Understanding the effects of chitosan, chia mucilage, levan based composite coatings on the shelf life of sweet cherry.

Sweet cherry (Prunus avium L.) fruits are prone to quality and quantity loss in shelf-life conditions and cold storage due to their short post-harvest life. Until now efforts have been made to extend the shelf life of the sweet cherry. However, an efficient and commercially scalable process remains elusive. To contribute to this challenge, here in this study, biobased composite coatings consisting of chitosan, mucilage, and levan, were applied on sweet cherry fruits and tested for postharvest parameters in both market and cold storage conditions. Results demonstrated that the shelf life of sweet cherries can be extended until the 30th day while retaining important post-harvest properties like decreased weight loss, fungal deterioration, increased stem removal force, total flavonoid, l-ascorbic acid, and oxalic acid. Given the cost-effectiveness of the polymers used, the findings of this study indicate the feasibility of extending the shelf-life of sweet cherries on a larger scale.

Determination of the relationship between respiration rate and ethylene production by fruit sizes of different tomato types.

BACKGROUND: Tomatoes of different types and cultivars are grown in different parts of the world. Accordingly, the phenological, pomological and biochemical characteristics of these types and cultivars may differ from each other, and therefore their ripening behaviours may also differ. The present study aimed to determine the respiration rate and ethylene production of twelve commonly grown cultivars in Turkey at harvest and during the ripening stage. The fruits were harvested at the mature green stage and categorized according to their size as small, medium and large-fruited cultivars. RESULTS: At harvest time, the highest respiration rate was determined from 'Moda' (small-fruited) cultivar and the lowest was from 'Elips' (medium-fruited). The highest ethylene production was determined from 'Sarikiz' (small-fruited) and the lowest was from 'Alberty' (large-fruited). All tomato cultivars examined in the study showed climacteric respiration behavior during the ripening, and it was determined that small-fruited types had a higher respiration rate and ethylene production compared to medium and large-fruited ones. 'Sarikiz' (small-fruited) had the highest climacteric peak and 'Gulpembe' (large-fruited) had the lowest. Moreover, it was determined that the respiration rate of small-fruited cultivars were 5.01-fold higher compared to other cultivars and this type of cultivars produced 4.19-fold higher ethylene compared to big-fruited cultivars at harvest. Medium-fruited tomatoes had 1.90-fold higher respiration rate and 1.64-fold ethylene production compared to big-fruited tomatoes. CONCLUSION: It was determined that fruit size and respiration rate were related independently of the cultivars, although there was no relationship between fruit size and ethylene production. © 2022 Society of Chemical Industry.

Maintenance shelf-life quality of cocktail tomatoes by using UV-C illumination and Arabic gum coating.

BACKGROUND: The aim of the study was to investigate the effects of Arabic gum (AG) coating, UV-C illumination and its combinations on postharvest quality parameters of cocktail tomatoes (Solanum lycopersicum L. cv. Ipekce F1 ). After harvest, mature green tomatoes were treated with 10% Arabic gum (AG10), 20% AG (AG20), 3.6 kJ m-2 ultraviolet-C (UV-C) illumination, 3.6 kJ m-2 UV-C+AG10 and 3.6 kJ m-2 UV-C+AG20, and stored at 20 °C for 20 days. RESULTS: The highest titratable acidity (TA), total soluble solids (TSS) and the lowest weight loss were obtained in AG20 treatments. Maximum fruit firmness and L* value were in AG20 and UV-C+AG20 treatment. The greatest h° values were recorded in AG20, UV-C+AG20 and control group. The highest vitamin C content were obtained from AG20, UV-C+AG10 and UV-C+AG20 treated tomatoes. Minimum lycopene content was determined from AG10, AG20, UV-C+AG10 and UV-C+AG20 treatments. Maximum chlorophyll content was determined from UV-C+AG20-treated tomatoes. AG10, AG20, UV-C+AG10 and UV-C+AG20 treatments resulted in lower ethylene emissions as compared to control and UV-C-treated tomatoes. AG20, UV-C+AG10 and UV-C+AG20 treatments generally had lower values than control and UV-C in term of respiration rates. CONCLUSION: It is concluded that AG20 treatment effectively maintained the postharvest quality and biochemical properties of cocktail tomatoes as compared to other tested treatments. © 2021 Society of Chemical Industry.

