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Long-term physical inactivity can cause the atrophy of skeletal muscle. The aim of this study is to explore the underlying mechanisms of physical inactivity-induced atrophy of skeletal muscle.14 Sprague- Dawley (SD) male rats were divided into 2 groups including normal control (NC) and hindlimb suspension (HS) groups. After two weeks of HS stimulation, the ratio between skeletal muscle weight and body weight, and cross-sectional area (CSA) of skeletal muscle fibers, were measured. Western blot was applied to evaluate the expression of proteins associated with atrophy and autophagy. The transmission electron microscope was used to observe the ultra-microstructure and the mitochondrial quality of skeletal muscle.The rats subjected to 2-week HS treatment presented an evident atrophy of the skeletal muscle with a significantly reduced ratio between skeletal muscle weight and body weight, and smaller cross-sectional area (CSA) of skeletal muscle fibers when compared with control rats. Meanwhile, HS stimulation resulted in the damage of mitochondria, the increased expression of MuRF1 and Atrogin-1/MAFbx, and enhanced apoptosis, as well as dysfunctional autophagy in skeletal muscle.HS-induced skeletal muscle atrophy involves the activation of AMPK/FoxO3 signal pathway, evidenced as AMPK phosphorylation, FoxO3 activation, and Atrogin-1 and MuRF1 up-regulation. FoxO3-mediated autophagy plays an important regulatory role in HS-induced skeletal muscle atrophy.

In the field of tissue engineering, adult stem cells are increasingly recognized as an important tool for in vitro reconstructed tissue-engineered grafts. In the world of cell therapies, mesenchymal stem cells from bone marrow or adipose tissue are undoubtedly the most promising progenitors for tissue engineering applications. In this setting, adipose-derived stem cells (ASC) are generally similar to those derived from bone marrow and are most conveniently extracted from tissue removed in elective cosmetic liposuction procedures; they also show a great potential for endothelization. The aim of the present work was to investigate how the co-commitment into a vascular and bone phenotype of ASC could be a usefull tools for improving the in vitro and in vivo reconstruction of a vascularized bone graft. Human ASC obtained from abdominoplasty procedures were loaded in a hydroxyapatite clinical-grade scaffold, co-differentiated and tested for proliferation, cell distribution, and osteogenic and vasculogenic gene expression. The chromosomal stability of the cultures was investigated using the CGH array for 3D cultures. ASC adhesion, distribution, proliferation and gene expression not only demonstrated a full osteogenic and vasculogenic commitment in vitro and in vivo, but also showed that endothelization strongly improves their osteogenic commitment. In the end, genetic analyses confirmed that no genomical alteration in long-term in vitro culture of ASC in 3D scaffolds occurs., Italian Journal of Anatomy and Embryology, Vol 116, No 1 (Supplement) 2011

Female patients on estroprogestinic therapy undergoing extraction of the third lower molar have a higher incidence of postoperative complications (dry socket -DS- pain). The purpose of this study is to verify such data and analyse if there are risk factors for the appearance of other postoperative complications.One hundred eighteen non-smoking healthy patients were included who underwent extraction of the impacted third lower molar (38 on oral contraceptives, OC, 80 as control). After the extraction, patients were prescribed with a pharmacological therapy, consisting of a per os antibiotic and antiseptic rinse. Each patient was examined after 7 days following surgery to verify the state of tissues. In addition subjective postoperative pain (VAS - Visual Analogue Scale) and intake of analgesic drugs were recorded.One case of DS (2.64%) occurred in the OC group, and 1 case of DS occurred in control-patients group (1.25%) (P=0.4436). The postoperative pain proved significantly higher in OC compared to control (first and fifth postoperation day). In OC a predisposition to dehiscence of the wound (86.84% P=0.0021) and emergence of laterocervical lymphadenitis (81.57% P=0.0010) was found, while no cases of postextractive abscesses and trismus of the masseter were found.Although no correlation between DS and estroprogestinic therapy has been found, a more difficult healing of tissues has been observed as well as a significantly higher subjective pain index in the postoperative days considered in OC patients.

