bluuebunny/crossref_metadata_2025 huggingface dataset:
The Use of Stellate Ganglion Block in the Treatment of Panic/Anxiety Symptoms with Combat‐Related Post‐Traumatic Stress Disorder; Preliminary Results of Long‐Term Follow‐Up: A Case Series
Authors: Mulvaney Sean W. , McLean Brian , De Leeuw Jason
Published: April 2010

Objective:  Report the successful use of stellate ganglion blocks (SGBs) in two patients experiencing symptoms of post‐traumatic stress disorder (PTSD).

Background:  Successful treatment of PTSD with SGB has been reported previously. A similar protocol was employed at Walter Reed Army Medical Center to treat two soldiers with chronic, combat‐related PTSD.

Methods:  Both patients received a SGB on the right side at C6 level. The patients' PTSD symptoms were evaluated using the Post‐traumatic Stress Disorder Checklist (PCL). The PCL was administered the day prior to treatment, to establish a baseline, and the day after treatment. The PCL was also utilized during follow‐up visits to quantify the patient's symptomotology. The SGB was administered by an anesthesiologist and the psychometric tests administered by a psychologist.

Results:  Both patients experienced immediate, significant and durable relief as measured by the PCL (score minimum 17, maximum 85). In both instances, the pre‐treatment score suggested a PTSD diagnosis whereas the post‐treatment scores did not. One patient requested repeat treatment after 3 months, and the post‐treatment score remained below the PTSD cutoff after 7 additional months of follow‐up. Both patients discontinued all antidepressant and antipsychotic medications while maintaining their improved PCL score.

Conclusion:  Selective blockade of the right stellate ganglion at C6 level is a safe and minimally invasive procedure that may provide durable relief from PTSD symptoms, allowing the safe discontinuation of psychiatric medications. ▪
Judging a Book by Its Cover: Seizures versus Its Mimickers
Authors: Sirven Joseph I.
Published: April 2010

Interrater Reliability of EEG-Video Monitoring. Benbadis SR, LaFrance WC Jr, Papandonatos GD, Korabathina K, Lin K, Kraemer HC, NES Treatment Workshop. Neurology 2009;73(11):843–846. OBJECTIVE: The diagnosis of psychogenic nonepileptic seizures (PNES) can be challenging. In the absence of a gold standard to verify the reliability of the diagnosis by EEG-video, we sought to assess the interrater reliability of the diagnosis using EEG-video recordings. METHODS: Patient samples consisted of 22 unselected consecutive patients who underwent EEG-video monitoring and had at least an episode recorded. Other test results and histories were not provided because the goal was to assess the reliability of the EEG-video. Data were sent to 22 reviewers, who were board-certified neurologists and practicing epileptologists at epilepsy centers. Choices were: 1) PNES, 2) epilepsy, and 3) nonepileptic but not psychogenic (“physiologic”) events. Interrater agreement was measured using a κ coefficient for each diagnostic category. We used generalized κ coefficients, which measure the overall level of between-method agreement beyond that which can be ascribed to chance. We also report category-specific κ values. RESULTS: For the diagnosis of PNES, there was moderate agreement ( κ = 0.57, 95% confidence interval [CI] 0.39–0.76). For the diagnosis of epilepsy, there was substantial agreement ( κ = 0.69, 95% CI 0.51–0.86). For physiologic nonepileptic episodes, the agreement was low ( κ = 0.09, 95% CI 0.02–0.27). The overall κ statistic across all three diagnostic categories was moderate at 0.56 (95% CI 0.41–0.73). CONCLUSIONS: Interrater reliability for the diagnosis of PNES by EEG-video monitoring was only moderate. Although this may be related to limitations of the study (diagnosis based on EEG-video alone, artificial nature of the forced choice paradigm, single episode), it highlights the difficulties and subjective components inherent to this diagnosis.
Epilepsy Surgeons, Rather than Vascular Neurosurgeons, Should Operate on Cavernous Malformations that Cause Seizures—A Modest Proposal
Authors: Schwartz Theodore H.
Published: April 2010

Electrocorticography-Guided Resection of Temporal Cavernoma: Is Electrocorticography Warranted and Does It Alter the Surgical Approach? Van Gompel JJ, Rubio J, Cascino GD, Worrell GA, Meyer FB. J Neurosurg 2009;110(6):1179–1185. OBJECT: Cavernous hemangiomas associated with epilepsy present an interesting surgical dilemma in terms of whether one should perform a pure lesionectomy or tailored resection, especially in the temporal lobe given the potential for cognitive damage. This decision is often guided by electrocorticography (ECoG), despite the lack of data regarding its value in cavernoma surgery. The purpose of the present study was several-fold: first, to determine the epilepsy outcome following resection of cavernomas in all brain regions; second, to evaluate the usefulness of ECoG in guiding surgical decision making; and third, to determine the optimum surgical approach for temporal lobe cavernomas. METHODS: The authors identified from their surgical database 173 patients who had undergone resection of cavernomas. One hundred two of these patients presented with epilepsy, and 61 harbored temporal lobe cavernomas. Preoperatively, all patients were initially evaluated by an epileptologist. The mean follow-up was 37 months. RESULTS: Regardless of the cavernoma location, surgery resulted in an excellent seizure control rate: Engel Class I outcome in 88% of patients at 2 years postoperatively. Of 61 patients with temporal lobe cavernomas, the mesial structures were involved in 35. Among the patients with temporal lobe cavernomas, those who underwent ECoG typically had a more extensive parenchymal resection rather than a lesionectomy ( p < 0.0001). The use of ECoG in cases of temporal lobe cavernomas resulted in a superior seizure-free outcome: 79% (29 patients) versus 91% (23 patients) of patients at 6-month postresection, 77% (22 patients) versus 90% (20 patients) at 1 year, and 79% (14 patients) versus 83% (18 patients) at 2 years without ECoG versus with ECoG, respectively. CONCLUSIONS: The surgical removal of cavernomas most often leads to an excellent epilepsy outcome. In cases of temporal lobe cavernomas, the more extensive the ECoG-guided resection, the better the seizure outcome. In addition to upholding the concept of kindling, the data in this study support the use of ECoG in temporal lobe cavernoma surgery in patients presenting with epilepsy.
The utility of patient characteristics in predicting severe ADAMTS13 deficiency and response to plasma exchange
Authors: Bentley Melissa J. , Lehman Chris M. , Blaylock Robert C. , Wilson Andrew R. , Rodgers George M.
Published: April 2010