Assessment of the Effectiveness of Transcranial Magnetic Stimulation in Subjective Tinnitus.

Introduction Increases in spontaneous activity in the neurons of the auditory cortex are presumed as the pathophysiology of tinnitus. Objective To investigate the effectiveness of transcranial magnetic stimulation (TMS) in the treatment of tinnitus. Methods A total of 62 patients between the ages of 22 and 74 with chronic subjective tinnitus were enrolled in the study. The inclusion criteria were normal findings on an otolaryngologic examination and normal ranges of complete blood count, routine biochemical parameter levels, thyroid function, air-bone gap on pure-tone audiometry, and middle-ear pressure and stapedial reflex on tympanometry. The patients were randomized into 2 groups: 40 patients were placed in the treatment for TMS (tTMS) group, and the rest (22 patients) were placed in the sham TMS group. The frequency and severity of the tinnitus, as well as the tinnitus handicap inventory (THI) score of each patient were measured before and one month after the treatment, and the values were statistically evaluated. Results We observed a statistically significant improvement in the tTMS group ( p < 0.05 and p < 0.05 respectively) regarding the THI and tinnitus severity scores. The sham TMS group showed no significant improvement in terms of the THI ( p > 0.05). However, the tinnitus severity showed a significant increase in this group ( p < 0.05). The comparison of differences in the changes in the THI and the tinnitus severity scores showed a significant statistical improvement in the tTMS group compared with the sham TMS group ( p < 0.05 and p < 0.05 respectively). Conclusion Transcranial magnetic stimulation was found to be effective in the treatment of tinnitus, and may be adopted as a treatment for tinnitus after further comprehensive studies.

Assessment of the Effectiveness of Quercetin on Cisplatin-Induced Ototoxicity in Rats.

OBJECTIVES: This study aimed to evaluate the effect of quercetin on cochlear function and morphology, and its possible protective effect against acute cisplatin-induced ototoxicity in rats. MATERIALS AND METHODS: This prospective and controlled animal study was conducted on Wistar albino rats divided into four groups. Otoacoustic emission measures were performed three days after the first infiltration in Group 1 (saline), 2 (cisplatin), and 3 (quercetin). This interval was five days for Group 4 (cisplatin+quercetin). At the end of the study, the rats were decapitated with deep anesthesia, and histological changes in the cochleas were observed by light microscopy. RESULTS: Group 2 (cisplatin) revealed significant differences between the first and second measures in all frequencies. When compared to other group, the difference of the changes in Group 2 statistically significantly decreased, especially in higher frequencies. Morphologically, there were no acute changes in Group 1 and Group 3. Outer hair cell loss and the degeneration of stria vascularis and spiral ganglion were observed in both Groups 2 and 4; the damages in the latter were lesser. CONCLUSION: Quercetin does not have negative effect on cochlea, and it has protective effect on cisplatin-induced ototoxicity.

Case report: epidermoid inclusion cyst of the clitoris as a long-term complication of female genital mutilation.

BACKGROUND: Female genital mutilation is a common procedure in sub-Saharan Africa that causes serious short- and long-term complications. Although physicians can overcome these complications sometimes, they can be very confusing to diagnose. In this report, we discuss the surgical management of a patient with an epidermal inclusion cyst of the clitoris as a long-term complication of type III female genital mutilation. CASE PRESENTATION: A healthy 43-year-old African woman who was a nonsmoker and nonalcoholic presented with a large genital mass causing difficulty in urination and sexual discomfort. The patient had three full-term spontaneous vaginal deliveries without any complications. Perineal examination revealed a 6 × 10-cm, well-circumscribed, mobile, nontender, rounded cystic swelling in the right periclitoral area that was obstructing the urinary meatus and vaginal introitus. A surgical procedure was performed for total excision of the clitoral mass. Pathological findings showed an epidermoid inclusion cyst. CONCLUSIONS: Besides increasing clinicians' awareness of female genital mutilation and its long-term complications, public education campaigns should be designed to eradicate this practice.

Comparison of organically and conventionally produced Batavia type lettuce stored in modified atmosphere packaging for postharvest quality and nutritional parameters.

