Comparison of Two Neutral Oral Contrast Agents in Pediatric Patients: A Prospective Randomized Study.

Purpose To prospectively compare small bowel distention provided by, as well as patient acceptance of, two different neutral (negative) oral contrast materials used for cross-sectional enterography in a pediatric population. Materials and Methods In this noninferiority study, 66 pediatric patients undergoing clinical computed tomographic (CT) or magnetic resonance (MR) enterography were randomized to receive either a flavored beverage for neutral abdominal and pelvic imaging (Breeza; Beekley Medical, Bristol, Conn) or a low-density barium sulfate suspension. Patients were blinded to the oral contrast material administered and were asked to rate taste, texture, and their perceived health state (where 0 was very bad and 10 was very good). Ingested volume of the prescribed weight-based oral contrast material preparation was recorded. Maximum small bowel diameter was measured in all four abdominal quadrants. Mean bowel diameter as well as taste, texture, and health state scores were compared between cohorts by using t tests; proportions were compared by using Fisher exact tests. Results Thirty-three patients each received Breeza and barium sulfate suspension, respectively. No difference was found in age (Breeza, 13.5 years ± 2.6 [standard deviation]; barium sulfate suspension, 13.9 years ± 2.8; P = .49), sex distribution (15 girls each; P > .99), or health state (P = .21) between cohorts. Twenty-eight of 33 (84.8%) and 17 of 33 (51.5%) patients completed the Breeza and barium sulfate suspension preparations, respectively (P = .007). Breeza received higher scores for taste (6.1 ± 2.5 vs 2.7 ± 2.5; P < .0001) and texture (7.3 ± 2.3 vs 3.6 ± 2.9; P < .0001). No difference was found in bowel distention between Breeza and barium sulfate suspension (1.63 cm ± 0.24 vs 1.69 cm ± 0.25; P = .44). Conclusion The neutral oral contrast materials Breeza and low-density barium sulfate suspension provide similar small bowel distention. Patients receiving Breeza are more likely to ingest the entire prescribed volume.

Inter-rater Agreement of Clinicians' Treatment Recommendations Based on Modified Barium Swallow Study Reports.

The modified barium swallow study (MBSS) is a commonly used radiographic procedure for diagnosis and treatment of swallowing disorders. Despite attempts by dysphagia specialists to standardize the MBSS, most institutions have not adopted such standardized procedures. High variability of assessment patterns arguably contribute to variability of treatment recommendations made from diagnostic information derived from the MBSS report. An online survey was distributed to speech-language pathologists (SLPs) participating in American Speech Language Hearing Association (ASHA) listservs. Sixty-three SLPs who treat swallowing disorders participated. Participating SLPs reviewed two MBSS reports and chose physiologic treatment targets (e.g., tongue base retraction) based on each report. One report primarily contained symptomatology (e.g., aspiration, pharyngeal residue) with minimal information on impaired physiology (e.g., laryngeal incompetence, reduced hyolaryngeal elevation/excursion). In contrast, the second report contained a clear description of impaired physiology to explain the dysphagia symptoms. Fleiss kappa coefficients were used to analyze inter-rater agreement across the high and low physiology report types. Results revealed significantly higher inter-rater agreement across clinicians when reviewing reports with clear explanation(s) of physiologic impairment relative to reports that primarily focused on symptomatology. Clinicians also reported significantly greater satisfaction and treatment confidence following review of reports with clear description(s) of impaired physiology.

Evaluation of Antimicrobial Efficacy of Root Canal Sealers against Enterococcus faecalis: A Comparative Study.

