Calcifying odontogenic cysts: A 20-year retrospective clinical and radiological review

Objective:Calcifying odontogenic cysts (COCs) exhibit diverse clinical behaviours and may be associated with other benign odontogenic tumours. In this study, the clinical and radiological features of COCs were analysed according to subtypes based on the classification by Praetorius et al. Emphasis was placed on cases exhibiting atypical or aggressive radiological appearances. This information may assist the clinician to better understand the radiological spectrum of COCs.Methods:Histologically confirmed cases of COCs were retrospectively reviewed in a 20-year period from three tertiary institutions. The following clinical information was reviewed: patient demographics, main complaint, clinical duration, anatomical site and detailed radiological features.Results:Twenty-seven cases of COCs were included in the study. Asymptomatic swelling was the main clinical presentation with infrequent reports of associated pain. COCs had an anterior mandibular predilection. Well-demarcated borders were seen in all cases with isolated cases showing focal areas with loss of demarcation. Unilocular lesions were more common than multilocular variants. Internal calcifications were frequent and six cases presented with associated odontomas. Maxillary COCs resulted in the displacement of the maxillary sinus and/or nasal cavity walls. Radiological signs of aggression, including cortical destruction, were noted in a few cases.Conclusion:Given the fact that COCs can present with a spectrum of clinical behaviours and radiological presentations, the academic debate regarding the cystic versus neoplastic nature of the entity is justifiable. The cases in the current sample presented with diverse presentations, ranging from indolent to lesions with significant growth and aggression.     

Comparison of two effervescent agents for double-contrast upper gastrointestinal tract radiography

We prospectively evaluated the efficacy in 100 patients of two effervescent contrast agents commonly used in routine double-contrast upper gastrointestinal (GI) tract examinations: Baros and E-Z-Gas II granules. The study was double blinded. Two radiologists, who were not aware of which effervescent agent was being used, objectively evaluated the radiographic studies. Patient ease in swallowing and acceptance of the effervescent granules was 94% for Baros and 68% for E-Z-Gas II granules. The objective evaluation of the radiographs showed adequate gastric distension (Baros, 94%; E-Z-Gas II, 90%) and adequate to excellent mucosal coating for both agents (Baros, 92%, E-Z-Gas II, 94%). Areae gastricae were better seen with Baros (64% vs. 30%), and air bubbles were less of a problem with Baros. We conclude that Baros effervescent granules have certain distinct advantages over E-Z-Gas II granules regarding patient tolerance and acceptance, better visualization of the areae gastricae, and less degradation of the quality of the radiographs by air bubbles. The differences in mucosal coatings for the two agents was insignificant.     

Effect of hydrogel lens wear on the major tear proteins during extended wear

Purpose: The purpose of the present study was to determine whether contact lens wear disturbed the levels of tear proteins and to further determine whether this was a transient or continuous disruption. Methods: Lactoferrin, lysozyme and albumin were quanti-tated from tears of neophyte patients and were compared with the levels of these proteins in contact lens wearers after one and six nights and 6 months of extended wear The quantitation of these tear proteins was performed by sandwich ELISA and turbidimetric assay. Results: Results showed that there were no statistically significant changes in the concentration of any of the proteins investigated. Conclusions: Extended wear of hydrogel lenses does not appear to alter the concentration of the major tear film proteins, indicating that the tear film is constantly replenished to maintain protein levels, which are depleted due to protein adsorption to the lens surface.     

Cardiac arrhythmias mimicking primary neurological disorders: a difficult diagnostic situation

Cardiac arrhythmias can present with the signs and symptoms of a seizure disorder. This potentially life–threatening underlying cause of non–febrile seizures should be recognized early, since successful specific treatment is possible. The purpose of this retrospective study was to examine common features in such patients. Over a period of 25 years, eight patients were initially treated for up to 5 years at our institution for a seizure disorder until dysrhythmia as the underlying cause of the seizures was disclosed. The main symptom was drop attacks coinciding with physical activity or emotional stress. Convulsions were only rarely observed. In five of the eight patients the underlying disorder was the long–QT–syndrome (Romano–Ward syndrome). In one patient intermittent complete atrioventricular block was found, another patient showed ventricular tachydysrhythmia of unknown etiology and the last patient suffered from hypertrophic cardiomyopathy.     

Mouse choroideremia gene mutation causes photoreceptor cell degeneration and is not transmitted through the female germline

Choroideremia (CHM) is an X-linked progressive eye disorder which results from defects in the human Rab escort protein-1 (REP-1) gene. A gene targeting approach was used to disrupt the mouse chm/rep-1 gene. Chimeric males transmitted the mutated gene to their carrier daughters but, surprisingly, these heterozygous females had neither affected male nor carrier female offspring. The targeted rep-1 allele was detectable, however, in male as well as female blastocyst stage embryos isolated from a heterozygous mother. Thus, disruption of the rep-1 gene gives rise to lethality in male embryos; in female embryos it is only lethal if the mutation is of maternal origin. This observation can be explained by preferential inactivation of the paternal X chromosome in murine extraembryonic membranes suggesting that expression of the rep-1 gene is essential in these tissues. In both heterozygous females and chimeras the rep-1 mutation causes photoreceptor cell degeneration. Consequently, conditional rescue of the embryonic lethal phenotype of the rep-1 mutation may provide a faithful mouse model for choroideremia.      

Relation between Hypofractionated Radiotherapy,Toxicity and Outcome in Early Breast Cancer

To compare adjuvant conventional radiotherapy (C‐RT) to hypofractionated schedule (HF‐RT) in early breast cancer. Between May 2012 and September 2015, 120 patients were included in the analysis. All patients underwent conservative surgery and adjuvant RT. RT was delivered in C‐RT (50 Gy; 2 Gy/fr) or HF‐RT (42.5 Gy; 2.66 Gy/fr), followed by a tumor bed boost (10 Gy; 2 Gy/fr). RT‐induced toxicity was recorded and compared between groups. Toxicity results were graded according to the Common Terminology Criteria for Adverse Events guidelines. A multivariate analysis was performed of the factors associated with acute toxicity onset. Mild acute skin toxicity was observed in 71.7% of patients. No grade 4 toxicity was observed. From the multivariate analysis, Breast volume and RT fractionation significantly affected acute radiation‐related toxicity. No increase in late toxic effects has been reported between C‐RT and HF‐RT schedules. Overall, the 2‐year disease free survival was 94.4%. HF‐RT represents a valid adjuvant treatment option in early breast cancer patients, without negative impact on acute and late radiation sequelae, as well as tumor control.