Improved bone regeneration through amniotic membrane loaded with buccal fat pad-derived MSCs as an adjuvant in maxillomandibular reconstruction

BackgroundHuman amniotic membranes (HAMs), as a biological membrane with healing, osteogenic, and cell therapy potential, has been in the spotlight to enhance the outcomes of treating bone defects. Present study aims to clinically assess the potential of HAM loaded with buccal fat pad-derived stem cells (BFSCs) as an osteogenic coverage for onlay bone grafts to maxillomandibular bone defects.Materials and methodsNine patients with jaw bone defects were enrolled in the present study. The patients were allocated to two study groups: Iliac crest bone graft with HAM coverage (n = 5), and Iliac bone grafts covered with HAM loaded with BFSCs (n = 4). Five months following the grafting and prior to implant placement, cone beam computed tomography was performed for radiomorphometric analysis.ResultsThe mean increase in bone width was found to be significantly greater in the HAM + BFSCs group (4.42 ± 1.03 mm versus 3.07 ± 0.73 mm, p < 0.05). Further, the changes in vertical dimension were greater in the HAM + BFSCs group (4.66 ± 1.06 mm versus 4.14 ± 1.03 mm, p > 0.05).ConclusionCombined use of HAM with mesenchymal stem cells may enhance bone regeneration specifically in the horizontal dimension. Moreover, this methodology reduces the amount of harvested autogenous bone and diminish secondary bone resorption.     

Comparison of salivary and plasma antioxidant levels in lichen planus patients and healthy subjects

J Oral Pathol Med (2012) 41 : 524–526 Introduction: Oral lichen planus (OLP) is a chronic, mucocutaneous, inflammatory disease. It has become more evident that the immune system plays a primary role in the development of this disease. The aim of the present study was to evaluate the total antioxidant status (TAS) of saliva and serum in patients with erosive OLP. Method and Materials: This study was designed as case‐control. In total, 48 patients with erosive OLP (34 women and 14 men) were enrolled as case group, and 44 self‐admitted healthy people (34 women and 10 men) were selected as control group. Measurement of total antioxidant status was carried out in saliva and plasma. t‐test was used for statistical analysis with significant level set at P < 0.05. Results: The mean ± SD of salivary TAS in case group was 0.98 ± 0.12, and in control group was 1.32 ± 0.18 mM, respectively, and there were significant differences between groups (P < 0.02). The mean ± SD of the plasma TAS in the case group and the control group was 1.24 ± 0.17 and 1.84 ± 0.34 mM, respectively. There were significant differences between two groups (P < 0.01). Conclusion: Our results showed that salivary and plasma levels of total antioxidant status in erosive OLP patients were lower than those in healthy subjects.     

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