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Abstract In this paper, a statistical uranium isotope dilution mass spectrometry approach is presented to simulate the wide range of spike-sample mixed ratios of 235U/238U, in terms of their related expanded uncertainties and uncertainty budget indexes. To obtain the lowest expanded uncertainty in uranium isotope dilution mass spectrometry (U-IDMS) technique, uranium certified materials of U-CRM 112A (spike) and U-CRM 149 (treated as unknown) are statistically employed and simulated. The simulated data is further applied to project U-IDMS samples by using the “Guide to the Expression of Uncertainty in Measurement (GUM)” software.

Menderes Masifi' nin çok geniş bölümlerinde yüzeyleyen gnaysik granitlerin yerleşim yaşları ve mekanizmalarının belirlenmesi, masifin tektonik evriminin anlaşılması açısından kritik önem taşır. Birçok araştırıcı bu gnayslardan elde ettikleri radyojenik zirkon yaşlarına dayanarak granitlerin ve yüksek dereceli mikaşistlerden oluşan yan kayalarının Menderes Masifi' nin Prekambriyen yaşlı "Çekirdeği" olduğunu ve Pan-Afrikan orojenezi sırasında yüksek dereceli metamorfizma geçirdiğini savunur. Mikaşist ve mermerlerden oluşan PaleozoyikMesozoyik yaşlı "Örtü birimleri" olarak tanımlanmış istifin "çekirdek birimlerini" uyumsuz olarak örtmüş olduğu belirtilir. Alpin orojenezi sırasındaki Ana Menderes Metamorfizması sırasında "Çekirdek" ve "Örtü birimleri" birlikte fakat daha düşük dereceli metamorfizmaya uğradığı ileri sürülür. Menderes Masifi kayaları Batı Anadolu'da çok geniş ve açık mostralar sunmasına rağmen Pan-Afrikan çekirdek ile örtü birimleri arasında olması beklenen açısal diskordansın yapısal verileri hiçbir yerde açık olarak saptanamamıştır. Alpin olaylarının Pan-Afrikan yapılarını tamamen silmiş olması açıklanması zor bir sorun olarak durmaktadır. Bu çalışmada Menderes Masifi'nde Prekambriyen yaşlı çekirdek olarak tanımlanan gnaysik granitler ile Paleozoyik-Mesozoyik çevre kayaların ilişkisi Dibekdağı, Çine-Yatağan yolu ve Incirliova Barajı alanlarında yeniden haritalanarak incelenmiştir. Dibekdağı alanında gnaysik granitler çevre kayaların foliasyonu boyunca migmatitik cepheler şeklinde mermer mercekleri içeren mikaşistlerin içine yerleşmiştir. Şistlerden granitlerin içerisine doğru çevre kayalar derece derece özümlenir ve kuvarso-feldspatik mercekler ve girdiler artarak magmatik cephenin içine girilir. Çine-Yatağan Yolu boyunca migmatitik sintektonik granitik cephe, masifin Paleozoyik yaşlı siyah mermer, siyah çört ve şist ardalanmasını yutarak yerleşmiştir. Bu alanda Paleozoyik birimler stratigrafik olarak üste doğru Triyas yaşlı mafik volkanik ara katkılı kırıntılı birimlere ve onlar da Mesozoyik platform mermerlerine geçer. Bu alanda yaşları masifin başka bölgelerinde fosillerle belirlenmiş ve fasiyesleri iyi bilinen Paleozoyik-Mesozoyik örtü birimleri gnaysik granitler tarafından yutulmuştur. Benzer şekilde, Incirliova baraj alanında gözlü gnays-migmatitik granit kompleksi Paleozoyik yaşlı siyah çört ve mermer istifini ve onların üzerine gelen Triyas metakırıntılı kayalarını ve en üstte Mesozoyik beyaz mermer istifinin tümünü keser. Yeni saha verileri yüksek sıcaklık trendine sahip Barroviyen tipi Ana Menderes Metamorfizması' nın kabukta rejüvenasyona neden olduğunu ve migmatitik cepheler şeklinde yükselen sintektonik granitlerin oluştuğunu ve bunların hem çekirdek-örtü sınırını hem de Paleozoyik-Mesozoyik örtü birimlerini yutarak yerleştiğini gösterir. Masifteki gnaysik granitlerden yaygın olarak elde edilen Prekambriyen ve yer yer ise Alpin yaşları bu tür bir rejüvenasyon ve migmatitleşme ile açıklanabilir.

Nanophotonics excels at confining light into nanoscale optical mode volumes and generating dramatically enhanced light matter interactions. These unique aspects have been unveiling a plethora of fundamentally new optical phenomena, yet a critical issue ahead for nanophotonics is the development of novel devices and applications that can take advantage of these nano-scale effects. It is expected that nanophotonics will lead to disruptive technologies in energy harvesting, quantum and integrated photonics, optical computing and including biosensing. To this end, our research is focused on the application of nanophotonics to introduce powerful biosensors that can have impact on a wide range of areas including basic research in life sciences, early disease diagnostics, safety and point-of-care testing. In particular, we exploit nanophotonics and its integration with microfluidics to address key challenges of current biosensors and develop devices that can enable label-free, ultra-sensitive, multiplexed, rapid and real-time measurements on biomolecules, pathogens and living systems. In this talk I will present some of our recent work on nanophotonic meta surfaces for biosensing and bioimaging as well as their applications in real-world settings.

Background: The aim of this study was to evaluate the effects of melatonin (MLT) and paricalcitol (PRC) on the healing of the extraction socket following tooth extraction in rats with cyclosporine-A (CsA)., Material and Methods: 76 male Wistar rats were divided into five different groups, one of which was a control (C) group. All groups other than the control group were applied CsA (10 mg/kg/daily) intraperitoneally 7 days before the tooth extraction. The left upper incisors were extracted on day 8 and CsA injections were continued in all groups until sacrification. Starting from the day of tooth extraction, in group 1 (CsA) were given CsA, in group 2 (CsA+MLT) were applied intraperitoneal MLT injection in a dose of 4 mg/kg, in group 3 (CsA+PRC) were applied intraperitoneal PRC injection in a dose of 200 ng/kg, and in group 4 (CsA+MLT+PRC) were applied intraperitoneal PRC injection and intraperitoneal MLT until the day of sacrification of all groups. The subjects were sacrificed on day 7 and 14 following tooth extraction. For histopathological examination, the subjects stained Hemotoxylin-Eosin and evaluated histologically under the light microscope. The intensity of inflammation in extraction socket was scored based on a four-grade system., Results: The level of inflammation was found to be lower in group C on day 7, while the inflammation value was found to be higher in the group 1 on day 14 (p>0.05). Statistically significant differences were found in the ossification values on day 7 between the groups(p<0.05). The percentage of ossification on day 7 was significantly lower in the group 1 than in the C and group 3, and significantly lower in the group 2 than in the group 3. The percentage of ossification on day 14 in the group 1 was significantly lower than in group C (p<0.05)., Conclusions: CsA has a negative effect on bone healing. The application of MLT and PRC following the toxicity produced by CsA was found to positively affect the healing of the socket that develops after tooth extraction.

Objective: Semaphorin4D (Sema4D), a novel integral membrane glycoprotein, plays a role in atherosclerosis, angiogenesis and chronic inflammation. Elevated levels of sema4D were presented in myocardial infarction, heart failure and atrial fibrillation. Aim of the study was to investigate the relation between sema4D and recurrence after catheter ablation (CA) in paroxysmal AF., Methods: The present study included 161 paroxysmal AF patients (PAF) (101 patients undergone CA) and 60 healthy subjects. Serum levels of sema4D were measured and study participants were followed-up for 3 months and 1 year since CA in terms of recurrence respectively., Results: Sema4D levels were significantly elevated in the recurrent group compared to the non-recurrent PAF patients ( p  < 0.001). Sema4D was importantly positively correlated with both left atrial volume index ( r  = 0.51, p  < 0.013) and high sensitive C-reactive protein ( r  = 0.38), p  < 0.011). In multivariate analysis, sema4D [odds ratio (OR) = 1.23, 95% CI 1.11-1.42; p  < 0.001] and left atrial diameter (OR = 1.13, 95% CI 1.02-1.23; p  = 0.012) were found to be significant independent risk parameters for recurrence., Conclusions: Sema4D is a novel biomarker that may help to identify individuals with recurrence after CA procedure in long term period in PAF.

