Insidious Mass Within a Sinus

A 75-year-old patient was incidentally found to have an intracardiac mass by echocardiography. Subsequent cardiac magnetic resonance imaging and cardiac positron emission tomography confirmed a large and possibly malignant mass extending from the right atrium into the coronary sinus. The patient underwent an intracardiac echocardiography guided biopsy, which revealed diffuse B-cell lymphoma, and is currently undergoing rituximab, etoposide, vincristine, cyclophosphamide, and doxorubicin (R-EPOCH)-based chemotherapy.

Autogenous Mineralized Dentin versus Xenograft granules in Ridge Preservation for Delayed Implantation in Post-extraction Sites: A Randomized controlled clinical trial with an 18 months follow-up

OBJECTIVES

To test primary stability of delayed implants placed in post-extraction ridges preserved with autogenous mineralized dentin matrix (MDM) versus xenograft granules. Clinical, histological and pain experience outcomes were further assessed.

MATERIAL AND METHODS

From March 2018 to July 2020, patients requiring ridge preservation in preparation for delayed implant placement in post-extraction sites were included. Participants were randomly allocated to either the test (MDM) or control group (xenograft granules) prior to ridge preservation. Visual analogue scale and analgesic consumption were measured every day for a week. Six months after preservation, trephine cores were harvested for histomorphometry prior to implant placement. Implants were then placed, and implant stability was measured immediately as well as two months after placement. Marginal bone loss and presence of mucositis/peri-implantitis were registered up to 18 months after prosthetic loading.

RESULTS

Fifty-two patients (66 implants) completed the study. MDM and xenograft groups presented similar primary (77.1 ± 6.9 versus. 77.0 versus. 5.9) and secondary (81.8 ± 5.1 versus. 80.1 ± 3.8) implant stabilities. The percentage of newly formed bone in MDM (47.3%) was significantly higher than xenograft (34.9%) (p < .001), and the proportion of residual graft was significantly lower (12.2% in MDM and 22.1% in xenograft) (p < .001). No significant differences were found as far as clinical, radiographic and patient-related outcomes.

CONCLUSIONS

Implants placed in sites preserved with MDM had similar primary stability in comparison to xenograft granules. MDM showed a significantly higher quantity of newly formed bone and lower amount of residual graft in histomorphometry results and equal clinical and patient-related outcomes.

Effect of Muscle Strength by Trichinella spiralis Infection during Chronic Phase

Introduction:Trichinella spiralis establishes a chronic infection in skeletal muscle by developing nurse cells within muscle fibers. During symbiosis in host, changes in the muscle fibers and inflammation may affect muscle function. Methods: We investigated muscle strength and inflammation in T. spiralis-infected mice during 1 to 48 weeks after infection. Results: Muscle strength decreased compared to that in uninfected control mice during the late infection stage. Additionally, inflammatory related cytokines increased significantly during early stage of infection and then rapidly decreased. In pathological study, nuclear infiltration maintained from the early infection stage to chronic infection stage. Moreover, vacuoles and eosinophil infiltration were observed in infected muscle in chronic stage. Conclusion: These results suggest that infection by T. spiralis significantly affects muscle function was continuously being weakness because vacuoles formation and maintained nucleus and eosinophil infiltration during chronic phase of T. spiralis infection.

Cephalotheca sulfurea (Ascomycota, Sordariomycetes), a new fungal pathogen of the farmed rainbow trout Oncorhynchus mykiss

The first case of visceral mycotic infection due to Cephalotheca sulfurea (Cephalothecaceae, Ascomycota) is documented in farmed rainbow trout from a raceway culture system. The disease clinically manifested as a hyperaemic area in the liver of the fish, and histological examination using silver and PAS staining showed the presence of numerous foci of hyphae and spores. The causative agent was first isolated in pure culture from the liver and identified using morphological characteristics. Sequence data from ITS and LSU rDNA also clearly confirmed C. sulfurea as the causal agent. The pathogenicity of related species belonging to the family Cephalothecaceae has been well-documented in humans and dogs (superficial as well as systemic infections). However, C. sulfurea has never been reported as a pathogen of humans or animals, including marine and freshwater fishes. The morphological identification of C. sulfurea is difficult due to its similarity to several different fungal genera, and molecular methods are strongly recommended for reliable identification.

