Varying views of maxillary and mandibular aspects of teeth: A dataset.

Real teeth or dental image datasets are a valuable resource that is transforming the field of dentistry by enabling automation, improving diagnostics and accelerating research and development.This article presents a comprehensive dataset containing 9,562 images of healthy teeth (noncarious) from children aged 1 to 14 years. The images capture different views of the teeth, including maxillary (upper) and mandibular (lower) arches, front, right, left, and occlusal (biting surface) views. These images are stored under eight subcategories in the Mendeley repository, a platform for research data. The potential application of this dataset involves using machine learning to analyze the dental condition. This could provide a faster analysis and facilitate remote assessment of dental conditions in underserved areas. Overall, this dataset seems like a promising tool for advancing dental care through the power of machine learning.

Chemical profiling of bioactive compounds in the methanolic extract of wild leaf and callus of Vitex negundo using gas chromatography-mass spectrometry.

BACKGROUND: The investigation of plant-based therapeutic agents in medicinal plants has revealed their presence in the extracts and provides the vision to formulate novel techniques for drug therapy. Vitex negundo (V. negundo), a perennial herb belonging to the Varbanaceae family, is extensively used in conventional medication. AIM: To determine the existence of therapeutic components in leaf and callus extracts from wild V. negundo plants using gas chromatography-mass spectrometry (GC-MS). METHODS: In this study, we conducted GC-MS on wild plant leaf extracts and correlated the presence of constituents with those in callus extracts. Various growth regulators such as 6-benzylaminopurine (BAP), 2,4-dichlorophenoxyacetic acid (2,4-D), α-naphthylacetic acid (NAA), and di-phenylurea (DPU) were added to plant leaves and in-vitro callus and grown on MS medium. RESULTS: The results clearly indicated that the addition of BAP (2.0 mg/L), 2,4-D (0.2 mg/mL), DPU (2.0 mg/L) and 2,4-D (0.2 mg/mL) in MS medium resulted in rapid callus development. The plant profile of Vitex extracts by GC-MS analysis showed that 24, 10, and 14 bioactive constituents were detected in the methanolic extract of leaf, green callus and the methanolic extract of white loose callus, respectively. CONCLUSION: Octadecadienoic acid, hexadecanoic acid and methyl ester were the major constituents in the leaf and callus methanolic extract. Octadecadienoic acid was the most common constituent in all samples. The maximum concentration of octadecadienoic acid in leaves, green callus and white loose callus was 21.93%, 47.79% and 40.38%, respectively. These findings demonstrate that the concentration of octadecadienoic acid doubles in-vitro compared to in-vivo. In addition to octadecadienoic acid; butyric acid, benzene, 1-methoxy-4-(1-propenyl), dospan, tridecanedialdehyde, methylcyclohexenylbutanol, chlorpyrifos, n-secondary terpene diester, anflunine and other important active compounds were also detected. All these components were only available in callus formed in-vitro. This study showed that the callus contained additional botanical characteristics compared with wild plants. Due to the presence of numerous bioactive compounds, the medical use of Vitex for various diseases has been accepted and the plant is considered an important source of therapeutics for research and development.

Rv0495c regulates redox homeostasis in Mycobacterium tuberculosis.

Mycobacterium tuberculosis (Mtb) has evolved sophisticated surveillance mechanisms to neutralize the ROS-induces toxicity which otherwise would degrade a variety of biological molecules including proteins, nucleic acids and lipids. In the present study, we find that Mtb lacking the Rv0495c gene (ΔRv0495c) is presented with a highly oxidized cytosolic environment. The superoxide-induced lipid peroxidation resulted in altered colony morphology and loss of membrane integrity in ΔRv0495c. As a consequence, ΔRv0495c demonstrated enhanced susceptibility when exposed to various host-induced stress conditions. Further, as expected, we observed a mutant-specific increase in the abundance of transcripts that encode proteins involved in antioxidant defence. Surprisingly, despite showing a growth defect phenotype in macrophages, the absence of the Rv0495c enhanced the pathogenicity and augmented the ability of the Mtb to grow inside the host. Additionally, our study revealed that Rv0495c-mediated immunomodulation by the pathogen helps create a favorable niche for long-term survival of Mtb inside the host. In summary, the current study underscores the fact that the truce in the war between the host and the pathogen favours long-term disease persistence in tuberculosis. We believe targeting Rv0495c could potentially be explored as a strategy to potentiate the current anti-TB regimen.