BACKGROUND: Idiopathic thrombotic thrombocytopenic purpura (TTP) is a rare form of thrombotic microangiopathy (TMA) characterized by extreme deficiency of ADAMTS13, an enzyme responsible for cleavage of von Willebrand factor. Plasma exchange therapy is the cornerstone of current treatment and is ineffective for most other forms of TMA. The availability of ADAMTS13 testing has improved diagnostic accuracy and appropriate selection of patients who are most likely to respond to plasma exchange.

STUDY DESIGN AND METHODS: We performed a retrospective chart review of 110 cases of clinically suspected TTP with ADAMTS13 test results from 2005 to the present. The primary goal was to identify presenting clinical and/or laboratory features of patients with ADAMTS13 deficiency that would prove useful in increasing the likelihood of, or excluding the possibility of, TTP. In addition, patient outcomes including alternative diagnoses and response to plasma exchange were reviewed.

RESULTS: Significant correlations for severe ADAMTS13 deficiency were seen for four of the observed variables: indirect bilirubin, reticulocyte percentage, creatinine, and platelet count; a fifth variable, D‐dimer, just missed significance but performed well in subsequent analysis. Receiver operator characteristics curves for individual variables had area under the curve (AUC) values ranging from 0.75 to 0.85; a combined model had an AUC of 0.98. In addition, we constructed tree models both for clinical use as a diagnostic algorithm and for recursive partitioning to help establish cutoff points for categorical variables in developing an easy‐to‐use clinical prediction score.

CONCLUSION: These results may enable the rapid exclusion and accurate diagnosis of TTP using readily available laboratory data.
Morality and Nuclear Energy: Perceptions of Risks and Benefits, Personal Norms, and Willingness to Take Action Related to Nuclear Energy
Authors: De Groot Judith I. M. , Steg Linda
Published: April 2010

We examined factors underlying people's willingness to take action in favor of or against nuclear energy from a moral perspective. We conducted a questionnaire study among a sample of the Dutch population (N = 123). As expected, perceptions of risks and benefits were related to personal norms (PN), that is, feelings of moral obligation toward taking action in favor of or against nuclear energy. In turn, PN predicted willingness to take action. Furthermore, PN mediated the relationships between perceptions of risk and benefits and willingness to take action. In line with our hypothesis, beliefs about the risks and benefits of nuclear energy were less powerful in explaining PN for supporters compared to PN of opponents. Also, beliefs on risks and benefits and PN explained significantly more variance in willingness to take action of opponents than of supporters. Our results suggest that a moral framework is useful to explain willingness to take action in favor of and against nuclear energy, and that people are more likely to protest in favor of or against nuclear energy when PN are strong.
Dielectric Breakdown of Thinned BaO–Al2O3–B2O3–SiO2 Glass
Authors: Lee Hoikwan , Smith Nicholas J. , Pantano Carlo G. , Furman Eugene , Lanagan Michael T.
Published: April 2010

The dielectric breakdown behavior of alkali‐free glass was determined as a function of thickness and surface roughness. The thickness of commercially available glass (as‐received thickness=50 μm) was reduced to a range of thicknesses between 47 and 5 μm by chemical etching. The RMS surface roughness of the as‐received glass was in the range of 0.14–0.47 nm, and the surface roughness increased to up 10 nm after etching; it was also found that agitating the etching solution by ultrasound reduced the overall surface roughness. The evaluation of these samples revealed that the dielectric breakdown strength increased as the thickness decreased. However, the Weibull modulus representing the distribution of dielectric strengths showed a dependence on the surface roughness of the etched glass. A power law dependence, EB∝d−n, where d is the glass thickness and n=0.14 and 0.86, has been found to fit the data in the respective thickness ranges of 5–20 and 25–50 μm. Self‐healing behavior, which allows the dielectric to continue to support a high electric field after breakdown, was found to be more likely as the dielectric layer thickness decreased. The susceptibility to self healing was correlated with the stored electrostatic energy and latent heat of vaporization for the gold electrode material.
R Curves from Compliance and Optical Crack‐Length Measurements
Authors: Fünfschilling Stefan , Fett Theo , Oberacker Rainer , Hoffmann Michael J. , Özcoban Hüseyin , Jelitto Hans , Schneider Gerold A. , Kruzic Jamie J.
Published: April 2010

