Search results for: inferior dental nerve
Commenced in January 2007
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Edition: International
Paper Count: 721

Search results for: inferior dental nerve

241 [Keynote Talk]: From Clinical Practice to Academic Setup, 'Quality Circles' for Quality Outputs in Both

Authors: Vandita Mishra

Abstract:

From the management of patients, reception, record, and assistants in a clinical practice; to the management of ongoing research, clinical cases and department profile in an academic setup, the healthcare provider has to deal with all of it. The victory lies in smooth running of the show in both the above situations with an apt solution of problems encountered and smooth management of crisis faced. Thus this paper amalgamates dental science with health administration by means of introduction of a concept for practice management and problem-solving called 'Quality Circles'. This concept uses various tools for problem solving given by experts from different fields. QC tools can be applied in both clinical and academic settings in dentistry for better productivity and for scientifically approaching the process of continuous improvement in both the categories. When approached through QC, our organization showed better patient outcomes and more patient satisfaction. Introduced in 1962 by Kaoru Ishikawa, this tool has been extensively applied in certain fields outside dentistry and healthcare. By exemplification of some clinical cases and virtual scenarios, the tools of Quality circles will be elaborated and discussed upon.

Keywords: academics, dentistry, healthcare, quality

Procedia PDF Downloads 76
240 Investigating Combined Effect of Aerobic Training and Crataegus elbursensis Extract on Plasma Angiogenic Mediators in Male Wistar Rats

Authors: Behnam Hasanzadeh, Asieh Abbassi Daloii, Ailin Ebrahimi

Abstract:

The present study aims to investigate the effect of six weeks of progressive aerobic training and aqueous extract of Crataegus monogyna on VEGF variations and plasma angiopoetin-1/2 (ANG- 1/2) in male Wistar rats. Materials and methods: A number of 30 male Wistar rats, 4-6 months old, were randomly divided into four groups: control Crataegus monogyna (N=8), training Crataegus monogyna (N=8), control saline (N=6), and training saline (N=8). The aerobic training program included running on the treadmill at the speed of 34 meters per minute for 60 minutes per day. The training was conducted for six weeks, five days a week. Following each training session, both experimental and control subjects of Crataegus monogyna groups were orally fed with 0.5 mg Crataegus monogyna extract per gram of body weight. The normal saline group was given the same amount of normal saline solution (NS). Eventually, 72 hours after the last training session, blood samples were taken from inferior verna cava. Results: the results showed that progressive endurance training caused insignificant reductions in plasma VEGF concentration in the training group, Crataegus monogyna group and training-Crataegus monogyna group comparing the control group. Plasma ANG-1 concentration reduced in the training, Crataegus monogyna and training-Crataegus monogyna groups while plasma ANG-2 concentration significantly increased in the Crataegus monogyna group (P=0.022) comparing with the control group. The results showed that the ratio of plasma ANG-2 to ANG-1 significantly increased in the Crataegus monogyna group (P=0.028) comparing with the control group. Conclusion: the findings suggest that combination of aerobic training and Crataegus monogyna extract has no synergistic effect on anti-angiogenesis indicators and Crataegus monogyna extract had a stronger effect on anti-angiogenesis indicators.

Keywords: angiopoetin-1/2, VEGF, Crataegus monogyna extract, aerobic training

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239 Antibiotic Prophylaxis Habits in Oral Implant Surgery in the Netherlands: A Cross-Sectional Survey

Authors: Fabio Rodriguez Sanchez, Josef Bruers, Iciar Arteagoitia, Carlos Rodriguez Andres

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Background: Oral implants are a routine treatment to replace lost teeth. Although they have a high rate of success, implant failures do occur. Perioperative antibiotics have been suggested to prevent postoperative infections and dental implant failures, but they remain a controversial treatment among healthy patients. The objective of this study was to determine whether antibiotic prophylaxis is a common treatment in the Netherlands among general dentists, maxillofacial-surgeons, periodontists and implantologists in conjunction with oral implant surgery among healthy patients and to assess the nature of antibiotics prescriptions in order to evaluate whether any consensus has been reached and the current recommendations are being followed. Methodology: Observational cross-sectional study based on a web-survey reported according to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines. A validated questionnaire, developed by Deeb et al. (2015), was translated and slightly adjusted to circumstances in the Netherlands. It was used with the explicit permission of the authors. This questionnaire contained both close-ended and some open-ended questions in relation to the following topics: demographics, qualification, antibiotic type, prescription-duration and dosage. An email was sent February 2018 to a sample of 600 general dentists and all 302 oral implantologists, periodontists and maxillofacial surgeons who were recognized by the Dutch Association of Oral Implantology (NVOI) as oral health care providers placing oral implants. The email included a brief introduction about the study objectives and a link to the web questionnaire, which could be filled in anonymously. Overall, 902 questionnaires were sent. However, 29 questionnaires were not correctly received due to an incorrect email address. So a total number of 873 professionals were reached. Collected data were analyzed using SPSS (IBM Corp., released 2012, Armonk, NY). Results: The questionnaire was sent back by a total number of 218 participants (response rate=24.2%), 45 female (20.8%) and 171 male (79.2%). Two respondents were excluded from the study group because they were not currently working as oral health providers. Overall 151 (69.9%) placed oral implants on regular basis. Approximately 79 (52.7%) of these participants prescribed antibiotics only in determined situations, 66 (44.0%) prescribed antibiotics always and 5 dentists (3.3%) did not prescribe antibiotics at all when placing oral implants. Overall, 83 participants who prescribed antibiotics, did so both pre- and postoperatively (58.5%), 12 exclusively postoperative (8.5%), and 47 followed an exclusive preoperative regime (33.1%). A single dose of 2,000 mg amoxicillin orally 1-hour prior treatment was the most prescribed preoperative regimen. The most frequent prescribed postoperative regimen was 500 mg amoxicillin three times daily for 7 days after surgery. On average, oral health professionals prescribed 6,923 mg antibiotics in conjunction with oral implant surgery, varying from 500 to 14,600 mg. Conclusions: Antibiotic prophylaxis in conjunction with oral implant surgery is prescribed in the Netherlands on a rather large scale. Dutch professionals might prescribe antibiotics more cautiously than in other countries and there seems to be a lower range on the different antibiotic types and regimens being prescribed. Anyway, recommendations based on last-published evidence are frequently not being followed.

