[Cone-beam CT analysis of the correlation between incisor root resorption rate and tooth movement index in adult patients with fixed orthodontics appliance].

Objective: To analyze the correlation between the root resorption rate and tooth movement of the maxillary and mandibular incisors before and after orthodontic treatment in adult patients using cone-beam CT (CBCT), and to explore the related factors that affect the apical root resorption. Methods: In this retrospective study, 23 adult patients with classⅠor class Ⅱ division 1 malocclusion [2 males and 21 females, mean age (23.4±6.3) years, treatment time (2.1±0.7) years] who received orthodontic treatment with fixed appliance in Department of Oral & Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital from January 2017 to June 2021 were enrolled. Full-column CBCT examination was performed before and after treatment. A three-dimensional model was established to observe and record the volume of the maxillary and mandibular central and lateral incisors before and after treatment. The change of the incisal edge, the angle of rotation of the incisal edge, and the direction of the long axis of the tooth were also measured. The root resorption in each tooth before and after treatment was compared, and the root resorption rate was calculated. Pearson correlation analysis was performed on the root absorption rate before and after treatment with age, treatment time and tooth movement. Results: After treatment, the tooth volume of the maxillary and mandibular central and lateral incisors decreased significantly (P<0.01). The root absorption volumes were (20.2±6.0) mm3 and (11.2±4.7) mm3 in maxillary central and lateral incisors, and (14.7±4.6) mm3 and (14.8±5.0) mm3 in mandibular central and lateral incisors, respectively. The root absorption rates were (9.49±1.75)% and (9.13±3.24)% in maxillary central and lateral incisors, and (8.56±3.43)% and (9.13±3.24)%, in mandibular central and lateral incisors, respectively (F=0.56, P=0.640). The root resorption rate of maxillary central incisors had a weak positive correlation with the change of sagittal distance of incisal edge (r=0.36, P=0.015). The root resorption rate of mandibular central incisors had a moderate positive correlation with the vertical movement distance (r=0.48, P=0.001). The root resorption rate of mandibular lateral incisors was weakly positively correlated with the vertical movement of incisal edge and the treatment time (r=0.35, P=0.016; r=0.34, P=0.021), and was moderately positively correlated wit the change of sagittal movement of incisal edge (r=0.44, P=0.002). Conclusions: During orthodontic treatment, both maxillary and mandibular incisors had a certain degree of root resorption, which was related to sagittal and vertical movement of the incisors and the time of orthodontic treatment.

Effect of body positioning during transcranial Doppler detection of right-to-left shunts.

We adopted an expanded transcranial Doppler (TCD) protocol to evaluate if additional injections of agitated saline in different positions would improve shunt detection or grading. We report the safety and feasibility of this expanded contrast TCD protocol. Patients with ischemic stroke were evaluated. The standard protocol for RLS detection was followed and expanded after the initial injection in the supine position to the right lateral decubitus, upright sitting, and sitting with right lateral leaning. Changes in blood pressure, heart rate, and any subjective complaints were noted. Changes in body position and additional agitated saline injections were tolerated. Right-to-left shunt (RLS) was detected in 35% of patients (n = 55). If the initial supine testing was negative, all subsequent positions/injections were also negative for RLS. However, if the supine injection was positive for RLS, the change in body positions increased the microbubble (microB) count in eight of 19 (42%) RLS-positive patients. The mean microB count in RLS-positive patients was 20 (95% CI: 9-32). The use of three additional body positions increased the microB count to 73 (95% CI: 13-132). The highest microB yield was achieved in the upright sitting position. Our findings support the safety and feasibility of the expanded TCD protocol. If the initial supine Valsalva-aided contrast TCD test is negative, there may be no need to study the patient in additional positions. However, if microB are detected in the supine position, additional testing for RLS in alternative positions may be found to be worthwhile.

Thrombotic occlusion of the common carotid artery (CCA) in acute ischemic stroke treated with intravenous tissue plasminogen activator (TPA).

Although common carotid artery (CCA) occlusions are rare, acute clinical presentations vary from mild to devastating strokes primarily due to tandem occlusions in the intracranial arteries. Three patients with acute CCA occlusions were treated with systemic tissue plasminogen activator (TPA). Blood pressures were kept at the upper limits allowed with TPA therapy with fluid balance and the 'head-down' position. Recanalization occurred in intracranial vessels only. Marked early neurological improvement occurred in two of three patients. CCA occlusions should not be considered contra-indication to systemic thrombolysis.

