Phytochemical profile, antimicrobial, and anti-quorum sensing properties of fruit stalks of Prunus avium L.

The aim of this study is to investigate the phytochemical contents and antibacterial properties of 2-year Prunus avium L. standard cultivars [Cristalina (Cr), 0900 Ziraat (Zr)] and to elucidate the mechanism of action of the extracts on the quorum sensing (QS) system by using homology modelling and molecular docking. Phenolic contents of methanol extract of Cr and Zr stalks were detected by HPLC. As a result, catechin hydrate (6364·67-8127·93 µg g-1 ) and chlorogenic acid (998·81-1273·4 µg g-1 ) were found to be the highest in stalk extracts in the two varieties in 2017. All extracts had inhibitory effect on Gram-positive bacteria. Stalk extract of Zr showed higher inhibition rate (86%) on swarming motility. Stalk samples of Zr collected in 2017 and 2018 also reduced biofilm formation by 75 and 73%, respectively. The computational analysis revealed that one of the major component of the extracts, chlorogenic acid, was able to bind to the QS system receptors, LasR, RhlR, and PqsR. Therefore, the mechanism of decreasing the production of virulence factors by the extracts might be through inhibiting these receptors and thus interfering with the QS system.

Transcatheter vs. surgical aortic valve replacement and medical treatment : Systematic review and meta-analysis of randomized and non-randomized trials.

BACKGROUND: Transcatheter aortic valve replacement (TAVR) has emerged as the procedure of choice for patients with severe aortic stenosis (AS) and high perioperative risk. We performed a meta-analysis to compare the mortality related to TAVR with medical therapy (MT) and surgical aortic valve replacement (SAVR). METHODS: A systematic literature search was conducted by two independent investigators from the database inception to 30 December 2014. Relative risk (RR) and odds ratio (OR) were calculated and graphically displayed in forest plots. We used I 2 for heterogeneity (meta-regression) and Egger's regression test of asymmetry (funnel plots). RESULTS: We included 24 studies (n = 19 observational studies; n = 5 randomized controlled trials), with a total of 7356 patients in this meta-analysis. Mean age had a substantial negative impact on the long-term survival of AS patients (OR = 1.544; 95% CI: 1.25-1.90). Compared with MT, TAVR showed a statistically significant benefit for all-cause mortality at 12 months (OR = 0.68; 95% CI: 0.49-0.95). Both TAVR and SAVR were associated with better outcomes compared with MT. TAVR showed lower all-cause mortality over SAVR at 12 months (OR = 0.81; 95% CI: 0.68-0.97). The comparison between SAVR and TAVR at 2 years revealed no significant difference (OR = 1.09; 95% CI: 1.01-1.17). CONCLUSION: In AS, both TAVR and SAVR provide a superior prognosis to MT and, therefore, MT is not the preferred treatment option for AS. Furthermore, our data show that TAVR is associated with lower mortality at 12 months compared with SAVR. Further studies are warranted to compare the long-term outcome of TAVR versus SAVR beyond a 2-year follow-up period.

Ex vivo comparison of radiographic and electronic root canal length measurements in primary molars.

