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Dec 2025 DOI 10.14302/issn.2473-1005.jdoi-25-5870
Arthur Ferreira RibasCorresponding author
This narrative literature review investigates the clinical feasibility of maxillary sinus lift using the lateral window (or traumatic) technique, employing a grafting material composed of hydroxyapatite associated with beta-tricalcium phosphate. The study is based on the premise that bone resorption and sinus pneumatization—common in edentulous posterior maxillae—pose a challenge to achieving primary stability during dental implant placement. Given the limitation imposed by reduced residual bone height, bone-grafting surgical techniques become necessary to enable implant-supported rehabilitation. The objective of this work is to analyze, through a literature review, the efficacy of combining synthetic biomaterials as an alternative to autogenous bone grafts, which are considered the gold standard in implant dentistry. A bibliographic search was conducted in the PubMed and LILACS databases and through the VHL portal, prioritizing articles addressing the biological properties of alloplastic grafts, the indications of the lateral window technique, and the clinical success rates of implants placed in previously grafted areas using such materials. The findings demonstrated that hydroxyapatite associated with beta-tricalcium phosphate exhibits favorable osteoconductive characteristics, such as adequate porosity and gradual resorption, while allowing the formation of viable bone within a clinically acceptable timeframe. The combination of these materials eliminates the need for a second surgical site, reduces morbidity, and maintains treatment predictability. It is concluded that the lateral window technique associated with synthetic biomaterials is a safe and effective alternative for patients with maxillary bone atrophy, capable of promoting suitable bone beds for dental implant placement and stabilization, with lower surgical risk and satisfactory clinical outcomes.
Jul 2025 DOI 10.14302/issn.2379-8572.joa-25-5592
Zakariya Yahya Al Riyami ShadenCorresponding author
Objective The repair of the tympanic membrane has been attempted with large variety of synthetic, homologous and autologous tissue; however, temporalis fascia and cartilage-perichondrium are used most commonly today. Study Design This is a prospective study of patients confirmed to have CSOM and operated during the years of 2012-2013 at Al Nahdha Hospital, Muscat, Sultanate of Oman. The patients were followed up postoperatively at which we compared the graft success rate and level of hearing improvement. Setting ENT clinic at Al Nahda hospital Subjects Patients who presented to the ENT clinic at Al Nahda hospital, operated in the period between 2012 and 2013, diagnosed as CSOM and meeting our inclusion criteria. Methods We compared the outcome of the repair of the tympanic membrane perforation using temporalis fascia graft versus cartilage perichondrium grafts. Results 100% of the cartilage-perichondrium group showed a successful graft uptake in comparison to 98.9% in the temporalis fascia. Our data did not show significant differences in the average air bone gap change in both groups. Conclusion Both cartilage-perichondrium and temporalis fascia provide viable autograft material. Both achieve comparable and excellent graft uptake. Completion of our study is needed to study the hearing restoration in both groups.
Jun 2023
Rifkatu Kambel DogaraCorresponding author
The increasing demand for environmentally-friendly materials has led to a surge in research on the production of biodegradable polymers. In this study, we investigate the synthesis of a biodegradable polymer by graft copolymerization of gum Arabic (GA) and polyethylene glycol (PEG). GA, a natural polysaccharide and PEG, a synthetic water-soluble polymer, were used as the backbone and graft monomer, respectively. The graft copolymerization was carried out using benzoyl peroxide as an initiator and performed under nitrogen atmosphere. The resulting polymer was characterized by Fourier transform infrared (FTIR) spectroscopy, Xray diffraction (XRD), thermogravimetric analysis (TGA), and scanning electron microscopy (SEM). The FTIR spectra confirmed the formation of the graft copolymer, and TGA analysis showed that the copolymer had higher thermal stability than GA. The DTA thermograms indicated two thermal events. The evaporation of water and organic polyethylene glycol components was measured, and the first mass loss was due to the loss of adsorbed and structural water in the gum Arabic, which occurred between 31.87 and 180°C, while the second, corresponding to the pyrolysis of polyethylene glycol functional groups and polysaccharide decomposition, resulted in a 70% mass loss. SEM morphological analysis of gum Arabic showed aggregates of high irregularity in particle shape. The cracks and holes obtained in the Gum Arabic micrograph disappeared from the new gum Arabic-graft-polyethylene glycol, leaving a smooth surface with scattered particles in the image, which was due to the grafting copolymer. From the XRD patterns, the percentages of the amorphous and crystalline phases were determined. The results show that gum Arabic has a 78% degree of crystallinity, whereas gum Arabic-graft-polyethylene glycol has the lowest value of 51%. Biodegradation activity was observed using the fungus Aspergillus flavus on different days on gum Arabic-g-polyethylene glycol. The results clearly showed inhibition zones with a change in the state of the copolymer from solid to liquid from days 8 to 14. These results indicate that the GA-PEG copolymer has potential as a biodegradable material for use in various applications, such as packaging, agriculture, and medical industries.
Jan 2021 DOI 10.14302/issn.2766-8630.jrnm-20-3689
K Dhingra VandanaCorresponding author
Department of Nuclear Medicine AIIMS Rishikesh, India
The goal of this review is to assess the importance of various imaging modalities which can be used in assessing the viability and integrity of the bone allograft. As it is widely in use in majority of major and minor reconstructive procedures.
