Evaluation of surface characteristics of rotary nickel-titanium instruments produced by different manufacturing methods.

BACKGROUND: Instrument fracture is a serious concern in endodontic practice. OBJECTIVE: The aim of this study was to investigate the surface quality of new and used rotary nickel-titanium (NiTi) instruments manufactured by the traditional grinding process and twisting methods. MATERIALS AND METHODS: Total 16 instruments of two rotary NiTi systems were used in this study. Eight Twisted Files (TF) (SybronEndo, Orange, CA, USA) and 8 Mtwo (VDW, Munich, Germany) instruments were evaluated. New and used of 4 experimental groups were evaluated using an atomic force microscopy (AFM). New and used instruments were analyzed on 3 points along a 3 mm. section at the tip of the instrument. Quantitative measurements according to the topographical deviations were recorded. The data were statistically analyzed with paired samples t-test and independent samples t-test. RESULTS: Mean root mean square (RMS) values for new and used TF 25.06 files were 10.70 ± 2.80 nm and 21.58 ± 6.42 nm, respectively, and the difference between them was statistically significant (P < 0.05). Mean RMS values for new and used Mtwo 25.06 files were 24.16 ± 9.30 nm and 39.15 ± 16.20 nm respectively, the difference between them also was statistically significant (P < 0.05). CONCLUSION: According to the AFM analysis, instruments produced by twisting method (TF 25.06) had better surface quality than the instruments produced by traditional grinding process (Mtwo 25.06 files).

Evaluation of antimicrobial and thermal effects of diode laser on root canal dentin.

OBJECTIVES: The aim of this study was to evaluate the antimicrobial effects of diode laser and temperature rise on the root surface during application. MATERIALS AND METHODS: Thirty-six teeth were chemomechanically prepared and irrigated with 2.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid, and then autoclaved and incubated with a suspension of Enterococcus faecalis. The specimens were randomly divided into three groups (n = 12): Group 1, irradiated by diode laser at 1.2 W; Group 2, irradiated by diode laser at 2 W; and Group 3, irradiated by diode laser at 3 W. The grown bacteria were counted and the mean numbers of the each test tube were determined. The temperature was measured on the external apical third of the root during laser application. The mean values of results for each group were compared using one-way analysis of variance and Tukey test. RESULTS: No significant difference was obtained among the test groups in terms of the colony counts (P > 0.05). According to the temperature changes, there was a significant difference between groups (P < 0.05). Temperature rises were 16.79°C, 10.20°C, and 6.25°C in Group 3, Group 2, and Group 1, respectively. CONCLUSION: Diode laser irradiation with 1.2 W demonstrated comparable performance with 2 W and 3 W power sets for elimination of E. faecalis from root canal with less temperature rise.

Vascular patterns of nonpigmented tumoral skin lesions: confocal perspectives.

BACKGROUND: The characteristic vascular patterns of nonpigmented skin tumors have been established by dermoscopy. Recently, in vivo reflectance confocal microscopy (RCM) has become an established method for the noninvasive examination of skin tumors. OBJECTIVES: Determination of the value of RCM on the vascularity of nonpigmented skin tumors. METHODS: One hundred and twenty two tumoral lesions have been evaluated by RCM in terms of their vascular structures. They were classified in five groups as basal cell carcinoma (BCC), seborrheic keratosis (SK), squamous cell carcinoma (SCC)/keratoacanthoma, actinic keratosis (AK)/Bowen disease and others. Vascular morphologies were investigated as curved linear, straight linear, branching, tubular/canalicular, round and polymorphic vessels in six types. LIMITATIONS: Relatively, small number of patients with some tumor subgroups is limitation. Larger prospective studies are required before firm conclusions can be drawn. RESULTS: Excellent compliance was obtained in interobserver analysis. Branching vessels had a high predictive value for basal cell carcinoma (BCC) with RCM (P < 0.001). Also vascular polymorphism was more frequently (69.4%) seen in malignant nonpigmented tumors (P < 0.05) than benign nonpigmented tumors (30.6%). Furthermore, vessels with opposite flows had high predictive value for malignant tumors (P < 0.05) compared with benign tumors. CONCLUSION: Vascular properties can be evaluated in the diagnosis of nonpigmented tumoral skin lesions via RCM.

