Tongues Tied by Orofacial Myofunctional Therapy about Tongue Tie: A Narrative Review.

Aim and Background: The respective review articles aim is to provide an overview as well as describes and enlists different orofacial myofunctional therapy exercises as a modality for tongue tie secondary to surgery.Tongue tie is the basically a connection that joints base of tongue to the floor of mouth. This leads to difficulties various difficulties such as altered speech, oral habits, maligned teeth and many more. During formative years, most children successfully treated of tongue tie by releasing it, but problems start after its correction. That it may can reappear or may lead to same difficulties as prior. Parents and clinicians are only concerned about speech and aesthetics after release of tongue tie. But OMT plays important role ore and post-surgical procedure. OMT help in proper tongue posture along with reducing the probability of tissue reattachment after surgery by exercises. This therapy positively influenced functions by reducing deleterious habits. Methods: A review of relevant literature is predicated on articles found using free text terms, mesh terms, and some basic tongue tie as well as tongue tie release pamphlets that were published in English up until the year 2023 in the electronic databases PubMed, EBSCO, Scopus, Google Scholar, and Web of Science. With the aid of mesh keywords, the initial search yielded 38-40 articles; 20-35 were chosen depending on the requirements. Also we searched for orofacial myofunctional exercises or exercises recommended after tongue tie release. Results: Various exercises enlisted in our article that will guide a individual before and after tongue tie release which will give positive outcomes such as proper tongue posture, speech, swallow, regained aesthetics and self-esteem. Conclusion: Tongue plays an important role in development of perioral structures as well as in the swallow to good speech articulation and dental occlusion. So, as pediatric dentist its important know that after release of tongue tie what to do and how to maintain. This review article is focused on the various orofacial myofunctional therapy techniques employed for tongue tie but not a single one to describe them. Clinical significance: Our pertaining review act as a guide for clinicians as well as individuals to manage tongue tie after its release. How to cite this article: Shah SS, Agarwal PV, Rathi N, et al. Tongues Tied by Orofacial Myofunctional Therapy about Tongue Tie: A Narrative Review. Int J Clin Pediatr Dent 2024;17(1):109-113.

Investigation of optimal planning strategy in gamma knife perfexion for vestibular schwannoma tumor using hybrid plan technique.

Purpose.Stereotactic radiosurgery (SRS) for vestibular schwannoma (VS) is clinically challenging because of surrounding critical structures. We generated and compared the forward plan (FP), inverse plan (IP), and hybrid plan (HP) for the optimal planning strategy in Gamma Knife stereotactic radiosurgery (GKSRS) for vestibular schwannoma tumors (VS).Methods and materials. In this study, 51 planning scenarios of 17 patients with VS were planned for GKSRS using FP, IP, and HP in Leksell Gamma plan (LGP10.1) using the TMR10 algorithm. The planning images were obtained using the following MRI (GE, USA) scan parameters: T1W images-MPRAGE sequence, FOV-256 mm × 256 mm, matrix size-512 mm × 512 mm, and the slice thickness 1 mm. The total dose was prescribed12Gy and normalized at 50% isodose level.Results and discussion. The plan parameters were compared dosimetrically by maintaining FP as a base plan. The statistical analysis, including one-factor, repeated measures ANOVA and Bonferroni correction tests, were performed. The p-value for planning parameters such as brainstem dose, beam ON time, and gradient index significantly favored HP.Conclusion. Overall results show that HP is an efficient method for GKSRS of VS The p-value was less than 0.001 and statistically significant for various plan indices.

Epitope Mapping of Therapeutic Antibodies Targeting Human LAG3.

