Can ultrasonography be used to determine working length in endodontic treatment? An in vitro study

This study was conducted to evaluate efficacy of ultrasonography (USG) in determining working length in in-vitro conditions. Twenty five access cavities of maxillary incisor teeth were opened and actual working lengths (AWL) were measured with dental operating microscope. The working length were then measured with an electronic apex locator and USG. USG and apex locator measurements were statistically analyzed using one sample t-test and compared with AWL. The mean AWL measurment was 20.68 mm. USG measured the working length slightly longer (21.09 mm) than the measurements of apex locator (20.64 mm). Statistical analysis showed that the USG method provided similar measurements to electronic apex locators and with no statistical difference with actual working length (P < .05). USG emerges as a promising method for working length measurement that allows simultaneous visualization of root tip anatomy in cases where electronic apex locators may be insufficient and there is buccal cortical bone loss.

Evaluation of the differences in the localization of the lingula mandibulae according to pubertal development in children: A new anthropological and forensic approach

OBJECTIVE

This study aims to investigate changes in lingula mandibulae localization before and after puberty and sex differences.

DESIGN

288 panoramic radiographs evaluated retrospectively were divided into four groups according to pubertal development: under and over 10 years old for females and under and over 11 years old for males. Four anatomic sites were used as reference points: (a) the anterior border of the ramus; (b) the posterior border of the ramus; (c) the deepest point of mandibular notch; and (d) the angulus mandibulae. The ratio of the distances from the lingula mandibulae to points (a) and (b) and the ratio of the distances from the lingula mandibulae to points (c) and (d) were determined. Two-way ANOVA was performed to assess differences between subgroups based on sex and puberty, and a Bonferroni post-hoc test was performed for multiple comparisons.

RESULTS

Puberty and sex has a significant interaction effect on the vertical location of the lingula mandibulae. Postpubertal lingula mandibulae is positioned proportionally more anteriorly by prepubertal localization. In addition, the lingula mandibulae is situated more posteriorly in females compared to males. A significant interaction effect of puberty and sex was observed in relation to the vertical positioning of the lingula mandibulae.

CONCLUSIONS

The spatial localization of the lingula mandibulae and its spatial displacement with age can be used both in estimating sex and the onset of puberty. Changes in the localization of lingula mandibulae according to pubertal development and sex can be used in forensic and anthropological contexts.

Comparison of CBCT radiation doses with conventional radiographs in TMJ imaging using Monte Carlo simulations

Three-dimensional imaging methods are widely used for evaluation of bony changes of temporomandibular joint (TMJ). Besides, lateral and posterio-anterior TMJ projections in both closed- and open-jaw positions for each temporomandibular joint are used as two-dimensional diagnostic tools. The purpose of the present study was to compare effective and mean organ absorbed doses of plain radiography techniques with those of different modalities of cone beam computed tomography (CBCT) scanning of an adult's temporomandibular joint. PCXMC 2.0 software was used to calculate mean organ and effective doses. A NewTom CBCT device (Newtom 5G XL; QR systems; Verona, Italy) was simulated at 360° rotation using a 6 × 6 cm2 FOV in standard and high-resolution modes. Lateral and posterio-anterior TMJ plain projections were simulated according to recommendations of the manufacturer of the Planmeca ProMax® 2D S3 device. Doses for both projections were simulated with Monte Carlo methods and the International Commission on radiological protection adult reference computational phantoms. The highest mean organ absorbed doses occurred in bone surfaces, salivary glands, and skull for posterio-anterior TMJ and lateral TMJ, and for CBCT scanning in all examinations. The effective doses of posterio-anterior and lateral TMJ plain radiographs were found to be higher than those of the Standard Mode-Eco Scan CBCT. Therefore, the lowest effective dose was calculated in Standard Mode-Eco Scan CBCT. It is concluded that NewTom 5G XL Standard Mode-Eco Scan CBCT can be used instead of plain radiographs (lateral and posterio-anterior TMJ) in temporomandibular joint imaging as it allows visualizing the three-dimensional structure of the temporomandibular joint as an advantage.

Vascular complications and associated comorbidities in newly diagnosed pre-diabetes: is it the tip of the iceberg?

OBJECTIVE

The aim of this study was to investigate the prevalence of microvascular and macrovascular diabetic complications and the associated comorbidities in newly diagnosed pre-diabetic individuals.

PATIENTS AND METHODS

This cross-sectional study includes 100 newly diagnosed pre-diabetic individuals. Fasting plasma glucose, HbA1c, and oral glucose tolerance (OGTT) were tested according to the American Diabetes Association's diagnostic criteria for pre-diabetes, besides anthropometric measurements, lipid profiles, and demographic and biochemical parameters. Comorbidities like hypertension, obesity, dyslipidemia etc., were evaluated. All participants were screened for microvascular (retinopathy, nephropathy, neuropathy) and macrovascular [coronary artery disease (CAD) and cerebrovascular event-peripheral artery disease] complications.

RESULTS

Microvascular complications were found in 12% of the participants (neuropathy: 4%, nephropathy: 8%) and 19% had macrovascular complications. Of the participants, 21% of the cases presented hypertension, 21% dyslipidemia and 48% obesity. A high probability of developing non-alcoholic fatty liver disease-related fibrosis [estimated using non-alcoholic fatty liver disease fibrosis score (NFS)] was found in 68% of cases. History of dyslipidemia (OR: 5.00, 95% CI: 1.10-22.56; p=0.037) was an independent risk factor for the development of vascular complications.

CONCLUSIONS

Diabetic vascular complications were found in approximately one-third of pre-diabetic cases. Dyslipidaemia was found to be an important risk factor for the development of vascular complications in these individuals.

