Conservative Management of Keratocystic Odontogenic Tumors of Jaws

Purpose. The aim of this study was to evaluate different surgical treatment methods for keratocystic odontogenic tumors (KCOTs) and the outcome of those treatments over a 9-year period. Patients and Methods. A retrospective review was performed on 43 KCOTs in 39 patients. In radiographic evaluations for diagnosis, follow ups and before and after treatment, panoramic, 3D CT and MR images were used. The three groups of different surgical treatment were (1) enucleation for small unilocular lesions without certainty of histology; (2) enucleation with Carnoy's solution, for small unilocular lesions after previous histological confirmation of KOCT; (3) marsupialization followed by enucleation with Carnoy's solution implemented for large often multilocular KCOTs with intact or destruction of cortical bone without infiltration of neighbouring tissue. Results. 43 KCOT cases were mostly localized in mandible (76.7%), radiologically unilocular (72%), and parakeratocysts (88.4%). Inflammation and satellite cysts (daughter cysts) were detected histopathologically in 14 (32.5%) and 7 (16.3%), respectively. Among the 43 cysts, 20 (46.5%) were associated with the impacted third molar and of 21 (48.8%) was in tooth bearing area, and 5 (11, 6%) located on edentulous areas. It was located mostly in the anterior region of maxilla (90%) and in mandibular molar and ramus (62.8%). The treatments of KCOTs were 18 (41.9%) for group 1, and 10 (23.3%) group 2, and 15 (34.8%) group 3. A statistically significant relationship was found between the radiographic appearance and treatment methods (P = 0.00). No recurrence was found on 40.54 ± 23.02 months follow up. Conclusion. We concluded that successful treatment methods were enucleation and Carnoy's solution in small lesions and marsupialization in lesions that have reached a very large size, but because KCOT was observed in second decade mostly, long-term follows up are suggested

Mikrodalga ve mikrodalga-kızıl ötesi kombinasyonu ile pişirilen değişik kek formülasyonlarının fiziksel özelliklerinin incelenmesi.

The main objective was to determine the variation of physical properties of different cake formulations during baking in microwave and infrared-microwave combination ovens. In the first part of the study, rheological and dielectric properties of cake batter with different formulations were determined. Different concentrations of fat and different types of emulsifier and fat replacer were used. The variation of formulation had a significant effect on the apparent viscosity of the cake batter. Cake batter was found to show shear thinning and time independent behaviour for all formulations. Dielectric properties of cake batter were dependent on formulation, frequency and temperature. In the second part of the study, physical properties (dielectric properties, volume, texture, color and porosity) of cakes baked in microwave and infrared-microwave combination oven were determined. In addition, starch gelatinization during baking was investigated. For comparison, cakes were also baked in conventional oven. Formulation and baking time were found to affect physical properties and gelatinization degree of cakes. Addition of fat to the formulation was found to increase the dielectric properties and gelatinization degree of microwave and infrared-microwave combination baked cakes. For both microwave and combination baking, cake samples with SimplesseTM had the highest volume but the firmest texture. Addition of maltodextrin resulted in a more uniform structure for infrared-microwave combination baking. There was insufficient gelatinization in microwave baked cakes ranging from 70 to 78% depending on fat content. The gelatinization degree ranged from 88 to 93% in conventionally baked cakes. Combining infrared with microwaves increased gelatinization degree (80-90%).Ph.D. - Doctoral Progra

Validity and reliability study of the Turkish version of the tolerance for mental pain scale-10

OBJECTIVE: Psychological pain has been accepted as one of the most critical psychological risk factors underlying suicidal ideation and behaviour. Suicide is chosen as a way to get rid of intense, painful and unbearable psychological pain. Since the level of tolerance rather than the intensity of psychological pain was considered to be more predictive for suicide, we aimed to investigate the validity and reliability of the Turkish version of Tolerance for Mental Pain Scale-10 (TMPS-10). METHODS: A total of 121 patients diagnosed with depression in 62 of them had previous suicide attempts and 105 healthy controls who applied to the outpatient clinics of Çukurova University Faculty of Medicine Psychiatry Department were included in the study. Beck Depression Inventory (BDI), Beck Scale for Suicidal Ideation (BSIS), Beck Hopelessness Scale (BHS), Psychache Scale (PS) and TMPS-10 were applied to participants. RESULTS: In the internal consistency analysis, Cronbach’s alpha coefficient was 0.96 for enduring the pain, 0.96 for managing the pain, 0.98 for the whole scale, and item-total correlation coefficients were found to be between 0.87 and 0.93. The scale fit well to both the two-factor and single-factor structure in the confirmatory factor analysis. The multi-group confirmatory factor analysis showed that both the depressive patients and the control group interpreted the scale items in the same way. In convergent validity analysis, there was a negative, linear, high and statistically significant relationship between TMPS-10 scores and PS, BSIS, BDI and BHS scores (r = −0.935; −0.779; −0.890; −0.808; p < .0.001, respectively). In discriminant function analysis, TMPS-10 successfully differentiated the depressive group and the control group, as well as the depressive patients who did or did not attempt suicide (96.5%, 88.1%, respectively). CONCLUSION: The Turkish version of TMPS-10 is valid and reliable, and may be useful in research and clinical practices about suicide

