First detection of Ehrlichia chaffeensis, Ehrlichia canis, and Anaplasma ovis in Rhipicephalus bursa ticks collected from sheep, Turkey.

Anaplasmosis and ehrlichiosis are important tick-borne rickettsial diseases of medical and veterinary importance that cause economic losses in livestock. In this study, the prevalence of Anaplasma ovis, Ehrlichia canis and Ehrlichia chaffeensis was investigated in ticks collected from sheep in various farms in Van province, which is located in the Eastern Anatolian Region of Turkey. The ticks used in this study were collected by random sampling in 26 family farm business in 13 districts of Van province. A total of 688 ticks were collected from 88 sheep and 88 tick pools were created. All ticks identified morphologically as Rhipicephalus bursa. Phylogenetic analysis of Chaperonin and 16S rRNA gene sequences confirmed A. ovis, E. canis and E. chaffeensis in this study. Of the 88 tick pools tested, 28.41% (25/88) were positive for at least one pathogen. Anaplasma DNA was detected in five of the 88 pools (5.68%), E. canis DNA was detected in 19 of the 88 pools (21.59%), and E. chaffeensis DNA was detected in one of the 88 pools (1.14%) of R. bursa ticks. To our knowledge, this is the first report describing the presence of A. ovis, E. canis, and E. chaffeensis in R. bursa ticks collected from sheep in Turkey. Further studies are needed to investigate other co-infections in sheep in Turkey.

Occurence and genotype distributionof Cryptosporidium spp.,and Giardia duodenalis in sheep in Siirt, Turkey.

Cryptosporidium spp., and Giardia duodenalis are intestinal protozoan parasites known to infect humans and various animals and cause diarrhea. This study aimed at determining the prevalence and genotype of Cryptosporidium spp. and Giardia duodenalis in sheep in different locations of Siirt province. The fecal material for this study was collected from 500 sheep in different locations of Siirt province, Turkey. Fecal samples obtained from sheep were examined for Cryptosporidium spp. by Kinyoun Acid Fast staining and the Nested PCR method. Microscopic and Nested PCR methods revealed a prevalence of 2.4% (12/500) and 3.6% (18/500), respectively. Sequence analysis revealed the presence of C. ryanae, C. andersoni, and zoonotic C. parvum. In terms of Giardia duodenalis, 8.4% (42/500) and 10.2% (51/500) prevalence was determined using Nativ-Lugol and Nested PCR methods, respectively. Using sequence analysis, zoonotic assemblages A and B as well as assemblages E and D were detected. As a result of this study, both the prevalence of Cryptosporidium spp. and Giardia duodenalis and the presence of species that appear to be host-specific, as well as those known to be zoonotic, were revealed. A large-scale study is needed to understand the impact of these agents on sheep farming and their consequences on human health.

First report of Blastocystis subtype ST25 in calves in Turkey.

Blastocystis spp. is a parasite that causes intestinal infection in humans and other animals. A few studies have been performed in Turkey on the distribution of Blastocystis in cattle. In this study, fecal samples were collected from 100 calves and subjected to analysis based on an SSU rRNA gene fragment. The overall prevalence of the disease was determined as 15% (15/100). This rate was 14.04% for females and 16.28% for males. In addition, three Blastocystis subtypes were identified: ST10, ST14, and novel subtypes ST25. To our knowledge, the ST25 subtype was reported with this study for the first time in Turkey. The nucleotide sequences (OM920832-OM920839) obtained in this study were deposited in GenBank. The results obtained will be useful for a better understanding of the epidemiology of Blastocystis spp., and its effects on public health.

Oral manifestations in SARS-CoV-2 infection.

