MRI-based analysis of predictive factors for nucleus pulposus resorption in patients with lumbar disc herniation treated with three-dimensional balanced chiropractic technique / 中国辐射卫生

Objective To observe the effectiveness of the three-dimensional balanced chiropractic technique in the treatment of lumbar disc herniation (LDH) and analyze predictive factors for resorption of the herniated nucleus pulposus based on magnetic resonance imaging (MRI). Methods From June 2015 to June 2021, 95 patients with LDH treated with the three-dimensional balanced chiropractic techniquein our hospital were followed up for clinical and MRI data. They were divided into resorption group and non-resorption group based on the nucleus pulposus resorption rate. Multivariable binary logistic regression analysis was performed to determine the association of 12 factors (sex, age, course of disease, etc.)with nucleus pulposus resorption. Results Thirty-two cases (33.7%)were found at follow-up to have nucleus pulposus resorption (resorption rate≥30%). Resorption was most likely to occur in patients with a disease course of less than a year (P < 0.001), type 3 LDH accoding to the Michigan State University (MSU) classification (P = 0.014), leg numbness (P = 0.006), and a L4/5 or L5/S1 disc herniation (P < 0.001). Conclusion MRI can be used as an important tool to observe nucleus pulposus resorption in LDH. A disease course of less than a year, MSU type 3, leg numbness, a L4/5 or L5/S1 disc herniation are associated with a higher possibility of nucleus pulposus resorption, which can be used as indicators predicting the outcome of patients with LDH treated with the three-dimensional balanced chiropractic technique.

Efficacy and Mechanism of Danlu Tongdu Tablets on Lumbar Disc Herniation with Kidney Deficiency and Stasis Syndrome / 中国实验方剂学杂志

Objective: To observe short-term and long-term efficacies of Danlu Tongdu tablets on lumbar disc herniation (LDH) with kidney deficiency and stasis syndrome, and its effect on nucleus pulposus reabsorption and immunoinflammatory factors. Method: One hundred and sixty patients were randomly divided into control group (80 cases) and observation group by random number table. Patients in control group (80 cases) got acupoint massage and acupuncture, 1 time/day. In addition to the therapy of control group, patients in observation group were also given Danlu Tongdu tablets, 4 tablets/time, 3 times/days. A course of treatment was 12 weeks, and a 9-month follow-up was recorded. Lumbago and leg pain were recorded by visual simulation (VAS) before treatment and at the first, second, third month after treatment. Before and after treatment, Japanese orthopaedic association (JOA), symptoms and signs were scored. During the 9-month follow-up, relapse rate and relapse time were recorded, and VAS and JOA were scored. Absorption of nucleus pulposus was assessed, and levels of interleukin-1 (IL-1), IL-17, tumor necrosis factor-α (TNF-α), matrix metalloproteinases-3 (MMP-3) were detected. Result: By rank sum test, the clinical efficacy in observation group was better than that in control group (Z=2.125, PZ=1.924, PPPPPχ2=5.138, Pα and MMP-3 were lower than that in control group (Pχ2=4.668, PPPPConclusion: In addition to acupuncture and massage therapy, Danlu Tongdu tablets can also be used to relieve pain and ameliorate function, improve clinical efficacy, reduce relapse rate, promote nucleus pulposus reabsorption, and relieve inflammation of nerve root.

External root resorption of second molars caused by impacted third molars: an observational study in panoramic radiographs / Reabsorção radicular externa de segundos molares ocasionadas por terceiros molares impactados: estudo observacional em radiografias panorâmicas

Objective: This research investigate the presence of external root resorption (ERR) in second molars caused by impacted third molars in panoramic radiographs, relating to the position of third molars according to classification of Winter, Pell and Gregory. Material and method: A cross-sectional, retrospective study using panoramic radiographs obtained from January 2014 to December 2015. The inclusion criterion was the presence of a second molar adjacent to an impacted third molar. Data were analyzed using descriptive and inferential statistics. Pearson's Chi-Square Test and Fisher's Exact Test (p≤0.05) were performed. Result: The sample consisted of 584 panoramic radiographs, 356 (60.95%) of women, and 228 (39.05%) of men, the mean age was 25.31 years. The prevalence of ERR was 12.5%, and the group of 14-24 year olds was the most affected (p = 0.46). The presence of ERR was statistically higher in the mandible (42.1%) with p=0.01. The ERR located in the cervical (57.1%) and medium (58.8%) thirds was proportionally higher in the teeth with B2 (p=0.02) and mesio-angular positions (p=0.26). Conclusion: The prevalence of ERR in second molars, caused by impacted third molars, was shown to be similar to results found in the literature, with no gender preference, this affects young patients, occurring frequently in mandible teeth, and presents greater severity in the cervical and middle thirds. The B2 and mesio-angular positions were more prone to ERR.

