Disruptions of the pulp-dentin complex in an investigated case of pink secondary retained molar

A pink retained left mandibular first molar without carious lesions was diagnosed in a healthy 12-year-old girl presenting normal clinical tests. An orthopantomogram failed to detect other retained teeth. Both periapical radiography and computed tomography showed the absence of a periodontal ligament space in the bifurcation area and the presence of radiolucency or calcifications in the pulp cavity. The coronal part of the removed tooth was subjected to histological and immunohistochemical analysis using anti-PCNA (proliferation marker) and anti-p53 (apoptosis marker) antibodies. Root surfaces were observed by scanning electron microscopy. The pink color of the molar reflected the extension of resorptive tissue into the clinical crown and the underlining proliferation of pulp vessels. Ankylosis observed in the bifurcation area was also detected in the coronal part of the pulp. Whereas odontoblasts secreted tertiary dentin despite no evidence for a carious lesion, only osteocytes in the newly formed bone were apoptotic and the root surfaces were free of resorption lacunae. The etiopathology of the lesion in this case indicated a pulp origin, suggesting that new therapies targeting this tissue should be developed.     

Endothelial nitric oxide synthase gene polymorphism is associated with Behçet's disease in Tunisian population

Nitric oxide (NO) is a molecule that plays a key role in many physiologic and pathologic processes. It is produced in vivo from the aminoacid l-arginine by a family of nitric oxide synthases (NOS). Endothelial NOS (eNOS) is a constitutively expressed isoform of NOS. The eNOS gene entails several polymorphisms, of which certain were investigated in Beh?et's disease (BD). We sought to establish the association of eNOS gene Glu298Asp polymorphism in exon 7 with susceptibility to BD. In this study, 135 Tunisian patients with BD and 157 healthy blood donor controls from the same geographic area were genotyped by polymerase chain reaction technique for eNOS polymorphism in exon 7. Our results showed that the distribution of the Glu298Asp genotype differed between BD patients and controls but did not reach statistical significance (p = 0.06). Allele Asp298 was significantly more frequent in healthy controls than in BD patients (p = 0.037, chi(2) = 4.33, OR = 1.01, 95% CI = 1.41-1.99). A significant difference was found (p = 0.004, OR = 1.26, 95% CI = 2.13-3.62) between BD patients with skin lesions and patients without this manifestation. Our findings suggest that Glu298Asp polymorphism of eNOS gene is associated with BD susceptibility as well as skin lesions.     

Chromophenazines from the terrestrial Streptomyces sp. Ank 315

The new chromophenazines A-F [9-methyl-5-(3'-methylbut-2'-enyl)-5H-benzo[a]phenazin-7-one (1a), 9-methyl-5-(3'-methylbut-2'-enyl)-7-oxo-5,7-dihydrobenzo[a]phenazine-1-carboxylic acid (1b), 5-(3'-methylbut-2'-enyl)-7-oxo-5,7-dihydrophenazine-1-carboxamide (2), 3-benzoyl-5-(3'-methylbut-2'-enyl)-5,10-dihydrophenazine-1-carboxylic acid (5a), 3,7-dibenzoyl-5-(3'-methylbut-2'-enyl)-5,10-dihydrophenazine-1-carboxylic acid (5b), and 3,7-dibenzoyl-5-(3'-methylbut-2'-enyl)-5,10-dihydrophenazine-1-carboxamide (5c)], together with phenazine-1-carboxylic acid, 1-phenazinecarboxamide, 1-phenazinol, tryptophol, and anthranilic acid, were isolated from Streptomyces sp. Ank 315. The structures of the new compounds were established on the basis of spectroscopic data, 1D NOE, 2D NMR, and ESIMS measurements and comparison with literature values.     

Cardiovascular risk factors in the Maghreb. A systematic review.

