Analysis of the biocompatibility of a biocelulose and a poly L- lactic acid membrane

The use of selective barriers as resorbable membranes has become a routine clinical procedure for guided bone regeneration. Therefore, the production of membranes with a low inflammatory potential during their resorption process has become the goal of a considerable number of researches. Aim: The purpose of the present study was to evaluate the biocompatibility of poly (L- lactic acid) (PLLA) and biocelulose membranes (BC) inserted in the subcutaneous tissue on the dorsum of rats. Methods: Fifteen animals underwent surgical procedures for the insertion of 4 types of membranes: COL (Collagen membrane) ­ Control Group; BC (Biocellulose membrane); BCAg (Biocellulose membrane impregnated with Silver); PLLA (Poly (L-lactic acid) membrane). All membrane types were inserted into each animal. Animals were euthanized after 3, 7, and 15 days of the surgical procedure. Descriptive histological analyses were carried out to investigate host tissue reaction to membrane presence by assessing the anti-inflammatory process composition associated with the membrane resorption and the presence of foreign-body reaction or encapsulation. Results: The BC membranes showed a higher degree of inflammation and poor pattern of integration with the surrounding tissues than the PLLA and COL membranes. Conclusion: The PLLA and COL membranes present better biocompatibility than the BC membranes

Angiosarcoma radioinducido de mama: reporte de caso / Radioinduced angiosarcoma of the breast: Case report / Angiossarcoma radioinduzido de mama: reporte de caso

El angiosarcoma es un tumor vascular maligno poco frecuente. Constituye menos del 2% de todos los sarcomas. Existen varias formas clínicas, una es la producida después de radioterapia, en pacientes que fueron tratadas por un cáncer de mama, con cirugía conservadora y radioterapia. Se presenta como un sarcoma de alto grado, localizado en la piel o en el tejido subcutáneo y, ocasionalmente, el parénquima mamario. El único tratamiento curativo es la cirugía, con tendencia a la recurrencia y a hacer metástasis hematógena, el pronóstico es malo, con alta tasa de mortalidad.

Angiosarcoma is a rare malignant vascular tumor. It constitutes less than 2% of all sarcomas. There are several clinical forms; the one produced after radiation therapy is that associated with patients who were treated for breast cancer with conservative surgery and radiation therapy. It presents as a high-grade sarcoma located on the skin or the subcutaneous tissue and, occasionally, the breast parenchyma. The only curative treatment is surgery, with a tendency to recurrence and visceral hematogenous metastasis, with a poor prognosis and a high mortality rate.

El angiossarcoma é um tumor vascular maligno pouco frequente. Constitui menos de 2% de todos os sarcomas. Existem várias formas clínicas, uma é a produzida depois da radioterapia, em pacientes que foram tratadas por um câncer de mama, com cirurgia conservadora e radioterapia. Se apresenta como um sarcoma de alto grau, localizado na pele ou no tecido subcutâneo e, ocasionalmente, o parênquima mamário. O único tratamento curativo é a cirurgia, com tendência à recorrência e a fazer metástasehematogênica, o prognóstico é mau, com alta taxa de mortalidade.

The characterization of a hospitalized population at the pediatric emergency service of mother and child hospital, Marrakech, Morocco

Introduction: the pediatric emergency department is the first contact between the population and the hospital. Consequently, its dysfunction influences the quality of general health care. However, any successful policy must first be based on convincing results hence the need to better explore this service, diagnose the various dysfunctions, and survey disease trends to identify the needs of the local population. In this perspective, we propose to describe the epidemiological profile of children hospitalized at the emergency service of the Mother-Child hospital, University Hospital Centre Marrakech, and establish the prevalence table for childhood pathologies. Methods: a retrospective study was carried out in pediatric emergency services for 1658 hospitalized patients between March 2015 and December 2018. The collected data concerns mainly the socio-demographic, clinical profile, evolution status, mode of admission, and medical history. Results: the characterization of the studied population by sex and age showed a predominance of Male with a sex ratio of 1.36, infants with 625 patients. Concerning the final diagnosis, the most frequent pathologies affected the respiratory system in 28% of cases, then the digestive system (11.3%), while infectious pathologies represented 10.7% of admissions. The death rate in the emergency department was 7.4%. Multivariate analysis of the data showed a statistically significant relationship between the final diagnosis (16 diseases by a system according to The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) and age, season, and weight. Thus, for the association between Diseases of the digestive system and weight (aOR=1.052, 95% CI= 1.019-1.086, p=0.02). While for Diseases of the skin and subcutaneous tissue and the autumn season (aOR=11.37, 95% CI= 1.272-<101.777, p=0.03) and age has a negative significance for most diseases. Conclusion: the epidemiological profile study will allow knowledge of patient´s pathologies typology for a well-supported and better definition of needs.

