3D EVALUATION OF MICROGAPS AT THE IMPLANT-ABUTMENT CONNECTION BEFORE AND AFTER THERMODYNAMIC CYCLING.

PURPOSE: To analyze the microgap changes between hybrid-abutment crowns made of two materials and three internal taper connec9on implants with different connection designs before and after thermodynamic loading. MATERIALS AND METHODS: A total of 30 implants-10 each of Straumann Bone Level Implant-RC (STR); GC AADVA Implant (AAD); and Astra-Tech OsseoSpeed EV (AST)-were included in this laboratory study. Each implant had an internal taper connection, but their designs were slightly different. Five hybrid-abutment crowns were fabricated using a lithium disilicate ceramic (LD), and five were fabricated using polymethylmethacrylate (PMMA) with CAD/CAM technologies for each implant system, providing six sample groups STR-LD, AAD-LD, AST-LD, STR-PMMA, AAD-PMMA, and ASTPMMA. The microgap volume was measured using micro-CT images obtained before and after thermodynamic loading equivalent to 4 months of clinical use. Student t test, one-way ANOVA, and Tukey test were used for comparisons. RESULTS: The greatest microgap volume increase was recorded (3.405% ± 1.567%) in the AST-LD group, and the lowest increase (0.45% ± 0.373%) was in the STR-PMMA group. A statistically significant difference in microgap increase was not detected among PMMA and LD groups: for STR-LD/STR-PMMA (t test: P = .273); for AAD-LD/AAD-PMMA (t test: P = .374); and for AST-LD/AST-PMMA (t test: P = .268). However, the difference in the microgap increase between the different implant systems was statistically significant. CONCLUSIONS: The microgap between hybrid-abutment crowns and implants increased after short-term thermodynamic cycling. Hybrid-abutment crowns with different elastic modulus showed similar microgap increase. The geometric shape of the connection influenced the microgap increase.

Analysis of Biomarkers and Marginal Bone Loss in Platform-Switched and Nonplatform-Switched Implants: A Randomized Clinical Trial.

Objectives: To compare the peri-implant crevicular fluid (PICF) biomarker levels, peri-implant status, and marginal bone level (MBL) differences of implants restored with randomly assigned nonplatform-switched (NPS) or platform-switched (PS) abutments. Methods: Ninety-four implants in 27 subjects were included in this study. Receptor activator of nuclear factor kappa-B ligand (RANKL), osteoprotegerin (OPG), interleukin-1ß (IL-1ß), monocyte chemotactic protein-1 (MCP-1) levels in PICF, peri-implant health, and the change in the MBL were evaluated at the time of restoration (T 1) and after 12 months (T 2). Results: The IL-1ß levels decreased and the RANKL, OPG, and MCP-1 levels increased from T 1 to T 2 (P < 0.05) in both groups. RANKL/OPG ratio at T 1, MCP-1 levels at T 2, and the MCP-1 change from T 1 to T 2 were lower in the PS group than in the NPS group (P < 0.05). MBL change was lower (0.51 ± 0.31 mm) in the PS group than that (0.75 ± 0.29 mm) in the NPS group at T 2 (P < 0.001). Peri-implant health status between the study groups was negligible. Conclusion: PS was superior to NPS regarding the preservation of MBL. Higher MCP-1 levels, altered RANKL/OPG ratio, and lower OPG levels in the NPS group could be associated with subclinical peri-implant bone remodeling.

Clinical Evaluation of Three Types of CAD/CAM Inlay/ Onlay Materials After 1-Year Clinical Follow Up.