AIM: The aim of the study was to evaluate the accuracy of root canal length measurements of primary teeth using an electronic apex locator (EAL) and digital radiography in comparison to stereomicroscopic measurement as gold standard. MATERIALS AND METHODS: After preparation of access cavities of twenty extracted primary molars, the teeth were embedded in alginate blocks. Endodontic files were inserted in the root canals and the length was measured using ProPex II (Dentsply, Maillefer). When the reading was stable for 5s a silicone stop was used for reference. The true lengths of the files were then measured using a micrometer. The gold standard was determined by observing the tip of the file at the apical foramen under a stereomicroscope. For radiographic measurements standard images were obtained at 30 cm source-to-object distance, and zero degrees vertical and horizontal angulations. Radiographic images of each experimental tooth were obtained with the Digora Storage Phosphor Plates (SPP) (Soredex, Orion Corporation, Helsinki, Finland) with the x-ray unit operating at 65 kVp and 10 mA for 0.16 seconds (Trophy Radiologie, Vincennes, France). The radiographic root lengths were measured with the measurement tool of the Digora for Windows software. The mean measurements of both methods were compared to the gold standard measurements using Repeated Measure ANOVA test with Bonferroni adjustments to identify the pair-wise differences (p=0.05). RESULTS: The mean measurements obtained with the EAL (14.06±1.89 mm) were significantly lower than measurements done with SPP images (14.24±1.98 mm) (p<0.05). However, when both root canal length measurement techniques were compared to stereomicroscopic measurements (gold standard), no statistically significant difference was found. CONCLUSION: The EAL might be safer than digital radiography for the measurement of root canal length in primary teeth.

Pulmonary embolism severity index, age-based markers and evaluation in the emergency department.

OBJECTIVES: The purpose of this study was to assess the severity of pulmonary embolism in the emergency department using vital signs and age-based vital parameters and compare these parameters with pulmonary embolism severity index (PESI) score. METHODS: Between January 2011 and October 2014, there were 284 patients diagnosed with pulmonary embolism in the Emergency Unit of Selcuk University Hospital. Patient records were reviewed retrospectively. The PESI scores were calculated, and patients were divided into high- and low-risk groups. Shock index (SI), age-based shock index (SIA), maximum heart rate (MHR), minpulse (MP) and pulse maximum index (PMI) were calculated. The association of these parameters with PESI was evaluated. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the association of risk and mortality with age-based markers. RESULTS: There were 75 men (43%) in the 173 patients included in the study. The PESI classification showed 54 patients in the low-risk group and 119 patients in the high-risk group. Mortality was higher in the PESI high-risk group, and no deaths occurred in the low-risk group. Comparison of the age-based markers and PESI for patients who died or survived showed that AUC for PESI was 0.807, AUC for SI was 0.824 and AUC for SIA was 0.825. CONCLUSIONS: The SIA risk classification was more efficient than SI in pulmonary embolism patients who presented to the emergency unit. The SIA was more accurate than SI or PESI in predicting mortality.

Blunt chest trauma as a cause of acute myocardial infarction.

Chest pain after thoracic trauma may be a symptom of cardiac injury or myocardial infarction. A 63-year-old healthy man had chest pain after blunt chest trauma in a motor vehicle accident. Chest computed tomography scan showed a displaced sternal fracture, lung contusion in the left upper lobe, atelectasis and consolidation in both lower lobes, and bilateral haemothorax. Electrocardiography showed ST elevation (2 mm) in leads II, III, and aVF and ST depression (2 mm) in leads I and aVL, consistent with acute inferior myocardial infarction. Urgent coronary angiography showed ostial occlusion of the right coronary artery. After the right coronary occlusion was passed with a guide wire, dissection of the right coronary artery was observed and treated with a balloon and stent to reestablish normal flow. This case emphasizes the importance of a high index of suspicion for coronary artery injury and myocardial infarction after blunt chest trauma.

D-dimer and D-dimer/fibrinogen ratio in predicting pulmonary embolism in patients evaluated in a hospital emergency department.

