Evaluation of panoramic radiographs taken from 1,056 Turkish children.

OBJECTIVE: Panoramic radiographs (PRs) play an important role in the diagnosis and treatment planning of a wide range of dental and maxillofacial diseases and conditions. To examine and to determine the status of oral lesions, dental anomalies and pathologies in panoramic radiographs, which were taken at the department of pediatric dentistry, Dental School, Marmara University, Istanbul, Turkey. MATERIALS AND METHODS: This retrospective study consists of 1,056 randomly selected PRs of children aged from 4 to 12 years old, conducted at the department of pediatric dentistry at Dental School, Marmara University, between 5 th December 2011 and 17 th January 2012. The following information was obtained from the patients' records and PRs: Gender, age, presence or absence of oral lesions, dental anomalies and pathologies such as mesiodentes, supernumerary teeth, odontoma, radicular cyst, impacted tooth, and fusion. RESULTS: One thousand and fifty-six PRs from 520 girls and 536 boys were observed. The mean and standard deviation age of the patients was 8.43 ± 2.17. Among 1,056 patients, 457 (43.28%) of them had oral lesions, discovered by the PRs. The age of these 457 patients was ranged from 4 to 12 years. There were 37 (3.50%) mesiodentes, 9 (0.85%) supernumerary teeth, 4 (0.38%) odontoma, 12 (1.14%) radicular cyst, 16 (1.52%) impacted tooth, and 20 (1.89%) fusion. CONCLUSIONS: Oral lesions with a rate of 43.28% could be detected relatively at early age, as presented in the present study. Early treatment of these lesions, dental anomalies, and pathologies could avoid maxillofacial deformity and other complications.

Evaluation of vitamin D receptor (VDR) gene polymorphisms (FokI, TaqI and ApaI) in a family with dentinogenesis imperfecta.

Dentinogenesis imperfecta Type II (DGI-II) is a condition inherited as an autosomal dominant trait and characterized by abnormal dentine structure affecting both the primary and secondary dentitions. The genetic etiology of the disease still remains unclear, suggesting a genetically heterogeneous background. The aim of this study is to manifest briefly DGI-II and to investigate the association between BsmI, TaqI and FokI polymorphisms of Vitamin D receptor (VDR) gene and dentinogenesis imperfecta type II in a Turkish family by PCR-RFLP methodology. The affected mother and her two affected daughters were bb for BsmI polymorphism, whereas her unaffected son and her husband were Bb for the same polymorphism. One of the affected children was tt, the rest of the family were Tt for TaqI polymorphism, and all of the enrolled subjects were FF for FokI polymorphism. As a conclusion, BsmI polymorphism bb seems to be associated with (DGI-II), but should be examined in larger numbers in order to be considered as a risk factor.

Incidence and prevention of traumatic injuries in paediatric handball players in Istanbul, Turkey.

AIM: To investigate the frequency of dental injuries in paediatric handball players. In addition, the players' habits with regard to mouthguard usage, as well as their general knowledge of the prevention of traumatic dental injuries (TDIs) were investigated. Data were collected by structured one-to-one interviews with children of 14 randomly selected handball teams in the amateur national league. METHODS: The questionnaire consisted of 15 questions. The age, gender, trauma experience and league status of each interviewee was recorded. The interviews took place mainly at national championships or tournaments. RESULTS: A total of 212 individuals, 74 girls and 138 boys, were interviewed. Forty-one of the 212 participants (19.3 %) had sustained a dental injury. The mean age of participants was 12 ± 1.6 years. Concussion was the most frequent finding and the cause of injury was a blow from another player. The number of individuals that were aware of mouthguards was only 15.6 % and surprisingly no players used mouthguards. CONCLUSIONS: The results show that handball players need more knowledge and education considering the prevention of TDIs from their sports clubs and dentists. The importance of adequate facial protection in contact sports should be endorsed by all sports clubs, and parents advised accordingly.

