Relationship between Chromosomal Aberrations and Gene Expressions in the p53 Pathway in Chronic Lymphocytic Leukemia.

Chronic lymphocytic leukemia (CLL) is a neoplasm characterized by excessive accumulation of B lymphocytes in the peripheral blood, bone marrow and lymph nodes. We assessed the expressions of 22 genes in the p53 pathway in 30 CLL patients and 15 healthy subjects by a RT2 Profiler PCR (polymerase chain reaction) Array technique and their relation to cytogenetic aberrations detected by fluorescent in situ hybridization (FISH). Our Student's t-test results indicated that ATM, ATR, BAX, CASP9, CDK4, CDKN2A, CHEK1, CHEK2, E2F3, MCL1, MDM2, MDM4, PCNA, RB1, P53 and BCL2 genes were statistically significant (p <0.001). For six genes (APAF1, CDKN1A, E2F1, GADD45A, PTEN and PTX3) were not statistically significant. The ATM, ATR, BAX, CASP9, CDK4, CDKN1A, CDKN2A, CHEK1, CHEK2, MDM2, MDM4, PCNA, RB1, P53, E2F1, GADD45A and BCL2 genes were found to be upregulated by the 2-ᐃᐃCt (relative fold change in gene expression) method. The highest up-regulation was detected in CDKN2A and BCL2 genes, 10.22- and 8.51-fold, respectively. On the other hand, the PTX3 gene with a fold regulation of 1.84 was found to the highest downregulation. Overall, the CDNK2A BCL2 and PTX3 genes are related to the mechanism of the disease in the p53 pathway and may be an important predictor of the prognosis of the disease. The BCL2 gene may be associated with increased risk of developing CLL. We suggest that the PTX3 gene may be considered as a marker associated with CLL disease. The CDKN2A gene expression seems to play a protective role in CLL.

Effects of orthodontic force magnitude on cell apoptosis and RANKL-induced osteoclastogenesis : Studies in a rat model.

PURPOSE: The aim of this study was to evaluate the time course of orthodontic force-induced apoptosis and receptor activator of nuclear factor-κB ligand (RANKL)-induced osteoclastogenesis in a rat model under light- and heavy-force conditions. METHODS: Male Wistar rats were divided into light-force (10 cN) and heavy-force (60 cN) groups (N = 28/group). Each group was divided into four time-course subgroups to evaluate all phases of orthodontic tooth movement. Mesialization appliances were placed on three united maxillary molars unilaterally and activated. Tooth movements were calculated, and periodontal ligament (PDL) widths were measured. Expression of Bax, Bcl­2, caspase 3, caspase 9, and RANK-RANKL were assessed by immunohistochemistry. Expression levels at the PDL-alveolar bone border were compared between experimental and control groups and force groups. RESULTS: The rate of tooth movement did not differ between the force groups. PDL widths were higher on the tension side in the heavy-force group in the post-lag phase. Pro-apoptotic protein Bax expression was elevated in the heavy-force group, whereas anti-apoptotic protein Bcl­2 expression was elevated in the light-force group. RANK expression on days 7 and 21 and RANKL expression on day 21 differed between the force groups. CONCLUSIONS: Evidence of orthodontic force-induced apoptosis is more robust with stronger forces than with weaker forces. Exuberant RANKL-induced osteoclastogenesis that was seen when applying a low force results from increased RANK and RANKL expression in the post-lag phase.

A proposal for a problem-oriented pharmacobiochemistry course in dental education.

Problem-oriented learning is an effective method of learning that increases students' learning motivation, improves the relationship amongst students and results in open-minded discussions. In this study, a new problem-oriented pharmacobiochemistry course related to 'oxidative metabolism of drugs by cytochrome P450 (CYP450) systems' was designed. Students were divided into seven groups. Three keywords related to drug interaction through CYP450 were provided to each group in order for them to conduct research on the information given. After 1 month, the groups attended a session under the supervision of a tutor to solve a simulated problem case that was designed using the keywords. At the end of the integrated course, a multiple-choice examination was given. The success rate of 76 students who attended the course was found to be significantly higher than the success rate of the students who received the lecture-based course only (P < 0.0001). A questionnaire containing 20 items (Cronbach's alpha: 0.92) was administered to the students to learn about their perception regarding this educational model. The questionnaire was evaluated using the Likert scale. Student feedback was very positive, with fourteen answers rated as 'agree' and the remaining six rated as 'strongly agree'. Students thought that the problem-oriented model was very enjoyable and useful in regard to dental education. Based on these results, we conclude that this course model may help achieve an integrated curriculum for dental school programmes.

