Effects of Ozone Disc Nucleolysis in Management of Herniated Lumbar Intervertebral Disc: A Retrospective Single-Center Study of 149 Patients.

BACKGROUND Lower back pain is a common problem in the general population. Medical treatment is the first choice for patients without severe pain and major motor weakness. If patients do not benefit from conservative treatment, minimally invasive treatment is recommended. Ozone nucleolysis has recently been used to reduce pain and inflammation in herniated discs and other spinal conditions. This retrospective study from a single center aimed to evaluate the effects of ozone disc nucleolysis in the management of 149 patients with herniated lumbar intervertebral discs from 2022 to 2024. MATERIAL AND METHODS Between 2022 and 2024, intradiscal ozone nucleolysis was performed under operating room C-arm scopy in 149 patients who received medical treatment and physical therapy without surgical indication but did not benefit, and the results were evaluated retrospectively. Visual Analog Scale (VAS) scores and Oswestry Disability Index (ODI) scores were recorded before the procedure, and at 1 month, 3 months, 6 months, and 1 year. RESULTS The study enrolled 149 patients, comprising 61 males and 88 females, with an overall mean age of 43.9±4.7 years. The procedure was performed as 1 level in 138 patients and 2 levels in 11 patients. Among patients who underwent procedures based on lumbar MRI findings, 15 involved the L3-L4 intervertebral disc, 3 involved both the L3-L4 and L4-L5 discs, 90 involved the L4-L5 disc, and 31 involved the L5-S1 disc. Post-procedure VAS scores were significantly different at 1 month and 6 months (P<0.05). Post-procedure ODI scores were also significantly different at 1 month and 6 months. CONCLUSIONS Due to its low complication rate and effectiveness in treating lumbar disc herniation, ozone chemonucleolysis should be considered for use in patients who do not have a surgical indication or do not accept surgical intervention and did not benefit from medical treatment and physical therapy.

Left and right ventricular function by echocardiography, tissue doppler imaging, carotid intima media thickness, and asymmetric dimethylarginine levels in female adolescents with vitamin D deficiency.

BACKGROUND: The aim of our study was to assess left and right ventricle systolic and diastolic functions in female adolescents with vitamin D deficiency using conventional echocardiography and pulsed-wave tissue Doppler imaging and to investigate carotid intima media thickness and asymmetric dimethylarginine levels. METHODS: Sixty-six female adolescents were enrolled in this study. The female adolescents were divided into a vitamin D deficiency group (n: 34) and a control group (n: 32). All subjects underwent laboratory blood tests, including asymmetric dimethyl arginine, complete two-dimensional, pulse, and tissue Doppler echocardiography, and measurement of the carotid intima-media thickness. RESULTS: The vitamin D-deficient female adolescent group had normal left and right ventricle systolic and diastolic functions and normal global systolic and diastolic myocardial performance. In the patients with vitamin D deficiency, the carotid intima-media thickness was higher than that in the controls. In the patients within the vitamin D deficiency group, vitamin D was found to be positively correlated with magnesium and negatively correlated with phosphorus and left atrial dimension. CONCLUSIONS: The results of this study demonstrate that vitamin D deficiency in female adolescence is associated with normal myocardial geometry and function. Although it has been associated with normal levels of asymmetric dimethyl arginine concentration, high measured carotid intima-media thickness may reflect endothelial dysfunction.

The evaluation of retrobulbar fat tissue in Graves' orbitopathy with shear-wave ultrasound elastography.

PURPOSE: To evaluate retrobulbar adipose tissue of patients with active and inactive Graves' orbitopathy (GO) by shear-wave ultrasound elastography (SWE). METHODS: Followed-up in our ophthalmology clinic due to GO, 72 eyes of 36 patients and 38 eyes of 19 healthy controls were included in this cross-sectional case-control study. Graves' patients were divided into two subgroups under clinical activity score (CAS): active Graves' orbitopathy (AGO) (CAS ≥ 3) and inactive Graves' orbitopathy (IGO) (CAS < 3). SWE measurement values of retrobulbar adipose tissue of all participants were recorded in meters/second, and the intergroup comparisons were performed. RESULTS: Thirty-four eyes of 17 patients in AGO, 38 eyes of 19 patients in IGO, and 38 eyes of 19 participants in the control group were included in the study. Mean values measured from retrobulbar adipose tissue through SWE were 1.00 ± 0.01 m/sec in AGO, 1.16 ± 0.01 m/sec in IGO, and 0.94 ± 0.01 m/sec in the control groups. Even so, the mean SWE value was significantly higher in the IGO group than in the other groups (p < 0.001). Mean SWE values were significantly higher in the AGO group than in the controls (p = 0.008). In the correlation analysis performed, a significant positive correlation was found between SWE and Hertel exophthalmometer measurement values (p = 0.026, r = 0.212), and thyroid-stimulating hormone receptor antibody (TSHR-Ab) levels (p = 0.018, r = 0.224). CONCLUSION: We detected SWE values of retrobulbar adipose tissue high in GO, especially in the IGO group. Such a situation, which we associated with the development of fibrosis, may be an indicator of unresponsiveness to immunomodulatory treatments.

