Milk feeding level and starter protein content: Effects on growth performance, blood metabolites, and urinary purine derivatives of Holstein dairy calves.

The objective of this study was to investigate the effects of milk allowances equal to 526 g/d as moderate (MOD) versus 790 g/d of milk dry matter as high (HI), and starter diets containing 18% or 23% crude protein (CP), on growth performance, blood metabolites, and purine derivative (PD) excretion in the urine of dairy calves. A total of 52 female Holstein dairy calves (40.8 kg of body weight) were randomly assigned to the experimental diets. The treatments were (1) moderate milk and 18% CP starter diet (MOD-18CP); (2) MOD and 23% CP starter diet (MOD-23CP); (3) high milk and 18% CP starter diet (HI-18CP); and (4) HI and 23% CP starter diet (HI-23CP). Calves had free access to a starter feed and water and were weaned on d 53 but remained in the study until d 73. Urine samples were collected during the preweaning period (for 6 consecutive days between d 35 and 40) and postweaning period (for 6 consecutive days between d 65 and 70) to investigate urinary excretion of PD. Starter feed intake, ß-hydroxybutyrate (BHB), and blood urea concentrations were reduced; however, average daily gain (ADG) and blood glucose levels increased in calves fed HI before weaning compared with MOD. During the preweaning period, high milk feeding increased total urinary PD excretion but decreased it after weaning. The 23CP diet resulted in higher feed intake and ADG before weaning and higher excretion of allantoin and total excretion of PD compared with the 18CP diet. The HI-23CP treatment resulted in the greatest withers and hip heights at weaning and final measurement, as well as the highest preweaning blood insulin concentrations. In terms of rumen development, MOD-23CP showed the greatest benefits based on starter intake, blood BHB concentration, and urinary excretion of PD. Based on the higher urinary excretion of PD found in HI-fed calves before weaning, it is possible that milk feeding overestimates estimated microbial yield. The results suggest that feeding starters with a higher proportion of CP may help maintain a more balanced ratio of CP to ME during high milk feeding, to avoid protein deficiency due to low starter intake. When calves are fed a high milk allowance, urine excretion of PD may be misinterpreted as a measure of estimated microbial growth and rumen development; this should be considered during calculations of estimated microbial yield in milk-fed calves.

The safety of continued low dose aspirin therapy during Complete Supine Percutaneous Nephrolithotomy (csPCNL).

OBJECTIVE: Using anticoagulants and antiplatelet drugs in patients with cardiovascular and medical comorbidities is prevalent. Because of hyper vascular nature of kidney, physicians tend to stop using aspirin before percutaneous nephrolithotomy (PCNL). We have shown the effects of remaining on low dose aspirin in complete supine PCNL (csPCNL). MATERIAL AND METHODS: The records of 643 patients who underwent csPCNL between 2012 and 2018 were analyzed. Surgical outcomes and complications of patients who were on aspirin therapy and continued it daily (group A) were compared with those not taking aspirin (group B). RESULTS: Of the 643 csPCNLs, 40 (6%) were performed in patients of group A and the rest of 603 (94%) cases were in group B. The differences between the mean age of groups were statistically significant (60.08±9.45, group A and 48.66±12.32, group B) (P<0.001). Thirty-nine (97.5%) of patients in group A and 548 (90.9%) of group B were stone free by the end of the study which was not statistically significant (P=0.118). The mean operative time between groups A and B (43.20±21.37 and 44.83±16.83, respectively) was not considered significant (P=0.561). There was also no significant difference between 2 groups in any types of complications. Multivariate analysis showed that, perioperative aspirin use was not a significant predictor of transfusion, Hb drop, operative time and other complications. CONCLUSIONS: Remaining on aspirin does not increase the risk of bleeding, transfusionand other complications. Consequently, continuing aspirin prioperatively in csPCNL appears safe. There is no fear for continuing aspirin in csPCNL.

Occupational exposure of health care personnel to SARS-CoV-2 particles in the intensive care unit of Tehran hospital.

