Inflammation Of Surrounding Tissues Research Articles

Inflammatory tissue response in human soft tissue is caused by a higher particle load near carbon fiber-reinforced PEEK compared to titanium plates

Titanium as the leading implant material in locked plating is challenged by polymers such as carbon fiber-reinforced polyetheretherketone (CFR-PEEK), which became the focus of interest of researchers and manufacturers in recent years. However, data on human tissue response to these new implant materials are rare.Osteosynthesis plates and peri‑implant soft tissue samples of 16 healed proximal humerus fractures were examined (n = 8 CFR-PEEK, n = 8 titanium). Soft tissue was analyzed by immunohistochemistry and µCT. The entrapped foreign bodies were further examined for their material composition by FTIR. To gain insight into their origin and formation mechanism, explanted and new plates were evaluated by SEM, EDX, profilometry and HR-CT.In the peri‑implant soft tissue of the CFR-PEEK plates, an inflammatory tissue reaction was detected. Tissues contained foreign bodies, which could be identified as tantalum wires, carbon fiber fragments and PEEK particles. Titanium particles were also found in the peri‑implant soft tissue of the titanium plates but showed a less intense surrounding tissue inflammation in immunohistochemistry. The surface of explanted CFR-PEEK plates was rougher and showed exposed and broken carbon fibers as well as protruding and deformed tantalum wires, especially in used screw holes, whereas scratches were identified on the titanium plate surfaces.Particles were present in the peri‑implant soft tissue neighboring both implant materials and could be clearly assigned to the plate material. Particles from both plate materials caused detectable tissue inflammation, with more inflammatory cells found in soft tissue over CFR-PEEK plates than over titanium plates. Statement of significanceOsteosynthesis plates are ubiquitously used in various medical specialties for the reconstruction of bone fractures and defects and are therefore indispensable for trauma surgeons, ENT specialists and many others. The leading implant material are metals such as titanium, but recently implants made of polymers such as carbon fiber-reinforced polyetheretherketone (CFR-PEEK) have become increasingly popular. However, little is known about human tissue reaction and particle generation related to these new implant types. To clarify this question, 16 osteosynthesis plates (n = 8 titanium and n = 8 CFR-PEEK) and the overlying soft tissue were analyzed regarding particle occurrence and tissue inflammation. Tissue inflammation is clinically relevant for the development of scar tissue, which is discussed to cause movement restrictions and thus contributes significantly to patient outcome.

Detection of native, activated Notch receptors in normal human apocrine-bearing skin and in hidradenitis suppurativa.

Notch signalling has generated considerable interest as a pathogenetic factor and a drug target in a range of human diseases. The gamma-secretase complex is crucial in the activation of Notch receptors by cleaving the intracellular domain allowing nuclear translocation. In recent years several mutations in gamma-secretase components have been discovered in patients with familial hidradenitis suppurativa (HS). This has led to hypotheses that impaired Notch signalling could be an important driver for HS in general, not only in the monogenic variants. However, no study has examined insitu Notch activation per se in HS, and some reports with conflicting results have instead been based on expression of Notch receptors or indirect measures of Notch target gene expression. In this study we established immunostaining protocols to identify native, activated Notch receptors in human skin tissue. The ability to detect changes in Notch activation was confirmed with an exvivo skin organ model in which signal was reduced or obliterated in tissue exposed to a gamma-secretase inhibitor. Using these methods on skin biopsies from healthy volunteers and a general HS cohort we demonstrated for the first time the distribution of active Notch signalling in human apocrine-bearing skin. Quantification of activated NOTCH1 & NOTCH2 revealed similar levels in non-lesional and peri-lesional HS to that of healthy controls, thus ruling out a general defect in Notch activation in HS patients. We did find a variable but significant reduction of activated Notch in epidermis of lesional HS with a distribution that appeared related to the extent of surrounding tissue inflammation.

Precise Lipidomics Decipher Circulating Ceramide and Sphingomyelin Cycle Associated with the Progression of Rheumatoid Arthritis.

Rheumatoid arthritis (RA) is a long-term autoimmune condition that causes joint and surrounding tissue inflammation. Lipid mediators are involved in inflammation and deterioration of the joints. Despite attempts to discover effective drug targets to intervene with lipid metabolism in the disease, progress has been limited. In this study, precise lipidomic technology was employed to quantify a broad range of serum ceramides and sphingomyelin (SM) in a large cohort, revealing an association between the accumulation of circulating ceramides and disturbed ceramide/SM cycles during the progression of RA. In our investigation, we discovered that eight ceramides exhibited a positive correlation with the activity of RA, thereby enhancing the accuracy of RA diagnosis, particularly in patients with serum antibody-negative RA. Furthermore, the enzyme SM phosphodiesterase 3 (SMPD3) was found to disrupt the circulating SM cycle and accelerate the progression of RA. The activity of SMPD3 can be inhibited by methotrexate, resulting in decreased metabolic conversion of SM to ceramide. These findings suggest that targeting the SM cycle may provide a new therapeutic option for RA.