Long-term evaluation of masseter muscle activity, dimensions, and elasticity after orthognathic surgery in skeletal class III patients

OBJECTIVE

To evaluate changes in the masseter muscle after orthognathic surgery using electromyography (EMG), ultrasonography (US), and ultrasound elastography (USE) in individuals with skeletal class III anomaly over long-term follow-up and compare with a control group.

MATERIALS AND METHODS

The study group included 29 patients with class III dentofacial deformities scheduled to undergo orthodontic treatment and orthognathic surgery. The control group included 20 individuals with dental class I occlusion. Assessment of the masseter muscles using EMG, US, and USE was performed before orthognathic surgery (T1) and at postoperative 3 months (T2) and 1 year (T3) in the study group, and at a single time point in the control group. All assessments were performed at rest and during maximum clenching. Masseter muscle activity, dimension, and hardness were analyzed.

RESULTS

Electromyographic activity of the masseter muscle during maximum clenching was increased at postoperative 1 year but did not reach control group values. On ultrasonography, the masseter muscle showed minimal changes in dimension at postoperative 1 year compared to preoperative values and remained below control group values. The postoperative increase in masseter muscle hardness at rest and during maximum clenching persisted at postoperative 1 year.

CONCLUSION

The results of this study suggest that after orthognathic surgery, additional interventions and much longer follow-up are needed to ensure better muscle adaptation to the new occlusion and skeletal morphology.

CLINICAL RELEVANCE

All assessment methods are useful for comprehensively evaluating changes in the masticatory muscles after orthognathic surgery.

The Evaluation of the Relationship between Changes in Masseter Muscle Thickness and Tooth Clenching Habits of Bruxism Patients Treated with Botulinum Toxin A

Background

Bruxism is defined as recurrent masticatory muscle activity. Although there is not an agreed treatment method for bruxism, the application of botulinum toxin A (BT-A) has become a reliable lately. This study aimed to evaluate the correlation between the changes in masseter muscle thickness and clenching habits in bruxism patients treated with BT-A.

Methods

Twenty-five patients, 23 females and 2 males, diagnosed with possible sleep bruxism were included in the study. The Fonseca Anamnestic Index was applied to the patients to determine their clenching habits and depression levels both before the treatment, and 6 months after it. The masseter muscle thickness was measured using ultrasonography before the treatment and 3 months and 6 months after the treatment. All the patients were injected with a total of 50 U of BT-A, 25 U to each masseter.

Results

A statistically significant decrease in masseter muscle thickness was observed in the ultrasonography 3 and 6 months after the BT-A treatment. There was a statistically significant decrease in the Fonseca scores, in which the teeth clenching habits of the patients were evaluated 6 months after the treatment. Although there was a decrease in the depression levels of the patients 6 months after the treatment, this difference was not statistically significant.

Conclusion

When the results of this study were evaluated, it was seen that the BT-A injections are an effective, safe, and side effect-free method in the treatment of bruxism and masseter hypertrophy.

Ultrasonographic and electromyographic evaluation of three types of occlusal splints on masticatory muscle activity, thickness, and length in patients with bruxism

OBJECTIVE

To evaluate occlusal splint type differences in patients with bruxism.

METHODS

Seventeen controls and 51 patients were divided into three subgroups, each assigned to use a different occlusal splint (hard, soft, or semi-soft) for 3 months and assessed by ultrasonography and electromyography (EMG) before (BT) and 3 months after treatment (AT).

RESULTS

EMG values in all of the occlusal splint groups were significantly lower AT than BT (p < 0.05). BT and AT EMG values in the control group did not differ. Mean muscle thicknesses in bruxism patients was greater than in controls, and the greatest muscle thickness changes occurred with the hard occlusal splint (p < 0.05).

DISCUSSION

A decrease in EMG activity occurred with all three splint types and was most prominent in the hard occlusal splint group. Ultrasonographic measurements of muscle length and thickness should be used alongside EMG to measure muscle activity in bruxism patients.

Influence of Cone-Beam Computed Tomography Voxel Sizes in the Detection of Chemically Induced External Root Resorptions

BACKGROUND External root resorption usually does not present a clinical sign or symptom, and, therefore, diagnosis is mainly based on radiographic examination. Many studies confirmed the advantage and accuracy of cone-beam computed tomography (CBCT) in evaluating root resorptions. We aimed to evaluate the diagnostic accuracy of CBCT images of chemically induced external root resorptions on extracted human teeth taken in different voxel sizes. MATERIAL AND METHODS In this in vitro study, 36 maxillary and 36 mandibular human incisor teeth, extracted owing to periodontal disease, were used. External resorption cavities were created on the buccal and proximal surfaces by using 10% hydrochloric acid with different application periods of 10, 30, and 60 min. Resorption cavities in different depths were induced to simulate different levels of external resorption. CBCT images were taken with Planmeca Promax 3D Max CBCT (Planmeca, Helsinki, Finland) in 4 different voxel sizes: 400, 200, 150, and 100 μm. RESULTS There was no statistically significant difference between interobserver and intraobserver reliability. Higher observer agreement was obtained for 100-μm and 150-μm voxel sizes. For detection of external root resorption defects, interobserver agreement was highest for the 100-μm voxel size and when defects were located on the proximal side of the samples. The highest k values were obtained for samples kept in hydrochloric acid for 60 min. CONCLUSIONS Chemically induced resorption cavities should be used for experimental studies to better imitate clinical conditions. CBCT requirement is still ambiguous for detection of external resorptions, and more experimental and clinical studies are needed.

