p27Kip1 represses the Pitx2-mediated expression of p21Cip1 and regulates DNA replication during cell cycle progression.

The tumor suppressor p21 regulates cell cycle progression and peaks at mid/late G1. However, the mechanisms regulating its expression during cell cycle are poorly understood. We found that embryonic fibroblasts from p27 null mice at early passages progress slowly through the cell cycle. These cells present an elevated basal expression of p21 suggesting that p27 participates to its repression. Mechanistically, we found that p27 represses the expression of Pitx2 (an activator of p21 expression) by associating with the ASE-regulatory region of this gene together with an E2F4 repressive complex. Furthermore, we found that Pitx2 binds to the p21 promoter and induces its transcription. Finally, silencing Pitx2 or p21 in proliferating cells accelerates DNA replication and cell cycle progression. Collectively, these results demonstrate an unprecedented connection between p27, Pitx2 and p21 relevant for the regulation of cell cycle progression and cancer and for understanding human pathologies associated with p27 germline mutations.

In vitro antifungal evaluation of seven different disinfectants on acrylic resins.

OBJECTIVE: The aim of this study was to evaluate alternative methods for the disinfection of denture-based materials. MATERIAL AND METHODS: Two different denture-based materials were included in the study. Before microbial test, the surface roughness of the acrylic resins was evaluated. Then, the specimens were divided into 8 experimental groups (n = 10), according to microorganism considered and disinfection methods used. The specimens were contaminated in vitro by standardized suspensions of Candida albicans ATCC#90028 and Candida albicans oral isolate. The following test agents were tested: sodium hypochlorite (NaOCl 1%), microwave (MW) energy, ultraviolet (UV) light, mouthwash containing propolis (MCP), Corega Tabs, 50% and 100% white vinegar. After the disinfection procedure, the number of remaining microbial cells was evaluated in CFU/mL. Kruskal-Wallis, ANOVA, and Dunn's test were used for multiple comparisons. Mann Whitney U test was used to compare the surface roughness. RESULTS: Statistically significant difference (P < 0.05) was found between autopolymerised and heat-cured acrylic resins. The autopolymerised acrylic resin surfaces were rougher than surfaces of heat-cured acrylic resin. The most effective disinfection method was 100% white vinegar for tested microorganisms and both acrylic resins. CONCLUSION: This study showed that white vinegar 100% was the most effective method for tested microorganisms. This agent is cost-effective and easy to access and thus may be appropriate for household use.

Influence of gag reflex on dental attendance, dental anxiety, self-reported temporomandibular disorders and prosthetic restorations.

To assess the influence of gag reflex severity, assessed according to the short form of the patient part of Gagging Problem Assessment Questionnaire (GPA-pa SF), on the dental attendance, dental anxiety, self-reported temporomandibular disorder (TMD) symptoms and presence of prosthetic restorations among patients requiring prosthodontic treatment in Turkey. A total of 505 patients (305 women; mean age: 46·35 years, SD: 28·2 years) undergoing dental examination were administered a questionnaire containing questions regarding their age, gender, education level, dental attendance, TMD symptoms (limitation in jaw opening, muscle pain, pain/sounds in the temporomandibular jaw), the Turkish version of the Modified Dental Anxiety Scale (MDAS) and the GPA-pa SF. Subsequently, any prosthetic restoration was recorded by a dentist. Descriptive statistics, one-way analysis of variance (anova) and the chi-square test were used for statistical analysis. Differences were found between GPA-pa SF scores 0, 1 and 2 for education level (P = 0·001), MDAS scores (P = 0·003), self-reported TMD (P = 0·000) and prosthesis wear (P = 0·000), but not for attendance patterns (P = 0·826). Patients with gag reflex had lower education levels, higher levels of dental anxiety, more self-reported TMD symptoms and fewer fixed or removable prosthetic restorations than patients without gag reflex. Gag reflex has impacts on dental anxiety, self-reported TMD and prosthetic restorations, but not on dental attendance patterns, according to the results of the GPA-pa SF.

Brachialis muscle transfer to the forearm for the treatment of deformities in spastic cerebral palsy.

