Management of vertical bony defect using novel xenogeneic/allogeneic bone graft: case report

BACKGROUND

Guided tissue regeneration (GTR) is a common treatment modality for correcting vertical or bony defects in furcations. Multiple materials are used in GTR with allografts and xenografts being the most widely used. Each material has distinctive properties affecting the regenerative potential. A new bone graft combination of xenogenic/allogenic may improve the outcome of GTR by providing space maintenance (Xenograft) and osteoinductive potential (Allograft). The aim of this case report is to evaluate the efficacy of the new combined xenogenic/allogenic material based on clinical and radiographic outcomes.

METHODS

A 34-year old, healthy male presented with vertical bone loss interproximally between #'s 9 and 10. Clinical exam revealed 8 mm probing depth without mobility. The radiographic exam revealed a wide and deep vertical bony defect of 30-50% bone loss. The defect was treated using a layering technique with xenogenic/allogenic bone graft and collagen membrane.

RESULTS

The 6 and 12-months follow-ups revealed significant reduction in probing depths and radiographic bone fill.

CONCLUSIONS

GTR using a layering technique of xenogenic/allogenic bone graft and collagen membrane showed proper correction of a deep and wide vertical bony defect. The 12-month follow-up revealed healthy periodontium with normal probing depths and bone level. This article is protected by copyright. All rights reserved.

Sage, Rosemary, and Bay Laurel Hydrodistillation By-Products as a Source of Bioactive Compounds

Essential oils from Mediterranean wild plants are widely used, but the hydrodistillation residues produced in parallel with these essential oils are significantly understudied and underexploited. Since there are only fragmentary data in the literature, we have, for the first time, systematically analyzed the chemical composition of the by-products obtained after hydrodistillation of sage, bay laurel, and rosemary leaves, i.e., hydrolates, water residues, and solid residues. The chemical composition of the hydrolates changed compared to their respective essential oils towards the dominance of more hydrophilic, oxygenated compounds, such as camphor in sage, 1,8-cineole in bay laurel, and berbenone in rosemary. However, some compounds, mostly sesquiterpenes, which were present in considerable amounts in essential oils, were absent or only present in very small amounts in the hydrolates. Furthermore, both the water and the solid residues were rich in polyphenols, such as procyanidins in bay laurel and rosmarinic acid in rosemary and sage. In conclusion, we demonstrate the valuable chemical composition of sage, rosemary, and bay laurel hydrodistillation by-products and discuss a wide range of their possible applications.

Sage Extract as a Natural Source of Corrosion Inhibitor for Tinplate in 3.0 % NaCl

Research background

Due to the growing interest and attention of the world towards environmental problems and protection of environment, the worldwide demand for biodegradable and effective corrosion inhibitors for tinplate has grown. Considering the diversity of the structures of polyphenols that are present in sage extract, it represents a promising potential source of low-cost and effective biodegradable green corrosion inhibitor for tinplate in 3.0% sodium chloride solution which is evaluated in this study.

Experimental approach

Tafel polarisation and electrochemical impedance spectroscopy (EIS) at 25 °C have been used to evaluate the inhibitory activity of sage (Salvia officinalis L.) extract as a green inhibitor for the protection of tinplate from corrosion in 3.0% sodium chloride solution.

Results and conclusions

We used electrochemical impedance spectroscopy to show that sage extract could serve as an effective inhibitor (94.1%) of the corrosion of tinplate in 3.0% NaCl at a mass concentration of 0.2 mg/L and temperature of 25 °C. The results obtained from potentiodynamic polarisation reveal that the sage extract acts as a mixed type inhibitor, with inhibition efficiency up to 82.5%, and the inhibition efficiencies calculated from EIS are in close agreement with these results. Attenuated total reflection-Fourier transform infrared spectroscopy (ATR–FTIR) results indicated that the inhibitory effect of the sage extract is due to the presence of a passivation layer on the tinplate surface, which consists of organic compounds such as polyphenols. These results confirm that the sage extract is more efficient in inhibiting the corrosion of tinplate at a concentration of 0.2 mg/L than at higher concentrations. Also, it shows good inhibition of tinplate in 3.0% sodium chloride solution.

Novelty and scientific contributions

The exceptional corrosion inhibition potential of sage extract opens a door for its use and revalorization as a green corrosion inhibitor in the food industry.

