Hydrothermally treated coral scaffold promotes proliferation of mesenchymal stem cells and enhances segmental bone defect healing

Introduction: Synthetic hydroxyapatite (HAp) scaffolds have shown promising therapeutic outcomes in both animals and patients. In this study, we aim to evaluate the chemical and physical phenotype, biocompatibility, and bone repair effects of hydrothermally treated coral with natural coral and synthetic HAp. Methods: The phase composition, surface pattern, 3D structures, and porosity of the scaffolds were characterized, and cell viability, proliferation, and osteogenic differentiation of mesenchymal stem cells (MSCs) after seeding onto the scaffold were determined. The scaffolds were implanted into rats to assess their bone repair effects using micro-CT analysis, mechanical testing, and histological staining. Results: The results showed that the phase composition, porous structure, and porosity of hydrothermally treated coral were comparable to pure HAp scaffold. While only the natural coral happens to be dominantly calcium carbonate. Higher cell proliferation and osteogenic differentiation potential were observed in the hydrothermally treated coral scaffold compared to natural coral and pure HAp. Histological results also showed increased new bone formation in the hydrothermally treated coral group. Discussion: Overall, our study suggests that hydrothermal modification enhances the cytocompatibility and therapeutic capacity of coral without altering its physical properties, showing superior effectiveness in bone repair to synthetic HAp.

Comparison of tissue displacement in edentulous arches among three-dimensional files obtained through different impression-making methods: A retrospective study

PURPOSE

To retrospectively compare and analyze differences in tissue displacement of edentulous arches among three-dimensional (3D) files obtained using various impression-making techniques.

MATERIALS AND METHODS

Fourteen patients who underwent prosthodontic treatment for edentulous arches at Yonsei University Dental Hospital between June 2020 and April 2023 were included in the study. Three types of 3D files were used for the evaluation of each arch: a 3D scan file of a definitive cast (Group DEF), a preliminary cast (Group PRE), and an intraoral scan file (Group IOS). The files were superimposed on a reference 3D scan file of the definitive cast group through best-fit matching using metrology software. Seventeen measurement points (MP1-4, RC1-6, TB1-2, and PPS1-5 for the maxilla and RP1-2, RC1-7, BS1-4, and LS1-4 for the mandible) were selected for both the maxillary (n = 13) and mandibular arches (n = 6). The deviation considering the direction (DD) between the three groups and the absolute deviation (AD) between the three groups were recorded. Kruskal-Wallis and post-hoc Mann-Whitney tests were used for statistical analyses (α = 0.05 and α = 0.0167, respectively).

RESULTS

Concerning the DD values, at the RC4 point of the maxillary arch, Group PRE exhibited significantly higher values than Groups IOS (p = 0.006) and DEF (p < 0.001), and at the RC5 point of the maxillary arch, Group IOS exhibited significantly lower values than Groups PRE (p = 0.016) and DEF (p < 0.001). Group IOS showed significantly lower DD values in the mandibular arch than Group DEF at the RP2 and RC3 points (p < 0.167). The AD values in Groups PRE and IOS significantly differed from those in Group DEF (all p < 0.001) at all measurement points but did not exhibit significant differences between each other (p > 0.05).

CONCLUSIONS

Different impression-making methods yielded different amounts of tissue displacement. The tendency of 3D files regarding tissue displacement varied at certain residual ridge crest areas and retromolar pad areas. The absolute amount of tissue displacement observed in the intraoral scan data was comparable to that observed in the preliminary casts.

Deep learning and clustering approaches for dental implant size classification based on periapical radiographs

This study investigated two artificial intelligence (AI) methods for automatically classifying dental implant diameter and length based on periapical radiographs. The first method, deep learning (DL), involved utilizing the pre-trained VGG16 model and adjusting the fine-tuning degree to analyze image data obtained from periapical radiographs. The second method, clustering analysis, was accomplished by analyzing the implant-specific feature vector derived from three key points coordinates of the dental implant using the k-means++ algorithm and adjusting the weight of the feature vector. DL and clustering model classified dental implant size into nine groups. The performance metrics of AI models were accuracy, sensitivity, specificity, F1-score, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUC-ROC). The final DL model yielded performances above 0.994, 0.950, 0.994, 0.974, 0.952, 0.994, and 0.975, respectively, and the final clustering model yielded performances above 0.983, 0.900, 0.988, 0.923, 0.909, 0.988, and 0.947, respectively. When comparing the AI model before tuning and the final AI model, statistically significant performance improvements were observed in six out of nine groups for DL models and four out of nine groups for clustering models based on AUC-ROC. Two AI models showed reliable classification performances. For clinical applications, AI models require validation on various multicenter data.

Enhanced Bone Formation by Rapidly Formed Bony Wall over the Bone Defect Using Dual Growth Factors

BACKGROUND

In guided bone regeneration (GBR), there are various problems that occur in the bone defect after the wound healing period. This study aimed to investigate the enhancement of the osteogenic ability of the dual scaffold complex and identify the appropriate concentration of growth factors (GF) for new bone formation based on the novel GBR concept that is applying rapid bone forming GFs to the membrane outside of the bone defect.

METHODS

Four bone defects with a diameter of 8 mm were formed in the calvaria of New Zealand white rabbits each to perform GBR. Collagen membrane and biphasic calcium phosphate (BCP) were applied to the bone defects with the four different concetration of BMP-2 or FGF-2. After 2, 4, and 8 weeks of healing, histological, histomorphometric, and immunohistochemical analyses were conducted.

RESULTS

In the histological analysis, continuous forms of new bones were observed in the upper part of bone defect in the experimental groups, whereas no continuous forms were observed in the control group. In the histomorphometry, The group to which BMP-2 0.5 mg/ml and FGF-2 1.0 mg/ml was applied showed statistically significantly higher new bone formation. Also, the new bone formation according to the healing period was statistically significantly higher at 8 weeks than at 2, 4 weeks.

CONCLUSION

The novel GBR method in which BMP-2, newly proposed in this study, is applied to the membrane is effective for bone regeneration. In addition, the dual scaffold complex is quantitatively and qualitatively advantageous for bone regeneration and bone maintenance over time.