The outbreak of SARS-CoV-2 (COVID-19) has attracted much attention to study its possible presence and airborne transmission. The possibility of COVID-19 airborne transmission in indoor environments is debatable. The present study examined the concentration of viral RNA-containing particles produced directly or indirectly by breathing or coughing of confirmed COVID-19 patients or by carriers without symptoms. Some studies do not accept this method of transmission (COVID-19 airborne transmission). The present study aimed to measure the possible exposure of health care personnel to SARS-CoV-2 particles that may have been suspended in the air to respond to the hypothesis of COVID-19 airborne transmission. Airborne particle sampling was performed using impingement method based on NIOSH (chapter BA) and ASHRAE. Selection of sampling sections was in line with the WHO guidelines. The samples were analyzed using RT-PCR technique. Based on the given results, airborne particles of COVID-19 may present in the air and affect the health of hospital personnel. In fact, the analysis of gene expression in ambient conditions and thereby aerosol transmission of SARS-CoV-2 through air is possible and may lead to occupational exposure of health care personnel. Furthermore, it was found that airborne emission of COVID-19 through the breathing zone of patients, particularly in ICU wards with confirmed cases of COVID-19, may be higher than in other ICU wards. Also, the demonstrated results showed that there is a possibility of reaerosolization (reintroduction) of previously airborne SARS-CoV-2 particles into the atmosphere due to health care personnel frequently walking between different wards and stations of ICU.

MicroRNAs and exosomes: key players in HIV pathogenesis.

OBJECTIVES: HIV infection is well known to cause impairment of the human immune system, and until recently was a leading cause of death. It has been shown that T lymphocytes are the main targets of HIV. The virus inactivates T lymphocytes by interfering with a wide range of cellular and molecular targets, leading to suppression of the immune system. The objective of this review is to investigate to what extent microRNAs (miRNAs) are involved in HIV pathogenesis. METHODS: The scientific literature (Pubmed and Google scholar) for the period 1988-2019 was searched. RESULTS: Mounting evidence has revealed that miRNAs are involved in viral replication and immune response, whether by direct targeting of viral transcripts or through indirect modulation of virus-related host pathways. In addition, exosomes have been found to act as nanoscale carriers involved in HIV pathogenesis. These nanovehicles target their cargos (i.e. DNA, RNA, viral proteins and miRNAs) leading to alteration of the behaviour of recipient cells. CONCLUSIONS: miRNAs and exosomes are important players in HIV pathogenesis. Additionally, there are potential diagnostic applications of miRNAs as biomarkers in HIV infection.

Effects of physical forms of starter and milk allowance on growth performance, ruminal fermentation, and blood metabolites of Holstein dairy calves.

A 2 × 2 factorial study was conducted to evaluate the effects of milk allowance and physical forms of starter on growth performance, ruminal fermentation, and blood metabolites of Holstein dairy calves. A total of 48 calves [40.4 ± 1.55 kg of body weight (BW), n = 12 per treatment: 6 males and 6 females] were randomly assigned to 1 of the 4 treatments: (1) calves fed low milk allowance and finely ground (FG) starter feed [low-FG; 1.47 ± 2.12-mm geometric mean particle size (GMLP)], (2) calves fed low milk allowance and textured (TS) starter feed [low-TS, includes steam-flaked grains (corn and barley) with a pelleted supplement, GMLP 4.15 ± 1.77 mm], (3) calves fed high milk allowance and FG starter feed (high-FG); and (4) calves fed high milk allowance and TS starter feed (high-TS). The starter diets were blended with 7% of chopped alfalfa hay as a proportion of diet dry matter (DM). No milk refusal was observed in any treatments, and calves on both treatments were weaned from milk by wk 8 of the study using a gradual weaning procedure. We observed no interaction between milk allowance and physical forms of starter on feed intake, average daily gain, feed efficiency, BW, and structural growth. Calves fed high milk allowance had lower starter feed intake but greater feed efficiency and overall BW compared with those fed low allowance. Total DM intake and average daily gain were not different among treatments. Regardless of the physical form of starter feed, hip height, heart girth, the molar proportion of ruminal acetate, acetate to propionate ratio, plasma cholesterol, and high-density lipoprotein were greater, but ruminal total volatile fatty acids, the molar proportion of propionate, and plasma ß-hydroxybutyrate were lower in calves fed high milk allowance compared with those fed low allowance. Regardless of the milk allowance, calves fed the FG starter feeds had greater blood urea nitrogen concentrations compared with calves fed the TS starter diets. In conclusion, both forms of the starter feeds can be used when calves are fed high milk allowance with no negative effect on their performance.

[Rieger-Marchac flaps: Complications and patient satisfaction]. / Le lambeau de Rieger-Marchac : complications et satisfaction des patients.

