The Effect of Platelet‐Rich Plasma on Healing of Palatal Donor Site following Connective Tissue Harvesting: A Pilot Study in Dogs

Background: Peri‐implant plastic surgery includes soft tissue enhancement by connective tissue grafting. The palatal donor site provides peri‐implant keratinized mucosa and soft tissue height. Platelet‐rich plasma (PRP) contains growth factors that may enhance early healing. Purpose: The present animal study investigated the effect of PRP on wound healing of palatal donor site after connective tissue harvesting. Materials and Methods: In 12 mongrel dogs, bilateral palatal connective tissues of 10 × 15 mm were harvested. At test site, PRP was applied into the wound, and the contralateral site served as control. The healing was evaluated clinically and histologically at 1 week, 2 weeks, and 4 weeks after surgeries. Exact binomial probability and Wilcoxon signed‐rank test were used to compare the clinical and histologic measurements. Results: No statistically significant differences between PRP and control sites were measured with regard to clinical healing (p = 1.000) and histologic variables, including inflammatory cells (p = .750), collagen fibers (p = .375), and granulation tissue (p = .500) at any time interval. Conclusion: The addition of PRP to palatal mucosal wound sites did not accelerate wound healing.     

Risk factors of regression and undercorrection in photorefractive keratectomy:a case-control study

AIM:To determine risk factors of regression and undercorrection following photorefractive keratectomy (PRK) in myopia or myopic astigmatism.METHODS: A case-control study was designed in which eyes with an indication for re-treatment (RT) were defined as cases; primary criteria for RT indication, as assessed at least 9mo postoperatively, included an uncorrected distance visual acuity (UDVA) of 20/30 or worse and a stable refraction for more than 3mo. Additional considerations included optical quality symptoms and significant higher order aberrations (HOAs). Controls were chosen from the same cohort of operated eyes which had complete post-operative follow up data beyond 9mo and did not need RT. The cohort included patients who had undergone PRK by the Tissue-Saving (TS) ablation profile of Technolas 217z100 excimer laser (Bausch & Lomb, Rochester, NY, USA). Mitomycin C had been used in all of the primary procedures.RESULTS:We had 70 case eyes and 158 control eyes, and they were comparable in terms of age, sex and follow-up time (P values:0.58, 1.00 and 0.89, respectively). Pre-operative spherical equivalent of more than -5.00 diopter (D), intended optical zone (OZ) diameter of less than 6.00 mm and ocular fixation instability during laser ablation were associated with RT indications (all P values <0.001). These factors maintained their significance in the multiple logistic regression model with odd ratios of 6.12, 6.71 and 7.89, respectively.CONCLUSION:Higher refractive correction (>-5.00 D), smaller OZ (<6.00 mm) and unstable fixation during laser ablation of PRK for myopia and myopic astigmatism were found to be strong predictors of undercorrection and regression.     

The validity and reliability of the Persian version of the Revised Fibromyalgia Impact Questionnaire

The Revised Fibromyalgia Impact Questionnaire (FIQR), an updated version of the Fibromyalgia Impact Questionnaire (FIQ) achieved a better balance among different domains (i.e., function, overall impact, and symptom severity) and attempts to address the limitations of FIQ. As there is no Persian version of the FIQR available, we aimed to investigate the validity and reliability of a Persian translation of the FIQR in Iranian patients. After translating the FIQR into Persian, it was administered to 77 female patients with fibromyalgia syndrome. All of the patients filled out the questionnaire together with a Persian version of the FIQ, short form-12 (SF-12). The tender-point count was also calculated. One week later, FM patients filled out the Persian FIQR at their second visit. Reliability was analyzed by internal consistency and reproducibility including Cronbach’s α coefficient and intra-class correlation coefficient. Construct validity was evaluated by Spearman’s correlation coefficient and Pearson’s correlation coefficient. Statistical analysis was performed using SPSS for Windows version 17.0. All patients included in this study were female, and the mean age was 38.23 ± 10.68 years. The total scores of the FIQR and FIQ were 49.77 ± 18.27 and 54.05 ± 14.00 that were closely correlated (r = 0.63, p < 0.01), and each of the three domains of the Persian FIQR was also correlated well with the three related FIQ domains (r = 0.36–0.63, p < 0.01). Also some significant inverse correlations of FIQR with quality-of-life (assessed by SF-12) domains and items were found. Cronbach’s α was 0.87 for FIQR in the first visit. The Persian FIQR showed adequate reliability and validity. This instrument can be used in the clinical evaluation of Iranian patients with fibromyalgia.     

