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BACKGROUND: Accepted 'standard practice' for the diagnosis of immunobullous disease is a perilesional sample for direct immunofluorescence (DIF). OBJECTIVES: To compare diagnostic outcomes of a normal buccal punch biopsy (NBPB) with a perilesional biopsy (PLB) for mucous membrane pemphigoid (MMP) and pemphigus vulgaris (PV). METHODS: A retrospective analysis of 251 DIF-positive patients with MMP and 77 DIF-positive patients with PV was undertaken. Parameters analysed included the intraoral sites of involvement and histopathological, DIF and indirect immunofluorescence (IIF) findings. RESULTS: For MMP, PLB was positive in 134 of 143 (93·7%) samples, compared with 129 of 144 (89·6%) by NBPB. The diagnostic sensitivities for PLB (81%, 39 of 48) and NBPB (77%, 37 of 48) among 48 patients who underwent both techniques were not significantly different (P = 0·62). In gingival-only MMP, PLB was positive in 63 of 69 (91%) and NBPB was positive in 63 of 75 (84%). For multisite MMP, PLB was positive in 71 of 74 (96%) and NBPB was positive in 66 of 69 (96%). In gingival-only MMP, biopsies from reflected alveolar mucosa in 17 consecutive patients were positive in 17 of 17 cases (100%). For PV, PLB was positive in 42 of 43 (98%), compared with 42 of 42 (100%) by NBPB. Histopathology was diagnostic in 93 of 134 (69·4%) cases of MMP and 38 of 41 (93%) cases of PV. IIF was positive in 126 of 197 (64·0%) MMP and 68 of 74 (92%) PV patient sera. CONCLUSIONS: In the largest series of combined oral DIF results in patients with MMP and PV, we have shown that NBPB is equivalent to PLB for the diagnosis of PV and multisite MMP, and is more sensitive than both histology and IIF. What's already known about this topic? The variation in sensitivity of oral biopsy sites for direct immunofluorescence (DIF) in the diagnosis of oral MMP and PV has not been studied in detail in large series of patients. Biopsy can be challenging due to difficult access and fragility of the oral mucosa. The diagnostic biopsy technique is therefore critical. What does this study add? We have shown that a normal buccal punch biopsy (NBPB) from uninvolved oral mucosa is as sensitive as a perilesional biopsy (PLB) for diagnosis of oral PV, and superior to serology and histology. For multisite MMP, NBPB is equivalent to PLB and is more sensitive than serology and histology. The oral punch biopsy technique on uninvolved buccal mucosa tissue is a simple and safe practical method for diagnosing oral PV and MMP.
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Penfigoide Mucomembranoso Benigno , Penfigoide Bolhoso , Pênfigo , Biópsia , Humanos , Penfigoide Mucomembranoso Benigno/diagnóstico , Pênfigo/diagnóstico , Estudos RetrospectivosRESUMO
OBJECTIVE: The purpose of this study was to determine the amount of bone available for harvesting from the anterior palate region using IOPA (Intra Oral Peri Apical) radiographs. MATERIALS AND METHODS: A total of 80 patients visiting the outpatient Department of Periodontics were selected. Two groups of male and female consisting 40 patients each were made. They were further subdivided into two groups based on age, 18-30 and 31-60 years of age, each with twenty patients. The patients were subjected to radiographic examination consisting of IOPA radiographs. All IOPA radiographs were taken using long cone paralleling technique. Availability of bone for harvesting, above the apices of teeth was calculated. RESULTS: The bone available in the incisor region was approximately 6.5 to 6.9 mm in height and 7.4 to 8 mm in width, in canine region 6.35 to 6.65 mm in height and 7.6 to 8.1 mm width, and in the premolar region 3.65 to 3.75 mm in height and width. When the bone height and width were compared gender and age wise for CI (central incisors), LI (lateral incisors), canine and premolars, using Student's t- test the results were not statistically significant. CONCLUSION: For the purpose of harvesting autogenous bone, from the region of incisor and canine approximately 6.35 to 6.9 mm height and 7.4 to 8.1 mm width of bone may be harvested maintaining a safe distance from the apices of the teeth and the nasal floor. The premolar region does appear to yield sufficient bone at safe distances from the maxillary sinus and the apices of the premolars.
