Mustafa Cihat Avunduk

The comparison of efficacies of topical corticosteroids and nonsteroidal anti-inflammatory drops on dry eye patients: a clinical and immunocytochemical study

PURPOSE To investigate whether conjunctival inflammation represents a primary event in the pathogenesis of keratoconjunctivitis sicca or whether it is a secondary inflammatory reaction caused by enhanced mechanical irritation as a result of surface dryness and whether anti-inflammatory drops (corticosteroids and nonsteroidal anti-inflammatory) have therapeutic effects and are similar. DESIGN Single-masked, randomized, prospective clinical trial. METHODS Thirty-two keratoconjuctivitis patients with or without Sjögren syndrome were included in the study. The patients were randomized to three groups. Group 1 patients received a topical artificial tear substitute (ATS); group 2 received ATS plus nonsteroidal anti-inflammatory drops (NSAID); and group 3 received ATS plus topical corticosteroidal drops. The eye symptom severity scores, Schirmer test values, rose bengal and fluorescein staining scores were evaluated before treatment and 15 and 30 days after start of treatment. Impression cytology specimens were stained using immunohistochemical methods to detect the percentages of human leukocyte antigen II (HLA-DR) positive, Apo 2.7 positive, and periodic acid-Schiff positive cells. Statistical analyses were performed within and between groups. Group 3 patients had significantly lower symptom severity scores, fluorescein and rose bengal staining, and HLA-DR positive cells on days 15 and 30 compared with patients in other groups. They also had a significantly higher number of periodic acid-Schiff positive (goblet) cells in their impression cytology specimens on days 15 and 30 compared with the other patients. On day 30, group 3 patients had significant differences compared with their baseline measurements in terms of above-mentioned parameters. However, we did not detect a significant effect of any treatment schedule on the Shirmer test value and the numbers of Apo 2.7 cells in impression cytology specimens. CONCLUSION Topical corticosteroids had a clearly beneficial effect both on the subjective and objective clinical parameters of moderate-to-severe dry eye patients. These effects were associated with the reduction of inflammation markers of conjunctival epithelial cells.

Effect of different finishing techniques for restorative materials on surface roughness and bacterial adhesion

STATEMENT OF PROBLEM The formation of biofilm and bacterial accumulation on dental materials may lead to the development of gingival inflammation and secondary caries. PURPOSE The purpose of this study was to examine the effect of different surface finishing and polishing methods on surface roughness and the adhesion of S. mutans bacteria to 2 new-generation indirect composite resins, 1 direct composite resin, and 1 ceramic material. MATERIAL AND METHODS Forty specimens (10 x 10 x 2 mm) of each material, indirect composite resins (SR Adoro, Estenia), direct composite resin (Tetric), and a ceramic material (VITABLOCS Mark II), were fabricated. Specimens were divided into 4 groups (n=10) that were treated with 1 of the following 4 surface finishing techniques: diamond rotary cutting instrument, sandpaper discs (Sof-Lex), silicone-carbide rubber points (Shofu), or a felt wheel with diamond paste. Surface roughness was measured with a profilometer. Test specimens were covered with artificial saliva and mucin to produce pellicle. Bacterial suspension (10(9) CFU/ml) was then added to the pellicle-coated specimens, and bacterial adhesion was determined using a confocal laser microscope and image analyzing program. Data were analyzed with 2-way ANOVA, followed by Tukey HSD test, Pearson correlation, and regression analysis (alpha=.05). RESULTS The highest surface roughness values were recorded in SR Adoro and diamond rotary cutting instrument groups. The lowest vital S. mutans adhesion was seen in the ceramic group and in SR Adoro indirect composite resin (P<.05). CONCLUSIONS Bacterial adhesion to indirect composite resin materials differed from that to ceramic material after surface treatments. A positive correlation was observed between surface roughness and the vital S. mutans adhesion.

Cyclosporine Effects on Clinical Findings and Impression Cytology Specimens in Severe Vernal Keratoconjunctivitis

Purpose: To investigate the possible effects of topical cyclosporine eye drops 2% (CsA) on conjunctival immune cells obtained by impression cytology technique and to determine the clinical relevance of this effect if present. Methods: Ten consecutive patients with severe, resistant, and active vernal keratoconjunctivitis (VKC) were included in this study. All of them were treated with 2% of topical CsA drops. Symptom and clinical scores and conjunctival impression cytology specimens were obtained both before and following treatment. Impression cytology specimens were stained with anti-CD8+, CD4+, CD45RA+, and CD23+ antibodies and the percentages of positive cells were counted. The results were compared and correlation analyses were performed between clinical and laboratory data. Results: Significant reductions were observed with respect to the percentages of CD4+ and CD23+ cells in the conjunctival impression cytology specimens and clinical and symptom scores following treatment with topical CsA, while no change occurred in the percentages of CD8+ and CD45RA+ cells. The percentages of CD4+ and CD23+ cells showed good correlations with symptom and clinical scores. Conclusion: Topical CsA treatment is a very effective alternative in severe VKC cases in clinical ground and clinical efficacy of topical CsA treatment in severe, resistant VKC cases can be (at least partly) related to reduction of the CD23+ and CD4+ cell populations on the conjunctival surface.

