Impact of low-level laser therapy as an adjunct to non-surgical periodontal treatment on the levels of tissue plasminogen activator and plasminogen activator inhibitor 1 in Stage 3-4, Grade C periodontitis patients: a split-mouth, randomized control study.

AIM: To investigate the effects of low-level laser therapy (LLLT) as an adjunct to non-surgical periodontal treatment (NSPT) on the plasminogen-activating system. MATERIALS AND METHODS: Stage 3-4 Grade C periodontitis and age-gender-matched healthy individuals participated in the split-mouth study (ClinicalTrials.gov identifier, NCT05233501). The study groups were Periodontitis/NSPT (Sham); Periodontitis/NSPT + LLLT (LLLT); Healthy (Control). Following NSPT, LLLT was applied on Days 0, 2 and 7. Clinical parameters were recorded at baseline and on Day 30. Gingival crevicular fluid (GCF) was collected at baseline, on days 7, 14, and 30; tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) levels were measured with ELISA. RESULTS: Clinical parameters, total GCF tPA (tPAt) and PAI-1 (PAI-1t) levels significantly reduced in LLLT and Sham groups (< 0.001). GCF tPAt levels in LLLT were significantly lower (< 0.05) than Sham on Day 7. GCF tPAt levels in periodontitis groups were significantly higher than the Control at baseline, on Days 7 and 14 (< 0.01). By Day 30, both groups decreased to control levels (> 0.05). GCF PAI-1t levels were significantly lower in LLLT than the Sham on day 30 (< 0.01), comparable to healthy controls (> 0.05). CONCLUSION: Adjunctive LLLT modulates the plasminogen activating system in severe periodontitis by altering GCF tPA and PAI-1 levels. CLINICAL RELEVANCE: LLLT as an adjunct to non-surgical periodontal treatment in patients with Stage 3-4 Grade C leads to reduced plasminogen activation.

Predictive value of lymphocyte to monocyte ratio for cardiac syndrome X.

OBJECTIVE: Cardiac syndrome X (CSX) is typically described with ischemia in stress tests in addition to angina-like chest pain and without stenosis in coronary angiography. We aimed at determining the relationship between LMR and CSX. PATIENTS AND METHODS: We retrospectively collected patients with CSX between January 2016 and December 2019. Patients with typical angina-like chest pain, normal 12-lead electrocardiography at rest, a positive response to the exercise test (> 0.1 mV ST-segment depression at 80 ms after the J point in two or more contiguous leads) or ischemia on myocardial perfusion scintigraphy and normal coronary angiography were included in the study as CSX patients. RESULTS: This study consisted of 116 patients with CSX and 153 control groups. The mean age of the patients with CSX was 52.7±9.7 years, and the mean age of the control group was 53.7±10.6 years (p= 0.416). The patients with CSX were more likely to have higher monocyte counts and LMR. According to the Pearson correlation test, the CRP value negatively correlated with the LMR. In multivariate logistic regression analysis, LMR remained a significant predictor of CSX. In ROC analysis, LMR < 4.1 had 64% sensitivity and 50% specificity (ROC area under curve: 0.587, 95% CI: 0.519-0.655, p=0.015) in accurately predicting a CSX diagnosis. CONCLUSIONS: We showed that lower LMR levels were associated with the presence of CSX.

Effects of molsidomine on retinal ischemia/reperfusion injury in rabbits.

We investigated the effect of molsidomine (MOL) on ischemia/reperfusion (I/R) injury. Rabbits were assigned to four groups: group 1, sham; group 2, I/R; group 3, MOL treatment for 4 days after I/R; group 4, MOL treatment for 1 day before I/R and 3 days after I/R. Retinal I/R was produced by elevating the intraocular pressure to 150 mm Hg for 60 min. Seven days after I/R, the eyes were enucleated. Retinal changes were examined using histochemistry. The levels of malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) also were measured. We found a significant increase in the thickness of the outer nuclear layer of group 3 compared to the other groups. In groups 3 and 4, caspase-3 stained cells in the ganglion cell layer were decreased compared to group 2. We found a significant increase in caspase-3 stained cells in the inner nuclear layer (INL) of group 2 compared to the other groups. We found a significant increase in caspase-3 stained cells in group 3 compared to group 4 in the INL. The MDA level in group 2 was significantly higher than group 1 and MOL significantly decreased MDA levels in groups 3 and 4. We found that MOL protected the retina from I/R injury by enhancing antioxidative effects and inhibiting apoptosis of retinal cells.

Association between the neutrophil to lymphocyte ratio and prehypertension.

