Graft materials in oral surgery: revision

Oral implantology is a common procedure in dentistry, especially for fully or partially edentulous patients. The implants must be placed in the best location from both the aesthetic and functional point of view. Because of this it is increasingly more frequent to resort to regeneration techniques that use substitutes of the bone itself, in order to be able to insert the implants in the most appropriate location. Material and Methodology: A review was performed on the literature from the last ten years based on the following search limitations: "graft materials', 'allograft', 'xenograft', 'autologous graft" and 'dentistry". Results: 241 works were obtained that after reading their respective summaries, they were reduced to 38, and 9 previous works were included in order to summarize the concepts. Discussion: Autologous grafts are the 'gold standard' of the bone regeneration. They have obvious advantages, but they also have drawbacks. This is why allogeneic and xenogeneic tissues are used. The former because of their clear similarity with the recipient's tissue and the latter due to their wide availability. Given that these grafts also have drawbacks, the industry has developed synthetic materials that have properties similar to those of human bone tissue. However, as of today, the ideal material to substitute human bone has not yet been found. In recent years the tendency has been to combine these synthetic materials with the patient's own bone, which is extracted during drilling in implant placement, with bone marrow aspiration, or with bone morphogenetic proteins. Thus the intention is to equip these substances with the osteogenic capacity. Conclusions: There is currently no ideal graft material, with the exception of those materials that come directly from the patient. We hope that in the coming years we will have products that will allow us to perform rehabilitations with better results and provide a better quality of life for our patients, especially those who have more complex situations to resolve, like the patients that are operated on for head and neck cancer

Stability of a nanofiltration membrane after contact with a low-level liquid radioactive waste

This study investigated the treatment of a liquid radioactive waste containing uranium (235U + 238U) using nanofiltration membranes. The membranes were immersed in the waste for 24-5000 h, and their transport properties were evaluated before and after the immersion. Surface of the membranes changed after immersion in the waste. The SW5000 h specimen lost its coating layer of polyvinyl alcohol, and its rejection of sulfate ions and uranium decreased by about 35% and 30%, respectively. After immersion in the waste, the polyamide selective layer of the membranes became less thermally stable than that before immersion.

Caracterização de membranas assimétricas de acetato de celulose produzidas a partir do aproveitamento do resíduo da palha de milho para uso em ultrafiltração

Cellulose acetates (CA) with different degrees of acetylation were synthesized from cellulose extracted from corn stover. Membranes were prepared for the ultrafiltration process with pure polymers and blend form of CA utilizing a dioxane/acetone system. The membranes were characterized according to their transport properties. The blend form materials presented the best results for application in ultrafiltration experiments. M-TAC/DAC (corn stover triacetate and diacetate) and M-TAC/DAC-Rho (corn stover triacetate and Rhodia diacetate) presented rejection to egg albumin protein of 87.39% and 80.50%, respectively. Thus, MWCO of 45 kDa was determined for these materials.

Paavin ei naispappeudelle

Kirjallisuusarvostelu

‘Sweet grape’ tomato post harvest packaging

ABSTRACT This paper aims at evaluating the shelf life of mini tomatoes (Lycopersicum esculentum Mill.) cultivar ‘Sweet Grape’, grown in hydroponics, and stored under environmental and refrigerated conditions inside different packages. We adopted a completely randomized design, in which treatments were combinations of storage conditions: environment (e) and refrigerated (r) with packaging: polyvinyl chloride film (PVC); low-density polyethylene (LDPE); biofilm of tomato fruit of Solanum lycocarpum A.St.-Hil (lobeira) (TFB); cassava starch biofilm (CSB); carnauba wax (Copernicia prunifera) (CW), and without packaging - control (C). Physicochemical and sensory tests were carried out at the beginning (day zero), and at 8, 19, and 33 days of storage (DS). Fruit stored inside PVCr, LDPEe, LDPEr, and CWr had an acceptable shelf life of 33 days. The use of cassava and tomato starches were not effective in controlling fruit fresh weight loss. ‘Sweet Grape’ tomato postharvest conservation was enhanced under refrigerated conditions. The sensory evaluation results revealed that CWr treatment most pleased appraisers, while PCV had the highest rejection rate.