PURPOSE: Like all surgical procedures, dorsal nasal flaps may be followed by both early and late complications. The aim of this study was to evaluate the surgical complications and cosmetic outcome of dorsal nasal flaps over a 7-year period in an academic dermatologic surgery unit. PATIENTS AND METHODS: Data were collected retrospectively for all patients undergoing dorsal nasal flap between 1 January 2006 and 31 December 2013. Early and late complications were recorded. Patients were contacted by phone to assess long-term outcomes. RESULTS: A total of 35 patients were included. Early complications included bleeding (n=2), local infection (n=2) and focal flap necrosis (n=1). Late complications comprised flap thickening (n=7), restriction of the medial canthus (n=2), opening of the labionasal angle (n=1), stitch granuloma (n=1) and telangiectasia on the flap (n=1). Regarding the aesthetic result, seven patients were very satisfied with the flap. Four patients underwent corrective surgery and one patient had laser treatment for telangiectasia on the flap. CONCLUSION: Two thirds of patients were satisfied with the aesthetic results and one third had late complications of the flap. Consequently, patients undergoing Rieger-Marchac procedures must be informed of the potential need for further corrective measures following nasal dorsal flap repair.

[Complications after Percutaneous Endoscopic Gastrostomy Tube Placement - A Retrospective Analysis]. / Komplikationen nach Anlage einer perkutanen endoskopischen Gastrostomie - eine retrospektive Analyse.

BACKGROUND: Enteral nutrition is vital for patients with inadequate or absent oral food intake, as it can help to avoid catabolic metabolism. Enteral feeding can be secured by placing a percutaneous endoscopic gastrostomy tube (PEG-tube) which is an approved method. Several clinical studies could verify the superiority of this procedure compared to other options. Even though PEG-tube placement is regarded as less invasive surgery, a considerable rate of complications is reported in literature. MATERIAL/METHODS: Here, we report a retrospective analysis of PEG-tube placements in the Bonn University Hospital from January 2005 to December 2012. RESULTS: Overall, 641 PEG-tubes were placed with a complication rate of 9.4 %, which can be further divided in 5.5 % minor complications (mic) and 3.9 % major complications (mac). Two cases of death occurred in the context of PEG-tube placement. Endoscopically inserted PEG-tubes showed a complication rate of 8.6 % (4.8 % mic, 3.8 % mac). 63.2 % of mac consisted of perforations, 15.8 % of intra-abdominal abscesses and 15.8 % of buried bumper syndromes. The complication rate of CT-guided placement of PEG-tubes was 38.9 % (27.8 % mic, 11.1 % mac). In this group, all mac were perforations. Surgical PEG-tube placement was accompanied by no mac and 7.7 % mic. CONCLUSION: The amount of complications during PEG-tube placement is remarkable, therefore the indication of this procedure must be contemplated critically and careful follow-up is crucial.

Association of BRCA2 variants with cardiovascular disease in Saudi Arabia.

Abnormalities in the breast cancer tumor suppressor genes (BRCA1 and BRCA2) are associated with breast and ovarian cancer. Recently, two single nucleotide polymorphisms (SNPs; rs11571836 and rs1799943) were identified, both located in untranslated regions of chromosome 13, associated with cardiovascular disease (CVD) in a multi-ethnic population. We examined the association between these BRCA2 polymorphisms and traits of CVD patients from Saudi Arabia. We genotyped rs11571836 and rs1799943 in 159 unrelated CVD patients and 176 healthy controls. The genotype and allele distributions in the overall population revealed a statistically significant association between rs1799943 and CVD (P = 0.01-0.022), whereas no risk association was identified for rs11571836. Additionally, haplotype analysis using both SNPs demonstrated no association between the SNPs and CVD. The genotype distribution of the 2 SNPs in the normal Saudi population deviated significantly (P < 0.000001) from that of the 6 different HapMap populations (CEU, CHB-Han, JPT, YRI, GIH, and MKK), except for the JPT population for rs1799943. This is the first study to examine the association between these SNPs and CVD in a Saudi population. Our results suggest that the increased health risk associated with the rs11571836 genotype is specific to male patients suffering from CVD. Stratification of patients and controls based on gender revealed no association between rs1799943 and the risk of CVD in either gender. These SNPs should be evaluated in larger cohorts in different populations to determine their suitability as screening markers for predicting CVD risk earlier in life to implement necessary preventive measures.

Knowledge of and attitudes towards periodontal health among adults in Tehran.

