Eighteen-month radiographic and histologic evaluation of sinus grafting with anorganic bovine bone in the chimpanzee.

Maxillary sinus grafting procedures are currently the treatment of choice when the alveolar crest of the posterior maxilla is in close approximation to the maxillary sinus. The short-term histologic and radiographic healing following sinus grafting with natural bone mineral (Bio-Oss) in the chimpanzee has been evaluated. We have previously shown by histomorphometric and radiographic analysis that the percentage of vital bone area, the vertical height, and the density of new bone in the maxillary sinus was significantly greater with anorganic bovine bone compared to bovine Type I collagen matrix. The purpose of this in vivo study was to determine the bone mineral density (BMD) of the sinus grafts, the vertical height stability, the vital bone area, and the extent of anorganic bovine bone replacement 18 months postoperatively in 4 maxillary sinuses from 4 different animals. Radiographic analysis of computed tomographic scans taken at 1.5 years revealed an average BMD of 658 mg/mL, which was not significantly different from the values found at 6.5 months. The radiographic vertical height was maintained between the 6.5- and 18-month time points. On average, the grafts were found to have a height of 14 mm. Lateral wall biopsy specimens at 7.5 months were compared to those at 18 months. With the anorganic bovine bone treatment, the percentage of vital bone area increased from 62 +/- 3% to 70 +/- 7% and the percentage of natural bone mineral area decreased from 19 +/- 14% to 6 +/- 3%. The bovine Type I collagen matrix vital bone percentage at 7.5 months was 34 +/- 21%. These results demonstrate that sinus grafting with anorganic bovine bone maintains radiographic evidence of density and height stability of 1.5 years. In addition, histologic evidence supports the hypothesis that anorganic bovine bone is replaced by vital bone.     

An audit of hip fracture services in the Mater Hospital Dublin 2001 compared with 2006

Background  

Evidence-based practice supports the provision of integrated geriatric multidisciplinary care for older people with hip fractures.     

Phase-Field Models for Biofilms II 2-D Numerical Simulations of Biofilm-Flow Interaction

We study the biofilm-flow interaction resulting in biofilm growth, deformation and detachment phenomena in a cavity and shear flow using the phase field model developed recently [28]. The growth of the biofilm and the biofilm-flow interaction in various flow and geometries are simulated using an extended Newtonian constitutive model for the biofilm mixture in 2-D. The model predicts growth patterns consistent with experimental findings with randomly distributed initial biofilm colonies. Shear induced deformation, and detachment in biofilms is simulated in a shear cell. Rippling, streaming, and ultimate detachment phenomena in biofilms are demonstrated in the simulations, respectively, in a shear cell. Possible merging of detached biofilm blobs in oscillatory shear is observed in simulations as well. Detachment due to the density variation is also investigated shedding light on the possible bacteria induced detachment.     

GH1 gene deletions and IGHD type 1A

Human Growth Hormone gene ( GH1 ) resides on chromosome 17q22-24 and it is expressed in somatotropic cells of the anterior pituitary gland. While there are multiple causes of GH Deficiency (GHD) a significant proportion have a genetic basis. The most severe Mendelian form of IGHD, called IGHD IA, has an autosomal recessive mode of inheritance. While affected individuals can have short lengths at birth and hypoglycemia in infancy, all develop severe dwarfism by six months of age. Although short stature, delayed growth velocity, and delayed skeletal maturation all occur with IGHD, none are specific for IGHD 1A. GH1 gene deletions, frameshifts, or nonsense mutations cause complete absence of GH in IGHD 1A. Thus IGHD 1A is best described as being complete GHD caused by severe loss of function GH1 gene mutations rather than being limited to only those having GH1 gene deletions. Interestingly, GH1 gene deletions are recurring mutations that can arise through unequal recombination in meiosis rather than by allele sharing through common descent. Individuals with IGHD 1A develop severe dwarfism in early infancy and often develop anti-GH antibodies after receiving exogenous GH. These antibodies can prevent the growth response expected from exogenous GH therapy. Individuals who are heterozygous for a GH1 gene deletion but whose other GH1 allele is not deleted and produces a non truncated product are usually immune tolerant.     

New and persistent controlled substance use among patients undergoing mastectomy and reconstructive surgery

Breast Cancer Research and Treatment - Prolonged use of controlled substances can place patients at increased risk of dependence and complications. Women who have mastectomy and reconstructive...