Does measuring the medial gap before bone resection in total knee arthroplasty provide optimum gap adjustment and prevent bone recutting?

This study aimed to demonstrate that measuring the medial gap before bone resection during total knee arthroplasty (TKA) provides an optimum gap adjustment in varus knees. In this study, patients were separated into two groups. Group 1 included patients whose medial joint gap was measured before bone resection and Group 2 included patients who underwent conventional technique without measuring. The medial joint gap was measured with a custom-made gap measuring device up to the point that the knee was corrected and aligned along its mechanical axis. Medial joint gap distances, distal medial femoral bone cut thicknesses, amounts of tibial resection calculated; gap internal distances measured after cutting and the thicknesses of the trial inserts were recorded. A comparison was made between the groups concerning the number of patients requiring an additional tibial bone cut and the distribution of insert thicknesses. Extra tibial bone resections were performed in two (5.7%) patients in Group 1 and 10 (28.6%) patients in Group 2. In Group 1, where the medial joint gap was measured, the need for an additional bone resection was statistically less (p=0.018). In comparing the distribution of insert size by group, the number of patients on whom an 8 mm insert had been used was significantly greater in Group 1 (p=0.024). The findings obtained in this study suggest that measuring the medial joint gap before bone resection in total knee arthroplasty may prevent repeated bone recutting and additional bone resections.

Bilateral calcaneal insufficiency fractures due to chronic carbamazepine use for trigeminal neuralgia: A case report.

Stress fractures of calcaneus are uncommon cause of heel pain. Stress fractures could be seen in risc groups such as metabolic diseases/medications causing poor bone quality and exposing repetitive microtrauma. Anti-epileptic drug (AED) use is related with poor bone quality and increased fracture risc. Although carbamazepine-induced stress fracture is a well-known entity and there are case reports in other bones such as the femoral neck, bilateral calcaneal insufficiency fractures is an extraordinary location. To the best of our knowledge, this is the first case reporting an insufficiency fracture involving calcaneus in the relevant literature. Due to the rarity of both conditions, we decided to present and discuss this patient. When patients receiving AED treatment present with heel pain without previous plantar fasciitis history or traumatic event, insufficiency fractures should be kept in mind. This case highlights the importance of screening adverse effect of CBZ on bone metabolism in patients with long CBZ use. We report here a 41-year-old lady suffering from bilateral heel pain without trauma history. Her complaining did not respond to analgesics and stretching exercises of plantar fascia. In her past medical history she reported ongoing carbamazepine (CBZ) use over 8 years for trigeminal neuralgia. She had had low bone mineral density; defined as osteopenia. Both calcaneus MRI revealed bilateral stress fractures of calcaneum. She had been advised immobilization for 6 weeks, vitamin D and calcium supplements. CBZ has been stopped by neurology specialist and she had undergone microvascular decompression surgery for intractable pain of trigeminal neuralgia. She is doing well with full recovery from heel pain and trigeminal neuralgia at the end of one year. CBZ use causes poor bone quality through vitamin D metabolism. Heel pain without traumatic event, objective findings of plantar fasciitis and calcaneal spur syndrome in an CBZ using patient insufficiency fracture of calcaneus should be remembered and evaluated rigorously.

Peri-implant bone defects: A 1-year follow-up comparative study of use of hyaluronic acid and xenografts.

OBJECTIVE: The aim of this study was to compare the efficacy of hyaluronic acid (HA) and xenografts on the repair of peri-implant dehiscence-type bone defects occur during implant placement. PATIENTS AND METHODS: Forty-two dehiscence Class I type defects located on the buccal surface of the implants were included in this study. Defects were divided into two main groups as small sized (height of <3 mm) and medium sized (height between 3 and 5 mm). Both of the main groups were further divided into two subgroups as HA plus xenograft plus collagen membrane (HAXC) or xenograft plus collagen membrane (XC) applied groups. After grafting, repair of defect site was evaluated with the help of the cross-sectional images on cone-beam computed tomography at 6th and 12th months. RESULTS: In both main groups, vertical bone height (VBH) was higher in defects repaired with HAXC (2.65 ± 1.12 mm) than in the XC (2.45 ± 1.10 mm) groups at the 6th month. However, the difference between two subgroups was not statistically significant (P > 0.05). Reduction in VBH was observed up to 6-12 months after prosthetic loading in all defect sites. This reduction was found statistically significant in medium-sized defects that grafted with XC (P < 0.05, paired t-test). However, in other subgroups, the difference between measurements at 6th and 12th months was not statistically significant (P > 0.05). CONCLUSIONS: According to the data obtained from this study, it can be concluded that HA did not have a significant positive effect on the repair of defects around dental implants.

