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Submersion is a clinical term describing a tooth depressed below the occlusal plane. In this case report, we present the treatment of a patient who had totally submerged primary maxillary second molar, which caused impaction of the second premolar and space loss in the maxillary arch due to tipping of adjacent teeth. A 12-year-old girl was referred to the pediatric dentistry clinic. The intra-oral examination revealed that right maxillary second primary molar was localized buccal side of posterior maxillary alveolar process, being almost completely covered by gingiva and adjacent teeth inclined closing the space of the related teeth completely. Periapical radiograph demonstrated that maxillary second premolar was impacted. Based on clinical and radiographic findings, maxillary primary second molar was extracted. Headgear was used for the distalization of maxillary right first molar in order to create space for the impacted second premolar. Eruption begun spontaneously 6 months later.

District heating and cooling (DHC) systems are gaining importance due to their ability to integrate renewable and waste heat sources and connect with other infrastructures. However, the complexity of DHC systems rises as technical components and potential interactions grow, and energy demands increase. Heat transportation via water flow involves time- and temperature-dependent changes based on mass flow rates and heat losses, influenced by the dynamic properties of consumers and distribution pipes. To optimise DHC operations and simulate their complexities, dynamic modelling tools are necessary. However, dynamically simulating large-scale DHC networks are computationally demanding. One method to improve district heating networks (DHNs) is to replace dynamic pipe models with static models, simplifying the network's topological complexities. This paper proposes a framework for simulating DHNs using the NetworkX Python package to create and manipulate complex networks and the Modelica environment to simulate physical systems. The study highlights the constraints of the pipe replacement workflow due to its dependence on seasonal variation. The findings indicate that replacing pipe models can reduce CPU time by 30% to 65% in simulations, depending on the required accuracy during the summer season.

Purpose: We suggested that polymorphic differences affect the performance of cyclists. In this study we designed the experiment to identify collagen type I alpha 1 (COL1A1) rs1800012 polymorphism in cyclists. Methods: We isolated genomic DNA from buccal epithelial cells of 38 cyclists. We followed COL1A1 rs1800012 single nucleotide polymorphism genotyping technology protocol. We reported allele frequencies for rs1800012 gene variants of cyclists in our kohort. Results: Our results indicated the differences of the distribution of COL1A1 rs1800012 SNP between cyclists. The numbers and percentages of CC, AC and AA genotypes for rs1800012 polymorphism that we obtained were 24 (63%), 13 (34%) and 1 (3%), respectively. The distributions of C and A alleles were counted as 61 (80%) and 15 (20%). Conclusions: There was difference in the genotype and also allele distribution between cyclists. Carriers of a C allele as compared to carriers of the allele A are more prone to cyclism. Larger homogenous cohorts may help clarify the association between COL1A1 rs1800012 polymorphism and physical performance. [ABSTRACT FROM AUTHOR]

Objective:A functional polymorphism on the 16th exon of the alpha-actinin-3 gene has an effect on the protein structure and cellular signaling and therefore on muscle contraction. In this study, we aimed to analyze the alpha-actinin-3 rs1815739 polymorphism in 3-dimensional malocclusions and different craniofacial skeletal patterns.Methods: Forty-nine volunteering subjects enrolled for the study. Genotyping of alpha-actinin-3 rs1815739 polymorphism was performed using real-time polymerase chain reaction. Pre-orthodontic cephalometric radiographs were traced using NemoTech cephalometric tracing software. IBM SPSS Statistics for Windows was utilized to carry out statistical analysis. P < .05 was considered to be statistically significant.Results: The respective numbers and the percentages of alpha-actinin-3 rs1815739 polymorphisms for RR, RX, and XX genotypes were 39 (79.6%), 4 (8.2%), and 6 (12.2%), respectively. Twenty-one patients had low angle vertical patterns and 17 patients had Class I and the same number of the patients had Class III facial patterns. But none of these had statistically significant difference in terms of alpha-actinin-3 rs1815739 polymorphism and in vertical or sagittal facial patterns, and mandibular incisor inclination. When we examined the maxillary anteroposterior position, we found a significant difference between rs1815739 polymorphisms (P < .05). Also, we detected a significant difference between rs1815739 polymorphism and maxillary incisor inclination (P < .05).Conclusion: Maxillary incisor inclination and maxillary anteroposterior position are associated with alpha-actinin-3 rs1815739 polymorphism in a Turkish cohort.

According to the literature, the genetic makeup of athletes contributes to their athletic performance. Athletic performance depends on genetic and environmental factors relating to the athlete. The study of sports genetics includes extensive research into identifying genes that affect athletic performance. Psychological factors affect athletic performance and so dopamine contributes to the determination of that performance. One of the neurotransmitters of the dopaminergic system is dopamine, which affects the athlete mentally and psychologically. The dopamine receptor D2 (DRD2) rs1800497 polymorphism affects the brain’s dopaminergic system and athletic performance. This study aimed to determine the genotype and allele distributions of the DRD2 rs180047 polymorphism in football players and compare them with the control group. For this purpose, 21 football players were enrolled in our study. Genotyping was performed by PCR after DNAs were isolated from buccal epithelial cells. When we examined the genotype distributions, the AG and GG were found as 5 (24%) and 16 (76%), respectively. No AA genotype was found for DRD2. When allelic distributions were examined in the athlete group, the A allele was counted as 5 (12%) and the G allele as 37 (88%). In our study cohort, the DRD2 rs1800497 polymorphism was found to be dominated by the GG genotype and the G allele. We believe that the DRD2 A allele is associated with addiction and thus with athletic performance. However, more studies with athletes from different branches are needed to reveal the effect of DRD2 rs1800497 polymorphism on athletic performance.

