Effects of Coloring Liquid Dipping Time and Surface Finishing Procedures on the Optical Properties of Monolithic Zirconia.

BACKGROUND: Monolithic zirconia restorations can be produced from self-colored or uncolored blocks. The coloring procedure of uncolored blocks and surface treatments may affect the appearance of the restoration. AIM: The purpose of this study is to evaluate the effect of liquid coloring and surface treatments on optical properties of translucent monolithic zirconia. METHODS: All specimens were cut from zirconia blocks with a thickness of 1 mm. Specimens were dipped in the coloring liquids for 3 min, 5 min, and 7 min and then divided into groups of 10 specimens for surface treatments. Glaze and mechanical polishing were applied, and the color of the specimens was measured under the D65 lighting condition with a spectrophotometer device. Color values obtained from the CIE Lab formula and the translucency parameter (TP), opalescence parameter (OP), and contrast ratio (CR) were calculated. The normality of the data was confirmed with the Shapiro-Wilk test. A three-way analysis of variance (ANOVA) was used to assess the effect of dipping time, liquid shade, and surface treatments. RESULTS: The effect of liquid shade and dipping time on the TP, OP, and CR parameters were statistically significant, and the TP values were reduced with the application of coloring liquid. Mechanical polishing groups had higher OP values and lower TP values than glazed groups. CONCLUSION: In cases where high translucency is required, it may be advisable to use self-colored blocks and apply glaze as a surface treatment to achieve the desired optical properties.

How are the color parameters of a CAD/CAM feldspathic ceramic of the material affected by its thickness, shade, and color of the substructure?

OBJECTIVES: The purpose of this study was to evaluate the effect of the tooth color, ceramic color, and ceramic thickness on the final color parameters of a feldspathic computer-aided design (CAD)/computer-aided manufacturing (CAM) ceramic material. MATERIALS AND METHODS: Resin specimens (12 × 14 × 4 mm) were prepared from six shades, namely, 0M1S, 1M1S, 2M3S, 3M2S, 4M3S, and 5M3S, to simulate tooth color. Ceramic slices with thicknesses of 0.3, 0.5, 0.7, and 1 mm were sectioned from Vitablocs Mark II (12 × 14 × 18 mm) in 10 shades-OM1C, 1M1C, 1M2C, 2M1C, 2M2C, 2M3C, 3M1C, 3M2C, 3M3C, and 4M2C. An intraoral spectrophotometer was used and three axes of Commission Internationale de l'Eclairage (CIE) LAB color space (CIE L* a* b*) and chroma (C) and hue (H) values were obtained. RESULTS: The a* and b* values showed a decrease with increasing thickness. Generally, C decreased with the increasing ceramic thickness. The effect of ceramic thickness on H changed depending on the block and substructure color. The change of ceramic thickness resulted in changes in the lightness parameter (L*) of the ceramics. Generally, with an increase in the thickness, the L* value increased. The univariate analysis of variance (ANOVA) indicated a significant interaction between ceramic thickness and substructure color (P <. 005) and ceramic thickness and ceramic color (P <. 005). CONCLUSION: The final color parameters of a feldspathic CAD/CAM block were significantly affected by the changes in the ceramic thickness and substructure color.

Diagnostic performance of p16 staining in atypical squamous cells 'cannot exclude high-grade squamous epithelial lesion' in predicting high-grade cervical pathology.

Atypical squamous cells 'cannot exclude high-grade squamous epithelial lesion' (ASC-H) cytology represents clear risk and has been a controversial issue in clinical practice. The objective of this study is to investigate the diagnostic performance of p16(INK4A) immunohistochemistry (IHC) among ASC-H Pap smears in predicting high-grade cervical intraepithelial lesions. Decolourisation and staining process with p16(INK4A) is applied to 27 ASC-H diagnosed conventional Pap smears, which were all managed with colposcopy-directed cervical biopsy priorly. Staining characteristics of ASC-H Pap smears were compared with histopathological data and sensitivity-specificity values of p16 triage to detect CIN2 + histopathology were determined. The sensitivity and specificity of positive p16(INK4A) immune staining to detect CIN2 + histopathology were as 87.5% and 68%, respectively. The positive predictive value of p16 triage is found as 53.8% and negative predictive value was as 92.8%. p16(INK4A) IHC seems applicable for conventional Pap smears and may provide an alternative triage option in ASC-H category.

