Evaluation of Three-Dimensional Volumetric Changes After Sinus Floor Augmentation with Mineralized Cortical Bone Allograft

Aim

The aim of this retrospective study was to quantify three-dimensional (3D) volumetric bone changes over a two-year period in maxillary sinuses augmented with a mineralized cortical bone allograft material (MCBA) material.

Patients and Methods

Eleven patients (6 males and 5 females) with mean of age of 51.6 (range: 46–61) years were treated to increase the vertical dimension of the alveolar crest by maxillary sinus floor augmentation procedure. Study data were collected from patient records and by analyzing preoperative radiographs and cone beam computed tomography (CBCT) scans taken within the first two weeks after maxillary sinus lift (T0), immediately before implant placement four months after grafting (T1), and after one year of implant loading (T2). All DICOM-formatted images were rendered into volumetric images using software that automatically calculated the volume of the grafted material in cubic centimeters.

Results

Mean graft volume was 16.24 ± 1.54 cm³ at T0, 14.48 ± 1.48 cm³ at T1 and 13.06 ± 1.39 cm³ at T2. Mean volume retraction resulted in 1.76 ± 0.34 cm³ ΔV1 (T0–T1) and 1.42 ± 0.4 cm³ ΔV2 (T1–T2) and was 10.83 % of the initial total volume at (T0–T1) and 9.8 % of the total volume (T1–T2).

Conclusion

The present retrospective investigation demonstrated a 20.63 % decrease in graft volume. Volumetric 3D assessment of CBCT scans with the selected software appeared to be a promising approach to quantifying long-term changes in the grafted area.     

The dorsal raphe nucleus as a site of action of the antinociceptive and behavioral effects of the alpha4 nicotinic receptor agonist epibatidine

The mechanisms and sites of action of epibatidine-induced antinociception and side effects are poorly understood. The present study tested the hypothesis that the serotonergic dorsal raphe nucleus is a site of action of epibatidine. Behavioral responses of rats to hindpaw formalin injection were compared after direct administration of epibatidine into the dorsal raphe and after subcutaneous administration. Different groups of rats were injected with formalin into the rear paw after administration of either epibatidine (0.01, 0.015, 0.03, and 0.06 microg) in the dorsal raphe or epibatidine (2.5-5 microg/kg) subcutaneously. Assessment of pain related behavior was done evaluating the incidence of favoring, lifting, and licking of the injected paw in the different groups. Abnormal behavior (freezing) was also recorded. Epibatidine was at least 100 times more potent when administered into the dorsal raphe nucleus versus systemically, implicating this nucleus as a site of action of the analgesic effects of epibatidine. Thus, epibatidine (0.015, 0.03, and 0.06 microg) in the dorsal raphe resulted in a significant lower pain score in the second phase of the formalin test compared with control rats and was as effective as subcutaneous epibatidine. The analgesic effects of epibatidine were regionally selective in that administration of epibatidine within the periaqueductal gray area but outside the dorsal raphe area was not analgesic. The highest doses of intraraphe epibatidine (i.e., 0.03-0.06 microg) also produced "freezing" behavior immediately after injection, which was relatively short-lived compared with the analgesic effect. Together, the results implicate the dorsal raphe nucleus as a target for the analgesic and perhaps anxiogenic effects of epibatidine.     

Acetylcholinesterase Inhibitory Activity and Molecular Docking Study of 1‐Nitro‐2‐Phenylethane,the Main Constituent of Aniba canelilla Essential Oil

The odoriferous principle of Aniba canelilla (H.B.K.) Mez is due 1‐nitro‐2‐phenylethane, the main constituent of its essential oil and also responsible for the plant's cinnamon scent. This nitroderivative was previously reported by their antioxidant, antinociception, cardiovascular, and vasorelaxant properties, and now it was tested as the inhibitor of acetylcholinesterase using bioautography on TLC plates. The oil and a purified fraction containing 1‐nitro‐2‐phenylethane were analyzed by GC and GC‐MS. The percentage content of 1‐nitro‐2‐phenylethane in the oil and after fractionation was 70.2% and 98.0%, respectively. The results showed that the oil and 1‐nitro‐2‐phenylethane are strong acetylcholinesterase inhibitors with the detection limit of 0.01 ng, equivalent to physostigmine used as the positive control. A molecular docking study was used to determine the position and conformation of the 1‐nitro‐2‐phenylethane inhibitor in the receptor‐binding pocket of the acetylcholinesterase enzyme. The nitrogroup of 1‐nitro‐2‐phenylethane was positioned near of the catalytic serine residue of acetylcholinesterase, forming strong hydrogen bond with its hydroxyl group. Therefore, the electronegative character of 1‐nitro‐2‐phenylethane may explain the interaction that occurs with the catalytic serine residue and its significant inhibitory activity of acetylcholinesterase.     

