Effect of simulated gastric acid on aesthetical restorative CAD-CAM materials' microhardness and flexural strength.

Background: Gastric acid, which is among erosive substances, gradually rises to the mouth in individuals with reflux and bulimia nervosa disorders, and this causes various effects on dental restorations. Aim: The objective of this study is in vitro investigation of gastric acid's effect on flexural strength and hardness on aesthetic restorative computer-aided design and computer-aided manufacturing (CAD-CAM) materials. Materials and Methods: For this study, four materials have been used, namely Enamic (Vita), Superfect Zir (Aidite) Zirconia, IPS e.max CAD (Ivoclar Vivadent), and Mark II (Vita). From these four different materials, 24 samples with 14 × 4 × 1 dimensions in rectangular prism form are used, which makes a total of 96 samples. One group was separated as the control group, while the rest was allowed to wait at 37°C, 5 ml gastric acid for 96 hours. Hardness value and flexural strengths were measured as pre-exposure and post-exposure to gastric acid. Results: There is a statistically significant difference between the groups in terms of the amount of decrease in the mean hardness after exposure to gastric acid compared to pre-exposure values (p: 0,000; P < 0,05). There was no statistically significant difference between the groups in terms of the amount of decrease in the post-exposure average flexural strength compared to the pre-exposure value (p: 0.063; P > 0.05). There is a statistically significant difference between the groups in terms of the average flexural strength after exposure to the acid. Conclusions: According to the data obtained, it was concluded that exposure to gastric acid affects the hardness and flexural strength properties of dental restorative ceramic materials.

Multibreed genomic prediction using summary statistics and a breed-origin-of-alleles approach.

Because of an increasing interest in crossbreeding between dairy breeds in dairy cattle herds, farmers are requesting breeding values for crossbred animals. However, genomically enhanced breeding values are difficult to predict in crossbred populations because the genetic make-up of crossbred individuals is unlikely to follow the same pattern as for purebreds. Furthermore, sharing genotype and phenotype information between breed populations are not always possible, which means that genetic merit (GM) for crossbred animals may be predicted without the information needed from some pure breeds, resulting in low prediction accuracy. This simulation study investigated the consequences of using summary statistics from single-breed genomic predictions for some or all pure breeds in two- and three-breed rotational crosses, rather than their raw data. A genomic prediction model taking into account the breed-origin of alleles (BOA) was considered. Because of a high genomic correlation between the breeds simulated (0.62-0.87), the prediction accuracies using the BOA approach were similar to a joint model, assuming homogeneous SNP effects for these breeds. Having a reference population with summary statistics available from all pure breeds and full phenotype and genotype information from crossbreds yielded almost as high prediction accuracies (0.720-0.768) as having a reference population with full information from all pure breeds and crossbreds (0.753-0.789). Lacking information from the pure breeds yielded much lower prediction accuracies (0.590-0.676). Furthermore, including crossbred animals in a combined reference population also benefitted prediction accuracies in the purebred animals, especially for the smallest breed population.

Maternal and Fetal Outcomes in Caesarean Sectıons Repeated Fourth and Fıfth Tımes

ABSTRACT Objective: To evaluate the maternal and fetal outcomes associated with caesarean sections (CS) repeated fourth and fifth times. Methods: We performed a retrospective study of 110 patients undergoing CS repeated fourth and fifth times between May 2014 and May 2015. The patients were divided into two groups: group 1 had CS repeated four times (n = 90) and group 2 had CS repeated five times (n = 20), and the maternal and fetal outcomes of the groups were retrospectively evaluated. Results: There were no statistically significant differences between fourth and fifth CS groups with regard to the maternal age, gravida, body mass index, gestational age at birth, birth-weight, and Apgar scores at 5 minutes (p > 0.05). We found no significant differences between the fourth and fifth CS groups in terms of injury to peripheral organs, intra-abdominal adhesions, caesarean hysterectomy, uterine dehiscence or rupture, time during operation, length of hospital stay, and need for blood transfusions (p > 0.05). Compared with the elective cases, perioperative complications and length of hospital stay were significantly higher in the urgent group (p = 0.034 and p = 0.005). Conclusion: Women with CS repeated four or five times have increased risks for perioperative complications. Placenta previa with or without accreta and intra-abdominal adhesions seem to be the major causes of increased morbidity.

