Is methyl methacrylate fixator reliable for the treatment of gartland type IV supracondylar fractures?

Background: In childhood supracondylar fractures of the humerus, fixation with percutaneous Kirschner wire is the standard treatment. In the case of irreducible-unstable fractures, these can be defined as fractures in which reduction is not well-achieved or in which fixation cannot be achieved with the K-wire. Intraoperative management of these types of fractures may be difficult. Treatment with a methyl methacrylate fixator consisting of K-wire and methyl methacrylate cement, as defined by the senior author of the article, may be a good option for Gartland type IV supracondylar humeral fractures where the fracture is unstable in flexion and extension due to complete periosteal tearing. Materials and Methods: The short-term and mid-term results of 27 patients between the ages of 4-12 with Gartland type IV supracondylar fracture of the humerus treated with methyl methacrylate fixation were reviewed. The patients were scored in terms of function and cosmetic satisfaction. Results: A total of 19 of the 27 patients treated with the methyl methacrylate fixator had full elbow motion function and rated the outcome of the treatment as excellent, which was judged by orthopedic surgeons on the basis of Flynn's criteria. Six patients had nearly full elbow motion and evaluated their recovery outcome as good. Two patients reported nearly full range of motion (ROM) and evaluated the method as moderate in terms of treatment. Discussion: Treatment with the methyl methacrylate fixation method is an inexpensive method that allows early joint mobilization, provides strong biomechanical stability, ensures good outcomes, and should be considered in the treatment of irreducible and unstable supracondylar fractures of the humerus.

Comparative proteomics analysis of transforming growth factor-beta1-overexpressed human dental pulp stem cell-derived secretome on CD44-mediated fibroblast activation via canonical smad signal pathway.

PURPOSE: The aim of this study investigates whether the secretome collected from human dental pulp stem cells (hDPSCs) transfected with transforming growth factor-beta1 (TGF-ß1) is related to CD44 expression of fibroblasts and canonical smad signaling pathway via proteomic analyzes. MATERIALS AND METHODS: In order to obtain secretome, hDPSCs were conditioned with serum-free alpha-MEM in an incubator containing 37°C, 5% CO2, and humidity for 18-24 h. Proteins in control and TGF-ß1 secretome were analyzed by tandem mass spectrometry-based shotgun proteomic method. Bioinformatic evaluations were completed via Ingenuity Pathway Analysis (IPA, QIAGEN) software. CD44 expressions in fibroblasts were evaluated by real time-PCR, western blot, and immunofluorescent staining. The relationship of canonical smad pathway and CD44 was analyzed by western blot and LC-MS/MS. Cell cycle, proliferation and wound healing tests were performed in the secretome groups. RESULTS: Venn diagram was showed 174 common proteins were identified from each group. In the control secretome 140 unique proteins were identified and 66 entries were exclusive for TGF-ß1 secretome. CD44 gene and protein expressions were increased in fibroblasts treated with TGF-ß1 secretome. Relationship between targeted protein data showed that activation of the canonical TGF-ß1/Smad pathway was up-regulated CD44 expression in fibroblasts. The canonical smad pathway-mediated upregulation of CD44 may increase the mitotic activity, proliferation, and wound healing potential in fibroblasts. CONCLUSION: While TGF-ß1-transfected hDPSC secretome may be a potential therapeutic candidate in regenerative connective tissue therapies as it induces fibroblast activation, anti-TGF-ß1-based therapies would be considered in histopathological conditions such as pulmonary fibrosis or hepatic fibrosis.

Transforming growth factor ß1-enriched secretome up-regulate osteogenic differentiation of dental pulp stem cells, and a potential therapeutic for gingival wound healing: A comparative proteomics study.