BACKGROUND: We aimed to evaluate the prevalence of predisposing factors and oral manifestations in SARS-CoV-2 infection. MATERIAL AND METHODS: 204 SARS-CoV-2 positive patients were included in the study. Questions regarding the systemic, periodontal health, oral hygiene habits, common symptoms and, oral manifestations of COVID-19 such as oral lesions, and dry mouth were included in the survey. The Visual Analogue Scale (VAS) was used. RESULTS: 47.5% of individuals had various systemic diseases. Dry mouth (44.2%) and oral lesions (22.4%) were the most common oral manifestations in COVID-19 patients. Also, dry mouth had the highest VAS score. The most common oral lesion locations were buccal mucosa (15.2%) and tongue (10.8%). The majority of participants (142 patients) were affected by taste disorders. Patients who received periodontal treatment before SARS-CoV-2 infection reported fewer oral complaint and manifestations than those who did not receive periodontal therapy (p=0.032). There was no statistically significant difference between males and females on the presence of any oral manifestations, and taste disorders. CONCLUSIONS: Our results showed that SARS-CoV-2 could cause oral manifestations. However various predisposing factors may be part of the etiology and promote oral findings.

Biomechanical evaluation of two miniplate fixations applied in the anterior region after Le Fort I osteotomy: an experimental study.

The aim of this experimental study was to evaluate the reliability of two-plate fixations applied to the anterior region of the maxilla after Le Fort I osteotomy in terms of stability. Twenty polyurethane-based skull models were used to evaluate two fixation techniques. Two groups consisting of four and two L-shaped titanium miniplates were tested. Each group was tested with the application of vertical forces in the anteroposterior direction using a servohydraulic testing unit. The displacement values in each group at each stage (from 10 N - 120 N) were compared using the Mann-Whitney U test. The displacement values for the two groups were not statistically significant up to 20 N, but differed significantly between 20 N and 120 N (p < 0.05). The results showed that the biomechanical behaviour of fixation with four miniplates was better than that of two after a load of 20 N. It can be concluded that when the amount of maxillary advancement is increased to 10 mm or more, fixation with only two plates does not provide sufficient stability experimentally.

Endohelminth Fauna of Teleost Fishes from Coasts of Sile Region of the Black Sea.

A total of 508 fish specimens belonging to 19 species collected in the coast of Sile region of the Black sea were examined to detect the presence of endohelminths. Of this, 357 (70.27%) were found to be infected with parasites. 15 distinct helminths species were recovered including four species of nematodes, seven digenean species, one species of cestodes and three species of acanthocephalans. It was also determined that the species of nematode Hysterothylacium aduncum was the most common parasite and the most diverse endohelminth fauna was found in Gobius niger and Solea vulgaris, with five species. Furthermore, it should be noted that Capillaria gracilis is reported for the first time from the Turkish coasts. The infection rates, hosts, and parasites are listed in this paper.

Salivary ß-galactosidase, halitosis parameters in periodontal health and disease, and their changes after periodontal treatment.

BACKGROUND: In this study, we aimed to evaluate the salivary ß-galactosidase and Halimeter values (HMV), organoleptic scores (OLS) and Winkel tongue coating index (WTCI) in periodontal health and periodontitis (P), and also their changes after phase I periodontal therapy and tongue cleaning. METHODS: The participants were separated as follows: 25 P with halitosis (Group 1), 25 P without halitosis (Group 2) and 25 healthy controls (Group 3). Periodontal recordings, HMV, OLS and WTCI scores were recorded, and whole saliva ß-galactosidase levels were measured colorimetrically in the samples at baseline and 1 month after the therapy. RESULTS: The baseline values of HMV, OLS, WTCI and salivary ß-galactosidase levels were significantly higher in Group 1 than in Group 2 (P < 0.05). There was a statistically significant decrease in periodontal recordings, HMV, OLS, WTCI and salivary ß-galactosidase levels in all P patients by the therapy (P < 0.05). However, major reductions in halitosis measurements and saliva enzyme levels were observed in Group 1 after the treatment. CONCLUSION: Our results showed that salivary ß-galactosidase was associated with halitosis parameters and phase I periodontal therapy played an important role to reduce this enzyme level and halitosis parameters in P.

The efficacy of the ON-Q elastomeric pump system in post-thoracotomy acute pain control.