Purpose: Trauma care poses many challenges in small hospitals in rural settings. This report was designed to assess the role of a rural general surgeon with trauma patients. Methods: A cohort study was designed using a retrospective analysis of a cohort at Bozkır Community Hospital that included trauma patients admitted to the emergency department between June 2007 and May 2009. The patients of group 1 were those treated during the first year of the study period, when the hospital staff was only non-specialist physicians. In the second year, a general surgeon was added to the staff, and the patients from this period constituted group 2. Results: The top three leading causes of injuries were falls (46.5 %), piercing/cutting injuries (38.2 %), and assault (6.5 %). The frequency of trauma due to falls was higher in group 1, and assault and piercing/cutting injuries were higher in group 2 ( p < 0.001 for each). The percentage of discharged and transferred patients was not significantly different between groups ( p = 0.065 and p = 0.082, respectively). Similar mortality rates were also detected (group 1: 0.5 %, group 2: 0.3 %, p = 0.479). Conclusions: The presence of a solo general surgeon was not found to be adequate for improving the outcome for trauma patients in a rural hospital. [ABSTRACT FROM AUTHOR]

Abstract Background Psoriasis is a chronic systemic inflammatory disease frequently associated with serious comorbidities. Objectives To investigate the systemic inflammatory burden in psoriasis and to assess the correlation between traditional and novel inflammatory markers and the severity of the disease. Methods This cross-sectional study was conducted on 60 patients with psoriasis vulgaris and 50 healthy volunteers. Data including demographics, Psoriasis Area and Severity Index scores, and laboratory results were analyzed and compared. Results Compared with the control group, the psoriatic patients had significantly higher high sensitive C-reactive protein, serum amyloid A, erythrocyte sedimentation rate, leukocyte, neutrophil, neutrophil-to-lymphocyte ratio, monocyte to high density lipoprotein (HDL) cholesterol ratio, and aspartate aminotransferase levels, and significantly lower HDL cholesterol levels (p < 0.05). No significant difference was found in procalcitonin, lymphocyte, monocyte, hemoglobin, red blood cell distribution width, platelet, mean platelet volume, platelet distribution width, lymphocyte-to-monocyte ratio, anti-cyclic citrullinated peptide, glucose, alanine aminotransaminase, blood urea nitrogen, creatinine, triglyceride, total cholesterol, and LDL cholesterol levels between the two groups (p > 0.05). The Psoriasis Area and Severity Index score was positively correlated with high-sensitivity C-reactive protein, serum amyloid A, and monocyte to HDL cholesterol ratio, and negatively correlated with lymphocyte-to-monocyte ratio (p < 0.05). Study limitations This was a single-center study with relatively limited numbers of patients and controls. Conclusions The data show that high sensitivity C-reactive protein, serum amyloid A, erythrocyte sedimentation rate, neutrophil-to-lymphocyte ratio, and monocyte to HDL cholesterol ratio can be used as markers of systemic inflammation in patients with psoriasis. Moreover, high sensitivity C-reactive protein, serum amyloid A, monocyte to HDL cholesterol ratio and lymphocyte-to-monocyte ratio are closely related to the Psoriasis Area and Severity Index score, and they may be regarded as objective indicators in determining the disease severity.

Amaç: D vitamini kasların gelişmesinde, kasılmasında ve rejenerasyonunda görev alan önemli bir moleküldür. Çalışmamızda profesyonel Türk atletlerde D vitamin reseptör (VDR) Fok1 (rs 2228570) ve Bsm1 (rs1544410) polimorfizmlerinin dağılımını araştırmayı amaçladık. Yöntem: Çalışmamıza 13 kadın ve 14 erkek atlet olmak üzere 27 sporcu katılmıştır. DNA izolasyonları sonrasında D vitamini reseptörü polimorfizmleri gerçek zamanlı PZR (RT-PCR) metodu ile saptanmıştır. Bulgular: Fok1 polimorfizmi açısından atletlerin 12’si CC, 5’i CT ve 10’u ise TT genotipindedir. Kadın atletlerin 6’sı CC, 2’si CT ve 5’i ise TT genotipinde bulunmuştur. Erkek atletlerde 6 sporcu CC, 3 sporcu CT ve 5 sporcu ise TT genotipindedir. Bsm1 polimorfizmi için 9 atlet AA, 14'ü AG, 4’ü ise GG genotipindedir. Kadın atletlerin 3’ü AA, 8’i AG ve 2’si GG genotipindedir. Erkek atletlerin 6’sı AA, 6’sı AG ve 2’si GG genotipinde saptanmıştır. Sonuç: Çalışma grubumuzda Fok1 polimorfizmi için CC genotipi ve C allelinin, Bsm1 içinde AG genotipinin ve A allelinin baskın olduğu gözlenmiştir. Bu çalışmanın VDR geninin atletik performansa etkisinin araştırılması için yapılacak yeni çalışmalar için referans olacağını düşünmekteyiz.

