Comparison of the Surface Properties of 3D-printed Permanent Restorative Resins and Resin-based CAD/CAM Blocks.

OBJECTIVE: This study aimed to investigate the surface roughness, microhardness, and color changes of resin-based computer-aided design/computer-aided manufacturing (CAD/CAM) blocks and 3D-printed permanent resins in different beverages. METHODS AND MATERIALS: Resin-based CAD/CAM blocks (Cerasmart 270 and Grandio Blocs) and 3D-printed permanent restorative resins (Crowntec and Permanent Crown) were used in this study. A total of 96 specimens were prepared from CAD/CAM blocks and 3D-printed permanent resins. The initial surface roughness, microhardness, and shade value of the specimens were measured. Then, the specimens prepared from each material were divided into three subgroups (n=8) and immersed in tea, coffee, and distilled water for 30 days. After the specimens were immersed in the beverages, the surface roughness, microhardness, and tone values were measured again. The data were statistically analyzed using a two-way analysis of variance test (p<0.05). RESULTS: No statistically significant difference was found in the surface roughness values of the resin-based CAD/CAM blocks and 3D-printed resins (p<0.05). Resin-based CAD/CAM blocks showed statistically significantly higher microhardness than 3D-printed permanent resins (p<0.05). Although the color changes in 3D-printed resins in tea and coffee were similar to those in resin-based CAD/CAM blocks on the first and seventh days, more color changes appeared in the 3D-printed resins after 30 days. The surface roughness and microhardness values of the specimens submerged in tea, coffee, and distilled water showed no statistically significant changes (p<0.05). CONCLUSIONS: Although the surface roughness of 3D-printed permanent resins was similar to that of resin-based CAD/CAM blocks, they had a lower microhardness value. Moreover, 3D-printed permanent resins showed more color changes in tea and coffee.

Resistance of Single-shade Composites to Discoloration.

The aim of this study was to examine the color change of single-shade resin composites, which can be used for all tooth shades. In this study, samples were prepared using resin composites with single-shade (Omnichroma, Vitra Unique) and multishade composite systems (G-aenial A'Chord, Clearfil Majesty ES-2 Premium). The initial color values were measured with a spectrophotometer. Then, samples were kept in wine, coffee, black tea, and distilled water and color measurements were made after days 1, 7, and 30. Color change (ΔE00) and whiteness index (WID) values were statistically analyzed using a one-way analysis of variance (ANOVA) test (α=0.05). Single-shade resin composites showed more color change from wine, coffee, and black tea than multishade resin composites (p<0.001). Single-shade composites have a greater discoloration potential. Single-shade resin composites may show more color change from beverages than multishade resin composites, which may negatively affect clinical success.

Evaluation of the cytotoxicity of contemporary glass-ionomer cements on mouse fibroblasts and human dental pulp cells.

PURPOSE: This study aimed to evaluate the cytotoxic effects of different types of contemporary GICs on human dental pulp cell (hDPCs) and mouse fibroblast (L929) cultures. METHODS: Three high-viscosity GICs (HVGIC; GC Equia Forte, Riva Self Cure, IonoStar Plus), three resin-modified GICs (RMGIC; Photac Fil, Riva Light Cure, Ionolux), and a metal-reinforced GIC (MRGIC; Riva Silver) were investigated. Twelve disc-shaped specimens of each material were prepared and stored in Dulbecco's modified Eagle medium (DMEM). L929 fibroblasts and DPCs were then cultured in 96-well plates. Uncultured DMEM was used as a negative control. Mitochondrial dehydrogenase activity (MTT) assays were performed to detect cell viability after 24, 48, and 72 h. Data were analysed using Mann-Whitney U and Friedman tests followed by a Bonferroni-corrected Wilcoxon signed rank test, with the statistical significance set at P < 0.05. RESULTS: Toxicity levels varied between the cell-culture systems. MTT assays of L929 cells showed significant differences in percentages of viable cells, as follows: Riva Self Cure = Riva Silver > GC Equia Forte > IonoStar Plus = Riva Light Cure = Photac Fil > Ionolux. MTT assays of DPCs showed the percentages of viable cells to be significantly lower for the Ionolux group when compared to the other GICs, which did not differ significantly from one another. With the exception of Ionolux, none of the other GICs tested showed any toxicity, and in fact, they all induced cell proliferation (> 100% cell viability). CONCLUSIONS: Although the degree of toxicity varied between the two cell-culture systems investigated, all the GICs tested, with the exception of Ionolux, performed favorably with regard to cytotoxicity (> 100% cell viability in both cell systems).