OBJECTIVES: Current study aimed at comparing the human dental pulp-derived stem cell (hDPSC) secretome (Control secretome) and transforming growth factor beta1 (TGF-ß1)-transfected hDPSC secretome (TGF-ß1 Secretome), which have the potential to be therapeutic in terms of regenerative dentistry, in terms of osteogenesis, adipogenesis and gingival wound healing with proteomic analyses. MATERIALS AND METHODS: pCMV-TGF-ß1 plasmid was transfected into hDPSCs by electroporation. hDPSC and TGF-ß1 transfected hDPSC secretomes were collected for LC-MS/MS. Protein contents in control secretome and TGF-ß1 secretome were analyzed by tandem mass spectrometry-based shotgun proteomic method. Bioinformatic evaluations for canonical pathways, upstream regulators and networks were completed via Ingenuity Pathway Analysis (IPA, QIAGEN) software. Surface marker expressions between groups, treated secretome were measured by flow cytometry. To support the proteomic data morphologically, we performed osteogenic-adipogenic differentiation in hDPSCs treated with control secretome and TGF-ß1 secretome, and scratch wound healing assay in gingival fibroblasts. Statistical analyses were performed by GraphPad Prism 8.02. RESULTS: Venn diagram classification showed us 174 common proteins were identified from each group. In the control secretome 140 unique proteins were identified and 66 entries were exclusive for TGF-ß1 secretome. TGF-ß1 secretome was found to have therapeutic effect on MSC-specific immunophenotypes. TGF-ß1 secretome was determined to up-regulate osteogenesis-related molecules and pathways while down-regulating adipogenesis-related pathways. Analysis of canonical pathways showed that TGF-ß1 secretome is associated with the wound healing pathway. CONCLUSION: Our study provided the first evidence that proteins identified in TGF-ß1-transfected hDPSC secretomes are potential regulators of osteogenic/adipogenic differentiation and fibroblast wound healing. CLINICAL SIGNIFICANCE: Based on these results, TGF-ß1 secretome may have a therapeutic effect in repairing osteoporosis-related bone injuries, wound healing of oral mucosa and gingival tissue. TGF-ß1 secretome may be a potential cell-free therapeutic in orthopedics and regenerative dentistry.

The state of the art in beyond 5G distributed massive multiple-input multiple-output communication system solutions.

Beyond fifth generation (5G) communication systems aim towards data rates in the tera bits per second range, with improved and flexible coverage options, introducing many new technological challenges in the fields of network architecture, signal pro- cessing, and radio frequency front-ends. One option is to move towards cell-free, or distributed massive Multiple-Input Multiple-Output (MIMO) network architectures and highly integrated front-end solutions. This paper presents an outlook on be- yond 5G distributed massive MIMO communication systems, the signal processing, characterisation and simulation challenges, and an overview of the state of the art in millimetre wave antennas and electronics.

Azoles containing naphthalene with activity against Gram-positive bacteria: in vitro studies and in silico predictions for flavohemoglobin inhibition.

Azoles are first-line drugs used in fungal infections. Topical antifungals, such as miconazole and econazole, are known to be active against Gram-positive bacteria, which was reported to result from bacterial flavohemoglobin (flavoHb) inhibition. Dual antibacterial/antifungal action is believed to have benefits for antimicrobial chemotherapy. In this study, we tested antibacterial effects of an in-house library of naphthalene-bearing azoles, some of which were reported as potent antifungals, in an attempt to find dual-acting hits. Several potent derivatives were obtained against the Gram-positive bacteria, Enterococcus faecalis and Staphylococcus aureus. 9 was active at a minimum inhibitor concentration (MIC) less than 1 µg/ml against E. faecalis and S. aureus, and 10 against S. aureus. 16 was also potent against E. faecalis and S. aureus (MIC = 1 and 2 µg/ml, respectively). Six more were active against S. aureus with MIC ≤ 4 µg/ml. In vitro cytotoxicity studies showed that the active compounds were safe for healthy cells within their MIC ranges. According to the calculated descriptors, the library was found within the drug-like chemical space and free of pan-assay interference compounds (PAINS). Molecular docking studies suggested that the compounds might be bacterial flavohemoglobin (flavoHb) inhibitors and the azole and naphthalene rings were important pharmacophores, which was further supported by pharmacophore modeling study. As a result, the current study presents several non-toxic azole derivatives with antibacterial effects. In addition to their previously reported antifungal properties, they could set a promising starting point for the future design of dual acting antimicrobials. Communicated by Ramaswamy H. Sarma.

Azole derivatives with naphthalene showing potent antifungal effects against planktonic and biofilm forms of Candida spp.: an in vitro and in silico study.

