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Especially in the presence of agoraphobia and comorbid conditions, panic disorder causes significant impairment in life quality. Although there are several studies about epidemiology and clinical features, subthreshold symptoms and courses of comorbidity have not been studied sufficiently in panic disorder. The current study assessed the courses of panic disorder and subthreshold panic symptoms in consideration of the major and subthreshold comorbid conditions. Patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-diagnosed panic disorder were assessed using the panic disorder follow-up questionnaire, Panic and Agoraphobia Scale, Hamilton Depression Rating Scale, and State-Trait Anxiety Inventory. Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders was used to determine comorbidity, and all participants were received to 1-year follow-up. Comorbidity assessment showed that the threshold comorbidity decreased, while the subthreshold comorbidity increased at 1-year follow-up. Panic disorder symptom severity was decreased, but subthreshold panic symptoms continued to be present within the course of the illness. Presence of agoraphobia and duration of disease were significantly related with higher Panic and Agoraphobia Scale scores in the second assessment, and these relationships were independent from the treatment process. Even if the comorbidity and the severity of panic decrease with treatment, subthreshold panic and comorbid symptoms may still resist in panic disorder., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Background: Current evidence suggests that high concentrations of pro-inflammatory markers are associated with bipolar disorder characterized by severe impairment during inter-episodic periods, reduced treatment response and persistent subsyndromal symptoms. We tested whether persistent subsyndromal symptoms in euthymic bipolar patients were associated with markers of an ongoing chronic pro-inflammatory process., Methods: Forty-five euthymic bipolar patients (22 with subsyndromal symptoms (BD+) and 23 without subsyndromal symptoms (BD-) and 23 well controls (WC) were recruited for assessment of soluble tumor necrosis factor receptor-1 (sTNF-R1), soluble interleukin-6 receptor (sIL-6R) and soluble interleukin-2 receptor (sIL-2R) concentrations. Soluble cytokine receptor concentrations were assessed using enzyme-linked immunosorbent assay., Results: In comparison to WC, sTNF-R1 concentration was higher in both BD- and BD+ (age and sex adjusted standardized β, respectively: β = 0.34, p = 0.012 and β = 0.41, p = 0.003). Similarly, compared to WC, sIL-6R concentration was higher in both BD- and BD+ (age and sex adjusted standardized β, respectively: β = 0.44, p = 0.001 and β = 0.37, p = 0.008). There was no difference between BD- and BD+ in the concentration of either sTNF-R1 or sIL-6R; plasma concentration of sIL-2R was not analyzed as 75% percent of the samples were non-detectable., Conclusions: Although bipolar patients present with a pro-inflammatory shift compared to well controls, subsyndromal symptoms are not associated with additive increasing effects. Longitudinal studies with larger samples are required to clarify the relationship between illness course and inflammatory markers in bipolar disorder.

In this paper, we investigate the effect of non-uniformities (enlargement of current passage, non-equal surface current densities, etc.) in axial as well as transverse directions of a porous silicon Fabry-Perot (FP) cavity as well as loss nature of bulk silicon on spectral properties of this cavity, even that cavity is created with an anisotropic etching process. Without correct and comprehensive characterization of such cavities by incorporating these non-uniformities and inherent lossy nature of a cavity, detection and identification of biological and chemical molecules by that cavity may yield unpredictable and misleading results. From our simulations, we note the following two key points. First, effects of the refractive index and the thickness of microcavity region of a lossless or lossy FP cavity on resonance wavelength is more prevailing than those of first and last layers. Second, the effect of some small loss inside the FP cavity is not detectable by the measurement of resonance wavelength whereas the same influence is noticeable by the measurement of reflectivity. We carried out some measurements from two different regions on the fabricated cavities to validate our simulation results. From a practical point of view in correct detection and/or identification of lossy biological or chemical vapor by FP cavities, we conclude that not only the measurement of resonance wavelength as well as its shift but also the reflectivity value at the resonance wavelength or some specific wavelengths should be utilized.

Objective: We assessed major cognitive domains in major depressive disorder (MDD) compared to a healthy control group using neurocognitive tests. We hypothesized that lower serum brain-derived neurotrophic factor (BDNF) levels would be associated with poorer neurocognitive performance in patients with major depression and that these associations would be shown in healthy controls as well., Method: Executive functions, sustaining and focusing of attention, memory functions, and verbal fluency were assessed in this study using the Trail-Making Test (TMT), Stroop Color Word Interference Test-TBAG Form (SCWT), Wisconsin Card Sorting Test (WCST), Test of Variables of Attention (TOVA), Auditory Consonant Trigram test (ACTT), Digit Span subtest of the Wechsler Memory Scale (DST), Rey Auditory Verbal Learning Test (RAVLT), and Controlled Oral Word Association Test (COWAT)., Results: The MDD group showed significantly poorer performance than the control group in cognitive functions; they also had lower levels of BDNF than the control group. However, there was no correlation between cognitive performances and BDNF levels except in the TMT, Part B., Conclusions: The current understanding of the importance of neurocognitive assessment and related biological markers in depression is improving. Further studies with larger sample sizes evaluating neurocognitive functions with molecular analyses of BDNF levels may reveal a novel marker for predicting and monitoring neurocognitive deficits in depression., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Purpose: To investigate whether serum anti-müllerian hormone (AMH), follicle stimulating hormone (FSH), or antral follicle count (AFC) are predictive for clinical pregnancy in in vitro fertilization (IVF) patients., Methods: Serum AMH, inhibin B, FSH, luteinizing hormone (LH), estradiol (E2), prolactin, and thyroid stimulating hormone (TSH) levels and AFC of 189 women under 40 years of age were investigated. Pregnant and non-pregnant women were compared., Results: Forty-seven (24.8 %) clinical pregnancies were observed in 189 women. There was no significant difference in terms of mean age, duration of infertility, body mass index, AMH, LH, FSH, E2, TSH, Inhibin B, AFC and total oocyte number between women who did and who did not become pregnant. Additionally, there was no significant difference in clinical pregnancy rates between the quartiles of AMH, FSH and AFC. (P values were 0.668, 0.071, and 0.252, respectively.), Conclusion: Serum AMH and FSH, and AFC cannot predict clinical pregnancy in IVF patients under 40; the pregnancy rate tends to increase as AMH increases, although this remains non-significant.

Purpose of Review: Over the last decade, a number of studies have been published on whether fertility has declined. The purpose of this article is to review the trends in fertility rates and assess how biological, behavioural, social and environmental factors affect fertility rates., Recent Findings: The average total fertility rate (TFR) in Europe is down to 1.5 children per woman, and the perceived ideal family size is also declining. Factors impacting on lower fertility include the instability of modern partnerships and value changes. Fertility depends on natural fecundity but also on a number of behavioural determinants, such as culture, society, economic conditions, living standards and other similar background determinants on individual reproductive behaviour., Summary: Increasing use of infertility treatment and a decline in demographic fertility in some countries have raised concern whether human fecundity is declining or has declined over time. The downward trend in fecundity articulated on numerous occasions over the last decade, seems unsubstantiated as the forecasting agencies such as the United Nations and Eurostat are likely to be right in their medium variant assumption that TFR levels in most countries will rise to 1.5 or above in the decades ahead.