Objectives: In this study, the effects of ozonetherapy on secondary wound healing were evaluated histologically and immuno-histochemically., Material and Methods: Material and Methods: 8 healthy pigs were used in this study. Six wounds with 10 mm in diameter were created through the punch technique on the palatinal gingiva of each pig. Ozone gas was applied on only 3 wounds (test group) and the remaining 3 were left to natural healing (control group). Biopsy samples were taken from one of the wounds in each group on the third day, from another wound of each group on the seventh day, and from another one on the tenth day. Routine histological analysis and immuno-histochemical staining were performed to investigate transforming growth factor-beta (TGF-β) and (VEGF) expressions., Results: Results: No statistical difference was found between the test and control groups in terms of collagen fibers, epithelial formation and inflammation scores. A VEGF expression found in the test group was statistically higher than control group samples taken on the 3rd and 7th day. There was no statistical difference between the test and control groups in terms of TGF-β expression on any of the sampling days., Conclusions: Conclusion: The topical application of ozone gas could be effective in the early stages of wound healing by increasing the amount of VEGF expression. Clinical Relevance: Topical application of ozone gas may be effective in the early stages of oral wound healing.

Objective: To evaluate whether hyperbaric oxygen (HBO) treatment has a favorable effect on implant osseointegration in diabetic rabbits., Material and Methods: An experimental diabetes model was induced in 32 New Zealand rabbits through IV injection of alloxan. After the state of diabetes had been confirmed, one dental implant was placed in the metaphysical region of each animal's tibia. After the implants' placements, the animals were divided into two groups. Half of the animals underwent HBO treatment, while the other group did not receive HBO treatment and served as the control group. The animals were euthanized at the 4th and 8th weeks. The osseointegration of the implants were compared by histomorphometry and resonance frequency analysis (RFA)., Results: The Bone Implant Contact (BIC) values were significantly higher in the HBO group than in the control group at the 4th week. There was no difference in the BIC values between the groups at the 8th week. There was no significant difference in the RFA scores between the groups both at the 4th and 8th weeks after the operation., Conclusion: Histomorphometry findings suggest that HBO has positive effect on implant osseointegration in the early healing period in diabetic rabbits. However, implant stability is not affected by HBO treatment.

Background: Cardiac cachexia is an important predictive factor of the reduction in survival of patients with heart failure with reduced ejection fraction., Objectives: The aims of the present study were to evaluate adropin and irisin levels in cachectic and non-cachectic subjects and the relationships between the levels of these proteins and clinical and laboratory parameters in patients with HFrEF., Methods: The clinical records of patients who were admitted to the cardiology outpatient clinic for heart failure with reduced ejection fraction were screened. Cachectic patients were identified and assigned to the study group (n = 44, mean age, 65.4 ± 11.2 y; 61.4% men). Heart failure with reduced ejection fraction patients without weight loss were enrolled as the control group (n = 42, mean age, 61.0 ± 16.5 y; 64.3% men). The serum adropin and irisin levels of all patients were measured. A p-value < 0.05 was considered significant., Results: Serum adropin and irisin levels were significantly higher in the cachexia group than in the controls (Adropin (ng/L); 286.1 (231.3-404.0) vs 213.7 (203.1-251.3); p < 0.001, Irisin (µg/mL); 2.6 (2.2-4.4) vs 2.1 (1.8-2.4); p = 0.001). Serum adropin and irisin levels were positively correlated with brain natriuretic peptide (BNP) levels and New York Heart Association (NYHA) class and negatively correlated with body mass index (BMI) and serum albumin levels (all p values: < 0.001). In a multivariate analysis, adropin was the only independent predictor of cachexia in the heart failure with reduced ejection fraction patients (OR: 1.021; 95% CI: 1.004-1.038; p = 0.017)., Conclusions: The results suggest that adropin and irisin may be novel markers of cardiac cachexia in heart failure with reduced ejection fraction patients. Adropin and irisin are related with the severity of heart failure.

Objective: The aim of this study was to evaluate the relation of three new inflammatory markers with presence and severity of preeclampsia and to compare the predictive values of all markers for presence of this setting., Methods: In this study, a total of 100 consecutive pregnants with a diagnosis of preeclampsia and 40 healthy pregnants between October 2014 and April 2015 were included. Epicardial fat tissue was calculated by two-dimensional transthoracic echocardiography, and pentraxin-3 and neutrophil-to-lymphocyte ratio were measured by using an enzyme-linked immunosorbent assay method and routine blood count analysis, respectively., Results: Epicardial fat thickness (p < 0.001), pentraxin-3 (p < 0.001), and neutrophil-to-lymphocyte ratio (p < 0.001) were found to be significantly increased in the preeclampsia as compared to the healthy pregnants. Furthermore, epicardial fat thickness (p = 0.002), pentraxin-3 (p < 0.001), and neutrophil-to-lymphocyte ratio (p < 0.001) were significantly elevated in the severe preeclampsia compared to mild preeclampsia. In the multivariate analysis, epicardial fat thickness (p = 0.013), pentraxin-3 (p = 0.04), and neutrophil-to-lymphocyte ratio (p < 0.001) were found as significant independent predictors of presence of preeclampsia after adjusting for other risk factors., Conclusion: Epicardial fat thickness, neutrophil-to-lymphocyte ratio, and pentraxin-3 are important markers that provide an additional information beyond that provided by conventional methods in predicting presence and severity of preeclampsia.

Paramolars are rare supernumerary molars occurring buccally or lingually/palatally near the molar row. They may cause complications such as caries, periodontal disease and delay or prevention eruption of permanent teeth. Reports of bilateral entity are rarely found in the dental literature. The present article reports a rare case of bilateral double paramolars in the maxillary molar region in 21-year-old male patient.

Introduction: Inflammation and increased platelet activation play a crucial role in the initiation and progression of atherosclerosis. Platelet-to-lymphocyte ratio (PLR) has recently been reported as a new independent predictor for major adverse cardiovascular events in cardiovascular diseases., Aim: To investigate the relation between PLR and cardiovascular mortality in patients with intermittent claudication or critical limb ischemia (CLI) or both., Material and Methods: In our retrospective study, 602 consecutive patients who were admitted to a large tertiary hospital with the diagnosis of symptomatic peripheral arterial occlusive disease (PAOD) were included. Patients were divided into two groups according to their PLR as follows: high PLR (PLR > 142) and low PLR (PLR ≤ 142) groups., Results: During the follow-up period (median: 33.8 months (interquartile range: 21-45)), 131 deaths occurred out of 602 (21.8%) patients. Cardiovascular mortality was found to be significantly higher in the high PLR group compared to the low PLR group (31.6% vs. 17.2 %; p < 0.001). Even after adjustment for various risk factors, PLR > 142 and age were found to be independent predictors of long-term cardiovascular mortality in Cox regression analysis (hazard ratios (95% confidence interval): 1.03 (1.01-1.04) and 1.04 (1.02-1.06), p < 0.001 and p < 0.001, respectively)., Conclusions: Platelet-to-lymphocyte ratio, which is one of the parameters of routine complete blood count, reflects increased inflammatory status, platelet activation and aggregation. PLR is a cheap and readily available marker that has the ability to improve risk stratification provided by conventional risk scores in predicting long-term cardiovascular mortality in PAOD., Competing Interests: The authors declare no conflict of interest.

Objectives: The aim of the present study was to retrospectively make a volumetric evaluation of symphysis sites of patients by the use of cone beam computed tomography (CBCT)., Methods: This retrospective study evaluated dentate symphysis region of the mandibles in CBCT scans taken for different reasons in 90 patients (45 women and 45 men). Three-dimensional (3D) data were obtained using a CBCT device Kodak 9000 3D CMOS sensor with optical fiber. CBCT images were then transferred as digital imaging and communications in medicine files and imported into a volumetric-rendering software 3D DOCTOR (Able Software Corp., Lexington, MA) capable of measurements of vector based-segmentation technology for volumetric measurements., Results: The total average bone volume is 2616.45 mm. Significant differences in average bone volume were found between group I and group IV (P < 0.001). Higher bone volume was obtained in the male groups (2903.01 mm) than in the female groups (2329.88 mm)., Conclusions: CBCT is a good candidate for 3D assessment of high-contrast structures in the oral region. We suggest that the use of 3D computed tomography in combination with a software program is a dependable means of measuring the volume of the symphysis bone graft.

