Utility of Diagnostic Imaging in the Early Detection and Management of the Fournier Gangrene.

Fournier gangrene represents a urologic emergency. It is a rapidly progressing necrotizing fasciitis that comprises the perineal, perianal, and genital regions and has a high mortality rate. Diagnosis is usually made clinically, but radiological diagnostics, such as ultrasound (US), computed tomography (CT), or magnetic resonance imaging (MRI), can determine the extent of the disease in relation to pelvic structures. Early and accurate diagnosis precipitates the initiation of the effective treatment and, thus, affects the outcome of the therapy. The article reports an illustrative case study of a patient with Fournier gangrene, secondary to a perianal fistula and perianal abscess with a massive accumulation of fluid around the anus and testicles, requiring unilateral orchidectomy. Rapid radiological diagnosis via MRI enabled precise assessment of the degree of the disease, early surgical intervention, and a successful outcome.

Tomographic Evaluation of Reparative Dentin Formation after Direct Pulp Capping with Ca(OH)2, MTA, Biodentine, and Dentin Bonding System in Human Teeth.

INTRODUCTION: New materials can increase the efficiency of pulp capping through the formation of a complete reparative dentin bridge with no toxic effects. The present study involved tomographic evaluations of reparative dentin bridge formation after direct pulp capping with calcium hydroxide, mineral trioxide aggregate (MTA), Biodentine (Septodont, Saint Maur des Fossés, France), and Single Bond Universal (3M ESPE, Seefeld, Germany) in human teeth. METHODS: Forty-four caries-free, intact, human third molars scheduled for extraction were subjected to mechanical pulp exposure and assigned to 1 of 4 experimental groups depending on the pulp capping agent used: calcium hydroxide, MTA, Biodentine, or Single Bond Universal. After 6 weeks, the teeth were extracted and processed for cone-beam computed tomographic imaging and histologic examination. Tomographic data, including the density and volume of formed reparative dentin bridges, were evaluated using a scoring system. RESULTS: The reparative dentin formed in the calcium hydroxide, MTA, and Biodentine groups was significantly superior to that formed in the Single Bond Universal group in terms of thickness and volume. The dentin bridges in the Biodentine group showed the highest average and maximum volumes. The mean density of dentin bridges was the highest in the MTA group and the lowest in the Single Bond Universal group. CONCLUSIONS: The volume of reparative dentin bridges formed after direct pulp capping is dependent on the material used. Biodentine and MTA resulted in the formation of bridges with a significantly higher average volume compared with Single Bond Universal, and cone-beam computed tomographic imaging allowed for the identification of the location of dentin bridges.

Decreased reactive oxygen generation during H2O2 decomposition in the presence of samples from human rectal cancer.

Reactive oxygen species (ROS) have generated a great deal of interest in the clinical field since experimental studies showed the involvement of these species in carcinogenesis. This paper reports the detection of ROS during the decomposition of H2O2 in the presence of samples obtained from tissues of 16 patients with rectal carcinoma (age 64 +/- 9 years) operated on in the Division of Surgical Oncology of Pomeranian Medical University, Szczecin (Poland). The samples were cut from the middle of the resected tumors and from the colonic mucosa (10 cm distant from the tumor and free of disease); they were processed and the supernatants, representing the soluble fraction, were used for measurements. Various methods for measuring free radical activity of the examined samples were used, such as chemiluminescence, fluorescent probe 2',7'-dichlorodihydrofluorescein, spin trap 5,5-dimethyl-pyrroline-1-oxide and EPR, the spectrophotometrically examined formation of diformazan during reduction of the p-nitroblue tetrazolium salt, and bleaching of p-nitrosodimethylalanine. A statistically significant difference (P < 0.001) was noticed in mean chemiluminescence +/- standard error of the mean in the presence of the tumor samples (42.6 +/- 7.3) in comparison to the control samples (234.6 +/- 36.0). Significantly decreased generation of ROS from the decomposition of H2O2 in the presence of the tumor samples in comparison to the control samples was also observed when the above-mentioned methods were used. Tumor samples had significantly lower superoxide dismutase activity (33 +/- 4 U/mg protein) than controls (93 +/- 14 U/mg, P < 0.001), which should contribute to a lower capacity of endogenous H2O2 production and therefore less ROS generation upon H2O2 decomposition. We conclude that the tested samples have different redox properties; this supports a possible role of ROS activity during carcinogenesis. Moreover, we propose a new, simple, and sensitive chemiluminescent method, which might be effective in sample differentiation.