High‐toughness, high‐strength ceramics, such as self‐reinforced Si3N4, derive their superior mechanical properties from microstructures that promote very steeply rising R curves. Furthermore, accurately evaluating the R curve at the earliest stages of crack growth is necessary for correctly understanding, and predicting, the mechanical behavior. Compliance‐ and optical‐based methods for evaluating the crack length, and R curve, at the early stages of crack extension from machined notches are discussed. The earliest stages of crack growth are missed during measurements of the crack length by optical observations due to the nonuniform extension of the crack front during initial crack extension. The most accurate method of evaluating the crack length over all amounts of crack extension is from compliance measurements analyzed by solving a system of equations that incorporates both the effects of the notch and the changes in compliance with the development of bridging tractions. Such a method is computationally expensive, but for materials with steeply rising R curves, simply applying the linear‐elastic compliance evaluation, which only accounts for the notch, but not the bridging tractions, gives a result within about 1%. At longer crack extensions, such an approximation method will incur significant errors; however, at this stage, optical measurements can provide accurate assessments of crack length and enable an accurate assessment of the R curve.
Syntheses and Crystallization of Mineralogically Relevant Chalcogenide Glasses
Authors: Tao Hui , Pring Allan , Xia Fang , Brugger Joël , Zhao Jing , Wang Shufen , Chen Guorong
Published: April 2010

Mineralogically relevant chalcogenide glasses with the composition CuxBi5Ag5 (As0.33S0.335Se0.335)90−x (x=2, 6, and 10, in mol%) that approximate the chemistry of some unusual sulfide mineral assemblages were synthesized. The differential thermal analyses revealed that the glass transition temperature (Tg), onset crystallization temperature (Tc), and peak temperature of crystallization (Tp) first increase significantly with an increasing Cu content from 2 to 6 mol%, and then remain almost constant when the Cu content further increases to 10 mol%; the glass thermal stability also increases with an increasing Cu content. Both dry annealing and hydrothermal treatments were carried out in the temperature range of 207°–331°C for up to 96 h. X‐ray diffraction analyses on annealed samples showed that dry annealing and hydrothermal treatments produced different phase assemblages. Dry annealing produced crystallized phases AgBiSe2 (bohdanowiczite), Cu2Se (berzelianite), Ag3AsS3 (xanconthite), Cu3AsS4 (luzonite), AgBi3S5, and As4CuS9, while hydrothermal treatments produced phases AgBiSe2 (bohdanowiczite), AgBi3S5, and AgAsSe2. This case study presents a new way for studying the formation and alteration of minerals in nature.
Synthesis and Characterization of Silver Nanoparticles and Titanium Oxide Nanofibers: Toward Multifibrous Nanocomposites
Authors: Ochanda Fredrick O. , Barnett Matthew R.
Published: April 2010

A new method was investigated to produce new multiscale fibrous nanocomposites comprised of titanium oxide (TiO2) nanofibers and silver (Ag) nanoparticles (NPs). The process involved electrospinning TiO2 precursor solution containing colloidal solution of Ag NPs, and organic solvent (dimethyl‐n′n‐formamide) to fabricate a porous, nonwoven, free‐standing nanofiber mesh. Postprocess heating of the electrospun nanofibers entailed calcination in air environment at 500°C for 3 h. Microemulsion processing was used to generate NPs of Ag in a monodispersed distribution throughout the colloidal solution. X‐ray diffraction data were consistent with the anatase phase of TiO2, while transmission electron microscopy and hydrogen desorption measurements revealed a very porous microstructure. It was demonstrated that NP colloidal stability is solvent dependent. It is anticipated that incorporation of metal particles in nanofibers will lead to enhanced photocurrent generation, when used in functional devices.
Probing parentage in parasitic birds: an evaluation of methods to detect conspecific brood parasitism using goldeneyesBucephala islandicaandBl. clangulaas a test case
Authors: Eadie John M. , Smith James N. M. , Zadworny David , Kühnlein Urs , Cheng Kim
Published: April 2010

Conspecific brood parasitism (CBP) occurs in over 200 species of birds. Efforts to detect CBP have relied on either observational criteria, or more recently, on molecular methods. While molecular approaches are powerful, they are expensive, time consuming and may prove prohibitive for studies requiring estimates of CBP over large spatial and temporal scales involving hundreds of nests. We evaluated a series of observational methods that have been applied in previous studies to detect CBP, using two species of cavity‐nesting ducks, the Barrow's goldeneyeBucephala islandicaand common goldeneyeB. clangula, as test species. We first describe a method based on differences in egg morphology and find it to be a reliable method to detect CBP in both species in British Columbia, Canada. The application of recursive partitioning analysis was especially effective in classifying parasitized and non‐parasitized nests using differences in egg morphology. We then evaluated five additional observational criteria that have been used previously in several studies to detect CBP in birds. We show that considerable redundancy exists among all criteria, as expected, but no single method is effective at detecting all suspected cases of CBP. Subsets of criteria (2 or more eggs/d, eggs laid 2 or more days after incubation, and clutch sizes exceeding 12 eggs) were successful, in combination, in detecting 75% of parasitized nests for goldeneyes. Finally, we suggest that ecological and evolutionary analyses of the dynamics of CBP will require estimates of the frequency of the parasitic tactic in the population (rather than just the proportion of parasitized nests) and we provide a simple method to obtain such an estimate. Although our data are specific to goldeneyes, the techniques we used should have broad application to other studies of CBP.
Geographic variation in the plumage coloration of willow flycatchers Empidonax traillii
Authors: Paxton Eben H. , Sogge Mark K. , Koronkiewicz Thomas J. , McLeod Mary Anne , Theimer Tad C.
Published: April 2010