Candida infections pose a serious public health threat due to increasing drug resistance. Azoles are first-line antifungal drugs for fungal infections. In this study, we tested an in-house azole collection incorporating naphthalene ring to find hits against planktonic and biofilm forms of resistant Candida spp. In the collection, potent derivatives were identified against the susceptible strains of Candida with minimum inhibitory concentration (MIC) values lower than those of the reference drug, fluconazole. MIC values of 0.125 µg/ml against C. albicans, 0.0625 µg/ml against C. parapsilosis, and 2 µg/ml against C. krusei, an intrinsically azole-resistant non-albicans Candida, were obtained. Some of the derivatives were highly active against fluconazole-resistant clinical isolate of C. tropicalis. Inhibition of C. albicans biofilms was also observed at 4 µg/ml similar as amphotericin B, the reference drug known for its antibiofilm activity. Through molecular docking studies, affinities and key interactions of the compounds with fungal lanosterol 14α-demethylase (CYP51), the target enzyme of azoles, were predicted. The interactions of imidazole with heme cofactor and of the naphthalene with Tyr118 were highlighted in line with the literature data. As a result, this study proves the importance of naphthalene for the antifungal activity of azoles against Candida spp. in both planktonic and biofilm forms.

The occurrence of deep pectoral myopathy in broilers and associated changes in breast meat quality.

1. Two experiments were conducted to determine the effect of slaughter weight on the incidence and intensity of deep pectoral myopathy (DPM) of M. pectoralis minor (p. minor muscle) in commercial conditions in Turkey and to evaluate the impact of DPM on meat quality traits of pectoralis major (p. major) muscle in broilers. 2. In Experiment 1, a total of 116 250 carcasses from 59 Ross-308 broiler flocks, classified according to slaughter weight as 2.0-2.2, 2.2-2.4, 2.4-2.6 and >2.6 kg, were evaluated for occurrence of DPM. In Experiment 2, p. major samples from unaffected broilers and each DPM stage were evaluated for meat quality, oxidant and antioxidant properties, nutritional value and fatty acid profile. DPM was characterised as 1: muscles with coagulative necrosis, 2: muscles with fibrous tissue texture and pink to plumb and 3: muscles with green necrotic area. 3. The average incidence of DPM was found to be 0.73% in Experiment 1 and independent of slaughter weight. 4. In Experiment 2, p. major muscle of broilers with DPM 1 and 2 had higher pH values with higher redness and drip loss. All DPM stages resulted in an increase in lipid content and malondialdehyde activity and lowered ash content of p. major muscle compared with unaffected birds. DPM 2 increased superoxide dismutase and glutathione peroxidase activities in M. p. major. The p. major of broilers with DPM had lower content of C18:2 conjugated linoleic and C20:3n-6 fatty acids than those of unaffected broilers. Lower Δ6 desaturase and thiosterase activities and 18:2n-6 to 18:3n-3 ratio were observed for all DPM stages compared to unaffected. 5. It was concluded that these changes obtained in p. major muscle of broilers with DPM might indicate biochemical characteristics of muscle degenerations.

Can curcumin modulate allergic rhinitis in rats?

OBJECTIVES: This study aimed to explore the effects of curcumin on experimental allergic rhinitis in rats. METHODS: Twenty-eight male Wistar albino rats were randomly divided into four groups: a control group; a group in which allergic rhinitis was induced and no treatment given; a group in which allergic rhinitis was induced followed by treatment with azelastine hydrochloride on days 21-28; and a group in which allergic rhinitis was induced followed by treatment with curcumin on days 21-28. Allergy symptoms and histopathological features of the nasal mucosa were examined. RESULTS: The sneezing and nasal congestion scores were higher in the azelastine and curcumin treatment groups than in the control group. Histopathological examination showed focal goblet cell metaplasia on the epithelial surface in the azelastine group. In the curcumin group, there was a decrease in goblet cell metaplasia in the epithelium, decreased inflammatory cell infiltration and vascular proliferation in the lamina propria. CONCLUSION: Curcumin is an effective treatment for experimentally induced allergic rhinitis in rats.

Potential protective effect of resveratrol on acoustic trauma: electron microscopy study.

OBJECTIVE: To investigate the potential preventive effect of resveratrol in rats exposed to acoustic trauma (AT). MATERIALS AND METHODS: In this experimental study, Wistar albino rats were divided into three groups: Group 1 (Control, n = 6), Group 2 (AT, n = 6), and Group 3 (resveratrol + AT). The rats in Group 2 were exposed to AT. The rats in Group 3 received resveratrol (300 mg/kg/day) via gavage for 7 days. On day 7, the rats were exposed to AT 10 min following resveratrol treatment. Histological sections of the cochleae were examined using light microscopy, transmission (TEM), and scanning electron microscopy (SEM). RESULTS: The cochlear hair cells, stereocilia, and Deiters' cells of the control group appeared normal in all microscopic evaluations. In Group 2, light microscopy revealed predominantly inner hair cell loss, although the outer hair cells were affected. TEM and SEM examination showed severe loss of stereocilia and SEM revealed stereocilia arranged in an asymmetric array. The cochlear structure in Group 3 appeared well preserved under the light microscope, and although TEM and SEM revealed stereocilia loss, the hair cells and stereocilia appeared near normal compared with those of Group 2. CONCLUSIONS: Resveratrol may have a protective effect against AT damage in the cochlea, most likely through its antioxidant activity. Our results may be useful for studies in humans exposed to AT and noise-induced hearing loss related to chronic exposure to occupational noise.

