Relationship between Postendodontic Pain,Tooth Diagnostic Factors,and Apical Patency

This study compares the incidence, degree, and length of postoperative pain in 300 endodontically treated teeth, with and without apical patency, in relation to some diagnostic factors (vitality, presence of preoperative pain, group, and mandible of treated tooth). Of the questionnaires received back, apical patency was maintained during shaping procedures with a #10 K-file in one group (n = 115) and not in the other (n = 121). There was significantly less postendodontic pain when apical patency was maintained in nonvital teeth. If pain appeared, its duration was longer when apical patency was maintained in teeth with previous pain or located in the mandible. Maintenance of apical patency does not increase the incidence, degree, or duration of postoperative pain when considering all variables together.     

Carcinoma verrugoso de vagina. Presentación de un caso

Verrucous carcinoma of the vagina is a rare neoplasm. This entity is a slow-growing, locally invasive but generally nonmetastasizing neoplasm, with a characteristic gross and microscopic appearance.We report a case of verrucous carcinoma of the vagina in a postmenopausal woman diagnosed 4 years after transvaginal hysterectomy for grade 4 uterine prolapse. We also discuss the differential diagnosis and treatment.Verrucous carcinoma of the vagina is a rare neoplasm. The differential diagnosis includes typical squamous cell carcinoma, warty carcinoma, and condyloma acuminatum. Surgery remains the most effective treatment.     

Influence of neck rotation and neck lateroflexion on mandibular equilibrium

Summary Neuromuscular interaction between neck and jaw muscles has been reported in several studies. However, the influence of experimentally modified posture of the neck on jaw muscle activity during isometric biting was not investigated so far. The aim of the present study was to test by the aid of simultaneous electromyographic and intraoral bite force measurements whether neck rotation and lateroflexion, in contrast to a straightforward neck position, change the isometric cocontraction patterns of masticatory muscles under identical submaximum bite forces of 50–200 N. Electric muscle activity of all masticatory muscles and changes of the reduction point (RP) of the resultant bite force vectors were examined. An anteroposterior displacement of the RPs could be observed for the rotated and lateroflexed neck position in comparison with the straightforward position. On the other hand, the results revealed no significant differences between bilateral muscle activation under the different test conditions. These findings suggest a force transmission between the neck and the masticatory system, but no essential activity changes in the masticatory muscles under short time posture modification of the neck.     

Uterine artery embolization for symptomatic fibroids with imaging follow up

The aim of this study was to determine the effectiveness of uterine artery embolization (UAE) as a primary treatment method in treatment of symptomatic fibroids, whether there are any preembolization MRI characteristics of fibroid predictive of reduction in volume and assess reduction in uterine and dominant fibroid volumes using ultrasound (US) and MRI. Study was carried out in total of 32 patients aged 25–49 years (mean 40.9 years). Uterine and dominant fibroid volume were determined using US and MRI before UAE, MRI and US at 3 months and US alone at 6 and 12 months post‐UAE, supplemented by clinical evaluation at interval of 3, 6 and 12 months. Procedure was carried out through unilateral femoral puncture using poly vinyl alcohol (PVA) particles 355–500 μm in size. All 32 patients had successful procedures. Overall, 25 patients responded, giving a clinical success rate of 78.12%. Mean reduction in volume of uterus and fibroid was 33 and 59.7% and 48.9 and 75.5% on US at 3 and 12 months respectively, and 33.3 and 58.6% on MRI at 3 months. Volume reduction on US and MRI at 3 months was highly correlative. There was no statistical difference in size reduction in volume of fibroids, which were hypointense or hyperintense on T2‐weighted image (T2WI) on pre‐UAE MRI. Uterine artery embolization leads to good technical success and fibroid volume reduction. Ultrasound alone may be used for follow up of patients post‐UAE. Preprocedure signal characteristics on T2WI are not predictors of volume reduction after UAE.     

Primary central nervous system lymphoma treated with rituximab plus temozolomide in a second line schedule

We report a case of primary CNS lymphoma treated with high-dose methotrexate in the first line. After disease progression the patient received cranial radiotherapy with concomitant temozolomide, followed by rituximab plus temozolomide, with complete remission of the disease maintained for at least two years and without major toxicity.     

Induction of an antigen specific humoral immune response by immunization with the aggregate‐free human TGFα‐P64k fusion protein

Transforming growth factor alpha (TGFα) is an important epidermal growth factor receptor (EGFR) ligand. Over‐expression of both molecules in epithelial tumors has been correlated with poor prognosis and disease progression. Due to the importance of TGFα in tumorigenesis, this molecule has great potential for cancer immunotherapy. We previously designed a TGFα‐based vaccine consisting of a fusion protein between human TGFα (hTGFα) and P64k protein from Neisseria meningitidis expressed in Escherichia coli. However, this protein was obtained highly aggregated, which hampered its introduction into clinical use. In this study, we demonstrate that this aggregation state is not a consequence of IMAC purification, but is formed after bacterial disruption. To obtain this protein as a monomer, we designed a procedure that included an unfolding/refolding step at the end of purification. We verified that hTGFα in the refolded fusion protein (hTGFα‐P64k‐r) is immunogenic in mice. The latter was capable of inducing a humoral immune response against hTGFα identical to that generated with the aggregated fusion protein, demonstrating that the aggregation level has no influence on hTGFα immunogenicity. We also showed that TGFα‐directed antibodies induced apoptosis in A431 cells. The present results also validated the potential use of this vaccine in cancer patients with tumors overexpressing TGFα. Drug Dev Res 69 2008. © 2008 Wiley‐Liss, Inc.     

Differences between pregnant and nulliparous rats in basal and stress levels of metallothionein

The present experiment was designed to examine the influence of pregnancy on basal and stress levels of serum and liver metallothionein (MT). Eighteen-day pregnant rats showed higher serum MT levels and lower liver MT levels than nulliparous rats, suggesting that a great MT mobilization from the liver into the serum was present in the former rats. Serum MT levels were not changed by either restraint or starvation. It is unlikely that the lower liver MT levels showed by pregnant rats were due to competition by progesterone for glucocorticoid receptors, as previously suggested, since the corticosterone/progesterone ratio was unchanged in pregnant rats. Liver MT response to food and water deprivation with or without restraint was somewhat different in nulliparous and pregnant rats. Thus, food and water deprivation for 24 h caused higher liver MT induction in pregnant than in nulliparous rats. When food and water deprivation was accompanied by restraint stress a further increase in liver MT was observed in nulliparous but not in pregnant rats. This suggests that food and water deprivation may be a more severe stress in pregnant rats because of the additional demands of the growing fetuses. Fetal liver MT was increased by restraint stress but not by food and water deprivation. The role of Zn influx into the liver is discussed.