Substance P expression in the gingival tissue after upper third molar extraction: effect of ketoprofen, a preliminary study.

The aim of this study was to evaluate substance P (SP) levels and the effect of a non-steroidal anti-inflammatory drug (NSAID), ketoprofen, on SP in the pericoronal gingival tissue after extraction of upper third molars. A sample of 20 young non-smoking systemically healthy adults of both sexes, with a healthy upper third molar to extract for orthodontic purposes, was selected. After extraction, a sample of the gingival tissue of the pericoronal region was collected with a sterile scalpel, placed into test tubes and kept frozen at -20°C until the SP determination. SP levels were determined by using a commercially available enzyme immunoassay (ELISA) kit. The subjects were randomly divided into two groups: group 1 received a single dose of ketoprofen 30 minutes prior to the experimental procedure. The subjects of group 2 did not receive any kind of drug administration before extraction. The patients were asked to complete a diary on the postoperative pain. A relevant amount of SP was measured in all the gingival samples. No statistically significant difference could be detected in SP expression between the two groups. In group 1 pain appearance was significantly delayed (6.2±0.13 hours) in comparison with group 2 (3.95±0.2 hours). In this small selected group of subjects and limited study design, preventive administration of ketoprofen did not significantly affect the gingival levels of SP, the clinical recommendation emerging is that of NSAID administration postoperatively but before pain appearance in order to optimize the management of pain of the patient.

Validation of a method for measuring (226)Ra in drinking waters by LSC.

A simple method for measuring (226)Ra in drinking waters has been validated and validation parameters are provided. It is based on the measurement by LSC of (222)Rn, at equilibrium with (226)Ra, which is absorbed into a water immiscible scintillation cocktail (Ultima Gold F) inside the counting vial. The validated application field ranges between the detection limit (2·10(-3) Bq/kg) to 150 Bq/kg. The method has proven to be reliable, effective and suitable for wide-range measuring campaigns. A summary of results obtained in recent years is also given.

Correlation between unstimulated salivary flow, pH and streptococcus mutans, analysed with real time PCR, in caries-free and caries-active children.

AIM: Evaluate the correlations between unstimulated salivary flow, pH and level of S. mutans, analysed through real time PCR, in caries-free and caries-active children. MATERIALS AND METHODS: Thirty healthy children were divided into 2 groups: test group (DMFT/dmft ≥ 3 and at least 1 active caries lesion) and control group (DMFT/dmft=0). Un-stimulated saliva was collected, pH was measured and S. mutans and total bacterial amount were evaluated with real-time PCR analysis. RESULTS: Unstimulated salivary flow in the test group was significantly lower (p = 0.0269) compared to group control. The level of S. mutans was higher in the test group (p = 0.176), and an inverse correlation was recorded between total bacterial amount and un-stimulated salivary flow (p = 0.063). In the control group a positive relationship was found between total bacterial amount and S. mutans (p = 0.045) and an inverse correlation between pH and S. mutans (p = 0.088). A t-test and a linear regression analysis were performed. CONCLUSION: A higher salivary flow and an increased salivary pH seem to represent protective factors against caries in children, while high levels of S. mutans are correlated with caries active lesions. Caries risk assessment should be performed considering all parameters involved in the development of the disease.

Salivary pH after a glucose rinse: effect of a new mucoadhesive spray (Cariex) based on sodium bicarbonate and xylitol.

OBJECTIVE: This study evaluated whether sodium bicarbonate applied on the oral mucosa through a new mucoadhesive spray (Cariex) could control a drop in salivary pH after a glucose rinse, and therefore enhance the buffering potential of saliva. METHODS: A sample of 50 healthy adults was selected. At day 1, the measurement of salivary pH was performed in the lower fornix in correspondence with the lower molars. Each subject rinsed with 10 ml of a 10% glucose solution and then pH was monitored continually for 40 minutes. At day 2, the same experimental procedure was repeated and three shots of the spray were administered on the oral mucosa. The tested spray is composed of sodium bicarbonate, xylitol, and excipients. RESULTS: Without the mucoadhesive spray, salivary pH became significantly lower following the glucose rinse (p < 0.01). Following the spray, the time in which the pH remained lower than 6.0 was reduced statistically significantly (p < 0.01). A continual rise of salivary pH was observed for the 40 minutes in which the pH recording was performed. Conclusions: The use of a sodium bicarbonate spray on the mucosa was shown to control the lowering of salivary pH following carbohydrate consumption, and might therefore add to the prevention of caries and dental erosion.