An In-vitro study on thermal changes during implant drilling with different irrigation volumes.

OBJECTIVE: Irrigation with saline is one of the essential methods for reducing the heat generated during dental implant osteotomy. High irrigation volume impairs visibility of the surgical field, thus complicates the surgery. In this study, we aimed to determine the optimal irrigation volume for heat reduction during dental implant drilling. MATERIALS AND METHODS: Thirty-two implant osteotomies were prepared on four fresh cow ribs. Heat generated during the final implant drilling was measured both with infrared thermography and thermocouple method. Initial and maximum temperatures were measured at four different irrigation volumes; 32, 44, 56, and 68 ml/min. RESULTS: Both measurement methods showed that the amount of temperature rise is associated with the irrigation volume during implant drilling. There is no further decrease in temperature rise above irrigation volume of 56 ml/min. CONCLUSION: Saline irrigation with 56 ml/min provides sufficient heat reduction during dental implant drilling and higher irrigation volumes are not necessary.

Experiences in microarray-based evaluation of developmental disabilities and congenital anomalies.

BACKGROUND: Chromosomal microarray analysis is the first-tier test for the evaluation of developmental disabilities and congenital anomalies. In this report, we present CMA results of 971 patient and 301 parent samples. MATERIALS AND METHODS: Among 971 patient samples, 133 (13.6%) had pathogenic variants. RESULTS: While analyzing, an "in-house" variant database was also used besides other databases. Owing to this, we have found chance to report the most frequent benign variants in Turkish population. CONCLUSION: With the additional data we acquired in this study, we also emphasized the high potential of CMA in revealing single gene disorders and novel gene-phenotype associations as well as copy number variations.

Consistent modelling of wind turbine noise propagation from source to receiver.

The unsteady nature of wind turbine noise is a major reason for annoyance. The variation of far-field sound pressure levels is not only caused by the continuous change in wind turbine noise source levels but also by the unsteady flow field and the ground characteristics between the turbine and receiver. To take these phenomena into account, a consistent numerical technique that models the sound propagation from the source to receiver is developed. Large eddy simulation with an actuator line technique is employed for the flow modelling and the corresponding flow fields are used to simulate sound generation and propagation. The local blade relative velocity, angle of attack, and turbulence characteristics are input to the sound generation model. Time-dependent blade locations and the velocity between the noise source and receiver are considered within a quasi-3D propagation model. Long-range noise propagation of a 5 MW wind turbine is investigated. Sound pressure level time series evaluated at the source time are studied for varying wind speeds, surface roughness, and ground impedances within a 2000 m radius from the turbine.

Evaluation of the effect of selective serotonin reuptake inhibitors on bone mineral density: an observational cross-sectional study.

