Gender Estimation from Morphometric Measurements of Mandibular Lingula by Using Machine Learning Algorithms and Artificial Neural Networks.

BACKGROUND: Sex determination from the bones is of great importance for forensic medicine and anthropology. The mandible is highly valued because it is the strongest, largest and most dimorphic bone in the skull. AIM: Our aim in this study is gender estimation with morphometric measurements taken from mandibular lingula, an important structure on the mandible, by using machine learning algorithms and artificial neural networks. METHODS: Cone beam computed tomography images of the mandibular lingula were obtained by retrospective scanning from the Picture Archiving Communication Systems of the Department of Oral, Dental and Maxillofacial Radiology, Faculty of Dentistry, Inönü University. Images scanned in Digital Imaging and Communications in Medicine (DICOM) format were transferred to RadiAnt DICOM Viewer (Version: 2020.2). The images were converted to 3-D format by using the 3D Volume Rendering console of the program. Eight anthropometric parameters were measured bilaterally from these 3-D images based on the mandibular lingula. RESULTS: The results of the machine learning algorithms analyzed showed that the highest accuracy was 0.88 with Random Forest and Gaussian Naive Bayes algorithm. Accuracy rates of other parameters ranged between 0.78 and 0.88. CONCLUSIONS: As a result of the study, it is thought that mandibular lingula-centered morphometric measurements can be used for gender determination as well as bones such as the pelvis and skull as they were found to be highly accurate. This study also provides information on the anatomical position of the lingula according to gender in Turkish society. The results can be important for oral-dental surgeons, anthropologists, and forensic experts.

Effects of ß-1,3/1,6 glucan dietary supplements on some immunological and hematological health markersin Siberian sturgeon (Acipenser baerii) infected with Aeromonas hydrophila.

This experimental study aimed to investigate some hematological and immunological changes as a result of Aeromanas hydrophila infection in Siberian sturgeon (Acipenser baerii Brandt, 1869). Their feeds were supplemented with ß-1,3/1,6 glucan at different ratios, 250 mg/kg (ßG250); 500 mg/kg (ßG500) and 750 mg/kg (ßG750). To create an experimental infection, 4×106 cfu/ml Aeromonas hydrophila inoculum was intraperitoneally injected to fish. 0.1 ml intraperitoneal bacteria injection was given to the fish in 12 of 15 tanks, each consisting of 10 fish (the fish in the control group were not given bacteria). Considering the ßG500 and ßG750 group fish as positive (C+) and negative control (C-) groups in terms of hematological parameters, it was found that RBC (erythrocyte) and Hb (hemoglobin) values, as well as RBC indices (MCV, MCHC, MCH) significantly increased. The immunological parameters, including WBC (leukocyte), leukocyte cell percentages (lymphocyte, monocyte, neutrophil, eosinophil), as well as cytokines, including IL-1ß, IL-6, IL-8, and TNF-α values showed similar increases in the ßG500 and ßG750 groups. It was found that the addition of 500 and 750 mg/kg doses of ß-1,3/1,6 glucan to the feed stimulated non-specific immunity of fish against bacterial agents and/or septicemic diseases and beta glucan at this dosage range was determined to be ideal for fish health and that it may be a herbal immunostimulant that can be an alternative to many medicaments.

Factors Influencing Complication Rates in the Orthopaedic Theatre.