Purpose of Review: Over the past decade, a large number of studies examining the multiple roles of anti-Müllerian hormone (AMH) have been published. The purpose of this article is to focus on the clinical usefulness of AMH in the fields of current gynecological clinical practice., Recent Findings: AMH has entered clinical practice in terms of poor ovarian response definition. It prevents folliculogenesis by reducing follicle sensitivity to follicle-stimulating hormone (FSH), and leads to anovulation when secreted in excess amounts in polycystic ovary syndrome (PCOS). Better results might be obtained in the assisted reproductive technique cycle in the presence of high AMH levels even though FSH is increased in women diagnosed with diminished ovarian reserve. In a more recently published study it has been reported that AMH can also predict the outcome of pregnancy in assisted reproduction., Summary: AMH levels accurately reflect the ovarian follicular reserve and might, therefore, be considered as a sensitive marker of ovarian aging and ovarian reserve. Evaluation of the level of AMH has clinical value in predicting the success of in-vitro fertilization (IVF). Hyper-response/ovarian hyperstimulation syndrome (OHSS) might be anticipated as about 3.5 ng/ml or above. The cycle stability and operator independency make AMH a most appealing single marker of ovarian reserve. Use of AMH to paint tailored stimulation protocol could result in a reduced risk of OHSS, optimized treatment burden and maintained pregnancy rates. Cost-effectiveness of the use of AMH as a single test before initiating an IVF program should be determined.

Although synovial fluid lipids were found to absorb in ultrahigh molecular weight polyethylene (UHMWPE) total joint implants in vivo, their effect on the oxidation of the polymer was not known. Current understanding of the oxidation and oxidative stability of UHMWPE joint implants is focused on the presence or elimination of radiation-induced free radicals, which are long-lived and can react with oxygen over the long term. Recently, we found unexplained oxidation in irradiated and melted UHMWPE components that were exposed to bodily fluids then stored on the shelf despite being free of detectable free radicals at the time of implantation. Thus, we hypothesized that lipids absorbed from the synovial fluid in vivo could initiate and accelerate oxidation of UHMWPE even in the absence of detectable residual free radicals. We found that squalene, a precursor in cholesterol synthesis and a synovial fluid lipid with unsaturated bonds, accelerated oxidation in irradiated and melted UHMWPE under in vitro accelerated aging conditions. This result represents a paradigm shift in our understanding of oxidative stability of UHMWPE and prompts further investigation of in vivo oxidation mechanisms as well as the development of relevant in vitro aging models., (Copyright © 2011 Wiley Periodicals, Inc.)

Objective: Estrogen is suggested to be one of the most important regulators of neuronal function, including neuronal proliferation, survival and plasticity. There is a broad consensus that the loss of ovarian hormones is associated with neurodegeneration in the hippocampus that leads to cognitive impairment., Methods: A total of 8 female rats which were subjected to bilateral ovariectomy were included in this study. After ovariectomy, the rats were housed for 123 days in a standard laboratory. At the end of the 123 days, the rats were euthanized and the brain sections were investigated by conventional light microscopic and electron microscopic techniques., Results: The regular structure of almost all axon extensions was lost. The majority of these extensions had a sawtooth-like appearance in longitudinal section profiles. Especially in transfer section profiles of myelinated axons, some morphological changes were shown which may be matched up with light microscopic findings., Conclusions: Deficiency of estrogen will initially affect microtubule organization. When this organization breaks down, it will physically cause the distribution of the normal structure of axonal plasmalemma. This in turn will lead to the distribution of physical organizations of estrogen and other different types of receptors which are placed in both the membrane and microtubules in the axon., (Copyright © 2011 S. Karger AG, Basel.)

Background: Assaults on health professionals have been an area of burgeoning clinical and political interest in recent years. There is now a body of literature suggesting that violence towards psychiatrists is more common than to other doctors. Thus far the vast majority of research in this area has been conducted in Western European and North American clinical settings. For the first time, this study examines this issue in the context of Turkish psychiatric settings., Objective: (i) The study aims to detect the prevalence of verbal and physical assaults towards psychiatrists in Turkey. (ii) It aims to compare the experience of verbal and physical assaults according to the gender and training experience of psychiatrists. (iii) The paper intends to investigate how psychiatrists reacted to and appraised the experience of violence., Methods: A questionnaire was prepared to evaluate violence towards psychiatrists (adapted from the Overt Agression Scale). The questionaire was administered to psychiatric specialists and residents working in state hospitals, research and training hospitals, mental health hospitals and university psychiatry clinics. A response rate of 93% was achieved with 186 out of 200 psychiatrsits approached completing the study questionnaire., Results: Of all the psychiatrists who responded, 71% reported having experienced verbal or physical assaults during their professional life (verbal assaults only (19.9%), physical assaults only (2.7%) and both (48.4%)). Of these, 26% suffered injury to at least a mild degree. There was no statistically significant difference in terms of gender and workplace. In spite of the extremely high rates of aggression and violence towards psychiatrists, roughly 50% perceived these acts a normal part of their job and only 5% formally reported the violent incident., Conclusion: The majority of psychiatrists described having been victims of verbal and physical assaults although half perceived aggression and violence as a normal part of their job. Levels of reporting of violence were very low in the context of this study. Studies such as this provide evidence to inform the development of improved management of violence and may encourage psychiatrists to report violence.

Background: Osteolysis due to wear of UHMWPE limits the longevity of joint arthroplasty. Oxidative degradation of UHMWPE gamma-sterilized in air increases its wear while decreasing mechanical strength. Vitamin E stabilization of UHMWPE was proposed to improve oxidation resistance while maintaining wear resistance and fatigue strength., Questions/purposes: We reviewed the preclinical research on the development and testing of vitamin E-stabilized UHMWPE with the following questions in mind: (1) What is the rationale behind protecting irradiated UHMWPE against oxidation by vitamin E? (2) What are the effects of vitamin E on the microstructure, tribologic, and mechanical properties of irradiated UHMWPE? (3) Is vitamin E expected to affect the periprosthetic tissue negatively?, Methods: We performed searches in PubMed, Scopus, and Science Citation Index to review the development of vitamin E-stabilized UHMWPEs and their feasibility as clinical implants., Results: The rationale for using vitamin E in UHMWPE was twofold: improving oxidation resistance of irradiated UHMWPEs and fatigue strength of irradiated UHMWPEs with an alternative to postirradiation melting. Vitamin E-stabilized UHMWPE showed oxidation resistance superior to that of irradiated UHMWPEs with detectable residual free radicals. It showed equivalent wear and improved mechanical strength compared to irradiated and melted UHMWPE. The biocompatibility was confirmed by simulating elution, if any, of the antioxidant from implants., Conclusions: Vitamin E-stabilized UHMWPE offers a joint arthroplasty technology with good mechanical, wear, and oxidation properties., Clinical Relevance: Vitamin E-stabilized, irradiated UHMWPEs were recently introduced clinically. The rationale behind using vitamin E and in vitro tests comparing its performance to older materials are of great interest for improving longevity of joint arthroplasties.