UNLABELLED: Sixty patients diagnosed with generalized anxiety disorder and treated with either paroxetine, sertraline, or citalopram for at least 12 months were enrolled in this study, and the bone mineral density (BMD) of the patients was compared with that of 40 healthy volunteers. Selective serotonin reuptake inhibitor (SSRI) therapy in generalized anxiety disorder was found to be related with decreased BMD values. INTRODUCTION: The objectives of this study were to evaluate the effect of SSRI therapy on BMD in postmenopausal women diagnosed with generalized anxiety disorder (GAD) and to identify the effects of the duration of disease and treatment on risk factors for osteoporosis. METHODS: Sixty patients diagnosed with GAD and treated with paroxetine, sertraline, or citalopram from the SSRI group for at least 12 months were enrolled. Social demographic features, the Hamilton Anxiety Scale (HAS) results, and the Hamilton Depression Scale (HDS) scores of all the patients were assessed. The BMD of the patients was measured by dual-energy X-ray absorptiometry (DXA) at the femoral and lumbar regions. The patients were divided into three groups which are the paroxetine, sertraline, and citalopram groups. The BMD of the patients was compared with that of 40 healthy volunteers. RESULTS: The L2-L4, total lumbar vertebrae, femoral intertrochanteric, total femoral Z-scores, and femoral Ward's region T-scores of the treatment group were lower than the median T- and Z-scores of the control group (p < 0.05). Of the treatment groups, the femoral neck, trochanteric and intertrochanteric T- and Z-scores, total femoral T- and Z-scores, and femoral Ward's T- and Z-scores of the sertraline group were significantly lower than the BMD values measured at the identical regions in the paroxetine and citalopram groups (p < 0.05).There was a significant negative correlation between the duration of treatment and the BMD values. CONCLUSION: SSRI therapy in GAD was found to be related with decreased BMD values. Further randomized controlled studies are warranted to determine whether SSRI use is a risk factor for osteoporosis; such studies should investigate these factors by performing BMD assessments before treatment.

Dilatation of the cervix at non-labour caesarean section: Does it improve the patients' perception of pain post-operatively?

Our aim was to determine the effect of cervical dilatation at non-labour caesarean section on post-operative pain and maternal morbidity. This prospective, randomised, single-blinded trial was conducted from March 2013 to February 2014. In all, 199 patients were enrolled in the study: 102 in non-dilated group and 97 in cervical dilatation group. Based on Visual Analogue Scale, there were no significant differences between the two groups on post-operative 8th, 24th and 48th hour pain scores. We observed thinner endometrial cavity thickness, shorter operation time and shorter hospitalisation duration in cervical dilatation group. However, change in haemoglobin concentrations and puerperal fever rates were found to be comparable between the groups. In conclusion, intra-operative cervical dilatation does not seem to benefit in terms of post-operative pain, change in haemoglobin concentrations or puerperal fever.

First Report of Diplodia pinea on Pseudotsuga menziesii in Turkey.

Diplodia pinea is a latent, opportunistic pathogen of Pinus and other coniferous species, including Pseudotsuga menziesii (3). The fungus causes twig blight, branch cankers, tree and seedling collar rot, root rot, and can also infect cones (1). D. pinea has often been reported causing tip and shoot blight on various Pinus spp. in different parts of Turkey. During disease surveys on Pinus spp. carried out in May 2012 in Izmit in the Marmara Region (37°36'54″N, 31°20'00″E), typical shoot blight symptoms of D. pinea infection were also observed on the neighboring P. menziesii trees. Shoots and cones of P. menziesii were investigated for the presence of D. pinea pycnidia. Pycnidia from cones and shoots were placed on potato dextrose agar (PDA) and incubated at 23°C. Three isolates were obtained from shoot and cone samples. Identification of the pathogen was based on morphological characteristics of the conidia and by PCR of the ITS region of nuclear rDNA. Colonies on PDA were woolly, whitish at first turning black, sometimes partly or entirely turning light gray. Micromorphological characteristics of the Diplodia isolates were similar to those described in (2): conidia width 18.4 µm (SD ± 2.8) (range 11 to 22 µm) × length 34.0 µm (SD ± 5.3) (range 20 to 41 µm) (n = 100). Conidia were at first hyaline, later becoming brown to dark brown, oblong ellipsoid, bicellular with a distinct septum. To confirm the identity of the isolates, genomic DNA was extracted and the internal transcribed spacer (ITS) region of the rDNA was amplified using primers ITS1 and ITS4 (4). Amplicons were 483 bp in length (GenBank Accession No. KF372874) and shared 98% nucleotide identity with HM100285.1 and 97% nucleotide identity with JX981458.1 of D. pinea. Inoculation tests were performed on 2-year-old P. menziesii seedlings by placing mycelial plugs of three isolates obtained from pycnidia on the main stem after wounding with a cork borer. Control seedlings were inoculated with PDA plugs without mycelium. All seedlings were incubated at 24°C for 3 weeks in a climate chamber. Following incubation, the seedlings displayed dark brown-to-black discoloration, measuring on average 10.7 ± 0.6 cm, of the bark and wood tissues around the inoculation points on the stems. The pathogen was successfully re-isolated from symptomatic stem tissues, thus fulfilling Koch's postulates. To our knowledge, this is the first report of P. menziesii as a host of D. pinea in Turkey. P. menziesii is not endemic to Turkey and to date has a limited distribution (approximately 140 ha), but it is an important fast growing tree species for new industrial plantations. References: (1) J. de Wet. PhD thesis, University of Pretoria, 2008. (2) J. de Wet et al. Plant Dis. 84:151, 2000. (3) G. Hausner et al. Can. J. Plant Pathol. 21:256, 1999. (4) T. J. White et al. PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, CA, 1990.

