Technique for treatment of dens in dente

This article describes a case involving a maxillary lateral incisor with dens in dente and how it was treated with a procedure that differs from standard endodontic treatment.     

Isolated Neurosarcoidosis Revealed by Diabetes Insipidus,Visual Loss and Diplopia in a Child Patient: A Diagnostic Problem

We report a case of 15-yr-old child that was presented with headache, polyuria, polydipsia, recent ocular motor and abducens nerve palsies and rapid visual loss. He had a long history of progressive symmetric muscular weakness predominant in the lower limb girdle. Water deprivation revealed central diabetes insipidus. Hormonal explorations demonstrated preserved pituitary function with mild hyperprolactinemia at 21.5 ng/ml (N: 2.6 to 13.1 ng/ml). Magnetic resonance imaging showed an extensive isosignal T1 and hyposignal T2 enhanced lesion infiltrating the pituitary gland, optic-chiasmal hypothalamic region, cavernous sinus, cerebrum tent and sphenoid and temporal meningeal spaces. The serum level of angiotensin converting enzyme and cerebrospinal fluid analysis were normal. No other systemic localisation was identified. Muscle biopsy objectified dystrophic changes. Genetic study identified a delT 521 mutation characteristic of Limb-girdle muscular dystrophy type 2C. Corticotherapy rapidly ameliorated the neurological symptoms. This patient was diagnosed as having neurosarcoidosis. Neurosarcoidosis is rarely reported in childhood. We discuss the problems related to diagnosis in such a situation below.     

Almost Complete Lack of Human Cytomegalovirus and Human papillomaviruses Genome in Benign and Malignant Breast Lesions in Shiraz,Southwest of Iran

Breast cancer ranks as the most common cancer among women worldwide. There have been controversial reports regarding contributions of human papillomaviruses (HPVs) and human cytomegalovirus (HCMV) to its development. The aim of this study was to determine the frequency of HPV and HCMV positivity in benign and malignant breast tumors. Materials and Methods: Formalin fixed paraffin-embedded tissue specimens of 150 breast cancers (invasive ductal and lobular carcinomas) and 150 non-malignant breast lesions (fibroadenomas, fibrocystic disease and adenosis) were examined. All samples were first deparafinized then subjected to commercial DNA extraction. The β-globin gene fragment was amplified using polymerase chain reaction (PCR) to confirm the quality of extracted DNA. The presence of HPV and HCMV genomic DNA was determined using PCR and Real time PCR techniques, respectively. Results: The mean ages of the test and control groups were 35.2 and 45 years, respectively. For HCMV, none of the malignant lesions were positive and only 2 of the 150 benign samples demonstrated presence of the virus. No HPV genomic DNA was found in either malignant or benign cases. Conclusion: The results of this study indicated no relationship between HCMV or HPV infection with breast cancer development. Whether investigations in larger populations with longer follow-up might demonstrate any role remains unclear.     

“Facial vascular anomalies; MRI and TRICKS-MR angiography diagnostic approach”

Purpose

Evaluate role of MRI and TRICKS-MR angiography in diagnosis of facial vascular anomalies.

伊朗东北部儿童代表性样本中儿童肥胖的膳食预测因素

目的：伊朗儿童的肥胖患病率不断升高。这项研究旨在评价伊朗东北部城市Neishabour的儿童代表性样本中肥胖的某些膳食决定因素。方法：在这项病例对照研究中,病例组为114名在校学生,年龄6~12岁,体重指数（BMI）≥第95个百分位（根据伊朗儿童的参考值）,而对照组为102名年龄和性别匹配的非肥胖同班同学。由受过训练的营养师在儿童在场的情况下与母亲面谈,进行两次24 h膳食回顾调查,收集了营养摄入数据;使用食物频率问卷调查了零食摄入模式;使用SPSS软件（第16版）进行了单因素和多因素logistic回归分析。结果：单因素logistic回归分析显示,总能量、蛋白质、碳水化合物、脂肪（包括饱和脂肪、单不饱和脂肪和多不饱和脂肪）和膳食纤维是学生肥胖的正向预测因素;玉米膨化食品、碳酸饮料、薯片、快餐食品和巧克力的摄入频率的粗估比值比（OR）有统计学意义。多因素logistic回归分析显示,肥胖与能量摄入量（OR = 2.489,95%CI：1.667~3.716）、玉米膨化食品摄入频率（OR=1.122,95%CI：1.007~1.250）及薯片摄入频率（OR=1.143,95%CI：1.024~1.276）显著相关;而膳食纤维摄入量（OR=0.909,95%CI：0.835~0.988）和天然果汁摄入量（OR= 0.601,95%CI：0.368~0.983）是预防肥胖的保护因素。结论：该研究结果证实了不健康饮食对儿童肥胖的作用,尤其是高热量零食。应鼓励儿童养成健康的饮食习惯,如摄入高纤维食物。     

