Efficiency Research of Conformal Channel Geometries Produced by Additive Manufacturing in Plastic Injection Mold Cores (Inserts) Used in Automotive Industry.

In the production of geometries that traditional methods cannot produce, it is seen that additive manufacturing (AM) technology, which has come to the fore, has been used extensively in conformal cooling channel (CCC) applications in recent years. This study, conducted within the scope of CCC's use of applied mold cores in automotive industry plastic part production, aimed to reduce the cycle time in the injection printing process. The v1 geometry, which gives the analysis results for ideal printing quality from the channel geometries developed with three different design approaches, is produced with direct metal laser sintering, which is an AM laser sintering technology, and the injection printing cycle time has been reduced by 38%. CCC applied the study's primary motivation to develop duct geometry to provide balanced cooling in the automotive industry's mold cores produced with AM. It is known that the Computer Numerical Control machining process in traditional mold methods does not allow the processing of the channels in the internal geometries, and the deep areas where the heat is concentrated cannot be cooled sufficiently. In the study, CCC geometries where AM design parameters are used effectively and the balanced cooling performance expected from the die core can be achieved. The effects of different geometries on production are discussed.

Correlation of proximal and distal muscle strength with upper limb functional ability in patients with essential tremor.

Despite being considered as a benign, genetic and monosymptomatic disorder, ET is a poorly understood entity with etiological and pathological heterogeneity. The aim of the present study was to examine the relation between proximal and distal muscle strength and upper limb functionality and tremor severity in patients with essential tremor (ET). The study enrolled 25 tremor patients followed at the neurology clinic of a university hospital and 19 healthy controls. Demographic data, risk factors, disease duration and dominant hand of the participants were recorded. Back and leg strength was assessed using a back and leg dynamometer and hand dynamometer and pinchmeter were used to determine hand strength. Functional ability of the participants was evaluated using the Minnesota Manual Dexterity Test (MMDT), Perdue Pegboard (PPBT) and Nine Hole Peg Test (NHPT). Tremor severity was assessed using the Fahn-Tolosa-Marin Tremor Rating Scale (FTMTRS) and the Lower Extremity Clinical Tremor Assessment Scale (LECTAS). A significant difference was found in the average back and leg muscle strength between ET patients and healthy controls (p < 0.05). The mean values for right/left hand muscle strength were not significantly different between the two groups (p > 0.05). Among the upper limb functional ability tests, significant differences were found between the two groups in the mean time to complete NHPT, Minnesota placing subtest and PPBT test (p < 0.05). While gender and risk factors were not significantly different between the two groups (p > 0.05), there was a significant difference with respect to the educational level (p < 0.01). No significant difference was found between back and leg muscle strength and FTMTRS and LECTAS (p > 0.05). A negative correlation and a significant association were found between average strength measurements obtained with the left hand dynamometer and FTMTRS in the ET group (p = 0.030, r = - 0.434). A positive correlation and a significant association were found between left hand strength and mean turning time in the MMDT in the control group (p = 0.041, r = 0.473). ET patients experience loss of proximal muscle strength and functional disability. Further studies are planned to investigate the effects of physical therapy modalities targeting increased proximal muscle strength on tremor severity and functional ability in ET patients.

Neck pain: is it part of a migraine attack or a trigger before a migraine attack?

BACKGROUND: A migraine is a primary headache disorder characterized by recurrent headaches that are moderate to severe. Neck pain may actually be the most common migraine symptom despite the fact that it is rarely listed among usual symptoms such as nausea and light sensitivity. The aim of this study is to determine the relationship between migraine and neck pain. METHODS: A total of 50 patients (41 females and 9 males) diagnosed with migraine were included in the study. 50 patients with migraine were asked about the occurrence of neck symptoms during different phases of their attacks. Patients of both sex, aged 12-61 years, diagnosed as having migraine according to the definition of the ICHD-3-ß, and having neck pain any time during the attack phase, were included in the study. Migraine severity was measured using the Visual Analogue Scale (VAS). RESULTS: In our study, we compared the clinical and demographic characteristics of migraine patients. While 89.1% of the patients reported that their headache and neck pain started and ended concurrently, only 10.9% of them had neck pain starting at different times in comparison to migraine headache (30 min before headache, 2 h before or later than headache and 12 h later than headache). CONCLUSIONS: As a result of our study, we have concluded that neck pain begins simultaneously with migraine attacks and concurrently, and may be part of migraine attacks accordingly.

