Study on the Impact of Post-Mastectomy Radiotherapy on Immediate Breast Reconstruction and Complications: A Meta-Analysis

Background and objective:Immediate breast reconstruction not only reduces the number of surgeries for patients after mastectomy but also decreases psychological and physical trauma,making it increasingly popular.However,there is currently no consensus on the integration of post-mastectomy radiotherapy(PMRT)with reconstruction techniques.This review evaluates the impact of PMRT on complications following immediate breast reconstruction,providing guidance for clinical treatment decisions.Methods:PubMed,Web of Science,Embase,and other databases were searched for studies published in the past 15 years on outcomes of implant-based breast reconstruction in the context of radiotherapy to identify articles for analysis.RevMan 5.4 software was used to analyze the risks of seroma,infection,wound dehiscence,flap necrosis,implant exposure,capsule contracture,and reconstruction failure.Results:A total of 1l relevant studies were included,comprising 6323 cases of immediate breast reconstruction.It was found that breasts receiving postoperative irradiation had a significantly increased risk of complications,with statistically significant differences in seroma(P=0.004),infection(P<0.00001),wound dehiscence(P=0.04),implant exposure(P<0.00001),capsule contracture(P<0.00001),and reconstruction failure(P<0.00001).There was no statistically significant difference in flap necrosis(P=0.88).Conclusion:The results indicate that postoperative radiotherapy significantly increases the risk of complications for patients undergoing immediate implant-based reconstruction.Preventive measures may be taken in advance with the assistance of healthcare providers if necessary.

Effects of Immediate Dental Loading Implant Therapy on Electroencephalography (EEG) and Stress

Purpose: Implant therapy restores masticatory function by restoring lost tooth morphology. It has been shown that mastication contributes not only to food intake and digestion, but also to the improvement of overall health. However, there have been no studies on the effects of implant treatment on electroencephalography (EEG). In this study, we investigated the effects of restoration of masticatory function by implant treatment on EEG and stress. Methods: 13 subjects (6 males, 7 females, age 64.1 ± 5.8 years) who had lost masticatory function due to tooth loss and 11 healthy subjects (6 males, 5 females, age 47.6 ± 2.4 years) as a control group. EEG (θ, α, β waves, α/β ratio) and salivary cortisol were measured before immediate dental implant treatment and every month of treatment for 6 months. EEG (θ, α, β waves, α/β ratio) was measured with a simple electroencephalograph miniature DAQ terminal (Intercross-410, Intercross Co., Ltd., Japan) in a resting closed-eye condition, and salivary cortisol was measured using an ELISA kit. Results: Compared to the control group, the appearance of θ and α waves were significantly decreased and β waves were increased, and α/β ratio was significantly decreased. The cortisol level of the subject group was significantly higher compared with the control group. With the course of implant treatment, the appearance of θ and α waves of the subject group increased, while β waves decreased. However, no significant difference was observed. The α/β ratio of the subject group increased from the first month after implant treatment and increased significantly after 5 and 6 months (0 vs. 5 months: p < 0.05, 0 vs. 6 months: p < 0.01). The cortisol levels in the subject group decreased from the first month after implant treatment and significantly decreased after 3 or 4 months (0 vs. 3 months: p < 0.05, 0 vs. 4 months: p < 0.01). These results suggest that tooth loss causes mental stress, which decreases brain stimulation and affects function. Restoration of masticatory function by implants was suggested to alleviate the effects on brain function and stress.

Effect of Training Nurses in ICU in Immediate Care Post Cardiac Surgery

The specialty of cardiovascular surgical nursing has advanced patient care significantly both before and after surgery, and it is now a well-established field. The primary goal of cardiovascular surgical nursing is to optimize the patient's recovery and prevent complications. Immediate nursing care for post-operative cardiac patients in a state of controlled shock due to fluid shift and varying vascular tone. Aim of the Study: Assessment of nurse’s knowledge and performance after the training program of nursing care immediately after a patient arrives from cardiac surgery. Methods: This pre and post-intervention study was conducted at cardiac centers in Sudan Alshaab and Ahmed Gasim Cardiac Center. The aim of the study was to evaluate the impact on nurses’ performance after training program post open-heart surgery. In the initial phase of the study, all 98 nurses working in the intensive care units at Alshaab and Ahmed Gasim cardiac centers were designated as the study group and evaluated before the intervention. Subsequently, the same group was reassessed after the intervention (phase 2), allowing for a comparison of the pre- and post-intervention results. The assessment involved the use of a specifically designed questionnaire and an observation checklist developed in accordance with the standards recommended by the American Nurses Association (phase 3). Result: Descriptive analysis was performed using the Chi-square test, the difference in the performance between the study group before intervention and after the intervention was assessed by the mean of chi-square significantly was taken as p < 0.05.

