Influence of access cavity design and use of operating microscope and ultrasonic troughing to detect middle mesial canals in extracted mandibular first molars.

AIM: To evaluate the influence of various endodontic access cavity designs and the use of an operating microscope (OM) with or without ultrasonic troughing to detect middle mesial canals (MMCs) in extracted mandibular first molars. METHODOLOGY: Sixty extracted mandibular first molars were evaluated by cone beam computed tomography (CBCT) in order to detect the presence of MMCs and then divided into two groups (n = 30) with an equal proportion of 1 molar with MMC for each 3 molars. A specific access cavity design was performed for each group, either a conservative access cavity (CAC) or a traditional access cavity (TAC). Root canals were detected in three assessment stages: (i) no magnification, (ii) using an OM and (iii) using an OM together with ultrasonic troughing. Evaluations were performed on a mannequin head in an ergonomic working position. The confidence obtained in the assessment stages was portrayed by sensitivity, specificity and accuracy, calculated by the area under the ROC curve. The difference in the proportion of correct diagnoses in identifying the MMC using either CAC or TAC preparation, at each of the three stages, was checked using Cochran's Q tests. Binomial tests were performed at each stage to investigate whether there was a difference between the types of endodontic access designs to detect MMCs. Significance was set at P < 0.05. RESULTS: Accuracy increased at each assessment stage. At the third stage, both groups provided perfect accuracy (1.00). Cochran's Q tests indicated that the confidence of MMC detection for both TAC and CAC groups (P < 0.05) increased significantly at each stage. Binomial tests demonstrated that there was no significant difference between the TAC and CAC groups, when evaluation was performed without magnification (P > 0.05), with OM (P > 0.05), or with OM associated with ultrasonic troughing (P > 0.05). CONCLUSION: The access cavity design did not significantly affect detection of middle mesial canals in extracted mandibular first molars placed in a mannequin. However, the use of OM increased the accuracy of the MMC identification, especially when associated with ultrasonic troughing.

A kinetic model of T cell autoreactivity in autoimmune diseases.

We construct a mathematical model of kinetic type in order to describe the immune system interactions in the context of autoimmune disease. The interacting populations are self-antigen presenting cells, self-reactive T cells and the set of immunosuppressive cells consisting of regulatory T cells and Natural Killer cells. The main aim of our work is to develop a qualitative analysis of the model equations and investigate the existence of biologically realistic solutions. Having this goal in mind we describe the interactions between cells during an autoimmune reaction based on biological considerations that are given in the literature and we show that the corresponding system of integro-differential equations has finite positive solutions. The asymptotic behaviour of the solution of the system is also studied. We complement our mathematical analysis with numerical simulations that study the sensitivity of the model to parameters related to proliferation of immunosuppressive cells, destruction of self-antigen presenting cells and self-reactive T cells and tolerance of SRTCs to self-antigens.

Evaluation of cone beam computed tomography and periapical radiography in the diagnosis of root resorption.

BACKGROUND: This study aimed to evaluate the accuracy of cone beam computed tomography (CBCT) and periapical radiography in diagnosing root resorption and verify the influence of filling material in detecting these lesions. METHODS: Digital periapical radiographs and CBCT images of patients with root resorption and a history of dental trauma from a radiology clinic were reviewed retrospectively. The sample comprised 40 teeth with root resorption and 20 normal teeth as controls. Images were analysed by two radiologists and two endodontists. The sensitivity, specificity and accuracy were determined. The kappa coefficient assessed interobserver agreement and the t test determined significant differences between the imaging methods. RESULTS: The accuracy of CBCT in diagnosing external (P = 0.0144) and internal (P = 0.0038) inflammatory resorption was significantly higher than for periapical radiography. For replacement resorption, no statistical difference was noted (P > 0.05). In endodontically treated teeth, CBCT was statistically superior in diagnosing root resorption (P = 0.0138). CONCLUSIONS: CBCT was superior to digital periapical radiography in diagnosing external and internal inflammatory root resorption after dental trauma and can be considered in the differential diagnosis of resorptive lesions in teeth with endodontic treatment.

A surgical device for radiofrequency ablation of large liver tumors.

Radiofrequency ablation has become an accepted treatment option of patients with primary and metastatic liver tumors. We propose an ablation electrode array consisting of 4-8 blade shaped electrodes arranged in a circular geometry for the treatment of large liver tumors. We developed a 3D code based on the finite difference method for evaluating the effect of different numbers of electrodes (4, 6 and 8) and electrode distance on lesion size. The configuration with six electrodes can ablate a volume of 70 x 70 x 40 mm(3) in approximately 5 min, with tissue temperature above 50 degrees C throughout the treatment volume. We then performed an experimental study in polyacrylamide gel in order to validate the theoretical results. The average temperature error between the simulation and the experiment was 3.8% at the center of the electrode array. This study shows that the proposed device potentially allows more rapid treatment of large tumors than current radiofrequency ablation devices.

[Cryptococcus neoformans isolated from patients with AIDS]. / Cryptococcus neoformans isolados de pacientes com AIDS.