OBJECTIVE: To evaluate the clinical performance and the marginal adaptation of inlay/ onlay restorations made of lithium of a new lithium disilicate strengthened, lithium alumino-silicate glass-ceramic (LAS) material compared with a conventional lithium-disilicate glass-ceramic (LDS) and new-generation polymer-based CAD/CAM resin composite (CS) materials over one year. MATERIALS AND METHODS: Seventy-five inlay-onlay restorations were placed in 35 patients. The restorations were assigned and randomized to three groups as LDS, LAS, and CS. Clinical evaluations were performed after one week, six months, and one year after the cementation, according to the modified United States Public Health Services (USPHS) criteria. The marginal quality analyses of 21 samples (n=7) were assessed under a scanning electron microscope. The data were analyzed by using Friedman, Wilcoxon Signed Ranks, Chi-square and Paired t-tests (p⟨0.05). RESULTS: No statistically significant difference (p⟩0.05) was found between groups in the modified USPHS, gingival index, and plaque index evaluations, and the total success rate was 100% for three groups after one year. Following SEM evaluations in all groups, continuous margin percentages were decreased, but these results were not statistically significant (p⟩0.05). CONCLUSIONS: Lithium disilicate-strengthened lithium aluminosilicate glass-ceramics can be considered a reliable material for an option for posterior onlay/inlay restorations.

Highly Proton-Conductive Zinc Metal-Organic Framework Based On Nickel(II) Porphyrinylphosphonate.

The design of new solid-state proton-conducting materials is a great challenge for chemistry and materials science. Herein, a new anionic porphyrinylphosphonate-based MOF (IPCE-1Ni), which involves dimethylammonium (DMA) cations for charge compensation, is reported. As a result of its unique structure, IPCE-1Ni exhibits one of the highest value of the proton conductivity among reported proton-conducting MOF materials based on porphyrins (1.55×10-3  S cm-1 at 75 °C and 80 % relative humidity).

Coordination self-assembly through weak interactions in meso-dialkoxyphosphoryl-substituted zinc porphyrinates.

The self-assembly of seven zinc 10-(dialkoxyphosphoryl)-5,15-diarylporphyrinates Zn5-Zn11 containing different substituents at the phosphonate and aryl groups was investigated. Single crystals of Zn5-Zn9 complexes were grown under the same conditions and analyzed by X-ray structural analysis. A supramolecular self-assembly is observed in all crystals through weak coordinative bonding of the phosphoryl group of one porphyrin molecule to the zinc(ii) ion of a second molecule. The geometry of the porphyrin macrocycle is similar in all of the studied crystals and the central zinc atom in each case adopts a distorted tetragonal pyramidal environment. However, the Zn5-Zn7 porphyrins display a 1D polymeric structure while the Zn8 and Zn9 complexes exist as discrete cyclotetramers in the crystals. This data demonstrates that the non-coordinating meso-aryl substituents of meso-(dialkoxyphosphoryl)porphyrins influence their crystalline organization. A self-assembly of the Zn5-Zn11 complexes is also observed in toluene and chloroform solutions over a large temperature range (223-323 K). According to NMR studies, the associates exhibit dynamic behavior. A well-defined supramolecular aggregate of complex Zn10 at 10-3 M in toluene and chloroform solutions was unambiguously characterized as a cyclotetramer [Zn10]4 by 1H NMR spectroscopy at 223 K. The structure of the Zn10 association in toluene and chloroform shows a concentration dependence. When a solution of Zn10 in toluene was diluted from 10-3 M to 10-5 M, the average number of molecules in the associated unit decreased to about two.

Electrochemical, Spectroelectrochemical, and Structural Studies of Mono- and Diphosphorylated Zinc Porphyrins and Their Self-Assemblies.

Three series of porphyrins containing a Zn(II) central metal ion and zero, one, or two phosphoryl groups at the meso-positions of the macrocycle were characterized as to their electrochemical, spectroscopic, and structural properties in nonaqueous media. The investigated compounds are represented as 5,15-bis(4'-R-phenyl)porphyrinatozinc, 10-(diethoxyphosphoryl)-5,15-bis(4'-R-phenyl)porphyrinatozinc, and 5,15-bis(diethoxyphosphoryl)-10,20-bis(4'-R-phenyl)porphyrinatozinc, where R = OMe, Me, H, or CN. Linear-free energy relationships are observed between the measured redox potentials at room temperature and the electronic nature of the substituents at the 5 and 15 meso-phenyl groups of the macrocycle. The mono- and bis-phosphoryl derivatives with two p-cyanophenyl substituents provide electrochemical evidence for aggregation at low temperature, a greater degree of aggregation being observed in the case of 5,15-bis(diethoxyphosphoryl)-10,20-bis(4'-cyanophenyl)porphyrinatozinc(II). This compound was characterized in further detail by variable-temperature 1H and 31P{1H} NMR spectroscopy in solution combined with single crystal X-ray analysis in the solid state. The data obtained from these measurements indicate that this porphyrin has a dimeric structure in CDCl3 at 223-323 K but forms a 2D polymeric network when it is crystallized from a CHCl3/MeOH mixture.

