Experimental burns: Comparison between silver sulfadiazine and photobiomodulation / Queimadura experimental: comparativo entre sulfadiazina de prata e fotobiomodulação

Summary Objective: To analyze morphological characteristics and organization of the collagen fibers of third degree burns from scalding compared to laser therapy and silver sulfadiazine, the latter considered as the gold standard. Method: Were selected 12 animals (Rattus norvegicus) also divided into three groups (control group [CG] - untreated burns; sulfadiazine group [SG] - burns were treated with silver sulfadiazine at 1%; laser group [LG] - burns were treated with photobiomodulation). The scald burns were carried out by using PVC mold, and the material collected on the 14th day after burn was prepared for morphological and optical retardation analysis for evaluation of inflammatory infiltrates and collagen organization, respectively. Results: On the 14th day, the laser and sulfadiazine groups had mild inflammatory response, while the control group showed an intense inflammatory process, with statistical significance between laser and control groups, but not between sulfadiazine and control groups. Laser and sulfadiazine groups no longer had granulation tissue, opposite to what was seen in the control group. The presence of hair follicles and ulcer did not significantly differ between groups. The optical retardation of collagen fibers was higher in sulfadiazine group, followed by laser and control groups. As for systemic effect, we were able to identify it by simply analyzing the presence or absence of granulation tissue. Conclusion: Morphologically, the laser or silver sulfadiazine treatments were similar and both provided better organization of collagen fibers in relation to the untreated group. However, the sulfadiazine group modulated the deposition of collagen fibers more efficiently than the laser group.

Resumo Objetivo: Analisar características morfológicas e organização das fibras colágenas de queimaduras de terceiro grau provocadas por escaldo em relação à terapia com laser e àquela considerada padrão-ouro, a sulfadiazina de prata. Método: Foram selecionados 12 animais (Rattus norvegicus), divididos igualmente em três grupos (grupo controle [GC] - queimaduras não tratadas; grupo sulfadiazina [GS] - queimaduras tratadas com sulfadiazina de prata 1%; grupo laser [GL] - queimaduras tratadas com fotobiomodulação). As queimaduras foram realizadas por escaldo com a utilização de molde de PVC, e o material coletado no 14º dia pós-queimadura foi preparado para análise morfológica e de retardo óptico, para avaliação do infiltrado inflamatório e da organização do colágeno, respectivamente. Resultados: No 14º dia, os grupos laser e sulfadiazina apresentaram resposta inflamatória leve, enquanto o grupo controle apresentou processo inflamatório intenso, havendo significância estatística entre os grupos laser e controle, mas não entre os grupos sulfadiazina e controle. Enquanto os grupos laser e sulfadiazina não apresentavam mais tecido de granulação, o grupo controle ainda apresentava. A presença de folículo piloso e de úlcera não diferiu significantemente entre os grupos. O retardo óptico das fibras colágenas foi maior no grupo sulfadiazina, seguido dos grupos laser e controle. Apenas a análise da presença ou ausência de tecido de granulação permitiu identificar o efeito sistêmico. Conclusão: Morfologicamente, os tratamentos com laser ou sulfadiazina de prata foram similares e ambos proporcionaram maior organização das fibras colágenas em relação ao grupo não tratado. Entretanto, o grupo sulfadiazina modulou a deposição das fibras colágenas mais eficientemente que o grupo laser.

Use of low-power laser to assist the healing of traumatic wounds in rats

PURPOSE: To investigate the morphological aspects of the healing of traumatic wounds in rats using low-power laser. METHODS: Twenty four non isogenic, young adult male Wistar rats (Rattus norvegicus) weighing between 200 and 300g was used. The animals were randomly distributed into two groups: Control (GC) and Laser (GL), with 12 animals each. After shaving, anesthesia was performed in the dorsal region and then a surgical procedure using a scapel was carried out to make the traumatic wound. GL received five sessions of laser therapy in consecutive days using the following laser parameters: wavelength 660 nm, power 100 mW, dose 10 J/cm2. The wounds were evaluated through measurement of the area and depth of the wound (MW) and histological analysis (HA). RESULTS: When comparing the GC with the GL in MW there was a difference in area (p<0.001) and depth (p=0.003) measurement of the wounds in GL. The laser group presented more epithelization than GC (p=0.03). The other histological parameters were similar. CONCLUSION: The healing of wounds in rats was improved with the use of the laser. .