The role of preoperative B-mode and Doppler ultrasonography in predicting technical challenges for laparoscopic cholecystectomy.

PURPOSE: The aim of this study was to predict probable technical challenges before laparoscopic cholecystectomy and to operate the proper patient at the right time and by the right technique. METHODS: The study was performed in a tertiary reference hospital in six months. B-mod grey scale, colour, and power Doppler ultrasonographies were obtained for fifty consecutive patients for whom elective laparoscopic holecystectomies were planned. The technical difficulties were noted by a single surgeon observer while the teams were performing the operations. Neither the observer nor the members of the surgical team were aware of the preoperative test results. These two groups of parameters were compared. RESULTS: There were significant correlations between the technical challenges encountered during the operations and preoperative ultrasonographic measurements: the mean of gallbladder wall thickness, increasing power Doppler signal of the gallbladder wall, stone size and the gallbladder's stone loading pattern. CONCLUSION: B-mod grey scale and Doppler ultrasonography are the best tests at hand for predicting intraoperative challenges before laparoscopic surgery. It is important that the radiologist and surgeon reach consensus.

A prospective, multi-center study: factors related to the management of diabetic foot infections.

The Turkish Association of Clinical Microbiology and Infectious Diseases, Diabetic Foot Infections Working Group conducted a prospective study to determine the factors affecting the outcomes of diabetic foot infections. A total of 96 patients were enrolled in the study. Microbiological assessment was performed in 86 patients. A total of 115 causative bacteria were isolated from 71 patients. The most frequently isolated bacterial species was Pseudomonas aeruginosa (n = 21, 18.3%). Among cases with bacterial growth, 37 patients (43%) were infected with 38 (33%) antibiotic-resistant bacteria. The mean (±SD) antibiotics cost was 2,220.42 (±994.59) USD in cases infected with resistant bacteria, while it was 1,206.60 (±1,160.6) USD in patients infected with susceptible bacteria (p < 0.001). According to the logistic regression analysis, the risk factors related to the growth of resistant bacteria were previous amputation (p = 0.018, OR = 7.229) and antibiotics administration within the last 30 days (p = 0.032, OR = 3.796); that related to the development of osteomyelitis was wound size >4.5 cm(2) (p = 0.041, OR = 2.8); and that related to the failure of the treatment was the growth of resistant bacteria (p = 0.016, OR = 5.333). Diabetic foot osteomyelitis is usually a chronic infection and requires surgical therapy. Amputation is the accepted form of treatment for osteomyelitis. Limited limb-saving surgery and prolonged antibiotic therapy directed toward the definitive causative bacteria are most appropriate. This may decrease limb loss through amputations. As a result the infections caused by resistant bacteria may lead to a high cost of antibiotherapy, prolonged hospitalization duration, and failure of the treatment.

Predictors for duration of hospital stay after abdominal wall hernia repairs.