Oral Signs and HLA-DQB1∗02 Haplotypes in the Celiac Paediatric Patient: A Preliminary Study.

Celiac disease (CD) diagnosis can be extremely challenging in the case of atypical patterns. In this context, oral signs seem to play a decisive role in arousing suspicion of these forms of the disease. At the same time, the different expressions of the HLA-DQB1∗02 allele apparently seem to facilitate the interpretation of signs and highlighted symptoms. The aim of this work was to verify whether it is possible to identify a correlation between the development of oral signs and different DQ2 haplotypes in celiac pediatric patients. 44 celiac patients with a medium age of 9.9 were studied. Oral examinations were performed in order to identify recurrent aphthous stomatitis (RAS) and dental enamel defects (DED). The diagnosis of DED resulted as being related to allele expression (P value = 0.042) while it was impossible to find a similar correlation with RAS. When both oral signs were considered, there was an increase in correlation with HLA-DQB1∗02 expression (P value = 0.018). The obtained results identified both the fundamental role that dentists can play in early diagnosis of CD, as well as the possible role of HLA haplotype analysis in arousing suspicion of atypical forms of the disease.

pH of tooth surface in healthy adolescents at rest and after a glucose rinse: effect of 72 hours of plaque accumulation.

AIM: This study was performed to evaluate the effect of a glucose rinse and of plaque accumulation on pH of tooth surface in healthy adolescents with a device used in gastroenterology and never tested in the oral cavity. MATERIALS AND METHODS: Values of pH were monitored in 12 adolescents using a portable device (pH-day 2® Menfis, bioMedica S.r.l., Bologna, Italy) with a disposable antimonium electrode kept in contact with the interproximal surface of the upper molars for 40 minutes respectively before and after a one-minute rinse with 10 ml of a 10% glucose solution. The same procedure was repeated in the same subjects after 72 hours of plaque accumulation. RESULTS: The device tested resulted difficult to use on the tooth surface because of the size of the active part of the probe. The glucose rinse caused a statistically significant decrease of the mean pH, restrained in basal conditions (d = -0.16, p <0.05), clinically relevant after plaque accumulation (d = -1.24, p <0.05). Time in minutes of pH < 6 grew considerably only in case of combination of plaque accumulation and glucose rinse (d = 20.90, p <0.05). A Stephan's curve of drop and recover of the pH values was not recorded. CONCLUSIONS: The continuous recording of pH of natural plaque present on the tooth could represent an alternative to other techniques found in literature. More studies are necessary to verify the suitability of this new device for the monitoring of pH in the oral cavity.

Protection of ovarian tissue from radiotherapy.

Advances researches in the diagnosis and treatment of childhood, adolescent and adult cancer have greatly increased the life expectancy of premenopausal women with cancer. However, one of the serious side effects of these treatments is the risk of damage to fertility. The ovaries are very sensitive to cytotoxic and radiotherapeutic treatment. The only established method of fertility preservation is embryo cryopreservation according to the Ethics Committee of the American Society for Reproductive Medicine (2005), but this option requires the patient to be of pubertal age, have a partner or use donor sperm, and be able to undergo a cycle of ovarian stimulation, which is not possible when the radiotherapy has to be initiated immediately or when stimulation is contraindicated according to the type of cancer. For patients who need immediate radiotherapy, cryopreservation of ovarian tissue is the only possible alternative. This manuscript reports the different techniques of cryopreservation and the results of transplantation of cryopreserved ovarian tissue. The current techniques allow cryopreservation of human ovarian fragments for a long time with good follicular survival rate after thawing. Numerous studies ultimately in this field have demonstrated to improve the survival rate of the oocytes and cryopreserved follicles. Moreover this manuscript includes a case of a 17-year-old girl who had to undergo pelvic irradiation for non-Hodgkin's lymphoma and the laparoscopic treatment to preserve the fertility (Fig. 2, Ref. 47).