Efeito da natação na expressão de fatores regulatórios miogênicos durante o reparo do musculoesquelético de rato / Swimming influence on the expression of myogenic regulatory factors during skeletal muscle repair of rats

CONTEXTUALIZAÇÃO: O músculo esquelético tem a capacidade de adaptação frente a estímulos variados, tais como atividade contrátil, danos diretos e indiretos. Uma das modalidades terapêuticas utilizadas na reabilitação de disfunções musculoesqueléticas que vem demonstrando resultados positivos no tratamento e na prevenção de várias patologias é a terapia aquática. OBJETIVO: Analisar o efeito da natação na expressão dos fatores regulatórios miogênicos MyoD e miogenina durante o reparo do músculo esquelético de rato após criolesão. MÉTODOS: Foram utilizados 40 ratos Wistar, divididos em 04 grupos: (1) Controle; (2) "Sham" (sem lesão, submetido a exposição do músculo tibial anterior (TA); (3) Criolesionado e (4) Criolesionado e submetido à natação, analisados em 7, 14 e 21 dias. A criolesão foi realizada por meio de duas aplicações, utilizando um bastão metálico de extremidade plana, resfriado em nitrogênio líquido diretamente no ventre muscular. O protocolo consistiu de sessões de natação com duração de 90 minutos, realizadas 6 vezes por semana. Ao término do protocolo os animais foram eutanasiados, os músculos TA foram removidos e o RNA total foi extraído. Em seguida, foi obtido o cDNA para a realização do PCR em tempo real utilizando primers específicos para MyoD e miogenina. RESULTADOS: Os resultados evidenciaram uma redução na expressão de miogenina após 7 dias nos grupos criolesionado com (p<0.01) e sem (p<0.01) natação e após 14 no grupo criolesionado com natação (p<0.05) com relação aos grupos controle e "sham", respectivamente. Não encontramos diferenças entre os grupos criolesionados com (p>0.05) e sem natação (p>0.05). Com relação à expressão de MyoD não houve diferença entre os grupos avaliados. CONCLUSÃO: A natação não influenciou a expressão dos fatores regulatórios miogênicos durante o processo de reparo de músculo esquelético de rato após criolesão.

BACKGROUND: Skeletal muscle has the ability to adapt to several stimuli, such as contractile activity as well as direct and indirect damage. Aquatic therapy has been used in the rehabilitation of musculoskeletal disorders. In addition, it has demonstrated positive results in the therapeutic process and preventing several diseases.. OBJECTIVE: The aim of the present study was to analyze the effect of swimming on the expression of the myogenic regulatory factors MyoD and myogenin during the skeletal muscle repair process in rats following cryoinjury. METHODS: Forty Wistar rats were randomly divided into four groups: 1) Control; 2) Sham - non-muscle damaged, submitted to procedure for exposure of the tibialis anterior (TA) muscle; 3) Cryoinjured; and 4) Cryoinjured and submitted to swimming. Analyses were carried out at 7, 14 and 21 days. Cryoinjury was performed with two applications of the flat end of a metal rod previously cooled in liquid nitrogen directly to the belly of the TA muscle. The protocol consisted of 90-minute swimming sessions six times a week. At the end of the protocol, the animals were euthanized and the TA muscles were removed. Total RNA was extracted using the TRIzol reagent. Next, cDNA was obtained to perform real-time PCR using specific primers for MyoD and myogenin. RESULTS: The results showed a reduction in the expression of myogenin in the groups cryoinjury with p<0.01and without p <0.01 swimming after 7 days, and in group cryoinjury with swimming (p<0.05) after 14 days respect to the control groups and "sham", respectively. There were no differences between groups cryoinjury with (p> 0.05) and without (p>0.05) swimming. Regarding the expression of MyoD there was no difference between the groups. CONCLUSION: Swimming did not affect the expression of myogenic regulatory factors during the skeletal muscle repair process in rats following cryoinjury.