Cutaneous leiomyosarcoma: a 20-year retrospective study and review of the literature

Abstract Background: Cutaneous leiomyosarcoma is a rare malignant neoplasm with muscular origin, representing 2%-3% of all cutaneous soft tissue sarcomas. Objectives: The aim of this study was to characterize clinicopathological features of patients diagnosed with cutaneous leiomyosarcoma in our center over the last 20-years. Methods: A retrospective study of patients with a histopathological diagnosis of leiomyosarcoma between 1999 and 2018 was conducted. Results: Eleven patients were diagnosed with cutaneous leiomyosarcoma during this period. Most cases occurred in men (n = 7). Age at presentation ranged from 47 to 92 years (mean 64.9 years). Head and neck were the most frequently involved locations (n = 5). Ten leiomyosarcoma were dermal, with one cutaneous metastasis. Immunohistochemical staining was available for 7 patients, demonstrating positivity for smooth muscle actin in all of them. All neoplasms were treated surgically. Mean survival was 32.2-months. Study limitations: This was a retrospective study based on medical and pathological records. Conclusions: Histopathology is essential for the diagnosis of leiomyosarcoma, usually revealing a dermal or subcutaneous lesion composed of intertwined fascicles of smooth muscle fibers. Immunohistochemistry is then used to adequately differentiate leiomyosarcoma from other spindle cell tumors. When dealing with cutaneous leiomyosarcoma, it is advisable to carefully evaluate the depth of subcutaneous extension, since even minimal subcutaneous involvement may be associated with a poorer prognosis.

Photosensitizers and exposure times to light showed tissue compatibility in isogenic mice / Fotossensibilizadores e tempo de exposição a luz em relação a compatibilidade de tecidos em ratos isogênicos

Objective: The aim of this study was to evaluate the subcutaneous tissue response after different protocols to photodynamic therapy (PDT). In Phase 1, were tested the diode laser (used for 1min) associated to the photosensitizer phenothiazine chloride solution (PCS) in different concentrations. In Phase 2 ­ the diode laser and LED were tested associated to two different photosensitizers, PCS and Curcumin, in different exposure times of light application. Material and Methods: After 7, 21 and 63-days the animals were euthanized and the subcutaneous tissue processed to histological analysis. Qualitative and semi-quantitative descriptions of the inflammatory process and immunohistochemical technique were performed. The obtained data were analyzed by Kruskal-Wallis and Dunn's post-test (α= 0.5). Results: On Phase 1, the tissue response was very similar among the groups. For the inflammatory infiltrate, PCS with concentration of 10mg/mL exhibited the most intense reaction (p > 0.05). On Phase 2, at 7-days period, the analyzed parameters presented small magnitude and after 21 and 63-days, all the parameters demonstrated tissue compatibility. Conclusion: Both photosensitizers presented proper tissue compatibility regardless the different concentrations used on Phase 1 and different durations of light exposure on Phase 2 (AU)

Objetivo: Este estudo avaliou a resposta do tecido subcutâneo após terapia fotodinâmica, utilizando na Fase 1 - laser diodo por 1min e solução fotossensibilizadora de cloreto de fenotiazina (CF) em diferentes concentrações e Fase 2 - laser diodo e LED e dois fotossensibilizadores, CF e Curcumina, em diferentes tempos de exposição da aplicação de luz. Material e Métodos: Após 7, 21 e 63 dias, foram realizadas descrições qualitativas e semiquantitativas do processo inflamatório e técnica de imunoistoquímica. Os dados foram analisados pelo pós-teste de Kruskal-Wallis e Dunn (α = 0,5). Resultados: Na Fase 1, a resposta do tecido foi muito semelhante. O infiltrado inflamatório, na concentração de 10 mg / mL, exibiu reação mais intensa (p > 0,05). Na Fase 2, aos 7 dias, os parâmetros analisados apresentaram pequena magnitude. Aos 21 e 63 dias, todos os parâmetros demonstraram compatibilidade com o tecido. Conclusão: Ambos os fotossensibilizadores apresentaram compatibilidade de tecido adequada, independentemente das diferentes concentrações utilizadas na Fase 1 e diferentes durações de exposição à luz na Fase 2 (AU)

Biocompatibility, biomineralization, and maturation of collagen by rtr®, bioglass and dm bone® materials