OBJECTIVES: The D-dimer level, fibrinogen level, and D-dimer/fibrinogen ratio are used in the diagnosis of pulmonary embolism, but results vary. We evaluated these parameters in the diagnosis of pulmonary embolism in emergency clinic patients. METHODS: In this prospective study, 200 patients (pulmonary embolism, 100 patients; no pulmonary embolism, 100 patients) had D-dimer and fibrinogen levels measured before intervention. Pulmonary embolism was diagnosed with computed tomography angiography or ventilation-perfusion scintigraphy. RESULTS: Compared with patients who did not have pulmonary embolism, patients who had pulmonary embolism had significantly greater mean D-dimer level (pulmonary embolism, 6±7 µg/ml; no pulmonary embolism, 1±1 µg/ml; P⩽0·001) and D-dimer/fibrinogen ratio (pulmonary embolism, 3±3; no pulmonary embolism, 0·4±0·4; P⩽0·001), but similar mean fibrinogen levels (pulmonary embolism, 337±184 mg/dl; no pulmonary embolism, 384±200 mg/dl; not significant). In patients who had pulmonary embolism, mean D-dimer level and D-dimer/fibrinogen ratio were greater in high-risk than non-high-risk patients. With D-dimer cutoff 0·35 µg/ml, sensitivity was high (100%) and specificity was low (27%) for pulmonary embolism. With D-dimer/fibrinogen ratio cutoff 0·13, sensitivity was high (100%) and specificity was low (37%) for pulmonary embolism. CONCLUSION: A D-dimer level <0·35 µg/ml may exclude the diagnosis of pulmonary embolism. At a D-dimer cutoff 0·5 µg/ml and D-dimer/fibrinogen ratio cutoff 1·0, the D-dimer/fibrinogen ratio may have better specificity than D-dimer level in the diagnosis of pulmonary embolism, but the D-dimer/fibrinogen ratio may lack sufficient specificity in screening.

The effects of ubiquinone (CoQ10) on heart tissue in cardiac toxicity related to organophosphate poisoning.

The aim of this study was to examine the effects of ubiquinone (CoQ10) on heart tissue and erythrocytes in acute organophosphate poisoning (AOP). A total of 20 rabbits were divided into three groups: sham (n = 8), pralidoxime (PAM) + atropine (n = 6), and CoQ10 + PAM + atropine (n = 6). Blood samples were taken from each test subject to measure the values of acetylcholinesterase (AChE), nitric oxide (NO), and malondialdehyde (MDA) in the plasma and erythrocyte before administration of 50 mg/kg dichlorvos by orogastric tube. Blood samples were then taken at 1, 12, and 24 h post-dichlorvos to determine plasma and erythrocyte levels of AChE, NO, and MDA. Sham group received no treatment. PAM + atropine group received 0.05 mg/kg atropine with repeated doses and PAM: first a 30-mg/kg intravenous (IV) bolus, then a 15-mg/kg IV bolus every 4 h. CoQ10 + PAM + atropine group received same dose PAM and atropine and a 50-mg bolus of IV CoQ10. Thoracotomy was performed in all the animals 24 h after poisoning and then heart tissue samples were obtained. At 12 and 24 h, erythrocyte AChE levels in the CoQ10 animals were considerably higher than those in PAM + atropine animals (p = 0.023 and 0.017, respectively). At 12 and 24 h, erythrocyte MDA and NO levels in CoQ10 animals were significantly lower than those in PAM + atropine animals (p < 0.05). Heart tissue AChE levels in CoQ10 animals were considerably higher than those of the sham and PAM + atropine animals (p = 0.001). Heart tissue MDA and NO levels of CoQ10 animals were significantly lower than those of the sham and PAM + atropine animals (p < 0.01). Treatment of AOP with CoQ10 + PAM + atropine in this animal model had a beneficial effect on both erythrocyte and heart tissue lipid peroxidation and AChE activity.

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

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

Effect of saliva contamination on microleakage of three different pit and fissure sealants.