Objetivo: Esta pesquisa investigou a presença de reabsorção radicular externa (RRE) em segundos molares ocasionada pelos terceiros molares impactados em radiografias panorâmicas, relacionando com a posição dos terceiros de acordo com a classificação de Winter e de Pell e Gregory. Material e método: Um estudo transversal, retrospectivo, por meio de radiografias panorâmicas obtidas no período de janeiro de 2014 a dezembro de 2015. Adotou-se como critério de inclusão, a presença um segundo molar adjacente a um terceiro molar impactado. Os dados foram analisados por meio de estatística descritiva e inferencial. Foram realizados o Teste Qui-Quadrado de Pearson e Teste Exato de Fisher (p≤0,05). Resultado: A amostra foi composta por 584 radiografias panorâmicas, sendo 356 (60,95%) do gênero feminino e 228 (39,05%) do masculino, a média de idade foi de 25,31 anos. A prevalência de RRE foi de 12,5%, e a faixa etária de 14-24 anos foi mais acometida (p=0,46). A presença de RRE foi estatisticamente maior na mandíbula (42,1%) com p=0,01. As RRE localizadas nos terços cervical (57,1%) e médio (58,8%) foram proporcionalmente maiores nos dentes nas posições B2 (p=0,02), e mesioangular (p=0,26). Conclusão: A prevalência de RRE em segundos molares causada por terceiros impactados se mostrou estar de acordo com a média existente na literatura mundial, sem predileção por gênero, acometendo mais pacientes jovens, frequentemente ocorre nos dentes da mandíbula e apresenta um maior grau de severidade no terço cervical e médio. As posições B2 e mesioangular apresentaram maior propensão à RRE.

Diagnosis and treatment of renal glucosuria / 中华实用儿科临床杂志

Renal glycosuria (RG) is an inherited disorder due to defective reabsorption of glucose by the proximal renal tubular.It is attributed to the mutations in the SCL5A2 gene,encoding the sodium-glucose transporter 2 (SGLT2).A defect of SGLT2 is responsible for impaired reabsorption of the filtered glucose in the proximal renal tubular,termed S1,which leads to glycosuria.RG is characterized by normal fasting serum glucose concentration and persistent isolated glucosuria,identification of glucose as the urinary sugar.The inherited pattern of RG is co-dominant inheritance trait with incomplete penetrance.The diagnostic criteria of glycosurias are as follows:a constant and relatively stable urinary glycosurias (10-100 g/d),identification of glucose as the urinary sugar,normal concentration of fasting plasma glucose and normal oral glucose tolerance test,evidence that individuals have normal carbohydrates intake,storage and metabolism.RG does not require special treatment generally,but the advice concerns diet with increasing the intake of carbohydrates.Physical activity should be moderate and professional,and excesive muscle and exercise should be not advisable.

Reabsorção óssea associada ao implante de silicone em mentoplastia: relato de caso clínico / Bone reabsorption associated with silicone implants in mentoplasty: a clinical case report

Durante muitos anos, os implantes de silicone foram utilizados em cirurgias reconstrutivas e estéticas, principalmente em casos em que o perfil facial do paciente apresenta deficiência no terço inferior da face. Este material tem provado ser bem sucedido na maioria dos aspectos, contudo, algumas complicações já foram bem relatadas na literatura, como é o caso das reabsorções ósseas na região de mento mandibular. No presente artigo os autores apresentam dois casos clínicos de reabsorção óssea da cortical anterior do mento, associada ao implante de silicone e discutem a etiologia, as complicações e o plano de tratamento.