Caffeic acid is a selective inhibitor for leukotriene biosynthesis.

.eukotrienes are significantly involved in immunoregulation and in a variety of diseases, including asthma, inflammation and various allergic conditions. They are initially biosynthesized by 5-lipoxygenase from arachidonic acid, which can also be metabolized to prostaglandin endoperoxide by cyclooxygenase. The specific inhibitors for 5-lipoxygenase would be useful not only as tools for investigating the regulation mechanism of leukotriene biosynthesis, but also as drugs for clinical use. Although recently a few selective inhibitors have been reported, most of them are difficult to obtain, since they are new compounds. We found that caffeic acid, which is one of the most common reagents, is a selective inhibitor for 5-lipoxygenase and therefore for leukotriene biosynthesis. The inhibitory effect of its methyl ester on 5-lipoxygenase (ID50 = 4.8 X 10(-7) M) was stronger than that of caffeic acid itself (ID50 = 3.7 X 10(-6) M). Caffeic acid inhibited 5-lipoxygenase in a non-competitive manner. Caffeic acid and its methyl ester did not inhibit prostaglandin synthase activity at all, at least up to 5 X 10(-4) M, but rather stimulate at higher doses. The biosynthesis of leukotriene C4 and D4 in mouse mast tumor cells was also inhibited completely with 10(-4) caffeic acid. Besides, caffeic acid had little effect on arachidonic acid metabolism in platelet at less than 1 X 10(-5) M, but at higher doses it showed a definite inhibitory effect, i.e., thromboxane B2, HHT (12(S)-hydroxy-5,8,10-heptadecatetraenoic acid) and 12-HETE (12(S)-hydroxy-5,8,10,14-eicosatetraenoic acid) syntheses were inhibited 33, 40 and 80% at 1 X 10(-4) M, respectively. Platelet aggregation induced by arachidonic acid was also inhibited by caffeic acid at high dose, while platelet aggregation induced by ADP is not influenced by caffeic acid at all. The observations on caffeic acid and its derivatives may contribute to leukotriene research.

Selective inhibition of 5-lipoxygenase by natural compounds isolated from Chinese plants, Artemisia rubripes Nakai.

Three of four natural compounds, which are caffeic acid, eupatilin and 4'-demethyleupatilin, isolated from Chinese plant, Artemisia rubripes Nakai selectively inhibited 5-lipoxygenase of cultured mastocytoma cells. Half-inhibition doses (ID50) for caffeic acid, eupatilin and 4'-demethyleupatilin were 3.7, 14 and 18 X 10(-6) M, respectively. The inhibition by caffeic acid was non-competitive types. Prostaglandin synthase activities were little inhibited by eupatilin and 4'-demethyleupatilin, but rather stimulated by caffeic acid. The formation of leukotriene C4 and D4 by mast tumor cells was almost completely suppressed by these compounds at 10(-4) M.

Myocardial infarction. Changes in the concentrations of high-energy compounds and free amino acids in erythrocytes.

Quantitative determination of the nucleotides AMP, ADP, ATP, GTP, NAD, NADP, 2,3-DPG and the free amino acids Lys, His, Gly, Ala, Val, Met, Phe, Tyr, Pro, Thr, Ser, Glu, Asp in erythrocytes was carried out in early and late stages of myocardial infarction. It was found that in erythrocytes, in the early stage of myocardial infarction, the concentrations of AMP, NADP and 2,3-DPG increased, whereas those of ADP, ATP, GTP and NAD decreased. In the third week of the disease the concentrations of AMP, ADP, NADP, and especially 2,3-DPG remained high, while those of ATP and GTP shifted towards the control. The concentrations of His, Gly, Ala, Val, Met, Phe, Thr and Glu increased, while those of Tyr, Ser and Asp decreased in the first stage of myocardial infarction. At the later stage of the illness (21 days) the concentrations of free amino acids returned to normal.

Effects of acute administration of transdermal estrogen on postmenopausal women with systemic hypertension.

