The Biomechanical Effect of Different Denture Base Materials on the Articular Disc in Complete Denture Wearers: A Finite Element Analysis

AIM: The objective of the present study was to evaluate the effect of different denture base materials on the stress distribution in TMJ articular disc (AD) in complete denture wearers.MATERIAL AND METHODS: Two three dimensional Finite Element (FEA) models of an individual temporomandibular joint (TMJ) were built on the basis CT scan. The FEA model consisted of four parts: the condyle, the articular disc, the denture base, and the articular eminence skull. Acrylic resin and chrome-cobalt denture base materials were studied. Static loading of 300N was vertically applied to the central fossa of the mandibular second premolar. Stress and strain were calculated to characterize the stress/strain patterns in the disc.RESULTS: The maximum tensile stresses were observed in the anterior and posterior bands of (AD) on load application with the two denture base materials. The superior boundaries of the glenoid fossa showed lower stress than those on the inferior boundaries facing the condyle.CONCLUSIONS: Within the limitations of the present study it may be concluded that: The denture base material may a have an effect in stress-strain pattern in TMJ articular disc. The stiffer denture base material, the better the distribution of the load to the underling mandibular supporting structures & reducing stresses induced in the articular disc

Bone Height Changes of the Mandibular Edentulous Ridge in Screw Retained Versus Telescopic Restorations for Completely Edentulous Patients

AIM: This study was established to evaluate the amount of bone height changes in the posterior mandibular area of edentulous patients receiving screw-retained prostheses versus removable telescopic implant overdentures.MATERIAL AND METHODS: Every patient received four inter-foraminal implants regarding the mandibular arch and four anterior implants for the maxillary arch, computer guided surgical guides were planned for the insertion of the implants accurately with a flapless technique. Panoramic radiographs were made immediately, six months and twelve months after the prostheses` use proportional area and vertical measurements were applied to determine changes in the bone height of the posterior mandibular edentulous area.RESULTS: After twelve months, a statistically non-significant amount of bone resorption was reported for both groups.CONCLUSION: Up to the limitations of this study both treatment options the screw retained and telescopic overdenture can be used for rehabilitation of completely edentulous patients. These cases must be followed for a longer period to have a definite answer regarding their efficiency in the long run

Vinorelbine plus platinum compared to vinorelbine plus capecitabine in treatment of patients with metastatic triple negative breast cancer previously treated with anthracycline and taxane: a prospective randomized study

Introduction. This study aims to investigate the efficacy and tolerability of the vinorelbine-based combination chemotherapy with either cisplatin or capecitabine in metastatic triple-negative breast cancer (mTNBC) pretreated with anthracycline and taxane.  Material and methods. This is an open-labeled randomized prospective single-institute study, that included all patients who received chemotherapy for mTNBC in the period between 1st of July 2016 and 30th of June 2017 and were pretreated with anthracycline and taxane. Patients were randomized to either vinorelbine 25 mg/m2 I.V on days 1 and 8 plus oral capecitabine 1000 mg/m2 twice daily, on days 1–14 (NX); or vinorelbine 25 mg/m2 I.V on days 1 and 8 plus cisplatin 75 mg/m2 (NP), every 21 days. The primary endpoint was time to progression (TTP), whereas the secondary endpoints were objective response rate (ORR), safety, and overall survival (OS).  Results. Median TTP was 9.9 months with NP vs. 8 months with NX, (p = 0.22). ORR was 40% with NP vs. 36% with NX, (p = 0.77). Median OS was 13 months with NP vs. 13.2 months with NX (p = 0.599). Both regimens demonstrated similar rates of grade ≥ 3 vomiting and neutropenia. A higher incidence of thrombocytopenia, tinnitus, and kidney function alteration were reported with NP. A higher incidence of anorexia, diarrhea, mucositis, and hand-foot syndrome were reported with NX.  Conclusions. Vinorelbine-based combination chemotherapy regimens with either cisplatin or capecitabine are active in the treatment of mTNBC pretreated with anthracycline and taxane with manageable toxicity profiles. Both regimens have comparable TTP, ORR, OS, and safety profiles

Prevalence of Female Sexual Dysfunction among Psoriatic Females: a Cross Sectional Case Controlled Study