Hepatitis B Reactivation in HBsAg-negative Anti-HBc-positive patients receiving cytotoxic chemotherapy for solid tumors.

PURPOSE: The prevalence of hepatitis B virus (HBV) reacti- vation in HBsAg-negative/anti-HBc-positive patients receiving chemotherapy for solid tumors is not fully known. The aim of this study was to investigate the incidence and outcomes of HBV reactivation in these patients. METHODS: Data among 645 HBsAg-negative/ anti-HBc-positive patients who underwent intravenous chemotherapy were retrospectively analyzed. Patients were categorized into two groups, based on received antiviral prophylaxis (n = 43) or not (n = 602). HBV reactivation was defined as the presence of detectable serum HBV DNA or HBsAg seroconversion from negative to positive, with or without increased liver enzymes. RESULTS: HBV reactivation was detected in 3 patients (0.49%) among non-antiviral prophylaxis group and in none of those with antiviral prophylaxis. Two of the HBV reactivation detected patients were successfully treated with rescue therapy, while the third died due to liver failure. CONCLUSIONS: HBV reactivation is rare in HBsAg-negative and anti-HBc-positive patients receiving chemotherapy for solid tumors. However, considering the fatal outcomes patients must be closely monitored in terms of HBV-DNA positivity and/or HBsAg seroreversion and pre-emptive antiviral therapy must be initiated as soon as HBV reactivation occurs.

Analysis of gene copy number changes in head and neck cancer.

OBJECTIVE: Chromosomal alterations and copy number changes are frequent events in tumors, leading to amplification of focal regions containing several oncogenes. Gains and losses of several regions have been reported in head and neck cancer (HNC) but the copy number changes of the individual genes located in these regions have not been analyzed so far. In this study we aimed to analyze the copy number variations in patients with HNC. DESIGN: Prospective study SETTING: University hospital PARTICIPANTS: 50 patients with squamous cell carcinoma of the head and neck METHODS: Copy number changes and amplifications of 22 genes in tumors and matched tissue were analyzed by MLPA which allows simultaneous analysis of gene copy numbers in multiple genetic regions. RESULTS: Amplifications were observed in 52% and losses were detected in 20% of the samples. Chromosome 8 was found to harbor the most frequent copy number alterations. The most frequently amplified genes were CCND1 and the MED1 genes followed by the MTDH and MYC genes on the long arm and ZNF703 on the short arm of chromosome 8. Amplification of the ZNF703, PRDM14 and MYC genes were highly correlated suggesting that the genes displaying high copy number changes on chromosome 8 collaborate during carcinogenesis. CONCLUSIONS: The alterations found in our study supports the contribution of gene amplifications and indicate cooperation between certain oncogenes in the pathogenesis of HNSCC. Correlations between amplification of less familiar genes and known oncogenes warrant further investigation. This article is protected by copyright. All rights reserved.

Clinical Evaluation of a Silorane- and a Methacrylate-Based Resin Composite in Class II Restorations: 24-Month Results.

OBJECTIVE: To compare the 24-month clinical performance of two different resin composites in class II slot restorations. METHODS AND MATERIALS: Thirty-seven patients having at least two approximal carious lesions were enrolled in the study. A total of 116 teeth (58 pairs) were restored with either a silorane-based composite (Filtek Silorane) and its self-etch adhesive (Silorane Adhesive System, 3M ESPE) or a methacrylate-based packable resin composite (X-tra Fil) and its self-etch adhesive (Futurabond NR, VOCO GmbH) according to the toss of a coin. The restorations were evaluated at baseline and at six-, 12-, and 24-month recalls by two calibrated examiners according to the modified US Public Health Service criteria. The comparison of the two restorative materials for each category was performed with the Pearson chi-square test. Within group differences of the materials at different recall times were compared using the Cochran Q and Friedman tests. Bonferroni-adjusted McNemar test was used when significant difference was found (p<0.05). RESULTS: After 24 months, no statistically significant differences were found between the two restorative materials for the criteria evaluated. CONCLUSIONS: Both silorane- and methacrylate-based resin composites showed clinically acceptable performance in class II slot restorations after 24 months.

