Effects of different storage media on dentin moisture, microhardness, and bond strength of resin composite.

Background: In in vitro studies, it is desirable that the storage solutions in which dental samples kept between extraction and experiment should prevent dehydration and have antimicrobial properties. However, it should be taken into consideration that these solutions may have some effects that directly change test results on physical and mechanical properties of laboratory samples. Aims: The aim of this in vitro study was to evaluate the effects of different storage media on dentin moisture, microhardness, and microshear bond strength of resin composite to dentin. Thirty non-carious human premolars were randomly divided into three groups: 1. 0.1% Thymol (T), 2. Distilled water (DW), 3. Dry storage (DS) (control) (n = 10). Dentin moisture was measured with a digital grain moisture meter. Dentin microhardness was measured with the Vickers test. The bond strength was measured with a microshear test. Materials and Methods: Analysis of variance (ANOVA) followed by the Bonferroni test was used for statistical evaluation (p = 0.05). Results: Dentin moisture of the experimental groups was statistically higher than that of the control group (p < 0.05). In addition, the dentin moisture of group DW was significantly higher than that of group T (p < 0.05). The mean microshear bond strength of resin composite to dentin was higher in group DW than in group T and group DS (p < 0.05), while there was no statistical difference between group T and group DS. The microhardness values of all groups were statistically similar. Conclusions: Storage solutions used for disinfection and to prevent dehydration may have negative effects on dentin moisture and bond strength.

Escherichia coli cellular responses to exposure to atmospheric-pressure dielectric barrier discharge plasma-treated N-acetylcysteine solution.

AIM: To understand the underlying cellular mechanisms during inactivation of Escherichia coli in response to antimicrobial solution of nonthermal plasma-activated N-acetylcysteine (NAC). METHODS AND RESULTS: The recommended techniques were used to demonstrate E. coli cellular and transcriptomic changes caused associated with peroxynitrite and compared with plasma-treated NAC solution. The findings demonstrate that E. coli cells respond to plasma-treated NAC and undergo severe oxidative and nitrosative stress, and leading to stress-induced damages to different components of bacterial cells, which includes loss of membrane potential, formation of oxidized glutathione (GSSG), formation of nitrotyrosine (a known marker of nitrosative stress), DNA damage, and generated a prominent pool of peroxynitrite. Reverse-transcriptase (RT)-polymerase chain reaction analysis of reactive nitrogen species (RNS) responsive genes indicated their differential expressions. CONCLUSION: For the first time, we report that the plasma-treated NAC solution activates predominantly nitrosative stress-responsive genes in E. coli and is responsible for cell death. SIGNIFICANCE AND IMPACT OF THE STUDY: The reactive species generated in solutions by nonthermal plasma treatment depends on the type of solution or solvent used. The plasma-treated NAC solution rapidly inactivates E. coli, mostly involving highly RNS generated in NAC solution, and has high potential as disinfectant.

European Society of Endodontology position statement: the use of antibiotics in endodontics.

This position statement represents a consensus of an expert committee convened by the European Society of Endodontology (ESE) on Antibiotics in Endodontics. The statement is based on current scientific evidence as well as the expertise of the committee. The goal is to provide dentists and other healthcare workers with evidence-based criteria for when to use antibiotics in the treatment of endodontic infections, traumatic injuries of the teeth, revascularization procedures in immature teeth with pulp necrosis, and in prophylaxis for medically compromised patients. It also highlights the role that dentists and others can play in preventing the overuse of antibiotics. A recent review article provides the basis for this position statement and more detailed background information (International Endodontic Journal, 2017, https://doi.org/10.1111/iej.12741). Given the dynamic nature of research in this area, this position statement will be updated at appropriate intervals.

Anatomical landmarks of mandibular interforaminal region related to dental implant placement with 3D CBCT: comparison between edentulous and dental mandibles.