For many years, silicone implants were used in reconstructive and esthetic surgeries, especially in cases in which the facial profile of patients presented deficiencies in the inferior third of the face. This material proved to be successful in most aspects. However, several complications were well reported in the literature, as the case of bone reabsorption in the region of the mandibular chin. In this article, the authors present two clinical cases of bone reabsorption from the anterior cortex of the chin associated with silicone implants and discuss the etiology, complications, and treatment plan.

Segundos molares mandibulares permanentes impactados en pacientes de 8 a 15 años del programa de presupuesto participativo de Medellín, Colombia / Impactation of Permanent Mandibular Second Molars in 8 to 15 Year-Old Patients from the Participative Budget Program in Medellín, Colombia

Antecedentes: La impactación de segundos molares mandibulares permanentes (2MM) se presenta con variaciones considerables según el grupo poblacional. Además de los problemas asociados a esta alteración, podrían requerir tratamientos múltiples y complejos. Por lo tanto, el diagnóstico temprano de una alteración en el proceso de erupción del 2MM es imperativo para reducir el riesgo de impactación, la dificultad de tratamiento y la aparición de problemas asociados en las poblaciones. Propósito: Describir las características de impactación del 2MM en pacientes de 8 a 15 años en una muestra de Medellin, Colombia. Métodos: En este estudio descriptivo retrospectivo se evaluaron 1756 radiografias panorámicas de las cuales 95 presentaron impactación de 2MM. Estas se analizaron según sexo, localización en la mandíbula y tipo de inclinación, y se realizaron 13 mediciones lineales y angulares para identificar parámetros dentoesqueléticos característicos del lado de la impactación. Para el análisis de los datos se utilizó estadística descriptiva y la prueba T (p < 0,05). Resultados: La prevalencia de impactación fue del 5,4 %. La impactación bilateral con inclinación mesial fue la más frecuente. El lado izquierdo predominó en impactaciones unilaterales. El único parámetro dentoesquelético característico de impactación fue el ángulo de inclinación del 2MM con respecto al plano oclusal, con mayor severidad en el lado izquierdo. Conclusiones: Un ángulo igual o mayor a 112,94° podría indicar riesgo de impactación contra el primer molar mandibular permanente. Por lo tanto, este parámetro debería incluirse en el análisis radiográfico para el diagnóstico temprano de impactación del 2MM.

Background: Impactation of permanent mandibular second molars (2MM) occurs with significant variations according to the population group. In addition to the problems associated with it, they could require multiple and complex treatments. Therefore, the early diagnosis of an alteration in the 2MM eruption process is a must to reduce the impactation risk, the treatment difficulty and the occurrence of related problems in the populations. Purpose: To describe the 2MM impactation characteristics in an 8 to 15 year-old patient sample in Medellin, Colombia. Methods: This retrospective descriptive study evaluated 1 756 panoramic radiographs and 95 of them showed 2MM impactation. The latter were analyzed based on the sex, location in the mandible and type of inclination; 13 linear and angle measurings were then carried out in order to identify dental-skeletal parameters characteristic in the impactation side. The data analysis used descriptive statistics and a T test (p < 0.05). Results: The impactation prevalence was 5.4% and the bilateral impactation with mesial inclination was the most frequently found. Unilateral impactations prevailed in the left side of the mandible/maxilla. The only dental-skeletal parameter of impactation was the 2MM inclination angle regarding the occlusal plane, with a greater severity on the left side. Conclusions: An angle of 112.94° or greater could indicate an impactation risk on the permanent mandibular first molar. Therefore, this parameter should be included in the radiographic analysis when diagnosing the early 2MM impactation.

Extruded Lumbar Disc Herniation with Spontaneous Reabsorption: Case Report and Review / Reabsorção espontânea de hérnia discal lombar extrusa: relato de caso

Disc herniation is a common condition in the population and has a direct impact on the quality of life in patients, also causing functional limitations in the work place. Treatment protocols include conservative management and/or various surgical interventions. This paper reports on a case of symptomatic large extruded disc herniation, together with spontaneous clinical regression and total re-absorption. We show here conservative management, and a literature review of the main pathophysiological hypotheses for such an unusual evolution.

Hérnia discal é condição comum na população e tem impacto direto na qualidade de vida dos pacientes, assim como causa limitações funcionais em seu ambiente de trabalho. Protocolos de tratamento incluem manejo conservador e/ou diversos tipos de intervenção cirúrgica. Este artigo relata o caso de uma extensa hérnia extrusa sintomática, juntamente a sua regressão clínica espontânea e sua total reabsorção. Descrevemos também seu manejo conservador e uma revisão da literatura para a principal hipótese diagnóstica nesta evolução incomum.

