Is magnetic resonance imaging or cone beam computed tomography alone adequate for the radiological diagnosis of symptomatic temporomandibular joint osteoarthritis? A retrospective study.

This study was performed to compare the diagnostic accuracy of cone beam computed tomography (CBCT) alone and magnetic resonance imaging (MRI) alone in patients with clinical symptoms of temporomandibular joint osteoarthritis (TMJ-OA). Fifty-two patients (83 joints) with clinical signs of TMJ-OA were included in the study. Two examiners evaluated CBCT and MRI images. McNemar and kappa tests and Spearman's correlation analysis were applied. Radiological findings of TMJ-OA were detected in all 83 joints on CBCT or MRI . Seventy-four joints (89.2%) were positive for degenerative osseous changes on CBCT. MRI findings were positive in 50 joints (60.2%). Osseous changes were found in 22 joints, joint effusion in 30 joints, and disc perforation/degeneration in 11 joints on MRI. CBCT was more sensitive than MRI in detecting condylar erosion (P = 0.001), osteophyte (P = 0.001), and flattening (P = 0.002) and flattening of the articular eminence (P = 0.013) . Poor agreement (κ = -0.21) and weak correlations were found between CBCT and MRI. The study findings suggest that CBCT is superior to MRI in evaluating osseous changes of TMJ-OA, and that CBCT is more sensitive than MRI in detecting condylar erosion, condylar osteophyte, and flattening of the condyle and articular eminence.

Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations.

The aim of this study was to determine the prevalence of and associations between clinical signs and symptoms and cone beam computed tomography (CBCT) findings of temporomandibular joint osteoarthritis (TMJ-OA). Seventy-six patients (total 117 TMJ) with osteoarthritis were included in this study. Clinical signs and symptoms and CBCT findings were reviewed retrospectively. A considerable decrease in mandibular motions and mastication efficiency, and considerable increase in joint sounds and general pain complaints were observed. The most frequent condylar bony changes were erosion (110 joints, 94.0%), followed by flattening (108 joints, 92.3%), osteophytes (93 joints, 79.5%), hypoplasia (22 joints, 18.8%), sclerosis (14 joints, 12.0%), and subchondral cyst (four joints, 3.4%). Flattening of the articular eminence and pneumatization were each observed in five joints. Forty-one patients had bilateral degeneration and 35 had unilateral degeneration. Hypermobility was detected in 47 degenerative joints. Masticatory efficiency was negatively correlated with both condylar flattening and sclerosis, and general pain complaints was positively correlated with condylar flattening. Condylar erosion, flattening, osteophytes, pain, joint sounds, reduced jaw movements, and worsened mastication were common findings in TMJ-OA in the present study. Poor correlations were found between osseous changes and clinical signs and symptoms of TMJ-OA. CBCT is a powerful diagnostic tool for the diagnosis of TMJ-OA.

Slight conductive hearing loss in children with narrowed maxilla and deep palatal vault.

UNLABELLED: PROBLEM/OBJECTIVES: Maxillary constriction and high palatal arch are associated with increased risk of chronic eustachian tube dysfunction and conductive hearing loss (CHL) due to chronic effusion. However, this relationship has not been clearly demonstrated. This study assessed CHL in school children with a narrowed maxilla and deep palatal vault. METHODOLOGY: Thirty-two children with maxillary constriction were randomly selected for the study group and 28 children with normal transverse maxillary development were selected for the control group. Pure-tone audiograms were obtained for all children, and hearing levels and air-bone gaps were measured. RESULTS: Air-bone gap measurements in the control group ranged from 5.50 to 14.50 decibels (dB), and in the study group they were between 5.00 and 24.00 dB. In the study group, 14 (43.8%) children had slight CHL, and the remaining 18 (56.2%) children had normal hearing levels. In the control group, all of the children had normal hearing levels. Hearing levels and air-bone gaps were greater in the study group than the control group. CONCLUSION: This study showed that children with a narrowed maxilla and deep palatal vault may have slight CHL. Therefore, the onset of CHL should be followed with hearing screening programs.

Bioremoval of Reactive Blue 220 by Gonium sp. biomass.

