Effects of sodium hypochlorite and chlorhexidine solutions on Resilon (synthetic polymer based root canal filling material) cones: an atomic force microscopy study

The aim of the present study is to evaluate the effects of 2% chlorhexidine and 5.25% sodium hypochlorite on the surface properties of Resilon cones with the atomic force microscopy. The Resilon cones were immersed in disinfecting agents (5.25% sodium hypochlorite and 2% chlorhexidine) at 1 and 5 min time intervals. Atomic force microscopy was used to evaluate topographical deviations of Resilon cones. Root mean square (RMS) parameters for topographic amplitudes were calculated. The cones exhibited statistically significant low RMS values at 5-min immersion in sodium hypochlorite and chlorhexidine groups compared to the all other groups (p < 0.05). One-minute immersion did not show any significant deterioration on the Resilon surface (p > 0.05). In conclusion, sodium hypochlorite and chlorhexidine solutions used for disinfection significantly decreased (p < 0.05) the RMS values of Resilon cones at 5-min applications.     

Tunnel enlargement after arthroscopic anterior cruciate ligament reconstruction: Comparison of bone-patellar tendon-bone and hamstring autografts

Bone tunnel enlargement associated with anterior cruciate ligament (ACL) reconstruction has recently become a topic of interest in the literature. This association was examined, along with the effect of femoral and tibial tunnel enlargement on the clinical results of ACL reconstruction performed with either bone-patellar tendon-bone (BPTB) or hamstring (HST) autografts. Forty-six patients underwent arthroscopic ACL reconstruction (23 receiving BPTB autograft and 23 HST) between March 1999 and July 2001. Thirty patients (13 receiving BPTB autograft and 17 HST) completed the last clinical and radiologic evaluations and were included in the study. The mean age of patients in the HST group was 29.8 years (range 18–39) and that in the BPTB group was 27.6 years (range 20–37). The mean follow-up period was 24.6 months (range 12–36) in HST group and 18.5 months (range 12–40) in BPTB group. The effect of tunnel enlargement on the clinical results was evaluated by comparing preoperative and postoperative Lysholm, Tegner, and International Knee Documentation Committee scores and ligament laxity measurements between and within the groups. Postoperative femoral and tibial tunnel diameters in both groups were significantly larger than their corresponding preoperative tunnel diameters. In an intergroup evaluation, the enlargement of the tibial tunnel was similar in both groups (P=.556), but the femoral tunnel diameter was significantly larger in the HST group than in the BPTB group (P>.001). Preoperative laxity of the knees significantly improved after the operations in both groups, but no difference between the groups was evident at the final follow-up visit. No correlation between tunnel widening and the clinical results of the BPTB and HST procedures was observed.     

Visually evoked startle response in a patient with epilepsy: a case report and review of the literature

Both symptomatic and genetic, cases with hyperekplexia or startle seizures induced by acoustic stimuli, are previously reported. By contrast, startle response induced by visual stimuli is rare. While visual stimuli are more commonly associated with startle seizures, here we present an 11-year-old girl with epilepsy, motor-mental retardation, and spastic tetraparesis, who had repetitive startle responses by photic stimulation during the electroencephalogram recording, without any spike-and-wave discharges associated with the startles. We report this unique case with startle responses induced both by acoustic and photic stimuli and review the literature related to this exceptionally rare combination of symptoms.     

Changes in intraocular pressure during cardiopulmonary bypass

Purpose

The aim of the present study was to investigate the changes in intraocular pressures (IOP) in patients who underwent pulsatile and non-pulsatile cardiopulmonary bypass (CPB).

Methods

A total of 42 patients operated for elective coronary bypass surgery (CABG) on CPB were randomly allocated to pulsatile (Group P) and non-pulsatile (Group N) groups. Pulsatile flow was applied to Group P patients during crops-clamp period. The IOP measurements were made before and after the induction of anesthesia, before the onset of CPB, on the 5th, 15th, 30th, 45th, and 60th min of CPB, after CPB and at the end of the operation. The results of repetitive measurements were analyzed at different intervals and in two groups.

Results

The second IOP measurements of right and left eyes displayed statistically significant decreases from the baseline level [11.9 ± 2.9 (p = 0.0001) and 12.5 ± 3.2 (p = 0.0001), respectively]. The significant decrease in the IOP values persisted in the repeated measurements except for the 5th min of CPB values [17.0 ± 3.5 (p = 0.346) and 16.7 ± 3.6 (p = 0.399)]. Comparison of two groups demonstrated significant differences at pre-CPB (right 12.8 ± 2.3 vs. 10.8 ± 2.4; p = 0.013 and left 13.3 ± 2.4 vs. 11.5 ± 2.5; p = 0.023), and 5th min of CPB measurements (right 18.5 ± 3.1 vs. 15.9 ± 3.4; p = 0.015; left 18.2 ± 3.0 vs. 15.7 ± 3.6; p = 0.019).

