The effect of diode laser application on restoration of non carious cervical lesion: Clinical follow up.

AIMS: The aim of this study is to evaluate the effect of the diode laser used for dentin sensitivity on the clinical success of non-carious cervical lesion (NCCL) restorations restored with different adhesive systems. METHODS: 20 NCCLs were restorated with Universal Single Bond (Self Etch) (3M, USA) and Grandio (Voco, Germany), 20 NCCLs were restorated with Universal Single Bond (Total Etch) and Grandio. After diode laser application, 20 NCCLs were restorated with Universal Single Bond and Grandio, 20 NCCLs were restorated with Universal Single Bond (Total Etch) and Grandio. The restorations were clinical evaluated by two examiners at baseline, for 6 and 18 months using modified United States Public Health Service (USPHS) Criteria. Chi-square test was used for statistical analyse. RESULTS: The lowest rates of retention was found in the Group 1. There was no statistically significant difference among the groups in marginal discoloration, marginal integrity, sensitivity (P > 0.05). CONCLUSION: Diode laser application prior to the restoration of teeth with NCCL don't reduce the retention rate of restorations, may reduce hypersensitivity and may affect the success of restoration. However, further laboratory and clinical studies are required.

Anxiety boosts progression of prediabetes to type 2 diabetes: findings from the prospective Cooperative Health Research in the Region of Augsburg F4 and FF4 studies.

AIM: To investigate the association between anxiety symptoms and the progression from prediabetes to type 2 diabetes. METHODS: A sample of 1708 participants aged 31-82 years from the population-based Cooperative Health Research in the Region of Augsburg F4 and the follow-up Cooperative Health Research in the Region of Augsburg FF4 studies was included. Prediabetes was defined as impaired fasting glucose and/or impaired glucose tolerance, and anxiety status was measured by the generalized anxiety disorder-7 questionnaire. Newly diagnosed type 2 diabetes cases were identified after 6.5 years (11 102 person-years) and confirmed by medical records. Multivariate logistic regression analyses were employed to estimate the effect of prediabetes and anxiety on the incidence of type 2 diabetes with different levels of adjustments for potential confounders. The population attributable risk of type 2 diabetes in participants with prediabetes and anxiety was estimated. RESULTS: Prediabetes at baseline was prevalent in 247 participants, of whom 77 developed diabetes after follow-up, accounting for a progression rate of 31%. In participants with prediabetes, high anxiety was associated with a 3-fold increased risk of progression to type 2 diabetes in comparison with low anxiety, even after accounting for socio-demographic, lifestyle and metabolic risk factors (OR = 2.82, 95% CI = 0.95-8.37, P = 0.06). A significant proportion of incident type 2 diabetes was attributed to having anxiety in addition to prediabetes (attributable risk proportion: 0.52; 95% CI = 0.004-1.04, P = 0.05). CONCLUSIONS: Anxiety symptoms independently increase the progression risk of prediabetes to type 2 diabetes and should be routinely considered alongside the traditional risk factors in people with prediabetes.

Cumulative effect of depressed mood and obesity on type II diabetes incidence: Findings from the MONICA/KORA cohort study.

BACKGROUND: Obesity and depression both individually contribute to the risk of Type II Diabetes (T2DM). The extent to which obesity can be set-off by depression is unknown. METHODS: In a sample of 9340 participants followed for 15.4 years (79,372 person-years) from the prospective MONICA/KORA population-based cohort conducted in Southern Germany, we investigated the impact of obesity, defined as Body Mass Index (BMI) ≥ 30, and depression on the incidence of T2DM using Cox Proportional Hazards Regression. RESULTS: The relative risk of T2DM was over 6 fold higher among obese participants in comparison to normal weight participants (HR 6.05; 95% CI 4.82 to 7.59; p < .0001). Nonetheless, among participants with obesity, comorbidity of depression was associated with an additional 2 fold risk T2DM (HR 8.05, 95% CI 5.90-10.98; p < .0001). This finding corresponded to an increase in the 15.4-year absolute risk of T2DM from 15.9 cases per 1000 person-years (py) in participants with obesity but not depression, to 21.4 cases per 1000 py for participants with obesity and depression. Further analysis of joint effects and Relative Excess Risk due to Interaction disclosed that depressed mood is associated with significantly higher risk of T2DM in participants with obesity, and to a lesser extent in overweight participants, however an association was not found in normal weight participants. CONCLUSIONS: The present investigation discloses that despite the overreaching importance of obesity as a risk factor for T2DM, there is room for depressed mood to add measurable risk prediction.