We studied 16 postmenopausal women with mild to moderate hypertension according to a randomized, double-blind protocol. They received patches of transdermal estradiol-17beta rated to deliver 100 mg/day of substance or matched placebo. A 24-hour ambulatory blood pressure (BP) monitoring was performed at baseline and after drug administrations. Our data show that estradiol-17beta exerts beneficial effects, both in lowering elevated BP levels and in maintaining a uniform BP control over 24 hours. Estrogen replacement therapy could be considered when significant changes in BP occur during the postmenopausal period.

Estradiol-17beta reduces blood pressure and restores the normal amplitude of the circadian blood pressure rhythm in postmenopausal hypertension.

After menopause, both systolic (SBP) and diastolic (DBP) blood pressure (BP) become higher in women than in men of the same age, suggesting that estrogen deficiency may influence the age-related increase in BP. We studied 30 postmenopausal women (mean age, 55 +/- 5.7 years; time from menopause, 2-5 years) affected by mild hypertension with no target-organ complications by means of 24-h BP monitoring. None of the group were undergoing estrogen replacement therapy or taking antihypertensive drugs. According to a randomized, double-blind protocol, subjects received patches of transdermal estradiol-17beta (E2) or a matched placebo, with crossover after a 7-day washout period. In 12 patients the 24-h peak-to-trough variation in SBP and DBP amounted to less than 10% (nondippers). Administration of E2 significantly decreased 24-h SBP and DBP in the whole cohort (P < .05). Furthermore, E2 restored the expected reduction in BP during nighttime in the nondipper subgroup. It is well known that estrogen replacement therapy protects against the development of both cardiovascular diseases and stroke. Our data suggest that this activity could be attributed, at least in part, to the activity of E2 in preserving physiologic circadian fluctuation of BP.

Four new steroidal saponins from the seeds of Allium tuberosum.

Four new steroidal saponins, 26-O-beta-D-glucopyranosyl-(25S,20R)-20-O-methyl-5alpha-furost-22(23)-en-2alpha,3beta,20,26-tetraol 3-O-alpha-L-rhamnopyranosyl-(1-->2)-[alpha-L-rhamnopyranosyl-(1-->4)]-beta-D-glucopyranoside (1); 26-O-beta-D-glucopyranosyl-(25S,20R)-5alpha-furost-22(23)-en-2alpha,3beta,20,26-tetraol 3-O-alpha-L-rhamnopyranosyl-(1-->2)-[alpha-L- rhamnopyranosyl-(1-->4)]-beta-D-glucopyranoside (2); 26-O-beta-D-glucopyranosyl-(25S,20S)-5alpha-furost-22(23)-en-2alpha,3beta,20,26-tetraol 3-O-alpha-L-rhamnopyranosyl-(1-->2)-[alpha-L- rhamnopyranosyl-(1-->4)]-beta-D-glucopyranoside (3); and 26-O-beta-D-glucopyranosyl-(25S,20S)-5alpha-furost-22(23)-en-3beta,20,26-triol 3-O-alpha-L-rhamnopyranosyl-(1-->2)-[alpha-L-rhamnopyranosyl-(1-->4)]-beta-D-glucopyranoside (4), have been isolated from the seeds of Allium tuberosum. Their structures were established by spectroscopic studies such as MS, IR, NMR, and 2D-NMR and the results of acid hydrolysis and named tuberosides F, G, H, and I, respectively.

New spirostanol saponins from Chinese chives (Allium tuberosum).

Three new spirostanol saponins have been isolated from the seeds of Allium tuberosum. On the basis of acid hydrolysis and comprehensive spectroscopic analysis, their structures were established as tuberoside J, (25R)-5alpha-spirostan-2alpha,3beta,27-triol 3-O-alpha-L-rhamnopyranosyl-(1-->2)-beta-D-glucopyranoside; tuberoside K, (25R)-5alpha-spirostan-2alpha,3beta,27-triol 3-O-alpha-L-rhamnopyranosyl-(1-->2)-[alpha-L-rhamnopyranosyl-(1-->4)]-beta-D-glucopyranoside; and tuberoside L, 27-O-beta-D-glucopyranosyl-(25R)-5alpha-spirostan-2alpha,3beta,27-triol 3-O-alpha-D-rhamnopyranosyl-(1-->2)-[alpha-L-rhamnopyranosyl-(1-->4)]-beta-D-glucopyranoside.