PURPOSE OF THE STUDY The prevalence of complications in surgical units is available in the literature. The aim of this study was to compare the "rotational" (more than one surgeon) and "full-time single surgeon" use of the orthopedic theater. MATERIAL AND METHODS We retrospectively evaluated patients who underwent orthopedic surgery in 2016 in different theaters. A total of 604 of 1973 patients were excluded from the study, and 1369 patients were analyzed. The follow-up period was 1 year. While evaluating the cases, the duration and order of each case, the total operation time on the table, the number of surgeons, the total number of cases, the number of residents, and the experiences of the surgeons were investigated, and the effects of these parameters on the complication rates were analyzed. The Dindo-Clavien system was used to classify the complications. RESULTS When comparing the methods, the complication rate of the full-time single-surgeon method (12.9%) was less than that of the rotational method (21.7%) (p: 0.022). A higher rate of complications (8.5%) was observed in operations with a duration of 115 minutes or more compared to other operations (p <0.001). A higher complication rate (23.7%) was observed in cases lasting more than 345 minutes (p = 0.002). CONCLUSIONS According to our study, full-time use of the orthopedic theater by a single surgeon was found to be safer than rotational use. In addition, the duration of surgeries lasting longer than 115 minutes or longer than 345 minutes during the day increased the rate of surgical complications. Key words: patient safety, surgical planning, operation time, operation order, orthopedic complication.

Reduced Activity of von Willebrand Factor after Flow-Diverting Stent Implantation for Intracranial Aneurysms: A Link to Acquired von Willebrand Disease?

BACKGROUND AND PURPOSE: Vascular devices generating high shear stress can cause type 2A acquired von Willebrand disease, which is characterized by low von Willebrand factor activity accompanied by hemorrhagic complications. The braided mesh structure of flow-diverting stents with a relatively small strut size can create abnormally high shear stress while arterial blood flows through the stent struts into the aneurysm, and flow-diverting stent may be associated with reduced von Willebrand factor activity. MATERIALS AND METHODS: Aneurysmal morphologic parameters and patient data were examined retrospectively among patients who had an unruptured intracranial aneurysm treated with a flow-diverting stent. The RISTOtest (test for whole blood ristocetin-induced platelet aggregation) for von Willebrand factor activity, as well as tests for aspirin and clopidogrel/prasugrel effectiveness, were performed immediately before the endovascular procedure and 24 hours later by multiple electrode aggregometry. RESULTS: A total of 39 patients with 56 aneurysms were recruited, and statistical analyses were performed in 32 patents with 49 aneurysms. Compared with the baseline values, von Willebrand factor activity was reduced in 16 patients but increased in 23 patients. Aneurysmal variables (eg, neck area, volume, volume-to-neck area ratio, size ratio, and morphologic index) clearly distinguished patients with reduced von Willebrand factor activity from those with nonreduced von Willebrand factor activity. The receiver operating characteristic curve showed that the morphologic index and volume had the highest discriminative power, with an area under the curve of 0.99. CONCLUSIONS: In high-volume/large-neck aneurysms, flow-diverting stent implantation can cause reduced von Willebrand factor activity, which may be linked causally to acquired von Willebrand disease.

Alternative cone-beam CT method for the analysis of mandibular condylar bone in patients with degenerative joint disease.

OBJECTIVE: The aim of this study was to investigate the use of 3D microstructural bone analysis in patients with degenerative joint disorder (DJD) to enhance the diagnostic capacity of cone beam computed tomography (CBCT) in the evaluation of bone tissue. METHODS: 147 TMJ CBCT images of 88 participants were assessed with regard to DJD in the mandibular condyle. We divided each condyle into 3 groups (0, 1, 2) according to diagnosis of DJD: 0 indicates normal condyles (control individuals), 1 indicates mild erosive osteoarthritic change (EOC) and 2 indicates severe EOC. 3D fractal dimension (FD) was calculated on CBCT images of mandibular condyle and were compared with the radiographic diagnosis of patients. RESULTS: ANOVA test showed that there was statistically significant difference in FD values among each groups. The average FD value of group 0 was 1.971, group 1 was 1.918 and group 2 was 1.863. Lower FD values and more severe degenerative changes were seen in patient group 2. To evaluate the reliability of fractal analysis (FA) method, receiver operating characteristic (ROC) curve analysis was performed. Area under the curve (AUC) was 0.717 (p < 0.001). CONCLUSION: This study provides a preliminary conclusion that fractal analysis may be a helpful tool to enhance the diagnostic capacity of CBCT in the evaluation of DJD.

Evaluation of localisation of mandibular foramen in patients with mandibular third molar teeth using cone-beam computed tomography.

