transplant recipients and end-stage renal disease (ESRD) patients on hemodialysis have a higher incidence of white matter changes (WMC) on brain magnetic resonance imaging (MRI). The lesions appear as focal or patchy areas in the periventricular white matter. Both these patient groups are known to be affected by accelerated atherosclerosis, which produces small-vessel disease. This may lead to thromboembolic complications that cause these white matter lesions. This study retrospectively assessed the frequency of MRI-detected WMC in ESRD patients on hemodialysis and kidney recipients, and correlated the rates with hemodialysis duration and post-transplantation interval. Focal and patchy type lesions were distinguished, and the frequencies of these were studied. Also, in the respective groups, comparisons were made among patients with different hemodialysis durations and post-transplantation intervals. The results showed that specifically focal lesions increase in parallel with hemodialysis duration, but there was no statistical relationship between WMC and post-transplantation interval.

Intralesional treatments for hypertrophic scars: comparison among corticosteroid, 5-fluorouracil and botulinum toxin in rabbit ear hypertrophic scar model

OBJECTIVE

Different treatment modalities have been used either alone, or in combination to achieve an optimum improvement for hypertrophic scars. Intralesional injections of corticosteroids and 5-fluorouracil are among the most commonly used treatments. Recently, botulinum toxin is proposed as a new treatment option. In this study, it is aimed to compare the efficacies of intralesional triamcinolone acetonide, 5-fluorouracil and botulinum toxin-A for hypertrophic scars. In order to minimize the variables affecting scar formation, standardized wounds in rabbit ear hypertrophic scar model was used.

MATERIALS AND METHODS

Four surgical wounds were created on both ears of eight rabbits. Injections to be compared (triamcinolone acetonide, 5-fluorouracil, botulinum toxin-A and control) are administered intralesionally to established scars on day 30. Scars were harvested on day 60 for morphometric analysis including hypertrophic index, fibroblast density, and relative collagen density.

RESULTS

Triamcinolone acetonide and 5-fluorouracil injections decreased hypertrophic indexes significantly compared to botulinum toxin-A and control group. However, only 5-fluorouracil was effective to reduce fibroblast counts significantly. No statistically significant differences were found between the treatment groups in terms of collagen index.

CONCLUSIONS

According to the results of our study, triamcinolone acetonide and 5-fluorouracil are comparatively effective as monotherapy, but botulinum toxin-A was not effective on established hypertrophic scars.

Cytoreductive surgery and perioperative intraperitoneal chemotherapy for gynecological malignancies: a single center experience

INTRODUCTION

The objective of this study was to assess the outcome of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) plus early postoperative intraperitoneal chemotherapy (EPIC) in patients with advanced gynecological malignancies.

MATERIALS AND METHODS

A retrospective series of 51 patients with advanced gynecologic cancer, evaluated between May 2008 to February 2014. Peritoneal Cancer Index (PCI) and Completeness of Cytoreduction (CCR) score were used in the study group. The study group consisted of the cancers of ovarian, fallopian tube, endometrial, and uterine sarcomas.

RESULTS

Mean PCI score of the study group was 18, and the postoperative complications were similar with the literature. Patients were followed in a period of 15 days to 64 months and the mean survival time was 22.8 months. Fifty-two percent of the patients were alive without evidence of the disease and overall one-year survival was found 56%.

CONCLUSIONS

The authors concluded that CRS, HIPEC, EPIC, and peritonectomy are a crucial options in patients with advanced gynecological cancers.

The association between serum YKL-40 levels, mean platelet volume, and c-reactive protein in patients with cellulitis

BACKGROUND

Lower limb cellulitis is an infectious disease that has serious complications unless it is treated.

OBJECTIVES

In this pilot study, we evaluated whether levels of YKL-40, an acute-phase reactant, and mean platelet volume (MPV), which occurs secondary to inflammation in cellulitis, increase compared to healthy subjects. We also aimed to investigate the association between YKL-40 and MPV in the prognosis of the patients.

MATERIAL AND METHODS

A total of 55 patients with cellulitis (23 men and 32 women) and a similar age group of 46 healthy individuals (22 men and 24 women) were included in the study. Cellulitis was diagnosed according to guideline. Serum YKL-40 levels, MPV, C-reactive protein (CRP), and other biochemical values of both groups were compared.