Estenose arterial pós-transplante hepático: tratamento com angioplastia transluminal percutânea

Vascular complications after liver transplantation include oclusion or stenosis at the sites of anastomosis in the hepatic artery, portal vein, and vena cava. Balloon angioplasty of these stenosis carries little risk and is a useful procedure for the treatment of these problems. The purpose of this paper was to assess whether percutaneous transluminal angioplasty can help to prolong allograft survival and impruve allograft function in patient with hepatic artery stenosis after liver transplantation. We report a 43-year-old mate with stenosis of hepatic artery anastomosis after liver transplantation. An abrupt elevation of liver enzymes and serum bilirrubin levels was noted on the fifth postoperative month. The patient underwent percutaneous liver biopsy, which revealed important ductal depletion due to hypoperfusion, even though Doppler ultrasound examination demonstrated arterial flow. An angiogram confirmed severe stenosis of the arterial anastomosis with poor intraparenchymal arterial perfusion pattern. In an attempt to preserve the graft, a percutaneous transluminal angioplasty was performed using microballoons mounted on a hydrophylic micro guidewire. Intervention proceeded without complications. Liver enzimes and bilirrubin levels decreased within twenty-four hours of angioplasty. Normal levels were achieved after one week. Seven month after angioplasty, the patient is in a optimal clinical condition with no signs of graft impairment. We conclude that percutaneous transluminal angioplasty of hepatic artery stenosis after liver transplantation is relatively safe and may help decrease allograft loss.

Katsastuksen teknisen laadun mittaaminen ja johtaminen

Suorituskyvyn mittaamisella on monia myönteisiä vaikutuksia koko organisaation toimintaan. Mittaamisen avulla toimintaa voidaan johtaa haluttuun suuntaan. Tutkimuksen tavoitteena oli tutkia, minkälainen suorituskykymittaristo tarvitaan katsastusyrityksen ylimmän johdon käyttöön, jotta katsastuksen teknisen laadun johtaminen mahdollistuisi. Tutkimuksen tarkoituksena oli rakentaa katsastuksen teknisen laadun suorituskykymittaristo ylimmälle johdolle. Katsastuksen tekninen laatu on keskeinen kysymys katsastusyritysten olemassaololle. Tekninen laatu on koko katsastustoiminnan perusta, jonka päälle liiketoiminta voidaan rakentaa. Ilman tätä perustaa ei ole jatkuvuutta liiketoiminnalle. Teknisen laadun mittaaminen ei kuitenkaan ole tällä hetkellä järjestelmällistä, eikä käytettävissä ole ollut tehtävään soveltuvaa mittaristoa. Tutkimuksessa käytettiin A-Katsastus Oy:n vuosien 2008–2011 aikana syntyneitä katsastustilastoja. Tilastollista prosessin valvonta-menetelmää (SPC) soveltamalla määritettiin toimipaikka- ja katsastajakohtaiset valvontarajat hylkäysprosenteille ja vikojen määrille. Valvontarajojen avulla rakennettiin katsastuksen teknisen laadun suorituskykymittaristo toimiala-, yritys-, toimipaikka- ja katsastajatasoille. Mittariston avulla voidaan asettaa tekniselle laadulle tavoitteet, seurata tavoitteiden toteumaa ja käynnistää tarvittaessa korjaavat toimenpiteet.

Generation and Characterization of Knockout Mice and Analysis of Patient Material Demonstrates a Role for Tissue Inhibitor of Metalloproteinases 4 (Timp4) in the Cardiovascular System and Tumor Metastasis

This thesis focuses on tissue inhibitor of metalloproteinases 4 (TIMP4) which is the newest member of a small gene and protein family of four closely related endogenous inhibitors of extracellular matrix (ECM) degrading enzymes. Existing data on TIMP4 suggested that it exhibits a more restricted expression pattern than the other TIMPs with high expression levels in heart, brain, ovary and skeletal muscle. These observations and the fact that the ECM is of special importance to provide the cardiovascular system with structural strength combined with elasticity and distensibility, prompted the present molecular biologic investigation on TIMP4. In the first part of the study the murine Timp4 gene was cloned and characterized in detail. The structure of murine Timp4 genomic locus resembles that in other species and of the other Timps. The highest Timp4 expression was detected in heart, ovary and brain. As the expression pattern of Timp4 gives only limited information about its role in physiology and pathology, Timp4 knockout mice were generated next. The analysis of Timp4 knockout mice revealed that Timp4 deficiency has no obvious effect on the development, growth or fertility of mice. Therefore, Timp4 deficient mice were challenged using available cardiovascular models, i.e. experimental cardiac pressure overload and myocardial infarction. In the former model, Timp4 deficiency was found to be compensated by Timp2 overexpression, whereas in the myocardial infarct model, Timp4 deficiency resulted in increased mortality due to increased susceptibility for cardiac rupture. In the wound healing model, Timp4 deficiency was shown to result in transient retardation of re-epithelialization of cutaneous wounds. Melanoma tumor growth was similar in Timp4 deficient and control mice. Despite of this, lung metastasis of melanoma cells was significantly increased in Timp4 null mice. In an attempt to translate the current findings to patient material, TIMP4 expression was studied in human specimens representing different inflammatory cardiovascular pathologies, i.e. giant cell arteritis, atherosclerotic coronary arteries and heart allografts exhibiting signs of chronic rejection. The results showed that cardiovascular expression of TIMP4 is elevated particularly in areas exhibiting inflammation. The results of the present studies suggest that TIMP4 has a special role in the regulation of tissue repair processes in the heart, and also in healing wounds and metastases. Furthermore, evidence is provided suggesting the usefulness of TIMP4 as a novel systemic marker for vascular inflammation.

