The recurrence of odontogenic keratocysts in pediatric patients is associated with clinical findings of Gorlin-Goltz Syndrome.

BACKGROUND: Odontogenic keratocyst (OKC) is an odontogenic developmental cyst that presents distinct clinical behavior. This lesion has been described as dental cysts with keratinization since the 1930s, however the term OKC was established in 1956. This study aims to determine the frequency and features of OKC in children aged 0 to 14 years in an oral pathology service in Brazil. MATERIAL AND METHODS: A retrospective study was performed to review cases of OKC in children diagnosed between 1986 and 2017. Clinical data were evaluated from medical records (gender, race, age, anatomical location, treatment, radiographic findings and follow-up). RESULTS: Ninety-seven cases of OKC were diagnosed in a 31-year-period in all age groups and 10 were found in children (10.3%). Age ranged from 2 to 14 years (mean age=10.5±3.5), with 8 males and 2 females. The most frequent location was the anterior region of the mandible (n=4). Patients were predominantly asymptomatic. Moreover, in two children, clinical findings of Gorlin-Goltz Syndrome were observed. The most commonly used treatment was enucleation followed by curettage. In all cases of Gorlin-Goltz Syndrome were observed recurrences and occurrence of new keratocysts. CONCLUSION: Although uncommon in pediatric patients, OKC should be considered a differential diagnosis in cases of osteolytic lesions in gnathic bones. Thus, the periodic assessment of children by dentists and pediatricians is essential to get a correct diagnosis and early treatment to avoid greater mutilation of these patients.

Clinicopathological analysis of odontogenic tumors over 22 years period: Experience of a single center in northeastern Brazil.

BACKGROUND: Odontogenic tumors (OTs) are uncommon neoplastic lesions of the maxilla and mandible, which present difficult diagnosis and therapeutics. This paper aims to determine the frequency and distribution of OTs, over a period of 22 years, at a public university in Northeastern Brazil. MATERIAL AND METHODS: We reviewed all cases of OTs from oral pathology laboratory of Federal University of Rio Grande do Norte (UFRN), from 1996 to 2017. The tumors were classified according to the latest (2017) World Health Organization Classification of Tumors. Data on age, gender, anatomic site, symptomatology, radiographic findings and tumor size were analyzed. RESULTS: In the analyzed period, 247 cases of OTs were diagnosed. Epithelial tumors were more common with 127 cases (51.8%). The most common tumors were ameloblastoma (n = 112 / 45.4%), odontoma (n = 89 / 36.1%) and odontogenic myxoma (n = 17 / 6.9%). Malignant odontogenic tumors were extremely rare in the studied population with only 2 cases (0.8%) of diagnosed carcinomas. These tumors were diagnosed in a wide age range, from 5 to 81 years, being more common in the second and third decades of life. In general, the mandible was the most affected anatomic site (n = 162/66%) and the mandible:maxilla ratio was of 2:1. Ameloblastoma was the tumor with the highest number of symptomatic cases (n = 26) and with the highest mean size (cm) with 4.5cm. CONCLUSIONS: Odontogenic tumors were rare in the sample studied (2.2%), with ameloblastoma and odontoma being the most common tumors. Continuous studies that show the characteristics of these lesions are fundamental, especially after modifications in the international classification.

Reformulating Minas Frescal cheese using consumers' perceptions: Insights from intensity scales and check-all-that-apply questionnaires.

We evaluated the performance of check-all-that-apply (CATA) questions and intensity scales to describe Minas Frescal cheese and its reformulation based on consumers' perceptions. Ten commercial samples with different formulations (full-fat, low-fat, or low-lactose) were evaluated by 200 consumers divided equally into 2 groups: 1 evaluated samples and described their ideal cheese using intensity scales and 1 did the same using CATA questions. Both methodologies provided similar information about the sensory characteristics of the Minas Frescal cheeses, the description of the ideal product, and directions for product reformulation. The ideal Minas Frescal cheese was characterized by high moisture, intense white color, homogeneous mass, typical Minas Frescal cheese aroma and flavor, softness, and juiciness. For the intensity scales, the recommendation was to increase the typical aroma and flavor, salty taste, and juiciness, and to decrease the bitter flavor; for the CATA questions, only increasing the typical Minas Frescal cheese flavor was important for all classes of cheeses. Even for a heterogeneous product with no defined manufacturing protocol, both methodologies presented satisfactory results that should be considered for use by cheese producers and the dairy industry.

