Infrequent Presentation of Pilonidal Sinus over the Nasal Bridge.

We report a patient with recurrent discharging sinus over the nasal bridge which was finally diagnosed as pilonidal sinus over the nasal bridge. Nasal pilonidal sinus is a rare condition that presents as a chronic and recurrent inflammation of the hair follicles and surrounding tissues of the nose, leading to the formation of abscesses and sinus tracts. The following report deals the dilemma of diagnosing and management of the patient. Though rare, nasal pilonidal sinus should be included as a differential diagnosis to aid in management as well as to improve awareness and inclusion of this condition. This report provides an overview of the clinical presentation, diagnosis and management of nasal pilonidal sinus.

Regularized cost function in wavefront shaping for advancing the contrast of structured light.

The cost function in the iterative optimization algorithms is one of the sensitive optimization controllers that plays a crucial role in feedback based wavefront shaping for constructing well-resolved complex structured light through scattering media. There has been a trade-off between resolution and the contrast enhancement of the structured light in wavefront shaping. We have developed an ℓ 2-norm based quadratic cost function (L2QN) and proposed a regularized cost function (RCF) for advancing the contrast and maintaining the high resolution of structured light. Both the simulations and experiments have been performed, and it has been found that the proposed RCF significantly advances the contrast and structural uniformity for focusing light through scattering media as well as for diffused reflection mode. The potential applications of the method demonstrated in this study can be extended into holographic displays, structured light illumination microscopy, photo-lithography, photothermal treatments, dosimetry, laser materials processing, and energy control inside and outside an incubation system.

Effects of Titanium Implant Surface Topology on Bone Cell Attachment and Proliferation in vitro.

Purpose: Titanium is commonly used for implants because of its corrosion resistance and osseointegration capability. It is well known that surface topology affects the response of bone tissue towards implants. In vivo studies have shown that in weeks or months, bone tissue bonds more efficiently to titanium implants with rough surfaces compared to smooth surfaces. In addition, stimulating early endosseous integration increases the long-term stability of bone-implants and hence their clinical outcome. Here, we evaluated the response of human MG-63 osteoblast-like cells to flat and solid, compared to rough and porous surface topologies in vitro 1-6 days post seeding. We compared the morphology, proliferation, and attachment of cells onto three smooth surfaces: tissue culture (TC) plastic or microscope cover glasses, machined polyether-ether-ketone (PEEK), and machined solid titanium, to cells on a highly porous (average Ra 22.94 µm) plasma-sprayed titanium surface (composite Ti-PEEK spine implants). Methods: We used immuno-fluorescence (IF) and scanning electron microscopy (SEM), as well as Live/Dead and WST-1 cell proliferation assays. Results: SEM analyses confirmed the rough topology of the titanium implant surface, compared to the smooth surface of PEEK, solid titanium, TC plastic and cover glasses. In addition, SEM analyses revealed that MG-63 cells seeded onto smooth surfaces (solid titanium, PEEK) adopted a flat, planar morphology, while cells on the rough titanium surface adopted an elongated morphology with numerous filopodial and lamellipodial extensions interacting with the substrate. Finally, IF analyses of focal adhesions (vinculin, focal adhesion kinase), as well as proliferation assays indicate that MG-63 cells adhere less and proliferate at a slower rate on the rough than on a smooth titanium surface. Conclusion: These observations suggest that bone-forming osteoblasts adhere less strongly and proliferate slower on rough compared to smooth titanium surfaces, likely promoting cell differentiation, which is in agreement with other porous implant materials.

Impact of National Economy and Policies on End-Stage Kidney Care in South Asia and Southeast Asia.