Dysregulated cysteine metabolism leads to worsened liver pathology in diabetes-tuberculosis comorbid condition.

Diabetes mellitus (DM) is a risk factor for developing active tuberculosis (TB) with a 3-fold increase in susceptibility and a 4-fold higher relapse rate. With increasing DM prevalence in TB endemic regions, understanding pathophysiological changes associated with DM-TB comorbidity is imperative. In this study, streptozotocin (STZ)-induced DM C57BL/6 mice were aerosol infected with low dose (100-120 CFU) Mycobacterium tuberculosis H37Rv. At 3 weeks post infection (w.p.i.), multiple tissue mycobacterial load and metabolites were profiled. The liver proteome of DM-TB and controls were analyzed using quantitative proteomics, and multi-omics data were integrated. DM-TB mice showed dysregulated multi-tissue (lungs, liver, brain, kidney and thigh muscle) metabolism. In contrast, the mycobacterial burden in the lung, spleen and liver was similar at 3 w.p.i. in DM-TB and TB groups. Enrichment analysis of deregulated liver metabolites (n = 20; log2DM-TB/TB>±1.0) showed significant perturbation in cysteine-methionine, glycine-serine, BCAA and fatty acid metabolism. 60 out of 1660 identified liver proteins showed deregulation (log2DM-TB/TB>±1.0) and contributed from perturbed cysteine-methionine metabolism corroborating metabolomics data. In addition, amino acid biosynthesis, retinol metabolism and polyol biosynthetic process were also differentially enriched in the livers of DM-TB groups. Global correlation analysis of liver metabolome and proteome data showed a strong association between aspartic acid, pyruvic acid, leucine and isoleucine with CYP450 enzymes involved in retinol metabolism, while iminodiacetic acid, isoleucine and γ-aminobutyric acid (GABA) strong positive correlation involved in cysteine metabolism. Targeting perturbed cysteine metabolism using micro molecules, like DL-Propargylglycine, might help prevent liver damage in DM-TB comorbid conditions.

Scanning electron microscope analysis to evaluate the effect of pretreatment with ozone and sodium hypochlorite on pits and fissures of primary teeth.

Introduction: The cornerstone of preventative therapy is made up of pit and fissure sealants and fluorides. Resin sealants have been shown to help reduce fissure decay in both primary and permanent teeth. Etching of primary molars is not effective due to prismless enamel, higher organic content, and diversity in fissure shape. Methods of pretreatment of pits and fissures have been hypothesized to promote microporosities in etched enamel and hence sealant adherence. Examining the etching pattern and surface roughness of the enamel surface can be used to gauge these. Objective: This study aimed to evaluate the effect of pretreatment with ozone gas and 5.25% sodium hypochlorite solution on pits and fissures of primary teeth to check for the etching pattern and surface roughness. Materials and Methods: Thirty noncarious primary molars were sectioned to retain the crowns, and randomly divided into three groups, sodium hypochlorite, ozone gas, and control. Each sample was pretreated with the agent, washed, followed by etching with 37% phosphoric acid. Samples were sectioned and subjected to scanning electron microscope analysis to evaluate the etching pattern and surface roughness. Results: Comparison of the etching pattern in three groups showed a statistically insignificant difference (P=0.364). Surface roughness was highest in the hypochlorite group followed by ozone and control which showed a statistically significant difference (P = 0.001). The surface area between the three groups showed a statistically insignificant difference. Conclusion: Sodium hypochlorite is a better pretreatment agent compared to ozone gas and acid etching alone. However, as all results were not statistically significant further research must be carried out to prove the effectiveness of these agents.

A Systematic Review on Polyester Scaffolds in Dental Three-dimensional Cell Printing: Transferring Art from the Laboratories to the Clinics.