La práctica restaurativa atraumática: una alternativa dental bien recibida por los niños / Atraumatic restorative treatment: a dental alternative well-received by children

El presente estudio se propuso comparar la práctica restaurativa atraumática (PRAT) con el método tradicional (MT) rotacional, con el objetivo de determinar en ambos casos el tiempo total del procedimiento, el costo, la presencia de dolor y el comportamiento en pacientes pediátricos de Perú. De los 30 niños y niñas seleccionados para el estudio, la mitad fueron sometidos a la PRAT y restauración con cemento de ionómero de vidrio y la otra mitad fueron tratados con el MT y restauración con amalgama. Los parámetros de análisis fueron los tiempos necesarios para remover el tejido cariado y el procedimiento operatorio total, el costo total del procedimiento, la manifestación de dolor y el comportamiento del paciente durante el tratamiento. Se hallaron diferencias significativas entre ambas técnicas en todos los parámetros, excepto en el comportamiento del paciente. Si bien la remoción del tejido cariado con el MT fue más rápida, el procedimiento completo fue más rápido en la PRAT, que además resultó significativamente menos costosa y menos dolorosa que el MT. Los resultados indicaron que la PRAT es una muy buena alternativa por su bajo costo y aceptación por parte de los niños.

The purpose of this study is to compare atraumatic restorative treatment (ART) with the conventional rotational restorative method (CM) to determine in both cases the total time required for the procedure, the cost, the presence of pain, and the behavior of pediatric patients in Peru. Of the 30 children selected for the study, half received ART and restoration with glass ionomer cement and the other half, CM and restoration with amalgam. The study parameters were the times required to remove the decayed tissue and to complete the entire procedure, the total cost of the procedure, the presence of pain, and the patient's behavior during treatment. Significant differences were found between the two techniques in all parameters, except for the patient's behavior. Although removing the decayed tissue was faster with the CM, the entire procedure was faster with ART, which, moreover, was significantly less expensive and less painful than the CM. The results indicated that ART is a very good alternative due to its low cost and acceptance by the children.

Response of peripheral blood mononuclear cells to conditioned medium from cultured oral squamous cell carcinomas

The current study investigated the capacity for tumor factors secreted by head and neck squamous cell carcinoma (HNSCC) cell lines, KB, KB16, and HEP, to induce the secretion of various cytokines from peripheral blood mononuclear cells (PBMCs). PBMCs were isolated from blood samples collected from six healthy volunteers and these cells were incubated for 6, 24, 48, or 72 hours in the presence of 50 percent conditioned medium collected from cultured cell lines pretreated with, or without, stimulants such as phytohemagglutinin (PHA) or lipopolysaccharides (LPS). Aliquots of each supernatant were then assayed for levels of IFN-Γ, vascular endothelial growth factor (VEGF), TNF-α, and IL-4 using enzyme linked immunosorbent assays (ELISAs). Data collected were analyzed using Student's t-test, an ANOVA test followed by Tukey's test, and tests of Pearson's Correlation. PBMCs cultured with KB16-conditioned medium produced the highest levels of IFN-Γ. VEGF was also detected in conditioned media collected from all of the squamous cell carcinoma (SCC) cell lines used, and a significant difference in VEGF levels between control and KB- or KB16-conditioned media was observed. TNF-α was secreted by all PBMC groups within 6 hours of receiving conditioned media, and these levels increased up to the 24 hour timepoint, after which levels of TNF-α stabilized. In contrast, none of the supernatant samples contained detectable levels of IL-4. In combination, these data suggest that direct contact between fresh human PBMCs and conditioned media from tumor cells induces the secretion of TNF-α and VEGF by PBMCs, and this represents an initial angiogenic response.

