Residual Granules Research Articles

Xenograft Combined with a Mixture of Polynucleotides and Hyaluronic Acid (PNs-HA) for Horizontal Alveolar Bone Regeneration: Clinical and Histologic Assessments in a Case Series.

The present case series aims to investigate the use of polynucleotides mixed with hyaluronic acid (PNs-HA) in the form of gel to promote bone regeneration in horizontal alveolar defects. Overall, 6 adult patients underwent localized horizontal guided bone regeneration by means of xenogeneic bone substitute and a resorbable barrier with a staged approach. The graft consisted in a mixture of deproteinized bovine bone mineral (DBBM) particles and PNs-HA gel in a 3:1 ratio, respectively. The material was covered by a resorbable collagen membrane fixed with pins to the underlying bone. Implant placement was performed after 5 months. Healing proceeded uneventfully, and, upon re-entry, the graft appeared well vascularized and firmly attached to the recipient bone. Histologically, the regenerated bone appeared highly mineralized, well-organized in lamellae and totally embedding the residual granules of the biomaterial. Histomorphometric evaluations revealed that newly formed bone occupied on average 41.2% ± 12.4% of the analysed samples. Linear measurements performed on CBCT scans yielded an overall linear horizontal bone gain of 4.91 ± 0.88 mm. These data suggest that a mixture of DBBM and PNs-HA can be safely used to promote bone regeneration in case of horizontal alveolar defects.

A new way of repairing special wounds

PurposeWound repair has always been the basic method of burn surgery, but not all wounds in clinical work can regain both function and appearance. For relatively small wounds with irreversible functional damage accompanied by necrotic bone, joint and tendon exposure, and the wounds in non-functional sites with necrotic bone, tendon exposure and poor surrounding tissue conditions, the value and significance of tissue flap transplantation for wound repair are debatable. This paper discusses a new repair method as a supplementary choice for tissue flap transplantation: autologous granulation tissue and autologous thin split-thickness skin graft, which not only repairs the wound in a simple way but also avoids the cost of tissue flap transplantation. MethodsA total of 11 patients were collected from June 2019 to July 2022, with a total of 20 exposed wounds of bone, joint and tendon necrosis. During the operation, the necrotic exposed bone tissue and the completely necrotic tendon tissue were removed, and the necrotic soft tissue around the wound was completely excised until the wound appeared bleeding. We cut granulation tissue from other parts of the patient's body with a thickness of about 0.5–0.8 mm, cover the deep wound after thorough debridement with granulation tissue, and transplant autologous thin split-thickness skin to the deep wound covered with granulation tissue. The surgical area was compressed and immobilized. ResultsIn 11 patients, 20 wounds were surgically treated, and the wounds healed 15–25 days after the operation, and no bone tissue, joints, or tendons were exposed. No case underwent secondary surgery after surgery. Some wounds were treated with bedside allograft with the consent of the patient due to a small amount of residual granulation wound healing after transplantation. ConclusionUsing autologous granulation tissue and autologous thin split-thickness skin transplantation to repair some special wounds can not only repair the wounds simply and effectively but also avoid the cost of tissue flap transplantation.

Preclinical evaluation of the effect of periodontal regeneration by carbonate apatite in a canine one-wall intrabony defect model.

This study aimed to histologically compare periodontal regeneration of one-wall intrabony defects treated with open flap debridement, β-tricalcium phosphate (β-TCP), and carbonate apatite (CO3Ap) in dogs. The mandibular third premolars of four beagle dogs were extracted. Twelve weeks after the extraction, a one-wall bone defect of 4mm×5mm (mesio-distal width×depth) was created on the distal side of the mandibular second premolar and mesial side of the fourth premolar. Each defect was randomly allocated to open flap debridement (control group), periodontal regeneration utilizing β-TCP, or CO3Ap. Eight weeks after the surgery, histologic and histometric analyses were performed. No ankylosis, infection, or acute inflammation was observed at any of the experimental sites. Newly formed bone and cementum were observed in all experimental groups. The mineral apposition rate of the alveolar bone crest was higher in the CO3Ap group than in the control and β-TCP groups. The ratio of the new bone area was significantly higher in the CO3Ap group than in the control group (P<0.05). The bone contact percentage of the residual granules was significantly higher in the CO3Ap group than in the β-TCP group (P<0.05). Although this study has limitations, the findings revealed the safety and efficacy of CO3Ap for periodontal regeneration in one-wall intrabony defects in dogs, and CO3Ap has a better ability to integrate with bone than β-TCP.

