Influence of Different Finishing-Polishing Procedures and Thermocycle Aging on the Surface Roughness of Nano-Ceramic Hybrid CAD/CAM Material.

Aim: The aim of this study was to evaluate the effectiveness of different finishing-polishing (FP) procedures on reducing surface roughness of nanoceramic hybrid CAD/CAM material before and after thermocycle (TMC) aging. Materials and Methods: Nano-ceramic hybrid CAD/CAM specimens were subjected to 8 different (2-glaze and 6-mechanical) FP procedures as follows (n=20): 1. Optiglaze (OG) 2. Diamond glaze (DG), 3. Vita Enamic Polishing Set (VE), 4. VE+Gradia Diapolisher paste (VE-G) 5. VE+Super-Snap SuperBuff (VE-S) 6. Sof-Lex Disc kit (SL) 7. SL+Gradia Diapolisher paste (SLG) 8. SL+Super-Snap SuperBuff (SL-S). Surface roughness of each specimen was measured by using a contact profilometer. All specimens were artificially aged with TMC (5000 cycles, 5°C/55°C) and surface roughness measurements were repeated. One extra specimen from each group before and after TMC was examined with SEM. Surface roughness data were analyzed by repeated measures ANOVA, dependent t-test and Tukey test. Results: Significantly higher mean Ra values were found for groups OG and DG compared to other groups (P<0.05). Differences between glaze groups and differences between mechanical FP groups were not significant (P>0.05). Groups SL-S and DG demonstrated comparable results before and after TMC (P>0.05). SEM analysis revealed that surfaces of VE-S and SL-S groups were smooth and free of scratches. Conclusions: Mechanical FP procedures were more effective in reducing surface roughness of nanoceramic hybrid CAD/CAM material than glaze applications. Sof-Lex kit followed by Super-Snap SuperBuff disc application can be recommended as the mechanical FP procedure of choice considering that this method provided smooth surfaces that were maintained after TMC.

Mechanical Characteristics of Composite Resins Produced by Additive and Subtractive Manufacturing.

INTRODUCTION: The aim of the study was to evaluate the mechanical characteristics of resin composites produced by additive and subtractive manufacturing. METHODS: Six composite resin materials produced by subtractive (Vita Enamic-VE, Cerasmart-CE, Lava Ultimate-LU) and additive manufacturing (Varseo Smile Crown plus-VSC, Saremco Print Crowntec-SPC, Formlabs 3B Permanent crown-FLP) were selected. The three-point bending test was performed, and surface hardness of test specimens was measured. RESULTS: The flexural strength values of CE, SPC and LU test groups were found to be statistically higher when compared to VE, FLP and VSC test groups (p⟨0.0033). The modulus of elasticity values of the test specimens was listed as VE>LU>CE>SPC>FLP>VSC. The FLP group [35.11(4.46)] had the lowest surface hardness values, whereas the VE group [252.50 (21.5)] had the highest values. Other groups were listed as LU⟩CE⟩SPC⟩VSC in terms of surface hardness. CONCLUSIONS: According to the ISO 6872:2015, the flexural strengths of all resin composites were found to be acceptable for single unit fixed restorations. However, the VSC group's flexural strength is suitable for inlay, onlay, veneer restorations or single-unit anterior fixed dental prostheses. Also, VSC may not be a suitable choice for posterior restorations due to its low flexural strength.

Trichoderma harzianum antagonistic activity and competition for seed colonization against seedborne pathogenic fungi of sunflower.

