Background and Aim: Postoperative pain is well known and usually disturbing complication of surgery. Inflammation plays an important role in the development and progression of postoperative pain. We aimed to investigate possible relationship between preoperatively measured neutrophil-lymphocyte ratio (NLR) - as an inflammation marker - and postoperative analgesic demand in patients underwent orthognathic surgery. Materials and Methods: We retrospectively investigated medical and anesthesia records of 177 patients underwent orthognathic surgery. Demographical data, preoperative NLR, type of surgery, modified Mallampati score, difficulty degree of intubation, duration of surgery, and postoperative analgesic (tenoxicam - as the first drug of choice, paracetamol, tramadol, or pethidine) usage were recorded. A cutoff value of NLR >= 2 was determined for inflammation threshold. Two groups (Group 1 NLR >= 2, Group 2 NLR <2) were compared for analgesic doses, numbers of patients needed analgesic treatment, and other parameters. Results: Mean administered tenoxicam dose was significantly higher in Group 1 than in Group 2 (P < 0.0001). Further, ratio of patients treated with tenoxicam in Group 1 was significantly higher than that in Group 2 (chi(2) = 4.779, P = 0.029). Conclusions: Preoperatively measured NLR may help to predict postoperative analgesic demand in patients undergoing orthognathic surgery, and thus sufficient postoperative pain control can be achieved with various preventive treatments taken at the perioperative period such as preemptive analgesia, local anesthetic administration at the end of surgery, or early administration of analgesics.

The aim of the present study was to investigate serum homocysteine levels in patients with erectile dysfunction and to evaluate the relationship between serum homocysteine levels and response to the standard 50 mg phosphodiesterase 5 inhibitor treatment. Twenty-eight erectile dysfunction patients having normal vascular parameter according to Penile Doppler Ultrasonography and twenty healthy subjects were enrolled in the study. All subjects filled The International Index of Erectile Function (IIEF) questionnaire. A total of 4-6 doses of phosphodiesterase 5 inhibitor (sildenafil 50 mg) were given to patients. Later, they were divided into two groups as sildenafil responder and non-responder. Serum homocysteine levels were compared in groups based on sildenafil response. Compared with healthy subject, higher homocysteine levels were observed in patients with erectile dysfunction (p = 0.005), especially in sildenafil non-responder group (p = 0.005). There was significant negative correlation between homocysteine and IIEF scores in group responder to sildenafil treatment (r = -0.698, p = 0.008). Mean IIEF scores of patients with non-responder to sildenafil 50 mg were lower than those of controls (p = 0.0001), but mean IIEF scores of patients with responders approached values observed in control subjects (p = 0.002). The results indicated that measurement of serum homocysteine levels could be used as a marker for the evaluation of efficacy of phosphodiesterase 5 inhibitor and the selection of efficacious alternative therapies.

Oxygen-derived free radicals are important agents of tissue injury during ischemia and reperfusion. The aim of this study was to investigate changes in protein and lipid oxidation and antioxidant status in beating heart coronary artery surgery and conventional bypass and to compare oxidative stress parameters between the two bypass methods. Serum lipid hydroperoxide, nitric oxide, protein carbonyl, nitrotyrosine, vitamin E, and β-carotene levels and total antioxidant capacity were measured in blood of 30 patients undergoing beating heart coronary artery surgery (OPCAB, off-pump coronary artery bypass grafting) and 12 patients undergoing conventional bypass (CABG, on-pump coronary artery bypass grafting). In the OPCAB group, nitric oxide and nitrotyrosine levels decreased after reperfusion. Similarly, β-carotene level and total antioxidant capacity also decreased after anesthesia and reperfusion. In the CABG group, nitric oxide and nitrotyrosine levels decreased after ischemia and reperfusion. However, protein carbonyl levels elevated after ischemia and reperfusion. Vitamin E, β-carotene, and total antioxidant capacity decreased after ischemia and reperfusion. Significantly decreased nitration and impaired antioxidant status were seen after reperfusion in both groups. Moreover, elevated protein carbonyls were found in the CABG group. The off-pump procedure is associated with lower degree of oxidative stress than on-pump coronary surgery.