Background: Bipolar patients spend up to one third of their lives in depression however, acute treatment guidelines mainly focused on the manic phase of illness. With recent attention to the importance of evidence-based medicine in psychiatry, a number of treatment guidelines have emerged to aid clinicians in clinical decision making. Here, we aim to measure concordance with the Turkish Psychiatric Association Treatment Guideline for Bipolar Disorders (TPATGBD) for the depressive phase of illness., Subjects and Methods: Bipolar patients attending the Rasit Tahsin Mood Disorders Outpatient Unit of Istanbul Bakırköy Research and Training Hospital for Psychiatry, Neurolgy & Neurosurgery, were assessed using standardized forms based on a nation-wide mood disorders follow-up program. Concordance of implementations with the TPATGBD were evaluated step by step for each level of depression severity., Results: Concordance rates with the first step recommendations of the guideline were 29.4%, 27.4% and 87.5% for mild-moderate, moderate-severe (without psychosis) and severe depression (with psychosis), respectively. Concordance rates with the second step recommendations of the guideline were lower for bipolar depressions without psychosis. Overall, adherence to the guideline did not impact on time to remission (p=0.19)., Conclusions: Despite considerable efforts to develop and disseminate evidence-based guidelines, they are not widely followed by clinicians and important opportunities clearly exist to educate clinicians about the feasibility and utility of clinical guidelines for bipolar disorder. Systematic studies in the future are required to clarify our understanding of clinicians' attitudes to the use of guidelines and to explain the discrepancy between guidelines and clinical practice.

Vitamin E (α-tocopherol) is a free-radical stabilizing antioxidant used to maintain oxidative stability in radiation cross-linked ultra-high molecular weight polyethylene (UHMWPE) used in total joint replacements. We investigated the oxidative resistance of vitamin E-stabilized UHMWPE in (i) postirradiation vitamin E-diffused UHMWPE, (ii) vitamin E blended and irradiated UHMWPE, and (iii) unstabilized, irradiated UHMWPE after accelerated aging and real-time aging in an aqueous environment at 40°C for 36 months. Unstabilized samples exhibited substantial oxidation throughout the surface and bulk with both types of aging. While vitamin E-stabilized, radiation cross-linked UHMWPEs were all superior to unstabilized samples, irradiated blends showed surface oxidation and subsurface oxidation potential beginning at ten months in real-time aging. In contrast, postirradiation vitamin E-diffused UHMWPEs showed no detectable oxidation and no increase in oxidation potential despite elution of some vitamin E. We also showed that current thermal accelerated aging methods were unable to differentiate among the oxidative stability of vitamin E-stabilized, radiation cross-linked UHMWPEs prepared by different processes., (Copyright © 2010 Orthopaedic Research Society.)

Objective: Although atypical antipsychotics are well-tolerated and effective treatment options for schizophrenia, they have metabolic side effects, including weight gain and increased risk of Type II Diabetes Mellitus (DM). Adiponectin, produced exclusively in adipocytes, is the most abundant serum adipokine. Low levels of adiponectin are correlated with DM, insulin resistance and coronary heart disease. Usage of atypical antipsychotics may create a risk of metabolic syndrome. The aim of this study was to evaluate the effects of antipsychotic usage on parameters related to development of metabolic syndrome., Materials and Methods: A total of 27 patients (n=27) (13 women and 14 men) were recruited from our out-patient psychiatry clinic. All patients had been treated with atypical antipsychotics for at least 3 months and were in remission. Patients were evaluated for levels of HDL (High Density Lipoprotein), LDL (Low Density Lipoprotein), TG (Triglyceride) total cholesterol and fasting blood glucose, body weight, BMI (Body Mass Index), waist circumference and serum adiponectin levels., Results: Serum adiponectin levels were significantly lower (p:0.000) and body weights were significantly higher (p:0.003) in the patients who had been using atypical antipsychotics for longer than a year in comparison to patients who had been using atypical antipsychotics for one year or less., Conclusion: Our findings supported the hypothesis that the length of administration of atypical antipsychotics has an effect on metabolic changes. They also highlight the fact that when investigating metabolic changes generated by atypical antipsychotic effects, the length of time that the patient has been on the atypical antipsychotics should also be considered.

The scope of this article involved qualitative research conducted together with pregnant women attended by the Brazilian Unified Health System (SUS) and private services, seeking to identify the perception of these women on the role of health professionals in relation to dental care during pregnancy. The data were collected through recorded, semi-structured interviews based on a questionnaire and analyzed by assessment of thematic content. It was noted that some health professionals propagate and reinforce misconceptions and fears about dental care and oral health during pregnancy. The need for investment in education on dental care during pregnancy, both at undergraduate and graduate level, was clearly revealed, since knowledge on the subject can contribute to a review of concepts, and consequently the manifest behavior vis-à-vis this segment of the population.

Radiation crosslinking of ultrahigh molecular weight polyethylene (UHMWPE) has been used to decrease the wear of joint implant bearing surfaces. While radiation crosslinking has been successful in decreasing femoral head penetration into UHMWPE acetabular liners in vivo, postirradiation thermal treatment of the polymer is required to ensure the oxidative stability of joint implants in the long term. Two types of thermal treatment have been used: (i) annealing below the melting point preserves the mechanical properties but the residual free radicals trapped in the crystalline regions are not completely eliminated, leading to oxidation in the long-term and (ii) annealing above the melting point (melting) eliminates the free radicals but leads to a decrease in mechanical properties through loss of crystallinity during the melting process. In this study, we hypothesized that free radicals could be reduced by annealing below the melting point under pressure effectively without melting due to the elevation of the melting point. By avoiding the complete melting of UHMWPE, mechanical properties would be preserved. Our hypothesis tested positive in that we found the radiation-induced free radicals to be markedly reduced (below the detection limit of state-of-the-art electron spin resonance) by thermal annealing under pressure in radiation crosslinked virgin UHMWPE and UHMWPE/vitamin-E blends without loss of mechanical properties., (Copyright © 2011 Wiley Periodicals, Inc.)

