Coexistence of diffuse plane normolipaemic xanthoma and amyloidosis in a patient with monoclonal gammopathy

Diffuse plane normolipaemic xanthomatosis (DPNX) is a well-defined clinicopathological entity that characteristically presents with yellow–orange plaques in the periorbital areas, the neck, the upper trunk and the flexural folds. DPNX has been reported in association with lymphoproliferative disorders and, occasionally, with miscellaneous, probably coincidental disorders. A case of DPNX in a patient with an IgGλ monoclonal gammopathy and systemic amyloidosis is reported. Clinical and histopathological findings revealed typical features of DPNX and amyloidosis coexisting in the cutaneous lesions. To our knowledge this is the first reported case showing coexistence of xanthoma and amyloidosis in cutaneous lesions in a patient with a monoclonal gammopathy.     

Micro-sized erosions in a nanofilled composite after repeated acidic beverage exposures: consequences of clusters dislodgments

Objective

To evaluate the hardness (KHN), color stability (DE), and superficial micromorphology of two categories of composites after immersion in either distilled water or grape juice for up to 45 days.

Material and Methods

Cylindrical specimens (6 mm diameter x 2 mm thick) were obtained according to the factors: composite [Opallis (FGM) and Filtek Z350XT (3M ESPE)]; immersion solution (distilled water and grape juice); and evaluation time: 24 h and 7, 14, 21, 28, and 45 days. After photoactivation, the specimens were stored at 37ºC for 24 h. KHN (50 g/15 s) and ΔE were then repeatedly assessed according to the immersion solutions. Data were analyzed (three-way ANOVA/Tukey''s test). Scanning electron microscopy (SEM) topographic analysis was also performed.

Results

In general, KHN of both composites reduced after 24 h, irrespective of the immersion solution and time. A significantly lower KHN was noted for Opallis compared with Filtek Z350XT in all parameters. An increase in ΔE over time was noted for both composites, irrespective of the immersion solution. Significantly higher ΔE was noted for Filtek Z350XT immersed in grape juice compared with Opallis, regardless of the evaluation time. The grape juice caused significantly higher DE compared with water in all periods. SEM analysis showed eroded areas for Filtek Z350XT but not for Opallis.

Conclusions

The compositions and immersion solutions influence the composite hardness and the color stability. In spite of the higher hardness, the nanofilled composite is more susceptible to color change than the microhybrid when immersed in an acidic dyed solution.     

Automated diagnosis of fetal alcohol syndrome using 3D facial image analysis

OBJECTIVES: Use three-dimensional (3D) facial laser scanned images from children with fetal alcohol syndrome (FAS) and controls to develop an automated diagnosis technique that can reliably and accurately identify individuals prenatally exposed to alcohol. METHODS: A detailed dysmorphology evaluation, history of prenatal alcohol exposure, and 3D facial laser scans were obtained from 149 individuals (86 FAS; 63 Control) recruited from two study sites (Cape Town, South Africa and Helsinki, Finland). Computer graphics, machine learning, and pattern recognition techniques were used to automatically identify a set of facial features that best discriminated individuals with FAS from controls in each sample. RESULTS: An automated feature detection and analysis technique was developed and applied to the two study populations. A unique set of facial regions and features were identified for each population that accurately discriminated FAS and control faces without any human intervention. CONCLUSION: Our results demonstrate that computer algorithms can be used to automatically detect facial features that can discriminate FAS and control faces.     

经口腔机器人手术治疗头颈癌的初步经验

该文旨在研究经口腔机器人手术（TORS）治疗头颈部恶性肿瘤的技术可行性、安全性及有效性。对应用daVinci外科机器人治疗的20例患者进行前瞻性研究。纳入标准为成年患者的早期头颈癌，包括口腔癌、口咽癌、下咽癌及喉癌。结果，2例无法充分达到手术部位，手术终止。其他18例术后手术切缘阴性。8例行组织重建。10行单侧颈淋巴清扫，5例行双侧颈清，未行气管切开，术中、术后无并发症。     

Digital Gangrene Associated with Anticentromere Antibodies

Anticentromere antibodies have been associated with peripheral vascular occlusive disease, but then it is mostly accompanied by sclerodactyly in the context of a connective tissue disorder. We report a case of digital gangrene in a 75 year old lady with no other associations except positive anticentromere antibodies.     

The role of plain radiographs in the diagnosis of chronic maxillary rhinosinusitis in adults

Background

Computed tomography is currently the gold standard for the diagnosis of chronic rhinosinusitis. However, this facility is not readily available in many developing countries. Thus, plain sinus radiography is still widely in use in our practice.

Objectives

To assess the diagnostic value of plain radiographs in adult patients with uncomplicated chronic maxillary rhinosinusitis.

Methods

This study was carried out at a tertiary health facility in Northern Nigeria. All adult patients with clinical and radiological diagnosis of chronic maxillary rhinosinusitis were included.

Results

A total of 88 patients were recruited into the study. There were 51 males (58.0%) and 37 (42.0%) females. Their ages ranged from 18 to 60 years; with a mean age of 31.7±9.20 years. Mucosal thickening was the commonest diagnostic plain radiographic feature, and fluid level was the least. Maxillary antra with diagnostic plain radiographic interpretations of fluid level, haziness and opacity had high specificities (100%, 95.2%, and 85.7%) and high positive predictive values (100%, 75%, and 70%) respectively.

Conclusions

Plain radiographs are relevant in the diagnosis of chronic maxillary rhinosinusitis in our locality only when they show features of fluid level: findings of haziness and opacity are of less diagnostic value.     

