Clinical performance of resin composite restorations after 2 years

The objective of this study was to evaluate the clinical performance of a packable restorative material, after 2 years in stress-bearing posterior cavities, according to the Ryge criteria. At least two Class 2 restorations (occluso-mesial, mesial-occlusal-distal, occlusal-distal) were placed in 46 patients (36.7 +/- 16 years). In each of the restorations (lot 221, metal matrix band system, glass ionomer-cement-base in 53% of the cavities, mostly no rubber dam) an adhesive system was used. Additionally, in each patient a flowable composite was used in one of the two fillings. After 2 years, 70% of the patients were available for reevaluation. Two restorations needed to be replaced as a result of postoperative sensitivities within the observation period, and one tooth received root canal treatment. All other restored teeth remained vital. One restoration with marginal discoloration received a score of Charlie; another with secondary caries received a score of Bravo. All the others revealed excellent and clinically acceptable results. No statistically significant difference (Chi-square-test) was observed between the two groups, with and without an additional flowable composite. After 2 years, the restorative material performed clinically well, with no observable fractures in the restoration.     

Short- and Mid-term Effects of Irreversible Electroporation on Normal Renal Tissue: An Animal Model

Purpose

Irreversible electroporation (IRE) is a novel nonthermal tissue ablation technique by high current application leading to apoptosis without affecting extracellular matrix. Previous results of renal IRE shall be supplemented by functional MRI and differentiated histological analysis of renal parenchyma in a chronic treatment setting.

Methods

Three swine were treated with two to three multifocal percutaneous IRE of the right kidney. MRI was performed before, 30 min (immediate-term), 7 days (short-term), and 28 days (mid-term) after IRE. A statistical analysis of the lesion surrounded renal parenchyma intensities was made to analyze functional differences depending on renal part, side and posttreatment time. Histological follow-up of cortex and medulla was performed after 28 days.

Results

A total of eight ablations were created. MRI showed no collateral damage of surrounded tissue. The highest visual contrast between lesions and normal parenchyma was obtained by T2-HR-SPIR-TSE-w sequence of DCE-MRI. Ablation zones showed inhomogeneous necroses with small perifocal edema in the short-term and sharp delimitable scars in the mid-term. MRI showed no significant differences between adjoined renal parenchyma around ablations and parenchyma of untreated kidney. Histological analysis demonstrated complete destruction of cortical glomeruli and tubules, while collecting ducts, renal calyxes, and pelvis of medulla were preserved. Adjoined kidney parenchyma around IRE lesions showed no qualitative differences to normal parenchyma of untreated kidney.

Conclusions

This porcine IRE study reveals a multifocal renal ablation, while protecting surrounded renal parenchyma and collecting system over a mid-term period. That offers prevention of renal function ablating centrally located or multifocal renal masses.     

Vergiftung durch injizierte Borsäure

Zusammenfassung Der vorliegende (durch Tierversuche erg?nzte) Fall bildet einen Beitrag zur Bors?ure-Vergiftung durch Injektion und zur Frage der strafbaren Fahrl?ssigkeit bei Medikamenten-Verwechselungen.     

Early onset of obsessive–compulsive disorder and associated comorbidity

Background: Previous studies have aimed to identify subtypes of obsessive–compulsive disorder (OCD) based on their age of onset (AOO). Obsessive–compulsive spectrum disorders (OCS disorders) such as tic disorders have been particularly associated with an early onset in some studies. However, subtypes of early‐ and late‐onset OCD are unevenly determined, and the biological and the clinical validity of these subtypes are unknown. This study was undertaken to discriminate the subtypes of OCD in different AOO levels and to test the hypothesis that different AOO bands are associated with a differential pattern of comorbidity. Methods: Two hundred fifty‐two patients with OCD were interviewed directly with the German version of the Schedule for Affective Disorders and Schizophrenia—Lifetime Anxiety Version, which provides DSM‐IV diagnosis. Subgroups with different ages of onset were investigated (cut‐off levels of 10, 15, and 18 years). Results: Subjects with an early AOO (onset ≤10 years) were significantly more likely to have OCS disorders (odds ratio [OR]=3.46; P =.001; 95% confidence interval [CI]: 1.72–6.96), in particular tic/Tourette's disorders (OR=4.63; P =.002; 95% CI: 1.78–12.05), than were late‐onset subjects. Conclusions: For most mental disorders (e.g., anxiety and mood disorders), no associations with AOO of OCD were identified. However, subjects in the early‐onset group (≤10 years) had a significant increase in comorbid tic and Tourette's disorders. Future research should examine potential neurobiological features associated with early‐onset presentations of OCD. Early detection and management of comorbidities may offset impairments later in life. Depression and Anxiety 26:1012–1017, 2009. © 2009 Wiley‐Liss, Inc.     