Pre-dilatation prior to carotid artery stenting in very severe carotid artery stenosis: beneficial or detrimental?

Background

There are many technical variations in carotid artery stenting and there is not a clear recommendation in pre-dilatation (Pre-D) prior to stenting. In this study we investigated the role of Pre-D before carotid artery stenting in patients with very severe carotid artery stenosis (≥90%).

Methods

A total of 298 patients with a carotid stenosis equal to or more than 90% were included to our study. Patients were divided into two groups as Pre-D and No-Pre-D. In-hospital and 3-year long-term clinical outcomes were compared between the groups.

Results

During the hospitalization, major stroke was more common in Pre-D group [n=6 (5.5%) vs. n=3 (1.5%), respectively], whereas overall ipsilateral stroke rates were similar between the groups. The rates of myocardial infarction were similar between the groups. In- hospital mortality was significantly higher in the Pre-D group than non-pre-D group [n=4 (3.6%) vs. n=0 (0%), respectively]. During the 3-year follow up period, the rates of ipsilateral stroke, major stroke, transient ischemic attack, myocardial infarction, and mortality were similar between the groups.

Conclusion

According to the literature, this is the first study evaluates the role of Pre-D in very severe (&gt;90%) carotid artery stenosis. The current study demonstrated that Pre-D might have a detrimental effect on in-hospital outcomes.

Funding Acknowledgement

Type of funding sources: None.

Systemic immune-inflammation index predicts in-hospital and long-term outcomes in patients with ST-segment elevation myocardial infarction

Background

Inflammatory markers are significantly associated with cardiovascular disease and many markers have been used as predictor in patients with STEMI. This study examines the predictive value of the novel systemic immune-inflammation index (SII) in patients with ST-segment elevation myocardial infarction (STEMI).

Method

A total of 1660 patients with STEMI who underwent primary percutaneous coronary intervention in a tertiary heart center were enrolled in the study. SII was calculated using the following formula: Platelet × Neutrophil/Lymphocyte ratio. The patients were stratified into four quartiles (Q) according to admission SII level. In-hospital and 3-year outcomes were compared between the four groups (Q1–4)

Results

In-hospital cardiogenic shock, acute respiratory failure, acute kidney injury, ventricular arrhythmia, stent thrombosis, recurrent myocardial infarction, major adverse cardiac events, and mortality were significantly higher in the high SII groups (Q3 and Q4). Logistic regression models demonstrated that Q3 and Q4 had independent risk of mortality and Q4 had an independent risk of cardiogenic shock compared to Q1. ROC analysis showed that the best cut-off value of the Systemic Immune-Inflammatory Index to predict the in-hospital mortality was 1781 with 66% sensitivity and 74% specificity (AUC: 0.75; 95% CI: 0.69–0.81; p&lt;0.001). Kaplan Meier overall survivals for Q1, Q2, Q3 and Q4 were 97.6%, 96.9%, 91.6% and 81.0% respectively. Cox proportional analysis for 3-year mortality demonstrated that Q3 and Q4 had independent risk of death compared to Q1.

Conclusion

SII, a novel inflammatory index, had a better prediction of in-hospital and long-term outcomes than traditional risk factors in patients with STEMI.

Funding Acknowledgement

Type of funding sources: None.

Evaluation of Changes in Depression Levels of Bruxism Patients Treated With Botulinum Toxin-A

Aim:

Bruxism is defined as the involuntary recurrent masticatory muscle activity characterized by gnashing, grinding, clenching of teeth, and/or pushing the mandible. Factors creating its etiology are peripheral (morphological) or central (physiopathological and physiological), and exogenous. Recently, among physiological factors, depression and bruxism were considered to be related. A definitive treatment method does not exist for bruxism; however, botulinum toxin-A (BT-A) application is an up-to-date and effective way of treatment. The present study is aimed to evaluate the levels of depression in bruxism patients treated with BT-A application.

Materials and Methods:

A total of 25 individuals (23 females and 2 males) who were diagnosed as bruxism patients were included in the study. 25 U of BT-A for each masseter muscle was injected into the patients. Patients were prospectively observed for a possible change in depression levels by using Beck’s Depression Inventory. The inventory was implemented before and six months after the BT-A application. Depression levels before and six months after the injection were compared. A paired t-test was used to compare “before” and “after” treatment values. One-way analysis of variance and post-hoc Tukey tests were used to evaluate the change in Beck’s Depression Inventory scores according to age groups.

Results:

The mean total score was 7.80 ± 8.10 before the treatment and 7.16 ± 6.52 six months after the treatment. The decrease in the mean score was not statistically significant ( P > .05).

Conclusion:

In conclusion, despite the decrease in the mean Beck’s Depression Inventory scores, a statistically significant decrease in the depression levels of patients was not observed.

Corticosteroid injection in treatment of persistent oral lichen planus: Three cases

Oral lichen planus (OLP) is a chronic inflammatory disease with unknown etiology. There are many clinical types of OLP. OLP cases are often asymptomatic; however, atrophic or erosive forms may cause sensitivity, burning, and discomfort. The best model of the OLP treatment modality is to evaluate the restorations that may lead to oral mucosa hypersensitivity as the first step. Local corticosteroid injection therapy may be preferred to eliminate the possible systemic side effects of systemic corticosteroid medication in patients with OLP. The aim of this case series is to evaluate treatment alternatives in OLP.

Investigating the effect of dental implant materials with different densities on radiotherapy dose distribution using Monte-Carlo simulation and pencil beam convolution algorithm

OBJECTIVES

The aim of this study was to investigate the effect of dental implant materials with different physical densities on dose distribution for head and neck cancer radiotherapy planning.