Female university students' knowledge and practice of breast self-examination in Turkey.

BACKGROUND: Breast cancer keeps its importance as an important health problem in developing countries like Turkey. Therefore, breast cancer screening and early diagnosis are more important for these countries. Although there are debates about breast self- examination, it is still involved in breast cancer screening programs in many countries. AIM: This study aimed to determine university students' knowledge and practice of Breast Self-Examination (BSE). MATERIALS AND METHODS: The study universe consisted of all the female students studying at a public university. Sample size of 161 was calculated for a predicted event frequency. The research data were collected using a questionnaire. RESULTS: A total of 73.3% of the subjects students had heard about BSE. Only half of these students had obtained additional information about BSE. While half of the students indicated that they did perform BSE, 33.3% reported doing so at regular intervals. The majority of the students were aware of BSE and its purpose. Only about half stated, however, that they practice it. Those who practiced BSE were not knowledgeable about how and when to perform it. CONCLUSIONS: In developing countries, to have adequate knowledge of BSE of young women and to do BSE, it is important to develop a consciousness of breast health and an awareness of breast cancer at this age.

Cutaneous drug reactions to antiepileptic drugs and relation with HLA alleles in the Turkish population.

Summary: Background and objective. Many studies have shown associations between HLAB*15:02, HLA-A*31:01 and carbamazepine (CBZ)-induced delayed cutaneous hypersensitivity reactions. The aim of this study is to evaluate a possible association between delayed cutaneous reactions to antiepileptic drugs (AEDs) and certain HLA-A and HLA-B alleles in the Turkish population. Methods. The study consisted of 3 groups: Group I (reactive group) included the patients who had documented delayed cutaneous reactions to any antiepileptic drug. Group II (non-reactive group) included the patients who have been on antiepileptic treatment at least for three months without any adverse reactions. Group III consisted of healthy subjects. The HLA-A and B alleles were analyzed in all groups. Results. Forty patients (29 female) had experienced different hypersensitivity reactions due to AEDs: maculopapular exanthema (26 patients), Stevens-Johnson syndrome (6 patients), drug rash with eosinophilia and systemic symptoms (7 patients), toxic epidermal necrolysis (1 patient). Lamotrigine (11) and CBZ (10) were the most common culprit drugs involved in the reactions. The HLA-B*15:02 was not present in any of the study groups. However, HLA-B*35:02 was found in 4 patients from the reactive group, while it was not observed in non-reactive patients and was detected in only one healthy subject (p = 0.021). Conclusion. Although our preliminary results did not indicate a strong allele association with AED hypersensitivity, HLA-B*35:02 appears to be a candidate allele for MPE / DRESS / DIHSS induced by AED's in Turkish population. Further studies with a larger sample size may result in more comprehensive data about the genetic tendency for AED hypersensitivity in the Turkish population.

eNOS and XRCC4 VNTR variants contribute to formation of nicotine dependence and/or schizophrenia.

