Effects of ipriflavone on augmented bone using a guided bone regeneration procedure

: This study investigated the effects of ipriflavone (IP) on augmented bone using a guided bone regeneration (GBR) procedure. In 15 rabbits, two titanium caps were placed into calvarial bone for GBR. The animals were divided into three groups: the No-IP (no intake of IP), Post-IP (IP orally, 10 mg/kg/day after GBR), and Pre-IP (IP intake beginning before GBR) groups. One cap was removed from each rabbit after 3 months, and the remaining site was a control. One month after one cap removal, all the animals were euthanized, and histologic and histomorphometric analyses were performed. In all of the groups, the newly generated tissue was of varying size, and it consisted of thin pieces of mineralized bone and large marrow spaces with fat cells and some hematopoietic cells. In all of the control sites, the newly generated tissue was noted and almost filled the space under the cap. There was a significant difference between groups No-IP and Pre-IP (93.8+/-4.6% vs. 98.5+/-0.8%, P<0.05). The tissue generated at the test sites in all of the groups was resorbed, and its original shape and volume were not maintained 1 month after one cap removal. In particular, the greatest percentage, approximately 20% of the newly generated tissue, was resorbed in the No-IP group (93.8+/-4.6% vs. 73.9+/-3.7%, P<0.05), and approximately 11% and 15% in groups Post-IP and Pre-IP, respectively. The relative amount of mineralized bone generated at the control and test sites was significantly larger in groups Post-IP and Pre-IP when compared with group No-IP, except for the test site between groups No-IP and Post-IP (P<0.05). Therefore, the amount of mineralized tissue generated appeared to increase with an increase in the total IP dose. Within the limitations of this rabbit experimental model, we conclude that the daily intake of IP before or after GBR inhibits the resorption of augmented tissue and would be useful for improving the quality of newly generated bone beyond the skeletal envelope.     

Hard palate mucoperiosteal graft for posterior lamellar reconstruction of the upper eyelid: histologic rationale

Reconstruction of full-thickness upper eyelid defects often requires repair of both the anterior lamella (skin and orbicularis oculis muscle) and the posterior lamella (tarsus and conjunctiva). Various autogenous grafts have been used for posterior lamellar reconstruction, but it is still unclear which material is most suitable for repairing the posterior lamella. We report a patient in whom a subtotal defect of upper eyelid was reconstructed with a bipedicled myocutaneous flap lined by hard palate mucoperiosteum. We also examined tarsoconjunctiva, labial mucosa, hard palate mucoperiosteum, and auricular cartilage histologically and assessed the histologic features of these tissues as substitutes for the posterior lamella. An even and stable upper eyelid was formed by our method of reconstruction. A mucoperiosteal graft from the hard palate bears a close resemblance to the tarsoconjunctiva histologically because it contains both fibrous connective tissue and a mucous membrane. The graft took completely and there was no donor site morbidity or postoperative complications. A hard palate mucoperiosteal graft may be an optimal substitute for the posterior lamella of the upper eyelid.     

Circadian rhythm of serum concentration of small dense low-density lipoprotein cholesterol

BACKGROUND: The atherogenicity of small dense low-density lipoprotein (sdLDL) has been reported and recently a new easy-handling method for measuring serum concentration of sdLDL cholesterol (sdLDLC) has been developed. Using this method, we observed the circadian rhythm of sdLDLC to determine the adequacy of fasting measurement of it and to seek the modulator of the atherogenic lipoprotein. METHODS: Study population was consisted of 20 healthy volunteers (10 women and 10 men, mean age 28 y). They had 3 meals per day and blood samples were taken before and 2 h after every meal and next morning. Serum concentrations of sdLDLC and other valuables including triglyceride (TG) and remnant-like particles cholesterol (RLPC) were determined. RESULTS: Serum concentration of sdLDLC had a unique circadian rhythm that was highest before breakfast (fasting status), decreased after each meal, hit the bottom after dinner and then increased during at night. Fasting sdLDLC was highly correlated with TG levels. The sum of the 6 TG values during a day (i.e., average TG level) had higher correlation coefficient with sdLDLC than fasting TG or fasting RLPC. CONCLUSIONS: From the observation of the unique circadian rhythm, measuring sdLDLC at fasting status is exactly reasonable because it never underestimate the risk of atherosclerotic diseases. Measuring sdLDLC can also be used as a marker for average TG levels regardless of the existence of postprandial hyperlipidemia.     

