Tomografía computarizada en la identificación de la sinusitis odontogénica de origen endodóntico: reporte de un caso / Computerized tomography in the identification of odontogenic sinusitis of endodontic origin: report of a case

Objetivo: se presenta el caso clínico de sinusitis de origen endodóntico, conocida como síndrome en-doantral, haciendo énfasis en la dificultad de diag-nóstico con radiografía periapical y la importancia de la tomografía computarizada. Caso clínico: una mujer de 32 años, con antecedentes de apretamiento dental nocturno y sinusitis recurrente, fue remitida para evaluación endodóntica. El examen clínico reve-ló sensibilidad a la percusión y palpación en la unidad dental. La radiografía periapical no indicó lesión en el diente 16 y la prueba de sensibilidad pulpar fue ne-gativa, además, la tomografía computarizada reveló una extensa lesión periapical y comunicación entre la raíz del diente 16 y el seno maxilar, confirmada por la pérdida de la continuidad de la imagen hiperdensa en el suelo del seno, lo que llevó al tratamiento endo-dóntico. El control de la infección dental resolvió la sinusitis, resaltando la importancia del diagnóstico preciso y el tratamiento en casos de sinusitis odon-togénica. Conclusión: este caso destaca el valor de la tomografía computarizada como herramienta diag-nóstica crucial en contextos clínicos complejos (AU)

Objective: the clinical case of sinusitis of endodontic origin, known as endoantral syndrome, is presented, emphasizing the difficulty of diagnosis with periapical radiography and the importance of computed tomography. Clinical case: a 32-year-old woman, with a history of tooth clenching and recurrent sinusitis, was referred for endodontic evaluation. The clinical examination revealed sensitivity to percussion and palpation in the dental unit. The periapical radiograph did not indicate a lesion in tooth 16 and the pulp sensitivity test was negative, in addition, the computed tomography revealed an extensive periapical lesion and communication between the root of tooth 16 and the maxillary sinus, confirmed by the loss of continuity of the hyperdense image in the sine floor, which led to endodontic treatment. Dental infection control resolved sinusitis, highlighting the importance of accurate diagnosis and treatment in cases of odontogenic sinusitis. Conclusion: this case highlights the value of computerized tomography as a crucial diagnostic tool in complex clinical contexts (AU)

Microwave-induced combustion for petroleum coke digestion: a promising sample preparation strategy for subsequent elemental determination.

The increasing demand for the elemental determination of petrochemical samples by inductively coupled plasma techniques requires the development of suitable sample preparation methods that permit high sample throughput and are in accordance with green chemistry recommendations. For this aim, the development of microwave-induced combustion (MIC) method has been attempted to completely digest petroleum coke samples and address quantitative determination of elements, such as Ag, Al, Ba, Ca, Cd, Co, Cu, Fe, Mg, Mn, Mo, Na, Ni, Pb, Sr, V and Zn, by inductively coupled plasma optical emission spectrometry (ICP OES). A sequential procedure to evaluate the sample mass and the solution to retain the analytes quantitatively was first conducted. Satisfactory results were obtained (residual carbon content in final solutions was lower than 0.5%) by digesting 400 mg of samples using 20 bar of oxygen and analytes were quantitatively retained in a dilute acid solution such as 4.2 mol L-1 HNO3. An agreement better than 87% was achieved using certified reference materials and the performance of the proposed method was also compared to that of the standard procedure recommended by the American Society of Testing and Materials ASTM D 5600. Despite both methods producing similar results, the proposed method by MIC was much simpler, offered a higher sample throughput and the digests were compatible with ICP OES measurements avoiding interferences in the determination step compared the ASTM D 5600 method. These results clearly demonstrated that the proposed MIC method in combination with ICP OES could be a promising alternative to obtain quantitative information about the elemental composition of petroleum coke.

Microwave-induced combustion of crude oil for further rare earth elements determination by USN-ICP-MS.

