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In implant-supported prosthetic treatments, the jaw bones may not always have enough bone to accommodate implants. Allogeneic grafts can also be preferred as an alternative to autogenous grafts in cases of vertical and horizontal bone deficiencies. The aim of this study is to evaluate the osseointegration levels of lathe-faced titanium implants placed together with allogeneic bone tissue transplants obtained from tibia, femur, and mandible bones using a biomechanical method. Twenty-eight female Sprague Dawley rats were included in the study. The subjects were divided into groups where bone transplantations were performed together with implant placement from the tibia (n=7), femur (n=7), and lower jaw (n=7) regions. Four rats (left and right) were used as donors. Grafts, along with implants, were surgically placed in the corticocancellous part of the metaphyseal parts of the tibia bones of rats. At the end of the 2-week experimental setup, all rats were killed, and the implants and surrounding bone tissues were subjected to biomechanical reverse torque analysis (N/cm), no statistical difference was detected in terms of bone-implant fusion between the groups in which the femur and tibia bones were transplanted (P>0.05), while the bone-implant fusion value in the group in which the lower jaw bone was transplanted was found to be statistically higher than the femur and tibia bones (P<0.05). Based on the limited results of this study, it can be thought that the lower jaw allogeneic jawbone has a higher osseointegration potential than allogeneic grafts obtained from the femur and tibia., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Introduction: Bone regeneration depends on vascularization in the pertaining site. This study aims to investigate autogenous bone grafts mixed with recombinant human vascular endothelial growth factor (rhVEGF) effect on bone regeneration in rat mandibular bone defect., Material Methods: Using 32 Wistar Albino rats, our experimental study consists of 4 groups: Group1 (control group), the defect was empty; Group 2, autogenous bone graft only; Group 3, gelatin sponge plus rhVEGF applications; Group 4, autogenous bone graft plus rhVEGF applications. The rats were sacrificed on the 28th day after the operation. New bone regeneration was analyzed histologically and immunohistochemically., Results: Our histological analyses revealed that new bone regeneration in Group 3 was enhanced in comparison to Group 1 and Group 2. However, autogenous bone grafts combined with rhVEGF provided the best outcome in conjunction with the increased remodeling of the new bone., Conclusions: In the light of our results, it can be concluded that autogenous bone grafts in combination with rhVEGF can, potentially, enhance neovascularization and bone regeneration., Competing Interests: The authors report no conflicts of interest., (Copyright © 2020 by Mutaz B. Habal, MD.)

Objectives: To evaluate the effects of certolizumab, a pegylated monoclonal antibody to tumor necrosis factor α (TNF-α), on experimentally induced acute pancreatitis., Methods: Healthy Wistar Albino male rats (n = 36) were randomly divided into 4 groups (9 rats in each group): group 1, control group; group 2, certolizumab group; group 3, cerulein group; and group 4, cerulein + certolizumab group. Acute edematous pancreatitis was induced via intraperitoneal injection of 80-μg/kg cerulein (20 μg/kg, 4 times at 1-hour intervals) in groups 3 and 4. Certolizumab (10 μg) was intraperitoneally administered in groups 2 and 4. Serum levels of amylase, lipase, TNF-α, and lactate dehydrogenase were evaluated. Histopathology and immunohistochemistry of the pancreatic tissue for assessing the activities of malondialdehyde, myeloperoxidase, TNF-α, and caspase-3 were also performed after 72 hours., Results: Certolizumab treatment significantly decreased the serum levels of amylase, lipase, and lactate dehydrogenase. Histopathological edema, hemorrhage, parenchymal necrosis, and infiltration scores were also decreased, along with a decrease in malondialdehyde, myeloperoxidase, TNF-α, and caspase-3 activities., Conclusion: This study suggests that certolizumab is a beneficial treatment mode for reducing the severity of acute pancreatitis.

Objectives: Diabetes mellitus (DM) is a global epidemic with increasing prevalence. The disease is chronic in nature, and patients must use antidiabetic drugs or insulin during their lifespan. Because of the difficulty of using injectable insulin preparations, patients and practitioners prefer to use oral antidiabetic drugs for prophylaxis and treatment. There are, however, numerous adverse effects of antidiabetic drugs and rapidly increasing attention is being paid to new nutraceutical drugs with fewer adverse effects. The purpose of this study was to evaluate the effects of caffeine and lycopene on streptozotocin (STZ)-induced DM in rats., Methods: Caffeine and lycopene were administered to the study groups by oral gavages for 1 month whereafter experimental diabetes was induced in 90 rats in 6 groups., Results: There were no pathological effects of lycopene and caffeine on the pancreas. Marked vacuolization and degeneration were observed in STZ-treated groups. Caffeine and lycopene decreased the pathological findings and lowered the blood and urine glucose levels in the rats with STZ-induced DM, whereas these compounds increased serum insulin levels., Conclusions: This study showed that caffeine and lycopene provided protective effects against experimentally induced DM. The protective effects of lycopene were observed to be much greater than those of caffeine.

