Effects of risk factors on periodontal disease defined by calibrated community periodontal index and loss of attachment scores.

OBJECTIVES: We evaluated whether and how the effects of risk factors on periodontal disease (PD) were modified by measurement errors using community periodontal index (CPI) and loss attachment (LA) in the community-based survey. METHODS: A pilot validation study was performed to estimate the rates of false negative and false positive for both CPI and LA in 31 subjects from different regions using measurements from 12 well-trained dentists and a senior periodontist as a gold standard. Afterward, a Taiwanese nationwide survey was conducted by enrolling 3,860 participants to estimate the effect of each risk factor on PD calibrated with both sensitivity and specificity of two indices. RESULTS: The values obtained for the sensitivity to false-positive ratio for CPI ranged widely from 1.12 to 7.71, indicating regional variation in both errors. The calibrated adjusted odds ratio for smoking vs non-smoking was higher than the uncalibrated odds ratio for PD defined by CPI (2.75 (2.01, 3.77) vs 2.02 (1.63, 2.52)) and LA (3.85 (2.44, 6.13) vs 1.93 (1.47, 2.54)) scores. Similar underestimation was noted for other risk factors. CONCLUSION: The effects of risk factors on PD measured using CPI and LA in a large population-based survey were underestimated without correcting for measurement errors.

[10-Methacryloyloxydecyl dihydrogen phosphate in resin-to-zirconia bonding durability: a systematic review and meta-analysis].

Objective: To systematically assess the durability of the 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) pretreated resin-to-zirconia bonding and conducted a meta-analysis to provide clinical guidance on zirconia bonding strategies. Methods: A comprehensive search was conducted on PubMed, Scopus, Web of Science, CNKI, and Wanfang database to identify relevant studies on the resin-to-zirconia bonding after surface pretreatment with 10-MDP. Strict inclusion and exclusion criteria were applied to select appropriate literature and extract essential information and data. The included studies were categorized based on aging methods (water storage, thermocycling, or both), 10-MDP application methods (within primer, adhesive, resin cement, or both), and additional surface treatments (alumina sandblasting, tribochemical silica coating, acid etching, laser etching, and plasma treatment) and were analyzed by Review Manager 5.4. The evaluation indicator was the bonding strength of zirconia after surface pretreatment with 10-MDP. Results: A total of 72 studies were included in the systematic review, with 68 studies eligible for the meta-analysis. The bonding strength of zirconia decreased significantly after aging [P<0.001; mean difference (MD): 5.58; 95%CI: 5.11-6.05]. No significant differences in bonding strength of zirconia were observed after aging when employing various application methods of 10-MDP (all P>0.05). The bonding strength of zirconia was significantly enhanced after aging when 10-MDP was applied in conjunction with additional surface treatments, as compared to the application of 10-MDP alone (P<0.001; MD: 10.17; 95%CI: 8.20-12.14). Conclusions: The bonding strength of zirconia pretreated with 10-MDP exhibited a reduction after undergoing water storage or thermocycling. The application of 10-MDP with additional surface treatments enhanced the bonding strength of zirconia after aging, while the application methods of 10-MDP did not exert an influence.

Validity of near-infrared light transillumination for the assessment of proximal caries in permanent teeth.

PURPOSE: The aim of this study was to evaluate the performance of DIAGNOcam (DC) in diagnosing proximal caries and to compare its effectiveness with the International Caries Detection and Assessment System (ICDAS) and bitewing radiography (BWR). METHODS: 118 premolars extracted for orthodontic reasons were included and examined using three detection methods and validated by histological sections as the gold standard. The sensitivity, specificity and areas under the ROC curve (Az value) at the outer half enamel (D1), inner half enamel (D2) and dentine (D3) thresholds were compared between different methods. RESULTS: At all categories, the specificity of DC was almost as high as ICDAS and BWR. DC showed a significantly higher sensitivity (0.68) than both visual (0.33) and radiographic examination (0.47) at the D1 threshold. DC presented the highest Az value (area under the ROC curve) at the D1 and D2 threshold (0.81, 0.86), while BWR showed the greatest Az values at D3 (0.94). Furthermore, DC had the highest association strength with the gold standard (Spearman's ρ = 0.80). CONCLUSIONS: It can be concluded that DC could detect proximal caries effectively and showed comparable or even better performance than ICDAS and BWR.