European Laryngological Society: ELS recommendations for the follow-up of patients treated for laryngeal cancer

It is accepted that the follow-up of patients who had treatment for laryngeal cancer is a fundamental part of their care. The reasons of post-treatment follow-up include evaluation of treatment response, early identification of recurrence, early detection of new primary tumours, monitoring and management of complications, optimisation of rehabilitation, promotion smoking and excessive alcohol cessation, provision of support to patients and their families, patient counselling and education. Controversies exist in how these aims are achieved. Increasing efforts are being made to rationalise the structure and timing of head and neck cancer follow-up clinics. The aim of this document is to analyse the current evidence for the need to follow up patients who have been treated for LC and provide an up to date, evidence-based statement which is meaningful and applicable to all European Health Care Systems. A working group of the Head and Neck Cancer Committee of the ELS was constituted in 2009. A review of the current published literature on the management and follow-up of laryngeal cancer was undertaken and statements are made based on critical appraisal of the literature and best current evidence. Category recommendations were based on the Oxford Centre for Evidence-Based Medicine. Statements include: length, frequency, setting, type of health professional, clinical assessment, screening investigations, patient’s education, second primary tumours, and mode of treatment considerations including radiotherapy, chemo-radiation therapy, transoral surgery and open surgery. It also addresses specific recommendations regarding patients with persistent pain, new imaging techniques, tumour markers and narrow band imaging.     

CO2 laser-assisted microsurgery for intracordal cysts: technique and results of 49 patients

Microsurgery for intracordal cysts is a challenging procedure, because cysts are close to the vocal ligament and the risk of inducing a scar is high. In this retrospective study, our experience with the CO₂-laser scanning system (Acublade^®) is reported on 49 patients. There were 41% epidermoid cysts and 59% mucous retention cysts. A quarter of the patients presented with bilateral cystic lesions and 59% had a contralateral lesion other than a cyst. The cyst was removed after a minimicroflap. It was dissected away from the lamina propria and the epithelium. Collagen was injected intraoperatively if the glottal gap was considered important. The epithelium was redraped using Tissucol (Baxter, Vienna, Austria). The mean follow-up time was 160 days. We noted a statistically significant improvement in the grade of the dysphonia according to Hirano’s perceptual scale (G pre = 2, G post = 1, p = 0.002); the Vocal Handicap Index (VHI pre = 51, VHI post = 28, p = 0.001) and the maximal phonation time in milliseconds (MPT pre = 11, 1 MPT post = 12.7, p = 0.033) in all the patients. In the professional voice subgroup (20/49 patients), there was a significant improvement in the frequency range (FR pre = 310 Hz, FR post = 434 Hz, p = 0.001). The CO₂-laser scanning system is reliable in the treatment of intracordal cysts.     

Secondary metabolic effects in complex I deficiency

The objective of this study was to investigate clinical, biochemical, and genetic features in 7 probands (a total of 11 patients) with nicotine-amide adenine dinucleotide (NADH) dehydrogenase (complex I) deficiency. We screened the mitochondrial DNA for mutations and found pathogenic mutations in complex I genes (mitochondrial NADH dehydrogenase subunit (MTND) genes) in three probands. The 10191T>C mutation in MTND3 and the 14487T>C mutation in MTND6 were present in two probands with Leigh's-like and Leigh's syndrome, respectively. Four siblings with a syndrome consisting of encephalomyopathy with hearing impairment, optic nerve atrophy, and cardiac involvement had the 11778G>A mutation in MTND4, previously associated with Leber hereditary optic neuropathy. These findings demonstrate that mutations in MTND genes are relatively frequent in patients with complex I deficiency. Biochemical measurements of respiratory chain function in muscle mitochondria showed that all patients had a moderate decrease of the mitochondrial adenosine triphosphate production rate. Interestingly, the complex I deficiency caused secondary metabolic alterations with decreased oxaloacetate-induced inhibition of succinate dehydrogenase (complex II) and excretion of Krebs cycle intermediates in the urine. Our results thus suggest that altered regulation of metabolism may play an important role in the pathogenesis of complex I deficiency.