Twenty-Four-Month Clinical Comparison of Two Bulk-Fill and a Microhybrid Composite Restorations in Class II Cavities.

OBJECTIVES: The aim of this study was to evaluate the clinical performance of two bulk-fill composite resins in Class II cavities for up to twenty-four months. MATERIALS AND METHODS: In total 75 Class II restorations were made in 25 patients using two nanohybrid bulk-fill resin composites and a microhybrid composite. The restorations were evaluated at baseline and at 6, 12, and 24 months, using U.S. Public Health Service (USPHS) criteria. The restoration groups were compared using the Pearson chi-square test, and the Cochran Q-test was used to compare the changes across different time points within restorative materials (p⟨0.05). RESULTS: Two patients who did not attend the appointments were excluded from the study, so 23 patients were evaluated with a 92% recall rate; at the end of the two-year follow-up, 66 restorations were evaluated. Three restorations underwent endodontic treatment and were deemed failures. The overall success rate was 96%. There were statistically significant differences between the three restorative resins in terms of color match parameter (p⟨0.05). No differences were observed between the restorative resins in terms of other criteria (p⟩0.05). CONCLUSIONS: During the two-year follow-up period, the three composite resins showed similar clinical performance except for the color match parameter.

Protective effects of udenafil citrate, piracetam and dexmedetomidine treatment on testicular torsion/detorsion-induced ischaemia/reperfusion injury in rats.

The aim of this study was to investigate the antioxidant properties of udenafil citrate (1.4 mg kg(-1) -2.8 mg kg(-1) ), dexmedetomidine 25 µg kg(-1) and piracetam 200 mg kg(-1) administered on ipsilateral/contralateral testes after ischaemia in a rat model of testicular torsion/detorsion (T/D) and define its protective effect histologically. Fifty-six Wistar albino rats were included and randomly assigned into 6 groups. No intervention was performed in control group (Group 1, n = 8) and in torsion/detorsion group, (Group 2, n = 8). Udenafil 1.4 mg kg(-1) was given to torsion/detorsion group (Group 3, n = 10), udenafil 2.8 mg kg(-1) was given to torsion/detorsion group (Group 4, n = 10), piracetam 200 mg kg(-1) was given to torsion/detorsion group (Group 5, n = 10) and dexmedetomidine 25 µg kg(-1) was given to torsion/detorsion group (Group 6, n = 10) intraperitoneally after 60 mins of testicular torsion. Biochemical and histopathological testicular injury were evaluated. When the tissue was examined by TOS values, Group 3, Group 4 and Group 5 were significantly lower than Group 2. In contrary Group 6 values were significantly higher than Group 2. The increasing doses of udenafil demonstrated antioxidant properties on the testis tissue and histopathological that protects the testicles.

A proposal for a problem-oriented pharmacobiochemistry course in dental education.

Problem-oriented learning is an effective method of learning that increases students' learning motivation, improves the relationship amongst students and results in open-minded discussions. In this study, a new problem-oriented pharmacobiochemistry course related to 'oxidative metabolism of drugs by cytochrome P450 (CYP450) systems' was designed. Students were divided into seven groups. Three keywords related to drug interaction through CYP450 were provided to each group in order for them to conduct research on the information given. After 1 month, the groups attended a session under the supervision of a tutor to solve a simulated problem case that was designed using the keywords. At the end of the integrated course, a multiple-choice examination was given. The success rate of 76 students who attended the course was found to be significantly higher than the success rate of the students who received the lecture-based course only (P < 0.0001). A questionnaire containing 20 items (Cronbach's alpha: 0.92) was administered to the students to learn about their perception regarding this educational model. The questionnaire was evaluated using the Likert scale. Student feedback was very positive, with fourteen answers rated as 'agree' and the remaining six rated as 'strongly agree'. Students thought that the problem-oriented model was very enjoyable and useful in regard to dental education. Based on these results, we conclude that this course model may help achieve an integrated curriculum for dental school programmes.

The effects of ovariectomy and naproxen treatment on the strength of femoral midshaft and molar alveolar region in rats / Efectos de la ovariectomía y tratamiento con naproxeno sobre la resistencia de la parte media de la diáfisis femoral y la región alveolar molar en ratas

The goal of the present study was to investigate the effects of ovariectomy and naproxen treatment on both femoral and mandibular bone mass and biomechanical competence. Sprague-Dawley rats were used and divided into five groups: baseline, sham ovariectomized, ovariectomized, sham ovariectomized + naproxen treatment, ovariectomized + naproxen treatment. Mandibles and femurs of the rats were extracted and bone mineral density of the extracted specimens were determined. The volumes and ash weights of the femurs and mandibles were estimated. Maximum loads of the femurs and mandibles were determined by using a three point bending test. Ovariectomy decreased bone mineral density of the femoral midshaft, however naproxen prevented this decrease. Neither ovariectomy nor naproxen treatment affected the BMD in the molar alveolar region. Maximum load was found significantly decreased in the femoral midshaft, however, naproxen treatment prevented this decrease. Maximum load of the molar alveolar region did not significantly change. Naproxen prevents the strength characteristics of femoral midshaft afforded by ovariectomy. However, neither ovariectomy nor naproxen has an effect on the molar alveolar region of the mandible.