OBJECTIVES: We aimed to evaluate the efficacy of continuous local anesthetic infusion to the incision site with the On-Q elastomeric pump system in postoperative acute pain control after thoracotomy. METHODS: A retrospective comparative analysis of of sixty patients who underwent thoracotomy for lung cancer by the same surgical team was performed between January 2016 and December 2017. The patients were divided into two groups according to postoperative pain management, those who were traditionally received tramadolol (15 mg/h) by intravenous continuous infusion (Group IVT, n = 30) and those who were administered continuous local anesthetic (0.5% bupivacaine, 4 ml/h) infusion to the incision site through an elastomeric pump in addition to the traditional treatment (Group LA, n = 30). The primary outcomes were postoperative acute pain scores on the numeric rating scale and postoperative rescue opioid consumption for 72 hours following surgery reported as pethidine equivalents. The secondary outcomes were frequency of analgesia related adverse events/complications, ICU and hospital stay, drug and total hospital cost. RESULTS: The mean pain scores at 2, 12, 24, 48 and 72th hours at rest and during coughing were found to be significantly lower in group LA (p < 0.05). Rescue opioid consumption on postoperative 0, 1, 2 and 3rd days and in total was found to be significantly lower in Group LA (p < 0.05). In Group LA, postoperative length of hospital stay was significantly shorter (5.8 ± 2.1 days vs. 8.0 ± 3.1 days; p = 0.034), drug costs (95.24 vs. 160.08 Euro; p = 0.023) and total hospital costs were lower (434.26 vs. 685.75 Euro; p = 0.014) than Group IVT. CONCLUSIONS: We believe that continuous local anesthetic infusion to the incision site in addition to systemic analgesic treatment for multimodal acute pain management after thoracotomy is an effective and safe method.

Performance of integrated pulmonary index for pulmonary embolism in dyspneic patients.

OBJECTIVES: The aim of this study was to evaluate the diagnostic capacity of integrated pulmonary index (IPI) in predicting the pulmonary embolism (PE) in patients admitted to emergency departments (ED) with dyspnea. BACKGROUND: The acute dyspnea is one of the most common chief complaints in EDs. PE is a potentially fatal disease and the delay in specific therapy increases the worst outcomes. METHODS: This study is a prospective methodological study, in which we evaluated the diagnostic performance of the IPI in predicting PE in patients admitted to ED with dyspnea. ROC analysis was used for estimating the accuracy of IPI and OCRS. RESULTS: Of the 144 patients included in the study, there were 20 (13.9 %) PE patients. In the ROC analysis, the best cut-off point for IPI was ≤ 2. For this cut-off point, the sensitivity and specificity of IPI were 100.0 % and 96.0 %, respectively. Besides, the accuracy of IPI was 96.5 % with a +LR of 24.8 and a -LR of 0.0. CONCLUSION: IPI was a potential candidate for evaluating the respiratory status, and a limiting tool to prevent unnecessary diagnostic tests and save time in determining the treatment course in dyspneic patients at ED (Tab. 5, Fig. 3, Ref. 34).

Nanohardness reduction and root dentine erosion after final irrigation with ethylenediaminetetraacetic, etidronic and peracetic acids.