Effectiveness of MeroGel hyaluronic acid on tympanic membrane perforations

Conclusions. Our results support the proposition that hyaluronic acid (HA) provides a moist wound-healing environment to aid in the healing process of tympanic membrane perforation. A single MeroGel administration can be effective as well as daily topical HA application in the treatment of tympanic membrane perforations. A single application of esterified HA may be more suitable for patients and also for otolaryngologists. Objective. The purpose of the present study was to evaluate the effectiveness of a single MeroGel application on traumatic tympanic membrane perforations in rats. Materials and methods. The posterior quadrant of the tympanic membranes in both ears of 24 male pathogen-free Sprague-Dawley rats was perforated with a 20-gauge needle. Subjects were divided into two groups: MeroGel and daily topical HA-treated groups. All subjects were sacrificed and histopathological examinations of the tympanic bullas were carried out. Results. Perforations of controls, and MeroGel- and daily HA-treated groups closed in 17/24 (70.8%), 11/12 (91.7%), and 12/12 (100%) ears, respectively. There was a significant difference between control and MeroGel-treated groups, and also between control and daily topical HA-treated groups for the presence of vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF), lymphocytes and collagen fibrils (p<0.05), whereas there was no significant difference between MeroGel- and daily topical HA-treated groups (p>0.05).

Effects of melatonin on spermatogenesis and testicular ischemia-reperfusion injury after unilateral testicular torsion-detorsion

PURPOSE This study aimed to determine the effect of melatonin in preventing ischemia-reperfusion (I-R) injury-induced tissue damage and on spermatogenesis after experimental testicular torsion (TT). METHODS Forty peripubertal rats were divided into 4 groups each containing 10 rats: control (C), sham (S), torsion plus detorsion (TD), and torsion plus melatonin (M). The left testes were rotated 720 degrees for 6 hours and detorsed for 6 hours thereafter. Serum inhibin B (IB) levels were measured in blood samples taken from all groups. Left orchiectomies were performed to determine the tissue levels of Johnsens scores (JS) and malondialdehyde (MDA). RESULTS Serum IB levels in the S and TD groups were significantly lower compared with that in the C group, whereas they were higher in the M group compared with the TD group. The MDA levels were significantly lower in the C, S, and, M groups compared with the TD group. Johnsens scores were significantly higher in the C, S, and M groups compared with the TD group. CONCLUSIONS Our results suggested that melatonin is a potent antioxidant agent in preventing testicular I-R injury, as shown by increased IB levels and JS.

Mechanisms and comparison of anti-allergic efficacy of topical lodoxamide and cromolyn sodium treatment in vernal keratoconjunctivitis

PURPOSE To explore the mechanism of action of topical lodoxamide and cromolyn sodium treatment in vernal keratoconjunctivitis (VKC) and to compare the efficacy of these drugs to each other. DESIGN Single-investigator, masked, randomized, clinical trial. PARTICIPANTS Twenty male and 10 female patients between the ages of 6 and 19 years, who were diagnosed as having active VKC, were enrolled in this study. INTERVENTIONS The patients were randomly divided into two equal groups (groups A and B). Group A patients received topical lodoxamide ophthalmic solution 0.1% (LOS); topical cromolyn sodium ophthalmic solution 4% (CSO) was prescribed to group B patients in a dose of two drops four times daily. MAIN OUTCOME MEASURES The eye symptom severity scores and clinical signs of the patients were evaluated both in the pre- and post-treatment periods. In addition to the clinical data, conjunctival impression cytologic specimens were obtained from patients both before and after treatment. Impression cytologic specimens were stained using immunohistochemical methods to detect the percentages of CD4(+), CD8(+), CD45RA(+), and CD23(+) cells. Statistical analyses were performed within and between groups. RESULTS The percentages of CD4(+) and CD23(+) cells in tear samples of patients in groups A and B were significantly higher in the pretreatment stage than post-treatment stage. In the post-treatment stage, group A patients had significantly lower CD4(+) and CD23(+) cell values compared with group B patients. Patient symptom scores and clinical signs were at a significantly lower level after treatment with either LOS or CSO in both groups A and B compared with their pretreatment values. Moreover, group A patients had significantly lower symptom scores and clinical signs than group B patients in the post-treatment stage. CONCLUSIONS Clinical superiority of LOS over CSO may be linked to its greater effect on the CD4(+) cells, because CD4(+) cells plays a pivotal role in the pathogenesis of VKC.

