Comparison of the Color Change of Porcelain Laminate Veneers Produced by Different Materials After Luting with Three Resin Cements.

OBJECTIVES: This study aimed to compare color change of porcelain laminate veneers fabricated with two lithium disilicate ceramics and a zirconia-reinforced lithium silicate ceramic material after luting with conventional dual-cure, amine-free dual-cure, or light-cure resin cements using artificial accelerated aging (AAA). METHODS AND MATERIALS: Ninety noncarious human maxillary central incisors were embedded in autopolymerizing acrylic resin blocks to prepare conventional laminate veneers with incisal coverage. Prepared teeth were randomly divided into 3 groups (n=30) to fabricate laminate veneer restorations using: (1) lithium disilicate ceramic, (2) lithium disilicate ceramic with high-density micronization, and (3) zirconia-reinforced lithium silicate ceramic. Impressions of the preparations were taken with a laboratory scanner. Acquired 3D images were processed into a surface tessellation language file. Data were exported for 3D printing on a printer, and laminate veneers were printed in castable wax resin. Ceramic veneers were heat-pressed after investment according to the manufacturer's recommendations and further divided into three groups (n=10) according to luting cement type: (1) light-cure resin cement, (2) amine-free dual-cure resin cement, and (3) conventional dual-cure resin cement. Color measurements were performed from the middle of each specimen with a spectrophotometer before and after AAA for 300 hours with a total energy of 150 kJ/m2. Color changes were calculated with the CIEDE 2000 (ΔE00) formula. Color differences were assessed using two-way analysis of variance (ANOVA) (α=0.05), and the paired t-test was used to compare the L*, a*, and b* parameters in each group before and after aging. RESULTS: There were no significant differences between the ceramic groups (p>0.05). The color changes of the materials ranged from 2.26 to 3.13. All materials were above the clinically acceptable limit (ΔE00>1.8). The conventional dual-cure resin cement group showed more color change (p>0.05). CONCLUSIONS: Color changes were observed in all porcelain laminate veneers after artificial accelerated aging. The zirconia-reinforced lithium silicate veneers showed similar color changes as lithium disilicate veneers; the amine-free dual-cure resin cement showed a similar color change as light-cure resin cement after aging.

Quantitative level determination of fixed restorations on panoramic radiographs using deep learning.

AIM: Although many studies in various fields employ deep learning models, only a few such studies exist in dental imaging. The present article aims to evaluate the effectiveness of convolutional neural network (CNN) algorithms for the detection and diagnosis of the quantitative level of dental restorations using panoramic radiographs by preparing a novel dataset. MATERIALS AND METHODS: 20,973 panoramic radiographs were used, all labeled into five distinct categories by three dental experts. AlexNet, VGG-16, and variants of ResNet models were trained with the dataset and evaluated for the classification task. Additionally, 10-fold cross-validation (ie, 9 folds were separated for training and 1 fold for validation) and data augmentation were carried out for all experiments. RESULTS: The most successful result was shown by ResNet-101, with an accuracy of 92.7%. Its macro-average AUC was also the highest, at 0.989. Other accuracy results obtained for the dataset were 75.5% for AlexNet, 85.0% for VGG-16, 92.1% for ResNet-18, 91.7% for ResNet-50, and 92.1% for InceptionResNet-v2. CONCLUSIONS: An accuracy of 92.7% is a very promising result for a computer-aided diagnostic system. This result proved that the system could assist dentists in providing supportive preliminary information from the moment a patient's first panoramic radiograph is taken. Furthermore, as the introduced dataset is powerful enough, it can be relabeled for different problems and used in different studies.

Effect of mixed feeds containing different levels of olive cake on fattening performance, carcass, meat quality and fatty acids of lambs.

In this study, the effects of diet including different levels of olive cake were investigated on the fattening performance, blood parameters, certain slaughtering traits, and carcass quality of lambs. Thirty-six male lambs were used in the experiment. The lambs were randomly assigned to three groups with 12 lambs each. Groups included control, 12.5 and 25% olive cake (OC). The mixed feeds were offered ad libitum. All lambs were also allowed to consume alfalfa hay (83.8 g DM/animal/day). The experiment lasted for a period of 56 days. The effect of different levels of olive cake was not found different in fattening performance values of lambs in 0-56 days (P > 0.05). Carcass weight, pH, and yield were not different (P > 0.05). While the values of color parameters, cooking loss, tenderness, and ether extract level of longissimus dorsi muscle (MLD) was not found different (P > 0.05), it was determined that the levels of olive cake increased the water-holding capacity of meat (P < 0.05). Furthermore, although the levels of olive cake were shown to decrease total n-3 and total saturated fatty acids (Σ SFA), they also increased total n-6, n-6/n-3 ratio, total monounsaturated fatty acids (Σ MUFA), and total polyunsaturated fatty acids (Σ PUFA) were not different (P > 0.05).