A chromatographically purified human TGF-ß1 fraction from virally inactivated platelet lysates.

BACKGROUND AND OBJECTIVES: TGF-ß1 exerts important physiological functions in osteogenesis and chondrogenesis and may be of therapeutic interest. The aim of this work was to develop a scalable purification process of TGF-ß1 from virally inactivated human platelets. STUDY DESIGN AND METHODS: Apheresis platelet concentrates (N=12) were solvent/detergent (S/D) treated (1% TnBP/1% Triton X-45; 31°C) and the resulting platelet lysates were clarified by oil extraction and centrifugation, then chromatographed on an anion-exchange DEAE-Sepharose Fast-Flow column equilibrated in a PBS buffer, pH 7.5. The column was washed to eliminate unbound proteins and the S/D agents. Bound proteins were eluted using a 1 M NaCl-PBS buffer pH 7.5 (DEAE-eluate). The content in TGF-ß1, PDGF-AB, VEGF, IGF-1, EGF, and b-FGF was measured by ELISA. Proteins, lipids, and S/D agents were assessed. Protein profile was determined by SDS-PAGE under reduced or non-reduced conditions. RESULTS: Most proteins, including albumin and immunoglobulins G, A, and M did not bind to the DEAE column as evidenced also by SDS-PAGE. Essentially all PDGF, VEGF, and IGF were in the breakthrough. The DEAE-eluate contained close to 60% of the TGF-ß1 at a mean concentration of about 102 ng/ml, whereas EGF, b-FGF were at about 0.72 and 0.18 ng/ml, respectively. The content in TnBP and Triton X-45 was <2 ppm. CONCLUSION: A fraction enriched in TGF-ß1 can be prepared from virally inactivated human platelet lysates using an easily scale process. Its interest in regenerative medicine and cell therapy will be evaluated in further studies.

[Clinical follow-up and genetic analysis of six cases with hypophosphatasia].

Objective: To analyze the clinical, genetic characteristics and follow-up data of Chinese patients with hypophosphatasia (HPP). Methods: A retrospective analysis was conducted on six children with HPP admitted to the Department of Endocrinology, Genetics and Metabolism in Beijing Children's Hospital from October 2010 to January 2019. Summarized the clinical and follow-up data of all six patients, as well as the pathogenic variants of five children. Results: The serum alkaline phosphatase levels of all six children (five males and one female) were significantly reduced (2-49 U/L). The 6 patients aged from 2 months to 6 years and 4 months, 4 infantile HPP, 1 childhood HIP and 1 odonto HPP. The four patients with infantile HPP presented with anorexia, slow weight gain and hypercalcemia, whereas the one patient with childhood HPP and the other patient with odonto HPP had tooth loss. The patient with childhood HPP also manifested with motor dysfunction. Genetic testing was conducted for five patients and 4 unrelated Chinese families and revealed 10 variations in ALPL gene, including 7 missense variation, 1 insertion variation, 1 frameshift variation, 1 deletion variation.Of which 3 were novel (p.Y28C, p.268, F>L, p.A176V).One of the infantile patients lost follow-up and the other three deceased. The clinical conditions were much improved with medical intervention for patients with childhood, orodonto HPP. Conclusions: While HPP patients with different ages of onset present with common features, the prognosis differ significantly. The prognosis is good for patients with childhood, orodonto HPP and poor for patients with infantile HPP. Genetic testing is the main method for definitive diagnosis.

In vivo monitoring of quantum dots in the extracellular space using push-pull perfusion sampling, online in-tube solid phase extraction, and inductively coupled plasma mass spectrometry.