Healing properties of papain-based gel on oral ulcers

The oral mucous membrane is prone to developing ulcers originating from traumatic or immunological processes. Aim: The aim of the present study was to perform a histological evaluation of the antiinflammatory and healing properties of PapacarieTM applied to oral ulcers. Methods: Fifty adult female albino Wistar rats were randomly separated into two groups: control and PapacarieTM. The animals were anesthetized, placed in prone position and ulcers were induced in the middle dorsum of the tongue through a 3-mm-diameter punch. The control group received no treatment thereafter, while those in the PapacarieTM group received an application of the gel twice a day for 14 days. Five animals from each group were euthanized on days 1, 3, 5, 7 and 14. The tongues were removed, fixed, routinely processed for hematoxylin-eosin staining and analyzed by two blind, calibrated pathologists for the presence or absence of ulcer, inflammatory infiltrate and neutrophils. Data were submitted to statistical analysis by the Fisher’s exact test. Results: On day1, both groups exhibited ulceration and dense acute inflammatory infiltrate. On day 5, reepithelization and scanty chronic inflammatory infiltrate were observed. On day 14, all animals were healed. There were no statistically significant differences between groups with regard to ulceration (p=0.81), inflammation (p=0.55) or neutrophils (p=0.53). Conclusions: Oral ulcers treated with a papain based gel exhibited the same inflammatory reaction and healing aspects as those of the nontreated control group.

Pulp capping materials exert an effect on the secretion of IL-1β and IL-8 by migrating human neutrophils

Pulp repair is a complex process whose mechanisms are not yet fully understood. The first immune cells to reach the damaged pulp are neutrophils that play an important role in releasing cytokines and in phagocytosis. The objective of this study was to analyze the effect of different pulp-capping materials on the secretion of interleukin-1 beta (IL-1β) and interleukin-8 (IL-8) by migrating human neutrophils. Neutrophils were obtained from the blood of three healthy donors. The experimental groups were calcium hydroxide [Ca(OH)2], an adhesive system (Single Bond), and mineral trioxide aggregate (MTA). Untreated cells were used as control. Transwell chambers were used in performing the assays to mimic an in vivo situation of neutrophil chemotaxis. The pulp-capping materials were placed in the lower chamber and the human neutrophils, in the upper chamber. The cells were counted and the culture medium was assayed using ELISA kits for detecting and quantifying IL-1β and IL8. The data were compared by ANOVA followed by Tukey's test (p < 0.05). The secretion of IL-8 was significantly higher in all groups in comparison to the control group (p < 0.05). The adhesive system group showed higher IL-8 than the MTA group (p < 0.05). The secretion of IL-1β was significantly greater only in the MTA group (p < 0.001). It was concluded that only MTA is able to improve the secretion of IL-1β, and all materials tested increased IL-8 secretion. These results combined with all the other biological advantages of MTA indicate that it could be considered the material of choice for dental pulp capping.

Estudo do grau de polarização linear em lesões de pele irradiadas com laser durante o processo de cicatrização / Study of linear polarization degree in skin lesions irradiated with laser during the healing process

Introdução: Alguns dos fatores determinantes na resposta fotobiológica da terapia laser em baixa intensidade são o estado fisiológico do tecido e as características ópticas do feixe, como a polarização de seu campo elétrico. Objetivos: Investigaram-se o grau e a preservação da polarização linear em amostras de pele de rato sadia e lesionada. Métodos: Criolesões foram realizadas no dorso de ratos e tratadas por quatro dias com 1J/cm2. O campo elétrico do laser foi alinhado a 0º e a 90º em relação à coluna vertebral dos animais. Resultados: A polarização foi mantida nas camadas superficiais da pele, sendo mais preservada na pele queimada. Durante o processo cicatricial, a lesão cujo campo elétrico foi alinhado a 0º em relação à coluna vertebral mostrou um grau de polarização semelhante àquele da pele sadia. Conclusões: O processo de reparação da pele foi influenciado pela polarização linear do feixe laser de He-Ne.

Introduction: The physiological conditions of tissue and optical characteristics of beam, like electric polarization, are some of the determining factors in the photobiological response of low intensity laser therapy. Objectives: The degree and preservation of linear polarization in samples of healthy and injured rat skin were investigated. Methods: Cryolesions were created in the lower back of rats and treated for four days with 1J/cm2. The laser electric was aligned in 0º and 90º to the backbone of the animals. Results: The polarization was maintained in the superficial layers of the skin, being better preserved in burned skin. During the wound healing, the lesion whose electric was aligned parallel to the spine showed a degree of bias similar to that of healthy skin. Conclusions: The repair process of skin was influenced by linear polarization of He-Ne laser beam.

