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ABSTRACT Objective: This study aimed to investigate the frequency of sexual dysfunction and the effect of short-term testosterone replacement therapy on sexual functions in congenital hypogonadism patients. Furthermore, we sought to reveal the consistency of the self-report scales used for the diagnosis of sexual dysfunction and the relationship between biochemical parameters. Materials and methods: The study was conducted on 47 young male patients aged above 18 years who were diagnosed with hypogonadotropic hypogonadism. Short (IIEF-5) and long (IIEF-15) forms of the International Index of Erectile Function and Arizona Sexual Experiences Scale (ASEX) were applied before treatment under the supervision of a physician. The patients’ blood pressure, height, and weight were measured, and their luteinizing hormone (LH), FSH, and total testosterone levels were recorded. Patients who started their treatments were called for a follow-up checkup after 6 months. Their blood pressure, height, and weight were measured by reapplying the ASEX, IIEF-5, and IIEF-15. In addition, their LH, FSH, and total testosterone levels in the biochemical tests were rerecorded. Results: In this study, the sexual dysfunction status of patients diagnosed with hypogonadotropic hypogonadism before and after treatment was evaluated using the ASEX, IIEF-15, and IIEF-5 scales. A decrease in sexual dysfunction was observed in all three scales after treatment compared with that before treatment. The IIEF-5 and IIEF-15 scales were found to be uncorrelated in terms of the pretreatment values but were correlated in terms of the post-treatment values. Although a correlation was observed between ASEX and IIEF-5 before treatment, no correlation was detected between ASEX and IIEF-15. After the treatment, ASEX was found to be correlated with both IIEF-5 and IIEF-15. The results of the scales indicated the correlation in all categories, except the pretreatment results of the IIEF-15 scale. Conclusion: The results of the current study demonstrated a significant improvement in the sexual function of hypogonadism patients undergoing short-term testosterone therapy. The ASEX, IIEF-5, and IIEF-15 scales used in the diagnosis and follow-up of sexual dysfunction were useful for evaluating sexual functions in hypogonadotropic hypogonadism patients.

ABSTRACT Objectives: This study aimed to investigate the triglyceride-glucose (TyG) index, which is a simple surrogate marker of insulin resistance that is associated with various cardiometabolic diseases, in patients with Klinefelter syndrome (KS). Subjects and methods: A total of 30 patients with KS (mean age: 21.53 ± 1.66 years) and 32 healthy controls (mean age: 22.07 ± 1.01 years) were included in the study.The clinical and laboratory parameters,TyG index, asymmetric dimethylarginine (ADMA) level, homeostatic model assessment of insulin resistance (HOMA-IR) score, and high-sensitivity C-reactive protein level were measured in patients with KS and healthy subjects. Results: Patients with KS had higher HOMA-IR score (p = 0.043), ADMA levels (p < 0.001), and TyG index (p = 0.031) and lower high-density lipoprotein cholesterol levels (p < 0.001) than healthy subjects. TyG index was positively correlated with plasma ADMA (r = 0.48, p < 0.001) and HOMA-IR (r = 0.36, p = 0.011). Multivariate analyses showed that total testosterone level (β = −0.44, p = 0.001) and TyG index (β = 0.29, p = 0.045) were independent determinants of plasma ADMA levels. Conclusion: Patients with KS had higher TyG indices than healthy subjects. Moreover, TyG index was independently associated with endothelial dysfunction in patients. TyG index may be a practical and useful measure to show the increased endothelial dysfunction in patients with KS.

In this work, bisphenol A propoxylate diglycidyl ether–piperazine copolymer functionalized MWCNTs (oxidized MWCNT + aminated MWCNT) composites were prepared and structurally characterized using FTIR and NMR spectroscopy. The composites were investigated in terms of their electrical and thermal properties. The surface morphology of the composites was examined by SEM. It was observed that thermal stability decreased while the ac conductivity and dielectric constant (relative permittivity) increased with increasing functionalized MWCNT content (2, 5, 10 and 15 mass %) of the composites. The electrical conductivity increased with increasing temperature and the activation energy of ac conductivity was determined and discussed.