O uso da prótese na correção das hérnias da parede abdominal é um avanço, mas o seu uso indiscriminado, um abuso

The objective is to alert the surgeon about the indiscriminate use of synthetic prosthesis in the correction of inguinal and incisional hernias. The authors provide a brief history of surgery on hernias and a review of the literature, showing the importance of classifying inguinal hernias to fit the type of surgical correction with the defect found, abstaining from treating all hernias, with the same type of surgical procedure. In our opinion, small indirect inguinal hernias (type 1 and 2 of Gilbert) and hernias in women must not, in general, be treated with prostheses. The synthetic material should be reserved for direct and large indirect hernias. Even so, this attitude, besides determining a higher cost for the procedure, can lead to important complications such as infection, rejection, fistula formation, chronic pain, alterations in spermatogenesis and the possibility of carcinogenesis, according to more recent reports. The physiology and anatomy of the abdominal wall should be considered when dealing with incisional hernia corrections, where the surgeon can choose among many techniques to correct those defects, and in selected cases, utilize synthetic material. We conclude that although the use of biomaterials has constituted a great advance in surgery for abdominal wall hernia corrections because they decrease recurrences, and permit treatment of large abdominal hernias, the indiscriminate prosthesis usage is an abuse, and it can determine many serious complications, certainly avoidable with a well indicated non mesh technique .

Tutkimusretki Venäjän uusvanhaan sieluun

Kirjallisuusarvostelu

Surgical treatment of subcostal incisional hernia with polypropylene mesh - analysis of late results

OBJECTIVE: To evaluate the results of subcostal incisional hernia repair using polypropylene mesh, the technical aspects of musculo-aponeurotic reconstruction, routine fixation of supra-aponeurotic mesh and follow-up for five years.METHODS: We conducted a retrospective study that assessed 24 patients undergoing subcostal incisional hernia repair with use of polypropylene mesh; 15 patients (62.5%) were female; ages ranged from 33 to 82, and 79.1% had comorbidities.RESULTS: Early complications: three cases (12.5%) of wound infection, three cases (12.5%) of seroma, one case (4.1%) of hematoma; and one case (4.1%) of wound dehiscence. Late complications occurred in one case (4.1%) of hernia recurrence attributed to technical failure in the fixation of the mesh and in one case (4.1%) of chronic pain. There were no cases of exposure or rejection of the mesh.CONCLUSION: The subcostal incisional hernia, though not very relevant, requires adequate surgical treatment. Its surgical correction involves rebuilding the muscle-aponeurotic defect, supra-aponeurotic fixation of polypropylene mesh, with less complexity and lower rates of complications and recurrences.

Effects of mineral sorting on concentrator design and economics

Ore sorting after crushing is an effective way to enhance the feed quality of a concentrator. Sorting by hand is the oldest way of concentrating minerals but it has become outdated because of low capacities. Older methods of sorting have also been difficult to use in large scale productions due to low capacities of sorters. Data transfer and processing and the speed of rejection mechanisms have been the bottlenecks for effective use of sorters. A fictive chalcopyrite ore body was created for this thesis. The properties of the ore were typical of chalcopyrite ores and economical limit was set for design. Concentrator capacity was determined by the size of ore body and the planned mine life. Two concentrator scenarios were compared, one with the sorting facility and the other without sorting. Comparison was made for quality and amount of feed, size of equipment and economics. Concentrator with sorting had lower investment and operational cost but also lower incomes due to the ore loss in sorting. Net cash flow, net present value and internal rate of interest were calculated for comparison of the two scenarios.