Keywords: clinical decision making, infection control, antibiotic prophylaxis, dental implants

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238 Impact of Massive Weight Loss Body Contouring Surgery in the Patient’s Quality of Life

Authors: Maria Albuquerque, Miguel Matias, Ângelo Sá, Juliana Sousa, Maria Manuel Mouzinho

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Obesity is a frequent disease in Portugal. The surgical treatment is very effective and has an indication when there is a failure of the medical treatment. Although massive weight loss is associated with considerable health gains, these patients are characterized by a variable degree of dermolipodistrophy. In some cases, there is even the development of physical symptoms such as intertriginous, and some degree of psychological distress is present. In almost all cases, a desire for a better body contour, which inhibits some aspects of social life, is a fact. A prospective study was made to access the impact of body contouring surgery in the quality of life of patients who underwent a massive weight lost correction surgical procedure at Centro Hospitalar de Lisboa Central between January 2020 and December 2021. The patients were submitted to the Body Q subjective questionnaire adapted for the Portuguese language and accessed for the following categories: Anguish with Appearance, Contempt with Body Image, Satisfaction with the Abdomen, and Overall Satisfaction with the Body. The questionnaire was repeated at the 6 months mark. A total of 80 patients were sampled. The sex distribution was 79 female and 1 male. The median BMI index before surgery was inferior to 28%. The pre operatory questionnaire showed high scores for Anguish with Appearance and low scores for the body image self-evaluation. Overall, there was an improvement of at least 50% in all the evaluated scores. Additionally, a correlation was found between abdominoplasty and the contempt with body image and satisfaction with the abdomen (p-value <0.05). Massive weight loss is associated with important body deformities that have a significant impact on the patient’s personal and social life. Body contouring surgery is then vital for these patients as it implicates major aesthetic and functional benefits.

Keywords: abdominoplasty, cruroplasty, obesity, massive weight loss

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237 Right Cerebellar Stroke with a Right Vertebral Artery Occlusion Following an Embolization of the Right Glomus Tympanicum Tumor

Authors: Naim Izet Kajtazi

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Context: Although rare, glomus tumor (i.e., nonchromaffin chemodectomas and paragan¬gliomas) is the most common middle ear tumor, with female predominance. Pre-operative embolization is often required to devascularize the hypervascular tumor for better surgical outcomes. Process: A 35-year-old female presented with episodes of frequent dizziness, ear fullness, and right ear tinnitus for 12 months. Head imaging revealed a right glomus tympanicum tumor. She underwent pre-operative endovascular embolization of the glomus tympanicum tumor with surgical, cyanoacrylate-based glue. Immediately after the procedure, she developed drowsiness and severe pain in the right temporal region. Further investigations revealed a right cerebellar stroke in the posterior inferior cerebellar artery territory. She was treated with intravenous heparin, followed by one year of oral anticoagulation. With rehabilitation, she significantly recovered from her post embolization stroke. However, the tumor was resected at another institution. Ten years later, follow-up imaging indicated a gradual increase in the size of the glomus jugulare tumor, compressing the nearby critical vascular structures. She subsequently received radiation therapy to treat the residual tumor. Outcome: Currently, she has no neurological deficit, but her mild dizziness, right ear tinnitus, and hearing impairment persist. Relevance: This case highlights the complex nature of these tumors, which often bring challenges to the patients as well as treatment teams. The multi-disciplinary team approach is necessary to tailor the management plan for individual tumors. Although embolization is a safe procedure, careful attention and thoughtful anatomic knowledge regarding dangerous anastomosis are essential to avoid devastating complications. Complications occur due to encountered vessel anomalies and new anastomoses formed during the gluing and changes in hemodynamics.

Keywords: stroke, embolization, MRI brain, cerebral angiogram

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236 Young Female’s Heart Was Bitten by Unknown Ghost (Isolated Cardiac Sarcoidosis): A Case Report

Authors: Heru Al Amin

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Sarcoidosis is a granulomatous inflammatory disorder of unclear etiology that can affect multiple different organ systems. Isolated cardiac sarcoidosis is a very rare condition that causes lethal arrhythmia and heart failure. A definite diagnosis of cardiac sarcoidosis remains challenging. The use of multimodality imaging plays a pivotal role in the diagnosis of this entity. Case summary: In this report, we discuss a case of a 50-year-old woman who presented with recurrent palpitation, dizziness, vertigo and presyncope. Electrocardiogram revealed variable heart blocks, including first-degree AV block, second-degree AV block, high-degree AV block, complete AV block, trifascicular block and sometimes supraventricular arrhythmia. Twenty-four hours of Holter monitoring show atrial bigeminy, first-degree AV block and trifascicular block. Transthoracic echocardiography showed Thinning of basal anteroseptal and inferred septum with LV dilatation with reduction of Global Longitudinal Strain. A dual-chamber pacemaker was implanted. CT Coronary angiogram showed no coronary artery disease. Cardiac magnetic resonance revealed basal anteroseptal and inferior septum thinning with focal edema with LGE suggestive of sarcoidosis. Computed tomography of the chest showed no lymphadenopathy or pulmonary infiltration. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) of the whole body showed. We started steroids and followed up with the patient. Conclusion: This case serves to highlight the challenges in identifying and managing isolated CS in a young patient with recurrent syncope with variable heart block. Early, even late initiation of steroids can improve arrhythmia as well as left ventricular function.

Keywords: cardiac sarcoidosis, conduction abnormality, syncope, cardiac MRI

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235 Effect of Silver Diamine Fluoride on Reducing Fungal Adhesion on Dentin

Authors: Rima Zakzouk, Noriko Hiraishi, Mohamed Mahdi Alshahni, Koichi Makimura, Junji Tagami

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Background and Purpose: Silver diamine fluoride (SDF) is used to prevent and arrest dental caries. The aim of this study is to evaluate the effect of SDF on reducing Candida albicans adhesion on dentin. Materials and Methods: Bovine dentin disks (6×6 mm) were cut by Isomet and polished using grit silicon carbide papers down to 2000 in order to obtain flat dentin surfaces. Samples were divided into two groups. The first group (SDF group) was treated with 38% SDF for 3 min, while the other group (control group) did not undergo SDF treatment. All samples were exposed to C. albicans suspension, washed after 6 hours incubation at 30 °C before to be tested using XTT (2,3-Bis-(2-Methoxy-4-Nitro-5-Sulfophenyl)-2H-Tetrazolium-5-Carboxanilide) and real time PCR approaches. Statistical analyses of the results were performed at the significance level α = 0.05. Results: SDF inhibited C. albicans adhesion onto dentin. A significant difference was found between the SDF and control groups in both XTT and real time PCR tests. Conclusion: Using SDF to arrest the caries, could inhibit the Candida growth on dentin.

