Radiopacity of Posterior Restorative Materials: A Comparative In Vitro Study

BACKGROUND

The objective was to investigate the radiopacity of 11 commercial posterior restorative materials by establishing their mean gray values (MGVs) and comparing them with dental hard tissues.

METHODS AND MATERIALS

Five-disc specimens were prepared for each of the following materials: Cerasmart 270 CAD/CAM block A3LT (CS), Amalgam (A), Ketac Molar A3 (KM), Cention-N A2 (CN), G-aenial Universal Flo AO2 (GO2) and A2 (G2), Ever-X Flow Dentine (EXD) and Bulk (EXB) shades, Equia Forte HT Fil A2 (EF2) and A3 (EF3), and Equia Fil A3 (E3). Freshly extracted maxillary premolar teeth were used as a control. The MGVs of specimens and a 10-step aluminum stepwedge (Al) were measured with Adobe Photoshop. ANOVA and Dunnett T3 tests were used to assess the significance of the differences (α=0.05).

RESULTS

Statistically significant differences were revealed between some of the groups. Amalgam had the highest radiopacity. The radiopacity of dentin and CS were close to that of 1 mm Al. G2, KM, GO2, EXB, and EXD showed higher mean radiopacity than dentin. Enamel had a radiopacity equivalent to 2 mm Al. CN, EF2, and E3 had higher mean radiopacity than enamel.

CONCLUSIONS

All materials met the ISO requirements. Alkasite and reinforced glass ionomer restoratives demonstrated higher mean radiopacity than the posterior flowable composites. Material shades did not affect the radiopacity.

EFFECTIVENESS OF UNILATERAL ADRENALECTOMY IN BILATERAL ADRENAL INCIDENTALOMA PATIENTS WITH SUBCLINICAL HYPERCORTISOLEMIA

OBJECTIVE

Unilateral adrenalectomy (UA) is an alternative for treatment in bilateral adrenal incidentaloma (AI) to avoid possible long-term risks of bilateral adrenalectomy. In this study, we aimed to evaluate the effectiveness of UA in bilateral AI patients with subclinical hypercortisolemia (SH).

METHOD

A total of 35 patients were included in this study. The patients were divided into two groups; those who underwent UA (n=27) and patients without adrenalectomy (PWA) (n=8). Hormone tests related to cortisol mechanism were reviewed to analyze results at the time of diagnosis compared to the latest available results to figure out any changes in cortisol mechanism and determine whether SH has recovered or not.

RESULTS

Median age of PWA group were higher compared to UA group (p=0.03). Median duration of follow-up in groups were similar (p=0.3). In the PWA group, none of the patients recovered from hypercortisolemia during their follow-up. In UA group 92.6% of the patients went into remission, whereas during follow-up 3.3% had recurred and another 3.3% were found to have post-adrenalectomy persistent SH. Patients in UA group had lower final cortisol level following dexamethasone suppression (p=0.003) and higher final adrenocorticotrophic hormone (ACTH) levels (p=0.001) than patients in PWA group. In UA group, final basal cortisol level (p=0.009) and final cortisol level after 1 mg dexamethasone suppression test (DST) (p=0.004) were lower than corresponding levels at the time of diagnosis.

DISCUSSION

Our study demonstrates unilateral adrenalectomy targeting the side with the larger lesion is an effective approach to reduce excess cortisol levels in bilateral AI patients with SH.

Significant worsening sperm parameters are associated to testicular hypotrophy in patients with a high grade varicocele

OBJECTIVE

To investigate the relationship between testicular volume and semen parameter sin patients with unilateral high grade left varicocele.

MATERIAL AND METHODS

One hundred eighty seven patients who had left high grade varicocele aged 19-to-25 years were included in this study. All patients underwent a standard evaluation, including medical history and physical examination. The percentage testicular volume difference between the right and left testicles was calculated. The patients were divided into the following three groups; Group 1 (n=72) testicular volume difference <10%, testicular volume difference 10%-20% Group 2 (n=74) and testicular volume difference >20% Group 3 (n=41).