Objective: The purpose of this systematic review is to describe developments in three-dimensional (3D) cell printing in the formation of dental pulp tissue using polyester as a scaffold to revitalize the damaged dental pulp tissue. Materials and methods: A literature search for all the data published in PubMed and Google Scholar from January 2000 to April 2022 was conducted. Articles with the keywords 3D cell printing, scaffolds, polyester, dental pulp, and dentistry were used. Inclusion criteria consisted of any publication in electronic or print media directly studying or commenting on the use of polyester scaffolds in 3D cell printing technology in the regeneration of dental pulp. A total of 528 articles were selected, of which 27 duplicates and 286 irrelevant articles were discarded. A total of 215 articles were finally included in the systematic review. Result and conclusion: For dental pulp regeneration, several scaffolds have been discovered to be appealing. Polylactic acid (PLA), polyglycolic acid (PGA), and their copolymers are nontoxic and biocompatible synthetic polyesters that degrade by hydrolysis and have received Food and Drug Administration (FDA) approval for a variety of applications. This review paper is intended to spark new ideas for using a certain scaffold in a specific regenerative approach to produce the desired pulp-dentin complex.

Clinical Evaluation of Overall Efficacy and Pain Perception of Ultrasonic Oscillating Tips and Conventional High-speed Burs for Removal of Dental Caries in Children in Age-group of 6-8 Years.

Aim: To clinically evaluate the overall efficacy and pain perception of ultrasonic oscillating tips and conventional high-speed burs to remove enamel and dentinal caries in children of ages 6-8 years. Materials and methods: Bilateral deciduous canines with caries involving enamel or enamel and dentin were excavated by using a high-speed airrotor on one tooth and ultrasonic oscillating tips on another tooth in the same appointment. The overall response of the patient, both ultrasonic oscillating tips and airrotor along was recorded by Wong-Baker's Facial Pain Rating Scale (WBFPS) along with time taken to make each cavity and noise level generated by high-speed and ultrasonic system. Results: Evaluation of WBFPS after every method of caries excavation showed that 84% of subjects in the ultrasonic group reported score of 0 as compared to only 24% of subjects in the airrotor group. Score 2 was reported by 16% of the subjects in the ultrasonic group and 32% of the subjects in the airrotor group. Score 4 was reported by 44% of the subjects in the airrotor group. Ultrasonic groups reported more time to remove caries as compared to the airrotor group. The ultrasonic group reported less noise as compared to the airrotor group and the difference between the two was significant. Conclusion: Patients preferred the ultrasonic method for caries excavation because of less pain and noise. The use of ultrasonic oscillating tips is as effective in caries excavation, less painful, and more time-consuming than the conventional airrotor. Significance: Ultrasonic oscillating tips can be successfully used in pediatric dentistry to aid patient cooperation and reduce pain during caries excavation. How to cite this article: Kenjale MA, Shah P, Desai S, et al. Clinical Evaluation of Overall Efficacy and Pain Perception of Ultrasonic Oscillating Tips and Conventional High-speed Burs for Removal of Dental Caries in Children in Age-group of 6-8 Years. Int J Clin Pediatr Dent 2023;16(2):251-258.

NCoR1 controls immune tolerance in conventional dendritic cells by fine-tuning glycolysis and fatty acid oxidation.

Dendritic cells (DCs) undergo rapid metabolic reprogramming to generate signal-specific immune responses. The fine control of cellular metabolism underlying DC immune tolerance remains elusive. We have recently reported that NCoR1 ablation generates immune-tolerant DCs through enhanced IL-10, IL-27 and SOCS3 expression. In this study, we did comprehensive metabolic profiling of these tolerogenic DCs and identified that they meet their energy requirements through enhanced glycolysis and oxidative phosphorylation (OXPHOS), supported by fatty acid oxidation-driven oxygen consumption. In addition, the reduced pyruvate and glutamine oxidation with a broken TCA cycle maintains the tolerogenic state of the cells. Mechanistically, the AKT-mTOR-HIF-1α-axis mediated glycolysis and CPT1a-driven ß-oxidation were enhanced in these tolerogenic DCs. To confirm these observations, we used synthetic metabolic inhibitors and found that the combined inhibition of HIF-1α and CPT1a using KC7F2 and etomoxir, respectively, compromised the overall transcriptional signature of immunological tolerance including the regulatory cytokines IL-10 and IL-27. Functionally, treatment of tolerogenic DCs with dual KC7F2 and etomoxir treatment perturbed the polarization of co-cultured naïve CD4+ T helper (Th) cells towards Th1 than Tregs, ex vivo and in vivo. Physiologically, the Mycobacterium tuberculosis (Mtb) infection model depicted significantly reduced bacterial burden in BMcDC1 ex vivo and in CD103+ lung DCs in Mtb infected NCoR1DC-/-mice. The spleen of these infected animals also showed increased Th1-mediated responses in the inhibitor-treated group. These findings suggested strong involvement of NCoR1 in immune tolerance. Our validation in primary human monocyte-derived DCs (moDCs) showed diminished NCOR1 expression in dexamethasone-derived tolerogenic moDCs along with suppression of CD4+T cell proliferation and Th1 polarization. Furthermore, the combined KC7F2 and etomoxir treatment rescued the decreased T cell proliferative capacity and the Th1 phenotype. Overall, for the first time, we demonstrated here that NCoR1 mediated control of glycolysis and fatty acid oxidation fine-tunes immune tolerance versus inflammation balance in murine and human DCs.