Immunoexpression of VEGFR-3, but not the immunoexpression of VEGF-C or lymphatic density, is correlated with metastasis in lower lip squamous cell carcinoma.

The purpose of this study was to evaluate the immunoexpression of vascular endothelial growth factor C (VEGF-C) and VEGF receptor 3 (VEGFR-3) and their correlation with intratumoural lymphatic density (ILD) and peritumoural lymphatic density (PLD) in metastatic and non-metastatic lower lip squamous cell carcinoma (LLSCC). Twenty-five LLSCC with regional nodal metastasis and 25 LLSCC without metastasis were selected. The percentages of VEGF-C and VEGFR-3 staining in each tumour core and at the deep invasive front were assessed. PLD and ILD were determined using anti-podoplanin antibody. Immunohistochemical findings were correlated with nodal metastasis, clinical staging, local recurrence, clinical outcome, and histological grade. Cytoplasmic immunoexpression of VEGFR-3 in the tumour core was associated with metastasis (P=0.009), patient death (P=0.008), and histological grade (P<0.005). PLD, ILD, and VEGF-C expression showed no significant associations with clinicopathological parameters (P>0.05). PLD and ILD were not significantly correlated with the immunoexpression of VEGF-C or VEGFR-3 (P>0.05). There was a significant positive correlation between PLD and ILD (P=0.004), and between cytoplasmic immunoreactivity of VEGF-C and VEGFR-3 (P=0.011). These results suggest an important role for VEGFR-3 in the progression of LLSCC, and highlight the possible influence of its expression on the prognosis of these tumours. ILD and PLD may not be associated with lymph node metastasis in LLSCC.

The impact of anthropogenic food supply on fruit consumption by dusky-legged guan (Penelope obscura Temminck, 1815): potential effects on seed dispersal in an Atlantic forest area.

Frugivorous birds are important seed dispersers and influence the recruitment of many plant species in the rainforest. The efficiency of this dispersal generally depends on environment quality, bird species, richness and diversity of resources, and low levels of anthropogenic disturbance. In this study, we compared the sighting number of dusky-legged guans (Penelope obscura) by km and their movement in two areas of Serra do Japi, one around the administrative base (Base) where birds received anthropogenic food and a pristine area (DAE) with no anthropogenic resource. We also compared the richness of native seeds in feces of birds living in these two areas. Although the abundance of P. obscura was higher in the Base, these individuals moved less, dispersed 80% fewer species of plants and consumed 30% fewer seeds than individuals from DAE. The rarefaction indicated a low richness in the frugivorous diet of birds from the Base when compared to the populations from DAE. We conclude that human food supply can interfere in the behavior of these birds and in the richness of native seeds dispersed.

The impact of anthropogenic food supply on fruit consumption by dusky-legged guan (Penelope obscura Temminck, 1815): potential effects on seed dispersal in an Atlantic forest area / O impacto do fornecimento de alimentos humanos no consumo de frutos por jacuguaçus (Penelope obscura Temminck, 1815): potenciais efeitos na dispersão de sementes em uma área de Mata-Atlântica

Abstract Frugivorous birds are important seed dispersers and influence the recruitment of many plant species in the rainforest. The efficiency of this dispersal generally depends on environment quality, bird species, richness and diversity of resources, and low levels of anthropogenic disturbance. In this study, we compared the sighting number of dusky-legged guans (Penelope obscura) by km and their movement in two areas of Serra do Japi, one around the administrative base (Base) where birds received anthropogenic food and a pristine area (DAE) with no anthropogenic resource. We also compared the richness of native seeds in feces of birds living in these two areas. Although the abundance of P. obscura was higher in the Base, these individuals moved less, dispersed 80% fewer species of plants and consumed 30% fewer seeds than individuals from DAE. The rarefaction indicated a low richness in the frugivorous diet of birds from the Base when compared to the populations from DAE. We conclude that human food supply can interfere in the behavior of these birds and in the richness of native seeds dispersed.