AIM: The aim of the study was to evaluate the effect of saliva contamination and compare the microleakage of three different pit-and-fissure sealants namely, Helioseal F, Enamel Loc and Fuji VII. MATERIALS AND METHODS: Sixty recently extracted sound third molars were randomly assigned to three groups for three different sealant materials (n=20). Each sealant group was then randomly divided into two as uncontaminated (n=10) and saliva contaminated (n=10) prior to sealant placement. The samples were thermocycled in water for 500 cycles between 5 and 55 degrees C with a dwell time of 30 s and immersed in 1% methylene-blue for 24 h. The samples were sectioned and scored on a 3 point rating scale using a light microscope. RESULTS: Among both contaminated and uncontaminated groups Helioseal F showed statistically significantly less microleakage compared to Enamel Loc and Fuji VII groups (p<0.05). There was no statistically significant difference between Enamel Loc and Fuji VII in both absence and presence of saliva contamination (p>0.05). STATISTICS: The results were analysed using Kruskal Wallis test while study groups were compared with Mann-Whitney test for statistically significant differences at 5% significance level. CONCLUSION: Under both uncontaminated and saliva contaminated conditions, the light-cured resin-based pit-and-fissure sealant Helioseal F yielded lower microleakage scores compared to Enamel Loc and Fuji VII.

Effects of deferoxamine on tissue lactate and malondialdehyde levels in cerebral ischemia.

In the present study, the effects of deferoxamine on tissue lactate and malondialdehyde (MDA) levels after cerebral ischemia in rabbits was studied. Rabbits were divided equally into three groups: group 1: sham-operated group; group 2: cerebral ischemia produced by clamping bilateral common carotid arteries for 60 min; and group 3: deferoxamine 100 mg/kg i.v. administered within 5 min after opening the clamps. EEG recordings were obtained in all groups before clamping and in group 2 and 3 60 min after clamping and 60 min after opening the clamps. One hour after opening the clamps and taking EEG recordings, brain cortices were resected and the concentrations of lactate and MDA were determined using the spectrophotometric enzymatic and thiobarbituric acid methods, respectively. There were significant differences between group 1 and the other groups in MDA and lactate levels (p < 0.05). There were no significant differences in lactate levels between groups 2 and 3. Preischemic EEG grades were the same in all groups. Preischemic and postischemic EEG values were significantly different (p < 0.05), but there were no significant differences between postischemic EEG grades in groups 2 and 3. There was also a correlation between postischemic EEG grades and lactate levels, but no correlation between postischemic EEG grades and MDA levels. These results demonstrate that cerebral ischemia leads to an increase in brain tissue lactate and MDA levels and deferoxamine suppresses the increase of MDA, but not lactate. Deferoxamine treatment caused no significant EEG changes. EEG grades correlated well with lactate levels.

Effects of magnesium sulfate on tissue lactate and malondialdehyde levels after cerebral ischemia.

In the present study, the effects of magnesium sulfate on tissue lactate and malondialdehyde (MDA) levels after cerebral ischemia in rabbits were studied. The rabbits were divided equally into three groups. Group 1 (n = 8) was the sham-operated control group, in group 2 (n = 8) only cerebral ischemia was induced by clamping bilaterally the common carotid arteries for 60 min, and in group 3 (n = 8) magnesium sulfate was administered at a dose of 100 mg/kg i.v. within 5 min after opening the clamps. In group 1 EEG recordings were obtained immediately and 60 and 120 min after craniectomy. In groups 2 and 3 EEG recordings were obtained immediately after craniectomy but before clamping and 60 min after clamping. One hour after opening the clamps and taking EEG recordings, brain cortices were resected, and the concentrations of lactate and MDA were determined using spectrophotometric/enzymatic and thiobarbituric acid methods, respectively. In all groups, there were significant differences between MDA and lactate levels (p < 0.05). There were no significant differences in lactate levels between groups 2 and 3 (p > 0.05), and also the preischemic EEG grades were the same in all groups. Preischemic and postischemic EEG values were significantly different (p < 0.05), and there were also significant differences between postischemic EEG grades in groups 2 and 3 (p < 0.05). There was a correlation between postischemic EEG grades and MDA and lactate levels. These results demonstrate that cerebral ischemia-reperfusion injury leads to an increase in brain tissue lactate and MDA levels, that magnesium sulfate suppresses the increase of MDA and lactate concentrations, and that magnesium sulfate treatment improves the EEG changes. The EEG grades correlated well with MDA and lactate levels.