AIM: The study aimed to evaluate the efficacy of root canal sealer's antimicrobial activity against Enterococcus faecalis. MATERIALS AND METHODS: Root canal sealers with the brands Endoflas FS, AH Plus, and Tubli-Seal EWT were selected. Enterococcus faecalis organisms' zone of inhibition was measured. Tukey post hoc tests and one-way analysis of variance (ANOVA) were used to compare the data among study groups and within its group. The data were said to be statistically significant with an established p-value less than 0.05. RESULTS: The maximum zone of inhibition (23.20 ± 1.202 mm) was shown by Endoflas FS sealer; AH Plus and Tubli-Seal showed the inhibition zone of (18.42 ± 1.023) and (16.88 ± 0.962) respectively, following Endoflas FS. The ANOVA test showed p < 0.0001, which is highly statistically significant. AH Plus and Endoflas FS showed a statistically significant difference of 0.04 and 0.001 in between groups, and there was no statistically significant difference in the Tubli-Seal group from Tukey post hoc test. CONCLUSION: The study showed that Endoflas FS sealer has a significant antimicrobial effect against E. faecalis. CLINICAL SIGNIFICANCE: In clinical situation, despite perfect che-momechanical root canal preparation, persistence of microorganisms may reinfect the root canal. Therefore, endodontic root canal sealers play a major role in the eradication of bacteria. The polymicrobial nature of endodontic infection plays a main role during the usage of endodontic sealer with antimicrobial agents, which in turn reduces the failure of endodontic treatment.

No genotoxicity in rat blood cells upon 3- or 6-month inhalation exposure to CeO2 or BaSO4 nanomaterials.

In the course of a 2-year combined chronic toxicity-carcinogenicity study performed according to Organisation for Economic Co-operation and Development (OECD) Test Guideline 453, systemic (blood cell) genotoxicity of two OECD representative nanomaterials, CeO2 NM-212 and BaSO4 upon 3- or 6-month inhalation exposure to rats was assessed. DNA effects were analysed in leukocytes using the alkaline Comet assay, gene mutations and chromosome aberrations were measured in erythrocytes using the flow cytometric Pig-a gene mutation assay and the micronucleus test (applying both microscopic and flow cytometric evaluation), respectively. Since nano-sized CeO2 elicited lung effects at concentrations of 5mg/m3 (burdens of 0.5mg/lung) in the preceding range-finding study, whereas nano-sized BaSO4 did not induce any effect, female rats were exposed to aerosol concentrations of 0.1 up to 3mg/m3 CeO2 or 50mg/m3 BaSO4 nanomaterials (6h/day; 5 days/week; whole-body exposure). The blood of animals treated with clean air served as negative control, whereas blood samples from rats treated orally with three doses of 20mg/kg body weight ethylnitrosourea at 24h intervals were used as positive controls. As expected, ethylnitrosourea elicited significant genotoxicity in the alkaline Comet and Pig-a gene mutation assays and in the micronucleus test. By contrast, 3- and 6-month CeO2 or BaSO4 nanomaterial inhalation exposure did not elicit significant findings in any of the genotoxicity tests. The results demonstrate that subchronic inhalation exposure to different low doses of CeO2 or to a high dose of BaSO4 nanomaterials does not induce genotoxicity on the rat hematopoietic system at the DNA, gene or chromosome levels.

Protein Activation in Periapical Reaction to Iodoform Containing Root Canal Sealer.

OBJECTIVES: An association between root canal sealers and periapical lesions in primary dentition has been suggested, yet the chemical-protein interactions that may be involved in it have not been studied. The present study explored root sealer components' effect on periapical tissue proteins using bioinformatics tools. STUDY DESIGN: For each chemical component of Endoflas F.S. root sealing material we identified the known and predicted target proteins, using STITCH (search tool for interactions of chemicals http://stitch.embl.de/ ). Identified target proteins were grouped into functional categories using the annotation clustering tool from DAVID, the Database for Annotation, Visualization and Integrated Discovery ( http://david.abcc.ncifcrf.gov/ ). STRING Protein-Protein Interaction network database identified associations between the proteins. RESULTS: Sixteen proteins identified with STITCH served as input to DAVID annotation clustering tool. Only ZnO and Eugenol targeted proteins had statistically significant annotations. Gene Ontology terms of ZnO and Eugenol targeted proteins demonstrated that these proteins respond to mechanical stimulus and to oxidative stress. They highlight these proteins' role in the positive regulation of transcription, gene expression, cell proliferation and apoptosis, and their complementary role in the negative regulation of cell death. CONCLUSION: When stimulated by Zinc Oxide, Eugenol and Calcium hydroxide, chemical-protein and subsequent protein-protein interactions result in cell proliferation in the periapical area. Our findings indicate that certain root sealers components may cause enlargement of the permanent tooth follicle. Dentists should be aware of this phenomenon and radiographically monitor root canal treated teeth until shedding.