ABSTRACT Background Cardiometabolic risk is high in patients with hypogonadism. Visceral adiposity index (VAI) and triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio are the practical markers of atherosclerosis and insulin resistance and independent predictors of cardiaovascular risk. To date, no study has evaluated VAI levels and TG/HDL-C ratio in hypogonadism. Subjects and methods A total of 112 patients with congenital hypogonadotrophic hypogonadism (CHH) (mean age, 21.7 ± 2.06 years) and 124 healthy subjects (mean age, 21.5 ± 1.27 years) were enrolled. The demographic parameters, VAI, TG/HDL-C ratio, asymmetric dimethylarginine (ADMA), high-sensitivity C-reactive protein (hs-CRP), and homeostatic model assessment of insulin resistance (HOMA-IR) levels were measured for all participants. Results The patients had higher total cholesterol (p = 0.04), waist circumference, triglycerides, insulin, and HOMA-IR levels (p = 0.001 for all) than the healthy subjects. VAI and ADMA and TG/HDL-C levels were also higher in patients than in healthy subjects (p < 0.001 for all). VAI was weakly correlated with ADMA (r = 0.27, p = 0.015), HOMA-IR (r = 0.22, p = 0.006), hs-CRP (r = 0.19, p = 0.04), and total testosterone (r = −0.21, p = 0.009) levels, whereas TG/HDL-C ratio was weakly correlated weakly with ADMA (r = 0.30, p = 0.003), HOMA-IR (r = 0.22, p = 0.006), and total testosterone (r = −0.16, p = 0.03) levels. Neither VAI nor TG/HDL-C ratio determined ADMA, HOMA-IR, and hs-CRP levels. Conclusions The results of this study demonstrate that patients with hypogonadism have elevated VAI and TG/HDL-C ratio. These values are significantly correlated with the surrogate markers of endothelial dysfunction, inflammation, and insulin resistance. However, the predictive roles of VAI and TG/HDL-C ratio are not significant. Prospective follow-up studies are warranted to clarify the role of VAI and TG/HDL-C ratio in predicting cardiometabolic risk in patients with hypogonadism.

The aim of this study was the preparation of 1,1′-(2,5-thiophenediyl) bis[1-(2-benzofuranyl)methanone] (2), the corresponding diketoxime (3), and the ether and ester derivatives (4a–e) of the diketoxime. These compounds were prepared in good yields. Minimum inhibitory concentrations (MIC) of the synthesized compounds 1–4 were determined against Salmonella enterica subsp. enterica serovar Typhimurium, Escherichia coli and Staphylococcus aureus. Among the synthesized compounds, 1 and 4e showed good activity against E. coli, S. enterica and S. aureus.

The current study aims to examine the relation between concept images and procedural understanding of prospective Mathematics teachers (PMTs) related to ‘continuity’ in Math. The participants (n=9) study Mathematics Education at a state university during spring 2018; they are third, fourth and fifth grade students. The data come from interviews and open-ended tests developed by the researchers. More specifically, the data of concept images were collected through interviews and the data of procedural understanding were gathered via open-ended tests. The methodological approach used in the current study is descriptive analysis. The results of the study revealed that in addition to the presence of the PMTs whose understanding of concept images and procedural understanding are in accordance with each other, there are those whose understanding of these two concepts are not compatible with each other. Moreover, it has been observed that while PMTs who hold a concordant understanding between concept image and procedural understanding tend to express the concept of ‘continuity’ as rooted in their images, PMTs who have an incompatible understanding between these two concepts tend to provide formal definitions for the notion of ‘continuity’, as different from their own images.

Turkey, which meets nearly 70 per cent of its energy demands with import, is facing the problems of energy security and current account deficit as a result of its dependence on foreign sources in terms of energy input. It is also known that Turkey is having environmental problems due to the increases in CO2 emission. Considering these problems in Turkish economy, where energy input is commonly used, it is necessary to use energy sources efficiently and provide alternative energy sources. Due to the dependency of renewable sources on meteorological conditions (the absence of enough sun, wind, and water sources), the energy generation could not be provided efficiently and permanently from these sources. At this point, nuclear energy as analternative energy source maintains its importance as a sustainable energy source that providing energy in 7 days and 24 hours. The main purpose of this study is to evaluate the nuclear energy subject within the context of negative public perceptions emerged after Chernobyl (1986) and Fukushima (2011) disasters and to investigate in the economic framework.

Abstract Background Whole pelvis intensity modulated radiotherapy (IMRT) is increasingly being used to treat cervical cancer aiming to reduce side effects. Encouraged by this, some groups have proposed the use of simultaneous integrated boost (SIB) to target the tumor, either to get a higher tumoricidal effect or to replace brachytherapy. Nevertheless, physiological organ movement and rapid tumor regression throughout treatment might substantially reduce any benefit of this approach. Purpose To evaluate the clinical target volume - simultaneous integrated boost (CTV-SIB) regression and motion during chemo-radiotherapy (CRT) for cervical cancer, and to monitor treatment progress dosimetrically and volumetrically to ensure treatment goals are met. Methods and materials Ten patients treated with standard doses of CRT and brachytherapy were retrospectively re-planned using a helical Tomotherapy - SIB technique for the hypothetical scenario of this feasibility study. Target and organs at risk (OAR) were contoured on deformable fused planning-computed tomography and megavoltage computed tomography images. The CTV-SIB volume regression was determined. The center of mass (CM) was used to evaluate the degree of motion. The Dice’s similarity coefficient (DSC) was used to assess the spatial overlap of CTV-SIBs between scans. A cumulative dose-volume histogram modeled estimated delivered doses. Results The CTV-SIB relative reduction was between 31 and 70%. The mean maximum CM change was 12.5, 9, and 3 mm in the superior-inferior, antero-posterior, and right-left dimensions, respectively. The CTV-SIB-DSC approached 1 in the first week of treatment, indicating almost perfect overlap. CTV-SIB-DSC regressed linearly during therapy, and by the end of treatment was 0.5, indicating 50% discordance. Two patients received less than 95% of the prescribed dose. Much higher doses to the OAR were observed. A multiple regression analysis showed a significant interaction between CTV-SIB reduction and OAR dose increase. Conclusions The CTV-SIB had important regression and motion during CRT, receiving lower therapeutic doses than expected. The OAR had unpredictable shifts and received higher doses. The use of SIB without frequent adaptation of the treatment plan exposes cervical cancer patients to an unpredictable risk of under-dosing the target and/or overdosing adjacent critical structures. In that scenario, brachytherapy continues to be the gold standard approach.