BACKGROUND: The impacts of organic and conventional production systems on postharvest life and quality parameters of Batavia type 'Caipira' lettuce heads (Lactuca sativa L.) were investigated. Harvested lettuce heads grown in two different production systems were stored at 0 °C temperature and 95-98% relative humidity for 20 days in modified atmosphere packaging. RESULTS: The lowest weight loss, the highest ascorbic acid content and antioxidant activity were obtained from the organic production system (Org-2). The conventional production system had higher total soluble solids, titratable acidity, and total phenolic contents. During the shelf-life period at 20 °C, the weight losses of lettuce heads grown conventionally were higher than with the other production system. Conventionally grown heads had higher titratable acidity and total phenolic contents than organically grown heads. The highest titratable acidity and h° values were obtained from the plants grown under conventional and organic production systems (Org-2), while the highest chroma value and antioxidant activity were detected from the control treatment. The highest ascorbic acid content was detected in the control treatment, but the effects of control, organic (Org-2) and conventional production systems on ascorbic acid content were not statistically significant. CONCLUSION: The results indicated that the organic production system (Org-2) was the most effective treatment in prolonging postharvest life and protecting the quality of Batavia type 'Caipira' lettuce heads stored in modified atmosphere packaging. © 2018 Society of Chemical Industry.

Research of genetic bases of hereditary non-syndromic hearing loss.

AIM: Hearing loss is the most common sensory disorder that affects approximately one per 1000 live births. With this project, we aimed to identify gene variants that were common causes of hearing loss in Turkey to contribute to the planning of genetic screening programs for hearing loss, as well as to improve genetic counseling to affected families. MATERIAL AND METHODS: Twenty-one families with at least two affected individuals and parental consanguinity who presented with non-syndromic severe-to-profound sensorineural hearing loss were included in this study. We first screened for mutations in GJB2 and mitochondrial DNA 12S RNA genes. Subsequently, we genotyped the TMIE c.250C>T and SNP markers flanking the SLC26A4, MYO7A, MYO15A, OTOF, CDH23, TMIE, TECTA, PCDH15, TMC1, TMPRSS3, TMHS genes in the remaining twelve families without mutations in GJB2. RESULTS: Screening for mutations in GJB2 gene showed c.[35delG];[35delG] mutation in four families, c.[35delG];[507C>A] mutation in two families, c.[35delG];[-23+1G>A] mutation in one family, and c.457G>A heterozygous mutation in one family. Genotyping SNP markers showed the c.[250C>T];[250C>T] mutation in TMIE in one family. A homozygous region with SNP genotypes was detected with the OTOF gene in one family, the TMPRSS3 gene in another family, and also a homozygous region was detected with TMHS, OTOF, and TMPRSS3 genes in another family. CONCLUSIONS: Further research will be required to determine the genetic bases of hearing loss in families with non-syndromic hearing loss.

Palatine tonsil volume estimation using different methods after tonsillectomy.

This study was carried out to measure the volume of the palatine tonsil in otorhinolaryngology outpatients with complaints of adenotonsillar hypertrophy and chronic tonsillitis who had undergone tonsillectomy. To date, no study has investigated palatine tonsil volume using different methods and compared with subjective tonsil size in the literature. For this purpose, we used three different methods to measure palatine tonsil volume. The correlation of each parameter with tonsil size was assessed. After tonsillectomy, palatine tonsil volume was measured by Archimedes, Cavalieri and Ellipsoid methods. Mean right-left palatine tonsil volumes were calculated as 2.63 ± 1.34 cm3 and 2.72 ± 1.51 cm3 by the Archimedes method, 3.51 ± 1.48 cm3 and 3.37 ± 1.36 cm3 by the Cavalieri method, and 2.22 ± 1.22 cm3 and 2.29 ± 1.42 cm3 by the Ellipsoid method, respectively. Excellent agreement was found among the three methods of measuring volumetric techniques according to Bland-Altman plots. In addition, tonsil grade was correlated significantly with tonsil volume.

A Prospective Experimental Study on the Protective Effect of Resveratrol against Amikacin-Induced Ototoxicity in Rats.