Gonium sp. was tested for the bioremoval of Reactive Blue 220 (RB220) dye at different conditions such as pH values, initial dye concentrations and biomass concentrations to evaluate the possibility of using this microalga in treating wastewaters. According to the data obtained from the experiments, microalgae removed RB220 with the highest yield (54.2%) at pH 8, and could treat the applied dye with the highest removal percentage as 84.2% at the lowest dye concentration (26.2 mg/L RB220). Increasing Gonium sp. biomass concentration from 0.21 to 0.53 g/L stimulated RB220 removal rate from 87.7% to 96.8%. The present study clearly indicated that Gonium sp. biomass could be used as a bioremediation biosorbent in treating RB220 dye in the related wastewaters.

A novel approach to malignant-benign classification of pulmonary nodules by using ensemble learning classifiers.

Computer-aided detection systems can help radiologists to detect pulmonary nodules at an early stage. In this paper, a novel Computer-Aided Diagnosis system (CAD) is proposed for the classification of pulmonary nodules as malignant and benign. The proposed CAD system using ensemble learning classifiers, provides an important support to radiologists at the diagnosis process of the disease, achieves high classification performance. The proposed approach with bagging classifier results in 94.7 %, 90.0 % and 77.8 % classification sensitivities for benign, malignant and undetermined classes (89.5 % accuracy), respectively.

A new method for pulmonary nodule detection using decision trees.

A computer-aided detection (CAD) can help radiologists in diagnosing of lung diseases at an early level. In this study, a new CAD system for pulmonary nodule detection from CT imagery is presented by using morphological features and patient information properties. Decision trees are utilized for classification and overall detection performance is evaluated. Results are compared to similar techniques in the literature by using standard measures. Proposed CAD system with random forest classifier result in 90.5 % sensitivity and 87.6 % specificity of detection performance.

Blockade of endothelin receptors with bosentan limits ischaemia/reperfusion-induced injury in rat ovaries.

OBJECTIVE: To investigate the role of endothelin receptors in ovarian ischaemia/reperfusion (I/R) injury in rats using the endothelin receptor antagonist bosentan. STUDY DESIGN: Group 1: sham operation; Group 2: sham operation and bosentan 60 mg/kg; Group 3: bilateral ovarian ischaemia; Group 4: 3-h period of ischaemia followed by 3h of reperfusion; Groups 5 and 6: bosentan 30 and 60 mg/kg, respectively, with bilateral ovarian ischaemia applied 30 min later; the bilateral ovaries were removed after 3h of ischaemia; Groups 7 and 8: 3h of bilateral ovarian ischaemia was applied, with bosentan 30 and 60 mg/kg, respectively, administered 2.5h after the induction of ischaemia; following the 3-h period of ischaemia, 3h of reperfusion was applied, after which the ovaries were removed. RESULTS: Ischaemia and I/R decreased superoxide dismutase (SOD) activity and the level of glutathione (GSH) in ovarian tissue, but increased the level of malondialdehyde (MDA) significantly compared with the sham operation group. Bosentan 30 and 60 mg/kg before ischaemia and I/R decreased the MDA level and increased SOD activity and the GSH level in the experimental groups. The serum levels of the inflammatory cytokines interleukin (IL)-1ß, IL-6 and tumour necrosis factor-α were also measured in the I/R injury model in rat ovaries. The levels of these cytokines were significantly higher in the ischaemia and I/R groups compared with the sham operation and sham operation plus bosentan groups. The histopathological findings also demonstrated the protective role of bosentan against I/R-induced injury in rat ovaries. CONCLUSION: Administration of bosentan protects the ovaries against oxidative damage and I/R-induced injury.

Evaluation of radon concentration in well and tap waters in Bursa, Turkey.

