Search

A letter to the editor on the diagnostic performance of intracranial translucency is presented.

The article discusses a study on the significance and detection of micrometastases in lymph nodes in endometrial carcinoma (EC). It mentions that the status of the said node is considered the most significant prognostic factor in relation to patients with the disease. It also notes the application of immunohistochemistry to monitor the cytokeratin staining of the nodes that were reported to be negative for their metastases.

AIM: The aim of this study was to evaluate the immediate post-operative pain, wound healing and clinical results after the application of an enamel matrix protein derivative (EMD) alone or combined with a low-level laser therapy (LLLT) for the treatment of deep intra-bony defects. MATERIAL AND METHODS: This study was an intra-individual longitudinal test of 12 months' duration conducted using a blinded, split-mouth, placebo-controlled and randomized design. In 22 periodontitis patients, one intra-bony defect was randomly treated with EMD+LLLT, while EMD alone was applied to the contra-lateral defect site. LLLT was used both intra- and post-operatively. Clinical measurements were performed by a blinded periodontist at the time of surgery, in the first week and in the first, second, sixth and 12th month. Visual analogue scale (VAS) scores were recorded for pain assessment. RESULTS: The results have shown that the treatment of intra-bony defects with EMD alone or EMD+LLLT leads to probing depth reduction and attachment-level gain. In addition, EMD+LLLT had resulted in less gingival recession (p<0.05), less swelling (p<0.001) and less VAS scores (p<0.02) compared with EMD alone. CONCLUSION: This study shows that EMD is an effective, safe and predictable biomaterial for periodontal regeneration and LLLT may improve the effects of EMD by reducing post-operative complications. [ABSTRACT FROM AUTHOR]

BACKGROUND: Occult cystobiliary communication (CBC) presents with biliary leakage, if the cystobiliary opening cannot be detected and repaired at operation. We investigated the clinical signs associated with the risk of occult CBC in the preoperative period by studying patients who developed biliary leakage after hydatid liver surgery. METHODS: We analyzed the records of 191 patients treated for hydatid liver cyst. Postoperative biliary leakage developed in 41 patients (21.5%). Independent predictive factors were established by logistic regression analysis using clinical parameters, whose cutoff values were determined by receiver operating characteristic (ROC) curves. RESULTS: Postoperative biliary leakage presented as external biliary fistula in 31 (75.6%) of 41 patients, as biliary peritonitis in 6 (14.6%) and as cyst cavity biliary abscess in 4 (9.8%). Independent clinical predictors of occult CBC, represented by biliary leakage, were alkaline phosphatase > 250 U/L, total bilirubin > 17.1 micromol/L, direct bilirubin > 6.8 micromol/L, gamma-glutamyl transferase > 34.5 U/L, eosinophils > 0.09 and cyst diameter > 8.5 cm. Multilocular or degenerate cysts increased the risk of biliary leakage (p = 0.012). Postoperative complication rates were 53.7% in the patients with biliary leakage, and 10.0% (p < 0.001) in those without. The mean postoperative hospital stay was longer in patients with biliary leakage (14.3 [and standard deviation {SD} 1.9] d) than in those without (7.3 [SD 2.3] d) (p < 0.001). Nineteen (61.3%) of 31 biliary fistulae closed spontaneously within 10 days. The remaining 12 (38.7%) fistulae closed within 7 days after endoscopic sphincterotomy. CONCLUSION: Factors that predict occult CBC due to hydatid liver cyst were identified. These factors should allow the likelihood of CBC to be determined and, thus, indicate the need for additional procedures during operation to prevent the complications of biliary leakage. [ABSTRACT FROM AUTHOR]