Lymphocyte activation gene 3 protein (LAG3; CD223) is an inhibitory receptor that is highly upregulated on exhausted T cells in tumors and chronic viral infection. Consequently, LAG3 is now a major immunotherapeutic target for the treatment of cancer, and many mAbs against human (h) LAG3 (hLAG3) have been generated to block its inhibitory activity. However, little or no information is available on the epitopes they recognize. We selected a panel of seven therapeutic mAbs from the patent literature for detailed characterization. These mAbs were expressed as Fab or single-chain variable fragments and shown to bind hLAG3 with nanomolar affinities, as measured by biolayer interferometry. Using competitive binding assays, we found that the seven mAbs recognize four distinct epitopes on hLAG3. To localize the epitopes, we carried out epitope mapping using chimeras between hLAG3 and mouse LAG3. All seven mAbs are directed against the first Ig-like domain (D1) of hLAG3, despite their different origins. Three mAbs almost exclusively target a unique 30-residue loop of D1 that forms at least part of the putative binding site for MHC class II, whereas four mainly recognize D1 determinants outside this loop. However, because all the mAbs block binding of hLAG3 to MHC class II, each of the epitopes they recognize must at least partially overlap the MHC class II binding site.

Exploiting hydrogen bonding to enhance lidocaine loading and stability in a poly ethylene-co-vinyl acetate carrier matrix.

Sustained release of lidocaine from poly ethylene-co-vinyl acetate (EVA) implants can significantly improve pain management outcomes; however, poor drug loading is a major limitation. Recently, myristic acid was found to improve drug loading in EVA by inhibiting the crystallization of lidocaine. Here, lidocaine's interaction with myristic acid was studied by differential scanning calorimetry. Spectra of lidocaine-myristic acid mixtures were analysed using two-dimensional correlation (2DCOS) maps. Furthermore, spectroscopic analysis of EVA matrices containing lidocaine, alone and in combination with myristic acid, was also performed and drug release was evaluated in vitro. A eutectic was obtained on combining lidocaine and myristic acid at the molar ratio of 1:1 due to loss of myristic acid's dimeric conformation resulting in hydrogen bonding of its COOH group with lidocaine's amide I moieties. In EVA, hydrogen bonding between adjacent lidocaine molecules caused crystallization above a threshold concentration and could be inhibited by incorporation of myristic acid by eutectic formation. By altering the molecular confirmation and solid state properties of lidocaine in EVA, myristic acid reduces lidocaine crystallization, increases drug loading and influences drug release kinetics. Exploiting these interactions and promoting further hydrogen bonding through the addition of specific excipients presents a viable strategy to enhance and stabilise drug loading in polymer matrices for various applications.

Natural Antioxidant Extracted Waste Cooking Oil as Sustainable Biolubricant Formulation in Tribological and Rheological Applications.

Developing eco-friendly formulations using waste cooking oil as renewable biomass is of great interest and commercial importance in the fuels and lubricant industry. This manuscript reports novel study on preparing a biolubricant formulations as WCO-1, WCO-2 and WCO-3 by blending the curcumin extracted soybean waste cooking oil in three different compositions viz 10%, 20%, 30% v/v with the mineral base oil N-150. Curcumin was extracted as a natural antioxidant in 0.5 wt% waste cooking oil to inhibit thermal oxidation. This study comprises a detailed analysis in terms of tribological, rheological and thermophysical characteristics such as viscosity, viscosity index, pour point and flash point parameters of the biolubricant by standard ASTM methods. Further, tribological and rheological analysis was done by the four-ball wear tester and Anton Paar, MCR-72, respectively. The thermophysical evaluation of WCO formulated biolubricant has shown excellent properties. The viscosity index of the formulated biolubricant increases with an increase in the concentration of waste cooking oil. In contrast, the pour point has also been depressing at lower temperature conditions. Thus, WCO based biolubricant was found to be more effective at extreme temperature conditions than the mineral base oil (N-150). Rheological studies have indicated the non-Newtonian behaviour of the biolubricant with an increase in shear rate. Whereas, tribological analysis demonstrates that wear scar diameter has significantly reduced from 0.685 to 0.573 mm, and the coefficient of friction decreased from 0.117 to 0.080 with respect to the mineral base oil. Thus, a straightforward green approach has been discovered by directly utilizing waste cooking oil for biolubricant formulation.

