Effect of Bovine Milk on Implant Osseointegration: an in vivo Study.

The safety and success of an implant after surgery depend on many factors, some related to the implant's biocompatibility, properties, surface modification, design, and other factors related to surgical procedures, implant bed preparation, and drilling techniques. It is recognized that the success of implant dentistry depends on several factors that may be related to biochemical properties and modification in mechanical properties. The present study aimed to assess the effect of using bovine milk as an irrigant solution on implant osseointegration. The implant socket was prepared by drilling bone holes in 20 femurs of the rabbits at steady rotation speeds with different irrigate solutions (normal saline / commercial pasteurized bovine milk). Mechanical tests and histological investigation were performed to estimate the removal torque record and implant contact area, BIC. Findings illustrate that implant contact area (BIC) and removal torque mean values are higher in experimental compared to control with more bone apposition and maturation at 4&8 week measured periods. Osseointegration is accelerated by using bovine milk in irrigation and rinsing of implant socket.

Assessment of Interleukin-13(rs20541) Genomic Polymorphism in Patients with Acute Respiratory Distress Syndrome in Relation to COVID19 Infection.

Elevated Interleukin-13 (IL-13) may play an important role in the pathophysiology of COVID-19, yet, the attenuated response did not notice across all severe cases. Susceptibility to asthma in specific populations is associated with several SNPs of multifunctional cytokines, such as IL-13, IL-31 and IL-33. This prospective case-control study is designed to investigate the extent of genetic susceptibility in subsets of Iraqi patients with COVID-19 by targeting the variants of interleukin IL-13rs20541 polymorphism in relation to disease susceptibility and severity of clinical presentation. One hundred samples were obtained from the throat, nasopharyngeal and nasal swabs enrolled in this study. Eighty samples of the throat, nasopharyngeal and nasal localization swabs were obtained from patients with acute respiratory distress syndrome (ARDS) (both COVID-19 and non-COVID19 patients), while other 20 nasopharyngeal swabs were included as a healthy control group (AHC). Detection of IL-13rs20541 polymorphism was done by ARMS technique. The frequencies of GG- genotype in ARDS- patients with COVID-19, non-COVID19-, and AHC groups were respectively 14%, 12% and 3%, where, and as compared to the control group, showed a significant increase in COVID-19 patients. The AA- genotype in patients with COVID-19 group, non- COVID-19 group and healthy control group documented the frequency of 9%, 7%, and 14%, respectively, where the frequency decreased in the patient's groups as compared to the AHC group. Finally, and among the studied groups, an increase of AG- genotype (as rate OR=1.89) was documented compared to genotype GG and A-. Genetic polymorphisms in the IL-13rs20541 gene might influence its functions in patients with SARS-associated respiratory tract infection and thus might involve the pathogenicity of patients with COVID-19.

Platelet Concentrate Treatments for Temporomandibular Disorders: A Systematic Review and Meta-analysis.