OBJECTIVE: The purpose of this study was to evaluate the protective effect of resveratrol against amikacin-induced ototoxicity in rats by otoacoustic emission and histopathology of the cochlea. MATERIALS AND METHODS: This study was conducted with 31 Sprague Dawley adult female rats that were 20-21 weeks old and 190-245 g in weight. Before the drug administration, distortion product otoacoustic emission (DPOAE) tests were performed in both ears of each rat. The rats were divided into four groups. Group 1 (n=7) received ethanol 1cc 4%, Group 2 (n=8) received 600 mg/kg amikacin, Group 3 (n=8) received 10 mg/kg resveratrol and 600 mg/kg amikacin, and Group 4 (n=8) received 1cc resveratrol at 10 mg/kg. The drugs were administered once a day for 21 consecutive days. Control DPOAE tests were performed at the 7th, 14th, and 21st days after the administration of drugs. At the end of the study, the rats were sacrificed and their cochleae were dissected. The cochleae were evaluated for histopathologic changes. RESULTS: There was no statistically significant difference in the DPOAE measurements before the procedure between groups. The DPOAE measurements significantly decreased after the procedure in the amikacin group. There was no statistically significant difference in DPOAE measurements after the procedure in the amikacin + resveratrol, resveratrol, and ethanol groups. The histopathologic findings supported these results. CONCLUSION: We found that if resveratrol is administered with amikacin, the severity of amikacin-induced hearing loss is decreased. These findings suggest that resveratrol, a strong antioxidant, has a protective effect in amikacin ototoxicity.

Characterization of tympanic cavity volume in newborns using computerized tomography scanning / Caracterización del volumen de la cavidad timpánica en recién nacidos usando tomografía computadorizada

This study reports tympanic cavity (TC) volume in newborns, which was missing in the literature. Ex vivo histology and computerized tomography (CT) scans were performed on temporal bone and data were analyzed in part using software developed in house. CT images with a slice thickness of 0.5 mm were obtained from 5 newborn cadavers and analyzed independently by two expert researchers. The border of the TC was delineated manually and measurement of area of interest was calculated on masked images. Then, the area measurements from all sections were added to estimate the total volume. The agreements between the histological and CT findings were then compared for accuracy, repeatability and reliability. The Dice and Jaccard similarity coefficient measures were used as a statistical validation metric to evaluate the assessor's performance in manual volume segmentation. Good assessor agreement was observed with average Dice values above 0.8 indicating that consistent and reliable volume measurements were feasible. The proposed protocol was shown to be accurate in calculating the TC volume, and thus can be used for computer-assisted presurgical planning or for diagnosing structural alterations in TC.

El objetivo fue determinar el volumen de la cavidad timpánica (CT) en recién nacidos, información no encontrada en la literatura. Se realizaron escaners a través de tomografia computadorizada (TC) y estudios histológicos en el hueso temporal; los datos se analizaron utilizando un software desarrollado en nuestra institución. Se obtuvieron imágenes de secciones de TC, de 0,5 mm de grosor, a partir de 5 cadáveres de recién nacidos, los que fueron analizados de forma independiente por dos investigadores expertos. El margen de los cortes de TC fue delineado manualmente y la medición del área de interés se estimó sobre imágenes ocultas. Después, se añadieron las mediciones de área de todas las secciones para estimar el volumen total. Las concordancias entre el estudio histológico y los hallazgos de la TC se compararon en cuanto a precisión, repetibilidad y confiabilidad. Se utilizaron las medidas de coeficiente de similitud de Jaccard y Dice como métrica de validación estadística para evaluar el desempeño del asesor en la medición manual del volumen. Se observó una buena correlación del evaluador con los valores medios de Dice, por encima de 0,8 indicando que es factible obtener mediciones coherentes y confiables de volumen. El protocolo propuesto ha demostrado ser preciso para calcular el volumen de la CT, y por lo tanto se puede utilizar para la planificación prequirúrgica asistida o para el diagnóstico de alteraciones estructurales en la CT.

Vulvar Epidermoid Cyst and Type 2 Radical Genital Mutilation.

About 100 million women are estimated to be circumcised globally. Various rates of complications have been encountered, especially after circumcision, such as bleeding, infection, shock, menstrual irregularity, difficulty in urination or common urinary tract infections, inguinal pain, difficulty in sexual intercourse, and genital circumcision scar especially at the vulvar region, and cystic or solid character mass in short and long term. Furthermore, the maternal-fetal morbidity and mortality increase due to bleeding and fistula, which develop after prolonged labor, travail, and difficult labors. Our aim in this paper was to discuss a 42-year-old multiparous female case who had undergone type 2 radical genital mutilation (circumcision) when she was 7 years of age, along with the literature, which has been evaluated for the gradually growing mass at the left inguinal canal region in the last 10 years and diagnosed as epidermoid inclusion cyst developing secondary to postcircumcision surgical ground trauma, since there was no other case found in the literature search that had been circumcised at such an early age and developing after circumcision at such advanced age, and, therefore, this is suggested to be the first case on this subject.