To monitor the dynamic changes of extracellular quantum dots (QDs) in vivo in the livers of anesthetized rats, we developed an automatic online analytical system comprising push-pull perfusion (PPP) sampling, the established in-tube solid phase extraction (SPE) procedure, and inductively coupled plasma mass spectrometry (ICPMS). The method takes advantage of the retention of QDs onto the interior surface of a polytetrafluoroethylene (PTFE) tube as a means of extracting the QDs from complicated push-pull perfusates. For the injected QDs present in the liver extracellular fluid (ECF) at low picomolar levels, a temporal resolution of 10 min was required to collect sufficient amounts of QDs to meet the sensitivity requirements of the ICPMS system. To the best of our knowledge, this study is the first to exploit the PPP technique for the collection of QDs from living animals and PTFE tubing as a SPE adsorbent for the online extraction of QDs and the removal of biological matrix prior to ICPMS analysis of cadmium-containing inorganic nanocrystal. We confirmed the analytical reliability of this method from measurements of the spike recoveries of saline samples; in addition, we demonstrated the systems' applicability through in vivo monitoring of the time-dependent concentration profile of liver extracellular QDs in living rats after intravenous administration.

Online in-tube solid-phase extraction using a nonfunctionalized PVC tube coupled with ICPMS for in vivo monitoring of trace metals in rat brain microdialysates.

We have developed a simple, automatic, online in-tube solid-phase extraction (SPE) method for the preconcentration of trace elements from saline samples. The method takes advantage of the adsorption of trace metal ions onto the interior of a nonfunctionalized PVC tube as a means of separation from the matrix salt. The adsorption of transition metal ions is presumably dominated by Lewis acid/base interactions, which facilitate the formation of metal-PVC complexes. For simultaneous determination of multiple trace metals in the extracellular fluid from the brains of anesthetized rats, we developed an online analytical system comprising microdialysis sampling, the established in-tube extraction procedure, and ICPMS. In the extraction step, the efficiency was optimal when the pH of the sample was adjusted to 8.0 using phosphate buffer. After extraction onto the interior of PVC tube, the adsorbed analytes were eluted with 0.5% HNO 3 prior to online ICPMS measurement. For those elements present in the extracellular fluid at less than nanogram-per-milliliter concentrations (i.e., Cu, Zn, and Mn), a temporal resolution of 12 min was required to collect enough microdialysate to meet the sensitivity requirements of the ICPMS instrument. Noteworthily, because washing and postconditioning the interior of PVC tube are not necessary, a relatively unsophisticated and clean procedure was attained and extremely low detection limits in the range of 5.0 to 510 ng L (-1) were thus obtained for the analysis of Mn, Cu, Zn, Pb, Cd, Ni, and Co in microdialysate samples of 8 microL by ICPMS. To the best of our knowledge, this study is the first to exploit PVC peristaltic tubing as an SPE adsorbent in the laboratory-on-valve mode for online sample treatment and trace metal preconcentration prior to ICPMS measurement. We confirmed the analytical reliability of this method through the analysis of the certified reference material SLEW-3 (estuarine water) and 2670a (human urine) and demonstrated its applicability through simultaneous in vivo monitoring of the basal concentrations and concentration profiles of multiple metal ions in the brain extracellular fluid of a living rat.

Ablation of advanced tongue or base of tongue cancer and reconstruction with free flap: functional outcomes.

AIM: To evaluate the functional outcomes of patients who underwent total or nearly total glossectomy for advanced tongue or base of tongue cancer. MATERIAL AND METHODS: We used the radial forearm free flap (RFFF), anterior lateral thigh flap (ALTF) or fibular osteocutaneous flap (FOCF) to reconstruct the oral defect after radical resection in 39 patients undergoing total or nearly total glossectomy with laryngeal preservation. RESULTS: Good functional outcomes, measured by independent feeding, speech and swallowing were achieved in 35, 36 and 35 patients, respectively. The cumulative 4-year survival rates were 63.8% for tongue cancer and 42.9% for base of tongue cancer. CONCLUSION: Reconstruction with free flaps is a feasible method to restore the functional outcomes in speech and deglutition among patients who undergo total or nearly total glossectomy with laryngeal preservation.