Determining what people know and believe about periodontal health and disease is important in order to establish prevention practices. This study aimed to assess knowledge of and attitudes towards periodontal health among adults in Tehran, Islamic Republic of Iran. We conducted a cross-sectional face-to-face interview survey in 2011 of 791 adults aged 18-50 years using a stratified, multistage sampling method. We recorded demographic characteristics including age, sex, education, marital status, employment and economic status (housing density). The lowest percentage of correct answers was related to the definition of dental plaque (11.6%) and the highest was for the role of the dental visit in prevention (92.8%). Female sex, university education and higher economic status were significantly associated with a higher mean score on periodontal health knowledge. The regression analysis showed that positive attitudes were associated with higher periodontal health knowledge and having university education. In this study positive attitudes towards prevention were related to better knowledge.

Primary perivascular epitheloid cell tumour (PEComa) of the liver: case report and review of the literature.

PURPOSE: Perivascular epitheloid cell tumour [PEComa] is a rare neoplasm entity, characterized by perivascular epitheloid cells with a coexpression of smooth muscle and melanocytic markers. PEComas are found in a variety of localizations, though lesions within the liver are still scarcely found. Although the majority of these tumours are recognized as benign, there are some reports about advanced and aggressive tumours even with fatal outcome. By means of this case report and literary review including other 21 published cases, potential treatment modalities concerning clinical diagnostics, therapy and the follow-up care should be discussed. METHODS: The following report presents the case of a 53-year old woman with a known liver lesion, since four years under regularly sonographic controls. Finally, after a haemorrhage episode, the lesion was resected and the diagnosis found. For the literary review a systematic search for case reports published between January 1, 1999 and May 1, 2012 was performed on Pubmed. RESULTS: The only way, till now, of confirming the diagnosis is through immunohistochemical examinations. The already published Malignancy criteria by Folpe et al. must be taken carefully in question, as there are cases of malignant behaviour, that do not exactly coincide with these. CONCLUSION: Primary PEComa of the liver must be treated as potential malignant and therefore a close follow-up is demanded.

Tobacco use among Iranian dental students: a national survey.

A national survey was conducted to provide up-to-date data on current and ever use of tobacco among Iranian dental students. All 4th-year students of 8 randomly selected dental schools were surveyed anonymously in December 2010 using the Global Health Professions Student Survey questionnaire. Of 325 participants, 54.2% were ever users of tobacco products (73.0% of males versus 44.4% of females); 50.8% had used waterpipes, 34.2% cigarettes and 9.3% other products. The most common age at first use was 20-24 years for both sexes. Current tobacco use was reported by 20.6% of respondents, cigarette smoking by 10.8% and waterpipe smoking by 15.8%. Regression models showed that current cigarette and waterpipe smoking were significantly associated with male sex but not with type of dental school (state/private). Current waterpipe smoking was also associated with age at first experience. In view of the important role of dentists in tobacco control, the prevention of tobacco use should be stressed among Iranian dental students.

Electro-pharmacological profile of a mitochondrial inner membrane big-potassium channel from rat brain.

Recent studies have indicated a calcium-activated large conductance potassium channel in rat brain mitochondrial inner membrane (mitoBK channel). Accordingly, we have characterized the functional and pharmacological profile of a BK channel from rat brain mitochondria in the present study. Brain mitochondrial inner membrane preparations were subjected to SDS-PAGE analysis and channel protein reconstitution into planar lipid bilayers. Western blotting and antibodies directed against various cellular proteins revealed that mitochondrial inner membrane fractions did not contain specific proteins of the other subcellular compartments except a very small fraction of endoplasmic reticulum. Channel incorporation into planar lipid bilayers revealed a voltage dependent 211 pS potassium channel with a voltage for half activation (V(1/2)) of 11.4±1.1mV and an effective gating charge z(d) of 4.7±0.9. Gating and conducting behaviors of this channel were unaffected by the addition of 2.5mM ATP, and 500 nM charybdotoxin (ChTx), but the channel appeared sensitive to 100 nM iberiotoxin (IbTx). Adding 10mM TEA at positive potentials and 10mM 4-AP at negative or positive voltages inhibited the channel activities. These results demonstrate that the mitoBK channel, present in brain mitochondrial inner membrane, displays different pharmacological properties than those classically described for plasma membrane, especially in regard to its sensitivity to iberiotoxin and charybdotoxin sensitivity.

Intestinal regeneration, residual function and immunological priming following rescue therapy after rat small bowel transplantation.

