PurposeAntenatal hydronephrosis (AH) is found in 0.5%-1% of neonates. The aim of the study was to assess the urinary concentrations of 3 biomarkers, endothelin-1 (ET-1), monocyte chemotactic peptide-1 (MCP-1), and N-acetyl-glucosaminidase (NAG) in severely hydronephrotic neonates.Materials and MethodsNeonates with a history of prenatal hydronephrosis were enrolled in the prospective study in 2 groups. Group 1 included neonates with severe forms of obstruction requiring surgical intervention and group 2 included neonates with milder forms of obstruction without any functional impairment. Fresh voided urinary levels of ET-1, MCP-1, and NAG were measured and their ratios to urinary Cr were calculated.ResultsFourty-two neonates were enrolled into the 2 groups: group 1, 24 patients (21 male, 3 female); group 2, 18 neonates (16 male, 2 female). There were no statistically significant differences between urinary ET-1, NAG, MCP-1 values, and ET-1/Cr and NAG/Cr ratios in groups 1 and 2. The urinary MCP-1/Cr ratio was significantly higher in group 1 than in group 2. For comparison of groups 1 and 2, the cut-off values were measured as 0.5709 ng/mg (sensitivity, 75%; specificity, 67%; positive predictive value [PPV], 71%; negative predictive value [NPV], 71%), 0.927 ng/mg (sensitivity, 77%; specificity, 72%; PPV, 77%; NPV, 72%), and 1.1913 IU/mg (sensitivity, 62%; specificity, 67%; PPV, 68%; NPV, 60%) for ET-1/Cr, MCP-1/Cr, and NAG/Cr ratios, respectively.ConclusionsThe urinary MCP-1/Cr ratio is significantly elevated in neonates with severe obstruction requiring surgical intervention. Based upon these results, urinary MCP-1/Cr may be useful in identification of severe obstructive hydronephrosis in neonates.

We report on a case of AA as well as examine the literature to review a total of 32 cases. We note that AA is often misdiagnosed and tends to recur in the ischiorectal and retroperitoneal spaces. By means of immunohistochemical analysis, we conclude: the estrogen and progesterone receptor status was weakly positive, but could not be distinguished from the background-fibroblastic tissue, PCNA correlates well in this tumor with its low mitotic index; however, further similar studies are needed to characterize this tumor. This may aid in treatment.

Evaluation of the urinary KIM-1:Cr ratio may help identify neonates with severe obstructive hydronephrosis.

Ceramic implant abutments are becoming increasingly popular due to the growing esthetic demands of patients. Two-piece ceramic abutments have the advantages of both ceramic and titanium abutments. This study aimed to review the published articles regarding hybrid abutments and their characteristics.Published articles regarding two-piece abutments were retrieved by electronic search of PubMed, Embase, Scopus, Medline, and Google Scholar databases using certain keywords. Articles highly relevant to our topic of interest were selected and reviewed.The presence of titanium inserts in hybrid abutments can overcome the brittleness of ceramic, increase the overall fracture resistance, prevent the implant connection wear, and provide better marginal fit compared with one-piece zirconia abutments. Hybrid abutments enable the fabrication of monolithic metal-free implant restorations with optimal esthetics. Furthermore, the risk of porcelain chipping, which is a common complication of implant restorations, is eliminated due to the monolithic structure of these restorations.According to the available literature, hybrid implant abutments have shown promising results with regard to optimal esthetics in the rehabilitation of the esthetic zone. However, long-term clinical studies are required to assess the long-term durability of all-ceramic restorations supported by hybrid abutments.

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Objective: Urinary tract infection occurs in 1.8-6.6% of children under 6 years old. The aim of this study was to assess the urinary concentrations of matrix metalloproteinase 9 (MMP9) and tissue inhibitor of metalloproteinase 1 (TIMP1), in children with acute pyelonephritis (APN) and the potential to develop renal scarring. Material and methods:Children who had experienced an episode of APN were divided into 2 groups. Group 1 included children with APN who exhibited scarring and group 2 included children with APN who had a normal 99m Technetium dimercaptosuccinic acid scan. Urinary levels of MMP9 and TIMP1 were measured in the acute phase of infection. A receiver operating characteristic curve was generated to allow calculation of cut-off values.Results: Sixty-one children were enrolled across the 2 groups: group 1 contained 16 patients (all female); group 2, 38 children (36 female and 2 male). Urinary levels of MMP9 and TIMP1 were significantly higher in group 1 than in group 2 (p= 0.037 and 0.022 respectively). For comparison of groups 1 and 2, the cut-off values were measured as 75.5 ng/mL (sensitivity 62.5%, specificity 71.1%, positive predictive value, PPV, 48%, negative predictive value, NPV, 82%), 16.1 ng/mL (sensitivity 75%, specificity 55.3%, PPV 41%, NPV 84%), and 1310.7 ng/mL (sensitivity 75% specificity 60.5%, PPV 44%, NPV 85%) for MMP9, TIMP1, and MMP9×TIMP1 levels, respectively. Conclusion:Evaluation of urinary MMP9 and TIMP1 levels may help to identify children with APN who are at risk of developing renal scarring.Keywords: Children; matrix metalloproteinase; pyelonephritis; tissue inhibitor of metalloproteinase 1; urinary tract infection; vesico-ureteral reflux.Cite this article as: Abedi SM, Mohammadjafari H, Rafiei A, Bazi S, Yazdani P. Urinary matrix metalloproteinase 9 and tissue inhibitor of metalloproteinase 1 biomarkers for predicting renal scar in children with urinary tract infection. Turk J Urol 2017; 43(4): 536-42.

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Evaluation of urinary levels of MMP9, or the MMP9/Cr, MMP9/TIMP1, or MMP9/TIMP1/Cr ratios may help us to differentiate the newborns with hydronephrosis and VUR from those without reflux.