New frontiers and emerging applications of 3D printing in ENT surgery: A systematic review of the literature

3D printing systems have revolutionised prototyping in the industrial field by lowering production time from days to hours and costs from thousands to just a few dollars. Today, 3D printers are no more confined to prototyping, but are increasingly employed in medical disci- plines with fascinating results, even in many aspects of otorhinolaryngology. All publications on ENT surgery, sourced through updated electronic databases (PubMed, MEDLINE, EMBASE) and published up to March 2017, were examined according to PRISMA guidelines. Overall, 121 studies fulfilled specific inclusion criteria and were included in our systematic review. Studies were classified according to the specific field of application (otologic, rhinologic, head and neck) and area of interest (surgical and preclinical education, customised surgical planning, tissue engineering and implantable prosthesis). Technological aspects, clinical implications and limits of 3D printing processes are discussed focusing on current benefits and future perspectives

In vitro synergistic cytoreductive effects of zoledronic acid and radiation on breast cancer cells

INTRODUCTION: Bisphosphonates are mostly used in the treatment of bone metastases. They have been shown to act synergistically with other chemotherapeutic agents. It is not known, however, whether similar synergistic effects exist with radiation on breast cancer cells. METHODS: Human MCF-7 breast cancer cells were treated with up to 100 μM zoledronic acid, were irradiated with up to 800 cGy or were exposed to combinations of both treatments to determine the antiproliferative effects of zoledronic acid and radiation. RESULTS: Zoledronic acid and radiation caused a dose-dependent and time-dependent decrease in cell viability (approximate 50% growth inhibition values were 48 μM and 20 μM for 24 hours and 72 hours, respectively, for zoledronic acid and 500 cGy for radiation). A synergistic cytotoxic effect of the combination of zoledronic acid and radiation was confirmed by isobologram analysis. CONCLUSION: These data constitute the first in vitro evidence for synergistic effects between zoledronic acid and radiation. This combination therapy might thus be expected to be more effective than either treatment alone in patients with metastatic breast carcinoma

Zoledronic acid impairs myeloid differentiation to tumour-associated macrophages in mesothelioma

Background: Suppressive immune cells present in tumour microenvironments are known to augment tumour growth and hamper efficacy of antitumour therapies. The amino-bisphosphonate Zoledronic acid (ZA) is considered as an antitumour agent, as recent studies showed that ZA prolongs disease-free survival in cancer patients. The exact mechanism is a topic of debate; it has been suggested that ZA targets tumour-associated macrophages (TAMs). Methods: We investigate the role of ZA on the myeloid differentiation to TAMs in murine mesothelioma in vivo and in vitro. Mice were intraperitoneally inoculated with a lethal dose of mesothelioma tumour cells and treated with ZA to determine the effects on myeloid differentiation and survival. Results: We show that ZA impaired myeloid differentiation. Inhibition of myeloid differentiation led to a reduction in TAMs, but

Administration of zoledronic acid enhances the effects of docetaxel on growth of prostate cancer in the bone environment

BACKGROUND: After development of hormone-refractory metastatic disease, prostate cancer is incurable. The recent history of chemotherapy has shown that with difficult disease targets, combinatorial therapy frequently offers the best chance of a cure. In this study we have examined the effects of a combination of zoledronic acid (ZOL), a new-generation bisphosphonate, and docetaxel on LuCaP 23.1, a prostate cancer xenograft that stimulates the osteoblastic reaction when grown in the bone environment. METHODS: Intra-tibial injections of LuCaP 23.1 cells were used to generate tumors in the bone environment, and animals were treated with ZOL, docetaxel, or a combination of these. Effects on bone and tumor were evaluated by measurements of bone mineral density and histomorphometrical analysis. RESULTS: ZOL decreased proliferation of LuCaP 23.1 in the bone environment, while docetaxel at a dose that effectively inhibited growth of subcutaneous tumors did not show any effects in the bone environment. The combination of the drugs significantly inhibited the growth of LuCaP 23.1 tumors in the bone. CONCLUSION: In conclusion, the use of the osteolysis-inhibitory agent ZOL in combination with docetaxel inhibits growth of prostate tumors in bone and represents a potential treatment option