Dosimetric impact of target definition in brachytherapy for cervical cancer - Computed tomography and trans rectal ultrasound versus magnetic resonance imaging.

Background and Purpose: Magnetic Resonance Imaging (MRI) based target definition in cervix brachytherapy is limited by its availability, logistics and financial implications, therefore, use of computed tomography (CT) and Trans Rectal UltraSonography (TRUS) has been explored. The current study evaluated the dosimetric impact of CT + TRUS based target volumes as compared to gold standard MRI. Methods and Materials: Images of patients (n = 21) who underwent TRUS followed by MRI and CT, were delineated with High-Risk Clinical Target Volume in CT (CTVHR-CT) and in MRI (CTVHR-MR). CTVHR-CT was drawn on CT images with TRUS assistance. For each patient, two treatment plans were made, on MRI and CT, followed by fusion and transfer of CTVHR-MR to the CT images, referred as CTVHR-MRonCT. The agreement between CTVHR-MRonCT and CTVHR-CT was evaluated for dosimetric parameters (D90, D98 and D50; Dose received by 90%, 98% and 50% of the volumes) using Bland-Altman plots, linear regression, and Pearson correlation. Results: No statistically significant systematic difference was found between MRI and CT. Mean difference (±1.96 SD) of D90, D98 and D50 between CTVHR-MRonCT and CTVHR-CT was 2.0, 1.2 and 5.6 Gy respectively. The number of patients who have met the dose constraints of D90 > 85 Gy were 90% and 80% in MR and in CT respectively, others were in the borderline, with a minimum dose of 80 Gy. The mean ± SD dose-difference between MR and CT plans for bladder was significant (5 ± 13 Gy; p = 0.12) for D0.1cm3, while others were statistically insignificant. Conclusion: CT + TRUS based delineation of CTVHR appear promising, provide useful information to optimally utilize for brachytherapy planning, however, MRI remains the gold standard.

Placental levels of polycyclic aromatic hydrocarbons (PAHs) and their association with birth weight of infants.

As an alarming group of pollutants, polycyclic aromatic hydrocarbons (PAHs) gather much public health concern not only because of their carcinogenic or co-carcinogenic risk but also by interfering with hormone systems or by causing oxidative damage, henceforth liable to toxic actions on reproduction. Accordingly, the present study was aimed to explore the association between in-utero exposure to PAHs by evaluating their placental levels and infant birth weight among 110 healthy and nonsmoking pregnant women. Placental tissue samples were collected instantly after delivery and were analyzed for the presence of sixteen Environmental Protection Agency (EPA) listed PAHs with the help of Gas chromatography equipped with flame ionization detector (GC-FID). Chrysene and benzo(k)fluoranthene were the predominant PAHs detected in tissue samples. To assess the source of origin of PAHs in placenta tissue samples, the ratio of low molecular weight PAHs to high molecular weight (∑LMW/∑HMW PAHs) was calculated, showing the predominance of pyrogenic sources of PAHs possibly responsible for the exposure of the studied population. Results of regression analysis demonstrated the inverse although not significant association of naphthalene (Nap), acenaphthylene (Acy), anthracene (Anth), pyrene (Pyr), benzo(b)fluoranthene (BbF), benzo(k)Fluoranthene (BkF), benzo(a)pyrene (BaP), indeno (123 cd pyrene (IcdP), dibenzo(ah)anthracene (DahA) and benzo(ghi)Perylene (BghiP) with birth weight of neonates. Additionally, the regression model lay light upon the significant association of fluoranthene (Fla) (coefficient= -1.41 gram, p < 0.05) to the depletion trend of birth weight after adjusting for potential covariates. These findings suggest the possible role of an environmental contaminants like PAHs on impairment of fetal growth.

