Artificial Intelligence-Based Diagnosis of Obstructive Sleep Apnea Syndrome: A Scoping Review / Diagnóstico Basado en Inteligencia Artificial para el Síndrome Obstructivo de Apnea del Sueño: Una Revisión de Alcance

SUMMARY: To diagnose obstructive sleep apnea syndrome (OSAS), polysomnography is used, an expensive and extensive study requiring the patient to sleep in a laboratory. OSAS has been associated with features of facial morphology, and a preliminary diagnosis could be made using an artificial intelligence (AI) predictive model. This study aimed to analyze, using a scoping review, the AI-based technological options applied to diagnosing OSAS and the parameters evaluated in such analyses on craniofacial structures. A systematic search of the literature was carried out up to February 2024, and, using inclusion and exclusion criteria, the studies to be analyzed were determined. Titles and abstracts were independently selected by two researchers. Fourteen studies were selected, including a total of 13,293 subjects analyzed. The age of the sample ranged from 18 to 90 years. 9,912 (74.56 %) subjects were male, and 3,381 (25.43 %) were female. The included studies presented a diagnosis of OSAS by polysomnography; seven presented a control group of subjects without OSAS and another group with OSAS. The remaining studies presented OSAS groups in relation to their severity. All studies had a mean accuracy of 80 % in predicting OSAS using variables such as age, gender, measurements, and/or imaging measurements. There are no tests before diagnosis by polysomnography to guide the user in the likely presence of OSAS. In this sense, there are risk factors for developing OSA linked to facial shape, obesity, age, and other conditions, which, together with the advances in AI for diagnosis and guidance in OSAS, could be used for early detection.

Para diagnosticar el Síndrome Apnea Obstructiva del Sueño (SAOS) se utiliza la polisomnografía, el cual es un costoso y extenso estudio que exige que el paciente duerma en un laboratorio. El SAOS ha sido asociado con características de la morfología facial y mediante un modelo predictivo de la Inteligencia Artificial (IA), se podría realizar un diagnóstico preliminar. El objetivo de este estudio fue analizar por medio de una revisión de alcance, las opciones tecnológicas basadas en IA aplicadas al diagnóstico del SAOS, y los parámetros evaluados en dichos análisis en las estructuras craneofaciales. Se realizó una búsqueda sistemática de la literatura hasta febrero del 2024 y mediante criterios de inclusión y exclusión se determino los estudios a analizar. Los títulos y resúmenes fueron seleccionados de forma independiente por dos investigadores. Se seleccionaron 14 estudios, incluyeron un total de 13.293 sujetos analizados. El rango edad de la muestra oscilo entre 18 y 90 años. 9.912 (74.56 %) sujetos eran de sexo masculino y 3.381 (25,43 %) eran de sexo femenino. Los estudios incluidos presentaron diagnóstico de SAOS mediante polisomnografía, siete estudios presentaron un grupo control de sujetos con ausencia de SAOS y otro grupo con presencia de SAOS. Mientras que los demás estudios, presentaron grupos de SAOS en relación con su severidad. Todos los estudios tuvieron una precisión media del 80 % en la predicción de SAOS utilizando variables como la edad, el género, mediciones y/o mediciones imagenológicas. no existen exámenes previos al diagnóstico por polisomnografía que permitan orientar al usuario en la probable presencia de SAOS. En este sentido, existen factores de riesgo para desarrollar SAOS vinculados a la forma facial, la obesidad, la edad y otras condiciones, que sumados a los avances con IA para diagnóstico y orientación en SAOS podrían ser utilizados para la detección precoz del mismo.

Morphological and Morphometric Analysis, Apoptosis and Oxidative Stress Study in Hep 2 Cells Treated by Resveratrol or Quercetine / Análisis Morfológico y Morfométrico, Estudio de Apoptosis y Estrés Oxidativo en Células Hep 2 Tratadas con Resveratrol o Quercetina

SUMMARY: Resveratrol (RES) and quercetine (QRC), is a promising agent relevant for both cancer chemoprevention and treatment via several signaling pathways, involved in their anticancer activity related to its chemotherapeutic potential, associated with the induction of ROS generation in cancer cells, leading to apoptosis. In our study, we have summarized the mechanisms of action of RES and QRC, and their pharmacological implications and potential therapeutic applications in cancer therapy. After treatment of Hep 2 cells with QRC or RES, the death pathways such as the cytochrome c release, ERK1/2 and IRS-1 pathways were upregulated, while cell survival pathway, including PI3K/AKT were downregulated. The RES and QRC caused oncosis, cells hypertrophy, hypercondensatin of chromatin, rupture of the plasma membrane and nuclear membrane, and formation of apoptotic bodies. Morphometric measurements of some cellular and nuclear parameters showed that RES and QRC induced an increase in cells and nuclear size, the nucleocytoplasmic ratio remained below 1 (N-Cyt R < 1), sign of low nuclear activity. The RES and QRC induced apoptosis of Hep2 cells by increasing of oxidative stress markers, MDA, and by modulating detoxifying enzymes, CAT and SOD. Our study results prove antiproliferative and proapoptotic properties of quercetin and resveratrol with regard to larynx cancer.

Resveratrol (RES) y quercetina (QRC), es un agente prometedor y relevante tanto para la quimioprevención como para el tratamiento del cáncer a través de varias vías de señalización, involucrado en su actividad anticancerígena relacionada con su potencial quimioterapéutico, asociado con la inducción de la generación de especies reactivas del oxígeno (ROS) en células cancerosas, lo que lleva a apoptosis. En nuestro estudio, hemos resumido los mecanismos de acción de RES y QRC, y sus implicaciones farmacológicas y posibles aplicaciones terapéuticas en la terapia del cáncer. Después del tratamiento de las células Hep 2 con QRC o RES, las vías de muerte, tal como la liberación de citocromo c, las vías ERK1/2 e IRS-1, se regulaban positivamente, mientras que la vía de supervivencia celular, incluida PI3K/AKT, se regulaba negativamente. El RES y el QRC provocaron oncosis, hipertrofia celular, hipercondensación de la cromatina, rotura de la membrana plasmática y nuclear y formación de cuerpos apoptóticos. Las mediciones morfométricas de algunos parámetros celulares y nucleares mostraron que RES y QRC indujeron un aumento en las células y el tamaño nuclear, la proporción nucleocitoplasmática se mantuvo por debajo de 1 (N- Cyt R <1), signo de baja actividad nuclear. RES y QRC indujeron la apoptosis de las células Hep2 aumentando los marcadores de estrés oxidativo, MDA, y modulando las enzimas desintoxicantes, CAT y SOD. Los resultados de nuestro estudio demuestran las propiedades antiproliferativas y proapoptóticas de la quercetina y el resveratrol con respecto al cáncer de laringe.