Abstract This study evaluated the biocompatibility, biomineralization, and collagen fiber maturation induced by Resorbable Tissue Replacement (RTR®; β-tricalcium phosphate [TCP]), Bioglass (BIOG; bioactive glass), and DM Bone® (DMB; hydroxyapatite and β-TCP) in vivo. Sixty-four polyethylene tubes with or without (control group; CG) materials (n=8/group/period) were randomly implanted in the subcutaneous tissue of 16 male Wistar rats (four per rat), weighting 250 to 280 g. The rats were killed after 7 and 30 days (n=8), and the specimens were removed for analysis of inflammation using hematoxylin-eosin; biomineralization assay using von Kossa (VK) staining and polarized light (PL); and collagen fiber maturation using picrosirius red (PSR). Nonparametric data were statistically analyzed by Kruskal-Wallis and Dunn tests, and parametric data by one-way ANOVA test (p<0.05). At 7 days, all groups induced moderate inflammation (p>0.05). At 30 days, there was mild inflammation in the BIOG and CG, and moderate inflammation in the RTR and DMB groups, with a significant difference between the CG and RTR (p<0.05). The fibrous capsule was thick at 7 days and predominantly thin at 30 days in all groups. All materials exhibited structures that stained positively for VK and PL. Immature collagen fibers were predominant at 7 and 30 days in all groups (p>0.05), although DMB exhibited more mature fibers than BIOG at 30 days (p<0.05). RTR, BIOG, and DMB were biocompatible, inducing inflammation that reduced over time and biomineralization in the subcutaneous tissue of rats. DMB exhibited more mature collagen fibers than BIOG over a longer period.

Resumo Este estudo avaliou a biocompatibilidade, biomineralização e maturação das fibras de colágeno induzidas por Resorbable Tissue Replacement (RTR®; fosfato β-tricálcico [TCP]), Bioglass (BIOG; vidro bioativo) e DM Bone® (DMB; hidroxiapatita e β-TCP) in vivo. Sessenta e quatro tubos de polietileno com ou sem (grupo controle; GC) os materiais (n=8/grupo/período) foram implantados aleatoriamente em tecido subcutâneo de 16 ratos machos Wistar (quatro por rato), pesando entre 250 a 280g. Os ratos foram mortos após 7 e 30 dias (n=8), e as amostras foram removidas para análise da inflamação utilizando hematoxilina-eosina; avaliação da biomineralização utilizando coloração de von Kossa (VK) e luz polarizada (LP); e maturação das fibras colágenas, utilizando picrosirius red (PSR). Os dados não-paramétricos foram analisados pelos testes de Kruskal-Wallis e Dunn, e os paramétricos pelo teste de one-way ANOVA (p<0.05). Aos 7 dias, todos os grupos induziram inflamação moderada (p>0,05). Aos 30 dias, houve inflamação leve nos grupos BIOG e GC, e inflamação moderada nos grupos RTR e DMB, com diferença significativa entre os GC e RTR (p<0,05). A cápsula fibrosa foi espessa aos 7 dias, e predominantemente fina aos 30 dias em todos os grupos. Todos os materiais exibiram estruturas positivas para VK e LP. Fibras colágenas imaturas foram predominantes aos 7 e 30 dias em todos os grupos (p>0,05), embora o DMB exibiu fibras mais maduras do que o BIOG aos 30 dias (p<0,05). RTR, BIOG e DMB foram biocompatíveis, induzindo inflamação que reduziu com o tempo, e biomineralização no tecido subcutâneo de ratos. O DMB exibiu mais fibras colágenas maduras do que o BIOG em período mais longo.

Microfilaremia by Cercopithifilaria bainae in a dog from the central western region of Brazil: case report / Microfilaremia por Cercopithifilaria bainae em um cão da região Centro-Oeste do Brasil: relato de caso

Cercopithifilaria bainae is a nematode belonging to the family Onchocercidae that parasitizes the subcutaneous tissue of dogs. Its transmission occurs through the tick Rhipicephalus sanguineus and its geographical distribution overlaps that of this vector. The present study reports the detection of microfilaremia by C. bainae in an eight-year-old male dog that presented anorexia, hyperthermia, motor incoordination, mydriasis, a nodule in the left testicle and concomitant infection by Ehrlichia sp. Blood samples were analyzed using microscopy, PCR and DNA sequencing. Microfilariae measuring 150±5.5µm in length and 7±1.8µm in width were retrieved. The DNA sequence exhibited 98% identity with C. bainae sequences available in Genbank. This is the first report of microfilaremia by C. bainae in a dog in the central western region of Brazil.(AU)