Retentive strength of cement-retained implant-supported fixed dental prostheses according to different cement types and cementation protocols: An in vitro study

PURPOSE

To develop the most compatible cementation protocol for ensuring minimal residual cement and optimal retention of cement-retained implant-supported fixed dental prostheses.

MATERIALS AND METHODS

Thirty custom implant abutments and zirconia crowns with bilateral wings were prepared. Three cement types were used for cementation: non-eugenol resin cement (Premier Implant Cement; Group IC), dual-polymerizing self-adhesive resin cement (SmartCem 2; Group SC), and zinc oxide eugenol cement (Temp-Bond; Group TB) (n=30 per group). Three cementation methods were applied for each cement type and the samples were divided into subgroups: 1) cement was injected using a graduated syringe (IC-N, SC-N, and TB-N); 2) a cementation jig made with a silicone impression material and temporary resin material was used (IC-CJ, SC-CJ, and TB-CJ); 3) three dimensionally (3D) printed abutments were used as replicas for cementation (IC-3DP, SC-3DP, and TB-3DP). The amount of cement injected, surface area of the residual cement, and retentive strength were measured. Kruskal-Wallis and post-hoc Mann-Whitney tests were used for statistical analyses.

RESULTS

Excess cement was not observed when cementation jig or 3D-printed replicas were used. For IC and SC subgroups, non-use of these auxiliary tools resulted in significantly higher amounts of injected cement. The retentive strength differed significantly among the IC subgroups, but not among the SC subgroups. The retentive strength of subgroups TB-N and TB-CJ was significantly higher than that of subgroup TB-3DP.

CONCLUSIONS

To prolong the main purpose of each cement type, a cementation jig or 3D-printed replica is highly recommended regardless of the cement type. Int J Prosthodont 2023. doi: 10.11607/ijp.8344.

Improving Bone Formation by Guided Bone Regeneration Using a Collagen Membrane with rhBMP-2: A Novel Concept

We examined whether recombinant human bone morphogenetic protein-2 (rhBMP-2) when applied to collagen membranes, would reinforce them during guided bone regeneration. Four critical cranial bone defects were created and treated in 30 New Zealand white rabbits, including a control group, critical defect only; group 1, collagen membrane only; group 2, biphasic calcium phosphate (BCP) only; group 3, collagen membrane + BCP; group 4, collagen membrane with rhBMP-2 (1.0 mg/mL); group 5, collagen membrane with rhBMP-2 (0.5 mg/mL); group 6, collagen membrane with rhBMP-2 (1.0 mg/mL) + BCP; and group 7, collagen membrane with rhBMP-2 (0.5 mg/mL) + BCP. After a 2-, 4-, or 8-week healing period, the animals were sacrificed. The combination of collagen membranes with rhBMP-2 and BCP yielded significantly higher bone formation rates compared to the other groups (control group and groups 1-5 < groups 6 and 7; p < 0.05). A 2-week healing period yielded significantly lower bone formation than that at 4 and 8 weeks (2 < 4 = 8 weeks; p < 0.05). This study proposes a novel GBR concept in which rhBMP-2 is applied to collagen membranes outside instead of inside the grafted area, thereby inducing quantitatively and qualitatively enhanced bone regeneration in critical bone defects.

Comparative evaluation of digitally fabricated complete dentures versus conventional complete dentures: A randomized, single-blinded, cross-over clinical trial

STATEMENT OF PROBLEM

Clinical trials comparing outcomes associated with digital complete dentures (CDs) fabricated from intraoral scan data with those of CDs fabricated by using the conventional workflow are lacking.

PURPOSE

The purpose of this randomized clinical trial was to evaluate the clinical performance of and patient satisfaction associated with digitally versus conventionally fabricated CDs.

MATERIAL AND METHODS

Eight participants requiring CDs were enrolled in this study. Two sets of CDs were fabricated for each participant. One set was fabricated by using a digital workflow, which involved digital scanning with an intraoral scanner, whereas the other set was made by using the conventional workflow. The participants were given 1 set of CDs for 1 month and another set for the next month. The order of placing CDs was randomly selected for each participant. The internal adaptation, masticatory force, and masticatory efficiency of the CDs in each group were evaluated for objective analysis. Additionally, a questionnaire was provided to the participants, and the responses were evaluated for subjective satisfaction analysis. All parameters were analyzed by using t tests (α=.05).

RESULTS

The internal adaptation did not statistically significantly differ between the conventional and digital CDs with regard to the maxillary arches (P=.406) and mandibular arches (P=.412). The average masticatory force (P=.051) and maximum masticatory force (P=.110) likewise did not statistically significantly differ between the 2 types of CDs. Masticatory efficiency, expressed via the mixing ability index, was statistically better for conventional CDs than the digital CDs (P=.009). No statistically significant differences were observed between the 2 types of CDs in terms of overall patient satisfaction as assessed by using the study questionnaire (P=.172 for maxillary CD and P=.161 for mandibular CD). However, the conventional CDs were statistically significantly better than the digital CDs with regard to subjective satisfaction with pronunciation ability (P=.006).

CONCLUSIONS

The digital CDs were inferior to the conventional CDs in terms of masticatory efficiency and pronunciation. However, internal adaptation and overall patient satisfaction were comparable between conventional and digital CDs. This finding suggests that intraoral scanning and additively manufactured CDs may be suitable for edentulous patients, at least for interim use.

Improvement of Osseointegration by Ultraviolet and/or Simvastatin Treatment on Titanium Implants with or without Bone Graft Materials

We evaluated and compared ultraviolet (UV) treatment and simvastatin (SIM) immersion effects on the osseointegration of sandblasted, large-grit, acid-etched (SLA) titanium dental implants at two different time points in rabbit tibias, with or without xenogenic bone graft materials. The surface alteration on simvastatin treatment titanium discs was analyzed using an infrared spectrometer. Implants were categorized into four groups according to the surface treatment type. Twelve rabbits received two implants per tibia. A tibial defect model was created using a trephine bur, with implants in contact with the bone surface and bovine bone graft materials for gap filling. The rabbits were sacrificed after 2 or 4 weeks. UV treatment or SIM immersion increased the bone-to-implant contact (BIC) on nongrafted sides, and both increased the BIC and bone area (BA) on grafted sides. The application of both treatments did not result in higher BIC or BA than a single treatment. At two different time points, BIC in the nongrafted sides did not differ significantly among the UV and/or SIM treated groups, whereas BA differed significantly. UV or SIM treatment of SLA titanium implants accelerates osseointegration in tibias with or without xenogenic bone graft materials. The combination of both treatments did not show synergy.