Prediction of gastric cancer by machine learning integrated with mass spectrometry-based N-glycomics.

Early and accurate diagnosis of gastric cancer is vital for effective and targeted treatment. It is known that glycosylation profiles differ in the cancer tissue development process. This study aimed to profile the N-glycans in gastric cancer tissues to predict gastric cancer using machine learning algorithms. The (glyco-) proteins of formalin-fixed parafilm embedded (FFPE) gastric cancer and adjacent control tissues were extracted by chloroform/methanol extraction after the conventional deparaffinization step. The N-glycans were released and labeled with a 2-amino benzoic (2-AA) tag. The MALDI-MS analysis of the 2-AA labeled N-glycans was performed in negative ionization mode, and fifty-nine N-glycan structures were determined. The relative and analyte areas of the detected N-glycans were extracted from the obtained data. Statistical analyses identified significant expression levels of 14 different N-glycans in gastric cancer tissues. The data were separated based on the physical characteristics of N-glycans and used to test in machine-learning models. It was determined that the multilayer perceptron (MLP) was the most appropriate model with the highest sensitivity, specificity, accuracy, Matthews correlation coefficient, and f1 scores for each dataset. The highest accuracy score (96.0 ± 1.3) was obtained from the whole N-glycans relative area dataset, and the AUC value was determined as 0.98. It was concluded that gastric cancer tissues could be distinguished from adjacent control tissues with high accuracy using mass spectrometry-based N-glycomic data.

Nocardia cyriacigeorgica brain abscess with Pemphigus vulgaris: first report.

Nocardia brain abscess is an uncommon but potentially life threatening opportunistic infection that generally occurs in immunocompromised patients. Nocardia cyriacigeorgica is a recently described species rarely reported as a cause of human disease. Pemphigus vulgaris is managed with immunosuppression. There have been four prior reports of brain abscess caused by Nocardia cyriacigeorgica.

Long-term follow-up results of surgically treated patients with foraminal and far lateral disc herniations.

PURPOSE: Foraminal and far lateral disc herniations are rarer cause of nerve root compression. There are reports regarding the outcome, however long-term follow-up results of surgically treated patients are few. The purpose of this retrospective study is to analyze the clinical characteristics and long-term surgical outcomes of the foraminal and far lateral disc herniations. MATERIALS AND METHODS: The 114 patients who underwent an operation for foraminal and far lateral disc herniaitions were reviewed. Visual analogue scale of back and leg pain, the ocurrence of motor deficit and sensory dysesthesia before and after operations were used to compare the results of early and long-term outcome. RESULTS: A total of 114 telephone interviews were conducted. The mean follow up was 134 months. Complete relief of symptoms were reported by 77 patients (67.1%). The average VAS of radicular leg pain was 7.5 Post-operatively the average VAS of radicular pain decreased to 2.2. Preoperatively, 9 patients (7.6%) had motor deficit and 17 (14.4%) patients had sensory dysesthesia. Post-operatively 9 (100%) of the patients showed motor, and 12 (70.6%) of the patients showed sensory improvement. In 17 patients with hypoesthesia the complaints continued during 2 weeks to 6 months. They were given gabapentin as medical treatment, however 5 of these patients still have sensory dysesthesia. The outcome was: 67.1% excellent (77 patients), 26.3% good (30 patients), 6.1% fair (7 patients). CONCLUSION: The far lateral approach is a minimally invasive and safe procedure with low complication rates.

Comparison of the effect of using panoramic and cone-beam computed tomography on the accuracy of root position in indirect digital bracket placement: A retrospective study.

