Translation, validation, and cross-cultural adaption of the Western Ontario Meniscal Evaluation Tool (WOMET) into German.

PURPOSE: The Western Ontario Meniscal Evaluation Tool (WOMET) was developed in order to investigate the health-related quality of life of patients with meniscal pathologies. The aim of the present study was to translate and validate the WOMET into German. METHODS: A standardized forward backward translation of the WOMET into German was first performed. One hundred ninety-two patients with isolated meniscal tears completed the German version of the WOMET as well as the Western Ontario McMasters University Arthritis Index, and the Knee Osteoarthritis Outcome Score. Furthermore, reliability, construct validity, feasibility, internal consistency, ceiling, and floor effects were then calculated. RESULTS: Excellent feasibility (85.4% fully complete questionnaire), internal consistency (Cronbach's α = 0.92), and test-retest reliability (ICC, r = 0.90) were found. The standard error of measurement and the minimal detectable change were ±4.6 and 12.7 points, respectively. All predefined hypothesises were confirmed. No floor or ceiling effects were found. CONCLUSIONS: The presented German version of the WOMET is a valid and reliable tool for investigating the health-related quality of life of German-speaking patients with meniscal pathologies. LEVEL OF EVIDENCE: Cross-sectional study, Level II.

Comparison of ProTaper Next and HyFlex instruments on apical debris extrusion in curved canals.

AIM: To evaluate the amount of apically extruded debris after root canal instrumentation with ProTaper Next and HyFlex instruments in curved root canals. METHODOLOGY: Forty extracted mandibular first molar teeth with curved mesial roots and of similar lengths were instrumented using ProTaper Next or HyFlex instruments. The extruded debris was collected into pre-weighed Eppendorf tubes. The tubes were stored in an incubator at 68 °C for 5 days. The tubes were weighed to obtain the final dry weight of the extruded debris. The weight of the extruded debris was determined by subtracting the initial weight from the final weight. Distribution of data was determined by Shapiro-Wilk test. Continuous variables were compared with the Independent Sample t-test or Mann-Whitney U-test. The significance level was set at P = 0.05. RESULTS: Both instruments were associated with apical debris extrusion. The HyFlex group had significantly less debris extrusion than the ProTaper Next group (P = 0.014). CONCLUSION: HyFlex CM was associated with significantly less apical extrusion than ProTaper Next.

Apical extrusion of debris using ProTaper Universal and ProTaper Next rotary systems.

AIM: To assess and compare the amount of extruded debris after canal preparation using ProTaper Universal and ProTaper Next files. METHODOLOGY: Forty extracted mandibular premolars with single canals and of similar lengths were instrumented using the ProTaper Universal F3 or the ProTaper Next X3. The extruded debris during instrumentation was collected into pre-weighed Eppendorf tubes. The tubes were stored in an incubator for 5 days. The tubes were weighed to obtain the final dry weight of the extruded debris. The amount of apically extruded debris was calculated by subtracting the initial weight of the tube from the final weight. The distribution of the data was examined using the Shapiro-Wilks test. Continuous variables were compared with an independent-samples t-test for two groups. RESULTS: All specimens were associated with apical debris extrusion. The ProTaper Universal group produced a significantly greater amount of debris extrusion (P < 0.001). The lowest and highest amounts of debris for PTU and PTN groups were recorded as 0.00117-0.00165 g and 0.00017-0.00067 g, respectively. CONCLUSION: ProTaper Next files was associated with significantly less extruded apical debris when compared to ProTaper Universal files.

Comparison of various current electronic apex locators to determine the working length using the clearing technique.