Keywords: silver diamine fluoride, dentin, real time PCR, XTT

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234 Exploration of Sweet Potato Cultivar Markets Availability in North West Province, South Africa

Authors: V. M. Mmbengwa, J. R. M. Mabuso, C. P. Du Plooy, S. Laurrie, H. D. van Schalkwyk

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Sweet potato products are necessary for the provision of essential nutrients in every household, regardless of their poverty status. Their consumption appears to be highly influenced by socio-economic factors, such as malnutrition, food insecurity and unemployment. Therefore, market availability is crucial for these cultivars to resolve some of the socio-economic factors. The aim of the study was to investigate market availability of sweet potato cultivars in the North West Province. In this study, both qualitative and quantitative research methodologies were used. Qualitative methodology was used to explain the quantitative outcomes of the variables. On the other hand, quantitative results were used to test the hypothesis. The study used SPSS software to analyse the data. Cross-tabulation and Chi-square statistics were used to obtain the descriptive and inferential analyses, respectively. The study found that the Blesbok cultivar is dominating the markets of the North West Province, with the Monate cultivar dominating in the Bojanala Platinum (75 %) and Dr Ruth Segomotsi Mompati (25 %) districts. It is also found that a unit increase in the supply of sweet potato cultivars in both local and district municipal markets is accompanied by a reduced demand of 28 % and 33 % at district and local markets, respectively. All these results were found to be significant at p<0.05. The results further revealed that in four out of nine local municipality markets, the Blesbok cultivar seems to be solely available in those four local municipal markets of North West Province. It can be concluded that Blesbok, relative to other cultivars, is the most commercialised sweet potato variety and that consumers across this Province are highly aware of it. For other cultivars to assume market prominence in this Province, a well-designed marketing campaign for creating awareness may be required. This campaign may be based on nutritional advantages of different cultivars, of which Blesbok is relatively inferior, compared to orange-fleshed sweet potato varieties.

Keywords: cultivar, malnutrition, markets, sweet potato

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233 Migration in Times of Uncertainty

Authors: Harman Jaggi, David Steinsaltz, Shripad Tuljapurkar

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Understanding the effect of fluctuations on populations is crucial in the context of increasing habitat fragmentation, climate change, and biological invasions, among others. Migration in response to environmental disturbances enables populations to escape unfavorable conditions, benefit from new environments and thereby ride out fluctuations in variable environments. Would populations disperse if there is no uncertainty? Karlin showed in 1982 that when sub-populations experience distinct but fixed growth rates at different sites, greater mixing of populations will lower the overall growth rate relative to the most favorable site. Here we ask if and when environmental variability favors migration over no-migration. Specifically, in random environments, would a small amount of migration increase the overall long-run growth rate relative to the zero migration case? We use analysis and simulations to show how long-run growth rate changes with migration rate. Our results show that when fitness (dis)advantages fluctuate over time across sites, migration may allow populations to benefit from variability. When there is one best site with highest growth rate, the effect of migration on long-run growth rate depends on the difference in expected growth between sites, scaled by the variance of the difference. When variance is large, there is a substantial probability of an inferior site experiencing higher growth rate than its average. Thus, a high variance can compensate for a difference in average growth rates between sites. Positive correlations in growth rates across sites favor less migration. With multiple sites and large fluctuations, the length of shortest cycle (excursion) from the best site (on average) matters, and we explore the interplay between excursion length, average differences between sites and the size of fluctuations. Our findings have implications for conservation biology: even when there are superior sites in a sea of poor habitats, variability and habitat quality across space may be key to determining the importance of migration.

Keywords: migration, variable-environments, random, dispersal, fluctuations, habitat-quality

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232 A Rational Strategy to Maximize the Value-Added Products by Selectively Converting Components of Inferior Heavy Oil

Authors: Kashan Bashir, Salah Naji Ahmed Sufyan, Mirza Umar Baig

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In this study, n-dodecane, tetralin, decalin, and tetramethybenzene (TMBE) were used as model compounds of alkanes, naphthenic-aromatic, cycloalkanes and alkyl-benzenes presented in hydro-diesel. The catalytic cracking properties of four model compounds over Y zeolite catalyst (Y-Cat.) and ZSM-5 zeolite catalysts (ZSM-5-Cat.) were probed. The experiment results revealed that high conversion of macromolecular paraffin and naphthenic aromatics were achieved over Y-Cat, whereas its low cracking activity of intermediate products micromolecules paraffin and olefin and high activity of hydride transfer reaction goes against the production of value-added products (light olefin and gasoline). In contrast, despite the fact that the hydride transfer reaction was greatly inhabited over ZSM-5-Cat, the low conversion of macromolecules was observed attributed to diffusion limitations. Interestingly, the mixed catalyst compensates for the shortcomings of the two catalysts, and a “relay reaction” between Y-Cat and ZSM-5-Cat was proposed. Specifically, the added Y-Cat acts as a “pre-cracking booster site” and promotes macromolecules conversion. The addition of ZSM-5-Cat not only significantly suppresses the hydride transfer reaction but also contributes to the cracking of immediate products paraffin and olefin into ethylene and propylene, resulting in a high yield of alkyl-benzene (gasoline), ethylene, and propylene with a low yield of naphthalene (LCO) and coke. The catalytic cracking evaluation experiments of mixed hydro-LCO were also performed to further clarify the “relay reaction” above, showing the highest yield of LPG and gasoline over mixed catalyst. The results indicate that the Y-cat and ZSM-5-cat have a synergistic effect on the conversion of hydro-diesel and corresponding value-added product yield and selective coke yield.

Keywords: synergistic effect, hydro-diesel cracking, FCC, zeolite catalyst, ethylene and propylene

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231 The Effects of Continuous and Interval Aerobic Exercises with Moderate Intensity on Serum Levels of Glial Cell Line-Derived Neurotrophic Factor and Aerobic Capacity in Obese Children

Authors: Ali Golestani, Vahid Naseri, Hossein Taheri

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Recently, some of studies examined the effect of exercise on neurotrophic factors influencing the growth, protection, plasticity and function in central and peripheral nerve cells. The aim of this study was to investigate the effects of continuous and interval aerobic exercises with moderate intensity on serum levels of glial cell line-derived neurotrophic factor (GDNF) and aerobic capacity in obese children. 21 obese students with an average age of 13.6 ± 0.5 height 171 ± 5 and BMI 32 ± 1.2 were divided randomly to control, continuous aerobic and interval aerobic groups. Training protocol included continuous or interval aerobic exercises with moderate intensity 50-65%MHR, three times per week for 10 weeks. 48 hours before and after executing of protocol, blood samples were taken from the participants and their GDNF serum levels were measured by ELISA. Aerobic power was estimated using Shuttle-run test. T-test results indicated a small increase in their GDNF serum levels, which was not statistically significant (p =0.11). In addition, the results of ANOVA did not show any significant difference between continuous and interval aerobic training on the serum levels of their GDNF but their aerobic capacity significantly increased (p =0.012). Although continuous and interval aerobic exercise improves aerobic power in obese children, they had no significant effect on their serum levels of GDNF.