Abstract Background The ongoing EORTC 22042–26042 trial evaluates the efficacy of high-dose radiotherapy (RT) in atypical/malignant meningioma. The results of the Dummy Run (DR) and prospective Individual Case Review (ICR) were analyzed in this Quality Assurance (QA) study. Material/methods Institutions were requested to submit a protocol compliant treatment plan for the DR and ICR, respectively. DR-plans (n=12) and ICR-plans (n=50) were uploaded to the Image-Guided Therapy QA Center of Advanced Technology Consortium server (http://atc.wustl.edu/) and were assessed prospectively. Results Major deviations were observed in 25% (n=3) of DR-plans while no minor deviations were observed. Major and minor deviations were observed in 22% (n=11) and 10% (n=5) of the ICR-plans, respectively. Eighteen% of ICRs could not be analyzed prospectively, as a result of corrupted or late data submission. CTV to PTV margins were respected in all cases. Deviations were negatively associated with the number of submitted cases per institution (p=0.0013), with a cutoff of 5 patients per institutions. No association (p=0.12) was observed between DR and ICR results, suggesting that DR’s results did not predict for an improved QA process in accrued brain tumor patients. Conclusions A substantial number of protocol deviations were observed in this prospective QA study. The number of cases accrued per institution was a significant determinant for protocol deviation. These data suggest that successful DR is not a guarantee for protocol compliance for accrued patients. Prospective ICRs should be performed to prevent protocol deviations.

Aim: To determine the clinical relevance of a rigid endoscopy surgical method for subdural hematomas, as previously described in a cadaver study., Material and Methods: Between May 2021 and September 2023, 21 patients underwent subdural hematoma drainage using a 0-degree rigid endoscope. Traumatic acute subdural hematomas were excluded. The demographic data of the patients, antiplatelet/ antiaggregant use, perioperative findings, and pre- and post-surgery modified Rankin Scale (mRS) scores were recorded and analyzed., Results: The mean age of our cohort was 65.63 (±20.52), and the male/ female ratio was 3.2: 1. The hematoma was unilateral in 90.5% of the patients, and the rate of trauma history was 42.9%. The most common radiological diagnosis was chronic subdural hematoma with septa (61.9%). The percentage of patients with a history of antiplatelet/ antiaggregant therapy was 23.8%. No mortality related to the surgery was observed in the early postoperative period; however, two patients underwent reoperation for further bleeding. The neurological grade was the only preoperative factor that had a statistically significant effect on the mRS score at discharge, with significantly better discharge mRS scores in grade 1 and 2 patients (p=0.014)., Conclusion: The procedure was found to be safe and feasible, with surgery-related morbidity and mortality within acceptable limits.

Aim: To compare T1-weighted contrast-enhanced (T1+C) with fast imaging employing steady-state acquisition (FIESTA) magnetic resonance imaging (MRI) sequences to protect healthy brain tissue during meningioma treatment with Gamma-Knife radiosurgery (GKRS)., Material and Methods: After reviewing the data of 54 patients with solitary meningioma who underwent GKRS between January 2020 and June 2022, demographic characteristics were noted, tumor volumes on T1+C and FIESTA MRI sequences were measured, and sequences were compared. The patients were then divided into two groups according to the presence of invasion to intracranial venous sinuses (groups 1 and 2, respectively). SPSS 11.5 software was used for data analysis, with the level of significance set at 0.05., Results: While no significant age and tumor size differences were observed between groups 1 and 2, sinus invasion was significantly higher among males. Tumor volumes measured in both groups were significantly smaller on FIESTA sequences than on T1+C sequences., Conclusion: The T1+C sequence has been the primary imaging method because of meningiomas' high contrast enhancement feature. However, the T1+C sequence during GKRS planning is an effective imaging method in treating meningiomas; FIESTA sequences can more precisely delineate the tumor border. In this study, we consider that using the FIESTA/CISS sequence MRI for planning meningioma therapy with Gamma-Knife can reduce target volume and prevent irradiation of healthy brain tissue.

