The effect of interleukin-20 on periodontal tissue destruction in individuals with periodontitis.

BACKGROUND AND OBJECTIVE: Periodontitis is an inflammatory disease that destroys periodontal tissues. Interleukin-20 (IL-20), on the other hand, is known as a potent angiogenic, chemotactic, and pro-inflammatory cytokine associated with various chronic inflammatory disorders. IL-20 has a significant role in the regulation of osteoclastogenesis and osteoblastogenesis. This study aimed to evaluate the effect of IL-20 on periodontal destruction. METHODS: In this study, a total of 60 participants were included, 30 of whom were systemically and periodontally healthy (control group), and 30 were systemically healthy but had periodontitis (periodontitis group). Gingival crevicular fluid (GCF) and serum samples were collected from the participants for biochemical analysis. Enzyme-linked immunosorbent assay was used to determine the levels of IL-20, tumor necrosis factor (TNF)-α, IL1ß/IL-10, RANKL/osteoprotegerin (OPG), and matrix metalloproteinase-8 (MMP8). For statistical analysis, the independent t-test, Pearson correlation coefficients, and the Chi-square test were used. RESULTS: GCF IL-20, RANKL, RANKL/OPG, serum IL-20, RANKL, RANKL/OPG, MMP-8, TNF-α, IL-1B, and IL-1ß/IL-10 values were found to be statistically significantly higher in the periodontitis group than in the control group. GCF OPG and serum IL-10 values were found to be statistically significantly higher in the control group than in the periodontitis group. No statistically significant difference was observed between the groups in serum OPG values. A statistically significantly positive correlation was observed between serum IL-20 value and serum RANKL, RANKL/OPG, MMP-8, TNF-α, IL-1ß values, and periodontal clinical parameters. The ROC curves showed: AUC = 0.788 for GCF IL-20, and AUC = 1.000 for serum IL-20. CONCLUSION: According to the results of the study, IL-20 was found to be associated with periodontitis. The role of IL-20 in periodontal pathogenesis is related to osteoclastogenesis and collagen degradation. It is conceivable that IL-20 may increase bone destruction by both affecting the RANKL/OPG ratio and proinflammatory cytokines.

Demystifying and Mitigating Bias for Node Representation Learning.

Node representation learning has attracted increasing attention due to its efficacy for various applications on graphs. However, fairness is a largely under-explored territory within the field, although it is shown that the use of graph structure in learning amplifies bias. To this end, this work theoretically explains the sources of bias in node representations obtained via graph neural networks (GNNs). It is revealed that both nodal features and graph structure lead to bias in the obtained representations. Building upon the analysis, fairness-aware data augmentation frameworks are developed to reduce the intrinsic bias. Our theoretical analysis and proposed schemes can be readily employed in understanding and mitigating bias for various GNN-based learning mechanisms. Extensive experiments on node classification and link prediction over multiple real networks are carried out, and it is shown that the proposed augmentation strategies can improve fairness while providing comparable utility to state-of-the-art methods.

Management of spaghetti wrist under WALANT technique.

This study aimed to evaluate the effectiveness of the WALANT technique in managing spaghetti wrist lacerations. Thirteen consecutive patients with spaghetti wrist laceration were operated on under WALANT technique and followed prospectively. All patients were operated on by the same hand surgeon in a university hospital setting. At the final follow-up, arterial patency, tendon repair, nerve regeneration, handgrip strength and overall patient satisfaction were assessed. All patients were male, with a mean age of 23.8 ± 7.7 years (range, 18-42). The mean waiting time from admission to operation was 33.6 ± 5.1 min (range, 26-42). The operation lasted a mean 119.6 ± 33.8 min (range, 75-185). Mean time from admission to discharge was 269.3 ± 35.0 min (range, 225-341). Mean VAS for intraoperative pain was 1.0 ± 0.9 points (range, 0-3). Patients were followed up for at least 6 months: mean 9.8 ± 1.6 months (range, 7-12). Ten of the 12 repaired arteries were patent and 2 were occluded at the final follow-up. Six of the 17 repaired nerves were evaluated as excellent, 9 as good and 2 as fair on 2-point discrimination test. Total active range of motion was perfect in 6 patients, good in 6, and fair in 1. Grip strength was averaged 86.8% (range, 76.9-93.5%) of the contralateral value. All patients were either very satisfied (n: 9) or satisfied (n: 4). The WALANT technique can be used for spaghetti wrist lacerations involving the tendons, arteries and nerves, with favorable outcome. Major arterial anastomosis can be performed without any surgical limitation.

