Background: Cervical cancer continues to be a major problem in Bangladesh with approximately 18,000 new cases annually of which over 10,000 women die from it. Visual inspection of the cervix after 3-5% acetic acid (VIA) application is a simple and easy to learn method for cervical cancer screening, although cytology-based screening is more often applied in developed countries where it has successfully reduced the prevalence of cervical cancer. Objective: To compare the efficacy of VIA and cytology-based primary methods for cervical cancer screening in Bangladesh. Materials and Methods: This hospital based comparative study was conducted at the VIA centre and Colposcopy Clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU) from October 2008 to October 2010. Results: Among 650 women, 74 (11.4%) were VIA+ve and 8 (1.2%) had abnormalities in their Pap smear reports. During colposcopy, 38 (7.7%) women had different grades of CIN and 4 (0.6%) had cervical cancer. The gold standard histology findings proved 20 women had CIN I, 14 had CIN II/II and 4 had cervical cancer. Among the 38 histology diagnosed abnormalities, VIA test could identify 30 abnormalities including two cervical cancers. However, Pap smear could detect only 8 cases of histological abnormalities (2 low grade and 6 had high grade lesion) and it missed all the cervical cancer cases. The sensitivity and specificity of VIA were 88.9% and 52.1%. The positive predictive value (PPV) and negative predictive value (NPV) were 41.0%, and 92.6% respectively. Moreover, the sensitivity, specificity, PPV and NPV of Pap smear were 33.3%, 95.8%, 75.0% and 79.3%, respectively. Conclusions: VIA test should be used as the primary screening tool even with its low sensitivity and specificity in low resource countries like Bangladesh. False positive results may be greater, but overtreatment can be minimized by colposcopy evaluation of the VIA positive women.
Objectives : The purpose of this study is to observe the effects of Carthami Flos herbal-acupuncture (CF-HA) at Joksamni($ST_{36}$) on arthritis in mice induced by Collagen II. Methods : The author performed several experimental items, including arthritis evaluation, change in weight, spleen size and stenosis rate, change in cytokine level, IgG, IgM and anti-collagen II, change of immunocyte count and histological change of the CIA mouse joint. Conclusions are as follows: Results : 1. In the CF-HA, the arthritis index and rate and the incidence of arthritis were decreased as the experiment proceeded. 2. In the CF-HA, spleen swell and stenosis, joint edema and change were decreased. 3. In the CF-HA, the level of $IL-1{\beta}$, IL-6, $TNF-{\alpha}$ and $IFN-{\gamma}$ in blood serum were significantly decreased. 4. In the CF-HA, the level of IgG, IgM and anti-collagen II were decreased. 5. In the CF- HA, $IFN-{\gamma}$, $IFN-{\gamma}/IL-4$, IL-10 of the culture fluid was decreased. 6. In the CF-HA, the cell rate of $CD3e^+$ and $CD45R^+$, $CD4^+$ and $CD8^+$, $CD4^+/CD25^+$ in spleen was similar to the cell rate of the normal group. 7. In the CF-HA, the cell rate of $CD4^+/CD25^+$, $CD45R^+/CD69^+$ in a lymph node was decreased as in the normal group. 8. In the CF-HA, the cell rate of $CD3^+/CD69^+$, $CD11b^+/Gr-1^+$ in joints was decreased as in the normal group. 9. In the CF-HA, the cartilage destruction and the inflammation cell growth in the H&E stain were decreased. The collagen fiber in the M&T stain were less destructed, therefore the result was similar to the normal group. Conclusions : These results suggest that CH-HA at $ST_{36}$ has an effect in controlling immune reaction and suppressing inflammation in rheumatoid arthritis therefore, the continuous flow of the following study is expected.
