Use of a titanium device in lateral sinus floor elevation: an experimental study in monkeys

Aim: To evaluate the effect of a space-maintaining device fixed to the lateral wall of the maxillary sinus after the elevation of the sinus mucosa on bone filling of the sinus cavity. Material and methods: Immediately after the elevation of the maxillary sinus Schneiderian membrane accomplished through lateral antrostomy in four monkeys, a titanium device was affixed to the lateral sinus wall protruding into the sinus cavity to maintain the mucosa elevated without the use of grafting material. The healing of the tissue around the implants was evaluated after 3 and 6 months. Ground sections were prepared and analyzed histologically. Results: The void under the elevated sinus membrane, originally filled with the blood clot, was reduced after 3 as well as after 6 months of healing of about 56% and 40.5%, respectively. In seven out of eight cases, the devices had perforated the sinus mucosa. The formation of mineralized bone and bone marrow amounted to about 42% and 69% after 3 and 6 months, respectively. The connective tissue represented about 53% and 23% of the newly formed tissue after 3 and 6 months, respectively. Conclusions: New bone formation was found below the devices. However, shrinkage of the newly formed tissue was observed both after 3 and 6 months of healing. Hence, the space-maintaining function of the devices used in the present study has to be questioned.

Comparison of active and passive forces of the pelvic floor muscles in women with and without stress urinary incontinence

Background: The reduction of the pelvic floor muscles (PFM) strength is a major cause of stress urinary incontinence (SUI). Objective: To compare active and passive forces, and vaginal cavity aperture in continent and stress urinary incontinent women. Method: The study included a total of thirty-two women, sixteen continent women (group 1 - G1) and sixteen women with SUI (group 2 - G2). To evaluate PFM passive and active forces in anteroposterior (sagittal plane) and left-right directions (frontal plane) a stainless steel specular dynamometer was used. Results: The anteroposterior active strength for the continent women (mean +/- standard deviation) (0.3 +/- 0.2 N) was greater compared to the values found in the evaluation of incontinent women (0.1 +/- 0.1 N). The left-right active strength (G1=0.43 +/- 0.1 N; G2=0.40 +/- 0.1 N), the passive force (G1=1.1 +/- 0.2 N; G2=1.1 +/- 0.3 N) and the vaginal cavity aperture (G1=21 +/- 3 mm; G2=24 +/- 4 mm) did not differ between groups 1 and 2. Conclusion: The function evaluation of PFM showed that women with SUI had a lower anteroposterior active strength compared to continent women.

Composite connections in slim-floor system: An experimental study

This paper reports the results of full-scale tests in beam-to-column connections for composite slim floor systems, including tests on Bare Steel connection and composite connection. The tested system consists of a concrete-filled composite column and a composite floor where an asymmetric steel beam is connected to a composite column by shear steel plates. Tests results previously obtained on partially encased composite beams were used to define the position of the headed studs in the slim floor system. Based on the obtained results of connections, the composite and Bare Steel connection behaved as semi-rigid and nominally pinned respectively. The tests results also indicated a significant contribution of the slim floor to the moment capacity of the connection. (C) 2011 Elsevier Ltd. All rights reserved.

Is the Sexual Satisfaction of Postmenopausal Women Enhanced by Physical Exercise and Pelvic Floor Muscle Training?

Introduction. Physical exercise including pelvic floor muscle (PFM) training seems to improve the sexual function of women with urinary incontinence. This effect in postmenopausal women who are continent has not yet been determined. Aim. The aim of this study was to assess the effect of a 3-month physical exercise protocol (PEP) on the sexual function and mood of postmenopausal women. Methods. Thirty-two sedentary, continent, sexually active women who had undergone menopause no more than 5 years earlier and who had follicle stimulating hormone levels of at least 40 mIU/mL were enrolled into this longitudinal study. All women had the ability to contract their PFMs, as assessed by vaginal bimanual palpation. Muscle strength was graded according to the Oxford Modified Grading Scale (OMGS). A PEP was performed under the guidance of a physiotherapist (M. M. F.) twice weekly for 3 months and at home three times per week. All women completed the Sexual Quotient-Female Version (SQ-F) and the Hospital Anxiety and Depression Scale (HADS) before and after the PEP. Main Outcome Measures. SQ-F to assess sexual function, HASDS to assess mood, and OMGS to grade pelvic floor muscle strength. Results. Thirty-two women (24 married women, eight women in consensual unions) completed the PEP. Following the PEP, there was a significant increase in OMGS score (2.59 +/- 1.24 vs. 3.40 +/- 1.32, P < 0.0001) and a significant decrease in the number of women suffering from anxiety (P < 0.01), but there was no effect on sexual function. Conclusion. Implementation of our PEP seemed to reduce anxiety and improve pelvic floor muscular strength in sedentary and continent postmenopausal women. However, our PEP did not improve sexual function. Uncontrolled variables, such as participation in a long-term relationship and menopause status, may have affected our results. We suggest that a randomized controlled trial be performed to confirm our results. Lara LAS, Montenegro ML, Franco MM, Abreu DCC, Rosa e Silva ACJS, Ferreira CHJ. Is the sexual satisfaction of postmenopausal women enhanced by physical exercise and pelvic floor muscle training? J Sex Med 2012; 9: 218-223.