BACKGROUND: Correct working length determination is an important step for successful endodontic therapy. OBJECTIVE: The objective was to compare in vitro the accuracy of three electronic apex locators (EALs) (DentaPort ZX [Morita Co., Tokyo, Japan], SIROEndo Pocket [Sirona Dental Systems, NY, USA], and Rootor [Meta Biomed, Cheongwon-gun, Korea]) in detecting the major foramen using the clearing technique. MATERIALS AND METHODS: Forty-five human extracted single-rooted teeth with mature apices were used for the study and divided into three groups of 15 teeth each. All teeth were embedded in an alginate model, and the electronic measurements were taken following the manufacturers' orientations. Then, the teeth were cleared and photographed under a stereomicroscope with a digital camera. The distance from the file tip to the major foramen was measured using image analysis software program. Statistical analysis was performed using the Kruskal-Wallis, Mann-Whitney U, and Chi-square tests at a significance level of 0.05. RESULTS: The mean distances from the file tip to the major foramen were 0.164 ± 0.292, -0.162 ± 0.234, 0.341 ± 0.166 mm in the DentaPort ZX, SIROEndo Pocket, and Rootor groups, respectively. Statistical analysis showed that there was a significant difference between SIROEndo Pocket and Rootor (P < 0.05). However, no significant difference was found between DentaPort ZX and other EALs (P > 0.05). CONCLUSION: DentaPort ZX located the major foramen with 100% accuracy within the range of ± 0.5 mm. However, the accuracy of the SIROEndo Pocket and Rootor in locating the major foramen within ± 0.5 mm was 73.3% and 86.7%, respectively. All EALs showed an acceptable determination of the major foramen within the range of ± 0.5 mm.

Comparison of hardness of three temporary filling materials cured by two light-curing devices.

AIM: Polymerization ability of light-curing devices can affect the light-cured material hardness. The purpose of the present study was to evaluate and compare the hardness of three temporary filling materials that had been light-cured by either a light emitting diode (LED) or a halogen light-curing unit. METHODS: The temporary filling materials, First Fill, Voco Clip and Bioplic, were placed in wells in a Teflon plate. The 24 specimens of each material were divided into two groups (N.=12/group) for photo-activation by either of the two light-curing units. The LED or halogen device was applied for 40s to the top surface of each specimen. A Knoop hardness test was performed on the top and bottom surface of each specimen, with five measurements per specimen. RESULTS: The highest hardness values for both the LED and halogen treated groups were observed for First Fill and the lowest values were for Voco Clip in top and bottom surfaces. The hardness obtained for the three materials with the halogen unit were significantly higher than the values obtained with the LED unit in both surfaces (P<0.05). CONCLUSION: First Fill light-cured temporary material exhibited the highest hardness values on the top and bottom surfaces than Voco Clip and Bioplic temporary materials. The hardness of light-cured temporary filling materials can be affected by the type of light-curing unit.

Comparison of laparoscopic and open adrenalectomy.

UNLABELLED: Laparoscopic adrenalectomy is one of the most significant advances in the past 20 years for treating adrenal disorders. Laparoscopic adrenalectomy has been the golden standard procedure for all adrenal pathologies since it was first defined in 1992. Laparoscopic adrenalectomy is preferred and has advantages such as less postoperative pain, earlier resumption of oral intake, shorter hospital stay, earlier return to normal life and better esthetical results. In our study we compared morbidity and mortality rates of laparoscopic and open adrenalectomy cases. MATERIAL AND METHODS: In Ankara University Faculty of Medicine General Surgery department 92 cases of adrenalectomy were performed between january 2000-july 2006. The patients were evaluated for age, sex, duration of perioperative hospital stay, resumption of oral intake, duration of operation, surgical wound infection, conversion rate and complications. RESULTS: In patients who underwent laparoscopic surgery, rate of conversion to open surgery was 9.3% (4 patients). The mean operative duration in the laparoscopic adrenalectomy group was 150 minutes and the mean operative duration in the open adrenalectomy group was 120 minutes (p = 0.001). Surgical wound infection rate was 6% in the open adrenalectomy group and 2% in the laparoscopic adrenalectomy group. Mean perioperative hospital stay was 7.1 days in the open adrenalectomy group and 5.1 days in the laparoscopic adrenalectomy group. Time to resumption of oral intake was 2.42 days in the open adrenalectomy group and 1.05 days in the laparoscopic adrenalectomy group (p = 0.001). There was no perioperative mortality in none of the groups. CONCLUSION: Laparoscopic adrenalectomy is the golden standard surgical treatment for benign and selected malignant adrenal diseases. Laparoscopic adrenalectomy is a safe and effective technique and has advantages such as less postoperative pain, earlier resumption to oral intake, shorter hospital stay, earlier return to normal life and better esthetical results compared to open adrenalectomy.

An in vitro comparison of working length determination by two motor-driven electronic apex locators.