Medical management of an ovarian ectopic pregnancy: a case report.

BACKGROUND: Primary ovarian ectopic pregnancy is a rare type of ectopic pregnancy which has an estimated prevalence ranging from 1:7000 to 1:70,000 accounting for almost 3 % of all ectopic cases. Here we report the case of a 25-year-old woman who presented to our clinic with abdominal pain, 6 weeks' delay of menstruation and 3 days of vaginal bleeding, whose transvaginal ultrasonography showed an ectopic gestational sac with yolk sac inside, in her right ovary. This case shows that early diagnosis is very important particularly in places like the Sub-Saharan region of Africa. CASE PRESENTATION: A 25-year-old African woman was referred to our clinic with 6 weeks' delay of menstruation, frequent increasing abdominal pain and 3 days of vaginal bleeding. Her general condition was good and her vital signs were normal. She felt tenderness in an abdominal examination and had a small amount of vaginal bleeding. Transvaginal ultrasonography showed an ectopic gestational sac with yolk sac inside, in her right ovary. Our final diagnosis was ectopic ovarian pregnancy and we successfully treated her with methotrexate. After 3 weeks of methotrexate administration her beta human chorionic gonadotropin was negative and a sonographic examination was completely normal. CONCLUSIONS: Ectopic ovarian pregnancy is a very important medical situation. It should be diagnosed in its early stages otherwise it could be life-threatening and surgical treatment may be inevitable. Because of the importance of fertility, medical treatment is an acceptable option and can be feasible with early diagnosis.

Youssef's Syndrome following Cesarean Section.

Youssef's syndrome is characterized by cyclic hematuria (menouria), absence of vaginal bleeding (amenorrhea), and urinary incontinence due to vesicouterine fistula (VUF), the least common of the urogynecological fistulas. Youssef's syndrome has a variable clinical presentation. A vesicouterine fistula is an abnormal pathway between the bladder and the uterus. The most common cause is lower segment Cesarean section. Conservative treatment may be appropriate in some cases, but surgery is the definitive treatment. Vesicouterine fistula should be suspected in cases presenting with urinary incontinence even years after Cesarean section. Diagnostic tests as well as necessary appropriate surgery should be performed on cases with suspected vesicouterine fistula. We present a 40-year-old multiparous woman with vesicouterine fistula after primary Cesarean section; she presented with urinary incontinence, hematuria, and amenorrhea 1 year after the birth. Here, we discuss our case with the help of previously published studies found in the literature.

Comparison of Subcuticular Suture Materials in Cesarean Skin Closure.

Aim. Comparison of the rate of wound complications, pain, and patient satisfaction based on used subcuticular suture material. Methods. A total of 250 consecutive women undergoing primary and repeat cesarean section with low transverse incision were prospectively included. The primary outcome was wound complication rate including infection, dehiscence, hematoma, and hypertrophic scar formation within a 6-week period after operation. Secondary outcomes were skin closure time, the need for use of additional analgesic agent, pain score on numeric rating scale, cosmetic score, and patient scar satisfaction scale. Results. Absorbable polyglactin was used in 108 patients and nonabsorbable polypropylene was used in 142 patients. Wound complication rates were similar in primary and repeat cesarean groups based on the type of suture material. Skin closure time is longer in nonabsorbable suture material group in both primary and repeat cesarean groups. There was no difference between groups in terms of postoperative pain, need for additional analgesic use, late phase pain, and itching at the scar. Although the cosmetic results tended to be better in the nonabsorbable group in primary surgery patients, there was no significant difference in the visual satisfaction of the patients. Conclusions. Absorbable and nonabsorbable suture materials are comparable in cesarean section operation skin closure.

Attachment styles and psychopathology among adolescent children of parents with bipolar disorder.