A procedure for light and heavy crude oils digestion by microwave-induced combustion (MIC) is proposed for the first time for further rare earth elements (REE) determination by inductively coupled plasma mass spectrometry (ICP-MS) equipped with an ultrasonic nebulizer (USN). Samples of crude oil (API density of 10.8-23.5, up to 250 mg) were inserted in polycarbonate capsules and combusted using 20 bar of oxygen and 50 µL of 6 mol L(-1) ammonium nitrate as igniter. Nitric acid solutions (1-14.4 mol L(-1)) were evaluated for analyte absorption and a reflux step was applied after combustion (5 min of microwave irradiation at 1400 W) in order to achieve better analyte recoveries. Accuracy was evaluated using a spiked sample and also by comparison of results obtained by microwave-assisted digestion combined to ultraviolet radiation (MW-UV) and by neutron activation analysis (NAA). Using 3 mol L(-1) HNO3, quantitative recoveries (better than 97%) were obtained for all analytes. Blank values were always negligible. Agreement was higher than 96% for La, Ce, Pr, Nd, Sm, Eu, Gd, Tb, Dy, Ho, Er, Tm, Yb, Lu and Y by comparison of results with those obtained by MW-UV and by NAA (only for La, Ce, Nd, Sm, and Yb). Residual carbon content in digests using MIC was always below 1%. As an advantage over conventional procedures for crude oil digestion, using MIC, it was possible to use diluted acid as absorbing solution, obtaining better limits of detection and avoiding interferences in REE determination by USN-ICP-MS.

High-efficiency microwave-assisted digestion combined to in situ ultraviolet radiation for the determination of rare earth elements by ultrasonic nebulization ICPMS in crude oils.

A method for heavy and extraheavy crude oil digestion based on microwave-assisted wet digestion (MW-AD) and ultraviolet (UV) radiation using diluted HNO3 was applied for the determination of rare earth elements (REE) by inductively coupled plasma mass spectrometry (ICPMS) with an ultrasonic nebulizer (USN). Even using pressurized systems conventional acid digestion is not feasible for efficient crude oil digestion, especially for heavy and extraheavy crude oils that generally present high amounts of asphaltenes and resins. In the proposed system, UV radiation is generated in situ by immersed electrodeless Cd discharge lamps positioned inside quartz vessels. The use of diluted solutions (1-14.4 mol L(-1) HNO3 and 1-4 mol L(-1) H2O2) were evaluated for heavy and extraheavy crude oil digestion (API density of 11.1-19.0). With the proposed method the residual carbon content was lower than 13 mg C/100 mg of sample, and it was possible to digest sample masses up to 500 mg using 4 mol L(-1) HNO3 and 4 mol L(-1) H2O2. Interferences caused by excessive acid concentration and carbon content in digests were minimized allowing limits of quantification for REEs as low as 0.3 ng g(-1). Samples were also digested using MW-AD in pressurized systems with concentrated HNO3, but even using 280 °C, 80 bar, and concentrated HNO3, MW-AD method was not suitable for REE determination due to interferences in ICPMS determination. The combination of microwave heating with UV was considered a suitable and effective way to digest crude oil allowing further determination of low concentrations of REE by ICPMS.

Analysis of the frequency and nature of hyaline ring granulomas in inflammatory odontogenic cysts.

AIM: To determine the prevalence of hyaline ring granulomas (HRGs) in a large case series of inflammatory odontogenic cysts, and to investigate the nature of these structures. METHODOLOGY: All records from the patients diagnosed with inflammatory odontogenic cysts between January 1970 and April 2009 were reviewed. Histologic sections were evaluated by light microscopy and cases with HRGs for which sufficient biological material was available were submitted to histochemical analysis (Masson's trichrome) and immunohistochemistry (CD34, CD68 and collagen IV). RESULTS: Twenty-two (3.3%) of the 661 cases of inflammatory odontogenic cysts diagnosed during the study period presented HRGs. The relative frequency of HRGs was higher amongst residual radicular cysts (6.1%), followed by paradental cysts (5.6%) and radicular cysts (3.0%). HRGs appeared as roughly circular homogeneous/fibrillar masses in 14 (63.6%) cases and as round structures enclosing amorphous material in 3 (13.6%) cases. Most (77.8%) roughly circular homogeneous/fibrillar masses were positive for collagen, whereas all (100.0%) round structures enclosing amorphous material were negative for this protein. Immunohistochemistry showed that most mononucleated cells and all multinucleated giant cells were positive for CD68, but negative for CD34, in all cases. In addition, collagen IV immunostaining was negative in amorphous structures and weakly positive in homogeneous/fibrillar masses. CONCLUSIONS: The present results suggest a very low frequency of HRGs in inflammatory odontogenic cysts and support the hypothesis that these structures arise from the implantation of foreign material, most likely food particles of plant or vegetable origin. The diverse microscopic features of HRG possibly represent different developmental stages of this structure.