Aim: To evaluate and compare open cranial vault remodeling (OCVR) and endoscopy-assisted craniosynostosis surgery (EACS) in patients with non-syndromic craniosynostosis and to develop an algorithm to determine the most appropriate surgery for each patient., Material and Methods: Eighty-five children with craniosynostosis who underwent surgery between 2010 and 2022 were retrospectively analyzed. Demographic data, comorbidities, and peri-operative findings of the patients were recorded. Pre- and post-operative comparisons were made between predetermined measurement techniques for each deformation. In addition, measurements were obtained by computed tomography (CT) or 3D stereophotogrammetric (3DSPG) methods from eligible patients and compared with one another., Results: In our study, 61 patients underwent EACS, whereas 24 underwent OCVR. The operating time of OCVR was approximately 54.4 minutes longer than that of EACS (p < 0.001). The intra-operative blood loss was around 139 ml higher in OCVR (p < 0.001). The length of hospital stay for patients who underwent EACS was shorter at 8.4 days on average (p < 0.001). Surprisingly, 5 complications were observed in OCVR compared with 7 in EACS. While the cosmetic outcome of EACS was superior in most of the pathologyspecific measurement techniques, the metopic index increased only in patients with metopic synostosis after both surgical operations. Still, this increase was lower in EACS than in OCVR., Conclusion: This study suggests that endoscopic craniosynostosis surgery has lower estimated blood loss and operation and hospitalization times, as well as comparable cosmetic results compared with open vault surgeries on long-term follow-up. CT and 3DSPG methods can help distinguish between different types of measurement techniques for synostoses. However, no significant differences were found in the comparisons since 3DSPG can also provide reliable measurements comparable to those on CT during follow-up.

Aim: To define a novel autologous bone graft insertion technique, and to evaluate its effects on bone fusion in patients with lumbar stenosis who underwent laminoplasty., Material and Methods: Fifty-six patients and 142 vertebrae that underwent autologous bone graft insertion technique between 2009 and 2018 were analysed retrospectively. Demographic data, comorbidities, and perioperative findings of patients were recorded. The midline anteroposterior (AP) diameter was measured at the bone graft insertion levels, and fusion formation was evaluated with computed tomography (CT) and dynamic X-Ray images. Pain scores were assessed preoperatively with the visual analogue scale (VAS) for both legs and Oswestry Disability Index (ODI) for overall life quality. Scores were re-evaluated on 1 < sup > st < /sup > day, at 3 < sup > rd < /sup > , and 12 < sup > th < /sup > months, postoperatively., Results: Degenerative spinal stenosis was present in 56 patients who underwent autologous bone graft insertion technique. It was found that the diameter of the spinal canal increased by 37% in CT measurements. In postoperative radiological followups, fusion developed in 49 (87.5%) patients. There was a statistically significant decrease in both VAS and ODI scores in the postoperative period when compared to the preoperative evaluations., Conclusion: Bone graft insertion technique supports posterior fusion and protects against dural injuries during revision surgery by creating a barrier over the dura. The prevention of epidural fibrosis formation reduces the symptoms of the postlaminectomy syndrome. The fact that this technique does not require fixation material. Therefore, it reduces expenditure and eliminates the risk of complications related to synthetic materials.

Objective: Neurosurgery training programs aim to train specialists. In addition, they are expected to equip the residents with necessary knowledge and skills for academic development. This study aims to gain insights into academic productivity after neurosurgeons graduated from residency training in Turkey., Methods: An electronic survey was sent to all Turkish Neurosurgical Society members (n = 1662 neurosurgeons) between September and November 2019. The number of participants was 289 (17.4%). Participants were divided into subgroups based on three main factors: training institution type (university hospital [UH] vs training and research hospital [TRH]), training institution annual case volume (low [< 1000 or inadequate cranial/spinal case numbers] vs high [> 1000 and adequate cranial/spinal case numbers]), and training program accreditation status (accredited vs nonaccredited)., Results: The majority of the participants (64.7%) graduated from the UHs. Those trained at UHs (vs TRHs) and high- (vs low-) volume centers had their dissertations more frequently published in Science Citation Index/Science Citation Index-Expanded journals, gave more oral presentations after residency, had higher h-indices, had higher rates of reviewership for academic journals, and had greater participation in projects with grant support. In addition, graduates of accredited programs reported more PhD degrees than those of nonaccredited programs., Conclusions: Neurosurgeons trained in higher-case-volume, accredited programs, mostly in the UHs, performed better in terms of scientific activities and productivity in Turkey. Strong research emphasis and supportive measures should be instituted to increase academic performance during and after residency training.

