Congenital midline sinus of the upper lip

A congenital lip sinus is a rare condition that has been reported to occur in both the upper and lower lips, either in isolation or in association with congenital deformities such as a cleft lip and palate in Van der Woude syndrome. The prevalence of lower lip sinuses has been estimated to be about 0.00001% of the white population. Upper lip sinuses are even more uncommon. To date, there have been several case reports of upper lip sinuses and fistulas, but no similar cases have been described in Singapore. We herein report a case of congenital upper lip sinus presenting as a recurring upper lip abscess and review the current literature on this condition.     

Therapeutic effects of transarterial infusion of lipiodol and ethanol in various ratios in a rabbit VX2 tumor model

PUSRPOSE

We aimed to evaluate the therapeutic effect and safety of transcatheter arterial embolization with various volume ratios of lipiodol and ethanol in a rabbit VX2 tumor model to identify the optimal volume ratio.

METHODS

Eighteen adult male New Zealand white rabbits implanted with VX2 tumors in their left liver lobes were randomly divided into six groups based on volume ratios of lipiodol to ethanol: group A, 3:1; group B, 2:1; group C, 1:1; group D, 1:2; group E, 1:3; and group F, 1:4. Pre- and post-treatment unenhanced magnetic resonance imaging was used to detect tumor formation and evaluate tumor growth rates. Liver samples were harvested one week after the procedure, and apoptosis index of tumor tissues was evaluated by pathologic examination and TUNEL assay.

RESULTS

Tumor size decreased in groups B, C, and D, but increased in groups A, E, and F. Tumor growth rates in groups A–F were 0.40±0.03, −0.11±0.21, −0.08±0.09, −0.12±0.07, 0.06±0.12, and 0.05±0.09, respectively. The change in tumor size was significantly different in group A compared with the rest of the groups, but no significant difference was observed among groups B–F. Apoptosis indexes of the six groups were 4.7±2.1%, 6.7±2.1%, 11.7±3.1%, 11.0±2.0%, 10.7±3.2%, and 12±3%, respectively. Apoptosis index was significantly lower in group A compared with groups C–F (P < 0.05). Apoptosis index of group B was significantly lower than groups C and F. There was no significant difference among the other groups.

CONCLUSION

The volume ratios of lipiodol to ethanol ranging from 2:1 to 1:4 were equally effective, the ratios 2:1 and 1:3 had equal safety, and the ratios 1:1 and 1:2 indicated better long-term therapeutic effect. Increasing ethanol in the mixture caused more severe liver injury. Optimal efficacy and safety was achieved with a lipiodol to ethanol volume ratio of 1:1.Hepatocellular carcinoma (HCC) is one of the most common solid malignancies in the world (1). Transarterial chemoembolization (TACE) is widely used to treat HCC patients who are not suitable candidates for curative treatments (2–5). The most common embolic agent used in TACE is lipiodol, which can be mixed with surgical glues (cyanoacrylates) or with ethanol for interventional procedures. Ethanol was confirmed to be effective in occluding the hepatic arterial system, but it can cause perisinusoidal fibrosis (6). Transarterial ethanol ablation (TEA) with a mixture of lipiodol-ethanol has been shown to be an effective treatment for HCC (7). Yu et al. (8) reported that the embolization efficacy and treatment effectiveness of TEA were probably superior to those of TACE for HCC, and a decreased proportion of ethanol (33% by volume) in the mixture was suggested. Lipiodol-ethanol mixtures with reduced ethanol proportions have been shown to be associated with decreased endothelial damage while maintaining effective delivery of the mixtures to tumor vasculature (9). However, the optimal ratio between lipiodol and ethanol that should be used for TEA remains controversial.In the present study, we aimed to determine the efficacy and optimum volume ratio of lipiodol-ethanol mixture in a rabbit VX2 hepatoma model.     

Association between Plasma Leptin Level and Systemic Inflammatory Markers in Patients with Aggressive Periodontitis

Background:

Increasing evidence supports an association between periodontitis and systemic diseases. Leptin is involved both in the energy metabolism and inflammatory processes and is suggested to be a link between periodontal infection and systemic health. The present study aimed to evaluate the peripheral leptin concentration in patients with aggressive periodontitis (AgP) and to explore the relationship between leptin and systemic inflammation.

Methods:

Ninety patients with AgP visiting the Clinic of the Periodontology Department, Peking University School and Hospital of Stomatology between July 2001 and May 2006, and 44 healthy controls (staff and student volunteers in the same institute) were recruited. Plasma levels of leptin and inflammatory cytokines including interleukin (IL)-1β, IL-6, tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) were measured by enzyme-linked immunosorbent assay. Correlation and multiple linear regression analysis were performed to analyze the association between plasma leptin level and other variables.

Results:

Plasma leptin level of AgP group was significantly higher than that of the control group (19.7 ± 4.4 ng/ml vs. 7.5 ± 1.3 ng/ml, P < 0.01). After controlling for age, gender, and body mass index, positive correlation was observed between plasma leptin concentration and log-transformed levels of pro-inflammatory cytokines (IL-1β, IL-6, TNF-α and CRP), and the partial correlation coefficients ranged from 0.199 to 0.376 (P < 0.05). Log-transformed IL-1β and IL-6 levels entered the final regression model (standardized β were 0.422 and 0.461 respectively, P < 0.01).

Conclusions:

Elevated plasma leptin concentration may be associated with increased systemic levels of inflammatory markers in AgP patients.