Highly crosslinked UHMWPE has become the bearing surface of choice in total hip arthroplasty. First generation crosslinked UHMWPEs, clinically introduced in the 1990s, show significant improvements compared to gamma sterilised, conventional UHMWPE in decreasing wear and osteolysis. These crosslinked UHMWPEs were thermally treated (annealed or melted) after irradiation to improve their oxidation resistance. While annealing resulted in the retention of some oxidation potential, post-irradiation melted UHMWPEs had reduced fatigue strength due to the crystallinity loss during melting. Thus, the stabilisation of radiation crosslinked UHMWPEs by the diffusion of the antioxidant vitamin E was developed to obtain oxidation resistance with improved fatigue strength by avoiding post-irradiation melting. A two-step process was developed to incorporate vitamin E into irradiated UHMWPE by diffusion to obtain a uniform concentration profile. Against accelerated and real-time aging in vitro, this material showed superior oxidation resistance to UHMWPEs with residual free radicals. The fatigue strength was improved compared to irradiated and melted UHMWPEs crosslinked using the same irradiation dose. Several adverse testing schemes simulating impingement showed satisfactory behaviour. Peri-prosthetic tissue reaction to vitamin E was evaluated in rabbits and any effects of vitamin E on device fixation were evaluated in a canine model, both of which showed no detrimental effects of the inclusion of vitamin E in crosslinked UHMWPE. Irradiated, vitamin E-diffused, and gamma sterilised UHMWPEs have been in clinical use in hips since 2007 and in knees since 2008. The clinical outcome of this material will be apparent from the results of prospective, randomised clinical studies.

The objective of this study was to fabricate hydrogel matrix-engineered biosynthetic cartilage using a porous poly(vinyl alcohol) hydrogel (PVA-H) and articular chondrocytes. Chondrocytes were suspended in fibrin gel (FG) or saline carriers and injected into porous PVA-H discs and three-layered constructs (PVA-H between devitalized cartilage). After implantation in nude mice, PVA discs were explanted at 6 weeks and subjected to creep testing for a 20 h period. The three-layered constructs were explanted at 12 weeks and subjected to tensile testing to determine the strength of the interface between the engineered hydrogel and devitalized cartilage. Histological analysis revealed PVA-H porous channels occupied by chondrocytes. Extracellular matrix was identified by Safranin-O and toluidine blue stains. Immunohistochemical analysis revealed a positive stain for COL II and scant staining for COL I. Creep and relaxation response of PVA-FG-chondrocyte constructs was similar to that of native cartilage. The presence of cells and FG significantly enhanced the integration strength of layered constructs (p < 0.05). These results demonstrate that porous PVA-H in combination with FG and chondrocytes provides a favorable microenvironment for tissue engineering of articular cartilage, creating a biosynthetic construct that can adhere to native devitalized articular cartilage utilizing hydrogel matrix-engineered technology.

Introduction: Labial fusion is described as partial or complete adherence of the labia minora. Adhesions of the labia are extremely rare in the reproductive population with only a few cases described in the literature and none reported with pregnancy., Case Presentation: A 24-year-old woman who had extensively fused labia with a pinhole opening at the upper midline with menstrual delay was diagnosed at six weeks of pregnancy. The case and its management are presented., Conclusion: The condition was treated surgically with complete resolution of the urinary symptoms.

Background: Cross-linking has decreased the wear of ultra-high molecular weight polyethylene, a cause of osteolysis leading to total joint replacement failure. Compared with melting or annealing, doping cross-linked ultra-high molecular weight polyethylene with vitamin E stabilizes free radicals from irradiation while maintaining mechanical properties and wear resistance. This study was done to determine the local tissue effects of free vitamin E and vitamin E eluted from ultra-high molecular weight polyethylene implants in the joint space., Methods: Three studies were performed. First, pure vitamin E and solubilized vitamin E were injected into rabbit knees to simulate vitamin-E elution from radiation cross-linked ultra-high molecular weight polyethylene; second, vitamin-E-doped, irradiated ultra-high molecular weight polyethylene plugs were implanted into dorsal subcutaneous pouches of rabbits to determine the local effects of vitamin-E elution from radiation cross-linked ultra-high molecular weight polyethylene; and, third, two groups of vitamin-E-doped, irradiated acetabular liners (high surface and uniform vitamin-E concentration profiles) were compared with undoped, control ultra-high molecular weight polyethylene liners in a canine model of total hip replacement to determine the effect of possible vitamin-E elution on bone ingrowth and the local tissue response to it in a load-bearing environment., Results: Injection of solubilized vitamin E resulted in histologically normal surrounding soft tissue at both two and twelve-week follow-up intervals, while injection of pure vitamin E resulted in acute and chronic inflammation at the time of the two-week follow-up. Both control and vitamin-E-doped subcutaneous plugs showed inflammation associated with surgery at two weeks of follow-up, but showed stable fibrous encapsulation without inflammation at twelve weeks of follow-up. In the canine total hip replacement model, there was no qualitative difference in local tissue appearance and no significant difference in the percent bone ingrowth and the percent bone density between the control and vitamin-E groups., Conclusions: These investigations showed that vitamin-E-doped ultra-high molecular weight polyethylene plugs and total hip replacement components are well tolerated in both a small and a large-animal model with no observed adverse effects on the surrounding tissues at twelve weeks of follow-up.

Background: The pathophysiology of bipolar disorder is not thoroughly understood. Several studies have investigated the possible role of cytokines in psychiatric disorders, based on their role in neuro-immune modulation; however, findings in studies on bipolar disorder remain limited and contradictory, and most studies have focused on either manic or depressive episodes. These studies suggest that both manic and depressive episodes could be pro-inflammatory states. The present study aimed to determine whether there are enduring differences in cytokine levels-unrelated to the effects of medication-between euthymic bipolar patients and healthy controls., Methods: The study included 31 euthymic bipolar patients-16 medication-free (MF) and 15 on lithium monotherapy (LM) and 16 healthy volunteers in whom serum cytokine levels were measured. The 3 groups were homogenous in terms of age, gender, and ethnicity. IFN-γ, TNF-α, IL-2, IL-4, IL-5, and IL-10 levels were measured in all groups using flow cytometry., Results: There were no differences in cytokine levels between MF euthymic bipolar patients and healthy controls. TNF-α and IL-4 levels in LM euthymic bipolar patients were higher than in both the MF euthymic bipolar patients and controls., Limitations: The small and strictly selected study sample could limit the generalizability of the findings., Conclusions: Cytokine production in MF euthymic bipolar patients was similar to that in healthy controls. The present study shows that the pro-inflammatory state resolves in euthymia and that lithium had an influence on the cytokine profile, which could create a confounding factor while investigating disease- related immunopathology of bipolar disorder., (Copyright © 2010 Elsevier B.V. All rights reserved.)

Wear particle-induced periprosthetic osteolysis has been a clinical problem driving the development of wear resistant ultrahigh molecular weight polyethylene (UHMWPE) for total joint replacement. Radiation crosslinking has been used to decrease wear through decreased plastic deformation; but crosslinking also reduces mechanical properties including fatigue resistance, a major factor limiting the longevity of joint implants. Reducing UHMWPE wear with minimal detriment to mechanical properties is an unaddressed need for articular bearing surface development. Here we report a novel approach to achieve this by limiting crosslinking to the articular surface. The antioxidant vitamin E reduces crosslinking efficiency in UHMWPE during irradiation with increasing concentration, thus we propose to spatially control the crosslink density distribution by controlling the vitamin E concentration profile. Surface crosslinking UHMWPE prepared using this approach had high wear resistance and decreased crosslinking in the bulk resulting in high fatigue crack propagation resistance. The interface region did not represent a weakness in the material due to the gradual change in the crosslink density. Such an implant has the potential of decreasing risk of fatigue fracture of total joint implants as well as expanding the use of UHMWPE to younger and more active patients., (Copyright (c) 2010 Elsevier Ltd. All rights reserved.)