Cercopithifilaria bainae é um nematoide pertencente à família Onchocercidae, que parasita o tecido subcutâneo de cães. Sua transmissão ocorre pelo carrapato Rhipicephalus sanguineus, e sua distribuição geográfica se sobrepõe ao espalhamento desse vetor. O presente estudo relata a detecção de microfilaremia por C. bainae em um cão macho de oito anos que apresentava anorexia, hipertermia, incoordenação motora, midríase e nódulo no testículo esquerdo e infecção concomitante por Ehrlichia sp. A coleta de sangue foi realizada, e o material analisado por meio dos exames de microscopia, PCR e sequenciamento de DNA. Microfilárias medindo 150±5,5µm de comprimento e 7±1,8µm de largura foram recuperadas. A sequência de DNA obtida mostrou 98% de identidade com sequências de C. bainae disponíveis no Genbank. Este é o primeiro relato de microfilaremia de C. bainae em um cão na região Centro-Oeste do Brasil.(AU)

Cytotoxicity, inflammation, biomineralization, and immunoexpression of IL-1β and TNF-α promoted by a new bioceramic cement

Abstract Aim To evaluate the cytotoxicity, biocompatibility and mineralization capacity of BIO-C PULPO, and MTA. Methodology L929 fibroblasts were cultured and MTT assay was used to determine the material cytotoxicity on 6, 24, and 48 h. A total of 30 male rats (Wistar) aged between 4 and 6 months, weighing between 250 and 300 g were used. Polyethylene tubes containing BIO-C PULPO, MTA, and empty tubes were implanted into dorsal connective tissue. After the experimental periods (7, 15, 30, 60, and 90 days) the tubes were histologically analyzed using hematoxylin-eosin (H&E), immunolabeling of IL-1β and TNF-α, and von Kossa staining, or without staining for polarized light analysis. The average number of inflammatory cells was quantified; the mineralization assessment was determined by the area marked in μm2 and semiquantitative immunolabeling analyses of IL-1β and TNF-α were performed. Then, data underwent statistical analysis with a 5% significance level. Results It was observed that BIO-C PULPO and MTA presented cytocompatibility at 6, 24, and 48 similar or higher than control for all evaluated period. On periods 7 and 15 days, BIO-C PULPO was the material with the highest number of inflammatory cells (p<0.05). On periods 30, 60, and 90 days, BIO-C PULPO and MTA presented similar inflammatory reactions (p>0.05). No statistical differences were found between Control, BIO-C PULPO, and MTA for immunolabeling of IL-1β and TNF-α in the different periods of analysis (p<0.05). Positive von Kossa staining and birefringent structures under polarized light were observed in all analyzed periods in contact with both materials, but larger mineralization area was found with BIO-C PULPO on day 90 (p<0.05). Conclusion BIO-C PULPO was biocompatible and induced mineralization similar to MTA.

A preformulation strategy for the selection of controlled-release components to simulate a subcutaneous implant / Una estrategia de preformulación para la selección de componentes de liberación controlada para simular un implante subcutáneo

Many chronic diseases require repetitive injections as maintenance treatment. It is therefore important to investigate a possible alternative. A simulated subcutaneous implant prototype was fabricated as a polymer matrix covered by cylinder-shape tubing having a porous membrane. Sucrose, bovine serum albumin, and gelatin were selected as matrix excipients. Eight APIs with different physiochemical properties were used to investigate the releasing mechanism. Drug release was tested through an in vitrodissolution apparatus. Drug release of eight APIs followed zero-order kinetics with a minimum 12-hour duration. Release rates also showed linear correlations with the APIs' solubilities under physiological pH. For releasing mechanism studies, different combinations of matrix and membrane were investigated in detail. A 144-hour continuous zero-order release of caffeine was achieved as the best controlled simulated prototype. The results showed that drug release of our simulated prototype was primarily achieved by drug diffusion rather than dissolution.

Muchas enfermedades crónicas requieren inyecciones repetitivas como tratamiento de mantenimiento. Por lo tanto, es importante investigar una posible alternativa. Se fabricó un prototipo de implante subcutáneo simulado a partir de una matriz de polímero cubierta por un tubo en forma de cilindro que tiene una membrana porosa. La sacarosa, la albúmina de suero bovino y la gelatina se seleccionaron como excipientes matriciales. Se utilizaron ocho APIs con diferentes propiedades fisicoquímicas para investigar el mecanismo de liberación. La liberación del fármaco se probó a través de un aparato de disolución in vitro. La liberación del fármaco de las ocho APIs siguió una cinética de orden cero con una duración mínima de 12 horas. Las tasas de liberación también mostraron correlaciones lineales con las solubilidades de las APIs a pH fisiológico. Para los estudios de mecanismos de liberación, se investigaron en detalle diferentes combinaciones de matriz y membrana. El prototipo simulado con mejor control logró una liberación continua de cafeína de orden cero durante 144 horas. Los resultados mostraron que la liberación del fármaco del prototipo simulado ocurrió principalmente mediante la difusión del fármaco en lugar de la disolución.