Chronic hepatitis C responds poorly to combination therapy in chronic hepatis B carriers.

BACKGROUND: The effect of conventional interferon-based therapy of hepatitis B virus (HBV) and hepatitis C virus (HCV) dual infection is controversial. Yet, no studies have been carried out into pegylated interferon treatment for chronic HBV/HCV coinfection. We aimed to evaluate the response rate and side effects of conventional or pegylated interferon combined with ribavirin on chronic HBV/HCV coinfection therapy. METHODS: The study included 36 chronic hepatitis patients (M/F: 28/8, mean age 47+/-12 years) who were positive for HBsAg and anti-HCV. They were tested for the presence of HBV-DNA by hybridisation assay, and the samples giving negative results were retested by polymerase chain reaction (PCR). All patients were tested for HCV-RNA using PCR, and the HCV genotype was determined. RESULTS: Nineteen patients were given standard interferon either alone or in combination with ribavirin, whereas 17 were given pegylated interferon and ribavirin combination therapy. None of the patients had HBV-DNA positivity; however, all had HCV-RNA detectable by PCR. All the patients had HCV genotype 1b. The mean alanine aminotransferase and aspartate aminotransferase levels were 118+/-65 U/l and 90+/-95 U/l respectively. Five patients in each group discontinued the treatment due to side effects. Only two patients (one from each group) reached sustained virological response. CONCLUSION: Neither pegylated nor conventional interferon based regimes were effective for HBV/HCV coinfection, in which the dominant virus was HCV. Pegylated interferon and ribavirin therapy was not superior to conventional interferon based regimes in the treatment of HBV/HCV coinfection.

Clinical, biochemical and histological correlations in a group of non-drinker subjects with non-alcoholic fatty liver disease.

The correlation between biochemistry, imaging-studies and histology is a matter of controversy in non-alcoholic fatty liver disease (NAFLD) and the major pathophysiology of non-alcoholic steatohepatitis (NASH) is still unknown. We aimed to perform a comparative analysis between clinical, biochemical and histological variables of NAFLD. One-hundred and five NAFLD patients (F/M: 51/54), were studied, all with no-alcohol intake. The groups were followed-up for six months. Necroinflammation and fibrosis were more severe in patients with diabetes (p = 0.002, and p = 0.0001, respectively). In comparing NAFL to NASH, plasma nitric-oxide and malondialdehyde levels were significantly higher (p = 0.05, for-both), and vitamin-E and-C levels were significantly lower in NASH (p = 0.002, and 0.001, respectively). The serum ferritin levels were higher in NASH patients (p = 0.016). While the ultrasonographic grade was significantly higher, the liver-spleen density gradient was significantly lower in NASH group (p = 0.017, and 0.005, respectively). Within a six month period, serum ALT levels dropped into the normal range in 23/76 (30.3%) patients and serum ALT in the 6th month correlated significantly with the severity of steatosis, inflammation and fibrosis in initial biopsy (p = 0.023, 0.035, 0.011, respectively). In conclusion, the probability of severe liver disease is higher in patients with elevated-ALT in NAFLD. Serum ferritin levels have some prognostic significance in liver damage and fibrosis. Overt diabetes is predictive of advanced fibrosis and inflammation. However impaired glucose-tolerance is not. The advice on diet and exercise for six months after diagnosis may be a good strategy in NAFLD. The patients with normal-ALT without hepatomegaly, morbid-obesity and diabetes seem to have a good prognosis, however some of these patients may still require liver biopsy.

Diffuse diabetic glomerulosclerosis in a patient with impaired glucose tolerance: report on a patient who later develops diabetes mellitus.

Diabetic glomerulosclerosis might be seen in diabetics but its presence in patients with impaired glucose tolerance is quite rare. A 31-year-old woman who was admitted to our department was diagnosed with hypertension, nephrotic syndrome and impaired glucose tolerance. Her renal biopsy was compatible with diabetic glomerulosclerosis. She developed overt diabetes mellitus (DM) after one year of impaired glucose tolerance. Hypertension might have accelerated the progression of diabetic nephropathy.