Effects of nimodipine on tissue lactate and malondialdehyde levels in experimental head trauma.

We studied the effects of nimodipine on brain tissue lactate and malondialdehyde (MDA) levels one hour after experimental head trauma in 25 New Zealand rabbits. Group 1 (n=5) was the sham operated group. Group 2 (n=10) received head trauma without treatment and in group 3 (n=10) nimodipine was administered for 30 minutes intravenously (2 microg/kg/min) immediately after head trauma. In groups 2 and 3, tissue samples from the non-traumatized side was named as "a" and traumatized side as "b". The lactate and malondialdehyde contents were significantly higher in groups 2a, 2b, 3a and 3b when compared with to group 1 (P<0.05). The differences between non-treated groups (2a, 2b) and nimodipine treated groups (3a, 3b) were not significant (P>0.05). The differences between the traumatized sides (2b, 3b) and non-traumatized sides (2a, 3a) were significant (P<0.05). These results demonstrated that nimodipine is ineffective in suppressing the increase of tissue lactate and malondialdehyde levels in the early period of experimental head trauma.

Effects of nimodipine and magnesium sulfate on endogenous antioxidant levels in brain tissue after experimental head trauma.

To examine the effects of calcium antagonists nimodipine and magnesium sulfate (MgSO4) on tissue endogenous antioxidant levels, the authors studied superoxide dismutase (SOD) and glutathione peroxidase (GPx) levels in rabbit brain 1 hour after experimental head trauma. Forty New Zealand rabbits were anesthetized and randomly divided into four groups. Group 1 (n = 10) was the sham operated group. Group 2 (n = 10), the control group, received head trauma and no treatment. Group 3 (n = 10) received head trauma and intravenous (IV) 2 microgr/kg nimodipine. Group 4 (n = 10) received head trauma and IV 100 mg/kg MgSO4. Head trauma was delivered by performing a craniectomy over the right hemisphere and dropping a weight of 20 g from a height of 40 cm. In the right (traumatized) hemisphere, SOD and GPx decreased by 57.60% +/- 9.60% and 72.93% +/- 5.51% respectively from sham values. Magnesium sulfate, but not nimodipine, reduced the magnitude of decrease of SOD and GPx to 19.43% +/- 7.15% and 39.01% +/- 7.92% respectively from sham values. In the left (nontraumatized) hemisphere, MgSO4 increased SOD to 42.43% +/- 24.76% above sham values. The authors conclude that MgSO4 treatment inhibited the decrease in SOD and GPx levels in experimental brain injury.

Effects of high-dose methotrexate on the hemostatic system in childhood acute lymphoblastic leukemia.

BACKGROUND: Thromboembolic and hemorrhagic complications are significant causes of death in patients with malignancy. These are well-known with the use of certain drugs. This study was planned to investigate whether there was any effect of high-dose methotrexate on the hemostatic system in childhood acute lymphoblastic leukemia. PROCEDURE: To evaluate the hemostatic system, we investigated coagulation screening tests (prothrombin time, activated partial thromboplastin time, and fibrinogen), coagulation inhibitors (protein C, protein S, and antithrombin III), and fibrinolytic system (fibrin degradation products and tissue plasminogen activator). These parameters were measured in 35 cycles of high dose-methotrexate (3 g/m(2)) of 20 childhood acute lymphoblastic leukemia cases at baseline and on days 1 and 7 after the therapy. RESULTS: We found that high-dose methotrexate administration adversely affected both the coagulation system (prolonged prothrombin time and activated partial thromboplastin time and decreased fibrinogen levels) and coagulation inhibitors (decreased protein C, protein S, antithrombin III) on day 1 after chemotherapy compared to the baseline values. The hemostatic parameters began to improve on day 7 after chemotherapy, except for fibrin degradation products. Tissue plasminogen activator levels were not changed with the therapy. CONCLUSIONS: Coagulation cascade (prolonged prothrombin time and activated partial thromboplastin time and decreased fibrinogen) and coagulation inhibitors (decreased protein C, protein S, and antithrombin III levels) have been found to be affected by high-dose methotrexate therapy, but these transient changes did not cause clinical thromboembolic or hemorrhagic complications.