Causes of Emergency Bleeding after Nonsurgical Periodontal Therapy in Adult Periodontitis Patients: A Retrospective Analysis.

Background Emergency gingival uncontrollable bleeding after nonsurgical periodontal therapy (NSPT) could be caused by a variety of factors; local oral factors are the main cause of gingival bleeding in most patients. Because the doctor will do a good job of evaluating the patient's physical condition before nonsurgical periodontal therapy. This study is subjected to evaluate the possible factors associated with emergency uncontrollable bleeding within 24-48 hours after NSPT. Material and Methods. A total of fifty-eight patients with emergency bleeding after NSPT in the past four years were enrolled. The related factors in patients, such as age, gender, clotting function, systemic diseases, and baseline periodontitis severity, were analyzed. The site-related factors, such as tooth type, tooth distribution, and alveolar bone resorption at the bleeding site, were compared. The possible relationship of the parameters to the causes of emergency bleeding with NSPT was also evaluated. Results Gingival bleeding after NSPT was registered. In this retrospective study, a total of 58 patients were selected. There were 29 males and 29 females, aged from 20 to 67 years old, with an average age of 35.21 ± 10.09 years. Among them, 8.6% were over 50 years old, and 91.4% were under 50 years old. Completed evaluations were performed in 15.5% gingivitis and 84.5% periodontitis. The causes of emergency bleeding after nonsurgical periodontal therapy in this study were residual subgingival calculus or granulation tissue in 63.79% of cases: severe gingival inflammation, 29.32%; gum trauma, 3.45%; and poor compliance, 3.45%. The therapy method before bleeding includes supragingival scaling accounted for 72.4% and subgingival scaling accounted for 27.6%. 23 cases of horizontal absorption at the bleeding site accounted for 39.66%, and 35 cases of angular absorption accounted for 60.34%. Bleeding of maxillary posterior teeth accounted for 34.48%; mandibular anterior teeth accounted for 15.52%; mandibular anterior teeth accounted for 8.62%; and mandibular posterior teeth accounted for 18.97%; multiple sites accounted for 22.41%; eliminating residual subgingival calculus and granulation tissue were the main and most effective hemostatic methods, 86.21%. Conclusion Residual subgingival calculus or granulation tissue and severe gingival inflammation were the main causes of emergency gingival bleeding after nonsurgical periodontal therapy. Severe gingival inflammation causing emergency bleeding was more common in maxillary posterior teeth areas. Angular alveolar bone resorption was more likely to cause bleeding than horizontal resorption. Careful debridement of residual subgingival calculus and granulation tissue was the main hemostatic method.

DIFFERENCES OF CULEX SPP AND AEDES SPP LARVAE MORTALITY RATES ON THE USE OF THEMEFOS

Eradication of the mosquito vectors that cause several diseases is still being carried out today where methods are still being developed. This research aims to identify the mortality rate of Culex spp. and Aedes spp. larvae for the use themefos or abate with sowed and wrapped of filter paper. The author uses quasi-experimental to observe that mortality. The design was devided into two groups, giving themepos/abate with a national dose of (1gr/10 liters of water) in 24 hours with threatment sowed and wrapped of filter paper through the analysis of varians/annova test to observe the varians of the time of mortality of Culex spp. and Aedes spp. larvae as well as probit analysis to see the probability of time of the larvae’s death.The result of this research is no defference in the mortality of Culex spp. and Aedes spp. larvae for the uses of themefos/abate with sowed and wrapped of filter paper. The authors suggestion is giving themefos or abate by wrapping filter paper preverably for larvae in a stagnant water such as Aedes spp larvae because it does not provide residual granules in water reservoirs used for human activities while the used of themepos/abate with sowed can also be used for a stagnant water or has a small discharge.