BACKGROUND: The association between economic status and kidney disease is incompletely explored even in countries with higher economy (HE); the situation is complex in lower economies (LE) of South Asia and Southeast Asia (SA and SEA). METHODS: Fifteen countries of SA and SEA categorized as HE and LE, represented by the representatives of the national nephrology societies, participated in this questionnaire and interview-based assessment of the impact of economic status on renal care. RESULTS: Average incidence and prevalence of end-stage kidney disease (ESKD) per million population (pmp) are 1.8 times and 3.3 times higher in HE. Hemodialysis is the main renal replacement therapy (RRT) (HE-68%, LE-63%). Funding of dialysis in HE is mainly by state (65%) or insurance bodies (30%); out of pocket expenses (OOPE) are high in LE (41%). Highest cost for hemodialysis is in Brunei and Singapore, and lowest in Myanmar and Nepal. Median number of dialysis machines/1000 ESKD population is 110 in HE and 53 in LE. Average number of machines/dialysis units in HE is 2.7 times higher than LE. The HE countries have 9 times more dialysis centers pmp (median HE-17, LE-02) and 16 times more nephrologist density (median HE-14.8 ppm, LE-0.94 ppm). Dialysis sessions >2/week is frequently followed in HE (84%) and <2/week in LE (64%). "On-demand" hemodialysis (<2 sessions/week) is prevalent in LE. Hemodialysis dropout rates at one year are lower in HE (12.3%; LE 53.4%), death being the major cause (HE-93.6%; LE-43.8%); renal transplants constitute 4% (Brunei) to 39% (Hong Kong) of the RRT in HE. ESKD burden is expected to increase >10% in all the HE countries except Taiwan, 10%-20% in the majority of LE countries. CONCLUSION: Economic disparity in SA and SEA is reflected by poor dialysis infrastructure and penetration, inadequate manpower, higher OOPE, higher dialysis dropout rates, and lesser renal transplantations in LE countries. Utility of RRT can be improved by state funding and better insurance coverage.

Potential of tailored amorphous multiporous calcium silicate glass for pulp capping regenerative endodontics-A preliminary assessment.

INTRODUCTION/OBJECTIVE: The tailored amorphous multi-porous (TAMP) material fabrication technology has led to a new class of bioactive materials possessing versatile characteristics. It has not been tested for dental applications. Thus, we aimed to assess its biocompatibility and ability to regenerate dental mineral tissue. METHODS: 30CaO-70SiO2 model TAMP discs were fabricated by a sol-gel method followed by in vitro biocompatibility testing with isolated human or mini-swine dental pulp stem cells (DPSCs). TAMP scaffolds were tested in vivo as a pulp exposure (pin-point, 1 mm, 2 mm, and entire pulp chamber roof) capping material in the molar teeth of mini-swine. RESULTS: The in vitro assays showed that DPSCs attached well onto the TAMP discs with comparable viability to those attached to culture plates. Pulp capping tests on mini-swine showed that after 4.5 months TAMP material was still present at the capping site, and mineral tissue (dentin bridge) had formed in all sizes of pulp exposure underneath the TAMP material. CONCLUSIONS: TAMP calcium silicate is biocompatible with both human and swine DPSCs in vitro and with pulp in vivo, it may help regenerate the dentin bridge after pulp exposure.

Nanostructure of bioactive glass affects bone cell attachment via protein restructuring upon adsorption.

The nanostructure of engineered bioscaffolds has a profound impact on cell response, yet its understanding remains incomplete as cells interact with a highly complex interfacial layer rather than the material itself. For bioactive glass scaffolds, this layer comprises of silica gel, hydroxyapatite (HA)/carbonated hydroxyapatite (CHA), and absorbed proteins-all in varying micro/nano structure, composition, and concentration. Here, we examined the response of MC3T3-E1 pre-osteoblast cells to 30 mol% CaO-70 mol% SiO2 porous bioactive glass monoliths that differed only in nanopore size (6-44 nm) yet resulted in the formation of HA/CHA layers with significantly different microstructures. We report that cell response, as quantified by cell attachment and morphology, does not correlate with nanopore size, nor HA/CHO layer micro/nano morphology, or absorbed protein amount (bovine serum albumin, BSA), but with BSA's secondary conformation as indicated by its ß-sheet/α-helix ratio. Our results suggest that the ß-sheet structure in BSA interacts electrostatically with the HA/CHA interfacial layer and activates the RGD sequence of absorbed adhesion proteins, such as fibronectin and vitronectin, thus significantly enhancing the attachment of cells. These findings provide new insight into the interaction of cells with the scaffolds' interfacial layer, which is vital for the continued development of engineered tissue scaffolds.