Bispectral Index Score (BIS) is an objective tool to assess sedation depth. Benzodiazepines have different pharmacological profiles and diazepam may be safer than midazolam in this setting. The aim of this study was to compare BIS values observed during anxiolysis after diazepam versus sedation after midazolam.Thirty-six patients were randomly assigned to 3 groups: group 1 was treated with i.v. diazepam, groups 2 and 3 with iv midazolam 1 and 3 mg, respectively. Sedation was monitored clinically and by means of BIS. BIS values were evaluated as area under the curve (AUC) and compared by variance analysis. The statistical comparison of other data was performed by variance analysis or, alternatively, the χ2 according to Yates. The statistical significance was indicated by P values0.05.AUC values were significantly lower after midazolam when compared to AUC values registered in diazepam treated patients; 22.6% of the group 3 patients showed BIS values80, versus 0.4% of group 1 patients.Diazepam has a safer profile, with BIS values and clinical conditions according to the definition of minimal and/or moderate sedation. Diazepam represents the safer drug for anxiety management in dentistry, because regularly produces a state of sedation during which verbal contact with the patient is maintained and carry a margin of safety wide enough to render loss of consciousness unlikely.

To retrospectively analyze 14 consecutively treated cases of dental implants placed along with sinus lift procedures in patients with severe bone atrophy (residual bone height of 2 to 5 mm).Thirty-one implants were placed with a lateral window sinus lift in 14 patients using deproteinized bovine bone alone (no membrane) for the graft. The implants were monitored for a mean 43.20 ± 9.30 months (minimum, 25.00 months; maximum, 53.00 months) after placement and 32.40 ± 11.10 months (minimum, 11.40 months; maximum, 41.60 months) after fitting of the prostheses. The outcome measures evaluated were implant success, radiographic measurements (original alveolar bone height, peri-implant marginal bone loss, and relationship of implant apex to graft), implant-related probing pocket depth (PPD), Bleeding Index (BI), and prosthesis sucess.The implant success rate was 93.3%. The mean real alveolar bone height was 3.05 ± 0.87 mm, and there was evidence of peri-implant marginal bone loss (mean, 1.02 ± 1.40 mm). The relationship of implant apex to graft remained stable during follow-up. PPD was5 mm in 91.6% of implants. The BI was 11.6%. The prosthetic success rate was 100%.These findings indicate that dental implants can be employed successfully, even in conditions of severe bone atrophy, using only heterologous bone, provided suitable methods and materials are used (eg, site preparation, rough implant surfaces, and self-tapping screw implants).The treatment described appears to afford acceptable results, with lower overall costs and treatment time.

Anxiety is a relevant problem in dental practice. The Modified Dental Anxiety Scale (MDAS) is a brief, simple questionnaire consisting of five questions with a total score ranging from 5 to 25, the Italian version of which is not available yet. The aim of the study was to provide an Italian version of the MDAS and check its reliability in oral surgery, which is a major cause of dental anxiety due to the expected perception of pain and suffering.The Italian version of the test was administered to 230 patients (98 male and 132 female patients, ages 14-88 years) undergoing oral surgery. Further recorded data were: American Society of Anaesthesiologists physical status classification (ASA-PS), frequency of visiting the dentist and any previous distressing experiences in dental or medical setting.The internal consistency of the test was high, with a Cronbach's alpha=0.92. The MDAS score was significantly higher in females (p0.0001) and in patients with previous distressing experiences in medical and/or dental settings (p0.0001); the correlation with age (p=0.01) and frequency on visiting the dentist (p=0.02) were also significant.The patients' selection (oral surgery only) may be a limit of the study, which might not provide an estimation of anxiety prevalence in the general dental population; however our result agree with those of studies performed in other Countries in the generic population, suggesting the absence of major differences with respect to the surgical setting and show the reliability and manageability of the Italian version of MDAS.

