Labial inverse dilaceration of bilateral maxillary central incisors: A case report.

BACKGROUND: Dilaceration is a rare dental developmental anomaly characterized by an abrupt deviation along the longitudinal axis of the root in which an angulation forms between the root and the crown. Here, we report on dilacerated bilateral maxillary central incisors in mixed dentition. CASE SUMMARY: A 10-year-old girl presented with a chief complaint of unerupted central incisors. An oral examination and radiography provided the basis for a diagnosis of dilaceration of the maxillary central incisors. After surgical exposure of the impacted teeth, a button with an attached chain was applied to the palatal surface of teeth 11 and 21. After 8 mo, a button was bonded to the labial surface of the crown to fix an elastic chain and move the teeth toward the maxillary arch. Finally, a fixed appliance was applied to tooth alignment to Class 1 malocclusion using a 0.019 × 0.025-inch nickel-titanium wire. After 3 years of follow-up, the clinical findings and radiographic assessment showed that the roots had developed with vital dental pulp and healthy periodontium, were acceptable aesthetically, and showed no resorption. CONCLUSION: The rare occurrences of dilacerated bilateral maxillary central incisors can be successfully treated through surgical exposure and orthodontics.

Mouse model of plasma cell mastitis.

BACKGROUND: Plasma cell mastitis is distinct from the common form of mastitis and clinically resembles breast carcinoma. The lesion occurs in non-lactating young women, and the incidence rate is rising. Surgical resection is the main treatment, but cannot prevent recurrence of the disease. Disfigurement or removal of breast after the operations can cause marked physical and psychological distress. The etiology of plasma cell mastitis is unclear up till now. It is therefore necessary to investigate further the underlying immunological changes of the disease. METHODS: The lesions of plasma cell mastitis removed from patients through aseptic operation were mixed with normal saline into homogenate tube machine (homogenate tubes were disinfected and sterilized prior to treatment). The mixture was homogenized at medium speed and grinded in ultrasonic cell disruptor. The homogenate obtained was made into oil emulsion with Freund's adjuvant. Thirty female BALB/c mice (6 weeks after sexual maturity) were divided into five groups A-E: group A was blank control; group B was normal saline control; group C was inoculated with 0.02 ml water-in-oil emulsion; group D was inoculated with 0.04 ml water-in-oil emulsion; group E was complete Freund's adjuvant control. RESULTS: Pathology results showed that mouse mammary gland acinar cells remained integral without any abnormal changes observed in control groups A and B. Experimental groups C and D showed dilation of mouse mammary ductal tissue with a large number of epithelial cells and debris in the lumen, and fibrosis around ducts accompanied by large duct cells, neutrophils, lymphocytes, and especially plasma cell infiltration. Pathological changes were observed in 3 (50%) mice and 5 (83.3%) mice in group C and D respectively. In group E, neutrophil infiltration in mammary gland was observed in 5 mice, but neither infiltration of plasma cells nor other abnormal pathological changes were observed. CONCLUSIONS: The lesions of patient with plasma cell mastitis could make the female BALB/c mice experience the similar clinical and pathological manifestation. High-dose group can successfully establish a mouse model of plasma cell mastitis.

Minimally invasive video-assisted thyroidectomy for the early-stage differential thyroid carcinoma.

