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Concept: Touring car racing


PURPOSE: To investigate the protective effects of Coenzyme Q10 (CoQ10) on bladder dysfunction in a rat model of atherosclerosis-induced chronic bladder ischemia (CBI). MATERIALS AND METHODS: Twenty-four 16-week-old male Sprague-Dawley rats were divided into four groups (six rats in each group; group 1, untreated sham-operated rats; group 2, CoQ10-treated sham-operated rats; group 3, untreated CBI rats; group 4, CoQ10-treated CBI rats). Groups 3 and 4 received an endothelial injury of the iliac arteries and were fed a 2% cholesterol diet for eight weeks. Groups 2 and 4 were treated with CoQ10, and the others were treated with vehicle for 4 weeks. Eight weeks after the operations, we performed continuous in vivo cystometry, in vitro detrusor muscle strip study, and malondialdehyde (MDA) assay. Histological examinations of the bladder walls and iliac arteries were also performed. RESULTS: Results from in vivo cystometry revealed that the administration of CoQ10 after induction of CBI prolonged the micturition frequency and intercontraction interval and increased bladder capacity in comparison to untreated CBI rats. In the detrusor muscle strip study, the administration of CoQ10 after induction of CBI increased the contractile responses compared to untreated CBI rats. CBI rats also showed higher MDA levels in bladder tissues and serum than the other groups. CBI induced submucosal fibrosis of the bladder walls and a degenerative change in the media of the blood vessels, as shown on histologic examinations. CONCLUSIONS: Our study suggests that CoQ10 acts as an antioxidant to protect bladder function in chronic bladder ischemia model.

Concepts: Atherosclerosis, Blood vessel, In vivo, Histology, Urinary bladder, Touring car racing, Pelvis, Coenzyme Q10


Background:  Dentinal hypersensitivity has been defined as a short, sharp pain arising from exposed dentine as a result of various stimuli such as heat, cold, chemical, or osmotic, that cannot be ascribed to any other pathology. This study was conducted to assess the efficacy of three commercially available toothpastes in the reduction of dentinal hypersensitivity. Methods:  A total of 149 subjects (72 males and 77 females; aged 20 to 60 years) were entered into the study and randomly divided into four groups: Group 1 - toothpaste containing 5% potassium nitrate; Group 2 - toothpaste containing 5% calcium sodium phosphosilicate with fused silica; Group 3 - toothpaste containing 3.85% amine fluoride; and Group 4 - a placebo toothpaste. After sensitivity scores for controlled air stimulus and cold water at baseline were recorded, subjects were given toothpastes and sensitivity scores were measured again at 2 weeks and 6 weeks. Results:  All groups showed a reduction in sensitivity scores at 2 weeks and 6 weeks. The calcium sodium phosphosilicate group was found to be significantly better compared to the other groups at the end of 6 weeks. Conclusions:  The calcium sodium phosphosilicate group showed a better reduction in the symptoms of dentinal hypersensitivity.

Concepts: Clinical trial, Randomized controlled trial, Touring car racing, Sodium, Potassium, Dentine hypersensitivity, Remineralisation of teeth, Toothpaste


BACKGROUND: Snake bites are an important cause of mortality and morbidity worldwide, especially in rural areas. OBJECTIVE: The aim of this study was to investigate serum paraoxonase (PON), arylesterase (ARLY), ceruloplasmin (Cp), and myeloperoxidase (MPO) activity and lipid hydroperoxide (LOOH) and total sulfhydryl group (-SH) levels in patients with snake venom poisoning. METHODS: The study included 49 patients with snake bite envenomation (Group 1) and 39 healthy volunteers as the control group (Group 2). Plasma PON, ARLY, Cp, and MPO activity and LOOH and -SH levels were measured. Laboratory measurements of 20 patients with snake bite envenomation (Group 3) were performed again after treatment. RESULTS: PON and ARLY activity and -SH levels were significantly decreased in Group 1 compared with those in Group 2. Cp and MPO activity and LOOH levels were significantly elevated in Group 1 compared with those in Group 2. PON and ARLY activity were significantly elevated in Group 3 compared with those in Group 1. Cp and MPO activity and LOOH levels were significantly decreased in Group 3 compared with those in Group 1. CONCLUSIONS: Patients with snake bite envenomation had increased oxidants (MPO and LOOH) and decreased antioxidants (PON, ARLY, and -SH). Results obtained in this study demonstrate that snake bites are associated with a shift to oxidative status. Therapy with antioxidants can lead to an increase in the antioxidant defense system, and thus improvements in clinical symptoms.