"Eye-tracking" for assessment of image perception in gastrointestinal endoscopy with narrow-band imaging compared with white-light endoscopy.

BACKGROUND AND STUDY AIMS: Narrow-band imaging (NBI) is a new imaging methodology for improving the detection rate of gastrointestinal lesions. We aimed to evaluate perception of images by NBI and corresponding standard white-light-endoscopy (WLE) using a computer-guided eye-tracking system. METHODS: A total of 23 NBI images of various lesions with the 23 corresponding WLE images were assessed in random order by 18 subjects with various endoscopy experience. Before evaluation, a teaching set of three NBI and corresponding WLE images was shown to highlight the characteristics of lesions. An eye-tracking system (Tobii X series with integrated 17-inch monitor) was used to record the eye movements of the subjects while they examined respective images. The following parameters were measured: total time spent on image, time until first fixation of lesion, total number of fixations per image and per lesion, and number of fixations until finding the lesion. RESULTS: In total, 828 experiments were conducted. Lesions could not be detected in 6.5 % (NBI) and 4.1 % (WLE) of images ( P = NS). The total number of fixations and total time spent on respective figures as a whole were significantly greater for NBI images compared with WLE images ( P < 0.003). However, the number of fixations until the lesion was found, the number of fixations on the lesion, and the time until first fixation of the lesion did not differ between the two image groups ( P > 0.1). CONCLUSION: This is the first study using eye tracking to evaluate image perception in gastrointestinal endoscopy. Significant differences in the interpretation of NBI and WLE images were observed, which may be relevant for the detection and characterization of lesions during endoscopy.

Differential Y-chromosome Anatolian influences on the Greek and Cretan Neolithic.

The earliest Neolithic sites of Europe are located in Crete and mainland Greece. A debate persists concerning whether these farmers originated in neighboring Anatolia and the role of maritime colonization. To address these issues 171 samples were collected from areas near three known early Neolithic settlements in Greece together with 193 samples from Crete. An analysis of Y-chromosome haplogroups determined that the samples from the Greek Neolithic sites showed strong affinity to Balkan data, while Crete shows affinity with central/Mediterranean Anatolia. Haplogroup J2b-M12 was frequent in Thessaly and Greek Macedonia while haplogroup J2a-M410 was scarce. Alternatively, Crete, like Anatolia showed a high frequency of J2a-M410 and a low frequency of J2b-M12. This dichotomy parallels archaeobotanical evidence, specifically that while bread wheat (Triticum aestivum) is known from Neolithic Anatolia, Crete and southern Italy; it is absent from earliest Neolithic Greece. The expansion time of YSTR variation for haplogroup E3b1a2-V13, in the Peloponnese was consistent with an indigenous Mesolithic presence. In turn, two distinctive haplogroups, J2a1h-M319 and J2a1b1-M92, have demographic properties consistent with Bronze Age expansions in Crete, arguably from NW/W Anatolia and Syro-Palestine, while a later mainland (Mycenaean) contribution to Crete is indicated by relative frequencies of V13.

Table-moving contrast-enhanced magnetic resonance angiography in the evaluation of lower extremity peripheral arterial bypass grafts.

The aim of this study was to investigate the utility of table-moving contrast-enhanced three-dimensional MR angiography in the evaluation of lower extremity peripheral arterial bypass grafts. Twenty-two lower extremity peripheral arterial grafts (13 autologous saphenous vein, 7 polytetrafluoroethylene and 2 Dacron) in 18 patients were evaluated. Preoperative diagnosis were occlusive arterial segments in 14 cases, 4 aneurysms in 2 cases (3 aneurysms in one case) and traumatic femoral artery injury in 2 cases. 1.5T superconductive magnet was used with torso-phase and whole body coil system on MRI examinations. Lower extremity peripheral arterial grafts were evaluated and anastomosis sites were classified into five groups as normal, insignificant stenosis (< 50%), significant stenosis (> 50%), occlusion and ectatic or aneurysmatic appearance. Contrast-enhanced MR angiography imaging of 66 segments of 22 graft patients were of high quality. No difficulties were confronted in the radiological evaluation of peripheral bypass grafts. Graft stenosis as detected in five grafts. Stenotic segments were at the proximal (n = 4) and distal (n = 3) anastomosis sites. Total occlusion was shown in three grafts. Ectasia or aneurysm was seen in only one graft. In lower extremity peripheral bypass graft patients, table-moving contrast enhanced MR angiography can be used in the evaluation and follow-up of the vascular lesions.