A survey of zoonotic diseases in trade cattle slaughtered at Tanga city abattoir: a cause of public health concern

Objective

To estimate the prevalence of hydatidosis, cysticercosis, tuberculosis, leptospirosis, brucellosis and toxoplasmosis in slaughtered bovine stock (aged ±3 years) at Tanga city abattoir, Tanzania.

Methods

Prevalence estimation of the five zoonotic diseases was undertaken through an active abattoir and sero-survey was carried out in Tanga city, during the period of January 2002 and March 2004. Serum samples collected from a sub-sample (n=51) of the slaughter stock were serologically screened for antibodies against brucellosis, leptospirosis and toxoplasmosis using Rose Bengal plate test, microscopic agglutination test (for 5 serovars of Leptospira interrogans) and Eiken latex agglutination test, respectively. The same animals were tested for tuberculosis using the single intradermal tuberculin test.

Results

Post mortem examination of 12 444 slaughter cattle (10 790 short horn zebu and 1 654 graded) over a period of twenty two months, showed a prevalence of 1.56% (194) for hydatidosis, 1.49% (185) for cysticercosis and 0.32% (40) for tuberculosis. In all three zoonoses, a statistically significant difference in infection rates was noted between the short horn zebu and graded breeds (P<0.05). The overall seroprevalences of animals with brucellosis, toxoplasmosis and leptospirosis antibodies were found to be 12%, 12% and 51%, respectively. The most common leptospiral antibodies detected were those against antigens of serovars Leptospira hardjo (29%), Leptospira tarassovi (18%), Leptospira bataviae (4%) and Leptospira pomona (0%). With regard to tuberculosis, 10% (n=5) of the animals tested were classified as non-specific reactors or inconclusive.

Conclusions

The study findings suggest that brucellosis, toxoplasmosis and leptospirosis are prevalent in Tanga and provide definitive evidence of slaughtered stock exposure to these zoonotic agents with concurrent public health consequences.     

Assessment of microalbuminuria and glycated hemoglobin in type 2 diabetes mellitus complications

ObjectiveTo relate microalbuminuria with the degree of glycaemic control in type 2 diabetic patients and determine the prevalence of poor glycemic control amongst the normotensive diabetes mellitus (NDM) and hypertensive diabetes mellitus (HDM) with or without microalbuminuria.MethodsA total of 95 type 2 diabetes mellitus patients and 30 healthy controls were randomly selected and studied. 17 of the 95 patients were normotensive diabetic with microalbuminuria, 40 of them were HDM presenting with microalbuminuria and 38 were NDM without microalbuminuria. Their blood was obtained for fasting plasma glucose and glycated haemoglobin while their urine was obtained for albumin and creatinine estimation and the ratio was calculated.ResultsOut of the 95 diabetic patients studied, 57 (60%) of them had microalbuminuria while 38 (40%) had normoalbuminuria. The mean ages in the diabetics with microalbuminuria were higher than those without microalbuminuria (P=0.054 6). The mean glycated haemoglobin was the highest (5.95±2.06)% in NDM with microalbuminuria when compared with HDM with microalbuminuria (5.83±1.62)% and that in (5.66±2.49)% in NDM without microalbuminuria (P=0.000 9). Similarly, fasting plasma glucose was the highest (9.09±4.31) mmol/L in NDM with microalbuminuria than those without microalbuminuria (7.70±3.33) mmol/L (P=0.000 1). The prevalence of poor glycaemic control was the highest (29%) in NDM with microalbuminuria while the least (21%) in NDM without microalbuminuria.ConclusionsThe risk of microalbuminuria increases with poor glycemic control. Persistent increase in glycated haemoglobin may be an indicator of worsening albumin creatinine ratio and diabetic nephropathy. Therefore, regular screening for microalbuminuria in addition to continuous (3-monthly) glycated HbA1c estimation is advised.     

Prevalence of alveolar bone loss in healthy children treated at private pediatric dentistry clinics

Objectives

The purpose of this study was to evaluate the prevalence of alveolar bone loss (BL) in healthy children treated at private pediatric dentistry clinics in Brasília, Brazil.

Material and Methods

The research included 7,436 sites present in 885 radiographs from 450 children. The BL prevalence was estimated by measuring the distance from the cementoenamel junction (CEJ) to alveolar bone crest (ABC). Data were divided in groups: (I) No BL: distance from CEJ to ABC is ≤2 mm; (II) questionable BL (QBL): distance from CEJ to ABC is >2 and <3 mm; (III) definite BL (DBL): distance from CEJ to ABC ≥3 mm. Data were treated by the chi-square nonparametric test and Fisher''s exact test (p<0.05).

Results

Among males, 89.31% were classified in group I, 9.82% were classified in group II and 0.85% in group III. Among females, 93.05%, 6.48% and 0.46% patients were classified in Group I, II and III, respectively. The differences between genders were not statistically significant (Chi-square test, p = 0.375). Group composition according to patients’ age showed that 91.11% of individuals were classified as group I, 8.22% in group II and 0.67% in group III. The differences among the age ranges were not statistically significant (Chi-square test, p = 0.418). The mesial and distal sites showed a higher prevalence of BL in the jaw, QBL (89.80%) and DBL (79.40%), and no significant difference was observed in the distribution of QBL (Fisher’s exact test p = 0.311) and DBL (Fisher’s exact test p = 0.672) in the dental arches. The distal sites exhibited higher prevalence of both QBL (77.56%) and DBL (58.82%).

Conclusions

The periodontal status of children should never be underestimated because BL occurs even in healthy populations, although in a lower frequency.