Association of radiological type of dural tail sign in contrast MRI with histopathological grading of intracranial meningiomas

Background: In neurosurgical practice meningiomas are one of the commonest intracranial tumors to seek surgical intervention which is classified into 3 histological grades and 15 subtypes according to the 2016 WHO classification of tumors of the CNS. The aim of this study was to evaluate the association between radiological type of dural tail sign in contrast MRI with histopathological grading of intracranial meningiomas. Methods: This was a cross sectional interventional study carried out in the Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Dhaka Medical College Hospital and National Institute of Neuroscience Hospital including 35 patients of intracranial meningiomas who fulfilled the selection criteria were enrolled in this study. Results: This study included 35 cases of intracranial meningiomas. There were 22 individuals (62.9%) in the 28-47 age group. The mean±standard deviation (SD) age of the participants was 45.97±9.56 years. There were 9 male participants (25.7%) and 26 female participants (74.3%) with ratio 1:3. We see that parasagittal location (50%) and sphenoid wing (33.3%) were more prevalent in grade II. We found significant distribution of the types of DTS among the histological grades of meningioma. The nodular cases (6,100%) were all grade II type. Mixed type was the most prevalent type among grade I. Conclusions: There is association of radiological type of dural tail sign in contrast MRI with histopathological grading of intracranial meningiomas and may be used as a good tools for forecasting tumor type and prognosis.

Root Canal Treatment of Mandibular First Premolar with 3 Canals: A Case Report / Tratamiento Endodóntico de Primer Premolar Mandibular con 3 Canales: Reporte de un Caso

SUMMARY: The mandibular first premolar is commonly a single-rooted tooth with occasional presentation of radicular variations. This tooth usually has one root with only one canal (97.9 %). Presence of three canals is very rare. Anomalies may appear during odontogenesis which can lead to anatomical variations in teeth. Similarly, these variations may be associated with characteristics that can be attributed to specific population groups. Due to their low frequency, these additional canals can easily be missed. For this reason, a meticulous knowledge of tooth morphology and their possible anatomical variations are necessary, and the presence of extra roots and canals should be always considered before initiation of root canal treatment. Additionally, different radiographs and appropriated access cavity preparation is needed to ensure a success endodontic treatment. This article reports a diagnosis and endodontic treatment of a mandibular first premolar with three canals.

El primer premolar mandibular suele ser un diente unirradicular con presentación ocasional de variaciones radiculares. Este diente suele tener una raíz con un solo conducto (97,9 %). La presencia de tres canales es muy rara. Durante la odontogénesis pueden aparecer anomalías que pueden provocar variaciones anatómicas en los dientes. De manera similar, estas variaciones pueden estar asociadas con características que pueden atribuirse a grupos de población específicos. Debido a su baja frecuencia, estos canales adicionales pueden pasar desapercibidos fácilmente. Por esta razón, es necesario un conocimiento meticuloso de la morfología dental y sus posibles variaciones anatómicas, y siempre se debe considerar la presencia de raíces y conductos adicionales antes de iniciar el tratamiento de conducto. Además, se necesitan diferentes radiografías y una preparación adecuada de la cavidad de acceso para garantizar un tratamiento de endodoncia exitoso. Este artículo reporta un diagnóstico y tratamiento endodóntico de un primer premolar mandibular con tres canales.

Anatomical Study of the Pterion in a South African Population of KwaZulu-Natal / Estudio Anatómico del Pterion en una Población Audafricana de KwaZulu-Natal

SUMMARY: Morphologically the Pterion marks the location of the four cranial bones, viz. frontal bone, sphenoid angle of the parietal bone, squamous part of the temporal bone and the greater wing of the sphenoid bone. Population-specific differences exists in the position and union of the Pterion. The Pterion is also an important neurosurgical landmark for surgical procedures, viz. Pterional/lateral approach, as it provides wide access to the base of the skull. This study aimed to determine the position and incidence of the various sutural patterns of the Pterion in a South African population of KwaZulu-Natal. This retrospective study was conducted bilaterally on 36 dry human skulls (11 females and 25 males) obtained from the Department of Clinical Anatomy at University of KwaZulu-Natal. Ethical clearance obtained from the Biomedical Research Ethics Committee. The morphometric parameters of the Pterion were measured using a digital Vernier caliper, while the morphological characteristics were examined using Murphy's classification scheme to determine (if any) laterality or sex differences exists. The mean distance of the Centre of the pterion from midpoint of zygoma was 44.4+/-4.1 mm in males and 45.1+/-4.6 mm in females. While the distance from frontozygomatic suture was 32.7+/-4.7 mm and 32.6+/-4.8 mm in males and females, respectively. Sphenoparietal type of pterion was most prevalent at 55.6 %, followed by the frontotemporal, stellate and epipteric type with an incidence of 27.8 %; 11.1 % and 5.6 %, respectively. No statistically significant difference for sex or laterality were documented in this study. The present study concluded that the sphenoparietal type of sutural pattern was most prevalent with an incidence of 55.6 %. While the epipteric type was the least prevalent. The comprehensive data about the position of the Pterion is important to neurosurgeons, forensics scientists and anthropologists.