Fungal mycelia as the source of chitin and polysaccharides and their applications as skin substitutes.

A wovenable skin substitute (Sacchachitin) made from the residue of the fruiting body of Ganoderma tsugae was developed in this study. Chemical analysis revealed that the treated residue was a copolymer of beta-1,3-glucan (ca 60%) and N-acetylglucosamine (ca 40%) with a filamental structure of mycelia form, as demonstrated by both optical and scanning electron microscopy. The pulp-like white residue was then woven into thin, porous sheets 7.0 cm in diameter and 0.1-0.2 mm in thickness by filtration and lyophilized for use as a skin substitute. The wound area produced by dissecting rat skin of full thickness was found to almost completely heal on the side covered with Sacchachitin, whereas the control side covered with cotton gauge was around 6.0 cm2 on the 28th day. Furthermore, the wound healing effects of the chitin sheet from crab shell (Beschitin) and Sacchachitin were not found to be significantly different.

Development of fungal mycelia as skin substitutes: effects on wound healing and fibroblast.

In this study, Sacchachitin membrane, prepared from the residue of the fruiting body of Ganoderma tsugae, was estimated for its effects on wound healing and the proliferation and migration of fibroblast cells. Two mirror-image wounds were made on the back of female guinea pigs by dissecting a 1.5 x 1.5 cm2 skin surface of full thickness. Sacchachitin membrane was placed randomly on one of the wounds and gauze or Beschitin on the other. Changes in the wound area were measured and photographed after a predetermined amount of time postoperatively. Histological examination of the wound and surrounding tissue was also performed to reveal any interaction of tissue with the dressing. The results showed that the wound area covered with Sacchachitin membrane was statistically smaller than that covering with gauze on day 10, whereas there was no significant difference in the wound size compared to that with Beschitin. Fibroblast cells from the dermis layer of guinea pigs were used. The number of fibroblast cells were counted on the predetermined days in the culture suspended with or without 0.01% w/v dressing materials. By layering on DMEM plates, the number of fibroblast cells migrating across the center line or outside of the central hole were counted after five days. All the results indicated that both 0.01% w/v of Sacchachitin and chitin significantly enhanced the proliferation and migration of fibroblast cells.

A new transnasal approach to endoscopic marsupialization of the nasolabial cyst.

OBJECTIVE: Nasolabial cyst is a mucus-secreting, nonodontogenic cyst in the nasofacial area. It is usually situated behind the ala nasi, extending backward beneath the nasal floor into the inferior meatus and forward into the labio-gingival sulcus behind the upper lip. Patients with nasolabial cysts generally undergo surgical removal of the cyst via a transoral sublabial approach. This article reports a simple, less invasive surgical procedure for the treatment of nasolabial cysts. STUDY DESIGN: A transnasal endoscopic marsupialization method was designed to treat patients with nasolabial cysts. From 1996 through 1998, 16 consecutive patients underwent this new surgical procedure. METHODS: With patients under local anesthesia, the roof of the cyst, which was firmly attached to the mucous membrane of the anterior nasal floor, was removed transnasally with a sickle knife and scissors. Under the guidance of a nasoendoscope, the opening of the cyst was widened with bite forceps. Meanwhile, the cut edges of the nasal mucosa and the epithelium lining of the cyst were adequately matched. The nose was then loosely packed. RESULTS: All but 1 of the 15 patients were successfully treated with this technique, and the whole surgical procedure was usually completed within 15 to 20 minutes. Postoperative endoscopic and radiological findings revealed that the cyst was replaced by an air-containing sinus with a persistent opening at the anterior or anterolateral nasal floor. There has been no evidence of mucus accumulation in the newly created sinus or recurrence of the cyst during a mean follow-up of 16 months. CONCLUSIONS: Transnasal endoscopic marsupialization is a simple and effective surgical procedure for treatment of nasolabial cysts.