Objectives : The present study was designed to evaluate the anti-inflammatory and anti-oxidative stress activities through regulation of Nrf2-mediated genes by Rhei rhizoma and Glycyrrhiza rhizoma combined extract (RGE) in reflux esophagitis.Methods : The antioxidant activity of RGE in vitro was measured in terms of radical scavenging capacity such as DPPH and ABTS. RGE was administered at 350 mg/kg body weight prior to induction of reflux esophagitis. Reflux esophagitis was induced that tied the pylorus and the transitional junction between the forestomach and the corpus in Sprague-Dawley rats.Results : RGE scavenged DPPH and ABTS effectively and IC50of RGE each were 4.9 μg/ml and 45.6 μg/ml. Our results show that RGE administration markedly ameliorated mucosal damage upon histological evaluation. In serum and esophagus tissue, RGE significantly suppressed the oxidative stress biomarkers. Reflux esophagitis induced rats exhibited down-regulation of antioxidant-related proteins in the esophagus; however, the levels with treatment of RGE were significantly higher than those of vehicle reflux esophagitis rats. RGE treatment caused significant reductions in activation of NF-κB transcription factor. Thus, RGE significantly exhibited potent anti-inflammatory activities by suppressing the protein expression levels of pro-inflammatory proteins such as COX-2 and iNOS and inflammatory cytokines such as TNF-αin the esophagus tissue.Conclusions : Reflux esophagitis caused considerable levels of oxidative stress in the esophageal mucosa and the administration of RGE reduced the esophageal mucosa damage through the regulation of Nrf2 and NF-κB pathways. Our findings can considered as supplementary therapy in the prevention or treatment of reflux esophagitis.
본 연구에서는 백서에 구속 스트레스를 통하여 정서적인 스트레스를 가한 후, 이하선 조직의 형태학적 변화 양상을 광학 현미경으로 관찰하였으며, 타액선 조직에서 세포자멸사의 평가는 TUNEL assay에 양성을 보이는 세포 수를 측정하여, 각 군별 차이를 비교하여 다음과 같은 결과를 얻었다. 1. 백서 이하선에서 구속 스트레스를 가한 후, 5일부터 타액선 선포의 위축 및 농염이 관찰되었으며, 7일부터 세포자멸사소견이 관찰되기 시작하였다. 2. In situ DNA end labelling assay를 통하여 TUNEL 염색을 시행한 결과, 타액선 장액선포에서 양성세포가 구속 스트레스에 대해 5일부터 통계학적으로 유의하게 증가하여 7일째에 가장 큰 지수를 보여 조직학적 소견과 일치하였다. 따라서 구속에 의한 스트레스 증가에 따라 생체 내 타액선조직에서 세포자멸사가 유도됨을 증명할 수 있었으며, 향후 유도 신호전달 기전에 관한 연구가 이루어져야 한다고 사료된다.
dos Santos, Pamela Leticia;de Molon, Rafael Scaf;Queiroz, Thallita Pereira;Okamoto, Roberta;de Souza Faloni, Ana Paula;Gulinelli, Jessica Lemos;Luvizuto, Eloa Rodrigues;Garcia, Idelmo Rangel Junior
Journal of Periodontal and Implant Science
/
제46권3호
/
pp.176-196
/
2016
Purpose: We sought to evaluate the effectiveness of bone substitutes in circumferential periimplant defects created in the rabbit tibia. Methods: Thirty rabbits received 45 implants in their left and right tibia. A circumferential bone defect (6.1 mm in diameter/4 mm depth) was created in each rabbit tibia using a trephine bur. A dental implant ($4.1mm{\times}8.5mm$) was installed after the creation of the defect, providing a 2-mm gap. The bone defect gaps between the implant and the bone were randomly filled according to the following groups: blood clot (CO), particulate Bio-Oss$^{(R)}$ (BI), and Bio-Oss$^{(R)}$ Collagen (BC). Ten animals were euthanized after periods of 15, 30, and 60 days. Biomechanical analysis by means of the removal torque of the implants, as well as histologic and immunohistochemical analyses for protein expression of osteocalcin (OC), Runx2, OPG, RANKL, and TRAP were evaluated. Results: For biomechanics, BC showed a better biological response ($61.00{\pm}15.28Ncm$) than CO ($31.60{\pm}14.38Ncm$) at 30 days. Immunohistochemical analysis showed significantly different OC expression in CO and BC at 15 days, and also between the CO and BI groups, and between the CO and BC groups at 60 days. After 15 days, Runx2 expression was significantly different in the BI group compared to the CO and BC groups. RANKL expression was significantly different in the BI and CO groups and between the BI and BC groups at 15 days, and also between the BI and CO groups at 60 days. OPG expression was significantly higher at 60 days postoperatively in the BI group than the CO group. Conclusions: Collectively, our data indicate that, compared to CO and BI, BC offered better bone healing, which was characterized by greater RUNX2, OC, and OPG immunolabeling, and required greater reversal torque for implant removal. Indeed, along with BI, BC presents promising biomechanical and biological properties supporting its possible use in osteoconductive grafts for filling peri-implant gaps.