Recent studies have reported circulating microRNAs (miRNAs) as novel biomarkers for cardiovascular diseases including acute myocardial infarction, heart failure, diabetes mellitus, stroke, and acute pulmonary embolism. The aims of this study were 1) to compare the plasma expression levels of miRNAs in patients with acute coronary syndrome (ACS) and control subjects and in ST-elevation myocardial infarction (STEMI) and non-STEMI 2) to evaluate miRNAs potential to be used as novel diagnostic biomarkers for ACS. Twenty seven consecutive patients, admitted to emergency department of a training and research hospital between January-December 2013 with acute chest pain and/or dyspnea and diagnosed with ACS, and 16 non-ACS control subjects were included in this study. miRNA profiling was performed by using real time polymerase chain reaction. Functions of dysregulated miRNAs were evaluated by computerized-pathways analysis. miR-221-3p was one of the two most dysregulated miRNAs with a fold regulation of 3.89. It was significantly positively correlated with both Troponin and GRACE and Synthax Score. Moreover, miR221-3p was found to be significantly inversely correlated with left ventricular ejection fraction. miR-221-3p was the most prominent biomarker candidate with an area under curve (AUC) level of 0.881 (95% confidence interval: 0.774-0.987; p=0.002). The present study is the first to report an increased expression levels of miR-221-3p in AMI. Since miR-221-3p has a high discriminative value and significant relations with Troponin, GRACE and Synthax score and left ventricular systolic function, it may be a potential biomarker for early prediction of AMI., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Background: The purpose of this study is to assess the electrocardiographic and electrophysiological parameters of conduction abnormalities in patients undergoing transcatheter aortic valve implantation (TAVI) due to severe aortic valve stenosis., Methods: The study included 55 patients who underwent TAVI using either the Boston Scientific Lotus (n:25) (Boston Scientific, Natick, MA, USA) or Edwards Sapien XT (n:30) (Edwards Lifesciences, Irvine, CA, USA) prostheses. An electrophysiological study (EPS) was performed in the catheterization room immediately before the initial balloon valvuloplasty and immediately after prosthesis implantation., Results: QRS duration and His-bundle to His-ventricle (HV) intervals, which were similar between the two groups before the procedure, were found to be significantly higher in the Lotus valve group postprocedure. Permanent pacemakers (PPMs) were required more frequently in the Lotus group than in the Sapien XT group at discharge (24.0% vs 6.7%, P = 0.07). With the exception of a higher prevalence of paravalvular leakage (P < 0.001) in patients undergoing Sapien XT implantation, other clinical outcomes were similar between the two groups. Multiple regression analysis revealed that baseline atrioventricular (AV) conduction disorders and HV intervals after the procedure were independently associated with PPM implantation after TAVI., Conclusion: In this first study comparing the findings of EPS and electrocardiography, the impact of the Lotus valve on AV conduction systems was greater than that of the Sapien XT. However, the need for PPM was higher in the Lotus valve than in the Sapien XT. PPM requirement is related to valve design; it may decrease with reduced frame height and metal burden in novel valve systems., (© 2016 Wiley Periodicals, Inc.)

The plateletcrit has been investigated as a new predictor of cardiovascular risk. The objective of our study was to investigate the role of admission plateletcrit in predicting long-term cardiovascular mortality in patients presenting with non-ST-segment elevation myocardial infarction (NSTEMI). We enrolled 296 patients with NSTEMI (mean age 59.2 ± 11.8 years; 228 men, 68 women) in this study. The study population was divided into tertiles on the basis of admission plateletcrit values. A high plateletcrit (n = 98) was defined as a value in the upper third tertile (plateletcrit >0.23), and a low plateletcrit (n = 198) was defined as any value in the lower two tertiles (plateletcrit ≤0.23). The median follow-up time was 38 months. In multivariate analyses, a significant association was noted between high plateletcrit values and the adjusted risk of long-term mortality (odds ratio = 12.15, 95% confidence interval = 1.78-82.77; P < 0.001). In the Kaplan-Meier survival analysis, the long-term mortality rate was 20.4% in the high plateletcrit group versus 4.5% in the low plateletcrit group (P < 0.001). Long-term major advanced cardiac events (MACE), hospitalization for heart failure and reinfarction were significantly higher in patients with high plateletcrit. Admission plateletcrit is a strong and independent predictor of long-term cardiovascular mortality in patients with NSTEMI.

Objectives: Hypertension (HT) is a complex disorder influenced by both genetic and environmental factors. Recent genome-wide association studies have identified a major risk locus for atherosclerosis on chromosome 9p21.3. SNPs within the coding sequences of CDKN2A/B and the long non-coding RNA CDKN2B-AS1 could potentially contribute to HT development. Thus, this study aimed to investigate whether the frequency of four SNPs on chromosome 9p21.3 affects blood pressure (BP) levels in Turkish HT patients, and to examine correlations between these SNPs, specific SNP haplotypes, and HT., Design and Methods: This is a case-control study comparing HT patients and healthy controls. Real-time polymerase chain reaction (RT-PCR) analysis was utilized to detect SNPs rs10757274, rs2383207, rs10757278, and rs1333049 in 170 HT patients and 180 healthy controls., Results: Each SNP was detected at significantly higher frequencies in HT patients than in controls (p values 0.001); however, there was no significant link between rs10757274, rs2383207, rs10757278, and rs1333049 SNPs and HT grades. Furthermore, there was a significant association between elevated systolic BP levels and rs1333049 GG genotype (p=0.047), while weight gain and increased fasting glucose levels were significantly associated with rs2383207 AA genotype (p=0.020 and p=0.009, respectively). Lastly, we detected a correlation between GG, GA, and AG haplotypes in block 1 (rs10757274, rs2383207) and GC and AG haplotypes in block 2 (rs10757278, rs1333049) and HT., Conclusions: Our findings suggest that SNPs rs10757274, rs2383207, rs10757278, and rs1333049, particularly those within the CDKN2B-AS1 gene, and related haplotypes may confer increased susceptibility to HT development., (Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.)

Background: Mean platelet volume to platelet count (MPV/Plt) ratio has been demonstrated to be a good indicator of long-term mortality in patients with non-ST-segment elevation myocardial infarction (NSTEMI). However, the prognostic value of MPV/Plt in ST-elevation myocardial infarction (STEMI) is not reported., Aim: To determine whether the MPV/Plt ratio on admission has any predictive value for major adverse cardiac events including short- and long-term mortality in STEMI., Methods: In this prospective study, 470 STEMI patients who underwent primary percutaneous coronary intervention (PCI) were enrolled. The patients were divided into three tertiles based on the MPV/Plt ratio on admission. The first tertile (n = 149) was defined as MPV/Plt ratio ≤ 0.029, second tertile (n = 154) 0.029-0.038, and third tertile (n = 159) ≥ 0.038. Primary clinical outcomes consisted of the sum of cardiovascular (CV) mortality, non-fatal re-infarction, and stroke. Secondary clinical outcomes were CV mortality, non-fatal re-infarction, target-vessel revascularisation, stroke, and advanced heart failure., Results: There was no difference between study groups regarding the primary (p > 0.05) and the secondary outcomes (p > 0.05) except for one-year non-fatal re-infarction rate, which was found to be significantly higher in the highest MPV/Plt ratio group (p = 0.045). Age, Killip class > 1, and left ventricular ejection fraction were found to be independent predictors of long-term CV mortality in multivariate analysis (p = 0.009, p = 0.035, and p < 0.001, respectively)., Conclusions: While the MPV/Plt ratio was demonstrated to be associated with one-year non-fatal re-infarction, it was not related to in-hospital, one-month, and one-year CV mortality in patients with STEMI, who underwent primary PCI.

Background: Acute pulmonary embolism (APE) is a common disease which is associated with high mortality and morbidity. Circulating level of copeptin, which was demonstrated to be elevated in heart failure, acute myocardial infarction and pulmonary arterial hypertension, were reported to be independent predictors of poor outcome in recent studies. The aim of the present study was to investigate the clinical utility of copeptin in the diagnosis of APE., Methods: A total of 90 consecutive patients, admitted to emergency service due to acute chest pain and/or dyspnea and who underwent pulmonary computerized tomography angiography (CTA) due to suspicion of APE, were included in this prospective study. The patients diagnosed with APE were defined as APE (+) group and the remaining individuals with normal pulmonary CTA result were defined as APE (-) group., Results: Copeptin levels (7.76 ± 4.4 vs. 3.81 ± 1.34 ng/dL; p < 0.001) were higher in the APE (+) group as compared to the APE (-) group. Copeptin was significantly positively correlated with B-type natriuretic peptide (r = 0.434, p < 0.001), D-dimer (r = 0.315, p = 0.003) and troponin I (r = 0.300, p = 0.004) and inversely correlated with arterial oxygen saturations (r = -0.533, p < 0001). When the correlation of copeptin with right ventricular dysfunction parameters was investigated, it was significantly inversely correlated with the tricuspid annular plane systolic excursion (r = -0.521, p < 0.001) and positively correlated with right to left ventricle ratio (r = 0.329, p = 0.024). Copeptin (OR 1.836, 95% CI 1.171-2.878, p = 0.008) was found as a significant independent predictor of APE in a multivariate analysis, after adjusting for other risk parameters., Conclusions: Copeptin is a promising new biomarker, which may be used to support the need for further investigations and to improve the diagnosis of patients with APE.