Histopathological studies of a new liquid embolization method using estrogen-alcohol and polyvinyl acetate. Experimental evaluations with a model of cortical arterial cannulation in the canine brain.

This experimental report evaluates the histopathological effects of a new embolization method using estrogen-alcohol (E-A) and polyvinyl acetate solution (PVac) as tested on 21 mongrel dogs. Three other animals treated with normal saline served as controls. All agents were introduced through an isolated cortical artery. Estrogen-alcohol induced immediate occlusion of small vessels (less than 20 microns), and then progressive obstruction of larger ones (200-300 microns) within several days. Animals treated with PVac showed vascular obliteration (greater than 100 microns) and moderate chronic fibrosis. The effects of embolization using E-A followed by PVac were found to have the combined advantages of both materials, showing diffuse occlusion of the vascular network with less tissue reaction. Hyalinization of embolized vessels with extensive fibrosis occurred afterward. For 6 weeks there was no evidence of recanalization or foreign body giant cell reaction. This study shows that E-A and PVac are capable of producing vascular occlusions with only mild tissue reaction. Because they are easily controllable and have no adverse effects, they may be suitable for intravascular application in the central nervous system.

Silicone implants and the inhibition of cancer.

The safety of augmentation mammaplasty and its relationship to breast cancer has been a much debated topic. The authors previously showed a decreased incidence of breast cancer in rats who had received silicone implants 2 weeks before carcinogen stimulation. The present study was designed to determine (1) whether this protective effect is influenced by the location of the implant, and (2) whether tumor incidence could also be altered in spontaneous mammary tumor-forming animals, the C3H/OuJ mice. (1) A total of 110 rats received either a silicone implant or a sham operation in one of three locations: inframammary region, dorsum, or intraperitoneal cavity. Methylnitrosoured (MNU) injections occurred 14 days after implantation. Animals were examined weekly for tumor growth and were killed 250 days after MNU injection. Animals with silicone implants beneath the mammary gland had a statistically significant lower incidence of breast cancer formation (11.5 percent) compared with both dorsally implanted animals (45.8 percent) and sham controls (64 percent). (2) Sixty C3H/OuJ mice underwent implantation of either a silicone implant, free silicone gel, silicone sheet, or a sham operation. At 50 weeks of age, after weekly examinations, the animals were killed. The cancer incidence in mice with silicone implants was 17 percent compared with 50 percent found in sham controls. Exposure to a silicone prosthesis at an early age does not seem to increase tumor incidence and may even have a locally protective effect against breast cancer formation.

Sagittal fractures of the maxilla and palate.

Sagittal fractures of the maxilla and palate are infrequent and can demonstrate significant instability with conventional methods of treatment. They require that rigid, horizontal stability of the dentition be obtained, as well as restoration of midface projection and height. The most effective and precise management has utilized a combination of open reduction and internal fixation at the piriform aperture and zygomatic buttress and posterior palate, use of a maxillary arch bar as a tension band, and utilization of a palatal splint.

[Computed tomography of gastric carcinoma using water as a contrast agent].

To overcome the problem of poor mixing of gastrointestinal tract contents with a diluted iodinated contrast agent in abdominal computed tomography, pure water was adopted as an oral contrast agent. In 25 cases of clinically suspected gastric carcinoma, a subsequent pathological examination revealed six cases of early gastric cancer and 19 cases of advanced gastric cancer. We performed CT of the stomach using the following revised procedure: patients were given 600-1000 mL of water by mouth after an intramuscular dose of Buscopan to distend and immobilize the stomach. Gastric mucosal enhancement and the poorer enhanced submucosal layer were demonstrated by a bolus intravenous injection of iodine-containing contrast medium using an automatic injector synchronized with the CT machine. Based on abnormal gastric wall thickening and the abnormal mural enhancement patterns, an accuracy of 96% was attained in differentiating early gastric cancer from advanced gastric cancer, but the detection rates for extragastric invasion, gastric ulcers and lymphadenopathy were 67%, 43% and 63%, respectively. CT staging of gastric cancer was 72%, and was especially accurate for stages I and IV. Water as oral contrast agent for CT of the GI tract was readily accepted by patients and caused no side effects. Using water as an oral contrast for gastric CT is of great help in staging gastric cancer.