Progressive increase of glucose transporter-3 (GLUT-3) expression in estrogen-induced breast carcinogenesis.

INTRODUCTION: Increased glucose uptake and glycolysis are main metabolic characteristics of malignant cells. A family of glucose transporters (GLUTs) facilitates glucose movement across the plasma membranes in a tumor-specific manner. Glucose transporter-1 (GLUT-1), GLUT-3 and recently GLUT-12, have been previously shown in breast cancer cells and are found to be associated with poor prognosis. In addition, it has been shown that estrogen plays critical roles in GLUT regulation, however, the stage-specific GLUT regulation of mammary carcinogenesis is unclear. METHODS: GLUT expression patterns were investigated in an in vitro-in vivo progressive, estrogen-induced, mammary carcinogenesis model which consisted of four cell lines, with same genetic background. In this model, different stages of tumor initiation and progression are represented, MCF-10F being the normal stage, E2 cells the transformed stage by estrogen, C5 cells, the invasive stage, and T4 cells the tumorigenic stage. In addition, loss of ductulogenesis and solid mass formation in collagen matrix and invasiveness of the cells were counted. RESULTS: Real time PCR showed that GLUT1 expression was downregulated in MCF10F after treatment with 17ß-estradiol (E2), and in the invasive cell type (C5), but not in the tumor cells (T4), which had no changes compared to MCF10F. C5 and T4 cells showed the highest rate of GLUT-3 expression. These cells were also found to be associated with loss of ductulogenesis, solid mass formation and higher invasive capacity, whereas, GLUT-12 was downregulated in C5 and T4 cells. CONCLUSION: Estrogen-induced malignant transformation is associated with remarkable and progressive GLUT-3 expression, GLUT-1 re-expression at further stages, as well as GLUT-12 downregulation.

Correlation between total nitrite/nitrate concentrations and monoamine oxidase (types A and B) and semicarbazide-sensitive amine oxidase enzymatic activities in human mesenteric arteries from non-diabetic and type 2 diabetic patients

The aim of this study was to determine the correlation between total nitrite/nitrate concentrations (NOx) and the kinetic parameters of monoamine oxidase enzymes (MAO-A and MAO-B) and semicarbazide-sensitive amine oxidase (SSAO) in human mesenteric arteries. Arteries were from non-diabetic and type 2 diabetic patients with sigmoid or rectum carcinoma for whom surgery was the first option and who were not exposed to neo-adjuvant therapy. Segments of human inferior mesenteric arteries from non-diabetic (61.1 ± 8.9 years old, 7 males and 5 females, N = 12) and type 2 diabetic patients (65.8 ± 6.2 years old, 8 males and 4 females, N = 12) were used to determine NOx concentrations and the kinetic parameters of MAO-A, MAO-B and SSAO by the Griess reaction and by radiochemical assay, respectively. The NOx concentrations in arteries from diabetic patients did not differ significantly from those of the non-diabetic group (10.28 ± 4.61 vs 10.71 ± 4.32 nmol/mg protein, respectively). In the non-diabetic group, there was a positive correlation between NOx concentrations and MAO-B parameters: Km (r = 0.612, P = 0.034) and Vmax (r = 0.593, P = 0.042), and a negative correlation with the SSAO parameters: Km (r = -0.625, P = 0.029) and Vmax (r = -0.754, P = 0.005). However, in the diabetic group no correlation was found between NOx concentrations and the three kinetic parameters of the enzymes. These results suggest an important function of sympathetic nerves and vascular NOx concentrations in arteries of non-diabetic patients. Thus, these results confirm the importance of a balance between oxidants and antioxidants in the maintenance of vascular homeostasis to prevent oxidative stress.