End-to-end anastomosis in the management of laryngotracheal defects.

OBJECTIVE: To present clinical experience and surgical outcomes of end-to-end anastomosis in the management of laryngotracheal stenosis and tracheal defects following invasive thyroid malignancy resection. METHODS: A retrospective analysis was performed of 14 patients with laryngotracheal stenosis and tracheal invasive thyroid malignancy. All patients underwent tracheal or cricotracheal resection and primary end-to-end anastomosis. RESULTS: Length of stenosis was 1.7-4 cm. Stenosis was classified as Myer and Cotton grade II in 4 patients, grade III in 6 and grade IV in 2. Surgical procedures included tracheotracheal end-to-end anastomosis (n = 4), cricotracheal anastomosis (n = 2) and thyrotracheal anastomosis (n = 6). Patients with invasive thyroid malignancy underwent segmental resection of the involved segment with tumour-free margins, and tracheal or cricotracheal end-to-end anastomosis. Successful decannulation was achieved in 13 patients (93 per cent). Post-operative complications were: wound infection (n = 1), subcutaneous emphysema (n = 1), temporary unilateral vocal fold palsy (n = 1), granulation tissue development (n = 1), and restenosis (n = 2). CONCLUSION: End-to-end anastomosis can be used safely and successfully in the management of advanced laryngotracheal stenosis and wide laryngotracheal defects. Greater success can be achieved using previously described surgical rules and laryngotracheal release manoeuvres.

Bayesian inference of genetic parameters for ultrasound scanning traits of Kivircik lambs.

Ultrasound scanning traits have been adapted in selection programs in many countries to improve carcass traits for lean meat production. As the genetic parameters of the traits interested are important for breeding programs, the estimation of these parameters was aimed at the present investigation. The estimated parameters were direct and maternal heritability as well as genetic correlations between the studied traits. The traits were backfat thickness (BFT), skin+backfat thickness (SBFT), eye muscle depth (MD) and live weights at the day of scanning (LW). The breed investigated was Kivircik, which has a high quality of meat. Six different multi-trait animal models were fitted to determine the most suitable model for the data using Bayesian approach. Based on deviance information criterion, a model that includes direct additive genetic effects, maternal additive genetic effects, direct maternal genetic covariance and maternal permanent environmental effects revealed to be the most appropriate for the data, and therefore, inferences were built on the results of that model. The direct heritability estimates for BFT, SBFT, MD and LW were 0.26, 0.26, 0.23 and 0.09, whereas the maternal heritability estimates were 0.27, 0.27, 0.24 and 0.20, respectively. Negative genetic correlations were obtained between direct and maternal effects for BFT, SBFT and MD. Both direct and maternal genetic correlations between traits were favorable, whereas BFT-MD and SBFT-MD had negligible direct genetic correlation. The highest direct and maternal genetic correlations were between BFT and SBFT (0.39) and between MD and LW (0.48), respectively. Our results, in general, indicated that maternal effects should be accounted for in estimation of genetic parameters of ultrasound scanning traits in Kivircik lambs, and SBFT can be used as a selection criterion to improve BFT.

Expression of VEGF and CD68 in the placenta of gestational diabetic mothers (immunohistochemistry and ultrastructural study) / Expresión de VEGF y CD68 en la placenta de madres diabéticas gestacionales (estudio inmunohistoquímico y ultraestructural)

Placental angiogenesis, is essential for embryonic and fetal development. In this study, 18 gestational diabetes mellitus and 22 control pregnancies were included. Gestational diabetes mellitus (GDM) groups compared to the control group significantly higher values were detected (p<0.01). The following histological results were assessed; villous immaturity, chorangiosis, presence of, sncytial knots,mononuclear cell infiltration ischemia and fibrinoid necrosis. To evaluate and compare the placental histology of normal and GDM pregnancies. placentas of pregnant women with gestational diabetes also in terms of angiogenesis and macrophages and ultratructural revealed by examining the possible relationship between fetal complications were investigated.