Comparison of the Influence of a Packaged Fruit Juice on the Bacterial Adhesion on a Glass Ionomer Cement and an Esthetic Restorative Material In Vitro.

Objective: The aim of this research was to evaluate and compare the effect of a packaged orange juice on the two most commonly used restorative materials in pediatric dentistry. Methodology: Fifteen samples each of 6 mm diameter and 2 mm thickness of a glass ionomer cement (GIC) and an esthetic restorative material were prepared using silicone rings. These were exposed to a packaged orange fruit juice and then placed in a standard culture of Streptococcus mutans. The bacterial adhesion to these samples was evaluated after exposure to the fruit juice for 1 day and for 7 days. Results: Results from the study show that there is a decrease in the colony forming unit (CFU) after exposure to the packaged fruit juice as opposed to the studies using carbonated acidic drinks, which have shown a consistent rise in the CFU due to a change in the surface morphology. Conclusion: Within the limitations of this study, it was seen that the consumption of fruit juice may not cause a deteriorating effect on the restorative materials considered. However, the results were not statistically significant and further research is necessary to come to a conclusion regarding the reduction in the bacterial count after exposure to the fruit juice. Clinical implications: With further research, such studies can help in improving the diet counseling practices. How to cite this article: Patel A, Belsare SP, Jajoo SS, et al. Comparison of the Influence of a Packaged Fruit Juice on the Bacterial Adhesion on a Glass Ionomer Cement and an Esthetic Restorative Material In Vitro. Int J Clin Pediatr Dent 2022;15(3):327-331.

A Case of a Rare, Incidental Discovery of Fibrous Obliteration of an Appendiceal Diverticulum.

Diverticulosis of the appendix (DA) is rare and frequently found incidentally. Some cases are discovered after presenting with similar symptomatology to acute appendicitis, whereas other cases may be completely silent. Fibrous obliteration (FO) is a histologic finding indicative of cellular proliferation secondary to relapses of subclinical inflammatory processes. We report a case of a 75-year-old female with a history of chronic, intermittent abdominal pains who presented to the general surgery clinic after an abnormal thickening of the appendix was discovered on abdominal and pelvic computed tomography imaging. The patient underwent laparoscopic appendectomy for suspicion of malignancy. The histologic evaluation of the specimen demonstrated a diverticulum at the distal end of the appendix with FO of the lumen. We suspect the chronic nature of her disease course may have led to the FO of the diverticulum. An extensive literature search was performed, which revealed no other cases of FO of appendiceal diverticula. This may be the first case of diverticulosis of the appendix with FO in the English medical literature. If DA is discovered early with non-invasive imaging, surgical excision should be performed prophylactically as an association with an increased risk of perforation and neoplastic progression has been found.

Comparative Evaluation of the Remineralization Potential of Fluoride-containing Toothpaste, Honey Ginger Paste and Ozone. An In Vitro Study.