(222)Rn measurements in water samples collected from 27 wells and 19 taps that were supplied from the investigated wells were conducted using the AlphaGUARD PQ 2000PRO radon gas analyser at sites across several geologic formations within the city of Bursa, Turkey. The measured radon concentrations ranged from 1.46 to 53.64 Bq l(-1) for well water and from 0.91 to 12.58 Bq l(-1) for tap water. Of the 27 sites sampled, only 7 had radon levels above the safe limit of 11.1 Bq l(-1) recommended by the USEPA. In general, all determined concentrations were well below the 100 Bq l(-1) revised reference level proposed by the European Union. These values of radon concentrations in water samples are compared with those reported from other countries. Doses resulting from the consumption of these waters were calculated. The minimum and the maximum annual mean effective doses due to (222)Rn intake through water consumption were 0.02 µSv a(-1) and 1.11 µSv a(-1), respectively.

Plerixafor is effective and safe for stem cell mobilization in heavily pretreated germ cell tumor patients.

Up to 10% of germ cell tumor patients require salvage high-dose chemotherapy with stem cell support, achieving cure rates in the range of 10-60%. Stem cell mobilization may be difficult in these patients because of multiple lines of treatment known to seriously hamper stem cell recovery. Plerixafor significantly enhances the success of the CD34+ cell harvest, even in cases where prior mobilization attempts have failed. Six germ cell tumor patients provided informed consent and were included in the compassionate use program. All patients were heavily pretreated, with a median of 3.5 prior lines of therapy. All failed prior mobilization with G-CSF in combination with chemotherapy. Five patients yielded a median of 2.6 × 10(6) CD34+ cells per kg body weight in a median of 4 apheresis days when plerixafor was used. Three patients underwent subsequent high-dose chemotherapy with autologous stem cell support. Median time to leukocyte engraftment was 11 days. Median time to platelet engraftment was 12.5 days, both of which are comparable to previous historical data. Accordingly, plerixafor seems to be safe and effective in germ cell tumor patients who have failed prior mobilization therapy. Larger prospective studies are warranted to further assess its use in germ cell cancer.

[The concept of chronic disease in the palliative treatment of oncologic patients: current Swiss data and insights in the context of breast and ovarian cancer]. / Das Konzept der chronischen Erkrankung in der Palliativbehandlung onkologischer Patientinnen: Schweizer Daten und Fakten zu Mamma- und Ovarialkarzinom.

In the last years, incurable oncologic diseases have become increasingly viewed as chronic disease processes. In order to evaluate the treatment course of a chronic disease and to demonstrate whether the concept of a palliative oncologic situation as a chronic disease can be translated into practice, it is essential to give an overview of the entire course of the disease (i.e. from the first diagnosis of recurrence/metastases to death). There are only few reports regarding this approach in the international literature. We present Swiss long-term data (1990-2007) for breast and ovarian cancer and demonstrate drawbacks and opportunities of an exact retrospective data collection and analysis. When an incurable disease which requires periodic therapy cycles to control progressive course and symptoms is increasingly treated with a strategy that permits stabilization and uses regimens that have limited cumulative toxicity with particular consideration of quality of life, then the requirements of a chronic disease management have been fulfilled.

Ghrelin and obestatin levels in end-stage renal disease.

Malnutrition is fairly common in end-stage renal disease (ESRD) patients, persistent lack of appetite being a major symptom. Ghrelin and obestatin are two hormones that are involved in appetite and energy homeostasis. The present study examined ghrelin and obestatin levels in 24 ESRD patients undergoing haemodialysis and 24 age-matched healthy controls. Serum and saliva ghrelin and obestatin levels in the ESRD patients were significantly higher compared with controls, while saliva ghrelin and obestatin levels in all study participants were significantly higher than serum levels. Saliva ghrelin correlated with serum ghrelin and saliva obestatin correlated with serum obestatin in all study participants, although there was no correlation between ghrelin and obestatin levels. In conclusion, the results suggest that the kidneys may have a role in the metabolism and/or clearance of obestatin, as they do for ghrelin. Further studies are needed to determine if elevated levels of these hormones in ESRD patients contribute to the malnutrition that is common in these patients.

Malignity-like peritoneal tuberculosis associated with abdominal mass, ascites and elevated serum Ca125 level.