METHODS

Titanium (Ti), Titanium alloy (Ti-6Al-4V), Zirconia (Y-TZP), Zirconium oxide (ZrO₂), Alumina (Al₂O₃) and polyetheretherketone (PEEK) dental implant materials were used for determination of implant material effect on dose distribution. Dental implant effect was investigated by using pencil beam convolution (PBC) algorithm of Eclipse treatment planning systems (TPS) and Monte Carlo (MC) simulation technique. 6 MV photon beam of the Varian 2300 C/D linear accelerator was simulated by EGSnrc-based BEAMnrc MC code system.

RESULTS

Reasonable consistency was determined for percentage depth dose (PDD) curves between MC simulation and water phantom measurements at 6.4 MeV initial electron energy. The consistency between modelled linear accelerator PDD curve calculations and water-phantom PDD measurements were compatible within 1 % range. The dose increase in front of the dental implant calculated by MC simulation is in the range of 0.4-20.2%. We found by MC and PBC calculations that the differences in dose increase in front of the dental implant materials is in the range of 0.1-17.2% and is dependent on the physical density of the dental implant.

CONCLUSIONS

Dose increase for Zirconia was noted to be maximum while PEEK implant dose increase was minimum among the whole dental implant materials studied. This study revealed that the Eclipse TPS PBC algorithm could not accurately estimate the backscatter radiation from dental implant materials.

Molecular screening of Leishmania spp. infection and bloodmeals in sandflies from a leishmaniasis focus in southwestern Turkey

Leishmaniasis is an arthropod-borne disease that affects approximately 2 million people worldwide annually. The aims of this study were to detect the presence of Leishmania (Kinetoplastida: Trypanosomatidae) DNA and the feeding preferences of probable vector species in an endemic focus of Leishmania infantum in Turkey. Entomological sampling was performed in August and October 2015 in Aydın province, where cases of human and canine leishmaniasis have been reported previously. A total of 1059 sandfly specimens comprising nine species belonging to two genera, Phlebotomus and Sergentomyia (both: Diptera: Psychodidae), and five subgenera of the Phlebotomus genus (Phlebotomus, Paraphlebotomus, Larroussius, Adlerius and Transphlebotomus) were collected in five villages. Among all Phlebotomus specimens, Phlebotomus neglectus (39%) was noted as the most abundant species, followed by Phlebotomus tobbi (18%). Leishmania DNA was detected in pools from P. neglectus, P. tobbi and Sergentomyia dentata by kDNA polymerase chain reaction (PCR). Leishmania DNA from Phlebotomus specimens was identified as L. infantum, but Leishmania DNA from Sergentomyia spp. could not be identified to species level by ITS-1 real-time PCR. The detection of Leishmania DNA in wild-caught P. neglectus and the high percentage (24.2%) of human DNA in engorged specimens suggests that P. neglectus is probably an important vector species for L. infantum in Aydın province.

BURNOUT AND OCCUPATIONAL PARTICIPATION AMONG TURKISH DENTAL STUDENTS

The aim of the present study was to investigate the prevalence of burnout and occupational participation limitation among dental students in a dental school in Turkey. Four hundred fifty-eight dental students (females=153; males=305) were included in the study. The age range varied from 17-to-38 years. Maslach Burnout Inventory-Student Version (MBI-SV) and Canadian Occupational Performance Measure (COPM) were used to gather data. Descriptive analyses, t-test, and Kruskall-Wallis test for independent groups were used for data analyses. The results indicated that 26% of all the students have burnout in terms of emotional exhaustion (25%), cynicism (18%), and academic efficacy (14%). The results showed that burnout is statistically significant in relation to demographics (p<0.05). Twenty-four percent of the students showed considerably decreased occupational performance and satisfaction scores, which suggested occupational participation limitations. Occupational performance and satisfaction scores were inversely correlated with emotional exhaustion and cynicism, while directly correlated with reduced academic efficacy (p<0.05). The results of the present study indicates that burnout and occupational participation limitation can be seen among dental students. Students with burnout may also have occupational participation limitation. Enriching dental education programs with different psychological strategies may be useful for education of healthy dentists and improve the quality of oral and dental health services.

Diagnostic accuracy of different display types in detection of recurrent caries under restorations by using CBCT

OBJECTIVES

To assess the in vitro diagnostic ability of CBCT images using seven different display types in the detection of recurrent caries.

METHODS

Our study comprised 128 extracted human premolar and molar teeth. 8 groups each containing 16 teeth were obtained as follows: (1) Black Class I (Occlusal) amalgam filling without caries; (2) Black Class I (Occlusal) composite filling without caries; (3) Black Class II (Proximal) amalgam filling without caries; (4) Black Class II (Proximal) composite filling without caries; (5) Black Class I (Occlusal) amalgam filling with caries; (6) Black Class I (Occlusal) composite filling with caries; (7) Black Class II (Proximal) amalgam filling with caries; and (8) Black Class II (Proximal) composite filling with caries. Teeth were imaged using 100 × 90 mm field of view at three different voxel sizes of a CBCT unit (Planmeca ProMax(®) 3D ProFace™; Planmeca, Helsinki, Finland). CBCT TIFF images were opened and viewed using custom-designed software for computers on different display types. Intra- and interobserver agreements were calculated. The highest area under the receiver operating characteristic curve (Az) values for each image type, observer, reading and restoration were compared using z-tests against Az = 0.5. The significance level was set at p = 0.05.

