OD Groups Research Articles

Tensions between end-of-life care and organ donation in controlled donation after circulatory death: ICU healthcare professionals experiences

BackgroundThe development of controlled donation after circulatory death (cDCD) is both important and challenging. The tension between end-of-life care and organ donation raises significant ethical issues for healthcare professionals in the intensive care unit (ICU). The aim of this prospective, multicenter, observational study is to better understand ICU physicians’ and nurses’ experiences with cDCD.MethodsIn 32 ICUs in France, ICU physicians and nurses were invited to complete a questionnaire after the death of end-of-life ICU patients identified as potential cDCD donors who had either experienced the withdrawal of life-sustaining therapies alone or with planned organ donation (OD(-) and OD( +) groups). The primary objective was to assess their anxiety (State Anxiety Inventory STAI Y-A) following the death of a potential cDCD donor. Secondary objectives were to explore potential tensions experienced between end-of-life care and organ donation.ResultsTwo hundred six ICU healthcare professionals (79 physicians and 127 nurses) were included in the course of 79 potential cDCD donor situations. STAI Y-A did not differ between the OD(-) and OD( +) groups for either physicians or nurses (STAI Y-A were 34 (27–38) in OD(-) vs. 32 (27–40) in OD( +), p = 0.911, for physicians and 32 (25–37) in OD(-) vs. 39 (26–37) in OD( +), p = 0.875, for nurses). The possibility of organ donation was a factor influencing the WLST decision for nurses only, and a factor influencing the WLST implementation for both nurses and physicians. cDCD experience is perceived positively by ICU healthcare professionals overall.ConclusionscDCD does not increase anxiety in ICU healthcare professionals compared to other situations of WLST. WLST and cDCD procedures could further be improved by supporting professionals in making their intentions clear between end-of-life support and the success of organ donation, and when needed, by enhancing communication between ICU physician and nurses.Trial registrationThis research was registered in ClinicalTrials.gov (Identifier: NCT05041023, September 10, 2021).

Intravenous calcitriol administration improves the liver redox status and attenuates ferroptosis in mice with high-fat diet-induced obesity complicated with sepsis

Obesity aggravates ferroptosis, and vitamin D (VD) may inhibit ferroptosis. We hypothesized that weight reduction and/or calcitriol administration have benefits against the sepsis-induced liver redox imbalance and ferroptosis in obese mice. Mice were fed a high-fat diet for 11 weeks, then half of the mice continued to consume the diet, while the other half were transferred to a low-energy diet for 5 weeks. After feeding the respective diets for 16 weeks, sepsis was induced by cecal ligation and puncture (CLP). Septic mice were divided into four experimental groups: OS group, obese mice injected with saline; OD group, obese mice with calcitriol; WS group, weight-reduction mice with saline; and WD group, weight-reduction mice with calcitriol. Mice in the respective groups were euthanized at 12 or 24 h after CLP. Results showed that the OS group had the highest inflammatory mediators and lipid peroxide levels in the liver. Calcitriol treatment reduced iron content, enhanced the reduced glutathione/oxidized glutathione ratio, upregulated nuclear factor erythroid 2-related factor 2, ferroptosis-suppressing protein 1, and solute carrier family 7 member 11 expression levels. Also, mitochondrion-associated nicotinamide adenine dinucleotide phosphate oxidase 1, peroxisome proliferator-activated receptor-γ coactivator 1, hypoxia-inducible factor-1α, and heme oxidase-1 expression levels increased in the late phase of sepsis. These results were not noted in the WS group. These findings suggest that calcitriol treatment elicits a more-balanced glutathione redox status, alleviates liver ferroptosis, and enhances mitochondrial biogenesis-associated gene expressions. Weight reduction alone had minimal influences on liver ferroptosis and mitochondrial biogenesis in obese mice with sepsis.