Clinical evidence suggests that recurrent acute cellular rejection (ACR) may trigger chronic rejection and impair outcome after intestinal transplantation. To test this hypothesis and clarify underlying molecular mechanisms, orthotopic/allogenic intestinal transplantation was performed in rats. ACR was allowed to occur in a MHC-disparate combination (BN-LEW) and two rescue strategies (FK506monotherapy vs. FK506+infliximab) were tested against continuous immunosuppression without ACR, with observation for 7/14 and 21 days after transplantation. Both, FK506 and FK506+infliximab rescue therapy reversed ACR and resulted in improved histology and less cellular infiltration. Proinflammatory cytokines and chemotactic mediators in the muscle layer were significantly reduced in FK506 treated groups. Increased levels of CD4, FOXP3 and IL-17 (mRNA) were observed with infliximab. Contractile function improved significantly after FK506 rescue therapy, with a slight benefit from additional infliximab, but did not reach nontransplanted controls. Fibrosis onset was detected in both rescue groups by Sirius-Red staining with concomitant increase of the fibrogenic mediator VEGF. Recovery from ACR could be attained by both rescue therapy regimens, progressing steadily after initiation of immunosuppression. Reversal of ACR, however, resulted in early stage graft fibrosis. Additional infliximab treatment may enhance physiological recovery of the muscle layer and enteric nervous system independent of inflammatory reactions.

Short-,moderate-, and long-term treadmill training protocols reduce plasma, fundus, but not small intestine ghrelin concentrations in male rats.

BACKGROUND: It has been suggested that circulating ghrelin levels are upregulated by fasting, hypoglycemic status, and a physical exercise-induced energy deficit. AIM: The purpose of the present study was to investigate the timecourse adaptations of the plasma, fundus, and small intestine ghrelin concentrations as well as related hormones and liver ATP levels to 3, 6, and 12 weeks of treadmill endurance running. MATERIAL/SUBJECTS AND METHODS: Thirty-nine male Wistar rats (12-14 weeks old) were randomly assigned to 3 control (C3, no.=5; C6, no.=7 and C12, no.=7) and 3 training groups (E3, no.=6; E6, no.=7 and E12, no.=7). The rats in the 3 training groups were exercised on a motor-driven treadmill at 25 m/min (0% grade) for 60 min/day, 5 days/week for 3, 6, and 12 weeks, respectively. The animals were sacrificed 48 h after the last session of each training program and tissues were analyzed. RESULTS: Total ghrelin concentrations were significantly (p<0.05) lower in trained rat plasma and fundus tissue after all treadmill endurance running programs. Small intestine ghrelin concentrations remained unchanged. Plasma GH concentrations and liver ATP content were significantly higher in E6 and E12 groups. CONCLUSION: Data indicate that as little as 3 weeks of moderate treadmill exercise reduces plasma and fundus total ghrelin concentrations with elevated plasma GH and liver ATP content occurring after 6 and 12 weeks of training. Exercise training-induced improvement of energy source availability and negative feedback from increased GH levels may play a role in reducing plasma and fundus ghrelin levels.

Extracting Mutual Interaction Rules Using Fuzzy Structured Agent-based Model of Tumor-Immune System Interactions.

BACKGROUND: There are many studies to investigate the effects of each interacting component of tumor-immune system interactions. In all these studies, the distinct effect of each component was investigated. As the interaction of tumor-immune system has feedback and is complex, the alternation of each component may affect other components indirectly. OBJECTIVE: Because of the complexities of tumor-immune system interactions, it is important to determine the mutual behavior of such components. We need a careful observation to extract these mutual interactions. Achieving these observations using experiments is costly and time-consuming. MATERIAL AND METHODS: In this experimental and based on mathematical modeling study, to achieve these observations, we presented a fuzzy structured agent-based model of tumor-immune system interactions. In this study, we consider the confronting of the effector cells of the adaptive immune system in the presence of the cytokines of interleukin-2 (IL-2) and transforming growth factor-beta (TGF-ß) as a fuzzy structured model. Using the experimental data of murine models of B16F10 cell line of melanoma cancer cells, we optimized the parameters of the model. RESULTS: Using the output of this model, we determined the rules which could occur. As we optimized the parameters of the model using escape state of the tumor and then the rules which we obtained, are the rules of tumor escape. CONCLUSION: The results showed that using fuzzy structured agent-based model, we are able to show different output of the tumor-immune system interactions, which are caused by the stochastic behavior of each cell. But different output of the model just follow the predetermined behavior, and using this behavior, we can achieve the rules of interactions.

