Focal Dermal Hypoplasia (Goltz Syndrome): A Case Report Showing a Wide Variety of Systemic and Oral Manifestations.

Focal dermal hypoplasia (FDH), also known as Goltz syndrome, consists of an unusual genodermatosis that affects tissues of ectodermal and mesodermal origin and various organs and systems, especially skin, bones, eyes, and oral cavity. While systemic manifestations of FDH have been well documented, the oral manifestations have not been extensively discussed. We present a 22-year-old female patient with history of FDH that showed a variety of systemic and oral manifestations. FDH was diagnosed at birth based on cutaneous alterations. Extra and intraoral examination showed facial asymmetry, lip and perioral atrophy, upper lip papilloma, malocclusion, enamel hypoplasia, and gingival hyperplasia. Mucosal lesions, periodontal diseases, and malocclusion were treated by oral surgery, periodontal therapy and orthodontic treatment, respectively. Although FDH is an uncommon syndrome, health professionals should be aware of its systemic and oral manifestations to establish an early diagnosis and adequate treatment.

Kallikrein 5 Inhibition by the Lympho-Epithelial Kazal-Type Related Inhibitor Hinders Matriptase-Dependent Carcinogenesis.

Head and neck squamous cell carcinoma remains challenging to treat with no improvement in survival rates over the past 50 years. Thus, there is an urgent need to discover more reliable therapeutic targets and biomarkers for HNSCC. Matriptase, a type-II transmembrane serine protease, induces malignant transformation in epithelial stem cells through proteolytic activation of pro-HGF and PAR-2, triggering PI3K-AKT-mTOR and NFKB signaling. The serine protease inhibitor lympho-epithelial Kazal-type-related inhibitor (LEKTI) inhibits the matriptase-driven proteolytic pathway, directly blocking kallikreins in epithelial differentiation. Hence, we hypothesized LEKTI could inhibit matriptase-dependent squamous cell carcinogenesis, thus implicating kallikreins in this process. Double-transgenic mice with simultaneous expression of matriptase and LEKTI under the keratin-5 promoter showed a prominent rescue of K5-Matriptase+/0 premalignant phenotype. Notably, in DMBA-induced SCC, heterotopic co-expression of LEKTI and matriptase delayed matriptase-driven tumor incidence and progression. Co-expression of LEKTI reverted altered Kallikrein-5 expression observed in the skin of K5-Matriptase+/0 mice, indicating that matriptase-dependent proteolytic pathway inhibition by LEKTI occurs through kallikreins. Moreover, we showed that Kallikrein-5 is necessary for PAR-2-mediated IL-8 release, YAP1-TAZ/TEAD activation, and matriptase-mediated oral squamous cell carcinoma migration. Collectively, our data identify a third signaling pathway for matriptase-dependent carcinogenesis in vivo. These findings are critical for the identification of more reliable biomarkers and effective therapeutic targets in Head and Neck cancer.

Value of adding the apparent diffusion coefficient to capsular contact for the prediction of extracapsular extension in prostate cancer.

OBJECTIVE: To determine whether evaluating the mean apparent diffusion coefficient (ADC) together with capsular contact (CC) adds value in the prediction of microscopic extracapsular extension (ECE) of prostate cancer. MATERIALS AND METHODS: Between January 2012 and December 2016, 383 patients underwent multiparametric magnetic resonance imaging (mpMRI) of the prostate. A total of 67 patients were selected for inclusion. Two radiologists (observers 1 and 2), working independently, performed qualitative and quantitative analyses of ECE, macroscopic ECE, and microscopic ECE. A third radiologist assessed the correlation with the clinical data, and two experienced pathologists reviewed all histopathological findings. RESULTS: Among the 67 patients, mpMRI showed lesions that were confined to the capsule in 44 (66.7%), had microscopic ECE in 12 (17.9%), and had macroscopic ECE in 11 (16.4%). There were no significant differences, in terms of the diagnostic accuracy, as measured by determining the area under the curve (AUC), of CC on T2-weighted images (CCT2), CC on diffusion-weighted imaging (CCDWI), and the mean ADC for the prediction of microscopic ECE, between observer 1 (AUC of 0.728, 0.691, and 0.675, respectively) and observer 2 (AUC of 0.782, 0.821, and 0.799, respectively). Combining the mean ADC with the CCT2 or CCDWI did not improve the diagnostic accuracy for either observer. There was substantial interobserver agreement for the qualitative evaluation of ECE, as demonstrated by the kappa statistic, which was 0.77 (0.66-0.87). The diagnostic accuracy (AUC) of the qualitative assessment for predicting microscopic ECE was 0.745 for observer 1 and 0.804 for observer 2, and the difference was less than significant. In a multivariate analysis, none of clinical or imaging parameters were found to be associated with ECE. CONCLUSION: For the detection of microscopic ECE on mpMRI, CC appears to have good diagnostic accuracy, especially if the observer has considerable experience. Adding the mean ADC to the CCT2 or CCDWI does not seem to provide any significant improvement in that diagnostic accuracy.