This study investigated the antagonistic effects of Trichoderma harzianum isolate (TRIC8) on mycelial growth, hyphal alteration, conidial germination, germ tube length and seed colonization by the seedborne fungal pathogens Alternaria alternata, Bipolaris cynodontis, Fusarium culmorum and F. oxysporum, the causes of seedling rot in over 30% of sunflowers. The antagonistic effect of TRIC8 on mycelial growth of pathogens was evaluated on dual culture that included two inoculation assays: inoculation of antagonist at 48 h before pathogen (deferred inoculation) and inoculation at the same time with pathogen (simultaneous inoculation). TRIC8 inhibited mycelial growth of the fungal pathogens between 70·67 and 76·87% with the strongest inhibition seen with deferred inoculation. Alterations in hyphae were observed in all pathogens. Conidial germination of F. culmorum was inhibited by most of the fungal pathogens (38·28%) by TRIC8. Inhibition of germ tube length by the antagonist varied from 31·83 to 37·67%. In seed colonization experiments, TRIC8 was applied in combination with each pathogen to seeds of a sunflower genotype that is highly tolerant to downy mildew. Seed death was inhibited by TRIC8 and the antagonist did not allow growth of A. alternata, B. cynodontis and F. culmorum on seeds and inhibited the growth of F. oxysporum at the rate of 58·32%.

Is 2 mm a safe distance from the inferior alveolar canal to avoid neurosensory complications in implant surgery?

AIM: The aim of the present study was to compare the neurosensory complications related to implants inserted closer than 2 mm to the inferior alveolar canal (IAC) with those inserted further than 2 mm. MATERIALS AND METHODS: A total of 474 implants in 314 patients placed posterior to mental foramen area were evaluated retrospectively on panoramic radiographs. Patients were divided into two groups regarding implant proximity to the IAC (Group 1, distance ≤2 mm, Group 2, distance >2 mm). Postoperative neurosensory complications (pain and paresthesia) were recorded. Chi-square test was used for statistical comparison and P ≤ 0.05 was considered significant. RESULTS: One hundred and fifty-three implants (32.2%) were inserted closer than 2 mm to the IAC whereas 321 implants (67.8%) were inserted further than 2 mm. Three implants which had a distance of 0 mm to the IAC (0.63%) caused paresthesia after surgery. Implant distance to IAC did not show a significant difference regarding pain and paresthesia (P = 0.06 and P = 0.08, respectively). CONCLUSION: When 2 mm is considered as a safety distance, the distance of the implants to the IAC did not yield any statistical difference regarding postoperative neurosensory complications.

Ultrasonographically guided obturator nerve block for bilateral adductor spasticity in a paraplegic patient.

STUDY DESIGN: A case report defining an interventional procedure. OBJECTIVES: To reveal the role of the ultrasonography in nerve blocks at difficult anatomical locations of the obturator nerve. SETTING: The study was conducted in Ankara, Turkey. METHODS: A paraplegic patient with lower limb adductor spasticity treated with phenol block using the guidance of ultrasonography. RESULTS: After treatment of the adductor spasticity by obturator nerve block the patient achieved an upright standing position with a walker. Hygienic care was improved and spasticity-related pain was reduced. CONCLUSION: Ultrasound is a challenging tool for nerve blocks. Ultrasound guidance seems as an essential approach for the blocking of the nerves with variable anatomical courses, such as the obturator nerve.

Possible prenatal impact of sertraline on human placental glutathione S-transferase-π.

Sertraline (SER), a tricyclic antidepressant, is considered to belong to the group of selective amine reuptake inhibitors. Its ability to cross the blood-brain barrier and transplacental transport has been reported previously. It is widely distributed in the brain and is bound to human glutathione S-transferase-π (GST-π). If SER is taken during pregnancy, it gets accumulated in the embryo and fetus, and some studies have suggested it may cause congenital malformations, thus the study of the interaction of GST-π with antidepressants is crucial. In this study, the interaction of human placental GST-π with SER in the presence of the natural ligand, reduced glutathione (GSH) and a xenobiotic ligand, 1-chloro-2,4-dinitrobenzene (CDNB) was investigated. The V(m) values obtained at variable [CDNB] and variable [GSH] were 61.3 ± 2.3 and 46.4 ± 1.7 U/mg protein, respectively. The k(cat) and k(cat)/K(m) values for GSH and CDNB were 3.63 × 10(6) s(-1), 2.59 × 10(10) M(-1) s(-1) and 4.79 × 10(6) s(-1), 1.29 × 10(10) M(-1) s(-1), respectively. The half maximal inhibitory concentration value for SER was 4.60 mM. At constant [CDNB] and variable [GSH] the inhibition type was linear mixed-type, with K(s), α, and K(i) values of 0.14 ± 0.02, 2.90 ± 1.64, and 2.18 ± 0.80 mM, respectively. On the other hand, at fixed [GSH] and at variable [CDNB], the inhibition type was competitive, with K(i) value of 0.96 ± 0.10 mM. Thus, these findings weaken the importance of the protective role of GST against toxic electrophiles in vivo in adults, but due to its immature enterohepatic system SER may accumulate in the fetus and cause congenital malformations.