Alexithymia in obsessive-compulsive disorder - results from a family study

BACKGROUND: Previous studies have suggested an association between alexithymia and obsessive-compulsive disorder (OCD). However, it is unclear to which extent alexithymic traits in OCD patients reflect familial deficits in cognitively processing and communicating feelings that are also present in their first-degree relatives. This study investigates the hypotheses of an elevated level of alexithymia in subjects with OCD and their first-degree relatives compared to controls and their first-degree relatives. METHODS: 82 cases with OCD and 169 first-degree relatives were compared to 76 controls and 144 first-degree relatives from a German family study on OCD (GENOS). All subjects completed the 20-item Toronto Alexithymia Scale (TAS-20). Direct or family informant interviews were carried out with the German version of the Schedule for Affective Disorders and Schizophrenia - lifetime version for anxiety disorders (DSM-IV). RESULTS: OCD was associated with significantly higher scores of alexithymia. However, first-degree relatives of OCD cases and of controls did not differ in TAS-20 scores. In linear regression analyses, the TAS-20 total score showed significant intrafamilial associations within the families of control subjects but not within families of OCD cases. CONCLUSION: OCD is a severe mental disorder that is associated independently from other current comorbid axis I disorders with deficits in identifying and expressing feelings. However, alexithymia does not represent a familial risk factor for OCD.     

Up-regulation of cathepsin X in prostate cancer and prostatic intraepithelial neoplasia

BACKGROUND: Evidence is accumulating that several proteases are involved in prostate cancer progression. A locus which is often amplified in prostate cancer is the chromosomal region 20q13. Interestingly, one of the genes encoding the cysteine protease cathepsin X maps to this region. The aim of this study was to assess the expression pattern of cathepsin X in malignant and non-malignant prostatic tissue samples. METHODS: Matched malignant and non-malignant tissue specimens were obtained from 56 men after radical prostatectomy. Cathepsin X was quantified at both protein and mRNA levels using several detection methods: Western blotting, immunohistochemistry, quantitative RT-PCR, and in situ hybridization. Furthermore, genomic DNA was analyzed by PCR for possible gene amplification. RESULTS: Immunohistochemical analysis of formalin-fixed, paraffin-embedded sections of radical prostatectomy specimens was performed utilizing a polyclonal antibody against human procathepsin X and revealed staining of acinar basal cells in normal prostate glands. Prostatic intraepithelial neoplasias (PINs) and prostate carcinomas stained highly positive for cathepsin X, showing a significant difference to the staining of normal prostate glands. In contrast, relatively weak and heterogeneous staining was observed for cathepsins F, B, and L. Up-regulation of cathepsin X at the protein level was confirmed by Western blotting. No statistically significant difference was observed at the mRNA level. PCR of genomic DNA revealed that cathepsin X up-regulation most likely occurs in the absence of genomic amplification. CONCLUSIONS: The high expression levels of cathepsin X both in PIN and invasive adenocarcinomas of the prostate suggest that cathepsin X may play a role in the early tumorigenesis of prostate cancer. Further studies are needed to define the utility of this cysteine protease as a diagnostic marker for the early detection of prostate cancer.     

Multiple metachrone Metastasen eines Nierenzellcarcinoms im Pankreas Fallbeschreibung und Literaturübersicht

Zusammenfassung. Das Nierenzellcarcinom ist eine Tumorentit?t mit ungew?hnlichen Charakteristika. Eine der Besonderheiten besteht im relativ h?ufigen Auftreten von Sp?tmetastasen erst viele Jahre nach der Diagnose und Therapie des Prim?rtumors. Eine isolierte Metastasierung in das Pankreas wird extrem selten beobachtet. In der Literatur sind bisher nur 96 derartige F?lle beschrieben worden, wobei es sich in 89 F?llen um solit?re Metastasen handelte. Wir berichten über eine 69 j?hrige Patientin, bei der 2 Metastasen im Pankreas 12 Jahre nach einer Tumornephrektomie auftraten. Die Patientin wurde uns prim?r wegen eines Zweitcarcinoms im Coecum zugewiesen. In der pr?operativen Diagnostik stellte sich eine 4 cm gro?e Raumforderung im Corpus pancreatis dar. Intraoperativ erfolgte die histologische Diagnosestellung einer Pankreasmetastase des Nierencarcinoms. Neben der Rechtshemicolektomie wurden eine Pankreaslinksresektion und Splenektomie ausgeführt. Die histologische Aufarbeitung des Pankreaspr?parats erbrachte den Befund einer zweiten Nierenzellcarcinommetastase. Eine radikale chirurgische Therapie ist für die weitere Prognose von gro?er Bedeutung. Adjuvante Therapiem?glichkeiten werden diskutiert. Aufgrund der M?glichkeit des Auftretens von Sp?tmetastasen noch nach Jahren ist eine sorgf?ltige und langfristige Nachbeobachtung für Patienten mit Nierenzellcarcinom unumg?nglich.