Cooperation of the maxillofacial and plastic surgeon in reconstructive surgical procedures in gunshot injury - a case report.

Lower and middle face defects resulting from gunshot wounds often cause severe functional and cosmetic deformities. The purpose of this case report is to refer to our experiences in the treatment of facial gunshot trauma associated with attempted suicide that resulted in a complex facial injury. The goal of the treatment of complex facial injuries is a proper reconstruction of the hard and soft tissue defects and sufficient rehabilitation of the relevant functions, such as speech, nutrition and appearance. A close cooperation of the maxillofacial and plastic surgeon is essential to achieve a satisfactory outcome.

Aggressive periodontitis.

AIM: Horizontally impacted mandibular molars may cause loss of bone, and development of periodontal pockets on the distal root surface of adjacent second molars. The reported patient was confirmed to have aggressive periodontitis. The aim of this presentation is to describe a novel view of a complex treatment approach to promote periodontal healing in a patient. MATERIAL AND METHODS: Our study presents the results of a patient with generalized aggressive periodontitis, horizontally impacted left third mandibular molar, and a second molar with a deep periodontal pocket. The treatment concept was recommended based on the idea of "one-stage treatment". The removal of the third molar was followed by deep scaling and root planing, and the xenogenic grafting material was placed on the bone defect. The flap completely covered the wound. The patient received systemic antibiotics. RESULTS: The probing pocket depth was 9 mm before surgical treatment and 0-2 mm 1, 5, and 10 years postoperatively. The radiographic bone level was 50 % before surgery and 100 % after the surgical approach. CONCLUSION: This presentation with a 10-year follow-up describes the implementation of one-stage treatment management to promote periodontal healing in a patient via full-mouth periodontal and surgical therapy (Fig. 4, Ref. 33).

Dental treatment recommendations and coronavirus disease 19 (COVID-19).

Health is a state of complete physical, mental and social well-being. The outbreak of coronavirus disease 2019 (COVID-19) in the area of Wuhan, China, has evolved rapidly into a public health crisis and has spread exponentially to other parts of the world.There is strong evidence that this novel coronavirus is similar to coronavirus species found in bats and potentially pangolins, confirming the zoonotic nature of this new cross-species virus-mediated disease.Dentists provide support and management for patients. They proceed in accordance with the current guidelines of the government of each country as well as with the valid standards and preventive, diagnostic and therapeutic procedures for COVID-19.This article mainly focuses on the recommended methods in dental medicine designed to protect patients and healthcare professionals (Tab. 2, Ref. 29). Keywords: coronavirus, COVID-19, dental strategies, dental treatment recommendations.

Methylation of MMP2, TIMP2, MMP9 and TIMP1 in abdominal aortic aneurysm.

OBJECTIVES: Abdominal aortic aneurysm (AAA) and its complications are among the most serious cardiovascular diseases and its occurrence has risen sharply in recent years. The aim of this pilot study is to explore the relationship between the methylation of matrix metalloproteinases and tissue inhibitors of the metalloproteinases genes' promoter region, and abdominal aortic aneurysm (AAA) through the detection of the methylation status of MMP2, TIMP2, TIMP1, and MMP9 genes in peripheral blood. METHODS: The study included 43 males with verified AAA (case group) and 34 healthy males (control group). The methylation status of the genes' promoter region was detected by methylation-specific polymerase chain reaction (MS-PCR). RESULTS: In adominal aortic aneurysm patients, the methylation ratio of MMP2 gene was positive in 9.3 % (4 cases), 2.3 % (1 case) had methylated TIMP2 gene, 7.0 % (3 cases) had methylated TIMP1 gene, while the methylation ratio of MMP9 gene was positive in 93.0 % (40 cases). In the control group, MMP2 gene was found to be methylated in 5.9 % (2 cases), 5.9 % of cases had methylated TIMP2 and TIMP1 genes (2 cases), and MMP9 gene was found to be methylated in 91.2 % (31 cases). CONCLUSION: In our pilot study, we found no association between DNA methylation of gelatinases and their tissue inhibitors, and the development of an abdominal aortic aneurysm (Tab. 2, Fig. 1, Ref. 27).