OBJETIVO: Avaliar se o coeficiente de difusão aparente (apparent diffusion coefficient - ADC) médio tem valor incremental ao contato capsular (CC) na predição da extensão extracapsular (EEC) do câncer de próstata. MATERIAIS E MÉTODOS: De janeiro de 2012 a dezembro de 2016, 383 pacientes realizaram ressonância magnética multiparamétrica de próstata. Após os critérios de inclusão e exclusão, 67 pacientes foram selecionados para avaliação qualitativa e quantitativa, por dois radiologistas independentes, da EEC, EEC grosseira e EEC microscópica. Um terceiro observador coletou dados clínicos e dois patologistas experientes revisaram os achados histopatológicos. RESULTADOS: Dos 67 pacientes selecionados, 44 apresentaram lesões restritas à cápsula (66,7%), 12 com EEC microscópica (17,9%) e 11 com EEC grosseira (16,4%). Não houve diferença significativa entre a acurácia diagnóstica, medida pela área sob a curva, entre o CC na ponderação T2 (CCT2), CC-difusão e ADC para predição da EEC microscópica para ambos os observadores (0,728, 0,691 e 0,675, respectivamente, para o observador 1, e 0,782, 0,821 e 0,799, respectivamente, para o observador 2). A associação dos valores médios do ADC ao CCT2 e ao CC-difusão não promoveu melhora da acurácia diagnóstica. A concordância interobservador para a avaliação qualitativa da EEC mostrou coeficiente kappa de 0,77 (0,66-0,87), inferindo concordância substancial. A acurácia da avaliação qualitativa para EEC microscópica foi de 0,745 e 0,804 para os observadores 1 e 2, respectivamente, diferença não significativa. Na análise multivariada, nenhum parâmetro clínico ou de imagem foi associado a EEC. CONCLUSÃO: O CC mostrou boa acurácia diagnóstica para a detecção de EEC microscópica, especialmente para o observador mais experiente. A inclusão dos valores médios de ADC não melhorou a acurácia do CC para predição de EEC microscópica.

Value of adding the apparent diffusion coefficient to capsular contact for the prediction of extracapsular extension in prostate cancer / Valor incremental do coeficiente de difusão aparente ao contato capsular na predição da extensão extracapsular do câncer de próstata