BACKGROUND: This study aimed to evaluate whether VNTR variants in the Endothelial Nitric Oxide Synthase (eNOS) and the XRCC4 gene play any role in nicotine dependence (ND) and/or Schizophrenia+ND (Sch+ND) ethiopathogenesis. METHODS: Present study included 100 individuals with ND, 60 patients with Sch+ND, and 70 healthy controls. These variants were analyzed using PCR. RESULTS: The cases with ND had higher eNOS VNTR-BB genotype than the healthy control subjects (p = 0.001). eNOS-AA genotype was lower in cases with Sch+ND and ND groups compared to the controls (p = 0.001, p = 0.001, respectively). eNOS-B allele was found significantly more frequently in Sch+ND group compared to the controls (p = 0.001). eNOS-A allele was significantly lower in ND group than the controls (p = 0.001). XRCC4-ID genotype was more common in the ND group than the control group (p = 0.001) as heterozygosity disadvantage. XRCC4-DD genotype was more common in the Sch+ND group compared to the controls (p = 0.035). The frequency of XRCC4-I allele was lower in the Sch+ND group compared to the controls (p = 0.012). CONCLUSIONS: Our results showed that eNOS and XRCC4 VNTR variants might play a potential role in Sch+ND and/or ND pathophysiology (Tab. 2, Ref. 48).

Monitoring and assessment of heavy metal contamination in a constructed wetland in Shaoguan (Guangdong Province, China): bioaccumulation of Pb, Zn, Cu and Cd in aquatic and terrestrial components.

The objective of this study is to evaluate the current status of heavy metal concentrations in constructed wetland, Shaoguan (Guangdong, China). Sediments, three wetland plants (Typha latifolia, Phragmites australis, and Cyperus malaccensis), and six freshwater fish species [Carassius auratus (Goldfish), Cirrhinus molitorella (Mud carp), Ctenopharyngodon idellus (Grass carp), Cyprinus carpio (Wild common carp), Nicholsicypris normalis (Mandarin fish), Sarcocheilichthys kiangsiensis (Minnows)] in a constructed wetland in Shaoguan were collected and analyzed for their heavy metal compositions. Levels of Pb, Zn, Cu, and Cd in sediments exceeded approximately 532, 285, 11, and 66 times of the Dutch Intervention value. From the current study, the concentrations of Pb and Zn in three plants were generally high, especially in root tissues. For fish, concentrations of all studied metals in whole body of N. mormalis were the highest among all the fishes investigated (Pb 113.4 mg/kg, dw; Zn 183.1 mg/kg, dw; Cu 19.41 mg/kg, dw; 0.846 mg/kg, dw). Heavy metal accumulation in different ecological compartments was analyzed by principle component analysis (PCA), and there is one majority of grouped heavy metals concentration as similar in composition of ecological compartment, with the Cd concentration quite dissimilar. In relation to future prospect, phytoremediation technology for enhanced heavy metal accumulation by constructed wetland is still in early stage and needs more attention in gene manipulation area.

Approach to the Porta Hepatis During Cytoreductive Surgery: Technical Considerations.

Peritoneal carcinomatosis has until recently been considered uniformly fatal; it results in intestinal obstructions, eventually leading progression of disease and death. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy have become important options for patients with peritoneal carcinomatosis. Completeness of cytoreduction is a major determinant of survival. Frequently, the porta hepatis and the lesser sac are massively involved by tumor. Encasement of portal triad, lesser omentum, retrohepatic vena cava, duodenum, and stomach is frequently seen. The proximity to major portal structures as well as the retrohepatic vena cava makes this dissection challenging. This is the area where meticulous surgical technique and expertise are necessary to obtain complete removal of tumor. Some specific technical considerations are important to assure that all tumor is safely removed.

Extensive surgical history prior to cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is associated with poor survival outcomes in patients with peritoneal mucinous carcinomatosis of appendiceal origin.

