Supernumerary breast in an adolescent boy.

We present an adolescent boy with unilateral supernumerary breast. It was a V type by Leung Clasification. Despite the average occurence between 0.22% and 6% in a normal population we have not had other cases in the last 20 years. The patient was an asthenic boy of sixteen in the IV stage of puberty. Sometimes he felt swelling and tenderness in this breast tissue two years ago. These symptoms became worse two months ago. At the admission he was symptom free. In the right hypochondrium inferomedially he had a nipple and areola with a small part of the glandular tissue. The axilla was empty. After an excision we got a 15 x 10 x 8 mm specimen. Pathohistological report described incompletely formed mammary lobule with smooth muscles and lactiferous ducts of nipple in dermis. This was consistent with the diagnosis of ectopic breast tissue. He wanted it removed for esthetic reasons. His hormonal state was normal. All blood checks were normal. Kidney ultrasound was normal. His grandmother had pyelon duplex and frequent uroinfections. As it is known, there is an association between supernumerary breast tissue and renal malformations. Since he did not have it, we think that a routine screening of the uropoetic system should be performed in any patient with supernumerary breast.

Dental and Skeletal Age in Patients with Palatally Displaced Canines.

Objective: To determine potential associations between dental and skeletal maturation and palatally displaced canines (PDC) considering gender and chronological age. Material and methods: This study included pretreatment panoramic and lateral cephalometric radiographs of 43 subjects with PDCs and 203 randomly selected orthodontic subjects with normally erupted canines. Both groups were non syndromic patients. Chronological age of subjects was rounded and noted in years with decimal points and compared with chronological age according to Demirjian's dental age assessment. Skeletal maturation was determined by cervical vertebrae changes on cephalometric radiographs. Results: Female subjects with PDC were more affected by left side canine displacement than males (p=0.027) with five times higher odds ratio (OR = 4.9; 95% CIL=1.2-19.7). A comparison of chronologic and skeletal age indicated that PDC subjects were skeletally younger than unaffected groups with statistically significant differences at the age of 10, 12 and 13. (p=0.05). Conclusion: Young subjects with PDCs showed skeletal maturation delay compared to control group, indicating that skeletal maturation assessment could be one of unexplored predicting factors of a PDC, especially at the age between 10 and 13 years in both genders. Subjects with PDC showed intensive growth spurt after the age of 12 years in females, and after the age of 13 in males. Dental maturation delay showed no statistical significance in PDC prediction.

Novel benzimidazole derivatives as selective CB2 agonists.

The preparation and evaluation of a novel class of CB2 agonists based on a benzimidazole moiety are reported. They showed binding affinities up to 1nM towards the CB2 receptor with partial to full agonist potencies. They also demonstrated good to excellent selectivity (>1000-fold) over the CB1 receptor.

Shear Bond Strength of Orthodontic Brackets Luted with RMGIC After Er:YAG Laser Etching with Two Pulse Modes Using a Digitally Controlled "X-Runner" Handpiece.

OBJECTIVE: To compare the shear bond strength (SBS) values of orthodontic brackets luted using a resin-modified glass ionomer cement (RMGIC) on enamel surfaces etched using either an Er:YAG laser in two different working modes, or a conventional etching protocol, including phosphoric acid. MATERIALS AND METHODS: Sixty healthy human premolars were randomly allocated to three experimental groups (n = 20) and etched with: Group 1: Er:YAG laser in super-short pulse (SSP) mode (100 mJ, 20 Hz, 2 W); Group 2: Er:YAG laser in quantum square pulse mode (120 mJ, 10 Hz, 1.2 W) using a digitally controlled handpiece ("X-Runner"); Group 3 (control): 5.25% sodium hypochlorite pretreatment, then 37% phosphoric acid for 15 sec. Stainless steel brackets were bonded using light-curing RMGIC for orthodontic bonding. After term cycling (1800 cycles), SBS testing was performed using a universal testing machine. After debonding, both enamel and bracket surfaces were examined to determine the amount of RMGIC still present on the surfaces. RESULTS: Group 3 surfaces gave the lowest mean SBS (10.6104 ± 2.66196 MPa), whereas Group 1 provided the highest 1 (13.1795 ± 3.37904 MPa), which was significantly different from the control (Group 3, p = 0.0226). Group 2 provided intermediate values (11.8486 ± 0.59832 MPa) nonsignificantly different from the control or from SSP (p = 0.4215 and p = 0.3082, respectively). CONCLUSIONS: Er:YAG laser treatment in SSP mode of enamel surfaces for orthodontic bonding provided higher SBS and a shear behavior of the luting material similar to the conventional acid-etching procedures, making it a viable alternative to acid etching.