Oct 2019 DOI 10.14302/issn.2577-2279.ijha-19-3050
N Bhatti AmjadCorresponding author
Brighton & Sussex Medical School, BN1 9PX
Background Free vascularised fibular bone grafting has gained popularity in various Orthopaedic and Oral & maxillofacial reconstructive surgeries. The objective of the present study was to identify the morphology and topography of nutrient foramina of fibula and to determine the foraminal index (FI) of the fibula using a more surgeon friendly bony landmark. Methods The study comprised examination of 100 fibulae specimens. Each bone was divided into 03 parts and topographical analysis was performed on each section. The nutrient foramina were identified macroscopically using size 24-gauge needle. Modified Hughes formula was used to calculate the foraminal index using distance of foramen (DF) from distal end which is easier to palpate in living human beings, total length of fibula (TL); and the formula was DF/TL x100. Results With respect to fibulae, 98% had single foramen and foramen was absent in 2%. The mean foraminal index (FI) was 56% for fibulae using modified Hughes’ formula. The majority of the fibulae showed nutrient foramen in the middle 3rd in relation to distal end of fibula. Conclusion The study provides information on the morphology of nutrient foramina in relation to easily palpable landmark on living human beings, which can provide guidance to surgeon while performing microvascular bone transfer procedures.
Mar 2019 DOI 10.14302/issn.2473-1005.jdoi-19-2654
Ricardo Kina JoséCorresponding author
DDS, MSc, PhD. Retired Associate Professor, Department of Surgery and Integrated Clinic, Araçatuba School of Dentistry, Sao Paulo State University – UNESP. Rua José Bonifácio, 1193. Zip code: 16015-050, Araçatuba, Brazil.
Areas of gingival recession cause either an esthetic problem and or root sensitivity. Obtaining predictable root coverage has become an important part of periodontal therapy. A deep, long – standing recession promoted by ANUG was treated using subepithelial connective tissue graft technique combined with decontamination of root surface by using Er:YAG laser. Our clinical findigs suggest that this technique is a predictable procedure to treat gingival recession and promote root decontamination.
Dec 2017 DOI 10.14302/issn.2576-9359.jot-17-1807
J. Schutt RyanCorresponding author
Scripps Center for Organ and Cell Transplantation, Scripps Green Hospital, 10666 North Torrey Road, La Jolla, California
Purpose Intra-operative insults may subject living kidney transplants to poor outcomes. Therefore, we investigated whether intra-operative recipient and donor hemodynamics could act as predictors of delayed graft function and subsequent outcomes. Materials and Methods Living kidney donors and recipients from 2010-2016 at this institution underwent a retrospective chart review. Graft function by post-operative day 7 was used to classify recipients as delayed graft function (need for dialysis), slow graft function (creatinine > 2.5) and good function. Groups were analyzed for intra-operative hemodynamic differences and at one year, incidence of rejection, graft function and survival were compared. Results A total of 111 living renal transplants were performed. Average recipient age was 50 and just over halfwere male (53%). 9% (n=10) and 10% (n=11) developed delayed graft function and slow graft function, respectively. Minimum recipient post re-perfusion central venous pressure ≥12 mmHg was associated with poor graft function (delayed graft function/slow graft function/good function=67%/56%/24%, p=0.009), while intra-operative hypotension (systolic <90 mmHg or diastolic <50 mmHg) was not. Delayed graft function and slow graft function had higher incidences of rejection than good function (30% and 36% vs 9%, p=0.012). Graft function and survival were similar. One patient died with a functioning graft. Conclusions This single center retrospective study suggests that a post re-perfusion central venous pressure ≥12 mmHg is associated with delayed graft function.
Sep 2016 DOI 10.14302/issn.2473-1005.jdoi-16-1196
Singh Nayyar AbhishekCorresponding author
Reader, Department of Oral Medicine and Radiology, Saraswati-Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani, Maharashtra, India
Background and Context: Autologous bone grafts require a second surgical exposure to harvest the graft with a significant risk of post-operative complications and donor site morbidity. Employment of allografts potentially eliminates donor site morbidity but carries the potential of causing foreign body immune reactions with a high rate of rejection and failures. Hence, Alloplasts have emerged as novel materials to overcome the drawbacks of autogenous and allogenous bone grafts. Today’s advanced dentistry is enterprising a putty form of calcium phosphosilicate (CPS) into several aspects of reconstructive domain of dentistry including the sinus augmentation procedures, osseous regeneration of periodontal bone defects, cystic cavity defects and alveolar socket preservation. This eccentric multifaceted study was planned as an honest effort on the path of proving the efficiency of CPS as an alloplastic bioactive graft material and aimed at quantitative evaluation of regenerated bone radiographically using Cone Beam Computed Tomography (CBCT) scans following sinus augmentation procedures. Materials and Methods: A total of 20 sinus augmentations were carried-out in 17 patients satisfying the criteria (inclusion and exclusion) requiring placement of implants in atrophic maxilla and in other situations of anatomic constraints. The graft material used was calcium phosphosilicate (CPS) putty (Nova bone dental putty, Novabone products, Alachua, Fla). The residual bone height was recorded using CBCT scans and a computer based software where the measurements were made from the crest of the ridge till the sinus floor lining. The patients were assessed clinically at immediate post-operative, 1 week, 1 month, 3 months and 6 months follow-up recalls post-operatively. Radiographic assessment for bone height was done pre-operatively and at 6 months follow-up recall post-operatively using Cone Beam Computer Tomography scans. Results: The post-treatment bone height (11.76+0.97mm) was found to be significantly higher than the pre-treatment bone height (6.8 +0.70mm) in indirect sinus augmentation procedures (t=14.4, p<0.005). In case of direct sinus augmentation group also, the post-treatment bone height (11.27 +0.71mm) came-out to be significantly higher than the pre-treatment bone height (2.44 +0.81mm) (t=32.17, p<0.005). The post-treatment bone grafted sinus floor measurements (1107.6 + 155.6mm) were also found to be significantly higher than the original sinus floor measurements of bone density (Grayscale values) (412+ 65.5mm) (t=16.6, p<0.001) in case of indirect sinus augmentation procedures. Similarly, the post-treatment bone grafted sinus floor measurements (1169.6+136.7mm) were found to be significantly higher than the original sinus floor measurements of bone density (Grayscale values) (416.4+ 0.70mm) (t=17.9, p<0.001) in case of direct sinus augmentation group. Conclusion: Calcium Phosphosilicate (CPS) was accepted well at the recipient sites without any complications demonstrating its efficiency and reliability in sinus augmentation procedures.