BACKGROUND: Anterior mandibular (interforaminal) region is important in implant applications as it serves a basis for neurovascular bedding and holds the prosthesis for patients. Treatment planning for dental implant patients is often complicated by the unknown extent of the anterior loop of the neurovascular bundle. Anatomical structures including mandibular incisive canal (MIC) and lingual foramen (LF) should also be examined as part of the detailed analysis for their neurovascular structures. This study aimed to detect the positions of LF and MIC as well as the prolongation of interforaminal region in Anatolian population to supply the reference data of the surgical safe zone in chin for the clinicians. MATERIALS AND METHODS: Mandibles of 70 adult specimens (35 edentulous + 35 dentate) were retrieved from the Department of Anatomy, Ege University. Images of the dry mandibles were obtained using a cone beam computed tomography unit applying a standardized exposure protocol. Afterwards, mandibles were sawn into vertical sections according to the respective tomographic cross-sections. Images were evaluated for the absence/presence of the MIC, its dimensions and antero-posterior length for both edentulous and dentate groups. In addition; the presence, number, location, labial canal and LF diameter and height of the LF were determined for both groups. RESULTS: The MIC was observed in 80 and 68.6% of the dentate and edentulous groups, consecutively (p > 0.05). The MIC continued towards the incisor region in a slightly downward direction. The LF was observed in all dentate mandibles (100%), while it was present in 94.3% of the edentulous mandibles (p > 0.05). For the dentate group, 62.9% of the specimens had two foramens and 20% had three foramens in the mandibular midline. Mean length of the MIC in dentate groups and edentulous groups was measured as 2.55 ± 0.809 and 3.08 ± 1.745 mm, respectively. Well-defined MIC mean diameter in dentate groups and edentulous groups were measured as 2.44 ± 0.702 and 2.35 ± 0.652 mm, respectively. Significant difference was found between dentate and edentulous group in most of the parameters except for the LF and the diameter of the MIC (p > 0.05). The correlation between observers' measurements ranged between 0.742 and 0.993 for all anatomical landmarks and mandible groups. CONCLUSION: The MIC and LF are associated with neurovascular bundle variations in number, location and size. Therefore, clinicians should determine each of these anatomical structures on a case-by-case basis to recognize their presence and to take measures for the possible implications of various treatment options. These guidelines included leaving a 2 mm safety zone between an implant and the coronal aspect of the neurovascular bundle. To avoid neurovascular injury during surgery in the interforaminal area, guidelines were developed with respect to validating the presence of an anterior loop of the neurovascular bundle.

Antibiotics in Endodontics: a review.

The overuse of antibiotics and the emergence of antibiotic-resistant bacterial strains is a global concern. This concern is also of importance in terms of the oral microbiota and the use of antibiotics to deal with oral and dental infections. The aim of this paper was to review the current literature on the indications and use of antibiotics and to make recommendations for their prescription in endodontic patients. Odontogenic infections, including endodontic infections, are polymicrobial, and in most cases, the prescription of antibiotics is empirical. This has led to the increasing use of broad-spectrum antibiotics even in cases where antibiotics are not indicated, such as symptomatic irreversible pulpitis, necrotic pulps and localized acute apical abscesses. In case of discrete and localized swelling, the primary aim is to achieve drainage without additional antibiotics. Adjunctive antibiotic treatment may be necessary in the prevention of the spread of infection, in acute apical abscesses with systemic involvement and in progressive and persistent infections. Medically compromised patients are more susceptible to complication arising from odontogenic infections and antimicrobials have a more specific role in their treatment. Therefore, antibiotics should be considered in patients having systemic diseases with compromised immunity or in patients with a localized congenital or acquired altered defence capacity, such as patients with infective endocarditis, prosthetic cardiac valves or recent prosthetic joint replacement. Penicillin VK, possibly combined with metronidazole to cover anaerobic strains, is still effective in most cases. However, amoxicillin (alone or together with clavulanic acid) is recommended because of better absorption and lower risk of side effects. In case of confirmed penicillin allergy, lincosamides such as clindamycin are the drug of choice.

Associations between participation in family activities and adolescent school problems.