Evaluation of a Maxillary Sinus Floor Augmentation in the Presence of a Large Antral Pseudocyst

Sinus floor augmentation has been established as a predictable technique to overcome maxillary bone loss. Antral cystic lesions may lead to intrasurgical complications and should be accurately diagnosed. However, antral pseudocysts have recently been described not to be contraindicated for sinus-grafting procedures. The current article sought to report clinical, cone beam computed tomographic, and histologic results of a maxillary sinus floor augmentation, performed with piezoelectric surgery, in the presence of a large antral pseudocyst. Success of graft maturation was confirmed with histologic analysis, which also indicated the absence of inflammatory infiltration in the tissue evaluated. On the basis of our findings, it is possible to perform a predictable treatment based on sinus floor augmentation in the presence of antral pseudocysts. Graft maturation can also be achieved 6 months after sinus-lifting surgeries.

Early postoperative pelvic-floor biofeedback improves erectile function in men undergoing radical prostatectomy: a prospective, randomized, controlled trial

Erectile dysfunction (ED) and urinary incontinence are common complications following radical prostatectomy (RP). Although pelvic-floor biofeedback training (PFBT) may improve urinary continence following RP, its effects on the recovery of potency are unknown. Fifty-two patients selected for RP were prospectively randomized for a treatment group (n=26) receiving PFBT once a week for 3 months and home exercises or a control group (n=26), in which patients received verbal instructions to contract the pelvic floor. Erectile function (EF) was evaluated with the International Index of Erectile Function-5 (IIEF-5) before surgery and 1, 3, 6 and 12 months postoperatively. Patients were considered potent when they had a total IIEF-5 score >20. Continence status was assessed and defined as the use of no pads. Groups were comparable in terms of age, body mass index, diabetes, pathological tumor stage and neurovascular bundle preservation. A significant reduction in IIEF-5 scores was observed after surgery in both groups. In the treatment group, 8 (47.1%) patients recovered potency 12 months postoperatively, as opposed to 2 (12.5%) in the control group (P=0.032). The absolute risk reduction was 34.6% (95% confidence interval (CI): 3.8-64%) and the number needed to treat was 3 (95% CI: 1.5-17.2). A strong association between recovery of potency and urinary continence was observed, with continent patients having a 5.4 higher chance of being potent (P=0.04). Early PFBT appears to have a significant impact on the recovery of EF after RP. Urinary continence status was a good indicator of EF recovery, with continent patients having a higher chance of being potent.

Intraoral carcinosarcoma on the floor of the mouth mimicking a benign lesion

Carcinosarcoma is a rare malignant disease with aggressive behaviour rarely producing oral manifestations. This article reports a case of an intraoral carcinosarcoma affecting a 71-year-old black male; the diagnosis was made by histopathological and immunohistochemical analyses. Computed tomography scanning showed metastatic masses in the lungs. The patient was underwent a chemotherapy protocol regimen, but died as a consequence of the disease within 10 months of diagnosis. Distinctive characteristics of this presentation were the location of the lesion (floor of the mouth) and its clinical features resembling a benign lesion. A brief review of intraoral carcinosarcoma cases in the literature is also presented.

Immunohistochemical evaluation of MMP-2, MMP-9 and CD31/microvascular density in squamous cell carcinomas of the floor of the mouth