Factors predicting lapatinib efficacy in HER-2+ metastatic breast carcinoma: Does it work better in different histologic subtypes?

CONTEXT: Introduction of trastuzumab, a recombinant monoclonal antibody against the extracellular domain of HER-2, is a cornerstone in the treatment of HER-2+ breast carcinoma. However, many cancers that have an initial response to trastuzumab will progress some time later. After progression on trastuzumab-based first-line treatment, there are several options. Although TDM-1 (Trastuzumab emtansine) has prolonged progression-free survival (PFS) and overall survival in patients previously treated with trastuzumab and taxane, it is still not available in Turkey. Patients may be switched to lapatinib (an oral tyrosine kinase inhibitor targeting both HER-1 and HER-2), or they may re-challenge with trastuzumab. There is no clear definition of the patients who should be switched to lapatinib. AIM: In this study, we investigated the factors predicting the efficacy of lapatinib. SUBJECTS AND METHODS: Totally, 94 patients treated with lapatinib for metastatic breast carcinoma was included in our study. Retrospective data including pathology, treatments and treatment results, metastatic sites, and laboratory tests were collected. RESULTS: Progression-free survival was 9.1 months. Histologic subtypes other than invasive ductal carcinoma and liver metastasis were inversely related with PFS. Overall survival was 22.1 months, and patients with histologic subtypes other than invasive ductal carcinoma and who progress with brain metastasis had a worse prognosis. CONCLUSION: Clinicians should give attention to histologic subtype and metastatic sites when choosing patients for lapatinib treatment.

Line of abiraterone acetate in castration-resistant metastatic prostate cancer--Does it matter? report of a multi-institutional experience.

OBJECTIVE: We present our data comparing retrospectively the efficacy of abiraterone and cabazitaxel in patients who progress after docetaxel treatment. PATIENTS AND METHODS: The study included 56 patients diagnosed with hormone-refractory metastatic prostate cancer who were previously treated with abiraterone therapy at four oncology centers in Turkey. RESULTS: With abiraterone, the patients had a median progression-free survival (PFS) of 5.9 months (95% confidence interval (CI) for hazard ratio (HR) (4.4-7.4)) and an overall survival of 13.4 months (95% CI for HR (5.5-21.3)). When we compared the disease-free survival (DFS) of reference patients treated with cabazitaxel as a second-line treatment with those receiving second-line abiraterone therapy, there was no significant difference. (PFS = 5.9 months with cabazitaxel vs. 6.7 months with abiraterone, P = 0.213). CONCLUSION: This study has shown that in our experience abiraterone acetate is an effective agent in metastatic castration-resistant prostate cancer (mCRPC) regardless of the line of treatment.

Complete response of primary bladder adenocarcinoma with the FOLFOX4 regimen.

INTRODUCTION: Primary adenocarcinoma of the bladder is a very rare disease that is difficult to treat. In this paper, we report the second case in the literature with primary mucinous adenocarcinoma of the bladder which showed complete response to FOLFOX4 (fluorouracil, leucovorin, oxaliplatin) chemotherapy regimen. CASE REPORT: A 41-year-old man was admitted to our hospital with a diagnosis of primary adenocarcinoma of the bladder. Due to the similarity in histology with colon carcinoma, a FOLFOX4 regimen was started. Complete response was achieved at the end of this treatment. Today the patient is free of local or systemic disease. CONCLUSION: FOLFOX4 regimen may be a treatment option for primary adenocarcinoma of the bladder.

Can positron emission tomography-computed tomography predict response in locally advanced rectal cancer patients treated with induction folinic acid and 5-florouracil?

