Biocompatibility of mineral trioxide aggregate flow and biodentine.

AIM: To evaluate the influence of powder-to-gel ratio (0.19 g powder to 50 µL of gel, thick MTA Flow, and 0.06 g powder to 50 µL of gel, fluid MTA Flow) on biocompatibility of MTA Flow (Ultradent Products Inc., South Jordan, UT, USA, lot: 2015122901) and compare it with Biodentine (Septodont Inc., Saint-Maur-des-Fossés, France, lot: B18542A). METHODOLOGY: The materials were manipulated and inserted into polyethylene tubes for implantation in twenty rats. After 7, 15, 30 and 60 days, the specimens were removed and embedded in paraffin. Haematoxylin and eosin sections were used to count the number of inflammatory cells (IC) and fibroblasts mm-2 (Fb). In the Masson's trichrome-stained sections, the fibrous capsule thickness was measured; picrosirius red-stained sections were used for birefringent collagen quantification. The data were submitted to two-way ANOVA and Tukey test (P ≤ 0.05). RESULTS: A significantly lower number of IC and consequently higher number of Fb were observed in the capsules adjacent to thick MTA Flow at all periods, in comparison with other materials (P ≤ 0.05). At 60 days, the quantity of birefringent collagen was significantly greater in the tissue in contact with thick MTA Flow, when compared with fluid MTA Flow and Biodentine. CONCLUSIONS: Although thick MTA Flow induced a less intense inflammatory response, all evaluated materials are biocompatible because they allowed regression of this process after 60 days.

Region-specific expression and hormonal regulation of the first exon variants of rat prolactin receptor mRNA in rat brain and anterior pituitary gland.

Recent studies have revealed the occurrence of five first exon variants of the rat prolactin receptor mRNA, suggesting that multiple promoters direct prolactin receptor transcription in response to different regulatory factors. In the present study, regional expression of these first exon variants, as well as two prolactin receptor subtypes generated by alternative splicing, was examined in the brains and anterior pituitary glands of female rats. Expression of the long-form was detected in the choroid plexus, hypothalamus, hippocampus, cerebral cortex and anterior pituitary gland, whereas the short form was detected only in the choroid plexus. E1-3 mRNA, a first exon variant, was detected in the choroid plexus, hypothalamus, and anterior pituitary gland, whereas E1-4 was detected only in the choroid plexus. Other variants were not detectable by the polymerase chain reaction protocol employed in this study. Ovariectomy increased the short form in the choroid plexus and the E1-3 expression in the choroid plexus and pituitary gland, but changes in the long-form and E1-4 expression were minimal. Replacement of oestrogens and prolactin suggest that oestrogens down-regulate E1-3 expression in the choroid plexus and pituitary gland, and that the negative effect of oestrogen is mediated by prolactin in the pituitary gland. The present results revealed the region-specific promoter usage in prolactin receptor mRNA transcription, as well as the involvement of oestrogens in the regulation of E1-3 mRNA expression in the brain and pituitary gland.

Constitutive activation of mitogen-activated protein (MAP) kinases in human renal cell carcinoma.

Mitogen-activated protein kinases (MAPKs) play a pivotal role in the mitogenic signal transduction pathway and are essential components of the MAPK cascade, which includes MEK (also known as MAP kinase kinase), Raf-1, and Ras. In this study, we examined whether constitutive activation of the MAPK cascade was associated with the carcinogenesis of human renal cell carcinomas in a series of 25 tumors and in corresponding normal kidneys. Constitutive activation of MAPKs in tumor tissue, as determined by the appearance of phosphorylated forms, was found in 12 cases (48%), and this activation was confirmed by a direct in vitro kinase assay of immunoprecipitate using myelin basic protein as the substrate. The phosphorylation of MEK and of Raf-1, as monitored by a mobility shift in SDS-PAGE, which is reportedly associated with the activation of these kinases, occurred in 9 of 18 cases (50%) and in 6 of 11 cases (55%) respectively. The activation of MAPKs was correlated with MEK activation (P = 0.0045) and with Raf-1 activation (P = 0.067). Furthermore, overexpression of MEK was found in 13 of 25 cases (52%) by Western blot analysis, and this overexpression was associated significantly with MAPK activation (P = 0.034). No mutations were noted in H-,K-, or N-ras genes by PCR direct sequencing in any of the 25 tumor samples. Of the patients studied, 8 of 18 (44%) stage pT2 patients and four of six (67%) stage pT3 patients showed MAPK activation. The single stage pT1 patient did not evidence MAPK activation. Furthermore, one of seven (14%) grade 1 patients, 9 of 13 (69%) grade 2 patients, and two of five (40%) grade 3 patients showed MAPK activation (grade 1 versus grades 2 and 3, P = 0.046). Our results suggest that constitutive activation of MAPKs may be associated with the carcinogenesis of human RCCs.