A Potentially Fatal Outcome of Oral Contraceptive Therapy: Estrogen-Triggered Hereditary Angioedema in an Adolescent

Hereditary angioedema (HAE) is characterized by recurrent angioedema attacks with no urticaria. This disease has a high mortality due to asphyxia. Level of complement component 4 (C4), C1 esterase inhibitor (C1-INH) level and function, and genetic mutations determine different endotypes of HAE. Clinical presentation and the triggers of vasogenic edema may change according to the endotypes. An adolescent girl with oligomenorrhea, obesity, hirsutism, and acanthosis nigricans was diagnosed with polycystic ovary syndrome and prescribed ethinyl estradiol and cyproterone acetate containing oral contraceptive (OC). On the sixteenth day of treatment, she developed angioedema of the face, neck, and chest leading to dyspnea. Adrenaline, antihistamine, and corticosteroid treatments were ineffective. In the family history, the patient’s mother and two cousins had a history of angioedema. C1-INH concentrate was administered with a diagnosis of HAE. C4 and C1-INH level and activity were normal. Genetic analysis identified a mutation in the factor 12 (F12) gene, and the diagnosis of F12-related HAE was made. OC treatment was discontinued. She has had no additional angioedema attacks in the follow-up period of two years. OC containing estrogen may induce the life-threatening first attack of F12-related HAE even in children. Recurring angioedema attacks in the family should be asked before prescribing estrogen-containing OC pills

Psychache and Suicidal History in Patients with Obsessive-Compulsive Disorder

Purpose: Suicide is an important cause of death in patients diagnosed with obsessivecompulsive disorder (OCD) as well as other psychiatric disorders. Early determining of risk factors provides an opportunity for intervention. The mediating effect of psychological pain (also known as psychache) on suicide has been shown in various disorders but has not been investigated in patients with OCD. In this study, we aimed to show the relationship between psychological pain and other clinical variables and suicide in OCD patients. Patients and methods: This cross-sectional study consisted of 67 patients diagnosed with OCD according to DSM-5 criteria with no comorbid psychiatric diagnosis who applied to the psychiatric outpatient clinic of Çukurova University Faculty of Medicine and 63 healthy controls. Among the OCD patients, 12 had previous suicide attempts. In addition to the sociodemographic data form, participants filled out the Yale-Brown Obsessive Compulsive Scale (YBOCS), the Psychache Scale (PS), the Beck Scale for Suicidal Ideation (BSIS), and the Hamilton Depression Scale (HDS). Results: OCD group’s median obsession, compulsion, and the total scores of YBOCS, and the mean PS scores were higher than the control group. There was no difference between the sociodemographic variables of OCD patients with and without previous suicide attempts such as age, gender, years of education, place of residence, marital, and occupational status. The median scores of obsession, avoidance, global severity, and indecisiveness subdimensions of YBOCS, the mean BSIS and PS scores, the rates of current aggressive, current contamination, and the past religious obsessions were higher in the suicidal group. There were moderately significant relationships in the same direction between the PS, BSIS, and total YBOCS scores. Multivariate regression analysis demonstrated that only the PS scores predicted previous suicide attempts. Conclusion: Our results demonstrated that current aggressive, current contamination, past religious obsessions, and the higher psychological pain are related to previous suicide attempts in OCD patients. Our regression analysis supports Shneidman’s hypothesis: there would be no suicide without psychache. Relieving psychache in OCD patients may reduce suicide attempts even if there is no diagnosis of comorbid depression