OBJECTIVES: This systematic review compared platelet concentrates (PCs) versus hyaluronic acid (HA) or saline/Ringer's solution injections as treatments of temporomandibular osteoarthritis and disc displacement in terms of pain and maximum mouth opening (MMO). METHODS: PubMed, Cochrane, and Scopus were searched up to March 6, 2020. Inclusion criteria were randomized clinical trials (RCTs). Exclusion criteria were case series, observational studies, animal studies, and reviews. The Effective Public Health Practice Project (EPHPP) quality assessment tool was used to assess the risk of bias in the included studies. The weighted mean difference was used to compare the results. RESULTS: Nine RCTs were included with a total of 407 patients. The numbers of joints treated were 262, 112, and 112 in the PC, HA, and saline groups, respectively. The quality of studies was rated as strong in 4 studies, moderate in 4 studies, and weak in 1 study. The meta-analysis revealed that PCs decreased pain visual analogue scale (VAS) scores compared to HA by an average of -1.11 (CI, -1.62 to -0.60; P < 0.0001) and -0.57 (CI, -1.55 to 0.41; P = 0.26) at 3 and 12 mo follow-up respectively. Also, the average decrease in pain scores with PC compared to saline was -1.33 (CI, -2.61 to -0.06; P = 0.04), -2.07 (CI, -3.46 to -0.69; P = 0.003), and -2.71 (CI, -4.69 to -0.72; P = 0.008) at 3, 6, and 12 mo, respectively. Regarding MMO measurements, PC was comparable to HA, but it was significantly better than saline after 3 and 6 mo [2.9 mm (CI,1.47 to 4.3; P < 0.0001), and 1.69 mm (CI, 0.13 to 3.25; P = 0.03) respectively]. CONCLUSION: PC reduces pain VAS scores compared to HA during the first 3 m after treatment, and when compared to saline, it reduces pain and increases MMO for longer durations. However, due to differences between groups regarding PC preparation protocols and study heterogeneity, further standardized RCTs are required. KNOWLEDGE TRANSFER STATEMENT: This study provides researchers and clinicians with quantitative and qualitative analyses of the current evidence regarding the clinical outcomes of platelet concentrate injections in the treatment of temporomandibular joint osteoarthritis and disc displacement in terms of pain control and maximum mouth opening.

Cancer associated retinopathy with periphlebitis and bilateral vitreous hemorrhage.

INTRODUCTION: Cancer associated retinopathy (CAR) is an uncommon paraneoplastic syndrome associated with epithelial neoplasm. Ocular symptoms of this syndrome are varied. CASE REPORT: A 40-year-old man with an existing smoking history noticed a bilateral visual loss.Fundus examination showed a bilateral vitreous hemorrhage.In the left eye, there were narrowed retinal arterioles and peripapillary neovessels. An X-ray chest revealed a lung lesion which on biopsy proved to be a bronchial squamous cell carcinoma. After conducting several explorations,we have diagnosed CAR. CONCLUSION: Vitreous hemorrhage is one of the symptoms of CAR. Thus, systems review, searching for an extraocular cancer, X-ray chest and ERG are recommended in this case.

[Ocular risk factors for progression of primary open angle glaucoma in the Tunisian population]. / Facteurs oculaires prédictifs de la progression du glaucome primitif à angle ouvert dans la population tunisienne.

PURPOSE: To evaluate intraocular pressure parameters and the role of other ocular risk factors in the progression of primary open angle glaucoma. PATIENTS AND METHODS: We performed a retrospective analysis of long-term glaucomatous progression in 140 patients (280 eyes) with primary open angle glaucoma (POAG) between 1998 and 2009. After analyzing their disease progression, the eyes of our patients were divided into two groups: group 1 (G1) consisted of eyes with worsening of their POAG, and group 2 (G2) consisted of the eyes that remained stable. The indicators of progression studied were factors associated with glaucomatous optic neuropathy, other ocular risk factors, and treatment-related risk factors. RESULTS: We found 188 eyes with stable visual fields (G2) and 92 eyes with glaucoma progression (G1), for a progression rate of 32.9%. Mean intraocular pressure (IOP) at diagnosis was statistically higher in the cases with progression, 22.78 mmHg vs. 19.9 mmHg for stable cases (P=0.03; OR=5.25). Higher final intraocular pressure (IOP) was also associated with progression (16.82 mmHg for G1 vs. 14.85 mmHg for G2; P=0.051). IOP less or equal to 12.75 mmHg was identified as the target pressure for our population. Progressed eyes also showed a statistically higher diurnal peak IOP (23.13 mmHg vs. 19.87 mmHg for G2; P=0.007). Long term IOP fluctuation was also predictive of progression (4.43 mmHg for G1 vs. 2.31 mmHg for G2; P=0.003). Eyes with initial visual field defect more than 8.2dB had 4.8 times the risk of progression (P=0.07). However, eyes diagnosed in an early glaucoma stage had four times the chance of maintaining a stable visual field (P=0.003). Statistically significant risk factors between the two groups also included: pseudoexfoliation (OR=2.84; P=0.05), cornea less than 505 µ (OR=10.89; P=0.005), topical beta blockers (P=0.003), and more than two topical medications (OR=3; P=0.003). CONCLUSION: It is currently known that IOP lowering contributes to glaucoma stabilization. However, this single criterion remains insufficient, as other, particularly ocular, factors have been implicated in glaucoma progression. Identification of these risk factors allows for a better therapeutic approach toward these patients, so as to preserve their vision and quality of life.