AIM: To evaluate the nanohardness reduction and erosion in root canal dentine after application of 17% ethylenediaminetetraacetic acid (EDTA), 9% etidronic acid (HEBP) and 2% peracetic acid (PAA) either alone or combined with sodium hypochlorite (NaOCl). METHODOLOGY: One hundred and sixty single-rooted teeth were decoronated and their root canals were chemomechanically prepared. For the nanohardness evaluation, 80 roots with instrumented canals were split longitudinally into two halves. Dentine blocks with a length of 7 mm were obtained from the middle third of one half of each tooth and were embedded in epoxy resin blocks exposing the root canal walls. Initial nanohardness values of root canal dentine were measured for each specimen using a nanoindenter with a Berkovich tip. The specimens were divided into seven experimental (n = 10) and one control (n = 10) group according to the final irrigation regimens: Group 1: 2.5% NaOCl, Group 2: 17% EDTA, Group 3: 2.5% NaOCl-17% EDTA, Group 4: 2% PAA, Group 5: 2.5% NaOCl-2% PAA, Group 6: 9% HEBP, Group 7: 2.5% NaOCl + 9% HEBP and Group 8: Distilled water (control). The measurement of the nanohardness values was repeated for each specimen after being exposed to the irrigants. The nanaohardness reduction of each sample was calculated and recorded. The other 80 instrumented root canals were used for scanning electron microscope (SEM) evaluation. First, they were irrigated with the same protocols stated above and longitudinally split into two halves. One half of each root canal was viewed using SEM for the amount of erosion. The erosion scores were recorded. Data were analysed statistically using Kruskal-Wallis and Bonferroni-adjusted Mann-Whitney U-tests with a significance level of 0.05. RESULTS: Use of etidronic acid and NaOCl + HEBP reduced the nanohardness values significantly more than the other experimental solutions (P < 0.05). There was no significant difference between the values for the nanohardness reduction in the samples irrigated with a single chelator and chelator combined with NaOCl (P > 0.05). Peritubular and intertubular erosion were observed in the samples irrigated with HEBP and NaOCl + HEBP. CONCLUSION: Final irrigation of root canals using etidronic acid alone or combined with NaOCl was associated with structural alterations in root canal dentine of extracted teeth.

Two Novel CEBPA Mutations in a Turkish Patient with Acute Myeloid Leukemia.

Acute myeloid leukemia (AML) was first categorized in 1976 by French, American and British researchers, and divided into eight subgroups (M0 to M7), depending on the cytochemical or histological changes in the leukemic cells. The gene mutations of FLT3-ITD, CEBPA and NPM1 are the most common that cooperate together in the prognosis of AML. The CEBPA gene that is a hematopoietic transcription factor, is located on chromosome 19q13.11, and its prevalence is between 5.0 and 14.0% in AML. The patient was referred to our clinic suffering from menorrhagia, unplanned weight loss in a month and low platelet levels, and was diagnosed with AML on clinical and laboratory examination. Here, we report a patient carrying two novel pathogenic mutations that create a frameshift mutation on the CEBPA gene, c.940_941insCCGTCG TGGAGACGA CGAAGG and c.221_222delAC by Sanger sequencing methodology.

Determination of genotoxic and antigenotoxic effects of wild-grown Reishi mushroom (Ganoderma lucidum) using the hen's egg test for analysis of micronucleus induction.

The micronucleus (MN) technique is commonly used for genotoxicity testing. The hen's egg test (HET) for analysis of MN induction (HET-MN) is an inexpensive, rapid and simple genotoxicity assay that is compatible with animal protection and ethical considerations. Ganoderma lucidum (Curtis) P. Karst is known also as reishi mushroom and mushroom of immortality. It has long been used to treat disorders including fungal infections, influenza, common cold, hepatitis, diabetes, high cholesterol and cancer in many countries including China and Japan. G. lucidum strengthens the immune system and reduces the side effects of chemo- and radiotherapy. We investigated the possible genotoxic and antigenotoxic effects of the aqueous extract of wild-grown G. lucidum from Turkey using the HET-MN test. Three different doses of aqueous extract of G. lucidum, 50 µg/egg vitamin C as an antigenotoxic agent and 50 µg/egg cyclophosphamide as a genotoxic compound were injected separately or together into fertilized chicken eggs at incubation day 8. Embryonic peripheral blood smears were prepared and stained with a modified May-Grünwald-Giemsa method on incubation day 11. The frequencies of MN and nuclear abnormalities in erythrocytes were determined using light microscopy. Although the aqueous extract G. lucidum exhibited no genotoxic effect, it did exhibit an antigenotoxic effect. Our findings suggest that G. lucidum extract is a valuable natural antigenotoxic agent.