A primary squamous cell carcinoma of the trachea: case report and review of the literature.

Primary windpipe tumour is extremely rare. Squamous cell carcinoma is the most common malignant form, especially in smokers. The radiological appearance of these neoplasms can be classified as intra-luminal, wall-thickening, exophytic form; the majority of the lesions are obstructive in nature and then tend to extra-luminal invasion. This tumour is usually diagnosed late on account of delayed specific symptoms: haemoptysis, dyspnoea, coughing, hoarseness, stridor. Surgery, followed by adjuvant radiotherapy, is the treatment of choice; primary radiotherapy, in inoperable cases, can represent a curative management option. A case of primary tracheal cancer is described and a review of the literature is presented.

Two unusual presentations of cervicofacial actinomycosis and review of the literature.

Cervicofacial actinomycosis is the most common clinical form of actinomycosis. This bacterial infection is rare. Diagnosis is difficult, often it is definitive only after surgical excision of the cervicofacial mass. Personal experience is reported concerning two cases of cervicoactinomycosis. Diagnosis, in both cases, has been based on histological findings, not on clinical symptoms. A review of the literature shows that mainly males are affected by this condition and, in fact, both patients described here are males. Symptoms of acute infection were absent. Both patients denied any history of oromaxillofacial trauma or recent dental extraction or oral manipulations. Imaging techniques--ultrasonography and computerized tomography--were not effective in making the diagnosis, in either of these patients. Furthermore, fine needle aspiration cytology did not provide a definitive diagnosis. Both patients underwent surgical excision of the mass. Penicillin was the drug of choice in post-operative long-term treatment (one month). In one of the two men, intravenous steroids were administered. As in several reports in the literature, the definitive diagnosis was histological and not clinical.

Influence of rarefaction on the flow dynamics of a stationary supersonic hot-gas expansion.

The gas dynamics of a stationary hot-gas jet supersonically expanding into a low pressure environment is studied through numerical simulations. A hybrid coupled continuum-molecular approach is used to model the flow field. Due to the low pressure and high thermodynamic gradients, continuum mechanics results are doubtful, while, because of its excessive time expenses, a full molecular method is not feasible. The results of the hybrid coupled continuum-molecular approach proposed have been successfully validated against experimental data by R. Engeln [Plasma Sources Sci. Technol. 10, 595 (2001)] obtained by means of laser induced fluorescence. Two main questions are addressed: the necessity of applying a molecular approach where rarefaction effects are present in order to correctly model the flow and the demonstration of an invasion of the supersonic part of the flow by background particles. A comparison between the hybrid method and full continuum simulations demonstrates the inadequacy of the latter, due to the influence of rarefaction effects on both velocity and temperature fields. An analysis of the particle velocity distribution in the expansion-shock region shows clear departure from thermodynamic equilibrium and confirms the invasion of the supersonic part of the flow by background particles. A study made through particles and collisions tracking in the supersonic region further proves the presence of background particles in this region and explains how they cause thermodynamic nonequilibrium by colliding and interacting with the local particles.

Activation of protease-activated receptor-2 reduces airways inflammation in experimental allergic asthma.