Metastatic Melanoma of the Parotid Glands Bilaterally.

Melanoma is the most serious form of skin cancers and life-time risk of melanoma is increasing rapidly both in men and women. Melanoma in the parotid gland is seen rarely and it is more likely to be metastatic disease. We present here a rare case of metastatic malignant melanoma from the forehead skin to the parotid glands bilaterally.

Abdominal cocoon with imaging findings: Importance of radiology.

Abdominal cocoon is a rare disease characterized by a thick fibrous membrane surrounding and compressing the small intestines completely or partially, which results in mechanical small bowel obstruction. The clinical findings of the disease include recurrent ileus and subileus episodes, colicky abdominal pain, weight loss, and abdominal distension. The etiology and pathogenesis of abdominal cocoon is not clearly defined. Detection of the disease is essential for accurate treatment. Imaging modalities come into prominence due to the nonspecific clinical findings of the disease.

Clinical comparison of hook plate fixation versus extension block pinning for bony mallet finger: a retrospective comparison study.

The aim of this retrospective study was to determine whether traumatic mallet fractures had better outcomes when treated by hook plate fixation (13 patients) or extension block pinning (19 patients). We assessed outcomes using Crawford's criteria; distal interphalangeal joint range of motion; the DASH score; and a visual analogue scale score for pain. We measured radiological parameters. No significant differences were observed in functional and clinical outcomes and in complications. Whereas the operative time was longer in the hook plate group, intraoperative fluoroscopy use, time to bone union and time to return to work were greater in the extension block group. Although the hook plate method is more technically demanding, it provides good stable reduction, earlier mobilization and an earlier return to work. The extension block pinning technique is easier and as effective but it requires greater peri-operative fluoroscopy. Level of evidence: Level III.

Obstructive sleep apnoea syndrome does not negatively affect oral and dental health.

OBJECTIVE: Obstructive sleep apnoea syndrome can lead to unhealthy open-mouth breathing. We investigated the possible relationship between obstructive sleep apnoea syndrome and dental health. We also evaluated other clinical factors that may affect oral health. METHODS: We measured sleep using polysomnography and determined the apnoea-hypopnoea index for a total of 291 patients. We also recorded the demographic data, duration of snoring complaints, educational status and income levels for our patient cohort; finally, we calculated the decayed, missing and filled teeth index. RESULTS: Forty-one patients presented with primary snoring (control group) and 250 patients (study group) presented with mild, moderate and severe obstructive sleep apnoea syndrome. We found no correlation between obstructive sleep apnoea syndrome severity and the decayed, missing and filled teeth index (p = 0.057). We also found no correlation between the apnoea-hypopnoea and decayed, missing and filled teeth indexes. Age and the duration of snoring complaints were positively correlated with the decayed, missing and filled teeth index while educational status and income levels were negatively correlated (p < 0.001). CONCLUSION: Obstructive sleep apnoea syndrome does not negatively affect oral and dental health.

Titanium dioxide nanoparticles induce cytotoxicity and reduce mitotic index in human amniotic fluid-derived cells.

Titanium dioxide (TiO2) nanoparticles (NPs) are commonly used materials present in many consumables for which most people are exposed to. The biological hazards of the NPs on human health have been demonstrated previously. In this study, we aimed to assess the cytotoxicity potency of TiO2 NPs on the primary human amniotic fluid cells. The cells derived from amniotic fluid were treated with different dosages of TiO2 NPs for some periods. Cell adhesion status was assessed using a light microscopic observation. Cell proliferation and cell death rates were determined using trypan blue staining and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Also, mitotic index was determined using fluorescence in situ hybridization with chromosome 8 centromer-specific DNA probe. Disrupted cell adhesion, decreased proliferation, and increased mortality rates were detected in the cells that were treated with TiO2 NPs depending on the dosage (p < 0.001). Also, reduced mitotic index was determined in the cells depending on the time and TiO2 dosage when compared with the controls (p < 0.0001). These results showed that TiO2 NPs have high cytotoxicity for amniotic fluid-derived cells. Therefore, different products containing TiO2 NPs should be used with care, especially for pregnant women.