Mitral valve replacement with beating heart technique via right thoracotomy in a patient with previous Bentall operation.

Traditionally, reoperations for mitral valve replacement are carried out under cardioplegic arrest with cross-clamping of the ascending aorta via a median sternotomy. In this case, the mitral valve replacement operation was performed with an on-pump beating heart technique without cross-clamping the aorta and via a right thoracotomy because of diffuse adhesions around the ascending aortic tube graft. A 44-year-old male patient had undergone a Bentall operation via a median sternotomy for annulo-aortic ectasia 3 years ago. He was admitted to the hospital complaining of palpitation and dyspnea. Transthoracic echocardiography revealed 4th degree mitral insufficiency. Mitral valve replacement was carried out through a right thoracotomy using an on-pump beating heart technique without cross clamping the aorta. In conclusion, mitral valve replacement with an on-pump beating heart technique via a right thoracotomy offers a safe approach when excessive dissection is required to place a cross-clamp to the ascending aorta.

Effect of vitamin A and/or E on plasma enzymatic antioxidant systems and total antioxidant capacity of broiler chickens challenged with carbon tetrachloride.

This study was conducted to investigate the effect of vitamin A and E supplementation on the antioxidant defences of broiler chickens against carbon tetrachloride (CCl(4))-induced oxidative stress at 4 weeks of age. Superoxide dismutase (SOD) and glutathione peroxidase (GPX) activities as well as total antioxidant (TAO) level were analysed before and after CCl(4) challenge. Day-old Lohman broiler chickens (n = 144) were randomly assigned to six factorially arranged dietary treatments consisting of vitamin A [1.35 (control) or +20 mg/kg] and vitamin E [20 (control), +40 or +60 mg/kg]. The background of vitamins A and E in the basal diet was 4500 IU (1.35 mg) and 30 IU (20 mg) respectively. At 4 weeks of age, eight chickens from each treatment were bled before interperitoneal injection with 1 ml of CCl(4) (mixed with olive oil in a ratio of 1:1) and bled again 24 h post-injection. Vitamin E supplementation decreased (p < 0.05) the activity of both SOD and GPX and showed a tendency (p = 0.07) for TAO reduction. CCl(4) attenuated SOD and GPX activities as well as TAO level. The decrease was profound (p < 0.05) in chickens fed the basal diet as well as those fed basal diet supplemented with 20 mg vitamin A. TAO levels behaved similarly when chickens were challenged with CCl(4). After CCl(4) injection, SOD activities of all experimental groups were equivalent. The presence of vitamin A decreased (p < 0.05) plasma GPX activity in chickens fed the basal diet supplemented with 40 mg/kg of vitamin E. Results of this experiment suggested that vitamin E supplementation elevated antioxidant enzyme activities while vitamin A supplementation attenuated this effect. Vitamin E supplementation improved the total reducing power by maintaining comparable levels of TAO upon CCl(4) challenge. Further experiments need to be carried out to investigate the role of vitamin A in oxidative stress and to evaluate the lipid peroxidation products.

Embolization of Gianturco coil into the pulmonary artery requiring emergency surgical intervention.