OBJECTIVES: To explore the neutrophil-lymphocyte ratio (NLR) in patients with prehypertension (PHT). BACKGROUND: Inflammation plays an important role in the development of cardiovascular diseases. A pathophysiological link also exists between inflammation and PHT. NLR is a simple marker for the assessment of inflammatory status. There is a lack of data regarding the association between NLR and pre-hypertensive state. METHODS: The present cross-sectional study included 33 newly diagnosed PHT patients and 35 normotensive control subjects. Prehypertension was defined as a systolic blood pressure (BP) of 120-139 mm Hg and/or a diastolic BP of 80-89 mm Hg. RESULTS: Patients were divided into tertiles based on NLR values: 1.17 (0.9-1.42) in tertile 1; 1.57 (1.43-1.78) in tertile 2; and 2.40 (1.82-4.5) in tertile 3. The frequency of PHT was significantly higher for patients in the upper NLR tertile compared to the middle and lower NLR tertiles (21 (91.3%), 7 (30.4%), and 5 (22.7%), respectively; p<0.001). Systolic BP and diastolic BP were significantly higher among patients in the upper NLR tertile than among those in the other NLR tertiles. CONCLUSION: An association exists between PHT and NLR. NLR measurement, as well as monocyte count, may be used to indicate increased risk of prehypertension (Tab. 2, Ref. 48).

Long-term prognostic value of coronary flow velocity reserve in renal transplant recipients.

BACKGROUND: In this prospective study, we sought to investigate the long-term prognostic value of coronary flow reserve (CFR) and carotid intima media thickness (IMT) estimates in renal transplant recipients without known coronary artery disease. METHODS: The 20 renal transplant recipients included in this study underwent CFR recordings performed by trans-thoracic Doppler echocardiography (TTDE) and carotid IMT measured by carotid Doppler ultrasonography. RESULTS: During a 3-year follow-up only one patient experienced a cardiac event. The baseline CFR and carotid IMT values of the patients were 1.77 ± 0.47 and 0.67 ± 0.15 mm, respectively. After 3 years of follow-up, there were no significant differences compared with baseline measurements with regard to CFR and IMT values. CFR values at the third year of follow-up showed significant correlation with age as well as IMT at baseline and at the third year. Upon multivariate analysis, baseline carotid IMT (ß = -0.562; P = .05) was a significant independent predictor of CFR at the third year. CONCLUSION: Carotid IMT showed a greater predictive value for impaired CFR in renal transplant recipients. CFR was not an independent predictor for cardiovascular events among renal transplant recipients within the first 3 years of follow-up measurements.

The positivity of rheumatoid factor and anti-cyclic citrullinated peptide antibody in nonarthritic patients with chronic hepatitis C infection.

Chronic hepatitis C virus (HCV) has extrahepatic autoimmune properties and a variety of autoantibodies were found in patients with HCV. Patients with HCV infection may have rheumatic symptoms and signs, and 50-70% of the cases may contain rheumatoid factor (RF). The increased prevalence of RF in patients with HCV infection diminishes the diagnostic specificity of serum RF for rheumatoid arthritis (RA) in patients with HCV. Therefore, the presence of RF mostly does not help in distinguishing between RA and HCV-associated rheumatic symptoms. In this study, we studied whether cyclic citrullinated peptide (CCP) antibody, a highly specific biomarker for RA in the general population, was useful for the diagnosis of RA in nonarthritic patients with HCV (hepatitis C virus). Blood samples from 39 patients with chronic HCV infection, 87 normal sera from volunteer blood donors and 108 blood samples from patients with rheumatoid arthritis, from the rheumatology clinic, were taken. RF was measured using the Dade-Behring nephelometer and antibodies to CCP were measured with ELISA. According to statistical analysis, the sensitivity, specificity and positive predictive value of the anti-CCP test was superior to the RF test. Cyclic citrullinated peptide antibody is a more useful test than RF among patients with chronic HCV infection without arthritis.

Inflammatory pseudo-tumour of the appendix and acute appendicitis: a case report.

Inflammatory myofibroblastic tumour (IMT) is a rare benign lesion of unknown aetiology. It mimics, clinically and radiologically, malignant tumours (especially sarcoma). It was initially described in the lung, but it was subsequently recognised that virtually any anatomic location can be involved. IMTs of the gastro-intestinal tract are rare and there have been only nine confirmed cases involving the appendix to date. We presented a 20-year-old male patient with a diagnosis of IMT that caused acute appendicitis. An appendectomy is the most efficient treatment in cases where the lesion is limited to the appendix. Being aware of such an entity and being careful in the differential diagnosis of the appendiceal masses, especially the large masses, may prevent overtreatment.

Effects of gingival retraction materials on gingival blood flow.