OBJECTIVE: The aim of this study was to determine the pathological complete response rates in a group of locally advanced rectal cancer patients who underwent chemoradiotherapy (CRT) after treatment with induction folinic acid and 5-florouracil (FOLFOX) chemotherapy and the relationship between the complete response and positron emission tomography-computed tomography (PET-CT). MATERIALS AND METHODS: The files of 239 patients who were diagnosed with rectal cancer between January 2008 and January 2012 were evaluated retrospectively. Of these, there were 24 locally advanced rectal cancer patients who met the following criteria: They were administered CRT after receiving four courses induction oxaliplatin, FOLFOX and they underwent PET-CT for staging and for the evaluation of their response to FOLFOX treatment. Of these 24 patients, 20 operable patients were included in the study. RESULTS: The pathological complete response was obtained in seven patients (35%) who were operated on and then given induction four courses FOLFOX chemotherapy and CRT. We determined that age, gender, clinical stage at diagnosis and PET-CT before and after induction chemotherapy were not predictive of the pathological complete response to tumor fluorodeoxyglucose uptake activity. CONCLUSION: The rates of pathological complete response were increased in locally advanced rectal cancer patients who underwent short-term induction chemotherapy. Although the PET-CT has retained its importance in predicting pathological complete response, there is still a need for studies with a larger number of patients and long-term follow-ups.

Effect of different levels of crude glycerol on the morphology and some pathogenic bacteria of the small intestine in male broilers.

The gut health of poultry is closely associated with feeds and feeding. The experiment was conducted to the effect of crude glycerol addition to diets of male broilers on the bacterial microflora and morphology of their small intestines (duodenum, jejunum and ileum). A total of 120 Ross 308 broiler chicks received diets containing 0% (GLY 0), 4% (GLY 4) or 8% (GLY 8) crude glycerol for 42 days. The presence of Coliform bacteria and Enterobacteria was reduced in the duodenal tract of the broilers of GLY 4 (P<0.001); however, the presence of Staphylococci/Micrococci in the GLY 8 was reduced relative to the other groups (P<0.001). The presence of Salmonella spp. decreased in conjunction with the increasing quantities of glycerol (P<0.001). Analysis of the data regarding gut morphology (epithelial cell thickness, villi length and width, and crypt length and width) indicated that the glycerol levels fed to the different groups of broilers represented statistically different results in the small intestine. In general, whereas the diet with 4% glycerol statistically affected the investigated parameters of the gut, the diet with 8% glycerol statistically affected some segments of the broiler intestines.

The importance of COX-2 expression as prognostic factor in early breast cancer.

PURPOSE: A number of studies have been carried out, showing that the risk for breast carcinoma is decreased in those using non-steroidal anti-inflammatory drugs (NSAIDs). Increased cyclooxygenase-2 (COX-2) level is considered as a factor indicating poor prognosis and responsible for angiogenesis, increased cellular proliferation, apoptotic defect and aromatase enzyme induction. For this reason the level of COX-2 might have a prognostic and predictive value in breast cancer as well. This question has become the basis of the present study. METHODS: Eighty-eight female patients with early stage breast cancer being under adjuvant anthracycline based chemotherapy were prospectively recruited. The patient age, body weight, menopausal status, tumor size and grade as well as axillary lymph node involvement were recorded. Routine pathological examination was performed, and COX-2, CerbB2 (HER2), estrogen (ER) and progesterone receptors (PR) levels in breast cancer tissue were determined immunohistochemically. RESULTS: Multivariate analysis confirmed the independent predictive value of both menopausal status and ER expression for overall survival (OS) (p=0.009, HR=1.92, and p=0.014, HR=0.20, respectively). A negative correlation was observed between COX-2 levels and the levels of ER and PR (p=0.006, R= -0.303, and p=0.004, R=-0.312, respectively) whereas no significant correlation was observed concerning CerbB2. No statistically significant correlation was determined between COX-2 levels and the disease-free (DFS) and OS rates. CONCLUSION: Further studies investigating the role of COX- 2 levels in breast cancer progression are needed.

Comparison of the effects of pulsatile cardiopulmonary bypass, non-pulsatile cardiopulmonary bypass and off-pump coronary artery bypass grafting on the respiratory system and serum carbonyl.