Essential Oils of Sage, Rosemary, and Bay Laurel Inhibit the Life Stages of Oomycete Pathogens Important in Aquaculture

Saprolegnia parasitica, the causative agent of saprolegniosis in fish, and Aphanomyces astaci, the causative agent of crayfish plague, are oomycete pathogens that cause economic losses in aquaculture. Since toxic chemicals are currently used to control them, we aimed to investigate their inhibition by essential oils of sage, rosemary, and bay laurel as environmentally acceptable alternatives. Gas Chromatography-Mass Spectrometry (GC-MS) analysis showed that the essential oils tested were rich in bioactive volatiles, mainly monoterpenes. Mycelium and zoospores of A. astaci were more sensitive compared to those of S. parasitica, where only sage essential oil completely inhibited mycelial growth. EC₅₀ values (i.e., concentrations of samples at which the growth was inhibited by 50%) for mycelial growth determined by the radial growth inhibition assay were 0.031-0.098 µL/mL for A. astaci and 0.040 µL/mL for S. parasitica. EC₅₀ values determined by the zoospore germination inhibition assay were 0.007-0.049 µL/mL for A. astaci and 0.012-0.063 µL/mL for S. parasitica. The observed inhibition, most pronounced for sage essential oil, could be partly due to dominant constituents of the essential oils, such as camphor, but more likely resulted from a synergistic effect of multiple compounds. Our results may serve as a basis for in vivo experiments and the development of environmentally friendly methods to control oomycete pathogens in aquaculture.

Effect of Enzymatic, Ultrasound, and Reflux Extraction Pretreatments on the Chemical Composition of Essential Oils

The effect of different hydrodistillation pretreatments, namely, reflux extraction, reflux extraction with the addition of cell wall-degrading enzymes, and ultrasound, on the yield and chemical composition of essential oils of sage, bay laurel, and rosemary was examined. All pretreatments improved essential oil yield compared to no-pretreatment control (40–64% yield increase), while the oil quality remained mostly unchanged (as shown by statistical analysis of GC-MS results). However, enzyme-assisted reflux extraction pretreatment did not significantly outperform reflux extraction (no-enzyme control), suggesting that the observed yield increase was mostly a consequence of reflux extraction and enzymatic activity had only a minute effect. Thus, we show that ultrasound and reflux extraction pretreatments are beneficial in the production of essential oils of selected Mediterranean plants, but the application of enzymes has to be carefully re-evaluated.

Prophylaxis of impacted teeth using MRI and focal ultra-sound ablation?… a feasible hypothesis

Teeth start as bi-layered epithelial soft tissue follicles within bony jaws. Follicles grow into teeth and erupt. Early third molar follicles are detectable 8-9 years (±9 months). Intra-oral dental arches of jaws have finite space accommodating formed crowns. The last teeth to erupt are third molars. When the space needed by all the teeth exceeds the total arch space available, wisdom teeth may become impacted in bone. Lower impactions are more prevalent due to the mandible shape, and impaction associated pathologies with erupting partially or totally impacted teeth are common. Impacted third molars are universally prevalent from 17 to 23 years. Third molar impactions are sources of infection, pain, cyst formation and contribute to malocclusions and other pathologies. Surgical removal of third molars is traumatic, invasive and painful and may produce complicating morbidities. Magnetic resonance imaging (MRI) is used to locate lesions with clear definition and accurate targeting, both in soft and hard tissue organs. Focused ultrasound (FUS) is used to ablate hard and soft tissue structures and stops growth of targeted pathologies. For example, FUS is used to ablate CNS brain tumours, cell causing Parkinson's disease, prostatic growths and thrombolysis in strokes.

HYPOTHESIS

Modern imaging techniques, like MRI, can accurately locate third molar follicles at age 9, before wisdom teeth form and grow. MRI in combination with FUS could be used to ablate follicles of third molars, stop tooth growth (both crown and root) and so avoid later impactions.

The development of medical-manager roles in European hospital systems: a framework for comparison

A central motif of health reforms around the world has been the drive to persuade doctors and other clinical professionals to become more actively engaged in the management of services. Examples include moves to extend the commissioning role of primary care doctors (such as general practitioners in the UK) and the introduction of ‘clinical directorates’ in secondary care. This strategy has been seen as a means of controlling professionals, turning ‘poachers into game keepers’, especially with regard to resource allocation. However, there is also a mounting body of evidence pointing to how clinical leadership may play a role in stimulating quality improvement and new innovations inservice design, with positive consequences for patient safety and satisfaction (1). Focusing on the top 100 hospitals in the US Goodall (2) finds a strong positive association between the ranked quality of hospitals and whether the chief executive officer was a clinician. A survey of 1200 hospitals across seven countries (UK, US, Germany, France, Italy,Canada and Sweden) conducted by McKinsey and LSE also finds that clinically qualified managers improve both the effectiveness of management decisions and clinical performance of hospitals overall (3).

