Biocompatibility of bioactive sealers Bio-C sealer vs MTA repair HP in human fibroblasts / Biocompatibilidad de selladores bioactivos Bio-C Sealer vs MTA Repair HP en fibroblastos humanos

Abstract Bioactive cements based on tricalcium silicate have been introducedto the market for use in dentistry, with a variety of clinical applications. These cements are in contact with vital tissues such as dental pulp or periodontium in cases of unintentional extrusion; thus, it is important to know the genotoxicity and cytoxicity of these materials. The objective of this study was to evaluate the cytotoxicity and genotoxicity of bioactive sealers, Bio-C® Sealer and MTA Repair HP®, in human fibroblasts. Discs of bioactive sealers Bio-C® Sealer, and MTA Repair HP®, were prepared and set for 24h under sterile conditions. The discs were placed in culture medium at 2.5mg/mL inside a SRT6D roller mixer (Stuart, UK) at 60rpm for 24h. The eluates obtained were incubated for 24h with previously activated and cultured ATCC cell line fibroblasts at 80% confluence. The cytotoxicity was evaluated by Alamar Blue® and LIVE/ DEAD assays, as well as the analysis of the Tunel and Mitotracker assays to evaluate genotoxicity using the confocal laser-scanning microscope. In the Alamar Blue® assay, the Bio-C® Sealer presented a cell proliferation of 87%, while the MTA Repair HP® Sealer was 72%. A statistically significant difference was found between the MTA Repair HP® Sealant and the negative control (p=<0.001). Regarding the genotoxicity tests, in the Tunel assay, both materials stain the nucleus of the fibroblast cells exposed to the eluates, while in the Mitotracker assay, the MTA Repair HP® Sealer showed greater mitochondrial function than the Bio-C® Sealer. Calcium silicate-based sealers, Bio-C® Sealer and MTA Repair HP®, are not cytotoxic and have low genotoxicity.

Resumen Los cementos bioactivos a base de silicato tricálcico se introdujeron en el mercado para uso en odontología, con una variedad de aplicaciones clínicas. Estos cementos pueden estar en contacto con tejidos como la pulpa dental o el periodonto, en caso de extrusión no intencionada. Por lo tanto, es importante conocer la genotoxicidad y la citoxicidad de estos materiales. El objetivo de este estudio fue evaluar la citotoxicidad y genotoxicidad de los selladores bioactivos Bio-C® Sealer y MTA Repair HP® en fibroblastos humanos. Se prepararon discos de selladores bioactivos Bio-C® Sealer y MTA Repair HP® y se colocaron durante 24h en condiciones de esterilidad. Los discos se colocaron en medio de cultivo a 2,5mg/mL dentro de un mezclador de rodillos SRT6D (Stuart, Reino Unido) a 60rpm durante 24h. Los eluidos obtenidos se incubaron durante 24h con fibroblastos de la línea celular ATCC previamente activados y cultivados al 80% de confluencia. La citotoxicidad se evaluó mediante ensayos Alamar Blue® y LIVE/DEAD; así como el análisis de los ensayos Tunnel y Mitotracker para evaluar la genotoxicidad, utilizando el microscopio confocal láser de barrido. En el ensayo Alamar Blue®, el Sellador Bio-C® presentó una proliferación celular del 87%, mientras que el sellador MTA Repair HP® fue del 72%. Se encontró una diferencia estadísticamente significativa entre el sellador MTA Repair HP® con respecto al control negativo (p=<0.001). En cuanto a las pruebas de genotoxicidad, en el ensayo Tunel, ambos materiales tiñen el núcleo de las células fibroblásticas expuestas a los eluidos, mientras que el ensayo Mitotracker, el sellador MTA Repair HP®, mostró una mayor función mitocondrial que el Bio-C® Sealer. Los selladores a base de silicato de calcio, Bio-C® Sealer y MTA Repair HP® no son citotóxicos y tienen una baja genotoxicidad.

Hernia lumbar de Grynfeltt-Lesshaft / Grynfeltt-Lesshaft lumbar hernias

RESUMEN Las hernias lumbares son defectos infrecuentes de la pared abdominal con pocos casos publicados en la literatura. En la región lumbar existen dos zonas de debilidad, un triángulo superior de Grynfeltt y otro inferior de Petit. Se presenta el caso de una mujer que consultó por dolor y tumoración lumbar derecha. Ante sospecha de hernia lumbar se realizó una tomografía computarizada que informó una hernia de Grynfeltt con contenido de grasa retroperitoneal. Se realizó una plástica protésica por abordaje abierto. No se observaron complicaciones post posoperatorias. Las hernias lumbares pueden ser congénitas o adquiridas, y estas primarias o secundarias. La tomografía computarizada (TC) es el procedimiento de referencia (gold standard) para su diagnóstico. La plástica protésica es el tratamiento de elección. El abordaje abierto y laparoscópico constituyen opciones válidas, y se deben valorar según las características del defecto, el paciente y la experiencia del equipo quirúrgico para su selección.

ABSTRACT Lumbar hernias are rare abdominal wall defects with few cases published in the literature. Two welldefined areas of weakness are identified in the lumbar region, the superior lumbar (Grynfeltt-Lesshaft) triangle and the inferior lumbar (Petit) triangle. We report the case of a female patient who sought medical care due to low back pain and a tumor in the right lumbar region. A lumbar hernia was suspected, and a computed tomography scan was performed, which revealed a Grynfeltt hernia with retroperitoneal fat content. The defect was repaired with mesh placement through an open approach. There were no postoperative complications. Lumbar hernias can be congenital or acquired (primary or secondary). Computed tomography scan is the gold standard for the diagnosis. Mesh repair is the treatment of choice. The open approach and laparoscopy are valid and safe options, and their implementation should be considered based on the characteristics of the defect, the patient, and the experience of the treating team.