Inverse klippel-trenaunay syndrome / Síndrome de klippel-trenaunay inverso

ABSTRACT Objective: To report a rare case of inverse Kipplel-Trenaunay. Case description: A 16-year-old girl with a grayish-depressed plaque on her left thigh. Angioresonance showed a vascular malformation affecting the skin and subcutaneous tissue. Comments: Inverse Klippel-Trenaunay is a Klippel-Trenaunay syndrome variation in which there are capillary and venous malformations associated to hypotrophy or shortening of the affected limb. Modifications on the limb's length or width result from alterations in bones, muscles, or subcutaneous tissues. It has few described cases. Further clinical and molecular studies must be performed for a proper understanding.

RESUMO Objetivo: Relatar um caso raro de Klippel-Trenaunay inverso. Descrição do caso: Menina de 16 anos com placa deprimida acinzentada na coxa esquerda, evidenciando-se, por meio de angioressonância, uma malformação vascular, acometendo a pele e tecidos subcutâneos. Comentários: Klippel-Trenaunay inverso é uma variante da síndrome de Klippel-Trenaunay em que há malformação capilar e venosa associada à hipotrofia ou encurtamento do membro afetado. Pode envolver acometimento ósseo, muscular ou subcutâneo, modificando o comprimento ou a circunferência do membro. Há poucos casos descritos, e mais estudos clínicos e moleculares precisam ser realizados para seu correto entendimento.

Magnetic Resonance Imaging Findings Differentiating Cutaneous Basal Cell Carcinoma from Squamous Cell Carcinoma in the Head and Neck Region

OBJECTIVE: This study aimed to evaluate the efficacy of magnetic resonance (MR) imaging in differentiating between cutaneous basal cell carcinoma (cBCC) and cutaneous squamous cell carcinoma (cSCC) in the head and neck region.MATERIALS AND METHODS: Among patients with cutaneous head and neck cancers, 14 with primary cBCCs and 15 with primary cSCCs with a histologic tumor height of ≥ 4 mm underwent MR examinations; the findings were then examined for correlations.RESULTS: cBCCs (71%) occurred more frequently on the nose than cSCCs (13%) (p < 0.01). The maximum diameter (23.5 ± 7.2 mm vs. 12.7 ± 4.5 mm; p < 0.01) and diameter-to-height ratio (2.8 ± 0.9 vs. 1.7 ± 0.4; p < 0.01) were significantly greater in cSCCs than in cBCCs. Superficial ulcer formation (67% vs. 21%; p < 0.05), protrusion into the subcutaneous tissue (60% vs. 21%; p < 0.05), ill-demarcated deep tumor margins (60% vs. 7%; p < 0.01), and peritumoral fat stranding (93% vs. 7%; p < 0.01) were more frequently observed in cSCCs than in cBCCs. Intratumoral T2-hyperintense foci (57% vs. 13%; p < 0.05) were more frequently observed in cBCCs than in cSCCs.CONCLUSION: cBCCs predominantly occurred on the nose with intratumoral T2-hyperintense foci, whereas cSCCs predominantly exhibited a flattened configuration, superficial ulcer formation, protrusion into the subcutaneous tissue, ill-demarcated deep tumor margin, and peritumoral fat stranding.

Effect of bupivacaine on postoperative pain and analgesics use after single-incision laparoscopic appendectomy: double-blind randomized study

PURPOSE: Local anesthetics can decrease postoperative pain after appendectomy. This study sought to verify the efficacy of bupivacaine on postoperative pain and analgesics use after single-incision laparoscopic appendectomy (SILA).METHODS: Between March 2014 and October 2015, 68 patients with appendicitis agreed to participate in this study. After general anesthesia, patients were randomized to bupivacaine or control (normal saline) groups. The assigned drugs were infiltrated into subcutaneous tissue and deep into anterior rectus fascia. Postoperative analgesics use and pain scores were recorded using visual analogue scale (VAS) by investigators at 1, 8, and 24 hours and on day 7. All surgeons, investigators and patients were blinded to group allocation.RESULTS: Thirty patients were allocated into the control group and 37 patients into bupivacaine group (one patient withdrew consent before starting anesthesia). Seven from the control group and 4 from the bupivacaine group were excluded. Thus, 23 patients in the control group and 33 in the bupivacaine group completed the study. Preoperative demographics and operative findings were similar. Postoperative pain and analgesics use were not different between the 2 groups. Subgroup analysis determined that VAS pain score at 24 hours was significantly lower in the bupivacaine group (2.1) than in the control group (3.8, P = 0.007) when surgery exceeded 40 minutes. During immediate postoperative period, bupivacaine group needed less opioids (9.1 mg) than control (10.4 mg).CONCLUSION: Bupivacaine did not decrease pain and analgesics use. When surgery exceeded 40 minutes, bupivacaine use might be associated with less pain and less analgesics use.