A non-opioid analgesic implant for sustained post-operative intraperitoneal delivery of lidocaine, characterized using an ovine model.

Appropriate management of post-operative pain is an ongoing challenge in surgical practice. At present, systemic opioid administration is routinely used for analgesia in the post-operative setting. However, due to significant adverse effects and potential for misuse, there is a perceived need for the development of alternative, opioid-sparing treatment modalities. Continuous infusion of local anesthetic into the peritoneum after major abdominal surgery reduces pain and opioid consumption, and enhances recovery from surgery. Here we describe a non-opioid, poly(ethylene-co-vinyl-acetate) intraperitoneal implant for the sustained delivery of local anesthetic following major abdominal surgery. A radio-opaque core had the required mechanical strength to facilitate placement and removal procedures. This core was enclosed by an outer shell containing an evenly dispersed local anesthetic, lidocaine. Sustained release of lidocaine was observed in an ovine model over days and the movement modelled between peritoneal fluid and circulating plasma. While desirably high levels of lidocaine were achieved in the peritoneal space these were several orders of magnitude higher than blood levels, which remained well below toxic levels. A pharmacokinetic model is presented that incorporates in vitro release data to describe lidocaine concentrations in both peritoneal and plasma compartments, predicting similar release to that suggested by lidocaine concentrations remaining in the device after 3 and 7 days in situ. Histological analysis revealed similar inflammatory responses following implantation of the co-extruded implant and a commercially used silicone drain after three days. This non-opioid analgesic implant provides sustained release of lidocaine in an ovine model and is suitable for moving onto first in human trials.

Cancer epithelia-derived mitochondrial DNA is a targetable initiator of a paracrine signaling loop that confers taxane resistance.

Stromal-epithelial interactions dictate cancer progression and therapeutic response. Prostate cancer (PCa) cells were identified to secrete greater concentration of mitochondrial DNA (mtDNA) compared to noncancer epithelia. Based on the recognized coevolution of cancer-associated fibroblasts (CAF) with tumor progression, we tested the role of cancer-derived mtDNA in a mechanism of paracrine signaling. We found that prostatic CAF expressed DEC205, which was not expressed by normal tissue-associated fibroblasts. DEC205 is a transmembrane protein that bound mtDNA and contributed to pattern recognition by Toll-like receptor 9 (TLR9). Complement C3 was the dominant gene targeted by TLR9-induced NF-κB signaling in CAF. The subsequent maturation complement C3 maturation to anaphylatoxin C3a was dependent on PCa epithelial inhibition of catalase in CAF. In a syngeneic tissue recombination model of PCa and associated fibroblast, the antagonism of the C3a receptor and the fibroblastic knockout of TLR9 similarly resulted in immune suppression with a significant reduction in tumor progression, compared to saline-treated tumors associated with wild-type prostatic fibroblasts. Interestingly, docetaxel, a common therapy for advanced PCa, further promoted mtDNA secretion in cultured epithelia, mice, and PCa patients. The antiapoptotic signaling downstream of anaphylatoxin C3a signaling in tumor cells contributed to docetaxel resistance. The inhibition of C3a receptor sensitized PCa epithelia to docetaxel in a synergistic manner. Tumor models of human PCa epithelia with CAF expanded similarly in mice in the presence or absence of docetaxel. The combination therapy of docetaxel and C3 receptor antagonist disrupted the mtDNA/C3a paracrine loop and restored docetaxel sensitivity.

Heterogeneous cancer-associated fibroblast population potentiates neuroendocrine differentiation and castrate resistance in a CD105-dependent manner.