Nasal septal body and inferior turbinate sizes differ in subjects grouped by sex and age.

OBJECTIVES: To compare the size of the nasal septal body (SB) and inferior turbinate (IT) of subjects grouped by sex and age. METHOD: We measured SB and IT areas (in cm2) bilaterally in computed tomography (CT) sections of 150 para nasal sinuses from 72 males and 78 females. RESULTS: The right and left SB areas were smaller in females than in males. In the s25-year-old group, the right IT (RIT) was significantly smaller in females than in males. In the 26-35 and 46-45 age groups, the right SB (RSB) was significantly smaller in females than in males. CONCLUSION: The nasal SB may play a role in nasal physiology similar to a turbinate and help support optimal airflow. The vascular and glandular structures of the SB should be investigated in detail, and minimal invasive procedures should be performed in nasal surgery to avoid damaging essential structures.

Volumetric evaluation of fat in the renal sinus in normal subjects using stereological method on computed tomography images and its relationship with body composition.

BACKGROUND: The aim of the study was: to describe a simple, accurate and practical technique for estimating the volume of adipose tissue within the renal sinus (RS) using stereological method on computed tomography (CT) images; to establish a population database for volume of fat within the RS from 21 to 80 years of age; to investigate the effect of age, gender, body mass index (BMI) and abdominal diameters on RS fat volume in normal subjects. MATERIALS AND METHODS: We retrospectively reviewed abdominal CT examinations of 240 patients without renal pathology between the ages of 21 and 80 years. There were 6 groups of patients, with 40 patients for each decade. RESULTS: RS fat volumes in the left and right kidney were 5.70 ± 2.87 cm³ and 4.15 ± 2.39 cm³, respectively, in males and 3.51 ± 2.67 cm³ and 2.49 ± 2.16 cm³, respectively, in females. RS fat volume and age were positively correlated for both kidneys (left: r = 0.46; right: r = 0.44; p < 0.001, both), though it appeared to decline after age 70. CONCLUSIONS: Quantitative data may allow clinicians to better estimate the age-related RS fat volume changes and help them in decision making.

The Stoppa approach versus the ilioinguinal approach for anterior acetabular fractures: a case control study assessing blood loss complications and function outcomes.

BACKGROUND: The modified Stoppa approach was introduced to manage fracture of the anterior column instead of the ilioinguinal approach to reduce morbidity. However there is no clinical evidence to confirm its efficiency. Therefore this study was designed to ascertain: (1) if the Stoppa approach versus ilioinguinal allows less blood loss, (2) if functional and radiological results are superior to that of the ilioinguinal approach, (3) if the rate of complication was different. HYPOTHESIS: The modified Stoppa approach allows less blood loss than the ilioinguinal in management of fractures of the anterior column of the acetabulum. PATIENTS AND METHODS: Nineteen patients who were treated with the ilioinguinal approach (Group A) at a mean follow-up of 33 months and 17 patients who were treated with the modified Stoppa approach (Group B) at a mean follow-up of 28.9 months were retrospectively reviewed. Patients were called to the final follow-up examination, mean follow-up durations were set and the functional evaluation of patients was made with measurement of range of motion, Harris Hip Scores (HHS), and Merle D'Aubigné score. RESULTS: Average blood loss was determined at a mean 1170 mL (range, 750-2150 mL) in Group A and at a mean 1110 mL (range, 450-2000 mL) in Group B (P=0.168). The mean HHS (group A=89.4 [73-99] and group B=88.4 [75-97]) and Merle D'Aubigné scores (group A=16.8 [13-18] and group B=16.5 [13-18]) showed no significant difference between the groups (P=0.169). At the final follow-up, the mean hip flexion was found to be 106.83 ± 12.47 and the hip extension was 10.33 ± 6.12 in Group A, while these values were 103.71 ± 14.32 and 10.69 ± 8.17 in Group B (NS between groups regarding flexion [P=0.678] and extension [P=0.445]). The complication rate was 31% in Group A (6 patients) and 23% in Group B (4 patients) (P>0.05). DISCUSSION: Both surgical approaches give successful results in the treatment of acetabular fractures. Contrary to expectations, there was no difference in the amount of bleeding at the wound site from the Stoppa technique, even though it is minimally invasive, compared to the ilioinguinal approach. LEVEL OF EVIDENCE: Level III retrospective case control study.