Environmental risk factors analysis in paediatric oral health: a cross-sectional study.

AIM: The aim of the present study was to evaluate the association between environmental risk factors [adherence to the Mediterranean diet (MD), eating habits, hygiene habits, body mass index (BMI)] with the presence of caries in a university-based cohort of paediatric patients. MATERIALS: A total of 118 paediatric patients were included in the study. In addition to the evaluation of clinical (vitality test, percussion test) and radiographic (X-ray bitewing, OPT) parameters, patients' lifestyle was investigated through validated questionnaries. Data regarding decayed, missing, filled teeth index were recorded for both permanent (DMFT) and deciduous teeth (dmft). Logistic/linear regression models (crude estimates) and multiple regression models (logistic/linear) adjusted for confounding factors were built to evaluate the association between lifestyle habits and caries. The results were reported as Odds Ratio (OR - con 95% CI) for logistic regression models and Mean Difference (MD - con 95% CI) for linear models. CONCLUSION: The present study confirmed the role of nutritional habits in caries development in the paediatric population, especially for deciduous dentition. Further clinical studies are needed to improve the quality of administered questionnaires and evaluate the cause/effect relationship between environmental risk factors and caries.

Qualitative and quantitative performance of ¹8F-FDG-PET/MRI versus ¹8F-FDG-PET/CT in patients with head and neck cancer.

BACKGROUND AND PURPOSE: MR imaging and PET/CT are integrated in the work-up of head and neck cancer patients. The hybrid imaging technology (18)F-FDG-PET/MR imaging combining morphological and functional information might be attractive in this patient population. The aim of the study was to compare whole-body (18)F-FDG-PET/MR imaging and (18)F-FDG-PET/CT in patients with head and neck cancer, both qualitatively in terms of lymph node and distant metastases detection and quantitatively in terms of standardized uptake values measured in (18)F-FDG-avid lesions. MATERIALS AND METHODS: Fourteen patients with head and neck cancer underwent both whole-body PET/CT and PET/MR imaging after a single injection of (18)F-FDG. Two groups of readers counted the number of lesions on PET/CT and PET/MR imaging scans. A consensus reading was performed in those cases in which the groups disagreed. Quantitative standardized uptake value measurements were performed by placing spheric ROIs over the lesions in 3 different planes. Weighted and unweighted κ statistics, correlation analysis, and the Wilcoxon signed rank test were used for statistical analysis. RESULTS: κ statistics for the number of head and neck lesion lesions counted (pooled across regions) revealed interreader agreement between groups 1 and 2 of 0.47 and 0.56, respectively. Intrareader agreement was 0.67 and 0.63. The consensus reading provided an intrareader agreement of 0.63. For the presence or absence of metastasis, interreader agreement was 0.85 and 0.70. The consensus reading provided an intrareader agreement of 0.72. The correlations between the maximum standardized uptake value in (18)F-FDG-PET/MR imaging and (18)F-FDG-PET/CT for primary tumors and lymph node and metastatic lesions were very high (Spearman r = 1.00, 0.93, and 0.92, respectively). CONCLUSIONS: In patients with head and neck cancer, (18)F-FDG-PET/MR imaging and (18)F-FDG-PET/CT provide comparable results in the detection of lymph node and distant metastases. Standardized uptake values derived from (18)F-FDG-PET/MR imaging can be used reliably in this patient population.

Recurrent and metastatic breast cancer PET, PET/CT, PET/MRI: FDG and new biomarkers.

Primary breast cancer often displays only moderately increased glucose metabolism resulting in a low sensitivity of positron emission tomography (PET) using [F-18]fluorodeoxyglucose (FDG) in detecting small breast carcinomas, locoregional micrometastases and non-enlarged tumor infiltrated lymphnodes. In contrast, distant breast cancer metastases are generally characterized by significantly increased metabolic activity compared to normal tissue. Therefore, FDG-PET provides accurate diagnostic information as a whole body imaging modality in staging of breast cancer patients. The metabolic information from FDG-PET/CT is often more sensitive than conventional imaging for the detection of distant metastases, particularly in the recurrent setting. FDG-PET is superior in detecting tumor-involved distant lymphnodes, particularly those which are normal in size, as well as in characterizing enlarged lymphnodes as positive or negative for malignancy. Of note, CT is superior in detecting small lung metastases. Although the overall sensitivity for bone scintigraphy and FDG-PET are comparable, bone scintigraphy seems to be superior in the detection of osteoblastic disease whereas FDG-PET is superior for osteolytic metastases, suggesting a complementary role for both imaging procedures. FDG-PET/MR has an evolving role in breast cancer management, for example in the detection of liver metastases and in the research setting for treatment monitoring. The utilization of PET for prediction of treatment response to primary chemotherapy is an area of active research, using FDG as well as other PET biomarkers including [F-18]Fluoroestradiol, [F-18]Fluorothymidine and integrin targeting tracer for monitoring anti-angiogenic therapy.