Idiopathic acute massive pulmonary embolism in childhood.

Acute pulmonary embolism (PE) is an uncommon clinical condition in childhood. We hereby present a case report of a 10-year-old child who presented to the emergency department with an acute massive PE. He was transferred by ambulance to our emergency department for dyspnea and perioral cyanosis. His parents denied any previous history of illness or familial disease. Arterial blood gas analysis, electrocardiography, and clinical symptoms and signs collectively raised a suspicion of a probable PE. A contrast-enhanced pulmonary computed tomography scan revealed a massive thrombus in the distal part of the right pulmonary artery with no contrast passage into upper, middle, and lower lobar arteries. Upon ascertaining, the diagnosis of PE, intravenous saline infusion, 3 L/min oxygen through nasal route, and subcutaneous enoxaparin 0.4 cc was administered promptly. As our hospital lacked a pediatric intensive care unit and a further need for administration of pharmacological thrombolysis was anticipated, we transferred the patient to a tertiary care center. PE should always be kept in mind as a differential diagnosis in emergency departments even in pediatric patients.

The effectiveness of various irrigation protocols on organic tissue removal from simulated internal resorption defects.

AIM: To evaluate the effectiveness of NaOCl, NaOCl-EDTA and NaOCl + HEBP activated by ultrasonics and XP-endo Finisher on organic tissue removal from simulated internal root resorption cavities. METHODOLOGY: The root canals of 144 single-rooted teeth were instrumented. The teeth were split longitudinally, and semicircular cavities were prepared in the canal walls on each half of the roots. Samples obtained from ground bovine muscle tissue were weighed and adapted into the semicircular cavities. The root fragments were reassembled and cemented to create a circular simulated resorption cavity within the canal. Teeth were divided into twelve groups (n = 12) according to the irrigation protocols: group 1: NaOCl, no activation; group 2: NaOCl, passive ultrasonic irrigation (PUI); group 3: NaOCl, XP-endo Finisher; group 4: NaOCl-EDTA, no activation; group 5: NaOCl-EDTA, PUI; group 6: NaOCl-EDTA, XP-endo Finisher; group 7: NaOCl + HEBP, no activation; group 8: NaOCl + HEBP, PUI; group 9: NaOCl + HEBP, XP-endo Finisher; group 10: distilled water, no activation; group 11: distilled water, PUI; and group 12: distilled water, XP-endo Finisher. The teeth were disassembled, and the tissue remaining inside the resorption cavities were weighed. The data were analysed statistically using two-way anova and Fisher's LSD tests with a significance level of 0.05. RESULTS: The use of XP-endo Finisher with the experimental solutions resulted in the greatest tissue weight loss compared to the other activation protocols (P < 0.001). There was no significant difference between NaOCl and NaOCl + HEBP in terms of tissue removal. CONCLUSION: The use of a NaOCl + HEBP mixture activated with XP-endo Finisher was an effective irrigation regimen for removing simulated organic tissues from artificial internal root resorption cavities in the straight root canals of single-rooted teeth.

Peripheral and bone marrow CD34+ cell levels on chronic myeloproliferative disease.

PURPOSE: The aim of the present study was to examine the relationship between peripheral CD34+ and bone marrow CD34+ levels and the clinicopathologic characteristics and laboratory parameters of myeloproliferative disease (MPD) patients. PATIENTS AND METHODS: A total of 103 MPD patients were enrolled in this study. We examined the relationship between bone marrow CD34+ and peripheral CD34+ levels and the patients' clinicopathologic and laboratory parameters. RESULTS: There were no significant correlations between the peripheral CD34+ levels and the JAK-2 V617F mutation, thrombosis, white blood cells (WBC), lactate dehydrogenase (LDH), transferrin saturation (TS), ferritin, or bone marrow cellularity. In addition, there were no significant correlations between bone marrow CD34+ levels and the JAK-2 V617F mutation, thrombosis, WBC, LDH, TS, ferritin, or bone marrow cellularity (P > 0.05). We did not identify any significant relationship between peripheral CD34+ and bone marrow CD34+ levels (P > 0.05). However, there were significant correlations between peripheral CD34+ levels and bone marrow fibrosis (P < 0.001), between bone marrow CD34+ levels and constitutional symptoms (P < 0.05), and between bone marrow CD34+ levels and bone marrow fibrosis (P < 0.001). CONCLUSION: We did not find any significant relationship between the clinicopathologic and laboratory characteristics and peripheral and bone marrow CD34+ cells from bone marrow fibrosis patients. There was also no significant relationship between bone marrow CD34+ cells and peripheral CD34+ cells. Some peripheral CD34+ cells may originate from the spleen rather than the bone marrow, which may given us different result of some parameters.