We assessed major cognitive domains in symptom-free children of patients with schizophrenia compared to the healthy children of parents with no psychopathology using neurocognitive tests. We hypothesized that, offspring at high-risk for schizophrenia would have significant impairment in major domains: attention, memory, verbal-linguistic ability and executive functions. Thirty symptom-free children (17-males, 13-females; intelligence quotient=99.6+/-13.6; age=12.69+/-2.32 and education=5.8+/-2.3 years) having a parent diagnosed with schizophrenia and 37 healthy children matched for gender (19-males, 18-females), IQ (106.05+/-14.70), age (12.48+/-2.58) and years of education (6.0+/-2.5) were evaluated. The study group showed significant poor performance in cognitive domains, such as working memory (assessed with Auditory consonant trigram test), focused attention (Stroop test), attention speed (Trail making test), divided attention (Auditory consonant trigram test), executive functions (Wisconsin card sorting test), verbal fluency (Controlled word association test) and declarative memory (Rey verbal learning and Short-term memory test). However, no group differences were detected either on verbal attention (Digit span forward test) or sustained attention (TOVA, a continuous performance task); the latter as consistently reported to be a predictor of schizophrenia. In order to determine the cognitive endophenotype of schizophrenia, it seems more rational to conduct comprehensive evaluation of neurocognitive domains in well-matched groups via using sufficiently challenging tests to detect slight deficits. In addition, longitudinal studies with a larger sample size evaluating neurocognitive functions combined with genetic analysis may provide clues about explaining the genetic background of the disorder within the endophenocognitype concept and serve as new targets for early interventions., (Copyright (c) 2010 Elsevier Inc. All rights reserved.)

Objective: To determine the attitudes and behaviors of psychiatrists and psychiatry residents towards pharmaceutical representatives and their promotional activities, and to evaluate the effect of the duration of residency and type of the training institution on these attitudes and behaviors., Method: A validated questionnaire for assessing the attitudes and behaviors of physicians towards the pharmaceutical industry was administered to psychiatrists and psychiatry residents at regional meetings. Of the 1973 participants, 348 responded., Results: Although there was significant interaction between psychiatrists and pharmaceutical representatives, 50.7% of psychiatrists reported that they thought these interactions had no impact on their prescribing practices. First- and second-year residents agreed more than the other residents and the specialist that pharmaceutical representatives provided accurate information and had no effect on physician prescribing practices. First- and second-years residents agreed less than older residents that pharmaceutical representatives used marketing techniques. The psychiatrists regarded most of the pharmaceutical promotions as appropriate. State hospital staff agreed more than the university hospital staff that the pharmaceutical industry should support educational meetings in their institutions., Conclusion: There was intense interaction (3/4)characterized by undefined boundaries (3/4)between psychiatrists and the pharmaceutical industry. Most physicians were not provided any guidelines concerning their interactions with pharmaceutical representatives and there was general concern about the necessity of restricting these interactions.

Bipolar disorder is a severe mental illness that afflicts approximately 1% of the world's population, and is characterized by mood swings from elation to depression. Although the etiology of bipolar disorder remains unclear, heritable factors have been shown to be involved. Family, twin, and adoption studies suggest a genetic etiology. Molecular genetic studies also support a genetic component. Many chromosomal regions have been implicated by these molecular genetic studies, but no single susceptibility gene has been identified. These findings show that bipolar disorder has a complex genetic etiology in which multiple unidentified genes and environmental factors play an important role in its pathogenesis. Herein, molecular genetic studies of bipolar disorder are reviewed based on a search of Medline using the key words, bipolar, genetic, and chromosome. Studies with positive results for bipolar disorder were selected first. The findings from these molecular genetic studies are reviewed systematically, chromosome by chromosome. Causes of the differences between the reported findings and of non-replication are discussed. Finally, important factors for designing a genetic study of bipolar disorder are examined.

Ultrahigh molecular weight polyethylene (UHMWPE) is a bearing surface material for total joint implants. It is radiation cross-linked for high wear resistance and is melted or treated with vitamin E for oxidative stability. We investigated high pressure crystallization (HPC) of irradiated UHMWPE as an alternative method to improve the mechanical strength while stabilizing the residual free radicals from radiation cross-linking. HPC of uncross-linked UHMWPE has resulted in the formation of extended chain crystals and increased crystallinity, leading to improved strength. We hypothesized that increased cross-link density would hinder crystallization during HPC due to decreased chain mobility. Therefore, we investigated the crystalline structure and tensile mechanical properties of high pressure crystallized 25-, 65- and 100-kGy irradiated UHMWPE. We also determined free radical content and wear. The strength of 25- and 65-kGy irradiated UHMWPEs was improved by HPC with increased crystallinity and crystal size. 100-kGy irradiated UHMWPE did not show improved strength, supporting our hypothesis that decreased chain mobility would hinder crystal formation and strength improvement. None of the HPC irradiated UHMWPEs contained detectable free radicals and their wear properties were maintained, suggesting oxidative and mechanical stability in the long term. Therefore, HPC can be used effectively for imparting oxidative stability while strength improvement can be achieved for irradiated UHMWPE with low to moderate cross-link density.

Cardiovascular disease, the leading cause of death in patients with type 2 diabetes mellitus (T2DM), is usually preceded by endothelial dysfunction and altered myocardial blood flow (MBF) regulation. Hyperglycemia, oxidative-nitrosative stress, systemic inflammation, and insulin resistance are implicated in the pathogenesis of abnormal MBF regulation, myocardial ischemia, and apoptosis. However, the impact of oral antihyperglycemic therapy on myocardial perfusion is controversial. Our objective was to explore the effect of rosiglitazone and glyburide on nitrosative stress and MBF regulation in subjects with T2DM. [(13)N]ammonia positron emission tomography and cold pressor testing were used in 27 diabetic subjects (mean age, 49 +/- 11 years; glycohemoglobin, 7% +/- 1.5%) randomized to either rosiglitazone 8 mg/d or glyburide 10 mg/d for 6 months. Isotope dilution gas chromatography-mass spectrometry was used to quantify plasma 3-nitrotyrosine, a stable marker of reactive nitrogen species. At 6 months, there were no significant differences between groups in the mean glycohemoglobin, blood pressure, or plasma lipids. Rosiglitazone significantly reduced plasma nitrotyrosine, high-sensitivity C-reactive protein, and von Willebrand antigen (P < .03 for all) and significantly increased plasma adiponectin (P < .05). No significant changes in these parameters were observed with glyburide. Treatment with glyburide, but not rosiglitazone, resulted in a significant deterioration in both resting and stress MBF. Rosiglitazone, but not glyburide, ameliorated markers of nitrosative stress and inflammation in subjects with T2DM without impairing myocardial perfusion.