Titanium dioxide is a prevalent food ingredient for human ingestion. We investigated the nephrotoxic effects of titanium dioxide in Wistar albino rats subjected to oral exposure for 14 days. The rats were categorized into four groups (n = 8): (1) control (saline solution), (2) exposure to titanium dioxide (30 mg/kg), (3) exposure to resveratrol (100 mg/kg), and (4) exposure to both titanium dioxide and resveratrol. The investigations revealed that the administration of titanium dioxide resulted in considerable histological abnormalities and a significant prevalence of apoptotic cells marked by caspase-3 in the titanium dioxide group, with a markedly elevated quantity and strong staining of cells reacting with 4-HN across the tissue in the kidney. Blood serum assessments revealed that BUN and creatinine levels were elevated in the titanium group relative to the other three groups, with a reduction in these levels observed in the group receiving both titanium and resveratrol (P < 0.05). The assessment of oxidative stress markers in kidney tissue revealed that GSH-Px and SOD activity considerably decreased in the titanium dioxide group relative to the other experimental groups. In contrast, MDA levels increased markedly (P < 0.05). The activities of GSH-Px and SOD were significantly elevated in the group receiving both titanium dioxide and resveratrol compared to the titanium dioxide-only group (P < 0.05). The analysis of inflammation markers TNF-α and IL-6 revealed a substantial rise in their levels in the titanium dioxide group compared to the other groups (P < 0.05)., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: In this study, we aimed to investigate whether ursodeoxycholic acid (UDCA) would reduce the necessity of cholecystectomy in patients diagnosed with asymptomatic gallstones after laparoscopic sleeve gastrectomy (LSG) and in patients diagnosed with asymptomatic gallstones before LSG., Methods: Between July 2020 and November 2022, at least 2-year follow-ups of patients who underwent LSG for obesity were retrospectively analyzed. Patients with pre-existing asymptomatic gallstones during preoperative evaluation, those with UDCA treatment (group 1), and observation group (group 2). Patients with newly formed gallstones in postoperative outpatient clinic follow-up, those with UDCA treatment (group A), and those without UDCA treatment (group B)., Results: A total of 425 patients included. At the end of the first year, patients who had newly formed gallstones after LSG had a higher total weight loss percentages (TWL%) (39.8 ± 6.1) compared to those who did not develop gallstones (37.9 ± 7.4), which were statistically significant (p = 0.004). Among patients who developed gallstones postoperatively, UDCA treatment was associated with a significantly lower cholecystectomy rate in patients with newly formed gallstones postoperatively (p = 0.025), while no significant difference was shown in patients with preoperative gallstones (p = 0.631)., Conclusion: UDCA is a promising option for reducing the need for cholecystectomy in patients with post-LSG gallstones, but it appears ineffective for pre-existing gallstones., Competing Interests: Declarations. Ethical approval and consent to participate: The study was approved by the Ethics Committee of University of Health Sciences Umraniye Training and Research Hospital. Approval of protocol number was (29.04.2024/242359507). Consent for publications: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Introduction: The most popular approach for treating obesity is laparoscopic sleeve gastrectomy (LSG). The enhanced recovery after surgery (ERAS) protocol aims to reduce the patient's surgical stress response, optimize their physiological function, and facilitate recovery. The purpose of this study was to investigate the efficacy and safety of the ERAS protocol in patients who have undergone LSG. Methods: Between January 2020 and March 2021, a single-center randomized controlled study with patients undergoing LSG was planned. Patient demographics, duration of surgery and anesthetic induction, postoperative nausea-vomiting (PONV) and pain scores, length of hospital stay, and emergency room readmissions within the first 30 days were also documented. Patients were divided into two groups: those who followed the ERAS protocol and those who did not. The senior surgeon was blinded for the preoperative and postoperative period, whereas the other surgeon was not. The groups were compared in terms of length of hospital stay, duration of surgery, visual analog scale (VAS) scores, PONV effect scores, and emergency service admissions within the first 30 days after surgery. Results: A total of 96 patients were included in this study. Of these, 49 were in the ERAS protocol group and 47 were in the traditional treatment group. The mean age of the patients in the ERAS and traditional treatment groups were 37.47 ± 10.11 years and 35.77 ± 9.62 years, respectively. While the ERAS group patients were hospitalized for a mean of 30.46 ± 11.26 hours, the traditional group patients were hospitalized for 52.02 ± 6.63 hours ( P : .001). There was no difference between the groups in terms of the first 30-day readmission to the emergency department ( P : .498). Both VAS and PONV effect scores at the 2nd and 12th hours of the ERAS group patients were lower ( P : .001, .002, .001, .001, respectively). Conclusions: When compared with the conventional method, the ERAS protocol reduced patient hospitalization time, decreased postoperative nausea, vomiting, and pain scores, and did not vary in postoperative emergency department readmissions. In patients receiving LSG, the ERAS protocol can be employed safely and successfully. Clinical Trial Registration number: NCT04442568.