One-year outcome of combination therapy with intravitreal anti-vascular endothelial growth factor and photodynamic therapy in patients with pachychoroid neovasculopathy

Graefe's Archive for Clinical and Experimental Ophthalmology - To identify the functional outcome and evaluate the morphologic changes of patients with pachychoroid neovasculopathy (PNV)...     

Vascularity of gastric carcinoma: evaluation using color Doppler ultrasonography

Purpose The purpose of this study was to investigate the vascularity of primary gastric cancer lesions using color Doppler ultrasonography.Methods We used color Doppler ultrasonography to study 78 patients with gastric cancer detected on B-mode ultrasonographic examination and 14 patients without gastric tumors but with a slightly thickened gastric wall that was also detected on B-mode ultrasound. The color Doppler signals of the gastric lesions were graded as (–), no color signals; (+), slight increase in number of color signals; and (++), an obvious increase in number of color signals. The vessel area outside the tumor area in the microscopic pathological specimens was also calculated.Results The color signals of 13 (18%) of the 71 gastric cancer patients were graded (–); those of 14 (20%) patients were graded (+); and those of 44 (62%) patients were graded (++). The color signals for 9 (65%) of 14 patients without gastric tumors were graded (–); those of 4 (28%) patients were graded (+), and those of 1 patient (7%) were graded (++). These differences were significant (P = 0.0002). The vessel count ratio in the microscopic pathologic specimens was also significantly higher in patients with an increased number of color signals than in those without an increased number of color signals (P = 0.002).Conclusion Color Doppler ultrasound showed increased vascularity in the gastric cancers in most of the subjects (82%, 58/71). Furthermore, color Doppler ultrasound also showed no increase in vascularity in most subjects (65%, 9/14) whose B-mode ultrasonograms showed thickened gastric walls but who did not have gastric cancer. Thus, color Doppler imaging may prove useful as a screening modality for gastric cancer.     

Echocardiographic changes in diastolic filling and stroke volume during postural alterations and ankle exercise in a patient with congenital defect of the pericardium

Journal of Echocardiography -     

Biofilm Producing Staphylococcus epidermidis (RP62A Strain) Inhibits Osseous Integration Without Osteolysis and Histopathology in a Murine Septic Implant Model

Despite its presence in orthopaedic infections, Staphylococcus epidermidis's ability to directly induce inflammation and bone destruction is unknown. Thus, we compared a clinical strain of methicillin-resistant biofilm-producing S. epidermidis (RP62A) to a highly virulent and osteolytic strain of methicillin-resistant Staphylococcus aureus (USA300) in an established murine implant-associated osteomyelitis model. Bacterial burden was assessed by colony forming units (CFUs), tissue damage was assessed by histology and micro-computed tomography, biofilm was assessed by scanning electron microscopy (SEM), host gene expression was assessed by quantitative polymerase chain reaction, and osseous integration was assessed via biomechanical push-out test. While CFUs were recovered from RP62A-contaminated implants and surrounding tissues after 14 days, the bacterial burden was significantly less than USA300-infected tibiae (p < 0.001). In addition, RP62A failed to produce any of the gross pathologies induced by USA300 (osteolysis, reactive bone formation, Staphylococcus abscess communities, marrow necrosis, and biofilm). However, fibrous tissue was present at the implant-host interface, and rigorous SEM confirmed the rare presence of cocci on RP62A-contaminated implants. Gene expression studies revealed that IL-1β, IL-6, RANKL, and TLR-2 mRNA levels in RP62A-infected bone were increased versus Sterile controls. Ex vivo push-out testing showed that RP62A-infected implants required significantly less force compared with the Sterile group (7.5 ± 3.4 vs. 17.3 ± 4.1 N; p < 0.001), but required 10-fold greater force than USA300-infected implants (0.7 ± 0.3 N; p < 0.001). Taken together, these findings demonstrate that S. epidermidis is a commensal pathogen whose mechanisms to inhibit osseous integration are limited to minimal biofilm formation on the implant, and low-grade inflammation. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:852-860, 2020