A Reliable Stem Cell Carrier: An Experimental Study in Wistar Rats.

INTRODUCTION: Treatments based on cell biology need reliable and precise carriers for reaching the desired targets. For that reason, a PDO-based cell carrier was idealized, with the purpose of carrying stem cells to distant sites at room temperature. MATERIALS AND METHODS: Three modalities of the same carrier were evaluated: one containing undifferentiated human dental pulp stem cells (DPSCs); one loaded with stem cells induced to neurogenic differentiation (DPSCNs); and one without cells (Blank). The carriers were implanted in sciatic nerve gaps in 48 Wistar rats that were divided in three groups. Two other rats were included in a SHAM control group. Immunohistochemical, histological and clinical analyses were performed in two, four, six and eight weeks of time. RESULTS: Efficacy of human stem cell transportation at room temperature to rats was attested. Moreover, it was possible to confirm that those cells show tropism for inflamed environments and are also prone to induction of neurogenesis in the first two weeks, vanishing after that period. CONCLUSION: Clinical evaluation of the animals' gait recovery shows a promising perspective of success with the inclusion of stem cell-loaded PDO tubes in nerve gaps, which may be positively compared to previously published studies. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors - www.springer.com/00266.

Durability of Three Different Types of Hyaluronic Acid Fillers in Skin: Are There Differences Among Biphasic, Monophasic Monodensified, and Monophasic Polydensified Products?

Background: Hyaluronic acid fillers are used for facial rejuvenation and are classified as non-cross-linked or cross-linked (monophasic mono- or polydensified). Objectives: To histologically assess the intradermal durability of three types of fillers (biphasic, monophasic monodensified, and monophasic polydensified), to compare the durability of the products over 6 months, and to evaluate the structural changes after application. Methods: In all, 25 volunteers received injections of three different fillers in the dermis of the right lumbar region (in one line), and equal amounts of the fillers were injected into three different sites (in the same column), yielding nine points of application in each patient. Each line was biopsied on days 2, 92, and 184; these skin samples were analyzed histologically, and the presence or absence of these fillers was verified by a dermatopathologist. Results: The histological analysis showed that over 182 days, the amount of the injected monophasic polydensified, monophasic monodensified, and biphasic filler products decreased by 62.5%, 25%, and 12.5%, respectively. Conclusions: The biphasic and monophasic monodensified fillers presented greater intradermal durability than did the monophasic polydensified filler at 6 months after intradermal injection.

Panoramic radiography and its role in the diagnosis of systemic disorders.

This article presents a case report in which a systemic disease was first suspected by viewing a panoramic radiograph. A 49-year-old man sought prosthetic rehabilitation with implants. Panoramic radiography revealed an osteolysis of poorly defined limits in the apical region of teeth No. 26 to 28. The patient's medical history included the recent removal of a giant cell lesion from the left tibia. During palpation of the neck, a fixed nodule was detected on the superior portion of the left thyroid gland. Biochemical tests showed elevated levels of serum alkaline osphatase, serum calcium, and parathyroid hormone. As the serum phosphate was low, the final diagnosis was primary hyperparathyroidism. A CT scan showed a hypodense lesion involving teeth No. 26 to 28, with preserved cortical bone. A whole-body bone scintigraphy showed lesions in the mandible and other long bones. A high radiopharmaceutical capitation was present in the left parathyroid gland. The patient was referred to a head and neck surgeon, who removed the left thyroid lobule and the parathyroid gland. The microscopic diagnosis was parathyroid carcinoma. After eight months of follow-up, the mandibular lesion disappeared.

Cisto nasolabial bilateral como causa de obstrução nasal: relato de caso e revisão de literatura / Nasolabial bilateral cyst as cause of the nasal obstruction: case report and literature review

INTRODUÇÃO: O cisto nasolabial é uma doença rara, normalmente unilateral, benigna, de origem embrionária, localizada em partes moles da região do sulco nasolabial e asa nasal. O diagnóstico é essencialmente clínico, levando em consideração a topografia do cisto, que geralmente é assintomático. OBJETIVO: Este artigo tem como objetivo principal à descrição de um caso incomum de cisto nasolabial bilateral com obstrução nasal, seu tratamento, aspectos anatomopatológicos e acompanhamento, além de revisão de literatura. RELATO DO CASO: Paciente do sexo feminino, parda, 24 anos de idade, apresentando abaulamento em região nasolabial e obstrução nasal. Exames físico e complementares compatíveis com cisto nasolabial. Indicado tratamento cirúrgico para exérese da lesão. CONSIDERAÇÕES FINAIS: O cisto nasolabial bilateral, apesar de raro, é uma possível causa de obstrução nasal, com boa resposta à terapia cirúrgica.