RESULTS

We found poor and moderate agreements. In general, Az values were found when software and medical diagnostic monitor were utilized. For Observer 2, Az values were statistically significantly higher when software was used on medical monitor [p = 0.036, p = 0.015 and p = 0.002, for normal-resolution mode (0.200 mm(3) voxel size), high-resolution mode (0.150 mm(3) voxel size) and low-resolution mode (0.400 mm(3) voxel size), respectively]. No statistically significant differences were found among other display types for all modes (p > 0.05). In general, no difference was found among 3 different voxel sizes (p > 0.05). In general, higher Az values were obtained for composite restorations than for amalgam restorations for all observers. For Observer 1, Az values for composite restorations were statistically significantly higher than those of amalgam restorations for MacBook and iPhone (Apple Inc., Cupertino, CA) assessments (p = 0.002 and p = 0.048, respectively).

CONCLUSIONS

Higher Az values were observed with medical monitors when used with dedicated software compared to other display types which performed similarly in the diagnosis of recurrent caries under restorations. In addition, observers performed better in detection of recurrent caries when assessing composite restorations than amalgams.

Laparoscopic transperitoneal nephrectomy in non-functioning inflammatory kidneys with or without renal stone

OBJECTIVE

To compare our laparoscopic simple nephrectomy results in non-functioning inflammatory kidneys with or without renal stones.

PATIENTS AND METHODS

Patients, who underwent laparoscopic transperitoneal nephrectomy for non-functioning kidney between June, 2010 and October, 2014 were included to study. Overall, data of 32 patients including 15 patients with renal stone (Group 1) and 17 patients without renal stone (Group 2) were retrospectively reviewed.

RESULTS

Mean age was 44.4 ± 18.5 years (10-71) in group 1 and 35.2 ± 21 years (9-77) in group 2. Mean operation time was 95.0±25.9 minutes (70-175) in group 1 and 86.7 ± 15.1 minutes (70-125) in group 2. Mean estimated blood loss was found to be 64.13 ± 26.67 ml (30-120) in group 1 and 58.94 ± 24.24 ml (30-100) in group 2. Both groups had inflammatory findings in pathological analysis. There was no significant difference between groups regarding estimated blood loss, operation time, pre-operative and post-operative hemoglobin values, percent hemoglobin decrease, complications and hospitalization times (p > 0.05).

CONCLUSIONS

Non-functioning kidney with or without renal stone could be operated safely with comparable complication rates and success via laparoscopy in experienced hands.

Genome-wide fungal stress responsive miRNA expression in wheat

MicroRNAs (miRNAs) are small non-coding class of RNAs. They were identified in many plants with their diverse regulatory roles in several cellular and metabolic processes. A number of miRNAs were involved in biotic and abiotic stress responses. Here, fungal stress responsive wheat miRNAs were analyzed by using miRNA-microarray strategy. Two different fungi (Fusarium culmorum and Bipolaris sorokiniana) were inoculated on resistant and sensitive wheat cultivars. A total of 87 differentially regulated miRNAs were detected in the 8 × 15 K array including all of the available plant miRNAs. Using bioinformatics tools, the target transcripts of responsive miRNAs were predicted, and related biological processes and mechanisms were assessed. A number of the miRNAs such as miR2592s, miR869.1, miR169b were highly differentially regulated showing more than 200-fold change upon fungal-inoculation. Some of the miRNAs were identified as fungal-inoculation responsive for the first time. The analyses showed that some of the differentially regulated miRNAs targeted resistance-related genes such as LRR, glucuronosyl transferase, peroxidase and Pto kinase. The comparison of the two miRNA-microarray analyses indicated that fungal-responsive wheat miRNAs were differentially regulated in pathogen- and cultivar-specific manners.

Comparison of Different Techniques in Breast Cancer Radiotherapy Planning

OBJECTIVE

This study aimed to minimize the radiation dose to organs other than the target tissue during adjuvant therapy applied for breast cancer, by using different planning methods.

MATERIALS AND METHODS

30 women with T1-2 N1-3 M0 breast cancer were included in the study. Planning was performed using four different methods to the supraclavicular area, internal, and external tangential fields. All planning was done in a virtual environment by and the requested data was obtained. All patients were treated by the 1st method. Method 1: Different isocenter, complete supraclavicular area, breast half beam. Method 2: Different isocenter, half supraclavicular area, breast half beam. Method 3: Single isocenter, half supraclavicular area, breast half beam. Method 4: Different isocenter, supraclavicular area full beam, breast full beam.

RESULTS

Evaluation of PTV values showed a statistically significant reduction in D-max, 110% and 115% values by method III. Lower doses in other parameters were not statistically significant.

CONCLUSION

Based on these results, the application of single isocenter, 3D radiotherapy in breast cancer provides significant advantages especially in PTV and pulmonary dosages.

Assessment of buccal marginal alveolar peri-implant and periodontal defects using a cone beam CT system with and without the application of metal artefact reduction mode

OBJECTIVES

To investigate the accuracy of cone beam CT (CBCT) images obtained with and without artefact reduction (AR) in detecting simulated buccal peri-implant and buccal periodontal defects.

METHODS

42 implants inserted into edentulous mandibles, and 38 teeth present in dry mandibles were used. Simulated buccal peri-implant defects (n = 22) and buccal periodontal defects (n = 22) were prepared. 20 implants and 18 teeth without simulated defects were the control group. Images of the mandibles were obtained using a Planmeca ProMax(®) 3D Max CBCT unit (Planmeca Oy, Helsinki, Finland). Image reconstructions were prepared without and with low, medium and high AR modes. Images were viewed randomly by six observers twice for the presence of defects. Kappa coefficient was calculated. F2_LD_F1 design for non-parametric analysis of longitudinal data was used. Area under curves (AUCs) were calculated for each observer. Significance level was taken as α = 0.05.