Background: This study aimed to determine the importance of leukocytes, leukocyte subgroups, platelets, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio in deciding whether laparotomy is required during observation in patients with penetrating abdominal stab wounds who were followed up because there was no indication for an emergency laparotomy., Methods: Patients who did not indicate an emergency laparotomy were monitored. After 48 hours from initial hospitalization, patients who did not require laparotomy were discharged nonoperatively. The total leukocytes, leukocyte subsets, platelets, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio of patients who underwent laparotomy during the follow-up compared with those who were discharged nonoperatively. The sensitivity and specificity of these laboratory values in predicting the necessity of laparotomy were calculated., Results: In the operated group (n = 71), leukocytes, neutrophils, monocytes, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio examined during observation were significantly higher (P < .001). Eosinophils and lymphocytes were significantly lower (P < .001) than in nonoperated (n = 476). Based on the deviation in the reference ranges of leukocyte and its subgroups, we report the sensitivity and specificity for predicting the necessity of laparotomy as 86% and 72% for leukocyte, 88% and 75% for neutrophil, 92% and 83% for neutrophil-to-lymphocyte ratio, and 72% and 77% for platelet-to-lymphocyte ratio, respectively. In receiver operating characteristic curve analysis, the cut-off value was found to be 4 for neutrophil-to-lymphocyte ratio and 125 for platelet-to-lymphocyte ratio (area under the curve/receiver operating characteristic curve of 0.929 and 0.808, respectively)., Conclusion: Leukocyte, leukocyte subgroups, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio may be useful to determine if a laparotomy is necessary in patients in whom the necessity of laparotomy is undetermined owing to unclear examination findings., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Aim: Although appendicitis is a disease of the young, it has been speculated that its incidence has increased among the elderly people. In this study, it was aimed to evaluate annual changes of appendicitis seen in older patients (≥60 years) throughout a 10-year period., Methods: All adult patients who were surgically treated for acute appendicitis were retrospectively analyzed with respect to pathological analysis, gender, age and proportion of the patients aged 60 or over in an annual base. Variability in the mean age and proportion of the older patients aged 60 or over throughout the study years were regarded as the main outcomes., Results: There were 3296 patients with a mean age of 30.42 ± 12 years. Distribution of gender was similar ( p  = 0.636). There was a significant positive correlation in the mean age of the patients throughout the study years ( p  = 0.043). Stratification by the age of 60 yielded a significant increase in percent of the older patients, from 0.93% at 2007 to 4.28% at 2016 ( p  = 0.019)., Conclusions: The mean age of the patients with acute appendicitis is going to increase. Therefore, it is expected that all surgeons are more likely to be confronted with elderly patients with appendicitis in the near-future.

Aim: The present study evaluates the relationship between the monocyte-to-high-density lipoprotein cholesterol ratio (MHR) and the percentage of excess weight loss (%EWL) in patients undergoing laparoscopic sleeve gastrectomy. Method: This prospective cohort study evaluated 125 patients who underwent laparoscopic sleeve gastrectomy. The MHR before and at 6 months after surgery were compared in patients with <50 and ≥50 %EWL. Results: The MHR was lower in patients with a %EWL of <50 than in patients with a %EWL of ≥50 (p = 0.019). The decrease in the MHR at postoperative 6 months was more remarkable in patients with a %EWL of ≥50 (p < 0.001). Conclusion: The present study suggests that MHR decreased more remarkably at postoperative 6 months in patients with high %EWL, predicting a decrease in cardiovascular risk.

Purpose: Conditions associated with surgical technique and postoperative lifestyle changes, as well as the characteristics of patients, may affect weight loss following laparoscopic sleeve gastrectomy. In this study, the effects of age, gender, BMI, and excess weight at the time of surgery on weight loss during follow-up were examined., Materials and Methods: Demographic data (age, gender), preoperative BMI, and weight values of the patients were recorded. TWL% and EWL% values of patients were recorded during follow-up at 1st, 3rd, 6th, 9th, 12th, and 18th months. Patients were grouped according to age (AGE1 < 30, AGE2 30-50, AGE3 ≥ 50 years), BMI at the time of surgery (BMI1 ≤ 50, BMI2 > 50 kg/m 2 ), and EW at the time of surgery (EW1 ≤ 60, EW2 > 60 kg). EWL% values obtained in the follow-up visits were compared among the gender, age, BMI, and EW groups., Results: A total of 456 patients (371 females, 85 males) were operated. Mean EWL% was lower in AGE3 group (p < 0.001). Patients in AGE1 group had the highest mean EWL%, while those in BMI2 and EW2 groups had lower mean EWL% values throughout the follow-up period (p < 0.001). Regression analysis showed that age and BMI were associated with EWL% at all follow-up visits (p < 0.05)., Conclusion: Patients with less than 60 kg of excess weight, those with BMI ≤ 50 kg/m 2 and younger patients may lose weight more effectively following LSG.