Practices of Maternity’s Care Providers in the Municipality of Kozah 1 Regarding the Administration of Vitamin K1, Eye Care, and Umbilical Cord Care in Immediate Postpartum Newborns

Background: Neonatal mortality is a real public health problem in the world and particularly in countries with limited resources. Essential care remains an effective means of reducing this mortality. Objective: To evaluate the practice of administering of vitamin K1, ocular and cord care in maternity wards in the Kozah 1 municipality. Method: This is a cross-sectional study conducted from March 1st to June 30th, 2022 in all maternity wards in the Kozah 1 municipality. Socioprofessional aspects of providers and those related to the administration of vitamin K1, ocular and cord care were studied. Results: Eighty-five (85) maternity providers were included in this study. The average age of the providers was 36.2 years with extremes of 21 and 55 years. Providers were midwives (51.8%), childbirth attendants (35.3%), and matrons (12.9%). The average length of practice was 9.5 years with extremes of 1 and 28 years. For three out of four providers (75.3%), the postpartum period was defined as a period of 02 hours following delivery. The importance of cord, ocular care, and administration of vitamin K1 in postpartum was known respectively by 84.7%, 98.8%, and 92.9% of the providers. Chlorhexidine gel was used by 81.2% of providers for umbilical cord care. For ocular disinfection, more than half of the providers (52.9%) reported using half-diluted povidone iodine. No center had displayed care protocol. Conclusion: This study highlighted the level of knowledge and practice of three essential postpartum care practices. The products used for the different care practices are consistent with recommendations but vary according to the care providers.

Management of Immediate Postpartum Hemorrhage at the University Hospital Center of the Sino-Central African Friendship

Introduction: Immediate postpartum hemorrhages constitute a frequent maternal complication and remain at the forefront of maternal death in our countries. Objective: Contribute to improving the management of immediate postpartum hemorrhage in our context with a view to reducing maternal mortality. Patients and Methods: We conducted a retrospective descriptive and analytical study over a period of 12 months from January 1st to December 31st 2020. Results: We collected a total of 109 files on a total of 4360 deliveries. The frequency of postpartum haemorrhages was of the order of 2.5%. The most represented age group was between 20 and 24 years old. Pauciparas represented the majority of our study population. 64.5% of patients were uneducated. These hemorrhages occurred in patients who often gave birth outside the department with 63.8%. The main causes of postpartum hemorrhage were cervical tears (51.2%) and partial placental retention (30.7%). The majority of these deliveries (48.8%) were carried out by midwives followed by assistant midwives (33.2%). Active management of the third period of delivery was systematic and immediate followed by the valve examination completed by the infusion of oxytocin in case of uterine atony, tranexamic acid ans misoprostol intrarectally. In the event of persistent hemorrhage, suture of the cervical lesions, ligation of the cervical vessels or even laparotomy either for the selective ligation of the blood vessels or for the hysterectomy for hemostasis were practiced. We do not have a Nalador, nor a Bakry balloon, nor an Interventional Radiology service for embolization of the uterine arteries. We deplore 1.3% of deaths from afibrinogenemia. Conclusion: The frequency of immediate postpartum hemorrhages is lower in our health facility. This is due to the rapid handling of cases. Improving the quality of services offered to women during childbirth can further help reduce the frequency of these hemorrhages.