Relationship between chronological and bone ages and pubertal stage of breasts with bone biomarkers and bone mineral density in adolescents / Relação entre as idades cronológica e óssea e o estágio puberal das mamas com os biomarcadores ósseos e a densidade mineral óssea em adolescentes

OBJECTIVE: To study bone mineral density (BMD) in adolescent females according to five groups of chronological age (CA), bone age (BA), and breast development stage (B), and to correlate these parameters with plasma bone biomarkers (BB). METHODS: This was a cross-sectional study performed in 101 healthy adolescent females between 10 and 20 years old. The study variables were: weight, height, body mass index (BMI), CA, B, BA, calcium intake, BMD, and BB. Osteocalcin (OC), bone alkaline phosphatase (BAP), and C-terminal telopeptide (S-CTx) were evaluated for BB. BMD was measured using dual energy X-ray absorptiometry (DXA). RESULTS: BMD in lumbar spine, proximal femur, and total body increased with age, and the respective observed averages were: in CA1 (10 years old), 0.631, 0.692, 0.798 g/cm2; in CA2 (11 to 12 years old), 0.698, 0.763, 0.840 g/cm2; in CA3 (13 to 14 years old), 0.865, 0.889, 0.972 g/cm2; in CA4 (15 to 16 years old), 0.902, 0.922, 1.013 g/cm2; and in CA5 (17 to 19 years old), 0.944, 0.929, 1.35 g/cm2. These results showed significant differences between 13 and 14 years of age (CA3) or when girls reached the B3 stage (0.709, 0.832, 0.867 g/cm2). The highest median concentrations of BB were between 10 and 12 years of age when adolescents were in the B2-B3 (p < 0.001). Median BB concentrations decreased in advanced BA and B. CONCLUSIONS: BB concentrations were positively correlated with the peak height velocity and negatively correlated with BMD in the study sites. Increased BMD and BB concentrations were observed in B3. .

OBJETIVO: Avaliar a densidade mineral óssea (DMO) em adolescentes do sexo feminino de acordo com a idade cronológica (IC), idade óssea (IO) e desenvolvimento das mamas (M) e suas correlações com biomarcadores de remodelação óssea em plasma (BO). MÉTODOS: Este foi um estudo transversal prospectivo feito em 101 adolescentes saudáveis do sexo feminino com idade entre 10 e 20 anos. As variáveis estudadas foram: peso, altura, índice de massa corpórea (IMC), IC, IO, M, ingestão de cálcio, DMO e BO. A osteocalcina (OC), fosfatase alcalina óssea (BAP) e o telopeptídeo C terminal (S-CTx) foram os biomarcadores de remodelação óssea avaliados. A DMO foi obtida por absorciometria de raios-X de dupla energia (DXA). RESULTADOS: A DMO de coluna lombar, fêmur proximal e corpo total aumentou com a idade, e as respectivas médias observadas foram: IC1 = 0,631, 0.692, 0,798 g/cm2; IC2, 0,698, 0,763, 0,840 g/cm2; IC3, 0,865, 0,889, 0,972 g/cm2; IC4, 0,902, 0,922, 1,013 g/cm2; e IC5, 0,944, 0,929, 1,35 g/cm2. Observou-se diferença significativa entre 13 e 14 anos (IC3) ou quando as meninas estavam em M3 (0,709, 0,832, 0,867 g/cm2). Os valores dos BO apresentaram elevação entre 10 e 12 anos e quando as adolescentes estavam em M2-M3 (p < 0,001). Os valores das medianas dos BO diminuíram com o avançar da IO e M. CONCLUSÕES: Os BOs mostraram paralelismo com o pico de velocidade de crescimento e demonstraram correlação negativa com a DMO no sítios avaliados. O aumento da DMO e dos BOs foi observado em M3. .