Introduction: A drop in pH of the oral cavity results in demineralization, which, if continued, leads to loss of minerals from tooth structure, resulting in dental caries. A goal of modern dentistry is to manage noncavitated caries lesions noninvasively through remineralization in an attempt to prevent disease progression. Materials and methods: A total of 40 extracted premolar teeth were selected for the study. The specimens were divided into four groups, group I, the control group; group II, remineralizing agent as fluoride toothpaste; group III, the treatment material as ginger and honey paste; and group IV, the treatment material as ozone oil. An initial reading of surface roughness and hardness was recorded for the group (control group). Repeated treatment has continued lasting 21 days. This saliva was changed each day. Following the lesion formation procedure, the surface microhardness was measured for all specimens. The parameters were 200 gm force for 15 seconds with a Vickers indenter and the roughness of the demineralized area of each specimen was obtained by using the surface roughness tester. Results: Surface roughness was checked by using a surface roughness tester. Before starting the pH cycle, the baseline value for the control group was calculated. The baseline value for the control group was calculated. The surface roughness average value for 10 samples is 0.555 µm and the average surface microhardness is 304 HV; the average surface roughness value for fluoride is 0.244 µm and the microhardness is 256 HV, 0.241 µm, and 271 HV value for honey-ginger paste. For ozone surface roughness average value is 0.238 µm and the surface microhardness average mean value is 253 HV. Conclusion: The future of dentistry will rely on the regeneration of tooth structure. There is no significant difference seen between each treatment group. Considering the adverse effect of fluoride, we can consider honey-ginger and ozone as good remineralizing agents for fluoride. How to cite this article: Kade KK, Chaudhary S, Shah R, et al. Comparative Evaluation of the Remineralization Potential of Fluoride-containing Toothpaste, Honey Ginger Paste and Ozone. An In Vitro Study. Int J Clin Pediatr Dent 2022;15(5):541-548.

Comparative Evaluation of Compressive Strength and Diametral Tensile Strength of Conventional Glass Ionomer Cement and a Glass Hybrid Glass Ionomer Cement.

Aim: The aim of this study is to compare and evaluate compressive strength (CS) and diametral tensile strength (DTS) of a conventional glass ionomer cement (GIC) and a glass hybrid GIC. Materials and methods: Five samples each were prepared of GC Fuji IX and EQUIA Forte cements for CS testing and five samples of each material for tensile strength testing. Specimens were subjected to a universal testing machine. Comparison of CS and DTS among two study groups was made using an independent t-test for each. Level of significance was set at p ≤ 0.05. Results: Both test values were on the higher side for EQUIA Forte cement as compared to conventional GIC (p ≥ 0.05). However, the differences in values were not statistically significant. Conclusion: EQUIA Forte can serve as an alternative to conventional GIC in stress-bearing primary teeth areas. Considering several factors like cost-effectiveness, surface to be restored, moisture contamination, and time considerations, the material of choice can be tailored to one's needs. Clinical significance: EQUIA Forte can serve as a viable alternative to conventional GIC because of its improved qualities. How to cite this article: Kunte S, Shah SB, Patil S, et al. Comparative Evaluation of Compressive Strength and Diametral Tensile Strength of Conventional Glass Ionomer Cement and a Glass Hybrid Glass Ionomer Cement. Int J Clin Pediatr Dent 2022;15(4):398-401.

Comparative Evaluation of Water Sorption, Solubility, and Microhardness of Zirconia-reinforced Glass Ionomer, Resin-modified Glass Ionomer, and Type IX Glass Ionomer Restorative Materials: An In Vitro Study.

The challenge that practicing dentists face every day is to decide which dental material is best suited for each dental treatment. New glass-ionomer cement (GIC) formulations have been introduced in order to overcome the drawbacks of conventional ones thereby catering to the needs of the pediatric population. Aim and objective: The study aimed to evaluate and compare water sorption, solubility, and microhardness of zirconia-reinforced glass ionomer, resin-modified glass ionomer, type IX glass ionomer cements. Materials and methods: 90 specimens were prepared in total of which 45 cylindrical specimens with dimensions of (6 × 4) mm and 45 disks with (10 × 2) mm were prepared from Zirconomer, RMGIC, and Type IX GIC restorative materials, each material having 30 specimens (15 disks, 15 cylinders). After taking the initial weight (W1), the 45 cylinders (15 of each material) were immersed in artificial saliva at 37°C for 28 days after which the weights W2 and W3 were weighed. The other 45 disks (15 of each material) were subjected to microhardness test under microhardness tester. Results were subjected to ANOVA and Tuckey's post hoc test. Results: Zirconomer showed the maximum resistance to water sorption and solubility followed by RMGIC and type IX GIC with a significant p value of < 0.001 difference. For microhardness, Zirconomer showed the highest value with a significant p value of < 0.001 difference. But, there was no significant difference between RMGIC and Type IX GIC depicting almost equal strength. Conclusion: Water sorption, solubility, and microhardness of Zirconomer were significantly high in comparison to the other groups and it can be used as a posterior restorative material for stress-bearing areas. Clinical Significance: As pediatric dentistry demands restorations to be completed frequently in less than ideal conditions, Zirconomer has shown to be better than RMGIC and conventional GIC probably because of the improvisation in the GIC properties. How to cite this article: Bethapudy DR, Bhat C, Lakade L, et al. Comparative Evaluation of Water Sorption, Solubility, and Microhardness of Zirconia-reinforced Glass Ionomer, Resin-modified Glass Ionomer, and Type IX Glass Ionomer Restorative Materials: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(2):175-181.