Reliability of subluxation and articular involvement measurements during the assessment of bony mallet finger.

The aim of this study was to investigate the reliability of distal interphalangeal joint (DIPJ) subluxation and articular surface involvement measurements during the assessment of bony mallet finger. Two observers measured articular involvement, subluxation ratio and rated joint congruency on 30 lateral radiographs of patients with bony mallet finger on two separate occasions. All measurements and ratings were done on magnified digital radiographs on a workstation. The intraclass correlation coefficient (ICC) and kappa statistics were used to establish relative agreement between observers. The intra-observer reliability for articular involvement and subluxation ratio were good for Observer A (ICCs 0.888 and 0.775) and excellent for Observer B (ICCs 0.958 and 0.910) on both occasions. However, the subluxation rating was moderate for both observers (kappa 0.772 and 0.780, respectively). Inter-observer reliability for articular involvement (ICC 0.884) and the subluxation ratio (ICC 0.818) was good on the first measurement. Although the subluxation rating was perfect for the first measurement (kappa 0.927), it was moderate for the second (kappa, 0.619). The reliability of articular involvement (%) and subluxation ratio (%) measurement was good and excellent. However, the decision on whether the DIPJ is congruent or incongruent was only moderately reproducible. These findings show us that surgeons should be cautious when assessing subluxation, which is the most important criterion for choosing the appropriate treatment.

Bilateral calcaneal insufficiency fractures due to chronic carbamazepine use for trigeminal neuralgia: A case report.

Stress fractures of calcaneus are uncommon cause of heel pain. Stress fractures could be seen in risc groups such as metabolic diseases/medications causing poor bone quality and exposing repetitive microtrauma. Anti-epileptic drug (AED) use is related with poor bone quality and increased fracture risc. Although carbamazepine-induced stress fracture is a well-known entity and there are case reports in other bones such as the femoral neck, bilateral calcaneal insufficiency fractures is an extraordinary location. To the best of our knowledge, this is the first case reporting an insufficiency fracture involving calcaneus in the relevant literature. Due to the rarity of both conditions, we decided to present and discuss this patient. When patients receiving AED treatment present with heel pain without previous plantar fasciitis history or traumatic event, insufficiency fractures should be kept in mind. This case highlights the importance of screening adverse effect of CBZ on bone metabolism in patients with long CBZ use. We report here a 41-year-old lady suffering from bilateral heel pain without trauma history. Her complaining did not respond to analgesics and stretching exercises of plantar fascia. In her past medical history she reported ongoing carbamazepine (CBZ) use over 8 years for trigeminal neuralgia. She had had low bone mineral density; defined as osteopenia. Both calcaneus MRI revealed bilateral stress fractures of calcaneum. She had been advised immobilization for 6 weeks, vitamin D and calcium supplements. CBZ has been stopped by neurology specialist and she had undergone microvascular decompression surgery for intractable pain of trigeminal neuralgia. She is doing well with full recovery from heel pain and trigeminal neuralgia at the end of one year. CBZ use causes poor bone quality through vitamin D metabolism. Heel pain without traumatic event, objective findings of plantar fasciitis and calcaneal spur syndrome in an CBZ using patient insufficiency fracture of calcaneus should be remembered and evaluated rigorously.

Remodelling of Humeral Fracture in a Child with Osteopetrosis Tarda following Conservative Management - A 7-year Follow-up: A Case Report.

