Critical size defect in the canine mandible.

OBJECTIVE: The purpose of this study was to determine the minimum size defect in a canine mandible that would not spontaneously heal during the dog's natural life (the critical size defect). STUDY DESIGN: Sixteen adult female mongrel dogs underwent continuity resection on both sides of the mandible to create bilateral defects. In 8 dogs, mandibular defects ranging from 5 to 20 mm were created with periosteal resection. In the other 8 dogs, mandibular defects ranging from 30 to 60 mm were created preserving the periosteum. The dogs were then killed at 6 months and the defects examined using radiographs and histologic analysis. RESULTS: When the periosteum was removed, mandibular defects greater than 15 mm failed to heal across the entire defect. However, when the periosteum was preserved, mandibular defects needed to be greater than 50 mm in order to fail to heal. CONCLUSION: The critical size defect in a canine mandible model is 15 mm when the periosteum is removed and 50 mm when the periosteum is preserved.     

Studies on the synthesis andin vitro antitumor activity of the isoquinolone derivatives

3-Arylisoquinolin-1(2H)-ones (2) are possible bioisosteres of the 5-[4'-(piperidinomethyl)phenyl]-2,3-dihydroimidazo[2,1-a]iso quinoline (1) which is in clinical evaluation for the treatment of cancer. Structure-activity relationship studies of 3-arylisoquinolin-1(2H)-ones (2) led to the synthesis of 3-arylquinolin-2(1H)-ones (3). A number of 3-phenyl substituted quinolin-2(1H)-ones were synthesized and tested for their in vitro antitumor activity against four different human tumor cell lines and 3-phenyl-N-benzyl-3,4-dihydroquinolin-2(1H)-one (12) showed the most potent activity.     

Synthesis of benzo[c]phenanthridine derivatives and theirin vitro antitumor activities

Aiming at the development of anticancer agents by modification of phenolic benzo[c]phenanthridine alkaloid, additional hydroxyl group was put on C10 position of fagaridine (1) by a biomimetic synthetic procedure to afford 10-hydroxyfagaridine (12). All of the synthetic intermediates were also screenedin vitro antitumor activities against five different cell lines as well as12. Among them the representative cytotoxic results are shown as follows;p-quinone (11) [ED₅₀ (A549=0.22 μg/ml), (HCT15=0.21 μg/ml), fagaridine (1) (HCT 15=0.41 μg/ml), olefin (6) (HCT 15=0.06 μg/ml), acetal (7) (SKMEL-2=0.07 μg/ml), dihydrofagaridne (10) (A549=0. 38 μg/ml), 10-hydroxyfagaridine (12) (A 549=0.45 μg/ml). From these observation three main remarks can be drawn; (i) the iminium part of benzo[c]phenanthridine is not essential for showing acitvities, (ii) the additional hydroxyl group did not contribute to enhance the cytotoxicity, (iii) the 3-arylisoquinolin-1(2H)-one derivatives were found to display significantin vitro antitumor activity.     

Etiologic Classification Criteria of ARCO on Femoral Head Osteonecrosis Part 2: Alcohol-Associated Osteonecrosis

Background

Although alcohol is a leading risk factor for osteonecrosis of the femoral head (ONFH) and its prevalence reportedly ranges from 20% to 45%, there are no unified classification criteria for this subpopulation. In 2015, Association Research Circulation Osseous decided to develop classification criteria for alcohol-associated ONFH.

A likely explanation for the J-curve of blood pressure cardiovascular risk

We prospectively tested in the combined original and offspring Framingham cohorts the hypothesis that the increase in cardiovascular disease (CVD) incidence at low diastolic blood pressure (BP) is largely confined to subjects with increased systolic BP and hence an increased pulse pressure. The 10-year risk of 951 nonfatal CVD events and 204 CVD deaths was estimated at diastolic pressures of <80, 80 to 90, and > or =90 mm Hg, according to concomitant systolic BP. An increasing tendency for a J-curve relation of CVD incidence to diastolic BP was observed with successive increments in accompanying systolic BP. In both genders, a statistically significant excess of CVD events was observed at a diastolic BP of <80 mm Hg only when accompanied by a systolic BP of >140 mm Hg that persisted after adjustment for age and associated CVD risk factors. Patients with this condition of isolated systolic hypertension have been shown to benefit from antihypertensive treatment.     

