Detection of high-risk Human Papillomavirus in prostate cancer from a UK based population.

Human papillomavirus (HPV) infection is one of the sexually transmitted diseases which have been implicated in the etiology of multiple cancers. To date, several studies have been conducted to evaluate the incidence of high-risk (HR) HPV in prostate cancer (PCa) which have generated widely conflicting data. Hence, this leaves a lack of awareness on the causal role of persistent HPV infection in the development of PCa. Although this has been investigated in a handful of countries, to the best of our knowledge, no prior studies have been conducted in the UK. In this study, polymerase chain reaction (PCR) and Sanger sequencing were implemented to analyze a total of 49 fresh prostate specimens (35 benign and 14 malignant specimens) for the presence of viral DNA of 12 HR-HPV types. Data obtained confirmed the presence of HR-HPV in 32.7% of analyzed benign and malignant prostate tissues with HPV 35 being identified as the most frequent type. Moreover, HR-HPV positivity rate was found to be higher in abnormal prostate tissues (adenocarcinoma and benign with prostatitis) compared those with normal prostate condition. Using immunohistochemistry, we have confirmed the expression of HPV E7 protein in prostate tissues positive for HPV DNA. This observation, the first reported from a UK population, suggests that the presence of HPV in prostate tissue is likely to be a related factor in the progression of certain cases of prostate cancer.

The efficacy and results of medical treatment in postoperative ileus.

Background: Postoperative paralytic ileus refers to the disruption of the normal coordinated propulsive motor activity of the gastrointestinal system following surgery. Surgery causes inflammation in the muscle walls of organs with an intestinal lumen that, in turn, leads to a decrease in intestinal motility. Aim: The aim of this study was to investigate the efficacy of gastrografin, neostigmine, and their combined administration in patients diagnosed with paralytic ileus in the postoperative period. Patients and Methods: One-hundred twelve patients were included from January 2017 and November 2019. The retrospective study is involving prolonged postoperative ileus cases following colorectal surgery. The effect of gastrografin, neostigmine, and gastrografin neostigmine combination was compared retrospectively in the treatment of prolonged ileus after surgery. Results: The study covered 112 patients. Gastrografin was administered to 63 patients; neostigmine was administered to 29, while 20 patients received the combination of the two. Data pertaining to the comparison of the two groups revealed that patients in the gastrografin group were discharged earlier than those in the neostigmine group. Further, patients in the combined group had earlier gas and/or stool discharge and were also discharged from the hospital earlier than those in the neostigmine group. Conclusion: Gastrografin and combined use of gastrografin and neostigmine are effective and viable methods for postoperative ileus cases. Gastrografin can safely be used in patients with anastomoses.

Long-term follow-up results and treatment outcomes of children and adults with resistance to thyroid hormone alpha.

PURPOSE: Resistance to thyroid hormone alpha (RTHα) is a rare entity and has no specific treatment. To date, mostly levothyroxine has been used, but there is a lack of knowledge about the long-term outcomes of this treatment. We aimed to evaluate the long-term follow-up results and treatment outcomes of children and their parents diagnosed with RTHα. METHODS: Four children [the median (minimum-maximum) age at diagnosis, 4.5 (1.4-9.5) years] and three adults [age at diagnosis, 31.7 (28.0-35.3) years] from two families were included in the study, who had RTHα and followed up between 2014 and 2021. RESULTS: The median duration of treatment was 6.7 (5.9-8.0) years, and the levothyroxine dose at the final visit was 1.4 (1.2-2.2) and 1.9 (1.2-2.4) mcg/kg/day for adults and pediatric patients, respectively. Treatment ameliorated constipation in all patients with this complaint (n = 5). Normal mental functions were achieved and IQ scores improved in most children except one (age at diagnosis, 9.5 years). At the final visit, creatine kinase levels relative to the reference upper limit were significantly lower compared to the pre-treatment ratios [0.9 (0.2-1.3) vs. 1.3 (0.5-1.6), p = 0.028]. Anemia was present in five patients at diagnosis, which resolved in one adult patient but occurred in one child despite treatment (p = 0.999). A minimal pericardial effusion persisted in one pediatric patient. CONCLUSIONS: We demonstrated that constipation was ameliorated, neuromotor development of some children was improved, and creatine kinase levels were diminished with levothyroxine treatment in patients with RTHα, while some features including anemia did not resolve.