RESULTS

Intraobserver kappa ranged from 0.140 to 0.792 for peri-implant and from 0.189 to 1.0 for periodontal defects. All factors were statistically significant (p < 0.001), except for image mode and implant brand. Pairwise interactions were found between periodontal defects and peri-implant defects (p < 0.001), observers (p < 0.001), observer and image mode (p < 0.001), defect model and observer (p < 0.001) and defect model, image mode and observer (p = 0.04). AUC values ranged from 0.39 to 0.52 for peri-implant and from 0.45 to 0.71 for periodontal defects. Higher AUC values were found for periodontal defects than for peri-implant defects.

CONCLUSIONS

Buccal peri-implant defects were more difficult to detect than buccal periodontal defects. No difference was found among CBCT images obtained with and without AR modes.

Effects of dietary supplementation with a herbal extract on the performance of broilers infected with a mixture of Eimeria species

1. A herbal extract containing a blend of three essential oils, derived from oregano, laurel leaf and lavender, was investigated as a feed additive alternative to the conventional anticoccidial sodium monensin. 2. Broilers were infected with a mixture of Eimeria species or left uninfected. Both infected and uninfected broilers were provided with diets containing either herbal extract (HEX), monensin (MON) or without these supplements (CON). The HEX group had 50 mg herbal extract/kg diet and the MON group 100 mg monensin/kg diet. 3. All of the uninfected broilers exhibited higher body weight gain and better feed conversion when compared with their infected counterparts at d 28 and 42 of age. Both HEX and MON supplements caused significant improvements in performance in the infected broilers, but failed to have any effect on uninfected broilers. 4. Faecal oocyst output measured daily by sampling excreta, and expressed on a per bird basis, was lower in the HEX and MON groups than in the CON group. However, the herbal extract was not as effective as monensin in reducing oocyst excretion. Coccidial infection caused a significant increase in total intestinal length and caecal weight, but the dietary treatments did not influence these measurements. 5. These results indicate that providing a herbal extract in the diet was not as effective as monensin in protecting broilers exposed to a coccidial challenge.

Evaluation of Macular Changes After Uncomplicated Phacoemulsification Surgery by Optical Coherence Tomography

PURPOSE

To evaluate the effect of uncomplicated phacoemulsification surgery on macula by optical coherence tomography (OCT).

METHODS

A total of 110 eyes of 102 patients who underwent uncomplicated phacoemulsification and foldable intraocular lens implantation at Beyoglu Eye Research and Training Hospital between February and March 2005 and who were without any systemic disease, fundus or other ocular pathology were included. Postoperatively, topical prednisolone acetate (6 x 1) and ofloxacine (5 x 1) was started, and by decreasing the dosage progressively, treatment was continued for 6 weeks. Full ophthalmologic and OCT examinations were done preoperatively and at the postoperative 1st day, 1st week, 1st, 3rd, and 6th months. Mean retinal thicknesses, volumetric analyses at central fovea, superior, inferior, temporal, and nasal macular quadrants, and thinnest foveal retinal thicknesses were recorded. Preoperative and postoperative measurements were analyzed statistically by using ANOVA test, paired samples t-test with Bonferroni correction, and Pearson's correlation test.

RESULTS

The mean central foveal retinal thickness was preoperatively 202.4 +/- 25.9 micro m, postoperatively 200.4 +/- 26.1 micro m at 1st day (p = 0.29), 208.4 +/- 27.6 micro m at 1st week (p = 0.29), 226.2 +/- 54.9 micro m at 1st month, 215.2 +/- 24.0 micro m at 3rd month, 213.5 +/- 29.4 micro m at 6th month (p < 0.001). Perifoveal macular thicknesses at superior, inferior, temporal, and nasal quadrants were 264.9 +/- 28.8 micro m, 266.1 +/- 29.5 micro m, 255.0 +/- 31.3 micro m, 260.3 +/- 34.0 micro m, respectively, preoperatively; 287.9 +/- 28.4 micro m, 288.0 +/- 26.3 micro m, 286.8 +/- 33.1 micro m, 272.0 +/- 32.4 micro m, respectively, at postoperative 1st month (p < 0.001). The change in mean central foveal thickness, foveal thinnest retinal thickness, mean perifoveal retinal thickness and volumetric analyses was insignificant at postoperative 1st day (p > 0.05), and significant at 1st week, 1st, 3rd, and 6th months (p < 0.05 for all measurements).

CONCLUSIONS

Statistically significant increase in macular thickness was detected at postoperative early periods, after the 1st week after uncomplicated cataract operation. The increase in macular thickness starts from parafoveal regions. Longer follow-up of patients is required for the macular consequences, and different treatment protocols should be studied in a randomized controlled fashion.

Post-trabeculectomy choroidal detachment: not an adverse prognostic sign for either visual acuity or surgical success

PURPOSE

To report the incidence of choroidal detachment (CD) following trabeculectomy and to evaluate its effect on long-term surgical success and best-corrected visual acuity (BCVA).

METHODS

A total of 253 eyes of 198 subjects who underwent trabeculectomy between 1993 and 2003 with at least 1 year follow-up were reviewed retrospectively. Twenty-eight eyes of 28 subjects which developed CD postoperatively were classified as Group 1 and the remaining 225 eyes of 170 subjects as Group 2. The risk factors for the development of CD and the influence of CD on BCVA and on the success of trabeculectomy were analyzed and compared between the two groups.