Proceedings from the OMS Resurgence Conference for resuming clinical practice after COVID-19 in the USA

The COVID-19 pandemic has altered and reshaped the delivery of oral and maxillofacial surgery (OMS) over the past few months. As the USA gradually lifts restrictions and re-opens, surgeons must adjust accordingly. Therefore, the OMS Resurgence Conference: Safely Resuming Practice with a New Normal was organized for 11 May 2020 to gather and disseminate expert opinions and recommendations for OMSs to thoughtfully resume work with efficiency and safety. This manuscript offers a summary of the highlights from the conference discussion.

Effects of Scanning Strategy and Scanner Type on the Accuracy of Intraoral Scans: A New Approach for Assessing the Accuracy of Scanned Data

PURPOSE

This study aimed to determine the most reliable scanning strategy and scanner type, using a new protocol for assessing the accuracy (trueness and precision) of intraoral scan data.

MATERIALS AND METHODS

Five different maxillary and mandibular typodont pairs (n = 10) and 2 intraoral scanners were used for the study. A reference scan for each arch was obtained with an industrial scanner. Scanning strategies were classified into 2 continuous methods-continuous scan in horizontal direction (CH group) and continuous scan with vertical rotation in anterior region (CV group)-and 1 segmental method (S group). In the CH group, the scanner head was maintained mostly in a horizontal position. In the CV group, the scanners were rotated 180° around the anterior tooth region to allow smooth scanning through the area. The intraoral scan data were individually superimposed over their corresponding reference scan data. Raw data of the distances between paired surface points were extracted from the superimposed pairs of datasets, with (original distance values) or without consideration (absolute distance values) of the value signs. Trueness values were calculated using absolute distance values, while precision values were obtained from original distance values. Data were analyzed with a 2-way repeated-measures analysis of variance using α = 0.05 as the level of significance.

RESULTS

The CV group produced significantly inferior outcomes compared to the CH and S groups in terms of trueness (p < 0.001, F = 24.67), whereas no significant differences were observed among the 3 scanning strategies with respect to precision (p = 0.451, F = 0.83). Scanner type did not produce significant differences in terms of either trueness (p = 0.058, F = 4.72) or precision (p = 0.742, F = 0.12).

CONCLUSIONS

The segmental approach for scanning the region of interest first and continuous scanning with the scanner head held mostly in a horizontal position are both acceptable as full-arch scanning strategies. However, vertical rotation of intraoral scanners should be minimized.

Multidrug-resistant tuberculosis in South Korea: a retrospective analysis of national registry data in 2011-2015

BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) poses a threat to public health as a result of high treatment costs and unsatisfactory outcomes.OBJECTIVE: To elucidate trend, demographic and clinical characteristics and treatment outcomes of patients with MDR-TB between 2011 and 2015 in South Korea.METHOD: Data of patients with MDR-TB diagnosed between 1 January 2011 and 31 December 2015 were retrieved from the nationwide Internet-based TB notification system and analysed retrospectively.RESULTS: During the study period, 5192 MDR-TB patients were notified. We identified an increasing number of MDR-TB patients among foreign populations (from 1.3% to 7.7%), decreasing resistance rates to other anti-TB drugs (e.g., resistance to pyrazinamide, from 40.9% to 28.2%), a decreasing interval from treatment initiation to negative conversion of sputum culture (from 165.7 to 103.7 days) and shortening of treatment duration (719.7 to 613.2 days). However, treatment success rates did not change, and had an average of 65.7%.CONCLUSION: Despite decreasing resistance rates to other drugs and faster treatment responses, treatment outcomes did not improve during the study period. Strict management of MDR-TB patients on treatment should be adopted to improve treatment outcomes.

Denture-reversing technique for assessing the soft tissue dimensional changes according to artificial tooth position in completely edentulous patients

A digital workflow to assess the soft tissue dimensional changes in completely edentulous patients is described. Diagnostic casts obtained at 2 time points and the complete denture were scanned by using a desktop scanner. The denture scan was inverted by using a metrology software program to obtain the soft tissue contour. Using this reversed file as a reference, the file and 2 scan files obtained at different time points were aligned individually with the best fit alignment function. The scanned denture file and the 2 realigned scan files were imported into the same software. A plane vertical to the occlusal plane was determined such that it moved anteroposteriorly. The distance between the contours of the 2 realigned files was measured by selecting a point and a vector based on the artificial tooth positions of the denture. This technique of using a reversed denture file may provide a quantitative evaluation of soft tissue changes and further aid in determining appropriate intervals for denture relining or rebasing.

Two-visit placement of immediate dentures with the aid of digital technologies

BACKGROUND AND OVERVIEW

In this report, the authors describe a combined digital and conventional work flow that enabled placement of immediate dentures in 2 patient visits.

CASE DESCRIPTION

Digital intraoral impressions and interarch relationship were obtained with an intraoral scanner during the first visit. The residual teeth from the digital intraoral impressions were removed, and a series of modules were used to design trial denture base and occlusal rim assemblies. The assemblies of both arches were fabricated with a 3-dimensional printer and resin material. Dental stone was poured into the intaglio of each assembly to fabricate dental casts. The assemblies and their corresponding dental casts were mounted on the articulator. The portion of the resin occlusal rim was removed, and the artificial teeth were arranged in an alternating manner; the immediate dentures were processed via conventional protocols. During the second visit, these immediate dentures were placed after extraction and relined with a denture relining material.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

Advances in digital technologies have enabled the establishment of treatment plans that would not have been considered previously. The combination of digital and conventional work flow in fabricating immediate dentures has eliminated the risk of experiencing unintentional tooth extraction during impression-making procedures, reduced the number of patient visits for the placement of immediate dentures, and resulted in satisfactory esthetic and functional outcomes.