Oct 2014 DOI 10.14302/issn.2329-9487.jhc-14-404
Handa RichaCorresponding author
Dept. of Medicine, Central Cardiology Medical Clinic, Bakersfield, CA
This review discusses causes of lower‑limb bypass graft failure and strategies to improve durability. It considers patient selection, conduit choice, surveillance, and re‑intervention options.
Feb 2026 DOI 10.14302/issn.2473-1005.jdoi-25-5935
Romulus Calin FodorCorresponding author
The aim of this article is to present alternative possibilities for corrective intervention using corticobasal implants, following the failure of treatment with two stage implant in cases of extensive edentulism, multi-segmented edentulism, and the development of peri-implantitis 1 at the level of these implants. For this purpose, a case was selected involving a patient treated with two stage implants in a multi-segmented manner, in the distal regions of the maxilla and mandible, where the implants were affected after 12 years by peri-implantitis in proportions ranging from 20% to 100% in different areas of bone, with a predominance in the vestibular area. The decision was made to remove the affected two stage implants, as well as the remaining deciduous teeth, with or without periodontal conditions, but whose position on the arch made improperly rehabilitation, both functionally and aesthetically impossible, and made the second rehabilitation with polished corticobasal and compressive implants in immediate loading 2. Function and aesthetics of the gnathological apparatus were restored through definitive fixed metal-ceramic prosthetics on the support of corticobasal and compressive implants within 4 days from the beginning of the treatment, with the result being monitored over a period of 3 years and 3 months, and this evaluation is to continue over time. From a surgical perspective, for secondary rehabilitation with polished corticobasal and compressive implants, strategic positions in the maxillary and mandibular bones were used as follows: the fusion area of the maxillary bone with the sphenoid bone, the nasal cortex, the sinus cortex the lingual cortex distal to the mylohyoid line, and the interforaminal mandible area.34 These areas correspond to methods described in Consensus Number 6 in the IF The Foundation of Knowledge 5. In conclusion, the treatment with corticobasal, compressive polished implants is successful even in the case of a difficult clinical scenario like the one described for this patient 6. The reduced treatment time, along with the absence of the need for sinus lifts or bone grafts, makes it the ideal solution in any situation. The use of corticobasal implants, with fixation in the second/third cortical layer and an immediate loading protocol, should represent the primary solution in treating cases with poor bone representation, and no only as a “Corrective Intervention with Corticobasal® Implants”7.
Oct 2022 DOI 10.14302/issn.2576-9359.jot-22-4303
Morteza Bagheri SeyedCorresponding author
Department of Radiology, School of medicine, Iran University of Medical Sciences
Background Doppler ultrasonography can evaluate vascular and renal parenchymal disorders. In this study, color Doppler patterns in transplanted kidneys were compared with histological diagnosis to develop diagnostic models for transplanted kidney failure. Method 45 kidney transplant patients participated in this prospective study (16 suffered acute tubular necrosis (ATN), and 29 had transplant rejection). All patients had color-Doppler ultrasonography to measure kidney parameters and Doppler indices. Serum creatinine levels also assessed the transplanted kidney's function. Result Ultrasound showed a significant difference between the two groups in iliac and interlobar PSV. The ROC analysis showed a high diagnostic value of the iliac artery PSV, in distinguishing ATN from kidney transplant rejection. Serum creatinine level correlated directly with transplanted kidney volume, renal cortical thickness, and transplanted kidney length, and inversely with interlobar artery PSV and EDV. In graft rejection patients, the only significant inverse correlation was found between serum creatinine level and PSV of the iliac artery and EDV of the intrelobar artery. Discussion and conclusion The iliac artery PSV can differentiate between ATN and rejection after renal transplantation. Evaluation of renal metric parameters along with PSV and EDV of the interlobar artery (in patients with ATN) and iliac artery and interlobar artery (in transplant rejection) help determine renal dysfunction.
Jul 2021 DOI 10.14302/issn.2575-1212.jvhc-21-3873
Zalama EsraaCorresponding author
Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Mansoura University, 35516 Mansoura, Egypt.
