Clinical comparison of ultrasonic surgery and conventional surgical techniques for enucleating jaw cysts

The conventional treatment of odontogenic cysts usually involves enucleation of the cyst using rotary and manual instruments; such procedures can cause trauma to the cystic epithelium or soft tissues in the region, such as sinus membrane perforation or nerve damage. The use of ultrasonic surgery may reduce the risk of damage to soft tissues. The objective of this study was to evaluate the performance of ultrasonic surgery in removing odontogenic cysts. Eighty-two cysts were removed from 68 patients over a period of 45 months. Ultrasonic surgery was used for 34 patients and conventional surgical procedures were used for 34 control patients. Two surgeons rated the cutting efficiency, visibility of the surgical field, ease of operation, and ease of cyst epithelium removal on a 100-mm visual analogue scale. The operation time was also recorded. No major intraoperative or postoperative complications were observed, and there was no cyst recurrence. Ultrasonic surgery for enucleating jaw cysts was found to increase the operation time, but also markedly increased the visibility of the operation field. In cases where cyst enucleation is performed in difficult areas that require delicate manipulation, there is less risk of damage to vital structures such as neurovascular tissues with ultrasonic surgery.     

Vertical distraction osteogenesis of fibula transplant for mandibular reconstruction: a case report.

Bone continuity defects in the mandible are caused by tumor surgery, trauma, infection, or osteoradionecrosis. Today, reconstruction of long-span mandibular defects with a free fibular flap is a routine procedure. However the bone height of the mandible after reconstruction is about half that of the dentulous mandible. Therefore, the deficiency in bone height makes implant placement impractical. In our case, because it was necessary to restore the mandibular height, a vertical distraction osteogenesis was performed on the grafted mandible of the patient who was referred to our clinic with a reconstructed mandible owing to a gunshot injury. As a result, the vertical discrepancy between the fibula and the native hemimandible of the patient was corrected. And the placement of dental implants was performed without any complications. In conclusion, we believe that the vertical distraction osteogenesis of free vascularized fibula flaps is a reliable technique that optimizes implant positioning for ideal prosthetic rehabilitation.     

Telomere and microtubule targeting in treatment-sensitive and treatment-resistant human prostate cancer cells

Modulating telomere dynamics may be a useful strategy for targeting prostate cancer cells, because they generally have short telomeres. Because a plateau has been reached in the development of taxane-based treatments for prostate cancer, this study was undertaken to evaluate the relative efficacy of targeting telomeres and microtubules in taxane-sensitive, taxane-resistant, androgen-sensitive, and androgen-insensitive prostate cancer cells. Paclitaxel- and docetaxel-resistant DU145 cells were developed and their underlying adaptive responses were evaluated. Telomere dynamics and the effects of targeting telomeres with sodium meta-arsenite (KML001) (an agent undergoing early clinical trials), including combinations with paclitaxel and docetaxel, were evaluated in parental and drug-resistant cells. The studies were extended to androgen-sensitive LNCaP cells and androgen-insensitive LNCaP/C81 cells. Both P-glycoprotein (Pgp)-dependent and non-Pgp-dependent mechanisms of resistance were recruited within the same population of DU145 cells with selection for drug resistance. Wild-type DU145 cells have a small side population (SP) (0.4-1.2%). The SP fraction increased with increasing drug resistance, which was correlated with enhanced expression of Pgp but not breast cancer resistance protein. Telomere dynamics remained unchanged in taxane-resistant cells, which retained sensitivity to KML001. Furthermore, KML001 targeted SP and non-SP fractions, inducing DNA damage signaling in both fractions. KML001 induced telomere erosion, decreased telomerase gene expression, and was highly synergistic with the taxanes in wild-type and drug-resistant DU145 cells. This synergism extended to androgen-sensitive and androgen-insensitive LNCaP cells under basal and androgen-deprived conditions. These studies demonstrate that KML001 plus docetaxel and KML001 plus paclitaxel represent highly synergistic drug combinations that should be explored further in the different disease states of prostate cancer.     

Electrophysiological evidence of biphasic action of carnosine on long-term potentiation in urethane-anesthetized rats

Carnosine is a dipeptide synthesized by the carnosine synthetase from β-alanine and l-histidine. The well-known effects of carnosine may be related with mechanisms producing long-term potentiation which is one of the electrophysiological signs of memory. In the present study we aimed to investigate the effect of four different doses of carnosine on long-term potentiation in urethane-anesthetized rat. A bipolar stimulating electrode was placed in the medial perforant path and a double-barrel glass micropipette was placed in the dentate gyrus as the recording electrode. Artificial cerebrospinal fluid (in the control group) or carnosine (0.1, 1, 10, and 100 μg/μL) was infused into the dentate gyrus. Our results showed that the I/O curve of the excitatory postsynaptic potential slope or population spike amplitude was not significantly shifted by carnosine. We found that population spike amplitude increased to 244% and 287% at the dose of 100 μg/μL in the post-tetanic and induction phases, respectively, but decreased to 163% and 186% at the dose of 0.1 μg/μL and to 145% and 162% at the dose of 1 μg/μL when compared with 203% and 232% of the control values. However, there were no significant differences for the slope of excitatory postsynaptic potential. Carnosine had no effect on the EPSP slope or PS amplitude recorded from the dentate gyrus in response to test stimuli when high-frequency stimulation was not delivered. In the present study, we speculated that the effects of carnosine in lower or higher doses could be explained by its effect on different processes, such as soluble guanylyl cyclase inhibition or the conversion of carnosine into histamine.     