NeuroPipe-Chip: A digital neuro-processor for spiking neural networks.

Computing complex spiking artificial neural networks (SANNs) on conventional hardware platforms is far from reaching real-time requirements. Therefore we propose a neuro-processor, called NeuroPipe-Chip, as part of an accelerator board. In this paper, we introduce two new concepts on chip-level to speed up the computation of SANNs. These concepts are implemented in a prototype of the NeuroPipe-Chip. We present the hardware structure of the prototype and evaluate its performance in a system simulation based on a hardware description language (HDL). For the computation of a simple SANN for image segmentation, the NeuroPipe-Chip operating at 100 MHz shows an improvement of more than two orders of magnitude compared to an Alpha 500 MHz workstation and approaches real-time requirements for the computation of SANNs in the order of 10(6) neurons. Hence, such an accelerator would allow for applications of complex SANNs to solve real-world tasks like real-time image processing. The NeuroPipe-Chip has been fabricated in an Alcatel 0.35-mum digital CMOS technology.

Gamma-vinyl-GABA potentiates the severity of naloxone-precipitated abstinence signs in morphine-dependent rats.

Effects of gamma-vinyl-GABA (GVG), an antiepileptic drug that inhibits GABA transaminase and increases extracellular GABA concentrations in the brain, were investigated on the morphine abstinence syndrome (AS) in male Wistar rats. Two morphine pellets (75 mg morphine base in each) were implanted subcutaneously on the back of the rats. Seventy-two hours after the morphine implantation, naloxone (NL, 2 mg kg-1) was injected intraperitoneally (i.p.) to induce precipitated morphine AS. GVG was administered at the doses of 250 mg kg-1 (n = 11) and 500 mg kg-1 (n = 11) i.p. 24 h prior to AS and at the dose of 500 mg kg-1 (n = 13) i.p. 6 h prior to AS. Immediately after NL injections, rats were observed for 5 min and AS signs (jumping, teeth chattering, wet dog shake, diarrhoea, ptosis and defecation) were assessed. The behavioural signs of GVG-treated rats were compared with the control groups (n = 10) during the AS. Jumping, wet dog shake, teeth chattering were found to be significantly increased in all of the GVG-treated groups. Ptosis was found to have increased in only 500 mg kg-1 GVG groups. GVG potentiated the severity of morphine AS signs. GVG does not seem to have any therapeutic potential for treatment of morphine abstinence unlike some other drugs that enhance GABAergic transmission.

Polymorphism of conventional genetic markers and HLA system in Turkey.

This study is part of a general survey in which the regional variability of various genetic markers in Turkey will be analyzed with special regard to its application in forensic medicine. Blood samples from 3173 unrelated healthy individuals of both sexes and from different regions of Turkey have been sampled and were typed for the blood group polymorphisms AB0, MNSs, Kell, Duffy, Kidd, P, Lutheran and Lewis, for the red cell enzyme polymorphisms adenylate kinase (AK), glyoxalase (GLO), phosphoglucomutase (PGM), esterase D (ESD), red cell acid phosphatase (aP), and for the serum protein polymorphisms group specific component (vitamin D binding protein, GC) and transferrin (TF). In addition to this the HLA-A and HLA-B antigens of the major histocompatibility complex (HLA) were also typed in 973 individuals. The blood group polymorphisms were typed by the classical haemagglutination methods. Serum protein and red cell enzyme polymorphisms were determined by conventional cellulose acetate electrophoresis. HLA antigens were typed by the standard two stage microlymphocytotoxicity technique. Genetic equilibrium can be assumed for all polymorphic systems under study. The results indicate some regional differences in the distribution of allele frequencies.

Genetic variation at five STR loci in subpopulations living in Turkey.

Five short tandem repeat (STR) systems HumVWA, HumTH01, HumCD4, HumF13B and HumFES were investigated in 2 subpopulations living in Turkey (Laz Turks and Kurds). The population genetic data were compared to a Turkish population sample from the Adana area. A closer genetic relationship was found to the Laz Turks than to the Kurdish sample which was also confirmed by phylogenetic tree reconstruction with seven populations from three major ethnic groups (Caucasian, Asian and African). In contrast to the Laz and Adana populations the Kurdish sample showed relatively low heterozygosity values and deviations from Hardy-Weinberg equilibrium in four of the five systems.

