Cementoblastoma related to a primary tooth: a case report

Cementoblastomas are benign lesions of the odontogenic ectomesenchyme that rarely occur related to the primary dentition, especially on the left side of the mandible. This study describes a case of a true cementoblastoma related to the left second primary mandibular molar in a 7-year-old child (the largest one seen in the left side of the mandible). Additionally, the radiographic and histologic findings of the lesion are described in details.     

A Contribution for the Definition of Serum Chemistry Values in Captive Adults Antillean Manatees (Trichechus manatus manatus Linnaeus, 1758)

Serum chemistry analyses represents a fundamental tool for the diagnosis and understanding of diseases in marine mammals. Although several studies are being conducted within the field of clinical pathology, haematological and serum chemistry data for Antillean manatees are deficient. The purpose of this study was to determine serum chemistry values for captive Antillean manatees within the CMA/Ibama facility in Brazil. Serum samples were obtained from five captive adult Antillean manatees fed with seagrass and analysed for aspartate aminotransferase, alanine aminotransferase, bilirubin, alkaline phosphatase, urea, creatinine, glucose, triglycerides, cholesterol, total protein, albumin, globulin, phosphate, chloride, calcium and uric acid. Blood chemistry parameters were determined using a semi‐automatic analyzer. Maximum, minimum, mean and standard deviations were calculated for each serum chemistry parameter. Differences on the values of males and females were verified using an unpaired Student's t‐test. All the parameters analysed were similar between sexes, with exception of AP, which was higher in females (191.43 ± 31.86 U/l). Alanine aminotransferase and uric acid values for Trichechus manatus manatus are reported for the first time in this paper. This study is the first to report serum chemistry parameter values for long‐term captive male and female Antillean manatees. Therefore, the lower values of albumin, phosphate, chloride, cholesterol and triglycerides obtained here highlight the importance of clinical pathology during health monitoring of captive marine mammals.     

Hepatic UDP-glucose 13C isotopomers from [U-13C]glucose: a simple analysis by 13C NMR of urinary menthol glucuronide.

Menthol glucuronide was isolated from the urine of a healthy 70-kg female subject following ingestion of 400 mg of peppermint oil and 6 g of 99% [U-(13)C]glucose. Glucuronide (13)C-excess enrichment levels were 4-6% and thus provided high signal-to-noise ratios (SNRs) for confident assignment of (13)C-(13)C spin-coupled multiplet components within each (13)C resonance by (13)C NMR. The [U-(13)C]glucuronide isotopomer derived via direct pathway conversion of [U-(13)C]glucose to [U-(13)C]UDP-glucose was resolved from [1,2,3-(13)C(3)]- and [1,2-(13)C(2)]glucuronide isotopomers derived via Cori cycle or indirect pathway metabolism of [U-(13)C]glucose. In a second study, a group of four overnight-fasted patients (63 +/- 10 kg) with severe heart failure were given peppermint oil and infused with [U-(13)C]glucose for 4 hr (14 mg/kg prime, 0.12 mg/kg/min constant infusion) resulting in a steady-state plasma [U-(13)C]glucose enrichment of 4.6% +/- 0.6%. Menthol glucuronide was harvested and glucuronide (13)C-isotopomers were analyzed by (13)C NMR. [U-(13)C]glucuronide enrichment was 0.6% +/- 0.1%, and the sum of [1,2,3-(13)C(3)] and [1,2-(13)C(2)]glucuronide enrichments was 0.9% +/- 0.2%. From these data, flux of plasma glucose to hepatic UDPG was estimated to be 15% +/- 4% that of endogenous glucose production (EGP), and the Cori cycle accounted for at least 32% +/- 10% of GP.     

Home-based Health Risk Appraisal and screening program

In an effort to improve Health Risk Appraisals and to induce individuals to change their lifestyles, comprehensive evaluations and counseling sessions were carried out for 476 participants of an experimental preventive care program (1984). Nurse practitioners interviewed participants in their homes and collected information about their lifestyle, medical history, and family history. In addition, physical examinations were performed and blood samples were obtained for laboratory analysis. This information was used to formulate health risk profiles for all participants who were then counseled on how to decrease identified health risks. Interventions included education about health risks and specific programs which were administered to help modify high-risk behaviors. At one year follow-up, significant risk reductions were reported in many areas of increased risk.Victor W. Acquista, M.D., is a Fellow in General Internal Medicine, Rhode Island Hospital. Tom J. Wachtel, M.D., is Director, Medical Primary Care Unit, Rhode Island Hospital, and Assistant Professor of Community Health, Brown University. Celia I. Gomes, M.P.H., is Health Education Coordinator, Blue Cross/Blue Shield of Rhode Island. Michael Salzillo, M.S., is Team Leader, Statistical Analysis Department, Blue Cross/Blue Shield of Rhode Island. Melanie Stockman, R.N., is Director of Ambulatory Nursing, Rhode Island Hospital.     