Osteopetrosis (OP) is a rare hereditary sclerosing bone dysplasia characterised by generalised hard and brittle bone secondary to defective osteoclastic function. Osteopetrotic bone is brittle, thus these subjects are prone to frequent fractures, particularly of the long bones. Due to defective osteoclastic function, remodeling is also defective in OP. This report is a case of humeral fracture in a 9 years old girl who was followed seven years. The fracture had remodeled totally similar to healthy bone at the final follow-up. Conservative treatment should be kept in mind in the management of fractures in children with OP, and fractures within acceptable angulations and/or translations should be treated conservatively without hesitation.

Remodelling of Humeral Fracture in a Child with Osteopetrosis Tarda following Conservative Management -A 7-year Follow-up: A Case Report

@#Osteopetrosis (OP) is a rare hereditary sclerosing bone dysplasia characterised by generalised hard and brittle bone secondary to defective osteoclastic function. Osteopetrotic bone is brittle, thus these subjects are prone to frequent fractures, particularly of the long bones. Due to defective osteoclastic function, remodeling is also defective in OP. This report is a case of humeral fracture in a 9 years old girl who was followed seven years. The fracture had remodeled totally similar to healthy bone at the final follow-up. Conservative treatment should be kept in mind in the management of fractures in children with OP, and fractures within acceptable angulations and/or translations should be treated conservatively without hesitation.

Autologous osteochondral transplantation (mosaicplasty) in articular cartilage defects of the patellofemoral joint: retrospective analysis of 33 cases.

OBJECTIVE: The purpose of this retrospective study was to evaluate the results of osteochondral autografting (mosaicplasty) in isolated articular cartilage defects of the patellofemoral joint. MATERIALS AND METHODS: Thirty-three patients who underwent mosaicplasty for patellofemoral (either patella or trochlea) cartilage defects (modified Outerbridge classification: grades III and IV) of the knee joint were retrospectively reviewed. There were 25 male and 8 female patients with a mean age of 31.3 ± 6.7 (range 22-47) years. The average size of the lesion was 2.4 ± 0.55 cm2 (range 1.5-4.0). Patients with patellofemoral malalignment were excluded. All patients were followed at least one year with a mean of 19.3 ± 4.3 months (range 12-24 months) using Lysholm knee score. RESULTS: The mean preoperative Lysholm knee score was 51.9 ± 2.6 (47-58) points and increased to 85.5 ± 4.2 (75-89) points at the final follow-up. There was a significant increase in Lysholm score during follow-up period (p = 0.0001). The results were good in 24 cases and fair in 9 cases. No patients had poor results. No patients had infection. Five patients had postoperative mild painful hemarthrosis. Of these patients, four were treated with rest, ice, compression (elastic bandage) and elevation and the remaining one was treated by aspiration. No patients needed secondary open or arthroscopic drainage. No systemic complications occurred during the follow-up. CONCLUSIONS: Mosaicplasty is an effective technique for the treatment of articular cartilage defects of the patellofemoral joint knee which restores the joint function in a short period of follow-up. However, a meticulous surgical technique should be followed to restore the native articular surface and the congruity of the joint.

Biochemical and histopathologic analysis of the effects of periodontitis on left ventricular heart tissues of rats.

BACKGROUND AND OBJECTIVE: Current epidemiological works have suggested that chronic infections, such as periodontitis, are associated with an increased risk of cardiovascular diseases, including hypertrophy and heart failure. However, mechanisms behind the association are not known. The aim of this study was to evaluate the effects of periodontitis on the serum lipid levels, inflammatory marker levels and left ventricular heart muscle tissues of rats. MATERIAL AND METHODS: Eighteen male Sprague-Dawley rats were randomly divided into two groups: control (without ligature) and experimental periodontitis (EP; ligatured). Periodontitis was induced by placing ligatures (3.0 silk) at a submarginal position of the lower first molar teeth for 5 wk. Serum samples were collected for biochemical studies (C-reactive protein, interleukin-1ß, tumor necrosis factor-α and serum lipids), after which the rats were killed and heart tissue samples were obtained for histopathological and immunological studies (nuclear factor kappa B and ß-myosin heavy chain). RESULTS: Significant increases in C-reactive protein and interleukin-1ß levels and no statistically significant increase in tumor necrosis factor-α level were observed in the EP group compared to the control group. In addition, total cholesterol, low-density lipoprotein cholesterol and triglyceride levels were significantly higher in the EP group. Stereological and immunological findings showed that the number of nuclear factor kappa B-p65- and ß-myosin heavy chain-positive cardiomyocytes increased significantly in the left ventricular tissue samples of the rats with periodontitis. CONCLUSION: Early chronic phase effects of periodontitis on heart tissue are in the form of degenerative and hypotrophic changes. Prolonging the exposure to systemic inflammatory stress may increase the risk of occurrence of hypertrophic changes.