OBJECTIVE: The purpose of this study was to compare the root position accuracy of the use of panoramic radiography and cone-beam computed tomography (CBCT) in the indirect digital bracket placement. METHODS: Two hundred and eighty-six maxillary and 300 mandibular teeth of 27 patients who have digital model, panoramic image and CBCT scan were included to the study. Indirect digital bonding was performed by using digital models and panoramic images in Group 1 and by superimposing the CBCT on the digital models with the OrthoAnalyzer™ 2020 (3Shape, Copenhagen, Denmark) software in Group 2. Angular measurements were calculated with 3-dimensional superimposition of the positions of the brackets placed with the Gom Inspect 2020 software. In the statistical analysis, One-way Analysis of Variance (ANOVA) and the Paired t test were used. RESULTS: Maxillary canines had the highest angular deviation at 5.56°± 4.01° in comparison with the maxillary teeth (P < .001). Mandibular canines and second premolars had the highest angular deviation in the comparison between mandibular teeth (P < .001). Considering the groups of ranges by clinical limits of the deviations, these differences were significant in the angular dimensions with 3.57° ± 2.59° (P < .001). The amount of deviation of all teeth was found 3.57° ± 2.59°in the study. CONCLUSIONS: Using panoramic images or CBCT in the digital bonding had clinical significantly effects on the angular deviation of bracket position. These findings may be taken into consideration when implementing bracket placement in indirect digital bonding. Despite the successful results, indirect digital bonding should not be the single reason to take the CBCT from the patients.

Effect of scan pattern on the scan accuracy of a combined healing abutment scan body system.

STATEMENT OF PROBLEM: A recently introduced scan body combined with a contoured healing abutment enables digital scans of the implant while its healing abutment shapes the soft tissue for an appropriate emergence profile. However, information on the effect of different scan patterns on the scan accuracy of this new system is lacking. PURPOSE: The purpose of this in vitro study was to evaluate the effect of scan pattern on the accuracy of digital implant scans by using a combined healing abutment-scan body system. MATERIAL AND METHODS: A combined healing abutment-scan body system was secured on a single implant at the right first molar site in a dentate mandibular model. A master reference model was generated by scanning the model with an industrial light scanner. The model was then scanned with 4 different scan patterns (SP-A, SP-B, SP-C, and SP-D) by using an intraoral scanner (TRIOS 3). Test scans (n=8) were superimposed over the master reference model by using a metrology software, and distance and angular deviations were calculated. Distance and angular deviation data were analyzed with a multivariate analysis of variance and the Tukey honestly significant difference tests for trueness and precision (α=.05). RESULTS: Distance deviations (trueness [P=.461] and precision [P=.533] deviations) in the scans were not significantly affected by the scan pattern. Scan pattern affected the trueness (P=.001) and precision (P=.002) when angular deviations were considered. In terms of trueness, SP-D resulted in the highest angular deviations in scans (P≤.031), while the difference in deviations in scans obtained by using other scan patterns was not significant (P≥.378). When angular deviation data were considered, SP-D resulted in lower scan precision than SP-A (P=.014) and SP-B (P=.007). The precision of scans using SP-C was similar to the precision of the scans made by using other scan patterns (P≥.055) in terms of angular deviations. CONCLUSIONS: The scan accuracy of a combined healing abutment-scan body system was affected by the scan pattern. The scans performed with SP-D presented the lowest accuracy considering the angular deviation data and, therefore, may be the least favored among the patterns tested for scanning a combined healing abutment-scan body system.

Comparison of fit accuracy between conventional and CAD/CAM-fabricated band-loop space maintainers.

AIM: The aim of this in vitro study was to evaluate the band fit of metallic band-loop space maintainers fabricated by conventional and 3D printing technologies for clinical applications. DESIGN: Sixteen digital intraoral impressions were selected, and resin models were printed with a 3D printer. Forty band-loop space maintainers were fabricated (20 each for both the conventional and digital groups). To evaluate the band fit of conventional and CAD/CAM-fabricated space maintainers, cement space was visualized with low-viscosity condensation silicone material on resin models. Digital evaluation was carried out using dual scan method by superimposing two scans of resin models covered with or without a silicone layer on the abutment tooth. The mean quadratic deviation (root mean square, RMS) was calculated. The RMS values between the groups were evaluated with Student's t test. Statistical significance was set at p < .05. RESULTS: No statistical significance was found between the conventional and digital groups (p = .56). CONCLUSIONS: Within the limitations of this study, the band fit of conventional and CAD/CAM-fabricated space maintainers had no difference. Future research into CAD/CAM-fabricated appliances from different perspectives such as fracture strength and patient comfort is warranted.