Activation of the 41/43 kDa mitogen-activated protein kinase signaling pathway is required for hepatocyte growth factor-induced cell scattering.

Hepatocyte growth factor (HGF) markedly induced the spreading, dissociation and scattering of Madin-Darby canine kidney epithelial cells (MDCK) and human stomach adenocarcinoma cells (TMK1). Scattering of MDCK and TMK1 cells was induced by 12-O-tetradecanoyl-phorbol-13-acetate (PMA) and epidermal growth factor (EGF), respectively. In all these agent-stimulated cells, rapid activation of Raf-1, MAP kinase/ERK kinase (MEK), 41/43 kDa MAP kinases and p90rsk was commonly observed. In contrast, PMA neither induced the scattering nor activation of all these kinases in TMK1 cells. Pretreatment of MDCK and TMK1 cells with 2-(2-amino-3-methoxyphenyl) choromone (AMPC), a specific inhibitor of MEK, selectively inhibited the HGF-, PMA- and EGF-stimulated activities of MEK, 41/43 kDa MAP kinases and p90rsk in a dose dependent manner. AMPC-pretreatment, however, did not affect HGF-, PMA- or EGF-induced activation of Raf-1, nor HGF-induced activation of phosphatidylinositol 3-kinase in these cells. Importantly, HGF-, PMA- and EGF-induced scattering of MDCK and TMK1 cells was inhibited at doses of AMPC similar to those that gave comparable levels of inhibition of the activities of MEK, 41/43 kDa MAP kinases and p90rsk. These results suggest that activation of the 41/43 kDa MAP kinase signaling pathway is required for the motility response of MDCK and TMK1 cells induced by agents such as HGF, PMA and EGF.

Constitutive activation of the 41-/43-kDa mitogen-activated protein kinase signaling pathway in human tumors.

The 41-kDa and 43-kDa mitogen-activated protein (MAP) kinases play a pivotal role in the mitogenic signal transduction pathway and are essential components of the MAP kinase cascade, which includes MAP kinase kinase (MEK) and Raf-1. As aberrant activation of signal transducing molecules such as Ras and Raf-1 has been linked with cancer, we examined whether constitutive activation of the 41-/43-kDa MAP kinases is associated with the neoplastic phenotype of 138 tumor cell lines and 102 primary tumors derived from various human organs. Constitutive activation of the MAP kinases was observed in 50 tumor cell lines (36.2%) in a rather tissue-specific manner: cell lines derived from pancreas, colon, lung, ovary and kidney showed especially high frequencies with a high degree of MAP kinase activation, while those derived from brain, esophagus, stomach, liver and of hematopoietic origin showed low frequencies with a limited degree of MAP kinase activation. We also detected constitutive activation of the 41-/43-kDa MAP kinases in a relatively large number of primary human tumors derived from kidney, colon and lung tissues but not from liver tissue. Many tumor cells, in which point mutations of ras genes were detected, showed constitutive activation of MAP kinases, however, there were also many exceptions to this observation. In contrast, the activation of the 41-/43-kDa MAP kinases was accompanied by the activation of Raf-1 in the majority of tumor cells and was completely associated with the activation of MEK and p90rsk in all the tumor cells examined. These results suggest that the constitutive activation of 41-/43-kDa MAP kinases in tumor cells is not due to the disorder of MAP kinases themselves, but is due to the disorder of Raf-1, Ras, or some other signaling molecules upstream of Ras.

Abdominal aortic aneurysm with left-sided inferior vena cava. Report of a case.