La angiogénesis de la placenta es esencial para el desarrollo embrionario y fetal. En este estudio, se incluyeron 18 casos de diabetes mellitus gestacional (DMG) y 22 embarazos de control. En grupos los de DMG en comparación con el control, se detectaron valores significativamente mayores (p<0,01) en los siguientes parámetros histológicos que fueron evaluados: inmadurez vellosa, chorangiosis, presencia de nodos sincicial, infiltración celular isquémica mononuclear y necrosis fibrinoide. La investigación de las placentas de mujeres con DMG, reveló mediante el examen en términos de angiogénesis, macrófagos y ultraestructural, la posible relación entre las complicaciones fetales.

Expression of human chorionic gonadotropin (ßhCG) in pre-eclamptic placenta / Expresión de gonadotropina coriónica humana (ßhCG) en placenta preeclámptica

This study aimed to assess association between preeclampsia with trophoblast cells and serum level of b-human chorionic gonadotropin (ß-hCG). Were compared 20 patients with preeclampsia and 20 control patients with respect to demographics, hematological parameters and the presence of trophopblast in placental samples. Patchy necrosis with loss of microvilli and gross thinning of the syncytium with distorted microvilli were seen in terminal villi of placentae of women with pre-eclampsia Syncytial cells at the molecular level crossings, especially at the level of ßhCG in conjunction with the changes in the preeclampsia was made on the histopathological changes to clarify the villi.

El objetivo fue evaluar la asociación entre la preeclampsia con células trofoblásticas y concentración sérica de la gonadotropina coriónica humana b (ß-hCG). Se compararon 20 pacientes con preeclampsia y 20 pacientes de control con respecto a datos demográficos, parámetros hematológicos y la presencia de trofoblasto en muestras de placenta. Se observaron áreas dispersadas de necrosis, con pérdida de microvellosidades y adelgazamiento del sincitio con microvellosidades distorsionadas en las vellosidades terminales de placentas en mujeres con células sincitiales preeclámticas a nivel molecular, junto a altos niveles de ßhCG asociados a los cambios generados por la preeclampsia sobre los parámetros histopatológicos.

The effect of LKB1 on the PI3K/Akt pathway activation in association with PTEN and PIK3CA in HNC.

OBJECTIVE: PI3K/Akt signalling pathway is frequently activated in several types of cancer. However, activator molecules have not been analysed systematically in HNSCC. The aim of this study was to investigate upstream activators and inhibitors of this pathway. DESIGN: Prospective study. SETTING: University hospital. PARTICIPANTS: 108 patients with HNC who were operated at the Istanbul University, Cerrahpasa Medical Faculty, Department of Otorhinolaryngology. METHODS: Mutations in the coding exons and the flanking intronic sequences of the PIK3CA, PIK3R1 and AKT1 genes were analysed by direct sequencing. Expression levels in the tumours and non-cancerous tissue samples were analysed by quantitative RT-PCR, and Western blotting was performed to determine the phosphorylation levels of the Akt1 protein. RESULTS: Two synonymous alterations in exon 20 of the PIK3CA gene, a 6-bp duplication in the coding region of the PIK3R1 and two different alterations in the non-coding regions of the AKT1 and PIK3R1 genes were observed. Significant downregulation of LKB1 and PTEN mRNA expression levels were detected in tumour tissues compared to non-cancerous tissues. However, we did not observe any difference between the PIK3CA and AKT1 mRNA expression levels in the tumours and non-cancerous tissue samples. Akt1 phosphorylation was increased in 53.57% of the patients. CONCLUSIONS: Our results indicate that the PI3K pathway has an important function in HNSCC progression with the contribution of more than one gene of this pathway. Our data suggest that in a high number of HNSCC tumours, PI3K/Akt signalling is activated by different molecules or by the combination of these molecules.