Higher crystallinity and extended chain morphology are induced in ultra-high molecular weight polyethylene (UHMWPE) in the hexagonal phase at temperatures and pressures above the triple point, resulting in improved mechanical properties. In this study, we report the effects of the presence of a plasticizing agent, namely vitamin E (alpha-tocopherol), in UHMWPE during high pressure crystallization. We found that this new vitamin E-blended and high pressure crystallized UHMWPE (VEHPE) has improved fatigue strength and wear resistance compared to virgin high pressure crystallized (HP) UHMWPE. This suggested different mechanisms of wear reduction and fatigue crack propagation resistance in UHMWPE.

Schizophrenia is referred to as cerebral lateralisation abnormality. In this study the possible relationships among handedness, eye dominance, and crossed and non congruent hand-eye dominance in patients with schizophrenia are investigated. A total of 88 patients with schizophrenia and 118 controls were included in the study.The patient group included 60 men and 28 women who ranged in age from 17 to 63 years. Diagnoses were made on the basis of information provided from clinical interviews and Structured Clinical Interview for DSM-IV. Handedness was ascertained by using the Edinburgh Handedness Inventory. Eye dominance was measured only by the near-far alignment test. Patients with schizophrenia had a significantly increased frequency of mixed-handedness and decreased frequency of both right- and left-handedness in comparison with controls. Also, the male patients with schizophrenia had significantly increased frequencies of left eye dominance, crossed hand-eye dominance, and non-congruent hand-eye dominance compared to controls, but not the female patients. Cerebral lateralisation abnormalities in schizophrenia may be associated with sex-related hormonal factors.

Background: Children born after in vitro fertilisation (IVF) are under greater risk of development of some health problems than those children born after spontaneous conception. Yet it is not exactly known what the prevalence of asthma and other allergic diseases among these children is., Aims of the Study: To investigate the prevalence of asthma, allergic rhinitis and atopic dermatitis in children born after IVF, and controls born after spontaneous pregnancy using questionnaires of International Study of Asthma and Allergies in Children (ISAAC)., Methods: We recruited 158 children (mean age: 4.60 +/- 2.14 years) born after IVF pregnancies and 102 children (mean age: 5.27 +/- 2.8 years) as control group to investigate the prevalences of asthma, atopic dermatitis and allergic rhinitis. The questions in the questionnaire were asked to the parents by telephone or face to face., Results: Wheezing ever has been reported in 19 % of the children born after IVF and in 17.6 % of the control group (p > 0.05). No significant differences were found between groups, in terms of use of any anti-asthma drugs, physician diagnosed asthma and admission to emergency room with wheezing (p > 0.05). In addition, prevalence of allergic rhinitis and atopic dermatitis were also comparable between two groups (p > 0.05)., Conclusions: Prevalences of asthma, allergic rhinitis and atopic dermatitis are similar in children born after IVF and children born after spontaneous conception.

Electroconvulsive therapy (ECT) is largely historical but is still in use. Modern psychiatry requires careful selection of patients in whom ECT will be performed. The indications for ECT treatment are limited, and the selection criteria should be strictly followed. The advantages and the disadvantages of the methods are discussed here. Despite the limitations, ECT seems to have real value in selected mental conditions in which it can even be considered a life-saving procedure.

Ultra-high molecular weight polyethylene (UHMWPE) is radiation cross-linked to decrease wear in total joint applications. Irradiation decreases the strength of UHMWPE and introduces residual free radicals, which can cause oxidation in the long-term. We advanced a method eliminating the free radicals without a reduction in strength. UHMWPE exhibits a hexagonal phase at high pressure and temperature, where chain mobility in the crystalline phase is increased, leading to the formation of extended chain crystals. We hypothesized that the increased chain mobility during transformation from the orthorhombic to hexagonal phase could be used to eliminate the residual free radicals in irradiated UHMWPE. We eliminated the free radicals in 25-, 65- and 100-kGy irradiated UHMWPE and these materials did not show oxidation after accelerated aging. The ultimate tensile strength and work to failure of 25 and 65-kGy irradiated UHMWPEs were improved significantly while that of 100-kGy irradiated UHMWPE was lower compared to irradiated UHMWPE melted at ambient pressure.

Eliminating postirradiation melting and stabilizing the residual free radicals of radiation cross-linked ultrahigh molecular weight polyethylene (UHMWPE) with vitamin E resulted in improved fatigue crack propagation resistance without compromising wear resistance. We designed a cantilever postbending test to determine the bending fatigue resistance of alpha-tocopherol-doped, irradiated UHMWPE (alpha-TPE) in comparison to conventional UHMWPE. The bending fatigue behavior of alpha-TPE was comparable to conventional UHMWPE. Upon accelerated aging, the fatigue resistance of alpha-TPE was substantially better than that of conventional UHMWPE. alpha-TPE has shown improved wear and oxidation resistance, migration stability of vitamin E, and improved mechanical properties. The use of this material may be beneficial in total knee arthroplasty where its improved fatigue properties may be an advantage under high stresses.

Vitamin E-stabilized, highly cross-linked ultrahigh molecular weight polyethylene (UHMWPE) is a promising oxidation and wear resistant UHMWPE with improved mechanical strength in comparison with the first generation, irradiated and melted UHMWPE. One approach of incorporating vitamin E in UHMWPE is through blending of vitamin E in UHMWPE powder followed by consolidation and radiation cross-linking. However, radiation cross-linking efficiency of UHMWPE decreases in the presence of vitamin E. Therefore an optimum vitamin E concentration and radiation dose level need to be determined to achieve a cross-link density comparable to 100-kGy irradiated and melted UHMWPE, which has shown excellent wear properties in vivo. We investigated the cross-link density and mechanical properties of vitamin E-blended UHMWPEs as a function of vitamin E concentration in the blend and gamma irradiation doses up to 200kGy. We found that 0.3wt% vitamin E-blended UHMWPE could not be cross-linked above a cross-link density achieved at a radiation dose of 65kGy for virgin UHMWPE and 1.0wt% vitamin E-blended UHMWPE could not be cross-linked above a cross-link density achieved at a radiation dose of 25kGy for virgin UHMWPE even when the these UHMWPEs were irradiated to a radiation dose of 200kGy. In addition, higher plasticity at vitamin E concentrations at and above 0.3wt% indicated that increased chain scissioning may be prevalent. Since the wear resistance of this irradiated UHMWPE would be expected to be low, vitamin E concentrations equal to or above 0.3wt% are not recommended for subsequent irradiation to achieve a wear resistant cross-linked UHMWPE. The long-term oxidative stability of irradiated blends with low vitamin E concentrations has yet to be studied to determine an optimum between cross-link density and long-term oxidative stability.