BACKGROUND: Proteinase-activated receptors (PAR)-2 are members of the family of G-protein-coupled receptors activated by proteases. These receptors are widely expressed in several tissues and in virtually all cells involved in rhinitis and asthma. In particular, proteinases activating PAR-2 may affect airway functions and play a role in human diseases. OBJECTIVE: Assessment of the role of PAR-2 in bronchoconstriction, airway responsiveness and immune response after allergic challenge, in rabbits sensitized to Par j 1, the major allergen of Parietaria judaica pollen. METHODS: Evaluation of antigen challenge in rabbits treated with PAR-2-activating peptide (PAR-2AP) (SLIGRL) or the scrambled peptide LSIGRL or vehicle immediately before allergen exposure measuring airway responsiveness. Characterization of bronchoalveolar lavage (BAL) following histamine challenge and phenotype analysis of cells by flow cytometry and analysis of cytokine production by quantitative PCR. RESULTS: PAR-2AP pre-treatment, but not the scrambled peptide, was able to significantly inhibit bronchoconstriction, airway hyper-responsiveness and to modulate the immune response induced by allergic challenge in sensitized rabbits. The phenotype analysis of the cells recovered from BAL showed an increase in RLA-DR-positive cells while RTLA-positive cells were unchanged. IFN-gamma and IL-2 production were inhibited, with a concomitant increase in IL-10 of about 10-fold over the control values. CONCLUSIONS: In this experimental model, PAR-2 modulates bronchoconstriction interfering with antigen challenge-induced immune response in rabbits sensitized and challenged to Par j 1.

Mixed laryngocele: a case report and review of the literature.

Laryngocele is a rare, benign dilatation of the laryngeal saccule that may extend internally into the airway or externally through the thyrohyoid membrane. Many laryngoceles are asymptomatic; sometimes they may cause a cough, hoarseness, stridor, sore throat and may present as a swelling on one or both sides of the neck. Laryngocele may be associated with supraglottic squamous cell carcinoma. Computed tomography scan is the most effective imaging method for diagnosis. Surgery is the treatment of choice. A case of large mixed laryngocele in a 75-year-old male is described together with surgical management and followup. A review of the literature is also presented.

Neoplastic transformation of oral lichen: case report and review of the literature.

Aim of the present investigation was to analyse the possible malignant transformation of oral lichen planus to carcinoma, especially in the atrophic erosive forms and those displaying plaques involving the top of the tongue. A review has been made of the literature, from 1986 to the present day. This search outlines the relationship between oral lichen planus, hepatitis C virus infection, Epstein-Barr virus infection and the importance of periodic follow-up in all patients with oral lichen planus. The case is described of malignant transformation of oral lichen planus to oral cancer in a female presenting asymptomatic hepatitis C virus infection. The clinical history confirms the most important aspects of the relationship between oral lichen planus and oral cancer. Oral lichen planus should be considered as a precancerous lesion, particularly in patients presenting hepatitis C virus infection, requiring follow-up, at close intervals, starting from 3 months after diagnosis.

Dynamical behaviour of holographic gratings with a nematic film--Polymer slice sequence structure.

We have studied the dynamical response of a new kind of holographic grating to a pulsed electric field. The structure, named POLICRYPS, consists of a sequence of homogeneous polymer slices separated by liquid-crystal films. We have found that both the rise and fall response times depend on the pulse duration and amplitude of the applied electric field. We propose a phenomenological explanation for this behaviour, outlining the possibility of getting response times of the order of 100 micros by properly choosing the pulse shape. Results are very interesting for developments in which POLICRYPS gratings could be proposed as basic elements in photonic devices for telecom applications, and induce to a deeper analysis of the microscopic interaction between liquid crystal and polymer interfaces in these samples.

Spectroscopic ellipsometry study of liquid crystal and polymeric thin films in visible and near infrared.

In this work, we propose spectroscopic ellipsometry as a suitable method for measuring optical properties in soft materials, polymers and liquid crystals, specially selected for use in photonics applications. We show the results of our measurements on some multilayered samples, in the range from visible to the near-IR region, of interest for telecom applications. We point out potentialities and limits of the technique and compare the obtained results with another experimental method, the m-lines spectroscopy, and/or with existing data in the literature. The results about the optical parameters for the analysed materials (the nematic liquid crystal 5CB, one commercial and one lab made optical polymer, and an Indium Tin Oxide film) are useful and interesting by themselves. In fact, as a paradigmatic example, we briefly discuss how an incomplete knowledge of this kind of data can lead to a wrong design of a Bragg grating device. However, more than in the provided data, we put the interest of the present analysis in the warnings about spectroscopic ellipsometry utilization and eventually the necessity of getting complementary information.

