Color stability, roughness, and water sorption/solubility of glass ionomer-Based restorative materials.

OBJECTIVES: The aim of this study was to investigate the effects of various drinks on color stability and roughness of glass ionomer cement-based/-containing restorative materials and water sorption/solubility behavior of them. MATERIALS AND METHODS: A total of 130 specimens for each material (GC Equia, GCP Glass Fill, Ketac N100, Glasiosite; a total of 520) were prepared using a Tefl on ring (7 × 2 mm). After specimen preparations, baseline color and surface roughness measurements were performed using a spectrophotometer and surface profi lometer, respectively. Specimens were immersed in four different solutions (n = 15; distilled water, cola, orange juice, and chocolate milk) during the 28-day test period. The immersion media were renewed daily. Color and surface roughness measurements were repeated at 1st, 7th, and 28th days. For water sorption, specimens (n = 15) were immersed in 10 mL of distilled water in individual containers and weighed at 1st week, 14th, and 28th days. After a total immersion time of 28 days, the specimens were dried to a constant mass, in a desiccator for 28 days. Each specimen was measured using a digital electronic caliper. Data were statistically analyzed (P < 0.05). RESULTS: After 28 days, the highest ΔE* value was calculated in GCP Glass Fill immersed in chocolate milk (10.54 ± 0.69). All the tested materials showed signifi cantly higher Ra values compared with baseline scores after immersion in various beverages regardless of the immersion solutions used (P < 0.05). Glasiosite showed the smallest water sorption (16.75 µg/mm3) among the tested materials, whereas Ketac N100 (155.41 µg/mm3) and GCP Glass Fill (161.01 µg/mm3) had the highest. CONCLUSIONS: The compositions of restorative materials play key roles in their color stability, surface roughness, and water sorption/solubility.

Fluoride release/recharging ability and bond strength of glass ionomer cements to sound and caries-affected dentin.

OBJECTIVES: The aim of this in vitro study was to evaluate the microtensile bond strength (µTBS) of different glass ionomer cements (GICs) on sound/caries-affected dentin and to assess the fluoride release/recharging ability. METHODS: After creating artificial caries lesions, teeth with sound and caries-affected dentin were assigned to be restored with one of the GICs: Ketac N100; GC Equia; GCP Glass Fill, and tested using a microtensile test. Ten of each material were prepared, and fluoride ion-release was measured at 10 different intervals. After 1.23% acidulated phosphate fluoride-gel immersion, fluoride re-release was then measured at the same intervals. RESULTS: In sound dentin, GC Equia exhibited significantly higher µTBS value (P < 0.05). The mean µTBS of Ketac N100 to caries-affected dentin was significantly lower than the other materials (P < 0.05). All materials showed maximal fluoride release at 24 h, GC Equia released the most fluoride. CONCLUSION: The bond strength of GICs is affected by tooth substrate. High-viscosity GICs show higher initial fluoride release as well as greater fluoride recharge capacity.

Evaluation of shear bond strength, penetration ability, microleakage and remineralisation capacity of glass ionomer-based fissure sealants.

AIM: The aim of this study was to evaluate the bond strength, penetration ability, microleakage, and remineralisation capacity of glass ionomer-based fissure sealant materials. MATERIALS AND METHODS: In this study, three glass ionomer-based fissure sealants were evaluated (Fuji Triage, Fuji VII EP, and GCP Glass Seal). A dye-penetration test was performed to evaluate microleakage under a stereomicroscope. The materials were applied to occlusal tooth surfaces, and bucco-lingual sections (1 mm width) were assessed to evaluate the penetration ability. Shear bond strength of tested materials was assessed using a universal testing machine. Finally, the remineralisation capacities of the materials were evaluated with EDS. RESULTS: The Fuji Triage exhibited the lowest microleakage and unfilled area proportion (p<0.05). The highest shear bond strength was calculated with Fuji VII EP (p<0.05). The fluoride content for all treatment groups was significantly different when remineralisation values were compared to demineralisation (p<0.05). CONCLUSION: Both the Fuji Triage and Fuji VII EP yielded compatible and satisfactory results and all fissure sealants used in this study are sufficient as anti-caries agents.