Temperature Increase Dependence on Ultrasound Attenuation Coefficient in Innovative Tissue-mimicking Materials

AbstractAlthough high intensity focused ultrasound beams (HIFU) have found rapid agreement in clinical environment as a tool for non invasive surgical ablation and controlled destruction of cancer cells, some aspects related to the interaction of ultrasonic waves with tissues, such as the conversion of acoustic energy into heat, are not thoroughly understood. In this work, innovative tissue-mimicking materials (TMMs), based on Agar and zinc acetate, have been used to conduct investigations in order to determine a relation between the sample attenuation coefficient and its temperature increase measured in the focus region when exposed to an HIFU beam. An empirical relation has been deduced establishing useful basis for further processes of validations of numerical models to be adopted for customizing therapeutic treatments

Use of Fuel Cells as Auxiliary Power Unit for Air Conditioning of Industrial Vehicles

The need to integrate the air conditioning system of industrial vehicles with an Auxiliary Power Unit (APU) is becoming more and more important to assure comfort conditions to drivers when the vehicle doesn’t travel, both due to energy saving and pollutions reduction, and security of the onroad behaviour of drivers after rest periods. Presently, on the market, systems are available that rarely meet the requirement of long distance drivers, particularly during the day stay in hot country climate. Main problems are: size of devices, weight, cost, produced noise and pollution. Besides, such devices are often a duplicate of the on board air conditioning system and work only with the engine switched on. But, due to the reduced available space, and other limits, the performances are far from being satisfactory. Furthermore these devices can be used only for a limited length of time, maximum a few hours. On the contrary a long term use (many hours) is strongly required by the drivers, and this request forces the producers to develop a specific APU for this purpose. The present paper shows the activity of IVECO, supported by University of Rome Tor Vergata, Fiat Research Centre (C.R.F.) and WEBASTO, in developing a new system able to meet the driver’s requirements in the most extreme ambient conditions existing in Europe, and to guarantee comfort conditions for at least 8 hours. The use of fuel cells is foreseen to supply power to an electric engine that moves the compressor of the on board air conditioning system when the engine is switched off. Characteristics and performances of the new designed system are compared with a traditional APU using a thermal engine. On board space required by the new system may be much lower, due to the strong integration with the existing air conditioning system. The best temperature distribution in the cab can also be assured. Last but not least, the working time of both APU (fuel cells or thermal engine) is limited only by the on board fuel storage

Use of Fuel Cells as Auxiliary Power Unit for Air Conditioning of Industrial Vehicles

The need to integrate the air conditioning system of industrial vehicles with an Auxiliary Power Unit (APU) is becoming more and more important to assure comfort conditions to drivers when the vehicle doesn’t travel, both due to energy saving and pollutions reduction, and security of the onroad behaviour of drivers after rest periods. Presently, on the market, systems are available that rarely meet the requirement of long distance drivers, particularly during the day stay in hot country climate. Main problems are: size of devices, weight, cost, produced noise and pollution. Besides, such devices are often a duplicate of the on board air conditioning system and work only with the engine switched on. But, due to the reduced available space, and other limits, the performances are far from being satisfactory. Furthermore these devices can be used only for a limited length of time, maximum a few hours. On the contrary a long term use (many hours) is strongly required by the drivers, and this request forces the producers to develop a specific APU for this purpose. The present paper shows the activity of IVECO, supported by University of Rome Tor Vergata, Fiat Research Centre (C.R.F.) and WEBASTO, in developing a new system able to meet the driver’s requirements in the most extreme ambient conditions existing in Europe, and to guarantee comfort conditions for at least 8 hours. The use of fuel cells is foreseen to supply power to an electric engine that moves the compressor of the on board air conditioning system when the engine is switched off. Characteristics and performances of the new designed system are compared with a traditional APU using a thermal engine. On board space required by the new system may be much lower, due to the strong integration with the existing air conditioning system. The best temperature distribution in the cab can also be assured. Last but not least, the working time of both APU (fuel cells or thermal engine) is limited only by the on board fuel storage