[Effects of different growth factors on new bone formation: a systematic review]

Using different osteogenic growth factors, which is still under investigation, is a favorable method for bone regeneration. This systematic review is aimed at evaluating the effects of different growth factors and their carriers on osteogenesis. Electronic databases [Medline, EMBase and Cochrane] were searched by the authors for articles published from 1999 to April 2010. Clinical and animal studies evaluating bone formation by applying a specific growth factor and the related carrier were included in this investigation. Obtained data were organized in a table and evaluated through a qualitative analysis. Sixty-three studies most of which evaluated the effects of BMP-2 osteogenesis in different models were included in this study. Totally, twenty-five carriers were applied with different growth factors in the experiments. Among these carriers, poly lactic- co glycolic acid [PLGA], hydroxy apatite/tricalcium phosphate/absorbable collagen sponge [HA/TCP/ACS] and BioOss were the most frequently used carriers with the growth factors in bone regeneration studies. The current evidence, although not strong enough, confirms that BMP-2 has more favorable results in osteogenesis compared with other factors. The carrier scaffold, methods of measurement [histologic or radiographic], type of animal, defect diameter and the length of follow-up are the variables that should be matched before reaching definite results for the effect of growth factors in bone regeneration

effect of barrier membranes on regeneration of bony defects in human and animal models a systematic review

Barrier membranes have been extensively used for bone regeneration. However their effectiveness is still under investigation. This review was designed to answer the following question: [Do barrier membranes affect the successfulness of bone graft/ bone substitute materials?]. Published articles were collected through hand and electronic searching in medline, embase and central databases. Controlled animal and human studies which had evaluated efficacy of membranes in defects other than periodontal lesion, extraction socket preservation and maxillary sinus graft, and had more than 4 weeks follow-up period were considered. Articles which had assessed membrane effect on oseointegration of implants, or had used osteoinductive materials in the bony defect were excluded. Meta-analysis was performed in the following groups: vertical bone augmentation, horizontal bone augmentation and eventful healing. Due to different outcome measurement, analysis was not done for horizontal bone augmentation. A total of 34 studies were selected. Meta-analysis of studies for vertical bone augmentation revealed that membranes may increase the amount of augmented bone [mean difference= 0.32 mm; P=0.006]. No statistically significant differences were observed among groups in case of eventful healing both in human [odds ratio- 5.67; P-0.32] and animal studies [odds ratio- 3.35; P=0.12]. Available evidence suggested that membranes might be useful for vertical bone augmentation. There was not strong evidence that membranes have an adverse effect on the healing process of the wound. More randomized clinical trials are necessary for applicable results

[ ten years epidemiologic study of salivary gland tumors in Loghman Hospital]

Salivary gland tumors are rarely reported comprising 2-3% of head and neck neoplasms. About 75% of salivary gland tumors are benign and 25%a are malignant. Major salivary glands include parotid, submandibular and sublingual while minor salivary glands distribute through submucosa of palate, lip and buccal mucosa. The present study was done to evaluate salivary gland tumors in patients referred to Loghman hospital during 1997-2007. In this retrospective descriptive study, patients with salivary gland tumors were studied by means of existing data technique. Data collection sheet included gender, age, location and size of tumor, clinical and pathologic diagnosis, pathological diagnosis and treatment. The histopathological analysis of all cases was meticulously reviewed and classified by 3 expert pathologists. Descriptive analysis was used for the analysis. Forty four patients were found with salivary gland tumors. 36.4% of them were females and 63.6% were males. Benign tumors calculated about 72.7% and malignant tumors as 27.3%. The most common tumors were pleomorphic adenoma [70.4%], warthin tumors [2.2%], and mucoepidermoid carcinoma [11.3%] was the most common malignancies. Parotid [77.2%] was the most common site following by submandibular gland [11.3%] and palate with 11.3% occurrence. The size range of tumors was 1-9 cm with the average size of 2-4cm. Pleomorphic adenoma was the most common benign tumor and mucoepidermoid carcinoma was the most malignant tumor resembling the other studies done in the field

Localization of bone lesions in multiple myeloma and plasmacytoma by scintigraphic and roentgenographic techniques

A systematic comparison of scintigraphic and roentgenographic bone studies was carried out in 15 patients with multiple myeloma [MM] or plasmacytoma of bone [PC[B]]. The results varied for different anatomical regions of the skeletal system. Scintigrams were clearly more sensitive than the roentgenograms in detecting myelomatous rib lesions at an early phase of their evolution. The extent of myelomatous bone disease identified by scintigraphic and roentgenographic techniques was relatively comparable in skull and spine. In pelvic and long bones, however, scintigrams were markedly less efficient than roentgenograms. Although bone marrow is the primary site of neoplastic proliferation of plasma cells, in multiple myeloma [MM], bone itself is often the earliest site of the disease presentation [1]. A typical osteolysis in MM generally starts as progressive endosteal resorption [2], which may eventually lead to disabling pathologic fracture. The extent of such bone involvement has reportedly been diagnosed more efficiently b] roentgenograms than by scintigrams [3-7]. The latter diagnostic modality, however, has been shown to be more sensitive than the former in localizing skeletal lesions due to other malignancies [8]. The present comparative study was conducted to determine whether in MM and plasmacytoma of bone [PC[B]] the previously noted discordance between these two diagnostic techniques holds true for all anatomical regions of the skeletal system

Remission of thrombotic thrombocytopenic purpura with plasma infusion

A dramatic and long lasting response to plasma infusion, as the only modality of treatment is reported in a patient with thrombotic thrombocytopenic purpura [TTP]. The current understanding of the pathogenesis of TTP and the hemolytic uremic syndrome and its relevance to plasma therapy is reviewed. Thrombotic thrombocytopenic purpura [TTP] in its complete form is a disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, fluctuating neurologic signs, renal dysfunction and fever [1]. The endothelial proliferation and widespread deposition of hyaline thrombi within the lumen of arterioles and capillaries have been identified as the principal histopathologic findings of this entity [2] Present address: Department of Medicine, Shiraz University, Shiraz, Iran. Requests for reprints should be addressed to A. Khojasteh, M.D., Department of Medicine, Shiraz University, School of Medicine, Shiraz, Iran. The etiology and pathogenesis of TTP are still debatable. The occasional response to whole blood exchange transfusion [3] and plasmapheresis [4] have been demonstrated. The therapeutic efficacy of plasma [5-10], however, has provided a new insight into the pathophysiology of TTP. In this report, we describe a patient with TTP, in whom the administration of fresh frozen plasma alone led to a complete remission