Spectroscopic imaging of the pilocarpine model of human epilepsy suggests that early NAA reduction predicts epilepsy.

Reduced hippocampal N-acetyl aspartate (NAA) is commonly observed in patients with advanced, chronic temporal lobe epilepsy (TLE). It is unclear, however, whether an NAA deficit is also present during the clinically quiescent latent period that characterizes early TLE. This question has important implications for the use of MR spectroscopic imaging (MRSI) in the early identification of patients at risk for TLE. To determine whether NAA is diminished during the latent period, we obtained high-resolution (1)H spectroscopic imaging during the latent period of the rat pilocarpine model of human TLE. We used actively detuneable surface reception and volume transmission coils to enhance sensitivity and a semiautomated voxel shifting method to accurately position voxels within the hippocampi. During the latent period, 2 and 7 d following pilocarpine treatment, hippocampal NAA was significantly reduced by 27.5 +/- 6.9% (P < 0.001) and 17.3 +/- 6.9% (P < 0.001) at 2 and 7 d, respectively. Quantitative estimates of neuronal loss at 7 d (2.3 +/- 7.7% reduction; P = 0.58, not significant) demonstrate that the NAA deficit is not due to neuron loss and therefore likely represents metabolic impairment of hippocampal neurons during the latent phase. Therefore, spectroscopic imaging provides an early marker for metabolic dysfunction in this model of TLE.     

Patellar prosthesis positioning in total knee arthroplasty. A roentgenographic study

Patellar prosthesis positioning in 40 primary total knee replacements was evaluated with regard to (1) patellar tilt, (2) angle between the patellar component and patellar bony remnant, (3) lateral versus medial placement, (4) patellar height, and (5) size of the patellar component versus patellar length. Two different designs were evaluated. Twenty knees that were resurfaced with a patellar button prosthesis and implanted with conventional surgical technique constituted Group A. Twenty knees that were resurfaced with a new biconvex prosthesis and implanted with specially designed instrumentation constituted Group B. For Group A, the patellar tilt averaged 4.25 degrees preoperative and 8.35 degrees postoperative. For Group B the patellar tilt averaged 4.60 degrees preoperative and 1.83 degrees postoperative. In Group B, there was significant improvement in patellar position, with only two patients showing values exceeding the neutral range (p = 0.0409). The angle between the patellar component and the bony remnant in Group A averaged 5.975 degrees, and in Group B, 1.447 degrees. Two patients in Group A and 18 patients in Group B had values in the normal range for patellar tilt and the angle between the prosthesis and the bone. The prosthesis was inserted medial to the patellar center in six patients in Group A and one patient in Group B. A significant decrease in patellar height was noted for both groups, but values were still within the normal range. Both groups showed significant increase in the postoperative articular length, indicating that oversized prostheses were inserted and excess bone removed.     

Increased tissue-type plasminogen activator activity in orthotopic but not heterotopic liver transplantation: the role of the anhepatic period.

The major cause of the increased tissue-type plasminogen activator activity during orthotopic liver transplantation is still unclear. Both the lack of hepatic clearance of tissue-type plasminogen activator in the anhepatic period and increased endothelial release from the graft on reperfusion have been proposed as the major causes. Heterotopic liver transplantation avoids the resection of the host liver and is a useful model to help differentiate between these two possibilities. In this study the fibrinolytic system was evaluated in 10 orthotopic liver transplantations, 18 heterotopic liver transplantations and a control group of 10 partial hepatic resections. A marked increment in tissue-type plasminogen activator activity, from 0.2 to 5.2 IU/ml (p less than 0.02), was observed during the anhepatic period of orthotopic liver transplantation, which rapidly normalized after reperfusion. In contrast, tissue-type plasminogen activator activity levels remained normal in heterotopic liver transplantation and partial hepatic resections. In orthotopic liver transplantation and in heterotopic liver transplantation no increase occurred in tissue-type plasminogen activator activity after reperfusion. The first venous hepatic outflow after reperfusion did not contain elevated tissue-type plasminogen activator activity levels. Plasma degradation products of fibrin and fibrinogen increased during the anhepatic period of orthotopic liver transplantation (from 2.60 to 8.80 micrograms/ml [p less than 0.008] and from 0.40 to 1.60 micrograms/ml [p less than 0.04], respectively) and remained elevated thereafter. In heterotopic liver transplantation and partial hepatic resections these levels remained low. In conclusion, the lack of hepatic clearance during the anhepatic period is probably the most important factor in the evolution of increased tissue-type plasminogen activator activity during orthotopic liver transplantation.