Shear bond strength of a novel porcelain repair system for different computer-aided design/computer-assisted manufacturing ceramic materials.

OBJECTIVES: The purpose of this study was to compare the shear bond strength of a novel repair system, Nova Compo SF with Ceramic Repair, Ivoclar, to computer-aided design/computer-assisted manufacturing (CAD/CAM) restorative materials (IPS e.max CAD and Empress CAD). MATERIALS AND METHODS: The specimens of each CAD/CAM restorative material were randomly divided into two subgroups of nine specimens, using one of two repair systems. All specimens were etched with hydrofluoric acid and rinsed under a water spray for 10 s, then air-dried for 10 s. Next, repair systems were applied according to the manufacturer's instructions. All specimens were stored in distilled water at 37°C for 24 h and then additionally aged for 5000 thermal cycles. A shear bond strength test was performed using a universal testing machine. Each fracture type was examined under a stereomicroscope at ×12.5 magnification. A two-way ANOVA test was used to detect significant differences between the CAD/CAM restorative materials and the composite repair systems. Subgroup analyses were performed using Tukey's honest significant difference. RESULTS: No statistically significant differences were observed between the repair systems (P = 0.9). The bond strength values from Empress CAD were statistically higher than those from e.max CAD (P < 0.05). CONCLUSIONS: Within limitations, SuperFlow may be an alternative to the ceramic repair materials we routinely used in the clinic. Empress CAD can be preferable to e.max CAD in terms of esthetically suitable clinical indications.

Evaluating the Psychometric Properties of the Eating Assessment Tool (EAT-10) Using Rasch Analysis.

Early and reliable screening for oropharyngeal dysphagia (OD) symptoms in at-risk populations is important and a crucial first stage in effective OD management. The Eating Assessment Tool (EAT-10) is a commonly utilized screening and outcome measure. To date, studies using classic test theory methodologies report good psychometric properties, but the EAT-10 has not been evaluated using item response theory (e.g., Rasch analysis). The aim of this multisite study was to evaluate the internal consistency and structural validity and conduct a preliminary investigation of the cross-cultural validity of the EAT-10; floor and ceiling effects were also checked. Participants involved 636 patients deemed at risk of OD, from outpatient clinics in Spain, Turkey, Sweden, and Italy. The EAT-10 and videofluoroscopic and/or fiberoptic endoscopic evaluation of swallowing were used to confirm OD diagnosis. Patients with esophageal dysphagia were excluded to ensure a homogenous sample. Rasch analysis was used to investigate person and item fit statistics, response scale, dimensionality of the scale, differential item functioning (DIF), and floor and ceiling effect. The results indicate that the EAT-10 has significant weaknesses in structural validity and internal consistency. There are both item redundancy and lack of easy and difficult items. The thresholds of the rating scale categories were disordered and gender, confirmed OD, and language, and comorbid diagnosis showed DIF on a number of items. DIF analysis of language showed preliminary evidence of problems with cross-cultural validation, and the measure showed a clear floor effect. The authors recommend redevelopment of the EAT-10 using Rasch analysis.

Reliability and validity of a tool to measure the severity of tongue thrust in children: the Tongue Thrust Rating Scale.

This study aimed to develop a scale called Tongue Thrust Rating Scale (TTRS), which categorised tongue thrust in children in terms of its severity during swallowing, and to investigate its validity and reliability. The study describes the developmental phase of the TTRS and presented its content and criterion-based validity and interobserver and intra-observer reliability. For content validation, seven experts assessed the steps in the scale over two Delphi rounds. Two physical therapists evaluated videos of 50 children with cerebral palsy (mean age, 57·9 ± 16·8 months), using the TTRS to test criterion-based validity, interobserver and intra-observer reliability. The Karaduman Chewing Performance Scale (KCPS) and Drooling Severity and Frequency Scale (DSFS) were used for criterion-based validity. All the TTRS steps were deemed necessary. The content validity index was 0·857. A very strong positive correlation was found between two examinations by one physical therapist, which indicated intra-observer reliability (r = 0·938, P < 0·001). A very strong positive correlation was also found between the TTRS scores of two physical therapists, indicating interobserver reliability (r = 0·892, P < 0·001). There was also a strong positive correlation between the TTRS and KCPS (r = 0·724, P < 0·001) and a very strong positive correlation between the TTRS scores and DSFS (r = 0·822 and r = 0·755; P < 0·001). These results demonstrated the criterion-based validity of the TTRS. The TTRS is a valid, reliable and clinically easy-to-use functional instrument to document the severity of tongue thrust in children.