Improved Behavioural Engagement of Students through Low-stakes Online Tests and Immediate Dialogic Feedback

The engagement of students is a recognised challenge for teachers.Technology offers some practical student engagement tools,and this paper examines the use of low-stakes online tests and immediate dialogic feedback to improve behavioural engagement.The academic exploration of low-stakes tests and dialogic feedback has been extensive,and they are credible teaching tools.In this study,we explore the learning benefit of their combination.Postgraduate engineering students’self-reported and learning analytics data shows conclusive evidence of improved behavioural engagement.We measured a 500%increase in the Learning Management System(LMS)page views on the days when we ran the low-stakes tests(each worth 2%of the marks for the subject)and engaged in immediate dialogic feedback.To interpret these results,we draw on theories of behavioural engagement,low-stakes tests,and feedback.We conclude that the combination of low-stakes tests and immediate feedback improves student behavioural engagement.

A randomized trail comparing primary percutaneous coronary intervention with a strategy of short-acting thrombolysis and immediate planned primary percutaneous coronary intervention in acute myocardial infarction

Objective This study was to evaluate the efficacy and safety of a short acting reduced dose fibrinolytic regimen to promote early infarct related artery (IRA) patency for acyute myocardial infarction (AMI) patients referred for percutaneous coronary intervention (PCI).Methods Following aspirin and heparin, 166 patients were randomized to a 50 mg bolus of recombinant tissue type plasminogen activator(rt PA) or to a same volume sodium chloride injection followed by immediate primary PCI. The end points included patency rates on catheterization laboratory (cath lab) arrival, revascularization results when PCI was performed, complication rates, left ventricular function and restored patency rate following PCI. Results Patency on cath lab arrival was 64% with rt PA (34% TIMI 3,30% TIMI 2), while 31% of placebo (13% TIMI 3, 18% TIMI 2). There was no difference in the restored TIMI 3 rates of IRA between the two groups (85% vs 87%). No difference were observed in stroke or major bleeding. Left ventricular function was similar in both groups (52±9% vs 50±8%), but left ventricular ejection fraction fraction (LVEF) was higher with patent IRA (TIMI 3) on cath lab arrival than that of others (56±12% vs 48±10%).Conclusions Strategy thrombolytic regimens were compatible with subsequent PCI lead to more frequenc early recanalization (before cath lab arrival), which facilitates greater left ventricular function preservation with no augmentation of adverse events.

Sensory innervation around immediately vs. delayed loaded implants: a pilot study

Although neurophysiological and psychophysical proof of osseoperception is accumulating, histomorphometric evidence for the neural mechanisms of functional compensation following immediate and delayed implant loading is still lacking. For this randomized split-mouth study, six mongrel dogs randomly received one of four treatment protocols at 36 implant-recipient sites over 16 weeks （third maxillary incisor, third and fourth mandibular premolar）： immediate implant placement and immediate loading （liP＋ IL）; delayed implant placement and delayed loading （DIP＋DL）; delayed implant placement and immediate loading （DIP＋IL）; and natural extraction socket healing （control）. Histomorphometry was performed in the peri-implant bone and soft tissues within 300 pm around the implants. Immunocytochemistry and transmission electron microscopy were used to confirm the presence of neural structures and to reveal their ultrastructural characteristics, respectively. Myelinated nerve fibres densely populated the peri-implant crestal gingival and apical regions, although they were also identified in the woven bone and in the osteons near the implant threads. Compared with the control group in the mandible, the group that received IIP＋IL showed a higher innervation （in N.mm^-2, 5.94±1.12 vs. 3.15±0.63, P〈0.001） and smaller fibre diameter （in pm, 1.37±0.05 vs. 1.64±0.13, P=0.016）, smaller axon diameter （in pm, 0.89±0.05 vs. 1.24±0,10, P=0.009） and g-ratio （0.64±0.04 vs. 0.76±0.05, P〈0.001） in the middle region around the implants. Compared with DIP＋IL in the mandible, IIP＋IL had a higher nerve density （in N.mm^-2, 13.23±2.54 vs. 9.64±1.86, P=0.027）, greater fibre diameter （in pm, 1.32±0.02 vs. 1.20±0.04, P=0.021）, greater axon diameter （in μm, 0.92±0.01 vs. 0.89±0.03, P=-0.035） and lower g-ratio （0.69±0.01 vs. 0.74±0.01, P=-0.033） in the apical region around the implants. It may be assumed that the treatment protocol with liP＋ IL is the preferred method to allow optimized peri-implant re-innervation, but further functional measurements are still required.

