Browsing by Author "Demian, Nagi M."

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    Evaluation of antibiotic releasing porous polymethylmethacrylate space maintainers in an infected composite tissue defect model
    (Elsevier, 2013-11) Spicer, Patrick P.; Shah, Sarita R.; Henslee, Allan M.; Watson, Brendan M.; Kinard, Lucas A.; Kretlow, James D.; Bevil, Kristin; Kattchee, Lauren; Bennett, George N.; Demian, Nagi M.; Mende, Katrin; Murray, Clinton K.; Jansen, John A.; Wong, Mark E.; Mikos, Antonios G.; Kasper, F.Kurtis; Bioengineering; Biosciences
    This study evaluated the in vitro and in vivo performance of antibiotic-releasing porous polymethylmethacrylate (PMMA)-based space maintainers comprising a gelatin hydrogel porogen and a poly(DL-lactic-co-glycolic acid) (PLGA) particulate carrier for antibiotic delivery. Colistin was released in vitro from either gelatin or PLGA microparticle loaded PMMA constructs, with gelatin-loaded constructs releasing colistin over approximately 7 days and PLGA microparticle-loaded constructs releasing colistin up to 8 weeks. Three formulations with either a burst release or extended release in different doses were tested in a rabbit mandibular defect inoculated with Acinetobacter baumannii (2 × 107 colony forming units/mL). In addition, one material control that released antibiotic but was not inoculated with A. baumannii was tested. A. baumannii was not detectable in any animal after 12 weeks by culture of the defect, saliva, or blood. Defects with high-dose, extended-release implants had greater soft tissue healing compared to defects with burst release implants, with 8 out of 10 animals showing healed mucosae compared to 2 out of 10 with healed mucosae, respectively. Extended release of locally delivered colistin via a PLGA microparticle carrier improved soft tissue healing over the implants compared to burst release of colistin from a gelatin carrier.
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    Interobserver agreement in dysplasia grading: toward an enhanced gold standard for clinical pathology trialsﾠ
    (Elsevier, 2015) Speight, Paul M.; Abram, Timothy J.; Floriano, Pierre N.; James, Robert; Vick, Julie; Thornhill, Martin H.; Murdoch, Craig; Freeman, Christine; Hegarty, Anne M.; D’Apice, Katy; Kerr, A. Ross; Phelan, Joan; Corby, Patricia; Khouly, Ismael; Vigneswaran, Nadarajah; Bouquot, Jerry; Demian, Nagi M.; Weinstock, Y. Etan; Redding, Spencer W.; Rowan, Stephanie; Yeh, Chih-Ko; McGuff, H. Stan; Miller, Frank R.; McDevitt, John T.; Bioengineering; Chemistry
    Objective: Interobserver agreement in the context of oral epithelial dysplasia (OED) grading has been notoriously unreliable and can impose barriers for developing new molecular markers and diagnostic technologies. This paper aimed to report the details of a 3-stage histopathology review and adjudication process with the goal of achieving a consensus histopathologic diagnosis of each biopsy. Study Design: Two adjacent serial histologic sections of oral lesions from 846 patients were independently scored by 2 different pathologists from a pool of 4. In instances where the original 2 pathologists disagreed, a third, independent adjudicating pathologist conducted a review of both sections. If a majority agreement was not achieved, the third stage involved a face-to-face consensus review. Results: Individual pathologist pair κ values ranged from 0.251 to 0.706 (fair-good) before the 3-stage review process. During the initial review phase, the 2 pathologists agreed on a diagnosis for 69.9% of the cases. After the adjudication review by a third pathologist, an additional 22.8% of cases were given a consensus diagnosis (agreement of 2 out of 3 pathologists). After the face-to-face review, the remaining 7.3% of cases had a consensus diagnosis. Conclusions: The use of the defined protocol resulted in a substantial increase (30%) in diagnostic agreement and has the potential to improve the level of agreement for establishing gold standards for studies based on histopathologic diagnosis.