Correlation between total nitrite/nitrate concentrations and monoamine oxidase (types A and B) and semicarbazide-sensitive amine oxidase enzymatic activities in human mesenteric arteries from non-diabetic and type 2 diabetic patients.

The aim of this study was to determine the correlation between total nitrite/nitrate concentrations (NOx) and the kinetic parameters of monoamine oxidase enzymes (MAO-A and MAO-B) and semicarbazide-sensitive amine oxidase (SSAO) in human mesenteric arteries. Arteries were from non-diabetic and type 2 diabetic patients with sigmoid or rectum carcinoma for whom surgery was the first option and who were not exposed to neo-adjuvant therapy. Segments of human inferior mesenteric arteries from non-diabetic (61.1 ± 8.9 years old, 7 males and 5 females, N = 12) and type 2 diabetic patients (65.8 ± 6.2 years old, 8 males and 4 females, N = 12) were used to determine NOx concentrations and the kinetic parameters of MAO-A, MAO-B and SSAO by the Griess reaction and by radiochemical assay, respectively. The NOx concentrations in arteries from diabetic patients did not differ significantly from those of the non-diabetic group (10.28 ± 4.61 vs 10.71 ± 4.32 nmol/mg protein, respectively). In the non-diabetic group, there was a positive correlation between NOx concentrations and MAO-B parameters: Km (r = 0.612, P = 0.034) and Vmax (r = 0.593, P = 0.042), and a negative correlation with the SSAO parameters: Km (r = -0.625, P = 0.029) and Vmax (r = -0.754, P = 0.005). However, in the diabetic group no correlation was found between NOx concentrations and the three kinetic parameters of the enzymes. These results suggest an important function of sympathetic nerves and vascular NOx concentrations in arteries of non-diabetic patients. Thus, these results confirm the importance of a balance between oxidants and antioxidants in the maintenance of vascular homeostasis to prevent oxidative stress.

Polymorphisms of p53, GSTM1 and GSTT1, and HPV in uterine cervix adenocarcinoma.

OBJECTIVE: To analyze the participation of glutathione-S-transferase (GST) M1 and T1 polymorphisms associated or not with protein p53 polymorphism at codon 72 and in the presence of HPV in the carcinogenesis of uterine cervix adenocarcinoma. METHODS: Forty-three samples of uterine cervix adenocarcinoma were studied and 86 samples of endocervical cells of women without tumors formed the control group. The presence of HPV was determined in order to genotype the isoforms of p53 at codon 72, GSTM1, GSTM1*0, GSTT1 and GSTT1*0 which were evaluated by the PCR method. RESULTS: HPV was present in 97.67% of the adenocarcinoma cases and in 31.40% of the control group. Statistical analysis showed differences (p = 0.001) and an OR of 113.3 (CI 95%: 13.67-947.14). GSTT1 and GSTT1*0 analysis showed a significant difference between the groups (p = 0.001) with an OR of 4.58 (CI 95%: 2.041-10.28) (p < 0.001) for the presence of GSTT1*0. When it was associated with HPV OR was 6.6 (CI 95%: 0.04-0.50). Analyses of p53 and GSTM1 and GSTM1*0 either alone or associated with HPV were not significant. CONCLUSION: The presence of GSTT1*0 increased the risk for uterine cervix adenocarcinoma development while the allele GSTT1 had a protective action. The other isoforms did not appear to participate in the carcinogenesis of uterine cervix adenocarcinoma.

Detección del tipo de papilomavirus humano por el método de PCR-RFLP en uncaso con neoplasia intraepitelial de alto grado y captura híbrida II negativa / Detection of human papillomavirus by PCR RFLP assay in a case with negative hybrid capture II result and high grade intraepithelial neoplasia Pap smear result

La infección persistente del virus del papiloma humano (HPV) es un factor necesario para eldesarrollo del cáncer de cuello uterino. Este caso reporta una mujer de 43 años, con imágenescitológicas persistentes de neoplasia intraepitelial de grado III (CIN III) y resultados negativos paraestudios colposcópicos y anatomopatológicos, como también, para HR-HPV analizado por el métodode Captura Híbrida II. Una evaluación histopatológica posteriormente confirmó la existencia de CINIII en mucosa cervical. A fin de detectar otros tipos de HPV no incluidos en la Captura Híbrida II, lamuestra fue analizada por el método de PCR-RFLP obteniendo un resultado positivo para HPV 73.En este caso, el uso del método de PCR-RFLP permitió detectar una infección por un tipo específicode HPV, brindando una información útil que puede ayudar en el manejo clínico de mujeres condiagnóstico citológico de CIN III y resultado de Captura Híbrida II negativo