Cryptococcosis is considered the most frequent fungal systemic opportunist infection in patients with AIDS. C. neoformans var. neoformans infects the patients with AIDS more often than C. neoformans var. gattii which has been rarely isolated from patients with AIDS. Even in endemic regions of C. neoformans var. gattii, the variety of neoformans is still the most common agent diagnosed in cryptococcosis of patients with AIDS. Cerebrospinal fluid (CSF) from fifty patients with neurocryptococcosis associated with AIDS were studied. The fungi were isolated in agar Sabouraud medium, and were identified by microscopic and macroscopic examination by agar Sabouraud, agar niger and Christensen's urea medium. The variety was determined based on a color characteristic reaction on glycine-L-canavanina-bromothymol blue agar. From all of the fifty patients' cerebrospinal fluid (CSF) we were able to recover C. neoformans. The isolates were identified as C. neoformans var. neoformans in 47 patients and as C. neoformans var. gattii. in the 3 remaining patients. These findings suggest that both varieties, gattii and neoformans, are agents of neurocryptococcosis in patients with AIDS.

[The etiology and epidemiology of dermatophytoses in Goiânia, GO, Brazil]. / Etiologia e epidemiologia das dermatofitoses em Goiânia, GO, Brasil.

Dermatophytoses are superficial infections that may lead to lesions of keratinized tissues, like skin, hair and nails. A total of 6068 individuals from Goiânia, GO, with suspected dermatophytic lesions were examined over a period of five years (1993-1997) in order to determine the incidence and etiology of dermatophytosis. Material collected from different body parts was submitted to direct microscopic examination using KOH, cultured in Sabouraud agar and microscopically examined for colony morphology, with the identification of 1595 dermatophytes. Trichophyton rubrum (37.4%), T. mentagrophytes (36.4%) and Microsporum canis (16%) were the species most frequently isolated. Dermatophytes were more frequently found producing lesions in the feet (30.5%), inguinal and crural regions (17.8%) and glabrous body regions (15.5%). The distribution of the different infected body sites was determined in terms of the respective etiologic agents found. Better hygiene conditions and an early diagnosis are the most important tools to control and reduce the incidence of dermatophytosis in Goiânia, GO.

[Killer toxin and enzyme production by Candida albicans isolated from buccal mucosa in patients with cancer]. / Toxinas killer e produção de enzimas por Candida albicans isoladas da mucosa bucal de pacientes com câncer.

Opportunistic infections of the oral cavity are primarily caused by Candida and frequently occur in patients with cancer who are undergoing chemotherapy and antibiotic treatment. Of the specimens received from the oral mucosa of 44 patients with cancer, 25 (56.8%) yielded Candida on culture in Sabouraud agar. Twenty four of these isolates were identified as C. albicans (96%) and 1 as C. krusei (4%). The phenotypic characteristics of these isolates showed that all of them were strongly proteolytic, had a high ability to produce phospholipase, and presented the byotypes characterized as 811 (95.8%) and 511 (4.2%) in terms of susceptibility to killer toxins.

Toxinas killer e produção de enzimas por Candida albicans isoladas da mucosa bucal de pacientes com câncer / Killer toxin and enzyme production by Candida albicans isolated from buccal mucosa in patients with cancer

Opportunistic infections of the oral cavity are primarily caused by Candida and frequently occur in patients with cancer who are undergoing chemotherapy and antibiotic treatment. Of the specimens received from the oral mucosa of 44 patients with cancer, 25 (56.8%) yielded Candida on culture in Sabouraud agar. Twenty four of these isolates were identified as C. albicans (96%) and 1 as C. krusei (4%). The phenotypic characteristics of these isolates showed that all of them were strongly proteolytic, had a high ability to produce phospholipase, and presented the byotypes characterized as 811 (95.8%) and 511 (4.2%) in terms of susceptibility to killer toxins.

Infecções oportunistas da cavidade bucal são primariamente causadas por fungos do gênero Candida e freqüentemente ocorrem em pacientes com câncer que estão sobtratamento quimioterápico e antibacteriano. De 44 amostras coletadas da mucosa oral de pacientes com câncer, observou-se o isolamento de 25 leveduras do gênero Candida em cultivo realizado em ágar Sabouraud-dextrose. Foram identificados Candida albicans em 24 (96%) isolados e C. krusei em 1 (4%). As características fenotípicas das amostras de Candida albicans mostraram que todos os isolados foram fortemente proteolíticos, capazes de produzir fosfolipases e possuíam os biotipos caracterizados como 811(95,8%) e 511 (4,2%) em relação a susceptibilidade às toxinas killer.

A new approach to artificial neural networks.

A novel approach to artificial neural networks is presented. The philosophy of this approach is based on two aspects: the design of task-specific networks, and a new neuron model with multiple synapses. The synapses' connective strengths are modified through selective and cumulative processes conducted by axo-axonic connections from a feedforward circuit. This new concept was applied to the position control of a planar two-link manipulator exhibiting excellent results on learning capability and generalization when compared with a conventional feedforward network. In the present paper, the example shows only a network developed from a neuronal reflexive circuit with some useful artifices, nevertheless without the intention of covering all possibilities devised.