The Osteogenetic Potential of Chitosan Coated Implant: An In Vitro Study.

Objective: Chitosan is a promising polymer that has been used for coating dental implants. However, research concerning coatings with implant surfaces other than commercially pure titanium is limited. Therefore, this study aims to clarify the chitosan material's effect with two degrees of deacetylation (DDA) as coatings for laser surface microtopographic implants. Methods: Sixty-three Laser-Lok (LL) implant discs were divided into three groups (21 in each group), and two groups were coated with either 80 or 95 DDA chitosan. The groups were categorized as LL 95, LL 80, or LL control. Then, hMSC-TERT 20 cells were used to evaluate the cell morphology, viability, and osteogenic capacity of the chitosan material 7 and 14 days after culture. Two-way ANOVA followed by one-way analysis of variance (ANOVA) and Tukey's post hoc test were used. Results: All samples were biocompatible and allowed cell attachment. However, cell spreading and attachment were noticeably increased in the LL 95 group. There was a significant increase in the expression of osteogenic markers in chitosan-coated samples compared to the control group. The 95 DDA-coated group exhibited higher ALP, Runx2, osteocalcin, and osteonectin expression compared to the 80 DDA and control groups on days 7 and 14. Conclusion: A high DDA of chitosan promotes biomineralization and osteoblast formation. Therefore, this combination of laser surface and chitosan can enhance future dental implant healing processes and osseointegration.

Associations between ApoE gene and psychological consequences post stroke in a Bahraini cohort.

BACKGROUND: The contribution of genetic factors such as the presence of ApoE allele e4 and its association with psychological consequences post stroke remains unknown within Middle-Eastern regions. This study examined the association of ApoE genotype with cognitive impairment and mood in stroke patients and compare with healthy older adults in Bahrain. METHOD: A prospective sample of n = 62 stroke patients (case group) and n = 53 healthy ageing individuals (control group) were eligible to participate in the study. A neuropsychological battery of cognitive assessments were conducted on all participants, and then stratified by cognitive function: no cognitive impairment, mild cognitive impairment and moderate to severe cognitive impairment. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). RESULTS: Most frequent ApoE genotype was e2/e3 in case (44%) and control groups (63%). ApoE allele e3 had the highest frequency for both groups with all stroke patients presenting with this allele and 86% for the control group (χ2 = 12.14, p < .0001). Stroke patients' non-carriers for ApoE allele e4 performed better on all cognitive measures but differences were not statistically significant (ns). Carriers of ApoE allele e2 in both groups had less mood symptoms compared to non-carriers. DISCUSSION: ApoE genotype e3/e4 and e4/e4 was low in this Bahraini cohort explaining why there may been no significant associations found for this genotype variant with cognitive impairment. Further investigation of cognitive impairment and mood dysregulation with the different variants of the ApoE gene in general ageing and stroke populations is required from different ethno-cultural groups and geographical regions globally.

Association Between Metacognition and Mood Symptoms Poststroke.

INTRODUCTION: The link between metacognition and mood has been well established, particularly in other conditions with psychological comorbidity, however, there is no evidence regarding this association in the area of stroke. AIM: The aim of this study was to examine the association between metacognition, based on the Self-Regulatory Executive Function model, and mood symptoms in the acute phase after stroke. METHODS: One hundred thirty patients were recruited to a prospective stroke study in Bahrain, and n = 64 were assessed for mood and cognition. A neuropsychological battery of cognitive assessments included the following measures: the Mini-Mental State Examination, the Trail Making Test (A+B), and the Metacognition Questionnaire 30 (MCQ-30) for metacognition. The Hospital Anxiety and Depression Scale assessed mood symptoms, and stroke severity was measured using the National Institute of Health Stroke Severity Scale. RESULTS: Total MCQ-30 scores were significantly associated with both anxiety (r = .47, P = .001) and depression (r = .54, P <. 0001). The MCQ-30 subscales' cognitive confidence, cognitive self-consciousness, and uncontrollability/danger were the specific factors to be associated with mood symptoms (P < .01). Global cognition (r =.32, P < .01), but not executive function, was significantly associated with depression only. Metacognition remained a statistically significant correlate with depression (ß = .42, P < .0001) and anxiety (ß = .51, P < .0001) after adjusting for education and global cognition. DISCUSSION: Metacognition is a better determinant of mood symptoms after stroke, especially in regions where illiteracy levels are high in older populations, in comparison to executive function and global cognition.