PURPOSE: The effects of 2 chemical retraction agents on gingival blood flow and systemic blood pressure in subjects with healthy gingiva were investigated. MATERIALS AND METHODS: Thirty volunteer dental students were selected for the study and randomly divided into 2 groups. Aluminium chloride-impregnated cord (right side) and nonimpregnated cord (left side) were placed in the gingival sulcus of group 1. Epinephrine-impregnated cord (right side) and nonimpregnated cord (left side) were placed in group 2. Blood flow in the retracted marginal gingiva was measured by laser Doppler flowmetry, and the systemic blood pressures of subjects were recorded before and after the retraction procedure. RESULTS: A statistically significant decrease in blood flow was observed in group 2, but there was no significant change in gingival blood flow in group 1. A decrease in diastolic blood pressure of the subjects in group 2 was also observed. However, there was no significant change in blood pressure of the subjects in group 1. CONCLUSION: Gingival retraction affects gingival blood flow temporarily. Epinephrine-impregnated cords can be used safely in patients who have healthy gingiva, if patient stress and gingival trauma are avoided during cord placement.

The lamp effect of laser Doppler flowmetry on teeth.

The aim of this study is to analyse the intra and extracoronal scattering of laser light. Twelve vital teeth from 12 volunteer individuals (aged 22-29 years) were used. The camera removing the charge coupled device's infrared cut filter was used for imaging the laser Doppler flowmetry light during pulpal blood flow measurement. When the obtained photos were analysed, it was seen that the laser beam caused the tooth to shine like a lamp and it also illuminated the tissues inside the mouth (tongue, lips, adjacent teeth, etc.). As a result, it was shown that when the necessary cautions were not taken, the laser could scatter all around the tissues surrounding the tooth. Because of the conductive characteristic of the fibre and the optical characteristics of the tooth, we think that the beam is inevitably scattered onto the tissues outside the pulp and together with the isolation of the gingiva, crown should be isolated, as well.

Lipiodol UF retention in dental sialography.

Lipiodol is a lipid based contrast medium and is very useful in sialography. It gives very fine images and clearly shows the details of the gland. It is viscous and has a relatively high iodine content. However, lipiodol UF drops sometimes remain in the salivary gland and in the adjacent tissues for a long time and may cause irritation. We report a case where lipiodol UF leaked from Stensen's duct and was not resorbed after a period of 70 months.

The sources of laser Doppler blood-flow signals recorded from vital and root canal treated teeth.

OBJECTIVES: The aim was to determine the strength of signals derived from the dental pulp and those from the surrounding tissues in human teeth using the laser Doppler flowmetry (LDF). METHODS: Twenty-six vital teeth (13 experimental and 13 controls) from 12 patients were used. Experimental teeth had root canal treatment in a single visit and their healthy antimeres were controls. Blood flow measurements were made before and after local anaesthesia, after root canal preparation, following root canal filling and coronal restoration. RESULTS: Perfusion unit (PU) values recorded from empty pulp chamber were determined to be only 30% lower than the values recorded before anaesthesia from the experimental intact teeth. When the measurements in the group were compared with each other the values of variation in the both groups were not statistically significant. The variation between the groups when the measurement values before anaesthesia, 10min after anaesthesia and after coronal restoration were compared, it was not statistically significant (P>0.05). The variation between the groups after preparation and root canal filling in their values of measurements was important statistically (P<0.05). The measurement values of the study group were lower than that of the control group. CONCLUSIONS: In pulpal, LDF a major portion of the signal comes from tissues other than pulp. Without taking precautions (such as rubber-dam application) in pulp blood flow measurements, the results may be inconsistent.

Reliability of frozen section in determining tumor thickness intraoperatively in laryngeal cancer.

OBJECTIVES: The relationship between locoregional lymph metastasis and tumor thickness in head and neck cancer has been well documented in recent years. Determining tumor thickness by frozen section may help the surgeon decide intraoperatively whether to perform elective neck dissection, whereas paraffin section results could be obtained at a later time for this decision. The aim of this study was to evaluate the accuracy of tumor thickness measurements obtained by macroscopic measurement and by frozen section intraoperatively in laryngeal cancer. STUDY DESIGN: Prospectively we compared the tumor thickness results obtained by gross visual examination, by frozen section, and by paraffin section in 20 total, near-total, and horizontal supraglottic laryngectomy specimens. METHODS: The sections were stained with hematoxylin and eosin and tumor thickness was measured under a light microscope with an ocular micrometer. RESULTS: A strong correlation was found between frozen section and paraffin section tumor thickness measurements (Pearson correlation coefficient = 0.993, P <.001). Paired t test showed a 4.59 mm mean difference between macroscopic and paraffin section measurements, and a 0.76 mm mean difference between frozen and paraffin section measurements. CONCLUSION: Assessment of tumor thickness in laryngeal cancer intraoperatively by frozen section is a reliable method.

Thiemann's disease: a case report.

In this case report, we describe a patient with the diagnosis of Thiemann's disease, which is a genetically determined rare form of idiopathic avascular necrosis of the proximal interphalangeal joints of the hands.