Resumo Aves frugívoras são importantes dispersoras de sementes e influenciam no recrutamento de muitas espécies na floresta tropical. A eficiência dessa dispersão geralmente depende da qualidade do meio ambiente, das espécies de aves envolvidas, da riqueza e diversidade de recursos e de baixos níveis de impactos antrópicos. Neste estudo nós comparamos o número de avistamentos de jacuguaçus (Penelope obscura) por Km e seus movimentos em duas áreas na Serra do Japí, uma no entorno da base administrativa (Base) onde as aves receberam alimentos antropogênicos e outra em área pristina (DAE) sem fornecimento de alimentos humanos. Também comparamos a riqueza de sementes nativas nas fezes das aves que vivem nestas duas áreas. Embora a abundância de P. obscura tenha sido maior na Base, esses indivíduos deslocaram-se menos, dispersaram 80% menos espécies de plantas e consumiram 30% menos sementes do que os indivíduos do DAE. A rarefação indicou uma baixa riqueza na dieta frugívora das aves da Base quando comparada às populações do DAE. Concluímos que o fornecimento de alimentos humanos pode interferir no comportamento dessas aves e na riqueza de espécies de sementes nativas dispersadas.

Analysis of the frequency and nature of hyaline ring granulomas in inflammatory odontogenic cysts.

AIM: To determine the prevalence of hyaline ring granulomas (HRGs) in a large case series of inflammatory odontogenic cysts, and to investigate the nature of these structures. METHODOLOGY: All records from the patients diagnosed with inflammatory odontogenic cysts between January 1970 and April 2009 were reviewed. Histologic sections were evaluated by light microscopy and cases with HRGs for which sufficient biological material was available were submitted to histochemical analysis (Masson's trichrome) and immunohistochemistry (CD34, CD68 and collagen IV). RESULTS: Twenty-two (3.3%) of the 661 cases of inflammatory odontogenic cysts diagnosed during the study period presented HRGs. The relative frequency of HRGs was higher amongst residual radicular cysts (6.1%), followed by paradental cysts (5.6%) and radicular cysts (3.0%). HRGs appeared as roughly circular homogeneous/fibrillar masses in 14 (63.6%) cases and as round structures enclosing amorphous material in 3 (13.6%) cases. Most (77.8%) roughly circular homogeneous/fibrillar masses were positive for collagen, whereas all (100.0%) round structures enclosing amorphous material were negative for this protein. Immunohistochemistry showed that most mononucleated cells and all multinucleated giant cells were positive for CD68, but negative for CD34, in all cases. In addition, collagen IV immunostaining was negative in amorphous structures and weakly positive in homogeneous/fibrillar masses. CONCLUSIONS: The present results suggest a very low frequency of HRGs in inflammatory odontogenic cysts and support the hypothesis that these structures arise from the implantation of foreign material, most likely food particles of plant or vegetable origin. The diverse microscopic features of HRG possibly represent different developmental stages of this structure.

Maxillo-mandibular counter-clockwise rotation and mandibular advancement with TMJ Concepts total joint prostheses: part I--skeletal and dental stability.

The purpose of this study was to evaluate skeletal and dental stability in patients who had temporomandibular joint (TMJ) reconstruction and mandibular counterclockwise advancement using TMJ Concepts total joint prostheses (TMJ Concepts Inc. Ventura, CA) with maxillary osteotomies being performed at the same operation. All patients were operated at Baylor University Medical Center, Dallas TX, USA, by one surgeon (Wolford). Forty-seven females were studied; the average post-surgical follow-up was 40.6 months. Lateral cephalograms were analyzed to estimate surgical and post-surgical changes. During surgery, the occlusal plane angle decreased 14.9+/-8.0 degrees. The maxilla moved forward and upward. The posterior nasal spine moved downward and forward. The mandible advanced 7.9+/-3.5 mm at the lower incisor tips, 12.4+/-5.4 mm at Point B, 17.3+/-7.0 mm at menton, 18.4+/-8.5 mm at pogonion, and 11.0+/-5.3 mm at gonion. Vertically, the lower incisors moved upward -2.9+/-4.0 mm. At the longest follow-up post surgery, the maxilla showed minor horizontal changes while all mandibular measurements remained stable. TMJ reconstruction and mandibular advancement with TMJ Concepts total joint prosthesis in conjunction with maxillary osteotomies for counter-clockwise rotation of the maxillo-mandibular complex was a stable procedure for these patients at the longest follow-up.