RESULTS

YKL-40 levels (52.2±34.5 ng/mL vs 34.6±18.0 ng/mL, P=0.004), MPV (7.7±1.0 fL vs 6.9±0.7 fL, P<0.001), and CRP (9.5±8.2 mg/dL vs 0.7±0.6 mg/dL, P<0.001) were significantly higher in the patients with cellulitis than the control. The mean recovery time (RT) of the patients was 22.6±6.9 days. We found that YKL-40 (odds ratio [OR] 0.1, confidence interval [Cl] 0.028-0.191, P=0.009) and MPV (OR 2.4, Cl 0.254-4.578, P=0.029) have an independent association with RT.

CONCLUSION

YKL-40 and MPV values were correlated with higher CRP in the cellulitis group than in controls. According to these results, increased YKL-40 and MPV levels might be a prognostic factor for cellulitis in patients.

The association between serum YKL-40 levels, mean platelet volume, and c-reactive protein in patients with cellulitis

BACKGROUND

Lower limb cellulitis is an infectious disease that has serious complications unless it is treated.

OBJECTIVES

In this pilot study, we evaluated whether levels of YKL-40, an acute-phase reactant, and mean platelet volume (MPV), which occurs secondary to inflammation in cellulitis, increase compared to healthy subjects. We also aimed to investigate the association between YKL-40 and MPV in the prognosis of the patients.

MATERIAL AND METHODS

A total of 55 patients with cellulitis (23 men and 32 women) and a similar age group of 46 healthy individuals (22 men and 24 women) were included in the study. Cellulitis was diagnosed according to guideline. Serum YKL-40 levels, MPV, C-reactive protein (CRP), and other biochemical values of both groups were compared.

RESULTS

YKL-40 levels (52.2±34.5 ng/mL vs 34.6±18.0 ng/mL, P=0.004), MPV (7.7±1.0 fL vs 6.9±0.7 fL, P<0.001), and CRP (9.5±8.2 mg/dL vs 0.7±0.6 mg/dL, P<0.001) were significantly higher in the patients with cellulitis than the control. The mean recovery time (RT) of the patients was 22.6±6.9 days. We found that YKL-40 (odds ratio [OR] 0.1, confidence interval [Cl] 0.028-0.191, P=0.009) and MPV (OR 2.4, Cl 0.254-4.578, P=0.029) have an independent association with RT.

CONCLUSION

YKL-40 and MPV values were correlated with higher CRP in the cellulitis group than in controls. According to these results, increased YKL-40 and MPV levels might be a prognostic factor for cellulitis in patients.

Combined usage of estrogen and melatonin restores bladder contractility and reduces kidney and bladder damage in ovariectomized and pinealectomized rat

OBJECTIVE

The incidence of urinary bladder disturbances and renal structural changes and functional decline are found to increase with age.

METHODS

We investigated the effect of melatonin treatment in addition to estrogen replacement therapy in pinealectomized (Px) and ovariectomized (Ovx) rats. 56 female Wistar rats were divided into seven groups, each containing eight animals: Sham, (Ovx), (Px), Px+Ovx, Px+Ovx receiving estrogen (Px+Ovx+E), Px+Ovx receiving melatonin (Px+Ovx+M) and Px+Ovx estrogen and melatonin supplemented (Px+Ovx+EM) group (EM group). We evaluated reduced glutathione (GSH) levels and malondialdehyde (MDA) levels. The mean collagen fiber (CF)/smooth muscle (SM) ratio in the bladder wall and structure of the kidney were examined histolologically. We also recorded response of the bladder contractility to acetylcholine (Ach).

RESULTS

Px and Ovx groups showed statistically significant reductions of antioxidant defenses, impaired Ach-evoked contraction, histological changes compared with the control group. Also, these changes were prominent in Px+Ovx group compared with all other groups. Both estrogen and melatonin reversed these changes however best restoration was observed in the EM group.

CONCLUSIONS

Px performed in addition to Ovx led to a distinct increase in oxidative damage in bladder and renal tissue and deteriorate of the detrussor function. Either estradiol or melatonin replacement alone or in combination prevents significant alterations of tissue histology and bladder contractility following Ovx and Px. Thus, combination treatment appears to be the best method to restore both contractility and histomorphology of bladder and kidney tissues after Ovx and Px (Tab. 3, Fig. 4, Ref. 44).