Concepts: Antioxidant, Touring car racing, Glutathione, Cysteine, Snakebite, Viperidae, Thiol, Snake venom


OBJECTIVES:: To evaluate the treatment alternatives for the management of the metaphyseal tibial comminution in severe plafond fractures, and to investigate the role of the fibula fracture fixation. DESIGN:: Retrospective clinical study. SETTING:: Level-2 trauma hospital. PARTICIPANTS:: Patients with highly comminuted tibial plafond fractures. INTERVENTION:: All patients were treated with open reduction and internal fixation of the articular surface and external fixation of the metaphyseal fracture. If metaphyseal comminution was minimal, bone graft was applied and the fibular was plated (group 1); if comminution was between 1 and 3 cm, acute shortening and distraction osteogenesis was performed (group 2); and if comminution was >3 cm, distraction osteogenesis without acute shortening was performed (group 3). MAIN OUTCOME MEASUREMENTS:: Radiographic union, AOFAS ankle score. RESULTS:: Of 30 fractures, 15 fractures (50%) had an anatomic reduction of the joint. Union occurred in all but 2 fractures. Group 1 fractures healed at an average of 19 weeks (16-22). Four fractures had associated malalignment problems. The mean AOFAS score was 72.5 (range 45-100). Group 2 fractures healed at an average of 18.3 weeks (16-21). One fracture healed with 5-degrees of angulation. Group 3 fractures healed at an average of 17.5 weeks (14-24). Two fractures healed with malalignment. When groups 2 and 3 were combined to evaluate the AOFAS outcome for fractures treated with distraction osteogenesis, a score of 75.83 was obtained (45-90). There was no difference between the Group 1 versus combined Groups 2/3 with regard to this latter score (P = 0.372). Additionally, when fibula fixation (Group 1) was compared with those fractures where it was not performed (groups 2/3), no difference was seen (P = 0.276). CONCLUSIONS:: The reconstruction of severe tibial plafond fractures treated with small wire hybrid fixation may be achieved by different techniques leading to a satisfactory result. The fixation of the fibula fracture is dependent mainly on the treatment chosen for the management of the metaphyseal lesion. LEVEL OF EVIDENCE:: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Concepts: Bone, Bone fracture, Fracture, Skeletal system, Touring car racing, Orthopedic surgery, Distraction osteogenesis, External fixation


SUMMARY Fracture resistance of inlays and onlays may be influenced by the quantity of the dental structure removed and the restorative materials used. The purpose of this in vitro study was to evaluate the effects of two different cavity preparation designs and all-ceramic restorative materials on the fracture resistance of the tooth-restoration complex. Fifty mandibular third molar teeth were randomly divided into the following five groups: group 1: intact teeth (control); group 2: inlay preparations, lithium-disilicate glass-ceramic (IPS e.max Press, Ivoclar Vivadent AG, Schaan, Liechtenstein); group 3: inlay preparations, zirconia ceramic (ICE Zirkon, Zirkonzahn SRL, Gais, Italy); group 4: onlay preparations, lithium-disilicate glass-ceramic (IPS e.max Press); and group 5: onlay preparations, zirconia ceramic (ICE Zirkon). The inlay and onlay restorations were adhesively cemented with dual polymerizing resin cement (Variolink II, Ivoclar Vivadent AG). After thermal cycling (5° to 55°C × 5000 cycles), specimens were subjected to a compressive load until fracture at a crosshead speed of 0.5 mm/min. Statistical analyses were performed using one-way analysis of variance and Tukey HSD tests. The fracture strength values were significantly higher in the inlay group (2646.7 ± 360.4) restored with lithium-disilicate glass-ceramic than those of the onlay group (1673.6 ± 677) restored with lithium-disilicate glass-ceramic. The fracture strength values of teeth restored with inlays using zirconia ceramic (2849 ± 328) and onlays with zirconia ceramic (2796.3 ± 337.3) were similar to those of the intact teeth (2905.3 ± 398.8). In the IPS e.max Press groups, as the preparation amount was increased (from inlay to onlay preparation), the fracture resistance was decreased. In the ICE Zirkon ceramic groups, the preparation type did not affect the fracture resistance results.