Mercury vapor as a contaminant of hospital environment.

Surveys for airborne mercury in two Ottawa hospitals have been conducted. Two different analytical methods were used. Although the concentrations of mercury vapor were below the TLV, all samples analyzed showed measureable amounts of mercury to be present. Predominant sources of mercury contamination are broken thermometers and sphygmomanometers.

[Studies on chemical constituents of Fritillaria thunbergii Miq].

A new C-nor-D-homosteroidal alkaloid was isolated from the bulbs of Fritillaria thunbergii Miq. with peimine (I) and peiminine (II), named zhebeinine (III), C27H45O3N, mp. 240-242 degrees C. On the basis of the IR, 1HNMR, 13CNMR and MS of zhebeinine (III), the structure of zhebeinine (III) has been established as 5 alpha, 14 alpha-cevanine-3 beta, 6 alpha, 20 beta-triol.

[Studies on the chemical constituents of Fritillaria thunbergii Miq. III. Isolation and identification of zhebeinone].

A new C- nor D-homo steroidal alkaloid named zhebeinone was isolated from the bulbs of Fritillaria thunbergii Miq. Its structure was determined by spectral analyses and chemical conversion as 5 alpha, 14 alpha-cevanine-3 beta, 20 beta-dihydroxy-6-one or C-27 epimer of peiminine.

[Bladder carcinosarcoma with osteosarcomatous differentiation]. / Carcinosarcoma vesical con diferenciación osteosarcomatosa.

Osteoid tissue can eventually be identified outside the bone skeleton adopting the form of metastasis, osteoid metaplasia or primitive osteosarcoma. This latter presentation is most frequently located in soft tissues and exceptionally at the visceral level. The term used for any of these forms is extra-bone osteogenic sarcoma. This paper reports the case of a 62 year-old female patient diagnosed with vesical urothelial carcinosarcoma treated with external radiotherapy. After a disease-free period of 20 years the patient developed osteosarcomatous-differentiated vesical carcinosarcoma. A literature review is made to analyze, from a clinical and histopathological perspective, several items of interest presented by this pathology. The role of sarcomatous radio-induction is also highlighted. Finally, we emphasize the relevance of using radical treatments from the start, so as to restrain the highly malignant potential of this condition.

[Metastasis of prostatic origin in periorbital soft tissues]. / Metástasis de origen prostático en tejidos blandos periorbitarios.

Appearance of orbital metastatic (OM) neoplasia is the most frequent cause of eye tumour; however, its incidence related to prostatic carcinoma (PC) is rare, primarily when there is sole infiltration of the periorbital soft tissue (STOM). The paper describes the case of a patient diagnosed with PC presenting proptosis and diplodia as first spread symptoms. The rarity of STOM of the prostatic carcinoma prompted the diagnosis to be seen sceptically until immunohistochemical confirmation was obtained. An analysis is made of various features of interest regarding the grading of OM, clinical incidence and diagnostic methods. The singularity of the present case, affecting only the periocular soft tissues is illustrated. Finally, the situations requiring orbital biopsy in order to avoid a second neoplasia are analyzed.

[Giant liposarcoma of the spermatic cord]. / Liposarcoma gigante del cordón espermático.

Liposarcomas (LS) are malignant mesenchymal tumours which develop in fatty tissues. They are basically found at the retroperitoneum where they are relatively frequent in adults. The most common type is myxoid LS which, although less malignant, has like any other LS a high incidence of local relapses. Primary myxoid liposarcoma of the spermatic cord is an unusual, low-aggressiveness tumour. Under natural development, it can reach large dimensions with only local symptomatology. Pre-operative diagnosis of the paratesticular tumour is often difficult to establish, cuenca the teste suénate be differentiated from the tumoral mass by physical examination. A diagnostic approach of paratesticular tumours, scarcely reported in the literature, can be made by means of a vascular study with radionuclides. The choice therapy is surgical, through orchiectomy and extensive local removal. Considering the frequency of local relapse of myxoid liposarcoma, long-term follow-up is recommended. This paper reports the unusual presentation of one case of primary myxoid LS of the spermatic cord with an intrascrotal mass of 38 x 24 cm weighing 4,950 gr which is exceptional not only because of the site's infrequency but also for its size.