The safety and feasibility of same-day discharge after subcutaneous implantable cardioverter defibrillator implantation

Abstract Introduction Subcutaneous Implantable cardioverter defibrillators (S-ICDs) are now progressively administered as a day-case procedure. While existing data supports the feasibility and safety of same-day discharge after transvenous ICD implantation, comparable evidence for S-ICDs is not well established. This study addresses this by presenting data from the most extensive population documented in the medical literature. We seek to evaluate the feasibility and safety of same-day discharge after S-ICD implantation. Purpose To investigate the feasibility and safety of same-day discharge following S-ICD implantation. Methods A retrospective analysis was conducted, encompassing data from all patients who underwent S-ICD implantation at our institution between January 2011 to April 2023 (n=240). The cohort was stratified into two groups: those discharged on the same day of the procedure (SD, n=124) and those subject to at least overnight hospital observation (OD, n=116). The medical records were reviewed during this period aiming to identify potential complications. Complications were categorized as device-related complications or inappropriate shock. Specific events, such as inappropriate shocks; lead revision; infection necessitating lead or generator extraction; pocket hematoma requiring drainage, blood transfusion, or prolongation of hospitalization; and other complications related to the lead or generator prompting medical or surgical intervention were documented. An inappropriate shock was defined as one delivered for any rhythm other than ventricular fibrillation or ventricular tachycardia. Results Among the 240 patients included in the study, 123 were scheduled for a day case procedure, while the remaining 117 underwent S-ICD implantation as in-patients. Notably, 112(91%) out of 123 planned-day patients and 12 in-patients (SD, total n=124) were successfully discharged on the same day. A substantial proportion (84%) of SD group had undergone the procedure for primary prevention. Patients with congenital heart disease were predominantly observed overnight. Defibrillation testing (DFT) is routine in our practice to ensure S-ICD integrity and was conducted in all S-ICD patients unless contraindicated. The success rate of DFT among attempted patients was high, standing at 72% and 78% in the SD and OD groups, respectively. The incidence of device-related complications was comparable between the two groups. The SD group displayed a slightly higher superficial infection rate but the incidence of inappropriate shocks was lower in the SD groups. Conclusion Based on our findings, same-day discharge following S-ICD implantation emerges as an appropriate practice. Our data strongly supports the assertion that same-day discharge in this context is safe and feasible, offering valuable insights into the optimal post-procedural management of S-ICD patients.Table 1ComplicationsTable 2Defibrillation Test

Immunohistochemical and histopathological analyses of cutaneous innervation to improve the diagnostic efficacy in hansen disease skin lesion

Abstract Background The diagnosis of Hansen disease (HD) can be difficult when acid-fast bacilli are not detected in the patient's skin sample. Objective To demonstrate that detailed morphological analysis of nonspecific inflammatory and/or noninflammatory alterations in dermal nerves as well as skin adnexa in leprosy-suspected biopsy samples could improve the efficacy of histopathological diagnosis. Methods Patients with one to five skin lesions were enrolled in the study and classified into three groups by skin histopathology findings: Hansen disease (HD, n = 13), other diseases (OD, n = 11), and inconclusive cases (INC, n = 11). We quantified dermal nerve damage via the nerve lesion index (NLI) and PGP9.5-immunoreactive axon quantitative index in dermal nerves (AQI). We also measured inflammatory involvement of adnexa in cutaneous samples as indirect evidence of HD. Results We observed a higher median endoneurial inflammatory infiltrate NLI (HD = 0.5; INC = 0; OD = 0; p < 0.001) and more frequent inflammatory involvement of skin adnexa in samples of the HD group compared with those of the INC and OD groups (HD = 7; INC = 1; OD = 0). However, samples from the INC and OD groups also showed inflammatory and noninflammatory damage of dermal nerves, with 2 or more kinds of alterations in nerves in the same sample (respectively: INC = in 1 and 2 samples; OD = in 3 and 5 respectively). The quantification of PGP9.5-immunoreactive axons in dermal nerves revealed no difference between the groups. Conclusion A detailed morphological analysis of cutaneous nerves in lesions with a suspicion of HD enabled us to select patients with nonspecific inflammatory or non-inflammatory lesions in the dermal nerves in the INC and OD groups, so they may be clinically monitored aiming at a possible future diagnosis of the disease. These INC and OD patients cannot have the HD diagnosis definitely excluded, and HD may coexist with another disease as a comorbidity.