Keywords: aerobic power, continuous aerobic training, glial cell line-derived neurotrophic factor (GDNF), interval aerobic training, obese children

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230 Sustainable Community Participation in Australia

Authors: Virginia Dickson-Swift, Amanda Kenny, Jane Farmer, Sarah Larkins, Karen Carlisle, Helen Hickson

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In this presentation, we will focus on the methods of Remote Services Futures (RSF), an evidence-based method of community participation that was developed in Scotland. Using oral health as the focus, we will discuss the ways that RSF can be used to achieve sustainable engagement with stakeholders from various parts of the community. We will describe our findings of using RSF methods to engage with rural communities, including the steps involved and what happened when we asked people about the oral health services that they thought were needed in their community. We found that most community members started by thinking that a public dental clinic was required in every community, which is not a sustainable health service delivery option. Through a series of facilitated workshops, communities were able to discuss and prioritise their needs and develop a costed plan for their community which will ensure sustainable service delivery into the future. Our study highlights the complexities of decision making in rural communities. It is important to ensure that when communities participate in health care planning that the outcomes are practical, feasible and sustainable.

Keywords: community participation, sustainable health planning, Remote Services Futures, rural communities

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229 Influence of Glenohumeral Joint Approximation Technique on the Cardiovascular System in the Acute Phase after Stroke

Authors: Iva Hereitova, Miroslav Svatek, Vit Novacek

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Background and Aim: Autonomic imbalance is one of the complications for immobilized patients in the acute stage after a stroke. The predominance of sympathetic activity significantly increases cardiac activity. The technique of glenohumeral joint approximation may contribute in a non-pharmacological way to the regulation of blood pressure and heart rate in patients in this risk group. The aim of the study was to evaluate the effect of glenohumeral joint approximation on the change in heart rate and blood pressure in immobilized patients in the acute phase after a stroke. Methods: The experimental study bilaterally evaluated heart rate, systolic and diastolic pressure values before and after glenohumeral joint approximation in 40 immobilized participants (72.6 ± 10.2 years) in the acute phase after stroke. The experimental group was compared with 40 healthy participants in the control group (68.6 ± 14.2 years). An SpO2 vital signs monitor and a validated Microlife WatchBP Office blood pressure monitor were used for evaluation. Statistical processing and evaluation were performed in MATLAB R2019 (The Math Works®, Inc., Natick, MA, USA). Results: Approximation of the glenohumeral joint resulted in a statistically significant decrease in systolic and diastolic pressure. An average decrease in systolic pressure for individual groups ranged from 8.2 to 11.3 mmHg (p <0.001). For diastolic pressure, the average decrease ranged from 5.0 - 14.2 mmHg (p <0.001). There was a statistically significant reduction in heart rate (p <0.01) only in patients after ischemic stroke in the inferior cerebral artery. There was the average decrease in heart rate of 3.9 beats per minute (median 4 beats per minute). Conclusion: Approximation of the glenohumeral joint leads to a statistically significant decrease in systolic and diastolic pressure in immobilized patients in the acute phase after stroke.

Keywords: Aproximation technique, Cardiovaskular system, Glenohumeral joint, Stroke

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228 An Event-Related Potential Investigation of Speech-in-Noise Recognition in Native and Nonnative Speakers of English

Authors: Zahra Fotovatnia, Jeffery A. Jones, Alexandra Gottardo

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Speech communication often occurs in environments where noise conceals part of a message. Listeners should compensate for the lack of auditory information by picking up distinct acoustic cues and using semantic and sentential context to recreate the speaker’s intended message. This situation seems to be more challenging in a nonnative than native language. On the other hand, early bilinguals are expected to show an advantage over the late bilingual and monolingual speakers of a language due to their better executive functioning components. In this study, English monolingual speakers were compared with early and late nonnative speakers of English to understand speech in noise processing (SIN) and the underlying neurobiological features of this phenomenon. Auditory mismatch negativities (MMNs) were recorded using a double-oddball paradigm in response to a minimal pair that differed in their middle vowel (beat/bit) at Wilfrid Laurier University in Ontario, Canada. The results did not show any significant structural and electroneural differences across groups. However, vocabulary knowledge correlated positively with performance on tests that measured SIN processing in participants who learned English after age 6. Moreover, their performance on the test negatively correlated with the integral area amplitudes in the left superior temporal gyrus (STG). In addition, the STG was engaged before the inferior frontal gyrus (IFG) in noise-free and low-noise test conditions in all groups. We infer that the pre-attentive processing of words engages temporal lobes earlier than the fronto-central areas and that vocabulary knowledge helps the nonnative perception of degraded speech.

Keywords: degraded speech perception, event-related brain potentials, mismatch negativities, brain regions

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227 Biological Optimization following BM-MSC Seeding of Partially Demineralized and Partially Demineralized Laser-Perforated Structural Bone Allografts Implanted in Critical Femoral Defects

Authors: S. AliReza Mirghasemi, Zameer Hussain, Mohammad Saleh Sadeghi, Narges Rahimi Gabaran, Mohamadreza Baghaban Eslaminejad

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Background: Despite promising results have shown by osteogenic cell-based demineralized bone matrix composites, they need to be optimized for grafts that act as structural frameworks in load-bearing defects. The purpose of this experiment is to determine the effect of bone-marrow-mesenchymal-stem-cells seeding on partially demineralized laser-perforated structural allografts that have been implanted in critical femoral defects. Materials and Methods: P3 stem cells were used for graft seeding. Laser perforation in four rows of three holes was achieved. Cell-seeded grafts were incubated for one hour until they were planted into the defect. We used four types of grafts: partially demineralized only (Donly), partially demineralized stem cell seeded (DST), partially demineralized laser-perforated (DLP), and partially demineralized laser-perforated stem cell seeded (DLPST). histologic and histomorphometric analysis were performed at 12 weeks. Results: Partially demineralized laser-perforated had the highest woven bone formation within graft limits, stem cell seeded demineralized laser-perforated remained intact, and the difference between partially demineralized only and partially demineralized stem cell seeded was insignificant. At interface, partially demineralized laser-perforated and partially demineralized only had comparable osteogenesis, but partially demineralized stem cell seeded was inferior. The interface in stem cell seeded demineralized laser-perforated was almost replaced by distinct endochondral osteogenesis with higher angiogenesis in the vicinity. Partially demineralized stem cell seeded and stem cell seeded demineralized laser-perforated graft surfaces had extra vessel-ingrowth-like porosities, a sign of delayed resorption. Conclusion: This demonstrates that simple cell-based composites are not optimal and necessitates the supplementation of synergistic stipulations and surface changes.