Morfológicamente, el pterion marca la ubicación de los cuatro huesos craneales: hueso frontal, ángulo esfenoidal del hueso parietal, parte escamosa del hueso temporal y el ala mayor del hueso esfenoides. Existen diferencias específicas de la población en la posición y unión del pterion. El pterion es también un hito neuroquirúrgico importante para los procedimientos quirúrgicos en el bordaje pterional/lateral, ya que proporciona un amplio acceso a la base del cráneo. Esta investigación tuvo como objetivo determinar la posición y la incidencia de los diversos patrones suturales del pterion en una población sudafricana de KwaZulu-Natal. Este estudio retrospectivo se realizó bilateralmente en 36 cráneos humanos secos (11 mujeres y 25 hombres) obtenidos del Departamento de Anatomía Clínica de la Universidad de KwaZulu-Natal. ALa autorización ética fue otorgada porel Comité Ético de Investigación Biomédica. Los parámetros morfométricos del pterion se midieron usando un calibrador Vernier digital, mientras que las características morfológicas se examinaron usando el esquema de clasificación de Murphy para determinar, si existe alguna lateralidad o diferencias sexuales. La distancia media del centro del pterion desde el punto medio del cigoma fue de 44,4+/- 4,1 mm en hombres y de 45,1+/-4,6 mm en mujeres. Mientras que la distancia desde la sutura frontocigomática fue de 32,7+/-4,7 mm y 32,6+/-4,8 mm en hombres y mujeres, respectivamente. El tipo de pterion esfenoparietal fue el más prevalente con un 55,6 %, seguido del tipo frontotemporal, estrellado y epiptérico con una incidencia del 27,8 %; 11,1 % y 5,6 %, respectivamente. En el estudio no se documentaron diferencias estadísticamente significativas para el sexo o la lateralidad. Concluimos que el tipo de patrón de sutura esfenoparietal fue el más prevalente con una incidencia del 55,6 %. Mientras que el tipo epiptérico fue el menos prevalente. Los datos completos sobre la posición del pterion son importantes para los neurocirujanos, los científicos forenses y los antropólogos.

Morphological Assessment of the Anterior Loop in the Region of Mental Foramen Using Cone Beam Computed Tomography / Evaluación Morfológica del Asa Anterior en la Región del Foramen Mentoniano Mediante Tomografía Computarizada de Haz Cónico

SUMMARY: Anterior loop in the mental foramen region is a critical region in the mandible. The non detection of anterior loop leads to inadvertent complications during the surgical procedures in this region. This study aimed to evaluate the morphological assessment of the mental foramen's anterior loop (AL) using (CBCT) cone-beam computed tomography. CBCT data was retrieved from January 2018 to December 2022 and screened for eligibility. Images were viewed using panoramic reconstructed views for initial screening. Further multiplanar reformatted view in axial, coronal and sagittal planes were examined. When anterior loop was detected, the path of inferior alveolar canal was traced and the anterior loop was analyzed. Statistical analysis was carried out on the data. Cross-tabulation was done to associate gender and age with the achieved findings (heights and diameters) using the Chi-square test. In this analysis 519 cases were included and examined for presence of anterior loop. 22 cases were included in the study, out of which 10(45.5%) males and 12(54.5%) females. The prevalence of AL is high among females. AL was found higher on the right side in 14 (68.2%) cases compared to the left side with 7 (31.8%) cases. The mean diameter of AL on the right side was 2.5 mm, and on the left side diameter was 1.96 mm. The prevalence of anterior loop in the region of mental foramen in Saudi Population was found to be 4.24%. Careful evaluation for the anterior loop can prevent hemorrhagic episodes during surgical intervention or implant procedures in the mandibular premolar region.

El asa anterior en la región del foramen mentoniano es una región crítica en la mandíbula. La no detección del asa anterior conduce a complicaciones inadvertidas durante los procedimientos quirúrgicos en esta región. Este estudio tuvo como objetivo evaluar la evaluación morfológica del asa anterior (AL) del foramen mental mediante tomografía computarizada de haz cónico (CBCT). Los datos CBCT se recuperaron desde enero de 2018 hasta diciembre de 2022 y se examinaron para determinar su elegibilidad. Las imágenes se visualizaron utilizando vistas panorámicas reconstruidas para la evaluación inicial. Se examinaron además, vistas reformateadas multiplanares en los planos axial, coronal y sagital. Cuando se detectó el asa anterior, se trazó el trayecto del canal mandibular y se analizó el asa anterior. Se realizó un análisis estadístico de los datos. Mediante la prueba de Chi-cuadrado se realizó una tabulación cruzada para asociar el sexo y la edad con los hallazgos obtenidos (alturas y diámetros). En este análisis se incluyeron y examinaron 519 casos para detectar la presencia de asa anterior. Se incluyeron en el estudio 22 casos, de los cuales 10 (45,5 %) eran hombres y 12 (54,5 %) mujeres. La prevalencia de AL es alta entre las mujeres. Se observó que AL fue mayor en el lado derecho en 14 (68,2 %) de los casos en comparación con el lado izquierdo con 7 (31,8 %) casos. El diámetro medio de AL en el lado derecho fue de 2,5 mm y en el lado izquierdo fue de 1,96 mm. La prevalencia del asa anterior en la región del foramen mental en la población saudí fue de 4,24 %. Una evaluación rigurosa del asa anterior puede prevenir episodios hemorrágicos durante una intervención quirúrgica o procedimientos de implante en la región de los premolares mandibulares.

Morphology and Morphometry of the Dorsal Interosseous Muscles of the Hand: Laterality and Sexual Dimorphism / Morfología y Morfometría de los Músculos Interóseos Dorsales de la Mano: Lateralidad y Dimorfismo Sexual