Hyaluronic acid application vs arthroscopy in treatment of internal temporomandibular joint disorders.

AIMS: The goal of this study was to compare the treatment outcome after two different treatment modalities in cases of disc displacement of the temporomandibular joint diagnosed via magnetic resonance technique, namely surgical procedure in form of arthroscopic lysis and lavage vs. hyaluronic acid superior joint space application. MATERIALS AND METHODS: Magnetic resonance imaging was performed before and one year after treatment. Simultaneously, pre- and post-treatment visual analogue scales and maximal mouth opening distance were documented. RESULTS: In our study, out of the total of 145 patients who were initially diagnosed with magnetic resonance imaging to have internal derangements and treated with arthroscopic lysis and lavage or hyaluronic acid application, we observed progression of internal derangement in 27 cases (18.6 %), improvement in 37 cases (25.5 %) and stationary state in 81 patients (55.9 %). Both treatment methods significantly improved the followed maximal mouth opening distance and visual analogue scale, as confirmed upon the 12­month follow-up examination. Maximal mouth opening was 4.7mm for hyaluronic acid application and 12.2mm for arthroscopic lysis and lavage (p<0.005). The mean visual analogue scale values decreased from 6.2 to 2.1 for hyaluronic acid application and from 6.9 to 1.2 for arthroscopic lysis and lavage (p<0.005). CONCLUSION: Our study shows that both arthroscopic lysis and lavage and hyaluronic acid injections are effective and safe in the treatment of disc displacement in the temporomandibular joint (Tab. 3, Ref. 30).

Therapeutic effects of arthrocentesis in treatment of temporomandibular joint disorders.

OBJECTIVE: Analyse, compare and evaluate the effects of the treatment arthrocentesis with a control group of non-steroid drugs treated patients. MATERIAL AND METHODS: 1752 out-patients (1293 females, 459 males) were examined within the years 2013-2017. We evaluated the following criteria: gender, age, visual analog scale for pain (VAS), inter-incisal distance and reducing intake of orally administered analgesics. RESULTS: The pain level of the group of patients with arthrocentesis had stabilized at mark 2.5 on the pain scale, unlike in the control group after treatment with non-steroidal anti-inflammatory drugs, pain had stabilized at mark 9 on the pain scale. The inter incisal distance amongst the first group was 37 mm and in the control group only 27 mm, after completed treatment. The amount of applied analgesics in the group with arthrocentesis decreased to 100 mg daily, while in the control group, the dose was adjusted to 700 mg daily. CONCLUSION: In the observed study, arthrocentesis was effective in reducing pain, amount of analgesics per day and improving the mobility of temporomandibular joint (TMJ). The results of this study we use in the ongoing project, that focuses on progressive and innovative methodology of endoscopically assisted arthrocentesis. (Tab. 4, Fig. 5, Ref. 39).

Omalizumab in an 8-year-old boy with diabetes mellitus and refractory chronic spontaneous urticaria

No disponible

The effect of passive smoking on bacterial colonisation of the upper airways and selected laboratory parameters in children.

Exposure to tobacco smoke is associated with a higher risk of respiratory tract diseases. The aim of this study was to determine the influence of passive smoking on selected characteristics of children with adenoid hypertrophy. Sixty-one children with adenoid hypertrophy were enrolled in the prospective study. Differences in bacterial colonisation of middle nasal meatus and nasopharynx and changes in selected laboratory immune and inflammatory markers according to the tobacco smoke exposure were analysed. Exposure to tobacco smoke was associated with significantly higher colonisation of pathogenic bacteria and polymicrobial growth of pathogenic bacteria (≥ 2 bacteria) in middle nasal meatus compared to non-exposed children (P = 0.045, P = 0.032, respectively). Identification of pathogenic bacteria in the middle nasal meatus did not correlate with isolation of pathogenic bacteria in the nasopharynx in either group of children. Parameters of humoral immunity in serum, IgA and IgG, were detected at higher concentrations in children exposed to tobacco smoke (P = 0.047, P = 0.031, respectively). Differences in selected parameters of cellular immunity in peripheral blood according to passive smoking were not observed. Tobacco smoke exposure is related to increased colonisation by pathogenic bacteria in middle nasal meatus and elevation of IgA and IgG in peripheral blood, but does not seem to influence markers of cellular immunity parameters in children with adenoid hypertrophy. Avoidance of passive smoking could be recommended as a universal preventive strategy against microbial colonisation of the upper airways and development of various inflammatory diseases in children, e.g. adenoid hypertrophy.

