Optochiasmatic tuberculoma as the sole manifestation of late recurrent tuberculosis

Brain tuberculomas account for 10-20% of space occupying brain lesions in developing countries. Most lesions are observed at time of tuberculosis diagnosis or soon after starting treatment. We herein describe a 32 year-old patient with a 14-month history of headache and progressive visual loss. Her past medical history revealed pulmonary tuberculosis treated eight years before. A brain MRI showed a T1- and T2-weighted isointense contrast-enhancing lesion in the optic chiasm. A presumptive diagnosis of optochiasmatic tuberculoma was made and isoniazid, rifampin, pyrazinamide, and ethambutol were started. Despite treatment, the patient evolved to blindness. The prompt recognition of this condition is extremely important since the presence of optochiasmal enhancement is associated with blindness in patients with tuberculosis.     

Healing of donor defect after mandibular parasymphyseal block harvesting: A 6-year computerized tomographic follow-up

ObjectivesA long-term survey on the healing potential of large-sized parasymphyseal osseous defects.Patients and methodsTen patients, subjected to 14 bilateral and 3 unilateral parasymphyseal bone harvesting for alveolar ridge augmentation, were selected for the retrospective chart review. CT scans were performed immediately before bone grafting, before implant insertion, and then once annually for 6 years, and the volumes of the bone defects at the buccal aspect in the healing process were measured using a software program. Volumes from the yearly measurements were then compared statistically.ResultsVolumes of both the intrasurgical defects, 0.77 (0.20) cc and of those in the one-year group, 0.60 (0.26) cc were statistically different from volumes of all the other time intervals (from 24 to 72 months) with all p-values less than 0.002 and 0.004, respectively. The healing of osseous defects in the long-term radiographic survey (6 years) resulted in bony infill of 63%.ConclusionFor parasymphyseal defects of 0.7 cc, a maximum possible healing of two-thirds can be expected; a re-harvesting procedure could be performed 24 months after early surgery, due to both the formation of a new buccal cortical plate and the achievement of a steady state of osseous remodelling.     

Degree of conversion of nanofilled and microhybrid composite resins photo-activated by different generations of LEDs

Objective

This study aimed at evaluating the degree of conversion (DC) of four composite resins, being one nanofilled and 3 microhybrid resins, photo-activated with second- and third-generation light-emitting diodes (LEDs).

Material and methods

Filtek^TM Z350 nanofilled composite resins and Amelogen^® Plus, Vit-l-escence^TM and Opallis microhybrid resins were photo-activated with two second-generation LEDs (Radii-cal and Elipar Free Light^TM 2) and one third-generation LED (Ultra-Lume LED 5) by continuous light mode, and a quartz halogen-tungsten bulb (QHT, control). After 24 h of storage, the samples were pulverized into fine powder and 5 mg of each material were mixed with 100 mg of potassium bromide (KBr). After homogenization, they were pressed, which resulted in a pellet that was evaluated using an infrared spectromer (Nexus 470, Thermo Nicolet) equipped with TGS detector using diffuse reflectance (32 scans, resolution of 4 cm^-1) coupled to a computer. The percentage of unreacted carbon-carbon double bonds (% C=C) was determined from the ratio of absorbance intensities of aliphatic C=C (peak at 1637 cm-1) against internal standard before and after curing of the specimen: aromatic C-C (peak at 1610 cm-1).

Results

The ANOVA showed a significant effect on the interaction between the light-curing units (LCUs) and the composite resins (p<0.001). The Tukey''s test showed that the nanofilled resin (Filtek^TM Z350) and Opallis when photo-activated by the halogen lamp (QTH) had the lowest DC compared with the other microhybrid composite resins. The DC of the nanofilled resin (Filtek^TM Z350) was also lower using LEDs. The highest degrees of conversion were obtained using the third-generation LED and one of second-generation LEDs (Elipar Free Light^TM 2).

Conclusions

The nanofilled resin showed the lowest DC, and the Vit-l-escence^TM microhybrid composite resin showed the highest DC. Among the LCUs, it was not possible to establish an order, even though the second-generation LED Radii-cal provided the lowest DC.     

Sealability of MTA and calcium hydroxidecontaining sealers

Objectives

The aim of this study was to evaluate the apical sealability of Fillapex^®, Endo-CPM-Sealer^® and Sealapex^®.

Material and Methods

Ninety-four freshly extracted single-rooted teeth were selected and decoronated. All teeth were radiographed to confirm the existence of a single and straight root canal, which was prepared using Protaper Universal and 2.5% sodium hypochlorite. The teeth were randomly divided in groups of 10 specimens each according to the sealer, and the canals were filled using the single cone technique and one of the sealers. Four additional teeth were used as controls. The teeth were submitted to dye leakage with Rhodamine B for 24 h but using vacuum on the initial 15 min. Thereafter, they were cut longitudinally and the leakage was measured in a linear fashion from apex to crown. Data were analyzed by ANOVA and Tukey''s tests at 5% significance level.

Results

Fillapex^® and Sealapex^® showed significantly less dye leakage than Endo-CPM-Sealer^® (p<0.05).

Conclusions

It was concluded that Fillapex^® and Sealapex^® were able to prevent apical dye leakage differently from Endo-CPM-Sealer^®.     

Vascular endothelial dysfunction in Duchenne muscular dystrophy is restored by bradykinin through upregulation of eNOS and nNOS

Little is known about the vascular function and expression of endothelial and neuronal nitric oxide synthases (eNOS and nNOS) in Duchenne muscular dystrophy (DMD). Bradykinin is involved in the regulation of eNOS expression induced by angiotensin-converting enzyme inhibitors. We characterized the vascular function and eNOS and nNOS expression in a canine model of DMD and evaluated the effects of chronic bradykinin treatment. Vascular function was examined in conscious golden retriever muscular dystrophy (GRMD) dogs with left ventricular dysfunction (measured by echocardiography) and in isolated coronary arteries. eNOS and nNOS proteins in carotid arteries were measured by western blot and cyclic guanosine monophosphate (cGMP) content was analyzed by radioimmunoassay. Compared with controls, GRMD dogs had an impaired vasodilator response to acetylcholine. In isolated coronary artery, acetylcholine-elicited relaxation was nearly absent in placebo-treated GRMD dogs. This was explained by reduced nNOS and eNOS proteins and cGMP content in arterial tissues. Chronic bradykinin infusion (1 μg/min, 4 weeks) restored in vivo and in vitro vascular response to acetylcholine to the level of control dogs. This effect was NO-mediated through upregulation of eNOS and nNOS expression. In conclusion, this study is the first to demonstrate that DMD is associated with NO-mediated vascular endothelial dysfunction linked to an altered expression of eNOS and nNOS, which can be overcome by bradykinin.