We report the case of a 20-month-old girl who underwent Gianturco coil embolization to a patent ductus arteriosus in May 1997. The coil migrated to the pulmonary artery. After unsuccessful attempts to retrieve it with snares and forceps, we engaged the coil with an end-hole balloon catheter and pulled it down to the right ventricle. There it became entangled in the tricuspid valvular apparatus and could not be moved farther. Due to concerns about sequelae, the patient was referred for surgery. Following a mid-sternotomy under cardiopulmonary bypass, we removed the coil and ligated the patent ductus arteriosus. The patient made an uneventful recovery. A brief review of the literature is presented.

Coronary artery fistula and atrial septal defect: a case report and brief review of the literature.

We present a case of a 25-year-old male with a large secondum atrial septal defect (ASD) associated with a coronary artery fistula (CAF) between the right coronary artery and the right atrium. The ASD was diagnosed preoperatively by transesophageal echocardio-graphy (TEE). The fistula was found at surgery. The ASD and fistula were closed successfully without any complication. The case highlights the common presenting features of the two conditions as well as the low sensitivity of pre-operative TEE in diagnosing CAF in the setting of an ASD.

Juvenile friends, behavior, and immune responses to separation in bonnet macaque infants.

Individual differences in the response to maternal separation in nonhuman primate infants have been attributed to (among other variables) presence or absence of processes that may model social support in humans. Alternative attachments to other members of the social group buffer the infant against a depressive response to maternal separation. This hypothesis was tested in a group of bonnet macaques by manipulating the presence or absence of alternative juvenile attachment figures (friends) during separation. Infants who retained such attachments showed fewer behavioral evidences of depression when separated from their mothers. These infants without friends also showed changes in lymphocyte activation by mitogens or natural cytotoxicity that were not evident in the infants with juvenile friends. Across all separated infants, natural cytotoxicity was positively correlated with juvenile affiliative behavior directed toward the infants during the separation. These results support the hypothesis that social support, available from alternative attachments, can modulate the response to loss, and can account for some of the individual differences seen in these responses.

Coronary steal through anomalous internal mammary artery graft. Treated by ligation without sternotomy.

A patient who had undergone adequate coronary revascularization with a left internal mammary artery graft to the left anterior descending coronary artery and with saphenous vein grafts to the right coronary artery and to the 1st and 2nd obtuse marginal branches presented with early-onset recurrent angina. A repeat angiogram showed an abnormally large branch arising from the very proximal segment of the left internal mammary artery and supplying the whole lateral chest wall via many intercostal tributaries. Relief of symptoms was achieved by ligation of this branch, and the patient remains symptom free more than 6 years after the procedure.

Intracellular calcium signalling in peripheral cells of patients with bipolar affective disorder.

Consistent with previous studies, elevated free intracellular calcium ion concentrations ([Ca2+]i) were found in blood platelets and lymphocytes of patients with mania and bipolar depression. Incubation with an ultrafiltrate of plasma from patients with bipolar illness had no effect on intracellular calcium ion concentration in platelets from normal subjects, suggesting that elevated [Ca2+]i is not due to a circulating factor. As was true in an earlier study of the effect of lithium on platelets, incubation with therapeutic levels of carbamazepine lowered [Ca2+]i in lymphocytes from affectively ill patients but not controls. Increased [Ca2+]i in peripheral cells may reflect a diffuse change in cellular homeostasis and may contribute to mixtures as well as rapid alternations of activity of affective, behavioral and physiologic systems in bipolar illness. Correction of the abnormality may at least be a marker of a relevant therapeutic action if it is not the action itself.

Antibodies to bladder-tumor-associated antigens as prognosis probes in the flow-cytometric analysis.