Immediate implant placement in combination with platelet rich-fibrin into extraction sites with periapical infection in the esthetic zone:A case report and review of literature

BACKGROUND In this case,platelet-rich fibrin(PRF)was added to guided tissue regeneration as a biomaterial in proper order for immediate planting in aesthetic area with periapical infection.CASE SUMMARY With the history of endodontic failure in maxillary central incisor,a 34-year-old female patient required the extraction of maxillary anterior residual root and immediate implantation.Cone beam computed tomography and clinical observation were used to assess the regeneration of soft and bone tissue.Before operation,cone beam computed tomography showed the anterior residual root had serious periapical periodontitis with insufficient labial bone in the aesthetic zone.The patient underwent immediate implant placement and reconstruction of the bone substitution by modified guided bone regeneration.The barrier was a three-layer structure of PRF-collagen membrane-PRF that covered the mixture of PRF and Bio-Oss to promote both osteogenesis and soft tissue healing.At 6 mo postoperatively,the definitive crown was placed after accomplished finial impression.One-year follow-up showed a satisfactory aesthetic effect with no obvious absorption of the labial bone and soft tissue.CONCLUSION The use of PRF in combination with guided bone regeneration can serve as a reliable and simple adjuvant for immediate implanting in infected socket and result in a stable osteogenic effect with good aesthetic outcome.

Influence of backfilling rate on the stability of the"backfilling bodyimmediate roof"cooperative bearing structure

To reduce the cost of backfilling coal mining and utilize the underground space of coal mines,a new backfilling mining method with low backfilling rate called constructional backfilling coal mining(CBCM)is proposed.The "backfilling body-immediate roof" cooperative bearing structure of CBCM is analyzed by establishing the model of the medium thick plate on an elastic foundation.The influence of the backfilling rate on the stability of overlying strata is analyzed by the numerical simulation experiment.The control effect of CBCM is verified by a physic similar simulation test.The economic benefit of CBCM is analyzed.The conclusions are:the deformation characteristics of the immediate roof and critical backfilling spacing in CBCM can be analyzed based on the Hu Haichang’s theory.Exerting the bearing capacity of the immediate roof is beneficial to the stability of the overlying strata.The CBCM has a good control effect on the overburden in Xinyang Mine when the backfilling rate is lower than 25%.The backfilling cost of per ton coal is 37.39 yuan/t when the backfilling rate is 13.7%,with a decrease rate of 56.63%than the full-filling.The research results can provide theoretical support for the application of CBCM in coal mining.

Comparison of outcomes between immediate implantbased and autologous reconstruction: 15-year, single-center experience in a propensity score-matched Chinese cohort

Objective:The number of immediate breast reconstruction(IBR)procedures has been increasing in China.This study aimed to investigate the oncological safety of IBR,and to compare the survival and surgical outcomes between implant-based and autologous reconstruction.Methods:Data from patients diagnosed with invasive breast cancer who underwent immediate total breast reconstruction between 2001 and 2016 were retrospectively reviewed.Long-term breast cancer-specific survival(BCSS),disease-free survival(DFS),and locoregional recurrence-free survival(LRFS)were evaluated.Patient satisfaction with the breast was compared between the implantbased and autologous groups.BCSS,DFS,and LRFS were compared between groups after propensity score matching(PSM).Results:A total of 784 IBR procedures were identified,of which 584 were performed on patients with invasive breast cancer(implantbased,n=288;autologous,n=296).With a median follow-up of 71.3 months,the 10-year estimates of BCSS,DFS,and LRFS were 88.9%[95%confidence interval(CI)(85.1%–93.0%)],79.6%[95%CI(74.7%–84.8%)],and 94.0%[95%CI(90.3%–97.8%)],respectively.A total of 124 patients completed the Breast-Q questionnaire,and no statistically significant differences were noted between groups(P=0.823).After PSM with 27 variables,no statistically significant differences in BCSS,DFS,and LRFS were found between the implant-based(n=177)and autologous(n=177)groups.Further stratification according to staging,histological grade,lymph node status,and lymph-venous invasion status revealed no significant survival differences between groups.Conclusions:Both immediate implant-based and autologous reconstruction were reasonable choices with similar long-term oncological outcomes and patient-reported satisfaction among patients with invasive breast cancer in China.