The next step in the treatment of persistent temporomandibular joint pain following arthrocentesis: a retrospective study of 18 cases.

Temporomandibular joint disorders affect a big portion of the population. There are a variety of treatment methods currently in use. Conservative treatment modalities are followed by more invasive approaches like arthrocentesis or arthroscopy. The aim of the study is to compare the effects of intra-articular tenoxicam injection and arthrocentesis plus viscosupplementation on patients in which a previous arthrocentesis plus viscosupplementation has failed to relieve pain and restore function. The study group consists of 18 TMJs in 16 patients (15 female and 1 male) and the patients were randomly divided into two groups as the arthrocentesis plus viscosupplementation group (n: 8) and tenoxicam injection (n: 10). 20 mg of tenoxicam was injected to the upper compartments of 10 joints without arthrocentesis. The other 8 joints were treated with a second arthrocentesis and sodium hyaluronate injection. VAS scores and maximum mouth opening with and without assistance were recorded in the post operative first week, first month and third month. The results show that there is little benefit in using relatively conservative methods once an arthrocentesis together with viscosupplementation has failed to relieve the patients pain. It is concluded that more invasive procedures should be considered for the patients who do not benefit from arthrocentesis.

Surface roughness of fluoride-releasing restorative materials after topical fluoride application.

AIM: The aim of this study was to assess the effect of a single application of two topical fluoride agents: NNaF and APF (2% neutral sodium fluoride gel and 1.23% acidulated phosphate fluoride gel, respectively) on the surface roughness (Ra) of Fuji IX GP, Ketac N100, Vitremer, Dyract AP, Compoglass F and Filtek Ultimate. STUDY DESIGN: The effect of NNaF and APF on the surface roughness of fluoride-releasing restorative materials was tested on disk-shaped material specimens with a surface profilometer. METHODS: All materials were handled according to manufacturer's instructions. ISO standardised specimens were prepared for each material and then stored in distilled water for 24 hr. Each sample was polished with 600 and 1200 grit sandpaper on both sides while keeping the material surface wet. Ra measurements were performed on untreated specimens initially and after 1 min, 4 min and simulated 2-years for both fluoride applications, respectively. The mean Ra values for all specimens were measured using a surface profilometer. STATISTICS: Differences in surface roughness values were assessed using paired t-test. The differences between the experimental groups were analysed with one-way ANOVA; p<0.05 was accepted as statistically significant. RESULTS: The results of the present study indicated that Ra values for Fuji IX GP and Vitremer increased significantly after all APF, but not NNaF applications. All tested materials exhibited increased Ra values for both treatment regimes, but this was not found statistically significant. CONCLUSION: APF gel application significantly increased the surface roughness of both Fuji IX GP and Vitremer for all time periods.

Periodontal health and treatment needs among hospitalized chronic psychiatric patients in Istanbul, Turkey.

OBJECTIVE: The aim of the study was to evaluate the periodontal health and treatment needs of chronically hospitalized psychiatric patients in Istanbul, Turkey. METHOD: The subjects' periodontal health was recorded by the CPI (Community Periodontal Index) method. RESULTS: Of the 330 patients examined, 179 (52.5%) were males and 151 (47.5%) females. The mean age of the patients was 49.2 +/- 11.7 years. The majority (61.8%) was diagnosed with schizophrenia and 30.6% diagnosed with mental retardation. The mean length of hospitalization was 16.0 +/- 10.9 years. Healthy periodontal tissues (CPI 0) were found in 8.8% of the subjects. Bleeding on probing (CPI 1) was recorded in 6.3%, and dental calculus (CPI 2) in 51.8% of the subjects. These were determined as the worst findings. Altogether, 33% of the subjects had deep periodontal pockets, 14.2% with at least one 4- to 5-mm pocket (CPI 3), and 18.8% with at least one 6-mm pocket (CPI 4). The stepwise logistic regression analysis, between the final CPI score and seven variables including age, gender, psychiatric diagnosis, length of hospitalization, degree of helplessness, tooth brushing habits and smoking, showed that irregular tooth brushing habits and male gender were significant contributors to having a final CPI score of 2 or more. The regression analysis also showed that tooth brushing habits remained as an explanatory variable in CPI 0 coded subjects; helplessness and psychiatric diagnosis (mental retardation) in CPI 2; tooth brushing habits and psychiatric diagnosis (schizophrenia) in CPI 3; and only helplessness in CPI 4. CONCLUSION: The present study underlines a considerable need for prevention and treatment of periodontal disease among chronic psychiatric patients in Istanbul. Efforts need to be focused above all on raising this population's awareness of the importance of oral hygiene and on early diagnosis of periodontal problems.