Abstract Objective: To determine whether evaluating the mean apparent diffusion coefficient (ADC) together with capsular contact (CC) adds value in the prediction of microscopic extracapsular extension (ECE) of prostate cancer. Materials and Methods: Between January 2012 and December 2016, 383 patients underwent multiparametric magnetic resonance imaging (mpMRI) of the prostate. A total of 67 patients were selected for inclusion. Two radiologists (observers 1 and 2), working independently, performed qualitative and quantitative analyses of ECE, macroscopic ECE, and microscopic ECE. A third radiologist assessed the correlation with the clinical data, and two experienced pathologists reviewed all histopathological findings. Results: Among the 67 patients, mpMRI showed lesions that were confined to the capsule in 44 (66.7%), had microscopic ECE in 12 (17.9%), and had macroscopic ECE in 11 (16.4%). There were no significant differences, in terms of the diagnostic accuracy, as measured by determining the area under the curve (AUC), of CC on T2-weighted images (CCT2), CC on diffusion-weighted imaging (CCDWI), and the mean ADC for the prediction of microscopic ECE, between observer 1 (AUC of 0.728, 0.691, and 0.675, respectively) and observer 2 (AUC of 0.782, 0.821, and 0.799, respectively). Combining the mean ADC with the CCT2 or CCDWI did not improve the diagnostic accuracy for either observer. There was substantial interobserver agreement for the qualitative evaluation of ECE, as demonstrated by the kappa statistic, which was 0.77 (0.66-0.87). The diagnostic accuracy (AUC) of the qualitative assessment for predicting microscopic ECE was 0.745 for observer 1 and 0.804 for observer 2, and the difference was less than significant. In a multivariate analysis, none of clinical or imaging parameters were found to be associated with ECE. Conclusion: For the detection of microscopic ECE on mpMRI, CC appears to have good diagnostic accuracy, especially if the observer has considerable experience. Adding the mean ADC to the CCT2 or CCDWI does not seem to provide any significant improvement in that diagnostic accuracy.

Resumo Objetivo: Avaliar se o coeficiente de difusão aparente (apparent diffusion coefficient - ADC) médio tem valor incremental ao contato capsular (CC) na predição da extensão extracapsular (EEC) do câncer de próstata. Materiais e Métodos: De janeiro de 2012 a dezembro de 2016, 383 pacientes realizaram ressonância magnética multiparamétrica de próstata. Após os critérios de inclusão e exclusão, 67 pacientes foram selecionados para avaliação qualitativa e quantitativa, por dois radiologistas independentes, da EEC, EEC grosseira e EEC microscópica. Um terceiro observador coletou dados clínicos e dois patologistas experientes revisaram os achados histopatológicos. Resultados: Dos 67 pacientes selecionados, 44 apresentaram lesões restritas à cápsula (66,7%), 12 com EEC microscópica (17,9%) e 11 com EEC grosseira (16,4%). Não houve diferença significativa entre a acurácia diagnóstica, medida pela área sob a curva, entre o CC na ponderação T2 (CCT2), CC-difusão e ADC para predição da EEC microscópica para ambos os observadores (0,728, 0,691 e 0,675, respectivamente, para o observador 1, e 0,782, 0,821 e 0,799, respectivamente, para o observador 2). A associação dos valores médios do ADC ao CCT2 e ao CC-difusão não promoveu melhora da acurácia diagnóstica. A concordância interobservador para a avaliação qualitativa da EEC mostrou coeficiente kappa de 0,77 (0,66-0,87), inferindo concordância substancial. A acurácia da avaliação qualitativa para EEC microscópica foi de 0,745 e 0,804 para os observadores 1 e 2, respectivamente, diferença não significativa. Na análise multivariada, nenhum parâmetro clínico ou de imagem foi associado a EEC. Conclusão: O CC mostrou boa acurácia diagnóstica para a detecção de EEC microscópica, especialmente para o observador mais experiente. A inclusão dos valores médios de ADC não melhorou a acurácia do CC para predição de EEC microscópica.

Impact of Bevacizumab on Experimentally Induced Endometriotic Lesions: Angiogenesis, Invasion, Apoptosis, and Cell Proliferation.

Endometriosis is responsible for pain symptoms with great impact on the patient's quality of life. Several medication lines have been studied aiming at its definitive treatment. Among them, angiogenesis inhibitor factors may be effective given that angiogenesis has fundamental role in the establishment and growth of endometriotic lesions. In this study, we investigated the influence of bevacizumab, anti-factor drug of endothelial growth (anti-VEGF), used at two different dosages, in experimental endometriosis induced in rats. After the induction of endometriosis lesions in rats, they were divided in 3 groups: control group, no treatment, and two other groups were treated with different dosages of the same medication for 4 weeks. At the end of the treatment, endometriotic lesions were removed and evaluated regarding area of lesions, presence of endometrial tissue in microscopy, positivity for anti-VEGF antibody in immunohistochemistry, and gene expression of Pcna, Mmp9, Tp63, and Vegfa. Bevacizumab acted by reducing the area of lesions in the groups that received medication (p = 0.002) and reducing gene expression to Tp63 in lesions (p = 0.04). There was no significant result in other evaluations. We observed that there was significant reduction of the area of lesions among groups, suggesting that bevacizumab has a positive effect on disease control. The gene expression of Tp63 was significantly lower in the group that received high dose of the drug when compared with the other two groups; therefore, we concluded that bevacizumab acts by reducing cell proliferation and differentiation in lesions, constituting a real option for treating endometriosis.