Accuracy of Customized Prefabricated Screw-Type Immediate Provisional Restorations after Single-Implant Placement

Limited evidence is available comparing the differences between pre-operative and post-operative 3D implant positions from the viewpoint of prosthetics. We aimed to investigate the differences between preplanned positions of virtual provisional restorations and their actual positions following fully guided single-implant placement. Ten maxillary typodonts with missing right central incisors were imaged using cone-beam computed tomography, and digital impressions were obtained using an intraoral scanner. These data were imported into implant-planning software, following which the provisional restorations were designed. After data superimposition, an appropriate implant position was determined, and a computer-assisted implant surgical guide was designed for each typodont. Orders generated from the implant-planning software were imported into relevant computer-aided design software to design the custom abutments. The abutments, provisional restorations, and surgical guides were fabricated, and each restoration was cemented to the corresponding abutments, generating a screw-type immediate provisional restoration. The implants were placed using the surgical guides, and the screw-type provisional restorations were engaged to the implants. The typodonts were then rescanned using the intraoral scanner. The restorations designed at the treatment planning stage were compared with those in the post-operative scan using metrology software. The angular deviation around the central axis of the implant was measured, and the differences in the crown position were converted to root mean square (RMS) values. The post-operative provisional restorations exhibited an absolute angular deviation of 6.94 ± 5.78° and an RMS value of 85.8 ± 20.2 µm when compared with their positions in the pre-operative stage. Within the limitations of the present in vitro study, the results highlight the potential application of customized prefabricated immediate provisional restorations after single-implant placement.

Effects of ultraviolet treatment and alendronate immersion on osteoblast-like cells and human gingival fibroblasts cultured on titanium surfaces

In this study, we evaluated the effects of ultraviolet (UV) treatment and alendronate (ALN) immersion on the proliferation and differentiation of MG-63 osteoblast-like cells and human gingival fibroblasts (HGFs) cultured on titanium surfaces. MG-63 cells were used for sandblasted, large grit, and acid-etched (SLA) titanium surfaces, and HGFs were used for machined (MA) titanium surfaces. SLA and MA specimens were subdivided into four groups (n = 12) according to the combination of surface treatments (UV treatment and/or ALN immersion) applied. After culturing MG-63 cells and HGFs on titanium discs, cellular morphology, proliferation, and differentiation were evaluated. The results revealed that UV treatment of titanium surfaces did not alter the proliferation of MG-63 cells; however, HGF differentiation and adhesion were increased in response to UV treatment. In contrast, ALN immersion of titanium discs reduced MG-63 cell proliferation and changed HGFs into a more atrophic form. Simultaneous application of UV treatment and ALN immersion induced greater differentiation of MG-63 cells. Within the limitations of this cellular level study, simultaneous application of UV treatment and ALN immersion of titanium surfaces was shown to improve the osseointegration of titanium implants; in addition, UV treatment may be used to enhance mucosal sealing of titanium abutments.

Robotic-assisted single incision myomectomy in large myoma cases

INTRODUCTION

Laparo-endoscopic single-incision surgery (LESS) has been developed and gradually adopted for both benign and malignant gynecological procedures. However, LESS has been hindered for use in procedures like myomectomy by limitations in natural architecture and instrumentation, especially in suturing. The da Vinci system features a single-site platform and wristed needle driver, which may help overcome conventional LESS limitations. This case report study describes the feasibility of this robotic single-site (RSS) platform in large myoma cases and offers suggestions.

RESULTS

Two cases of myomectomy with large myomas (with maximum diameters of 160 and 120 mm) with different locations, were addressed by RSS. Operative time was 180 and 240 minutes. Estimated blood loss was 200 and 150 ml. Pathologic analysis revealed uterine leiomyomas of 910 and 870 grams. No serious peri- or post-operative complications occurred.

DISCUSSION

Myomectomy with large myoma has presented a surgical challenge. RSS myomectomy appears to be a safe and feasible technique for it regardless of its localization. Advantages include less postoperative pain, fast recovery, less impact on quality of life, and improved cosmesis. LESS surgery has been challenging concerning suturing and multi-laparoscopic or multi-port robotic myomectomy can be difficult to extract myoma, especially with morcellation. RSS could be a solution that enables ease of manipflation and extraction.

Robot-assisted laparoscopic adenomyomectomy of adenomyotic nodule implanted in the uterine endometrium manifesting as endometrial cancer: a case report and literature review

Thickened uterine endometrium with abnormal uterine bleeding highly suggests endometrial hyperplasia or endometrial carcinoma. A case of 35-year-old nulliparous woman came to our department with endometrial mass manifesting as endometrial cancer. Transrectal ultrasonography and magnetic resonance imaging (MRI) showed an 8x6 cm multicystic, ill-defined mass compacted at the uterine endometrium, the anterior wall of the uterus, and 3x3 cm heterogenous mass at the left adnexa. The edometrial mass showed multiple septations with enhancement and low-signal intensity on T2-weighted images. After endometrial biopsy was done and simple hyperplasia without atypia was observed at the histopathologic finding, the patient underwent robot-assisted laparoscopy and diagnosed as adenomyoma at the frozen pathology. After adenomyomectomy, permanent pathologic analysis revealed the same result and she recovered without any complications and responded well to gonadotropin-releasing hormone (GnRH) agonist therapy.

Effects of alendronate on the peri-implant bone in rats

OBJECTIVES

The purpose of this study was to determine the effects of alendronate on the peri-implant bone in rat maxillae with the aid of micro-computed tomographic, histologic, and biochemical analyses.

MATERIALS AND METHODS

Thirty-six male Sprague-Dawley rats were used. After extraction of the maxillary first molars, each rat was given periodic subcutaneous injections of either alendronate (alendronate group) or saline (control group). Customized implants were placed bilaterally 4 weeks after these injections. The rats were sacrificed at either 4, 8, or 12 weeks after implantation (4-, 8-, and 12-week groups, respectively; n = 6 rats per group). Microcomputed tomographic and histologic analyses were conducted for all rats. Biochemical analyses were performed at four time points for the 12-week groups.

RESULTS

There were no significant differences between the groups on microcomputed tomographic and histologic analyses. All of the measured biochemical parameters tended to decrease over time, with significant differences among some time points within each group. The serum osteocalcin level was significantly lower in the 12-week alendronate group than in the control group (P < 0.05).

CONCLUSIONS

Three approaches were utilized in evaluating the effects of alendronate. It appears serum osteocalcin levels may serve as an adjuvant marker for this purpose, although further studies are required to confirm this.

