Comparison of the effects of three surgical techniques on the rate of orthodontic tooth movement in a rat model

Objective:To evaluate the effect of corticotomy and corticision, with and without a full mucoperiosteal flap, on the rate of tooth movement and alveolar response in a rat model.Materials and Methods:Sixty male, 6-week-old Wistar rats were divided into five groups based on surgical procedure, as follows: control (no tooth movement), orthodontic tooth movement (OTM) only, corticotomy, corticision, and corticision with full mucoperiosteal flap (corticision + flap). A force of 10–15g was applied from the maxillary left first molar to the maxillary incisors using nickel-titanium springs. Surgery was performed at the time of appliance placement (day 0), and tooth movement occurred for 21 days. Micro–computed tomography was performed on day 21 to evaluate the amount of tooth movement and alveolar bone parameters. Histomorphometry, including tartrate-resistant acid phosphatase staining, was performed to quantify the osteoclast parameters at day 21.Results:No statistical differences in the amount of OTM, bone volume fraction, and tissue density and the osteoclast parameters were found among all experimental groups.Conclusions:Corticotomy and corticision, with or without a full mucoperiosteal flap, did not show a significant effect on either the OTM magnitude or alveolar bone response.     

Duplication of gallbladder — Rare entity treated laparoscopically

Introduction

Gall bladder (GB) duplication is a rare condition that is often found incidentally. Its laparoscopic management has seldom been described. We report the case of a symptomatic duplicated gallbladder, successfully treated by laparoscopic cholecystectomy.

Case Profile

A 29-year-old woman was seen after several attacks of epigastric and right upper quadrant abdominal pain which radiated to the right upper back. Ultrasonography of the abdomen showed two pear-shaped structures in the GB fossa, which were confirmed on magnetic resonance imaging. She successfully underwent a laparoscopic cholecystectomy with an uneventful post operative course.

Conclusion

It is important that surgeons be aware of this rare anomaly because of the associated anatomical variations of main bile duct, hepatic artery and increased risk of common bile duct injury.

     

Metastatic Neuroendocrine Tumour in a Renal Transplant Recipient: Dual-Tracer PET-CT with 18F-FDG and 68Ga-DOTANOC in This Rare Setting

Nuclear Medicine and Molecular Imaging - Recipients of renal transplant are at increased risk of developing various malignancies, especially post-transplant lymphoproliferative disorder (PTLD) and...     

Pathophysiological Role of Vascular Smooth Muscle Alkaline Phosphatase in Medial Artery Calcification

Medial vascular calcification (MVC) is a pathological phenomenon that causes vascular stiffening and can lead to heart failure; it is common to a variety of conditions, including aging, chronic kidney disease, diabetes, obesity, and a variety of rare genetic diseases. These conditions share the common feature of tissue‐nonspecific alkaline phosphatase (TNAP) upregulation in the vasculature. To evaluate the role of TNAP in MVC, we developed a mouse model that overexpresses human TNAP in vascular smooth muscle cells in an X‐linked manner. Hemizygous overexpressor male mice (Tagln‐Cre^+/–; Hprt^ALPL/Y or TNAP‐OE) show extensive vascular calcification, high blood pressure, and cardiac hypertrophy, and have a median age of death of 44 days, whereas the cardiovascular phenotype is much less pronounced and life expectancy is longer in heterozygous (Tagln‐Cre^+/–; Hprt^ALPL/?) female TNAP‐OE mice. Gene expression analysis showed upregulation of osteoblast and chondrocyte markers and decreased expression of vascular smooth muscle markers in the aortas of TNAP‐OE mice. Through medicinal chemistry efforts, we developed inhibitors of TNAP with drug‐like pharmacokinetic characteristics. TNAP‐OE mice were treated with the prototypical TNAP inhibitor SBI‐425 or vehicle to evaluate the feasibility of TNAP inhibition in vivo. Treatment with this inhibitor significantly reduced aortic calcification and cardiac hypertrophy, and extended lifespan over vehicle‐treated controls, in the absence of secondary effects on the skeleton. This study shows that TNAP in the vasculature contributes to the pathology of MVC and that it is a druggable target. © 2015 American Society for Bone and Mineral Research.     