Prevalence and distribution of the fabella: a radiographic study in Turkish subjects.

BACKGROUND: The purpose of this study is to examine the plain knee radiographs in Turkish subjects in order to determine the prevalence of the fabella and analyse the differences between age, gender, laterality and its symmetry pattern. MATERIALS AND METHODS: Bilateral antero-posterior and lateral knee radiographs of 500 patients (250 male and 250 female subjects, 1000 knee radiographs) were randomly selected from the clinical database and retrospectively evaluated. Data on patient age, gender, and knee laterality (right-left) were evaluated from hospital records. The differences between the sesamoid bones at a particular location and the side, sex and age groups were analysed. RESULTS: The overall prevalence of the fabella (unilateral or bilateral) was 22.8% (114 subjects). The fabella was present unilaterally in 38 (7.6%) subjects, while it was present bilaterally in 76 (15.2%) subjects. The prevalence of the fabella was similar between the body sides. The prevalence of the fabella was also similar between genders (unilateral or bilateral cases) and age groups. CONCLUSIONS: We examined the prevalence, symmetry pattern, age and gender differences in Turkish population. It is the first study performed on Turkish population with the largest sample in current literature. Prevalence of fabella is found to be 22.8% which is quite similar with other Caucasian ethnic populations.

Melatonin prevents radiation-induced oxidative stress and periodontal tissue breakdown in irradiated rats with experimental periodontitis.

BACKGROUND AND OBJECTIVE: The aim of this study was to analyze the biochemical and histochemical effects of radiation therapy and protective melatonin administration on periodontal tissues in rats with experimental periodontitis. MATERIAL AND METHODS: Sixty male Sprague Dawley rats were divided into six groups, as follows: control; experimental periodontitis (Ped); radiotherapy administration (Rt); experimental periodontitis and exposure to irradiation (Ped-Rt); radiotherapy and protective melatonin administration (Rt-Mel); and periodontitis, radiation therapy and protective melatonin administration (Ped-Rt-Mel). The rats were killed at the end of the experimental procedure, and the oxidative stress level and periodontal destruction were compared among the groups. RESULTS: The oxidative stress index and the levels of 8-hydroxy-2'-deoxyguanosine, malondialdehyde and C-terminal telopeptide of type I collagen were found to be significantly higher in the Ped-Rt group compared with the Ped group (p < 0.05), and the levels were lower in the Ped-Rt-Mel group than in the Ped-Rt group (p < 0.05). Alveolar bone destruction and attachment level were also significantly lower in the Ped-Rt-Mel group than in the Ped-Rt group (p < 0.05). CONCLUSION: It was found that radiotherapy increased oxidative stress, the periodontal attachment level and alveolar bone loss, and protective melatonin administration significantly reduced the oxidative parameters and prevented periodontal damage in irradiated rats with experimental periodontitis. Further research is needed regarding the use of systemic melatonin administration before radiation therapy.

Influence of experimental periodontitis on cardiac oxidative stress in rats: a biochemical and histomorphometric study.