Assessment of neuromuscular blockade produced by atracurium in the rat diaphragm preparation. Measurements of tetanic fade, depression and recovery profile

The effect of atracurium, a relatively new muscle relaxant, on neuromuscular transmission, in the rat diaphragm preparation, was studied, by analysing the characteristic features of tetanic fade and recovery pattern following a blocking concentration of atracurium (10 microns). Tetanic fade (TF) and peak tetanic tension (Tp) and its depression by atracurium, were analysed and the results were interpreted in terms of atracurium action at the neuromuscular junction. Atracurium reduced the sustained tetanic tension, elicited at 50 Hz for 0.5 s duration, and produced a marked tetanic fade in 38 s. Atracurium also reduced the peak tetanic tension by 40%, of the control value, in 38 s. Maximum tetanic tension was 5.7 g tension, and the time taken to completely block the tetanus was 4.75 +/- 0.15 min (means +/- SE, n = 8). Recovery from atracurium-induced blockade occurred in 30s (tetanic fade) and in 3-4 min (peak tetanic tension). It was concluded that atracurium produces a profound tetanic fade, at a time when the peak tetanic tension is reduced by only 40%. The data presented indicate that atracurium has a rapid onset of blockade, intermediate duration and a quick recovery profile at the rat neuromuscular junction.     

Effects of two combined oral contraceptives containing ethinyl estradiol 30 μg combined with either gestodene or drospirenone on hemostatic parameters,lipid profiles and blood pressure

Objective  The aim of this study is to compare the effect of ethinyl estradiol 0.03 mg/gestodene 0.075 mg (EE/GSD) with ethinylestradiol 0.03 mg/drospirenone 3 mg (EE/DRSP) administered according to conventional 21/7 regimen on body mass index (BMI), blood pressure (BP), lipid metabolism and hemostatic parameters. Method  In this study, 160 healthy women were randomized to EE/GSD mg or EE/DRSP for 12 months. Mean differences in BMI, high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C), total cholesterol (TC) levels and BP compared to baseline were assessed. Results  One hundred and forty-five (89%) of the women completed all 12 treatment cycles. The subjects randomly assigned into two treatment groups. Group EE/GSD (n = 71) and group EE/DRSP (n = 72). In group B, BMI values were significantly lower than baseline at the sixth cycle. DRSP/EE had more favorable effects on BP than GSD/EE with the mean systolic and diastolic BPs remaining lower in the DRSP/EE group. The difference between the two preparations was not statistically significant at the end of the study. TC levels remained similar in both groups throughout the study period. In both groups LDL-C levels decreased, triglyceride and HDL-C levels significantly increased from baseline levels. These changes result in increasing HDL-C/LDL-C ratio, demonstrating anti-atherogenic effect. Menstrual cycle patterns and the incidence of adverse events were similar between groups. The duration of withdrawal bleeding decreased during the study for both groups and was similar. Conclusion  The EE/DRSP regimen provides good cycle control with reliable contraceptive efficacy and low incidence of adverse events. Compared with the EE/GSD preparation, the EE/DRSP preparation demonstrated a more favorable effect on BMI and BP with the mean BMI and mean BP remaining lower than baseline mean. The new formulation may be especially beneficial for women susceptible to body weight gain and rise in BP.     

Tetanic fade during neuromuscular blockade produced by atracurium in the rat diaphragm preparation

In the present investigation, we studied and measured the phenomenon of tetanic fade and peak tetanic tension depression in the rat diaphragm preparation in the presence of a blocking concentration of atracurium (e.g., 10 μmol.l^-1). Atracurium (10 μmol.l^-1) produced a pronounced tetanic fade (i.e., 47–69% reduction of total sustained tetanic tension) at a time (15 s) when it reduced the peak tetanic tension by only 25%. The time course for total tetanic fade was 30–35 s, whereas the time taken for complete peak tetanic tension depression was 3-3.5 min, suggesting that the two effects were produced via different mechanisms, involving presynaptic and postsynaptic mechanism. It was concluded that atracurium produces a profound tetanic fade, with respect to its effect on twitch or tetanic tension, suggesting that the drug is a potent neuromuscular blocker, with rapid onset of blockade.     

Local anaesthetics inhibit influx of calcium, sodium and potassium into rat ileum, diaphragm and human isolated saphenous vein

The effects of 5 different local anaesthetics, lignocaine, prilocaine, etidocaine, mepivacaine, bupivacaine, on uptake of Ca2+, Na+ and K+ were studied, using a Kone Microlyte Analyzer, into 3 different types of muscle fibres, the rat ileum, rat diaphragm and human isolated saphenous vein. The aim of the present experiments was to see if local anaesthetics had a calcium antagonistic activity, like that produced by calcium antagonists, e.g. verapamil. The results showed that local anaesthetics in moderate and high concentrations (more than 100 microM) depressed uptake of Ca2+, as well as the Na+ and K+, although the depression of the uptake of Ca2+ was 7 and 2 times less than those of Na+ and K+. In low concentrations (1-10 microM), the local anaesthetics had no or little effect on Ca2+ uptake, although they still significantly reduced Na+ and K+ uptake. It was concluded that the effect of local anaesthetics on uptake of Ca2+, Na+ and K+ into rat ileum, diaphragm and human saphenous vein, is concentration-dependent, and that only at high concentrations do they have a calcium antagonistic activity in muscle. Furthermore, there was no clear evidence that the effect of local anaesthetics was species-dependent, since the uptake of Ca2+ was depressed by only about 17% more in smooth muscle than in skeletal muscle.