Correlation between the radiological observation of isolated tertiary waves on an esophagram and findings on high-resolution esophageal manometry.

Barium esophagrams are a frequently performed test, and radiological observations about potential abnormal esophageal motility, such as tertiary contractions, are commonly reported. We sought to assess the correlation between tertiary waves, and in particular isolated tertiary waves, on esophagrams and findings on non-synchronous high-resolution esophageal manometry. We retrospectively reviewed reports of esophagrams performed at a tertiary referral center and identified patients in whom tertiary waves were observed and a high-resolution esophageal manometry had been performed. We defined two groups; group 1 was defined as patients with isolated tertiary waves, whereas group 2 had tertiary waves and evidence of achalasia or an obstructing structural abnormality on the esophagram. We collected data on demographics, dysphagia score, associated findings on esophagram, and need for intervention. We reviewed the reports of 2100 esophagrams of which tertiary waves were noted as an isolated abnormality in 92, and in association with achalasia or a structural obstruction in 61. High-resolution manometry was performed in 17 patients in group 1, and five had evidence of a significant esophageal motility disorder and 4 required any intervention. Twenty-one patients in group 2 underwent manometry, and 18 had a significant esophageal motility disorder. An isolated finding of tertiary waves on an esophagram is rarely associated with a significant esophageal motility disorder that requires intervention. All patients with isolated tertiary waves who required intervention had a dysphagia to liquids. Tertiary contractions, in the absence of dysphagia to liquids, indicate no significant esophageal motility disorder.

Recurrent neck lesions secondary to pyriform sinus fistula.

Recurrent neck lesions associated with third or fourth branchial arch fistula are much less common than those of second arch and usually present with acute suppurative thyroiditis or neck abscess. Our aim is to describe clinical features, management and treatment outcomes of 64 cases of congenital pyriform sinus fistula (PSF). Medical record of these 64 patients (33 males, 31 females) treated at the First Affiliated Hospital of Zhengzhou University from 2011 to 2014 were reviewed. The patients comprised 33 males and 31 females, and their ages ranged from 18 months to 47 years (median 10 years, mean 12.7 years). Neck abscess and recurrent infection was the mode of presentation in 37 cases (57.8 %), 4 patients (6.3 %) presented with acute suppurative thyroiditis, neck mass was the mode of presentation in 17 cases (26.6 %), 2 patients (3.1 %) presented with neck mass with respiratory distress, and cutaneous discharging fistula was the mode of presentation in 1 cases (1.6 %). The remaining 3 patients (4.7 %) presented with cutaneous discharging fistula with neck infection. Investigations performed include barium swallow, CT scan, and ultrasound which were useful in delineating PSF tract preoperatively. Barium swallow was taken as the gold standard for diagnosis. Our patients were treated by fistulectomy with hemithyroidectomy, fistulectomy, fistulectomy with endoscopic electric cauterization, endoscopic electric cauterization or endoscopic coblation cauterization, respectively. Histopathologic examination of the surgical specimens revealed that they were lined with ciliated epithelium, stratified cuboid epithelium with chronic inflammatory cell infiltration and fibrosis. Voice hoarseness occurred after operation in seven patients, but disappeared 1 week later. PSF recurred in 6 patients, 4 of them were cured by a successful re-excision. One patient was cured by successful endoscopic electric cauterization. The other 1 has remained asymptomatic for 5 months. In our series, mean follow-up period was 13.3 months and median follow-up period was 12.5 months (range 2-40 months). Presence of congenital PSF should be suspected when intra-thyroidal abscess formation occurs as the gland is resistant to infection. Strong clinical suspicion, barium swallow study, CT scan and ultrasound are the key to diagnosis. Both fistulectomy with hemithyroidectomy and endoscopic treatment have comparable success rate. Endoscopic coblation cauterization may prove a useful and equally effective method of treatment for PSF in future.