The ability to identify distinct taxonomic groups of birds (species, subspecies, geographic races) can advance ecological research efforts by determining connectivity between the non‐breeding and breeding grounds for migrant species, identifying the origin of migrants, and helping to refine boundaries between subspecies or geographic races. Multiple methods are available to identify taxonomic groups (e.g., morphology, genetics), and one that has played an important role for avian taxonomists over the years is plumage coloration. With the advent of electronic devices that can quickly and accurately quantify plumage coloration, the potential of using coloration as an identifier for distinct taxonomic groups, even when differences are subtle, becomes possible. In this study, we evaluated the degree to which plumage coloration differs among the four subspecies of the willow flycatcher Empidonax traillii, evaluated sources of variation, and considered the utility of plumage coloration to assign subspecies membership for individuals of unknown origin. We used a colorimeter to measure plumage coloration of 374 adult willow flycatchers from 29 locations across their breeding range in 2004 and 2005. We found strong statistical differences among the mean plumage coloration values of the four subspecies; however, while individuals tended to group around their respective subspecies’ mean color value, the dispersion of individuals around such means overlapped. Mean color values for each breeding site of the three western subspecies clustered together, but the eastern subspecies’ color values were dispersed among the other subspecies, rather than distinctly clustered. Additionally, sites along boundaries showed evidence of intergradation and intermediate coloration patterns. We evaluated the predictive power of colorimeter measurements on flycatchers by constructing a canonical discriminant model to predict subspecies origin of migrants passing through the southwestern U.S. Considering only western subspecies, we found that individuals can be assigned with reasonable certainty. Applying the model to migrants sampled along the Colorado River in Mexico and the U.S. suggests different migration patterns for the three western subspecies. We believe that the use of plumage coloration, as measured by electronic devices, can provide a powerful tool to look at ecological questions in a wide range of avian species.
Ant‐following and the prevalence of blood parasites in birds of African rainforests
Authors: Peters Marcell K.
Published: April 2010

Blood parasites are widespread in birds, several are pathogenic and may affect the fitness of their hosts, and their evolution. By reanalyzing recently published data I show that parts of the variation in prevalences of parasites in the blood of African rainforest birds and the occurrence of similar or same parasite haplotypes in rather unrelated birds are well understood when considering the ecological aspects of foraging of some of these birds. Specialized ant‐following birds, which regularly follow the massive swarm raids of army ants and feed on insects flushed by the ants, have higher prevalences of nematode microfilariae (~10×),Trypanosoma(~10×), andPlasmodiumparasites (~2×) and a much higher probability of infection with multiple parasites than other birds. Moreover, birds regularly attending army ant swarms share identicalTrypanosomahaplotypes and show genetically similar microfilariae haplotypes. I conclude that ant‐following increases the probability of birds to get infected with blood parasites and may facilitate the switch of a parasite species from one host species to another. The costs of higher parasite intensities involved when specializing on following ant swarms may have influenced the evolution of foraging behaviour in birds of African rainforests and may help to explain the relatively low number of specialized ant‐following bird species on the African continent.
Loop migration in adult marsh harriers Circus aeruginosus, as revealed by satellite telemetry
Authors: Klaassen Raymond H. G. , Strandberg Roine , Hake Mikael , Olofsson Patrik , Tøttrup Anders P. , Alerstam Thomas
Published: April 2010

Loop migration among birds is characterized by the spring route lying consistently west or east of the autumn route. The existence of loops has been explained by general wind conditions or seasonal differences in habitat distribution. Loop migration has predominantly been studied at the population level, for example by analysing ring recoveries. Here we study loop migration of individual marsh harriers Circus aeruginosus tracked by satellite telemetry. We show that despite a generally narrow migration corridor the harriers travelled in a distinct clockwise loop through Africa and southern Europe, following more westerly routes in spring than in autumn. We used the Normalized Difference Vegetation Index (NDVI) to identify potential feeding habitat in Africa. Suitable habitat seemed always more abundant along the western route, both in spring and autumn, and no important stopover site was found along the eastern route. Observed routes did thus not coincide with seasonal variation in habitat availability. However, favourable habitat might be more important during spring migration, when the crossing of the Sahara seems more challenging, and thus habitat availability might play an indirect role in the harriers’ route choice. Grid‐based wind data were used to reconstruct general wind patterns, and in qualitative agreement with the observed loop marsh harriers predominantly encountered westerly winds in Europe and easterly winds in Africa, both in autumn and in spring. By correlating tail‐ and crosswinds with forward and perpendicular movement rates, respectively, we show that marsh harriers are partially drifted by wind. Thus, we tentatively conclude that wind rather than habitat seems to have an overriding effect on the shape of the migration routes of marsh harriers. General wind conditions seem to play an important role also in the evolution of narrow migratory loops as demonstrated for individual marsh harriers.
The effects of enamel matrix derivative on the proliferation and differentiation of human mesenchymal stem cells
Authors: Jue Seong‐Suk , Lee Won Young , Kwon Yong‐Dae , Kim Young‐Ran , Pae Ahran , Lee Baeksoo
Published: April 2010

Purpose: This study was designed to investigate the effect of enamel derivative matrix (EMD) on the proliferation, mineralization, and differentiation of human mesenchymal stem cells (hMSCs).

