The Use of Lactide Polymers in Bone Tissue Regeneration in Dentistry-A Systematic Review.

(1) Background: Different compositions of biodegradable materials are being investigated to successfully replace non-resorbable ones in bone tissue regeneration in dental surgery. The systematic review tried to address the question, "Can biodegradable polymers act as a replacement for conventional materials in dental surgery procedures?" (2) Methods: An electronic search of the PubMed and Scopus databases was conducted in October 2022. The following keywords were used: (lactide polymers) and (hydroxyapatite or fluorapatite) and (dentistry) and (regeneration). Initially, 59 studies were found. Forty-one studies met the inclusion criteria and were included in the review. (3) Results: These usually improved the properties and induced osteogenesis, tissue mineralisation and bone regeneration by inducing osteoblast proliferation. Five studies showed higher induction of osteogenesis in the case of biomaterials, UV-HAp/PLLA, ALBO-OS, bioresorbable raw particulate hydroxyapatite/poly-L-lactide and PLGA/Hap, compared to conventional materials such as titanium. Four studies confirmed improvement in tissue mineralisation with the usage of biomaterials: hydroxyapatite/polylactic acid (HA/PLA) loaded with dog's dental pulp stem cells (DPSCs), Coll/HAp/PLCL, PDLLA/VACNT-O:nHAp, incorporation of hydroxyapatite and simvastatin. Three studies showed an acceleration in proliferation of osteoblasts for the use of biomaterials with additional factors such as collagen and UV light. (4) Conclusions: Lactide polymers present higher osteointegration and cell proliferation rate than the materials compared. They are superior to non-biodegradable materials in terms of the biocompability, bone remodelling and healing time tests. Moreover, because there is no need of reoperation, as the material automatically degrades, the chance of scars and skin sclerosis is lower. However, more studies involving greater numbers of biomaterial types and mixes need to be performed in order to find a perfect biodegradable material.

Ischemic postconditioning reduces infarct size and microvascular obstruction zone in acute ST-elevation myocardial infarction - a randomized study.

INTRODUCTION: Ischemic postconditiong (postcon) has been reported to reduce infarct size in ST-segment myocardial infarction (STEMI). However, recently a few other studies did not show any effect of postcon or suggested that it may even be harmful. AIM: We sought to assess whether postcon could reduce infarct size (IS) and the microvascular obstruction (MVO) zone in early presenters with STEMI. MATERIAL AND METHODS: Seventy-four STEMI patients treated with primary coronary intervention (PCI) < 4 h from symptoms onset were randomly assigned to the postcon group (n = 37) or standard PCI group (n = 37). Postcon was performed immediately after obtaining reperfusion with 4 balloon occlusions, each lasting 60 s, followed by 60 seconds of reperfusion. Cardiac magnetic resonance was performed in all subjects within 48 to 96 h after admission. To evaluate the infarct size and MVO, the late gadolinium enhancement (LGE) technique was used. Infarct size was defined as an area greater than 50% of the maximal signal intensity within LGE. MVO was defined as the area of the absence or hypoenhancement of contrast surrounded by LGE. Infarct size and MVO were determined by planimetry and the summation of discs method. RESULTS: Postcon was associated with significantly smaller IS (16.42 ±9.6 vs. 31.2 ±22.2 g; p = 0.007) and higher ejection fraction (59.8 ±9.2% vs. 52.3 ±10.2%). The extent of MVO was significantly lower in the postcon group in comparison to the control group (0.76 ±1.4 g vs. 2.2 ±3.2 g; p = 0.03). CONCLUSIONS: In early presenters with STEMI postcon could significantly reduce infarct size and limit reperfusion injury.

Postconditioning attenuates early ventricular arrhythmias in patients with high-risk ST-segment elevation myocardial infarction.