INTRODUCTION: The nasolabial cyst is a rare disease, usually unilateral, benign, of embryonic origin, located in soft parts from the nasolabial folds and nasal wings. The diagnosis is essentially clinic, take into consideration the cyst topography, that is usually asymptomatic. OBJECTIVE: This article has as main goal the description of a unusual case of nasolabial bilateral cyst with nasal obstruction, its treatment, anatomic pathological and accompaniment, besides the literature review. CASE REPORT: Female patient, brown, 24 years old, showing bulging in nasolabial region and nasal obstruction. Physical and complementary exams with nasolabial cyst. Indicate surgical treatment of excision of the lesion. FINAL CONSIDERATIONS: The nasolabial bilateral cyst, although is rare, is a possible cause for the nasal obstruction, with good response to surgical therapy.

Carcinoma papilífero da tireóide: estudo comparativo entre os casos usuais e aqueles associados à tireoidite autoimune / Papillary carcinoma of the thyroid: a comparison of typical cases with those associated autoimmune thyroiditis

Os nódulos de tireóide são frequentes no mundo todo, principalmente entre as mulheres. A preocupação maior no seu estudo é afastar a presença de neoplasia maligna, que corresponde a aproximadamente 10% de todos os casos. Alguns procedimentos médicos têm sido usados para se chegar ao diagnóstico pré-operatório dos nódulos tireoideanos, dentre os quais a cintilografia, a ultrassonografia e, mais recentemente, a punção aspirativa com agulha fina... Na tentativa de colaborar para o esclarecimento desse tema, estudamos 102 amostras de tireóide arquivadas no banco de tumores do Hospital AC Camargo, formando com elas dois grupos de pacientes, um com carcinoma e tireoidite (70 pacientes) e outro, somente com carcinoma (32 pacientes). Tendo em vista a importância da caracterização objetiva do fenômeno inflamatório, subclassificamos, por parâmetros histológicos, a tireoidite em leve, moderada e intensa. Foi realizado estudo imunoistoquímico para avaliação de 16 proteínas relacionadas à presença de células indiferenciadas (p63), à via das MAPKs (Ras, AKT-1e ERK1/2), às moléculas de adesão (E-caderina e CD44), à ativação da via de sinalização Wnt (beta-catenina), à via do receptor de morte (Fas-L e caspase 8), às moléculas ligadas à indução de interleucinas (iNOS e COX-2), aos fatores de crescimento e diferenciação celulares (galectina 3 e VEGF) e aos índices de proliferação celular e apoptose (Ki-67, caspase 3 clivada e Fas). Além disso, fizemos a pesquisa da mutação V600E do gene BRAF por pirossequenciamento e a pesquisa dos rearranjos cromossômicos RET/PTC1 e RET/PTC3 por RT-PCR. Os resultados evidenciaram diferenças estatisticamente significativas na expressão de Ras, ERK1/2, CD44, COX-2 e Fas entre os grupos com e sem tireoidite. Essas diferenças também validaram a subclassificação histológica para a intensidade da tireoidite, ao demonstrar que quanto mais intensa ela se apresentou, maior foi a expressão imunoistoquímica dessas proteínas.

Thyroid nodules are common throughout the world, mainly in women. The principal focus of their study is to exclude the possibility of a malignant neoplasm, which is found in approximately 10% of all cases. Various medical procedures, such as scintillography, ultrasonography, and, more recently, fine needle aspiration biopsy are used pre-operatively to diagnose thyroid nodules. However, the definitive diagnosis is still the pathologic diagnosis, often preceded by examination of multiple frozen sections. One of the limiting factors of this method is the presence of autoimmune thyroiditis, as the morphological tissue alterations associated with this inflammation cause problems in the macroscopic and microscopic evaluation of the tissue. Not only during the frozen section analysis, but also during the definitive evaluation, the association between thyroiditis and papillary carcinoma is a challenge, as there is still no consensus about the nature of this association. In an attempt to help clarify this situation, we studied samples of thyroid tissue from 102 patients, collected from the archives of the Tumor Bank of the AC Camargo Hospital, divided into two groups; the first group consisted of 70 patients with both carcinoma and thyroiditis, while the second group of 32 patients had only carcinoma. Due to the importance of an objective characterization of the inflammatory process, specifically in this research, histological parameters were used to sub classify the thyroiditis as mild, moderate or severe. We used immunihistochemical methods to study 16 proteins related to: the presence of undifferentiated cells (p63); the MAPK pathway (Ras, AKT-1 and ERK1/2); adhesion molecules (E-caderin and CD44); the Wnt signal activation pathway (beta-catenin); the death receptor pathway (Fas-L and caspase 8); molecules associated with induction of interleukins (iNOS and COX-2); factors of growth and cellular differentiation (Galactin 3 and VEGF); and indices of cellular proliferation and apoptosis (Ki67, activated caspase 3 and Fas). As well, we used pyrosequencing to study the V600E mutation of the BRAF gene, and RT-PCR to evaluate rearrangements of chromosomes RET/PTC1 and RET/PTC3. Our results showed statistically significant differences between the groups with and without thyroiditis in the expression of Ras, ERK 1/2, CD44, COX-2 and Fas. These results also validated the histological sub classification used to grade the intensity of the thyroiditis; the more intense the thyroiditis, the greater was the immunihistochemical expression of these proteins.