Material and methods: For the proliferation assay, water‐soluble tetrazolium salt‐8 tests were carried out after culturing for 24 and 48 h. For the evaluation of mineralization, Alizarin red S (ARS) tests were performed after 21 days of culturing in an osteogenic medium. In order to investigate some of the bone‐related proteins, namely type I collagen (Col I A2), bone sialoprotein (BSP), and bone γ‐carboxyglutamate (Gla) protein (BGLAP, osteocalcin), real‐time polymerase chain reaction (RT‐PCR) tests were carried out after 2, 3, and 4 weeks of culturing, respectively.

Results: The activity of proliferation and mineralization increased significantly depending on the concentration of EMD (P<0.05). In the control group, the expression of Col I A2 decreased, but EMD enhanced its expression over time and was correlated to the concentration. The amount of expression of BSP in this group increased over time, but EMD strikingly suppressed its expression in the fourth week. As well, the amount of expression of BGLAP increased as the culture duration lengthened in the control group. However, the expression of BGLAP was suppressed in the experimental group with EMD.

Conclusion: Within the limits of this study, EMD enhanced the proliferation of hMSCs. After evaluation with ARS staining, EMD seemed to enhance mineralization, and the RT‐PCR test revealed that EMD promoted early‐stage osteoblast differentiation by enhancing Col I A2 expression, but exerted an inhibitory effect on the mineralization by lowering the gene expression of BSP and BGLAP. Mineralized nodules formed with EMD may be composed of substances other than normal bone. Because most of the organic matrix of bone is type I collagen, which acts as the mineralization site, bone or bone‐like mineralized mass might have been formed in spite of the different components of the non‐collagenous proteins.

To cite this article:
 Jue S‐S, Lee WY, Kwon Y‐D, Kim Y‐R, Pae A, Lee B. The effects of enamel matrix derivative on the proliferation and differentiation of human mesenchymal stem cells. Clin. Oral Impl. Res. 21, 2010; 741–746. doi: 10.1111/j.1600‐0501.2009.01901.x
Biofunctionalization of titanium implants with a biomimetic active peptide (P‐15) promotes early osseointegration
Authors: Lutz R. , Srour S. , Nonhoff J. , Weisel T. , Damien C. J. , Schlegel K. A.
Published: April 2010

Objectives: The early stages of peri‐implant bone formation play an essential role in the osseointegration and long‐term success of dental implants. By incorporating bioactive coatings, this biofunctionalization of implant surfaces may enhance the attachment of the implant to the surrounding bone and stimulate bone regeneration.

Material and methods: To demonstrate faster osseointegration, the surfaces of dental implants were grit‐blasted and acid‐etched. They were then coated with hydroxyapatite (HA) and experimental implants were further coated with a biomimetic active peptide (P‐15) in one of two concentrations. These biofunctionalized samples and controls with no peptide were placed in the forehead region of 12 adult pigs. Six animals were evaluated for a period of 14 or 30 days.

Results: Histomorphometric analysis demonstrated that the implants with the high concentration of P‐15 had significantly higher percentage of bone‐to‐implant contact (BIC) at 14 (P=0.018) and 30 (P=0.015) days compared with the other groups. Both concentrations of P‐15 showed increased peri‐implant bone density compared to the control group at 30 days.

Conclusion: Biofunctionalization of the implant surface with a biomimetic active peptide leads to significantly increased BIC rates at 14 and 30 days and higher peri‐implant bone density at 30 days.

To cite this article:
 Lutz R, Srour S, Nonhoff J, Weisel T, Damien CJ, Schlegel KA. Biofunctionalization of titanium implants with a biomimetic active peptide (P‐15) promotes early osseointegration. Clin. Oral Impl. Res. 21, 2010; 726–734. doi: 10.1111/j.1600‐0501.2009.01904.x
Accuracy of measuring the cortical bone thickness adjacent to dental implants using cone beam computed tomography
Authors: Razavi Touraj , Palmer Richard M. , Davies Jonathan , Wilson Ron , Palmer Paul J.
Published: April 2010

Objective: To assess the accuracy of measuring the cortical bone thickness adjacent to dental implants using two cone beam computed tomography (CBCT) systems.

Material and methods: Ten 4 × 11 mm Astra Tech® implants were placed at varying distances from the cortical bone in two prepared bovine ribs. Both ribs were scanned in a reproducible position using two different CBCT scanners. Ten examiners each carried out four measurements on all 10 implants using the two CBCT systems: vertical distance between the top of the implant and the alveolar crest (IT–AC), and thickness of the cortical bone from the outer surface of the implant threads at 3, 6 and 9 mm from the top of the implant. Ground sections were prepared and bone thickness was measured using a light microscope and a graticule to give a gold standard (GS) measurement.

Results: The examiner's measurements were significantly different between CBCT systems for the vertical and thickness dimensions (P<0.001) while measuring the cortical bone thickness between 0.3 and 3.7 mm. Within that range, i‐CAT NG® measurements were consistently underestimated in comparison with the GS. Accuitomo 3D60 FPD® measurements closely approximated the GS, except when cortical bone thickness was <0.8 mm. The mean percentage errors from the GS at 3, 6 and 9 mm measurement levels were 68%, 28% and 18%, respectively, for i‐CAT NG® and 23%, 5% and 6%, respectively, for Accuitomo 3D60 FPD®.