BACKGROUND: It has been demonstrated that postconditioning (postcon), brief episodes of ischemia during reperfusion period, in patients with ST-segment elevation myocardial infarction (STEMI) confers protection against ischemia-reperfusion injury and as a result, postcon might reduce infarct size. However, whether postcon may exert its beneficial effect on STEMI patients by reducing the occurrence of early malignant ventricular arrhythmias (VA) is still unknown. The aim of the study was to evaluate the influence of postcon on the presence of VA in early presenters with high-risk STEMI treated with primary coronary intervention (PCI). METHODS: Seventy-five STEMI patients treated with primary PCI within 6h from symptoms onset were randomly assigned to postcon group (n=37) or conventional PCI group (n=38) in 1:1 ratio. Postcon was performed immediately after restoration of coronary flow as follows: the angioplasty balloon was inflated 4× 1min with low-pressure inflations, each separated by 1min of deflation. After that the patients were continuously monitored electrographically for 48h. The end-point of the study was the occurrence of VA (ventricular fibrillation-VF, sustained ventricular tachycardia-sVT, non-sustained ventricular tachycardia-nsVT) within 48h after the procedure. RESULTS: In the postcon group, the occurrence of VAs was significantly lower: VF-3, sVT-0, nsVT-15, i.e. (18 patients - 48.6%) in comparison to control group: VF-2, sVT-4, nsVT-23 (29 patients - 76.3%); p=0.013. The occurrence of accelerated idioventricular rhythm varied insignificantly between both groups (postcon - 45.9% vs control - 34.2%; p=NS). CONCLUSIONS: Postcon may reduce the occurrence of malignant VA in patients with STEMI treated with primary PCI.

The role of bioactive lipids in the development of soft tissue sarcomas in children ­ a review article.

Soft tissue sarcoma accounts for almost 7% of all malignant tumours in children and adolescents. This heterogeneous group of mesenchymal and neuroectodermal tissue neoplasms can be characterized by common biological and clinics traits. Bioactive lipids are described as lipids, the levels of which ­ when changed ­ lead to changes in cell functioning. The role of bioactive lipids in the biology of neoplasmatic cells is unquestionable. In this paper we present an overview of articles describing the impact of selected bioactive lipids on the development of sarcoma in children.

Postconditioning reduces enzymatic infarct size and improves microvascular reperfusion in patients with ST-segment elevation myocardial infarction.

OBJECTIVES: Postconditioning has been reported to reduce infarct size in ST-segment myocardial infarction (STEMI). However, recently, few other studies did not show any effect of postconditioning and suggested that it may be even harmful. We sought to assess whether postconditioning could reduce infarct size and improve myocardial reperfusion in early presenters with STEMI. METHODS: 72 STEMI patients treated with primary percutaneous coronary intervention (PCI) were randomly assigned to either the postconditioning (n = 35) or the standard PCI group (control group; n = 37). Blood samples were obtained for creatine kinase (CK) and its MB isoform (CK-MB) within 36 h. The angiographic (myocardial blush grade, MBG) and electrocardiographic (ST-segment resolution, STR) data were evaluated and compared between groups. RESULTS: The areas under the curve of CK and CK-MB release were significantly reduced in the postconditioning group compared with the control group (38,612.91 ± 25,028.42 vs. 60,547.30 ± 25,264.63 for CK and 5,498.23 ± 3,787.91 vs. 7,443.12 ± 3,561.13 for CK-MB, p < 0.0001). MBG was significantly better in the postconditioning group than in the control group (MBG 3: 82.3 vs. 47.1%, p = 0.0023). In the postconditioning group, STR >70% was more often observed (97.1 vs. 64.1%, p = 0.0007). CONCLUSIONS: In patients with STEMI, postconditioning could significantly reduce enzymatic infarct size and improve myocardial reperfusion.

Estimation of vascular endothelial growth factor and placental growth factor serum levels' in infant with hemangioma and population of healthy infants.

INTRODUCTION: Hemangioma is found in approximately 10% of infants as the most prevalent benign neoplasm. The natural history of hemangioma is typical for this lesion and includes two phases: fast growth during the first year of life of the child and subsequent slow regression lasting some five years. Even though the etiopathogenesis of hemangioma has not been fully elucidated, the role played in this process by vascular growth factors remains unquestionable. The aim of this work was to assess the value of serum levels of the vascular endothelial growth factor (VEGF) and placental-derived growth factor (PlGF) for therapy planning in infants with hemangiomas. MATERIAL AND METHODS: The study group comprised 43 infants, aged 2 weeks to 6 months, with hemangiomas on the body. 25 girls and 11 boys participated in the second stage of the study done 14 months later. We analyzed correlations between serum levels of vascular growth factors and phase of hemangioma, clinical symptoms, and findings in ultrasonography with Power Doppler visualization. Normal ranges for VEGF and PlUF were established for healthy infants. RESULTS: The results in the study group were analyzed statistically and presented as arithmetic means, standard deviations, medians, minimal and maximal values, and percentage distributions. CONCLUSIONS: In local population of healthy infants the ranges of VEGF and P1GF serum levels are very wide; VEGF and P1GF serum levels determined in infants affected with hemangioma do not reflect the dynamics of observable lesion's evolution.