AIM: The aim of this study was to evaluate the in vitro working length determination of two different apex locator integrated endodontic motors during mechanical preparation. METHODS: A total of 51 maxillary incisors were selected. The access cavities were prepared. The actual working lengths (AWL) were predetermined with a #15 stainless steel file. Specimens were then mounted in an alginate model. RESULTS: Working lengths recorded were VDW Gold (V1), Tri Auto ZX (T1) without using electronic motor and VDW Gold (V2), Tri Auto ZX (T2) by using apex locators in electronic motor operation mode. Data was analyzed by repeated measurements of ANOVA (α=0.01). No difference was found between V1, V2, T1 and T2 (P>0.01). However, statistical analysis found significant differences between AWL and other groups (P<0.01). CONCLUSION: As the values obtained in motor driven mode are equivalent to manual mode measurements, both devices can be safely used without disruption of working length.

The predictive value of the clinical features of malignancy in cases of preoperative follicular thyroid neoplasia.

AIM: It is generally impossible to make a distinction between benign and malign with a cytopathological examination using a fine needle aspiration biopsy (FNAB) in follicular lesions of the thyroid gland. This is the reason why lesions are frequently reported as follicular neoplasia (FN). Our study aims to examine the predictive value of carcinoma detection of different clinical features in cases with determined FN with FNAB. METHODS: Clinical and histopathological data of a total of 116 patients (26 male, 90 female) subjected to surgery because of thyroid gland pathology with FN between March 1997 and December 2011 were retrospectively examined in two different centers. RESULTS: Results of the histopathological examinations were reported as: carcinoma in 33 (28.4%) cases (18 [54.5%] cases with papillary thyroid cancer, 11 [33.3%] cases with follicular thyroid cancer and 4 [12.1%] cases with papillary thyroid cancer follicular variant), as follicular adenoma (FA) in 32 (27.6%) patients and as a benign colloidal nodule in 51 (43.9%) patients. No statistical significance was determined between advanced age, male sex, solid single nodule, increased nodule diameter, hypoactive nodule existence and malignancy (P>0.05). CONCLUSION: Malignancy was found in 28.4% cases with FN detected as a result of FNAB in our study series, a ratio which is significantly higher than that reported in the literature. We think that the characteristics of the patient and the tumor are not effective in diagnosing cancer. In the case of the existence of bilateral thyroid pathology, the surgical therapy option should be bilateral total thyroidectomy due to such a high ratio of cancer occurrence.

The frequency of sodium hypochlorite extrusion during root canal treatment: an observational clinical study.

BACKGROUND: To determine the frequency of sodium hypochlorite (NaOCl) extrusion and evaluate the outcome of the injury. METHODS: A total of 1123 teeth indicated root canal treatment were included. An open-ended needle was used during/after the instrumentation. Acute burning pain during irrigation was considered as NaOCl extrusion. Negative aspiration was applied for patients with extrusion, and appropriate treatment was planned due to the symptoms. The number of patients who experienced extrusion and symptoms were recorded. Analysis of variance (ANOVA), at P < 0.05, was used to compare the data groups. RESULTS: NaOCl extrusion rate was found at 0.89%, and the injury with swelling that differential diagnosis of NaOCl accident caused by extrusion rate was 0.18%. The most common findings besides acute pain, as a sign of extrusion (n = 10), were accompanying apical bleeding (n = 6) and swelling (n = 2). According to the number of visits, a significant correlation was found between the symptoms (P = 0.010). No serious injury such as a neurological sign, tissue necrosis or trismus occurred in any patient. CONCLUSIONS: Demographic characteristics of the patients and preoperative condition of teeth were not related to NaOCl extrusion. The increasing number of visits may affect the probability of an accident. Negative aspiration immediately may be crucial in preventing severe injuries.

Fluid replacement via the rectum for treatment of hypovolaemic shock in an animal model.