Keywords: structural bone allograft, partial demineralization, laser perforation, mesenchymal stem cell

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226 The Effect of Aerobic Training and Aqueous Extract of C. monogyna (Hawthorn) on Plasma and Heart Angiogenic Mediators in Male Wistar Rats

Authors: Asieh Abbassi Daloii, Ahmad Abdi

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Introduction: Sports information suggests that physical inactivity increases the risk of many diseases, including atherosclerosis. Coronary heart disease, stroke and peripheral vascular disease, atherosclerosis and clinical protests. However, exercise can have beneficial effects on risk factors for atherosclerosis by reducing hyperlipidemia, hypertension, obesity, plaque density, increased insulin sensitivity and glucose tolerance is improved. Despite these findings, there is little information about the molecular mechanisms of interaction between the body and its relation to sport and there arteriosclerosis. The present study aims to investigate the effect of six weeks of progressive aerobic training and aqueous extract of crataegus monogyna on vascular endothelial growth factor (VEGF) variations and angiopoetin-1/2 (ANG- 1/2) in plasma and heart tissue in male Wistar rats. Methods: 30 male Wistar rats, 4-6 months old, were randomly divided into four groups: control crataegus monogyna (N=8), training crataegus monogyna (N=8), control saline (N=6), and training saline (N=8). The aerobic training program included running on treadmill at the speed of 34 meters per minute for 60 minutes per day. The training was conducted for six weeks, five days a week. Following each training session, both experimental and control subjects of crataegus monogyna groups were orally fed with 0.5 mg crataegus monogyna extract per gram of the body weight. The normal saline group was given the same amount of the normal saline solution (NS). Eventually, 72 hours after the last training session, blood samples were taken from inferior Verna cava. Conclusion: It is likely that crataegus monogyna extract compared with aerobic training and even combination of both training and crataegus monogyna extract is more effective on angiogenesis.

Keywords: angiopoietin 1, 2, vascular endothelial growth factor, aerobic exercise

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225 Comparative Evaluation of a Dynamic Navigation System Versus a Three-Dimensional Microscope in Retrieving Separated Endodontic Files: An in Vitro Study

Authors: Mohammed H. Karim, Bestoon M. Faraj

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Introduction: This study aimed to compare the effectiveness of a Dynamic Navigation System (DNS) and a three-dimensional microscope in retrieving broken rotary NiTi files when using trepan burs and the extractor system. Materials and Methods: Thirty maxillary first bicuspids with sixty separate roots were split into two comparable groups based on a comprehensive Cone-Beam Computed Tomography (CBCT) analysis of the root length and curvature. After standardized access opening, glide paths, and patency attainment with the K file (sizes 10 and 15), the teeth were arranged on 3D models (three per quadrant, six per model). Subsequently, controlled-memory heat-treated NiTi rotary files (#25/0.04) were notched 4 mm from the tips and fractured at the apical third of the roots. The C-FR1 Endo file removal system was employed under both guidance to retrieve the fragments, and the success rate, canal aberration, treatment time and volumetric changes were measured. The statistical analysis was performed using IBM SPSS software at a significance level of 0.05. Results: The microscope-guided group had a higher success rate than the DNS guidance, but the difference was insignificant (p > 0.05). In addition, the microscope-guided drills resulted in a substantially lower proportion of canal aberration, required less time to retrieve the fragments and caused minimal change in the root canal volume (p < 0.05). Conclusion: Although dynamically guided trephining with the extractor can retrieve separated instruments, it is inferior to three-dimensional microscope guidance regarding treatment time, procedural errors, and volume change.

Keywords: separated instruments retrieval, dynamic navigation system, 3D video microscope, trephine burs, extractor

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224 Diagnostic Properties of Exercise or Pharmacological Stress Myocardial Perfusion Scintigraphy in Per-Vessel Basis: A Clinical Validation Study

Authors: Ahmadreza Bagheri, Seyyed S. Eftekhari, Shervin Rashidinia

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Background: Various stress tests have been proposed yet to assess patients with suspected coronary artery disease. However, their diagnostic properties in terms of sensitivity, specificity, and accuracy are variable and their applicability remained somewhat vague. The aim of this study is to validate per-vessel diagnostic properties of 3 types of stress myocardial perfusion scintigraphy in gated SPECT (Single-Photon Emission Computed Tomography) using either exercise or pharmacological stress testing with dipyridamole or dobutamine. Materials and Methods: Hospital records of 314 patients who referred to Imam Khomeini hospital of Tehran between September 2015 and January 2017 were completely reviewed in this study. All patients underwent coronary angiography within 3 months after stress myocardial perfusion scan. Eventually, the results were analyzed in per-vessel basis to find the proper modality for each involved vessel or scanned site. Results: The mean age of patients was 62.15 ± 4.94 years (30-85) and 35.03% were women. The overall sensitivity, specificity, and accuracy were calculated as 56.59%, 54.24%, and 55.09%, respectively. These values were 56.43% and 53.25%, 54.46% and 47.36%, 56.75% and 54.83% for dipyridamole and exercise, respectively. Ischemia of the anterior wall through exercise stress testing has the highest diagnostic accuracy in detecting LAD (Left Anterior Descending artery) involvement. Inferior wall hypokinesia and anterolateral wall ischemia during exercise stress testing have the highest diagnostic accuracy in detecting RCA (Right Coronary Artery) and LCX artery (Left Circumflex Artery) stenosis, respectively. Conclusion: Stress myocardial perfusion scan should be carried out on the basis of the findings of the preliminary investigations on suspicion of a specific coronary artery or involved myocardial wall.

Keywords: dipyridamole, dobutamine, single-photon emission computed tomography, stress myocardial perfusion scintigraphy

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223 The Bone Remodeling of Mandible in Bruxers

Authors: Eni Rahmi, Rasmi Rikmasari, Taufik Soemarsongko

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Background: One of the bad habits that requires a treatment and viewed as a risk factor of the temporomandibular disorder is bruxism. Bruxism defined as an awake and/or asleep parafunctional activities include grinding, gnashing, bracing or clenching of the teeth. In particular circumstances such as an increased frequency of episode, duration and the intensity of masseter contractions, caused phenomenon with pathological consequences, i.e., mandibular remodeling. The remodeling in mandibular angle was associated with the masseter and pterygoid medial muscles attachment which in its insertion area. The aim of this study was to compare the mandibular remodeling between bruxers and non-bruxers with ramus height, gonial angle and bigonial width as parameters, and to identify correlation among those parameters in bruxers, using panoramic radiographic. Methods: This study was conducted on 35 bruxers (10 phasic bruxism patients, 6 tonic bruxism patients, and 19 mixed bruxism patients) and 20 non-bruxers as control group. The data were obtained by using questionary, clinical examination, and radiographic measurement. Panoramic radiograph measurement was done using soft CBCT EPX Impla (E-Woo Korea). The data was analyzed by using Paired T-Test to see differences between parameters in both group and Pearson Correlation Test to evaluate correlation among parameters. Result: There was significant differences between bruxers and non-bruxers in ramus heights (p=0,04), bigonial widths (p=0,001), and gonial angles(p=0,015). The bruxers showed increased ramus heights and bigonial widths, in other hand, the gonial angles decreased. This study also found that there was highly correlation among ramus height, gonial angles, and bigonial widths. Conclusion: the bone remodeling occurred on inferior and posterior border of mandibular angle in bruxism patient, indicated by the form and size differences between bruxers (phasic bruxism, tonic bruxism, and mixed bruxism) with non-bruxers, which shown by panoramic radiograph.