Extraction of antioxidants and caffeine from green tea (Camelia sinensis) leaves: kinetics and modeling.

The effects of temperature (50, 60, 70, 80, 90 °C) and time (5, 10, 20, 40, 80 min) on catechins and caffeine solubility in water from Iranian green tea were investigated, The best combinations of temperature and time extraction with water were 20-40 min, 80 °C for epigallocatechin (EGC), epicatechin (EC) and caffeine (Caff), and 80 min, 90 °C for catechin (C), epicatechin gallate (ECG) and epigallocatechin gallate (EGCG). A mathematical model derived from Fick's second law was then used to calculate the diffusivity of the components, and to monitor the effect of temperature on the diffusivities. The extraction of these components is governed by two diffusion processes: fast and slow. The results showed that the intra-particle diffusion was the rate-governing step of the extraction process. The slow stage diffusivities of these components at their optimum extraction temperatures were calculated as: 1.94e-9 (EGC), 8.1e-10 (EC), 3.9e-10 (Caff), 1.34e-8 (C), 4.2e-9 (ECG) and 4.63e-9 (EGCG).

Radioanatomic Characteristics of the Posteromedial Intraconal Space: Implications for Endoscopic Resection of Orbital Lesions.

BACKGROUND AND PURPOSE: Imaging is essential in the diagnostic work-up of patients with orbital lesions. The position of an orbital lesion relative to the inferomedial muscular trunk of the ophthalmic artery determines endoscopic resectability, anticipated technical difficulty, and patient morbidity. Although the inferomedial muscular trunk is not readily identifiable on preoperative imaging, we hypothesize that it is spatially approximate to the location where the ophthalmic artery crosses the optic nerve. Our aim was to determine whether the ophthalmic artery-optic nerve crosspoint anatomically approximates the inferomedial muscular trunk in a cadaver study and can be appreciated on imaging of known posteromedial orbital lesions. MATERIALS AND METHODS: Dissection was performed on 17 fresh-frozen cadaver orbits to assess the relationship between the inferomedial muscular trunk and ophthalmic artery-optic nerve crosspoint. Retrospective review of imaging in 9 patients with posteromedial orbital lesions assessed posteromedial orbital compartment characteristics and the ability to locate the ophthalmic artery-optic nerve crosspoint. RESULTS: In our cadaver study, the mean distance between the ophthalmic artery-optic nerve crosspoint and the inferomedial muscular trunk was 1.21 ± 0.64 mm. Retrospectively, the ophthalmic artery-optic nerve crosspoint was identifiable in 9/9 patients, whereas the inferomedial muscular trunk was not identifiable in any patient. Total or partial effacement of the posteromedial intraconal fat triangle was observed in 9/9 patients. CONCLUSIONS: This study of neurovascular relationships within the posteromedial orbit demonstrates that the ophthalmic artery-optic nerve crosspoint closely approximates the inferomedial muscular trunk and can be seen in patients with posteromedial orbital lesions. Posteromedial intraconal fat effacement may help to localize these lesions. These findings may facilitate multidisciplinary communication and help predict lesion resectability and patient outcomes.

An in-vitro comparison of visual inspection, bite-wing radiography, and laser fluorescence methods for the diagnosis of occlusal caries.

PURPOSE: The purpose of this study was to compare accuracy and reproducibility of visual inspection (VI), bitewing (BW) radiography, and laser fluorescence (LF, DIANOdent) methods in the diagnosis of occlusal caries. MATERIALS AND METHODS: The study was done on 80 extracted permanent premolars that seem to be intact or with primary caries in fissures. Three trained dentist examined the teeth in four stages: VI, BW radiography, LF, and histologic examination. Sensitivity, specificity, positive and negative predictive values, and accuracy of all methods were calculated and compared. For the LF method, using ROC curve and counterpart points on it, we determined upper and lower limits and calculated the parameters. RESULTS: The estimated accuracy was 58.9% for VI and 45.1% for BW radiography methods. Kappa coefficient for interexaminer reproducibility was 57% and 34.1% in VI and BW radiography, respectively. Inter- and intraexaminer reproducibility coefficients of LF methods were 78.4% and 83.6%, respectively. The mean intraexaminer reproducibility coefficient in the VI method was 61.2%. CONCLUSION: Although accuracy and reproducibility of the LF method were higher than those of the VI and BW radiography, it is better to use this method together with other methods to reduce diagnostic faults.