Benign mesenchymal odontogenic tumors of the maxillofacial bones: A report of 3 cases with 3 years follow-up.

Benign mesenchymal odontogenic tumors are lesions derived from the mesenchymal components of the tooth-forming apparatus and are consequently found within the jawbone. Benign fibro-osseous tumors are part of this category of lesions in which normal bone is substituted, initially by fibrous tissue and within time become infiltrated by osteoid and cementoid elements. They are asymptomatic, slow-growing lesions and remain undiagnosed until swelling of the face becomes prominent and they share similar radiological characteristics. Herein, we report three cases of ossifying fibroma, cemento-osseous fibroma and periapical cemento-osseous dysplasia and analyze all the correlating factors, clinical history, radiological and histological features, intraoperative appearance, and treatment with a 3-year follow-up period. Despite the advances in the identification of these pathologies, clinicians still face difficulties in their classification and the diagnosis due to overlap in both histological and radiographic findings. An accurate final diagnosis is essential for appropriate treatment and an informative prognosis.

Value Added Impact of Both Point-of-Care and Laboratory Lactic Acid Analysis When Emergently Evaluating Cancer Patients.

INTRODUCTION: Cancer patients are immunosuppressed and may present to an emergency department with atypical symptoms. In the emergency setting, it is important ascertain rapidly if lactic acid levels are high, either due to sepsis or tumor lysis syndrome, to effectively manage symptoms. Therefore, it is critical to determine the blood lactic acid level to timely identify who is at risk of sepsis and provide early intervention. We have compared blood lactic acid concentrations (BLAC) in cancer patients obtained by point-of-care testing (POCT) and those measured by laboratory analysis in blood samples drawn within a short time of each other. METHODS: This was a retrospective study in cancer patients whose BLAC had been determined by POCT and laboratory analysis. Only those patients who had blood withdrawn for both testing methods within a 2-h timeframe were included in the study. Regressions were performed together with an analysis categorizing the BLAC from both testing methods. RESULTS: A total of 274 patients met the criteria for the study. The BLAC from POCT correlated well with the values from laboratory testing (R = 0.925). Categorization of BLAC showed that 88.32% of the patients had BLAC that directly matched between the two tests; 28 (10.22%) patients had a normal BLAC according to laboratory analysis but a high BLAC on POCT; and four (1.46%) patients had a high BLAC according laboratory analysis but normal BLAC on POCT. CONCLUSIONS: There was a high correlation between POCT and laboratory analysis values of BLAC in cancer patients, with the results from both testing methods agreeing 96% of the time. This finding suggests that POCT would suffice in most cases. Importantly, in 2% of the cancer patients who presented emergently, BLAC determined by POCT and laboratory analysis did not agree. Therefore, in subsequent decision-making, we recommend that if sepsis is suspected and BLAC determined by POCT is normal, nucleic acids, proteins, circulating cells, and interleukin-3 levels should also be obtained by POCT to confirm sepsis and/or rule out tumor lysis syndrome in patients with cancer.

Parkin maintains mitochondrial levels of the protective Parkinson's disease-related enzyme 17-ß hydroxysteroid dehydrogenase type 10.

Mutations of the PARK2 and PINK1 genes, encoding the cytosolic E3 ubiquitin-protein ligase Parkin and the mitochondrial serine/threonine kinase PINK1, respectively, cause autosomal recessive early-onset Parkinson's disease (PD). Parkin and PINK1 cooperate in a biochemical mitochondrial quality control pathway regulating mitochondrial morphology, dynamics and clearance. This study identifies the multifunctional PD-related mitochondrial matrix enzyme 17-ß hydroxysteroid dehydrogenase type 10 (HSD17B10) as a new Parkin substrate. Parkin overproduction in cells increased mitochondrial HSD17B10 abundance by a mechanism involving ubiquitin chain extension, whereas PARK2 downregulation or deficiency caused mitochondrial HSD17B10 depletion in cells and mice. HSD17B10 levels were also found to be low in the brains of PD patients with PARK2 mutations. Confocal and Förster resonance energy transfer (FRET) microscopy revealed that HSD17B10 recruited Parkin to the translocase of the outer membrane (TOM), close to PINK1, both in functional mitochondria and after the collapse of mitochondrial membrane potential (ΔΨm). PD-causing PARK2 mutations impaired interaction with HSD17B10 and the HSD17B10-dependent mitochondrial translocation of Parkin. HSD17B10 overproduction promoted mitochondrial elongation and mitigated CCCP-induced mitochondrial degradation independently of enzymatic activity. These effects were abolished by overproduction of the fission-promiting dynamin-related protein 1 (Drp1). By contrast, siRNA-mediated HSD17B10 silencing enhanced mitochondrial fission and mitophagy. These findings suggest that the maintenance of appropriate mitochondrial HSD17B10 levels is one of the mechanisms by which Parkin preserves mitochondrial quality. The loss of this protective mechanism may contribute to mitochondrial dysfunction and neuronal degeneration in autosomal recessive PD.

