Evaluation of osteoblastic activity in extraction sockets treated with platelet-rich fibrin

Objective: The aim of this study was to determine whether the use of platelet rich fibrin (PRF) improved the healing of extraction sockets. Study Design: A total of 20 patients with bilateral soft tissue impacted mandibular third molars were included in this study. The left and right third molars were extracted during the same session. Subsequently, the PRF membrane was randomly administered to one of the extraction sockets, whereas the contra lateral sockets were left without treatment. On postoperative 30. and 90. days, panoramic images and bone scintigrams were taken to evaluate the bone healing between PRF-treated and non-PRF-treated sockets. Also, periodontal evaluation was performed in the same control sessions. Dependent group t test for paired samples was used for statistical analysis. Results: The average increase in technetium-99m methylene diphosphonate uptake as an indication of enhanced bone healing did not differ significantly between PRF-treated and non-PRF-treated sockets 30 and 90 days post operatively. Radio opacity that can show the bone healing on panoramic images were measured by Image J programmer and they did not differ significantly. Also periodontal values did not differ significantly. Conclusions: PRF might not lead to enhanced bone healing in impacted mandibular third molar extraction sockets 30 and 90 days after surgery. It is thought that PRF has the potential characteristics of an autologous fibrin matrix and can accelerate the healing. To better understand the effects of PRF on healing, further research is warranted with larger sample sizes. Key words:PRF, scintigraphy, healing, extraction sockets.     

Lung cancer histopathology in the Thrace region of Turkey and comparison with national data

Following the trends in lung cancer (LC) morbidity and mortality rates can show past trends of cigarette smoking and can give clues on some geographical factors. The demographics of LC patients and the histopathologic distribution of their disease in the Thrace region of Turkey have yet to be defined. A retrospective chart review of primary LC patients admitted to the pulmonology department of Trakya University Hospital between 1992 and 2001 was performed. Charts were available for review in 521 of 567 patients. The mean age was 61 +/- 10 years (30-86 years) and 497 (95.4%) patients were male (male/female ratio= 20.7). When compared with national and international data, male/female ratio for the LC patients from Thrace region was higher than the ratio found from Turkey in general and also from other countries. Adenocarcinoma (ADC) was present in seven of the 24 (29.2%) of the females and prevalence of ADC was more than 2.5 times in females than males (p< 0.05). Squamous cell types were more common in males. Histopathological type did not vary with age in females, but small cell carcinoma was more prevalent in males under the age of 45 (44.7% if . 45 years old vs. 29.1% if > 45 years old, p< 0.05). These data may support that the LC associated with smoking is in the earlier phase of the epidemic in Thrace region. Monitoring the LC trend in our region can give clues on evolving cigarette design and smoking attitudes and geographic factors.     

Effect of acute cigarette smoking on left and right ventricle filling parameters: a conventional and tissue Doppler echocardiographic study in healthy participants

Acute effects of smoking on left and right ventricular function is determined by conventional and tissue Doppler imaging methods in this study. Pulsed-wave Doppler indices of the left and right ventricle diastolic function, including mitral and tricuspid inflow peak early and late velocity and their ratio were obtained from 20 healthy subjects by conventional Doppler and tissue Doppler imaging. Echocardiographic indices of left and right ventricles, including isovolumetric relaxation time, deceleration time, isovolumetric contraction time, ejection time, and myocardial performance index of right ventricle were measured before and 30 minutes after smoking a cigarette. Mitral and tricuspid inflow parameters and right ventricular myocardial performance index significantly altered after smoking a cigarette. Among the tissue Doppler imaging parameters, mitral and tricuspid lateral annulus diastolic, but not systolic, velocities altered after smoking a cigarette. Acute cigarette smoking alters left and right ventricular diastolic functions in healthy nonsmokers.     

Application of thoracic endovascular dissecting aneurysm repair for secondary type B aortic dissection

Type A aortic dissection is an emergency condition that requires immediate surgery. Graft replacement of the ascending aorta is the main treatment for this disorder. However, after ascending aortic replacement, the dissection flap may progress to the distal side (to the descending aorta) and a new intimal tear may develop. In this study, we report on a 66-year-old woman who had a history of ascending aortic replacement six months earlier. She was admitted to hospital with a new onset of back pain. Computed tomography revealed a new dissection tear originating from the distal side of the subclavian artery orifice. Thoracic endovascular dissecting aneurysm repair (TEVDAR) was carried out on the patient. Additional complications were not observed in the postoperative period. Complete cure was provided and the patient was discharged on the fourth day after the operation. TEVDAR may be safe and effective in preventing progression of the aortic flap and the formation of a new intimal tear in type A aortic dissections. Optional hybrid interventions could ameliorate the outcomes in aortic dissection cases.     

Imaging findings and endovascular management of iatrogenic hepatic arterial injuries

Iatrogenic hepatic arterial injuries (IHAIs) include pseudoaneurysm, extravasation, arteriovenous fistula, arteriobiliary fistula, and dissection. IHAIs are usually demonstrated following percutaneous transhepatic biliary drainage, percutaneous liver biopsy, liver surgery, chemoembolization, radioembolization, and endoscopic retrograde cholangiopancreatography. The latency period between the intervention and diagnosis varies. The most common symptom is hemorrhage, and the most common lesion is pseudoaneurysm. Computed tomography angiography (CTA) is mostly performed prior to angiography, and IHAIs are demonstrated on CTA in most of the patients. Patients with IHAI are mostly treated by coils, but some patients may be treated by liquid embolic materials or stent-grafts. CTA can also be used in the follow-up period. Endovascular treatment is a safe and minimally invasive treatment option with high success rates.Iatrogenic hepatic arterial injuries (IHAIs) arising from percutaneous interventions, laparoscopic or open surgery include pseudoaneurysm (PA), extravasation, arteriovenous fistula (AVF), arteriobiliary fistula (ABF), and dissection (1–3). AVF can occur between hepatic artery and hepatic vein or between hepatic artery and portal vein, called arterioportal fistula (APF). Percutaneous interventions seem to have a higher incidence of IHAIs than surgery (4). The incidence of IHAIs is more than the incidence of traumatic hepatic arterial injuries (5). Hemorrhage following an invasive upper abdominal procedure such as hepatic, pancreatic, and biliary intervention may indicate an IHAI that requires early diagnosis and treatment. Angiography is not only the gold standard imaging modality but also the first suggested treatment option with the advantage of endovascular treatment (6).The etiologies of IHAIs are percutaneous transhepatic biliary drainage, percutaneous liver biopsy, liver surgery (pancreaticoduodenectomy, laparoscopic cholecystectomy, and mass excision), transcatheter chemoembolization, transcatheter radioembolization, and endoscopic retrograde cholangiopancreatography (1–3). Mean latency period between the intervention and the diagnosis of IHAI varies. The symptoms are hemorrhage, hemobilia, and pain. Computed tomography angiography (CTA) is mostly performed prior to angiography, and IHAIs are demonstrated on CTA in most patients. Due to technical limitations of the CTA, IHAI cannot be clearly demonstrated in some patients; however, CTA can show perihepatic hematoma in these patients. CTA findings and hemodynamic status of the patients are considered to determine the indication for angiography.