[The role of cellular mediators in the development of the phenomenon of inhibition induced by barium sulfate luminol-dependent chemiluminescence of blood under the influence of non-steroidal anti-inflammatory drugs in patients with intolerance to these drugs].

We investigated contribution mediator mechanism in the development of the phenomenon of inhibition induced by barium sulfate luminol-dependent chemiluminescence (SLCHL) of blood under the influence of nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with intolerance to these drugs. It was found that the phenomenon of suppression SLCHL blood under the influence of NSAIDs in patients with intolerance is mediated by the participation of mediators, and the contribution of H1--and H2--histamine receptors, 5-HT2 serotonin receptors and Cys-leukotriene receptors in the development of that phenomenon depends on the chemical nature of NSAIDs and the clinical manifestations of intolerance.

Treatment of sigmoid volvulus: a single-center experience of 952 patients over 46.5 years.

BACKGROUND: Sigmoid volvulus describes the wrapping of the sigmoid colon around itself and its mesentery, causing an intestinal obstruction. The aim of this study was to assess the outcomes of 952 patients treated for sigmoid volvulus over a period of 46.5 years. METHODS: Clinical records were reviewed retrospectively. RESULTS: Nonsurgical detorsion was performed in 686 patients with 77.1 % success, 2.5 % morbidity, 0.7 % mortality, and 4.5 % early recurrence rates; emergency surgical procedures were performed in 447 patients with 35.3 % morbidity, 16.1 % mortality, 0.7 % early recurrence, and 7.4 % late recurrence rates, while elective surgical treatment was performed in 104 patients with 12.5 % morbidity, no mortality, and no recurrence. CONCLUSIONS: The principal strategy in the treatment for sigmoid volvulus is early nonsurgical detorsion followed by elective surgery in uncomplicated patients, while emergency surgical treatment is performed for patients with bowel gangrene, perforation, or peritonitis, other difficulties with diagnosis, unsuccessful nonsurgical detorsion, and early recurrence.

Effects of barium sulfate on rheological properties and IDDSI flow consistency of liquid stimuli prepared using commercial thickening powders.

During videofluoroscopic swallowing study (VFSS), barium sulfate (BaSO4 ) is commonly added into food samples as a radiopaque contrast media for bolus visualization and examination. Accordingly, the consistency and flow behavior of barium stimuli can differ significantly from their non-barium counterparts. Such differences may have a subsequent impact on the validity of VFSS. Therefore, in this study, effects of barium sulfate on the shear and extensional rheological properties and IDDSI (International Dysphagia Diet Standardization Initiative) flow consistency of liquids prepared using various commercial thickening powders were investigated. Results showed that all barium stimuli exhibited shear thinning behavior but with significantly higher shear viscosity compared to the non-barium counterparts. A shift factor of viscosity at shear rate 50 s-1 with values in range of 1.21-1.73 could be used to describe the increase in the viscosity for samples thickened with gum-based thickeners. However, the change in the viscosity was not invariant for the stimuli prepared starch-based thickener. The addition of BaSO4 had a negative impact on extensional properties of samples by demonstrating a faster filament rupture. The extent of impact on the decrease in filament breakup time was more pronounced in xanthan > guar gum ≈ tara gum-based thickeners. Based on the IDDSI flow test, no significant effect of BaSO4 was found on the gum-based thickeners, whereas there was a marked effect in the starch-based sample. These results can be used beneficially to assist clinicians in the dysphagia diagnosis for matching rheological properties of the barium stimuli to enhance effectiveness dysphagia interventions.