Evaluation of the response to treatment of psoriasis vulgaris with reflectance confocal microscopy.

BACKGROUND/OBJECTIVE: Reflectance confocal microscopy (RCM) is a noninvasive, objective imaging technique that provides in vivo, high-resolution skin imaging. We sought to assess epidermal and dermal changes associated with the psoriasis and its treatment with RCM before the treatment and at weeks 4 and 8 of the treatment. MATERIAL AND METHODS: This is an investigator-blinded, internal-controlled, follow-up study. A total of 25 patients with plaque psoriasis were included in the study. The RCM evaluation criteria were defined on the basis of the histopathological diagnostic criteria for psoriasis. The clinical severity of the psoriasis was evaluated using the Psoriasis Area Severity Index (PASI). RESULTS: The RCM findings which were correlated with the PASI can be used to follow up the patient's response to treatment have been identified as follows: the acanthosis, the number of spongiotic sites, the number of regular/irregular honeycomb-like sites, the number of epidermal inflammatory cells, the number of focal microabscesses, the total epidermal thickness, the number of nonedge dermal papillae, the length of the papillary dermis, the number of dermal inflammatory cells, and the vascularization in the papillary dermis (P < 0.05). CONCLUSION: This is the first study with a large group of patients to perform a noninvasive assessment with RCM of the response of psoriasis to different treatments: phototherapy, systemic and topical treatment. Micrometric and morphometric changes occurring in the psoriatic tissue during the 8-week treatment period were identified by in vivo RCM in a noninvasive manner. RCM is capable of monitoring of treatment response in psoriasis.

First imported coccidioidomycosis in Turkey: A potential health risk for laboratory workers outside endemic areas.

Coccidioidomycosis caused by Coccidioides immitis or Coccidioides posadasii is endemic in arid climate zones in America, travel-related cases have been reported. We report the first documented case of coccidioidomycosis in Turkey, overviewing reported cases in Europe and underlying difficulties of differential diagnosis outside endemic regions. The patient was an otherwise healthy 41-year-old man who travelled endemic areas. Laboratory diagnosis was based on direct microscopy of two subsequent subcutaneous biopsy specimens and culture and confirmed molecularly. Laboratory personnel should become aware that BioSafety Level-3 organisms may become more frequent and widespread.

Reflectance confocal microscopy vs. standardized skin surface biopsy for measuring the density of Demodex mites.

BACKGROUND: Reflectance confocal microscopy (RCM) has been recently shown to be effective for measuring the Demodex mite density. OBJECTIVES: To compare and demonstrate the advantages and disadvantages of standardized skin surface biopsy (SSSB) and RCM for measuring the density of Demodex mites. MATERIALS AND METHODS: Forty-eight patients (30 female, 18 male) and 47 healthy controls (30 female, 17 male) were enrolled in the study. The patients diagnoses were pityriasis folliculorum (n = 40), papulopustulary rosecea (n = 7) and erythema-telengiectatic rosacea (n = 1). The area with the most intense erythema on the right cheek was selected for imaging with RCM (VivaScope 3000) and SSSB. RESULTS: Forty-two patients demonstrated high Demodex density [(Dd) > 5 mites/cm(2) ] with SSSB (85.7%). RCM identified demodicosis in 48 patients (100%). The mean Dd measured with RCM (409.8 ± 209.2) was significantly higher than SSSB (15.33 ± 18.1) (P < 0.001). In the patients, RCM demonstrated the mean number of mites 40.90 ± 20.9 and 4.11 ± 6.4 in the controls per 10 mm(2) area. The corresponding mean number of 2.63 ± 0.77 mites was detected in the infested follicles per area of view compared to a mean of 0.77 ± 0.98 mites in the infested follicles in the controls (P < 0.001). CONCLUSION: Reflectance confocal microscopy is a fast, direct and noninvasive method for Demodex-associated diseases and it is superior to SSSB for Demodex mite detection.

Assessment of skin photoaging with reflectance confocal microscopy.