[Impact of L-thyroxine replacement therapy on pituitary changes secondary to congenital primary hypothyroidism--three cases report]. / Wplyw leczenia substytucyjnego L-tyroksyna na zmiany w przysadce we wrodzonej pierwotnej niedoczynnosci tarczycy--opis trzech przypadków.

The aim of the study was an evaluation of the impact of L-thyroxine substitution therapy on the size and structure of the pituitary gland using MRI in three patients with pituitary hyperplasia or tumor secondary to primary congenital hypothyroidism. Along with imaging studies (MRI, skull X-rays) all patients had performed hormonal tests. All hormones (except adrenocorticotropic hormone) of anterior pituitary lobe were measured in basal condition, and some of them (GH, PRL) after stimulation tests, which showed hyperprolactinemia in one case and pituitary somatotropin insufficiency in the other. Only in one out of three patients the regression of the pituitary enlargement was complete, whereas in second case the regression was partial and in third patient evaluation revealed no changes on the MRI. Correct L-thyroxine therapy prevents enlargement of pituitary gland and may regress these changes, but is not the only outcome of pituitary enlargement. Those results shows, that other coexisting disturbances like TSH-secreting adenoma or thyroid hormone resistance must be considered when the treatment is not successful.

[Magnetic resonance imaging and hormonal profile of the pituitary gland in patients with primary congenital hypothyroidism]. / Rezonans magnetyczny i profil hormonalny przysadki u chorych na pierwotna wrodzona niedoczynnosc tarczycy.

UNLABELLED: The aim of our study was an estimation of the size and structure of the pituitary gland using MRI and the estimation of hormonal profile of the pituitary anterior lobe (except for ACTH) in 21 adult patients with congenital primary hypothyroidism. MATERIAL AND METHODS: The studied group was divided into 2 subgroups: A--with normal level of serum TSH and B--with its elevated. The MRI showed pituitary hyperplasia or tumor in 28.5% of patients, partially empty sella in 14.3% and hypoplasia in 9.5%. In subgroup B there were mostly hyperplasia or tumor (35.7%), while in subgroup A there were no domination of any abnormalities. RESULTS: Serum mean TSH level was 49.8+/-86.2 mU/l with an increase in 67%. The mean prolactin was 11.2+/-7.5 mg/ml with an increase in 19%. Serum LH and FSH concentrations were normal in the whole group. The mean alpha subunit level was elevated in 52%. In 42.8% somatotropic hypopituitarism was recognised due to GH stimulation tests. CONCLUSIONS: The TRH hyperstimulation in patients with congenital primary hypothyroidism may lead to pituitary hyperplasia or tumor visible on MRI and to pituitary hormonal abnormalities.

[Analysis of changes in peripheral and central nervous system in irregularly treated adult patients with primary congenital hypothyroidism]. / Analiza zmian w obwodowym i osrodkowym ukladzie nerwowym u niesystematycznie leczonych doroslych chorych na pierwotna wrodzona niedoczynnosc tarczycy.