Sodium Glucose Co-Transporter 2 (SGLT2) Inhibitor / 대한내과학회지

Sodium glucose co-transporter 2 (SGLT2) inhibition is a new therapeutic approach for the treatment of type 2 diabetes mellitus, independent of insulin secretion and activity. SGLT2 inhibitors have a unique mechanism of action via inhibition of renal glucose reabsorption, which is different from the mechanisms of prior medications. Clinical trials have supported the efficacy of SGLT2 inhibitors in the reduction of HbA1c as monotherapy or add-on therapy with other existing medications, including insulin. In addition to their glucose-lowering effect, SGLT2 inhibitors can significantly reduce blood pressure and body weight. The most concerning side effects are genital and urinary tract infections, especially in females. SGLT2 inhibitors offer a promising potential strategy for diabetes treatment because they can be combined with nearly any existing anti-diabetic medication, cause less hypoglycemia, and possess additional metabolic benefits beyond glucose level reduction.

Expression and activity identification of recombinant human stanniocalcin 1 / 军事医学

Objective To obtain recombinant human stanniocalcin 1 ( STC1 ) with biological activity in Escheri.coli cells expression.Methods The gene was cloned into pET32b( +) vector by fused with thioredoxin and His tag .E.coli BL21(DE3) competent cells were transfomed by the recombinant vector .After renaturation, the fusion protein was digested with thrombin and intact STC1 protein was purified from the digested protein using Ni ion affinity chromatography .Recombi-nant humanSTC1 protein was confirmed by Western blot analysis using goat anti-STC1 antibody.The biological activity of STC1 in rat was assayed using standard method for assessment of renal function .Results The recombinant human STC 1 fu-sion protein is successfully expressed in Escherichia coli, the fusion protein was purified by affinity chromatography from the inclusion body and renaturated .Intact hSTC1 protein was released by thrombin digestion and purified by Ni ion affinity col-umn.The intact STC1 proteins was confirmed by Western blot analysis .Rat bioassay revealed that STC1 boosted phosphate reabsorption.Conclusion Recombinant STC1 protein was successfully expressed and has native biological activities .This protein could be used as an antigen for the preparation of monoclonal antibody against humanSTC 1.

Roles of estrogen and progesterone in modulating renal nerve function in the rat kidney

The maintenance of extracellular Na+ and Cl- concentrations in mammals depends, at least in part, on renal function. It has been shown that neural and endocrine mechanisms regulate extracellular fluid volume and transport of electrolytes along nephrons. Studies of sex hormones and renal nerves suggested that sex hormones modulate renal function, although this relationship is not well understood in the kidney. To better understand the role of these hormones on the effects that renal nerves have on Na+ and Cl- reabsorption, we studied the effects of renal denervation and oophorectomy in female rats. Oophorectomized (OVX) rats received 17β-estradiol benzoate (OVE, 2.0 mg·kg-1·day-1, sc) and progesterone (OVP, 1.7 mg·kg-1·day-1, sc). We assessed Na+ and Cl- fractional excretion (FENa+ and FECl- , respectively) and renal and plasma catecholamine release concentrations. FENa+ , FECl- , water intake, urinary flow, and renal and plasma catecholamine release levels increased in OVX vs control rats. These effects were reversed by 17β-estradiol benzoate but not by progesterone. Renal denervation did not alter FENa+ , FECl- , water intake, or urinary flow values vs controls. However, the renal catecholamine release level was decreased in the OVP (236.6±36.1 ng/g) and denervated rat groups (D: 102.1±15.7; ODE: 108.7±23.2; ODP: 101.1±22.1 ng/g). Furthermore, combining OVX + D (OD: 111.9±25.4) decreased renal catecholamine release levels compared to either treatment alone. OVE normalized and OVP reduced renal catecholamine release levels, and the effects on plasma catecholamine release levels were reversed by ODE and ODP replacement in OD. These data suggest that progesterone may influence catecholamine release levels by renal innervation and that there are complex interactions among renal nerves, estrogen, and progesterone in the modulation of renal function.