Tratamento da flacidez músculo aponeurótica acentuada da parede abdominal, experiência de 26 anos / Treatment of marked abdominal wall musculoaponeurotic flaccidity: 26 years of experience

Realizamos uma análise de quais são os elementos responsáveis pelo sustento e formato abdominal, determinando assim, que é devido a uma excessiva flacidez musculoaponeurótica de origem primária, à qual promove uma incapacidade do suporte da parede abdominal e pode estar relacionada a fatores predisponentes. Para esses casos específicos, desenvolvemos um tratamento propondo a colocação da tela e apresentando nossa experiência. Apresentamos esta série de casos de experiência em 26 anos. Onde 15 pacientes foram tratados com abdominoplastia primária e secundária. O reforço da parede abdominal foi realizado através da colocação de tela de polipropileno no plano submuscular com pontos em U na fáscia transversalis, buscando-se fortalecer o músculo e a fáscia transversa. Os resultados foram satisfatórios a longo prazo. Obtendo resolução das protuberâncias abdominais e restaurando a harmonia dos músculos. Apenas duas complicações ocorreram, que foram a presença de dor crônica localizada no abdome tratada com infiltrações de esteroides e fístula umbilical precoce de resolução rápida espontânea, independente da proposta.

We investigated the causative factors of abdominal support and shape and found that excessive musculoskeletal flaccidity of primary origin causes an inability to support the abdominal wall and may be associated with the predisposing factors. For such cases, we developed a treatment consisting of the placement of a subcutaneous mesh. Here, we present our experience with this treatment. We present a case series of 15 patients in our 26 years of experience who were treated with primary and secondary abdominoplasties. The abdominal wall was reinforced by placing a polypropylene mesh in the submuscular plane with U-stitches in the transversalis fascia, aiming at strengthening the muscle and transverse fascia. The results were satisfactory in the long term. Abdominal bulges were repaired, and muscle harmony was restored. Only two complications occurred: chronic pain localized in the abdomen, which was treated with steroid infiltrations, and an early umbilical fistula with spontaneous and rapid resolution, regardless of the proposal.

Cytotoxicity, biocompatibility and biomineralization of a new ready-for-use bioceramic repair material

Abstract New mineral trioxide aggregate (MTA) formulations are constantly introduced in the market, usually in a powder-and-liquid form. Bioceramic (Bio-C) Repair is a ready-for-use material suggested as substitute for MTA, but its properties need to be studied. This study evaluated the cytotoxicity, biocompatibility and biomineralization of Bio-C Repair compared to MTA Repair High-Plasticity (MTA-HP) and white MTA-Angelus (MTA-Ang). L929 fibroblasts were exposed to material-extracted (undiluted, ½ and » dilutions; 6, 24 and 48h). Polyethylene tubes with material or empty (control) were implanted in the subcutaneous tissue of rats. After 7 and 30 days (n=8), the specimens were removed for analysis (hematoxylin-eosin, von Kossa and polarized light). Cytotoxicity data were statistically analyzed by two-way ANOVA, and biocompatibility data by Kruskal-Wallis and Dunn tests (p<0.05). The cells exposed to the materials had greater viability at most of the periods compared with control (p<0.05). The undiluted and ½ dilutions of MTA-HP extract showed higher cytocompatibility than Bio-C Repair at 6 h and with the » dilution at 24 h (p<0.05); the white MTA-Ang showed higher cytocompatibility than Bio-C Repair at most of periods (p<0.05). The undiluted white MTA-Ang extract had higher cytocompatibility at 6 and 24h than MTA-HP, and with ½ dilution at 24h (p<0.05). The materials' cytocompatibility was similar at 48h for most dilutions (p>0.05). At 7 and 30 days, the groups had moderate and mild inflammation, respectively (p>0.05). All materials showed positive structures for von Kossa and polarized light. In conclusion, Bio-C Repair had similar cytocompatibility to MTA-based materials is biocompatible and induces biomineralization.