Peritoneal tuberculosis (TB) is similar to ovarian cancers with respect to clinical, radiological laboratory findings. In this report, we present 10 TB cases with malignity pre-diagnosis based on the presence of ascites, pelvic mass, abdominal lymph nodes and elevated Ca125. The mean age of the cases was 29 +/- 14.4 years (18-63). Eight cases were associated with ascites, and the mean adenosine deaminase (ADA) value in ascitic fluid was 130.37 +/- 92.2. All cases had elevated levels of serum Ca125. In 6 cases, we identified lung pathologies based on chest radiography. Diagnoses were made based on diagnostic laparotomy in four cases, laparoscopy in two cases, percutaneous needle biopsy in two cases, and clinical evaluation in two cases. Anti-TB treatments lasted 12 months. Serum Ca125 levels normalised in the 3rd month of treatment. In the differential diagnosis of ascites and high serum Ca125 levels, tuberculosis should be considered in patients from developing countries.

The combination of low-dose levobupivacaine and fentanyl for spinal anaesthesia in ambulatory inguinal herniorrhaphy.

This study investigated whether the addition of 25 microg intrathecal fentanyl to levobupivacaine spinal anaesthesia for outpatient inguinal herniorrhaphy allows a sub-anaesthetic levobupivacaine dose to be used. Forty patients were assigned to receive 5 mg levobupivacaine 0.5% mixed with 25 microg fentanyl (group LF) or 7.5 mg levobupivacaine 0.5% (group L). The highest sensory block levels achieved were T7 (range T5 - T9) and T6 (range T4 - T9) in groups LF and L, respectively. The times to two-segment regression, S2 regression, ambulation, urination and discharge were all significantly shorter in group LF than group L. These results indicate that, for outpatient inguinal herniorrhaphy, intrathecal fentanyl combined with low-dose levobupivacaine provides good quality spinal anaesthesia and minimizes the need for intra-operative analgesia. This protocol is well suited for the outpatient setting because it features rapid recovery of full motor power, sensory function and bladder function.

Evaluation of the inclination in posterior dentoalveolar structures after rapid maxillary expansion: a new method.

OBJECTIVES: In order to compare the skeletal and dental effects of rapid maxillary expansion, orthodontists need an assessment of buccal dentoalveolar inclination. The aim of the present paper is to introduce a new technique for the evaluation of buccal inclinations in dentoalveolar structures. METHODS: Using barium sulphate solution with a paintbrush, a thin line was drawn on and between the first molars of the maxillary stone casts. Then, radiographic images of the stone casts were obtained. Buccal tipping of molar crowns and alveolar processes were evaluated on these images by means of a computerized imaging software program. CONCLUSIONS: This new evaluation technique is inexpensive, simple and reliable for the assessment of dentoalveolar inclination. In addition, the changes in dentoalveolar structures may also be visualized by superimposing the pre- and post-treatment images.

[One molecule, two faces. Epithelial loss of cell adhesion molecule CEACAM1 activates angiogenesis in bladder and prostate cancer]. / Ein Molekül, zwei Gesichter. Epithelialer Verlust des Zelladhäsionsmoleküls CEACAM1 aktiviert Angiogenese beim Harnblasen- und Prostatakarzinom.

BACKGROUND: Angiogenesis is a prerequisite for tumor growth and metastasis in which CEACAM1 plays an essential role. PATIENTS AND METHODS: The role of CEACAM1 in vascularization and invasion of prostate and bladder cancer was studied. RESULTS: Our analyses demonstrate an epithelial downregulation of CEACAM1 in superficial bladder tumors and in PIN of the prostate. Concurrently, CEACAM1 is upregulated in endothelial cells of tumor blood vessels. CEACAM1 knockdown in tumor cell lines of the prostate and urinary bladder via siRNA results in an increase of tumor vascularization while CEACAM1 overexpression in these cells suppresses it. CONCLUSIONS: CEACAM1-induced signaling mechanisms play a role in induction of angiogenesis in superficial tumors of the prostate and bladder. Strategies to either conserve the epithelial CEACAM1 or to target endothelial CEACAM1 might be useful for an antiangiogenic therapy of bladder and prostate cancer.

Extended pedigree with multiple cases of XX sex reversal in the absence of SRY and of a mutation at the SOX9 locus.