Aim: To retrospectively evaluate the overall survival (OS) of patients with brain metastases (BMs) who had been treated with whole brain radiotherapy (WBRT) and Gamma Knife (GK) according to prognostic factors and prognostic index scores., Material and Methods: The study included 91 patients with BMs who had been treated with WBRT and/or GK between 2014 and 2017. The patients with BMs were retrospectively evaluated regarding age, sex, Karnofsky Performance Status (KPS), recursive partitioning analysis (RPA) class, basic score for BM (BS-BM), Graded Prognostic Assessment (DS-GPA) index, primary tumour type, extracranial metastases, primary tumour control, number of BMs, and brain metastasectomy. A univariate analysis of the OS was performed using the Kaplan-Meier method, supplemented by the log-rank test. We also applied a multivariate survival analysis using the Cox regression model., Results: The median OS for all patients with BMs was 6 months. Meanwhile, the median OSs for those with WBRT, GK, and WBRT-GK treatment were 6, 4, and 15 months, respectively (p=0.00). In the multivariate analysis, the female sex (p=0.030), brain metastasectomy (p=0.047), treatment with WBRT-GK (p=0.001), and the controlled primary tumour (p=0.007) significantly correlated with the OS. Furthermore, the BS-BM (p=0.022) was closely related with the OS compared to the RPA and DS-GPA in the multivariate analysis., Conclusion: The BS-BM was found to better predict the survival of patients with BMs according to the prognostic index scores in the multivariate analysis. Thus, our data suggest that the BS-BM is the most appropriate prognostic index.

Idiopathic pulmonary hemosiderosis is an infrequent cause of pulmonary hemorrhage in children. It is classically defined by the triad of recurrent hemoptysis, iron-deficiency anemia, and diffuse parenchymal infiltration without an obvious cause. The pathogenesis remains unexplained, diagnosis may be difficult, and the clinical course exceedingly variable. A 4-year-old girl was admitted to the hospital with complaints of dyspnea, and skin and mucous membrane pallor. The suspicion of idiopathic pulmonary hemosiderosis led to the use of corticosteroid therapy with rapid improvement in clinical condition and discharge from hospital.

Oxidative stress may contribute to the pathogenesis of congenital heart defects, but the role of dynamic thiol/disulphide homeostasis has not been evaluated. The objective of this study was to assess whether there are changes in thiol/disulphide homeostasis and nitric oxide levels in children with tetralogy of Fallot (TOF) and ventricular septal defect (VSD). A total of 47 children with congenital heart defects (24 TOF and 23 VSD) and 47 healthy age- and sex-matched controls were included in this study. Serum total thiol and native thiol levels were measured using a novel automatic spectrophotometric method. The amount of dynamic disulphide bonds and related ratios were calculated from these values. Serum nitric oxide levels were detected using a chemiluminescence assay. We found that the average native thiol, total thiol, and disulphide levels were decreased in patients with VSD when compared with healthy individuals (p &lt; 0.001, p &lt; 0.001, and p &lt; 0.01, respectively). While native thiol levels were decreased (p &lt; 0.01), disulphide levels were elevated in the TOF group (p &lt; 0.05). We observed marked augmentation of disulphide/native thiol (p &lt; 0.001) and disulphide/total thiol ratios (p &lt; 0.01) in the TOF group. However, there was a significant decrease in native thiol/total thiol ratio in patients with TOF. No significant changes in these ratios were noted in the VSD group. We detected significant elevations in serum nitric oxide levels in children with TOF and VSD (p &lt; 0.001 for all). These results are the first to demonstrate that thiol/disulphide homeostasis and nitric oxide are associated with TOF and VSD in children.

Background: Alteration in thiol level under oxidative stress may contribute to community-acquired pneumonia (CAP). The goal of this study was to determine whether there are changes in thiol/disulfide homeostasis and nitric oxide (NO) in children with CAP., Methods: In total, 130 participants were involved in the study. Of these, 65 had been diagnosed with CAP on admission, and the remaining 65 were healthy individuals. Serum total thiol and native thiol were measured in each participant using a novel automated spectrophotometric method. The amount of dynamic disulfide bonds and related ratios were calculated from these values. Serum NO was measured on chemiluminescence assay., Results: Average native thiol, total thiol, and disulfide in the CAP group were significantly lower than in the healthy individuals (P < 0.0001, P < 0.0001, P = 0.0126, respectively). In addition, disulfide/native thiol (P = 0.0002), and disulfide/total thiol ratios (P = 0.0004) were significantly higher, whereas the native thiol/total thiol ratio (P = 0.0004) was lower in the CAP group. High serum NO was noted in the CAP group (P = 0.0003), but there was no marked correlation between thiol/disulfide and NO., Conclusion: The changes in endogenous thiol levels under oxidative stress may be associated with the pathogenesis of CAP in pediatric patients., (© 2018 Japan Pediatric Society.)