Biodegradable versus titanium plates and screws for paediatric facial skeleton fractures.

OBJECTIVE: The use of biodegradable materials represents a new option in the treatment of paediatric facial skeleton fractures. The benefits of a resorbable system include reductions in time for long-term stability, diminished immobilisation period, and elimination of painful procedures for implant removal. The resorption of the material did not influence bone repair and growth. Bioresorbable plates and screws get completely excreted through physiological routes. MATERIAL AND METHODS: The age of the patients ranges from that of pre-schoolers till 18 years. The mean age of boys and girls was 12.18 (range 4-18 years) and 13.59 (range 5-18 years), respectively. RESULTS: During the ten-year period, 168 children and adolescents, 136 boys and 32 girls, were treated. The conservative treatment was performed in 67 patients (39.9 %). Open surgical reduction was performed in 101 patients (60.1 %). Bioresorbable plates were applied in 44 patients (43.6 % of surgically treated). CONCLUSION: The implementation of biodegradable osteosynthetic materials is optimal for the treatment of fractures of the middle third of the facial skeleton, lower part of the upper third of the facial skeleton, mandibular body and parasymphysis (Tab. 3, Fig. 3, Ref. 31).

DNA repair genes polymorphism and lung cancer risk with the emphasis to sex differences.

Polymorphisms in nucleotide and base excision repair genes are associated with the variability in the risk of developing lung cancer. In the present study, we investigated the polymorphisms of following selected DNA repair genes: XPC (Lys939Gln), XPD (Lys751Gln), hOGG1 (Ser326Cys) and XRCC1 (Arg399Gln), and the risks they present towards the development of lung cancer with the emphasis to gender differences within the Slovak population. We analyzed 761 individuals comprising 382 patients with diagnosed lung cancer and 379 healthy controls. Genotypes were determined by polymerase chain reaction/restriction fragment length polymorphism method. We found out statistically significant increased risk for lung cancer development between genders. Female carrying XPC Gln/Gln, XPC Lys/Gln+Gln/Gln and XRCC1 Arg/Gln, XRCC1 Arg/Gln+Gln/Gln genotypes had significantly increased risk of lung cancer corresponding to OR = 2.06; p = 0.04, OR = 1.66; p = 0.04 and OR = 1.62; p = 0.04, OR = 1.69; p = 0.02 respectively. In total, significantly increased risk of developing lung cancer was found in the following combinations of genotypes: XPD Lys/Gln+XPC Lys/Lys (OR = 1.62; p = 0.04), XRCC1 Gln/Gln+hOGG1 Ser/Ser (OR = 2.14; p = 0.02). After stratification for genders, the following combinations of genotype were found to be significant in male: XPD Lys/Gln+XPC Lys/Lys (OR = 1.87; p = 0.03), XRCC1 Arg/Gln+XPC Lys/Lys (OR = 4.52; p = 0.0007), XRCC1 Arg/Gln+XPC Lys/Gln (OR = 5.44; p < 0.0001). In female, different combinations of the following genotypes were found to be significant: XRCC1 Arg/Gln+hOGG1 Ser/Ser (OR = 1.98; p = 0.04), XRCC1 Gln/Gln+hOGG1 Ser/Ser (OR = 3.75; p = 0.02), XRCC1 Arg/Gln+XPC Lys/Gln (OR = 2.40; p = 0.04), XRCC1 Arg/Gln+XPC Gln/Gln (OR = 3.03; p = 0.04). We found out decreased cancer risk in genotype combinations between female patients and healthy controls: XPD Lys/Lys+XPC Lys/Gln (OR = 0.45; p = 0.02), XPD Lys/Gln+XPC Lys/Lys (OR = 0.32; p = 0.005), XPD Lys/Gln+XPC Lys/Gln (OR = 0.48; p = 0.02). Our results did not show any difference between pooled smokers and non-smokers in observed gene polymorphisms in the association to the lung cancer risk. However, gender stratification indicated the possible effect of heterozygous constitution of hOGG1 gene (Ser/Cys) on lung cancer risk in female non-smokers (OR = 0.20; p = 0.01) and heterozygous constitution of XPC gene (Lys/Gln) in male smokers (OR = 2.70; p = 0.01).