Several experimental studies showed that the application of small amounts of electric current to bone stimulated osteogenesis at the site of the cathode and suggested that electrical currents promote osseointegration around dental implants. The purpose of this study was to determine the effect of direct microcurrent to endosseous titanium implants placed in bone defects. The right and left 2nd, 3rd and 4th mandibular premolars in ten mongrel dogs (15Kg of weight) were extracted. One monthe later, Ti-machined screw type implants(3.8 mm diameter x 8.5 mm length, $AVANA^{(R)}$, Ostem) were placed in surgically created circumferential defect area(width 5mm, depth 4mm). The implants were divided into three groups according to the treatment modalities: Control group- implants without electrical stimulation; Experimental group I- implants with allogenic demineralized freeze dried bone grafting; and Experimental group II-implants allogenic demineralized freeze dried bone grafting and electric stimulation. The animals were sacrificed in the 4th and 8th week after implant placement and un-decalcified specimens were prepared for histological and histometrical evaluation of bone-implant contact ratio (BIC) and bone formation area ratio (BFA) in defect area. Some specimens at 8 weeks after implantation were used for removal torque testing. Histologically, there was connective tissue infiltration in the coronal part of defect area in control and the experimental group I, whereas direct bone contact was found in the experimental group II without connective tissue invasion. Average BIC ratios at 4 weeks of healing were 60.1% in the experimental group II, 47.4% in the experimental group I and 42.7% in the control. Average BIC ratios at 8 weeks after implantation were 67.6% in the experimental group II, 55.9% in the experimental group I and 54.6% in the control. The average BFA ratio was 84.0% in the experimental group II, 71.8% in the experimental group I and 58.8% in the control at 4 weeks, and the BFA ratios were 89.6% in the experimental group II, 81.4% in the experimental group I and 70.5% in the control at 8 weeks after implantation. The experimental group II showed also significantly greater BIC and BFA ratios compared to the control and the experimental group I (p<0.05). The removal torque values at 8 weeks after implantation were 56 Ncm in the experimental group II, 49 Ncm in the experimental group I and 43 Ncm in the control. There was a statistically significant difference among 3 groups (p<0.05). These results suggest that electrical stimulation improve and accelerate bone healing around endosseous titanium implants in bone defect.
The purpose of this investigation was to evaluate on the biodegradability, biocompatibility and tissue regenerative capacity of synthetic bioabsorbable membranes in beagle dogs. For animal study, 9 adult beagle dogs were used to examination, on the surgical implantation of membranes and histological analysis. In each animal, the 3rd and 4th premolars of the both sides of the mandible were selected as test teeth. Two types of bioresorbable membranes including "Guidor membrane", "S-membranes" were used to examining for biological activity, and also Gore-tex membranes was used for positive control. Surgically created defects were made in 2 premolars of both sides of the mandible at $3{\times}4mm^2$ in size and tested membranes were implanted in the defected area. A plaque control regimen was instituted with daily tooth brushing with a 0.1% chlorhexidine digluconate during experimental periods. All the experimental animals were sacrificed after 2, 4, and 8 weeks from surgery and undecalcified slides were prepared using the "sawing and grinding" technique described by Donath and Breuner". In biodegradability, all the membranes were started their biodegradation from two weeks after implantation and gradually demolished of their frame morphology from eight weeks. However, demolition of membranes in 8 weeks after implantation was highest in Guidor membranes and followed by S-membranes. Biocompatibilityof two kinds of biodegradable membranes including Guidor and S-mambrane were shown to be well tolerated to the surrounding tissue, and were minimal accumulation of inflammatory cell infiltration around the implanted membranes to compare with Gore-tex membrane. Regeneration of defected alveolar bone was initiated from two weeks of membrane implantation and new bone formation was gradually increased from that time. However, pattern of new bone formation on the defected areas of two kinds of biodegrable membranes was almost similar and quite competitive comparing with Gore-tex membrane. These results implicate that bioresorbable membranes should be highly useful tool for guided tissue regeneration of periodontal defects.