Aim: Endoscopic retrograde cholangiopancreatography (ERCP) is an important diagnostic and therapeutic tool in patients with hepato-pancreatobiliary diseases. In the present study, we sought to determine predictors of post-ERCP complications at our institution., Methods: A retrospective analysis of patients who underwent ERCP in between January 2010 and November 2011 was done. Demographics, indications, ERCP findings, success rate, complications and the need of repeat procedure were evaluated with special emphasis on the difficulty in cannulation procedure, the primary etiology of the disease (benign/malign) and age. Chi-square analysis was applied for statistical analysis. The differences were considered statistically significant, if the p value was less than 0.05., Results: A total of 112 ERCP was performed in 81 patients. Thirty-eight were male (46.9 %) and 43 were female (53.1%). Mean age was 61.3 (range 17-88), and 31 patients was seventy years and older (38.3 %). Complications were detected in 28 patients (34.6 %). Nine cases with difficult or unsuccessful cannulation (69.2 %) had complications (p=0.001). Patients with benign diseases showed less complications (21/70), in comparison with those with malignancies (7/11) (30 % vs. 63.6 %, respectively; p<0.05). Complication rate in patients 70 years and older was 32.2 % (n=10) compared to 35.3 % in patients younger than 70 (n= 18) (p<0.05)., Conclusion: Risk factors such as difficult or incomplete cannulation and malignancy are considered as possible predisposing factors for complications. Age is an independent factor., Key Words: Endoscopic cholangiopancreatography, Risk factors.

Aims: Retrorectal tumors are rare, mostly benign tumors and named due to their localization. Diagnoses of these tumors are usually delayed because of nonspecific complaints and symptoms. Magnetic resonance imaging has beneficial uses both for diagnosis and treatment. In this study, we reviewed a case series of retrorectal tumors., Subjects and Methods: The patients who were diagnosed with retrorectal tumors between 2008 and 2015 were analyzed. This investigation was conducted at a Tertiary Education and Research Hospital. Sixteen patients were included in this study. Patients' demographic data, imaging workups, surgical operation reports, pathologic examination results, postoperative complications, and follow-up results were examined. Descriptive statistics, median, and standard deviation for continuous variables were used. The primary outcomes measured were diagnostic conflict, knowledge, and preference for surgery., Statistical Analysis Used: Definitive statistical methods (mean, standard deviation, median, frequency, and percentage) were used to evaluate the study data., Results: One patient refused operation and one was in preoperative preparation period. Fourteen of sixteen patients were operated. Two (14.3%) of operated patients have malignant histopathological result (one gastrointestinal stromal tumor, one ganglioneuroblastoma). Rest of the operated patients' histopathological reports was as follows: Four schwannomas, three epidermoid cysts, two tailgut cyst, one dermoid cyst, one teratoma, and one angiomyolipoma. Eight patients were operated by posterior incision, five patients with transabdominal approach, and one patient with combined approach., Conclusions: Retrorectal tumors are rare cases, and treatment of retrorectal tumors is surgery and should be operated in referenced hospitals to avoid diagnostic and therapeutic problems., Competing Interests: None

Aims: Appendiceal mucocele (AM) is a rare pathology, and its reported incidence is 0.3% in all appendectomy specimens. Here, we report a case series of AM and make a brief review of literature., Subjects and Methods: We conducted a retrospective review of a prospectively collected data of patients who diagnosed as AM by histopathological evaluation between January 2009 and June 2015 were demographic data including age and gender, intraoperative findings, and histopathological reports were recorded. All cases were followed-up by routine examination and telephone interview., Statistical Analysis Used: Definitive statistical methods (mean, standard deviation, median, frequency, and percentage) were used to evaluate the study data., Results: Twelve patients were examined in the study with diagnose of AM. The mean age was 51.8 ± 18.6 years (26-83). Female-to-male ratio was 1.4 (7/5). Indications for surgery were acute abdomen in 8 (72.7%) patients with presumptive diagnosis of acute appendicitis and were AM in four patients diagnosed by imaging. Histopathological evaluation revealed mucinous cystadenoma in eight patients, simple retention cysts in three, and borderline mucinous tumor (pseudomyxoma peritonei) in one. The neuroendocrine tumor was obtained on the remaining portion of the appendix in one of the simple retention cysts patients. None of the patients died because of the AM with an average follow-up of 43 months (range: 7-74)., Conclusions: Surgical resection is the first choice therapy for AM. Precise treatment modality can remain unclear in some patients because of insufficient preoperative diagnosis. It is nonmalign AM mostly however having mucocele matters because of the significant association with synchronous tumors., Competing Interests: There are no conflicts of interest

Aim: This in vivo study was designed to compare the antimicrobial effect of toothpastes containing fluoride, xylitol, or xylitol-probiotic on Streptococcus mutans and Lactobacillus in 13-15-year-old children., Materials and Methods: The study consisted of 60 pediatric patients who were randomly divided into three groups of 20 each. Group 1 recieved fluoride toothpaste (Colgate Max Fresh), group 2 used xylitol toothpaste (Xyliwhite), and group 3 used xylitol-probiotic toothpaste (PerioBiotic). Participants were asked to use the allocated dentifrice two times a day for 6 weeks. We performed tests on the saliva samples at the beginning of the study and after 6 weeks' duration following the use of toothpaste. The Statistical Package for the Social Sciences version 15 software and chi-square test were used for data analysis., Results: PerioBiotic toothpaste and Colgate Max Fresh toothpaste showed significant reduction in the number of participants who, prior to commencing the study, were diagnosed with a high number of cariogenic bacteria. On the contrary, no significant changes were observed with respect to the number of participants with a very high number of S. mutans and Lactobacillus on Xyliwhite toothpaste group., Conclusion: In the light of the data obtained in this in-vivo study, a new innovational aspect has been reached in the use of probiotics to ensure the balance between bacterial flora in the oral cavity. In daily routine, the administration of probiotics to children is difficult. The toothpaste can be used as a vehicle to transport probiotics to children's mouth., Competing Interests: There are no conflicts of interest.