BACKGROUND: We aimed to investigate the effects of off-pump coronary artery bypass grafting (CABG), pulsatile cardiopulmonary bypass (CPB), and non-pulsatile CPB techniques on oxidative stress and the respiratory system in the current study. MATERIALS AND METHODS: The patients were allocated into three different groups according to perfusion techniques, as follows: off-pump CABG group (n=10); pulsatile CPB (n=11); and non-pulsatile CPB group (n=11). Serum carbonyl level was measured and a pulmonary function test was performed preoperatively and postoperatively. RESULTS: The postoperative increase in the carbonyl level was significantly lower in the off-pump CABG group compared to the other two groups, while there was no significant difference between the pulsatile and non-pulsatile CPB groups with respect to carbonyl levels. Arterial partial pressure of oxygen, forced expiratory volume in one second, and forced vital capacity were significantly higher in the off-pump CABG group compared to other two groups in the postoperative period. CONCLUSION: We found that off-pump CABG had less negative effects on oxidative stress and the respiratory system compared to pulsatile CPB and non-pulsatile CPB techniques. Additionally, there was no significant difference between pulsatile and non-pulsatile CPB.

Comparison of the effects of pulsatile cardiopulmonary bypass, non-pulsatile cardiopulmonary bypass and off-pump coronary artery bypass grafting on the inflammatory response and S-100beta protein.

BACKGROUND: We aimed to investigate the effects of off-pump coronary artery bypass grafting, pulsatile cardiopulmonary bypass, and non-pulsatile cardiopulmonary bypass techniques on the inflammatory response and the central nervous system in the current study. METHODS: A total of 32 patients who were scheduled for elective coronary artery bypass graft surgery were included in the study. The patients were allocated into three different groups according to the perfusion techniques used during the cardiopulmonary bypass procedure as follows: off-pump coronary artery bypass grafting group (n=10); pulsatile cardiopulmonary bypass group (n=11); and non-pulsatile cardiopulmonary bypass group (n=11). Serum interleukin-6, interleukin-8, tumor necrosis factor-alpha and S-100beta levels were measured preoperatively, and at 0, 6, and 24 hours postoperatively. RESULTS: The postoperative increase in the levels of interleukin-6 and interleukin-8 was significantly lower in the off-pump group compared to the other two groups (p<0.05), while there was no significant difference in tumor necrosis factor-alpha levels between the groups. Postoperative S-100ß levels, an indicator of cerebral injury, was significantly lower in the off-pump CABG group compared to the other two groups (p<0.05). CONCLUSION: We found that off-pump coronary artery bypass grafting had less negative effects on inflammatory response and central nervous system compared to pulsatile cardiopulmonary bypass and non-pulsatile cardiopulmonary bypass techniques.

Effect of gossypol on blood serum parameters and small intestinal morphology of male broilers.

Summary In the present study, the effect of varied gossypol (GOSS) amounts was investigated on blood parameters, the digesta pH, villus height, villus width, and crypta depth, width of duodenum, jejunum and ileum. A total of one hundred eight Ross 308 male broilers were fed with four diet groups as follows: no gossypol (control), gossypol rate 62 mg/kg (GOSS 62), gossypol rate 124 mg/kg (GOSS 124) and gossypol rate 186 mg/kg (GOSS 186). The effect of used gossypol amounts on blood parameters was not found to be statistically significant. Increases in digesta pH values of jejunum and ileum with GOSS 186 diet group were found to be statistically significant. The results also indicated that, except duodenum villus height, there was no statistical difference effect of GOSS on epithelial cell thickness, villus height, villus width, crypta depth and crypta width of the duodenum, jejunum and ileum. There have been no clearly negative effects of higher gossypol amounts up to 186 mg/kg diets on these parameters.

Frequency of comorbid illnesses in cancer patients in Turkey.

PURPOSE: Comorbidities in cancer patients can adversely affect the management and outcome of their primary illnesses at all levels from diagnosis to therapy. We sought to examine comorbid conditions of cancer patients, treated at 4 university hospitals, each representing a different geographic location in Turkey. METHODS: A total of 769 consecutive cancer patients presenting to outpatient clinics were recruited between November 2007 and May 2008. The patients filled in a questionnaire on comorbidities. Based on the questionnaire, Charlson Comorbidity Index (CCI( was calculated. RESULTS: The patient median age was 55 years (range 21-87) and 456 (59.3%) were female. Breast (36.5%), colorectal (21.4%) and lung cancers (13.9%) were the 3 most frequent malignancies. Of the patients, 59.3% had at least one comorbid disease and 46.3% were using at least one medication daily. The most frequent comorbidities were hypertension (25.3%), diabetes mellitus (13.1%) and peptic ulcer (7.7%). Increasing age positively correlated with the extent of comorbidities (r=0.30, p<0.001), number of medications (r=0.32, p<0.001) and the CCI (r=0.20, p<0.001). CONCLUSION: It is crucial to remember that comorbid illnesses are not rare and many patients are treated for conditions unrelated to their cancer, which potentially may affect various stages of their clinical management.