BACKGROUND: The aim of this study was to compare attachment styles and psychopathology in adolescent children of parents with bipolar disorder (BD) with a healthy control group. MATERIAL AND METHODS: We studied 25 adolescents who had at least 1 parent with BD (BD group) and 28 adolescents who had no parents with BD (control group). The adolescent participants were between the ages of 12 and 17 years. We used the Adolescent Relationship Scales Questionnaire (A-RSQ) for the adolescents in the BD vs. control groups, and we used the Schedule for Affective Disorders and Schizophrenia for School-age Children - present and lifetime version (K-SADS-PL). We used the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Clinician Version for each parent of adolescents in the BD and control groups to rule out psychopathologies. RESULTS: Attachment styles of participants were assessed according to A-RSQ, dismissing attachment style scores of adolescents in BD group were found significantly higher compared to the healthy control group (p<0.05). As a result of the assessments, 12 adolescents (48%) out of 25 in the BD group and 5 adolescents (18%) out of 28 in the control group were given DSM-IV Axis I diagnosis, which is a statistically significant result (p<0.05). However, when psychiatric diagnoses were assessed separately, the difference was not statistically significant. CONCLUSIONS: We found that the adolescent children of parents with BD have increased risk of developing mental illnesses, and that these adolescents adopt dismissing attachment styles.

The effects of UV radiation during the vegetative period on antioxidant compounds and postharvest quality of broccoli (Brassica oleracea L.).

In this study, the effects of supplementary UV radiation during the vegetative period on antioxidant compounds, antioxidant activity and postharvest quality of broccoli heads during long term storage was studied. The broccolis were grown under three different doses of supplementary UV radiation (2.2, 8.8 and 16.4 kJ/m(2)/day) in a soilless system in a glasshouse. Harvested broccoli heads were stored at 0 °C in modified atmosphere packaging for 60 days. The supplementary UV radiation (280-315 nm) during the vegetative period significantly decreased total carotenoid, the chlorophyll a and chlorophyll b content but increased the ascorbic acid, total phenolic and flavonoid contents of broccolis. All supplementary UV treatments slightly reduced the antioxidant activity of the broccolis, however, no remarkable change was observed between 2.2 and 8.8 kJ/m(2) radiation levels. The sinigrin and glucotropaeolin contents of the broccolis were substantially increased by UV treatments. The prolonged storage period resulted in decreased ascorbic acid, total phenolic and flavonoid contents, as well as antioxidant activity. Discoloration of the heads, due to decreased chlorophyll and carotenoid contents, was also observed with prolonged storage duration. Glucosinolates levels showed an increasing tendency till the 45th day of storage, and then their levels started to decline. The weight loss of broccoli heads during storage progressively increased with storage time in all treatments. Total soluble solids, solids content and titratable acidity decreased continuously during storage. Titratable acidity was not affected by UV radiation doses during the storage time whereas soluble solids and solids content (dry matter) were significantly affected by UV doses. Supplementary UV radiation increased the lightness (L*) and chroma (C*) values of the broccoli heads. Pre-harvest UV radiation during vegetative period seems to be a promising tool for increasing the beneficial health components of broccolis.

Condylar response to functional therapy with Twin-Block as shown by cone-beam computed tomography.

OBJECTIVE: To evaluate the condylar changes through cone-beam computed tomography (CBCT) images in patients treated with Twin-Block functional appliance. MATERIALS AND METHODS: In this retrospective study, CBCT images of 30 patients who were treated with the Twin-Block appliance were used. Mandible was segmented and pretreatment and posttreatment (T0 and T1) condylar volume was compared. The angle between sella-nasion-Point A (SNA), angle between sella-nasion-Point B (SNB), angle between Point A-nasion-Point B (ANB), midfacial length (Co-A), mandibular length (Co-Gn), and the distances from right condylion to left condylion (CoR-CoL) were also measured on three-dimensional images. Differences were analyzed with Wilcoxon signed rank tests, and Mann-Whitney U-tests were used to compare the scores of male and female participants. Significance was set at P < .05. RESULTS: In this study, a decrease in SNA and ANB (P < .05 and P < .01, respectively) and an increase in SNB (P < .01) were found. Additionally, CoR-CoL, Co-Gn, and condylar volume increased at both the left and right sides (P < .01). However, increase at Co-A was not statistically significant (P > .05). Comparison of differences by sex was not statistically significant for all measurements (P > .05). CONCLUSION: Twin-Block appliance increases condylar volume, mandibular length, and intercondylar distance by stimulating growth of condyle in an upward and backward direction.