Effect of a new treatment protocol called Functional Chewing Training on chewing function in children with cerebral palsy: a double-blind randomised controlled trial.

Cerebral palsy (CP) is a group of permanent sensorimotor impairments. Children with CP have various feeding difficulties including chewing disorder, which may affect their nutritional status. Functional Chewing Training (FuCT) was designed as a holistic approach to improve chewing function by providing postural alignment, sensory and motor training, and food and environmental adjustments. This study aimed to investigate the effect of FuCT on chewing function in children with CP. This study was designed as a double-blind, randomised controlled trial. Eighty CP children with chewing disorder were randomised and split between the FuCT group (31 males, 19 females; mean age 3·5 ± 1·9 years) and the control group (16 males, 14 females; 3·4 ± 2·3 years) receiving traditional oral motor exercises. Each group received the training programme for 12 weeks with weekly follow-up and with two evaluations at baseline and end of 12 weeks. Chewing function was evaluated by analysing video recordings and scored with the Karaduman Chewing Performance Scale (KCPS). The Behavioral Pediatrics Feeding Assessment Scale (BPFAS) was used to evaluate feeding behaviours of children. A significant improvement was observed in KCPS scores at 12 weeks after training in the FuCT group (P < 0·001), but no change was found in the control group (P = 0·07). A significant improvement was detected in all parameters of BPFAS at 12 weeks after training in the FuCT group (P < 0·001) and in four parameters of BPFAS in the control group (P = 0·02, P = 0·02). FuCT is an effective method to improve chewing function compared with traditional oral motor exercises.

Effect of Functional Chewing Training on tongue thrust and drooling in children with cerebral palsy: a randomised controlled trial.

Tongue thrust, which is an oral reflex associated with sucking behaviour, may cause problems in swallowing, speech, oro-facial development and also drooling. We aimed to examine the effect of Functional Chewing Training (FuCT) on tongue thrust and drooling in children with cerebral palsy. The study included 32 children with a mean age of 58·25 ± 9·58 months who had tongue thrust. Children were divided into two groups: the FuCT group and control group receiving classical oral motor exercises. Each group received training for 12 weeks. Oral motor assessment was performed. Chewing performance level was determined with the Karaduman Chewing Performance Scale. Tongue thrust severity was evaluated with the Tongue Thrust Rating Scale. The Drooling Severity and Frequency Scale was used to evaluate drooling severity and frequency. The evaluations were performed before and after treatment. Groups were well matched in age, gender and oral motor assessment. No significant difference was found between groups in terms of pre-treatment chewing function, tongue thrust severity, drooling severity and frequency (P > 0·05). The FuCT group showed improvement in chewing performance (P = 0·001), tongue thrust severity (P = 0·046) and drooling severity (P = 0·002), but no improvement was found in terms of drooling frequency (P = 0·082) after treatment. There was no improvement in chewing performance, tongue thrust, drooling severity and frequency in the control group. A significant difference was found between groups in favour of FuCT group in tongue thrust severity (P = 0·043). This study showed that the FuCT is an effective approach on the severity of tongue thrust and drooling in children with CP.

Expression of aquaporin-7 and aquaporin-9 in tanycyte cells and choroid plexus during mouse estrus cycle.