Adenomatoid Odontogenic Tumor of the Maxilla in a 13-year-old Patient: A Rare Case Report with a Review of Literature.

BACKGROUND: The AOT is an atypical tumor of odontogenic origin that comprises about 0.1% of jaw tumors and cysts as well as up to 3% of odontogenic tumors (OTs). AIM AND OBJECTIVE: This review describes the clinical, radiographical, histopathological, and immunohistochemical properties of adenomatoid odontogenic tumor (AOT) and reports an occurrence of an AOT in a boy, 13 years of age. CASE DESCRIPTION: A male, 13 years of age, presented with a swelling with respect to the left maxilla, painless, and with obvious facial asymmetry. The orthopantomogram and computed tomography scan revealed a large unilocular radiolucency in the left maxilla with permanent lateral incisor embedded within the lesion and permanent canine pushed away from its normal position. After complete enucleation of the cyst under local anesthesia and extraction of associated impacted permanent teeth and retained deciduous teeth related to the lesion, the defect was filled with a bone graft and closed. Postoperative follow-up was uneventful. CONCLUSION: An accurate diagnosis should be established through clinical, radiographical, and pathological correlations in order to be able to differentiate AOT from other conditions for early diagnosis. CLINICAL SIGNIFICANCE: This report highlights the salient features of the AOT to be able to correctly diagnose and manage the lesion. HOW TO CITE THIS ARTICLE: Kamble A, Shimpi MR, Dash JK, et al. Adenomatoid Odontogenic Tumor of the Maxilla in a 13-year-old Patient: A Rare Case Report with a Review of Literature. Int J Clin Pediatr Dent 2021;14(4):596-600.

Evaluation of Adhesive Bond Strength, and the Sustained Release of Fluoride by Chitosan-infused Resin-modified Glass Ionomer Cement: An In Vitro Study.

AIM AND OBJECTIVE: To evaluate the adhesive bond strength, and sustained release of fluoride in chitosan (CH)-infused RMGIC. MATERIALS AND METHODS: Twenty caries-free human permanent premolar teeth, extracted for orthodontic purposes, were cleaned and stored in thymol solution. The crown of each tooth was cut into two halves and RMGIC (n = 10) and CH-infused RMGIC (n = 10) was placed between the two halves of the crown. The tooth was then stored in 10 mL of artificial saliva for a period of 30 days. The fluoride levels of the saliva were checked on the 15th- and the 30th-day using ion chromatography. The adhesive bond strength was checked on the 30th day using a universal testing machine. RESULTS: This study has shown that the bond strength of RMGIC was not affected by the inclusion of CH in it. Whereas, the sustained fluoride release of CH-modified RMGIC indicated that the fluoride release of CH-RMGIC was 8.47% >RMGIC at the end of 15 days, and, 39.68% >RMGIC at the end of 30 days. CONCLUSION: The inclusion of CH in RMGIC does not alter its bond strength, while it does cause a greater release of fluoride. CLINICAL SIGNIFICANCE: In progression with these results, the inclusion of CH in RMGIC could provide desirable properties like mechanical reinforcement effects and catalytic effects on the fluoride release and growth factors. HOW TO CITE THIS ARTICLE: Patel A, Dhupar JKMS, Jajoo SS, et al. Evaluation of Adhesive Bond Strength, and the Sustained Release of Fluoride by Chitosan-infused Resin-modified Glass Ionomer Cement: An In Vitro Study. Int J Clin Pediatr Dent 2021;14(2):254-257.

Relative frequency and clinicopathologic characteristics of MYC-rearranged follicular lymphoma.