Feasibility, safety, and preliminary proof of principles of autologous neural stem cell treatment combined with T-cell vaccination for ALS patients.

Uncontrolled activation of the innate immune system promotes the deterioration of neurons in different neurodegenerative diseases, including amyotrophic lateral sclerosis (ALS). T-cell vaccination (TCV) was developed by Irun Cohen and coworkers at the Weizmann Institute of Science (Israel) during the late 1970s and has been demonstrated to be an effective treatment for human autoimmune diseases and a regulator of macrophage activation in animal models. We treated seven ALS patients with this cell therapy and were able to slow or stop disease progression in the affected individuals. The median survival, which is 3.5 years, was extended to 6 years. They were also treated with autologous adult neural stem cells associated with effector T cells. The observed neurologic improvements after treatment lasted for at least 1 year. Clinical recovery in the treated ALS patients was confirmed by an independent, skilled neurologist using the ALS Functional Rating Scale-Revised (ALSFRS-R). TCV in conjunction with an autologous neural stem cell treatment might be a feasible, minimally invasive, safe, and effective approach to obtain enduring therapeutic effects in ALS patients.

Case report on the clinical results of a combined cellular therapy for chronic spinal cord injured patients.

OBJECTIVES: With the intention to ameliorate the clinical condition of patients with chronic spinal cord injury (SCI), a program that combines three cell therapies and an appropriate neurorehabilitation program were used to recreate and enhance the natural conditions of SCI repair. METHODS: Vascularization recovery is approached by selective artery infusion of BMMNCs (bone marrow mononuclear cells) to the disrupted area. Eighteen days later, with the aim to restore the specific inflammatory activity, an i.v. infusion of spinal cord specific ETCs (effector T cells) is carried out. With the intention of supplying cellular components for the process of repair, an infusion of autologous neural stem cells (NSCs) through selective feeding artery infusion is carried out, followed by an appropriate neurorehabilitation program. RESULTS: A total of eight ASIA (American Spinal Injury Association) A patients (five with jeopardized brachial plexus and three without) received the treatment. No severe adverse events was observed in any of the receptor patients: five patients evolved from ASIA A to ASIA D and regained the ability to stand up and, with varying effectiveness, to walk; two patients remained in the same condition, but exhibited motor and sensitive improvements; and one patient could not be evaluated. CONCLUSIONS: These reports suggest that the biological characteristics of acute SCI may be recreated in a comprehensive, safe and effective manner.

Synthesis, structures, and properties of nine-, twelve-, and eighteen-membered N-benzyloxyethyl cyclic alpha-peptoids.

N-Benzyloxyethyl cyclic alpha-peptoids of various size were prepared and their conformational features were investigated by means of computational, spectroscopic, and X-ray crystallographic studies.

Performance evaluation of a conformal thermal monitoring sheet sensor array for measurement of surface temperature distributions during superficial hyperthermia treatments.

PURPOSE: This paper presents a novel conformal thermal monitoring sheet (TMS) sensor array with differential thermal sensitivity for measuring temperature distributions over large surface areas. Performance of the sensor array is evaluated in terms of thermal accuracy, mechanical stability and conformity to contoured surfaces, probe self-heating under irradiation from microwave and ultrasound hyperthermia sources, and electromagnetic field perturbation. MATERIALS AND METHODS: A prototype with 4 x 4 array of fiber-optic sensors embedded between two flexible and thermally conducting polyimide films was developed as an alternative to the standard 1-2 mm diameter plastic catheter-based probes used in clinical hyperthermia. Computed tomography images and bending tests were performed to evaluate the conformability and mechanical stability respectively. Irradiation and thermal barrier tests were conducted and thermal response of the prototype was compared with round cross-sectional clinical probes. RESULTS: Bending and conformity tests demonstrated higher flexibility, dimensional stability and close conformity to human torso. Minimal perturbation of microwave fields and low probe self-heating was observed when irradiated with 915 MHz microwave and 3.4 MHz ultrasound sources. The transient and steady state thermal responses of the TMS array were superior compared to the clinical probes. CONCLUSIONS: A conformal TMS sensor array with improved thermal sensitivity and dimensional stability was investigated for real-time skin temperature monitoring. This fixed-geometry, body-conforming array of thermal sensors allows fast and accurate characterization of two-dimensional temperature distributions over large surface areas. The prototype TMS demonstrates significant advantages over clinical probes for characterizing skin temperature distributions during hyperthermia treatments of superficial tissue disease.