Ethical leadership supports safety voice by increasing risk perception and reducing ethical ambiguity: Evidence from the COVID-19 pandemic.

Misconduct by business and political leaders during the pandemic is feared to have impacted people's adherence to protective measures that would help to safeguard against the spread of COVID-19. Addressing this concern, this article theorizes and tests a model linking ethical leadership with workplace risk communication-a practice referred to as 'safety voice' in the research literature. Our study, conducted with 511 employees from UK companies, revealed that ethical leadership is positively associated with greater intention to engage in safety voice regarding COVID-19. We also find that this association is mediated by relations with the perceived health risk of COVID-19 and ambiguity about ethical decision making in the workplace. These findings therefore underscore the importance of good ethical conduct by leaders for ensuring that health and safety risks are well understood and communicated effectively by organizational members particularly during crises. We discuss the theoretical and practical implications of our study and highlight further opportunities for future research to address the ethical dimensions of leadership, risk management, and organizational risk communication.

Is there a threshold for red cell distribution width to predict malignancy in breast masses?

Background: Red cell distribution width (RDW) has been shown to have predictive properties in different diseases as well as solid cancers. Aim: We aimed to investigate the discriminative properties of RDW in benign and malignant breast lesions. Subjects and Methods: In a retrospective cohort study the files of patients who underwent surgery for fibroadenomas (Group A) and breast cancer with axillary lymph node metastasis (Group B) were reviewed. The pathology reports and laboratory parameters and demographics of the patients were recorded for comparison. The patients were later excluded if they had an hemoglobin level below 12 mg/dl and the outliers were removed for a comparison. Seventy-six patients in the fibroadenoma group and 62 patients in the breast malignancy group were compared for the RDW levels to predict the presence of malignancy. Receiver operating characteristic curves were plotted for RDW and a threshold for prediction of malignancy was calculated. Results: The difference in RDW levels between group A and group B was found to be significant, 13,10% (IQR 12.60 -13.70) versus 13,80% (IQR 13.10-14.40) respectively, P = 0,00. The area under the curve was 0.71 (95% confidence interval 0.62 to 0.79), P = 0,00. For the threshold of 13,75 the positive predictive value was 67.35 (95% CI 55.72 to 77.17) and negative predictive value was 67.42 (95% CI 60.76% to 73.44). Conclusion: The RDW levels, after adjusted for anemia, were found to have a positive prediction for malignancy in more than two thirds of the patients for the level of 13.75%.

Gene expression profiles of transient receptor potential (TRP) channels in the peripheral blood mononuclear cells of psoriasis patients.

Psoriasis is a chronic autoimmune disease in which peripheral blood mononuclear cells (PBMCs) are involved in the pathological process. Transient receptor potential (TRP) channels expressed in immune cells have been shown to be associated with inflammatory diseases. We aimed to evaluate mRNA expression levels of TRP channels in PBMCs of patients with psoriasis. 30 patients with plaque psoriasis and 30 healthy age- and gender-matched control subjects were included in this study. mRNA expression levels of TRP channels in psoriasis patients were determined by Real-time polymerase chain reaction. A decreased TRPM4, TRPM7, TRPV3, TRPV4, and TRPC6 genes expression levels were found in the patient group compared to controls, respectively (p = 0.045, p = 0.000, p = 0.000, p = 0.045, p = 0.009), whereas, an increased expression level was found in TRPM2 and TRPV1 genes in the patient group compared to controls (p = 0.001 and p = 0.028). This is the first study showing the TRP channel mRNA expressions in PBMCs of psoriasis patients. Different expression patterns of TRP channels may have a role in pathogenesis of psoriasis.