UNLABELLED: Lack of thyroid hormones in the womb and the first years of life causes changes in the nervous system and mental retardation. The aim of the study was to assess changes in peripheral and central nervous system in 29 adult patients with primary congenital hypothyroidism (PCH) depending on the cause of the disease and systematic treatment of L-thyroxine. MATERIAL AND METHODS: The analysis was performed in 29 adult patients with PCH (16 women, 13 men) on the basis of the results of neurological examination, EEG, SPECT (Computer tomography single photon emission) of the brain. RESULTS: Changes in the nervous system were found in 72% of respondents. Patients who had implemented replacement therapy L-thyroxine after completing 12 months of age showed the most neurological disorders. There were variations in the cranial nerves III, IX, IV and VI. In 34% of respondents revealed paraneoplastic cerebellar symptoms, while the pyramid, and extrapyramidal symptoms in 10% and 3% of the people. EEG showed changes in brain bioelectrical activity in the entire study group. In the 83% found a significant asymmetry in regional cerebral blood flow (rCBF). Hypoperfusion outbreak occurred mainly in the stands and leading occipital. The relationship between time of initiation of treatment, and the presence of a systematic change in the nervous system was inversely proportional. In turn, analyzing the causes of most PCH deviations were found in the nervous system in patients with athyreosis. Brain SPECT study in these patients confirmed the organic changes in brain development. CONCLUSIONS. The presence and extent of changes in peripheral and central nervous system depends on the cause PCH, pending the implementation of L-thyroxine treatment and systematic. Studies of brain SPECT and EEG confirmed the existence of developmental changes of the brain in patients with PCH.

[Cantrell's pentalogy--a case report]. / Pentalogia Cantrella--opis przypadku.

Pentalogy of Cantrell is a rare multiple congenital malformation syndrome characterized by a combination of features: a midline supraumbilical abdominal wall defect, a defect of the lower sternum, a defect of the diaphragmatic pericardium, deficiency of the anterior diaphragm, and congenital cardiac anomalies. This congenital defects could be diagnosed as early as in the first trimester of pregnancy. The complexity of this anomaly especially coexistent heart defects, determines the way and order of surgical treatment and commonly is a prognostic factor. A case of male newborn with prenatal diagnosed omphalocele and diaphragmatic hernia is reported in the present work. The child was operated within two hours after birth. Intraoperativelly a significant defect of diaphragmatic pericardium and heart surrounded by a small bowel were discovered. The defect of diaphragm was sutured and a drainage of left pericardial cavity was put in place. Afterwards, the abdominal wall defect was sutured after transferring organs into a peritoneal cavity. Six days after the procedure cardiac sonography was performed and it indicated the presence of hemodynamically insignificant congenital intracardiac defect--atrial septal defect. Up-to-date psychomotor development of the boy currently five months old, is correct. Prenatal diagnosis of the complexity of congenital defects and possibility of fetus condition monitoring allows to plan precisely the time and way of the delivery as well as to decide the treatment method of the newborn. Due to the absence of hemodynamic disorders and in spite of the present cardiac defect, an early surgical treatment of our patient was possible.

[Primary hyperparathyroidism in patient with thyroid papillary cancer--case report]. / Pierwotna nadczynnosc przytarczyc u chorej leczonej z powodu raka brodawkowatego tarczycy--opis przypadku.

Patient with primary hyperparathyroidism and papillary thyroid cancer was presented. The female patient, 45 years old, because of papillary thyroid cancer was treated in the typical way by total strumectomy with lymphadenectomy following by 1131 therapy and L-thyroxine suppressive therapy. After 9 years, during one of control routine examinations, the serum levels of calcium and parathormone were increased (Ca2+: 1.449 mmol/l; Ca: 2.91 mmol/l; PTH: 256 pg/ml). Primary hyperparathyroidism was diagnosed and the patient underwent the surgery in the anterior cervical region with removal of parathyroid adenoma, histopathologically confirmed. Serum PTH level together with calcium levels decreased into the normal range. The coexistence of primary hyperparathyroidism and thyroid non-medullary cancer was already reported, but in this case the time of the onset was delayed. Due to the fact that patients after the treatment of thyroid non-medullary cancer, especially after of the neck radiation or radioactive iodine therapy, are more exposed to develop hyperparathyroidism, complete and wide examinations, even many years after treatment of thyroid cancer, are needed.

[Intrauterine intestinal volvulus]. / Wewnatrzmaciczny skret jelita.