Immediate–Early(IE) gene regulation of cytomegalovirus:IE1-and pp71-mediated viral strategies against cellular defenses

Three crucial hurdles hinder studies on human cytomegalovirus(HCMV): strict species specificity, differences between in vivo and in vitro infection, and the complexity of gene regulation. Ever since the sequencing of the whole genome was first accomplished, functional studies on individual genes have been the mainstream in the CMV field. Gene regulation has therefore been elucidated in a more detailed fashion. However, viral gene regulation is largely controlled by both cellular and viral components. In other words, viral gene expression is determined by the virus–host interaction. Generally, cells respond to viral infection in a defensive pattern; at the same time, viruses try to counteract the cellular defense or else hide in the host(latency). Viruses evolve effective strategies against cellular defense in order to achieve replicative success. Whether or not they are successful, cellular defenses remain in the whole viral replication cycle: entry, immediate–early(IE) gene expression, early gene expression, DNA replication, late gene expression, and viral egress. Many viral strategies against cellular defense, and which occur in the immediate–early time of viral infection, have been documented. In this review, we will summarize the documented biological functions of IE1 and pp71 proteins, especially with regard to how they counteract cellular intrinsic defenses.

Flapless immediate implant placement into fresh molar extraction socket using platelet-rich fibrin: A case report

BACKGROUND There are some challenges concerning immediate implant placement in the molar region.Platelet-rich fibrin(PRF),an autologous biomaterial,has been used widely for periodontal intra-bony defects,sinus augmentation,socket preservation,and gingival recession.However,the literature remains scarce for reports on immediate implants with PRF,particularly in the case of fresh molar extraction socket.CASE SUMMARY The patient was a 43-year-old woman with maxillary molar vertical crown-root fracture.She underwent flapless immediate implant placement into the fresh molar socket with PRF.At the follow-up visit 15 d post procedure,the vascularization of soft tissue was visible.There was no swelling or pain after the surgery.Six months postoperatively,the regeneration of bone and soft tissues was visible.Subsequently,the definitive restoration was placed.The patient was satisfied with the aesthetic outcomes.CONCLUSION The flapless immediate implant placement into the fresh molar socket with PRF is a feasible procedure.This case report demonstrates that PRF promotes bone and soft tissue regeneration apart from having an enhanced anti-inflammatory ability.Furthermore,the procedure involves a minimally invasive technique,thus reducing the surgical complexity.

Compound Kushen injection induces immediate hypersensitivity reaction through promoting the production of platelet-activating factor via de novo pathway

OBJECTIVE Compound Kushen injection(CKI)is a bis-herbal formulation extracted from Kushen(Radix Sophorae Flavescentis)and Baituling(Rhizoma Heterosmilacis Japonicae).Clinically,it is used as the adjuvant treatment of cancer.However,with the increased application,the cases of immediate hypersensitivity reactions(IHRs)also gradually rise.In this study,we investigated the underlying mechanism(s)and active constituent(s)for CKI-induced IHRs in experimental models.METHODS T helper 2(Th2)immunity-amplified mice were prepared by aluminum adjuvant.Anaphylactic shock was detected by measuring rectal thermometry in propranolol pretreated mice.For evaluating microvascular permeability,Evans blue extravasation assay was used.Platelet-activating factor(PAF),serum total IgE(tIgE)and mouse mast cell protease 1(MMCP1)were measured by ELISA.RESULTS The obtained results showed that CKI did not elevate serum tIgE and MMCP1 after consecutive immunization for five weeks,but could induce Evans blue extravasation(local)and cause obvious hypothermia(systemic)after a single injection.Further study showed that alkaloids in Kushen,especially matrine,were responsible for CKI-induced IHRs.Mechanism study showed that various PAF receptor antagonists could significantly counter CKI-induced IHRs locally or systemically.In cell system,CKI was able to promote PAF production in a non-cell-selective manner.In cell lysate,the effect of CKI on PAF production became stronger and could be abolished by blocking de novo pathway.CONCLUSION In conclusion,our study identifies,for the first time,that CKI is a PAF inducer.It causes non-immunologic IHRs,rather than IgE-dependent IHRs,by promoting PAF production through de novo pathway.Alkaloids in Kushen,especially matrine,are the prime culprits for IHRs.Our findings may provide a potential approach for preventing and treating CKI-induced IHRs.