Headaches in the different phases of relapsing-remitting multiple sclerosis: a tendency for stabbing headaches during relapses.

INTRODUCTION: Primary headaches are known to be associated with multiple sclerosis. We aimed to determine headaches using ICHD-II in different phases of relapsing-remitting multiple sclerosis, and the correlation between headaches and several features of the disease. RESULTS: Migraine (41.2%) and tension-type headaches (20.6%) were the most common headaches in remission, and primary stabbing headache (PSH) (27.8%) was common in the relapsing phase. Although headaches seemed to occur independently of disease duration, extended disability status scale, beck depression inventory scores, and treatments, the total number of headaches was correlated with periventricular lesions (P = 0.03) and tension-type headaches were correlated with spinal lesions in remission (P = 0.02). Total number of headaches was correlated with brain stem lesions in the relapsing phase (P = 0.05). CONCLUSION: The high frequency of PSHs in relapse was notable, and, to the best of our knowledge, PSH was not reported in relapsing-remitting multiple sclerosis before. Further studies with larger samples are recommended.

Intravenous theophylline decreases post-dural puncture headaches.

Post-dural puncture headache (PDPH) is a common complication of lumbar puncture. As invasive treatments for PDPH have known complications, pharmacologic management may be preferable. The aim of this study was to evaluate and to compare the efficacy of intravenous theophylline treatment for PDPH, in comparison with a placebo. We found that intravenous theophylline infusion was effective for decreasing the painfulness of PDPH compared with the control group. The mean visual analogue scale (VAS) value was 7.05+/-1.47 before the theophylline infusion and 2.88+/-2.31 after infusion. An average of 59.1% relief of pain was obtained in the group treated with theophylline infusion. The improvement in VAS in the study group was significant (p < 0.001), whereas that in the control group was not (p = 0.15). The mean VAS decrease after theophylline infusion was 4.17+/-2.03 in the study group and 0.41+/-0.71 in the control group; the difference in improvement between the groups was significant (p < 0.001). Intravenous theophylline infusion is an easy, rapid, minimally invasive, an effective treatment for PDPH. It may be attempted in PDPH patients before invasive techniques are used. To the best of our knowledge, this is the first report on the effect of intravenous infusion of theophylline compared with a placebo in the treatment of PDPH.

Complexed prostate specific antigen density is better than the other PSA derivatives for detection of prostate cancer in men with total PSA between 2.5 and 20 ng/ml: results of a prospective multicenter study.

PURPOSE: This prospective, multicenter study was initiated to evaluate the diagnostic performance of PSA, free/total PSA (f/tPSA) and complexed PSA (cPSA) with volume-based parameters for early detection of prostate cancer in patients with PSA between 2.5 and 20 ng/ml. MATERIALS AND METHODS: 408 subjects with serum PSA values between 2.5 and 20 ng/ml regardless of digital rectal examination (DRE) were included in to the study. The diagnostic validity, sensitivity, specificity and cut-off values were evaluated by Receiver Operating Characteristic (ROC) curve analysis. RESULTS: Of 408 patients 77 (18.9%) were positive for prostate cancer. Digital rectal examination was non-suspicious in 86% (351/408) of the patients. Area under curve (AUC) values for cPSA were better than PSA and f/tPSA in patients with PSA values of 2.5-10 ng/ml and 4-10 ng/ml, as well as the whole group. Furthermore, on ROC curve analysis cPSAD was the best predictor of prostate cancer for all PSA ranges regardless of the DRE findings except PSA values between 2.5 and 4 ng/ml. The cut-off value of cPSAD at 90% sensitivity was 0.06 ng/ml/cm(3) with a 35.3% specificity saving 126 unnecessary biopsies in the whole group. CONCLUSION: cPSA might be a better initial test than PSA for prostate cancer detection and measurement of cPSA alone and its derivatives obviate the need for additional fPSA testing.

Validation of 2001 Partin tables in Turkey: a multicenter study.