The object of the study is to determine the effect of thyme loading during exercise at elite wrestlers on oxidant stress and anti-oxidant capacity. Totally 18 elite wrestlers were involved in the study. The wrestlers were randomly divided into two groups, experimental and placebo. The subjects were loaded 1 g dried thyme tea three times a day after meals during 35-day period. The blood samples were taken before and after loading thyme, and total antioxidant capacity (TAC), melondialdehyde (MDA) and total sulphydryl group (RSH) were analysed. To evaluate the dates, Wilcoxon signed rank test was used for in-group evaluation and Mann–Whitney U test was used for inter group evaluation and significance level α was set at 0.05. While there were no differences between groups before loading thyme, TAC values were found meaningfully increased after loading in experimental group (p<0.05). However, the decrease in MDA values of the experimental group after loading thyme was statistically significant (p<0.01). The decreases in RSH values of the experimental group were insignificant (p>0.05). In the other hand experimental group decreasing of the MDA values and increasing of the TAC values were found statically significant compared with placebo groups (p<0.05). But compared with two groups RSH values were statically insignificant. It was concluded that thyme loading increases enzymatic antioxidant capacity but does not have any effects on non-enzymatic antioxidant structures during exercise. However, thyme loading reduced oxidant stress in elite sportsmen.

Cephalometric studies show significant gender differences in the size of the pharyngeal airway space. This study aimed to investigate and compare morphologic changes after mandibular setback or two-jaws surgery on the pharyngeal airway in men and women using computed tomography (CT). The sample included 34 women and 13 men diagnosed with Class III skeletal deformities, who had been treated by mandibular setback or bimaxillary surgery (maxillary advancement and mandibular setback). Anteroposterior, lateral and cross-sectional area dimensions of the airway, at the level of soft palate and base of tongue, were measured pre- and postoperatively on CT images. In the mandibular setback group, the anteroposterior and cross-sectional area of the pharyngeal airway at the level of the soft palate and base of tongue were significantly reduced for men or women (P<.05). In the two-jaws surgery group, only midsagittal anteroposterior dimensions at the same levels were significantly decreased for men or women (P<.05). The difference between any values measured between men and women who received bilateral sagittal split ramus osteotomy setback surgery or two-jaws surgery for the treatment of class III anteroposterior discrepancy were not statistically significant (P>.05). This study suggests that oropharyngeal airway measurements, important for airway patency, do not demonstrate sex dimorphism.

This study compared the data on mandibular fractures that occurred in a city in the United States and one in Turkey between 1991 and 2000. The 210 Turkish patients had 252 mandibular fractures, whereas the 665 US patients had 1042 mandibular fractures. Males accounted for 84% (560 patients) and females for 16% (105 patients) of the cases in the US. The male:female ratio was 5.5:1. In Turkey, males accounted for 76% (160 patients) and females for 24% (50 patients) of cases. The male:female ratio was 3.2:1. Assault (53.7%) was the most common cause of fracture in the US, whereas in Turkey the most common cause was a motor vehicle accident (36.2%). The most common site of mandibular fracture in the US was the angle (27.57%); in Turkey the most common site was the body (28.97%). Many of these variations may be related to socioeconomic, cultural and environmental differences between the two countries.

Purpose: The aim of this study was to evaluate the effects of different inter-implant distances on stress distribution in the bone around the endosseous titanium implants under vertical, oblique and horizontal loads in the posterior mandibular edentulousim by finite element analysis (3D FEA).Materials and methods: 3D FEA models representing mandible and ITI (R) implant (Straumann, Waldenburg, Switzerland) were simulated. The distances in-between the units were set at 0.5, 1.0 and 2.0 cm. Vertical (V) 70 degrees N, 60 degrees oblique (BL) 35 degrees N in buccolingual direction and horizontal (MD) 14 degrees N in mesiodistal direction loads were applied to each of these designs. The principal stresses (tensile and compressive stress) on each model were calculated using MSC MARC finite element analyze solver software.Results: The tensile stress (P-max) values have been evaluated that they rose at the cervical region of buccal side when the inter-implant distances increased under V and BL loads and they diminished while the inter-implant distances decreased. In short inter-implant distances the compressive stress (P-min) has been presented with increased values and found at the lingual surface of the cervical region.Discussion: The results of this study indicated that the magnitude of the stress was influenced by complex factors such as the direction of loads and the distance between adjacent fixtures. The stress occurring around fixtures differs significantly with various types of inter-implant distance.Conclusion: The evaluation of tensile and compressive stresses for cortical and cancellous bone under V,(MD)-M-1 and BL loading conditions in aspect of inter-implant distance shows; the 1.0 cm of inter-implant distance is the optimum distance for two fixture implantation. (c) 2005 IPEM. Published by Elsevier Ltd. All rights reserved.