Dislodgement resistance of calcium silicate-based materials from root canals with varying thickness of dentine.

AIM: To evaluate the dislodgement resistance of DiaRoot BioAggregate and Biodentine from canals in roots with varying amounts of remaining dentine thickness. METHODOLOGY: A total of 90 maxillary incisor teeth with similar dimensions were used. The teeth were extracted for periodontal reasons from adult subjects aged between 52 and 61 years. They were decoronated at the cemento-enamel junction. Simulated internal cavities with a depth of 3 mm were performed by widening the canals on the coronal thirds of the roots, leaving varying amounts of remaining dentine thickness. The canals were enlarged progressively using round diamond burs until the desired dentine wall thickness was obtained. The samples were divided into three main groups (n = 30 each) according to the dentine thickness as follows: group 1: dentine thickness of 0.75 mm, group 2: dentine thickness of 1.50 mm and group 3: dentine thickness of 2.25 mm. Then, these main groups were further divided into two subgroups (n = 15 each) according to the filling material (DiaRoot BioAggregate or Biodentine). Horizontal root slices of 1 mm were obtained from each specimen. Vertical loading was applied to the filling materials at a cross-head speed of 1 mm min-1 using a universal testing machine. The force that led to dislodgement of the filling was recorded in Newtons. The resistance to dislodgement was calculated in megapascals (MPa) by dividing the load in Newtons by the area of the bonded interface. The data were statistically analysed with two-way anova with Tukey's honestly significant difference (HSD) test. RESULTS: Biodentine had significantly higher resistance to dislodgement than DiaRoot BioAggregate (P < 0.001). The specimens with thinner remaining dentine had lower dislodgement resistance compared to those with dentine thicknesses of 1.50 and 2.25 mm (P < 0.001). The lowest mean value for dislodgement resistance was obtained from the DiaRoot BioAggregate group with 0.75 mm dentine thickness (2.72 ± 0.90 MPa). CONCLUSION: The dislodgement resistance of Biodentine and DiaRoot BioAggregate from root dentine was influenced by remaining dentine thickness, which determines dentinal tubular density.

Testicular torsion in spinal cord injury: a case report.

STUDY DESIGN: Case report. OBJECTIVE: To describe a case of testicular torsion in spinal cord injury (SCI). SETTING: Physical Medicine Rehabilitation Training and Research Hospital in Turkey. METHODS: We present the first case of testicular torsion in SCI along with its clinical presentation and follow-up results. RESULTS: Testicular torsion is a rare condition. No case was reported in people with SCI so far. The main difficulty in the diagnosis is that the nociceptive pain is below the injury level and the acute condition could be overlooked. CONCLUSION: Testicular torsion is an acute condition for which early diagnosis is critical in the treatment. The case we describe adds new pitfalls in the diagnosis of this rare condition in people with SCI from the perspective of nociceptive pain below the injury level.

How Do Patients and Parents Decide for Orthodontic Treatment-Effects of Malocclusion, Personal Expectations, Education and Media.