Barium sulphate microparticles are taken up by three different cell types: HeLa, THP-1, and hMSC.

Cytotoxicity and cellular uptake of spherical barium sulphate microparticles (diameter 1 µm) were studied with three different cell lines, i.e. THP-1 cells (monocytes; model for a phagocytosing cell line), HeLa cells (epithelial cells; model for a non-phagocytosing cell line), and human mesenchymal stem cells (hMSCs; model for non-phagocytosing primary cells). Barium sulphate is a chemically and biologically inert solid which allows to distinguish two different processes, e.g. the particle uptake and potential adverse biological reactions. Barium sulphate microparticles were surface-coated by carboxymethylcellulose (CMC) which gave the particles a negative charge. Fluorescence was added by conjugating 6-aminofluorescein to CMC. The cytotoxicity of these microparticles was studied by the MTT test and a live/dead assay. The uptake was visualized by confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). The particle uptake mechanism was quantified by flow cytometry with different endocytosis inhibitors in THP-1 and HeLa cells. The microparticles were easily taken up by all cell types, mostly by phagocytosis and micropinocytosis, within a few hours. STATEMENT OF SIGNIFICANCE: The interaction of particles and cells is of primary importance in nanomedicine, drug delivery, and nanotoxicology. It is commonly assumed that cells take up only nanoparticles unless they are able to phagocytosis. Here, we demonstrate with chemically and biologically inert microparticles of barium sulphate that even non-phagocytosing cells like HeLa and hMSCs take up microparticles to a considerable degree. This has considerable implication in biomaterials science, e.g. in case of abrasive debris and particulate degradation products from implants like endoprostheses.

An in vitro evaluation of antimicrobial efficacy of primary root canal filling materials.

OBJECTIVE: The present study aimed to evaluate and compare six different materials commonly used for filling the root canals of primary teeth for antimicrobial efficacy against some of the microorganisms commonly found in infected root canals. STUDY DESIGN: In this experimental in vitro study six root canal filling materials were tested for antimicrobial efficacy against eight microbial strains using the agar diffusion method. RESULTS: Zinc oxide eugenol paste exhibited the strongest antimicrobial potential followed by Endoflas, zinc oxide-calcium hydroxide-sodium fluoride mixture, zinc oxide-calcium hydroxide mixture and calcium hydroxide paste (Apexcal). The addition of sodium fluoride to the zinc oxide-calcium hydroxide mixture enhanced the antimicrobial efficacy. Metapex demonstrated minimal inhibition and Vaseline was non-inhibitory. CONCLUSIONS: All the test filling materials demonstrated varying antimicrobial activity against the microorganisms tested. Zinc oxide eugenol paste and materials containing zinc oxide were found to be more effective against the microorganisms compared to materials without zinc oxide.

Identification of tolerance levels on the cold-water coral Desmophyllum pertusum (Lophelia pertusa) from realistic exposure conditions to suspended bentonite, barite and drill cutting particles.