The aim of this study was to evaluate the immunoexpression of MMP-2, MMP-9 and CD31/microvascular density in squamous cell carcinomas of the floor of the mouth and to correlate the results with demographic, survival, clinical (TNM staging) and histopathological variables (tumor grade, perineural invasion, embolization and bone invasion). Data from medical records and diagnoses of 41 patients were reviewed. Histological sections were subjected to immunostaining using primary antibodies for human MMP-2, MMP-9 and CD31 and streptavidin-biotin-immunoperoxidase system. Histomorphometric analyses quantified positivity for MMPs (20 fields per slide, 100?points grade, ×200) and for CD31 (microvessels <50?µm in the area of the highest vascularization, 5 fields per slide, 100?points grade, ×400). Statistical design was composed by non-parametric Mann-Whitney U test (investigating the association between numerical variables and immunostainings), chi-square frequency test (in contingency tables), Fisher's exact test (when at least one expected frequency was less than 5 in 2×2 tables), Kaplan-Meier method (estimated probabilities of overall survival) and Iogrank test (comparison of survival curves), all with a significance level of 5%. There was a statistically significant correlation between immunostaining for MMP-2 and lymph node metastasis. Factors associated negatively with survival were N stage, histopathological grade, perineural invasion and immunostaining for MMP-9. There was no significant association between immunoexpression of CD31 and the other variables. The intensity of immunostaining for MMP-2 can be indicative of metastasis in lymph nodes and for MMP-9 of a lower probability of survival

Study of materials and technology of ancient floor mosaics' substrate

Ancient pavements are composed of a variety of preparatory or foundation layers constituting the substrate, and of a layer of tesserae, pebbles or marble slabs forming the surface of the floor. In other cases, the surface consists of a mortar layer beaten and polished. The term mosaic is associated with the presence of tesserae or pebbles, while the more general term pavement is used in all the cases. As past and modern excavations of ancient pavements demonstrated, all pavements do not necessarily display the stratigraphy of the substrate described in the ancient literary sources. In fact, the number and thickness of the preparatory layers, as well as the nature and the properties of their constituent materials, are often varying in pavements which are placed either in different sites or in different buildings within a same site or even in a same building. For such a reason, an investigation that takes account of the whole structure of the pavement is important when studying the archaeological context of the site where it is placed, when designing materials to be used for its maintenance and restoration, when documenting it and when presenting it to public. Five case studies represented by archaeological sites containing floor mosaics and other kind of pavements, dated to the Hellenistic and the Roman period, have been investigated by means of in situ and laboratory analyses. The results indicated that the characteristics of the studied pavements, namely the number and the thickness of the preparatory layers, and the properties of the mortars constituting them, vary according to the ancient use of the room where the pavements are placed and to the type of surface upon which they were built. The study contributed to the understanding of the function and the technology of the pavements’ substrate and to the characterization of its constituent materials. Furthermore, the research underlined the importance of the investigation of the whole structure of the pavement, included the foundation surface, in the interpretation of the archaeological context where it is located. A series of practical applications of the results of the research, in the designing of repair mortars for pavements, in the documentation of ancient pavements in the conservation practice, and in the presentation to public in situ and in museums of ancient pavements, have been suggested.

Analysis of an innovative slim floor composite beam conformed by a custom GFRP pultruded profile and reinforced concrete.

GFRP pultruded profiles have shown to be structural profiles with great stiffness, strenght and very low specific weight, making it a great candidate for the rehabilitation of damaged strucutres. To further enhance the strucutral mechanism of these type of beams, the Slimflor composite structural system has lead as basis for this analysis; by replacing the steel beam with a GFRP pultruded profile. To further increase its composite action, a continuous shear connector has been set as part of the beam cross section as well as its needed reinforcement and fire protection.

Repair of orbital floor fractures using bioresorbable poly-L/DL-lactide plates

To assess the long-term clinical and radiologic findings after insertion of a bioresorbable polylactide plates P(L/DL)LA 70/30 implant (PolyMax) in the repair of orbital floor and wall defects, with special focus on stability and clinical signs of foreign-body reaction.

Influence of rhBMP-2 on bone formation and osseointegration in different implant systems after sinus-floor elevation. An in vivo study on sheep

Several studies have reported certain bone morphogenic proteins (BMPs) to have positive effects on bone generation. Although some investigators have studied the effects of human recombinant BMP (rhBMP-2) in sinus augmentation in sheep, none of these studies looked at the placement of implants at the time of sinus augmentation. Furthermore, no literature could be found to report on the impact that different implant systems, as well as the positioning of the implants had on bone formation if rhBMP-2 was utilized in sinus-lift procedures.

Vaginal prolapse, pelvic floor function, and related symptoms 16 years after sex reassignment surgery in transsexuals

To evaluate the prevalence of prolapse and related bladder, bowel, and sexual problems in transsexual patients (TS) after sex reassignment surgery.

Continuous versus intermittent stochastic resonance whole body vibration and its effect on pelvic floor muscle activity

To determine the optimal stochastic whole body vibration (SR-WBV) load modality regarding pelvic floor muscle (PFM) activity in order to complete the SR-WBV training methodology for future PFM training with SR-WBV.