Effect of sandblasting, silica coating, and erbium: Yttrium-Aluminum-Garnet laser treatment on the shear bond strength of self-adhesive resin cement to alumina ceramics.

OBJECTIVE: The aim of this study was to investigate the different surface treatments on the bond strength of self-adhesive resin cement to high-strength ceramic. MATERIALS AND METHODS: Ninety aluminum oxide ceramic (Turkom-Ceramic Sdn. Bhd., Kuala Lumpur, Malaysia) specimens were produced and divided into nine groups to receive the following surface treatments: control group, no treatment (Group C), sandblasting (Group B), silica coating (Group S), erbium: yttrium-aluminum-garnet (Er:YAG) laser irradiation at 150 mJ 10 Hz (Group L1), Er:YAG laser irradiation at 300 mJ 10 Hz (Group L2), sandblasting + L1 (Group BL1), sandblasting + L2 (Group BL2), silica coating + L1 (Group SL1), and silica coating + L2 (Group SL2). After surface treatments, surface roughness (SR) values were measured and surface topography was evaluated. Resin cement was applied on the specimen surface, and shear bond strength (SBS) tests were performed. Data were statistically analyzed using one-way ANOVA and Tukey's multiple comparisons at a significance level of P < 0.05. RESULTS: Group S, SL1, and SL2 showed significantly increased SR values compared to the control group (P < 0.05); therefore, no significant differences were found among the SR values of Groups B, BL1, BL2, L1, and L2 and the control group (P > 0.05). Group S showed the highest SBS values, whereas the control group showed the lowest SBS values. CONCLUSION: Silica coating is the most effective method for resin bonding of high strength ceramic, but Er:YAG laser application decreased the effectiveness.

Immunohistochemical analysis of the gingiva with periodontitis of type I plasminogen deficiency compared to gingiva with gingivitis and periodontitis and healthy gingiva.

OBJECTIVE: Type I plasminogen deficiency (Plgdef) is an uncommon chronic inflammation of mucous membranes. Gingival enlargements usually proceed with progressive periodontal destruction and tooth-loss. Plasmin(ogen)-independent enzymatic mechanisms for fibrin clearance have already been discussed in the literature. Our primary objective was to verify, immunohistochemically, the occurrence of different enzymatic factors involved in tissue breakdown of inflamed compared to healthy gingiva. Secondly, we tried to find out, if these patients have a similar microbiological profile to the patients with known gingivitis and periodontitis. MATERIALS AND METHODS: Immunohistochemical analysis of enzymes elastase, plasminogen (plg), cathepsin G, matrix-metalloproteinase (MMP)-3 and MMP-7 and of glycoprotein fibrinogen were performed with gingival tissues from 3 healthy controls, 8 patients with Plgdef and 3 patients with gingivitis and periodontitis. Furthermore, plaque from 5 patients with plasminogen deficiency were also obtained to determine the microbiological profile. RESULTS: Significantly high numbers of elastase positive leukocytes were detected in all samples. Staining for MMP-3 and MMP-7 was seen in samples with gingivitis and periodontitis with a stronger staining in samples with periodontitis by Plgdef. Fibrinogen was detectable in all samples. Staining for plg was stronger in samples with periodontitis than in other samples. Staining for cathepsin G was weak in gingivitis and periodontitis. Subgingival microbial flora showed elevated colony forming units of Prevotella intermedia/nigrescens, Fusobacterium spp., Eikenella corrodens, Porphyromonas gingivalis and viridans streptococci. CONCLUSION: Strong staining of elastase, MMP-3 and MMP-7 and weak staining of plg in Plgdef samples supports the plasmin(ogen) - independent fibrin clearance. Similar subgingival microbiological flora was observed in periodontitis with Plgdef as in other periodontal diseases. Further investigations should determine the exact pathomechanism and focus on effective treatment methods of this entity.