Monoclonal antibodies directed against bladder tumor cells (10D1, 7C12, 6D1, 3C6, G4 and E7) and human leukocyte antigen (HLe1) were tested by flow cytometry on 68 bladder tumors involving 10 grade I, 29 grade II and 29 grade III tumors (WHO classification). According to their evolution stage, these tumors can be subdivided into 17 stage Pa, 34 stage P1, 7 stage P2 and 10 stage P3. Fifteen normal bladder samples were used as a control. Analysis of DNA content revealed a first group of 31 tumors with a unimodal DNA profile. In the second groups of 37 tumors, the DNA profile was bimodal. Cells from grade I tumors were labelled with 10D1 and 6D1 antibodies; all these cells showed a unimodal DNA profile. Grade III tumor cells were labelled with antibodies G4 and E7; most of these cells showed a bimodal DNA profile. The percentage of HLe1-positive cells decreased with the pathological grade and stage of tumor. The composition of infiltrating leukocytes was different in unimodal and bimodal tumors. In conclusion, cells of low-grade tumors can be identified with 10D1 and 6D1 antibodies, and antigens recognized by G4 and E7 antibodies are mostly expressed by aneuploid cells. HLe1 antibody demonstrates the importance of the inflammatory reaction in bladder tumors. Moreover, in flow cytometry, leukocytes within a tumor could be used as internal reference for precise measurement of the DNA content of tumor cells.

Immune responses following competitive water tests in two species of macaques.

A panel of immune parameters (lymphocyte activation by mitogens, natural cytotoxicity, and differential cell counts) was assessed in socially housed pigtail and bonnet macaques 1 and 2 weeks before, 48 h after, and 1 and 2 weeks after a competitive water test. Species differences were found in both baseline measures and the responses to the test: Immune measures observed during baseline periods were lower in pigtail macaques. Furthermore, only the pigtail macaques showed changes in mitogen activation and cytotoxicity at 48 h post-test. Dominance-related behaviors affected these responses both within and across social groups. The species differences may be accounted for by the differences in the behavioral responses of the two species to the test: Pigtail macaques consistently contested access to the water during the test, whereas bonnet macaques did not. These results suggest that the immune system can be modulated by psychosocial behavioral systems, particularly during times of stress.

Use of leukocytes infiltrating bladder tumors as an internal reference for determining the DNA index by flow cytometry.

The use of leukocytes infiltrating bladder tumors as an internal standard for flow cytometric measurements of DNA and SG2M indices was investigated in comparison with the conventional use of chicken erythrocytes (chicken red blood cells; CRBC). The leukocytes were identified by indirect fluorescence, using a mouse anti-CD45 monoclonal antibody and a fluorescein isothiocyanate-conjugated goat anti-mouse Ig F(ab')2 fragment. DNA was stained with propidium iodide. The percentage of CD45-positive cells averaged 37% in 23 unimodal bladder tumors and 30% in 27 bimodal ones. The diploid peak of CD45-positive cells was always easily identified and permitted a more accurate calculation of the DNA index and the percentage of cells in SG2M phases than did the use of CRBC. Seven tumors that were classified as unimodal using CRBC as the standard did, in fact, contain a minor clone (with a DNA index of 1.80) that could be detected only when CD45-positive leukocytes were used as the internal standard.

Flow cytometry analysis of urothelial cell DNA content according to pathological and clinical data on 100 bladder tumors.

DNA content of 100 bladder tumors (34 grade I, 42 grade II and 24 grade III, WHO classification) were studied by flow cytometry. Ten normal bladder samples were used as control. The 100 bladder tumors could then be separated into two groups. A first group of 60 tumors (60%) had a unimodal distribution with a diploid peak and a DNA index close to 1.0, 32 grade I, 22 grade II and 6 grade III tumors displayed this pattern as did the 10 normal bladders. The second group (40%) had a bimodal distribution with two peaks, the first one (diploid peak) with a DNA index of 1.0, the second (aneuploid peak) with a DNA index greater than 1.0. Two grade I, 20 grade II and 18 grade III tumors belonged to this group. Frequency of the aneuploid peak increased with tumor grade and infiltration progression. Hence 6% of grade I, 48% of grade II and 75% of grade III tumors showed an aneuploid peak as well as 8% of Pa, 46% of P1, 73% of P2 and 87.5% of P3 stage tumors. This study showed that a good correlation exists between flow-cytometric, pathological and clinical data.