STRUCTURE OF THE KNEE ARTICULAR CARTILAGE AFTER THE FEMUR AND TIBIA EXTRA-ARTICULAR INJURY

The aim: To study the microscopic, ultramicroscopic, and histomorphometric features of the knee articular cartilage in rats with an extra-articular injury of the femur and tibia. Materials and methods: 60 white laboratory rats divided into three groups (I – control; II – animals with traumatic femur injury; III – animals with traumatic tibia injury) were used for the study. The light microscopy was performed by Olympus BH-2 microscope (Japan), transmission electron microscopy – by JEM-1230 microscope (Japan). SPSS software (version 17.0) was used for mathematical analysis. Results: The more pronounced morphological changes were observed in the articular cartilage of the proximal tibial epiphysis after mechanical tibial injury. The thickness of the articular cartilage was 27.89 % less than in the control. The chondrocyte number in the superficial zone was lower by 8.94 %, intermediate zone – by 14.23 %, and deep zone – by 21.83%, compared to control. Herewith, the histological changes were mostly detected in the intermediate and deep zones of the articular cartilage of both bones. Also, some chondrocytes had deformed nuclei, hypertrophied organelles, numerous inclusions, and residual glycogen granules. Conclusion: The extra-articular mechanical trauma of the lower limb bones leads to pathological changes in the knee articular cartilage. The structural changes include the articular cartilage thickening, the decrease in chondrocyte number, as well as chondrocyte rearrangement due to degenerative-dystrophic processes.

Endobronchial HDR Brachytherapy for Post-Transplant or Wegener’s Granulomatosis Associated Bronchial Stenosis

Bronchial stenosis is a clinically challenging problem following lung transplant and in Wegener’s Granulomatosis. Despite laser, stenting, balloon dilation among other interventions, worsening of stenosis often occurs. Endobronchial brachytherapy has been implemented for treatment refractory stenotic areas based on limited data. We hypothesize that high dose rate (HDR) Brachytherapy using 3Gy x1 fraction is effective in alleviating treatment refractory stenosis of bronchus. Patients who underwent endobronchial HDR Ir-192 brachytherapy from January 2016 to January 2020 for bronchial stenosis were retrospectively reviewed. Patients were selected for HDR brachytherapy if they had treatment refractory symptomatic re-stenosis. On day of brachytherapy, a flexible bronchoscopy was performed and a brachytherapy catheter was inserted. Intraoperative fluoroscopic imaging confirmed catheter positioning. Treatment length ranged from 3-5cm. The dose of 3Gy in 1 fraction was prescribed 1cm from the catheter surface. Patients were followed with bronchoscopies and pulmonary function testing (PFTs). Four patients were included with median follow-up of 5.2m (range: 0.9-16.8). One patient received brachytherapy 12Gy in 4 fractions 12 years prior to re-treatment. The same patient received a second double lung transplant due to bronchiolitis obliterans. All patients had initial clinical & bronchoscopic improvement with brachytherapy. The one Wegener’s Granulomatosis patient required an additional two courses of brachytherapy due to residual granulation tissue found proximally outside of the prior radiation treatment fields. Median time to next endobronchial intervention after brachytherapy was 5.2m [0.9-18.8]. The median number of interventions pre and post brachytherapy are listed below (Table 1). FEV1 prior to brachytherapy was 33% predicted [27-65] and PFT after brachytherapy was 40% predicted [25-72]. The one Wegener granulomatosis patient had a balloon dilation procedure induced grade 4 bronchopulmonary hemorrhage three months after 3rd brachytherapy treatment, requiring bronchial artery embolization. They were subsequently discharged 36 hours after the initial bleed and remains free of stenosis. Table 1 Endobronchial HDR brachytherapy utilizing 3Gy x 1 fraction was safe and effective in resolving refractory re-stenotic areas of bronchus caused by granulation tissue. There were no toxicities associated with lung transplant patients. The Wegener’s Granulomatosis patient had a potential G4 toxicity after a third brachytherapy treatment. Caution needs to be applied in the setting of repeated endobronchial brachytherapy procedures. More robust follow up is needed to assess long term success.Abstract 2512; TablePatientNumber of Pre-Brachytherapy InterventionNumber of Post-Brachytherapy Intervention12-6 months6-0 months0-6 months6-12 months194191221311303442042900Median [range]6.5 [2-13]6.5 [4-11]2.5 [0-19]0 [0-12] Open table in a new tab