INTRODUCTION: Adolescent risk outcomes related to school issues are widespread, with about 20% parents reporting poor school engagement amongst their youth. Previous literature suggests that adolescents who report strong bonds with their parents are often identified as being less likely to engage in risky behaviours, such as substance use. The current study sought to examine the association between the frequencies of selected family activities and school problems amongst adolescents after adjustments for family connectedness and other characteristics. METHODS: Data were drawn from the National Longitudinal Survey of Youth, 1997. Of the 8984 youth interviewed, 3855 also had a sibling interviewed who met the selection criteria. School problem outcomes measured were suspension occurrence, poor grades and highest grade completed low for age. Independent variables of interest were self-reported frequency of family dinner, fun and religious activities in a typical week. Multivariable logistic models were estimated for each outcome, and multivariable linear probability models were estimated adjusting for family fixed effects. RESULTS: Adjusting for family connectedness, there were significant associations between certain family activities and adolescent school problem measures. However, these results did not remain significant in models with family fixed effects, suggesting that associations could be driven by family-level confounders. DISCUSSION: This study did not find strong evidence of a protective relationship between family activities and school problems. Therefore, it suggested that programme and policymakers be cautious in overstating the importance of family activities in preventing adolescent risk outcomes until true causal relationships can be determined.

Studies on Acinetobacter baumannii involving multiple mechanisms of carbapenem resistance.

AIMS: Characterize the genetic type and resistance mechanisms of 16 carbapenem-resistant Acinetobacter baumannii (CRAB) isolates recovered between January 2010 and March 2011 from US tertiary-care hospital. METHODS AND RESULTS: A modified Hodge test demonstrated the presence of carbapenemases, but meropenem and ethylenediaminetetraacetic acid (EDTA) double-disc synergy tests and PCR for metallo-ß-lactamase (MBL) genes were negative. The genes of ampC ß-lactamase and efflux pump of adeABC and adeIJK were detected. The presence of oxacillinase (OXA)-like genes, blaOXA-51-like , blaOXA-23-like and blaOXA-40-like genes, and insertion sequence ISAba1 in promoter region of blaOXA-51-like and blaOXA-23-like genes were detected; and confirmed by RT-PCR analyses. The sequencing of blaOXA-51-like genes revealed two major alleles, blaOXA-66-like (blaOXA-82 ) and blaOXA-113 from 31·2 to 68·8% of isolates respectively. The blaOXA-23 and blaOXA-72 genes showed high expression and found co-harbouring blaOXA-51-like gene preceded by ISAba-1. All CRAB isolates revealed significant reduction in carO transcription, indicated downregulation of CarO porin system, a potentially independent mechanism of carbapenam resistance. Sequencing of carO gene from representative isolates showed no ISAba1 insertional inactivation. Pulsed-field gel electrophoresis revealed a clonal relationship. CONCLUSIONS: CRAB exhibited diversity of mechanisms of carbapenem resistance, and clonal relationship. SIGNIFICANCE AND IMPACT OF THE STUDY: Studies on distinct outbreaks of CRAB are alarming situation for clinicians.

Screening Brucella spp. in bovine raw milk by real-time quantitative PCR and conventional methods in a pilot region of vaccination, Edirne, Turkey.

Brucellosis is a worldwide zoonotic disease transmitted to humans by consumption of contaminated milk and milk products. Brucellosis is endemic in Turkey, and Edirne has a high Brucella prevalence. Brucellosis is prevented by live-attenuated vaccines for animals and the vaccination program has been in place since 1984 in Turkey. Thrace is the pilot region for this vaccination program. The gold standard diagnostic technique for brucellosis is still the isolation of suspicious bacterial colonies followed by bacteriological identification, but it is very time consuming and laborious. In many studies, Brucella has been investigated by PCR techniques. However, PCR-based methods cannot differentiate between the vaccine strain and the virulent strain; thus, the vaccine strain may interfere with the virulent strain and causes false-positive reactions. To monitor brucellosis control programs effectively, it is important to distinguish vaccine and field strains of Brucella spp. In this study, raw milk samples were collected from 99 cows at 12 different barns in 5 villages of Edirne (Turkey). Bacteriological analyses and real-time quantitative (q)PCR experiments were applied to all samples. The DNA was isolated using Biospeedy DNA-Tricky Purification Kit (Bioeksen, Istanbul, Turkey). For all reactions, Roche Light Cycler Nano (Roche Diagnostics, Mannheim, Germany) instrument and Biospeedy EvaGreen qPCR Pre-Mix (Bioeksen) were used. The data were analyzed using Roche LightCycler NanoSoftware 1.0. For samples that were negative by bacteriological analyses and positive by qPCR, we developed a novel qPCR-based method to differentiate the virulent B. abortus strains and B. abortus S19 vaccine strain. We designed qPCR primers targeting the outer membrane protein of B. abortus. The qPCR products were sequenced using the ABI Prism Big Dye Terminator Cycle Sequencing Ready Reaction Kit on an ABI Prism 377 DNA sequencer (Applied Biosystems, Foster City, CA). In total, 2.02% of the samples were Brucella positive, by both bacteriological method and the novel qPCR method. We concluded that, to obtain true-positive results in Brucella spp. screening studies for milk, differentiating the virulent and vaccine strain should not be disregarded.