Reverse osmosis membrane surface modification: effects on membrane performance

The aim of this thesis was to study the surface modification of reverse osmosis membranes by surfactants and the effect of modification on rejection and flux. The surfactants included anionic and nonionic surfactants. The purpose of membrane modification was to improve pure water permeability with increasing salt rejection. The literature part of the study deals with the basic principles of reverse osmosis technology and factors affecting the membrane performance. Also the membrane surface modification by surfactants and their influence on membrane’s surface properties and efficiency (permeability and salt rejection) were discussed. In the experimental part of the thesis two thin-film composite membranes, Desal AG and LE-4040, were modified on-line with three different surfactants. The effects of process parameters (pressure, pH, and surfactant concentration) on surface modification were also examined. The characteristics of the modified membranes were determined by measuring the membranes’ contact angle and zeta potentials. The zeta potential and contact angle measurements indicate that the surfactants were adsorbed onto the both membranes. However, the adsorption did not effect on membrane’s pure water permeability and salt rejection. Thereby, the surface modification of the Desal AG and LE-4040 membranes by surfactants was not able to improve the membrane’s performance.

Issuant views of hell in contemporary Anglo-American theology

This problem of hell is a specific form of the problem of evil that can be expressed in terms of a set of putatively incompatible statements: 1. An omnipotent God could create a world in which all moral agents freely choose life with God. 2. An omnibenevolent God would not create a world with the foreknowledge that some (perhaps a significant proportion) of God’s creatures would end up in hell. 3. An omniscient God would know which people will end up in hell. 4. Some people will end up forever in hell. Since the late twentieth century, a number of British and North American philosophical theologians, inspired by C.S. Lewis, have developed a new approach to answering the problem of hell. Very little work has been done to systematize this category of perspectives on the duration, quality, purpose and finality of hell. Indeed, there is no consensus among scholars as to what such an approach should be called. In this work, however, I call this perspective issuantism. Starting from the works of a wide range of issuantist scholars, I distill what I believe to be the essence of issuantist perspectives on hell: hell is a state that does not result in universal salvation and is characterized by the insistance that both heaven and hell must issue from the love of God, an affirmation of libertarian human freedom and a rejection of retributive interpretations of hell. These sine qua non characteristics form what I have labeled basic issuantism. I proceed to show that basic issuantism by itself does not provide an adequate answer to the problem of hell. The issuantist scholars themselves, however, recognize this weakness and add a wide range of possible supplements to their basic issuantism. Some of these supplemented versions of issuantism succeed in presenting reasonable answers to the problem of hell. One of the key reasons for the development of issuantist views of hell is a perceived failure on the part of conditionalists, universalists and defenders of hell as eternal conscious torment to give adequate answers to the problem of hell. It is my conclusion, however, that with the addition of some of the same supplements, versions of conditionalism and hell as eternal conscious torment can be advanced that succeed just as well in presenting answers to the problem of hell as those advanced by issuantists, thus rendering some of the issuantist critique of non-issuantist perspectives on hell unfounded.

Detection of cytomegalovirus infections by PCR in renal transplant patients

Cytomegalovirus (CMV) is the single most important infectious agent affecting recipients of organ transplants. To evaluate the incidence and the clinical importance of CMV infection in renal transplants in Brazil, 37 patients submitted to renal allograft transplants were tested periodically for the presence of cytomegalovirus DNA in urine using the polymerase chain reaction (PCR), and for the presence of IgM and IgG antibodies against CMV by enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence (IIF). The PCR-amplified products were detected by gel electrophoresis and confirmed by dot-blot hybridization with oligonucleotide probes. Thirty-two of the 37 patients (86.4%) were positive by at least one of the three methods. In six patients, PCR was the only test which detected the probable CMV infection. Ten patients had a positive result by PCR before transplantation. In general, the diagnosis was achieved earlier by PCR than by serologic tests. Active infection occurred more frequently during the first four months after transplantation. Sixteen of the 32 patients (50%) with active CMV infection presented clinical symptoms consistent with CMV infection. Five patients without evidence of active CMV infection by the three tests had only minor clinical manifestations during follow-up. Our results indicate that PCR is a highly sensitive procedure for the early detection of CMV infection and that CMV infection in renal transplant patients is a frequent problem in Brazil.