SUMMARY: The dorsal interosseous muscles (DIM) are intrinsic muscles of the hand located dorsally between metacarpal bones, which play a role in finger abduction. Anatomical variations of these muscles in terms of form and length have been well documented, but variations regarding sex and laterality are underexplored. The aim of this study was to investigate the morphology and morphometry of the DIM of the hand regarding sexual dimorphism and laterality. Twenty human cadavers belonging to the white individuals (n = 40 hands) with known sex and laterality were used for this study. DIMs were dissected and observed for morphology. Also, a digital calliper was used to measure the midpoint length of the DIM. The origin and insertion of all the DIM were normal with the left hand having no additional, supernumerary, and absent muscles in each compartment. The variations were only found on the right side and predominant in females: 2 out of 11 (18.18%) hands containing a space with a supernumerary muscle; 1 out of 11 (9.09%) hands having a space with a double muscle; and 1 out of 11 (9.09%) hands having a compartment with a unipennate muscle. In males, 1 out of 9 (11.11%) hands had a compartment with a supernumerary muscle. The mean midpoint length of each muscle in females and males in both hands from the first to the fourth muscle, respectively, was documented. In females on the left: 46.79 ± 3.56; 42.62 ± 3.57; 49.02 ± 4.21; 41.66 ± 2.15 and right: 47.30 ± 2.49; 39.27 ± 4.14; 45.69 ± 4.64; 38.12 ± 4.08. In males, it was on the left: 50.01 ± 3.95; 41.98 ± 3.79; 47.90 ± 4.83; 41.79 ± 4.25, and on the right: 46.65 ± 2.09; 39.01 ± 4.25; 47.47 ± 3.41; 38.31 ± 4.40. The mean midpoint length of the DIM was relatively higher on the left hand compared to the right hand in both females and males. In this study, variations regarding the supernumerary muscle, double interosseous space, and unipennate muscles were only observed on the right-hand side and predominantly in females, an insight that may guide in the treatment of fractures, stiffness of the hand, and compartment syndromes.

Los músculos interóseos dorsales (DIM) son músculos intrínsecos de la mano ubicados dorsalmente entre los huesos metacarpianos, que desempeñan un papel en la abducción de los dedos. Las variaciones anatómicas de estos músculos en términos de forma y longitud están bien documentadas, pero las variaciones con respecto al sexo y la lateralidad están poco exploradas. El objetivo de este estudio fue investigar la morfología y morfometría de los DIM de la mano con respecto al dimorfismo sexual y la lateralidad. Para este estudio se utilizaron veinte cadáveres humanos pertenecientes a individuos blancos (n = 40 manos) con sexo y lateralidad conocidos. Los DIM se diseccionaron y observaron para determinar su morfología. Además, se utilizó un calibrador digital para medir la longitud del punto medio del DIM. El origen y la inserción de todos los DIM fueron normales y la mano izquierda no tenía músculos adicionales, supernumerarios y ausentes en cada compartimento. Las variaciones se encontraron sólo en el lado derecho y predominaron en el sexo femenino: 2 de 11 (18,18%) manos contenían un espacio con un músculo supernumerario; 1 de cada 11 (9,09%) manos presentando un espacio con doble músculo; y 1 de cada 11 (9,09%) manos presentaba un compartimento con músculo unipenate. En los hombres, 1 de cada 9 (11.11%) manos tenía un compartimento con un músculo supernumerario. Se documentó la longitud media del punto medio de cada músculo en mujeres y hombres en ambas manos desde el primer al cuarto músculo, respectivamente. En mujeres de izquierda: 46,79 ± 3,56; 42,62 ± 3,57; 49,02 ± 4,21; 41,66 ± 2,15 y derecha: 47,30 ± 2,49; 39,27 ± 4,14; 45,69 ± 4,64; 38,12 ± 4,08. En los varones fue hacia la izquierda: 50,01 ± 3,95; 41,98 ± 3,79; 47,90 ± 4,83; 41,79 ± 4,25, y a la derecha: 46,65 ± 2,09; 39,01 ± 4,25; 47,47 ± 3,41; 38,31 ± 4,40. La longitud media del punto medio del DIM fue relativamente mayor en la mano izquierda en comparación con la derecha tanto en mujeres como en hombres. En este estudio, las variaciones con respecto al músculo supernumerario, el doble espacio interóseo y los músculos unipennados sólo se observaron en el lado derecho y predominantemente en el sexo femenino, un conocimiento que puede guiar en el tratamiento de fracturas, rigidez de la mano y síndromes compartimentales.

Características Morfológicas y Morfométricas de la Silla Turca Según Clase Esqueletal / Morphological and Morphometric Characteristics of the Sella Turcica According to Skeletal Class

El desarrollo craneofacial es un proceso complejo con diversos factores involucrados. Cuando las maloclusiones son de origen esqueletal pueden generar una relación ortognática (clase I), retrognática (clase II) o prognática (clase III) de la mandíbula respecto de la maxila. Esta configuración está estrechamente relacionada con la base del cráneo donde la silla turca ha sido estudiada con este fin debido a su origen ectomesenquimático (Dasgupta et al., 2018) y sus relaciones anatómicas. Diversos estudios se han realizado para dilucidar esta relación y este trabajo busca aportar a la discusión comparando las características de la silla turca entre las maloclusiones esqueletales a través de telerradiografías laterales. El estudio se realizó mediante 52 placas radiográficas de individuos de entre 18 a 24 años con igual número de sujetos masculinos y femeninos, 15 de clase I, 7 de clase II y 30 de clase III. Se realizó la medición digital del área radiográfica de la silla turca y se clasificó morfológicamente mediante las categorías de Axelsson et al. (2004). Se utilizó coeficiente de correlación intraclase con un 95 % de confianza arrojando un valor de 0,88 para el área de la silla turca, 0,89 para el ángulo ANB y de 0,70 para el valor Wits demostrando una excelente fiabilidad del observador. Con un 95 % de confianza la prueba exacta de Fisher evidenció una asociación significativa (p = 0,029) entre las variaciones morfológicas de la ST y la clase esqueletal siendo más frecuentes en clase III. La prueba H de Kruskal Wallis no arrojó diferencias significativas (p=0,550) en las medianas del área selar entre las clases esqueletales. Las variaciones morfológicas parecen ser más relevantes que las variaciones anatómicas en esta asociación. Se requieren nuevos estudios en población chilena con un mayor número de casos.