Comparison of laparoscopy and laparotomy in surgical staging of clinical early stage endometrial cancer: a report of early experiences from Turkey.

The objective of this study was to assess the feasibility of laparoscopy (LS) in endometrial carcinoma staging. Clinical early stage endometrial cancer patients (n = 153) staged by LS or laparotomy (LT) were compared. A total of 40 (26.1%) patients were treated by LS and 113 (73.9%) by LT. All patients underwent pelvic lymphadenectomy. Lymphadenectomy has been extended to para-aortic space in 55% of the LS group and 70% of the LT group. The majority of patients had stage I-II disease. The median numbers of removed pelvic and para- aortic lymph nodes were similar in two groups (p values 0.213 and 0.199, respectively). Body mass index (BMI) (kg/m(2)) was higher in the LT group (31.2 vs 27.4, p < 0.05). Operation time, age, tumour histology, para-aortic lymphadenectomy and complication rates were similar in the two groups. Four (10%) patients in the LS group and 12 (10.6%) in the LT group had recurrence of disease (p = 1.0). There was no statistical difference for overall survival between the two groups. In conclusion, these findings showed that in endometrial carcinoma cases, laparoscopy has provided adequate staging and similar survival rates with laparotomy.

Malign peritoneal mesothelioma with nephrotic syndrome.

Nephrotic syndrome may occur in malignancies like Hodgkin Disease and other solid tumors due to glomerulonephritis, amyloidosis or other causes. However, it is rare in peritoneal mesothelioma. We report a 42-year old female patient with peritoneal mesothelioma and nephrotic syndrome together with a review of literature (Tab. 1, Fig. 3, Ref. 7).

Clinical features, risk factors, and antimicrobial resistance of pseudomonas putida isolates.

Pseudomonas putida rarely results in infection, primarily in patients undergoing invasive procedures or immunocompromised hosts. We aimed to investigate the characteristics of Pseudomonas putida infections. This is a retrospectively designed cross-sectional observational study. We retrospectively scanned the data from our hospital for the 10 years before February 15, 2022. The patients with Pseudomonas putida growth in the microbiological cultures and with antibiotic susceptibility tests were included in the study. We recorded culture isolates types, age, gender, comorbidities, immunosuppressive factors, symptoms, invasive medical procedures, length of hospital stay, and radiological findings. The mean age of the patients was 66.2 ±â€…14.5 years, and the male patients predominated (76.3%, n = 58/76). There was growth in bronchial lavage in 33 patients, sputum in 28, pleural effusion fluid in 12, and tracheal aspirate in 3 patients. The rate of antibiotic-resistant strains was 56.6% (n = 43). All strains were sensitive to colistin (100%), and carbapenem, amikacin, and gentamicin sensitivity rates were high. We observed that the risk of antibiotic resistance increased 4.29 times in the patients in the intensive care unit (Cl:1.27-14.47, P = .01). The patients with Diabetes Mellitus had a higher risk (OR 4.33, Cl:1.11-16.77, P = .03), and in cancer cases, the risk was 3.31 times higher (Cl:1.06-10.32, P = .03). The risk of Pseudomonas putida infection should be considered, particularly in patients with comorbid disorders causing immunosuppression, including Diabetes Mellitus and Cancer.

Effects of soldering and laser welding on bond strength of ceramic to metal.