Objective Evaluation of the ability of autogenous Platelet Rich Fibrin (PRF) and Zinc Oxide Nanoparticles (ZnONPs) to repair critical-sized ulnar defects in rabbits based on radiographic assessment. Design Randomized controlled study. Animals Twenty-four healthy male white New Zealand rabbits with an age of 6.0 ± 0.3 months and weight of 2.5 ± 0.29 Kg were used. Procedures A 12 mm defect was created in the diaphysis of the right ulnae in allrabbits,then the rabbits were randomly allocated into three groups (8 each): Control group, (the defect left for healing without grafts), platelets rich fibrin group (PRF group, the defect filled with PRF) and combination group (PRF/ZnONPs group, the defect filled with both PRF and ZnONPs). Healing capacity between the groups was evaluated by immediate postoperative radiographic assessment and subsequently at the first and the second postoperative months. Results Statistical analysis showed significant differences in the radiographic healing score between the groups (P = 0.000) at all-time points (P = 0.000- 0.003) during the study. Rabbits in the combination group showed the highest radiographic healing scores followed by the PRF group meanwhile, the Control group showed minimal radiographic healing scores. Conclusion and Clinical Relevance The addition of ZnONPs to PRF can accelerate the healing of ulnar critical-size defects in rabbits.
Jul 2020 DOI 10.14302/issn.2831-8846.j3dpa-20-3438
Shirbhate NimishaCorresponding author
Department of Mechanical Engineering, LT College of Engineering, Koparkhairne, Navi Mumbai, India
Bone Scaffold is a three-dimensional porous construction which provides support to promote natural cell growth in damaged or broken section of bone. In recent years researchers from various departments like biomedical, mechanical, orthopedics, have shown significant interest in adopting ‘Bone Scaffolds’ as a promising treatment for bone defects. ‘Bone Scaffold’ is a honeycomb-like architecture composes of bio-compatible material having grater advantages over current grafting solution. In this paper, the authors try to review the available e-articles in an organized way on the bone scaffold in the field of biomedical implants with 3D printing. The selected literature mainly focuses on the biocompatible material and various advanced manufacturing methods used for manufacturing / preparing of bone scaffolds. This article tries to padding the gap between theoretical and actual implementation of ‘Bone Scaffolds’ by properly analyzing selected research and allowing future opportunities for reinventing the new possibilities in the field of biomedical.
Dec 2019 DOI 10.14302/issn.2372-6601.jhor-19-3092
S. Tsingotjidou AnastasiaCorresponding author
Laboratory of Anatomy, Histology and Embryology, Faculty of Veterinary Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GR-541 24, Greece
Waldenström Macroglobulinemia (WM) is a B-cell lymphoproliferative disorder characterized mainly by uncontrolled accrual of M- immunoglobulin, secreted by malignant lymphoplasmatic cells. Mast cells interacting with malignant B-cells play an important role at the manifestation of the disease. Utilizing a previous xenotransplantation mouse model, this study evaluates long-term implant viability and quantifies distinct bone marrow mast cell populations along with their dynamics in non-WM and WM human bone implants. Non-WM bone implants were obtained from the femoral head of adult humans undergoing hip arthroplasty or hemiarthroplasty, whereas WM human bone implants originated from bone biopsies obtained from the posterior iliac crest of patients with active WM. All bone particles were implanted intramuscularly in twenty-four NOD/SCID mice. Following 3, 4 or 8 months postoperatively, xenografts were removed and studied using special histological techniques to identify mature and immature mast cells. Xenografts survived up to 8 months after implantation presenting normal cytoarchitecture (non-WM) or high-grade neoplastic infiltration and microresorption (WM bone biopsies). Statistical analysis of mast cell populations showed significant elevation regarding time progression and bone marrow microenvironment, thus suggesting the possible influence of malignant cells to the mast cell population in WM. This study presents the extended survival of intramuscular implantation of human adult bone xenografts into NOD/SCID mice and provides additional information on the interaction between mast cells and malignant B-cells.
Nov 2019
Miroslav Budoš MUDr.Corresponding author
Traumatology dep., Bata Hospital Zlín, Chzech Republic.
Modern medicine gives treatment options even in cases, where this has not been possible in the past. We want to present how negative pressure wound therapy (NPWT) helps in limb salvage. The case report brings our insight and experience on how to be successful with NPWT. We present a high-energy injury with an open tibial fracture IIIB according to Gustillo-Anderson classification 11. NPWT is an excellent option to treat extensive soft tissue injury. NPWT is also beneficial in the application of the dermoepidermal graft as we have found. We can confirm that this therapy contributed to a faster healing of soft tissues compared to classical wound healing.
Oct 2019 DOI 10.14302/issn.2577-2279.ijha-19-3053
A TiwariCorresponding author
MBBS II Year, School of Medical Science & Research, Sharda University, Greater Noida.