Kissing molars (KM) or rosette formation is a term that is used to describe impacted teeth contacting occlusal surfaces in a single follicular space and their roots pointing in opposite directions. In some cases kissing molars can be seen but occurrence of bilateral kissing molars is extremely rare phenomenon in the dental literature and the aetiology of this phenomenon is still unknown. In this paper we describe a case and review of the literature and discuss the management of this pathology. In our case, extremely rare form of impacted bilateral kissing molars was extracted surgically. The decision of extraction of asymptomatic kissing molars represents surgical dilemma. There may be many surgical complications; on the other hand in some cases surgical intervention is unavoidable. Few treatment options were described in the literature. This phenomenon can be sign of various medical conditions that may require further investigation. In this paper, our treatment option is in agreement with the literature suggesting the surgical removal of both teeth at either side of the mandible.

Background: End stage renal disease is related to increased cardiovascular mortality and morbidity. Hypertension is an important risk factor for cardiovascular disorder among hemodialysis (HD) patients. The aim of this study was to investigate the effect of low-sodium dialysate on the systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels detected by ambulatory BP monitoring (ABPM) and interdialytic weight gain (IDWG) in patients undergoing sustained HD treatment., Patients and Methods: The study included 46 patients who had creatinine clearance levels less than 10 mL/min/1.73 m(2) and had been on chronic HD treatment for at least 1 year. After the enrollment stage, the patients were allocated low-sodium dialysate or standard sodium dialysate for 6 months via computer-generated randomization., Results: Twenty-four hour SBP, daytime SBP, nighttime SBP, and nighttime DBP were significantly decreased in the low-sodium dialysate group (P<0.05). No significant reduction was observed in both groups in terms of 24-hour DBP and daytime DBP (P=NS). No difference was found in the standard sodium dialysate group in terms of ABPM. Furthermore, IDWG was found to be significantly decreased in the low-sodium dialysate group after 6 months (P<0.001)., Conclusion: The study revealed that low-sodium dialysate leads to a decrease in ABPM parameters including 24-hour SBP, daytime SBP, nighttime SBP, and nighttime DBP and it also reduces the number of antihypertensive drugs used and IDWG.

Background and Objectives: Obstructive sleep apnea syndrome (OSAS) is associated with increased arterial stiffness and cardiovascular complications. The objective of this study was to assess whether the color M-mode-derived propagation velocity of the descending thoracic aorta (aortic velocity propagation, AVP) was an echocardiographic marker for arterial stiffness in OSAS., Subjects and Methods: The study population included 116 patients with OSAS and 90 age and gender-matched control subjects. The patients with OSAS were categorized according to their apnea hypopnea index (AHI) as follows: mild to moderate degree (AHI 5-30) and severe degree (AHI≥30). Aortofemoral pulse wave velocity (PWV), carotid intima-media thickness (CIMT), brachial artery flow-mediated dilatation (FMD), and AVP were measured to assess arterial stiffness., Results: AVP and FMD were significantly decreased in patients with OSAS compared to controls (p<0.001). PWV and CIMT were increased in the OSAS group compared to controls (p<0.001). Moreover, AVP and FMD were significantly decreased in the severe OSAS group compared to the mild to moderate OSAS group (p<0.001). PWV and CIMT were significantly increased in the severe group compared to the mild to moderate group (p<0.001). AVP was significantly positively correlated with FMD (r=0.564, p<0.001). However, it was found to be significantly inversely related to PWV (r=-0.580, p<0.001) and CIMT (r=-0.251, p<0.001)., Conclusion: The measurement of AVP is a novel and practical echocardiographic method, which may be used to identify arterial stiffness in OSAS.

Background: Hypertension, diabetes mellitus, and osteoporosis are important comorbidities commonly seen in postmenopausal women. The aim of the present study was to investigate the relationships between blood pressure, blood glucose, and bone mineral density (BMD) in postmenopausal Turkish women., Methods: In this cross-sectional study, 270 consecutive patients who were admitted to an outpatient clinic with vasomotor symptoms and/or at least 1 year of amenorrhea were included. The patients were categorized into three groups according to their blood pressure and metabolic status as follows: normotensive, hypertensive nondiabetics, and hypertensive diabetics. The T- and z-scores of the proximal femur and lumbar vertebrae were measured with the dual-energy X-ray absorptiometry method to assess the BMD of the study groups., Results: Lumbar vertebral T-scores (P<0.001), lumbar vertebral z-scores (P<0.003), and proximal femoral T-scores (P<0.001) were demonstrated to be significantly lower in the hypertensive diabetic group compared to the hypertensive nondiabetic and normotensive groups. Systolic blood pressure was significantly inversely correlated with lumbar vertebral T-scores (r=-0.382; P=0.001), lumbar vertebral z-scores (r=-0.290; P=0.001), and proximal femoral T-scores (r=-0.340; P=0.001). Moreover, diastolic blood pressure was significantly inversely correlated with lumbar vertebral T-scores (r=-0.318; P=0.001), lumbar vertebral z-scores (r=-0.340; P=0.001), and proximal femoral T-scores (r=-0.304; P=0.001). Hypertension (odds ratio [OR]: 2.541, 95% confidence interval [CI]: 1.46-3.48, P=0.003), diabetes mellitus (OR: 2.136, 95% CI: 1.254-3.678, P=0.006), and age (OR: 1.069, 95% CI: 1.007-1.163, P=0.022) were found to be significant independent predictors of osteopenia in a multivariate analysis, after adjusting for other risk parameters., Conclusion: The present study is the first to evaluate the relationships between blood pressure, blood glucose, and BMD in postmenopausal Turkish women. Moreover, both hypertension and diabetes were demonstrated as significant independent predictors of osteopenia in postmenopausal Turkish women. Clinicians should be aware of the high risk of developing osteopenia in diabetic hypertensive postmenopausal women.

Objective: Red cell distribution width (RDW) is a measure of variation in the size of circulating red blood cells. Recent studies have reported a strong independent relation between elevated RDW and short- and long-term prognosis in various disorders. The aim of the present study was to investigate the relationship between admission RDW-to-platelet ratio (RPR) and in-hospital and long-term prognosis in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI)., Methods: A total of 470 consecutive patients with a diagnosis of STEMI who underwent primary PCI were included in this prospective study. The patients were divided into two groups based on their admission RPR: high (>0.061) RPR group and low (≤0.061) RPR group. The patients were followed for adverse clinical outcomes in-hospital and for up to one year after discharge., Results: In-hospital cardiovascular mortality, major adverse cardiovascular events (MACE), advanced heart failure and cardiogenic shock were significantly higher in the high RPR group (p<0.05). All-cause and cardiovascular mortality, MACE, fatal reinfarction, advanced heart failure, and rehospitalization for cardiac cause were more frequent in the high RPR group in one-year follow-up (p<0.05). High RPR was found to be a significant independent predictor of one-year cardiovascular mortality in multivariate analysis (p=0.003, OR: 3.106, 95% CI: 1.456-6.623)., Conclusion: RPR is an inexpensive and readily available biomarker that provides an additional level of risk stratification beyond that provided by conventional risk parameters in predicting long-term MACE and cardiovascular mortality in STEMI., (Copyright © 2015 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.)

Background: Increased levels of visfatin, a novel adipocytokine, are reported in atherosclerosis, obesity, and type 2 diabetes. The aim of the present study was to investigate the relationship between coronary slow flow (CSF) and visfatin in patients undergoing elective coronary angiography for suspected coronary artery disease., Patients and Methods: A total of 140 recruited participants (90 patients with CSF and 50 controls) were divided into two groups according to their coronary flow rates. Coronary flow was quantified by thrombolysis in myocardial infarction (TIMI) frame count (TFC)., Results: Serum visfatin levels were higher in the CSF group than in the control group (3.29 ± 1.11 vs. 2.70 ± 1.08 ng/ml, p = 0.003). A significant correlation was found between TFC and visfatin (r = 0.535, p < 0.001). The area under the receiver operating characteristic curve was 0.720 (95 % confidence interval, 0.622-0.817, p < 0.001) for visfatin in the diagnosis of CSF. If a cut-off value of 2.59 ng/ml was used, higher levels of visfatin could predict the presence of CSF with 78.9 % sensitivity and 64.0 % specificity., Conclusion: Visfatin levels might be a useful biomarker for predicting CSF in patients undergoing diagnostic coronary angiography.