Oral health and treatment needs of institutionalized chronic psychiatric patients in Istanbul, Turkey.

OBJECTIVE: To assess the oral health status and treatment needs in a group of hospitalized chronic psychiatric patients. METHOD: The dental status was assessed using the DMFT index. Demographic and medical data were retrieved from the institutional clinical files. RESULTS: 491 patients were examined in the study. 258 (52.5%) of the patients were males. The mean age was 52.3 +/- 12.3 years and the average length of hospitalization was 17.5 years. The majority of the patients (69%) were diagnosed with schizophrenia. The mean DMFT was 19.25 +/- 7.85. Missing teeth (81.4%) comprised the largest proportion of the DMFT while filled teeth (0.5%) the smallest. 18.1% of the DMFT consisted of decayed teeth. Stepwise logistic regression analysis showed that the DMFT significantly increased with age (p < 0.001) and was significantly higher in schizophrenia patients than those with mental retardation (p < 0.01). Males had significantly higher decayed teeth (p < 0.01) and fewer missing teeth (p < 0.01) than females. 58 dentate subjects (14.4%) were caries free. Two hundred and thirty five patients (58.5%) required restorative care, the mean number of treatments required per patient was 1.42 +/- 1.82. Eighty-nine subjects (18.1%) were found to be completely edentulous with only 17 wearing complete dentures. 70.6% of dentate patients needed tooth extraction for caries and 36.1% for periodontal disease. CONCLUSION: The findings of this study demonstrate poor oral health status with extensive unmet dental and prosthetic needs. These underline the urgent need for specific preventive oral health programme to improve the dental care of these chronic psychiatric inpatients.

Comparison of the QuantiFERON-TB Gold In-Tube test with the tuberculin skin test for detecting latent tuberculosis infection in hemodialysis patients.

BACKGROUND AND OBJECTIVES: Hemodialysis (HD) patients are at increased risk of reactivation of latent tuberculosis (TB) infection (LTBI). LTBI screening of this population is recommended. The QuantiFERON-TB Gold assay (QFT-G) may be more accurate than the tuberculin skin test (TST) in the detection of LTBI. We prospectively compared the results of QFT-G to TST in HD patients. METHODS: We examined 100 patients and performed TST and QFT-G tests. Data obtained from patients and medical records included medical history (past history of TB, Bacillus Calmette-Guerin [BCG] vaccination, history of contact with previous TB cases), radiography reports (chest x-ray with changes consistent with old TB), and basic laboratory findings. RESULTS: Forty-three of 100 patients (43%) had a positive QFT-G test result and 34 (34%) had a positive TST test result. Overall agreement between the QFT-G and the TST was 65% (concordance [k]=0.26, P=0.01). Discordant test results were seen in 13 TST-positive/QFT-G-negative patients and in 22 TST-negative/QFT-G-positive patients. Before BCG vaccination and radiographic reports (of old TB changes) were associated with discordant test results. On multivariate analysis, a positive QFT-G test was associated with contact with previous TB cases (P=0.026) and radiographic report (P=0.034), whereas a positive TST test also was associated with a history of BCG vaccination (P=0.015). CONCLUSIONS: QFT-G test results were more closely associated with TB risk factors than were positive TST results. Additionally, the QFT-G test was not affected by BCG vaccination. We concluded that QFT-G test is a more useful diagnostic method than TST for detecting LTBI in HD patients.

Hypertension in leather tanning workers working in Istanbul, Turkey.