Keratoacanthoma of the lower lip: still a matter of diagnosis / Ceratoacancoma do lábio inferior: ainda um problema de diagnóstico

Introduction: Keratoacanthoma is a lesion that may mimic squamous cells carcinoma clinically and histologically and the distinction between both lesions has been a matter of discussion. Typical lesions consist of a firm dome-shaped nodule, 1 to 2 centimeters in diameter, with a horn-filled crater in its center. Objectives: To present it was selected an atypical case of a 43-year-old woman who had a solitary keratoacanthoma (KA) of the lower lip with a history of two years of evolution and mistreatment and to discuss the difficulties of the diagnosis process. Conclusion: Because of the rarity of the lesion and its similarity with squamous cells carcinoma the general dentist must explain to the patient that the clinical aspects are not conclusive of the diagnosis and a correct acquisition of the surgical specimen is crucial to an accurate histopathological interpretation and conclusive diagnosis.

Introdução: O ceratoacantoma é uma lesão que pode mimetizar clínica e histologicamente o carcinoma espinocelular, sendo discutível a distinção entre as duas lesões. As lesões típicas consistem em um nódulo firme, em forma de cúpula, com 1 a 2 centímetros de diâmetro e uma cratera central preenchida com queratina. Objetivo: Apresentar um caso atípico de uma mulher de 43 anos que apresentava uma lesão solitária de queratoacantoma no lábio inferior, com uma história de dois anos de evolução e erros de tratamento e discutir a dificuldade no processo de diagnóstico. Conclusão: Devido à raridade da lesão e sua semelhança com o carcinoma, o clínico geral deve explicar ao paciente que os aspectos clínicos não são conclusivos do diagnóstico e que a aquisição correta do espécime cirúrgico são cruciais para a análise histopatológica correta e para o diagnóstico conclusivo.

Enxertia óssea e bases biológicas e aplicações clínicas / Boné Graft and biological basis and clinical approaches

A utilização de técnicas de enxertia óssea previamente à instalação de implantes osseointegráveis representa, em muitas situações clínicas, uma prática indispensável para o sucesso das reabilitações protéticas sobreimplante. O conhecimento sobre as bases biológicas que norteiam a cicatrização óssea e sobre o potencial reparador dos diferentes biomateriais utilizados na clínica odontológica torna-se, portanto, pré-requisito fundamental ao implantodontista

Imunomarcação da p63 em carcinoma espinocelular de boca e orofaringe e comparação com os graus de malignidade / Immunolabelling of p63 in oral and oropharyngeal squamous cell carcinoma and comparison with the degree of differentiation

Introdução: o carcinoma espinocelular (CEC) é a neoplasia maligna mais freqüente da cavidade oral e, apesar dos avanços dos métodos de diagnóstico, a sobrevida ainda é menor que 50%. Marcadores tumorais têm sido pesquisados no intuito de obterem-se informações mais precisas sobre o prognóstico dos pacientes e a proteína p63 é uma das candidatas a desempenhar esse papel. Objetivo: avaliar, por meio de análise imunoistoquímica, a possível associação entre a expressão da p63 e os graus de malignidade de carcinomas de boca e orofaringe. Material e Método: Foram selecionados 14 casos de CEC de boca e orofaringe dos arquivos de dois Serviços de Cirurgia de Cabeça e Pescoço e os cortes obtidos a partir dos blocos de parafina submetidos à análise imunoistoquímica. Os tumores foram classificados em alto e baixo grau de malignidade e os escores comparados com a imunomarcação da p63. Resultados: Seis casos (43%) foram classificados como de baixo grau e, destes, quatro positivos e dois negativos para a p63, enquanto oito casos (57%) classificados como de alto grau, três foram positivos e cinco negativos para p63. Conclusão: houve uma tendência da proteína p63 ser expressa nos tumores com melhor diferenciação, todavia, maior número de casos e estudo em separado das isoformas da p63 são necessários para confirmar esses resultados.