BACKGROUND: It is important to know the correct anatomical location of the mandibular foramen to obtain successful anaesthesia of inferior alveolar nerve and to prevent injury to the mandibular vessels and nerve, during a variety of oral and maxillofacial surgical procedures. The aim of this study is to evaluate localisation of the mandibular foramen in patients with the third molars using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Cone-beam computed tomography was used to determine the location of the mandibular foramen in 67 patients (totally 99 sides) with unilateral or bilateral impacted mandibular third molars. RESULTS: The distance from the posterior border of the mandibular ramus to mandibular foramen did not differ significantly among the other angulations. But the difference between vertical and horizontal angulation of the impacted mandibular third molars according to 'fd' values (the shortest distance between mandibular foramen and the posterior border of mandibular ramus) was found to be statistically significant (p < 0.05). CONCLUSIONS: The present study provides new information to the literature concerning relationship between the location of the mandibular foramen and the mandibular third molars.

Cone beam computed tomography evaluation of ponticulus posticus in patients with cleft lip and palate: a retrospective radio-anatomic study.

BACKGROUND: Ponticulus posticus (PP) is an abnormal bony bridge on the atlas. It plays a significant role in patients undergoing C1 lateral mass screw procedure. Patients with cleft lip and palate (CLP) have higher risk than patients in general population for the appearance of cervical vertebral anomalies. The purpose of the this study was twofold: to determine the prevalence and characteristics of PP in patients with CLP, and to compare the findings with patients in general population using cone beam computed tomography. MATERIALS AND METHODS: Cone beam computed tomography images from 54 individuals who had undergone surgical repair of cleft lip and/or palate were analysed as the study group. For comparison purposes a control group was randomly selected from 108 patients and matched with the CLP subjects. RESULTS: Although 12 of the 54 (22.3%) patients with surgically repaired cleft lip and/or palate in the study group were identified to have PP, only 10 of the 108 (9.2%) patients in the control group had PP. The distribution of the presence of PP between the groups was statistically significant. CONCLUSIONS: Ponticulus posticus is an important anomaly and the presence of PP is important for patients. PP can have clinical significance in cervical spine surgery as this study has indicated that the likelihood of encountering PP is higher in patients with CLP. We suggest that PP should be taken into account prior to cervical vertebral surgery in patients with CLP. (Folia Morphol 2018; 77, 1: 72-78).

Paediatric orthopaedics through paintings.

PURPOSE: Some famous artistic representations created throughout the centuries can reveal a hidden or mysterious diagnosis of some diseases and these paintings have always drawn the attention of physicians interested in art. Artistic illustration of a child with a malformation or disability can reflect the characteristic appearance of a disease and its historic perspective. Some articles have revealed the definite diagnosis of a child with achondroplasia through portraits of dwarfs and some studies have discussed the secret diagnosis of a crippled child with Pes Equinovarus or poliomyelitis. In this study, we aim to introduce some paintings that reveal musculoskeletal diseases related to paediatric orthopaedics. METHODS: Paintings painted since the Renaissance were reviewed and collected via web searches. Artistic paintings depicting children with suspected paediatric orthopaedic diseases were analyzed in this study. RESULTS: Paintings in which artists have depicted children with achondroplasia, poliomyelitis and clubfoot were found. CONCLUSION: The investigation of a drawing depicting a disabled child may encourage an orthopaedic surgeon to introduce an analytical approach using visual cues. These paintings may also enhance the observational skills of paediatric orthopaedic surgeons, give information about the historical process of a disease and demonstrate the impact of the disease at the time the painting was painted.

Relationship between MCP1 (-2518A>G) gene variants and ovarian cancer in Turkish population.