HBV vaccination of HCV-infected patients with occult HBV infection and anti-HBc-positive blood donors

Anti-HBc positivity is a frequent cause of donation rejection at blood banks. Hepatitis B virus (HBV) infection may also occur in HBsAg-negative patients, a situation denoted occult infection. Similarly, very low levels of HBV-DNA have also been found in the sera of patients with chronic hepatitis C virus (HCV) infection, even in the absence of serum HBsAg. Initially we searched for HBV-DNA in serum of 100 blood donors and 50 HCV-infected patients who were HBsAg negative/anti-HBc positive by nested-PCR and by an HBV monitor commercial test for HBV-DNA. Anti-HBs seroconversion rates were measured in 100 blood donors and in 22 patients with chronic HCV infection after HBV vaccination to determine if the HBV vaccination could eliminate an occult HBV infection in these individuals. Occult HBV infection was detected in proportionally fewer blood donors (6/100 = 6 percent) than chronic hepatitis C patients (12/50 = 24 percent) (P < 0.05). We noted seroconversion in 6/6 (100 percent) HBV-DNA(+) and in 84/94 (89.4 percent) HBV-DNA(-) blood donors (P > 0.05). All subjects who were HBV-DNA(+) before the first dose of HBV vaccine (D1), became HBV-DNA(-) after D1, D2, and D3. Among 22 HCV-positive patients, 10 HBV-DNA(+) and 12 HBV-DNA(-), seroconversion was observed in 9/10 (90 percent) HBV-DNA(+) and in 9/12 (75 percent) HBV-DNA(-) subjects (P > 0.05). The disappearance of HBV-DNA in the majority of vaccinated patients suggests that residual HBV can be eliminated in patients with occult infection.

Prognostic value of P53 codon 72 polymorphism in invasive cervical cancer in Brazil.

OBJECTIVE: The prognostic value of p53 codon72 polymorphism was analyzed in Brazilian women with cervical cancer. METHODS: The present study consists of 148 women diagnosed and treated for invasive cervical carcinoma (FIGO stages Ib-IIIb) between 1992 and 2002. Demonstration of p53 polymorphism was performed in DNA extracted from paraffin-embedded sections using the polymerase chain reaction (PCR). RESULTS: Among the 148 women, arg/arg was found in 99 (67%) and, arg/pro in 49 (33%). The overall survival (OS) curves (univariate) were different between arg/arg and arg/pro patients (P = 0.01). There was slightly increased risk of death for arg/arg patients (crude HR 2.2 CI 95% 1.2-4.0), which was not confounded by FIGO stages (adjusted HR 2.4 CI 95% 1.3-4.3). For disease-free survival (DFS), two situations were considered: (1) 124 women who received any treatment, and (2) 118 who received FIGO-recommended treatment. In the first group, 59% of arg/arg patients presented recurrence as compared to 32% in the arg/pro group (P = 0.02), whereas in the second group, 61% of the arg/arg and 34% arg/pro showed recurrence (P = 0.04). The risk of recurrence adjusted by FIGO stage for the 124 patients was 2.4 (CI 95% 1.0-3.7) and for the 118 it was 1.9 (CI 95% 1.0-3.4). These adjusted models showed no confounding and no interaction. CONCLUSIONS: Despite the prognostic significance of p53 polymorphism in univariate survival analysis, there was no or only marginal evidence on the independent prognostic value of p53arg/arg in multivariate analysis. The more ominous prognosis of the homozygous (arg/arg) patients was explained by the primary treatment, independent on the FIGO stage.

Cervical coinfection with human papillomavirus (HPV) types as a predictor of acquisition and persistence of HPV infection.