Development of highly inhomogeneous temperature profile within electrically heated alkali silicate glasses.

According to Joule's well-known first law, application of electric field across a homogeneous solid should produce heat uniformly in proportion to the square of electrical current. Here we report strong departure from this expectation for common, homogeneous ionic solids such as alkali silicate glasses when subjected even to moderate fields (~100 V/cm). Unlike electronically conducting metals and semiconductors, with time the heating of ionically conducting glass becomes extremely inhomogeneous with the formation of a nanoscale alkali-depletion region, such that the glass melts near the anode, even evaporates, while remaining solid elsewhere. In situ infrared imaging shows and finite element analysis confirms localized temperatures more than thousand degrees above the remaining sample depending on whether the field is DC or AC. These observations unravel the origin of recently discovered electric field induced softening of glass. The observed highly inhomogeneous temperature profile point to the challenges for the application of Joule's law to the electrical performance of glassy thin films, nanoscale devices, and similarly-scaled phenomena.

Evaluation of SmearOFF, maleic acid and two EDTA preparations in smear layer removal from root canal dentin.

Objectives: To evaluate SmearOFF, 7% maleic acid (MA) and two different preparations of ethylenediaminetetraacetic acid (EDTA) in smear layer removal.Materials and methods: Fifty single-rooted teeth were separated into five groups, instrumented and irrigated as follows: (1) SmearOFF, (2) 7% MA, (3) 18% EDTA (pH 11.4), (4) 17% EDTA (pH 8.5) and (5) 0.9% saline. Teeth samples were blinded and examined by scanning electron microscopy with Image J software.Results: Eighteen percent EDTA was less efficient when compared to SmearOFF and MA at all thirds of the root canal system. There was no difference between SmearOFF and MA in the coronal and middle thirds. In the apical third, MA removed more smear layer. Seventeen percent EDTA was as efficient as SmearOFF and MA in coronal and middle third but not in the apical third. Eighteen percent EDTA removed smear layer less efficiently in the coronal and middle thirds than 17% EDTA; in the apical third, there was no difference observed. In the saline group, all specimens were heavily smeared. There was no significant difference between 18% EDTA and saline at all canal thirds.Conclusions: SmearOFF and 17% EDTA (pH 8.5) had better smear layer removal capability in the coronal and middle thirds of the root canal system. In the apical third, 7% MA was superior. 18% EDTA (pH 11.4) and saline had poor smear layer removal ability.

Influence of nanoporosity on the nature of hydroxyapatite formed on bioactive calcium silicate model glass.

For hard tissue regeneration, the bioactivity of a material is measured by its ability to induce the formation of hydroxyapatite (HA) under physiological conditions. It depends on the dissolution behavior of the glass, which itself is determined by the composition and structure of glass. The enhanced HA growth on nanoporous than on nonporous glass has been attributed by some to greater specific surface area (SSA), but to nanopore size distribution by others. To decouple the influence of nanopore size and SSA on HA formation, we have successfully fabricated homogeneous 30CaO-70SiO2 (30C70S) model bioactive glass monoliths with different nanopore sizes, yet similar SSA via a combination of sol-gel, solvent exchange, and sintering processes. After incubation in PBS, HA, and Type-B carbonated HA (HA/B-CHA) form on nanoporous monoliths. The XPS, FTIR, and SEM analyses provide the first unambiguous demonstration of the influence of nanopore size alone on the formation pathway, growth rate, and microstructure of HA/CHA. Due to pore-size limited diffusion of PO43- , two HA/CHA formation pathways are observed: HA/CHA surface deposition and/or HA/CHA incorporation into nanopores. HA/CHA growth rate on the surface of a nanoporous glass monolith is dominated by the pore-size limited transport of Ca2+ ions dissolved from nanoporous glass substrates. Furthermore, with increasing nanopore size, HA/CHA microstructures evolve from needle-like, plate-like, to flower-like appearance. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 886-899, 2019.

