[The prevalence of liver trematodes in equines in different cities of Turkey]. / Türkiye'nin Farkli Illerindeki Tek Tirnaklilarda Karaciger Trematodlarinin Yayginligi

OBJECTIVE: This study was carried out between March 2004- April 2005 to determine the prevalance of liver trematode infections of equids in different cities of Turkey. METHODS: A total of 117 equids (72 horses, 39 donkeys and 6 mules) in Ankara were examined for liver parasites after the slaugthering process. On the other hand, a total of 620 feces of horses in Bursa, Gemlik, Malatya, Eskisehir and Ankara provinces were detected for determining liver trematodes in live equines. The fecal samples of horses were examined for liver fluke infection by Benedect's sedimentation methods. RESULTS: Of these 117 equids, 6 equids (5.1%) were infected with liver flukes. The liver flukes were found only in donkeys. Infection rates were found to be Fasciola hepatica 2.6%, Dicrocoelium dendriticum 12.8% in donkeys.Trematode eggs were encountered in these horses. The distribution of liver fluke infections was found to be very low. For this reason, the importance of the results for the groups of different age (young-old) and sex (male-female) were not determined. CONCLUSION: This study determinated the prevalance of the liver trematodes to be low in the equines, higher in donkeys than in horses and no clinical signs due to the number of parasites which cause helminthosis.

Control of helminth contamination of raw vegetables by washing.

This study was conducted to determine the control of helminth egg contamination of raw vegetables by washing. A total of 199 unwashed and 199 washed lettuce, parsley, carrots, dill, rocket, and green-peppers, provided by a catering service in Bursa, Turkey, between March and June 2009, were subjected to helminth egg count under light microscopy. Helminth eggs were detected in six (3.0%) unwashed samples and not in any washed samples (p<0.01). Ascaris lumbricoides and Toxocara spp. were detected in four (2.0%) and two (1.0%) unwashed vegetables, respectively, mostly among leafy vegetables such as lettuce and parsley. Our data confirm that washing procedures before consumption of raw vegetables regardless of the providers' sanitation should be performed to avoid transmission of helminths.

Inflammatory mediators and posterior segment involvement in ocular Behcet disease.

PURPOSE: To assess the serum level of mediators and their relation with posterior ocular involvement in patients with Behcet disease (BD). METHODS: This study was a prospective, institutional clinical trial including 43 patients with ocular BD. Patients were divided into two subgroups: those with active posterior segment involvement (Group A) and those with inactive ocular BD (Group B). Group A included patients with posterior uveitis (vitritis or chorioretinal involvement), while Group B included patients with no active intraocular inflammation within the last 3 months. Serum levels of interleukin (IL)-6, IL-8, tumor necrosis factor alpha (TNF-alpha), vascular endothelial growth factor (VEGF), and malondialdehyde (MDA) were measured by sandwich enzyme-linked immunosorbent assay and spectrophotometric assay and compared among the groups by independent sample t test and Mann-Whitney U-test. RESULTS: Serum levels of the mediators in Group A (IL-6 [23.1 pg/mL], IL-8 [161.1 pg/mL], TNF-alpha [30.5 pg/mL], VEGF [455.9 pg/mL], MDA [10.7 microm]) were found to be significantly higher than those in Group B (IL-6 [12.2 pg/mL], IL-8 [48.4 pg/mL], TNF-alpha [18.6 pg/mL], VEGF [138.0 pg/mL], MDA [5.1 microm]). CONCLUSIONS: This study demonstrated that increased serum levels of inflammatory mediators including IL-6, IL-8, TNF-alpha, VEGF, and MDA were possibly involved in the development of posterior uveitis in BD.

Ocular findings in childhood-onset Behçet disease.