The monocyte chemoattractant protein-1 (MCP-1) gene polymorphism(-2518A>G)  in the regulatory region of the MCP-1 protein has been reported to be associated with cancer risk. In this study we aimed to investigate the relationship of MCP-1 (-2518A>G) gene polymorphism and ovarian cancer. MCP-1 genotyping was performed using polymerase chain reaction from blood samples ofovarian cancer patient (n=56) and a control groups (n=52).There was a significant difference in MCP1 (-2518A>G) genotypes between the patient and control groups (p=0.049; x2=6.042). AA carriers were significantly higher in the control group (p=0.014) whereas AG genotype and G allele carriers were significantly higher in the ovarian cancer group (p=0.029, p=0.014, respectively). This study suggests that MCP-1 (-2518A>G) AG genotype and G allele could be considered as risk factor for susceptibility to ovarian cancer.

Indium selenide: an insight into electronic band structure and surface excitations.

We have investigated the electronic response of single crystals of indium selenide by means of angle-resolved photoemission spectroscopy, electron energy loss spectroscopy and density functional theory. The loss spectrum of indium selenide shows the direct free exciton at ~1.3 eV and several other peaks, which do not exhibit dispersion with the momentum. The joint analysis of the experimental band structure and the density of states indicates that spectral features in the loss function are strictly related to single-particle transitions. These excitations cannot be considered as fully coherent plasmons and they are damped even in the optical limit, i.e. for small momenta. The comparison of the calculated symmetry-projected density of states with electron energy loss spectra enables the assignment of the spectral features to transitions between specific electronic states. Furthermore, the effects of ambient gases on the band structure and on the loss function have been probed.

The influence of chemical reactivity of surface defects on ambient-stable InSe-based nanodevices.

We demonstrate that, in contrast to most two-dimensional materials, ultrathin flakes of InSe are stable under ambient conditions. Despite their ambient stability, InSe-based nanodevices show an environmental p-type doping, suppressed by capping InSe with hexagonal boron nitride. By means of transport experiments, density functional theory and vibrational spectroscopy, we attribute the p-type doping assumed by uncapped InSe under an ambient atmosphere to the decomposition of water at Se vacancies. We have estimated the site-dependent adsorption energy of O2, N2, H2O, CO and CO2 on InSe. A stable adsorption is found only for the case of H2O, with a charge transfer of only 0.01 electrons per water molecule.

Impedance ratio: a novel marker and a powerful predictor of mortality in hemodialysis patients.

PURPOSE: Impedance ratio (Imp-R) obtained by multifrequency bioimpedance analysis (BIA) has been shown to be associated with volume and nutrition status. In this prospective study, the predictive role of Imp-R for mortality in hemodialysis (HD) patients was investigated. METHODS: Multifrequency (5-50-100-200 kHz) BIA was applied to 493 prevalent HD patients in March-April 2006. Imp-R was defined as the ratio of 200-5 kHz impedance values. Demographical, clinical and laboratory data at the time of the analysis were recorded. All-cause and cardiovascular (CV) mortality were assessed during 3 years of follow-up. RESULTS: Mean age was 57.7 ± 13.9 years, HD duration 52.1 ± 42.6 months and prevalence of diabetes 21.7 %. Imp-R was negatively correlated with nutritional markers including albumin, creatinine and hemoglobin levels. In addition, there was a positive correlation between Imp-R and age, ratio of extracellular water to total body water and high-sensitive C-reactive protein. Over a mean follow-up period of 27.9 ± 11.1 months, 93 deaths (52 from CV reasons) were observed. In the multivariate analysis, Imp-R was significantly associated with all-cause and CV mortality after adjustments [HR 1.13, 95 % CI (1.04-1.23); p = 0.004 and HR 1.15, 95 % CI (1.03-1.27); p = 0.01, respectively]. The risk of all-cause mortality was 3.4 times higher in the fourth quartile of Imp-R (>83.5 %) compared to the first Imp-R quartile (<78.8 %) as reference. Cutoff value of Imp-R for all-cause mortality was 82.0 % with a sensitivity of 65.5 % and specificity of 64 %. CONCLUSION: Impedance ratio measured by multifrequency in standardized conditions BIA is an independent and powerful predictor of both all-cause and CV mortality in hemodialysis patients.

