Keratocystic odontogenic tumour arising as a periapical lesion.

AIM: To document a case of a keratocystic odontogenic tumour (KOT) involving the apical region in the maxilla mimicking a periapical lesion of endodontic origin. SUMMARY: Benign and malignant tumours, including odontogenic lesions, can be erroneously diagnosed as periapical radiolucencies. KOTs mimicking periapical lesions of endodontic origin are uncommon, especially when the lesions involve the maxilla. This article describes a 55-year-old man with a well-delimited, oval-shaped, radiolucent lesion, occupying the middle and apical third of teeth 22 and 23. After 30 days, the clinical and radiographic findings remained unchanged and the patient was referred for surgical removal of the lesion. Clinical, radiographic and histopathological features are also discussed and compared with current literature.

Altered phenotype and function of dendritic cells in individuals with chronic periodontitis.

OBJECTIVE: To investigate the effects of periodontal bacterial lysates on maturation and function of mature monocyte-derived dendritic cells (m-MDDCs) derived from individuals with chronic periodontitis (CP) or healthy periodontal tissue (HP). DESIGN: m-MDDCs derived from peripheral blood monocytes, cultured for 7 days in presence of interleukin (IL)-4 and granulocyte-macrophage colony stimulating factor (GM-CSF), were stimulated with lysates of Streptococcus sanguinis, Prevotella intermedia, Porphyromonas gingivalis, or Treponema denticola on day 4, and were then phenotyped. IL-10, IL-12 and IFN-gamma concentration in the supernatant of cultures were measured. RESULTS: Expression of HLA-DR was lower in bacterial-unstimulated mature m-MDDC from CP compared to HP (p=0.04), while expression of CD1a and CD123 were higher in CP. The expression pattern of HLA-DR, CD11c, CD123, and CD1a did not change on bacterial stimulation, regardless of the bacteria. Stimulation with P. intermedia upregulated CD80 and CD86 in CP cells (p≤0.05). Production of IL-12p70 by bacterial-unstimulated m-MDDCs was 5.8-fold greater in CP compared to HP. Bacterial stimulation further increased IL-12p70 production while decreasing IL-10. Significantly more IFN-gamma was produced in co-cultures of CP m-MDDCs than with HP m-MDDCs when cells were stimulated with P. intermedia (p=0.009). CONCLUSIONS: Bacterial-unstimulated m-MDDC from CP exhibited a more immature phenotype but a cytokine profile biased towards proinflammatory response; this pattern was maintained/exacerbated after bacterial stimulation. P. intermedia upregulated co-stimulatory molecules and IFN-gamma expression in CP m-MDDC. These events might contribute to periodontitis pathogenesis.

Actinic cheilitis among agricultural workers in Campinas, Brazil.

OBJECTIVE: To assess the prevalence of Actinic Cheilitis (AC) among agricultural workers and analyze its risk factors. DESIGN: A cross sectional epidemiological study. A lip lesion was defined as an abnormal change on the lip mucosa surface, such as erythematous pigmented, ulcerative or swelling (Cataldo and Doku, 1981). Data were gathered according to age group, gender, ethnicity-time and frequency of occupational sunlight exposure, smoking habits, drinking habits and socio-economic status. SETTING: Sugar-cane plantation farms in Brazil. PARTICIPANTS: Full-time workers of both genders employed at sugar-cane plantation farms for at least six months. OUTCOME MEASURES: Correlations between AC prevalence, demographic and socioeconomic risk factors. RESULTS: 202 people were examined and the prevalence of AC was 39.6%. Results revealed that being black (0.15-0.88- 95% CI; OR = 0.36; p = 0.025) or mulatto (0.21-0.82- 95% CI; OR = 0.42; p =0.011) decreased the risk for AC, while age and gender sex had no effect. In relation to socioeconomic variables, formal education and more than four years of education (0.07-0.68- 95% CI; OR = 0.22; p = 0.009) decreased the risk for AC. Moreover, drinking alcohol was a risk for AC (1.05-3.37- 95% CI; OR = 1.88; p = 0.034), while tobacco smoking was not (0.60-2.02- 95% CI; OR = 1.10; p = 0.763). CONCLUSIONS: The prevalence of AC is high in agricultural workers who were fairskinned, had low education and high alcohol intake. Prevention and early diagnosis are required for workers exposed to sunlight.

Efficacy of nimesulide versus meloxicam in the control of pain, swelling and trismus following extraction of impacted lower third molar.