DETECTION OF CYTOMEGALOVIRUS(CMV) IMMEDIATE EARLY ANTIGEN IN KIDNEY BIOPSIES AND TRANSPLANT NEPHRECTOMIES

Objective To investigate the relationship between CMV infection and renal allograft rejection. Methods 39 kidney biopsies and transplant nephrectomies were collected and investigated for CMV immediate early antigen by immunohistochemistry. Results In 14 out of 39 tissue specimens CMV immediate early antigen were found. 8 biopsies from normal donor kidneys were negative; only 1 (10%) in 10 tissue specimens with early stage acute rejection was positive; 5(55.6%) in 9 biopsies with late stage acute rejection and 8 (66.7%) in 12 tissue blocks with chronic rejection were positive. Compared with normal kidney tissues, the infections in tissues with early stage acute rejection didn't increase obviously, but increased obviously in kidney tissue specimens with late stage rejection and with chronic rejection (P< 0.05). Conclusion CMV infection appears to contribute to late stage acute rejection and chronic rejection after renal transplantation.

Aesthetic gingival management: Preservation of the anatomical structures and the gingival aesthetics by immediate implant-insertion after loss of anterior teeth and premolars—Results of a 5-year prospective study with 348 inserted one-phase implants

Implant insertion is an alternative to classical treatment with bridges after tooth extraction or traumatic tooth loss in the anterior and premolar region of the upper and lower jaw. Nevertheless both types of prosthetic treatment inhere major gingival aesthetic pitfalls by physiological vertical and horizontal resorption. Aim of the study was to investigate if the immediate insertion of root analogue single-stage implants and prosthetic treatment could prevent gingival recessions and bone resorption thus keeping the natural gingival aesthetics untouched. Between 2003 and 2006, 348 root analogue Q1-Implants (TRINON Karlsruhe GmbH/Germany) were inserted in 342 patients’s premolar and molar regions immediately after tooth extraction or traumatic tooth loss and treated with provisional resin crowns. The observation period with recurring 6-month clinical and radiographic check-ups was a minimum of 5 years. Of 348 inserted implants 4 (1.15%) were lost resulting in an overall success rate of 98.85%. In the first 12 weeks after surgery a mean recession of the buccal gingival margin of 0.2 mm (SD 0.34) could be detected, after final prosthetic treatment an overall mean recession of 0.2 mm (SD 0.13) within the survey period. Immediate implant insertion of root analogue single stage implants and immediate prosthetic treatment with provisional resin crowns after minimal invasive tooth extraction seems to be appropriate to prevent bone resorptions of the buccal alveolar crest and the recessions of the gingiva and papillae and thus suggests to be the preferable treatment to keep the natural gingival and papillary aesthetics untouched preventing further traumatic surgical gingival reconstructions.

Immediate virological response predicts the success of shortterm peg-interferon monotherapy for chronic hepatitis C

AIM:To investigate the efficacy of short-term peginterferon(PEG-IFN)monotherapy for chronic hepatitis C patients who achieved an immediate virological response.METHODS:Defining an"immediate virological response(IVR)"as the loss of serum hepatitis C virus(HCV) RNA 7 d after the first administration of PEG-IFNα,we conducted a 12-wk course of PEG-IFNα2a monotherapy without the addition of ribavirin for 38 patients who had low pretreatment HCV RNA load and exhibited IVR.The patients included 21 men and 17 women,whose ages ranged from 22 to 77 years(mean±SD:52.0±17.8 years).There were 4 patients with HCV genotype 1b,23 patients with genotype 2a and 4 patients with genotype 2b.HCV genotype was not determined for the remaining 7 patients.Patients were categorized into a sustained virological response(SVR)group,if serum HCV RNA remained negative for 24 wk after the end of treatment,or into a relapse group.RESULTS:Based on the intention-to-treat analysis,35 patients(92.1%)achieved SVR.One patient(2.6%)relapsed with serum HCV RNA 12 wk after the end of treatment.Two patients(5.3%)withdrew from the study during the 24-wk follow-up period.With regard to the HCV RNA genotype,the SVR rates were 100%(4/4) for genotype 1b,95.7%(22/23)for genotype 2a and 100%(4/4)for genotype 2b.The SVR rate in 7 patients,whose HCV RNA genotypes were not determined,was 71.4%(5/7).CONCLUSION:Short-term PEG-IFNα2a monotherapy is highly effective for chronic hepatitis C patients who have low pretreatment HCV RNA load and exhibit IVR.

