Luca Giacomelli

A Randomized Clinical Evaluation of Ultrasound Bone Surgery Versus Traditional Rotary Instruments in Lower Third Molar Extraction

PURPOSE The purpose of this study was to investigate and compare, in a randomized and controlled clinical trial, the use of ultrasound bone surgery devices and the use of rotary instruments in lower third molar extractions. MATERIALS AND METHODS We selected 26 patients (12 women and 14 men) for this study; the mean age was 31.2 years (range, 24-45 years). A randomized clinical trial was planned. Patients in the control group received treatment with the conventional rotary instruments; patients in the test group received treatment with the ultrasound bone surgery tools. Twenty-six third molars were allocated to the test and control groups according to a computer-generated randomization list. All the surgical procedures were performed by the same surgeon. Pain, trismus, cheek swelling, and number of analgesics taken were evaluated at baseline (before surgery) and at the first-, third-, fifth-, and seventh-day visits. RESULTS Pain levels (evaluated on a visual analog scale) were higher in the control group when compared with the ultrasonic group; however, no statistically significant differences were found. On the contrary, the number of analgesics taken in the test group was significantly lower when compared with the control group. The occurrence of trismus was significantly higher in the control group when compared with the test group. The clinical values of cheek swelling were higher in the rotary group when compared with the ultrasound group at the fifth-day visit. CONCLUSION This study showed that the use of ultrasound bone surgery for third molar extraction significantly reduced the occurrence of postsurgical trismus, the occurrence of swelling, and the number of analgesics taken after surgery.

Immunosuppressive drug‐free operational immune tolerance in human kidney transplants recipients. Part II. Non‐statistical gene microarray analysis

Kidney transplant is the reference treatment for patients with end‐stage renal disease, but patients may develop long‐term rejection of the graft. However, some patients do not reject the transplant, but instead are operationally tolerant state despite withdrawal of immunosuppressive treatment. In this second article we outline a microarray‐based identification of key leader genes associated respectively to rejection and to operational tolerance of the kidney transplant in humans by utilizing a non/statistical bioinformatic approach based on the identification of “key genes,” either as those mostly changing their expression, or having the strongest interconnections. A uniquely informative picture emerges on the genes controlling the human transplant from the detailed comparison of these findings with the traditional statistical SAM (Tusher et al. 2001 Proc Natl Acad Sci USA 98:5116–5121) analysis of the microarrays and with the clinical study carried out in the accompanying part I article. J. Cell. Biochem. 103: 1693–1706, 2008.

Surface Roughness of Commercial Composites after Different Polishing Protocols: An Analysis with Atomic Force Microscopy

Background and Aims: Polishing may increase the surface roughness of composites, with a possible effect on bacterial growth and material properties. This preliminary in vitro study evaluates the effect of three different polishing systems (PoGo polishers, Enhance, Venus Supra) on six direct resin composites (Gradia Direct, Venus, Venus Diamond, Enamel Plus HFO, Tetric Evoceram, Filtek Supreme XT). Materials and Methods: For each composite, 12 square specimens were prepared: 9 specimens were polished, three for each different method, while three specimens were used as controls. Surface roughness was determined with AFM by measuring Root Mean Square (RMS) of average height. Results: PoGo polisher determined a significantly rougher surface, versus controls, in 5 out of 6 composites evaluated. Some significant differences from unpolished controls were observed also for Enhance polishing. Polishing with Venus Supra did not result in any significant difference in surface roughness versus controls. No differences were observed between different polishing systems. Conclusions: These preliminary results suggest that Venus Supra polishing system could determine a smoother composite surface if compared to the other polishing systems tested. On this basis, we are conducting an in vivo study to evaluate bacterial colonization on some combinations of composites and polishing protocols.

Gene expression of human T lymphocytes cell cycle: experimental and bioinformatic analysis.

Human lymphocytes gene expression is monitored before and after PHA stimulation over 72 h, using DNA microarray technology. Results are then compared with our previous bioinformatics predictions, which identified six leader genes of highest importance in human T lymphocytes cell cycle. Experimental data are strikingly compatible with bioinformatic predictions of the specific role and interaction of PCNA, CDC2, and CCNA2 at all phases of the cell cycle and of CHEK1 in regulating DNA repair and preservation. It does not escape our notice that the conception and use of ad hoc arrays, based on a bioinformatics prediction which identifies the most important genes involved in a particular biological process, can really be an added value in cell biology and cancer research alternative to massive frequently misleading molecular genomics. J. Cell. Biochem. 99: 1326–1333, 2006.

Gene expression in the cell cycle of human T lymphocytes: I. Predicted gene and protein networks

The key genes involved in the cell cycle of human T lymphocytes were identified by iterative searches of gene‐related databases, as derived also from DNA microarray experimentation, revealing and predicting interactions between those genes, assigning scores to each of the genes according to numbers of interaction for each gene weighted by significance of each interaction, and finally applying several types of clustering algorithms to genes basing on the assigned scores. All clustering algorithms applied, both hierarchical and K‐means, invariably selected the same six “leader” genes involved in controlling the cell cycle of human T lymphocytes. Relations of the six genes to experimental data describing switching between stages of cell cycle of human T lymphocytes are discussed. J. Cell. Biochem. 97: 1137–1150, 2006.

