Survival after minimally invasive vs. open radical nephrectomy for stage I and II renal cell carcinoma

International Journal of Clinical Oncology - A recently reported phase III randomized trial comparing open and minimally invasive hysterectomy showed significantly higher rates of local recurrence...     

Clinical, genetic, and biochemical findings in two siblings with Papillon-Lefèvre Syndrome

BACKGROUND: Papillon-Lefèvre Syndrome (PLS) is an autosomal recessive disease characterized by palmoplantar hyperkeratosis and severe periodontitis affecting both primary and secondary dentitions. Cathepsin C (CTSC) gene mutations are etiologic for PLS. The resultant loss of CTSC function is responsible for the severe periodontal destruction seen clinically. METHODS: A 4-year-old female (case 1) and her 10-year-old sister (case 2) presented with palmoplantar skin lesions, tooth mobility, and advanced periodontitis. Based on clinical findings, the cases were diagnosed with PLS. Mutational screening of the CTSC gene was conducted for the cases, and their clinically unaffected parents and brother. Biochemical analysis was performed for CTSC, cathepsin G (CTSG), and elastase activity in neutrophils for all members of the nuclear family. The initial treatment included oral hygiene instruction, scaling and root planing, and systemic amoxicillin-metronidazole therapy. RESULTS: CTSC mutational screening identified a c.415G>A transition mutation. In the homozygous state, this mutation was associated with an almost complete loss of activity of CTSC, CTSG, and elastase. Although monthly visits, including scaling, polishing, and 0.2% chlorhexidine digluconate irrigation were performed to stabilize the periodontal condition, case 1 lost all her primary teeth. In case 2, some of the permanent teeth could be maintained. CONCLUSIONS: This report describes two siblings with a cathepsin C gene mutation that is associated with the inactivity of cathepsin C and several neutrophil serine proteases. The failure of patients to respond to periodontal treatment is discussed in the context of these biological findings.     

Influence of different periodontal curette grips on the outcome of mechanical non-surgical therapy

AIM: To determine to whether successful scaling and root planing (SRP) depends upon the grip used on the periodontal curette. METHODS: The hand grips used by dentists for holding periodontal curettes were examined and the dentists were allocated to one of two matched groups, one in which they used a modified pen grip, the other in which they did not. Using a split-mouth technique, patients scheduled for SRP had one quadrant treated by a dentist from each group. Instrument application force was recorded as were periodontal measures at operation and 3-months later. RESULTS: During scaling, forces reached a mean of 0.77N in dentists using a curette with a non-pen grip and 0.54N in those using a pen grip and during root planing, 0.93N and 0.64N respectively. These forces were statistically significantly different between the two groups. Pocket depth reduction in teeth treated by the two groups was similar but attachment levels were statistically significantly different. CONCLUSIONS: Instrument grip had a significant effect on response to SRP, suggesting that dentists using a modified pen grip achieved better clinical results.     

Flow-cytometric analysis of T-lymphocyte subsets after different treatment methods in smokers and non-smokers with chronic periodontitis

Aim : To determine any change in T‐lymphocyte subsets after applying different treatment methods in smokers and non‐smokers with chronic periodontitis. Participants : 50 adults with chronic periodontitis. Method : The subjects were divided into smokers and non‐smokers. Biopsy samples were taken from the gingival pocket wall tissues at sites with chronic periodontitis before treatment, after initial treatment, after curettage and after flap operation and tested for CD4⁺, CD8⁺ lymphocyte and CD4/CD8 ratio values. Gingival pocket depth, gingival index (Gl‐Löe‐Silness) and plaque index (Pl‐Silness‐Löe) scores were also recorded. Analysis aimed at determining the relation between the clinical measurements and the laboratory results. Results : Flow cytometry findings in both groups showed that CD4⁺ and CD8⁺ lymphocyte values before treatment were under the normal value while the CD4⁺/CD8⁺ ratio was within normal distribution interval. The lymphocyte values observed in the smokers were found to be lower than those in the non‐smokers. After treatment the difference between the lymphocyte values in smokers and non‐smokers was found to be statistically significant. However, the difference between the CD4/CD8 rate obtained in smokers and non‐smokers was not found to be statistically significant. Conclusions : The lymphocyte values observed in smokers were found to be lower than those in non‐smokers after applying different treatment methods and the local immune response was poor in the smokers.