RESULTS

The mean age and BMI of the patients were 21.5 years and 23.1kg/m(2), respectively (P=.596, P=.943). The semen parameters and testicular volumes of the three groups were compared. The total motile sperm count, percentage of motile sperm, percentage of normal morphology sperm were found to be lower in Group 3 (P=.011, P=.012, P=.029 respectively). The mean testicular volumes for the left and the right testis were found to be 15.2cm(3) and 17.7cm(3) (P<.001), respectively. No significant difference was found in the right testicular volumes between groups (17.4, 17.7 and 18.1cm(3), P=.573).

CONCLUSIONS

A high grade left testicular varicocele is associated with ipsilateral testicular hypotrophy and parallel to worsened sperm parameters.

Cancer and tuberculosis: case series

Tuberculosis is seen with an increased frequency in cancer patients. Possible reasons of reactivation are thought to be related to chemotherapy and insufficient nutrition together with compromised immune system. The diagnosis of tuberculosis may be missed in cancer patients and may be diagnosed with newly developed radiological and clinical findings during treatment. In this case, tuberculosis should be considered and related diagnostic work up should be completed. Also, PPD test should be applied to cancer patients and if needed isoniazid prophylaxis should be initiated. We present herein 4 cancer patients diagnosed with pulmonary tuberculosis. Two patients suffered from solid malignancies (lung cancer) and 2 from non-solid malignancies (acute myeloid leukemia).

Inhibition of systemic inflammatory response with sodium nitroprusside in open heart surgery

BACKGROUND

A nitric oxide donor, sodium nitroprusside has been reported to reduce the inflammatory response during cardiopulmonary bypass (CPB). To investigate this, a double-blind and prospective study was conducted.

METHODS

Twenty patients with multi vessel coronary disease were randomly chosen to form study (SNP) and control groups. In the SNP group, 0.5 microg/kg/min sodium nitroprusside were administered for 20 min right after the release of the aortic crossclamp. Mac-1 (CD11b/CD18) leukocyte adhesion molecule expressions, interleukin-6 levels were measured from radial artery blood as well as leukocyte and platelet counts in both groups at 6 different time points: a) before anesthesia, b) after heparin administration, c) after aortic crossclamp release, d) after protamine administration, e) 3 hours after the termination of CPB, f) 24 hours after the termination of CPB.

RESULTS

The increase in Mac-1 expressions were not different between the two groups at any time point except the measurements after the administration of protamine. At this time point, Mac-1 expressions were not different between the groups (99.8+/-30.7 vs 134.6+/-95.1%, p=0.076), but higher when compared with the preinduction levels. IL-6 levels for SNP and control groups was 89+/-43 and 215+/-131 pg/dL, respectively (p=0.016) 3 hours after the termination of CPB. Twenty-four hours after the termination of CPB, IL-6 levels were still significantly higher in the control group (47+/-27 vs 111+/-68 pg/dL, p=0.039). Leukocyte and platelet counts were not different at any time point between the groups.

CONCLUSIONS

Systemic inflammatory response in patients undergoing CPB can be reduced to a certain level with sodium nitroprusside, especially the activation of vascular endothelial cells can be inhibited, but activation of leukocytes still takes place.

Associations between human leukocyte antigens and leprosy in the Turkish population

Leprosy is a chronic infection caused by an intracellular microorganism. Genetic predisposition to both disease susceptibility and to host immunological response has been postulated for many years. The aim of this study was to determine whether there is HLA-linked susceptibility to leprosy and its different types. HLA-class I (A, B, C) and II (DR, DQ) antigen frequencies in 80 patients with leprosy (35 borderline lepromatous, 25 lepromatous, 15 borderline tuberculoid, five tuberculoid) were compared with those in 120 healthy individuals. HLA-class I antigens A9, A10, A32, B5, B21, Bw4, Bw6, Cw1, Cw2 and HLA-class II antigens DR9, DR10, DRw52, DQ1, DQ3 were found to be significantly more frequent in patients with leprosy, whereas HLA-class I antigens A3, B44, B49 and HLA-class II antigen DQ5 were so in controls. However, there was no significant difference in HLA-class I and II antigen frequencies between subtypes of leprosy. HLA-A null antigen was found to have weak expression in patients with leprosy. In conclusion, factors other than HLA-class I and class II antigens may have a more critical role in the pathophysiology of leprosy infection in man.