The influence of soft contact lenses on the intraocular pressure measurement.

PURPOSE: To evaluate the influence of silicone hydrogel contact lenses on the intraocular pressure (IOP) measurement using Goldmann applanation tonometry (GAT), non-contact tonometry (NCT), and Pascal dynamic contour tonometry (DCT). METHODS: We included in the study 40 eyes of 40 patients who did not have any ocular or systemic diseases or contraindications to contact lens use. We measured and recorded the IOP values of each patient using NCT without and with contact lenses (groups 1 and 2, respectively), using DCT without and with contact lenses (groups 3 and 4, respectively), and using GAT without contact lenses (group 5). RESULTS: The mean IOP value of group 1 was 14.55 ± 2.95 mm Hg and 13.92 ± 2.58 mm Hg in group 2. We detected no statistically significant difference between group 1 and group 2 (P=0.053). The mean IOP values for group 3 and group 4 were 16.26 ± 2.33 mm Hg and 15.19 ± 2.40 mm Hg, respectively. We detected a statistically significant difference between groups 3 and 4 (P=0.005). Group 5's mean IOP value was 12.97 ± 2.65 mm Hg. IOP values measured with DCT were statistically significantly higher compared with IOP values measured with NCT and GAT (P<0.0001 and P<0.0001, respectively). Additionally, IOP values measured with NCT were statistically significantly higher compared with IOP values measured with GAT (P<0.0001). CONCLUSION: According to the results of our study, silicone hydrogel soft contact lens use does not significantly affect IOP values measured with NCT, but it affects IOP values measured with DCT.

Trimethylaminuria (fish malodour syndrome) in chronic renal failure.

Trimethylaminuria (fish malodour syndrome) is a rare genetic metabolic disorder presented with a body odour which smells like a decaying fish. This odour is highly objectionable, that can be destructive for the social, and work life of the patient. Trimethylamine is derived from the intestinal bacterial degradation of foods that are rich of choline and carnitine. Trimethylamine is normally oxidised by the liver to odourless trimethylamine N-oxide which is excreted in the urine, so, uremia may worsen the condition. Uremia itself may cause more or less unpleasant odour. Poor uremic control may worsen the odour. We reported this case because Trimethylaminuria is not usually considered in the differential diagnosis of malodour in chronic renal failure and it is the first case that shown the association with Trimethylaminuria and chronic renal failure in the literature.

Non steroidal antiinflammatory drugs may be harmful to normal kidneys: experimental surgery model*.

BACKGROUND AND AIM: The exact effect of analgesics on normal kidneys is not known yet. We aimed to evaluate the impression of non steroidal antiinflammatory drugs (NSAID) used post-operatively on kidneys, in rat (tracheotomy) model. METHODS: Twenty-five non-uremic male wistar albino rats were included. For 18 rats, tracheotomy was performed and divided into two groups. First group, NSAID (diclofenac 10 mg/kg/day intramuscular (im)) (NSAID, n=8); second group isotonic (im)(Control, n=10) were administered for a week. For third group (Histological control,n=7) in order to evaluate normal histology neither surgery nor medication were applied. At the end (7th day), 24 hours urine collected then, blood samples were taken by intracardiac punction and were sacrified. One of the kidneys fixed for histological evaluation, the other was preserved for the measurements of tissue enzyme levels. Lipid peroxidation products and antioxidant enzyme levels were measured both from plasma and renal tissues. Histologically inflammation, regeneration, degeneration assessed semiquatitativelly and immunohistochemical dyes were applied. RESULTS: Hemoglobin thiobarbituric acid reactive substance level indicating the increase of lipid peroxidation in NSAID group was higher than control group (673±204 vs.373±27nmol/gHb respectively, p>0.05). Superoxide dismutase (one of the antioxidant enzymes responsible for reduction of reactive oxygen substances) and serum nitrate levels were lower in NSAID groups (700±68 vs.1371±164U/gHb and 26±4.4 vs.50.8±6.8 µmol/mL respectively, p<0.05).Although tissue levels were parallel to plasma levels but the difference wasn't significant. In histological assessment degeneration was present only in NSAID group (1.3±0.6 vs.0.0±0, p<0.05). Inflammation were lower than the control group (0.8±0.4 vs.1.2±0.2, p>0.05). Cyclooxygenase-2 expression was disappeared in NSAID group. CONCLUSIONS: NSAIDs mostly used post-operatively for analgesia, may cause unfavorable effects on kidneys by oxidative stress.