The antimicrobial effect of doxycycline and doped ZnO in TiO2 nanotubes synthesized on the surface of orthodontic mini-implants

Objectives: Anchorage preservation is crucial in orthodontic treatment success. Mini-implants make a revolution in this domain. The failure of orthodontic mini-implants due to inflammation and infection is one of the reasons for anchorage loss. The purpose of this study was to evaluate the effect of a novel mini-implant surface modification to improve resistance against microbial contamination and surrounding tissue inflammation. Material and Methods: Twenty-four orthodontic mini-implants (Jeil Medical Corporation, Korea) with 1.6 mm diameter and 8 mm length were randomly divided into three groups: Group 1: Control group, Group 2: Nanotubes were made on the surface with anodisation, and Group 3: Zinc Oxide (ZnO) doped into nanotubes, and then doxycycline is added to them. The anti-bacterial efficacy against Porphyromonas gingivalis was evaluated using the disk diffusion method. To analyze data, Kruskal–Wallis, Friedman, and Wilcoxon tests were done. The significance level was set at 0.05. Results: No zone of the inhibition was formed in Groups 1 and 2. In Group 3, the mean (SD) diameter of the inhibition zone in the first 5-day to sixth 5-day were 38.7(8.2), 25(4.8), 17.8(5.6), 7.63(5.37), 1.5(2.83), and 0 millimeters, respectively. Conclusion: Nanotubes containing doped ZnO and Doxycycline are capable of preventing bacterial growth around the mini implant surfaces for at least up to 30 days. To manage inflammation of surrounding tissues of mini-implants, nanotubes are not effective alone. Therefore, the presence of diffusible materials in addition to nanotubes on the surface of mini-implants is necessary.

To Study the Efficacy of Placental Extract Gel in Chronic Non Healing Foot Ulcer

Wound healing is a complex and regulated process that is critical in maintaining the skin barrier function. The numerous disease processes can affect the events involved in wound healing, resulting in chronic, non-healing wounds. These would subject them to significant discomfort and distress and drain the medical system resources enormously. A chronic wound can be defined as that does not heal in an orderly set of stages and in a predictable amount of time or within three months. They remain in the inflammatory phase for too longand never heal or may take years.3,4 Chronic leg and foot ulcers occur in many adults with diabetes, chronic venous insufficiency, arterial disease, prolonged pressure, or neuropathy.5 Chronic ulcers may last for 12 to 13 months and even recur in 60-70% of cases. They cause loss of function and decreased quality of life and significant morbidity.6,7 These chronic ulcers are predominantly seen in elderly, becoming more prevalent and more difficult to treat and are associated with high treatment costs. So wound care has become essential in these ulcers, and surgical debridement and dressings are the corners stones. Many wound dressings like gauge, films, hydrocolloids, gels, foams etc. were developed to both protect the healing wound from infection and to promote the healing process.1 Placental extract gel is a rich source of various peptides, amino acids, nucleotides, PDRNs and carbohydrates, which are believed to support the healing process.9 Application of placental extract preparation increases collagen synthesis, increases tissue protein, accelerates neoangiogenesis, and epithelialization.10 It has an immunotropic effect and causes the release of Epidermal growth factor, Fibroblast growth factor at the tissue level. It also reduces surrounding tissue inflammation and oedema and reduces microbial burden.11 Its application accelerates healing because of amino acids, nucleotide and vitamins that improve healing.

Update options in the treatment of coccydina(tail bone pain): article review

This literature review is intended to provide oversight on the anatomy, incidence, etiology, presentation, diagnosis, and treatment of coccydynia. Relevant articles were retrieved with PubMed using keywords such as “coccydynia”, “coccyx”, “coccyx pain”, and “coccygectomy. Literature accumulated for this study was accumulated from PubMed using sourcombined to form this study. Images were also added from three separate sources to aid in the understanding of the coccyx and coccydynia. Focal points of this study included the anatomy of the coccyx, etiology and presentation of coccydynia, how to properly diagnose coccydynia, and possible treatments for the variety of etioloces. The coccyx morphology is defined using different methods by different authors as presented in this study. There is no conclusive quantitative data on the incidence of coccydynia; however, there are important factors that lead to increased risk of coccydynia such as obesity, age, and female gender. Injury to the coccyx or coccygeal joints with surrounding tissue inflammation and contraction of the muscles attached to the coccyx causes coccydynia. Diagnosis is made predominantly in clinical examinations with static standard radiographs, CT, and routine blood tests. Treatment options include conservative care, physical therapy, intrarectal massage and manipulation, sacrococcygeal injections (including ganglion impar block), and coccygectomy. Many cases are resolved with conservative treatments, despite the wide array of etiologies for the diagnosis. In more extreme cases, physician intervention requires a multidisciplinary approach. Surgical treatment is used as a last resort.