BACKGROUND: To identify variables those predict length of hospital stay separately after groin, primary ventral and incisional hernias. METHODS: A total of 1170 groin, primary ventral, and incisional hernia repairs (n = 959, 132, 79 respectively) and their perioperative variables were analyzed. For each subgroup of hernia type, univariate analysis was performed. Multivariate logistic regression model was used to determine independent variables that predict length of hospital stay in each group of hernia. RESULTS: Out of 1170 repairs; 959 were inguinal, 132 were primary ventral repairs and 79 were incisional hernia repairs. Strangulation (p = 0.021), ASA III-IV class (p < 0.001), longer duration of surgery (p < 0.001), systemic postoperative complications (p < 0.001), and local postoperative complications (p < 0.001) were associated with longer length of hospital stay in inguinal hernia repairs; type of repair procedure (p = 0.028), longer duration of surgery (p < 0.001), and systemic postoperative complications (p = 0.006) were associated with longer length of hospital stay in ventral primary hernias repairs; ASA III-IV class (p = 0.027) and longer duration of surgery (p = 0.003) were associated with longer length of hospital stay in incisional hernia repairs. CONCLUSIONS: Postoperative hospital stay can be predicted before the operation by evaluating certain factors related to the patient or procedure. Longer duration of surgery predict longer hospital stay in all types of ventral hernias where as strangulation, high ASA class, systemic-local postoperative complications, and type of repair procedures may predict longer length of hospital stay in different ventral hernia types.

Stasis dermatitis: A skin manifestation of poor prognosis in patients with heart failure.

BACKGROUND:  The relationship between stasis dermatitis (SD), clinical factors, and heart failure (HF) outcomes in outpatients has not been previously assessed. METHODS:  This observational cross-sectional study evaluated 324 patients admitted to the HF outpatient clinic. A total of 158 HF outpatients (100 males and 58 females) were enrolled in the study and were divided into two groups depending on whether they were diagnosed with SD within six months before attending the outpatient clinic. Forty-one patients (26 %) diagnosed with SD in the preceding six months were designated group 1, and 117 (74 %) not diagnosed were designated group 2. RESULTS:  Diabetes mellitus (DM) (OR =5.473, p <0.001), chronic obstructive pulmonary disease (COPD) (OR =2.623, p =0.039), and increased systolic pulmonary artery pressure (SPAP) (OR =1.061, p =0.001) values were independently associated with SD in multivariate logistic regression analysis. During the follow-up of 12 ± 4 months, no significant difference was documented between group 1 and group 2 regarding the death ratio (17 % vs. 19 %, p =0.991). In the multivariate Cox proportional-hazards model with a stepwise forward method, the presence of SD diagnosis [hazard ratio (HR) =2.933, 95 % Confidence Interval (CI): 1.660-5.181, p <0.001] and coronary artery disease (CAD) (HR=2.492, 95%CI: 1.238-5.018, p= 0.011) remained independently associated with the risk of HF-related hospitalization. CONCLUSION: SD was found, for the first time, to be independently associated with DM, COPD, and increased SPAP values and determined as an independent predictor for HF-related hospitalization.HIPPOKRATIA 2022, 26 (1):13-18.

Different responses of apoptotic, inflammatory and heat shock protein gene expression to a single bout of high-intensity interval exercise between physically active and inactive men.

High mechanical load of muscles may induce muscular apoptosis on the one hand and adaptation to exercise on the other. This study aimed to explore whether changes of circulatory levels of inflammation, apoptosis and heat shock proteins (HSPs) messenger RNA (mRNA) following single bout of high-intensity interval exercise (HIIE) differs between physically active (PA) and inactive (PI) men. Nine PA and 9 PI (peak oxygen consumption: 2.6 ± 0.4 vs. 2.0 ± 0.2 L·min-1) healthy men (age: 28.7 ± 6.3 vs. 30.2 ± 4.5 years and body mass index: 2.6 ± 2.1 vs. 23.3 ± 2.8 kg·m-2) performed HIIE, comprising 4 repeats of a Wingate test (load: 0.050 kg·kg-1 body weight). Blood samples were collected before exercise, 5 min after HIIE, and 24 h after HIIE for measuring mRNA of inflammation markers interleukin-6 (IL-6) and tumor necrosis factor alpha (TNFα), apoptosis markers including Bcl-2, Bax, and HSP27, HSP60, HSP70, HSP90 using quantitative real-time PCR analysis. Post-HIIE IL-6, TNFα and HSP60 were higher in the PI than the PA group 5 min after exercise (p = 0.003, effect size (ES) = 1.59; p = 0.007, ES = 1.59 and p = 0.027, ES = 1.10 respectively). HSP70 acutely increased only in the PA group (p = 0.024, ES = 1.20). The increase in Bcl-2 (p = 0.047, ES = 1.08) and Bax (p = 0.024, ES = 1.20) levels were higher in the PI group 5 min after HIIE. The present study indicated that the response of inflammatory, apoptosis and HSP gene expressions to HIIE in blood of healthy male volunteers strongly depends on their level of regular physical activity. Novelty: Blood IL-6 and HSP60 mRNA levels following high intensity exercise may indicate metabolic stress. Increased blood HSP70 mRNA in physically active men may show an alternative apoptosis suppression pathway.