Autoimmune cholangitis in a patient with thymoma

Autoimmune cholangitis is characterized biochemically by chronic cholestasis and histopathologically by chronic non-suppurative destructive cholangitis. It is associated with positive antinuclear antibody test and negative antimitochondrial antibody test results. Recently, we experienced a case of a 35-year-old woman with autoimmune cholangitis associated with thymoma who presented with pruritis, jaundice, chronic fatigue and anterior chest discomfort. Her laboratory examinations revealed marked increases in levels of serum alkaline phosphatase and gamma-glutamyl transpeptidase. In serological tests, antinuclear antibody was found, but antimitochondrial antibody was not. Liver biopsy findings were compatible with chronic non-suppurative destructive cholangitis. On computed tomography (CT) of the chest, a large anterior mediastinal mass was found. The mass was totally resected and the patient was treated with ursodeoxy cholic acid. Thereafter, her clinical symptoms improved and liver functions completely returned to the normal range. We describe here an uncommon association of autoimmune cholangitis with thymoma, which has not been reported previously in the English-written literature.     

Ridge alterations following immediate implant placement and the treatment of bone defects with Bio-Oss in an animal model

Background: Conflicting data exist on the outcome of placing Bio‐Oss® (Geitslich Pharm AG, Wolhausen, Switzerland) into extraction sockets. It is therefore relevant to study whether the incorporation of Bio‐Oss into extraction sockets would influence bone healing outcome at the extraction sites. Purpose: The aim of this study was to assess peri‐implant bone changes when implants were placed in fresh extraction sockets and the remaining defects were filled with Bio‐Oss particles in a canine mandible model. Materials and Methods: Six mongrel dogs were used in the study. In one jaw quadrant of each animal, the fourth mandibular premolars were extracted with an elevation of the mucoperiosteal flap; implants were then placed in the fresh extraction sockets and the remaining defects were filled with Bio‐Oss particles. After 4 months of healing, micro‐computed tomography at the implant sites was performed. Osseointegration was calculated as the percent of implant surface in contact with bone. Additionally, bone height was measured in the peri‐implant bone. Results: Average osseointegration was 28.5% (ranged between 14.8 and 34.2%). The mean crestal bone loss was 4.7 ± 2.1 mm on the buccal aspect, 0.4 ± 0.5 mm on the mesial aspect, 0.4 ± 0.3 mm on the distal aspect, and 0.3 ± 0.4 mm on the lingual aspect. Conclusion: The findings from this study demonstrated that the placement of implants and Bio‐Oss® particles into fresh extraction sockets resulted in significant buccal bone loss with low osseointegration.     

Clinically distinguishing between appendicitis and right-sided colonic diverticulitis at initial presentation

PURPOSE: Most patients diagnosed with right-sided colonic diverticulitis complain of right lower quadrant pain, which is frequently confused for appendicitis and therefore may result in unnecessary emergency surgery. In this paper we intend to differentiate between right-sided colonic diverticulitis and appendicitis by initial presentation in the emergency department. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 450 patients between January 1997 and July 2003. Among these patients, 92 with right-sided colonic diverticulitis were classified as group I; 268 patients with simple appendicitis were classified as group II; and 90 patients with perforated appendicitis were classified as group III. RESULTS: Prodromal symptoms were less common in group I (p < 0.05) than in the other groups. In comparing the location of maximal tenderness among groups, 19.6% of group I patients complained of maximal tenderness at a point lateral to McBurney's point, a greater percentage than those in groups II and III (p=0.002). Group I experienced less leukocytosis (10,913.8/mm(3)) than did groups II (13,238.3/mm(3)) and III (15,589.3/mm(3)). The percentage of segmented forms in the differential counts was also smaller in group I (73.6%) than in groups II (79.1%) and III (81.8%). In addition, the proportion of lymphocytes was larger in group I (17.7%) than in groups II (13.9%) and III (9.3%). CONCLUSION: Among patients complaining of right lower quadrant pain in an emergency setting, right-sided colonic diverticulitis must be considered in the following conditions to avoid unnecessary emergency operations: lack of prodromal symptoms, tenderness at a point lateral to McBurney's point, and absent or mild leukocytosis with a low fraction of segmented forms and a high fraction of lymphocytes in the CBC.