Tanycytes are special ependymal cells located in the ventrolateral wall and floor of the third ventricle having processes extending nuclei that regulate reproductive functions and around of vessels in median eminance. The aquaporins (AQPs) are a family of transmembrane proteins that transport water and glycerol. AQP-7 and -9 are permeable to other small molecules as glycerol and therefore called aquaglyceroporins. In this study, we aimed to show localization of AQP-7 and -9 in epithelial cells of choroid plexus and tanycytes during female mouse estrus cycle. AQP-7 and -9 proteins were detected in α2 and ß1 tanycytes in prœstrus stage. Interestingly, there is no staining in estrus stage in any type of tanycytes. We observed weak immunoreactivity in α1, α2 and ß1 tanycyte cells in metestrus stage for AQP-7 and α1 for AQP-9 protein. AQP-7 and -9 showed intense immunoreactivity in α2, ß1 and ß2 tanycyte cells during diestrus stage. Consequently, AQP-7 and -9 showed differential staining pattern in different stages of mouse estrus cycle. In the light of our findings and other recent publications, we suggest that AQP-7 and -9-mediated glycerol transport in tanycyte cells might be under hormonal control to use glycerol as a potential energy substrate during mouse estrus cycle.

mTOR expression in human testicular seminoma.

The mammalian target of rapamycin (TOR) has been implicated in the control of different stressors, growth factors, nutrients and hormones, participating in the control of key cellular functions. Controlling this many pathways poses mTOR signalling as a potential new target in new treatment strategies for multiple cancer types. mTOR components could potentially mislocated in tumour cells, which could lead to activation of signalling pathway that should not be active. Therefore, we aimed to show localisation of mTOR signal proteins in testicular seminoma. Tumoural testicular tissues were obtained from 10 patients with unilateral classic seminoma undergoing to therapeutic orchidectomy and compared with control human testicular tissues. Upon immunohistochemical evaluation, we detected mTOR and p-mTOR (serine 2448), P70S6K, p-P70S6K, PKCalpha and p-PKCalpha, CD36 and MAPLC3 proteins in the cytoplasm of Sertoli cells in the seminiferous tubules. We also showed cytoplasmic perinuclear staining in seminoma cells. This study demonstrated the interaction of mTOR signalling pathway and testicular seminoma by showing intense cytoplasmic mTOR pathway proteins immunoreactivity in the seminoma, for the first time in humans. Therefore, we suggested that mTOR signalling components could create new clinical targets for treatment of testicular seminoma patients and male infertility in the future.

Development of a new instrument for determining the level of chewing function in children.

This study aimed to develop a chewing performance scale that classifies chewing from normal to severely impaired and to investigate its validity and reliability. The study included the developmental phase and reported the content, structural, criterion validity, interobserver and intra-observer reliability of the chewing performance scale, which was called the Karaduman Chewing Performance Scale (KCPS). A dysphagia literature review, other questionnaires and clinical experiences were used in the developmental phase. Seven experts assessed the steps for content validity over two Delphi rounds. To test structural, criterion validity, interobserver and intra-observer reliability, two swallowing therapists evaluated chewing videos of 144 children (Group I: 61 healthy children without chewing disorders, mean age of 42·38 ± 9·36 months; Group II: 83 children with cerebral palsy who have chewing disorders, mean age of 39·09 ± 22·95 months) using KCPS. The Behavioral Pediatrics Feeding Assessment Scale (BPFAS) was used for criterion validity. The KCPS steps arranged between 0-4 were found to be necessary. The content validity index was 0·885. The KCPS levels were found to be different between groups I and II (χ(2) = 123·286, P < 0·001). A moderately strong positive correlation was found between the KCPS and the subscales of the BPFAS (r = 0·444-0·773, P < 0·001). An excellent positive correlation was detected between two swallowing therapists and between two examinations of one swallowing therapist (r = 0·962, P < 0·001; r = 0·990, P < 0·001, respectively). The KCPS is a valid, reliable, quick and clinically easy-to-use functional instrument for determining the level of chewing function in children.

Monitoring and treatment results of 88 HBsAg-positive pregnant women.