BACKGROUND/PURPOSE: Increased interest in antiaging methods, mandates a development of reliable noninvasive technique to assess skin aging. In this study, we aimed to determine the effects of photoaging at histopathologic resolution by means of reflectance confocal microscopy. METHOD: The sun-exposed malar area, the anterior aspect of ear lobule, and the sun-protected posterior aspect of ear lobule had been evaluated in 120 volunteers from different age groups over 10 previously reported and new confocal parameters for skin aging. RESULT: The sun-exposed areas revealed more frequent irregular honeycomb pattern, polycylic papillary contours, coarse collagen, huddled collagen, curled bright structures with higher epidermal thickness, and furrow depth values. However, the incidence of thin reticulated collagen and the number of dermal papillae were statistically higher on the sun-protected posterior aspect of ear lobule. CONCLUSION: Reflectance confocal microscopy is a reliable diagnostic technique for evaluation of skin photoaging with objective criteria. With the new emerging compact models it is possible to scan even the least accessible body parts with no discomfort to the patient, which offers the possibility to assess the effect of antiaging applications and to identify early signs of solar damage in cosmetically sensitive areas.

Endogenous ochronosis.

Endogenous ochronosis or alkaptonuria is a rare, autosomal recessive disease of tyrosine metabolism that is caused by a deficiency of the enzyme homogentisic acid oxidase. The disease results in the accumulation and deposition of homogentisic acid in the cartilage, eyelids, forehead, cheeks, axillae, genital region, buccal mucosa, larynx, tympanic membranes, and tendons. The disease generally presents in adults with arthritis and skin abnormalities; occasionally, involvement of other organs may be seen. A 49-year-old man was referred to our clinic with verrucous lesions on his hands. On physical examination, caviar-like ochronotic papules were found around his eyes and the helix cartilage of his ears, and on the dorsa of both hands. There were brown macules on the sclera (Osler's sign). The patient had arthritis and nephrolithiasis, and a sample of his urine darkened upon standing. Histopathological examination showed deposition of ochronotic pigment. High-dose ascorbic acid was given, and the patient showed improvement on follow-up examination 6 months later.

Effect of using propionic acid bacteria as an adjunct culture in yogurt production.

Propionibacteria are able to produce a wide variety of food components beneficial to human health. In this study, yogurt was produced by using the adjunct starter cultures Propionibacterium jensenii B1264 and Propionibacterium thoenii (jensenii) P126. Although the total solids and protein contents of the yogurts did not show any significant differences, titratable acidity of the control sample (YC-380) remained lower than that of Propionibacterium spp.-supplemented yogurts during 15 d of storage. The yogurts produced by YC-380 + P126 cultures had the firmest structure (0.26 N). The highest acetaldehyde (29.35 mg/kg) content was obtained with yogurt made with YC-380 + P126 + B1264 on d 1. The addition of propionibacteria to yogurt did not have any negative effect on the counts of Streptococcus thermophilus and Lactobacillus delbrueckii ssp. bulgaricus in yogurt. During the first week of storage, propionibacteria counts remained high, suggesting that yogurt provided a good environment for these organisms. This new product would provide not only beneficial health effects, but also a new alternative product to plain set-type yogurt.

Applicability of modelling tools in watershed management for controlling diffuse pollution.

Diffuse pollution is hard to analyze, control and manage by its nature. Watershed models and Geographical Information Systems (GIS) are recently developed tools that aid analysis of diffuse sources of pollution. However, their applications are not always easy and straightforward. Turkey is a typical example of a mountainous country rich in rivers and streams. Due to the complex geomorphology, land-use and agricultural practices in most of the watersheds in Turkey, modelling, analyzing and managing diffuse pollution has been a challenge. The complex watershed structure forces the modellers to work with spatially high resolution data. Apart from the data, the models themselves may also cause operational problems. These issues and their probable solutions form the basis of the discussions in this paper. It acts as a guideline for modelling and analyzing diffuse pollution by emphasizing the referred problems and difficulties. Design of an Information Technology-based system tool for watershed and/or water quality modelling, which would be suitable for countries having watersheds with similar structure and problems to those of Turkey, is also outlined.

Analysis and modelling of land-based nutrient pollution by watershed models coupled with GIS: a case study from Turkey.