Incidence of acute hepatitis B in patients with spinal cord injury.

STUDY DESIGN: Retrospective case survey. OBJECTIVE: To examine incidence and clinical characteristics of hepatitis B infection in individuals with spinal cord injury (SCI). SETTING: Inpatient clinic within a physical medicine and rehabilitation hospital specialized in rehabilitation. PARTICIPANTS: A total of 161 patients with SCI. INTERVENTIONS: Patients' records were investigated and the status of hepatitis B surface antigen (HBsAg), anti-hepatitis C virus (HCV), anti-hepatitis B surface antigen positivity, alanine aminotransferase levels, duration of hospitalization and cost were recorded. MAIN OUTCOME MEASURES: Incidence of acute hepatitis B. RESULTS: Six patients were diagnosed with acute hepatitis B on the first hospitalization for rehabilitation. A total of 11 patients (4.2%) were HBsAg positive with a previously established diagnosis of hepatitis B virus infection, 1 patient (0.4%) was anti-HCV positive. After a follow-up of 6 months, three of the acute hepatitis B patients progressed into chronic hepatitis B stage. In acute hepatitis B patients' initiation of the rehabilitation was delayed, duration of hospitalization was increased. CONCLUSIONS: After SCI, patients are at high risk of acute hepatitis B infection. A high rate of chronicity may be associated with impaired immune response, secondary to neurological deficit. Screening and vaccination protocols may prevent the spread of the hepatitis B infection, healthcare losses and financial loss.

Lack of association between angiotensin-converting enzyme gene polymorphism and type I aortic dissection.

The relationship between angiotensin-converting enzyme (ACE) gene polymorphism and type I aortic dissection was examined in 205 unrelated hypertensives. A total of 94 patients underwent emergency repair due to type I aortic dissection, confirmed by computed tomography, and the remaining 111 were controls. Polymerase chain reaction was used to confirm that ACE gene polymorphism was due to insertion (I) or deletion (D) of a 287 base pair (bp) DNA sequence within intron 16. The genotype distribution and allele frequency of ACE I/D polymorphism between patients and controls were not statistically significant. When the frequency of at least one D allele carrier (DD or ID genotype) was compared with the II homozygous genotype, there was also no significant difference between the study groups. The findings revealed no association between ACE I/D polymorphism and aortic dissection. We conclude that I/D mutation of the ACE gene does not seem to be a risk factor for aortic dissection.

Unsuspected location of a ventricular septal defect after blunt chest trauma.

A 40-year-old woman, without previous cardiac symptoms, was referred to our hospital from a local hospital with a subpulmonary ventricular septal defect following blunt chest trauma. The patient was in cardiogenic shock and emergency repair was mandatory. Ventricular septal defect is uncommon after blunt chest trauma. It may develop either immediately or be delayed. Echocardiography is very important for rapid detection. Early repair is necessary and constitutes a lifesaving procedure when hemodynamic instability is present.

Sand fly species of Sanliurfa province in Turkey.