SUMMARY: Craniofacial development is a complex process with several factors involved. When malocclusions have a skeletal origin, they can generate an orthognathic (class I), retrognathic (class II) or prognathic (class III) relationship of the mandibular bone respect to the maxilla. This configuration is closely related to the base of the skull where the sella turcica has been studied for this purpose due to its ectomesenchymal origin (Dasgupta et al., 2018) and its anatomical relationships. Several studies have been conducted to elucidate this relationship and this work seeks to contribute to the discussion by comparing the characteristics of the sella turcica among skeletal malocclusions through lateral teleradiographies. The study was conducted using 52 radiographic plates of individuals between 18 and 24 years old with an equal number of male and female subjects, 15 class I, 7 class II and 30 class III. The radiographic area of the sella turcica was digitally measured and morphologically classified using the categories of Axelsson et al. (2004). An intraclass correlation coefficient was obtained with 95 % confidence, yielding a value of 0.88 for the sella turcica area, 0.89 for the ANB angle and 0.70 for the Wits value, demonstrating excellent observer reliability. With 95 % confidence, Fisher's exact test showed a significant association (p = 0.029) between the morphological variations of the ST and the skeletal class, being more frequent in class III. The Kruskal Wallis H test did not show significant differences (p=0.550) in median sellar area between skeletal classes. Morphological variations seem to be more relevant than anatomical variations in this association. New studies are required in the Chilean population with a greater number of cases.

Analysis of the Chemical Composition, Morphological Characterization, and Porosimetry of Allograft and Comparison with Xenograft for Dental Applications / Análisis de la Composición Química, Caracterización Morfológica y Porosimetría de Aloinjerto y Comparación con Xenoinjerto para Aplicaciones Odontológicas

SUMMARY: Tissue engineering aims to fabricate a scaffold that exhibits a suitable surface topography for a desired cellular response. Therefore, a study analyzing the characteristics of bone grafts is important for future research directions. This work aims to analyze the physical-chemical characteristics of commercially available bone grafts of human and bovine origin for dental use, using morphological analysis of the surface and chemical composition by variable pressure scanning electron microscope (VP-SEM) and energy-dispersive x-ray (EDX) spectrometry. In addition, pore diameter and surface area were analyzed by degassing method using a porosimeter, and particle size by laser diffraction. The analyzed allograft and xenograft particles differ in morphological characteristics and chemical composition. The allograft particles present a cuboidal and prismatic geometric morphology with angled edges and the absence of macropores. On the contrary, the xenograft particles present an irregular morphology with macropores in their structure. There is a statistically significant difference in C, P, and Ca between the xenograft and allografts (p < 0,05). The analyzed composition of allografts showed mainly the presence of C and O. In contrast, the composition of the xenograft was mainly Ca. These differences could influence the osteogenic properties of allografts and xenografts. This analysis provides basic information to understand the physicochemical properties of allografts and xenografts that facilitate cell-graft interaction.

La ingeniería de tejidos tiene como objetivo fabricar un andamio que muestre una topografía de superficie adecuada para una respuesta celular deseada. Por tanto, un estudio que analice las características de los injertos óseos es importante para futuros enfoques de investigación. Este trabajo tiene como objetivo analizar las características físico-químicas de injertos óseos de origen humano y bovino disponibles comercialmente para uso odontológico, mediante análisis morfológico de la superficie y composición química mediante microscopio electrónico de barrido de presión variable (VP-SEM) y x-dispersivo de energía. espectrometría de rayos (EDX). Además, el diámetro de los poros y el área superficial se analizaron mediante el método de desgasificación utilizando un porosímetro y el tamaño de las partículas mediante difracción láser. Las partículas de aloinjerto y xenoinjerto analizadas difieren en características morfológicas y composición química. Las partículas del aloinjerto presentan una morfología geométrica cúbica y prismática con bordes angulados y ausencia de macroporos. Por el contrario, las partículas de xenoinjerto presentan una morfología irregular con macroporos en su estructura. Existe una diferencia estadísticamente significativa en C, P y Ca entre el xenoinjerto y los aloinjertos (p < 0,05). La composición analizada de los aloinjertos mostró principalmente la presencia de C y O. Por el contrario, la composición del xenoinjerto fue principalmente Ca. Estas diferencias podrían influir en las propiedades osteogénicas de los aloinjertos y xenoinjertos. Este análisis proporciona información básica para comprender las propiedades fisicoquímicas de aloinjertos y xenoinjertos que facilitan la interacción célula-injerto.

Quality-by-Design Optimization of Electrospinning Parameters to Formulate Scaffolds for Topical Inflammatory Disease Management via Drug Repurposing

This study investigates the fabrication of chitosan (CS)/polyvinyl alcohol (PVA) blend nanofibers via electrospinning, aiming to create nanofibers with enhanced properties for broad applications. The research focuses on optimizing electrospinning parameters to reduce bead formation and achieve uniform nanofiber morphology. A detailed experimental design, employing a nineteen-point plan developed with Design-Expert software, examined variables such as polymer concentration, distance from the needle to the collector, the required voltage, and the rate at which solution was ejected from the needle. Morphological characteristics of the nanofibers were analyzed using advanced microscopy, complemented by drug release and wound healing assessments. The optimal electrospinning conditions were determined to be a 1:3 CS/PVA solution concentration ratio, an 8 cm needle-to-collector distance, a 20 kV applied voltage, and a 1 mL/hour flow rate. Scanning electron microscopy revealed uniform nanofibers with diameters between 100 to 250 nm, devoid of bead defects. In-vitro analysis demonstrated a sustained release profile of azilsartan (AZL), while in-vivo studies on rats indicated enhanced wound healing, corroborated by histological examination. The findings suggest that CS/PVA nanofibers, fabricated under these conditions, possess promising characteristics for use as a drug-delivery scaffold in wound treatment applications.

Descripción de la Morfología del Sistema de Canales Radiculares en Premolares Maxilares Mediante Tomografía Computarizada Cone Beam en una Población Chilena

El tratamiento endodóntico requiere detallados conocimientos sobre la morfología radicular. En premolares maxilares, se ha reportado variabilidad en el número de raíces y morfología del sistema de canales radiculares (SCR). La causa más frecuente de fracaso endodóntico son los conductos no tratados. Por lo tanto, una mejor compresión de la morfología del SCR y sus variaciones es crucial para el tratamiento endodóntico. El objetivo de esta investigación fue describir la frecuencia del número de raíces y morfología del SCR en premolares maxilares, mediante exámenes de tomografía computarizada Cone Beam (CBCT) en una población chilena. Se realizó un estudio observacional descriptivo de corte transversal donde se observó la morfología del sistema de canales radiculares de primeros y segundos premolares maxilares a través de exámenes CBCT, agrupándolos de acuerdo con la Clasificación de Vertucci. Se observaron 228 exámenes CBCT, donde se incluyeron 268 primeros premolares superiores y 233 segundos premolares maxilares. Se determinó que en primeros premolares maxilares un 56,3 % presentó una raíz, un 43,3 %, siendo más frecuente una morfología del SCR tipo IV. En los segundos premolares maxilares, se determinó la presencia de una raíz en el 95,7 % de los casos, siendo más frecuente una morfología del SCR tipo I. Estos resultados pueden ser de interés para endodoncistas, ya que conocer la morfología del SCR de premolares maxilares permite mejorar la planificación de la terapia endodóntica realizada en estos dientes.