The combination of abdominal aortic aneurysms and congenital anomalies of the inferior vena cava and its tributaries, such as double inferior vena cava, left-sided inferior vena cava, circumaortic renal collar, and retroaortic renal vein, are very rare but of clinical importance to vascular surgeons since these conditions can increase the difficulty of aneurysm resection as well as the risk of venous injury and subsequent excessive bleeding. This report describes a case of an abdominal aortic aneurysm with a left-sided inferior vena cava, and reviews of the incidence, diagnosis, and treatment of these conditions.

Tc-99m-methylene diphosphonate (Tc-99 MDP) and Ga-67 concentration in soft tissue malignant fibrous histiocytoma (MFH): case report.

A case of calcifying soft tissue malignant fibrous histiocytoma (MFH) which showed a concentration of Tc-99m MDP and Ga-67 citrate, is presented. Tc-99m MDP and Ga-67 citrate scintigraphies of the thigh mass were correlated with conventional radiography, computed tomography (CT) and angiography.

[Mitral valve replacement for three cases of hypertrophic obstructive cardiomyopathy--surgical treatment].

Three patients with obstructive cardiomyopathy underwent surgical treatment. Mitral valve replacement was performed in all three cases and myectomy of hypertrophic septal muscle was performed in one case. The pressure gradients between the left ventricle and the aorta was less than 10 mmHg in all cases after surgery, Clinical symptoms strikingly improved in three cases. An accurate surgical treatment could be achieved by choosing either myotomy-myectomy, mitral valve replacement or both in the setting of individual condition of each patients.

[High-dose methylprednisolone-containing chemotherapy in advanced invasive thymoma--report of three cases].

During the period from May, 1995 to August, 1996, three patients with Stage III or IVa invasive thymoma received chemotherapy consisting of cisplatin, doxorubicin and methylprednisolone (1000 mg on days 1 through 5, and 500 mg on days 6 and 7). The first case, a 55-year-old woman, who underwent extended thymectomy 7 years ago, was found to have a recurrent tumor in the left pleural cavity. The second case, a 38-year-old man, who had first operation 3 years ago, developed recurrent tumor in the right pleural cavity. These two patients were treated with the above regimen as the primary mode of therapy. The third case, a 61-year-old woman, had a thymoma with direct invasion to right upper lobe. The same chemotherapy regimen was employed as the induction chemotherapy. All patients showed a major response to treatment with only a small amount of tumor remaining. The effectiveness of chemotherapy in the treatment of malignant tumors has been recently reported to be at least partly due to induction of apoptosis. Steroids are known to induce apoptosis in normal thymic cells, and thus steroid in chemotherapy regimen against invasive thymoma may enhance the effect of anti-cancer drugs through the induction of apoptosis.

Terminal warm blood cardioplegia improves the recovery of myocardial electrical activity. A retrospective and comparative study.

OBJECTIVE: The effect of terminal warm blood cardioplegia was analyzed in 191 patients undergoing either coronary artery bypass grafting (CABG) or prosthetic heart valve replacement between Jan. 1990 and Dec. 1995. METHODS: Patients were subdivided into 3 historical cohorts based on the method of myocardial protection: Group A (n = 106), multidose cold crystalloid glucose-potassium cardioplegia, alone; Group B (n = 37), cold crystalloid glucose-potassium cardioplegia plus terminal warm blood cardioplegia, Group C (n = 48), cardioplegia induction with cold crystalloid glucose-potassium cardioplegia, maintenance with multidose cold blood cardioplegia, and terminal warm blood cardioplegia. RESULTS: Of patients undergoing CABG, 5.6% of group A, 70.4% of group B, and 86.7% of group C spontaneously resumed sinus rhythm after aortic declamping, as did 9.1% of group A, 60.0% of group B, and 55.6% of group C of patients undergoing prosthetic heart valve replacement. The incidence of spontaneous recovery was significantly better in groups B and C than in group A (p < 0.05). Over 90% of patients without terminal warm blood cardioplegia developed ventricular fibrillation or tachycardia requiring electrical cardioversion (p < 0.05). Postoperatively, patients without terminal warm blood cardioplegia required temporary epicardial pacing more frequently than those with terminal warm blood cardioplegia (p < 0.05). In patients undergoing prosthetic heart valve replacement, groups B and C, the incidence of postoperative atrial fibrillation was significantly lower than in group A. CONCLUSION: Terminal warm blood cardioplegia thus promoted better postoperative electrophysiological cardiac recovery.