The purpose of this paper was to report the case of a 2-year-old Caucasian female who was referred with a presumed diagnosis of pediatric rheumatoid arthritis. The patient presented widespread gingival swelling with bleeding, sharp pain, and halitosis. The patient also presented pain and swelling of the right knee joint, and psychomotor restlessness associated with muscular frailty. Little compliance on the part of both the patient and parents was also noted. Oral manifestations, together with an accurate medical history, led to the diagnosis of infantile scurvy, caused by an inadequate dietary supply of vitamin C. Administering 250 mg of ascorbic acid orally twice a day led to the remission of gingival swelling and of the other symptoms. The parents were advised to feed the child appropriate foods. Nutritional problems are traditionally linked to an insufficient availability of food, but can also be associated with child- or family-related psychological problems.

The aim of this study was to evaluate the effects of sedation with benzodiazepines in a large population of patients undergoing oral surgery and age-related implications.A group of 1 179 consecutive patients undergoing oral surgery in the Dental Clinic of the University of Padua between 2001 and 2003 was evaluated by analysing their anaesthesiological records. The patients were divided into 5 age groups. All were pre-sedated with chlordemethyldiazepam per os, while induction of maximum subjective tranquillity was obtained with fractionated doses of intravenous diazepam. Arterial pressure (AP), heart rate (HR), anxiety level, pathologies, drugs taken, types of intervention, techniques of loco-regional anaesthesia, immediately preoperative AP and HR and tranquillity, intraoperative AP and HR, data regarding postoperative psychomotor recovery, complications and drugs used for the treatment of perioperative pain, were evaluated in each group.Most of the patients (679) were in the 45-64 year-old group. Cardiovascular, respiratory and digestive pathologies proved to be age-dependent. Control AP and HR respectively increased and decreased with age. The doses of chlordemethyldiazepam used induced age-dependent preoperative tranquillity levels. The doses of i.v. diazepam necessary to obtain maximal preoperative subjective tranquillity fell as a function of age. The AP and HR values respectively increased during intervention and decreased in the first hour of intervention. Normal psychomotor recovery was less evident in older patients. The most significant corrective intraoperative interventions consisted of the administration of sublingual hypotensive drugs and in the immediate treatment of some cases of orthostatic hypotension and vaso-vagal syncope.The sedation technique and the antistress procedures employed proved safe and the intra- or postoperative complications almost non-existent. The variations observed in the parameters considered are compatible with the greater age of the treated subjects.

The features of implant devices and the reactions of bone-derived cells to foreign surfaces determine implant success during osseointegration. In an attempt to better understand the mechanisms underlying osteoblasts attachment and spreading, in this study adhesive peptides containing the fibronectin sequence motif for integrin binding (Arg-Gly-Asp, RGD) or mapping the human vitronectin protein (HVP) were grafted on glass and titanium surfaces with or without chemically induced controlled immobilization. As shown by total internal reflection fluorescence microscopy, human osteoblasts develop adhesion patches only on specifically immobilized peptides. Indeed, cells quickly develop focal adhesions on RGD-grafted surfaces, while HVP peptide promotes filopodia, structures involved in cellular spreading. As indicated by immunocytochemistry and quantitative polymerase chain reaction, focal adhesions kinase activation is delayed on HVP peptides with respect to RGD while an osteogenic phenotypic response appears within 24 h on osteoblasts cultured on both peptides. Cellular pathways underlying osteoblasts attachment are, however, different. As demonstrated by adhesion blocking assays, integrins are mainly involved in osteoblast adhesion to RGD peptide, while HVP selects osteoblasts for attachment through proteoglycan-mediated interactions. Thus an interfacial layer of an endosseous device grafted with specifically immobilized HVP peptide not only selects the attachment and supports differentiation of osteoblasts but also promotes cellular migration.