Experimental investigations concerning a new liquid embolization method: combined administration of ethanol-estrogen and polyvinyl acetate.

A new embolization agent combining ethanol-estrogen and polyvinyl acetate was evaluated angiographically and histologically in 18 canine renal arterial systems. Peripheral vessels of less than 100 microns diameter were obliterated by thrombus induced by ethanol-estrogen, and larger vessels were obliterated by polyvinyl acetate casts and/or thrombus. This embolization method is easily controlled and has fewer adverse effects, so is suitable for intravascular applications, especially in the head and neck regions.

The role of multiple segment osteotomies in orthognathic surgery.

Multiple segment orthognathic (MSO) surgery is an effective approach to deal with a wide range of dento-facial deformities that have occlusal problems. The indications for MSO surgery were patients with dentofacial deformities and malocclusion requiring stable correction within a short overall treatment period. From 1991 to 1998, 107 patients had MSO orthognathic procedures done at Chang Gung Memorial Hospital for maxillary protrusion/deformity (34 cases), maxillary protrusion and mandibular prognathism (69 cases), and non-cleft maxillary retrusion (4 cases). Follow up period ranged from 6 months to 7 years and results showed stability in movements with only 3 complications. The average overall treatment time was approximately 15 months. Our experience with 107 consecutive patients have shown the results of MSO surgery to be good and the procedure safe with no tooth or segment loss.

Combined use of an amniotic membrane and tissue adhesive in treating corneal perforation: a case report.

We report a new method combining the use of an amniotic membrane and cyanocrylate tissue adhesive to seal a corneal perforation. A 47-year-old male suffered from an alkali injury complicated with corneal melting and perforation in the left eye. We placed an amniotic membrane of optimal size in the anterior chamber directly under the corneal perforation lesion. The cyanocrylate tissue adhesive was then applied over the perforation site and sealed successfully. Three weeks later, the tissue adhesive had dislodged. The amniotic membrane had sealed the perforated lesion and was well adhered to the surrounding corneal tissue with complete epithelial covering. Vision was 20/25 six months after the operation. The combined use of an amniotic membrane and tissue adhesive is a promising method in the treatment of corneal perforation.

Remodeling of rabbit abdominal aorta and Cx43 gap junctions after stent placement: effect of balloon injury plus cholesterol-enriched diet.

AIM: To examine the effect of stenting and cholesterol-enriched diet (CED) on vascular remodeling, including the expression of connexin43 (Cx43) gap junctions in smooth muscle cells (SMC). METHODS: Rabbits abdominal aortae were either implanted stent made of 316 stainless steel (group 1) or denuded followed by stent placement 28 days later (groups 2 and 3). Animals were given normal chow except those of group 3, which were fed CED after the denudation. Eight weeks later, the development of neointima and the expression of connexin43 (Cx43) were examined. In parallel, human aortic SMC were grown on 316 stainless steel or treated with C-reactive protein (CRP) followed by analysis of Cx43. RESULTS: The results showed that, serum CRP levels became transiently elevated after denudation and stent implantation. For the stented aortic segments, the dimensions of neointima were group 3 > group 2 > group 1 (P<0.05). In groups 1 and 2, Cx43 gap junctions are less in amount in neointima of the stented segment, compared to the unstented upstream neointima or medial layer (all P<0.01). In culture experiments, Cx43 in SMC grown on stent material was up-regulated in growth medium but down-regulated in differentiation medium, and CRP did not affect Cx43 expression. CONCLUSION: Vascular remodeling post stent implantation varied according to the presence of balloon injury, CED, or both. Cx43 expression in SMC is altered after exposure to stent and the regulation depended on the milieu.