Utilización de bisfosfonatos en las enfermedades de los huesos / Use of bisphosponates in bone-related diseases

Los bifosfonatos son medicamentos que ayudan a fortalecer los huesos, reducen el riesgo de fracturas y dolor en los que han sido debilitados por el cáncer metastásico. Estos disminuyen la reabsorción ósea de modo general por vía oral; por vía intravenosa se suelen utilizar como tratamiento coadyuvante de algunos tipos de cáncer y, por ende, es necesario tener presente los efectos adversos asociados a su uso. El presente trabajo tiene como objetivo realizar una revisión bibliográfica sobre este grupo de fármacos, los cuales se emplean en el tratamiento de las enfermedades relacionadas con los huesos, para esto se efectuó una búsqueda en la que se utilizaron algunas de las bases de datos disponibles en la web tales como Google, Scirus y Medline durante los últimos 10 años. Se concluye que los bifosfonatos inhiben la reabsorción ósea mediada por osteoclastos y debido a este mecanismo de acción se han empleado en el tratamiento de la osteoporosis

Protocolos clínicos atuais para os reimplantes dentais tardios / Actual clinical protocol to delayed dental replanation

Os casos de reimplante tardio de dentes avulsionados são considerados de prognóstico duvidoso, pois a ocorrência de anquilose e reabsorção são fatos comuns para esta condição. Com o intuito de prevenir tais conseqüências, a literatura propõe a utilização de substâncias no tratamento das superfícies radiculares dos dentes avulsionados cujo reimplante ocorra tardiamente. A proposta deste trabalho foi realizar uma discussão da literatura dentre as várias substâncias citadas e estudadas e apresentar protocolos de atendimento nas diversas situações possíveis. A remoção do ligamento periodontal e aplicação de solução de fluoreto de sódio a 2% por 20 minutos têm sido indicados no tratamento das superfícies radiculares de dentes reimplantados tardiamente. Além disso, muitos estudos estão sendo realizados com outras substâncias para tal finalidade, e algumas têm apresentado resultados promissores.

The delayed replantation of avulsed teeth has a critical long-term prognosis due to the common ankylosis and root resorpition ocurrency. The literature has purposed the use of several substances to the root surface treatment in order to delay or prevent these consequences. The aim of this study is to present a literature discussion about several substances studied, and discrible a clinical guidelines recommended to various situations. The periodontal ligament elimination and 2% sodium fluoride solution application for 20 minutes have been indicated to the root surface treatment in delayed tooth replantation. Furthermore, many studies have been done with other substances with the same goal and some of that have showed promising results.

Implantes cigomáticos: soluciones implantosoportadas sin injertos / Zygomatic implants: implant-supported solution without grafts

El uso de implantes cigomáticos provee una opción de tratamiento para pacientes con reabsorción maxilar severa, defectos maxilares grandes como en secuelas de trauma o en maxilectomías o situaciones con previa pérdida de implantes. El tratamiento con implantes cigomáticos es predecible, con alto porcentaje de éxito y poco índice de complicaciones, siempre y cuando sea realizado por cirujanos maxilofaciales con preparación adecuada en el procedimiento. El propósito de éste artículo es ilustrar al lector sobre una opción más de tratamiento en pacientes edéntulos maxilares, además de mencionar las indicaciones y contraindicaciones de los implantes cigomáticos y de la descripción de la técnica de la cirugía.

The use of zygomatic implants provides an alterative treatment option for patients with severe maxillary resorption, large maxillary defects sequale of trauma or maxillectomies or prior to implant placement. Treatment with this technique is predictable, has a high success rate and very few complications when carried out by maxillofacial surgeons with adequate training. The purpose of this article is to present a description of the zygomatic implant technique as an alternative for the treatment of edentulous maxillaries as well its indications and contraindications.

Aspectos celulares, teciduais e moleculares da osteogênese ectópica e ortotópica induzida pela matriz alogênica óssea e dentinária / Cellular, tissue and molecular aspects of the ectopic and orthotopic osteogenese induced by bone and dentine allogenic matrix

