Novel noninvasive detection method for endometriosis: research and development of scintigraphic survey on endometrial implants in rats

In this experimental study on endometriosis, the majority of the implants were successfully detected with technetium-(99mTc) labeled red blood cell scintigraphy.     

Four synchronous female genital malignancies: the ovary,cervix, endometrium and fallopian tube

Objective To present a unique case of a 63 year-old woman with coexistent adenocarcinoma of the ovary, endometrium, cervix and fallopian tube. Materials and methods A case report from a tertiary health center. Results A woman presenting with postmenopausal bleeding and abdominal distantion was assessed by endometrial biopsy and explorative surgery. The frozen section of the mass on the right adnex revealed malign mucinous carcinoma of the ovary. As usual, optimal debulking was performed as initial surgical staging procedure of ovarian cancer. The microscopic examination of the right ovary revealed a typical mucinous cystadenocarcinoma. Furthermore, the focal endometrial irregularity at the left uterine cornus turned out to be a well differentiated endometrial carcinoma of the endometrioid type with <1/3 myometrial invasion. The pale infiltrative lesion in the cervix also turned out to be an adenocarcinoma of the endocervical type with deep stromal invasion and areas of diffuse glandular dysplasia and in-situ glandular neoplasia at the periphery. Besides, several sections from the left fallopian tube uncovered diffuse dysplasia in the lining epithelium and a focus of adenocarcinoma with papillary and cribriform pattern. Discussion When compared with patients having metastatic lesions, most synchronous female malignancies are accompanied with early stage and low-grade with a more favorable prognosis. However, there is paucity of data for the exact criterion to distinguish primary tumors from metastatic lesions. In such cases, the validity of immunohistochemical and cloning studies are not clear.     

Consistent intrafamilial transmission of Actinobacillus actinomycetemcomitans despite clonal diversity

BACKGROUND: Actinobacillus actinomycetemcomitans is a major pathogen in aggressive periodontitis. Our objectives were to determine the periodontal status and occurrence of A. actinomycetemcomitans in family members of subjects with A. actinomycetemcomitans-positive aggressive periodontitis (AgP) and to evaluate the probability of its intrafamilial transmission. METHODS: Of the 300 subjects screened, 66 (22%) had AgP and A. actinomycetemcomitans. Eleven (probands) of these 66 subjects with AgP met the strict inclusion criteria for the study. The study population consisted of 55 subjects, including probands and their family members (N = 44). Two family groups were formed according to whether the proband was a child (N = 7) or a parent (N = 4). Subgingival samples from all subjects were cultured for A. actinomycetemcomitans, and its clonal types were determined by combining serotype and genotype data for each isolate. RESULTS: Among 42 dentate family members, 16 (38%) exhibited periodontitis and eight (50%) had AgP. Periodontitis was found in nine of 12 (75%) of the dentate parents and six of 17 (35%) siblings of the child probands. A. actinomycetemcomitans was detected in 16 of 31 (52%) family members, i.e., one parent and at least one sibling in six families. The child probands shared A. actinomycetemcomitans clonal types with their parents in five of six (83%) families and with their siblings in three of six (50%) families. In the four parent-proband families, A. actinomycetemcomitans occurred in two spouses and all nine children. The parent probands shared A. actinomycetemcomitans clonal types with their spouses in both families and with their children in three of four families. In all families, the likelihood of intrafamilial transmission of A. actinomycetemcomitans was statistically significant. Members of most families (eight of 11, 73%) also harbored additional clonal types of A. actinomycetemcomitans. CONCLUSION: Parents and siblings of an individual with A. actinomycetemcomitans-positive AgP may have an increased susceptibility to periodontitis and shared and/or other clonal types of oral A. actinomycetemcomitans.     

Effect of fiber-reinforced composite at the interface on bonding of resin core system to dentin

The aim of this study was to evaluate the effect of fiber-reinforced composite (FRC) at the interface on bonding of resin core systems to bovine dentin using different adhesive systems. To this end, the labial surfaces of 60 bovine incisors were ground to obtain flat dentin surfaces and then divided into two groups according to the adhesive system used: total-etching (Solobond Plus) versus self-etching (Clearfil SE Bond). Resin core systems were bonded to tooth structure either without or with a FRC layer (everStick Net, StickTech). For groups with FRC layer, a silicon forming aid was used to adapt the latter on the dentin surfaces. After resin core was polymerized with Optilux 501 for 40 seconds, the specimens were tested in a universal testing machine. ANOVA revealed that presence of FRC at the interface had a significantly positive effect on bond strength (p < 0.001). However, differences between groups were not significant for either adhesive system (p = 0.076) or with the use of silicon forming aid (p = 0.348).     

A probiotic lozenge administered medical device and its effect on salivary mutans streptococci and lactobacilli

BACKGROUND: Previous studies have suggested that lactobacilli-derived probiotics in dairy products may affect oral ecology, but the effects of different delivery methods have received little attention. AIM: The aim of the present study was to investigate the effect of the probiotic Lactobacillus reuteri, delivered by a new medical device, on the levels of salivary mutans streptococci and lactobacilli in young women with high Streptococcus mutans counts. DESIGN: This is a randomized, double-blind, placebo-controlled study involving 20 healthy young women (aged 20 years): 10 as subjects and 10 as controls. The study subjects (Group A) sucked the medical device containing the probiotic lozenge with L. reuteri ATCC 55730/L. reuteri ATCC PTA 5289 (1.1 x 10(8) CFU) once daily for 10 days, while the control subjects (Group B) received placebo medical devices without bacteria. Salivary mutans streptococci and lactobacilli were enumerated with chair-side kits at baseline and 1 day after the final ingestion. RESULTS: Salivary S. mutans levels in the probiotic test group were significantly reduced, with statistical significance of reduction (P < 0.05). CONCLUSIONS: A short-term daily ingestion of lactobacilli-derived probiotics delivered via medical device containing probiotic lozenge reduced the levels of salivary mutans.     

Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia

Purpose

Midazolam has only sedative properties. However, dexmedetomidine has both analgesic and sedative properties that may prolong the duration of sensory and motor block obtained with spinal anesthesia. This study was designed to compare intravenous dexmedetomidine with midazolam and placebo on spinal block duration, analgesia, and sedation in patients undergoing transurethral resection of the prostate.

Methods

In this double-blind randomized placebo-controlled trial, 75 American Society of Anesthesiologists’ I and II patients received dexmedetomidine 0.5 μg · kg^?1, midazolam 0.05 mg · kg^?1, or saline intravenously before spinal anesthesia with bupivacaine 0.5% 15 mg (n = 25 per group). The maximum upper level of sensory block and sensory and motor regression times were recorded. Postoperative analgesic requirements and sedation were also recorded.

Results

Sensory block was higher with dexmedetomidine (T 4.6 ± 0.6) than with midazolam (T 6.4 ± 0.9; P < 0.001) or saline (T 6.4 ± 0.8; P < 0.001). Time for sensory regression of two dermatomes was 145 ± 26 min in the dexmedetomidine group, longer (P < 0.001) than in the midazolam (106 ± 39 min) or the saline (97 ± 27 min) groups. Duration of motor block was similar in all groups. Dexmedetomidine also increased the time to first request for postoperative analgesia (P < 0.01 compared with midazolam and saline) and decreased analgesic requirements (P < 0.05). The maximum Ramsay sedation score was greater in the dexmedetomidine and midazolam groups than in the saline group (P < 0.001).

Conclusion

Intravenous dexmedetomidine, but not midazolam, prolonged spinal bupivacaine sensory blockade. It also provided sedation and additional analgesia.