Pregnancy outcomes in women with primary ovarian insufficiency in assisted reproductive technology therapy: a retrospective study.

This study aims to retrospectively estimate cumulative reproductive outcomes in women with primary ovarian insufficiency (POI) in assisted reproductive technology (ART) therapy. A total of 139 patients diagnosed with POI were reviewed in this study. Firstly, they were divided into two groups according to oocyte origin: using their own oocytes (OG group) or accepting oocyte donations (OD I group). Secondly, the patients were split depending on the pregnancy outcome. In the OG group, nine patients decided to use others' oocytes after a failure of attempting to use their own, and this population was the oocyte donation II group (OD II group). There were 88 patients who used their own oocytes, while 51 patients accepted oocyte donations. In the OG group, there are only 10 (7.2%) patients who got pregnant, and patients in the OD group had worse hormone levels (FSH 71.37 ± 4.18 vs. 43.98 ± 2.53, AMH 0.06 ± 0.04 vs. 1.15 ± 0.15, and AFC 0.10 ± 0.06 vs. 1.15 ± 0.15) and more years of infertility (5.04 ± 0.48 vs. 3.82 ± 0.30), which explained why they choose oocyte donation. In all the three groups, baseline characteristics were comparable between pregnant women and non-pregnant women. Of the 10 pregnant patients in the OG group, four of them used luteal-phase short-acting long protocol and had pregnancies successfully in their first cycles. Ovarian stimulation in POI women requires more cost and time. For those with a stronger desire to have genetic offspring, luteal-phase short-acting long protocol may help them obtain pregnancy rapidly.

Maxillary Sinus Floor Elevation and Simultaneous Implant Installation via Osseodensification Drills: A Retrospective Analysis of Bone Gain in 72 Patients Followed for 6 Months.

Background/Objectives: The aim of this retrospective study was to radiographically evaluate the endo-sinus bone gain (ESBG) following osseodensification procedures using CBCT and compare the results to more conventional sinus lifting techniques. Methods: A total of 72 patients underwent crestal sinus floor elevation procedures and were provided with 102 implants with a sand-blasted and acid-etched surface with microthreads (Medentika® Microcone Implants, Hugelsheim, Germany). Patients were divided into two groups; the osseodensification group (OD; n = 36) and the osseodensified augmentation group (ODA; n = 36). Results: The mean residual bone height (RBH) was 5.71 (1.77) and 4.30 (0.94) mm in the OD and ODA groups, respectively. An ESBG of 3.45 (1.18) and 5.74 (1.31) mm was observed in the OD and ODA groups, respectively, and as compared to the baseline RBH, the ESBG was statistically significant in both groups after 6 months (p < 0.001). Conclusions: Within the limits of this retrospective study, crestal sinus lifting with the osseodensification technique seems to be a fast, effective, and safe method. Longer follow-up studies with full intrasinus bone topography and structure analyses are needed to prove the success rate of endo-sinus bone gain.

Effect of Tempeh and Daidzein on Calcium Status, Calcium Transporters, and Bone Metabolism Biomarkers in Ovariectomized Rats.