Endodontic treatment requires detailed knowledge of root morphology. In maxillary premolars, variability in root number and root canal system (RCS) morphology has been reported. The most frequent cause of endodontic failure is non treated canals. Therefore, a better understanding of RCS morphology and its variations is crucial for endodontic treatment. The aim of this research was to describe the frequency of root number and SCR morphology in maxillary premolars, by means of Cone Beam Computed Tomography (CBCT) examinations in a Chilean population. A cross-sectional descriptive observational study was carried out in which the morphology of the root canal system of maxillary first and second premolars was observed through CBCT examinations, grouping them according to the Vertucci Classification. A total of 228 CBCT examinations were observed, which included 268 upper first premolars and 233 maxillary second premolars. It was determined that in maxillary first premolars 56.3 % presented one root, 43.3 %, being more frequent a SCR type IV morphology. In maxillary second premolars, the presence of one root was determined in 95.7 % of the cases, being more frequent a SCR type I morphology. These results may be of interest to endodontists, since knowing the morphology of the RCS of maxillary premolars allows improving the planning of endodontic therapy performed on these teeth.

Comparación Morfométrica de Esqueletos Transparentados de Cuatro Especies de Roedores Myomorfos / Morphometric Comparison of Transparent Skeletons of Four Species of Myomorphic Rodents

Las técnicas de doble tinción y transparentación se han usado desde 1897, pero su utilidad ha sido poco explorada en los estudios anatómicos de micromamíferos adultos. No obstante, la combinación de estas técnicas con el análisis alométrico mutivariado posibilita el estudio de esqueletos poscraneales articulados de tales grupos de micromamíferos como los roedores, los cuales son muy limitados ya que casi siempre se enfocan en los cráneos. En este estudio, analizamos y comparamos la morfometría del esqueleto de Neotomodon alstoni con la de Meriones unguiculatus, Phodopus campbelli y Rattus norvegicus. Usamos la técnica de doble tinción y transparentación para analizar las relaciones morfométricas entre estos roedores utilizando sesenta caracteres esqueléticos. Se encontró que tres especies comparten dos correlaciones comunes y compartieron el mismo tipo de crecimiento isométrico en una de ellas; además se encontraron similitudes aparentes entre los patrones de la morfometría de P campbelli con el patrón de osificación descrito para la especie relacionada Mesocricetus auratus. Las diferencias en el crecimiento alométrico pueden representar también diferencias en el ritmo de desarrollo de acuerdo con el tipo de historia de vida de cada especie. Aquí demostramos que tanto la técnica de preparación como el método de análisis morfométricos son herramientas poderosas pero simples, para realizar estudios anatómicos y morfológicos en el laboratorio. Nuestros resultados reflejan las condiciones del desarrollo ontogenético derivados delpropio patrón de heterocronía para cada especie, y además representan la historia evolutiva de este grupo analizado. Sin embargo, consideramos que es deseable más investigación.

SUMMARY: Clearing and staining techniques have been present since 1897, However, their use in anatomical studies of adult micromammals has been limited. When using such techniques in combination with allometric method, it is possible to study articulated skeletons of micromammals, instead of relying only on the skulls, which is important in morphologically complicated groups as the rodents. Research involving multivariate allometric analysis of postcranial skeleton of rodents has been limited and confined to specific items. In this study, we analyzed and compared the morphometry of the skeleton of Neotomodon alstoni with that of Meriones unguiculatus, Phodopus campbelli and Rattus norvegicus. We applied the double staining and clearing technique in order to determine the morphometric relation between these rodents using sixty skeletal characters. We found that three species share two common correlations and one isometric, with apparent similarities between the morphometry patterns of P campbelli with the ossification pattern described for the related species Mesocricetus auratus. The differences in allometric growth could represent differences in the development stages according to the type of life history for each species. In this analysis we confirmed that both the preparation technique and morphometric analysis method, are simple yet verifiable tools for anatomical and morphological studies. Our results reflect the conditions of ontogenetic development derived from the heterochrony pattern for each species, representing the evolutionary history for this group. Therefore, as this approach continues to be discussed, ongoing research is warranted.

Effect of Long-term Peripheral Nerve Stimulation on Neuro-Muscular Complex Morphologic Recovery in Experiment / Efecto de la Estimulación del Nervio Periférico a Largo Plazo sobre la Recuperación Morfológica del Complejo Neuromuscular en Experimento

SUMMARY: Peripheral nerve injury is an extremely important medical and socio-economic problem. It is far from a solution, despite on rapid development of technologies. To study the effect of long-term electrical stimulation of peripheral nerves, we used a domestically produced electrical stimulation system, which is approved for clinical use. The study was performed on 28 rabbits. Control of regeneration was carried out after 3 month with morphologic techniques. The use of long-term electrostimulation technology leads to an improvement in the results of the recovery of the nerve trunk after an injury, both directly at the site of damage, when stimulation begins in the early period, and indirectly, after the nerve fibers reach the effector muscle.

La lesión de los nervios periféricos es un problema médico y socioeconómico extremadamente importante. Sin embargo, y a pesar del rápido desarrollo de las tecnologías, aún no tiene solución. Para estudiar el efecto de la estimulación eléctrica a largo plazo de los nervios periféricos, utilizamos un sistema de estimulación eléctrica de producción nacional, que está aprobado para uso clínico. El estudio se realizó en 28 conejos. El control de la regeneración se realizó a los 3 meses con técnicas morfológicas. El uso de tecnología de electro estimulación a largo plazo conduce a una mejora en los resultados de la recuperación del tronco nervioso después de una lesión, tanto directamente en el lugar del daño, cuando la estimulación comienza en el período temprano, como indirectamente, después de que las fibras nerviosas alcanzan el músculo efector.