BACKGROUND: Patients with PMCA commonly undergo surgery before CRS/HIPEC. We evaluated the role of extensive surgical treatment before CRS/HIPEC in terms of overall survival (OS). METHODS: 105 patients with PMCA who underwent a CRS/HIPEC procedure were identified from a prospective database. Patients were divided into two groups based on Prior Surgery Score (PSS): PSS ≤ 1 limited surgery group (LSG), PSS >1 extensive surgery group (ESG). Survival of lymph node (LN) negative and positive patients was analyzed separately. RESULTS: 40 patients were in LSG and 65 in ESG. Mean time from diagnosis to CRS/HIPEC was 6 and 17 months for LSG and ESG, respectively (p = 0.004). Groups were well balanced in peritoneal cancer index, complete cytoreduction rate, and LN status. One, 3, and 5-year OS among LN negative patients was 95, 83, and 75% for the LSG (n = 22) group and 87, 55, and 32% for the ESG (n = 35), group respectively (p = 0.026). One, 3, and 5-year OS among LN positive patients was 69, 50, and 17% for the LSG (n = 18) group and 80, 21, and 14% for the ESG (n = 30), group respectively (p = 0.613). For all patients 1, 3, and 5-year OS was 84, 65, and 54% for the LSG (n = 40) group and 86, 43, and 26% for the ESG (n = 65) group, respectively (p = 0.029). CONCLUSION: Extensive surgical treatment before CRS/HIPEC is associated with delay of CRS/HIPEC and poorer OS overall, especially among LN negative patients. We recommend early referral of PMCA patients to a peritoneal surface malignancy center.

Systemic chemotherapy (SC) before cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) in patients with peritoneal mucinous carcinomatosis of appendiceal origin (PMCA).

BACKGROUND: The role of SC before CRS/HIPEC for patients with PMCA is unclear. This study explores the effect of SC prior to CRS/HIPEC on overall survival (OS) in patients with PMCA. METHODS: 72 patients with recently diagnosed PMCA who underwent CRS/HIPEC were identified from a prospective database. Thirty patients had SC before CRS/HIPEC (Group 1) and 42 did not (Group 2). Patients who were referred to our center after multiple lines of SC were excluded from this analysis. OS was estimated. RESULTS: Median follow-up was 3.2 years. Groups were similar regarding lymph node positivity, postoperative SC and rate of complete cytoreduction. Twenty-four (80%) patients in Group 1 and 21 (50%) in Group 2 had high grade histology (HG) (p = 0.01). OS from CRS/HIPEC at 1, 2, and 3 years was 93, 68, 51% in Group 1 and 82, 64, 60% in Group 2, respectively (p = 0.74). Among HG patients 3-year survival was 36% in the SC group vs. 35% in the group without SC (p = 0.67). The 3-year OS for patients with low grade (LG) tumors was 100% in the SC group vs. 79% in the group with no prior SC (p = 0.26). Among patients with signet ring cell (SRC) histology, 1, 2 and 3-year survival was 94, 67 and 22% in the SC group vs. 43, 14, 14% in the group with no SC, respectively (p = 0.028). There were only 6 patients with LG PMCA who received prior SC. CONCLUSIONS: Preoperative SC could improve the prognosis of patients with high-grade PMCA with SRC histology.

Follicular dendritic cell sarcoma associated with hyaline-vascular Castleman's disease.

Follicular dendritic cell sarcoma (FDCS) of the head and neck region, associated with Castleman's disease (CD), is an extremely rare entity. To the best of our knowledge, we report the first case demonstrating the transformation of the former into the latter as documented in the same lymph node disection material. A 45-year-old female presented to our hospital with right sided neck swelling. Radiologic imaging showed a well defined 3.5 x 3.5 cm mass of soft tissue at the right side of the neck with multiple bilateral cervical lymph nodes. Excision of the right neck mass with lymph node disection was performed. Microscopic examination and immunohistochemical findings showed features of follicular dendritic cell sarcoma. The associated lymph nodes exhibited changes consistent with hyaline-vascular type CD, follicular dendritic cell hyperplasia and foci of overgrowth in which FDCS possibly evolved. This report confirms the evolving of FDCS in the setting of follicular dendritic cell hyperplasia occurring in Castleman's disease.

How olfaction disorders can cause depression? The role of habenular degeneration.

