Maxillary advancement with internal distraction device in cleft palate patients

This study aimed to evaluate the results of maxillary advancement by using internal Le Fort 1 distractors on six patients with unilateral cleft lip and palate who had maxillary hypoplasia.The retrognathic maxilla of five patients were protracted with distractor bilaterally, and asymmetric advancement was performed in one patients. A removable intraoral acrylic appliance was used as an anchorage appliance in two patients, and Ragno fan-type expander appliance was used in the others to prevent maxillary collapse during the distraction period. The maxilla of one patient was not distracted successfully due to the maxillary collapse in result of breaking the removable anchorage appliance away. Lateral cephalograms were evaluated before 3 and 12 months after distraction.A desired level of advancement was attained in five patients. In one patient distraction was not performed due to the maxillary collapse. In one of the five patients with a wide oronasal fistula, the size of the fistula was decreased with asymmetric advancement of right and left maxillary segments. Following the retention period of 12 months, the results were stable.It was concluded that effective and easy distraction is possible with internal Le Fort 1 distractors in cleft lip and palate patients who requires maxillary advancement.     

Predictors of response and relapse in a cohort of adults with thrombotic thrombocytopenic purpura-hemolytic uremic syndrome: a single-institution experience

BACKGROUND: Thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS) is a diagnosis of exclusion when a patient presents with the sine qua non findings of thrombocytopenia and microangiopathic hemolytic anemia without an identifiable cause. Although most patients respond to therapeutic plasma exchange (TPE), a significant number of patients relapse. The aim was to determine if clinical, laboratory, and/or treatment features could predict response and/or relapse. STUDY DESIGN AND METHODS: This study was a retrospective review of adults with TTP-HUS treated with TPE at our institution from January 1996 to February 2004. RESULTS: The study population consisted of 90 patients (69% female) with mean age of 45 years and mostly obese (65%). The majority of cases were considered idiopathic. Ten patients died (11%) from the disease before achieving a response, whereas 79 percent were considered responders. Obesity and severe anemia at presentation were predictors of response to TPE (p = 0.0126 and p = 0.0071, respectively). Among the responders, 28 percent relapsed in a median of 14 months. Male sex, severe thrombocytopenia (mean +/- SD, 13 x 10(9) +/- 8 x 10(9)/L), and higher lactate dehydrogenase pre-/posttreatment ratio were associated with relapse (p values of 0.0141, 0.0199, and 0.0407, respectively). ADAMTS-13 values were not obtained on enough number of patients to provide important data. CONCLUSION: Although patient and laboratory characteristics associated with response and relapse were identified, there was significant overlap between patient groups. Thus, our findings offer preliminary evidence and do not yet justify short- or long-term changes in the management of patients with TTP-HUS.     

The role of periodontal mechanoreceptors in mastication

The aim of this review is to discuss what is known about the reflex control of the human masticatory system by the periodontal mechanoreceptors and to put forward a method for standardised investigation. To deliver mechanical stimulus in a reproducible way, the following precautions are suggested: the stimulus should be brought into secure contact with the area of stimulation, and slack between the probe and the area to be stimulated should be taken up by the application of a preload. It is also important to ensure that there is minimal simultaneous activation of receptor systems other than the periodontal mechanoreceptors. It is also necessary to standardise the method for recording and analysing the response.     

Corneal endothelial changes in long-term cannabinoid users

Purpose: The aim of this study was at evaluating the effects of long-term cannabis use on the corneal endothelial cells with the specular microscopy.

Methods: The study enrolled 28 eyes of 28 patients diagnosed with cannabinoid use disorder. The cannabinoid group was selected among patients who had been using the substance for three days or more per week over the past one year. Thirty-two eyes of 32 age- and sex-matched healthy individuals enrolled as control group in the study. Corneal endothelial cell density (CD), coefficient of variation (CV) and hexagonal cell ratio (HEX) values were analyzed by specular microscopy.

Results: The mean CD was 2900?±?211 cells/mm² in the cannabinoid group and 3097?±?214 cells/mm² in the control group (p?p?>?0.05). No significant difference was present between the cannabinoid and the control groups in terms of mean CV value. The mean HEX was 52?±?5% in the cannabinoid group and 53?±?10% in the control group (p?>?0.05). There was not a significant difference between the cannabinoid and the control groups in terms of mean HEX value.

Conclusion: A significant decrease in CD was found in cannabinoid users compared the control group.     