Generation and trapping of a highly strained bicyclic alkyne: tricyclo[6.3.1.0(2,7)]dodeca-2,4,6-trien-9-yne

High-temperature bromination of 10-bromotricyclo[6.3.1.0(2,7)]dodeca-2,4,6,9-tetraene (8) resulted mainly in the formation of two isomeric tribromides (16 and 17) whose dehydrobromination with DBU afforded the corresponding 9,10-dibromotricyclo [6.3.1.0(2,7)] dodeca-2,4,6,9-tetraene (14). Treatment of 14 with tert-butyllithium in THF at -78 degrees C produces the strained bicyclic alkyne (10) which is trapped by 1,3-diphenylisobenzofuran to give two isomeric cycloadducts 12a and 12b. The adducts 12a and 12b were found to readily rearrange to the isomeric ketones 19a and 19b upon chromatography. Upon treatment with potassium tert-butoxide, the adducts 12a and 12b undergo base-catalyzed double bond isomerization to give four products 20-23. Furthermore, reaction of 14 with one and two mole of potassium tert-butoxide has been studied and the mechanism of the product formation is discussed with regard to either an allene or alkyne as a possible intermediate.

Effect of cefodizime on peritoneal mononuclear- and polymorphonuclear-cell chemotaxis

In this study, a third-generation cephalosporin with proposed immunomodulatory properties, cefodizime, was investigated to see if it has any effect on the chemotactic activity of human peritoneal monocyte and polymorphonuclear cell populations ex vivo. Ten continuous ambulatory peritoneal dialysis patients with peritonitis were entered in the study. Monocytes and polymorphonuclear cells were isolated from the patients' peritoneal effluent prior to initiation of any antibiotic therapy. Chemotaxis was measured by the Boyden chamber method before and after 2-hour incubation with cefodizime (200 mg/2L). Following 2-hour incubation with 200 mg/2L cefodizime, monocyte chemotaxis was increased from 36.8 +/- 5.6 microns to 50.2 +/- 6.6 microns (P = 0.0005). A similar increase was observed in polymorphonuclear cells from 42.0 +/- 8.8 microns to 48.7 +/- 10.3 microns (P = 0.02). We conclude that cefodizime acts as a priming agent on peritoneal polymorphonuclear cells, particularly on monocytes, and increases their chemotactic movements.

Attempted Synthesis of a Highly Strained Bicyclic Alkyne: Reaction of 8-Chloro-6,9-Dihydro-5,9-Methano-5h-Benzocycloheptene With Potassium T-Butoxide and an Anomalous Substitution Reaction at a Vinyl System

Treatment of alkene (9) with N- bromosuccinimide gave a mixture of monobromides [(10) and (11)] which were hydrolysed to the corresponding exo alcohol (13). Oxidation of (13) and subsequent hydrogenation of unsaturated ketone (14) afforded the ketone (15). Ketone (15) was treated with PCl5, followed by potassium t- butoxide to give chloro alkene (8b). Reaction of (8b) with potassium t- butoxide resulted in the formation of unexpected allyl ether (18) whose formation mechanism has already been discussed.

Cycloheptatriene Norcaradiene Equilibrium in Dimethyl trans-3,8-Dihydroheptalene-3,8-dicarboxylate

Diels-Alder cycloadditions of dienophiles , such as 4-phenyl-1,2,4-triazoline-3,5-dione, dimethyl acetylenedicarboxylate, dimethyl fumarate , diethyl azodicarboxylate , maleic anhydride, benzyne and p-benzoquinone, to dimethyl trans-3,8-dihydrohexalene-3,8-dicarboxylate (4) have been investigated, and monoaddition products (9)-(16) have been isolated. It has been shown that a second addition to this system occurs only with singlet oxygen and with benzyne. Furthermore, it has been established that the second addition is retarded because of the strain in the cycloheptatriene molecule. The anti bicyclic endoperoxides (21)-(25) formed have been converted, either on heating or in a Co( tpp )- catalysed reaction, into the corresponding bisepoxides (27)-(31).