Trichoscopy in paediatric patients with tinea capitis: a useful method to differentiate from alopecia areata.

OBJECTIVES: Trichoscopy (hair and scalp dermatoscopy) facilitates the diagnosis of hair and scalp disorders. The aim of our study was to identify the trichoscopic features in diagnosis of tinea capitis (TC) and to compare these findings with alopecia areata (AA). MATERIALS AND METHODS: Our study included 15 children with TC and 10 children with AA as a control group. Affected areas of the scalp on all the cases were analysed under a magnification of 20X and 40X by a digital dermatoscope (MoleMax II). RESULTS: Broken and dystrophic hairs were found in dermatological examination of all the patients with TC. In addition, corkscrew hairs, comma hairs and black dots were observed respectively. Yellow dots, exclamation mark hairs and vellus hair were observed in patients with AA. CONCLUSIONS: Broken and dystrophic hairs, corkscrew hairs, comma hairs and black dots were observed only in patients with TC; yellow dots, exclamation mark hairs and vellus hairs were observed only in patients with alopesi areata. Further studies with larger numbers of patients are needed to determine specific trichoscopic findings of TC and to access differential diagnosis.

Irritable bowel syndrome in patients with chronic pruritus of undetermined origin.

BACKGROUND: Chronic pruritus is an important distressing condition that is often refractory to treatment. Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that occurs without an organic cause. OBJECTIVES: We aimed to investigate the relationship between chronic pruritus of undetermined origin (CPUO) and IBS. METHODS: Eighty patients with chronic pruritus (CP) of undetermined origin and fifty healthy control subjects without pruritus were included into the study. All of the participants were examined by a gastroenterologist for concomitant IBS. RESULTS: The frequency of IBS was found higher in patients with CP of undetermined origin (P: 0.02), but we did not observe any significant association between pruritus intensity and either presence of IBS (P: 0.08) or the subtypes of the syndrome (P: 0.40). Furthermore, patients with CP of undetermined origin between 40 and 60 years, female gender and longer duration of the disease were found to be significantly associated with the presence of IBS (P: 0.02, P: 0.01 and P < 0.001). CONCLUSIONS: We found that the frequency of IBS was higher in patients with CP than in healthy controls. Our study is the first report about the relation between CP of undetermined origin and IBS. Further studies with larger numbers of the patients are needed to show association between IBS and CPUO using laboratory tests to define underlying diseases such as lactose intolerance, functional dyspepsia and emotional diseases.

Behcet disease and pregnancy.

PURPOSE: Behcet disease (BD) is a multisystemic vaculitis commonly diagnosed in reproductive years. The authors aimed to investigate the relationship between BD and pregnancy outcomes. MATERIALS AND METHODS: In this multicenter retrospective survey study, the authors compared the pregnancy outcomes of BD patients with the healthy controls. RESULTS: A total of 298 pregnancies of 94 patients with BD and 219 pregnancies of 95 healthy controls were evaluated. The mean birth weight of all babies of women with BD and the control group were 3,214 grams and 3,351 grams, respectively (p = 0.028). The miscarriage rates were also higher in the BD group. The com- plication rates of pregnancy with hypertension, preeclampsia, preterm labour in the study group and the control group were 12.8% and 11.6%, respectively (p = 0.489). CONCLUSION: The current study demonstrated that BD patients delivered smaller babies and they have higher miscarriage rates when compared to the healthy controls which might be due to the vasculitis of the placenta.

Correlation of platelet count and acute ST-elevation myocardial infarction.