Keywords: bruxism, ramus height, gonial angle, bigonial width

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222 The Importance of a Coating and Architecture of the Surface Metal on the Survival of Uncemented Total Knee Arthroplasty

Authors: Raymond Puijk, Rachid Rassir, Inger N. Sierevelt, Anneke Spekenbrink-Sporen, Bart G. C. W. Pijls, Rob G. H. H. Nelissen, Peter A. Nolte

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Background: Among uncemented total knee arthroplasty (TKA), a wide variety of metal surface structures (MSS) and coatings exist to enhance implants' biological properties (i.e., bone ingrowth). This study explores the variety of MSS-coating combinations and compares their mid-long-term survivorships with cemented TKAs, by using data from the Dutch Arthroplasty Register. Methods: A total of 235,500 cemented and 11,132 uncemented primary TKAs with a median follow-up of 5.1 years were included. MSS-coating combinations were (1) Porous-uncoated (n=8986), (2) Beaded-hydroxyapatite (HA)(n=1093), (3) Matte-uncoated (n=846), (4) Matte-Titanium-nitride (TiN) (n=207). Five- and 10-year revision-free survival for all-cause revisions, and aseptic loosening of the tibial component, were calculated and compared by using Kaplan-Meier, Log-rank tests, and multivariable Cox proportional hazard regression analyses. Results: Ten-year survival rates with all-cause revisions as an endpoint, were 94.2% for cement, and 94.7%, 96.3%, 92.1%, and 79.0% for porous-uncoated, beaded-HA, matte-uncoated, and Matte-TiN, respectively (p<0.01). Rates for aseptic loosening were 98.8% for cemented, and 98.7%, 99.8%, 97.2%, and 94.9% for the uncemented, respectively (p<0.01).The beaded-HA implants were half the risk for an all-cause revision compared to cemented implants (p<0.01). Matte-uncoated and matte-TiN implants were at more risk of an all-cause revision than cemented implants (p=0.01, p<0.01). Proportions of revisions for aseptic loosening were comparable among most groups. Conclusion: Based on Dutch registry data, four main MSS-coating combinations among uncemented TKAs were found. survivorships for all-cause revisions and aseptic release differed widely between groups. Beaded-HA and porous-uncoated implants had the best survival rates among the uncemented TKAs and were non-inferior to the cemented TKAs.

Keywords: total knee arthroplasty, cement, uncemented, cementless;, metal surface structure, coating

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221 The Impact of Pediatric Cares, Infections and Vaccines on Community and People’s Lives

Authors: Nashed Atef Nashed Farag

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Introduction: Reporting adverse events following vaccination remains a challenge. WHO has mandated pharmacovigilance centers around the world to submit Adverse Events Following Immunization (AEFI) reports from different countries to a large electronic database of adverse drug event data called Vigibase. Despite sufficient information about AEFIs on Vigibase, they are not available to the general public. However, the WHO has an alternative website called VigiAccess, an open-access website that serves as an archive for reported adverse reactions and AEFIs. The aim of the study was to establish a reporting model for a number of commonly used vaccines in the VigiAccess system. Methods: On February 5, 2018, VigiAccess comprehensively searched for ESSI reports on the measles vaccine, oral polio vaccine (OPV), yellow fever vaccine, pneumococcal vaccine, rotavirus vaccine, meningococcal vaccine, tetanus vaccine, and tuberculosis vaccine (BCG). These are reports from all pharmacovigilance centers around the world since they joined the WHO Drug Monitoring Program. Results: After an extensive search, VigiAccess found 9,062 AEFIs from the measles vaccine, 185,829 AEFIs from the OPV vaccine, 24,577 AEFIs from the yellow fever vaccine, 317,208 AEFIs from the pneumococcal vaccine, 73,513 AEFIs from the rotavirus vaccine, and 145,447 AEFIs from meningococcal cal vaccine, 22,781 EI FI vaccines against tetanus and 35,556 BCG vaccines against AEFI. Conclusion: The study found that among the eight vaccines examined, pneumococcal vaccines were associated with the highest number of AEFIs, while measles vaccines were associated with the fewest AEFIs.

Keywords: surgical approach, anatomical approach, decompression, axillary nerve, quadrangular space adverse events following immunization, cameroon, COVID-19 vaccines, nOPV, ODK vaccines, adverse reactions, VigiAccess, adverse event reporting

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220 Improved Benzene Selctivity for Methane Dehydroaromatization via Modifying the Zeolitic Pores by Dual Templating Approach

Authors: Deepti Mishra, K. K Pant, Xiu Song Zhao, Muxina Konarova

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Catalytic transformation of simplest hydrocarbon methane into benzene and valuable chemicals over Mo/HZSM-5 has a great economic potential, however, it suffers serious hurdles due to the blockage in the micropores because of extensive coking at high temperature during methane dehydroaromatization (MDA). Under such conditions, it necessitates the design of micro/mesoporous ZSM-5, which has the advantages viz. uniform dispersibility of MoOx species, consequently the formation of active Mo sites in the micro/mesoporous channel and lower carbon deposition because of improved mass transfer rate within the hierarchical pores. In this study, we report a unique strategy to control the porous structures of ZSM-5 through a dual templating approach, utilizing C6 and C12 -surfactants as porogen. DFT studies were carried out to correlate the ZSM-5 framework development using the C6 and C12 surfactants with structure directing agent. The structural and morphological parameters of the synthesized ZSM-5 were explored in detail to determine the crystallinity, porosity, Si/Al ratio, particle shape, size, and acidic strength, which were further correlated with the physicochemical and catalytic properties of Mo modified HZSM-5 catalysts. After Mo incorporation, all the catalysts were tested for MDA reaction. From the activity test, it was observed that C6 surfactant-modified hierarchically porous Mo/HZSM-5(H) showed the highest benzene formation rate (1.5 μmol/gcat. s) and longer catalytic stability up to 270 min of reaction as compared to the conventional microporous Mo/HZSM-5(C). In contrary, C12 surfactant modified Mo/HZSM-5(D) is inferior towards MDA reaction (benzene formation rate: 0.5 μmol/gcat. s). We ascribed that the difference in MDA activity could be due to the hierarchically interconnected meso/microporous feature of Mo/HZSM-5(H) that precludes secondary reaction of coking from benzene and hence contributing substantial stability towards MDA reaction.