Observation of superior and inferior limit of lobes of the thyroid gland: a postmortem study.

The size of thyroid gland varies considerably with age, sex, physiologic state, race and geographical location. Diseases of thyroid may need surgical intervention. This study is to carry out the macroscopic architecture of thyroid gland of different age and sex groups in Bangladeshi people to establish a normal standard. This is a descriptive cross-sectional study with an analytic component and was carried out on 54 autopsied human thyroid glands aged 5 to 65 years were collected from unclaimed dead bodies autopsied in morgue of Sylhet MAG Osmani Medical College, Sylhet. It was done in department of Anatomy, from 1st July 2006 to 30th June 2007. The collected specimens were divided into age Group A (10 years and below), Group B (11 to 20 years), Group C (21 to 30 years), Group D (31 to 40 years), Group E (41 to 50 years) and Group F (51 years and above). All specimens were examined morphologically by fine dissection method. It was observed that in most cases superior limit did not reach the midpoint of thyroid cartilage on either side. Inferior limit reached up to 6th tracheal ring on right side and 5th tracheal ring on left side in most cases.

The relative efficacy of fluoxetine and manual-based self-help in the treatment of outpatients with bulimia nervosa.

A randomized, placebo-controlled study was conducted examining the singular and combined effects of fluoxetine and a self-help manual on suppressing bulimic behaviors in women with bulimia nervosa. A total of 91 adult women with bulimia nervosa were randomly assigned to one of four conditions: placebo only, fluoxetine only, placebo and a self-help manual, or fluoxetine and a self-help manual. Subjects were treated for 16 weeks. Primary outcome measures included self-reports of bulimic behaviors. Fluoxetine and a self-help manual were found to be effective in reducing the frequency of vomiting episodes and in improving the response rates for vomiting and binge-eating episodes. Furthermore, both factors were shown to be acting additively on the primary and secondary efficacy measures in this study. Results are discussed in relation to previous research and the implications for treatment of bulimia nervosa.

Management of laparoscopic-related bowel injuries.

BACKGROUND: Bowel injury is an uncommon but severely hazardous complication of various laparoscopic procedures. METHODS: Twelve cases of bowel injuries complicating different laparoscopic procedures were diagnosed or received at Ain Shams University and Menofia University hospitals over the last 3 years. The mechanism of injury was analyzed, the diagnostic methods and surgical management scrutinized, and the prognosis studied. RESULTS: The injuries were attributed to the inadvertant introduction of Veress needles or sharp-tipped trocars or forcible undue dissection. Failure of pneumoperitoneum was implicated in two cases. Faulty judgment of the extent and site of adhesions contributed to the damage in two cases. In four cases, the duodenum was injured. The colon was perforated in six cases, and the small bowel sustained damage in two cases. Three of the patients died, all of duodenal injury. The other nine patients survived by virtue of diagnosis and proper operative management. CONCLUSION: Every measure should be taken to avoid the occurrence of bowel injury during laparoscopy. Intraoperative or early postoperative diagnosis and proper management of laparoscopic-induced bowel injuries can minimize morbidity and mortality and yield a better prognosis.

Effectiveness of fluoxetine therapy in bulimia nervosa regardless of comorbid depression.