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Transplante Ósseo , Tomografia Computadorizada de Feixe Cônico/métodos , Maxila/diagnóstico por imagem , Palato Duro/diagnóstico por imagem , Adulto , Feminino , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Palato Duro/cirurgia , Interpretação de Imagem Radiográfica Assistida por Computador , Adulto JovemRESUMO
INTRODUCTION: C.E.R.A. reported effective correction of anaemia and was well tolerated in International studies on CKD patients not on dialysis. OBJECTIVE: The study aimed to describe the management of renal anaemia in CKD patients not on dialysis with C.E.R.A. in routine clinical practice in India. METHODS: This was a prospective, single-arm, open-label, multi-centre, non-interventional, Phase IV study which followed 108 CKD Stage III-IV patients, not on dialysis with Hb < 10 g/dL for correction of anaemia with C.E.R.A. RESULTS: Of the 108 patients with Hb < 10 g/dL at baseline, 83 (90.2%) patients achieved target Hb of 10-12 g/dL and the time taken to achieve correction of anaemia was 9.6 weeks ± 6.13 weeks in the Intent-to-treat population. Haemoglobin concentration increased from 8.59 ± 0.808 g/dL pre-therapy to 10.91 ± 0.634 g/dL post-therapy. The change in mean ± SD Hb value was 2.32 ± 0.174 g/dL. Maintenance of Hb levels within the target range of Hb 10 - 12 g/dL was observed in 78.2% of ITT and 80.8% of the PP population for mean duration of 16.69 weeks. Four patients (3.7%) experienced 5 AEs and 2 patients (1.9%) experienced 3 SAEs in the safety population. As per the treating physician none of the AEs or SAEs was considered related to study drug. There were no deaths reported. CONCLUSIONS: This study demonstrated successful correction of anaemia in Indian patients with C.E.R.A. treatment as well as maintenance of Hb levels within the target range. C.E.R.A. was well tolerated with no new safety concerns specific to the Indian population. The less frequent up to monthly dosing schedule of C.E.R.A. may offer clinicians and patients a simplified regimen of anaemia management as compared to traditional frequently administered (thrice weekly to once weekly) ESAs.
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Anemia/tratamento farmacológico , Eritropoetina/uso terapêutico , Hematínicos/uso terapêutico , Hemoglobinas/metabolismo , Polietilenoglicóis/uso terapêutico , Insuficiência Renal Crônica/complicações , Adulto , Idoso , Anemia/sangue , Anemia/etiologia , Eritropoetina/efeitos adversos , Feminino , Hematínicos/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Polietilenoglicóis/efeitos adversos , Estudos ProspectivosRESUMO
BACKGROUND: The adhesive strength of sealers to dentin is influenced by various factors, and the presence of a smear layer is among the critical variables. Chitosan, known for its dentin compatibility, has previously demonstrated a reduction in dentin change and resin sealer bond strength comparable to ethylenediaminetetraacetic acid (EDTA) when used as an irrigant and final rinse. The study investigates the impact of chitosan, used as both a lubricating gel and final rinse, on the push-out bond strength of resin sealer. MATERIALS AND METHOD: Forty single-rooted premolar teeth, each with a fully formed root and a single root canal, were collected post-extraction. During canal preparation, 1 ml sodium hypochlorite (3%) was used for irrigation at every change of instrument, followed by applying specific chelating gel and final rinse for each experimental group. The groups included: Group 1 (17% EDTA chelating gel, final rinse with saline), Group 2 (17% EDTA chelating gel, final rinse with 17% EDTA solution), Group 3 (chitosan chelating gel, final rinse with saline solution), and Group 4 (chitosan chelating gel, final rinse with 0.2% chitosan solution), 10 specimens in each group. After obturation, specimens were sealed and incubated for a week at 37°C with 100% humidity. The universal testing machine was used for push-out tests, and specimens were examined using a scanning electron microscope (SEM) to identify various types of bond failure. RESULTS: Among the four groups, Group 2 exhibited the highest mean push-out bond strength (7.33 ± 0.26 MPa), followed by Group 4 (5.33 ± 0.25 MPa), Group 1 (4.61 ± 0.30 MPa), and Group 3 (2.94 ± 0.32 MPa). The variations in bond strength suggest a notable impact of the chelating agents and final rinse solutions on the resin sealer's interaction with dentin. CONCLUSION: The study concludes that the use of EDTA as both a lubricating gel and a final rinse significantly enhances push-out bond strength, outperforming chitosan in this study. Groups with saline as the final rinse (Group 1 and Group 3) exhibited the least bond strength, highlighting the importance of the final rinse in root canal therapy.