El objetivo del presente estudio fue investigar los efectos de la ovariectomía y el tratamiento con naproxeno sobre la masa y la competencia biomecánica del fémur y hueso mandibular. Fueron utilizadas ratas Sprague-Dawley, la que se dividieron en cinco grupos: referencia, ovariectomizadas simuladas, ovariectomizadas, ovariectomizadas simuladas + tratamiento naproxeno, ovariectomizadas + tratamiento naproxeno. Las mandíbulas y los fémures de las ratas fueron extraídos y se determinó la densidad mineral ósea (DMO) de las muestras extraídas. Los volúmenes y pesos de la ceniza fueron estimados. Las cargas máximas de las mandíbulas y fémures se determinaron utilizando un ensayo de flexión de tres puntos. La ovariectomía disminuyó la densidad mineral ósea de la diáfisis media del fémur; sin embargo, el naproxeno impidió esta disminución. Ninguna ovariectomía sin tratamiento de naproxeno afectó a la DMO en la región alveolar molar. La carga máxima se encontró significativamente disminuida en las diáfisis femoral media, pero por el tratamiento de naproxeno no se produjo esta disminución. La carga máxima de la región alveolar molar no cambió en ninguna condición. El naproxeno previene los cambios de resistencia causados por la ovariectomía de la diáfisis media del fémur. Sin embargo, ni la ovariectomía ni el naproxeno tienen un efecto en la región alveolar molar de la mandíbula.

[Necrobiotic xanthogranuloma with scleroatrophic lichen associated with paraproteinemia]. / Xantogranuloma necrobiótico con paraproteinemia asociado a liquen escleroatrófico.

Necrobiotic xanthogranuloma (Xn) with paraproteinemia is a histiocytoxanthomatosis (non-X histiocytosis) that affects the dermis and subcutaneous tissue of the face and less frequently the trunk and limbs. We present the case of a 58-year-old woman with a previous background of IgG (lambda) paraproteinemia and multiple autoimmune diseases, that associate clinically and histologically typical lesions of Xn on face, neck and limbs and of lichen sclerosus et atrophius (LEA) on skin and mucosae. The treatments performed were ineffective, the Xn lesions followed a chronic and progressive course with increased number, size and ulceration of them. The paraproteinemia has remained stable since it was diagnosed eight years ago. We have not found the association of Xn with paraproteinemia and SAL described in the literature. We review the characteristics of this rare disease and its possible pathogenic mechanisms.

Cytogenetic results of amniocentesis materials: incidence of abnormal karyotypes in the Turkish collaborative study.

The experience on prenatal chromosome diagnosis of four Turkish centers participating in a collaborative study on 6041 genetic amniocentesis performed during a 4-8 years period were reviewed. 5887 (97.5%) patients had strong clinical indications for prenatal chromosome studies and 154 (2.5%) were referred because of maternal anxiety and a bad history of previous gestations. The main indication groups were: advanced maternal age (3197 cases), positive serum screening (2011 cases), ultrasound-identified anomaly (492 cases), previous fetus/child with chromosomal aberrations (103 cases), a history of a previous abnormal and/or mentally handicapped child (70 cases) and a parental chromosome rearrangement (14 cases). The average maternal age was 33.9 years and average gestational age was 18 weeks. A total of 179 affected fetuses were detected in this collaborative study (3%) of which 133 were unbalanced (74.3%). Among the 124 (69%) numerical aberrations, 102 (82.3%) were autosomal aneuploidies, 20 (16.1%) were gonosomal aneuploidies and 2 (1.6%) were poliploidies. Among the 55 (31%) structural aberrations, balanced translocation was the most common (63.6%) and 11 cases of inversion, four cases of unbalanced translocation, two cases of marker chromosome and three cases of other abnormalities were found. The overall culture success rate was 99.7%. Pregnancy termination that is permitted by legal authorities was accepted by 94.7% (126/133) with parents at unbalanced cytogenetic result announcement.

Two autoimmune diseases: Hashimoto's thyroiditis and vitiligo accompanying breast cancer; A coincidence?