We investigated the association between the preoperative logistic clinical syntax score (log CSS), saphenous vein graft (SVG) patency, and major adverse cardiac and cerebrovascular events (MACCEs) after coronary artery bypass surgery (CABG). Of 1875 patients undergoing isolated CABG between 2009 and 2011, 267 patients, who later underwent coronary angiography, were included in the study. The primary end point was at least 1 graft occlusion on the follow-up coronary angiogram. The secondary end point was a composite of MACCE. In multivariate analysis, log CSS was found as a strong predictor of SVG failure (odds ratio [OR] 0.66, 95% confidence interval [CI]: 0.46-0.94, P = .02; and OR: 2.21, 95% CI: 1.02-4.75, P = .04, respectively): log CSS was also associated with MACCE (P = .001 and P < .001, respectively). The addition of clinical parameters to the anatomical SYNTAX score, termed as "log CSS", augmented the accuracy and reliability of the prediction of SVG failure and MACCE in patients undergoing CABG., (© The Author(s) 2014.)

Background: Fragmented QRS (fQRS) arises from impaired ventricular depolarization due to heterogeneous electrical activation of ischemic and/or infarcted ventricular myocardium. The short- and long-term prognostic values of fQRS have been reported for myocardial infarction, heart failure, fatal cardiac arrhythmias, and sudden cardiac death. The aim of this study was to investigate the predictive value of admission fQRS complex for in-hospital cardiovascular mortality of patients with type 1 acute aortic dissection (AAD)., Methods: In this retrospective study, 203 consecutive patients with type 1 AAD who had been admitted to either of two large-volume tertiary hospitals between December 2008 and October 2013 were included. The patients were divided into two groups according to the presence or absence of the fQRS complex on admission., Results: In-hospital cardiovascular mortality (P < 0.001), major adverse cardiovascular events (P < 0.001), acute renal failure (P = 0.022), multiorgan dysfunction (P < 0.001), and acute decompensated heart failure (P < 0.001) were observed to be significantly more frequent in the fQRS-positive group than in the fQRS-negative group. fQRS (odds ratio [95% confidence interval]: 4.184 [1.927-9.082], P < 0.001), operation duration (4.184 [1.927-9.082], P = 0.001), and Killip class IV (3.900 [1.699-8.955], P = 0.001) were found to be significant independent predictors of in-hospital cardiovascular mortality after adjustment of other risk factors in the multivariate analysis., Conclusions: fQRS is a simple, inexpensive, and readily available electrocardiographic entity that provides an additional risk stratification level beyond that provided by conventional risk parameters in predicting in-hospital cardiovascular mortality in type 1 AAD., (© 2014 Wiley Periodicals, Inc.)

Background: Sudden cardiac deaths due to arrhythmias are thought to be an important cause of mortality in patients with renal transplants. Exposure to immunosuppressive drugs may lead to QT or PR interval abnormalities which may consequently cause arrhythmias. Our study investigated the long term impact of four different immunosuppressive drugs on PR and corrected QT intervals (QTc) in renal transplant patients, Methods: The study population consisted of 98 kidney transplant recipients. Study patients were receiving immunosuppressive management with tacrolimus, cyclosporine A, everolimus or azathioprine according to the local protocols. QTc and PR intervals obtained from the most recent post-transplant electrocardiograms were compared with the pre-transplant intervals dated before the transplantation procedure., Results: Post-transplant QTc intervals had prolonged significantly in comparison to the pre-transplant QTc intervals in all groups. However, there were no significant differences between the immunosuppressive agents with regard to post-transplant QTc interval prolongation (p > 0.05). There were no significant differences between the groups with regard to the pre and post-transplant PR interval changes (p > 0.05)., Conclusions: QT interval prolongation, a marker of risk for arrhythmias and sudden death, is highly prevalent among kidney transplant patients receiving different classes of immunosuppressive drugs., (© 2014 Wiley Periodicals, Inc.)

Background: Levels of galectin-3, a member of a family of soluble β-galactoside-binding lectins, are reported to be higher in patients with type 2 diabetes mellitus (DM) and metabolic syndrome. Conflicting results exist on the effects of galectin-3 in diabetic patients. The aim of this study was to investigate the relationship between galectin-3 levels and coronary artery disease (CAD), coronary plaque burden, and plaque structures in patients with type 2 DM., Patients and Methods: A total of 158 consecutive patients with type 2 DM undergoing planned coronary computed tomography angiography (CCTA) were included in this study. The study population was divided into CAD and non-CAD groups according to the presence of CCTA-determined coronary atherosclerosis., Results: Galectin-3 concentrations were significantly higher in the CAD group than in the non-CAD group (1412.0 ± 441.7 vs. 830.2 ± 434.9 pg/ml, P < 0.001). Galectin-3 levels were correlated positively with BMI, high-sensitivity C-reactive protein, the total number of diseased vessels, the number of plaques (all, P < 0.001), and the calcified plaque type (P = 0.001). In addition, galectin-3 levels were found to be a significant independent predictor of coronary atherosclerosis in type 2 diabetic patients (P = 021; odds ratio, 1.002; 95% confidence interval, 1.000-1.003)., Conclusion: Galectin-3 is a novel, promising biomarker that may help identify type 2 diabetic patients who may require early CAD intervention because of the potential risk of coronary atherosclerosis.

Introduction: Recent studies have demonstrated the potential of microRNAs (miRNA) as biomarkers in various cardiovascular disorders. The aim of the present study was to quantitatively evaluate the expression levels of miRNAs in patients with chronic congestive heart failure (CHF) in order to identify differential expression profiles as biomarkers with prognostic values., Materials and Method: The study included 20 clinically stable [New York Heart Association (NYHA) II] and 22 decompensated (NYHA III and IV) CHF patients and 15 healthy controls. miRNA profiling was performed using a microarray method. Dysregulated miRNAs were evaluated for their biomarker potential., Results: Microarray profiling revealed an increase in the expression of miR-21, miR-650, miR-744, miR-516-5p, miR-1292, miR-182, miR-1228, miR-595, miR-663b, miR-1296, miR-1825, miR-299-3p, miR-662 miR-122, miR-3148 and miR-518e and a decrease in the expression of miR-129-3p, miR-3155, miR-3175, miR-583, miR-568, miR-30d, miR-200a-star, miR-1979, miR-371-3p, miR-155-star and miR-502-5p in sera of CHF patients. The prognostic value of miR-182 [area under the curve (AUC) 0.695] was found to be superior to pro-brain type natriuretic peptide (NT-proBNP; AUC 0.350) and high-sensitivity C-reactive protein (hs-CRP) (AUC 0.475) by receiver operator characteristic (ROC) analysis. Cox regression analysis showed that miR-182 could predict cardiovascular mortality (P = 0.032)., Conclusion: We demonstrated the increased expression levels of circulating miRNAs in CHF as compared with controls. Moreover, miR-182 was found to be a potential prognostic marker in CHF.

Unlabelled: Use of last fluoro hold (LFH) mode in fluoroscopy, which enables the last live image to be saved and displayed, could reduce radiation during percutaneous coronary intervention when compared with cine mode. No previous study compared coronary angiography radiation doses and image quality between LFH and conventional cine mode techniques., Methods: We compared cumulative dose-area product (DAP), cumulative air kerma, fluoroscopy time, contrast use, interobserver variability of visual assessment between LFH angiography, and conventional cine angiography techniques. Forty-six patients were prospectively enrolled into the LFH group and 82 patients into the cine angiography group according to operator decision., Results: Mean cumulative DAP was higher in the cine group vs the LFH group (50058.98 ± 53542.71 mGy•cm² vs 11349.2 ± 8796.46 mGy•cm²; P<.001). Mean fluoroscopy times were higher in the cine group vs the LFH group (3.87 ± 5.08 minutes vs 1.66 ± 1.51 minutes; P<.01). Mean contrast use was higher in the cine group vs the LFH group (112.07 ± 43.79 cc vs 88.15 ± 23.84 cc; P<.001). Mean value of Crombach's alpha was not statistically different between visual estimates of three operators between cine and LFH angiography groups (0.66680 ± 0.19309 vs 0.54193 ± 0.31046; P=.20)., Conclusion: Radiation doses, contrast use, and fluoroscopy times are lower in fluoroscopic LFH angiography vs cine angiography. Interclass variability of visual stenosis estimation between three operators was not different between cine and LFH groups. Fluoroscopic LFH images conventionally have inferior diagnostic quality when compared with cine coronary angiography, but with new angiographic systems with improved LFH image quality, these images may be adequate for diagnostic coronary angiography.