Effects of omega-3 polyunsaturated fatty acid supplementation on serum fetuin-A levels in type 2 diabetic patients

Fetuin-A is an endogenous inhibitor of the insulin-stimulated insulin receptor tyrosine kinase recently shown that high levels of circulating fetuin-A are associated with insulin resistance in humans suggesting that fetuin-A may represent a novel mechanism involved in the pathophysiology of type 2 diabetes (T2DM). Dietary omega-3 polyunsaturated fatty acids (n-3 PUFAs) are known to reduce triglyceride levels, but their impact on glycemic control are not well known. The aim of this study to determine the effects of omega-3 PUFA supplementation on fetuin-A and glycemic control in patients with type 2 diabetes mellitus. 40 T2DM patients (17 males/23 females; aged 39-65 years) were included in the study. Serum fetuin-A levels and metabolic and biochemical profiles were measured before (baseline) and two months after n-3 PUFA supplementations (1.2 g/day). Serum fetuin-A levels were measured by enzyme-linked immunosorbent assay. Our results indicated that serum fetuin-A, fasting glucose, HbA1c and triglyceride levels were significantly decreased after supplementation (P<0.02, P<0.001, P<0.02 and P<0.01, respectively). At baseline, serum fetuin-A levels were correlated with HbA1c (r:-0.391, P<0.04). A significant positive correlation between fetuin-A and both triglycerides (r: 0.343, P<0.05) and total cholesterol (r: 0.330, P<0.05) and negative correlation between fetuin-A and fasting glucose (r: -0.405, P<0.01) were found after the supplementations. When performed multiply regression analysis, we found that serum fetuin-a levels were related with triglyceride levels (r: 0.351, P<0.01) at baseline and HbA1c levels (r: 0.344, P<0.04) after the supplementation. Based on the results, it thought that omega-3 PUFA intake decreases serum fetuin-A levels and serum fetuin-A is associated with plasma lipids and glycemic controls in type 2 diabetic patients. Further studies are required to resolve the question.

Prevention of ischemia-reperfusion injury in rat ovarian tissue with the on-off method

Ischemia is defined as cell death caused by insufficient perfusion of the tissue due to reduction in arterial or venous blood flow, depletion of cellular energy storages, and accumulation of toxic metabolites. The positive effects of controlled reperfusion are known and are used clinically. But the positive effects of controlled reperfusion on ovarian tissue have not been seen in the literature yet. The biochemical and histopathological comparative investigation of rat ovaries that were experimentally exposed to ischemia (IG), ischemia-reperfusion (I/R), and ischemia-controlled reperfusion (ICR) was aimed. Forty rats were divided into four groups (10 rats per group). First group: 3 h ischemia by vascular clips on ovarian tissue. Second group: 3 h ischemia + 1 h reperfusion. Third group: 3 h ischemia + 1 h controlled reperfusion (on-off method: controlled reperfusion by opening and closing the clips (on/off) in 10-second intervals, for 5 times for a total of 100 seconds). Fourth group: healthy rats. Biochemical (tGSH, MDA, and DNA damage level and SOD activity) and histopathological analysis were performed. The highest glutathione and superoxide dismutase measurements were found in ischemia/controlled reperfusion group among the ischemia or ischemia/reperfusion groups. Similarly the damage indicators (malondialdehyde, DNA damage level and histopathological damage grade) were the lowest in ischemia/controlled reperfusion group. These results indicate that controlled reperfusion can be helpful in minimizing ischemia-reperfusion injury in ovarian tissue exposed to ischemia for various reasons (ovarian torsion, tumor, etc.).

Serum thyroid hormones levels are significantly decreased in septic neonates with poor outcome

The aim of this prospective study was to investigate the effects of thyroid hormone levels on the sepsis criteria and mortality in septic newborns. This study was performed at the Firat University Hospital Neonatal Intensive Care Unit. A group of septic newborns and a control group of healthy non-infected newborns were evaluated. Blood samples were obtained at onset from septic and healthy newborns and at 10th day of the antibiotic therapy from only septic newborns, and thereafter serum total T(3) (TT(3)), total T(4) (TT(4)), and TSH levels were determined. A total of 292 newborns were included in the study. Serum TT(3) levels at onset and at 10th day of the antibiotic therapy were 163.8±63.4 and 178.3±33.1 ng/dl, TT(4) levels were 6.9±2.2 and 11.0±2.6 mg/ml, and TSH levels were 3.8±2.1 and 4.0±2.5 μU/ml, respectively in septic newborns. Serum TT3 levels were 180.3±47.6 ng/dl, TT(4) levels were 10.9±2.3 mg/ml, and TSH levels were 4.1±2.2 μU/ml in healthy newborns. Serum TT(3), TT(4) levels of septic newborns were significantly decreased with respect to those of healthy newborns at onset and serum TT(4) levels was increased significantly after antibiotic therapy. To the best of our knowledge, this report is the first study to compare thyroid hormone levels in a large number of septic newborns and a healthy group. Our findings suggest that before and after treatment of neonatal sepsis a significant change is realized in thyroid hormone levels.