The predictors of the efficacy of high-dose chemotherapy and stem cell support in the management of metastatic germ cell cancer.

OBJECTIVES: We aimed to analyze the predictors of outcome in metastatic germ cell cancer (MGCC) patients treated with High-dose Chemotherapy (HDC) and stem cell rescue. BACKGROUND: Various prognostic factors have been suggested in the treatment of metastatic germ cell cancer. However, there is no comprehensive evaluation of independent prognostic factors for the efficacy of HDC in published patient cohorts. METHODS: Thirty-two published patient cohorts with MGCC (encompassing 2176 patients; 510 patients treated upfront and 1666 at relapse) were identified from PUBMED and Cochrane Registry of Clinical Trials. Weighted Regression Analyses of these trials were conducted to define prognosticators. RESULTS: Independent correlates of overall survival (OAS) when all trials were considered were line of chemotherapy index, an indicator of line of HDC utilization (1st line: 71% vs 2nd or higher line: 40%, p < 0.001), and number of HDC cycles administered (1 cycle: 43%, 1 to 2 cycles: 43%, 2 or more cycles: 64%, p = 0.021). In cohorts having HDC for relapsed disease, lower line of chemotherapy index again (p = 0.004), and higher median age (p = 0.023) were independently associated with better OAS. In trials utilizing upfront HDC, higher number of chemotherapeutics in the HDC regimen was marginally linked with improved OAS (p = 0.047). CONCLUSION: The efficacy of various forms of HDC in MGCC patients with diverse prognostic factors may vary both as an initial or salvage therapy. Clinicians need to be aware of these factors for optimal patient selection for HDC in MGCC (Tab. 3, Fig. 2, Ref. 54).

Correlates of benefit from neoadjuvant chemotherapy before radiotherapy in non-small cell lung cancer: a meta-analytical approach with meta-regression analysis.

PURPOSE: Induction chemotherapy before radiotherapy, although inferior to concomitant chemoradiotherapy, is still used in clinical practice, and improves survival compared to radiotherapy alone in unresectable non-small cell lung cancer (NSCLC). In this setting, we assessed the predictors of benefit from neoadjuvant chemotherapy before radiotherapy. METHODS: Searches were made for randomized clinical trials (RCTs) that compared neoadjuvant chemotherapy with no treatment, administered before definitive radiotherapy. Relative risk (RR) was employed to define the risk of death at 2 and 3 years. Additionally, meta-regression analysis was conducted to explain heterogeneity. RESULTS: Thirteen RCTs to date, encompassing 2776 patients, were identified. In this updated meta-analysis, neoadjuvant chemotherapy significantly reduced the risk of death, both at 2 and 3 years (RR = 0.91 and 0.94, respectively, both p < 0.001). Additionally, time to radiotherapy was inversely associated with the benefit from neoadjuvant chemotherapy at 2 (t = 2.20, p = 0.050) and 3 years (t = 1.84, p = 0.093). CONCLUSION: This meta-analysis confirms the importance of neoadjuvant chemotherapy before radiotherapy and highlights the importance of shorter time to radiotherapy to maximize NSCLC patients' survival.

Advanced glycation end products and antioxidant status in nondiabetic and streptozotocin induced diabetic rats: effects of copper treatment.

The effects of Cu(II) supplementation on glycemic parameters, advanced glycation end products (AGEs), antioxidant status (glutathione; GSH and total antioxidant capacity; TAOC) and lipid peroxidative damage (thiobarbituric acid-reactive substances, TBARS) were investigated in streptozotocin (STZ) induced diabetic rats. The study was carried out on Wistar albino rats grouped as control (n = 10), CuCl(2) treated (n = 9), STZ (n = 10) and STZ,CuCl(2) treated (n = 9). STZ was administered intraperitoneally at a single dose of 65 mg/kg and CuCl(2), 4 mg copper/kg, subcutaneously, every 2 days for 60 days. At the end of this period, glucose(mg/dl), Cu(microg/dl), TBARS(micromol/l), TAOC(mmol/l) were measured in plasma, GSH(mg/gHb) in erythrocytes and glycated hemoglobin (GHb)(%) in blood. Plasma AGE-peptides(%) were measured by HPLC flow system with spectrofluorimetric and spectrophotometric detectors connected on-line. Data were analyzed by the non-parametric Kruskal-Wallis and Mann-Whitney U test. In the STZ group glucose, GHb and AGE-peptide levels were all significantly higher than the control group (P < 0.01, P < 0.05, and P < 0.01, respectively). CuCl(2) treated group had significantly lower glucose but significantly higher GHb, TAOC and TBARS levels than the control group (P < 0.05, P < 0.001, P < 0.05 and P < 0.001, respectively). STZ,CuCl(2) treated group had significantly higher GHb, TAOC and TBARS levels compared with the control group (P < 0.001, P < 0.05 and P < 0.05, respectively); but only TAOC level was significantly higher than the STZ group (P < 0.01). This experimental study provides evidence that copper intake increases total antioxidant capacity in both nondiabetic and diabetic states. However despite the potentiated antioxidant defence, lipid peroxidation and glycation enhancing effects of CuCl(2) are evident under nondiabetic conditions.