Cystic degeneration in fibrous dysplasia of the jaws: a case report

A case of nonspecific cystic degeneration complicating fibrous dysplasia of the mandible is presented. This condition is extremely rare in the jaw bones. The patient had a painless swelling of the right face measuring 10 cm in diameter, and there was no history of trauma. Radiographs showed a poorly defined, "ground glass" radiopaque lesion; a central well-defined cyst was confirmed by means of computed tomography. During surgery, a large cystic cavity with surrounding, soft fibrous bone that merged with the cortex was observed. Histologic examination showed a large non-epithelial-lined cystic cavity with a surrounding fibro-osseous lesion, which was consistent with a diagnosis of fibrous dysplasia.

Changes in practice nursing: professionalism, segmentation and sponsorship

In the wake of recent government policies and legislation, practice nursing has undergone major changes. Not least of these has been the rapid growth in the number of practice nurses. In addition, their work role has grown greatly over recent years. This has given rise to the question of whether their professional development now justifies their status as autonomous nurse practitioners. This and related issues are explored in the empirical part of this paper, which focuses on the changes in the work and responsibilities of practice nurses in two industrial towns in the English Midlands.

Characterisation of seven human ovarian tumour cell lines

Characteristics of a panel of seven human ovarian tumour cell lines are presented. Positive staining with HMFG2 and ultrastructural identification of desmosomes confirmed the epithelial nature of the cell lines. The lines showed wide variations in ploidy, doubling times and clonogenicity in soft agar. Both vimentin and keratin were equally expressed in five lines, one line showed strong preferential expression of keratin and one line showed preferential expression of vimentin. Karyotypic changes associated with ovarian cancer were identified in all the lines. Four of the seven cell lines showed loss of chromosome material distal to 11p13-15. These cell lines offer considerable potential for research into the biology and genetics of ovarian cancer.

18-year longitudinal study of cantilevered fixed restorations

One hundred thirty-seven cantilevered fixed partial dentures made between 1974 and 1990 were clinically and radiographically evaluated. Thirty-three of the prostheses were located in the mandible (11 in the anterior and 22 in the posterior region) and 104 were located in the maxillae (58 anterior prostheses and 46 posterior prostheses). Median duration was 84 +/- 3.6 months. During the 18 years, 41 (30%) failed. Of those that "failed," 28 (68%) were in the maxillae and 13 (32%) were in the mandible. Reasons for failure included abutment fracture (4), loosening with or without caries (18), secondary caries (9), fracture of prosthesis (2), fracture of extension (1), periodontal problems (6), and apical reaction (1). Failures occurred significantly more when endodontically treated abutments were used. More mandibular restorations failed than did maxillary units, but the difference was not significant. The prosthesis length ratio and the crown length-bone ratio did not influence the failure rate. The overall success rate of cantilever fixed prostheses was 70% over a period of 18 years.

Managerialism and professionalism in general practice: teamwork and the art of "pulling together"

Considers the impact of recent government policy on the organization of primary care in England and Wales. Discusses the notion and practice of "teamworking" currently in vogue, and analyses implications for doctors, nurses and managers working in/attached to general practices. Draws on the findings of a study of primary care team building which took place in a UK health authority (here referred to as "Weston"), and focuses on the experience of four general practices as they have attempted to develop as multidisciplinary partnerships. Gives consideration to the "new managerialism" evident in the NHS and its attempt to redefine professionalism and professional autonomy.

Xamoterol improves the control of chronic atrial fibrillation in elderly patients