Diffuse pollution is usually temporally and spatially uncertain, and thus hard to analyze. In many cases, discretizing a diffuse source of pollution into individual point sources can ease diffuse pollution modelling and analysis, and therefore reduce high uncertainty especially in the spatial distribution of pollution loads. This is however a difficult task, since quite a number of sub-drainage areas, with complex structures and land-use properties, has to be delineated. Watershed models can be used to delineate the sub-drainage areas in a watershed with high accuracy and locate the related outlets which connect the sub-drainage areas to the main waterbody in a watershed. In this study, such an approach has been used on a case study to model the diffuse nutrient loads carried to streams that reach to a medium-sized lake in Turkey. The annual nutrient loads, which were calculated by using mathematical models, were then converted to a load-map with the help of a geographical information system.

The psychological impact of cutaneous leishmaniasis.

A psychiatric disorder would be associated with extensive, unsightly lesions on exposed body parts. Cutaneous leishmaniasis (CL) has long been endemic in Sanliurfa and is called 'beauty scar'. The aim of this study was to determine psychological impact of CL. Patients with active CL, with CL that had healed with scaring, and healthy controls were included in this case-control study. The Hospital Anxiety Depression Scale (HAD), Body Image Satisfaction Scale (BIS), and Dermatology Quality of Life Scale (DQL) assessments were performed to determine the psychological effect of CL. The patients with CL had significantly higher HAD anxiety and depression subscale scores than the control groups. Patients with CL have decreased body satisfaction and lower quality of life than those in the control group. It was found that CL patients with active lesions have the lowest quality of life score than other groups. CL lesions on exposed body parts such as the face and hands, active CL for more than 1 year, permanent scar formation, and social stigmatization cause anxiety, depressive symptoms, decreased body satisfaction and quality of life in CL patients.

Erythrocyte antioxidative enzyme activities and lipid peroxidation levels in patients with cutaneous leishmaniasis.

Although cutaneous leishmaniasis (CL) is a local infection, the cellular immune response against the disease is systemic, and reactive oxygen intermediates (ROIs) are an important part of cellular immune response involved in killing the parasite. However, whether these intermediates cause oxidative damage in host is unknown. In this study, the metabolism of ROIs were investigated in patients with CL, and compared with healthy subjects. Erythrocyte lipid peroxidation was determined, as an index of oxidative damage, by measurement of malondialdehyde (MDA) levels. Erythrocyte MDA levels and SOD activities were found to be significantly higher in CL patients than in control subjects (p < 0.01 and p < 0.01, respectively). However, CAT and GSH-Px activities were significantly lower in the CL group (p < 0.05 and p < 0.01, respectively). There was a tendency to decreased hemoglobin (Hb) levels, but values did not reach statistical significance. These findings suggest that changes in antioxidant enzyme activities may amplify the leishmanicidal effect in patients with CL. However, these changes may not only cause the killing of parasite but also may cause oxidative damage in the other cells or tissues.

99mTc-MIBI scintigraphy in untreated stage III multiple myeloma: comparison with X-ray skeletal survey and bone scintigraphy.

Technetium-99m 2-methoxyisobutylisonitrile (99mTc-MIBI) is a lipophilic agent that has been proposed as a useful tracer for the detection of disease sites in patients with multiple myeloma (MM). We performed a prospective study to determine the potential of 99mTc-MIBI imaging for the evaluation of the extent of primary disease in patients with advanced stage MM, compared with skeletal survey and bone scintigraphy. Twenty patients with advanced stage MM at initial diagnosis underwent whole-body 99mTc-MIBI imaging, together with contemporaneous skeletal survey and bone scintigraphy. The findings of 99mTc-MIBI imaging were correlated with the results of skeletal survey and bone scan. All 99mTc-MIBI scans were positive for the presence of active MM, whereas skeletal surveys were positive in 18 patients (90%) with osteolytic lesions. Bone scintigraphy demonstrated MM in only 15 patients (75%). In two patients with no detectable lesions on skeletal survey, 99mTc-MIBI imaging revealed uptake in the spine, corresponding to the abnormalities seen on magnetic resonance imaging (MRI). With respect to the localization of bone lesions, 99mTc-MIBI imaging was superior to bone scintigraphy in 15 patients (75%) and had concordant results with bone scintigraphy in four (20%). 99mTc-MIBI imaging is a very sensitive imaging modality for the identification of the extent of disease in patients with advanced MM. It is clearly superior to bone scintigraphy and complements the results of skeletal survey by finding additional disease sites. Hence, in active MM patients, 99mTc-MIBI imaging has the potential to detect bone marrow disease that cannot be detected by skeletal survey and bone scintigraphy.