Accuracy of a titanium maxillary complete denture baseplate fabricated by using the electron beam melting technique: An in vitro study.

STATEMENT OF PROBLEM: Electron beam melting (EBM) is a promising additive manufacturing technique for fabricating denture baseplates; however, studies evaluating its accuracy are sparse. PURPOSE: The purpose of this in vitro study was to compare the fit accuracy of titanium maxillary complete denture baseplates fabricated by using the EBM technique with those fabricated by using the conventional casting technique and to evaluate the dimensional accuracy of the EBM baseplate by using a 3-dimensional inspection software program. MATERIAL AND METHODS: Definitive casts of an edentulous maxilla were prepared. After the casts were optically scanned, computer-aided designs for the EBM baseplate were created by using a software program for standard tessellation language file editing. The EBM baseplates were fabricated with an EBM machine by using a Grade II titanium powder as the raw material. The cast baseplates were fabricated with a lost-wax casting technique by using refractory casts duplicated from the definitive casts. After fitting the EBM and cast baseplates to their corresponding definitive cast, they were embedded in a Type IV stone. The embedded baseplates on the casts were sectioned at 3 regions: posterior palatal seal, molar, and premolar. The maximum gaps between the baseplate and definitive cast were measured in these 3 regions. The virtual casts obtained by scanning the EBM baseplate were superimposed on the computer-aided design to evaluate the dimensional accuracy. Distribution color maps were then generated, and the mean absolute deviations and root mean square deviations were calculated. One-way analysis of variance and t tests were used for statistical analysis (α=.05). RESULTS: No significant differences in the maximum gaps among the 3 regions were found in the cast or EBM baseplate groups (P>.05). The EBM baseplate group showed significantly lower values than the cast baseplate group in all regions (premolar: P=.008; molar: P=.003; posterior palatal seal: P=.004). The mean maximum gap for the 3 regions in the cast baseplates was 168.0 µm and that in the EBM baseplates was 60.7 µm. The distribution color map of the EBM baseplate showed a favorable dimensional accuracy. The mean absolute deviation value was 19.7 µm, and the root mean square deviation value was 25.1 µm. CONCLUSIONS: The EBM baseplates had a significantly higher fit accuracy than the cast baseplates. Thus, the fit accuracy of the EBM technique is suitable for fabricating metal baseplates.

Development of image analysis using Python: Relationship between matrix ratio of composite resin and curing temperature.

The aim of this study was to establish a measurement method for filler and matrix in cured resin composite (RC) using Python programming and to investigate the correlation between matrix ratio and curing temperature rise. Eight kinds of RCs were used. Backscattered electron images were taken for each cured specimen. Matrix and filler contents were calculated using Python programming with the K-means or area segmentation method. Volume measurement methods were assessed for comparison. Heat released during the polymerization reaction was measured. The matrix ratio was calculated without human intervention. Three specimens contained only inorganic filler, and other specimens contained multiple types of fillers. Almost the same values of the matrix ratio were obtained by programming and the volume measurement methods for specimens containing a single type of inorganic filler. Moreover, a strong correlation was found between the matrix ratio obtained by the programming method and curing temperature rise (R=0.9826).

Effect of Balloon Pulmonary Angioplasty on Respiratory Function in Patients With Chronic Thromboembolic Pulmonary Hypertension.

BACKGROUND: Balloon pulmonary angioplasty (BPA) in chronic thromboembolic pulmonary hypertension (CTEPH) improves hemodynamics and exercise capacity. However, its effect on respiratory function is unclear. Our objective was to investigate the effect of BPA on respiratory function. METHODS: We enrolled patients with inoperable CTEPH who underwent BPA primarily in lower lobe arteries (first series) and upper and middle lobe arteries (second series). We compared changes in hemodynamics and respiratory function between different BPA fields. RESULTS: Sixty-two BPA sessions were performed in 13 consecutive patients. Mean pulmonary arterial pressure and pulmonary vascular resistance significantly improved from 44 ± 8 to 23 ± 5 mm Hg and 818 ± 383 to 311 ± 117 dyne/s/cm-5. The percent predicted diffusion capacity of lung for carbon monoxide (Dlco) decreased after BPA in the lower lung field (from 60% ± 8% to 54% ± 8%) with no recovery. Percent Dlco increased after BPA in the upper middle lung field (from 53% ± 6% to 58% ± 6%) and continued to improve during the follow-up (from 58% ± 6% to 64% ± 11%). The ventilation/Co2 production (V˙e/V˙co2) slope significantly improved after BPA in the lower lung field (from 51 ± 13 to 41 ± 8) and continued to improve during the follow-up (from 41 ± 8 to 35 ± 7); however, the V˙e/V˙co2 slope remained unchanged after BPA in the upper/middle lung field. Changes in % Dlco and the V˙e/V˙co2 slope differed significantly between lower and upper/middle lung fields. CONCLUSIONS: The effect of BPA on respiratory function in patients with CTEPH differed depending on the lung field.

Immature muscular tissue differentiation into bone-like tissue by bone morphogenetic proteins in vitro, with ossification potential in vivo.