Histopathological changes in thyroid tissue after fine needle aspiration biopsy

Fine needle aspiration biopsy (FNAB) is a method that is frequently used in the diagnosis for neoplastic and non-neoplastic thyroid lesions. However, despite the contribution of this method to diagnosis, varying degrees of histopathological alterations in thyroid tissue occur due to the trauma caused by the aspiration needle. In this study, we compared the histopathology of the thyroidectomy specimens obtained by FNAB with the specimens obtained without the use of FNAB. A hundred and fifty thyroidectomy specimens obtained by FNAB were compared histopathologically with 150 thyroidectomy specimens (control group) obtained without a FNAB procedure. The thyroidectomy specimens were evaluated for hemorrhage, fibrosis, siderophagia, vascular thrombosis, vascular proliferation, infarction, granulation tissue, cystic degeneration, papillary hyperplasia, nuclear atypia, mitosis, calcification, vascular invasion, capsular distortion (pseudoinvasion), cholesterol clefts, and the presence of metaplasia. The thyroidectomy specimens obtained by FNAB had rates of hemorrhage, siderophagia, granulation tissue, papillary hyperplasia, fibrosis, calcification, capsular distortion, cholesterol clefts (P<0.001), and vascular thrombosis (P=0.001) that were statistically significantly higher than those obtained without FNAB. However, there were no clinically significant differences between the two groups in terms of vascular proliferation, nuclear atypia, mitosis, infarction, and oncocytic and squamous metaplasia. Alterations in thyroid tissue in association with FNAB show a considerable variation. Some of the alterations make diagnosis difficult, even leading to misdiagnosis in favor of carcinoma. Therefore, a thorough knowledge of possible alterations is essential to the differential diagnosis.     

Smoking habits of the elementary school teacher students in education faculty and related factors

In this study we aimed to determine the smoking habits of the elementary school teacher students and to examine the factors affecting smoking. The prepared questionnaires were applied to 3rd and 4th year students by selecting randomly. The ratio of the students smoking regularly and occasionally was 45.8%. The smoking frequency was higher in male and fourth year students [63 (53.8%) of males, 85 (41.3%) of females (p< 0.05); 102 (52.3%) students in 4th year and 46 (35.9%) students in 3rd year (p< 0.01)]. The most common reason of not smoking was the harmful effect of smoking to life (45.8%), the most common reason of initiating smoking was to decrease their stress (43.1%) and the most common reason to keep on smoking was difficulty of quitting (56.7%). When compared to nonsmokers, the smoking frequency of mothers, brothers, all family members and close friends of smoker students were higher (p< 0.05). There was significant difference between depression symptom scores of the students who were smoking and the ones who were nonsmokers (14.9 +/- 7.6 in smokers, 9.8 +/- 6.3 in nonsmokers; p< 0.05). The smoking frequency among school teacher students was very high. The smoking habits of close friends, regular alcohol intake, and presence of depressive symptoms were increasing the risk of smoking. It will be beneficial for public health to plan and apply appropriate education program for students who will be the first teachers of the primary school students, not to start smoking.     

Association of increased QTc dispersion and right ventricular hypertrophy.

BACKGROUND: There have been reports demonstrating an association between increased QT dispersion and ventricular arrhythmia in a variety of pathological cardiac conditions, including left ventricular hypertrophy. However, there are limited data about an association of right ventricular hypertrophy (RVH) and corrected QT (QTc) dispersion. MATERIAL/METHODS: Eighty-five persons who emigrated from a high-altitude region (2800-4200 m) of Afghanistan to Van, Turkey, (altitude: 1700-1800 m) 25 years ago were referred to our hospital for transthoracic examination between April 2003 and May 2007. RVH was detected in 37 of the persons, 12 of whom were not included in the study due to coexisting systemic hypertension, COPD, or pulmonary hypertension. Twenty-five individuals of the same population with normal echocardiographic findings were enrolled as the control group. Symptoms that may be consequent to arrhythmia (such as palpitation, dizziness, and syncope) were not reported by the study population. Twelve-lead electrography was performed to measure the heart rate, QTc intervals, and QTc dispersion values. RESULTS: The age and gender of both the patient and control groups were similar. There was no significant difference between patients and controls with respect to QTmax, QTmin, and heart rate. However, mean QTc dispersion values were significantly increased in patients with RVH compared with the control group (59.0+/-14.7 vs. 35.9+/-11.4 ms, p<0.001). CONCLUSIONS: Right ventricular hypertrophy is associated with an increase in QTc dispersion.     

Development of controlled release sildenafil formulations for vaginal administration

Sildenafil is an active substance that has already been approved by FDA for human use. It is known to be an active compound for the treatment of sexual dysfunction in men. Some encouraging results have been published concerning the treatment of infertility with sildenafil in women, but there is no pharmaceutical preparation available. Therefore, various formulations were prepared and the most suitable sildenafil release was found to be with the sildenafil-containing suppositories prepared using Eudragit RS100 and Witepsol H15. The vaginal insert with EVAC 210 polymer containing sildenafil has also provided sildenafil release for a longer period.