Loss of AA13 LPMOs impairs degradation of resistant starch and reduces the growth of Aspergillus nidulans

BackgroundLytic polysaccharide monooxygenases (LPMOs) are often studied in simple models involving activity measurements of a single LPMO or a blend thereof with hydrolytic enzymes towards an insoluble substrate. However, the contribution of LPMOs to polysaccharide breakdown in complex cocktails of hydrolytic and oxidative enzymes, similar to fungal secretomes, remains elusive. Typically, two starch-specific AA13 LPMOs are encoded by mainly Ascomycota genomes. Here, we investigate the impact of LPMO loss on the growth and degradation of starches of varying resistance to amylolytic hydrolases by Aspergillus nidulans.ResultsDeletion of the genes encoding AnAA13A that possesses a CBM20 starch-binding module, AnAA13B (lacking a CBM20) or both AA13 genes resulted in reduced growth on solid media with resistant, but not soluble processed potato starch. Larger size and amount of residual starch granules were observed for the AA13-deficient strains as compared to the reference and the impairment of starch degradation was more severe for the strain lacking AnAA13A based on a microscopic analysis. After 5 days of growth on raw potato starch in liquid media, the mount of residual starch was about fivefold higher for the AA13 gene deletion strains compared to the reference, which underscores the importance of LPMOs for degradation of especially resistant starches. Proteomic analyses revealed substantial changes in the secretomes of the double AA13 gene deletion, followed by the AnAA13A-deficient strain, whereas only a single protein was significantly different in the proteome of the AnAA13B-deficient strain as compared to the reference.ConclusionsThis study shows that the loss of AA13, especially the starch-binding AnAA13A, impairs degradation of resistant potato starch, but has limited impact on less-resistant wheat starch and no impact on processed solubilized starch. The effects of LPMO loss are more pronounced at the later stages of fungal growth, likely due to the accumulation of the less-accessible regions of the substrate. The striking impairment in granular starch degradation due to the loss of a single LPMO from the secretome offers insight into the crucial role played by AA13 in the breakdown of resistant starch and presents a methodological framework to analyse the contribution of distinct LPMOs towards semi-crystalline polysaccharides under in vivo conditions.

Durability of resin on bleached dentin treated with antioxidant solutions or lasers

ObjectiveTo assess the influence of antioxidants (sodium ascorbate - SA, epigallocatechin-3-gallate (EGCG) from Camellia sinensis and punicalagin from Punica granatum) or lasers (Er:YAG and diode) on bleached dentin. MethodsFour hundred and forty slabs of intracoronary dentin were prepared: 224 for bond strength (debonding test) (n = 14), 96 for chemical analysis (EDS) and morphology (SEM) (n = 6), 96 for interface analysis (n = 6) and 24 for atomic force microscopy (AFM). The slabs were distributed according to the post-treatment after bleaching (35% hydrogen peroxide): GI- no bleaching and no post-treatment, GII- only bleached, GIII- 10-days delay in restorative procedure, GIV- 10% SA (10 min), GV- 0.5% EGCG (10 min), GVI- 0.5% punicalagin (10 min), GVII- Er:YAG laser (0.80W, 20s) and GVIII- diode laser (1.5W, 20s). Restorative procedures were done. Half of the slabs were analyzed immediately and the others, after 12 months. Debonding and AFM data were analyzed by ANOVA and Tukey tests (α = 0.05). ResultsAll the post-treatments, except for punicalagin, reestablished the immediate bond strength, similar to those restored after 10 days (p > 0.05). Following degradation, EGCG and punicalagin reestablished the bond strength (p < 0.05). Lasers were not effective in maintaining the bond strength after 12 months (p < 0.05). Higher O levels were found after bleaching but were reduced overtime. Ca and P remained stable. SEM and AFM showed residual granules of SA and irregular surface due to the laser action. After aging, tags and good interface were verified in GI, GIII, GV and GVI. ConclusionSodium ascorbate, EGCG or lasers restored the immediate bond strength, but only the natural extracts were effective in the long-term durability of resin. Thus, EGCG at 0.5% for 10 min seems to be the best pre-restorative treatment for bleached substrate.