Autoreactive T cells induce in vitro BM mesenchymal stem cell transdifferentiation to neural stem cells.

BACKGROUND: The degree of post-injury inflammation of the damaged area of a spinal cord is the main difference between the natural successful repair in inferior vertebrates and failure in superior vertebrates. The treatment of rats with anti-myelin lymphocytes after experimental spinal cord injury induces their functional recovery. On the other hand, mesenchymal stem cells (MSC) from adult BM implanted in injured areas recover the morphology and function of spinal cord in mammals. The purpose of this study was to determine whether there is a direct relationship between anti-nervous tissue T cells and MSC reparatory properties. METHODS: Circulating autoreactive lymphocytes of patients with spinal cord injuries and amyotrophic lateral sclerosis were isolated and activated in vitro. These cells were cocultured with autologous MSC for 2-15 days. Cocultures of non-selected lymphocytes were used as controls. RESULTS: After 48 h of coculture, MSC adopted a spindle shape with polarization of the cytoplasm that resembled bipolar neurons. Their nuclei diminished the nucleolus number and the chromatin lost its granular appearance. After 15 days of culture the cells developed the typical structure of a neural network. No morphologic changes were observed in control cultures. The differentiated cells reacted positively to tubuline III, GFAP and nestin. No differences were observed between the different patient cell sources. DISCUSSION: We observed that autoreactive cells may induce the transdifferentiation of MSC to neural stem cells. This T-cell-MSC interaction may be a common phenomenon during physiologic nerve tissue repair.

Combined protocol of cell therapy for chronic spinal cord injury. Report on the electrical and functional recovery of two patients.

BACKGROUND: This is a preliminary report on successful results obtained during treatment of two patients with chronic spinal cord injury. The therapeutic approach was based on the generation of controlled inflammatory activity at the injury site that induced a microenvironment for the subsequent administration of autologous, BM-driven transdifferentiated neural stem cells (NSC). METHODS: BM mesenchymal stem cells (MSC) were cocultured with the patient's autoimmune T (AT) cells to be transdifferentiated into NSC. Forty-eight hours prior to NSC implant, patients received an i.v. infusion of 5 x 10(8) to 1 x 10(9) AT cells. NSC were infused via a feeding artery of the lesion site. Safety evaluations were performed everyday, from the day of the first infusion until 96 h after the second infusion. After treatment, patients started a Vojta and Bobath neurorehabilitation program. RESULTS: At present two patients have been treated. Patient 1 was a 19-year-old man who presented paraplegia at the eight thoracic vertebra (T8) with his sensitive level corresponding to his sixth thoracic metamere (T6). He received two AT-NSC treatments and neurorehabilitation for 6 months. At present his motor level corresponds to his first sacral metamere (S1) and his sensitive level to the fourth sacral metamere (S4). Patient 2 was a 21-year-old woman who had a lesion that extended from her third to her fifth cervical vertebrae (C3-C5). Prior to her first therapeutic cycle she had severe quadriplegia and her sensitive level corresponded to her second cervical metamere (C2). After 3 months of treatment her motor and sensitive levels reached her first and second thoracic metameres (T1-T2). No adverse events were detected in either patient. DISCUSSION: The preliminary results lead us to think that this minimally invasive approach, which has minor adverse events, is effective for the repair of chronic spinal cord lesions.

Periodontal pathogens in atheromatous plaques. A controlled clinical and laboratory trial.

OBJECTIVE: A possible relationship between periodontitis and cardiovascular disease has been suggested. The aims of this controlled clinical study were: (i) to ascertain the presence of periodontal bacteria DNA [Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythensis (formerly Bacteroides forsythus)] in carotid atheromatous plaques and (ii) to assess the concomitant presence of the same periodontal bacteria DNA, if any, in periodontal pockets and in carotid atheroma in the same patient. METHODS: A total of 52 patients scheduled for carotid endarderectomy were enrolled in this study. The test group consisted of 26 dentate patients; the control group included 26 edentulous patients. A complete periodontal examination, including radiographic orthopanoramic and subgingival plaque sample, was performed in the test population. Oral and X-ray examinations were performed in the control group. Atheromatous plaques were harvested during surgical procedure for each dentate and edentulous patient and then sent to the microbiological laboratory. Subgingival plaque samples and carotid specimens were examined using the polymerase chain reaction (PCR) technique by means of specific primers for periodontal bacteria. Amplification of extracted DNA was tested using human beta-globin specific-primers. RESULTS: Out of 52 endarterectomy samples, 12 (seven dentate, five edentulous patients) were excluded as negative to DNA amplification. In subgingival plaque samples of 19 test patients, T. forsythensis (79%), F. nucleatum (63%), P. intermedia (53%), P. gingivalis (37%) and A. actinomycetemcomitans (5%) were found. No periodontal bacteria DNA was detected by PCR in any of the carotid samples in either patient group. CONCLUSION: The presence of periodontal bacteria DNA in atheromatous plaques could not be confirmed by this study and thus no correlation could be established between species associated with periodontal disease and putative bacteria contributing to atheromatous plaques.