EBV-negative lymphoepithelial-like carcinoma of the lower lip

Lymphoepithelial-like carcinoma (LEC) is a rare malignant neoplasm, which can be associated with Epstein-Barr virus (EBV) infection. Histologically, LEC is an undifferentiated carcinoma with an intermixed reactive lymphoplasmacytic infiltrate. LEC appears to be an uncommon tumor type of lip carcinoma. An 82-year-old white woman presented a lesion on her lower lip that developed over the last year. The lesion was characterized by ulceration with flat edges, hardened base, painful, and absence of regional lymphadenopathy. Microscopical analysis evidenced an intense inflammatory infiltrate, composed of lymphoplasmacytic cells, associated with scarce pleomorphic epithelial cells. Immunohistochemistry highlighted the LEC cells with strong expression of pan-CK AE1/AE3, EMA, p63, and p53. CD138 was also faintly positive. Ki-67 was >85%. In situ hybridization analysis did not show evidence of EBV. A diagnostic of EBV-negative LEC was made. We present an uncommon type of lip carcinoma, which can represent a diagnostic challenge for clinicians and pathologists.

The Role of the LY294002 - A Non-Selective Inhibitor of Phosphatidylinositol 3-Kinase (PI3K) Pathway- in Cell Survival and Proliferation in Cell Line SCC-25.

The activation of PI3K further activates subsequent regulatory pathways, which are activated via AKT phosphorylation. AKT is closely related to the Bcl-2 family, a protein known to be involved in cell survival. AKT also has a relationship with inflammatory and glycolytic mediators. The present work aimed to evaluate the relationship between the PI3K/AKT pathway, cell survival/proliferation, inflammatory mediators and the glycolytic pathway in oral squamous cell carcinoma. All experiments were performed in the SCC25 oral squamous cell carcinoma cell line. In the presence or absence of PI3K pathway inhibitors, we analyzed the protein expression of pAKT and AKT; X-linked inhibitor of apoptosis protein; Bcl-2-associated death promoter; Bcl-2-like protein two inhibitor; cyclooxygenase 1; cyclooxygenase-2; and glycoprotein-associated glucose transporter 1. For the functional characterization of treated or untreated cells, we also performed matrix invasion assays, cell migration assays, and cell proliferation assays. Our results demonstrated that activation of the PI3K/AKT pathway is directly related to members of the Bcl-2 family and GLUT1, but not the inflammatory mediators COX1 and COX2. Our data suggest that the PI3K/AKT pathway is related to cell survival and proliferation in oral squamous cell carcinoma through its interaction with Bcl-2 family members.
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Produção de oócitos em mamíferos adultos: o camundongo como modelo / Oocyte production in adult mammals: mice as the model

Objetivo: identificar produção de oócitos em mamíferos adultos com o uso de camundongo como modelo experimental. Método: empregamos a técnica de imuno-histoquímica em cortes de ovários de camundongos Balb-c (45 dias de idade) com o uso de anticorpo específico para marcação de células germinativas. Como controles positivos da reação, usamos cortes de testículos de camundongos. Resultados: as células germinativas (espermatogônias, espermatócitos e espermátides) dos controles positivos sofreram marcação, enquanto células não pertencentes a essa linhagem (células de Leydig e de Sertoli) mostraram negatividade de reação; nos cortes ovarianos observou-se marcação de oócitos de folículos em diferentes estágios de maturação, mas houve também marcação de células não englobadas pela estrutura folicular. Conclusões: os achados sugerem que durante a puberdade ovários de camundongos fêmeas contêm células da linhagem germinativa em estágios anteriores à formação folicular, o que corrobora estudos anteriores; o trabalho é pioneiro no Brasil e progredirá para a completa caracterização de células com potencial oogênico em outras espécies de mamíferos. Resultados positivos poderão alterar o entendimento da biologia reprodutiva e abrir novas portas para o tratamento de infertilidade.