Explantador de Cabrera: un nuevo dispositivo para explantar endoprótesis aórticas después de reparo endovascular de aneurisma de aorta, un estudio experimental ex vivo / Cabrera explanter: a new device to explant aortic stents after endovascular aortic aneurysm repair, an ex vivo experimental study

Introducción. Las complicaciones posteriores a la reparación endovascular de aneurisma (EVAR) pueden resolverse con técnicas endovasculares. Sin embargo, cuando está indicada, la explantación de una endoprótesis es un procedimiento complejo, que se asocia a lesiones vasculares o viscerales, con alta morbimortalidad, en pacientes con edad avanzada y múltiples comorbilidades, y por lo tanto, alto riesgo quirúrgico. No existen dispositivos producidos por la industria para explantar las endoprótesis aórticas, por lo que el objetivo de este trabajo fue desarrollar un dispositivo para la explantación de endoprótesis aórticas. Métodos. Se llevó a cabo un estudio experimental, en fase preclínica, para desarrollar un dispositivo para la explantación de endoprótesis aórticas, con pruebas en modelos 3D y en un modelo animal porcino cadavérico. Resultados. Es factible desarrollar un modelo experimental de un nuevo dispositivo para explantar endoprótesis aórticas, denominado explantador de Cabrera, y comprobar su funcionamiento en un modelo animal cadavérico. El uso del explantador de Cabrera limitó el daño de la pared aórtica por parte de la endoprótesis en un 100 % al momento de su explantación en un modelo experimental ex vivo. Conclusión. Usando una jeringa septo, el explantador de Cabrera es superior a la técnica estándar de explantación de una endoprótesis al limitar la lesión de la pared aórtica, al colapsar y liberar los ganchos de fijación suprarrenal de forma controlada y segura al interior de la luz aórtica y, posteriormente, extraerla de forma rápida y efectiva, conservando la mayor cantidad de aorta sana para la posterior reconstrucción aorto-ilíaca.

Introduction. Complications after endovascular aneurysm repair (EVAR) can be resolved with endovascular techniques; however, when indicated, stent explantation is a complex procedure, which is associated with vascular or visceral injuries, with high morbidity and mortality in patients, with advanced age and multiple comorbidities, and therefore high surgical risk. There are no devices produced by the industry to explant aortic endoprostheses, so the objective of this work was to develop a device for the explantation of aortic endoprostheses. Methods. An experimental study was carried out, in the preclinical phase, to develop a device for the explantation of aortic endoprostheses, with tests in 3D models and in a cadaveric porcine animal model. Results. It is feasible to develop an experimental model of a new device for explanting aortic endoprostheses, called Cabrera explanter, and verify its operation in a cadaveric animal model. The use of the Cabrera explanter limited damage to the aortic wall by the endoprosthesis by 100% at the time of explantation in an ex vivo experimental model. Conclusions. Using a septum syringe, the Cabrera explanter is superior to the standard stent explantation technique by limiting injury to the aortic wall, collapsing and releasing the adrenal fixation hooks in a controlled and safe manner into the aortic lumen, and subsequently, extract it quickly and effectively, preserving the greatest amount of healthy aorta for the subsequent aorto-iliac reconstruction.

CRISPR/Cas9-mediated genome editing: from basic research to gene therapy

CRISPR/Cas9 mediated genome editing is one of the most significant molecular tools discovered to edit the desired genes. It has ushered in a new era of novel possibilities of gene therapy. CRISPR/Cas9 system was originally observed as a part of the adaptive immune system in bacteria. It later on was adapted to carry precise and targeted alterations to the DNA in human cells to be used for gene therapy to correct genetic disorders and treat various severe diseases associated with the genetic changes. Besides this, the CRISPR/Cas9 system has been employed in pharmacogenomics to develop new drugs based on the patient’s genes, in modifying the organisms for research and even for diagnostic purposes in developing CRISPR based COVID-9 test. The recent approval of a CRISPR/Cas9 cellular gene therapy by FDA named “Casgevy” to treat sickle cell anemia is a testimonial to the potentials of CRISPR/Cas9 system in developing innovative gene therapies. This review details the mechanisms of CRISPR/Cas9 gene editing and its utilization in the ongoing clinical trials in the treatment of not only the monogenic disorders like sickle cell disease, thalassemia, and genetic blindness but also in treating multi-factorial diseases like cancers, cardiac diseases, diabetes, autoimmune diseases, viral infections such as human immunodeficiency virus (HIV) etc. An attempt has also been made to discuss the various limitations, challenges and ethical frameworks encompassing CRISPR/Cas9 based gene therapy in clinical settings.

Reparación tisular de los tejidos orales: una revisión de la literatura / Oral tissues healing: a review of the literature

El odontólogo realiza de forma rutinaria procedimientos que generan lesiones en los tejidos duros y blandos, por lo que resulta importante que el profesional conozca los procesos normales de cicatrización y reparación. La cicatrización es un fenómeno fisiológico que se presenta en cualquier tejido vivo que ha sido lesionado, que tiene importantes componentes vasculares y celulares que llevan una secuencia específica y que dependiendo de la magnitud de la lesión, el tejido podrá regenerar o cicatrizar según sea el caso. Asimismo, existen patologías sistémicas específicas y locales capaces de retrasar el proceso normal de cicatrización. El objetivo del presente artículo es explicar el proceso normal de reparación tisular de los tejidos orales y periorales (AU)