Resumo Novas formulações de agregado de trióxido mineral (MTA) são constantemente introduzidas no mercado, geralmente em forma de pó e líquido. O Biocerâmico (Bio-C) Reparador (Repair) é um material pronto para uso sugerido como substituto do MTA, mas suas propriedades precisam ser estudadas. Este estudo avaliou a citotoxicidade, biocompatibilidade e biomineralização do Bio-C Repair comparado ao MTA-High Plasticity (MTA-HP) e MTA branco da Angelus (MTA-Ang). Fibroblastos L929 foram expostos a extratos dos materiais (não diluído, ½ e » diluições; 6, 24 e 48 h). Tubos de polietileno contendo os materiais ou vazios (controle) foram implantados no tecido subcutâneo de ratos. Após 7 e 30 dias (n=8), os espécimes foram removidos para análises (hematoxilina-eosina, von Kossa e luz polarizada). Os dados da citotoxicidade foram analisados estatisticamente pelo teste de two-way ANOVA, e os dados da biocompatibilidade pelos testes de Kruskal-Wallis e Dunn (p<0,05). As células expostas aos materiais apresentaram maior viabilidade celular na maior parte dos períodos, comparados com o controle (p<0,05). O extrato não diluído e ½ diluição do MTA-HP apresentaram maior citocompatibilidade do que Bio-C Repair às 6h, e com » diluição às 24h (p<0,05); o MTA-Ang branco apresentou maior citocompatibilidade do que o Bio-C Repair na maior parte dos períodos (p<0,05). O extrato não diluído do MTA-Ang branco apresentou maior citocompatibilidade às 6 e 24 h comparado ao MTA-HP, e com ½ diluição às 24h (p<0,05). A citocompatibilidade dos materiais foi semelhante às 48 h para a maior parte das diluições (p>0,05). Aos 7 e 30 dias, os grupos apresentaram inflamação moderada e leve, respectivamente (p>0,05). Todos os materiais mostraram estruturas positivas para von Kossa e luz polarizada. Em conclusão, o Bio-C Repair teve citocompatibilidade semelhante aos materiais à base de MTA, é biocompatível e induz à biomineralização.

Evaluación de la respuesta inflamatoria en ratas Wistar a TheraCalTM LC implantado vía subcutánea / Evaluation of the inflammatory response in Wistar rats to TheraCalTM LC implanted subcutaneously

El Theracal TM LC es un cemento silicato de calcio (Ca) modificado con resina (SMCR) que ha demostrado ser un material ideal para el tratamiento dentino-pulpar por su alta tasa de formación de calcio. Los biomateriales por su contenido de Ca tienden a tener un aumento en su biodisponibilidad, estimulando la formación del puente dentario atreves de las células involucradas en la formación de tejidos mineralizados, promoviendo la diferenciación de fibroblastos en odontoblastos y aumentando la actividad de la enzima pirofostasa responsable en la mineralización de la dentina. El presente estudio con el objetivo de evaluar la respuesta inflamatoria a Theracal TM LC subcutáneamente en ratas Wistar. Fueron usados seis ratas cepa Wistar en las cuales se realizaron cuatro bolsillos quirúrgicos subcutáneos. Cada uno de estos bolsillos se determinó como cuadrante distinto, conteniendo los siguientes implantes: 1 Theracal TM LC en tubo polietileno, 2 tubo de polietileno, 3 Theracal TM LC directo y 4 como control. Las muestras histológicas se procesaron y se evaluaron distintos tipos celulares mediante conteo a microscopio de luz a 100X utilizando las tinciones H&E y AT pH 2.3. Los resultados mostraron que existen diferencias significativas en todos los tipos celulares observados durante los diferentes tiempos de exposición. Las diferencias en los tipos celulares observados podrían ser debido al tiempo de exposición al Theracal TM LC, al tubo polietileno y a ambos. El tejido evaluado del implante del tubo polietileno y al tubo polietileno con Theracal TM LC, presentan mayor respuesta inflamatoria, a diferencia en el tejido implantado con Theracal TM LC directamente.

TheraCalTM LC is a resin-modified calcium silicate (Ca) resin (SMCR) that has proven to be an ideal material for dentin-pulp treatment due to its high rate of calcium formation. Biomaterials due to their Ca content tend to have an increase in their bioavailability, stimulating the formation of the dental bridge through the cells involved in the formation of mineralized tissues, promoting the differentiation of fibroblasts in odontoblasts and increasing the activity of the pyrophosphate enzyme responsible in dentin mineralization. The present study aimed to evaluate the inflammatory response to TheracalTM LC subcutaneously in Wistar rats. Six Wistar strain rats were used in which four subcutaneous surgical pockets were made. Each of these pockets was determined as a different quadrant, containing the following implants: 1 TheracalTM LC in polyethylene tube, 2 polyethylene tubes, 3 TheracalTM LC direct and 4 as control. The histological samples were processed, and different cell types were evaluated by light microscopy at 100X using the H&E and AT pH 2.3 stains. The results showed that there are significant differences in all cell types observed during the different exposure times. The differences in the cell types observed could be due to the exposure time to TheracalTM LC, to the polyethylene tube and to both. The evaluated tissue of the polyethylene tube implant and the polyethylene tube with TheracalTM LC present a greater inflammatory response, unlike in the tissue implanted with TheracalTM LC directly.