Effect of Scanner Type and Scan Body Location on the Accuracy of Mandibular Complete-Arch Digital Implant Scans: An In Vitro Study.

PURPOSE: To compare the accuracy (trueness and precision) of scans of a newly introduced intraoral scanner (IOS) (Virtuo Vivo) and a widely used IOS (Trios 3) to a laboratory scanner (LBS) (Cares 7 SERIES) for 6 implants placed in an edentulous mandible, and to investigate the effect of scan body location on trueness. MATERIAL AND METHODS: Scanbodies were tightened on 6 implants placed in an edentulous polymethylmethacrylate mandibular model. An industrial scanner was utilized to generate a master reference model STL file. Three different scanners were used to scan the model (2 IOSs and 1 LBS), and the scans (n = 10) were exported into STL files. Best-fitting algorithm was used to superimpose test scans over the MRM-STL (nominal). ANOVA and Tukey HSD tests were performed to analyze the data (α = 0.05). RESULTS: The distance deviations in Car7-LBS scans were the highest (p < 0.001), whereas those in Tri-IOS scans were the lowest (p < 0.001). Vir-IOS had lower angular deviations than those of Tri-IOS (p = 0.031). In Vir-IOS scans, SB5 had higher distance deviations than SB2 (p = 0.029) and SB3 (p = 0.044). In Car7-LBS scans, SB1 had higher distance deviations than SB3 (p = 0.015) and SB5 (p = 0.005). In Tri-IOS scans, SB1 had higher mean distance deviations than SB2 and SB5 (p = 0.005). Vir-IOS had lower precision than Car7-LBS (distance deviation data) (p = 0.01). No difference was found among scanners for the precision of angular deviation data (p = 0.840). CONCLUSION: When trueness and precision were considered, distance and angular deviations depended on the scanner type. None of the scanners outperformed others in accuracy considering all distance and angular deviations. Scan body location affected only the trueness (distance deviations).

A rare case of cervical metastatis of glioblastoma after cranial tumor resection: case report and review of literature.

Glioblastoma multiforme (GBM) is the most common and the most malignant primary intracranial tumor in adults. GBM extraneural metastases occur in only approximately 0.2-0.4% of patients. We present a case of a cervical metastasis of glioblastoma after cranial tumor resection. In concord with case presentation, we reviewed the metastatic location and metastasis time of the gliablastomas seen in the literature.

Effect of Impression Technique and Operator Experience on Impression Time and Operator-Reported Outcomes.

PURPOSE: To investigate the effect of impression technique (conventional preliminary alginate and digital scan) and operator experience in impression making (experienced in digital and conventional, experienced in conventional and inexperienced in digital, and inexperienced in conventional and digital) on impression time, satisfaction and stress levels, and the preference of the operators. MATERIAL AND METHODS: One patient was assigned for each of the 60 operators, who were experienced in impression techniques at different levels (Group 1: experienced in conventional and digital, Group 2: experienced in conventional and inexperienced in digital, Group 3: inexperienced in conventional and digital). They made conventional impressions (irreversible hydrocolloid) and digital scans (Trios 3) from the same patient. The impression times were recorded at each step (patient registration, maxillary arch, mandibular arch, and bite registration) and in total. A visual analog scale (VAS) was used for the operator satisfaction for applicability, comfort, and hygiene; the State-Trait Anxiety Inventory form (STAI-TX1) was used for stress, and a questionnaire was completed to measure the operator's impression preference. The data were analyzed with a 2-way ANOVA and Chi-square test (α = 0.05). RESULTS: A significant interaction was found between the operator experience in impression making and the impression technique on time for maxillary and mandibular arch impressions and total time (p ≤ 0.002). Operator experience and impression technique interaction had a significant effect on comfort and average VAS scores (p ≤ 0.016). Whereas, no significant effect of this interaction was found on stress (p ≥ 0.195). Operator experience in impression making had a significant effect on applicability (p < 0.001), and the impression technique had a significant effect on hygiene VAS scores (p < 0.001). Operators in Group 1 and Group 3 preferred the digital scans, however, operators in Group 2 had no preference (p = 0.022). CONCLUSION: Operator experience in impression making and impression technique had varying effects on clinician's impression time, comfort, applicability, hygiene, and preference. Operators needed less time for the impressions they were experienced with. Operator stress level was not affected by the operator experience in impression making and the impression technique. Dental students and operators experienced in both techniques were satisfied with the digital scans and they preferred digital scans. Operators experienced with conventional impressions were satisfied with conventional impressions but didn't have a preference for the impression type.