The use of the brachialis muscle for tendon transfers in cerebral palsy has not been described previously. In this study, the brachialis muscle was used for transfer in 11 patients with spastic cerebral palsy for the restoration of forearm supination, wrist extension, or finger extension. Four patients underwent brachialis rerouting supinatorplasty. Active supination increased in two (60° and 50°), minimally increased in one (5°), and did not change in one patient. Five patients had a brachialis to extensor carpi radialis brevis transfer. The mean gain in postoperative active wrist extension was 65°. Two patients with finger flexion deformity and no active metacarpophalangeal joint movement underwent a brachialis to extensor digitorum communis transfer, and they attained an improved posture of finger extension although their postoperative metacarpophalangeal flexion-extension movement arc was 5° and 25°. None of the patients developed any loss of active flexion at the elbow. Our preliminary experience suggests that the brachialis muscle may serve as an alternative tendon transfer in cerebral palsy.

Utility of the gagging problem assessment questionnaire in assessing patient sensitivity to dental treatments.

Although the Gagging Problem Assessment Questionnaire (GPA) can be used to identify patients with gag reflex, it does not provide information about patient sensitivity to dental procedures. The aim of this study was to assess the utility of GPA in determining patient sensitivity (i.e. gag reflex) in response to intra-oral radiography and impression-taking procedures. The study included 95 patients (65 women; mean age, 44·2 ± 13·4 years) undergoing dental treatment at a Turkish dental school. Patients completed the patient section of the GPA before their dental examination. An observing dentist monitored and scored the gag reflex of patients during each step of intra-oral radiographic examination and impression taking. The overall sensitivity of the patient to the entire process was also recorded. Descriptive statistics, one-way analysis of variance and the Tukey's test were used for statistical analysis. Patients with GPA scores of 1·00-1·74 did not show any gagging or displayed only mild discomfort during the procedures. Patients with GPA scores of 1·75-3·24 showed moderate gagging, which was managed with prophylactic and suppressive precautions. Patients with GPA scores of 3·25-4·00 were unable to complete the procedures because of gagging. Differences (all P < 0·001) were found between the three groups for the observed responses of patients during radiography (F, 203·343), impression (F, 175·035) and radiography + impression procedures (F, 228·319), with no significant difference between women and men. In conclusion, GPA may be helpful for the prediction of patient sensitivity to dental treatments.

Shoulder pain and disability index: a validation study in Turkish women.

INTRODUCTION: The Shoulder Pain and Disability Index (SPADI) is a valid and reliable questionnaire used in shoulder disorders. The purpose of this study was to test the convergent validity and the reliability of the SPADI. METHODS: A total of 101 female patients with shoulder pain were enrolled in the study. The SPADI and the Health Assessment Questionnaire (HAQ) were completed by all the participants. Pain was measured using the Visual Analogue Scale (VAS) during the active range of motion. Reliability was measured by internal consistency and test-retest reliability. Internal consistency was determined by calculating Cronbach's alpha value. Convergent validity was examined by correlating the SPADI questionnaire with the VAS and HAQ scales. RESULTS: Cronbach's alpha value for the SPADI was found to be 0.94. Test-retest reliability of the SPADI was found to be high (0.92). The correlation coefficient for convergent validity of the SPADI was 0.65 and 0.67 for the VAS and HAQ overall scores, respectively. CONCLUSION: The results of the present study suggest that the SPADI is a valid and reliable instrument to assess shoulder pain in Turkish female patients.

Coexistence of osteopoikilosis and discoid lupus erythematosus: a case report.

Osteopoikilosis is an uncommon, benign sclerosing bone dysplasia characterised by typical roentgenographic findings and usually seen in patients with dermatological problems. We report a case of osteopoikilosis and discoid lupus erythematosus presenting with skin and mucosal involvement, an association that has never previously been reported. We also discuss the differential diagnosis and the clinical pathologies accompanying osteopoikilosis in the literature.

Fixed drug eruption due to tiaprofenic acid.

Tiaprofenic acid is a propionic acid derivative with analgesic, anti-inflammatory and antipyretic properties. Fixed drug eruption is a common cutaneous reaction by various drugs. Fixed drug eruption induced by tiaprofenic acid has not been reported previously. Described in this paper is a 57-year-old female patient with tiaprofenic acid-associated fixed drug eruption, which occurred shortly after starting tiaprofenic acid therapy for her osteoarthritis. Upon establishment of the diagnosis, tiaprofenic acid therapy was stopped and topical corticosteroids and systemic antihistamines were administered. The eruption resolved, leaving post-inflammatory hyperpigmentation within 5 days. The rash returned following tiaprofenic acid rechallenge. It is proposed that fixed drug eruption is a new side effect of tiaprofenic acid.