Tuberculosis of the breast: medical treatment.

Two patients with breast tuberculosis (BT) were discussed. In the presentation of each of the patients were a breast lump without pain and purulent discharge. There was associated axillary lymphadenopathy in one patient. Diagnoses were done by open biopsy and only antitubercular therapy was given to the patients. After two months of therapy, the breast lumps disappeared completely from both patients. Treatment was continued for 9 months. In breast tuberculosis, medical therapy can be used without further surgical intervention.

Humans Predict Action using Grammar-like Structures.

Efficient action prediction is of central importance for the fluent workflow between humans and equally so for human-robot interaction. To achieve prediction, actions can be algorithmically encoded by a series of events, where every event corresponds to a change in a (static or dynamic) relation between some of the objects in the scene. These structures are similar to a context-free grammar and, importantly, within this framework the actual objects are irrelevant for prediction, only their relational changes matter. Manipulation actions and others can be uniquely encoded this way. Using a virtual reality setup and testing several different manipulation actions, here we show that humans predict actions in an event-based manner following the sequence of relational changes. Testing this with chained actions, we measure the percentage predictive temporal gain for humans and compare it to action-chains performed by robots showing that the gain is approximately equal. Event-based and, thus, object independent action recognition and prediction may be important for cognitively deducing properties of unknown objects seen in action, helping to address bootstrapping of object knowledge especially in infants.

Diaphragmatic injuries: a surgical challenge. Report of forty-one cases.

BACKGROUND: We present a discussion of the management of diaphragmatic injury and the factors that influence the choice of surgical approach based on our experience and a review of the literature. METHODS: Data of 41 patients with diaphragmatic injuries treated between 1996 and 2007 were analyzed retrospectively. RESULTS: A total of 29 men and 12 women between 15 and 56 years of age (mean age 34) were included in the study. Twenty-one patients had penetrating injuries and 20 patients had blunt injuries. The diagnosis was done preoperatively in 21 cases and intraoperatively in 20 cases. Thoracotomy was used in 23 cases, laparotomy in 11 cases, laparotomy-thoracotomy in 5 cases, sternotomy-laparotomy in 1 case, and sternotomy in 1 case. Emergency surgery was performed in 30 cases. Five cases were operated within 24 hours after admission to the emergency department. In 6 cases, surgery was performed 6 months to 4 years after the initial trauma. The mortality rate was 14.6 % and the operative morbidity was 2.4 %. CONCLUSION: A high index of suspect is vital for the diagnosis of diaphragmatic injuries in an emergency setting. The type of approach is closely related to the associated injuries.

Nesfatin-1 protects from acute pancreatitis: role of melanocortin receptors.