Cold-water coral (CWC) reefs are numerous and widespread along the Norwegian continental shelf where oil and gas industry operate. Uncertainties exist regarding their impacts from operational discharges to drilling. Effect thresholds obtained from near-realistic exposure of suspended particle concentrations for use in coral risk modeling are particularly needed. Here, nubbins of Desmophyllum pertusum (Lophelia pertusa) were exposed shortly (5 days, 4h repeated pulses) to suspended particles (bentonite BE; barite BA, and drill cuttings DC) in the range of ~ 4 to ~ 60 mg.l-1 (actual concentration). Physiological responses (respiration rate, growth rate, mucus-related particulate organic carbon OC and particulate organic nitrogen ON) and polyp mortality were then measured 2 and 6 weeks post-exposure to assess long-term effects. Respiration and growth rates were not significantly different in any of the treatments tested compared to control. OC production was not affected in any treatment, but a significant increase of OC:ON in mucus produced by BE-exposed (23 and 48 mg.l-1) corals was revealed 2 weeks after exposure. Polyp mortality increased significantly at the two highest DC doses (19 and 49 mg.l-1) 2 and 6 weeks post-exposure but no significant difference was observed in any of the other treatments compared to the control. These findings are adding new knowledge on coral resilience to short realistic exposure of suspended drill particles and indicate overall a risk for long-term effects at a threshold of ~20 mg.l-1.

Evaluation of a novel radiopacifiying agent on the physical properties of surgical spineplex.

Polymethlylmethacrylate (PMMA) is the most frequently used cement for percutaneous vertebroplasty and kyphoplasty. To aid visualisation during surgery cements are doped with radiopacifying agents such as Barium sulphate (Ba(2)SO(4)) or Zirconium Dioxide (ZiO(2)). Mounting research suggests that these agents may impair the biocompatibility of the cements. However, incorporating an alternative radiopacifier agent with excellent biocompatibility would be a significant step forward. Bioactive radiopaque glasses incorporating elements such as strontium (Sr) and zinc (Zn), known to have beneficial and therapeutic effects on bone, are of great interest in this respect. In this study, the Ba(2)SO(4) of the commercially available Spineplex was incrementally replaced with a radiopaque therapeutic glass composition. The resulting effects on cement setting time, peak isotherm, ultimate compressive strength, Young's modulus (up to 30 days cement maturation) and radiopacity were evaluated. The substitution lead to an increase in cement setting time from 13.1 mins for Spineplex to 16.6-18.3 mins for the glass substituted cements. The peak exotherm during curing was reduced from 74 degrees C for Spineplex to a minimum of 51 degrees C for the fully substituted cement, indicating that reduced thermal necrosis in the in vivo setting is likely with these materials. Ultimate compressive strength and Young's modulus of each formulation showed no significant deterioration due to the substitution. Finally, the radiopacity of the substituted cements were reduced by up to a maximum of 18% in comparison to the control. However, the experimental formulations still maintained radiopacity equivalent to several millimetres of aluminium. As such the substituted cements had substantial equivalence to the Spineplex control. In order to assess the clinical relevance of these findings further investigation is warranted.

Evaluation of gastrointestinal tract transit times using barium-impregnated polyethylene spheres and barium sulfate suspension in a domestic pigeon (Columba livia) model.

Barium impregnated polyethylene spheres (BIPS) are used in small animal medicine as an alternative to barium sulfate for radiographic studies of the gastrointestinal tract. To determine the usefulness of BIPS as an alternative to barium suspension in measuring gastrointestinal (GI) transit time for avian species, ventrodorsal radiographs were used to follow the passage of BIPS and 30% barium sulfate suspension through the GI tracts of domestic pigeons (Columba livia). Gastrointestinal transit times of thirty 1.5-mm BIPS administered in moistened gelatin capsules and 30% barium sulfate suspension gavaged into the crop were compared in 6 pigeons. Although the barium suspension passed out of the GI tract of all pigeons within 24 hours, the 1.5-mm BIPS remained in the ventriculus for 368.0 +/- 176.8 hours and did not clear the GI tract for 424.0 +/- 204.6 hours. Although the times for passage of BIPS and 30% barium sulfate suspension from the crop into the ventriculus were not significantly different (P = .14), the times for passage of BIPS from the ventriculus into the large intestine-cloaca and for clearance from the GI tract of the pigeons were significantly longer (P < .001) than for the 30% barium sulfate suspension. From the results of this study, we conclude that BIPS are not useful for radiographically evaluating GI transit times in pigeons and are unlikely to be useful in other avian species that have a muscular ventriculus. BIPS may or may not be useful for evaluating GI transit times in species that lack a muscular ventriculus.