Traumatic optic neuropathy - to treat or to observe?

We present a case of acute traumatic optic neuropathy in 54 year old male patient. The patient presented with acute loss of vision in the right eye due to a blunt trauma to the eye. Lid haematoma and subconjunctival hemorrhage were present. Fluorescein staining was negative, anterior chamber and lens was clear. Intraocular pressure was normal. Retina and optic nerve head appeared normal on fundoscopy. The vision was "counting fingers at 1 meter" in the right eye. Color test indicated color perception dysfunction of the right eye. Relative afferent pupillary defect (RAPD) was positive. Ocular ultrasound, orbital X ray and CT scan was normal, but visual evoked potentials test was pathologic. The consideration was made whether to treat a patient or not since there are no consensus on the treatment of traumatic optic neuropathy. We decided to treat the patient immediately with the megadoses of steroids following the protocol suggested by Cerovski. The patient responded well to the treatment and recovered vision to normal.

Embolism in retinal circulation after invasive cardiovascular procedures.

UNLABELLED: To determine the occurence of embolism in retinal circulation after invasive cardiovascular procedures and the risk of central retinal artery occlusion (CRAO) and branch retinal artery occlusion (BRAO). MATERIAL AND METHODS: During a 3 month period 153 patients (303 eyes)--101 male/52 female--who had undergone coronarography or stent implantation were examined before and 24 hours after the procedure. Best corrected visual acuity (BCVA) was taken, visual field examination was done and fundoscopy was performed. Eyes with the opacities in the anterior segment (corneal leucoma, dense cataracts) were excluded from the study. Prior to invasive procedure none of the patients had embolism in the retinal circulation. RESULTS AND DISCUSSION: Embolism was found in 3 patients (male) who all had hyperlipidemia with normal blood pressure. Two of them had coronarography and one patient had stent implantation. One of the patients had a previous branch retinal vein occlusion (BRVO) that was treated with photocoagulation. They did not report any symptoms. BCVA was the same before and after the procedure. Two of the emboli were located in the first branch of the central retinal artery and one was located in the branch of cillioretinal artery. All of the emboli were transient after 48 hours. CONCLUSION: The study showed that invasive cardiovascular procedures do have the risk of developing transient embolism in retinal circulation. However, there have been reports of CRAO and BRAO after diagnostic cardiac procedures, therefore clinicians should be aware of this potential complication.

Laparoscopic transgastric gastrocystostomy pancreatic pseudocyst.

Article presents a laparoscopic cystogastrostomy of pancreatic pseudocysts. Pancreatic pseudocyst is a common complication of acute or chronic pancreatitis. It is treated by drainage. Until the development of laparoscopic method, the only surgical type of treatment was a drainage of pseudocyst into the stomach or intestine by the open surgery. In a recent years, a new procedures of laparoscopic treating of pseudocysts pancreatic were published. Despite of the small number of cases it is legible that this certain method of operative treatment has clear benefits for the patient. Herewith, we present a laparoscopic transgastric cystogastrostomy of the 44-year old woman who was admitted because of acute biliary pancreatitis. She was operated six months after the acute attack.