BACKGROUND AND OBJECTIVE: The role of oxidative stress in the process of cardiac remodeling, hypertrophy and heart failure is a current topic. The purpose of this experimental study was to investigate the influences of periodontitis on levels of cardiac oxidative stress. MATERIAL AND METHODS: Twenty rats were separated into two groups: control and experimental periodontitis (EP). Periodontitis was induced by placing a 3.0 silk suture in the cervix of the left and right mandibular first molar teeth for 5 wk. At the end of the experiment, the animals were killed and blood samples and mandibular and ventricular cardiac tissue samples were collected. Levels of alveolar bone loss were determined using measurements performed on histological slices and radiographies. Left ventricular tissue 8-hydroxy-2'-deoxyguanosine, malonylaldehyde, glutathione peroxidase, total oxidant status, total antioxidant status (TAS) levels and serum paraoxonase-1 activity were evaluated biochemically. RESULTS: Measurements performed on the histological slices and radiographies demonstrated that applying the ligature caused obvious alveolar bone loss. Oxidative damage markers (malonylaldehyde, 8-hydroxy-2'-deoxyguanosine, oxidative stress index: total oxidant status/TAS) were significantly higher, and antioxidant markers (glutathione peroxidase, TAS) were statistically insignificantly higher, in the hearts of rats with EP when compared to the controls. In addition, reduced serum paraoxonase-1 activity was also detected in the EP group. CONCLUSION: The pronounced increase in cardiac oxidative stress caused by periodontitis was due to an excessive increase in the production of reactive oxygen species, rather than due to decreased antioxidant capacity. The results indicate that periodontitis-related cardiac oxidative stress might be one of the mechanisms that contribute to the pathological process that leads to heart failure.

Prognostic factors affecting the outcome of arthroscopic saucerization in discoid lateral meniscus: a retrospective analysis of 48 cases.

PURPOSE: The purpose of this retrospective study was to evaluate the results and prognostic factors affecting the outcome of arthroscopic saucerization for discoid lateral meniscus (DLM). METHODS: Forty-eight patients who underwent arthroscopic saucerization for DLM between January 2009 and January 2012 in two hospitals were included. There were 21 (43.8%) male and 27 (56.3%) female patients with a mean age of 36.02 ± 14.5 (range 9-65) years at the time of operation. According to Watanabe classification, 33 (68.7%) patients had type II (incomplete) discoid meniscus and 15 (31.3%) had type I (complete) discoid meniscus. Of the 48 patients, 26 (54.2%) had an associated lateral meniscal tear. Seventeen patients (35.4%) had accompanying ligamentous, chondral and/or medial meniscal lesions. The symptoms were present for a mean of 8.04 ± 4.48 (range 1-24) months before the operation. All patients were followed up with a mean of 27.7 ± 10.7 (range 12-47) months using Lysholm knee score. We analyzed the relationship between the outcome variable (Lysholm knee score at the final follow-up) and the predictor variables (age, gender, type of DLM, presence of meniscal tear, duration of symptoms, follow-up and accompanying intra-articular lesions). RESULTS: The mean preoperative Lysholm knee score was 46.6 ± 10.2 points and increased to 85.08 ± 13.45 points at the final follow-up (p = 0.0001). Twenty (41.7%) excellent, seven (14.6%) good, nineteen (39.6%) fair and two (4.2%) poor results have obtained. No complications were observed in any patient. Regression analysis showed that age was the only predictor of the Lysholm score at the final follow-up (R2 = 0.545, p = 0.0001). The linear regression equation was (Lysholm score at final follow-up) = 106.1 - [0.58 × (age of patient)]. CONCLUSIONS: This study demonstrated that arthroscopic saucerization is an effective and safe treatment modality for DLM. Furthermore, age of the patient was shown to be the most important prognostic factor over the final clinical outcome. An excellent or a good result can be expected when the patient is young at the time of operation. LEVEL OF EVIDENCE: IV.

Temporal triangular alopecia: significance of trichoscopy in differential diagnosis.