Conclusions: Within the limitations of this study, it was concluded that i‐CAT NG® (voxel size 0.3) may not produce sufficient resolution of the thin cortical bone adjacent to dental implants and, therefore, the measurements may not be accurate; whereas, Accuitomo 3D60 FPD® (voxel size 0.125) may produce better resolution and more accurate measurement of the thin bone.

To cite this article: Razavi T, Palmer RM, Davies J, Wilson R, Palmer PJ. Accuracy of measuring the cortical bone thickness adjacent to dental implants using cone beam computed tomography. Clin. Oral Impl. Res. 21, 2010; 718–725. doi: 10.1111/j.1600‐0501.2009.01905.x
Effect of six different peri‐implantitis disinfection methods on in vivo human oral biofilm
Authors: Gosau Martin , Hahnel Sebastian , Schwarz Frank , Gerlach Till , Reichert Torsten E. , Bürgers Ralf
Published: April 2010

Objective: The aim of this human in vivo pilot study was to evaluate the efficacy of six antimicrobial agents on the surface decontamination of an oral biofilm attached to titanium implants.

Design: For in vivo biofilm formation, we fixed titanium specimens to individual removable acrylic upper jaw splints (14 specimens in every splint), which were worn by four volunteers overnight for 12 h. The specimens were then treated with different antimicrobial agents for 1 min (Sodium hypochlorite, Hydrogen peroxide 3%, Chlorhexidingluconate 0.2%, Plax, Listerine, citric acid 40%). Afterwards, we quantified the total bacterial load and the viability of adhering bacteria by live or dead cell labelling in combination with fluorescence microscopy.

Results: The total bacterial load on the titanium surfaces was significantly higher after incubation in the control solution phosphate‐buffered saline (PBS) than after disinfection in sodium hypochlorite, hydrogen peroxide, chlorhexidine, Plax, Listerine, and citric acid. Furthermore, a significantly lower ratio between dead and total adhering bacteria (bactericidal effect) was found after incubation in control PBS, Plax mouth rinse, and citric acid than after incubation in sodium hypochlorite, hydrogen peroxide, chlorhexidine, and Listerine.

Conclusions: All tested antiseptics seem to be able to reduce the total amount of microorganisms accumulating on titanium surfaces. Furthermore, sodium hypochlorite, hydrogen peroxide, chlorhexidine, and Listerine showed a significant bactericidal effect against adhering bacteria.

To cite this article:
 Gosau M, Hahnel S, Schwarz F, Gerlach T, Reichert TE, Bürgers R. Effect of six different peri‐implantitis disinfection methods on in vivo human oral biofilm. Clin. Oral Impl. Res. 21, 2010; 866–872. doi: 10.1111/j.1600‐0501.2009.01908.x
Factors influencing resonance frequency analysis assessed by Osstell™mentor during implant tissue integration: II. Implant surface modifications and implant diameter
Authors: Han Jie , Lulic Martina , Lang Niklaus P.
Published: April 2010

Objectives: To monitor the development of the stability of Straumann® tissue‐level implants during the early phases of healing by resonance frequency analysis (RFA) and to determine the influence of implant surface modification and diameter.

Material and methods: A total of twenty‐five 10 mm length implants including 12 SLA RN ∅4.1 mm implants, eight SLActive RN ∅4.1 mm implants and five SLA WN ∅4.8 mm implants were placed. Implant stability quotient (ISQ) values were determined with Osstell™mentor at baseline, 4 days, 1, 2, 3, 4, 6, 8 and 12 weeks post‐surgery. ISQ values were compared between implant types using unpaired t‐tests and longitudinally within implant types using paired t‐tests.

Results: During healing, ISQ decreased by 3–4 values after installation and reached the lowest values at 3 weeks. Following this, the ISQ values increased steadily for all implants and up to 12 weeks. No significant differences were noted over time. The longitudinal changes in the ISQ values showed the same patterns for SLA implants, SLActive implants and WB implants. At placement, the mean ISQ values were 72.6, 75.7 and 74.4, respectively. The mean lowest ISQ values, recorded at 3 weeks, were 69.9, 71.4 and 69.8, respectively. At 12 weeks, the mean ISQ values were 76.5, 78.8 and 77.8, respectively. The mean ISQ values at all observation periods did not differ significantly among the various types. Single ISQ values ranged from 55 to 84 during the entire healing period. Pocket probing depths of the implants ranged from 1 to 3 mm and bleeding on probing from 0 to 2 sites/implant post‐surgically.

Conclusions: All ISQ values indicated the stability of Straumann® implants over a 12‐week healing period. All implants showed a slight decrease after installation, with the lowest ISQ values being reached at 3 weeks. ISQ values were restored 8 weeks post‐surgically. It is recommended to monitor implant stability by RFA at 3 and 8 weeks post‐surgically. However, neither implant surface modifications (SLActive) nor implant diameter were revealed by RFA.

To cite this article:
 Han J, Lulic M, Lang NP. Factors influencing resonance frequency analysis assessed by Osstell™mentor during implant tissue integration: II. Implant surface modifications and implant diameter. Clin. Oral Impl. Res. 21, 2010; 605–611. doi: 10.1111/j.1600‐0501.2009.01909.x
Transmucosal healing around peri‐implant defects: crestal and subcrestal implant placement in dogs
Authors: Tran Binh L. T. , Chen Stephen T. , Caiafa Anthony , Davies Helen M. S. , Darby Ivan B.
Published: April 2010

Objective: This study was designed to evaluate the transmucosal healing response of implants placed with the junction of the smooth surfaces, either crestal or subcrestal, into simulated extraction defects after healing periods of 1 and 3 months.