Purpose: The aim of this study was to investigate the relationship between volume-based quantitative PET parameters and survival in patients with malignant pleural mesothelioma (MPM) and to evaluate the potential value of bone marrow (BM) uptake in predicting prognosis., Materials and Methods: We retrospectively reviewed the data of 51 patients with MPM who underwent initial staging by fluorine-18-fluorodeoxyglucose (F-FDG) PET/computerized tomography (PET/CT). F-FDG-PET images were visually and quantitatively re-evaluated and maximum standardized uptake values (SUVmax), mean standardized uptake values (SUVmean), metabolic tumor volume (MTV), total lesion glycolysis of primary tumors, and pleural thickening were calculated. In addition, BM and liver uptakes were measured; also, the degree of BM uptake was scored visually. BM/liver ratio and visual BM uptake score were noted. The correlations between quantitative PET parameters, BM uptake, and overall survival were analyzed., Results: F-FDG-PET scans upstaged 6 (11.8%) of 51 patients because of detection of previously unknown distant metastasis. On univariate analysis, advanced disease stage, high leukocyte count (≥10×10/ml), pleural thickening greater than 13 mm, SUVmax, SUVmean, MTV, total lesion glycolysis, BM/liver greater than 1.01, and visual score 1 and 2 were negative prognostic factors (P<0.05). In multivariate analysis, SUVmax greater than 8.6 [P=0.027, hazard ratio (HR): 2.961], MTV greater than 112 (P=0.001, HR: 4.861), and visual score 2 (P=0.035, HR: 3.827) were associated independently with a poor prognosis., Conclusion: The presence of distant metastasis is more predictive of survival than PET nodal status in MPM patients. PET/CT has the potential to provide prognostic information in MPM patients and there was a good correlation between overall survival and volume-based PET parameters. Determination of BM uptake may contribute toward the prediction of patient outcome with other quantitative PET parameters.

The design of a diving regulator's mouthpiece increases the risk of a temporomandibular disorder (TMD) in scuba divers. The total weight of a diving regulator is reflected directly on the temporomandibular joint, causing articular and periarticular disorders. In the current study, the prevalence of TMD in scuba divers triggered during diving certification training is investigated. We also aimed to determine the factors that lead to TMD during diving training and clarify the observation that there is an increased incidence of TMD in inexperienced divers. The study was held between 2006 and 2011. Ninety-seven divers were referred with the complaint of pain around temporomandibular area. The divers were classified according to their diving experience. Symptoms and signs of TMD were graded. Fourteen divers were diagnosed with TMD. Temporomandibular disorder was seen more frequently in inexperienced divers than in experienced divers (P = 0.0434). The most prevalent symptom was an increased effort for mouthpiece gripping. Temporomandibular joint tenderness and trigger point activation were the mostly seen physical signs. Thirteen divers had an improvement with therapy. The increased effort for stabilizing the mouthpiece is a recognized factor in TMD development. Attention must be paid to an association of scuba diving with TMDs, especially in inexperienced divers having a scuba certification training.

The authors review their 5 years' experience with endonasal endoscopic repair of the anterior skull base fistulas presenting with cerebrospinal fluid (CSF) rhinorrhea. A total of 12 patients were managed endoscopically between 2004 and 2008. Seven patients (58.3%) had nonsurgical posttraumatic CSF rhinorrhea, 2 patients (16.7%) had CSF rhinorrhea due to surgical/iatrogenic trauma, and 3 patients (25%) had spontaneous onset of CSF rhinorrhea. Radiosurgical correlation for CSF fistula identification was positive in all patients. The most common site of leak was the fovea ethmoidalis. The repair method consisted of an extradural underlay closure of a defect with fascia lata. The largest diameter of a defect to be closed was 15 mm. Immediate results were good in all patients, but later in the follow-up, CSF rhinorrhea recurred in 2 patients, and each patient had a revision 2 times. In the first revisions, transcranial approach was used, whereas in the second revisions endonasal endoscopic route was resorted. The primary closure rate was 83.3%, and the overall closure rate was 100%. The average follow-up period thus far is 21 months. Endonasal endoscopic technique well known to otolaryngologists should be considered as the first choice of surgery in the repair of CSF rhinorrhea because of low morbidity and a higher closure rate. The possibility of revision with the same technique makes this approach ideal for the repair of cranionasal osteodural defects.

This study was undertaken to evaluate and concentrate on the recurrent pleomorphic adenomas (PAs) of the parapharyngeal space. The records of 9 patients treated for recurrent PAs occupying parapharyngeal space were retrospectively reviewed. The study population comprised 6 women and 3 men with a mean age of 51 (range, 35-79 years). Before the first revision surgery, imaging studies and clinical examinations showed 1 solitary mass in 4 patients, 2 solitary masses in 3 patients, and 3 or more masses in 2 patients. After first revision surgery, 4 patients had rerecurrences with multinodular disease. Two of 4 patients underwent radiation therapy (RT), and the other 2 patients underwent second revision surgery, among whom 1 patient underwent third revision surgery, and the other one was also submitted to RT. Overall, 12 reoperations were performed, and at the end of all operations, 4 patients had rerecurrences and residual disease. In conclusion, we recommend RT to patients with multinodular disease, known tumor spillage, and residual tumor in addition to revision surgery. Histopathologic features, surgical resection, relationship to surrounding vital tissues, and postoperative adjuvant radiotherapy are the most important determinants for recurrent PAs.