Intrauterine intestinal volvulus is an extremely rare case of acute congenital intestinal obstruction. The diagnosis is usually possible in the third trimester of a pregnancy. Fetal midgut volvulus is most likely to be recognized by observing a typical clockwise whirlpool sign during color Doppler investigation. Multiple dilated intestinal loops with fluid levels are usually visible during the antenatal ultrasound as well. Physical and radiographic findings in the newborn indicate intestinal obstruction and an emergency surgery is required. The authors describe intrauterine volvulus in 3 female newborns in which surgical treatment was individualized. The decision about primary or delayed anastomosis after resection of the gangrenous part of the small bowel was made at the time of the surgery and depended on the general condition of the newborn, as well as presence or absence of meconium peritonitis. Double loop jejunostomy was performed in case of two newborns, followed by a delayed end-to-end anastomosis. In case of the third newborn, good blood supply of the small intestine after untwisting and 0.25% lignocaine injections into mesentery led to the assumption that the torsion was not complete and ischemia was reversible. In the two cases of incomplete rotation the cecum was sutured to the left abdominal wall to prevent further twisting. The postoperative course was uneventful and oral alimentation caused no problems. Physical development of all these children has been normal (current age: 1-2 years) and the parents have not observed any disorders or problems regarding passage of food through the alimentary canal. Prompt antenatal diagnosis of this surgical emergency and adequate choice of intervention may greatly reduce mortality due to intrauterine volvulus.

[Intralesional corticosteroid therapy in infantile hemangiomas]. / Miejscowa sterydoterapia w naczyniakach krwionosnych u dzieci.

INTRODUCTION: This study was undertaken to evaluate the effectiveness of intralesional corticosteroid therapy in infantile hemangiomas. MATERIAL AND METHODS: The study was done in 38 patients aged 1 month to 14 years with infants accounting for 84% of all patients. Physical investigation was carried out before and after treatment. Localization, size of tumor, pressure, and surface features were recorded. Doppler ultrasound was performed concomitantly and served to measure tumor size and blood flow in tumor vasculature. Midazolanium 1-2 mg/kg was administered intravenously without general anesthesia. Treatment consisted of 3-5 doses of Polcortolon with intervals of 5-6 weeks between doses. The corticosteroid dose was individualized and depended on tumor size and age of patient. The results were analyzed with the modified Sloan's scale. RESULTS: Hemangioma was disclosed immediately after birth in 30 patients (78%). The tumor had an intense cherry color and demonstrated increased pressure and fast enlargement during the first weeks of life. In the remaining eight patients (22%), the tumor appeared after the second month of life and failed to show features of fast growth during the first year of life. The location of hemangioma was on the head and neck in 22 children (58%) and on the chest, extremities, abdomen, or lower back (lumbar region) in the remaining children. Doppler ultrasound revealed increased vascular flow in the tumor of all patients. Intralesional corticosteroid therapy resulted in reduction of tumor volume of more than 50% in 18 (47%), less than 50% in 12 (32%), and little or no change in eight (21%) cases. A very good result in one patient was achieved with two weeks of supplemental oral Prednisolon therapy. Total or partial excision of the tumor for aesthetic reasons was done in eight patients in whom intralesional corticosteroid therapy produced substantial reduction in tumor size. CONCLUSIONS: Intralesional corticosteroid therapy is an effective and safe modality particularly suitable for the management of extensive hemangiomas of the head and neck when surgical options are limited.

[Biologically active compounds of edible mushrooms and their beneficial impact on health]. / Zwiazki biologicznie aktywne zawarte w grzybach jadalnych i ich korzystny wplyw na zdrowie.

Edible mushrooms are valuable a source of biologically active compounds. Some are used in the prophylaxis and therapy of such diseases as cancer and cardiovascular disease. Their antitumor mechanism is complex. The biologically active substances in mushrooms decrease DNA damage, reduce carcinogen concentrations and their activation, inhibit the growth of cancer cells by scavenging free radicals, stimulate the immune system, and induce tumor cell apoptosis. The stimulation of the immune system by the biologically active compounds in edible mushrooms protects against cold, flu, infections, well as AIDS by inhibition of viral replication. Mushrooms contain effective substances which decrease the LDL fraction of cholesterol in blood. They also prevent the accumulation of serum triaclyglycerols, thus decreasing the risk of developing cardiovascular disease. The therapeutic properties of mushrooms result from the specific polysaccharides, such as beta-glucans and chitosans, that are present in the fructification of fungi.