Fate of Barium Sulfate Nanoparticles Deposited in the Lungs of Rats.

We have shown that barium [from BaSO4 nanoparticles (NPs)] was cleared from the lungs faster than other poorly soluble NPs and translocated mostly to bone. We now studied barium biokinetics in rats during Study 1: two-year inhalation exposure to 50 mg/m3 BaSO4 NP aerosols, and Study 2: single intratracheal (IT) instillation of increasing doses of BaSO4 NPs or BaCl2. Study 1 showed that lung barium content measured by inductively coupled plasma mass spectrometry increased during 360 days of BaSO4 NP aerosol exposures. An equilibrium was established from that time until 2 years. Barium concentrations in BaSO4-exposed animals were in the order (lungs > lymph nodes > hard bone > bone marrow > liver). In Study 2, there was an increase in lung barium post-IT instillation of BaSO4 NPs while barium from BaCl2 was mostly cleared by day 28. Transmission electron microscopy showed intact BaSO4 NPs in alveolar macrophages and type II epithelial cells, and in tracheobronchial lymph nodes. Using stimulated Raman scattering microscopy, specific BaSO4 Raman spectra were detected in BaSO4 NP-instilled lungs and not in other organs. Thus, we posit that barium from BaSO4 NPs translocates from the lungs mainly after dissolution. Barium ions are then incorporated mostly into the bone and other organs.

Comparison of Three-Dimensional Micro-CT Angiography of Cervical Spinal Cord between Two Contrast Agents.

Purpose: Barium sulfate and lead oxide are commonly used for angiographic studies, but there is no report on the comparison of two contrast agents in angiography of cervical spinal cord. This study was aimed to compare the microvascular architecture of cervical spinal cord in rats after angiography with the barium sulfate agent to the lead oxide agent. Methods: Twelve adult Sprague-Dawley rats were randomly divided into the barium sulfate group (n=6) and the lead oxide group (n=6). Each rat was perfused under the same protocol using either two contrast agents. The angiography was evaluated with the vascular number at different ranks. The cervical spinal cord samples were scanned using micro-CT with low resolution and high resolution. The microvascular parameters, including ratio of vascular volume to tissue volume (VV/TV), vascular number (V.N), diameter (V.Dm), separation (V.Sp), connectivity density (Conn.D), structure model index (SMI), percentage, and volume of vessels at different diameters were measured. Results: The perfusion was better in the barium sulfate group, with more blood vessel trees of rank II and III visible compared to the lead oxide group. Low-resolution micro-CT analysis showed no difference in microvascular parameters except SMI between the two groups. High-resolution micro-CT analysis results showed that V.N and Conn.D of barium sulfate group were 60% and 290% more than those of the lead oxide group; however, V.Sp was 41% less than the lead oxide group. The percentage of vessels with diameter of 10 µm and 20 µm, and the volume of vessels with diameter of less than 100 µm was higher in the barium sulfate group than in the lead oxide group. The SMI index in the barium sulfate group was higher than that in the lead oxide group at both low resolution and high resolution. Conclusions: Compared with lead oxide, barium sulfate is more suitable for perfusion of cervical spinal cord microvessels, and cheap and nontoxic with high resolution.

Vascularisation of pectoralis maior myocutaneous flap: anatomical study in human fetuses and cadavers.