Keywords: hierarchical pores, Mo/HZSM-5, methane dehydroaromatization, coke deposition

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219 Investigating Clarity Ultrasound Transperineal Ultrasound Imaging as a Method of Localising the Prostate, Compared to Cone Beam Computed Tomography with Fiducials

Authors: Harley Stephens

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Although fiducial marker insertion is regarded as the ‘gold standard’ in terms of image guided radiotherapy (IGRT), its application must be considered carefully as the procedure can be invasive, time-consuming, and reliant on consultant expertise. Precision of the fiducials is dependent on these markers remaining in the same location and on the prostate not changing shape during the course treatment. To facilitate the acquirement of non-ionising IGRT and intra-fractional prostate tracking, Clarity TPUS was developed as an alternative imaging system. The main benefits of Clarity TPUS are that it is non-invasive, non-ionising and cost-effective. Other studies have compared fiducials to transabdominal ultrasound, which has since been proven to not be as accurate as trans-perineal imaging, as included in this study. CBCT fiducial translations and Clarity TPUS translations for 120 images as part of the PACE-C prostate SABR trial were retrospectively evaluated by three imaging specialists. Differences were analysed using correlation and Bland-Altman plots. Inter-observer matches agreed within 3mm 88.3 % of the time in left/right direction, 86.7 % of the time in in superior/inferior direction, and 91.7% of the time in ant/post direction. They agreed within 5mm more than 98.3 % of the time in all directions. The intra-class correlation co-efficient was calculated for each direction to show agreement between imaging specialist for inter-observer variability. Each was 0.95 or above, with 1 indicating perfect reliability. Agreement between observers was slightly higher for CBCT and fiducials at 98.7% agreement within 5 mm, compared to clarity TPUS where 96.7% agreement was seen within 5mm. Clarity TPUS has the benefit of no additional dose and intra-fractional monitoring, and results show a good correlation between the different modalities. Inter-observer variability is to be considered, and further research with a larger population would be of benefit.

Keywords: oncology, prostate radiotherapy, image guided radiotherapy, IGRT

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218 The High Strength Biocompatible Wires of Commercially Pure Titanium

Authors: J. Palán, M. Zemko

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COMTES FHT has been active in a field of research and development of high-strength wires for quite some time. The main material was pure titanium. The primary goal of this effort is to develop a continuous production process for ultrafine and nanostructured materials with the aid of severe plastic deformation (SPD). This article outlines mechanical and microstructural properties of the materials and the options available for testing the components made of these materials. Ti Grade 2 and Grade 4 wires are the key products of interest. Ti Grade 2 with ultrafine to nano-sized grain shows ultimate strength of up to 1050 MPa. Ti Grade 4 reaches ultimate strengths of up to 1250 MPa. These values are twice or three times as higher as those found in the unprocessed material. For those fields of medicine where implantable metallic materials are used, bulk ultrafine to nanostructured titanium is available. It is manufactured by SPD techniques. These processes leave the chemical properties of the initial material unchanged but markedly improve its final mechanical properties, in particular, the strength. Ultrafine to nanostructured titanium retains all the significant and, from the biological viewpoint, desirable properties that are important for its use in medicine, i.e. those properties which made pure titanium the preferred material also for dental implants.

Keywords: CONFORM, ECAP, rotary swaging, titanium

Procedia PDF Downloads 219
217 Reconstruction of Womanhood: Narratives of Unmarried Basotho Women in Lesotho

Authors: Neo Mohlabane

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-- Feminists across various contexts have written extensively on the subject of ‘Woman.’ Recently the question of difference; to account for the cultural, ethnic, and racial diversity among women themselves has become a highly contested issue in feminist theories. Tensions have ensued where ‘western feminisms’ have been criticized for bias that is embedded in the objectification of ‘different’ women often regarded as ‘other’; traditional, therefore inferior. Thus, it is argued that womanhood; a set of socially defined attributes appropriate for women, holds different meanings depending on the context in which it is defined. Drawing on decolonial feminist approaches, this qualitative study explored the constructions of ‘womanhood’ from the perspective of unmarried Basotho women in Lesotho, where womanhood is predominantly defined in marital terms. Through the narrated life-stories of twenty unmarried Basotho women, the study revealed that as opposed to the ‘traditional’ definition that accounts for a single attribute woman as ‘wife,’ unmarried Basotho women defined ‘womanhood’ in different ways that deconstructed fixed gendered categories. The women drew meaning from their past personal experiences of childhood to construct and re-construct womanhood in adulthood. By transforming their embodied experiences of hardship and sorrow into valuable constructs with which they self-evaluated as resilient and perseverant, the women constructed a base for self-affirmation as woman. In addition, the women anchored their constructions and reconstructions of woman by transforming the meanings attached to the realms of respectability, sexuality and motherhood. Thus, to the question; what is a Woman? In part, the study concluded that there is no such thing as a ‘unitary’ definition of womanhood, instead Mosotho womanhood has always been and will always be in a state of flux; bearing multiplicity and complexity. This study highlights the need to exercise caution when using western concepts to understand the experiences of women in local African contexts. In order to decolonize feminist scholarship, African feminisms need to re-construct conceptual and theoretical frameworks appropriate for analyzing and understanding gender issues in African contexts.

Keywords: decoloniality, feminism, Lesotho, womanhood

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216 Malignant Idiopathic Intracranial Hypertension Revealed a Hidden Primary Spinal Leptomeningeal Medulloblastoma

Authors: Naim Izet Kajtazi

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Context: Frequently, the cause of raised intracranial pressure remains unresolved and rarely is related to spinal tumors, moreover less to spinal medulloblastoma without primary brain focus. Process: An 18-year-old woman had a 3-month history of headaches and impaired vision. Neurological examination revealed bilateral sixth cranial nerve palsies with bilateral papilloedema of grade III. No focal brain or spine lesion was found on imaging. Consecutive lumbar punctures showed high opening pressure and subsequent increasing protein level. The meningeal biopsy was negative. At one point, she developed an increasing headache, vomiting and back pain. Spine MRI showed diffuse nodular leptomeningeal enhancement with the largest nodule at T6–T7. Malignant cells were detected in cerebrospinal fluid. She underwent laminectomy with excisional biopsy, and pathology showed medulloblastoma WHO grade IV. Outcome: She was treated with chemotherapy and craniospinal irradiation and made a good recovery. Relevance: Primary spinal leptomeningeal medulloblastoma is extremely rare, especially without primary brain focus, but may cause increased intracranial pressure, even in the early microscopic phases, and it should be considered in the differential diagnosis if conventional and aggressive treatment of idiopathic intracranial hypertension fails. We assume that arachnoiditis from tumor seeding caused increased intracranial pressure. Appropriate neurosurgical intervention and surgical biopsy are mandated if a suspicious lesion is detected. Consider proper rescreening of the whole neuroaxis in refractory cases of intracranial hypertension.