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AIM: The aim of present study was to evaluate the salivary sialic acid levels in Acute Lymphoblastic Leukemic (ALL) children and to correlate it with dental caries experience. METHOD: A total of 120 children aged 4-10 yrs were divided into 4 groups of 30 each. Dental caries experience was recorded followed by un-stimulated saliva collection. RESULTS: The mean salivary sialic acid levels of the study group were much higher when compared with the control group, which was statistically significant. A linear relationship between salivary sialic acid levels and dental caries in leukemic children was observed. CONCLUSION: The findings of our study conclude that salivary sialic acid levels may have a potent activity in dental caries process and can be used as a useful marker in cancer
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Índice CPO , Ácido N-Acetilneuramínico/análise , Leucemia-Linfoma Linfoblástico de Células Precursoras/metabolismo , Saliva/química , Antineoplásicos/uso terapêutico , Biomarcadores Tumorais/análise , Criança , Pré-Escolar , Estudos Transversais , Cárie Dentária/metabolismo , Humanos , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Saliva/efeitos dos fármacos , Saliva/metabolismo , Taxa Secretória/efeitos dos fármacos , Dente Decíduo/metabolismoRESUMO
We describe the case of a 53-year-old woman who presented with a metatarsal fracture and was found to have a bone mineral density (BMD) T-score of +11 in the lumbar spine and +7.6 in the hip. Subsequent investigation revealed very high serum, urine and tissue fluoride levels, associated with excessive tea and toothpaste consumption. The case emphasises the need to exclude fluorosis in individuals with unexpectedly high BMD levels.
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Densidade Óssea/fisiologia , Intoxicação por Flúor/etiologia , Fluoretos/administração & dosagem , Chá/intoxicação , Cremes Dentais/intoxicação , Feminino , Intoxicação por Flúor/diagnóstico , Fluoretos/química , Fraturas Ósseas/etiologia , Humanos , Pessoa de Meia-Idade , Cremes Dentais/administração & dosagemRESUMO
Leukemia constitutes approximately 30% of all childhood cancers and Acute Lymphoblastic Leukemia (ALL) is the most common type of malignancy. Oral dryness, ulceration, increased dental decay seen is due to altered salivary flow rate and buffering capacity in these children. Oxidative stress may play an important role in the malignancies resulting in onset of inflammatory oral pathologies. Saliva constitutes first line of defense against free radical-mediated oxidative stress. The present study attempted to relate the oral health status, salivary flow rate, salivary pH, gingival health status, dental caries experience and total salivary antioxidant levels in ALL children. A total of 120 children aged 4-10 years (90 leukemic children, study group and 30 normal healthy siblings, control group) were divided into 4 groups of 30 each. Oral health status, gingival status and dental caries experience was recorded followed by un-stimulated saliva collection. Total antioxidant capacity of un-stimulated saliva was evaluated. The results depicted deterioration in oral health status, gingival status and increased dental caries experience in leukemic children. Salivary flow rate, salivary pH and total salivary antioxidant levels were lowered in leukemic children when compared with control group.
