METHOD: A total of 3825 trauma patients from 2011 to 2016 were extracted from the Hospital Sultanah Aminah Trauma Surgery Registry. Patients were split into a development sample (n = 2683) and a validation sample (n = 1142). Univariate analysis is applied to identify significant anatomic predictors. These predictors were further analyzed using multivariable logistic regression to develop the new score and compared to existing score systems. The quality of prediction was determined regarding discrimination using sensitivity, specificity and receiver operating characteristic [ROC] curve.
RESULTS: Existing simplified score systems (GAP & mGAP) revealed areas under the ROC curve of 0.825 and 0.806. The newly developed HeCLLiP (Head, cervical spine, lung, liver, pelvic fracture) score combines only five anatomic components: injury involving head, cervical spine, lung, liver and pelvic bone. The probabilities of mortality can be estimated by charting the total score points onto a graph chart or using the cut-off value of (>2) with a sensitivity of 79.2 and specificity of 70.6% on the validation dataset. The HeCLLiP score achieved comparable values of 0.802 for the area under the ROC curve in validation samples.
CONCLUSION: HeCLLiP Score is a simplified anatomic score suited to the local Malaysian population with a good predictive ability for trauma mortality.
AIM AND OBJECTIVES: In this study, we aim at investigating the mechanism of apoptosis by N-(4-chlorophenyl)-2-(4- (3,4,5-trimethoxybenzyloxy)benzoyl)-hydrazinecarbothioamide, a triazole precursor, henceforth termed compound P7a, in breast cancer cell line, MCF-7. We first screen a series of analogues containing (3,4,5-trimethoxybenzyloxy) phenyl moiety in breast cancer cell lines (MCF-7 and MDA-MB-231) to select the most cytotoxic compound and demonstrate a dose- and time-dependent cytotoxicity. Then, we unravel the mechanism of apoptosis of P7a in MCF-7 as well as its ability to cause cell cycle arrest.
METHODS: Synthesis was performed as previously described by Kareem and co-workers. Cytotoxicity of analogues containing (3,4,5-trimethoxybenzyloxy)phenyl moiety against MCF-7 and MDA-MB-231 cell lines was evaluated using the MTS assay. Flow cytometric analyses was done using Annexin V/PI staining, JC-1 staining and ROS assay. The activity of caspases using a chemoluminescence assay and western blot analysis was conducted to study the apoptotic pathway induced by the compound in MCF-7 cells. Lastly, cell cycle analysis was conducted using flow cytometry.
RESULTS: Upon 48 hours of treatment, compound P7a inhibited the proliferation of human breast cancer cells with IC50 values of 178.92 ± 12.51μM and 33.75 ± 1.20μM for MDA-MB-231 and MCF-7, respectively. Additionally, compound P7a showed selectivity towards the cancer cell line, MCF-7 compared to the normal breast cell line, hTERT-HME1, an advantage against current anticancer drugs (tamoxifen and vinblastine). Flow cytometric analyses using different assays indicated that compound P7a significantly increased the proportion of apoptotic cells, increased mitochondria membrane permeabilisation and caused generation of ROS in MCF-7. In addition, cell cycle analysis showed that cell proliferation was arrested at the G1 phase in the MCF-7 cell line. Furthermore, upon treatment, the MCF-7 cell line showed increased activity of caspase-3/7, and caspase-9. Lastly, the western blot analysis showed the up-regulation of pro-apoptotic proteins along with up-regulation of caspase-7 and caspase-9, indicating that an intrinsic pathway of apoptosis was induced.
CONCLUSION: The results suggest that compound P7a could be a potential chemotherapeutic agent for breast cancer.
PURPOSE: The purpose of this pilot clinical study was to compare casts generated from a conventional definitive impression with casts generated from an altered cast impression using a 3-dimensional (3D) analysis software program.