The species composition and seasonal abundance of sand flies (Diptera: Phlebotominae) were studied in the years 2000-2002 in the Sanliurfa region, which is the largest focus of cutaneous leishmaniasis in south-eastern Turkey. Sixteen species were identified among 29 771 specimens collected at 17 different sites by light traps, sticky papers and aspirators. The most common species were Phlebotomus papatasi (Scopoli) (45.4%), P. perfiliewi Parrot (21.9%), and P. sergenti Parrot (19.4%). The other species found were P. major Adler & Theodor (3%), P. neglectus Leger & Pesson (2.2%), P. brevis Theodor & Mesghali (2%), P. alexandri Sinton (1.9%), P. galilaeus Theodor (1.6%), P. halepensis Theodor (0.84%), Sergentomyia adleri Theodor (0.78%), S. dentata Sinton (0.49%), S. minuta Rondani (0.42%), S. theodori Parrot (0.16%), P. kazeruni Theodor & Mesghali (0.001%) and P. mascitti Grassi (0.001%) and one unidentified Phlebotomus species. Among these species P. galilaeus, S. minuta and S. dentata are the first records for this area. All species showed seasonal fluctuations, with the period of highest abundance between May and October.

The role of free oxygen radicals in the aetiopathogenesis of rosacea.

A possible link between superoxide dismutase activity and malondialdehyde level with the clinical manifestations of rosacea was investigated. We found differences in superoxide dismutase activities between mild rosacea (stages I and II) and severe involvement (stage III) groups, as well as between disease and control groups that were statistically significant (P < 0.05). In the mild involvement group (stages I and II), the superoxide dismutase activity was higher than in the control group (P < 0.05), while the malondialdehyde levels did not differ from the control. In the severe involvement group (stage III), the superoxide dismutase activity was lower than in the control group (P < 0.05), and this was coupled to a raised level of malondialdehyde (P < 0.05). These findings clearly show that in the mild involvement phase of rosacea patients, superoxide dismutase activity was stimulated to protect the skin against reactive oxygen species so that the malondialdehyde levels were maintained. In contrast, in more severe disease, due to a decrease in the capacity of the antioxidant defence system, the malondialdehyde levels were increased. These findings support the 'antioxidant system defect hypothesis' in rosacea patients.

Intracellular superoxide dismutase, catalase, and glutathione peroxidase activities and membrane lipid peroxide levels in Fusarium acuminatum upon environmental changes in a defined medium.

The variations of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) activities and lipid peroxide (LPO) levels in Fusarium acuminatum, an aerobic filamentous fungus, were investigated depending on the carbon and nitrogen sources during the incubation period. Fungus was cultivated in growing medium containing either maltose or saccharose in 5-25 g/L concentration range as a carbon source and either glycine or peptone in 5-35 g/L concentration range as a nitrogen source at 28 degrees C and 100 rpm. The observed highest SOD, CAT, and GSH-Px activities were 31.2+/-0.655, 62.5+/-5.23, and 1.52+/-0.0122 IU/mg in the presence of 20 g/L maltose and 73.96+/-1.48, 74.46+/-2.94, 3.48+/-0.083 IU/mg in the 15 g/L glycine-containing medium at 16 days, respectively. At the same time, the minimum LPO level was observed at 20 g/L maltose and 15 g/L glycine compared with the other carbon and nitrogen sources. The results showed a negative correlation between antioxidant enzyme activities and membrane LPO levels in F. acuminatum cells.

Poly(hydroxybutyrate-co-hydroxyvalerate) nanocapsules as enzyme carriers for cancer therapy: an in vitro study.

In the present paper, poly(3-hydroxybutyrate-co-3-hydroxyvalerate) nanocapsules were prepared by a double emulsion-solvent evaporation procedure (w/o/ w) for the encapsulation of model enzymes (L-asparaginase, catalase, glucose oxidase) and bovine serum albumin. To increase the encapsulation efficiency and activity of the encapsulated enzyme, numerous modifications were made in the compositions of the phases of double emulsion. For the preparation of low molecular weight PHBV, the polymer was treated with sodium borohydride. A 14-fold decrease in molecular weight (from 297000 to 21000) was observed upon 4 h of incubation. Although the amount of encapsulated protein was not increased, the enzyme activity increased upon use of low molecular weight PHBV, indicating that these nanocapsules have a higher permeability to solutes (reactants and products). The adjustment of the second water phase to the isoelectric point of the proteins significantly increased the encapsulation yields of catalase, L-asparaginase and BSA. Likewise, polyethylene glycol coupling significantly increased the entrapment efficiency as well as the activity of catalase and L-asparaginase. A combination of the various optimum preparation conditions further increased the encapsulated catalase activity (about six-fold) in comparison to the initial basic conditions (with no modification and no isoelectric point adjustment).