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Cárie Dentária/complicações , Doenças da Gengiva/complicações , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Saliva/metabolismo , Salivação/fisiologia , Análise de Variância , Antioxidantes/metabolismo , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos de Coortes , Índice CPO , Assistência Odontológica para Crianças , Assistência Odontológica para Doentes Crônicos , Testes de Atividade de Cárie Dentária , Tratamento Farmacológico , Humanos , Concentração de Íons de Hidrogênio , Higiene Bucal , Índice Periodontal , Leucemia-Linfoma Linfoblástico de Células Precursoras/metabolismo , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Valores de Referência , Saliva/efeitos dos fármacos , Salivação/efeitos dos fármacos , Taxa SecretóriaRESUMO
Congenital bony fusion of the maxilla and mandible, especially as an isolated occurrence, is a very rare condition. The very few cases reported in the literature are mostly inadequate in description and confusing in nomenclature. An isolated case of syngnathia in a 60-year-old female patient with unilateral bony fusion (synostosis) of the maxilla and mandible associated with fibrous adhesions (synechiae) of the opposite site is reported. The existent literature is also reviewed.
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Anormalidades Maxilomandibulares/patologia , Anquilose/complicações , Anquilose/congênito , Anquilose/diagnóstico por imagem , Anquilose/cirurgia , Anodontia/complicações , Feminino , Humanos , Anormalidades Maxilomandibulares/complicações , Anormalidades Maxilomandibulares/diagnóstico por imagem , Anormalidades Maxilomandibulares/cirurgia , Pessoa de Meia-Idade , Recidiva , Sinostose/complicações , Sinostose/diagnóstico por imagem , Sinostose/patologia , Sinostose/cirurgia , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/congênito , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Falha de TratamentoRESUMO
The purpose of the present study was to investigate the potential use of two PEGylated derivatives of rosin (PD) as sustained release film forming materials. The derivatives differed chemically by their acid numbers--PD-1 with 120.93 and PD-2 with 88.19. The derivative films were characterized for surface morphology, water uptake-weight loss, angle of contact, water vapor transmission rate, mechanical properties and permeability study. Dissolution of diclofenac sodium (DS) and propranolol hydrochloride (PHL) as model drugs was studied from coated pellets. The films of derivatives with and without plasticizers were smooth and continuous. PD-2 films developed greater numbers of pores when in contact with phosphate buffer pH 6.8. The low weight loss, low angles of contact and high water vapor transmission rate of PD-2 films were related to presence of higher concentration of PEG esters. Higher tensile strength and percent elongation of PD-2 films was due to greater degree of internal plasticization of the derivative. The permeability of films to model drugs propranolol hydrochloride and diclofenac sodium was inversely proportional to the film thickness and dibutyl phthalate concentration in them; the permeability being greatest in PD-2 films containing 10% PEG 200. Dissolution rate of propranolol hydrochloride was higher from the coated pellets. The dissolution data followed zero order, Baker-Lonsdale equation and Hixon-Crowell equation of release kinetics with high correlation coefficients. The mechanism of drug release from these coated systems however followed class II transport (n > 1.0). The derivatives investigated could successfully retard release of the model drugs and offers an alternative to the conventionally used polymers.
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Preparações de Ação Retardada/química , Portadores de Fármacos/química , Avaliação Pré-Clínica de Medicamentos/métodos , Membranas Artificiais , Modelos Químicos , Polietilenoglicóis/química , Dureza , Cinética , Permeabilidade , Propriedades de Superfície , Resistência à TraçãoRESUMO
INTRODUCTION: In Nepal, various field programs such as community diagnosis programmes (CDP) have been initiated to make the education of doctors, nurses and dentists more community oriented and relevant and suited to the health care scenario. Community diagnosis refers to the identification and quantification of the health problems in a community and identification of their correlates for the purpose of defining those individuals or groups at risk or those in need of health care. The article presents the main activities of community diagnosis as a core component of community-based education for the medical students at Kathmandu Medical College, Kathmandu, Nepal. METHODOLOGY: A 4 weeks' Community Diagnosis Programme was conducted by MBBS II students (9th Batch) of the Kathmandu Medical College under the supervision of the Department of Community Medicine in November 2006 in the rural community of Gundu VDC (village development committee). The tools used included pre-tested questionnaires, weighing machines, measuring tapes, stethoscopes and sphygmomanometers. After the data collection and compilation, the students presented their findings in oral presentations, accompanied by a written report, including essential recommendations for improving the health status of these communities. RESULTS: The students benefited from the necessary process of integrating clinical skills and a public health approach, so as to enhance their epidemiological thinking and be of greater use to the communities where they will practice. The community also benefited by achievement of behavioral changes leading to healthier lifestyles and increased awareness of health-related matters and their role in quality of life. CONCLUSIONS: CDP is a way to practically demonstrate that the link between a medical college and society is possible. That is, a medical college can serve the community and thus society, with specific activities to improve health and the skills of students who will serve as future health professionals.