Egg shell quality in Japanese quail: characteristics, heritabilities and genetic and phenotypic relationships.

The objective of the present study was to estimate heritabilities as well as genetic and phenotypic correlations for egg weight, specific gravity, shape index, shell ratio, egg shell strength, egg length, egg width and shell weight in Japanese quail eggs. External egg quality traits were measured on 5864 eggs of 934 female quails from a dam line selected for two generations. Within the Bayesian framework, using Gibbs Sampling algorithm, a multivariate animal model was applied to estimate heritabilities and genetic correlations for external egg quality traits. The heritability estimates for external egg quality traits were moderate to high and ranged from 0.29 to 0.81. The heritability estimates for egg and shell weight of 0.81 and 0.76 were fairly high. The genetic and phenotypic correlations between egg shell strength with specific gravity, shell ratio and shell weight ranging from 0.55 to 0.79 were relatively high. It can be concluded that it is possible to determine egg shell quality using the egg specific gravity values utilizing its high heritability and fairly high positive correlation with most of the egg shell quality traits. As a result, egg specific gravity may be the choice of selection criterion rather than other external egg traits for genetic improvement of egg shell quality in Japanese quails.

Depression, self-esteem and sexual function in laryngeal cancer patients.

OBJECTIVE: The purpose of this study was to assess sexual function, affective disorders and self-esteem in patients who were surgically treated for laryngeal cancer. DESIGN: Retrospective, blind, cross-sectional study. SETTING: Single tertiary cancer centre. PARTICIPANTS: Seventy four patients who were operated on Istanbul University Cerrahpasa School of Medicine Otorhinolaryngology Department between 2008 and 2012 were classified according to the type of the operation as total laryngectomy (Group 1) and partial laryngectomy (Group 2). MAIN OUTCOME MEASURES: Sexual dysfunction, depression and self-esteem were evaluated with The Arizona Sexual Experiences Scale (ASEX), Beck's Depression Inventory (BDI) and Rosenberg Self-Esteem Scale (RSES), respectively. RESULTS: Average ASEX scores of the Group 1 were (13.98 ± 6.32) and Group 2 were (13.08 ± 4.96) without statistically significant difference (P = 0.537). Mean BDI score of Group 1 was (13.20 ± 10.41) higher than Group 2 (7.76 ± 8.14) and the difference was significant statistically (P = 0.026). Mean RSES scores of Group 1 and Group 2 were 20.68 ± 5.33 and 19.25 ± 4.70, respectively, again without significant difference (P = 0.262). However, when the average scores of each item of Rosenberg Scale were compared, significant difference was found in d4 (2.37 ± 0.78; 1.64 ± 0.99; P = 0.001), d6 (1.22 ± 1.05; 1.84 ± 1.14; P = 0.023), d10 (2.55 ± 2.39; 1.28 ± 1.49; P = 0.018) and d11 (1.35 ± 0.95; 2.00 ± 1.41; P = 0.021). BDI scores were correlated with RSES scores, and ASEX scores were correlated with age. CONCLUSION: The patients with total laryngectomy seem to have more psychological problems that must be addressed in the postoperative period.

Polymerization shrinkage of different types of composite resins and microleakage with and without liner in class II cavities.

AIM: To determine the volumetric polymerization shrinkage of four different types of composite resin and to evaluate microleakage of these materials in class II (MOD) cavities with and without a resin-modified glass ionomer cement (RMGIC) liner, in vitro. MATERIALS AND METHODS: One hundred twenty-eight extracted human upper premolar teeth were used. After the teeth were divided into eight groups (n=16), standardized MOD cavities were prepared. Then the teeth were restored with different resin composites (Filtek Supreme XT, Filtek P 60, Filtek Silorane, Filtek Z 250) with and without a RMGIC liner (Vitrebond). The restorations were finished and polished after 24 hours. Following thermocycling, the teeth were immersed in 0.5% basic fuchsin for 24 hours, then midsagitally sectioned in a mesiodistal plane and examined for microleakage using a stereomicroscope. The volumetric polymerization shrinkage of materials was measured using a video imaging device (Acuvol, Bisco, Inc). Data were statistically analyzed with Kruskal-Wallis and Mann-Whitney U-tests. RESULTS: All teeth showed microleakage, but placement of RMGIC liner reduced microleakage. No statistically significant differences were found in microleakage between the teeth restored without RMGIC liner (p>0.05). Filtek Silorane showed significantly less volumetric polymerization shrinkage than the methacrylate-based composite resins (p<0.05). CONCLUSION: The use of RMGIC liner with both silorane- and methacrylate-based composite resin restorations resulted in reduced microleakage. The volumetric polymerization shrinkage was least with the silorane-based composite.