Expression of Ki-67, Bcl-2, Survivin and p53 Proteins in Patients with Pulmonary Carcinoma.

Apoptosis is the fundamental process necessary for eliminating damaged or mutated cells. Alterations in the apoptotic pathway appear to be key events in cancer development and progression. Bcl-2 is the key member of the Bcl-2 family of apoptosis regulator proteins with anti-apoptotic effects. Survivin acts as an inhibitor of apoptosis as well and has been implicated in both inhibition of apoptosis and mitosis regulation. p53 is one of the tumor suppressor proteins, prevents tumor formation through cell cycle blocking and eliminates damaged cells via the activation of apoptosis. The Ki-67 protein is a cellular marker for proliferation. To investigate the possible interactions of the aforementioned proteins, we examined their expression in 76 patients with diagnosed lung cancer using immunohistochemical visualisation. Ki-67 protein was expressed in the cancer cells of all patients with small cell lung cancer (SCLC). We found a negative correlation between survivin and p53 expression. A decreased intensity of survivin expression and fewer cells positive for survivin (66.7%) in SCLC in comparison with other lung cancer types (98.0%) was detected. Reversely, expression of Bcl-2 was found in more than 90% of cases with SCLC. We hypothesize that high expression and intensity of Bcl-2 protein could be a factor behind a bad prognosis in SCLC.

[Atypical maxillofacial shot wound]. / Atypické strelné poranenie maxilofaciálnej oblasti.

Maxillofacial shot wounds belong to the relatively less frequent injuries. The soft tissues might be affected in particular, however the most of injuries are combined with infliction of hard tissues. Shot wounds by the bow or crossbow are very rare. They might result as a consequence of either accident or suicide. In the literature some cases of a suicidal experiments had been published, all of these cases were due to arrow from the crossbow. There was no injury being documented due to arrow from the bow. The authors present a case of maxillofacial injury done by shoot of arrow from the bow in the course of a child's play.

Expression of anti-apoptotic protein survivin and tumor suppressor p53 protein in patients with pulmonary carcinoma.

BACKGROUND: Survivin is one of the inhibitors of the apoptosis gene family that has been implicated in both inhibition of apoptosis and mitosis regulation. p53 is one of the tumor suppressor genes; prevents tumor formation through cell cycle blocking and eliminates damaged cells via activation of apoptosis. OBJECTIVE: To investigate the possible regulation of survivin by p53, we examined the expression of both proteins in 67 patients with diagnosed lung cancer using immunohistochemical visualization. RESULTS: Survivin was predominantly expressed in both nucleus and cytoplasm, whereas p53 was expressed in the nucleus. There was a negative correlation between survivin and p53 expression. A decreased intensity of expression and fewer cells positive for survivin in small cell lung cancer in comparison with other lung cancer types were detected. There was no significant difference in the intensity of expression and the number of cells positive for p53 between small cell and non-small cell lung cancer types. CONCLUSION: The present study suggests that survivin expression, as opposed to that of p53, is decreased in small cell lung cancer, which may differentiate this cancer from other lung cancer types other types.