Introduction: Sexual relationships are an integral part of females psychological and physiological wellbeing. Objectives: The study aimed to identify prevalence and impact of Female Sexual Dysfunction (FSD) in women affected with psoriasis. Methods: This cross-sectional study was carried out on 150 married females who were interviewed to answer Female Sexual Function Index (FSFI) questionnaire and were divided into two groups: the first group included 100 female patients complaining of psoriasis (50 suffering from moderate psoriasis and 50 with severe psoriasis). The disease severity was graded according to the Psoriasis Area and Severity Index (PASI) while the second group included 50 age matched women who served as controls. Results: Female sexual dysfunction (FSD) in psoriasis female groups was higher than that in the control group (47%, 24%, P < 0.05). The mean total scores of FSFI ranged from 12.30 to 34.20 and were significantly lower in the severe PASI affected group (22.34 ± 5.35) when compared to moderate PASI group (26.24 ± 2.67) or control group (28.79 ± 2.22). In addition, total scores were significantly lower among moderate PASI affected females when compared to control group. Conclusions: Sexual dysfunction should be routinely investigated in female patients with psoriasis in the case of moderate-severe disease due to its negative impact on quality of life. Further research over the effect of certain interventional programs on FSD should be considered for patients suffering from psoriasis

In Vivo Visualization of Hair Follicles by Ultrasound Biomicroscopy in Alopecia Areata and its Correlation with Histopathology

Ultrasound biomicroscopy (UBM) is a non-invasive imaging technique used in examination of several skin diseases but never in imaging hair and scalp diseases.  Main objective of this investigation was assessment of the efficacy of UBM for in vivo visualization of hair follicles in cases of alopecia areata (AA) and correlation of findings with histopathological findings. This study included 30 patients with AA. Two areas, one with AA and a control area, were marked, examined by UBM and then biopsied for histopathological examination. In patients with alopecia totalis (AT) or universalis (AU) only an AA area was examined. Non-echogenic conical shadows reaching the epidermal entrance echo (probably corresponding to the hair follicles) were seen and were wider and fewer in number in areas of AA than in normal control areas. No significant difference was found regarding number and width of hair follicles between UBM and histopathological examination. However, a significant increase in length of follicles in histopathology was detected, indicating that the UBM image was probably unable to reach the deepest part of the follicle. Main limitation of the study is small number of cases. No significant difference was found between UBM and histological measurements of hair follicle number and width in patients with AA, making UBM a useful tool for in vivo visualization of hair follicles. </p

Osteogenic Differentiation Potential of Human Bone Marrow and Amniotic Fluid-Derived Mesenchymal Stem Cells in Vitro & in Vivo

BACKGROUND: Cell therapies offer a promising potential in promoting bone regeneration. Stem cell therapy presents attractive care modality in treating degenerative conditions or tissue injuries. The rationale behind this is both the expansion potential of stem cells into a large cell population size and its differentiation abilities into a wide variety of tissue types, when given the proper stimuli. A progenitor stem cell is a promising source of cell therapy in regenerative medicine and bone tissue engineering. AIM: This study aimed to compare the osteogenic differentiation and regenerative potentials of human mesenchymal stem cells derived from human bone marrow (hBM-MSCs) or amniotic fluid (hAF-MSCs), both in vitro and in vivo studies. SUBJECTS AND METHODS: Human MSCs, used in this study, were successfully isolated from two human sources; the bone marrow (BM) and amniotic fluid (AF) collected at the gestational ages of second or third trimesters. RESULTS: The stem cells derived from amniotic fluid seemed to be the most promising type of progenitor cells for clinical applications. In a pre-clinical experiment, attempting to explore the therapeutic application of MSCs in bone regeneration, Rat lumbar spines defects were surgically created and treated with undifferentiated and osteogenically differentiated MSCs, derived from BM and second trimester AF. Cells were loaded on gel-foam scaffolds, inserted and fixed in the area of the surgical defect. X-Ray radiography follows up, and histopathological analysis was done three-four months post- operation. The transplantation of AF-MSCs or BM-MSCs into induced bony defects showed promising results. The AF-MSCs are offering a better healing effect increasing the likelihood of achieving successful spinal fusion. Some bone changes were observed in rats transplanted with osteoblasts differentiated cells but not in rats transplanted with undifferentiated MSCs. Longer observational periods are required to evaluate a true bone formation. The findings of this study suggested that the different sources; hBM-MSCs or hAF-MSCs exhibited remarkably different signature regarding the cell morphology, proliferation capacity and osteogenic differentiation potential CONCLUSIONS: AF-MSCs have a better performance in vivo bone healing than that of BM-MSCs. Hence, AF derived MSCs is highly recommended as an alternative source to BM-MSCs in bone regeneration and spine fusion surgeries. Moreover, the usage of gel-foam as a scaffold proved as an efficient cell carrier that showed bio-compatibility with cells, bio-degradability and osteoinductivity in vivo

