Autogenous Bone Marrow Aspirate Coated Synthetic Hydroxyapatite for Reconstruction of Maxillo-Mandibular Osseous Defects: A Prospective Study.

PURPOSE: This prospective study was conducted to evaluate the bone regeneration capacity of synthetic hydroxyapatite mixed with autogenous bone marrow aspirate when used as a bone graft substitute in maxillo-mandibular osseous defects. METHODS: This study included nine patients with histopathalogically proven benign osteolytic lesions in maxilla and mandible that were treated with enucleation or marginal resection followed by bone marrow aspirate coated synthetic biphasic hydroxyapatite (hydroxyapatite and beta tricalcium phosphate) graft placement. Incorporation of graft was assessed based on Irwin's radiologic staging. The efficacy of graft to form new bone was radiologically evaluated by observing the sequential changes of density at grafted site using gray scale level histogram which was processed in adobe photoshop 7.0 elements. Clinical assessment of recipient and donor sites was done. RESULTS: Based on Irwin's radiologic staging, at 6 month follow up period, obvious incorporation of graft with new bone was observed. Sequential changes in bone density measured by gray scale histogram revealed initial resorption followed by replacement of BMA coated hydroxyapatite with new bone formation. None of the patients eventually had complications like infection, wound dehiscence, graft loss at recipient sites at 6 months follow up period. CONCLUSION: Autogenous bone marrow aspirate in combination with synthetic hydroxyapatite is an effective option for accelerating bone regeneration in small to moderate sized jaw bone defects. This mixture provides all the three critical elements needed for bone regeneration (osteogenesis, osteoinduction and osteoconduction) with an added advantage of obviating donor site morbidity.

Differential diagnosis of byssinosis by blood histamine and pulmonary function test: a review and an appraisal.

A study was conducted on byssinotic (N = 8) and nonbyssinotic (N = 16) mill workers exposed to cotton dust and on controls (N = 15) from a cotton dust-free zone. They were examined for chest tightness and breathlessness during successive days from Mondays to Fridays. In addition to monitoring the workers only on Mondays after shift work, their blood histamine levels and pulmonary function tests such as FEV1, PEFR, and FEF25-75% (PEFR represents airflow of larger airways, FEF25-75% reflects airflow in smaller airways, and FEV1 represents airflow in both central and peripheral airways) were screened, but Monday data were only counted to appraise a contrast between these two parameters. The results showed that the histamine levels were significantly higher in the cotton dust-exposed workers in association with significantly decreased FEV1, PEFR, and FEF25-75%, indicating bronchoconstriction of the central, larger, and peripheral airways. Histamine can cause a severe constriction of the central as well as peripheral airways in cotton dust-exposed workers, enabling a paradoxical effect for a differential diagnosis of byssinosis.

Pulmonary function tests--a comparison between urban industrial and rural agricultural workers of Andhra Pradesh.

Physical parameters and pulmonary function tests (VC, FEV1, FEV1% and FEF25-75%) were collected in 112 urban industrial workers and 104 rural agricultural workers. These average values, values according to age and smoking habits were compared between urban and rural workers. Inspite of no differences in age, rural workers average height, weight, BSA is significantly lower than urban workers. A significant increase in VC value to the extent of 0.22 lit (7.1%), significantly lower FEV 1% value by 4.7% and reduce FEF25-75% value (4.7%) is demonstrated in rural than urban workers. Smoking is shown to produce airway obstruction in both urban and rural workers. A wide variation of PFT values between the present workers and other reported values in India is observed. This study indicates rural workers have better pulmonary capacity and less flow rates than their urban counterpart.