Menopause marks a critical life stage characterized by hormonal changes that significantly impact bone health, leading to a heightened susceptibility to bone fractures. This research seeks to elucidate the impact of daidzein and tempeh on calcium status, calcium transporters, and bone metabolism in an ovariectomized rat model. Forty female Wistar rats, aged 3 months, participated in a two-phase experiment. The initial phase involved inducing a calcium deficit, while the second phase comprised dietary interventions across five groups: Sham (S) and Ovariectomy (O) with a standard diet, O with bisphosphonate (OB), O with pure daidzein (OD), and O with tempeh (OT). Multiple parameters, encompassing calcium levels, calcium transporters, bone histopathology, and serum bone metabolism markers, were evaluated. The findings revealed that the OT group showcased heightened levels of bone turnover markers, such as pyridinoline, C-telopeptide of type I collagen, bone alkaline phosphatase, and procollagen type I N-terminal propeptide, in contrast to S and O groups, with statistical significance (p < 0.05). Histopathologically, both the OD and OT groups exhibited effects akin to the OB group, indicating a decrease in the surface area occupied by adipocytes in the femoral bone structure, although statistically non-equivalent, supporting the directionally similar trends. Although TRPV5 and TRPV6 mRNA expression levels in the jejunum and duodenum did not display statistically significant differences (p > 0.05), the OD and OT groups exhibited increased expression compared to the O group. We hypothesized that obtained results may be related to the effect of isoflavones on estrogen pathways because of their structurally similar to endogenous estrogen and weak estrogenic properties. In conclusion, the daily consumption of pure daidzein and tempeh could potentially improve and reinstate calcium status, calcium transport, and bone metabolism in ovariectomized rats. Additionally, isoflavone products demonstrate effects similar to bisphosphonate drugs on these parameters in ovariectomized rats.

Comparison of metabolic parameters between oral and total parenteral nutrition in children with severe eating disorders.

This study investigated changes of lipid parameters in children with severe eating disorders during refeeding in order to explore the optimal timing for lipid preparation administration. We prospectively assessed the physical conditions of patients with eating disorders after the start of nutrition therapy. The assessments were performed at admission and at 2 and 4 weeks. Lipid metabolism was assessed based on triglyceride (TG), total cholesterol (TC), and free carnitine (FC) levels, as well as acylcarnitine/free carnitine (AC/FC) ratio. A total of 18 patients were included. Of these, 12 and 6 received an oral diet (OD group) and total parenteral nutrition (TPN group), respectively. The mean body mass indexes at hospital admission were 12.8 kg/m2 in the OD group and 12.7 kg/m2 in the TPN group. At 2 weeks after the start of refeeding, TC, TG, and AC/FC levels were significantly lower in the TPN group than in the OD group. Other blood test results did not show any significant differences between the two groups. Fat-free glucose-based nutrition promoted lipid metabolism over a 2-week period after the start of refeeding, suggesting that balanced energy and lipid intake are essential, even in TPN.

Comparison of metabolic parameters between oral and total parenteral nutrition in children with severe eating disorders.

This study investigated changes of lipid parameters in children with severe eating disorders during refeeding in order to explore the optimal timing for lipid preparation administration. We prospectively assessed the physical conditions of patients with eating disorders after the start of nutrition therapy. The assessments were performed at admission and at 2 and 4 weeks. Lipid metabolism was assessed based on triglyceride (TG), total cholesterol (TC), and free carnitine (FC) levels, as well as acylcarnitine/free carnitine (AC/FC) ratio. A total of 18 patients were included. Of these, 12 and 6 received an oral diet (OD group) and total parenteral nutrition (TPN group), respectively. The mean body mass indexes at hospital admission were 12.8 kg/m2 in the OD group and 12.7 kg/m2 in the TPN group. At 2 weeks after the start of refeeding, TC, TG, and AC/FC levels were significantly lower in the TPN group than in the OD group. Other blood test results did not show any significant differences between the two groups. Fat-free glucose-based nutrition promoted lipid metabolism over a 2-week period after the start of refeeding, suggesting that balanced energy and lipid intake are essential, even in TPN.