RESULTS

In Group 1, preoperative BCVA was significantly lower and cup to disc ratio and the frequency of pseudoexfoliative glaucoma were higher with respect to the control group (p=0.009, p=0.01, p=0.02). The correlations between the development of CD and postoperative findings such as shallowing of the anterior chamber, hypotony, hypotonic maculopathy, hyphema, and fibrin reaction in the anterior chamber were statistically significant.CD was not associated with a significant reduction of BCVA. Intraocular pressures at postoperative first day, sixth month, and first year were lower in Group 1. The success of trabeculectomy and the average number of medications used were not significantly different between the two groups.

CONCLUSIONS

CD following trabeculectomy occurred in 11% of our patients. CD was not associated with either a significant drop in BCVA or an adverse influence on long-term IOP control.

Peripheral odontogenic myxoma located on the maxillary gingiva: report of a case and review of the literature

BACKGROUND

Odontogenic myxoma is a rare, benign neoplasm and is often located in the maxillofacial region centrally most common in the mandible. Soft tissue localization that can be classified as a peripheral myxoma is rarely seen than the central localization. Peripheral myxoma is slowly growing and less aggressive compared to the central myxoma and has a low recurrence rate.

CASE REPORT

In this presentation, the patient with a peripheral odontogenic myxoma of the posterior maxillary gingiva was presented with histological findings following surgery, and the clinical differences and characteristics of the various types of myxomas were discussed by a review of the literature.

The use of blood culture bottles in endophthalmitis

PURPOSE

To study the use of blood culture bottles for culturing vitreous specimens in acute-onset postoperative infectious endophthalmitis cases.

METHODS

Forty-eight eyes of 48 patients with mean age of 66.4 +/- 14.7 years with postoperative endophthalmitis that occurred within 6 weeks after ocular surgery, presenting from June 2001 to January 2005, were retrospectively studied. Vitreous fluid specimens of these patients were cultured in blood culture bottles. The measured outcome is the yield of positive culture.

RESULTS

Vitreous specimens yielded positive in 34 of 48 (70.8%) eyes with blood culture bottles. The most common organism isolated was Staphylococcus epidermidis in 17.6% (6/34) of cases.

CONCLUSION

The direct inoculation of vitreous specimens into the blood culture bottles is easy to perform, with a high yield positive rate (70.8%). It may be an alternative to conventional culture media for culturing vitreous specimen in infectious endophthalmitis especially in clinics or hospitals that are unable to have adequate microbiology laboratory facilities.

ZB5M Anterior Chamber and Fyodorov's Posterior Chamber Phakic Intraocular Lenses: Long-term Follow-up

PURPOSE

To compare the long-term complications of two outdated phakic intraocular lenses (PIOL) implanted in eyes with high myopia to aid development of better PIOL designs.

METHODS

Sixty-two eyes of 37 patients implanted with the ZB5M anterior chamber PIOL (anterior chamber group) and 22 eyes of 14 patients implanted with Fyodorov's posterior chamber PIOL (posterior chamber group) were examined. Complications were compared after a mean follow-up of 71.15 +/- 32.17 months (range: 24 to 145 months) in the anterior chamber group and 84.14 +/- 26.43 months (range: 24 to 132 months) in the posterior chamber group (P = .07).

RESULTS

At last follow-up, pupil ovalization was present in 32 (51.6%) eyes in the anterior chamber group and 1 (4.5%) eye in the posterior chamber group (P < .001), and cataract in 5 (8.1%) eyes in the anterior chamber group and 7 (31.8%) eyes in the posterior chamber group (P = .007). Phakic intraocular lens decentration, glaucoma, retinal detachment, corneal decomposition, and monocular diplopia were additional complications encountered in both groups, with no statistically significant difference.

CONCLUSIONS

Proper understanding of these outdated PIOLs may be helpful in developing better PIOL designs.

Radial keratotomy for the optical rehabilitation of mild to moderate keratoconus: more than 5 years' experience

PURPOSE

To present the authors' long-term experience of radial keratotomy (RK) for the optical rehabilitation of patients with mild to moderate keratoconus--central corneal thickness of greater than 400 microm and without apical scarring.

METHODS

In this observational, noncomparative series of cases, all consecutive patients with mild or moderate keratoconus, treated by RK between 1990 and 2002, with at least 1 year follow-up were included. A total of 170 eyes of 96 patients were investigated. Mean follow-up was 42.08 +/- 28.14 months. Visual acuity, refraction, corneal curvature, central corneal thickness, and complications were evaluated.

RESULTS

In all of the control visits, mean uncorrected and best spectacle corrected visual acuities were better than preoperative values (p<0.0001). Preoperative myopic spherical refraction decreased significantly (p<0.0001), and remained relatively unchanged throughout the follow-up (p=0.43). A small but statistically significant decrease from baseline was ob-served in astigmatism (p=0.038), which almost disappeared 1 year after the surgery (p=0.47). The surgery produced a statistically significant flattening of the corneal curvature (p<0.0001). Central corneal thickness did not change significantly (p>0.05) in either control visit. In 33 eyes (19.4%), re-deepening of the incisions was required. In 3 eyes (1.8%) penetrating keratoplasty was performed, due to disease progression in 2 eyes (1.2%) and acute traumatic hydrops in 1 eye (0.6%). In 4 eyes (2.2%) microperforation, in 2 eyes (1.2%) macroperforation, in 1 eye (0.6%) infectious keratitis, and in 1 eye (0.6%) hyperopic shift occurred.

CONCLUSIONS

RK surgery was found to be a reasonable option for the rehabilitation of a selected group of keratoconus patients in the early or moderate stages.