Objective: To demonstrate the influence of ventilation tube insertion to the quality of life in a group of children in Southeast Anatolia by Otitis Media 6-item (OM6) questionnaire., Design: Patients who underwent ventilation tube insertion due to otitis media with effusion (OME) at Otorhinolaryngology Department of Gaziantep University between December 2016 and April 2017 were enrolled in this prospective study. All patients were evaluated with the OM-6 survey before operation and 6 weeks after surgery., Results: The mean age of 45 patients out of 50 accounted for 67.64 ± 42.89 months with 27 (60%) males and 18 (40%) females. The numbers of preoperative and postoperative overall OM6 scores represented a significant improvement with 4.34 and 2.16, respectively. Moreover, each domain of OM6 (physical suffering, hearing loss, speech impairment, emotional distress, activity limitations and caregiver concerns) showed statistically significant difference., Conclusion: Ventilation tube insertion procedure provided a significant improvement in a group of children in Southeast Anatolia suffering from chronic OME in terms of Quality of Life (QOL) assessed by OM6. We believe that OM6 is a useful tool for evaluating the patients' health-related quality of life and for providing additional information to the caregivers' or families' enquiries regarding the consequences of surgical intervention., (© 2018 John Wiley & Sons Ltd.)

Background/purpose: Air-particle abrasion process used to increase surface roughness in order to increase metal-ceramic bond strength varies in each study. This study aims to optimize the air-particle abrasion protocol., Material and Methods: 820 cylindrical nickel-chrome specimens divided equally into 82 groups (n:10). The specimens' s surfaces were air-particle abraded with 50, 110, 250 μm Al 2 O 3 at 25, 50,75 psi for 10, 20, 30 s at a distance of 10, 20, 30 mm. To determine the surface roughness, profilometer and atomic force microscope were used. Veneering ceramic was fired onto the specimens and shear bond tests were performed with a universal testing machine. Statistical analyzed were performed using analysis of variance (Kolmogorov-Smirnov)., Results: The difference of surface roughness between all groups were statistically significant (P < .05). The highest surface roughness value was measured in 110 μm, 75 psi, 20 mm and 30 s. The higher bond strength values were obtained in 110 μm, 75 psi groups and no statistically significant difference was observed within each group., Conclusion: While all the air-particle abrasion parameters were effective on surface roughness, only the pressure and grain size make statistically significant difference on shear bond strength.

Objective: The aim of this study was to determine the optimum operating parameters (pulse duration, energy levels, and application time) to promote induction of osteoblast and fibroblast cell proliferation and to maintain cell viability treated with low-intensity pulsed ultrasound (LIPUS) and low-level laser therapy (LLLT)., Background Data: The positive effects of LIPUS and LLLT on cellular activity have been reported in recent years. Comparisons between experimental parameters of previous studies are difficult because scientific studies reported frequencies and the duty cycles of LIPUS and wavelengths and doses of LLLT in a wide range of parameters. However, optimum amount of energy and optimum time exposure must be determined to induce bone and tissue cell proliferation for effective healing process and to avoid cell damage., Material and Methods: Fibroblast and osteoblast cell cultures were irradiated with LIPUS (10-50% pulse and continuous mode at 1 and 3 MHz for 1, 3, and 5 min) and LLLT (4, 8, and 16 J at 50, 100, 200, 300, 400, and 500 mW). Cell cultures were analyzed using XTT assay., Results: For both cell types, LIPUS treatment with 10% pulse (1:9 duty cycle), 3 MHz, and for 1 min and LLLT treatment over 100 mV for 4, 8, and 16 J modalities contributed to the growth, and may help bone repair and tissue healing process optimally., Conclusions: Bio-stimulating effects of LLLT irradiation promote proliferation and maintain cell viability better than LIPUS treatment without causing thermal response for both cell types, and the therapeutic modality above 200 mV has maximum effectiveness.