Objective: The aim of the study was to compare the effect of submucosal injection of dexamethasone and triamcinolone acetonide on postoperative pain, swelling, and trismus occurring after impacted mandibular third molar surgery., Method and Materials: A total of 78 patients (aged 18 to 35) with asymptomatic, unilateral, impacted mandibular third molar, and without any systemic disease were included in this study. Patients were divided into three groups randomly (control, dexamethasone, and triamcinolone acetonide). In the experimental groups, dexamethasone and triamcinolone acetonide were injected into submucosa at about 1 cm above the surgical area submucosally. The control group of patients did not take any drug submucosally but the same surgical procedure was applied. Pain evaluation was performed by visual analog scale (VAS). Swelling was measured using a flexible standard ruler measuring the dimensions of the axes between certain points on the face. For trismus evaluation, maximum mouth opening was measured. Measurements taken on the preoperative, and on postoperative first, third, and seventh days were compared with each other and statistically evaluated., Results: There were statistically significant differences between the control and experimental groups on the different days of the postoperative period. The effect of triamcinolone acetonide on pain started on the first day postoperatively and the effect of triamcinolone acetonide on trismus and pain was better than other groups at the third and seventh days. However, there was no statistically significant difference between the effects of dexamethasone and triamcinolone acetonide regarding postoperative complications., Conclusion: The submucosal injection of dexamethasone or triamcinolone acetonide might be an effective treatment for postoperative discomfort occurring following impacted mandibular third molar surgery, and triamcinolone acetonide could be applied as an alternative to dexamethasone.

Objectives: Fragmented QRS (fQRS) has been found to be associated with high mortality and arrhythmic events in acute coronary syndromes. Regional systolic function using wall motion score index (WMSI) is an alternative to left ventricular ejection fraction (LVEF) for the assessment of left ventricular systolic function. The aim of this study was to investigate the relation between the presence of fQRS on admission electrocardiogram (ECG) and WMSI in ST elevation myocardial infarction (STEMI) underwent primary coronary intervention (PCI). The in-hospital and long-term prognostic significance of persistent fQRS was also evaluated., Methods: In this retrospective study, 542 patients with a diagnose of STEMI underwent primary PCI were included. Study patients were divided into two groups according to the presence (n = 153) or absence (n = 389) of a fQRS on admission ECG., Results: WMSI was found to be significantly higher in fQRS(+) group compared to the fQRS(-) group (P < 0.001). In multivariete analysis, WMSI was found to be an independent predictor of fQRS, and fQRS was inversely associated with LVEF. The in-hospital reinfarction (P = 0.003), MACE (P = 0.024), intraaortic balloon pump use (P = 0.014), and advanced heart failure (P < 0.001) were found to be significantly more frequent in the fQRS(+) group. The presence of fQRS on admission was found to be associated with an increase in long-term cardiovascular mortality (P = 0.028), and long-term all-cause mortality (P = 0.022)., Conclusion: WMSI was significantly related with the presence of the fQRS, which reflects the linking between impairment of regional left ventricular systolic function and the presence of severe myocardial injury in STEMI., (© 2014 Wiley Periodicals, Inc.)

The aim of this study was to investigate the association of serum hyaluronidase and nitric oxide (NO) levels with arterial stiffness in patients with hypertension (HT) and diabetes mellitus (DM). A total of 101 patients with diagnosis of DM and HT were enrolled in this study. The patients were divided into three groups as follows: only hypertensive (I), only diabetic (II) and both diabetic and hypertensive (III). Serum hyaluronidase levels were negatively correlated with aortic strain (AS) and aortic distensibility (AOD) in all groups, whereas a significant positive correlation was noted between serum hyaluronidase levels and aortic strain index (ASI) (all p-values < 0.05). There was a significant negative correlation between serum hyaluronidase and NO levels in all patients (p < 0.001). When the correlation between serum hyaluronidase and serum NO levels was investigated in the individual patient groups, a negative correlation was found in groups I, II and III (p = 0.017, p < 0.001 and p < 0.001, respectively). A significant relationship between plasma hyaluronidase level and parameters of aortic stiffness was found in patients with HT and/or DM. We suggest that the pathophysiological mechanisms responsible for the development of arterial stiffness in subjects with impaired endothelial function may involve pathological changes in the HA metabolism.

Background: Lingula is a tongue-like flap of bone that overlaps the mandibular foramen antero-medially and location is clinically significant in oral and maxillofacial surgeries. The aim of this study was to assess the shape and precise location of lingula using cone-beam computed tomography (CBCT)., Materials and Methods: In this study, 3-dimensional images provided by CBCT of 63 patients (28 females, 35 males, age range 25-70 years) were retrospectively evaluated. All CBCT images were performed due to implant planning. From both sides of 63 mandibles were classified in the following shapes: triangular, truncated, nodular and assimilated. The location was determined by 5 distances from the lingula: the anterior and the posterior borders of the mandibular ramus, man-dibular notch and lover border of mandible. Height of the lingula was measured from the lingular tip to the mandibular foramen., Results: Nodular shape of lingula was the most commonly found (32.5%). The mean distance of lingula from anterior and posterior borders of mandibular ramus was 18.5 ± 2.3 and 16.9 ± 3.5 mm, respectively. The lingula was located at 18.1 ± 3.6 mm from the mandibular notch and 38.3 mm from the lover border of mandible. The mean height of lingula was 7.8 ± 2.4 mm., Conclusions: The present study provides the morphological variation and localization of the lingula. The lingula is an important clinical landmark for mandibular osteotomy, and for determining the distance to mandibular foramen entrance.

Background: The beneficial effects of the transcatheter aortic valve implantation (TAVI) on echocardiographic parameters including left atrial (LA) and left ventricular (LV) functions were described by previous studies. The aim of this study was to analyze the effects of TAVI on left atrial appendage (LAA) function assessed by transthoracic and transesophageal echocar-diography., Methods: Fifty-five patients with severe symptomatic aortic stenosis were included in this prospective study. LAA early and late emptying velocities, LAA filling velocity, peak early diastolic (EM), late diastolic (AM), and systolic (SM) velocities were measured with pulsed wave Doppler and tissue Doppler imaging, and E/Em ratio was calculated before and 7.1 ± 2.8 days after TAVI. A subgroup analysis was performed in accordance with the left ventricular ejection fraction (LVEF) of the patients and the severity of their LV diastolic dysfunction., Results: Although the post-procedure peaks and mean gradients of the patients decreased sig-nificantly, the LVEF increased significantly in those who had low LVEF before the procedure. The post-procedure E/Em ratio decreased significantly (p < 0.001). The post-procedural LAA mean filling velocity and EM velocity were significantly higher than the pre-procedural filling velocity (p < 0.001, p = 0.002, respectively). In the subgroup analysis, the post-procedural LAA filling velocity, early and late LAA emptying velocities, in addition to the mean velocity of the EM, AM, and SM were significantly higher than before the procedure in patients with LVEF of < 50% and E/Em ratios of > 15., Conclusions: LAA function improved soon after the TAVI procedure, especially in patients with low LVEF and marked LV diastolic dysfunction.

Background: The coronary slow flow (CSF) phenomenon is a delayed antegrade progression of contrast agent to the distal branch of a coronary artery in the absence of obstructive coronary artery disease (CAD). A narrow fragmented QRS (fQRS) has been reported as a significant predictor of sudden cardiac death in patients with idiopathic dilated cardiomyopathy. The present study aimed to investigate the relationship between a narrow fQRS on the admission electrocardiogram (ECG) and CSF on coronary angiography., Methods: This study included 165 consecutive patients (112 CSF, 53 controls) who underwent first-time diagnostic conventional coronary angiography for suspected CAD. Coronary flow was quantified by thrombolysis in myocardial infarction (TIMI) frame count (TFC). The patients were divided into two groups according to the presence or absence of a narrow fQRS complex on the admission ECG., Results: Forty four patients were in the fQRS group (mean age, 52.97 ± 3.13 years). There was no difference between the two groups with respect to age, gender, body mass index, family history, hyperlipidemia, hypertension, or diabetes mellitus. The extent of CSF was significantly greater in the fQRS group compared to the non-fragmented group (p < 0.001). A significant correlation was also found between mean TFC values and fQRS (p < 0.001). On multivariate analysis, only CSF (p = 0.03) was a significant independent predictor for narrow fQRS, after adjustment for other parameters., Conclusions: The narrow fQRS is a simple, inexpensive, and readily available noninvasive ECG parameter that may be a new potential indicator of myocardial damage in patients with CSF.