Comparison of alfuzosin 10 mg with or without propiverine 10 mg, 20 mg in men with lower urinary tract symptom and an overactive bladder: randomised, single-blind, prospective study

PURPOSE

The efficacy and safety of treatment with alfuzosin 10 mg plus propiverine 10 or 20 mg in men with lower urinary tract symptoms (LUTS) and an overactive bladder were investigated.

MATERIALS AND METHODS

In this parallel-arm, prospective, multicentre, single-blind study, men who were ≥ 40 years old, had an International Prostate Symptom Score (IPSS) of ≥ 8, an Overactive Bladder Symptom Score (OABSS) of ≥ 3 and an OABSS urgency item score of ≥ 2 were randomised in a 1 : 1 :1 ratio to receive alfuzosin 10 mg alone (Group A) or with propiverine 10 mg (Group B) or 20 mg (Group C) for 8 weeks. Four and 8 weeks after commencing treatment, OABSS was measured along with IPSS, maximal urinary flow rate (Qmax ) and postvoid residual volume (PVR). Adverse events were recorded.

RESULTS

A total of 135 men, including 43 in Group A, 48 in Group B and 44 in Group C, completed the study. Relative to baseline, all groups demonstrated significant reductions in OABSS and the IPSS after eight treatment weeks (p < 0.005). The improvement of OABSS in Group C was significantly greater than Group A and B (Group A: 0.70 ± 1.94; Group B: 2.50 ± 2.98; Group C: 4.30 ± 3.40; p < 0.005). An observed improvement of Qmax and PVR in the three groups did not achieve statistical significance. Overall adverse event rates were higher in Group C but not significant compared with others.

CONCLUSION

In patients with LUTS and overactive bladder, combined therapy with alfuzosin 10 mg plus propiverine 20 mg was significantly more effective than alfuzosin monotherapy and propiverine 10 mg combined therapy in terms of improving OABSS while not significantly affecting Qmax or PVR.

The effects of ErhBMP-2-/EGCG-coated BCP bone substitute on dehiscence around dental implants in dogs

OBJECTIVES

The purpose was to evaluate the effect of Escherichia coli-derived recombinant human bone morphogenetic protein-2 (ErhBMP-2)-/epigallocatechin-3-gallate (EGCG)-coated biphasic calcium phosphate (BCP) and titanium barrier membrane on dehiscence defects in dogs.

MATERIALS AND METHODS

In five mongrel dogs, the dehiscence bony defects around dental implants were surgically created and in total three implants were placed at edentulous ridge of which teeth had been extracted 12 weeks before. For the control group, BCP was applied to the dehiscence defect. For experimental groups, ErhBMP-2-coated BCP and ErhBMP-2-/EGCG-coated BCP were applied. The newly designed titanium barrier membrane was used to apply all the defects. The defects were evaluated histologically and histometrically after 12 weeks. The comparative statistics of the groups were obtained through Kruskal-Wallis test.

RESULTS

In bone-to-implant contact (BIC), bone density (BD), bone regeneration height (BRH), and bone mineralization apposition rate (BMAR), differences among groups were not found. ErhBMP-2/EGCG group appeared to have higher value. In fluorescence analysis, bone remodeling around graft material was more active in the ErhBMP-2/EGCG group.

CONCLUSION

Within the limit of this study, it is reasonable to assume that BMP-2-/EGCG-coated biphasic BCP and the newly designed titanium membrane were more beneficial in dehiscence defect healing with increased bone remodeling.

High-throughput on-chip leukemia diagnosis

Advances in lab-on-a-chip technologies enabled programmable, reconfigurable, and scalable manipulation of a variety of laboratory procedures. Samples, reagents, and fluids can be precisely controlled; buffer temperature, pH, and concentration control systems as well as a variety of detection systems can be integrated on a small chip. These advantages have attracted attention in various fields of clinical application including leukemia diagnosis and research. A lot of research on lab-on-a-chip based diagnosis has been reported and the field is rapidly expanding. This review describes recent developments of lab-on-a-chip technologies as solutions to challenges for high-throughput leukemia diagnosis.

Efficacy of vasectomy reversal according to patency for the surgical treatment of postvasectomy pain syndrome

This study was conducted to assess outcomes (according to patency) of vasectomy reversal (VR) in qualified patients with postvasectomy pain syndrome (PVPS). A total of 32 patients with PVPS undergoing VR between January 2000 and May 2010 were examined retrospectively. Of these, 68.8% (22/32) completed a study questionnaire, either onsite at the outpatient clinic or via telephone interview. Preoperative clinical findings, preoperative and postoperative visual analogue scale (VAS) pain scores, patency and pregnancy rate and overall patient satisfaction were analyzed. For the latter, a four-point rating of (1) cure, (2) improvement, (3) no change or (4) recurrence was used. The mean age was 45.09±4.42 years and the mean period of follow-up was 3.22 years (0.74-7.41). Patency rates were 68.2% (15/22) and pregnancy rates were 36.4% (8/22). The mean VAS was 6.64±1.00 preoperatively and 1.14±0.71 postoperatively (P<0.001). The difference in the mean preoperative and postoperative VAS was 6.00±1.25 (4-8) in the patency group and 4.43±0.98 (3-6) in the no patency group (P=0.011). A significant difference in procedural satisfaction with surgical outcome was observed between patency and no patency groups (P=0.014). In conclusion, in PVPS patients requiring VR, a significant difference was observed between the patency and no patency groups in terms of pain reduction and the degree of patient procedural satisfaction.

Biodegradability and biodegradation rate of poly(caprolactone)-starch blend and poly(butylene succinate) biodegradable polymer under aerobic and anaerobic environment

The biodegradability and the biodegradation rate of two kinds biodegradable polymers; poly(caprolactone) (PCL)-starch blend and poly(butylene succinate) (PBS), were investigated under both aerobic and anaerobic conditions. PCL-starch blend was easily degraded, with 88% biodegradability in 44 days under aerobic conditions, and showed a biodegradation rate of 0.07 day(-1), whereas the biodegradability of PBS was only 31% in 80 days under the same conditions, with a biodegradation rate of 0.01 day(-1). Anaerobic bacteria degraded well PCL-starch blend (i.e., 83% biodegradability for 139 days); however, its biodegradation rate was relatively slow (6.1 mL CH(4)/g-VS day) compared to that of cellulose (13.5 mL CH(4)/g-VS day), which was used as a reference material. The PBS was barely degraded under anaerobic conditions, with only 2% biodegradability in 100 days. These results were consistent with the visual changes and FE-SEM images of the two biodegradable polymers after the landfill burial test, showing that only PCL-starch blend had various sized pinholes on the surface due to attack by microorganisms. This result may be use in deciding suitable final disposal approaches of different types of biodegradable polymers in the future.