Self-rated treatment outcomes in medical rehabilitation among German and non-German nationals residing in Germany: an exploratory cross-sectional study.

BACKGROUND: In many European countries, foreign nationals experience, on average, less favorable treatment outcomes in rehabilitative care than the respective majority population. In Germany, this for example is reflected in a lower occupational performance and a higher risk of disability retirement after rehabilitation as analyses of routine data show. However, little is known about the perspective of health care users. The aim of the present study was to compare self-rated treatment outcomes between German and non-German nationals undergoing in-patient medical rehabilitation in Germany. METHODS: We analyzed data from a cross-sectional representative rehabilitation patient survey of 239,811 patients from 642 clinics in Germany who completed about 3 weeks of in-patient rehabilitative treatment. The self-rating of the treatment outcome was based on a dichotomized Likert scale consisting of three items. A multilevel logistic regression analysis adjusted for various demographic, socio-economic, health and other covariates was conducted to examine differences in the self-rated treatment outcome between German and non-German nationals. RESULTS: Of the 239,811 respondents 0.9% were nationals from Turkey, 0.8% had a nationality from a former Yugoslavian country, 0.9% held a nationality from the South European countries Portugal, Spain, Italy or Greece and 1.9% were nationals from other countries. Non-German nationals reported a less favorable self-rated outcome than Germans. Adjusted odds ratios [OR] for reporting a less favorable treatment outcome were 1.24 (95%-confidence interval [95%-CI]: 1.12-1.37) for nationals from the South European countries Portugal/Spain/Italy/Greece, 1.62 (95%-CI: 1.45-1.80) for Turkish nationals and 1.68 (95%-CI: 1.52-1.85) for nationals from Former Yugoslavia. CONCLUSIONS: Knowledge on health outcomes from the patients' point of view is important for the provision of patient-centered health care. Our study showed that non-German nationals report less favorable outcomes of rehabilitative care than Germans. This may be due to cultural and religious needs not sufficiently addressed by health care providers. In order to improve rehabilitative care for non-German nationals, rehabilitative services must become sensitive to the needs of this population group. Diversity management can contribute to this process.

Determinants of mammography screening participation among Turkish immigrant women in Germany--a qualitative study reflecting key informants' and women's perspectives.

Mammography screening programmes aiming to reduce mortality from breast cancer are implemented in most European countries. Immigrant women are less likely to participate than women of the respective autochthonous populations in several European countries but not in Germany. Qualitative, semi-structured interviews were conducted with 16 key informants and 10 Turkish immigrant women aged 50-69 years to analyse the factors influencing their screening participation in Germany. Interviews were analysed using summarising content analysis. The Theory of Planned Behaviour was used for structuring the results. Key informants stated poor German language skills and insufficient knowledge about breast cancer and screening as factors influencing screening participation. Immigrant women demonstrated basic knowledge about screening, but their attitudes towards screening varied. Information from the invitation letter of the screening programme was often filtered by family members. Key informants tended to emphasise barriers and system-related factors while the Turkish women focused more on factors on the individual level. Contrasting both perspectives is helpful for health professionals to critically assess their own views. Measures to improve screening participation need to address not only barriers but also take women's attitudes and norms into account, thus helping women to make an informed decision.