Comparison between the use of thermoplasticized gutta-percha and a polydimethyl siloxane-based material in filling internal resorptive cavities using spiral computed tomography.

To evaluate the fill of internal resorption cavities obturated with thermoplasticized gutta-percha and GuttaFlow2 using CT scan. Twenty human maxillary anterior teeth were selected and root canals were prepared using ProTaper system to size F3. Irrigation was performed with 5 ml of 2.5% sodium hypochlorite (NaOCl) and 5 ml of 17% ethylenediaminetetraacetic acid (EDTA). Each root was then sectioned horizontally into two halves and semicircular cavities were prepared around the periphery of the root canal opening of each root half, using a round bur. Both the root halves were then fixed using cyanoacrylate glue. All the specimens were subjected to preoperative CT scan analysis to determine the volume of internal cavities. The samples were then randomly divided into two groups. In Group 1, the specimens were obturated with thermoplasticized gutta-percha (E&Q system) and specimens in Group 2 were obturated using GuttaFlow2. All specimens were then subjected to postoperative CT scan analysis. The volume of voids in internal resorptive cavities were calculated, which was then used to estimate the amount of gutta-percha filled. There was no significant difference in volume of internal resorptive cavities between thermoplasticized gutta-percha and GuttaFlow2 groups before obturation (p = 0.466). However, after obturation there was a significant difference between both the groups, in which GuttaFlow2 demonstrated better fill (p = .014). Thermoplasticized gutta-percha filled 81% of internal resorptive cavity while GuttaFlow2 filled 91%, respectively. GuttaFlow2 showed better fill than thermoplasticized gutta-percha in the filling of internal resorptive cavities.

New bioactive glass scaffolds with exceptional qualities for bone tissue regeneration: response of osteoblasts and osteoclasts.

Tissue regeneration is a significantly improved alternative to tissue replacement by implants. It requires porous bioscaffolds for the restoration of natural tissue rather than relying on bio-inactive, often metallic implants. Recently, we developed technology for fabricating novel, nano-macroporous bioactive 'tailored amorphous multi-porous (TAMP)' hard tissue scaffolds using a 70 mol% SiO2-30 mol% CaO model composition. The TAMP silicate scaffolds, fabricated by a modified sol-gel process, have shown excellent biocompatibility via the rapid formation of hydroxyapatite in biological fluids as well as in early tests with bone forming cells. Here we report an in depth investigation of the response of MC3T3-E1 pre-osteoblast cells and bone marrow derived (BMD) osteoclasts to these TAMP scaffolds. Light and electron microscopic imaging, gene and protein expression, and enzyme activity analyses demonstrate that MC3T3-E1 pre-osteoblasts adhere, proliferate, colonize, and differentiate on and inside the bioactive TAMP scaffolds. Additionally, BMD precursor cells mature into active osteoclasts and remodel the scaffold, highlighting the exceptional qualities of this novel scaffold material for bone tissue regeneration.

Role of phase separation on the biological performance of 45S5 Bioglass®.

We analyzed the biological performance of spinodally and droplet-type phase-separated 45S5 Bioglass® generated by quenching the melt from different equilibrium temperatures. MC3T3-E1 pre-osteoblast cells attached more efficiently to 45S5 Bioglass® with spinodal than to the one with droplet morphology, providing the first demonstration of the role of micro-/nano-scale on the bioactivity of Bioglass®. Upon exposure to biological solutions, phosphate buffered saline (PBS) and cell culture medium (α-MEM), a layer of hydroxyapatite (HA) formed on both glass morphologies. Although both Bioglass® varieties were incubated under identical conditions, and physico-chemical characteristics of the HA layers were similar, the adsorption magnitude of a model protein, bovine serum albumin (BSA, an abundant blood serum component) and its ß-sheet/ß-turn ratio and α-helix content were significantly higher on spinodal than droplet type Bioglass®. These results indicate that: (i) a protein layer quickly adsorbs on the surface of 45S5 Bioglass® varieties (with or without HA layer), (ii) the amount and the conformation of adsorbed proteins are guided by the glass micro-/nano-structure, and (iii) cell attachment and proliferation are influenced by the concentration and the conformation of attached proteins with a significantly better cell adhesion to spinodal type 45S5 Bioglass® substrate. Taken together, our results indicate that the biological performance of 45S5 Bioglass® can be improved further with a relatively simple, inexpensive fabrication procedure that provides a superior glass micro-/nano-structure. A simple modification to the fabrication procedure of classic 45S5 Bioglass® generates spinodal (A(a)) and droplet (A(b)) varieties and has a significant impact on protein adsorption (B) and cell adhesion (C).