Evaluation of water absorption and solubility of digitally and conventionally produced temporary fixed materials

Background/Aim: The study aims to evaluate water sorption and solubility of conventional and digitally produced temporary fixed materials. Material and Methods: A total of 40 disc-shaped specimens were prepared from two conventionally produced temporary fixed materials: bis-acrylic composite resin (Protemp 4-PT) and acrylic resin (Dentalon plus-DP) and two digitally produced [3D printing (MACK4D Temp-MT) and CAD/CAM milling (On Dent-OD)]. The prepared disks were dried in a desiccator until they reached a constant mass. They were then kept in distilled water at 37°C for 1 week and weighed. The weights of the specimens, which were again subjected to conditions similar the initial drying procedure, were measured. Water absorption and solubility values were calculated by formula. The data obtained were analyzed using 1-way analysis of variance (ANOVA) and the Tamhane or Tukey post hoc test (a=.05). Results: Water absorption values of the PT group (24.16±8.1 µg/mm 3) were statistically higher than all other groups (p= 0.001). However, there was no significant difference in the pairwise comparisons of OD, MT, and DP groups (p&gt;0.05). When the water solubility values were analyzed, DP group (0.49±2.01 µg/mm 3) showed no significant difference with the PT group (1.69±2.2 µg/mm 3) (p=0.402), while they were higher than OD (-3.96±0.84 µg/mm 3) and MT (-10.29±1.37 µg/ mm 3) groups. In addition, a significant difference was observed in the water solubility values of CAD/CAM-3D groups (p&lt;0.05). Conclusions: All of test groups were found to be within the values recommended by ISO standards. It can be inferred that the PT material may cause the most staining.

Ion Mobility in Hydroxy-Functionalized Ionic Liquids Depends on Cationic Clustering: Tracking the Alkyl Chain Length Behavior with Deuteron NMR Relaxation.

Observing and quantifying the like-charge attraction in liquids and solutions is still challenging. However, we showed that elusive cation-cation hydrogen bonding may govern the structure and interaction in hydroxyl-functionalized ionic liquids. Therefore, cationic cluster formation depends on the shape, charge distribution, and functionality of the ions. We demonstrated by means of solid-state 2H NMR spectroscopy that cationic clusters change the structure and dynamics of ionic liquids. With increasing alkyl chain length, we observed two deuteron quadrupole coupling constants for the OD groups, differing by about 30 kHz. The lower value was assigned to the cation-cation interaction, indicating that the average (c-c) hydrogen bonds are stronger than the (c-a) hydrogen bonds between the cation and the anion despite the repulsive and attractive Coulomb interaction in the first and latter cases. Ion mobility could be studied by 2H NMR spectroscopy, although the deuterons in the hydrogen-bonded clusters underwent fast exchange. Our results also showed that simple relaxation models are not applicable anymore and that anisotropic motion must be considered.

Outcomes of endoscopic papillectomy of ampullary carcinoma and factors affecting additional surgery.

Data on the prognosis of endoscopic papillectomy (EP) for ampullary carcinoma (AC) is limited; therefore, we aimed to identify the factors associated with endoscopically controlled AC. Between January 2003 and October 2022, 75 patients underwent EP for ampullary tumors and were diagnosed with AC based on the pathological features of the resected tissue. The factors associated with additional surgery after EP were also evaluated. A total of 67 patients had ACs ranging from carcinoma in situ to tumors limited to the mucosa (M group), and eight patients had ACs ranging from those limited to the sphincter of Oddi to those invading the duodenal muscularis propria (OD group). The 3-year endoscopic tumor control (condition not requiring additional surgery) rates in the M and OD groups were 90.8% and 84.6% (p = .033), respectively. In the M group, the presence of tumor components in the resection margins was the only significant factor associated with additional surgeries (p = .010) in the univariate analysis. The 3-year endoscopic tumor control rates were 100% for negative and uncertain resection margins and 76.6% for positive margins (p = .009). If the AC is confined to the mucosa and the resection margins are negative or uncertain, the tumor can be well-controlled endoscopically.