Three horizontal muscle surgery for large-angle esotropia: success rate and dose-effect ratio

Non-simulator-based examination methods of the fundal examination have shown to be cost-effective. We reviewed different non-simulator-based direct fundoscopy examination methods used in undergraduate curricula and their outcomes. PubMed (MEDLINE) and Cochrane Database of Systematic Reviews were searched using standard Medical Subject Heading (MeSH) terms ophthalmoscopy, medical education, undergraduate medical education, medical student, educational assessment and learning. The search included publications until 28th February 2019. We obtained 34 articles after screening abstracts; of them, 12 articles were included in the qualitative synthesis. The studies were comprised of diverse teaching methods which included fundal photograph matching with corresponding eye, continuous education using community-based eye clinics, formal instructions and demonstrations prior to skills training, ophthalmoscopy skills practice using eye pathologies, teaching versus conventional ophthalmoscopy and group-based teaching. We concluded that non-simulator-based techniques such as use of fundal photograph matching of an eye of a volunteer, introduction to eye pathologies, smaller student groups and formal instructions with video demonstrations prior to skills training were highly effective in teaching direct ophthalmoscopy for undergraduate medical students.     

Automatic 3D modelling of human diaphragm from lung MDCT images

Purpose

The thoracic diaphragm separates the thorax and abdomen cavity and also performs an important function in respiration. An automatic algorithm to model the human full diaphragm from multi-detector computed tomography (MDCT) images has been developed and tested.

Method

The modelling algorithm comprises these steps: (i) diaphragm top boundary estimation (ii) diaphragm side boundary estimation and (iii) full diaphragm modelling in 3D. Diaphragm top boundary is estimated based on lungs’ diaphragmatic surfaces with three different methods including: linear interpolation and fitting fourth and fifth degree polynomial surfaces. Diaphragm side boundary is assumed as the inner surfaces of the lower ribs, spinal column and costal cartilages, estimated via interpolation. As the last step, the full diaphragm is modelled by employing 3D active contours that are initiated from a predefined mesh and expand towards the estimated boundaries of the diaphragm. The proposed algorithm was tested on MDCT datasets from 15 patients, and the result were compared to reference masks provided by an experienced radiologist.

Results

Based on quantitative evaluations, the accuracy of the algorithm highly depends on the diaphragm top surface estimation, e.g., the proposed algorithm failed on two datasets, both with enlarged pericardial fat pad that cuts off the left lung from the diaphragm. The proposed algorithm was tested on the remaining 13 datasets in which lungs’ lower surfaces have normal contact with the diaphragm. To perform quantitative evaluations, four slices per dataset including an axial, mid-coronal and one-fourth of the sagittal planes from left and right, were compared to the ground truth. Hausdorff distance and mean distance to the closest point were measured to be 11.61 and 3.46 mm respectively, when the diaphragm top surface is modelled by a fourth degree polynomial surface.

Conclusion

Human full diaphragm can be automatically modelled with 3D active contours bounded by the lower surfaces of the lungs and inner surfaces of the lower ribs, spinal column and costal cartilages.

     

Potentiation of imipramine-induced antinociception by nicotine in the formalin test.

In this study, the effect of cholinergic agents on imipramine antinociception in mice, in the formalin test, has been investigated. Intraperitoneal (i.p.) administration of different doses of imipramine (2.5, 5, 10, 20 and 30 mg/kg) or nicotine (0.25, 0.5, 0.75 and 1 mg/kg) induced a dose dependent antinociception in both the first and second phases of the formalin test in mice. The combination of imipramine with doses of 0.5 and 0.75 mg/kg of nicotine showed a potentiated response, in both phases of the test. However, neither hexamethonium (5 and 10 mg/kg), atropine (0.25 mg/kg) or mecamylamine (0.25 mg/kg) altered the antinociception induced by imipramine. It is concluded that nicotinic receptor activation but not the cholinergic muscarinic mechanism is involved in the imipramine-induced antinociception.     

Effects of Qigong Exercises on 3 Different Parameters of Human Saliva

Objective： To analyze the effects of a Qigong program on various parameters of unstimulated saliva, including volume, pH and secretory immunoglobulin A （S-IgA） level. Methods： Twice a day from the beginning of Fall 2005, twenty-three healthy volunteers aged 22-24 did special Qigong exercises and massage of acupuncture points which stimulated the energy cycle and increased body water energy. The unstimulated saliva volume and pH were recorded every week in Spring （April, May, June） 2005 before the volunteers started to learn and exercise Qigong, and after Qigong intervention in Spring （April, May, June） 2006. During the period of study, saliva was collected in the same location and on similar dates at the Dental Faculty of Tehran University of Medical Sciences. The S-IgA levels of the last samples of the last week of Spring 2005 and 2006 were measured. Results： The unstimulated saliva volume after Qigong exercises （2.94±0.20 mL/5min） was significantly higher as compared to the pre-Qigong phase （1.65±0.102 mL/5min, P〈0.05）. The S-IgA level was 105.45±69.41 mg/mL before doing Qigong exercises, and 156.23±88.56 mg/mL after doing Qigong exercises, and a statistically significant difference was seen between the two measurements （P=0.005）. The change in pH was not statistically significant. Conclusions： The application of Qigong is beneficial for increasing salivary volume and other parameters. Moreover, the results suggest that Qigong may be a useful medication for patients with salivary hyposecretion. Further research is recommended in examining the long-term effects of Qigong on improving salivary volume and other parameters in individuals with salivary hyposecretion.