Interest in coinfection with multiple types of human papillomavirus (HPV) has increased in response to the possibility of vaccination and the discovery that the host immune response appears to be mainly type specific. This study attempts to document the occurrence of coinfection with multiple HPV types and to determine whether these coinfections predicted acquisition or persistence of other HPV types in a prospective cohort of women in Brazil. Multiple HPV types were detected at the same visit in one-fifth of all women who tested positive for HPV at any time. Acquisition of an HPV infection was more likely among women with any HPV type detected on study entry. Persistence of HPV infection, the true precursor of cervical abnormalities, was independent of coinfection with other HPV types. Given the increasing prominence of HPV vaccination as a potential preventive approach, it is imperative that additional insights on cross-type protection be obtained from longer-term longitudinal investigations.

Kinetic differences in cardiac myosins with identical loop 1 sequences.

The kinetics of nucleotide turnover vary considerably among isoforms of vertebrate type II myosin, possibly due to differences in the rate of ADP release from the nucleotide binding pocket. Current ideas about likely mechanisms by which ADP release is regulated have focused on the hyperflexible surface loops of myosin, i.e. loop 1 (ATPase loop) and loop 2 (actin binding loop). In the present study, we investigated the kinetic properties of rat and pig beta-myosin heavy chains (beta-MHC) in which we have found the sequences of loop 1 (residues 204-216) to be virtually identical, i.e. DQSKKDSQTPKG, with a single conservative substitution (rat E210D pig). Pig myocardium normally expresses 100% beta-MHC, whereas rat myocardium was induced to express 100% beta-MHC by surgical thyroidectomy and subsequent treatment with propylthiouracil. Slack test measurements at 15 degrees C yielded unloaded shortening velocities of 1.1 +/- 0.8 muscle lengths/s in rat skinned ventricular myocytes and 0.35 +/- 0.05 muscle lengths/s in pig skinned myocytes. Similarly, solution measurements at the same temperature showed that actin-activated ATPase activity was 2.9-fold greater for rat beta-myosin than for pig beta-myosin. Stopped-flow methods were then used to assess the rates of acto-myosin dissociation by MgATP both in the presence and absence of MgADP. Although the rates of MgATP-induced dissociation of acto-heavy meromyosin (acto-HMM) were virtually identical for the two myosins, the rate of ADP dissociation was approximately 3.8-fold faster for rat beta-myosin (135 s(-)(1)) than for pig beta-myosin (35 s(-)(1)). ATP cleavage rates were nearly 30% faster for rat beta-myosin. Thus, whereas loop 1 appears from other studies to be involved in nucleotide turnover in the pocket, our results show that loop 1 does not account for large differences in turnover kinetics in these two myosin isoforms. Instead, the differences appear to be due to sequence differences in other parts of the MHC backbone.

Immunohistochemical characterization of intraocular metastasis of a canine transmissible venereal tumor.

Little has been published on intraocular metastasis of transmissible venereal tumors (TVT) in dogs. This report presents a 4-year-old male Labrador Retriever with a previous history of subcutaneous TVT which underwent total remission after treatment with vincristine. The dog presented with clinical signs of uveitis and increased intraocular pressure (IOP) in both eyes. After enucleation of the left eye, a diagnosis of TVT was made based on morphology, histology and immunohistochemistry (IHC). IHC staining for vimentin, S-100 protein, cytokeratin and HMB45 was performed to differentiate this lesion from TVT, lymphoma, melanoma, carcinomas, neurogenic tumors and fibrosarcoma. The IHC findings supported the diagnosis of TVT for this round cell tumor.

Discinesia tardia: I. Fisiopatologia e tratamento. / Tardive dyskinesia: I.Physiopathology and treatment

A introducao dos neurolepticos foi importante contribuicao para o tratamento das doencas mentais. Contudo sua eficacia foi limitada por efeitos colaterais, entre os quais se encontram movimentos anormais da musculatura orofacial, cujo aparecimento parece estar relacionado a desnervacao far macologica cronica de receptores no estriado, com o consequente desenvolvimento de hipersensibilidade de desnervacao. E feita revisao desta e de outras teorias fisiopatologicas, alem do tratamento,que deve basear-se na retirada dos neurolepticos,sempre que possivel. Sao apresentadas varias drogas com acao nos sistemas dopaminergico colinergico e GABA-ergico que podem ser uteis no tratamento