This study compared the efficacy of nimesulide and meloxicam in the control of pain, swelling and trismus, following the extraction of impacted inferior third molars. Twenty patients with two impacted inferior third molars, in similar positions, were selected. The patients were designated randomly to the meloxicam group (MEL: 7.5mg twice a day for 5 days) or the nimesulide group (NIM: 100mg for 5 days). Following the extractions, swelling was more pronounced in the MEL group than in the NIM group (P0.05). At the 72-h evaluation, reduction was significantly larger in mouth opening in the MEL group compared with the NIM group (P<0.05). In conclusion, pain control was similar in both treatment groups. NIM was more effective than MEL in the control of swelling and trismus following the extraction of impacted lower third molars.

Substance P regulates the expression of matrix metalloproteinases and tissue inhibitors of metalloproteinase in cultured human gingival fibroblasts.

BACKGROUND AND OBJECTIVE: Substance P may play a role in the pathogenesis of periodontal disease; however, its mechanisms of modulation are not clear. This study evaluated the effect of two concentrations of Substance P on the expression of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in cultured human gingival fibroblasts. MATERIAL AND METHODS: Fibroblasts were stimulated for 48 h with 10(-4) or 10(-9) m Substance P; untreated fibroblasts served as controls. The expression of MMP-1, -2, -3, -7 and -11 and of TIMP-1 and -2 was evaluated using real-time polymerase chain reaction and western blotting. RESULTS: There was a significant, concentration-dependent stimulatory effect of Substance P on MMP-1, -2, -3 and -7 and TIMP-2 gene expression (p < 0.05), and a probable effect on MMP-11 (p = 0.06). At the higher concentration (10(-4) m Substance P), MMP-1, -2, -3, -7 and -11 and TIMP-2 showed the greatest up-regulation; at the lower concentration (10(-9) m Substance P), MMP-1, -3 and -7 and TIMP-2 exhibited diminished up-regulation, with MMP-2 and -11 showing down-regulation (p < 0.05). Expression of TIMP-1 was not affected by Substance P (p > 0.05). Western blotting confirmed that Substance P up-regulated MMP-1, -2, -3 and -11 and TIMP-2. MMP-1, -3 and -11 and TIMP-2 showed greater up-regulation at the higher Substance P concentration and diminished up-regulation at the lower concentration. MMP-2 was up-regulated to a similar degree at both Substance P concentrations. CONCLUSION: In gingival fibroblast cells, Substance P at the higher concentration (10(-4) m) induced greater up-regulation of MMP-1, -3 and -11 and TIMP-2 expression, but at the lower concentration (10(-9) m) induced diminished up-regulation, which may represent a mechanism for modulating periodontal breakdown.

Long-term results of guided tissue regeneration therapy in the treatment of class II furcation defects: a randomized clinical trial.

BACKGROUND: The purpose of this study was to evaluate the results after guided tissue regeneration (GTR) using a bioabsorbable membrane in Class II furcation defects in mandibular molars over a 24-month period. METHODS: Nine patients with 2 comparable Class II furcation defects were included. The defects in each patient were randomly assigned to either test (GTR) or control (open flap debridement) group. Clinical measurements and standardized radiographs were taken at baseline, and at 6, 12, 18, and 24 months. The radiographs were analyzed by subtraction radiography. RESULTS: There were significant probing depth reductions for both test and control groups (P < 0.007, P < 0.0005, respectively); however the differences between groups were not significant at any examination. The intra-group and inter-group differences in the vertical clinical attachment level gain were not significant (P > 0.05). Over 24 months, a significant horizontal clinical attachment level gain was observed in the test group compared to control (P<0.03). In the test group, 2 sites showed complete closure, one was converted to Class I, and one tooth was lost due to root resorption. In the control group, 2 defects progressed to Class III over 24 months. At 6 months, the test group showed 0.14 mm of bone loss while the control group showed 0.86 mm of bone gain (P = 0.035). The inter-group differences were not significant at 12, 18, and 24 months. A significant bone height gain was observed in the test group at 24 months when compared to the values obtained after 6 months (P = 0.015). CONCLUSION: GTR may provide a greater horizontal clinical attachment level gain with the possibility of complete closure of some defects and stability over time.