Background: In recent years, many microRNAs (miRNAs) were shown to be dysregulated in specific tissues playing critical roles in the pathogenesis and progression of heart failure (HF). Left ventricular (LV) mass (LVM) has long been recognised as an important prognostic marker in systolic HF patients., Aim: We hypothesised that circulating miRNAs may be associated with LVM in systolic HF patients. The present study aimed to evaluate the relationship between previously reported and novel dysregulated circulating miRNAs and echocardiographically determined LVM in symptomatic HF patients with LV systolic dysfunction., Methods: Forty-two consecutive patients diagnosed with NYHA II-IV symptomatic systolic HF and a control group consisting of 15 age- and sex-matched healthy volunteers were enrolled. After labelling extracted RNA, poly-A tails were added. RNAs were later hybridised on a GeneChip miRNA 2.0 array. After hybridisation and staining, arrays were scanned to determine miRNA expression levels, and differentially expressed miRNAs were identified., Results: Eighteen miRNAs were found to be upregulated in serum of HF patients, while 11 were demonstrated to be downregulated. When the association between dysregulated miRNAs and echocardiographic findings was investigated, miR-182 (p = 0.04), miR-200a* (p = 0.019), and miR-568 (p = 0.023) were found to be inversely correlated with LVM index (LVMI), while miR-155 (p = 0.019) and miR-595 (p = 0.04) were determined to be positively correlated with LVMI., Conclusions: The results of our study revealed that dysregulated circulating miRNAs were correlated with anatomic changes in LV, in terms of LVMI, in symptomatic HF patients with systolic LV dysfunction.

Objective: Left ventricular (LV) hypertrophy (LVH) predicts increased mortality in part due to an elevated incidence of sudden cardiac death in hypertension. The aim of the present study was to investigate the relation of microvolt T-wave alternans (MTWA) with different LV geometric patterns in patient with sustained hypertension., Methods: This study consisted of 311 consecutive patients with sustained hypertension who were divided into four groups according to LV geometrical patterns. 90 patients were in the normal geometry group (NGG) [mean age 49.6 ± 7.8 years; 60 males (66.7%)], 99 patients were in the concentric remodeling group (CRG) [mean age 50.9 ± 6.6 years; 50 males (50.6%)], 63 patients were in the concentric hypertrophy group (CHG) [mean age 51.6 ± 7.3 years; 32 males (50.7%)] and 58 patients were in the eccentric hypertrophy group (EHG) [mean age 51.6 ± 9.0 years; 30 males (51.7%)]. Physical examination, laboratory work-up, office blood pressure measurement, transthoracic echocardiography and MTWA measurements were performed on all participants., Results: MTWA positivity was significantly higher in EHG and CHG as compared to CRG and NGG (p < 0.001). Left ventricle mass index (LVMI), LV end-diastolic diameter (LVEDD), LV end-systolic diameter (LVESD), interventricular septum diameter (IVSd), posterior wall diameter (PWd) and office systolic blood pressure (SBP) were found to be significantly positively correlated with MTWA (all p-values < 0.05)., Conclusion: We demonstrated that increased LVMI is associated with an elevated MTWA positivity in sustained hypertensives. Moreover, clinically significant LV geometric patterns including both concentric and eccentric hypertrophy are related with a raised MTWA positivity, which may lead to particular predilection to life-threatening ventricular arrhythmias and sudden cardiac death in sustained hypertension.

Background: Peripheral arterial occlusive disease (PAOD), which is common in male gender and elderly population, is related with increased cardiovascular mortality and morbidity. Neutrophil to lymphocyte ratio (NLR) has been found to be an independent predictor of cardiovascular mortality in atherosclerosis. The aim of the present study was to investigate the association between NLR and cardiovascular mortality both in patients with intermittent claudication and critical limb ischemia., Methods: In a retrospective study, 593 consecutive patients who had been admitted to the inpatient ward of the vascular department of a large tertiary training and research hospital with diagnosis of symptomatic PAOD between May 2009 and September 2012 were included. Patients were divided into two groups according to their NLR as follows: high NLR (NLR>3.0) and low NLR (NLR ≤ 3.0) groups., Results: During the course of the present study [median follow-up period of 20 months (interquartile range, 12-27)], 75 deaths occurred out of 508 patients (14.8%). Cardiovascular mortality was found to be significantly higher in elevated NLR group (n = 43) as compared to low NLR group (n = 32) (23.6% vs 9.8%, respectively; p < 0.001). Even after adjustment of various risk factors, NLR > 3 and age were found as independent predictors of long-term cardiovascular mortality in Cox regression analysis [hazard ratios (95% confidence interval), 2.04 (1.26-3.30) and 1.04 (1.01-1.07), p = 0.004 and p = 0.004, respectively]., Conclusion: We demonstrated that an increased NLR was related with higher cardiovascular mortality in patients with PAOD, who were admitted with critical limb ischemia or intermittent claudication. NLR, which reflects the patient's inflammatory status, is an inexpensive and readily available biomarker that provides an additional level of risk stratification beyond that provided by conventional risk scores in predicting long-term cardiovascular mortality in PAOD., (Copyright © 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.)

Background: Elevated gamma-glutamyl transferase (GGT) levels have been demonstrated to be associated with poor prognoses in patients with coronary artery disease. Coronary computed tomography angiography (CCTA) is a noninvasive imaging modality that may differentiate the structure of coronary plaques. Elevated plaque burdens and noncalcified plaques, detected by CCTA, are important predictors of atherosclerosis in young adults., Hypothesis: The present study investigated the possible relationship between GGT levels and coronary plaque burdens/structures in young adults with coronary atherosclerosis., Methods: CCTA images of 259 subjects were retrospectively examined, and GGT levels were compared between patients with coronary plaques and individuals with normal coronary arteries. Coronary plaques, detected by CCTA, were categorized as noncalcified, calcified, and mixed, according to their structures. The significant independent predictors of coronary atherosclerosis were also analyzed using multivariate logistic regression analysis., Results: GGT levels were significantly higher in patients with coronary plaque formation than in controls (35.7 ± 14.7 vs 19.6 ± 10.0 U/L; P < 0.001). GGT levels were also positively correlated with the number of plaques; presence of noncalcified plaques; and levels of high-sensitivity C-reactive protein (hs-CRP), hemoglobin A1c, uric acid, and triglycerides. Moreover, smoking and levels of GGT, hs-CRP, uric acid, and low high-density lipoprotein cholesterol were independent predictors of coronary atherosclerosis., Conclusions: GGT is an inexpensive and readily available marker that provides additional risk stratification beyond that provided by conventional risk factors for predicting coronary plaque burdens and plaque structures in young adults., (© 2014 Wiley Periodicals, Inc.)

The aim of this study was to investigate immunohistochemically the influence of cigarette smoking on the socket healing after tooth extraction in rats. Eighty-four male rats were divided into 3 groups; 2 groups were considered as experimental and the other as control. The animals in test 1 were exposed to smoking regimen before the surgery and after the surgery, but the animals in test 2 were exposed to the smoking regimen only before surgery. All animals' maxillary right central incisors were extracted and killed at the 3rd, 7th, 15th, and 28th day. The samples taken on third day after tooth extraction were stained immunohistochemically with fibronectin antibody and the other with type I collagen antibody. On the third day after tooth extraction, samples in the control group were intense stained (3) (+++); in the test 1 they were slight positive (1) (+) and in the test 2 they were moderate positive (2) (+ +). As a result of scoring type I collagen antibody, there was no statistically significant difference between the groups at seventh day, but there were statistically significant differences between the groups at the 15th and 28th day (P = 0.000 and P = 0.001, respectively). Comparison of the paired intense scores of type I collagen antibody staining according to days within each groups were not statistically significant. As a result, we have found out that the healing process of the tooth extraction socket is negatively affected by cigarette smoke.