Approximately 5% of all women in the world are HBsAg-positive. Chronic hepatitis B is a problem in women of reproductive age. This paper assessed 88 HBsAg-positive pregnant women, of whom 11 began treatment during pregnancy and five became pregnant while receiving treatment. The files of HBsAg-positive pregnant women were reviewed between January 2010 and December 2013-retrospectively. From these 88 pregnant women, 72 did not receive any treatment during their pregnancy, 11 began treatment during their pregnancy, and five became pregnant while receiving treatment. Nine of these 11 pregnant women were given tenofovir disoproxil fumarate and two of them lamivudine. Ten babies of the 11 mothers that began treatment during their pregnancy were healthy, but one was lost due to preterm birth. Of the five patients who became pregnant while receiving treatment, the treatments of four women were discontinued and they were monitored during their pregnancies because mild-moderate (less than stage 3) fibrosis was found in their liver biopsy results. It is important to screen all pregnant women for hepatitis B and to assess those found HBsAg-positive. It is possible to protect both the mother and baby using appropriate approaches.

MEGALENCEPHALY, POLYMICROGYRIA, POLYDACTYLY AND HYDROCEPHALUS (MPPH) SYNDROME: A NEW CASE WITH OCCIPITAL ENCEPHALOCELE AND CLEFT PALATE.

The megalencephaly, polymicrogyria, polydactyly, and hydrocephalus (MPPH) syndrome is quite rarely seen. The four main findings in this syndrome may be accompanied by severe psychomotor retardation, blindness, hypotonia, convulsions, and facial dysmorphism. In this paper, we present a female newborn at 39 weeks gestational age born to parents who are first degree cousins. Beside the facial dysmorphism and four main features of the MPPH syndrome, the findings on the physical examination of the patient were, hypertonicity, occipital encephalocele, cleft palate, and multiple polyps in the tongue. The presence of occipital encephalocele, cleft palate, and polyps in the tongue in this patient was not reported previously in the literature.

The effects of some tumor markers on human erythrocyte (HCA-I and HCA-II), bovine erythrocyte (BCA) and bovine lung (CA-IV) carbonic anhydrase enzyme activities in vitro.

OBJECTIVE: The influence of prostatic acid phosphatase (PAP) and human chorionic gonadotropin (HCG), tumor markers have been investigated on human erythrocyte carbonic anhydrase (HCA-I and HCA-II) and bovine erythrocyte (BCA) and bovine lung carbonic anhydrase (CA-IV) in vitro. BACKGROUND: Tumor markers are substances that can often be detected in higher-than-normal amounts in the blood, urine, or body tissues of some patients with certain types of cancer. Tumor markers are produced either by the tumor itself or by the body in response to the presence of cancer or certain benign (noncancerous) conditions. In addition to their role in cancer diagnosis, some tumor marker levels are measured before treatment to help doctors plan appropriate therapy. RESULTS AND CONCLUSION: All of the tumor markers were determined to have inhibition effect, on human CA-I, CA-II, bovine erythrocyte CA (BCA) and bovine lung CA-IV isoenzymes. The effect of each tumor marker on CA was investigated by Wilbur-Andersen method modified by Rickly et al Inhibition effects of two different tumor markers on human CA-I, CA-II, bovine erythrocyte CA (BCA) and bovine lung CA-IV isoenzymes were determined by using the CO2-Hydratase method by plotting activity % vs (tumor markers). I50 values of tumor markers exhibiting inhibition effects were found by means of these graphs (Tab.1, Fig. 2, Ref. 20).

Serum annexin A2 levels in acute brucellosis and brucellar spondylodiscitis.

Brucellosis is a chronic granulomatous infection and may present with various clinical manifestations. Brucellar spondylodiscitis symptoms are initially subtle and nonspecific. Annexin A2 (ANXA2) is involved in various biological functions, including osteoclast formation, bone resorption, and cell growth regulation. In this study, we aimed to determine the clinical significance of serum ANXA2 levels in acute brucellosis and brucellar spondylodiscitis. This prospective study included 96 acute brucellosis patients and 51 healthy controls. Acute brucellosis was diagnosed by a 1/160 or higher titer in a standard tube agglutination (STA) test or a four-fold increase in titers between two STA tests performed two weeks apart in the presence of clinical symptoms within the last eight weeks and/or growth of Brucella spp. in appropriately prepared culture media. ANXA2 levels were determined with an enzyme-linked immunosorbent assay (ELISA). Forty (41.7 %) of 96 acute brucellosis patients were male and 56 (58.3 %) were female. Serum ANXA2 levels were elevated in patients compared to healthy controls (p = 0.001). Eighteen of 96 (18.7 %) acute brucellosis patients had brucellar spondylodiscitis. The serum ANXA2 levels of patients with brucellar spondylodiscitis were higher than those of patients with acute disease without brucellar spondylodiscitis (p = 0.001). ANXA2, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) values were elevated in the brucellar spondylodiscitis group compared to patients without brucellar spondylodiscitis. Serum ANXA2 measurement together with ESR and CRP is thought to be indicative in the diagnosis of brucellar spondylodiscitis, a common complication of brucellosis.