Budd-Chiari syndrome (BCS) is caused by hepatic venous outflow obstruction commonly seen with myeloproliferative neoplasms (MPNs). Polycythaemia vera (PV) is a very rare MPN in childhood. This is the youngest reported patient diagnosed with PV and BCS secondary to JAK V617F mutation.A 26-month-old girl was admitted with a 5-month history of abdominal distension, hepatosplenomegaly and ascites. Imaging studies revealed occlusion of the right hepatic vein and marked attenuation of the middle and left hepatic veins. BCS was diagnosed after excluding other causes of chronic liver disease. Mandatory prothrombotic workup revealed underlying PV.Partial recanalisation of hepatic veins occurred following anticoagulation therapy and PV was well controlled by pegylated interferon and hydroxycarbamide until she developed nephrotic syndrome, likely secondary to pegylated interferon. Therefore, treatment was modified to ruxolitinib, a novel-JAK-2 inhibitor; the therapy has been effective for almost 20 months with a good response and has no side effects., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Objective: The aim of this study was to assess the influence of neutrophil to lymphocyte (N/L) ratio and platelet indices on patent ductus arteriosus (PDA) in preterm infants., Background: PDA is a common problem with potentially serious associated morbidities in preterm neonates., Methods: Premature infants with hemodynamically significant PDA (n = 47) and a control group without PDA (n = 50) who were hospitalized in the neonatal intensive care unit were retrospectively evaluated. The characteristics, perinatal factors, N/L ratio, platelet counts and other platelet indices of the infants in both groups during the first 3 days of life were recorded., Results: Platelet counts were significantly lower in the patient group than in the control group (p = 0.0343). There was a marked positive correlation between body weight and N/L ratio in preterm infants with PDA (p = 0.0001). PDA was associated with low platelet count., Conclusion: Our results showed that N/L ratio is positively correllated with body weight in PDA group. These data suggest that platelet counts and N/L ratio might be useful predictors for the early diagnosis and evaluation of the clinical course of PDA in preterm infants (Tab. 2, Ref. 28).

The aim of the study was to determine the effect of direct application of rifampin, povidone-iodine, and hydrogen peroxide on the formation of epidural fibrosis in rats. Forty-eight adult male Wistar albino rats were equally and randomly divided into four groups (laminectomy, topical rifampin, topical povidone-iodine, and topical hydrogen peroxide). Laminectomy was performed at the T12 level in all rats. Four weeks later, the extent of epidural fibrosis was assessed both macroscopically and histopathologically. ANOVA test was used for the evaluation of dural thickness. Kruskal-Wallis test was used for the pathology and macroscopic evaluation. Chi-square test was used for evaluation of the arachnoid involvement. p value <0.05 was accepted as statistically significant. Our data revealed that topical application of both povidone-iodine and hydrogen peroxide were effective in reducing epidural fibrosis formation. The results of our study provide the experimental evidence of the preventive effects of topical application of povidone-iodine and hydrogen peroxide over epidural fibrosis.

Purpose: The bond strength of soft denture liner to a recently introduced denture base resin after thermocycling has not been compared to traditional denture base materials. The objective of this study was to investigate the effects of thermocycling on the tensile bond strength of soft denture liners to two chemically different denture base resins, polymethyl methacrylate (PMMA) and urethane dimethacrylate (UDMA)., Materials and Methods: A total of 48 PMMA and UDMA tensile test specimens were fabricated by attaching two different soft denture liners (Molloplast-B, Permaflex) according to the manufacturers' instructions and assigned to two groups. Half of the specimens for each group were stored in water for 1 week, and the other half were thermocycled (5000 cycles) between baths of 5°C and 55°C. Specimens were mounted on a universal testing machine with a 5 mm/min crosshead speed. The data were analyzed with three-way ANOVA and post hoc Tukey-Kramer multiple comparisons tests (α = 0.05)., Results: The highest bond strength was measured in the specimens from the UDMA/Molloplast groups, and the lowest was seen in the PMMA/Permaflex group. No significant difference in bond strength was detected in PMMA/Permaflex groups after thermocycling (p = 0.082), whereas other groups exhibited significant differences after thermocycling (p < 0.05)., Conclusions: Thermocycling decreased the bond strength values in both the PMMA and UDMA groups. Regardless of types of soft liners, PMMA specimens presented lower bond strength values than UDMA specimens, both before and after thermocycling., (© 2015 by the American College of Prosthodontists.)

Many complications related to the resection of an ossified posterior longitudinal ligament via the anterior approach have been reported. Postoperative neurological deterioration is one such complication that may appear due to massive anterior spinal cord herniation related to a dural defect following resection of the ossified posterior longitudinal ligament. Specifically, spinal cord herniations have been reported to be associated with posterior approaches, and a large number of theories regarding this association have been offered by various authors. However, anterior spinal cord herniation is extremely rare, and its pathophysiology has not yet been explained. In this case report, we report a male patient who experienced anterior spinal cord herniation following anterior surgery. Spinal cord herniation may develop following the removal of the anterior cervical corpectomy. Therefore, surgeons should be aware of this condition when planning treatments for cervical spondylotic myelopathy via the anterior approach., (Copyright © 2016 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.)

