A comparison of the mandibular index on panoramic and cross-sectional images from CBCT exams from osteoporosis risk group

Osteoporosis is a degenerative disease that primarily affects postmenopausal women. Based on panoramic radiographs, several assessment methods have been proposed for the diagnosis and evaluation of bone changes and as a predictor of osteoporosis for example the mandibular index.

INTRODUCTION

The purpose of this study is to compare the assessment of mandibular indices on panoramic and cross-sectional images.

METHODS

Forty-four cone beam computed tomography (CBCT) images from postmenopausal female subjects aged more than 45 years without systemic changes were selected for this study. From those images, cross-sectional and panoramic reconstruction images were assembled into a template for evaluation. The evaluation was conducted by observing the panoramic images and parasagittal sections. The appearance of the inferior cortex of the mandible was classified according to the mandibular index: C1, the endosteal margin of the cortex was even and sharp; C2, the endosteal margin presented semilunar defects or appeared to form endosteal cortical residues; or C3, the cortical layer formed heavy endosteal cortical residues and was clearly porous.

RESULTS

Based on Wilcoxon statistical test (p > 0.01), the data showed no statistically significant difference between the exams.

CONCLUSION

The mandibular index assigned in tomographic images is comparable to that obtained in panoramic images, indicating a valid use of the index in CBCT images, which can lead to the identification of patients with bone mass loss and a premature referral to further exams and treatment.

Impact of WWOX alterations on p73, ΔNp73, p53, cell proliferation and DNA ploidy in salivary gland neoplasms

OBJECTIVE

WWOX gene is altered in a variety of neoplasms. Wwox is pro-apoptotic through interaction with p73 and may be involved in chromosomal stability by interaction with p73 and p53. The aims of this study were to characterize WWOX transcription, methylation status and immunoexpression in salivary neoplasms and to determine whether these were associated with p73, p53, cell proliferation and DNA ploidy.

MATERIALS AND METHODS

Seven malignant and 21 benign fresh salivary neoplasms were included. WWOX expression was determined by RT-PCR and sequencing of transcripts, quantitative PCR and immunohistochemistry. Methylation-specific PCR was used to assess the methylation of its first exon. For p73, ΔNp73, p53 and ki67 immunohistochemistry and ploidy analysis, 29 malignant samples from archives were included.

RESULTS

No consistent pattern of WWOX exon 1 methylation was found, but aberrant and novel transcripts were observed in 17/28 neoplasms; 55% of tumours showed reduced WWOX RNA. WWOX RNA levels were associated with p53 immunopositivity. Immunohistochemical Wwox expression did not correlate with methylation status, p53 or p73 expression or proliferation. p73, proliferation and DNA ploidy were associated with malignant phenotype.

CONCLUSION

Aberrant WWOX transcription and decreased expression are frequent in salivary neoplasms and WWOX transcription is associated with p53 staining.

Microchimerism in labial salivary glands of hematopoietic stem cell transplanted patients

OBJECTIVE

Microchimerism has been extensively investigated in autoimmune diseases, which display similarities with graft-vs-host disease. This study was conducted to investigate the presence of microchimerism in minor salivary glands of hematopoietic stem cell transplanted patients, one of the targets of graft-vs-host disease.

METHODS

Labial salivary glands biopsy specimens from 11 stem cell transplanted patients were analysed. The samples were grouped in control (five specimens from a female-to-female transplantation) and study group (five glands from male-to-female transplantation). One male transplanted patient was used as a positive control. Fluorescence in situ hybridization with Y-chromosome probe and immunofluorescence with anticytokeratin AE1/AE3 and CD45 were used to identify Y-chromosome positive glandular epithelial cells from allogeneic hematopoietic stem cell transplanted patients.

RESULTS

In the study group, all samples were positive to Y-chromosome and cytokeratin AE1/AE3, in agreement with the pattern exhibited by male labial salivary gland. None of the samples from control group were positive to Y-chromosome despite being positive to cytokeratin AE1/AE3. Positivity to CD45 was not relevant.