O objetivo do atual trabalho, foi correlacionar os eventos celulares e teciduais com a expressão das proteínas VEGF, BMP-7, RANKL e OPG durante a osteogênese ectópica e ortotópica, induzida pela matriz óssea (MO) e dentinária (MD) alogênica. Matrizes alogênicas desmineralizada em HCl a 0,6N, obtidas de fêmur e incisivo de ratos, fori implantada entre as fáscias musculares da coxa e em defeito trans-ósseo de 8mm de diâmetro nos ossos parietais. As análises radiográfica e histomorfométrica da neoformação óssea e, a imunohistoquímica e o western blotting para as proteínas VEGF, BMP, RANKL e OPG, mostraram que: a) o volume da região do enxerto nos sítios ortotópicos reduziu 19% em 42 dias; b) em ambos tipos de enxerto e locais de implantação, ocorreu formação de tecido cartilaginoso e ósseo; c) nos sítios intramusculares, a reabsorção da matriz alogênica e a remodelação do tecido cartilaginoso, ósseo e medular foi mais acelerado, em relação a implantação ortotópico; d) o aumento na densidade de volume dos vasos sanguíneos e no número de osteoblastos/osteócitos e osteoclastos ocorreu simultaneamente e estava associado à maior reabsorção da matriz alogênica e à formação do tecido medular (hematopoiético); e) as proteínas VEGF, BMP-7, RANKL, OPG foram expressas em condrócitos, osteoblastos ativos, osteócitos recém aprisionados na matriz e em células estromais próximas aos osteoblastos ou às áreas da matriz alogênica reabsorvida; e f) a expressão das proteínas VEGF, BMP-7, RANKL e OPG foi maior no grupo MO. O pico de expressão dessas proteínas ocorreu nos períodos de 14 aos 21 dias no grupo da MO e 21 e 28 dias no grupo da MD.

Concluímos que, a capacidade osteoindutora da matriz alogênica desmineralizada está relacionado a origem da matriz e ao sítio de implantação e que, as proteínas VEGF, BMP-7, RANKL e OPG estão associadas a maior reabsorção da matriz implantada, promovendo uma rápida e contínua liberação dos morfógenos contidos em seu interior que, induzem temporal e espacialmente a formação óssea/medular.

The aim of the present work was to correlate the cellular and tissue events with the expression of VEGF, BMP-7, RANKL and OPG during ectopic and orthotopic osteogenesis, induced by bone and dentin allogeneic matrix. Allogenic matrices obtained from femur and incisor of rats and demineralized in 0.6 N HCl were implanted into a intramuscular pocket and a 8mm-diameter bone defect in the skull. The radiographic and histomorphometric analysis of new bone formation, and immunohistochemistry and western blotting for VEGF, BMP, RANKL and OPG proteins, showed that: a) the total volume of the graft region in orthotopic site decreased 19% at 42 days b) in both graft types and implantation sites occurred formation of cartilaginous and bone tissues, c) in intramuscular sites, the resorption of allogenic matrix and remodeling of the new formed cartilage and bone were faster, in relation to orthotopic implantation sites; d) the increase in the volume density of blood vessels and in the number of osteoblasts/osteocytes and osteoclasts occurred simultaneously and was associated with greater reabsorption of the allogenic matrix and hematopoietic bone marrow formation; e) VEGF, BMP-7, RANKL, OPG proteins were expressed in chondrocytes, active osteoblasts, newly osteocytes confined and stromal cells located near the osteoblasts or in the surface of the reabsorbed matrix; and f) the VEGF, BMP-7, RANKL and OPG expression was higher in MO grafts than in the MD. The peak of expression of these proteins each occurred at 14 and 21 days in MO and 21 and 28 days in MD. We concluded that, the osteoinductive capacity of allogeneic demineralized matrix is related to matrix origin and implantation site and that the VEGF, BMP-7, RANKL and OPG proteins are associated with greater reabsorption of the implanted matrix, promoting rapid and continuous matrix-release morphogens that induces spatially and temporally the bone and bone marrow formation.

The Expression and Implication ofTRPV5, Calbindin-D28k and NCX1 in Idiopathic Hypercalciuria / 华中科技大学学报（医学）（英德文版）