Introduction: Squamous cell carcinoma (SCC) is the most frequent malignant neoplasm of the oral cavity and oropharynx and albeit the advances in diagnosis, the overall survival of the patients is less than 50%. Tumoral markers have been searched in order to obtain more precise information on the prognosis of the patients and p63 protein is one of the candidates do play this role. Objective: to evaluate immunohistochemically the putative association between the expression of p63 protein and the malignity degrees of oral cavity and oropharynx carcinomas. Materials and methods: 14 cases of SCC of oral cavity and oropharynx were selected from the archives of two services of Head and Neck Surgery and the specimens obtained from paraffin blocks underwent imunohistochemical analyzes. The tumors were classified in high or low degree of malignity and the scores compared with the immunolabelling of p63. Results: 6 cases (43%) were classified as low degree and from these, 4 were positive and 3 negative to p63 labelling. The other 8 cases (57%) were classified as high degree and from these, 3 were positive and 5 negative to p63 protein. Conclusion: there was a trend of the p63 protein to be expressed in tumors with higher differentiation, although to confirm these results a higher number of specimens, as well as a study of the different isoforms of the protein are necessary.

Apresentação incomun de paracoccidioidomicose língual / Unusual presentation of tongue paracoccidioidomycosis

A paracoccidioidomicose é uma infecção micótica sistêmica causada pelo fungo dimórfico Paracoccidioides brasiliensis (P. brasiliensis), podendo causar doença severa. No Brasil é a micose sistêmica mais comun, mas o envolvimento da língua não é freqüente e, se presente, costuma ser secundário a outros sítios, especialmente os pulmões.O objetivo deste trabalho é apresentar o caso clínico de um paciente do sexo masculino, 43 anos, caucasiano, proveniente de região rural com contato com gado de leite. Clinicamente o paciente apresentava lesão ulcerada dolorosa na parte posterior da borda lingual direita, posteriormente diagnosticada como paracoccidioidomicose. Os autores discutem as características clínicas da lesão, mortalidade no Brasil, papel da resposta imunológica e formas de tratamento atuais.

Estudo in vitro do efeito da molécula de adesäo neural (N-CAM) na invasäo de células do carcinoma adenóide cístico / In vitro study of neural cell adhesion molecule in the invasion of adenoid cystic carcinoma cell line

O carcinoma adenóide cístico (CAC) de glândulas salivares caracteriza-se por comportamento agressivo, alto índice de recidivas locais e metástases. Nosso objetivo foi verificar se células cultivadas do CAC (linhagem CAC2) apresentariam capacidade invasiva in vitro e se a molécula de adesäo neural (N-CAM) participaria desse mecanismo. Utilizamos ensaios de invasäo com câmaras bipartite Transwell, que, apesar de clássicos para a análise da atividade de invasäo tumoral, näo têm sido utilizados em estudos de neoplasias de glândulas salivares. Estudamos 6 grupos experimentais: em 3 as células CAC2 näo receberam pré-tratamento (G1-G3) e nos outros 3 as células foram previamente tratadas por anticorpo específico anti-N-CAM (G4-G6). Para os ensaios, na câmara inferior do Transwell foram colocados: meio de cultivo fresco (G1 e G4) ou meio condicionado por células PC12 diferenciadas (G2 e G5) ou meio contendo fator de crescimento neural (NGF- G3 e G6). Um total de 10(5) células CAC2 foram dispensadas sobre filtros previamente cobertos com Matrigel. As células que invadiram os filtros nas primeiras 8 horas foram contadas sob microscópio de luz para a obtençäo do índice de invasäo (porcentagem). Células CAC2 controles apresentaram índice de invasäo de 5,28 ñ 0,04 por cento. O fator de crescimento neural elevou a invasäo para 6,90 ñ 0,18 por cento (p<0,001). O bloqueio da molécula de adesäo neural aumentou significantemente a invasäo das células CAC2 (6,90 ñ 0,18 por cento, p<0,001)