Comparison of Oral Health and Salivary Biomarkers in Children with Juvenile Idiopathic Arthritis and Healthy Individuals.

AIM: This study examines the effects of juvenile idiopathic arthritis (JIA) on the oral health and detectability of inflammatory biomarkers IL-17, tumour necrosis factor-alpha (TNF-α) and total antioxidant status (TAS) in the saliva of children with JIA. PATIENTS AND METHODS: This study included 117 participants (39 patients with JIA and 78 systemically healthy subjects aged 8-12 years). Demographic data, responses to an oral health-related questionnaire, saliva samples, periodontal parameters [plaque index (PI), gingival index (GI) and bleeding on probing (BOP)] and dental recordings [facial profile (FP) and dental occlusion relationship (DOR)] were obtained. Enzyme-linked immunosorbent assays were used to determine the levels of salivary IL-17, TNF-α and TAS. RESULTS: The Caries Assessment Spectrum and Treatment (CAST) index, FP and DOR distributions did not change between groups (P > 0.05). JIA patients had more temporomandibular joint (TMJ) discomfort than gingivitis patients and healthy subjects (P < 0.05). JIA patients had greater salivary IL-17 levels than healthy subjects (P < 0.05). The healthy group's TAS was higher than that of the JIA and gingivitis groups (P < 0.05). Saliva TNF-α levels were similar between groups (P > 0.05). PI, GI, BOP and TNF-α were positively associated with salivary IL-17 (P < 0.001). CONCLUSION: Elevated salivary IL-17 and TAS levels could be used as biological markers for discriminating the clinical health status of children with JIA and gingivitis.

Evaluation and therapy in four patients with Takayasu's arteritis.

Takayasu's arteritis (TA) is a large-vessel vasculitis primarily affecting the aorta and its branches. It ranks third among other types of childhood vasculitis, while it is the most common large vessel vasculitis observed in childhood. The diagnosis of TA should be made on the basis of clinical criteria and supported with laboratory findings, while confirming it with the imaging methods. Angioplasty, stent and bypass grafts may be necessary in the case of an irreversible arterial stenosis. Small-vessel involvement in TA and acute phase reactants should be taken into account for the diagnosis of an attack. In this report, treatment choices for four patients with the diagnosis of pediatric TA, their clinical and laboratory findings and their responses to treatment will be discussed.

Cardiac tamponade as a first manifestation of possible systemic lupus erythematosus in a 3-year-old female child.

Cardiac manifestations of pediatric systemic lupus erythematosus (SLE) usually occur as an initial manifestation of the disease or within six months after the diagnosis of SLE. Pericarditis is the most frequent cardiac manifestation of SLE, but pericardial effusion causing tamponade, which has a very serious prognosis, rarely occurs, and it is even less frequent for the pericardial tamponade to be the presenting feature of SLE. In the present case which is the youngest case in the literature we report a 3 year old girl who presented to the emergency room with solely pericardial effusion causing tamponade, bilateral pleural effusion and diagnosed "possible SLE" based on American College of Rheumatology criteria.

Association between Toll-like receptors 4 and 2 gene polymorphisms with chronic allograft nephropathy in Turkish children.

Toll-like receptor (TLR) gene polymorphism is known to impair intracellular signaling pathways following adaptive immune responses. Our aim was to investigate the distribution of TLR4 and TLR2 gene polymorphisms among pediatric renal transplantation patients in relation to chronic allograft nephropathy (CAN). In addition to 115 healthy controls, we included 69 renal recipients, 19 of whom were identified as CAN by biopsy scored according to the Banff criteria. Polymorphisms at TLR4 Asp299Gly and/or Thr399Ile were present in 11.6% of renal transplant recipients. None of these subjects was identified in cosegregation with the Thr399Ile allele, whereas three had an isolated Asp299Gly and five had an isolated Thr399Ile. Neither renal recipients nor healthy controls were homozygous for both Asp299Gly and Thr399Ile polymorphisms. However, TLR4 Thr399Ile polymorphism and Ile allele was greater among CAN (-) versus CAN (+) recipients (P > .05). The frequency of TLR2 mutant type Gln allele was significantly higher in recipients than among healthy controls (P < .0001). However, the Gln allele frequency was similar between CAN (+) and CAN (-) patients. The results of present study may be speculated to show TLR4 and TLR2 gene polymorphisms as protective factors from CAN development due to impaired immune responses.