INTRODUCTION: Leather tanning may result in various occupational diseases. The aim of this study was to compare the relation between blood pressure levels and vocations in leather tanning. METHODS: Our study was conducted in Turkey's leading leather process plant located in Tuzla organised industry zone, between March 11 and May 30, 2005. All leather plants that consented to participate in our study were included. The blood pressure, height and weight of the workers were measured. Their ages, educational levels, smoking habits and hypertension history were obtained via interviewing the subjects. The relation between three main factors, i.e. age, body mass index (BMI), working period, and hypertension were analysed through multiple logistic regression analysis. RESULTS: 40.4 percent (295) of 730 workers' blood pressure values were found to be within normal limits. 59.6 percent (435) were found to be hypertensive. The hypertension correlation remained significant, along with BMI and their working period (p-values were 0.0001 and 0.035, respectively). CONCLUSION: Our study demonstrated that BMI and working period have a key influence on the increased risk of hypertension, which leads us to consider the importance of occupational exposure. Different hypertension studies to be conducted in various occupational fields would likely be able to confirm our findings.

Vascular endothelial growth factor gene polymorphisms in Turkish patients with sarcoidosis.

Polymorphism at +813 locus of vascular endothelial growth factor (VEGF) gene is considered to decrease predisposition to sarcoidosis. Our study aimed to investigate the roles of this polymorphism in the development and extent of sarcoidosis. We examined polymorphisms of the VEGF gene in 90 cases with histopathological diagnosis of sarcoidosis and in 110 healthy subjects. VEGF +813 gene polymorphisms were determined using a polymerase chain reaction-based method after DNA isolation. A significant increase in the frequency of the T allele was found in healthy subjects (odds ratio 0.55; 95% confidence interval 0.32-0.97, P<0.05). Our results suggest that increase in rarer T allele at + 813 locus of VEGF gene may diminish susceptibility to sarcoidosis in Turkish population.

Confirmed prevalence of food allergy and non-allergic food hypersensitivity in a Mediterranean population.

BACKGROUND: Until the present, no comprehensive studies evaluating the prevalence of food allergy and non-allergic food hypersensitivity (FA/NAFH) in adults have been done in Turkey or its surrounding countries. OBJECTIVE: This large population-based study was planned to identify the confirmed prevalence of adverse reactions to food in adults in Istanbul. METHODS: A total of 17 064 telephone numbers were randomly selected from both the European and Asian sides of Istanbul, and the 11 816 subjects who agreed to participate in the study were addressed with a questionnaire of eight items. Those who disclosed food-related complaints in this survey were called again and a similar questionnaire was repeated. The respondents who were suspected of having food allergy or food hypersensitivity were invited for a personal clinical investigation that included double-blind, placebo-controlled food challenge tests. RESULTS: The lifetime prevalence of self-reported FA/NAFH was found to be 9.5% [1118/11 816; 95% confidence interval (CI): 8.94-10.00%]. After the clinical investigations, the point prevalence of FA/NAFH, which also included the 'possible FA/NAFH group', was found to be as low as 0.3% (30/11 816; 95% CI: 0.17-0.36%), and the FA/NAFH rates assessed by double-blind, placebo-controlled food challenge tests were 0.1% (12/11 816; 95% CI: 0.05-0.18%) and 0.1% (11/11 816; 95% CI: 0.05-0.17%), respectively. The most significant factor influencing FA/NAFH was familial atopy (adjusted OR 4.3; 95% CI: 3.67-4.99), and the most related atopic disease was itching dermatitis/urticaria (adjusted OR: 3.9; 95% CI: 3.31-4.54). CONCLUSION: We may conclude that FA/NAFH in the Turkish population seems to be low when compared with Northern and Western European countries. This may be due to genetic, cultural or dietary factors, and further studies evaluating the reasons for this low prevalence of FA/NAFH in our population are needed.

Electrocautery for cutaneous flap creation during thyroidectomy: a randomised, controlled study.