The objective of this study was to induce bone formation from immature muscular tissue (IMT) in vitro, using bone morphogenetic proteins (BMPs) as a cytokine source and an expanded polytetrafluoroethylene (ePTFE) scaffold. In addition, cultured IMTs were implanted subcutaneously into Sprague-Dawley (SD) rats to determine their in vivo ossification potential. BMPs, extracted from bovine cortical bones, were applied to embryonic SD rat IMT cultures, before 2 weeks culture on ePTFE scaffolds. Osteoblast-like cells and osteoid tissues were partially identified by hematoxylin-eosin staining 2 weeks after culture. Collagen type I (Col-I), osteopontin (OP), and osteocalcin (OC) were detected in the osteoid tissues by immunohistochemical staining. OC gene expression remained low, but OP and Col-I were upregulated during the culture period. In vivo implanted IMTs showed slight radiopacity 1 week after implantation and strong radiopacity 2 and 3 weeks after implantation. One week after implantation, migration of numerous capillaries was observed and ossification was detected after 2 weeks by histological observation. These results suggest that IMTs are able to differentiate into bone-like tissue in vitro, with an ossification potential after implantation in vivo.

Effect of 2-hydroxyethyl methacrylate on antioxidant responsive element-mediated transcription: a possible indication of its cytotoxicity.

BACKGROUND: The resin monomer 2-hydroxyethyl methacrylate (HEMA) is known to be more cytotoxic than methyl methacrylate (MMA). Using a luciferase reporter assay system, we previously showed that MMA activates the glutathione S-transferase alpha 1 gene (Gsta1) promoter through the anti-oxidant responsive element (ARE). However, it is not known whether HEMA induces ARE-mediated transcription. METHODOLOGY/PRINCIPAL FINDINGS: We further developed the reporter system and studied the concentration-dependent effect of HEMA on ARE enhancer activity. The revised system employed HepG2 cells stably transfected with a destabilized luciferase reporter vector carrying 2 copies of the 41-bp ARE region of Gsta1. In this system, MMA increased ARE activity by 244-fold at 30 mM; HEMA augmented ARE activity at 3 mM more intensely than MMA (36-fold versus 11-fold) and was equipotent as MMA at 10 mM (56-fold activation); however, HEMA failed to increase ARE activity at 30 mM. In HepG2 cells, HEMA detectably lowered the cellular glutathione levels at 10 mM and cell viability at 30 mM, but MMA did not. CONCLUSIONS: These results suggest that the low-concentration effect of HEMA on ARE activity reflects its cytotoxicity. Our reporter system used to examine ARE activity may be useful for evaluating cytotoxicities of resin monomers at concentrations lower than those for which cell viabilities are reduced.

Cardiac rehabilitation and artificial heart devices.

Recently, cardiac rehabilitation has gained popularity in Japan because beneficial effects on patients' prognosis have been reported. Another reason is that cardiac rehabilitation has been covered by health insurance since 1988 in Japan. Currently, cardiac rehabilitation is covered for the diseases of angina pectoris, acute myocardial infarction, chronic heart failure (CHF), peripheral arterial disease, and diseases of the aorta and after open-heart surgery. Left ventricular assist devices (LVADs) are sometimes used in patients with progressive CHF symptoms to provide circulatory support, because in most of these patients heart failure does not improve with application of medical therapy, intra-aortic balloon pumping, or a percutaneous cardiopulmonary system. Modern VAD control systems are compact, allowing patients to carry them around without difficulty. Since patient management at the outpatient clinic has become possible, patients are able to expand the scope of their activities. Early active rehabilitation in patients implanted with a LVAD improves their condition, favorably impacts the clinical course while they await heart transplantation, and also improves posttransplant recovery. Exercise therapy is one of the important components in comprehensive cardiac rehabilitation. Exercise therapy is important to improve the quality of life of patients with LVADs. Appropriate exercise therapy is effective for patients with various cardiac conditions who undergo diverse treatments and is practiced actively by many patients. In order to facilitate cardiac rehabilitation safely and effectively for patients with serious conditions, education for health care professionals is essential. In this review, we describe the concept of rehabilitation followed by cardiac rehabilitation for patients with heart failure, patients after open-heart surgery, and patients with implanted LVADs.

Increases in circulating T lymphocytes expressing HLA-DR and CD40 ligand in patients with dilated cardiomyopathy.

Inflammatory and immunological mechanisms are implicated in the development of idiopathic dilated cardiomyopathy (DCM). Since activated T lymphocytes express surface HLA-DR antigens, an increased level of these cells in the circulation could indicated an ongoing immune response. While the role of activated T lymphocytes in experimental myocarditis has been elucidated, the contribution of T lymphocyte activation in clinical DCM remains unclear. We therefore examined the role of T-cell activation in peripheral blood samples obtained from 10 patients with DCM (mean age, 49 +/- 12 years) and from 10 age-matched healthy controls. Citrated whole blood was mixed with fluorescein isothiocyanate- or phycoerythrin-conjugated specific monoclonal antibodies and analyzed using a fluorescence-activated cell sorter (FACS). The ratio (%) of histocompatibility leukocyte antigen (HLA)-DR positive cells in the FACS gated lymphocyte population was significantly higher in DCM patients than in controls (7.9% +/- 5.3% vs 2.0% +/- 0.9%; P < 0.01). The expression of CD40L on T cells determined as mean fluorescence intensity (MFI) was also significantly higher in DCM patients than in controls (3.6 +/- 2.1 vs 1.8 +/- 0.4 MFI; P < 0.05). Furthermore, the ratios of T cells expressing HLA-DR and serum brain natriuretic peptide (BNP) levels closely correlated (P = 0.0008). We showed that HLA-DR on peripheral T cells significantly correlated with serum BNP levels and that high CD40L expression on T cells was concomitant with increased BNP levels (P < 0.05). Therefore the magnitude of T-cell expression, such as increased expression of HLA-DR and CD40L, contributes to myocardial dysfunction in DCM.