Postgraduate forensic science education in Turkey.

Legal medicine in Turkey, has an educational background that goes back to 1839 and the first autopsy in modern terms was performed in 1841. In the early days, it was common practice for those involved in this work to extend their investigative knowledge into areas not directly concerned with medical matters. However forensic medical investigations cannot be entrusted in the hands of single investigators, but should rather be dealt with by cooperative groups of experts nowadays. This need was the major force for the establishment of the Institute of Legal Medicine and Forensic Sciences by a special article of the law (section 2547) as a training and research center in 1982. The Institute being the first and only institution giving master's and doctorate degrees in Forensic Sciences, has 3 major departments: 1) Medical Sciences Department, 2) Basic Sciences Department and 3) Social Sciences Department. Graduates of various fields ranging from medical doctors specialized in any field, biologists, chemists to lawyers, district attorneys, psychologists and other related fields are composing the multidisciplinary structure of the institute. The main research fields of the Institute are: population genetics, paternity investigation, child abuse, and identification of human remains.

Coarctation of the aorta in infants and neonates: results and assessment of prognostic variables.

From 1984 until 1994, 75 consecutive patients younger than 12 months of age were operated on for coarctation of the aorta. We retrospectively analyzed predictive factors for morbidity and mortality, and also interaction between surgical procedures and recoarctation. Surgical procedures were as follows: resection with a traditional end-to-end (E-E) anastomosis in 55 patients (73.3%), prosthetic patch aortoplasty (PPA) in 12 patients (16%) and subclavian flap aortoplasty (SFA) in 8 patients (10.7%). Early mortality was 9.33% (7 patients). Logistic regression analysis proved that age at operation, associated anomalies of heart, type of coarctation, aortic arch hypoplasia and pulmonary banding were independent predictors of hospital death. Late mortality occurred in 7 patients (10.3%). Associated anomalies of heart were an independent prognostic factor for late mortality. Actuarial freedom from recoarctation at 1 year was 91% [confidence limits (CL): 82% to 97%] and 5 years were 74% (CL: 67% to 86%). Immediate postrepair gradient was equal after E-E anastomosis and other procedures. We conclude that the treatment of first choice in the management of coarctation of the aorta in infants is E-E anastomosis.

Long-term experience with pericardiectomy: analysis of 105 consecutive patients.

A retrospective analysis of the records of 105 patients who underwent pericardiectomy from 1983 to 1993 was performed. Primarily, 40 patients (38%) had tuberculosis, 16 patients (15%) a malignancy, 12 patients (11.4%) uremia, and 11 patients (10.5%) had rheumatic disorders. Pericardiectomy was performed through midline sternotomy in all cases, 9 of them required cardiopulmonary bypass. On operation, the anterior pericardium was excised parallel to the phrenic nerves on both side. The early mortality rate was 10.5% (11 patients). Mean follow-up time was 5.8 +/- 2.1 years, ranging from 1 year to 11 years. Actuarial survival of the patients at 1 year and 5 years were 81.1% +/- 6.8% and 63.5% +/- 8.2%, respectively. We conclude that pericardiectomy using midline sternotomy with or without cardiopulmonary bypass can be performed safely and can lead to good functional results and long-term survival.

Congenital absence of the pulmonary valve associated with pulmonary stenosis, large ductus arteriosus and intact ventricular septum. Case report.

A six-day-old neonate was diagnosed with a severe form of the syndrome of absent pulmonary valve associated with pulmonary stenosis, aneurysmal dilatation of the pulmonary artery and rare findings including an intact ventricular septum and large ductus arteriosus. The patient underwent surgical repair by closed technique. Cardiac catheterization data, hemodynamic and clinical findings, and surgical technique are reported. Congenital absence of the pulmonary valve is a rare cardiac anomaly. An especially severe form occurs with ventricular septal defect and pulmonary stenosis. The usual findings are respiratory distress, aneurysmal dilatation of the pulmonary arteries and pulmonary stenosis.

Response to intradermal injection of monosodium urate crystals in Behçet's syndrome.

The cutaneous response to intradermal injection of monosodium urate crystals was investigated in 97 patients with Behçet's syndrome in Turkey and 14 in the United Kingdom, and in 82 healthy and 88 diseased controls. Urate crystals produced an increased erythematous response in patients compared with controls in both countries. This response was different from that of the pathergy test performed at the same time. The systemic acute phase response, studied only in Turkey, showed no differences between patients and controls.