Objective:To assess the distribution of cardiovascular risk factors in Maghreb''s countries. Methods:It is a systematic review including articles and reports that applied the WHO «STEPwise» approach, or a similar approach, studying cardiovascular risk factors in the Maghreb countries: Tunisia, Morocco, Algeria, Libya and Mauritania between 2004 and 2018. Results:We selected five articles, a report for each country. The prevalence of smoking was between 13.4% (12.2-14.6) in Morocco and 29.4% (28.3-30.4%) in Tunisia. 50.6% of the population of Mauritania had insufficient physical activity. The prevalence of high blood pressure was highest in Libya (40.6%) The prevalence of obesity was up to 41.1% (37-43.3) for women and 21.4% (19-23.8) in men in Libya. The prevalence of diabetes mellitus was between 10.6% (9.7-11.6) in Morocco and 16.4% (14.7-19.1) in Libya. Conclusion:The distribution of cardiovascular risk factors in the Maghreb countries shows that the level of cardiovascular risk is high, particularly in the central Maghreb. This attests to the fairly advanced epidemiological transition related to the rapid modernization of the Arab countries, hence the importance of launching an integrated project for the fight against cardiovascular diseases based on the global experience.     

Prognostic factors for visual recovery in idiopathic rhegmatogenous retinal detachment: a prospective study of 90 patients.

Aim: To determine the preoperative clinical and tomographic factors involved in the postoperative visual prognosis of macula-off rhegmatogenous retinal detachment. Methods: We conducted a prospective analytical study of 90 eyes of 90 patients who suffered from macula-off rhegmatogenous retinal detachment and were treated in department “A” of “Hedi Raies Institute of Ophthalmology”, Tunis. All the patients were examined prior and after the operation, with a thorough interrogation and complete ophthalmological examination. Also, we continued assessing their status for 6 months. We looked for the clinical factors predictive of postoperative visual recovery. The data collected was stored using Excel software and analyzed using SPSS version 18 for Windows (IBM Corp., Armonk, NY). For all statistical tests, the significance level was set at p=0.05. Results: The mean preoperative visual acuity (VA) was 1.73 +/- 0.34 LogMAR. It was significantly correlated with management delay (p<0.001). Postoperative VA was 0.61 +/- 0.43 LogMAR. The various pre-operative clinical risk factors for poor final visual recovery (VA<5/10) were: preoperative VA ≥ 2 LogMAR, management delay > 15 days (p<0.01), proliferative vitreoretinopathy (PVR) stage C or greater (p=0.01), and number of detached retinal quadrants > 2 (p=0.05). Furthermore, we have found that the preoperative tomographic risk factors for poor visual recovery were: height of sub retinal fluid > 760µm (p < 0.001), disruption of the external limiting membrane and/or ellipsoid zone (p < 0.001), presence of cavitations in the external and/or internal nuclear layer (p = 0.002), and finally the absence of a thickening of the photoreceptor outer segments (p = 0.001). Conclusion: Predictive preoperative clinical factors in macula off RRD are mainly preoperative visual acuity, the management delay, number of quadrants reached and PVR stage. Mastering these factors builds a better understanding of the functional recovery after macula-off retinal detachment and helps advise the patients who will consequently be more involved in the management of this serious disease. Spectral domain OCT allows detection of specific microscopic macular changes. These anomalies could be predictive of final postoperative visual outcome.rhegmatogenous retinal detachment, prognosis, preoperative factors, tomography.     

Role of FDG-PET and PET/CT in the diagnosis and management of vasculitis

Purpose

to investigate the role of FDG-PET and PET/CT in the evaluation of vasculitis.

Materials and methods

a systematic revision of the papers published in PubMed/Medline until December 2009 was done.

Results

FDG-PET and PET/CT have been proven to be valuable in the diagnosis of large-vessel vasculitis, especially giant cells arteritis with sensitivity values ranging 77% to 92%, and specificity values ranging 89% to 100%. In particular, FDG-PET/CT has demonstrated the potential to non-invasively diagnose the onset of the vasculitis earlier than traditional anatomical imaging techniques, thus enabling prompt treatment. False positive results mainly occur in the differential diagnosis between vasculitis and atherosclerotic vessels in elderly patients. Another area where FDG-PET/CT is gaining wider acceptance is in monitoring response to therapy; it can reliably detect the earliest changes of disease improvement post-therapy, and persistent activity is an indicator of non-responders to therapy. A few data have been reported about medium/small vessel vasculitis.

Discussion

FDG-PET and PET/CT have proven utility: (a) in the initial diagnosis of patients suspected of having vasculitis particularly in those who present with non-specific symptoms; (b) in the identification of areas of increased FDG uptake in which a biopsy should be done for obtaining a diagnosis; (c) in evaluating the extent of the disease; (d) in assessing response to treatment.