Objective: The aim of this study is to assess the distance between the anterior nasal spine and the sphenoidal rostrum related to the LeFort I surgery in a Turkish population sample., Material and Methods: We retrospectively reviewed multidetector computerized tomography (MDCT) scans of 209 patients (134 males and 75 females). The images were obtained on a 64-MDCT scanner. The imaging parameters were 0.5 × 64 mm slice thickness, 0.5/0.3 mm increment, 120 kV, 250 mAs, 0.5 sn rotation time, 0.641 pitch, and 512 matrix. The distance between the anterior nasal spine and the sphenoidal rostrum was assessed with the Vitrea 2 software program., Results: The study group consisted of 134 male (mean age 57.90 ± 5.86) and 75 female (mean age 54.84 ± 4.31) patients. The distance between the anterior nasal spine and the sphenoidal rostrum was ranging between 40.4 and 70.9 mm (average 58.3 ± 5.9) in males and 45.0 and 63.2 mm in (average 55.2 ± 4.3) females. In addition, no statistically significant differences were found between genders., Conclusion: The results of the current study showed that after 40 mm proceeding of the ball end nasal osteotome, the surgeons must be aware of penetrating the sphenoidal rostrum.

Odontomas are the most common odontogenic tumors, representing 70% of all odontogenic tumors. They may present in two specific forms; compound odontoma forms multiple small tooth-like structures, while complex odontoma forms an amorphous calcified mass. In this report, we present a 27-year-old male patient with multiple compound odontoma occupied regions at his jaws. The odontomas involve both alveolar and basal processes of the maxilla and mandible as well as both maxillary sinuses. Converse to conventional recommended treatment, which is surgical excision of the lesion, the management was removal of the lesion and clinical-radiologic followup. The first year's follow-up findings are presented in this case report.

AIM. This study aimed to clarify the relation between the angulation of the curved osteotome and fracture of the pterygoid plate during Le Fort I osteotomy. MATERIAL AND METHODS. Twenty-one specimens of hemisectioned Turkish skulls were used for the study. The maxilla was sectioned transversely on the floor of the pyriform aperture and posteriorly to the lateral pterygoid plate with a mechanical saw. The pterygomaxillary junction was separated with a curved osteotome by angulating the osteotome with, 0° and -30° to the occlusal plane. The undesired fractures of the lateral pterygoid plate were determined. Among 21 specimens, 7 pterygomaxillary junctions were separated with an angle of +30° , 7 with 0° and 7 with -30° to the occlusal plane. RESULTS. In group +30°, the undesired fracture occured in 6 of the cases. In group -30°, the undesired fracture was determines in one case. In cases where the separation was performed by placing the osteotome paralell to the occlusal plane all plates remained safe. CONCLUSION. Within the limited knowledge of the current study it can be concluded that the osteotome should be placed paralell to the occlusal plane.

Introduction: Many studies have reported the diagnostic and prognostic value of haemoglobin A1c (HbA1c) levels in patients with acute coronary syndrome. However, the short- and long-term prognostic value of HbA1c level in patients with ST elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) is controversial., Aim: To investigate whether admission HbA1c level has a prognostic value for in-hospital, short-, and long-term cardiovascular (CV) mortality and major adverse cardiovascular events in patients with STEMI undergoing primary PCI., Material and Methods: This prospective study included 443 consecutive patients with STEMI who underwent primary PCI between September 2010 and July 2012. The patients were divided into three groups based on admission HbA1c levels: group I (HbA1c ≤ 5.6%), group II (HbA1c 5.7-6.4%), and group III (HbA1c ≥ 6.5%). The in-hospital, 1-month, and 1-year CV events of all 3 patient groups were followed up., Results: A significant association was found between HbA1c level and 1-year primary clinical outcomes, including CV mortality, non-fatal reinfarction, and stroke (p = 0.037). In addition, age, Killip class > 1, and left ventricular ejection fraction were found to be independent predictors of long-term CV mortality in multivariate analysis (hazard ratios (95% confidence interval) 1.081 (1.020-1.146), 4.182 (1.171-14.935), and 0.832 (0.752-0.920); p = 0.009, p = 0.028, and p < 0.001, respectively)., Conclusions: In this study, we demonstrated that increased admission HbA1c levels were associated with higher rates of major adverse CV events, including mortality, non-fatal reinfarction, and stroke, in patients with STEMI who underwent primary PCI.

Background: Urocortin 1 (UCN1) has cardiostimulatory, vasodilatory, diuretic and natriuretic effects, and its expression increases in heart failure (HF)., Aim: To determine UCN1 levels in patients with HF, to evaluate UCN1's relationship with various clinical parameters, and to assess UCN1 as a diagnostic marker in HF, compared to pro-B-type natriuretic peptide (pro-BNP)., Methods: We investigated serum levels of UCN1 and pro-BNP in 90 consecutive patients with systolic HF (left ventricular ejection fraction [LVEF] ≤ 45%) and 90 healthy controls. Serum UCN1 and pro-BNP levels were measured using the ELISA method. Transthoracic echocardiography was performed to determine LVEF and pulmonary artery systolic pressure (PASP). Glomerular filtration rate (GFR) was estimated using the Cockcroft-Gault formula., Results: UCN1 level was higher in HF patients (391.5 [357.0-482.0] pg/mL, p < 0.001). UCN1 was positively related with NYHA class (r = 0.89, p < 0.001), and PASP (r = 0.39, p < 0.001); and negatively related with LVEF (r = -0.46, p < 0.001), and GFR (r = -0.21, p = 0.046). A significant positive correlation was found between pro-BNP and UCN1 levels (p < 0.001, r = 0.96). Receiver operating characteristic (ROC) curves yielded an area under the curve (AUC) of 0.99 (95% CI 0.98-1.00,p < 0.001) for UCN1 and 1.00 (p < 0.001) for pro-BNP in the diagnosis of HF., Conclusions: UCN1 increases with worsening HF and left ventricular dysfunction. It may be used as a diagnostic biomarker in systolic HF, but the incremental value of measuring UCN1 in patients tested for pro-BNP is questionable.

Background: Isolated systolic hypertension (ISHT) is a subtype of hypertension (HT) that often exhibits wide pulse pressure, and pulse pressure has a strong predictive value for future adverse cardiovascular events. Previous studies have shown the effects of leukocyte count on the prognosis of ischaemic heart disease and HT., Aim: Thus, in this cross-sectional study, we analysed the relationship between leukocyte counts and subtypes in HT and non-HT groups., Methods: The study population consisted of 960 consecutive patients who were admitted to the outpatient clinic of our hospital. After ambulatory blood pressure values were assessed, the participants were divided into three groups: ISHT (n = 98), systo-diastolic hypertensives (SDHT, n = 405), and non-hypertensives (non-HT, n = 457)., Results: The subjects in the ISHT group were older than those in the SDHT and non-HT groups (64 ± 10, 53 ± 12, and 52 ± 13, respectively; p < 0.001). The leukocyte and neutrophil counts and neutrophil/lymphocyte (NL) ratios were significantly different in all groups. In subgroup analysis, the leukocyte count, neutrophil count, and N/L ratio were higher in the ISHT and SDHT groups than in the non-HT group (p < 0.001 for all). The leukocyte count, neutrophil count, and N/L ratio were significantly higher in the ISHT group than in the SDHT group (p = 0.023, p = 0.007, p = 0.010, respectively). Neutrophil count (p = 0.012; OR = 1.229, 95% CI 1.046-1.444) was an independent risk factor for ISHT in multivariate logistic regression analysis., Conclusions: The leukocyte and neutrophil counts and N/L ratios were higher in the ISHT group than in the SDHT and non-HT groups. High neutrophil count was an independent predictor of ISHT.

Background: Apelin is a novel endogenous peptide with inotropic and vasodilatory properties., Aim: To investigate the role of apelin in the prognosis of acute coronary syndromes (ACS) and to assess the relationship between apelin and other diagnostic and prognostic markers., Methods: Seventy-six patients with ACS (mean age 62.1 ± 10 years) were evaluated in terms of their plasma apelin-36 concentrations, ejection fraction (EF), high sensitivity C-reactive protein (hsCRP), creatine kinase (CK), CK-MB and troponin I levels. The study group consisted of 35 ST elevation myocardial infarction (STEMI) and 41 non-ST elevation (NSTE) ACS patients. Patients were followed up for one year for cardiovascular outcomes., Results: There was no significant relationship between apelin and TIMI, GRACE, GENSINI scores, hsCRP and EF in STEMI and NSTE-ACS groups (p > 0.05). Apelin showed positive correlations with CK, CK-MB and troponin I in patients with NSTE-ACS, but a negative correlation in patients with STEMI (p < 0.05). There were no statistically significant differences between patients reaching the composite end point at one year with regard to apelin levels., Conclusions: Apelin was positively correlated with cardiac biomarkers in patients with NSTE-ACS but negatively correlated in patients with STEMI. In STEMI, generally larger amounts of myocardial cells are subjected to infarction compared to NSTE-ACS, which may explain why apelin levels decrease with increasing CK, CK-MB and troponin levels in STEMI patients.