Context: Colorectal cancers are frequent among cancers of gastrointestinal system. Whether there are any differences between survival in rectum and colon cancer patients is controversial., Aims: In this study, we aimed to compare survival in surgically treated rectum and colon cancers and determine the factors affecting survival., Subjects and Methods: The patients with colon and rectum cancer operated between 2009 and 2013 were examined retrospectively using prospective database. Patients were categorized as colon and rectum according to the tumor's location. Survival was identified as the primary outcome. Kaplan-Meier survival analysis and log-rank tests in survival assessment were used., Results: One hundred and sixty-one patients with a mean age of 62.8 ± 12.7 years were included in the study. Male/female ratio was 1.6. Colon and rectum patients were counted as 92 (%57.1) and 69 (%42.9), respectively. Both groups were similar in demographic data (P > 0.05). It was observed that in 46 months (mean) of follow-up, 39.7% (n: 64) died, and 60.3% (n: 97) survived. Median survival time was 79 months, and 5-year cumulative survival rate was 60.8%. Five-year cumulative survival rates in stages for 1, 2, 3 and 4 were 88.2%, 64.7%, 48.5%, and 37.0%, respectively. It was noted that median survival time for colon cancer was 78 months and for rectum cancer was 79 months. Five-year cumulative survival rates for colon and rectum cancers were calculated as 56.7% and 63.4%, respectively. There were no significant differences in colon and rectum cancers in the means of survival rate (P: 0.459)., Conclusions: While location of colorectal cancers shows no significant effect on survival, treatment in the early stages increases survival rate., Competing Interests: There are no conflicts of interest.

Aims: Hereditary nonpolyposis colorectal cancer (HNPCC) is a subgroup of colorectal cancer (CRC) which should be differentiated because of the high risk for additional cancers and risk evaluation for other family members, especially for CRC. It is not practical to perform genetic testing for all CRC patients; therefore, various prediction modalities, for example, Bethesda guideline (BG) were studied in the literature. We aimed to assess the association of microsatellite instability (MSI), histology scores, and BG for predicting HNPCC risk., Subjects and Methods: Data were collected from CRC patients between 2009 and 2012. A total of 127 patients were retrospectively reviewed for BG status and the MSI scores, MsPath, and PathScore., Statistical Analysis Used: Definitive statistical methods (mean, standard deviation, median, frequency, and percentage) were used to evaluate the study data. Comparison used Student's t-test, Continuity (Yates) correction, Fisher-Freeman-Halton test, Pearson correlation, and receiver operating characteristics curve analysis., Results: Patients who were detected as Bethesda-positive had significantly higher MsPath and PathScore scores (P = 0.001 and P = 0.007, respectively). According to the cut-off value of 2.8 and 2.9 for MsPath and PathScore, respectively, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 90%, 43%, 22.8%, 95.8%, and 50.4% for MsPath, and 55%, 83.2%, 37.9%, 90.8%, and 78.7% for PathScore, respectively., Conclusions: The MSI scoring systems, MsPath, and PathScore, are reliable systems and effectively correlated with BG for predicting patients who need advanced analysis techniques because of the risk of HNPCC.

Objective: The aim of this study was to evaluate and to compare clinical and radiographic outcomes of 4 materials (formocresol, mineral trioxide aggregate (MTA), Portland cement and enamel matrix derivative) using in primary teeth pulpotomies., Study Design: Sixty-five patients aged 5-9 years (32 female, 33 male) were included in this study. A total of 140 primary first and second molars with deep caries were treated with pulpotomy. All teeth were then restored with stainless steel crowns. The treated teeth were evaluated clinically and radiographically at 3, 6, 12, 18 and 24 months., Results: At 24 months, the clinical success rates of formocresol, MTA, Portland cement, and enamel matrix derivative were 96.9%, 100%, 93.9%, and 93.3%, respectively. The corresponding radiographic success rates were 84.4%, 93.9%, 86.7% and 78.1%, respectively., Conclusion: Although there were no statistically significant differences in clinical and radiographic success rates among the 4 groups, MTA appears to be superior to formocresol, Portland cement, and enamel matrix derivative as a pulpotomy agent in primary teeth.

Objective: The aim of this study is to evalute risk factors which trigger the development of trocar site hernia after elective laparoscopic cholecystectomy operation and to discuss what needs to be done to prevent it., Methods: Patients operated with laparoscopic cholecystectomy between 2011 and 2013 were evaluated. Patients were called back for follow-up visit at 12 month after operation. Physical and ultrasonographic examinations were performed at follow-up. Factors that facilitate development of trocar site hernia were investigated., Results: One hundred and ninty patients were operated during the study period. One hundred and thirty-two patients who had been examined at follow-up period were included in the study. Mean age of the patients was 50.64±11.86 (18-76) years and female/male ratio was five. Trocar site hernia was detected in four patients at umblical trocar site. One of these patients had chronic obstructive lung disease, two of them had diabetes and three of them had obesity. Advanced age and obesity were found to be statistically significant in patients having trocar site hernia (p value: 0.007, and 0.008, respectively)., Conclusion: Development of trocar site hernia after laparoscopic surgery may be prevented by repair of trocar site in patients taken into consideration risk factors such as advanced age and obesity., Competing Interests: No conflict of interest was declared by the authors.