Microbial reduction of uranium under iron- and sulfate-reducing conditions: Effect of amended goethite on microbial community composition and dynamics

There is a growing need for a better understanding of the biogeochemical dynamics involved in microbial U(VI) reduction due to an increasing interest in using biostimulation via electron donor addition as a means to remediate uranium contaminated sites. U(VI) reduction has been observed to be maximized during iron-reducing conditions and to decrease upon commencement of sulfate-reducing conditions. There are many unknowns regarding the impact of iron/sulfate biogeochemistry on U(VI) reduction. This includes Fe(III) availability as well as the microbial community changes, including the activity of iron-reducers during the uranium biostimulation period even after sulfate reduction becomes dominant. Column experiments were conducted with Old Rifle site sediments containing Fe-oxides, Fe-clays, and sulfate rich groundwater. Half of the columns had sediment that was augmented with small amounts of Fe(III) in the form of (57)Fe-goethite, allowing for a detailed tracking of minute changes of this added phase to study the effects of increased Fe(III) levels on the overall biostimulation dynamics. Mössbauer spectroscopy showed that the added (57)Fe-goethite was bioreduced only during the first thirty days of biostimultuion, after which it remained constant. Augmentation with Fe(III) had a significant effect on the total flux of electrons towards different electron acceptors; it suppressed the degree of sulfate reduction, had no significant impact on Geobacter-type bacterial numbers but decreased the bacterial numbers of sulfate reducers and affected the overall microbial community composition. The addition of Fe(III) had no noticeable effect on the total uranium reduction.

A multicenter phase II study of belotecan, new camptothecin analogue, in patients with previously untreated extensive stage disease small cell lung cancer

Belotecan (Camtobell, CKD602) is a new camptothecin derivative antitumor agent that belongs to the topoisomerase inhibitors. The aim of this phase II study was to evaluate the efficacy and safety of single agent belotecan in patients with small cell lung cancer (SCLC). Patients with previously untreated extensive stage disease (ED) SCLC were entered into the study. Belotecan was given by daily intravenous infusion at 0.5mg/m(2)/day for 5 consecutive days, every 3 weeks. 62 patients were enrolled in this study. The overall response rate to chemotherapy on an intention-to-treat basis was 53.2%. The median overall survival was 10.4 months, the median time to progression 4.6 months, and the 1-year survival rate 49.9%. The most common toxicity was hematologic. Grade 3/4 neutropenia occurred in 71.0% of patients and grade 3/4 thrombocytopenia 12.9%. Non-hematologic toxicity of grade 3 or 4 was low. The results suggest that belotecan is relatively active and well tolerable as single agent in patients with ED SCLC. Further investigations with platinum or other active agents are needed.

Biogenic U(IV) oxidation by dissolved oxygen and nitrate in sediment after prolonged U(VI)/Fe(III)/SO(4)(2-) reduction

Sediment column experiments were performed to quantify the effect of biogenic iron sulfide precipitates on the stability of bioreduced uranium during and after a simulated bioremediation scenario. In particular, this study examined the effect of different oxidants (dissolved oxygen and nitrate) on biogenic U(IV) oxidation in sediment that experienced significant sulfate reduction in addition to Fe(III) and U(VI) reduction. The experimental set-up included five replicate columns (each 5 cm in diameter, 15 cm long and packed with background sediment from a site contaminated with uranium) that were bioreduced for 70 days by injecting a nutrient media containing 3 mM acetate and 6 mM sulfate prior to oxidation. Upon oxidation, iron sulfide precipitates formed during bioreduction acted as a buffer to partially prevent biogenic U(IV) oxidation. The iron sulfides were more effective at protecting biogenic U(IV) from oxidation when dissolved oxygen was the oxidant compared to nitrate. A constant supply of 0.25 mM and 1.6 mM nitrate over a 50 day period resulted in uranium resolubilization of 11% and 60%, respectively, while less than 1% of the uranium was resolubilized in the column supplied 0.27 mM dissolved oxygen during the same time period. Over time, oxidation increased pore water channeling, which was more pronounced during oxidation with nitrate. Increased channeling with time of oxidation could affect the transport of an oxidant through the previously reduced zone, and hence the oxidation dynamics of the reduced species.

Use of transferable Nicotiana tabacum L. microsatellite markers for investigating genetic diversity in the genus Nicotiana

The recent development of microsatellite markers for tobacco, Nicotiana tabacum L., may be valuable for genetic studies within the genus Nicotiana. The first objective was to evaluate transferability of 100 N. tabacum microsatellite primer combinations to 5 diploid species closely related to tobacco. The number of primer combinations that amplified scorable bands in these species ranged from 42 to 56. Additional objectives were to assess levels of genetic diversity amongst available accessions of diploid relatives closely related to tobacco (species of sections Sylvestres and Tomentosae), and to evaluate the efficacy of microsatellite markers for establishing species relationships in comparison with existing phylogenetic reconstructions. A subset of 46 primer combinations was therefore used to genotype 3 synthetic tobaccos and an expanded collection of 51 Nicotiana accessions representing 15 species. The average genetic similarity for 7 diverse accessions of tobacco was greater than the average similarity for N. otophora accessions, but lower than the average genetic similarities for N. sylvestris, N. tomentosa, N. kawakamii, and N. tomentosiformis accessions. A microsatellite-based phylogenetic tree was largely congruent with taxonomic representations based on morphological, cytological, and molecular observations. Results will be useful for selection of parents for creation of diploid mapping populations and for germplasm introgression activities.

