Irreversible but not reversible pulpitis is associated with up-regulation of tumour necrosis factor-alpha gene expression in human pulp.

AIM: To analyse the gene expression of tumour necrosis factor-alpha (TNF-alpha) in human dental pulps, under normal and inflammatory conditions and to examine the association between any observed alterations in the expression of this cytokine with the severity of the clinical symptoms. METHODOLOGY: Eighteen pulpal samples were obtained from single-rooted human teeth. Six of the teeth were normal (group A), six had been diagnosed with reversible pulpitis (group B), and the remaining six were from teeth diagnosed with irreversible pulpitis (group C). TNF-alpha gene expression was semi-quantitatively analysed in each sample with RT-PCR, and the results from each group of teeth were compared with the Kruskal-Wallis and Mann-Whitney tests. RESULTS: Tumour necrosis factor-alpha was detected in all three groups of dental pulp. Statistical analysis provided evidence of a significant increase of TNF-alpha gene expression associated with irreversible inflammation compared with healthy controls (P = 0.002). No such difference was detected in reversibly inflamed pulp in comparison to healthy teeth (P = 0.699). CONCLUSION: Tumour necrosis factor-alpha gene expression in inflamed human dental pulp tissue is positively associated with the severity of clinical symptoms.

Doppler ultrasonography in testicular tumors presenting with acute scrotal pain.

PURPOSE: To determine whether Doppler ultrasonography (US) could be useful in the evaluation of testicular neoplasms presenting with acute scrotal pain. MATERIAL AND METHODS: We examined 18 patients with acute scrotal pain using Doppler US. Peak systolic and end-diastolic velocity measurements were performed at first admission and on completion of 1-week proper antibiotic treatment. Data were retrospectively reviewed and compared with findings of a control group of 17 age-matched subjects. RESULTS: Of the 18 patients evaluated, 11 were found to have testicular tumors and 7 testicular inflammation. Peak systolic and end-diastolic velocities were significantly increased in patients with testicular tumor (p<0.002) and orchitis (p<0.01) versus normal controls. Follow-up examination on completion of 1-week antibiotic treatment demonstrated persistent high velocity values in patients with tumor and normalization of velocity values in patients with orchitis. CONCLUSION: Our results support the concept that follow-up Doppler US examination is of value in patients with acute scrotal pain submitted to antibiotic treatment since it may contribute to the differentiation between orchitis and testicular tumor.

Doppler ultrasonography in predicting relapse of hyperthyroidism in Graves' disease.

PURPOSE: To determine whether Doppler ultrasonography could be useful in the prediction of relapse of hyperthyroidism in patients with Graves' disease. MATERIAL AND METHODS: Forty patients with Graves' disease confirmed by laboratory tests were examined for a number of blood flow parameters in the inferior thyroid artery before and after they were subjected to proper antithyroid drug treatment. Data were retrospectively reviewed and compared with findings for a control group of 16 age-matched subjects. RESULTS: Significantly increased blood flow parameters were observed both in patients with active hyperthyroidism before treatment and in euthyroid patients who presented a relapse shortly after withdrawal of proper antithyroid drug treatment versus normal controls. Conversely, no significant differences were observed between patients who remained in stable remission and normal controls. CONCLUSION: Our results support the concept that Doppler ultrasonography evaluation of patients with Graves' disease may contribute to the detection of a relapsing course of hyperthyroidism.

Color Doppler sonography in the detection of parathyroid adenomas.

BACKGROUND: Various diagnostic modalities have been utilized to aid in the detection of abnormal parathyroid tissue; however, its localization is not always easy. The purpose of this study was to determine whether the evaluation of potential hemodynamic changes in thyroid arteries could aid in the detection of parathyroid adenomas. METHODS: Twenty-eight patients with laboratory evidence of hyperparathyroidism were examined with color Doppler sonography. Data were collected for the superior and inferior thyroid arteries separately. These findings were compared with data for a control group of 14 healthy subjects. RESULTS: Retrospective analysis of the data indicated that peak systolic velocities in the inferior thyroid arteries ipsilateral with the parathyroid adenomas were significantly higher than in normal controls (p <.001). Peak velocity values in the superior thyroid arteries ipsilateral with parathyroid adenomas located in the upper position were also significantly increased compared with those in control subjects (p <. 02). Conversely, peak velocities in the inferior and superior thyroid arteries contralateral with the adenomas, as well as velocities in the superior thyroid arteries ipsilateral with lower position adenomas, did not differ significantly from those in control subjects. The localization of both side and level site of the adenomas presented an accuracy of 86.6%, sensitivity reached 96. 5%, and specificity 83.1%. CONCLUSION: Our results suggest that color Doppler sonography can be used to improve diagnostic accuracy in detecting parathyroid adenomas.