Effects of magnesium sulfate on tissue lactate and malondialdehyde levels in experimental head trauma.

OBJECTIVE: To determine the effects of magnesium sulfate (MgSO4) on tissue lactate and malondialdehyde (MDA) levels in rabbit brain after experimental head trauma. DESIGN: Prospective, randomized trial. SUBJECTS: Thirty New Zealand rabbits. INTERVENTIONS: Group 1 (n = 10) was the sham operated group. Group 2 (n = 10) (untreated group) and group 3 (n = 10) received head trauma with the weight drop method. MgSO4 was administered 100 mg/kg (15 %) i. v. immediately after the head trauma to group 3. Trauma was applied to one side. The non-contused side was named as "a" and the contused side as "b". MEASUREMENTS: One hour after trauma, brain cortices were resected and the concentrations of lactate and MDA were determined using the spectrophotometric enzymatic and thiobarbituric acid methods. One-way ANOVA and Tukey's HSD tests were used for the evaluation of the results. P < 0.05 was considered as significant. Pearson's correlation test was used between lactate and MDA levels (P < 0.001). RESULTS: There were significant differences between MDA and lactate levels of group 1 and all other groups; non-contused (a) and contused (b) sides of groups 2 and 3; groups 2b-3a, 2b-3b (P < 0.05). The difference in MDA levels was significant between groups 2a-3b (P < 0.05). Correlation between lactate and MDA was very good in group 1, and excellent in groups 2a, 2b, 3a, and 3b. CONCLUSIONS: These results demonstrate that head trauma leads to an increase in brain tissue lactate and MDA levels, and MgSO4 suppresses the rise in contused tissue when given after head trauma.

Partial colocalization of NADPH-diaphorase and acetylcholinesterase positivity in spinal cord neurons.

The freely diffusible radical, nitric oxide (NO), has been assumed to act as a retrograde signaling molecule that modulates transmitter release. Acetylcholine (ACh) is known to function as a typical neurotransmitter. In the present work we have examined the presence of both transmitters (NO and ACh) and their possible relations in the rabbit spinal cord. In our experiments we have used histochemical methods for the visualization of acetylcholinesterase (AChE) and NADPH diaphorase (NADPH-d) which label neurons that express nitric oxide synthase (NOS). Both histochemical methods were performed separately or together on the same sections of the thoracic spinal cord. NADPH-d positive dark blue stained neurons were seen mostly in superficial and deep layers of the dorsal horn, preganglionic autonomic neurons and pericentral area. The presence of AChE positive amber yellow neurons was confirmed mostly in motoneurons located in the ventral horns and in neurons of the pericentral and intermediate zone. Besides the above mentioned neurons, also double-labeled neurons were found which contained both the yellow and dark blue histochemical product. Their presence was confirmed in the intermediate zone and in the pericentral area. Thus, the co-existence of NADPH-d and AChE occurred in the location of interneurons. Our observations suggest that NO may play a role in the control of cholinergic neuronal activity and that NO can be involved in the modulation of synaptic transmission.

Cheese Slurry in the Acceleration of Cephalotyre "Ras" Cheese Ripening.

A method has been adopted for the acceleration of Cephalotyre "Ras" cheese ripening. Ras cheese slurry incubated at 30° C for 7 d was added to cheese milk before addition of the starter or to the cheese curd before hooping. Flavor development. protein degradation and fat hydrolysis were enhanced in cheeses with added slurry. Moreover, the ripening period was reduced to 2 months compared with 4 months required for the control cheese. The effect of cheese slurry was more remarkable when it was added to the curd.