Introduction: Surgery is a major stress factor for patients, and is associated with significant anxiety or depression. The Hospital Anxiety and Depression Scale is one of the most common instruments used for assessment of patients' psychological stress. Here, we aimed to identify predictors of anxiety and depression in surgical inpatients., Methods: The study group consisted of consecutive two-hundred patients who completed the Hospital Anxiety and Depression Scale questionnaire. A patient scoring more than cut-off values (10 for anxiety and seven for depression) was considered as being at risk of anxiety or depression. Demographical data, socioeconomic status, education level and diagnoses were recorded. The Chi-square, Fisher's exact, Mann-Whitney, Kruskal-Wallis tests and binary logistic regression analysis were used to identify the predictive parameters for anxiety and depression., Results: It was found that female patients, patients older than 35 years, patients with low socioeconomic status and low education level had a relatively higher risk of anxiety. In addition, patients with low education and a hospital stay greater than seven days were at risk of depression. Logistic regression analysis revealed that socioeconomic status and education level were strongly predictive for anxiety. However, presence of anxiety was shown to be strongly predictive for depression., Conclusion: Healthcare providers should be aware of their patients' psychology and, therefore, it is recommended to consider predictive factors for anxiety and depression., (Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.)

Objective: Gastric cancer (GC) is the fifth most common cancer worldwide, and in Turkey, GC is placed among the 10 most frequently seen cancers. However, analyzing the epidemiology of cancers and improving screening programs for cancers are not still the top priorities for healthcare professionals. This study aims to show distribution of GC based on stages in a tertiary hospital of Istanbul, Turkey., Methods: All surgically treated GC cases in the General Surgery Department, between January 2009 and January 2014 were retrospectively reviewed. Data including the operation year, the demographic, clinical and histopathological parameters were recorded and statistically analyzed., Results: The study group consisted of 111 patients. Seventy-four (66.66%) patients were men, and 37 (33.33%) patients were women with a mean age of 63.49±11.83 years. Stage 3 and 4 were the most frequently observed stages with 62 and 18 cases, respectively. Stage 3 was the most common stage found during the study period (p<0.05). During 5 years of the study period, GC was less frequently located on the cardia (n=31) when compared with other locations (n=75) for GC (p<0.05)., Conclusion: Turkey's population has generally advanced stage GC disease. New strategies are needed for achievement of early diagnosis and better outcomes., Competing Interests: No conflict of interest was declared by the authors.

Introduction: Penetrating left thoracoabdominal stab injuries are accompanied by diaphragmatic injury in 25-30% of cases, about 30% of which later develop into diaphragmatic hernia. This study aimed to determine the role of multislice computed tomography in the evaluation of left diaphragm in patients with penetrating left thoracoabdominal stab wounds., Materials and Methods: This study reviewed penetrating left thoracoabdominal stab injuries managed in our clinic between April 2009 and September 2014. The thoracoabdominal region was defined as the region between the sternum, fourth intercostal space, and arcus costa anteriorly and the vertebra, lower tip of scapula, and the curve of the last rib posteriorly. Unstable cases and cases with signs of peritonitis were operated with laparotomy; the remaining patients were closely monitored. Forty-eight hours later, a diagnostic laparoscopy was applied to evaluate the left hemidiaphragma in asymptomatic patients who did not need laparotomy. The preoperatively obtained multislice thoracoabdominal computed tomography images were retrospectively examined for the presence of left diaphragm injury. Then, operative and tomographic findings were compared., Results: This study included a total of 43 patients, 39 (91%) males and 4 (9%) females of mean age 30 years (range 15-61 years). Thirty patients had normal tomography results, whereas 13 had left diaphragmatic injuries. An injury to the left diaphragm was detected during the operation in 9 (1 in laparotomy and 8 in diagnostic laparoscopy) of 13 patients with positive tomography for left diaphragmatic injury and 2 (in diagnostic laparoscopy) of 30 patients with negative tomography. Multislice tomography had a sensitivity of 82% (95% CI: 48-98%), a specificity of 88% (71-96%), a positive predictive value of 69% (39-91%), and a negative predictive value of 93% (78-99%) for detection of diaphragmatic injury in penetrating left thoracoabdominal stab injury., Conclusions: Although diagnostic laparoscopy is the gold standard for diaphragmatic examination in patients with penetrating left thoracoabdominal stab wounds, multislice computed tomography is also valuable for detecting diaphragmatic injury., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

A selective conservative treatment for penetrating anterior abdominal stab injuries is an increasingly recognized approach. We analyzed patients who followed-up and treated for penetrating anterior abdominal stab injuries. The anterior region was defined as the area between the arcus costa at the top and the mid-axillary lines at the laterals and the inguinal ligaments and symphysis pubis at the bottom. An emergency laparotomy was performed on patients who were hemodynamically unstable or had symptoms of peritonitis or organ evisceration; the remaining patients were followed-up selectively and conservatively. A total of 175 patients with purely anterior abdominal injuries were included in the study. One hundred and sixty-five of the patients (94.29%) were males and 10 (5.71%) were females; the mean age of the cohort was 30.85 years (range: 14-69 years). While 16 patients (9%) were made an emergency laparotomy due to hemodynamic instability, peritonitis or evisceration, the remaining patients were hospitalized for observation. During the selective conservative follow-up, an early laparotomy was performed in 20 patients (12%), and a late laparotomy was performed in 13 patients (7%); the remaining 126 patients (72%) were discharged after non-operative follow-up. A laparotomy was performed on 49 patients (28%); the laparotomy was therapeutic for 42 patients (86%), non-therapeutic for 4 patients (8%), and negative for 3 patients (6%). A selective conservative approach based on physical examination and clinical follow-up in penetrating anterior abdominal stab injuries is an effective treatment approach.