A male newborn with Simpson-Golabi-Behmel syndrome, presenting with metopic synostosis, anal atresia, and total anomalous pulmonary venous return.

Simpson-Golabi-Behmel syndrome is a clinical condition described by Simpson, characterized with multiple congenital anomalies and caused by Glypican 3 (GPC3) mutations of the X-linked gene. Typical findings such as overgrowth, hypoplastic changes of hands and feet, visceromegaly, cleft palate and macrocephalic distinctive facial features and multiple organ anomalies might be observed. GPC3 mutation is claimed to generally cause metopic synostosis. This case was reported because even though a lot of anomalies accompanying Simpson-Golabi-Behmel syndrome had been noticed, combination of metopic synostosis, has not been reported before.

Large Cell Neuroendocrine Carcinoma of the Ovary and Its Skin Metastases: A Case Report and Review of the Literature.

Large cell neuroendocrine carcinoma in the gynaecological organs affects the uterine cervix and ovary. Large cell neuroendocrine carcinoma of the ovary is extremely rare, and prognosis is quite poor even when diagnosed at an early stage. These tumours respond poorly to standard chemotherapy regimens. The clinical observation of skin metastasis in patients with epithelial ovarian cancer is relatively uncommon, occurring in only 3.5% of patients. These lesions are observed mostly in skin of the abdominal wall adjacent to the primary ovarian tumours. Metastatic skin lesions on extremities are much more rare; it is reported that only 12% of epithelial ovarian carcinoma skin metastases occur on the limbs. Skin metastasis due to large cell neuroendocrine carcinoma of the ovary has not been previously reported. We report the case of a large cell neuroendocrine tumour of the ovary with skin metastases on extremities appearing two months after surgery in a 68-year old woman.

Evaluation of T-cell subsets in pregnant women infected with SARS-CoV-2.

OBJECTIVE: Immune responses to SARS-CoV-2 are the main cause of tissue damage in coronavirus disease 2019. However, the pathophysiological mechanism of the disease has not been fully elucidated. The aim of this study was to examine T cell subsets of pregnant women infected with SARS-CoV-2 and evaluate the relationship between the possible differences in trimesters and clinical findings of the disease. MATERIALS AND METHODS: Fifty-six pregnant patients with SARS-CoV-2 and 61 healthy pregnant controls were included in the study. T cell subsets were analyzed by flow cytometry. RESULTS: The CD3+ total T cell (p = 0.006 and p = 0.027) of pregnant patients infected with SARS-CoV-2 in second and third trimesters was found to be lower than in the control group. CD3+CD4+ helper T cell (p = 0.035), Treg (p = 0.001), and Treg/Th17 ratio (p = 0.001) were found to be lower in the third trimester patients infected with SARS-CoV-2 than in the controls. Significant decreases were observed only in the Treg (p = 0.001) and Treg/Th17 ratio (p = 0.001) in the first trimester patients infected with SARS-CoV-2 compared to the controls. When trimesters were compared in terms of T subsets, no difference was found (p > 0.05). CONCLUSION: The CD3+ total T cell (p = 0.001), CD3+CD4+ helper T cell (p = 0.011), Treg (p = 0.001), and Treg/Th17 ratio (p = 0.001) were found to be lower in pregnant women infected with SARS-CoV-2. This difference was associated with the development of pneumonia but not with adverse pregnancy outcomes.