Hippocampal volume loss in individuals with a history of non-fatal opioid overdose.

Incidence of opioid-related overdoses in the United States has increased dramatically over the past two decades. Despite public emphasis on overdose fatalities, most overdose cases are not fatal. Although there are case reports of amnestic syndromes and acute injury to the hippocampus following non-fatal opioid overdose, the effects of such overdoses on brain structure are poorly understood. Here, we investigated the neuroanatomical correlates of non-fatal opioid overdoses by comparing hippocampal volume in opioid use disorder (OUD) patients who had experienced an opioid overdose (OD; N= 17) with those who had not (NOD; N= 32). Voxel-based morphometry showed lower hippocampal volume in the OD group than in the NOD group, which on post hoc analysis was evident in the left but not the right hippocampus. These findings strengthen the evidence that hippocampal injury is associated with non-fatal opioid overdose, which is hypothesized to underlie overdose-related amnestic syndrome.

Efficacy and safety of latanoprost/timolol fixed combination dosed twice daily compared to once daily in patients with primary open angle glaucoma.

To evaluate whether latanoprost/timolol fixed combination (LTFC) dosed twice daily may provide further intraocular pressure (IOP) reduction and evaluate the safety profile at this dose. This is an open-labeled, randomized, prospective crossover study on fourty primary open angle glaucoma patients. Two weeks of washout period were followed by randomization to either once daily (OD, group A) or twice daily dosing (BD, group B) of LTFC for 4wk. After another 2-week washout period, the patients' treatment dose was crossed-over for another 4wk. IOP reduction alongside ocular and systemic side effects were evaluated. Mean baseline IOP was 18.57±2.93 and 17.8±3.01 mm Hg before OD and BD dose respectively, (P=0.27). Mean IOP after BD dose was statistically lower (12.49±1.59 mm Hg) compared to OD (13.48±1.81 mm Hg, P=0.017). Although IOP reduction after BD dose was more (5.32±3.24 mm Hg, 29.89%) than after OD dosing (5.04 mm Hg, 27.14%), it did not reach statistical significance (P=0.68). Patients switched from OD to BD (group A) showed mean IOP reduction by 0.69 mm Hg [95% confidence interval (CI): -0.09 to 1.48 mm Hg, P=0.078]; but patients switched from BD to OD (group B) had significantly higher mean IOP by 1.25 mm Hg (95%CI: -2.04 to -0.46 mm Hg, P=0.006). BD dose had more ocular side effects albeit mild. Mean IOP after LTFC dosed twice daily is statistically lower, with additional mild side effects.

New strategy for osseodensification during osteotomy in low-density bone: an in vitro experimental study

The goal of this in vitro study was to evaluate and propose a new strategy for osseodensification technique using a drill counterclockwise to densification of bone of low density. Synthetic bone blocks of two different low densities (type III and IV) were used for the tests. The conventional drilling group (CD group) used Turbo-drill in a clockwise direction, and the osseodensification group (OD group) applied Turbo-drill in a counterclockwise direction. The applied tests were: (i) measurement of the temperature variation (ΔT) and (ii) measurement of the torque during the osteotomies, comparing the new strategy with the conventional drilling. Both groups were tested without (condition c1) and with (condition c2) irrigation, generating four subgroups: CDc1, CDc2, ODc1, and ODc2. Twenty osteotomies were made for each subgroup with a thermocouple positioned intra-bone (1 mm distant from the osteotomy) to measure the temperature produced. Other 20 samples/group were used to measure the torque value during each osteotomy in both synthetic bone density blocks. The mean of the ΔT during the osteotomies in type III bone was: 6.8 ± 1.26 °C for the CDc1 group, 9.5 ± 1.84 °C for the ODc1, 1.5 ± 1.35 °C for the CDc2, and 4.5 ± 1.43 °C for ODc2. Whereas, in the type IV bone, the ΔT was: 5.2 ± 1.30 °C for the CDc1 group, 7.0 ± 1.99 °C for the ODc1, 0.9 ± 1.05 °C for the CDc2, and 2.7 ± 1.30 °C for ODc2. The maximum torque during the osteotomies was: 8.8 ± 0.97 Ncm for CD samples and 11.6 ± 1.08 Ncm for OD samples in the type III bone; and 5.9 ± 0.99 Ncm for CD samples and 9.6 ± 1.29 Ncm for OD samples in the type IV bone. Statistical differences between the groups were detected in tests and conditions analyzed (p < 0.05). Using the drill counterclockwise for osseodensification in low-density bone generated a significantly greater torque of a drill than in CD and temperature variation during osteotomies. However, the temperature range displayed by the OD group was below critical levels that can cause damage to bone tissue.