Introduction The human tibia is a complex anatomical unit and the knowledge of its morphometric values is important in Forensic, Anatomic and Radiological cases in order to identify unknown bodies and stature. Objective It was to analyze the tibia, its morphometry, side difference and to investigate the position of nutrient foramina in tibia. Methods In this study, 60 adult human tibias (30 right and 30 left) were obtained from the Department of Anatomy SMSR SHARDA UNIVERSITY. In the study a total of two parameters i.e. Cross Section Index in the middle and Cnemicus Index of the bones were obtained and evaluated by using two instruments- a Measuring Tape and a Vernier Calipers. All the bones were dry and showed normal anatomical features. Results The mean Cross Section Index in the middle was calculated as 80.42 ± 11.33 on the right side and 78.15± 12.78 on the left side; and the Cnemicus index was 78.40 ± 13.19 on the right side and 70.84 ± 11.38 on the left side Conclusion The two parameters in the North Indian population were compared with other populations. The values were found to be almost comparable however there were subtle differences between different populations. The position of nutrient foramen was also assessed. This knowledge will thus help further researchers and orthopedic surgeons in various procedures like joint replacement therapy, fracture repair, bone grafts and vascularized bone microsurgery as well as in medico‐legal cases.
Oct 2019 DOI 10.14302/issn.2641-5518.jcci-19-3039
Sanikidze TamarCorresponding author
Tbilisi State Medical University, Tbilisi, Georgia
Chronic total occlusion (CTO) of the left main coronary artery (LMCA) is rare on the angiograms; Coronary Artery Bypass Grafting is the standard method of its revascularization. To demonstrate that PCI may in some cases be a safe option for patients with a high-risk surgical category, we report a complex clinical case of revascularization of chronic total occlusion of the LMCA, left anterior descending artery (LAD), and circumflex artery (CX). Methods Recanalization of the occluded LMCA and LAD was performed by utilizing the support-balloon technique, and CTO wires (Miracle 3™ wire, Abbott Vascular; Runthrough® NS Intermediate wire, Terumo); LAD, CX, LMCA, and its bifurcation, were stented with 3 drug-eluting stents (Resolute Integrity DES, Medtronic); the "Culotte Stenting " technique was used for bifurcation stenting, followed by "Kissing Balloon" post-dilatation technique; proximal optimization technique was performed in the LMCA. Results The intervention ended without complications. 2 months after stenting, the ejection fraction increased from 20% to 38%, improved almost all parameters of the heart, Congestive Heart Failure functional class decreased to class I. Conclusions It should be considered that LMCA CTO lesions can be successfully revascularized with PCI in case of the selection of the suitable patient and appropriate revascularization technique.
Apr 2019 DOI 10.14302/issn.2377-2549.jndc-19-2720
El-hoshoudy A.N.Corresponding author
Production department, Egyptian Petroleum Research Institute, Naser City, Cairo, Egypt.
Currently, enhanced oil recovery (EOR) acquire increased attention to recover more residual oil trapped after the primary and secondary process in petroleum reservoirs. EOR comprise different technologies involving chemical, thermal, miscible flooding techniques. Chemical flooding by the polymer is a widely implemented method on the academic and industrial scale. In this chapter, the authors discuss polymer flooding using polyacrylates that involve hydrolyzed polyacrylamide (HPAM), hydrophobically associated polyacrylamides (HAPAM), which grafted with different vinyl monomers such as acrylic acid, methyl methacrylates, and 2-acrylamido-2-methylpropane sulfonic acid (AMPS). These polymers increase the viscosity of injected brine solutions, as a result, decrease mobility ratio and enhance sweeping efficiency, so the water act as a piston, which pushes oil in front of it, and consequently increase the recovery factor. The advantages and disadvantages of these polymers as well as comparing different flooding scenarios are reported.
Apr 2019 DOI 10.14302/issn.2688-5328.ijp-19-2717
Ip DavidCorresponding author
FRCS FHKCOS FHKCOS (Rehabilitation) FHKAM (Ortho Surg), Wellness Pain Centre Hong Kong
Objective The current clinical case series assess the clinical outcome of the use of low-level laser in the treatment of painful pediatric fractures not solidly consolidated and re-modelled after casting for a standard of 4-6 weeks Materials and Methods The patient cohort consisted of 17 consecutive unselected patients in pediatric age group with delayed fracture consolidation and/or undesirable angulation despite casting for a standard period of 4-6 weeks in whom the parents refused any surgical intervention and/or bone grafting options. All subjects were referred from other medical centers after inadequate healing of the fracture ends upon repeating the x ray after the cast was off at the 4-6 weeks mark. Low-level laser therapy (LLLT) on alternate days for 8weeks in upper limb fracture cases, and 12 weeks in lower limb fracture cases were administered with a view of enhancing bone healing and/or re-modelling since both previous clinical and basic science studies on LLLT showed a stimulatory effect on fracture healing. Results All patients had solid union, mean time for union for upper and lower limb fractures were 6 and 10 weeks respectively. The calculated p value is statistically significant at p < 0.05. No patient defaulted follow up. All parents were satisfied with the clinical and radiological result of the LLLT treatment. Conclusion LLLT was found not only to enhance bone healing potential but in fact improved bone re-modelling when used in the proper wavelength and energy density in pediatric upper and lower limbs fractures, thereby also rapidly resolve the intolerable pain in paediatric fracture population
Mar 2019 DOI 10.14302/issn.2641-5518.jcci-19-2626
Bertasi GiampietroCorresponding author
University of Padua, Italy
Matrices or tissue scaffolds provide a collagen structure for tissue remodelling while the removal of viable cells aims to minimize or prevent inflammatory or immunogenic response. Allograft collagen scaffold can support the patient’s own cellular ingrowth, ingeneered to minimize an immune response and to yeld a bio-compatible matrix and support incoming cellular growth. The decellyularized dermis retains its growth factors, native collagen scaffold, and elastin, thanks to a LifeNet Health proprietaryprocessin technology.