The study was conducted in the Department of cardiology, NICVD Dhaka during the period January 2006 to December 2007 to assess the impact of platelet on ST-elevation myocardial infarction (STEMI). To perform this prospective study 200 patients with STEMI within 72 hours of chest pain of both sexes were randomly selected and were evaluated by clinical history, physical examination and with the help of ECG, Echocardiography and others cardiac risk factors analysis. Heparin therapy before admission, previously documented thrombocytopenia (<140,000/cmm), history of previous or current haemostatic disorder, renal impairment (Creatinine >1.6mg/dl) and history of PCI & CABG were excluded in this study. Patient of Platelet count (PC) ≤200000/cubic millimeter (cmm) in Group I and patient of Group II, platelet counts were PC >200000/cmm. Follow up period was 3 days to 7 days after hospital admission. Primary outcome heart failure (any Killip class) was significantly more in Group II than Group I (40.0% vs. 23.0%; p=0.009). Though the incidence of Killip class I and cardiogenic shock were not significant between these two groups but Killip class II (18.0% vs. 8.0%; p=0.036) and Killip class III (15.0% vs. 6.0%; p=0.037) heart failure were significantly more among the patient with higher platelet counts. In-hospital mortality, one of the primary outcomes of this study, was significantly higher in Group II (13.0%) than Group I (5.0 %) and p value was 0.048. Re-infarction was more in patient with higher platelet counts group (Group II) than patients with lower platelet count (Group I) but statistically was not significant (16.0% vs.11.0%; p=0.300).

Cone beam computed tomography evaluation of c-shaped canal morphology in mandibular premolar teeth.

Purpose: The aim of this study was to evaluate the prevalence and the morphology of c-shaped root canal(s) in mandibular premolars using cone beam computed tomography (CBCT) images. Materials and methods: CBCT images of 1095 mandibular premolars were examined at coronal, middle, and apical levels of the root canals. The type, the level, and the position (buccal or lingual) of the c-shaped anatomy were recorded. Absolute counts and percentages of different groups and subgroups of C-shape morphologies were calculated. The Chi-square test was used to compare the prevalence of C-shaped morphology between mandibular first and second premolars. The Z-test for proportions in independent groups was used to analyze the differences in mandibular C-shaped premolar proportions between location (left and right side) and tooth (first or second premolars) (p=0.05). Results: C-shaped root canal morphology was present in 44 teeth. The percentage of c-shaped morphologies was 6.9% and 1.6% in mandibular first and second premolars, respectively. Comparison of the first and the second premolars showed that C1 type (p=0.008) and C4b type (p=0.013) configurations are more common in the first premolars at the coronal level. In contrast, the C2 type configuration showed significantly higher prevalence in the second premolars (p=0.009). Additionally, the C4c type configuration was significantly frequent on the right premolars at the coronal level (p=0.038). Conclusion: C-shape canal morphology is a rare but complex anatomic feature in mandibular premolars. Therefore, clinicians should be aware of this complex root canal anatomy for the success of endodontic treatment in mandibular premolar teeth.

Increased epicardial fat tissue is a marker of subclinical atherosclerosis in patients with psoriasis.

BACKGROUND: Carotid intima-media thickness (CIMT) is a potential indicator of subclinical atherosclerosis in patients with psoriasis. Epicardial fat thickness (EFT) is proposed as a new cardiometabolic risk factor. OBJECTIVE: To evaluate the association between EFT and CIMT in patients with psoriasis. METHODS: This was a cross-sectional and observational study; 65 patients with psoriasis and 50 age- and sex- matched control subjects were included. Data about echocardiographic EFT, CIMT, anthropometric measurements and metabolic profile were obtained. RESULTS: The EFT and CIMT were significantly increased (7.3 ± 0.5 vs. 6.5 ± 0.5 mm, P < 0.01; 0.74 ± 0.11 vs. 0.60 ± 0.07 mm, P < 0.01, respectively) in patients with psoriasis compared with the controls. EFT was significantly correlated with CIMT (r = 0.69, P < 0.01). In a multiple linear regression model in which EFT was independently associated with psoriasis (ß = 0.45, P < 0.01), age (ß = 0.33, P = 0.01), CIMT (ß = 0.50, P < 0.01), body mass index (ß = 0.25, P = 0.01), high-sensitivity C-reactive protein (ß = 0.32, P < 0.01) and duration of disease (ß = 0.34, P = 0.03). CONCLUSIONS: We demonstrated that EFT and CIMT are increased in patients with psoriasis, and that echocardiographic EFT is closely correlated with CIMT in patients with psoriasis. The echocardiographic assessment of EFT may have the potential to be a simple marker of subclinical atherosclerosis and increased cardiovascular risk in patients with psoriasis.