Materials and methods: A total of 23 Straumann SP ∅3.3 mm NN, SLA® 10 mm implants were placed in the mandibular premolar regions of three greyhound dogs 3 months after the teeth were removed. Five control implants were placed at the crestal bone level, and test implants with surgically created peri‐implant defects of 1.25 mm wide × 5 mm depth were placed either at the crestal (nine implants) or at the 2 mm subcrestal (nine implants) bone level. Implants on the right side were placed 1 month before the dogs were sacrificed, and implants on the left side were placed 3 months before sacrifice. All dogs had daily plaque control following surgery and were sacrificed 3 months after implant placement for histological and histometric analyses.

Results: Mesial–distal ground sections of the control and test implant specimens showed a greater %BIC in the coronal defect region after 3 months of healing. This healing response was incomplete for the test implants compared with the control implants after a 1‐month healing period. The histometric measurements for test implants placed at the crestal bone level or 2 mm subcrestal with surgically created peri‐implant defects were more coronal or closer to the implant margin compared with the control implants. Additionally, the degree of osseointegration between the newly formed bone and the implant surface was similar between the test implants.

Conclusion: Peri‐implant defects of 1.25 mm width healed with spontaneous bone regeneration around implants placed transmucosally at crestal or 2 mm subcrestal with a high degree of osseointegration after a 3‐month healing period.

To cite this article:
 Tran BLT, Chen ST, Caiafa A, Davies HMS, Darby IB. Transmucosal healing around peri‐implant defects: crestal and subcrestal implant placement in dogs. Clin. Oral Impl. Res. 21, 2010; 794–803. doi: 10.1111/j.1600‐0501.2010.01911.x
Long‐term implant survival and success: a 10–16‐year follow‐up of non‐submerged dental implants
Authors: Simonis Pierre , Dufour Thomas , Tenenbaum Henri
Published: April 2010

Objectives: The aim of the present study was to evaluate the long‐term results of dental implants using implant survival and implant success as outcome variables.

Methods: Of the 76 patients who received 162 implants of the Straumann Dental Implant System during the years 1990–1997, 55 patients with 131 implants were recalled 10–16 years after implant placement for a complete clinical and radiographic examination, followed by a questionnaire that examined the degree of satisfaction. The incidence of biological and technical complications has been carefully analysed for each implant. Success was defined as being free of all these complications over the entire observation period. Associated factors related to peri‐implant lesions were analysed for each implant.

Results: The long‐term implant cumulative survival rate up to 16 years was 82.94%. The prevalence of biological complications was 16.94% and the prevalence of technical complications was 31.09%. The cumulative complication rate after an observation period of 10–16 years was 48.03%, which meant that substantial amounts of chair time were necessary following implant placement. The majority of implant losses and biological complications were concentrated in a relatively small number of patients.

Conclusion: Despite a relatively high long‐term survival rate, biological and technical complications were frequent. Patients with a history of periodontitis may have lower implant survival rates than patients without a history of periodontitis and were more prone to biological complications such as peri‐implant mucositis and peri‐implantitis.

To cite this article: Simonis P, Dufour T, Tenenbaum H. Long‐term implant survival and success: a 10–16‐year follow‐up of non‐submerged dental implants. Clin. Oral Impl. Res. 21, 2010; 772–777 doi: 10.1111/j.1600‐0501.2010.01912.x
Establishment of a streptozotocin‐induced diabetic domestic pig model and a systematic evaluation of pathological changes in the hard and soft tissue over a 12‐month period
Authors: Von Wilmowsky Cornelius , Stockmann Philipp , Metzler Philipp , Harsch Igor Alexander , Amann Kerstin , Schlegel Karl Andreas
Published: April 2010

Objective: The number of diabetic patients in need of medical treatment is growing steadily. Therefore, a diabetic animal model with high degree of similarities with humans, which is suitable for the systematic evaluation of biomaterials and medical devices, is needed.

Materials and methods: Twenty domestic pigs were used for the study. Fifteen received Streptozotocin (STZ) to induce diabetes mellitus. Internal parameters were measured and bone as well as soft tissues biopsies were taken after 0, 6 and 12 months and evaluated qualitatively and quantitatively by means of scanning electronic microscopy, light microscopy and microradiography.

Results: The results of the clinical internal parameters, determined by the American Diabetes Association for the definition of diabetes mellitus could be fulfilled. Pathological changes of the skin vasculatures were already visible after 6 months with a significant wall thickening in the diabetic group. The bone mineralization was lower in the diabetic group after 6 months and with a significant difference after 12 months.

Conclusion: From the present results, it can be concluded that a STZ dosage of 90 mg/kg body weight in the domestic pig is suitable for the induction of an apparent diabetes, leading to histolopathological changes in the hard and soft tissues already after 6 months. The high degree of similarities with humans makes it an interesting diabetic animal model for biomaterial research in a compromised animal model.