BACKGROUND: Although electrocautery has been used widely in surgery, the fear of delayed wound healing and infection persists. We aimed to evaluate the risk factors for wound complications and the rate of wound complications, comparing the use of electrocautery or scissors in cutaneous flap creation during thyroidectomy. DESIGN: The study group comprised 239 consecutive patients scheduled for thyroidectomy. SUBJECTS: Patients were randomly assigned to cutaneous flap dissection by either electrocautery (group one, n = 126) or scissors (group two, n = 113). Age, gender, body mass index, American Society of Anesthesiology score, tissue weight, operating time, incision length, cutaneous tissue depth, thyroid function and surgeon experience were recorded and compared with the rate of post-operative wound complications in both groups. RESULTS: There were no significant differences between the overall rate of post-operative wound complications, comparing groups one and two (7.9 vs 10.6 per cent, respectively; p = 0.74). Significant positive correlations were found between wound complication and age (Spearman's rank coefficient (rs) = 0.135, p = 0.036), body mass index (rs = 0.379, p = 0.0001), cutaneous tissue depth (rs = 0.677, p = 0.0001) and tissue weight (rs = 0.643, p = 0.0001). According to logistic regression analysis, a body mass index of more than 27.5 kg/m2 was associated with a 13.7-fold increased rate of post-operative wound complications. CONCLUSION: When creating cutaneous flaps during thyroidectomy, the use of electrocautery is as safe as the use of scissors. Such electrocautery does not increase the risk of wound complications in thyroid surgery.

Evaluation of periodontal parameters in patients undergoing peritoneal dialysis or hemodialysis.

OBJECTIVE: To analyze and compare periodontal parameters in chronic renal failure (CRF) patients undergoing peritoneal dialysis (PD) therapy with a group of patients on hemodialysis (HD) treatment and healthy controls (C). PARTICIPANTS: Seventy-five PD patients (mean age: 44 +/- 12 years) were matched with 41 HD patients (mean age: 46 +/- 15 years) and 61 C (mean age: 46 +/- 18 years). METHODS: Plaque (PI) and calculus (CSI) accumulation and gingival bleeding (GI) were recorded with the appropriate indices. Periodontal condition was assessed using the probing pocket depth (PPD). One-way anova test, Pearson chi-squared test, Mann-Whitney U-test and Kruskal-Wallis test were performed to compare PD patients with HD patients and healthy C. RESULTS: Plaque Index values were significantly higher (P < 0.001) in the PD and HD groups than the C group. GI values were significantly higher (P < 0.01) in the HD group than the PD group. Finally, CSI values in the PD and HD groups were also significantly higher (P < 0.001) than the C group. CONCLUSIONS: Chronic renal failure patients on PD treatment are more susceptible to periodontal diseases like HD patients. Thus, it is very important to maintain an optimal oral hygiene level. Further studies on periodontal parameters of only PD patients are needed to get more information on the oral health status of this patient group.

Determination of remnant thyroid volume: comparison of ultrasonography, radioactive iodine uptake and serum thyroid-stimulating hormone level.

PURPOSE: We aimed to evaluate the accuracy of ultrasonography, radioactive iodine uptake and serum thyroid-stimulating hormone level in predicting the volume of remnant thyroid gland. METHODS: Sixty-six thyroidectomy patients were divided into two groups according to their functional status, i.e. those operated upon for nontoxic multinodular goitre (group one) and those operated upon for hyperthyroidism (group two). Ultrasonography, radioactive iodine uptake and thyroid-stimulating hormone assay were performed in all patients during the first post-operative month. The two groups were subdivided according to the amount of remnant thyroid volume detected on ultrasonography: <2 ml, 2-5 ml and >5 ml. RESULTS: The remnant thyroid volume was positively correlated with the radioactive iodine uptake (rs = 0.684, p = 0.0001). The increase in remnant thyroid tissue radioactive iodine uptake was significantly greater in the patients operated upon for hyperthyroidism compared with those operated upon for nontoxic multinodular goitre (p = 0.0001). There was a negative correlation between remnant thyroid volume and post-operative serum thyroid-stimulating hormone level (rs = -0.865, p = 0.0001) and between remnant thyroid tissue radioactive iodine uptake and post-operative serum thyroid-stimulating hormone level (rs = -0.682, p = 0.0001). CONCLUSION: Ultrasonography is a more accurate measure of remnant thyroid volume than radioactive iodine uptake in patients operated upon for hyperthyroidism, compared with those operated upon for nontoxic multinodular goitre.

Circulating ghrelin levels in obese women: a possible association with hypertension.