Clinical and Pathological Characteristics of Extrapleural Solitary Fibrous Tumor / 昆明医科大学学报

Objective To investigate the clinical and pathological characteristics of the extrapleural solitary fibrous tumor and the relevant differential diagnosis.Methods HE and immunohistochemical staining were performed on 26 samples of isolated fibrous tumors outside the pleura,and a comprehensive analysis was conducted based on the clinical and imaging data.Results The histological morphology of isolated fibrous tumors was diverse,with typical cases showing the irregular arrangement of oval or spindle shaped cells.In the stroma,thick collagen bands,antler like blood vessels,and peritubular transparent degeneration could be seen.The immunohistochemical staining demonstrated that the positive rates of STAT-6、CD34、Bcl-2、CD99、SMA were 96.2% 、92.3% 、92.3% 、76.9% and 26.9%,respectively.Conclusion SFT commonly occurs in the pleura and can also occur in other areas.Its histological characteristics and immunohistochemical phenotype help to clarify the diagnosis.However,when it occurs in uncommon anatomical sites,it is necessary to carefully and meticulously distinguish and comprehensively judge the clinical prognosis of key diseases that need to be distinguished or excluded..

Orrelations of sperm parameters with fertilization rate of in vitro fertilization / 临床检验杂志

Objective To investigate the correction between the fertilization rate of in vitro fertilization(IVF)and sperm parameters.Methods This retrospective study included 327 cases undergoing IVF procedures in the Center for Reproductive Medicine of Chenz-hou First People's Hospital,who were divided into a low fertilization group(fertilization rate＜30％,n=19)and normal fertilization group(fertilization rate≥30％,n=308)based on the assessment standards of quality control data in the embryology laboratory of our center.The basic information of males,embryo information and related sperm parameters were collected,and the correction between sperm parameters and the fertilization rate was analyzed by Pearson correlation.The influencing factors of the fertilization rate were ana-lyzed by binary logistic regression,and the area under the receiver operating characteristic(ROC)curve(AUC)was performed to ana-lyze the predictive value of low fertilization rate.Results The sperm acrosin activity,percentage of spermatozoa with normal morpholo-gy and sperm DNA fragmentation index(DFI)were the relevant factors affecting the fertilization rate,and the correlation coefficients were 0.168,0.306,and-0.243,respectively(all the P＜0.05).Logistic regression analysis showed that all the three indicators were independent factors affecting the fertilization rate of IVF,and the multivariate logistic equation was as follows:estimated fertilization rate=-2.561+0.035 ×acrosin activity+2.066×percentage of sperm with normal morphology-1.51×sperm DFI.The areas under the ROC curve(AUC)of acrosin activity,percentage of sperm with normal morphology,sperm DFI and the combination of them were 0.806,0.889,0.827 and 0.899,respectively.The corresponding cut-off values for the Yuden index were 61.20 μIU/106 sperm,2.98％,27.50％and-21.32,respectively.The sensitivity of acrosin activity,percentage of sperm with normal morphology,sperm DFI and the combination of three indicators for the prediction of low fertilization rate were 95.70％,76.90％,68.40％,64.30％,and their specificity were 43.50％,94.70％,87.70％,100.00％,respectively.The combination of three indicators showed the best prediction ef-ficiency.Conclusion Acrosin activity,percentage of sperm with normal morphology and sperm DFI should be the independent factors to predict the fertilization rate of IVF,and the multivariate logistic equation can be used as a reference to predict the fertilization rate of IVF.

Predictive value of combination of normal morphology sperm percentage and sperm DNA fragmentation index for in vitro fer-tilization embryo transfer outcomes / 临床检验杂志

Objective To investigate the effects of combined assessment of normal morphology sperm rate(MNS)with sperm DNA fragmentation index(DFI)on the outcomes of in vitro fertilization-embryo transfer(IVF-ET).Methods A retrospective analysis was conducted on the clinical data of 641 patients who underwent IVF-ET in our center from June 2020 to February 2023.According to MNS and DFI levels,the patients were divided into group A(MNS＜4％,DFI＜25％,403 cases),group B(MNS ≥4％,DFI ≥25％,9 ca-ses),group C(MNS≥4％,DFI＜25％,125 cases),group D(MNS＜4％,DFI≥25％,104 cases),group A1(MNS＜1％,DFI＜25％,106 cases)and group D1(MNS＜1％,DFI≥25％,60 cases).The general information,semen parameters,embryo develop-ment and pregnancy outcomes were compared among all the 6 groups.Results No statistically significant differences were found be-tween female and male age among these groups(P＞0.05).Significant differences were observed in sperm motility,progressive motili-ty,sperm concentration and fertilization rates(P＜0.05),but no differences of usable embryo rates,good-quality embryo rates,clinical pregnancy rates,early miscarriage rates,or live birth rates(P＞0.05)among the groups A,B,C,D,A1 and D1.Conclusion The decreased MNS and increased DFI in males were associated with reduced sperm motility and concentration,affecting fertilization rates in IVF-ET,but had no significant impact on clinical pregnancy outcomes.The combined assessment of MNS with DFI had limited pre-dictive value for IVF-ET pregnancy outcomes.

Analysis of Cumulative Live Birth Rate of Selective Single Embryo Transfer by Time-lapse Monitoring System and Conventional Morphological Assessment in IVF/ICSI-ET / 实用妇产科杂志