Pathologic changes in soft tissues associated with asymptomatic impacted third molars.

OBJECTIVE The aim of this study was to examine the need for routine removal of asymptomatic impacted third molars under the prophylactic indication, based on the incidence of pathologic changes. The frequency and type of pathologic conditions associated with impacted third molars were also evaluated. STUDY DESIGN One hundred twenty impacted third molar dental follicles were submitted for histopathologic examination. The association between dental follicles and pathologic changes, age, gender, and angular position were statistically evaluated. RESULTS Among these dental follicles, pathologic conditions were found in 23%. The relation between pathologic changes and angular position was not statistically significant (chi(2) = 2.040; P > .05). Pathologic changes were seen mostly in women who were > or = 20 years old. CONCLUSIONS Cystic changes may be developed in asymptomatic impacted third molars. Asymptomatic impacted third molars should be removed before pathologic changes can occur.

Effects of Gender on the Severity of Sepsis

PurposeTo investigate the differences between male and female rats and the effects of sex hormones on tissue changes in the lung and liver in a sepsis model.MethodsSixty Sprague-Dawley rats were divided into six groups of ten. Groups 1 and 2 were the control male and female groups, respectively, subjected only to sepsis; groups 3 and 4 were the male and female groups, respectively, subjected to sepsis, then given 0.04 mg/kg estrogen + progesterone (E-P) intramuscularly (i.m.); and groups 5 and 6 were the male and female groups, respectively, subjected to sepsis, then given 0.5 mg/kg testosterone (T) i.m. The rats were killed and the histopathological changes in the lung and liver were examined, and plasma endotoxin levels were measured.ResultsHistopathological examination revealed less congestion, portal inflammation, and focal necrosis of the liver, and less congestion, edema, and emphysematous and inflammatory changes in the lung in the E-P groups than in the other groups. Moreover, signs of systemic endotoxemia in plasma were proportionally less in the female rats and in the E-P groups than in the male rats and the T groups.ConclusionFemale rats subjected to sepsis showed less liver and lung tissue damage and less systemic endotoxemia than male rats, because of the effects of female sex hormones.

Effects of recombinant human erythropoietin on mandibular distraction osteogenesis.

PURPOSE To evaluate the effects of subcutaneous administration of recombinant human erythropoietin (rHuEPO) on regeneration formation and quality during mandibular distraction osteogenesis. MATERIALS AND METHODS Sixteen adult male New Zealand rabbits were used in this study. Ethical approval was obtained from the Animal Research Institute of Selcuk University, Konya, Turkey. Subjects were randomly divided into 2 groups. Distraction osteogenesis (DO) was performed with a custom-made distractor on the left mandibles of rabbits. In the experimental group, 4 doses of 150 IU/kg rHuEPO were administered at 48-hour intervals. The first dose was given immediately after surgery. Control subjects received 0.5 mL/kg isotonic solution in the same manner. After 2 days of latency, mandibles were distracted 1 mm/day at 12-hour intervals for 5 days. A 5-mm lengthening was achieved. All animals were sacrificed after 30 days of consolidation. Afterward, samples were prepared for histomorphometric evaluation of newly formed bone area. RESULTS The number of osteoblasts and blood vessels was significantly higher, whereas the number of osteoclasts was significantly lower, in the experimental group than in the control group (P < .05). In the experimental group, the area of new bone formation was greater than in the control group (P < .05). Moreover, fibroblast and collagen numbers per unit area were higher in the experimental group. However, this finding was not statistically significant (P > .05). CONCLUSION The subcutaneous administration of rHuEPO improves the rate and quality of bone-healing during distraction osteogenesis. However, the short-term favorable effects of rHuEPO in this study should be extended with long-term investigations before clinical application.

Haemostatic role and histopathological effects of a new haemostatic agent in a rat bladder haemorrhage model: an experimental trial

To investigate the haemostatic efficacy and histopathological effects of a new haemostatic agent, Ankaferd BloodStopper® (ABS; Ankaferd Drug Cosmetic Co., Istanbul, Turkey) in a rat bladder haemorrhage model. ABS is a unique combination of five plant extracts that has been used in Turkish traditional medicine as a haemostatic agent for external traumatic bleeds.