Heterogeneous prostatic carcinoma-associated fibroblasts (CAF) contribute to tumor progression and resistance to androgen signaling deprivation therapy (ADT). CAF subjected to extended passaging, compared to low passage CAF, were found to lose tumor expansion potential and heterogeneity. Cell surface endoglin (CD105), known to be expressed on proliferative endothelia and mesenchymal stem cells, was diminished in high passage CAF. RNA-sequencing revealed SFRP1 to be distinctly expressed by tumor-inductive CAF, which was further demonstrated to occur in a CD105-dependent manner. Moreover, ADT resulted in further expansion of the CD105+ fibroblastic population and downstream SFRP1 in 3-dimensional cultures and patient-derived xenograft tissues. In patients, CD105+ fibroblasts were found to circumscribe epithelia with neuroendocrine differentiation. CAF-derived SFRP1, driven by CD105 signaling, was necessary and sufficient to induce prostate cancer neuroendocrine differentiation in a paracrine manner. A partially humanized CD105 neutralizing antibody, TRC105, inhibited fibroblastic SFRP1 expression and epithelial neuroendocrine differentiation. In a novel synthetic lethality paradigm, we found that simultaneously targeting the epithelia and its microenvironment with ADT and TRC105, respectively, reduced castrate-resistant tumor progression, in a model where either ADT or TRC105 alone had little effect.

Stromal epigenetic alterations drive metabolic and neuroendocrine prostate cancer reprogramming.

Prostate cancer is an androgen-dependent disease subject to interactions between the tumor epithelium and its microenvironment. Here, we found that epigenetic changes in prostatic cancer-associated fibroblasts (CAF) initiated a cascade of stromal-epithelial interactions. This facilitated lethal prostate cancer growth and development of resistance to androgen signaling deprivation therapy (ADT). We identified a Ras inhibitor, RASAL3, as epigenetically silenced in human prostatic CAF, leading to oncogenic Ras activity driving macropinocytosis-mediated glutamine synthesis. Interestingly, ADT further promoted RASAL3 epigenetic silencing and glutamine secretion by prostatic fibroblasts. In an orthotopic xenograft model, subsequent inhibition of macropinocytosis and glutamine transport resulted in antitumor effects. Stromal glutamine served as a source of energy through anaplerosis and as a mediator of neuroendocrine differentiation for prostate adenocarcinoma. Antagonizing the uptake of glutamine restored sensitivity to ADT in a castration-resistant xenograft model. In validating these findings, we found that prostate cancer patients on ADT with therapeutic resistance had elevated blood glutamine levels compared with those with therapeutically responsive disease (odds ratio = 7.451, P = 0.02). Identification of epigenetic regulation of Ras activity in prostatic CAF revealed RASAL3 as a sensor for metabolic and neuroendocrine reprogramming in prostate cancer patients failing ADT.

Association Between Placental Polycyclic Aromatic Hydrocarbons (PAHS), Oxidative Stress, and Preterm Delivery: A Case-Control Study.

Polycyclic aromatic hydrocarbons are known to disturb the antioxidant defense system, which may indirectly contribute to induction of early pregnancy in women. Therefore, the present investigation was designed to offer preliminary information about exposure to PAHs by estimating their placental levels and its association with oxidative stress as well as with preterm birth. Placenta tissue samples were drawn after delivery from 84 healthy pregnant women, recruited at a local nursing home of Agra, India, and levels of PAHs were quantified by gas chromatograph equipped with flame ionization detector. To evaluate redox status biomarkers, malondialdehyde (MDA) and glutathione (GSH) were determined in placenta tissue. Significantly elevated levels of benzo(a)pyrene and MDA while decreasing trend of GSH was found in women with preterm delivery group (study) than women with a full-term delivery group (control). Results demonstrated higher, but statistically insignificant (p > 0.05), levels of naphthalene, anthracene, fluorene, pyrene, benzo(b)fluoranthene, benzo(k)fluoranthene, indeno[1,2,3-cd]pyrene, dibenzo(ah)anthracene, and benzo(ghi)perylene in the study group than the control group. However, higher and lower molecular weight PAHs showed significant correlation for the depletion trend of GSH sights upon an example of oxidative stress mechanism. Because of limited statistical power and absence of controlled confounders, this study does not provide an ample involvement of PAHs with preterm delivery but increased MDA and decreased GSH in cases than controls gives the possible contribution of PAHs to early delivery.