A case with balanced reciprocal translocation t(5;11)(q32;q24.2) and situs inversus viscerum

Situs inversus viscerum is a condition in which the organs of the chest and abdomen are arranged in a perfect mirror image reversal of the normal positioning. The condition is in about 1 in 8,500 people. Although the mechanism that causes the heart loop to go left is not fully understood, it is thought that many factors are involved. Here we report a case with balanced reciprocal translocation and situs inversus viscerum. The case was a 35 year old single person. In the imaging studies, his heart was on the right (dextrocardia), his liver was on the left, and his spleen was on the right. Cytogenetic study showed that the man carried a balanced reciprocal translocation: 46,XY, t(5;11)(q32;q24.2). He had no dysmorphism. He had chronic gastritis and chronic esophageal acid reflux.

Comparison of biomechanical behaviour of maxilla following Le Fort I osteotomy with 2- versus 4-plate fixation using 3D-FEA. Part 1: advancement surgery

The study aimed to calculate the location and intensity of the maximum stress fields on the fixation plates and surrounding maxilla following Le Fort I osteotomies after advancement procedures using three-dimensional finite element analysis. The models were generated using skull CT scan data. Le Fort I osteotomy simulations were made and two separate impacted maxillary models were designed. The ADV-2 model has 2 plate fixations bilaterally at the piriform rims, the ADV-4 model has 4 plate fixations at the zygomatic buttresses and piriform rims. The stress fields on bone, plate and screws were computed for each model. Posterior occlusal loads were simulated on one side in the molar-premolar region, in all three directions, reflecting the chewing forces. The increased locations of highest Von Mises stresses on the plates and highest maximum principle stresses on the bones were determined in ADV-2 models especially under horizontal and oblique loads when compared with ADV-4 models. Evaluation of the highest Von Mises stress values and maximum principal stress revealed that oblique load in the ADV-2 model received the highest values. 4-plate fixation following Le Fort I advancement surgery exerts less stress on the maxillary bones and fixation materials than 2-plate fixation.

Determination of the effect of a single hemodialysis session on retrobulbar blood hemodynamics by color Doppler ultrasonography

BACKGROUND

Retrobulbar hemodynamic alterations can occur during hemodialysis sessions, and patients with chronic renal failure may experience visual problems.

PURPOSE

To evaluate the effect of single-session hemodialysis on retrobulbar vessel hemodynamics by color Doppler ultrasonography.

MATERIAL AND METHODS

Thirty-five patients were included in the study. Retrobulbar blood flows were examined before and after dialysis sessions. Doppler spectral patterns of retrobulbar blood flow were evaluated. The t test for paired samples and the Wilcoxon matched-pairs signed-rank test were used for comparing the flow values before and after dialysis.

RESULTS

Systolic and diastolic blood flow velocities of the ophthalmic artery, central retinal artery, central retinal vein, nasal posterior ciliary artery, and temporal posterior ciliary artery were found to be decreased bilaterally after hemodialysis sessions. No significant change was observed in resistivity index values after hemodialysis sessions.

CONCLUSION

Our findings reveal that retrobulbar circulation was disturbed after a single hemodialysis session.

Raman lasing near 630 nm from stationary glycerol-water microdroplets on a superhydrophobic surface

We demonstrate, for the first time to our knowledge, Raman lasing from stationary microdroplets on a superhydrophobic surface. In the experiments, glycerol-water microdroplets with radii in the 11-15 microm range were pumped at 532 nm with a pulsed, frequency-doubled Nd:YAG laser. Two distinct operation regimes of the microdroplets were observed: cavity-enhanced Raman scattering and Raman lasing. In the latter case, the Raman lasing signal was higher than the background by more than 30 dB. Investigation of the Raman spectra of various glycerol-water mixtures indicates that lasing occurs within the glycerol Raman band. Raman lasing was not sustained; rather, oscillation would occur in temporally separated bursts. Increasing the rate of convective cooling by nitrogen purging improved the lasing performance and reduced the average interburst separation from 2.3 to 0.4 s.