Reduced lipolysis in lipoma phenocopies lipid accumulation in obesity.

BACKGROUND: Elucidation of lipid metabolism and accumulation mechanisms is of paramount importance to understanding obesity and unveiling therapeutic targets. In vitro cell models have been extensively used for these purposes, yet, they do not entirely reflect the in vivo setup. Conventional lipomas, characterized by the presence of mature adipocytes and increased adipogenesis, could overcome the drawbacks of cell cultures. Also, they have the unique advantage of easily accessible matched controls in the form of subcutaneous adipose tissue (SAT) from the same individual. We aimed to determine whether lipomas are a good model to understand lipid accumulation. METHODS: We histologically compared lipomas and control SAT, followed by assessment of the lipidome using high-resolution 1H NMR spectroscopy and ESI-IT mass spectrometry. RNA-sequencing was used to obtain the transcriptome of lipomas and the matched SAT. RESULTS: We found a significant increase of small-size (maximal axis < 70 µm) and very big (maximal axis > 150 µm) adipocytes within lipomas. This suggests both enhanced adipocyte proliferation and increased lipid accumulation. We further show that there is no significant change in the lipid composition compared to matched SAT. To better delineate the pathophysiology of lipid accumulation, we considered two groups with different genetic backgrounds: (1) lipomas with HMGA2 fusions and (2) without gene fusions. To reduce the search space for genes that are relevant for lipid pathophysiology, we focused on the overlapping differentially expressed (DE) genes between the two groups. Gene Ontology analysis revealed that DE genes are enriched in pathways related to lipid accumulation. CONCLUSIONS: We show that the common shared lipid accumulation mechanism in lipoma is a reduction in lipolysis, with most gene dysregulations leading to a reduced cAMP in the adipocyte. Superficial lipomas could thus be used as a model for lipid accumulation through altered lipolysis as found in obese patients.

Preoperative appendix diameter obtained by computerized tomography scanning predicts conversion from laparoscopic to open appendectomy.

BACKGROUND: Open appendectomy (OA) has been the gold standard for a long time. Laparoscopic appendectomy (LA) has gained wide acceptance and popularity, outdoing open approach. Yet, conversion may be required when laparoscopic approach fails. AIMS: To predict conversion from laparoscopic appendectomy to open appendectomy sing Oreo-ratio radiological appendices diameter. MATERIALS AND METHODS: This is a retrospective cohort study conducted on 320 (included) patients who underwent appendectomy between January 2018 and August 2018 in the General Surgery departmentof Haseki Training and Research Hospital, Istanbul, Turkey. Appendiceal diameter obtained during preoperative radiological screening was evaluated about its relationship to conversion from LA to OA. Age, sex, inflammatory serum parameters and pathology reports were also investigated. RESULTS: A total of 269 (84%) cases were started LA and 17 (6,3%) laparoscopic cases were converted to open. The appendix diameter, the grade of inflammation (perforated or gangrenous), age, and c-reactive protein (CRP) were found to have significant importance in conversion, P = 0.003, P = 0.000, P = 0.042, and P = 0.018, respectively. When a cutoff of 50 years was chosen for age, the odds ratio (OR) was 3. For the appendiceal diameter of 14 mm, the OR was 3.0286. CONCLUSION: Preoperative evaluation of appendix diameter is a quick and useful method for a surgeon to distinguish cases with risk of conversion in the emergency department. The other risk factors associated with conversion of LA to OA are grade of inflammation, age and CRP levels.

Optimization of production parameters for fabrication of thymol-loaded chitosan nanoparticles.