OBJECTIVE: To evaluate fluoxetine efficacy in the treatment of bulimia nervosa patients with or without comorbid depression. METHOD: Two parallel, multicenter, double-blind, randomized, placebo-controlled fluoxetine clinical trials were retrospectively analyzed to determine the effect of comorbid depression on bulimia treatment response. Patients were stratified by their 21-item Hamilton Rating Scale for Depression (HAMD21) scores at baseline and by the presence or absence of historical or current depression. Change from baseline to endpoint in the number of binge eating and vomiting episodes was used to assess efficacy. RESULTS: Fluoxetine 60 mg treatment statistically significantly reduced (p < .05) the median number of binge eating and vomiting episodes. These improvements were independent of baseline HAMD21 score and of historical or current comorbid depression diagnosis. DISCUSSION: Fluoxetine 60 mg was effective in treating bulimia nervosa, regardless of the presence or absence of comorbid depression. Fluoxetine's efficacy in treating bulimia nervosa is not simply a secondary effect of its antidepressant properties.

The possibility of lice allergy among Egyptian patients with asthmatic bronchitis.

The aim of this work was to study the possibility of lice allergy among Egyptian asthmatic patients. Sixty asthmatic patients were examined by prick skin tests as compared to ten normal subjects as controls using HD, CD, MP, MM, CH, DH, F, W, and two lice extracts: one was prepared from head and salivary glands and the second was prepared from the abdomen. Precipitin tests with the 2 lice extracts were done using the double immunodiffusion test for both patients and controls. Out of the sixty asthmatic patients only six gave positive skin reactions to both lice extracts. All the controls gave negative skin reactions. There was statistically insignificant difference between both groups and there was no difference between reactivity to different parts of lice body used as skin test antigens at the dilutions 1/10 and 1/100. On the other hand, 25 reacted to H.D., of whom two patients gave positive skin reactions to lice extracts. Twelve asthmatic patients (20%) gave positive skin reactions to M.M. of whom 2 patients (16.7%) gave positive skin reactions to lice extracts. Thirteen asthmatic patients reacted to C.D. of whom 3 cases gave positive skin reactions to lice extracts. These results were statistically insignificant. The precipitin tests were negative in both asthmatic and control groups. It was concluded that the lice allergens have insignificant role in asthmatic bronchitis.

Congenital muscular dystrophy with abnormal radiographic myelin pattern.

We report 11 children with a homogeneous clinical syndrome affecting both sexes, characterized by weakness at birth, slowly improving course, weakness of all muscle groups, arreflexia, elevated blood creatine kinase, normal nerve conduction velocity, dystrophic changes on muscle biopsy, and diffuse periventricular cortical white-matter abnormalities with sparing of corpus callosum, internal capsule, and brain stem. We compare them to 48 other previously reported similar cases and designate them as altered myelin radiographic pattern congenital muscular dystrophy (CMD), which is the same as occidental CMD. We compare them to the other presently accepted phenotypes: progressive Fukuyama CMD, Walker-Warburg or cerebral-ocular CMD, and Santavuori or muscle-eye-brain CMD. We suggest that the different phenotypes are alleles of the same gene, which regulates or expresses a structural protein required for muscle integrity, myelination, and formation of the cortex. Such phenotypic diversity has been established for mutations of Xp21 in X-linked muscular dystrophies.

Post-angiographic blindness in a patient with sickle cell disease.

This article described a 19-year-old woman with homozygous sickle disease in whom multiple cerebral infarcts developed after a technically uncomplicated cardiac angiogram. The article highlighted the risks of hyperosmolar solutions in patients with sickle cell disease and emphasized that only low osmolar contrast media, nonionic or ionic, should be used.

Embolization of dissecting aneurysms of the petrocavernous segment of the carotid artery.

The authors present two patients who had dissecting aneurysms of the petrocavernous segment of the internal carotid artery. They successfully treated the condition with balloon embolization of the artery proximal to the aneurysm.

Neurologic involvement in Behçet disease: imaging findings in 16 patients.

Behçet disease is a rare multisystem immune-related vasculitis that is prevalent in Japan, the Middle East, and many Mediterranean countries. In our study population of 36 patients with Behçet disease, 16 (44%) had CNS involvement. CT was noncontributory, except in a single patient with dural sinus thrombosis. MR imaging in nine patients showed foci of high signal intensity on T2-weighted images within the brainstem, the basal ganglia, and the cerebral hemispheres in that order of frequency. Unlike the plaques associated with multiple sclerosis, Behçet lesions show no predilection for the periventricular regions.