A total of 1083 burn cases hospitalised at a burn center between August 1988 and the end of 1997 were studied retrospectively to determine the factors and demographic features associated with burn injury in Turkey. The means for patient age and percent total body surface area (TBSA) burned were 18.1 years and 31.2%, respectively (medians were 14.0 years and 25.0%, respectively). Burn injuries were more common in winter and spring, and most occurred in the home. The majority of patients were city dwellers, and had been referred from public hospitals. There was a predominance of male patients (71.9%) in the study population, but the proportions of children and adults were equal. Almost half of the males and the majority of the females were children/students. The vast majority of female adults were housewives, and most of the men were employed outside the home. More than half of the patients suffered second-degree burns, and the others all had deeper burn injuries. The most frequent cause of burn in the study population was flame. Children mainly suffered from scalding, and adults from flame and electrical burns. There were no differences between the sexes regarding depth of burn; whereas percentage total burned surface area was higher in females. Children had a lower mean TBSA and lower rate of third-degree burns. Mortality rate of the study population was 33.5%. The study results identified various risk factors and the groups at high risk for serious burns and indicated some ways that prevention programmes can be improved. [ABSTRACT FROM AUTHOR]

Purpose: We investigated the relationship between the distribution of the IL- 1RN, TNF- β and IL- 4 polymorphism and the clinical features of bladder cancer. Materials and methods: A total of 100 patients with bladder carcinoma and 102 healthy control subjects were enrolled in the study. The IL- 1RN, IL- 4 and TNF- β gene polymorphisms were identified by PCR restriction fragment length polymorphism-based analysis. Allelic frequencies were compared between patient and the controls. Tumor stage, histopathological grade, tumor size/number and smoking condition were evaluated with IL- 1RN, IL- 4 and TNF- β gene polymorphisms. Results: Allele distribution frequencies of IL- 1RN and IL- 4 gene polymorphisms were significantly different between patients and control groups. However, allele distribution of TNF- β gene was not statistically significant. There was no difference in allele distribution of the three genes in both groups regarding stage, tumor size, number of tumors and smoking condition. Although allele distribution of IL- 4 gene showed significant difference considering histopathological grades in both smoking and total patients group, allele distribution of IL- 1RN and TNF- β was not different. Conclusion: The present research suggests that the IL- 1RN and IL- 4 gene polymorphisms are potential genetic markers of susceptibility to bladder cancer. In the future, clinical improvements on diagnosis, treatment and prognosis of bladder carcinoma are expected owing to development of more sensitive and specific tests for genetic polymorphisms of cytokines that are effective on inflammation. [ABSTRACT FROM AUTHOR]

Objectives: To assess the levels of psychological symptoms in the parents of children with school refusal and determine the familial risk factors in its development. Methods: This study was performed on 55 pairs of parents who had children exhibiting school refusal and were compared with a control group. A socio-demographic data form, the Beck Depression Inventory, the State-Trait Anxiety Inventory, and the Symptom Checklist-90 revised were applied to these parents. Results: Parents of the school refusal group had higher anxiety and depression scores than the controls. Among the risk factors for school refusal, physical punishment by the parents, a history of organic disease in the parents or children, and a history of psychiatric disorders in the parents or other relatives were found to be significant. Conclusions: Depending on genetic and environmental factors, parents with psychiatric disorders appeared to be associated with development of psychiatric disorders in their children. Moreover, psychiatric disorders in parents negatively affected the treatment of their children and adolescents who exhibited school refusal. It is therefore vital to treat psychiatric disorders of parents with the children having psychiatric disorders, and thus increase parent participation in their children's therapeutic process. [ABSTRACT FROM AUTHOR]