BACKGROUND: Minimally invasive video-assisted thyroidectomy (MIVAT), the modified Miccoli's thyroid surgery, is the most widespread minimally invasive technique and has been widely used for treatment of thyroid disease. This study aimed to verify the potential benefits of the modified Miccoli's thyroid surgery, determine the feasibility of the MIVAT for early-stage differential thyroid carcinoma and evaluate the likelihood of the surgical method as a standard operation for early malignant thyroid carcinoma. METHODS: A total of 135 patients were retrospectively compared which included two groups of patients: the first group underwent the conventional thyroidectomy; the other group underwent MIVAT. Patients with thyroid nodule smaller than 20 mm and without previous neck surgery were included while those with wide-ranging and distant metastases of cervical tissues, or any suspected thyroid nodal metastases were excluded for analysis. MIVAT and the central compartment (level VI) lymph nodes dissection (LND) were considered as a new treatment method for this retrospective study. In addition to the comparison of surgical outcomes between the new treatment and the conventional thyroid surgery, other surgical parameters including operative time, operative volume of hemorrhage, incisional length, postoperative volume of drainage, length of hospitalization, accidence of hoarse voice, accidence of bucking, accidence of hypocalcemia and peak angle of cervical axial rotation were also compared. RESULTS: Out of 135 patients, 111 patients underwent conventional thyroid surgery and 24 patients underwent MIVAT plus level VI LND for treatment of early-stage differential malignant carcinoma. Patients who received the new surgical treatment had significantly shorter incisional length (3.1 cm vs. 6.9 cm, p < 0.0001), shorter operative time (109 min vs. 139 min, p = 0.014) and fewer operative hemorrhage (29.5 ml vs. 69.7 ml, p < 0.0001) when compared to the conventional treatment. Postoperative peak angle of cervical axial rotation of patients treated with MIVAT was less than those treated with conventional surgery (L: 31.5° vs. 39.0°, p < 0.0001; R: 31.5° vs. 38.0°, p < 0.0001). Incisional wound infection, postoperative hoarse voice, bucking and hypocalcemia were not observed in all patients. Postoperative analgetica was not required as well. CONCLUSIONS: Compared with conventional thyroid surgery for early-stage differential thyroid carcinoma, the new surgical treatment could be considered as an alternative surgical method for treatment of early-stage thyroid carcinoma since it was feasible, safe and clinically effective with better surgical and cosmetic outcomes.

[Effects of rhubarb on intestinal flora and bacterial translocation in rats with sepsis].

OBJECTIVE: To investigate the effects of rhubarb on intestinal flora and bacterial translocation in septic rats. METHODS: One hundred and four Sprague-Dawley (SD) rats were randomly divided into normal control group, burn group, sepsis group, and sepsis with rhubarb treatment group. All the animals except those in the normal control group were given 30% total body surface area (TBSA) III degree burn on their back followed by endotoxin challenge intraperitoneally in a dose of 20 mg/kg 24 hours after the burn injury. The animals were treated with intraperitoneal injection of ceftriaxone 24 hours after the second hit in various groups in a dose of 60 mg/kg, twice a day with a interval of 12 hours. Rhubarb was also given orally with a dose of 50 mg/kg, twice a day with an interval of 12 hours, at the same time. On 1, 3 and 9 days after treatment, intestinal bacilli in colon and the incidence of bacterial translocation in content of large intestine, liver, lung, mesenteric lymph node and blood in each group were determined. RESULTS: Neither intestinal bacilli in colon nor bacterial translocation showed significant change after the burn injury [(5.86+/-0.62) log cfu/g vs. (5.52+/-0.41) log cfu/g]. The second hit with endotoxin obviously increased the number of intestinal bacilli in colon [(8.96+/-0.73) log cfu/g, P<0.01], in which Colibacillus remain the predominant flora. At the same time, the incidence of Colibacillus translocation was also very high. The antibiotic ceftriaxone markedly reduced the number of Colibacillus on the 3rd and 9th day after the therapy [(4.43+/-0.64) log cfu/g, (5.82+/-0.99) log cfu/g, both P<0.01]. However, the number of some opportunistic pathogens, such as Pseudomonas aeruginosa and Baumanii, significantly increased, and they substituted Colibacillus to become the predominant flora in gut. Furthermore, the species of bacterial translocation also switched to Pseudomonas aeruginosa and Baumanii from Colibacillus. Rhubarb could prevent the loss of enteric bacilli in gut [(8.24+/-1.32) log cfu/g]. Moreover, it also extenuated the effects of antibiotics in diminishing commensal flore in gut. Lastly, the rhubarb could inhibit bacterial translocation at the early stage of sepsis (incidence of translocation on 1 th day of the therapy: 40.62% vs. 6.25%, P<0.05). CONCLUSION: Rhubarb can protect the gut microbiogeocoenosis, mitigate the bactericidal effect on antibiotics on commensal flora, and inhibit bacterial translocation at the early stage of sepsis.