Follow-up of a patient with chronic hepatitis C-associated cryoglobulinemia during four and a half years of maintenance interferon treatment.

In this report, we present a patient with chronic hepatitis C-associated cryoglobulinemia who was kept on maintenance interferon treatment because of flare-ups in cryoglobulinemia-associated signs and hepatitis after withdrawal, dose reduction, and increase in dose intervals of interferon. This type of interferon use for treatment of cryoglobulinemia gave us a chance to observe the long-term effects of interferon on cryoglobulinemia and chronic hepatitis C remission for biochemical, virologic, and histologic aspects.

Right ventricular aneurysm complicating right ventricular infarction.

Right ventricular (RV) involvement commonly occurs in patients with acute inferior myocardial infarction and is associated with high mortality and morbidity. RV dysfunction and dilatation commonly recover in survivors; chronic RV dyskinesia and failure are rare complications. This case report presents a patient in whom an isolated RV aneurysm complicates a RV involvement of acute inferior-posterior myocardial infarction.

Intermittent mode reversion to VOO of a dual chamber pacemaker model.

This report describes an asymptomatic patient with a DDDR pacemaker system (Inos Cls, Biotronik) that showed intermittent mode reversion to VOO and sometimes to VVI without a detectable source of electromagnetic interference and oversensing. Patients with this Biotronik model should be carefully assessed along with a surface ECG before placing the programming head.

Chylous ascites after liver transplantation with mesentero-portal jump graft.

Chylous effusions and lymphatic leaks occur after trauma, malignant disease, primary lymphatic disorders, and parasitosis, and rarely after abdominal surgery. Chylous ascites after orthotopic liver transplantation is a rare complication. We report a case of chylous ascites occurring after hepatic transplantation with a mesentero-portal venous jump graft, successfully treated with conservative management.

[Quantitative ultrasonic myocardial texture analysis of the diabetic heart]. / Diyabet kalbinin kantitatif ultrasonik miyokard dokusu analizi.

OBJECTIVE: Contraction and relaxation of the heart cause decrease and increase in myocardial video intensity (MVI) recorded from echocardiographic images, respectively. The present study was planned to compare this physiological cyclic variations of MVI in patients with type 1 diabetes mellitus and healthy subjects. METHODS: For this purpose, standard echocardiographic examination was performed to 18 young patients (age 23.2+6.4; range: 15-37 years) with insulin dependent type 1 diabetes mellitus (diabetes duration: 7.8+5.6; range: 1-17 years) and 14 age and sex matched controls. In all subjects, end-diastolic and end-systolic 2D echocardiographic images of 3 consecutive beats that had been recorded on videotapes were digitized. The quantitative analysis of digitized imaging was performed with the help of a calibrated digitization system in order to calculate the septum and the posterior wall textural parameters. The cyclic variation index (CVI) of the mean gray level (MGL) was calculated according the formula: (MGL dias- MGL diast x 100. RESULTS: Among the groups, left ventricular diastolic dimension-index, fractional shortening, E/A ratio, and isovolumic relaxation time showed no statistically significant differences, while septum and (8.3+1.1 vs. 7.3+0.9 mm; p=0.016) and posterior wall thickness (8+0.6 vs. 6.8+1.1mm; p=0.004) and E-deceleration time (167+23 vs. 140=19 msec.; p=0.003) were significantly higher in diabetics. The diabetic patients showed significantly lower CVI both for septum (18.2+11.5% vs. 39.3+11.5%; p=0.0001) and posterior wall (16.4+16% vs. 40.5+9.2%; p=0.0001), respectively. CONCLUSIONS: Altered videoensitometric parameters possibly represent a preclinical alteration, conceivably related to the myocardial collagen content increase, which does not necessarily indicate an actual disease but may be considered an early marker of the histopathologic findings of diabetic cardiomyopathy.