The removal of bilateral olfactory bulbs (OBs) can result in serious behavioral, neurochemical, neuroendocrine, and neuroimmune alterations in depressed patients. However, there is little information on how olfactory bulbectomy (OBX) leads to depression. Habenular nuclei and their connections are important in the regulation of psychomotor and psychosocial behaviors through afferent impulses of the olfactory system. Therefore, we investigated whether OB lesions lead to habenular degeneration. We used a sample of 50 rats (25 female and 25 male) for this study. Of these rats, five male and five female rats were taken as the control group. The remaining 40 rats (20 male and 20 female rats) constituted the study group, and frontal burr holes were performed at the OB level on these rats. OB cauterization was applied to 10 male and 10 female rats (n=10, 10; study group 1), mechanical OBX was applied to five male and five female rats (n=5, 5; study group 2), and no procedure was performed on the remaining 10 rats (n=5, 5). The psychomotor movements; pregnancy rates; and sexual, feeding, maternal, social, and grooming behaviors for both study groups were observed daily for 3 months. Their OBs, olfactory cortices, and habenular complexes were examined using stereological methods. All of the animals in the study groups, especially in the cauterization group, demonstrated anorexia, nutritional disorders, weight loss, psychomotor retardation, sexual aversion, decreased grooming behavior, and reduced social interaction similar to depression symptoms. As compared to the control group, the pregnancy rates, number of offspring per mother rat, and birth weights in the study groups were lower, whereas the number of stillbirths was higher. Gross anatomical examinations revealed that the OBs of all of the animals in the study groups were atrophied. Histopathological examinations detected prominent neuronal loss due to apoptosis in the habenular structures in the study groups. We detected a relationship between a decreased healthy neuronal density of the habenula and depressive symptomatology in rats with OBX. We suggest that olfaction disorders might cause neuropsychiatric disorders by affecting neuronal degeneration in habenular nuclei.

Luteal serum BDNF and HSP70 levels in women with premenstrual dysphoric disorder.

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome characterized by psychological and somatic symptoms commencing in the luteal phase of the menstrual cycle and concludes with menstrual bleeding. PMDD affects 3-8 % of premenopausal women and represents a significant public health problem especially in young women. Decreased brain-derived neurotrophic factor (BDNF) levels are associated with several mental disorders. Heat-shock protein-70 (HSP70) is an important member of the molecular chaperone system, which provides a molecular defense against proteotoxic stress. We hypothesized that there would be changed levels of BDNF and HSP70 in women with PMDD compared with non-symptomatic women, reflecting impaired and/or activated stress-related responses involved in the underlying pathogenesis of PMDD. Female medical students were screened, and 24 women without premenstrual symptoms and 25 women with PMDD were enrolled in the study. Psychiatric evaluation and the Daily Record of Severity of Problems-Short Form were used for two consecutive menstrual cycles to diagnose PMDD. Serum BDNF and HSP70 levels were assessed in the third luteal phase. Participants with PMDD had significantly higher serum BDNF and HSP70 levels compared with controls, and there was a significant positive correlation between serum BDNF and HSP70 levels. Increased HSP70 levels may reflect cellular distress in PMDD. Increased serum BDNF levels in the luteal phase in subjects with PMDD may reflect a compensation process, which results in subsequent improvement of PMDD-associated depressive symptoms in the follicular phase. Thus, increased serum BDNF levels may be indicative of a compensating capacity in PMDD.

Cystic adrenal lymphangioma--report of two cases and review of the literature.

Cystic adrenal lymphangiomas are very rare, benign vascular lesions. They are usually found during a work up for abdominal pain or incidentally during imaging studies for an unrelated cause. We report two cases of cystic adrenal lymphangiomas. They presented with flank discomfort, hypertension and flushing. Their laboratory findings were in normal limits. Radiologic imagings showed adrenal cystic neoplasm and the patients underwent adrenelectomy. Histopathologic examination and immunohistochemical findings were consistent with lymphangioma. Cystic lymphangiomas may imitate other adrenal neoplasms and must be kept in mind in the clinical and radiologic differential diagnosis of cystic adrenal lesions.

CT findings related to exposure to polyvinyl chloride.