Keywords: CNS infection, IIH, headache, primary spinal leptomeningeal medulloblastoma

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215 Injection of Bradykinin in Femoral Artery Elicits Cardiorespiratory Reflexes Involving Perivascular Afferents in Rat Models

Authors: Sanjeev K. Singh, Maloy B. Mandal, Revand R.

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The physiology of baroreceptors and chemoreceptors present in large blood vessels of the heart is well known in regulation of cardiorespiratory functions. Since large blood vessels and peripheral blood vessels are of same mesodermal origin, therefore, involvement of the latter in regulation of cardiorespiratory system is expected. Role of perivascular nerves in mediating cardiorespiratory alterations produced after intra-arterial injection of a nociceptive agent (bradykinin) was examined in urethane anesthetized male rats. Respiratory frequency, blood pressure, and heart rate were recorded for 30 min after the retrograde injection of bradykinin/saline in the femoral artery. In addition, paw edema was determined and water content was expressed as percentage of wet weight. Injection of bradykinin produced immediate tachypnoeic, hypotensive and bradycardiac responses of shorter latency (5-8 s) favoring the neural mechanisms involved in it. Injection of equi-volume of saline did not produce any responses and served as time matched control. Paw edema was observed in the ipsilateral hind limb. Pretreatment with diclofenac sodium significantly attenuated the bradykinin-induced responses and also blocked the paw edema. Ipsilateral femoral and sciatic nerve sectioning attenuated bradykinin-induced responses significantly indicating the origin of responses from the local vascular bed. Administration of bradykinin in the segment of an artery produced reflex cardiorespiratory changes by stimulating the perivascular nociceptors involving prostaglandins. This is a novel study exhibiting the role of peripheral blood vessels in regulation of cardiorespiratory system.

Keywords: vasosensory reflex, cardiorespiratory changes, nociceptive agent, bradykinin, VR1 receptors

Procedia PDF Downloads 119
214 Bilingual Experience Influences Different Components of Cognitive Control: Evidence from fMRI Study

Authors: Xun Sun, Le Li, Ce Mo, Lei Mo, Ruiming Wang, Guosheng Ding

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Cognitive control plays a central role in information processing, which is comprised of various components including response suppression and inhibitory control. Response suppression is considered to inhibit the irrelevant response during the cognitive process; while inhibitory control to inhibit the irrelevant stimulus in the process of cognition. Both of them undertake distinct functions for the cognitive control, so as to enhance the performances in behavior. Among numerous factors on cognitive control, bilingual experience is a substantial and indispensible factor. It has been reported that bilingual experience can influence the neural activity of cognitive control as whole. However, it still remains unknown how the neural influences specifically present on the components of cognitive control imposed by bilingualism. In order to explore the further issue, the study applied fMRI, used anti-saccade paradigm and compared the cerebral activations between high and low proficient Chinese-English bilinguals. Meanwhile, the study provided experimental evidence for the brain plasticity of language, and offered necessary bases on the interplay between language and cognitive control. The results showed that response suppression recruited the middle frontal gyrus (MFG) in low proficient Chinese-English bilinguals, but the inferior patrietal lobe in high proficient Chinese-English bilinguals. Inhibitory control engaged the superior temporal gyrus (STG) and middle temporal gyrus (MTG) in low proficient Chinese-English bilinguals, yet the right insula cortex was more active in high proficient Chinese-English bilinguals during the process. These findings illustrate insights that bilingual experience has neural influences on different components of cognitive control. Compared with low proficient bilinguals, high proficient bilinguals turn to activate advanced neural areas for the processing of cognitive control. In addition, with the acquisition and accumulation of language, language experience takes effect on the brain plasticity and changes the neural basis of cognitive control.

Keywords: bilingual experience, cognitive control, inhibition control, response suppression

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213 Biological Activity of Mesenchymal Stem Cells in the Surface of Implants

Authors: Saimir Heta, Ilma Robo, Dhimiter Papakozma, Eduart Kapaj, Vera Ostreni

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Introduction: The biocompatible materials applied to the implant surfaces are the target of recent literature studies. Methodologies: Modification of implant surfaces in different ways such as application of additional ions, surface microstructure change, surface or laser ultrasound alteration, or application of various substances such as recombinant proteins are among the most affected by articles published in the literature. The study is of review type with the main aim of finding the different ways that the mesenchymal cell reaction to these materials is, according to the literature, in the same percentage positive to the osteointegration process. Results: It is emphasized in the literature that implant success as a key evaluation key has more to implement implant treatment protocol ranging from dental health amenity and subsequent of the choice of implant type depending on the alveolar shape of the ridge level. Conclusions: Osteointegration is a procedure that should initially be physiologically independent of the type of implant pile material. With this physiological process, it can not "boast" for implant success or implantation depending on the brand of the selected implant, as the breadth of synthetic or natural materials that promote osteointegration is relatively large.

Keywords: mesenchymal cells, implants, review, biocompatible materials

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212 Late Presentation of Pseudophakic Macula Edema from Oral Kinase Inhibitors: A Case and Literature Review

Authors: Christolyn Raj, Lewis Levitz

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Introduction: Two cases of late presentation ( > five years ) of bilateral pseudophakic macula edema related to oral tyrosine kinase inhibitors are described. These cases are the first of their type in the published literature. A review of ocular inflammatory complications of tyrosine kinase inhibitors in the current literature is explored. Case Presentations(s): Case 1 is an 83-year-old female who has been stable on Ibrutinib (Imbruvica ®) for chronic lymphocytic leukemia (CLL). She presented with bilateral blurred vision from severe cystoid macula edema seven years following routine cataract surgery. She was treated with intravitreal steroids with complete resolution without relapse. Case 2 is a 76-year-old female who was on therapy for polycythemia vera with Ruxolitinib (Jakafi®). She presented with bilateral blurred vision from mild cystoid macula edema six years following routine cataract surgery. She responded well to topical steroids without relapse. In both cases, oral tyrosine kinase inhibitor agents were presumed to be the underlying cause and were ceased. Over the last five years, there have been increasing reports in the literature of the inflammatory effects of tyrosine kinase inhibitors on the retina, uvea and optic nerve. Conclusion: Late presentation of pseudophakic macula edema following routine cataract surgery is rare. Such presentations should prompt investigation of the chronic use of systemic medications, especially oral kinase inhibitors. Patients who must remain on these agents require ongoing ophthalmologic assessment in view of their long-term inflammatory side effects.

Keywords: macula edema, oral kinase inhibitors, retinal toxicity, pseudo-phakia

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