Los parámetros espermáticos significativos que empeoran están asociados con la hipotrofia testicular en pacientes con varicocele de alto grado / Significant worsening sperm parameters are associated to testicular hypotrophy in patients with a high grade varicocele

Objetivo: Investigar la relación entre el volumen testicular y los parámetros seminales en pacientes con varicocele izquierdo de alto grado unilateral. Material y métodos: Ciento ochenta y siete pacientes que tenían varicocele izquierdo de alto grado de entre 19 y 25 años fueron incluidos en este estudio. Todos los pacientes se sometieron a una evaluación estándar, incluyendo historia clínica y examen físico. Se calculó la diferencia de porcentaje de volumen testicular entre los testículos derecho e izquierdo. Los pacientes fueron divididos en los siguientes 3 grupos: grupo 1 (n = 72) diferencia de volumen testicular < 10%; diferencia de volumen testicular 10-20% grupo 2 (n = 74); y diferencia de volumen testicular > 20% grupo 3 (n = 41). Resultados: La media de edad y el IMC de los pacientes fueron de 21,5 años y 23,1 kg/m2, respectivamente (p = 0,596, p = 0,943). Se compararon los parámetros seminales y los volúmenes testiculares de los 3 grupos. Se descubrió que el recuento total de espermatozoides móviles, porcentaje de espermatozoides móviles y porcentaje de espermatozoides de morfología normal eran menores en el grupo 3 (p = 0,011, p = 0,012, p = 0,029, respectivamente). Se encontró que los volúmenes testiculares medios para el testículo izquierdo y derecho eran 15,2 cm3 y 17,7 cm3 (p < 0,001), respectivamente. No se encontraron diferencias significativas en los volúmenes testiculares derechos entre los grupos (17,4, 17,7 y 18,1 cm3; p = 0,573). Conclusiones: Un varicocele testicular izquierdo de alto grado se asocia con hipotrofia testicular ipsilateral y paralela a los parámetros del esperma empeorado

Objective: To investigate the relationship between testicular volume and semen parameter sin patients with unilateral high grade left varicocele. Material and methods: One hundred eighty seven patients who had left high grade varicocele aged 19-to-25 years were included in this study. All patients underwent a standard evaluation, including medical history and physical examination. The percentage testicular volume difference between the right and left testicles was calculated. The patients were divided into the following three groups; Group 1 (n = 72) testicular volume difference < 10%, testicular volume difference 10%-20% Group 2 (n = 74) and testicular volume difference > 20% Group 3 (n = 41). Results. The mean age and BMI of the patients were 21.5 years and 23.1 kg/m2, respectively (P = .596,P = .943). The semen parameters and testicular volumes of the three groups were compared. The total motile sperm count, percentage of motile sperm, percentage of normal morphology sperm were found to be lower in Group 3 (P = .011, P = .012, P = .029 respectively). The mean testicular volumes for the left and the right testis were found to be 15.2 cm3 and 17.7 cm3 (P < .001), respectively. No significant difference was found in the right testicular volumes between groups (17.4, 17.7 and 18.1 cm3, P = .573). Conclusions: A high grade left testicular varicocele is associated with ipsilateral testicular hypotrophy and parallel to worsened sperm parameters

Significant worsening sperm parameters are associated to testicular hypotrophy in patients with a high grade varicocele.

OBJECTIVE: To investigate the relationship between testicular volume and semen parameter sin patients with unilateral high grade left varicocele. MATERIAL AND METHODS: One hundred eighty seven patients who had left high grade varicocele aged 19-to-25 years were included in this study. All patients underwent a standard evaluation, including medical history and physical examination. The percentage testicular volume difference between the right and left testicles was calculated. The patients were divided into the following three groups; Group 1 (n=72) testicular volume difference <10%, testicular volume difference 10%-20% Group 2 (n=74) and testicular volume difference >20% Group 3 (n=41). RESULTS: The mean age and BMI of the patients were 21.5 years and 23.1kg/m(2), respectively (P=.596, P=.943). The semen parameters and testicular volumes of the three groups were compared. The total motile sperm count, percentage of motile sperm, percentage of normal morphology sperm were found to be lower in Group 3 (P=.011, P=.012, P=.029 respectively). The mean testicular volumes for the left and the right testis were found to be 15.2cm(3) and 17.7cm(3) (P<.001), respectively. No significant difference was found in the right testicular volumes between groups (17.4, 17.7 and 18.1cm(3), P=.573). CONCLUSIONS: A high grade left testicular varicocele is associated with ipsilateral testicular hypotrophy and parallel to worsened sperm parameters.