Gene expression in the cell cycle of human T-lymphocytes: II. Experimental determination by DNASER technology

Human lymphocytes gene expression before and after PHA stimulation is monitored by DNASER technology, a novel bioinstrumentation entirely constructed in our laboratories as previously reported. The validity of the DNASER measurements is confirmed by standard fluorescence microscopy equipped with CCD. The human lymphocytes gene expression here experimentally probed using commercially available DNA microarrays such as Human Starter, appears compatible both with independent bioinformatic prediction and with existing experimental data, pointing to MYC as the key gene in the G0–G1 transition induced by PHA in resting lymphocytes. It does not escape our notice that in cell biology and cancer research DNASER technology based on microarray constructed with few leader genes identified from bioinformatics represents a meaningful cost‐effective route alternative to massive frequently misleading molecular genomics. J. Cell. Biochem. 97: 1151–1159, 2006.

Atomic force microscopy of protein films and crystals

A customized atomic force microscopy (AFM) instrument optimized for imaging protein crystals in solution is described. The device was tested on crystals and Langmuir-Blodgett (LB) films of two proteins with quite different molecular weights. This approach enables the periodicity and morphology of crystals to be studied in their mother liquid, thereby preserving the native periodic protein crystal structure, which is typically destroyed by drying. Moreover, the instrument appears to distinguish protein crystals from salt crystals, which under the optical microscope are frequently quite similar, the difference between them often being revealed only during x-ray analysis. AFM estimates of the packing, order, and morphology of the given single proteins appear quite similar in the LB thin film and in the crystals, which means that routine crystal measurements can be performed at high resolution. The AFM consists of a custom-built measuring head and a homemade flexible SPM controller which can drive the head for contact, noncontact and spectroscopy modes, thus providing the user with a high degree of customization for crystal measurement.

Relationship Between Human Periodontitis and Type 2 Diabetes at a Genomic Level: A Data-Mining Study

BACKGROUND The leader gene approach is a data-mining method based on the systematic search for the genes involved in a specific process and their ranking according to the interconnections with the other genes identified. The application of this algorithm to human periodontitis gave promising results. The present study used this algorithm to formulate new hypotheses about the association between periodontitis and type 2 diabetes. METHODS The genes involved in a given process were identified via interrelated queries of several databases. The interactions among such genes were mapped and given a significance score. The weighted number of links (sum of weighted scores for every interaction in which a gene is involved) was calculated for each gene. Genes were clustered according to this parameter; those in the highest cluster were termed leader genes. This algorithm was applied to diabetes and sinusitis. Sinusitis was chosen as a control because it is an inflammatory infectious disease like periodontitis. The results were compared to those previously calculated for periodontitis. RESULTS Periodontitis and diabetes share four leader genes; all leader genes are linked in a complex map of interactions. Periodontitis and sinusitis share no leader genes; no interactions were identified. CONCLUSIONS Even with the limitations of ab initio analyses, these theoretical results might suggest the existence of some common genomic pathways between periodontitis and type 2 diabetes, despite the different pathogenesis of these diseases. In particular, the shared leader genes could have an important role in this relationship, which may be investigated further with targeted experimentation.

Transarterial radioembolization for hepatocellular carcinoma: An update and perspectives

In the last decade trans-arterial radioembolization has given promising results in the treatment of patients with intermediate or advanced stage hepatocellular carcinoma (HCC), both in terms of disease control and tolerability profile. This technique consists of the selective intra-arterial administration of microspheres loaded with a radioactive compound (usually Yttrium(90)), and exerts its therapeutic effect through the radiation carried by these microspheres. A careful and meticulous selection of patients is crucial before performing the radioembolization to correctly perform the procedure and reduce the incidence of complications. Radioembolization is a technically complex and expensive technique, which has only recently entered clinical practice and is supported by scant results from phase III clinical trials. Nevertheless, it may represent a valid alternative to transarterial chemoembolization (TACE) in the treatment of intermediate-stage HCC patients, as shown by a comparative retrospective assessment that reported a longer time to progression, but not of overall survival, and a more favorable safety profile for radioembolization. In addition, this treatment has reported a higher percentage of tumor shrinkage, if compared to TACE, for pre-transplant downsizing and it represents a promising therapeutic option in patients with large extent of disease and insufficient residual liver volume who are not immediately eligible for surgery. Radioembolization might also be a suitable companion to sorafenib in advanced HCC or it can be used as a potential alternative to this treatment in patients who are not responding or do not tolerate sorafenib.

Implant survival after sinus elevation with Straumann® BoneCeramic in clinical practice: ad-interim results of a prospective study at a 15-month follow-up

OBJECTIVES Elevation of the sinus floor with Straumann(®) BoneCeramic gave promising results in some recent clinical studies. However, no study has evaluated the long-term survival of implants after this surgical procedure. We are conducting a prospective, observational study to evaluate the long-term implant survival after this surgical procedure in clinical practice. We present here an ad-interim report of this study, including only patients with ≥12-month follow-up after implant placement. METHODS This prospective cohort study will last until a follow-up of 5 years will be achieved in at least 50 patients. Inclusion criteria are: age ≥18 years; presence of a maxillary partial unilateral or bilateral edentulism involving the premolar/molar areas; elective rehabilitation with oral implants; and physical capability to tolerate conventional surgical and restorative procedures. Patients are treated according to the two-stage technique and the preparation is filled with Straumann(®) BoneCeramic. Implant survival is evaluated every 3 months for the first 2 years, and then every 6 months up to 5 years. RESULTS Fifteen patients are considered in this ad-interim analysis. Mean follow-up was 14.9 ± 3.1 (range: 6-18 months). In total, three implants failed, in one single patient, 6 months after insertion. The cumulative implant survival rate was 92.5% (95% confidence interval: 83.0-100%). CONCLUSIONS This ad-interim analysis suggests that the elevation of the sinus floor with Straumann(®) BoneCeramic may be an effective clinical option over >1-year follow-up. A longer term follow-up will allow a deeper characterization of these preliminary findings.