Adoptive transfer of allogeneic Epstein-Barr virus (EBV)-specific cytotoxic T cells with in vitro antitumor activity boosts LMP2-specific immune response in a patient with EBV-related nasopharyngeal carcinoma.

BACKGROUND: The outcome of patients with nasopharyngeal carcinoma (NPC) presenting as advanced-stage disease or failing conventional radio-chemotherapy is poor. Thus, additional forms of effective, low-toxicity treatment are warranted to improve NPC prognosis. Since NPC is almost universally associated with Epstein-Barr virus (EBV), cellular immunotherapy with EBV-specific cytotoxic T lymphocytes (CTLs) may prove a successful treatment strategy. Patient and methods A patient with relapsed NPC, refractory to conventional treatments, received salvage adoptive immunotherapy with EBV-specific CTLs reactivated ex vivo from a human leukocyte antigen-identical sibling. EBV-specific immunity, as well as T-cell repertoire in the tumor, before and after immunotherapy, was evaluated. RESULTS: CTL transfer was well tolerated, and a temporary stabilization of disease was obtained. Moreover, notwithstanding the short in-vivo duration of allogeneic CTLs, immunotherapy induced a marked increase of endogenous tumor-infiltrating CD8+ T lymphocytes, and a long-term increase of latent membrane protein 2-specific immunity. CONCLUSIONS: Preliminary data obtained in this patient indicate that EBV-specific CTLs are safe, may exert specific killing of NPC tumor cells in vitro, and induce antitumor effect in vivo.

Preservation of clonal heterogeneity of the Pneumocystis carinii-specific CD4 T cell repertoire in HIV infected, asymptomatic individuals.

The loss of CD4 lymphocytes in HIV disease associates with opportunistic infections. Since diverse CD4 T cell clones respond to an opportunistic pathogen, we asked whether CD4 depletion deletes selected clones in the repertoire (vertical depletion) or it affects all clones by reducing the cell number in each progeny without affecting the overall number of clones (horizontal depletion). Understanding this point may help explain the mode of CD4 depletion and the mode of immunoreconstitution after therapy. Therefore we examined the CD4 T cell repertoire specific for Pneumocystis carinii, a relevant opportunistic pathogen in AIDS, in HIV-infected, asymptomatic individuals. We identified two patients of 36 asymptomatics for lack of proliferation to P. carinii, suggesting selective depletion of specific CD4 cells. To investigate clonal heterogeneity of P. carinii-responsive CD4 lymphocytes, specific CD4 T cell lines were generated and studied by TCR BV gene family usage and CDR3 length analysis (spectratyping). Clonal heterogeneity was similar in antigen-specific CD4 lines generated from P. carinii non-responding HIV seropositives and from controls. Thus, despite undetectable response to the pathogen, residual specific cells probably prevent overt infection and, when expanded in vitro, exhibit a clonal diversity similar to normal controls. These findings suggest a horizontal, rather than vertical, depletion in these asymptomatic patients.

The involvement of sensory neuropeptides in airway hyper-responsiveness in rabbits sensitized and challenged to Parietaria judaica.