STATEMENT OF PROBLEM: Welding or soldering of metal frameworks negatively affects the overall bond strength between the veneering ceramic and metal. PURPOSE: The purpose of this study was to evaluate the effect of soldering and laser-welding procedures on the bond strength between ceramic and metal. MATERIAL AND METHODS: Thirty Ni-based metal specimens (Wiron 99) (8 × 4 × 4 mm) were fabricated and divided into 3 groups; soldered (S), laser welded (L), and control (untreated cast alloy) (n=10). In S and L specimens, a notch (1 × 1.5 mm) was prepared longitudinally on the surface of each specimen and filled with compatible alloy (Wiron soldering rods and Wiroweld NC, respectively). Vickers hardness measurements were made after polishing the surfaces with a metallographic polishing kit. A veneering ceramic (VITA VMK 95) was vibrated, condensed in a mold, and fired on the metal frameworks. The specimens were sectioned in 2 axes to obtain nontrimmed bar specimens with a bonding area of approximately 1 mm². Forty bars per block were obtained. Each bar was subjected to microtensile bond strength (µTBS) testing with a crosshead speed of 1 mm/min. The µTBS data (MPa) were recorded, and SEM was used for failure analysis of the tested bars. The measurements were statistically analyzed using a 1-way ANOVA and Tamhane tests (α=.05). RESULTS: The mean differences in µTBS of veneering ceramic to soldered (10.4 ±2.4 MPa) and laser-welded (11.7 ±1.3 MPa) metal surfaces were not significantly different and were significantly lower than that of the cast alloy (25.4 ±3.6 MPa) (P<.05). The mean Vickers hardness of cast alloy was significantly higher (236 ±17 HV) than soldered (114 ±9 HV) and laser-welded groups (129 ±11 HV) (P<.05). CONCLUSIONS: Soldering and laser welding significantly decreased the µTBS of a veneering ceramic to a base metal alloy.

The role of telomerase activity in predicting early recurrence of epithelial ovarian cancer after first-line chemotherapy: a prospective clinical study.

PURPOSE OF INVESTIGATION: To investigate the value of telomerase activity (TA) in the detection of early recurrence in primary epithelial ovarian cancer (EOC). METHOD(S): In this study, TA was studied in 30 patients with Stage III EOC and 50 control patients with benign gynecological disease. All enrolled EOC patients had had primary cytoreductive surgery and six cycles of platinum-based first-line chemotherapy previously. Semi-quantative TA measurements were done by TRAP assay in ascites, taken at second-look surgery, of cancer patients and in peritoneal washings, taken during planned surgery, of the control group. RESULT(S): Early recurrence was diagnosed in ten EOC patients (33.3%). Mean TA was statistically higher in EOC patients than in patients with benign disease. However, the mean TA was insignificantly lower in early recurrent EOC patients than in disease-free EOC patients. CONCLUSION(S): The value of TA is limited in the detection of early recurrence in primary EOC.

Evaluation of bond strength of various margin ceramics to a zirconia ceramic.

OBJECTIVE: This study evaluated the bond strengths of four different margin ceramics based on fluoroapatite and feldspath to a zirconia ceramic. METHODS: Zirconia cores (Zirconzahn) (N=28, n=7/margin ceramic group) were fabricated according to the manufacturers' instructions (diameter: 4mm; thickness: 2mm) and ultrasonically cleaned. Four different margin ceramics (thickness: 5mm) (Cerabien Zr, Noritake; Ceramco PFZ, Ceramco; e.max, Ivoclar Vivadent and Triceram, Dentaurum) were vibrated and condensed in a stainless steel mould and fired onto their zirconia cores. After trying the specimens in the mould for minor adjustments, they were again ultrasonically cleaned and embedded in PMMA. The specimens were stored in distilled water at 37 degrees C for 1 week and shear bond strength (MPa+/-S.D.) tests were performed in a universal testing machine (crosshead speed: 0.5mm/min). Failure modes were recorded under SEM. RESULTS: Significant effect of margin ceramic types were found on the bond strength values (P<0.05). The mean bond strength values of Ceramco margin ceramic to zirconia was significantly lower (25.4+/-4.5 MPa) (P<0.05) than those of Cerabien (31.6+/-6.4 MPa), e.max (35.9+/-8.4 MPa), and Triceram margin ceramic (38.8+/-7.1 MPa) systems. CONCLUSIONS: Margin ceramics, compatible with zirconia framework material tested in the present study, exhibited high bond strength values. Variations in thermal expansion coefficients might influence their bond strength values.