Imaging algorithm and multimodality evaluation of spinal osteoblastoma

BackgroundTo analyze the features of CT, MRI and PET/CT and their diagnostic value for spinal osteoblastomas (OBs).MethodsThe radiological and clinical data of 21 patients with histopathologically-confirmed spinal OBs were analyzed retrospectively.ResultsSixteen of the 21 cases were benign and 5 were aggressive OBs. Tumors were located in the lumbar (n = 11), cervical (n = 4), thoracic (n = 5), and sacral (n = 1) spinal regions. Nineteen cases were centered in the posterior elements of the spine, 13 of which extended into the vertebral body. Punctate or nodular calcifications were found in all cases on CT with a complete sclerotic rim (n = 12) or incomplete sclerotic rim (n = 8). The flare phenomenon (indicative of surrounding tissue inflammation) was found in 17/21 cases on CT, thin in 11 cases and thick in 6 cases, and in 19/19 cases on MRI, thin in 1 case and thick in 18 cases. On 18F-FDG PET/CT, all cases (8/8) were metabolically active with the SUVmax of 12.3–16.0; the flare sign was observed in 8 cases, including 7 cases of hypometabolism and 1 case of coexistence of hypermetabolism and hypometabolism. Based on CT, 3, 12, and 6 cases were classified as Enneking stage 1, 2 and 3, respectively. Of 19 cases with MRI, 1 and 18 cases were classified as Enneking stage 2 and 3, respectively.ConclusionsSpinal OB has multiple unique characteristic radiological features. Although a larger sample size is needed, combining CT, MRI and PET may be beneficial to optimize preoperative diagnosis and care of patients with OBs.

A randomized comparative study between omentopexy and omental plugging in treatment of duodenal perforation

Background: Perforation due to duodenal ulcer is a common cause of peritonitis and is considered as one of the most catastrophic complication of duodenal ulcer perforation. Repair of perforation are considered particularly hazardous because of the extensive duodenal tissue loss, friability of the ulcer margins, surrounding tissue inflammation, poor general condition of the patient and overwhelming sepsis due to bacterial peritonitis. Thus, there is a need to compare closure of duodenal perforations by either Graham’s patch (OX) or omental plugging (OP) which are the simpler and more common methods followed these days in duodenal perforation management.Methods: The clinical material consists of all inpatients admitted under General Surgery for management of duodenal ulcer perforation at College of Medicine and JNM Hospital, Nadia. The study was conducted during the period from July 2018 to June 2019. This study consisted of 50 consecutive cases and diagnosis was made on the basis of clinical and histopathological findings.Results: A total of 73 patients were enrolled for the study. All our patients were males. Wound infection (OX -21.1%, OP -14.3%), septicaemia (OX-15.8%, OP-11.4%), and lung complication (OX-13.2%, OP-11.4%) were the commonest complications. Mean postoperative stay for OX was 12.92 with standard deviation 3.00 while in OP was 11.54 with standard deviation 1.54 (statistically significant).Conclusions:OP is associated with less incidence of postoperative complication in compared to omentopexy procedure for example wound infection, reperforation, lung complication, septicemia and intra-abdominal abscess. OP is associated with less number of mortality. OP is associated with higher mean operative time as it is a relatively newer and less utilized technique.

Novel hydrogels based on carboxyl pullulan and collagen crosslinking with 1, 4-butanediol diglycidylether for use as a dermal filler: initial in vitro and in vivo investigations.

Novel hydrogels based on carboxyl pullulan (PC) and human-like collagen (HLC) crosslinking with 1,4-butanediol diglycidyl ether (BDDE) are promising soft fillers for tissue engineering due to their highly tunable properties. Recent studies, however, have shown that incorporating hyaluronic acid and BDDE results in hydrogels with a microporous structure, a large pore size and high porosity, which reduce cell adhesion and enhance degradation in vivo. To improve biocompatibility and prevent biodegradation, the use of PC to replace hyaluronic acid in the fabrication of PC/BDDE (PCB) and PC/BDDE/HLC (PCBH) hydrogels was investigated. Preparation of gels with PC is a promising strategy due to the high reactivity, superb selectivity, and mild reaction conditions of PC. In particular, the Schiff base reaction of HLC and PC produces the novel functional group -RCONHR' in PCBH hydrogels. Twenty-four weeks after subcutaneous injection of either PCB or PCBH hydrogel in mice, the surrounding tissue inflammation, enzymatic response and cell attachment were better compared to hyaluronic acid-based hydrogels. However, the biocompatibility, cytocompatibility and non-biodegradability of PCBH were milder than those of the PCB hydrogels both in vivo and in vitro. These results show that the proposed use of PC and HLC for the fabrication of hydrogels is a promising strategy for generating soft filler for tissue engineering.