Autoimmune diseases can accompany cancer either sporadically or as part of certain genetic abnormalities or syndromes. We report on a breast cancer case with both Hashimoto's thyroiditis and vitiligo. To the best of our knowledge, this case constitutes the first breast cancer patient in the literature with both of these two autoimmune diseases. The patient did not have significant genetic abnormalities, so this might be a simple coincidence. Evaluation of cancer cases for the existence of comorbid autoimmune diseases might yield more such cases, and their genetic analyses may be helpful for better understanding of the pathogenesis of cancer.

The in vitro effect of beta-carotene and mitomycin C on SCE frequency in Down's syndrome lymphocyte cultures.

Down's syndrome (DS) has the highest incidence among chromosomal disorders and is a predisposing factor in acute leukemia pathogenesis. DS patients are sensitive to both physical and chemical inducers at the DNA level. Studies on beta-carotene, an antioxidant, suggested the there is a relationship between high beta-carotene diet and reduced tumor incidence in humans indicating that beta-carotene is a chemopreventive agent against cancer. Sister chromatid exchange (SCE) is known as a sensitive parameter among the genotoxicity tests. In this study, we aimed to investigate the in vitro effect of beta-carotene on SCE frequencies in 7 DS patients and 7 healthy controls aged between 0-16 years. A direct leukomogenic agent Mitomycin-C (MMC) was used as a powerful SCE inducer. Addition of MMC to the cultures alone resulted in a significant enhancement of SCE frequencies in both groups when compared to the spontaneous values. In the study, beta-carotene seemed to decrease MMC induced mean SCE/cell values, but did not have an effect on unstimulated cells. As this is a limited study, it is hard to conclude that beta-carotene is a chemopreventive agent in DS patients, although our results seem to support other investigators' reports.

Development and biochemical characterization of a double-virus-inactivated factor VIII preparation.

This paper describes the development of a double-virus-inactivated preparation. The original goal was to inactivate and/or remove parvovirus from plasma-derived factor VIII. More recently, attention has also been focused on the controversial issue of transmission of the non-lipid-coated hepatitis A virus by preparations of factor VIII which have been solvent/detergent-treated and purified by ion-exchange chromatography.

In vitro effects of prostaglandin E1 and indomethacin on mitomycin C-induced sister-chromatid exchanges in mitogen-stimulated human lymphocytes.

In this study, the individual and combined effects of prostaglandin E1 (PGE1) and Indomethacin on mitomycin C (MMC)-induced SCEs in human lymphocytes was investigated in vitro. All MMC-treated cultures showed a great increase of SCEs (approximately two-fold), indicating its ability to induce mutations. SCE data showed that MMC-induced SCEs were reduced significantly in the presence of PGE1 in pooled analysis of six experiments (60.55% reduction of SCEs at 10(-6) M, 34.13% reduction of SCEs at 10(-9) M). In contrast the presence of indomethacin in the medium during MMC treatment of cells failed to show a significant reduction of SCEs in pooled analysis (21.17%). However, individual analyses revealed only two of six donors with a significant SCE response. Thus, the findings suggest that PGE1 can modify the DNA damaging effect of carcinogens and thereby may prevent the initiation of the carcinogenic process.

A solvent I detergent treated, pasteurised and highly purified factor VIII concentrate.

In an assessment of the risks of virus transmission by clotting concentrates it is clear that the currently practised procedures for virus inactivation are not equally effective against all types of viruses; neither a pasteurisation nor the solvent detergent (SID) process alone are adequate enough to inactivate viruses that are strongly resistant to heat and organic solvents. In this context, human parvovirus B19 and hepatitis A virus (HAV) are of particular concern. In order to improve this situation which still poses a risk to the haemophiliac patients, a more effective pasteurisation process has been developed that could be easily applied to an already well established factor VIII (FVIII) process in addition to the SID-treatment. Experiments using temperatures above 60 degrees C were performed prompted by two recent publications, which demonstrate that HAV becomes instable at temperatures exceeding 62 degrees C. It is the purpose of this paper to present the following progress: achievement of a pasteurisation procedure for FVIII at 63 degrees C for 10 h with no discernible change in the structure of the factor VIII/von Willebrand factor (FVIII/VWF) complex owing to a newly developed composition of stabilizers; application of this pasteurisation procedure to a purified FVIII fraction that has already been submitted to a SID-treatment: Doing so, two independent virus inactivation steps are performed as previously recommended by the International Association of Biological Standardization (IABS). Introduction of a second purification step on an anion exchange resin, achieving an additional virus reduction over the presently manufactured FVIII preparation.(ABSTRACT TRUNCATED AT 250 WORDS)

Isolation of plasma proteins from the clotting cascade by heparin affinity chromatography.