Open intramedullary Kirschner wire versus screw and plate fixation for unstable forearm fractures in children.

PURPOSE: To compare the outcomes of intramedullary Kirschner wire versus screw and plate fixation for unstable forearm fractures in children aged older than 10 years. METHODS: Records of 32 children aged 10 to 15 (mean, 12) years with displaced fractures of the radius and ulna were retrospectively reviewed. 17 boys and 4 girls underwent intramedullary Kirschner wiring, whereas 10 boys and one girl underwent plating. All patients had been initially treated with closed reduction and casting. Indications for surgical intervention were fractures with angulation of >10 degrees and total displacement. Patients were followed up for a mean of 24 (range, 13-40) months. Angulation and range of movements of the elbow, wrist, and forearm, as well as clinical and cosmetic results were compared. RESULTS: Both treatments achieved excellent clinical outcomes, but intramedullary Kirschner wiring resulted in better cosmesis, shorter operating times, easier hardware removal, and lower implant costs. CONCLUSION: Intramedullary Kirschner wiring is a better option than plating for the treatment of unstable forearm fractures in older children.

The role of p53, Bcl-2 and Ki-67 in premalignant cervical lesions and cervical cancer.

PURPOSE: The aim of this study was to determine the role of p53, Bcl-2 and Ki-67 expression in the carcinogenesis of cervical carcinoma and aggressiveness of cervical intraepithelial neoplasia (CIN). METHODS: The pathology specimens of 63 patients with a diagnosis of normal squamous epithelium (22 cases), CIN I (14), CIN II (5), CIN III (8) and squamous cell carcinoma (14) were evaluated immunohistochemically for the expression of p53, Bcl-2 and Ki-67 in paraffin sections. RESULTS: The expression of p53 and Ki-67 increased proportionally to the grade of CIN and cervical cancer, but only the increase of p53 expression was statistically significant (p = 0.002). There was no significant correlation between Bcl-2 expression and premalignant and malignant cervical lesions. CONCLUSION: p53 expression may have a role in the carcinogenesis of squamous cell cervical carcinoma whereas Bcl-2 expression has no role. Ki-67 expression can not be used in determining the aggressiveness of CIN lesions.

Bond strengths of all-ceramics: acid vs laser etching.

Various applications of dental lasers on dental materials have been proposed for surface modifications. This study evaluated whether laser etching could be an alternative to hydrofluoric acid (HF) etching. One hundred and ten lithia-based all-ceramic specimens (Empress 2) (R: 4 mm, h: 4 mm) were prepared and divided into five groups (n = 22/group). The untreated specimens served as the control, while one of the experimental groups was treated with 9.5% HF for 30 seconds. Three remaining test groups were treated with different laser (Er:YAG laser wavelength:2940 nm, OpusDent) power settings: 300 mJ, 600 mJ and 900 mJ. Ten specimens in each group were luted to the other 10 specimens by a dual-curing cement (Variolink II), and shear-bond strength (SBS) tests were performed (Autograph, crosshead speed: 0.5 mm/minute). The results were statistically analyzed (Kruskal Wallis and Mann Whitney-U, alpha = .05). Mean SBS (MPa) were 31.9 +/- 4.0, 41.4 +/- 4.3, 42.8 +/- 6.2, 29.2 +/- 4.5 and 27.4 +/- 3.8 for the control and HF, 300, 600 and 900 mJ groups, respectively. SEM evaluations revealed different surface morphologies depending on the laser parameters. The differences between HF acid and 300 mJ, when compared with the control, 600 and 900 mJ groups, were significant (p < .05). The 300 mJ laser group exhibited the highest shear-bond strength values, indicating that laser etching could also be used for surface treatments.