Glomus tumor of the oral cavity: report of a rare case and literature review

Abstract Glomus tumor is a benign neoplasm composed of a perivascular proliferation of glomic cells that resembles the normal glomus body. Usually, it appears as a solitary, symptomatic small blue-red nodule, located in the deep dermis or subcutis of upper or lower extremities of young to middle-aged adults. Cases affecting the oral cavity are very rare, with only 23 well-documented cases reported in the English-language literature. Herein, we present a rare case of glomus tumor of the upper lip, and review the literature of cases involving the mouth.

Resumo Tumor glômico é uma neoplasia benigna composta de uma proliferação perivascular de células glômicas que lembram o corpo glômico normal. Usualmente, ele se apresenta como um nódulo pequeno, solitário, sintomático e azul-avermelhado, localizado na derme profunda ou subcutânea de extremidades superiores ou inferiores de adultos jovens e de meia-idade. Casos afetando a cavidade oral são muito raros, com apenas 23 casos bem documentados relatados na literatura de língua Inglesa. A seguir, nós apresentamos um caso raro de tumor glômico do lábio superior, e revisão da literatura dos casos envolvendo a boca.

Desmoplastic melanoma: a rare variant with challenging diagnosis

Abstract: Desmoplastic melanoma, a distinct and uncommon variant, is characterized as an invasive lesion with proliferation of fusiform melanocytes in the dermis and subcutaneous tissue, associated with varying patterns of desmoplasia. Neurotropism and neural differentiation may occur. The clinical presentation is variable and nonspecific, easily confused with other fibrous neoplasms. The disease is locally aggressive and shows lower metastasis rates than other types of melanoma. Histopathology may be insufficient, requiring positive immunohistochemistry for S-100 protein and other antigens of melanocytic differentiation. Because desmoplastic melanoma represents a true clinical, dermoscopic, and histopathological diagnostic challenge, a case of invasive desmoplastic melanoma is reported, affecting a photoexposed area in an elderly woman after histological revisions and an initial diagnosis of fibroma.

Pseudotumor fibro-óseo digital / Fibro-osseous pseudotumour of the digit

Introducción El pseudotumor fibro-óseo de los dedos es una lesión reparativa, autolimitada, que aparece en el tejido celular subcutáneo. Se presenta como una masa dolorosa de rápido crecimiento y pronóstico excelente ya que raramente recidiva si la escisión es completa. El objetivo de este trabajo es realizar reporte de caso y revisión de la literatura. Caso clínico Paciente de 14 años de edad que presenta una masa pequeña y dolorosa en el pulpejo del 2° dedo de la mano derecha. Se realiza radiografías y se observa una lesión de partes blandas radiopaca compatible con calcificación próxima a la 3° falange. Se realizó biopsia escicional para estudio anatomopatológico. Resultados Teniendo en cuenta los antecedentes del paciente, la clínica de presentación, los estudios por imagen y el resultado de la biopsia escicional, los hallazgos son compatibles con «Pseudotumor Fibro-óseo Digital¼. La paciente actualmente no presenta dolor, conserva la movilidad, sensibilidad y funcionalidad del dedo afectado. Discusión Ante una lesión en los dedos con características clínicas, radiológicas o morfológicas de malignidad debemos plantearnos en el diagnóstico diferencial el pseudotumor fibro-óseo de los dedos, su conocimiento es importante para evitar intervenciones quirúrgicas radicales innecesarias ya que esta lesión es de características benignas y muy bajo índice de recidiva.

Background A fibro-osseous pseudotumour of the fingers is a reparative and self-limited lesion that appears in the subcutaneous tissue. It presents as a rapid-growing painful mass. It has an excellent prognosis and rarely relapses if the excision is complete. The aim of this work is to present a case report and literature review. Case report A 14 year-old patient with a small, painful mass in the ball of the 2nd finger of his right hand. The X-rays performed showed a soft radio-opaque tissue lesion compatible with calcification of the 3rd phalanx. An excisional biopsy was performed for histopathological study. Results Given the history of the patient, the clinical presentation, imaging studies and the outcome of the excisional biopsy, the findings were consistent with a fibro-osseous digital pseudotumour. The patient currently does not currently have pain, with conserved mobility, sensitivity, and functionality of the affected finger. Discussion As with any finger lesion with clinical, radiological or morphological characteristics of malignancy, a differential diagnosis of a fibro-osseous pseudotumour of the fingers must be considered. Knowledge of this is important in order avoid unnecessary radical surgery, as this lesion is benign, and has very low rate of recurrence.