[Renal hydatid cyst: a nuclear magnetic resonance study]. / Quiste hidatídico renal: estudio con resonancia magnética nuclear.

A case of renal hydatid cyst (R.H.C.) in which study both traditional diagnostic methods (such as serology, radiology, ecoraphia, C.A.T., etc.) and the newer ones, including Nuclear Magnetic Resonance (N.M.R.) were used, is presented. The diagnostic characteristics of this type of cystic pathology were reviewed through N.M.R. study, as well as current criteria to outline a correct differential diagnosis with simple Renal Cysts (R.C.). Finally, a theoretical place for each of these methods within the diagnostic algorithm of renal masses is suggested.

[Experimental study of the expression of the bladder wall proteins in bladder outlet obstruction in the rabbit]. / Estudio experimental de la expresión de las proteínas de la pared vesical en la obstrucción del tracto urinario inferior en el conejo.

OBJECTIVES: To determine the relationship of the bladder wall levels of the contractile proteins: whole actin, beta-actin, alpha-sarcomeric-actina caldesmon and of the Heat Stress Protein HSP-70, with the partial bladder outlet obstruction. MATERIAL AND METHODS: It was carried out an experimental study on 43 New-Zealand rabbits. These animals were divided into a control group and six experimental groups with partial bladder outlet obstruction induced by an incomplete tie around the urethra. The experimental groups were defined according the day when the animals were sacrified: at 24 hours, 7 days, 15 days, 1 month, 3 months and 6 months of the obstruction. It was determined in all animals the muscular bladder wall concentration of whole actin, beta-actin, alpha-sarcomeric-actin, caldesmon and HSP-70 protein, according to Western Blotting technique. The results were analyzed by means of ANOVA, using the Scheffe post hoc method. RESULTS: The bladder weight of the obstructed animals increased significantly in two stages: until the day 15 and between the day 15 and the end of the study, corresponding to theoretical phases of initial hypertrophy and compensation. The level of whole actin showed a significant decrease at the beginning of compensation phase, while the beta-actin level increased in the phase of initial hypertrophy and the alpha-sarcomeric-actin level increased at the end of the compensation phase, while the caldesmon and the HSP-70 made it at the end of the initial hypertrophy phase. CONCLUSIONS: Analysing our data we conclued that the determination of the caldesmon levels is the marker that better adjusts to the changes associated with partial bladder outlet obstruction in the rabbit.

[Retrovesical hemangiopericytoma]. / Hemangiopericitoma retrovesical.

The hemangiopericytoma is an uncommon variety of the mesenchymal tumour derived from pericapillary structures, most frequently located in limbs and exceptionally at the retroperitoneum level. Although macroscopically the aspect is benign, this tumour has a recognised ability for local invasion and distant dissemination.

[Clinical experience with the treatment of metastatic renal cell carcinoma with subcutaneous interleukin-2r (IL-2r) and interferon Alpha-2b (IFN Alfa-2b)]. / Experiencia clínica en el tratamiento del carcinoma de células renales metastático con interleucina-2r (IL-2r) e interferón alfa 2b (IFN alfa 2b) por vía subcutánea.

This work presents our recent clinic experience in the treatment of advanced RCC with IL-2 in association to alpha IFN given subcutaneously. Fifteen patient with histologically confirmed advanced RCC and measurable lesions were entered in the study. Patients were treated in cycles of 7 weeks at a IL-2 dose of 4.8 million IU/m2 (induction phase)-2.4 million IU/m2 (maintenance phase) every 12h five days a week and alpha IFN: 6 million IU/m2 every 24h three days a week, and were afterwards evaluated for response. Responders with localized residual bulk underwent rescue surgery. Seven patient has objective response (3 complete, 2 partial and 2 stable responses). The complete responses were stable and lasted 36 m, 14 m and 8 m, and global survival was of 14.6 m (3-36 m). All patients had toxicity at various degrees but WHO grade II was not exceeded at any time. The association of IL-2 and alpha IFN 2b given subcutaneously, appears to have antitumoral activity against advanced RCC with durable responses and in a proportion similar to other associations in intravenous administration, but with lower systemic toxicity. Surgical resection of residual bulk can be beneficial in selected patient with partial response.