Objective:To analyse the clinical significance of selective single embryo transfer by time-lapse mo-nitoring(TLM)or conventional morphology assessment(CMA)in vitro fertilization/intracytoplasmic sperm in-jection and embryo transfer(IVF/ICSI-ET),and to initially explore the predictive value of Raman spectral analy-sis of embryo culture medium for clinical pregnancy rate.Methods:The study is a prospective randomized con-trolled clinical trial.We assigned 139 patients treated with IVF/ICSI-ET in Reproductive and Genetics Center of Suzhou Municipal Hospital from April 2019 to July 2020,which were randomly assigned to either the CMA or the TLM group.We performed selective single-embryo transfer(fresh cycle and FET)after selecting the optimal em-bryos with TLM or CMA respectively.If the patient's first embryo transfer was unsuccessful,a second one would be performed to compare the differences in the cumulative live birth rate of embryo transfer and other pregnancy outcomes between the two groups.Meanwhile,we collected 15 μl of embryo culture medium at day 3 after IVF/ISCI fertilization for Raman spectroscopy analysis.Results:There were no differences in cumulative live birth,cu-mulative clinical pregnancy,cumulative premature birth,cumulative early spontaneous abortion,cumulative ectopic pregnancy and LGA or SGA between TLM and CMA groups(P＞0.05).The Neonatal sex ratio in the TLM group was lower than that in the CMA group,but the difference was not significant(P＞0.05).Raman spectros-copy analysis of embryo culture medium predicted the clinical pregnancy rate with 67.21％accuracy.Conclu-sions:In young women with a good ovarian reserve,the advantage of using TLM to evaluate embryos is not obvi-ous,so we should remain vigilant that embryo selection based on morphokinetic parameters may affect the sex ratio.Raman spectroscopic analysis of embryo culture medium is not yet able to effectively predict the planting ability of embryos.

Three-dimensional magnetization prepared rapid acquisition gradient echo for evaluation on the corpus callosum morphological alterations in children with spastic cerebral palsy / 实用放射学杂志

Objective To analyze the morphological alterations of corpus callosum in children with spastic cerebral palsy(SCP)using three-dimensional magnetization prepared rapid acquisition gradient echo(3D-MPRAGE)technology and to investigate the correlation between morphological indexes and gross motor function.Methods Sagittal T1WI 3D-MPRAGE data was collected from 136 children with SCP(SCP group)and 132 age-and gender-matched healthy controls(HC)(HC group),and the gross motor function measure-88(GMFM-88)was applied to assess the gross motor function.Independent sample t-test was used to compare the corpus callosum surface area,volume,maximum anterior-posterior diameter,median sagittal area(total area and area of Ⅰ-Ⅴ zone)between the two groups.Partial correlation analysis was performed to calculate the correlation between morphological indexes of the corpus callosum and GMFM-88 with age as a covariate.Results Children under 3 years old,the corpus callosum surface area of the SCP group(3 914.51 mm2±1 207.97 mm2)was lower than that of the HC group(5 725.51 mm2±1 412.66 mm2).The volume of the corpus callosum(6 108.46 mm3±2 803.97 mm3)in the SCP group was lower than that of the HC group(11 297.96 mm3±4 109.02 mm3).Also,the maximum anterior-posterior diameter of the corpus callosum in the SCP group(53.40 mm±6.31 mm)was lower than that of the HC group(57.74 mm±6.04 mm)(all P<0.05).Children over 3 years old,the corpus callosum surface area of the SCP group(4 970.06 mm2±1 191.31 mm2)was lower than that of the HC group(6 372.55 mm2±1 445.59 mm2).The volume of the corpus callosum(8 330.20 mm3±2 888.20 mm3)in the SCP group was lower than that of the HC group(13 599.82 mm3±3 429.81 mm3)(all P<0.05).Partial correlation analysis showed significant correlation between corpus callosum volume,median sagittal area and gross motor score(P<0.01)with age as a covari-ate.Conclusion The 3D-MPRAGE technology can be useful for the comprehensive assessment of morphological alterations of the corpus callosum in SCP.The corpus callosum volume,and median sagittal area may become neuroimaging references for the assess-ment of motor development in cerebral palsy(CP).

Recent advances on the application of deep learning in assisted reproductive technology / 实用医学杂志

Deep learning is a machine learning method in the field of artificial intelligence,which simu-lates the workings of the neural network of the human brain to solve complex problems,and has been used in many important researches and applications in the field of medicine,such as diagnostic imaging,biomedical data pro-cessing,drug research and development,personalized medicine,etc.,which improves the accuracy and efficiency of diagnosis and treatment.In the field of assisted reproduction,deep learning could efficiently identify well-grown embryos,suitable oocytes,or sperms during the intervention process,assisting medical staff to make more accu-rate choices to improve pregnancy rates and reduce the risk of multiple pregnancies.This paper summarizes the latest advances in the application of deep learning in the field of assisted reproduction technology in the past 5 years,and provides an outlook for future research.

Effect of minimalist shoes on foot muscle morphology:systematic evaluation and Meta-analysis / 中国组织工程研究

OBJECTIVE:With the popularity of simulated barefoot running,minimalist shoes have become a new way of foot exercise.As an important muscle group of the foot,the maintenance of foot muscle morphology is important for the execution of foot functions.In this paper,by combing the literature about the effect of minimalist shoes on foot muscle morphology in recent years,we systematically evaluate the effect of minimalist shoes on foot muscle morphology compared with traditional running shoes. METHODS:The relevant articles published from 2012 to 2022 were searched in Chinese and English databases(PubMed,Web of Science,ProQuest,CNKI and WanFang databases)with"minimal shoes,minimal footwear,minimalist shoes,minimalist footwear,foot muscle,feet muscle"as Chinese and English keywords,respectively.Meta-analysis,sensitivity tests were performed on the included literature using Review Manager 5.4.1 and Stata 14 software,the Egger method was used to test for publication bias in the literature,and Meta-regression was used to identify the subgroups with heterogeneity. RESULTS:Compared with traditional running shoes,minimalist shoes increased muscle circumference of the abductor hallucis[standardized mean difference=2.034,95%confidence interval(1.192,2.877),Z=4.73,P＜0.001].And the results were not reversed after clipping and patching,with a more robust combined effect size(P＜0.05).For the toe short flexors,the total combined effect size did not show a difference between traditional running shoes and minimalist shoes[standardized mean difference=0.470,95%confidence interval(-0.45,1.39),Z=1.00,P=0.318]. CONCLUSION:Compared with traditional running shoes,minimalist shoes intervention can effectively improve muscle circumference of the abductor hallucis,but the promoting effect on the flexor digitorum brevis muscle is not obvious.Running in minimalist shoes has positive implications for the maintenance of the medial longitudinal arch,but it is necessary to enrich the research content of minimalist shoes on different foot muscles and different populations in order to further explore the mechanisms by which minimalist shoe interventions promote foot function.