Thymol is the major antimicrobial and bioactive constituent found in thyme (Thymus vulgaris) essential oil. In this study, it was aimed to determine the parameters for fabrication of thymol loaded chitosan nanoparticles with optimum encapsulation efficiency, zeta potential, and particle size properties using a two-stage emulsion-ionic gelation approach. For this purpose, temperature (25-45 °C) and chitosan (3-6 mg/mL), thymol (3-6 mg/mL), Tween 80 (3-6 mg/mL) and TPP (0.15-0.75 mg/mL) concentrations were studied as optimization parameters by applying the numerical point prediction method. The results showed that the particle size, zeta potential and encapsulation efficiency of the chitosan nanoparticles could be controlled by processing conditions. Additionally, this study was focused on optimization of these parameters with factorial design (FD) in nanoencapsulation of Thymol. The optimized production parameters on the basis of the criteria of attaining the minimum particle size, maximum zeta potential, and maximum encapsulation efficiency were 42 °C temperature, chitosan rate 3 mg/mL, Thymol rate 5.9 mg/mL, Tween 80 rate 3 mg/mL and TPP rate 0.75 mg/mL.

The discriminative properties of erythrocyte anisocytosis in patients with resectable malignant pancreatic masses compared with an age and gender matched control group.

INTRODUCTION: Red cell distribution width (RDW) is a parameter that reflects the heterogeneity in the size of the circulating erythrocytes. Elevated levels of RDW have been found related to various pathologic conditions including cancers. We hypothesized that elevated RDW levels might correspond to advanced stages of pancreatic cancer. METHODS: The medical files and pathology reports of patients who underwent Whipple procedure were evaluated in a retrospective casecontrol study. The relationship of RDW to age, gender, cancer antigen 19-9 (CA 19-9), blood hemoglobin levels, stage of the tumor, tumor size, tumor grade, number of lymph nodes with metastasis, the status of lymphovascular and perineural invasion were investigated. A oneto-two, age- and- gender matched group of seemingly healthy patients was used to compare the levels of RDW between the patients of pancreatic head malignancy and healthy people. ROC (receiver operating characteristics) curves analysis was conducted to define a threshold to discriminate malignant pancreatic head tumors from healthy control subjects. Then, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (+LR), and negative likelihood ratio (-LR) were calculated. RESULTS: The median age was 61 years (IRQ 54.75-69). The median RDWs were 15.20% (IQR 13.20-19.50) vs 13.00 (IQR 12.60-13.48) in the pancreas adenocancer and the control group, respectively, p=0.000). There was significant relationship between RDW and the grade of the tumor, p=0.026. An RDW level of 14% was obtained as a result of the ROC curves analysis and the positive predictivity about malignancy was 70.73% with a negative predictive rate of 89.95% compared with the healthy group of patients. CONCLUSION: The elevated levels of RDW in patients with a pancreatic mass may point to a possible malignancy; however, an elevated RDW in a patient with a malignant pancreatic head mass is related to the grade of the disease, not the stage.

Endoscopic triple-C tympanoplasty: an alternative approach to anteriorly located tympanic membrane repair.

OBJECTIVE: Anteriorly located tympanic membrane perforations can negatively affect surgical success rates. This study aimed to present, using our case series results, endoscopic triple-C (composite chondroperichondrial clip) tympanoplasty as an alternative method in the repair of tympanic membrane anterior quadrant perforations. METHODS: This study included patients with a perforation sized greater than 3 mm, who had an anterior quadrant dominant perforation where the anterior portion could not be seen during microscopic examination; all underwent endoscopic triple-C tympanoplasty. RESULTS: Operating time was 30-79 minutes (mean, 46.6 minutes). The post-operative graft success rate at six months was 92 per cent (23 out of 25). Mean post-operative follow-up duration was 21.5 ± 7.3 months (range, 11-40 months), and no intratympanic cholesteatoma was observed. CONCLUSION: Endoscopic triple-C tympanoplasty is a comfortable, minimally invasive alternative method to repair anterior tympanic membrane perforations. The graft success rate and the degree of recovery from hearing loss were in accordance with the literature. However, more reliable results may be obtained in a larger series with longer follow-up times.

Effects of Inferior Alveolar Nerve Neurosensory Deficits on Quality of Life.