The Psychological Effects of COVID 19 on Medical and Non-medical University Students.

BACKGROUND: The COVID 19 pandemic has had significant psychological effects on university students as well as in all segments of society. The aim of this study is to examine the relationship between education fields (medical-non medical), education styles (online-face to face), sociodemographic characteristics of university students and their levels of depression, anxiety, stress, fear of COVID-19. SUBJECTS AND METHODS: In the cross-sectional designed research, 1213 university students studying in Turkey was reached online. A sociodemographic form, the Depression Anxiety Stress Scale (DASS 21) and the Fear of COVID-19 Scale (FCV-19S) was applied to the participants. RESULTS: Of all participants 887 (73%) were women. 647 (53%) students were studying in the medical field. The scores of FCV-19S and all subscales of DASS 21 were significantly higher in women. In the comparison between the field and style of education, no difference was found. DASS 21 scores were higher in the participants whose relatives had COVID-19 or who had a mental disorder in the past or medical disease. CONCLUSIONS: In this study, it was observed that while there was no significant difference in the scores of DASS 21 among university students in terms of the field and style of education, variables such as gender, not having COVID-19 so far, having lost a relative due to COVID-19 could cause significant differences. Identifying sensitive groups will create early intervention opportunities.

Neutrophil-to-lymphocyte and Platelet-to-lymphocyte Ratios in those with Pulmonary Embolism in the Course of Coronavirus Disease 2019.

BACKGROUND: To investigate the levels of neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios in those having a pulmonary embolism (PE) in the course of coronavirus disease 2019 (COVID-19). METHODS: The records of those having COVID-19 were retrospectively obtained from the hospital automation system. NLR and PLR were measured with the help of patients' blood cell counts. RESULTS: Of 1,452 COVID-19 patients, 17 (1.2%) were diagnosed with PE. Compared with the controls, while leukocyte (p = 0.001), neutrophil (p <0.001), and neutrophil percentages, (p = 0.001) and NLR (p <0.001) and PLR (p = 0.006) had higher values, lymphocyte count (p = 0.004) and lymphocyte percentage (p <0.001) showed lower values in the patients with PE.Compared to the survivors, the non-survivors were found to have increased leukocyte (p <0.001), neutrophil (p <0.001), and neutrophil percentages (p <0.001), NLR (p <0.001) and PLR (p <0.001), and decreased lymphocyte (p <0.001) counts and percentage (p <0.001), hemoglobin (p = 0.005), hematocrit (p = 0.012), and platelet counts (p <0.001).While NLR and PLR cutoffs were found as 4.338 and 187.83 in predicting PE, the cutoff values of NLR and PLR were, respectively, 4.301 and 172.5 in predicting mortality.The logistic regression analysis also revealed that all hematological parameters had no effects on the development of PE. CONCLUSION: Although NLR and PLR had higher scores in PE patients, no relationship was determined between the levels of NLR and PLR and PE development. Further prospective studies including larger populations are required to enlighten the increased NLR and PLR in PE patients having COVID-19. HOW TO CITE THIS ARTICLE: Akkus C, Yilmaz H, Duran R, Diker S, Celik S, Duran C. Neutrophil-to-lymphocyte and Platelet-to-lymphocyte Ratios in those with Pulmonary Embolism in the Course of Coronavirus Disease 2019. Indian J Crit Care Med 2021;25(10):1133-1136.

Celiac disease does not influence markers of ovarian reserve in adolescent girls.

