The effect of He-Ne and Ga-Al-As laser light on the healing of hard palate mucosa of mice

Low-level laser therapy (LLLT) has been used to accelerate wound healing, yet questions remain concerning its therapeutic applications. This study aimed to compare the healing efficacy of helium-neon (He-Ne) red light (laser) and gallium aluminum arsenide (Ga-Al-As) infrared lasers at two different doses on hard palate wounds. In a randomized controlled study, 75 adult male mice were divided into five groups of 15 each, after undergoing identical surgical procedures; a control group, with no laser irradiation; HD1 and HD2 groups, treated with He-Ne laser (wavelengths 632.8 nm, power 5 mW, and spot size 0.02 cm²) at doses of 4 J/cm² and 7.5 J/cm² respectively; and GD1 and GD2 groups, treated with Ga-Al-As laser (wavelengths 830 nm, peak power 25 mW, and spot size 0.10 cm²) at the doses of 4 J/cm² and 7.5 J/cm², respectively. Five animals from each group were killed on the third, seventh, and 14 days after surgery, and biopsies were made for histological analysis. On the 3rd and 7th day after the surgery, the number of polymorphonuclear cells (PMN) in HD1, HD2, GD1, and GD2 groups was significantly lower than that of the control group. On the 7th and 14th day, the fibroblasts and new blood vessels counts and collagen density fibers in HD1, HD2, GD1, and GD2 groups were also significantly higher than that of the control groups, and the fibroblast counts and collagen density fibers in HD1 and HD2 groups were higher than that of the GD1 and GD2 groups. LLLT with He-Ne laser compared to Ga-Al-As laser has a positive healing effect on hard palate gingival wounds in mice regardless of the radiation dose.     

Left Atrial Appendage Occlusion and Ligation Devices: What Is Available, How to Implement Them, and How to Manage and Avoid Complications

OPINION STATEMENT: Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide, and it is associated with an elevated risk of thromboembolic events, including ischemic stroke. Evidence suggests that at least 90?% of left atrial thrombi discovered in patients with AF are localized to the left atrial appendage (LAA). Surgical ligation or excision of the LAA is considered the standard of care in patients who undergo mitral valve surgery or as an adjunct to a surgical Maze procedure for treatment of AF. In addition, in selected patients with AF and an elevated risk of thromboembolic events, particularly in those with contraindication to oral anticoagulation (OAC) therapy, it is reasonable to consider LAA exclusion to offer protection against ischemic stroke and other embolic complications. This can be achieved through a number of different strategies, including surgical amputation or ligation of the LAA, percutaneous endocardial occlusion of the LAA by deployment of occlusive devices, and also ligation of the LAA via a closed-chest, percutaneous, epicardial catheter-based approach in select patients. Although results from several recent percutaneous LAA closure and ligation studies are highly promising, the evidence for long-term efficacy and safety is insufficient to presently recommend this approach to all patients other than those in whom long-term OAC is contraindicated. Future randomized studies are required to further address the long-term safety and efficacy of these therapeutic options. Finally, the role for LAA occlusion and ligation seems less clear in patients who undergo successful catheter ablation of AF, since at least in a subgroup of these patients antiplatelet therapy alone has been shown to be sufficient.     

Proposing an ensemble learning model based on neural network and fuzzy system for keratoconus diagnosis based on Pentacam measurements

International Ophthalmology - The present study was done to evaluate efficiency of an ensemble learning structure for automatic keratoconus diagnosis and to categorize eyes into four different...     

Combined turnover vastus lateralis and lateral gastrocnemius flaps as a salvage option for soft tissue reconstruction of the knee

Infection with subsequent wound breakdown and soft tissue deficit represents the most devastating complication after total knee arthroplasty. Although microsurgical reconstruction is increasingly being performed in this setting, several factors may preclude its use. We present a case of a 52-year-old female patient who presented with a complex right anterior knee wound resulting from a complicated clinical course following total knee arthroplasty. Initial reconstructive efforts included coverage with a superiorly based fasciocutaneous thigh flap as well as a medial gastrocnemius flap. Persistence of infection and necrosis of the distal aspect of the fasciocutaneous flap eventually required salvage by means of a vastus lateralis turnover muscle flap augmented by a lateral gastrocnemius muscle flap. The combination of these two fairly straightforward muscle flaps provided stable wound coverage with well-vascularized tissue without the use of sophisticated microsurgical expertise. Level of Evidence: V, therapeutic study     

Risk of renal cell carcinoma and polymorphism in phase I xenobiotic metabolizing CYP1A1 and CYP2D6 enzymes