Management of the stiff shoulder. A prospective multicenter comparative study of the six main techniques in use: 235 cases.

INTRODUCTION: Stiffness in the shoulder is a frequent symptom associated with a number of clinical entities whose management remains inadequately defined. PATIENTS AND METHODS: This prospective study of 235 cases of stiffness in the shoulder compared six therapeutic techniques with a mean follow-up of 13 months (range, 3-28 months) (T1: 58 cases, conventional rehabilitation under the pain threshold, T2: 59 cases, self-rehabilitation over the pain threshold, T3: 31 cases, T2 + supervision, T4: 11 cases, T1 + capsular distension, T5: 31 cases, T1 + locoregional anesthesia, T6: 45 cases, T1 + T5 + capsulotomy). The therapeutic power of each technique and its impact on the result were assessed at each self-rehabilitation and rehabilitation session during the first 6 weeks and then at 3 months, 6 months, and at the final revision depending on subjective criteria (pain, discomfort, and morale) and objective criteria (Constant score, goniometric measurements). RESULTS: Conventional rehabilitation (T1) is less effective than self-rehabilitation over the pain threshold (T2 & T3) during the first 6 weeks (P<0.05). Self-rehabilitation stagnates between the 6th and 12th week except when it is supervised by a therapist (T3). Anesthesia (T4) and capsular distension (T5) do not lead to significantly different progression beyond 6 months. Capsulotomy does not demonstrate greater therapeutic power but its failure rate (persisting stiffness at 1 year) is 0% versus 14-17% for the other techniques (P<0.05). DISCUSSION: The techniques are complementary and therapeutic success stems from an algorithm adapted to the individual patient with, over the first 3 months, successive self-rehabilitation and conventional rehabilitation, possibly completed by capsular distension or anesthesia between the 3rd and 6th months. In case of failure at 6 months, endoscopic capsulotomy can be proposed. Therapeutic patient education and active participation are the key to treatment success or failure.

Comparison and critical evaluation of rehabilitation and home-based exercises for treating shoulder stiffness: prospective, multicenter study with 148 cases.

INTRODUCTION: The goal of this study was to evaluate the effectiveness of individual exercises performed as classic rehabilitation or a home program on the clinical progression of patients with shoulder stiffness. Based on this information, the secondary goal was to develop a new rehabilitation protocol. PATIENTS AND METHODS: This prospective, comparative series included 148 cases of shoulder stiffness. There were three treatment groups: T1: classic rehabilitation performed below the pain threshold (58 cases); T2: home program with provocation above the pain threshold (59 cases); T3: home program supervised by a physical therapist (31 cases). The execution, pain level and time spent doing each exercise were compiled for each work session - every day for the first 6 weeks, then every week up to 3 months. Clinical (Constant score) and range of motion evaluations were performed at enrollment, week 6 and month 3.Changes were compared between groups; correlation tests were used to analyse the effectiveness of each exercise during each session. RESULTS: Other than physical therapy and balneotherapy, classic rehabilitation exercises had a negative effect on clinical progression during the first 3 to 5 weeks (P<0.05), but this did not hinder the occurrence of a slow, continuous clinical improvement (P<0.05). Home programs led to rapid functional progression with improvement directly related to the number of exercises actually performed (P<0.05), however, pain during the day increased and pain at night decreased. Supervision by a physical therapist helped to optimize the home program, with the same result at week 6, but a better result at month 3 (P<0.05). CONCLUSIONS: Based on the results of this study, a new treatment protocol for shoulder stiffness was proposed that combines an intensive patient home program with a well-informed physical therapist, who progressively adds classic rehabilitation techniques when they provide the best treatment value for each exercise. Patient education is the key to treatment success.