BACKGROUND: Although some adverse health effects of exposure to polyvinyl chloride (PVC) are well known, there is limited evidence of its effects on the respiratory system. AIMS: To assess the pulmonary effects of exposure to PVC with high-resolution computed tomography (HRCT). METHODS: Workers and administrative staff of two PVC production plants completed questionnaires and went through pulmonary function testing and HRCT. Analysis of PVC dust in the work environment was performed by the Directorate of Occupational Health and Safety. RESULTS: In total, 104 PVC-exposed workers and 43 administrative controls participated. HRCT revealed pleural and/or parenchymal changes in 55% of the exposed subjects. Pleural thickening was detected in 14 subjects, 13 of whom were in the exposed group (P < 0.05). Isolated pleural thickening without parenchymal involvement was present in seven workers, who were all in the exposed group (P < 0.05). Pleural thickening was frequently bilateral and localized to the parietal and visceral pleura. Round opacities, heterogeneous attenuation and ground-glass opacities were only detected in the exposed group (P < 0.05). Exposure to dust increased the risk of findings on HRCT (odds ratio (OR) 4.2, P < 0.05). There were no correlations between pulmonary function tests or respiratory symptoms and HRCT findings. HRCT changes were more common in subjects with forced mid-expiratory flow (FEF(25-75)) < 50% (P < 0.001). CONCLUSIONS: This study found that exposure to PVC dust, at levels below the legal limit for respirable particulate matter, was associated with parenchymal changes and pleural thickening on HRCT.

The effects of Teucrium polium on ionizing radiation-induced intestinal damage in rats.

BACKGROUND AND STUDY AIMS: Oxidative stress plays an important role in development of intestinal injury after abdomino-pelvic radiation therapy. Teucrium polium (TP) is a medicinal plant which has antioxidant and anti-inflammatory properties. The aim of this study was to investigate the effect of TP on radiation-induced intestinal oxidative damage in rats. MATERIALS AND METHODS: Group 1 (n = 8), the control group; Group 2 (n = 8), the RAD (radiation) group in which each rat received a single whole-body 800 cGy radiation performed with a LINAC ; Group 3 (n = 8), the RAD + TP group in which rats were exposed to radiation as in Group 2, followed by intragastric administration of 0.5 g/kg/daily TP extract for 7 consecutive days; and Group 4 (n = 8), the TP group, rats received only intragastric TP for 7 days. RESULTS: Radiation led to intestinal damage, which was accompanied by an increase in intestinal thiobarbituric-acid-reactive substances (TBARS) and myeloperoxidase (MPO) levels, and a decrease in reduced glutathione (GSH) levels. Although TP significantly decreased intestinal MPO levels and inflammation scores, it neither reverted intestinal TBARS and GSH levels nor ameliorated other histological parameters of the disease. CONCLUSIONS: Our results suggest that TP reduces inflammation but does not ameliorate the increased oxidative stress conditions in radiation-induced intestinal damage in rats.

Symmetrical modified dual tree complex wavelet transform for processing quadrature Doppler ultrasound signals.

Dual-tree complex wavelet transform (DTCWT), which is a shift invariant transform with limited redundancy, is an improved version of discrete wavelet transform. Complex quadrature signals are dual channel signals obtained from the systems employing quadrature demodulation. An example of such signals is quadrature Doppler signal obtained from blood flow analysis systems. Prior to processing Doppler signals using the DTCWT, directional flow signals must be obtained and then two separate DTCWT applied, increasing the computational complexity. In this study, in order to decrease computational complexity, a symmetrical modified DTCWT algorithm is proposed (SMDTCWT). A comparison between the new transform and the symmetrical phasing-filter technique is presented. Additionally denoising performance of SMDTCWT is compared with the DWT and the DTCWT using simulated signals. The results show that the proposed method gives the same output as the symmetrical phasing-filter method, the computational complexity for processing quadrature signals using DTCWT is greatly reduced and finally the SMDTCWT based denoising outperforms conventional DWT with same computational complexity.

Variable optimisation of medical image data by the learning Bayesian Network reasoning.

The method proposed here uses Bayesian non-linear classifier to select optimal subset of attributes to avoid redundant variables and reduce data uncertainty in the classification process often used in medical diagnosis. The method also exploits the structural reasoning ability of Bayesian Networks (BN) to optimize large number of attributes to prevent overfitting, meanwhile it maintains the high classification accuracy. This process simplifies the complex data analyses and may lead to a cost reduction in clinical data acquisition process.