Feb 2019
P Dargan DallanCorresponding author
Mersey Regional Burns and Plastic Surgery Centre, Whiston Hospital, Warrington Road, Prescot, Merseyside, L35 5DR, United Kingdom
Background: Chest wall deformities may be managed with skeletal manipulation, which risks life-threatening complications. Custom-made prostheses are a less invasive surgical option, manufactured from silicone elastomer using 3D computed tomographic reconstruction and 3D-printed thoracic models. Methods: All patients undergoing custom-made implants between January 2010 and March 2017 were identified from the prosthetic department records. A retrospective review of the clinical records was performed. Mean follow up period was 1.8 years. A comparison was made with our earlier results from 1995 to 2009. Results: Twenty-six patients underwent insertion of custom-made implants for chest wall deformity. Pectus excavatum was present in 50% (n=13), and Poland syndrome 42% (n=11). All 11 female patients underwent 3D reconstruction and 3D printed models, and 3 of 15 males. Four underwent simultaneous bilateral breast augmentation, and three had staged breast augmentation. Seroma occurred in 27% (n=7), and hypertrophic scar in 12% (n=3). The reoperation rate was 23% (n=6), including autologous fat graft in two patients. Surgical suction drains were used in 42% (n=11) patients, of whom 36% (n=4) developed seroma, compared with 17% (n=2) of those without drains (p=0.08). Conclusions: Custom-made prostheses are an effective and safe option for patients with chest wall deformities. The majority have a short postoperative inpatient stay (81%) and are satisfied with the outcome (77%). Seroma was the commonest complication (27%), and drains did not reduce seroma risk. Single dose intravenous antibiotic prophylaxis is adequate. A minority of patients opt for further aesthetic procedures.
Dec 2018 DOI 10.14302/issn.2640-6403.jtrr-18-2442
Pontini A.Corresponding author
Department of Neuroscience Specialties, Plastic Reconstructive Surgery and Burn Unit – Padova University Hospital
Background: Lyell Syndrome (TEN, Toxic epidermal necrolysis) represents a medical emergency particularly in pediatric patients in whom the massive skin damage can quickly lead to multi-organ dysfunction and death. Prompt restoration of the physiologic mucosal/cutaneous barrier is mandatory. The use of amniotic membranes has been described in the treatment of ophthalmic Lyell Syndrome, but its use has not yet been adopted for the management of larger cutaneous wounds. Study Hypothesis: Here we report the use of amniotic membranes in a pediatric case of severe Lyell Syndrome with complete skin surface, ocular and mucosal involvement with life threating presentation. Methods: A 7-year old female was admitted to our Burn Centre for severe cutaneous/mucosal exfoliation (100% Total body surface area, TBSA) as a result of an adverse reaction to ibuprofen administration. Supportive fluid administration, cardiac-pulmonary assistance and pain management were complemented by serial grafting of amniotic membranes on all affected areas to provide coverage of the exfoliated skin/mucosa. Biopsies were obtained to monitor histological skin changes. Results: The patient showed an excellent response to amniotic membrane treatment, with rapid restoration of mucosal and cutaneous layers in the grafted areas. This resulted in a decreased need for dressing changes, avoidance of additional surgeries and a reduced dependence on supportive therapy. Lower pain levels than usually expected led to a reduced need for narcotic pain medications and allowed for early physical rehabilitation and a short hospital stay. Histology confirmed evidence of topical immune-modulation in treated areas (reduction of inflammatory infiltrate). Conclusion: As we tested in numerously TEN and burn pediatric injuries Amniotic membranes with their regenerative and immune-modulatory effects may represent an life saving treatment even in the worst cases of pediatric Lyell syndrome.
Aug 2018 DOI 10.14302/issn.2576-6694.jbbs-18-2143
V. Dorozhkin SergeyCorresponding author
Independent Researher
The chemical and structural similarities of calcium orthophosphates (abbreviated as CaPO4)to the mineral composition of natural bones and teeth have made them a good candidate for bone tissue engineering applications. Nowadays, a variety of natural or synthetic CaPO4-based biomaterials is produced and has been extensively used for dental and orthopedic applications. Despite their inherent brittleness, CaPO4 materials possess several appealing characteristics as scaffold materials. Namely, their biocompatibility and variable stoichiometry, thus surface charge density, functionality and dissolution properties, make them suitable for both drug and growth factor delivery. Therefore, CaPO4, especially hydroxyapatite (HA) and tricalcium phosphates (TCPs), have attracted a significant interest in simultaneous use as bone grafts and drug delivery vehicles. Namely, CaPO4-based three-dimensional (3D) scaffolds and/or carriers have been designed to induce bone formation and vascularization. These scaffolds are usually porous and harbor various types of drugs, biologically active molecules and/or cells. Over the past few decades, their application as bone grafts in combination with stem cells has gained much importance. This review discusses the source, manufacturing methods and advantages of using CaPO4 scaffolds for bone tissue engineering applications. Perspective future applications comprise drug delivery and tissue engineering purposes.