The Behavior of New Hydrophilic Composite Bone Cements for Immediate Loading of Dental Implant

We introduced the hydrophilic groups to acrylic bone cement to improve compliance and achieve more interdigitation between the bone and the acrylic bone cement in order to create better substrates for immediate loading. FTIR-ATR, contact angle, and maximum breach torque were employed for measurement. The results reveal that the introduction of hydrophilic functional groups has increased PMMA＇s surface hydrophilicity after contact angle test. FTIR-ATR results suggest the hydrophilic groups participate in the polymerization reactions, and maximum breach torque of the hydrophilic acrylic bone cements is near 110 Ncm torque. Those effects make it possible for conventional acrylic bone cement application in immediate loading of dental implant.

Immediate and delayed micro-tensile bond strength of different luting resin cements to different regional dentin

We sought to evaluate immediate and delayed micro-tensile bond strength of Panavia F2.0 and Multilink Sprint resin cement to superficial, deep and cervical dentin. Thirty-six freshly extracted non-carious human molars were sectioned in the mesiodistal direction to expose three different dentin regions including superficial dentin （1 mm below the dentine-enamel junction）, deep dentin （1 mm above the highest pulp horn） and cervical dentin （0.5 mm above the cemento-enamel junction and 0.5 mm below the dentine-enamel junction）. Resin cements were applied on dentin surfaces and composite blocks were luted under constant seating pressure. Each group was divided into three subgroups according to time intervals. Specimens were sectioned to obtain sticks of 1 mm2 in diameter and subjected to microtensile bond strength testing at a cross head speed of 1 mrn/min. Both resin cements showed higher micro-tensile bond strength to superficial dentin than that to deep or cervical dentin （P 〈 0.001）. Micro-ten- sile bond strengths of Panavia F2.0 were higher than those of Multilink Sprint at different dentin regions （P 〈 0.001）. Immediate ＂micro-tensile bond strengths were higher than those of delayed micro-tensile bond strengths for both resin cements （P 〈 0.001）. It was concluded that resin cements with different chemical formulations and applications yield significantly different micro-tensile bond strengths to different dentin regions.

Immediate balloon deflation method in endoscopic papillary large balloon dilation for extraction of difficult bile duct stones

Background/Aims: Recently, endoscopic papillary large balloon dilation (EPLBD) using a large balloon (12 - 20 mm) for extraction of difficult common bile duct (CBD) stones has been widely accepted with favorable outcomes. However, there is no consensus with regard to the ballooning time. The aim of our study was to evaluate the efficacy and safety of immediate balloon deflation in EPLBD for the treatment of difficult bile duct stone. Methods: This was a retrospective study of 80 consecutive patients with bile duct stones who were treated with an immediate balloon deflation method in EPLBD combined with endoscopic sphincterotomy (EST) between January 2010 and December 2012. Overall success rate, success rate at first ERCP, and the frequency of mechanical lithotripsy for complete stone removal were assessed for efficacy and safety was evaluated by assessing major complications. Results: Overall success rate for complete stone removal was high (78/80, 97.5%) and success rate for complete stone removal at first ERCP was 86.3% (69/80). The use of mechanical lithotripsy was 0% (0/80). The overall complication rate was favorable (5/80, 6.3%). PostERCP pancreatitis was observed in 3 patients (two: mild, one: moderate). In subgroup analysis, the presence of periampullary diverticulum was the only factor affecting the success rate at first ERCP. Conclusion: This study demonstrated the favorable outcome of immediate balloon deflation for treatment of difficult CBD stones and can be considered for clinical application.