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Serviços de Saúde Comunitária/organização & administração , Relações Interinstitucionais , Administração em Saúde Pública/métodos , Faculdades de Medicina/organização & administração , Adolescente , Adulto , Características Culturais , Feminino , Educação em Saúde , Nível de Saúde , Inquéritos Epidemiológicos , Humanos , Higiene , Masculino , Pessoa de Meia-Idade , Nepal , Aceitação pelo Paciente de Cuidados de Saúde , População Rural , Fatores Socioeconômicos , Adulto JovemRESUMO
Cannabis is one of the most commonly abused drugs in the UK. The debate about its legality has grown in recent times but the health implication of cannabis use is an issue of today. It is a drug commonly described as being 'soft' but its use has profound effects on many of the body's systems, including the oral cavity. This is of particular importance to the dental clinician. This paper aims to discuss the oral implications of cannabis use and provide advice on ways in which dental professionals can approach this sensitive topic and provide support.
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Relações Dentista-Paciente , Fumar Maconha/efeitos adversos , Cannabis , Odontólogos , Humanos , Saúde BucalRESUMO
Tooth agenesis in human being is the most common congenital anomaly associated with dental development. Mutations in many genes such as MSH homeobox 1 (MSX1), paired box gene 9 (PAX9), ectodysplasin A (EDA) and EDA receptor (EDAR) have been associated with familial form of this condition. However, in large majority of patients, genetic cause could not be identified. The primary aim of present study was to identify the causative mutation(s) in these genes in Saudi Arabian families diagnosed with non-syndromic form of disease. Direct sequencing of coding regions, including exon-intron boundaries of these genes was carried out. All identified nucleotide variations were also tested to exclude possibility of being rare polymorphisms. The sequence analysis of exons and exon-intronic regions of these genes revealed five new mutations that include four in MSX1, one in PAX9 and one single nucleotide polymorphism (SNP) in majority of the patients in MMP20. One novel mutation in exon 1 of MSX1 gene (5354C > G; A40G) was found in three patients. In addition, another novel mutation was detected in two patients in exon 3 (PAX9) as g.10672A > T which changes asparagine to isoleucine at position 40. These mutations were not found in any of the control subjects. A single SNP in MMP20 genes (g.5066A > C) that changes lysine to threonine at position 18 was found in 10% controls as well. Our results for the first time demonstrates that mutations in MSX1 gene might play an important role in hypodontia cases involving pre-molars and is a risk factor for this ethnic population mainly of Arabs and is first report linking these mutations with tooth agenesis.
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Anodontia/diagnóstico , Anodontia/genética , Fator de Transcrição MSX1/genética , Metaloproteinase 20 da Matriz/genética , Mutação , Fator de Transcrição PAX9/genética , Adolescente , Adulto , Alelos , Sequência de Aminoácidos , Criança , Biologia Computacional/métodos , Análise Mutacional de DNA , Éxons , Feminino , Ordem dos Genes , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Fenótipo , Polimorfismo de Nucleotídeo Único , Arábia Saudita , Adulto JovemRESUMO
There are several lectins with anti-H specificity but few of them serve as useful reagents. An anti-H lectin, extracted from the seeds of the plant Momordica dioica Roxb. ex willd., was tested for its hemagglutination and inhibition properties, using standard serologic methods and panel RBCs, serum, saliva, milk, and oligosaccharides purified from milk. The extract displayed strongest agglutination with group O RBCs and was weakest with group A1B RBCs in a spectrum of O>A2>B>A2B>A1>A1B; the extract failed to react with the RBCs from 25 individuals with the Bombay (Oh) phenotype and was inhibited by H secretor saliva, hence it was characterized as anti-H. However, its inhibition by milk samples from five mothers with the Bombay phenotype called into question its specificity as anti-H. The lectin reacted as strongly with group O ii (adult) RBCs as with normal OI RBCs, ruling out its specificity as anti-HI. Hemagglutination inhibition was observed with 2'-fucosyllactose (Type 2 H) and lacto-N-fucopentose-I (Type 1 H), suggesting that the binding of the lectin had preference for H structures. However, inhibition by N-acetyllactosamine, lacto-Ntetraose, and lacto-N-neotetraose suggested that the lectin also recognized unsubstituted terminal beta-linked galactose units. The hemagglutinin property in the present lectin showed an unusual anti-H specificity. The lectin was inhibited by milk from Bombay phenotype individuals and certain milk oligosaccharides not specific for the H antigen.
