Experimental evaluation of microsurgical repair of the lingual nerve

Epineural microsurgical repair of the lingual nerve has been shown to be effective in leading to return of sensation in an animal model. Cadaver dissections have provided information regarding surgical access to the operative site, some possible anatomic variations that may be encountered, and a method for nerve repositioning to allow a gain in length.     

Five-year 224-patient prospective histological study of clinical applications using a synthetic bone alloplast

Clinical and histologic evaluations of a synthetic bone were performed in 224 patients in a well monitored environment. This material (Bioplant HTR, Bioplant Inc., South Norwalk, CT) was used to obliterate cysts, treat periodontal defects, correct jawbone contours and deficiencies, and gain sufficient support for the placement of dental implants in maxillary subantral augmentation. Implants were positioned either at the time of the synthetic bone graft or after the new supporting tissue was formed. Evidence of new bone formation between the synthetic granules and host tissue was observed during histological examinations. After the material was placed, tissue that could strengthen and augment the inferior wall of the maxillary sinus formed in 3 months. This was observed both clinically and radiographically. After 8 to 12 months, this tissue provided sufficient hard tissue support for the placement of dental implants. This clinical study reconfirmed the applicability of a synthetic bone for bone replacement and augmentation in oral and maxillofacial surgery. No complications caused by infection, inflammation, or rejection of the implanted graft material were observed.     

Molecular mechanisms of basic fibroblast growth factor effect on healing of ulcerative colitis in rats

We demonstrated previously that basic fibroblast growth factor (bFGF) accelerated the healing of experimental duodenal ulcers, and we now hypothesize that bFGF might also accelerate the healing of experimental ulcerative colitis (UC). We also explored the potential molecular mechanisms involved in the accelerated healing of UC in rats treated with bFGF. The results demonstrated that colonic lesions were significantly reduced by bFGF treatment, whereas neutralization of bFGF aggravated iodoacetamide-induced UC. Protein expression of bFGF was increased during the healing stage of UC. Tumor necrosis factor-α levels and myeloperoxidase activity were significantly decreased in UC rats treated with bFGF, whereas they increased in rats treated with anti-bFGF antibody. Real-time polymerase chain reaction and immunohistochemistry showed decreased levels of p27 in the UC rats compared with the healthy controls, which was reversed by bFGF treatment in a dose-dependent manner. By immunohistochemistry and double labeling of Ki-67 and CD34, prominent positive staining of Ki-67 and CD34 was seen after bFGF treatment, indicating the enhanced proliferation of fibroblasts and epithelial and endothelial cells, i.e., angiogenesis. We conclude that bFGF plays a beneficial role in the healing of UC in rats. The molecular mechanisms of bFGF in UC healing not only involve the expected increased cell proliferation, especially angiogenesis, but also encompass the reduction of inflammatory cytokines and infiltration of inflammatory cells. Thus, bFGF enema may be a new therapeutic option for UC.     

Impact of age on risk of complications after gastric bypass: A cohort study from the Scandinavian Obesity Surgery Registry (SOReg)

Background

An increasing number of older patients undergo bariatric surgery.

Epidermal growth factor receptor (EGFR) high gene copy number and activating mutations in lung adenocarcinomas are not consistently accompanied by positivity for EGFR protein by standard immunohistochemistry

The purpose of this study was to investigate whether detectable protein biomarker overexpression is a prerequisite for the presence of increased gene copy number or activating mutations and responsiveness to the epidermal growth factor receptor (EGFR) inhibitors gefitinib and erlotinib in patients with lung adenocarcinomas. EGFR status was prospectively analyzed in tumor biopsy samples by three methods: protein expression (n = 117) by standardized immunohistochemistry (IHC), gene copy number (n = 97) by fluorescent in situ hybridization (FISH), and mutation analysis by sequencing (n = 126). Fifty-nine percent of the samples were positive by IHC, 40% were positive by FISH, and 13.5% contained activating kinase domain mutations. Thirty-four percent of the FISH-positive and 27% of the mutant samples were also IHC-negative. All EGFR mutant patients had major clinical responses (five complete response and five partial response) to gefitinib or erlotinib treatment, although three of these tumors were IHC-negative and four were FISH-negative. In a retrospective analysis of samples from nine patients with excellent therapeutic responses (three complete response, five partial response, one stable disease) to erlotinib or gefitinib, mutations were identified in eight cases, but IHC was negative in four of these tumors. These results indicate that molecular diagnostic methods appear to be most important for the identification of lung adenocarcinoma patients who may benefit from EGFR inhibitor treatments.