MYC rearrangement is a relatively rare genetic abnormality in follicular lymphoma (FL). In this study, we evaluated the relative frequency of MYC rearrangement in 522 cases of FL and studied their clinicopathologic, cytogenetic, and molecular characteristics. Fluorescence in situ hybridization studies for MYC (break-apart probe), MYC/IGH, IGH/BCL2, and BCL6 rearrangements were performed on tissue microarrays. Immunohistochemical stains for CD10, BCL2, BCL6, and MYC were performed and scored on MYC-rearranged cases. On 4 FL cases, a custom targeted panel of 356 genes was used for mutation analysis. Ten cases (1.9%) were positive for MYC rearrangement. Histologically, 6 of 10 cases were grade 1-2, and 4 cases were grade 3A. By immunohistochemistry, 9 of 9 tested cases were CD10+, all cases were BCL6+, and 9/10 cases were BCL2+. MYC protein staining was low in all cases tested. IGH/BCL2 rearrangement was detected in 5 of 9 cases, whereas BCL6 rearrangement was detected in 3 of 7 tested cases and 4 of 10 cases showed MYC/IGH rearrangement. The most commonly detected mutations in the MYC-positive cases included HLA-B, TNFRSF14, and KMT2D. MYC and/or B2M abnormalities were detected in 2 cases. In conclusion, MYC rearrangement is uncommon in FL and these cases do not appear to have specific histologic characteristics. Molecular analysis showed abnormalities in genes associated with transformation, namely MYC and B2M. Larger studies are needed to evaluate if MYC-rearrangement in FL has prognostic significance.

Heterotopic Pancreas Located at the Gastroesophageal Junction in a Hiatal Hernia: A Case Report.

Heterotopic pancreas, commonly referred to as pancreatic rest or ectopic pancreas, is a congenital anomaly in which pancreatic tissue is anatomically separate from the main pancreatic gland without continuity of a duct system or vascularity. It is commonly found in the upper gastrointestinal tract, specifically in the stomach and small intestine. To date, only about 18 adult cases of heterotopic pancreas in the esophagus have been reported in the English medical literature; seven of which were in women, and five of which originated at the gastroesophageal junction (GEJ). Of these five cases, only two occurred in a hiatal hernia. We report the third case of the heterotopic pancreas at the GEJ in a hiatal hernia discovered in a 62-year-old Caucasian female who presented to the outpatient clinic complaining of worsening reflux characterized as burning retrosternal chest pain. The patient failed maximum medical therapy and was referred to general surgery for laparoscopic hiatal hernia repair with Toupet fundoplication to prevent further reflux and damage to the esophagus. The reflux symptoms persisted after the procedure. Follow-up esophagogastroduodenoscopy with biopsy of the GEJ revealed a small focus of heterotopic pancreas tissue, confirmed by histopathology. The management of heterotopic pancreas differs throughout the literature depending on the size, symptomatology, and potential for malignancy. Management in cases of pancreatic rest, specifically at the GEJ, ranges from observation with conservative medical therapy, resection, or esophagectomy. With this case, we aim to contribute to the literature with the third case of pancreatic rest in the GEJ of a hiatal hernia.

The effect of various media and probe angles on the power output of the Cyclo G6 Glaucoma Laser System.

To evaluate the effect of various media and Iridex MicroPulse P3 (MP3) probe angles on the power output from the Cyclo G6 Glaucoma Laser (G6) System. A laser power meter was used to measure the power output (milliwatts, mW) of the Cyclo G6 System. Each of the ten trials consisted of measurements in six different media: no substrate, balanced salt solution (BSS), artificial tears (AT), tetracaine eye drop, lubricating ointment, and lidocaine gel. The output of the MP3 probe was measured at an angle of 90° and 45°, submerged in the respective media. The output was also measured with the probe held at 90° but above the medium. The mean power outputs with the probe being held at 90° to the sensor with no substrate, BSS, AT, tetracaine eye drop, lubricating ointment, and lidocaine gel were 358 ± 16.8 mW, 612 ± 14.2 mW, 613 ± 13.3 mW, 612 ± 14.0 mW, 620 ± 9.9 mW, and 610 ± 12.2 mW, respectively. These values were statistically higher than noncontact and 45° probe angles for each medium. The values between any two media (excluding no substrate) at a 90° probe angle with full contact were not statistically significant. The highest output of the G6 System was obtained with a 90° probe angle, with full contact and any of the coupling media.