CONCLUSION

Microchimerism in the labial salivary glands of sex-mismatched stem cell transplanted patients is a real phenomenon. Further studies are necessary to elucidate the impact of this phenomenon on the clinical status of stem cell transplanted patients.

Herpes simplex virus type 1 shedding in the oral cavity of seropositive patients

OBJECTIVE

Investigate the frequency of herpes simplex virus type 1 (HSV-1) reactivation in the oral cavity of seropositive patients with previous history of recurrent herpes labialis (recrudescent group) compared with those without any history of recrudescent lesions (asymptomatic HSV-1 infection). In addition, the relation between recrudescence and the presence of the virus in the saliva was assessed.

MATERIALS AND METHODS

Fourteen individuals with previous history of herpes labialis (recrudescent group) and 11 HSV-1 seropositive asymptomatic volunteers were included in the study. Swabs were performed periodically in all subjects and the presence of HSV-1 DNA was identified by nested PCR.

RESULTS

All the 25 subjects enrolled in the study, revealed at least one positive swab for HSV-1. The frequency of HSV-1 positivity in the group with recrudescent herpes labialis was not statistically different from the other group. Ten subjects of the recrudescent group presented with herpes labialis at least once during the study.

CONCLUSIONS

HSV-1 shedding in the oral cavity occurs independently of herpes labialis recrudescence.

Risk factors for breast cancer among pre- or post-menopausal women in Belo Horizonte, Brazil

BACKGROUND

Much controversy has been generated about pre- and post-menopausal breast cancer patients and investigators have sought to identify whether risk factors differ between these two groups. In Brazil, breast cancer is an important cause of death among women and there are few analytical studies concerning pre- or post-menopausal comparisons.

METHODS

A case-control study was carried out at the Federal University Hospital, Belo Horizonte, Brazil, to determine if selected socio-economic and reproductive risk factors for breast cancer differed between pre-menopausal and post-menopausal women. Cases were 300 women with breast carcinoma and controls were 600 women with other benign diseases matched for age and date of diagnosis, admitted to the same hospital during the same period (1978-1987). Univariate and multivariate conditional logistic regression analyses were performed.

RESULTS

Multivariate analysis showed no differences in breast cancer risk in pre- and post-menopausal women (risk factors were similar in direction and magnitude). Occupation, irregular menstrual cycles, parity, history of breast cancer in at least one first-degree female relative, and oral contraceptive use had similar associations in both groups.

CONCLUSIONS

The present study indicates that breast cancer diagnosed before and after menopause has a similar risk profile.

Pichia anomala outbreak in a nursery: exogenous source?

BACKGROUND

Pichia anomala is a rare cause of fungemia. From February to April, 1998, eight cases of fungemia occurred in the intensive care and high risk units of the Nursery. There were four infants with P. anomala infection, one of whom also had Candida parapsilosis infection, two cases with C. parapsilosis infection and two with Candida albicans infection.

OBJECTIVE

To determine factors associated with fungemia in the intensive care and high risk units of the Nursery, especially P. anomala.

METHODS

A cohort study with 59 newborns.

RESULTS

Factors associated with fungemia were: central venous catheter (CVC) (P = 0.0006); total parenteral nutrition (TPN) (P = 0.0005); lipid emulsion (P = 0.002); previous antimicrobial use (P = 0.002); and other invasive procedures (P = 0.002). Factors associated with P. anomala fungemia were: CVC (P = 0.004); TPN (P = 0.018); previous antibiotic use (P = 0.037); and other invasive procedures (P = 0.037). Evaluation of the units demonstrated that there were several technical problems involving administration of TPN that was manipulated in the Nursery without precautions. Changes in TPN formulation and education as to adequate technique were implemented. During follow-up (1998 to 1999) only two fungemias occurred that were caused by C. albicans. Cultures of hands of personnel were negative for P. anomala. Electrophoretic karyotyping of P. anomala showed three profiles.

CONCLUSIONS

Factors associated with fungemia were catheter use, invasive procedures and total parenteral nutrition, suggesting that the acquisition of P. anomala was exogenous.