A 45 X male patient with 7q distal deletion and rearrangement with SRY gene translocation: a case report.

Here we present a male newborn with multiple congenital anomalies who also has an extremely rare form of testicular disorder of sex development (DSD). His karyotype was 45X, without any mosaicism. SRY gene was positive by polymerase chain reaction (PCR), and rearranged on distal part of the 7th chromosome by fluorescence in situ hybridization (FISH) analysis. SRY, normally located on the Y chromosome, is the most important gene that plays a role in the development of male sex. SRY gen may be translocated onto another chromosome, mostly X chromosome in the XX testicular DSD. On the other hand very few cases of 45 X testicular DSD were published to date. Other clinical manifestations of our patient were compatible with distal 7 q deletion syndrome. To the best of our knowledge this is the first case of 45 X testicular DSD with SRY gene rearranged on the 7th autosomal chromosome.

Universal newborn hearing screening; automated transient evoked otoacoustic emissions.

OBJECTIVE: The purpose of this study is to describe the results of universal newborn hearing screening (UNHS) in 2229 newborns and to assess the effectiveness of a two-stage automated transient evoked otoacoustic emission (a-TEOAE) test protocol. MATERIALS AND METHODS: Between May 2007 and January 2008, a universal newborn hearing screening program, instituting two-stage a-TEOAE, was evaluated. The hearing status of the newborns who failed the two-stage screening tests were evaluated with the auditory brainstem response (ABR) test during the diagnostic stage. The risk factors for hearing loss determined by the Joint Committee on Infant Hearing Loss (JCIH) and prematurity, consanguineous marriage, and birth type as presumptive risk factors were recorded. RESULTS: During the study period, 2229 newborns were screened. Sensorineural hearing loss (SNHL) was identified in 8 newborns. Fourteen newborns were lost to follow-up. One hundred thirty six newborns were high-risk neonatal intensive care unit (NICU) patients. The prevalence of SNHL was 2.9% (4/136) in NICU newborns, and 0.19% (4/2079) in the well-baby nursery. SNHL prevalence in the study group overall was found to be 0.36% (8/2215). Craniofacial anomalies and family history of hearing loss were found to be significantly related to SNHL in newborns. Prematurity and consanguinity that are not listed among JCIH risk factors were also found to be statistically significantly related with SNHL. CONCLUSIONS: This is the first report of a universal hearing screening program in the Eastern Black Sea region of Turkey. Two-stage a-TEOAE is an efficient and feasible hospital-based screening protocol in newborns.

[Health care among older people with Turkish migration background: qualitative survey of health mediators]. / Gesundheitsversorgung älterer Menschen mit türkischem Migrationshintergrund: Qualitative Befragung von Gesundheitsmediatoren.

BACKGROUND: Older people with a Turkish migration background face various barriers in terms of access to and quality of health care. Providing health care according to their subjective and objective needs is of increasing importance considering demographic aging. The aim of this study was to illustrate challenges older migrants experience in the health care process from the viewpoint of health mediators. METHOD: Construct interviews were conducted with six health mediators and were analyzed by means of content analysis. RESULTS: The interviews showed three different challenges in health care for people with a Turkish migration background. These were the patients' coping with the disease, their health beliefs, and factors associated with the health care process and the doctor-patient relationship. CONCLUSION: The study highlights that it is important to make health care institutions aware of the culture specific characteristics of illness and therapy beliefs among people with a Turkish migrations background. Diversity management is an adequate strategy to adjust health care to the needs and requirements of an increasingly diverse population.

Synthesis and self-organization of zinc ß-(dialkoxyphosphoryl)porphyrins in the solid state and in solution.