Apr 2018 DOI 10.14302/issn.2372-6601.jhor-18-1988
M RoviraCorresponding author
Bone Marrow Transplantation Unit. Hematology Department. Hospital Clinic-IDIBAPS. Josep Carreras Leukaemia Research Institute (IJC)
Hematopoietic stem cell transplantation (HSCT) from a mismatched unrelated donor, an haploidentical donor or a cord blood unit (CBU) has become a widely aviable approach if patient lacks a matched related or unrelated donor. However, if the patient has anti-HLA antibodies against antigens present in the mismatched donor or CBU (donor-specific antibodies, DSAs) this option should be disregarded due to the high risk of graft failure. Desensitization can be used to reduce levels of DSAs but this technique has limited results. We report the case of a 62-year-old woman with DSAs against two haploidentical familiar donors who failed desensitization of DSAs. Finally she underwent a HSCT from a 5/10 mismatched unrelated donor which has been successful.
Dec 2017 DOI 10.14302/issn.2766-8630.jrnm-17-1770
Y. Moawad EmadCorresponding author
Independent researcher graduated from department of engineering, Ain Shams University
The aims of this study are to investigate the variation in the mechanical behaviour of the primary cancer from cancer relapse, and measuring the therapeutic resistance acquired by cancer relapse. A431-cultured cells were irradiated for 7 months until 85 Gy. Then, a selected single cell was left to grow as stable A431-R cell line. 106 cells of A431 cells and 106 of A431-R cells suspended in 100 μL of medium were injected into subcutaneous tissues on the right thigh of athymic mice to generate tumor xenografts models of primary cancer (A431-P) and cancer relapse (A431-R). Radiotherapy of a low-dose of 30Gy was applied on xenoimplanted tumors after one week from inoculation. A mock process was performed on untreated groups of mice for controls. Tumor size was monitored starting from inoculation and tumor growth was measured along 42 days. Rates of mitosis and apoptosis and the histologic grade (HG) that characterize the tumor response were determined as described in earlier studies. Alterations induced on tumor HG in the treated models were 100% identical to the energy of the applied doses. The differences in response energy between cancer relapse and primary cancer irrespectively of the treatment (untreated vs. treated) or origin of the cells (A431-P vs. A431-R) in all phases of tumor responses (growth, shrinkage or regrowth) were 100% identical to the total differences in the administered regimens applied on those groups during those phases. Cancer relapse is characterized by a delay in growth before second line therapy for its relatively lower rate of mitosis compared by the primary cancer inducing a corresponding delay in the early detection. The therapeutic resistance of the cancer relapse is equivalent to the energy of the doses which have been delivered in the prior therapies, and requires increasing the administered dose by an amount equivalent to that resistance.
Sep 2017 DOI 10.14302/issn.2576-9359.jot-17-1594
Seguchi OsamuCorresponding author
Department of Transplantation, National Cerebral and Cardiovascular Center, Japan
Constrictive pericarditis (CP) represents a rare complication after heart transplantation (HTx), resulting from various postoperative events such as mediastinitis, pericardial effusion, or allograft rejection. We describe our recent experience with managing an HTx recipient who developed atypical patterns of CP predominantly involving the right ventricle. A 52-year-old male who had received heart transplantation 2.5 years before was admitted to our institution because of progressive symptoms of heart failure. The patient had experienced acute rejection twice post-HTx, both with International Society for Heart and Lung Transplantation grade 1R, undergoing an additional endomyocardial biopsy other than those performed during regular check-ups. On admission, echocardiography revealed paradoxical septal motion and a large cystic-like mass with a thick capsule in front of the right ventricle. Right heart catheterization revealed elevation of right atrial pressure, with severely reduced cardiac index. Magnetic resonance imaging revealed both seroma and a thick cystic-like capsule tightly adhered to the right ventricle. CP was suspected despite the atypical patterns of presentation. Seroma was removed through exploratory lateral thoracotomy, without improvement in symptoms, which was only achieved via subsequent pericardiectomy involving resection of the thickened parietal pericardium, removal of effusion fluid, and further excision of diffusely thickened visceral pericardium and epicardium. The patient is currently recovering uneventfully. The possibility of CP after HTx should be considered despite the rarity of this condition and HTx recipients should be closely monitored using various imaging modalities because CP typically demonstrates non-specific symptoms and physical findings of heart failure, with high mortality.
Jun 2017 DOI 10.14302/issn.2576-9359.jot-17-1603
Caprara CarlottaCorresponding author
Department of Nephrology, Dialysis and Transplantation; International Renal Research Institute Vicenza (IRRIV); San Bortolo Hospital; Vicenza.
Single-nucleotide polymorphisms (SNPs) in genes involved in immune responses and in the pharmacokinetics/pharmacodynamics of immunosuppressive drugs influence transplant outcomes of patients receiving the same immunosuppressive therapy. The aim of our preliminary study was to determine the SNPs profiles of ABCB1/MDR-1, UGT1A9, IMPDH2, IL-10 and TNF-α genes associated with acute rejection (AR) events in renal allograft recipients. DNA was extracted from whole blood samples of 220 individuals in 3 experimental groups; Case: 41 kidney transplant patients with AR event(s), Control I: 109 kidney transplant patients without AR event, Control II: 70 healthy blood donors. Acute rejection defined as rapid, unexplained rise in serum creatinine was biopsy-proven. 19 SNPs were analyzed by Sanger Sequencing. Analysis of allele and genotype frequencies and gene-disease association tests were performed. Allele frequencies of healthy persons are in line with ones reported from Europe indicating that the studied population is representative. Statistically significant differences only by the comparison of kidney transplant patients with AR event(s) and healthy individuals are found for rs2032582 and rs1045642 SNPs of ABCB1/MDR1, the latter is also not in Hardy-Weinberg equilibrium in our population. Patients with specific alleles for these SPNs are more prone to have acute rejection events. Certain allele variants of ABCB1/MDR1 by modifying the effectiveness of the drugs may compromise the success of the immunosuppressive therapy and put patients at higher risk to reject the new organ. Therefore screening for these polymorphisms before transplantation would help clinicians to more accurately personalize medications.