OBJECTIVE: The orexigenic hormone ghrelin induces weight gain by stimulating food intake. Ghrelin has been shown to modulate sympathetic activity, to exert vasodilative effects and to counterreact with leptin on both food intake and blood pressure. Of these two hormones, ghrelin levels are decreased in obesity, whereas leptin levels are increased. In this cross-sectional study, differences in serum ghrelin and leptin levels were examined in normotensive and hypertensive obese women. MATERIAL AND METHODS: Sixty-one normotensive and hypertensive women were classified according to the body mass indices as follows: (a) 18 healthy subjects with BMI 21.5-27.5 kg/m(2); (b) 22 normotensive subjects with BMI 30-47 kg/m(2); (c) 21 hypertensive obese subjects (BMI 30-48 kg/m(2)) with systolic blood pressure > or =140 mmHg or diastolic blood pressure > or =90 mmHg. Anthropometric measurements including height, weight, BMI, waist and hip circumferences and blood pressure were recorded. The levels of ghrelin and leptin were determined in sera using the commercial ELISA kits. RESULTS: In normotensive obese subjects, ghrelin levels were significantly lower than in controls (0.21+/-0.13 vs 0.60+/-0.3 ng/mL), whereas hypertensive obese women had elevated ghrelin levels (0.64+/-0.36 ng/mL). Ghrelin concentration was decreased despite the presence of hypertension in the patients who had BMIs above 35 kg/m(2). Leptin levels were significantly higher in both normotensive and hypertensive obese groups (19.54+/-11.19 and 21.61+/-12.7 ng/mL, respectively) than in controls (7.61+/-3.3 ng/mL), and were not affected by the presence of hypertension in obese subjects. CONCLUSION: Ghrelin was positively associated with hypertension in obese women and this association was inversely influenced by the increase of BMI.

Dental and periodontal findings in hemodialysis patients.

OBJECTIVE: Oral health problems of chronic renal failure patients can compromise systemic health. This study compared the periodontal and dental health status of patients on hemodialysis (HD) with healthy controls (C). STUDY DESIGN: Seventy-six HD patients and 61 controls were examined for plaque deposits, gingivitis, periodontitis, calculus accumulation and oral health status. RESULTS: There was no statistically significant difference in the measurement of probing pocket depths (PPD) in HD and C groups, but a highly significant difference was found for plaque index (P < 0.001), gingival index (GI) (P = 0.007) and calculus surface index (P < 0.001). There was a highly significant difference for GI (P = 0.001) and PPD scores (P < 0.001) between subgroups receiving HD for <3 years or more. A positive correlation between time on dialysis and parameter of missing teeth (r = 0.259; P = 0.024), GI scores (r = 0.474; P < 0.001) and measurement of PPD (r = 0.481; P < 0.001) was found in the HD group. Decayed, missing and filled teeth index scores were higher in the controls than the HD group, with no statistical significance. CONCLUSIONS: The dental and periodontal health status of HD patients is comparable with healthy controls, but becomes worse with time on dialysis. Thus, oral health maintenance is of utmost importance in this patient group.

Predictive factors for recurrent laryngeal nerve palsy and hypoparathyroidism after thyroid surgery.

OBJECTIVES: To evaluate the incidence and risk factors of recurrent laryngeal nerve palsy and hypoparathyroidism following thyroidectomy. DESIGN: Retrospective case-control study. SETTING: Tertiary clinic. PARTICIPANTS: From September 1990 to September 2005, 3250 consecutive patients who had a thyroidectomy for treatment of various thyroid diseases. MAIN OUTCOME MEASURES: The rates of nerve palsy and hypoparathyroidism were evaluated based on thyroid pathology, the choice of operative procedure, whether the nerve was identified, and the experience of the surgeon. RESULTS: Overall, the rate of nerve palsy was 1.8% and that of hypoparathyroidism was 6.6%. On univariate analysis the rates of complications were siginificantly higher in the patients who had an extended thyroidectomy, identification of the recurrent laryngeal nerve during surgery, repeat surgery and patients older than 50 years of age. Complications were no commoner in operations performed by trainees under supervision than experienced surgeons. On multivariate analysis extended thyroidectomy had a 12 fold (95% CI 1.7, 92) increased risk of nerve palsy. Repeat surgery had a 3 fold (95% CI 2.1, 4.7) increased risk of postoperative hypoparathyroidism. CONCLUSION: Extentended thyroidectomy and repeat surgery had a significant effect on the incidence of recurrent laryngeal nerve palsy and postoperative hyperparathyroidism respectively following thyroid surgery.