The aim of this retrospective study was to investigate factors affecting clinical pregnancy rates, especially age and duration of embryo transfer, in IVF/intracytoplasmic sperm injection cycles (1313 embryo transfers). Overall clinical pregnancy rate was 30.0% (n = 394). Clinical pregnancy rates were found to be 31.6% for the <44 s interval, 25.9% for the 45-59 s interval and 23.6% for the ≥60 s interval (P = 0.020). In the <35 year age group, clinical pregnancy rates were 35.1%, 29.9% and 30.6%, and in the ≥35 year age group, they were 26.9%, 21.0% and 13.4% (P = 0.013), respectively. According to logistic regression analyses, the odds of failed pregnancy increased by 1.61 times [95% confidence interval (CI) 1.07-2.41] for embryo transfer durations longer than 60 s and odds ratios of a failed pregnancy were 1.53 (95% CI 1.18-1.99) in the ≥35 year age group, 1.49 (95% CI 1.05-2.12) for fewer than five oocytes and 3.38 (95% CI 2.10-5.43) for fewer than two transferred embryos. In conclusion, to increase the likelihood of a successful pregnancy in women over 35 years of age, the duration of embryo transfer must be kept below 60 s. The number of oocytes obtained and the number of transferred embryos also play a role in the success of pregnancy. [ABSTRACT FROM AUTHOR]

AIM: Low-level laser therapy (LLLT) may induce morphological, molecular and cellular processes, which are involved in wound healing. The aim of this split-mouth controlled clinical trial was to assess the effects of LLLT on healing of gingiva after gingivectomy and gingivoplasty. MATERIAL AND METHODS: Twenty patients with inflammatory gingival hyperplasias on their symmetrical teeth were included in this study. After gingivectomy and gingivoplasty, a diode laser (588 nm) was randomly applied to one side of the operation area for 7 days. The surgical areas were disclosed by a solution (Mira-2-tones) to visualize the areas in which the epithelium is absent. Comparison of the surface areas on the LLLT-applied sites and controls were made with an image-analysing software. RESULTS: Despite the prolonged time needed for application, patients have tolerated LLLT well. While there were no statistically significant differences between the stained surface areas of the LLLT applied and the control sites immediately after the surgery, LLLT-applied sites had significantly lower stained areas compared with the controls on the post-operative third, seventh and 15th day (p<0.001 for each). CONCLUSIONS: Within the limitations of this study, the results indicated that LLLT may enhance epithelization and improve wound healing after gingivectomy and gingivoplasty operations. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of regular submaximal exercise on quality of life, exercise capacity and pulmonary function in asthmatic children.Patients and methods: Sixty-two children with mild-moderate asthma (mean age 10.4 (SD 2.1) years) were randomly allocated into exercise and control groups. The exercise group underwent a moderately intensive basketball training program for 8 weeks. A home respiratory exercise program was advised to both groups. Pediatric Asthma Quality of Life Questionnaire (PAQLQ) was used for the evaluation of activity limitation, symptoms and emotional functions. Exercise capacity was evaluated through the physical work capacity (PWC 170 test) on a cycle ergometer and 6-minute walk test. Spirometric tests were also performed and medication and symptom scores were recorded.Results: Although PAQLQ scores improved in both groups, the improvement in the exercise group was significantly higher. The exercise group performed better in the PWC 170 and 6-minute walk tests, whereas no improvement was detected in the control group at the end of the trial. Medication scores improved in both groups, but symptom scores improved only in the exercise group. No significant changes were detected in pulmonary function in either group, except for peak expiratory flow values in the exercise group.Conclusion: Eight weeks of regular submaximal exercise has beneficial effects on quality of life and exercise capacity in children with asthma. Submaximal basketball training is an effective alternative exercise program for asthmatic children. [ABSTRACT FROM AUTHOR]

Epidemiological investigations of burn patient series help practitioners to identify factors that affect patient survival. Our aim was to contribute to the body of knowledge in this area by determining how survival related to certain variables in burn cases. The records of 1083 burn patients who were hospitalised between August 1988 and the end of 1997 were retrospectively reviewed. Of this total, 363 (33.5%) died of burn complications, namely, multi-organ injury due to sepsis (47.1% of deaths), renal failure (44.6%), respiratory injury (5.8%) and gastrointestinal bleeding (2.5%). Mortality was higher in children/students, females, retired persons. Extent and depth of burn were important predictors of patient survival. Flame not only was the commonest burn cause but also carried the highest mortality risk. Most of the 1083 patients were referred to our hospital within 3 days of the injury. Deaths commonly occurred within 7 days. The mortality rate for patients who received medical therapy only was higher than that in the group that underwent both medical and surgical treatment (48.4 versus 10.0%, respectively). The study results highlighted various factors that are related to patient survival. These should be considered in the provision of optimal burn care. Training and experience are important elements in burn care and educational meetings should be held regularly for the staff of the burn unit. [ABSTRACT FROM AUTHOR]