Pectoral major flap is one of most frequently used flaps in head and neck reconstruction. The wide attractiveness of this flap is based on secure vascular stalk made from pectoral branch of thoracoacromial artery. The aim of study was to analyze the variations in vascular supply of pectoral major muscle. The investigation was performed on 30 fetuses from 20 to 36 gestation week both gender. For determining vascular network the samples injected with barium sulphate were subjected to Spalteholtz technique, and on 30 fresh cadavers where and we performed injection of Metilen blue 1% in pectoral branch of thoracoacromial artery. In 87% we found one pectoral branch and in 13 % two branches for pectoral muscle were found. Before entering the muscle, pectoral branch is dividing in two terminal branches (67%). In all cases lateral part of pectoral muscle is supplied by branch of lateral thoracic artery. The average area of dyed skin was 13 x 20 cm in region between III and VI rib and from parasternal line to anterior axillar line. The average distance of most distal part of dyed skin to midclavicular point was 24 cm. The pectoral branch of thoracoactomial artery obtains main blood supply for pectoral major muscle mass and despite of anatomical variations can be defined as main pedicle for musculocutaneous flap. Dyed skin confirms that pectoral major flap has defined skin territory sufficient for reconstructions in head and neck area.

The Radiopacity and Antimicrobial Properties of Different Radiopaque Double Antibiotic Pastes Used in Regenerative Endodontics.

INTRODUCTION: We evaluated the radiopacity and antibacterial properties of various concentrations of double antibiotic paste (DAP) containing barium sulfate (BaSO4) or zirconium oxide (ZrO2) radiopaque agents. METHODS: The radiopacity of 1, 10, and 25 mg/mL DAP containing 30% (w/v) BaSO4 or ZrO2, DAP-free radiopaque pastes, and commercially available radiopaque calcium hydroxide (Ca[OH]2) were evaluated according to ISO 6876/2001 with slight modifications (n = 6 per group). Dentin samples (n = 70) infected anaerobically for 3 weeks with bacterial biofilms obtained from a root canal of an immature tooth with pulpal necrosis were treated with similar experimental pastes or received no treatment (n = 7). After 1 week, the pastes were rinsed off, and biofilm disruption assays were conducted. To show the residual antibacterial effects, sterile dentin samples (n = 70) were pretreated for 1 week with the same pastes (n = 7). The pastes were rinsed off, and the samples were immersed in phosphate-buffered saline for 24 hours and infected anaerobically with the same bacterial biofilm mentioned earlier for 3 weeks before conducting biofilm disruption assays. Sterile dentin blocks were used in both antibacterial analyses as negative control groups (n = 7). Wilcoxon rank sum tests were used for statistical analyses. RESULTS: No tested concentrations of BaSO4 DAP or ZrO2 DAP showed significant differences from Ca(OH)2 in radiopacity. However, all tested concentrations of BaSO4 DAP, ZrO2 DAP, and Ca(OH)2 exhibited significant direct antibacterial effects. ZrO2 DAP at 1 mg/mL and Ca(OH)2 did not show significant residual antibacterial effects. CONCLUSIONS: BaSO4 DAP at 1 mg/mL provided significantly superior residual antibacterial effects and comparable radiopacity with the commercially available Ca(OH)2.

Angiographic Evaluation of Vascular Damage in Rat Liver After Administration of Epirubicin or Miriplatin.

BACKGROUND: Maintaining the function of blood vessels is important for the control of hepatocellular carcinoma (HCC) during treatment with repeated transcatheter arterial chemoembolization (TACE). This study was designed to compare the vascular damage caused by miriplatin (MPT), which has been commonly used for TACE, with the damage caused by epirubicin (EPI). MATERIALS AND METHODS: We used the portal vein of healthy rats for the administration of the drug (MPT or EPI) and/or soybean oil as vehicle. After 2 days, angiography was performed by X-ray computer tomography. RESULTS: The influence of soybean oil on blood vessel function was volume-dependent. EPI showed dose-dependent effects on angiography, and 0.5 mg EPI led to severe (grade 4) blood flow disturbance in all animals. The effect of 1 mg MPT on blood vessels was mild (grade 1) in all animals and not different from that of soybean oil alone. CONCLUSION: Less vascular damage is caused by MPT than by EPI, suggesting that MPT is a useful drug for TACE in HCC.