Objectives: Inhibin B reveals Sertoli cell activity. After our previous findings of an increase in inhibin B succeeding classic inguinal orchiopexy, we sought to determine the changes in endocrine parameters after scrotal orchiopexy in patients with cryptorchidism and to compare these findings with the results of classic orchiopexy., Methods: A total of 50 boys with an undescended testis, 32 unilateral and 18 bilateral, were included in the present study. Scrotal orchiopexy was performed in all of them. Before and 6 months after orchiopexy, the serum basal inhibin B and other serum hormonal levels were measured in all patients., Results: The mean serum basal inhibin B levels had significantly increased and the other reproductive hormonal levels had not changed at 6 months after successful scrotal orchiopexy in our 50 patients (P = 0.016). Within the subgroups, the increase in inhibin B levels was significant in only those 2-9 years old with a unilateral undescended testis. The increase in inhibin B in those 10-12 years old with unilateral or bilateral undescended testis resulted from the start of puberty. No significant difference was found in terms of an increase in inhibin B after classic and scrotal orchiopexy., Conclusions: The measurement of inhibin B levels could be used as a follow-up parameter after orchiopexy. The serum inhibin B level increases after scrotal incision orchiopexy just as after classic inguinal orchiopexy. The increased level of inhibin B might indicate that the orchiopexy has been beneficial.

Poly(vinyl alcohol) (PVA) hydrogels are candidate biomaterials for cartilage resurfacing or interpositional arthroplasty devices requiring high-creep resistance and high water content to maintain lubricity. Annealing of PVA improves creep resistance but also reduces the water content. We hypothesized that maintaining poly(ethylene glycol) (PEG) within PVA during annealing would prevent the collapse of the pores and thus would result in high equilibrium water content (EWC). Our hypothesis tested positive. The PVA hydrogels containing PEG maintained their opacity through annealing and exhibited large pores under confocal imaging while hydrogels not containing PEG turned translucent and no pores were visible after annealing. The EWC of gels annealed with PEG (83 +/- 1.0%) was higher than that of the gels processed without PEG (55 +/- 4.8). The crystallinity of the former was 8.0 +/- 1.7% and the latter was 27.5 +/- 8.7%. The hydrogels processed in the presence of PEG exhibited a significantly higher total creep strain (69 +/- 3.4%) when compared to the PEG-free hydrogels (17 +/- 3.7) under an initial contact stress of 0.45 MPa. EWC appeared to be strongly related to the creep resistance of annealed PVA theta-gels.

The motivation for radiation cross-linking of ultra-high molecular weight polyethylene (UHMWPE) is to increase its wear resistance to be used as bearing surfaces for total joint arthroplasty. However, radiation also leaves behind long-lived residual free radicals in this polymer, the reactions of which can detrimentally affect mechanical properties. In this review, we focus on the radiation cross-linking and oxidative stability of first and second generation highly cross-linked UHMWPEs developed in our laboratory.

Vitamin E-doped, radiation crosslinked ultra-high molecular weight polyethylene (UHMWPE) is developed as an alternate oxidation and wear resistant bearing surface in joint arthroplasty. We analyzed the diffusion behavior of vitamin E through UHMWPE and predicted penetration depth following doping with vitamin E and subsequent homogenization in inert gas used to penetrate implant components with vitamin E. Crosslinked UHMWPE (65- and 100-kGy irradiation) had higher activation energy and lower diffusion coefficients than uncrosslinked UHMWPE, but there were only slight differences in vitamin E profiles and penetration depth between the two doses. By using homogenization in inert gas below the melting point of the polymer following doping in pure vitamin E, the surface concentration of vitamin E was decreased and vitamin E stabilization was achieved throughout a desired thickness. We developed an analytical model based on Fickian theory that closely predicted vitamin E concentration as a function of depth following doping and homogenization.

Objective: Even though quality of life and functioning are topics that are point of interest, they are not assessed adequately in mood disorders. In this study, it is aimed to develop a functioning assessment scale in bipolar disorder., Method: Bipolar Disorder Functioning Questionnaire (BDFQ) is developed by the Scientific Section for Mood Disorders of the Psychiatric Association of Turkey. The questionnaire contains 58 items, and consists of eleven subscales: emotional functioning, intellectual functioning, sexual functioning, feelings of stigmatization, social withdrawal, household relations, relations with friends, participation to social activities, daily activities and hobbies, taking initiative and self sufficiency, and occupation., Results: In this study, 252 remitted bipolar patients from 15 centers were included. In addition, thirty subjects without any lifetime psychiatric, neurological or physical disease were recruited. The mean age of the patients was 38.6+/-12.1 and 56% (n=141) were female. The mean duration of the bipolar disorder was 11.9+/-9.2 years, and 91.3% of the patients were diagnosed to have bipolar I disorder. In the reliability analyses, after the exclusion of six items with low reliability coefficients, The Cronbach alpha coefficient was calculated to be 0.91. The item-total scale correlations were between 0.22-0.86. In test-retest reliability, the correlation between the two ratings was high (r=0.82, p<0.0001). In validity analyses, 13 factors were obtained representing 65.1% of the total variance in exploratory factor analysis. In confirmatory factor analysis, 11 domains fit the model with a RMSEA of 0.061. BDFQ significantly correlated with GAF (r=0.428, p<.0001). BDFQ also showed significantly negative correlation with HAM-D (r=-0.541, p<0.0001) and YMRS (r=-0.365, p<0.0001). It discriminated the patients (mean score=111.8+/-15.2) from the healthy subjects (mean score=121.4+/-10.4) well (t=-2.300, p=0.038)., Conclusion: With the six items excluded, it is suggested that the 52-item BDFQ is a reliable and valid instrument in the assessment of functioning in bipolar disorder.

Autoantibodies directed against specific epitopes in the insulin receptor are rarely the cause of either recurrent hypoglycemia or a severe form of insulin resistance (type B insulin resistance). Type B insulin resistance occurs more commonly in women of African heritage and is frequently associated with a history of other autoimmune diseases. We present the unusual case of a 61-year-old African American woman with a background of autoimmune hypothyroidism and autoimmune hepatitis who developed type 2 diabetes mellitus and marked facial acanthosis nigricans (AN) over a period of weeks. Despite treatment with multiple oral antidiabetic agents, she rapidly developed severe, recalcitrant hyperglycemia and ketoacidosis, requiring hospitalization and intravenous insulin administration for 4 weeks at rates of up to 180 U/h. Immunologic testing revealed a high titer of anti-insulin receptor autoantibodies of both immunoglobulin G and immunoglobulin A classes. After a recurrence of diabetic ketoacidosis despite aggressive management, the patient was treated with a short course of cyclophosphamide; within 10 weeks, she experienced striking improvement of her hyperglycemia as well as marked regression of the AN lesions. Subsequently, the patient also experienced episodes of fasting hypoglycemia, which resolved with a brief course of glucocorticoids. She has since remained euglycemic with no therapy for 5 years. We have documented, for the first time, regression of AN in temporal association with disappearance of circulating anti-insulin receptor autoantibodies and achievement of euglycemia in a patient with type B insulin resistance.