Objective: to identify oocyte production in adult mammals using the mouse as the experimental model. Method: we used the immunohistochemistry technique on ovary sections of Balb-c mice (45 days old), with antibody that labels germline cells specifically. We used sections of mice’s testes as positive reaction controls.Results: in testes samples, germ cells (spermatogonia, spermatocytes and spermatids) were stained, while cells not belonging to germ lineage (Leydig and Sertoli cells) showed negativereaction; in ovarian samples, oocytes from follicles in different stages of maturation werestained, but the reaction was also positive for cells not enclosed by the follicular structure. Conclusions: the findings suggest that, during puberty, female mice ovaries contain germline cells in earlier stages before follicular formation, as was found in previous studies. Thework, pioneering in Brazil, must progress to a complete characterization of these cells (with oogenesis potential) in mice and in other mammal species. Positive results may change the understanding of the reproductive biology and open new possibilities for infertility treatment.

Clinical-Pathological Correlation of KRAS Mutation Status in Metastatic Colorectal Adenocarcinoma.

BACKGROUND: KRAS gene mutations play an important role in the carcinogenesis of colorectal tumors. However, studies that have assessed the association between KRAS gene mutation status and disease characteristics report conflicting results. To assess KRAS gene status (mutated or wild-type) and its association with the clinical, epidemiological, and histopathological features of metastatic colorectal adenocarcinoma as well its association with clinical outcomes. METHODS: Cross-sectional descriptive study in which clinical and histopathological data were collected from the medical records of 65 patients diagnosed with metastatic colorectal adenocarcinoma at the Clinical Oncology Service of the Teaching Hospital of the School of Medicine of Ribeirao Preto, University of Sao Paulo (Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo -HCFMRP-USP) between 2005 and 2012 and analyzed based on their KRAS gene status. RESULTS: KRAS gene mutations were found in 49.2% of the tumors, and G/A (25.5%) and Gly12Asp (34.37%) were the most frequent mutations. Among the investigated clinical features (gender, ECOG (Eastern Cooperative Oncology Group), histology, degree of cell differentiation, lymph node ratio, primary tumor site, staging, presence of synchronous metastasis, lung metastasis, and liver metastasis), the association between age less than 65 years with KRAS mutation was statistically significant (P = 0.046). KRAS mutation status did not exhibit a significant correlation with the overall survival of the patients (P = 0.078); however, the cases with KRAS mutation exhibited shorter survival. In the multivariate analysis, synchronous metastasis (P = 0.03) and liver metastasis (P = 0.008) behaved as independent factors of poor prognosis relative to the overall survival of the patients. CONCLUSION: The KRAS mutation status did not exhibit prognostic value in the investigated sample. Among the older patients (> 65 years old), wild-type KRAS was more frequently observed compared to mutated KRAS.

Avaliação da mucosa sinusal do coelho à presença de implante biodegradável / Assessing the maxillary sinus mucosa of rabbits in the presence of biodegradable implants

Pensando em melhorar a qualidade de vida dos pacientes com doenças do humor vítreo, os oftalmologistas começaram a utilizar recentemente implantes biodegradáveis com corticoide. Estes mesmos implantes podem ser uma alternativa no tratamento da RSC e, para isso, realizamos um estudo experimental em seios maxilares de coelhos. OBJETIVO: Avaliar histologicamente a mucosa de seio maxilar de coelhos após a colocação de implante biodegradável de prednisolona. MÉTODO: Dezoito coelhos foram divididos aleatoriamente em dois grupos: Grupo 1: no seio maxilar esquerdo foi inserido um implante biodegradável com prednisolona; Grupo 2: No seio maxilar esquerdo foi inserido um implante biodegradável sem medicação. Os seios maxilares do lado direito serviram como controle. Após 7, 14 e 28 dias foram escolhidos aleatoriamente três coelhos de cada grupo e a resposta tecidual inflamatória foi avaliada. RESULTADOS: Foi encontrada diferença não significativa de inflamação na mucosa, quando comparamos o grupo de coelhos que receberam implantes com e sem medicação com o grupo controle; ou quando comparamos o grupo que recebeu implante com prednisolona com o grupo que recebeu implante sem medicação. CONCLUSÃO: Não foram observados sinais de toxicidade ou inflamação na mucosa do seio maxilar do coelho à presença do implante com ou sem prednisolona.