Hybrid Prosthesis versus Overdenture: Effect of BioHPP Prosthetic Design Rehabilitating Edentulous Mandible.

To compare the BioHPP (biocompatible high-performance polymer) as a substructure for the hybrid prosthesis versus the BioHPP bar supporting and retaining implant overdenture by radiographic evaluation to identify bone height alteration around the implants and to evaluate satisfaction based on visual analoge scale questionnaire. Ill-fitting mandibular dentures were chosen for 14 fully edentulous male patients with adequate dental hygiene, enough interarch space, and free of systemic diseases and parafunctional habits. Patients who received new dentures (CDs) were randomly allocated into each group using computer software, and four interforaminal implants were inserted in parallel using a surgical guide. Three months after osseointegration, the patients received either CAD-CAM BioHPP framework hybrid prosthesis (Group I) or BioHPP bar supported and retained overdenture (Group II). Using digital preapical radiography, the bone loss is evaluated 6, 12, and 18 months after insertion. The subjective patient evaluation was done using a questionnaire based on the VAS includes five points for chewing, comfort, esthetics, speech, oral hygiene, and general satisfaction. The overall marginal bone loss (MBL) revealed that Group I (hybrid prosthesis) was more than Group II (bar overdenture) at all intervals in the anterior and posterior implants' mesial and distal surfaces. The patient satisfaction survey results showed that, after 18 months, the difference was statistically not significant between them all (P > 0.05) except for the comfort (for the overdenture group, 4.43 ± 0.53 while the fixed hybrid was 5.00 ± 0.00). BioHPP framework material is an alternative material for implant rehabilitation of edentulous mandible with minimal MBL in BioHPP bar overdenture compared to BioHPP hybrid prosthesis.

Analysis of oxygen-based species introduced during plasma assisted reactive processing of a-IGZO films

Thermal desorption spectroscopy using stable isotopes of 18O2 and D2 was employed to investigate the incorporation and behavior of oxygen-based species in a-IGZO films during plasma assisted processing. Specifically, the behavior of oxygen introduced during deposition with an Ar-18O2 plasma was assessed. The data show that the oxygen amount incorporated in these films during deposition was greatly reduced by a post-deposition plasma treatment. The OD radicals introduced into a-IGZO films deposited with Ar-16O2 during a post-treatment with an Ar + D2 + O2 mixture was also examined. The results indicate that −OD groups in the films were strongly bonded to the metal atoms.

Near-Infrared Spectroscopic Analysis─Formation of Ca(OH)2 and Ca(OD)2 by Hydration of CaO with H2O and D2O