The increased production of reactive oxygen species (ROS) from activated neutrophils in Behçet's disease (BD) and recurrent aphthous stomatitis (RAS) may result in increased oxidative stress. Uric acid can react rapidly with neutrophil‐derived ROS to form allantoin. The purpose of the study was to evaluate the serum levels of allantoin as a new marker of oxidative stress in BD compared with malondialdehyde (MDA) levels as a well‐known marker. Blood samples were obtained from 23 BD patients, 22 RAS patients as positive controls, and 21 healthy controls. When compared to the healthy controls, we found higher allantoin and MDA levels in the BD patients and higher MDA levels in the RAS patients. Serum ascorbic acid levels in the BD patients were significantly lower than in the controls. Increased allantoin and MDA levels suggest the possible involvement of free radicals in BD. As allantoin is only a product of uric acid oxidation by reactive oxygen and nitrogen species, it may also be used as a marker of oxidative stress in BD.

Changes in the levels of malondialdehyde (MDA), nitrate and nitrite (as an index of nitric oxide production), lipid hydroperoxide (LOH), total antioxidant capacity (TAC), lipids (total cholesterol and triglycerides) and lipoproteins (HDL- and LDL-cholesterol) were estimated in breast cancer patients (n = 15) and benign breast disease (n = 15). Serum and tissue MDA levels were found to be decreased in breast cancer patients compared to the benign group (p < 0.05). In contrast, nitrate and nitrite levels were increased in serum and tissue of the cancer group compared to benign breast disease patients (p < 0.05). Compared to the benign group, tissue TAC levels were elevated in the breast cancer patient group (p < 0.05). Total cholesterol and HDL-cholesterol were elevated in the benign group compared with cancer patients (p < 0.05). These findings support the hypothesis that lipid peroxidation in serum and tissue of benign breast disease is greater than in breast cancer. However, the enhanced levels of nitric oxide may be in response to inflammation in patients with breast cancer. Total antioxidant status is lower in benign tissue than in cancerous tissue, probably to compensate for this elevated free radical production.

Chondrosarcomas are the malignant cartilagenous tumors and they are seen rarely in the head and neck area. They are usually slow growing lesions. The head and neck chondrosarcomas may show an aggressive course and the occurrence of this malignant cartilagenous tumor in the parapharyngeal space is only a few. They are mostly located in relation with jaw bones and base of the skull. Chondrosarcomas of the parapharyngeal space are limited in number and among them there is no low-grade one. In this case report, a case of low-grade chondrosarcoma which was treated with a simple excision without neck dissection was reported.

Zinc is an essential trace element for many biological functions, including immune functions. The mechanism by which zinc may affect the immune system is certainly multifaceted, due to zinc's widespread action on different enzymes, peptides, transcriptional factors and cytokines involved in the various physiological steps of immune development and reactivity. In this study, prevalence of zinc deficiency and alteration in complement system, immunoglobulins and T cell subsets depending on zinc levels were analyzed in short-term hemodialysis patients and compared with healthy controls. Plasma zinc levels were measured by flame atomic absorption spectrometry. Serum levels of complement C3 and C4, immunoglobulins G (IgG), M (IgM), and A (IgA), and prealbumin were measured by nephelometry depending on antigen-antibody reactions. Percentages of CD4 and CD8+ were calculated using a flow cytometer. Statistically significant decreased zinc levels, especially in the age group > or = 40 years, and increased C4, IgA, IgM, IgG and CD4+ levels were observed in hemodialysis patients. The prevalence of hypozincemia in hemodialysis patients was found to be 40%. A higher CD4+/CD8 ratio was also obtained in patients. We conclude that patients on maintenance hemodialysis for a short time exhibit zinc deficiency and disturbed immune response.

The purpose of this study was to evaluate the mechanical behavior of different fixation methods used in bilateral sagittal split ramus osteotomy (BSSRO). Part 1 comprises of the results of the analysis for mandibular advancement, four different fixation configurations of six hole fragmentation mini plates with monocortical screws and lag screws and posterior loading conditions in the molar and premolar region. The finite element analysis method (FEA) appears suitable for simulating complex mechanical stress situations in the maxillofacial region. The mechanical behavior of selected lag screws with linear or triangular configuration and double parallel or single oblique six hole mini plates with monocortical screws were compared by FEA after 5 mm BSSRO advancement procedure. Four separate three-dimensional finite element models of the mandible were created to simulate the BSSRO and corresponding fixation methods. These models consisted of 122,717 elements and 25,048 nodes. The mechanical parameters of the materials studied were adopted from the literature or were based on manufacturer's information. 500 N posterior occlusal loads were simulated on the distal segments. The commercial finite element solver MSC Marc software was utilized to calculate the stress fields on both the segments and fixative appliances. It was concluded that the use of 2.0mm lag screws placed in a triangular configuration following the BSSRO advancement surgery provides sufficient stability with any rotational movement and less stress fields at the osteotomy site, when compared with the other rigid fixation methods used in the current study.