MATERIAL AND METHODS: Three partially edentulous participants with mandibular Kennedy Class I were enrolled, and impressions were made with the 2 techniques and poured in stone. The casts were scanned, aligned, and superimposed by using a 3D analysis software program. Surface deviations were measured to evaluate the differences in displacement induced by the impression on the tissue surface. Five observations were made in 4 different areas on each partially edentulous side. Means from these observations were generated, and the Wilcoxon and Mann Whitney tests were performed for all data to assess the differences between the right and left sides in the same participant and among the 3 participants (α=.05).
RESULTS: The casts made from the altered cast impression had an overall mean ±standard deviation displacement of -0.05 ±1.25 mm on the right and left sides of the mandibular buccal shelf area. Moreover, the greatest overall difference of about 0.45 ±0.41 mm occurred on the lingual slope of the residual ridge, and the differences in the other areas were 0.10 ±0.99 mm (crest of the residual ridge) and 0.16 ±0.66 mm (buccal slope of the residual ridge). The overall differences varied statistically between significance and nonsignificance for the same participant and among the 3 participants.
CONCLUSIONS: A digital comparative analysis of the conventional and altered cast methods of recording the bilateral distal extension areas in partially edentulous participants showed that the altered cast method exhibited more displacement on the buccal vestibule or buccal shelf area compared with other examined areas. The differences between the 2 impression methods in the displacement values among the examined areas were minimal and in close proximity, and such differences may lack clinical significance.
MATERIALS AND METHODS: The cytotoxicity was studied by examining the hFOB cell response by MTT assessment. The cell morphology was evaluated by inverted microscopy and observed under scanning electronic microscopy (SEM).
RESULTS: MTT assay results displayed that the Cu content on the surface of Ti-6Al-7Nb alloys did not produce any cytotoxic effect on cell viability. The cell viability rate in all samples ranges from 97% to 126%, indicating that hFOB cells grew at a high proliferation rate. However, no significant differences in cell viability were observed between Ti and Ti Cu and between Ti HA and Ti Cu/HA groups. Microscopic examination demonstrated no difference in the cell morphology of hFOB among all samples. In addition, SEM observation indicated favorable adhesion and spreading of the cells on the coated and uncoated samples.
CONCLUSIONS: The surface modification of Ti-6Al-7Nb alloy with Cu, HA, and Cu/HA exhibits good cell biocompatibility, and the Cu has no influence on the cell proliferation and differentiation of hFOB.
PURPOSE: The purpose of part II of this study was to evaluate the stress distribution in different designs of Aramany class I obturators using finite element analysis (FEA) and photoelastic stress analysis.
MATERIAL AND METHODS: Four finite element and 8 photoelastic models, including 2 acrylic resin base obturators retained with 2 Adams clasps, 2 linear, 2 tripodal, and 2 fully tripodal design obturators, were used in this study. The frameworks were fabricated on the casts obtained from a modified printed model. Vertical and oblique loads were applied on 2 points (anterior and posterior) of the models. The quantitative measurement was done by measuring the fringe orders and von Mises values to compare the influences of occlusal forces on the obturator components and their supporting structures. The qualitative evaluation was done by visual color mapping to identify the stress concentration.
RESULTS: In the photoelastic analysis, the anterior abutments of the tripodal showed the highest stress, followed by the fully tripodal obturators, while, in FEA, the anterior abutments of the linear design received the most in both vertical and oblique load. The central incisor received the most stress in photoelastic (3 or more fringe orders) and FEA (687.3 and 150.1 MPa for vertical and oblique loads, respectively), followed by the lateral incisors. Upon posterior loading, the base of the defect of the linear design demonstrated the most stress in photoelastic (3 or more fringes) and FEA (94.3 and 130.5 MPa for vertical and oblique loads, respectively). The acrylic resin base obturator retained with Adams clasps demonstrated the lowest stress distribution in abutments and their supporting bone upon anterior and posterior loads.
CONCLUSIONS: Upon vertical and oblique load application, the fully tripodal design was comparable with the tripodal in terms of stress distribution. Both designs were better than the linear in response to the same loading. The stress was concentrated at the anterior palatal part of the obturator, the base of the defect, and the junction of the metal and acrylic resin part of the prostheses upon anterior and posterior loading, respectively.