BACKGROUND: The importance of early and effective fluid resuscitation in hypovolaemic shock treatment is indisputable. AIM: To examine the effects of fluid replacement via the rectum in an animal model of hypovolaemic shock as a possible life-saving method in situations where veins cannot be accessed quickly. METHODS: Rabbits were randomly divided into two groups: a control group of 7 animals and a second group of 10, the fluid replacement via the rectum (FRVR) group. The femoral artery of each subject was catheterised and 15 ml blood was withdrawn over 1 min at 5-min intervals. After reaching a mean arterial pressure (MAP) of 30 mm Hg, additional blood was withdrawn until the MAP dropped to <25 mm Hg, at which time blood withdrawal ceased. At this point, control animals were given no treatment and were monitored for 30 min. The FRVR group, however, was given 0.9% sodium chloride solution (amount equal to three times the amount of blood withdrawn) via the rectum over a 15-min period. The MAPs of both groups were then measured, every 5 min after the start of resuscitation, for 30 min. RESULTS: In the FRVR group, the MAP began to rise significantly after 15 min of receiving fluid per rectum (p = 0.035) and continued to be significantly greater than the control group at 20, 25 and 30 min (p = 0.035, 0.002 and 0.001, respectively). CONCLUSION: FRVR is a viable alternative for fluid resuscitation in this animal model of hypovolaemic shock. This easy and non-invasive method of fluid replacement may be useful when standard intravenous access is unobtainable, and should be compared with other access routes using varying types and amounts of fluids in future animal studies.

Attitudes toward physical education classes of primary school students in Turkey.

The purposes of this study were to report an investigation of attitudes toward physical education in a sample of primary school students and examine the predictive influence of students' sex, grades in physical education classes, and parents' education and socioeconomic status on students' attitudes. Participants, 963 (474 girls and 489 boys) primary school students from Grades 6 (12.7%), 7 (10.3%) and 8 (77%), completed the Wear Attitude Inventory. Analysis indicated students had positive scores on General Attitudes rather than on Social, Emotional, and Physical Attitudes. In addition, girls (M = 32.6, SD = 3.9) had more positive General Attitudes than boys (M = 32.0, SD = 4.6). Also, students' grades in physical education classes were statistically significantly related to their Attitudes toward physical education (Wilks lambda, F1,1110 = 2.88, p < .05). However, parents' education and socioeconomic status were not. One may infer that ways of encouraging more favorable attitudes might be planned.

The risk of hypoparathyroidism after central compartment lymph node dissection in the surgical treatment of pT1, N0 thyroid papillary carcinoma.

OBJECTIVE: The role of central compartment lymph node dissection (CCLND) in the treatment of papillary thyroid carcinoma (PTC) is still controversial. The benefits of CCLND should be weighed against its potential risks. We aim to evaluate the positivity of central lymph nodes in pT1, N0 PTC and to establish the complication rates of total thyroidectomy (TT)+CCLND. PATIENTS AND METHODS: This is a retrospective study on prospectively collected data over a 45-month period. A total of 329 patients were included. Total thyroidectomy was performed in 130 (39.5%) of these patients due to benign thyroid pathologies, and 199 (60.5%) pT1, N0 PTC patients had TT+CCLND. Our TT technique was applied in the same way in both groups. Central lymph node positivity, the number of lymph nodes removed during CCLND and the operative complications were evaluated. T-test and chi-square analysis were conducted in independent groups for statistical evaluation. RESULTS: The rate of central lymph node positivity in TT+CCLND group was 38%. The average number of lymph nodes removed by CCLND is 10.2 (1-36). Complication rates between TT and TT+CCLND groups were statistically significant (3.8% vs. 11.1%, respectively) (p<0.05). The difference was found to be particularly more pronounced for transient hypocalcemia. Although there was no significant relation between the number of lymph nodes removed during CCLND and the number of parathyroid glands detected in the pathology specimens (p>0.05), the relation between the development of symptomatic hypocalcemia and the number of the parathyroid glands removed during surgery was significant (p <0.05). CONCLUSIONS: Central compartment lymph node metastasis in PTC is common. CCLND may increase the rate of transient hypocalcemia.

The impact of the multifocality and subtypes of papillary thyroid carcinoma on central compartment lymph node metastasis.