Avaliaçäo cardiocirculatória do sevofluorano como agente de manutençäo anestésica em cäes, em diferentes concentraçöes de oxigênio e óxido nitroso / Sevoflurane cardiocirculatory study in dog with different oxygen and nitrous oxide concentrations

Com o objetivo de avaliar as alteraçöes cardiocirculatórias resultantes da manutençäo anestésica com sevofluorano, três grupos de 10 cäes cada foram anestesiados por 60 minutos com fluxo diluente de 100 por cento de oxigênio (grupo 1), de 50 por cento de oxigênio e de óxido nitroso (grupo 2) ou 27 por cento de oxigênio e 63 por cento de óxido nitroso (grupo 3). A tranqüilizaçäo foi realizada com levomepromazina (0,5 mg/kg) e a induçäo com tiopental (12,5 mg/lg). A freqüência cardíaca apresentou elevaçäo significativa após a induçäo (P<0,05), mantendo-se mais alta que a basal, em todos os grupos, durante toda a anestesia. As variaçöes das pressöes arteriais sistólica, média e diastólica foram pouco significativas e mantiveram-se em todos os grupos dentro de valores aceitáveis para a espécie e a utilizaçäo do óxido nitroso näo interferiu nessa variaçäo. O sevofluorano demonstrou ser um bom agente de manutençäo anestésica em cäes, e a adiçäo de 63 por cento de óxido nitroso ao fluxo diluente de oxigênio reduziu a necessidade anestésica de maneira significativa

Clinical, cytogenetic and toxicological studies in rural workers exposed to pesticides in Botucatu, São Paulo, Brazil.

Pesticides can cause gene mutations and chromosomal aberrations in exposed individuals. We have investigated 24 workers exposed to pesticides. Clinical examinations and cytogenetic and toxicological tests were performed. Ten non-exposed individuals were used as controls. Toxicological dosages of copper, zinc and manganese (metals found in some pesticides), hepatic enzyme dosage (GOT, GPT, AR) and acetylcholinesterase activity were performed in 16 workers and 8 controls. In the exposed workers, the most relevant clinical symptoms were poor digestion with fullness sensation after meals, irritated eyes, headache and fasciculations. The exposed group showed significantly lower manganese dosage and acetylcholinesterase activity, and significantly higher levels of alkaline phosphatase. Cytogenetic studies showed significantly higher chromosomal aberrations in the exposed group compared to the control group. Although the workers used protection against the pesticide's fog, the results revealed that the workers were contaminated with the pesticides. Therefore, the cytogenetic, toxicological studies with clinical examination are necessary for monitoring workers who are exposed to pesticides in any situation.

Ausência de ação antitrombótica em trombose venosa experimental / Absence of antithrombotic effect of metronidazolin experimental venous thrombosis

Com base na utilização empírica do metronidazol no tratamento de picada de cobra e em uma possível ação fibrinolítica, alguns médicos brasileiros o usaram no tratamento de trombose venosa profunda, embora não existam estudos que justifiquem tal emprego. OBJETIVO: Verificar possível existência de efeito antitrombótico do metronidazol em modelo de trombose induzida na veia cava de ratos e uma eventual ação anticoagulante ou fibrinolítica dessa droga. MÉTODO: 71 ratos da raça Wistar foram usados em 4 experimentos. No primeiro, 29 animais foram divididos em três grupos: controle (solução salina), heparina (200UI/kg) e metronidazol (6mg/kg). 10 minutos após a injeção IV a trombose foi induzida pela ligadura da veia cava, distalmente à veia renal esquerda. Três horas depois, a veia cava era removida e aberta, e o trombo, se presente, retirado para pesagem, sendo o sangue do animal retirado para medida do TTPA, TT e TP. No segundo experimento, o sangue foi retirado dos animais (n=18) 10 minutos após a injeção das drogas, para medida dos mesmos parâmetros. No terceiro experimento os animais (n=22) foram injetados com metronidazol ou salina e o tempo de lise de euglobulina medido 3 horas após. No quarto experimento, 22 animais foram sorteados para um de dois grupos: controle, com injeção IV de 12ml de salina ou metronidazol, (12mg/kg), sendo a trombose induzida 10 minutos após. RESULTADOS: Não houve diferença entre os grupos controles e os grupod tratados com metronidazol, em relação à incidência e peso dos trombos e com relação aos parâmetros hemostáticos estudados. Nos animais tratados com heparina não houve formção de trombos, havendo aumento de TTPA e de TT aos 10 minutos, e de TT, após 3 horas. CONCLUSÄO: No modelo experimental empregado, o metronidazol não mostrou efeito antitrombótico e também ação sobre o parâmetros hemostáticos estudados, sugerindo que o uso clínico dessa droga no tratamento de trombose venosa é duvidoso, a menos que outros estudos venham demosntrar algum efeito benéfico.