In an attempt to improve the quality of life of patients with vitreous humor disease, ophthalmologists began offering steroid-eluting biodegradable implants to their patients. These implants can be used as an alternative treatment for CRS and this is why this experimental study was carried out on rabbit maxillary sinuses. OBJECTIVE: This study aims to assess the histology of the mucosa of the maxillary sinuses of rabbits after the placement of a prednisolone-eluting biodegradable implant. METHOD: Eighteen rabbits were randomly divided into two groups: group 1 - subjects had drug-eluting implants placed on their left maxillary sinuses; group 2 - subjects had non-drug-eluting implants placed on their left maxillary sinuses. The right maxillary sinuses served as the controls. After seven, 14, and 28 days three rabbits in each group were randomly picked to have their tissue inflammatory response assessed. RESULTS: Levels of mucosal inflammation were not significantly different between the groups with and without drug-eluting implants and the control group, or when the groups with drug-eluting implants and non-drug-eluting implants were compared. CONCLUSION: Signs of toxicity or mucosal inflammation were not observed in the maxillary sinuses of rabbits given prednisolone-eluting implants or non-drug-eluting implants.

Immunohistochemical features of claudin-low intrinsic subtype in metaplastic breast carcinomas.

PURPOSE: The claudin-low molecular subtype of breast cancer includes triple negative invasive carcinomas, with a high frequency of metaplastic and medullary features. The aim of this study was to evaluate the immunohistochemistry expression of claudins in a series of metaplastic breast carcinomas. We also assessed other claudin-low features, such as the cancer stem cell-like and epithelial-to-mesenchymal transition phenotypes. RESULTS: The majority of the cases showed weak or negative staining for membrane claudins expression. We found 76.9% (10/13) low expressing cases for claudin-1, 84.6% (11/13) for claudin-3 and claudin-4, and 92.3% (12/13) for claudin-7. Regarding the cancer stem cell marker ALDH1, 30.8% (4/13) showed positive staining. We also showed that the majority of the cases presented a CD44(+)CD24(-/low) phenotype, positivity for vimentin and lack of E-cadherin expression. Interestingly, these claudin-low molecular features were specific of the mesenchymal component of metaplastic breast carcinomas, since its frequency was very low in other breast cancer molecular subtypes, as luminal, HER2-overexpressing and non-metaplastic triple negative tumors. CONCLUSIONS: The negative/low expression of claudins and E-cadherin, high levels of vimentin, and the breast cancer stem cell phenotype suggests that metaplastic breast carcinomas have similar features to the ones included in the claudin-low molecular subtype, specially their mesenchymal components.

Tumor neuroendócrino primário de mama: relato de três casos e revisão de literatura / Primary neuroendocrine carcinoma of the breast: case report and literature review

Os tumores neuroendócrinos primários de mama (TNPMs) são incomuns e não há consenso quanto a tratamento e prognóstico. No presente trabalho, foram revisados os diagnósticos de 1.184 pacientes com câncer de mama atendidos no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP/USP), identificando três casos que preenchiam os critérios de TNPM, segundo classificação estabelecida pela Organização Mundial da Saúde (OMS) em 2003. Foram avaliados os achados clinicopatológicos e imuno-histoquímicos e as terapias realizadas, buscando caracterizar os padrões histopatológicos e de comportamento distintos dos carcinomas convencionais de mama.

Primary neuroendocrine breast carcinomas (NECs) are uncommon. Moreover, there is no consensus as to its treatment and prognosis. In this study, the diagnoses of 1,184 cases of breast cancer treated at Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto/Universidade de São Paulo (HCFMRP/USP) were reviewed. Three among them fulfilled the criteria for primary NEC according to the classification established by the World Health Organization (WHO) in 2003. Clinicopathological, immunohistochemical features and treatments were assessed in order to characterize histopathological and distinct patterns of conventional breast carcinomas.