Maxillo-mandibular counter-clockwise rotation and mandibular advancement with TMJ Concepts total joint prostheses: part III--pain and dysfunction outcomes.

47 end-stage TMJ patients with high occlusal plane angulation, treated with TMJ custom-fitted total joint prostheses and simultaneous maxillo-mandibular counter-clockwise rotation were evaluated for pain and dysfunction presurgery (T1) and at the longest follow-up (T2). Patients subjectively rated their facial pain/headache, TMJ pain, jaw function, diet and disability. Objective functional changes were determined by measuring maximum interincisal opening (MIO) and laterotrusive movements. Patients were divided according to the number of previous failed TMJ surgeries: Group 1 (0-1), Group 2 (2 or more). Significant subjective pain and dysfunction improvements (37-52%) were observed (

The TSH response to domperidone reflects the biological activity of prolactin in macroprolactinaemia and hyperprolactinaemia.

OBJECTIVE: To test the hypothesis that patients with hyperprolactinaemia due to biologically inactive macroprolactin will not show the characteristically increased dopaminergic inhibition of TSH release seen in patients with microprolactinomas secreting biologically active monomeric PRL. DESIGN: Comparison of the TSH and PRL responses to dopamine antagonism with domperidone (10 mg i.v.) in patients with hyperprolactinaemia due to macroprolactinaemia or microprolactinomas. PATIENTS: Twenty-two patients referred for the investigation of their hyperprolactinaemia were studied: 11 patients with macroprolactinaemia and 11 patients with hyperprolactinaemia due to microprolactinoma. MEASUREMENTS: TSH and PRL levels were measured at baseline and 30 min following domperidone in both groups. RESULTS: Patients with macroprolactinaemia showed normal TSH and PRL responses to dopamine antagonism whereas patients with microprolactinomas showed exaggerated TSH responses and reduced PRL responses. Although there was considerable overlap between the PRL responses in the two groups, there was very clear separation between the PRL/TSH response ratios (normal > 1.0) of 4.0 +/- 1.8 for the macroprolactinaemia group and 0.4 +/- 0.2 for the microprolactinoma group (P < 0.0001). CONCLUSIONS: These data support the hypothesis that elevated circulating levels of macroprolactin, as opposed to biologically active monomeric PRL, do not exert increased positive feedback on the hypothalamic dopaminergic inhibition of TSH release.

Hyperplasia of myoepithelial cells expressing calponin during atrophy of the rat parotid gland induced by duct ligation.

The number and location of myoepithelial cells in the rat parotid gland submitted to surgical ligation of its main excretory duct were studied through immunohistochemical labelling for calponin. These cells were labelled by the streptavidin-biotin method using anti-calponin primary antibody, and their number was determined during each step of glandular atrophy, i.e., at time zero (control) and 1, 7, 15, 21, 30 and 60 days after ligation. Morphological analysis showed a gradual decrease and fibrosis of the glandular lobules accompanied by disappearance of the acini and the occurrence of duct-like structures. The expression of calponin was observed in all specimens analysed, being restricted to myoepithelial cells. Labelling revealed the distribution of myoepithelial cells around the acini and intercalated ducts in the control group and around duct-like structures later during the course of atrophy. Quantitative analysis demonstrated significant increase in the number of myoepithelial cells up to day 7 post-ligation, followed by gradual increases which, however, were not statistically significant. These results suggest that myoepithelial cells proliferate intensely up to day 7 post-ligation, an event that coincides with a higher rate of disappearance of acinar cells. After this period, the elevatednumber of cells observed at the end of the previous period is maintained.

Odontogenic tumors: analysis of 127 cases.

One hundred and twenty-seven cases of histologically confirmed odontogenic tumors were retrieved from a total of 5,289 oral and maxillary lesions diagnosed at the Division of Oral Pathology, Federal University of Rio Grande do Norte, during a period of 30 years (1970-1999). The most common histological diagnosis was odontoma (50.40%), followed by ameloblastoma (30.70%). The prevalence of odontogenic tumors was greater in females and the peak incidence occurred in the second and third decades of life. The main anatomical location was the mandible, and no malignant tumors were found.