In vivo half life of nanoencapsulated L-asparaginase.

In the present study, antileukemic enzyme L-asparaginase (ASNase) was encapsulated into poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) nanocapsules in order to decrease the immunogenicity and toxicity of the enzyme and to increase its in vivo half life in mice. Nanocapsules were prepared by water-in-oil-in-water approach and each phase was changed systematically. By changing the pH of the w(2) phase to the isolelectric point of L-ASNase, the encapsulation efficiency was increased from 23.7% to 28.0%. Also, modification of ASNase with PEG(2) increased the encapsulation efficiency from 23.7% to 27.9% and protected the enzyme against denaturation. Combination of the various optima enabled a substantial increase in the activity (0.074-0.429 U/mg nanocapsule). The enzyme activity in the blood due to unmodified PHBV nanocapsules dropped to 38% of its initial value 4 h after injection. When the same sample was tested for the enzyme content in the circulation by using the radio-labeled enzyme a much lower enzyme (30% of initial) could be detected after a shorter time (3 h). The PHBV nanocapsules with heparin conjugated on their surface had a longer presence in the circulation than unmodified PHBV nanocapsules. After 6 h, around 50% of the enzyme was still present in the blood. Radioactivity measurements using the same sample showed a sharp decrease in enzyme amount in the circulation in the early stages. However, radioactivity was still detectable at the eighth hour. No adverse effects and symptoms of anaphylaxis were observed upon injection of encapsulated ASNase-PHBV nanocapsules to mice i.v. through the tail vein.

Effect of balloon-induced acute ischaemia on P wave dispersion during percutaneous transluminal coronary angioplasty.

AIMS: P wave dispersion is a recent ECG marker that reflects discontinuous and inhomogeneous conduction of sinus impulses, which has been studied in a limited number of cardiac conditions. The aim of our study was to investigate the effects of angioplasty induced-ischaemia on atrial conduction abnormalities as estimated by P maximum and P dispersion. METHODS AND RESULTS: The study consisted of 67 consecutive patients (41 men, mean age 58 +/- 11 years) with 1-vessel coronary artery disease who underwent elective single vessel coronary angioplasty (left anterior descending (LAD) coronary artery in 28 patients, the right coronary artery (RCA) in 22 patients and the left circumflex coronary artery (LCx) in 17 patients. All patients underwent 12-lead surface ECG before the first inflation (baseline) and then 60 s after intra-coronary balloon inflation. The maximum P wave duration, the minimum P wave duration, and P wave dispersion (Pd=Pmax - Pmin) were calculated from 12-lead surface ECGs. Baseline P wave duration measurements were not significantly different among the patients with LAD, RCA and LCx coronary artery disease (P>0.05). P dispersion and P maximum were significantly higher during balloon occlusion compared with the baseline condition in all three types of coronary dilatation procedures. However, P minimum was not found to differ between baseline and during balloon occlusion (P>0.05). CONCLUSION: The prolongation of P wave dispersion may be a useful and simple additional marker for myocardial ischaemia.

The in-vitro and in-vivo characterization of PLGA:L-PLA microspheres containing dexamethasone sodium phosphate.