Effect of fudosteine on mucin production

Fudosteine is a novel mucoactive agent, although little is known about how fudosteine decreases mucin production. The present study examined the effects of fudosteine on MUC5AC mucin synthesis and cellular signalling. An animal model of lipopolysaccharide (LPS)-induced inflammation and a bronchial epithelial cell line model of tumour necrosis factor (TNF)-alpha-induced inflammation were used. Fudosteine was administered before stimulation with LPS or TNF-alpha. The MUC5AC mucin levels were assayed and the expression of the MUC5AC gene was measured. Western blotting was carried out for the detection of phosphorylated epidermal growth factor receptor (p-EGFR), phosphorylated p38 mitogen-activated protein kinase (p-p38 MAPK) and phosphorylated extracellular signal-related kinase (p-ERK). MUC5AC mucin synthesis and the expression of the MUC5AC gene were increased by LPS in rats or TNF-alpha in NCI-H292 cells; these effects were inhibited by fudosteine treatment. After stimulation with LPS or TNF-alpha, the expression of p-EGFR, p-p38 MAPK and p-ERK were detected. Fudosteine treatment reduced the expression levels of p-p38 MAPK and p-ERK in vivo and of p-ERK in vitro. The present results suggest fudosteine inhibits MUC5AC mucin hypersecretion by reducing MUC5AC gene expression and the effects of fudosteine are associated with the inhibition of extracellular signal-related kinase and p38 mitogen-activated protein kinase in vivo and extracellular signal-related kinase in vitro.

Regulation of adipocyte differentiation by PEGylated all-trans retinoic acid: reduced cytotoxicity and attenuated lipid accumulation

Obesity is major risk factor for many disorders, including diabetes, hypertension and heart disease. Unfortunately, there is a dearth of therapeutic agents available to clinicians for the treatment of obesity. The principal aim of this study was to investigate whether PEGylated all-trans retinoic acid (PRA) can have favorable stability and biological activity in 3T3-L1 preadipocytes as an antiobesity drug. Here, we found that PRA inhibits the process of adipogenesis, including survival of adipocytes and differentiation to mature adipocytes. The results showed that RA nanoparticles (NPs) were prepared by PEGylation; below 200 nm, PRA-NPs were obtained. Moreover, PRA decreased glycerol-3-phosphate dehydrogenase activity in 3T3-L1 preadipocytes by acting with major adipocyte marker proteins such as PPARgamma2, C/EBPalpha and aP2 modulators. Apoptosis, in addition, increased as the level of RA increased from 10 to 20 microM, whereas PRA reduced apoptosis with increasing concentrations. Our data suggest that PRA-NP has potential as an antiobesity drug carrier due to its small particle size and PEGylated core-shell structure. In addition, our results suggest that PRA inhibits the process of adipogenesis and may be developed to treat obesity. Based on these results, PRA is suitable for adipocyte studies, and an enhanced effect of PRA with adipocyte differentiation offers a challenging approach for pharmaceutical applications.

Coherent multi-frequency optical source generation using a femto-second laser and its application for coherent population trapping

We present a coherent multi-frequency source generated from a mode-locked femto-second laser. The key concept for the coherent multi-frequency source generation is using the mode-locked femto-second laser as many continuous wave (CW) optical sources. We simultaneously selected and amplified the desired modes of the optical frequency comb using femto-second laser injection-locking (FSLIL). Using two coherent sources generated by the mode-locked femto-second laser, we have demonstrated a coherent spectroscopy in a Lambda-type system of the Cs D2 line. The proposed coherent multi-frequency source generation technique will be a useful technique for optical frequency standards based on multi-photon schemes.

Speed improvement of a pathogenic micro-organism population detection with LAPS system by a magnetic bead separation and a pH detection

In this paper, a magnetic bead based immobilization method and pH detection method is applied to the LAPS (light addressable potentiometric sensor) system to detect a pathogenic micro-organism population. Magnetic beads are very small, superparamagnetic particles (0.8 approximately 5.0 microm in diameter) that are able to sustain a magnetic domain under excitation and do not exhibit residual magnetization when the external field is removed. By using magnetic beads as an immobilization method, other bulky and complex method can be alternated. To verify the method, an urease labeled anti-salmonella typhimurium antibody is used to detect a pathogenic micro-organism( S. typhimurium ) population by a bias voltage maximum slope detection.

Sweep optical frequency synthesizer with a distributed-Bragg-reflector laser injection locked by a single component of an optical frequency comb

A sweep optical frequency synthesizer is demonstrated by using a frequency-stabilized optical frequency comb and injection-locked distributed-Bragg-reflector (DBR) laser diode. The injection-locked DBR laser acts as a single-frequency filter and, simultaneously, a high-gain amplifier of the optical frequency comb. The frequency instability of the heterodyne beat signal between two independently injection-locked DBR lasers is measured to be 2.3 x 10(-16) at 1 s averaging time. The output frequency of the sweep optical frequency synthesizer can be precisely tuned over 1 GHz, and a saturated absorption spectrum of the Cs D2 line at 852 nm is recorded by the injected DBR laser.

Down-regulation of PPARgamma2-induced adipogenesis by PEGylated conjugated linoleic acid as the pro-drug: Attenuation of lipid accumulation and reduction of apoptosis

This study is designed to evaluate whether the PEGylated conjugated linoleic acid (PCLA) as the pro-drug can have favorable stability, bioavailability, and anti-adipogenic activity in 3T3-L1 cells for anti-obesity when compared with conjugated linoleic acid (CLA) itself. The CLA was simply coupled to poly(ethylene glycol) (PEG) at the melting state without solvents or catalysts through ester linkages between the carboxylic group of CLA and the hydroxyl group of PEG. To confirm of PCLA as the pro-drug, CLA release from PCLA was investigated by using high-performance liquid chromatographic (HPLC), showing that CLA release from PCLA was almost 90% in a nearly continuous fashion over the next 75h. Apoptosis was promoted by both CLA- and PCLA-treatments with increasing concentrations. However, the level of cell apoptosis induced by PCLA was lower than that induced by CLA owing to the biocompatible and hydrophilic properties of PEG. Moreover, the PCLA decreased glycerol-3-phosphate dehydrogenase (GPDH) activity in 3T3-L1 cells by acting upon major adipocyte marker proteins such as PPARgamma2, C/EBPalpha, and aP2 modulators. Furthermore, either CLA or PCLA stimulated basal, but not isoproterenol-sensitive, lipolysis in our cell model, suggesting that both CLA and PCLA may stimulate lipolysis via hormone sensitive lipase (HSL)-independent mechanisms. These results suggest that the PCLA may prove to be a stable pro-drug to control the deposition of fat in the human body, and that the anti-adipogenic effect of the PCLA on 3T3-L1 cells will offer a challenging approach for anti-obesity.