To cite this article: von Wilmowsky C, Stockmann P, Metzler P, Harsch IA, Amann K, Schlegel KA. Establishment of a streptozotocin‐induced diabetic domestic pig model and a systematic evaluation of pathological changes in the hard and soft tissue over a 12‐month period. Clin. Oral Impl. Res. 21, 2010; 709–717. doi: 10.1111/j.1600‐0501.2010.01914.x
Effects of dose reduction on multi‐detector computed tomographic images in evaluating the maxilla and mandible for pre‐surgical implant planning: a cadaveric study
Authors: Koizumi Hiroshi , Sur Jaideep , Seki Kenji , Nakajima Koh , Sano Tsukasa , Okano Tomohiro
Published: April 2010

Objective: To assess effects of dose reduction on image quality in evaluating maxilla and mandible for pre‐surgical implant planning using cadavers.

Materials and methods: Six cadavers were used for the study using multi‐detector computed tomography (CT) operated at 120 kV and the variable tube current of 80, 40, 20 and 10 mA. A slice thickness of 0.625 mm and pitch 1 were used. Multi‐planar images perpendicular and parallel to dentitions were created. The images were evaluated by five oral radiologists in terms of visibility of the anatomical landmarks including alveolar crest, mandibular canal, floors of the maxillary sinus and nasal cavity, contours/cortical layer of jaw bones and the details of trabecular bone. Observers were asked to determine the quality of the images in comparison with 80 mA images based on the criteria: excellent, good, fair or non‐diagnostic. The average scores of all observers were calculated for each specimen in all exposure conditions.

Results: The 40 mA images could visualize such landmarks and were evaluated to be same or almost equivalent in quality to the 80 mA images. Even the 20 mA images could be accepted just for diagnostic purpose for implant with substantial deterioration of the image quality. The 10 mA images may not be accepted because of the obscured contour caused by image noise.

Conclusion: Significant dose reduction by lowering mA can be utilized for pre‐surgical implant planning in multi‐detector CT.

To cite this article:
 Koizumi H, Sur J, Seki K, Nakajima K, Sano T, Okano T. Effects of dose reduction on multi‐detector computed tomographic images in evaluating the maxilla and mandible for pre‐surgical implant planning: a cadaveric study. Clin. Oral Impl. Res. 21, 2010; 830–834. doi: 10.1111/j.1600‐0501.2010.01925.x
Early loading of single crowns supported by 6‐mm‐long implants with a moderately rough surface: a prospective 2‐year follow‐up cohort study
Authors: Rossi Fabio , Ricci Emanuele , Marchetti Claudio , Lang Niklaus P. , Botticelli Daniele
Published: April 2010

Aim: To evaluate prospectively the clinical and radiographic outcomes after 2 years of loading of 6 mm long moderately rough implants supporting single crowns in the posterior regions.

Material and methods: Forty SLActive Straumann® short (6 mm) implants were placed in 35 consecutively treated patients. Nineteen implants, 4.1 mm in diameter, and 21 implants, 4.8 mm in diameter, were installed. Implants were loaded after 6 weeks of healing. Implant survival rate, marginal bone loss and resonance frequency analysis (RFA) were evaluated at different intervals. The clinical crown/implant ratio was also calculated.

Results: Two out of 40 implants were lost before loading. Hence, the survival rate before loading was 95%. No further technical or biological complications were encountered during the 2‐year follow‐up. The mean marginal bone loss before loading was 0.34±0.38 mm. After loading, the mean marginal bone loss was 0.23±0.33 and 0.21±0.39 mm at the 1‐ and 2‐year follow‐ups. The RFA values increased between insertion (70.2±9) and the 6‐week evaluation (74.8±6.1). The clinical crown/implant ratio increased with time from 1.5 at the delivery of the prosthesis to 1.8 after 2 years of loading.

Conclusion: Short implants (6 mm) with a moderately rough surface loaded early (after 6 weeks) during healing yielded high implant survival rates and moderate loss of bone after 2 years of loading. Longer observation periods are needed to draw more definite conclusions on the reliability of short implants supporting single crowns.

To cite this article:
 Rossi F, Ricci E, Marchetti C, Lang NP, Botticelli D. Early loading of single crowns supported by 6‐mm‐long implants with a moderately rough surface: a prospective 2‐year follow‐up cohort study. Clin. Oral Impl. Res. 21, 2010; 937–943. doi: 10.1111/j.1600‐0501.2010.01942.x
Review article: Phenytoin use and efficacy in the ED
Authors: Gallop Katharine
Published: April 2010

This article reviews the evidence regarding the use of phenytoin in adult and paediatric patients experiencing seizures in the ED in Australasia, including relevant pharmacokinetics, dosage, therapeutic drug monitoring and methods of administration. It summarizes current evidence regarding the use of phenytoin in a number of seizure types commonly seen in ED. A search of Medline, Embase and Cochrane was performed using appropriate keyword and MeSH headings. A loading dose of phenytoin should be given to phenytoin naïve patients for the emergency treatment of seizures; parenteral administration results in therapeutic concentration sooner than oral administration but is associated with more frequent and significant adverse effects. Diluting phenytoin is safe but there is limited evidence regarding adverse effects of diluted phenytoin; a filter is probably not needed. Free phenytoin concentrations correlate best with antiseizure efficacy. Phenytoin is used in the treatment of status epilepticus although evidence here is limited; it may also be given to prevent early post‐traumatic seizures. It should not be given to treat or prevent eclamptic or alcohol‐related seizures. There is insufficient evidence regarding its use in preventing febrile convulsions, treating or preventing seizures due to space occupying lesions or intracerebral haemorrhage and thrombosis. In conclusion, phenytoin is appropriate for treatment of some seizures seen in the ED; it is associated with significant adverse effects; trials are ongoing regarding the use of other anticonvulsants in the treatment of status epilepticus.