Effect of different surface pre-treatment methods on the microleakage of two different self-adhesive composites in Class V cavities.

AIM: To evaluate the effect of different surface pre-treatment methods on the microleakage of self-adhesive flowable composites (SAFCs) in comparison with a conventional flowable composite applied with an etch-and-rinse adhesive system. MATERIALS AND METHODS: One hundred and thirty-five standardised Class V cavities were randomly divided into nine groups: (1) three-step etch-and-rinse adhesive (Optibond FL - Kerr, Orange, USA)/flowable composite (Clearfil Majesty Flow - Kuraray, Tokyo, Japan) (E&Ra/flowC); (2) Fusio Liquid Dentin (Pentron Clinical, Orange, USA); (3) Er:YAG Laser/Fusio Liquid Dentin (Er&Las/Fusio Liquid Dentin); (4) Phosphoric Acid/Fusio Liquid Dentin (PhosA/Fusio Liquid Dentin); (5) Polyacrylic Acid/Fusio Liquid Dentin (PolyA/Fusio Liquid Dentin); (6) Vertise Flow (Kerr, Orange, USA); (7) Er:YAG Laser/Vertise Flow (Er&Las/Vertise Flow); (8) Phosphoric Acid/Vertise Flow (PhosA/Vertise Flow); (9) Polyacrylic Acid/Vertise Flow (PolyA/Vertise Flow). After thermocycling and immersion in a 0.5% basic fuchsin, the restorations were evaluated under a stereomicroscope (n = 30). The data were statistically analysed (α = 0.05). RESULTS: Both SAFCs showed higher leakage scores than E&Ra/flowC in enamel and dentin (p < 0.05). Vertise Flow showed lower leakage than Fusio Liquid Dentin in dentin (p < 0.05). Pre-phosphoric acid etching reduced the microleakage scores of Fusio Liquid Dentin in both enamel and dentin (p < 0.05), while all surface pre-treatment methods led to a significant reduction in the microleakage scores of Vertise Flow at the enamel margin (p < 0.05). CONCLUSION: Pre-etching of enamel and dentin by phosphoric acid may be satisfactory in improving the sealing ability of Fusio Liquid Dentin, while phosphoric acid or polyacrylic acid etching or laser irradiation may be used to improve the adhesion of Vertise Flow to enamel.

Influence of pre-diagnostic cigarette smoking on colorectal cancer survival: overall and by tumour molecular phenotype.

BACKGROUND: Smoking is a risk factor for incident colorectal cancer (CRC); however, it is unclear about its influence on survival after CRC diagnosis. METHODS: A cohort of 706 CRC patients diagnosed from 1999 to 2003 in Newfoundland and Labrador, Canada, was followed for mortality and recurrence until April 2010. Smoking and other relevant data were collected by questionnaire after cancer diagnosis, using a referent period of '2 years before diagnosis' to capture pre-diagnosis information. Molecular analyses of microsatellite instability (MSI) status and BRAF V600E mutation status were performed in tumour tissue using standard techniques. Multivariate hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with Cox proportional hazards regression, controlling for major prognostic factors. RESULTS: Compared with never smokers, all-cause mortality (overall survival, OS) was higher for current (HR: 1.78; 95% CI: 1.04-3.06), but not for former (HR: 1.06; 95% CI: 0.71-1.59) smokers. The associations of cigarette smoking with the study outcomes were higher among patients with ≥40 pack-years of smoking (OS: HR: 1.72; 95% CI: 1.03-2.85; disease-free survival (DFS: HR: 1.99; 95% CI: 1.25-3.19), those who smoked ≥30 cigarettes per day (DFS: HR: 1.80; 95% CI: 1.22-2.67), and those with microsatellite stable (MSS) or MSI-low tumours (OS: HR: 1.38; 95% CI: 1.04-1.82 and DFS: HR: 1.32; 95% CI: 1.01-1.72). Potential heterogeneity was noted for sex (DFS HR: 1.68 for men and 1.01 for women: P for heterogeneity=0.04), and age at diagnosis (OS: HR: 1.11 for patients aged <60 and 1.69 for patients aged ≥60: P for heterogeneity=0.03). CONCLUSIONS: Pre-diagnosis cigarette smoking is associated with worsened prognosis among patients with CRC.