BACKGROUND: C-fibres have received considerable attention in the context of airway hyper-responsiveness (AHR), in fact several lines of evidence suggest that tachykinins might be involved in the pathogenesis of AHR. OBJECTIVE: The aim of this study was to investigate the role of capsaicin-sensitive sensory C-fibres and tachykinins in rabbits sensitized to the major allergen of Parietaria judaica pollen (Par j1). METHODS: Airway responsiveness was determined by exposing sensitized rabbits to cumulative concentrations of aerosolized histamine before and after an allergic challenge and after a pre-treatment with either vehicle or capsaicin or tachykinin receptor antagonists. Bronchoalveolar lavage was performed following histamine challenge and total and differential cell counts were performed. RESULTS: In sensitized rabbits, an AHR to inhaled histamine was observed 24 h after a Par j1 challenge. Capsaicin pre-treatment inhibited the AHR achieved 24 h following antigen exposure (P < 0.01). Pre-treatment with the tachykinin NK2 receptor antagonist, SR 48968, significantly reduced the antigen-induced AHR (P < 0.05), while pre-treatment with tachykinin NK1 (SR 140333) and NK3 (SR 142801) receptor antagonists did not significantly modify it. Bronchoalveolar lavage fluid obtained from vehicle and capsaicin-treated rabbits challenged with Par j1 exhibited no significant differences in total and differential cell counts. CONCLUSIONS: Parietaria judaica-induced AHR in immunized rabbits was shown to be inhibited by pre-treatment with capsaicin, an effect that is not related to an action on the associated pulmonary infiltration of eosinophils. The involvement of NK2 receptor stimulation in this phenomenon also suggests that NK2 receptor antagonists may be useful for investigating mechanisms of bronchopulmonary alterations in asthmatic patients.

Epidemiology of allergic occupational diseases induced by Tetranychus urticae in greenhouse and open-field farmers living in a temperate climate area.

BACKGROUND: The role of Tetranychus urticae (TU) as an occupational allergen has thus far been investigated only in selected farmer samples. METHODS: The prevalence of TU-induced sensitization and occupational diseases in a randomized sample of farmers living in a temperate climate area was investigated. Occupational/nonoccupational symptoms, skin prick test (SPT) results with common allergens and TU, specific occupational test results, and greenhouse or open-field sources of TU exposure were assessed. The study design was cross-sectional. RESULTS: The prevalence of positive SPT to TU was 6%. TU-induced allergic/nonallergic complaints accounted for 65% of farmers with challenge-confirmed occupational disease. In all farmers, sensitization to common allergens was a risk factor for both current occupational and nonoccupational complaints, while TU sensitization was a prominent risk factor for occupational complaints. Furthermore, in SPT-positive farmers, only the presence of seasonal occupational complaints was significantly associated with TU sensitization. Common allergen sensitization was a risk factor for development of TU sensitization, which was more frequent in greenhouse than in open-field workers. CONCLUSIONS: TU was a common nontraumatic, allergic occupational hazard for farmers. Since occupational seasonal symptoms could be directly related to the presence of TU sensitization, allergy to this mite should be routinely investigated in farmers.

Long-term absence of sensitization to mepivacaine as assessed by a diagnostic protocol including patch testing.

BACKGROUND: Prospective assessment of non-reactivity to local anaesthetics is a frequent reason for allergy consultation. OBJECTIVES: To investigate the clinical profiles of subjects referred for allergy evaluation; to prospectively reduce the frequency of evaluation by assessing the persistence, during clinical use, of non-reactivity to contaminant/additive-free mepivacaine; and to determine the usefulness of a diagnostic protocol involving patch testing. METHODS: In a prospective study, 198 consecutive patients underwent collection of clinical data, skin prick tests and patch tests using allergens/antigens relevant for the investigation, and an intradermal/subcutaneous challenge procedure using contaminant/additive-free mepivacaine, as appropriate. Patients were followed up for 3 years for assessment of non-reactivity persistence using the same diagnostic protocol. RESULTS: Only one-third of the patients had a history of previous adverse local anaesthetic reactions. Absence of sensitization to contaminant/additive-free mepivacaine persisted in all subjects completing the follow-up. Controlled challenge with mepivacaine was negative in 196 patients with both negative specific skin prick tests and patch tests but it was eventful in two subjects with positive specific patch tests. A few subjects displayed positive skin prick tests and/or patch tests for latex and/or additives. CONCLUSIONS: A few patients had a relevant history for potential local anaesthetic-induced adverse reactions. Upon assessment of absence of sensitization and reactivity, contaminant/additive-free mepivacaine could safely be given for as long as 3 years. The patch testing was shown to be useful and safe for prediction of challenge outcomes. True allergic reactions to contaminant/additive-free mepivacaine were not observed in our patient series.