OBJECTIVE: Although Partin tables were developed in United States to predict the stage of prostate cancer preoperatively, they are used by many clinics throughout the world assuming that these figures apply to their population as well. However the predictive value of current Partin tables, which was updated in 2001, has not been validated in most of the countries as well as in Turkey. Therefore, we evaluated the validity of 2001 Partin tables, for the ability to predict the pathological stage in Turkish patients. PATIENTS AND METHODS: The clinical and pathological findings of 1043 patients who have had radical prostatectomy were assessed. Serum PSA values, clinical stage, biopsy Gleason score and the pathological features of the radical prostatectomy specimens were collected from each clinic and evaluated. The predictive value of Partin nomogram and pathological findings of prostatectomy specimens were compared and analyzed according to Receiver Operating Characteristics (ROC) analysis. RESULTS: Median age of the patients was 60 (45-74). In the presented study, percentage of patients with clinical stage T1c was 43%. Patients with Gleason score of 2-4 in biopsy constituted 23.4% of the study group. In the present study, the ratio of the patients with serum PSA higher than 10 ng/ml was 39.6%. Organ confined disease, seminal vesicle involvement, lymph node metastases ratios were 64.7%, 10.3%, 1.8% respectively. Area Under Curve (AUC) values for organ confined disease, seminal vesicle involvement and lymph node involvement were calculated as 0.665, 0.733 and 0.759 respectively. CONCLUSION: It appears that Partin tables have a reasonable predictive value for the final pathological features like organ confined disease, seminal vesicle and lymph node involvement in Turkish patients. This multicenter study showed that current Partin tables could also be used in Turkish patients with comparable accuracy.

Potential value of soluble intercellular adhesion molecule-1 in the serum of patients with bladder cancer.

INTRODUCTION: The potential value of serum levels of intercellular adhesion molecule-1 (ICAM-1) in the staging and pathological nature of bladder cancer was investigated in this study. MATERIALS AND METHODS: A total of 90 patients (mean age 64.5 +/- 7.1) having transitional cell carcinoma of the bladder and 30 control patients (mean age 64.0 +/- 5.5) were enrolled in the study. The serum samples of the patients were obtained on the day before surgery, at the same hour of the day. RESULTS: The preoperative sICAM-1 levels were found to be 46.2 +/- 14.7 and 28.0 +/- 7.8 ng/ml in the tumor group and the control group respectively, which is significantly higher (p = 0.00). The ICAM-1 levels were not different in the invasive tumor group (36 patients) and the superficial tumor group (54 patients; 47.3 +/- 13.8 ng/ml in the invasive group and 45.5 +/- 15.3 ng/ml in the superficial tumor group; p = 0.520). The serum levels of sICAM-1 were significantly higher in grade III tumors than grade I and II tumors (62.0 +/- 8.7, 38.4 +/- 11.9 and 42.2 +/- 8.2 ng/ml respectively; p = 0.000). The mean serum sICAM-1 levels in tumors >3 cm and <3 cm were found to be 52.6 +/- 15.8 and 40.7 +/- 11.0 ng/ml respectively which is statistically significant (p = 0.000). CONCLUSIONS: In this study, serum ICAM-1 levels were found to be related to tumor presence, grade and size. Larger series are needed for the thorough understanding of the role of ICAM-1 in bladder cancer.

Value of urinary NMP-22 in patients with renal cell carcinoma.

OBJECTIVES: To investigate the preoperative and postoperative levels of urinary nuclear matrix protein-22 (NMP-22) in patients with renal cell carcinoma (RCC) and compare them with those of control patients. We also investigated and reported the relationship of NMP-22 with the pathologic grade and stage of RCC tumors. Urinary NMP-22 is currently used for monitoring patients with transitional cell carcinoma of the bladder. METHODS: The preoperative and postoperative urinary NMP-22 levels were measured in 23 patients with RCC and 20 control patients in whom solid renal masses were ruled out by either computed tomography or renal ultrasonography. The control group consisted of patients with benign conditions from the urology, gastroenterologic surgery, and cardiovascular surgery departments. Of the 23 patients with RCC, 21 underwent radical nephrectomy and 2 underwent partial nephrectomy. RESULTS: The preoperative urinary NMP-22 levels were significantly higher in the RCC group than in the control group (10.65 +/- 5.49 U/mL and 4.64 +/- 3.10 U/mL, respectively, P <0.001). Ten days postoperatively, the urinary NMP-22 levels had decreased from 10.65 +/- 5.49 U/mL to 5.98 +/- 3.86 U/mL in the RCC group, which was statistically significant (P <0.001). The postoperative urinary NMP-22 levels were not different from those of the control group (5.98 +/- 3.86 U/mL versus 4.64 +/- 3.10 U/mL, P = 0.176). CONCLUSIONS: The results of this study are promising for the use of urinary NMP-22 in the evaluation of patients who are at risk of RCC because the relationship between urinary NMP-22 and the presence of RCC has been shown.