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Sistema ABO de Grupos Sanguíneos/imunologia , Tipagem e Reações Cruzadas Sanguíneas/métodos , Leite Humano/imunologia , Lectinas de Plantas/imunologia , Eritrócitos/imunologia , Hemaglutinação , Testes de Inibição da Hemaglutinação , Testes de Hemaglutinação , Humanos , Isoanticorpos/sangue , Leite Humano/química , Oligossacarídeos/imunologia , Fenótipo , Saliva/imunologia , Sementes/química , Sementes/imunologiaRESUMO
Stability of solid-phase antibody (SP-Ab) was investigated using polystyrene surface coated, by simple physical adsorption, with a rabbit antibody against the beta subunit of human chorionic gonadotropin. SP-Ab stored wet in 0.1 M Tris-HCl buffer, pH 7.2, or in 10% ammonium sulphate solution in the Tris buffer did not lose any activity upto the entire period of the study, i.e., 95 days at 6 degrees C and room temperature and 53 days at 40 degrees C. However, SP-Ab lost some activity upon drying and decrease in activity continued when air-dried SP-Ab was stored at any of these temperatures. Secondary coating of SP-Ab with sucrose or lactose before drying offered only partial protection to the activity of SP-Ab. Using radiolabeled antibody it was found that the loss of activity was not caused by desorption of the antibody; rather it could be the result of surface denaturation of the molecules. Binding of the antibody to polystyrene was so strong that week-long storage of SP-Ab in 6 M urea or 0.1% acetic acid could not bring about desorption by more than 1.8%. It is recommended that SP-Ab should be stored in a buffer and should not be allowed to dry.
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Anticorpos/imunologia , Ensaio de Imunoadsorção Enzimática/instrumentação , Preservação Biológica/métodos , Adsorção , Animais , Gonadotropina Coriônica/análise , Gonadotropina Coriônica Humana Subunidade beta , Dessecação , Humanos , Lactose , Fragmentos de Peptídeos/análise , Poliestirenos , Desnaturação Proteica , Coelhos , Sacarose , Temperatura , Fatores de TempoRESUMO
The present investigation reports on the efficacy of 5-FU encapsulated in liposomes for the treatment of leukemia using a murine model of gamma radiation-induced transplantable leukemia in ICRC strain of mice. Multi-lamellar vesicles (MLVs) or large unilamellar vesicles (REVs) prepared using phosphatidyl choline and cholesterol in a molar ratio of 8:2 for neutral and 7:2:1 for charged vesicles were administered as a single i.p. dose in mice. 5-FU encapsulated in MLVs at a concentration of 0.6-2.5 mg/kg had no effect, whereas REVs at a single i.p. dose of 9 mg/kg increased survival of leukemic mice with T/C = 138%, decreased peripheral blood count and considerably reduced infiltration of leukemic cells in different tissues (supported by histopathology) as compared to 60 mg/kg of free drug (LD10 = 70 mg/kg).