The dentist routinely performs procedures that generate injuries to hard and soft tissues, so it is important that the professional knows the normal healing and repair processes. Cicatrization is a physiological phenomenon that occurs in any living tissue that has been injured that has important vascular and cellular components that carry a specific sequence and that, depending on the magnitude of the lesion, the tissue may regenerate or heal as the case may be. Likewise, there are specific systemic and local pathologies capable of delaying the normal healing process. The aim of this article is to explain the normal tissue repair process of oral and perioral tissues (AU)

A clinical study on reconstruction of traumatic auricular defects

The auricle or external ear is an important aesthetic subunit of the face. The intricate anatomy due to multiple convolutions along with the thin integument poses a challenge to the reconstructive surgeon. The prominent position of the ear on either side of the face and over a bony prominence makes it more prone for injury. The objective of the study is to describe various traumatic auricular defects and their subsequent reconstructive methods. A retrospective analysis of 15 patients with traumatic auricular defects was carried out over a period of 2 years between the time period of January 2022 and December 2023. Various reconstructive methods such as Primary closure, use of chondral grafts and chondrocutaneous flaps, local flaps were employed depending on the size of the defect and according to the reconstructive ladder. Out of 15 patients, 12 were male and 3 were female, with traumatic ear defects secondary to road traffic accidents (12) and human bite (3). The site of the defect was upper 1/3d (8), upper+middle 1/3rd (3), lower+middle third (2), middle third (1) and lower 1/3rd (1) of the auricle. They were managed by debridement and primary closure in 5 cases, post auricular flap in 5 cases, preauricular flap in 2 cases, peninsular conchal island flap+postauricular flap in 1 case, and bilobed flap in 1 case. All the flaps settled well. 4 patients needed secondary procedures in the form of flap division and contour corrections. This study employed a variety of reconstruction methods of the auricle as per the reconstructive ladder. Some of the patients required secondary procedures. All patients in this study had a satisfactory end aesthetic outcome with no major complications.

Comparative study between open versus laparoscopic inguinal hernioplasty

Background: Inguinal hernia repair is one of the commonly performed procedure and has undergone a paradigm shift from open to laparoscopic approach in the era of minimally invasive surgery but the superiority is still debatable. The aim was to compare open (Lichtenstein) versus laparoscopic transabdominal preperitoneal approach (TAPP) hernia repair techniques. Methods: A total of 60 patients were enrolled in the study and divided into two equal groups (open versus laparoscopic) were compared. Results: It was observed that laparoscopic repair (TAPP) has statistically significant superiority than open inguinal hernioplasty in terms of lesser post-operative pain (VAS score of 4.8±0.66, 3.67±0.66, 2.53±0.82 versus 6.7±0.92, 5.03±0.72, 3.83±0.65 at 24 hours, 48 hours and 72 hours post operatively, p value <0.001), shorter duration of hospital stay (3.1±0.71 days versus 5.83±0.75 days, p value <0.001) and early resumption to regular activities (10.57±2.28 days versus 12.2±1.52 days, p value 0.002). It also showed that incidence intra operative and post-operative complications was lesser in laparoscopic group but not statistically significant. Whereas duration of surgery was prolonged in laparoscopic group (104±27.49 min versus 61.5±17.08 min, p value <0.001). Conclusions: Laparoscopic inguinal hernioplasty (TAPP) is superior to open inguinal hernioplasty in terms of lesser intra operative and post-operative complications, lesser post-operative pain, shorter duration of hospital stay with early resumption to regular activities having better subjective and objective cosmetic results in short term follow-up. However, duration of surgery was prolonged on comparison with Lichtenstein open inguinal hernioplasty.

A study on complications and outcome of hypospadias repair at tertiary care hospital

Background: The surgical procedure used to treat hypospadias varies widely in clinical practice due to several considerations. In light of this, we assessed the risks and results of many surgical techniques for correcting hypospadias.Methods: It was a prospective hospital-based study done for a period of 1 year. All patients with age greater than 12 months who underwent hypospadias repair in the surgery department of PMSSY super speciality hospital (KIMS, Hubballi) from January 2022 to December 2023 were included in the study. Approval from institutional ethical committee was taken before initiation of the study. Written informed consent was taken from the parents of the study participants. Total 42 patients with hypospadias were included in the present study.Results: The most common type of hypospadias was distal seen in 67% of patients among distal the most common site of urethral opening was distal penile in 43% followed by mild penile in 40%. Proximal type was second most common type seen in 24% and 7% were granular. TPIF repair was the most common choice of operation among surgeons in distal and proximal hypospadias due to ease of application and less complications and it was statistically significant followed by Snodgrass repair mostly seen in distal hypospadias.Conclusions: In this study, distal type hypospadias was the most prevalent form. Roughly one-third of the patients received TPIF surgery, whereas the same percentage had Snodgrass repair for their hypospadias.

Aneurisma de arteria carótida interna. Caso clínico

Introducción: Los aneurismas de la arteria carótida extracraneal (ACEC) son poco frecuentes en comparación con las lesiones oclusivas. Los ACEC son menos del 1% de todos los aneurismas arteriales y solo el 10% son considerados aneurismas verdaderos. Caso Clínico: Paciente femenina de 84 años, en excelentes condiciones generales, hipertensa e hiperlipidémica, neurológicamente asintomática, con hallazgo de aneurisma de carótida interna derecha en el contexto de una arteria elongada, estenosis moderada ostial y oclusión de arteria carótida interna contralateral. Se realiza resección de aneurisma con anastomosis término terminal, endarterectomía del ostium y angioplastía con parche. Su evolución fue favorable, manteniéndose asintomática y con la reconstrucción permeable a 6 meses de seguimiento en eco duplex. Discusión: La elección del manejo del ACEC va a depender de sus características morfológicas, en este caso la presencia de tortuosidad extrema de la arteria carótida interna dificultaba la posibilidad de manejo endovascular, pero facilitaba la resección del aneurisma con anastomosis primaria término terminal. Conclusión: La aneurismectomía y reconstrucción es una modalidad de manejo disponible para los ACEC.