Reading a smiling face: messages conveyed by various forms of smiling.

This study investigated the effect of various forms of smiling (closed smile, upper smile, or broad smile) on person perception. Brazilian undergraduates (N = 330) judged a photograph of a male or female stimulus person in three age ranges (young, middle-aged, and old) and smiling or not. 7-point scales were used to measure respondents' perception of the stimulus persons on various attributes (attractiveness, happiness, extroversion, sympathy, kindness, submission, ambition, and intelligence). We found that a smile enhanced attractiveness and kindness ratings independently of its form, whereas the influence of the various forms on ratings of happiness was additive. As the neutral face changed to a closed smile and the closed smile became a broad smile, target stimuli were attributed greater rated happiness. We also found a contribution of perceivers' gender to the judgements of extroversion and sympathy, indicating a slightly greater discrimination of facial expressions among women than among men.

[A case of left atrial myxoma with remarkable elevation of serum alkaline phosphatase level].

A 53-year-old woman was admitted suffering from high grade fever. Laboratory findings revealed leukocytosis, high CRP, high erythrocyte sedimentation rate and remarkable elevation of serum alkaline phosphatase level. Echocardiogram demonstrated left atrial tumor which was later diagnosed as myxoma. Although remarkable elevation of serum alkaline phosphatase level often indicates malignant disease, tumor makers were normal level and whole body computerized tomography couldn't detect other noncardiac diseases. Because of patient's deterioration due to sustained high grade fever, the left atrial tumor was excised. After the excision of the left atrial myxoma, patient's clinical signs and symptoms disappeared, and the serum alkaline phosphatase level was gradually normalized. We conclude that the cause of remarkable elevation of serum alkaline phosphatase level was the left atrial myxoma.

[Concomitant coronary artery bypass and cholecystectomy: a case report].

A case is reported in which simultaneous surgical correction of coronary atherosclerosis and cholelithiasis was performed. A 71-year-old man was admitted with severe stable angina and right hypochondrial dull pain. Coronary angiograms disclosed severe triple vessel disease, and abdominal echography demonstrated gallstone. He underwent bypass of left anterior descending, diagonal, obtuse marginal, and right coronary arteries with autogenous saphenous vein on cardiopulmonary bypass. The procedure was followed immediately by cholecystectomy. His postoperative course was uneventful.

[Three cases of adult intrapulmonary sequestration].

Three cases of adult intrapulmonary sequestration were presented. They were all females ranging from 22 to 49-year-old (mean age 35 yrs.). Chest X-rays showed abnormal shadows in the right or left lower lobe. Aortograms showed aberrant arteries in each cases, and the diagnosis of pulmonaly sequestration was made preoperatively. Lobectomies were performed in all cases because of recurrent bronchopulmonary infections. We could not classify our cases based on Pryce's classification by unclear margins between sequestrated lungs and normal pulmonary tissues. All cases had no histories of infantile bronchopulmonary infections which supported the theory of acquired origin.

[A case of penetrating chest injury with tension hemothorax by gunshot].

The patient, a 36-year-old male, was admitted with massive hemoptysis. He had two gunshot wounds in the right lateral abdomen and supraclavicular fossa. His chest X-ray showed right tension hemothorax. Emergency thoracotomy and laparotomy were performed. Massive bleeding from the right pulmonary artery (A4+5), lacerations in the diaphragm and injuries of the liver were found. We performed right middle lobectomy, S3 segmentectomy and plication of the diaphragm and liver. He was discharged uneventfully.

[Recurrent right atrial myxoma five years after removal of left atrial myxoma; report of a case].

A 41-year-old man had undergone resection of a left atrial myxoma 5 years previously. Echocardiography revealed a new mass in the right atrium. Because of had increased in size gradually, removal of the right atrial mass involving full-thickness resection of the fossa ovalis was performed. Cardiac myxoma has the potential for heterotopic recurrence.