The effect of Syzygium cumini (L.) skeels on post-prandial blood glucose levels in non-diabetic rats and rats with streptozotocin-induced diabetes mellitus.

This study was undertaken to investigate whether a tea prepared from Syzygium cumini, reported to be used by diabetics in Porto Alegre, Brazil, might have an antihyperglycemic effect in experimental models. Teas prepared from leaves and seeds of S. cumini, in concentrations ranging from 2-64 g/l, were administered, as water substitute for 14-95 days, to 16 groups with 8-9 normal albino rats and to four groups with 10-12 rats with streptozotocin-induced diabetes mellitus. Post-prandial blood glucose levels were determined by the glucose oxidase method on blood samples obtained by decapitation. None of the tea concentration had any detectable antihyperglycemic effect either in normal or in diabetic rats, suggesting that this plant, prepared in a manner similar to that employed by humans, is destitute of an antihyperglycemic effect.

Activity measurements support dimensional assessment.

The Diagnostic and Statistical Manual approach to motor excess has been to treat it as a categorical variable whose presence functions as an inclusion criterion. Motor excess is thought to occur primarily during structured settings that maximize attentional demands. Activity is rarely measured as a dimensional attribute despite availability of a wide variety of suitable instruments for more than a decade (Tryon, 1985). The present study measured activity using electronic step counters in structured and unstructured school settings, commuting from home to school and back home, and at home for 2 consecutive weeks in 60 children selected from 450 children using Factor IV (hyperactivity) scores from the Conners Teacher Rating Scale to represent three levels of hyperactivity. Results indicate that (a) children rated as hyperactive are measurably more active than children rated as normally active in unstructured as well as structured situations, (b) measured activity correlates consistently and substantially with rated activity in unstructured and structured situations, and (c) a single activity factor characterizes measured activity in all situations except for class transitions during school. These results and other published findings support a quantitative (dimensional) rather than qualitative (categorical) approach to motor excess.

Hematologic disorders in trauma patients during parenteral alimentation with lipids.

Total parenteral nutrition with lipids is a well-accepted modality of metabolic support in seriously ill trauma patients. Intolerance to lipid administration is unusual when dosage limits are not exceeded, and few hematologic disturbances have been recorded with modern fat emulsions. In the course of intravenous alimentation of six adults admitted for traumatic lesions, eosinophilia with or without leukocytopenia was noticed after periods of four days to five weeks. Principal clinical events and hematologic derangements were documented in this population. Sepsis was not always present in the patients by the time of the complication, and in those that did require antibiotics and other drugs, the prescription remained unchanged along the episode. Discontinuation of the nutritional regimen with lipids was followed by normalization of the hematologic profile, suggesting that an acute or sub-acute allergic reaction was responsible. The appearance of skin rash in two occasions reinforces this hypothesis, and the possibility of hemophagocytosis merits consideration in two of the cases who displayed reversible acute leukocytopenia. It is concluded that blood cell aberrations are possible during intravenous feeding with lipids in trauma subjects, but tend to respond to suppression of the lipid-containing nutritional prescription.

Habitat, density and group size of primates in a Brazilian tropical forest.

Habitats, population densities and group sizes of 5 primate species (Callithrix flaviceps, Callicebus personatus personatus, Cebus apella nigritus, Alouatta fusca clamitans, and Brachyteles arachnoides) were estimated, using the method of repeated transect sampling, in an area of montane pluvial forest in eastern Brazil (Atlantic forest). A. fusca and C. apella had the highest densities in terms of groups and individuals per square kilometer, respectively, while B. arachnoides was least abundant. The highest primate densities were observed in areas of secondary vegetation. Both group sizes and population densities for the 5 species were generally lower at the Reserva Biologica Augusto Ruschi than those reported in other areas of Atlantic forest. Hunting pressure and the different carrying capacity of the habitat are suggested as possible causes for the low number of sightings registered for these species.

[Multiple neurofibromatosis--report of a case]. / Neurofibromatose múltipla--relato de um caso.

A case of multiple neurofibromatosis with oral manifestation in a 37-year-old woman is reported. The general examination revealed the presence of "café-au-lait" spots and cutaneous nodular lesions scattered in different sites of the body. A brief review of the literature concerning the polymorphus characteristics of the disease is presented.