PURPOSE: To investigate the demographic characteristics and ocular features of patients with childhood-onset Behçet disease. PATIENTS AND METHODS: Patients for this retrospective study were selected using the data obtained from medical records of 34 patients with childhood-onset Behçet disease being followed up in the Uveitis Department of Ankara Ulucanlar Eye Education and Research Hospital between January 2003 and May 2008. RESULTS: Of 34 patients, 24 were boys (70.5%) and 10 were girls (29.4%). The average age of patients was 14.5 +/- 1.9 years (range, 10-16 years). Mean follow-up period was 4.5 +/- 2 years (range, 2-10 years). During the follow-up, panuveitis, posterior uveitis, and anterior uveitis were diagnosed in 18 (52.9%), 11 (32.3%), and 5 (14.7%) patients, respectively. Ocular findings included cataract in 20 patients (58.8%), posterior synechiae in 8 (23.5%), posterior capsular opacification secondary to cataract surgery in 8 (23.5%), vitreous condensation due to previous episodes of vitritis in 17 (50%), optic atrophy in 10 (29.4%), cystoid macular edema in 5 patients (14.7%), narrowed and occluded retinal vessels due to retinal periphlebitis and branched retinal vein occlusion in 2 (5.8%), neovascularization of the disk in 1 (2.9%), and phthisis bulbi in 1 patient (2.9%). CONCLUSIONS: Based on the results that were obtained in this series, panuveitis was the most common type of uveitis in cases with childhood-onset Behçet disease. Cataract was the most common anterior segment complication. Optic atrophy was the most common posterior segment complication. Male predominance was determined in this study.

Vogt-Koyanagi-Harada syndrome in children: report of a case and review of the literature.

This article reviews the therapeutic approaches in children with Vogt-Koyanagi-Harada (VKH) syndrome, and reports on a 9-year-old girl with progressive visual loss due to VKH syndrome in spite of treatment. In previous reports, corticosteroids were found to be the most effective agents in the treatment of VKH syndrome, while combination therapies with cyclosporine, methotrexate, or azathioprine were used with favorable results in refractory cases. In the current case, none of the treatments sufficiently stabilized the vision, but triple combination of corticosteroids, cyclosporine, and methotrexate suppressed the relapses of intraocular inflammation. Treatment of children with VKH syndrome is challenging. Various treatment modalities have been reported with various responses, but there is still no definite treatment regimen, and the treatment is usually individualized in pediatric VKH cases.

Topographic optic disc analysis by Heidelberg retinal tomography in ocular Behcet's disease.

AIM: To compare the topographic characteristics of the optic discs in patients with severe and mild ocular Behçet's disease by using Heidelberg retinal tomographaphy (HRT). METHODS: This prospective study included 47 eyes of 47 patients with ocular BD who were being followed-up at the Uveitis Clinic of the Ankara Ulucanlar Eye Research Hospital, Ankara, Turkey. The patients were divided into two groups. Group 1 consisted of 21 eyes with mild uveitis, and group 2 consisted of 26 eyes with severe uveitis. All patients underwent topographic optic disc analysis by HRT II, and the quantitative optic disc parameters of both groups were compared by non-parametric Mann-Whitney U test. RESULTS: The mean cup volume, rim volume, cup area, disc area and cup depth in group 1 were found to be statistically significantly greater than those in group 2 (p<0.0001, p = 0.03, p = 0.021, p = 0.01 and p = 0.017, respectively), while the difference between the mean cup-to-disc ratios in group 1 and group 2 were found to be statistically insignificant (p = 0.148). CONCLUSION: A relationship was found between the severity of ocular BD and optic disc topography determined by HRT. In eyes with smaller optic discs, uveitis was observed to have a more severe course with more frequent relapses than those with larger discs.

Trabeculectomy with mitomycin C in secondary glaucoma associated with Behçet disease.