Cuspal deflection in premolar teeth restored using current composite resins with and without resin-modified glass ionomer liner.

AIM: To evaluate the effects of four different types of composite resins and a resin modified glass ionomer cement (RMGIC) liner on the cuspal deflection of large MOD cavities in vitro. MATERIALS & METHODS: One hundred twenty-eight extracted human upper premolar teeth were used. After the teeth were divided into eight groups (n=16), standardized large MOD cavities were prepared. The distance between cusp tips was measured before and after the cavity preparations with a digital micrometer. Then the teeth were restored with different resin composites (Filtek Supreme XT, Filtek P60, Filtek Z250, Filtek Silorane - 3M ESPE, St Paul, MN, USA) with and without a RMGIC liner (Vitrebond, 3M ESPE, St Paul, MN, USA). Cuspal deflection was measured 5 min, 24 h, and 48 h after the completion of restorations. The data were statistically analyzed with Friedman and Kruskal Wallis tests. RESULTS: A significant reduction in cuspal deflection was observed in Filtek Silorane restorations with and without RMGIC liner (p<0.05). In all restored teeth, the distance between cusps was reduced but they did not return to their original positions during the 48 h period. All teeth showed cuspal deflection, but placement of RMGIC liner reduced it. CONCLUSION: The use of silorane-based composites and the placement of RMGIC liner under the composite resin restorations resulted in significantly reduced cuspal deflection.

Comparison of acid versus laser etching on the clinical performance of a fissure sealant: 24-month results.

OBJECTIVE: To compare the clinical performance of a pit and fissure sealant placed with the use of different enamel preparation methods, i.e. acid or Er,Cr:YSGG laser etching, over 24 months. METHODS: Sixteen subjects (15 female, 1 male) with no restorations or sealant present on their fissures and no detectable caries participated. Using a table of random numbers, a total of 112 sealants (56 with acid-etching, 56 with laser etching) were placed on the permanent premolar and molar teeth. All restorative procedures except for application of the laser were performed by the same dentist. After completion of the fissure preparation either with acid or laser, the adhesive was applied; then a pit and fissure sealant, Clinpro Sealant, was placed and polymerized. Clinical evaluations were done at baseline and at 6-, 12-, 18-, and 24-month follow-up visits by two calibrated examiners, who were unaware of which etching method had been used. The retention of sealants and caries were evaluated with the aid of a dental explorer and an intra-oral mirror. Each sealant was evaluated using the following criteria: 1=completely retained; 2= partial loss; 3= total loss. The Pearson chi-square test was used to evaluate differences in the retention rates among the sealants used with different etching methods. RESULTS: All patients attended the 24-month follow-up visit and all sealants were evaluated (total recall rate 100%). At the end of 24 months, 83.9% of the sealants from laser group and 85.7% of those from acid-etch group were recorded as "completely retained". There were no statistically significant differences in retention rates among the preparation methods after all evaluation periods (p>0.05). No statistically significant differences were found between the retention rates of premolar and molars at each evaluation period. No secondary caries was detected in association with any sealants. CONCLUSION: The clinical performance of fissure sealants placed after acid or Er,Cr:YSGG laser etching was similar.

A 48-month clinical evaluation of fissure sealants placed with different adhesive systems.