Safety evaluation of a low-heat producing zeolite granular hemostatic dressing in a rabbit femoral artery hemorrhage model.

Aluminum silicate materials were widely used for temporary hemostasis of external wounds. Although they are commonly deemed to be nontoxic, side effects were proved to have some potential risks. In addition to obvious thermal effect and distal thrombosis, other chemical analysis should be performed to validate whether there is active components in the blood circulation system even when there is no obvious distal thrombosis. On the other hand, blood electrolytes disturbance is a safety concern, and this issue has been ignored in previous studies. In this study, a systematic and stringent safety evaluation of aluminium silicate hemostatic agents was performed to provide useful information for their future clinical applications. In this study, a low-heat producing Zeolite Granular Dressing (Z-Granular, Zeo-Innov Medical Technology Co., Ltd, Hangzhou, China) was used as hemostatic agents for safety evaluation in a rabbit femoral artery hemorrhage model. In addition to the time to achieve definite hemostasis and heat producing properties, blood electrolytes concentrations of the rabbits pre- and post-application were measured. Although the in vitro electrolyte concentration tests indicated the significant change of Ca2+ and K+ after the zeolite-accelerated hemostasis, in vivo rabbit model suggested that no obvious blood electrolyte disordered occurred. X-ray photography confirmed that there is no zeolite residual granule remained in the wound sites after the debridement. Element analysis proved that the possibility of these inorganic materials entering the blood circulation is very low. The histological results revealed that no pathological changes resulting from Z-Granular were found. Thus, Zeolite Granular Dressing would be an effective and safe hemostatic agent for emergency arterial bleeding. Furthermore, packing zeolite granules within nonwoven-fabric bags would solve the problem of debridement without compromising their hemostatic efficiency. This is a systematic and stringent safety evaluation of aluminium silicate hemostatic agents and provides useful information for their future clinic applications.

New bovine bone graft with integrated atelocollagen Type I in artificial defects. Histologic and histomorphometric study in sheep

Background: A new natural bovine bone grafting material with incorporated Type I atelocollagen has been recently introduced for the use in regenerative dentistry. Aims: The aim of the study was to evaluate the bone regeneration obtained using bovine bone graft with integrated atelocollagen Type I in artificial jaw bone defects, in sheep. Setting and Design: This is an in vivo study using an animal model (sheep). Materials and Methods: Four hollow titanium cylinders 4.0-mm internal diameter and 8-mm length, termed “bone growing chambers” (BGC), were inserted in two sheep mandibles. In the right side of each animal, the BGC was filled by the novel natural bovine bone graft with integrated atelocollagen Type I (test group), while the left BGC was left empty to be filled only by blood clot (control group). After 2 months of healing, the animals were sacrificed, and both histological and morphometric analysis were performed. Statistical Analysis Used: A nonparametric Mann–Whitney test was used. Results: All titanium chambers were well osseointegrated after 2 months of healing. In the test group, newly formed bone mixed with residual granules appeared incorporated in the new trabeculae. The histomorphometric analysis revealed a total bone volume percentage of 52.01 ± 8.62 for the test group and 33.72 ± 18.18 for the control group. Conclusion: The bone structure observed in the test group was more compact than the control group. This result could be attributed only partially to the presence of newly formed bone mixed to residual granules of grafting material. The graft material with atelocollagen seemed to improve the new bone formation; however, other studies are needed to compare regenerated tissue properties over the time.

Protocols for sodium ascorbate application on intracoronary dentin bleached with high-concentrated agent.