Conclusion

We noted a steady decrease in repeated IOP measurements except for the transient increase in CPB values on 5th min. The IOP values were higher in pulsatile CPB group in pre-CPB and 5th min of CPB measurements; however, the difference was not significant in the repeated measurements.

     

Evaluation of the correlation between preoperative airway assessment tests,anthropometric measurements,and endotracheal intubation difficulty in obesity class III patients undergoing bariatric surgery

In this study, we investigated the correlation between airway assessment tests, anthropometric measurements, and the Modified Cormack– Lehane Classification (MCLC) assessed by videolaryngoscopy in patients undergoing bariatric surgery.This study included 121 morbidly obese patients undergoing bariatric surgery. The body mass index, Modified Mallampati Score (MMS), thyromental distance, sternomental distance, interincisor distance, and neck, waist, and chest circumferences were recorded. The correlation between the airway assessment tests, anthropometric parameters, and the MCLC were analyzed. The time required for endotracheal intubation (EI) and the attempt required for EI were also recorded.Thirty-three patients were found to be at risk of a difficult EI. The MMS, neck circumference, waist circumference, chest circumference, the time required for EI, and the number of attempts for EI were positively correlated with MCLC (all P < .05). As the MMS increased, the risk of a difficult EI increased (P < .001). The cutoff values of neck, waist, and chest circumference for the risk of a difficult EI were 41.5, 153.5, and 147.5 cm, respectively (P < .05).This study indicates that the high MMS, as well as increased neck, waist, and chest circumference, should be considered EI difficulty in obese patients, even if a videolaryngoscopy is used.     

Assessment of alveolar epithelial permeability with Tc-99m DTPA aerosol scintigraphy in patients with Sjogren syndrome

Sjögren’s syndrome (SjS) is a systemic autoimmune disease that mainly affects the exocrine glands and usually presents as persistent dryness of the mouth and eyes. Lung disease in SjS has been reported to occur early following clinical presentation of the disease. In this study, technetium-99m diethylene triamine penta-acetic acid (Tc-99m DTPA) aerosol inhalation scintigraphy was used to assess the pulmonary membrane permeability in patients with primary SjS. A total of 18 patients with primary SjS and 13 healthy controls were investigated. Clinical evaluation, chest X-ray examination, pulmonary function tests, Tc-99m DTPA aerosol scintigraphy were performed in all the cases. The presence of respiratory symptoms (dyspnea and cough), duration of sicca symptoms were recorded. The clearance half time of Tc-99m DTPA radioaerosols in patients with SjS (20.49 ± 2.56 min) was faster when compared to normal controls (42.32 ± 13.28 min) (P = 0.000) which means that there is a significant increase in lung permeability in patients with SjS compared to the controls. There is also a significant difference between PI of patients with SjS (0.34 ± 0.09) and that of controls (0.42 ± 0.07) (P = 0.012). According to the results of our preliminary study, one can detect pulmonary involvement by Tc-99m DTPA aerosol inhalation scintigraphy in patients with primary SjS.     

Functional analysis of <Emphasis Type="Italic">BMP4</Emphasis> mutations identified in pediatric CAKUT patients

Human congenital anomalies of the kidney and urinary tract (CAKUT) represent the major causes of chronic renal failure (CRF) in children. This set of disorders comprises renal agenesis, hypoplasia, dysplastic or double kidneys, and/or malformations of the ureter. It has recently been shown that mutations in several genes, among them BMP4, are associated with hereditary renal developmental diseases. In BMP4, we formerly identified three missense mutations (S91C, T116S, N150K) in five pediatric CAKUT patients. These BMP4 mutations were subsequently studied in a cellular expression system, and here we present functional data demonstrating a lower level of messenger RNA (mRNA) abundance in Bmp4 mutants that indicates a possible negative feedback of the mutants on their own mRNA expression and/or stability. Furthermore, we describe the formation of alternative protein complexes induced by the S91C-BMP4 mutation, which results in perinuclear endoplasmic reticulum (ER) accumulation and enhanced lysosomal degradation of Bmp4. This work further supports the role of mutations in BMP4 for abnormalities of human kidney development.