PURPOSE: To determine the outcome of initial trabeculectomy with mitomycin C (MMC) in the management of secondary glaucoma associated with Behçet disease (BD) in a 1-year follow-up period. METHODS: Twenty-three eyes of 13 cases with secondary glaucoma associated with BD, were evaluated prospectively. They underwent primary trabeculectomy with MMC. The operative success was defined as an intraocular pressure (IOP) < or =20 mm Hg (+/- medical therapy) in the absence of phthisis and without the necessity of further surgery for glaucoma and success rates at the postoperative first day, first month, sixth month, and first year were determined. RESULTS: Success was achieved in all of the eyes (100%) at the postoperative first day and month, in 21 eyes (91.3%) at the postoperative sixth month and in 19 eyes (82.6%) at the postoperative first year. The mean preoperative IOP was 30.9+/-5.3 mm Hg under the mean 3.3+/-0.7 antiglaucoma medications but it reduced to 16.8+/-3.1 mm Hg under the mean 1.7+/-0.8 medications at the postoperative sixth month and 18.5+/-3.2 mm Hg under the mean 2.6+/-1.1 medications at the postoperative first year. CONCLUSIONS: Trabeculectomy with MMC provides reduction of IOP and the number of antiglaucoma medications in cases with secondary glaucoma associated with BD in a 1-year follow-up period.

Short-term side effects of 0.2% alcohol-free chlorhexidine mouthrinse used as an adjunct to non-surgical periodontal treatment: a double-blind clinical study.

BACKGROUND: The aims of this clinical study were to evaluate the short-term subjective (by means of questionnaire) and objective (by means of clinical examination) side effects of 0.2% chlorhexidine (CHX) mouthrinse without alcohol used as an adjunct to non-surgical periodontal treatment and to elucidate the relationship between the subjective and objective evaluations. METHODS: This was a randomized, double-blind, placebo-controlled clinical trial with two groups: 1) the test group, rinsing with the test product (0.2% CHX without alcohol) twice per day for 1 week, and 2) the control (placebo) group, rinsing with a placebo solution twice per day for 1 week. Following the start of rinsing, patients were subjectively and objectively evaluated for the presence and severity of side effects (pain, burning sensation, pruritus, dryness of mouth, taste disturbance, mucosal irritations, and discoloration of tooth and tongue surfaces) at days 1, 3, and 7 of the rinsing period. The presence of subjective and objective side effects of the groups was compared via use of chi2 and Fisher exact tests. Analysis of the subjective and objective side effects within the evaluation periods was done by McNemar test. Spearman correlation analysis was used to assess the relationships between the subjective and objective side effects. RESULTS: None of the patients in either group complained of dryness of the mouth. The most commonly reported side effect was the change in color of the labial and buccal mucosa, particularly of the gingiva, after day 3 of rinsing. There were significant (r=0.308 to 0.835; P<0.05) correlations between the discolorations of tongue and tooth surfaces reported by the patients and clinically detected at all evaluation periods. There was a significant and positive relationship between the subjective side effects and the soft tissue irritations when the duration of rinsing increased. CONCLUSION: Within the limits of this clinical evaluation, rinsing with 0.2% alcohol-free CHX for 1 week caused more irritation to oral mucosa, greater burning sensation, and increased altered taste perception compared to the placebo rinse.

Phacoemulsification cataract extraction and intraocular lens implantation in patients with Behçet's disease.

BACKGROUND AND OBJECTIVE: To evaluate the outcomes of phacoemulsification cataract extraction and intraocular lens implantation in patients with Behçet's disease. PATIENTS AND METHODS: This prospective study was based on 40 eyes of 34 patients with Behçet's disease who underwent phacoemulsification cataract extraction and intraocular lens implantation between May 2000 and February 2003. Their postoperative ocular complications and visual outcomes were observed during a mean follow-up period of 18.35 +/- 6.17 months (range, 6 to 32 months). RESULTS: Postoperative visual acuity increased in 29 eyes (72.5%) and was 20/40 or better in 18 eyes (45%). It decreased in 7 eyes (17.5%), resulting in a visual acuity of 20/400 or worse. The most frequent postoperative complication was posterior capsular opacification, which developed in 15 eyes (37.5%). Other complications were posterior synechiae formation in 7 eyes (17.5%), severe inflammation in 5 eyes (12.5%), cystoid macular edema in 5 eyes (12.5%), epiretinal membrane in 3 eyes (7.5%), and optic atrophy in 2 eyes (5%). CONCLUSION: With appropriate preoperative and postoperative suppression of inflammation, phacoemulsification and intraocular lens implantation are safe procedures leading to visual improvement in patients with Behçet's disease without preexisting fundus lesions.