Purpose:Composite resin restorations are normally replaced after the internal bleaching of endodontically treated-teeth because the bleaching agent does not alter the color of the restorative material. This study evaluated the effect of 10% sodium ascorbate (SA) applied at different protocols on bleached dentin.Materials and Methods:One-hundred slabs of intracoronary bovine dentin were divided into 5 groups: 2 controls-GI without bleaching (positive), GII bleached with 35% hydrogen peroxide (HP) (negative); and 3 experimentals – GIII. 35% HP + SA at protocol 1 (dripping, washing and drying the solution), GIV. 35% HP + SA at protocol 2 (dripping and aspirating the solution) and GV. 35% HP + SA at protocol 3 (dripping, rubbing and aspirating the solution). Sixty fragments were restored and subjected to shear bond strength test (n = 12). Forty fragments (n = 8) were prepared for chemical analysis (energy dispersive X-ray spectrometry) and surface morphology (scanning electron microscopy). Data were analyzed by ANOVA and Tukey test (P < 0.05).Results:GI (3.169 ± 1.510a) had the highest means values, similar to GIV (2.752 ± 0.961a) and GV (2.981 ± 1.185a) (P < 0.05). Inferior values were obtained in GII (1.472 ± 0.342b) and GIII (2.037 ± 0.742ab) had intermediate values (P > 0.05). Oxygen concentration was reduced in groups treated with SA, and the surface exhibited residual granules of the solution.Conclusion:The 10% SA solution reestablishes the bond strength of restorative material to bleached dentin, especially if active protocols of application and aspiration were used.

Impact of moisture and magnesium stearate functionality on manufacturability of wet granulated metformin tablets

During the development of a wet granulated 850 mg metformin hydrochloride tablet formulation, the tablets exhibited high friability (>3% w/w) irrespective of the source of extra-granular magnesium stearate (MgSt). High friability values indicated that an anti-bonding effect of MgSt was too high to be overcome by 3.3% w/w povidone as a binder in the formulation with 1.5% w/w residual granule moisture. Increasing the povidone concentration up to 7% w/w showed limited improvement in friability, with tablets showing variable friability depending on MgSt source. Characterization of MgSt indicated differences in crystallinity, surface area and particle morphology between different vendors. In addition, a new bulk yield strength test, which determines the MgSt fragmentation tendency, was found to be indicative of the MgSt performance in the tablet formulation. To improve bonding properties of granules, residual granule moisture was increased to 2% w/w at different povidone concentrations. At 2% w/w residual granule moisture content, regardless of MgSt source, the tablets showed significant improvement in friability (∼0.6% w/w) even at the lowest povidone concentration (3.3% w/w). The bonding power of higher residual granule moisture had a greater impact than higher povidone concentration in overcoming the anti-bonding effects of magnesium stearate.

Influence of in line monitored fluid bed granulation process parameters on the stability of Ethinylestradiol

Ethinylestradiol (EE) as a highly active and low dosed compound is prone to oxidative degradation. The stability of the drug substance is therefore a critical parameter that has to be considered during drug formulation. Beside the stability of the drug substance, granule particle size and moisture are critical quality attributes (CQA) of the fluid bed granulation process which influence the tableting ability of the resulting granules. Both CQA should therefore be monitored during the production process by process analytic technology (PAT) according to ICH Q8.This work focusses on the effects of drying conditions on the stability of EE in a fluid-bed granulation process. We quantified EE degradation products 6-alpha-hydroxy-EE, 6-beta-hydroxy-EE, 9(11)-dehydro-EE and 6-oxo-EE during long time storage and accelerated conditions. PAT-tools that monitor granule particle size (Spatial filtering technology) and granule moisture (Microwave resonance technology) were applied and compared with off-line methods. We found a relevant influence of residual granule moisture and thermic stress applied during granulation on the storage stability of EE, whereas no degradation was found immediately after processing. Hence we conclude that drying parameters have a relevant influence on long term EE stability.

Defective PDI release from platelets and endothelial cells impairs thrombus formation in Hermansky-Pudlak syndrome

AbstractProtein disulfide isomerase (PDI), secreted from platelets and endothelial cells after injury, is required for thrombus formation. The effect of platelet and endothelial cell granule contents on PDI-mediated thrombus formation was studied by intravital microscopy using a mouse model of Hermansky-Pudlak syndrome in which platelet dense granules are absent. Platelet deposition and fibrin generation were nearly absent, and extracellular PDI was significantly reduced in HPS6−/− mice after vascular injury. HPS6−/− platelets displayed impaired PDI secretion and impaired exocytosis of α granules, lysosomes, and T granules due to decreased sensitivity to thrombin, but these defects could be corrected by addition of subthreshold amounts of adenosine 5′-diphosphate (ADP). Human Hermansky-Pudlak syndrome platelets demonstrated similar characteristics. Infusion of wild-type platelets rescued thrombus formation in HPS6−/− mice. Human umbilical vein endothelial cells in which the HPS6 gene was silenced displayed impaired PDI secretion and exocytosis of Weibel-Palade bodies. Defective thrombus formation in Hermansky-Pudlak syndrome, associated with impaired exocytosis of residual granules in endothelial cells and platelets, the latter due to deficiency of ADP, is characterized by a defect in T granule secretion, a deficiency in extracellular PDI secretion, and impaired fibrin generation and platelet aggregation. Hermansky-Pudlak syndrome is an example of a hereditary disease whereby impaired PDI secretion contributes to a bleeding phenotype.