Autologous Platelet-rich Fibrin Matrix in Non-healing Trophic Ulcers in Patients with Hansen's Disease.

BACKGROUND: Non-healing trophic ulcers in Hansen's disease patients is one of the major causes for disability. It has been shown that autologous platelet-rich fibrin matrix (PRFM) is effective in healing chronic non-healing leg ulcers. AIM: The objective of this study is to demonstrate the efficacy of autologous platelet-rich fibrin matrix (PRFM) in non-healing trophic ulcers in patients treated for Hansen's disease. DESIGN: A prospective study. SETTING: An institution-based clinic. PARTICIPANTS: Seven treated patients with Hansen's disease, with a mean age of 38.33 years, with nine non-healing trophic ulcer of more than 6 weeks duration. MEASUREMENTS: Photographs were taken before treatment and at every subsequent sitting. Area and volume were calculated at baseline and every subsequent sitting till the closure was achieved. MATERIALS AND METHODS: The healthy ulcers were treated with PRFM at weekly intervals, repeated once a week for a maximum of five sittings as per requirement. RESULTS: The mean percentage improvement in the area was 93.52%, and volume was 97.74% at the end of the second sitting. All ulcers closed by a maximum of five sittings. No adverse events were noted. CONCLUSION: PRFM for the treatment of trophic ulcers in treated patients with Hansen's disease is a feasible, safe, simple and inexpensive method.

MicroRNA applications for prostate, ovarian and breast cancer in the era of precision medicine.

The high degree of conservation in microRNA from Caenorhabditiselegans to humans has enabled relatively rapid implementation of findings in model systems to the clinic. The convergence of the capacity for genomic screening being implemented in the prevailing precision medicine initiative and the capabilities of microRNA to address these changes holds significant promise. However, prostate, ovarian and breast cancers are heterogeneous and face issues of evolving therapeutic resistance. The transforming growth factor-beta (TGFß) signaling axis plays an important role in the progression of these cancers by regulating microRNAs. Reciprocally, microRNAs regulate TGFß actions during cancer progression. One must consider the expression of miRNA in the tumor microenvironment a source of biomarkers of disease progression and a viable target for therapeutic targeting. The differential expression pattern of microRNAs in health and disease, therapeutic response and resistance has resulted in its application as robust biomarkers. With two microRNA mimetics in ongoing restorative clinical trials, the paradigm for future clinical studies rests on the current observational trials to validate microRNA markers of disease progression. Some of today's biomarkers can be translated to the next generation of microRNA-based therapies.

Lobule separator prosthesis to prevent adhesion of reconstructed ear lobe.

An adhesion is a band of scar tissue that binds two parts of the tissue together, which develops when the body's repair mechanisms respond to any tissue disturbance, such as surgery, infection, trauma, or radiation. Prevention of unwanted scar bands is of utmost importance to develop esthetic and healthy tissue. This article describes a technique to prevent the adhesion of the surgically reconstructed ear lobule with facial skin, using novel lobule separator prosthesis.

Autologous Smashed Dermal Graft with Epidermal Re-closure: Modified Technique for Acne Scars.

Conventional technique of dermal grafting for acne scars where the source of filler material used is the patient's own dermis requires longer surgical time, recovery period and can result in unsightly scars at the donor area. Hence, it is not suitable for treating a larger number of scars. Furthermore, these dermal grafts are firm and cannot be contoured to fit all types of acne scars. Occurrence of epidermal cyst and secondary infection is another complication if epidermis is not completely removed. Enzymatic techniques need trypsinisation which is expensive and requires laboratory facilities.