Nesfatin-1, a recently discovered peptide, was shown to have anti-inflammatory effects. Acute pancreatitis (AP) is a life-threatening condition caused by various reasons. Although the etiology of AP is well-known, its pathogenesis is not clear. The aim of this study is to investigate the possible anti-inflammatory role of nesfatin-1 and its probable protective underlying mechanisms in an acute pancreatitis model. Caerulein was applied intraperitoneally to induce acute pancreatitis in Sprague-Dawley female rats. Nesfatin-1 was administered 5 minutes before the application of caerulein to determine its potential anti-inflammatory role on AP. Five minutes before nesfatin-1 injection, in order to investigate the underlying mechanism, oxytocin receptor antagonist (atosiban), melanocortin receptor antagonist (HS024), or ghrelin receptor antagonist (cortistatin) were administered. Five minutes after nesfatin-1 administration, two doses of caerulein were applied one hour apart. The rats were sacrified 12 hours after the first caerulein dose for serum and pancreatic tissue sampling. Microscopic damage scoring, malondialdehyde and glutathione levels, myeloperoxidase activity, luminol and lucigenin chemiluminescence levels in pancreatic tissue and amylase, lipase, trypsinogen-2 levels in serum were evaluated. Oxidative damage was decreased with nesfatin-1 treatment in the acute pancreatitis model (P < 0.05 - 0.001). The administration of HS024 reversed the effect of nesfatin-1, via increasing lipase, amylase, trypsinogen-2, malondialdehyde (MDA), myeloperoxidase (MPO) and lucigenin levels (P < 0.05 - 0.01). Atosiban pre-treatment elevated MPO activity, luminol and lucigenin chemiluminescence levels (P < 0.01 - 0.001) and cortistatin increased lucigenin and luminol chemiluminescence (P < 0.05 - 0.01). Although receptor antagonists reversed the effect of nesfatin-1 on related biochemical parameters, no significant difference was found in histological scoring. Our results indicated that nesfatin-1 had an anti-inflammatory effect on acute pancreatitis via mainly effecting melanocortin receptors.

The comparison of the efficacy of diffusion weighted imaging (DWI) sequences with 3 different T2-weighted sequences in the detection of focal liver lesions.

PURPOSE: In this study we aimed to compare and evaluate the efficacies of the low and high b value diffusion weighted imaging (DWI) sequences with three different T2-weighted (T2W) sequences. MATERIALS AND METHODS: 255 liver lesions of 147 patients who had undergone MR examinations of the upper abdomen were evaluated. A maximum number of 4 lesions was taken for consideration in patients with multiple lesions. Low and high b valued DWI and 3 different T2W sequences (SSFSE, FIESTA, and PROPELLER FSE) were utilized. The evaluations were done by 3 different radiologists, by utilizing the double blind principle. RESULTS: The lesion detection performances of the b 0 DWI, b 600 DWI, FIESTA T2W, SSFSE T2W, and PROPELLER FSE T2W sequences, were 95.7 %, 66.3 %, 94.4 %, 92.8 %, and 93.8 %, in sequence order. The high b value DWI sequence was able to detect malignant lesions with a higher accuracy rate than the T2W sequences. There was a moderate to high rate of agreement among the interpreters, and the lesion-detection rates of the interpreters were in line with their levels of expertise. CONCLUSION: Even though the higher lesion detection rates of the DWI sequences were not found to be statistically significant, it was concluded that making the evaluations with the addition of DWI to the imaging protocol would certainly decrease the lesion-missing rate, and it would be wise to utilize the DWI technique in routine liver MR imaging.

Describing the mandible in patients with craniofacial microsomia based on principal component analysis and thin plate spline video analysis.

Craniofacial microsomia (CFM) is most often described as a unilateral malformation of derivatives of the first and second branchial arches. The mandible has been classified using several classification systems. However, all are based on two-dimensional imaging. The aim of this study was to mathematically describe the deformed mandible based on principal component analysis (PCA) in a three-dimensional way. This may aid in defining the flaws in existing surgical corrections of the mandible through the identification of the differences in shape compared with a normal mandible in a holistic view with the help of videos. Forty-three homologous landmarks were defined to describe a mandible with CFM. Computed tomography scans of 22 patients and 30 controls were marked manually. The changes in shape between the mandibles were visualized using videos. A lateral rotation with increase in posterior rotation of the condyle due to shortening of the condyle-gonial height and a longitudinal rotation with outward bending of the mandibular angle were noted on the affected side, as well as an inward bending of the angle on the unaffected side. Due to the compensatory remodelling of the mandible on the unaffected side, one could suggest that CFM is never truly unilateral.