Dexamethasone sodium phosphate (DSP) is a widely used corticosteroid in the treatment of brain oedema associated with brain tumours. DSP has many side effects that limit its usage at an effective concentration. The objective of this study was to minimize these side effects by encapsulating DSP using biodegradable synthetic polymers, to extend the release time from microspheres and to evaluate the effectiveness in the treatment of brain oedema. Microspheres containing 5% DSP were formulated by the solvent evaporation method by using a 1:1 mixture of two synthetic polymers, poly(lactic-co-glycolic acid) and L-polylactic acid (PLGA and L-PLA). The surface morphologies and particle size distribution of the microspheres were investigated. The in-vitro release studies were performed in pH 7.4 phosphate buffer solution. For determining the effectiveness of microspheres in the treatment of brain oedema, Sprague-Dawley rats weighing 200-250g were used as an animal model. Brain oedema was generated by the cold lesion method, and the effectiveness of the microspheres in treatment of oedema was investigated by the wet-dry weight method, lipid peroxidation ratios and histological evaluations. The average particle size of the microspheres was 13.04 +/- 2.05 microm, and the in-vitro release time of the microspheres was 8 h for 100/release. The degree of oedema was significantly different from the control group for the wet-dry weight method and lipid peroxidation ratio (p < 0.05). Similarly, histological evaluation of the tissues shoved that degree of oedema was significantly decreased with respect to the control group. All these results showed that implantation of microspheres was significantly more effective with respect to the systemic administration of DSP.

Percutaneous balloon pericardiotomy for patients with malignant pericardial effusion including three malignant pleural mesotheliomas.

Ten patients were enrolled in this study to evaluate the therapeutic value of percutaneous balloon pericardiotomy in patients with symptomatic pericardial effusion secondary to malignant diseases. Four patients had breast cancer; 2 had lung cancer; 1 had non-Hodgkin's lymphoma; and 3 had malignant pleural mesothelioma, which is commonly seen in Central Anatolian region of Turkey. All patients underwent percutaneous balloon pericardiotomy with monofoil balloons (Mansfield, NuMed). No complication was seen during these procedures. In 3 patients, the balloon could not be expanded completely and was entered from a more lateral position by a second puncture. There was no recurrence of pericardial effusion in 6 of 7 patients without mesothelioma. After percutaneous balloon pericardiotomy, surgical subxiphoid windowing was performed due to drainage greater than 100 mL/day in a patient with lung cancer and in 1 patient with mesothelioma. In the other 2 patients with mesothelioma, recurrence of pericardial effusion was seen and then subxiphoid surgical windowing was performed due to development of cardiac tamponade in 1 of them. All the patients died 68.6 +/- 36 days later due to the primary malignancies. The survival time of patients with mesothelioma was shorter than that of the others (p < 0.05). These results suggest that percutaneous balloon pericardiotomy may be used in the treatment of patients with malignant pericardial effusion as an alternative to surgical pericardial window creation. But in patients with malignant pleural mesothelioma, the success rate of this procedure was lower than that of the others.

Echocardiographic evaluation of left and right ventricular diastolic function in patients with chronic obstructive pulmonary disease.

The aim of this study was to investigate the effects of chronic obstructive pulmonary disease (COPD) on left ventricular and right ventricular diastolic and systolic functions. Forty-eight patients with severe COPD were studied. Patients were divided into 2 subgroups according to pulmonary artery pressures: 25 patients with pulmonary hypertension (group 1) and 23 patients with normal pulmonary artery pressure (group 2). As a control group, 59 normal subjects were studied (group 3). Patients in group 1 had higher tricuspid peak A velocity, lower tricuspid E velocity, longer isovolumetric relaxation time, higher mitral A wave, lower mitral E wave, and slower color propagation velocity than groups 2 and 3. There was no significant difference between left ventricular diastolic filling parameters between groups 2 and 3. Patients with COPD and pulmonary hypertension have left and right ventricular diastolic dysfunction. However, patients with COPD and normal pulmonary artery pressure have normal left and right ventricular diastolic function.

Acute anterior myocardial infarction following a mild nonpenetrating chest trauma--a case report.

Myocardial infarction in patients under age 45 years is a relatively unusual phenomenon; blunt chest trauma is one of the nonatherosclerotic mechanisms leading to acute myocardial infarction in young adults. The authors report a rare case of anterior myocardial infarction in a 22-year-old man following a mild nonpenetrating chest trauma whose left chest was elbowed during a soccer game.