The antagonizing effect of aspartic acid on morphine withdrawal and levallorphan-precipitated abstinence syndrome signs and on associated changes in brain levels of free amino acids in the rat.

We have previously demonstrated the antagonizing effect of aspartic acid on some effects of morphine and on the development of physical dependence on, and tolerance to, morphine. In the present study, we have withdrawal from morphine or administration of a morphine antagonist. For this purpose sixty five white rats were given morphine and aspartic acid separately and in combination in a 5% saccharose solution instead of drinking water for 30 days. Some of the dependent rats were then withdrawn and others were injected with levallorphan. Flying, jumping, wet-dog shaking, body weight loss and motor activity were estimated and free amino acid levels in the brain were determined. Aspartic acid was found to prevent or antagonize the behavioural signs and the changes in the free amino acid levels in the brain. The results are discussed in the light of the previous data.

The antagonizing effect of aspartic acid on the brain levels of monoamines and free amino acids during the development of tolerance to the physical dependence on morphine.

Since it has been shown in previous study that aspartic acid prevents the development of physical dependence on and tolerance to morphine and antagonizes the abstinence syndrom signs, the biochemical bases of that prevention were investigated in the present study. The brain contents of serotonin, DA, NA, and free amino acids of the rats given aspartic acid and morphine separately and in combination were determined. It has been observed that most of the morphine-induced changes in the brain were normalized in the group given aspartic acid and morphine together. The relative ineffectiveness of aspartic acid in normalizing some amino acid levels decreased by morphine was discussed and some logical explanations were found.

The relationship between morphine, aspartic acid and L-asparaginase in rats.

Morphine and aspartic acid were administered separately and in combination to 80 rats divided into 8 groups. Ten and 20 min following the injections, brain, liver and kidney L-asparaginase activity was determined. Morphine decreased brain and liver L-asparaginase activity and increased that of kidney. Aspartic acid completely antagonized the effect of morphine. Additionally 500 IU/kg L-asparaginase and 5 or 10 mg/kg morphine were i.v. injected into 56 rats divided into 5 groups. L-Asparaginase, which, in turn, increased motor activity, antagonized the morphine-induced hypoactivity and analgesia. These results support our previous findings.

Suppression by ketamine and dextromethorphan of precipitated abstinence syndrome in rats.

The development of physical dependence on opiates appears to involve an inhibition by opiates of L-asparaginase and glutaminase, and the blockade by opiates of aspartatergic (ASPergic)/glutamatergic (GLUergic) receptors. Ketamine (K) (0.5 or 1 mg/kg) or dextromethorphan (DM) (1 or 2 mg/kg), both of which are known to decrease the responsiveness of ASPergic/GLUergic receptors, were administered to the three morphine (M)-containing pellets implanted rats prior to 2 mg/kg naloxone (NL) injection. Whereas 0.5 mg/kg K showed no significant effect on abstinence syndrome signs, 1 mg/kg K and 1 mg/kg DM significantly attenuated some of the signs. The attenuation or prevention of all the signs were observed after 2 mg/kg DM administration. Almost complete prevention was seen from the second minute on during the ten-minute observation period. As ASP and GLU antagonists K and DM have this antagonizing effect on the precipitated abstinence syndrome signs, the manifestation of abstinence syndrome may mainly result from the normalization of ASP and GLU production because of the disinhibition by NL of the enzymes and the stronger stimulation of ASPergic/GLUergic receptors which have no opiate blockade after NL injection.

Intensification and attenuation of morphine dependence by D-aspartic acid and PLG.