Cardiovascular complications due to atherosclerosis (AS) are the major cause of mortality in hemodialysis (HD) patients. Inflammation may play an important role in the development of AS. Several studies have demonstrated the association of acute-phase proteins and cytokines with AS in the general population and in HD patients. Interleukin-10 (IL-10) is an anti-inflammatory cytokine. The aim of study was to compare serum levels inflammatory and anti-inflammatory indicators in HD patients according to the presence or absence of AS. Thirty-three HD patients were enrolled. AS was defined as the detection of plaques by Doppler ultrasonography. The patients were subgrouped according to the presence or absence of plaques. Serum levels of IL-1, IL-2, IL-6, IL-10, C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) were measured. The factors for AS such as age, gender, hypertension, hyperlipidemia, and HD duration were also evaluated. We found that the patients with AS had significantly higher hs-CRP and lower IL-10. Blood pressure values were also increased in patients with AS. Additionally, there was an increased correlation between CRP and IL-10. AS(+) patients undergoing HD had low serum levels of anti-inflammatory cytokine IL-10 and high serum levels of hs-CRP. These results may suggest that the limitation of anti-inflammatory response in atherosclerotic uremic patients is a triggering or contributing factor for AS. [ABSTRACT FROM AUTHOR]

Arteriosclerosis is characterized by stiffening of arteries. The incremental elastic modulus (Einc) measurement is a good marker of arterial wall stiffness. Arteriosclerosis is characterized by stiffening of arteries. Metabolic, inflammatory, and hemodynamic alterations cause structural changes and vascular complications in end-stage renal disease. The aim of the present study was to evaluate the factors that may affect the development of arteriosclerosis by measurement of Einc in hemodialysis (HD) patients. Thirty-two patients (16 men and 16 women) on chronic HD with a mean age of 42.2 ± 19.3 (range, 15–80) were included in the study. The carotid Einc was measured to determine arteriosclerosis by high-resolution echo-tracking system. Einc measurement was calculated from transcutaneous measurements of carotid arterial internal diameter and wall thickness and carotid pulse pressure. Common carotid compliance (CCC) and distensibility (CCD) were determined from changes in carotid artery diameter during systole and simultaneously measured carotid pulse pressure. Serum levels of calcium (Ca), phosphorus (P), parathormone (PTH), ferritin, C-reactive protein (CRP), predialysis systolic blood pressure (SBP), predialysis diastolic blood pressure (DBP), pulse pressure (PP), age, HD duration, CCC, and CCD were correlated with Einc in all patients. A significant positive correlation was found between Einc and age (r = 0.40, p < 0.02), SBP (r = 0.39, p < 0.02), PP (r = 0.40, p < 0.02), Ca (r = 0.43, p < 0.01), CRP (r = 0.38, p < 0.02). As expected, Einc was correlated inversely with CCD (r = −0.77, p < 0.0001). The correlation between Einc and HD duration, DBP, ferritin, P, PTH, and CCC was not significant. In conclusion, the stiffening of carotid artery in HD patients is related not only to hemodynamic changes (increased SBP and PP) but also to metabolic (increased Ca) and inflammatory (increased CRP) responses. Carotid Einc is an accepted independent risk factor for cardiovascular mortality. Because of the positive correlation between Einc and serum Ca, vitamin D and Ca-containing P binder should be used carefully in HD patients. [ABSTRACT FROM AUTHOR]