OBJECTIVE: Papillary thyroid carcinoma (PTC) may often appear as multifocal disease. Few studies demonstrated a higher rate of central compartment lymph node metastasis (CCLNM) in multifocal PTC patients. Therefore, the effect of different histological subtypes of multifocal PTC on CCLNM is another subject for further examination. The aim of the present study is to evaluate the rate of central lymph node positivity in multifocal PTC as compared to unifocal disease, and to identify the role of different histologic subtypes of PTC on central neck lymph node positivity. PATIENTS AND METHODS: Patients with PTC who underwent total thyroidectomy (TT) + central cervical lymph node dissection (CCLND) at authors' institution between January 2012 and June 2016 were included (n=274). Independent Samples t-test, Mann-Whitney U test and Chi-square tests were used to determine univariate associations, and multivariate analysis was conducted by logistic regression. RESULTS: The rate of CCLND positivity in multifocal PTC is higher than unifocal tumors and the difference is significant (p < 0.05). The univariate analysis demonstrated significant relation with male sex, lymphovascular invasion and size of dominant nodule > 10 mm regarding of CCLND positivity in multifocal PTC patients. The comparison between solitary and mixed histologic subtype of multifocal PTC is also significant (p < 0.05). CONCLUSIONS: Multifocality is an important risk factor for CCLNM. Male sex, dominant tumor size >10 mm and mixed histological subtype in multifocal PTC may play an important role in CCLND positivity.

Simultaneous differential pulse polarographic determination of cadmium, lead, and copper in milk and dairy products.

The contents of potentially toxic elements lead and cadmium and the essential element copper in various milk and dairy products consumed in Turkey were determined by differential pulse polarography (DPP), primarily to assess whether the intakes comply with recommended desired concentrations for essential and permissible levels for toxic elements. A simple and rapid DPP method has been developed for the simultaneous determination of cadmium, lead, and copper in samples. Using the differential pulse mode, half-wave peak potentials as E(1/2) were -0.58, -0.40, and -0.07 V for cadmium (Cd), lead (Pb), and copper (Cu), respectively. Marketed formulations of dairy products have been analyzed by calibration and standard addition methods. Recovery experiments were found to be quantitative. The linear domain ranges were 0.00-674.28 microg/L for Cd (R2 = 0.9999), 0.19-2.94 mg/L (p < 0.01) for Pb (R2 = 0.9997), and 0.41-133.46 microg/L for Cu (p < 0.01) (R2 = 0.9999). The studies have shown that the method is a rapid, reproducible, and accurate determination of these elements in milk and dairy products and can be used in the analysis of marketed formulations in the milk and dairy industry.

Radioguided surgery in primary hyperparathyroidism.

UNLABELLED: Surgical neck exploration is usually made in primary hyperparathyroidism (PHPT). Localization of the adenoma or detection of hyperplasia may reduce the operation period and limit the extent of the surgery. In this study the effficacy of preoperative Tc-99m MIBI scintigraphy and intraoperative gamma probe was evaluated. MATERIALS AND METHODS: Six patients with PHPT had preoperative Tc-99m MIBI parathyroid scintigraphy and intraoperative gamma probe (IGP) was used in surgical neck exploration. RESULTS: Parathyroid adenoma was observed in 2/6 patients on scintigraphy in the right retroclavicular region and the left lobe of the thyroid. Both of them were clearly detected by IGP during the surgery and easily removed by the surgeon in a short time (35 min) with a small incision. Pathologic examination confirmed the parathyroid adenoma. No abnormal MIBI uptake was not observed in scintigraphy in 4/6 patients. Subtotal parathyroidectomy was performed in these patients. CONCLUSION: Preoperative Tc-99m MIBI scintigraphy and the use of IGP may limit the exploration and also the operation time and reduce surgical complications.

Can post-adenotonsillectomy morbidity be reduced by intravenous 24 h hydration in pediatric patients following adenotonsillectomy?

OBJECTIVE: To determine the benefit of 24 h intravenous hydration for pediatric postoperative adenotonsillectomy patients. STUDY DESIGN: A prospective, randomized controlled clinical study. METHODS: The study is consisting of two groups of pediatric patients following adenotonsillectomy performed in a university hospital. One group received 24 h IV hydration at hospital while the other did not have IV hydration. Chi-square and two-tailed unpaired Student's t-tests were used to compare the two independent groups. P < 0.05 was accepted as statistically significant. RESULTS: Although the postoperative parameters such as nausea, fever, vomiting, odor, bleeding, otalgia and trismus were not statistically different between the two groups based on chi-square analysis (P > 0.05), a significant pain-relieving effect was seen in hydration group after the second day (P < 0.05). There were no complications associated with intravenous hydration. CONCLUSION: Results of the current study suggest that 24 h IV hydration can reduce postoperative pain in late postoperative period following adenotonsillectomy in children but does not offer much advantage over without IV hydration therapy based on a number of other parameters. Furthermore, it seems to be cost effective, safe and easy and even these are encouraging for further studies in the future.