Twenty digitalized elderly patients with chronic atrial fibrillation were randomized into a double-blind cross-over study. None was in overt heart failure and all were taking < 80 mg frusemide daily. They received xamoterol 200 mg b.d. for 2 months with their usual dose of digoxin for 1 month and placebo digoxin for the other month. Twenty-four-hour heart rate analysis was done at baseline and at the end of each treatment period. Compared with baseline digoxin, xamoterol alone significantly increased nocturnal minimum heart rate [85 +/- 17 vs. 62 +/- 9 (mean +/- SD), p < 0.0001] without affecting daytime maximum heart rate (132 +/- 18 vs. 122 +/- 20, p = NS). Compared with baseline digoxin, xamoterol plus digoxin significantly increased nocturnal minimum heart rate (68 +/- 8, p < 0.05) and reduced daytime heart rate (114 +/- 17, p < 0.05). The mean number of pauses > 1.5 s was significantly reduced by xamoterol alone. Walking distance in 6 minutes was 406.1 +/- 27.1 m (mean +/- SE) at baseline and improved significantly on both treatments (450.3 +/- 19.8 on xamoterol; p < 0.02 and 453.7 +/- 19.2 on xamoterol plus digoxin; p < 0.01). No significant change was found in subjective measurements of palpitations, breathlessness and well-being using visual analogue scales. Xamoterol combined with digoxin improves effort tolerance and heart-rate control by reducing diurnal tachycardia and nocturnal bradycardia and pauses.

Expression of a cardiac Ca(2+)-release channel isoform in mammalian brain

Mammalian brain possesses ryanodine-sensitive Ca2+ channels, which in muscle cells mediate rapid Ca2+ release from intracellular stores during excitation-contraction coupling. Analysis of bovine brain ryanodine receptor (RyR) channels suggests specific expression of the cardiac-muscle RyR isoform in mammalian brain. Localization using cardiac-muscle RyR-specific antibodies and antisense RNA revealed that brain RyRs were present in dendrites, cell bodies and terminals of rat forebrain, and highly enriched in the hippocampus. Activity of skeletal-muscle RyR channels is coupled to sarcolemmal voltage sensors, in contrast with cardiac-muscle RyR channels, which are known to be Ca(2+)-induced Ca(2+)-release channels. Thus Ca(2+)-induced Ca2+ release from intracellular stores mediated by brain RyR channels may be a major Ca(2+)-signalling pathway in specific regions of mammalian brain, and hence may play a fundamental role in neuronal Ca2+ homoeostasis.

A comparison of the growth promoting properties of ascitic fluids, cyst fluids and peritoneal fluids from patients with ovarian tumours

The growth promoting properties of ascitic fluids, cyst fluids and peritoneal fluids from patients with ovarian malignancy, benign ovarian tumours and non-tumour related gynaecological conditions have been investigated using an ovarian carcinoma cell line (OAW 42), mesothelial cells (58MC) and rat kidney cells (NRK-49F). Colony stimulating activity (CSA) for tumour cells and transforming activity (TA) for mesothelial cells were weakly correlated, but whereas elevated TA was tumour-associated, CSA was not. However, TA was not cancer-associated and, although the difference between the mean TA values of benign and malignant cyst fluids was of borderline significance, some benign cyst fluids from cystadenomas showed high TA values. Higher levels of TA in the cystadenomas showed a significant correlation with the menopausal status of the patient and higher levels of TA in the malignant cyst fluid/peritoneal fluid groups were associated with more advanced disease. Results indicated that some fluids contained TGF-beta-like activity, but there was no direct evidence for the presence of TGF-alpha/EGF-like activity in the fluids. Heparin inhibited clonogenic growth of tumour cells but not mesothelial cells. The reduced CSA which was observed after treatment of fluids with both heparin and thrombin implicated coagulation factors in the manifestation of CSA. It was concluded that CSA in the fluids was due, at least partly, to fibrin coagulation, and TA was due to unknown growth factor(s) which may include TGF-beta-like activity. The results are discussed in the context of the aetiology of ovarian carcinoma, and the possible clinical significance of TA.

The effect of posture at the time of administration on the central depressant effects of the new hypnotic zopiclone

Nine healthy volunteers swallowed 7.5 mg zopiclone in the standing and lying positions on different occasions. Plasma concentrations of zopiclone and psychometric tests, including simple and complex reaction time, and critical flicker fusion threshold, were performed at regular intervals after drug administration. The results show that when the drug was swallowed in the supine position, there was a significant delay in the onset of the impairment of psychomotor function, with prolongation in time to peak impairment by 30-40 min (P less than 0.02). The overall impairment in psychomotor performance was found to be significantly less after administration of the drug in the supine position (P less than 0.005). Pharmacokinetic analysis revealed a prolongation in lag time of greater than 20 min before absorption began (P less than 0.002) after supine drug administration, with a significantly lower rate constant of absorption (P less than 0.02). Area under the plasma concentration-time curve extrapolated to infinity and rate constant of elimination were not significantly different between the two modes of administration. We conclude that to obtain a rapid and complete effect from the hypnotic zopiclone, the tablet should be swallowed in the standing position.