Otogenic brain abscess: review of 41 cases.

Forty-one patients in whom otogenic brain abscess was diagnosed and has been treated since 1968 are presented. Sixty-five percent of the patients were between 5 and 15 years of age. All patients had chronic otitis media, and 95% had cholesteatoma. Abscess was located in the temporal lobe in 54%, in the cerebellum in 44%, and in both locations in 2% of the cases. Most patients had radical mastoidectomy and evacuation of the abscess through the mastoidectomy (61%). In addition to mastoidectomy, burr hole drainage was used in 20% and craniotomy in 15%. The most common micro-organism involved was Proteus. Overall mortality in this series is 29%, but after 1976, when CT became available for the diagnosis and follow-up, the mortality rate was reduced to 10%.

Prognostic value of p53, proliferating cell nuclear antigen, and Ki-67 expression in undifferentiated nasopharyngeal carcinomas.

In this study the prognostic importance of p53, proliferating cell nuclear antigen (PCNA), and Ki-67 expression was analyzed along with the clinical parameters in 35 consecutive patients with undifferentiated nasopharyngeal carcinomas. Immunohistochemistry was used to detect p53, PCNA, and Ki-67 staining. Among the clinical findings, stage IV disease (P = 0.01), cranial nerve paralysis (P = 0.02), and lymph node metastasis (P = 0.06) were associated with shorter survival. The p53 positivity correlated with the presence of lymph nodes, but it was not a significant factor to predict the outcome. PCNA expression was not found to be a prognostic indicator. On the other hand, the proliferative value of Ki-67 staining was suggestive of prognosis. A proliferation index of Ki-67 less than 10% indicated longer survival (P = 0.03). There was no correlation between Ki-67 staining and PCNA index. As a result, the prognostic value of Ki-67 may alert the physician to more aggressive and adjuvant treatment modalities.

Aneurysmal bone cyst of the zygoma. A case report and review of the literature.

Aneurysmal bone cyst is a cystic vascular osseous tumor. It is rare in the craniofacial area; it is even rarer in the zygoma. A case of aneurysmal bone cyst of the zygoma was presented. Its pathogenesis, clinical and radiological features and treatment options were discussed under the view of the literature.

Otological findings in idiopathic hyperphosphatasia.

A 17-year-old male patient was admitted because of progressive hearing loss since the age of six. His former blood and radiology investigation had revealed idiopathic hyperphosphatasia. On ENT examination bilateral thickened tympanic membranes with severe mixed-type hearing loss was diagnosed. Computerized tomography (CT) demonstrated expansion of the calvarial bones, including the temporal bones, except for the otic capsule. Middle-ear exploration revealed thickened middle-ear mucosa and a stone hard, immobile bony mass instead of the normal ossicular chain at the posterior superior part of the mesotympanum. No ossicular reconstruction could be attempted and the patient was rehabilitated with a hearing aid.

Myositis ossificans in the neck.

Myositis ossificans is a non-neoplastic heterotopic bone formation within muscle or soft tissues. The most commonly involved muscles are the muscles of the upper arm and thigh. Occurrence in the head and neck is rarely encountered clinically. A 53-year-old Turkish man (farmer) was operated on for traumatic myositis ossificans circumscripta in his neck. During the operation the mass was found to originate from the scalenus medius muscle and was readily and completely dissected from surrounding tissues. The histologic examination of the specimen revealed focal cartilage and mature bone tissue, which was compatible with the late stage of myositis ossificans. In 5 years of follow-up, the patient has remained asymptomatic and no signs of recurrence have been noted.

Laryngeal pleomorphic rhabdomyosarcoma.

