Correlation between bradykinin concentration and blood pressure during Rheocarna therapy: A single-center case series.

INTRODUCTION: A novel LDL (low-density lipoprotein) apheresis therapeutic option, Rheocarna, has garnered attention as an alternative therapy for chronic limb-threating ischemia (CLTI). Bradykinin-mediated vasodilation is involved in the effects of LDL apheresis and a decrease in blood pressure (BP), but the changes in bradykinin concentration during Rheocarna therapy are unknown. METHODS: The study involved patients with CLTI treated with Rheocarna at our hospital, from April 2022 to August 2023. RESULTS: After Rheocarna therapy, skin ulcers improved in 80% of the patients. Circuit coagulation was observed in two patients with high fibrinogen levels. A decrease in BP was observed at approximately the same time when the bradykinin concentration peaked. The peak bradykinin concentration in a patient undergoing hemodialysis at the same time was considerably lower than that in the other patients. CONCLUSION: This is the first report on the changes in bradykinin concentration under Rheocarna therapy.

Effects of implant thread design on primary stability-a comparison between single- and double-threaded implants in an artificial bone model.

BACKGROUND: Primary implant stability is essential for osseointegration. To increase stability without changing the implant size, the thread length must be extended by reducing pitch, using a double-threaded implant, or reducing pitch/lead and lead angle to half that of a single-threaded implant. MATERIALS AND METHODS: We tested the stabilities of these configurations using artificial bone. A 1.2-mm pitch, single-threaded implant (12S) was the control. We tested a 0.6-mm pitch/1.2-mm-lead double-threaded implant (06D) and a 0.6-mm pitch/lead single-threaded implant (06S). We compared stabilities by measuring insertion torque, removal torque, and the implant stability quotient (ISQ). Damage to bone tissue caused by the implants was evaluated using microscopy and morphometric analysis. RESULTS: We show that 06D and 06S significantly improved stability compared with the 12S reference. The stability of 06S was significantly greater compared with that of 06D, except for ISQ. The three implants were associated with bone tissue damage characterized by debris and voids surrounding the implant/bone interface. The 06D caused the most tissue damage, followed by 06S and then 12S. CONCLUSION: These findings indicate that primary stability was significantly improved by changing the implant size, extending the thread length with reduced pitch/lead, and reducing the lead angle to half that of a single-threaded implant compared with a double-threaded implant.

Cationic Iridium Complex-Catalyzed Intermolecular Hydroalkylation of Unactivated Alkenes with 1,3-Diketones.

Intermolecular hydroalkylation of unactivated terminal alkenes with 1,3-diketones under neutral conditions has been achieved using a cationic iridium catalyst. An active C-H bond of 2,4-pentadione (2a) added to 1-octene (1a) under refluxing DCE to give a Markovnikov product in 88% yield. A broad scope of alkenes and 1,3-diketones was observed. The products were easily converted to heterocycles. This reaction provides a new method for extending a carbon chain from an unactivated aliphatic terminal alkene.

Development and application of a direct method to observe the implant/bone interface using simulated bone.

BACKGROUND: Primary stability after implant placement is essential for osseointegration. It is important to understand the bone/implant interface for analyzing the influence of implant design on primary stability. In this study rigid polyurethane foam is used as artificial bone to evaluate the bone-implant interface and to identify where the torque is being generated during placement. METHODS: Five implant systems-Straumann-Standard (ST), Straumann-Bone Level (BL), Straumann-Tapered Effect (TE), Nobel Biocare-Brånemark MKIII (MK3), and Nobel Biocare-Brånemark MKIV (MK4)-were used for this experiment. Artificial bone blocks were prepared and the implant was installed. After placement, a metal jig and one side artificial bone block were removed and then the implant embedded in the artificial bone was exposed for observing the bone-implant interface. A digital micro-analyzer was used for observing the contact interface. RESULTS: The insertion torque values were 39.35, 23.78, 12.53, 26.35, and 17.79 N cm for MK4, BL, ST, TE, and MK3, respectively. In ST, MK3, TE, MK4, and BL the white layer areas were 61 × 103 µm(2), 37 × 103 µm(2), 103 × 103 µm(2) in the tapered portion and 84 × 03 µm(2) in the parallel portion, 134 × 103 µm(2), and 98 × 103 µm(2) in the tapered portion and 87 × 103 µm(2) in the parallel portion, respectively. CONCLUSIONS: The direct observation method of the implant/artificial bone interface is a simple and useful method that enables the identification of the area where implant retention occurs. A white layer at the site of stress concentration during implant placement was identified and the magnitude of the stress was quantitatively estimated. The site where the highest torque occurred was the area from the thread crest to the thread root and the under and lateral aspect of the platform. The artificial bone debris created by the self-tapping blade accumulated in both the cutting chamber and in the space between the threads and artificial bone.

Capability of new bone formation with a mixture of hydroxyapatite and beta-tricalcium phosphate granules.

OBJECTIVES: The aim of this experimental study was to test a mixture of hydroxyapatite (HA) and beta-tricalcium phosphate (beta-TCP) granules inserted in cranial defects in rabbits, by the evaluation of the hard tissues volume, new bone formation, and residual graft after 4 and 8 weeks. MATERIAL AND METHODS: Two defects of 8 mm diameter were created at the calvarial bone of 24 Japanese white rabbits for a total of 48 defects. Four groups were created: defects filled with a mixture of HA and beta-TCP granules (test A), defects filled with HA alone (test B), defects filled with beta-TCP (test C), and empty defects (control). Hard tissues volume (remaining graft + new bone) was evaluated by µ-CT and new bone (NB) and remaining graft (RG) percentages were evaluated by histomorphometry. The animals were sacrificed at 4 or 8 weeks postoperatively. RESULTS: The test groups A, B, and C showed a significant higher total volume compared with controls at 4 and 8 weeks (P < 0.05). Regarding the percentages of NB and RG at 4 and 8 weeks, no significant differences were detected (P > 0.05). When comparing 4 and 8 weeks, test group A showed a significant increase in new bone formation. At both 4 and 8 weeks, no group showed significant differences in NB (P > 0.05). At 8 weeks, test group B had more RG than test group A. CONCLUSIONS: The novel mixture could maintain the volume of the grafted area compared with that with intervention, and in a similar way compared with HA.

[Implant placement on restricted mesiodistal space with simulation software and guiding system: a case report].

A surgical guiding system with simulation software has recently been used for safe implant treatment. We report a clinical case in which we successfully used this system for implant treatment of a congenital tooth missing region with severely restricted mesiodistal space. The patient was a 19-year-old female whose mandibular right deciduous canine was wobbling without a successional permanent tooth and who desired implant treatment. CT images showed that this site was narrow buccal-lingually and only five millimeters in mesiodistal width. The implant position was planned using simulation software (SimPlant : Materialise Dental) based on CT data and a surgical guide template (SurgiGuide : Materialise Dental) was fabricated prior to the implant surgery. During the implant surgery, the deciduous canine was extracted under local anesthesia. The implant bed was prepared with the surgical guide template and an implant was installed. One month after surgery, the position of the implant was examined with a cone-beam CT, which demonstrated that the implant position was exactly the same as planned. At 5 months, a provisional prosthesis was delivered and optimal soft-tissue condition was formed by modifying the provisional prosthesis. Then, the final impression was taken and a ceramo-metal implant-supported crown was delivered. In this case of a congenital tooth missing region with narrow space, implant treatment with simulation software and the surgical guide system provided excellent clinical results.