The inhibition by opiates and the sudden normalization by opioid antagonists of the brain L-asparaginase activity (BAA) have previously been reported to be the main factors in the development of physical dependence and the manifestation of precipitated abstinence syndrome, respectively. As a result, L-asparaginase inhibitors D-aspartic acid and prolyl-leucyl-glycinamide (PLG) were separately given to mice and rats either just after morphine (M)-containing pellet implantation or 15 min before naloxone (NL)-precipitated abstinence syndrome. The animals treated in this manner were used to assess the intensity of the physical dependence and to determine the BAA. D-ASP or PLG administration following pellet implantation significantly increased all of the observed signs such as flying, jumping, wet dog shake and writhing. When D-ASP or PLG were given 15 min before precipitated abstinence they significantly decreased the number of the signs. The determination of the BAA showed significant decreases or increases more or less parallel to the severity of the physical dependence on M. The intensification of physical dependence by D-ASP or PLG given just after the pellet implantation was attributed to their additional inhibitory effect to that of M on the BAA at the beginning of the physical dependence development. The attenuating effect of BAA inhibitors D-ASP or PLG administered before precipitated abstinence was explained with the prevention of the increase in the BAA.

Brain asparaginase, ACE activity and plasma cortisol level in morphine dependent rats: effect of aspartic acid and naloxone.

The activities of the brain L-asparaginase and angiotensin converting enzyme (ACE), and the plasma cortisol level were found to be decreased in the rats implanted with morphine (M) containing pellets. Even though 10 mg/kg of naloxone (N) itself showed an inhibitory effect on ACE it abolished the inhibitions seen in the M dependent rats five min following subcutaneous injection. The chronic administration of L-aspartic acid (ASP) during the development of physical dependence or just before the N injection prevented the increase of the plasma cortisol caused by N. It is concluded that in addition to the inhibition of the brain L-asparaginase activity which was previously hypothesized to be the main reason of the development of physical dependence on opiates as a result of the related experimental and clinical data, the inhibition by M of the brain ACE activity may take part in the development of physical dependence. With regard to the plasma cortisol level, the concomitant administration of ASP with M blocks, to a great extent, the development of physical dependence on opiate. The single dose of ASP administration before N injection prevents the effect of N, the manifestation of abstinence syndrome.

Utility of CD15, CD30 & CD45 in the immunohistochemical diagnosis of Hodgkin's disease by antigen retrieval method.

The utility of staining Reed-Sternberg (RS) cells with CD30, CD15 and CD45 as a diagnostic aid in Hodgkin's disease (HD) and the value of microwave citrate antigen retrieval (AR) method in improving the results of immunohistochemical (IHC) studies were evaluated. Histological and immunohistological studies were carried out on 21 patients with HD seen from January 1987 to December 1996 in the Pathology Department of the Cumhuriyet University, School of Medicine. Avidin biotin peroxidase complex (ABC) was used in IHC study as a method for detection of RS cells. Monoclonal antibodies CD30, CD15 and CD45 were applied on formalin fixed paraffin embedded tissue sections. In order to enhance the immunoreactivity, microwave citrate AR method and proteolytic pretreatment were used. The reactivity of RS cells and staining patterns were determined. In 14 (70%) of the 20 patients, RS cells stained positively with CD30, in 16 (80%) CD15 staining was positive and only 1 (5%) was positively stained with CD45. A combination of cytoplasmic with cell surface staining was common with CD30, while paranuclear deposit with cell surface and cytoplasmic staining was common with CD15. In conclusion, to facilitate the detection of RS cells in formalin fixed paraffin embedded tissues, the application of a panel of markers appears to be necessary. Also AR method seems to be helpful in obtaining optimal results on formalin fixed paraffin embedded tissue.

Primary carcinoma of the fallopian tube in a 88 years old woman: review of the literature.

A woman of 88 years old with primary carcinoma of the fallopian tube, the oldest patient reported in the English literature according to the best of our knowledge, was presented. After debulking surgery four courses of chemotherapy including paclitaxel and carboplatin was performed. The patient was free of disease during two years follow-up.