A challenging problem. Vertebral pseudoaneurysm and arteriovenous fistula involving vertebral artery and ipsilateral internal jugular vein due to craniocervical penetrating trauma

SUMMARY

Vertebral pseudoaneurysm and arteriovenous fistulas are very rare and are commonly due to penetrating trauma to craniocervical region. A 20-year-old man was presented with progressive swelling and pulsatile mass on the left side of his face. He had been stabbed two weeks ago on the left side of his face. Doppler Ultrasound revealed large left vertebral pseudoaneursym and arteriovenous fistulisation with the ipsilateral internal jugulat vein. MR Angiography and conventional angiography confirmed arteriovenous fistula between left vertebral artery and ipsilateral internal jugular vein and large pseudoaneurysm formation on vertebral artery. Arteriovenous fistula was closed surgically and embolized with surgicell. But the pseudoaneurysm was treated with endovascular covered stent placement.

Intracranial Lipoma of the Sylvian Fissure: MR and CT Findings

We present the CT and MR features of a rare intracranial lipoma located in the right sylvian fissure in a patient who presented with a five-year history of headache. The lesion was well demonstrated on Fluid Attenuated Inversion Recovery (FLAIR), Turbo Spin Echo (TSE), T1 weighted and fat supressed T2 weighted sequences.

Cardiomyopathy in motor neuron diseases

OBJECTIVE

Myocardial involvement in motor neuron diseases (MND) is an uncommon feature. In amyotrophic lateral sclerosis (ALS) abnormalities of the autonomic nervous system affecting cardiac function have been described, for the hereditary spastic paraplegias (HSP) comparable manifestations are unknown. This study observed ALS and HSP patients with coexisting cardiomyopathy without major cardial risk factors.

METHODS

Four patients with definite ALS and two pHSP patients. In all patients detailed clinical, cardiological, electrophysiological and laboratory data were analysed. In two ALS patients skeletal muscle biopsy was performed.

RESULTS

In all investigated MND patients cardiomyopathy was present. Beside hyperlipoproteinaemia and mild hypertension in one case, none of the patients showed major cardiovascular risk factors. There was no evidence for a secondary cause of cardiomyopathy like coronary heart disease, myocarditis, or mitochondrial damage mimicking MND.

CONCLUSION

This report could not conclude that the occurrence of cardiomyopathy is rare logically. Although an underlying pathophysiological cause was not obvious, it is proposed that in all MND patients a routine cardiological evaluation should be performed.

Inorganic phosphate has a crucial effect on Cry3Aa delta-endotoxin production

AIMS

The study aimed at increasing Cry3Aa delta-endotoxin production by a local isolate of Bacillus thuringiensis (B.t. strain Mm2). To this end, different nutritional conditions were tested for their effects on Cry3Aa yields.

METHODS AND RESULTS

Bacillus thuringiensis Mm2 was grown by shaking at 30 degrees C in different media. Samples were taken from the cultures at intervals and used for protein extraction. SDS-PAGE was performed for toxin analysis. Inclusion of inorganic phosphate (Pi) into the Difco's sporulation medium at an increased level of 200 mmol l-1 caused a fivefold increase (from 3 to 15.6 microg ml-1) in toxin production. Omission of FeSO4 from the medium decreased this yield by half. Resuspension experiments suggested catabolite repression of toxin biosynthesis by glucose. The inclusion of high Pi invariably increased toxin synthesis, even in the absence of sugars.

CONCLUSIONS

Inorganic phosphate had the most striking effect on toxin biosynthesis. Iron effect was found to be unique to our isolate whereas Pi effect seemed to be common to the biosynthesis of Cry3Aa-type toxins. Stimulation of toxin synthesis by Pi did not seem to represent a relief from glucose repression.

SIGNIFICANCE AND IMPACT OF THE STUDY

Bacillus thuringiensis is the most versatile biopesticide for use in pest management. Regarding cost-effectiveness of related fermentations, high Pi supplement drastically increases Coleoptera-specific toxin synthesis.