Objectives: In this study, the effects of adalimumab (ADA), a fully humanized IgG1 monoclonal antibody to tumor necrosis factor α, on experimentally acute pancreatitis (AP) were examined., Methods: Healthy Wistar rats (n = 32) were randomly divided into 4 groups: group 1, AP; group 2, AP + ADA; group 3, control (physiologic saline), and group 4, physiologic saline + ADA (n = 8/group). Acute pancreatitis was induced with a retrograde injection of 3% sodium (Na)-taurocholate into the common biliopancreatic duct. Adalimumab was simultaneously administered at 50 mg/kg intraperitoneally for groups 2 and 4. Physiologic saline was administered instead of Na-taurocholate for non-AP groups. After 24 hours, serum amylase, lactate dehydrogenase, pancreatic myeloperoxidase, and malondialdehyde activities, along with pancreatic histopathology, were examined., Results: Adalimumab treatment significantly decreased serum amylase activity (AP, 2778.25 ± 298.80; AP + ADA, 2143.13 ± 221.69; control, 1541.00 ± 148.39; ADA, 1143.00 ± 256.30 U/L; P < 0.001), lactate dehydrogenase activity (AP, 2978.37 ± 364.65; AP + ADA, 2582.75 ± 164.23; control 931.25 ± 135.93; ADA, 582.62 ± 99.37 U/L; P < 0.001), myeloperoxidase activity (AP, 1.44 ± 0.20; AP + ADA, 0.86 ± 0.01; control, 0.60 ± 0.17; ADA, 0.41 ± 0.00 U/g of wet tissue; P < 0.001), malondialdehyde activity (AP, 16.94 ± 3.98; AP + ADA, 7.66 ± 2.27; control, 9.07 ± 1.00; ADA, 3.58 ± 0.30 nmol/g; P < 0.01), and total histopathologic scores (AP, 2.75 ± 0.16; AP + ADA, 1.50 ± 0.19; control, 0.00 ± 0.00; ADA, 0.00 ± 0.00; P < 0.001)., Conclusions: These results support the idea that adalimumab might be beneficial for severity of AP.

Objectives: Pancreas pathology in subacute endosulfan toxicity and the effect of vitamin C in rabbits were studied., Methods: : Twenty-four rabbits in 4 groups were used. The rabbits in group END were given a daily sublethal dose (1 mg/kg of body weight) of endosulfan in corn oil by oral gavage for 6 weeks. Group END+C received the same dose of endosulfan and also vitamin C (20 mg/kg) every other day. Group OIL+C received oral corn oil daily and vitamin C (20 mg/kg) every other day. Group OIL received corn oil daily by oral gavage throughout the experiment. Serum amylase, lipase, and glucose levels were analyzed 1 week after the last treatment. Histopathological and immunohistochemical methods were used., Results: The amylase levels were normal, but the lipase levels were increased in all the groups. Marked increases in glucose levels were observed in the END and the OIL+C groups. Microscopy examination of the pancreases indicated degenerative changes in the END group. The pancreases of the END+C group were relatively normal in appearance. The immunohistochemistry of the pancreas showed marked decreases in proinsulin-, insulin-, and amylin-secreting cells and slight decreases in glucagon-secreting cells, whereas cells expressing caspase 3 increased., Conclusion: Endosulfan can cause toxic effects on rabbit pancreases, but vitamin C has an ameliorative effect.

Objectives: In this study, we investigated clinically, pathologically, and immunohistochemically the effect of insufficient short-acting insulin treatment on streptozotocin (STZ)-induced diabetes mellitus in rats., Methods: Three groups composed of 10 rats each were studied as follows: (1) a group that received only STZ (50 mg/kg) (STZ group); (2) a group that received 50 mg/kg STZ and, after 12 hours, 8 IU of short-acting insulin treatment (STZ + INS group), repeated every night for 5 days; and (3) a control group. Ketonuria and blood glucose levels were examined every day. Blood was obtained from 2 rats from each group, and necropsy was performed every day during the 5-day period., Results: Hyperglycemia was observed in the STZ and STZ + INS groups 24 hours after, but levels were higher in the STS + INS group than those in the STZ-only group. Histopathology was similar in the STZ and STZ + INS groups, and degeneration was observed in both groups, but immunohistochemistry revealed a more severe reduction in insulin-secreting cells in the STZ + INS group than that in the STZ group. There were no hyperglycemia and histopathological or immunochemical alteration in the control group., Conclusions: This study showed that insufficient short-acting insulin treatment can increase the diabetogenic effect of STZ in rats.