An exceptional case of urogenital sinus associated with a scrotal pouch and duplicate urethra in a female child

We report the case of an unusual genitourinary anomaly in a 5-year-old patient. The malformation consisted of a para-anal persistent urogenital sinus in a 46XX patient associated with a scrotum-like structure in the presumed clitoral location. A duplicate urethra arising from the anterior aspect of the bladder neck drained into the scrotal pouch. Two hemivaginas drained into the urogenital sinus. The patient was totally continent through the urogenital sinus but the duplicate urethra was incontinent. No hormonal problems were encountered. The girl underwent total urogenital sinus mobilization, scrotal pouch ablation, and duplicate urethra resection.     

Prognostic factors and patients’ profile in treated stage I and II lung adenocarcinoma: a Hospital’s Cancer Registry-based analysis

BackgroundIt is known that survival from lung cancer can differ between countries and even between different regions of the same country. The variability between hospitals, the age and social profile, and the time when this patient was treated, can influence survival, and these factors are intrinsic to each region. Knowing the profile of patients, hospitals, and other factors associated with the treatment of stage I and II lung cancer in a given region is important to understand outcomes and propose improvements that can be replicated in any region of the world that presents the same profile of patients and care structure. This study evaluates survival and possible predictors in all patients with stage I and II lung cancer adenocarcinoma through the Hospital’s Cancer Registry (HCR), responsible for the State of Sao Paulo’s cancer registry, a geographical area with 40 million inhabitants.MethodsBased on the HCR, an observational study was conducted, including 1,278 patients diagnosed with lung adenocarcinoma at clinical stages (CS) I and II. Sex, age at diagnosis, education, neighbourhood, CS at diagnosis, the time between diagnosis and treatment, 5-year periods in which patients were treated, treatment modality and hospitals where patients were treated were analysed. Cox univariate and multiple regression analyses were used to estimate the hazard ratio (HR).ResultsA total of 1,278 lung cancer patients with clinical lung cancer adenocarcinoma stages I and II were included. About 40.06% of patients did not receive surgery, and only 55.8% started the treatment within 2 months. The majority of the patients were treated in high complexity hospitals, 69%. Five-year overall survival (OS) was 45.6% in CS I and 27.5% in CS II. Patients treated in high complexity centres have lower mortality rates than those treated in Partial Hospital Complexity Centers in Oncology (PHCCO) (adjHR 1.18; 95% CI: 1.00–1.40; P=0.047). Patients diagnosed between 2010–2014 had a protective factor against the risk of death concerning patients diagnosed between 2000–2004.ConclusionsThe 5-year OS has significantly improved as long as the 5-year group analysed. Also, the 5-year OS of the patients treated in high complexity hospitals is higher than those treated in PHCCO.     

Inhibition of granulocyte-mediated release of oxygen free radicals following glutathione depletion

Treatment of granulocytes freshly isolated from the blood of healthy human adult donors with phorone (diisopropylidene acetone) resulted in a clear depletion of intracellular glutathione without affecting cell viability. Upon stimulation of the phagocytes with phorbol myristate acetate (PMA), however, the release of .O2- and H2O2 by glutathione-depleted granulocytes was inhibited by 50 or 95% as compared to control cells, respectively. These findings may be of toxicological importance, as many xenobiotics are known to interact with glutathione (GSH)-dependent cellular defense mechanisms and may thus influence the phagocytic activity of granulocytes.