OBJECTIVES: To examine patients' and parents' perceptions and expectations from orthodontic treatment. STUDY DESIGN: 491 patients (274 female, 217 male) aged 14-22 years, and 399 parents (245 female, 154 male) completed a questionnaire about preferences, needs and expectations about orthodontic treatment, and scored the present problem. Continuous variables were compared by Mann-Whitney U and Kruskal-Wallis tests, whereas Chi-square test was used for categorical variables. RESULTS: Patients'(77.1%) and parents'(84.6%), decision about orthodontic treatments were influenced by suggestion of dentists. Patients who decided to attend to clinic by themselves were higher than parents (p=0.006). Dental aesthetics was the determinant factor for treatment demand for patients(61.0%) and parents(57.3%). Improvement in oral functions was more important for Class III patients than Class I patients (p=0.040). Adult patients/parents with higher education gave more importance to oral functions as well as dental aesthetics (p=0.031). There was no difference among Angle classifications regarding orthodontic problem scores. Parents found media sources valuable (p=0.018) but majority expected dentists for information about orthodontic treatments. Education degree of adult patients/parents effected this decision(p=0.002). CONCLUSIONS: Desire to have better dental aesthetics was the primary motivating factor for all participants. Clinicians should consider concerns of Class III patients about oral functions during treatment planning.

The Usefulness of Early Surgical Rib Stabilization in Flail Chest.

BACKGROUND: Flail chest is a clinical condition observed in patients with blunt thorax trauma. Surgical stabilization methods performed on selected patients shorten the durations of mechanical ventilation and intensive care monitoring and significantly reduce the rates of ventilator-associated morbidity and mortality. MATERIAL AND METHOD: Patients treated and diagnosed with flail chest between 2009 and 2014 were studied retrospectively. RESULTS: There were two groups: 10 patients in the group treated surgically and 10 patients in the group treated non-surgically. The groups were similar in terms of age, ISS score, degree of pulmonary contusion, number of rib fractures and location of flail chest. There were no significant differences between the stabilization and non-surgical therapy groups in hospitalization and mechanical ventilation period, tracheostomies, hospital costs and mortality. However, there were significant differences in the intensive care period. The number of the patients who developed pneumonia was significantly lower in the stabilization group, and the difference was statistically significant. CONCLUSION: Early surgical rib stabilization in flail chest is a safe treatment method which has a low complication rate and can reduce the morbidity and mortality which develop from mechanical ventilation.

Centrosome-declustering drugs mediate a two-pronged attack on interphase and mitosis in supercentrosomal cancer cells.

Classical anti-mitotic drugs have failed to translate their preclinical efficacy into clinical response in human trials. Their clinical failure has challenged the notion that tumor cells divide frequently at rates comparable to those of cancer cells in vitro and in xenograft models. Given the preponderance of interphase cells in clinical tumors, we asked whether targeting amplified centrosomes, which cancer cells carefully preserve in a tightly clustered conformation throughout interphase, presents a superior chemotherapeutic strategy that sabotages interphase-specific cellular activities, such as migration. Herein we have utilized supercentrosomal N1E-115 murine neuroblastoma cells as a test-bed to study interphase centrosome declustering induced by putative declustering agents, such as Reduced-9-bromonoscapine (RedBr-Nos), Griseofulvin and PJ-34. We found tight 'supercentrosomal' clusters in the interphase and mitosis of ~80% of patients' tumor cells with excess centrosomes. RedBr-Nos was the strongest declustering agent with a declustering index of 0.36 and completely dispersed interphase centrosome clusters in N1E-115 cells. Interphase centrosome declustering caused inhibition of neurite formation, impairment of cell polarization and Golgi organization, disrupted cellular protrusions and focal adhesion contacts-factors that are crucial prerequisites for directional migration. Thus our data illustrate an interphase-specific potential anti-migratory role of centrosome-declustering agents in addition to their previously acknowledged ability to induce spindle multipolarity and mitotic catastrophe. Centrosome-declustering agents counter centrosome clustering to inhibit directional cell migration in interphase cells and set up multipolar mitotic catastrophe, suggesting that disbanding the nuclear-centrosome-Golgi axis is a potential anti-metastasis strategy.