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Fluoruracila/administração & dosagem , Leucemia Linfoide/tratamento farmacológico , Leucemia Induzida por Radiação/tratamento farmacológico , Animais , Química Farmacêutica , Modelos Animais de Doenças , Portadores de Fármacos , Estabilidade de Medicamentos , Feminino , Fluoruracila/toxicidade , Raios gama , Leucemia Linfoide/etiologia , Leucemia Induzida por Radiação/etiologia , Lipossomos , Masculino , Camundongos , Camundongos Endogâmicos ICR , Transplante de NeoplasiasRESUMO
The oral use of chewing tobacco has greatly increased in recent years, and this usage is associated with cancers of the mouth, lip, nasal cavities, esophagus and gut. Oral cancer accounts for 3% of all cancers in U.S.A. and is the seventh most common cancer. Previous studies in our laboratory have demonstrated the protective abilities of a novel IH636 grape seed proanthocyanidin extract (GSPE) against reactive oxygen species both in vitro and in vivo models, and provided significantly better protection as compared to vitamins C, E and beta-carotene. In the recent past, we have demonstrated smokeless tobacco (STE)-induced oxidative stress, apoptotic cell death in a primary culture of normal human oral keratinocytes (NHOK), and have compared the protective abilities of vitamins C and E, singly and in combination, and GSPE in this pathobiology [Free Rad. Biol. Med., 26, 992-1000 (1999)]. In the present study, we have assessed the protective role of vitamins C and E, and GSPE against STE-induced modulation of intracellular oxidized states in NHOK cells as demonstrated by laser scanning confocal microscopy. Approximately 11%, 26%, 28% and 50% protection were observed following incubation with vitamin C, vitamin E, a combination of vitamins C plus E, and GSPE, respectively. DNA fragmentation was assessed as an index of oxidative DNA damage and similar results were observed. Furthermore, the cellular viability and functional roles of Bcl-2, p53 and c-myc genes were assessed in STE-induced oxidative stress in NHOK cells. NHOK cells were treated with STE (0-200 micrograms/ml) for 24 h and changes in the expression of Bcl-2, p53 and c-myc genes were measured by reverse transcriptase-polymerase chain reaction (RT-PCR), and the protective effect of GSPE was assessed. Approximately a 2.0-fold increase in p53 gene expression was observed following incubation of the oral keratinocytes with 100 micrograms/ml of STE, beyond which the expression of p53 decreased, confirming increased apoptotic cell death with a higher concentration of STE as reported earlier. GSPE significantly modulated STE-induced changes in p53. The expression of antiapoptotic Bcl-2 gene decreased with STE treatment and the expression of Bcl-2 gene increased significantly following preincubation with GSPE. No significant change in the expression of transcription factor c-myc gene responsible for cell cycle growth was observed following incubation with STE and/or GSPE. Thus, c-myc may not be involved in STE-induced cytotoxicity towards NHOK cells. These results suggest that antioxidant protection of STE-induced cellular injury is associated with alterations in Bcl-2 and p53 expression.
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Antioxidantes/farmacologia , Regulação da Expressão Gênica/efeitos dos fármacos , Genes bcl-2/genética , Genes p53/genética , Queratinócitos/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Tabaco sem Fumaça/farmacologia , Ácido Ascórbico/farmacologia , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Dano ao DNA/efeitos dos fármacos , Feminino , Formazans , Genes myc/genética , Humanos , Queratinócitos/metabolismo , Masculino , Microscopia Confocal , Boca/citologia , Oxirredução/efeitos dos fármacos , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Sais de Tetrazólio , Azul Tripano , Vitamina E/farmacologia , Vitis/químicaRESUMO
OBJECTIVE: Extremely high flow through arteriovenous malformations (AVMs) may limit the safety and effectiveness of endovascular glue therapy. To achieve a more controlled deposition of glue, we used transient but profound systemic hypotension afforded by an intravenously administered bolus of adenosine to induce rapidly reversible high-degree atrioventricular block. METHODS AND CASE REPORT: A patient with a large high-flow occipital AVM fed primarily by the posterior cerebral artery underwent n-butyl cyanoacrylate glue embolization. Nitroprusside-induced systemic hypotension did not adequately reduce flow through the nidus, as determined by contrast injection in the feeding artery. In a dose-escalation fashion, boluses of adenosine were administered to optimize the dose and verify that there was no flow reversal in the AVM and no other unexpected hemodynamic abnormalities by arterial pressure measurements and transcranial Doppler monitoring of the posterior cerebral artery feeding the AVM. Thereafter, 64 mg of adenosine was rapidly injected as a bolus to provide 10 to 15 seconds of systemic hypotension (approximately 20 mm Hg). Although there were conducted beats and some residual forward flow through the AVM during this time, the mean systemic and feeding artery pressures were roughly similar and remained relatively constant. A slow controlled injection of n-butyl cyanoacrylate glue was then performed, with excellent filling of the nidus. CONCLUSION: Adenosine-induced cardiac pause may be a viable method of partial flow arrest in the treatment of cerebral AVMs. Safe, deep, and complete embolization with a permanent agent may increase the likelihood of endovascular therapy's being curative or may further improve the safety of microsurgical resection.