The autogenous free gingival graft is the most predictable procedure currently used to increase the width of the attached gingiva in periodontics. But the major disadvantage of the procedure is to create the multiple surgical wounds at both a donor site and a recipient site. The other problem is the limited amount of available graft material in oral cavity. Therefore, recent researches have been focused to develop the biomaterial to substitute the autogenous gingival tissue. The purpose of this study was to evaluate the histologic healing after grafting of bilayer artificial dermis, compared to the free gingival graft. Four non-smoking subjects (mean age, 32.5 years) in systemically healthy state and good oral hygiene were selected according to their particular needs for correction of mucogingival problems as suggested by Nabers(1966). The recipient sites were prepared through the procedure for the free gingival graft and were grouped according to the graft materials: Experimental group(n=5) - bilayer artifcia1 dermis ($Terudermis^{(R)}$; Terumo Co. Japan) and Control group(n=6) - free gingival graft with autogenous palatal mucosa. Biopsies were harvested at 1,2,3 and 6 weeks postsurgery to evaluate histologically. At the third week in the experimental group and at the second week of in the control group, the grafts has been clinically stabilized on the recipient bed and the graft border has been blended into the surrounding tissue. In the experimental group after 1 week of grafting, the epithelial migration from the adjacent tissue to graft material was seen and after 3 weeks of grafting, the : nflmmation decreased, collagen layer of the artificial dermis was lost and the basement membrane of epithelium was formed. After 6 weeks of grafting, both groups demonstrated orthokeratinized epithelium and increased thickness of epithelial tissue and the rete peg formation, similar to the adjacent tissue, Histologic evaluation revealed a biologic acceptance and incorporation of the collagen layers of the graft tissue to the host tissue, without foreign body reaction. In conclusion, a bilayer artificial dermis is essentially similar to autogeneous free gingival graft in the correction of mucogingival problems, and has the advantages of decreased patient morbidity (no donor site) and availability of abundant amounts of graft material when needed.
Periodontal regenerative therapy and tissue engineering on defects destructed by severe periodontitis need maintaining of space, which provides the environment for cell migration, proliferation and differentiation. Application of bone grafts may offer this environment in periodontal defects. This study evaluated bone graft materials, $MBCP^{(R)}$ and $Algipore^{(R)}$ , in surgically created i-wall periodontal intrabony defects of minipigs by histological analysis. Critical sized($4mm{\times}4mm$), one wall periodontal intrabony defects were surgically produced at the proximal aspect of mandibular premolars in either right and left jaw quadrants in four minipigs. The control group was treated with debridement alone, and experimental group was treated with debridement and $MBCP^{(R)}$ and $Algipore^{(R)}$ application. The healing processes were histologically observed after 8 weeks and the results were as follows. 1. In the control group, limited new bone formation was observed. 2. In MBCP group, more new bone formation was observed compared to other groups. 3. Histologically, dispersed mixture of new bone, biomaterial particles and connective tissue were shown and osteoblasts, osteoclasts and new vessels were present in this area. 4. Defects with Algipore showed limited new bone formation and biomaterial particles capsulated by connective tissue. 5. Histologically, lots of osteoclasts were observed around the biomaterial but relatively small numbers of osteblasts were shown. Within the limitation to this study protocol, $MBCP^{(R)}$ application in 1-wall intrabony defect enhanced new bone formation rather than $Algipore^{(R)}$ application.
Purpose: The purpose of this study was to elucidate the efficacy and safety of carbonate apatite (CO3Ap) granules in 2-stage sinus floor augmentation through the radiographic and histomorphometric assessment of bone biopsy specimens. Methods: Two-stage sinus floor augmentation was performed on 13 patients with a total of 17 implants. Radiographic assessment using panoramic radiographs was performed immediately after augmentation and was also performed 2 additional times, at 7±2 months and 18±2 months post-augmentation, respectively. Bone biopsy specimens taken from planned implant placement sites underwent micro-computed tomography, after which histological sections were prepared. Results: Postoperative healing of the sinus floor augmentation was uneventful in all cases. The mean preoperative residual bone height was 3.5±1.3 mm, and this was increased to 13.3±1.7 mm by augmentation with the CO3Ap granules. The mean height of the augmented site had decreased to 10.7±1.9 mm by 7±2 months after augmentation; however, implants with lengths in the range of 6.5 to 11.5 mm could still be placed. The mean height of the augmented site had decreased to 9.6±1.4 mm by 18±2 months post-augmentation. No implant failure or complications were observed. Few inflammatory cells or foreign body giant cells were observed in the bone biopsy specimens. Although there were individual differences in the amount of new bone detected, new bone was observed to be in direct contact with the CO3Ap granules in all cases, without an intermediate layer of fibrous tissue. The amounts of bone and residual CO3Ap were 33.8%±15.1% and 15.3%±11.9%, respectively. Conclusions: In this first demonstration, low-crystalline CO3Ap granules showed excellent biocompatibility, and bone biopsy showed them to be replaced with bone in humans. CO3Ap granules are a useful and safe bone substitute for two-stage sinus floor augmentation.
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