PURPOSE: The aim of the study was to determine whether celiac disease affects ovarian reserve assessed by antral follicle counting, ovarian volume, and anti-müllerian hormone in adolescent patients. METHODS: This case-control multicenter trial was performed from January 1, 2017 to May 31, 2018 and included 45 girls. On days 2-5 of the menstrual cycle, measurements of serum follicle stimulating hormone, luteinizing hormone, estradiol, prolactin, and anti-müllerian hormone were performed. Antral follicle counts and ovarian volumes were determined on the same day. RESULTS: Evaluation was made of 21 (47.7%) celiac patients with a mean age of 15.8 ± 1.3 years, and 24 (52.3%) healthy control subjects with a mean age of 16.2 ± 1.2. There was no difference between the groups in respect of right and left ovarian volumes (p = 0.790 and p = 0.670, respectively). Serum levels of anti-müllerian hormone of the celiac patients and controls were found comparable [(3.7 ± 2.9 (0.5-12) and 3.6 ± 1.8 (1.2-8.1)] ng/mL, respectively, p = 0.915). CONCLUSIONS: Celiac disease may not affect the ovarian reserve determined with established ovarian reserve markers including antral follicle counting, ovarian volume, and anti-müllerian hormone in adolescent patients. TRIAL REGISTRATION: ClinicalTrials.gov identifier (NCT number): NCT04024449 https://clinicaltrials.gov/ct2/show/NCT04024449.

Association between parity and lumbar spine degenerative disorders in young women.

Introduction: Estrogen helps to maintain the health of collagen-containing tissues including the intervertebral disc. Estrogen deficiency after menopause negatively affects the quality of vertebral end plates and induces development of degenerative disc disease (DDD). However, there is no study examining the relationship between parity and spinal degeneration in young women. The aim of this study was to define the relationship between parity and development of vertebral endplate signal changes and DDD in young premenopausal women.Materials and methods: This case-control case study included 224 patients aged 20-40 years with a history of low back pain for at least 3 months. Pfirrmann's grade, Modic changes (MCs), and Schmorl's nodes (SNs) were graded based on magnetic resonance images. Patients' parity, demographics, body mass index, physical activity level, and disability scores were assessed using a questionnaire.Results: The prevalence of abnormal total Pfirrmann's score (>10) and MCs was higher in primiparous patients than multiparous and grand-multiparous; however, it was not statistically significant. The presence of SN was statistically significantly associated with low parity. According to multivariate logistic regression analysis, it was found that the number of births increases by 1 unit, the abnormality in Pfirrmann's score decreases by 1.36 times.Conclusions: This cross-sectional study shows that parity is associated with DDD and vertebral end plate changes. SNs were significantly associated with parity. Modic changes and DDD were less common in grand multipara and multipara young women than in primipara women. These results indicate that low parity may possibly be associated with the development of spinal degeneration.

Flexural strength of CAD-CAM and conventional interim resin materials with a surface sealant.

STATEMENT OF PROBLEM: The flexural strength of computer-aided design and computer-aided manufacturing (CAD-CAM) and conventional interim resin materials when they are used with a surface sealant is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the flexural strength of different CAD-CAM polymethyl methacrylate (PMMA)-based polymers and conventional interim resin materials, autopolymerized bisacrylate composite resin and polyethyl methacrylate (PEMA) with and without a surface sealant after thermocycling. MATERIAL AND METHODS: Fourteen rectangular-shaped specimens (25×2×2 mm) were fabricated from 5 different interim resin materials, 3 different CAD-CAM PMMA-based polymers: Polident-PMMA, Telio CAD, M-PM-Disc; 2 different conventional interim resin materials, and 1 autopolymerized bisacrylate composite resin: Acyrtemp and 1 PEMA resin: Bosworth Trim according to ISO 10477:2018. Two different types of surface treatments (n=7), conventional polishing and surface sealant application, were applied to 1 surface of the specimens. Ten thousand thermocycles were applied in distilled water for all specimens (5 °C and 55 °C). A 3-point bend test was used to measure the flexural strength of specimens in a universal testing device at a 1 mm/min crosshead speed. The flexural strength data (σ) were calculated in megapascals (MPa) and analyzed by using a 2-way ANOVA. Post hoc pairwise comparisons and independent t test analysis were done (α=.05). RESULTS: According to the 2-way ANOVA, material type (P<.001) significantly affected the flexural strength. Surface treatment type (P=.818) had no significant effect on flexural strength, and no significant interaction was found between material type and surface treatment type (P=.111). CAD-CAM PMMA-based polymers had significantly higher flexural strength than the conventional interim resin materials. However, no significant difference was found within groups of the same type. Also, no significant difference was found in flexural strength values between the conventional polishing and surface sealant groups within each interim resin material (P≥.162). CONCLUSIONS: The flexural strength of CAD-CAM PMMA-based polymers was higher than the flexural strength of conventional bisacrylate composite resin and PEMA interim resin materials after thermocycling. The surface treatment type (conventional polishing and surface sealant application) was not found to affect the flexural strength of CAD-CAM PMMA-based polymers, conventional bisacrylate composite resin, or PEMA interim resin materials.