The use of heparin affinity chromatography for the isolation of plasma proteins from the clotting cascade is described. The separation is carried out with heparin agarose and, in parallel operations, with different rigid gels on a polymer base. The quality of the separation and the reproducibility of the results were investigated and the stability of the materials at high pH was tested. The affinity supports were used for the isolation of antithrombin III from human plasma and for the separation of factor IX from factor X, after partial purification by anion-exchange chromatography. The isolation of antithrombin III from human plasma served as a model. The non-specific bindings were investigated, together with the resistance of the support when treated with 0.2 and 0.5 M sodium hydroxide. Heparin agarose has low non-specific bindings, but it cannot be exposed to high pH. The supports on a polymer base are resistant to high pH, up to 13.7. However, they may remain slightly hydrophobic, and the hydrophobicity of the matrix leads to an increase in non-specific bindings. When antithrombin III is isolated, the non-specific bindings result in contamination of the final product. The lack of resistance of the matrix at high pH causes a weaker binding of antithrombin III, and the product is eluted at lower and lower sodium chloride concentrations. The results can be indicative of the behaviour of the support in the separation of factor IX from factor X. High non-specific bindings will lead to contamination of the factor IX product and consequently to low specific activity. Insufficient resistance of the support at high pH will result in failure to separate the two clotting factors satisfactorily. The separation can be monitored by heparin high-performance membrane affinity chromatography (HPMAC). Contamination of the sample, which occur in sodium dodecyl sulphate-polyacrylamide gel electrophoresis are detected within minutes by fast heparin HPMAC.

Long-lasting epidural sensory blockade by n-butyl-p-aminobenzoate in the terminally ill intractable cancer pain patient.

An aqueous suspension of n-butyl-p-aminobenzoate (BAB), a highly lipid-soluble congener of benzocaine, was applied epidurally in terminally ill cancer patients with intractable pain. The suspension consisted of 10% BAB and 0.025% of the nonionic surfactant polysorbate 80 in 0.9% sodium chloride. Twelve consecutive patients received epidural BAB because pain was uncontrollable either by palliative radiotherapy or oral or epidural administrations of analgesics. The catheter or injecting needle was positioned at the segmental level of the pain. Repeated epidural injections were administered. In all patients, long-lasting sensory blockade (segmental analgesia) occurred, accompanied by a marked reduction or even absence of pain. In all patients, treatment with epidural opioids, alone or combined with local anesthetics, was no longer necessary. Five of the 12 patients did not require further administration of oral opioids. Motor, bowel, and bladder function were well preserved. In 6 patients, extensive necropsy of the spinal cord and spinal nerves did not reveal pathomorphologic changes. The outer aspect of the dura showed signs of focal necrosis on microscopy, yet its collagen structure and thickness were unchanged. Epidurally, focal infiltrative reactions were seen. The epidural use of an extremely lipid-soluble--hence hydrophobic--local anesthetic, with an exceptionally low pKa (2.3), formulated in suspension of the base, is conceptually innovative and needs further investigation. The authors conclude that the epidural administration of a BAB suspension may be an effective alternative to the neurolytic agents alcohol and phenol and may replace procedures such as cordotomy. Further investigation to determine the safety of BAB in this patient group appears warranted.

Large-scale production and properties of a solvent-detergent-treated factor IX concentrate from human plasma.

A human solvent-detergent (SD)-treated factor IX concentrate has been produced from cryoprecipitate-poor plasma using DEAE-Sepharose CL-6B and heparin-Sepharose CL-6B chromatography. The DEAE eluate was incubated with an SD mixture [0.3% tri(n-butyl) phosphate-1% Tween 80, 6-h at 24 degrees C] which was found to inactivate, in less than 1 h, more than 3.8 log10 of vesicular stomatitis virus and more than 4.8 log10 of Sindbis virus; the SD was removed by a subsequent heparin adsorption step. The specific activity of the concentrate was 10.9 +/- 1.3 IU factor IX: c/mg protein (n = 15). The factor IX coagulant to antigen ratio was 0.7 +/- 0.1. The concentrate was essentially free of factors II, VII and X, and protein C. The usual major contaminants of prothrombin complex concentrate (PCC) were absent: the concentrate contained about 94% alpha-1 proteins, and only 4 major proteins were resolved by SDS-PAGE (respective apparent molecular weight: 130, 86, 76 and 69 kilodaltons), and by crossed immunoelectrophoresis against an anti-PCC serum. The nonactivated partial thromboplastin time was equivalent to that of PCC; the product was devoid of factor IXa, of other activated procoagulant factors and of coagulant-active phospholipids (removed with SD in the heparin breakthrough fraction). Animal studies using the Wessler test and acute-toxicity test in rabbits revealed no adverse side effects. SD treatment could thus be used to inactivate viruses in factor IX concentrate and improve the safety of replacement therapy in hemophilia B.