A case of an extremely unusual tumor of the larynx, pleomorphic rhabdomyosarcoma, is presented with a review of literature. This is the fifth case of this malignancy described in the larynx in the English language literature. A histopathological diagnosis was made with immunohistochemistry and electron microscopy. In contrast to other reported cases, the tumor in the present case had a very aggressive behavior. Despite radical surgery involving total laryngectomy and neck dissection followed by radiation therapy, the patient died of disease 8 months following treatment.

Malignant fibrous histiocytoma of the trachea. Case report.

Neoplasms of the trachea are rare. The fifth case of malignant fibrous histiocytoma that nearly obliterated the lumen is reported. It is one of the most frequent soft tissue sarcomas particularly in the extremities. It is very rare in the trachea. Treatment is mainly based on local resection. Postoperative radiotherapy seems of little value.

Epidermoid carcinoma-cell culture supernatant's inhibition of monocyte chemotaxis: evidence for a tumour-mediated effect.

Epidermoid carcinoma-cell culture supernatants obtained from three laryngeal-epidermoid carcinoma patients were tested in the monocyte suspensions of 13 stage I and stage II (TNM) head and neck epidermoid-carcinoma patients and seven healthy controls for its chemotactic inhibitor activity in vitro with a modified Boyden chamber method. Using 2% casein as the chemoattractant, mean values of monocyte chemotaxis and random migration were found to be decreased in the patient group compared to the controls in a simultaneous assay recorded by the "leading front" method. Simultaneous experiments performed with the supernatant revealed a nearly double-fold increase in random migration and depressed chemotaxis in both groups. The supernatant caused a further depression in the chemotaxis of the patients' already-disabled monocytes, which is thought to be representative for advanced stage tumours. The depression of monocyte chemotaxis, especially in the control group, implies the presence of tumour-derived chemotactic inhibitor(s) for monocytes in the supernatant.

Blindness after intranasal ethmoidectomy.

Orbital haemorrhage is an unusual and frustrating complication of ethmoid surgery. A case of reversible blindness which was due to intra-operative orbital haemorrhage occurring after intranasal ethmoidectomy is presented. Prevention and management of this kind of blindness can be reversed, if treated aggressively.

Defective monocyte chemotaxis in patients with epidermoid tumors of the head and neck.

Monocyte chemotactic activity was assayed by a modified Boyden-Chamber method using the chemoattractant casein and was found to be impaired in 13 patients with epidermoid tumors of the head and neck. Using 7 healthy subjects as controls, the depression in both monocyte chemotactic activity and monocyte random migration in the patients with tumors was found to be statistically significant by the "leading front" technique (P < 0.05).

Ameloblastic fibrosarcoma.

A case of an ameloblastic fibrosarcoma in the mandible is described. The primary tumor was seen in a 5-year-old child. In spite of repeated surgical interventions, the tumor recurred three times within a one and a half year period, but not metastases have been observed. The difficulties in arriving at a correct diagnosis for this rare tumor involving the mandible are discussed. The treatment of choice seems to be radical surgery.

[Auricular leiomyoma]. / Léiomyome auriculaire.

An auricular leiomyoma is reported. This neoplasm is extremely rare in the head and neck region. The clinical and histopathological features are discussed.

Biotinidase deficiency: a rare cause of laryngeal stridor.

A case of a child with a biotinidase deficiency who had a laryngeal stridor as a leading symptom is presented. This rare disease is distressing for diagnosis but easily treatable, if recognized. This condition, unless suspect clinically, could easily be overlooked and unnecessary tracheotomy could be done.

Tuberculosis of the parotid salivary gland.

An interesting and rare case of tuberculosis involving a parotid gland is discussed. Although pulmonary tuberculosis is not uncommon in Turkey, primary parotid gland involvement is rare. The patient was treated by parotidectomy and antituberculous chemotherapy.

Primary gingival leiomyosarcoma.

A case of primary gingival leiomyosarcoma in a 64-year-old woman is presented. The treatment modalities are discussed and the previous literature is reviewed.