It is well established that testicular differentiation of the human embryonic gonad depends on the action of the Y-chromosomal gene SRY. However, exceptional cases such as SRY-negative cases of 46,XX testicular disorder of sexual development (DSD), and of 46,XX ovotesticular DSD document that testicular tissue can develop in the absence of the SRY gene. These SRY-negative XX sex reversal cases are very rare and usually sporadic, but a few familial cases have been reported. We present a large, consanguineous family with nine affected individuals with phenotypes ranging from 46,XX testicular DSD to 46,XX ovotesticular DSD, with predominance of male characteristics. Absence of SRY in peripheral blood was documented by fluorescence in situ hybridization (FISH) and PCR analysis in all nine affected individuals, and by FISH analysis on gonadal sections with testicular tissue in four affected individuals. By quantitative PCR, a duplication of the SOX9 gene was excluded. In addition, as linkage analysis showed that the nine affected members of the family do not share a common SOX9 haplotype, any mutation at the SOX9 locus could be ruled out. Together, these findings implicate a mutation at a sex-determining locus other than SRY and SOX9 as the cause for the XX sex reversal trait in this family.

Adsorption of human salivary mucin MG1 onto glow-discharge plasma treated acrylic resin surfaces.

It has been suggested that altering the surface properties of acrylic resin material may change the nature of the adsorbed pellicle affecting denture retention and microbial adherence. This study aimed at evaluating the adsorption of salivary high molecular-weight mucins, a major component of denture pellicle, onto modified acrylic resin surfaces. (Poly) methylmethacrylate specimens were treated by glow discharge plasma technique, using hydrophilic 2-Hydroxyethylmethacrylate monomer or oxygen (O(2)) gas and hydrophobic Hexamethyldisiloxane monomer, at different discharge powers. Acrylic samples were incubated with high-molecular weight mucin, MG1 purified from saliva, the adsorbed fractions were transferred to nitrocellulose membranes by slot-blot technique, stained by periodic acid-Schiff and colour intensities were analysed by a colour densitometer. Higher amounts of mucins were adsorbed on all the surfaces modified by glow-discharge plasma treatment. Within the limitations of this study, it was concluded that glow-discharge plasma altered the surfaces of acrylic resin denture base materials and significantly increased the adsorption of high molecular-weight mucins at varying levels depending on plasma parameters.

Neural driven angiogenesis by overexpression of nerve growth factor.

Mechanisms regulating angiogenesis are crucial in adjusting tissue perfusion on metabolic demands. We demonstrate that overexpression of nerve growth factor (NGF) in brown adipose tissue (BAT) of NGF-transgenic mice elevates both mRNA and protein levels of vascular endothelial growth factor (VEGF) and VEGF-receptors. Increased vascular permeability, leukocyte-endothelial interactions (LEI), and tissue perfusion were measured using intravital microscopy. NGF-stimulation of adipocytes and endothelial cells elevates mRNA expression of VEGF and its receptors, an effect blocked by NGF neutralizing antibodies. These data suggest an activation of angiogenesis as a result of both: stimulation of adipozytes and direct mitogenic effects on endothelial cells. The increased nerve density associated with vessels strengthened our hypothesis that tissue perfusion is regulated by neural control of vessels and that the interaction between the NGF and VEGF systems is the critical driver for the activated angiogenic process. The interaction of VEGF- and NGF-systems gives new insights into neural control of organ vascularization and perfusion.

Lipid peroxidation levels in patients with acute brucellosis.

The purpose of this study was to investigate levels of lipid peroxidation, indicated by plasma malondialdehyde (MDA), with consideration of clinical status and treatment outcomes in patients with acute brucellosis. Plasma MDA levels were measured in patients with acute brucellosis and healthy subjects. Significantly higher MDA levels were detected in plasma of patients with acute brucellosis compared to controls (P<0.01). Plasma levels of MDA were significantly decreased after the brucellosis treatment (P<0.01). The results of the present study indicate for the first time that a considerable level of lipid peroxidation is involved in acute brucellosis cases and this may be of importance with respect to the understanding of disease pathogenesis and may serve as a target for treatment regime.