Bioimpedance and echocardiography used interchangeably in volume comparison of dialysis patients.

BACKGROUND: Euvolemia is a major issue in chronic kidney disease. The present study compares cardiac condition and volume status in peritoneal dialysis (PD) and hemodialysis (HD) patients and points out importance of volume control. METHODS: From a single-center center, 81 PD and 89 HD patients were enrolled. Echocardiography and body composition analysis using bioimpedance spectroscopy (BIS) technique were performed. Overhydration (OH) and extracellular water (ECW) in liters and OH/ECW % were used as volume indices. RESULTS: Patients were younger (47.6±14. 5 and 53.1±11.8 years, p< 0.05), daily urine volume higher (1068±926 vs 290±444 ml, p <0.001) and dialysis vintage was shorter (30.1±18.6 vs 53.6±35.4 months, p<0.001), systolic blood pressure was lower (127.5±15.4 vs 140.3±18.9 mmHg, p<0.001) in PD than HD group respectively. Volume indices were (OH, OH/ECW %, ECW/height, ECW to Intracellular Water ratios (E/I) (p<0.05)) significantly higher in HD patients compared to PD patients. Over all 66 of 170 patients (39%) had OH/ECW % <5 and OH/ECW % ratio was positively correlated with Left atrium index (R(2):0.105, p<0.05). Interventricular septum diameter and Left ventricular mass index (1.41±0.24 and 159.6±48.2 vs. 1.27±0.17 cm and 115.8±37 g/m(2), p<0.001) were increased in HD than in PD group. After multivariate adjustment OH/ECW increased with: HD and diabetic patients. LVH increased with: HD group, OH/ECW (%) and SBP significantly. CONCLUSION: Overhydration was more common among HD. Excess fluid may lead adverse effect in organ functions especially cardiac condition. This indicates that the current clinical and technical tools to achieve euvolemia are insufficient and that an additional tool, such as BIS, could be useful in the diagnosis of overhydration.

Topical cyclosporine A for the dry eye findings of thyroid orbitopathy patients.

PURPOSE: To determine the beneficial effect of topically administered Cyclosporine A (CsA) for the dry eye findings of thyroid orbitopathy patients. PATIENTS AND METHODS: This prospective pilot study included 73 eyes of 42 patients with thyroid orbitopathy who had documented dry eye findings. Patients were randomly assigned into two groups: in group 1 (48 eyes), patients received topical artificial tear-drop treatment. In group 2 (25 eyes), patients received topical CsA and artificial tear-drop treatment. During a mean follow-up of 6 months, change in Schirmer's test with aneasthesia, tear break-up-time (BUT) and impression cytology results were analyzed and were compared between groups. RESULTS: The two groups were age (P=0.449) and gender (P=0.942) matched. The Schirmer's test (P=0.441), tear BUT (P=0.718) and impression score (P=0.103) were also similar before the treatment in both groups. In group 1, all three parameters improved significantly with treatment (P<0.001 for all). In group 2, Schirmer's test (P=0.001) and tear BUT (P<0.001) improved, but the impression score (P=0.175) did not change significantly after treatment. The percentage of patients with improved tear BUT (P=0.04) and improved impression score (P<0.001) were higher in group 1. At the end of follow-up, group 1 patients had better Schirmer's test (P=0.004), tear BUT (P=0.021) and impression scores (P<0.001), than group 2 patients. CONCLUSIONS: The combined CsA use with artificial tear drops is not more advantageous than the use of artificial tear drops alone, for the dry eye findings of thyroid orbitopathy patients.