Introduction: Extracranial carotid artery aneurysms (ECAA) are rare compared to occlusive disease, less than 1% of all arterial aneurysms and only 10% are considered true aneurysms. Clinical case: A 84-year-old female, active and in excellent general health, with a prior history significant only for hypertension and hyperlipidemia was referred for a right internal carotid artery aneurysm and elongation in the context of contralateral internal carotid artery occlusion. The patient denied neurologic symptoms. Resection of the aneurysm and end-to-end anastomosis, endarterectomy of the ostium and patch angioplasty was performed. The patient had an uneventful recovery, remaining asymptomatic and the reconstruction patent on duplex scan at 6 month follow up. Discussion: The choice of repair alternatives for EICA depend on its morphological characteristics. The presence of extreme tortuosity of the internal carotid artery in this case, on one hand make difficult to consider endovascular alternatives, but facilitates aneurysm resection and primary end-to-end anastomosis. Conclusion: Aneurysmectomy and arterial reconstruction is a treatment alternative for EICA repair.

Hernia de la línea arcuata, una patología poco difundida

La hernia de la línea arcuata (HLA), es una entidad claramente reconocida, sin embargo, existen escasas publicaciones al respecto. Corresponde a un defecto en la vaina posterior del músculo recto del abdomen, separándose la línea arcuata del musculo, formando un bolsillo, lo que corresponde a un defecto inter-parietal y no una verdadera hernia. Probablemente este subdiagnosticado y sub reportado. Su relevancia es que puede constituir una parte relevante de las consultas en servicio de urgencia por dolor abdominal sin etiología demostrada1. El diagnóstico debe sospecharse ante la presencia de dolor abdominal de tipo orgánico, sin otra etiología demostrada. Se confirma con imágenes, especialmente la tomografía computada. El tratamiento, apoyándose en lo reportado en la literatura, sugiere que la vía laparoscópica sería de elección. A continuación, analizamos la anatomía de la linea arcuata, la presentación clínica de esta afección, sus hallazgos imagenológicos, quirúrgicos, y las diferentes alternativas de tratamiento que se han propuesto en la literatura.

The arcuate line hernia is a clearly recognized entity, but of which little is mentioned. It corresponds to a defect in the posterior wall of the rectus abdominis, separating the arcuate line of the muscle, forming a pocket, which corresponds to an interparietal defect and not a true hernia. It is probably underdiagnosed and underreported. Its relevance is that it can constitute a significant part of the consultations in the emergency department for abdominal pain without proven etiology. The diagnosis should be suspected in the presence of organic abdominal pain, with no other proven etiology. It is confirmed with images, especially computed tomography. The treatment, based on what has been reported in the literature, suggests that the laparoscopic approach should be the choice. We analyze the anatomy of the arcuate line, its clinical presentation, imaging and surgical findings, and the different treatment alternatives that have been proposed in the literature.

Perfil molecular de cáncer de endometrio en mujeres de Bogotá DC, Colombia / Molecular profile of endometrial cancer in women from Bogota DC, Colombia

Introducción: El cáncer de endometrio ocupa el sexto lugar en incidencia del cáncer en mujeres. La caracterización molecular de este cáncer permite optimizar la estratificación de riesgo para mejorar el tratamiento de las pacientes. Objetivo: Determinar el perfil molecular TCGA de pacientes con cáncer de endometrio en Bogotá, D.C., Colombia. Método: Estudio descriptivo en una cohorte de pacientes con cáncer de endometrio. Las mutaciones en los exones 9 a 14 del gen POLE fueron identificadas mediante amplificación por reacción en cadena de la polimerasa, seguida de secuenciación Sanger y análisis bioinformático. La expresión de las proteínas MMR y p53 se identificó mediante inmunohistoquímica. Resultados: Se incluyeron 40 pacientes con una mediana de edad de 66 años. El 15% presentaron mutaciones en el dominio exonucleasa de POLE. El 32% de las pacientes que no presentaron mutaciones manifestaron deficiencia en el sistema MMR. El 43,47% de las pacientes sin mutaciones en POLE ni alteración del sistema MMR presentaron alteración de la proteína p53. Conclusiones: La población de cáncer de endometrio analizada presenta un perfil molecular TCGA similar a lo reportado para otras poblaciones.

Introduction: Endometrial cancer ranks sixth in cancer incidence among women. Its molecular characterization allows for a more precise risk stratification with the aim of improving patient treatment. Objective: To determine the TCGA molecular profile of patients with endometrial cancer in Bogota, Colombia. Method: A descriptive study of a cohort of patients with endometrial cancer. The expression of MMR proteins and p53 was identified through immunohistochemistry. Mutations in exons 9 to 14 of the POLE gene were identified through polymerase chain reaction amplification, followed by Sanger sequencing and bioinformatic analysis. Results: Forty patients were included in the study, with a median age of 66 years, 15% of them exhibited mutations in the exonuclease domain of POLE, while 32% of patients without mutations showed deficiency in the MMR system. Forty three percent of patients without mutations in POLE or MMR alterations showed aberrant p53 protein expression. Conclusions: The analyzed population of endometrial cancer presents a TCGA molecular profile similar to that reported for other populations.