Autogenous demineralized dentin matrix from extracted tooth for the augmentation of alveolar bone defect: a prospective randomized clinical trial in comparison with anorganic bovine bone

OBJECTIVES

The aim of this study was to prospectively evaluate the clinical efficacy and histological outcome of the autogenous tooth graft material (AutoBT) compared to that of anorganic bovine bone (Bio-Oss^® , Geistlich, Switzerland) in post-extraction alveolar bone augmentation.

PATIENTS AND METHODS

A total of 33 graft sites in 24 patients were included in this study. AutoBT was used in 21 sites of 15 patients and Bio-Oss^® was used in 12 sites of 9 patients for alveolar bone augmentation 2-4 weeks after dental extraction. Vertical dimension of grafted bone was measured both at the time of graft placement and at implant fixture placement after 6 months. Trephine cores were harvested for the histomorphometric evaluations during implant placement when feasible. The primary stability of implant fixture was also measured.

RESULTS

Infection of graft material or graft bed was not observed and graft sites healed without any notable complications in both groups. The vertical dimensions of alveolar bone increased by 5.38 ± 2.65 mm in AutoBT group and 6.56 ± 3.54 mm in Bio-Oss^® group at 6 months post-extraction. Histomorphometrically, new bone formation of AutoBT-grafted site was 31.24 ± 13.87% while that of Bio-Oss^® was 35.00 ± 19.33%. The implant stability quotient (ISQ) of implants placed in AutoBT-grafted sites measured 72.80 ± 10.81 while those placed in Bio-Oss^® -grafted sites measured 70.0 ± 12.86. There were no statistically significant differences between measurements of the two groups.

CONCLUSION

Autogenous demineralized dentin matrix from extracted tooth grafted to extraction sockets for the augmentation of vertical dimension was as effective as augmentation using anorganic bovine bone. Both groups showed favorable wound healing, similar amount of implant stability, and histologically confirmed new bone formation. Thus, the results of this study suggest that autogenous tooth graft material is a viable option for alveolar bone augmentation following dental extraction.

Immediate dental implant placement into infected vs. non-infected sockets: a meta-analysis

OBJECTIVE

This meta-analysis was aimed at assessing whether immediate dental implant placement into infected vs. non-infected sites produced different effects on implant failure risk and marginal bone loss.

MATERIAL AND METHODS

Relevant studies were identified by searching articles in PubMed, Web of Knowledge, and the Cochrane Library through February 2015 and by reviewing the reference lists of the retrieved articles. When an intervention led to dichotomous outcomes, the outcomes were expressed as risk ratios, whereas continuous outcomes were expressed as mean differences in millimeters; each had a 95% confidence interval. Study-specific estimates were combined using fixed-effects models.

RESULTS

A total of 1743 articles were identified following the search process. Seven studies were finally included in the meta-analysis, which comprised a total of 1586 implants and 25 failures. Compared to the immediate insertion of a dental implant into a non-infected site, the insertion of an implant into an infected site showed 116% increase in the risk of implant failure, which had borderline statistical significance (risk ratio = 2.16, 95% confidence interval: 0.97, 4.80, P = 0.058; heterogeneity: I²  = 0.0%, P_{heterogeneity}  = 0.997). With regard to marginal bone loss, we observed no statistically significant difference between insertions into infected vs. non-infected sites (mean difference = -0.04, 95% confidence interval: -0.09, 0.02, P = 0.173, heterogeneity: I²  = 0.0%, P_{heterogeneity}  = 0.765).

CONCLUSION

This meta-analysis suggests that immediately placing a dental implant into an infected site may increase the risk of implant failure. Given the presence of uncontrolled confounders in the studies that were assessed, the results should be interpreted with caution.

Simulating an investigative study of clinical cancer samples: use of tissue slides and PCR-based promoter-hypermethylation analysis

Topics on the molecular basis underlying cancer are quite popular among students. Also, excellent textbooks abound that provide interesting materials for discussion during lectures and tutorials about major events leading to cancer formation and progression. However, much less is available for students to conduct experiments for the analysis of cancer samples in undergraduate modules where there is a limited time-frame. Given the difficulty of working with cancer samples and the scarcity of good samples even in the clinical laboratories, it is impossible to run large-class practicals using patients' samples. Here, we describe the use of tissue slides in combination with polymerase-chain reaction (PCR) as a means of simulating an investigative approach to supplement students' learning of clinical research. By using tissue slides for histo-pathological examinations and specific budding yeast genomic DNA and primers adapted to demonstrate methylation-specific PCR, we designed an inquiry-based lab session to simulate the clinical investigation of a cohort of biopsies that students could analyze in a one-session practical.