Effects of high dose oral creatine supplementation on anaerobic capacity of elite wrestlers.

AIM: The purpose of this study was to investigate the effect of high dose oral creatine supplementation on anaerobic capacity of elite wrestlers. EXPERIMENTAL DESIGN: comparative randomized design. SETTING: Wingate anaerobic tests of the participants were taken at the Human Performance Laboratory of the Department of Physical Education and Sports in The Middle East Technical University, Ankara, Turkey. PARTICIPANT: 20 active international level wrestlers participated (22 to 27 years old). INTERVENTIONS: the daily dosage of creatine or placebo was divided into 4 equal amounts (5 gx4 = 20 g). Every 5 g of supplement was dissolved in 250 ml water and it was given to participants 1 hour before breakfast, lunch, dinner, and workout session. MEASURES: subjects underwent a 30-s Wingate Anaerobic tests until exhaustion in pre- and post-tests. After the pretest measurements were completed, participants were classified as creatine (Cr., n=10) and placebo (Pl., n=10) groups with regard to their average anaerobic power scores obtained during the test. RESULTS: Results of paired "t"-test revealed that there was no significant change in placebo group between pre- and post-test in average and peak anaerobic power. However, average and peak power mean scores obtained from post-test (8.123+/-0.448 W/kg and 10.523 +/-1.004 W/kg) were significantly (p<0.01) higher than pretest (7.233+/-0.483 W/kg and 8.992+/- 0.665 W/kg) for creatine group. Results of the independent "t"-test also indicated that the mean gained scores of creatine group in average and peak power were significantly higher than placebo group (p<0.01). CONCLUSION: This study demonstrates that short-term high dose oral creatine supplementation has an ergogenic effect on anaerobic capacity of elite wrestlers.

Evaluation of impotent men with intracorporeal injection of papaverine and colour Doppler ultrasound.

Fifty impotent patients have been evaluated with intracorporeal injection of papaverine and colour Doppler ultrasound. The papaverine tests were negative in 34 of 50 patients. Nineteen of 34 patients with negative papaverine results showed normal colour Doppler findings. In 14 of 16 patients with positive papaverine results the colour Doppler analysis revealed normal structure and functions. Correlation between intracorporeal papaverine injection and colour Doppler ultrasound results was found in 59% (p < 0.01). We concluded that intracorporeal papaverine injection is an effective, simple diagnostic test for beginning evaluation of impotent men. However, this screening test should be supported by colour Doppler ultrasound.

Partial sacral resection and reconstruction with bone cement. Discussion of an operative experience.

Sacral resection is often the only way for effective palliation of the severe pain in tumors involving sacrum. However the operation hardly seems to be acceptable with the reported operative times, blood losses and complication rates. A case of retrorectal leiomyosarcoma invading sacrum, with severe pain resistant to combined irradiation and chemotherapy is reported. The tumor was removed with resection of the right two thirds of S2, S3 and S4, and the sacrum was reconstructed with bone cement. Complete relief of the pain was obtained with no postoperative complications. It is concluded that incomplete resection of the sacral vertebrae should be performed for sacral root pain palliation if other methods fail. Bone cement reconstruction seems to be a valuable alternative to muscle flaps in covering sacral defects.

Treatment of acute sigmoid volvulus.

Thirty-eight patients were treated for acute sigmoid volvulus in 9 years. Non operative decompression treatment was performed in 7 patients, and 31 patients underwent exploratory laparatomy (25 for suspected bowel necrosis and 6 for unsuccessful non operative treatment). Sigmoid resection and reanastomosis was performed in 5 of the 12 cases with gangrenous bowel and 10 of the 19 with viable bowel. There were no mortality and no morbidity related to the anastomoses. The results have shown that reanastomosis after sigmoid resection could be performed safely in selected cases of acute sigmoid volvulus even if there is bowel gangrene.