Thyroid hormone status in apparently healthy elderly persons.

Thyroid disorders are frequent in elderly population and difficult to recognize because of their atypical presentation, and the absence of classic signs and symptoms. Nonspecific symptoms, even in the absence of thyroid dysfunction, are common in this age group, including fatigue, anorexia, weight loss, failure to rehabilitate, and difficult to concentrate. Symptoms of aging can be confused easily with hypothyroidism. The interpretation of thyroid function tests is also cumbersome in aged individuals because of the difficulty in differentiating physiologic age-associated changes from alterations secondary to acute or chronic non-thyroidal illness. In the present study, a total 100 subjects were included. Subjects were divided into two groups: Group I - Control (n=50) and Group II - Case (n=50). Fifty apparently healthy young adults were taken as control (Group I) and 50 apparently healthy elderly subjects were included in case (Group II). Group I was subdivided into two groups- Group IA: young male (n=25) and Group IB: young female (n=25). Group II was also subdivided into two groups - Group IIA: elderly male (n=25) and Group IIB: elderly female (n=25). All the subjects were selected from the local community of Mymensingh Sadar, Mymensingh Medical College, Mymensingh and Community Based Medical College, Bangladesh, Mymensingh. In the present study, the difference of mean serum T3 concentration between Group I (control) and Group II (elderly subjects) was not found to be significant (p>0.05). Significant difference in serum TSH concentration between Group IA and Group IIA was to be found (p<0.001). The difference of mean serum T4 concentration between Group IB and Group IIB was not found significant (p>0.05). Significant difference in mean serum TSH concentration between Group IB and Group IIB was to be found (p<0.001).

Microhardness and surface roughness of glass ionomer cements after APF and TiF4 applications.

OBJECTIVE: To evaluate whether TiF4 solution and APF gel had any adverse effects on the surface morphology of newly developed glass ionomers. STUDY DESIGN: Fifteen disc-shaped specimens of Fuji IX Extra, Fuji II LC and Ketac N100 were prepared and stored in 2 ml of artificial saliva at 37 degrees C for 8 weeks. Specimens of each material were divided randomly into three subgroups as 1 and 4 minutes application of 1.23% APF gel and 1 minute application of 1% TiF4 solution. Specimens were reaged for another 8 weeks. Microhardness, surface roughness values and surface morphology were evaluated by using Vicker's hardness test, surface profilometry and scanning electron microscopy (SEM) for all time interventions, respectively. One-way Anova test was performed and differences were compared by Tukey's HSD and Dunnet T3 test RESULTS: APF and TiF4 applications decreased microhardness significantly in Fuji II LC. In Fuji IX Extra microhardness decreased significantly after 1- and 4-min APF applications. Ketac N100 showed no difference in microhardness after APF and TiF4 applications. Surface roughness was not affected at any time interval for three restorative materials. CONCLUSION: Within the limitations of this vitro study it was revealed that, potential adverse effects of APF and TiF4 applications might be material dependant. Hence, restorative materials should be selected in accordance with kind, frequency and application time of fluoridation to avoid deteriorations of the restorations.

Steady and oscillatory fluid flows produce a similar osteogenic phenotype.

Mechanical loading induces positive changes in the skeleton due to direct effects on bone cells, which may include regulation of transcription factors that support osteoblast differentiation and function. Flow effects on osteoblast transcription factors have generally been evaluated after short exposures. In this work, we assayed flow effects on osteogenic genes at early and late time points in a preosteoblast (CIMC-4) cell line and evaluated both steady and oscillatory flows. Four hours of steady unidirectional flow decreased the level of RANKL mRNA 53 ± 7% below that of nonflowed cells, but increases in Runx2 and osterix mRNA (44 ± 22% and 129 ± 12%, respectively) were significant only after 12-19 h of continuous flow. Late flow effects on RANKL and osterix were also induced by an intermittent flow-rest protocol (four cycles of 1 h on/1 h off + overnight rest). Four hours of oscillatory flow decreased RANKL mRNA at this early time point (63 ± 2%) but did not alter either osterix or Runx2. When oscillatory flow was delivered using the intermittent flow-rest protocol, Runx2 and osterix mRNA increased significantly (85 ± 19% and 161 ± 22%, respectively). Both ß-catenin and ERK1/2, known to be involved in RANKL regulation, were rapidly activated by steady flow. Inhibition of flow-activated ERK1/2 prevented the increase in osterix mRNA but not Runx2; Runx2 phosphorylation was increased by flow, an effect which likely contributes to osterix induction. This work shows that both steady and oscillatory fluid flows can support enhancement of an osteogenic phenotype.