Ampullary Carcinoma in a Patient with Agenesis of the Dorsal Pancreas: A Case Report

The most common congenital anomaly of the pancreas is pancreatic divisum (Tadokoro et al. in Anat Res Int 2011:1–7, 2011). Agenesis of the dorsal pancreas is extremely rare (Schnedl et al. in World J Gastroenterol 15(3):376–377, 2009). We are reporting a case of agenesis of dorsal pancreas presented with ampullary carcinoma.     

Contralateral reversed distal femoral locking plate for fixation of subtrochanteric femoral fractures

Purpose: Subtrochanteric fractures of the femur are being managed successfully with various intramedullary and extramedulary implants with reasonable success. However, these implants require precise placement under image intensifier guidance, which exposes the surgeon to substantial amount of radiation. It also restricts the management of these fractures at peripheral centers where facility of image intensifiers is not available. Keeping this in mind we designed this study to identify if contralateral reversed distal femoral locking plate can be used successfully without the use of image intensifier. Methods: Twenty-four consecutive patients (18 men and 6 women) with a mean age of 28 years (range 19e47 years) suffering subtrochanteric fractures of the femur underwent open reduction and internal fixation with reversed contralateral distal femoral locking plate. The outcome was assessed at the mean follow-up period of 3.2 years (range 2e4.6 years) using the Harris hip score. Results: Twenty-one fractures united with the primary procedure, with a mean time of consolidation being 11 weeks (range, 9e16 weeks). One patient developed superficial suture line infection, which resolved with oral antibiotics. Another patient had a fall 3 weeks after surgery and broke the plate. Repeat surgery with reversed distal femoral locking compression plate was performed along with bone grafting and the fracture united. Two cases had nonunion, which went in for union after bone grafting. The mean Harris hip score at the time of final follow-up was 90.63 (range 82-97). Conclusion: The reversed contralateral distal femoral plate is a biomechanically sound implant, which when used for fixation of the subtrochanteric fractures with minimal soft tissue stripping shows results comparable to those achieved by using other extramedullary implants as well as intramedullary devices. The added advantage of this implant is its usability in the absence of an image intensifier.     

Clinico-Pathologic Profile and Treatment Outcomes of Patients with Diffuse Large B Cell Lymphoma Based on Cell of Origin Classification

Diffuse large B cell lymphoma (DLBCLs) constitute 40% of all non-Hodgkin lymphoma and it represent a heterogeneous group of neoplasms rather than a single clinicopathological entity. We analysed the outcomes and clinical features based on the cell of origin in a series of patients with DLBCL from our institute. Medical case records of all newly diagnosed DLBCL treated in our institute from January 2015 to July 2017 were analysed for this study. Cell of origin classification was based on immunohistochemistry using Hans algorithm. Kaplan–Meier curves were used to determine survival. Ninety-five patients were diagnosed to have DLBCL subtype. Immunophenotypic subtyping was available for 71 patients. The median age at diagnosis was 56 years with no difference between Germinal centre B cell (GCB) and non-Germinal centre B cell (non-GCB) subtypes. Approximately 44% of patients had extra-nodal disease, stomach being the commonest site. Forty percent of patients had stage III/IV disease. Bulky disease and extra-nodal presentation was predominantly seen with non-GCB subtype (46% vs 20% and 36% vs 29% respectively). Rituximab was used in 75% of the patients with DLBCL. The 2-year disease-free survival was 70% versus 53% (p = 0.38) in GCB versus non-GCB subtype. This is one of the few data on DLBCL patients reported from India which has described outcomes based on the cell of origin. The disease-free survival in our country appears to be superior in GCB subtype which needs to be confirmed in a larger subset of patients.