BACKGROUND: There are only two case reports in literature regarding the trichoscopic features of temporal triangular alopecia (TTA). Differential diagnosis of other types of localized alopecia such as alopecia areata is necessary in some cases. OBJECTIVE: To evaluate the potential benefit of trichoscopy in the clinical diagnosis of TTA. METHODS: Nine patients with a clinical diagnosis of TTA were included in the study. Trichoscopic examination was performed by a polarized-light handheld dermatoscope with a 10-fold magnification. The images were obtained by a digital camera that produced imagery with a 3-fold optical zoom. RESULTS: Short vellus hairs, vellus hair length diversity and white hairs were encountered in all subjects, while white dots, honeycomb pigment pattern, arborising red lines and epidermal scale were noted in 22%-33% of them. None of the cases showed trichoscopic features such as tapering hairs, yellow dots or loss of follicular openings. CONCLUSION: We suggest that it seems possible to differentiate TTA by a handheld dermatoscope. Short vellus hairs with length diversity and white hairs in the absence of diagnostic features of other types of localized alopecia should be considered in favour of TTA.

Role of nuclear factor kappa-B in phenytoin-induced gingival overgrowth.

OBJECTIVE: This study investigates the expression of transcription factor nuclear factor-kappa B (NF-κB) and its relation to various cellular mediators that act in the pathogenesis of phenytoin-induced gingival overgrowth. MATERIALS AND METHODS: Eighteen epileptic patients had phenytoin-induced gingival overgrowth (PHT-GO), 20 patients with plaque-induced gingivitis (Gingivitis), and 20 periodontally and systemically healthy individuals (Control) were included in this study. The expression of activated NF-κB subunits (p50 and p65), IL-1ß, TNF-α and TGFß-1 levels were examined in the gingival sections obtained from each participant. RESULTS: The results demonstrated a significantly higher expression of p65 in fibroblasts in PHT-GO group with respect to Gingivitis (P < 0.05) and control groups (P < 0.01). However, we found no statistically significant differences between PHT-GO and Gingivitis groups according to the immunohistochemical staining in macrophages (P > 0.05). Immune-reactive TGFß-1 levels in the gingival connective tissue cells were statistically higher in PHT-GO group with respect to Gingivitis group(P < 0.05). Statistically significant correlations were found between the HI and activated TGFß-1 and p65 levels in PHT-GO group. CONCLUSION: The results of this study showed that NF-κB is activated in PHT-related gingival overgrowth. This study may provide a basis for future research into specific NF-κB inhibition for preventing of the side effects of this drug.

Molecular analysis of East Anatolian traditional plum and cherry accessions using SSR markers.

We conducted SSR analyses of 59 accessions, including 29 traditional plum (Prunus domestica), 24 sweet cherry (Prunus avium), and 1 sour cherry (Prunus cerasus) selected from East Anatolian gene sources and 3 plum and 2 cherry reference accessions for molecular characterization and investigation of genetic relationships. Eight SSR loci [1 developed from the apricot (UDAp-404), 4 from the peach (UDP96-010, UDP96-001, UDP96-019, Pchgms1) and 3 from the cherry (UCD-CH13, UCD-CH17, UCD-CH31) genome] for plum accessions and 9 SSR loci [5 developed from the cherry (PS12A02, UCD-CH13, UCD-CH17, UCD-CH31, UCD-CH21), 3 from the peach (Pchgms1, UDP96-001, UDP96-005) and 1 from the plum (CPSCT010) genome] for cherry accessions were used for genetic identification. A total of 66 and 65 alleles were obtained in the genetic analyses of 31 plum and 28 cherry accessions, respectively. The number of alleles revealed by SSR analysis ranged from 4 to 14 alleles per locus, with a mean value of 8.25 in plum accessions, and from 5 to 10 alleles per locus with a mean value of 7.2 in cherry accessions. Only one case of synonym was identified among the cherry accessions, while no case of synonym was observed among the plum accessions. Genomic SSR markers used in discrimination of plum and cherry accessions showed high cross-species transferability in the Prunus genus. Because of their appreciable polymorphism and cross species transferability, the SSR markers that we evaluated in this study will be useful for studies involving fingerprinting of cherry and plum cultivars.