Techniques in electromanometry of the upper esophageal sphincter.

The various pull-through techniques used to measure pressure and length of the upper esophageal sphincter have not been studied in depth. Because of the importance of obtaining further information about these techniques, a group of 25 dogs was submitted to upper esophageal sphincter pressure and length measurements by three different pull-through techniques (two of the continuous type and one of the station type), each with three replications per animal, to determine possible differences among techniques. A single introduction provided reliable results, with no sequential effect of the measurements or of any one technique on resting pressure. However, each technique yielded different sphincter lengths, higher values being obtained when the continuous techniques were used.

Morphometric evaluation of the time course of right ventricular hypertrophy after left coronary artery ligation in rats.

1. In order to describe the time course of compensatory right ventricular hypertrophy after infarction, rats submitted to left coronary obstruction and sham-operated controls were compared in terms of heart weight, chamber weight and right ventricular fiber diameter 1, 8 and 21 days after surgery. 2. One day after infarction, only the left ventricle weight increased (0.583 +/- 0.045 g vs 0.698 +/- 0.062 g, P less than 0.05), while right ventricular weight and fiber diameter suffered no change. 3. Eight days after infarction, heart weight (0.781 +/- 0.127 g vs 0.856 +/- 0.100 g, P greater than 0.05) as well as right ventricular fiber diameter (16.5 +/- 1.0 microns vs 17.5 +/- 2.1 microns, P greater than 0.05) and left ventricular weight did not differ between sham-operated animals and animals with left coronary obstruction. However, a significant increase in right ventricular weight was observed in infarcted animals (0.168 +/- 0.026 g vs 0.242 +/- 0.017 g, P less than 0.05). 4. Twenty-one days after infarction, right ventricular weight (0.198 +/- 0.034 g vs 0.316 +/- 0.118 g, P less than 0.05), heart weight (0.864 +/- 0.095 g vs 0.985 +/- 0.105 g, P less than 0.05) and right ventricular fiber diameter (15.0 +/- 1.8 microns vs 21.3 +/- 2.3 microns, P less than 0.05) were significantly increased in infarcted animals, whereas left ventricular weight (0.665 +/- 0.065 g vs 0.669 +/- 0.039 g, P greater than 0.05) was unchanged. 5. We conclude that hypertrophy occurs in the right ventricle of randomized infarcted rats 21 days after infarction, and that this phenomenon precedes the increase in fiber diameter.(ABSTRACT TRUNCATED AT 250 WORDS)

Paracoccidioidomycosis in the region of Botucatu (state of São Paulo, Brazil). Evaluation of serum thyroxine (T4) and triiodothyronine (T3) levels and of the response to thyrotropin releasing hormone (TRH).

T4, T3 and TSH serum levels were measured in 25 patients with paracoccidioidomycosis. Thyroid T3 reserves were measured on the basis of the increase in T3 (delta T3) 2 h after intravenous injection of 200 micrograms TRH, and pituitary TSH reserves were measured on the basis of TSH increase (delta TSH) 20 min after the same injection. Twenty healthy volunteers with no history of thyroid disease were used as controls. When the two groups were compared, the following results were obtained: (a) there was no significant difference in mean T4, T3, delta TSH between groups; (b) reduced T3 levels were detected more frequently in patients with paracoccidioidomycosis, especially among those with the acute form of the disease or with the severely disseminated chronic form. The results suggest the occurrence of a reduction in peripheral conversion of T4 to T3, but do not indicate the occurrence of hypothyroidism in any of its forms (thyroid, pituitary or hypothalamic).

Platelet activation in experimental arterial thrombosis.

Platelet aggregates were studied in dogs with induced arterial thrombosis, by the method of Wu and Hoak. Blood was withdrawn from a jugular vein and from the femoral vein on the operated side 24 h after thrombus induction and immediately and 2 h after blood flow was restored by thrombectomy. Platelet activation was significant in dogs with obstructive arterial thrombosis and which tended to subside after thrombectomy. Activation or formation of platelet aggregates seemed to occur in the ischemic limb. It is suggested that this experimental model could be useful to test the action of anti-platelet drugs in vivo.