Anaesthesia for caesarean section in the presence of multivalvular heart disease and severe pulmonary hypertension: a case report.

INTRODUCTION: Pulmonary hypertension is a rare condition and in combination with pregnancy, it can result in high maternal mortality. Mitral stenosis is one of the complicated cardiac diseases that may occur during pregnancy. In this report, we describe our management of such a case, which was even more difficult in combination with pulmonary hypertension, mitral stenosis, and aortic and tricuspid valve insufficiency requiring emergency caesarean section under general anaesthesia. CASE PRESENTATION: A 29-year-old primiparae was presented to the anaesthetic department for an urgent caesarean section with a diagnosis of severe pulmonary hypertension in combination with mitral stenosis. The patient was hospitalized prepartum and received oxygen therapy and anticoagulation with heparin. The patient was monitored during labour and delivery with oximetry and arterial and central venous pressure line. Pulmonary arterial lines were not used due to an increased risk and questionable usefulness. Echocardiography revealed a systolic pulmonary arterial pressure of 75 mmHg, and mitral stenosis, aortic and tricuspid valve insufficiency. We decided to proceed under general anaesthesia. Anaesthesia was induced with etomidate, and succinylcholine. Dopamine and nitroglycerin infusion was preoperatively started and infusion was also preoperatively continued. Hemodynamic parameters were stable during delivery. Neonatal weight and apgar score were satisfactory. After the delivery of a healthy baby, oxytocin was administered. Surgery was completed uneventfully. During the postoperative period, the patient received furosemide and morphine. As the arterial blood gas analyses were stable and the chest-ray was normal, the patient was extubated postoperatively in the second hour in ICU. CONCLUSION: Patients with significant multivalvular heart disease require careful preoperative, multidisciplinary assessment and anesthetic planning before delivery in order to optimize cardiac function during the peripartum period and make informed decisions regarding the mode of delivery and anaesthetic technique.

Complete remission of psoriasis following bevacizumab therapy for colon cancer.

Bevacizumab is a monoclonal antibody against vascular endothelial growth factor (VEGF), which is used to treat several cancers. Currently, experience with anti-VEGF treatment for psoriasis is limited, and no published reports on this use exist. We describe a patient with metastatic colon cancer and psoriasis who experienced complete remission of psoriasis during treatment with bevacizumab and combination chemotherapy without any other treatment for psoriasis. These data suggest that bevacizumab may be a promising therapeutic agent for the treatment of psoriasis.

Comparison of the short-term results after Limberg and Karydakis procedures for pilonidal disease: randomized prospective analysis of 100 patients.

OBJECTIVE: The study was designed to compare the early postoperative results of the commonly used two surgical flap procedures in pilonidal disease: Karydakis and Limberg. METHOD: One hundred patients were randomized into two groups and standard Limberg or Karydakis procedures were performed. All had primary sinus orifices. Infected cases and the ones with secondary orifices over 2 cm distant from primary were excluded. Data were recorded concerning complications, need for analgesia and wound dressing, periods of time off work and off driving. Patients were asked to classify their first defecation manner after the operation and also pain according to a Visual Analogue Scale with range of 1-10. RESULTS: There was a significantly higher wound infection rate in the Karydakis group than in the Limberg group (13/50 and 4/50 respectively). This also resulted in significantly higher values for wound dressings and need for analgesia. The time off work and off driving and also the Visual Analogue Scale scores were not significantly different between the two groups. CONCLUSION: Both procedures can be safely performed in pilonidal disease with a standard length of stay in hospital and a similar loss of productive power. However, the Karydakis flap seems to have a significant higher infection rate and this probably increases the cost.