Assessing the maxillary sinus mucosa of rabbits in the presence of biodegradable implants.

UNLABELLED: In an attempt to improve the quality of life of patients with vitreous humor disease, ophthalmologists began offering steroid-eluting biodegradable implants to their patients. These implants can be used as an alternative treatment for CRS and this is why this experimental study was carried out on rabbit maxillary sinuses. OBJECTIVE: This study aims to assess the histology of the mucosa of the maxillary sinuses of rabbits after the placement of a prednisolone-eluting biodegradable implant. METHOD: Eighteen rabbits were randomly divided into two groups: group 1 - subjects had drug-eluting implants placed on their left maxillary sinuses; group 2 - subjects had non-drug-eluting implants placed on their left maxillary sinuses. The right maxillary sinuses served as the controls. After seven, 14, and 28 days three rabbits in each group were randomly picked to have their tissue inflammatory response assessed. RESULTS: Levels of mucosal inflammation were not significantly different between the groups with and without drug-eluting implants and the control group, or when the groups with drug-eluting implants and non-drug-eluting implants were compared. CONCLUSION: Signs of toxicity or mucosal inflammation were not observed in the maxillary sinuses of rabbits given prednisolone-eluting implants or non-drug-eluting implants.

Menopause leading to increased vaginal wall thickness in women with genital prolapse: impact on sexual response.

INTRODUCTION: Hypoestrogenism causes structural changes in the vaginal wall that can lead to sexual dysfunction. A reduction in vaginal wall thickness has been reported to occur after menopause, although without precise morphometry. AIM: To measure vaginal wall thickness in women with genital prolapse in normal and hypoestrogenic conditions and to correlate sexual dysfunction with vaginal wall thickness and estradiol levels. METHODS: Surgical vaginal specimens from 18 normoestrogenic and 13 postmenopausal women submitted to surgery for genital prolapse grades I and II were examined. Patients were evaluated for FSH, estradiol, prolactin, glycemia, and serum TSH levels. For histological analysis, samples were stained with Masson's trichrome and hematoxylin-eosin. Sexual function was assessed by the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). MAIN OUTCOME MEASURES: GRISS questionnaire, histological analysis, morphometric methods, Masson's trichrome. RESULTS: The vaginal wall was thicker in the postmenopausal than premenopausal group (2.72 +/- 0.72 mm and 2.16 +/- 0.43, P = 0.01, and 2.63 +/- 0.71 mm and 2.07 +/- 0.49 mm, P = 0.01, for the anterior and posterior walls, respectively). These thicknesses seem to be due to the muscular layer, which was also thicker in the postmenopausal group (1.54 +/- 0.44 and 1.09 +/- 0.3 mm, P = 0.02, and 1.45 +/- 0.47 and 1.07 +/- 0.44 mm, P = 0.03, for the anterior and posterior wall, respectively). The vaginal epithelium was thinner in the middle segment than in the proximal one in the posterior wall (0.17 +/- 0.07 mm, 0.15 +/- 0.05 mm, 0.24 +/- 0.09 mm, P = 0.02). There was no correlation between coital pain, vaginal wall thickness, and estradiol levels in either group. CONCLUSION: The vaginal wall is thicker after menopause in women with genital prolapse. In this study, vaginal thickness and estrogen levels were not related to sexual dysfunction.

Phakomatous choristoma of the orbit.

Phakomatous choristoma is a rare adnexal congenital tumor of lenticular anlage. The authors performed a standard orbital tomography of the orbits for the evaluation of a mass that was palpable in the left lower eyelid of a 3-month-old boy. Hematoxylin-eosin, special stainings and immunohistochemistry were performed on the excised mass. The histopathological and immunohistochemical findings confirmed the diagnosis of phakomatous choristoma. The CT scans showed that the mass was located in the orbit. Even though phakomatous choristoma is usually reported as a lower eyelid lesion, the orbital localization offers a better explanation for the chronological embryonic origin of this rare pediatric tumor.