Determination of biodegradation potential by two culture-independent methods in PAH-contaminated soils

Biodegradation potentials of polycyclic aromatic hydrocarbons (PAHs) were determined with soil samples collected from various depths of a PAH-contaminated site and of a site nearby where PAHs were not found. Putative dioxygenase genes were amplified by a primer set specific for initial dioxygenases and identified by web-based database homology search. They were further categorized into several groups of which four dioxygenases were selected as probes for DNA hybridization. The hybridization signals according to the presence of putative dioxygenases were positively related to the extent of PAH contamination. However, the signal intensities varied depending on the probes hybridized and moreover were not consistent with PAH biodegradation activities determined by CO2 evolution. Despite widely accepted advantages of molecular biodegradation assessment, our data clearly present the variations of assessment results depending on the genetic information used and suggest that the methodology may tend to underestimate the real biodegradation capacity of a site probably due to the limited dioxygenase database available at the moment. Therefore, the molecular assessment of biodegradation potential should involve a very careful primer and probe design and an extensive microbiological examination of a site of interest to accurately delineate the biodegradation potential of the site.

Dendriform pulmonary ossification in patient with rare earth pneumoconiosis

The case history is presented of a patient with pathologically proven dendriform pulmonary ossification and rare earth pneumoconiosis confirmed by analytical transmission electron microscopy. This is thought to be the first report of this association.

Growth, productivity, and competitiveness of introgressed weedy Brassica rapa hybrids selected for the presence of Bt cry1Ac and gfp transgenes

Concerns exist that transgenic crop x weed hybrid populations will be more vigorous and competitive with crops compared with the parental weed species. Hydroponic, glasshouse, and field experiments were performed to evaluate the effects of introgression of Bacillus thuringiensis (Bt) cry1Ac and green fluorescent protein (GFP) transgenes on hybrid productivity and competitiveness in four experimental Brassica rapa x transgenic Brassica napus hybrid generations (F1, BC1F1, BC2F1 and BC2F2). The average vegetative growth and nitrogen (N) use efficiency of transgenic hybrid generations grown under high N hydroponic conditions were lower than that of the weed parent (Brassica rapa, AA, 2n = 20), but similar to the transgenic crop parent, oilseed rape (Brassica napus, AACC, 2n = 38). No generational differences were detected under low N conditions. In two noncompetitive glasshouse experiments, both transgenic and nontransgenic BC2F2 hybrids had on average less vegetative growth and seed production than B. rapa. In two high intraspecific competition field experiments with varied herbivore pressure, BC2F2 hybrids produced less vegetative dry weight than B. rapa. The competitive ability of transgenic and nontransgenic BC2F2 hybrids against a neighbouring crop species were quantified in competition experiments that assayed wheat (Triticum aestivum) yield reductions under agronomic field conditions. The hybrids were the least competitive with wheat compared with parental Brassica competitors, although differences between transgenic and nontransgenic hybrids varied with location. Hybridization, with or without transgene introgression, resulted in less productive and competitive populations.

Rapid in vitro adventitious shoot propagation of Scopolia parviflora through rhizome cultures for enhanced production of tropane alkaloids

A rapid micropropagation system for Scopolia parviflora Nakai (Solanaceae), a rare medicinal plant native to Korea, was established using rhizome cultures. Shoots that originated from adventitious shoots of the rhizome were multiplied when the rhizomes were cultured on half-strength B5 liquid medium supplemented with various growth regulators. Optimum shoot multiplication was observed in half-strength B5 medium containing 3% (w/v) sucrose and 5.77 microM gibberellic acid (GA(3)). Each rhizome gave rise to an average of 12 shoots. Shoot elongation and root induction from multiple shoots occurred on growth regulator-free half-strength B5 solid medium. Healthy plantlets were transferred to a peat moss:vermiculite mixture for acclimatization, which was successful. The concentrations of tropane alkaloids, hyoscyamine and scopolamine were determined in different tissues of native growing plants, in vitro-propagated plants and acclimatized plants by high-performance liquid chromatography. The analysis revealed that the levels of hyoscyamine and scopolamine were higher in in vitro-propagated plants than in the native growing plants. When the rhizome was cut into segments and transferred to optimal culture conditions for multiple shoot propagation, only 12 weeks were required to produce a mature plant. We conclude that in vitro propagation techniques through rhizome cultures provide an efficient and rapid method for shoot propagation of S. parviflora.

Use of autotrophic sulfur-oxidizers to remove nitrate from bank filtrate in a permeable reactive barrier system

This study was conducted to evaluate the potential applicability of an in situ biological reactive barrier system to treat nitrate-contaminated bank filtrate. The reactive barrier consisted of sulfur granules as an electron donor and autotrophic sulfur-oxidizing bacteria as a biological component. Limestone was also used to provide alkalinity. The results showed that the autotrophic sulfur oxidizers were successfully colonized on the surfaces of the sulfur particles and removed nitrate from synthetic bank filtrate. The sulfur-oxidizing activity continuously increased with time and then was maintained or slightly decreased after five days of column operation. Maximum nitrate removal efficiency and sulfur oxidation rate were observed at near neutral pH. Over 90% of the initial nitrate dissolved in synthetic bank filtrate was removed in all columns tested with some nitrite accumulation. However, nitrite accumulation was observed mainly during the initial operation period, and the concentration markedly diminished with time. The nitrite concentration in effluent was less than 2 mg-N/l after 12 days of column operation. When influent nitrate concentrations were 30, 40, and 60 mg-N/l and sulfur content in column was 75%, half-order autotrophic denitrification reaction rate constants were 31.73 x 10(-3), 33.3 x 10(-3), and 36.4 x 10(-3) mg(1/2)/l(1/2)min, respectively. Our data on the nitrate distribution profile along the column suggest that an appropriate wall thickness of a reactive barrier for autotrophic denitrification may be 30 cm when influent nitrate concentration is less than 60 mg-N/l.