Impact of Factor V Leiden, prothrombin and methylenetetrahydrofolate reductase gene mutations on infant birth weight in women with recurrent fetal loss and women with successful pregnancies.

PURPOSE: The aim of this study was to verify whether FV Leiden, PT G20210A, MTHFR C667T or MTHFR A1298C mutations influence the risk of recurrent fetal loss in a sample of Turkish women who had experienced recurrent fetal loss and to evaluate whether the aforementioned thrombophilias and recurrent fetal loss may affect the birth weight of subsequent pregnancies. METHODS: Fifty-eight women with recurrent pregnancy loss and 30 women with successful pregnancies were evaluated. RESULTS: The average birth weights for infants of all women in the study group and for infants of thrombophilia-positive women in the study group were markedly lower than the birth weight of infants in the control group (p<0.001 and p<0.001, respectively). CONCLUSION: Successful pregnancies in women with a history of recurrent fetal losses may be associated with lower birth weights compared to controls, irrespective of thrombophilia status. This conclusion warrants further research.

Expectant management of preterm premature rupture of membranes remote from term with exiguous amniotic fluid and a prolonged latency period: report of two cases.

Management of preterm premature rupture of membranes (PPROM) is a very challenging issue for the obstetricians. We report two cases of PPROM occurring in early gestation remote from term (both < 26 weeks) with exiguous amniotic fluid (amniotic fluid index of < or =2 cm) that were managed successfully by conservative treatment and resulted in a latency period of almost two months. This treatment option might be feasible in carefully selected patients following meticulous evaluation and warrants further research.

Reliability of Bigliani's Classification using Magnetic Resonance Imaging for Determination of Acromial Morphology.

Introduction: Bigliani classification is used for determination of acromial morphology, but poor inter-observer reliability has been reported on conventional radiographs. This study aims to assess inter- and intra-observer reliability using magnetic resonance imaging (MRI). Materials and methods: Forty consecutive patients diagnosed with subacromial impingement syndrome were included to study. All subjects underwent standard shoulder MRI scan and acromial shape was evaluated by nine observers of different level of expertise (three attending surgeons, three senior orthopaedic residents and three radiologists). A second set of evaluation was performed in order to assess intra-observer reproducibility. Kappa (κ) coefficient analyses both for interobserver reliability and intra-observer reproducibility were then performed. Results: Overall inter-observer agreement among nine observers was fair (κ=0.323). κ values for all 4 individual types ranged from 0.234 to 0.720 with highest agreement for type 4 and lowest agreement for type 3. Second evaluation did not result with an increase of inter-observer agreement (κ=0.338, fair). The κ coefficients for intra-observer reproducibility of nine observers ranged from 0.496 to 0.867. Overall intra-observer reproducibility was substantial. Comparison of inter- and intra-observer reliability among three groups showed no significant difference (p=0.92 and 0.22, respectively). Conclusion: Results showed that MRI did not show superior reliability compared to conventional radiographs. Moreover, inter- and intra-observer agreement did not differ between observers of different level of expertise. Findings of present study suggest that despite a sophisticated imaging modality like MRI, Bigliani's classification apparently lacks accuracy and additional criteria, or different assessment methods are required to assess acromial morphology for clinical guidance.

An audit of seafood consumption awareness during pregnancy and its association with maternal and fetal outcomes in a Turkish population.

This study was conducted to audit maternal seafood intake awareness during pregnancy and to determine whether there is an association between fish consumption and various pregnancy outcomes. In total, 553 low-risk and healthy pregnant women were given a questionnaire concerning fish consumption. Pregnant women who developed gestational diabetes mellitus, pre-term labour-birth, macrosomia, low birth weight and small for gestational age were analysed. Fatty fish consumers tended to have higher birth weight infants than lean fish consumers. Low fish consumption was significantly correlated with low birth weight and small for gestational age (SGA) infants. The more fatty fish that the low fish consumers consumed, the more likely they were to have SGA infants. Fish consumption did not have an impact on the development of gestational diabetes mellitus, macrosomia or pre-term labour-birth. Low fish consumption during pregnancy may be associated with the development of low birth weight and SGA infants in a Turkish population.