Hereditary haemorrhagic telangiectasia: mutation detection, test sensitivity and novel mutations.

BACKGROUND: Hereditary haemorrhagic telangiectasia (HHT) is a genetic disorder present in 1 in 8000 people and associated with arteriovenous malformations. Genetic testing can identify individuals at risk of developing the disease and is a useful diagnostic tool. OBJECTIVE: To present a strategy for mutation detection in families clinically diagnosed with HHT. METHODS: An optimised strategy for detecting mutations that predispose to HHT is presented. The strategy includes quantitative multiplex polymerase chain reaction, sequence analysis, RNA analysis, validation of missense mutations by amino acid conservation analysis for the ENG (endoglin) and ACVRL1 (ALK1) genes, and analysis of an ACVRL1 protein structural model. If no causative ENG or ACVRL1 mutation is found, proband samples are referred for sequence analysis of MADH4 (associated with a combined syndrome of juvenile polyposis and HHT). RESULTS: Data obtained over the past eight years were summarised and 16 novel mutations described. Mutations were identified in 155 of 194 families with a confirmed clinical diagnosis (80% sensitivity). Of 155 mutations identified, 94 were in ENG (61%), 58 in ACVRL1 (37%), and three in MADH4 (2%). CONCLUSIONS: For most missense variants of ENG and ACVRL1 reported to date, study of amino acid conservation showed good concordance between prediction of altered protein function and disease occurrence. The 39 families (20%) yet to be resolved may carry ENG, ACVRL1, or MADH4 mutations too complex or difficult to detect, or mutations in genes yet to be identified.

No relationship between lipoprotein-associated phospholipase A2, proinflammatory cytokines, and neopterin in Alzheimer's disease.

OBJECTIVE: Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a reported risk factor for dementia. However, the relationship between Alzheimer's disease (AD) and Lp-PLA2 is still debatable and, to the best of our knowledge, no study has evaluated the associations between levels of Lp-PLA2, proinflammatory cytokines, and neopterin in AD. METHODS: In total, 59 patients with AD and 38 non-demented individuals were included in the case-control study. Fasting serum concentrations of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), neopterin, and Lp-PLA2 were determined using ELISA. The associations between AD and each of the variables were analyzed by logistic regression. RESULTS: The median Lp-PLA2 levels in AD and controls were similar (P=0.29, not significant). Median serum neopterin and IL-6 levels were significantly higher in patients with AD than in controls (P=0.0001 and P=0.03, respectively). In regression analyses, median neopterin levels, a lower level of education, and female gender were significantly associated with AD when compared with controls (OR, 31.44, 95% CI 3.59-275.28, P=0.002; OR, 4.35, 95% CI 1.13-16.61, P=0.032; OR, 7.25, 95% CI 1.88-28.00, P=0.004, respectively). CONCLUSION: In contrast to previous evidence suggesting its role in dementia and AD, Lp-PLA2 enzyme levels were higher in the controls, and no relationship between Lp-PLA2 and either proinflammatory cytokines or neopterin was identified in AD. Elevated neopterin levels may be considered inflammatory markers of AD.

Program specification: a precursor to program monitoring and quality improvement. A case study from Boysville of Michigan.

As a result of new accreditation standards, diminishing resources, community concern with recidivism, and state agencies and foundations requiring more rigorous evaluations, program accountability is becoming a necessity for social services providers and contractors alike. In the subsequent discussion, Boysville of Michigan's program specification process is described; specifically, the ways in which the process has been useful for monitoring program operations, identifying quality improvement indicators, designing ongoing program evaluations, and developing consensus and continuity with respect to program theory and procedures. In addition, benefits, lessons learned, and implications for services delivery are discussed.