Meningocele sacro anterior. Caso clinico y revision de la literatura / Anterior sacral meningocele. Clinical case and literature review

Objective: to describe the surgical treatment of an anterior sacral meningocele (ASM). Description: a 67 year-old woman presented with pelvic mass symptoms, and had a previous history of four surgeries with mistaken diagnosis, consulted to the neurosurgery departament for pain treatment. MRI revealed a cystic sacral mass connected with the spinal subarachnoid space, with low density structures in the pedicle. MyeloCT showed no neural elements in the sac. Intervention: an anterior transabdominal approach with wall cyst dissection, excision of the sac and simple ligation of the neck was performed. Conclusion: we presented an uncommon case of ASM in an adult woman, with the transabdominal surgical approach was the treatment of choice in anterior sacral meningocele

Meningocele sacro anterior. Caso clinico y revision de la literatura / Anterior sacral meningocele. Clinical case and literature review

Objective: to describe the surgical treatment of an anterior sacral meningocele (ASM). Description: a 67 year-old woman presented with pelvic mass symptoms, and had a previous history of four surgeries with mistaken diagnosis, consulted to the neurosurgery departament for pain treatment. MRI revealed a cystic sacral mass connected with the spinal subarachnoid space, with low density structures in the pedicle. MyeloCT showed no neural elements in the sac. Intervention: an anterior transabdominal approach with wall cyst dissection, excision of the sac and simple ligation of the neck was performed. Conclusion: we presented an uncommon case of ASM in an adult woman, with the transabdominal surgical approach was the treatment of choice in anterior sacral meningocele (AU)

Single-pixel demonstration of innovative adaptive optics by use of a charge-transfer membrane light modulator.

We have constructed and demonstrated a single-pixel implementation of an all-optical membrane-based spatial light modulator as a compact optical wave-front error correction device. High rates of response of as much as 20 kHz in an open-loop configuration were obtained. The device was then used in an adaptive-optics servo to compensate successfully for a 1-kHz sinusoidal phase error with a peak-to-peak excursion of approximately pi/7 rad. A small-signal servo gain of the order of 10 was inferred from the closed-loop measurements.

Optical real-time defect-enhancement diagnostic system.

We have demonstrated an all-optical diagnostic system that enhances the observation of defects in periodic structures. This real-time technique employs a spatial light modulator as a smart-pixel array for information processing in the Fourier transform plane of a lens. The system also includes a phase-conjugate mirror for autoalignment and for correction of optical wave-front aberrations that are imparted on the object light by the smart-pixel processor and its associated optical train.

Retromodulation/conjugation using a self-pumped atomic sodium phase-conjugate mirror.

A self-pumped atomic sodium phase-conjugate mirror was modified to include an amplitude modulator, which thus formed a device capable of encoding temporal information onto the phase-conjugate return beam. Modulation rates of as much as 4 MHz with modulation depths in the range of 70-90% (both limited by the electronics and the modulator) have been obtained by using an intracavity acousto-optic modulator.

Analytical electrical model for a Si liquid crystal light valve.

An approximate analytical model has been developed which allows the voltage characteristics of the liquid crystal layer of a silicon liquid crystal light valve to be determined once the photocurrent level and device parameters have been specified. This model significantly decreases the computation time compared to current numerical techniques.

Continuous-wave self-pumped optical phase conjugation in atomic sodium vapor.

Self-pumped optical phase conjugation has been demonstrated for the first time to our knowledge in a resonant atomic system. This process was implemented by using a single cw pump beam to excite a sodium-vapor oscillator. The counterpropagating optical fields inside this oscillator then combine with the pump beam in an internal fourwave-mixing interaction to yield the phase conjugate of the incident (pump) beam.

Coupled cw dye lasers using intracavity four-wave mixing.

An experimental investigation of laser-oscillator frequency locking by a four-wave interaction was conducted. An experiment was performed that successfully demonstrated the locking of two cw dye lasers using this concept with Na vapor serving as the nonlinear (coupling) medium.