Experimental study on removal melanin granules from acellular dermal matrix of giant nevus

To study the possibility of removal melanin granules from autogenic acellular dermal matrix of giant nevus tissue by H2O2 bleaching technique. A total of 32 skin specimens (0.5 cm x 0.5 cm) from giant nevus tissue and 1 piece (0.5 cm x 0.5 cm) of normal skin were obtained from the surgical removal. One giant nevus tissue was chosen as control. The others and the normal skin tissue were treated with solution of 0.25% Dispase II for digestion for 24 hours under normal temperature to remove epidermis. Then each piece was immerged into solution of 0.5% Triton X-100 for digestion for 48 hours in normal temperature. One giant nevus tissue and the normal skin tissue were chosen as control. The others were immerged into solution of different concentrations of H2O2, treated under different temperature and lasting for different period. Lastly, all specimens were treated with HE staining, immunohistochemical staining, light microscopy and so on. After giant nevus tissues were treated with solution of 0.25% Dispase II and immerged into solution of 0.5% Triton X-100 in normal temperature, nevus cells and all other cellular components of pigmented nevus tissues can be effectively removed, there were the cavities left by removal of cells without any residual cell debris, but still remaining part of pigment. Then each specimen were immerged into solution of different concentrations of H2O2, under different temperature and lasting for different period which can remove residual melanin granules. In solution of 3% H2O2 for 36 h under 37 degrees C, can remove all the melanin particles, the content of collagen type I in the obtained specimen was not changed. Collagen fibers were uniform in thickness, regular in arrangement with no obvious degeneration. With solution of 0.25% Dispase II and solution of 0.5% Triton X-100 in normal temperature, all cells in nevus tissue can be removed effectively. Further treatment with 3% H2O2 at 37 degrees C for 36 h can remove all the melanin particles, while collagen type I has no obvious change. The preparation of acellular dermal matrix of the giant nevus may possibly be applied as autologous tissue implant to repair tissue defects.

Advanced imaging for the early diagnosis of local recurrence prostate cancer after radical prostatectomy.

Currently the diagnosis of local recurrence of prostate cancer (PCa) after radical prostatectomy (RT) is based on the onset of biochemical failure which is defined by two consecutive values of prostate-specific antigen (PSA) higher than 0.2 ng/mL. The aim of this paper was to review the current roles of advanced imaging in the detection of locoregional recurrence. A nonsystematic literature search using the Medline and Cochrane Library databases was performed up to November 2013. Bibliographies of retrieved and review articles were also examined. Only those articles reporting complete data with clinical relevance for the present review were selected. This review article is divided into two major parts: the first one considers the role of PET/CT in the restaging of PCa after RP; the second part is intended to provide the impact of multiparametric-MRI (mp-MRI) in the depiction of locoregional recurrence. Published data indicate an emerging role for mp-MRI in the depiction of locoregional recurrence, while the performance of PET/CT still remains unclear. Moreover Mp-MRI, thanks to functional techniques, allows to distinguish between residual glandular healthy tissue, scar/fibrotic tissue, granulation tissue, and tumour recurrence and it may also be able to assess the aggressiveness of nodule recurrence.