La importancia de evaluar el daño al DNA / The Importance of Assessing DNA Damage

Resumen Se calcula que el cuerpo humano está conformado por billones de células, las cuales sufren cientos de miles de lesiones al día en su DNA. Aunque el DNA no es la única biomolécula que sufre daños, su importancia radica en que es la única que no puede ser sustituida por la célula, así que, cuando esta sufre daños, la célula debe repararlos, tolerarlos o, en el caso extremo, activar las vías que la llevarán a la muerte, ya que lo importante es mantener la integridad celular y la homeostasis del organismo. Hay miles de agentes que pueden dañar al DNA, algunos los produce la misma célula y se les denomina 'agentes endógenos', mientras que otros son agentes externos y se les conoce como 'agentes exógenos'. La célula no puede evitar el daño causado por los agentes endógenos, ya que son productos de la actividad metabólica, por ejemplo; así que, cuando suceden se activan de forma inmediata los mecanismos celulares para mitigarlos. Lo mismo pasa con los daños causados por agentes exógenos, ya que la célula hará todo lo posible por disminuir los efectos adversos que pueden causar. El problema se pone de manifiesto cuando la célula no puede reparar los daños o los repara mal o son tantos que los mecanismos de reparación se ven rebasados, es entonces cuando el daño permanece en el DNA y se genera un estado de inestabilidad cromosómica que puede conducir a la célula a la disfunción y a la malignización. Este estado de inestabilidad cromosómica se puede ver reflejado en el aumento de rompimientos de DNA o de micronúcleos en las células expuestas, lo que se puede cuantificar por medio de métodos especiales como el 'Ensayo Cometa' y el 'Ensayo de Micronúcleos', ya que identificar el daño en el DNA es una forma de evaluar el potencial tóxico que tienen los agentes a los que están expuestas las poblaciones, permite conocer los mecanismos de acción que tienen y, además, ayuda a comprender los factores que influyen en el detrimento de la salud poblacional.

Abstract It is estimated that the human body is made of trillions of cells, which suffer hundreds of thousands of DNA lesions every day. Although DNA is not the only biomolecule that suffers damage, its importance lies in the fact that it is the only biomolecule that cannot be replaced by the cell, so when it suffers damage, the cell must repair it, tolerate or, in a extreme case, activate pathways that will lead to death, since the objective is to maintain cell integrity and the homeostasis of the organism.There are thousands of agents that can damage DNA, some are produced by the cell and are called 'endogenous, while others are external agents and are known as 'exogenous. The cell cannot avoid the damage caused by endogenous agents, since they are products of its metabolic activity, for example, so when they occur, cellular mechanisms are immediately activated to mitigate them. The same happens with the damage caused by exogenous agents, since the cell will do everything possible to diminish the adverse effects they can cause. The problem becomes apparent when the cell is unable to repair the damage or poorly repairs it, or repairs so much that the mechanisms are overwhelmed, when the damage remains in the DNA and a state of chromosomal instability is generated that can lead the cell to dysfunction and malignization. This state of chromosomal instability can be reflected in increased DNA breaks or micronuclei in exposed cells, which can be quantified by special methods such as the 'Comet Assay' and the 'Micronucleus Assay'. Since identifying DNA damage is a way of evaluating the toxic potential of the agents to which populations are exposed, it allows us to know their mechanisms of action and helps to understand the factors that influence the detriment in population's health.

Effect of different design and surface treatment on the load-to-failure of ceramic repaired with composite / Efeito de diferentes tratamentos de superficie e formas do preparo de cerámicas na resistencia de uniao de reparos em resina composta

ABSTRACT Glass ceramics are widely used to manufacture esthetic veneers, inlays, onlays, and crowns. Although the clinical survival rates ofglass-ceramic restorations arefavorable,fractures or chips are common. Certain cases can be repaired with direct composite. Aim The aim of this study was to investigate the interaction effect of different designs and surface treatments on the load-to-failure of lithium disilicate glass-ceramic repaired with nanofilled composite. Materials and Method Lithium-disilicate glass-ceramic slabs (IPS e.max Press, Ivoclar Vivadent) with three different designs of the top surface (flat, single plateau, or doubleplateau) (n=U) received 'no treatment', '5% HF etching', or "AI2O3 sandblasting". HF-etched and sandblasted slabs also received silane and universal one-step adhesive application. All slabs were incrementally repaired with nanofilled composite (Filtek Z350, 3M ESPE) up to6 mm above the highest ceramic top plateau. Specimens were stored in artificial saliva at 37 °C for 21 days and then subjected to 1,000 thermocycles between 5 and 55 °C. The interface composite-ceramic of each specimen was tensile tested until failure in a universal testing machine and the mode of failure was determined under a stereomicroscope. The ceramic surface morphology of one representative tested specimen from each subgroup (design/surface treatment) was observed through scanning electron microscopy (SEM). Results Regardless of ceramic design, the absence of surface treatment resulted in significantly lower load-to-failure values. No significant differences in load-to-failure values were observed between HF-etched and sandblasted specimens for the flat design; however, HF etching resulted in significantly higher load-to-failure values than sandblasting for both single plateau and double plateau designs. The majority (60%) of HF-etched specimens with single plateau or double plateau presented mixed failures. SEM photomicrographs showed that HF-etched specimens had smoother surfaces than sandblasted specimens. Conclusion The surface treatment of a defective lithium disilicate glass-ceramic restoration has more influence than its macroscopic design on the retention of the composite repair. HF etching seems to provide higher bond strength to the composite repair.