Single-incision laparoscopic cholecystectomy in a 6-month pregnant woman: a report of a case.

AIM: We aimed to present a case of single-incision laparoscopic cholecystectomy (SILC) in a pregnant woman. CASE: A 27-year-old, 24-week pregnant woman was referred to our clinic with abdominal pain, nausea, and vomiting. Physical examination and laboratory tests showed that she had acute biliary pancreatitis. An obstetric consultation showed that the patient and the fetus were healthy. After medical treatment the patient was discharged. However, she was again referred to our clinic with a second pancreatitis attack. We examined the patient and recommended cholecystectomy. Preoperative tests were completed and a new obstetric consultation was requested. After the receipt of informed consent for cholecystectomy, SILC was performed. CONCLUSIONS: SILC is a feasible surgical method in pregnant women as well.

Is the rabbit knee a suitable model for the human interphalangeal and metacarphophalangeal joints of the hand?

OBJECTIVES: The purpose of this study was to assess the suitability of the rabbit knee as a small joint model for the human interphalangeal and metacarphophalangeal joints of the hand. METHODS: The proximal joint surface areas of 47 middle phalanges, the proximal and distal joint surface areas of 90 proximal phalanges, and the distal joint surface areas of 42 metacarpals of various human cadavers were calculated and compared with the distal femoral and proximal tibial joint surface areas of 20 knee of 10 New Zealand white rabbits by a photogrammetric method. RESULTS: The mean joint surface area of the rabbit proximal tibia was larger than the proximal joint surface area of the middle phalanx, the distal joint surface area of the proximal phalanx, the proximal joint surface area of the proximal phalanx, and the distal joint surface area of the metacarpal. The mean joint surface area of the rabbit distal femur was larger than that of the middle phalanx, but similar to the proximal joint surface area of the proximal phalanx, and that of the distal metacarpal and distal proximal phalanx. CONCLUSION: The rabbit knee is not suitable model for the human interphalangeal and metacarphophalangeal joints of the hand. There is still a lack of an appropriate animal model for the small joints of the hand.

The correlation between nitric oxide and vascular endothelial growth factor in spinal cord injury.

STUDY DESIGN: Prospective, randomized, placebo-controlled, experimental study. OBJECTIVES: The issue of whether nitric oxide (NO) production is beneficial or deleterious on ischemic injuries of the central nervous system still remains doubtful. Vascular endothelial growth factor (VEGF) is known to induce the release of NO from endothelial cells. However, the effect of NO on VEGF synthesis is not clear. We aimed to determine the effects of L-arginine and NG-nitro-L-arginine methyl ester (L-NAME) on VEGF synthesis and free radicals in a rat model of spinal cord ischemia-reperfusion (IR) injury. SETTING: Surgical Research Laboratory of a Medical School. MATERIAL AND METHODS: Twenty-eight Wistar rats were divided into four groups as follows (n=7): Sham, IR injury, L-arginine, and L-NAME. Infrarenal abdominal aorta was occluded to induce spinal cord ischemia. L-Arginine (100 mg/kg) and L-NAME (10 mg/kg) were given before aortic occlusion. Biochemical assays of malondialdehyde (MDA), NO and VEGF were carried out in spinal cord specimens. RESULTS: L-Arginine treatment significantly increased MDA and NO, but decreased VEGF levels in spinal cord. However, nonselective inhibition of NOS with L-NAME significantly decreased MDA and NO, but increased VEGF levels. Besides, the positive linear correlation between MDA and NO, and negative linear correlations between MDA, NO and VEGF levels have also been demonstrated. CONCLUSION: Nonselective inhibition of NO synthase activity with L-NAME attenuated free radical formation and increased VEGF level when compared with NO precursor L-arginine in a rat model of spinal cord ischemia. We suggest that inhibition of NO synthase, as well as induction of VEGF, may be a therapeutic option in spinal cord IR injury.

Do undereducated patients read and understand written education materials? A pilot study in Isparta, Turkey.