MRI findings in neuro-Behçet's disease.

We report MRI findings in 6 patients with Behçet's disease and CNS involvement. There were 3 different stages of imaging appearance: (1) During the acute illness, there were scattered areas of high signal intensity on T2-weighted images with predilection to the central structures of the cerebrum, the cerebral peduncles, and basis pontis. (2) During the recovery phase, most of these findings improved, but some white matter high signal areas persisted in the upper brainstem and peripheral subcortical white matter. Occasionally, findings were suggestive of microhematoma. (3) During the chronic phase, atrophy of posterior fossa structures became evident with decreased signal intensity suggestive of hemosiderin deposits.

Pituitary tooth: case report of a suprasellar teratoma.

A rare case of intracranial teratoma is reported in which a tooth-like structure was clearly defined in the pituitary fossa. The authors are unaware of any similar case having been reported previously.

Experimental design and efficient parameter estimation in population pharmacokinetics.

A computer simulation technique used to evaluate the influence of several aspects of sampling designs on the efficiency of population pharmacokinetic parameter estimation is described. Although the simulations are restricted to the one-compartment one-exponential model, they provide the basis for a discussion of the structural aspects involved in designing a population study. These aspects include number of subjects required, number of samples per subject, and timing of these samples. Parameter estimates obtained from different sampling schedules based on two- and three-point designs are evaluated in terms of accuracy and precision. These simulated data sets include noise terms for both inter- and intraindividual variability. The results show that the population fixed-effect parameters (mean clearance and mean volume of distribution) for this simple pharmacokinetic model are efficiently estimated for most of the sampling schedules when two or three points are used, but the random-effect parameters (describing inter- and intraindividual variability) are inaccurate and imprecise for most of the sampling schedules when only two points are used. This drawback was remedied by increasing the number of data points per individual to three.

Lissencephaly and pachygyria.

Lissencephaly (agyria or smooth brain) is a rare congenital anomaly representing an arrest of brain development before the third or fourth month of gestational age. It may occur alone or in association with many other syndromes. In analyzing the findings in four patients it is evident that the main computed tomographic and magnetic resonance features are: (a) smooth brain surface, (b) shallow sylvian fissures resulting in a figure-eight appearance of the axial brain sections, (c) decreased white matter and a thick brain cortex, (d) absent or severely attenuated grey-white matter interdigitations, and (e) dilatation of the lateral ventricles. Other associated anomalies include microcephaly, absent corpus callosum, neuronal heterotopia, and cerebellar hypoplasia. Pachygyria is a less severe anomaly occurring at a later stage of brain development and is characterized by the presence of a relatively few broad coarse gyri. Lissencephaly and pachygria may coexist in the same brain.

Pituitary gland enlargement in primary hypothyroidism: a report of 5 cases with follow-up data.

Five female patients with primary hypothyroidism and radiological evidence of a pituitary enlargement were studied before and after a mean of 30 months (range 12-83 months) treatment with thyroxine (T4). Before treatment, serum thyroid-stimulating hormone (TSH) levels were elevated in every patient (mean 392 mU/l, range 240-475) and prolactin levels in 4 (mean 79 micrograms/l, range 48-143 micrograms/l). CT scanning confirmed the presence of pituitary enlargement in the 4 patients studied, which was suprasellar in 3. The remaining patient had an enlarged fossa on a lateral skull radiograph. During treatment with T4, TSH and prolactin levels were normal in all. Complete disappearance of the enlargement was seen on follow-up scans in all patients and 1 developed an empty sella. The induction of a pituitary enlargement by primary hypothyroidism results from reversible hyperplasia of both the TSH and prolactin-secreting cells in most instances. Occasionally, however, hyperplasia of the thyrotrophs can occur in isolation and an empty sella can occur after successful treatment with T4. Thyroid function tests should be obtained in all hyperprolactinemic patients.