Concepts: Touring car racing, FIA, Teeth, Analysis of variance, Crown, Dental restoration, CAD/CAM Dentistry, Inlays and onlays


Abstract Background: To determine and compare the incidence of intraoperative floppy iris syndrome (IFIS) features in patients using tamsulosin, and other chronic medications. Methods: We prospectively studied patients who underwent phacoemulsification (PE) between March 2006 and October 2007 on use of tamsulosin or a single medication like antihypertansive (AH), antiaggregant (AAg), antipsycotic (AP) or oral antidiabetic (OAD). Patients were grouped as tamsulosin users (Group 1), previous tamsulosin users (Group 2), chronic medication users (AH, AAg, AP or OAD) (Group 3) and patients with no medication (Group 4). Comparison of pre and postoperative visual acuities, intraocular pressures, intraoperative posterior capsular rupture (PCR) rates and grades of IFIS among groups were evaluated. Results: We studied 1567 eyes of 1530 subjects. Twenty five eyes in the study demonstrated IFIS (1.6%). Five cases were included in Group 1 and IFIS incidence was 80%, while it was 60% in Group 2 (n = 5), 1 % in Group 3 (n = 1099), 1.7% in Group 4 (n = 421). IFIS incidence was significantly higher in Groups 1 and 2 compared to Groups 3 and 4 (p < 0.001). There was no difference between Groups 1 and 2 (p = 1.0) and between 3 and 4 (p = 0.29). Most cases (72%) had all three signs of IFIS. Complete IFIS was seen in one patient in Groups 1 and 2, whereas it was seen in all IFIS patients of Groups 3 and 4 (p < 0.001). Incidence of PCR was significantly higher in Group 1 (p = 0.045). Conclusion: Tamsulosin was found to be the drug which was most likely to be associated with IFIS, but IFIS was also observed in patients chronically using losartan, aspirin, chlorpromazine and metformin. Although, IFIS incidences were found to be similar between chronic users of these drugs and those using no medications at the time of surgery, new studies in the future will introduce the predisposing factors and the possible mechanisms of IFIS with these medications.

Concepts: Pharmacology, Medicine, Drug, Touring car racing, FIA, Pharmaceutical drug, Tamsulosin, Intraoperative floppy iris syndrome


WHAT’S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: The occurence of lymphoceles in patients after radical prostatectomy is well known (2-10%). It appears that patients undergoing open extraperitoneal radical prostatectomy develop more lymphoceles than patients undergoing robot-assisted radical prostatectomy with transperitoneal access. The present study investigates in a prospective randomized manner whether the time of drainage (1 vs 7 days) makes a difference or whether drainage is even necessary. The study data, collected in the same institution, are compared with the incidence of lymphocele in patients treated by robot-assisted radical prostatectomy. OBJECTIVE: To investigate whether routine drainage is advisable after open extended pelvic lymph node dissection (ePLND) and retropubic radical prostatectomy (RRP) by measuring the incidence of lymphoceles and comparing these results with those of a series of robot-assisted radical prostatectomy (RARP) and ePLND. PATIENTS AND METHODS: A total of 331 consecutive patients underwent ePLND and RRP or RARP. The first 132 patients underwent open ePLND and RRP and received two pelvic drains; these patients were prospectively randomized into two groups: group 1 (n = 66), in which the drains were shortened on postoperative (PO) days 3 and 5 and removed on PO day 7, and group 2 (n = 66), in which the drains were removed on PO day 1. The next 199 patients were assigned to two consecutive groups not receiving drainage: group 3 (n = 73) undergoing open ePLND and RRP, followed by group 4 (n = 126) treated by transperitoneal robot-assisted ePLND and RARP. All patients had ultrasonographic controls 5 and 10 days and 3 and 12 months after surgery. RESULTS: Lymphoceles were detected in 6.6% of all patients, 3.3% of whom were asymptomatic and 3.3% of whom were symptomatic. Symptomatic lymphoceles were detected in 0% of group 1, 8% of group 2, 7% of group 3 and 1% of group 4, with groups 2 and 3 differing significantly from group 4 (P < 0.05). In total, 5% of all patients undergoing open RRP (groups 1-3) had symptomatic lymphoceles vs 1% of patients undergoing RARP (group 4) (P = 0.06). Nodal-positive patients had significantly more symptomatic lymphoceles than nodal-negative patients (10% vs 2%) (P < 0.02). CONCLUSIONS: Symptomatic lymphoceles occur less frequently after open RRP and pelvic drainage over 7 days than after open RRP and pelvic drainage over 1 day or without drainage. Patients undergoing RARP without drainage had significantly fewer lymphoceles than patients receiving open RRP without drainage.