Advanced oxidation protein products in obese women: its relation to insulin resistance and resistin.

Obesity is a major risk factor for insulin resistance and type 2 diabetes mellitus (T2DM). Resistin, an adipocyte-secreted hormone, is thought to take a part in the development of insulin resistance and T2DM. The aim of this study was to characterise the changes in circulating levels of resistin and proinflammatory cytokines tumour necrosis factor-alpha (TNF-alpha) and interleukin (IL)-6 in diabetic and prediabetic obese patients and to explore their relationship to insulin resistance. Attempts were also made to see whether resistin levels are related to the degree of oxidative stress, as determined by the measurement of advanced oxidation protein products (AOPPs). The study groups consisted of obese diabetic (BMI: 30-42 kg/m(2), n=28) and prediabetic (BMI: 29-41 kg/m(2), n=23) women. Fourteen healthy women, with BMI in the range 21.5-25.5 kg/m(2), were taken as controls. Serum levels of TNF-a, IL-6, resistin, glucose, insulin and AOPPs were measured. Insulin resistance was calculated by the homeostasis model assessment (HOMA-IR). Diabetic and prediabetic obese patients had increases in serum resistin and TNF-alpha levels (P<0.01 and P<0.001, respectively). IL-6 levels in diabetic patients were significantly higher than in prediabetics (P<0.05). AOPP levels were also significantly higher in diabetics than prediabetics and controls (P<0.05 and P<0.001, respectively); and positively correlated with blood glucose. Insulin was significantly associated with circulating resistin and TNF-alpha. The development of insulin resistance may contribute to the elevation of circulating resistin or vice versa. Determination of AOPPs may be helpful for monitoring the impaired glucose metabolism in obesity.

Prevalence of symptoms associated with temporomandibular disorders in a Turkish population.

Despite numerous studies having been published, the epidemiology of temporomandibular disorders remains uncertain and controversial. The aim of this study was to estimate the prevalence and distribution of symptoms commonly associated with such disorders among a sample of adults in Istanbul, Turkey. A total of 1253 individuals aged 18 years were identified by using a random-digit dialing technique. They were asked standard questions about joint and jaw muscle pain, jaw opening, and joint sounds. Additional questions on tooth grinding and clenching, sleep patterns, and treatment-seeking behaviour were posed. Jaw pain was reported by 31% of the population. Women were more likely, than men, to respond positively to the questions concerning jaw pain. No gender- and age-related differences in prevalence of difficulty opening, clicking, tooth grinding/clenching and being poorly rested were found.

Fluconazole and/or hexetidine for management of oral candidiasis associated with denture-induced stomatitis.

OBJECTIVE: The aim of the present study was to compare the influence of fluconazole capsules and/or hexetidine mouthrinses for the management of oral candidiasis associated with denture stomatitis. DESIGN RELEVANT: Sixty-one patients (ages 43-76 years, mean: 61) admitted to the Department of Oral Surgery and Medicine and diagnosed as suffering from oral candidiasis associated with denture stomatitis by microbiological examination were involved. MATERIALS AND METHODS: Patients in group 1 (n = 21) were given only fluconazole capsules (Zolax 50 mg once a day), those in group 2 (n = 18) were given only hexetidine mouthrinses (Heksoral 0.1%, twice daily), whereas those in group 3 (n = 22) were given both fluconazole capsules and hexetidine mouthrinses for 14 days. The yeast colonies of the saliva samples were counted and calculated as the number of colony forming units per milliliter. The presence of yeasts in the lesion and denture samples were evaluated as present/absent according to their growth on cultures. Candida albicans was identified by means of germ tube analysis. RESULTS: Patients in groups 1, 2 and 3 had a statistically significant decrease in the amount of C. albicans in saliva, lesions and dentures after treatment, when compared with pretreatment results (P < 0.05). Candida albicans counts in saliva, lesion and denture after treatment detected no statistically significant difference when the three groups were compared. CONCLUSION: Of the three study groups, group 2, where hexetidine was the only medication prescribed, was found to be superior on account of fewer potential complications. We conclude that dentists should employ a more conservative intervention with oral mouthrinses rather than risk adverse effects and complications of systemic drugs for the management of oral candidiasis.