Anterior chamber depth, iridocorneal angle width, and intraocular pressure changes after uneventful phacoemulsification in eyes without glaucoma and with open iridocorneal angles

PURPOSE

To investigate the influence of uneventful phacoemulsification on anterior chamber depth (ACD), iridocorneal angle (ICA) width, and intraocular pressure (IOP) in nonglaucomatous eyes with open ICA preoperatively.

SETTING

Beyoglu Eye Education and Research Hospital, Istanbul, Turkey.

METHODS

Fifty-three eyes of 49 patients were evaluated for 6 months postoperatively. The nonparametric Wilcoxon signed rank test was used to compare preoperative and postoperative IOP, ACD, and ICA width. Univariate and multivariate regression analyses were used to evaluate the relationships between IOP, ACD, and ICA width and between preoperative patient characteristics.

RESULTS

The mean preoperative IOP of 15.1 mm Hg +/- 2.8 (SD) dropped postoperatively to 13.4 +/- 3.4 mm Hg at 1 day, 13.3 +/- 2.6 mm Hg at 1 week, 13.2 +/- 3.1 mm Hg at 1 month, 13.3 +/- 2.7 mm Hg at 3 months, and 14.1 +/- 2.5 mm Hg at 6 months (P<.05). The mean preoperative ICA grade of 2.97 +/- 0.72 increased to 3.55 +/- 0.48 at 1 week and 3.68 +/- 0.45 at 1 month (P<.05). The mean preoperative ACD of 3.06 +/- 0.49 mm increased to 3.57 +/- 0.47 mm at 4 weeks, 3.69 +/- 0.32 mm at 1 month, and 3.70 +/- 0.36 mm at 3 months (P<.05). The IOP decrease was not correlated with the changes in ICA width or ACD. Multiple regression analysis showed preoperative IOP was the single predictor of the postoperative IOP drop (P<.001).

CONCLUSIONS

In nonglaucomatous eyes with an open ICA preoperatively, uneventful phacoemulsification reduced IOP, increased ACD, and widened the ICA. The changes were statistically significant over 6 months.

Studies on the epidemiology of tropical theileriosis (Theileria annulata infection) in cattle in Central Anatolia, Turkey

An epidemiological survey for Theileria annulata infection was conducted in 12 selected villages around Ankara in Central Anatolia, Turkey, during the period April 1990 to January 1993. During the survey, 198 cattle of 30 local breeds, 84 Holstein-Friesian x local breeds and 84 Holstein-Friesian breed were examined for antibodies to T. annulata and the presence of the vector ticks. Four species of Hyalomma ticks were identified: Hyalomma anatolicum anatolicum, Hyalomma anatolicum excavtum, Hyalomma detritum and Hyalomma marginatum marginatum. Salivary gland staining indicated that infected adult ticks of all four species were present and, therefore, were implicated in the transmission of tropical theileriosis in the field. Generally, the Hyalomma infestation rate was low, with the heaviest infestations occurring on the older animals. Young adults and calves had very low infestation rates. Most ticks seen on cattle were adults, very few nymphs were found. The blood smear and serological examination of the 198 cattle conducted in March, before the start of the first disease season, showed that the prevalence of piroplasmosis was 11.1% (22 out of 198) and the seroprevalence of T. annulata was 10.6% (21 out of 198). Forty-three animals were then excluded from the study because they were seropositive and/or harboured piroplasms. Ninety-two seronegative animals showed piroplasmosis (92 out of 155) and 34 seronegative animals became seropositive for T. annulata (34 out of 155) during the three disease seasons. One animal became clinically ill with tropical theileriosis and required treatment. The incidence of cattle showing piroplasmosis and disease in the total study sample was 50.7% and 0.5% per disease season, respectively. The seroconversion rate of new infection with T. annulata in the total study was 14.3% per animal season. The number of cattle showing piroplasmosis was much greater than the number of seropositive cattle, which may indicate the presence of another species of Theileria. The two different management systems encountered in the study were considered to have influenced the tick infestation levels.

A comparison of susceptibilities to infection of four species of Hyalomma ticks with Theileria annulata

In this comparative study unfed nymphs of four Hyalomma tick species (Hyalomma anatolicum anatolicum, Hyalomma anatolicum excavatum, Hyalomma detritum and Hyalomma marginatum marginatum) were allowed to engorge on calves experimentally infected with Theileria annulata. The infection prevalence in the salivary glands of the adult female and male ticks of each Hyalomma species used in the study were assessed. The infection prevalence with T. annulata was high and did not vary markedly in the four Hyalomma tick species. The mean number of infected acini per tick in female and male ticks was different with female ticks having higher numbers of infected acini than the male ticks. The sex difference was more significant between H.a. anatolicum and H.a. excavatum than between H. detritum and H.m. marginatum. This study clarifies the roles of four Hyalomma tick species, and their sex, in the development of T. annulata.

Status of the tick-borne diseases in sheep and goats in Turkey

A serological survey using Indirect Fluorescent Antibody Test (IFAT) for Babesia ovis infection of sheep has been carried out in different geographical regions of Turkey. The results indicated that 71.6% of 141 sheep in Black Sea region, 70.9% of 93 sheep in central Anatolia, 80.2% of 96 sheep in Aegean region and 55.7% of 122 sheep in eastern Anatolia were seropositive. This means that B. ovis infection is endemic throughout Turkey. In addition, occurrence of B. ovis, B. motasi, Theileria hirci, T. recondita and Anaplasma ovis infections in sheep and goats has been reported previously in Turkey as well. However further studies are needed to obtain more information about the agents to keep the infection under control.