Maxillary sinus augmentation procedures through equine-derived biomaterial or calvaria autologous bone: immunohistochemical evaluation of OPG/RANKL in humans

Autologous bone is considered the gold standard for bone regeneration, even if different heterologous bone substitutes have been proposed to overcome the limits related to its use. The aim of this study was to analyze and to compare the molecular events switched on by autologous or heterologous bone graft insertion, focusing on TGFβ1 expression and OPG/RANKL ratio, to analyze resorption process, and estimating graft vascularization, new bone tissue deposition and its mineralization, through VEGF, BSP and SPARC expression evaluation, respectively. Patients needing pre-prosthetic rehabilitation of the posterior maxilla were treated using an equine-derived biomaterial (Group 1) or calvaria autologous bone (Group 2), according to the morphology of the bone defect. Bone graft integration was evaluated on bone samples obtained from the treated areas at the moment of dental implant insertion, by morphological and immunohistochemical analyses for TGFβ1, OPG, RANKL, VEGF, BSP, and SPARC expression. Morpho - logical analysis shows the presence of biomaterial residual granules in Group 1, in parallel to a good integration between graft and host tissue. Moderate TGFβ1 expression is seen in both Group 1 and Group 2. OPG/RANKL ratio appears higher in Group 1; VEGF expression appears very strong in Group 1 and strong in Group 2, while BSP and SPARC expression results weak in Group 1 and moderate in Group 2. Our results reveal the good integration between both types of graft and the host tissue, even though autologous graft seems to produce a faster regenerative process, as evidenced by the different expression of the investigated molecules. According to these observations, the clinical use of heterologous particulate equine-derived biomaterial may ensure long-term predictability of implantprosthetic rehabilitation, comparable to that obtained with autologous bone graft.

Thickened area of external granular layer and Ki-67 positive focus are early events of medulloblastoma in Ptch1+/− mice

Patched1 (Ptch1) encodes a receptor for Sonic hedgehog (Shh) and is major gene related to human medulloblastoma (MB) in the Shh subgroup. MB is thought to arise from residual granule cell precursors (GCPs) located in the external granular layer (EGL) of the developing cerebellum. As the detailed preneoplastic changes of MB remain obscure, we immunohistochemically clarified the derived cell, early events of MBs, and the cerebellar developmental processes of Ptch1(+/-) (Ptch1) mice, an animal model of human MB of the Shh subgroup. In Ptch1 mice, the earliest proliferative lesions were detected at PND10 as focal thickened areas of outer layer of the EGL. This area was composed of GCP-like cells with atypia and nuclei disarrangement. In the latter cerebellar developmental period, GCP-like cell foci were detected at high incidence in the outermost area of the cerebellum. Their localization and morphological similarities indicated that the foci were derived from GCPs in the EGL. There were two types of the foci. A Ki-67-positive focus was found in Ptch1 mice only. This type resembled the GCPs in the outer layer of EGL characterized by having proliferating activity and a lack of neuronal differentiation. Another type of focus, Ki-67-negative, was observed in both genotypes and exhibited many of the same features of mature internal granule cells, suggesting that the focus had no preneoplastic potential. Due to morphological, immunohistochemical characteristics, our results indicate that the focal thickened area of EGL and Ki-67-positive foci are preneoplastic lesions of MB.

Impiego di osso bovino deproteinizzato granulare negli incrementi orizzontali: presentazione di una tecnica non convenzionale

ObjectivesTo assess the efficacy of a non-conventional technique of bone augmentation of an atrophic ridge for subsequent implant positioning. The method, easy to perform and with few complications, uses the periosteum in place of a membrane in combination with a biomaterial. Materials and methodsA patient with a ridge bone defect was treated with a regenerative technique that consists in a muco-periosteal flap with only a crestal incision – without release incisions – in order to preserve the integrity of the periosteum. After performing some drill holes in the cortical bone, granules of heterologous bovine bone were packed over the defect without any membrane. The flap was repositioned over the graft with passive sutures and after eight months the implants were positioned. After 21 months from the graft, a biopsy was performed in order to assess the microscopic features of the regenerated bone. ResultsThe histological findings showed dense, mature, new regenerated bone with lamellar structure. Residual granules of the biomaterial appeared to be integrated in the new bone without any inflammatory reaction. ConclusionsWith the limits of the single investigation, this simplified technique seems to be an alternative method to consider in non-collaborating patients or in front of operative clinical problems. Until now, the association of biomaterials and membranes is the gold standard in bone regeneration techniques for implant therapy.