OBJECTIVES: The aim of our study is to evaluate the effect of written information in improving the knowledge of the undereducated nonsteroidal anti-inflammatory drug (NSAID) users about the side effects of NSAIDs and to investigate the compliance of patients with the written information materials. METHODS: Thirty patients received only verbal information, 38 patients received only written, and 40 patients received both verbal and written information. After seven or ten days a questionnaire was administered to the patients on the phone to assess the patients' knowledge. RESULTS: Sixty one (78.2%) patients read the leaflets. Higher number of correct answers was obtained with both verbal and written information. Written information better informed than verbal information alone (p=0.02). CONCLUSION: We conclude that the undereducated patients will read and understand written education materials especially when the materials are written simple and short.

Endemic fluorosis in Turkish patients: relationship with knee osteoarthritis.

Fluoride excess primarily effects dental and skeletal tissues. leading to a condition known as endemic fluorosis. The radiological and clinical features of endemic fluorosis vary in different parts of the world. The aim of this study was to investigate the clinical and radiological features of endemic fluorosis in Turkish patients. Physical examination and radiological investigations were performed in 56 patients with endemic fluorosis and 40 age- and sex-matched controls. Knee osteoarthritis (OA) was the main abnormality in both groups, both clinically and radiologically. The radiological severity of knee OA was greater in the endemic fluorosis group than in controls (P=0.01). Osteophytes at the tibial condyles and superior margin of the patellar articular surface of the femur, polyp-like osteophytes on the non-weight-bearing medial side of the femoral condyle, and popliteal loose bodies were detected more frequently in the endemic fluorosis group than in controls (P=0.0001). We suggest that the presence of atypically located osteophytes in the knees may be a feature of endemic fluorosis in Turkish patients and that endemic fluorosis may increase the severity of OA in the knees.

Effect of ultrasound in the treatment of primary nocturnal enuresis.

OBJECTIVE: This study aimed to determine the efficacy of ultrasound therapy in patients with primary nocturnal enuresis. MATERIAL AND METHODS: Thirty-five patients with enuresis were included the study. Patients were divided into two groups: 27 patients with enuresis were treated with ultrasound with irradiation and heating, and eight patients with enuresis were treated with ultrasound without irradiation or heating (placebo group). Ultrasound therapy was performed using the Therasonic 350 machine. The ultrasound therapy was applied to the skin of lumbosacral region. A treatment course of ultrasound comprised 10 sessions of 0.8 W/cm2 intensity applied daily for 8 min. Symptoms were evaluated I week, and 3, 6 and 12 months after the treatment. RESULTS: Twenty-two (81.5%) patients responded to the ultrasound therapy at the first week after the treatment. The effect of ultrasound started immediately after the treatment and continued during the 12 months of the follow-up period. CONCLUSION: Ultrasound therapy seems to be effective in the treatment of primary nocturnal enuresis in the 1 year follow-up period.

Pentoxifylline reduces biochemical markers of ischemia-reperfusion induced spinal cord injury in rabbits.

STUDY DESIGN: Occlusion of the infrarenal abdominal aorta with administration of pentoxifylline was applied to adult rabbits, followed by removal of aortic clamp and reperfusion. Tissue levels of cytokines, lipid peroxides, and antioxidant enzymes were assayed and compared within groups. OBJECTIVES: To examine the effect of pentoxifylline (PTX) on cytokine levels, lipid peroxidation, and antioxidant enzymes in a rabbit model of spinal cord ischemia-reperfusion injury induced by aortic occlusion. SETTING: Isparta, Turkey. METHODS: Rabbits were randomly allocated into four groups of sham laparotomy (SHAM), sham laparotomy with PTX administration (SHAM+PTX), aortic occlusion and reperfusion (AOR), aortic occlusion and reperfusion with PTX administration (AOR+PTX). An intravenous bolus of 50 mg/kg PTX was given just before aortic cross clamping. An atraumatic microvascular clamp was then placed on the abdominal aorta immediately distal to the left renal artery for 30 min. PTX was infused at a rate of 0.5 mg/kg/min during the aortic occlusion. Animals were subjected to 120 min of reperfusion after removal of the aortic clamp. All animals were sacrificed at the end of reperfusion. The lumbosacral segments of spinal cords were quickly harvested and stored at -78 degrees C for biochemical assays of IL-6, TNF-alpha, MDA, SOD, and CAT levels. Differences among groups were analyzed by one-way analysis of variance followed by a post hoc Tukey's honestly significant difference test. RESULTS: No differences in mean levels of IL-6, TNF-alpha, MDA, SOD, and CAT were noted between SHAM and SHAM+PTX groups (P>0.05). There was a significant increase in all biochemical parameters in the AOR group (P<0.05). Administration of PTX significantly attenuated the levels of all biochemical parameters in the AOR+PTX group (P<0.05). CONCLUSION: PTX pretreatment attenuated ischemia-reperfusion induced spinal cord injury in a rabbit model, in terms of biochemical parameters of ischemia and reperfusion.