Objective: The purpose of this study was to investigate the effects of various surface pretreatments in the ridge lap area of acrylic resin denture teeth on the shear bond strength to heat-polymerized polymethylmethacrylate (PMMA) denture base resin., Background Data: Tooth debonding of the denture is a major problem for patients with removable prostheses., Methods: A total of 84 central incisor denture teeth were used in this study. Seven test groups with 12 specimens for each group were prepared as follows: untreated (control, group C), ground, with a tungsten carbide bur (group H), airborne-particle abrasion (group AA), primed with methyl methacrylate (group M), treated with izobutyl methacrylate (group iBMA), Eclipse Bonding Agent applied (group E), and Er:YAG laser irradiated (group L). Test specimens were produced according to the manufacturers' instructions and mounted to a universal testing machine for shear testing with a crosshead speed of 1 mm/min. Data were evaluated by one way variance analysis (ANOVA) and Tukey's test (α=0.05)., Results: Similar bond strength values were found between groups L and M, and these were the highest shear bond strengths among the groups. The lowest one was observed in group E. All surface treatments, except group E, exhibited significant difference when compared with group C (p<0.05)., Conclusions: Lasing of the ridge lap area to enhance the bond strength of acrylic resin denture teeth to PMMA denture base resin might be an alternative to wetting with MMA monomer. To overcome tooth debonding, surface treatment of the ridge lap area should be performed as part of denture fabrication.

Objective: The aim of this study was to compare the effect of different Er:YAG laser pulse durations on the shear bond strength (SBS) of metal brackets bonded to porcelain with two different adhesive systems., Background Data: Orthodontic brackets do not bond well to feldspathic porcelain surfaces, using resin cement. Various treatment methods have been suggested for the porcelain surface to improve bond strength. Thus far, no orthodontic study has evaluated the effect of different Er-YAG laser pulse durations on porcelain surfaces with or without sandblasting., Methods: In the present study, 150 porcelain crowns were assigned to 10 groups differing in adhesive system and surface treatment. In five groups, the adhesive system was RelyX(™) U 200 and in the other five, Transbond XT was used. For each adhesive system, the porcelain surfaces were treated in one of five different ways: sandblasted, Er:YAG laser short pulse (SP), Er:YAG laser super short pulse (SSP), sandblasted+SP, or sandblasted+SSP. The sandblasted group with Transbond XT served as the control. SBS test was conducted for each group. Samples were examined by scanning electron microscopy. ANOVA and independent t test were used for statistical analysis., Results: The control group had increased roughness and the highest SBS. Er:YAG laser application to the sandblasted porcelain flattened the roughness, and the effects of SP and SSP were similar., Conclusions: Er:YAG laser application did not allow for elimination of the hydrofluoric acid step. RelyX U 200 is a viable alternative to Transbond XT on sandblasted porcelain.

The fabrication of a Suersen obturator prosthesis with titanium framework is described in the case of a 43-year-old man with congenital absence of the soft palate. The patient revealed an open soft palate, bilateral cleft lip and palate, Angle Class III dental malocclusion, and anterior and posterior crossbite. He was treated with a multidisciplinary approach. A Dolder bar was fabricated between the maxillary canines, and telescopic crowns were prepared for maxillary premolars. Angle Class III tooth relation was readjusted to tooth-tooth relation; closure of the nasopharynx and oropharynx was performed by Suersen method, which improves speech.

Statement of Problem: Rare earth magnets have been used in prosthodontics, but their tendency for corrosion in the oral cavity and insufficient attractive forces limit long-term clinical application., Purpose: The purpose of this study was to evaluate the attractive force of different types of new-generation magnetic attachment systems., Material and Methods: The attractive force of the neodymium-iron-boron (Nd-Fe-B) and samarium-cobalt (Sm-Co) magnetic attachment systems, including closed-field (Hilop and Hicorex) and open-field (Dyna and Steco) systems, was measured in a universal testing machine (n=5). The data were statistically evaluated with 1-way ANOVA and post hoc Tukey-Kramer multiple comparison test (α=.05)., Results: The closed-field systems exhibited greater (P<.001) attractive force than the open-field systems. Moreover, there was a statistically significant difference in attractive force between Nd-Fe-B and Sm-Co magnets (P<.001). The strongest attractive force was found with the Hilop system (9.2 N), and the lowest force was found with the Steco system (2.3 N)., Conclusions: The new generation of Nd-Fe-B closed-field magnets, along with improved technology, provides sufficient denture retention for clinical application., (Copyright © 2011 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.)

Unlabelled: The loss of anterior teeth can be hurtful to the patient both psychologically and socially. In adolescent patients, temporary replacement of the teeth can minimize these concerns. Many approaches have been described for this temporary replacement. This article presents an alternative approach for the oral rehabilitation of the preadolescent male who has edentulous space including sutura palatina media in the anterior maxilla. High expectations regarding esthetics by the patient were successfully met by utilizing a glass fiber-reinforced composite temporary removable partial denture. The restorations remained intact, with no discoloration or deterioration at the 16-month recall., Clinical Significance: As growth and development of the jaws continue in the preadolescent patient, a glass fiber- reinforced composite temporary removable partial denture can be an esthetic and conservative option for replacement of missing anterior teeth.