OBJECTIVE: The purpose of this study was to investigate the effect of temporary or persistent neurosensory disturbance of the inferior alveolar nerve (IAN) on the quality of life using Oral Health Impact Profile (OHIP-14) questionnaire. METHODS: The patients with the neurosensory deficit of the IAN that was confirmed by subjective and objective neurosensory tests formed the study group. The patients who had dental or oral and maxillofacial surgery procedures in the same unit and did not present neurosensory deficit were matched with the study group according to their gender and age and were presented as the control group. Both groups filled OHIP-14 questionnaire. RESULTS: This study included 200 patients (122 female and 78 male), aged between 18 and 75 years. Kolmogrov-Smirnov, Levene, Mann-Whitney U, and Kruskal Wallis tests were used for statistical analysis. In study group, the average OHIP-14 scores were higher in women than in men in physical pain and handicap subgroups. There were significant differences between study and control groups in functional limitation, psychological discomfort, psychological disability, and handicap subgroups. The OHIP-14 scores were higher in study group compared with the control group. CONCLUSION: It was concluded that the patients with the neurosensory deficit of the IAN have a poorer quality of life than those without neurosensory deficits.

COMPARISON OF CARDIAC ARRHYTHMIA TYPES BETWEEN HYPERTHYROID PATIENTS WITH GRAVES' DISEASE AND TOXIC NODULAR GOITER.

PURPOSE: Previous studies have demonstrated the relationship between hyperthyroidism and increased risk of cardiac arrhythmias. The most common causes of hyperthyroidism are Graves' disease (GD) and toxic nodular goiter (TNG). The aim of our study was to demonstrate if the underlying mechanism of hyperthyroidism, in other words autoimmunity, has an impact on the type of cardiac arrhythmias accompanying hyperthyroidism. METHOD: Twenty patients with TNG and 16 patients with GD who had overt hyperthyroidism were included in the study. Age, sex, thyroid hormone levels, thyroid autoantibody positivity, thyroid ultrasonography and scintigraphy results were recorded. 24-hour Holter ECG monitoring was performed in all patients. RESULTS: Mean age was significantly higher in the TNG group compared to the GD group (62.9±11.5 vs. 48.9±8.6 years, p=0.001). Free T3 was significantly higher (7.87±3.90 vs. 5.21±1.53 pg/mL, p=0.033) in the GD group while free T4 and TSH levels were similar between the two groups. In 24-hour Holter ECG recordings nonsustained ventricular tachycardia (VT) rates were significantly higher in the GD group than in TNG group [18.75% (n=3/16) vs. 0% (n=0/20), respectively, (p=0.043)]. Paroxysmal atrial fibrillation (AF) rates were significantly higher in the TNG group compared to GD group [(30% (n=6/20) vs. 0% (n=0/16), respectively, (p=0.016)]. CONCLUSION: Although free T3 levels were lower, paroxysmal AF rates were found significantly higher in the TNG group which may be associated with significantly higher age of this group. On the other hand, higher rate of nonsustained VT in the GD group may be related to either significantly higher free T3 levels or autoimmunity.

Oral and dental health in children with chronic liver disease in the Turkey Northeast.

BACKGROUND: It is important to be aware of oral and dental problems in the early period in children with chronic liver disease (CLD) to prevent late complications. Therefore, we aimed to analyze the oral and dental health status in children with CLD. METHODS: The three groups of children (3-18 years old); Group 1 (disease group, n = 31) patients with CLD, Group 2 (disease control group, n = 17) patients with chronic renal failure, and Group 3 healthy children (control group, n = 35). Examination of oral and dental structures were made, and then salivary parameters were analyzed. Antegonial index were calculated from panoramic X-rays. RESULTS: Enamel hypoplasia was found in 54.8%, 41.1%, and 31.4% of the children in the Groups 1, 2, and 3, respectively (P1-3 < 0.05). High salivary buffer capacity was found in 45.2% and 70.6% of the patients in Groups 1 and 2, respectively, and 45.7% of the children in healthy group, (P1-2 and P2-3 < 0.05). Factors associated with enamel hypoplasia in patients with CLD were male gender (64.7% vs. 21.4%, P < 0.05) and the presence of malnutrition (41.1% vs. 7.1%, P < 0.05). CONCLUSION: Pediatric hepatologists must be aware of the dental problems in children with CLD. Enamel hypoplasia is common in children with CLD, and it may predispose to dental caries.