RESUMO Embora fraturas e lascamento de restauragoes vitrocerámicas sejam comuns, alguns casos podem ser reparados com compósito direto. Objetivo investigar o efeito da interagao de diferentes formas e tratamentos de superficie na carga de ruptura de uma vitrocerámica reforgada com dissilicato de litio reparada com compósito nanoparticulado. Materials e Método A superficie superior de espécimes de vitroceramica (IPS e.max Press, Ivoclar Vivadent) foi preparada com tres formas (plana, plato único, ou duplo) e recebeu (n=11): 'nenhum tratamento', 'condicionamento com ácido hidrofluoridrico 5%', ou 'jateamento com AfOf. Ambos espécimes condicionados e jateados receberam silano e adesivo universal. Todos os espécimes foram reparados incrementalmente com compósito (Filtek Z350, 3M ESPE) até6 mm acima do plato cerámico mais alto, armazenados em saliva artificial á 37 °C por 21 dias, e submetidos á 1.000 termociclos (5 e 55 °C). A interface compósito-cerámica de cada amostra foi testada á tragao até sua falha em máquina universal e o modo de falha foi determinado com estereomicroscópio. A morfologia da superficie de uma amostra representativa de forma/tratamento de superficie foi observada através de microscopia eletronica de varredura (MEV). Resultados Independentemente da forma ceramica, a ausencia de tratamento superficial resultou em valores de carga de ruptura significativamente menores. Nao foi observada differenga significativa entre os espécimes planos condicionados ou jateados; no entanto, o condicionamento resultou em valores significativamente maiores que o jateamento para espécimes com plato único e duplo. A maioria (60%) dos espécimes condicionados e com plato único ou duplo apresentou falhas mistas. Imagens SEM demonstraram rugosidade superficial mais regular dos espécimes condicionados que os jateados. Conclusoes O tratamento superficial de uma restauragao defeituosa de vitrocerámica reforgada por dissilicato de litio tem maior influencia na retengao do reparo de compósito do que sua forma macroscópica; ainda, o condicionamento com ácido hidrofluoridrico parece proporcionar maior resistencia de uniao ao reparo com compósito.

Evaluation of Meibomian gland dysfunction using meibography in patients with xeroderma pigmentosum

ABSTRACT Purpose: To assess Meibomian gland dysfunction using meibography in patients with xeroderma pigmentosum and correlate with ocular surface changes. Methods: This cross-sectional study evaluated patients with xeroderma pigmentosum. All patients underwent a comprehensive and standardized interview. The best-corrected visual acuity of each eye was determined. Detailed ophthalmic examination was conducted, including biomicroscopy examination of the ocular surface, Schirmer test type I, and meibography, and fundus examination was also performed when possible. Meibomian gland dysfunction was assessed by non-contact meibography using Oculus Keratograph® 5M (OCULUS Inc., Arlington, WA, USA). Saliva samples were collected using the Oragene DNA Self-collection kit (DNA Genotek Inc., Ottawa, Canada), and DNA was extracted as recommended by the manufacturer. Factors associated with abnormal meiboscores were assessed using generalized estimating equation models. Results: A total of 42 participants were enrolled, and 27 patients underwent meibography. The meiboscore was abnormal in the upper eyelid in 8 (29.6%) patients and in the lower eyelid in 17 (62.9%). The likelihood of having abnormal meiboscores in the lower eyelid was 16.3 times greater than that in the upper eyelid. In the final multivariate model, age (p=0.001), mutation profile (p=0.006), and presence of ocular surface malignant tumor (OSMT) (p=0.014) remained significant for abnormal meiboscores. For a 1-year increase in age, the likelihood of abnormal meiboscores increased by 12%. Eyes with OSMT were 58.8 times more likely to have abnormal meiboscores than eyes without ocular surface malignant tumor. Conclusion: In the final model, age, xeroderma pigmentosum profile, previous cancer, and clinical alterations on the eyelid correlated with a meiboscore of ≥2. Meibomian gland dysfunction was common in patients with xeroderma pigmentosum, mainly in the lower eyelid. The severity of Meibomian gland dysfunction increases with age and is associated with severe eyelid changes.

Reparación percutánea de insuficiencia mitral primaria con técnica borde a borde: primer reporte de caso en Uruguay / Percutaneous edge-to-edge repair of primary mitral regurgitation: first case report in Uruguay / Correção percutânea de regurgitação mitral primária com técnica "edge-to-edge": primeiro caso reportado em Uruguai

La insuficiencia mitral (IM) es una enfermedad frecuente. La degeneración mixomatosa es la principal causa de IM primaria en los países desarrollados. Si no se corrige, conduce a la disfunción ventricular y a la insuficiencia cardíaca congestiva, con elevada morbimortalidad. La cirugía de reparación valvular es el tratamiento recomendado en la IM primaria severa y sintomática. En los pacientes con alto riesgo quirúrgico las opciones terapéuticas son limitadas. El surgimiento de la reparación percutánea borde a borde ha permitido ofrecer alternativas terapéuticas para estos pacientes, y se han demostrado buenos resultados. Se presenta el caso clínico de un paciente añoso con IM primaria severa. Por su elevado riesgo quirúrgico se optó por realizar reparación percutánea con técnica borde a borde, con excelentes resultados clínicos y ecocardiográficos. Se trata del primer reporte de caso de estas características en nuestro país.

Mitral regurgitation (MR) is a common disease. Myxomatous degeneration is the main cause of primary MR in developed countries. If not corrected, it leads to ventricular dysfunction and congestive heart failure, with high morbidity and mortality. Valve repair surgery is the recommended treatment for severe and symptomatic primary MR. In patients with high surgical risk, therapeutic options are limited. The emergence of edge-to-edge percutaneous repair has made it possible to offer therapeutic alternatives for these patients, and good results have been demonstrated. We present the clinical case of an elderly patient with severe primary MR. Due to his high surgical risk, it was decided to perform percutaneous repair with edge-to-edge technique, with excellent clinical and echocardiographic results. It is the first case report of these characteristics in our country.