The first synthesis and self-organization of zinc ß-phosphorylporphyrins in the solid state and in solution are reported. ß-Dialkoxyphosphoryl-5,10,15,20-tetraphenylporphyrins and their Zn(II) complexes have been synthesized in good yields by using Pd- and Cu-mediated carbon-phosphorous bond-forming reactions. The Cu-mediated reaction allowed to prepare the mono-ß-(dialkoxyphosphoryl)porphyrins 1 Zn-3 Zn starting from the ß-bromo-substituted zinc porphyrinate ZnTPPBr (TPP = tetraphenylporphyrin) and dialkyl phosphites HP(O)(OR)(2) (R = Et, iPr, nBu). The derivatives 1 Zn-3 Zn were obtained in good yields by using one to three equivalents of CuI. When the reaction was carried out in the presence of catalytic amounts of palladium complexes in toluene, the desired zinc derivative 1 Zn was obtained in up to 72% yield. The use of a Pd-catalyzed C-P bond-forming reaction was further extended to the synthesis of ß-poly(dialkoxyphosphoryl)porphyrins. An unprecedented one-pot sequence involving consecutive reduction and phosphorylation of H(2)TPPBr(4) led to the formation of a mixture of the 2,12- and 2,13-bis(dialkoxy)phosphorylporphyrins 5 H(2) and 6 H(2) in 81% total yield. According to the X-ray diffraction studies, 1 Zn and 3 Zn are partially overlapped cofacial dimers formed through the coordination of two Zn centers by two phosphoryl groups belonging to the adjacent molecules. The equilibrium between the monomeric and the dimeric species exists in solutions of 1 Zn and 3 Zn in weakly polar solvents according to spectroscopic data (UV/Vis absorption and NMR spectroscopy). The ratio of each form is dependent on the concentration, temperature, and traces of water or methanol. These features demonstrated that zinc ß-phosphorylporphyrins can be regarded as new model compounds for the weakly coupled chlorophyll pair in the photosynthesis process.

[Storytelling: an intervention to improve home care of Turkish migrants]. / Storytelling als Intervention: Verbesserung der häuslichen Pflege von türkischen Migranten in Deutschland.

The number of people in need of nursing care in Germany is continuously increasing. As a result of problems with the foreign language and a lack of information, there are obstacles especially for people with a migrational background toward the use of professional help and offers for people in need of care. This report describes the saba study. We used the method of storytelling as a self-help oriented intervention strategy within the group of Turkish persons in need of care and their relatives who provide care. Health mediators facilitated weekly group meetings of Turkish family caregivers. During these meetings, the family caregivers talked to each other about their experiences. By sharing their stories, they increased their knowledge and information. The intervention encourages empowerment and self-management of Turkish people in need of care and their family caregivers. The study helps Turkish persons in need of care and their family caregivers to obtain knowledge and lower the barriers for access to the German Healthcare System.

An atypical form of necrotizing periodontitis.

BACKGROUND: Necrotizing ulcerative gingivitis/periodontitis are considered necrotizing periodontal diseases. This case report presents an atypical form of necrotizing periodontitis, which does not fit into this classification. METHODS: A 12-year-old child was referred to our clinic for gingival inflammation, extensive alveolar bone loss, and tooth mobility. Clinical and microbiologic examinations were carried out, and radiographs were taken. Clinical examination revealed soft and hard tissue destruction up to the mucogingival junction at the right maxillary premolar and mandibular incisors. Unusual infections or abnormalities in systemic functions were not detected through clinical and laboratory evaluations made at the Pediatrics Department, Istanbul University. Although an intensive established treatment protocol for necrotizing periodontitis was completed, management of long-standing health conditions could not be achieved because of recurrence of the disease, which caused us to repeat this treatment protocol at short intervals. RESULTS: Investigation led to a diagnosis of an atypical form of necrotizing periodontitis because the disease had a recurrent acute phase even under a standard treatment protocol. CONCLUSIONS: Our patient exhibits an unusual, necrotizing form of periodontal disease. The reason for the rapid rate of periodontal disease progression remains unclear.