Protective effects of salusin-α and salusin-ß on renal ischemia/reperfusion damage and their levels in ischemic acute renal failure.

Salusin-α and salusin-ß are expressed in many tissues including the central nervous system, vessels and kidneys; they have been shown to decrease endoplasmic reticulum stress during heart ischemia/reperfusion (I/R) and to decrease apoptosis. We investigated the relation of salusin-α and salusin-ß levels to acute ischemic renal failure. We also investigated whether these peptides are protective against renal I/R damage. Fifty-three rats were divided into six groups: control, I/R, I/R + salusin-α1, I/R + salusin-α10, I/R + salusin-ß1 and I/R + salusin-ß10. After removing the right kidney, the left kidney was subjected to ischemia for 1 h and reperfusion for 23 h. The treatment groups were injected subcutaneously at the beginning of ischemia with 1 or 10 µg/kg salusin-α, and 1 or 10 µg/kg salusin-ß. Histopathology was assessed at the end of the experiment. Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-PX) activity and malondialdehyde (MDA) levels were measured in the kidney tissue. Serum levels of blood urea nitrogen (BUN), creatinine (Cre), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and interleukin-1 beta (IL-1ß) also were measured. Levels of salusin-α and salusin-ß were measured in the serum and kidney tissues of the control and I/R groups. SOD, CAT and GSH-PX activities were decreased and the levels of MDA, TNF-α, IL-6, IL-1ß, BUN and Cre were increased in the I/R group compared to controls. Severe glomerular and tubular damage was apparent in the I/R group compared to controls. The level of salusin-ß was decreased in the serum and kidney tissue of the I/R group compared to controls, whereas the level of salusin-α was decreased in the serum and increased in the kidney tissue. Salusin-α and salusin-ß administration increased SOD and GSH-PX enzyme activation and decreased the levels of MDA, TNF-α, IL-6 and IL-1ß compared to the I/R group. BUN and Cre levels were decreased in the I/R + salusin-α1 group and the level of Cre was decreased in I/R + salusin-ß10 group compared to the I/R group. We demonstrated a protective effect of salusin-α and salusin-ß against renal I/R damage. Changes in the levels of salusin-α and salusin-ß in the I/R group suggest that these peptides may be associated with acute renal failure.

Oral mucosa and lung cancer: Are genetic changes in the oral epithelium associated with lung cancer?

AIM: To compare genetic aberrations in the oral epithelium of lung cancer patients with those without cancer. SUBJECTS AND METHODS: Buccal smears were performed to collect oral epithelium from each of the participants (smoker cancer patients n = 50, smoker control subjects n = 40, and nonsmoker control subjects n = 25). Cytogenetic changes in the samples were detected by micronuclei assay, whereas p53 and murine double minute 2 (MDM2) polymorphisms were genotyped using polymerase chain reaction-restriction fragment length polymorphism. RESULTS: p53 codon 72 polymorphism was seen in 44% of cancer patients versus 12.5% in smokers and 12% in nonsmokers of the control group. Similarly, MDM2 single nucleotide polymorphism 309 polymorphism was seen in 34% of patients with lung cancer as opposed to 12.5% of smokers (P = 0.038) and 8% of nonsmokers (P = 0.019) of the control group. CONCLUSION: A higher proportion of individuals with lung cancer demonstrate genetic damage to oral mucosa compared to those without cancer.

Planar Indium Tin Oxide Heater for Improved Thermal Distribution for Metal Oxide Micromachined Gas Sensors.