A regurgitação mitral (RM) é uma doença frequente. A degeneração mixomatosa é a principal causa de RM primária em países desenvolvidos. Se não for corrigido, leva à disfunção ventricular e insuficiência cardíaca congestiva, com alta morbimortalidade. A cirurgia de reparo valvular é o tratamento recomendado na RM primária grave. Em pacientes com alto risco cirúrgico, as opções terapêuticas são limitadas. O surgimento do reparo percutâneo com plicatura dos segmentos é uma opção terapêutica alternativa, com bons resultados demonstrados. Apresentamos o caso clínico de um paciente doente por RM primária grave. Devido ao seu alto risco cirúrgico, optou-se pela correção percutânea com técnica "edge-to-edge", com excelentes resultados clínicos e ecocardiográficos. Este é o primeiro caso publicado com a técnica em Uruguai.

Galectins in epithelial-mesenchymal transition: roles and mechanisms contributing to tissue repair, fibrosis and cancer metastasis

Galectins are soluble glycan-binding proteins that interact with a wide range of glycoproteins and glycolipids and modulate a broad spectrum of physiological and pathological processes. The expression and subcellular localization of different galectins vary among tissues and cell types and change during processes of tissue repair, fibrosis and cancer where epithelial cells loss differentiation while acquiring migratory mesenchymal phenotypes. The epithelial-mesenchymal transition (EMT) that occurs in the context of these processes can include modifications of glycosylation patterns of glycolipids and glycoproteins affecting their interactions with galectins. Moreover, overexpression of certain galectins has been involved in the development and different outcomes of EMT. This review focuses on the roles and mechanisms of Galectin-1 (Gal-1), Gal-3, Gal-4, Gal-7 and Gal-8, which have been involved in physiologic and pathogenic EMT contexts.

Investigating the Alkaline Potential of Mineral Trioxide Aggregate Repair Using Selenium Nanoparticles

Resumo Este estudo teve como objetivo determinar o efeito da adição de nanopartículas de selênio (SeNPs) ao agregado de trióxido mineral (MTA HP) em relação ao potencial alcalinizante. Além disso, examinou o material do conjunto após a incorporação de SeNPs usando a microscopia eletrônica de varredura de emissão de campo com análise de raios X por dispersão de energia (FE-SEM/EDX) para caracterizar a composição elementar e as alterações morfológicas resultantes da integração de SeNPs. As amostras de cimento, antes e depois da incorporação de SeNPs, foram examinadas usando FE-SEM/EDX. O nível de pH também foi medido com um pH-metro previamente calibrado com soluções de pH conhecido, para avaliar a atividade alcalinizante da substância integrada em diferentes concentrações de nanopartículas: Grupo 1 (controle): 0% p/p de SeNPs, Grupo 2: 0,5% p/p de SeNPs, Grupo 3: 1% p/p de SeNPs, Grupo 4: 1,5% p/p de SeNPs e Grupo 5: 2% p/p de SeNPs após 1, 7, 14 e 30 dias em água distal. Os dados foram analisados por ANOVA unidirecional e testes de Tukey (P≤0,05). De acordo com o FE-SEM/EDX, as características morfológicas indicam que as SeNPs foram dispersas e integradas com sucesso na matriz de reparo do MTA. A análise de EDX valida a presença de selênio, confirmando a integração bem-sucedida. Os resultados confirmaram que o MTAHP apresentou alto nível de pH com uma redução perceptível na atividade alcalinizante com cada concentração incorporada de (SeNPs) que diferiu significativamente do grupo de controle em vários períodos de tempo (P≤ 0,05). Consequentemente, os resultados indicam que a adição de SeNPs ao MTA HP tem um impacto notável sobre o pH da solução de armazenamento, levando a uma redução significativa nos valores de pH para todas as concentrações e períodos de tempo quando comparados ao grupo de controle. A ação alcalinizante do MTA HP é altamente afetada pelas SeNPs incorporadas, tornando-o mais adequado para aplicação no tecido pulpar. Este estudo contribui para a nossa compreensão das alterações morfológicas e da composição elementar do MTA HP incorporado com SeNPs, aprimorando suas possíveis aplicações na regeneração dentária e tecidual.

Abstract This study aimed to determine the effect of adding selenium nanoparticles (SeNPs) to mineral trioxide aggregate (MTA HP) concerning alkalinizing potential. Additionally, it examined the set material after SeNPs incorporation using Field Emission Scanning Electron Microscopy with Energy Dispersive X-ray analysis (FE-SEM/EDX) for characterizing the elemental composition and morphological alterations resulting from the integration of SeNPs. Cement samples, both before and after SeNPs incorporation, were examined using FE-SEM/EDX. The pH level was also measured with a pH-meter previously calibrated with solutions of known pH, to evaluate the alkalinizing activity of the integrated substance at different concentrations of nanoparticles: Group 1 (control): 0% w/w SeNPs, Group 2: 0.5% w/w SeNPs, Group 3: 1% w/w SeNPs, Group 4: 1.5% w/w SeNPs and Group 5: 2% w/w SeNPs after 1, 7, 14, and 30 days in distal water. The data were analyzed by one-way ANOVA and Tukey tests (P≤0.05). According to FE-SEM/EDX, the morphological characteristics indicate that SeNPs were successfully dispersed and integrated into the MTA repair matrix. EDX examination validates the presence of Selenium, confirming successful integration. The findings confirmed that the MTAHP showed a high pH level with a discernible reduction in the alkalinizing activity with each incorporated concentration of (SeNPs) that significantly differed from the control group across various periods at (P≤ 0.05). Consequently, the findings indicate that the addition of SeNPs to MTA HP has a notable impact on the pH of the storage solution, leading to a significant decrease in pH values for all concentrations and periods when compared to the control group. The alkalinizing action of MTA HP is highly affected by the incorporated SeNPs, making it more suitable for application in pulpal tissue. This study contributes to our understanding of the morphological alterations and elemental composition of SeNP-incorporated MTA HP, enhancing its potential applications in dental and tissue regeneration.