The progressive increase in sporadic renal cell carcinoma (RCC) observed in industrialized countries supports the opinion that certain carcinogens present in the environment (tobacco smoke, drugs, pollutants, and dietary constituents) may affect the occurrence and progression of this disease in developing countries like India. The polymorphism of the enzymes involved in metabolism of such environmental factors may, therefore, confer variable propensity to RCC. The possible association between RCC and a polymorphism of the CYP1A1 and CYP2D6 genes specific to the Indian population was examined using peripheral blood DNA from 196 RCC cases and 250 population controls with detailed data of clinicopathologic characteristics for the disease. The CYP1A1 (val) “variant” genotype, which contains at least 1 copy of the CYP1A1 variant alleles, was found to be associated with a 2.03-fold [GG ver. AA/AG, unadjusted OR = 2.03; 95%CI = 1.233–3.342; P = 0.005] increase in the risk of RCC. There was also a significant association (p^trend = 0.034) between higher frequency of RCC subjects containing at least of copy of the CYP1A1 (val) “variant” genotype with III or IV Fuhrman's grade. Whereas, the CYP2D6 polymorphism did not show any association with RCC risk [TT ver. CT/CC, unadjusted OR = 95%CI = 1.233–3.342; P = 0.005]. There was a significant association (p^trend = 0.001) between the poor metabolizer CYP2D6 (TT) and progression towards higher pathological stage of RCC. Our data demonstrate for the first time a significant association between pharmacogenetic polymorphisms of CYP1A1 and risk of RCC development in the Indian population. The findings suggest that inter-individual variation in the phase I metabolic enzymes involved in the fictionalization and detoxification of specific xenobiotics is an important susceptibility factor for development and progression of RCC in Indians.     

The objective CORE score allows early rule out in acute chest pain patients

Abstract

Objectives. Chest pain is a common complaint in the emergency department (ED), and it is a challenge to identify low-risk chest pain patients eligible for early discharge. We aimed to develop a simple objective decision rule to exclude 30-day major adverse cardiac events (MACE) in ED chest pain patients.

Design. We analyzed prospectively included patients presenting with chest pain. Low risk patients were identified with the clinical objective rule-out evaluation (CORE). CORE was based on high sensitivity cardiac troponin T (hs-cTnT) tests at ED presentation (0?h) and 2?h later together with a simplified risk score consisting of four objective variables: age ≥65 years and a history of arterial disease, hypertension or diabetes. For the patient to be classified as low risk in the CORE rule, hs-cTnT had to be ≤14?ng/L both at 0 and 2?h, and the sum of the risk score had to be 0. The primary outcome was MACE within 30 days.

Results. Among the 751 patients in the final analysis, 90 (11.9%) had a MACE. CORE identified 248 (33%) of patients as low risk with a sensitivity of 98.9% (CI 93.1–99.9) and a negative predictive value of 99.6% (95% CI 97.4–100) for 30-day MACE. Adding the ED physician’s interpretation of the ECG to CORE did not improve diagnostic performance.

Conclusion. A simple objective decision rule (CORE) identified one-third of all patients as having a very low 30-day risk of MACE. These patients may potentially be discharged without additional investigations for acute coronary syndrome.     

Trend in dental research output in Iran over a period of 20 years (1990–2009)

Introduction: The number of scientific papers is a conventional metric for the measurement of a country’s research performance in a particular area. Objective: To evaluate the trend in Iranian publications of dental research results in peer-reviewed international scientific journals over the period 1999–2009, using national and international databases, and to compare the results with other countries. Methods: The search process was performed by two independent persons in PubMed and Iranian Medline (IranMedex). Data extraction included the year of publication, total number of dental papers in each year, total number of Iranian dental papers in each year and number of papers with a high level of evidence; these were compared with those in other Asian countries. Results: The total number of dental articles indexed in PubMed during the studied period was 207,689, with 671 being written by researchers who stated their affiliation as Iran. Although the proportion of Iranian dental articles to all published dental articles was 0.01% in 1990, this increased to 1.4% in 2009. Of all clinical trials indexed in PubMed from 1990 to 2009, only 0.62% had an author from Iran. The collaboration rate of authors ranged between 1 and 10. Turkey and Iran had a larger number of dental research publications compared with other Asian countries assessed in this study. Conclusion: During the last two decades, there has been a considerable increase in the number of dental papers by Iranian researchers indexed in the PubMed database.Key words: Dental, research, Iran     

Posttraumatic reduction of edema with aquaporin-4 RNA interference improves acute and chronic functional recovery

Traumatic brain injury (TBI) is common in young children and adolescents and is associated with long-term disability and mortality. The neuropathologic sequelae that result from juvenile TBI are a complex cascade of events that include edema formation and brain swelling. Brain aquaporin-4 (AQP4) has a key role in edema formation. Thus, development of novel treatments targeting AQP4 to reduce edema could lessen the neuropathologic sequelae. We hypothesized that inhibiting AQP4 expression by injection of small-interfering RNA (siRNA) targeting AQP4 (siAQP4) after juvenile TBI would decrease edema formation, neuroinflammation, neuronal cell death, and improve neurologic outcomes. The siAQP4 or a RNA-induced silencing complex (RISC)-free control siRNA (siGLO) was injected lateral to the trauma site after controlled cortical impact in postnatal day 17 rats. Magnetic resonance imaging, neurologic testing, and immunohistochemistry were performed to assess outcomes. Pups treated with siAQP4 showed acute (3 days after injury) improvements in motor function and in spatial memory at long term (60 days after injury) compared with siGLO-treated animals. These improvements were associated with decreased edema formation, increased microglial activation, decreased blood–brain barrier disruption, reduced astrogliosis and neuronal cell death. The effectiveness of our treatment paradigm was associated with a 30% decrease in AQP4 expression at the injection site.     

Comparison of the accuracy of the London atlas and Smith method in dental age estimation in 5–15.99-year-old Iranians using the panoramic view

International Journal of Legal Medicine - Tooth development is widely used for age estimation and staging physical maturity. It is of great importance in dental age estimation in forensic...