Left and right ventricular function by echocardiography, tissue Doppler imaging, carotid intima-media thickness, and asymmetric dimethyl arginine levels in obese adolescents with metabolic syndrome.

PurposeThe aim of our study was to assess left ventricle and right ventricle systolic and diastolic functions in obese adolescents with metabolic syndrome using conventional echocardiography and pulsed-wave tissue Doppler imaging and to investigate carotis intima-media thickness, and asymmetric dimethyl arginine levels. METHODS: A total of 198 obese adolescents were enrolled in the study. The obese patients were divided into metabolic syndrome group and non-metabolic syndrome group. All subjects underwent laboratory blood tests, including asymmetric dimethyl arginine, complete two-dimensional, pulsed, and tissue Doppler echocardiography, and measurement of the carotid intima-media thickness. RESULTS: Obese adolescents were characterised by enlarged left end-diastolic, end-systolic and left atrial diameters, thicker left and right ventricular walls compared with non-obese adolescents. The metabolic syndrome group had normal left ventricle systolic function, impaired diastolic function, and altered global systolic and diastolic myocardial performance. In the metabolic syndrome obese group patients, left ventricle mass was found positively correlated with body mass index, waist and hip circumferences, diastolic blood pressure, age, and waist-to-hip circumference ratio. The carotid intima-media thickness was found positively correlated with waist and hip circumferences and total cholesterol levels. Asymmetric dimethyl arginine levels were found positively correlated with systolic blood pressure, waist-to-hip circumference ratio, and diastolic blood pressure. CONCLUSIONS: The results of this study demonstrate that metabolic syndrome in adolescence is associated with significant changes in myocardial geometry and function. In addition, it has been associated with a high level of asymmetric dimethyl arginine concentration and thicker carotid intima-media thickness reflecting endothelial dysfunction.

The top 50 most-cited articles on low-grade glioma: a bibliometric analysis.

PURPOSE: There is an abundance of articles published on low-grade glioma. The aim of this study was to identify and review the 50 most-cited articles on low-grade glioma, and to perform a bibliometric analysis. METHODS: In June 2017, we performed a basic search of the Web of Science database using "low-grade glioma management and/or treatment" as our search terms without publication date restrictions. The top 50 most-cited articles were obtained and reviewed. RESULTS: The top 50 most-cited articles received a mean 195 citations per paper, with 571 citations being the most and 81 citations being the least. Publication dates ranged from 1992 to 2013. The articles were published in 17 journals and Journal of Neurosurgery published the greatest number of articles (10 of 50), followed by Journal of Clinical Oncology (9 of 50). The most frequent study categories were natural history studies (19 of 50) and laboratory studies (13 of 50). Neurosurgery as a specialty contributed to 22 articles. The majority of the articles originated in the United States (44%). CONCLUSION: We identified the top 50 most-cited articles on low-grade glioma and the level of knowledge about this topic has been increased.

Digital versus conventional impression method in children: Comfort, preference and time.

BACKGROUND: The comfortness and effectiveness of digital and conventional impression methods in children have not yet been compared. AIM: To assess the digital and conventional impression methods in children in terms of comfort, preference, and the time required to take impressions. DESIGN: Digital impressions were taken by using an intraoral scanner, and conventional impressions were taken by using alginate from 28 patients by the same operator. In each impression-taking-process, comfort was assessed by both the children and the clinician, and the chairside times were written. Student's t tests and Mann-Whitney U tests were used for statistical analyses, and P < .05 was considered to be significant. RESULTS: The digital impression was considered to be more comfortable in the assessments by both the children and the clinician (P < .001). The total time the digital impression took was 465.89 ± 76.71 second(s) while that of the conventional impression was 450.25 ± 64.08 s when the chairside times of the two impression methods were compared. There was no statistically significant difference (P = .41). CONCLUSION: The digital impression method compared with the conventional impression method was found to be both more comfortable and preferable by the children, but there was no difference in terms of the time required to take impressions.