[Influence of broad-spectrum antibiotics on the gut microflora in sepsis in rats].

OBJECTIVE: To study the influence of broad-spectrum antibiotics on intestinal microecology in septic rats. METHODS: Fifty-six Sprague-Dawley (SD) rats were randomly divided into normal control, burn and sepsis group. Rats in the latter two groups received 30% total body surface area (TBSA) III degree burns on back followed by an injection of endotoxin in a dose of 20 mg/kg 24 hours later. The animals in sepsis group were treated with intraperitoneal injection of ceftriaxone 12 hours after the endotoxin challenge in a dose of 60 mg/kg, and it was repeated 12 hours later. Another group of rats received burn injury only. Eight rats in burn group and sepsis group were sacrificed before ceftriaxone treatment, 3 days and 9 days after the treatment, respectively. The gastric, intestinal and colonic contents were collected for bacterial cultures and species determination. RESULTS: The influence of burn injury on the number and species of gut bacteria was not obvious. The addition of endotoxin could markedly increase the number of enteric bacilli in small intestine and colon (both P < 0.01), but not in stomach. However, the number of enteric bacilli was sharply decreased in intestine and colon after ceftriaxone treatment (all P < 0.01). Furthermore, the ratio of cocci to bacilli was seriously inverted in intestine and colon after ceftriaxone treatment, though burn injury followed by endotoxin had dramatically raise the ratio of cocci to bacilli in intestine and colon.It also produce a loss of anaerobic bacteria in colon, though the difference in number was not statistically significant. CONCLUSION: Broad-spectrum antibiotics could decrease the amount of enteric bacilli, making enterococci to be the predominant microbial flora in gut.

[Selective action of broad-spectrum antibiotics on intestinal flora in sepsis in rats].

OBJECTIVE: To investigate the selective effect of broad-spectrum antibiotics on the intestinal flora in sepsis in rats. METHODS: Fifty-six SD rats were randomly divided into normal control group, scald group [before ceftriaxone sodium (rocephin) treatment group], scald group with 3 days of rocephin treatment, scald group with 9 days of rocephin treatment, and sepsis group (before rocephin treatment group), sepsis group with 3 days of rocephin treatment, and sepsis group with 9 days of rocephin treatment. All the animals were incurred with 30% III degree burns on their back followed by endotoxin challenge with a dose of 20 mg/kg 24 hours after the burn injury. The animals were treated with intraperitoneal injection of ceftriaxone 24 hours (60 mg/kg, quaque 12 hours) after the second hit with endotoxin. At the end of the treatment, the bacteria in stomach, intestine and colon were cultured. The number and kind of the bacteria were also determined. RESULTS: Antibiotics significantly increased the number of cocci (P<0.05 or P<0.01). The ratio between cocci and bacilli was markedly inverted. In selective culture of gut bacilli, E.Coli was almost the only bacteria in the contents of stomach, intestine and colon in normal control group, but after burns and endotoxin challenge, Klebsiella pneumoniae, Proteus mirabilis appeared. After the rats received antibiotics treatment, E. coli decreased in number or disappeared, and was replaced mainly by Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Enterobacter cloacae and Proteus and other bacilli. CONCLUSION: Broad-spectrum antibiotics can induce imbalance of bacteria flora in the gut, resulting in a reversion of the ratio between cocci and bacilli, and also reduction in intestinal colonization resistance. Then, opportunistic pathogens become dominant flora in gut, which may cause antibiotic-related gut-origin diseases.