Summary: The expression of calcium epithelium TRPV5, alcium binding protein Calbindin-D28k and Na+/Ca2+ exchanger NCX1 was detected in renal distal convoluted tubule, and their effects on urine calcium reabsorption and the possible pathogenic mechanism in idiopathic hypercalciuria (IH) were investigated. Genetic hypercalciuric stone-forming (GHS) rats were chosen as animal models to study urine calcium reabsorption and IH. The cognate female and male rats that had maximal urine calcium were matched to breed next generation. Twelve GHS rats and 12 normal control (NC) SD rats were selected. Western blot and real time quantitative PCR were used to detect the protein and gene expression of TRPV5, Calbindin-D28k and NCX1 respectively. The expression levels of TRPV5 protein and mRNA in GHS rats were significantly lower than in NC rats (P<0.05). Western blot revealed that the expression levels of Caibindin-D28k in GHS rats and NC rats were 0.49±0.02 and 0.20±0.01 respectively, with the difference being significant between them (P<0.05). By using real time quantitative PCR, it was found that there was no significant difference in Calbindin-28k mRNA expression levels between GHS rats and NC rats (P0.05). There was no significant difference in the NCX1 expression between GHS rats and NC rats (P0.05). It was suggested that TRPV5 and Caibindin-D28k might play an important role in urine calcium reabsorption and IH, but they differently contributed to the pathogenesis: The down-regulation of TRPV5 decreases urine calcium reabsorption, directly leading to loss of the urine calcium and resulting in hypercalciuria, and the increased Calbindin-D28k expression could relieve, neutralize and decrease intracellular Ca2+ concentration to maintain calcium balance. NCX1 is not the key protein in urine calcium reabsorption.

Reabsorção radicular externa inflamatória: descrição de caso clínico utilizando pasta de hidróxido de cálcio / External inflamatory root resorption: clinical case description using calcium hidroxide paste

A ocorrência de reabsorção radicular externa pode estar ligada a um processo inflamatório crônico e persistente na região periapical, que determina a presença de lesão com rarefação óssea promovida por algum agente irritante exógeno ou mesmo endógeno como fator predisponente. Nesses casos, a única forma de tentar impedir sua evolução é a remoção do agente, por meio do tratamento endodôntico ou da reintervenção. Um paciente relatava sintomatologia dolorosa à percussão vertical e à palpação apical no dente 11. A imagem radiográfica mostrava reabsorção radicular externa discreta no terço apical da raiz, provavelmente intensificando a sobreobturação pela perda radicular. O plano de tratamento de eleição constrou de desobturação do canal, determinação de nvo comprimento de trabalho e instrumentação. Trocas periódicas mensais de pasta de hidróxido de cálcio associada a polietilenoglicol foram realizadas. Após verificação da estagnação do processo de reabsorção radicular, apresentando radiograficamente uma melhora reparacional significativa, procedeu-se à obturação do canal radicular. As radiografias de controle mostram sucesso após reintervenção com utilização da pasta com até quatro anos da conclusão do tratamento

The occurrence of external root reabsorption can be associated to a persistentand chronic inflammatory process at the periapical area that determinesthe presence of bone rarefaction lesion promoted by some endogenous orexogenous irritant agent as predisponent factor. In these cases the only formto try to stop evolution is the agent remotion through endodontic treatmentor reintervention. A female patient, 40 years old, presented sensibility at theelement 11. The radiographic image showed discreet external rootreabsorption in apical third of the root probably intensifying the overfillingby the radicular loss. The election treatment plan consists in removing fillingmaterials of the root, determination of a new root length and instrumentation.Periodical monthly changes of calcium hydroxide and polyethyleneglycolassociated were carried out. After this period a root reabsorption stagnationprocess was verified radiographically, presenting a significant improvementof tissue repair allowing root filling. The radiographic control shows successeven after four years of treatment conclusion

Magnesium metabolism after a full-marathon race / 体力科学

We examined the relationship between serum magnesium (sMg) change and urinary Mg (uMg) excretion, lipid metabolism and hormonal responses induced by prolonged physical exercise. Six recreational runners voluntary participated in the study, and their sMg, uMg, serum lipid and circulatory levels of plasma hormones (ACTH, cortisol, ADH, aldosterone) were determined during a 1-week recovery period after a full-marathon race. Immediately after the race, fall of sMg was significant, but recovered to the pre-race level in the next day. Urinary Mg excretion decreased significantly after the race and the tubular reabsorption rate (%TRMg) was elevated for one week. The negative correlation between sMg and %TRMg suggested that a decreased level of sMg enhanced tubular reabsorption of Mg. On the other hand, no correlation was observed between the plasma hormone levels and %TRMg, thus hormonal responses induced by prolonged exercise had less effect on the tubular reabsorption of Mg. Therefore, fall of sMg after the full marathon race may not be a reflection of Mg depletion, but seems to be the result of a Mg shift to other regions (muscle, erythrocytes and adipose cells) from the serum. Increased level of serum FFA after the race suggested enhanced lipolysis, which might be a cause of sMg reduction.