AIM: To compare the retention rates of a nanofilled occlusal fissure sealant placed with the use of an etch-and-rinse or a self-etch adhesive over 48 months. MATERIALS AND METHODS: The authors enrolled 244 teeth, each with no restoration or sealant and no detectable caries, from 16 patients. The sealants were placed with Solobond M two-step etch-and-rinse adhesive or Futurabond NR one-step self-etch adhesive by four previously calibrated dentists using a table of random numbers. After completion of the adhesive application, a nanofilled sealant, Grandio Seal, was applied and light-cured. Two other calibrated examiners, who were unaware of which adhesive had been used, independently evaluated the sealants at baseline and at 12-, 24-, 36-, and 48-month recalls. Each sealant was evaluated in terms of caries formation being present or absent and retention using the following criteria: 1 = completely retained, 2 = partial loss, and 3 = total loss. The Pearson χ (2) test was used to evaluate differences in retention rates among the sealants used with different adhesives for each evaluation period. RESULTS: The retention rates for sealants in the Solobond M group were significantly higher than those in the Futurabond NR group in all periods of evaluation (p<0.05). No statistically significant difference between the retention rates for premolars and molars was found at each evaluation period (p>0.05). There was no new caries formation throughout the 48-month recall period. CONCLUSION: Fissure sealants placed with etch-and-rinse adhesive showed better retention rates than those placed with self-etch adhesive.

[A rare case of cervical lymphadenopathy--Kikuchi-Fujimoto's disease].

Kikuchi-Fujimoto's disease is a form of histocytic necrotizing lymphadenitis that largely affects women of Asian descent. The cause of this pathology remains to be elucidated although it is supposed that it has immunological and infectious nature. Clinically, Kikuchi-Fujimoto's disease manifests itself as unilateral lymphadenoapthy accompanied by febrile state and other non-specific symptoms. The diagnosis is based on the results of puncture (in the first place, excision) biopsy. No effective treatment of histocytic necrotizing lymphadenitis has thus far been proposed. Spontaneous regression of lymphadenopathy may occur within 1-6 months after the onset. A clinical observation of a 36 year-old patient presenting with a confirmed form of Kikuchi-Fujimoto's disease is presented.

Effect of septoplasty and per-operative antibiotic prophylaxis on nasal flora.

OBJECTIVES: Septoplasty is one of the most commonly performed procedures in otolaryngology practice. Prophylactic use of antibiotics is controversial. Disruption of nasal flora may predispose individuals to infection. We investigated the effect of antibiotic prophylaxis and septoplasty on nasal flora. METHODOLOGY: We included 115 consecutive patients who underwent septoplasty because of symptomatic nasal septal deviation. Patients were divided into study and control groups. Study patients received prophylactic parenteral sodium cefazoline twice a day beginning intra-operatively and while the nasal packing remained in the nose for 48 h, and expandable polyvinyl acetate (Merocel) packing covered with antibiotic ointment containing 0.2% nitrofurazone was inserted into each nostril at the end of the operation. Control patients received neither parenteral antibiotic prophylaxis nor antibiotic ointment around the Merocel packs. Both groups received oral prophylactic cefuroxime axetil for 5 d after nasal packing was removed. Nasal flora was determined pre-operatively, post-operatively when nasal packing was removed, and 3 mo after surgery. RESULTS: Study patients were compared to control patients at pack removal and 1 mo after surgery The effect of antibiotic use in septoplasty on nasal flora was as follows: Increased isolation rate of gram-positive rods (p = 0.007), decreased methicillin-sensitive coagulase-negative staphylococci (p = 0.002). Pre-operative and post-operative culture results at 3 mo were compared. The effect of septoplasty on nasal flora was as follows: Decreased coagulase-negative staphylococci (p = 0.05), decreased Klebsiella (p < 0.001), decreased gram-positive rods (p < 0.001), increased methicillin-sensitive Staphylococcus aureus (p < 0.001). CONCLUSIONS: Septoplasty increases S. aureus colonization and decreases normal flora. Antibiotics do not protect against S. aureus colonization and contribute to a decrease in normal flora. Antibiotics do not seem to confer benefit in terms of flora changes. Studies investigating flora changes with a longer follow-up should be conducted.