The dehydration behavior of Ca(OH)2 was analyzed using near-infrared (NIR) and mid-infrared spectroscopy, with typical absorption bands attributed to the surface and interlayer hydroxyl groups of Ca(OH)2 being observed at 7260 and 7083 cm–1 in the NIR region, respectively. The dehydration reaction of Ca(OH)2 proceeded at approximately 470 °C, resulting in the disappearance of the interlayer hydroxyls of Ca(OH)2 and the formation of isolated hydroxyls of the CaO surface (7231 cm–1). The hydration behavior of CaO with H2O was also investigated using NIR spectroscopy, revealing that upon contact with H2O vapor at 50 °C [relative humidity (RH), 55%], CaO was immediately hydrated to form the interlayer hydroxyls of Ca(OH)2 after several minutes. Furthermore, since the difference between Ca(OH)2 and Ca(OD)2 could not be distinguished by X-ray diffraction measurements, the hydration behavior of CaO upon exposure to D2O vapor at room temperature was examined using NIR spectroscopy. This revealed the NIR absorption bands at 5357 and 5259 cm–1, corresponding to the surface and interlayer OD groups of Ca(OD)2, respectively. However, it should be noted that since the dehydration of Ca(OH)2 and the hydration of CaO were evaluated under atmospheric conditions, the formation of CaCO3 due to CO2 adsorption on the CaO surface could not be disregarded.

Transcanal Excision of Exostoses: Large Series Comparing Bone Removal Methods.

External auditory exostosis (EAE) is a condition of progressive temporal bone growth into the external auditory canal most commonly from repeat cold water and wind exposure. Several tools have been utilized for EAE excision with varying implications for intra- and postoperative complications. However, comparisons of osteotome and microdrill are made difficult due to the few published cases and intervariability between surgeons. Furthermore, evidence is needed to analyze the safety of novel supplemental tools such as the piezoelectric bone-cutting device. Retrospective chart review. Medical clinic and surgery center. A total of 413 subjects representing 472 earsmet the inclusion criteria. Of which 159 ears were operated on using osteotome alone (OA), 271 using osteotome with a drill (OD), and 42 with osteotome with piezoelectric (OP). Charts were analyzed for the most reported intraoperative complications and postoperative symptoms and complications. There were no significant differences in the rate of tympanic membrane perforations nor in total intraoperative complications between OA, OD, or OP. The OD group contained the only nonperforation intraoperative event. OA had the lowest or near lowest incidence of all symptoms analyzed. OA showed a significantly lower incidence of tinnitus when compared to OD and OP. We found that OA performed the best, though not statistically significant in most measures, with regard to mitigating rates of complications postsurgery. Our findings suggest OA provides lower risk intraoperatively and postoperatively for patients undergoing transcanal exostosis excision.

Radiological Features of Atlas Occipitalization and Its Clinical Implications.

Retrospective radiographic analysis. Evaluation of the anatomical features of the craniovertebral junction in patients with occipitalization with and without atlantoaxial dislocation (AAD). Atlas occipitalization is a common feature of congenital AAD and usually requires surgical intervention. However, not all instances of occipitalization necessarily lead to AAD. No study has specifically examined and compared the craniovertebral bony morphology in occipitalization with, and without, AAD. We reviewed computed tomography (CT) scans of 2500 adult outpatients. Occipitalization cases without AAD (ON) were selected. Meanwhile, a series of 20 in-patient occipitalization cases with AAD (OD) were obtained in parallel. Another 20 control cases without occipitalization were also included. Multi-directional reconstructed CT images of all cases were analyzed. A total of 18 adults with ON were found in all 2500 outpatients (0.7%). Both anterior height (AH) and posterior height (PH) of C1 lateral mass (C1LM) in the control group were significantly larger than those in both the ON and OD groups, whereas PH in the OD group was significantly less than that in the ON group. Three morphological types of the occipitalized atlas posterior arch were identified: Type I, bilateral sides were unfused with opisthion; Type II, unilateral side was unfused with opisthion, while the other side was fused; and Type III, bilateral sides were fused with opisthion. In the ON group, 3 cases were type I (17%), 6 cases were type II (33%), and 9 cases were type III (50%). In the OD group, all 20 cases were type III (100%). Atlas occipitalization with, and without, AAD results from a distinctly different bony morphology at the craniovertebral junction. The novel classification system based on reconstructed CT images may be useful in prognosticating AAD in the setting of atlas occipitalization.