Fabrication of graded index single crystal in glass.

Lithium niobate crystals were grown in 3D through localized heating by femtosecond laser irradiation deep inside 35Li2O-35Nb2O5-30SiO2 glass. Laser scanning speed and power density were systematically varied to control the crystal growth process and determine the optimal conditions for the formation of single crystal lines. EBSD measurements showed that, in principle, single crystals can be grown to unlimited lengths using optimal parameters. We successfully tuned the parameters to a growth mode where nucleation and growth occur upon heating and ahead of the scanning laser focus. This growth mode eliminates the problem reported in previous works of non-uniform polycrystallinity because of a separate growth mode where crystallization occurs during cooling behind the scanning laser focus. To our knowledge, this is the first report of such a growth mode using a fs laser. The crystal cross-sections possessed a symmetric, smooth lattice misorientation with respect to the c-axis orientation in the center of the crystal. Calculations indicate the observed misorientation leads to a decrease in the refractive index of the crystal line from the center moving outwards, opening the possibility to produce within glass a graded refractive index single crystal (GRISC) optically active waveguide.

Demonstration of single crystal growth via solid-solid transformation of a glass.

Many advanced technologies have relied on the availability of single crystals of appropriate material such as silicon for microelectronics or superalloys for turbine blades. Similarly, many promising materials could unleash their full potential if they were available in a single crystal form. However, the current methods are unsuitable for growing single crystals of these oftentimes incongruently melting, unstable or metastable materials. Here we demonstrate a strategy to overcome this hurdle by avoiding the gaseous or liquid phase, and directly converting glass into a single crystal. Specifically, Sb2S3 single crystals are grown in Sb-S-I glasses as an example of this approach. In this first unambiguous demonstration of an all-solid-state glass → crystal transformation, extraneous nucleation is avoided relative to crystal growth via spatially localized laser heating and inclusion of a suitable glass former in the composition. The ability to fabricate patterned single-crystal architecture on a glass surface is demonstrated, providing a new class of micro-structured substrate for low cost epitaxial growth, active planar devices, etc.

Direct laser-writing of ferroelectric single-crystal waveguide architectures in glass for 3D integrated optics.

Direct three-dimensional laser writing of amorphous waveguides inside glass has been studied intensely as an attractive route for fabricating photonic integrated circuits. However, achieving essential nonlinear-optic functionality in such devices will also require the ability to create high-quality single-crystal waveguides. Femtosecond laser irradiation is capable of crystallizing glass in 3D, but producing optical-quality single-crystal structures suitable for waveguiding poses unique challenges that are unprecedented in the field of crystal growth. In this work, we use a high angular-resolution electron diffraction method to obtain the first conclusive confirmation that uniform single crystals can be grown inside glass by femtosecond laser writing under optimized conditions. We confirm waveguiding capability and present the first quantitative measurement of power transmission through a laser-written crystal-in-glass waveguide, yielding loss of 2.64 dB/cm at 1530 nm. We demonstrate uniformity of the crystal cross-section down the length of the waveguide and quantify its birefringence. Finally, as a proof-of-concept for patterning more complex device geometries, we demonstrate the use of dynamic phase modulation to grow symmetric crystal junctions with single-pass writing.

Failure of siblings to thrive beyond 5 years of age.