Metal oxide gas sensors with integrated micro-hotplate structures are widely used in the industry and they are still being investigated and developed. Metal oxide gas sensors have the advantage of being sensitive to a wide range of organic and inorganic volatile compounds, although they lack selectivity. To introduce selectivity, the operating temperature of a single sensor is swept, and the measurements are fed to a discriminating algorithm. The efficiency of those data processing methods strongly depends on temperature uniformity across the active area of the sensor. To achieve this, hot plate structures with complex resistor geometries have been designed and additional heat-spreading structures have been introduced. In this work we designed and fabricated a metal oxide gas sensor integrated with a simple square planar indium tin oxide (ITO) heating element, by using conventional micromachining and thin-film deposition techniques. Power consumption-dependent surface temperature measurements were performed. A 420 °C working temperature was achieved at 120 mW power consumption. Temperature distribution uniformity was measured and a 17 °C difference between the hottest and the coldest points of the sensor at an operating temperature of 290 °C was achieved. Transient heat-up and cool-down cycle durations are measured as 40 ms and 20 ms, respectively.

Use of alveolar distraction osteogenesis for implant placement: a case report with eight-year follow-up.

Insufficient alveolar ridge width may impede the success of dental implants. Techniques for resolving this problem include autologous bone grafts, guided bone regeneration, bone splitting and bone spreading techniques. Recently, alveolar distraction osteogenesis has become an alternative method for alveolar augmentation. We propose the use of alveolar bone distraction for insufficient alveolar ridge width. A healthy 33-year-old female presented with missing teeth to our clinic. Clinical and radiographic examination revealed the alveolar ridge was too narrow for placement of dental implants. Therefore, horizontal distraction osteogenesis of the posterior mandibular ridge was chosen for augmentation. Two months later, two implants were placed. No significant marginal bone resorption was seen around the implants eight years after placement. Our results indicate that horizontal alveolar distraction is recommended to increase ridge width and allow placement of standard dental implants.

Radiotherapy-induced hypopituitarism in nasopharyngeal carcinoma: the tip of an iceberg.

BACKGROUND: Radiation-induced hypopituitarism is an important late complication of cranial radiotherapy in children and adults. The purpose of this cross-sectional study was to evaluate the effects of radiotherapy on pituitary function in adult nasopharyngeal carcinoma patients. METHODS: Pituitary function was evaluated in 30 patients after cranial radiotherapy for nasopharyngeal carcinoma. Somatotroph and corticotroph axes were assessed by insulin tolerance test while gonadotroph and thyroid axes were evaluated by basal pituitary and end organ hormone levels at 10-133 months after radiotherapy. RESULTS: At least one hormonal disorder was observed in 28 (93%) patients after radiotherapy. 26 (87%) patients had one or more anterior pituitary hormone deficiencies. The rates of pituitary hormone deficiencies were 77% for growth hormone, followed by adrenocorticotropic hormone (73%), thyroid-stimulating hormone (27%) and gonadotropins (7%). Hyperprolactinemia was present in 13 (43%) patients. CONCLUSIONS: Radiation-induced hypopituitarism is more common than expected in patients with nasopharyngeal carcinoma.

Thermocouple and infrared sensor-based measurement of temperature distribution in metal cutting.

In metal cutting, the magnitude of the temperature at the tool-chip interface is a function of the cutting parameters. This temperature directly affects production; therefore, increased research on the role of cutting temperatures can lead to improved machining operations. In this study, tool temperature was estimated by simultaneous temperature measurement employing both a K-type thermocouple and an infrared radiation (IR) pyrometer to measure the tool-chip interface temperature. Due to the complexity of the machining processes, the integration of different measuring techniques was necessary in order to obtain consistent temperature data. The thermal analysis results were compared via the ANSYS finite element method. Experiments were carried out in dry machining using workpiece material of AISI 4140 alloy steel that was heat treated by an induction process to a hardness of 50 HRC. A PVD TiAlN-TiN-coated WNVG 080404-IC907 carbide insert was used during the turning process. The results showed that with increasing cutting speed, feed rate and depth of cut, the tool temperature increased; the cutting speed was found to be the most effective parameter in assessing the temperature rise. The heat distribution of the cutting tool, tool-chip interface and workpiece provided effective and useful data for the optimization of selected cutting parameters during orthogonal machining.