Mar 2017
Remberger MatsCorresponding author
Centre for Allogeneic Stem Cell Transplantation, Karolinska University Hospital,
This article examines how HLA‑DRB1 allele mismatching influences outcomes after hematopoietic stem cell transplantation. It reviews graft‑versus‑host disease risk, engraftment, and survival metrics in the context of donor matching strategies. The findings support careful allele‑level typing to optimize donor selection and improve post‑transplant prognosis.
Aug 2016 DOI 10.14302/issn.2473-1005.jdoi-16-1167
Singh Nayyar AbhishekCorresponding author
Reader, Department of Oral Medicine and Radiology, Saraswati-Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani, Maharashtra, India
Context: The present study was undertaken to do a comparative evaluation of the role of Cone Beam Computed Tomography (CBCT) imaging and Orthopantomography (OPG) for pre-operative implant planning in combination with sinus grafting procedures in order to assess sinus anatomy and morphology and the existing bone height in three dimensions. Aims: To assess sinus anatomy and morphology and the existing bone height in three dimensions. Materials and Methods: Pre-operative assessment of maxillary sinuses for implant planning using CBCT imaging was performed on 20 sinuses (17 patients). These patients were subjected to orthopantomographs and CBCT imaging both pre-operatively and post-operatively. CBCT imaging helped to decide the type of sinus augmentation procedure best suited for the patients as per the individual needs and depending on the residual alveolar bone height, timing of implant placement, sinus morphology, anticipation of complication and comparative analysis between pre-and post-procedural gain in vertical alveolar bone height and increase in bone density. Statistical Analysis: The results were tabulated and statistically analyzed using Paired and Unpaired t-tests. Results: In the majority of cases, there was a concordance between the treatment type based on pre-operative and post-operative CBCT scans. The assessment of sinus morphology revealed a significantly higher detection rate of abberations in the form of sinus mucosal hypertrophy and septae on CBCT which were imperceptible on routine radiographs. The most appealing result was that vertical alveolar bone height could be measured precisely and there was a significant increase in surgical confidence and a significantly better prediction of complications when using CBCT imaging. Conclusions: A pre-operative planning based on CBCT imaging seems to improve sinus diagnostics and helps to execute a better treatment plan. Also, it is a good tool for the comparison of vertical alveolar bone height pre-and post-operatively following sinus augmentation procedures using various graft materials.
Dec 2015 DOI 10.14302/issn.2473-1005.jdoi-15-742
Fortes Ferreira CimaraCorresponding author
Assistant Professor, Department of Prosthodontics, UTHSC, Memphis, TN, USA.
This case report details reconstruction of a severely atrophic pre‑maxilla using rhBMP‑2 and a titanium mesh framework. Surgical technique, graft outcomes, and implant rehabilitation are described, with notes on indications and complications.
May 2015 DOI 10.14302/issn.2379-8572.joa-14-545
Asrar Ahmed LatifiCorresponding author
Department of ENT, Buraidah Central Hospital, Buraidah,AlQassim-KSA
Objectives: The study was aimed to find out which of the two techniques, medial or lateral side of the temporalis fascia graft was better in underlay method for correcting the perforations of the tympanic membrane keeping all other factors constant. Methods: We designed a prospective randomized study from Jan 2010 to Jan 2013 at Buraidah Central Hospital, Al Qassim, Saudi Arabia. Eighty patients having dry central; moderate, large and subtotal perforations of the tympanic membrane were subjected for tympanoplasty type –I by underlay technique. In 41 patients the temporalis fascia graft was placed with medial (rough) side up (Technique-I) and 39 patients the graft was placed with the lateral (smooth) side up (Technique-II). Results: The graft take up rate was 95.1% in technique-I and 87.2% in technique -II. Failure rate was 4.9% in technique – I and 12.8% in technique – II. Conclusion: Technique – I was judge to be giving better result because: 1.Rough surface of the medial side of the graft after moistening enhances wetting, increases the critical surface tension and broadens the contact surface. 2.The friction due to rough surface resists displacement forces between the graft and remains of the tympanic membrane. 3.Rough surface of the medial side of the temporalis fascia increases the adhesion power and increases the overlap between the two surfaces. To the best of our knowledge this is the only such prospective study for this method.
Apr 2015 DOI 10.14302/issn.2329-9487.jhc-14-403
Handa RichaCorresponding author
Dept. of Medicine, Central Cardiology Medical Clinic, Bakersfield, CA
A surgical review of factors influencing femoropopliteal bypass longevity, including lesion characteristics, techniques, graft materials, and post‑operative surveillance.