Restoration-repair potential of resin-modified glass ionomer cement

Abstract: This in vitro study aimed to evaluate the repair bond strength of resin-modified glass ionomer cement using either the same material or a universal adhesive in the etch-and-rinse and self-etch modes plus resin composite. Twenty-four resin-modified glass ionomer cement blocks were stored in distilled water for 14 d and thermocycled. Sandpaper ground specimens were randomly assigned to three experimental groups according to the repair protocol: resin-modified glass ionomer cement (Riva Light Cure, SDI) and universal adhesive (Scotchbond Universal Adhesive, 3M Oral Care) in etch-and-rinse or self-etch modes and nanohybrid resin composite (Z350 XT, 3M Oral Care). After 24 h of water storage, the blocks were sectioned, and bonded sticks were subjected to the microtensile bond strength (μTBS) test. One-way ANOVA and Tukey's test were used to analyze the data. The failure mode was descriptively analyzed. The highest μTBS values were obtained when the resin-modified glass ionomer cement was repaired using the same material (p < 0.01). In addition, the mode of application of the universal adhesive system did not influence the repair bond strength of the resin-modified glass ionomer cement. Adhesive/mixed failures prevailed in all groups. Repair of resin-modified glass ionomers with the same material appears to be the preferred option to improve bond strength.

Cirugia de la insuficiencia tricuspidea / Tricuspid regurgitation surgery

La valvulopatía tricuspídea es considerada frecuente y sobre todo en pacientes con afectación mitral, habiendo sido sostenidamente objeto de controversias, tanto en la selección de la correcta actuación terapéutica, como del momento apropiado de su ejecución. Aunque la válvula tricúspide es afectada por estenosis, predominantemente es asiento de lesión tipo insuficiencia, que significa paso retrógrado de sangre desde el ventrículo derecho (VD) a la aurícula derecha durante la sístole. Puede ser primaria (orgánica) o secundaria (funcional), relacionada a dilatación/disfunción ventricular derecha, dilatación anular, tracción de sus valvas e hipertensión arterial pulmonar. La ecocardiografía tridimensional (3D) y la resonancia magnética cardiaca al permitir cuantificar con mayor precisión el tamaño del VD y la función sistólica, han permitido actuaciones terapéuticas más tempranas y con mejores resultados, que incluyen la reparación valvular tricuspídea, sustitución valvular y diversas modalidades de técnicas transcatéter. Con estas consideraciones, presentamos a consideración de ustedes el estado actual de la cirugía en la insuficiencia tricuspídea.

Tricuspid valve disease is considered common and especially in patients with mitral involvement, having been the subject of sustained controversy, both in the selection of the correct therapeutic action and the appropriate moment of its execution. Although the tricuspid valve is affected by stenosis, it is predominantly the seat of an insufficiency-type lesion, which means retrograde passage of blood from the right ventricle (RV) to the right atrium during systole. It can be primary (organic) or secondary (functional), related to right ventricular dilation/dysfunction, annular dilation, traction of its leaflets and pulmonary arterial hypertension. Three- dimensional (3D) echocardiography and cardiac magnetic resonance, by allowing more precise quantification of RV size and systolic function, have allowed earlier therapeutic actions with better results, which include tricuspid valve repair, valve replacement and various modalities of transcatheter techniques. With these considerations, we present for your consideration the current state of surgery in tricuspid regurgitation.

Efficacy and safety of branched stent and fenestrated stent for thoracic aortic diseases in short landing zone / 中华放射学杂志

Objective:To compare the efficacy and safety of Castor single-branch stent and in vitro fenestration stent in treating thoracic aortic diseases with insufficient landing zone.Methods:The clinical data of patients with thoracic aortic diseases treated with Castor single-branch stent or in vitro fenestrated stent between December 2017 and June 2021 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. A total of 184 patients were included, 99 patients were treated with Castor branch stent, and 85 patients with in vitro fenestration stent. All patients′ general clinical data, surgical data, perioperative and follow-up clinical and imaging data, and postoperative complications were collected. The χ2 test was used to compare the incidence of complications between the two groups, and the Kaplan-Meier method was used to plot the survival rate without adverse events between the two groups. Results:Stent placement was successful in all patients, and the success rate of the technique was 100%. Other branches were reconstructed in 2 patients in the Castor group and double fenestrated stent were reconstructed in 12 patients in the fenestrated group. The mean operation time of the Castor group was significantly shorter than that of the fenestrated group, the number of patients who received local anesthesia was significantly lower than that of the fenestrated group, and the endoleak rate during follow-up was significantly lower than that of the fenestrated group ( P<0.05). There was no significant difference in the postoperative hospital stay, the incidence rate of perioperative complications, mortality, the incidence rate of neurological complications, new dissection or aneurysm rate, branch stent stenosis rate, second surgical intervention rate, and false lumen thrombosis between the two groups ( P>0.05). The adverse event-free survival rate of the Castor group was slightly higher than that of the fenestrated group, but its difference was not statistically significant ( P>0.05). Conclusion:Castor branch stent and in vitro fenestration stent have good short-term and mid-term efficacy in the treatment of aortic diseases with insufficient landing zone, which are safe and effective options for reconstruction of LSA and other branch arteries.