Combination of Human Amniotic Fluid Derived-Mesenchymal Stem Cells and Nano-hydroxyapatite Scaffold Enhances Bone Regeneration

BACKGROUND: Human amniotic fluid-derived stem cells (hAF-MSCs) have a high proliferative capacity and osteogenic differentiation potential in vitro. The combination of hAF-MSCs with three-dimensional (3D) scaffold has a promising therapeutic potential in bone tissue engineering and regenerative medicine. Selection of an appropriate scaffold material has a crucial role in a cell supporting and osteoinductivity to induce new bone formation in vivo. AIM: This study aimed to investigate and evaluate the osteogenic potential of the 2nd-trimester hAF-MSCs in combination with the 3D scaffold, 30% Nano-hydroxyapatite chitosan, as a therapeutic application for bone healing in the induced tibia defect in the rabbit. SUBJECT AND METHODS: hAF-MSCs proliferation and culture expansion was done in vitro, and osteogenic differentiation characterisation was performed by Alizarin Red staining after 14 &amp; 28 days. Expression of the surface markers of hAF-MSCs was assessed using Flow Cytometer with the following fluorescein-labelled antibodies: CD34-PE, CD73-APC, CD90-FITC, and HLA-DR-FITC. Ten rabbits were used as an animal model with an induced defect in the tibia to evaluate the therapeutic potential of osteogenic differentiation of hAF-MSCs seeded on 3D scaffold, 30% Nano-hydroxyapatite chitosan. The osteogenic differentiated hAF-MSCs/scaffold composite system applied and fitted in the defect region and non-seeded scaffold was used as control. The histopathological investigation was performed at 2, 3, &amp; 4 weak post-transplantation and scanning electron microscope (SEM) was assessed at 2 &amp; 4 weeks post-transplantation to evaluate the bone healing potential in the rabbit tibia defect. RESULTS: Culture and expansion of 2nd-trimester hAF-MSCs presented high proliferative and osteogenic potential in vitro. Histopathological examination for the transplanted hAF-MSCs seeded on the 3D scaffold, 30% Nano-hydroxyapatite chitosan, demonstrated new bone formation in the defect site at 2 &amp; 3 weeks post-transplantation as compared to the control (non-seeded scaffold). Interestingly, the scaffold accelerated the osteogenic differentiation of AF-MSCs and showed complete bone healing of the defect site as compared to the control (non-seeded scaffold) at 4 weeks post-transplantation. Furthermore, the SEM analysis confirmed these findings. CONCLUSION: The combination of the 2nd-trimester hAF-MSCs and 3D scaffold, 30% Nano-hydroxyapatite chitosan, have a therapeutic perspective for large bone defect and could be used effectively in bone tissue engineering and regenerative medicine

Sediment Investigations in the Eastern Mediterranean Sea.

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Refractive error changes after bilateral medial rectus muscle recession surgery in congenital esotropia

Purpose The aim of this study was to evaluate the changes in refractive errors after bilateral medial rectus muscle recession surgery in children with congenital esotropia. Patients and methods Medical reports of 75 children with congenital esotropia were retrospectively reviewed. All included patients attended the Ain Shams University hospitals for undergoing bilateral medial rectus muscle recession surgery from January 2013 till January 2016. Cycloplegic refraction was done preoperatively and 3 months and 1 year postoperatively. Spherical equivalent (SE) was calculated to determine the amount of change in refractive error especially astigmatism and its axis. Patients were excluded if neurological abnormalities or developmental delays were documented and if structural eye abnormalities were present. Results Significant myopic shift and astigmatic change were determined in the SE refraction in the early postoperative period (3 months); however, these changes disappeared in the long term (at the postoperative first year). Conclusion Only the early postoperative period showed significant change in the SE value with myopic shift that necessitates early postoperative visual rehabilitation for fear of recurrence of the deviation or development of amblyopia