Ocular pathology in acquired immunodeficiency syndrome.

Gross and microscopic ocular findings were prospectively studied in 38 human immunodeficiency virus (HIV)-seropositive subjects undergoing postmortem examination. Pathologic lesions were detected in 27 patients (71%), with 67% of the abnormal findings detected only microscopically.

Acoustic sounding of wind velocity profiles in a stratified moving atmosphere.

The paper deals with analytical and numerical studies of the effects of atmospheric stratification on acoustic remote sensing of wind velocity profiles by sodars. Both bistatic and monostatic schemes are considered. Formulas for the Doppler shift of an acoustic echo signal scattered by atmospheric turbulence advected with the mean wind in a stratified moving atmosphere are derived. Numerical studies of these formulas show that errors in retrieving wind velocity can be of the order of 1 m/s if atmospheric stratification is ignored. Formulas for the height at which wind velocity is retrieved are also derived. Approaches are proposed which allow one to take into account the effects of atmospheric stratification when restoring the wind velocity profile from measured values of the Doppler shift and the time interval of acoustic impulse propagation from a sodar to the scattering volume and back to the ground.

Long-range soliton interactions in dispersion-managed links.

A numerical analysis of soliton propagation in a dispersion-compensated transmission system reveals the presence of a small dispersive-wave contribution to the propagating soliton that increases dramatically whenever the input soliton energy is detuned from its optimal value. A straightforward consequence of the dispersive-wave emission is an unexpectedly strong contribution to the long-range soliton-soliton interaction. We show that the combination of long- and short-range interactions induces soliton timing jitter that grows larger than that which arises from the Gordon-Haus effect.

Extended path-averaged soliton regime in highly dispersive fibers.

It is shown that solitons can survive the large temporal broadening induced by a propagation over many dispersion lengths. The propagation requires large excess power and specific conditions of the dispersion map.

Study of the continuum generated by in-line filtering of solitons.

The continuum generated by the filtering of solitons is studied analytically by use of a perturbation theory and numerically verified. The method applies to any filter transfer function and to sliding-frequency filtering as well. A general method for finding the input pulse adapted to a transmission line is presented and applied to the case of filtering.

Continuum generated by chromatic dispersion and power variations in periodically amplified soliton links.

The continuum generated by soliton power variations and chromatic dispersion fluctuations along the line of a periodically amplified system is analytically studied and numerically verified. A new design of two-step dispersion profiling is derived that leads to a reduction factor of the continuum energy of more than 9.

Influence of chromatic dispersion variation along the path of soliton jitter control with sliding filters.

We use perturbation theory to calculate the Gordon-Haus timing jitter in soliton communication systems with sliding filters. We analyze the effects of soliton parameter changes with distance that are due to the chromatic dispersion variation resulting from frequency sliding. We show that the timing-jitter control efficiency is nearly independent of the frequency-sliding sign, provided the frequency range is the same for both signs.

Analytic modeling of high-gain erbium-doped fiber amplifiers.

We describe an analytic method that calculates accurately (within a 1.5-dB discrepancy with numerical models) the gain of an erbium-doped fiber amplifier. Amplified spontaneous emission (ASE) is taken into account so that the gain of ASE-saturated erbium-doped fiber amplifiers is calculated properly. It is effective for wavelength multiplexing (several signals) and for different pumping schemes (copropagating or counterpropagating or both).

Influence of soliton interaction on amplifier noise-induced jitter: a first-order analytical solution.

Amplifier noise induces fluctuations on the soliton's mean frequency and amplitude. These fluctuations disturb the soliton phase difference, which modifies the soliton interaction. Amplifier noise jitter and soliton interaction cannot be studied independently for strongly interacting solitons in high-repetition-rate long-distance transmissions. A first-order analytical modeling for the jitter of two interacting solitons with periodic amplification is presented.

Focal increased lung perfusion and intrapulmonary veno-arterial shunting in bronchiolo-alveolar cell carcinoma.

A patient with bronchiolo-alveolar cell carcinoma presented with a veno-arterial shunt localized to the area of tumor involvement by differential position shunt testing. Perfusion lung scan revealed increased radionucleotide uptake in the area of the tumor, confirmed by pulmonary angiography, and suggested that the primary blood supply to the tumor was originating from the pulmonary circulation. Surgical resection of the tumor resulted in marked reduction of the intrapulmonary shunt.