Assuntos
Adenosina/uso terapêutico , Embolização Terapêutica , Bloqueio Cardíaco , Malformações Arteriovenosas Intracranianas/terapia , Adesivos , Adulto , Eletrocardiografia , Embucrilato , Feminino , HumanosRESUMO
BACKGROUND & OBJECTIVES: Though nonoxynol-9 (N-9) is available in India as a spermicidal pessary, data on its safety as a potential microbicide among Indian women are not available. Nonoxynol-9 containing compounds have shown anti-HIV activity in in vitro studies and protection against cervical infections. Nonoxynol-9 is being extensively evaluated as a vaginal microbicide world-wide. We assessed the safety and preliminary acceptability of nonoxynol-9 pessary as a vaginal microbicide in women at low risk for human immunodeficiency virus (HIV) infection and sexually transmitted diseases (STDs). METHODS: Twenty three HIV seronegative women enrolled in the study were given Today pessarys containing 5 per cent of nonoxynol-9 for vaginal use at bedtime for 14 days. Colposcopy was done at enrollment and on day 14 and speculum examination on day 7 to assess the local toxicity. RESULTS: Most of the women (16/23, 69.6%) did not experience any symptoms of genital irritation. The remaining 7 (30.4%, 95% CI 11.6-49.2) women reported 11 episodes of mild irritative symptoms of short duration. On clinical examination, three adverse events were reported of which one could have been product related. Eight (34.8%) women showed willingness to use the product for protection against HIV transmission if it was approved. INTERPRETATION & CONCLUSION: Nonoxynol-9 vaginal pessary was found to be safe and acceptable in once daily dose in low risk women after consecutive use for 14 days. Willingness for future use, if found safe and effective for HIV prevention was shown by 8 (34.8%) women.
Assuntos
Anti-Infecciosos/uso terapêutico , Nonoxinol/uso terapêutico , Administração Intravaginal , Anti-Infecciosos/administração & dosagem , Colposcopia , Feminino , Infecções por HIV/prevenção & controle , Soronegatividade para HIV , Humanos , Índia , Nonoxinol/administração & dosagem , Nonoxinol/efeitos adversos , Pessários , Fatores de RiscoRESUMO
Fifty per cent ethanolic extract of Curcuma longa (tuber) and Nardostachys jatamansi (whole plant) feeding elevates HDL-cholesterol/total cholesterol ratio. The extracts also caused a significant reduction in the ratio of total cholesterol/phospholipids. Curcuma longa exhibited better cholesterol and triglyceride lowering activity [Ch = -85%; Tg = -88%] as compared to N. jatamansi in triton-induced hyperlipidaemic rats. In view of the protective action of HDL against heart disease and atherogenecity, C. longa consumption is recommended.
Assuntos
Hiperlipidemias/tratamento farmacológico , Hipolipemiantes , Plantas Medicinais , Animais , Colesterol/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , VLDL-Colesterol/sangue , Hiperlipidemias/sangue , Hiperlipidemias/induzido quimicamente , Masculino , Ayurveda , Extratos Vegetais/farmacologia , Polietilenoglicóis , RatosRESUMO
Haemangiopericytoma of the floor of the mouth with metastases to the lumbar spine in a 23-year-old black woman is described. She represents the 36th patient with oral cavity haemangiopericytoma and the 4th with a floor of mouth lesion. The aggressive behaviour of haemangiopericytoma and its resistance to all forms of recommended treatment was shown in this patient.