A case-control study of risk factors for breast cancer in Brazil, 1978-1987

BACKGROUND

There are still controversies regarding the role of many risk factors assessed for breast cancer worldwide. In Brazil, it represents a major cause of death among women but yet few analytical studies have been published to date.

METHODS

The association of selected factors with breast cancer was assessed in a case-control study of 300 women, aged 25-75 years, treated at the Federal University Hospital, Belo Horizonte, Brazil, from 1978 to 1987. In all, 300 cases with diagnosed breast carcinoma were compared with 600 controls matched on age and date of diagnosis. Socio-economic, demographic and reproductive factors were analysed.

RESULTS

Multiple logistic regression analysis showed the following factors to be independently associated with increased risk of breast cancer: a) monthly family income (odds ratio [OR] = 1.69, 95% confidence interval [CI]: 1.18-2.42); b) being a housewife (OR = 2.86, 95% CI: 1.83-4.47; c) parity of less than six deliveries and nulliparous women (OR = 5.06, 95% CI: 3.01-8.52 and OR = 2.42, CI: 1.64-3.59, respectively); d) history of breast cancer among first degree female relatives (OR = 9.35, 95% CI: 3.22-27.14); and e) oral contraceptive use (OR = 1.81, 95% CI: 1.15-2.85). Irregular menstrual cycle (OR = 0.44, 95% CI: 0.25-0.75) was associated with breast cancer as a protective effect.

CONCLUSIONS

The study has confirmed most risk/protective factors previously demonstrated elsewhere in the world and provides clear documentation of breast cancer epidemiology in Brazil.

[Nasal rhinosporidiosis in children]

Rhinosporidiosis is a rare fungal disease resulting from infection by Rhinosporidium seeberi. There seems to be a relationship between the disease and agriculture, suggesting that Rhinosporidium lives in soil, and many authors agree that water is a necessary medium of transmission. The sites of infection are the nose (most common), eye, nasopharynx, penile urethra and external ear. Nasal cases generally present obstruction, epistaxis, watery or mucopurulent discharge, presence of tumoral pedunculated polypoid mass, generally with septal implantation. Histological examination presents characteristic sporangia in large numbers and in the submucosa a granulomatous host response. The treatment is by surgical excision (recurrence occurs in 10% of cases), and medical treatment used diaminodiphenylsulfone or Amphotericin B to avoid recurrent cases. We present a case of Rhinosporidiosis in a 10 years-old child, female, with 3 months history of nasal obstruction, epistaxis and presence of nasal mass in left nasal cavity that was submitted to surgical excision.

[Antral choanal polyp--cause of nasal obstruction in children: report of 12 cases]

Nasal obstruction is a common pediatric clinical complaint that involves a great number of pathologies (allergic rhinopathy,adenoid hypertrophy, septal deformities, infectious sinusitis, tumours, choanal atresia, nasal foreign bodies, etc.). Not only the history, and a through physical examination but also, the subsidiary exams are of great value in the etiologic diagnostic. Antro-choanal polyp (Killian's polyp) must be remembered in the differential diagnosis of nasal obstruction, when a sinus roentgenogram with unilateral maxillary opacification is seen. Clinically, the lesion often protrudes into the nasopharynx and in some cases it may even be seen extending into the oropharynx. The surgical procedure usually employed is a unilateral Caldwell-Luc antrostomy, with oropharyngeal remotion. We present 12 pediatric patients with antral-choanal polyps,and discuss history, radiology, nasal/nasopharyngeal endoscopic evaluation, considerations about the origin and surgical treatment of choice.

Button battery as a foreign body in the nasal cavities. Special aspects

Alkaline batteries as foreign bodies in the nasal cavities are dangerous because they can cause liquefaction necrosis with subsequent severe local tissue destruction. Batteries found in the nasal cavities should be removed immediately to prevent sequelae such as septal perforations or nasal meatus stenosis. Due to the common use of these batteries (e.g. watches, electronic toys and games, calculators) physicians and the general public should be more aware of this type of foreign body and the peculiarities in their management. We present five cases of button battery foreign bodies in the nasal cavities and review 12 cases described in the literature and discuss the special aspects of these foreign bodies.