Stigma is linked to negative prejudices without examining whether there is any justification for such behaviour. Over time, various efforts have been made to reduce prejudice toward people with mental illness. Yet, the World Health Organization (WHO) World Health Report still describes stigma as one of the greatest obstacles to the treatment of mental illness. While schizophrenia, among other mental illnesses, is the most stigmatized even to the point that some want the name of the illness to be hidden or changed, patients with bipolar illness may also be exposed to stigma. The degree of stigmatization has been found to be positively associated with the severity of the mental disorder, and stigma is carried out not only by patients but also by their families in correlation with the severity. Tragically, people with mental illness themselves are as negative in their opinions about mental illness as is the general public, and concerns about stigma adversely affect self-esteem and adaptive social functioning. There are many programmes worldwide for the fight against stigmatization, and there is clear recognition of the fact that stigma can only be successfully eliminated if the programme becomes a normal part of health service rather than of campaigns of limited duration.

We developed a radiation cross-linked ultra-high molecular weight polyethylene (UHMWPE) stabilized with alpha-tocopherol (Vitamin E) as a bearing material in total joint replacements. The stabilizing effect of alpha-tocopherol on free radical reactions in UHMWPE is not well understood. We investigated the effect of alpha-tocopherol on the oxidation and transformation of residual free radicals during real-time aging of alpha-tocopherol-doped, irradiated UHMWPE (alphaTPE) and irradiated UHMWPE (control). Samples were aged at 22 degrees C (room temperature) in air, at 40 degrees C in air and at 40 degrees C in water for 7 months. During the first month, alphaTPE showed some oxidation at the surface, which stayed constant thereafter. Control exhibited substantial oxidation in the subsurface region, which increased with time. The alkyl/allyl free radicals transformed to oxygen centered ones in both materials; this transformation occurred faster in alpha-TPE. In summary, the real-time oxidation behavior of alpha-TPE was consistent with that observed using accelerated aging methods. This new UHMWPE is oxidation resistant and is expected to maintain its properties in the long term.

The aim of this study was to assess the clinical value of serum oestradiol concentration 8 days after embryo transfer (D8E2) and beta-human chorionic gonadotrophin (HCG-beta) concentration 12 days after embryo transfer (D12HCG-beta) in the prediction of pregnancy and the outcome of pregnancy following assisted reproduction, taking into account the day of transfer, which was either day 3 (D3) or day 5 (D5). The objective was to improve patient counselling by giving quantitative and reliable predictive information instead of non-specific uncertainties. A total of 2035 embryo transfer cycles performed between January 2003 and June 2005 were analysed retrospectively. Biochemical pregnancy, ectopic pregnancy and first-trimester abortions were classified as non-viable pregnancies; pregnancies beyond 12 weeks gestation were classified as ongoing pregnancies (OP). Significantly higher D8E2 and D12HCG-beta were obtained in D5 transfers compared with D3 transfers with regard to pregnancy and OP (P

Highly cross-linked 2-hydroxyethyl methacrylate (HEMA) and poly(ethylene glycol) dimethacrylate with poly(ethylene glycol) of molecular weight 600 (PEG600DMA) were molecularly imprinted with hydrophilic templates glucose and proxyphylline using water as a solvent. Glucose-imprinted polymers showed increased recognitive capacity compared to nonimprinted polymers as well as increased glucose uptake compared to structurally similar galactose and methylglucopyranoside. Increasing glucose concentration in the imprinting mixture resulted in higher capacity and selective binding. Similar results were obtained for proxyphylline-imprinted P(HEMA-co-PEG600DMA) polymers, where the proxyphylline uptake was higher than structurally similar theophylline. Glucose-imprinted networks also showed diffusion coefficients on the order of 10(-6) cm2/s, conducive to applications in drug delivery and tissue engineering. This work showed that using pairs of hydrogen-bonding monomers and templates, selective, high-affinity sites could be created despite nonspecific binding., (Copyright (c) 2006 Wiley Periodicals, Inc.)

Objective: The Schedule for Deficit Syndrome (SDS) is an instrument for categorizing schizophrenic patients as those with and without deficit syndrome. This schedule has been translated and adapted into the Turkish language in order to study its reliability and validity., Method: 30 male schizophrenic patients were included in the study. The patients had been ill for a long period of time and the course was continuous. The patients were assessed by two different raters using the SDS as a means of testing its reliability. A third rater assessed the same group of patients using the BPRS to test the validity of the SDS., Results: The raters using the SDS demonstrated good inter-rater reliability for the categorization of patients with and without deficit syndrome, as well as for rating global severity (kappa: 0.88-0.93) and individual negative symptoms (kappa: 0.51-0.61). The schedule was also found to have a high validity for both categorization and measuring individual negative symptoms. (U: 60.0, P: 0.03)., Conclusion: The results demonstrated that the Turkish version of the SDS would be a reliable and valid instrument that could be used in the study of schizophrenia.

Our hypothesis was that cross-linked, ultrahigh-molecular weight polyethylene (UHMWPE) stabilized with vitamin E (alpha-tocopherol) would be wear-resistant and fatigue-resistant. Acetabular liners were radiation cross-linked, doped with vitamin E, and gamma-sterilized. Hip simulator wear rate of vitamin E-stabilized UHMWPE was approximately 1 and 6 mg/million-cycles in clean serum and in serum with third-body particles, respectively, a 4-fold to 10-fold decrease from that of conventional UHMWPE. The ultimate strength, yield strength, elongation at break, and fatigue resistance of vitamin E-stabilized UHMWPE were significantly higher than that of 100 kGy-irradiated and melted UHMWPE, and were unaffected by accelerated aging. Rim impingement testing with 3.7-mm-thick acetabular liners up to 2 million-cycles showed no significant damage of the cross-linked liners compared with conventional, gamma-sterilized in inert UHMWPE, vitamin E-stabilized liners. The data indicate good in vitro wear properties and improved mechanical and fatigue properties for vitamin E-stabilized, cross-linked UHMWPE.

The oxidation resistance of irradiated ultra-high molecular weight polyethylene (UHMWPE) components used in total joint arthroplasty can be improved by adding alpha-tocopherol (vitamin E) through diffusion. To ensure long-term oxidative stability, a minimum alpha-tocopherol concentration needs to be maintained throughout these components. Migration of alpha-tocopherol out of the components is one mechanism that could compromise long-term oxidative stability. We hypothesized that alpha-tocopherol could elute out during standard implant fabrication steps such as cleaning as well as during in vivo use. We doped 85 kGy irradiated UHMWPE with alpha-tocopherol at 120 degrees C and homogenized at 120 degrees C. We determined the extent of elution of alpha-tocopherol or its effect on oxidative stability following cleaning in isopropyl alcohol (IPA) and following 5 million cycles (MC) of simulated normal gait in bovine serum. There was no significant elution of alpha-tocopherol in repeated and prolonged cleaning in IPA as measured by average surface and bulk alpha-tocopherol concentrations. There was no change in the oxidative stability following 5 MC of hip simulator testing, indicating minimal elution during simulated normal gait.