Objective: Surgery for abdominal wall hernias is a common procedure in general surgery practice. The main causes of delay for the operation are comorbid problems and patient unwillingness, which eventually, means that some patients are admitted to emergency clinics with strangulated hernias. In this report, patients who admitted to the emergency department with strangulated adominal wall hernias are presented together with their clinical management., Methods: Patients who admitted to our clinic between January 2009 and November 2011 and underwent emergency operation were included in the study retrospectively. Demographic characteristics, hernia type, length of hospital stay, surgical treatment and complications were assessed., Results: A total 81 patients (37 female, 44 male) with a mean age of 52.1±17.64 years were included in the study. Inguinal, femoral, umbilical and incisional hernias were detected in 40, 26, 9 and 6 patients respectively. Polypropylene mesh was used in 75 patients for repair. Primary repair without mesh was used in six patients. Small bowel (n=10; 12.34%), omentum (n=19; 23.45%), appendix (n=1; 1.2%) and Meckel's diverticulum (n=1; 1.2%) were resected. Median length of hospital stay was 2 (1-7) days. Surgical site infection was detected in five (6.2%) patients. No significant difference was detected for length of hospital stay and surgical site infection in patients who had mesh repair (p=0.232 and 0.326 respectively)., Conclusion: The need for bowel resection is common in strangulated abdominal wall hernias which undergo emergency operation. In the present study, an increase of morbidity was seen in patients who underwent bowel resection. No morbidity was detected related to the usage of prosthetic materials in repair of hernias. Hence, we believe that prosthetic materials can be used safely in emergency cases., Competing Interests: No conflict of interest was declared by the authors.

In the present study, we described an easily reproducable experimental pancreatits model induced by biliopancreatic duct injection of ethyl alcohol. Seventy Wistar albino rats were divided equally into seven groups randomly: the control group (group 1), acute pancreatitis groups; induced by 20% ethanol (group 2), 48% ethanol (group 3), 80% ethanol (group 4), chronic pancreatitis groups; induced by 20% ethanol (group 5), 48% ethanol (group 6) and by 80% ethanol (group 7). Acute pancreatitis groups were sacrified on postoperative day 3, while the control group and chronic pancreatitis groups were killed on postoperative day 7. Histopathologic evaluation was done, and P < 0.05 was accepted as statistically significant. All rats in group 3 developed acute pancreatitis (100%). Inflammatory infiltration of neutrophils and mononuclear cells, interstitial edema, and focal necrotic areas were seen in the pancreatic tissues. Similarly, all rats in group 6 developed chronic pancreatitis (100%). Interstitial fibrosis, lymphotic infiltration, ductal dilatation, acinar cell atrophy, periductal hyperplasia were seen in the pancreatic tissues. Mortality was seen only in group 7. The biliopancreatic ductal injection of 48% ethanol induced acute and chronic pancreatitis has 100% success rate.

Background: The effect of MRI on microleakage of amalgam restorations is an important health issue that should be considered. If MRI application causes increase of microleakage, amalgam fillings should be reassessed after MRI and replaced if necessary., Objectives: The aim of this study is to compare the effect of magnetic resonance imaging (MRI) on microleakage of class II bonded amalgam versus classical amalgam restorations., Materials and Methods: Class II cavities (3 mm width × 1.5 mm depth) with gingival margins ending 1 mm below the cementoenamel junction (CEJ) were prepared in 40 permanent molar teeth. The teeth were randomly divided into four groups. Cavities in the first and second groups were restored with dentin adhesive and amalgam (bonded amalgam), and those in the third and fourth groups with amalgam only. MRI was performed with the teeth specimens from the first and third groups. All specimens were then thermocycled at 5° to 55° C with a 30-second dwell time for 1000 cycles. The samples were then immersed in 0.5% methylene blue dye for 24 hours and sectioned longitudinally. Dye penetration at the occlusal and gingival margins was quantified by 15× stereomicroscopy. IBM SPSS Statistics ver. 21.0 (IBM Corp., Released 2012., IBM SPSS Statistics for Windows, Armonk, NY: IBM Corp.) and MS-Excel 2007 programs were used for statistical analyses and calculations. "nparLD" module was used for F2&#95;LD&#95;F1 design analysis at R program. P<0.05 was considered statistically significant., Results: In teeth with amalgam filling, there were no significant differences of occlusal and gingival surface microleakage after MRI exposure. Occlusal and gingival surface microleakages were also similar with and without MRI in teeth with bonded amalgam filling., Conclusions: The results of this study suggest that MRI does not increase microleakage of amalgam restorations.