Screening of deletions in SMN, NAIP and BTF2p44 genes in Turkish spinal muscular atrophy patients.

Deletions of the spinal muscular atrophy (SMA)-determining gene, SMN1, NAIP, and a third multicopy gene, BTF2p44tel were investigated in 60 unrelated Turkish SMA patients. SMN1 was deleted for at least exons 7 and 8 in 85% of the Turkish SMA patients. The NAIP gene was deleted in 75 and 33% of type I and type II SMA patients, respectively. Analysis of the 5'end of the BTF2p44tel gene indicated the extension of deletion in 13.3% of the cases, mainly in type I patients. Deletions of the NAIP and BTF2p44tel genes were detected in 1.3 and 3.9% of carrriers, respectively, in Turkish SMA families. Two patients were detected to harbor the hybrid SMN gene, one type II with deletion of the NAIP gene, and one type III without deletion of the NAIP gene.

Prenatal prediction of childhood-onset spinal muscular atrophy (SMA) in Turkish families.

Childhood-onset spinal muscular atrophy (SMA) is one of the most common neurodegenerative genetic disorders. SMN1 is the SMA-determining gene deleted or mutated in the majority of SMA cases. There is no effective cure or treatment for this disease yet. Thus, the availability of prenatal testing is important. Here we report prenatal prediction for 68 fetuses in 63 Turkish SMA families using direct deletion analysis of the SMN1 gene by restriction digestion. The genotype of the index case was known in 40 families (Group A) but unknown in the remaining 23 families (Group B). A total of ten fetuses were predicted to be affected. Eight of these fetuses were derived from Group A and two of these fetuses were from Group B families. Two fetuses from the same family in Group A had the SMNhyb1 gene in addition to homozygous deletion of the NAIP gene. One fetus from Group A was homozygously deleted for only exon 8 of the SMN2 gene, and further analysis showed the presence of both the SMN1 and SMNhyb1 genes but not the SMN2 gene. In addition, one carrier with a homozygous deletion of only exon 8 of the SMN1 gene was detected to have a SMNhyb2 gene, which was also found in the fetus. To our knowledge, these are the first prenatal cases with SMNhyb genes. Follow-up studies demonstrated that the prenatal predictions and the phenotype of the fetuses correlated well in 33 type I pregnancies demonstrating that a careful molecular analysis of the SMN genes is very useful in predicting the phenotype of the fetus in families at risk for SMA.

Variable distribution of TFF2 (Spasmolysin) alleles in Europeans does not indicate predisposition to gastric cancer.

Peptides belonging to the trefoil factor family (TFF) protect the gastrointestinal epithelia. Overexpression of TFFs was observed in pathological conditions such as gastritis, ulceration, metaplasia and neoplasia of the gastrointestinal tract. The aims of this work were to investigate the recently described TFF2 gene polymorphism in different European populations. DNA samples from blood of healthy individuals and gastric cancer patients were genotyped using the polymerase chain reaction. They were compared to a gastric cancer population. The results do not show any significant difference in allelic frequencies between gastric cancer patients and healthy individuals from Portugal. However, the frequency of the two alleles found varies considerably among Europeans.