Concepts: Lymph node, Touring car racing, FIA, Lymphadenectomy, Surgical oncology, Rally racing terminology


Objective:  Antithyroid drug therapy is one of the main medical treatments for Graves' disease. There have been conflicting reports as to whether the addition of exogenous L-thyroxine improves remission rates more than antithyroid drugs alone. This randomized, controlled and prospective clinical trial was undertaken to investigate the long-term outcome of methimazole treatment with or without exogenous L-thyroxine in Chinese patients. Methods:  145 patients with Graves' disease were randomly divided into 3 groups and all patients initially received 30 mg of methimazole daily for at least 1 month and then followed the titration -regimen with or without L-thyroxine: group 1 (30 mg→20 mg→15 mg→10 mg→5 mg); group 2 (30 mg→20 mg→15 mg→10 mg+L-thyroxine→5 mg+L-thyroxine); group 3 (30 mg→20 mg→15 mg→10 mg+L-thyroxine→5 mg+L-thyroxine→2.5 mg+L-thyroxine). The drug therapy was discontinued after 5 months of the final dose. Results:  16 out of 46 patients in group 1 (34.8%), 12 out of 47 in group 2 (25.5%) and 16 out of 52 in group 3 (30.8%) had a recurrence of Graves' disease within 6-year follow-up after drug withdrawal. Survival Analysis showed no significant differences in the remission rates between any 2 groups, despite the remission rates in group 2 and 3 were slightly higher than that in group 1. Conclusions:  The addition of L-thyroxine to methimazole treatment in patients with Graves' disease neither improves nor prevents the remission or recurrence of Graves' disease in China.

Concepts: Pharmacology, Medicine, Touring car racing, Hyperthyroidism, Drug addiction, Addiction, Antithyroid drugs, Antithyroid agent


To compare tear films levels of various inflammatory cytokines in asymptomatic contact lens (CL) users. CL users of rigid gas-permeable CLs (RGPCL) (group 1) or silicone hydrogel CLs (SiHCL) (group 2) were compared with non-CL-using healthy subjects (group 3).

Concepts: Touring car racing, Cornea, FIA, Myopia, Lens, Contact lens, Corrective lens, Movie projector


The aim of this study is to evaluate the incidence of crack formation while using Reciproc, WaveOne and Twisted File Adaptive with and without ethylenediaminetetraacetic acid (EDTA) gel. Seventy extracted mandibular premolars were included. The teeth were decoronated until roots of 16 mm were obtained. Samples were distributed into seven groups: group 1, no canal preparation (control); other groups were instrumented so; group 2, Reciproc; group 3, Reciproc + EDTA; group 4, WaveOne; group 5, WaveOne + EDTA; group 6, Twisted File Adaptive; group 7, Twisted File Adaptive + EDTA. Roots were horizontally sectioned from 3, 6 and 9 mm from apex and observed under stereomicroscope. The number and the incidence of cracks were recorded and statistically analysed with chi-squared and Kruskal-Wallis tests. Control group did not reveal any cracks. Crack formation with three novel Ni-Ti instruments was similar. Using EDTA gel did not reduce crack occurrence.

Concepts: Touring car racing, Group, FIA, Periodic table, Transition metal, Sports car racing, Period 5 element, Chemical element groups