We describe a family in which parents had consanguinity, being children of real sisters. They had given birth to five children. In their family, children remained healthy from birth to pre-school age and then started having symptoms around the age of 5 years and two of them succumbed to this illness. Polyglandular autoimmune syndrome Type-1 is a rare sporadic autosomal recessive disease. It is characterized by the existence of two or more endocrinal disorders. Patients may require lifelong hormone replacement therapy for survival.

Direct investigation of silver photodissolution dynamics and reversibility in arsenic trisulphide thin films by atomic force microscopy.

The dynamics and reversibility of Ag nanoparticle photodissolution into As2S3 chalcogenide thin films have uniquely been directly measured by continuous AFM imaging during patterned optical illumination. The surface morphology, roughness and particle size distribution have thus been spatially and statistically monitored as a function of time, both during and following optical exposure. Photodissolution was observed to proceed via two mechanisms. In one case, nanoparticles abruptly and nearly completely disappeared along a sharp dissolution front traveling laterally at ∼0.19 µm s(-1). Following illumination, similarly sized nanoparticles uniformly reformed on the surface. A more inhomogeneous photodissolution process was separately recorded, clearing irregular ∼1-2 µm patches that grew with time until most of the surface was free of nanoparticles. Post-illumination, surface nanoparticle development and coverage were similarly inhomogeneous, with larger but 50% fewer particles in the final distribution. In every experiment, an initial roughening was detected before the nanoparticle surface coverage visually diminished, indicating the onset of photodissolution at widely distributed energetically and kinetically favored sites which temporarily enhances nanoscale roughness. Such direct studies of surface dynamics are crucial to understanding and ultimately optimizing chalcogenide film applications such as photomasks, optoelectronics media and bio-chemical sensors.

Thermostable luciferase from Luciola cruciate for imaging of carbon nanotubes and carbon nanotubes carrying doxorubicin using in vivo imaging system.

In the present study, we introduce a novel method for in vivo imaging of the biodistribution of single wall carbon nanotubes (SWNTs) labeled with recombinant thermo-stable Luciola cruciata luciferase (LcL). In addition, we highlight a new application for green fluorescent proteins in which they are utilized as imaging moieties for SWNTs. Carbon nanotubes show great positive potential compared to other drug nanocarriers with respect to loading capacity, cell internalization, and biodegradability. We have also studied the effect of binding mode (chemical conjugation and physical adsorption) on the chemiluminescence activity, decay rate, and half-life. We have shown that through proper chemical conjugation of LcL to CNTs, LcL remained biologically active for the catalysis of d-luciferin in the presence of ATP to release detectable amounts of photons for in vivo imaging. Chemiluminescence of LcL allows imaging of CNTs and their cargo in nonsuperficial locations at an organ resolution with no need of an excitation source. Loading LcL-CNTs with the antitumor antibiotic doxorubicin did not alter their biological activity for imaging. In vivo imaging of LcL-CNTs has been carried out using "IVIS spectrum" showing the uptake of LcL-CNTs by different organs in mice. We believe that the LcL-CNT system is an advanced powerful tool for in vivo imaging and therefore a step toward the advancement of the nanomedicine field.

Nanoporosity significantly enhances the biological performance of engineered glass tissue scaffolds.

Nanoporosity is known to impact the performance of implants and scaffolds such as bioactive glass (BG) scaffolds, either by providing a higher concentration of bioactive chemical species from enhanced surface area, or due to inherent nanoscale topology, or both. To delineate the role of these two characteristics, BG scaffolds have been fabricated with nearly identical surface area (81 and 83±2 m(2)/g) but significantly different pore size (av. 3.7 and 17.7 nm) by varying both the sintering temperature and the ammonia concentration during the solvent exchange phase of the sol-gel fabrication process. In vitro tests performed with MC3T3-E1 preosteoblast cells on such scaffolds show that initial cell attachment is increased on samples with the smaller nanopore size, providing the first direct evidence of the influence of nanopore topography on cell response to a bioactive structure. Furthermore, in vivo animal tests in New Zealand rabbits (subcutaneous implantation) indicate that nanopores promote colonization and cell penetration into these scaffolds, further demonstrating the favorable effects of nanopores in tissue-engineering-relevant BG scaffolds.