Goldenhar's Syndrome (oculo-auriculo-vertebral dysplasia) with congenital facial nerve palsy.

Goldenhar's Syndrome (oculo-auriculo-vertebral dysplasia) is a wide spectrum of congenital anomalies that involves structures arising from the first and second branchial arches. In this report, a case of a male infant, with the features of hemi facial microsomia, anotia, vertebral anomalies, congenital facial nerve palsy and lagophthalmos is described. Although the syndrome itself is not uncommon, the presence of congenital facial nerve palsy, which has been reported in rare cases, prompted this case report.

The influence of occlusal loading location on stresses transferred to implant-supported prostheses and supporting bone: A three-dimensional finite element study.

STATEMENT OF PROBLEM: Information about the influence of occlusal loading by location on the stress distribution in an implant-supported fixed partial denture and supporting bone tissue is limited. PURPOSE: The purpose of this study was to investigate the effect of loading at 1 to 3 different locations on the occlusal surface of a tooth on the stress distributions in an implant-supported mandibular fixed partial denture (FPD) and surrounding bone, using 3-dimensional finite element analysis. MATERIAL AND METHODS: A 3-dimensional finite element model of a mandibular section of bone (Type 2) with missing second premolar and its superstructures were used in this study. A 1-piece 4.1 x 10-mm screw-shape ITI dental implant system (solid implant) was modeled for this study. Cobalt-Chromium (Wiron 99) was used as the crown framework material and porcelain was used for occlusal surface. The implant and its superstructure were simulated in a Pro/Engineer 2000i program. Total loads at 300 N were applied at the following locations: 1) tip of buccal cusp (300 N); 2) tip of buccal cusp (150 N) and distal fossa (150 N); or 3) tip of buccal cusp (100 N), distal fossa (100 N), and mesial fossa (100 N). RESULTS: The results demonstrated that vertical loading at 1 location resulted in high stress values within the bone and implant. Close stress levels were observed within the bone for loading at 2 locations and 3 locations; the former created the most extreme stresses and the latter the most even stresses within the bone. With loading at 2 or 3 locations, stresses were concentrated on the framework and occlusal surface of the FPD, and low stresses were distributed to the bone. CONCLUSION: For the loading conditions investigated, the optimal combination of vertical loading was found to be loading at 2 or 3 locations which decreased the stresses within the bone. In this situation, von Mises stresses were concentrated on the framework and occlusal surface of the FPD.

Finite element analysis of forces created by root separation and resection modelling.

Natural teeth with a healthy periodontal support exhibit stress transfer when functional forces are applied to them. These stress patterns show considerable variations during differing treatment modalities, which may influence both the tooth and supporting alveolar bone. The purpose of this study was to evaluate variations in the stress transfer under functional loads on first molars with periodontal furcation involvement, which were treated either with by root resection or root separation. This study used a two dimensional mathematical model of a mandibular first molar that was subjected to either a root separation or a root resection procedure. An evenly distributed dynamic load (600 N) was applied on two buccal cusps and distal fossae of the molar in centric occlusion. The analysis was performed using an IBM-compatible computer running standard analysis software. It was found that in the root resection model the stress values were maximum on the centre of rotation, and compressive stresses increased towards the middle of the cervical line. For the root separation model, the maximum shear stress values were observed in the distal portion, and a uniform stress distribution was observed in the mesial portion. Shear stress values for bone increased towards the centre in the bifurcation area. The outcomes of this study may be useful as a guide in clinical restorative procedures.