Effect of Mandibular Angulation on Pre-Implant Site Measurement Accuracy Using CBCT.

PURPOSE: To evaluate the accuracy of available bone width, height, and length measurements on pre-planned implant sites using CBCT images scanned at different angulations of the mandible. MATERIALS AND METHODS: Standard cylindrical holes were prepared on six dry human mandibles and filled with warm gutta-percha to create spherical markers for measurements of available bone width, height, and length. Mandibles were first scanned with a CBCT device in an ideal position with the occlusal plane parallel to the horizontal plane. Then, images of the mandibles were obtained in rotation, tilt, flexion, and extension positions using 5- and 10-degree angulations. Measurements were done on a total of 54 images. Original dimensions of the available bone for planned implant sites were measured with a digital caliper on dry mandibles as the gold standard. The absolute values of the differences between each measurement and the gold standard were obtained for measurement errors. Repeated-measures analysis of variance and Dunnett's multiple comparisons test were used for comparisons (P = .05). Intraobserver and interobserver agreement was calculated using intraclass correlation coefficient (ICC). RESULTS: ICC was excellent for both intraobserver and interobserver reproducibility. No significant difference was found between length and height measurements in ideal position and in rotation, tilt, flexion, and extension movements of mandibles at two different angulations (P > .05). Width measurements revealed a significant difference among ideal measurements and measurements at 10-degree flexion, 10-degree extension, 10-degree rotation, and 10-degree tilted mandibular positions (P < .05). CONCLUSION: The position of the occlusal plane with respect to the floor during the CBCT scan may have a clinically significant effect on dental implant site dimensions.

Correlation of platelet count and acute ST-elevation in myocardial infarction.

The role of platelets in the pathogenesis of ST-elevation myocardial infarction (STEMI) has been substantiated by studies that demonstrated significant clinical benefits associated with antiplatelet therapy. Initial platelet counts in Acute Myocardial Infarction (AMI) may be a useful adjunct for identifying those patients who may or may not respond to fibrinolytic agents. Patient with acute STEMI has variable level of platelet count and with higher platelet count have poor in hospital outcome. There are many predictors of poor outcome in Acute Myocardial Infarction (AMI) like cardiac biomarkers (Troponin I, Troponin T and CK-MB), C-Reactive Protien (CRP) and WBC (White Blood Cell) counts. Platelet count on presentation of STEMI is one of them. Higher platelet count is associated with higher rate of adverse clinical outcome in ST-Elevation Myocardial Infarction (STEMI), like heart failure, arrhythmia, re-infarction & death. So, categorization of patient with STEMI on the basis of platelet counts may be helpful for risk stratification and management of these patients.

A case report of right ventricular mass.

Primary Cardiac tumors are uncommon during infancy and childhood. Myxomas originating in the right ventricles are even less common in paediatric patient. Our patient baby Rani, 3 months of age presented with shortness of breath and chest indrawing. Antenatal history and delivery was uneventful. The baby was under weight and also malnourished but there was no cyanosis and clubbing. Her respiratory rate was 25/minute. On precordium examination, first heart sound (S1) was normal but pulmonary component of second heart sound (P2) was soft. There was an ejection systolic murmur (Grade-3/6) in the left upper para-sternal area. Chest X-ray revealed cardiomegaly. Echocardiogram revealed a large mass (11x10mm) in the right ventricle, dynamically obstructing the right ventricular out-flow tract and compressing the left ventricle. There was a Tricuspid regurgitation (Grade-2) and moderate pulmonary hypertension (PASP-50 mmHg).